Abstract 16772: Quality of Life in Patients After LAD Revascularization by MIDCAB or by PCI

Abstract

Purpose: Outcome comparisons of minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI) for LAD-revascularization demonstrated equal survival. We assessed quality of life (QOL) in propensity matched MIDCAB and PCI patients where revascularization of the LAD was required. Methods: We used the SF-36 Health Survey to assess post-treatment health related QOL (HRQOL) in 330 patients (172 MIDCAB, 158 PCI). MIDCAB patients were all patients having undergone surgery between 11/1999 and 12/2006 in our department. The PCI patients were selected by propensity matching out of 1186 patients having undergone PCI of the LAD in this time period. HRQOL analysis consisted of 8 subscales including general health perception, and physical and emotional role functioning. We further subdivided the patients into two groups (less than 80 years of age and 80 years or older) Results: Follow up was up to 84 months, the average follow-up was 38 months. There was no significant difference in survival at latest follow-up ( 94% versus 92% in PCI patients, n.s.). Analyzing all patients, HRQOL was better in MIDCAB patients with significant improvements in general health perception (p<0.05). However, subdividing the groups by age showed continuous improvement of HRQOL by patients younger than 80 years but inferior HRQOL in patients older than 80 years of age. In the older patients specifically physical and emotional role function was improved (p<0.05). Conclusions: MIDCAB revascularization of the LAD results in improved HRQOL compared to PCI only in patients under the age of 80 years. Since survival is equal HRQOL aspects maybe helpful in guiding treatment selection for patients with isolated LAD-stenosis.