Analiza intervencijskih kardioloških zahvata u Hrvatskoj od 2010. do 2014. godine: ususret uvođenju nacionalnog registra. ; An Analysis of Cardiologic Interventional Procedures in Croatia between 2010 and 2014: Towards the Establishment of a National Registry
Iako intervencijska kardiologija u Hrvatskoj unatrag dvaju desetljeća bilježi napredak, ne nalazimo analizu broja intervencijskih kardioloških zahvata na nacionalnoj razini. Cilj je rada bila analiza broja koronarnih angiografija (CA) i perkutanih koronarnih intervencija (PCI) u razdoblju od 2010. do 2014. godine. Analizirani su dijagnostičko-terapijski postupci iz računa hospitaliziranih bolesnika u Hrvatskoj koji se odnose na CA i PCI u 13 hrvatskih centara. U promatranom je razdoblju prosječna stopa CA bila 4390 na milijun stanovnika godišnje uz porast od 8,5 % u promatranom razdoblju. Prosječna stopa PCI-ja bila je 2208 uz porast od 15 %. Omjer PCI/CA porastao je s 0,48 na 0,52. Od 47 470 PCI-ja učinjenih u Hrvatskoj od 2010. do 2014. godine 18,6 % učinjeno je u Klinici za kardiovaskularne bolesti Magdalena, 13,8 % u Kliničkom bolničkom centru (KBC) Zagreb, 11,9 % u KBC-u Rijeka i 11,3 % u Kliničkojbolnici Dubrava, dok su ostali centri imali udjele manje od 10 %. Prema broju PCI-ja, sedam hrvatskihcentara (54 %) ubrajamo u velike centre, a četiri (30,7 %) među srednje velike centre. Opća bolnica Dubrovnikod 2013. godine ima dovoljan godišnji broj PCI-ja (> 200), dok Opća bolnica Karlovac radi samo CA. Rezultati upućuju na izniman uspjeh hrvatske intervencijske kardiologije u zadnja dva desetljeća. Hrvatska je 2010. godine imala višu stopu PCI-ja od prosjeka članica Organizacije za ekonomsku suradnju i razvoj (OECD) i 21 zemlje članice Europske unije i veći prosječan godišnji rast (26,8 %) od svih analiziranih zemlja, osim Rumunjske. Stopa PCI-ja bila je viša od većine europskih zemalja, osim Njemačke, Belgije, Austrije i Norveške. Za daljnju analizu uspješnosti intervencijskih zahvata i planiranje daljnjeg razvoja nužno je formiranje unificiranoga Hrvatskog registra kardioloških procedura. ; Although there has been progress in interventional cardiology in Croatia over the last two decades, there has been no analysis of interventional cardiologic procedures at the national level. The aim of this article was to analyze of the number of coronary angiographies (CA) and percutaneous coronary interventions (PCI) in the period from 2010 to 2014. Diagnostic and treatment procedures were analyzed based on the CA and PCI hospital claims of Croatian patients in 13 Croatian centers. The average rate of CA in the observed period was 4 390 per million population annually, with a growth of 8.5% over the observed period. The average rate of PCI was 2 208 with an increase of 15%. The PCI/CA ratio grew from 0.48 to 0.52. Of the 47 470 PCI procedures performed in Croatia between 2010 and 2014, 18.6% were performed in the Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, 13.8% in the University Hospital Centre Zagreb, 11.9% in the University Hospital Centre Rijeka, and 11.3% in the University Hospital Dubrava, while other centers had shares below 10%. Based on PCI numbers, 7 Croatian centers (54%) can be classified as high volume centers, and 4 (30.7%) as medium volume centers. The Dubrovnik General Hospital since 2013 had a sufficient annual number of PCIs (>200), while the Karlovac General Hospital only performed CA. Results indicate that Croatian interventional cardiology has achieved a great success over the last two decades: in 2010, Croatia already had an above average rate of PCIs compared with the Organization for Economic Co-operation and Development and 21 countries of the European Union, as well as a larger annual growth (26.8%) than all analyzed countries except Romania. PCI rates were higher than most European countries except Germany, Belgium, Austria, and Norway. Further analysis of the success of interventional procedures and further development plans require the formation of a unified Croatian Registry of Cardiologic Procedures.