title: [Influence of initial admission department for coronary arteriography on choice of mode of coronary revascularization].
abstract: OBJECTIVE
  To investigate the influence of initial admission department for coronary arteriography on the choice of mode of coronary revascularization.
  
  
  METHODS
  From October 2003 to June 2004 2156 patients with coronary heart disease were admitted into the department of internal medicine (1667 cases) or department of surgery (489 cases) to undergo coronary arteriography (CAG) and coronary revascularization. The influence of the initial admission departments on the choice of mode of coronary revascularization for the patients with different clinical manifestations and angiographic characteristics, including one-vessel disease, two-vessel disease, three-vessel disease, and multi-vessel disease of different types was analyzed.
  
  
  RESULTS
  1336 (80.1), 326 (19.6%), and 5 (0.3%) of the 1667 patients initially admitted to the department of internal medicine, received percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and CABG + PCI respectively with a complete revascularization rate of 63.3%. 52 (10.6%) and 437 (89.4%) of the 489 patients initially admitted to the department of surgery received PCI and CABG respectively with a complete revascularization rate of 75.5%. The CABG rates for the patients different types of lesion were all significantly higher in the patients initially admitted to the department of surgery than in the patients initially admitted in the department of internal medicine (all P < 0.05). The in-hospital death rate, new-onset myocardial infarction rate, and main adverse cardio-cerebral event rate of the patients admitted into the department of surgery were 3.9%, 1.8%, and 5.7% respectively, all significantly higher than those of the patients initially admitted in the department of internal medicine (1.2%, 0.5%, and 1.5% respectively, all P < 0.01). Logistic regression showed that initial admission into department of surgery, number of diseased vessels, left main trunk disease, proximal descending anterior branch disease, and chronic total occlusion rate were independent predictor for choice of CABG (all P < 0.01).
  
  
  CONCLUSIONS
  Cardiologists are more likely to choose PCI and cardiac surgeons are more likely to choose CABG. It is imperative to collect more evidence-based data so as to develop guidelines for the choice of reasonable mode of revascularization.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.
authors.forename: Shao-ping
authors.initials: SP
authors.lastname: Nie
authors.forename: Chang-sheng
authors.initials: CS
authors.lastname: Ma
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lü
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.forename: Jun-ping
authors.initials: JP
authors.lastname: Kang
authors.forename: Yin
authors.initials: Y
authors.lastname: Zhang
authors.forename: Chang-qi
authors.initials: CQ
authors.lastname: Jia
authors.forename: Xin-min
authors.initials: XM
authors.lastname: Liu
authors.forename: Li-qun
authors.initials: LQ
authors.lastname: He
authors.forename: Ying-chun
authors.initials: YC
authors.lastname: Gao
authors.forename: Jian-zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Xiao-hui
authors.initials: XH
authors.lastname: Liu
authors.forename: Xue-si
authors.initials: XS
authors.lastname: Wu
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods; D015607:Stents