title: Kidney Function Does Not Modify the Favorable Quality of Life Changes Associated With Revascularization for Coronary Artery Disease: Cohort Study.
abstract: Although patients with kidney disease have potential to benefit from revascularization, they are also at higher risk of complications, which may affect quality of life.
  
  
  
  We studied a cohort of 8198 adults who underwent coronary angiography in Alberta, between 2004 and 2008, and completed health-related quality-of-life (HR-QOL) surveys. Changes in HR-QOL measures were most favorable among patients who received coronary artery bypass graft (CABG), but did not significantly differ by kidney function within groups of patients who received CABG, percutaneous coronary intervention (PCI), or medical therapy (P value for interaction between estimated glomerular filtration rate [eGFR] and revascularization status >0.10 for all outcomes). Among those who received CABG, the adjusted mean EuroQol 5 dimensions (EQ-5D) utility score for those with eGFR >90 mL/min per 1.73 m(2) increased by 0.11 (95% CI, 0.09-0.14) and for those with eGFR <30 mL/min per 1.73m(2) by 0.13 (95% CI, 0.05-0.21). The adjusted mean EQ-5D utility score also increased similarly at all levels of eGFR for those who received PCI and for those who received medical management. Mean changes in Seattle Angina Questionnaire (SAQ) scores were also similar across all levels of eGFR within each treatment group for the quality of life, angina frequency, angina stability, physical limitations, and treatment satisfaction domains of the SAQ. Among those who received CABG, the adjusted mean SAQ quality of life score for those with eGFR >90 mL/min per 1.73m(2) increased by 22.1 (95% CI, 18.5-25.7) and for those with eGFR <30 mL/min per 1.73m(2) by 14.0 (95% CI, 2.31-25.63).
  
  
  
  Changes in HR-QOL do not vary by kidney function among patients selected for CABG, PCI, or medical management of coronary disease.
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Alberta, Canada mjames@ucalgary.ca.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: James
authors.affiliation: Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Alberta, Canada.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Wilton
authors.affiliation: Department of Community Health Sciences, University of Calgary, Alberta, Canada.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Clement
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Alberta, Canada.
authors.forename: William A
authors.initials: WA
authors.lastname: Ghali
authors.affiliation: Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.
authors.forename: Merril L
authors.initials: ML
authors.lastname: Knudtson
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Tan
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Alberta, Canada.
authors.forename: Marcello
authors.initials: M
authors.lastname: Tonelli
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Alberta, Canada.
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Norris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D000787:Angina Pectoris / Q000453:epidemiology / Q000628:therapy*; D015331:Cohort Studies; D015897:Comorbidity; D000072700:Conservative Treatment; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005919:Glomerular Filtration Rate; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011721:Pyrenes; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: C550270:CoMoCAT compound; D011721:Pyrenes
keywords: chronic kidney disease; coronary disease; health‐related quality of life; kidney; revascularization