[Changes in percutaneous coronary intervention over the last 20 years: demographic, epidemiologic and clinical characteristics, techniques, and outcomes].
OBJECTIVE
The aim of this study was to describe the changes observed in clinical practice in our interventional cardiology unit over the last 20 years.


METHODS
Between January 1, 1986 and December 31, 2005, >or=17,204 percutaneous transluminal coronary angioplasties (PTCAs) were performed at our center. They were analyzed in four periods of 5 years each. After each procedure, prospective data on patient, procedural, and outcome variables were recorded. The data were analyzed with regard to when the procedure was performed, and the patients' sex and age (i.e., < or >or=75 years). Data from 2006 were used as a reference, but were not included in the analysis.


RESULTS
The number of PTCAs increased significantly. Over the time period, mean patient age increased (from 57[10] years to 62[12] years for males and from 66[10] years to 70[11] years for females), and there were significant increases in the proportions of women (from 16% to 22%) and patients aged >75 years (from 7% to 22%). Among men, the incidence of smoking decreased while that of hypertension, diabetes and hyperlipemia increased. Among women, however, there was no change in risk factors. The numbers of urgent and emergent procedures (17% of PTCAs were for acute myocardial infarction in 2006) increased in both sexes and age groups, more ad hoc procedures were carried out, and more lesions were treated, usually with a stent. Over time, the success rate increased and the complication rate decreased in both sexes and age groups. In-hospital mortality for all procedures, except those for acute myocardial infarction, was 0.7% in males and 1.4% in females (P=.012).


CONCLUSIONS
Significant changes were observed over the last 20 years in the baseline characteristics of, the techniques used in, and the outcomes obtained in patients undergoing percutaneous coronary intervention.
Pérez-Vizcayno
María J
MJ
Unidad de Hemodinámica, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, España.
Hernández-Antolín
Rosa A
RA
Alfonso
Fernando
F
Bañuelos de Lucas
Camino
C
Escaned
Javier
J
Jiménez
Pilar
P
Fernández-Ortiz
Antonio
A
Fernández
Cristina
C
Macaya
Carlos
C
D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000639:trends*; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome