Quality of Life After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting

• Published in: Journal of the American Heart Association 2023-11, Vol.12 (22), p.e030069
• Main Authors: Dimagli, Arnaldo, Spadaccio, Cristiano, Myers, Annie, Demetres, Michelle, Rademaker-Havinga, Tessa, Stone, Gregg W, Spertus, John A, Redfors, Bjorn, Fremes, Stephen, Gaudino, Mario, Masterson Creber, Ruth
• Format: Article
• Language: English
• Subjects: Coronary Artery Bypass - adverse effects; coronary artery bypass grafting; coronary artery disease; Coronary Artery Disease - psychology; Coronary Artery Disease - surgery; Female; Humans; Male; Middle Aged; Original Research; percutaneous coronary intervention; Percutaneous Coronary Intervention - adverse effects; Quality of Life; Randomized Controlled Trials as Topic; Surveys and Questionnaires; Time Factors; Treatment Outcome
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.123.030069

Differences in quality of life (QoL) after coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI) are not well characterized. We aimed to compare the short- and long-term effects of CABG versus PCI on QoL. We performed a systematic review and meta-analysis of randomized controlled trials comparing CABG versus PCI using the Seattle Angina Questionnaire (SAQ)-Angina Frequency, SAQ-QoL, SAQ-Physical Limitations, EuroQoL-5D, and Short-Form Questionnaire. We calculated mean changes within each group from baseline to 1, 6, 12, and 36 to 60 months (latest follow-up) and the weighted mean differences between groups using inverse-variance methods. A total of 10 760 patients were enrolled in 5 trials. From baseline to 12 months and 36 to 60 months, the mean change in SAQ-Angina Frequency was >22 points (95% CI, 21.0-25.6) after both PCI and CABG. The mean difference in SAQ-Angina Frequency was similar between procedures at 1 month and at 36 to 60 months but favored CABG at 12 months (1.97 [95% CI, 0.68-3.26]). SAQ-QoL favored PCI at 1 month (-2.92 [95% CI, -4.66 to -1.18]) and CABG at 6 (2.50 [95% CI, 1.02-3.97]), 12 (3.30 [95% CI, 1.78-4.82]), and 36 to 60 months (3.17 [95% CI, 0.54 5.80). SAQ-Physical Limitations (-12.61 [95% CI, -16.16 to -9.06]) and EuroQoL-5D (-0.07 [95% CI, -0.08 to -0.07) favored PCI at 1 month. Short-Form Questionnaire-Physical Component favored CABG at 12 months (1.18 [95% CI, 0.46-1.90]). Both PCI and CABG improved long-term disease-specific and generic QoL.