Portuguese National Registry of Interventional Cardiology

Abstract

Introduction and objectives: To present the report on the trends in percutaneous coronary activity data in Portugal from the last decade (from 2014 to 2023). Methods: Data were extracted from the Portuguese National Registry of Interventional Cardiology (RNCI) and the numbers in recent years were compared and complemented by information from the 2023 European Society of Cardiology Atlas in Interventional Cardiology (IC) survey, which was administered to the director of every IC department. Linear regression analysis was used to assess trends in activity over time. Results: From 2014 to 2023, there were 160 101 percutaneous coronary interventions reported in the RNCI. The number of annual PCI in the last decade remained constant (1360/million inhabitants in 2014 to 1322/million in 2023; R2=0.039, p=0.276). Importantly, there was a 22% increase in primary PCI (306/million inhabitants in 2014 to 374/million inhabitants in 2023; R2=0.759, p<0.001) and there was a decrease in the geographical disparities in primary PCI across Portugal. The following PCI trends were noted: a 43% increase in PCI performed by radial access (57.4% in 2014 to 82.1% in 2023; R2=0.908, p<0.001), a 27% increase in drug-eluting stents (78.4% in 2014 to 99.2% of all PCI with stents in 2023; R2=0.638, p=0.003), and a 47% decrease of thrombectomy in primary PCI (35.0% in 2014 to 18.6% in 2023; R2=0.649, p=0.003). There was a slight increase in the use of intracoronary diagnostic devices during PCI, with intravascular imaging and physiological assessments reaching 7.6% and 4.2%, respectively, in 2023. Conclusion: The RNCI was able to depict changes in our practice along the study period. The annual PCI volume per million inhabitants remained stable, driven by an increase in primary PCI offset by a decrease in chronic coronary syndrome indications. The geographical asymmetries were markedly reduced due to the expansion on PCI capable centers, enabling a progress towards a more universal access to percutaneous coronary techniques.