Abstract 2083: Five-Year Follow-Up of Quality of Life in Randomized Patients to Receive Coronary Bypass Surgery, Percutaneous Coronary Intervention or Medical Treatment: The Medicine Angioplasty or Surgery Study (MASS-II) Trial
Background: Although coronary bypass surgery (CABG), percutaneous coronary intervention (PCI) are used for the relief of symptoms and for a better tolerance to exercises, there is no conclusive evidence showing that these methods offer more benefits than the medical treatment (MT) to the quality of life (QoL) in patients with symptomatic coronary artery disease (CAD). This study sought to compare the QoL scores during 5-year in patients with stable multivessel CAD, who underwent one of the 3 therapeutic approaches.
Methods: From May 2000 and May 2005 a total of 611 patients were randomly assigned to a CABG (n=203), PCI (n=205) or MT (n=203). Of these patients, 546 (89%) were followed for assessments of QoL and demographic profile questionnaire for a 5-year period. 187 (34%) underwent CABG, 181 (33 %) PCI and 178 (33%) underwent MT. The Short Form Health-Related QoL Questionnaire (SF-36) was used to assess the patients, before randomization, six months, and 12months and annually until the end of study. The SF-36 comprises 36 items that can be combined into the following eight multi-item summary scores: physical functioning, vitality, bodily pain, mental heath, social functioning, and role limitation due to physical health, emotional problems and general health perceptions.
Results: At baseline, we found no difference relating to overall mortality between three groups. The eight domains of QoL showed improvement in all groups at 6-month follow-up visit compared with the baseline evaluation (p<0.001). Surgical therapy, PCI and MT showed improvements over baseline in most domains of quality of life (p<0.001). The improvements was observed mainly in surgical group and especially in physical role functioning. On the other hand medical therapy group showed fewer changed in their rating of general health. PCI group showed significant superiority over medical group in terms of physical functioning, vitality and general health after randomization.
Conclusion: All patients had improvement in QoL detected at 6 months persisting until 60 months. Moreover, CABG patients had better improvement of QoL compared with other groups. Furthermore, the QoL of PCI patients was better than MT patients at the end of follow-up.