Increased PCI Access Doesn’t Guarantee Lower Heart Attack Mortality, European Study Finds

Despite increased access to primary percutaneous coronary intervention (PCI), a life-saving procedure for heart attacks, mortality rates haven’t necessarily improved across Europe, according to new research presented at the inaugural European Association of Percutaneous Cardiovascular Interventions (EAPCI) Summit 2026. The study highlights the complex interplay between healthcare access, economic factors and cardiovascular health.

Study Findings: PCI Access and Mortality Rates

Researchers analyzed data from 21 European countries and found no significant correlation between the number of primary PCI procedures performed and reduced mortality rates following an acute myocardial infarction (AMI), commonly known as a heart attack. This finding challenges the long-held assumption that simply increasing PCI availability would automatically lead to better outcomes. Cardiovascular News and the European Society of Cardiology reported on these results.

Interestingly, the study revealed a strong correlation between a country’s gross domestic product (GDP) per capita and acute MI survival rates. Higher GDP was associated with lower mortality, suggesting that broader socioeconomic factors play a crucial role. Specifically, a higher GDP per capita correlated with lower acute MI mortality (ρ = -0.54, P = 0.004). Conversely, a higher prevalence of cardiovascular disease was linked to increased mortality (ρ = +0.45; P = 0.02). TCTMD detailed these correlations.

Counterintuitively, as the rate of PPCI procedures increased, so did acute MI mortality (ρ = +0.68; P < 0.001). This association was particularly strong in countries with lower incomes.

The Role of Systemic Factors

Ali Malik, from King’s College London, who led the study, emphasized that simply expanding PCI access may have “diminishing returns” without addressing underlying systemic issues. He suggested that coordinated networks, timely access to care, and proactive cardiovascular prevention strategies are essential for meaningful improvement. TCTMD reported on Malik’s conclusions.

Researchers noted that variations in treatment delays and operator experience could also contribute to the observed discrepancies. Further analysis, including examining the timing of procedures relative to symptom onset and differences in practice between centers, is planned. ESC confirmed that subsequent analyses will address these factors.

Implications for Cardiovascular Care

These findings underscore the need for a holistic approach to cardiovascular care that goes beyond simply increasing the availability of interventions like PCI. Addressing socioeconomic disparities, improving preventative measures, and optimizing the efficiency of healthcare systems are crucial steps toward reducing heart attack mortality rates across Europe and globally. As Sanjay Sivalokanathan, MD, noted, the global rise in cardiometabolic risk factors is increasing the complexity of cases, highlighting the importance of operator experience and advanced interventional strategies. TCTMD reported on Sivalokanathan’s statement.