BACKGROUND: This study examined the rates of coronary angiography (CA), percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) in British Columbia (BC) between 1995 and 2001. METHODS: Data sources were as follows: CABG--BC Cardiac Registries; CA and PCI--BC Medical Services Plan; acute coronary syndromes (ACS)--Hospital Separation database; population data--BC Statistics. All rates were age and sex standardized per 100,000 BC resident adults over 20 years of age. RESULTS: The rate of diagnostic CA increased from 352 per 100,000 in 1995 to 400 per 100,000 in 2001 (P<0.01). The rate of PCI increased from 101 per 100,000 in 1995 to 154 per 100,000 in 2001 (P<0.01). Single stage 'ad hoc' PCI increased from 38% in 1995 to 68% in 2001. The rate of CABG remained stable at between 70 and 79 per 100,000. There was a downward trend in the annual hospitalized incidence of ACS (477 to 430 per 100,000, P=0.04). The incidence of ACS and the rates of CA, PCI and CABG were higher for men in all age groups. PCI was more common than CABG in all groups. CONCLUSIONS: The incidence of ACS in BC is falling. The rates of diagnostic CA and PCI are increasing. The latter finding may reflect an appropriate evidence-based response to data supporting greater application of CA following ACS after publication of several studies supporting a routine invasive approach. The PCI rate is rising compared with the CABG rate, likely reflecting changes in patient selection and improved PCI technology, as well as a limited ability of the system to provide surgical procedures.
BACKGROUND: This study examined the rates of coronary angiography (CA), percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) in British Columbia (BC) between 1995 and 2001. METHODS: Data sources were as follows: CABG--BC Cardiac Registries; CA and PCI--BC Medical Services Plan; acute coronary syndromes (ACS)--Hospital Separation database; population data--BC Statistics. All rates were age and sex standardized per 100,000 BC resident adults over 20 years of age. RESULTS: The rate of diagnostic CA increased from 352 per 100,000 in 1995 to 400 per 100,000 in 2001 (P<0.01). The rate of PCI increased from 101 per 100,000 in 1995 to 154 per 100,000 in 2001 (P<0.01). Single stage 'ad hoc' PCI increased from 38% in 1995 to 68% in 2001. The rate of CABG remained stable at between 70 and 79 per 100,000. There was a downward trend in the annual hospitalized incidence of ACS (477 to 430 per 100,000, P=0.04). The incidence of ACS and the rates of CA, PCI and CABG were higher for men in all age groups. PCI was more common than CABG in all groups. CONCLUSIONS: The incidence of ACS in BC is falling. The rates of diagnostic CA and PCI are increasing. The latter finding may reflect an appropriate evidence-based response to data supporting greater application of CA following ACS after publication of several studies supporting a routine invasive approach. The PCI rate is rising compared with the CABG rate, likely reflecting changes in patient selection and improved PCI technology, as well as a limited ability of the system to provide surgical procedures.
Authors: Yana Gurevich; Anne McFarlane; Kathleen Morris; Aleksandra Jokovic; Gail M Peterson; Gregory K Webster Journal: Can J Cardiol Date: 2010 Aug-Sep Impact factor: 5.223
Authors: Gordon E Pate; May Lee; Karin Humphries; Eric Cohen; Robert Lowe; Rebecca S Fox; Robert Teskey; Christopher E Buller Journal: Can J Cardiol Date: 2006-12 Impact factor: 5.223
Authors: Gordon E Pate; Min Gao; Lillian Ding; Ronald G Carere; Frank O Tyers; Robert I Hayden Journal: Can J Cardiol Date: 2006-12 Impact factor: 5.223
Authors: Jean-Pierre S Awaida; Jocelyn Dupuis; Pierre Théroux; Guy Pelletier; Michel Joyal; Pierre De Guise; Serge Doucet; Luc Bilodeau; Bernard Thibault; Jean-Francois Tanguay; Richard Gallo; Jean Grégoire; Philippe L L'Allier; Laurent Macle; Anil Nigam Journal: Can J Cardiol Date: 2006-02 Impact factor: 5.223