EFFECTS OF CORONARY ANGIOPLASTY, CORONARY-BYPASS SURGERY, AND MEDICALTHERAPY ON EMPLOYMENT IN PATIENTS WITH CORONARY-ARTERY DISEASE - A PROSPECTIVE COMPARISON STUDY

Objective: To compare return-to-work rates after coronary angioplasty, coronary bypass surgery, and medical therapy in patients with coronar y disease. Design: Prospective cohort study. Setting: Tertiary care re ferral center. Patients: Between March 1986 and June 1990, we enrolled 1252 patients who were younger than 65 years, who had not had previou s coronary revascularization, and who were employed. All patients were followed for 1 year. Main Outcome Measure: One-year employment status . Results: After 1 year, 84% of patients who had coronary angioplasty were still working compared with 79% of patients who had bypass surger y and with 76% of patients who received medicine. After adjusting for the more favorable baseline characteristics of patients who had angiop lasty (less severe coronary artery disease, better left ventricular fu nction, and less functional impairment), however, no significant diffe rences were noted in 1-year employment rates among the three groups. T hese adjusted 1-year return-to-work rates were 84% for angioplasty, 80 % for surgery, and 79% for medicine (P > 0.05). In a random subset of 72 patients, 23 patients who had angioplasty returned to work after a median of 18 days (mean, 27 days) compared with 54 days (mean, 67 days ) for 24 patients having bypass surgery and with 14 days (mean, 45 day s) for 25 patients receiving medicine (P = 0.002). Conclusions: Patien ts who had coronary angioplasty were able to return to work earlier th an those who had bypass surgery, but by 1 year no significant differen ce was noted in employment rates. Neither revascularization strategy i mproved employment rates when compared with initial treatment using me dical therapy.