title: Changing outcomes of coronary revascularization in British Columbia, 1995-2001.
abstract: OBJECTIVE
  To examine outcomes following all first coronary revascularization procedures, isolated coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) on British Columbia (BC) resident adults from 1995 to 2001.
  
  
  METHODS
  CABG and PCI data were obtained from the BC Cardiac Registry, and mortality data were obtained from the BC Vital Statistics Agency. Analysis was performed by annual cohorts, and the rates reported are unadjusted.
  
  
  RESULTS
  An increasing percentage of revascularization procedures was performed with PCI (62% in 1995 to 73% in 2001; P<0.001) due to the increased use of PCI procedures. Except in emergent cases, 30-day mortality improved after PCI (1.8% to 1.1%; P=0.02) and CABG (1.8% to 1.2%; P=0.01). Emergent cases accounted for 9.0% of PCIs and 2.7% of CABGs, the percentage treated by CABG decreasing from 14.5% in 1995 to 7.5% by 2001 (P<0.001). Mortality rates among emergent cases was higher at 30 days, with no trend in PCI mortality (12%) but a substantial reduction in 30-day mortality after CABG (28% to 10%; P=0.003). One-year survival free from repeat revascularization following PCI increased from 73% in 1995 to 83% in 2001 (P<0.001) and from 94% to 95% (P<0.005) following CABG.
  
  
  CONCLUSIONS
  Improvements in procedure-related mortality observed in trials have extended to clinical practice. With respect to emergent cases, an increasing proportion were treated by PCI with no change in PCI mortality but associated with a drop in surgical mortality. There has been a consistent and substantial drop in the need for repeat procedures within one year for patients selected for PCI.
authors.affiliation: Interventional Cardiology Research, St Paul's Hospital, Vancouver. gordon.pate@galwayclinic.com
authors.forename: Gordon E
authors.initials: GE
authors.lastname: Pate
authors.forename: Min
authors.initials: M
authors.lastname: Gao
authors.forename: Lillian
authors.initials: L
authors.lastname: Ding
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Carere
authors.forename: Frank O
authors.initials: FO
authors.lastname: Tyers
authors.forename: Robert I
authors.initials: RI
authors.lastname: Hayden
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality / Q000706:statistics & numerical data*; D001955:British Columbia / Q000453:epidemiology; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D017678:Sex Distribution