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Variations in angioplasty and bypass surgery
1Health Statistics Division at Statistics Canada, Ottawa. johahel@statcan.ca
Insights
About 15% of acute myocardial infarction (AMI) patients received revascularization procedures within six months. Rates varied by sex, age, and province, with women and older patients less likely to undergo bypass surgery.
Area of Science:
- Cardiovascular medicine
- Health services research
Background:
- Acute myocardial infarction (AMI) is a leading cause of mortality.
- Revascularization procedures like angioplasty and bypass surgery are critical treatments for AMI.
- Understanding patterns of care is essential for improving outcomes.
Purpose of the Study:
- To describe the rates and timing of revascularization procedures in Canadian heart attack patients.
- To identify demographic and regional variations in the utilization of these procedures.
Main Methods:
- Utilized Statistics Canada's Person-Oriented Information Data Base.
- Linked hospital discharge records for patients with a primary diagnosis of AMI.
- Followed patients for six months to assess rates of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG) surgery.
Main Results:
- Of approximately 24,000 AMI patients, 14.9% underwent revascularization within six months (8.7% PTCA, 6.7% CABG).
- Women had lower bypass rates than men; angioplasty rates were similar.
- Revascularization rates decreased with age and were higher in western Canadian provinces.
Conclusions:
- Significant variations in revascularization rates exist among AMI patients in Canada.
- Further research is needed to understand and address disparities in treatment based on sex, age, and geography.
Objectives:
This article describes rates of and times to revascularization procedures for heart attack patients.
Data Source:
The data are from Statistics Canada's Person-Oriented Information Data Base. Hospital discharge records for heart attack patients were linked for fiscal years 1992/93 and 1993/94.
Analytical Techniques:
Hospital patients admitted between April 1 and September 30, 1993 with a primary diagnosis of acute myocardial infarction (AMI) were followed for six months to determine what percentage underwent percutaneous transluminal coronary angioplasty and/or coronary artery bypass graft surgery. Analyses of time-to-procedure were performed for those patients who had not been hospitalized for AMI in the previous 12 months.
Main Results:
Approximately 24,000 Canadians were discharged from hospital during the first half of fiscal year 1993/94 with a diagnosis of AMI. Within six months, 8.7% had an angioplasty and 6.7% had a bypass; overall, 14.9% were revascularized. Women were less likely than men to have a bypass, but angioplasty rates did not differ significantly. The rate of revascularization declined with age. After adjusting for age and sex, rates were higher in the western provinces.