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Heart, Lung and Circulation Abstracts S1832008;17S:S1–S209

433Clinical Outcome of Percutaneous Coronary Intervention(PCI) using ≤2.5 mm Drug-Eluting Stents (DES): Insightsfrom the Melbourne Interventional Group (MIG) Registry

William Chan 1,∗, Andrew E. Ajani 2, David J. Clark 3, NickAndrianopoulos 4, Michelle J. Butler 1, Angela Brennan 4,Gishel New 5, James A. Shaw 1, Anthony M. Dart 1,Stephen J. Duffy 1

1 The Alfred Hospital, Melbourne, Victoria, Australia; 2 TheRoyal Melbourne Hospital, Melbourne, Victoria, Australia;3 The Austin Hospital, Heidelberg, Victoria, Australia;4 Monash University, Department of Epidemiology & Preven-tive Medicine, Clayton, Victoria, Australia; 5 Box Hill Hospital,Box Hill, Victoria, Australia

Background: A recent randomised-controlled trial in smallcoronaries suggested superiority of sirolimus-elutingstents (SES) over paclitaxel-eluting stents (PES) in termsof late-luminal loss and target-lesion revascularisation.We aimed to determine clinically driven target-vesselrevascularisation (TVR) and clinical outcome in patientsundergoing PCI with either SES or PES in small vessels.Methods: We analysed outcomes of 1006 consecutivesmall-vessel (stent diameter ≤ 2.5 mm) patient proceduresin the MIG registry (April 2004–October 2006). One thou-sand one hundred and twenty one lesions were treatedwith PES (n = 606) or SES (n = 515).RwtgpsMlbstI2P2l(aCpcP

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434Sequential Performance Monitoring in InterventionalCardiology Applied to a Single Site Database

James Cameron 1,∗, John Rivers 1, Ian Smith 1, KerrieMengersen 2

1 St Andrew’s Medical Institute, Brisbane, QLD, Australia;2 Queensland University of Technology, Brisbane, QLD, Aus-tralia

Background: Cumulative sum (CUSUM) plots are a graph-ical method used to monitor procedure outcomes and canbe designed to promptly identify significant variations inperformance over time. We explored the application ofthese techniques to a prospective percutaneous coronaryintervention (PCI) registry at a single site.Methods: A prospective database of all patients undergo-ing PCI at our institution has been maintained from 2002,including baseline clinical and procedural data, alongwith one and twelve month major adverse cardiac events(MACE), and is the basis of an annual peer-reviewedaudit. We retrospectively applied CUSUMs to proce-dural and patient 1-month outcome data from January2003 to June 2007 (n = 2464) to develop a system for near“real-time” performance monitoring. We plotted higher-frequency aggregated events, including procedural failure(3%), acute post-procedural complications (1.3%), repeatangiography (2.6%) and angioplasty (2.1%), MACE (1.4%)avtoRsgibmafCmmv

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esults: Mean patient age was 65.7 ± 11.2 years and 28.8%ere female. Baseline clinical and procedural characteris-

ics were generally well matched between the PES and SESroups, with similar proportions of diabetics, patients withrior myocardial infarction (MI), concurrent cardiogenichock, and acute coronary syndrome and/or ST-elevation

I as the PCI indication. However, SES patients were moreikely to have dyslipidaemia, chronic renal failure, wereeing treated for in-stent restenosis, and longer meantent length. In contrast, PES patients were more likelyo have a family history of coronary disease, receive GP-Ib/IIIa-inhibitors, and need a stent >20 mm in length or.25 mm diameter. Mean stent diameter was smaller in theES group 2.39 ± 0.13 (mean ± S.D.) than the SES group.44 ± 0.11 mm, p < 0.0001). Twelve-month TVR was simi-ar for PES and SES (8.2% vs. 7.0%, p = 0.45), as was death2.8% vs. 5.1%, p = 0.06), MI (5.4 vs. 5.5%, p = 0.95) and majordverse cardiac events (MACE; 13.5% vs. 14.6%, p = 0.59).onclusion: These data suggest that in a large cohort ofatients with small vessels in real-world practise that thelinical TVR rate is comparable between patients receivingES and SES, with similar overall MACE.

oi:10.1016/j.hlc.2008.05.434

s well as procedural fluoroscopy time for all and indi-idual operators over time. “signal” thresholds were seto detect both a doubling and halving of the odds of anutcome.esults: Performance measures for all operators over the

tudy period were used as the internal benchmark for theroup. Instances of variation in performance were exam-

ned and using individual operator curves were able toe related to differences in individual operator perfor-ance. We are currently exploring risk modelling to be

ble to more accurately identify variation in operator per-ormance.onclusion: CUSUMs allow near “real-time” perfor-ance monitoring. Plots for all and individual operatorsight be helpful in detection of systemic versus individual

ariation.

oi:10.1016/j.hlc.2008.05.435

35esults of a Door to Balloon Time Audit for Patients Hav-

ng a ST Elevation Myocardial Infarction at a Tertiaryustralian Centre

orelle Martin ∗, Omar Farouque, Mark Horrigan, Davidlark, Andrew Tinney, Jayne Dicketts, Monica Nolen, Car-lyn Naismith

Austin Health, Melbourne, Victoria, Australia

ackground: Door to balloon time (DBT) for ST-elevationyocardial infarction (STEMI) patients who receive pri-ary PCI is a key indicator of quality of care. Theational Heart Foundation guidelines recommend a DBT