Table 2. Coronary heart disease deaths prevented or postponed due to changes in treatment uptake between 2000 and 2007 in England and stratified by deprivation quintiles.
Treatment by Patient Groups | England: DPP | By IMD: DPP | |||||||
n | Percent | Percent Lower limita | Percent Upper limita | n Most Affluent | n IMDQ2 | n IMDQ3 | n IMDQ4 | n Most Deprived | |
STEMI b | −130 | −0.3 | −0.8 | 0.5 | −6 | −27 | −28 | −31 | −38 |
Thrombolysis | −118 | −22 | −23 | −21 | −23 | −29 | |||
Aspirin | 24 | 5 | 4 | 5 | 3 | 7 | |||
B-blocker | 4 | 1 | 0 | 1 | 1 | 2 | |||
ACE inhibitor or ARB | 5 | 0 | 0 | 2 | 1 | 2 | |||
Clopidogrel | 65 | 12 | 14 | 14 | 13 | 12 | |||
Primary PCI | 139 | 30 | 28 | 28 | 27 | 25 | |||
Primary CABG | 1 | 0 | 0 | 0 | 0 | 0 | |||
CPR in hospitalc | −252 | −33 | −51 | −57 | −53 | −57 | |||
NSTEACS b | 295 | 0.8 | 0.0 | 2.2 | 57 | 59 | 62 | 53 | 65 |
Aspirin and heparin | 341 | 54 | 68 | 68 | 63 | 88 | |||
Aspirin alone | −114 | −15 | −24 | −21 | −21 | −31 | |||
PG IIB/IIIA inhibitors | −1 | −2 | −1 | 0 | 0 | 2 | |||
ACE inhibitor or ARB | 44 | 6 | 8 | 9 | 10 | 10 | |||
B-blocker | 27 | 5 | 5 | 6 | 5 | 6 | |||
Clopidogrel | 203 | 36 | 40 | 46 | 41 | 40 | |||
CABG surgery | 1 | 2 | 1 | 0 | 0 | −1 | |||
PCI | 54 | 11 | 10 | 12 | 12 | 10 | |||
CPR in hospitalc | −259 | −40 | −48 | −58 | −55 | −58 | |||
Secondary prevention post MI b | 3,510 | 9.2 | 7.2 | 11.4 | 640 | 775 | 746 | 711 | 639 |
Aspirin | 351 | 65 | 69 | 76 | 87 | 55 | |||
B-blocker | 862 | 158 | 197 | 194 | 167 | 146 | |||
ACE inhibitor or ARB | 903 | 166 | 200 | 190 | 175 | 172 | |||
Statin | 1,303 | 241 | 280 | 269 | 268 | 245 | |||
Warfarin | 92 | 8 | 30 | 17 | 15 | 21 | |||
Rehabilitationd | 0 | 0 | 0 | 0 | 0 | 0 | |||
Secondary prevention post revascularisation b | 590 | 1.5 | 1.2 | 1.9 | 112 | 121 | 128 | 117 | 110 |
Aspirin | 45 | 10 | 10 | 11 | 8 | 7 | |||
B-blocker | 154 | 29 | 31 | 34 | 31 | 30 | |||
ACE inhibitor or ARB | 179 | 35 | 37 | 37 | 34 | 36 | |||
Statin | 174 | 31 | 36 | 38 | 37 | 32 | |||
Warfarin | 0 | 0 | 0 | 1 | 0 | −1 | |||
Rehabilitation (post CABG)d | 0 | 0 | 0 | 0 | 0 | 0 | |||
Rehabilitation (post PTCA) | 36 | 7 | 7 | 7 | 7 | 7 | |||
Chronic stable CAD b | 4,835 | 12.7 | 9.6 | 16.8 | 851 | 1,007 | 1,015 | 1,016 | 955 |
Aspirin in community | 818 | 139 | 159 | 176 | 179 | 165 | |||
Statin in community | 2,488 | 443 | 523 | 526 | 510 | 485 | |||
ACE inhibitor or ARB | 1,292 | 241 | 281 | 268 | 261 | 241 | |||
CABG surgery | 236 | 27 | 44 | 45 | 57 | 63 | |||
Heart failure - hospital b | 250 | 0.7 | 0.5 | 0.8 | 42 | 47 | 53 | 59 | 51 |
ACE inhibitor | 49 | 8 | 9 | 10 | 10 | 11 | |||
B-blocker | 39 | 6 | 8 | 8 | 9 | 9 | |||
Spironolactone | 37 | 6 | 7 | 8 | 8 | 8 | |||
Aspirin | 126 | 21 | 22 | 27 | 32 | 23 | |||
Heart failure - community b | 3,335 | 8.8 | 7.3 | 10.4 | 564 | 689v | 732 | 711 | 641 |
ACE inhibitor or ARB | 737 | 125 | 158 | 171 | 146 | 137 | |||
B-blocker | 1,592 | 284 | 325 | 353 | 338 | 292 | |||
Spironolactone | 617 | 105 | 134 | 120 | 129 | 129 | |||
Aspirin | 389 | 50 | 72 | 88 | 97 | 83 | |||
Hypertension treatment b | 1,800 | 4.7 | 1.8 | 9.9 | 357 | 411 | 408 | 345 | 277 |
Hyperlipidemia treatment (statins) b | 5,300 | 13.9 | 5.0 | 31.8 | 1,054 | 975 | 1,305 | 1,194 | 772 |
Total treatment contribution b | 19,780 | 52.0 | 40.2 | 69.7 | 3,670 | 4,055 | 4,420 | 4,166 | 3,471 |
Subtotals for England (column 1) have been rounded to nearest 5.
The 95% uncertainty interval corresponds to the lower (2.5th percentile) and upper (97.5th percentile) limits of the uncertainty analysis. These are shown to indicate range around the central estimate of percent of DPPs explained (column 3).
Sub-totals (in rows) for CHD patient groups.
We have assumed no change in cardiopulmonary resuscitation (CPR) uptake in the community between 2000 and 2007. Their contribution to DPPs have therefore been set to zero.
No change in uptake between 2000 and 2007.
Abbreviations: B-blocker, beta-blocker; CABG, coronary artery bypass graft; CAD, coronary artery disease; IMD, index of multiple deprivation; MI, myocardial infarction; NSTEACS, non-ST elevation acute coronary syndrome; PCI, percutaneous coronary intervention; PG, platelet glycoprotein; PTCA, percutaneous transluminal coronary angioplasty; STEMI, ST elevation myocardial infarction.