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Purpose: Evidence suggests that technological innovations and reimbursement schemes of the National Health Insurance Service may have impacted the managementof coronary artery disease. Thus, we investigated changes in the practice patternsof coronary revascularization. Materials and Methods: Revascularization and in-hospital mortality among Koreans ≥20 years old were identified from medical claims filed between 2006 and 2010. The age- and sex-standardized procedure rate per 100000 person-years was calculated directly from the distribution of the 2008 Koreanpopulation. Results: The coronary revascularization rate increased from 116.1 (95% confidence interval, 114.9‒117.2) in 2006 to 131.0 (129.9‒132.1) in 2010. Comparedto the rate ratios in 2006, the rate ratios for percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in 2010 were 1.16 (1.15‒1.17) and 0.80 (0.76‒0.84), respectively. Among patients who received PCI, the percentagewith drug-eluting stents increased from 89.1% in 2006 to 93.0% in 2010. In-hospitalmortality rates from PCI significantly increased during the study period (p=0.03), whereas those from CABG significantly decreased (p=0.01). The in-hospital mortalityrates for PCI and CABG were higher in elderly and female patients and at the lowest-volume hospitals. Conclusion: The annual volume of coronary revascularizationcontinuously increased between 2006 and 2010 in Korea, although this trend differed according to procedure type. A high percentage of drug-eluting stent proceduresand a high rate of in-hospital mortality at low-volume hospitals were noted.
