BCIS Audit ReturnsAdult Interventional ProceduresJan 2004 to Dec 2004Peter F LudmanBCIS National Audit OfficerOn behalf ofBritish Cardiovascular Intervention SocietyBristol 2005

Audit DomainsStructureAppropriatenessProcessOutcome2004 data: Ludman

Angiography Centres - 200419 New Angiography Only centres 20042004 data: Ludman

Bedford HospitalDarlington MemorialDurhamEast SurreyKent and SussexKing George Hospital IlfordKing's Mill Centre, MansfieldLincoln County HospitalPrincess Alexandra, HarlowRussells Hall

ScunthorpeSolihull HospitalSouth TynesideSouth WarwickshireUniversity Hospital AintreeWansbeck, AshingtonWestmorland General HospWexam ParkWhipps Cross

North Tyneside (to Freeman Hospital)1 Stopped1 SwappedSt Albans fixed lab in Hemel HempsteadAngiography Centres - 20042004 data: Ludman 3 Started PCI in 2004TorbayBUPA HullSouthendTOTAL: 83 Angiography Only Centres(increase of 15 from 2003)

PCI Centres - 2004TorbaySouthendBUPA Hull3 Angio only centres now performing PCI in 2004New PCI centres in 2003Manor Hospital, Oxford2004 data: Ludman TOTAL: 77 PCI Centres(increase of 4 from 2003)

UK Centres - 2004

PCI Centres NHS (1)

England1Battle HospitalReading2Birmingham City HospitalBirmingham3Birmingham Heartlands HospitalBirmingham4Bristol Royal InfirmaryBristol5Castle Hill HospitalCottingham6Cheltenham General HospitalCheltenham7City General HospitalStoke on Trent8Derriford HospitalPlymouth9Eastbourne HospitalEastbourne10Freeman HospitalNewcastle11Glenfield HospitalLeicester12Hammersmith HospitalLondon13Harefield HospitalUxbridge14Heart HospitalLondon15James Cook University HospitalMiddlesbrough

16John Radcliffe HospitalOxford17King Edward VIIWest Sussex18Kings College HospitalLondon19Liverpool CTCLiverpool20London Chest HospitalLondon21Manchester Royal InfirmaryManchester22New Cross HospitalWolverhampton23North Hampshire HospitalBasingstoke24Northern General HospitalSheffield25Northwick Park HospitalHarrow26Nottingham City HospitalNottingham27Papworth HospitalCambridge28Queen Elizabeth HospitalBirmingham29Royal Brompton HospitalLondon

PCI Centres NHS (2)England (cont)

30Royal Cornwall HospitalTruro31Royal Devon & Exeter Exeter32Royal Free HospitalLondon33Royal Sussex County HospitalBrighton34Sandwell District General West Bromwich35Southampton General Southampton36Southend37St Bartholomew's Hospital London38St George's HospitalLondon39St Mary's HospitalLondon

40St Peter's HospitalChertsey41St Thomas' HospitalLondon42Taunton & SomersetTaunton43Torbay HospitalTorquay44Victoria HospitalBlackpool45Walsgrave HospitalWalsgrave46Wythenshawe HospitalManchester47Yorkshire Heart CentreLeeds

PCI Centres NHS (3)

PCI Centres NHS Scotland48Aberdeen Royal InfirmaryAberdeen49Edinburgh Royal InfirmaryEdinburgh50Glasgow Royal InfirmaryGlasgow51Glasgow Western InfirmaryGlasgow52Golden Jubilee National Hospital (formerly HCI)Clydesbank53Hairmyres HospitalEast Kilbride54Western General HospitalEdinburgh

PCI Centres NHS Wales55Morriston HospitalSwansea56University Hospital of WalesCardiff

PCI Centres NHS Northern Ireland57Belfast City HospitalBelfast58Royal Victoria HospitalBelfast

PCI Centres - Private

England59BMI Alexandra HospitalCheadle60BMI Park HospitalArnold61BMI Priory HospitalEdgbaston62BUPA Cambridge Lea Impington63BUPA Hospital BristolRedland Hill64BUPA Hospital Hull Anlaby, Hull65BUPA Hospital LeedsRoundhay66BUPA Hospital LeicesterOadby67BUPA Hospital SouthamptonSouthampton68Capio Yorkshire ClinicBingley69Cromwell HospitalLondon

70Harley Street ClinicLondon71Leeds Nuffield HospitalLeeds72London Bridge HospitalLondon73London Independent London74Manor HospitalHeadington75St Anthony's HospitalSurrey 76Wellington HospitalLondon

Scotland77Ross Hall HospitalGlasgow

Angiography Only Centres (1)

1Airedale General Hospital2Altmagelium Hospital3Arrowe Park Hospital4Ayr Hospital5Bedford Hospital NHS Trust6BMI The Princess Margaret Hospital7BMI Thornbury Hospital8Bradford Royal Infirmary9Broomfield Hospital10BUPA Hospital, Little Aston11BUPA Murrayfield Hospital12Calderdale Royal Hospital13Conquest Hospital14County Hospital15Craigavon Hospital16Cumberland Infirmary17Darlington Memorial Hospital18Derbyshire Royal Infimary

19Dewsbury and District Hospital20Diana Princess of Wales Hospital21Doncaster Royal Infirmary22Droitcwich Spa Hospital23Dudley Group of Hospitals24Dumfries & Galloway Royal Infirmary25Ealing Hospital26East Surrey Hospital27Good Hope District General Hospital28Goring Hall Hospital29Great Western Hospital30Harrogate District Hospital31Hemel Hempstead General32Huddersfield Royal Infimary33Inverclyde Royal Hospital34Kent and Sussex Hospital35King George Hospital36Kings Mill Hospital

Angiography Only Centres (2)

37Lincoln County Hospital38Lister Hospital39Manor Hospital40Mayday University Hospital41Nevill Hall Hospital42Ninewells Hospital43Norfolk & Norwich Hospital44North Middlesex Hospital45North Staffordshire Nuffield Hospital41Northampton General Hospital42Pinderfields General Hospital43Prince Philip Hospital44Princess Alexandra Hospital45Princess of Wales Hospital46Princess Royal Hospital47Princess Royal University Hospital48Queen Elizabeth Hospital49Queen Elizabeth Hospital

50Queens Medical Centre51Raigmore Hospital52Rochdale Infirmary53Rotherham Hospital54Royal Bournemouth Hospital55Royal Gwent Hospital56Royal Liverpool University Hospital57Royal Shrewsbury Hospital58Royal Surrey County Hospital59Royal United Hospital60Salisbury District Hospital61Scunthorpe General Hospital62Solihull Hospital63South Tyneside District Hospital64South Warwickshire NHS Trust64St James' University Hospital65St. Mary's Hospital

Angiography Only Centres (3)

66Sunderland Royal Hospital67University Hospital Aintree68University Hospital of North Durham69Wansbeck Hospital70West Cumberland Hospital71Westmorland General Hospital72Wexham Park Hospital73Whipps Cross University Hospital74Worcester Royal Hospital75Worthing Hospital76Wycombe Hospital77York District General Hospital

7783PCI centresAngiography onlyCentres2004

UK Interventional and Diagnostic centres2004Missing cath data estimated from 2003 figures

PCI Centres not reporting diagnostic numbers for 2004NHSDerriford HospitalSt Mary's Hospital, LondonSt Peter's Hospital, Chertsey(Belfast City Hospital very late)

PrivateBMI Park Hospital, NottsHarley Street Clinic

Angio only Centres not reporting diagnostic numbers for 2004Broomfield HospitalDiana Princess of Wales Hospital, GrimsbyDumfries & Galloway RIEaling HospitalNeville Hall HospitalQueen Elizabeth Hospital, WoolwichRoyal Gwent HospitalRoyal Surrey County HospSalisbury District HospitalWycombe HospitalSouth Warwickshire NHS TrustSouth Tyneside District Hospital

UK Interventional and Diagnostic centres2004Missing cath data estimated from 2003 figures if known

Centres Not ReportingPCI numbers for 2004SouthendSt Peter's Hospital, Chertsey(Belfast City Hospital very late)BMI Park Hospital

UK Interventional and Diagnostic centres2004Missing cath data estimated from 2003 figures if known

PCI per Angiogram ratio

PCI per Angiogram ratioESC Survey 2003Cook S for Working Group on Interventional Cardiology (WG 10) of the ESC In Press

Total UK PCI Procedures

Year

Centres

Total Procedures

Rate per million

Increase

(%)

1991

52

9,933

174

1992

52

11,575

203

16.5

1993

53

12,937

227

11.8

1994

54

14,624

256

13.0

1995

54

17,344

304

18.6

1996

53

20,511

359

18.1

1997

58

22,902

402

11.7

1998

61

24,899

437

8.7

1999

63

28,133

494

13

2000

66

33,652

590

20

2001

64

38,992

664

12.5

2002

64

44,913

759

14.3

2003

73

53,261

894

17.8

2004

77

62,780

1050

17.4

Rate of increase in PCI numbers pmp

PCI activity to 2004 (UK)

Total PCIs in the UK CountriesTotal No.s of PCI

Population estimatesMid 2004Scotland 5.08 mEngland 50.09 mWales 2.95 mRx in Wales: 2.25 mNorthern Ireland 1.71 mWelsh Rx in England 0.7 mTotal UK: 59.8 m Total Rx in England 50.79 m

PCIs/million UK Countries(2000 to 2004)

PCI vs Isolated CABG Numbers (UK)Data from BCIS and SCTS Registry Note:CABG data for financial yrall PCI v NHS CABGCABG data for 2003 and 2004 from DoH

PCI vs Isolated CABG Ratio (UK)Data from BCIS and SCTS Registry

Euro Heart Survey 3rd ReportCardiovascular Diseases in Europe 2004www.escardio.org/knowledge/ehs/slides/

Euro Heart Survey 3rd ReportCardiovascular Diseases in Europe 2004www.escardio.org/knowledge/ehs/slides/

Annual Procedures per cath lab(NHS centres)

Number of PCIs performed in NHS Centres(Total Per Annum)Data from: 57 of 58 centres (2 centres estimated data)

Day Case PCI22 of 77 Units performing day case PCITotal of 3018 procedures performed (21% increase cf 2003)4.8% of all PCI procedures (4.6% 2003)

Data from: 64 of 77 centres

No. of Interventional Consultants(NHS centres)Note: if work at two NHS centres will be counted twiceIncludes cardiologists and radiologistsData from: 57 of 58 centres

No. of Interventional Consultants(NHS centres)Mean2000 5.52001 6.1 6.5 6.7 7.4

MeanPCI/consultant20001252001126200213820031392004143No. of PCIs per Consultant (NHS Centres) 2004 data from 56 of 58 centresNote: data from institutional volume divided by No operators per institution

Visiting Interventionists(NHS Centres) 2004 data from 57 of 58 centres

Visiting Interventionists(NHS Centres)

Surgical Cover(NHS Centres)

On siteOff siteNo of centres57(74%)20(26%)No. of PCI(% of total)53,390(85%)9390(15%)Mean No. procedures per centre 936.7494.2Operator volume:PCIs per interventionist *164.6104.3

Surgical Cover

STEMI

Primary PCI for STEMIDo you offer at least some PCI for STEMI?Data from: 55 of 58 centres

Primary PCIRoutine Rx for STEMI Data from: 55 of 58 centres Working Hours Only24/7Number of Centres

Primary PCIRoutine Rx for STEMI Data from: 55 of 58 centres Working Hours Only24/7

PCI for STEMI(2004 NHS Hospitals: data from 48 of 58 units)5.5% of all PCI activity

PCI for STEMI(2004 NHS Hospitals: data from 48 of 58 units)

PCI for All STEMI 2004 data from 48 of 58 centresTotal 3447 proceduresNo data

PCI for All STEMI 2004 data from 48 centresTotal 3447 procedures

Primary PCI for STEMI 2004 data from 48 centresTotal 1438 proceduresNo data

Primary PCI for STEMI 2004 data from 48 centresTotal 1438 procedures

Primary PCI for STEMIAs Percentage of Each Centres PCI Activity

Primary PCI the experience

Primary PCI the experienceUK population 60 million, at 500 pmp = 30,000 procedures pa

2.3 %32 %1050 pmp1546 pmpUK Activity 2004

2.3 %32 %1050 pmp1546 pmpUK Growthassuming no in other PCI pmp + 30,000 PPCI

2.3 %32 %1050 pmp1546 pmpUK Growthassuming no in other PCI pmp

Uncertainties1546 pmp

PCI for Stable v ACSOf Total PCIs performed44% ACS (excluding STEMI)50% Elective

PCI for Stable v ACSOf Total PCIs performed44% ACS (excluding STEMI)50% Elective

Audit DomainsStructureAppropriatenessProcessOutcome

Stent procedures2004 data from 60 of 77 centres

Stenting in Different Centres

Drug Eluting Stent cases2004 data from 69 of 77 centresNHS and private

Drug Eluting Stent cases2004 data from 53 of 58 centresNHS only

DES use by Centre (NHS)

Drug Eluting Stent cases2004 data from 53 of 58 centres

PCI for Restenosis(2004 data from 54 of 77 centres)Mean:20024.9%20034.3%20043.6%

Bare Metal and DES use v PCI for Restenosis

PCI in patients with past CABG(Data from 53 of 77 centres)Mean 20028.4%20036.8%20046.7%Note: Includes procedures on native vessels and grafts

Use of GP IIb/IIIa blockers2004 data from 71 of 77 centresOverall mean % use

Abciximab use by Clinical Presentation

Multi-vessel TreatmentExcluding Rx of STEMI

Multi-vessel TreatmentExcluding Rx of STEMI

Mean (Range)Multi-vessel TreatmentAll Clinical Presentations

Multi-vessel TreatmentExcluding Rx of STEMI

Additional Interventional CoronaryTechniques (1)2004 data from 74 of 77 centres*% of all UK interventional procedures**Mean number in units using the technique

UnitsNo % cf 2003* % of all procsMean** RangeRotablation33338+17%0.54101-54Atherctmy (DCA)711-27%0.0171.61-7TEC22-33%0.00311Laser361+177%0.1201- 47Cutting balloon511169-12%1.8231-328

Additional Interventional CoronaryTechniques (2)2004 data from 74 of 77 centres

OtherInterventional Techniques2004 data from 74 of 77 centres

UnitsNo cf 2003% of all proceduresMean RangePTMR17- 61%0.0177Septal ablation13570 %0.14.41-12

Alcohol Mediated Septal Ablation(HOCM)Total 57 procedures

Other Diagnostic Techniques2004 data from 74 of 77 centres

UnitsNo cf 2003% of all proceduresMean RangeIVUS38689+ 18%1.1181-167

Press wire421281+ 30.5%2311-169Flow wire6119+ 1387%0.2201-98

Adult non coronary intervention2004 data from 74 of 77 centres

UnitsNo cf 2003 % of all proceduresMean RangeMV plasty33165-28%0.2651-18AV plasty922+29%0.042.41-5PV plasty926+4%0.042.91-9TV plasty22NA11-2PDA939+2.6%0.064.31-19ASD28475+5.6%0.8172-74PFO28379+94%0.6141-86VSD1434+6%0.052.41-6

Mitral Balloon ValvuloplastyTotal 165

Adult great vessel intervention2004 data from 74 of 77 centres

UnitsNo cf 2003% of all proceduresMean RangeCoarct / Re-coart935-60%0.063.41-9Carotid429+7%0.047.251-19Aorta27-41%0.013.51-6Pulm art832+3%0.0541-9SVC834-42%0.055.91-17

Other procedures2004 data from 74 of 77 centres

UnitsNo % cf 2002% of all procsMean RangeForeign body removal1127-4%0.042.41-9Embolisation927-51%0.032.41-7BalloonPericardiotomy33-78%0.00411Spinal cord stimulator328+115%0.0491-20

Radial Artery Access6457 cases: 10.2% of all PCIData from: 68 of 77 centres

Femoral artery closure devices2004 data from 69 of 77 centresMean: 45%

Audit DomainsStructureAppropriatenessProcessOutcome

Data to end of Procedure only2004 data

Battle HospitalReadingBirmingham Heartlands BirminghamCity General HospitalStoke Eastbourne HospitalEastbourneGlenfield HospitalLeicesterHeart HospitalLondonNorth Hampshire BasingstokeRoyal Free HospitalLondonSt Bartholomew's LondonVictoria HospitalBlackpoolWythenshawe HospitalManchesterGlasgow Royal InfirmaryGlasgowGolden Jubilee National ClydesbankHairmyres HospitalEast KilbrideBMI Alexandra HospitalCheadle

BUPA Cambridge Lea ImpingtonBUPA Hull and East RidingAnlaby, HullBUPA Hospital LeedsRoundhayBUPA LeicesterOadbyCapio Yorkshire ClinicBingleyCromwell HospitalLondonLeeds Nuffield HospitalLeedsLondon Independent LondonManor HospitalHeadingtonSt Anthony's HospitalSurrey Wellington HospitalLondonRoss Hall HospitalGlasgow

Mortality - All PCIsTo end of PCI or hosp discharge

YearData FromTotal with mortality dataMortality %Range %199535/5411,365(17,344)0.690-3.4199637/5314,476(20,511)0.720-3.2199741/5817,577(22,902)0.910-10199844/6116,946(24,899)0.800-9.1199948/6320,975(28,133)0.610-4200048/6624,323(33,652)0.640-2.6200145/6429,001(38,992)0.750-2.8200253/6437,437(44,913)0.540-1.9200364/7349,194(53,261)0.530-2.0200466/7856,027(62,780)0.560-2.2

MACE - All PCIsTo end of PCI or hosp discharge

Year% ProcedureSuccess% QMI % Re PCI for acute closure % Em. CABGMortality (%)1995891.41.90.691996901.41.70.721997921.21.10.891998920.80.70.801999900.570.480.612000920.60.40.642001940.50.40.75200292(51 of 64)0.57(49 of 64)0.33(50 of 64)0.28(53 of 64)0.54(53 of 64)200392(62 of 73)0.36(56 of 73)0.17(62 of 73)0.29(64 of 73)0.53(64 of 73)200493.5(63 of 78)0.30(57 of 78)0.30(61 of 78)0.21(64 of 78)0.56(66 of 78)

All Procedures: Outcome

Data on HOSPITAL outcome(2004 data 43 of 77 sites)

Birmingham City HospitalBirminghamBristol Royal InfirmaryBristolCastle Hill Hospital (Hull and East Yorkst)CottinghamCheltenham General HospitalCheltenhamDerriford HospitalPlymouth (limited data)Freeman HospitalNewcastle upon TyneHammersmith HospitalLondonHarefield HospitalUxbridgeJames Cook University HospitalMiddlesbroughJohn Radcliffe HospitalOxfordKing Edward VIIWest SussexKings College HospitalLondonLiverpool Cardiothoracic CentreLiverpoolManchester Royal InfirmaryManchesterNew Cross HospitalWolverhampton

Data on HOSPITAL outcome(2004 data 43 of 77 sites)

Northern General HospitalSheffieldNorthwick Park HospitalHarrowNottingham City HospitalNottinghamPapworth HospitalCambridgeQueen Elizabeth HospitalBirminghamRoyal Brompton HospitalLondonRoyal Cornwall HospitalTruroRoyal Devon & Exeter HospitalExeterRoyal Sussex County HospitalBrighton, SussexSandwell District General HospitalWest BromwichSouthampton General HospitalSouthamptonSt George's HospitalLondonSt Mary's HospitalLondonSt Thomas' HospitalLondonTaunton & SomersetTaunton

Data on HOSPITAL outcome(2004 data 43 of 77 sites)Some additional centres have provided CCAD data but not form C

Torbay HospitalTorquayWalsgrave HospitalWalsgraveAberdeen Royal InfirmaryAberdeenEdinburgh Royal InfirmaryEdinburghGlasgow Western InfirmaryGlasgowWestern General HospitalEdinburghMorriston HospitalSwanseaUniversity Hospital of WalesCardiff (limited data)Royal Victoria HospitalBelfastBMI Priory HospitalEdgbastonBUPA Hospital SouthamptonSouthamptonHarley Street ClinicLondonLondon Bridge HospitalLondon

Data on HOSPITAL outcome(2004 data 35 of 77 sites)

Hospital Outcome 2004Data from 43 centresAll Patients

No.

Success

Partial Success

Failed

Repeat

PCI

CABG

QMI

Death

(Range)

43,570

92.8%

2.5%

3.6%

0.4%

0.26%

0.4%

0.75%

(86-99)

(0-7)

(0-9)

(0-4)

(0-1.1)

(0-2.6)

(0-2.2)

Hospital Outcome 2004Data from 37 to 40 centresElective Patients

All Elective Cases Overall MACE22,9920.25%(0-1.3)0.24%(0-1.7)

No.

Success

Partial Success

Repeat

PCI

CABG

QMI

Death

(Range)

Stable

Single Vessel (no CTO)

14215

95%

(87-100)

1.5%

(0-9)

0.2%

(0-2)

0.2%

(0-1)

0.3%

(0-3)

0.16%

(0-1.3)

Stable Multivessel

(no CTO)

5597

93.0%

(52-100)

3.5%

(0-10)

0.3%

(0-8)

0.31%

(0-2.5)

0.4%

(0-5)

0.31%

(0-4)

Single Vessel

CTO

1591

69.5%

(37-100)

5.8%

(0-63)

0.24%

(0-4.5)

0.5%

(0-6.3)

0 %

(0)

0.13%

(0-2.8)

Multivessel

Inc. CTO

1589

72%

(0-100)

17.8%

(0-100)

0.27%

(0-7)

0.37%

(0-9)

0.45%

(0-6)

0.96%

(0-10)

Hospital Outcome 2004Data from 34 to 37 centresDoes not account for clinical syndromeCABG patients includes Rx of native and graftsPatients with previous bypass graftsPatients treated for restenosis

No.

Success

Partial Success

Repeat

PCI

CABG

QMI

Death

(Range)

CABG pts

2486

87.5%

(29-100)

3.5%

(0-15)

0.19%

(0-4)

0.08%

(0-1.1)

0.46%

(0-7)

0.52%

(0-5)

Restenosis

1668

91.7%

(50-100)

3.2%

(0-17)

0.35%

(0-4)

0.16%

(0-4)

0.49%

(0-14)

0.52%

(0-8)

Hospital Outcome 2004Data from 28 to 30 centresPatients Rx for acute vessel closureEquivalent to SAT rate 0.32% - likely underestimate

No.

Success

Partial

Success

Repeat

PCI

CABG

Q MI

Death

(Range)

Acute closure

199

87.7%

1.2%

3.8%

2.0%

6.4%

2.3%

(0-100)

(0-25)

(0-100)

(0-50)

(0-100)

(0-37)

Hospital Outcome 2004Data from 36 to 38 centresUA and NSTEMIIncludes all classified as treated for UA and post MI angina (stable and unstable)

No.

Success

Partial

Success

Repeat

PCI

CABG

Q MI

Death

(Range)

UA / NSTEMI

14,436

93.5%

2.5%

0.54%

0.21%

0.4%

0.75%

(86-100)

(0-6)

(0-5)

(0-2)

(0-3)

(0-2.9)

Hospital Outcome 2004Data from 30 to 32 centresPatients Rx for STEMI

No.

Success

Partial

Success

Repeat

PCI

CABG

re-MI

Death

(Range)

Primary

PTCA

1146

87.2%

(0-100)

4.2%

(0-17)

1.1%

(0-20)

3.5%

(0-100)

0.6%

(0-6)

2.6%

(0-13)

Rescue

PTCA

984

89%

(50-100)

6.9%

(0-96)

0.7%

(0-6.7)

0.5%

(0-7.7)

0 %

3.5%

(0-50)

Re-MI

PTCA

414

91.3%

(67-100)

1.8%

(0-15)

2.1%

(0-50)

0.34%

(0-7)

0%

3.8%

(0-20)

Shock

259

67.3%

(0-100)

7.1%

(0-50)

1.5%

(0-14)

1.1%

(0-14)

1.0%

(0-20)

34.0%

(0-100)

Summary: In Hospital MortalityRisk Stratified by Syndrome(Data from approx 43,000 patients)

In Hospital Mortality by Syndrome(Data from approx 43,000 patients)

Emergency CABG by Syndrome(Data from approx 43,000 patients)

Late Events post DischargeBCIS - CCAD

BCIS / CCAD projectThe VisionHospital 1Hospital 2Hospital 3Hospital nCCAD ServerencryptionInternetencryptionencryptionencryption..

BCIS / CCAD projectThe VisionHospital 1Hospital 2Hospital 3Hospital nCCAD ServerencryptionInternetencryptionencryptionencryption..Hospital 1 v All OthersHospital 2 v All Others

BCIS / CCAD projectThe VisionCCAD ServerONS trackingCrosslink (NHS No.)BCISSCTSMINAPEP / ICDPacingPatient outcomeAdvanced Analysis

Risk stratifiedAppropriatenessProcessOutcomeDevice monitoringetc.

Publication strategy

Downloading to CCADSeptember 200521 Centres

Birmingham Heartlands HospitalFreeman HospitalGlenfield HospitalJames Cook University HospitalJohn Radcliffe Hospital, OxfordKing Edward VII, MidhurstKings College HospitalLondon Chest HospitalQueen Elizabeth Hospital, BhamRoyal Devon & Exeter HospitalSouthend Hospital

St Bartholomew's HospitalSt Peter's HospitalTorbay HospitalYorkshire Heart CentreBradford Royal infirmaryRoyal BournemouthHemel HempsteadUniversity Hospital WalesHarley Street clinicLondon Bridge Hospital

Some Data to CCADSeptember 2005Total 28 Centres

North Hampshire HospitalSt Thomas' HospitalVictoria HospitalWalsgrave HospitalWythenshawe HospitalHarefield Hospital (imminent)Bristol Royal Infirmary

NO Data to CCADSeptember 200526 Centres

Birmingham City HospitalCastle Hill / Royal Hull HospitalCheltenham General HospitalCity General HospitalDerriford HospitalEastbourne HospitalHammersmith HospitalHeart Hospital (UCLH)

Liverpool CTCManchester Royal New Cross HospitalNorthern General HospitalNorthwick Park HospitalNottingham City HospitalPapworth HospitalRoyal Berkshire and Battle Royal Brompton Hospital

Royal Cornwall HospitalRoyal Free HospitalRoyal Sussex County Sandwell District General Southampton General St George's HospitalSt Mary's HospitalTaunton & SomersetMorriston

Monthly CCAD dataJan 2004 to Sept 2005

Total Data in CCADto Sept 2005

Tracking via CCADData completenessNHS numbersNational Average 63%MINAP 87%SCTS83%

24,073PCI Procedures15,250Successful ONS tracking

Length of follow-up(tracking performed July 2005)Median = 362 days

Survival after Any PCI(tracking performed July 2005)In Hospital :0.61%Subsequent :3.0% Approx 1.7% pa

Survival after Elective PCI(tracking performed July 2005)2005Approx 1 % pa

Survival after PCI for UA / NSTEMIby Procedure Urgencyurgentemergencysalvage(tracking performed July 2005)

No shockshockSurvival after PCIAll Shock(tracking performed July 2005)

Non-STEMISTEMIp

Non-STEMISTEMIp

Non-STEMISTEMIShockSurvival after PCI for ACSSTEMI v NSTEMI / UA v Shock (tracking performed July 2005)

Admission with ACS after PCI(any PCI indication)Patients with an exit diagnosis of ACS(tracking performed July 2005)

Non-STEMISTEMIShockp=n.s.Patients with an exit diagnosis of ACS(tracking performed July 2005)Re-admission with ACS after PCISTEMI v NSTEMI v Shock

Events: death, ACS admission, redo PCI, cardiac surgeryEvent free survival after PCIAll Cases(tracking performed July 2005)87% 1 yr83% 2 yr

Events: death, ACS admission, redo PCI, cardiac surgeryACS: non-STEMIACS: STEMIShockStableEvent free survival after PCI(tracking performed July 2005)

Summary77 PCI centres in UK1050 PCI pmp in UKCath : PCI = 31.3%PCI : CABG = 2.5 : 1MACEStable syndromesmortality 0.24%, CABG 0.25%UA / NSTEMIMortality 0.75%, CABG 0.21%BCIS CCADA new dawn

*Procedural successAll vessels successfully dilated with a residual stenosis