Percutaneous coronary interventions in Europe: prevalence, numerical estimates, and projections based on data up to 2004

AIMS: A registry mandated by the European Society of Cardiology collects data on trends in interventional cardiology within Europe. Special interest focuses on relative increases and ratios in new techniques and their distributions across Europe. We report the data through 2004 and give an overview of the development of coronary interventions since the first data collection in 1992. METHODS AND RESULTS: Questionnaires were distributed yearly to delegates of all national societies of cardiology represented in the European Society of Cardiology. The goal was to collect the case numbers of all local institutions and operators. The overall numbers of coronary angiographies increased from 1992 to 2004 from 684 000 to 2 238 000 (from 1250 to 3930 per million inhabitants). The respective numbers for percutaneous coronary interventions (PCIs) and coronary stenting procedures increased from 184 000 to 885 000 (from 335 to 1550) and from 3000 to 770 000 (from 5 to 1350), respectively. Germany was the most active country with 712 000 angiographies (8600), 249 000 angioplasties (3000), and 200 000 stenting procedures (2400) in 2004. The indication has shifted towards acute coronary syndromes, as demonstrated by rising rates of interventions for acute myocardial infarction over the last decade. The procedures are more readily performed and perceived safer, as shown by increasing rate of "ad hoc" PCIs and decreasing need for emergency coronary artery bypass grafting (CABG). In 2004, the use of drug-eluting stents continued to rise. However, an enormous variability is reported with the highest rate in Switzerland (70%). If the rate of progression remains constant until 2010 the projected number of coronary angiographies will be over three million, and the number of PCIs about 1.5 million with a stenting rate of almost 100%. CONCLUSION: Interventional cardiology in Europe is ever expanding. New coronary revascularization procedures, alternative or complementary to balloon angioplasty, have come and gone. Only stenting has stood the test of time and matured to the default technique. Facilitated access to PCI, more complete and earlier detection of coronary artery disease promise continued growth of the procedure despite the uncontested success of prevention.

Cenozoic palaeoclimate reconstructions from 35 sites in Central Europe

Continental climate evolution of Central Europe has been reconstructed quantitatively for the last 45 million years providing inferred data on mean annual temperature and precipitation, and winter and summer temperatures. Although some regional effects occur, the European Cenozoic continental climate record correlates well with the global oxygen isotope record from marine environments. During the last 45 million years, continental cooling is especially pronounced for inferred winter temperatures but hardly observable from summer temperatures. Correspondingly, Cenozoic cooling in Central Europe is directly associated with an increase of seasonality. In contrast, inferred Cenozoic mean annual precipitation remained relatively stable, indicating the importance of latent heat transport throughout the Cenozoic. Moreover, our data support the concept that changes in atmospheric CO2 concentrations, although linked to climate changes, were not the major driving force of Cenozoic cooling.

La organización de los juegos olímpicos como elemento de configuración de regímenes urbanos: Barcelona 1992 como estudio de caso

The games were an opportunity for Spain to show to the world as a modern, wealthy and democratic country of Western Europe, that successfully accomplished 15 years of political transition and dealt with identity issues. But the games also were a window of opportunity for the complete “reinvention” of Barcelona at all levels (political, economical, social and urbanistic) and laid the foundations for the development of the city in the next decades. This research argues that this process of “reinvention of the city” can be explained for three factors: 1) A policy coalition involving key economic and social actors under the leadership of Barcelona‟s Major, which led to a new urban regime. 2) An intergovernmental game that privileged the cooperation between the federal and urban government, as well as the international sports institutions 3) An understanding of the Olympic infrastructures not only as a guarantee for the success of the event, but as the starting point for a new model of urban and identity development regarding to the XXI siècle. The main objective of the research is to analyze the possible application of urban regime approach to different local government systems of the US by analyzing a case study, Barcelona...

Do Too Many Chefs Really Spoil the Broth? The European Commission, Bureaucratic Politics and European Integration, CES Germany & Europe Working Papers, No. 09.2, 5 August 1999

There is a puzzling, little-remarked contradiction in scholarly views of the European Commission. On the one hand, the Commission is seen as the maestro of European integration, gently but persistently guiding both governments and firms toward Brussels. On the other hand, the Commission is portrayed as a headless bunch of bickering fiefdoms who can hardly be bothered by anything but their own in­ ternecine turf wars. The reason these very different views of the same institution have so seldom come into conflict is quite apparent: EU studies has a set of relatively autonomous and poorly integrated sub­ fields that work at different levels of analysis. Those scholars holding the "heroic" view of the Com­ mission are generally focused on the contest between national and supranational levels that character­ ized the 1992 program and subsequent major steps toward European integration. By contrast, those scholars with the "bureaucratic politics" view are generally authors of case studies or legislative his­ tories of individual EU directives or decisions. However, the fact that these twO images of the Commis­ sion are often two ships passing in the night hardly implies that there is no dispute. Clearly both views cannot be right; but then, how can we explain the significant support each enjoys from the empirical record? The CommiSSion, perhaps the single most important supranational body in the world, certainly deserves better than the schizophrenic interpretation the EU studies community has given it. In this paper, I aim to make a contribution toward the unraveling of this paradox. In brief, the argument I make is as follows: the European Commission can be effective in pursuit of its broad integration goals in spite of, and even because of, its internal divisions. The folk wisdom that too many chefs spoil the broth may often be true, but it need not always be so. The paper is organized as follows. 1 begin with an elaboration of the theoretical position briefly out­ lined above. 1 then tum to a case study from the major Commission efforts to restructure the computer industry in the context of its 1992 program. The computer sector does not merely provide interesting, random illustrations of the hypothesis 1 have advanced. Rather, as Wayne Sandholtz and John Zysman have stressed, the Commission's efforts on informatics formed one of the most crucial parts of the en­ tire 1992 program, and so the Commission's success in "Europeanizing" these issues had significant ripple effects across the entire European political economy. I conclude with some thoughts on the fol­ lowing question: now that the Commission has succeeded in bringing the world to its doorstep, does its bureaucratic division still serve a useful purpose?

Divided but United: European Trade Policy & EC-U.S. Agricultural Negotiations in the Uruguay Round. CES Germany & Europe Working Papers, No. 07.3, 1996

How has the integration of trade policy and negotiating authority in Europe affected the external bargaining capabilities of the European Community (EC)? This paper analyzes the bargaining constraints and opportunities for the EC created by the obligation to negotiate as a single entity. The nature of demands in external~ the voting rules at the EC level, and the amount of autonomy exercised by EC negotiators contribute to explaining, this paper argues, whether the EC gains some external bargaining clout from its internal divisions and whether the final international agreement reflects the position of the median or the extreme countries in the Community. The Uruguay Round agricultural negotiations illustrate the consequences of the EC's institutional structure on its external bargaining capabilities. Negotiations between the EC and the U.S. were deadlocked for six years because the wide gap among the positions of the member states at the start of the Uruguay Round had prevented the EC from making sufficient concessions. The combination of a weakened unanimity rule and greater autonomy seized by Commission negotiators after the May 1992 reform of the Common Agricultural Policy made possible the conclusion of an EC-U.S. agricultural agreement. Although the majority of member states supported the Blair House agreement, the reinstating of the veto power in the EC and the tighter member states' control over the Commission eventually resulted in a renegotiation of the U.S.-EC agreement tilted in favor of France, the most recalcitrant country.

European Monetary Union: between the stakeholder and the stockholder models of capitalism. CES Germany & Europe Working Papers, No. 01.3, 2001

From the mid-1980s on a new attitude towards self-determination appeared in Western European integration. With the Maastricht Treaty of 1992 and, later, with theAmsterdam Treaty of 1997 the member countries of the European Community manifested their determination to be active players in the new international order. Accepting and instituting the single market and monetary union constituted, however, a challenge of compatibility between the traditional model of welfare European capitalism and the impositions coming from globalization under the neo-liberal model of Anglo-Saxon capitalism. This issue is examined here under two perspectives. The first reviews the implications which globalization has had on the European model of capitalism and the second the complications for monetary management as Europe moves from a nationally regulated to a union regulated financial structure.

National Role Conceptions and Foreign Policies: France and Germany Compared. CES Germany & Europe Working Papers, No. 02.4, 2002

In spite of domestic and international political changes, French and German foreign policies have displayed high degrees of continuity between the late 1950s and the mid-1990s. Over the same time period, the directions of the two states’ foreign policies have also continued to differ from each other. Why do states similar in many respects often part ways in what they want and do? This article argues that the French and German national role conceptions (NRCs) account for both of these continuities. NRCs are domestically shared understandings regarding the proper role and purpose of one’s own state as a social collectivity in the international arena. As internal reference systems, they affect national interests and foreign policies. This article reestablishes the NRC concept, empirically codes it for France and Germany for the time period under consideration, and demonstrates comparatively how different NRCs lead to varying interests and policies across the major policy areas in security, defense, and armament.

Europe in the 1980s. Speech by the Rt. Hon. Lord Carrington, KCMG, MC Secretary of State for Foreign and Commonwealth Affairs, to the Foreign Policy Association at the Sheraton Centre, New York, 23 September 1981

No abstract.