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Coronary Disease Surveillance in the Community: Angiography and Revascularization
Yariv Gerber1,2, Raymond J Gibbons3, Susan A Weston1
1Department of Health Sciences Research Mayo Clinic Rochester MN.
Journal of the American Heart Association
|April 3, 2020
Summary
Coronary heart disease trends show initial declines but recent increases in angiography use and stable revascularization rates suggest the burden of coronary artery disease may no longer be decreasing.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Favorable trends in cardiovascular health indicators suggested a declining burden of coronary artery disease (CAD) until the early 2000s.
- Recent data indicate these positive trends may be reversing, necessitating an updated assessment of population-level CAD burden.
- Understanding these shifts is crucial for public health strategies and clinical practice.
Purpose of the Study:
- To evaluate the recent evolution of the population burden of coronary artery disease.
- To examine trends in coronary angiography and revascularization procedures within a community setting.
- To identify potential shifts in CAD prevalence and severity.
Main Methods:
- Analysis of age- and sex-adjusted trends in all coronary angiographic procedures and revascularizations in Olmsted County, MN (2000-2018).
- Inclusion of both invasive angiography and computed tomography angiography to assess overall diagnostic imaging utilization.
- Examination of revascularization rates, differentiating between percutaneous coronary interventions (PCI) and coronary artery bypass graft (CABG) surgeries.
Main Results:
- Coronary angiography rates initially declined by 30% (2000-2009) but stabilized thereafter, with recent increases noted when including CT angiography.
- Prevalence and severity of coronary artery disease (CAD) on angiography declined from 2000 to 2009, followed by a plateau.
- Revascularization rates (PCI and CABG) decreased by 34% (2000-2009) and subsequently plateaued, with a slight recent increase.
Conclusions:
- Coronary angiography use in the community initially declined, then leveled off, and recently increased.
- Trends indicate a decrease followed by a plateau in CAD severity and revascularization rates.
- The recent stabilization and potential increase in utilization suggest the declining burden of coronary disease may be ending, highlighting the need for enhanced prevention and surveillance.
Keywords:
community surveillancecoronary angiographycoronary artery diseasecoronary revascularizationepidemiologysecular trendsMore Related Videos
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