TABLE 2.
Temporal changes in revascularization use in patients with and without diabetes mellitus (DM)
|
Age- and sex-adjusted revascularization use (%) and adjusted RR (95% CI) for DM vs no DM |
Change |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1995 | 1996 | 1997 | 1998 | 1999 | 2000 | 2001* | All years | % of annual change†(95% CI) | P‡ | |
| CABG use during index admission | ||||||||||
| DM | 5.2 | 5.5 | 5.8 | 7.3 | 7.4 | 8.0 | 9.3 | 6.9 | +10.3 (7.4 to 13.3) | 0.0072 |
| No DM | 4.5 | 4.6 | 4.7 | 5.5 | 5.4 | 6.1 | 6.0 | 5.2 | +5.3 (3.4 to 7.2) | |
| Adjusted RR for DM vs no DM | 1.19 (0.98–1.44) | 1.26 (1.04–1.51) | 1.39 (1.16–1.66) | 1.35 (1.15–1.59) | 1.48 (1.26–1.73) | 1.46 (1.26–1.70) | 1.75 (1.48–2.07) | 1.41 (1.33–1.51) | – | 0.0033 |
| One-year CABG use after discharge§ | ||||||||||
| DM | 5.8 | 4.9 | 6.2 | 5.4 | 6.3 | 5.5 | 4.9 | 5.6 | −0.7 (−3.9 to 2.4) | 0.2046 |
| No DM | 4.6 | 4.6 | 4.6 | 4.1 | 4.1 | 3.9 | 3.1 | 4.2 | −5.3 (−7.3 to −3.3) | |
| Adjusted RR for DM vs no DM | 1.33 (1.09–1.62) | 1.14 (0.92–1.40) | 1.36 (1.13–1.65) | 1.46 (1.20–1.78) | 1.62 (1.33–1.96) | 1.42 (1.17–1.73) | 1.52 (1.17–1.97) | 1.40 (1.29–1.51) | – | 0.1240 |
| One-year CABG use | ||||||||||
| DM | 9.6 | 9.0 | 10.5 | 11.1 | 12.0 | 12.2 | 13.4 | 11.1 | 6.6 (4.4 to 8.9) | 0.0006 |
| No DM | 8.1 | 8.2 | 8.3 | 8.5 | 8.4 | 8.8 | 7.9 | 8.3 | 0.08 (−1.3 to 1.4) | |
| Adjusted RR for DM vs no DM | 1.22 (1.06–1.40) | 1.19 (1.03–1.37) | 1.35 (1.18–1.54) | 1.40 (1.23–1.58) | 1.52 (1.34–1.72) | 1.49 (1.32–1.68) | 1.77 (1.54–2.04) | 1.41 (1.34–1.48) | – | 0.0005 |
| PCI use during index admission | ||||||||||
| DM | 8.1 | 10.1 | 12.8 | 13.7 | 18.6 | 21.6 | 25.6 | 15.8 | +20.6 (18.4 to 22.9) | 0.1144 |
| No DM | 11.9 | 13.1 | 16.8 | 19.2 | 22.5 | 26.1 | 30.5 | 19.2 | +16.6 (15.6 to 17.6) | |
| Adjusted RR for DM vs no DM | 0.74 (0.64–0.86) | 0.79 (0.70–0.90) | 0.75 (0.67–0.84) | 0.78 (0.71–0.87) | 0.85 (0.78–0.93) | 0.89 (0.83–0.96) | 0.89 (0.82–0.96) | 0.84 (0.81–0.87) | – | 0.0569 |
| One-year PCI use after discharge§ | ||||||||||
| DM | 5.0 | 5.8 | 6.9 | 6.8 | 6.5 | 7.1 | 7.1 | 6.4 | +5.7 (2.5 to 9.1) | 0.5991 |
| No DM | 6.1 | 6.5 | 7.5 | 7.3 | 7.1 | 6.9 | 7.6 | 7.0 | +2.0 (0.5 to 3.6) | |
| Adjusted RR for DM vs no DM | 0.81 (0.65–1.01) | 0.89 (0.73–1.08) | 0.88 (0.74–1.06) | 0.92 (0.77–1.10) | 0.92 (0.77–1.10) | 1.03 (0.87–1.22) | 0.96 (0.79–1.16) | 0.92 (0.86–0.98) | – | 0.5579 |
| One-year PCI use | ||||||||||
| DM | 10.3 | 12.1 | 14.6 | 16.2 | 19.7 | 22.0 | 25.0 | 17.1 | +16.3 (14.3 to 18.3) | 0.1321 |
| No DM | 13.8 | 15.1 | 18.8 | 20.7 | 22.9 | 25.7 | 28.6 | 20.2 | +12.2 (11.3 to 13.1) | |
| Adjusted RR for DM vs no DM | 0.78 (0.68–0.89) | 0.82 (0.73–0.93) | 0.78 (0.70–0.87) | 0.82 (0.75–0.91) | 0.89 (0.82–0.98) | 0.90 (0.83–0.98) | 0.90 (0.83–0.99) | 0.86 (0.83–0.89) | – | 0.1091 |
*
From April 1, 2001, to December 31, 2001;
†
Annual percentage of change = 100 × [exp (β)–1] adjusted for age and sex from log-binomial regression;
‡
P value of diabetes-year interaction;
§
One-year revascularization following discharge excluding in-hospital deaths. CABG Coronary artery bypass graft; PCI Percutaneous coronary intervention; RR Relative risk adjusted for age, sex, medical history and hospital characteristics; vs Versus