Key result
Unstable angina is linked to ~13-point lower 3-month SAQ-7 scores compared to NSTEMI.
Why the study?
The study was conducted to describe the magnitude and predictors of symptom burden and quality of life 3 months after hospital admission for acute chest pain.
Does discharge diagnosis and revascularization status predict symptom burden and quality of life in patients hospitalized with acute chest pain?
Observational (n=774)
No
Does discharge diagnosis and revascularization status predict symptom burden and quality of life in patients hospitalized with acute chest pain?
Effect estimate: median 75 vs 88
Absolute Event Rate: 75% vs 88%
p-value: p=<0.001
Symptom burden remains highly prevalent 3 months after hospitalization for acute chest pain, especially among patients with UAP and NCCP, highlighting the beneficial role of revascularization and the need for improved follow-up.
UAP patients may need closer symptom monitoring than NSTEMI; leaves open whether targeted interventions improve outcomes in this observational cohort.
OBJECTIVE: To describe the magnitude and predictors of symptom burden (SB) and quality of life (QoL) 3 months after hospital admission for acute chest pain. DESIGN: Prospective observational study. SETTING: Single centre, outpatient follow-up. PARTICIPANTS: 1506 patients. OUTCOMES: Scores reported for general health (RAND-12), angina-related health (Seattle Angina Questionnaire 7 (SAQ-7)) and dyspnoea (Rose Dyspnea Scale) 3 months after hospital admission for chest pain. METHODS: A total of 1506 patients received questionnaires assessing general health (RAND-12), angina-related health (SAQ-7) and dyspnoea (Rose Dyspnea Scale) 3 months after discharge. Univariable and multivariable regression models identified predictors of SB and QoL scores. A mediator analysis identified factors mediating the effect of an unstable angina pectoris (UAP) diagnosis. RESULTS: 774 (52%) responded. Discharge diagnoses were non-ST elevation myocardial infarction (NSTEMI) (14.2%), UAP (17.1%), non-coronary cardiac disease (6.6%), non-cardiac disease (6.3%) and non-cardiac chest pain (NCCP) (55.6%). NSTEMI had the most favourable, and UAP patients the least favourable SAQ-7 scores (median SAQ7-summary; 88 vs 75, p<0.001). NCCP patients reported persisting chest pain in 50% and dyspnoea in 33% of cases. After adjusting for confounders, revascularisation predicted better QoL scores, while UAP, current smoking and hypertension predicted worse outcome. NSTEMI and UAP patients who were revascularised reported higher scores (p<0.05) in SAQ-7-QL, SAQ7-PL, SAQ7-summary (NSTEMI) and all SAQ-7 domains (UAP). Revascularisation altered the unstandardised beta value (>±10%) of an UAP diagnosis for all SAQ-7 and RAND-12 outcomes. CONCLUSIONS: Patients with NSTEMI reported the most favourable outcome 3 months after hospitalisation for chest pain. Patients with other diseases, in particular UAP patients, reported lower scores. Revascularised NSTEMI and UAP patients reported higher QoL scores compared with patients receiving conservative treatment. Revascularisation mediated all outcomes in UAP patients. TRIAL REGISTRATION NUMBER: NCT02620202.
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Saeed et al. (2022) conducted an observational in Acute chest pain (n=774). Unstable angina pectoris (UAP) diagnosis vs. Non-ST elevation myocardial infarction (NSTEMI) diagnosis was evaluated on Seattle Angina Questionnaire 7 (SAQ-7) summary score (median 75 vs 88, p=<0.001). At 3 months after hospitalization for acute chest pain, patients with unstable angina pectoris had significantly worse SAQ-7 summary scores compared to those with NSTEMI (median 75 vs 88, p<0.001).
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