Medical care costs and quality of life after randomization to coronary angioplasty or coronary bypass surgery.
Background Randomized trials comparing coronary angioplasty with bypass surgery in patients with multivessel coronary disease have shown no significant differences in overall rates of death and myocardial infarction.
We compared quality of life, employment, and medical care costs during five years of follow-up among patients treated with angioplasty or bypass surgery.
Methods A total of 934 of the 1829 patients enrolled in the randomized Bypass Angioplasty Revascularization Investigation participated in this study.
Detailed data on quality of life were collected annually, and economic data were collected quarterly.
Results During the first three years of follow-up, functional-status scores on the Duke Activity Status Index, which measures the ability to perform common activities of daily living, improved more in patients assigned to surgery than in those assigned to angioplasty (P<0.05).
Other measures of quality of life improved equally in both groups throughout the follow-up period.
Patients in the angioplasty group returned to work five weeks sooner than did patients in the surgery group (P<0.001).
The initial mean cost of angioplasty was 65 percent that of surgery ($21,113 vs. $32,347, P<0.001), but after five years the total medical cost of angioplasty was 95 percent that of surgery ($56,225 vs. $58,889), a difference of $2,664 (P=0.047). (...)
Mots-clés Pascal : Plastie, Dérivation, Artère coronaire, Soin, Coût, Qualité vie, Postopératoire, Etude comparative, Homme, Essai clinique, Etude longitudinale, Prospective, Chirurgie
Mots-clés Pascal anglais : Plasty, Bypass, Coronary artery, Care, Costs, Quality of life, Postoperative, Comparative study, Human, Clinical trial, Follow up study, Prospective, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0137365
Code Inist : 002B30A01A2. Création : 21/05/1997.