Introduction: Coronary revascularisation has improved during the last decades, both technically and its adjuvant therapy. It is now a safe procedure in patients with suitable coronary anatomy. However, there is little information on quality of life after revascularization and reappearance of anginal symptoms.
Purpose: The aim of this study was to assess reappearance of symptoms after revascularization and its impact on quality of life (QoL) in patients with chronic stable angina (CSA).
Methods: Observational multicentric National survey where 1507 patients with CSA patients were prospectively and consecutively recruited. Baseline characteristics, Seattle Angina Questionnaire (SAQ), SF-12 and Morisky-Green scores were obtained.
Results: 1290 (85.6%) patients had prior revascularization: CABG+PCI 7.2%, CABG 13.9%, PCI 78.9%. Patients with coronary revascularization were more frequently men than women (p=0.001), were younger, had more prior myocardial infarction, less history of hypertension, more DM, less kidney disease, higher hemoglobin, lower LDL-C, higher triglycerides, and better heart rate control. Density of angina was similar in both groups. Revascularized patients were treated less frequently with non-dihydropiridinic CCB, nitrates, trimetazidine, but received more ivabradine, ranolazine, antiplatelet treatment, statins and oral antidiabetic treatment. New symptoms resumed in 31.2% of patients after a median of 12 months from revascularization. There was a trend to a worse Morisky Green score among non revascularized patients. SAQ questionnaire yielded worse results in non revascularized patients in all domains but one (similar perception of disease). Standardized SF12 domains showed an impaired physical component, with similar standardized mental component. However, any significant difference between groups disappeared in the multiple regression analysis.
Conclusions: Coronary revascularization is frequent in patients with chronic stable angina. However, reappearance of angina symptoms in also frequent: 31% of patients had new symptoms after a median of 12 months after coronary revascularization. There is no significant difference in QoL in revascularized patients.