FDA Approves SAPIEN Transcatheter Heart Valve
ACC, STS Developing New Registry to Track TAVR Procedures
The Food and Drug Administration (FDA) has announced approval of the Edwards Lifesciences SAPIEN Transcatheter Heart Valve. This is one of several devices in development for use in the emerging field of transcatheter aortic valve replacement (TAVR).

In their announcement, the FDA noted that Edwards Lifescience will continue to evaluate the outcomes of the SAPIEN transcatheter heart valve through a national Transcatheter Valve Therapy (TVT) registry that will track patient safety and real world outcomes related to emerging TAVR procedures.

The Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC) have been partnering in the development of this new registry. The TVT Registry™ will be the first national program to evaluate safety and efficacy of a transcatheter valve aortic replacement (TAVR) option for patients who are otherwise considered to be non-operable for conventional valve replacement surgery.

The TVT Registry will serve as the main repository for clinical data related to TAVR and is positioned to capture outcomes data for expanded indications, additional devices and procedures that will likely emerge in the future. The goal of the registry is to link clinical and administrative claims data to assess early and longer term outcomes. The registry forms the basis of a new platform that can be used for FDA post approval studies in future generations of transcatheter valve devices.

The registry, which is scheduled to launch in late 2011, is being developed in collaboration with the FDA and CMS with input from other professional societies including the Society for Cardiovascular Angiography and Interventions (SCAI) and the American Association for Thoracic Surgery (AATS), and trial sponsors from industry.

More information about the TVT Registry will be coming soon.

ACTION Registry®-GWTG™ Gold and Silver Award Recipients
The NCDR congratulates the recipients of the ACTION Registry-GWTG 2011 Performance Achievement Awards. Click here to see the complete list of Gold and Silver Award recipients. For information about how your ACTION Registry-GWTG hospital can earn a Performance Achievement Award, please contact us at (800) 257-4737 or ncdr@acc.org.

Paul Chan Discusses Appropriateness of PCI and the NCDR^®
The November issue of Cath Lab Digest features an interview with Paul S. Chan, MD, MSc, author of “Appropriateness of Percutaneous Coronary Intervention,” published in the Journal of the American Medical Association in July. In the interview, Chan was asked about the impact of his research, which was based on CathPCI Registry^® data − and the NCDR’s impact on cardiovascular research.

Commenting on the mixed attention that arose from the paper, Chan said, “In discussions with various news reporters and writers, I have found some people think it is good news and some think it is bad news. It is probably a little bit of both.”

Chan described the ways in which the research he and his colleagues conducted differed from previous PCI studies, as well as the findings that garnered so much attention. “There have been prior studies that have looked at whether PCIs were appropriate or not, but many of those studies used the authors’ own appropriateness assessments. What we wanted to leverage this time was a national set of appropriate use guidelines from organizations such as the American College of Cardiology (ACC) and the Society for Cardiac Angiography and Interventions (SCAI). We set forth to match percutaneous coronary intervention (PCI) procedures from a large national registry, the NCDR’s CathPCI Registry, to indications from the appropriate use criteria.”

When asked what impact the ACC’s NCDR has had on the cardiology community in general, Chan replied,”The creation of these registries was, in many ways, one of the most important steps in looking at and performing outcomes research in cardiology.” He discussed other groundbreaking studies made possible by NCDR data, and pointed out that resulting research can at times be provocative and cause concern, and at other times be a cause for celebration − such as the recent Circulation article highlighting advances in door-to-balloon (D2B) times.

“Still, the NCDR and the group effort behind it has fostered the expectation that we keep moving the quality yardstick one step further, with the goal of improving the care that we provide to our patients. Ultimately, that is really what it is about — ensuring safety and the delivery of the highest quality care we as a profession can provide. Most hospitals that participate in the NCDR value the comparative numbers that their participation provides them. It allows them to get a good handle on how they are doing compared to other hospitals nationwide.”

Click here to read the full article.

Helping Decision-Makers See the Value of NCDR.12 Attendance
Registration for NCDR.12 is opening soon! We hope you plan to join us next year at the Fairmont Chicago Millennium Park hotel in Chicago on March 21 and 22. Remember, your hospital will receive one complimentary registration for each NCDR registry you join or renew for 2012.

Each year, annual meeting attendees report gaining new registry-specific knowledge, learning about important healthcare issues and leaving the meeting equipped to improve the quality of their data and patient care.

If you need help demonstrating the value of your participation in NCDR.12 to your supervisor, view our decision-maker pass-along letter. The letter, developed by the NCDR, can be personalized with your administrator or manager’s name and then emailed or hand delivered.

ACC’s CEO Addresses Value-Based Purchasing and the NCDR
In a new video, ACC CEO Jack Lewin, MD discusses the impacts of the impending transformation of health care delivery and reimbursement — and how the NCDR will play a key role. Click here to view the video.

Taking It On With the NCDR: A Success Story Highlighting NCDR Data in Action
As we gear up for NCDR.12, we are reminded of the hard work and achievements of the NCDR.11 poster award winners. Being recognized as a poster winner at the annual meeting is something each awardee can be very proud of − not just for the recognition they and their hospital receive, but for the life-saving improvements the work behind each poster represents.		Barb Christensen, MSHA, RN, senior director, NCDR (far left) and Kathleen Hewitt, MSN, RN, AACC, associate vice president, NCDR (far right), present the 3rd Place Poster Award to Melissa Baker, LPN during NCDR.11.

When Melissa Baker, LPN, Nancy Arena-Gogal, RN, BSN, and the CathPCI Registry team at Abington Memorial Hospital in Abington, Pennsylvania took on the challenge that ultimately led to their 3rd place NCDR.11 poster, they had quality improvement and their patients’ health in mind.

After consistently achieving their goal of a 90 minute Door-to-Balloon (D2B) time in their ER, the team set their sights on transfer hospital D2B times. And the CathPCI Registry held the key to the information they needed.

“The CathPCI Registry version 4.0 form included the collection of ER arrival time at the transferring hospital. This helped us to collect Transfer-to-Balloon (T2B) time and allowed us to analyze this data on an individual basis as well as to track our progress on a quarterly basis,” said Baker.

After analyzing the hospital’s quarterly outcomes reports, Baker realized that engaging their transfer hospital in the process would significantly decrease their T2B time. She was also excited to discover that they had decreased their T2B time by 40 minutes over a period of one year − from 151 minutes in 2009 to 110 minutes in 2010.

“We were pleasantly surprised to find that our average of 110 minutes was below the national average of 117 minutes for 3rd quarter of 2010. We sometimes are so focused on the goal time of 90 minutes that we didn’t appreciate the improvements that had already been achieved,” continued Baker.

Excited about the improved care they are now providing to their patients, the team has much to celebrate.

“We are now able to offer our transferred patients the level of care that they deserve, and that is in-line with the national standard. A 40-minute reduction in time improves preserved heart muscle and decreases morbidity and mortality.”

Additionally, Baker reports that even after conducting their research, the team continues to fine tune their process and is still setting the bar for best practices, having achieved times as low as 74 minutes for T2B times.

When asked what advice she has for other NCDR sites looking to accomplish a similar goal, Baker recommends communication and collaboration.

“We partnered with our local EMS providers who are interested in improving care by providing early transmission of EKG’s and notification from the field. Our EMS has monthly representation at our PCI meetings. The implementation of our one call transfer line has also been critical in improving communication of a STEMI patient.”

The overwhelming support from the ER physicians, cardiologists, catheterization staff and critical care staff has been essential to our success,” concludes Baker.

To view Abington Memorial Hospital’s winning poster, click here.

For a complete list of NCDR.11 poster award winners, view the April 2011 issue of News and Views.

It’s Time to Renew Your Registry Participation for 2012
The NCDR has emailed renewal packets to the billing contact listed in your online profile. If your billing contact did not receive your renewal packet in early October, please check your online profile to be sure that the correct billing contact is listed for your hospital. You can access your profile under the Administration tab when logged into www.ncdr.com.

Some important information for 2012:

• A new contract amendment is required for all participants
• The deadline for renewals is December 31, 2011
• If your facility is setup under a corporate account, all renewal materials will be sent to your corporate contact

If you have any questions, please contact the NCDR Product Support Team at (800) 257-4737 or ncdr@acc.org. Thank you again for another successful year. We look forward to working with you in 2012!

NCDR Poster Author to be Recognized During AHA Scientific Sessions
Brian Hynes, MD, will be recognized for his research based on data from the CARE Registry^® during the AHA’s Scientific Sessions in Orlando this November. Selected by the Committee on Scientific Sessions Program, Dr. Hynes' abstract titled, “Outcomes of Carotid Artery Stenting for Recurrent Carotid Artery Restenosis Following Prior Ipsilateral Carotid Artery Endarterectomy or Stenting,” has been designated as a poster award winner. The poster received the highest score among all the abstracts accepted as a poster presentation under Core 6: Catheter-Based and Surgical Interventions.

Dr. Hynes’ poster will be displayed on Monday, November 14 from 9:30 – 11:00 a.m. on board number 6033.

A total of 14 abstracts based on NCDR data have been accepted for presentation during this year’s Scientific Sessions. The PINNACLE Registry^®, ACTION Registry^®-GWTG™, CathPCI Registry^®, CARE Registry^® and ICD Registry™ will be represented. For a complete list of these abstracts, visit the Latest News page www.ncdr.com after Wednesday, November 9 or watch your email for an electronic version of the NCDR Abstract Guide. You may also pick up an NCDR Abstract Guide at the ACC Central, booth number 1308, during the sessions in Orlando.  

PINNACLE Registry^® Expanding to Include Atrial Fibrillation Treatments
The PINNACLE Registry is expanding its CV outpatient registry with a new platform focusing on atrial fibrillation and including the next generation of anticoagulants. The new platform, PINNACLE-AF, will launch in 2012 and operate within the existing PINNACLE Registry. The PINNACLE Registry currently has 2.1 million patient records representing valid patient encounters from hundreds of outpatient practices nationwide. Of those patients, over 100,000 have atrial fibrillation.

This expansion is timely, coinciding with new treatments for atrial fibrillation coming online. In this context of innovation, the PINNACLE Registry can provide a means to assess current practice patterns and monitor practice pattern changes over time, helping providers evaluate and improve adherence to established guidelines and performance measures. The expansion will also provide a deeper data repository for future research and innovation. For more information about the registry, visit www.PINNACLEregistry.org. 

Recently Published NCDR Research
The following papers based on research conducted with NCDR data have recently been published. Click the links below to view the abstracts online.

CathPCI Registry
Use of Early Clopidogrel by Reperfusion Strategy Among Patients Presenting With ST-Segment Elevation Myocardial Infarction, Circulation Cardiovascular Quality and Outcomes

ACTION Registry-GWTG
Safety and Efficacy of Drug-Eluting Stents in Older Patients with Chronic Kidney Disease, JACC

Characteristics and In-hospital Outcomes of Patients with Non-ST-segment Elevation Myocardial Infarction and Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention, JACC Cardiovascular Interventions

NCDR Data Audit Program Update
The 2011 Data Audit for CathPCI Registry and ICD Registry was launched in September. All selected participants have been contacted and the review at some facilities has already occurred. The preliminary and confidential site report should be available by the end of the year. If you have not heard from the NCDR regarding this effort, your facility was not selected to participate in this year’s data audit. We would like to thank everyone involved for their time and attention during the 2011 audit cycle.

We are also preparing for our first nationwide data audit for the ACTION Registry-GWTG. Randomly selected participants will be notified by the end of the year and will receive all necessary information.

Please contact us at ncdrresearch@acc.org if you have any questions about the data audit process.

TRANSLATE-ACS Reaches an Important Milestone
The first abstract based on data from the TRANSLATE-ACS Study will be presented at the Transcatheter Cardiovascular Therapeutics (TCT) conference in San Francisco on November 8, 2011.

This first analysis of the longitudinal data from TRANSLATE-ACS assesses the incidence of bleeding and antiplatelet therapy disruption after hospital discharge among patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) and dual antiplatelet therapy. This is a particularly critical question as practice guidelines currently recommend at least one month and ideally one year of dual antiplatelet therapy after AMI, yet the occurrence of bleeding, even when mild in severity, may result in antiplatelet therapy discontinuation.

TRANSLATE-ACS is an observational study led by the American College of Cardiology Foundation and Duke Clinical Research Institute that allows CathPCI Registry hospitals to build on their routine quality improvement data collection and gain insight into patient outcomes and outpatient treatment patterns following AMI discharge. There are currently more than 200 hospitals participating in the TRANSLATE-ACS study. Hospitals receive tailored, confidential reports with feedback on their AMI patients, including 30-day rates of hospital readmission and medication adherence. These reports help hospitals identify unmet needs and targets for improvement.

As exemplified by this first TRANSLATE-ACS abstract, this longitudinal perspective of AMI patients in the “real-world” setting is key to identifying care gaps so patient outcomes can be optimized. Future studies of the TRANSLATE-ACS population will continue to examine post-discharge care patterns and treatment adherence, and evaluate the safety, effectiveness, and healthcare costs associated with therapies delivered to contemporary STEMI and NSTEMI patients.

Related Quality News

ACCF Joins Million Hearts Initiative, Offers Ambulatory Quality Improvement Opportunities
Earlier this fall, Secretary of Health and Human Services Kathleen Sebelius announced the creation of the Million Hearts initiative, a new public-private partnership aimed at preventing 1 million vascular events in the next five years. Million Hearts will pursue this prevention goal through a focus on ABCS: Aspirin for people at risk, Blood pressure control, Cholesterol management, and Smoking cessation. This initiative will be overseen by former ACC Senior Vice President of Science and Quality Janet Wright, MD, FACC.

In a recent letter to Secretary Sebelius, ACC CEO Jack Lewin, MD and ACC President David Holmes, MD, FACC noted that the PINNACLE Registry and its sister PINNACLE Network™ are well positioned for playing key roles in Million Hearts. PINNACLE Registry performance measures can be used to provide a current, baseline snapshot of care delivered in cardiology practices. As the Million Hearts initiative moves forward, PINNACLE Registry and Network providers will offer a forum for the collection, standardization and refinement of ABCS quality interventions. You’ll be hearing more about this important initiative in the coming weeks.

ACC’s 44th Annual New York Cardiovascular Symposium
The popular New York Cardiovascular Symposium examines the year’s latest advances in management and treatment of cardiovascular disease. Healthcare professionals from around the world will converge for an information-packed, three-day conference highlighting the current methods and technologies used to treat CVD. Year after year, Program Director Valentin Fuster, MD, PhD, MACC, selects renowned experts in the field to discuss and debate cutting-edge issues that impact the cardiovascular profession and practice. Register today for best rates!

Upcoming Webinar: Improve Outcomes, Lower Costs with Registry Data
Certified NCDR vendor Lumedx will host the webinar, “Improve Outcomes, Lower Costs with Registry Data: How to Make Your Quality Initiatives Pay Using Data You've Already Collected,” at 1:00 p.m. Eastern on Thursday, November 17, 2011.

Join Premier Healthcare Alliance's Principal Cardiovascular Consultant Dawn Terry as she shows how you can streamline your data management processes to improve quality and manage costs. Through proven strategies and techniques, you'll learn how to increase the value of your registry data - identify trends, package information to engage physicians and drive evidence-based care.

For more information and to register, click here.

NCDR Registry Stats

B11260
 

Paul Chan Discusses Appropriateness of PCI and the NCDR

Helping Decision-Makers See the Value of NCDR.12 Attendance

ACC’s CEO Addresses Value-Based Purchasing and the NCDR

Taking It On With the NCDR: A Success Story Highlighting NCDR Data in Action

It’s Time to Renew Your Registry Participation for 2012

NCDR Poster Author to be Recognized During AHA Scientific Sessions

PINNACLE Registry Expanding to Include Atrial Fibrillation Treatments

Recently Published NCDR Research

NCDR Data Audit Program Update

TRANSLATE-ACS Reaches an Important Milestone

ACCF Joins Million Hearts Initiative, Offers Ambulatory Quality Improvement

ACC’s 44th Annual New York Cardiovascular Symposium

Upcoming Webinar: Improve Outcomes, Lower Costs with Registry Data

NCDR in the News:

ACC expands PINNACLE Registry to include AF patients, Cardiovascular Business
 

Inappropriate” PCIs in the U.S.: Appropriate Use Criteria, Referrals to the Cath Lab, and the Nuances of Intervention, Cath Lab Digest
 

Value-Based Purchasing and the NCDR, CardioSource Video News

Previous Issues of News and Views

October, 2011

September, 2011

July/August, 2011

Calendar:

ICD Registry Site Manager Call
Tuesday, November 15, 2011
1:00 p.m. Eastern

CathPCI Registry Site Manager Call
Thursday, November 17, 2011
1:00 p.m. Eastern

ACTION Registry-GWTG New User Call
Monday, November 21, 2011
1:00 p.m. Eastern

ACTION Registry-GWTG Site Manager Call
Wednesday, November 23, 2011
1:00 p.m. Eastern

CathPCI Registry New User Call
Thursday, December 1, 2011
1:00 p.m. Eastern

ICD Registry New User Call
Tuesday, December 6, 2011
1:00 p.m. Eastern

CARE Registry RSM/New User Call
Tuesday, December 13, 2011
1:00 p.m. Eastern

IMPACT Registry RSM/New User Call
Wednesday, December 21, 2011
1:00 p.m. Eastern

NCDR Archived Webinars:

CathPCI Registry to ACTION Registry-GWTG Interoperability New

CathPCI Registry Dashboard Overview

ACTION Registry–GWTG Outcomes Reports – Basic Navigation (new participants)

ACTION Registry–GWTG 2011 Outcomes Reports Enhancements

The Importance of Getting Green

NCDR Systems Alerts Review: ICD Registry, CathPCI Registry, IMPACT Registry, ACTION Registry-GWTG

ACTION Registry–GWTG Updates V2.2

ACTION Registry–GWTG Website Navigation

ACTION Registry-GWTG Completing the Online Data Collection Tool: Session 1 & 2

CARE Registry Website Navigation

CathPCI Registry Case Study V4.3

CathPCI Registry Website Navigation

CathPCI Registry DQRI Process

ICD Registry Data Quality Review (DQR) Process V2.1

ICD Registry Data Collection Tool V2.1

ICD Registry Navigation Support

IMPACT Registry Version 1.0 Website Navigation

IMPACT Registry Version 1.0: Data Collection Form and Definitions Part I, II & II

To access recorded webinars, login here. Choose a registry home page and click on Resources.

NCDR Registries:

NCDR^® is an initiative of the American College of Cardiology Foundation^®, with partnering support from the following organizations: CARE Registry^®-The Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, American Academy of Neurology, American Association of Neurological Surgeons/Congress of Neurological Surgeons, Society for Vascular Medicine, and Society of Vascular and Interventional Neurology; CathPCI Registry^®-The Society for Cardiovascular Angiography and Interventions; ICD Registry™-Heart Rhythm Society; IMPACT Registry™-The Society for Cardiovascular Angiography and Interventions and American Academy of Pediatrics; PINNACLE Registry™-MedAxiom and Spirit of Women; ACTION Registry^®-GWTG™- An initiative of the American College of Cardiology Foundation and the American Heart Association, with partnering support from Society of Chest Pain Centers, The American College of Emergency Physicians, and The Society of Hospital Medicine.