Return to work after percutaneous transluminal coronary angioplasty: A continuing problem

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Abstract
Earlier studies have shown that return to work following PTCA is frequent; however PTCA is now performed in patients with more extensive coronary artery disease. The present study was designed to compare the vocational outcome of patients who underwent PTCA in 1980–1982 with that of patients who underwent the procedure in 1985. From 1980 to 1982, 53 of 73 consecutive patients who were employed before PTCA returned to work (73%). Return to work was related to primary success of the procedure (85% vs 40%, P <0·01) age (46·1 ±7·9 vs 49·3±6·6 years, P<0·05) and clinical status at follow-up (72% feeling well or very well vs 30%, P < 0·01). In 1985, although the primary success rate had increased to 89%, the overall rate of return to work in the 91 patients employed before PTCA was 64%. The decrease was particularly striking for patients with primary success of the procedure (64% vs 85%, P <0·01). The patients in the 1985 group had greater incidences of previous myocardial infarction (40% vs 11%, P < 0·01) and multivessel coronary disease (43% vs 8%, P < 0·01); however, these factors were not related to subsequent return to work. In contrast, the age of the patients, which was an important determinant of work resumption, was significantly higher in the 1985 patients (49·9 ± 7·3vs 46·4±9·1 years, P <0·01). Furthermore, the evolution of the general socio-economic context was likely to have impeded return to work, the rate of unemployment rising from 7·2%in 1980 to 12·3% by the end of 1985. Thus, despite marked improvement in the results of PTCA over the past years, the ‘social outcome’ of the patients after the procedure seems to have deteriorated.

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