Objectives

Aim of the research was to map coronary interventional practice across several European countries in terms of infrastructures and procedural volumes. Average length of stay (LOS) and 30-day mortality rates of in-patients with primary diagnosis of acute myocardial infarction (AMI) were compared.

Methods

Ten countries were included in the analysis: Belgium, France, Germany, Italy, Poland, Spain, Sweden, Switzerland, The Netherlands, and UK.

The following data sources were explored: European Society of Cardiology (ESC) statistics, the European Core Health Indicators (ECHI data tool from the European Commission), EuroStat and the OECD Health Statistics.

Data of the latest comparable year were taken into consideration and numbers were adjusted for population size.

Results

An annual median of 5505 diagnostic heart procedures per million people were reported, ranging from 3324 in Spain to 9392 Germany, with a significant correlation (r = 0.67, p = 0.013) with gross national income (GNI) per capita.

An annual median of 2497 percutaneous coronary interventions (PCIs) per million people were performed, ranging from <1500 in UK and Spain to >3000 in Switzerland and Germany. Correlation with GNI per capita was also significant (r = 0.62, p = 0.014). Number of catheterization laboratories per million people varied from 4.7 in UK to 11.8. Poland had the highest rate primary PCI procedures per million people followed by The Netherlands and Germany (674, 633 and 626, respectively); Spain had the lowest rate (356).

For in-patients with primary diagnosis of AMI, Sweden had the shortest LOS (4.3 days) and the lowest 30-day mortality rate (4.2%) whilst Germany had the longest LOS (10 days) and one of the highest 30-day mortality rates (7.7%).

Conclusions

Data showed variability in coronary interventional practice amongst European countries. Policymakers should be made aware of this heterogeneity and encouraged to develop interventional programs to match the best.