Abstract
Aims The purpose of the Euro Heart Survey Programme of the European Society of Cardiology is to evaluate to which extent clinical practice endorses existing guidelines as well as to identify differences in population profiles, patient management, and outcome across Europe. The current survey focuses on the invasive diagnosis and treatment of patients with established coronary artery disease (CAD). Methods and results Between November 2001 and March 2002, 7769 consecutive patients undergoing invasive evaluation at 130 hospitals (31 countries) were screened for the presence of one or more coronary stenosis .50% in diameter. Patient demographics and comorbidity, clinical presentation, invasive parameters, treatment options, and procedural techniques were prospectively entered in an electronic database (550 variables 3/4 29 per diseased coronary segment). Major adverse cardiac events (MACE) were evaluated at 30 days and 1 year. Out of 5619 patients with angiographically proven coronary stenosis (72% of screened population), 53% presented with stable angina while ST elevation myocardial infarction (STEMI) was the indication for coronary angiography in 16% and non-ST segment elevation myocardial infarction or unstable angina in 30%. Only medical therapy was continued in 21%, whereas mechanical revascularization was performed in the remainder [percutaneous coronary intervention (PCI) in 58% and coronary artery bypass grafting (CABG) in 21%]. Patients referred for PCI were younger, were more active, had a lower risk profile, and had less comorbid conditions. CABG was performed mostly in patients with left main lesions (21%), two- (25%), or three-vessel disease (67%) with 4.1 diseased segments, on average. Single-vessel PCI was performed in 82% of patients with either single- (45%), two- (33%), or three-vessel disease (21%). Stents were used in 75% of attempted lesions, with a large variation between sites. Direct PCI for STEMI was performed in 410 cases, representing 7% of the entire workload in the participating catheterization laboratories. Time delay was within 90 min in 76% of direct PCI cases. In keeping with the recommendations of practice guidelines, the survey identified under-use of adjunctive medication (GP IIb/IIIa receptor blockers, statins, and angiotensin-converting enzyme-inhibitors). Mortality rates at 30 days and 1 year were low in all subgroups. MACE primarily consisted of repeat PCI (12%). Conclusion The current Euro Heart Survey on coronary revascularization was performed in the era of bare metal stenting and provides a global European picture of the invasive approach to patients with CAD. These data will serve as a benchmark for the future evaluation of the impact of drug-eluting stents on the practice of interventional cardiology and bypass surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 1169-1179 |
| Number of pages | 11 |
| Journal | European Heart Journal |
| Volume | 26 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2005 |
Keywords
- CABG
- Coronary angiography
- Coronary artery disease
- PCI
- Practice survey
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Management and outcome of patients with established coronary artery disease : The Euro Heart Survey on coronary revascularization. / Lenzen, M. J.; Boersma, Eric; Bertrand, M. E. et al.
In: European Heart Journal, Vol. 26, No. 12, 2005, p. 1169-1179.Research output: Contribution to journal › Review article › peer-review
TY - JOUR
T1 - Management and outcome of patients with established coronary artery disease
T2 - The Euro Heart Survey on coronary revascularization
AU - Lenzen, M. J.
AU - Boersma, Eric
AU - Bertrand, M. E.
AU - Maier, W.
AU - Moris, Cesar
AU - Piscione, Federico
AU - Sechtem, Udo
AU - Stahle, E.
AU - Widimsky, Petr
AU - De Jaegere, P.
AU - Scholte Op Reimer, W. J.M.
AU - Mercado, N.
AU - Wijns, William
AU - Meier, B.
AU - Sergeant, P.
AU - Vos, Jeroen
AU - Unger, F.
AU - Manini, Malika
AU - Bramley, Claire
AU - Laforest, Valérie
AU - Taylor, Charles
AU - Del Gaiso, Susan
AU - Huber, Kurt
AU - De Backer, Guy
AU - Sirakova, Vera
AU - Cerbak, Roman
AU - Thayssen, Per
AU - Lehto, Seppo
AU - Blanc, Jean Jacques
AU - Delahaye, François
AU - Kobulia, Bondo
AU - Zeymer, Uwe
AU - Cokkinos, Dennis
AU - Karlocai, Kristof
AU - Graham, Ian
AU - Shelley, Emer
AU - Behar, Shlomo
AU - Maggioni, Aldo
AU - Grabauskiene, Virginija
AU - Deckers, Jaap
AU - Asmussen, Inger
AU - Stepinska, Janina
AU - Gonçalves, Lino
AU - Mareev, Vyacheslav
AU - Riecansky, Igor
AU - Kenda, Miran F.
AU - Alonso, Angeles
AU - Lopez-Sendon, José Luis
AU - Rosengren, Annika
AU - Buser, Peter
AU - Okay, Tugrul
AU - Sychov, Oleg
AU - Fox, Kevin
AU - Wood, David
AU - Crijns, Harry
AU - Fox, Kim
AU - McGregor, Keith
AU - Mulder, Barbara
AU - Priori, Sylvia
AU - Rydén, Lars
AU - Tavazzi, Luigi
AU - Vahanian, Alec
AU - Vardas, Panos
AU - Sarkisyan, Karine
AU - Glogar, H. D.
AU - Derntl, Michael
AU - Frick, Matthias
AU - Pachinger, O.
AU - Zwick, Ralf
AU - Vrints, Christiaan
AU - Van Hertbruggen, Els
AU - Vercammen, Marc
AU - Sysmans, Tineke
AU - Schroeder, E.
AU - Domange, Juliette
AU - De Pril, Hilde
AU - De Vriese, Johan
AU - Van Hecke, Tonny
AU - Legrand, V.
AU - Gillon, Marie France
AU - Richardy, Michel
AU - Doneux, P.
AU - Petrov, Ivo
AU - Jorgova, J.
AU - Starcevic, Boris
AU - Eeckhout, Eric
AU - Berger, Alexandre
AU - Prudent, Veronique
AU - Camenzind, E.
AU - Masson, Nicolas
AU - Zambartas, Costas
AU - Kleanthous, Helen
AU - Stellova, Blanka
AU - Aschermann, Michael
AU - Simek, Stanislav
AU - Kautzner, J.
AU - Karmazin, Vladimir
AU - Svab, P.
AU - Indrak, Jan
AU - Branny, M.
AU - Hladilova, Kveta
AU - Kala, P.
AU - Cappelen, Helle
AU - Jensen, Lisette Okkels
AU - Gitt, A.
AU - Gehrke, Konstanze
AU - Erbel, R.
AU - Gutersohn, Achim
AU - Eggebrecht, Holger
AU - Al Khani, Murad
AU - Rosenberger, Antje
AU - Vogelsberg, Holger
AU - Klepzig, H.
AU - Schmidt, Arnold
AU - Silber, Sigmund
AU - Mau, Birgit
AU - Leuner, Christian
AU - Czyborra, Karen
AU - Reuschling, Christina
AU - Muno, Eva
AU - Kleber, F.
AU - Rux, Sascha
AU - Saad, Aly
AU - Ibrahim, B. S.S.
AU - Elabady, Maged
AU - Castro Beiras, A.
AU - Fernandez, Jorge Salgado
AU - Navarro Del Arno, Felipe
AU - Iniguez Romo, A.
AU - Cruz Fernandez, J. M.
AU - Mayoreal, Alejandro Recio
AU - Rebanal, Franciso Javier Rivero
AU - De La Borbolla, Mariano Garcia
AU - Chaparro, Marinela
AU - Brotons, C.
AU - Permanyer Miralda, C.
AU - Vilai Perez, Srta Irma
AU - Fernandez Aviles, F.
AU - De La Fuente Galan, Luis
AU - Vinuela, Paula Tejedor
AU - Malpartida De Torres, F.
AU - Mora, Javier
AU - Rodriguez, Ignacio Santos
AU - Bustamante, Itziar Piedra
AU - Sanchez Fernandez, Pedro L.
AU - Diago Torrent, J. L.
AU - Diez Gil, Jose L.
AU - Perpinan, Javier
AU - Palacios Motilla, V.
AU - Soledad Alcasena Juango, M.
AU - Berjon-Reyero, Jesus
AU - Melgares Moreno, R.
AU - Guerrero, Juan Carlos Fernandez
AU - Savolainen, Kirsti
AU - Nieminen, M. S.
AU - Syvanne, Mikko
AU - Cohen-Solal, A.
AU - Oboa, Antoine Sylvain
AU - Bassand, J. P.
AU - Espinosa, Denis Pales
AU - Jouet, Veronique
AU - Montalescot, G.
AU - Gallois, Vanessa
AU - Daubert, J. C.
AU - Clerc, Jean Michel
AU - Machecourt, Jacques
AU - Cottin, Y.
AU - Walker, D.
AU - Holland, Fhiona
AU - Prosser, Jenni
AU - Muir, Lis
AU - Barber, Kate
AU - Cleland, J. G.F.
AU - Cook, Jocelyn
AU - Chapichadze, Zaza
AU - Christos, Ioannis Skoularigisn Athanasiou
AU - Tsiavou, Nastasia
AU - Chrysohoou, Christina
AU - Manginas, Athanassios
AU - Terrovitis, John
AU - Kanakakis, John
AU - Vavuranakis, Manolis
AU - Drakos, Stavros
AU - Farmakis, Thomas
AU - Samara, C.
AU - Papakosta, Christina
AU - Bourantas, Christos
AU - Michalis, L. K.
AU - Christos, Mpourantas
AU - Foussas, Stefanos
AU - Adamopoulou, Evdokia
AU - Vardas, P. E.
AU - Marketou, Mary
AU - Alotti, N.
AU - Basa, Anna Maria
AU - Vigh, Andras
AU - Preda, Istvan
AU - Csoti, Eva
AU - Keltai, M.
AU - Kerkovits, G.
AU - Hendler, Alberto
AU - Blatt, Alex
AU - Beyar, R.
AU - Shefer, Arie
AU - Halon, David
AU - Bentzvi, Margalait
AU - Avramovitch, Naomi
AU - Bakst, Avinoam
AU - Cafri, Carlos
AU - Grosbard, Aviva
AU - Margolis, Bella
AU - Suleiman, Khalid
AU - Banai, Shmuel
AU - Meerkin, David
AU - Mosseri, Morris
AU - Guita, Pnina
AU - Jabara, Rifat
AU - Jafari, Jamal
AU - Ben Shitrit, Debi
AU - Ghasan,
AU - Salameh,
AU - Brezins, Marc
AU - Van Den Akker-Berman, Lily
AU - Guetta, Victor
AU - Rozenman, Yoseph
AU - Biagini, A.
AU - Berti, Sergio
AU - Ferrero, Massimo
AU - Colombo, A.
AU - Roccaforte, R.
AU - Milici, Caterina
AU - Scarpino, L.
AU - Salvi, A.
AU - Desideri, Alessandro
AU - Sabbadin, Daniela
AU - Galassi, Alfredo
AU - Giuffrida, Giuseppe
AU - Rognoni, Andrea
AU - Vassanelli, Corrado
AU - Paffoni, Paola
AU - Cioppa, Angelo
AU - Rubino, Paolo
AU - De Carlo, Marco
AU - Petronio, Anna Sonia
AU - Naccarella, F.
AU - Saia, Francesco
AU - Marzocchi, Antonio
AU - Maranga, Stefano Sdringola
AU - Presbitero, P.
AU - Valsecchi, Fazya
AU - Esposito, Giovanni
AU - Santini, Napoli M.
AU - Tubaro, Marco
AU - Erglis, A.
AU - Narbute, Inga
AU - Kavoliuniene, Ausra
AU - Zaliunas, R.
AU - Navickas, Ramunas
AU - Luckute, Davia
AU - Subkovas, Eduardas
AU - Wagner, Daniel
AU - Vermeer, F.
AU - Lousberg, Aimee
AU - Fransen, Heidi
AU - Breeman, Arno
AU - Tebbe, Henriette
AU - De Boer, M. J.
AU - Van Der Wal, Metske
AU - Leenders, C. M.
AU - Veerhoek, M. J.
AU - Jansen, Chris
AU - Bijl, M.
AU - Koppelaar, Colinda
AU - Van Den Linden, Den Linden
AU - Brons, R.
AU - Widdershofen, J. W.M.G.
AU - Broers, Herman
AU - Kontny, F.
AU - Jonzon, Marianne
AU - Wodniecki, Jan
AU - Tomasik, Andrzej
AU - Trusz-Gluza, M.
AU - Nowak, Seweryn
AU - Ruzyllo, Witold
AU - Deptuch, Tomasz
AU - Marques, Jorge
AU - Matias, F.
AU - Madeira, H.
AU - Oliveira, Joaquim
AU - Sargento, Luis
AU - Ionac, Adina
AU - Dragulescu, Iosif Stefan
AU - Mut-Vitcu, Bogdan
AU - Maximov, Daniela
AU - Dorobantu, M.
AU - Apetrei, E.
AU - Niculescu, Rodica
AU - Petrescu, Virgil
AU - Bucsa, Adrian
AU - Deleanu, Dan
AU - Benedek, I. S.
AU - Hintea, Theodora
AU - Aronov, D.
AU - Tikhomirova, Elena
AU - Kranjec, I.
AU - Prokselj, Katja
AU - Kanic, Vojko
AU - Sepetoglu, Ahmet
AU - Aytekin, S.
AU - Aytekin, V.
AU - Catakoglu, Alp Burak
AU - Parlar, Hayri
AU - Tufekcioglu, Suavi
AU - Ozyedek, Zeki
AU - Baltali, Mehmet
AU - Kiziltan,
AU - Vukovic, Milan
AU - Neskovic, A. N.
N1 - Publisher Copyright: © The European Society of Cardiology 2005. All rights reserved.
PY - 2005
Y1 - 2005
N2 - Aims The purpose of the Euro Heart Survey Programme of the European Society of Cardiology is to evaluate to which extent clinical practice endorses existing guidelines as well as to identify differences in population profiles, patient management, and outcome across Europe. The current survey focuses on the invasive diagnosis and treatment of patients with established coronary artery disease (CAD). Methods and results Between November 2001 and March 2002, 7769 consecutive patients undergoing invasive evaluation at 130 hospitals (31 countries) were screened for the presence of one or more coronary stenosis .50% in diameter. Patient demographics and comorbidity, clinical presentation, invasive parameters, treatment options, and procedural techniques were prospectively entered in an electronic database (550 variables 3/4 29 per diseased coronary segment). Major adverse cardiac events (MACE) were evaluated at 30 days and 1 year. Out of 5619 patients with angiographically proven coronary stenosis (72% of screened population), 53% presented with stable angina while ST elevation myocardial infarction (STEMI) was the indication for coronary angiography in 16% and non-ST segment elevation myocardial infarction or unstable angina in 30%. Only medical therapy was continued in 21%, whereas mechanical revascularization was performed in the remainder [percutaneous coronary intervention (PCI) in 58% and coronary artery bypass grafting (CABG) in 21%]. Patients referred for PCI were younger, were more active, had a lower risk profile, and had less comorbid conditions. CABG was performed mostly in patients with left main lesions (21%), two- (25%), or three-vessel disease (67%) with 4.1 diseased segments, on average. Single-vessel PCI was performed in 82% of patients with either single- (45%), two- (33%), or three-vessel disease (21%). Stents were used in 75% of attempted lesions, with a large variation between sites. Direct PCI for STEMI was performed in 410 cases, representing 7% of the entire workload in the participating catheterization laboratories. Time delay was within 90 min in 76% of direct PCI cases. In keeping with the recommendations of practice guidelines, the survey identified under-use of adjunctive medication (GP IIb/IIIa receptor blockers, statins, and angiotensin-converting enzyme-inhibitors). Mortality rates at 30 days and 1 year were low in all subgroups. MACE primarily consisted of repeat PCI (12%). Conclusion The current Euro Heart Survey on coronary revascularization was performed in the era of bare metal stenting and provides a global European picture of the invasive approach to patients with CAD. These data will serve as a benchmark for the future evaluation of the impact of drug-eluting stents on the practice of interventional cardiology and bypass surgery.
AB - Aims The purpose of the Euro Heart Survey Programme of the European Society of Cardiology is to evaluate to which extent clinical practice endorses existing guidelines as well as to identify differences in population profiles, patient management, and outcome across Europe. The current survey focuses on the invasive diagnosis and treatment of patients with established coronary artery disease (CAD). Methods and results Between November 2001 and March 2002, 7769 consecutive patients undergoing invasive evaluation at 130 hospitals (31 countries) were screened for the presence of one or more coronary stenosis .50% in diameter. Patient demographics and comorbidity, clinical presentation, invasive parameters, treatment options, and procedural techniques were prospectively entered in an electronic database (550 variables 3/4 29 per diseased coronary segment). Major adverse cardiac events (MACE) were evaluated at 30 days and 1 year. Out of 5619 patients with angiographically proven coronary stenosis (72% of screened population), 53% presented with stable angina while ST elevation myocardial infarction (STEMI) was the indication for coronary angiography in 16% and non-ST segment elevation myocardial infarction or unstable angina in 30%. Only medical therapy was continued in 21%, whereas mechanical revascularization was performed in the remainder [percutaneous coronary intervention (PCI) in 58% and coronary artery bypass grafting (CABG) in 21%]. Patients referred for PCI were younger, were more active, had a lower risk profile, and had less comorbid conditions. CABG was performed mostly in patients with left main lesions (21%), two- (25%), or three-vessel disease (67%) with 4.1 diseased segments, on average. Single-vessel PCI was performed in 82% of patients with either single- (45%), two- (33%), or three-vessel disease (21%). Stents were used in 75% of attempted lesions, with a large variation between sites. Direct PCI for STEMI was performed in 410 cases, representing 7% of the entire workload in the participating catheterization laboratories. Time delay was within 90 min in 76% of direct PCI cases. In keeping with the recommendations of practice guidelines, the survey identified under-use of adjunctive medication (GP IIb/IIIa receptor blockers, statins, and angiotensin-converting enzyme-inhibitors). Mortality rates at 30 days and 1 year were low in all subgroups. MACE primarily consisted of repeat PCI (12%). Conclusion The current Euro Heart Survey on coronary revascularization was performed in the era of bare metal stenting and provides a global European picture of the invasive approach to patients with CAD. These data will serve as a benchmark for the future evaluation of the impact of drug-eluting stents on the practice of interventional cardiology and bypass surgery.
KW - CABG
KW - Coronary angiography
KW - Coronary artery disease
KW - PCI
KW - Practice survey
UR - http://www.scopus.com/inward/record.url?scp=84995360022&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehi238
DO - 10.1093/eurheartj/ehi238
M3 - Review article
C2 - 15802360
AN - SCOPUS:84995360022
SN - 0195-668X
VL - 26
SP - 1169
EP - 1179
JO - European Heart Journal
JF - European Heart Journal
IS - 12
ER -