Coronary revascularization in France: six-year trends and outcomes in coronary artery bypass grafting and percutaneous coronary intervention.

Publication date: Jul 07, 2025

This study aimed to analyze temporal trends in coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in France from 2017 to 2022. A retrospective analysis of all isolated CABG and PCI procedures was conducted using data from the French national hospital discharge database RESULTS: During the study period, 109,792 CABG and 1,228,509 PCI procedures were performed. CABG volumes declined by 9. 7%, while PCI increased by 11. 8%, resulting in a 24. 4% rise in the PCI-to-CABG ratio (from 9. 8 to 12. 2). The sharpest inflection occurred in 2020, with a pandemic-related procedural drop of 14. 9% for CABG and 5. 3% for PCI. CABG procedures involving 3 or ≥4 distal anastomoses increased by 5. 8% and 17. 7%, respectively, while the use of multiple arterial grafts rose to 72. 2% in 2022. PCI volumes increased across all categories, particularly for multivessel interventions. In-hospital mortality for elective CABG decreased from 1. 5% to 1. 3% (-13. 3%), while PCI mortality remained stable (0. 5%). In emergency settings, mortality declined by 7. 7% for PCI (3. 1% to 2. 8%) and 35. 1% for CABG (4. 6% to 3. 0%). Between 2017 and 2022, France experienced a sustained shift toward PCI and declining CABG volumes, amplified during the COVID-19 pandemic. Despite this, CABG outcomes improved, with broader adoption of extensive revascularization strategies and arterial grafting. These findings underscore the need for ongoing surveillance of national practice patterns to ensure evidence-based coronary care.

Semantics

Original Article