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Abstract：
Significant left main (LM) stem disease is potentially life-threatening and mandates revascularization. This study aimed to assess how patients rate the importance of particular features of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), how this determines their preference for a particular treatment strategy, and whether particular personality characteristics influence this preference.
In total, 1145 patients who visited the outpatient clinic of the Erasmus Medical Center for stable coronary artery disease were asked to complete a case vignette-questionnaire on a hypothetical significant LM stenosis amenable to PCI or CABG. To assess the individual\'s personality disposition and general distress level, each patient had to complete a set of 3 standardized, validated questionnaires with satisfactory psychometric properties. Overall 89% of patients preferred PCI to CABG. PCI was the preferred strategy despite a higher risk for repeat revascularization and need for more medication. Remarkably, the fact that a risk for repeat revascularization is more common in the PCI group is less important for the patients who opt for PCI. Risk for stroke and bleeding were the most important arguments to opt for PCI over CABG. Type D personality, depression, and anxiety were all associated with a relatively higher preference for CABG as revascularization strategy.
Overall, when given the choice patients seem to have a clear preference for PCI over CABG and consider stroke and bleeding important procedure-related complications. Patients with Type D personality, depression, or anxiety favor CABG.
In total, 1145 patients who visited the outpatient clinic of the Erasmus Medical Center for stable coronary artery disease were asked to complete a case vignette-questionnaire on a hypothetical significant LM stenosis amenable to PCI or CABG. To assess the individual\'s personality disposition and general distress level, each patient had to complete a set of 3 standardized, validated questionnaires with satisfactory psychometric properties. Overall 89% of patients preferred PCI to CABG. PCI was the preferred strategy despite a higher risk for repeat revascularization and need for more medication. Remarkably, the fact that a risk for repeat revascularization is more common in the PCI group is less important for the patients who opt for PCI. Risk for stroke and bleeding were the most important arguments to opt for PCI over CABG. Type D personality, depression, and anxiety were all associated with a relatively higher preference for CABG as revascularization strategy.
Overall, when given the choice patients seem to have a clear preference for PCI over CABG and consider stroke and bleeding important procedure-related complications. Patients with Type D personality, depression, or anxiety favor CABG.
摘要：
严重的左主干（LM）干疾病可能危及生命，并要求进行血运重建。本研究旨在评估患者如何评价冠状动脉旁路移植术（CABG）和经皮冠状动脉介入治疗（PCI）的特定特征的重要性。这如何决定他们对特定治疗策略的偏好，以及特定的个性特征是否会影响这种偏好。
总共，要求访问伊拉斯谟医学中心门诊治疗稳定型冠状动脉疾病的1145名患者填写有关适合PCI或CABG的假设的显着LM狭窄的病例小插图问卷。评估个人的人格倾向和一般痛苦水平，每个患者必须完成一组3个标准化，经过验证的问卷具有令人满意的心理测量特性。总体上89%的患者首选PCI而不是CABG。PCI是首选策略，尽管重复血运重建的风险较高，需要更多的药物治疗。值得注意的是,PCI组中重复血运重建的风险更常见,这一事实对于选择PCI的患者不那么重要.卒中和出血的风险是选择PCI而不是CABG的最重要论据。D型人格,抑郁症,焦虑与CABG作为血运重建策略的偏好相对较高相关.
总的来说，如果有选择，患者似乎更倾向于PCI而不是CABG，并考虑卒中和出血与手术相关的重要并发症。D型人格患者,抑郁症,或焦虑倾向于CABG。
总共，要求访问伊拉斯谟医学中心门诊治疗稳定型冠状动脉疾病的1145名患者填写有关适合PCI或CABG的假设的显着LM狭窄的病例小插图问卷。评估个人的人格倾向和一般痛苦水平，每个患者必须完成一组3个标准化，经过验证的问卷具有令人满意的心理测量特性。总体上89%的患者首选PCI而不是CABG。PCI是首选策略，尽管重复血运重建的风险较高，需要更多的药物治疗。值得注意的是,PCI组中重复血运重建的风险更常见,这一事实对于选择PCI的患者不那么重要.卒中和出血的风险是选择PCI而不是CABG的最重要论据。D型人格,抑郁症,焦虑与CABG作为血运重建策略的偏好相对较高相关.
总的来说，如果有选择，患者似乎更倾向于PCI而不是CABG，并考虑卒中和出血与手术相关的重要并发症。D型人格患者,抑郁症,或焦虑倾向于CABG。
