CathPCI registry shows contemporary state of interventional cardiology practice in USA


A report from the CathPCI registry, a data registry that includes information from 85% of the US heart catheterisation laboratories, has shown data on the current practice of invasive cardiology in the United States.

The CathPCI registry, part of the American College of Cardiology’s National Cardiovascular Data Registry, includes 1,488 facilities that conduct diagnostic tests and endovascular procedures to treat stenosed arteries. The Society for Cardiovascular Angiography and Interventions collaborates with the ACC on the CathPCI registry.

“These data will be of interest to the cardiovascular community because they show us where we are and where we can find opportunities for quality improvement,” said Gregory J Dehmer, lead author.

The report published on 17 October in the online version of
The Journal of the American College of Cardiology (JACC) analyses data from 1.1 million patients who underwent diagnostic cardiac catheterisation procedures and 941,248 patients treated with percutaneous coronary intervention (PCI) from 1 January 2010 through 30 June 2011.

Highlights from the report:

Patient risk factors: Almost 80% of angioplasty and stent patients were overweight, including 43% who were obese. Other risk factors were also prevalent:  80% had high blood cholesterol levels, and 82% had high blood pressure. Almost 28% of patients who underwent PCI were current or recent smokers.

Access to arteries for assessment and treatment:  patients were more likely to be accessed through the femoral artery than through transradial access. Femoral access was used in just over 90% of procedures vs. single-digit use of radial access. (8.3% for diagnostic tests and 6.9% for angioplasty and stenting procedures). 

Patient presentation
: among the patients undergoing angioplasty and stenting, 70% presented with heart attack or other acute symptoms, while approximately 18% had stable angina and 12% had atypical symptoms or no angina.

Procedural volume per facility
: 26% of the facilities were low-volume facilities, performing fewer than 200 angioplasty and stent procedures a year but these facilities accounted for only 4% of the total number of angioplasty and stent procedures during the study period.

Door-to-balloon time
: the average time for ST-elevation myocardial infarction (STEMI) patients from hospital arrival to treatment was 64.5 minutes. The average time from arrival at the first hospital to treatment for patients who required transfer to another hospital was 121 minutes. 

This report will also appear in the 13 November 2012, print issue of JACC.