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 objectives: Although 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.

Results: A 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.

Conclusion: These 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.

Keywords: Percutaneous coronary intervention; Registry.

Fig. 1. Geographic distribution of PCI facilities participating in the K-PCI registry. Ninety-two hospitals submitted data for 44967 PCI cases. High-volume facilities were concentrated in Seoul and metropolitan areas. PCI: percutaneous coronary intervention, K-PCI: Korean percutaneous coronary intervention.

Fig. 2. Distribution of facilities with different PCI volume. Sixty-two percent of the included hospitals performed 500 or fewer PCI procedures and 11% performed more than 1000 PCIs during the collection period. PCI: percutaneous coronary intervention.

Fig. 3. Age and gender distribution. Median age was 66 years and the proportion of male patients was 70.3%.

Fig. 4. Gender-specific clinical indications for PCI. The width of the bars in the histogram indicates the number of patients. NSTEMI: non-ST-elevation myocardial infarction, STEMI: ST-elevation myocardial infarction, PCI: percutaneous coronary intervention.

Fig. 5. Age-specific clinical indications for PCI. The width of the bars in the histogram indicates the number of patients. NSTEMI: non-ST-elevation myocardial infarction, STEMI: ST-elevation myocardial infarction, PCI: percutaneous coronary intervention.

Fig. 6. Temporal distribution of PCI procedures and in-hospital events. (A) Monthly distribution of PCI procedures and in-hospital cardiac events. (B) Weekly distribution of PCI procedures and in-hospital cardiac events. STEMI: ST-elevation myocardial infarction, NSTEMI: non-ST-elevation myocardial infarction, PCI: percutaneous coronary intervention, MACE: major adverse cardiac events.