University of Alberta, Edmonton, Alberta, Canada.
Can J Cardiol. 2013 Apr;29(4):460-5. doi: 10.1016/j.cjca.2012.06.008. Epub 2012 Aug 15.
Prior Canadian studies of cardiac procedure rates showed changes over time and regional variability, but more recent Canadian cardiac procedure rates are unknown.
We performed a study using the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry to evaluate the temporal trends and geographic distribution of cardiac procedures in Alberta from April 1, 2003 through March 31, 2010. Rates were age- and sex-standardized by means of the 1996 Canadian census.
While the raw number of cardiac catheterizations in Alberta was nearly uniform through the study period, age- and sex-standardized cardiac catheterizations declined from a rate of 480 per 100,000 in 2003 to a rate of 430 per 100,000 in 2010. The percutaneous coronary intervention (PCI) rates also declined, from a rate of 186 per 100,000 in 2003 to 170 per 100,000 in 2010. The rates for coronary artery bypass grafts declined from 84 per 100,000 in 2003 to 42 per 100,000 in 2010. There was geographic variability, with northern regions characterized by rates that were higher than the provincial average rates, and southern regions characterized by rates lower than the provincial average.
During the study period, age- and sex-standardized rates of cardiac catheterization and PCI in Alberta declined, reversing previous trends of increasing PCI rates. The rates of coronary artery bypass grafts in Alberta declined significantly, suggesting a change in practice consistent with that seen elsewhere. There are geographic differences in rates of cardiac procedures. These data have implications for other regions of Canada, for which registry data may not be available.
先前加拿大的心脏手术率研究显示了时间和地域差异的变化,但最近加拿大的心脏手术率尚不清楚。
我们使用艾伯塔省冠心病预后评估项目(Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry)进行了一项研究,以评估 2003 年 4 月 1 日至 2010 年 3 月 31 日期间艾伯塔省心脏手术的时间趋势和地理分布。通过 1996 年加拿大人口普查对年龄和性别进行标准化。
尽管艾伯塔省的心脏导管插入术数量在整个研究期间几乎保持不变,但年龄和性别标准化的心脏导管插入术数量从 2003 年的每 10 万人 480 例下降到 2010 年的每 10 万人 430 例。经皮冠状动脉介入治疗(PCI)的比例也从 2003 年的每 10 万人 186 例下降到 2010 年的每 10 万人 170 例。冠状动脉旁路移植术的比例从 2003 年的每 10 万人 84 例下降到 2010 年的每 10 万人 42 例。存在地域差异,北部地区的比率高于全省平均水平,南部地区的比率低于全省平均水平。
在研究期间,艾伯塔省的心脏导管插入术和 PCI 的年龄和性别标准化率下降,扭转了之前 PCI 率上升的趋势。艾伯塔省的冠状动脉旁路移植术比率显著下降,表明实践发生了变化,这与其他地区的情况一致。心脏手术的比率存在地域差异。这些数据对加拿大其他地区具有重要意义,因为这些地区可能没有登记处的数据。