PTCA and CABG both markedly improved quality of life and employment in angina patients over 3 years, with PTCA allowing faster return to work at 2 months (40% vs 10%) but CABG better avoiding angina.
RCT (n=1,011)
Randomized
Does PTCA compared to CABG improve quality of life, angina symptoms, and employment status in patients with angina?
PTCA and CABG both significantly improve quality of life and employment in patients with angina, with CABG providing better long-term angina relief and PTCA allowing for a faster return to work.
BACKGROUND: The Randomized Intervention Treatment of Angina (RITA) trial compares initial policies of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft surgery (CABG) in 1011 patients with angina. This report assesses the impact of these revascularization procedures on angina, quality of life (according to the Nottingham Health Profile), and employment over 3 years of follow-up. METHODS AND RESULTS: Both interventions produced marked improvement in all quality-of-life dimensions (energy, pain, emotional reactions, sleep, social isolation, and mobility) and seven aspects of daily living. Patients with angina at 2 years had more quality-of-life impairment than angina-free patients, whose perceived health was similar to population norms. This reflects the close link at baseline between angina grade and quality of life. The slightly greater impairment of quality of life in PTCA compared with CABG patients is a result of their significantly higher chances of having angina, especially after 6 months. Employment status was investigated mainly for men < or = 60 years old. PTCA patients returned to work sooner (40% at 2 months compared with 10% of CABG patients), but the latter caught up by 5 months. After 2 years, 22% and 26% of CABG and PTCA patients, respectively, were not working for cardiac reasons. Patients with angina at 2 years were much more likely to be unemployed than those without. CONCLUSIONS: The impact of angina on quality of life and unemployment is greatly alleviated by PTCA or CABG. Angina is avoided more successfully with CABG, but PTCA offers a speedier return to work. Both intervention strategies then produce similar benefits for quality of life and employment over several years.
Pocock et al. (Mon,) conducted a rct in Angina (n=1,011). Percutaneous transluminal coronary angioplasty (PTCA) vs. Coronary artery bypass graft surgery (CABG) was evaluated on Angina, quality of life, and employment. PTCA and CABG both markedly improved quality of life and employment in angina patients over 3 years, with PTCA allowing faster return to work at 2 months (40% vs 10%) but CABG better avoiding angina.