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Comparison of Exercise Performance and Clinical Outcome Between Functional Complete and Incomplete Revascularization
Korean Circulation Journal ; : 406-417, 2020.
Article in English | WPRIM | ID: wpr-816677
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Although percutaneous coronary intervention (PCI) is recommended to improve symptoms in patients with stable ischemic heart disease (SIHD), improvement of exercise performance is controversial. This study aimed to investigate changes in exercise duration after PCI according to functional completeness of revascularization by comparing pre- and post-PCI exercise stress test (EST).

METHODS:

Patients with SIHD were enrolled from a prospective PCI registry, and divided into 2 groups 1) functional complete revascularization (CR) group had a positive EST before PCI and negative EST after PCI, 2) functional incomplete revascularization (IR) group had positive EST before and after PCI. Primary outcome was change in exercise duration after PCI and secondary outcome was major adverse cardiac events (MACE, a composite of any death, any myocardial infarction, and any ischemia-driven revascularization) at 3 years after PCI.

RESULTS:

A total of 256 patients (149 for CR group, and 107 for IR group) were eligible for analysis. Before PCI, exercise duration was not significantly different between the functional CR and IR groups (median 540 [interquartile range; IQR, 414, 602] vs. 480 [402, 589] seconds, p=0.091). After PCI, however, the CR group had a significantly higher increment of exercise duration than the IR group (median 62.0 [IQR, 12.0, 141.0] vs. 30.0 [−11.0, 103.5] seconds, p=0.011). The functional CR group also had a significantly lower risk of 3-year MACE (6.2% vs. 26.1%; adjusted hazard ratio, 0.19; 95% confidence interval, 0.09–0.41; p<0.001).

CONCLUSIONS:

Functional CR showed a higher increment of exercise duration than functional IR.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Prospective Studies / Myocardial Ischemia / Exercise Test / Angina, Stable / Percutaneous Coronary Intervention / Myocardial Infarction Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Korean Circulation Journal Year: 2020 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Prospective Studies / Myocardial Ischemia / Exercise Test / Angina, Stable / Percutaneous Coronary Intervention / Myocardial Infarction Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Korean Circulation Journal Year: 2020 Type: Article