Why we need a national registry in interventional cardiology

Percutaneous coronary intervention (PCI) is increasingly used in the management of acute coronary syndromes and refractory angina, and technical advances such as drug‐eluting stents (DES) and potent antithrombotic therapies (such as clopidogrel and glycoprotein IIb/IIIa inhibitors) have been heralded as improving long‐term outcomes. Offsetting these advances has been: considerable concern about the safety of DES in regard to late stent thrombosis and antithrombotic drug‐induced bleeding; the rising use of PCI and DES in clinical situations where evidence of efficacy is lacking; preferential use of PCI in low‐risk populations; and limited cost‐effectiveness data comparing PCI with other treatments. There are few contemporary data in Australia on the efficacy, safety and costs of PCI — as used in everyday clinical practice — that matches clinical outcomes with baseline patient characteristics, indications for intervention, coronary anatomy, procedural technique, co‐interventions and site of care. A national registry that prospectively collects standardised data on processes and outcomes of PCI is warranted. This would ensure safe and appropriate evidence‐based use of limited resources in an era of expanding use of PCI in clinical circumstances not tested in randomised trials.