Abstract 3234: Twenty-Five Year Trends in In-Hospital and Long-Term Outcome Following Percutaneous Coronary Interventions: A Single Institution Experience
Background. We report temporal trends over 25 years in outcome following percutaneous coronary interventions (PCI)
Methods and Results. We analyzed the in-hospital and long-term outcome in 24,410 patients who underwent PCI at Mayo Clinic. Four groups were studied: Group 1, n=3708 who had PCI from 1979 – 89 (balloon angioplasty only era); Group 2, n=7020 from 1990–96 (new device and early stent era); Group 3, n=10952 from 1996–2003 (stent era), and Group 4, March 2003 to September 2004 (drug eluting stent era). Despite the fact that the patients in the recent subgroups were significantly older, sicker, with higher prevalence of comorbid conditions, heart failure, and prior revascularization as compared with groups 1 and 2, the procedural success improved significantly (94%) as compared with group 2 (89%) and group 1 (78%) (p<0.001). Significant reduction in the in-hospital mortality (1.7%, 1.8%, 2.6%, 3.0%, p<.001), MI (4%, 5%, 6%, 5%, p<.001) and need for emergency bypass surgery (0.4%, 0.5%, 1.6%, 5%, p<.001) was noted in groups 3 and 4 as compared with the earlier groups. Better adherence to evidence-based medications for secondary prevention was seen in the recent time periods. Following adjustment for significant risk factors, significant reduction in follow-up mortality (HR 0.81, 0.74 for groups 3 and 4), death/MI (HR 0.80, 0.75 for groups 3 and 4), death/MI/repeat revascularization (HR 0.72, 0.47 for groups 3 and 4) was noted in the recent eras.
Conclusions. Although higher-risk patients underwent PCI in the recent time periods, we report improved procedural success and significant improvement in the in-hospital and long-term outcomes.