As ACC Quality Summit 2025 convened in Denver, CO, this week, the top three poster winners presented research on the use of the Distressed Communities Index (DCI) to predict post-PCI in-hospital mortality; enhanced transitional care reducing readmissions after TAVR; and use of CathPCI metrics in the ongoing professional practice evaluation process (OPPE).

Does Neighborhood Distress Predict Post-PCI In-Hospital Mortality?

The first-place poster, presented by Ahmed Diab, MD, et al., of Washington University School of Medicine, used a retrospective observational analysis of 1,551 unique PCI patients through the CathPCI Registry at Barnes Jewish Hospital in St. Louis, MO, to compare mortality predictions powered by the DCI vs. the CathPCI Predicted Risk of Mortality (PROM) model and a combination of the two. The results were also published in JACC: Case Reports.

Results showed that 54 patients (3.5%) died in-hospital. Of the three models, PROM by itself showed the best discrimination (area under the receiver operating characteristic curve [AUC], 0.93) compared to DCI alone (AUC, 0.61) or PROM and DCI combined (AUC, 0.88; p<0.05). A higher score on the DCI, based on zip code and calculated by educational attainment, housing vacancy, labor participation, poverty rate, income ratio, employment change and business change, was associated with race (p<0.001), sex (p=0.009), insurance status (p<0.011), PCI indication (p<0.001), cardiogenic shock (p=0.0004) and in-hospital mortality (p=0.011) but not out-of-hospital cardiac arrest.

"Neighborhood distress is better suited to guide equity-focused interventions rather than prediction of short-term mortality after PCI," write the authors. "Future work should evaluate impact on longer term outcomes."

Enhanced Transitional Care Reduces Readmissions After TAVR

The second-place winners, Misty Theriot, BSN, RN, CPHQ, FACC, et al., from the Lake Charles Memorial Health System, Lake Charles, LA, used the STS/ACC TVT Registry and electronic medical record dashboards in a quality improvement project to reduce readmissions among TAVR patients – focusing on an enhanced transitional care pathway incorporating early follow-ups, the 'Meds-to-Beds' medication delivery program and home monitoring, all guided by Plan-Do-Study-Act cycles. The results were also published in JACC: Case Reports.

Results showed that among 360 patients (mean age, 77 years; mean STS PROM score, 5%) 30-day post-TAVR readmission rates dropped from 13% in 2018-2019 to 2% in 2024, saving an estimated $172,626. "Improved patient engagement and streamlined workflows decreased [length of stay] and lowered costs," write the authors, "demonstrating the financial value and scalability of this approach for structural heart programs."

The third-place winners, Megan Green, BSN, CCRN, RN, and Tammy Russo, ACNP, AACC, of Hackensack University Medical Center, Hackensack Meridian Health in New Jersey, showed that a quality assurance program using physician-level NCDR CathPCI data can achieve success beyond the initial implementation phase. The program incorporated three CathPCI metrics – outlier contrast volume, outlier radiation dose and major adverse events – into the OPPE process for interventional cardiologists and showed a significant impact and sustained improvements. "We believe this model can be replicated in other institutions to enhance the quality of care delivered in cath labs," write the authors, "offering a valuable framework for improving patient outcomes."

Three honorable mentions were also named:

Unmasking the Invisible Threat: Investigating a Pseudomonas Outbreak in a Cardiac Catheterization Laboratory in Limited-Resource Setting from Asad Ullah Bugti, MD, et al., at the Tabba Heart Institute in Pakistan.

Safeguarding Cath Lab Staff Without Delaying Door-to-Balloon Time from Hamza Alkowatli, MD, et al., at the HCA Blake Hospital and St. Vincent's Medical Center, in Florida.

Systematic Echocardiographic Screening Protocol For Cardiac Amyloidosis Detection: A Low-Cost High-Impact Innovation from Alaukika Agarwal, MD, et al., at the Staten Island University Hospital in New York and Deborah Heart and Lung Center in New Jersey.

Learn more about ACC Quality Summit 2025, taking place Oct. 14-16 in Denver, CO. Plus, follow the ACC on social media and use the hashtag #ACCQuality25 to join the conversations.

Clinical Topics: Cardiovascular Care Team, Invasive Cardiovascular Angiography and Intervention

Keywords: Quality Summit, Patient Reported Outcome Measures, Quality Improvement, Percutaneous Coronary Intervention