The Current Status of Percutaneous Coronary Intervention in Korea: Based on Year 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry

Abstract

Background and ObjectivesAlthough several multicenter registries have evaluated percutaneous coronary intervention (PCI) procedures in Korea, those databases have been limited by non-standardized data collection and lack of uniform reporting methods. We aimed to collect and report data from a standardized database to analyze PCI procedures throughout the country.Materials and Methods Both clinical and procedural data, as well as clinical outcomes data during hospital stay, were collected based on case report forms that used a standard set of 54 data elements. This report is based on 2014 Korean PCI registry cohort data.ResultsA total of 92 hospitals offered data on 44967 PCI procedures. The median age was 66.0 interquartile range 57.0-74.0 years, and 70.3% were men. Thirty-eight percent of patients presented with acute myocardial infarction and one-third of all PCI procedures were performed in an urgent or emergency setting. Non-invasive stress tests were performed in 13.9% of cases, while coronary computed tomography angiography was used in 13.7% of cases prior to PCI. Radial artery access was used in 56.1% of all PCI procedures. Devices that used PCI included drug-eluting stent, plain old balloon angioplasty, drug-eluting balloon, and bare-metal stent (around 91%, 19%, 6%, and 1% of all procedures, respectively). The incidences of in-hospital death, non-fatal myocardial infarction, and stroke were 2.3%, 1.6%, and 0.2%, respectively.ConclusionThese data may provide an overview of the current PCI practices and in-hospital outcomes in Korea and could be used as a foundation for developing treatment guidelines and nationwide clinical research.

In‐hospital outcome differences between transradial and transfemoral coronary approaches: Data from the Korean percutaneous coronary intervention registry

“…The recent analysis from the National Cardiovascular Data Registry characterized low volume operators as follows: (1) operated in lower volume hospitals, (2) more frequently performed emergent PCI and PCI for STEMI, (3) less frequently used radial access, and 4) substantial volume of contrast dye and longest fluoroscopic times. These correspond well with our K‐PCI data that lower volume centers had higher incidences of AMI, performed emergency PCI more frequently with a less transradial approach . For these reasons, an inverse relationship exists between hospital PCI volume and in‐hospital mortality.…”

“…3,14 Demographic characteristics, clinical history, procedural information, and PCI complications that occurred before hospital discharge were collected retrospectively using case report forms comprising a standard set of 54 data elements. 3 All variables corresponded with written definitions in the case report form dictionary (K-PCI Registry 2014 CRF v1.4.) 3 and were provided using common specifications with question and answer cases for participants.…”

“…These correspond well with our K-PCI data that lower volume centers had higher incidences of AMI, performed emergency PCI more frequently with a less transradial approach. 3 For these reasons, an inverse relationship exists between hospital PCI volume and in-hospital mortality. Given that learning curve period for TRI, 8 we speculate that the benefit of TRI over TFI may be augmented for experienced TRI operators in large PCI volume hospitals.…”

“…As the first transradial percutaneous coronary intervention (PCI) procedure (TRI) was performed decades earlier, the radial artery has been increasingly used as the primary access route . Compared to the transfemoral PCI procedure (TFI), TRI offers earlier ambulation and easier hemostasis, potentially reducing bleeding, and vascular‐related complications .…”

“…As the first transradial percutaneous coronary intervention (PCI) procedure (TRI) was performed decades earlier, the radial artery has been increasingly used as the primary access route. [1][2][3] Compared to the transfemoral PCI procedure (TFI), TRI offers earlier ambulation and easier hemostasis, potentially reducing bleeding, and vascular-related complications. 4 TRI has been more widely disseminated because of its supremacy over TFI in terms of reducing all-cause mortality, bleeding, and access site complications, especially in patients with acute coronary syndromes (ACSs).…”