[Coronary angiography in a defined population: a pilot study of the residents of Padua].
In recent years there has been a steady increase in number of coronary angiography procedures and coronary angioplasty. Since these interventions are relatively expensive, we tried to evaluate the appropriateness of coronary angiography indications. A retrospective pilot study was undertaken on all residents in Padua who had had a coronary angiography performed in 1988. In order to take into account patients who, although resident in Padua, had a coronary angiography performed outside Padua or even abroad, all Italian Hemodynamic Centers and the Office for Foreign Cures Authorization of ULSS 21 were contacted. Follow-up was stopped on April, 1991. Patients were first checked if living by consulting the Register's Office of the Community of Padua; they were then interviewed by letter on state of health. One hundred twenty-four patients underwent 138 coronary angiography. Utilization rate is 5.6 per 10,000 people (CI 4.6-6.6). This figure is lower than the present USA utilization rate, and is similar to the rate of late 70's. From patient records, 3 out 8 groups emerged as predominant indication for coronary angiography: unstable angina (37%), valvular heart disease (20%) and recent myocardial infarction (20%). According the ACC/AHA guidelines, indication was considered "appropriate" in 69%, "inappropriate" in 7%, "doubtful" in 20% and impossible to evaluate in 5% of cases. Although this classification may have been built up with incomplete information, it is note-worthy that the percentage of inappropriate indication is comparable to that of other reports. A further observation is that not in every case the treatment assigned at the time of diagnostic angiography was really carried out on the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Bressan
M
M
Cattedra di Cardiologia, Università degli Studi, Padova.
Stritoni
P
P
Razzolini
R
R
Favaretti
C
C
Bianchi
A
A
Menti
L
L
Mariotto
A
A
Maiolino
P
P
Chioin
R
R
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D014505:Urban Population / Q000706:statistics & numerical data
La coronarografia in una popolazione definita: studio pilota nei residenti a Padova.