|Mühlberger V et al.|
Herzkathetereingriffe in Österreich im Jahr 2014 (mit Audit bis 2015) // Austrian National CathLab Registry (ANCALAR): Cardiac Catheterization, Coronary Angiography (CA) and PCI in Austria during the Year 2014 (Registry Data with Audit including 2015)
Journal für Kardiologie - Austrian Journal of Cardiology 2016; 23 (1-2): 7-12
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Keywords: CA, Kardiologie, Koronarangiographie, PCI, Statistik, Österreich, ANCALAR, Austria, Austrian National CathLabRegistry, cardiology, Statistics, ultrasound
Our independent, purely academic activity is located in the area of health services research, and has also the option to generate benchmarks for individual centres. Participation in our surveys is voluntary. Since 1992, every year, without interruption 90–100 parameters are applicable. The questionnaire will be optimized and adapted to current conditions. This is done in cooperation with the participating centres. To provide comparability we make only minimal and absolutely most necessary modifications. The data are collected and summarized at the end of the year by each centre itself. During the year the centres are visited to perform audits and to keep personal contact to them.
Here are the results:
Concerning international comparison for the year 2014, Austria (A/AUT) is situated under the top nations in Europe with 6.534 Diagnostic Coronary Angiographies (CA), 2.686 Percutaneous Coronary Interventions (PCI), 379 Electrophysiologic Ablations, 70 Transarterial Aortic Valve Implantations (TAVI) per one million inhabitants. All numbers increased compared to 2013.
A higher mortality of 31.2% in PCI-patients due to pre-existing shock in ST-Segment-elevation-myocardial infarction (STEMI) is the main contributor to the constant all over mortality of PCI of 1.05% during 2014, left main dissections and emergency surgery being reported more frequently in 2014 than in 2013.
Innovations within the CathLab increased again in 2014, e.g. the leadless pacemaker, “new devices” of the foregoing years staying successful as well. Biodegradable stents were implanted in 7.3% of stent-cases during 2014 compared to 4.7% in 2013.
The continuous increase in PCI-Cases using non-femoral (mostly radial) puncture techniques of the years before showed 31% in 2013 vs 40% during the year 2014 and for the first time in 8.8% a necessary switch to femoral techniques was documented. At the same time a reduction in severe bleeding complications from (relative) 34% to 17.5% occurred during 2010 to 2014, a possible benefit of the radial approach.
Multi-vessel PCI during the same session (n = 3.094 cases in 2013) increased to n = 4.309 cases in 2014, implantation of multiple stents from 5.668 to 8.021 cases as well. Reintervention (REDO) – due to restenosis – reporting centres observed a reduction during 2003–2014 from 6.6% to 4.2% in such cases. From 2010 (15.2%) to 2014 (16.6%) the relative percentage of stent thromboses stayed constant (could not be improved) in those REDO cases.
Left ventricular angiography during diagnostic catheterization decreased rapidly and for the first time from 2013 to 2014 (from n = 18.572 to n = 11.834 cases) apparently due to multiple other possibilities of left ventricular imaging. Percutaneous Renal Denervation suffered the expected downslope in 2014.
Interestingly, not only in Austria, it is still observed that scientific knowledge, recommended as Class I Indications in the guidelines, takes several years to establish itself nationwide. This is evident 2014 again concerning intra-arterial balloon pump or antithrombotic management in the CathLab.
The data for 2014 are presented in Krems (November 27th–28th, 2015) at the autumn meeting of the working group “Interventional Cardiology of the Austrian Society of Cardiology” (ÖKG), as a basis for discussion. The presentation will also be placed under the website http://iik.i-med.ac.at.
Kurzfassung: Im internationalen Vergleich für das Jahr 2014 liegt Österreich (A/AUT) mit 6534 diagnostischen Koronarangiographien (CA), 2686 perkutanen Koronareninterventionen (PCI), 379 elektrophysiologischen Ablationen und 70 transarteriellen Aortenklappenimplantationen (TAVI) bezogen auf eine Million Einwohner im europäischen Spitzenfeld. Alle Parameter zeigten eine Zunahme gegenüber dem Vorjahr.