Zajecar invasive cardiology department during the period of 2014 to 2024

Background. The aim of this work is to present the results of the Department of Invasive Cardiology in Zaječar from 2014 to 2024. Methods. Between 2014 and 2024, 7,157 procedures were performed, including 4,775 (66.71%) coronary angiographies and 2,382 (33.29%) PCI procedures. Since June 26, 2015, the primary vascular approach has been the right radial, with femoral used only as an alternative. Results. The number of coronary angiographies was 188 in 2014, 470 in 2015, 416 in 2016, 502 in 2017, 328 in 2018, 561 in 2019, and 494 in 2020, 484 in 2021, 706 in 2022, and 626 in 2023. The number of PCI procedures also increased, from 36 in 2014 (19% of all diagnoses), to 159 (33%) in 2015, 173 (41%) in 2016, 253 (50%) in 2017, 174 (53%) in 2018, 372 (66%) in 2019, 297 (60%) in 2020, 292 (60%) in 2021, 343 (48%) in 2022, and 283 (45%) in 2023. The number of stents used per procedure was analyzed: 47 in 2014 (1.3 per procedure), 183 (1.1 per procedure) in 2015, 210 (1.2 per procedure) in 2016, 334 (1.3 per procedure) in 2017, 237 (1.3 per procedure) in 2018, 395 (1 per procedure) in 2019, 409 (1.3 per procedure) in 2020, 422 (1.4 per procedure) in 2021, 554 (1.6 per procedure) in 2022, and 725 (2.5 per procedure) in 2023. The outcomes of treatment were analyzed, including the ratio of number of patients indicated for optimal medication therapy(OMT), (normal angiographic results),to those who underwent PCI, or were referred for CABG (the most complex cases). Medication therapy was recommended for 77 (41%) patients and PCI was performed in 57 (30%) patients in 2014, for 180 (38%) OMT and 163 (35%) PCI in 2015, for 171 (41%) OMT and 177 (43%) with PCI in 2016. In 2017, 153 (30%) were treated with OMT and 256 (51%) with PCI; in 2018, 107 (33%) and 175 (53%); in 2019, 175 (31%) and 318 (57%); in 2020, 150 (32%) with OMT and 267 (56%) with PCI; in 2021, 137 (30%) with OMT and 258 (57%) with PCI; in 2022, 204 (30%) with OMT and 369 (54%) with PCI; and in 2023, 213 (33%) with OMT and 345 (54%) with PCI. Arterial access was femoral in 188 (100%) patients in 2014, 306 (65%) femoral and 164 (35%) radial in 2015, 59 (15%) femoral and 357 (85%) radial in 2016, 447 (89%) radial and 55 (11%) femoral in 2017, 296 (90%) radial and 32 (10%) femoral in 2018, 529 (94%) radial and 32 (6%) femoral in 2019, 476 (96%) radial and 18 (4%) femoral in 2020, 469 (97%) radial and 15 (3%) femoral in 2021, 676 (96%) radial and 30 (4%) femoral in 2022, and 601 (96%) radial and 25 (4%) femoral in 2023. Conclusion. In the first ten years of operation, the Department of Invasive Cardiology in Zaječar organized a 24/7 readiness for treating patients with acute coronary syndrome. Thanks to this organization, more than half of the treated patients had acute coronary syndrome and were treated with primary PCI. The last seven years show a constant increase in the number of PCI procedures, and a reduction in the number of patients referred for cardiac surgery consultations, and an increase in the number of stents used due to more complex procedures and the treatment of multivessel coronary disease in the same procedure.