The document summarizes coronary and non-coronary intervention data from 2013 in India. Key findings include: coronary interventions increased to over 216,000, with drug-eluting stents comprising 78% of stents used. Primary PCI for acute MIs rose to over 24,000 cases. Non-coronary interventions included over 5,000 peripheral, 13,000 valve, and 7,700 structural heart procedures. The data highlights growth in interventional cardiology in India but notes the need for a national prospective registry to improve data collection.

1. Interventional Council of India
Midterm Annual Meeting
2014 - Kochi
Coronary & Non Coronary Intervention Data
Year : 2013
Dr. Praveen Chandra
Chairman
National Interventional Council

2. Total Coronary Intervention 2010 2011 2012 2013
Centers 251 332 369 404
Coronary Intervention 117420 152332 177240 216817
Coronary Intervention Data for the year 2013

3. Cath Labs Across India
Average 1.23 per center
52 Biplane labs
134 centers have dedicated labs for specific
interventions
143
83
0
40
80
120
160
200
FFR
IVUS
Rota
Coronary Intervention Data for the year 2013

4. 0
40000
80000
120000
160000
200000
240000
2006 2007 2008 2009 2010 2011 2012 2013
Coronary Interventions
Coronary Intervention Data for the year 2013

5. 0
10
20
30
40
<200
200 - 500
500-1000
1000-2000
>2000
26.41
37.69
29.05
26.78
2.82
3.16
23.67
29.05
26.78
17.34
Percentage Volume share
Coronary Intervention Data for the year 2013
Centers with No of PCI per year

6. Centers Percentage in relation to No. of Procedure
Volume
Share
2012
Centers
Volume
Share
2013
Centers
No’s
2013
Centers %
2013
Volume %
<200 4.9% 107 26.41% 3.16%
201 to 500 19.4% 152 37.69% 23.67%
501 to 1000 25.9% 90 22.31% 29.05%
1001 to 2000 32.3% 43 10.77% 26.78%
2001> 17.5% 12 2.82% 17.34%
Coronary Intervention Data for the year 2013

7. Coronary Intervention Data for the year 2013
Practices in India
Mean % of diagnostic angios done as day
care – 60.05%
46% centers admit patients at least a day
prior
Mean % of PCI discharged next day
40.57%
Re-use of interventional material – 92.74%
of centers
– Only 27 centers do not reuse

8. Age Group Data
2010 2011 2012 2013
Less than 40 years 8.80% 13.57% 14.17% 11.21%
More than 70 years 11.04% 14.45% 15.59% 13.17%
Coronary Intervention Data for the year 2013
0.00%
4.00%
8.00%
12.00%
16.00%
20.00%
Less than 40 More than 70
2009
2010
2011
2012
2013
More than 80 years age: 6004 (4.61%)

9. Gender Data
2010 2011 2012 2013
Male 76.53% 74.06% 73.05% 74.71%
Female 23.47% 25.94% 26.95% 25.29%
Coronary Intervention Data for the year 2013

10. 2010 2011 2012 2013
Total No. of Radial
Procedures
22.89% 32.47% 45.96% 46.61%
Radial Approach
Coronary Intervention Data for the year 2013
0
20
40
60
2009 2010 2011 2012 2013
% Radial PCI

11. Coronary Intervention Data for the year 2013
30.19
26.08
18.77
20.28
4.68
Post MI
USA
CSA
Primary
Others
Indication for PCI

12. Vessels treated
2010 2011 2012 2013
Single Vessel 68.40% 66.70% 67.19% 66.74%
Multi Vessel 29.41% 30.50% 29.80% 30.04%
LMCA 1.02% 1.24% 1.33% 1.35%
Graft
Angioplasty
1.17% 1.56% 1.68% 1.87%
Coronary Intervention Data for the year 2013

13. Vessels Distribution
2011 2012 2013
LAD 49.06% 49.31% 49.74%
RCA 28.49% 28.47% 29.81%
LCX 21.47% 20.88% 19.15%
LMCA 0.98% 1.33% 1.30%
Coronary Intervention Data for the year 2013

14. PCI Details
Coronary Intervention Data for the year 2013
POBA only - 6547
Any GP IIb/IIIa use - 25160
Bivalirudin - 2511
Angioseal like - 987

15. Other Devices Used
2010 2011 2012 2013
Rotablator 480 498 478 717
IVUS 552 590 545 715
Thrombus Extraction
Device
6562 7527 7889 8523
FFR - - 1962 3373
Coronary Intervention Data for the year 2013

16. Antiplatelets
Coronary Intervention Data for the year 2013
Clopidogrel,
74.11%
Prasugrel,
15.91%
Ticagrelar,
9.98%
Clopidogrel
Prasugrel
Ticagrelar

17. 2010 2011 2012 2013
(N: 246)
Total No. of Primary PCI 14271 20541 21343 24375
% of Total Interventions 12.15% 13.48% 12.04% 17.04%
Interventions in Acute MI
Coronary Intervention Data for the year 2013
0
10000
20000
30000
2009 2010 2011 2012 2013
Primary PCI

18. Primary PCI
Coronary Intervention Data for the year 2013
Not offer
Working hours
Round the clock

19. Primary PCI
Door-Balloon time
Mean – 45 min
Range – 15-150 min
During off working hours – 60 min
Coronary Intervention Data for the year 2013

20. Source of funding
Coronary Intervention Data for the year 2013
Government,
45.34
Private
Insurance,
14.91
Own
spending,
39.75
Government
Private Insurance
Own spending

21. 2010
(N=251)
2011
(N=332)
2012
(N=369)
2013
(N=402)
Total Stents Used 146719 193728 215662 262349
Drug Eluting Stents
(DES)
90926 156919 160668 205419
% of DES in Total
Stents
62.75% 81.1% 74.5% 78.30%
Total Stents & DES Used
Coronary Intervention Data for the year 2013
Bio Absorbable Stents 2013– 3.23%
(Approx. 8500 stents)

22. Total Stents & DES Trends
Coronary Intervention Data for the year 2013
0
50000
100000
150000
200000
250000
300000
2007 2008 2009 2010 2011 2012 2013
Total No. of Stents
No. of DES

23. Company 2013
Abbott Vascular 28.41%
Medtronic 22.46%
Meril Life Sciences 11.90%
Vascular Concepts 8.46%
Boston Scientific 8.34%
Sahajanand 5.10%
Coronary Stents
Coronary Intervention Data for the year 2013

24. Company 2013
ATL Therapeutics 3.47%
Biosensors 1.68%
Others (Vasmed, relisys, Choksy, MIC,
Lancer, Cordis, B Braun, Optocircuit,
IBM, Biotronik, Heartbeat etc.
10.18%
Coronary Stents (Contd.,)
Coronary Intervention Data for the year 2013

25. Balloon & Wires. - -
Balloons
– Spinter
– Sapphire
– Maverik
– Voyager
Coronary Intervention Data for the year 2013
Guidewires
– BMW
– Galeo
– CougarXT
– All star
– Rinato

26. In Hospital Events
2010 2011 2012 2013
Death 0.61% 0.92% 0.91% 0.89%
Coronary Intervention Data for the year 2013
0
0.2
0.4
0.6
0.8
1
2009 2010 2011 2012 2013
In Hospital mortality

27. Coronary Intervention Data for the year 2013
In Hospital Events
2013
Emergency CABG 0.13%
In-hospital Q MI 0.91%
Ac Renal failure 3.20%
Major Bleeding 2.63%

28. Peripheral Interventions
2011 2012 2013
Renal 3393 2510 1976
Carotid 1165 740 1346
Stent graft 171 162 161
Peripheral/Others 1641 2662 2302
Total 6370 6074 5785
Non-Coronary Intervention Data - 2013

29. Valve Interventions
2011 2012 2013
PTMC 13872 12013 11341
PVBD 1210 1088 1238
AVBD 695 658 565
TVBD 71 98 67
Total 15848 13857 13211
Non-Coronary Intervention Data - 2013

30. Structural Heart - Interventions
2011 2012 2013
PDA Device
closure
2390 2366 3066
ASD Device
closure
1927 2507 3676
VSD Device
closure
620 611 927
Post MI & others 121 64 67
Total 5058 5548 7736
Non-Coronary Intervention Data - 2013

31. Other Non-Coronary Interventions
2011 2012 2013
Peripheral 6370 6074 5785
Valve 15848 13857 13211
Structural Heart 5058 5548 7736
Others 1041 1369 1523
Total 28317 26848 28255
Non-Coronary Intervention Data - 2013

32. Neonatal Interventions
2013
BAS 107
AVBD 140
PVBD 331
CoA dilatation 191
Pulmonary Valve Perforations 14
PDA Stenting 41
Others 23
Pediatric Intervention Data - 2013

33. Device Therapies
ASD 2485
VSD Muscular 216
VSD Perimembranous 572
VSD residual 42
PDA 2556
RSOV 120
AP Window 34
Paravalvular Leak 20
BT Shunt 13
Large Collaterals 232
Others 39
Pediatric Intervention Data - 2013

34. Balloon Therapies
AVBD(BAV) 416
PVBD(BPV) 909
PV Perforation-PVBD 14
PTMC(BMV) 5120
COA dilatation 321
PTA 785
Renal Angioplasty in Children 77
Coronary intervention in children 12
Obstructed TAPVC 2
BAS in infants and older children 53
Others 23
Pediatric Intervention Data - 2013

35. Procedures
Single Chamber Pacemaker 8859
Dual Chamber Pacemaker 6020
CRT-P 542
CRT-D 580
EpiCardial Pacemaker 102
EpiCardial LV Lead Implantation 55
Lead Extraction 116
EP Intervention Data - 2013

36. Realty Check : NIC vs Industry Data
Coronary Intervention Data for the year 2013
Total 2013
(NIC)
2013
(INDUSTRY)
No. of Hospitals with Cath Lab 404 800
PTCA 216517 2,30,000
Stent 2,62,349 3,43,300
As per the list of Cath Labs available, only 50% of the centres has
provided the data for the registry.
The need of the hour is that we look for a National Data Registry
Across India.

37. Company NIC INDUSTRY
Abbott Vascular 28.41% 32%
Medtronic 22.46% 21%
Meril Life Sciences 11.90% 11%
Vascular Concepts 8.46% 9%
Boston Scientific 8.34% 9%
Sahajanand 5.10% 4%
ATL Therapeutics 3.47% 8%
Biosensors 1.68% 2%
Others (Vasmed, relisys,
Choksy, MIC, Lancer, Cordis, B
Braun, Optocircuit, IBM,
Biotronik, Heartbeat etc.
10.18% 4%
Realty Check : NIC vs Industry Data
Coronary Intervention Data for the year 2013

38. Conclusions
Coronary interventions are increasing each year.
There is trend of smaller centres coming up across India and
medium volume centres are moving upwards.
Still 44% of Total reported Angioplasty are beind done by 54
centres (13.6%).
Against the trend of last few years, the percentage of interventions
in old & younger age group has decreased in previous year.
Radial approach did not have any significant upward trends in last
year. Some of the centers have reported extensive ulnar approch
for interventions.
Coronary Intervention Data for the year 2013

39. Conclusions
Percentage of Drug eluting stents has increased in the last year.
Use of Fully Bioresorbable Scaffold (BVS) was seen.
Percentage of Acute MI interventions has marginally decreased.
GP2B 3A use has decreased significantly.
Use of FFR has significantly increased.
All complex procedures have increased.
Complications rate has slightly decreased.
Coronary Intervention Data for the year 2013

40. So finally its High time that we start our
National Prospective Registry.

41. Thank you
Coronary Intervention Data for the year 2013
On Behalf of NIC, I would like to thanks
JVS Group
for running the NIC Registry for 2013 successfully.