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WASHINGTON (Jan 30, 2020) -
Data from the American College of Cardiology's NCDR was the source of several studies published and presented in recent months, including studies examining treatment for heart attack patients with cognitive impairment, outcomes for TAVR patients who smoke, as well as smoking cessation assistance in cardiology practices and more.
NCDR Study Shows Presence of Cognitive Impairment in Older MI Patients Impacts Treatment Selection
Among older patients presenting with a myocardial infarction (MI), those with an NSTEMI are less likely to receive invasive treatment and those with STEMI are less likely to receive fibrinolysis. The presence of cognitive impairment was also associated with increased in-hospital mortality. These are among the findings of a study conducted using data from ACC'sChest Pain-MI Registry and published in the Journal of the American Heart Association. Read more.
Contemporary Use of Hybrid Revascularization Characterized Using NCDR Data
Hybrid revascularization, combining PCI and CABG, for the treatment of multivessel coronary artery disease, is used infrequently. According to a new analysis, while the risk-adjusted in-hospital mortality rate was not different between hybrid revascularization and multivessel PCI, patients who had hybrid revascularization were less likely to receive P2Y12 inhibitors at discharge. The findings were published in the American Heart Journal. Angela Lowenstern, MD, et al., used data from ACC's CathPCI Registry from 2009 to 2017 to review the treatment of 775,000 patients with multivessel CAD. Read more.
Do PVI Treatments Put Some Patients at Risk Of Radiation Injury?
One in 14 patients undergoing peripheral endovascular intervention (PVI) using fluoroscopic imaging for the treatment of lower extremity peripheral artery disease suffer tissue injury from the treatment and have an increased risk of malignancy. Preprocedure assessments could enable the use of targeted treatments to reduce patient risk, according to a study published in JACC: Cardiovascular Interventions. Andrew M. Goldsweig, MD, FACC, et al., collected data on 27,119 patients enrolled inACC's PVI Registry from 2014 through 2017. Read more.
Fragmented Care Following TAVR Linked to Poorer Outcomes
The treatment of a patient at a second hospital within 90 days following a transcatheter aortic valve replacement (TAVR) procedure was associated with an increase in one-year mortality and readmissions. This "fragmented" treatment at a second institution often occurs when a patient lives in a remote area and faces a long drive to a referral center for a TAVR evaluation and procedure, according to a study published in the American Journal of Cardiology. Alice Wang, MD, MHS, et al., examined data from 8,927 patients in 374 institutions who had a TAVR procedure between 2011 and 2015 and were enrolled in the STS/ACC TVT Registry, linked to Centers for Medicare and Medicaid Services' claims data. Read more.
Long-Term Outcomes Worse For Smokers Following TAVR
Compared with nonsmokers, smokers have a lower in-hospital mortality rate after transcatheter aortic valve replacement (TAVR) but similar long-term survival and somewhat more long-term health problems. This puzzling difference in outcomes appears to be linked to the fact that TAVR patients who smoke often are younger than nonsmokers and have fewer comorbidities, according to a study published in the Journal of the American Heart Association. Mohammed Qintar, MD, MSc, et al., uncovered this difference while studying the association between smoking status and outcomes following TAVR. Researchers examined the data of 72,249 TAVR patients at 457 U.S. sites who were enrolled in the STS/ACC TVT Registry between November 2011 and June 2016. Read more.
STS/ACC TVT Registry: Aborted Elective TAVR Procedures Decline With Advances
The incidence of aborted transcatheter aortic valve replacement (TAVR) elective procedures has significantly declined in recent years, along with the evolution of TAVR and greater operator experience, according to study results published Sept. 16 in JACC: Cardiovascular Interventions. Thirty-day outcomes were worse when TAVR was aborted. Jennifer A. Rymer, MD, MBA, et al., analyzed data from 106,169 patients at 524 U.S. hospitals in the STS/ACC TVT Registry who had a first elective TAVR procedure between Nov. 11, 2011 and June 30, 2017 and a complete data set. Read more.
PINNACLE Registry Finds Smoking Cessation Assistance Lacking at Cardiology Practices
Only one in three smokers treated at U.S. cardiology practices linked to the PINNACLE Registry receive smoking cessation assistance from the practice despite the documented benefits of cessation. The lack of progress in helping patients stop smoking and the need for improved actions were detailed in a study published in the Journal of the American Heart Association. Read more.
Study Uses NCDR and CMS Claims Data to Examine Patterns in 30-Day Post-MI Readmissions
Patients readmitted to the discharging hospital after myocardial infarction (MI) do not have significant differences in outcomes compared with those who are readmitted to another hospital, according to a study published Sept. 20 in the Journal of the American Heart Association. Jennifer A. Rymer, MD, MBA, et al., linked data from ACC's Chest Pain-MI Registry with claims data from the Centers for Medicare and Medicaid Services to examine patterns in 30-day post-MI readmissions, stratified by the discharging hospital vs. nondischarging hospital. Read more.
What Percentage of Diabetes Patients Taking TZDs Show Signs of HF?
Up to 40 percent of type 2 diabetes patients currently taking thiazolidinediones (TZD) have evidence of heart failure (HF) and therefore should not be candidates for TZD therapy, according to a study published recently in Circulation: Heart Failure. TZDs can cause fluid retention, which is associated with an increased HF risk. Using data from ACC and Veradigm's Diabetes Collaborative Registry, Suzanne V. Arnold, MD, MHA, et al., examined the proportion of patients taking TZDs according to patient characteristics and over time. Read more.
Few Diabetes Patients Achieve ASCVD Risk Factor Targets, NCDR Study Shows
As few as one-fifth of adult diabetes patients are achieving target levels for atherosclerotic cardiovascular disease prevention risk factors, according to a study published in Diabetes, Obesity and Metabolism. Using data from ACC and Veradigm's Diabetes Collaborative Registry, Wenjun Fan, MD, et al., investigated target attainment of HbA1c, LDL cholesterol and blood pressure, as well as nonsmoking status, among 74,393 adult patients with diabetes. Read more.
PVI Registry: Driving Understanding, Science, Best Practices
The treatment of lower extremity peripheral artery disease and cerebrovascular disease has evolved in recent years to include more invasive procedures. ACC's PVI Registry is key to understanding patient and procedural characteristics and outcomes, and can play a pivotal role in scientific evidence generation, medical device surveillance and creation of best practices for peripheral vascular intervention (PVI) and carotid artery revascularization, according to authors of a study published in the American Heart Journal. Read more.
NCDR Study Suggests Failure to Rescue as New Quality Metric to Assess Pediatric Cath Lab Programs
The use of failure to rescue (FTR) as a quality metric provides important information about pediatric congenital cardiac catheterization laboratory programs and should be included in future research and quality improvement efforts, according to a study published Oct. 17 in the Journal of the American Heart Association. Using data from ACC's IMPACT Registry, Michael L. O'Bryne, MD, MSCE, et al., developed a modified FTR metric for the pediatric cardiac cath lab environment and then assessed what patient-, procedure- and hospital-level factors were associated with risk of complications and FTR. Read more.
The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.