Angina 1 year after percutaneous coronary intervention: a report from the NHLBI Dynamic Registry.
BACKGROUND
As percutaneous coronary intervention (PCI) is most commonly performed for relief of angina, it is important to identify factors associated with recurrence of anginal symptoms.


METHODS
We examined symptoms at 1-year follow-up in 1755 consecutive NHLBI Dynamic Registry patients who underwent PCI in the setting of symptoms or acute infarction.


RESULTS
At 1-year follow-up, 26% of patients reported angina in the previous 6 weeks. Younger patients and females reported more symptoms. History of coronary artery bypass graft (CABG) or PCI, prior myocardial infarction (MI), diabetes, graft disease, and extensive coronary artery disease (CAD) (>4 significant lesions) were also associated with follow-up angina. Patients receiving stents reported less angina (24% vs 29%, P <.05). Completely revascularized patients and those with residual single-vessel disease had comparable 1-year angina rates (23% both subgroups), while 32% of patients with residual multivessel CAD reported symptoms. Patients undergoing repeat PCI during follow-up reported more 1-year angina than others (34% vs 24%, P <.001), whereas those undergoing CABG after post-PCI hospitalization had less symptoms (15% vs 26%, P <.05). After adjustment for baseline symptom status and outcome of index PCI, residual CAD, and reintervention during follow-up, patient characteristics significantly predictive of angina included female sex, age <62 years, and prior MI.


CONCLUSIONS
While approximately three quarters of patients receiving PCI are angina-free at 1 year, females continue to have more symptoms, as do other subgroups including patients with history of MI or previous intervention. As these symptoms are associated with self-reported activity and quality of life limitation, evaluations of PCI should include angina as a key follow-up outcome.
Holubkov
Richard
R
Department of Epidemiology, Cardiovascular Institute, University of Pittsburgh, Pittsburgh, Pa 15261, USA. holubkov@edc.gsph.pitt.edu
Laskey
Warren K
WK
Haviland
Amelia
A
Slater
James C
JC
Bourassa
Martial G
MG
Vlachos
Helen Aslanidou
HA
Cohen
Howard A
HA
Williams
David O
DO
Kelsey
Sheryl F
SF
Detre
Katherine M
KM
D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy; D011788:Quality of Life; D012008:Recurrence; D012042:Registries; D012737:Sex Factors; D015607:Stents