Angioplasty, Coronary Bypass Surgery Tied to Similar Quality of Life Outcomes

NEW YORK (Reuters Health) – In high-risk patients with medically refractory ischemia, the type of revascularization therapy–surgical or percutaneous–does not appear to influence health-related quality of life (HRQL) at 6 months, according to a new report.

Based on this finding, “I don’t think that concerns about quality of life outcomes…should be the reason for choosing a revascularization strategy,” lead author Dr. John S. Rumsfeld, from the Denver VA Medical Center, said in a statement.

HRQL with a surgical or percutaneous approach is the same, but “how you get there…is going to be quite different,” he noted. “These differences in experiences may help different patients choose which one they want.”

In the Angina With Extremely Serious Operative Mortality (AWESOME) trial, 423 patients with medically refractory ischemia were randomized to undergo a percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). All of the patients had risk factors for adverse outcomes, such as advanced age, low ejection fraction, recent myocardial infarction, or the need for an intra-aortic balloon pump.

The main finding of the AWESOME trial, reported previously, was that mortality rates after PCI and CABG were comparable. In the current study, HRQL was assessed in 389 surviving patients who completed a health survey at 6 months, the researchers note.

The authors’ results are published in the May 21st issue of the Journal of the American College of Cardiology.

There was no evidence that the type of revascularization therapy influenced mental or physical well being at six months. Moreover, HRQL following PCI was comparable to that after CABG, the researchers note.

“The study tells us that angioplasty and bypass surgery, done on high risk patients with multivessel coronary disease, leads to equivalent quality of life outcomes,” Dr. Rumsfeld concluded.

J Am Coll Cardiol 2003;41:1732-1738.