Comparably improved health-related quality of life after total arterial revascularization versus conventional coronary surgery-Copenhagen arterial revascularization randomized patency and outcome trial

• Published in: European journal of cardio-thoracic surgery 2011-04, Vol.39 (4), p.478-483
• Main Authors: Damgaard, Sune, Lund, Jens T., Lilleør, Nikolaj B., Perko, Mario J., Madsen, Jan K., Steinbrüchel, Daniel A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Bypass - methods; Coronary Artery Disease - surgery; Coronary heart disease; Coronary Stenosis - surgery; Female; Health Status; Heart; Humans; Male; Medical sciences; Middle Aged; Myocardial Revascularization - methods; Pneumology; Quality of Life; Recovery of Function; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surveys and Questionnaires; Treatment Outcome
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2010.08.001

Abstract Objective: We compared health-related quality of life up to 11 months after coronary artery bypass grafting using total arterial revascularization versus conventional coronary surgery. Methods: In this randomized single-center trial, 161 patients underwent total arterial revascularization using single or bilateral internal thoracic artery (ITA) and radial artery grafts versus 170 patients conventionally revascularized using left ITA and saphenous vein grafts. Preoperatively, and at 3 and 11 months, postoperatively, patients filled in the generic questionnaire Short Form-36 (SF-36). Results: The mean age was 59 ± 8 years and 39 were women (12%). Median EuroSCORE (European System for Cardiac Risk Evaluation) was 2 (interquartile range 1-4). More than 90% of patients filled in the questionnaire at all three time points. Preoperatively, all scores were lower (P ≪ 0.001) than for a sample of the general Danish population. On all scales of the SF-36, there was statistically significant improvement at 3 and 11 months in both groups. For 'social functioning', the improvement following total arterial revascularization was significantly higher than following conventional revascularization (P = 0.01). For total arterial revascularization, there were also not statistically significant improvements for 'physical component summary' (P = 0.09), 'bodily pain' (P = 0.07) and 'vitality' (P = 0.08). Conclusion: Health-related quality of life up to 1 year after total arterial revascularization is equal or slightly better than results after conventional coronary surgery.