Novel insights into clinical characteristics and in-hospital outcomes of patients undergoing percutaneous coronary intervention in Vietnam

Hoa T T Vu; Hung M Pham; Hoai T T Nguyen; Quang N Nguyen; Loi D Do; Ngoc M Pham; Richard Norman; Rachel R Huxley; Crystal M Y Lee; Christopher M Reid

doi:10.1016/j.ijcha.2020.100626

Novel insights into clinical characteristics and in-hospital outcomes of patients undergoing percutaneous coronary intervention in Vietnam

Int J Cardiol Heart Vasc. 2020 Sep 4:31:100626. doi: 10.1016/j.ijcha.2020.100626. eCollection 2020 Dec.

Authors

Hoa T T Vu^{1

2}, Hung M Pham³, Hoai T T Nguyen³, Quang N Nguyen³, Loi D Do³, Ngoc M Pham^{1

2

4}, Richard Norman¹, Rachel R Huxley^{1

5

6}, Crystal M Y Lee^{1

7

8}, Christopher M Reid¹

Affiliations

¹ School of Public Health, Curtin University, Perth, Australia.
² Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Viet Nam.
³ Vietnam National Heart Institute, Hanoi, Viet Nam.
⁴ Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
⁵ College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
⁶ The George Institute for Global Health, University of New South Wales, Sydney, Australia.
⁷ School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
⁸ Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia.

Abstract

Background: Little is known about percutaneous coronary intervention (PCI) practices and outcomes in low-and middle-income nations, despite its rapid uptake across Asia. For the first time, we report on clinical characteristics and in-hospital outcomes for patients undergoing PCI at a leading cardiac centre in Vietnam.

Methods: Information on characteristics, treatments, and outcomes of patients undergoing PCI was collected into the first PCI registry through direct interviews using a standardised form, medical record abstraction, and reading PCI imaging data on secured disks. Subgroup analysis was also conducted to explore gender differences.

Results: Between September 2017 and May 2018, 1022 patients undergoing PCI were recruited from a total of 1041 procedures. The mean age was 68.3 years and two thirds were male. While 54.4% of patients presented with acute coronary syndromes, the rate of ST-elevation myocardial infarction was 14.5%. The majority of lesions were classified as type B2 and C and the radial artery was the most common access location for PCI (79.2%). The use of drug-eluting stents was universal and the angiographic success rate was 99.4%. Cardiac complications following PCI were rare with the exception of major bleeding (2.0%). Female patients were older with relatively more comorbidities and a higher incidence of major bleeding than males (p < 0.05).

Conclusions: Findings of this study provide an opportunity to benchmark current PCI practices in Vietnam, identify possible care gaps and potentially inform the adoption of treatment guidelines as well as use of prevention strategies.

Keywords: ACC/AHA, American College of Cardiology/American Heart Association; ACS, Acute coronary syndrome; APAC, Asia-Pacific; CABG, Coronary artery bypass grafts; CHD, Coronary heart disease; Clinical characteristic; DAPT, Dual-anti platelet therapy; DES, Drug eluting stent; ECG, Electrocardiogram; GRACE, Global Registry of Acute Coronary Events; MI, Myocardial infarction; NSTEMI, Non-ST-elevation myocardial infraction; Outcomes, Vietnam; PCI, Percutaneous coronary intervention; Percutaneous coronary intervention; STEMI, ST-elevation myocardial infraction; UA, Unstable angina; VNHI, Vietnam National Heart Institute.