Factors associated with the likelihood of revascularization instead of medical therapy among patients with stable ischemic heart disease
| Factor | OR (95% CI) |
|---|---|
| Patient | |
| Age (per additional 10 yr) | 0.89 (0.87–0.91) |
| Male (v. female) | 1.05 (0.99–1.10) |
| Rural residence (v. urban) | 0.96 (0.90–1.03) |
| Income quintile | |
| 1 (lowest) | 0.88 (0.82–0.95) |
| 2 | 0.96 (0.90–1.04) |
| 3 | 0.96 (0.89–1.03) |
| 4 | 0.99 (0.92–1.06) |
| 5 (highest) | 1.00 (ref) |
| Medical comorbidities | |
| Peripheral vascular disease (v. no disease) | 0.85 (0.79–0.92) |
| Prior MI (v. no prior MI) | 0.79 (0.74–0.83) |
| COPD (v. no COPD) | 0.84 (0.76–0.91) |
| Charlson comorbidity score (per additional point) | 0.92 (0.91–0.94) |
| Cardiac risk factors | |
| Diabetes (v. no diabetes) | 0.94 (0.89–0.99) |
| Hypertension (v. no hypertension) | 0.89 (0.83–0.96) |
| Hyperlipidemia (v. no hyperlipidemia) | 0.94 (0.89–1.00) |
| History of smoking (v. never smoked) | 1.07 (1.01–1.12) |
| Cardiac status/testing | |
| Native stenosis* (v. nonsignificant stenosis) | |
| Left main coronary artery | 1.51 (1.37–1.67) |
| Proxmal left anterior descending coronary artery | 1.69 (1.59–1.79) |
| Mid or distal left anterior descending coronary artery | 1.18 (1.11–1.25) |
| Circumflex artery | 1.03 (0.96–1.10) |
| Right coronary artery | 1.09 (1.02–1.17) |
| Prior CABG (v. no prior CABG) | 0.19 (0.18–0.20) |
| Coronary anatomy | |
| 1 vessel | 1.00 (ref) |
| 2 vessels | 1.45 (1.34–1.57) |
| 3 vessels | 1.66 (1.47–1.88) |
| Left ventricular function | |
| ≤ 34% | 0.50 (0.45–0.55) |
| 35%–49% | 0.83 (0.77–0.89) |
| ≥ 50% | 1.00 (ref) |
| Not done | 1.08 (1.01–1.14) |
| Exercise ECG risk | |
| Low risk | 1.00 (ref) |
| High risk | 1.27 (1.18–1.36) |
| Uninterpretable | 1.09 (0.97–1.22) |
| Not done | 0.94 (0.88–1.00) |
| Functional imaging risk | |
| Low risk | 1.00 (ref) |
| High risk | 1.07 (1.00–1.14) |
| Not done | 1.12 (1.05–1.20) |
| CCS class | |
| 0 | 1.00 (ref) |
| 1 | 1.36 (1.25–1.47) |
| 2 | 1.81 (1.69–1.93) |
| 3 | 2.31 (2.14–2.48) |
| 4 | 2.38 (2.04–2.78) |
| Physician† | |
| Age, yr (per additional yr) | 0.97 (0.94–0.99) |
| Male (v. female) | 1.29 (0.98–1.70) |
| Years since graduation (per additional yr) | 1.02 (1.00–1.05) |
| Total consultations billed per year (per additional consultation) | 1.00 (1.00–1.00) |
| Total visits billed per yr (per additional visit) | 1.00 (1.00–1.00) |
| Hospital | |
| Annual catheterization volume (per additional 1000) | 1.00 (0.98–1.02) |
| Hospital type | |
| CABG, PCI and catheterization | 1.00 (ref) |
| Catheterization only | 1.05 (0.81–1.36) |
| PCI and catheterization only | 0.86 (0.62–1.20) |
Note: CABG = coronary artery bypass grafting, CCS = Canadian Cardiovascular Society, CI = confidence interval, COPD = chronic obstructive pulmonary disease, ECG = electrocardiogram, MI = myocardial infarction, OR = odds ratio, PCI = percutaneous coronary intervention, ref = reference group.
↵* Significant stenosis ≥ 70% (≥ 50% in left main coronary artery).
↵† Procedural physician.