Complication rates and secondary interventions after coronary procedures in clinical routine: 1-year follow-up based on routine data of a German health insurance company

Complication rates and secondary interventions after coronary procedures in clinical routine: 1-year follow-up based on routine data of a German health insurance company Background: Data on 1-year complication and follow-up intervention rates after coronary angiography (CA) and percutaneous coronary intervention (PCI) in German clinical routine are sparse. This analysis aims to determine these rates. Methods: The analysis uses 2009 AOK claims data. Patients were divided into 3 groups (CA, without cardiac surgery and without acute myocardial infarction (AMI) n=116.071; PCI with stenting, without AMI: n=36.685; PCI with stenting and with AMI: n=32.707). The frequency of the endpoints MACCE (mortality, AMI, stroke, TIA), CABG, PCI and CA was recorded for up to one year. Results: 1-year MACCE rates were 8.1% (CA), 9.9% (PCI without AMI) and 17.9% (PCI with AMI). Quality-relevant follow-up intervention rates in the CA group were 2.5% for CABG (after 31-365 days), 1.7% for PCI within 90 days and 3.5% for follow-up CA within 1 year. In the PCI groups, the frequencies were 1.6% (without AMI) and 2.7% (with AMI) for CABG (after 31-365 days), and 10.2% (without AMI) and 10.1% (with AMI) for PCI after 91-365 days. Conclusion: This is the first cross-sectoral routine analysis of cardiac catheters and sequential events up to one year in Germany. The actual medical care situation revealed information particularly with regard to the second and follow-up inventions, which cannot be derived directly from medical guidelines. Beyond clinical trials, knowledge can be gained which is important both for medicine as well as the politics of health services.