title: Health-Related Quality of Life after Coronary Revascularization: A systematic review with meta-analysis.
abstract: OBJECTIVE
  To conduct a systematic review and meta-analysis to summarize evidence and determine the impact of coronary revascularization (CR) on cardiac patients' Health-Related Quality of Life (HRQoL), highlighting factors that may affect this outcome in patients.
  
  
  METHODS
  A systematic search of Medline (Pubmed), EMBASE, Cochrane Library, Sciverse (Science Direct and Scopus) and PsycInfo was conducted to identify studies published from January 2000 to December 2012. Data were analyzed using MIX 2.0 Pro and SPSS 20.
  
  
  RESULTS
  Thirty-four longitudinal studies met the inclusion criteria; these studies included 15,992 patients, of whom 8,027 had undergone PCI, 6,348 had undergone CABG and 1,617 had received medication treatment. Moderate long-term effect sizes were revealed for both CR procedures. Both percutaneous coronary interventions (PCI) and coronary artery bypass graft surgery (CABG) had significantly greater effects on HRQoL than did medication; however, the CR procedures did not differ significantly from each other. Moderators included the type of instrument used to assess HRQoL and the study quality. Benefits related to physical functioning were greater than those related to psychosocial functioning in patients treated with CABG.
  
  
  CONCLUSIONS
  Empirical research highlights the positive effect of CR on patient HRQoL. Researchers should carefully select the instrument they use to measure HRQoL, as this may affect the results and thus conclusions. More RCTs and between-group studies employing pre-post designs should be conducted before clear conclusions can be drawn.
authors.affiliation: Department of Psychology, Health & Human Sciences Research Institute, University of Hertfordshire, Hatfield, UK. Electronic address: m.takousi@herts.ac.uk.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Takousi
authors.affiliation: Department of Psychology, Health & Human Sciences Research Institute, University of Hertfordshire, Hatfield, UK.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schmeer
authors.affiliation: School of Health Sciences, Metropolitan College, Athens, Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Manaras
authors.affiliation: Department of Cardiology, Thriasio Hospital, Elefsina, Greece.
authors.forename: Christoforos D
authors.initials: CD
authors.lastname: Olympios
authors.affiliation: Department of Cardiothoracic surgery, Metropolitan Hospital, N. Faliro, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Makos
authors.affiliation: Department of Psychology, Health & Human Sciences Research Institute, University of Hertfordshire, Hatfield, UK.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Troop
keywords: CABG; Coronary Revascularization; HRQoL; PCI; Systematic Review