Defining the Severity and Duration of Health Status Decrements Due to Restenosis

Research Letter Percutaneous coronary intervention (PCI) reduces angina and improves quality of life.1–3 However, restenosis requiring target vessel revascularization (TVR) has been shown to diminish the health status benefits gained after PCI.1,2 Although drug-eluting stents (DES) reduce restenosis, TVR risk is heterogeneous,4 TVR continues to occur in the DES era, and some patients continue to require bare metal stents (BMS) to minimize the duration of dual antiplatelet therapy. Because there is no reduction in death or myocardial infarction with DES compared with BMS,5 and because TVR continues to occur in both DES and BMS, better understanding of the severity and duration of health status decrements associated with TVR is needed. SAQ health status scores on multiple SAQ subscales (physical limitation, angina frequency, quality of life, and a summary score combining these subscales) were compared between patients with and without TVR using repeated measures models, including fixed effects for TVR, month of assessment, a TVR-by-month interaction, adjustment for baseline SAQ scores, and (for patients who experienced TVR) the time from TVR to SAQ assessment. To our knowledge, no previous studies have evaluated serial assessments of disease-specific health status at multiple time points before and after ischemia-driven TVR, and no previous studies have documented the duration of diminished health status after TVR.