Trends in percutaneous coronary intervention and angiography in Ireland, 2004–2011: Implications for Ireland and Europe

• Routine hospital statistics and surveys in public & private sectors were analysed.
• Crude rates of angiography and PCI increased in Ireland between 2004 and 2011.
• Age standardised PCI rates decreased. PCI: angiography ratio decreased.
• PCI in public sector was performed predominantly for stable disease (54%) in 2011.
• One third of cardiac interventions go unrecorded as undertaken by private sector.

Background/objectivesTo study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004–2011.MethodsTwo data sources were used: a) a survey of publicly and privately funded hospitals with cardiac catheter laboratories to obtain the annual number of procedures performed and b) anonymised data from the Hospital In-Patient Enquiry (HIPE) for angiography and PCI in acute publicly funded hospitals; age standardised rates were calculated to study trends over time.ResultsFrom 2004 to 2011 the crude rate of angiography and PCI increased by 47.8% and 35.9% respectively, with rates of 6689 and 1825 per million population in 2011. Following age standardisation, however, PCI activity showed a non-significant decrease over time. The PCI to angiography ratio decreased from 30% to 27% and PCI was performed predominantly for stable coronary heart disease (54%) in 2011.ConclusionAngiography and PCI rates have increased in Ireland but PCI crude and age adjusted rates show divergent trends. While Ireland differs from USA and UK, with a higher proportion of PCI being performed for stable CHD in recent years, little systematic surveillance of cardiological interventions within Europe is available to benchmark improvements in Ireland.