Changes in the Practice of Coronary Revascularization between 2006 and 2010 in the Republic of Korea
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Purpose: Evidence suggests that technological innovations and reimbursement schemes of the National Health Insurance Service may have impacted the managementof coronary artery disease. Thus, we investigated changes in the practice patternsof coronary revascularization. Materials and Methods: Revascularization and in-hospital mortality among Koreans ≥20 years old were identified from medical claims filed between 2006 and 2010. The age- and sex-standardized procedure rate per 100000 person-years was calculated directly from the distribution of the 2008 Koreanpopulation. Results: The coronary revascularization rate increased from 116.1 (95% confidence interval, 114.9‒117.2) in 2006 to 131.0 (129.9‒132.1) in 2010. Comparedto the rate ratios in 2006, the rate ratios for percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in 2010 were 1.16 (1.15‒1.17) and 0.80 (0.76‒0.84), respectively. Among patients who received PCI, the percentagewith drug-eluting stents increased from 89.1% in 2006 to 93.0% in 2010. In-hospitalmortality rates from PCI significantly increased during the study period (p=0.03), whereas those from CABG significantly decreased (p=0.01). The in-hospital mortalityrates for PCI and CABG were higher in elderly and female patients and at the lowest-volume hospitals. Conclusion: The annual volume of coronary revascularizationcontinuously increased between 2006 and 2010 in Korea, although this trend differed according to procedure type. A high percentage of drug-eluting stent proceduresand a high rate of in-hospital mortality at low-volume hospitals were noted.
Abstract
Purpose: Evidence suggests that technological innovations and reimbursement schemes of the National Health Insurance Service may have impacted the managementof coronary artery disease. Thus, we investigated changes in the practice patternsof coronary revascularization. Materials and Methods: Revascularization and in-hospital mortality among Koreans ≥20 years old were identified from medical claims filed between 2006 and 2010. The age- and sex-standardized procedure rate per 100000 person-years was calculated directly from the distribution of the 2008 Koreanpopulation. Results: The coronary revascularization rate increased from 116.1 (95% confidence interval, 114.9‒117.2) in 2006 to 131.0 (129.9‒132.1) in 2010. Comparedto the rate ratios in 2006, the rate ratios for percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in 2010 were 1.16 (1.15‒1.17) and 0.80 (0.76‒0.84), respectively. Among patients who received PCI, the percentagewith drug-eluting stents increased from 89.1% in 2006 to 93.0% in 2010. In-hospitalmortality rates from PCI significantly increased during the study period (p=0.03), whereas those from CABG significantly decreased (p=0.01). The in-hospital mortalityrates for PCI and CABG were higher in elderly and female patients and at the lowest-volume hospitals. Conclusion: The annual volume of coronary revascularizationcontinuously increased between 2006 and 2010 in Korea, although this trend differed according to procedure type. A high percentage of drug-eluting stent proceduresand a high rate of in-hospital mortality at low-volume hospitals were noted.
참고문헌 (33)
- Feldman DN, "Comparison of outcomes of percutaneous coronary interventions in patients of three age groups (<60, 60 to 80, and >80 years) (from the New York State Angioplasty Registry)", Am J Cardiol, 98, pp.1334~1339 (2006)
- Huang HW, "Trends in percutaneous versus surgical revascularization of unprotected left main coronary stenosis in the drug-eluting stent era: a report from the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR)", Catheter Cardiovasc Interv, 68, pp.867~872 (2006)
- Kappetein AP, "Current percutaneous coronary intervention and coronary artery bypass grafting practices for three-vessel and left main coronary artery disease. Insights from the SYNTAX run-in phase", Eur J Cardiothorac Surg, 29, pp.486~491 (2006)
- van Domburg RT, "The impact of the introduction of drug-eluting stents on the clinical practice of surgical and percutaneous treatment of coronary artery disease", Eur Heart J, 26, pp.675~681 (2005)
- Morice MC, "Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery(SYNTAX)trial", Circulation, 121, pp.2645~2653 (2010)
- Rodés-Cabau J, "Nonrandomized comparison of coronary artery bypass surgery and percutaneous coronary intervention for the treatment of unprotected left main coronary artery disease in octogenarians", Circulation, 118, pp.2374~2381 (2008)
- Hlatky MA, "Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials", Lancet, 373, pp.1190~1197 (2009)
- Legrand VM, "Influence of age on the clinical outcomes of coronary revascularisation for the treatment of patients with multivessel de novo coronary artery lesions: sirolimus-eluting stent vs. coronary artery bypass surgery and bare metal stent, insight from the multicentre randomised Arterial Revascularisation Therapy Study Part I (ARTS-I) and Part II (ARTS-II)", EuroIntervention, 6, pp.838~845 (2011)
- Schapiro-Dufour E, "Drug-eluting stents in patients at high risk of restenosis: assessment for France", Int J Technol Assess Health Care, 27, pp.108~117 (2011)
- Stettler C, "Outcomes associated with drug-eluting and bare-metal stents: a collaborative network meta-analysis", Lancet, 370, pp.937~948 (2007)
- Jones WS, "Trends in the use of diagnostic coronary angiography, percutaneous coronary intervention, and coronary artery bypass graft surgery across North Carolina", Am Heart J, 162, pp.932~937 (2011)
- Douglas PS, "Clinical effectiveness of coronary stents in elderly persons: results from 262,700 Medicare patients in the American College of Cardiology-National Cardiovascular Data Registry", J Am Coll Cardiol, 53, pp.1629~1641 (2009)
- Boden WE, "Optimal medical therapy with or without PCI for stable coronary disease", N Engl J Med, 356, pp.1503~1516 (2007)
- Daemen J, "Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study", Lancet, 369, pp.667~678 (2007)
- Shuchman M, "Trading restenosis for thrombosis? New questions about drug-eluting stents", N Engl J Med, 355, pp.1949~1952 (2006)
- Epstein AJ, "Groeneveld PW. Coronary revascularization trends in the United States, 2001-2008", JAMA, 305, pp.1769~1776 (2011)
- Puricel S, "Long-term comparison of everolimus-eluting and biolimus-eluting stents", EuroIntervention, 9, pp.336~344 (2013)
- Gerber Y, "Coronary revascularization in the community. A population-based study, 1990 to 2004", J Am Coll Cardiol, 50, pp.1223~1229 (2007)
- Hassan A, "Increasing rates of angioplasty versus bypass surgery in Canada, 1994-2005", Am Heart J, 160, pp.958~965 (2010)
- Nallamothu BK, "Recent trends in hospital utilization for acute myocardial infarction and coronary revascularization in the United States", Am J Cardiol, 99, pp.749~753 (2007)
- Riley RF, "Trends in coronary revascularization in the United States from 2001 to 2009: recent declines in percutaneous coronary intervention volumes", Circ Cardiovasc Qual Outcomes, 4, pp.193~197 (2011)
- Neyt M, "Cost-effectiveness analyses of drug eluting stents versus bare metal stents: a systematic review of the literature", Health Policy, 91, pp.107~120 (2009)
- Applegate RJ, "Comparison of drug-eluting versus bare metal stents on later frequency of acute myocardial infarction and death", Am J Cardiol, 99, pp.333~338 (2007)
- Ryan J, "Temporal changes in coronary revascularization procedures, outcomes, and costs in the bare-metal stent and drug-eluting stent eras: results from the US Medicare program", Circulation, 119, pp.952~961 (2009)
- Hannan EL, "Drug-eluting stents vs. coronary-artery bypass grafting in multivessel coronary disease", N Engl J Med, 358, pp.331~341 (2008)
- Malenka DJ, "Gender-related changes in the practice and outcomes of percutaneous coronary interventions in Northern New England from 1994 to 1999", J Am Coll Cardiol, 40, pp.2092~2101 (2002)
- Jollis JG, "The relation between the volume of coronary angioplasty procedures at hospitals treating Medicare beneficiaries and short-term mortality", N Engl J Med, 331, pp.1625~1629 (1994)
- Rosenthal GE, "In-hospital mortality following coronary artery bypass graft surgery in Veterans Health Administration and private sector hospitals", Med Care, 41, pp.522~535 (2003)
- McGrath PD, "Relation between operator and hospital volume and outcomes following percutaneous coronary interventions in the era of the coronary stent", JAMA, 284, pp.3139~3144 (2000)
- 이혜아, "Trends in Ischemic Heart Disease Mortality in Korea, 1985-2009: An Age-period-cohort Analysis", 예방의학회지, 45(5), pp.323~328 (2012), 대한예방의학회
- 이수진, "Cost-Effectiveness of Drug-Eluting vs. Bare-Metal Stents in Patients with Coronary Artery Disease from the Korean National Health Insurance Database", Yonsei Medical Journal, 55(6), pp.1533~1541 (2014), 연세대학교의과대학[DOI]
- Lichtman JH, "Age and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: evidence from the NCDR(®)", Am Heart J, 167, pp.376~383 (2014)
- Shaw RE, "Development of a risk adjustment mortality model using the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR) experience: 1998-2000", J Am Coll Cardiol, 39, pp.1104~1112 (2002)