Determinants of cardiac outcomes and adherence behaviours post percutaneous coronary intervention (PCI)

Cardiovascular disease (CVD) is a chronic disorder where symptoms develop slowly; often symptoms appearing in late age. The development of CVD usually results through a combination of preventable lifestyle factors. The increased rate at which people develop and are dying from heart disease has made it the number one healthcare priority. People with CVD are often treated with interventions such as Percutaneous Coronary Intervention (PCI). These cardiac interventions and subsequent cardiac rehabilitation that includes an alteration of lifestyle behaviours post intervention can have beneficial outcomes for people’s health and their quality of life. The healthcare management for people living with CVD post PCI can be complex and multifaceted. Factors such as depression, advanced age and willingness to participate in cardiac rehabilitation such as stopping smoking, and altering exercise and diet routines have been found to impact on patients’ quality of life post surgical intervention. Patients with CVD must also adhere to taking to a number of medications and this too can be troublesome and confusing for some people. The psychological distress following treatment and living with a chronic illness may also negatively impact on quality of life.
The purpose of this study was to evaluate cardiac outcomes, health related quality of life (HRQoL), resilience and adherence behaviours in patients who have undergone a PCI at two time points (6 and 12 months) following their procedure.
Participants were recruited from a large, private hospital in metropolitan Melbourne. Potential participants who had undergone the intervention 6 months prior were initially contacted. Those participants who met the inclusion criteria and provided consent then completed a telephone survey. These participants were then contacted 6 months later (i.e. 12 months post their intervention) and the measures were repeated. The longitudinal prognostic design of this study allowed us to observe the cardiac outcomes across a cohort of patients who had undergone a PCI.
The study revealed that men were doing better than women in the 6 months post PCI particularly in the areas of mood (depression) and physical health. This pilot results indicate gender sensitive practices are recommended given the gender differences highlighted in consideration of mood and physical wellbeing 6 months post PCI. Further research into the management of mood particularly for women in the 6 months post PCI is warranted. A more detailed inquiry related to access/attendance to secondary prevention is also warranted.