On July 2, 2022, at the opening ceremony of the 25th National Interventional Cardiology Forum (CCIF2022), the chairman of the conference, Professor Huo Yong of Peking University First Hospital, released the 2021 coronary heart disease interventional treatment data in mainland China. . Overall, the total number of cases in 2021 is growing steadily. What is important is that while the number of cases is growing, data such as the number of direct PCI cases, drug-coated balloon applications, and NSTE ACS risk stratification are eye-catching, which fully reflects the The development trend of coronary heart disease intervention is good, which has taken an important step for my country to become a world power in PCI intervention.
1. Basic data
The coronary heart disease interventional treatment data in mainland China in 2021 mainly comes from online direct reporting data (855,663 cases) and the additional data after verification by the provincial quality control center (298,454 cases). Therefore, the statistics of mainland China in 2021 are The total number of registered cases of coronary heart disease intervention is 1,164,117. (The data does not include military hospital cases).
Figure 1. The number of PCI treatment cases in mainland China from 2009 to 2021
The growth rate of the number of PCI cases in 2021 is 20.18%. The top five provinces/regions/municipalities in the number of cases are: Shandong Province, Henan Province, Hebei Province, Beijing City, and Guangdong Province.
Figure 2. Growth rate of the number of PCI cases from 2010 to 2021
Table 1. Number of cases in each province/region/municipality (2021)
Note:
1, verified data from the provincial quality control center;
2, Number of cases in Xinjiang Production and Construction Corps Included in the data of the Xinjiang Uygur Autonomous Region
Compared with 2020, the top five increases in the number of cases in each province/region/municipality in 2021 are: Chongqing City, Anhui Province, Sichuan Province, Heilongjiang Province, and Beijing City, and the 2021 data is compared with 2019 The data from 2018 (before the epidemic) is more objective.
Table 2. Increase and decrease in the number of cases in each province/region/municipality (2021 vs 2020)
Note:
1, data reported from the Internet and verified by the provincial quality control center;
2, the number of cases in the Xinjiang Production and Construction Corps is included in the Xinjiang Uyghur Autonomous Region Table 3 in the data
Table 3. Increase and decrease in the number of cases in each province/region/municipality (2021 vs 2019)
2. Quality control indicators
The quality of interventional treatment for patients with coronary heart disease in mainland China in 2021 is mainly determined by the number of stents/balloons used. , utilization rate, proportion of drug-coated balloon usage, surgical approach, mortality, clinical diagnosis of PCI cases, number of PCI cases in STEMI/proportion of direct PCI, NSTE ACS risk stratification percentage and underreporting rate in each province/region/municipality Evaluate along other dimensions.
The average number of stents/drug balloons in 2021 is 1.48. Since 2014, the average number of stents/drug balloons for coronary heart disease intervention in my country has always remained stable below 1.5.
Figure 3. The average number of stents/drug-coated balloons in patients with coronary heart disease in mainland China from 2009 to 2021 (calculated based on 746,295 cases with statistical online reporting data)
In the past three years (2019-2021), the proportion of drug-coated balloons used They were 6.4%, 10.9% and 15% respectively, showing a continuous improvement trend. The application of drug-coated balloons is becoming more and more widespread.
Figure 4. Proportion of DCB and DES use in patients with coronary heart disease in mainland China from 2019 to 2021
Compared with femoral artery approach and other access methods, the radial artery approach has been the more mainstream approach in the past 10 years, among which In 2021, the proportion of radial artery approach was 96.67%, which was slightly higher than last year’s 96.37%.
Figure 5. Interventional surgical approaches for coronary heart disease patients in mainland my country from 2009 to 2021
In terms of surgical mortality, the surgical mortality rate in 2021 was the same as in 2020, at 0.38%. Death levels have continued to remain low since 2009.
Figure 6. Interventional surgery mortality in patients with coronary heart disease in mainland my country from 2009 to 2021
In terms of clinical diagnosis of PCI cases, unstable angina pectoris accounted for the highest proportion, 42.79%; ST segment elevation myocardial infarction accounted for 22.52%; stable angina pectoris accounted for 14.19%; non-ST segment elevation myocardial infarction accounted for 13.20%; suspicious angina pectoris and asymptomatic myocardial ischemia accounted for 5.31% and 1.99% respectively.
Figure 7. Clinical diagnosis of PCI cases in 2021 (calculated based on 746,295 statistical online reported data)
The number of STEMI cases and direct PCI cases in 2021 were 168,068 and 124,161 respectively, and the direct PCI percentage was 73.88%.
Figure 8. Number of STEMI cases and direct PCI cases from 2009 to 2021 (calculated based on 746,295 cases with statistical online reporting data)
Figure 9. Percentage of direct PCI (calculated based on 746,295 cases with statistical online reporting data)
NSTE ACS risk stratification The national average is 11.37%. The top 5 NSTE ACS risk stratification percentages in each province/region/municipality are: Jiangxi Province, Yunnan Province, Guizhou Province, Henan Province, and Shanxi Province.
Table 4. NSTE ACS risk stratification percentage of each province/region/municipality
The underreporting rate of direct online reporting of data in 2021 is 25.64%, which is significantly lower than the previous two years.
Figure 10. The underreporting rate of direct online reporting from 2009 to 2021
Summary
The number of coronary heart disease intervention cases has increased steadily in 2021, and the underreporting rate on the Internet has decreased compared with the previous two years.
The number of stents (balloons) is stably controlled below 1.5, indicating that the indications for interventional treatment and the use of instruments are more reasonable.
The increase in the application proportion of drug-coated balloons and other devices shows that there are now more diversified interventional treatments for coronary heart disease.
During the epidemic, the mortality rate of interventional treatment was still controlled at a low level, and the proportion of emergency PCI in STEMI patients further increased, proving that my country's coronary heart disease intervention system is relatively complete and the advantages of chest pain centers are reflected.
This year’s data has added NSTE ACS risk stratification and other data, which also shows that my country’s coronary heart disease interventional treatment is paying more and more attention to quality improvement, which also puts forward higher requirements for the quality control of chest pain centers.
