ABSTRACT
The present study is a 2-year follow-up of the 104 patients participating in the ESBY study (Electrical Stimulation versus Coronary Artery Bypass Surgery in Severe Angina Pectoris), a randomised prospective study including patients with increased surgical risk and no prognostic benefit from revascularisation. Hospital care costs, morbidity and causes of death after spinal cord stimulation (SCS) and coronary artery bypass grafting (CABG) were assessed, as well as the complication rate of SCS treatment. SCS proved to be a less expensive symptomatic treatment modality of angina pectoris than CABG (p < 0.01). The SCS group had fewer hospitalisation days related to the primary intervention (p < 0.0001) and fewer hospitalisation days due to cardiac events (p < 0.05). The groups did not differ with regard to causes of death. There were no serious complications related to the SCS treatment.
Subject(s)
Coronary Artery Bypass/economics , Electric Stimulation Therapy/economics , Adult , Aged , Aged, 80 and over , Angina Pectoris/therapy , Cause of Death , Coronary Artery Bypass/adverse effects , Cost-Benefit Analysis , Electric Stimulation Therapy/adverse effects , Female , Follow-Up Studies , Humans , Male , Middle Aged , Morbidity , Sweden , Technology Assessment, Biomedical/economicsABSTRACT
AIMS: To assess the long-term outcome regarding quality of life and survival in patients who were included in the ESBY study 1992-1995. The ESBY study (Electrical Stimulation versus Coronary Artery Bypass Surgery in Severe Angina Pectoris) included 104 patients-with severe angina, increased surgical risk and no prognostic benefits from revascularization-randomized to coronary artery bypass grafting or spinal cord stimulation. METHODS AND RESULTS: The ESBY patients' quality of life was analysed using two questionnaires, and 5-year mortality was assessed. Quality of life improved significantly 6 months after spinal cord stimulation and coronary artery bypass grafting, respectively, compared to run-in (P<0.001). The results were consistent after 4.8 years. The 5-year mortality was 27.9%. There were no significant differences between the groups. CONCLUSIONS: Spinal cord stimulation as well as coronary artery bypass grafting offered long-lasting improvement in quality of life. Survival up to 5 years was comparable between the groups. Both methods can be considered as effective treatment options for patients with severe angina, increased surgical risks and estimated to have no prognostic benefits from coronary artery bypass grafting.
