title: Effects of treating exhaustion in angioplasty patients on new coronary events: results of the randomized Exhaustion Intervention Trial (EXIT).
abstract: BACKGROUND
  Extreme fatigue is a common complaint in percutaneous coronary intervention (PCI) patients, and is associated with an increased risk for new cardiac events. The objective of the Exhaustion Intervention Trial (EXIT) was to determine whether a behavioral intervention on exhaustion reduces the risk of a new coronary event after PCI.
  
  
  RESULTS
  Seven hundred ten consecutive patients, ages 35 to 68 years, who felt exhausted after PCI were randomized into an intervention group and a usual-care group. The intervention was based on group therapy focusing on stressors leading to exhaustion, and on support for recovery by promoting rest and making rest more efficient. One month after PCI, 50% of the patients felt exhausted. The intervention reduced the odds of remaining exhausted at 18 months by 56% in those without a previous history of coronary artery disease (CAD) (OR = 0.44; 95% CI 0.29-0.66), but had no effect on exhaustion in those with a history of CAD (OR = 0.93; 95% CI 0.56-1.55; p = .78). The intervention did not reduce the risk of a new coronary event within 2 years (RR = 1.14; 95%CI 0.82-1.57). Post-hoc analyses suggest that the effect of the intervention was limited by a positive history of CAD, the presence of a chronic, painful condition (especially rheumatism), and by opposite effects on early and late cardiac events.
  
  
  CONCLUSIONS
  A behavioral intervention in PCI patients has a beneficial effect on feelings of exhaustion. It could not be demonstrated that the intervention reduces the risk of a new coronary event within 2 years.
authors.affiliation: Department of Medical Psychology, Maastricht University, Maastricht, The Netherlands. Ad.Appels@MP.unimaas.nl
authors.forename: Ad
authors.initials: A
authors.lastname: Appels
authors.forename: Frits
authors.initials: F
authors.lastname: Bär
authors.forename: Gerda
authors.initials: G
authors.lastname: van der Pol
authors.forename: Ruud
authors.initials: R
authors.lastname: Erdman
authors.forename: Maarten
authors.initials: M
authors.lastname: Assman
authors.forename: Wim
authors.initials: W
authors.lastname: Trijsburg
authors.forename: Rob
authors.initials: R
authors.lastname: van Diest
authors.forename: Jan
authors.initials: J
authors.lastname: van Dixhoorn
authors.forename: Carlos
authors.initials: C
authors.lastname: Mendes de Leon
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001521:Behavior Therapy / Q000379:methods*; D003324:Coronary Artery Disease / Q000517:prevention & control / Q000628:therapy*; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods; D012146:Rest; D018570:Risk Assessment / Q000706:statistics & numerical data; D055502:Secondary Prevention; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome