Key result
Having 2 to 4 occluded grafts compared to 0 to 1 occlusion after CABG was associated with significantly lower health-related quality of life (mean difference in EQ-VAS -19.8; P<0.001).
Why the study?
Does high graft patency improve health-related quality of life in patients after coronary artery bypass surgery?
Observational (n=233)
Does high graft patency improve health-related quality of life in patients after coronary artery bypass surgery?
Effect estimate: Mean difference -19.8 (EQ-VAS) and -0.13 (EQ-5D index) (95% CI -25.3 to -14.3 (EQ-VAS) and -0.19 to -0.08 (EQ-5D index))
p-value: p=<0.001
Higher graft patency (0-1 vs 2-4 occlusions) after CABG is significantly associated with better health-related quality of life at a mean of 7.5 years post-surgery.
Multiple graft occlusions after CABG may worsen long-term quality of life; leaves open whether patency-preserving strategies improve outcomes.
Objectives: The objective of this study was to investigate whether graft patency was associated with higher health-related quality of life in coronary artery bypass grafting patients and to compare this study with the general Swedish population. Methods: Patients were included from 3 randomized trials and 1 prospective cohort trial. The generic health-related quality of life instrument, EQ-5D (VAS and index) was used. Graft patency was assessed with computed tomography angiography. Patients were divided into 2 groups according to the number of occluded distal anastomosis: Group I with no to 1 occlusion ( n = 209) and Group II with 2 to 4 occlusions ( n = 24). Results: Two hundred and thirty-three patients underwent computed tomography angiography at a mean of 7.5 (1-18) years post-operatively. The mean difference in EQ-VAS and EQ-5D index between Groups II and I after model adjustment was -19.8 (95% CI -25.3 to -14.3; P < 0.001) and -0.13 (95% CI -0.19 to -0.08; P < 0.001), respectively. The EQ-5D index for the study population was similar compared with the Swedish population, 0.851 and 0.832, respectively, with an effect-size of 0.112 (trivial). The EQ-5D index of the study population was higher compared with the ischemic heart disease group in the Swedish population, 0.851 vs 0.60, with an effect-size of 0.999 (large). Conclusions: Graft patency was associated with higher health-related quality of life in coronary artery bypass patients. This patient group reported similar function and wellbeing compared to the general Swedish population and better health status than those in the same disease group in the general population. Clinical registration number: Clinicaltrials.gov: NCT02547194 and the Research and Development registry in Sweden: 167861.
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Samano et al. (2016) conducted an observational in Coronary artery bypass grafting (n=233). 0 to 1 graft occlusion (Group I) vs. 2 to 4 graft occlusions (Group II) was evaluated on Health-related quality of life (EQ-VAS and EQ-5D index) (Mean difference -19.8 (EQ-VAS) and -0.13 (EQ-5D index), 95% CI -25.3 to -14.3 (EQ-VAS) and -0.19 to -0.08 (EQ-5D index), p=<0.001). Having 2 to 4 occluded grafts compared to 0 to 1 occlusion after CABG was associated with significantly lower health-related quality of life (mean difference in EQ-VAS -19.8; P<0.001).
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