Trends in two year risk of repeat revascularisation or death from cardiovascular disease after coronary artery bypass grafting or percutaneous coronary intervention in Western Australlia, 1980-2001

Aims: To investigate whether, over the 21 year period 1980-2001, there had been a reduction in the risk of repeat revascularisation or death from cardiovascular disease in the cohort of all patients who were treated by coronary revascularisation in Western Australia.Setting: State of Western Australia.Patients: All patients treated by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) between 1980 and 2001.Design: Cohort study.Main outcome measures: Risk of repeat coronary artery revascularisation procedures (CARP) and risk of death from cardiovascular disease after first CARP.Results: After a CABG procedure, the two year risk of repeat revascularisation remained low (less than 2%) across the period 1980-2001. For PCI, however, this risk declined significantly from 33.6% in 1985-9 to 12.4% in 2000-1. The risk of death from cardiovascular disease after a CARP declined by about 50% between 1985 and 2001.Conclusions: Outcomes such as the risk of repeat revascularisation and the risk of death from cardiovascular disease have improved significantly for patients who underwent CARPs across the period 1980-2001. This has occurred despite an increasing trend in first CARP rates among older people and those with a recent history of myocardial infarction.