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Title: Evolution of Australian Percutaneous Coronary Intervention (from the Melbourne Interventional Group [MIG] Registry).
Austin Authors: Yeoh, Julian;Yudi, Matias B ;Andrianopoulos, Nick;Yan, Bryan P;Clark, David J ;Duffy, Stephen J;Brennan, Angela;New, Gishel;Freeman, Melanie;Eccleston, David;Sebastian, Martin;Reid, Christopher M;Wilson, William;Ajani, Andrew E
Affiliation: School of Public Health, Curtin University, Perth, Western Australia, Australia
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
Department of Cardiology, Box Hill Hospital, Melbourne, Australia
Department of Cardiology, University Hospital, Geelong, Australia
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
Department of Medicine, University of Melbourne, Melbourne, Australia
Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia
Centre of Cardiovascular Research and Education in Therapeutics (CCRET), Monash University, Melbourne, Australia
Issue Date: 1-Jul-2017
Date: 2017-08-12
Publication information: The American Journal of Cardiology 2017; 120(1): 47-54
Abstract: Percutaneous coronary intervention (PCI) continues to evolve with shifting patient demographics, treatments, and outcomes. We sought to document the specific changes observed over a 9-year period in a contemporary Australian PCI cohort. The Melbourne Interventional Group is an established multicenter PCI registry in Melbourne, Australia. Data were collected prospectively with 30-day and 12-month follow-ups. Demographic, procedural, and outcome data for all consecutive patients were analyzed with a year-to-year comparison from 2005 to 2013. National Death Index linkage was performed for long-term mortality analysis; 19,858 procedures were captured over 9 years. Patient complexity and acuity increased with a higher proportion of traditional risk factors and more elderly patients who underwent PCI. Angiographic lesion complexity increased with more multivessel coronary artery disease and more American College of Cardiology/American Heart Association type B2/C lesions proceeding to PCI. The 30-day rate of death, myocardial infarction, or target vessel revascularization has not changed nor has 12-month mortality, myocardial infarction, or major adverse cardiovascular event rates. The strongest independent predictor of long-term mortality was cardiogenic shock at presentation (hazard ratio [HR] 2.95, p <0.01). Drug-eluting stent use (HR 0.83, p <0.01) and a history of dyslipidemia (HR 0.81, p <0.01) were associated with long-term survival. In conclusion, from 2005 to 2013, we observed a cohort of higher risk clinical and angiographic characteristics, with stable long-term mortality.
DOI: 10.1016/j.amjcard.2017.03.258
ORCID: 0000-0002-3706-4150
Journal: The American Journal of Cardiology
PubMed URL: 28495431
Type: Journal Article
Appears in Collections:Journal articles

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