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Obstructive CAD in cardiac cath patients less common in New York vs. Ontario
An observational study found that patients undergoing elective cardiac catheterization in New York were significantly less likely to have obstructive CAD than their counterparts in Ontario, Canada.
The study also concluded that if New York adopts a similar rate of cardiac catheterization as Ontario, it would lead to a substantial annual savings to the state’s health care system.
Researchers of the study conducted an observational analysis of 18,114 patients from New York and 54,933 from Ontario. All patients were without a history of cardiac disease and underwent elective cardiac catheterization between Oct. 1, 2008, and Sept. 30, 2011 for obstructive CAD (stenosis ≥50% in the left main coronary artery or stenosis of ≥70% in a major epicardial vessel).
Obstructive CAD was significantly lower in New York at a rate of 30.4% (95% CI, 29.7%-31.0%) than in Ontario at 44.8% (95% CI, 44.4%-45.3%). The rate of left main or three-vessel CAD was also significantly lower in New York at 7.0% (95% CI, 6.6%-7.3%) compared with Ontario at 13.0% (95% CI, 12.8%-13.3%).
A substantially higher percentage of New York patients with low predicted probability of obstructive CAD underwent cardiac catheterization. Researchers noted that 19.3% (95% CI, 18.7%-19.9%) of patients undergoing cardiac catheterization in New York had a greater than 50% predicted probability of having obstructive CAD than those in Ontario at 41% (95% CI, 40.6%-41.4%).
Crude mortality at 30 days for patients undergoing cardiac catheterization was slightly higher in New York at 0.65% (90 of 13,824; 95% CI, 0.51%-0.78%) than in Ontario at 0.38% (153 of 40,794; 95% CI, 0.32%-0.43%).
Researchers noted that if New York adopts the same population rate of cardiac catheterization as in Ontario (from 1,185 per 100,000 to 605 per 100,000), the change could lead to potential savings of approximately $75 million per year.
Disclosure: Researchers reported no relevant financial disclosures.