Lebensqualität von Patienten nach MIDCAB-Operation versus isoliertem RIV A-Stenting im Langzeitverlauf
Aims: Studies are rare comparing post- treatment, health- related quality of life (HRQOL) for patients with isolated or predominant LAD- stenosis assigned to MIDCABG, versus percutaneous coronary stenting (PCS). Methods and results: Post- treatment HRQOL of 330 patients, 172 Midcab (28.48% women) and 158 PCS (27.22% women), all treated between 1999/11 and 2006/12, was assessed via SF-36 Health Survey. 137 MIDCAB patients had single- (79.7%), 23 double- (13.4%), and 12 triple vessel (7.0%) disease. The stent-grafted group showed 125 (79.1%) single-, 23 (14.6%) and 10 (6.3%) triple-vessel diseases. Primary outcomes were the scores of all eight scales as well as physical component summary (pcs) and mental component summary (mcs) scores. Mean follow up was 3.2 years. HRQOL of all MIDCAB- patients, and especially single- vessel diseased (SVD) ones, was better in six of eight subscales and significantly better in general health perception [ghp] (p 0.036, CI 95%). The group of 60 to 79 year- old MIDCAB- patients gained significantly higher results in ghp (p 0.011, CI 95%) and pcs (p 0.017, CI 95%). Time to data- collection had no influence on HRQOL. Stent-grafted patients older than 80 years showed better results in all eight sub- and the two summscales with significant differences in physical role functioning [pfi] (p 0.046, CI 95%) and role emotional functioning [rolem] (p 0.014, CI 95%). Conclusions: MIDCAB- strategy, especially on patients with isolated LAD- stenosis, seems to be superior to PCS regarding HRQOL, which suggests it is a valuable instrument in interdisciplinary decision- making process. However, in patients older than 80 years quality of life is higher after stent-grafting.