The Workload of the Interventional Cardiology Centers from Romania: a 2021 Overview and 2014–2021 Trends

This article provides data of the workload of the interventional cardiology centers from Romania during 2021, highlighting the trends in coronary and peripheral interventions between 2014 and 2021^{1,2,3,4,5,6,7}. Members from all interventional cardiology centers from Romania were requested to fill a standardized form about the total number of various procedures performed during 2021. Data was collected at the initiative of the Interventional Cardiology Working Group of Romanian Society of Cardiology.

Table 1 summarizes the data from 2021 provided by 40 public and private interventional cardiology centers from Romania. Currently, there are 40 interventional cardiology centers in Romania, of which 15 are private centers and 25 are public. In 2021, in Romania were 44 interventional cardiologists in training, 133 full interventional cardiologists and 55 functional angiografs. The exact number of full interventional cardiologist is difficult to know because of some interventional cardiologists are working in public and private hospitals, also.

The annual number of PCIs in every interventional cardiology center from Romania is represented in Figure 1. A direct comparison of data from 2014 to 2021 was completed, highlighting the continuous increase of workload of the interventional cardiology centers from Romania until 2021 when we have a clear decrease (Figure 2). In 2021, the number of PCIs increased, approaching the number of the pre-pandemic era. In 2021, in Romania, 19862 PCIs were performed compared to 15879 in 2019, that represent an increase by 25%. The total number of primary PCIs increased in 2021 with 10.8% compared to 2020 (Figure 3).

Figure 1

Total number of PCIs in 2021 in all interventional centers from Romania (PCI: percutaneous coronary intervention)

Figure 2

Total number of percutaneous coronary interventions from 2014 to 2021 in Romania.

Figure 3

Total number of primary PCIs in STEMI patients from 2015 to 2021 in interventional centers from Romania (PCI: percutaneous coronary intervention; STEMI: ST segment elevation myocardial infarction)

Although the total number of peripheral angioplasties doubled from 2014 to 2018, in 2019 there was a decrease in this regard by 13%, further decreasing in 2020 by 38% compared to 2019 (Figure 4). However, in 2021, 1695 peripheral angioplasties were performed, marking a 52% increase.

Figure 4

Total number of peripheral angioplasties from 2014 to 2021 in Romania (only in interventional cardiology centers)

The number of TAVI procedures doubled every year between 2015–2019, and the trend was maintained in 2021 with an increase of 43% compared to 2020 (Figure 5). The number of procedures performed in structural heart diseases increased from 2020 to 2021 by 15.2% (Figure 5).

Figure 5

Total number of TAVI and interventions in SHDs performed from 2017 to 2021 in Romania (TAVI - transcatheter aortic valve implantation, SHDs – structural heart diseases)

There is a continuous need for the implementation of a Mandatory Interventional Cardiology National Registry capable of objectively monitoring these key healthcare services in a standard manner. This national registry can guide further development of interventional cardiology in Romania^1,2,3,4,5,6.