Ischemic Heart Disease Outcomes - Faisal Bakaeen, MD and Samir Kapadia, MD

Ischemic Heart Disease

It is critical for patients who have a heart attack to get quick treatment. The American College of Cardiology (ACC) and American Heart Association (AHA) set a 90-minute treatment goal for all patients who have a type of heart attack called ST elevation myocardial infarction (STEMI). The ACC/AHA treatment goal means the patient should have the blockage(s) causing the heart attack cleared within 90 minutes of arriving at the hospital. It is called door-to-balloon time because it refers to the time from the patient comes through the door to the time a catheterization (which uses a tiny balloon to clear the blocked artery) is done/stent is placed. In 2016, the average treatment time at Cleveland Clinic for patients who had a STEMI was 48 minutes, which is well below the goal.

Outcomes - Ischemic Heart Disease | Door-to-Balloon Time

Coronary artery bypass graft (CABG) surgery is a type of heart surgery that is done to treat patients with unhealthy/blocked coronary arteries. The coronary arteries supply oxygen-rich blood to the heart. The surgery uses one or more healthy arteries from other parts of the body to create a detour (bypass) for blood to flow to the heart. An isolated procedure means the surgery is done alone. In 2016, Cleveland Clinic surgeons performed 810 isolated CABG surgeries, 751 were in combination with another procedure. The graph to the right shows that the percentage of patients who died as a result of the surgery (blue column) was lower than the predicted rate (orange column) in the past three years.

Outcomes: Ischemic Heart Disease | Isolated CABG Procedures

Approximately 12% to 15% of US hospitals received the STS “3 star” rating for CABG surgery. This denotes the highest category of quality. In the current analysis of national data covering the period from Jan. 1, 2016, through Dec. 31, 2016, the CABG surgery performance at Cleveland Clinic was found to lie in this highest quality tier, thereby earning the STS 3-star rating.

CABG: Composite Quality Rating