1. Fewer PCIs After Public Reporting Changes in NY
Public reporting of mortality outcomes for coronary revascularization has resulted in significant risk aversion among PCI operators.
The change in coronary revascularization and in-hospital mortality rates for acute myocardial infarction (AMI) patients complicated by cardiogenic shock (CS) (n=45,977) following CS exclusion from public reporting in New York were examined.1
There was an increase in the number of patients who underwent PCI for shock following the policy change of (49.2%) vs the reference period of (44.9%).
A trend toward decreased incidence of in-hospital mortality was also observed in New York:
47.1% in the reference period
35.5% in the post-policy period
New York also saw an increase in the following procedures (reference period to post-policy period):
Coronary angiography (63.6% to 67.9%, respectively)
PCIs (30.5% to 39.7%, respectively)
Despite these findings, New York continued to report lower rates of coronary revascularization for AMI patients complicated by CS, reflecting the persistent hesitation among physicians to recommend PCI for high-risk patients.
McCabe JM et al. JAMA Cardiol. 2016;1(6):
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