Table 1.
Baseline Characteristics, Coronary Anatomy, and Procedural Details of Patients With Multivessel Coronary Artery Disease Undergoing Nonemergent Angiography
| Variable | Hospital PCI/CABG ratio | |||
|---|---|---|---|---|
|
Low (0.70–0.85) n=17 487 |
Medium (1.01–1.17) n=15 275 n=15 275 |
High (1.18–1.29) n=11 526 |
P value | |
| Age, y, mean±SD | 67.2±10.6 | 66.8±11.0 | 66.9±11.3 | <0.01 |
| Male sex, n (%) | 13 331 (76.2%) | 11 588 (75.9%) | 8801 (76.4%) | 0.60 |
| Income quintile, n (%) | <0.01 | |||
| 1, lowest | 3458 (19.8%) | 3045 (19.9%) | 2702 (23.4%) | |
| 2 | 3517 (20.1%) | 3150 (20.6%) | 2643 (22.9%) | |
| 3 | 3584 (20.5%) | 3088 (20.2%) | 2597 (22.5%) | |
| 4 | 3609 (20.6%) | 3117 (20.4%) | 1692 (14.7%) | |
| 5, highest | 3283 (18.8%) | 2852 (18.7%) | 1858 (16.1%) | |
| Missing | 36 (0.2%) | 23 (0.2%) | 34 (0.3%) | |
| Rural, n (%) | 3351 (19.2%) | 2592 (17.0%) | 316 (2.7%) | <0.01 |
| Charlson index, mean±SD | 2.0±1.9 | 1.9±1.7 | 2.0±1.7 | 0.01 |
| Hypertension, n (%) | 12 375 (70.8%) | 10 623 (69.5%) | 8422 (73.1%) | <0.01 |
| Diabetes, n (%) | 5986 (34.2%) | 5469 (35.8%) | 4508 (39.1%) | <0.01 |
| Smoking status, n (%) | ||||
| Current | 3528 (20.2%) | 3675 (24.1%) | 1733 (15.0%) | <0.01 |
| Former | 6408 (36.6%) | 3723 (24.4%) | 2953 (25.6%) | |
| Never | 6399 (36.6%) | 7150 (46.8%) | 6210 (53.9%) | |
| Canadian Cardiovascular Society class, n (%)* | <0.01 | |||
| 0 | 1307 (7.5%) | 1823 (11.9%) | 1389 (12.1%) | |
| 1 | 1165 (6.7%) | 1199 (7.8%) | 1280 (11.1%) | |
| 2 | 2857 (16.3%) | 2863 (18.7%) | 2835 (24.6%) | |
| 3 | 2093 (12.0%) | 2033 (13.3%) | 1389 (12.1%) | |
| 4 | 473 (2.7%) | 554 (3.6%) | 312 (2.7%) | |
| ACS low risk | 3051 (17.4%) | 2224 (14.6%) | 737 (6.4%) | |
| ACS intermediate risk | 4676 (26.7%) | 2916 (19.1%) | 2865 (24.9%) | |
| ACS high risk | 1528 (8.7%) | 1599 (10.5%) | 690 (6.0%) | |
| Unknown | 337 (1.9%) | 64 (0.4%) | 29 (0.3%) | |
| Congestive heart failure, n (%) | 1224 (7.0%) | 1141 (7.5%) | 770 (6.7%) | 0.04 |
| Previous myocardial infarction, n (%) | 4126 (23.6%) | 2800 (18.3%) | 2513 (21.8%) | <0.01 |
| Peripheral vascular disease, n (%) | 1287 (7.4%) | 1103 (7.2%) | 695 (6.0%) | <0.01 |
| Cerebrovascular disease, n (%) | 1376 (7.9%) | 982 (6.4%) | 743 (6.4%) | <0.01 |
| Chronic obstructive pulmonary disease, n (%) | 1181 (6.8%) | 1060 (6.9%) | 462 (4.0%) | <0.01 |
| Creatinine, mean±SD | 97.4±74.6 | 100.1±95.9 | 103.3±94.1 | <0.01 |
| Dialysis, n (%) | 287 (1.6%) | 242 (1.6%) | 296 (2.6%) | <0.01 |
| Estimated glomerular filtration rate, n (%) | <0.01 | |||
| <30 | 526 (3.0%) | 507 (3.3%) | 482 (4.2%) | |
| 30–59 | 2981 (17.0%) | 2294 (15.0%) | 1846 (16.0%) | |
| 60–89 | 7861 (45.0%) | 6206 (40.6%) | 5137 (44.6%) | |
| ≥90 | 5220 (29.9%) | 4433 (29.0%) | 3596 (31.2%) | |
| Missing | 899 (5.1%) | 1835 (12.0%) | 465 (4.0%) | |
| Left main disease, n (%) | 4075 (23.3%) | 3295 (21.6%) | 2023 (17.6%) | <0.001 |
| 3‐VD with proximal LAD, n (%) | 3036 (17.4%) | 2168 (14.2%) | 2147 (18.6%) | <0.01 |
| 3‐VD without proximal LAD, n (%) | 3440 (19.7%) | 3439 (22.5%) | 2418 (21.0%) | <0.01 |
| 2‐VD with LAD, n (%) | 6936 (39.7%) | 6373 (41.7%) | 4938 (42.8%) | <0.01 |
| PCI, n (%) | 6774 (38.7%) | 8055 (52.7%) | 6989 (60.6%) | <0.01 |
| Physician performing index angiogram, n (%) | <0.01 | |||
| Diagnostic cardiologist | 2430 (13.9%) | 2558 (16.7%) | 3338 (29.0%) | |
| Interventional cardiologist | 15 057 (86.1%) | 12 717 (83.3%) | 8188 (71.0%) | |
| Hospital type, n (%) | <0.01 | |||
| Community | 8969 (51.3%) | 8010 (52.4%) | 5169 (44.8%) | |
| Teaching | 8518 (48.7%) | 7265 (47.6%) | 6357 (55.2%) | |
| Hospital capability, n (%) | <0.01 | |||
| Angiography only | 0 (0.0%) | 0 (0.0%) | 1647 (14.3%) | |
| Angiography and PCI only | 2620 (15.0%) | 4677 (30.6%) | 3522 (30.6%) | |
| Angiography, PCI and CABG | 14 867 (85.0%) | 10 598 (69.4%) | 6357 (55.2%) | |
| Primary reason for referral, n (%) | <0.01 | |||
| E: elective, stable coronary Disease | 4180 (23.9%) | 4103 (26.9%) | 4855 (42.1%) | |
| N: non–ST‐segment–elevation myocardial infarction | 6998 (40.0%) | 5633 (36.9%) | 3274 (28.4%) | |
| R: rule out coronary artery disease | 2091 (12.0%) | 2241 (14.7%) | 1152 (10.0%) | |
| U: unstable angina | 3362 (19.2%) | 2517 (16.5%) | 1907 (16.5%) | |
| O: other | 856 (4.9%) | 781 (5.1%) | 338 (2.9%) | |
ACS indicates acute coronary syndrome; CABG, coronary artery bypass grafting; LAD, left anterior descending; PCI, percutaneous coronary intervention; and VD, vessel disease.