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Evolution of Australian Percutaneous Coronary Intervention (from the Melbourne Interventional Group [MIG] Registry)
journal contributionposted on 2017-07-01, 00:00 authored by J Yeoh, N Andrianopoulos, B P Yan, D J Clark, S J Duffy, A Brennan, G New, M B Yudi, M Freeman, D Eccleston, M Sebastian, C M Reid, W Wilson, A E Ajani, C Reid, E Oqueli, J A Shaw, A Walton, A Dart, A Broughton, J Federman, C Keighley, C Hengel, K H Peter, D Stub, W Chan, S Nanayakkara, J O'Brien, L Selkrig, K Rankin, R Huntington, S Pally, O Farouque, M Horrigan, J Johns, L Oliver, J Brennan, R Chan, G Proimos, T Dortimer, B Chan, R Huq, D Fernando, K Charter, L Brown, A AlFiadh, J Ramchand, S Picardo, A Sharma, N Ryan, T Harrison, C Barry, L Roberts, A Teh, M Rowe, Y Cheong, C Goods, A Baradi, D Jackson, J Sajeev, T Yip, M Mok, C Jaworski, A Hutchison, M Turner, B Khialani, J Dyson, B McDonald, L Duff, V Chand, D Dinh, R Warren, J Lefkovits, R Iyer, R Gurvitch, M Brooks, S Biswas, Chin HiewChin Hiew
Percutaneous coronary intervention (PCI) continues to evolve with shifting patient demographics, treatments, and outcomes. We sought to document the specific changes observed over a 9-year period in a contemporary Australian PCI cohort. The Melbourne Interventional Group is an established multicenter PCI registry in Melbourne, Australia. Data were collected prospectively with 30-day and 12-month follow-ups. Demographic, procedural, and outcome data for all consecutive patients were analyzed with a year-to-year comparison from 2005 to 2013. National Death Index linkage was performed for long-term mortality analysis; 19,858 procedures were captured over 9 years. Patient complexity and acuity increased with a higher proportion of traditional risk factors and more elderly patients who underwent PCI. Angiographic lesion complexity increased with more multivessel coronary artery disease and more American College of Cardiology/American Heart Association type B2/C lesions proceeding to PCI. The 30-day rate of death, myocardial infarction, or target vessel revascularization has not changed nor has 12-month mortality, myocardial infarction, or major adverse cardiovascular event rates. The strongest independent predictor of long-term mortality was cardiogenic shock at presentation (hazard ratio [HR] 2.95, p <0.01). Drug-eluting stent use (HR 0.83, p <0.01) and a history of dyslipidemia (HR 0.81, p <0.01) were associated with long-term survival. In conclusion, from 2005 to 2013, we observed a cohort of higher risk clinical and angiographic characteristics, with stable long-term mortality.