BACKGROUND: The ALKK registry contains about 20% of the invasive and interventional cardiological procedures performed in Germany. METHODS: In 2003 a total of 82,282 consecutive diagnostic invasive and 30,689 interventional procedures from 75 hospitals were centrally collected and analyzed. RESULTS: The main indication for an invasive diagnostic procedure was coronary artery disease in 92.5% of cases, myocardial disease in 1.6%, impaired left ventricular function in 4.0%, valve disease in 4% and other indications in 1.9%. An acute coronary syndrome was present in 25% of the patients. The rate of severe complications in patients with a lone diagnostic invasive procedure was low (<0.5%). The indication for percutaneous coronary intervention (n=30,689) was stable angina in 44.1%, ST elevation myocardial infarction in 22.3%, non ST elevation myocardial infarction in 14.8%, unstable angina in 10.0%, silent ischemia in 2.2%, prognostic in 5.2% of patients. The majority of interventions were performed directly after the diagnostic procedure (n=23,887=78.6%). The intervention was successful in 94.6% of cases. Stent implantation was performed in 77.2%, with 1 stent in 88.4%, two stents in 7.6% and 3 or more stents in 3.3%. A drug-eluting stent was implanted in 3.6% of the cases. The complication rate after PCI was influenced by the indication for the intervention. The in-hospital mortality in patients with cardiogenic shock was 33%, while in patients with stable angina, silent ischemia and prognostic indication only 0.2% died. CONCLUSION: There is an increase of invasive diagnostic and interventional procedures in patients with acute coronary syndromes, with 47% of PCIs performed in these patient. PCIs were performed in 75% of the cases directly after the diagnostic procedure. The rate of stent implantation seems to have reached a plateau at around 80%, while drug-eluting stents were implanted only in a minority of cases. The complication rate is mainly dependent on the clinical presentation of the patients and the indication for PCI.
BACKGROUND: The ALKK registry contains about 20% of the invasive and interventional cardiological procedures performed in Germany. METHODS: In 2003 a total of 82,282 consecutive diagnostic invasive and 30,689 interventional procedures from 75 hospitals were centrally collected and analyzed. RESULTS: The main indication for an invasive diagnostic procedure was coronary artery disease in 92.5% of cases, myocardial disease in 1.6%, impaired left ventricular function in 4.0%, valve disease in 4% and other indications in 1.9%. An acute coronary syndrome was present in 25% of the patients. The rate of severe complications in patients with a lone diagnostic invasive procedure was low (<0.5%). The indication for percutaneous coronary intervention (n=30,689) was stable angina in 44.1%, ST elevation myocardial infarction in 22.3%, non ST elevation myocardial infarction in 14.8%, unstable angina in 10.0%, silent ischemia in 2.2%, prognostic in 5.2% of patients. The majority of interventions were performed directly after the diagnostic procedure (n=23,887=78.6%). The intervention was successful in 94.6% of cases. Stent implantation was performed in 77.2%, with 1 stent in 88.4%, two stents in 7.6% and 3 or more stents in 3.3%. A drug-eluting stent was implanted in 3.6% of the cases. The complication rate after PCI was influenced by the indication for the intervention. The in-hospital mortality in patients with cardiogenic shock was 33%, while in patients with stable angina, silent ischemia and prognostic indication only 0.2% died. CONCLUSION: There is an increase of invasive diagnostic and interventional procedures in patients with acute coronary syndromes, with 47% of PCIs performed in these patient. PCIs were performed in 75% of the cases directly after the diagnostic procedure. The rate of stent implantation seems to have reached a plateau at around 80%, while drug-eluting stents were implanted only in a minority of cases. The complication rate is mainly dependent on the clinical presentation of the patients and the indication for PCI.
Authors: H Vernon Anderson; Richard E Shaw; Ralph G Brindis; Kathleen Hewitt; Ronald J Krone; Peter C Block; Charles R McKay; William S Weintraub Journal: J Am Coll Cardiol Date: 2002-04-03 Impact factor: 24.094
Authors: Michel E Bertrand; Maarten L Simoons; Keith A A Fox; Lars C Wallentin; Christian W Hamm; Eugene McFadden; Pim J De Feyter; Giuseppe Specchia; Witold Ruzyllo Journal: Eur Heart J Date: 2002-12 Impact factor: 29.983
Authors: A Vogt; T Bonzel; D Harmjanz; E R von Leitner; C Pfafferott; H J Engel; W Niederer; P R Schuster; H G Glunz; K L Neuhaus Journal: Eur Heart J Date: 1997-07 Impact factor: 29.983
Authors: Benny Levenson; Alexander Albrecht; Stefan Göhring; Winfried Haerer; Harald Herholz; Martin Kaltenbach; Nicolaus Reifart; Gregor Sauer; Sigmund Silber; Bernhard Troger Journal: Herz Date: 2003-06 Impact factor: 1.443
Authors: L H Hilborne; L L Leape; S J Bernstein; R E Park; M E Fiske; C J Kamberg; C P Roth; R H Brook Journal: JAMA Date: 1993-02-10 Impact factor: 56.272
Authors: R Höllriegel; A Linke; M Hochadel; G Schuler; S Kerber; R Hambrecht; E Grube; K E Hauptmann; R Zahn; U Zeymer; J Senges Journal: Herz Date: 2013-01-18 Impact factor: 1.443
Authors: Guenter Pilz; Peter Bernhardt; Markus Klos; Eman Ali; Michael Wild; Berthold Höfling Journal: Clin Res Cardiol Date: 2006-08-16 Impact factor: 5.460
Authors: Tobias Härle; Uwe Zeymer; Arne Kristian Schwarz; Claus Lüers; Matthias Hochadel; Harald Darius; Wolfgang Kasper; Karl Eugen Hauptmann; Dietrich Andresen; Albrecht Elsässer Journal: Clin Res Cardiol Date: 2014-01-17 Impact factor: 5.460