Emanuele Barbato1, Marko Noc2, Andreas Baumbach3, Dariusz Dudek4, Matjaz Bunc5, Emmanouil Skalidis6, Adrian Banning7, Jacek Legutko8, Nils Witt9, Manuel Pan10, Hans-Henrik Tilsted11, Holger Nef12, Giuseppe Tarantini13, Dzianis Kazakiewicz14, Radu Huculeci14, Stephane Cook15, Ahmed Magdy16, Walter Desmet17, Guillaume Cayla18, Dragos Vinereanu19, Michiel Voskuil20, Omer Goktekin21, Panos Vardas22, Adam Timmis3, Michael Haude23. 1. Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini n. 5, 80131 Naples, Italy. 2. Center for Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia. 3. Queen Mary University of London, Barts Heart Centre, London, UK. 4. Institute of Cardiology, Jagiellonian University, Kopernika 17, Krakow, Poland. 5. University Clinical Center Ljubljana, Zaloška c. 004, Ljubljana, Slovenia. 6. Cardiology Department, Heraklion University Hospital. 7. Oxford Heart Centre, Oxford University Hospitals, Headley Way, Oxford OX3 9DU, UK. 8. Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland. 9. Department of Clinical Science and Education, Karolinska Institutet, Unit of Cardiology, Södersjukhuset, Stockholm, Sweden. 10. Reina Sofía Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Spain. 11. Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark. 12. University of Giessen, Department of Cardiology and Angiology, Germany. 13. Interventional Cardiology, Department of Cardiac Thoracic and Vascular Science University of Padua, Italy. 14. European Society of Cardiology Health Policy Unit, European Heart Health Institute, European Heart Agency, Brussels, Belgium. 15. Cardiology, University Hospital Fribourg, Switzerland. 16. National Heart Institute, Cairo, Egypt. 17. Department of Cardiovascular Diseases, University Hospital Leuven, and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. 18. Department of cardiology, University of Montpellier, Nimes, France. 19. University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania. 20. Department of Cardiology, University Medical Center Utrecht, The Netherlands. 21. Bahcelievler Memorial Hospital, Istanbul, Turkey. 22. Heart Sector, Hygeia Group Hospitals, 5 Erythrou Stavrou Str, 151 23, Marousi, Athens, Greece. 23. Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany.
Abstract
AIMS: The European Association of Percutaneous Cardiovascular Interventions (EAPCI) Atlas of Interventional Cardiology has been developed to map interventional practice across European Society of Cardiology (ESC) member countries. Here we present the main findings of a 16-country survey in which we examine the national availability of interventional infrastructure, human resource, and procedure volumes. METHODS AND RESULTS: Sixteen ESC member countries participated in the EAPCI Atlas survey. Interventional data were collected by the National Cardiac Society of each participating country. An annual median of 5131 [interquartile range (IQR) 4013-5801] diagnostic heart procedures per million people were reported, ranging from <2500 in Egypt and Romania to >7000 in Turkey and Germany. Procedure rates showed significant correlation (r = 0.67, P = 0.013) with gross national income (GNI) per capita. An annual median of 2478 (IQR 1690-2633) percutaneous coronary interventions (PCIs) per million people were reported, ranging from <1000 in Egypt and Romania to >3000 in Switzerland, Poland, and Germany. Procedure rates showed significant correlation with GNI per capita (r = 0.62, P = 0.014). An annual median of 48.2 (IQR 29.1-105.2) transcatheter aortic valve implantation procedures per million people were performed, varying from <25 per million people in Egypt, Romania, Turkey, and Poland to >100 per million people in Denmark, France, Switzerland, and Germany. Procedure rates showed significant correlation with national GNI per capita (r = 0.92, P < 0.001). CONCLUSION: The first report from the EAPCI Atlas has shown considerable international heterogeneity in interventional cardiology procedure volumes. The heterogeneity showed association with national economic resource, a reflection no doubt of the technological costs of developing an interventional cardiology service. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The European Association of Percutaneous Cardiovascular Interventions (EAPCI) Atlas of Interventional Cardiology has been developed to map interventional practice across European Society of Cardiology (ESC) member countries. Here we present the main findings of a 16-country survey in which we examine the national availability of interventional infrastructure, human resource, and procedure volumes. METHODS AND RESULTS: Sixteen ESC member countries participated in the EAPCI Atlas survey. Interventional data were collected by the National Cardiac Society of each participating country. An annual median of 5131 [interquartile range (IQR) 4013-5801] diagnostic heart procedures per million people were reported, ranging from <2500 in Egypt and Romania to >7000 in Turkey and Germany. Procedure rates showed significant correlation (r = 0.67, P = 0.013) with gross national income (GNI) per capita. An annual median of 2478 (IQR 1690-2633) percutaneous coronary interventions (PCIs) per million people were reported, ranging from <1000 in Egypt and Romania to >3000 in Switzerland, Poland, and Germany. Procedure rates showed significant correlation with GNI per capita (r = 0.62, P = 0.014). An annual median of 48.2 (IQR 29.1-105.2) transcatheter aortic valve implantation procedures per million people were performed, varying from <25 per million people in Egypt, Romania, Turkey, and Poland to >100 per million people in Denmark, France, Switzerland, and Germany. Procedure rates showed significant correlation with national GNI per capita (r = 0.92, P < 0.001). CONCLUSION: The first report from the EAPCI Atlas has shown considerable international heterogeneity in interventional cardiology procedure volumes. The heterogeneity showed association with national economic resource, a reflection no doubt of the technological costs of developing an interventional cardiology service. Published on behalf of the European Society of Cardiology. All rights reserved.