Predictors for improvement of dyspnea
dyspnea, angina, microvascular dysfunction, atypical angina, diabetes
DIABETIC POLYNEUROPATHY, DISEASE, ATYPICAL ANGINA PECTORIS, PULMONARY DISEASE, DIABETES
We found that the presence of atypical angina pectoris symptoms increases, and that diabetes reduces the probability of less dyspnea 6 months after PCI. Data about predictors for changes of dyspnea after PCI are sparse. Qintar et al. investigated the effect of PCI in patients with chronic total occlusion on dyspnea [The finding that “atypical angina” is a predictor for better reduction of dyspnea is unexpected as clinical prejudice would conclude that these patients tend to be especially difficult to effectively treat. The prevalence of diabetes was similar in patients with typical or atypical angina pectoris; thus, diabetic polyneuropathy does not seem to be relevant in this context. We did not routinely assess microvascular dysfunction which could help differentiate the physiological differences between patients with typical and atypical angina. Furthermore, there was no difference in the percentage of patients with “atypical angina” between patients with and without concomitant dyspnea (14.4% vs 9.6%, There is a lack of studies aiming to identify clinical predictors for symptomatic improvement following PCI. However, this knowledge could substantially improve clinical practice by aiding in the selection of the best treatment strategy for each individual patient. In our sample, we found a negative association of diabetes with improved NYHA class after PCI, whereas atypical angina pectoris and a lower angina frequency showed a positive correlation. Equally important is the finding that many factors, which might be intuitively associated with symptomatic outcome, showed no significant relationship in our sample. These include for example age, body mass index, presence of multivessel disease, previous PCI, stent diameter, number of implanted stents, or pulmonary disease. Our findings thus add information to this field; however, further research is definitely warranted.