Page last updated: 24-NOV-2009

Coronary Heart Disease

Operations

The main interventions used in hospital to diagnose and treat coronary heart disease include angiography, percutaneous coronary interventions (angioplasties) and coronary artery bypass graft. Angiography and angioplasty are less invasive procedures than coronary artery bypass graft.

Angiography is the x-ray study of the blood vessels of the heart. It is used to diagnose coronary heart disease by allowing doctors to view blood flow through the arteries to confirm whether the arteries are blocked or diseased.

Angioplasty involves the widening of a blocked artery by using a small balloon, which is gently inflated to squash the fatty deposits that affect the flow of blood. A stent (tube) may also be positioned in the narrowed area and remains in place to improve the flow of blood through the artery. Some stents are coated with a drug (drug-eluting) with the aim of reducing the risk of the artery becoming narrow again.

Coronary artery bypass graft involves grafting a blood vessel from elsewhere in the body, often the mammary artery, to allow the circulation of blood to the heart to bypass the blocked artery.

Further information on these procedures may be obtained from the British Heart Foundation's  web pages (they offer patient information booklets via their "Publications " link) or BBC's "Lifestyle"  web pages.


Key points:

  • The number of Coronary Artery Bypass Graft (CABG) operations decreased from 2,446 in 2007/08 to 2,026 in 2008/09. This follows a slight increase between the years 2006/07 and 2007/08. There's a general downward trend in the numbers of CABG operations reflecting the increased use of percutaneous coronary interventions (angioplasties) in the treatment of coronary artery disease (see Table OC1 ).
  • The number of coronary angioplasties cases has increased from 5,974  in 2007/08 to 6,320 in 2008/09, resuming the upward trend seen in recent years which had seen a minor decrease from 2005/06 to 2006/07 (see Table OC1 ).
  • The number of revascularisation procedures (Coronary Artery Bypass Grafts and Coronary Angioplasties) performed by NHSScotland decreased fractionally between 2007/08 and 2008/09 but has remained stable over the last 3 to 4 years. Reductions in coronary artery bypass operations are offset by increases in the number of coronary angioplasties being performed (see Table OC1 ).
  • Based on provisional 2008/09 data, the number of Coronary Angiography investigations was 16,847 in 2008/09, compared to 17,540 in 2007/08, a decrease of around 4%. Comparison with the Scottish Coronary Revascularisation Register (SCRR) suggested under-recording of angiographies on the SMR01 database in the past. Although the figures for 2007/08 were comparable between SCRR and SMR01 the decline may be due to late return of SMR01 data on angiography (see Table OC1 ).
  • The number of discharges involving a valve operation increased by almost 31% between 2007/08 and 2008/09, from 852 to 1,115 (see Table OC1 ). This may reflect better data capture on the SMR01 database following the establishment of the West of Scotland Heart and Lung Centre at the Golden Jubilee National Hospital. Comparison of SMR01 with the Scottish Coronary Revascularisation Register suggests this could be the case.
  • The mainland NHS Boards with the highest mortality adjusted operation ratios (a measure of relative level of provision) for coronary revascularisation were Borders and Grampian for men and women respectively (see Table OC2 ).

Use the list of tables below to choose the analysis of interest. Some are offered as both Excel and comma delimited values (CSV) files for downloading and importing to other software packages.

Analysis
(click on Table name below for Excel or in CSV column for CSV file)		 New/Updated Excel available

CSV
available

 Size (Excel/
CSV)		 National Statistics
Table OC1
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, health board, age group and sex 1999/00-2008/09, numbers, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 4,217 KB/
6,306 KB		 √
Table OC2
Mortality Adjusted Operation Ratios for CABG, Angioplasties and CABG & Angioplasties by health board, age group and sex 2008/09.		 24 November 2009 link to a microsoft excel file x 243 KB √
Table OC3
Number of CABGs, Angioplasties,Angiographies and Valves by hospital and quarter Jan 2008 - March 2009.		 24 November 2009 link to a microsoft excel file x 100 KB √
Table OC4
Ratio of CABGs to Angioplasties by Health Board of Residence and Treatment for year ending 31 March 2009.		 24 November 2009 link to a microsoft excel file x 31 KB √
Table OC5 (All Admissions)
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, council area, age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 2,609 KB/
3,704 KB		 √
Table OC5 (Elective Admissions) Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, council area, age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates. 24 November 2009 link to a microsoft excel file CSV 3,574KB/
2,535 KB		 √
Table OC5 (Transfer Admissions)
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, council area, age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 2,270 KB/
3,187 KB		 √
Table OC5 (Emergency Admissions)
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, council area, age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 1,741 KB/
2,420 KB		 √
Table OC6 (All Admissions)
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, community health partnership (CHP), age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 3,200 KB/
5,777 KB		 √
Table OC6 (Elective Admissions)
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, community health partnership (CHP), age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 3,082 KB/
5,558 KB		 √
Table OC6 (Transfer Admissions)
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, community health partnership (CHP), age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 2,737 KB/
4,916 KB		 √
Table OC6 (Emergency Admissions)
Operations by type (CABG, Angioplasty, Angiography, Revascularisation, Valves) by year, community health partnership (CHP), age group and sex 1999/00-2008/09, crude rates and age-sex standardised rates.		 24 November 2009 link to a microsoft excel file CSV 2,037 KB/
3,646 KB		 √

 

 


Main contact: Email Adam Redpath