Feelings of being disabled as a predictor of mortality in men 10 years after percutaneous coronary transluminal angioplasty.
OBJECTIVE
To examine the independent prognostic value of the four subscales of the Heart Patients Psychological Questionnaire (HPPQ) on mortality in male and female patients 10 years following percutaneous transluminal coronary angioplasty (PTCA).


METHODS
The HPPQ, which measures well-being, feelings of being disabled, despondency, and social inhibition, was administered to 356 patients (23% women) post-PTCA. The patients were followed for a median of 10 years. Clinical and demographic variables were sampled from medical records.


RESULTS
During the follow-up period, 104 patients (29%) had died. Women scored significantly worse on all psychological subscales compared with men. Fifty-nine (72%) women and 92 (34%) men had a score indicating at least mild to moderate feelings of being disabled. Men scoring high on feelings of being disabled were at increased risk of mortality compared with men having a low score, adjusted for other cardiac risk factors (chi(2)=7; P=.008). No differences were found between women with low or high scores on feelings of being disabled (relative risk (RR): 1.2; 95% confidence interval (CI): 0.5-3.3). None of the other HPPQ subscales were related to mortality.


CONCLUSIONS
Feelings of being disabled measured at least 1 year after hospital discharge is a significant predictor of mortality in men 10 years post-PTCA, but not in women. This finding adds to the increasing knowledge that psychosocial variables influence morbidity and mortality in cardiac patients.
van Domburg
R T
RT
Thoraxcenter, Department of Cardiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands. vandomburg@thch.azr.nl
Scmidt Pedersen
S
S
van den Brand
M J
MJ
Erdman
R A
RA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality / Q000523:psychology*; D001294:Attitude to Health; D003327:Coronary Disease / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D005221:Fatigue / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012494:Sampling Studies; D012649:Self Concept; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis