Vital exhaustion after successful PTCA was independently associated with an increased risk of future cardiac events over 1.5 years (OR 3.07; P=0.04).
Cohort (n=105)
Does vital exhaustion after successful PTCA predict new cardiac events in male patients?
Vital exhaustion after successful PTCA is an independent predictor of recurrent cardiac events, highlighting the prognostic importance of psychosocial and somatic symptoms in coronary artery disease.
Effect estimate: OR 3.07
p-value: p=0.04
It has been observed that vital exhaustion, a state characterized by unusual tiredness, increased irritability and feelings of demoralization not uncommonly precedes myocardial infarction in apparently healthy individuals. This observation raised the question as to whether vital exhaustion is a marker of subclinical coronary disease. To answer that question the condition was assessed in 105 male patients (mean age 54.8 year) before and 2 weeks after successful percutaneous transluminal coronary angioplasty (PTCA) by the Maastricht questionnaire. Vital exhaustion was found to be significantly correlated with the number of diseased vessels before PTCA and to decrease significantly after PTCA. However, the association was rather modest (R2 = 0.08) and most patients remained exhausted after PTCA. During a follow-up period of 1.5 years, 32 patients (30%) experienced a new cardiac event (cardiac death, myocardial infarction, coronary artery bypass grafting, repeat PTCA, a new coronary lesion or recurrent angina with documented ischaemia). Univariate and multivariate analyses showed that the number of diseased vessels, hypercholesterolaemia, and vital exhaustion were independently associated with future events. The odds ratios were 3.74 (P = 0.02), 3.08 (P = 0.08) and 3.07 (P = 0.04), respectively. It is concluded that the tiredness preceding a cardiac event is only modestly associated with the extent of coronary artery disease and that a state of exhaustion after PTCA increases the risk for a new cardiac event.
Appels et al. (1995) conducted a cohort in Coronary artery disease post-PTCA (n=105). Vital exhaustion was evaluated on New cardiac event (cardiac death, myocardial infarction, coronary artery bypass grafting, repeat PTCA, a new coronary lesion or recurrent angina with documented ischaemia) (OR 3.07, p=0.04). Vital exhaustion after successful PTCA was independently associated with an increased risk of future cardiac events over 1.5 years (OR 3.07; P=0.04).