Document Detail


Increasing rates of angioplasty versus bypass surgery in Canada, 1994-2005.
MedLine Citation:
PMID:  21095286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous coronary intervention (PCI) is increasingly being offered to patients with coronary artery disease. The purpose of this study was to determine the impact of this change in coronary revascularization strategy on PCI and coronary artery bypass grafting (CABG) utilization across Canada.
METHODS: All cases of PCI and isolated CABG between years 1994 and 2005 were identified through the Canadian Institute for Health Information. Age- and sex-standardized rates of PCI and CABG per 100,000 population as well as PCI-to-CABG ratios were calculated by year and province and across age, sex, income, diabetes, and recent acute coronary syndrome subgroups. In addition, risk-adjusted rates of in-hospital mortality after PCI and CABG were reported by year.
RESULTS: Between 1994 and 2005, PCI rates increased from 85.6/100,000 to 186.7/100,000 (P < .001), whereas CABG rates remained stable (75.6/100,000-70.8/100,000; P = .43), resulting in an increase in PCI-to-CABG ratio (1.13-2.64; P < .001). Significant increases in PCI-to-CABG ratios were seen across all provinces (except Newfoundland and Alberta), as well as across all age, sex, income, diabetes, and recent acute coronary syndrome categories. Decline in risk-adjusted in-hospital mortality was seen after both CABG (3.9%-2.2%; P < .001) and PCI (1.6%-1.3%; P < .001) but appeared larger after CABG.
CONCLUSIONS: Since 1994, rates of PCI have increased significantly as compared to CABG. During the same period, greater declines in risk-adjusted rates of in-hospital mortality were seen among CABG versus PCI patients. Further study is needed to determine the appropriateness of PCI and CABG rates in terms of clinical outcomes and resource utilization.
Authors:
Ansar Hassan; Alice Newman; Dennis T Ko; Stéphane Rinfret; Gregory Hirsch; William A Ghali; Jack V Tu
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  160     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  958-65     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiac Surgery, New Brunswick Heart Center, Saint John, New Brunswick, Canada. ahassan@dal.ca
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Angioplasty, Balloon, Coronary / trends*,  utilization
Canada / epidemiology
Coronary Artery Bypass / trends*,  utilization
Coronary Artery Disease / epidemiology,  therapy*
Female
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Sex Distribution
Survival Rate / trends
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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