019: National observational study of diagnostic and interventional cardiac catheterization by the French Society of Cardiology (ONACI): study design and baseline characteristics

The national observational study of diagnostic and interventional cardiac catheterization (ONACI) is a prospective multi-center registry of the French Society of Cardiology including all interventional cardiology procedures performed from 2004. We aimed to evaluate “real world” management of patients with coronary artery disease (CAD) in France from this registry. The present study is focused on data collected between 2004 and 2008. Patient demographics and co-morbidities, invasive parameters, treatment options, and procedural techniques were prospectively collected. Patients were recruited in 99 hospitals (55% of patients were hospitalized in private clinics, 45% in public institutions). Over a 5-year period, a total of 298,105 patients underwent coronary angiography (CAG) and 176,166 patients underwent percutaneous coronary intervention (PCI). Diagnosis was acute coronary syndrome (ACS) in 22%, stable angina or silent ischemia in 23% and atypical chest pain in 9% of cases. Normal coronary arteries or not significant coronary lesions were found in 26% of patients. Radial access was increasingly used over the years regardless of the indication. The average number of PCI per procedure was 1.5±0.7 (range from 1.3±0.7 to 1.5±0.7) and those of stents per procedure were 1.5±0.8 (range from 1.5±0.8 to 1.6±0.8). Drug-eluting stents (DES) were used in 45% (range from 34 to 62%). Coronary anatomy is highly dependent on clinical presentation. Strategies to reduce the number of normal CAG performed for atypical chest pain should be developed. The management of ACS is associated with less radial access, more single PCI and fewer DES.