{"id":3916,"date":"2013-07-10T00:00:00","date_gmt":"2013-07-10T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/prevalence-and-extent-of-obstructive-coronary-artery-disease-among-patients-undergoing-elective-coronary-catheterization-in-new-york-state-and-ontario\/"},"modified":"2023-06-14T19:30:25","modified_gmt":"2023-06-14T23:30:25","slug":"prevalence-and-extent-of-obstructive-coronary-artery-disease-among-patients-undergoing-elective-coronary-catheterization-in-new-york-state-and-ontario","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prevalence-and-extent-of-obstructive-coronary-artery-disease-among-patients-undergoing-elective-coronary-catheterization-in-new-york-state-and-ontario\/","title":{"rendered":"Prevalence and extent of obstructive coronary artery disease among patients undergoing elective coronary catheterization in New York State and Ontario"},"content":{"rendered":"<p><strong>Importance<\/strong> &#x2014; Prior studies have shown that physicians in New York State (New York) perform twice as many cardiac catheterizations per capita as those in Ontario for stable patients. However, the role of patient selection in these findings and their implications for detection of obstructive coronary artery disease (CAD) are largely unknown.<\/p>\n<p><strong>Objective<\/strong> &#x2014; To evaluate the extent of obstructive CAD and to compare the probability of detecting obstructive CAD for patients undergoing cardiac catheterization.<\/p>\n<p><span class=\"bold\">Design, Setting and Patients<\/span> &#x2014; An observational study was conducted involving patients without a history of cardiac disease who underwent elective cardiac catheterization between October 1, 2008, and September 30, 2011. Obstructive CAD was defined as diameter stenosis of 50% or more in the left main coronary artery or stenosis of 70% or more in a major epicardial vessel.<\/p>\n<p><span class=\"bold\">Main Outcomes and Measures<\/span> &#x2014; Observed rates and predicted probabilities of obstructive CAD. Predicted probabilities were estimated using logistic regression models.<\/p>\n<p><strong>Result<\/strong> &#x2014; A total of 18&#x2009;114 patients from New York and 54&#x2009;933 from Ontario were included. The observed rate of obstructive CAD was significantly lower in New York at 30.4% (95% CI, 29.7%-31.0%) than in Ontario at 44.8% (95% CI, 44.4%-45.3%; P&lt;&#x2009;.001). The percentage of patients with left main or 3-vessel CAD was also significantly lower in New York than in Ontario (7.0% [95% CI, 6.6%-7.3%] vs 13.0% [95% CI, 12.8%-13.3%]; P&#x2009;&lt;&#x2009;.001). In New York, a substantially higher percentage of patients with low predicted probability of obstructive CAD underwent cardiac catheterization; for example, only 19.3% (95% CI, 18.7%-19.9%) of patients undergoing cardiac catheterization in New York had a greater than 50% predicted probability of having obstructive CAD than those in Ontario at 41% (95% CI, 40.6%-41.4%; P&#x2009;&lt;&#x2009;.001). At 30 days, crude mortality for patients undergoing cardiac catheterization was slightly higher in New York at 0.65% (90 of 13&#x2009;824; 95% CI, 0.51%-0.78%) than in Ontario at 0.38% (153 of 40&#x2009;794; 95% CI, 0.32%-0.43%; P&#x2009;&lt;&#x2009;.001).<\/p>\n<p><span class=\"bold\">Conclusions and Relevance<\/span> &#x2014; In Ontario compared with New York State, patients undergoing elective cardiac catheterization were significantly more likely to have obstructive CAD. This appears to be related to a higher percentage of patients in New York with low predicted probability of CAD undergoing cardiac catheterization. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Importance &#x2014; Prior studies have shown that physicians in New York State (New York) perform twice as many cardiac catheterizations per capita as those in Ontario for stable patients. However, the role of patient selection in these findings and their implications for detection of obstructive coronary artery disease (CAD) are largely unknown. Objective &#x2014; To [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40],"migration-helper-qa-sample-set":[],"class_list":["post-3916","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease"],"acf":{"citation":"Ko DT, Tu JV, Austin PC, Wijeysundera HC, Samadashvili Z, Guo HC, Cantor WJ, Hannan EL. <em>JAMA. <\/em>2013; 310 (2):163-9. Epub 2013 Apr 6.","source_url":"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=1710454","ices_scientist":[1146,1385,1133],"site":[6733],"research_program":[6742],"news_release":[7420],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"BD462A08-39A1-4688-8EB3-37F7D433C2DD","sitecore_item_name":"Prevalence-and-extent-of-obstructive-coronary-artery-disease","sitecore_field_values":"{\n  \"Title\": \"Prevalence and extent of obstructive coronary artery disease among patients undergoing elective coronary catheterization in New York State and Ontario\",\n  \"Short title\": \"Prevalence and extent of obstructive\",\n  \"Citation\": \"<p>Ko DT, Tu JV, Austin PC, Wijeysundera HC, Samadashvili Z, Guo HC, Cantor WJ, Hannan EL. <em>JAMA. <\/em>2013; 310 (2):163-9. Epub 2013 Apr 6.<\/p>\",\n  \"Abstract\": \"<p><strong>Importance<\/strong> &mdash; Prior studies have shown that physicians in New York State (New York) perform twice as many cardiac catheterizations per capita as those in Ontario for stable patients. However, the role of patient selection in these findings and their implications for detection of obstructive coronary artery disease (CAD) are largely unknown.<\/p>n<p><strong>Objective<\/strong> &mdash; To evaluate the extent of obstructive CAD and to compare the probability of detecting obstructive CAD for patients undergoing cardiac catheterization.<\/p>n<p><span class=\"bold\">Design, Setting and Patients<\/span> &mdash; An observational study was conducted involving patients without a history of cardiac disease who underwent elective cardiac catheterization between October 1, 2008, and September 30, 2011. Obstructive CAD was defined as diameter stenosis of 50% or more in the left main coronary artery or stenosis of 70% or more in a major epicardial vessel.<\/p>n<p><span class=\"bold\">Main Outcomes and Measures<\/span> &mdash; Observed rates and predicted probabilities of obstructive CAD. Predicted probabilities were estimated using logistic regression models.<\/p>n<p><strong>Result<\/strong> &mdash; A total of 18&thinsp;114 patients from New York and 54&thinsp;933 from Ontario were included. The observed rate of obstructive CAD was significantly lower in New York at 30.4% (95% CI, 29.7%-31.0%) than in Ontario at 44.8% (95% CI, 44.4%-45.3%; P&lt;&thinsp;.001). The percentage of patients with left main or 3-vessel CAD was also significantly lower in New York than in Ontario (7.0% [95% CI, 6.6%-7.3%] vs 13.0% [95% CI, 12.8%-13.3%]; P&thinsp;&lt;&thinsp;.001). In New York, a substantially higher percentage of patients with low predicted probability of obstructive CAD underwent cardiac catheterization; for example, only 19.3% (95% CI, 18.7%-19.9%) of patients undergoing cardiac catheterization in New York had a greater than 50% predicted probability of having obstructive CAD than those in Ontario at 41% (95% CI, 40.6%-41.4%; P&thinsp;&lt;&thinsp;.001). At 30 days, crude mortality for patients undergoing cardiac catheterization was slightly higher in New York at 0.65% (90 of 13&thinsp;824; 95% CI, 0.51%-0.78%) than in Ontario at 0.38% (153 of 40&thinsp;794; 95% CI, 0.32%-0.43%; P&thinsp;&lt;&thinsp;.001).<\/p>n<p><span class=\"bold\">Conclusions and Relevance<\/span> &mdash; In Ontario compared with New York State, patients undergoing elective cardiac catheterization were significantly more likely to have obstructive CAD. This appears to be related to a higher percentage of patients in New York with low predicted probability of CAD undergoing cardiac catheterization. <\/p>n<p><a href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=1710454\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{92E2791D-5DAB-4244-8A85-434D524D9A12}\",\n  \"Related Products\": \"<h2>News Release<\/h2>rn<h3><a href=\"~\/link.aspx?_id=419DF567CE044651BC6FAE0D7F53ED77&amp;_z=z\">Ontario&rsquo;s method of selection of patients for cardiac catheterization is more efficient than that in New York State: ICES study<\/a><\/h3>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{B3827152-93D1-4FB2-B106-590CB331A264}|{956599EC-5699-41D3-9375-E0B6C25B12D5}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{8C2597F4-2B41-4E87-9F28-6887C689651B}\",\n  \"Posted Date\": \"20130710T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2013\/January\/Prevalence-and-extent-of-obstructive-coronary-artery-disease"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Prevalence and extent of obstructive coronary artery disease among patients undergoing elective coronary catheterization in New York State and Ontario<\/title>\n<meta name=\"description\" content=\"Importance &#x2014; Prior studies have shown that physicians in New York State (New York) perform twice as many cardiac catheterizations per capita as\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prevalence-and-extent-of-obstructive-coronary-artery-disease-among-patients-undergoing-elective-coronary-catheterization-in-new-york-state-and-ontario\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Prevalence and extent of obstructive coronary artery disease among patients undergoing elective coronary catheterization in New York State and Ontario\" \/>\n<meta property=\"og:description\" content=\"Importance &#x2014; Prior studies have shown that physicians in New York State (New York) perform twice as many cardiac catheterizations per capita as\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prevalence-and-extent-of-obstructive-coronary-artery-disease-among-patients-undergoing-elective-coronary-catheterization-in-new-york-state-and-ontario\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:30:25+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/prevalence-and-extent-of-obstructive-coronary-artery-disease-among-patients-undergoing-elective-coronary-catheterization-in-new-york-state-and-ontario\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/prevalence-and-extent-of-obstructive-coronary-artery-disease-among-patients-undergoing-elective-coronary-catheterization-in-new-york-state-and-ontario\\\/\",\"name\":\"ICES | Prevalence and extent of obstructive coronary artery disease among patients undergoing elective coronary catheterization in New York State and Ontario\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2013-07-10T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:30:25+00:00\",\"description\":\"Importance &#x2014; 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