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ARTICLE CONTRIBUTORS

Journal of the American College of Cardiology

Clinical Articles, Lead Article

CathPCI Registry – a snapshot of interventional cardiology

Data from the CathPCI Registry, which includes information from 85% of the heart catheterisation laboratories in the United States, provides a vivid snapshot of the current practice of invasive cardiology, according to a report1 published recently online in the Journal of the American College of Cardiology.

The CathPCI Registry, part of the American College of Cardiology’s National Cardiovascular Data Registry, includes 1,488 facilities. The report analyses data from 1.1 million patients undergoing diagnostic cardiac catheterisation procedures and 941,248 patients who underwent angioplasty and percutaneous coronary intervention (PCI), from January 1st 2010 to June 30th 2011.

Highlights from the report:

  • Patient risk factors: Almost 80% of angioplasty and stent patients were overweight, including 43% who were obese. Other risk factors were also prevalent:  80% had high blood cholesterol levels, and 82% had high blood pressure. Almost 28% of patients who underwent PCI were current or recent smokers.
  • Access to arteries for assessment and treatment:  During the time period analysed, patients’ arteries were more likely to be accessed through the femoral artery than through the transradial artery.  Femoral access was used in just over 90% of procedures vs. single-digit use of radial access. (8.3% for diagnostic tests and 6.9% for angioplasty and stenting procedures).
  • Patient presentation: Among the patients undergoing angioplasty and stenting, 70% presented with heart attack or other acute symptoms, while approximately 18% had stable angina and 12% had atypical symptoms or no angina.
  • Procedural volume per facility:  26% of the facilities were low-volume facilities, performing fewer than 200 angioplasty and stent procedures a year but these facilities accounted for only four percent of the total number of angioplasty and stent procedures during the study period.
  • Door-to-Balloon Time: Patients suffering a severe heart attack (ST-elevation myocardial infarction, or STEMI) who arrived at an angioplasty-capable hospital, the average time from hospital arrival to treatment was 64.5 minutes. Patients who required transfer to another hospital, the average time from arrival at the first hospital to treatment was 121 minutes.

“These data will be of interest to the cardiovascular community because they show us where we are and where we can find opportunities for quality improvement,” said Dr Gregory J. Dehmer, lead author.

References

1. Dehmer GJ, Weaver D, Roe MT, et al. A contemporary view of diagnostic cardiac catheterization and percutaneous coronary intervention in the United States. JACC 2012. http://dx.doi.org/10.1016/j.jacc.2012.08.966

JACC embargo

Published on: October 19, 2012

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