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Why we need a national registry in interventional cardiology
Author(s) -
Scott Ian A
Publication year - 2008
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2008.tb01989.x
Subject(s) - conventional pci , medicine , percutaneous coronary intervention , interventional cardiology , clopidogrel , antithrombotic , intensive care medicine , clinical trial , psychological intervention , unstable angina , acute coronary syndrome , stent , aspirin , myocardial infarction , cardiology , medical emergency , psychiatry
Percutaneous coronary intervention (PCI) is increasingly used in the management of acute coronary syndromes and refractory angina, and technical advances such as drug‐eluting stents (DES) and potent antithrombotic therapies (such as clopidogrel and glycoprotein IIb/IIIa inhibitors) have been heralded as improving long‐term outcomes. Offsetting these advances has been: considerable concern about the safety of DES in regard to late stent thrombosis and antithrombotic drug‐induced bleeding; the rising use of PCI and DES in clinical situations where evidence of efficacy is lacking; preferential use of PCI in low‐risk populations; and limited cost‐effectiveness data comparing PCI with other treatments. There are few contemporary data in Australia on the efficacy, safety and costs of PCI — as used in everyday clinical practice — that matches clinical outcomes with baseline patient characteristics, indications for intervention, coronary anatomy, procedural technique, co‐interventions and site of care. A national registry that prospectively collects standardised data on processes and outcomes of PCI is warranted. This would ensure safe and appropriate evidence‐based use of limited resources in an era of expanding use of PCI in clinical circumstances not tested in randomised trials.