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Quality of life in coronary artery disease
1Department of Nursing, University of Oulu, Oulu University Hospital, Finland.
Insights
Coronary artery disease (CAD) patients undergoing percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass surgery (CABS) reported better quality of life (QOL) than those on medication alone. Rehabilitation remains crucial for CAD patients.
Area of Science:
- Cardiology
- Quality of Life Research
- Health Economics
Background:
- Coronary artery disease (CAD) poses a significant financial burden in Finland, causing substantial mortality.
- CAD affects approximately 7,500 men and 6,500 women annually in Finland.
Purpose of the Study:
- To evaluate changes in quality of life (QOL) for CAD patients over one year.
- To compare QOL outcomes for patients treated with medication, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass surgery (CABS).
Main Methods:
- A cohort of 280 CAD patients was studied: 100 for CABS, 100 for PTCA, and 80 for drug therapy.
- Patients completed the Nottingham Health Profile (NHP) questionnaire pre-intervention and at 6 and 12 months post-intervention.
- NHP assessed health status, QOL, functional capacity, and distress.
Main Results:
- Patients treated with CABS and PTCA showed significant QOL improvements in energy, pain, and mobility after one year.
- The medication group experienced only an improvement in social isolation, with declines in energy and mobility.
- Post-treatment, patients continued to face QOL challenges, often in different areas than pre-treatment.
Conclusions:
- Surgical interventions (CABS, PTCA) generally lead to better QOL outcomes compared to medication alone for CAD patients.
- Despite treatment success, CAD patients experience persistent QOL issues, necessitating comprehensive rehabilitation.
- Patient preferences and QOL should be key factors in selecting CAD treatment modalities.
Background:
Coronary artery disease (CAD) constitutes a considerable financial burden on society in Finland; it is the cause of death of approximately 7,500 men and 6,500 women annually in a population of 5 million.
Objectives:
The purpose of this study was to assess the changes in the quality of life (QOL) of patients with CAD treated by medication, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass surgery (CABS) during 1 year.
Method:
The study population consisted of 280 patients with CAD. One hundred patients had been referred to CABS and another 100 to PTCA, whereas 80 patients were on drug therapy. The patients assessed their health status and QOL in terms of functional capacity and aspects of distress using self-completed questionnaires with the Nottingham Health Profile (NHP) instrument before the operation and 6and 12 months afterwards.
Results:
The QOL of the patients who had undergone CABS and PTCA was significantly better on the dimensions of energy, pain, and mobility 1 year after the intervention. In the medication group, the only improvement took place on the dimension of social isolation, whereas both energy and mobility deteriorated.
Conclusions:
The results on QOL obtained in this study support the notion that patients continue to have many problems even after medical treatment with a good outcome. The problems occur in different areas compared with the pretreatment situation as on the dimensions of social isolation and emotional reaction. The rehabilitation of CAD patients is therefore important because the new problems are manifested differently from those seen before the illness or the treatment. The patient's QOL and personal preference for a treatment modality should be important criteria in the choice of treatment.