当代美国诊断性心导管术和经皮冠状动脉介入治疗的观点：来自全国心血管数据注册中心 CathPCI 登记处的报告，2010 年至 2011 年 6 月。

A contemporary view of diagnostic cardiac catheterization and percutaneous coronary intervention in the United States: a report from the CathPCI Registry of the National Cardiovascular Data Registry, 2010 through June 2011.

机构信息

Texas A&M Health Science Center College of Medicine, Temple, TX, USA.

出版信息

J Am Coll Cardiol. 2012 Nov 13;60(20):2017-31. doi: 10.1016/j.jacc.2012.08.966. Epub 2012 Oct 17.

DOI:10.1016/j.jacc.2012.08.966

PMID:23083784

Abstract

OBJECTIVES

This study sought to provide a report to the public of data from the CathPCI Registry of the National Cardiovascular Data Registry.

BACKGROUND

The CathPCI Registry collects data from approximately 85% of the cardiac catheterization laboratories in the United States.

METHODS

Data were summarized for 6 consecutive calendar quarters beginning January 1, 2010, and ending June 30, 2011. This report includes 1,110,150 patients undergoing only diagnostic cardiac catheterization and 941,248 undergoing percutaneous coronary intervention (PCI).

RESULTS

Some notable findings include, for example, that on-site cardiac surgery was not available in 83% of facilities performing fewer than 200 PCIs annually, with these facilities representing 32.6% of the facilities reporting, but performing only 12.4% of the PCIs in this data sample. Patients 65 years of age or older represented 38.7% of those undergoing PCI, with 12.3% being 80 years of age or older. Almost 80% of PCI patients were overweight (body mass index ≥25 kg/m(2)), 80% had dyslipidemia, and 27.6% were current or recent smokers. Among patients undergoing elective PCI, 52% underwent a stress study before the procedure, with stress myocardial perfusion being used most frequently. Calcium scores and coronary computed tomography angiography were used very infrequently (<3%) before diagnostic or PCI procedures. Radial artery access was used in 8.3% of diagnostic and 6.9% of PCI procedures. Primary PCI was performed with a median door-to-balloon time of 64.5 min for nontransfer patients and 121 min for transfer patients. In-hospital risk-adjusted mortality in ST-segment elevation myocardial infarction patients was 5.2% in this sample.

CONCLUSIONS

Data from the CathPCI Registry provide a contemporary view of the current practice of invasive cardiology in the United States.

摘要

目的

本研究旨在向公众报告美国国家心血管数据注册中心的 CathPCI 注册研究数据。

背景

CathPCI 注册研究从美国大约 85%的心脏导管实验室收集数据。

方法

数据总结自 2010 年 1 月 1 日至 2011 年 6 月 30 日连续六个日历季度。本报告包括仅接受诊断性心脏导管检查的 1,110,150 例患者和接受经皮冠状动脉介入治疗（PCI）的 941,248 例患者。

结果

一些显著发现包括，例如，每年行 PCI 少于 200 例的 83%的设施没有现场心脏手术能力，这些设施占报告设施的 32.6%，但在本数据样本中仅完成了 12.4%的 PCI。接受 PCI 的患者中 65 岁或以上者占 38.7%，其中 12.3%为 80 岁或以上。将近 80%的 PCI 患者超重（体重指数≥25kg/m2），80%有血脂异常，27.6%为当前或近期吸烟者。在择期 PCI 患者中，52%在术前进行了负荷试验，其中最常使用负荷心肌灌注试验。在诊断性或 PCI 术前很少使用钙评分和冠状动脉计算机断层血管造影（<3%）。在诊断性和 PCI 操作中，桡动脉入路分别占 8.3%和 6.9%。非转运患者的门球时间中位数为 64.5 分钟，转运患者为 121 分钟，进行了直接 PCI。本样本中 ST 段抬高型心肌梗死患者的住院期间风险校正死亡率为 5.2%。