Regional differences in coronary revascularization procedures and outcomes : a nationwide 11-year observational study
Vaez, Marjan ; Dalén, Magnus ; Friberg, Örjan ; Nilsson, Johan LU
; Frøbert, Ole
; Lagerqvist, Bo
and Ivert, Torbjörn
(2017)
In European heart journal. Quality of care & clinical outcomes
3(3).
p.243-248
- Abstract
Aims: The study investigated whether regional differences in choice of coronary revascularization affected outcomes in Sweden.
Methods and results: We conducted a prospective nationwide study of outcome in patients undergoing coronary artery bypass grafting (CABG, n = 47 065) or percutaneous coronary intervention (PCI, n = 140 945) from 2001 through 2011, tracked for a median of 5 years. During this period, the proportion of CABG in revascularization procedures decreased nationwide from an average of 38% to 18%e. Three-vessel disease and left main stem coronary artery stenosis were more common among CABG patients than in PCI patients. In both males and females, all-cause mortality was higher in CABG patients than in PCI patients,... (More)
Aims: The study investigated whether regional differences in choice of coronary revascularization affected outcomes in Sweden.
Methods and results: We conducted a prospective nationwide study of outcome in patients undergoing coronary artery bypass grafting (CABG, n = 47 065) or percutaneous coronary intervention (PCI, n = 140 945) from 2001 through 2011, tracked for a median of 5 years. During this period, the proportion of CABG in revascularization procedures decreased nationwide from an average of 38% to 18%e. Three-vessel disease and left main stem coronary artery stenosis were more common among CABG patients than in PCI patients. In both males and females, all-cause mortality was higher in CABG patients than in PCI patients, while repeat PCI was performed more frequently in the PCI group. CABG proportions in 21 counties ranged from 13% to 42% in females and males. The combined outcomes of repeat revascularization, non-fatal acute myocardial infarction, and death during the tracking period was recorded in 151 936 patients without ST-elevation myocardial infarction after PCI (n = 37 820, 36%) and CABG (n = 18 903, 40%). The multivariable adjusted risk of combined outcomes was higher after both PCI and CABG in both females and males in the three quartiles of counties with a smaller proportion of CABG than in the quartile of counties with the highest proportion of CABG. Similar patterns persisted after including only mortality in the analyses.
Conclusion: There are subgroups of patients who have prognostic benefits of CABG in addition to symptomatic improvement that is well documented with both PCI and CABG.
(Less)
- author
- Vaez, Marjan
; Dalén, Magnus
; Friberg, Örjan
; Nilsson, Johan
LU
; Frøbert, Ole
; Lagerqvist, Bo
and Ivert, Torbjörn
- organization
- publishing date
- 2017-07-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European heart journal. Quality of care & clinical outcomes
- volume
- 3
- issue
- 3
- pages
- 6 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85032030587
- pmid:28838095
- ISSN
- 2058-1742
- DOI
- 10.1093/ehjqcco/qcx007
- language
- English
- LU publication?
- yes
- id
- 622e47c3-e162-4b9a-b083-49d622491a05
- date added to LUP
- 2018-10-25 18:02:33
- date last changed
- 2024-03-02 09:58:25
@article{622e47c3-e162-4b9a-b083-49d622491a05,
abstract = {{<p>Aims: The study investigated whether regional differences in choice of coronary revascularization affected outcomes in Sweden.</p><p>Methods and results: We conducted a prospective nationwide study of outcome in patients undergoing coronary artery bypass grafting (CABG, n = 47 065) or percutaneous coronary intervention (PCI, n = 140 945) from 2001 through 2011, tracked for a median of 5 years. During this period, the proportion of CABG in revascularization procedures decreased nationwide from an average of 38% to 18%e. Three-vessel disease and left main stem coronary artery stenosis were more common among CABG patients than in PCI patients. In both males and females, all-cause mortality was higher in CABG patients than in PCI patients, while repeat PCI was performed more frequently in the PCI group. CABG proportions in 21 counties ranged from 13% to 42% in females and males. The combined outcomes of repeat revascularization, non-fatal acute myocardial infarction, and death during the tracking period was recorded in 151 936 patients without ST-elevation myocardial infarction after PCI (n = 37 820, 36%) and CABG (n = 18 903, 40%). The multivariable adjusted risk of combined outcomes was higher after both PCI and CABG in both females and males in the three quartiles of counties with a smaller proportion of CABG than in the quartile of counties with the highest proportion of CABG. Similar patterns persisted after including only mortality in the analyses.</p><p>Conclusion: There are subgroups of patients who have prognostic benefits of CABG in addition to symptomatic improvement that is well documented with both PCI and CABG.</p>}},
author = {{Vaez, Marjan and Dalén, Magnus and Friberg, Örjan and Nilsson, Johan and Frøbert, Ole and Lagerqvist, Bo and Ivert, Torbjörn}},
issn = {{2058-1742}},
language = {{eng}},
month = {{07}},
number = {{3}},
pages = {{243--248}},
publisher = {{Oxford University Press}},
series = {{European heart journal. Quality of care & clinical outcomes}},
title = {{Regional differences in coronary revascularization procedures and outcomes : a nationwide 11-year observational study}},
url = {{http://dx.doi.org/10.1093/ehjqcco/qcx007}},
doi = {{10.1093/ehjqcco/qcx007}},
volume = {{3}},
year = {{2017}},
}