Abstract 16981: Impact of Economic Recession on PCI Trends
Background: The incidence of myocardial infarctions has steadily declined over the past decade. PCI rates peaked in 2004-2005 and have then declined. Practice and patient related factors have contributed to the decline of PCI. Our purpose is to examine the impact of the economic recession on PCI trends from 2001-2010 for New Hampshire, Maine, and Vermont.
Methods: The PCI were obtained through Dartmouth dynamic registry, which has a catchment area that encompasses New Hampshire, Vermont and Maine. Regional and National unemployment data were obtained through the Department of Labor and Statistic. National and State specific insurance rates were obtained through the US Census data for 2001-2010. State specific cardiovascular prevalence rates were obtained by through individual state specific CDC epidemiology department’s Behavioral Risk Factor Surveillance System (BRFS) questionnaire.
Results: The overall prevalence of cardiovascular disease remained stable in the last 5 years (2005-2010) but remained higher than the national average. The national unemployment rate increased from 4.7% in 2001 to high of 9.6% in 2010 while New Hampshire, Vermont and Maine followed the overall national trends however, had on average 15%-30% less unemployment.
National medical uninsured rate increased from 13.5% in 2001 to a high of 16.3% in 2010, while all three state’s medical uninsured rates stayed relatively stable between 8.8% and 10.8 and did not follow the national trend. DHMC catheterization lab showed steady increase in PCI volume 935 cases in 2001 to high of 1477 in 2005 but steadily declined to 1029 PCIs in 2010. During the same time STEMI cases have steadily increased from 10% to 28% of total volume. During the same time the PCIs due to NSTEMI/UA and stable angina percentage remained between 25%-30% of the total PCI volume but overall numbers declined. The New Hampshire unemployment rate was highly correlated with the STEMI rate (correlation coefficient 0.87, p-value 0.001). However, overall PCI volume trends did not correlate with state specific unemployment.
Conclusions: STEMI cases have increased steadily, while PCI for other indications have declined since peaking in 2005. This trend does not seem to match the overall economic trends in the region.
- Percutaneous coronary intervention
- Cardiovascular therapeutics
- Acute coronary syndromes
- © 2012 by American Heart Association, Inc.