Quality of life after surgical myocardial revascularization, angioplasty or medical treatment.
BACKGROUND
Although the clinical benefits of coronary interventions seem to be confirmed, their effects on quality of life (QoL) are still scarcely studied.


OBJECTIVE
To assess the QoL in multivessel coronary disease in patients randomly undergoing surgery, angioplasty or medical treatment.


METHODS
The Short-Form Health Survey (SF-36) questionnaire was answered by 483 patients. Of these, 161 underwent surgical revascularization, 166 underwent angioplasty, and 153 were medically treated.


RESULTS
At baseline, 86% of the patients referred angina, 34% referred infarction, and 32% were smokers. Medical Treatment: 12 patients (7.7%) had AMI, 24 (15.3%) underwent surgery, and 19 (12.1%) died. In addition, 5 (3.2%) had stroke, and 40 (25.6%) had angina. As regards the mental component, 64.1% and 30.8% had their condition improved and worsened, respectively. As regards the physical component, 70.5% and 27.6% had their condition improved and worsened, respectively.


METHODS
13 patients (8.1%) had AMI, 2 (1.2%) underwent surgery, and 12(7.4%) died. Also, 9 (5.6%) had stroke and 30 (18.6%) had angina. As regards the mental component, 72.7 % and 25.5% had their condition improved and worsened, respectively. As regards the physical component, 82.6% and 16.1% had their condition improved and worsened, respectively. Angioplasty: 18 patients (10.9%) had AMI, 51 (30.7%) underwent interventions, and 18 (19.9%) died. Additionally, six (3.6%) presented stroke and 35 (21%) reported angina. As regards the mental component, 66.9% and 26.5% had their condition improved and worsened, respectively. As regards the physical component, 77.1% and 20.5% had their condition improved and worsened, respectively.


CONCLUSIONS
Improvement was observed in all domains and in the three therapeutic modalities. Comparatively, surgery had provided a better quality of life after a four-year follow-up.
Takiuti
Myrthes Emy
ME
Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil.
Hueb
Whady
W
Hiscock
Shirley Borghetti
SB
Nogueira
Célia Regina Simões da Rocha
CR
Girardi
Priscyla
P
Fernandes
Fabio
F
Favarato
Desiderio
D
Lopes
Neuza
N
Borges
Jorge Chiquie
JC
de Góis
Aécio Flávio Teixeira
AF
Ramires
José Antonio Franchini
JA
D000800:Angioplasty, Balloon; D003324:Coronary Artery Disease / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome