IMPROVEMENT IN QUALITY-OF-LIFE AND EXERCISE CAPACITY AFTER CORONARY-BYPASS SURGERY

Background: Outcome after coronary artery bypass grafting is usually e valuated by exercise stress testing. Increased exercise capacity and r educed angina pectoris have been equated with improved quality of life , but this represents a limited view. Objective: To prospectively eval uate the effects of coronary artery bypass grafting on quality of life and exercise capacity and their interrelationship, Methods: In a cons ecutive series of patients (N=2365) who underwent coronary artery bypa ss grafting, we administered a questionnaire to assess quality of life before and 2 years after surgery. A standardized exercise test was pe rformed during the year before surgery and 2 years after. A preoperati ve exercise test was performed by 726 patients. Among these patients, 462 completed a quality-of-life questionnaire preoperatively and 578 d id so postoperatively. Preoperative and postoperative exercise tests w ere obtained from 362 patients. Results: The improvement in quality of life was related to the severity of preoperative angina (P<.001) and female sex (P=.004) and was inversely related to preoperative exercise performance (P=.04). The improvement in exercise capacity was greater among men (P<.001) and was inversely related to preoperative exercise capacity (P<.001). Conclusions: The greatest improvement in quality o f life after coronary artery bypass grafting appeared in those patient s with the most impaired exercise capacity, those with the most severe angina pectoris, and women. Improvement in exercise capacity was grea test in patients with the poorest preoperative exercise capacity and i n men. These findings indicate that exercise testing is of limited val ue asa measure of quality of life and that assessment by a questionnai re has a complementary place.