Abstract 14197: Population Trends in Percutaneous Coronary Intervention: 20 Year Results from the Swedish Coronary Angiography and Angioplasty Registry
Introduction Over the last 20 years, the treatment of patients with percutaneous coronary intervention (PCI) has evolved dramatically but the changing patient characteristics have not been well described. The aim of this study was to describe the characteristics of all consecutive patients treated with PCI in an unselected nation-wide cohort over the last 2 decades.
Methods We evaluated the PCI patients in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). We included all patients undergoing a PCI procedure for the first time between January 1990 and December 2010. Patients were divided in 8 year cohorts based on the year of the first PCI procedure.
Results A total of 144,039 patients were included. The number of treated patients increased from 51 in 1990 to 12,633 in 2010. The mean age increased from 60.1 (±9.9) in the cohort 1989-1995 to 67.1 (±11.3) in the cohort 2009-2010 (data shown in table). The proportion of patients undergoing a PCI procedure for stable coronary artery disease decreased (from 66.4% to 16.9%), and the proportion undergoing a PCI for unstable coronary artery disease or ST-elevation myocardial infarction increased over the year cohorts (from 27.4% to 47.7% and 6.2% to 32.5% respectively). In the later year cohorts PCI patients had more often diabetes and multivessel disease. Stent use and the number of stents increased over time. The 1 year mortality increased over the year cohorts, but after adjustment for age and indication a significant but slight decrease was shown despite a continuous increase in risk.
Conclusions In this nation-wide all comers study characteristics of PCI patients have changed substantially over time reflecting the establishment of new evidence. The understanding of changing patient characteristics and baseline risk is important for the translation of evidence to real world clinical practice. The increasing age and proportion of patients undergoing PCI for acute coronary syndromes greatly influences outcome.
- © 2012 by American Heart Association, Inc.