Use of coronary angiography and revascularization procedures following acute myocardial infarction. A European perspective.

Abstract:

AIMS:There is little evidence to inform routine practice in the use of coronary angiography and revascularization procedures after acute myocardial infarction. Large differences in the uptake of these procedures have been reported but representative data are scarce. Outcome studies have produced opposing conclusions concerning the impact of the high rate of these cardiac procedures. METHODS AND RESULTS:A population-based patient sampling approach was utilized to identify routine practice in representative samples from 11 European countries. Data were collected retrospectively on treatment in the 6 months following acute myocardial infarction (n=2807). There was wide variation in utilization of coronary angiography and revascularization procedures. Even after restricting the analysis to patients <65 years (n=1262), there remained a 6 13 fold variation in the use of these procedures. A decreased likelihood of undergoing these procedures was associated with older age. In addition, there was an independent and negative association between female sex and utilization of coronary angiography and coronary artery bypass grafting (CABG). CONCLUSION:The effect on patient outcome of the observed variation in use of these procedures is not known but has important cost and resource implications for the health services. Outcome research is needed to define patient selection criteria and to measure the cost-utility of different angiography and revascularization rates.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Woods KL,Ketley D,Agusti A,Hagn C,Kala R,Karatzas NB,Leizorowicz A,Reikvam A,Schilling J,Seabra-Gomes R,Vasiliauskas D,Wilhelmsen L

doi

10.1053/euhj.1998.1027

subject

Has Abstract

pub_date

1998-09-01 00:00:00

pages

1348-54

issue

9

eissn

0195-668X

issn

1522-9645

pii

S0195668X98910272

journal_volume

19

pub_type

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