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The Impact of Percutaneous Coronary Interventions on Outcomes for Acute Myocardial Infarction in Pennsylvania

Departments of Surgery and Health Evaluation Sciences, Pennsylvania State College of Medicine, Hershey, Pennsylvania, chollenbeak{at}psu.ed

John P. Fitzgibbons, MD

Department of Medicine, Lehigh Valley Hospital, Allentown, Pennsylvania

Michael Rossi, MD

Division of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania

D. Lynn Morris, MD

Division of Cardiovascular Disease, Albert Einstein Medical Center, Philadelphia, Pennsylvania

Paula Stillman, MD, MBA

Christiana Health Care Services, Newark, Delaware

This research estimates the benefits associated with percutaneous coronary interventions (PCIs) for patients with acute myocardial infarction (AMI) treated at hospitals in Pennsylvania. We studied 31 351 patients with AMI in Pennsylvania during the year 2000, including 10 170 who received PCI. Univariate comparisons between groups were made using ² tests for categorical outcomes and Student's t tests for continuous outcomes. A logit model for proportions was used to model the relationship between mortality and the proportion of AMI patients who received PCI. The mortality rate for patients undergoing PCI was significantly lower than for those being treated medically (1.4% vs 15.8%, P < .0001). Furthermore, significant survival benefits associated with PCI persisted when patients were stratified by age, sex, type of infarction, and severity at admission. At the hospital level, higher rates of PCI were associated with a significantly lower overall mortality rate among patients with AMI (P < .0001). (Am J Med Qual 2007;22:85-94)

Key Words: percutaneous coronary interventions • acute myocardial infarction • outcomes research

American Journal of Medical Quality, Vol. 22, No. 2, 85-94 (2007)
DOI: 10.1177/1062860606297998


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