The number of patients receiving coronary artery bypass graft (CABG) surgery decreased dramatically between 2001 and 2008, according to a study in the Journal of the American Medical Association.1
Researchers at the University of Pennsylvania conducted a study of patients undergoing CABG surgery or percutaneous coronary interventions (PCIs) between 2001 and 2008 in US hospitals in the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample, which reports inpatient coronary revascularizations. These data were supplemented by Medicare outpatient hospital claims.
A 15% decrease in the annual rate of coronary revascularizations was observed between 2001 to 2002 and 2007 to 2008. The annual CABG surgery rate decreased steadily from 1,742 CABG surgeries per million adults per year in 2001 to 2002 to 1,081 CABG surgeries per million adults per year in 2007 to 2008. There was, however, no significant change in PCI rates. Between 2001 and 2008, the number of hospitals providing CABG surgery increased by 12%, and the number of hospitals providing PCI increased by 26%; the median CABG surgery caseload per hospital decreased by 28%, and the number of CABG surgery hospitals providing fewer than 100 CABG surgeries per year increased from 23 in 2001 to 62 in 2008.
“Our data imply a sizeable shift in cardiovascular clinical practice patterns away from surgical treatment toward percutaneous, catheter-based interventions,” study author Peter W. Groeneveld, MD, MS, said in a news release. “This is concerning given that recent data from a national trial indicated CABG surgery remains the better choice for patients with previously untreated three-vessel or left main coronary artery disease.”
- Epstein AJ,Polsky D,Yang F,et al.Coronary revascularization trends in the United States,2001-2008.JAMA. 2011;305(17):1769-1776.
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