National Audit of Angioplasty Procedures - HQIP

8OutcomeThe complications from PCI haveprogressively fallen as techniques haveevolved. Nevertheless, this has alsomeant the procedure can be offered topatients who are considerably sicker, andin whom a higher risk of complicationsis expected. The rate of requirement foremergency coronary artery bypass graft(CABG) remains very low at less than 1%.The overall rate of death before dischargefrom hospital following PCI has, however,gradually increased over the past few years.Patients are treated by PCI for a number ofreasons. The mortality risk for each of themajor reasons for PCI treatment shows thatthe outcome for each of these remainedstable (figure 12).The increase in overall mortality is due toan increasing proportion of sicker patientsbeing treated by PCI. This change in casemix is driven by the increasing use ofemergency PCI to treat STEMI, (known asprimary PCI) (figure 13).654.44.9Mortality (%)4321.610200320042005200620072008200920102003200420052006200720082009All Elective Unstable angina/NSTEMI Primary PCI RescueFigure 12Mortality following PCI according to presenting clinical syndrome0.14201020032004200520062007200820090.61201020032004200520062007200820092010200320042005200620072008200920102000019469178671500016Number of PCIs10000500002001200220032004Figure 13Increase in primary PCI2005200620072008200920102001200220032004200520062007200820092010All STEMI Primary PCI Rescue20012002200320042005200620072008200916022010