Fewer heart bypass surgeries performed
Research Activities, September 2011, No. 373
Patients with heart disease may require interventions to clear blocked coronary arteries. The two most common procedures used to restore blood flow to the heart are coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI or coronary angioplasty). A new study of national trends in use of these procedures found a substantial decrease in the number of CABGs being performed during the past decade, while PCI rates remained stable.
Researchers analyzed data from 2001 through 2008 from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. This dataset includes information on patient discharge data from approximately 1,000 hospitals in 42 States. Results showed a 15 percent drop in the annual rate of these coronary procedures overall from 2001-2002 to 2007-2008. During the earlier period, there were 1,742 bypass surgeries per million adults per year, which dropped to 1,081 by 2007-2008, with a trend indicating a steady, annual decline.
However, the number of PCI procedures performed did not change significantly. In 2001-2002, the PCI rate was 3,827 per million adults per year and remained essentially steady at 3,667 by 2007-2008. Although CABG rates declined, the number of hospitals offering this surgery grew by 12 percent, and the number of hospitals providing PCI procedures expanded even more—by 26 percent. During the study period, drug-eluting stents were approved by the Food and Drug Administration in April 2003, and their popularity grew rapidly. At the end of 2008, 68 percent of all PCI procedures used drug-eluting stents. The study was supported in part by the Agency for Healthcare Research and Quality (HS18403).
See "Coronary revascularization trends in the United States, 2001-2008," by Andrew J. Epstein, Ph.D., Daniel Polsky, Ph.D., Feifei Yang, M.D., Lin Yang, M.S., and Peter W. Groeneveld, M.D., M.S., in the May 4, 2011 Journal of the American Medical Association 305(17), pp. 1769-1776.