Comparing the use of coronary revascularization in France and the United States: Divergent trends

IF 2.9 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2026-08-01 Epub Date: 2026-03-10 DOI:10.1016/j.acvd.2026.02.002

Michael K. Gusmano, Victor G. Rodwin, Daniel Weisz, Jonathan Cottenet, Nicolas Danchin, Catherine Quantin

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引用次数: 0

Abstract

Background

Coronary revascularization is a key treatment for coronary artery disease (CAD). Over the past 15 years, several randomized trials have shown that it failed to improve life expectancy in most patients with stable CAD.

Aim

To compare trends in the use of coronary revascularization from 2012 to 2018 in France and the United States (US).

Methods

Administrative databases were used in both countries to identify patients ≥ 35 years of age, hospitalized for CAD or congestive heart failure (CHF) undergoing coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), as identified from the International Classification of Diseases coding system. Independent correlates of the use of coronary revascularization were also investigated.

Results

In France, from 2012 to 2018, coronary revascularization increased by 13.3% among patients aged 35–64 years and by 24.6% among those aged ≥ 65 years. In contrast, in the US, it decreased by 16.3% and 19.6%, respectively. These trends were mainly related to the use of PCI: +15.8% and +28.8% in France versus–17.6% and–20.4% in the US. These divergent trends could not be explained solely by changes in the number of hospitalizations for CAD/CHF. In both countries and for both periods, use of revascularization was independently related to age, number of medical diagnoses, sex and income.

Conclusion

Divergent trends in the use of coronary revascularization were observed in France and the US that could not be explained by trends in the number of CAD/CHF hospitalizations, nor by differences in the correlates of its use.

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比较法国和美国冠状动脉血管重建术的使用：不同的趋势。

背景：冠状动脉血管重建术是治疗冠状动脉疾病（CAD）的关键手段。在过去的15年里，几项随机试验表明，它不能改善大多数稳定型CAD患者的预期寿命。目的：比较2012年至2018年法国和美国冠状动脉重建术的使用趋势。方法：使用两国的管理数据库，从国际疾病分类编码系统中识别年龄≥35岁，因冠心病或充血性心力衰竭（CHF）住院接受冠状动脉旁路移植术（CABG）或经皮冠状动脉介入治疗（PCI）的患者。冠状动脉血运重建术的独立相关因素也被调查。结果：在法国，从2012年到2018年，35-64岁患者的冠状动脉重建术增加了13.3%，≥65岁患者的冠状动脉重建术增加了24.6%。相比之下，美国则分别下降了16.3%和19.6%。这些趋势主要与PCI的使用有关：法国为+15.8%和+28.8%，而美国为-17.6%和20.4%。这些不同的趋势不能仅仅用CAD/CHF住院人数的变化来解释。在这两个国家和这两个时期，血运重建术的使用与年龄、医疗诊断次数、性别和收入独立相关。结论：在法国和美国，冠状动脉血运重建术的使用趋势不同，这不能用CAD/CHF住院人数的趋势来解释，也不能用其使用相关因素的差异来解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.