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National registry report shows increase in radial access stenting, other trends

Issue: October 2013

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Use of transradial PCI has increased from 2.9% of all PCI procedures in 2009 to 10.9% in 2011, whereas transfemoral PCI has decreased from 96.5% to 88.8% during the same period, according to a new report from the National Cardiovascular Data Registry.

Although the transradial PCI approach is new and still being studied, recent research has shown it can reduce the risk for complications, discomfort and recovery times in some patients. These data from the CathPCI Registry suggest that clinicians who perform PCI are becoming more comfortable with this approach, according to an American College of Cardiology press release.

Tools for understanding care of patients

The report highlights findings from five ACC National Cardiovascular Data Registries.

“The data in this report demonstrate the value of national registries in providing an unprecedented and broad perspective on the care and outcomes of patients with cardiovascular disease,” Frederick Masoudi, MD, MSP, senior medical office of the National Cardiovascular Data Registry, said in a press release. “These registries are key tools in understanding and improving care for cardiovascular patients across the United States.”

‘Cardiovascular care facts’

• Physicians have increased prescription of optimal medications to PCI patients at discharge, according to other data from the CathPCI Registry. In 2011, 97.9% of PCI patients were prescribed aspirin at discharge vs. 96.4% in 2009; 97.3% were prescribed thienopyridine/P2Y12 inhibitors in 2011 vs. 96.1% in 2009; 92.5% were prescribed lipid-lowering agents in 2011 vs. 89.7% in 2009; and 86.3% were prescribed beta-blockers in 2011 vs. 83.1% in 2009.
• In 2011, 99.1% of evaluated PCI procedures on ACS patients were deemed appropriate by 2009 appropriate use criteria vs. 52.8% of evaluated PCI procedures on patients without ACS, according to CathPCI Registry data.
• Median time to immediate PCI for STEMI patients decreased from 65 minutes in 2009 to 61 minutes in 2011 for nontransfer patients and from 119 minutes in 2009 to 111 in 2011 for transfer patients. The rate of STEMI patients receiving immediate PCI within 90 minutes rose from 85.8% in 2009 to 90.9% in 2011 for nontransfer patients and from 22.4% in 2009 to 28.5% in 2011 for transfer patients, according to CathPCI Registry data.
• The rate of door-to-balloon times less than 90 minutes increased from 81% in 2008 to 94.2% in 2011 for nontransfer patients and from 18% in 2008 to 30.4% in 2011 for transfer patients, data from the ACTION-GWTG Registry showed.
• Data from the ICD Registry revealed that 23.4% of implantable cardioverter defibrillator patients were not prescribed ACE inhibitors and/or beta-blockers at discharge, despite evidence of benefit.
• PINNACLE Registry data indicated that 95.1% of providers recorded BP in 2011, but only 34.5% implemented hypertension care plans, and that 57.2% of eligible patients with atrial fibrillation were prescribed anticoagulation therapy, despite evidence of benefit.

For more information:

Masoudi F. J Am Coll Cardiol. 2013;doi:10.1016/j.jacc.2013.05.099.

Disclosure: The authors report no relevant financial disclosures.