Exercise tolerance as evidence of quality of life in CAD patients after coronary artery bypass by comparison with medical treatment.
The effects of coronary artery bypass (CAB) by comparison with medical treatment were evaluated on exercise tolerance in 68 patients with stable angina on effort, who underwent coronary and left ventricular cineangiography. Stress tests were performed by bicycle ergometer before medical and surgical treatment, and 6 and 12 months thereafter. Thirty-five patients (31 males and 4 females; 7 with one 70% stenosed vessel, 12 with two, 16 with three) underwent CAB; 33 (30 males and 3 females; 9 with one 70% stenosed vessel, 11 with two, 13 with three), having refused CAB, only underwent medical treatment. Both groups were given long-acting oral nitrates, none received digitalis and/or propranolol; antiarrhythmic drugs were only administered in 5% of medical and 4% of surgical patients. Both groups at 6 and 12 months follow-up showed a significant improvement in exercise tolerance. Surgical patients showed a significant increase in exercise tolerance with lower angina incidence (from the preoperative 100% to 26% and 22%, respectively), higher work load (P < .001), and a significant reduction of S-T segment depression (P < .001). Medical treatment induced an increase of exercise tolerance; angina on effort decreased (from 100% to 74% and 72%, respectively) with higher work load, and a significant reduction of S T depression (in both cases P < .001). Comparing the data of the two groups, we observed that surgical patients showed higher exercise tolerance (P < .01), lower S-T depression (P < .001) and angina incidence. Our results suggest that surgical treatment is able to improve exercise tolerance more remarkably than medical treatment.
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life