title: Short- and long-term health related quality-of-life and anginal status of the Arterial Revascularisation Therapies Study part II, ARTS-II; sirolimus-eluting stents for the treatment of patients with multivessel coronary artery disease.
abstract: Assessment of health related quality-of-life (HRQL) has become increasingly important as not only the clinician's view of the technical success, but also the patient's perception is being measured. We evaluated the HRQL following sirolimus-eluting coronary stent (SES) (CYPHER(R); Cordis, Johnson & Johnson, Warren, NJ, USA) implantation in patients with multivessel disease, comparing the outcomes with the historical surgical and bare metal stent (BMS) arms of the ARTS-I study.
  
  
  
  The HRQL outcomes were compared to the outcome of the historical cohorts of the randomised ARTS-I trial using the same inclusion and exclusion criteria. HRQL was evaluated at baseline, at one month and at 6, 12 and 36 months after revascularisation using the SF-36 in patients treated with SES (n=585), BMS (n=483) or coronary artery bypass graft (CABG) (n=492). The HRQL compliance rates varied from 100% at baseline to 92% at 36 months. Both stenting and CABG resulted in significant improvement of HRQL and anginal status. There was a trend towards better HRQL after CABG than BMS beyond six months. Already from the first month up to three years, SES patients had, on average, 10% significantly better HRQL than BMS patients on the HRQL subscales physical functioning, role physical functioning, role emotional functioning and mental health (p<0.01) and a trend towards better HRQL in the other subscales. Up to 12 months, the HRQL was better after SES than CABG and was identical thereafter. At all time points, angina was more prevalent in the BMS group than in both the SES and CABG groups, in which the incidence of angina was similar. At three years, 10% of the SES patients suffered from angina, 13% of the CABG patients and 20% of the BMS patients.
  
  
  
  Both stenting and CABG resulted in a significant improvement in HRQL and angina. Along with a substantial reduction of restenosis, HRQL after SES was significantly improved as compared with BMS, and was similar to CABG.
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands. r.vandomburg@erasmusmc.nl <r.vandomburg@erasmusmc.nl>
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Morice
authors.forename: Bernard
authors.initials: B
authors.lastname: de Bruyne
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Jean
authors.initials: J
authors.lastname: Fajadet
authors.forename: Christian
authors.initials: C
authors.lastname: Hamm
authors.forename: Gerrit-Anne
authors.initials: GA
authors.lastname: van Es
authors.forename: Kristel
authors.initials: K
authors.lastname: Wittebols
authors.forename: Nathalie
authors.initials: N
authors.lastname: Macours
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Stoll
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000787:Angina Pectoris / Q000209:etiology / Q000517:prevention & control; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D054855:Drug-Eluting Stents; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D011788:Quality of Life; D020127:Recovery of Function; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D020123:Sirolimus