Coronary revascularization in Japan. Part 1: survey of facilities during 1997

Area of Science:

• Cardiology
• Health Services Research
• Interventional Cardiology

Background:

• Coronary artery disease (CAD) is a leading cause of death in industrialized nations like Japan.
• Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are common treatments for CAD.
• Data on the utilization and facility-level details of revascularization therapies in Japan is scarce.

Purpose of the Study:

• To conduct a nationwide survey on the use of coronary revascularization procedures and the characteristics of performing facilities in Japan.
• To assess the volume of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) procedures performed.
• To evaluate the distribution and capacity of facilities offering these advanced cardiac interventions.

Main Methods:

• A nationwide survey was conducted in 1997 by the Japanese Coronary Intervention Study (JCIS) Group.
• Questionnaires were distributed to hospitals performing PCI and/or CABG.
• Data collected included the number of procedures and facility-specific information.

Main Results:

• A total of 109,788 PCIs and 17,667 CABGs were reported.
• The rates per million population were 870 for PCI and 140 for CABG, with a PCI to CABG ratio of 6.2.
• A significant proportion of facilities (44% for PCI, 77% for CABG) performed 50 or fewer procedures annually, and only 50% of PCI labs had on-site surgical backup.

Conclusions:

• Coronary revascularization, especially PCI, is widely used in Japan.
• Despite high utilization, many facilities operate at low annual volumes.
• Further investigation into the implications of low-volume practice and resource availability is warranted.