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Published on: January 28, 2020

Functional capacity impairment in patients with coronary artery disease: prevalence, risk factors and prognosis

Alexander Tenenbaum1, Michael Motro, Enrique Z Fisman

  • 1Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel. altenen@post.tau.ac.il

Cardiology
|January 10, 2004
PubMed

Insights

Patients with coronary artery disease (CAD) and impaired functional capacity have similar survival rates whether or not they have a history of myocardial infarction (MI). However, a history of MI significantly increases mortality risk in these patients.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Public Health

Background:

  • Coronary artery disease (CAD) can cause heart failure and functional capacity impairment, even without a history of myocardial infarction (MI).
  • Stable angina pectoris is a primary manifestation of CAD in patients without prior MI.
  • Understanding the long-term outcomes of CAD-related functional impairment is crucial for patient management.

Purpose of the Study:

  • To evaluate the long-term outcomes of CAD-related functional capacity impairment.
  • To compare survival rates in patients with and without a history of MI.
  • To identify predictors of mortality in patients with coronary artery disease.

Main Methods:

  • A cohort of 14,283 coronary patients aged 45-74 years was analyzed.
  • Patients were categorized based on the presence or absence of a history of MI.
  • Functional capacity was assessed using the New York Heart Association (NYHA) functional classes (II for mild, III-IV for advanced impairment).

Main Results:

  • The prevalence of low functional capacity was similar in patients with and without a history of MI.
  • A history of MI was a significant predictor of increased all-cause and cardiac mortality.
  • Mortality risk escalated with advanced functional capacity impairment, particularly in patients with a history of MI.

Conclusions:

  • Long-term survival differs significantly between coronary patients with and without a history of MI, favoring those without prior MI.
  • Two distinct patterns of CAD-related functional capacity impairment exist: post-MI and non-post-MI.
  • Risk stratification and management strategies should consider the presence or absence of a prior MI.
Abstract

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