Quality of Life in Patients with Stable Coronary Artery Disease Submitted to Percutaneous, Surgical and Medical Therapies: A Cohort Study

Background: Clinical, surgical and percutaneous strategies have been shown similar effectiveness in the prevention of major cardiovascular events in patients with stable coronary artery disease (CAD). The possibility that these strategies have differential effects over health-related quality of life (HRQoL) has been debated, particularly in patients treated outside clinical trials. Methods: 454 patients diagnosed with coronary artery disease during an elective diagnostic coronary angiography were assigned to Coronary Artery Bypass Grafting (CABG), Percutaneous Coronary Intervention (PCI) or optimal medical treatment (OMT), and followed on average for 6.0 ± 1.9 years. HRQoL was assessed by a validated Brazilian version of the 12-Item Short-Form Health Survey (SF-12) questionnaire. The association between therapeutic strategies and scores of QoL were tested by ANOVA and adjusted for confounding in a general linear model. Results: There was no difference in the Mental Component Summary (MCS) scores in the follow-up evaluation by therapeutic strategies: 51.4, 53.7 and 52.3, respectively, for MT, PCI, and CABG. Physical Component Summary (PCS) scores were higher in the PCI group, when compared to the CABG and MT (46.4 vs. 42.9 and 43.8, respectively), but these differences were no longer different after adjustment for confounding variables. Conclusion: In a long-term follow-up of patients with stable CAD, HRQoL was not different in patients treated by medical, percutaneous or surgical treatments.