Application of cardiopulmonary exercise to predict death in anxious patients after PCI for coronary heart disease

  AIM   To determine the independent risk factors of cardiopulmonary exercise testing (CPET) related to death events within 5 years in coronary heart disease patients with anxiety after percutaneous coronary intervention (PCI) and to establish a prediction model for 5-year death events in such patients, so as to provide reference for the nursing and management of patients with coronary heart disease.

  METHODS  Retrospective analysis was conducted of the data of 868 coronary artery disease (CAD) patients with anxiety (GAD-7 score ≥5) who underwent PCI between October 2020 and September 2021 in the General Hospital of the Northern Theater Command. According to the results of a 5-year follow-up, 17 cases were included in the adverse event group and 851 cases were included in the event-free group. The independent risk factors associated with death were screened out by applying univariate and multifactor analysis. Then, logistic regression models were established. The receiver operating characteristic (ROC) curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the prediction efficiency and fitness of the prediction model.

  RESULTS  Three CPET parameters including forced vital capacity percentage predicted (FVC%), minimum carbon dioxide ventilation equivalent (VE/VCO₂min) and heart rate recovery after exercise (HRR) (all P<0.05) were independent risk factors for 5-year mortality risk in anxious CHD patients after PCI. The ROC curve was plotted and the area under the curve (AUC) was 0.795. Hosmer-Lemeshow was χ²=7.396, P=0.495>0.1.

  CONCLUSION  Although anxiety has certain effect on the objectivity of CPET results, some CPET parameters still have predictive power for the occurrence of 5-year death events in CHD patients with anxiety after PCI, and these parameters tend to be significantly worse in the population with death events.