Abstract 206: Descriptive Analysis of Patients Undergoing Percutaneous Coronary Interventions in India

Background: Patterns of percutaneous coronary intervention (PCI) use in economically disadvantaged patients are largely unknown in India. Yet it is important to understand PCI use given its increasing availability and the growth of social insurance programs. Leveraging a unique registry in Maharashtra from 2015 and 2016, we set out to evaluate how to collect data on PCI use in patients within a state-wide government funded health insurance scheme, the Rajiv Gandhi Jeevandayee Aarogya Yojana (RGJAY). RGJAY covers full costs for the procedure for eligible patients with an annual household income less than 100,000 rupees. Methods: Our registry collected detailed patient and procedural information on patients 18 years and older undergoing a PCI at one of 473 empaneled hospitals. Research coordinators obtained telephonic consent from the patients to participate in the study. Standardized forms were used to abstract data from electronic medical records that were uploaded onto a centralized database managed by the Department of Health and Family Welfare of the Government of Maharashtra. The coordinators followed up with participants at one-year with an additional telephonic survey. Patients with missing demographic and clinical data were excluded from this analysis (n=52). We report descriptive statistics, focusing on risk factors as well as the indication for PCI. Results: We included a total of 1829 PCI procedures from 34 public and 175 private hospitals that provided cardiology services. Mean age was 57.5 (SD, 10.5) and 28% were women. Nearly half of patients had no or primary school education only, and fewer than 40% were employed. Table 1 lists full descriptive statistics including risk factors. Importantly, 30% of PCIs were for chronic stable angina (in contrast to ~20% in US registries). Limited data were available on symptom burden, additional anti-anginal therapies, and ischemia evaluations prior to PCI. Overall mortality at 1-year follow-up was 4.3%. Conclusion: Data on PCI use in patients from lower income-backgrounds covered by social insurance programs can be collected but with limitations that make it challenging to assess quality and appropriateness. Our findings have implications for the recent roll-out of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).