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N Engl J Med. 2008 Aug 14;359(7):677-87. doi: 10.1056/NEJMoa072771.

Effect of PCI on quality of life in patients with stable coronary disease.

Collaborators (309)

Boden WE, O'Rourke RA, Teo KK, Hartigan PM, Weintraub W, Maron D, Mancini GB, Weintraub WE, Boden WE, O'Rourke RA, Teo KK, Hartigan PM, Knudtson M, Maron DJ, Bates E, Blaustein AS, Booth DC, Carere RG, Ellis SG, Gosselin G, Gau G, Jacobs AK, King SB 3rd, Kostuk WJ, Harris C, Spertus J, Peduzzi P, Ryan T, Turnbull B, Feldman T, Bonow RO, Haskell WL, Diehr P, Lachenbruch P, Waters DD, Johnstone DE, Cohen LS, Cantin B, Hager WD, Samaha FF, Januzzi JL, Arrighi J, Chaitman B, Weintraub WS, Hartigan P, O'Rourke RA, Boden WE, Barnett P, Spertus J, Goeree R, Maron D, Boden WE, O'Rourke RA, Teo KK, Weintraub WW, Peduzzi P, Antonelli M, Smith J, Kilstrom R, Hunter B, Edgington M, Petrokaitis E, Durant L, O'Neil S, Economou TM, Nabors J, Collins P, Kossack A, Sather M, Harris C, Gagne W, Fye C, Marottoli R, Allore HG, Beckwith DG, Farrell W, Feldman RC, Mehta R, Neiderman JC, Perry EB, Kasl S, Zeman M, O'Leary TJ, Huang GD, Boden WE, Dada M, Potter K, O'Rourke RA, Casperson P, O'Shea A, Jordan G, Teo KK, Piette JA, Woodcock G, Weintraub WS, Barnett P, Chen S, Goeree R, O'Brien B, Henderson C, Mancini GB, Yeoh E, Ladenson J, Thompson V, Gibson D, Mischle L, Luzzi V, Cole TG, McDowell J, Chaitman B, Bertran T, Bussen J, Moore C, Berman D, Germano G, Gerlach J, Littman R, Miranda-Peats R, Hurayt A, Calfas K, Sallis J, Freeman GL, O'Rourke RA, Bolton J, Freeman P, Mercado-Young R, Baker P, Blaustein A, Rowe C, Morris KG, Hoffman S, Sedlis SP, Scott MK, Anteola E, Duvernoy C, Starling M, Majors C, Syzmanski K, Booth DC, Shockey ML, Zoble R, Fernandez I, Bell K, Lehmann KG, Dinkelspiel J, Abel M, Sorley A, Sheldon MW, Crawford M, Wagoner K, Murphy E, Avalos K, Rossen JD, Jagasia D, Ollinger A, Schneider K, Molavi B, Garza L, Saucedo J, Barton P, Pacheco R, Dodson SS, Kitchens S, Mavromatis K, Leimbach M, Forghani Z, House D, Smith RF, Mitchell C, Holzapfel P, Brewer MJ, Ramanathan K, Touchstone T, Qualls Z, Kostuk WJ, Carr S, Sridhar K, Nawaz S, Dion C, Musseau S, Poirier RA, Sequin T, Gosselin G, Cuso M, Theberge J, Brouillette M, Thibeault P, Title LM, Simon P, Carroll L, Courtney-Cox K, Fitzgerald N, Carter C, Cohen EA, Hsu E, Balleza L, Dzavik V, Barolet PA, McLaughlin, Lazzam C, Lan J, Patel A, Knudtson M, Goodhart D, Lundberg D, Natarajan M, Cappelli G, Savoy S, Miller C, Kutryk M, Strauss B, Freeman M, DiMarco A, Young K, Fry A, O'Donnell D, Fung A, Buller C, Chow J, Marr D, Teskey R, Fitzgerald F, Collings E, Coyle C, Ramsay C, Williston A, Carere R, Thompson C, Nacario T, Williams T, Tymchak W, Harris L, Lazzam C, Carter A, Palisaitis D, Mercure C, Bell M, Gau PG, Berger P, Allison T, Peterson ME, Malibago T, Vicari R, Carroll M, Scallon N, Parker L, Howard M, Snyman A, Bates E, Chetcuti S, Luciano A, McNeely K, Mahrer P, Reyes S, Browning R, Scutella P, Saucedo J, Sadanandan S, Kugelmass A, vanWieren D, Feddersen L, Husain K, Wells J, O'Keefe J, McAllister B, Kennedy P, Rossen M, Jacobs A, Jacobs A, Berger C, Mayo S, Fine D, Zingariello C, Hutchinson J, Gannon D, Miller JI 3rd, Manoukian S, Arnold T, Kiernan F, Dada M, Potter K, Murphy D, Kugelmass A, Pangilinan R, Schwartz R, Caufield L, Smith R, Hansen D, Mitchell C, Holzapfel P, Brewer MJ, Carhart R, Pennella A, Jones M, Ellis SG, Stevenson C, Krone RJ, Humphrey J, Luepke KM, Appleton C, Crawford M, Wisbey J, Wood L, Pyle B, Stillabower ME, DiSabatino A, Davidson M, Hendel R, Mathien J.

Author information

  • 1Christiana Care Health System, Newark, DE 19718, USA. wweintraub@christianacare.org

Abstract

BACKGROUND:

It has not been clearly established whether percutaneous coronary intervention (PCI) can provide an incremental benefit in quality of life over that provided by optimal medical therapy among patients with chronic coronary artery disease.

METHODS:

We randomly assigned 2287 patients with stable coronary disease to PCI plus optimal medical therapy or to optimal medical therapy alone. We assessed angina-specific health status (with the use of the Seattle Angina Questionnaire) and overall physical and mental function (with the use of the RAND 36-item health survey [RAND-36]).

RESULTS:

At baseline, 22% of the patients were free of angina. At 3 months, 53% of the patients in the PCI group and 42% in the medical-therapy group were angina-free (P<0.001). Baseline mean (+/-SD) Seattle Angina Questionnaire scores (which range from 0 to 100, with higher scores indicating better health status) were 66+/-25 for physical limitations, 54+/-32 for angina stability, 69+/-26 for angina frequency, 87+/-16 for treatment satisfaction, and 51+/-25 for quality of life. By 3 months, these scores had increased in the PCI group, as compared with the medical-therapy group, to 76+/-24 versus 72+/-23 for physical limitation (P=0.004), 77+/-28 versus 73+/-27 for angina stability (P=0.002), 85+/-22 versus 80+/-23 for angina frequency (P<0.001), 92+/-12 versus 90+/-14 for treatment satisfaction (P<0.001), and 73+/-22 versus 68+/-23 for quality of life (P<0.001). In general, patients had an incremental benefit from PCI for 6 to 24 months; patients with more severe angina had a greater benefit from PCI. Similar incremental benefits from PCI were seen in some but not all RAND-36 domains. By 36 months, there was no significant difference in health status between the treatment groups.

CONCLUSIONS:

Among patients with stable angina, both those treated with PCI and those treated with optimal medical therapy alone had marked improvements in health status during follow-up. The PCI group had small, but significant, incremental benefits that disappeared by 36 months. (ClinicalTrials.gov number, NCT00007657.)

2008 Massachusetts Medical Society

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PMID:
18703470
[PubMed - indexed for MEDLINE]
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