Quality of Life After Percutaneous Coronary Intervention in No-Touch Saphenous Vein Grafts is Significantly Better Than in Conventional Vein Grafts

ABSTRACT Objective: To compare health-related quality of life (HRQoL) of patients primarily treated with a no-touch saphenous vein graft with that of patients who received a conventional graft. Methods: The study included all individuals treated with a percutaneous coronary intervention (PCI) on a saphenous vein graft (SVG) between January 2006 and June 2020. The RAND-36 health survey was used to assess HRQoL. The Mann-Whitney U test was used to test differences in HRQoL between the two groups. Effect size was estimated via Cohen’s d. The average treatment effect between the groups was tested by propensity score matching (PSM). Results: Of the 346 patients treated with a PCI in a stenosed or occluded SVG, 165 responded to RAND-36 (no-touch: n=48; conventional: n=117). Patients with a no-touch graft reported better mean values on seven of the eight health survey domains. Statistically significant differences were observed for four of the domains, all in favour of the no-touch group. The effect size estimates indicated a small difference for five domains, with the highest values (>0.40) seen for the general health and energy/fatigue domains. PSM confirmed a statistically significant difference for the physical functioning and general health domains. Conclusion: At a mean follow-up of 5.4 years, patients who received a PCI in no-touch vein grafts showed significantly better HRQoL than those who received a PCI in conventional vein grafts.

摘要
研究目的：对比以无接触大隐静脉移植物（no-touch saphenous vein graft）为主要治疗方案的患者，与接受常规移植物治疗的患者的健康相关生活质量（Health-Related Quality of Life, HRQoL）。
研究方法：本研究纳入2006年1月至2020年6月期间，所有接受经皮冠状动脉介入治疗（Percutaneous Coronary Intervention, PCI）治疗狭窄或闭塞性大隐静脉移植物（Saphenous Vein Graft, SVG）的患者。采用RAND-36健康调查量表（RAND-36 health survey）评估HRQoL；使用曼-惠特尼U检验（Mann-Whitney U test）检验两组间HRQoL的差异；通过科恩d值（Cohen’s d）估算效应量；通过倾向得分匹配（Propensity Score Matching, PSM）检验两组间的平均治疗效应。
研究结果：在346例接受狭窄或闭塞SVG行PCI的患者中，共165例完成了RAND-36量表调查（无接触组：n=48；常规组：n=117）。无接触移植物组患者在8个健康调查维度中的7个维度均获得更优的平均得分。其中4个维度存在统计学显著性差异，且均有利于无接触组。效应量估算结果显示，5个维度存在小幅差异，总体健康与精力/疲劳维度的效应量最高（>0.40）。PSM分析证实，躯体功能与总体健康两个维度存在统计学显著性差异。
研究结论：在平均5.4年的随访时长后，接受无接触静脉移植物PCI治疗的患者，其HRQoL显著优于接受常规静脉移植物PCI治疗的患者。