{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T13:44:15Z","timestamp":1789911855514,"version":"4.0.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,2]]},"abstract":"\n Background<\/jats:title>\n \n Patient selection and outcomes for percutaneous coronary intervention (\n PCI<\/jats:styled-content>\n ) and coronary artery bypass grafting (\n CABG<\/jats:styled-content>\n ) have changed over the past decade. However, there is limited information on outcomes for both revascularization strategies in the same population. The study evaluated temporal changes in risk profile, procedural characteristics, and clinical outcomes for\n PCI\u2010<\/jats:styled-content>\n and\n CABG<\/jats:styled-content>\n \u2010treated patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We analyzed all\n PCI<\/jats:styled-content>\n and isolated\n CABG<\/jats:styled-content>\n between 2005 and 2017 in nonfederal hospitals in Washington State. Descriptive analysis was performed to evaluate temporal changes in risk profile and, risk\u2010adjusted in\u2010hospital mortality. Over the study period, 178\u00a0474\n PCI<\/jats:styled-content>\n and 36\u00a0592\n CABG<\/jats:styled-content>\n procedures were performed.\n PCI<\/jats:styled-content>\n and\n CABG<\/jats:styled-content>\n volume decreased by 2.9% and 22.6%, respectively. Compared with 2005\u20132009, patients receiving either form of revascularization between 2014 and 2017 had a higher prevalence of comorbidities including diabetes mellitus and hypertension and dialysis. Presentation with ST\u2010segment\u2013elevation myocardial infarction (17% versus 20%) and cardiogenic shock (2.4% versus 3.4%) increased for patients with\n PCI<\/jats:styled-content>\n compared with CABG. Conversely, clinical acuity decreased for patients receiving\n CABG<\/jats:styled-content>\n over the study period. From 2005 to 2017, mean National Cardiovascular Data Registry Cath\n PCI<\/jats:styled-content>\n mortality score increased for patients treated with\n PCI<\/jats:styled-content>\n (20.1 versus 22.4,\n P<\/jats:italic>\n <0.0001) and decreased for patients treated with\n CABG<\/jats:styled-content>\n (18.8 versus 17.8,\n P<\/jats:italic>\n <0.0001). Adjusted observed\/expected in\u2010hospital mortality ratio increased for\n PCI<\/jats:styled-content>\n (0.98 versus 1.19,\n P<\/jats:italic>\n <0.0001) but decreased for\n CABG<\/jats:styled-content>\n (1.21 versus 0.74,\n P<\/jats:italic>\n <0.0001) over the study period.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Clinical acuity increased for patients treated with\n PCI<\/jats:styled-content>\n rather than\n CABG<\/jats:styled-content>\n . This resulted in an increase in adjusted observed\/expected mortality ratio for patients undergoing\n PCI<\/jats:styled-content>\n and a decrease for\n CABG<\/jats:styled-content>\n . These shifts may reflect an increased use of\n PCI<\/jats:styled-content>\n instead of\n CABG<\/jats:styled-content>\n for patients considered to be at high surgical risk.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.015317","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T05:01:09Z","timestamp":1590555669000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":60,"title":["Temporal Trends in Percutaneous Coronary\u00a0Intervention and Coronary Artery Bypass Grafting: Insights From the Washington Cardiac Care Outcomes Assessment Program"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2977-032X","authenticated-orcid":false,"given":"Akash","family":"Kataruka","sequence":"first","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles C.","family":"Maynard","sequence":"additional","affiliation":[{"name":"Department of Health Services University of Washington Seattle WA"},{"name":"Cardiac Care Outcomes Assessment Program Foundation for Health Care Quality Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen E.","family":"Kearney","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob A.","family":"Doll","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"},{"name":"VA Puget South Health Care System Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"McCabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chistopher","family":"Bryson","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitinder S.","family":"Gurm","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Michigan Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Jneid","sequence":"additional","affiliation":[{"name":"Division of Cardiology Michael E. 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