Interventional cardiology in Switzerland 2004

Abstract

Summary Background: Since 1987, a nationwide annual survey of percutaneous cardiac interventions is performed in Switzerland, which allows recognition of contemporary trends and comparison with other countries. Methods: Based on a standardised questionnaire, all adult percutaneous cardiac intervention centres in Switzerland were asked to report on the volume and the circumstances of their activities in 2004. The response rate was 100%. Data were compared with those from previous years. Results: In 2004, 35 201 coronary angiographies (CA; 2003: 33 066; + 6.5%) and 15 680 percutaneous coronary interventions (PCI; 2003: 14 235; + 10.2%) were carried out in 5 university hospitals, 9 public, non-university hospitals, and 12 private hospitals by 194 operators (75 of them performing only diagnostic studies). 86% of PCI were performed ad hoc, and 80% were single-vessel interventions. Stents were placed in 91% of PCI (2003: 88%). In 60% of stenting procedures one stent was implanted, whereas in 40% two or more stents were placed. Drug-eluting stents (DES) were used in 66% of procedures (2003: 52%). PCI for ongoing myocardial infarction, ie primary PCI or rescue PCI after failed thrombolysis, accounted for 20% of interventions. Glycoprotein IIb/IIIa inhibitors were used in 23% of PCI, the variability among different centres being high. Myocardial infarction after PCI was reported in 1.4% of PCI, emergency coronary artery bypass grafting was needed in 0.1% of cases, and in-hospital mortality after PCI was 0.5%. In addition to PCI, 40 mitral, 21 aortic, and 7 pulmonary balloon valvuloplasties, and 438 interventions for closure of patent foramen ovale as well as 92 interventions for closure of atrial septal defect were performed. Conclusions: The number of CA and PCI, the frequency of stent placement during PCI, and the utilisation of DES are steadily increasing in Switzerland. There is also a significantly growing number of interventions for closure of patent foramen ovale and atrial septal defect, whereas the number of balloon valvuloplasties has been more or less stable over the last years.