National Audit of Angioplasty Procedures - HQIP

ForewordThe United Kingdom is unique in having such a comprehensiveaudit of percutaneous coronary intervention procedures.We have seen a number of important changes over the years. The number of PCIs permillion population continues to rise and the rate of increase was the highest last year forfour years, although there are still marked geographical variations which may need to beaddressed.There has been continued rollout of primary angioplasty for acute ST elevation myocardialinfarction with a year on year reduction in call to balloon and door to balloon times, suchthat we now compare very favourably with our international colleagues. Radial access nowaccounts for half of all PCI procedures and the use of drug eluting stents has risen further.Although overall death rate following PCI has risen; this is almost certainly a reflection ofincreasing case complexity and case mix, with a higher proportion of urgent/emergencycases. Overall risk-adjusted outcome shows that all units are performing as predicted.The issue of variation in outcome according to unit volume is not directly addressed in thisreport and is subject to ongoing analysis.The number of centres sending data for analysis to the Central Cardiac Audit Databaseand the quality of the data submitted continues to improve, and this is down to the effortsof individual operators, numerous audit leads of individual centres, the staff at CCAD andNICOR and of course the enormous efforts of Peter Ludman for collation and analysis ofthese data.Simon RedwoodPresident, British Cardiovascular Intervention Society3