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The article analyzes studies comparing rates of in-hospital mortality and emergency percutaneous coronary artery bypass grafting (CABG) surgery at centers with and without on-site surgery. Analysis revealed a 4.6 percent average mortality rate in patients undergoing primary percutaneous coronary intervention (PCI) across studies for sites with on-site surgery and 5.1 percent for sites with on-site surgery. The average mortality rate in patients undergoing non-primary PCI for sites without on-site surgery was 0.9 percent and 0.8 percent for sites with on-site surgery. Evaluation showed low incidence of emergency CABG for both primary and non-primary PCI at centers without on-site surgery.

The article discusses the relevance of percutaneous coronary intervention (PCI), which is performed in about 600,000 cases in the U.S. per year and costs a total of 12 billion U.S. dollars. In a study conducted by the authors to understand the need for the procedure, they use data from the National Cardiovascular Data Registry between July 1, 2009 and September 30, 2010 with an aim of finding the proportion of appropriate, uncertain or inappropriate PCI. They conclude that most PCIs done in the U.S. were appropriate with only 12% being tagged as inappropriate.