Quality of Life of Chronic Stable Angina Patients 4 Years After Coronary Angioplasty or Coronary Artery Bypass Surgery

Published in: Journal of Internal Medicine, v. 249, no. 1, Jan. 2001, p.47-57

Posted on RAND.org on January 01, 2001

by Bengt Brorsson, Steven J. Bernstein, Robert H. Brook, Lars Werko

Read More

Access further information on this document at www.blackwell-synergy.com

This article was published outside of RAND. The full text of the article can be found at the link above.

Objective: To evaluate the quality of life experienced by chronic stable angina patients with one- or two-vessel coronary artery disease treated with percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass graft (CABG). Design: Prospective survey and review of medical records. Patients: Consecutive series of 601 Swedish chronic stable angina patients with one- or two-vessel disease who underwent CABG (n = 252) or PTCA (n = 349) between May 1994 and January 1995. Main Outcome Measures: The authors assessed five components of the Swedish Quality of Life Survey, anginal frequency, sublingual nitroglycerin use, and survival at 6, 21 and 48 months following coronary revascularization. Results: Anginal frequency and sublingual nitroglycerin use decreased for all patients by 6 months, but more amongst surgery patients than amongst angioplasty patients (P < 0.05). At 48 months, more bypass patients reported that they had not used sublingual nitroglycerin during the preceding 4 weeks (73.1 vs. 63.4%, P < 0.05). At 6 months, bypass patients had greater levels of improvement in physical functioning (15.3 vs. 10.5, P. <0.05) and general health perception (16.5 vs. 10.2, P < 0.05), than angioplasty patients. Bypass patients also had better relief from pain (19.4 vs. 14.6, P <0.05), quality of sleep (17.6 vs. 4.6, P < 0.05) and general health perception (17.3 vs 12.1, P < 0.05) at 21 months. By 48 months follow-up, there was no longer any difference in these measures between groups. Conclusions: Both bypass surgery and angioplasty lead to improved quality of life for patients with chronic stable angina and one- or two-vessel coronary artery disease. Bypass surgery is associated with better quality of life at 6 months, but by 48 months quality of life is similar for patients initially treated by either procedure.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.