Abstract P273: Influence of Fatigue and Depressive Symptoms on Physical Functioning 30-Days after Treatment for Stable Coronary Artery Disease

Fatigue and depressive symptoms are pervasive in patients with coronary heart disease. It is unknown how these symptoms impact physical functioning and secondary prevention efforts in patients with stable coronary artery disease (SCAD) who are treated with either percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) or OMT alone. The purpose of this study was to evaluate the influence of fatigue and depressive symptoms on physical functioning in patients with SCAD 30-days after treatment with PCI/OMT or OMT. In this prospective design, a convenience sample of SCAD patients ( n =180, age M=65.1, SD=8.3) were recruited after treatment with PCI/OMT ( n =90) or OMT ( n =90). Data collection occurred at baseline (post-procedure) and 30-days after discharge. Mailed surveys were used at 30-days with a 52.8% (94/180) response rate (OMT n =46, PCI/OMT n =48). Measurements included the Profile of Mood States (POMS) for fatigue, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, and Short Form-36 (SF-36) for physical functioning. Two linear regression models (see table ) were conducted to evaluate physical functioning predictors at 30-days for patients treated with PCI/OMT and OMT. Fatigue was a significant contributor for physical functioning after treatment with PCI/OMT and OMT. For PCI/OMT, fatigue ( b =-.434, p <.001) and age ( b =-.245, p =.03, bivariate: r=-.414, p=.003) were significant predictors for physical functioning at 30-days. For OMT, fatigue ( b =-.630, p =.03) and gender ( b =.499, p <.01) were found to influence physical functioning after treatment, with men demonstrating lower functioning at 30-days (m=37.6, sd=9) compared to women (m=49.6, sd=9.1). Depressive symptoms did not influence physical functioning in treatment groups (PMI/OMT: b =-.239, p =.05; OMT: b =.019, p =.89). Persistent fatigue may deter patients from engaging in physical activity to promote secondary prevention. Further research is needed to investigate the impact of fatigue on physical functioning. Predictors of Physical Functioning 30-Days After Treatment for Stable Coronary Artery Disease PCI/OMT Predictors Standardized Beta t value p value 95% CI (Lower Bound) 95% CI (Upper Bound) Age −.245 −.21 .03 −.495 −.017 Gender .082 .82 .41 −.273 6.505 Ejection Fraction .097 .85 .40 −.078 .191 POMS-Fatigue −.434 −.38 <.01 −1.419 −.441 PHQ-9 Depressive Symptoms −.239 −.20 .05 −1.673 −.002 OMT Predictors Standardized Beta t value p value 95% CI (Lower Bound) 95% CI (Upper Bound) Age .268 1.96 .05 −.008 .606 Gender .499 .42 <.01 6.470 18.401 Ejection Fraction −.195 −1.31 .19 −.427 .090 POMS-Fatigue −.630 −4.37 <.01 −2.319 −.852 PHQ-9 Depressive Symptoms .019 .13 .890 −1.474 1.691 Abbreviations: CI, Confidence Interval. Model Information: PCI/OMT n=48, f=11.23, df=6, r2=.622,p<.01. OMT: n=46, f=6.91, df=6, r2=.516, p<.01