Österr.kardiol.gesellschaft 1990 arbeitsgruppe intervent. kardiologie

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


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


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


%-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


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


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


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


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


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


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


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


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


% 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


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


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


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


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


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


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


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

Österr.kardiol.gesellschaft 1990 arbeitsgruppe intervent. kardiologie

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