An analysis presented at the EAPCI Summit 2026 suggests that an increase in primary percutaneous coronary interventions (PCI) across Europe has not led to a corresponding decrease in heart attack mortality rates. The summit, organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), brought together experts to discuss recent findings on cardiovascular care.
Primary PCI is a medical procedure aimed at quickly restoring blood flow following a heart attack by unblocking coronary arteries, often using stents inserted through catheters.
Ali Malik from King's College London, who presented the study, explained that researchers are continuing to analyze data regarding the impact of primary PCI procedures in Europe. "It is well established that primary PCI plays a pivotal role in reducing mortality after MI; however, significant variability exists at local, national and regional levels in the provision of primary PCI and associated patient outcomes," he stated.
The research team used information from several sources, including the ESC Atlas of Cardiology and Interventional Cardiology, as well as datasets from the World Health Organization, Institute for Health Metrics and Evaluation, and Eurostat. Data covered 21 European countries and included statistics on disease burden, risk factors, management practices, and economic indicators such as gross domestic product (GDP) per capita.
Analysis showed that countries with higher GDP per capita tended to have lower age-standardised mortality rates from myocardial infarction (MI), with a moderate inverse correlation (correlation coefficient=−0.54; p=0.004). In contrast, greater prevalence of cardiovascular disease was linked to higher MI mortality rates (correlation coefficient=+0.45; p=0.02).
When adjusting for both GDP per capita and CVD prevalence, results indicated a moderate positive correlation between higher rates of primary PCI procedures and increased age-standardised MI mortality (correlation coefficient=+0.68; p<0.001).
A weak inverse relationship was also observed: more primary PCI procedures performed per interventional cardiologist were associated with slightly lower MI mortality rates (correlation coefficient=−0.27; p=0.23).
Doctor Sanjay Sivalokanathan from Mount Sinai Health System in New York commented on these findings: "The global rise in cardiometabolic risk factors appears to play a meaningful role in the clinical complexity of patients presenting with acute coronary syndromes. As such, PCI may be challenging in certain settings, highlighting the importance of operator experience and advanced interventional strategies. These developments emphasise the need for collaborative, multidisciplinary approaches, while prevention remains the cornerstone of reducing the overall burden of cardiovascular disease and associated mortality."
