Frequency, characteristics and location of self-reported chest pain at baseline, 2-, 6- and 12 months after percutaneous coronary intervention

Background Persistent chest pain is a common and distressing symptom that can affect 20-80% of patients after percutaneous coronary intervention (PCI). However, few studies have investigated the characteristics and location of chest pain post-PCI. Purpose This study aimed to 1) describe the frequency, characteristics and localisation of self-reported chest pain after PCI, 2) determine associations between clinical and sociodemographic factors and chest pain frequency, and 3) examine the reciprocal association between chest pain frequency and self-reported physical health using baseline and three longitudinal measuring timepoints. Methods CONCARDPCI, a prospective, multi-centre cohort study, included patients treated with PCI at seven high-volume referral PCI centres in Norway and Denmark (N=3417). Self-reported chest pain was assessed with The Seattle Angina Questionnaire-7, and self-reported physical health (PCS) was assessed with the RAND-12 questionnaire. Multiple linear regression examined associations between chest pain frequency, sociodemographic and clinical factors at all timepoints. Cross-lagged longitudinal analysis examined the association between chest pain frequency and PCS. Results Post-revascularization chest pain frequency decreased, however, 40% reported persisting chest pain. At all timepoints, the most common chest pain characteristics were pressing (37-39%) and stabbing (22-24%) in the anterior upper left quadrant (62%). Female sex, younger age, previous coronary artery disease, and insulin-treated diabetes were significantly associated with worse chest pain frequency outcome at one year follow-up. Better PCS scores predicted better angina frequency for all timepoints (p≤0.006 for all comparisons). Conclusion Despite revascularization, a substantial proportion of patients experience persistent chest pain. Post-PCI management programmes tailored toward patients at risk, such as women, those with insulin treated diabetes mellitus, and of younger age could prove beneficial in optimizing symptom experience.