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Percutaneous coronary intervention

William Hulme, PhD student

Title

Outcomes following percutaneous coronary intervention: an analysis of the British Cardiovascular Intervention Society National Dataset

Project Overview

  • This research involves assessing outcomes following percutaneous coronary intervention (PCI) or ‘stenting’, a procedure where stents are placed within the heart to open up restricted or obstructed arteries to improve blood flow.
  • As PCI practice and patient case-mix has changed dramatically over the last decade there is a need to understand the effect that these many changes have had on patient outcomes, so that opportunities to adapt and optimise practice are not missed.

Start: September 2014

End: August 2017

Funded by: Medical Research Council

Disease Area

Coronary Artery Disease, both acute and stable

Data Source

  • The British Cardiovascular Intervention Society collects anonymised, patient-level information on every PCI performed in the UK for the purposes of audit and clinical research. Between 2006 and 2015 around one million procedures have been captured i this datset and these are available for analysis.

Methodology

  • Standard statistical methods such as survival and regression analyses are useful here but there is ample scope for novel statisical methods to be developed and used. For example, a risk-score decomposition method has been developed to determine the proportion of the overall change in mortality that can be attributed to, say, increases in average patient age or patients with diabetes.

Benefits and Outcomes

Understanding the drivers of mortality changes helps clinicians to identify aspects of procedural care that can be improved. Ultimately this work will feed into national clinical guidelines that inform best-practice.

A suite of related research outputs that inform and educate clinicians and patients regarding PCI practice over the last decade, and how this knowledge can be translated into improvements in patient care.

Early Findings

Mortality outcomes have improved after adjusting for patient case-mix. The improvements are associated primarily with changes in access site practice after the steady national adoption of trans-radial arterial access in favour of trans-femoral.

Researchers involved

Dr Matthew Sperrin

Prof. Mamas Mamas