Impact of Vascular Brachytherapy on Patient Reported Outcomes in Patients with Coronary Artery Disease
Background: Vascular brachytherapy (VBT) is an established treatment for the management of in-stent restenosis (ISR). However, whether VBT is associated with improved patient-reported outcomes is unknown and not been previously studied.
Methods: The authors evaluated 51 consecutive patients, age 18 years and older undergoing VBT in one or more coronary arteries from January 2018 to September 2019. Data on baseline characteristics, procedural outcomes, and occurrence of adverse events were obtained. All patients completed the Seattle Angina Questionnaire – 7 (SAQ-7) form before and after the intervention at 1 month and 6 months.
Results: The mean age was 69 ± 9 years and 29 (57%) of patients were males. Most patients had hypertension (n = 44, 86%) and diabetes (n = 29, 57%). The use of aspirin was 90% while 96% of patients were on P2Y12 inhibitors. 48 (94%) patients were on antianginal therapy. The procedural success was 94.1%. The mean summary SAQ-7 score improved significantly (53.2 ± 21 vs. 83 ± 19, p<0.001) at 30-days. The median Quality of Life (QoL) component of the SAQ-7 score at baseline was 31.3 (Interquartile Range [IQR]: 18.8, 62.5) and improved to 82.5 (IQR: 62.5, 100), p<0.001 at 30 days and 87.5 [IQR: 75, 100), p<0.001 at last follow up. Likewise, the median angina frequency component of the SQL-7 score pre-VBT was 55 (IQR: 45, 80) and improved significantly to 90 (IQR: 60, 100) at 30-days, p<0.001 and 100 [IQR: 68.8, 100], p=0.02 at last follow up. Lastly, the median activity component of the SAQ-7 score improved from 83.3 (IQR: 60 – 100) to 100 (IQR: 83, 100), p = 0.01 at 30-days.
Conclusion: This study demonstrated improvement in patient-reported outcome measures following vascular brachytherapy that are evident as early as 1 month after the intervention and sustained at a median follow up of 17 months.