Regional variations in the use of diagnostic coronary angiography - A one-year population-based study of all diagnostic coronary angiographies performed in a rural and an urban Danish county

The aim of this study was to monitor coronary angiography activity and resu lts, and to evaluate indications and treatment consequences using regional hospital registers and case records in the rural county of Ringkjobing and urban county of Aarhus The study included all patients who had undergone a coronary angiography during 1996. For women, there were 606 (rural) and 129 6 (urban) coronary angiographies per one million inhabitants (p < 0.0001) a nd fur men, 1884 (rural) and 3051 (urban) coronary angiographies per one mi llion inhabitants (p < 0.0001). In both counties the age distribution of th e women examined was the same as that for the men. The angiographic rates w ere the same in the two counties for patients examined for valvular heart d isease and severe arrhythmias. For patients with ischaemic heart disease, t he angiographic rate for rural patients was two to three times lower than t hat for urban patients (p < 0.01). Revascularization procedures were perfor med in 39% (rural) and 40% (urban) of the examined women (NS) and 66% (rura l) and 59% (urban) of the examined men (p < 0.05). Despite wide regional di fferences in coronary angiography activity, angiography was deployed to the same extent for examination of patients with valvular and severe arrhythmi a heart disease. For patients examined for ischaemic heart disease, angiogr aphy activity was considerably lower in the rural area. The female patients had a higher frequency of normal coronary angiograms than the male patient s.