title: Coronary artery disease performance measures and statin use in patients with recent percutaneous coronary intervention or recent coronary artery bypass grafting (from the NCDR PINNACLE registry).
abstract: The association between coronary revascularization strategy (percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]) and compliance with coronary artery disease (CAD) performance measures is not well studied. Our analysis studied patients enrolled in the Practice Innovation and Clinical Excellence registry, who underwent coronary revascularization using PCI or CABG in the 12 months before their most recent outpatient visit in 2011. We compared the attainment of CAD performance measures and statin use in eligible patients with PCI and CABG using hierarchical logistic regression models. Our study cohort consisted of 112,969 patients (80,753 with PCI and 32,216 with CABG). After adjustment for site and patient characteristics, performance measure compliance for tobacco use query (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.76 to 0.86), antiplatelet therapy (OR 0.9; 95% CI 0.86 to 0.94) and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy (OR 0.89; 95% CI 0.84 to 0.94) was lower in CABG compared with patients with PCI. Patients who underwent recent CABG had higher rates of β-blocker (OR 1.25; 95% CI 1.16 to 1.33) and statin treatment (OR 1.37; 95% CI 1.31 to 1.43) compared with patients with PCI. Of the 79 practice sites, 15 (19%) had ≥75% of their patients with CAD (CABG or PCI) meeting 75% to 100% of all eligible CAD performance measures. In conclusion, gaps persist in compliance with specific CAD performance measures in patients with recent PCI or CABG, and 1 in 5 practices had ≥75% compliance of eligible CAD performance measures in the most of their patients.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas; Section of Cardiology, Department of Medicine, Texas Heart Institute, CHI/ Baylor St. Luke's Medical Center, Houston, Texas. Electronic address: bandeali@bcm.edu.
authors.forename: Salman J
authors.initials: SJ
authors.lastname: Bandeali
authors.affiliation: Department of Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.
authors.forename: Kensey
authors.initials: K
authors.lastname: Gosch
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Mahboob
authors.initials: M
authors.lastname: Alam
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Waleed T
authors.initials: WT
authors.lastname: Kayani
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
authors.forename: Hani
authors.initials: H
authors.lastname: Jneid
authors.affiliation: American College of Cardiology Foundation.
authors.forename: Fran
authors.initials: F
authors.lastname: Fiocchi
authors.affiliation: Section of Cardiology, Department of Medicine, Texas Heart Institute, CHI/ Baylor St. Luke's Medical Center, Houston, Texas.
authors.forename: James M
authors.initials: JM
authors.lastname: Wilson
authors.affiliation: Department of Medicine, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Chan
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
authors.forename: Anita
authors.initials: A
authors.lastname: Deswal
authors.affiliation: VA Eastern Colorado Health Care System/University of Colorado School of Medicine, Denver, Colorado.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Maddox
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Health Policy, Quality and Informatics Program, Michael E. DeBakey Veteran Affairs Medical Center Health Services Research and Development Center for Innovations, Houston, Texas; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, Texas.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors