Disease-Specific Health Status After Stent-Assisted Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery

Abstract

Background-Functional status and quality of life are important outcomes in the evaluation of revascularization approaches for symptomatic coronary artery disease. Few data are available regarding the comparative improvement in disease-specific health status after CABG versus percutaneous coronary intervention (PCI) in the era of coronary stenting. Methods and Results-Cardiac-specific health status was evaluated at baseline and at 6 and 12 months after intervention with the Seattle Angina Questionnaire (SAQ) in patients randomized to stent-assisted PCI (nϭ488) versus CABG (nϭ500) in the Stent or Surgery trial. Scores for physical limitation, angina frequency, and quality of life improved significantly for both treatment groups at 6 months (range of improvement from 13.6 to 34.7 points) and 12 months (14.3 to 38.2 points; all PϽ0.001). CABG patients had greater improvement than those assigned to PCI, although the magnitude of the difference decreased over time (difference at 6 months, 4.03 to 6.48 points; 12 months, 2.05 to 2.93 points). A component of this reduction is accounted for by PCI-arm patients who required repeat intervention. Differences between treatment groups were greatest for the 6-month angina frequency scores (differenceϭ6.48 points; 95% CI 3.96 to 8.99). Overall, treatment satisfaction was high and did not differ significantly between groups. Conclusions-Both CABG and stent-assisted PCI dramatically improved cardiac-related health status in patients with multivessel disease at 6-and 12-month follow-up. During the first postprocedure year, patients' angina burden and physical limitations were alleviated to a greater extent with CABG. (Circulation. 2003;108:1694-1700.)

Examining the Health-Related Quality of Life after Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention in Iran via SF-36 and SAQ

“…Using SAQ in the present study, the highest and lowest scores of QoL in both interventions were related to 'angina stability' and 'disease perception', respectively (Table 5). In Zhang's study, however, the highest and lowest scores in both cases belonged to 'treatment satisfaction' and 'disease perception', respectively after six months (19). This implies that the patients' disease perception was lower compared to other dimensions of QoL.…”

Effects of Ranolazine on Angina and Quality of Life After Percutaneous Coronary Intervention With Incomplete Revascularization

“…5,6 Angina relief occurs often following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), particularly among patients with more frequent baseline angina. 7,8 CABG also appears to have better postprocedure results in terms of reducing future cardiovascular events among those with higher baseline Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) scores, which may be due to CABG allowing a more complete type of revascularization. January 5, 2016…”

Risk of Restenosis and Health Status Outcomes for Patients Undergoing Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft Surgery

“…For example, in the recent Stent or Surgery trial, 6-month angina frequency scores were significantly better among patients treated with CABG surgery overall, but no difference was seen in the subset of PCI patients who did not have a repeat procedure. 9 Similarly, an observational registry identified that patients who underwent surgical revascularization had better symptom control and quality of life and that most of this difference was attributable to PCI patients who required a repeat procedure. 10 If the health status (ie, angina and quality of life) benefits of CABG surgery are most evident in those PCI patients who develop clinical restenosis, then it is reasonable to consider preferential referral of patients at high risk of restenosis to CABG surgery.…”