Study reveals wide variation in reperfusion patterns in Europe

Primary PCI usage rates in European countries ranged from just over 20 to nearly 900 procedures per one million inhabitants, according to results of a recent cross-sectional descriptive study.

In the study, researchers from dozens of European institutions aimed to evaluate how PCI is being used to treat STEMI in 37 countries that are part of the European Society of Cardiology. They created data based on estimates for ESC countries with no formal registries in place.

The data were based on aggregated country-level findings for patients who underwent reperfusion therapy during 2010 or 2011.

In addition to information about STEMI reperfusion treatment, the analysis included data on mortality, the numbers of cardiologists and the availability of primary PCI sites in each country.

The number of primary PCI procedures ranged from 23 to 884 per one million inhabitants in the countries across the study group. The most common reperfusion strategy in 33 countries was primary PCI, followed by thrombolysis, which was the dominant strategy in four countries.

The analysis included data on the mean population served by a single primary PCI center offering round-the-clock service, 7 days a week. The range for this outcome was 31,300 inhabitants per center to 6,533,000 inhabitants per center.

A previous survey taken in 2007 sought similar data and included 27 of the countries that participated in the current analysis; major increases in primary PCI use were observed in 13 of the 27 countries.

“Large variations in reperfusion treatment are still present across Europe,” the researchers concluded. “Countries in Eastern and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encouraged.”

Disclosure: The researchers report no relevant financial disclosures.