title: Population trends in percutaneous coronary intervention: 20-year results from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry).
abstract: OBJECTIVE
  The aim of this study was to describe the characteristics and outcome of all consecutive patients treated with percutaneous coronary intervention (PCI) in an unselected nationwide cohort over the past 2 decades.
  
  
  BACKGROUND
  Over the last 20 years, treatment with PCI has evolved dramatically, but the change in patient characteristics has not been well described.
  
  
  METHODS
  We included all patients undergoing a PCI procedure for the first time between January 1990 and December 2010 from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Patients were divided into different cohorts on the basis of the year of the first PCI procedure.
  
  
  RESULTS
  A total of 144,039 patients was included. The mean age increased from 60.1 ± 9.9 years in 1990 to 1995 to 67.1 ± 11.2 years in 2009 to 2010. The proportion of patients presenting with unstable coronary artery disease and ST-segment elevation myocardial infarction increased from 27.4% and 6.2% to 47.7% and 32.5%, respectively. Diabetes mellitus and multivessel disease were more often present in the later-year cohorts. The 1-year mortality increased from 2.2% in 1990 to 1995 to 5.9% in 2009 to 2010, but after adjustment for age and indication, a modest decrease was shown, mainly in ST-segment elevation myocardial infarction patients.
  
  
  CONCLUSIONS
  Characteristics of PCI patients have changed substantially over time, reflecting the establishment of new evidence. The increasing age and proportion of patients undergoing PCI for acute coronary syndromes greatly influence outcome. Understanding the changing patient characteristics is important for the translation of evidence to real-world clinical practice.
authors.affiliation: Thoraxcenter, Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. m.l.fokkema@umcg.nl
authors.forename: Marieke L
authors.initials: ML
authors.lastname: Fokkema
authors.forename: Stefan K
authors.initials: SK
authors.lastname: James
authors.forename: Per
authors.initials: P
authors.lastname: Albertsson
authors.forename: Axel
authors.initials: A
authors.lastname: Akerblom
authors.forename: Fredrik
authors.initials: F
authors.lastname: Calais
authors.forename: Peter
authors.initials: P
authors.lastname: Eriksson
authors.forename: Jens
authors.initials: J
authors.lastname: Jensen
authors.forename: Tage
authors.initials: T
authors.lastname: Nilsson
authors.forename: Bart J
authors.initials: BJ
authors.lastname: de Smet
authors.forename: Iwar
authors.initials: I
authors.lastname: Sjögren
authors.forename: Björn
authors.initials: B
authors.lastname: Thorvinger
authors.forename: Bo
authors.initials: B
authors.lastname: Lagerqvist
mesh_terms: D000367:Age Factors; D000368:Aged; D000789:Angina, Unstable / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003925:Diabetic Angiopathies / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D012042:Registries; D016019:Survival Analysis; D013548:Sweden; D016896:Treatment Outcome; D014600:Utilization Review / Q000639:trends*