Why we need a national registry in interventional cardiology.
Percutaneous coronary intervention (PCI) is increasingly used in the management of acute coronary syndromes and refractory angina, and technical advances such as drug-eluting stents (DES) and potent antithrombotic therapies (such as clopidogrel and glycoprotein IIb/IIIa inhibitors) have been heralded as improving long-term outcomes. Offsetting these advances has been: considerable concern about the safety of DES in regard to late stent thrombosis and antithrombotic drug-induced bleeding; the rising use of PCI and DES in clinical situations where evidence of efficacy is lacking; preferential use of PCI in low-risk populations; and limited cost-effectiveness data comparing PCI with other treatments. There are few contemporary data in Australia on the efficacy, safety and costs of PCI--as used in everyday clinical practice--that matches clinical outcomes with baseline patient characteristics, indications for intervention, coronary anatomy, procedural technique, co-interventions and site of care. A national registry that prospectively collects standardised data on processes and outcomes of PCI is warranted. This would ensure safe and appropriate evidence-based use of limited resources in an era of expanding use of PCI in clinical circumstances not tested in randomised trials.
Scott
Ian A
IA
Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, QLD. ian_scott@health.qld.gov.au
D001315:Australia; D002309:Cardiology / Q000706:statistics & numerical data*; D013504:Cardiovascular Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D012042:Registries