Abstract 1203: Changes in Cardiovascular Events and Procedures from 2000–2005
Cardiovascular (CV) disease is the leading cause of death in the US. Recent research has shown a significant decrease in CV mortality over the past 2 decades. Our objective was to examine changes in rates of CV events and procedures based on data from hospital discharges in the US. We analyzed inpatient data from the Healthcare Cost and Utilization Project’s (HCUP) Nationwide Inpatient Sample (NIS), for specific CV events and procedures from 2000 –2005. Primary ICD-9-CM procedure codes and admission type were used to classify CV procedures into four categories: primary coronary bypass (CABG), elective (i.e., primary procedure, plus admission type=elective) CABG, primary percutaneous transluminal coronary angioplasty (PTCA), and elective PTCA. Among hospital admissions that were not elective PCTA or CABG, primary ICD-9-CM diagnosis codes were used to classify CV events into four categories: coronary heart disease (CHD) (myocardial infarction, angina and unstable angina), heart failure (HF), atherosclerosis, and stroke. An aggregate CV event measure was classified as any distinct hospitalization with a primary event or procedure as defined above. Age and sex-specific hospitalization rates were calculated and standardized to the 2005 US population. Total CV events and procedures decreased by 17.1% from 13.84 to 11.48 per 1000 persons from 2000 –2005. CHD decreased by 26.2% from 3.31 to 2.45, atherosclerosis by 24.4% from 3.54 to 2.67, stroke by 17.5% from 2.04 to 1.68, HF by 2.8% from 3.80 to 3.70, elective CABG by 45.9% from 0.57 to 0.31, primary CABG by 40.5% from 1.30 to 0.77, and elective PTCA by 0.76% from 0.77 to 0.76. The decline in rates was generally consistent from year to year since 2000. An increase was seen in primary PTCA of 13.7% from 2.24 to 2.54 per 1000 persons. There was a significant decrease in coronary and stroke-related hospitalizations over the first 6 years of this decade, while heart failure hospitalizations remained generally flat. With a total 3,391,680 hospitalizations for these CV events in 2005, this represents a net reduction in 697,637 hospitalizations on an age-sex adjusted basis.