EMPLOYMENT AFTER CORONARY ANGIOPLASTY OR CORONARY-BYPASS SURGERY IN PATIENTS EMPLOYED AT THE TIME OF REVASCULARIZATION

Background: Patients who undergo coronary angioplasty have a shorter c onvalescence than those who undergo coronary bypass surgery. This may improve subsequent employment. Objective: To compare employment patter ns after coronary angioplasty or surgery. Design: Multicenter, randomi zed clinical trial. Setting: Seven tertiary care hospitals. Patients: 409 employed patients with multivessel coronary artery disease. Interv ention: Coronary bypass surgery or balloon angioplasty. Measurements: Time to return to work and time spent working during 4 years of follow -up. Results: Patients who underwent angioplasty returned to work 6 we eks sooner than patients who underwent coronary bypass surgery (P < 0. 001), but long-term employment did not differ significantly (P > 0.2). Long-term employment was significantly lower among patients who were 60 to 64 years of age (P < 0.001), those who worked less than full-tim e at study entry (P < 0.001), and those who had less formal education (P = 0.005). Patients with only one source of health insurance were mo re likely to continue working (P = 0.005). Conclusions: Faster recover y after angioplasty speeds return to work but does not improve long-te rm employment, which is primarily associated with nonmedical factors.