Temporal Trends in Patient-Reported Angina at 1 Year After Percutaneous Coronary Revascularization in the Stent Era
Document Type
Article
Publication Date
2009
Digital Object Identifier (DOI)
https://doi.org/10.1161/CIRCOUTCOMES.109.869131
Abstract
Background— Percutaneous coronary intervention (PCI) has witnessed rapid technological advancements, resulting in improved safety and effectiveness over time. Little, however, is known about the temporal impact on patient-reported symptoms and quality of life after PCI.
Methods and Results— Temporal trends in post-PCI symptoms were analyzed using 8879 consecutive patients enrolled in the National Heart, Lung, and Blood Institute–sponsored Dynamic Registry (wave 1: 1997 [bare metal stents], wave 2: 1999 [uniform use of stents], wave 3: 2001 [brachytherapy], wave 4, 5: 2004, 2006 [drug eluting stents]). Patients undergoing PCI in the recent waves were older and more often reported comorbidities. However, fewer patients across the waves reported post-PCI angina at one year (wave 1 to 5: 24%, 23%, 18%, 20%, 20%; Ptrend<0.001). The lower risk of angina in recent waves was explained by patient characteristics including use of antianginal medications at discharge (relative risk [95% CI] for waves 2, 3, 4 versus 1: 1.0 [0.9 to 1.2], 0.9 [0.7 to 1.1], 1.0 [0.8 to 1.3], 0.9 [0.7 to 1.1]). Similar trend was seen in the average quality of life scores over time (adjusted mean score for waves 1 to 5: 6.2, 6.5, 6.6 and 6.6; Ptrend=0.01). Other factors associated with angina at 1 year included younger age, female gender, prior revascularization, need for repeat PCI, and hospitalization for myocardial infarction over 1 year.
Conclusion— Favorable temporal trends are seen in patient-reported symptoms after PCI in routine clinical practice. Specific subgroups, however, remain at risk for symptoms at 1 year and thus warrant closer attention.
Was this content written or created while at USF?
Yes
Citation / Publisher Attribution
Circulation: Cardiovascular Quality and Outcomes, v. 6, issue 2, p. 607-615
Scholar Commons Citation
Venkitachalam, Lakshmi; Kip, Kevin E.; Mulukutla, Suresh R.; Selzer, Faith; Laskey, Warren; Slater, James; Cohen, Howard A.; Wilensky, Robert L.; Williams, David O.; Marroquin, Oscar C.; Sutton-Tyrrell, Kim; Bunker, Clareann H.; and Kelsey, Sheryl F., "Temporal Trends in Patient-Reported Angina at 1 Year After Percutaneous Coronary Revascularization in the Stent Era" (2009). Nursing Faculty Publications. 210.
https://digitalcommons.usf.edu/nur_facpub/210
