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Meta-Analysis
. 2023 Nov 21;12(22):e030069.
doi: 10.1161/JAHA.123.030069. Epub 2023 Nov 20.

Quality of Life After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting

Arnaldo Dimagli  1   2 , Cristiano Spadaccio  3 , Annie Myers  4 , Michelle Demetres  2 , Tessa Rademaker-Havinga  5 , Gregg W Stone  6 , John A Spertus  7 , Bjorn Redfors  8 , Stephen Fremes  9 , Mario Gaudino  2 , Ruth Masterson Creber  10
Affiliations
Meta-Analysis

Quality of Life After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting

Arnaldo Dimagli et al. J Am Heart Assoc. .

Abstract

Background: Differences in quality of life (QoL) after coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI) are not well characterized. We aimed to compare the short- and long-term effects of CABG versus PCI on QoL.

Methods and results: We performed a systematic review and meta-analysis of randomized controlled trials comparing CABG versus PCI using the Seattle Angina Questionnaire (SAQ)-Angina Frequency, SAQ-QoL, SAQ-Physical Limitations, EuroQoL-5D, and Short-Form Questionnaire. We calculated mean changes within each group from baseline to 1, 6, 12, and 36 to 60 months (latest follow-up) and the weighted mean differences between groups using inverse-variance methods. A total of 10 760 patients were enrolled in 5 trials. From baseline to 12 months and 36 to 60 months, the mean change in SAQ-Angina Frequency was >22 points (95% CI, 21.0-25.6) after both PCI and CABG. The mean difference in SAQ-Angina Frequency was similar between procedures at 1 month and at 36 to 60 months but favored CABG at 12 months (1.97 [95% CI, 0.68-3.26]). SAQ-QoL favored PCI at 1 month (-2.92 [95% CI, -4.66 to -1.18]) and CABG at 6 (2.50 [95% CI, 1.02-3.97]), 12 (3.30 [95% CI, 1.78-4.82]), and 36 to 60 months (3.17 [95% CI, 0.54 5.80). SAQ-Physical Limitations (-12.61 [95% CI, -16.16 to -9.06]) and EuroQoL-5D (-0.07 [95% CI, -0.08 to -0.07) favored PCI at 1 month. Short-Form Questionnaire-Physical Component favored CABG at 12 months (1.18 [95% CI, 0.46-1.90]).

Conclusions: Both PCI and CABG improved long-term disease-specific and generic QoL.

Keywords: coronary artery bypass grafting; coronary artery disease; percutaneous coronary intervention.

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Figures

Figure 1
Figure 1. Forest plots showing pooled weighted mean differences of angina frequency scores with 1, 6, 12, and 36/60 months follow‐up data for SAQ‐AF., , , ,
CABG indicates coronary artery bypass grafting; MD, mean difference; PCI, percutaneous coronary intervention; and SAQ‐AF, Seattle Angina Questionnaire‐Angina Frequency.
Figure 2
Figure 2. Forest plots showing pooled weighted mean differences of quality of life scores with 1, 6, 12, and 36/60 months follow‐up data for SAQ‐QoL., , , ,
CABG indicates coronary artery bypass grafting; MD, mean difference; PCI, percutaneous coronary intervention; and SAQ‐QoL, Seattle Angina Questionnaire‐Quality of Life.
Figure 3
Figure 3. Forest Plots showing pooled weighted mean differences of physical limitation scores with 1, 6, 12, and 36/60 months follow‐up data for SAQ‐PL., , , ,
CABG indicates coronary artery bypass grafting; MD, mean difference; PCI, percutaneous coronary intervention; and SAQ‐PL, Seattle Angina Questionnaire‐Physical Limitation.
Figure 4
Figure 4. Forest plots showing pooled weighted mean differences of generic quality of life scores with 1, 6, 12, and 36/60 months follow‐up data for EQ‐5D., , ,
CABG indicates coronary artery bypass grafting; EQ‐5D, EuroQoL‐5D; MD, mean difference; and PCI, percutaneous coronary intervention.
Figure 5
Figure 5. Forest plots showing pooled weighted mean differences of the physical quality of life scores with 1, 6, 12, and 36/60 months follow‐up data for SF‐PC., , ,
CABG indicates coronary artery bypass grafting; MD, mean difference; PCI, percutaneous coronary intervention; and SF‐PC, Short Form Physical Component.
Figure 6
Figure 6. Forest plots showing pooled weighted mean differences of mental quality of life scores with 1, 6, 12, and 36/60 months follow‐up data for SF‐MC., , ,
CABG indicates coronary artery bypass grafting; MD, mean difference; PCI, percutaneous coronary intervention; and SF‐MC, Short Form Mental Component.
See this image and copyright information in PMC

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