CABG Takes the Brunt of Decline in Revascularization Procedures

May 3rd, 2011

CABG Takes the Brunt of Decline in Revascularization Procedures

Larry Husten, PHD

In recent years, the overall revascularization rate in the U.S. has declined only slightly, but CABG rates have taken the brunt of the change, while PCI rates have remained relatively stable, according to a new study by Andrew Epstein and colleagues published in JAMA.

The researchers found that from 2001-2002 to 2007-2008:

The annual rate of revascularization decreased significantly, but by only 15% (p<0.001).
The CABG rate decreased significantly, by nearly 40%, from 1742 surgeries per million adults per year to 1081 (p<0.001).
PCI rates did not change significantly (from 3827 procedures per million adults per year to 3667 procedures, p=0.74).
The number of hospitals that provide CABG increased, resulting in a 28% decrease in the median CABG caseload per hospital.

The results, write the authors, “suggest the possibility that several thousand patients who underwent PCI in 2008 would have undergone CABG surgery had patterns of care not changed markedly between 2001 and 2008. Our data imply a sizeable shift in cardiovascular clinical practice patterns away from surgical treatment toward percutaneous, catheter-based interventions.”

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May 3rd, 2011