Österr.kardiol.gesellschaft 1990 arbeitsgruppe intervent. kardiologie
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Österr.Kardiol.Gesellschaft 1990 Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. KardiologieArbeitsgruppe Intervent. Kardiologie
Monitor (Auditor) Report: 2006/2007
European Society of CardiologyEuropean Society of Cardiology WG 10 – EAPCI (2006)WG 10 – EAPCI (2006)
AUSTRIA 1990 -2006AUSTRIA 1990 -2006
BERNBERNESCESC
Contact and References:Contact and References:
http://iik.msig.at (V.Barbieri, http://iik.msig.at (V.Barbieri, L.Kaltenbach, KP Pfeiffer)L.Kaltenbach, KP Pfeiffer)
www.kardiologie.insel.ch/2164.html www.kardiologie.insel.ch/2164.html (T.Carrel, B Meier)(T.Carrel, B Meier)
CARDS; EU Heart J. 2005;26: 308-313 CARDS; EU Heart J. 2005;26: 308-313 (ESC-WG 10; F.Weidinger)(ESC-WG 10; F.Weidinger)
www.herzbericht.de (E.Bruckenberger)www.herzbericht.de (E.Bruckenberger)
Volker Mühlberger, QualityVolker Mühlberger, Quality
AUSTRIAN ANGIOGRAPHY AUSTRIAN ANGIOGRAPHY +/- PCI- CENTERS 2006/7 +/- PCI- CENTERS 2006/7
4 Pediatric 4 Pediatric 34 Adult 34 Adult ((10 10 in Vienna)in Vienna)
Rooms (n=46)Rooms (n=46) http://iik.i-med-ac.athttp://iik.i-med-ac.at Schwarzach + Wiener Privatklinik – 2005 Mödling ab 2006Schwarzach + Wiener Privatklinik – 2005 Mödling ab 2006
103 parameters were reported 103 parameters were reported by all by all 31/30/32 cathlabs 2003/2004/200531/30/32 cathlabs 2003/2004/2005
0
20
40
60
80
100
120
99,0
396
,12
93,2
90,2
987
,38
84,4
781
,55
78,6
475
,73
72,8
269
,966
,99
64,0
861
,17
58,2
555
,34
52,4
349
,51
46,6
43,6
940
,78
37,8
634
,95
32,0
429
,13
26,2
123
,320
,39
17,4
814
,56
11,6
58,
745,
832,
91
% Rückmeldung
% H
erz
kath
ete
rze
ntr
en
2003
2004
2005
Volker Mühlberger, QualityVolker Mühlberger, Quality
AUSTRIA 2005/2006AUSTRIA 2005/2006
� Angiography 48.791 50.667Angiography 48.791 50.667
� PTCA=PCI 18.591 19.263 PTCA=PCI 18.591 19.263
� stentstent 91% 91% 90%90%
� - DES- DES 66% 69% 66% 69%
� OP-CAD OP-CAD 3.443 3.443
� OP- valve 2.376OP- valve 2.376
Volker Mühlberger, QualityVolker Mühlberger, Quality
Coronary Angiography Frequency Coronary Angiography Frequency per One Million Inhabitants per One Million Inhabitants
0
2000
4000
6000
8000
10000
1992 1995 1998 2001 2004
AU8.12/8.3
CH 7.4
D 82.53
PCI Frequency per One Million PCI Frequency per One Million Inhabitants (Inhabitants (AUAU//CHCH//DD))
0
500
1000
1500
2000
2500
3000
3500
1992 1994 1996 1998 2000 2002 2004 2006
AU
CH
D
n= 32 centers - Austria 2005; according to incremental PCI/CA % quota (n=)
0
500
1000
1500
2000
2500
3000
3500
4000
4500
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
Zentrumsnummern geordnet nach Größenverhältnis PCI/CA aufsteigend
Ab
so
lute
An
za
hl
Anzahl KAG
GESAMT PCI
n= 32 centers - according to incremental PCI/CA % quota in Austria 2005; (%=)
0
10
20
30
40
50
60
70
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
Zentrumsnummern geordnet nach Größenverhältnis PCI/CA aufsteigend
PC
I/C
A in
Pro
zen
t (%
)
PCI/CA 2001
PCI/CA 2002
PCI/CA 2003
PCI/CA 2004
PCI/CA 2005
Volker Mühlberger, QualityVolker Mühlberger, Quality
%-PCI during Diagnostic %-PCI during Diagnostic Angio in Angio in
AustriaAustria//SwitzerlandSwitzerland//EUEU
0
10
20
30
40
50
60
70
80
90
1992 1994 1996 1998 2000 2002 2004 2006
AU
CH
EU
%-multivessel PCI %-multivessel PCI AustriaAustria//EUEU
0
2
4
6
8
10
12
14
16
18
20
2002 2003 2004 2005 2006
AUSTRIAEU
Volker Mühlberger, QualityVolker Mühlberger, Quality
Ratio of (CABG-OP+PCI) per Ratio of (CABG-OP+PCI) per Angiography in Angiography in AUAU CHCH DD
0
10
20
30
40
50
60
1992 1994 1996 1998 2000 2002 2004
AU
CH
D
Volker Mühlberger, QualityVolker Mühlberger, Quality
PCI Hospital-Mortality (%) in PCI Hospital-Mortality (%) in AustriaAustria, , SwitzerlandSwitzerland,,GermanyGermany, , EUEU
0,27
0,6
0,03
0,5
0
0,2
0,4
0,6
0,8
1
1,2
1992 1994 1996 1998 2000 2002 2004 2006
AU
CH
D
EU
Volker Mühlberger, QualityVolker Mühlberger, Quality
Elective (non-acute) and Overall - Elective (non-acute) and Overall - PCI PCI Hospital-Mortality (%) in AustriaHospital-Mortality (%) in Austria
0
0,2
0,4
0,6
0,8
1
1,2
1992 1994 1996 1998 2000 2002 2004 2006
Overall
Elective
Volker Mühlberger, QualityVolker Mühlberger, Quality
Ratio of STENTING per PCI Ratio of STENTING per PCI (%) in (%) in AUAU//CHCH//DD
2,4 4,38,9
27
47
58
6874 76
81 84 87 8791 90
0
10
20
30
40
50
60
70
80
90
100
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
AU
CH
D
Volker Mühlberger, QualityVolker Mühlberger, Quality
Ratio of emergency CABG due to Ratio of emergency CABG due to PCI (%) in PCI (%) in AustriaAustria//SwitzerlandSwitzerland,,EUEU
0
0,2
0,4
0,6
0,8
1
1,2
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
AU
CH
EU
Volker Mühlberger, QualityVolker Mühlberger, Quality
EMERGENCY CABG AFTEREMERGENCY CABG AFTER PCI (%)-MORTALITY in AustriaPCI (%)-MORTALITY in Austria
3,3
8,3
18,2
28,6
8,3
15,4 16
25
32
1210,5
18,2
13,6
23,1
0
5
10
15
20
25
30
35
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Volker Mühlberger, QualityVolker Mühlberger, Quality
Infarction as Complication (%) after Infarction as Complication (%) after PCI in PCI in AustriaAustria, , CHCH, , DD, , EUEU
0,85
0,8
0,3
0
0,2
0,4
0,6
0,8
1
1,2
1,4
1,6
1,8
2
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
AU
CH
D
EU
acute/nonacute PCI % Austria 2004 all Centers
0
50
100
1. Qrtl. 2. Qrtl. 3. Qrtl. 4. Qrtl.
Ost
West
Nord
0
5
10
15
20
25
30
35
40
MIT 24h Dienst (n=15) OHNE 24h Dienst (n=14)
% P
PC
I vo
n P
CI
acuteacute PCI (% of total PCI) in PCI (% of total PCI) in AustriaAustria and and SwitzerlandSwitzerland,,EUEU
17
20
0
5
10
15
20
25
30
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
AU
CH
EU
PCI for acute & subacute PCI for acute & subacute myocardial infarction (n) in Austriamyocardial infarction (n) in Austria
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
1998 1999 2000 2001 2002 2003 2004 2005 2006
PCI MIwith shock
PCI MIwithoutshock
Volker Mühlberger, QualityVolker Mühlberger, Quality
MORTALITY after PCI for acute & MORTALITY after PCI for acute & subacute myocardial infarction in Austria(%)subacute myocardial infarction in Austria(%)
27
2,5
31
2,8
35
2,6
30
2,1
17
2
17,2
2,2
21,8
1,6
22,8
1,5
25,3
1,2
0
5
10
15
20
25
30
35
1998 1999 2000 2001 2002 2003 2004 2005 2006
PCI forMI+Shock
PCI for MIwithoutShock
Volker Mühlberger, QualityVolker Mühlberger, Quality
% GP IIb/IIIa for PCI (% GP IIb/IIIa for PCI (AUAU//CHCH))
0
5
10
15
20
25
1996 1998 2000 2002 2004 2006
AU
CH
DRUG ELUTING STENTSDRUG ELUTING STENTS (DES) in (DES) in AUAU,,CHCH,,DD (% of stents) (% of stents)
0
10
20
30
40
50
60
70
80
2001 2002 2003 2004 2005 2006
CH
Austria
D
EU
DRUG ELUTING STENTS (DES) DRUG ELUTING STENTS (DES) in Austria (n)in Austria (n)
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
2002 2003 2004 2005 2006
Paclitaxel
Sirolimus
Zotarolimus
others/n.a.
Tacrolimus
Everolimus
DRUG ELUTING STENTS (DES) DRUG ELUTING STENTS (DES) versus REDO in Austria (%)versus REDO in Austria (%)
0
10
20
30
40
50
60
70
2002 2003 2004 2005 2006
DESREDO
Volker Mühlberger, QualityVolker Mühlberger, Quality
Puncture site closing devices Puncture site closing devices (% of PCI in (% of PCI in AUAU//CHCH))
0
10
20
30
40
50
60
70
1998 1999 2000 2001 2002 2003 2004 2005 2006
AU
CH
Volker Mühlberger, QualityVolker Mühlberger, Quality
Brachial and Radial Brachial and Radial Approach (% of PCI in Approach (% of PCI in AUAU//CHCH))
0
1
2
3
4
5
6
7
8
9
1999 2000 2001 2002 2003 2004 2005 2006
AUCH
Volker Mühlberger, QualityVolker Mühlberger, Quality
OLD and NEW DEVICES, AustriaOLD and NEW DEVICES, Austria
LASER
IVUS
STENT
0
5000
10000
15000
20000 LASER
DCA
ROTABL
IVUS
IIb/IIIa
DES
STENT
Volker Mühlberger, QualityVolker Mühlberger, Quality
NEW DEVICES NEW DEVICES Austria 2002 - 2006Austria 2002 - 2006
Brachytherapie 163/101/28/3/0Brachytherapie 163/101/28/3/0 Ultraschalltherapie 1/0/0/0/0Ultraschalltherapie 1/0/0/0/0 Gerinnselentferner 148/173/213/380/580Gerinnselentferner 148/173/213/380/580 Transmyokardialer Laser 16/0/13/0/0Transmyokardialer Laser 16/0/13/0/0 Spinal Cord Stimulation 4/0/0/0/0Spinal Cord Stimulation 4/0/0/0/0 Alkoholablation 4/4/6/15/11Alkoholablation 4/4/6/15/11 Defektverschlüsse 162/243/269/332/214Defektverschlüsse 162/243/269/332/214 DES 620/2938/6430/11209/12037DES 620/2938/6430/11209/12037
NEW DEVICES II NEW DEVICES II Austria 2003 - 2006Austria 2003 - 2006
Stammzelltherapie mit Katheter 21/16/23/12Stammzelltherapie mit Katheter 21/16/23/12 NOGA MappingNOGA Mapping
16/26/26/2616/26/26/26 Herzohrverschluss linksHerzohrverschluss links 7/4/13/0 7/4/13/0 PCI wg. instent-Restenose 737/921/905/1359PCI wg. instent-Restenose 737/921/905/1359 Thrombininjektion bei lokaler Thrombininjektion bei lokaler
Gefäßkomplikation -/ 88/143/111Gefäßkomplikation -/ 88/143/111
Volker Mühlberger, QualityVolker Mühlberger, Quality
Case load per physicianCase load per physician
0
50
100
150
200
250
1998PC I
1999PC I
2000PC I
2001PC I
2002PC I
2003PC I
2004PC I
2005PC I
2006PC I
1998C A
1999C A
2000C A
2001C A
2002C A
2003C A
2004C A
2005C A
2006C A
AU
CH
Volker Mühlberger, QualityVolker Mühlberger, Quality
NUMBER OF CENTERS WITH HIGH OR NUMBER OF CENTERS WITH HIGH OR LOW CASE LOAD FOR PCI DURING 2000/05LOW CASE LOAD FOR PCI DURING 2000/05
0
5
10
15
20
25
<200 PCI per yearand center
200-400 >400 PCI
AU 2000AU 2001AU 2002AU 2003AU 2004AU 2005CH 2004AU 2006
Volker Mühlberger, QualityVolker Mühlberger, Quality
NUMBER OF CENTERS WITH HIGH OR NUMBER OF CENTERS WITH HIGH OR LOW CASE LOAD FOR CA DURING 2000/05LOW CASE LOAD FOR CA DURING 2000/05
0
2
4
6
8
10
12
14
16
<400 CA peryear and
center
400-1000 1000-2000 >2000 CA
AU 2000AU 2001AU 2002AU 2003AU 2004AU 2005CH 2004AU 2006
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