Coronary artery disease: feelings of being disabled following PTCA increased the risk of dying

Clinical bottom line (level 1b)

  1. 30% of patients who underwent an elective PTCA were dead within 10 years.
  2. The risk of dying was increased with feelings of being disabled.
van Domburg et al: J Psychosomatic Research 2001; 51 : 469-477
Expires May 2004

The study

Prospective cohort study with objective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: community, the Netherlands

356 patients (aged 33 to 83; mean 60, 77% male) underwent elective PTCA

Excluded if
  • previous coronary intervention


Factors studied:
  • age, sex, cardiovascular risk factors, previous myocardial infarction, symptomatic heart failure, multivessel disease on angiography, ejection fraction < 50%

    Patients were assessed for psychological functioning using the HPPQ, a questionnaire validated in cardiac patients assesing well-being, feelings of being disabled, despondency and social inhibition.
    Multivariate Cox regression analysis was used to adjust for confounding factors.

    99.7% followed for

    Outcomes studied:
    • death

      The evidence

      outcome time to outcome number of patients/total number %
      (95% CI)      		 NNF
      (95% CI)
      death 10 years 104/356 29%
      (24% to 34%)      		 3
      (3 to 4)

        • The following factors were independently associated with death
          • feelings of being disabled
          • age
          • prior myocardial infarction
          • hypertension
          • diabetes
          • ejection fraction < 50%

      Citation

      1. van Domburg RT, Pedersen SS, van den Brand MJ, et al: feelings of being disabled as a predictor of mortality in men 10 years after percutaneous transluminal coronary angioplasty. J Psychosomatic Research 2001; 51 : 469-477
      Search Terms: from ACP Journal Club other articles noted
      Contributor: Chris Ball, May 2002
      Reviewer:

      Clinical Question.
      Patient coronary artery disease, post-PTCA
      Intervention or Exposure feelings of being disabled
      Outcome death