Does CABG compared with PCI improve quality of life in patients undergoing coronary revascularization?
Both PCI and CABG significantly improve long-term quality of life, with PCI offering better short-term QoL at 1 month and CABG providing slightly better QoL at 6 to 60 months.
BACKGROUND: Differences in quality of life (QoL) after coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI) are not well characterized. We aimed to compare the short- and long-term effects of CABG versus PCI on QoL. METHODS AND RESULTS: We performed a systematic review and meta-analysis of randomized controlled trials comparing CABG versus PCI using the Seattle Angina Questionnaire (SAQ)-Angina Frequency, SAQ-QoL, SAQ-Physical Limitations, EuroQoL-5D, and Short-Form Questionnaire. We calculated mean changes within each group from baseline to 1, 6, 12, and 36 to 60 months (latest follow-up) and the weighted mean differences between groups using inverse-variance methods. A total of 10 760 patients were enrolled in 5 trials. From baseline to 12 months and 36 to 60 months, the mean change in SAQ-Angina Frequency was >22 points (95% CI, 21.0-25.6) after both PCI and CABG. The mean difference in SAQ-Angina Frequency was similar between procedures at 1 month and at 36 to 60 months but favored CABG at 12 months (1.97 95% CI, 0.68-3.26). SAQ-QoL favored PCI at 1 month (-2.92 95% CI, -4.66 to -1.18) and CABG at 6 (2.50 95% CI, 1.02-3.97), 12 (3.30 95% CI, 1.78-4.82), and 36 to 60 months (3.17 95% CI, 0.54 5.80). SAQ-Physical Limitations (-12.61 [95% CI, -16.16 to -9.06) and EuroQoL-5D (-0.07 95% CI, -0.08 to -0.07) favored PCI at 1 month. Short-Form Questionnaire-Physical Component favored CABG at 12 months (1.18 [95% CI, 0.46-1.90). CONCLUSIONS: Both PCI and CABG improved long-term disease-specific and generic QoL.
Dimagli et al. (Mon,) studied this question.