Author + information
- Mohammed Qintar1,
- James Sapontis2,
- J. Aaron Grantham3,
- William Lombardi4,
- Dimitri Karmpaliotis5,
- Jeffrey Moses5,
- Kensey Gosch6,
- John Spertus6,
- Adam Salisbury7 and
- Suzanne Arnold8
- 1Saint Lukes Mid America Heart Institute, Overland Park, Kansas, United States
- 2MonashHeart, Victoria, Victoria, Australia
- 3University of Missouri Kansas City and Mid America Heart Institute, Kansas City, Missouri, United States
- 4University of Washington Medical Center, Seattle, Washington, United States
- 5NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York, United States
- 6Mid America Heart Institute, Kansas City, Missouri, United States
- 7Saint Lukes Mid America Heart Institute, Parkville, Missouri, United States
- 8Saint Luke's Hospital, Kansas City, Missouri, United States
Dyspnea is an under recognized angina equivalent that can be improved with coronary revascularization. We examined the prevalence of dyspnea and predictors of its improvement among patients selected for chronic total occlusion (CTO) PCI.
In a 12-center US CTO PCI registry, patients were assessed for dyspnea with the Rose Dyspnea Scale (RDS) at baseline and 1 month. RDS assesses patients’ level of dyspnea with common activities. Scores range 0-4; higher scores indicate more dyspnea. Dyspnea improvement was defined as a ≥1 point decrease in RDS from baseline to 1 month. Predictors of dyspnea improvement were examined with modified Poisson regression model.
Of 982 patients undergoing CTO PCI (procedure success 85%), 81% reported some dyspnea at baseline (mean RDS=2). Patients with dyspnea were more likely to be female, obese, smokers, have more comorbidities and angina. Among 716 patients with baseline dyspnea and 1 month RDS, 70% reported less dyspnea at 1 month after attempted PCI. Successful CTO PCI was associated with more frequent dyspnea improvement than failure (Figure), even after adjustment for other clinical variables (Table). Anemia, obesity, depression, CHF, and lung disease were associated with less dyspnea improvement after PCI.
Dyspnea is a common symptom among patients selected for CTO PCI and improves significantly with successful CTO PCI. Patients with other potential causes of dyspnea reported less dyspnea improvement after CTO PCI.
CORONARY: PCI Outcomes