Variations in the PCI to CABG ratio: Single centre experience in Saudi Arabia & International comparison

• Published in: Journal Of The Saudi Heart Association 2013-04, Vol.25 (2), p.119-119
• Main Authors: A-Arifi, Ahmed, Najm, Hani K., Ahmad, Munir, Ghamdi, Ali Al, Van Onselen, Rawdene, Zaibag, Muayed Al
• Format: Article
• Language: English
• ISSN: 1016-7315; 2212-5043
• DOI: 10.1016/j.jsha.2013.03.036

Over the past 20 years, the use of percutaneous coronary intervention (PCI), for myocardial revascularization has seen a dramatic turn, and increased compared to coronary artery bypass graft (CABG). However, although the evidence available is similar, there are a variation in the relative distribution of PCI to CABG among centers and regions. We sought to study the distribution and ratio of the PCI to CABG in our center and to compare it to the current international trend. We carried a review of the prospectively collected data on the annual cardiac procedure reports a the King Abdulaziz Cardiac Centre, Riyadh from 2001 through 2011, to identify the trends in PCI and CABG variation over the study period, and to compare it to the current world wide trend. Over the studied period, the centre performed a total of 4313 and 2531 cases of PCI and CABG respectively. The isolated CABG volume were static with an average 230 cases/year. While the PCI volume shows a yearly almost 50% increase with an average volume of 392 cases/year. PCI/CABG ratio increased from 1.1 in 2001–2002 to 2.7 in 2011. In comparison to UK data, since 1998, the ratio of PCI/CABG has increased from 1.1 to 3.1. In contrast in New York, Manhattan programme, the PCI/CABG ratio increased from 1.19 in 1994 to 8.04 in 2008. However, the average ratio in the rest of the New York programme is 3.31. The current trend in our centre put us in the medium to high group (2.7–3.2) of PCI to CABG ratio and utilization. Further in-depth analysis of these disparities may facilitate the selection of the most appropriate, effective, and evidence based revascularization strategy. Hence, we recommend the implementation of the appropriate criteria for PCI as a quality monitoring in each centre.