How has PCI grown in China since its introduction in 1985?
Since the introduction of PTCA into China in 1985, with a first report in 1986, there has been exponential growth in annual numbers of PCIs (Figure 1). The expansion and technical evolution of interventional cardiology in China can be roughly divided into three phases. During the first phase, spanning 1985–1996, PCI could only be performed in a few centres by a few cardiologists. According to a national survey, by the Chinese Society of Cardiology, a total of only 6,213 PCI cases had been performed by the end of 1996 in 51 hospitals nationwide with a success rate of 91.9%. Coronary stenting was introduced in 1992 and first reported in 1994.
By 1996, coronary stents had been implanted in 51.3% of patients undergoing PCI in China. The second phase, 1997–2001, saw a rapid growth of PCI in China with a 40% yearly increment in the number of cases. For instance, in 2001, 16,345 PCI cases were performed in 112 hospitals with a success rate of 97% — this number of cases was larger than the combined figures for the previous 15 years. During this time period, stents were implanted in more than 80% of PCI patients. During the third phase, from 2002 until now, the numbers continued to increase. In 2010, more than 290,000 cases were performed in 870 hospitals among 30 provinces.
How are drug-eluting stents being used in China at the moment?
The Cypher stent was introduced in China in 2001. Since then DES penetration rates has rapidly increased. There was a small decrease in the number of DES implanted after WCC, ESC 2006. However, this only lasted for a short period of time. At the moment, the penetration rates of DES are around 90–95% in most of hospitals. Domestically manufactured DES such as Firebird 2, Excel and Partner accounted for 60–70% of all DES used. Imported DES, such as Xience V, Resolute, Cypher, Taxus, etc. accounted for the rest.
What about transcatheter aortic valve implantation (TAVI)?
TAVI has just started in a few centres in China. Recently, the CoreValve was implanted in six cases and Edwards was implanted in only two cases. The wide spreading of TAVI technique will be not possible until the devices are approved by Chinese regulatory authority.
What is your opinion on new imaging technologies (eg, OCT)?
Optical coherence tomography (OCT) is an optical imaging modality that uses near-infrared light to create high-resolution images of coronary arteries. It provides up to 10 times greater resolution than ultrasound (10µm compared with 100µm). It can clearly display the morphology and composition of lesions to identify the vulnerable plaque with thin cap and minor rupture, and assists interventional cardiologists to optimally implant stents from stent placement to follow-up care. In my opinion, OCT is a useful tool in cardiac catheterisation laboratory. At Fu Wai Hospital, it is often used for detecting vulnerable plaque in patients with acute coronary syndrome, optimising stent implantation during procedure and observing the endothelial coverage, intima thickness, thrombosis and stent malapposition during follow-up.
You are the chairman of China Interventional Therapeutics 2012, taking place in Beijing next March. What can delegates expect of this symposium?
CIT, in partnership with TCT, will take place in the China National Convention Center (CHCC) Beijing, from 15–18 March 2012. The delegates will have the chance to celebrate the 10th anniversary of CIT with colleagues from all over the world. More than 5,000 delegates, including 600 international delegates, are expected to attend the meeting. The theme of CIT 2012 is “Clinical Practice and Optimization”. During the four-day meeting, 40 live cases will be transmitted from international and domestic centres. The keynote lecture will be presented at the TCT-CIT Plenary Session. Late-breaking trials, challenging cases and around 900 didactic lectures will be presented. PCR and ESC Working Group on Cardiovascular Surgery, CCT, SOLACI, Angioplasty Summit, CRT, AICT, and NCVH will organise joint programmes at CIT 2011.
The meeting venue, CNCC, is China’s largest and the most modern international conference centre with primary location and completed facilities. I cordially invite everybody to Beijing to attend CIT 2012 in partnership with TCT.
