Document Detail


Changing outcomes of coronary revascularization in British Columbia, 1995-2001.
MedLine Citation:
PMID:  17151768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine outcomes following all first coronary revascularization procedures, isolated coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) on British Columbia (BC) resident adults from 1995 to 2001.
METHODS: CABG and PCI data were obtained from the BC Cardiac Registry, and mortality data were obtained from the BC Vital Statistics Agency. Analysis was performed by annual cohorts, and the rates reported are unadjusted.
RESULTS: An increasing percentage of revascularization procedures was performed with PCI (62% in 1995 to 73% in 2001; P<0.001) due to the increased use of PCI procedures. Except in emergent cases, 30-day mortality improved after PCI (1.8% to 1.1%; P=0.02) and CABG (1.8% to 1.2%; P=0.01). Emergent cases accounted for 9.0% of PCIs and 2.7% of CABGs, the percentage treated by CABG decreasing from 14.5% in 1995 to 7.5% by 2001 (P<0.001). Mortality rates among emergent cases was higher at 30 days, with no trend in PCI mortality (12%) but a substantial reduction in 30-day mortality after CABG (28% to 10%; P=0.003). One-year survival free from repeat revascularization following PCI increased from 73% in 1995 to 83% in 2001 (P<0.001) and from 94% to 95% (P<0.005) following CABG.
CONCLUSIONS: Improvements in procedure-related mortality observed in trials have extended to clinical practice. With respect to emergent cases, an increasing proportion were treated by PCI with no change in PCI mortality but associated with a drop in surgical mortality. There has been a consistent and substantial drop in the need for repeat procedures within one year for patients selected for PCI.
Authors:
Gordon E Pate; Min Gao; Lillian Ding; Ronald G Carere; Frank O Tyers; Robert I Hayden
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  22     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-07     Completed Date:  2007-01-30     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1197-203     Citation Subset:  IM    
Affiliation:
Interventional Cardiology Research, St Paul's Hospital, Vancouver. gordon.pate@galwayclinic.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary / mortality,  statistics & numerical data*
British Columbia / epidemiology
Coronary Artery Bypass / mortality,  statistics & numerical data*
Coronary Artery Disease / mortality,  therapy*
Female
Humans
Male
Middle Aged
Prospective Studies
Registries
Sex Distribution
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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