title: Predictors of permanent work disability among ≤50-year-old patients undergoing percutaneous coronary intervention.
abstract: OBJECTIVE
  This study aimed to describe the incidence and periprocedural predictors of permanent work disability (PWD) pension among patients ≤50 years old who underwent percutaneous coronary intervention (PCI).
  
  
  METHODS
  Patient records of 910 consecutive patients undergoing PCI at four Finnish hospitals in 2002-2012 were reviewed for baseline and procedural data and late adverse events. Data on permanent work disability (PWD) pension allocation were acquired from the Finnish Centre for Pensions, which governs the statutory pension security in Finland.
  
  
  RESULTS
  Mean follow-up was 41 [standard deviation (SD) 31] months. Altogether 103/910 (11.3%) of patients were on PWD by the end of follow-up, 60 (58.3%) for cardiac diagnoses (cumulative freedom from PWD 81% at 7 years). Independent predictors of PWD were post procedural stroke [hazard ratio (HR) 4.7, 95% confidence interval (95% CI) 1.8-11.9], post procedural myocardial infarction (MI) (HR 3.3, 95% CI 1.8-6.0), diabetes (HR 2.0, 95% CI 1.1-3.7), discharge diuretics (HR 3.5, 95% CI 2.1-5.9), and increasing age (HR 1.2, 95% CI 1.1-1.3). Predictors of PWD for cardiac diagnoses were post procedural stroke and MI, discharge diuretics, and use of calcium-channel blockers, diabetes and older age.
  
  
  CONCLUSIONS
  Patients ≤50 years old undergoing PCI are at a high risk for subsequent permanent disability for cardiac diagnoses. This finding underscores the need for reinforcing adherence to secondary prevention by cardiac rehabilitation and early collaboration with occupational health care professionals.
authors.affiliation: Heart Center, Turku University Hospital, PO Box 52, 20521 Turku, Finland. jarmo.gunn@tyks.fi.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Gunn
authors.forename: Tuomas
authors.initials: T
authors.lastname: Kiviniemi
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.forename: Olli
authors.initials: O
authors.lastname: Kajander
authors.forename: Timo
authors.initials: T
authors.lastname: Mäkikallio
authors.forename: Markku
authors.initials: M
authors.lastname: Eskola
authors.forename: Erkki
authors.initials: E
authors.lastname: Ilveskoski
authors.forename: Kari
authors.initials: K
authors.lastname: Korpilahti
authors.forename: Jan-Ola
authors.initials: JO
authors.lastname: Wistbacka
authors.forename: Vesa
authors.initials: V
authors.lastname: Anttila
authors.forename: Jouni
authors.initials: J
authors.lastname: Heikkinen
authors.forename: Juhani
authors.initials: J
authors.lastname: Airaksinen
mesh_terms: D000367:Age Factors; D003920:Diabetes Mellitus / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D062707:Return to Work / Q000706:statistics & numerical data*; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors