QUALITY-OF-LIFE IN CORONARY-ARTERY DISEASE

Background: Coronary artery disease (CAD) constitutes a considerable f inancial burden on society in Finland; it is the cause of death of app roximately 7,500 men and 6,500 women annually in a population of 5 mil lion. Objectives: The purpose of this study was to assess the changes in the quality of life (QOL) of patients with CAD treated by medicatio n, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass surgery (CABS) during 1 year. Method: The study populat ion consisted of 280 patients with CAD. One hundred patients had been referred to CABS and another 100 to PTCA, whereas 80 patients were on drug therapy. The patients assessed their health status and QOL in ter ms of functional capacity and aspects of distress using self-completed questionnaires with the Nottingham Health Profile (NHP) instrument be fore the operation and 6 and 12 months afterwards. Results: The QOL of the patients who had undergone CABS I and PTCA was significantly bett er on the dimensions of energy, pain, and mobility 1 year after the in tervention. In the medication group, the only improvement took place o n the dimension of social isolation, whereas both energy and mobility deteriorated.Conclusions: The results on QOL obtained in this study su pport the notion that patients continue to have many problems even aft er medical treatment with a good outcome. The problems occur in differ ent areas compared with the pretreatment situation as on the dimension s of social isolation and emotional reaction. The rehabilitation of CA D patients is therefore important because the new problems are manifes ted differently from those seen before the illness or the treatment. T he patient's QOL and personal preference for a treatment modality shou ld be important criteria in the choice of treatment.