Postgraduate Studies Program in Cardiology, School of Medicine, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), RS, Porto Alegre, Brazil.
Division of Cardiovascular Surgery, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), SP, São Paulo, Brazil.
Health Qual Life Outcomes. 2021 Nov 24;19(1):261. doi: 10.1186/s12955-021-01886-7.
Clinical, surgical, and percutaneous strategies similarly prevent major cardiovascular events in patients with stable coronary artery disease (CAD). The possibility that these strategies have differential effects on health-related quality of life (HRQoL) has been debated, particularly in patients treated outside clinical trials.
We assigned 454 patients diagnosed with CAD during an elective diagnostic coronary angiography to coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or optimal medical treatment (OMT), and followed them for an average of 5.2 ± 1.5 years. HRQoL was assessed using a validated Brazilian version of the 12-Item Short-Form Health Survey questionnaire. The association between therapeutic strategies and quality of life scores was tested using variance analysis and adjusted for confounders in a general linear model.
There were no differences in the mental component summary scores in the follow-up evaluation by therapeutic strategies: 51.4, 53.7, and 52.3 for OMT, PCI, and CABG, respectively. Physical component summary scores were higher in the PCI group than the CABG and OMT groups (46.4 vs. 42.9 and 43.8, respectively); however, these differences were no longer different after adjustment for confounding variables.
In a long-term follow-up of patients with stable CAD, HRQoL did not differ in patients treated by medical, percutaneous, or surgical treatments.
在稳定型冠状动脉疾病（CAD）患者中，临床、外科和经皮策略同样可以预防主要心血管事件。这些策略对健康相关生活质量（HRQoL）可能具有不同影响的可能性一直存在争议，尤其是在临床试验之外接受治疗的患者中。
我们将 454 名在选择性诊断性冠状动脉造影中诊断为 CAD 的患者分配至冠状动脉旁路移植术（CABG）、经皮冠状动脉介入治疗（PCI）或最佳药物治疗（OMT）组，并对他们进行了平均 5.2±1.5 年的随访。采用经过验证的巴西版 12 项简明健康调查问卷评估 HRQoL。采用方差分析和一般线性模型中的混杂因素调整来检验治疗策略与生活质量评分之间的关联。
在治疗策略的随访评估中，心理成分综合评分没有差异：OMT、PCI 和 CABG 组分别为 51.4、53.7 和 52.3。PCI 组的生理成分综合评分高于 CABG 和 OMT 组（分别为 46.4、42.9 和 43.8）；然而，在调整混杂变量后，这些差异不再有统计学意义。
在稳定型 CAD 患者的长期随访中，接受药物、经皮或手术治疗的患者的 HRQoL 没有差异。
