Coronary artery bypass graft procedures and percutaneous coronary interventions are falling in California, according to the latest release of the nation's largest database on hospital and surgeon cardiac mortality.
"But while the PCI rate is declining, it's interesting that the PCI mortality rate is inching up a bit, while the mortality rate for CABG continues to decline," said Joe Parker, Director of the Healthcare Outcomes Center at the California Office of Statewide Health Planning and Development, which collects the data and adjusts it for patients' health status.
For example, operative mortality for isolated CABG procedures was 2.24% in 2008, down from 2.4% in 2007. For the four previous years, it was 2.2% in 2006, 3.2% in 2005, 3.3% in 2004 and 2.9 in 2003. This represents a 24% reduction in operative mortality rate since 2003, the first year state law mandated these reports.
CABG procedures have dropped steadily, by 45% since 1996, and percutaneous angiography dropping from its peak of 59,511 in 2004 to 52,089 in 2008.
"We're at the point now where the mortality rate for isolated CABG procedures is actually less than that for PCI," Parker says.
Additionally, Parker says, the number of CABG procedures is falling "much lower than probably would have been anticipated."
Asked why mortality has been dropping, Parker says he thinks that "procedural techniques are being improved, because this is a pretty constant, steady decline."