The most common type of heart disease -- coronary artery disease -- affects 6.7% of adults and accounts for 20% of 2 in 10 deaths of adults under age 65. The condition builds over time as inflammation and cholesterol-containing plaques settle in the heart's arteries, where they can eventually cause narrowing and blockages that lead to a heart attack.
In addition to lifestyle changes and medication, some people undergo revascularization, which is a medical procedure to open blocked coronary arteries and restore healthy blood flow. These procedures and the demographics of patients receiving revascularizations have changed over time.
Researchers evaluated nationwide data from 2003 to 2016 to assess current trends in the risk profiles and number of patients who had revascularization to treat coronary artery disease. They also assessed the in-hospital outcomes of more than 12 million revascularizations, 72% performed through percutaneous coronary intervention (PCI) and 28% by coronary artery bypass grafting (CABG). PCI, also known as angioplasty, uses a tiny balloon catheter that is inserted in a blocked blood vessel to widen it and may involve placing a mesh stent to hold the vessel open. CABG involves taking a healthy blood vessel from elsewhere in the body and connecting it beyond the blocked artery in the heart to redirect blood flow.
The resulting study, "Trends in Characteristics and Outcomes of Patients Undergoing Coronary Revascularization in the United States, 2003-2016," was published in JAMA Network Open . Mohamad Alkhouli, M.D., is first and corresponding author on the study and Amir Lerman, M.D., is senior author on the study. Drs. Alkhouli and Lerman are Mayo Clinic cardiologists.
There was an increase in the proportion of elderly patients (more than 85 years old), patients from racial minorities and those with lower income over the time period that we studied. Interestingly, men constituted two-thirds of the overall revascularization population, and this did not change much over time.
We noted a substantial decrease in the number of both PCI and CABG over time, likely because patients with stable coronary artery disease are increasingly being managed medically in light of the results of clinical trials demonstrating the effectiveness of that approach." Dr. Mohamad Alkhouli, first and corresponding author on the study Related Stories
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