QUALITY-OF-LIFE, EMPLOYMENT STATUS, AND ANGINAL SYMPTOMS AFTER CORONARY ANGIOPLASTY OR BYPASS-SURGERY - 3-YEAR FOLLOW-UP IN THE RANDOMIZED INTERVENTION TREATMENT OF ANGINA (RITA) TRIAL

Background The Randomized Intervention Treatment of Angina (RITA) tria l compares initial policies of percutaneous transluminal coronary angi oplasty (PTCA) and coronary artery bypass graft surgery (CABG) in 1011 patients with angina. This report assesses the impact of these revasc ularization procedures on angina, quality of life (according to the No ttingham Health Profile), and employment over 3 years of follow-up. Me thods and Results Both interventions produced marked improvement in al l quality-of-life dimensions (energy pain, emotional reactions, sleep, social isolation, and mobility) and seven aspects of daily living. Pa tients with angina at 2 years had more quality-of-life impairment than angina-free patients, whose perceived health was similar to populatio n norms. This reflects the close Link at baseline between angina grade and quality of life. The slightly greater impairment of quality of li fe in PTCA compared with CABG patients is a result of their significan tly higher chances of having angina, especially after 6 months. Employ ment status was investigated mainly for men less than or equal to 60 y ears old. PTCA patients returned to work sooner (40% at 2 months compa red 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, we re not working for cardiac reasons. Patients with angina at 2 years we re much more likely to be unemployed than those without. Conclusions T he impact of angina on quality of life and unemployment is greatly all eviated by PTCA or CABG. Angina is avoided more successfully with CABG , but PTCA offers a speedier return to work. Both intervention strateg ies then produce similar benefits for quality of life and employment o ver several years.