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Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery.
N Engl J Med. 2011 Mar 17; 364(11):1016-26.NEJM

Abstract

BACKGROUND

Previous studies have shown that among patients undergoing multivessel revascularization, coronary-artery bypass grafting (CABG), as compared with percutaneous coronary intervention (PCI) either by means of balloon angioplasty or with the use of bare-metal stents, results in greater relief from angina and improved quality of life. The effect of PCI with the use of drug-eluting stents on these outcomes is unknown.

METHODS

In a large, randomized trial, we assigned 1800 patients with three-vessel or left main coronary artery disease to undergo either CABG (897 patients) or PCI with paclitaxel-eluting stents (903 patients). Health-related quality of life was assessed at baseline and at 1, 6, and 12 months with the use of the Seattle Angina Questionnaire (SAQ) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The primary end point was the score on the angina-frequency subscale of the SAQ (on which scores range from 0 to 100, with higher scores indicating better health status).

RESULTS

The scores on each of the SAQ and SF-36 subscales were significantly higher at 6 and 12 months than at baseline in both groups. The score on the angina-frequency subscale of the SAQ increased to a greater extent with CABG than with PCI at both 6 and 12 months (P=0.04 and P=0.03, respectively), but the between-group differences were small (mean treatment effect of 1.7 points at both time points). The proportion of patients who were free from angina was similar in the two groups at 1 month and 6 months and was higher in the CABG group than in the PCI group at 12 months (76.3% vs. 71.6%, P=0.05). Scores on all the other SAQ and SF-36 subscales were either higher in the PCI group (mainly at 1 month) or were similar in the two groups throughout the follow-up period.

CONCLUSIONS

Among patients with three-vessel or left main coronary artery disease, there was greater relief from angina after CABG than after PCI at 6 and 12 months, although the extent of the benefit was small. (Funded by Boston Scientific; ClinicalTrials.gov number, NCT00114972.).

Authors+Show Affiliations

Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO 64111, USA. dcohen@saint-lukes.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21410370

Citation

Cohen, David J., et al. "Quality of Life After PCI With Drug-eluting Stents or Coronary-artery Bypass Surgery." The New England Journal of Medicine, vol. 364, no. 11, 2011, pp. 1016-26.
Cohen DJ, Van Hout B, Serruys PW, et al. Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery. N Engl J Med. 2011;364(11):1016-26.
Cohen, D. J., Van Hout, B., Serruys, P. W., Mohr, F. W., Macaya, C., den Heijer, P., Vrakking, M. M., Wang, K., Mahoney, E. M., Audi, S., Leadley, K., Dawkins, K. D., & Kappetein, A. P. (2011). Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery. The New England Journal of Medicine, 364(11), 1016-26. https://doi.org/10.1056/NEJMoa1001508
Cohen DJ, et al. Quality of Life After PCI With Drug-eluting Stents or Coronary-artery Bypass Surgery. N Engl J Med. 2011 Mar 17;364(11):1016-26. PubMed PMID: 21410370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery. AU - Cohen,David J, AU - Van Hout,Ben, AU - Serruys,Patrick W, AU - Mohr,Friedrich W, AU - Macaya,Carlos, AU - den Heijer,Peter, AU - Vrakking,M M, AU - Wang,Kaijun, AU - Mahoney,Elizabeth M, AU - Audi,Salma, AU - Leadley,Katrin, AU - Dawkins,Keith D, AU - Kappetein,A Pieter, AU - ,, PY - 2011/3/18/entrez PY - 2011/3/18/pubmed PY - 2011/3/25/medline SP - 1016 EP - 26 JF - The New England journal of medicine JO - N Engl J Med VL - 364 IS - 11 N2 - BACKGROUND: Previous studies have shown that among patients undergoing multivessel revascularization, coronary-artery bypass grafting (CABG), as compared with percutaneous coronary intervention (PCI) either by means of balloon angioplasty or with the use of bare-metal stents, results in greater relief from angina and improved quality of life. The effect of PCI with the use of drug-eluting stents on these outcomes is unknown. METHODS: In a large, randomized trial, we assigned 1800 patients with three-vessel or left main coronary artery disease to undergo either CABG (897 patients) or PCI with paclitaxel-eluting stents (903 patients). Health-related quality of life was assessed at baseline and at 1, 6, and 12 months with the use of the Seattle Angina Questionnaire (SAQ) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The primary end point was the score on the angina-frequency subscale of the SAQ (on which scores range from 0 to 100, with higher scores indicating better health status). RESULTS: The scores on each of the SAQ and SF-36 subscales were significantly higher at 6 and 12 months than at baseline in both groups. The score on the angina-frequency subscale of the SAQ increased to a greater extent with CABG than with PCI at both 6 and 12 months (P=0.04 and P=0.03, respectively), but the between-group differences were small (mean treatment effect of 1.7 points at both time points). The proportion of patients who were free from angina was similar in the two groups at 1 month and 6 months and was higher in the CABG group than in the PCI group at 12 months (76.3% vs. 71.6%, P=0.05). Scores on all the other SAQ and SF-36 subscales were either higher in the PCI group (mainly at 1 month) or were similar in the two groups throughout the follow-up period. CONCLUSIONS: Among patients with three-vessel or left main coronary artery disease, there was greater relief from angina after CABG than after PCI at 6 and 12 months, although the extent of the benefit was small. (Funded by Boston Scientific; ClinicalTrials.gov number, NCT00114972.). SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/21410370/Quality_of_life_after_PCI_with_drug_eluting_stents_or_coronary_artery_bypass_surgery_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa1001508?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -