Page 51 - JCTR-9-4

Seetharam et al. | Journal of Clinical and Translational Research 2023; 9(4):265-271 267
2.3. Study population post-PCI, and 6-month post-PCI by 2-D echocardiography based
on biplane Simpson’s method.
2.3.1. Study design
2.5. Health-related QoL assessment
The study participants were chosen using a systematic random
sampling technique. The patient’s QoL was investigated using the SF-12 health
survey questionnaire [6,8,15,16]. The SF-12 consists of eight
2.3.2. Inclusion and exclusion criteria health concepts representing physical functioning; role-

One forty-five ACS (AHA/ACC/ESC classification) [9,10] male limitations due to physical health problems, bodily pain, general
patients who have undergone PCI between March 2021 and May 2022 health, energy/fatigue, social functioning, role-limitations due to
were included in the study. Among the enrolled, 62 patients had a first emotional problems, and mental health (psychological distress or
AMI (STEMI), 18 patients had NSTEMI, 44 had evolved MI, and psychological well-being). The 12 questions in this instrument
11 patients exhibited unstable angina. Of the 145 participants, seven assessed health-related QoL (HRQoL) in the past 4 weeks,
had major clinical events (termed as death or re-AMI), providing a producing two different 0-100 scores, namely, physical component
final sample of 138 individuals (95%) for the health survey. Smokers (PCS-12) and mental component (MCS-12) scores. The results of
(cigarette/beedi) [11,12], tobacco chewers, and alcoholics [13] the SF-12 with a higher score indicated a better QoL. Thus, face-
were also included in this study. Among the recruited, 26% of them to-face interviews were conducted at cardiology OPD at various
were diabetics and 37% of them were hypertensive. Individuals time points. Consequently, PCS-12 and MCS-12 scores were
were excluded if they were critically ill/mentally challenged. All measured 1-month, 3-month, and 6-month post-PCI.
the subjects went through reperfusion therapy using percutaneous 2.6. Data analysis
coronary intervention (Primary/Elective PCI). Included participants
were COVID-19 negative. Heart failure patients with preserved/mid- Descriptive statistics were calculated and expressed as
range EF (HFpEF or HFmrEF) [14] were considered. percentages, mean, and standard deviation. Data were tested for
normal distribution using the Kolmogorov–Smirnov test. Non-
2.4. Study design parametric tests were performed because the data did not show

We prospectively studied consecutive patients admitted to Gaussian distribution. Friedman’s test was used to measure all
our intensive coronary care unit with the first episode of ACS, the quantitative variables (PCS-12 and MCS-12) and was stated
who underwent primary PCI of the culprit coronary vessel within as the median. Furthermore, Spearman’s correlation analysis was
3–24 h of symptom onset in acute STEMI patients. Non-STEMI performed to ascertain the relationship between QoL scores and
patients went through elective PCI within 24 h of symptom onset. LVEF%. Then, multiple regression analysis was performed to
Patients were also included if they had earlier failed thrombolysis explore the effect of confounding variables (such as smoking,
(rescue PCI), as pointed out by the persistent ST-segment elevation. tobacco chewing, alcohol consumption, Killip class, comorbidities,
In case of evolved MI/unstable angina patients, symptom-to-door and drugs) on QoL. All the data were analyzed using IBM SPSS
timings were 2 h to a month duration. software for Windows (version 22.0; SPSS, Chicago, IL, USA).
Patients with typical chest pain lasting ≥30 min who also had 3. Results
ST-segment elevation of ≥0.1 mV in ≥2 adjacent leads on the
admission electrocardiogram (ECG) were diagnosed to have acute The study population consisted of 145 ACS patients (aged
STEMI. Non-STEMI was associated with ST-segment depression 54.3 ± 10.7 years) with LVEF of 44.8 ± 9.6%. Patients were
of ≥0.1 mV in ≥2 contiguous leads on admission ECG, T wave on antiplatelets (100%); 96% of patients received antianginal
inversion, with the troponin-I positive, and a typical chest pain therapy; 35% were treated with β-blockers; 98% of them were
lasting ≥30 min. Evolved MI was detected with the on and off on anticoagulants; 9% were on vasodilators; 99% were on statins;
symptoms from a few hours to a week, from hyperacute T waves 56% were on diuretics; 27% were on oral hypoglycemic agents/
to ST-segment elevation, and T wave inversion in ≥2 neighboring insulin; 7% were on angiotensin receptor blockers; 2% were on
leads on the admission ECG. Unstable angina was identified with ACE inhibitors; and 7% were on calcium-channel blockers. The
the on and off symptoms from a few hours to a month duration. baseline characteristics of the study population (n = 138) are
The demographic, anthropometric, clinical, and laboratory presented in Table 1.
parameters obtained for each patient were: age, height, weight, QoL assessment was done among post-ACS survivors at
several cardiovascular risk factors, infarction location, symptom- various time points using Friedman’s test. Since P = 0.011, we
to-door timings, culprit coronary vessels (defined as the presence concluded that there was a significant improvement in the QoL
of diameter stenosis more than 50%), thrombolytic therapy, scores during the follow-up (Table 2).
thrombolysis in myocardial infarction coronary flow grade, peak 3.1. Correlation analysis
values of cardiac biomarkers (creatine kinase-myocardial band or
troponin-I), and drug therapy. Spearman’s correlation analysis was done to identify the likely
Left ventricular ejection fraction was measured on admission, correlation between QoL and left ventricular ejection fraction (%).
1-month post-PCI/post-phase 2 cardiac rehabilitation, 3-month All QoL parameters had significant correlations with the LVEF
DOI: http://dx.doi.org/10.18053/jctres.09.202304.23-00049