Relief of symptoms and improvement of health-related quality of life five years after coronary artery bypass graft in women and men

Background: Severe coronary artery disease can be successfully treated with coronary artery bypass graft (CABG), with considerable improvement in the symptoms of angina pectoris. Approximately three of four patients are free of ischemic events for 5 years; however, increased survival is demonstrated only in selected subgroups with advanced coronary artery disease, and this effect has not been established in elderly patients. Hypothesis: The study was undertaken to determine the relief of symptoms an d improvement in other aspects of health-related quality of life (QoL) duri ng 5 years after CABG in women and men. Methods: Patients who underwent CABG in western Sweden were approached prio r to and 5 years after surgery. Health-related QoL was estimated with Physi cal Activity Score (PAS), Nottingham Health Profile, and Psychological Gene ral Well-Being Index. Results: Women (n = 381) had a 5-year mortality of 17% compared with 13% fo r men (n = 1,619; NS). After 5 years, 1,719 patients (survivors) were avail able for the survey; of these, 876 (51%) answered the inquiry both prior to and after 5 years. Both women and men improved markedly and highly signifi cantly, both with respect to symptoms and other aspects of health-related Q oL. Women suffered more than men in terms of limitation of physical activit y, dyspnea, chest pain, and others aspects of health-related QoL. There was a significant interaction between time and gender, with more improvement i n men with regard to chest pain when walking uphill or quickly on level gro und, when walking on level ground at the speed of other persons their own a ge, when under stress, and in windy and cold weather. For those parameters as well as for PAS, improvement was more marked in men than in women. Ln th e other aspects of health-related QoL, there was no interaction between tim e and gender. Conclusion: Five years after CABG, limitation of physical activity, symptom s of dyspnea, and chest pain were reduced, and various aspects of health-re lated QoL had improved in both women and men. In general, women suffered mo re than men both prior to and after CABG; however, in some aspects the impr ovement was more pronounced in men. Because of the limited response rate, t he results may not be applicable to a nonselected population who had underg one CABG.