Symptoms and Functional Limitations in the First Year Following a Myocardial Infarction: A Qualitative Study

Gwaltney, Chad J.; Reaney, Matthew; Krohe, Meaghan; Martin, Mona M; Falvey, Heather; Mollon, Patrick

doi:10.1007/s40271-016-0194-8

Cited by 6 publications

(11 citation statements)

References 29 publications

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“…In addition, it may be useful to develop and prospectively evaluate risk-stratified clinical management pathways after TAVI based on these baseline predictors in order to increase patient safety both in the short-term and in the midterm. Similar to PROM findings reported in patients after myocardial infarction [33], the patients' experience after TAVI (especially the one depicted by KCCQ and EQ5D5L) may yield novel endpoints for use in clinical trials.…”

Section: Implications For Future Studiessupporting

confidence: 55%

A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation

et al. 2021

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Background and Objectives: We tested if a novel combination of predictors could improve the accuracy of outcome prediction after transfemoral transcatheter aortic valve implantation (TAVI). Materials and Methods: This prospective study recruited 169 participants (49% female; median age 81 years). The primary endpoint was midterm mortality; secondary endpoints were acute Valve Academic Research Consortium (VARC)-3 complication rate and post-TAVI in-hospital length of stay (LoS). EuroSCORE II (ESII), comorbidities (e.g., coronary artery disease), eGFR (estimated glomerular filtration rate; based on cystatin C), hemoglobin, creatinine, N-Terminal pro-Brain Natriuretic Peptide (NTproBNP) levels and patient-reported outcome measures (PROMs, namely EuroQol-5-Dimension-5-Levels, EQ5D5L; Kansas City Cardiomyopathy Questionnaire, KCCQ; clinical frailty scale, CFS) at baseline were tested as predictors. Regression (uni- and multi-variate Cox; linear; binary logistic) and receiver operating characteristic (ROC)-curve analysis were applied. Results: Within a median follow-up of 439 (318–585) days, 12 participants died (7.1%). Independent predictors of mortality using multivariate Cox regression were baseline eGFR (p = 0.001) and KCCQ (p = 0.037). Based on these predictors, a Linear Prediction Score (LPS1) was calculated. The LPS1-area under the curve (AUC)-value (0.761) was significantly higher than the ESII-AUC value (0.597; p = 0.035). Independent predictors for LoS > 6 days (the median LoS) were eGFR (p = 0.028), NTproBNP (p = 0.034), and EQ5D5L values (p = 0.002); a respective calculated LPS2 provided an AUC value of 0.677 (p < 0.001). Eighty participants (47.3%) experienced complications. Male sex predicted complications only in the univariate analysis. Conclusions: The combination of KCCQ and eGFR can better predict midterm mortality than ES II alone. Combining eGFR, NTproBNP, and EQ5D5L can reliably predict LoS after TAVI. This novel method improves personalized TAVI risk stratification and hence may help reduce post-TAVI risk.

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Section: Implications For Future Studiessupporting

confidence: 55%

A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation

et al. 2021

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“…In the study, it was observed that EDS is associated with a higher risk of re-infarction than in patients without EDS, and it was established as an independent risk factor for adverse cardiac outcomes in post-MI patients [ 24 ]. Sleep disturbances along with fatigue were one of the most common symptoms affecting patients post-MI [ 25 ]. Sleep apnea and MD are independently associated with adverse cardiac outcomes post-MI [ 26 ].…”

Section: Reviewmentioning

confidence: 99%

The Significance of Sleep Disorders in Post-myocardial Infarction Depression

Gutlapalli¹,

Pu²,

Zaidi³

et al. 2022

Cureus

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Sleep disorders are highly prevalent and often missed comorbidities in patients with cardiovascular disease (CVD), especially important in patients with depression associated with post-myocardial infarction (MI). Proactive screening and targeted treatment for sleep disorders are essential to reduce the morbidity and mortality associated with CVDs and MI in particular. We have reviewed all relevant information up to July 2022 regarding sleep disorders in CVD with a focus on post-MI depression and gathered around 350 articles in our research and narrowed it down to 31 articles. The database used was PubMed, and the keywords used were obstructive sleep apnea, sleep disorders, sleep-disordered breathing, major depression, and postmyocardial infarction. We have concluded from the available literature that there is a significant overlap between the etiologies and pathological mechanisms between conditions such as diabetes, obesity, and other comorbidities associated with both sleep disorders and CVD. Treatment such as psychotherapy and pharmacotherapy should be tailored according to the specific needs of the patients. Targeted treatment for sleep disorders has been shown to improve multiple factors and comorbidities associated with prognosis post-MI, including improvement in quality of life and significantly reduced short-term and long-term mortality. The incidence and prevalence of depression post-MI can be significantly reduced by focusing on the treatment of any underlying sleep disorders. We encourage larger-scale observational and interventional studies regarding the quality of sleep post-MI.

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“…(p3) may be triggered by memories of past cardiac events, thinking about having another cardiac event, or the consequences of another cardiac event. 14,25,26 On the other hand, individuals may experience improvement in HFA with certain cardiac interventions. In a prospective cohort study of 26 participants with heart failure, Sager et al 6 found that individuals experienced reduced HFA, particularly in the domain of fear, after implantation of a wireless hemodynamic monitor.…”

Section: Qualitative Descriptivementioning

confidence: 99%

“…9 This pattern leads to more episodes of HFA. 9 In a qualitative study by Gwaltney et al, 25 chest pain was a common symptom experienced by participants after MI, occurring with exertion, at rest, and with feelings of anxiety.…”

Section: Consequencesmentioning

confidence: 99%

Heart-Focused Anxiety

Barthle¹

2021

Advances in Nursing Science

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Although heart-focused anxiety is a common experience of patients following a myocardial infarction, it is one rarely addressed in nursing research. I used Rodger's evolutionary method of concept analysis to review uses of heart-focused anxiety in literature from several disciplines including nursing and synthesized a definition to guide future research. Heart-focused anxiety is an experience of avoidance, fear, and heart-focused attention that follows from cardiac diagnoses, somatic symptoms, and familial factors and results in adverse health outcomes, reassurance seeking, disruption of life, and recurrent chest pain. Although heart-focused anxiety is an evolving concept, the updated definition should help provide a foundation for future research.

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Symptoms and Functional Limitations in the First Year Following a Myocardial Infarction: A Qualitative Study

Cited by 6 publications

References 29 publications

A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation

A Novel Method to Predict Mortality and Length of Stay after Transfemoral Transcatheter Aortic Valve Implantation

The Significance of Sleep Disorders in Post-myocardial Infarction Depression

Heart-Focused Anxiety

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