Temporal Trends in Patient-Reported Angina at 1 Year After Percutaneous Coronary Revascularization in the Stent Era

Authors:
  • KKKevin E. Kip
    Kevin E. Kip
  • SMSuresh R. Mulukutla
    Suresh R. Mulukutla
  • FSFaith Selzer
    Faith Selzer
  • WLWarren Laskey
    Warren Laskey
  • HCHoward A. Cohen
    Howard A. Cohen
  • RWRobert L. Wilensky
    Robert L. Wilensky
  • DWDavid O. Williams
    David O. Williams
  • OMOscar C. Marroquin
    Oscar C. Marroquin
  • KSKim Sutton-Tyrrell
    Kim Sutton-Tyrrell
  • CBClareann H. Bunker
    Clareann H. Bunker
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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%; P trend P trend =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.

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