PCI volumes in US hospitals declined in 2022
After a surge during the COVID-19 pandemic, percutaneous coronary intervention (PCI) procedure volumes in U.S. hospitals dropped by about 5% in 2022 compared to the previous year. Data from the American College of Cardiology's CathPCI Registry highlights this trend, reflecting ongoing recovery challenges in cardiology care. Experts attribute the decline to lingering effects of the pandemic on patient volumes and procedural backlogs.
The American College of Cardiology's CathPCI Registry, which tracks interventional cardiology procedures across participating U.S. hospitals, reported a notable decrease in PCI volumes for 2022. According to the registry's analysis, total PCI procedures fell to approximately 1.1 million in 2022, down from 1.15 million in 2021—a decline of roughly 5%. This marks a reversal from the heightened activity seen during the height of the COVID-19 pandemic in 2020 and 2021, when emergency PCIs increased due to acute cardiac events amid healthcare disruptions.
The registry's data, covering over 2,000 hospitals and representing about 90% of U.S. PCI activity, shows that non-emergent elective PCIs were hit hardest. Volumes for these procedures dropped by up to 8%, as patients delayed non-urgent care. In contrast, primary PCIs for acute myocardial infarction remained relatively stable, decreasing only by 2%. 'The pandemic created a backlog of procedures, but as hospitals caught up, we saw a normalization that trended downward,' said Deepak L. Bhatt, MD, MPH, director of the ACC's Cardiovascular Innovation program, in a statement accompanying the report.
Background context reveals that PCI volumes surged in 2020-2021 due to a combination of delayed presentations leading to more severe cases and temporary increases in hospital capacity for cardiac care. However, by 2022, factors such as workforce shortages, supply chain issues, and patient hesitancy contributed to the slowdown. The report notes regional variations: urban centers saw a 6% drop, while rural hospitals experienced a milder 3% decline, possibly due to less backlog accumulation.
Implications for cardiology are significant. The decline raises concerns about access to timely interventions, particularly for elective cases that prevent future complications. ACC officials emphasize the need for sustained investment in cardiac infrastructure to rebuild volumes. 'While we're past the peak pandemic pressures, the data underscores the importance of addressing barriers to care,' Bhatt added. No major contradictions appear in the registry data, which is considered the gold standard for PCI tracking in the U.S.
This trend aligns with broader post-COVID healthcare patterns, where procedural volumes in specialties like cardiology have yet to fully rebound to pre-pandemic levels of 2019, when annual PCIs exceeded 1.2 million.