A report from the CathPCI Registry, a data registry that includes information from 85 percent of the heart catheterization laboratories in the United States, is providing a vivid snapshot of the current practice of invasive cardiology.

 

The CathPCI Registry, part of the American College of Cardiology’s National Cardiovascular Data Registry, includes 1,488 facilities that conduct diagnostic tests and procedures to open blocked arteries by inserting diagnostic tools or stents through arteries or veins. The Society for Cardiovascular Angiography and Interventions collaborates with the ACC on the CathPCI Registry.

 

“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 Gregory J. Dehmer, MD, lead author. 

 

The report published today in the online version of JACC: The Journal of the American College of Cardiology analyzes data from 1.1 million patients undergoing diagnostic cardiac catheterization procedures and 941,248 patients who underwent angioplasty and stenting, known as percutaneous coronary intervention or PCI, from Jan. 1, 2010, through June 30, 2011.

 

Highlights from the report:

•         Patient risk factors:  Almost 80 percent of angioplasty and stent patients were overweight, including 43 percent who were obese. Other risk factors were also prevalent:  80 percent had high blood cholesterol levels, and 82 percent had high blood pressure. Almost 28 percent of patients who underwent PCI were current or recent smokers.

•        Access to arteries for assessment and treatment:  During the time period analyzed, patients’ arteries were more likely to be accessed through an artery in the thigh – known as femoral access – than through an artery in the wrist (transradial access).  Femoral access was used in just over 90 percent of procedures vs. single-digit use of radial access. (8.3 percent for diagnostic tests and 6.9 percent for angioplasty and stenting procedures).  

•         Patient presentation: Among the patients undergoing angioplasty and stenting, 70 percent presented with heart attack or other acute symptoms, while approximately 18 percent had stable angina and 12 percent had atypical symptoms or no angina. 

•         Procedural volume per facility:  Twenty-six percent of the facilities were low-volume facilities, performing fewer than 200 angioplasty and stent procedures a year but these facilities accounted for only 4 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.  

This report will also appear in the Nov. 13, 2012, print issue of JACC.

 

The mission of the American College of Cardiology is to transform cardiovascular care and improve heart health. The College is a 40,000-member medical society comprised of physicians, surgeons, nurses, physician assistants, pharmacists and practice managers. The College is a leader in the formulation of health policy, standards and guidelines. The ACC provides professional education, operates national registries to measure and improve quality of care, disseminates cardiovascular research, and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more information, visit www.cardiosource.org/ACC.

The Society for Cardiovascular Angiography and Interventions is a 4,000-member professional organization representing invasive and interventional cardiologists in approximately 70 nations. SCAI’s mission is to promote excellence in invasive and interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. SCAI's patient education program, Seconds Count, offers comprehensive information about cardiovascular disease. For more information about SCAI and Seconds Count, visit www.scai.org or www.SecondsCount.org.

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Contact Rachel Cagan, rcagan@acc.org, for a copy of the study.