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This editorial summarises the results of the interesting confidential enquiry (NCEPOD) into death resulting from PTCA. It has to be viewed with some caution. Firstly, the data collection was not complete and refers only to those deaths reported rather than those obtained from a systematic follow up of patients out to the 30 day mark that is the conventional cut-off for perioperative mortality. Secondly, only 38% of the private centres and 84% of the NHS (state) centres in the UK contributed, and the cynic would say that the centres not reporting their results are likely to be those with the worst results. Finally, there is a surprisingly low surgery rate reported in a situation where surgery as a last resort might be expected. This may be a true finding or it may be that the deaths that occurred after a patent was taken over by the surgeons were not captured because they occurred outside the catheterisation laboratory and cardiology unit.
Despite these shortcomings the most striking finding is the very low mortality of elective rather than emergency or urgent PTCA. If these results are confirmed by a more complete survey this would be powerful ammunition for those arguing for a more widespread implementation of elective PTCA without on-site surgical cover. It is hoped that any future study of this type will address the problems of data collection since strong conclusions on incomplete data should be avoided at all costs.
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