Euro Heart Survey on Coronary revascularisation

All results from the EHS studies on Coronary Intervention

Over the past two decades, major advances have occurred in diagnostic techniques, understanding of natural history, coronary revascularisation and surgical procedures for patients with ischemic heart disease. These advances have resulted not only in a better diagnosis and patient management but also in an increased survival of patients with these disorders.

Since 2000, two studies were conducted within the EHS programme. The first project was completed before the use of DES. The second project was initiated as a survey and became a permanent registry after one year of success.

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Check the list of ESC guidelines on this topic

The first Euro Heart Survey on Coronary Revascularisation included consecutive patients who presented for coronary angiography and had significant coronary disease (any stenosis over 50% in diameter). In 2000-2001, over 8,000 procedures were screened and 5,767 cases were included from 132 hospitals of 31 ESC member countries.

Conclusion:

The percentage of invasive (PCI andCABG) and non-invasive treatment in patients with a stenose over 50% varied largely across hospitals.
Under-use and a large hospital variety inthe prescription of adjunctive medication(GP IIb/IIIa receptor blockers, statins, and ACE-inhibitors), were observed, withthe lowest prescription rates in CABG patients.
Most patients in clinical practice are not represented in RCTs.
The percentage of invasive and non invasive treatment in elderly patients with an angiographically proven stenosis over 50% did not differ from patients in the middle age group. Also the prescription of adjunctive medication did not differ for the elderly.

The Euro Heart Survey on Percutaneous Coronary Interventions (PCI) included 13,544 patients in 143 hospitals from 30 ESC member countries between June 2005 and January 2006. After the first year, this project became a PCI registry in which collected over 25,000 patients records so far.
Of all PCI procedures in this survey, ST elevation myocardial infarction (STEMI) was the indication for PCI in 25% of cases, non ST elevation myocardial infarction (NSTEMI) in 14%, unstable angina (UA) in 16%, and stable angina in 43% of cases. Overall, 43% of PCIs were elective with a relatively low number of elective PCIs in the elderly (38% vs. 44% in younger patients).

Conclusion:

Two-thirds of PCI patients had multivessel disease, which was almost three quarters in the elderly.
In the large majority of PCI patients stenting was applied. Less than half received DES, and a large variation in DES use was observed between countries.
Only a small number of patients undergoing PCI did receive GP IIb/IIIa blockers as adjunctive treatment.
Medical treatment for secondary prevention after PCI was well according to guidelines, also in the elderly.

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