title: Comparative outcomes for patients who do and do not undergo percutaneous coronary intervention for stable coronary artery disease in New York.
abstract: BACKGROUND
  Little is known about what treatments patients receive after being diagnosed with stable coronary artery disease or what the comparative outcomes are for routine medical treatment (RMT) versus percutaneous coronary intervention (PCI) with RMT for patients in a setting apart from randomized controlled trials.
  
  
  RESULTS
  Patients with stable coronary artery disease undergoing cardiac catheterization in New York State between 2003 and 2008 were followed up to determine the treatment they received. Patients receiving RMT and patients receiving PCI with RMT were propensity matched through the use of 20 factors that could have a bearing on outcomes. The resulting cohort of 933 matched pairs was used to compare mortality/myocardial infarction (MI), mortality, MI, and subsequent revascularization rates. A total of 89% of all patients underwent PCI with RMT. PCI/RMT patients had significantly lower adverse outcome rates at 4 years for mortality/MI (16.5% versus 21.2%; P=0.003), mortality (10.2% versus 14.5%; P=0.02), MI (8.0% versus 11.3%; P=0.007), and subsequent revascularization (24.1% versus 29.1%; P=0.005). Adjusted RMT versus (PCI with RMT) hazard ratios were 1.49 (95% confidence interval, 1.16-1.93) for mortality/MI and 1.46 (95% confidence interval, 1.08-1.97) for mortality. There were no differences for patients ≤ 65 years of age or for patients with single-vessel disease.
  
  
  CONCLUSIONS
  Most patients with stable coronary artery disease in New York undergoing catheterization between 2003 and 2008 received PCI. Patients who received PCI experienced lower mortality, mortality/MI, and revascularization rates. The reasons for this finding need to be better understood, including the possible role of low medication adherence rates that have been found in other studies.
authors.affiliation: School of Public Health, State University of New York, University at Albany, One University Place, Rensselaer, NY 12144-3456, USA. elh03@health.state.ny.us
authors.forename: Edward L
authors.initials: EL
authors.lastname: Hannan
authors.forename: Zaza
authors.initials: Z
authors.lastname: Samadashvili
authors.forename: Kimberly
authors.initials: K
authors.lastname: Cozzens
authors.forename: Gary
authors.initials: G
authors.lastname: Walford
authors.forename: Alice K
authors.initials: AK
authors.lastname: Jacobs
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Stamato
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Gold
authors.forename: Samin
authors.initials: S
authors.lastname: Sharma
authors.forename: Ferdinand J
authors.initials: FJ
authors.lastname: Venditti
authors.forename: Tia
authors.initials: T
authors.lastname: Powell
authors.forename: Spencer B
authors.initials: SB
authors.lastname: King
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D016896:Treatment Outcome