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Regional Variation in Cardiac Catheterization Appropriateness and Baseline Risk After Acute Myocardial Infarction

Dennis T. Ko, MD, MSc^_*,,1,_*, Yongfei Wang, MS, David A. Alter, MD, PhD^,2, Jeptha P. Curtis, MD, Saif S. Rathore, MPH, Therese A. Stukel, PhD, Fredrick A. Masoudi, MD, MSPH, FACC, Joseph S. Ross, MD, MHS^||,3, JoAnne M. Foody, MD, FACC and Harlan M. Krumholz, MD, SM, FACC^,¶

^_* Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
Department of Medicine, Denver Health Medical Center, and Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado
^|| Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, and Geriatrics Research, Education, and Clinical Center, James J. Peters VA Medical Center, Bronx, New York
^¶ Section of Health Policy and Administration, Department of Epidemiology and Public Health, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.

View larger version (17K): [in this window] [in a new window] [Download PPT slide]   Figure 1 ACC/AHA Procedure Appropriateness by Regional Invasive Intensity ACC = American College of Cardiology; AHA = American Heart Association.

View larger version (44K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Unadjusted Rates of Cardiac Catheterization After Acute Myocardial Infarction in the U.S.

View larger version (29K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Rates of Cardiac Catheterization According to ACC/AHA Class and Regional Invasive Intensity (A) Unadjusted and (B) adjusted rates. Abbreviations as in Figure 1.

View larger version (14K): [in this window] [in a new window] [Download PPT slide]   Figure 4 Relationship of Cardiac Catheterization and Risk by Regions Among All Patients AMI = acute myocardial infarction; GRACE = Global Registry of Acute Coronary Events.

View larger version (14K): [in this window] [in a new window] [Download PPT slide]   Figure 5 Relationship of Cardiac Catheterization and Risk by Region Among Class I Patients Abbreviations as in Figures 1 and 4.