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Randomized Controlled Trial
. 2024 Dec;113(12):1757-1767.
doi: 10.1007/s00392-024-02552-w. Epub 2024 Oct 1.

Predictors of symptom improvement in patients with chronic coronary syndrome after percutaneous coronary intervention

Michael Wester  1 , Franziska Koll  2 , Mark Luedde  3 , Christoph Langer  4 , Markus Resch  5 , Andreas Luchner  6 , Karolina Müller  7 , Florian Zeman  7 , Michael Koller  7 , Lars S Maier  2 , Samuel Sossalla  2   8
Affiliations
Randomized Controlled Trial

Predictors of symptom improvement in patients with chronic coronary syndrome after percutaneous coronary intervention

Michael Wester et al. Clin Res Cardiol. 2024 Dec.

Abstract

Background: Decreases in symptom load and improvements in quality of life are important goals in the invasive treatment of symptomatic chronic coronary syndrome (CCS). To date, it is not known which patients profit most from the invasive treatment.

Methods: This sub-analysis of the prospective, multi-centre PLA-pCi-EBO trial includes 145 patients with symptomatic CCS and successful PCI. The prespecified endpoints angina pectoris and quality of life (Seattle Angina Questionnaire-SAQ) were assessed 1 and 6 months after PCI. Predictors of symptom improvement were analyzed by logistic regression analysis.

Results: Quality of life, physical limitation, and angina frequency markedly improved 6 months after PCI. Worse baseline health status (i.e., low SAQ subscales) was the best predictor of highly clinically relevant improvements (≥ 20 points in SAQ subscales) in symptom load and quality of life. Demographic factors (age, sex, body-mass index) and cardiovascular disease severity (number of involved vessels, ejection fraction) did not predict relevant improvements after PCI. The influence of psychologic traits has not previously been assessed. We found that neither optimism nor pessimism had a relevant effect on symptomatic outcome. However, patients who exercised more after PCI had a much larger improvement in quality of life despite no differences in physical limitation or angina frequency.

Conclusion: PCI effectively reduces symptom load and improves quality of life in patients with symptomatic CCS. Reduced baseline health status (symptom load, quality of life) are the only relevant predictors for improvements after PCI. Physical activity after PCI is associated with greater benefits for quality of life.

Trial registry: The German Clinical Trials Register registration number is DRKS0001752.

Keywords: CCS; Outcome; PCI; Quality of life.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no conflict of interests to declare. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the University of Regensburg (19-1261-101). All patients gave informed and written consent.

Figures

Fig. 1
Fig. 1
Changes in the SAQ subscales 1 and 6 months after PCI for A quality of life, B physical limitation, and C angina frequency. PCI percutaneous coronary intervention, SAQ Seattle Angina Questionnaire
Fig. 2
Fig. 2
Proportion of patients experiencing large, moderate, or no changes in the SAQ subscales for A quality of life, B physical limitation, and C angina frequency six months after PCI. PCI percutaneous coronary intervention, SAQ Seattle Angina Questionnaire
See this image and copyright information in PMC

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