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Article
A community-wide perspective into changing trends in the utilization of diagnostic and interventional procedures in patients hospitalized with acute myocardial infarction
Open Access Articles
  • Jessica Hahn, University of Massachusetts Medical School
  • Darleen M. Lessard, University of Massachusetts Medical School
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Jordan H. Goldberg, University of Massachusetts Medical School
  • Sean Pruell, University of Massachusetts Medical School
  • Frederick A. Spencer
  • Joel M. Gore, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Cardiovascular Medicine
Date
3-27-2007
Document Type
Article
Subjects
Aged; Aged, 80 and over; Angioplasty, Transluminal, Percutaneous Coronary; Coronary Artery Bypass; Female; Heart Catheterization; *Hospitalization; Humans; Male; Middle Aged; Myocardial Infarction
Abstract

BACKGROUND: Limited data are available describing contemporary trends in the utilization of diagnostic and interventional procedures in patients hospitalized with acute myocardial infarction (AMI). The objectives of our population-based investigation were to examine long-term trends (1986-2003) in the utilization of cardiac catheterization, percutaneous coronary interventions (PCI), and coronary artery bypass graft surgery (CABG) in a community sample of patients hospitalized with AMI. We examined the demographic and clinical characteristics of patients who received these diagnostic and interventional procedures and determined whether the profile of patients undergoing these procedures had changed over time. METHODS: The study sample consisted of 9422 greater Worcester (MA) residents hospitalized with confirmed AMI at all metropolitan Worcester medical centers in 10 annual periods between 1986 and 2003. Information on patient demographics, clinical course, and treatment practices was obtained through the review of hospital medical records. RESULTS: Marked increases were observed in the utilization of cardiac catheterization (18.4% to 55.8%) and PCI (2.0% to 42.1%) between 1986 and 2003, respectively. Utilization of CABG showed modest increases in the early 1990s, whereas its use was relatively stable thereafter. Several demographic and clinical characteristics were associated with the receipt of these diagnostic and interventional procedures. CONCLUSIONS: The results of this study of patients hospitalized with AMI in a large New England community suggest evolving trends in the use of cardiac catheterization, PCI, and CABG. Despite these changing patterns, our findings suggest that there remains room for improvement in the therapeutic management of patients hospitalized with AMI, including certain high-risk groups.

Rights and Permissions
Citation: Am Heart J. 2007 Apr;153(4):594-605. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
17383299
Citation Information
Jessica Hahn, Darleen M. Lessard, Jorge L. Yarzebski, Jordan H. Goldberg, et al.. "A community-wide perspective into changing trends in the utilization of diagnostic and interventional procedures in patients hospitalized with acute myocardial infarction" Vol. 153 Iss. 4 (2007) ISSN: 1097-6744 (Electronic)
Available at: http://works.bepress.com/robert_goldberg/175/