THE EFFECT OF SUCCESSFUL CORONARY ANGIOPLASTY ON FEELINGS OF EXHAUSTION

Excess fatigue and exhaustion are among the most prevalent premonitory complaints of myocardial infarction and sudden cardiac death. These f eelings may reflect subclinical heart disease, prolonged psychological tension, or both. The present study investigates to what extent coron ary artery disease explains exhaustion. For this purpose, the relation ship between the severity of coronary artery disease and exhaustion, a nd the relief of exhaustion after successful percutaneous transluminal coronary angioplasty (PTCA) is investigated. Patients who had a succe ssful elective PTCA (N = 120) were evaluated on feelings of exhaustion on admission, 2 weeks after discharge and 6 months after discharge, m aking use of the Maastricht Questionnaire. Multiple regression analyse s were used to investigate to what degree exhaustion on admission and after PTCA was determined by the extent of coronary artery disease and other patient characteristics. Severity of coronary artery disease be fore PTCA was positively associated with exhaustion and successful PTC A resulted in a significant decrease of exhaustion scores (P < 0.001). However, less than 5% of the variance of the exhaustion scores before PTCA could be explained by severity of coronary artery disease (R(2) = 0.04, F = 5.1, P = 0.03). The majority of patients who were exhauste d before PTCA remained exhausted after PTCA. Exhaustion was present in 75% of the patients before PTCA and in 65% 2 weeks after PTCA, which indicates that restoration of coronary perfusion by successful PTCA do es not substantially reduce the number of exhausted patients. At 6 mon ths, exhaustion was present in 60% of the patients, and there was no d ifference between patients with and without typical anginal complaints at that time. It is concluded that impaired coronary perfusion can on ly partially account for the tiredness in patients with CAD and that s uccessful PTCA does not substantially ameliorate feelings of exhaustio n.