Cited by 288Coronary Interventions and DiagnosticsCardiac and Coronary Surgery TechniquesCardiac Imaging and Diagnostics

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Quality of Life after PCI with Drug-Eluting Stents or Coronary-Artery Bypass Surgery

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Cohen, David J., Van Hout, Ben, Serruys, Patrick W., Mohr, Friedrich W., Macaya, Carlos, den Heijer, Peter, Vrakking, M.M., Wang, Kaijun, Mahoney, Elizabeth M., Audi, Salma, Leadley, Katrin, Dawkins, Keith D., Kappetein, A. Pieter·2011·New England Journal of Medicine

DOI 10.1056/nejmoa1001508

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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.).

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Authors: 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.
Affiliations: Saint Luke's Hospital (US)
Erasmus MC (NL)
Leipzig University (DE)
Hospital Clínico San Carlos (ES)
Amphia Ziekenhuis (NL)
University of Missouri–Kansas City (US)
Boston Scientific (United States) (US)
ORCID: Cohen, David J.
Serruys, Patrick W.
Mohr, Friedrich W.
Macaya, Carlos
Wang, Kaijun
Kappetein, A. Pieter
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2011-03-17
Volume: 364
Issue: 11
Pages: 1016-1026
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa1001508
OpenAlex: W2163397430
Cited by: 288
References: 26
Citations by year: 2026: 10 · 2025: 9 · 2024: 7 · 2023: 12 · 2022: 20 · 2021: 19 · 2020: 20 · 2019: 10 · 2018: 14 · 2017: 18 · 2016: 25 · 2015: 21 · 2014: 22 · 2013: 34 · 2012: 29
FWCI: 33.67
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
RePub (Erasmus University Rotterdam) (submittedVersion)
Funders: Boston Scientific Corporation
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › 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: coronary artery bypass grafting, percutaneous coronary intervention, drug-eluting stents, paclitaxel-eluting stents, multivessel coronary artery disease, left main coronary artery disease, health-related quality of life, angina relief, Seattle Angina Questionnaire, SF-36, revascularization outcomes
MeSH terms: Activities of Daily Living, Aged, Angina Pectoris, Coronary Artery Bypass, Coronary Artery Disease, Female, Health Status, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Surveys and Questionnaires, Angioplasty, Balloon, Coronary, Outcome Assessment, Health Care, Drug-Eluting Stents

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