Cited by 82Coronary Interventions and DiagnosticsCardiac and Coronary Surgery TechniquesCardiac Imaging and Diagnostics

Quality of Life After Surgery or DES in Patients With 3-Vessel or Left Main Disease

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Abdallah, Mouin S., Wang, Kaijun, Magnuson, Elizabeth A., Osnabrugge, Ruben L., Kappetein, A. Pieter, Morice, Marie-Claude, Mohr, Friedrich A., Serruys, Patrick W. +1 more·2017·Journal of the American College of Cardiology

Abstract

Background In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) with drug-eluting stents (DES), improvements driven mainly by differences in myocardial infarction and repeat revascularization.Objectives This study compared the long-term quality-of-life benefits of DES-PCI versus CABG for patients with 3-vessel or left main CAD.Methods Between 2005 and 2007, the SYNTAX trial randomized 1,800 patients with 3-vessel or left main CAD to either CABG or DES-PCI. Health status was assessed at baseline and at 1, 6, 12, 36, and 60 months by using the Seattle Angina Questionnaire (SAQ) and the 36-Item Short Form Health Survey.Results At 5-year follow-up, CABG was superior to DES-PCI on several SAQ domains including angina frequency and physical function, as well as the role physical and role emotional scales of the 36-Item Short Form Health Survey. Subgroup analysis demonstrated a significant interaction between angiographic complexity (as assessed by the SYNTAX score) and angina relief (mean difference in the SAQ angina frequency score for CABG vs. PCI of -0.9, 3.3, and 3.9 points for low, intermediate, and high SYNTAX score patients, respectively; p = 0.048 for interaction).Conclusions Among patients with 3-vessel or left main CAD, both CABG and DES-PCI were associated with substantial and sustained quality-of-life benefits over 5 years of follow-up. In general, CABG resulted in greater angina relief, although the absolute treatment benefit was small. Angina relief at 5 years was enhanced with CABG among patients with high SYNTAX scores, a finding reinforcing the recommendation that CABG should be strongly preferred for such patients. (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery [SYNTAX]; NCT00114972).

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Crossref · 10.1016/j.jacc.2017.02.031

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  1. Kolh P, Windecker S. ESC/EACTS myocardial revascularization guidelines 2014. Eur Heart J 2014;35:3235-6.

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Authors
Abdallah, M. S., Wang, K., Magnuson, E. A., Osnabrugge, R. L., Kappetein, A. P., Morice, M.-C., Mohr, F. A., Serruys, P. W., & Cohen, D. J.
Affiliations
  • Cleveland Clinic (US)
  • Saint Luke's Hospital (US)
  • Erasmus MC (NL)
  • Hôpital Privé Jacques Cartier (FR)
Corresponding author
Cohen, David J.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2017-04
Volume
69
Issue
16
Pages
2039-2050
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2607400219
Cited by
82
References
31
Citations by year
2026: 7 · 2025: 6 · 2024: 3 · 2023: 10 · 2022: 10 · 2021: 13 · 2020: 8 · 2019: 7 · 2018: 11 · 2017: 7
FWCI
9.24
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Funders
  • Eli Lilly and Company
  • AstraZeneca
  • Edwards Lifesciences
  • Boston Scientific Corporation
  • Cardinal Health
  • Saint Luke's Health System
  • Daiichi-Sankyo
  • Abbott Vascular
Topics
  • Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords
quality of life, coronary artery bypass grafting, percutaneous coronary intervention, drug-eluting stents, three-vessel coronary artery disease, left main coronary artery disease, SYNTAX score, angina relief, Seattle Angina Questionnaire, SF-36, SYNTAX trial, revascularization
MeSH terms
Aged, Coronary Artery Bypass, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Drug-Eluting Stents, Percutaneous Coronary Intervention

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