Objective: It remains unclear whether feelings of being disabled are a relevant psychological factor that determines outcome after percutaneous coronary intervention (PCI). Therefore, we evaluated "feelings of being disabled" as an independent risk factor for mortality 4 years post-PCI. Methods: As part of the Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-SEARCH) Registry, 658 consecutive patients (age 63 years, 75% male) completed the subscale "feelings of being disabled" of the Heart Patients Psychological Questionnaire (HPPQ), within the first month after PCI. Results: At 4-year follow-up, 8% of the patients (n=55) had died, 2% (n=16) underwent a myocardial infarction (MI), 13% (n=90) had a target-vessel revascularization (TVR), and 21% (n=137) had one or more major adverse cardiac events (MACE). One-third of the patients (32%) had high scores on "feelings of being disabled" at baseline. After adjusting for baseline characteristics, including symptoms of anxiety and depression, patients with a high score on "feelings of being disabled" had an increased risk for all cause mortality (HR=2.9, 95% CI=1.5-5.6), the composite end point mortality/MI (HR=2.4, 95% CI=1.3-4.4), and the occurrence of MACE (HR=1.7, 95% CI=1.1-2.7). Conclusion: Feelings of being disabled were an independent predictor of all-cause mortality, mortality/MI, and MACE 4 years post-PCI. These patients should be identified in clinical practice, as they warrant additional treatment, e.g., of a psychosocial nature, in addition to the standard medical treatment.

Additional Metadata
Keywords Coronary artery disease (CAD), Feelings of being disabled, Heart Patients Psychological Questionnaire (HPPQ), Mortality, Percutaneous coronary intervention (PCI)
Persistent URL dx.doi.org/10.1016/j.jpsychores.2008.10.011, hdl.handle.net/1765/24447
Citation
Simsek, C., Pedersen, S.S., van Gestel, Y.R.B.M., Erdman, R.A.M., Daemen, J., Serruys, P.W.J.C., & van Domburg, R.T.. (2009). Feelings of being disabled as a prognostic factor for mortality in the drug-eluting stent era. Journal of Psychosomatic Research, 67(1), 85–91. doi:10.1016/j.jpsychores.2008.10.011