Publications (3)15.15 Total impact
- [Show abstract] [Hide abstract]
ABSTRACT: To characterize the patients, participating centers, and measures of quality of care and outcomes for five National Cardiovascular Data Registry (NCDR®) programs: 1) ACTION Registry®-GWTG for acute coronary syndromes; 2) CathPCI Registry® for coronary angiography and percutaneous coronary intervention; 3) CARE Registry® for carotid revascularization; 4) ICD Registry® for implantable cardioverter defibrillators; and 5) the PINNACLE Registry® for outpatients with cardiovascular disease (CVD). CVD is a leading cause of death and disability in the United States. The quality of patients with CVD is suboptimal. National registry programs such as NCDR® permit assessments of the quality of care and outcomes for broad populations of patients with CVD. For the year 2011, we assessed for each of the five NCDR® programs 1) demographic and clinical characteristics of enrolled patients 2) key characteristics of participating centers; 3) measures of processes of care and 4) patient outcomes. For selected variables, we assessed trends over time. In 2011 ACTION Registry® - GWTG enrolled 119,967 patients in 567 hospitals; CathPCI enrolled 632,557 patients in 1,337 hospitals; CARE enrolled 4,934 patients in 130 hospitals; ICD enrolled 139,991 patients in 1,435 hospitals; and PINNACLE enrolled 249,198 patients (1,436,328 individual encounters) in 74 practices (1,222 individual providers). Data on performance metrics and outcomes, in some cases risk-adjusted using validated NCDR® models, are presented. The NCDR® provides a unique opportunity to understand the characteristics of large populations of patients with CVD, the centers that provide their care; quality of care provided; and important patient outcomes.Journal of the American College of Cardiology 09/2013; · 14.09 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We describe characteristics associated with use of endarterectomy (CEA) versus stenting (CAS) in patients before urgent cardiac surgery. The optimal modality of carotid revascularization preceding cardiac surgery is unknown. Retrospective evaluation of the CARE (Carotid Artery Revascularization and Endarterectomy) registry from January 2005 to April 2010 was performed on patients undergoing CEA or CAS preceding urgent cardiac surgery within 30 days. Baseline characteristics were compared, and multivariate adjustment was performed. Of 451 patients who met study criteria, 255 underwent CAS and 196 underwent CEA. Both procedures increased over time to a similar degree (p = 0.18). Patients undergoing CAS had more frequent history of peripheral artery disease (38.2% vs. 26.5%, p < 0.01), neck surgery (5.5% vs. 1.0%, p = 0.01), neck radiation (4.3% vs. 1.0%, p = 0.04), left-main coronary disease (34.8% vs. 23.5%, p < 0.01), neurological events (45.8% vs. 31.3%, p < 0.01), carotid intervention (20.8% vs. 7.6%, p < 0.01), and higher baseline creatinine (1.3 vs. 1.1 mg/dl, p = 0.02). The target carotid arteries of CAS patients were more likely to be symptomatic in the 6 months before revascularization and have restenosis from prior CEA. Patients undergoing CAS had a lower American Society of Anesthesiology grade. Midwest hospitals were less likely to perform CAS than CEA, whereas in the other regions CAS was more common (p < 0.01). Non-Caucasian race, a history of heart failure, previous carotid procedures, prior stroke, left main coronary artery stenosis, lower American Society of Anesthesiology grade, and teaching hospital were independent predictors of patients who would receive CAS. Carotid artery stenting and CEA have increased among patients undergoing urgent cardiac surgery. Patients who underwent CAS had more vascular disease but lower acute pre-surgical risk. Significant regional variation in procedure selection exists.JACC. Cardiovascular Interventions 11/2011; 4(11):1200-8. · 1.07 Impact Factor
- Journal of The American College of Cardiology - J AMER COLL CARDIOL. 01/2010; 55(10).