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Birch S, Robinson N. Acupuncture as a post-stroke treatment option: A narrative review of clinical guideline recommendations. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 104:154297. [PMID: 35816994 DOI: 10.1016/j.phymed.2022.154297] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/05/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Acupuncture may be useful to treat the various clusters of symptoms occurring after a stroke. The use of evidence to underpin clinical practice and treatment guidelines (CPGs and TGs respectively) varies from country to country and may affect what recommendations are made by guideline developers. PURPOSE To examine the extent to which international clinical and treatment guidelines on post-stroke treatment mention the role of acupuncture and to identify what symptoms they recommend for its use. METHOD Scoping of national and international websites of CPGs and TGs r on the after care and rehabilitation of stroke patients provided by professional and government organisations was conducted. The presence/absence of recommendations and the underpinning evidence was appraised for the use of acupuncture for symptoms following stroke. RESULTS Of 84 CPGs and TGs on post stroke after-care identified from 27 countries between 2001 and 2021, 49 made statements about acupuncture. Positive recommendations on the use of acupuncture were identified for 15 symptom areas from 11 countries for: stroke rehabilitation, dysphagia, shoulder pain, motor recovery, walking, balance, spasticity, upper limb extremity impairment, post-stroke pain, central post stroke pain, cognitive disorder, depression, and sleep problems. Thirty-five CPGs (2001-2018) from 18 countries published over the same period were identified that made no mention of acupuncture and therefore no recommendations were made on its use. CONCLUSIONS Currently, evidence used by international guideline developers varies and this influences whether a positive or negative recommendation is made. Recommendations to use acupuncture should be based on the best available evidence which has been quality appraised.
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Affiliation(s)
- Stephen Birch
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Nicola Robinson
- Institute of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, UK; Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.
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Doedee F, van den Houdt S, Widdershoven J, Kupper N. Chronic stress exposure in men and women, and implications for the course of fatigue after percutaneous coronary intervention; the THORESCI study. Gen Hosp Psychiatry 2021; 72:45-52. [PMID: 34280618 DOI: 10.1016/j.genhosppsych.2021.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Fatigue is a prevalent symptom in patients with coronary heart disease (CHD). Individual differences in chronic stress may affect the experience and persistence of fatigue, and this may vary between the sexes. Therefore, we studied the effect of chronic stress on the course of fatigue over a 2-year period after percutaneous coronary intervention (PCI), and examined the moderating effects of sex. METHODS 1682 patients (78% men, age = 67.1 ± 10.6) were recruited and filled out multiple self-report questionnaires at baseline, one, 12, and 24 months post-PCI, including questions on demographics, fatigue (HCS). Multiple chronic stressors were assessed at baseline: work stress (ERI16), marital stress (MMQ-6), early life events (Life Events Questionnaire) and social stress. Latent class factor analysis (LatentGOLD) was used to construct a comprehensive chronic stress index. Linear mixed modeling examined the predictive quality of predictors and covariates. RESULTS Fatigue was found to substantially decrease over the first month post-PCI, then stabilized at a moderate level. Chronic stress impacted both the level and course of fatigue by increasing its level and delaying recovery. Overall and across time, women reported more fatigue than men. The level and course effects of chronic stress and sex were independent of demographic, health behavioral, and medical covariates. CONCLUSIONS Individual differences in chronic stress impact both the level and course of fatigue post-PCI, with women being affected most. Future research could further explain the mechanisms underlying the observed relationships. Developing and testing interventions focusing on exercise and stress-reduction could be used to alleviate fatigue.
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Affiliation(s)
- Fleur Doedee
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - Sophie van den Houdt
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - Jos Widdershoven
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands; Department of Cardiology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Nina Kupper
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands.
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Abstract
BACKGROUND Symptom clusters have not previously been explored among individuals with atrial fibrillation of any type. OBJECTIVE The purpose of this study is to determine the number of symptom clusters present among adults with chronic atrial fibrillation and to explore sociodemographic and clinical factors potentially associated with cluster membership. METHODS This was a cross-sectional secondary data analysis of 335 Australian community-dwelling adults with chronic (recurrent paroxysmal, persistent, or permanent) atrial fibrillation. We used self-reported symptoms and agglomerative hierarchical cluster analysis to determine the number and content of symptom clusters present. RESULTS There were slightly more male (52%) than female participants, with a mean (SD) age of 72 (11.25) years. Three symptom clusters were evident, including a vagal cluster (nausea and diaphoresis), a tired cluster (fatigue/lethargy, weakness, syncope/dizziness, and dyspnea/breathlessness), and a heart cluster (chest pain/discomfort and palpitations/fluttering). We compared patient characteristics among those with all the symptoms in the cluster, those with some of the symptoms in the cluster, and those with none of the symptoms in the cluster. The only statistically significant differences were in age, gender, and the use of antiarrhythmic medications for the heart cluster. Women were more likely to have the heart symptom cluster than men were. Individuals with all of the symptoms in the heart cluster were younger (69.6 vs 73.7 years; P = .029) than those with none of the symptoms in the heart cluster and were more likely to be on antiarrhythmic medications. CONCLUSION Three unique atrial fibrillation symptom clusters were identified in this study population.
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Self-reported symptoms 8 weeks after discharge: A comparison of takotsubo syndrome and myocardial infarction. Int J Cardiol 2016; 224:348-352. [DOI: 10.1016/j.ijcard.2016.09.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/12/2016] [Accepted: 09/15/2016] [Indexed: 02/07/2023]
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Wang W, Jiang Y, Lee CH. Independent predictors of physical health in community-dwelling patients with coronary heart disease in Singapore. Health Qual Life Outcomes 2016; 14:113. [PMID: 27464673 PMCID: PMC4963936 DOI: 10.1186/s12955-016-0514-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/23/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients with coronary heart disease (CHD) experienced poor physical health which was found to be associated with higher hospital readmission rates and increased mortality. The study aimed to identify the independent predictors of physical health in Singaporean patients with CHD. METHODS A consecutive sample of 129 patients with CHD was recruited from the medical heart clinic of a tertiary public hospital in Singapore. A set of questionnaires including the Short Form 12-item health survey version 2, Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Cardiac Self-Efficacy Scale were used to measure the study outcomes. The patients' socio-demographic and clinical data were also collected. RESULTS A multivariate linear regression analysis indicated that depression (B = -0.766, p < 0.05) and self-efficacy for maintaining function (B = 2.351, p < 0.05) remained significant while the other variables were adjusted and identified as the independent predictors of physical health in Singaporean patients with CHD. CONCLUSIONS This study has shed some light on the key factors influencing the physical health of Singaporean patients with CHD. The finding suggests tailored interventions that target mitigating a patient's depression and promote self-efficacy for maintaining function may be helpful in improving patients' physical health and quality of life.
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Affiliation(s)
- Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore, 117597, Singapore.
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore, 117597, Singapore
| | - Chi-Hang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Trivedi R, Gerrity M, Rumsfeld JS, Spertus JA, Sun H, McDonell M, Doak M, Lucas L, Fihn SD. Angina symptom burden associated with depression status among veterans with ischemic heart disease. Ann Behav Med 2015; 49:58-65. [PMID: 25008432 DOI: 10.1007/s12160-014-9629-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Angina and depression are common in ischemic heart disease (IHD), but their association remains understudied. PURPOSE This study was conducted in order to evaluate the association of 1 year change in depression with change in patient-reported outcomes of stable angina. METHODS Five hundred sixty-nine stable angina patients completed the Seattle Angina Questionnaire and Patient Health Questionnaire (PHQ) at baseline and 1 year. Participants were divided into four groups: not depressed, new onset of depression at 1 year, remitted at 1 year, and persistently depressed. Associations between depression and angina symptoms were evaluated using regression models. RESULTS Compared to those not depressed, newly depressed participants reported more angina (β = -11.7, p < 0.001) and physical limitations (β = -11.8, p < 0.001) and lower treatment satisfaction (β = -15.03, p < 0.001) and quality of life (β = -15.4, p < 0.001). Persistently depressed participants reported physical limitations (β = -7.4, p < 0.05), lower treatment satisfaction (β = -10.1, p < 0.001), and poorer quality of life (β = -10.03, p < 0.001). CONCLUSIONS Changes in depression scores and angina outcomes were significantly associated.
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Affiliation(s)
- Ranak Trivedi
- VA Puget Sound Health Care System, Seattle, WA, USA,
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Conducting Quality of Life Research in People With Coronary Artery Disease in Non–English-Speaking Countries. J Cardiovasc Nurs 2015; 30:74-84. [DOI: 10.1097/jcn.0000000000000116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lalanne C, Armstrong AR, Herrmann S, Le Coeur S, Carrieri P, Chassany O, Duracinsky M. Psychometric assessment of health-related quality of life and symptom experience in HIV patients treated with antiretroviral therapy. Qual Life Res 2014; 24:1407-18. [PMID: 25481725 DOI: 10.1007/s11136-014-0880-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 01/10/2023]
Abstract
PURPOSE Symptoms which are found to cluster consistently can have synergistic effects on patient outcomes and therefore may serve to predict morbidity or disentangle disease progression from comorbid conditions. Self-report HIV-specific symptom and HRQL measures were jointly analyzed in HIV-positive patients under different antiretroviral treatment regimens. METHODS The responses of N = 365 patients from four countries to the 9-item Physical Health and Symptom dimension of the PROOQL-HIV questionnaire and an HIV Symptom checklist were analyzed. Item response modeling and multidimensional scaling were used to derive HRQL scores free of any differential item functioning related to gender and target language and to summarize symptom co-expression in patients under protease inhibitor treatment(PI, N = 164, 45%) versus other medication (Non-PI). RESULTS Women reported poorer HRQL (p = 0:037), and HRQL did not differ between the target languages of French, English, and Thai. Fatigue, muscular pain, or difficulties falling asleep was the most frequently reported symptoms [35%). PI versus Non-PI patients exhibited different pattern of symptoms with lipodystrophy-related and gastrointestinal symptoms forming well-separated clusters in the PI group. A higher number of symptoms were associated with lower HRQL (p < 0:001), and patients taking PIs reported lower HRQL (p = 0:003). Patients in both groups who reported fatigue, sexual dysfunction, or several lipodystrophy-related symptoms had poorer quality of life.
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Affiliation(s)
- Christophe Lalanne
- Patient-Centered Outcomes Research, Paris Sorbonne Cité, EA, 7334 (REMES), University Paris Diderot, Paris, France,
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Muhammad I, He HG, Kowitlawakul Y, Wang W. Narrative review of health-related quality of life and its predictors among patients with coronary heart disease. Int J Nurs Pract 2014; 22:4-14. [DOI: 10.1111/ijn.12356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Imran Muhammad
- Ward B65 (General Medicine/Cardiology); Khoo Teck Phuat Hospital; Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Yanika Kowitlawakul
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
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Wu J, Han Y, Xu J, Lu Y, Cong H, Zheng J, Sun H. Chronic stable angina is associated with lower health-related quality of life: evidence from Chinese patients. PLoS One 2014; 9:e97294. [PMID: 24842793 PMCID: PMC4026133 DOI: 10.1371/journal.pone.0097294] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 04/18/2014] [Indexed: 12/20/2022] Open
Abstract
Objectives To compare health-related quality of life (HRQoL) between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. Methods A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411) and the general population recruited from 3 Physical Examination Centers (n = 549) was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ). Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. Results Compared with the general population (44.2±10 years, 49.9% females), stable angina patients (68.1±12 years, 50.4% females) had significantly lower HRQoL scores in EQ-5D utility index (0.75±0.19 vs. 0.90±0.20, p<0.05), SF-6D utility index (0.68±0.12 vs. 0.85±0.11, p<0.05), and EQ-VAS (71.2±12.3 vs. 83.9±10.9, p<0.05). The differences remained (−0.05 for EQ-5D, −9.27 for EQ-VAS and −0.13 for SF-6D) after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5±34.6). Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. Conclusions Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms. Further studies are needed to characterize the influence of geographic and cultural factors on the variations of health-related utility in stable angina patients.
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Affiliation(s)
- Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- * E-mail: (JW); (HS)
| | - Yuerong Han
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Judy Xu
- School of Public Administration, Southwest University of Finance and Economics, Chengdu, China
| | - Yang Lu
- Harbor UCLA Medical Center, Torrance, California, United States of America
| | | | | | - He Sun
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- * E-mail: (JW); (HS)
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Health-related quality of life and its predictors among outpatients with coronary heart disease in Singapore. Appl Nurs Res 2013; 27:175-80. [PMID: 25052181 DOI: 10.1016/j.apnr.2013.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 12/15/2022]
Abstract
AIMS AND BACKGROUND Coronary heart disease (CHD) is a major cause of death and disability and negatively impacts on patients' health-related quality of life (HRQoL). This study aimed to explore HRQoL and identify its predictors among outpatients with CHD in Singapore. METHODS A correlational study was conducted with a convenience sample of 106 outpatients with CHD recruited from a public hospital. HRQoL outcomes were measured using the Short Form-12 Health Survey (SF-12), Medical Outcomes Study Social Support Survey (MOS-SSS) and Hospital Anxiety and Depression Scale (HADS). RESULTS Patients reported a generally high level of HRQoL as assessed by SF-12. Those aged over 65years reported significantly higher mental health and those who were married had higher levels of education or income reported significantly higher physical health. There were significant negative correlations between physical and mental health and anxiety and depression (p<.05). Perceived social support was negatively correlated with anxiety and depression and positively correlated with mental health. Education level and depression significantly predicted physical health, while age, anxiety and depression predicted mental health. CONCLUSION Anxiety, depression, age and education are significant predictors of HRQoL in this patient population and should be assessed routinely and, where appropriate, addressed through individually-tailored interventions.
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Staniute M, Bunevicius A, Brozaitiene J, Bunevicius R. Relationship of health-related quality of life with fatigue and exercise capacity in patients with coronary artery disease. Eur J Cardiovasc Nurs 2013; 13:338-44. [PMID: 23818215 DOI: 10.1177/1474515113496942] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 06/17/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The study objective was to evaluate the relationship of health-related quality of life (HRQoL) with fatigue and exercise capacity in coronary artery disease (CAD) patients. METHODS A total of 1072 consecutive CAD patients on admission to a cardiac rehabilitation program were evaluated for HRQoL (36-item Short Form Medical Outcome Questionnaire; SF-36), body mass index, clinical characteristics (New York Heart Association (NYHA) class, angina pectoris class, coronary interventions, treatment with beta blockers, hypertension and diabetes), symptoms of depression and anxiety (Hospital Anxiety and Depression Scale), fatigue (Multidimensional Fatigue Inventory-20; MFI-20), and exercise capacity (bicycle ergometer test). RESULTS In univariate regression analyses lower scores on all SF-36 domains were associated with greater scores on all MFI-20 subscales. Exercise capacity was associated with all SF-36 domains, except for social functioning and mental health domains. In multivariate regression analyses, after adjusting for age, gender, body mass index, NYHA class, angina pectoris class, hypertension, diabetes, coronary interventions, treatment with betablockers, and symptoms of depression and anxiety, greater limitation due to physical and due to emotional problems, poor social functioning, decreased energy/vitality, worse general health perception, reduced mental component summary and lower global SF-36 score were independently associated with higher MFI-20 general fatigue score. Reduced physical functioning, greater pain, and reduced physical component summary SF-36 scores were associated with greater MFI-20 physical fatigue score. Lower SF-36 mental health score was associated, with greater MFI-20 mental fatigue score. CONCLUSION In CAD patients undergoing rehabilitation, poor HRQoL is associated with greater fatigue and decreased exercise capacity independently from mental distress and CAD severity score.
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Affiliation(s)
- Margarita Staniute
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Lithuania
| | - Adomas Bunevicius
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Lithuania
| | - Julija Brozaitiene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Lithuania
| | - Robertas Bunevicius
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Lithuania
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Nieuwenburg-van Tilborg EM, Horstman AM, Zwarts B, de Groot S. Physical strain during activities of daily living of patients with coronary artery disease. Clin Physiol Funct Imaging 2013; 34:83-9. [DOI: 10.1111/cpf.12065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 06/12/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - A. M. Horstman
- Division of Endocrinology; Department of Internal Medicine; The University of Texas Medical Branch; Galveston TX USA
| | - B. Zwarts
- Amsterdam Rehabilitation Research Center
- Reade; Amsterdam the Netherlands
| | - S. de Groot
- Amsterdam Rehabilitation Research Center
- Reade; Amsterdam the Netherlands
- Center for Human Movement Sciences; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
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Jaffery Z, Prasad A, Lee JH, White CJ. Drug-eluting coronary stents - focus on improved patient outcomes. PATIENT-RELATED OUTCOME MEASURES 2011; 2:161-74. [PMID: 22915977 PMCID: PMC3417932 DOI: 10.2147/prom.s24796] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Indexed: 01/12/2023]
Abstract
The development of stent has been a major advance in the treatment of obstructive coronary artery disease since the introduction of balloon angioplasty. Subsequently, neointimal hyperplasia within the stent leading to in-stent restenosis emerged as a major obstacle in long-term success of percutaneous coronary intervention. Recent introduction of drug-eluting stents is a major breakthrough to tackle this problem. This review article summarizes stent technology, reviews progress of drug-eluting stents and discusses quality of life, patient satisfaction, and acceptability of percutaneous coronary intervention.
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Affiliation(s)
- Zehra Jaffery
- Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA, USA
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