title: Temporal trends in patient-reported angina at 1 year after percutaneous coronary revascularization in the stent era: a report from the National Heart, Lung, and Blood Institute-sponsored 1997-2006 dynamic registry.
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.
  
  
  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)<0.001). The lower risk of angina in recent waves was explained by patient characteristics including use of antianginal medications at discharge (relative risk [95% CI] for waves 2, 3, 4 versus 1: 1.0 [0.9 to 1.2], 0.9 [0.7 to 1.1], 1.0 [0.8 to 1.3], 0.9 [0.7 to 1.1]). Similar trend was seen in the average quality of life scores over time (adjusted mean score for waves 1 to 5: 6.2, 6.5, 6.6 and 6.6; 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cardiovascular Institute, Department of Medicine, School of Medicine, Graduate School of Public Health, University of Pittsburgh, PA, USA. lvenkitachalam@saint-lukes.org
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Venkitachalam
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Suresh R
authors.initials: SR
authors.lastname: Mulukutla
authors.forename: Faith
authors.initials: F
authors.lastname: Selzer
authors.forename: Warren
authors.initials: W
authors.lastname: Laskey
authors.forename: James
authors.initials: J
authors.lastname: Slater
authors.forename: Howard A
authors.initials: HA
authors.lastname: Cohen
authors.forename: Robert L
authors.initials: RL
authors.lastname: Wilensky
authors.forename: David O
authors.initials: DO
authors.lastname: Williams
authors.forename: Oscar C
authors.initials: OC
authors.lastname: Marroquin
authors.forename: Kim
authors.initials: K
authors.lastname: Sutton-Tyrrell
authors.forename: Clareann H
authors.initials: CH
authors.lastname: Bunker
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000789:Angina, Unstable / Q000453:epidemiology*; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D005260:Female; D006760:Hospitalization; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D009566:Nitrates / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D019233:Retreatment; D012737:Sex Factors; D015607:Stents; D014481:United States / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D000960:Hypolipidemic Agents; D009566:Nitrates; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin