PS1-28: Psychosocial Factors Associated With Angina Occurrence, Physical Limitation, and Diminished Quality of Life After Hospitalization for an Acute Coronary Syndrome: Preliminary Data from TRACE-CORE

Abstract

Background/AimsContemporary risk profiling and treatment of patients hospitalized with an acute coronary syndrome (ACS) focuses primarily on reducing in-hospital morbidity and improving survival. Despite an increasing focus on improving the transition quality to the outpatient setting of patients hospitalized with ACS, little is known about the factors associated with persistent symptoms and reduced disease-specific quality of life after an ACS hospitalization.MethodsA total of 826 adults admitted with an ACS at 6 medical centers in central Massachusetts and Georgia were interviewed during hospitalization and 1-month (1M) after discharge as part of an ongoing study within the Transitions, Risk, and Actions in Acute Coronary Events: Center for Outcomes Research and Education (TRACE-CORE). Medical record abstraction is underway to characterize participants’ baseline demographic, clinical, laboratory, and procedural characteristics (n = 86 to date with full data expected in winter, 2013). Participants completed the Seattle Angina Questionnaire (SAQ) 1M after discharge, which includes questions regarding frequency of angina, physical limitation, and disease-specific quality of life (QoL). In the present study, the presence of angina, physical limitation, and QoL at 1M were examined in relation to key clinical characteristics and in-hospital treatment using regression models.ResultsThe mean age of the participants was 63 years, 38% (33 of 86) were women, and 91% (76 of 86) were non-Hispanic white. At 1M after discharge, 59% (51 of 86) reported angina. History of hypertension, heart failure, smoking, lower hemoglobin levels, intra-aortic balloon pump placement, and coronary artery bypass surgery were independently associated with greater physical limitation at 1M after discharge (all P’s <0.05). Higher admission respiratory rates were associated with angina occurrence and diminished quality of life at 1M after hospital discharge (P = 0.05).ConclusionsSeveral patient and treatment-level factors during ACS admission were related to CHD-specific functional status, angina, and QoL 1M after hospital discharge. These factors may help identify patients at higher risk for poor outcomes after an ACS. Studies are needed to determine if targeted interventions improve post-discharge functional status and quality of life in patients with an ACS.