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Significant Reduction in U.S. Coronary Bypass Rates

Percutaneous coronary intervention utilization rates remained unchanged from 2001 to 2008

TUESDAY, May 3 (HealthDay News) -- Coronary artery bypass graft (CABG) utilization rates in the United States decreased significantly between 2001 and 2008, but percutaneous coronary intervention (PCI) utilization rates remained unchanged, according to a study published in the May 4 issue of the Journal of the American Medical Association.

Andrew J. Epstein, Ph.D., from the Philadelphia Veterans Affairs Medical Center, and colleagues examined national time trends in the rates and different types of coronary revascularizations. Data from patients undergoing CABG surgery or PCIs between 2001 and 2008 at U.S. hospitals in the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample were supplemented with Medicare outpatient hospital claims. Annual rates of coronary revascularizations, CABG surgery, and PCI were measured.

The investigators identified a significant decrease of 15 percent in the annual coronary revascularization rate from 2001-2002 to 2007-2008. The annual CABG surgery rate decreased from 1,742 CABG surgeries per million adults per year in 2001-2002 to 1,081 in 2007-2008. The PCI rates did not change significantly from 3,827 PCI per million adults per year in 2001-2002 to 3,667 PCI in 2007-2008. The number of hospitals within the national sample providing CABG surgery and PCI increased significantly between 2001 and 2008, by 12 and 26 percent, respectively. The average CABG caseload per hospital decreased significantly -- by 28 percent from 2001 to 2008 -- and the number of hospitals performing fewer than 100 CABG surgeries per year increased from 11 to 26 percent from 2001 to 2008.

"In U.S. hospitals between 2001 and 2008, a substantial decrease in CABG surgery utilization rates was observed, but PCI utilization rates remained unchanged," the authors write.

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