Multidecade-long trends (1986-2005) in the utilization of coronary reperfusion and revascularization treatment strategies in patients hospitalized with acute myocardial infarction: a community-wide perspective
Wasser, Jared ; Goldberg, Robert J. ; Spencer, Frederick A. ; Yarzebski, Jorge L. ; Gore, Joel M.
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Student Authors
Faculty Advisor
Academic Program
UMass Chan Affiliations
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Keywords
Age Factors
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Community Health Services
Coronary Artery Bypass
*Delivery of Health Care
Female
Health Care Surveys
*Hospitalization
Humans
Male
Massachusetts
Middle Aged
Myocardial Infarction
*Physician's Practice Patterns
Sex Distribution
Sex Factors
Thrombolytic Therapy
Time Factors
Biostatistics
Cardiovascular Diseases
Epidemiology
Health Services Research
Subject Area
Embargo Expiration Date
Link to Full Text
Abstract
OBJECTIVES: The objectives of our community-wide investigation were to describe multidecade-long trends (1986-2005) in the utilization of thrombolytic therapy, percutaneous coronary interventions, and coronary artery bypass graft surgery in patients hospitalized with acute myocardial infarction (AMI).
METHODS: The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 11 annual periods between 1986 and 2005.
RESULTS: Increases in the utilization of percutaneous coronary interventions were observed between 1986 (2.0%) and 2005 (50.7%) with the most rapid increases beginning in the late 1990s. Utilization of coronary artery bypass graft surgery during hospitalization for AMI increased moderately in the 1990s, remained stable thereafter, and declined to being performed in 3.8% of hospitalized patients in 2005. The use of thrombolytic therapy increased between 1986 and 1995 (9.3-25.2%) and decreased markedly thereafter through 2005 (<1%). Demographic and clinical characteristics of several patients were associated with the receipt of these treatment regimens.
CONCLUSION: The results of this study in residents of a large Central New England community suggest an increasingly invasive approach to the management of patients hospitalized with AMI.
Source
Coron Artery Dis. 2009 Jan;20(1):71-80. Link to article on publisher's site