Ischemic Heart Disease

Cardiac Catheterization Laboratory Procedure

Medical Conditions Among Patients Undergoing PCI Procedures

N = 1577

Many patients who have percutaneous coronary intervention (PCI) procedures at Cleveland Clinic have complex medical backgrounds. Our physicians often treat patients who are referred for high-risk PCI who are on advanced life support, including Impella, intra-aortic balloon pump and extracorporeal membrane oxygenation (ECMO). Cleveland Clinic physicians also perform hybrid procedures that involve valve replacements and PCI at the same time. With this unique patient population, the risk of bleeding is higher than the expected rate as defined by the National Cardiovascular Data Registry (NCDR). Cleveland Clinic is continuously striving to achieve the best outcomes while providing the most advanced treatment options.

CABG = coronary artery bypass graft, LV = left ventricular, MI = myocardial infarction

ACC-NCDR database

Use of Appropriate Process Measures: Medications

N = 1577

The American College of Cardiology National Cardiovascular Data Registy (ACC-NCDR) has several key performance measures to evaluate hospitals. One of these measures is the use of appropriate adjunctive medications before and after percutaneous coronary intervention (PCI) procedures. Cleveland Clinic outperformed comparable hospitals (hospitals that perform more than 500 PCI procedures per year) in the use of all adjunctive medications.

ACC-NCDR database

PCI Procedure Complications

N = 1577

Many patients who have percutaneous coronary intervention (PCI) procedures at Cleveland Clinic have complex medical backgrounds, which increase the risk of complications. In addition, Cleveland Clinic interventionalists perform hybrid procedures, which increase the risk of bleeding as defined by The National Cardiovascular Data Registry (NCDR). These hybrid procedures are performed less often at comparable hospitals. Cleveland Clinic is continuously striving to achieve the best possible outcomes for patients while providing the most advanced treatments possible.

CABG = coronary artery bypass graft

ACC-NCDR database

*NCDR National Rate being used. The ACC-NCDR does not report a rate for PCI-related risk-adjusted bleeding events at hospitals comparable to Cleveland Clinic.

Door-to-Balloon Time

N = 58

The American College of Cardiology/American Heart Association (ACC/AHA) guideline for percutaneous coronary intervention (PCI) inflation for patients who come to the emergency department with ST-elevation myocardial infarction (STEMI) is 90 minutes. Cleveland Clinic continues to improve door-to-balloon time to reduce the risk of mortality and morbidity. In 2017, the median time at Cleveland Clinic was 51 minutes, which was lower than the average (59 minutes) at comparable hospitals.

Source: ACC-NCDR database

Use of Radial Access

2017

In 2017, Cleveland Clinic performed more percutaneous coronary intervention (PCI) procedures using radial access than did comparable hospitals. The use of radial access is associated with reductions in bleeding complications, readmission rates, infection, and recovery time compared with PCI procedures done using a femoral approach.

ACC-NCDR database