Han Seungbong, Park Gyung Min, Kim Yong Giun, Park Mahn Won, Her Sung Ho, Lee Seung Whan, Kim Young Hak
Department of Applied Statistics, Gachon University, Seongnam, Korea.
Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Korean Circ J. 2018 Apr;48(4):310-321. doi: 10.4070/kcj.2017.0359.
We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea.
From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed.
The mean age of patients was 64.4±12.2 years and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011-2012 and 2014-2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011-2012 and 2014-2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were 8,628,768±4,832,075 and 13,128,158±9,758,753 Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%).
Appropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.
我们试图评估韩国接受经皮冠状动脉介入治疗（PCI）患者的全国性趋势、特征及临床结局。
从韩国国民健康保险理赔数据中，纳入2011年至2015年间因首次发作冠状动脉疾病而接受PCI的81115例患者。将患者分为心绞痛组（n = 49288）和急性心肌梗死组（AMI，n = 31887）并进行分析。
患者的平均年龄为64.4±12.2岁，男性有56576例（69.7%）。分别有27086例（33.4%）、30675例（37.8%）和45389例（56.0%）患者患有糖尿病、高脂血症和高血压。2011 - 2012年至2014 - 2015年间，因心绞痛接受PCI的患者数量增加了10%（11105例对13261例；p = 0.021）。然而，2011 - 2012年至2014 - 2015年间，因AMI接受PCI的患者数量略有下降（8068例对7823例；p = 0.052）。在手术中，药物洗脱支架是最常用的器械（93.2%），其次是球囊血管成形术（5.5%）和裸金属支架（1.3%）。每位患者的平均支架数量为1.39±0.64。出院时，分别有76292例（94.1%）、71411例（88.0%）、57429例（70.8%）和54418例（67.1%）患者接受了双联抗血小板治疗、他汀类药物、β受体阻滞剂以及血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂治疗。住院期间和1年的平均总医疗费用分别为8628768±4832075韩元及13128158±9758753韩元。2094例患者（2.6%）发生了住院死亡。
韩国需要制定反映PCI趋势、特征及临床结局的适当医疗保健策略。
