Effects of percutaneous coronary intervention on dyspnea in stable coronary artery disease
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Published:2022-09-13
Issue:
Volume:
Page:
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ISSN:1861-0684
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Container-title:Clinical Research in Cardiology
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language:en
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Short-container-title:Clin Res Cardiol
Author:
Wester MichaelORCID, Koll Franziska, Luedde Mark, Langer Christoph, Resch Markus, Luchner Andreas, Müller Karolina, Zeman Florian, Koller Michael, Maier Lars S., Sossalla Samuel
Abstract
Abstract
Background
Dyspnea is a frequent symptom in patients with stable coronary artery disease (CAD) and is recognized as a possible angina equivalent.
Objectives
This study was to assess the impact of percutaneous coronary intervention (PCI) on dyspnea, quality of life, and angina pectoris in patients with stable CAD.
Methods
The prospective, multi-center PLA-pCi-EBO-pilot trial included 144 patients with symptomatic stable CAD and successful PCI. The prespecified endpoints angina pectoris (Seattle Angina Questionnaire–SAQ) and dyspnea (NYHA scale) were assessed 6 months after PCI. Predictors for symptomatic improvement were assessed with uni- and multivariable logistic regression analyses.
Results
Patients with concomitant dyspnea had worse SAQ physical limitation scores at baseline (49.5 ± 21.0 vs 58.9 ± 22.0, p = 0.013) but showed no difference for angina frequency or quality of life. Overall, symptomatic burden of angina pectoris and dyspnea was alleviated by PCI. However, patients with concomitant dyspnea had markedly worse scores for physical limitation (78.9 ± 25.0 vs 94.3 ± 10.6, p < 0.001), angina frequency (77.9 ± 22.8 vs 91.1 ± 12.4, p < 0.001), and quality of life (69.4 ± 24.1 vs 82.5 ± 14.4, p < 0.001) after PCI. The prevalence of dyspnea (NYHA class ≥ 2) declined from 73% before PCI to 54%. Of 95 initially dyspneic patients, 57 (60%) improved at least one NYHA class 6 months after PCI. In a multivariable logistic regression analysis, “atypical angina pectoris” was associated with improved NYHA class, whereas “diabetes mellitus” had a negative association.
Conclusion
PCI effectively reduced dyspnea, which is a frequent and demanding symptom in patients with CAD. The German Clinical Trials Register registration number is DRKS0001752 (www.drks.de).
Graphical abstract
Funder
Doktor Robert Pfleger-Stiftung Universitätsklinikum Regensburg
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,General Medicine
Reference20 articles.
1. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, Prescott E, Storey RF, Deaton C, Cuisset T, Agewall S, Dickstein K, Edvardsen T, Escaned J, Gersh BJ, Svitil P, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Valgimigli M, Achenbach S, Bax JJ (2020) 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 41:407–477. https://doi.org/10.1093/eurheartj/ehz425 2. Baron SJ, Chinnakondepalli K, Magnuson EA, Kandzari DE, Puskas JD, Ben-Yehuda O, van Es G-A, Taggart DP, Morice M-C, Lembo NJ, Brown WM, Banning A, Simonton CA, Kappetein AP, Sabik JF, Serruys PW, Stone GW, Cohen DJ (2017) Quality-of-life after everolimus-eluting stents or bypass surgery for left-main disease: results from the EXCEL trial. J Am Coll Cardiol 70:3113–3122. https://doi.org/10.1016/j.jacc.2017.10.036 3. Qintar M, Grantham JA, Sapontis J, Gosch KL, Lombardi W, Karmpaliotis D, Moses J, Salisbury AC, Cohen DJ, Spertus JA, Arnold SV (2017) Dyspnea among patients with chronic total occlusions undergoing percutaneous coronary intervention: prevalence and predictors of improvement. Circ Cardiovasc Qual Outcomes. https://doi.org/10.1161/CIRCOUTCOMES.117.003665 4. Spertus JA, Jones PG, Maron DJ, O’Brien SM, Reynolds HR, Rosenberg Y, Stone GW, Harrell FE, Boden WE, Weintraub WS, Baloch K, Mavromatis K, Diaz A, Gosselin G, Newman JD, Mavromichalis S, Alexander KP, Cohen DJ, Bangalore S, Hochman JS, Mark DB (2020) Health-status outcomes with invasive or conservative care in coronary disease. N Engl J Med 382:1408–1419. https://doi.org/10.1056/NEJMoa1916370 5. Xaplanteris P, Fournier S, Pijls NHJ, Fearon WF, Barbato E, Tonino PAL, Engstrøm T, Kääb S, Dambrink J-H, Rioufol G, Toth GG, Piroth Z, Witt N, Fröbert O, Kala P, Linke A, Jagic N, Mates M, Mavromatis K, Samady H, Irimpen A, Oldroyd K, Campo G, Rothenbühler M, Jüni P, de Bruyne B (2018) Five-year outcomes with PCI guided by fractional flow reserve. N Engl J Med 379:250–259. https://doi.org/10.1056/NEJMoa1803538
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