A retrospective single center registry and long term follow-up of patients undergoing elective percutaneous coronary intervention. Egyptian Critical Care Department Angioplasty Registry (ECDAR)

Abstract

Background: The field of interventional cardiology continues to rapidly evolve as a result of many advances in devices as well as adjunctive medications which have been paralleled by a concomitant improvement in the safety and efficacy of PCI. Objectives: We aimed at registering our elective PCI procedures with respect to their procedure details, outcome, in hospital complications and long term follow up. We tried to determine our performance in comparison to other registries and to find out risk factors associated with poor outcome. Patient and methods: The material of this study included 1897 patients (1564 males and 333 females) who underwent PCI at the Critical Care Department, Cairo University between January 2003 to December 2007 with a follow up of 1–5 years. Retrospective analysis of those data had been done including clinical events such as death, MI, target vessel revascularization (TVR) and major adverse cardiac events (MACE). Results: The cohort was predominantly male (82.2%) with a mean age of 55 ± 9 years. We had wide variety of PCI procedures, BMS stenting shared up 75.1% of our patients, DES 9.8%, PTCA 4.1%, failed PCI 4.4%, combined stents 1.2% and stenting with PTCA contributed 5.4% of the total patients. During hospital study clinical success was achieved in 92.8% of cases with low rate of clinical events; mortality (0.3%), MI (0.5%) with no reported cases of TVR. Angiographic success was achieved in 95.5% of treated segments with 6.7% angiographic complications. During follow up, death, MI, TVR and MACE rates increased from (3.2%, 2.1%, 8.5% and 10.2%) at first year to (24.2%, 17.2%, 35.9% and 57.2%), respectively, after 5 years follow up duration. There was a significant relationship between renal impairment, chronic total occlusion (CTO), bifurcation lesion, long lesion (>20 mm), number of stents implanted and occurence of PCI complications. Conclusion: Our experience is comparable to other registries. We differed in our demographic features which affected our patient’s characteristics. However, we need to establish our own registries based on our real life scenarios in the developing countries.

Keywords

• PCI
• Coronary angiography
• Registry