Skip to main content
PMC home page
Heart logoLink to Heart
. 2001 Jan;85(1):80–86. doi: 10.1136/heart.85.1.80

The influence of general health status and social support on symptomatic outcome following coronary artery bypass grafting

G Lindsay 1, L Smith 1, P Hanlon 1, D Wheatley 1
PMCID: PMC1729595  PMID: 11119470

Abstract

OBJECTIVES—To assess health status, level of social support, and presence of coronary artery disease risk factors before and after coronary artery bypass grafting (CABG); to assess symptomatic relief approximately 12 months postoperatively; and to examine the association between preoperative health status and recurrence of symptoms.
DESIGN—Observational study.
SETTING—Preoperatively, in hospital outpatient department (1995-1996); postoperatively, at home (1996-97).
SUBJECTS AND METHODS—Patients awaiting elective CABG were recruited one month before the expected date of operation. Preoperative assessment included severity of symptoms, coronary artery disease risk factors, short form 36 (SF-36) questionnaire, and social activities questionnaire. The presence and severity of angina and breathlessness were reported postoperatively (mean 16.4 months). Multiple regression analysis was used to identify factors associated with improved outcome following CABG.
MAIN OUTCOME MEASURE—Patient reported presence and severity of angina and breathlessness.
RESULTS—183 patients were followed for a mean of 16.4 months after CABG. Angina and breathlessness were completely relieved in 55% and 36% of patients, respectively. In patients with residual symptoms, the severity was significantly reduced (angina p < 0.001; breathlessness, p = 0.02). Patients with low SF-36 scores and low social network scores preoperatively were less likely to be relieved of symptoms (p < 0.001). Health status and social support levels preoperatively were lower than in other reported coronary artery disease patients groups. Preoperatively, coronary artery disease risk factors were higher than recommended in current guidelines: 67.4% had raised plasma cholesterol, 39.0% were hypertensive, 80% were moderately obese, and 22.9% were smokers.
CONCLUSIONS—Recurrence of symptoms exceeded other published studies. Patients' perception of general health, symptoms, and social support influences outcome.


Keywords: health status indicator; coronary artery bypass; social support; risk factors

Full Text

The Full Text of this article is available as a PDF (154.4 KB).

Figure 1  .

Figure 1  

Open in a new tab

Breakdown (%) of the numbers of grafts inserted at coronary artery bypass grafting in the study patients.

Figure 2  .

Figure 2  

Open in a new tab

Box and whisker plot of SF-36 health survey scores for the eight health domains, showing median, interquartile range, and total range of scores.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berkman L. F. The role of social relations in health promotion. Psychosom Med. 1995 May-Jun;57(3):245–254. doi: 10.1097/00006842-199505000-00006. [DOI] [PubMed] [Google Scholar]
  2. Berkman L. F. The role of social relations in health promotion. Psychosom Med. 1995 May-Jun;57(3):245–254. doi: 10.1097/00006842-199505000-00006. [DOI] [PubMed] [Google Scholar]
  3. Brandrup-Wognsen G., Haglid M., Karlsson T., Berggren H., Herlitz B. J. Preoperative risk indicators of death at an early and late stage after coronary artery bypass grafting. Thorac Cardiovasc Surg. 1995 Apr;43(2):77–82. doi: 10.1055/s-2007-1013775. [DOI] [PubMed] [Google Scholar]
  4. Bucher H. C. Social support and prognosis following first myocardial infarction. J Gen Intern Med. 1994 Jul;9(7):409–417. doi: 10.1007/BF02629526. [DOI] [PubMed] [Google Scholar]
  5. Cameron A. A., Davis K. B., Rogers W. J. Recurrence of angina after coronary artery bypass surgery: predictors and prognosis (CASS Registry). Coronary Artery Surgery Study. J Am Coll Cardiol. 1995 Oct;26(4):895–899. doi: 10.1016/0735-1097(95)00280-4. [DOI] [PubMed] [Google Scholar]
  6. Charlier L., Dutrannois J., Kaufman L. The SF-36 questionnaire: a convenient way to assess quality of life in angina pectoris patients. Acta Cardiol. 1997;52(3):247–260. [PubMed] [Google Scholar]
  7. First-year results of CABRI (Coronary Angioplasty versus Bypass Revascularisation Investigation). CABRI Trial Participants. Lancet. 1995 Nov 4;346(8984):1179–1184. [PubMed] [Google Scholar]
  8. Garratt A. M., Ruta D. A., Abdalla M. I., Buckingham J. K., Russell I. T. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ. 1993 May 29;306(6890):1440–1444. doi: 10.1136/bmj.306.6890.1440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hemingway H., Marmot M. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ. 1999 May 29;318(7196):1460–1467. doi: 10.1136/bmj.318.7196.1460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Herlitz J., Brandrup-Wognsen G., Haglid M., Hartford M., Emanuelsson H., Karlson B. W., Karlsson T., Hjalmarson A. Mortality and morbidity during a period of 2 years after coronary artery bypass surgery in patients with and without a history of hypertension. J Hypertens. 1996 Mar;14(3):309–314. doi: 10.1097/00004872-199603000-00006. [DOI] [PubMed] [Google Scholar]
  11. House J. S., Landis K. R., Umberson D. Social relationships and health. Science. 1988 Jul 29;241(4865):540–545. doi: 10.1126/science.3399889. [DOI] [PubMed] [Google Scholar]
  12. Huskisson E. C. Measurement of pain. Lancet. 1974 Nov 9;2(7889):1127–1131. doi: 10.1016/s0140-6736(74)90884-8. [DOI] [PubMed] [Google Scholar]
  13. Jenkinson C., Coulter A., Wright L. Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ. 1993 May 29;306(6890):1437–1440. doi: 10.1136/bmj.306.6890.1437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Kawachi I., Colditz G. A., Ascherio A., Rimm E. B., Giovannucci E., Stampfer M. J., Willett W. C. A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. J Epidemiol Community Health. 1996 Jun;50(3):245–251. doi: 10.1136/jech.50.3.245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. King K. B., Reis H. T., Porter L. A., Norsen L. H. Social support and long-term recovery from coronary artery surgery: effects on patients and spouses. Health Psychol. 1993 Jan;12(1):56–63. doi: 10.1037//0278-6133.12.1.56. [DOI] [PubMed] [Google Scholar]
  16. Lee K. A., Kieckhefer G. M. Measuring human responses using visual analogue scales. West J Nurs Res. 1989 Feb;11(1):128–132. doi: 10.1177/019394598901100111. [DOI] [PubMed] [Google Scholar]
  17. Lohr K. N., Brook R. H., Kamberg C. J., Goldberg G. A., Leibowitz A., Keesey J., Reboussin D., Newhouse J. P. Use of medical care in the Rand Health Insurance Experiment. Diagnosis- and service-specific analyses in a randomized controlled trial. Med Care. 1986 Sep;24(9 Suppl):S1–87. [PubMed] [Google Scholar]
  18. Lytle B. W. The clinical impact of atherosclerotic saphenous vein to coronary artery bypass grafts. Semin Thorac Cardiovasc Surg. 1994 Apr;6(2):81–86. [PubMed] [Google Scholar]
  19. McCarthy M. J., Jr, Shroyer A. L., Sethi G. K., Moritz T. E., Henderson W. G., Grover F. L., London M. J., Gibbs J. O., Lansky D., Miller D. Self-report measures for assessing treatment outcomes in cardiac surgery patients. Med Care. 1995 Oct;33(10 Suppl):OS76–OS85. doi: 10.1097/00005650-199510001-00009. [DOI] [PubMed] [Google Scholar]
  20. Morrison C., Woodward M., Leslie W., Tunstall-Pedoe H. Effect of socioeconomic group on incidence of, management of, and survival after myocardial infarction and coronary death: analysis of community coronary event register. BMJ. 1997 Feb 22;314(7080):541–546. doi: 10.1136/bmj.314.7080.541. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Orth-Gomér K., Johnson J. V. Social network interaction and mortality. A six year follow-up study of a random sample of the Swedish population. J Chronic Dis. 1987;40(10):949–957. doi: 10.1016/0021-9681(87)90145-7. [DOI] [PubMed] [Google Scholar]
  22. Parsonnet V., Dean D., Bernstein A. D. A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease. Circulation. 1989 Jun;79(6 Pt 2):I3–12. [PubMed] [Google Scholar]
  23. Pocock S. J., Henderson R. A., Seed P., Treasure T., Hampton J. R. Quality of life, employment status, and anginal symptoms after coronary angioplasty or bypass surgery. 3-year follow-up in the Randomized Intervention Treatment of Angina (RITA) Trial. Circulation. 1996 Jul 15;94(2):135–142. doi: 10.1161/01.cir.94.2.135. [DOI] [PubMed] [Google Scholar]
  24. Risum O., Abdelnoor M., Svennevig J. L., Levorstad K., Gullestad L., Bjørnerheim R., Simonsen S., Nitter-Hauge S. Diabetes mellitus and morbidity and mortality risks after coronary artery bypass surgery. Scand J Thorac Cardiovasc Surg. 1996;30(2):71–75. doi: 10.3109/14017439609107245. [DOI] [PubMed] [Google Scholar]
  25. Rumsfeld J. S., MaWhinney S., McCarthy M., Jr, Shroyer A. L., VillaNueva C. B., O'Brien M., Moritz T. E., Henderson W. G., Grover F. L., Sethi G. K. Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery. JAMA. 1999 Apr 14;281(14):1298–1303. doi: 10.1001/jama.281.14.1298. [DOI] [PubMed] [Google Scholar]
  26. Sever P., Beevers G., Bulpitt C., Lever A., Ramsay L., Reid J., Swales J. Management guidelines in essential hypertension: report of the second working party of the British Hypertension Society. BMJ. 1993 Apr 10;306(6883):983–987. doi: 10.1136/bmj.306.6883.983. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Heart are provided here courtesy of BMJ Publishing Group

RESOURCES