Variable | % of patients* | p value (medical therapy v. revascularization) | % of patients* | |||
---|---|---|---|---|---|---|
Total n = 39 126 | Medical therapy n = 15 138 | Revascularization n = 23 988 | PCI n = 15 601 | CABG n = 8387 | ||
Patient-level factors | ||||||
Demographics | ||||||
Age, mean ± SD, yr | 66.0 ± 10.3 | 67.0 ± 10.2 | 65.3 ± 10.3 | < 0.001 | 65.0 ± 10.7 | 66.0 ± 9.7 |
Sex, male | 75.3 | 74.3 | 75.9 | < 0.001 | 72.9 | 81.3 |
Rural residence | 14.5 | 14.4 | 14.5 | 0.7 | 14.6 | 14.5 |
Income quintile | < 0.001 | |||||
1 (lowest) | 18.6 | 19.6 | 17.9 | 18.4 | 17.1 | |
2 | 20.4 | 20.4 | 20.4 | 20.4 | 20.6 | |
3 | 20.2 | 20.3 | 20.2 | 20.3 | 19.9 | |
4 | 20.7 | 20.2 | 21.0 | 20.8 | 21.3 | |
5 (highest) | 20.1 | 19.4 | 20.5 | 20.2 | 21.1 | |
Medical comorbidities | ||||||
PVD | 9.4 | 11.5 | 8.1 | < 0.001 | 7.6 | 9.0 |
Previous MI | 28.1 | 35.8 | 23.3 | < 0.001 | 24.8 | 20.4 |
COPD | 6.9 | 8.6 | 5.8 | < 0.001 | 6.1 | 5.1 |
Charlson Comorbidity Index score, mean ± SD | 0.9 ± 1.3 | 1.1 ± 1.5 | 0.8 ± 1.2 | < 0.001 | 0.7 ± 1.3 | 0.8 ± 1.2 |
Cardiac risk factors | ||||||
Diabetes | 44.0 | 48.0 | 41.4 | < 0.001 | 40.5 | 43.1 |
Hypertension | 86.7 | 89.5 | 84.9 | < 0.001 | 84.9 | 85.1 |
Hyperlipidemia | 80.8 | 83.0 | 79.5 | < 0.001 | 79.9 | 78.7 |
History of smoking | 31.6 | 33.2 | 30.5 | < 0.001 | 30.3 | 31.0 |
Cardiac status/testing | ||||||
Native stenosis† | ||||||
LM | 13.0 | 10.8 | 14.4 | < 0.001 | 5.5 | 31.0 |
Proximal LAD | 33.2 | 28.7 | 36.0 | < 0.001 | 29.7 | 47.6 |
Mid/distal LAD | 49.6 | 47.5 | 51.0 | < 0.001 | 46.0 | 60.3 |
Circumflex | 51.5 | 50.9 | 51.9 | 0.07 | 43.6 | 67.2 |
RCA | 60.8 | 60.5 | 60.9 | 0.4 | 54.7 | 72.6 |
Had previous CABG | < 0.001 | |||||
Yes | 18.0 | 30.1 | 10.4 | 15.1 | 1.6 | |
No | 81.9 | 69.9 | 89.5 | 84.9 | 98.2 | |
LV function | < 0.001 | |||||
≤ 34% | 5.4 | 8.4 | 3.5 | 3.3 | 4.0 | |
35%-49% | 12.9 | 16.0 | 11.0 | 10.6 | 11.7 | |
≥ 50% | 48.6 | 46.5 | 50.0 | 49.7 | 50.5 | |
NA | 33.0 | 29.1 | 35.5 | 36.4 | 33.8 | |
Exercise ECG risk | < 0.001 | |||||
High risk | 27.7 | 21.3 | 31.7 | 28.8 | 37.1 | |
Low risk | 22.4 | 22.9 | 22.2 | 23.0 | 20.7 | |
Uninterpretable | 4.9 | 4.8 | 4.9 | 5.3 | 4.2 | |
NA | 45.0 | 51.1 | 41.2 | 42.9 | 38.0 | |
Patient-level factors cont'd | ||||||
Cardiac status/testing cont'd | ||||||
Functional imaging risk | < 0.001 | |||||
High risk | 32.0 | 31.2 | 32.6 | 31.1 | 35.3 | |
Low risk | 23.0 | 25.1 | 21.7 | 23.2 | 19.1 | |
Unknown/NA | 44.9 | 43.7 | 45.7 | 45.7 | 45.7 | |
CCS class | < 0.001 | |||||
0 | 16.5 | 22.0 | 13.0 | 11.3 | 16.2 | |
1 | 14.0 | 15.9 | 12.8 | 12.3 | 13.8 | |
2 | 38.3 | 35.5 | 40.0 | 40.8 | 38.5 | |
3 | 28.5 | 24.2 | 31.1 | 32.3 | 29.0 | |
4 | 2.8 | 2.4 | 3.0 | 3.3 | 2.5 | |
Physician-level factors | ||||||
Referral physician | 0.01 | |||||
Family physician | 25.7 | 26.1 | 25.5 | 25.6 | 25.3 | |
Cardiology | 41.4 | 40.5 | 14.9 | 42.1 | 41.6 | |
Internal medicine | 9.4 | 9.3 | 9.6 | 9.1 | 10.4 | |
Other | 6.6 | 6.8 | 6.5 | 6.2 | 7.0 | |
Missing | 16.9 | 17.4 | 16.5 | 17.0 | 15.6 | |
Hospital-level factors | ||||||
Annual no. of catheterization procedures, mean ± SD | 4092.3 ± 1696.4 | 4031.3 ± 1684.3 | 4130.9 ± 1702.9 | < 0.001 | 4120.9 ± 1702.6 | 4149.5 ± 1703.6 |
Hospital type | < 0.001 | |||||
Catheterization only | 13.2 | 13.6 | 13.0 | 13.4 | 12.2 | |
PCI and catheterization only | 6.1 | 7.2 | 5.4 | 5.0 | 6.1 | |
CABG, PCI and catheterization | 80.8 | 79.3 | 81.7 | 81.7 | 81.8 |
CABG = coronary artery bypass grafting, Cath = catheterization, CCS = Canadian Cardiovascular Society, COPD = chronic obstructive pulmonary disease, ECG = electrocardiogram, LAD = left anterior descending, LM = left main, LV = left ventricular, MI = myocardial infarction, NA = not done, PCI = percutaneous coronary intervention, PVD = peripheral vascular disease, RCA = right coronary artery.
*Unless stated otherwise.
†LM if ≥ 50% stenosis, proximal LAD if ≥ 70% stenosis, mid/distal LAD if ≥ 70% stenosis, circumflex if ≥ 70% stenosis, RCA if ≥ 70% stenosis.