Key result
PCI and CABG linked to similar long-term quality of life as OMT in stable CAD.
Why the study?
Clinical, surgical, and percutaneous strategies similarly prevent major cardiovascular events in stable CAD, but whether they differentially affect health-related quality of life outside clinical trials remains debated.
Does percutaneous coronary intervention or coronary artery bypass grafting improve health-related quality of life compared to optimal medical treatment alone in patients with stable coronary artery disease?
Cohort (n=402)
No
Does percutaneous coronary intervention or coronary artery bypass grafting improve health-related quality of life compared to optimal medical treatment alone in patients with stable coronary artery disease?
In a real-world cohort of patients with stable CAD, long-term health-related quality of life did not differ significantly between those treated with medical therapy alone, PCI, or CABG.
Does not support revascularization for HRQoL gains in stable CAD; leaves open confirmation in randomized cohorts.
BACKGROUND: Clinical, surgical, and percutaneous strategies similarly prevent major cardiovascular events in patients with stable coronary artery disease (CAD). The possibility that these strategies have differential effects on health-related quality of life (HRQoL) has been debated, particularly in patients treated outside clinical trials. METHODS: We assigned 454 patients diagnosed with CAD during an elective diagnostic coronary angiography to coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or optimal medical treatment (OMT), and followed them for an average of 5.2 ± 1.5 years. HRQoL was assessed using a validated Brazilian version of the 12-Item Short-Form Health Survey questionnaire. The association between therapeutic strategies and quality of life scores was tested using variance analysis and adjusted for confounders in a general linear model. RESULTS: There were no differences in the mental component summary scores in the follow-up evaluation by therapeutic strategies: 51.4, 53.7, and 52.3 for OMT, PCI, and CABG, respectively. Physical component summary scores were higher in the PCI group than the CABG and OMT groups (46.4 vs. 42.9 and 43.8, respectively); however, these differences were no longer different after adjustment for confounding variables. CONCLUSION: In a long-term follow-up of patients with stable CAD, HRQoL did not differ in patients treated by medical, percutaneous, or surgical treatments.
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Silveira et al. (2021) conducted a cohort in Stable coronary artery disease (n=402). Percutaneous coronary intervention (PCI) or Coronary artery bypass grafting (CABG) vs. Optimal medical treatment (OMT) alone was evaluated on Adjusted Physical Component Summary (PCS) score (PCI vs OMT) (p=NS). Percutaneous coronary intervention, coronary artery bypass grafting, and optimal medical therapy alone resulted in similar long-term health-related quality of life in patients with stable coronary artery disease.
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