{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:33:28Z","timestamp":1762079608213,"version":"3.41.2"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"\n Background<\/jats:title>\n \n Antianginal medications (\n AAMs<\/jats:styled-content>\n ) can be perceived to be less important after percutaneous coronary intervention (\n PCI<\/jats:styled-content>\n ) and may be de\u2010escalated after revascularization. We examined the frequency of\n AAM<\/jats:styled-content>\n de\u2010escalation at discharge post\u2010\n PCI<\/jats:styled-content>\n and its association with follow\u2010up health status.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In a 10\u2010center\n PCI<\/jats:styled-content>\n registry, the Seattle Angina Questionnaire was assessed before and 6\u00a0months post\u2010\n PCI<\/jats:styled-content>\n .\n AAM<\/jats:styled-content>\n de\u2010escalation was defined as fewer\n AAMs<\/jats:styled-content>\n at discharge versus admission or >25% absolute dose decrease. Of 2743\n PCI<\/jats:styled-content>\n patients (70% male),\n AAM<\/jats:styled-content>\n were de\u2010escalated, escalated, and unchanged in 299 (11%), 714 (26%), and 1730 (63%) patients, respectively. Patients whose\n AAM<\/jats:styled-content>\n were de\u2010escalated were more likely to report angina at 6\u00a0months, compared with unchanged or escalated\n AAM<\/jats:styled-content>\n (34% versus 24% versus 21%;\n P<\/jats:italic>\n <0.001). The association of\n AAM<\/jats:styled-content>\n de\u2010escalation with health status was examined using multivariable models adjusting for the predicted risk of post\u2010\n PCI<\/jats:styled-content>\n angina, completeness of revascularization, and the interaction of\n AAM<\/jats:styled-content>\n de\u2010escalation\u00d7completeness of revascularization. There was a significant interaction between\n AAM<\/jats:styled-content>\n de\u2010escalation and completeness of revascularization (\n P<\/jats:italic>\n <0.001), suggesting that\n AAM<\/jats:styled-content>\n de\u2010escalation was associated with greater impairment of health status among patients with incomplete revascularization. In patients with incomplete revascularization, de\u2010escalation of\n AAM<\/jats:styled-content>\n at discharge was associated with 43% increased angina risk (relative risk, 1.43; 95% confidence interval, 1.26\u20131.63) and worse angina\u2010related health status at 6\u00a0months post\u2010\n PCI<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n De\u2010escalation of\n AAM<\/jats:styled-content>\n occurs in 1 in 10 patients post\u2010\n PCI<\/jats:styled-content>\n , and it is associated with an increased risk of angina and worse health status, particularly among those with incomplete revascularization.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006405","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T15:34:59Z","timestamp":1508772899000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["The Impact of De\u2010escalation of Antianginal Medications on Health Status After Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"6","author":[{"given":"Mohammed","family":"Qintar","sequence":"first","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri\u2010Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arooge","family":"Towheed","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri\u2010Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengming","family":"Tang","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam C.","family":"Salisbury","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri\u2010Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Michael","family":"Ho","sequence":"additional","affiliation":[{"name":"University of Colorado, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Aaron","family":"Grantham","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri\u2010Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri\u2010Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne V.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri\u2010Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.3.309"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070829"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.07.017"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072771"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.978247"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.12559"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16980-8"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.763912"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.87.2.140"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26365"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.11.008"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcv010"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90555-X"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00397-9"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.114.000967"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000150392.70749.C7"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000752"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000020688.24874.90"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.108.829523"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.20.1927"},{"key":"e_1_3_4_22_2","unstructured":"National Clinical Guidelines Centre . 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