1. Matzo, Marianne PhD, GNP-BC, FAAN

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Better quality of life for bypass surgery patients.


Patients with moderate coronary artery disease (defined as blockage of the left anterior descending artery, blockage of two arteries, or certain types of less severe blockage of three arteries) are more likely to experience "relief from painful angina and less likely to have repeat procedures if they get bypass surgery rather than balloon angioplasty with or without a stent," according to a report issued by the Agency for Healthcare Research and Quality.


The authors considered 23 randomized, controlled trials comparing the effectiveness and outcomes of angioplasty and bypass surgery to treat coronary artery disease. As noted in the report, the rate of survival of either procedure is high (98.5%) and long-term survival is comparable (about 90% of patients having undergone either procedure live five years or longer). But one year afterward, 84% of bypass patients and 75% of angioplasty patients are free of anginal pain, a difference that "narrows but remains substantial five years after treatment."


The crux of the matter. Quality of life is an important consideration in patients undergoing treatment for coronary artery disease. Study findings indicate that six months to three years after treatment, the quality of life generally is significantly better among bypass surgery patients, compared with those who had undergone balloon angioplasty, a difference attributable to the more widespread relief of anginal pain among the former.


Stanford-UCSF Evidence-based Practice Center. Comparative effectiveness of percutaneous coronary interventions and coronary artery bypass grafting for coronary artery disease. Rockville, MD: Agency for Healthcare Research and Quality; 2007 Oct. Number 9. Comparative effectiveness review;