Chart of the day: What happened to CABG and angioplasty?

One of these things is not like the others:

That’s a figure from Amitabh Chandra, Jonathan Holmes, and Jonathan Skinner (PDF). The authors explain:

In the case of cardiac stenting and bypass surgery, there was a dramatic run-up in their use during the 1990s for heart attacks and other heart disease, and with a particularly rapid rise in the use of stents (wire cylindrical devices used to maintain blood flow in the heart’s arteries). During the mid-2000s, however, several randomized trials suggested very modest benefits arising from the use of stents for the most common types of heart disease, leading to a downturn in the use of these procedures.

According to this story, it’s all an angioplasty effect. Hold the CABG. However, no doubt the rise of statins also played a large role, probably affecting both CABG and angioplasty.

UPDATE: NodakEM on Twitter points out that smoking cessation also likely played a role in reducing incidence of heart disease.

UPDATE 2: By email, Amitabh Chandra points to this paper.


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