Introduction
Health-related quality of life (HRQoL) has become an important outcome measure. The majority of medical treatments are now evaluated not only in terms of clinical/biomarker benefits but also in terms of HRQoL improvements. In 2011, Noyez et al.1 reviewed the literature regarding HRQoL studies after cardiac surgery. The review showed few HRQoL studies as well as methodological weaknesses such as limited follow-up times and limited sample sizes.
More studies have been published in the last decade, and almost all have used the SF-36 or the RAND-36 to measure HRQoL after cardiac surgery, in particular after coronary artery bypass grafting (CABG)2-11. The RAND 36-item health survey 1.012 is a public domain and licence-free form equivalent to the SF-36. The scoring for six of the eight subscales is equivalent for the SF-36 and RAND-36, while scoring for the pain and general health scales differs marginally12. RAND-36 is a generic measure of HRQoL which has been validated in the general population and for different patient groups.
To our knowledge, no report published in English has investigated HRQoL in CABG patients who subsequently need a percutaneous coronary intervention (PCI) on a saphenous vein graft (SVG). PCI is an established procedure with excellent results in ischemic heart disease patients, particularly when revascularizing the native coronary arteries13. On the other hand, PCI of a degenerated SVG often results in a complex percutaneous intervention and its use is debated14. Controversial results with a high rate of major adverse cardiac events (MACE) have been observed in both the short and long term. No results have yet been reported regarding PCI of a saphenous vein harvested with the no-touch (NT)15technique or treated in any other way during the primary CABG operation. The no-touch technique differs from the conventional (C) technique in that it causes less endothelium damage during the harvesting procedure16, 17, and leads to reduced neo-intimal hyperplasia and subsequent atherosclerosis in the long term18. Our group has previously investigated HRQoL in CABG patients who had received a no-touch vein graft11, but that study did not compare the no-touch technique with the conventional technique.
The aim of this study was to evaluate HRQoL in individuals who needed a PCI of their SVG after a CABG operation. Our specific aim was to compare HRQoL between patients treated with a no-touch SVG and patients who received a conventional SVG.