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Population Trends in Percutaneous Coronary Intervention: 20-Year Results From the SCAAR (Swedish Coronary Angiography and Angioplasty Registry)
Study Questions:
How have the patients and outcomes of percutaneous coronary intervention (PCI) changed over the last 2 decades?
Methods:
The authors included all patients undergoing a PCI procedure for the first time between January 1990 and December 2010, from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Patients were divided into different cohorts on the basis of the year of the first PCI procedure.
Results:
A total of 144,039 patients underwent their first PCI in Sweden during the study period. The mean age increased from 60.1 years in 1990 to 1995, to 67.1 years in 2009 to 2010. The proportion of patients presenting with unstable coronary artery disease and ST-segment elevation myocardial infarction increased from 27.4% and 6.2% to 47.7% and 32.5%, respectively. The 1-year mortality increased from 2.2% in 1990 to 1995, to 5.9% in 2009 to 2010, but after adjustment for age and indication, better survival in later years was seen with a greater difference in the adjusted survival of ST-segment elevation myocardial infarction patients.
Conclusions:
There has been a change in the characteristic of patients undergoing PCI, with the procedure being performed in older patients and for acute coronary syndromes.
Perspective:
This study provides a nice overview of changes in patients and outcomes associated with PCI in Sweden. The procedure is increasingly being used in sicker patients, and despite this, there has been a reduction in adjusted mortality.
Keywords: Coronary Artery Disease, Myocardial Infarction, Acute Coronary Syndrome, Sweden, Coronary Angiography, Cardiology, Coronary Artery Bypass, Angioplasty, Percutaneous Coronary Intervention, Heart Septal Defects
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