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Registry Data Offer Glimpse into Catheterization Utilization in US
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Data from the CathPCI Registry have highlighted trends in the current practice of interventional cardiology, including patient presentation and risk factors, door-to-balloon times and availability of on-site cardiac surgery.
The registry, which is part of the National Cardiovascular Data Registry, collects data from 1,488 facilities, or about 85% of the cath labs, in the United States. Data were summarized for more than 1.1 million patients undergoing diagnostic catheterization and more than 940,000 undergoing PCI from 2010 to June 2011.
According to the findings, on-site cardiac surgery was not available in 83% of facilities performing fewer than 200 PCIs annually, although these facilities comprise 32.6% of the facilities in the registry; in total, they performed 12.4% of the PCIs. Almost 80% of PCI patients were overweight (BMI ≥25 kg/m2), approximately 45% were obese, and approximately 1% were thin (BMI ≤18.5 kg/m2).
Among patients undergoing elective PCI, 52% underwent a stress study before the procedure, with stress myocardial perfusion being used most frequently. Among patients undergoing diagnostic catheterization, 45.5% underwent some type of stress test before their procedure, including patients undergoing study for all indications, not just CAD.
Additional findings from the registry data included:
- There was a median door-to-balloon time of 64.5 minutes for patients who did not require transfers and 121 minutes for patients who were transferred;
- Radial artery access was used in 8.3% of diagnostic and 6.9% of PCI procedures;
- Patients aged 65 years or older were 38.7% of those undergoing PCI, with 12.3% aged 80 years or older;
- Eighty percent of patients had dyslipidemia and 27.6% were current or recent smokers;
- Calcium scores and coronary CTA were used <3% before diagnostic or PCI procedures.
In an era of transparency and public reporting of outcomes, the registry becomes an important tool to eliminate waste, researchers wrote.
“The value of the CathPCI Registry will be demonstrated as it is used to understand further the practice of invasive cardiology and to drive a higher level of quality into individual physician practice,” they said.
Perspective
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David Holmes, MD
The CathPCI Registry allows physicians to see their performance compared with guidelines and physicians nationwide. This report will provide wider access to a snapshot of the data routinely available to participants in the registry and provides an important benchmark for future studies. NCDR is the most comprehensive, patient-centered quality improvement program in the United States.
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