Retrospective cohort analysis of Spanish national trends of coronary artery bypass grafting and percutaneous coronary intervention from 1998 to 2017

Autor: Jose Albors Martin, Cristina Villamor, Luis Carlos Maroto Castellanos, Miguel Piñón, Manuel Carnero Alcázar, Daniel Hernández-Vaquero, Alberto Forteza, Hector Cubero-Gallego, José López Menéndez, Isaac Pascual, Gregorio Cuerpo Caballero, Javier Cobiella Carnicer
Přispěvatelé: UAM. Departamento de Cirugía
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Medicina
medicine.medical_treatment
Coronary Artery Disease
030204 cardiovascular system & hematology
Cardiovascular Medicine
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Internal medicine
medicine
Humans
030212 general & internal medicine
Myocardial infarction
cardiovascular diseases
coronary heart disease
Coronary Artery Bypass
cardiac epidemiology
Retrospective Studies
business.industry
Public health
public health
Percutaneous coronary intervention
Retrospective cohort study
General Medicine
medicine.disease
Cardiac surgery
medicine.anatomical_structure
surgical procedures
operative
Treatment Outcome
Spain
Conventional PCI
Cardiology
Medicine
coronary intervention
Risk adjusted mortality rate
business
cardiac surgery
Artery
Zdroj: BMJ Open
Biblos-e Archivo. Repositorio Institucional de la UAM
instname
BMJ Open, Vol 11, Iss 4 (2021)
ISSN: 2044-6055
Popis: IntroductionSpain is one of the countries with the lowest rates of revascularisation and highest ratio of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG).ObjectivesTo investigate the changes and trends in the two revascularisation procedures between 1998 and 2017 in Spain.DesignRetrospective cohort study. Analysis of in-hospital outcomes.SettingMinimum basic data set from the Spanish National Department of Health: mandatory database collecting information of patients who are attended in the Spanish public National Health System.Participants603 976 patients who underwent isolated CABG or PCI in the Spanish National Health System. The study period was divided in four 5-year intervals. Patients with acute myocardial infarction on admission were excluded.Primary and secondary outcomesWe investigated the volume of procedures nationwide, the changes of the risk profile of patients and in-hospital mortality of both techniques.ResultsWe observed a 2.2-fold increase in the rate of any type of myocardial revascularisation per million inhabitants-year: 357 (1998) to 776 (2017). 93 682 (15.5%) had a coronary surgery. PCI to CABG ratio rose from 2.2 (1998–2002) to 8.1 (2013–2017). Charlson’s index increased by 0.8 for CABG and 1 for PCI. The median annual volume of PCI/hospital augmented from 136 to 232, while the volume of CABG was reduced from 137 to 74. In the two decades, we detected a significant reduction of CABG in-hospital mortality (6.5% vs 2.6%, pConclusionWe detected a significant increase in the volume of revascularisations (particularly PCI) in Spain. Risk-adjusted in-hospital mortality was significantly reduced.
Databáze: OpenAIRE
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