Quality of Life After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting.
Quality of Life After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting.
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DOI：
10.1161/jaha.123.030069
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发表时间：
2023-11-20
影响因子：
5.4
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中科院分区：
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与经皮冠状动脉介入治疗（PCI）相比，冠状动脉旁路移植术（CABG）后的生活质量（QoL）差异尚未得到很好的表征。我们的目的是比较CABG与PCI对患者生活质量的短期和长期影响。我们使用西雅图心绞痛问卷(SAQ) -心绞痛频率、SAQ - QoL、SAQ -身体限制、EuroQoL - 5D和简短问卷对CABG和PCI的随机对照试验进行了系统回顾和meta分析。我们计算了每组从基线到1、6、12、36至60个月（最新随访）的平均变化，并使用反方差方法计算了组间加权平均差异。5项试验共纳入10760名患者。从基线到12个月和36到60个月，PCI和CABG后SAQ -心绞痛频率的平均变化为bb22点（95% CI, 21.0-25.6）。SAQ -心绞痛频率的平均差异在1个月和36 - 60个月时相似，但在12个月时CABG更受青睐（1.97 [95% CI, 0.68-3.26]）。SAQ - QoL倾向于PCI在1个月（- 2.92 [95% CI, - 4.66至- 1.18]）和CABG在6个月（2.50 [95% CI, 1.02-3.97]）， 12个月（3.30 [95% CI, 1.78-4.82]）和36至60个月（3.17 [95% CI, 0.54 - 5.80）。SAQ‐物理限制（- 12.61 [95% CI, - 16.16至- 9.06]）和EuroQoL‐5D （- 0.07 [95% CI, - 0.08至- 0.07）在1个月时支持PCI。简短问卷-身体成分倾向于在12个月时进行CABG （1.18 [95% CI, 0.46-1.90]）。PCI和CABG均改善了长期疾病特异性和一般生活质量。
Differences in quality of life (QoL) after coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI) are not well characterized. We aimed to compare the short‐ and long‐term effects of CABG versus PCI on QoL. We performed a systematic review and meta‐analysis of randomized controlled trials comparing CABG versus PCI using the Seattle Angina Questionnaire (SAQ)‐Angina Frequency, SAQ‐QoL, SAQ‐Physical Limitations, EuroQoL‐5D, and Short‐Form Questionnaire. We calculated mean changes within each group from baseline to 1, 6, 12, and 36 to 60 months (latest follow‐up) and the weighted mean differences between groups using inverse‐variance methods. A total of 10 760 patients were enrolled in 5 trials. From baseline to 12 months and 36 to 60 months, the mean change in SAQ‐Angina Frequency was >22 points (95% CI, 21.0–25.6) after both PCI and CABG. The mean difference in SAQ‐Angina Frequency was similar between procedures at 1 month and at 36 to 60 months but favored CABG at 12 months (1.97 [95% CI, 0.68–3.26]). SAQ‐QoL favored PCI at 1 month (−2.92 [95% CI, −4.66 to −1.18]) and CABG at 6 (2.50 [95% CI, 1.02–3.97]), 12 (3.30 [95% CI, 1.78–4.82]), and 36 to 60 months (3.17 [95% CI, 0.54 5.80). SAQ‐Physical Limitations (−12.61 [95% CI, −16.16 to −9.06]) and EuroQoL‐5D (−0.07 [95% CI, −0.08 to −0.07) favored PCI at 1 month. Short‐Form Questionnaire‐Physical Component favored CABG at 12 months (1.18 [95% CI, 0.46–1.90]). Both PCI and CABG improved long‐term disease‐specific and generic QoL.