ISSUES
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 selection of patients for surgery or catheter-based interventions versus medical management but also in an increased survival of patients with these disorders. Aging of the populations in Europe results in increased co-morbidity (peripheral vascular disease, metabolic disorders, cerebrovascular disease) and an increased incidence in the association of coronary and valvular diseases. The latter raises the problem of detecting and treating combined coronary and valvular diseases.
Information from which to make a clinical management decision has been greatly expanded in recent years, yet in many situations management issues remain controversial or uncertain. The availability of statins, ACE inhibitors, powerful antiplatelet agents or antibiotics has expanded the limits of medical treatment. As a result, the choice between mechanical revascularization and pharmacological treatment becomes an issue. It should also be noted that many factors ultimately determine the most appropriate treatment of individual patients with ischemic heart disease in a given community. These include the availability of diagnostic equipment and expert diagnosticians, and the expertise of interventional cardiologists and surgeons. Deviation from established guidelines may be appropriate in some circumstances. All these reasons form the rationale for the Euro Heart Survey on Percutaneous coronary intervention (EHS –PCI).
The Euro Heart Survey Programme uses the Cardiology Audit and Registration Data Standards (CARDS) for Europe, which were developed by the ESC in cooperation with the European Commission.
PCI registry objectives:
General: The objective of this survey is to provide a Quality control tool to the participating centres. Centres will be able to monitor and compare their activity with National and European data:
- Determine the regional variations in the indications for revascularization, the use of different procedures and their outcomes.
- Determine the adherence to existing guidelines of indications to perform a PCI.
- Determine the type of equipment and technology used for PCI procedures.
- Test prospectively the value of existing algorithms to predict procedural-related outcomes in patients undergoing PCIs or surgery.
- Assess the immediate, in-hospital and 1-year outcome of patients assigned to different treatment strategies stratified by severity and clinical presentation of CAD as well as comorbidities.
Specific objectives:
- Medical adjunctive treatment before and during PCI.
- Medical treatment after PCI (secondary prevention).
- Use of drug eluting stents.
- Use of adjunctive devices for PCI.
- Comparison of current practice in PCI with the new guidelines.
- Assessment of medical resource utilisation and its impact on outcome in different countries and different types of hospitals.
- Hospital complications and outcome after PCI.
- Longterm (1-year) outcome after PCI.
- Comparison of clinical practice of PCI 2005 with 2000 (Revascularisation Survey).
For more information, please contact ehs@escardio.org