Spanish Cardiac Catheterization and Coronary Intervention Registry. 27th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology (1990-2017)

doi:10.1016/j.rec.2018.09.009

Revista Española de Cardiología (English Edition)

Volume 71, Issue 12, December 2018, Pages 1036-1046

https://doi.org/10.1016/j.rec.2018.09.009 Get rights and content

Abstract

Introduction and objectives

To present the annual report of the Working Group on Cardiac Catheterization and Interventional Cardiology on the activity data for 2017.

Methods

Data were voluntarily provided by Spanish centers with a catheterization laboratory. The information was introduced online and was analyzed by the Steering Committee of the Working Group on Cardiac Catheterization and Interventional Cardiology.

Results

In 2017, data were reported by 107 hospitals, of which 82 are public. A total of 154 218 diagnostic procedures (138 448 coronary angiograms) were performed (2.2% increase vs 2016). The use of intracoronary diagnostic techniques significantly increased, especially that of pressure wire (23.2% vs 2016, n = 7003). In 2017, the number of percutaneous coronary interventions rose to 70 928 (3.2% increase), of which 21 395 interventional procedures were performed in the acute myocardial infarction setting. A total of 105 529 stents were implanted, of which 90.3% were drug-eluting stents (6% increase). Radial access was used in 85.7% of diagnostic procedures and in 88.4% of interventional procedures. The number of transcatheter aortic valve implantations continued to increase (28.2% increase, n = 2821), as did the number of left atrial appendage closures (14.8% increase, n = 582) and percutaneous mitral valve repair procedures (14.1% increase, n = 270).

Conclusions

Diagnostic and therapeutic procedures in acute myocardial infarction increased in 2017. The use of the radial approach and drug-eluting stents also increased in therapeutic procedures. The number of structural procedures rose significantly compared with previous years.

Resumen

Introducción y objetivos

La Sección de Hemodinámica y Cardiología Intervencionista presenta su informe anual con los datos del registro de actividad de 2017.

Métodos

Los centros españoles con laboratorio de hemodinámica proporcionan sus datos voluntariamente. La información se introduce online y la analiza la Junta Directiva de la Sección de Hemodinámica y Cardiología Intervencionista.

Resultados

Han participado en el registro nacional 107 centros, 82 de ellos, públicos. Se realizaron 154.218 estudios diagnósticos, entre ellos 138.448 coronariografías, un 2,2% más que en 2016. Se registró un incremento significativo en la utilización de técnicas de diagnóstico intracoronarias, especialmente en la guía de presión (el 23,2% más que en 2016, n = 7.003). Los procedimientos intervencionistas coronarios aumentaron un 3,2%, y se registraron 70.928. De ellos, 21.395 fueron en el infarto agudo de miocardio. Se implantaron 105.529 stents (el 90,3% farmacoactivos, un 6% más que en 2016). El acceso radial alcanzó el 85,7% de los procedimientos diagnósticos y el 88,4% de los intervencionistas. En intervencionismo estructural, destaca un aumento del 28,2% (n = 2.821) en implante transcatéter de válvula aórtica, del 14,1% (n = 270) en reparación percutánea de la válvula mitral y del 14,8% (n = 582) en cierre de orejuela izquierda.

Conclusiones

En 2017 se ha registrado un incremento en los procedimientos diagnósticos y terapéuticos en intervencionismo coronario, a expensas de un aumento de intervenciones en el infarto agudo de miocardio. Destaca el alto porcentaje de abordaje radial y el mayor uso de stents farmacoactivos. El intervencionismo estructural presenta un aumento significativo con respecto a años anteriores.

Section snippets

INTRODUCTION

As is the case each year, one of the fundamental tasks of the Steering Committee of the Working Group on Cardiac Catheterization and Interventional Cardiology is the collection of activity data from Spanish catheterization laboratories to prepare the annual registry. This work, which has been carried out uninterrupted since 1990,1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26 allows an overall view of changes over time in interventional cardiology

METHODS

In the present registry, data were collected on the diagnostic and cardiac interventional activity of most Spanish hospitals in 2017. Data collection was voluntary and was not audited. Anomalous data or data that deviated from the trend observed in a hospital in recent years were referred back to the responsible researcher from the center for reassessment. Data were collected via a standard electronic questionnaire that could be accessed, completed, and consulted through the website of the

Infrastructure and Resources

A total of 107 hospitals performing interventional activity participated in this registry; most of these centers (n = 82) were public (Appendix). This number effectively reflects the activity in Spain, with most of the volume concentrated in centers with public funding. Note that the number of centers reporting their data has remained stable in recent years, allowing sufficiently reliable comparisons with data from previous years. There were 225 catheterization laboratories: 142 (63.1%) were

DISCUSSION

The activity recorded in 2017 clearly reflects the changes over time in interventional cardiology in Spain and allows us to envisage the future path for this field. PCI activity has shown slow but steady growth and a clear qualitative leap, whose strongest indicator is the increase in all intracoronary diagnostic techniques and the high percentage of radial access. In structural heart interventions, the overall number of techniques implemented in recent years has increased and the significant

CONCLUSIONS

The activity collected in 2017 shows a slow but steady increase in the number of diagnostic and therapeutic coronary procedures, as well as a significant qualitative leap in intracoronary diagnostic techniques, particularly the use of the pressure guidewire. The dominance of the radial approach and the progressive increase in primary angioplasty as a treatment for AMI are clear indicators of the quality of Spanish interventional activity. There has been a marked increase in the number of

CONFLICTS OF INTEREST

None.

ACKNOWLEDGMENTS

The Steering Committee of the Working Group on Cardiac Catheterization and Interventional Cardiology would like to thank the directors of the cardiac catheterization laboratories throughout Spain, all of those responsible for data collection, and all of our peers whose work and enthusiasm ensure fair and first-rate patient care.