Clinical Practice Guidelines-Management
of Percutaneous Coronary
 Intervention (PCI) 2009

Introduction

Cardiovascular disease (CVD) is an important cause of morbidity and mortality in Malaysia. It accounted for about a fifth of the total burden of disease (admissions in government hospitals) in 2000. Coronary artery disease (CAD) and cerebrovascular disease accounted for 50% and 32% of the cardiovascular burden respectively. In 2006, CVD was the commonest cause of deaths in government hospitals accounting for 24.2% of total deaths.

Management of CAD includes aggressive risk factor modification and lifestyle changes, medical therapy and revascularisation procedures. Revascularisation is by percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery.

In Malaysia, there has been an increase in the number of diagnostic and interventional cardiac procedures performed over the last few years. With technical improvement in devices and skills, more complex PCI cases are now being addressed.

The National Cardiovascular Disease (NCVD) - PCI Registry was initiated in 2006 to obtain data and for clinical audit.

The objectives of this clinical practice guideline are to critically evaluate the use of PCI in the management of CAD based on currently available literature. It aims to:

• assist health care providers in clinical decision making regarding the appropriate use of coronary revascularisation procedures
• improve patient outcomes following PCI
• improve the standard of care in patients undergoing PCI

For this purpose, this guideline is divided into 2 parts:

• Part A: The role of PCI in the management of patients with CAD
• Part B: Technical aspects of PCI as a revascularisation strategy Guidelines help in the management of patients. Not all eligible patients will have access to all the recommendations stated in this guideline. Patient care should be individualised and clinical judgement plays an important role in decision making.

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