ACC registries give snapshot of trends

Recently released findings from analyses of the American College of Cardiology’s registries offered a trove of data and few surprises, in part because previous reports already provided glimpses of trends over time.

The report, “Cardiovascular Care Facts: A Report from the National Cardiovascular Data Registry – 2011,” was published online Sept. 18 in the Journal of the American College of Cardiology. It detailed findings from the National Cardiovascular Data Registry initiatives: the ACTION Registry‐GWTG; CathPCI Registry; CARE Registry; ICD (implantable cardioverter-defibrillator) Registry; and the PINNACLE Registry. Two more recent entries, IMPACT and the STS/ACC TVT Registries, were not included.

The registries are designed to accumulate large datasets on patients and to help measure outcomes and quality of care. The CathPCI, for instance, which captures coronary angiography and PCI data, included 632,557 patients and 1,337 hospitals in 2011. ACTION Registry‐GWTG for acute coronary syndromes enrolled 119,967 patients in 567 hospitals that year; PINNACLE, which covers outpatients with cardiovascular disease, had 249,198 patients (1,436,328 individual encounters) in 74 practices (1,222 individual providers); the ICD Registry enrolled 139,991 patients in 1,435 hospitals; and CARE for carotid revascularization had 4.934 patients and 130 hospitals.

The CathPCI registry showed a slight uptick in in-hospital risk-adjusted mortality rates for PCI patients from 2009 to 2011 (5.32 percent to 5.68 percent) and a slight drop in complications such as acute kidney injury (2.5 percent to 2.3 percent) and vascular access site injury (1.5 percent to 1.2 percent).

Transradial access continued to gain acceptance among interventional cardiologists, growing from a rate of 2.9 percent in 2009 to 10.9 percent. The findings mirrored a previously published study based on the same dataset but with a later cutoff. That study showed a radial use rate of 16.1 percent in the third quarter of 2012.

PINNACLE highlighted a shortfall in optimal care for patients with atrial fibrillation, with only 57.2 percent receiving oral anticoagulation therapy in 2011, up from 50.5 percent in 2009. The findings showed modest improvement from an earlier report that placed the 2011 anticoagulation rate at 55.1 percent.