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Coronary Bypass Benefits Older People, Too

The surgery can improve quality of life, study finds

WEDNESDAY, Oct. 15, 2003 (HealthDayNews) -- Coronary artery bypass surgery offers people over 75 as much improvement in quality of life as it does younger people, so age alone shouldn't be a deterrent to having the procedure.

That's the conclusion of a study in the Oct. 15 issue of the Journal of the American College of Cardiology.

"Age used to be a more important indicator of the risks and benefits of procedures than it is today," says study author Dr. John Spertus, a professor of medicine at the University of Missouri-Kansas City.

"While older patients did have a slower pace of recovering physical function, relief of [chest pain] was just as brisk as it was for the younger patients and the quality of life improvements were just as much," adds Spertus, who's also director of cardiovascular outcomes research at the Mid America Heart Institute of Saint Luke's Hospital in Kansas City, Mo.

Coronary artery bypass surgery is an invasive procedure in which surgeons take a piece of a healthy blood vessel and use it to make a detour around the blocked portion of a coronary artery.

Spertus and his colleagues asked 690 people undergoing coronary bypass surgery to complete a questionnaire designed to assess their quality of life and physical functioning before the surgery and one year later. One hundred fifty-six of these volunteers were over age 75.

The researchers also asked 224 people from the 690 to complete questionnaires monthly for the first six months.

The mortality rate during surgery was just over 2 percent for the group under 75 years old and slightly higher for the group over 75. People over 75 were also more likely to die in the year following surgery -- 11.5 percent, compared to 5.4 percent for the younger patients.

But, when it came to symptom relief, the older group fared just as well as the younger group.

"There's a sense that doing a very invasive, open procedure like bypass surgery on older patients subjects them to a lot of risk and potential pain, so one would want to be sure that there were benefits to offset the risk," Spertus explains.

"What we found was that compared to younger patients, older patients got just as much benefit in terms of quality of life," he says.

Dr. Stephen Siegel, a cardiologist at New York University Medical Center, says this is a very helpful study that supports the current standard of care.

"It's clear that older patients take longer to recover, but when they do they can have a very good quality of life and enjoy life," he says. "I don't see any reason why we should be more concerned about adding five years of life to a 60-year-old than an 80-year-old."

One thing this study did not assess, however, was who is a good candidate for surgery. Those included in the study were already chosen by surgeons to be good candidates for surgery, which could have affected the results.

Both Spertus and Siegel say it's very important that older people are involved in the decision-making process and are well-informed about the surgery and its risks and benefits.

More information

To learn more about coronary bypass surgery, visit the American Heart Association or the Carolina Regional Heart Center.

SOURCES: John Spertus, M.D., director, cardiovascular outcomes research, Mid America Heart Institute at Saint Luke's Hospital, and professor, medicine, University of Missouri, Kansas City, Mo.; Stephen Siegel, M.D., cardiologist, New York University Medical Center, and clinical assistant professor, medicine, New York University School of Medicine, New York City; Oct. 15, 2003, Journal of the American College of Cardiology
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