Quality of life (QOL) evaluation after acute coronary syndrome with simultaneous clopidogrel treatment

Abstract

Introduction: Double antiplatelet therapy with clopidogrel and acetylsalicylic acid is a standard procedure after acute coronary syndrome. This treatment carries a higher risk of complications. The main goal of this research was to assess the patients' quality of life after undergoing antiplatelet therapy with clopidogrel after acute coronary syndrome (ACS). Material and methods: In the questionnaire research 3220 patients after ACS and treated with clopidogrel were included. The evaluation was carried out with the quality of life questionnaire SF-12. Results: 37.9% of the interviewees experienced ACS-ST-elevation myocardial infarction (STEMI), 62.1% non-ST-elevation myocardial Infarction (NSTEMI), on average within 23 ±42 weeks (p < 0.05). 7.2% of the interviewees were receiving non-invasive treatment and in 2.4% cases it was fibrinolysis. 90.4% were treated with primary angioplasty and stenting. In 53.8% of cases a covered stent (DES) was implanted. 95.6% of the patients received, besides clopidogrel, acetylsalicylic acid. The lowest quality of life was observed after non-invasive treatment or fibrinolytic only (p < 0.05). The quality of life in those patients who underwent angioplasty and stent implantation was similar (p < 0.05). With time, a progressive improvement of all assessed quality of life aspects was observed (p < 0.05). The improvement was noted regardless of the ACS treatment method (p < 0.001). The differences between the patients were smaller at each successive evaluation (p < 0.05). In the case of vitality, emotional and psychic condition, they disappeared completely (p < 0.05). Conclusions: The quality of life rises along with time passed after acute coronary syndrome. Invasive methods provide better quality of life than fibrinolysis and non-invasive treatment in the acute coronary syndrome patients.