Original article: cardiovascularA comparison of the recovery of health status after percutaneous coronary intervention and coronary artery bypass
Section snippets
Patients
Between February 8, 1999 and July 7, 1999, 495 patients undergoing coronary revascularization were consecutively entered into a study protocol approved by our institutional review board. Details of data collection and potential selection biases have been described previously [5]. Twenty patients from this initial cohort were excluded because the revascularization procedure (PCI) was performed as primary reperfusion for an evolving acute myocardial infarction. Thus, a total of 475 patients were
Results
Sociodemographic and clinical characteristics are shown in Table 1, Table 2, respectively. Patients undergoing CABG tended to be older (p < 0.01) and had a greater extent of anatomic disease, manifested by increased frequency of three-vessel and left main coronary artery disease (p < 0.0001) and a larger proportion of patients with an ejection fraction less than 40% (p < 0.05). In contrast, the PCI group had an increased proportion of patients with a history of prior PCI or CABG (p < 0.0001)
Comment
This observational registry demonstrates improved symptom control after CABG as compared with PCI, such that CABG patients were able to attain better physical function and quality of life 1 year after their procedure. This study is unique in that it is the first reported comparison of CABG and PCI to include a disease-specific measure of health status and because it carefully assessed health status throughout the entire year of recovery. The use of the SAQ allowed a sensitive assessment of the
Acknowledgements
This work was supported in part by an unrestricted grant from Pharmacia and, in part, by grant R-01 HS11282-01 from the Agency for Healthcare Research and Quality.
References (8)
- et al.
Transmyocardial CO(2) laser revascularization improves symptoms, function, and quality of life: 12-month results from a randomized controlled trial
Am J Med
(2001) - et al.
Monitoring the quality of life in patients with coronary artery disease
Am J Cardiol
(1994) - et al.
Development and evaluation of the Seattle Angina Questionnairea new functional status measure for coronary artery disease
J Am Coll Cardiol
(1995) Five-year clinical and functional outcome comparing bypass surgery and angioplasty in patients with multivessel coronary diseasea multicenter randomized trial
JAMA
(1997)