2nd Department of Cardiology, Medical University, Lodz, Poland.
Kardiol Pol. 2010 Jan;68(1):22-30.
Treatment of chronic diseases, such as atherosclerosis, usually leads to significant short-term improvement. Mid- and long-term results are not always as satisfactory. That is why improvement of quality of life should be the leading qualification criterion for invasive procedures, which sometimes carry a risk of complications.
To determine the quality of life in patients with stable, multivessel coronary artery disease (MCAD), treated surgically or medically.
The study group comprised 107 patients (pts; 80 males) suffering from MCAD, assigned to coronary artery bypass grafting (CABG) (55 pts) or to medical treatment alone (52 pts). The mean Gensini score in the whole group was 90 (66-132). To evaluate quality of life we used a Short Form-36 (SF-36) health status survey by the International Quality of Life Assessment Project.
During a 12-month follow-up 9 pts died (6 pts in the medically treated group and 3 in the CABG group), all for cardiovascular reasons. Patients treated conservatively were more often hospitalised due to angina symptoms (20 vs. 5, p = 0.003). Analysis of SF-36 showed that pts treated surgically had better improvement of quality of life in comparison with medically treated patients. Significant differences were found for physical functioning, bodily pain, vitality, mental health and mental component summary.
This study has shown that there is a significant difference in health-related quality of life 12 months after CABG surgery and medical treatment alone in high-risk patients with MCAD. Surgical treatment decreases the number of adverse events, better attenuates of anginal and heart failure symptoms, and improves the quality of life, especially the mental component. Our results should encouraged selecting patients with advanced atherosclerosis for revascularisation procedures, even if there is a very high peri-procedural risk.
治疗慢性疾病，如动脉粥样硬化，通常会带来显著的短期改善。但中期和长期结果并不总是令人满意。这就是为什么生活质量的改善应该成为侵入性治疗的主要标准，这些治疗有时会带来并发症的风险。
确定接受手术或药物治疗的稳定型多支冠状动脉疾病（MCAD）患者的生活质量。
研究组包括 107 名患有 MCAD 的患者（107 名患者；80 名男性），分为冠状动脉旁路移植术（CABG）组（55 名患者）和单独药物治疗组（52 名患者）。全组患者的平均 Gensini 评分 90 分（66-132 分）。为了评估生活质量，我们使用了国际生活质量评估项目的 36 项简短健康状况调查（SF-36）。
在 12 个月的随访期间，有 9 名患者死亡（药物治疗组 6 例，CABG 组 3 例），均因心血管原因死亡。接受保守治疗的患者因心绞痛症状住院的频率更高（20 例 vs. 5 例，p = 0.003）。SF-36 分析表明，与药物治疗组相比，手术治疗组的生活质量有显著改善。在身体功能、身体疼痛、活力、心理健康和心理成分综合方面有显著差异。
这项研究表明，在高危 MCAD 患者中，CABG 手术后和单独药物治疗 12 个月后，健康相关生活质量存在显著差异。手术治疗可减少不良事件的发生，更好地减轻心绞痛和心力衰竭症状，并改善生活质量，尤其是心理成分。我们的研究结果应该鼓励对患有进展性动脉粥样硬化的患者进行血运重建治疗，即使围手术期风险非常高。
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