Coronary Revascularization Methods and Timing of Treatment: Comparative Effectiveness of PCI and CABG in British Columbia

Project number: 
17-089
Approval date: 
Thursday, February 1, 2018
Principal Investigator: 
Hardiman,Sean
Institution: 
UBC School of Population & Public Health
Funding Agency: 
Not Available
Datasets requested: 
Deaths (BC Vital Statistics Agency)
Consolidation - demographic (Ministry of Health)
Cardiac Services BC
consolidation - census geocodes
Hospital Separations (BC Ministry of Health)
Consolidation file (BC Ministry of Health)
Research objective: 

In the analysis of major adverse cardiac and cerebrovascular events, I will assess the risks of repeat revascularization, myocardial infarction, stroke, and death from any cause in the study groups to answer the following question:

(1) Was there a difference in MACCE between CABG and PCI when CABG is provided after the recommended time and PCI within the recommended time?

I hypothesize that patients that have CABG beyond recommended wait times will have poorer outcomes than patients who have PCI within recommended wait times.

In the analysis of hospital readmissions, I will assess the risk of hospital readmission in the study groups to answer the following questions:

(2) Was there a difference in the proportions and duration of hospital readmissions for any cause, cardiac causes, and heart failure, at one year, three years, and five years between CABG and PCI when CABG is provided after the recommended time and PCI provided within the recommended time?

I hypothesize that patients who have CABG beyond recommended waiting times will have a higher proportion of readmissions, longer readmissions and more frequent readmissions than patients at 30 days, 1 year, and 5 years, who have PCI, and that long waiters for CABG will have more readmissions for any cause, for cardiac causes, and for heart failure than those who have PCI with the recommended time..

In the subgroup analysis, I will assess the risks of repeat revascularization, myocardial infarction, stroke, and death from any cause in patients with diabetes to answer the following questions:

(3) Conditional on the patient having diabetes, was there a difference in MACCE between CABG and PCI when CABG is provided after the recommended wait time, and PCI within the recommended wait time?

I hypothesize that patients with diabetes who undergo CABG beyond recommended wait times will have a lower proportion of MACCE than those who have PCI within recommended wait times.

In a further subgroup analysis, I will also assess the risk of repeat revascularization, myocardial infarction, stroke, and death from any cause, stratifying by stent generation to answer the following questions:

(4) Conditional on stent generation (BMS, DES-1G, DES-2G), was there a difference in MACCE between CABG and PCI when CABG is provided after the recommended wait time, and PCI within the recommended wait time?

I hypothesize that patients who undergo CABG beyond recommended wait times will have the same or higher proportion of MACCE as those who have PCI with BMS within recommended wait times, and a higher proportion of MACCE than those who have PCI within recommended wait times with DES-1G or DES-2G.


Page last revised: June 5, 2018