Trends, Characteristics, and Clinical Outcomes of Patients Undergoing Percutaneous Coronary Intervention in Korea between 2011 and 2015

Background and Objectives: We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea. Methods: From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed. Results: The mean age of patients was $64.4{\pm}12.2years$ and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011-2012 and 2014-2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011-2012 and 2014-2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was $1.39{\pm}0.64$. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were $8,628,768{\pm}4,832,075$ and $13,128,158{\pm}9,758,753$ Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%). Conclusions: Appropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.