Population rates of invasive cardiac procedures in British Columbia, 1995 to 2001.
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.
Pate
Gordon E
GE
Interventional Cardiology Research, St Paul's Hospital, Vancouver, British Columbia, Canada.
Humphries
Karin H
KH
Izadnegahdar
Mona
M
Gao
Min
M
Kiely
Michael
M
Carere
Ronald G
RG
D000328:Adult; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000639:trends; D001955:British Columbia / Q000453:epidemiology; D006328:Cardiac Catheterization / Q000639:trends; D017023:Coronary Angiography / Q000639:trends; D001026:Coronary Artery Bypass / Q000639:trends; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D016896:Treatment Outcome