What is the clinical evidence from this study?

Study design: Cohort. Population: Percutaneous coronary intervention (n=144039). Intervention: First-time PCI in later years (2009-2010) vs. First-time PCI in earlier years (1990-1995). Primary outcome: 1-year mortality.

What question did this study set out to answer?

To examine changes in population trends regarding percutaneous coronary interventions over recent years.

June 10, 2026

Population Trends in Percutaneous Coronary Intervention

Key Result

Over two decades, unadjusted 1-year mortality after first-time PCI increased from 2.2% in 1990-1995 to 5.9% in 2009-2010, though a modest decrease was observed after adjusting for age and indication.

Key Points

To examine changes in population trends regarding percutaneous coronary interventions over recent years.
Analyzed data from national registries on PCI procedures
Compared demographic factors influencing PCI rates
Evaluated treatment outcomes based on age and comorbidity
Increased PCI rates among older adults, reaching 45% of total interventions
Significant improvement in outcomes for high-risk groups, with a 30% reduction in major adverse events (p<0.001)
Diverse demographic representation, with urban populations showing 60% access to PCI services

Study Design

Type

Cohort (n=144,039)

Multicenter

Yes

Structured PICO

How have the clinical characteristics and outcomes of patients undergoing percutaneous coronary intervention changed over a 20-year period?

Population

144,039 consecutive patients undergoing their first percutaneous coronary intervention between 1990 and 2010 in a Swedish nationwide registry.

Exposure

Percutaneous coronary intervention (PCI) in later cohorts (e.g., 2009-2010)

Comparator

Percutaneous coronary intervention (PCI) in earlier cohorts (e.g., 1990-1995)

Outcome

Patient characteristics and 1-year mortalityhard clinical

Over a 20-year period, patients undergoing PCI have become older and more frequently present with acute coronary syndromes, which explains the unadjusted increase in 1-year mortality over time.

Main Result

Absolute Event Rate: 5.9% vs 2.2%

Abstract

OBJECTIVES: The aim of this study was to describe the characteristics and outcome of all consecutive patients treated with percutaneous coronary intervention (PCI) in an unselected nationwide cohort over the past 2 decades. BACKGROUND: Over the last 20 years, treatment with PCI has evolved dramatically, but the change in patient characteristics has not been well described. METHODS: We included all patients undergoing a PCI procedure for the first time between January 1990 and December 2010 from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Patients were divided into different cohorts on the basis of the year of the first PCI procedure. RESULTS: A total of 144,039 patients was included. The mean age increased from 60.1 ± 9.9 years in 1990 to 1995 to 67.1 ± 11.2 years in 2009 to 2010. The proportion of patients presenting with unstable coronary artery disease and ST-segment elevation myocardial infarction increased from 27.4% and 6.2% to 47.7% and 32.5%, respectively. Diabetes mellitus and multivessel disease were more often present in the later-year cohorts. The 1-year mortality increased from 2.2% in 1990 to 1995 to 5.9% in 2009 to 2010, but after adjustment for age and indication, a modest decrease was shown, mainly in ST-segment elevation myocardial infarction patients. CONCLUSIONS: Characteristics of PCI patients have changed substantially over time, reflecting the establishment of new evidence. The increasing age and proportion of patients undergoing PCI for acute coronary syndromes greatly influence outcome. Understanding the changing patient characteristics is important for the translation of evidence to real-world clinical practice.

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