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Quality of Life after PCI with Drug-Eluting Stents or Coronary-Artery Bypass Surgery
Open accessAbstract
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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“residual angina after revascularization is quite common, with ≈20% to 30% of patients reporting angina at 1 year after revascularization”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [244]
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Metadata
- 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
- 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
- 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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