Coronary Revascularization in the Community

Results Revascularization utilization increased by 24% during the study (95% confidence interval [CI] 5% to 46%), but the trends diverged by procedure type, with a sustained increase (69%, 95% CI 43% to 101%) for percutaneous coronary interventions (PCI) contrasting with a stabilization, then decline ( 33%, 95% CI 16% to 47%) for coronary artery bypass grafting (CABG). For PCI, although the use increased in all categories, greater increases were noted in the elderly, in women, and for recurrent procedures. No such patterns were detected for CABG. Angiography use remained stable, and the rate of 3-vessel and/or left main disease declined ( 22%, 95% CI 8% to 33%).

[1]  T. Stukel,et al.  Proliferation of Cardiac Technology in Canada: A Challenge to the Sustainability of Medicare , 2006, Circulation.

[2]  D. Goldstein,et al.  Multivessel off-pump revascularization in octogenarians: early and midterm outcomes. , 2003, The Annals of thoracic surgery.

[3]  Edward L. Hannan,et al.  Long-Term Outcomes of Coronary-Artery Bypass Grafting Versus Stent Implantation , 2005 .

[4]  L. Melton,et al.  History of the Rochester Epidemiology Project. , 1996, Mayo Clinic proceedings.

[5]  J. Killian,et al.  Secular Trends in Deaths From Cardiovascular Diseases: A 25-Year Community Study , 2006, Circulation.

[6]  Amy. Bernstein,et al.  Health care in America; trends in utilization , 2004 .

[7]  M. Pfeffer,et al.  Sex differences in the management of coronary artery disease. Survival and Ventricular Enlargement Investigators. , 1991, The New England journal of medicine.

[8]  M. Mack,et al.  Current status and outcomes of coronary revascularization 1999 to 2002: 148,396 surgical and percutaneous procedures. , 2004, The Annals of thoracic surgery.

[9]  E. Fisher,et al.  Racial Trends in the Use of Major Procedures among the Elderly , 2005 .

[10]  B. Yawn,et al.  Trends in the Incidence and Survival of Patients with Hospitalized Myocardial Infarction, Olmsted County, Minnesota, 1979 to 1994 , 2002, Annals of Internal Medicine.

[11]  T. Ryan,et al.  Gender-related changes in the practice and outcomes of percutaneous coronary interventions in Northern New England from 1994 to 1999. , 2002, Journal of the American College of Cardiology.

[12]  Robert W Emery,et al.  Opposite trends in coronary artery and valve surgery in a large multisurgeon practice, 1979-1999. , 2004, The Annals of thoracic surgery.

[13]  M. Hobbs,et al.  Trends in coronary artery revascularisation procedures in Western Australia, 1980–2001 , 2004, Heart.

[14]  T. Ryan,et al.  Comparing Long-Term Survival of Patients With Multivessel Coronary Disease After CABG or PCI: Analysis of BARI-Like Patients in Northern New England , 2005, Circulation.

[15]  F. Tristani,et al.  Factors Affecting the Extent and Severity of Coronary Artery Disease in Patients Enrolled in the Coronary Artery Surgery Study , 1982, Arteriosclerosis.

[16]  M. Borger,et al.  The changing pattern of reoperative coronary surgery: trends in 1230 consecutive reoperations. , 2000, The Journal of thoracic and cardiovascular surgery.

[17]  M. Lauer,et al.  Selection of patients for coronary angiography and coronary revascularization early after myocardial infarction: is there evidence for a gender bias? , 1992, Annals of internal medicine.

[18]  J Z Ayanian,et al.  Differences in the use of procedures between women and men hospitalized for coronary heart disease. , 1991, The New England journal of medicine.

[19]  M. Mack,et al.  Current percutaneous coronary intervention and coronary artery bypass grafting practices for three-vessel and left main coronary artery disease. Insights from the SYNTAX run-in phase. , 2006, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[20]  G. Laarman,et al.  Actual outpatient PTCA: Results of the OUTCLAS pilot study , 2001, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[21]  L. Melton,et al.  Selection bias in the referral of patients and the natural history of surgical conditions. , 1985, Mayo Clinic proceedings.

[22]  K. Bailey,et al.  Gender differences and temporal trends in clinical characteristics, stress test results and use of invasive procedures in patients undergoing evaluation for coronary artery disease. , 2001, Journal of the American College of Cardiology.

[23]  C. Maynard,et al.  Changes in the use of coronary artery revascularization procedures in the Department of Veterans Affairs, the National Hospital Discharge Survey, and the Nationwide Inpatient Sample, 1991–1999 , 2003, BMC health services research.

[24]  D. Brock,et al.  Analysis of trends in coronary artery bypass grafting and percutaneous coronary intervention rates in Washington state from 1987 to 2001. , 2003, The American journal of cardiology.

[25]  F. L. Lucas,et al.  Temporal Trends in the Utilization of Diagnostic Testing and Treatments for Cardiovascular Disease in the United States, 1993–2001 , 2006, Circulation.

[26]  E. Hannan,et al.  Differences in per capita rates of revascularization and in choice of revascularization procedure for eleven states , 2006, BMC Health Services Research.

[27]  J. Killian,et al.  Sex and classic risk factors after myocardial infarction: a community study. , 2006, American heart journal.

[28]  M. Casper,et al.  Race and sex differences in rates of invasive cardiac procedures in US hospitals. Data from the National Hospital Discharge Survey. , 1995, Archives of internal medicine.

[29]  L D Fisher,et al.  Clinical and Angiographic Predictors of Operative Mortality from the Collaborative Study in Coronary Artery Surgery (CASS) , 1981, Circulation.

[30]  Sex differences in evaluation and outcome of unstable angina. , 2000 .

[31]  R. Allman,et al.  Age, Race, and Gender Variation in the Utilization of Coronary Artery Bypass Surgery and Angioplasty in SHEP , 1994, Journal of the American Geriatrics Society.

[32]  R. Reul.  Will drug-eluting stents replace coronary artery bypass surgery? , 2005, Texas Heart Institute journal.

[33]  J. Gurwitz,et al.  Narrowing gender differences in procedure use for acute myocardial infarction , 2003, Journal of General Internal Medicine.

[34]  L. Klein,et al.  Current usage and attitudes among interventional cardiologists regarding the performance of percutaneous coronary intervention (PCI) in the outpatient setting , 2005, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[35]  L. Kozak,et al.  Ambulatory surgery in the United States, 1994. , 1997, Advance data.

[36]  J. Sistino.  Epidemiology of cardiovascular disease in the last decade: treatment options and implications for perfusion in the 21st century , 2003, Perfusion.