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

Authors:

Wan Azman Wan Ahmad ,

University Malaya Medical Centre, Kuala Lumpur, MY
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Rosli Mohd Ali,

National Heart Institute, Kuala Lumpur, MY
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Robaayah Zambahari,

National Heart Institute, Kuala Lumpur, MY
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Omar Ismail,

Penang Hospital, Kuala Lumpur, MY
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Lee Chuey Yan,

Sultanah Aminah Hospital, Kuala Lumpur, MY
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Liew Houng Bang,

Queen Elizabeth Hospital, Kuala Lumpur, MY
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Chee Kok Han,

University Malaya Medical Centre, Kuala Lumpur, MY
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Sim Kui Hian

Sarawak General Hospital, Kuala Lumpur, MY
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Abstract

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 pharmacotherapy, 99.5% of all patients received unfractionated heparin, 5% received LMWH prior to intervention, 96% received aspirin and 98% received clopidogrel. Over-all in-hospital mortality and 30 day mortality for the entire cohort was 1.1% and 1.8%, respectively.

Conclusion: A summary of the first nationwide PCI registry has been presented. The subjects were much younger with a high prevalence of cardiovascular risk factors. The majority of cases (90%) were elective procedures with a low TIMI risk index. Mean door-to-balloon time for primary PCI was higher than the recommended guidelines. There was good prescribing of antiplatelets and heparin. Over-all in-hospital and 30 day mortality were comparable to other registries.

How to Cite: Ahmad WAW, Ali RM, Zambahari R, Ismail O, Yan LC, Bang LH, et al.. Highlights of the first Malaysian National Cardiovascular Disease Database (NCVD): Percutaneous Coronary Intervention (PCI) Registry. Global Heart. 2011;6(2):57–61. DOI: http://doi.org/10.1016/j.cvdpc.2011.02.006
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Published on 01 Jun 2011.

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