Quality of life of chronic stable angina patients 4 years after coronary angioplasty or coronary artery bypass surgery

Objective. To evaluate the quality of life experienced by chronic stable an gina patients with one- or two-vessel coronary artery disease treated with percutaneous transluminal coronary angioplasty (PTCA) or coronary artery by pass graft (CABG). Design. Prospective survey and review of medical records. Patients. Consecutive series of 601 Swedish chronic stable angina patients with one- or two-vessel disease who underwent CABG (n = 252) or PTCA (n = 3 49) between May 1994 and January 1995. Main outcome measures. We assessed five components of the Swedish Quality o f Life Survey, anginal frequency, sublingual nitroglycerin use, and surviva l at 6, 21 and 48 months following coronary revascularization. Results. Anginal frequency and sublingual nitroglycerin use decreased for a ll patients by 6 months, but more amongst surgery patients than amongst ang ioplasty patients (P < 0.05). At 48 months, more bypass patients reported t hat they had not used sublingual nitroglycerin during the preceding 4 weeks (73.1 vs. 63.4%, P < 0.05). At 6 months, bypass patients had greater level s of improvement in physical functioning (15.3 vs. 10.5, P < 0.05) and gene ral health perception (16.5 vs. 10.2, P < 0.05) than angioplasty patients, Bypass patients also had better relief from pain (19.4 vs. 14.6, P < 0.05), quality of sleep (17.6 vs. 4.6, P < 0.05) and general health perception (1 7.3 vs. 12.1, P < 0.05) at 21 months. By 48 months follow-up, there was no longer ally difference in these measures between groups. Conclusions. Both bypass surgery and angioplasty lead to improved quality o f life for patients with chronic stable angina and one- or two-vessel coron ary artery disease. Bypass surgery is associated with better quality of lif e at 6 months, but by 48 months quality of life is similar for patients ini tially treated by either procedure.