Quality of life and coronary artery bypass surgery: A longitudinal study

INTRODUCTION: Cardiovascular disease (CVD) remains a significant worldwide health problem leading to premature death and chronic illness with Coronary heart disease (CHD) accounts for 52% of CVD cases with 16 million cases of CHD in the US. One of the treatment options for those with CHD is Coronary Artery Bypass Surgery (CABG). The aim of the surgery is to alleviate symptoms such as angina and breathlessness, prevent further Myocardial Infarctions (MIs) and reduce the progression of CHD. METHOD and AIM OF STUDY: A study was undertaken in the United Kingdom five years after CABG. Patients from a previous study agreed to participate in a follow-up study five years after cardiac surgery. Participants were asked to complete a quality of life questionnaire, the Short-Form 36 (SF-36) and questionnaires on their psychological well-being (anxiety and depression symptoms). Neuropsychological assessment was also performed at the follow-up. The assessments of psychological well-being and neuropsychological tests were previously completed prior to surgery. RESULTS: One hundred and nine patients were interviewed face-to-face. The SF-36 component summaries of the patients indicated that their physical (PCS) and mental (MCS) health was relatively good (45.8 and 53.6, respectively, with 0 = worst health and 100 = best health and 50 being the mean score). Lower PCS scores were associated with comorbid illness. Psychological well-being (anxiety and depression) was found to correlate with the SF-36 physical and mental component summaries (p .001) at the time of follow-up. Deficits in neuropsychological scores five years post CABG were found in 28% of the patients with no correlation between the SF-36 component summaries and the neuropsychological assessment five years after CABG suggesting that these deficits do not interfere with patient perceived HRQoL. DISCUSSION: The significance of psychological well-being were highlighted in the hierarchical regression analysis with pre-operative angina scores and the following data five years post CABG; comorbid illness, anxiety and depressive symptoms and physical activity, accounting for 37% of the variance in PCS. Pre-operative anxiety, interim myocardial infarction and the following data five years post CABG: age, diet scores, anxiety and depression symptoms, accounted for 60% of the variance in MCS. CONCLUSION: The findings demonstrate that patient perceived HRQoL five years after CABG is generally good. However, it is negatively affected the presence of anxiety or depression symptoms at follow-up. The findings have implications for healthcare professionals and highlight the importance of anxiety and depression after surgical revascularisation.