title: Treatments of coronary artery disease improve quality of life in the long term.
abstract: BACKGROUND
  Cardiovascular diseases are currently the most common cause of death worldwide. This trend has been predicted to continue until 2020. The effects of treatments by bypass operation or angioplasty on the long-term health-related quality of life (HRQoL) in patients with coronary artery disease (CAD) have not been adequately studied.
  
  
  OBJECTIVE
  To measure the HRQoL and its changes during 8 years of follow-up after a treatment intervention.
  
  
  METHODS
  The primary study series consisted of 280 patients, of whom 100 underwent coronary artery bypass grafting (CABG), 100 had percutaneous transluminal coronary angioplasty (PTCA), and 80 were prescribed medication. At 1 year, 81 CABG patients, 74 PTCA patients, and 64 patients in the medication group responded. In the final analysis after 8 years, 63 CABG patients, 57 PTCA patients, and 34 patients in the medication group remained. HRQoL surveys were conducted 1 and 8 years after the treatment interventions. HRQoL was measured using the Nottingham Health Profile (NHP), which has been tested and evaluated in Finland.
  
  
  RESULTS
  CABG patients had a statistically significantly better HRQoL 8 years after the operation than at baseline on the dimensions of mobility (p <.001), energy (p =.003), and pain (p =.031). PTCA patients had a statistically significantly better HRQoL 8 years after the intervention on the dimensions of emotional reactions (p =.002), pain (p =.003), mobility (p =.004), and energy (p =.005). A significant impairment on the dimension of sleep had taken place during the 8 years follow-up after PTCA (p =.018). No significant changes were seen in the HRQoL of the patients on medication at either 1 or 8 years.
  
  
  CONCLUSIONS
  The need for treatment and primary and secondary prevention of CAD will increase in the future, especially in the case of high-risk patients. The present findings indicate that CABG and PTCA continue to significantly improve CAD patients' HRQoL 8 years after the intervention.
authors.affiliation: Department of Nursing and Health Administration, University of Oulu, Finland. hannele.lukkarinen@oulu.fi
authors.forename: Hannele
authors.initials: H
authors.lastname: Lukkarinen
authors.forename: Maija
authors.initials: M
authors.lastname: Hentinen
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000523:psychology*; D001294:Attitude to Health; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000523:psychology*; D003324:Coronary Artery Disease / Q000523:psychology / Q000628:therapy; D004358:Drug Therapy / Q000523:psychology*; D064420:Drug-Related Side Effects and Adverse Reactions; D005221:Fatigue / Q000209:etiology; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D012893:Sleep Wake Disorders / Q000209:etiology; D012934:Social Isolation; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome