Epidemiology of cardiovascular disease in the last decade: treatment options and implications for perfusion in the 21st century.

Cardiovascular disease (CVD) rates determine, to a large extent, the adult patient population that undergoes heart surgery. Many new treatment options have surfaced over the last decade which delay surgical intervention. The purpose of this study is to review the epidemiology of CVD in the USA over the past decade and project treatment patterns for the future. This information is important for the perfusion profession because it will influence the numbers of perfusionists required to staff open-heart centers in this country. Discharge data from hospitals in the USA were reviewed to determine numbers and rates of patients treated for CVD referenced to age and specific types of CVD. Operative procedure codes were reviewed to determine the volume and rates of cardiac surgical procedures, including catheterization and angioplasty, in the USA between 1990 and 2000. The results of this epidemiological review demonstrate that the surgical treatment rates for ischemic heart disease have not increased significantly over the past 10 years, except in the over-65 population. The large increase in the number of patients admitted for congestive heart failure (CHF) (39.4%) during this time period due to an aging population afford the perfusion profession an opportunity to become more involved in treatment options, such as cardiac assist devices. Cardiac surgeons are facing many of the same challenges that we face as perfusionists due to interventional cardiology, and should focus more attention on improving treatment for the heart failure population in the next decade. The continuation of perfusion education programs at their current rate of output seems justified, based on population projections and the increased incidence of CVD in the elderly population.