Feelings of being disabled as a prognostic factor for mortality in men and women post-PCI up to 12 years

Background
It remains unclear whether feelings of being disabled are a relevant psychological factor that determines long term outcome after percutaneous coronary intervention (PCI). Therefore, we evaluated ‘feelings of being disabled’ as an independent risk factor for mortality 12 years post-PCI.
Methods
The study population comprised a consecutive series of CAD patients (n = 845) treated with PCI as part of the Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-SEARCH) registry. Of these patients n = 646 (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 12 year follow-up, n = 209 patients (32%) died. Of the 162 females n = 73 (45%) experienced high feelings of being disabled (High-FOBD) and of the 484 males, n = 134 (28%) reported high-FOBD. Patients with high feelings of being disabled had a two-fold increased risk of mortality at 12-year follow-up (HR = 1.86, 95% CI = 1.41–2.45). After adjusting, high feelings of being disabled remained a predictor of 12-year mortality (HR = 2.53, 95% CI = 1.30–4.90).
Conclusions
This study confirms that psychosocial variables like feelings of being disabled influence cardiac morbidity and mortality. Furthermore, there is no difference in mortality between men and women with high feelings of being disabled 12 years post-PCI. It is important that clinicians are aware that PCI-patients who feel disabled have a less favorable survival and that the difference in survival is even greater for women who feel disabled.