Quality of life in high-risk patients with stable multivessel coronary artery disease treated either medically or with coronary artery bypass graft surgery - 12-month follow-up.
BACKGROUND
Treatment of chronic diseases, such as atherosclerosis, usually leads to significant short-term improvement. Mid- and long-term results are not always as satisfactory. That is why improvement of quality of life should be the leading qualification criterion for invasive procedures, which sometimes carry a risk of complications.


OBJECTIVE
To determine the quality of life in patients with stable, multivessel coronary artery disease (MCAD), treated surgically or medically.


METHODS
The study group comprised 107 patients (pts; 80 males) suffering from MCAD, assigned to coronary artery bypass grafting (CABG) (55 pts) or to medical treatment alone (52 pts). The mean Gensini score in the whole group was 90 (66-132). To evaluate quality of life we used a Short Form-36 (SF-36) health status survey by the International Quality of Life Assessment Project.


RESULTS
During a 12-month follow-up 9 pts died (6 pts in the medically treated group and 3 in the CABG group), all for cardiovascular reasons. Patients treated conservatively were more often hospitalised due to angina symptoms (20 vs. 5, p = 0.003). Analysis of SF-36 showed that pts treated surgically had better improvement of quality of life in comparison with medically treated patients. Significant differences were found for physical functioning, bodily pain, vitality, mental health and mental component summary.


CONCLUSIONS
This study has shown that there is a significant difference in health-related quality of life 12 months after CABG surgery and medical treatment alone in high-risk patients with MCAD. Surgical treatment decreases the number of adverse events, better attenuates of anginal and heart failure symptoms, and improves the quality of life, especially the mental component. Our results should encouraged selecting patients with advanced atherosclerosis for revascularisation procedures, even if there is a very high peri-procedural risk.
2nd Department of Cardiology, Medical University, Lodz, Poland. rkrecki@gazeta.pl
Radosław
R
Krecki
Jarosław
J
Drozdz
Piotr
P
Szcześniak
Jarosław D
JD
Kasprzak
Jan Z
JZ
Peruga
Piotr
P
Lipiec
Karina
K
Wierzbowska-Drabik
Jakub
J
Foryś
Daria
D
Orszulak-Michalak
Maria
M
Krzemińska-Pakuła
D015906:Angioplasty, Balloon, Coronary; D002423:Cause of Death; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011788:Quality of Life; D020521:Stroke / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome