While crude rates of angiography and PCI increased in Ireland from 2004 to 2011, age-standardised PCI rates decreased, with a high proportion of PCIs performed for stable coronary heart disease.
Crude PCI increases may reflect aging demographics; leaves open whether age-adjusted use aligns with evidence-based indications.
BACKGROUND/OBJECTIVES: To study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004-2011. METHODS: Two data sources were used: a) a survey of publicly and privately funded hospitals with cardiac catheter laboratories to obtain the annual number of procedures performed and b) anonymised data from the Hospital In-Patient Enquiry (HIPE) for angiography and PCI in acute publicly funded hospitals; age standardised rates were calculated to study trends over time. RESULTS: From 2004 to 2011 the crude rate of angiography and PCI increased by 47.8% and 35.9% respectively, with rates of 6689 and 1825 per million population in 2011. Following age standardisation, however, PCI activity showed a non-significant decrease over time. The PCI to angiography ratio decreased from 30% to 27% and PCI was performed predominantly for stable coronary heart disease (54%) in 2011. CONCLUSION: Angiography and PCI rates have increased in Ireland but PCI crude and age adjusted rates show divergent trends. While Ireland differs from USA and UK, with a higher proportion of PCI being performed for stable CHD in recent years, little systematic surveillance of cardiological interventions within Europe is available to benchmark improvements in Ireland.
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Jennings et al. (2014) studied this question.
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