Trajectories and factors influencing fear of progression in patients after percutaneous coronary intervention: a longitudinal study

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Methods Conveniently selected post-PCI patients with coronary artery disease who were hospitalized in the Department of Cardiology between April and December 2024,The Fear of Progression Questionnaire -Short Form(FoP-Q-SF) was used to assess the level of FoP in patients at four time points: immediately post-PCI, and at 1, 3, and 6 months after discharge.In addition, the potential category growth mixture model was used to identify the developmental trajectory of fear of progression, and univariate analysis and binary logistic regression were used to analyse its determinants.follow-up surveys and other variables were collected only at baseline, using online questionnaires. Results The trajectory of change in fear of progression after PCI in patients with coronary heart disease can be categorized into a high-fear-initial-rise-followed-by-decline group (31%), a medium-fear-gradual-decline group(45.7%), and a low-fear-stable group (23.3%);Occupational status, family history of coronary heart disease, the mode of PCI intervention, the level of social support received, and patients' perceptions of their disease are significant factors influencing the categorization of fear of progression trajectories in these patients post-PCI ( p < 0.05). Conclusion There is notable group heterogeneity in the fear of progression after PCI in patients with coronary heart disease. Healthcare professionals need to develop targeted interventions to reduce the level of fear of progression in patients based on the group characteristics and influencing factors of the trajectory of fear of progression. percutaneous coronary intervention fear of progression latent growth mixture modeling trajectory of change influencing factors Figures Figure 1 1 INTRODUCTION The number of patients with coronary heart disease (CHD) in China has reached approximately 11.39 million[ 1 ]. Percutaneous coronary intervention (PCI) can rapidly and efficiently relieve vascular obstruction, nevertheless, current treatments do not eliminate the risk factors for the development of the disease. The readmission rate of myocardial infarction patients is still 6.3% within 30 d after discharge from the hospital[ 2 ], and 20–30% of patients experience adverse cardiac events such as restenosis and myocardial infarction within 1 year after PCI[ 3 , 4 ],Consequently, patients often develop a fear of disease progression, which imposes a substantial psychological burden on them. The experience of surgery, interventions, near-death chest pain, and adverse drug reactions can create a profound sense of helplessness, thereby intensifying the FoP in post-PCI patients. It has been demonstrated that prolonged excessive FoP has been shown to affect patients' quality of life and is detrimental to cardiac rehabilitation[ 5 ]. Undoubtedly, fear of progression affects recurrence and survival.FoP may change significantly during the patient's recovery phase[ 6 ], and the variability of its trajectory is often overlooked by healthcare providers, leading to delayed or unnecessary interventions and wasted clinical resources. Understanding FoP in post-PCI patients is paramount for developing timely and effective interventions. 1.1 Backgroud Fear of Progression (FoP) is an individual's concern about the symptoms of the disease itself, as well as about the possibility that the disease may further deteriorate, get out of control, or lead to a life-threatening condition[ 7 ]. FoP persists from the post-PCI to the rehabilitation phase[ 8 ], posing a continuous psychological burden on patients. According to previous studies, the causes of FoP are multifaceted, including sociodemographic, disease-related, and psychological factors that may contribute to FoP in post-PCI patients[ 5 ].FoP is a psychological stressor for almost all patients with chronic diseases[ 9 , 10 ].FoP is a key psychosocial issue among post-PCI patients, but research on fear of disease progression after PCI in patients with coronary artery disease has been mostly limited to cross-sectional surveys[ 5 , 11 ], lacking dynamic tracking of changes in the FoP. 1.2 The study This study is a longitudinal study to identify the trajectory categories of FoP changes after PCI in patients with CHD by Latent Growth Mixture Modeling (LGMM) and analyze the influencing factors, so as to provide reference for healthcare professionals to develop a targeted intervention program. 2 METHODS 2.1 Study subjects Convenience sampling was employed to recruit patients with CHD who underwent PCI during their hospitalization in the cardiovascular medicine department of a tertiary-level hospital in Binzhou City from April to December 2024 as study subjects. Inclusion criteria:①Patients met the diagnostic criteria outlined in the “Stable Coronary Heart Disease Diagnostic and Treatment Guidelines”[ 12 ];②Patients underwent successful PCI for the first time;③Patients were aged ≥ 18 years;④Patients provided informed consent and participated voluntarily. Exclusion criteria:①Combined with other serious organic lesions;②unable to communicate;③Patients currently participating in other research projects. Exclusion Criteria: Loss of visit due to various reasons without completing the questionnaire and data collection. Based on the sample content estimation table for a single-group repeated measurement design provided by Barcikowski and Robey[ 13 ], with an average correlation coefficient ( r ) of 0.50, an effect size ( f ) of 0.14 and a significance level ( α ) of 0.01, the required sample size was calculated to be n = 202. According to the LGMM identification accuracy requirements [ 14 ], the sample size needed to be at least 200 cases. Considering a 20% loss of follow-up rate, the final sample size was adjusted to 258. 2.2Survey tools 2.2.1Demographic and clinical variables The content of the questionnaire is self-determined, mainly including gender, age, place of residence, education, marital status, occupational status, per capita monthly household income, medical payment method, BMI, duration of disease, family history, number of hospitalizations due to CHD, mode of intervention, and non-cardiovascular diseases. 2.2.2The Fear of Progression Questionnaire -Short Form(FoP-Q-SF) Fear of Progression Questionnaire-Short Form was developed by Mehnert and Herschbach [ 15 ]in 2006.translated and revised by domestic scholars Wu[ 16 ]in 2015. The scale includes 2 dimensions, namely physical health and social family, with 12 entries, each entry scoring range of 1–5 points, and total score of 12–60 points, with higher scores indicating that patients' FoP is more serious[ 17 ]. The Cronbach′s α coefficient of this scale was 0.88, with good reliability and validity. 2.2.3The Perceived Social Support Scale(PSSS) The scale was compiled by Zimet[ 18 ], and Chineseized by Jiang[ 19 ], which includes three dimensions, namely family, friends and others, with a total of 12 entries, each of which has a score range of 1 to 7, ranging from “Strongly Disagree” to “Strongly Agree” in order of magnitude. The total score ranges from 12 to 84, with higher scores indicating more social support. The Cronbach's alpha coefficient for this scale was 0.92. 2.2.4The Brief Illness Perception Questionnaire(BIPQ) The scale was developed by Broadbent[ 20 ]and Chineseized by Mei[ 21 ], the questionnaire includes 9 items, the first 8 items are scored on a scale of 0–10, the 9th item is an open-ended question, and the total score ranges from 0–80, with higher scores indicating that the patient's negative disease perceptions are greater. The Cronbach's alpha coefficient of the scale was 0.77. 2.3 Data collection This study is a prospective study, with reference to the selection of time points for previous longitudinal studies on the FoP, combined with the characteristics of the changes in the psychological state of CHD patients after PCI[ 22 – 24 ], four specific time points were chosen for the follow-up survey: the second day Post-surgery (T0), one month Post-discharge (T1), three months (T2), and six months (T3). The researcher thoroughly explained the study's objectives and significance to the participants and distributed the questionnaires only after obtaining their informed consent and having them sign the consent form. At the first survey (T0), the General Information Questionnaire, FoP-Q-SF, PSSS and BIPQ were used for data collection; only FoP-Q-SF was used at the follow-up stage from T1 to T3, and the patients' FoP was assessed in the form of a combination of outpatient clinic and telephone follow-up. 2.4 Statistical treatment SPSS 26.0 and Mplus8.3 statistical software were applied for statistical analyses.Latent variable growth mixed model analyses were conducted using Mplus8.3 statistical software, and the number of model categories started from “1” and gradually increased, and the model fitting results were comprehensively evaluated to select the model with the best fitting indexes. The fit indexes included the Akaike information criterion (AIC), BIC and sample size adjusted BIC (aBIC), the smaller the value, the better the fit.The entropy, which ranges from 0 to 1, represents classification accuracy. A higher value of entropy indicates a better model fit. The principle of both is to compare the fit difference between k-1 and k-category models, with a significance level of p < .05 indicating that the k-category model is better than the k-1 category model[ 25 ]. To ensure clinical meaningfulness, each category was required to include at least 5% of the participants[ 26 ].SPSS26.0 software was used for statistical analysis of the data. Measurements that conformed to normal distribution were expressed as mean and standard deviation, and count data were expressed as number of cases, percentage, or percent.Univariate analysis was performed using ANOVA test and F-test, and multivariate analysis was performed using multicategorical logistic regression for FoP. Differences were considered statistically significant at P < 0.05. 2.5 Ethical Considerations The study was approved by the Ethics Committee of Binzhou Medical University Hospital (NO:KYLL-362). Relevant information about the purpose and significance of the study was explained to the participants, and an informed consent form was signed before data collection. 3 RESULTS 3.1General information about the study population and scores on each scale A total of 258 patients completed al three follow-up surveys, while 31 patients were lost to follow-up due to loss of contact or voluntary withdrawal,resulting in a loss rate of 10.7%. Age 60 years 138 cases; male 184 cases, female 74 cases; marital status married 233 cases, unmarried/divorced/widowed 25 cases; BMI <24kg/m² 81 cases, ≥24kg/m² 117 cases; duration of the disease 5 years 36 cases; number of hospitalizations due to CHD 3 times 9 cases; 204 cases with non-cardiovascular diseases, 54 cases without non-cardiovascular diseases. FoP scores were (33.29±4.04), (34.05±5.89), (31.11±3.85), and (29.57±3.25) during the T0 to T3 periods, respectively. The PSSS and BIPQ scores on day 2 after PCI ，as shown in Table1. 3.2 Identification of trajectories of change in FoP after PCI in CHD patients Using the FoP scores at 4 different time points after PCI in patients with CHD as an observational index, a sample of 258 eligible cases was included in the model analysis, which was set as a free estimation of temporal parameters in LGMM, and the model was fitted to each of the 1 to 5 potential categories of possible change trajectories of FoP. As shown in Table 2, when the model categories were increased from 1 to 3, AIC, BIC, and aBIC decreased and Entropy>0.8, and LRT and BLRT reached a significant level; the decrease of AIC, BIC, and aBIC slowed down significantly when increased from 3 to 4, Entropy decreased and LRT and BLRT did not reach a significant level, and on balance, the 3-category model was considered the best model. Named according to the initial level and change trend of each potential category of FoP, as shown in Figure 1.①High-fear-initial-rise-followed-by-decline group (C1): the level of FoP showed a trend of first rising and then falling,with a total of 80 cases (31%);②medium-fear-gradual-decline group (C2): the level of fear of progression was in the middle and showed a trend of slowly falling, with a total of 118 cases (45.7%);③low-fear-stable group (C3):The level of fear of progression was low and showed an insignificant trend of change, with a total of 60 cases (23.3%). Table 2 LGMM Fitting of FoP After PCI in CHD Patients Model AIC BIC aBIC Entropy LMR(P) BLRT(P) Class probability(%) 1 4842.146 4874.123 4845.590 100.0 2 4549.276 4591.911 4553.867 1.000 ＜0.001 ＜0.001 23.3/76.7 3 4482.384 4535.679 4488.124 0.950 ＜0.001 ＜0.001 31.0/45.7/23.3 4 4476.656 4540.609 4483.543 0.905 0.094 0.107 9.0/45.3/31.4/14.3 5 4472.439 4547.051 4480.474 0.868 0.202 0.221 44.6/8.5/14.7/10.9/21.3 Abbreviation: AIC Akaike information criterion, BIC Bayesian information criterion, aBIC adjusted BIC, LMRT The Vuong Lo–Mendell–Rubin likelihood ratio test, BLRT bootstrapped likelihood ratio test. 3.3 Single factor analysis of influencing factors of the trajectory of change in FoP after PCI in patients with CHD The results revealed statistically significant differences in the distributional comparisons of age, gender, marital status, BMI, duration of disease, number of hospitalizations due to CHD, and non-cardiovascular diseases among the three groups ( P < 0.05). Refer to Table 1 for more detailed information. Table 1 Univariate analysis of general information and categories of trajectory of change in FoP after PCI in patients with CHD Project Class 1 (n= 80) Class 2 (n= 118) Class 3 (n= 60） F/X ² P Residence 22.003 ＜0.001 City 21 30 35 Rural 59 88 25 Educational level 23.339 ＜0.001 Junior high school and below 69 100 34 Senior high school 9 17 19 College and above 2 1 7 Occupation 22.271 ＜0.001 Employed 53 52 16 Non-Employed 27 66 44 Monthly income (yuan) 31.849 ＜0.001 ＜3000 37 62 23 3000-500 35 40 11 ＞5000 8 16 26 Medical Payment Methods 24.994 ＜0.001 employee medical insurance 8 33 28 Resident medical insurance 68 83 31 New Agricultural Cooperative Society 4 2 1 Interventional modalities 63.973 ＜0.001 stent implantation 24 83 39 balloon dilatation 2 5 13 stent implantation＋balloon dilatation 54 30 8 family history 10.29 0.006 Yes 21 12 7 No 59 106 53 PSSS（score，`X±S） 62.76±5.462 68.88±4.253 70.28±4.310 56.691 ＜0.001 BIPQ（score，`X±S） 48.19±4.897 45.61±4.368 41.82±6.312 27.422 ＜0.001 Abbreviations: PSSS, perceived social support scale;BIPQ,brief illness perception questionnaire. 3.4 Logistic regression analysis of influencing factors of the trajectory of change in FoP after PCI in patients with CHD Logistic regression analysis was conducted, with trajectory category analysis results serving as the dependent variable and all significant variables identified in the single-factor analysis as independent variables.Class 3 was used as the reference group. The results showed that occupational status, family history of CHD, mode of intervention, comprehension of social support, and disease perception were factors influencing the FoP after PCI in patients with CHD ( P <0.05), See Table 3 for details. Table 3 Multi-classification logistic regression analysis ofthe trajectory of change in FoP after PCI in patients with CHD( n =258) Groups Related factors reference groups β SE Wald X² P OR 95% Cl C3vs.C1 PSSS -0.326 0.073 19.723 ＜0.001 0.722 0.625~0.833 BIPQ 0.307 0.068 20.404 ＜0.001 1.360 1.190~1.554 Employed Non-Employed 2.082 0.755 7.600 0.006 8.017 1.825~35.217 family history:Yes No 2.222 0.784 8.032 0.005 9.221 1.984~42.855 balloon dilatation stent implantation＋balloon dilatation -3.061 1.366 5.024 0.025 0.047 0.003~0.681 C3vs.C2 BIPQ 0.160 0.051 9.997 0.002 1.173 1.063~1.295 Employed Non-Employed 1.616 0.523 9.532 0.002 5.033 1.804~14.041 balloon dilatation stent implantation＋balloon dilatation -2.256 0.818 7.611 0.006 0.105 0.021~0.520 4 DISCUSSION 4.1Different trajectories of change in FoP after PCI in patients with CHD and their main characteristics The findings of this study revealed that the overall trend of FoP after PCI in patients with CHD was gradually decreasing in patients with CHD after PCI was a gradual decline, which aligns with the results reported by Tian[8]. The LGMM model demonstrated the existence of three categories of the trajectory of change in the FoP in patients with CHD after PCI, indicating the existence of group heterogeneity in the FoP in patients with CHD after PCI. Specifically, 31% of the patients were classified into the high fear Initially rising then falling group, the level of FoP peaked at T1, which may be related to the lack of knowledge of the disease in postoperative patients and the need for long-term medication, which led to greater changes in the body and life, and a heavier psychological burden, and showed a downward trend over time, as the patients gradually adapted to the changes brought about by the operation, and had a more comprehensive understanding of the disease to alleviate their FoP.45.7% of the patients belonged to the medium fear slow decline group, that is, the average value of the patients' starting FoP scores was at a medium level, and the curve from T0 to T3 showed a slow decline trend; 23.3% of the patients belonged to the low-fear-stable group, that is, the average value of the patients' starting FoP scores was at a low level, and the trend of change during the follow-up period was not significant. Therefore, healthcare professionals should focus on the psychological status of the T0~T1 stage of patients in the high fear first rising then falling group, and provide the necessary psychological guidance and support to help patients reduce the level of FoP, and reduce the emergence of adverse emotions and behaviors. 4.2 Analysis of factors influencing the potential column of FoP after PCI in patients with CHD 4.2.1 Occupational status The results of this study indicate that employed patients were more likely to be categorized into the high-fear-initial-rise-followed-by-decline group and the medium-fear-gradual-decline group after surgery compared unemployed patients, which aligns with the results of the study by Wagner[27]. The reasons for this may be analyzed as Follows:①Employed patients are more concerned about the impact of the disease on their work and are more concerned about the disease progression compared to unemployed patients; ② The heavy workload and stressful working environment after returning to work is not conducive to cardiac rehabilitation, leading to increased concerns about their health status and disease progression. Therefore, healthcare professionals should inform patients of the appropriate time to return to work, adjust their work schedules appropriately, instruct them to arrange rehabilitation exercises reasonably,maintain a positive mindset, and view the impact of the disease on work with a positive attitude. 4.2.2 Family history of CHD The results of this study found that patients with a family history of CHD had a higher probability of entering the high fear-first-rise-last-fall group.Tommaso [28]found that family history of cardiovascular disease is an independent risk factor for morbidity. The reason for this analysis may be that patients with a family history of CHD means facing a high risk of recurrence and concerns about heredity, and are more likely to have a strong FoP. Therefore, healthcare professionals should focus on patients with a family history of CHD, explain the knowledge about the disease and family genetics, improve patients' knowledge of the disease, and reduce their FoP. 4.2.3 Interventional modalities The results of this study found that patients who underwent the combined intervention of stent + balloon placement had a higher likelihood of being classified into the high-fear-initial-rise-followed-by-decline group. It has been demonstrated[29,30]that the incidence of restenosis is 39.43% after stenting and 13.3% after ballooning alone. Compared with patients who underwent stent or balloon interventional modalities, patients who underwent the combined stent + balloon procedure perceived their condition as more severe, and the fear of adverse events such as stent fracture and restenosis of the dilated vessel after the procedure increased patients' fear. Therefore, healthcare professionals can organize regular knowledge lectures to help patients acquire accurate knowledge about the disease, correct misconceptions, monitor changes in their condition, and adhere to timely follow-ups, thereby alleviating their psychological burden. 4.2.4 Perceived Social Support Scale The findings of this study revealed that patients Who received higher levels of social support exhibited a higher probability of entering the moderate fear slowly declining group and the low fear stabilizing group, and high levels of social support would reduce patients' FoP, similar to the results of foreign studies [31]. Good social support may help patients better cope with stressful events, alleviate the fear of disease, motivate patients to cooperate with treatment, and improve overall survival [32]. Therefore, a sound social support system can reduce patients' trauma due to the disease, and healthcare professionals should provide individualized help for different patients and encourage patients' family members and relatives to increase their attention and support for patients in order to improve the level of patients' social support and reduce their FoP. 4.2.5 Brief Illness Perception Questionnaire The results of this study showed that patients with higher levels of disease perception had a higher probability of entering the high fear first ascending then descending group. There is a correlation between disease perception and FoP, and the higher the level of disease perception, the higher the level of FoP will be in patients [33]. In this study, the disease perception of CHD patients after PCI is mainly manifested in the belief that the disease duration is long and the need for lifelong medication after surgery, which has a greater impact on life and psychology. Therefore, healthcare professionals should provide appropriate health education and rehabilitation knowledge for the psychological changes of patients at different time points to help patients strengthen their understanding of recognizing their own diseases and establish correct disease perception. 4.3 Limitation First, this study employed a convenience sampling method and investigated patients who underwent PCI for CHD in only one tertiary hospital, which limits the representativeness of the study population and the generalizability of the findings. Second, the follow-up period of this study was only 6 months, however, the cardiac recovery period may require a longer duration, and the follow-up time may have infiuenced the results of the study. Therefore, future researchers may consider conducting a multicenter investigation with a larger sample size and a longer follow-up period to explore the long-term dynamic trend of FoP after PCI in patients with CHD, which may provide a reference for the implementation of precise interventions. 5 CONCLUSION The results of this study showed that three categories existed in the trajectory of FoP change after PCI in patients with CHD: a low-fear stabilized group, a medium-fear slowly declining group, and a high-fear first-rising-then-declining group. There is significant heterogeneity within the population, Which is influenced by factors such as occupational status, family history of coronary artery disease, mode of intervention, social support, and disease perception. In the future, healthcare professionals should enhance the assessment of the dynamics of FoP and develop precise and effective interventions based on the FoP of different patients at different times. Declarations Acknowledgements We would like to thank all participants for agreeing to cooperate with us in completing the questionnaires and undergoing followup visits. We would also like to thank all colleagues involved in this study who contributed to the design and completion of this study. Author contributions HM. S. and XY. X.: Formal analysis, Writing - original draft, Writing - review &editing. XX.W., JY. Z.,and YJ. L.: Investigation, review & editing. SS. M.,and F. Z.: Investigation, Supervision, Writing - review & editing. All authors reviewed the manuscript. Funding This study was supported by the Shandong Province Traditional Chinese Medicine Program(M-20244902). Data availability The datasets utilized and analyses conducted in the current study are available upon reasonable request from the corresponding author. Ethics approval and consent to participate This study adheres to the principles of the Declaration of Helsinki and has been approved by the Ethics Committee of the Affiliated Hospital of Binzhou Medical University (KYLL-362). All participants provided written informed consent to confirm their voluntary participation. The informed consent also ensured that the participants could withdraw at any time, which did not affect their normal treatment. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Clinical trial number Not applicable. References China WCOT. Report on Cardiovascular Health and Diseases in China 2021: An Updated Summary. Biomed Environ Sci. 2022;35:573–603. Zengwu W, Liyuan M, Mingbo L, Jing F, Shengshou H. Summary of the 2022 report on cardiovascular health and diseases in China. Chin Med J (Engl). 2023;136:2899–908. Tao S, Tang X, Yu L, Li L, Zhang G, Zhang L, Huang L, Wu J. 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Analysis of factors influencing the trajectory of fatigue in maintenance haemodialysis patients: a longitudinal study. Int Urol Nephrol. 2024;56:3825–33. Kim S. Determining the Number of Latent Classes in Single- and Multiphase Growth Mixture Models. Struct Equation Modeling: Multidisciplinary J. 2014;21:263–79. Amouzegar A, Honarvar M, Masoumi S, Khalili D, Azizi F, Mehran L. Trajectory patterns of metabolic syndrome severity score and risk of type 2 diabetes. J Transl Med. 2023;21:750. de Giorgis T, Giannini C, Scarinci A, D'Adamo E, Agostinelli S, Chiarelli F, Mohn A. Family history of premature cardiovascular disease as a sole and independent risk factor for increased carotid intima-media thickness. J Hypertens. 2009;27:822–8. Zhang J, Zhang Q, Zhao K, Bian Y, Liu Y, Xue Y. Risk factors for in-stent restenosis after coronary stent implantation in patients with coronary artery disease: A retrospective observational study. Med (Baltim). 2022;101:e31707. Jackson D, Tong D, Layland J. A review of the coronary applications of the drug coated balloon. Int J Cardiol. 2017;226:77–86. Ma H, Hu K, Wu W, Wu Q, Ye Q, Jiang X, Tang L, He Y, Yang Q. Illness perception profile among cancer patients and its influencing factors: A cross-sectional study. Eur J Oncol Nurs. 2024;69:102526. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6678162","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":477696470,"identity":"902ef79a-884b-464d-8f5e-e2e30664d0fd","order_by":0,"name":"Haimin Sun","email":"","orcid":"","institution":"Binzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Haimin","middleName":"","lastName":"Sun","suffix":""},{"id":477696471,"identity":"c7040fcc-0eb4-4a92-984e-b11fe048f985","order_by":1,"name":"Fang Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuUlEQVRIie3PMQrCMBTG8YbAA+GVrJYK3ZxTBEUoepVCoVMHJ+kYKGR0jhdxTunQpdQDdBG8QHoDVxfhdXPIb/7+wxcEnvePeNc7V2cohKImUJbMDOUmMpacVFu+0l0mVU4sEo3wZvqJMrDMzRUhYTrsd5dxwgNXPLo/CAlPbnlsrhMelQUeUhIAlDHCiNLmxAQB9zFquyBZAxSpGQqMTNvQviSaty9Xn85CNK2bKckXppbtPc/zvN8+hjAzikBTZFAAAAAASUVORK5CYII=","orcid":"","institution":"Affiliated Hospital of Binzhou Medical College","correspondingAuthor":true,"prefix":"","firstName":"Fang","middleName":"","lastName":"Zhang","suffix":""},{"id":477696472,"identity":"4f712003-f6bc-4a9b-9181-5cfb5bbb23e5","order_by":2,"name":"Xinxia Wang","email":"","orcid":"","institution":"Affiliated Hospital of Binzhou Medical College","correspondingAuthor":false,"prefix":"","firstName":"Xinxia","middleName":"","lastName":"Wang","suffix":""},{"id":477696473,"identity":"10660ea2-c0a0-4f4b-a654-3cc657013816","order_by":3,"name":"Xiangyu Xu","email":"","orcid":"","institution":"Binzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xiangyu","middleName":"","lastName":"Xu","suffix":""},{"id":477696474,"identity":"66794ed6-7f7e-4b7f-93c2-e1fe9f2b7d60","order_by":4,"name":"Shasha Ma","email":"","orcid":"","institution":"Affiliated Hospital of Binzhou Medical College","correspondingAuthor":false,"prefix":"","firstName":"Shasha","middleName":"","lastName":"Ma","suffix":""},{"id":477696475,"identity":"0df00c59-8c79-4c45-99e0-7a5a93c1ae6f","order_by":5,"name":"Yujia Liu","email":"","orcid":"","institution":"Binzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yujia","middleName":"","lastName":"Liu","suffix":""},{"id":477696476,"identity":"00afccf7-6069-4d96-b251-cef9bd27c039","order_by":6,"name":"Jiayue Zhao","email":"","orcid":"","institution":"Binzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jiayue","middleName":"","lastName":"Zhao","suffix":""}],"badges":[],"createdAt":"2025-05-16 07:23:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6678162/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6678162/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85822121,"identity":"895f1ae7-7b69-408a-a7d7-fef63ea343a5","added_by":"auto","created_at":"2025-07-02 06:44:39","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":124009,"visible":true,"origin":"","legend":"\u003cp\u003eTrajectory of the Potential Category Growth Model for FoP after PCI in CHD Patients\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6678162/v1/bea960e7a8197c0c514186d4.jpg"},{"id":87177476,"identity":"d92d0757-3307-4693-b5cc-9df7b0929a32","added_by":"auto","created_at":"2025-07-21 09:03:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1192321,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6678162/v1/a9b35528-c866-4daf-84c5-82168f878ecf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Trajectories and factors influencing fear of progression in patients after percutaneous coronary intervention: a longitudinal study","fulltext":[{"header":"1 INTRODUCTION","content":"\u003cp\u003eThe number of patients with coronary heart disease (CHD) in China has reached approximately 11.39 million[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Percutaneous coronary intervention (PCI) can rapidly and efficiently relieve vascular obstruction, nevertheless, current treatments do not eliminate the risk factors for the development of the disease. The readmission rate of myocardial infarction patients is still 6.3% within 30 d after discharge from the hospital[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], and 20\u0026ndash;30% of patients experience adverse cardiac events such as restenosis and myocardial infarction within 1 year after PCI[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e],Consequently, patients often develop a fear of disease progression, which imposes a substantial psychological burden on them. The experience of surgery, interventions, near-death chest pain, and adverse drug reactions can create a profound sense of helplessness, thereby intensifying the FoP in post-PCI patients. It has been demonstrated that prolonged excessive FoP has been shown to affect patients' quality of life and is detrimental to cardiac rehabilitation[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Undoubtedly, fear of progression affects recurrence and survival.FoP may change significantly during the patient's recovery phase[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], and the variability of its trajectory is often overlooked by healthcare providers, leading to delayed or unnecessary interventions and wasted clinical resources. Understanding FoP in post-PCI patients is paramount for developing timely and effective interventions.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Backgroud\u003c/h2\u003e \u003cp\u003eFear of Progression (FoP) is an individual's concern about the symptoms of the disease itself, as well as about the possibility that the disease may further deteriorate, get out of control, or lead to a life-threatening condition[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. FoP persists from the post-PCI to the rehabilitation phase[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], posing a continuous psychological burden on patients. According to previous studies, the causes of FoP are multifaceted, including sociodemographic, disease-related, and psychological factors that may contribute to FoP in post-PCI patients[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].FoP is a psychological stressor for almost all patients with chronic diseases[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].FoP is a key psychosocial issue among post-PCI patients, but research on fear of disease progression after PCI in patients with coronary artery disease has been mostly limited to cross-sectional surveys[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], lacking dynamic tracking of changes in the FoP.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e1.2 The study\u003c/h2\u003e \u003cp\u003eThis study is a longitudinal study to identify the trajectory categories of FoP changes after PCI in patients with CHD by Latent Growth Mixture Modeling (LGMM) and analyze the influencing factors, so as to provide reference for healthcare professionals to develop a targeted intervention program.\u003c/p\u003e \u003c/div\u003e"},{"header":"2 METHODS","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study subjects\u003c/h2\u003e \u003cp\u003eConvenience sampling was employed to recruit patients with CHD who underwent PCI during their hospitalization in the cardiovascular medicine department of a tertiary-level hospital in Binzhou City from April to December 2024 as study subjects. Inclusion criteria:①Patients met the diagnostic criteria outlined in the \u0026ldquo;Stable Coronary Heart Disease Diagnostic and Treatment Guidelines\u0026rdquo;[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e];②Patients underwent successful PCI for the first time;③Patients were aged\u0026thinsp;\u0026ge;\u0026thinsp;18 years;④Patients provided informed consent and participated voluntarily. Exclusion criteria:①Combined with other serious organic lesions;②unable to communicate;③Patients currently participating in other research projects. Exclusion Criteria: Loss of visit due to various reasons without completing the questionnaire and data collection. Based on the sample content estimation table for a single-group repeated measurement design provided by Barcikowski and Robey[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], with an average correlation coefficient (\u003cem\u003er\u003c/em\u003e) of 0.50, an effect size (\u003cem\u003ef\u003c/em\u003e) of 0.14 and a significance level (\u003cem\u003eα\u003c/em\u003e) of 0.01, the required sample size was calculated to be n\u0026thinsp;=\u0026thinsp;202. According to the LGMM identification accuracy requirements [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], the sample size needed to be at least 200 cases. Considering a 20% loss of follow-up rate, the final sample size was adjusted to 258.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.2Survey tools\u003c/h2\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1Demographic and clinical variables\u003c/h2\u003e \u003cp\u003eThe content of the questionnaire is self-determined, mainly including gender, age, place of residence, education, marital status, occupational status, per capita monthly household income, medical payment method, BMI, duration of disease, family history, number of hospitalizations due to CHD, mode of intervention, and non-cardiovascular diseases.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2The Fear of Progression Questionnaire -Short Form(FoP-Q-SF)\u003c/h2\u003e \u003cp\u003eFear of Progression Questionnaire-Short Form was developed by Mehnert and Herschbach [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]in 2006.translated and revised by domestic scholars Wu[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]in 2015. The scale includes 2 dimensions, namely physical health and social family, with 12 entries, each entry scoring range of 1\u0026ndash;5 points, and total score of 12\u0026ndash;60 points, with higher scores indicating that patients' FoP is more serious[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The Cronbach\u0026prime;s α coefficient of this scale was 0.88, with good reliability and validity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.2.3The Perceived Social Support Scale(PSSS)\u003c/h2\u003e \u003cp\u003eThe scale was compiled by Zimet[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and Chineseized by Jiang[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], which includes three dimensions, namely family, friends and others, with a total of 12 entries, each of which has a score range of 1 to 7, ranging from \u0026ldquo;Strongly Disagree\u0026rdquo; to \u0026ldquo;Strongly Agree\u0026rdquo; in order of magnitude. The total score ranges from 12 to 84, with higher scores indicating more social support. The Cronbach's alpha coefficient for this scale was 0.92.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e2.2.4The Brief Illness Perception Questionnaire(BIPQ)\u003c/h2\u003e \u003cp\u003eThe scale was developed by Broadbent[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]and Chineseized by Mei[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], the questionnaire includes 9 items, the first 8 items are scored on a scale of 0\u0026ndash;10, the 9th item is an open-ended question, and the total score ranges from 0\u0026ndash;80, with higher scores indicating that the patient's negative disease perceptions are greater. The Cronbach's alpha coefficient of the scale was 0.77.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Data collection\u003c/h2\u003e \u003cp\u003eThis study is a prospective study, with reference to the selection of time points for previous longitudinal studies on the FoP, combined with the characteristics of the changes in the psychological state of CHD patients after PCI[\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], four specific time points were chosen for the follow-up survey: the second day Post-surgery (T0), one month Post-discharge (T1), three months (T2), and six months (T3). The researcher thoroughly explained the study's objectives and significance to the participants and distributed the questionnaires only after obtaining their informed consent and having them sign the consent form. At the first survey (T0), the General Information Questionnaire, FoP-Q-SF, PSSS and BIPQ were used for data collection; only FoP-Q-SF was used at the follow-up stage from T1 to T3, and the patients' FoP was assessed in the form of a combination of outpatient clinic and telephone follow-up.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Statistical treatment\u003c/h2\u003e \u003cp\u003eSPSS 26.0 and Mplus8.3 statistical software were applied for statistical analyses.Latent variable growth mixed model analyses were conducted using Mplus8.3 statistical software, and the number of model categories started from \u0026ldquo;1\u0026rdquo; and gradually increased, and the model fitting results were comprehensively evaluated to select the model with the best fitting indexes. The fit indexes included the Akaike information criterion (AIC), BIC and sample size adjusted BIC (aBIC), the smaller the value, the better the fit.The entropy, which ranges from 0 to 1, represents classification accuracy. A higher value of entropy indicates a better model fit. The principle of both is to compare the fit difference between k-1 and k-category models, with a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;.05 indicating that the k-category model is better than the k-1 category model[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. To ensure clinical meaningfulness, each category was required to include at least 5% of the participants[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].SPSS26.0 software was used for statistical analysis of the data. Measurements that conformed to normal distribution were expressed as mean and standard deviation, and count data were expressed as number of cases, percentage, or percent.Univariate analysis was performed using ANOVA test and F-test, and multivariate analysis was performed using multicategorical logistic regression for FoP. Differences were considered statistically significant at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Ethical Considerations\u003c/h2\u003e \u003cp\u003e The study was approved by the Ethics Committee of Binzhou Medical University Hospital (NO:KYLL-362). Relevant information about the purpose and significance of the study was explained to the participants, and an informed consent form was signed before data collection.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 RESULTS","content":"\u003cp\u003e\u003cstrong\u003e3.1General information about the study population and scores on each scale\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 258 patients\u0026nbsp;completed al\u0026nbsp;three follow-up surveys, while 31 patients were lost to follow-up due to loss of contact or voluntary withdrawal,resulting in a loss rate of 10.7%. Age \u0026lt;40 years 5 cases, 40~60 years 115 cases, \u0026gt;60 years 138 cases; male 184 cases, female 74 cases; marital status married 233 cases, unmarried/divorced/widowed 25 cases; BMI \u0026lt;24kg/m\u0026sup2; 81 cases, \u0026ge;24kg/m\u0026sup2; 117 cases; duration of the disease \u0026lt;1 year 191 cases, 1~5 years 31 cases, \u0026gt;5 years 36 cases; number of hospitalizations due to CHD \u0026lt;1 time 139 cases, 1~3 times 110 cases, \u0026gt;3 times 9 cases; 204 cases with non-cardiovascular diseases, 54 cases without non-cardiovascular diseases. FoP scores were (33.29\u0026plusmn;4.04), (34.05\u0026plusmn;5.89), (31.11\u0026plusmn;3.85), and (29.57\u0026plusmn;3.25) during the T0 to T3 periods, respectively. The PSSS and BIPQ scores on day 2 after PCI\u0026nbsp;，as shown in Table1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Identification of trajectories of change in FoP after PCI in CHD patients\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUsing the FoP scores at 4 different time points after PCI in patients with CHD as an observational index, a sample of 258 eligible cases was included in the model analysis, which was set as a free estimation of temporal parameters in LGMM, and the model was fitted to each of the 1 to 5 potential categories of possible change trajectories of FoP. As shown in Table 2, when the model categories were increased from 1 to 3, AIC, BIC, and aBIC decreased and Entropy\u0026gt;0.8, and LRT and BLRT reached a significant level; the decrease of AIC, BIC, and aBIC slowed down significantly when increased from 3 to 4, Entropy decreased and LRT and BLRT did not reach a significant level, and on balance, the 3-category model was considered the best model.\u003c/p\u003e\n\u003cp\u003eNamed according to the initial level and change trend of each potential category of FoP, as shown in Figure 1.①High-fear-initial-rise-followed-by-decline group (C1): the level of FoP showed a trend of first rising and then falling,with a total of 80 cases (31%);②medium-fear-gradual-decline group (C2): the level of fear of progression was in the middle and showed a trend of slowly falling, with a total of 118 cases (45.7%);③low-fear-stable group (C3):The level of fear of progression was low and showed an insignificant trend of change, with a total of 60 cases (23.3%).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"645\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 645px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003cstrong\u003eTable 2\u003c/strong\u003e LGMM Fitting of FoP After PCI in CHD Patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003eAIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003eBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003eaBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003eEntropy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003eLMR(P)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003eBLRT(P)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003eClass probability(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4842.146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4874.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4845.590\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003e100.0\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4549.276\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4591.911\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4553.867\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.000\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003e23.3/76.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4482.384\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4535.679\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4488.124\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.950\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003e31.0/45.7/23.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4476.656\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4540.609\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4483.543\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.905\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.094\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003e9.0/45.3/31.4/14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4472.439\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4547.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 73px;\"\u003e\n \u003cp\u003e4480.474\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.868\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 183px;\"\u003e\n \u003cp\u003e44.6/8.5/14.7/10.9/21.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviation: AIC Akaike information criterion, BIC Bayesian information criterion, aBIC adjusted BIC, LMRT The Vuong Lo\u0026ndash;Mendell\u0026ndash;Rubin likelihood ratio test, BLRT bootstrapped likelihood ratio test.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Single factor analysis of influencing factors of the trajectory of change in FoP after PCI in patients with CHD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results revealed statistically significant differences in the distributional comparisons of age, gender, marital status, BMI, duration of disease, number of hospitalizations due to CHD, and non-cardiovascular diseases among the three groups (\u003cem\u003eP\u003c/em\u003e\u0026lt;\u0026thinsp;0.05). Refer to Table 1 for more detailed information.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"640\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" style=\"width: 640px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003eUnivariate analysis of general information and categories of trajectory of change in FoP after PCI in patients with CHD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eProject\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eClass 1 (n=\u0026thinsp;80)\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eClass 2 (n=\u0026thinsp;118)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eClass 3 (n=\u0026thinsp;60）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cem\u003eF/X\u003c/em\u003e\u003cem\u003e\u0026sup2;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eResidence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e22.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;City\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Rural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eEducational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e23.339\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eJunior high school and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Senior high school\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;College and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eOccupation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e22.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Non-Employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eMonthly income (yuan)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e31.849\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;＜3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;3000-500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;＞5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eMedical Payment Methods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e24.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;employee medical insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eResident medical insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eNew Agricultural Cooperative Society\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eInterventional modalities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e63.973\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003estent implantation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eballoon dilatation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003estent implantation＋balloon dilatation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003efamily history\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e10.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003ePSSS（score，`X\u0026plusmn;S）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e62.76\u0026plusmn;5.462\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e68.88\u0026plusmn;4.253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e70.28\u0026plusmn;4.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e56.691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 184px;\"\u003e\n \u003cp\u003eBIPQ（score，`X\u0026plusmn;S）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e48.19\u0026plusmn;4.897\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e45.61\u0026plusmn;4.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e41.82\u0026plusmn;6.312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e27.422\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: PSSS, perceived social support scale;BIPQ,brief illness perception questionnaire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Logistic regression analysis of influencing factors of the trajectory of change in FoP after PCI in patients with CHD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLogistic regression analysis was conducted, with trajectory category analysis results serving as the dependent variable and all significant variables identified in the single-factor analysis as independent variables.Class 3 was used as the reference group. The results showed that occupational status, family history of CHD, mode of intervention, comprehension of social support, and disease perception were factors influencing the FoP after PCI in patients with CHD (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05), See Table 3 for details.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"757\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" style=\"width: 757px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003eMulti-classification logistic regression analysis ofthe trajectory of change in FoP after PCI in patients with CHD(\u003cem\u003en\u003c/em\u003e=258)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003eGroups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eRelated factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003ereference groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026beta;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003eWald\u003cem\u003eX\u0026sup2;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;95% Cl\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003eC3vs.C1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003ePSSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-0.326\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.073\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e19.723\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.722\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e0.625~0.833\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eBIPQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.307\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.068\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e20.404\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.360\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e1.190~1.554\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003eNon-Employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.082\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.755\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e7.600\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.006\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e8.017\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e1.825~35.217\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003efamily history:Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.222\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.784\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e8.032\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.005\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e9.221\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e1.984~42.855\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eballoon dilatation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003estent implantation＋balloon dilatation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-3.061\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.366\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e5.024\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.025\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.047\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e0.003~0.681\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003eC3vs.C2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eBIPQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.160\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.051\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e9.997\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.002\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.173\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e1.063~1.295\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003eNon-Employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.616\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.523\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e9.532\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.002\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e5.033\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e1.804~14.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eballoon dilatation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003estent implantation＋balloon dilatation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-2.256\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.818\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 70px;\"\u003e\n \u003cp\u003e7.611\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.006\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.105\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 112px;\"\u003e\n \u003cp\u003e0.021~0.520\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"4 DISCUSSION","content":"\u003cp\u003e\u003cstrong\u003e4.1Different trajectories of change in FoP after PCI in patients with CHD and their main characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings of this study revealed that the overall trend of FoP after PCI in patients with CHD was gradually decreasing\u0026nbsp;in\u0026nbsp;patients with CHD after PCI was a gradual decline, which aligns with the results reported by Tian[8]. The LGMM model demonstrated the existence of three categories of the trajectory of change in the FoP in patients with CHD after PCI, indicating the existence of group heterogeneity in the FoP in patients with CHD after PCI. Specifically, 31% of the patients were classified into the high fear Initially rising then falling group, the level of FoP peaked at T1, which may be related to the lack of knowledge of the disease in postoperative patients and the need for long-term medication, which led to greater changes in the body and life, and a heavier psychological burden, and showed a downward trend over time, as the patients gradually adapted to the changes brought about by the operation, and had a more comprehensive understanding of the disease to alleviate their FoP.45.7% of the patients belonged to the medium fear slow decline group, that is, the average value of the patients' starting FoP scores was at a medium level, and the curve from T0 to T3 showed a slow decline trend; 23.3% of the patients belonged to the low-fear-stable group, that is, the average value of the patients' starting FoP scores was at a low level, and the trend of change during the follow-up period was not significant. Therefore, healthcare professionals should focus on the psychological status of the T0~T1 stage of patients in the high fear first rising then falling group, and provide the necessary psychological guidance and support to help patients reduce the level of FoP, and reduce the emergence of adverse emotions and behaviors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2 Analysis of factors influencing the potential column of FoP after PCI in patients with CHD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2.1 Occupational status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of this study indicate that employed patients were more likely to be categorized into the high-fear-initial-rise-followed-by-decline group and the medium-fear-gradual-decline group after surgery compared unemployed patients, which aligns with the results of the study by Wagner[27]. The reasons for this may be analyzed as Follows:①Employed patients are more concerned about the impact of the disease on their work and are more concerned about the disease progression compared to unemployed patients; ② The heavy workload and stressful working environment after returning to work is not conducive to cardiac rehabilitation, leading to increased concerns about their health status and disease progression. Therefore, healthcare professionals should inform patients of the appropriate time to return to work, adjust their work schedules appropriately, instruct them to arrange rehabilitation exercises reasonably,maintain a positive mindset, and view the impact of the disease on work with a positive attitude.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2.2 Family history of CHD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of this study found that patients with a family history of CHD had a higher probability of entering the high fear-first-rise-last-fall group.Tommaso\u0026nbsp;[28]found that family history of cardiovascular disease is an independent risk factor for morbidity. The reason for this analysis may be that patients with a family history of CHD means facing a high risk of recurrence and concerns about heredity, and are more likely to have a strong FoP. Therefore, healthcare professionals should focus on patients with a family history of CHD, explain the knowledge about the disease and family genetics, improve patients' knowledge of the disease, and reduce their FoP.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2.3\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eInterventional modalities\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of this study found that patients who underwent the combined intervention of stent + balloon placement had a higher likelihood of being classified into the high-fear-initial-rise-followed-by-decline group. It has been demonstrated[29,30]that the incidence of restenosis is 39.43% after stenting and 13.3% after ballooning alone. Compared with patients who underwent stent or balloon interventional modalities, patients who underwent the combined stent + balloon procedure perceived their condition as more severe, and the fear of adverse events such as stent fracture and restenosis of the dilated vessel after the procedure increased patients' fear. Therefore, healthcare professionals can organize regular knowledge lectures to help patients acquire accurate knowledge about the disease, correct misconceptions, monitor changes in their condition, and adhere to timely follow-ups, thereby alleviating their psychological burden.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2.4 Perceived Social Support Scale\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings of this study revealed that patients Who received higher levels of social support exhibited a higher probability of entering the moderate fear slowly declining group and the low fear stabilizing group, and high levels of social support would reduce patients' FoP, similar to the results of foreign studies\u0026nbsp;[31]. Good social support may help patients better cope with stressful events, alleviate the fear of disease, motivate patients to cooperate with treatment, and improve overall survival\u0026nbsp;[32]. Therefore, a sound social support system can reduce patients' trauma due to the disease, and healthcare professionals should provide individualized help for different patients and encourage patients' family members and relatives to increase their attention and support for patients in order to improve the level of patients' social support and reduce their FoP.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2.5 Brief Illness Perception Questionnaire\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of this study showed that patients with higher levels of disease perception had a higher probability of entering the high fear first ascending then descending group. There is a correlation between disease perception and FoP, and the higher the level of disease perception, the higher the level of FoP will be in patients\u0026nbsp;[33]. In this study, the disease perception of CHD patients after PCI is mainly manifested in the belief that the disease duration is long and the need for lifelong medication after surgery, which has a greater impact on life and psychology. Therefore, healthcare professionals should provide appropriate health education and rehabilitation knowledge for the psychological changes of patients at different time points to help patients strengthen their understanding of recognizing their own diseases and establish correct disease perception.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.3 Limitation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, this study employed a convenience sampling method and investigated patients who underwent PCI for CHD in only one tertiary hospital, which limits the representativeness of the study population and the generalizability of the findings. Second, the follow-up period of this study was only 6 months, however, the cardiac recovery period may require a longer duration, and the follow-up time may have infiuenced the results of the study. Therefore, future researchers may consider conducting a multicenter investigation with a larger sample size and a longer follow-up period to explore the long-term dynamic trend of FoP after PCI in patients with CHD, which may provide a reference for the implementation of precise interventions.\u003c/p\u003e"},{"header":"5 CONCLUSION","content":"\u003cp\u003eThe results of this study showed that three categories existed in the trajectory of FoP change after PCI in patients with CHD: a low-fear stabilized group, a medium-fear slowly declining group, and a high-fear first-rising-then-declining group. There is significant heterogeneity within the population, Which is influenced by factors such as occupational status, family history of coronary artery disease, mode of intervention, social support, and disease perception. In the future, healthcare professionals should enhance the assessment of the dynamics of FoP and develop precise and effective interventions based on the FoP of different patients at different times.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all participants for agreeing to cooperate with us in completing the questionnaires and undergoing followup visits. We would also like to thank all colleagues involved in this study who contributed to the design and completion of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthor contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHM. S. and XY. X.: Formal analysis, Writing - original draft, Writing - review \u0026amp;editing. XX.W., JY. Z.,and YJ. L.: Investigation, review \u0026amp; editing. SS. M.,and F. Z.: Investigation, Supervision, Writing - review \u0026amp; editing. All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Shandong Province Traditional Chinese Medicine Program(M-20244902).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData availability\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets utilized and analyses conducted in the current study are available upon reasonable request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study adheres to the principles of the Declaration of Helsinki and has been approved by the Ethics Committee of the Affiliated Hospital of Binzhou Medical University (KYLL-362). All participants provided written informed consent to confirm their voluntary participation. The informed consent also ensured that the participants could withdraw at any time, which did not affect their normal treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical trial number\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eChina WCOT. Report on Cardiovascular Health and Diseases in China 2021: An Updated Summary. Biomed Environ Sci. 2022;35:573\u0026ndash;603.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZengwu W, Liyuan M, Mingbo L, Jing F, Shengshou H. 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Eur J Oncol Nurs. 2024;69:102526.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"percutaneous coronary intervention, fear of progression, latent growth mixture modeling, trajectory of change, influencing factors","lastPublishedDoi":"10.21203/rs.3.rs-6678162/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6678162/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe aim of this study was to explore potential categories and factors influencing the trajectory of change in fear of progression in patients after percutaneous coronary intervention.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eConveniently selected post-PCI patients with coronary artery disease who were hospitalized in the Department of Cardiology between April and December 2024,The Fear of Progression Questionnaire -Short Form(FoP-Q-SF) was used to assess the level of FoP in patients at four time points: immediately post-PCI, and at 1, 3, and 6 months after discharge.In addition, the potential category growth mixture model was used to identify the developmental trajectory of fear of progression, and univariate analysis and binary logistic regression were used to analyse its determinants.follow-up surveys and other variables were collected only at baseline, using online questionnaires.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe trajectory of change in fear of progression after PCI in patients with coronary heart disease can be categorized into a high-fear-initial-rise-followed-by-decline group (31%), a medium-fear-gradual-decline group(45.7%), and a low-fear-stable group (23.3%);Occupational status, family history of coronary heart disease, the mode of PCI intervention, the level of social support received, and patients' perceptions of their disease are significant factors influencing the categorization of fear of progression trajectories in these patients post-PCI (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThere is notable group heterogeneity in the fear of progression after PCI in patients with coronary heart disease. Healthcare professionals need to develop targeted interventions to reduce the level of fear of progression in patients based on the group characteristics and influencing factors of the trajectory of fear of progression.\u003c/p\u003e","manuscriptTitle":"Trajectories and factors influencing fear of progression in patients after percutaneous coronary intervention: a longitudinal study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-02 06:44:34","doi":"10.21203/rs.3.rs-6678162/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"46c35cdb-6d8a-4498-8a1f-d5269f8c2be0","owner":[],"postedDate":"July 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-21T08:54:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-02 06:44:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6678162","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6678162","identity":"rs-6678162","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}