Trends in percutaneous coronary intervention and angiography in Ireland, 2004-2011: Implications for Ireland and Europe

Abstract

Background/objectives: To study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004-2011.

Methods: Two data sources were used: a) a survey of publicly and privately funded hospitals with cardiac catheter laboratories to obtain the annual number of procedures performed and b) anonymised data from the Hospital In-Patient Enquiry (HIPE) for angiography and PCI in acute publicly funded hospitals; age standardised rates were calculated to study trends over time.

Results: From 2004 to 2011 the crude rate of angiography and PCI increased by 47.8% and 35.9% respectively, with rates of 6689 and 1825 per million population in 2011. Following age standardisation, however, PCI activity showed a non-significant decrease over time. The PCI to angiography ratio decreased from 30% to 27% and PCI was performed predominantly for stable coronary heart disease (54%) in 2011.

Conclusion: Angiography and PCI rates have increased in Ireland but PCI crude and age adjusted rates show divergent trends. While Ireland differs from USA and UK, with a higher proportion of PCI being performed for stable CHD in recent years, little systematic surveillance of cardiological interventions within Europe is available to benchmark improvements in Ireland.

Keywords: Angiography; Europe; Ireland; Percutaneous coronary intervention; Population; Temporal trend.

Fig. 1

Trend in age standardised rate (ASR) per million (95% CI) on HIPE and crude rate per million on survey, 2004–2011.

Fig. 2

Trend in percentage (95% CI) clinical indication (acute or non-acute disease) for PCI in patients admitted with CHD, 2005–2011 in Ireland.