Population Trends in Percutaneous Coronary Intervention 20-Year Results From the SCAAR (Swedish Coronary Angiography and Angioplasty Registry)

Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. Electronic address: .
Journal of the American College of Cardiology (Impact Factor: 15.34). 03/2013; 61(12):1222-1230. DOI: 10.1016/j.jacc.2013.01.007
Source: PubMed

ABSTRACT OBJECTIVES: The aim of this study was to describe the characteristics and outcome of all consecutive patients treated with PCI in an unselected nation-wide cohort over the last 2 decades. BACKGROUND: Over the last 20 years, treatment with percutaneous coronary intervention (PCI) has evolved dramatically but the change in patient characteristics has not been well described. METHODS: We included all patients undergoing a PCI procedure for the first time between January 1990 and December 2010 from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Patients were divided in different cohorts based on the year of the first PCI procedure. RESULTS: A total of 144,039 patients were included. The mean age increased from 60.1 (SD±9.9) years in 1990-1995 to 67.1 (±11.2) years in 2009-2010. The proportion of patients presenting with unstable coronary artery disease and STEMI increased from 27.4% and 6.2% to 47.7% and 32.5% respectively. Diabetes and multivessel disease were more often present in the later year cohorts. The 1-year mortality increased from 2.2% in 1990-1995 to 5.9% in 2009-2010, but after adjustment for age and indication a modest decrease was shown, mainly in STEMI patients. CONCLUSIONS: Characteristics of PCI patients have changed substantially over time reflecting the establishment of new evidence. The increasing age and proportion of patients undergoing PCI for acute coronary syndromes greatly influence outcome. The understanding of the changing patient characteristics is important for the translation of evidence to real-world clinical practice.

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