Korean Circ J.  2017 May;47(3):320-327. 10.4070/kcj.2017.0070.

The Practice Pattern of Percutaneous Coronary Intervention in Korea: Based on Year 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry

Affiliations
  • 1Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea. jdw121620@naver.com
  • 3Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • 4Division of Cardiology, Busan Paik Hospital, University of Inje College of Medicine, Busan, Korea.
  • 5Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 7Division of Cardiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
  • 8Division of Cardiology, Heart Center of Chonnam National University Hospital, Gwangju, Korea.
  • 9Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 10Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • 11Division of Cardiology, Sanggye-Paik Hospital, University of Inje College of Medicine, Seoul, Korea.
  • 12Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Appropriate use criteria (AUC) was developed to improve the quality of percutaneous coronary intervention (PCI). However, these criteria should consider the current practice pattern in the country where they are being applied.
MATERIALS AND METHODS
The algorithm for the Korean PCI practice pattern (KP3) was developed by modifying the United States-derived AUC in expert consensus meetings. KP3 class A was defined as any strategy with evidence from randomized trials that was more conservative for PCI than medical therapy or coronary artery bypass graft (CABG). Class C was defined as any strategy with less evidence from randomized trials and more aggressive for PCI than medical therapy or CABG. Class B was defined as a strategy that was partly class A and partly class C. We applied the KP3 classification system to the Korean PCI registry.
RESULTS
The KP3 class A was noted in 67.7% of patients, class B in 28.8%, and class C in 3.5%. The median proportion of class C cases per center was 2.0%. The distribution of KP3 classes varied significantly depending on clinical and angiographic characteristics. The proportion of KP3 class C cases per center was not significantly dependent on PCI volume, but rather on the percentage of ACS cases in each center.
CONCLUSION
We report the current PCI practice pattern by applying the new KP3 classification in a nationwide PCI registry. The results should be interpreted carefully with due regard for the complex relationships between the determining variables and the healthcare system in Korea.

Keyword

Percutaneous coronary intervention; Appropriateness criteria; Clinical practice

MeSH Terms

Area Under Curve
Classification
Cohort Studies*
Consensus
Coronary Artery Bypass
Delivery of Health Care
Humans
Korea*
Percutaneous Coronary Intervention*
Transplants

Figure

  • Fig. 1 The proportion of class A, B and C cases according to clinical and angiographic variables.

  • Fig. 2 The proportion of class C cases among hospitals. (A) In all hospitals, median proportion was 2.0% (interquartile range 0.5-5.2%), (B) by geographic region.

  • Fig. 3 Determining factors of the proportion of class C in the hospital. (A) Relationship between the proportion of class C cases and the number of PCIs performed in the hospital. (B) Relationship between the proportion of class C cases and the proportion of ACS cases in the hospital. The geographic region of the hospital is indicated as follows; Seoul as an open circle, Gyeonggi province as a gray circle, and other provinces as closed circles. PCI: percutaneous coronary intervention, ACS: acute coronary syndrome.


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The Current Status of Intervention for Intermediate Coronary Stenosis in the Korean Percutaneous Coronary Intervention (K-PCI) Registry
Jin-Ho Kim, Woonggil Choi, Ki-Chang Kim, Chang-Wook Nam, Bum-Kee Hong, June-Hong Kim, Doo Soo Jeon, Jang-Whan Bae, Sang-Hyun Kim, Keon-Woong Moon, Byung-Ryul Cho, Doo Il Kim, Jae-Sik Jang
Korean Circ J. 2019;49(11):1022-1032.    doi: 10.4070/kcj.2019.0074.

The Current Status of Percutaneous Coronary Intervention in Korea: Based on Year 2014 & 2016 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry
Dong-Ho Shin, Hyun-Jae Kang, Jae-Sik Jang, Keon-Woong Moon, Young Bin Song, Duk-Woo Park, Jang-Whan Bae, Juhan Kim, Seung-Ho Hur, Byung Ok Kim, Dong Woon Jeon, Donghoon Choi, Kyoo-Rok Han
Korean Circ J. 2019;49(12):1136-1151.    doi: 10.4070/kcj.2018.0413.

Diffuse Long Coronary Artery Disease is Still an Obstacle for Percutaneous Coronary Intervention in the Second-Generation Drug-Eluting Stent Era?
Pyung Chun Oh, Seung Hwan Han
Korean Circ J. 2019;49(8):721-723.    doi: 10.4070/kcj.2019.0150.


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