Document Detail

Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery.
MedLine Citation:
PMID:  21410370     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Previous studies have shown that among patients undergoing multivessel revascularization, coronary-artery bypass grafting (CABG), as compared with percutaneous coronary intervention (PCI) either by means of balloon angioplasty or with the use of bare-metal stents, results in greater relief from angina and improved quality of life. The effect of PCI with the use of drug-eluting stents on these outcomes is unknown.
METHODS: In a large, randomized trial, we assigned 1800 patients with three-vessel or left main coronary artery disease to undergo either CABG (897 patients) or PCI with paclitaxel-eluting stents (903 patients). Health-related quality of life was assessed at baseline and at 1, 6, and 12 months with the use of the Seattle Angina Questionnaire (SAQ) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The primary end point was the score on the angina-frequency subscale of the SAQ (on which scores range from 0 to 100, with higher scores indicating better health status).
RESULTS: The scores on each of the SAQ and SF-36 subscales were significantly higher at 6 and 12 months than at baseline in both groups. The score on the angina-frequency subscale of the SAQ increased to a greater extent with CABG than with PCI at both 6 and 12 months (P=0.04 and P=0.03, respectively), but the between-group differences were small (mean treatment effect of 1.7 points at both time points). The proportion of patients who were free from angina was similar in the two groups at 1 month and 6 months and was higher in the CABG group than in the PCI group at 12 months (76.3% vs. 71.6%, P=0.05). Scores on all the other SAQ and SF-36 subscales were either higher in the PCI group (mainly at 1 month) or were similar in the two groups throughout the follow-up period.
CONCLUSIONS: Among patients with three-vessel or left main coronary artery disease, there was greater relief from angina after CABG than after PCI at 6 and 12 months, although the extent of the benefit was small. (Funded by Boston Scientific; number, NCT00114972.).
David J Cohen; Ben Van Hout; Patrick W Serruys; Friedrich W Mohr; Carlos Macaya; Peter den Heijer; M M Vrakking; Kaijun Wang; Elizabeth M Mahoney; Salma Audi; Katrin Leadley; Keith D Dawkins; A Pieter Kappetein;
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  364     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-17     Completed Date:  2011-03-24     Revised Date:  2012-03-01    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1016-26     Citation Subset:  AIM; IM    
Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO 64111, USA.
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MeSH Terms
Activities of Daily Living
Angina Pectoris / epidemiology,  therapy
Angioplasty, Balloon, Coronary
Coronary Artery Bypass*
Coronary Artery Disease / surgery,  therapy*
Drug-Eluting Stents*
Health Status
Middle Aged
Outcome Assessment (Health Care)
Prospective Studies
Quality of Life*
Comment In:
Internist (Berl). 2012 Jan;53(1):108-10   [PMID:  22090145 ]
Ann Intern Med. 2011 Jul 19;155(2):JC1-10   [PMID:  21768576 ]

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