Key result
Over a 10-year period, the proportion of high-risk patients undergoing PCI increased, with 1-year all-cause mortality rising from 15.5% to 19.4% in the highest risk quartile (p<0.001).
Why the study?
Mortality following PCI is a key quality measurement in clinical practice, motivating an investigation of its 10-year trends in an unselected nationwide cohort.
Cohort (n=437,436)
Yes
p-value: p=<0.001
Over a 10-year period in South Korea, the proportion of high-risk patients undergoing PCI increased, corresponding to higher 1-year mortality in these higher-risk quartiles.
Observed post-PCI mortality trends in Korea warrant ongoing quality monitoring; leaves open causal drivers and practice changes pending confirmatory studies.
OBJECTIVES: Mortality following percutaneous coronary intervention (PCI) is a key quality measurement in clinical practice. This study investigated the 10-year trends of mortality following PCI in an unselected nationwide cohort. DESIGN: Retrospective cohort study. SETTING: A nationwide study in South Korea. PARTICIPANTS: PCI claim data from 2006 to 2015 of the National Health Insurance Service and the Statistics of Korea. MEASURES: 1-year cardiovascular or non-cardiovascular death. RESULTS: In total, 437 436 patients were included. The annual number of PCI cases increased from 32 098 to 51 990 over the decade studied (p<0.001). Patients were divided into quartile subgroups according to an estimated adjusted probability for predicting 1-year all-cause death. The proportion of patients in the high-risk quartiles increased whereas those in the low-risk quartiles decreased (p<0.001). The 1-year cumulative incidence rate of all-cause death did not change in the population with risk scores in the 1st (0.9% to 0.8%) and 2nd (1.3% to 1.3%) quartiles, whereas it increased in the population with risk scores in the 3rd (3.4% to 5.1%) and 4th (15.5% to 19.4%) quartiles (p<0.001). Compared with year 2006, the mean survival time in year 2015 was shorter by 0, 3.3 and 12.4 days in patients with risk scores in the 1st or 2nd, 3rd and 4th quartiles, respectively. These findings were also consistent for cardiovascular or non-cardiovascular deaths. CONCLUSION: The number, proportion and the overall risk of patients with a high risk for mortality after PCI increased over the decade in Korea.
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Choi et al. (2022) conducted a cohort in percutaneous coronary intervention (n=437,436). Year of PCI (2006 to 2015) was evaluated on 1-year cardiovascular or non-cardiovascular death (p=<0.001). Over a 10-year period, the proportion of high-risk patients undergoing PCI increased, with 1-year all-cause mortality rising from 15.5% to 19.4% in the highest risk quartile (p<0.001).
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