Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie n H. Mlczoch n W.Klein(+) n P.Probst n F.Leisch n V.Mühlberger Monitor (Auditor)

Österr.Kardiol.Gesellschaft 1990 Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. KardiologieArbeitsgruppe Intervent. Kardiologie

H. MlczochH. Mlczoch W.Klein(+)W.Klein(+) P.ProbstP.Probst F.LeischF.Leisch V.MühlbergerV.Mühlberger

Monitor (Auditor) Report: 2005

European Society of CardiologyEuropean Society of Cardiology WG 10WG 10

AUSTRIA 1990 -2005AUSTRIA 1990 -2005

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 2005 +/- PCI- CENTERS 2005

4 Pediatric 4 Pediatric 31 Adult 31 Adult ((7 7 in Vienna)in Vienna)

Rooms (n=42)Rooms (n=42) (41 PTCA, 1 CAG)(41 PTCA, 1 CAG) http://iik.msig.athttp://iik.msig.at Schwarzach + Neue Wiener Privatklinik are new 2005Schwarzach + Neue Wiener Privatklinik are new 2005

103 parameters were reported 103 parameters were reported by all 31/30 cathlabs 2003/2004by all 31/30 cathlabs 2003/2004

0

20

40

60

80

100

120 10

0,0

0 97

,09

94,1

7 91

,26

88,3

5 85

,44

82,5

2 79

,61

76,7

0 73

,79

70,8

7 67

,96

65,0

5 62

,14

59,2

2 56

,31

53,4

0 50

,49

47,5

7 44

,66

41,7

5 38

,83

35,9

2 33

,01

30,1

0 27

,18

24,2

7 21

,36

18,4

5 15

,53

12,6

2 9,

71

6,8

0

3,8

8

0,9

7

% rückgemeldete Parameter

% d

er H

erzk

ath

ete

rlab

ors

2003 2004

AUSTRIA 2003/2004AUSTRIA 2003/2004

� Angiography 43.644 44.742Angiography 43.644 44.742� PTCA=PCI 15.056 16.738PTCA=PCI 15.056 16.738� stentstent 87% 87% 87%87%� -DES-DES 22%22% 44% 44%� OP-CAD OP-CAD 4.020 4.020 3.762 3.762� OP- valve 1.988 OP- valve 1.988 2.217 2.217


Coronary Angiography Frequency Coronary Angiography Frequency per One Million Inhabitants per One Million Inhabitants

0

2000

4000

6000

8000

10000

1992

1994

1996

1998

2000

2002

2004

AU 8.12

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

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

AU

CH

D

n= 29 centres - Austria 2004; according to incremental PCI/CA % quota (n=)

0

500

1000

1500

2000

2500

3000

3500

4000

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

Zentrums- Nummern 1-29 geordnet nach Größenverhältnis PCI/CA aufsteigend

Ab

solu

te A

nza

hl

CA 2004GESAMT PCI 2004

n= 29 centres - 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

Zentrums-Nummern geordnet nach Größenverhältnis PCI/CA aufsteigend

Pro

zen

twer

t P

CI/

CA

(%

)

PCI/CA 2001PCI/CA 2002

PCI/CA 2003PCI/CA 2004


%-PCI during Diagnostic %-PCI during Diagnostic Angio in Angio in

AustriaAustria//SwitzerlandSwitzerland//EUEU

0

10

20

30

40

50

60

70

80

9019

92

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

AU

CH

EU

%-multivessel PCI %-multivessel PCI AustriaAustria//EUEU

0

2

4

6

8

10

12

14

16

18

20

2002 2003 2004

AUSTRIAEU


Ratio of (CABG-OP+PCI) per Ratio of (CABG-OP+PCI) per Angiography in Angiography in AUAU CHCH DD

41

48

40

50

39

51

39

48

40

51

4047

42,844,9

43,744,9

47,4

44,2

0

10

20

30

40

50

6019

92

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

0,030

0,2

0,4

0,6

0,8

119

92

1994

1996

1998

2000

2002

2004

AU

CH

D

EU


Elective and Overall - Elective and Overall - PCI Hospital-PCI Hospital-Mortality (%) in AustriaMortality (%) in Austria

00,10,20,30,40,50,60,70,80,9

119

92

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Overall

Elective


Ratio of STENTING per PCI Ratio of STENTING per PCI (%) in (%) in AUAU//CHCH//DD

76 79 81 81,6

0

10

20

30

40

50

60

70

80

90

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

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

1,219

92

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

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

12 10,5

18,2

0

5

10

15

20

25

30

35

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004


Infarction as Complication (%) after Infarction as Complication (%) after PCI in PCI in AustriaAustria, , CHCH, , DD, , EUEU

0,850,8

0,3

00,2

0,40,60,8

11,21,4

1,61,8

219

92

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

AU

CH

D

EU

PPCI/PCI % Austria 2004 all Centres

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

PCI for acute Myocardial Infarction PCI for acute Myocardial Infarction (% of (% of total PCI) in total PCI) in AustriaAustria and and SwitzerlandSwitzerland,,EUEU

17

0

2

4

6

8

10

12

14

16

1819

92

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

AU

CH

EU

PCI for acute myocardial PCI for acute myocardial infarction (n) in Austriainfarction (n) in Austria

0

500

1000

1500

2000

2500

1998 1999 2000 2001 2002 2003 2004

PCI MIwith shock

PCI MIwithoutshock


MORTALITY in Austria FOR MORTALITY in Austria FOR PCI DURING ACUTE MIPCI DURING ACUTE MI (%)-(%)-

27

2,5

31

2,8

35

2,6

30

2,1

17

2

17,2

2,2

21,8

1,6

0

5

10

15

20

25

30

35

1998 1999 2000 2001 2002 2003 2004

PCI forMI+Shock

PCI for MIwithoutShock


% GP IIb/IIIa for PCI% GP IIb/IIIa for PCI

0

5

10

15

20

25

1996 1997 1998 1999 2000 2001 2002 2003 2004

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

2001 2002 2003 2004

CH

Austria

D

DRUG ELUTING STENTS (DES) DRUG ELUTING STENTS (DES) in Austria (n)in Austria (n)

0

500

1000

1500

2000

2500

3000

2002 2003 2004

Tacrolimus

Paclitaxel

Sirolimus

other


Puncture site closing devices Puncture site closing devices (% of PCI)(% of PCI)

1923

39,3

0

10

20

30

40

50

60

1998 1999 2000 2001 2002 2003 2004

AU

CH


Brachial Brachial and Radial Approach %and Radial Approach %

0

0,5

1

1,5

2

2,5

3

3,5

1999 2000 2001 2002 2003 2004

AUCH


NEW DEVICES, AustriaNEW DEVICES, Austria

1992

1994

1996

1998

2000

2002

2004

LASER

IVUS

STENT

0

5000

10000

15000 LASER

DCA

ROTABL

IVUS

IIb/IIIa

DES

STENT


NEW DEVICES NEW DEVICES Austria 2002/2003/2004Austria 2002/2003/2004 Brachytherapie 163/101/28Brachytherapie 163/101/28 Ultraschalltherapie 1/0/0Ultraschalltherapie 1/0/0 Gerinnselentferner 148/173/213Gerinnselentferner 148/173/213 Transmyokardialer Laser 16/0/13Transmyokardialer Laser 16/0/13 Spinal Cord Stimulation 4/0/0Spinal Cord Stimulation 4/0/0 Alkoholablation 4/4/6Alkoholablation 4/4/6 Defektverschlüsse 162/243/269Defektverschlüsse 162/243/269 Drug - Eluting - Stents 620/2938/6430Drug - Eluting - Stents 620/2938/6430

NEW DEVICES II NEW DEVICES II Austria 2003/2004Austria 2003/2004

Stammzelltherapie mit Katheter 21/16Stammzelltherapie mit Katheter 21/16 NOGA MappingNOGA Mapping 16/26 16/26 Herzohrverschluss linksHerzohrverschluss links 7/4 7/4 PCI wegen instent-Restenose 737/921PCI wegen instent-Restenose 737/921 Thrombininjektion bei lokaler Thrombininjektion bei lokaler

Gefäßkomplikation 88Gefäßkomplikation 88


Case load per physicianCase load per physician

0

50

100

150

200

250

1998

PC

I

2000

PC

I

2002

PC

I

2004

PC

I

1999

CA

2001

CA

2003

CA

AU

CH


NUMBER OF CENTERS WITH HIGH OR NUMBER OF CENTERS WITH HIGH OR LOW CASE LOAD FOR PCI DURING 2000/04LOW CASE LOAD FOR PCI DURING 2000/04

0

2

4

6

8

10

12

14

16

18

<200 PCI per yearand center

200-400 >400 PCI

AU 2000

CH 2000

AU 2001

AU 2002

AU 2003

AU 2004


NUMBER OF CENTERS WITH HIGH OR NUMBER OF CENTERS WITH HIGH OR LOW CASE LOAD FOR CA DURING 2000/04LOW CASE LOAD FOR CA DURING 2000/04

0

2

4

6

8

10

12

14

<400 CA peryear and

center

400-1000 1000-2000 >2000 CA

AU 2000

CH 2000

AU 2001

AU 2002

AU 2003

AU 2004

Österr.Kardiol.Gesellschaft 1990 Arbeitsgruppe Intervent. Kardiologie n H. Mlczoch n W.Klein(+) n P.Probst n F.Leisch n V.Mühlberger Monitor (Auditor)

Documents

austria n slide

pci slide

n austria

austria slide

austria pci

quota n

n alkoholablation

n schwarzach