Stability after initial decline in coronary revascularization rates in the united states.

Title

Stability after initial decline in coronary revascularization rates in the united states.

Creator

Raza S; Deo VS; Kalra A; Zia A; Altarabsheh SE; Deo VS; Mustafa RR; Younes A; Rao SV; Markowitz AH; Park SJ; Costa MA; Simon DI; Bhatt DL; Sabik JF 3rd

Publisher

The Annals of thoracic surgery

Date

2019
2019-11

Description

BACKGROUND: It remains uncertain how advances in revascularization techniques, availability of new evidence, and updated guidelines have influenced the annual rates of coronary revascularization in the United States. METHODS: We used the Nationwide Inpatient Sample data from 2005 to 2014 with appropriate weighting to determine national procedural volumes. To present accurately overall percutaneous coronary intervention (PCI) rates, PCI with same-day discharge numbers per year were estimated from the available literature and added to annual PCI procedures performed. RESULTS: Annual PCI rate declined from 353 per 100,000 adults in 2005 to 277 per 100,000 adults in 2009 (P < .001) but remained stable thereafter (P = .50). Annual coronary artery bypass grafting (CABG) rate declined steadily, at a shallower slope than PCI, from 120 per 100,000 in 2005 to 93 per 100,000 in 2009 (P = .02) but remained stable thereafter (P = .60). Similar trends were seen in men and women. Both PCI and CABG rates were lower in women than men over the study period (PCI, 482 to 324/100,000 in men vs 232 to 153/100,000 in women; CABG, 172 to 118/100,000 in men vs 64 to 38/100,000 in women). Annual PCI rates were higher than CABG rates in patients of all age groups including in younger patients (age < 50) and octogenarians. The proportion of coronary revascularization procedures performed per insurance type remained relatively similar across the study period. CONCLUSIONS: Annual rates of coronary revascularization have changed significantly over time, potentially because of advances in revascularization techniques, availability of new evidence, and updated guidelines. Rates of PCI declined more steeply than CABG before plateauing but remained higher than rates of CABG across the study period.

Subject

Female; Humans; Male; Aged; Middle Aged; United States; Aged 80 and over; Coronary Artery Bypass/statistics & numerical data; Percutaneous Coronary Intervention/statistics & numerical data; Procedures and Techniques Utilization/statistics & numerical data

Identifier

PMID: 31039350

Rights

Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

1404-1408

Issue

5

Volume

108

ISSN

1552-6259

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Internal Medicine

Update Year & Number

June2020SubmittedList

Affiliated Hospital

Cleveland Clinic Akron General Hospital

Citation

Raza S; Deo VS; Kalra A; Zia A; Altarabsheh SE; Deo VS; Mustafa RR; Younes A; Rao SV; Markowitz AH; Park SJ; Costa MA; Simon DI; Bhatt DL; Sabik JF 3rd, “Stability after initial decline in coronary revascularization rates in the united states.,” NEOMED Bibliography Database, accessed January 21, 2021, https://neomed.omeka.net/items/show/11184.

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