Functional status after coronary artery bypass grafting and percutaneous transluminal coronary angioplasty.
Two cohorts of consecutive patients of comparable age with similar preprocedure cardiac function who underwent either coronary artery bypass grafting (CABG; n = 106) or percutaneous transluminal coronary angioplasty (PTCA; n = 64) were entered into a prospective comparison study examining functional status and return to work during the first year of recovery. Patients were evaluated using standardized functional status instruments for activities of daily living, work performance, social activity, mental health and quality of social interaction at 1, 6 and 12 months after the procedure. Within the CABG group, statistically significant improvements of functional status on every subscale were noted over the 1-year follow-up. Patients undergoing PTCA demonstrated significant improvement in all dimensions except for the quality of interaction at 1 year as compared with baseline. When the 2 groups were compared, the PTCA group demonstrated greater participation than the CABG group in routine daily physical and social activities at 1 and 6 months, but this apparent advantage disappeared by 1 year. Measures of psychological functioning were better after CABG than after PTCA. A reduction in the number of those with employment occurred in both the CABG and PTCA groups, independent of physical functional status measures, which improved in both groups after the procedures. For those with employment, the CABG group reported the greatest improvement in work performance.
Allen
J K
JK
School of Nursing/School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205.
Fitzgerald
S T
ST
Swank
R T
RT
Becker
D M
DM
D000203:Activities of Daily Living; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D006801:Humans; D011446:Prospective Studies; D012917:Social Adjustment; D014938:Work Capacity Evaluation