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      The Current Status of Percutaneous Coronary Intervention in Korea: Based on Year 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry

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          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.

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          Most cited references24

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          2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

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            2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions.

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              Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National Cardiovascular Data Registry.

              We sought to create contemporary models for predicting mortality risk following percutaneous coronary intervention (PCI). There is a need to identify PCI risk factors and accurately quantify procedural risks to facilitate comparative effectiveness research, provider comparisons, and informed patient decision making. Data from 181,775 procedures performed from January 2004 to March 2006 were used to develop risk models based on pre-procedural and/or angiographic factors using logistic regression. These models were independently evaluated in 2 validation cohorts: contemporary (n = 121,183, January 2004 to March 2006) and prospective (n = 285,440, March 2006 to March 2007). Overall, PCI in-hospital mortality was 1.27%, ranging from 0.65% in elective PCI to 4.81% in ST-segment elevation myocardial infarction patients. Multiple pre-procedural clinical factors were significantly associated with in-hospital mortality. Angiographic variables provided only modest incremental information to pre-procedural risk assessments. The overall National Cardiovascular Data Registry (NCDR) model, as well as a simplified NCDR risk score (based on 8 key pre-procedure factors), had excellent discrimination (c-index: 0.93 and 0.91, respectively). Discrimination and calibration of both risk tools were retained among specific patient subgroups, in the validation samples, and when used to estimate 30-day mortality rates among Medicare patients. Risks for early mortality following PCI can be accurately predicted in contemporary practice. Incorporation of such risk tools should facilitate research, clinical decisions, and policy applications. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Korean Circ J
                Korean Circ J
                KCJ
                Korean Circulation Journal
                The Korean Society of Cardiology
                1738-5520
                1738-5555
                May 2017
                25 May 2017
                : 47
                : 3
                : 328-340
                Affiliations
                [1 ]Division of Cardiology, Busan Paik Hospital, University of Inje College of Medicine, Busan, Korea.
                [2 ]Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
                [3 ]Division of Cardiology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
                [4 ]Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
                [5 ]Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
                [6 ]Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
                [7 ]Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
                [8 ]Division of Cardiology, Heart Center of Chonnam National University Hospital, Gwangju, Korea.
                [9 ]Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
                [10 ]Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
                [11 ]Division of Cardiology, Sanggye-Paik Hospital, University of Inje College of Medicine, Seoul, Korea.
                [12 ]Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
                Author notes
                Correspondence: Hyo-Soo Kim, MD, PhD, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: 82-2-2072-2226, Fax: 82-2-766-8904, hyosoo@ 123456snu.ac.kr
                Article
                10.4070/kcj.2017.0071
                5449527
                28567083
                ac6e8c14-4ae0-414e-bd54-e59c54a9a510
                Copyright © 2017 The Korean Society of Cardiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 March 2017
                : 17 April 2017
                : 18 April 2017
                Funding
                Funded by: Korean Society of Cardiology;
                Funded by: Koran Society of Interventional Cardiology;
                Categories
                Original Article

                Cardiovascular Medicine
                percutaneous coronary intervention,registry
                Cardiovascular Medicine
                percutaneous coronary intervention, registry

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