Changes in the quality of life of patients with stable ischemic heart disease and preserved left ventricular ejection fraction after coronary artery bypass grafting or stenting at 6-month follow-up

Abstract

The aim — to compare the changes of the values of quality of life (QoL) in patients with stable coronary artery disease and preserved left ventricular (LV) ejection fraction (EF) within 6 months after revascularization interventions (coronary artery bypass grafting — CABG, or percutaneous coronary intervention — PCI) and to identify the factors that may affect QoL changes. Materials and methods. A single­center prospective study included data from a clinical, instrumental and laboratory examination of 115 patients (91 (79.1 %) men and 24 (20.9 %) women aged 32 to 92 years (mean age — 63 ± 10) with CAD and preserved LV systolic function (LVEF ≥ 45 %) consecutively selected for CABG (n = 71) or coronary stenting (n = 44). QoL was assessed by MLHFQ, SAQ and SF­36 questionnaires before and 6 months after myocardial revascularization. Also, changes in the distance of 6­minute walking test, Doppler echocardiographic indices of the LV diastolic function and the level of the brain natriuretic peptide (BNP) were analyzed. Results and discussion. After 6 months of follow­up in the study groups, the levels of QoL according to MLHFQ, SF­36 and SAQ scores significantly improved, compared to the baseline data (p < 0.001). In both groups there was a decrease of the functional class of angina by the Canadian classification (p < 0.001). There were no significant differences in the manifestation of stable angina pectoris in the compared groups after 6 months (p = 0.237). Improvement of QoL was associated with decrease of the BNP level from baseline 108.8 (50.1 — 185.4) to 32.3 (12.6 — 57.8) pg/ml in the stenting group (p = 0.002) and from 115.4 (62.0 — 150.6) to 52.4 (20.4 — 95.9) pg/ml in the CABG group (p < 0.001). The distance of the 6­minute walk test in the stenting group increased from 223 (148 — 328) m to 550 (400 — 600) m; in the CABG group this distance was, respectively, 260 (195 — 300) and 550 (415 — 600) m. Conclusions. Thus, in patients with stable ischemic coronary disease and preserved LV systolic function after coronary artery stenting or CABG, a significant improvement of QoL values was observed, compared to the baseline data. Favorable changes in QoL may be due to a decrease of angina pectoris, improvement of the Doppler echocardiographic parameters of LV diastolic function and functional status of the patients. The above­mentioned changes were associated with decrease of the BNP level.