Background
Evaluating trends in acute coronary syndrome (ACS) and invasive coronary procedures,
including coronary angiography, percutaneous coronary intervention (PCI) and coronary
artery bypass grafting (CABG) can identify areas for improvement in clinical care
and inform future health planning. This national data-linkage study reports trends
in ACS hospitalisations and procedure rates in New Zealand between 2006 and 2016.
Methods
All adult ACS hospitalisations and associated angiography and revascularisation procedures
were identified from hospital discharge codes. Crude and age-standardised ACS incidence
and procedure rates were calculated for each calendar year.
Results
Between 2006 and 2016 there were 188,264 ACS admissions. During this time, there was
a steady decline in hospitalisation rates, from 685 to 424 per 100,000 per year. This
decline was observed in both sexes and in all age groups. There were also significant
increases in coronary angiography and revascularisation rates, from 29.8% to 54.3%
and 20.6% to 37.3%, respectively, between 2006 and 2016. The rate of revascularisation
by PCI increased from 16.0% to 31.0%, a greater increase than revascularisation by
CABG, which increased from 4.6% to 6.5%. Increases in procedures were observed in
all age groups and both sexes. The proportions of coronary angiograms that resulted
in revascularisation each year consistently ranged from 67 to 70% throughout the period.
Conclusions
Acute coronary syndrome hospitalisation rates in New Zealand decreased by nearly 40%
between 2006 and 2016, while the use of coronary angiography and revascularisation
after ACS nearly doubled. The similar proportions of angiograms that resulted in revascularisation
each year suggests that, despite the doubling of angiograms over the 10-year study
period, they are not over-utilised.
Keywords
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Article info
Publication history
Published online: December 03, 2019
Accepted:
November 18,
2019
Received in revised form:
February 28,
2019
Received:
November 19,
2018
Identification
Copyright
© 2019 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
