Abstract
Objectives: There remains a controversy as to which is a better treatment for multi-vessel coronary artery disease (CAD): percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). Although the mortality and morbidities in those patients have been frequently evaluated, only a few studies reported on their health outcomes. The purpose of this study is to measure and compare the health outcomes in these patients in the Japanese population by using a disease-specific scale. Methods: A total of 354 patients were recruited from a university hospital in Tokyo. A cross-sectional postal survey was conducted by mailing self-administered questionnaires that measured health outcomes, and 331 patients (93.5%) responded. The selected disease-specific scale was the Japanese version of the Seattle Angina Questionnaire (SAQ-J). The score of each domain in the SAQ-J was set between 0 and 100. The higher the score, the better the outcome. Analysis of variance was used to analyze the data. Results: Non-PCI and non-CABG responders and those with incomplete responses were eliminated from the study, and data from 131 patients (PCI = 55, CABG = 76) were analyzed. The mean ages for PCI and CABG were 67.9 ± 9.5 and 69.6 ± 9.7 (mean ± SD), and the number of males was 46 (83.6%) and 68 (89.5%), respectively. The average interval between the procedure and the survey was 6.5 ± 8.0 and 7.6 ± 7.4 years, respectively. The number of 3-vessel CAD patients in PCI and CABG groups were 20 (36.4%) and 58 (76.3%)(P < 0.001). In terms of health outcomes after PCI and CABG, the PCI group had a significantly better score than the CABG group under the physical limitation domain of the SAQ-J (79.2 ± 19.7 vs. 71.5 ± 22.0; P = 0.005). On the other hand, the CABG group had a significantly better score in the quality of life (QOL) domain (70.9 ± 23.0 vs. 79.4 ± 18.1; P = 0.025). There was no significant difference between PCI and CABG in terms of anginal stability, anginal frequency, and treatment satisfaction. Conclusions: This is the first study to compare the health outcomes with PCI and CABG by using a disease specific scale in Japanese patients. The patients with CABG had a better QOL outcome than those with PCI. On the other hand, they were more likely to have physical limitations than the PCI group.
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