Effects of coronary angioplasty, coronary bypass surgery, and medical therapy on employment in patients with coronary artery disease: A prospective comparison study

Daniel B. Mark, Lai Choi Lam, Kerry L. Lee, Robert H. Jones, David B. Pryor, Richard S. Stack, Redford B. Williams, Nancy E. Clapp-Channing, Robert M. Califf, Mark A. Hlatky

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Abstract

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.

Original languageEnglish
Pages (from-to)111-117
Number of pages7
JournalAnnals of Internal Medicine
Volume120
Issue number2
StatePublished - Jan 15 1994
Externally publishedYes

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Angioplasty
Coronary Artery Disease
Prospective Studies
Return to Work
Therapeutics
Medicine
Tertiary Care Centers
Left Ventricular Function
Coronary Disease
Cohort Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

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Effects of coronary angioplasty, coronary bypass surgery, and medical therapy on employment in patients with coronary artery disease : A prospective comparison study. / Mark, Daniel B.; Lam, Lai Choi; Lee, Kerry L.; Jones, Robert H.; Pryor, David B.; Stack, Richard S.; Williams, Redford B.; Clapp-Channing, Nancy E.; Califf, Robert M.; Hlatky, Mark A.

In: Annals of Internal Medicine, Vol. 120, No. 2, 15.01.1994, p. 111-117.

Research output: Contribution to journalArticle

Mark, DB, Lam, LC, Lee, KL, Jones, RH, Pryor, DB, Stack, RS, Williams, RB, Clapp-Channing, NE, Califf, RM & Hlatky, MA 1994, 'Effects of coronary angioplasty, coronary bypass surgery, and medical therapy on employment in patients with coronary artery disease: A prospective comparison study', Annals of Internal Medicine, vol. 120, no. 2, pp. 111-117.
Mark, Daniel B. ; Lam, Lai Choi ; Lee, Kerry L. ; Jones, Robert H. ; Pryor, David B. ; Stack, Richard S. ; Williams, Redford B. ; Clapp-Channing, Nancy E. ; Califf, Robert M. ; Hlatky, Mark A. / Effects of coronary angioplasty, coronary bypass surgery, and medical therapy on employment in patients with coronary artery disease : A prospective comparison study. In: Annals of Internal Medicine. 1994 ; Vol. 120, No. 2. pp. 111-117.
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abstract = "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.",
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T2 - A prospective comparison study

AU - Mark, Daniel B.

AU - Lam, Lai Choi

AU - Lee, Kerry L.

AU - Jones, Robert H.

AU - Pryor, David B.

AU - Stack, Richard S.

AU - Williams, Redford B.

AU - Clapp-Channing, Nancy E.

AU - Califf, Robert M.

AU - Hlatky, Mark A.

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N2 - 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.

AB - 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.

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