The appropriateness of performing coronary angiography and coronary artery revascularization in a Swedish population.
OBJECTIVE
To evaluate the appropriateness of performing coronary angiography and revascularization in a Swedish population.


METHODS
Prospective population study of questionnaires and medical records.


METHODS
All the hospitals in southwestern Sweden that perform coronary angiography and revascularization.


METHODS
Random sample of 831 patients (with chronic stable angina) on the waiting list for coronary angiography or revascularization in southwestern Sweden in September 1990.


METHODS
Percentage of patients referred for coronary angiography or revascularization for appropriate, uncertain, or inappropriate indications.


RESULTS
Of the patients referred for angiography, 89% were classified as appropriate, 9% as uncertain, and 2% as inappropriate. The percentages are similar for patients referred for coronary artery bypass graft surgery and for angioplasty (91% and 86%, respectively, classified as appropriate). The majority of patients had chest pain rated as Canadian Cardiovascular Society classes II through IV (93%), despite maximum anti-ischemic therapy in 90% of these patients.


CONCLUSIONS
Few patients were referred for coronary angiography or revascularization for inappropriate or uncertain indications. The percentage of these patients who are from southwestern Sweden is similar to the percentage recently reported from New York State.
Bengtson
A
A
Division of Cardiology, Wallenberg Laboratory, University of Göteborg, Sweden.
Herlitz
J
J
Karlsson
T
T
Brandrup-Wognsen
G
G
Hjalmarson
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000601:surgery; D002908:Chronic Disease; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D009518:New York; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012040:Regional Health Planning; D013548:Sweden; D013673:Technology Assessment, Biomedical; D014600:Utilization Review