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Changing outcomes of coronary revascularization in British Columbia, 1995-2001

Gordon E Pate1, Min Gao, Lillian Ding

  • 1Interventional Cardiology Research, St Paul's Hospital, Vancouver. gordon.pate@galwayclinic.com

The Canadian Journal of Cardiology
|December 8, 2006
PubMed

Insights

Percutaneous coronary intervention (PCI) use increased, with improved 30-day survival for both PCI and coronary artery bypass graft surgery (CABG). Emergent CABG saw reduced mortality, while PCI showed fewer repeat procedures within a year.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Health Services Research

Background:

  • Coronary revascularization procedures, including coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI), are critical treatments for coronary artery disease.
  • Understanding the comparative outcomes of CABG and PCI in real-world clinical practice is essential for guiding treatment decisions.

Purpose of the Study:

  • To evaluate and compare the outcomes of all first-time coronary revascularization procedures, specifically isolated CABG and PCI, in adults residing in British Columbia between 1995 and 2001.

Main Methods:

  • Data for CABG and PCI procedures were sourced from the British Columbia Cardiac Registry.
  • Mortality data were obtained from the British Columbia Vital Statistics Agency.
  • Analysis involved annual cohorts, reporting unadjusted rates for PCI and CABG outcomes.

Main Results:

  • PCI utilization increased significantly from 62% in 1995 to 73% in 2001.
  • Thirty-day mortality improved for both PCI (1.8% to 1.1%) and CABG (1.8% to 1.2%), except in emergent cases.
  • Emergent cases, predominantly treated by PCI, showed no change in mortality, while emergent CABG mortality substantially decreased (28% to 10%).
  • One-year survival free from repeat revascularization improved for PCI (73% to 83%) but showed minimal change for CABG (94% to 95%).

Conclusions:

  • Observed improvements in procedure-related mortality from clinical trials are reflected in current clinical practice.
  • While PCI use increased for emergent cases without a change in mortality, CABG demonstrated a significant reduction in emergent case mortality.
  • Patients undergoing PCI experienced a consistent and substantial decrease in the need for repeat procedures within one year.
Abstract

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