PINNACLE Registry Study Shows Improvements in Ambulatory CV Care Processes

Between 2013 and 2017, care processes generally improved for patients in ACC and Veradigm's PINNACLE Registry, according to a review article published Jan. 6 in the Journal of the American College of Cardiology.

Thomas M. Maddox, MD, MSc, FACC, et al., reviewed PINNACLE Registry care patterns, adherence to evidence-based measures, data collection methods, patient populations and participating practices from 2013 to 2017. In 2013, the PINNACLE Registry included information on 2,898,505 patients treated by 4,859 providers in 431 practices. By 2017, the number of patients had increased to 6,040,996, cared for by 8,853 providers in 724 practices.

According to the results, hypertension was the most common condition among patients, occurring in 57.1 percent in 2013 and 58.5 percent in 2017. Coronary artery disease (CAD) was the second most common condition, followed by atrial fibrillation (AFib) and heart failure (HF).

Blood pressure control rates among patients with hypertension remained stable throughout the study period at 73.1 percent in 2013 and 72.3 percent in 2017. For patients with CAD, use of statin medications increased from 66 percent in 2013 to 80.1 percent in 2017. In addition, use of oral anticoagulation medications increased from 52.7 percent to 65.7 percent among patients with AFib, while use of combined beta blocker and renin-angiotensin antagonist medication increased from 60.7 percent to 72.8 percent among HF patients. The researchers also noted that data from the PINNACLE Registry contributed to a variety of quality improvement campaigns and 51 peer-reviewed publications during the study period.

“This report demonstrates the tremendous value that the PINNACLE Registry has brought to the practice of cardiovascular medicine over the better part of the past decade,” says William J. Oetgen, MD, MBA, FACC, clinical professor of medicine at Georgetown University. “Registry growth has been impressive, and the improved performance measures are a source of pride for participating cardiologists and the NCDR staff. Going forward, there should be a major focus on hypertension control.”

According to the researchers, the PINNACLE Registry represents the largest sample of ambulatory cardiology practices in the U.S. and "provides important insights into its current care delivery." They conclude that data from 2013 to 2017 suggest that care is improving and becoming more standardized at practices participating in the registry, however the study also "highlights areas where improvements should occur."

"No other registry provides as expansive a view of U.S. ambulatory cardiovascular care as the PINNACLE Registry," Maddox says. "It allows us to both see how trends have improved over the past several years and identify additional targets for improvement. Practices participating in PINNACLE Registry receive practice-specific data, which allows them to review their performance and design quality improvement efforts to optimize care for their patients."

Clinical Topics: Anticoagulation Management, Arrhythmias and Clinical EP, Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Prevention, Atherosclerotic Disease (CAD/PAD), Anticoagulation Management and Atrial Fibrillation, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Hypertension

Keywords: Registries, National Cardiovascular Data Registries, PINNACLE Registry, Atrial Fibrillation, Coronary Artery Disease, Angiotensins, Blood Pressure, Quality Improvement, Adrenergic beta-Antagonists, Heart Failure, Hypertension, Anticoagulants


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