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15 January 1994 | Volume 120 Issue 2 | Pages 111-117
Objective: To compare return-to-work rates after coronary angioplasty, coronary bypass surgery, and medical therapy in patients with coronary disease.
Design: Prospective cohort study.
Setting: Tertiary care referral center.
Patients: Between March 1986 and June 1990, we enrolled 1252 patients who were younger than 65 years, who had not had previous coronary revascularization, and who were employed. All patients were followed for 1 year.
Main Outcome Measure: One-year employment status.
Results: After 1 year, 84% of patients who had coronary angioplasty were still working compared with 79% of patients who had bypass surgery and with 76% of patients who received medicine. After adjusting for the more favorable baseline characteristics of patients who had angioplasty (less severe coronary artery disease, better left ventricular function, and less functional impairment), however, no significant differences were noted in 1-year employment rates among the three groups. These adjusted 1-year return-to-work rates were 84% for angioplasty, 80% for surgery, and 79% for medicine (P > 0.05). In a random subset of 72 patients, 23 patients who had angioplasty returned to work after a median of 18 days (mean, 27 days) compared with 54 days (mean, 67 days) for 24 patients having bypass surgery and with 14 days (mean, 45 days) for 25 patients receiving medicine (P = 0.002).
Conclusions: Patients who had coronary angioplasty were able to return to work earlier than those who had bypass surgery, but by 1 year no significant difference was noted in employment rates. Neither revascularization strategy improved employment rates when compared with initial treatment using medical therapy.
Author and Article Information
From Duke University Medical Center, Durham, North Carolina. Stanford University School of Medicine, Stanford, California.
ARTICLE
Effects of Coronary Angioplasty, Coronary Bypass Surgery, and Medical Therapy on Employment in Patients with Coronary Artery Disease: A Prospective Comparison Study
Requests for Reprints: Daniel B. Mark, MD, MPH, P.O. Box 3485, Duke University Medical Center, Durham, NC 27710.
Acknowledgments: The authors thank Ms. Susan Blackwell, Ms. Diane Cooper, Ms. Carolyn Lumpkins, Ms. Dorothy Brown, Mr. Charlie Moore, and Ms. Lori Baysden for providing technical assistance.
Grant Support: By grants HL-36587, HL-45702 and HL-17670 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland; grants HS-05635 and HS-06503 from the Agency for Health Care Policy and Research, Rockville, Maryland; and a grant from the Robert Wood Johnson Foundation, Princeton, New Jersey.
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