Population rates of invasive cardiac procedures in British Columbia, 1995 to 2001

Abstract

Background: This study examined the rates of coronary angiography (CA), percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) in British Columbia (BC) between 1995 and 2001. Methods: Data sources were as follows: CABG - BC Cardiac Registries; CA and PCI - BC Medical Services Plan; acute coronary syndromes (ACS) - Hospital Separation database; population data - BC Statistics. All rates were age and sex standardized per 100,000 BC resident adults over 20 years of age. Results: The rate of diagnostic CA increased from 352 per 100,000 in 1995 to 400 per 100,000 in 2001 (P<0.01). The rate of PCI increased from 101 per 100,000 in 1995 to 154 per 100,000 in 2001 (P<0.01). Single stage 'ad hoc' PCI increased from 38% in 1995 to 68% in 2001. The rate of CABG remained stable at between 70 and 79 per 100,000. There was a downward trend in the annual hospitalized incidence of ACS (477 to 430 per 100,000, P=0.04). The incidence of ACS and the rates of CA, PCI and CABG were higher for men in all age groups. PCI was more common than CABG in all groups. Conclusions: The incidence of ACS in BC is falling. The rates of diagnostic CA and PCI are increasing. The latter finding may reflect an appropriate evidence-based response to data supporting greater application of CA following ACS after publication of several studies supporting a routine invasive approach. The PCI rate is rising compared with the CABG rate, likely reflecting changes in patient selection and improved PCI technology, as well as a limited ability of the system to provide surgical procedures. © 2004 Pulsus Group Inc. All rights reserved.