Document Type : Original Article(s)


1 Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland

3 Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Health Management and Economics Research Center AND School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

6 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran


BACKGROUND: Health-related quality of life (HRQOL) evaluation is an important measure of the impact of the disease. As more people with coronary heart disease (CHD) live longer, doctors and researchers want to know how they manage in day to day life. It looked like adults with CHD had a decrease QOL. The aim of this study was to comparison of HRQOL of patients who underwent percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) and to assess its main determinants in the whole sample of coronary artery disease (CAD) patients. METHODS: The study was carried out to estimate HRQOL of 109 patients who underwent invasive coronary revascularization [PCI (n = 75) and CABG (n = 34)]. We applied HRQOL after 6 months and 2 years in both groups and scores were compared. The HRQOL data were obtained using MacNew Heart Disease questionnaire with dimensions emotional, physical and social that estimated. Data entry and analysis were performed by SPSS. RESULTS: A total MacNew scale in CABG and PCI group in 6 months after treatment were 45.32 ± 13.75 and 53.52 ± 15.63, respectively (P = 0.010). After 2 years HRQOL mean changed to 51.176 ± 14.80 and 49.55 ± 16.22, respectively, in CABG and PCI group (P = 0.428). Our results in within-group analysis showed total MacNew scale and its subscales were changed significantly after 2 years in CABG and PCI group’s scores were detected. We found in the whole sample of CAD patients those who had a higher level of income and education and were not either overweight or obese experienced better HRQOL. CONCLUSION: Our results showed that patients who underwent PCI experienced significantly higher HRQOL in 6 months after revascularization but over 24 months follow-up no difference was observed between the two groups.   


  1. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001; 104(22): 2746-53.
  2. Habib SH, Saha S. Burden of non-communicable disease: Global overview. Diabetes Metab Syndr 2008; 4(1): 41-7.
  3. Deaton C, Froelicher ES, Wu LH, Ho C, Shishani K, Jaarsma T. The global burden of cardiovascular disease. J Cardiovasc Nurs 2011; 26(4 Suppl): S5-14.
  4. Morabia A, Abel T. The WHO report "Preventing chronic diseases: a vital investment" and us. Soz Praventivmed 2006; 51(2): 74.
  5. Talaei M, Sarrafzadegan N, Sadeghi M, Oveisgharan S, Marshall T, Thomas GN, et al. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Arch Iran Med 2013; 16(3): 138-44.
  6. Hadaegh F, Harati H, Ghanbarian A, Azizi F. Prevalence of coronary heart disease among Tehran adults: Tehran Lipid and Glucose Study. East Mediterr Health J 2009; 15(1): 157-66.
  7. Ardito SQ, Bestetti RB, Cardinalli-Neto A, Otaviano AP, Nogueira PR. Chronic renal impairment in patients with Chagas cardiomyopathy with chronic systolic heart failure: prevalence and prognostic significance. Int J Cardiol 2011; 152(1): 133-4.
  8. Joshi VD, Mooppil N, Lim JF. Validation of the kidney disease quality of life-short form: a cross-sectional study of a dialysis-targeted health measure in Singapore. BMC Nephrol 2010; 11: 36.
  9. Lee AJ, Morgan CL, Conway P, Currie CJ. Characterisation and comparison of health-related quality of life for patients with renal failure. Curr Med Res Opin 2005; 21(11): 1777-83.
  10. Kim C, Bernstein SJ. Quality of life assessment for chronic stable angina. Expert Rev Pharmacoecon Outcomes Res 2003; 3(5): 637-50.
  11. Asadi-Lari M, Javadi HR, Melville M, Oldridge NB, Gray D. Adaptation of the MacNew quality of life questionnaire after myocardial infarction in an Iranian population. Health Qual Life Outcomes 2003; 1: 23.
  12. Loponen P, Luther M, Korpilahti K, Wistbacka JO, Huhtala H, Laurikka J, et al. HRQOL after coronary artery bypass grafting and percutaneous coronary intervention for stable angina. Scand Cardiovasc J 2009; 43(2): 94-9.
  13. Norris CM, Saunders LD, Ghali WA, Brant R, Galbraith PD, Graham M, et al. Health-related quality of life outcomes of patients with coronary artery disease treated with cardiac surgery, percutaneous coronary intervention or medical management. Can J Cardiol 2004; 20(12): 1259-66.
  14. Dorr DA, Jones SS, Burns L, Donnelly SM, Brunker CP, Wilcox A, et al. Use of health-related, quality-of-life metrics to predict mortality and hospitalizations in community-dwelling seniors. J Am Geriatr Soc 2006; 54(4): 667-73.
  15. DeSalvo KB, Fan VS, McDonell MB, Fihn SD. Predicting mortality and healthcare utilization with a single question. Health Serv Res 2005; 40(4): 1234-46.
  16. Naik H, White AJ, Chakravarty T, Forrester J, Fontana G, Kar S, et al. A meta-analysis of 3,773 patients treated with percutaneous coronary intervention or surgery for unprotected left main coronary artery stenosis. JACC Cardiovasc Interv 2009; 2(8): 739-47.
  17. Muller-Nordhorn J, Kulig M, Binting S, Voller H, Gohlke H, Linde K, et al. Change in quality of life in the year following cardiac rehabilitation. Qual Life Res 2004; 13(2): 399-410.
  18. Bravata DM, McDonald KM, Gienger AL, Sundaram V, Perez MV, Varghese R, et al. Comparative Effectiveness of Percutaneous Coronary Interventions and Coronary Artery Bypass Grafting for Coronary Artery Disease [Internet]. Journal of General Internal Medicine 2007.
  19. Luttik ML, Jaarsma T, Veeger N, van Veldhuisen DJ. Marital status, quality of life, and clinical outcome in patients with heart failure. Heart Lung 2006; 35(1): 3-8.
  20. Lukkarinen H, Hentinen M. Assessment of quality of life with the Nottingham Health Profile among patients with coronary heart disease. J Adv Nurs 1997; 26(1): 73-84.
  21. Duenas M, Ramirez C, Arana R, Failde I. Gender differences and determinants of health related quality of life in coronary patients: a follow-up study. BMC Cardiovasc Disord 2011; 11: 24.
  22. Unsar S, Sut N, Durna Z. Health-related quality of life in patients with coronary artery disease. J Cardiovasc Nurs 2007; 22(6): 501-7.
  23. Durmaz T, Ozdemiir O, Ozdemiir BA, Keles T, Bayram NA, Bozkurt E. Factors affecting quality of life in patients with coronary heart disease. Turkish J Med Sci 2009; 39(3): 343-51.
  24. Rumsfeld JS, Magid DJ, Plomondon ME, Sacks J, Henderson W, Hlatky M, et al. Health-related quality of life after percutaneous coronary intervention versus coronary bypass surgery in high-risk patients with medically refractory ischemia. J Am Coll Cardiol 2003; 41(10): 1732-8.