A Contemporary View of Diagnostic Cardiac Catheterization and Percutaneous Coronary Intervention in the United States

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. (J Am Coll Cardiol 2012;60:2017-31) (C) 2012 by the American College of Cardiology Foundation