Exploring the characteristics changes of cardiopulmonary exercise testing in patients with acute coronary syndrome after PCI before and during the COVID-19 pandemic
Objective To investigate the changes in cardiopulmonary exercise testing(CPET)characteristics before and after the outbreak of COVID-19 in patients with acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI).Methods This is a cross-sectional study that included ACS patients who underwent PCI at the General Hospital of the Northern Theater Command from July 2018 to February 2023.Based on the timeline of the COVID-19 pandemic,patients were divided into two groups:the pre-pandemic group and the during-pandemic group,with January 2020 as the dividing line.Clinical data were collected from both groups,and a comparative analysis was performed on their postoperative CPET outcomes,including peak oxygen uptake(peak VO2),peak metabolic equivalents(peak MET),and other indicators.Weber's classification was used to assess cardiac function.In addition,the 7-tiem generalized anxiety disorder scale(GAD-7)and the patient health questionnaire-9(PHQ-9)were used to assess the patients'psychological anxiety and depression states,respectively.Multivariate logistic regression was used to analyze the influencing factors of CPET after PCI.Results A total of 4 310 post-PCI ACS patients were included,with an average age of(58.7±9.1)years,and 3 464(80.37％)were male.There were 1 698 patients in the pre-pandemic group and 2 612 patients in the during-pandemic group.The main indicator of the CPET,peak VO2(15.04±3.93)ml·min-1·kg-1 in the during-pandemic group,was lower than that in the pre-pandemic group(15.52±3.68)ml·min-1·kg-1,and the difference was statistically significant(P＜0.001).Multivariate logistic regression analysis showed that advanced age,female gender,high body mass index,elevated high-sensitivity C-reactive protein,reduced high-density lipoprotein cholesterol,smoking history,history of myocardial infarction,more severe ACS classification,and mild to moderate degree of depression were related to poor cardiopulmonary outcomes(P＜0.05).Conclusion The COVID-19 pandemic had a negative impact on the cardiopulmonary outcomes of ACS patients after PCI.Reduced physical activity,and increased psychological stress should be given consideration and attention regarding their impact on patients'cardiopulmonary function.
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