title: A community-wide perspective into changing trends in the utilization of diagnostic and interventional procedures in patients hospitalized with acute myocardial infarction.
abstract: BACKGROUND
  Limited data are available describing contemporary trends in the utilization of diagnostic and interventional procedures in patients hospitalized with acute myocardial infarction (AMI). The objectives of our population-based investigation were to examine long-term trends (1986-2003) in the utilization of cardiac catheterization, percutaneous coronary interventions (PCI), and coronary artery bypass graft surgery (CABG) in a community sample of patients hospitalized with AMI. We examined the demographic and clinical characteristics of patients who received these diagnostic and interventional procedures and determined whether the profile of patients undergoing these procedures had changed over time.
  
  
  METHODS
  The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 10 annual periods between 1986 and 2003. Information on patient demographics, clinical course, and treatment practices was obtained through the review of hospital medical records.
  
  
  RESULTS
  Marked increases were observed in the utilization of cardiac catheterization (18.4% to 55.8%) and PCI (2.0% to 42.1%) between 1986 and 2003, respectively. Utilization of CABG showed modest increases in the early 1990s, whereas its use was relatively stable thereafter. Several demographic and clinical characteristics were associated with the receipt of these diagnostic and interventional procedures.
  
  
  CONCLUSIONS
  The results of this study of patients hospitalized with AMI in a large New England community suggest evolving trends in the use of cardiac catheterization, PCI, and CABG. Despite these changing patterns, our findings suggest that there remains room for improvement in the therapeutic management of patients hospitalized with AMI, including certain high-risk groups.
authors: Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
authors: Jessica
authors: J
authors: Hahn
authors: Darleen
authors: D
authors: Lessard
authors: Jorge
authors: J
authors: Yarzebski
authors: Jordan
authors: J
authors: Goldberg
authors: Sean
authors: S
authors: Pruell
authors: Frederick A
authors: FA
authors: Spencer
authors: Joel M
authors: JM
authors: Gore
authors: Robert J
authors: RJ
authors: Goldberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data* / Q000639:trends; D006328:Cardiac Catheterization / Q000706:statistics & numerical data* / Q000639:trends; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*