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Employment after Coronary Angioplasty or Coronary Bypass Surgery in Patients Employed at the Time of Revascularization

Mark A. Hlatky, MD; Derek Boothroyd, MS; Sarah Horine, MS; Carla Winston, MA; Maria Mori Brooks, PhD; William Rogers, MD; Bertram Pitt, MD; Guy Reeder, MD; Thomas Ryan, MD; Hugh Smith, MD; Patrick Whitlow, MD; Robert Wiens, MD; and Daniel B. Mark, MD
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From Stanford University School of Medicine, Stanford, California; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; University of Alabama, Birmingham, Alabama; University of Michigan School of Medicine, Ann Arbor, Michigan; Mayo Clinic Foundation, Rochester, Minnesota; Boston University School of Medicine, Boston, Massachusetts; Cleveland Clinic Foundation, Cleveland, Ohio; St. Louis University Medical School, St. Louis, Missouri; and Duke University Medical Center, Durham, North Carolina. Acknowledgments: The authors thank the staffs of BARI and SEQOL for assistance in data collection, the staff of the Data Coordinating Center at the University of Pittsburgh for assistance in data management, and Elaine Steel for typing the manuscript. Grant Support: By the Robert Wood Johnson Foundation, Princeton, New Jersey, and the National Heart, Lung, and Blood Institute, Bethesda, Maryland (HL38610). Requests for Reprints: Mark A. Hlatky, MD, Stanford University School of Medicine, HRP Redwood Building, Room 150, Stanford, CA 94305-5405; e-mail, hlatky@stanford.edu. Current Author Addresses: Dr. Hlatky, Mr. Boothroyd, Ms. Horine, and Ms. Winston: Stanford University School of Medicine, HRP Redwood Building, Stanford, CA 94305-5405.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(7):543-547. doi:10.7326/0003-4819-129-7-199810010-00006
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Background: Patients who undergo coronary angioplasty have a shorter convalescence than those who undergo coronary bypass surgery. This may improve subsequent employment.

Objective: To compare employment patterns after coronary angioplasty or surgery.

Design: Multicenter, randomized clinical trial.

Setting: Seven tertiary care hospitals.

Patients: 409 employed patients with multivessel coronary artery disease.

Intervention: Coronary bypass surgery or balloon angioplasty.

Measurements: Time to return to work and time spent working during 4 years of follow-up.

Results: Patients who underwent angioplasty returned to work 6 weeks sooner than patients who underwent coronary bypass surgery (P < 0.001), but long-term employment did not differ significantly (P > 0.2). Long-term employment was significantly lower among patients who were 60 to 64 years of age (P < 0.001), those who worked less than full-time at study entry (P < 0.001), and those who had less formal education (P = 0.005). Patients with only one source of health insurance were more likely to continue working (P = 0.005).

Conclusions: Faster recovery after angioplasty speeds return to work but does not improve long-term employment, which is primarily associated with nonmedical factors.





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