Highlights of the first Malaysian National Cardiovascular Disease Database (NCVD): Percutaneous Coronary Intervention (PCI) Registry

摘要

Objective: The Malaysian NCVD-PCI registry attempts to determine the number and to monitor the outcomes of Percutaneous Coronary Intervention (PCI), based on selected performance indicators. It provides a comprehensive view to determine the level of adherence to existing guidelines, to evaluate the cost-effectiveness of treatment and prevention programs and to facilitate quality improvement activities of the participants. It also aims to stimulate research and to act as a reference for future studies.Methods: It was a voluntary, multi-centered, observational, cohort study and included patients of 18 years or above, with coronary artery disease who underwent PCI at eight participating centers in the year 2007.Results: A total of 3677 patients underwent 3920 PCI procedures with 6299 stents for 5512 lesions. The mean age of patients was 56.7 +- 10.11 years. The mean BMI was 26.38 +-4.21 kg/ m2, while 80% of all subjects had a BMI above 23 kg/m2. Males constituted 81.2% of the total population and 98.4% of the total population had at least one cardiovascular risk factor. Regarding PCI status, 90.1% were elective cases and 94% of cases had a low TIMI risk index at the beginning of PCI. Femoral approach accounted for 59%, radial approach for 34% and brachial approach for 1% of all cases. The median fluoroscopy time was 15.7 min and the median door-to-balloon time for primary infarct PCI was 93.5 min. The commonest site of lesion was the left anterior descending artery, accounting for 48% of all lesions and 92.8% of all lesions were de novo. The mean lesion length was 24.4 +- 15.18 mm and about 28% of all lesions had high risk characteristics. Drug-eluting stents and bare metal stents were used in 53.6% and 42.5% of cases, respectively. After PCI, 91% of all lesions achieved TIMI grade 3 flow. Regarding pharma-cotherapy, 99.5% of all patients received unfractionated heparin, 5% received LMWH prior to intervention, 96% received aspirin and 98% received clopidogrel. Over-...