NIC PTCA Registry - Coronary Data Presentation by Dr. Rabin Chakraborthy

1. Interventional Council of India
Midterm Annual Meeting
2012 - Kochi
Coronary Intervention Data
Year : 2011
Dr. Rabin Chakraborty
S Ramakrishnan

2. Coronary Intervention Data for the year 2011
Total Coronary Intervention 2008 2009 2010 2011
Centers 306 158 251 332
Coronary Intervention 113359 67371 117420 152332

3. Coronary Intervention Data for the year 2011

4. Coronary Intervention Data for the year 2011
Centers Percentage in relation to No. of Procedure
2011 2011 2011
Center % Centers Volume Share
<200 30.4% 101 5.6%
201 to 500 36.14% 120 22.7%
501 to 1000 18.37% 61 25.6%
1001 to 2000 12.95% 43 29.9%
2001> 2.11% 7 16.1%

5. Coronary Intervention Data for the year 2011
Centers with No of PCI per year

6. Coronary Intervention Data for the year 2011
Centers Percentage in relation to No. of Procedure
2009 2010 2010 2011 2011
Center % Center % Centers Centers Centers
%
<200 41.27% 33.73% 85 101 30.4%
201 to 500 34.13% 36.95% 92 120 36.14%
501 to 1000 15.08% 17.27% 45 61 18.37%
1001 to
7.93% 10.44% 25 43 12.95%
2000
2001> 1.58% 1.61% 4 7 2.11%

7. Coronary Intervention Data for the year 2011
Centers Percentage in relation to No. of Procedure
2010 2010 2011 2011
Volume Centers Centers Volume
Share Share
<200 7.99% 85 101 5.6%
201 to 500 25.9% 92 120 22.7%
501 to 1000 26.43% 45 61 25.6%
1001 to 2000 27.58% 25 43 29.9%
2001> 12.1% 4 7 16.1%

8. Coronary Intervention Data for the year 2011
Age Group Data
2008 2009 2010 2011
Less than 40 9% 10.15% 8.80% 13.57%
More than 70 13% 14.87% 11.04% 14.45%

9. Coronary Intervention Data for the year 2011
Gender Data
2008 2009 2010 2011
Male 76% 78% 76.53% 74.06%
Female 24% 22% 23.47% 25.94%

10. Coronary Intervention Data for the year 2011
Cath Labs Across India
Average 1.42 per center
20 Biplane labs
80 centers have dedicated labs for specific
interventions

11. Coronary Intervention Data for the year 2011
Primary PCI

12. Coronary Intervention Data for the year 2011
Primary PCI
Door-Balloon time
Mean – 48.4 min
Range – 12-120 min
During off working hours – 74.14 min

13. Coronary Intervention Data for the year 2011
Radial Approach
2008 2009 2010 2011
Total No. of Radial
24% 25.46% 22.89% 32.47%
Procedures

14. Coronary Intervention Data for the year 2011
Practices in India
Mean % of diagnostic angios done as day
care - 48.97%
49.2% centers admit patients at least a
day prior
Mean % of PCI discharged next day
36.2%
Re-use of interventional material – 93.37%
of centers
– Only 22 centers do not reuse

15. Coronary Intervention Data for the year 2011
Indication for PCI

16. Coronary Intervention Data for the year 2011
Vessels treated
2009 2010 2011
Single Vessel 73.61% 68.40% 66.70%
Multi Vessel 24.56% 29.41% 30.50%
LMCA 0.74% 1.02% 1.24%
Graft
1.09% 1.17% 1.56%
Angioplasty

17. Coronary Intervention Data for the year 2011
Vessels Distribution
2009 2010 2011
LAD 49.86% 49.86% 49.06%
RCA 28.74% 28.54% 28.49%
LCX 20.76% 20.69% 21.47%
LMCA 0.63% 0.88% 0.98%

18. Coronary Intervention Data for the year 2011
Total Stents & DES Used
2008 2009 2010 2011
Total Stents Used 135322 65163 146719 193728
Drug Eluting Stents
69211 41301 90926 156919
(DES)
% of DES in Total
51.14% 63.38% 62.75% 81.1%
Stents

19. Coronary Intervention Data for the year 2011
Total Stents & DES Trends

20. Coronary Intervention Data for the year 2011
Coronary Stents
Product 2011
Medtronic 21.38%
Abbott Vascular 20.74%
Vascular Concepts 14.91%
Merill Life Sciences 10.37%
J&J 6.87%

21. Coronary Intervention Data for the year 2011
Coronary Stents (Contd.,)
Product 2011
Boston Scientific 4.70%
Shajanand 4.18%
ATL Therapeutics 3.96%
Biosensors 3.53%
Excel 2.42%

22. Coronary Intervention Data for the year 2011
Maximum, Most etc. - -
Most selling DES – Resolute
Most selling Non DES - Driver
Most growth of Stents: Meril (more than 300 %)
perhaps the largest growth in world
Most growth in multinationals - Aabott Vascular

23. Coronary Intervention Data for the year 2011
Other Devices Used
2008 2009 2010 2011
Rotablator 381 150 480 498
IVUS 141 52 552 590
Thrombus Extraction
4764 2398 6562 7527
Device
Distal Protection - 557 751 637

24. Coronary Intervention Data for the year 2011
PCI Details
POBA only - 5933
Any GP IIb/IIIa use - 46717
Bivalirudin - 2065
Angioseal like - 1761

25. Coronary Intervention Data for the year 2011
Final Frontiers of PCI
LMCA 1867
Bifurcation PCI (2 Sts) 6432
CTO ?? 3300
– Retrograde CTO 262
SVG & Post CABG 2972
Multi-vessel 58123

26. Coronary Intervention Data for the year 2011
Interventions in Acute MI
2008 2009 2010 2011
Total No. of Primary PCI 10465 5884 14271 20541
% of Total Interventions 9.23% 9.79% 12.15% 13.48%

27. Coronary Intervention Data for the year 2011
In Hospital Events
2008 2009 2010 2011
Death 0.62% 0.54% 0.61% 0.92%

28. Coronary Intervention Data for the year 2011
Conclusions
Coronary interventions are increasing each year.
There is trend of smaller centres coming up across India and
medium volume centres are moving upwards.
Around 45% of procedures are performed by larger volume
centers.
The percentage of interventions in old & younger age group has
increased.
Radial approach had a significant upward trends in last year.

29. Coronary Intervention Data for the year 2011
Conclusions
Percentage of Drug eluting stents has increased in last year. It
could be due to less costlier stents available in the market?.
Percentage of Acute MI interventions has marginally increased..
GP2B 3A Use has decreased significantly.
Use of IVUS/FFR has significantly increased.
All complex procedures have increased
Mortality rate has slightly increased - ?more challenging cases.

30. Coronary Intervention Data for the year 2011
Thank you