Introduction: Despite remarkable growth in the use of percutaneous coronary intervention (PCI) in China over the past 30 years, little is known about the impact of PCI on patient’s health status. This study aims to describe the change in angina symptom and angina-related quality of life during the first year of recovery among Chinese patients undergoing elective PCI.
Methods: We studied 2,252 patients undergoing elective PCI to 34 hospitals from December 2012 to August 2014 in the China PEACE Prospective Study of Percutaneous Coronary Intervention. Angina frequency and angina-related quality of life were assessed with the Seattle Angina Questionnaire (SAQ) at the time of hospitalization and 1 year later. Scores ranged from 0 to 100 points, with higher scores indicating fewer symptoms and better quality of life. We categorized both 1-year scores and changes in scores to facilitate clinical interpretability. We considered a clinically poor outcome at 1 year to be an angina frequency score ≤ 60 (daily/weekly angina) or quality of life score ≤ 50 (poor/fair quality of life). A 1-year change in score ≥ 5 was improvement, a change between -5 and 5 was interpreted as no change, and ≤ -5 was interpreted as being significantly worse at 1 year than before the PCI.
Results: The average age of the cohort was 62.3 years (±10.0) and 33.4% were women. The response rate was about 74% and non-responders had similar characteristics compared with responders. At baseline, the mean angina frequency score (61.4±30.4) and quality of life score (55.7±23.9) were markedly low. 53.5% of patients had severe angina symptoms and 47.9% had poor quality of life. Over the year of recovery, a majority of patients experienced a clinically important improvement in angina (74.8%), 18.2% had no change, and 7.0% had worse symptoms. Similarly, 59.7% had significantly improved quality of life, 13.4% had no change, and 26.9% had worse quality of life. At 1 year after PCI, 6.2% of patients still had poor angina symptom and 26.4% had poor quality of life.
Conclusion: Angina symptoms had greatly improved among most of the Chinese patients over the year following elective PCI, although the improvement in quality of life was relatively small. Future research is needed to characterize patients who have no improvement or have recession in angina symptoms and quality of life after PCI.