Social and Economic Costs and Health-Related Quality of Life in Patients With Acute Coronary Syndrome

Objectives: Health-related quality of life (HRQOL) evaluation is an important measure of the impact of certain inerventions, epecially coronary artery diseases treatments. As more patients with acute coronary syndrome (ACS) live longer, doctors and researchers want to know how they manage in day-to-day life. The aim of this study was to compare costs and HRQOL of patients who underwent percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and medical therapy (MT) and to assess its main determinants in the whole sample of patients with ACS for a period of 12 months. Methods: The study was carried out to estimate costs and HRQOL evaluation of 310 patients who underwent coronary revascularization (PCI, n = 139; CABG, n = 128; and MT, n = 43). We estimated direct costs (medical costs and nonmedical costs) and indirect costs (productivity losses owing to morbidity and mortality) based on a societal perspective, and HRQOL was assessed using the EQ-5D-3L (5 dimensions and 3 levels) and visual analog scale (VAS). We applied costs and HRQOL 1 month before treatment and 12 months after treatment in 3 groups, and scores were compared. Data entry and analysis were performed with SPSS. Results: Total EQ-5D index scores in PCI, CABG, and MT groups 1 month before treatment were 0.54 ± 0.26, 0.52 ± 0.25, and 0.56 ± 0.25, respectively. After 12 months, the HRQOL mean changed to 0.67 ± 0.20, 0.74 ± 0.15, and 0.65 ± 0.19, respectively, in PCI, CABG, and MT groups. The mean EQ-5D VAS score 1 month before treatment was 63 ± 15.4 for the PCI group, 62 ± 16.4 for the CABG group, and 64 ± 18.4 for the MT group; the mean EQ-5D VAS score 12 months after treatment was 74.8 ± 19.5 for the PCI group, 78.8 ± 18 for the CABG group, and 74 ± 19.7 for the MT group. All the 3 therapeutic strategies presented significant improvement in all dimensions of the follow-up. However, the CABG group was the one that had significantly greater improvement compared with PCI and MT. The mean (95 confidence interval) annual total cost for the overall sample was found to be 4940/patient. This cost was significantly higher among patients with CABG (7327/patient) compared with PCI (5225/patient) and MT (2278/patient). Direct costs accounted for 87.7 and indirect costs for 12.3 of the total costs. Conclusion: The quality of life was better in both CABG and PCI groups compared with MT after 1 year of follow-up. However, treatment with CABG is more difficult and expensive than PCI and MT, but it provides a better quality of life. The findings of the present study indicate the high economic burden of ACS in Iran. © 202

Social and Economic Costs and Health-Related Quality of Life in Patients With Acute Coronary Syndrome

Objectives: Health-related quality of life (HRQOL) evaluation is an important measure of the impact of certain inerventions, epecially coronary artery diseases treatments. As more patients with acute coronary syndrome (ACS) live longer, doctors and researchers want to know how they manage in day-to-day life. The aim of this study was to compare costs and HRQOL of patients who underwent percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and medical therapy (MT) and to assess its main determinants in the whole sample of patients with ACS for a period of 12 months. Methods: The study was carried out to estimate costs and HRQOL evaluation of 310 patients who underwent coronary revascularization (PCI, n = 139; CABG, n = 128; and MT, n = 43). We estimated direct costs (medical costs and nonmedical costs) and indirect costs (productivity losses owing to morbidity and mortality) based on a societal perspective, and HRQOL was assessed using the EQ-5D-3L (5 dimensions and 3 levels) and visual analog scale (VAS). We applied costs and HRQOL 1 month before treatment and 12 months after treatment in 3 groups, and scores were compared. Data entry and analysis were performed with SPSS. Results: Total EQ-5D index scores in PCI, CABG, and MT groups 1 month before treatment were 0.54 ± 0.26, 0.52 ± 0.25, and 0.56 ± 0.25, respectively. After 12 months, the HRQOL mean changed to 0.67 ± 0.20, 0.74 ± 0.15, and 0.65 ± 0.19, respectively, in PCI, CABG, and MT groups. The mean EQ-5D VAS score 1 month before treatment was 63 ± 15.4 for the PCI group, 62 ± 16.4 for the CABG group, and 64 ± 18.4 for the MT group; the mean EQ-5D VAS score 12 months after treatment was 74.8 ± 19.5 for the PCI group, 78.8 ± 18 for the CABG group, and 74 ± 19.7 for the MT group. All the 3 therapeutic strategies presented significant improvement in all dimensions of the follow-up. However, the CABG group was the one that had significantly greater improvement compared with PCI and MT. The mean (95 confidence interval) annual total cost for the overall sample was found to be 4940/patient. This cost was significantly higher among patients with CABG (7327/patient) compared with PCI (5225/patient) and MT (2278/patient). Direct costs accounted for 87.7 and indirect costs for 12.3 of the total costs. Conclusion: The quality of life was better in both CABG and PCI groups compared with MT after 1 year of follow-up. However, treatment with CABG is more difficult and expensive than PCI and MT, but it provides a better quality of life. The findings of the present study indicate the high economic burden of ACS in Iran. © 202

Determination of Peroxide Value of Edible Oils Used in Confectionary, Restaurants and Sandwich Shops in Gorgan in 2011

Introduction: High-rate frying with oil is a cause of hydrolyzation, oxidation and polymerization of oil, thus making free radicals in the human body. These free radicals can lead to cancer, inflammatory diseases, atherosclerosis, aging and others. The aim of this study was to survey the peroxide value of edible oils used in confectionary, restaurants and sandwich shops in Gorgan in 2011. Methods: This descriptive cross-sectional study was carried out on all confectionaries (n=43) Restaurants (n=15) and Sandwich Shops (n=66) in Gorgan in 2011. Samples were collected in the hours that oil was very hot. Samples were collected based on national standard procedure, number 493. After the transfer of samples to the chemistry laboratory of environmental health engineering department, the number of peroxide was determined based on national standard procedure, number 4179. Results: Out of 24 samples of the confectioneries, (56%) were consumable and 19 samples (44%) were inedible (p=0.015). Out of 15 restaurants and central kitchen, 6 cases (40%) were consumable and 9 cases (60%) were inedible. (p=0.021), and from 66 samples of sandwiches, 12 (18%) were consumable and 54 samples (82%) were inedible (p=0.000). The differences between the samples of consumable and inedible in three group was significant (p=0.000). Conclusion: The findings show that Peroxide value in sandwich and fast food shops, restaurants, and confectionary shop are higher than the standard, so its seems that having educational plan for staff about nutrition and the correct methods of frying food is necessary