A contemporary overview of percutaneous coronary interventions - The American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR)
A contemporary overview of percutaneous coronary interventions - The American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR)
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DOI：
10.1016/s0735-1097(02)01733-3
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发表时间：
2002-04-03
影响因子：
24
通讯作者：
Weintraub, WS
中科院分区：
文献类型：
--
作者：
Anderson, HV;Shaw, RE;Weintraub, WS
美国心脏病学会（ACC）建立了国家心血管数据登记处（ACC- ncdr），为全国心血管手术分析提供统一和全面的数据库。最初的重点是诊断性心导管插入术和经皮冠状动脉介入治疗（PCI）的大容量，高知名度的程序。背景：一些大规模的多中心研究已经评估了诊断性导管置入和PCI，但由于缺乏标准定义和相对不统一的数据收集和报告方法，这些研究受到了限制。方法收集临床和手术资料，以及直到出院前发生的不良事件，并根据统一的指南使用143个标准数据元素进行报告。每季度将数据集传送到一个中央设施，用于质量控制筛选、储存和分析。本报告基于从1998年1月1日到2000年9月30日收集的PCI数据。结果139家医院共提交了146907例PCI手术的数据。其中，32%（46,615例）因数据未通过质量控制筛选而被排除，其余100,292例（68%）被纳入分析集。平均年龄64±12岁；34%为女性，26%有糖尿病，29%有心肌梗死史，32%有PCI病史，19%有冠状动脉搭桥手术史。10%的PCI指征为急性心肌梗死：发病后56小时，52%为II级至IV级或不稳定型心绞痛，只有5%的手术没有ACC标准的I级指征，但这一比例因医院而异，从低至0到高至38%。在77%的手术中置入了冠状动脉支架，但这一比例因医院而异，低至0%，高至97%。院内q波心肌梗死发生率为0.4%，冠状动脉搭桥手术发生率为1.9%，死亡发生率为1.4%。死亡率因医院而异，低至0%，高至4.2%。本报告首次介绍了ACC-NCDR收集和分析的数据，采用统一的数据收集和报告标准，描绘了当代冠状动脉介入治疗实践和结果的概述。这些数据再次证实了总体上可接受的结果与其他报告的数据一致，但也证实了各个机构之间的巨大差异。(C) 2002年由美国心脏病学会基金会发布。
OBJECTIVES The American College of Cardiology (ACC) established the National Cardiovascular Data Registry (ACC-NCDR) to provide a uniform and comprehensive database for analysis of cardiovascular procedures across the country. The initial focus has been the high-volume, high-profile procedures of diagnostic cardiac catheterization and percutaneous coronary intervention (PCI).BACKGROUND Several large-scale multicenter efforts have evaluated diagnostic catheterization and PCI, but these have been limited by lack of standard definitions and relatively nonuniform data collection and reporting methods.METHODS Both clinical and procedural data, and adverse events occurring up to hospital discharge, were collected and reported according to uniform guidelines using a standard set of 143 data elements. Datasets were transmitted quarterly to a central facility for quality-control screening, storage and analysis. This report is based on PCI data collected from January 1, 1998, through September 30, 2000.RESULTS A total of 139 hospitals submitted data on 146,907 PCI procedures. Of these, 32% (46,615 procedures) were excluded because data did not pass quality-control screening, The remaining 100,292 procedures (68%) were included in the analysis set. Average age was 64 +/- 12 years; 34% were women, 26% had diabetes mellitus, 29% had histories of prior myocardial infarction (MI), 32% had prior PCI and 19% had prior coronary bypass surgery. In 10% the indication for PCI was acute MI :56 h from onset, while in 52% it was class II to IV or unstable angina, Only 5% of procedures did not have a class I indication by ACC criteria, but this varied by hospital from a low of 0 to a high of 38%. A coronary stent was placed in 77% of procedures, but this varied by hospital from a low of 0 to a high of 97%. The frequencies of in-hospital Q-wave MI, coronary artery bypass graft surgery and death were 0.4%, 1.9% and 1.4%, respectively. Mortality varied by hospital from a low of 0 to a high of 4.2%.CONCLUSIONS This report presents the first data collected and analyzed by the ACC-NCDR, It portrays a contemporary overview of coronary interventional practices and outcomes, using uniform data collection and reporting standards. These data reconfirm overall acceptable results that are consistent with other reported data, but also confirm large variations between individual institutions. (C) 2002 by the American College of Cardiology Foundation.