Journal of Clinical Trials
Open Access

Abstract

Quality of Life in Patients with Multivessel Coronary Artery Disease: Ten-year Follow-up of a Comparison of Surgical, Angioplasty or Medical Strategies - MASS II Trial

Ana Luiza de Oliveira Carvalhobraz, Whady Hueb, Bernard J Gersh, Eduardo Gomes Lima, Desiderio Favarato, Paulo Cury Rezende, Myrthes Emy Takiuti, Priscyla Girardi, Cibele Larrosa Garzillo, Thiago Luis Scudeler, Carlos Alexandre Wainrober Segre, Alexandre Ciappina Hueb, José Antonio Franchini Ramires and Roberto Kalil Filho

Aims: We assessed quality of life (QoL) in patients with symptomatic multivessel coronary disease who randomly underwent surgery, angioplasty, or medical treatment. Although the clinical benefits of coronary interventions seem to be confirmed, their effects on QoL are still scarcely studied.
Methods and Results: The Short-Form Health Survey (SF-36) questionnaire was applied in patients at baseline, 6 months, and annually until the end of the study. At five years of follow-up, SF-36 had been completed by 483 patients and at 10 years by 334 patients.
Of these, 110 underwent surgical revascularization, 126 underwent angioplasty, and 98 were medically treated. All three therapeutic strategies resulted in significant improvement in all dimensions (P<0.001). The improvement reached similar levels in the three treatment groups. However, this increase did not reveal differences between the physical and mental components between the three therapeutic groups. Medical Treatment: In this group, the mental component improved in 83.7% of patients, whereas in relation to the physical component there was an improvement in 84.7% of them. Surgery: Regarding the mental component, there was an improvement in 85.4% of patients, whereas in relation to the physical component there was an improvement in 92.7% of them. Angioplasty: In this group, the mental component improved in 77.8% of patients, whereas in relation to the physical component there was an improvement in 73.0% of them.
Conclusion: Improvement was observed in all domains and in the three therapeutic modalities. Regarding the beginning of the study and compared with medical therapy or angioplasty, surgery provided better quality of life after 5 years of follow-up and that remained in up to ten years of follow-up.