Differences in diagnostication, and revascularisation of ischaemic heart disease in Western Denmark

Dan Med J. 2023 Jan 17;70(2):A01220007.

Abstract

Introduction: In Denmark, the incidence of and mortality from ischaemic heart disease (IHD) has been declining. In this context, it is of interest to assess any regional differences in diagnostication and invasive treatment of IHD.

Methods: We intended to describe the diagnostication and invasive treatment of IHD in Western Denmark at the regional/municipal level using the Western Denmark Heart Registry. Coronary angiography (CAG), percutaneous coronary intervention (PCI) and coronary arterial bypass grafting were registered from 2000 through 2019; cardiac multislice computed tomography (CMCT), from 2015 through 2019.

Results: Concerning the use of revascularisation for acute coronary syndrome (ACS), we found comparable regional activity levels but significant differences between individual municipalities. Furthermore, the use of CAG for chronic coronary syndrome (CCS) was significantly higher and the use of CMCT significantly lower in the North Denmark Region than in the Central and South Denmark Regions.

Conclusion: We found differences in the rates of PCI for ACS at the municipal level but not between the Western Denmark regions. Furthermore, at the regional level, evaluation of chronic IHD differed regarding use of elective CAG and CMCT, and use of CMCT was not paralleled by a reduction in the number of CAG procedures. This may possibly prompt discussions on the strategy for invasive and non-invasive diagnosis of CCS and on targeted preventive measures.

Funding: none TRIAL REGISTRATION. not relevant.

MeSH terms

  • Acute Coronary Syndrome*
  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Artery Disease*
  • Denmark / epidemiology
  • Humans
  • Myocardial Ischemia* / diagnosis
  • Myocardial Ischemia* / surgery
  • Percutaneous Coronary Intervention*
  • Treatment Outcome