ACCF/AHA/SCAI 2013 Update of the Clinical Competence Statement on Coronary Artery Interventional Procedures

Harold, John; Bass, Theodore A.; Bashore, Thomas M.; Brindiss, Ralph G.; Brush, John E.; Burke, James A.; Dehmers, Gregory J.; Deychak, Yuri A.; Jneids, Hani; Jolliss, James G.; Landzberg, Joel S.; Levine, Glenn N.; McClurken, James B.; Messengers, John C.; Moussas, Issam D.; Pomerantz, Richard M.; Sanborn, Timothy A.; Sivaram, Chittur A.; Whites, Christopher J.; Williamss, Eric S.; Halperin, Jonathan L.; Beckman, Joshua A.; Bolger, Ann F.; Byrne, John G.; Lester, Steven J.; Merli, Geno J.; Muhlestein, J. Brent; Piña, Ileana L.; Wang, Andrew; Weitz, Howard H.

doi:10.1002/ccd.24985

Cited by 25 publications

(10 citation statements)

References 182 publications

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“…This approach would be consistent with current American College of Cardiology recommendations for triage and immediate transfer to a PCI‐capable facility with surgical backup for patients with acute coronary syndromes because revascularization has demonstrated a mortality benefit at both 6 and 12 months when compared with medical stabilization. 28,34 …”

Section: Discussionmentioning

confidence: 99%

Effect of Cardiogenic Shock Hospital Volume on Mortality in Patients With Cardiogenic Shock

Shaefi

O’Gara

Kociol

et al. 2015

JAHA

137

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BackgroundCardiogenic shock (CS) is associated with significant morbidity, and mortality rates approach 40% to 60%. Treatment for CS requires an aggressive, sophisticated, complex, goal‐oriented, therapeutic regimen focused on early revascularization and adjunctive supportive therapies, suggesting that hospitals with greater CS volume may provide better care. The association between CS hospital volume and inpatient mortality for CS is unclear.Methods and ResultsWe used the Nationwide Inpatient Sample to examine 533 179 weighted patient discharges from 2675 hospitals with CS from 2004 to 2011 and divided them into quartiles of mean annual hospital CS case volume. The primary outcome was in‐hospital mortality. Multivariate adjustments were performed to account for severity of illness, relevant comorbidities, hospital characteristics, and differences in treatment. Compared with the highest volume quartile, the adjusted odds ratio for inpatient mortality for persons admitted to hospitals in the lowest‐volume quartile (≤27 weighted cases per year) was 1.27 (95% CI 1.15 to 1.40), whereas for admission to hospitals in the low‐volume and medium‐volume quartiles, the odds ratios were 1.20 (95% CI 1.08 to 1.32) and 1.12 (95% CI 1.01 to 1.24), respectively. Similarly, improved survival was observed across quartiles, with an adjusted inpatient mortality incidence of 41.97% (95% CI 40.87 to 43.08) for hospitals with the lowest volume of CS cases and a drop to 37.01% (95% CI 35.11 to 38.96) for hospitals with the highest volume of CS cases. Analysis of treatments offered between hospital quartiles revealed that the centers with volumes in the highest quartile demonstrated significantly higher numbers of patients undergoing coronary artery bypass grafting, percutaneous coronary intervention, or intra‐aortic balloon pump counterpulsation. A similar relationship was demonstrated with the use of mechanical circulatory support (ventricular assist devices and extracorporeal membrane oxygenation), for which there was significantly higher use in the higher volume quartiles.ConclusionsWe demonstrated an association between lower CS case volume and higher mortality. There is more frequent use of both standard supportive and revascularization techniques at the higher volume centers. Future directions may include examining whether early stabilization and transfer improve outcomes of patients with CS who are admitted to lower volume centers.

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Section: Discussionmentioning

confidence: 99%

Effect of Cardiogenic Shock Hospital Volume on Mortality in Patients With Cardiogenic Shock

Shaefi

O’Gara

Kociol

et al. 2015

JAHA

137

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“…14 The most recent document on clinical competence in coronary intervention recommends a minimum of 50 PCI procedures per year to maintain competency but does not specifically address vascular access. 15 The European consensus statement recommends 80 transradial coronary procedures annually, both diagnostic and interventional, to maintain proficiency. 16 The next step in changing the transfemoral culture in the United States is to target the cardiology training curriculum and ensure that the next generation of operators has the cognitive knowledge and procedural skills for TR catheterization.…”

Section: 13mentioning

confidence: 99%

The Pace of Transradial Procedural Learning

Abbott

2014

Circulation

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“…27 This is re-iterated in the 2013 update on clinical competencies for PCI but with recognition that angiography provides ''an imperfect assessment of coronary structure and stenosis severity''. 22 Thus, it is recommended that ''other diagnostic modalities such as intravascular ultrasound (IVUS) and fractional flow reserve should be available'' during PCI. Indeed, Yoon and Hur 48 highlight four criteria for optimal stent deployment when using IVUS:…”

Section: Clinically Optimal Outcomesmentioning

confidence: 99%

Design Optimisation of Coronary Artery Stent Systems

2015

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In recent years, advances in computing power and computational methods have made it possible to perform detailed simulations of the coronary artery stenting procedure and of related virtual tests of performance (including fatigue resistance, corrosion and haemodynamic disturbance). Simultaneously, there has been a growth in systematic computational optimisation studies, largely exploiting the suitability of surrogate modelling methods to time-consuming simulations. To date, systematic optimisation has focussed on stent shape optimisation and has re-affirmed the complexity of the multi-disciplinary, multi-objective problem at hand. Also, surrogate modelling has predominantly involved the method of Kriging. Interestingly, though, optimisation tools, particularly those associated with Kriging, haven't been used as efficiently as they could have been. This has especially been the case with the way that Kriging predictor functions have been updated during the search for optimal designs. Nonetheless, the potential for future, carefully posed, optimisation strategies has been suitably demonstrated, as described in this review.

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ACCF/AHA/SCAI 2013 Update of the Clinical Competence Statement on Coronary Artery Interventional Procedures

Cited by 25 publications

References 182 publications

Effect of Cardiogenic Shock Hospital Volume on Mortality in Patients With Cardiogenic Shock

Effect of Cardiogenic Shock Hospital Volume on Mortality in Patients With Cardiogenic Shock

The Pace of Transradial Procedural Learning

Design Optimisation of Coronary Artery Stent Systems

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