An increase in percutaneous coronary interventions (PCI) has not led to reduced mortality rates from heart attacks, according to findings presented today at the EAPCI Summit 2026. The summit, a new initiative by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), part of the European Society of Cardiology (ESC), highlighted these unexpected results.
Primary PCI is a critical procedure designed to quickly restore blood flow after a heart attack, typically involving the insertion of a stent via a catheter. Despite its life-saving potential, the latest data suggests that more interventions have not translated into fewer deaths.
The Study and Its Findings
Ali Malik from King’s College London, UK, presented the study, noting that ongoing statistical analyses aim to assess the impact of primary PCI across 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,” Malik stated.
The research utilized data from the ESC Atlas of Cardiology and the ESC Atlas in Interventional Cardiology, integrating statistics from the World Health Organization, the Institute for Health Metrics and Evaluation, and Eurostat. The analysis covered 21 European countries, examining the relationship between PCI rates per million inhabitants and age-standardized acute myocardial infarction (MI) mortality rates, while adjusting for factors like cardiovascular disease (CVD) prevalence and GDP per capita.
Across the countries analysed, higher GDP per capita was associated with lower age-standardised MI mortality rates, demonstrating a moderate inverse correlation (population correlation coefficient=−0.54; p=0.004).
Conversely, the study found that greater CVD prevalence correlated with higher age-standardised MI mortality rates (population correlation coefficient=+0.45; p=0.02). After adjusting for GDP and CVD prevalence, a surprising positive correlation emerged: more primary PCI procedures were linked to increased MI mortality (population correlation coefficient=+0.68; p<0.001).
Expert Insights and Implications
Sukruth Pradeep Kundur, a co-investigator also from King’s College London, remarked, “One would anticipate that increased provision of primary PCI would yield lower mortality rates; therefore, we will conduct additional analyses to elucidate why this trend is not evident in our preliminary findings.” He emphasized the importance of operator expertise, noting that a greater number of procedures per interventional cardiologist was weakly associated with lower mortality rates (population correlation coefficient=−0.27; p=0.23).
Senior author Doctor Sanjay Sivalokanathan from the Mount Sinai Health System in New York, USA, offered further perspective: “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.
Looking Forward
The findings from the EAPCI Summit 2026 underscore the complexity of addressing heart attack mortality through procedural interventions alone. The data suggests that while PCI is a crucial tool, its effectiveness may be influenced by broader systemic factors, including healthcare infrastructure, operator skill, and patient demographics.
As the medical community continues to grapple with these challenges, the emphasis on prevention and comprehensive care remains paramount. Future research will likely focus on optimizing PCI strategies and understanding the nuanced interplay of factors that contribute to patient outcomes.
In light of these insights, healthcare policymakers and practitioners are encouraged to foster environments that enhance procedural expertise and integrate preventive measures to combat the persistent challenge of heart attack mortality.
