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

  • Gwon, Hyeon-Cheol (Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeon, Dong Woon (Division of Cardiology, National Health Insurance Service Ilsan Hospital) ;
  • Kang, Hyun-Jae (Department of Internal Medicine, Seoul National University Hospital) ;
  • Jang, Jae-Sik (Division of Cardiology, Busan Paik Hospital, University of Inje College of Medicine) ;
  • Park, Duk-Woo (Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shin, Dong-Ho (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Moon, Keon-Woong (Division of Cardiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jung-Sun (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Kim, Juhan (Division of Cardiology, Heart Center of Chonnam National University Hospital) ;
  • Bae, Jang-Whan (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Hur, Seung-Ho (Division of Cardiology, Keimyung University Dongsan Medical Center) ;
  • Kim, Byung Ok (Division of Cardiology, Sanggye-Paik Hospital, University of Inje College of Medicine) ;
  • Choi, Donghoon (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Han, Kyoo-Rok (Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center) ;
  • Kim, Hyo-Soo (Department of Internal Medicine, Seoul National University Hospital)
  • Received : 2017.03.31
  • Accepted : 2017.04.18
  • Published : 2017.05.31

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.

Keywords

Acknowledgement

Supported by : Korean Society of Cardiology, Korean Society of Interventional Cardiology

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