Elective Percutaneous Coronary Intervention

User Guide

The toolkit is composed of three sections:

  • Hospital and Health System Resources – for senior management, senior leaders for quality, clinic managers, nurse managers, key physician leaders and risk managers this section includes quality improvement resources and links to the National Cardiovascular Data Registry®.
  • Clinician Resources – for clinicians, this section includes mobile applications, guidelines and clinical evidence supporting the appropriate use of elective percutaneous coronary interventions.
  • Patient Resources – for patients, this section includes resources to understand the best use of angioplasty and how to obtain the right tests and treatments.

Hospital and Health System Resources

American Heart Association’s Get With The Guidelines® and Mission: Lifeline®
Get With The Guidelines®, a suite of hospital-based quality improvement programs and registries, offers online tools to provide patient-specific guidelines and track their adherence. Get With The Guidelines® helps hospitals follow the most up-to-date, research-based treatment guidelines, reducing gaps and disparities in the delivery of quality care, while supporting high value registries for cardiovascular research. To access, click here »

SCAI’s 2016 Quality Improvement Toolkit
This toolkit includes information on guidelines, peer review conferences, national database participation, pre-procedure checklists, data collection; and inventory management. The toolkit assists hospitals and health systems in identifying strengths as well as opportunities for improvement. To view, click here »

National Cardiovascular Data Registry® (NCDR) CathPCI Registry®
An ACC initiative, with SCAI partnering support, the CathPCI Registry® “assesses the characteristics, treatments and outcomes of cardiac disease patients who receive diagnostic catheterization and/or percutaneous coronary intervention (PCI) procedures. This powerful tool captures the data that measure adherence to ACC/American Heart Association clinical practice guideline recommendations, procedure performance standards, and appropriate use criteria for coronary revascularization.” To access, click here »

Understanding the Reporting of Appropriateness Use Criteria in the CathPCI Registry®
This guide explains how to interpret the Institutional Feedback Report organizational self-assessments of the appropriateness of PCI procedures at the hospital level. Each report includes the institution’s rate of appropriate, uncertain, and inappropriate procedures for PCIs in patients with acute coronary syndromes and non-acute presentations of coronary artery disease allowing participating hospitals to become more informed about their use of PCI and determine whether there are opportunities to improve the patients selected for coronary revascularization. To download, click here »

ACC Quality Improvement for Institutions Program
The ACC Quality Improvement for Institutions program gives health care institutions a comprehensive suite of cardiovascular registries and service solutions that supports quality clinical care and improves patient outcomes. To view, click here »

Expert Consensus Document: 2014 Update on PCI Without On-Site Surgical Backup
This study updates work on the performance of PCI without onsite surgery, recommendations and best practices for facilities engaged in PCI without on-site surgery. To download, click here »

What Each Registry Collects
A summary of the data collected by the National Cardiovascular Data Registry®, including patient demographics, provider and facility characteristics, history and risk factors appropriate use criteria and compliance with clinical guideline recommendations. To view, click here »

Clinician Resources

ACC’s Guideline Clinical Mobile Application
In addition to clinical guideline content, the application includes interactive tools for clinicians caring for patients with cardiovascular disease, such as risk scores, dosing calculators and algorithms. The application also includes features such as customizable bookmarks, note-taking and email compatible PDFs. To download, click here »

SCAI PCI Risk Calculator Application
SCAI has teamed up with the BMC2 Registry to create the SCAI PCI Risk Calculator will allow users to use one common tool to make a pre-procedure assessment of post-PCI risks including mortality, acute kidney injury and transfusion. To download, click here »

SCAI PCI Appropriateness Calculator
Online calculator offered by SCAI that allows determination of the appropriate use score for individual PCI procedures based on individual patient clinical characteristics. To access, click here »

Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator
A companion tool to the 2013 ACC/American Heart Association Guideline on the Assessment of Cardiovascular Risk, the ASCVD risk calculator enables health care providers and patients to estimate 10-year and lifetime risks for ASCVD. To access, click here »

The NCDR CathPCI Registry® Physician Dashboard

Guide for Physicians
This guide provides complete information about accessing and using the dashboard, including appropriate use criteria scores. To download, click here »

Powerpoint presentation
This presentation explains how the physician dashboard of the NCDR CathPCI Registry® can be used to ensure data is being accurately documented and abstracted, assess quality of care being provided and identify opportunities for improvement. To download, click here »

Coronary Revascularization Pocket Card
Developed by the ACC, this pocket card answers key questions and lists key decision variables about appropriate revascularization, as well as identifies reasons for which revascularization is rarely appropriate. To download, click here »

Guidelines and Appropriate Use Criteria

2012 Appropriate Use Criteria for Coronary Revascularization Focused Update
The ACC, in collaboration with SCAI, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America and the Society of Cardiovascular Computed Tomography published this focused update of the 2009 document to include new literature published since the original document and gaps noted during implementation. To download, click here »

2011 ACCF/American Heart Association/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary
Since 1980, the ACC and the American Heart Association have jointly produced guidelines in the area of cardiovascular disease. This guideline provides recommendations for CAD revascularization, pre- procedural, procedural, post-procedural and quality and performance considerations. To download, click here »

Clinical Articles

Variation in Patients’ Perceptions of Elective Percutaneous Coronary Intervention in Stable Coronary Artery Disease: Cross Sectional Study

Kureshi, F., Jones, P.G., Buchanan, D.M., Abdallah, M.S., & Spertus J.A. (2014). Variation in patients’ perceptions of elective percutaneous coronary intervention in stable coronary artery disease: cross sectional study. BMJ, 349:g5309. To download, click here »

Initial Coronary Stent Implantation with Medical Therapy vs Medical Therapy Alone for Stable Coronary Artery Disease: Meta-Analysis of Randomized Controlled Trials

Stergiopoulos, K., Brown, D.L. (2012). Initial coronary stent implantation with medical therapy vs medical therapy alone for stable coronary artery disease: meta-analysis of randomized controlled trials. Arch Intern Med, 172(4):312-319. To download, click here »

Patterns and Intensity of Medical Therapy in Patients Undergoing Percutaneous Coronary Intervention

Borden, W.B., Redberg, R.F., Mushlin, A.I., Dai, D, Kaltenbach, L.A., & Spertus J.A. (2011). Patterns and intensity of medical therapy in patients undergoing percutaneous coronary intervention. JAMA, 305(18):1882-1889. To download, click here »

Appropriateness of Percutaneous Coronary Intervention

Chan, P.S., Patel, M.R., Klein, L.W., et al. (2011). Appropriateness of percutaneous coronary intervention. JAMA, 306(1):53-61. To download, click here »

Meta-Analysis: Effects of Percutaneous Coronary Intervention versus Medical Therapy on Angina Relief

Wijeysundera, H. C., Nallamothu, B. K., Krumholz, H. M., Tu, J. V., & Ko, D. T. (2010). Meta-analysis: effects of percutaneous coronary intervention versus medical therapy on angina relief. Annals of Internal Medicine, 152(6), 370-379. To download, click here »

A Meta-Analysis of 17 Randomized Trials of a Percutaneous Coronary Intervention-Based Strategy in Patients with Stable Coronary Artery Disease

Schömig, A., Mehilli, J., de Waha, A., Seyfarth, M., Pache, J., & Kastrati A. (2008). A meta-analysis of 17 randomized trials of a percutaneous coronary intervention-based strategy in patients with stable coronary artery disease. J Am Coll Cardiol. 52(11):894-904. To download, click here »

Effect of PCI on Quality of Life in Patients with Stable Coronary Disease

Weintraub, W. S., Spertus, J. A., Kolm, P., Maron, D. J., Zhang, Z., Jurkovitz, C., & Boden, W. E. (2008). Effect of PCI on quality of life in patients with stable coronary disease. New England Journal of Medicine, 359(7), 677-687. To download, click here »

Optimal Medical Therapy With or Without PCI for Stable Coronary Disease

Boden, W. E., O’Rourke, R. A., Teo, K. K., Hartigan, P. M., Maron, D. J., Kostuk, W. J., & Weintraub, W. S. (2007). Optimal medical therapy with or without PCI for stable coronary disease. New England Journal of Medicine, 356(15), 1503-1516. To download, click here »

Percutaneous Coronary Intervention versus Optimal Medical Therapy for Prevention of Spontaneous Myocardial Infarction in Subjects with Stable Ischemic Heart Disease

Bangalore, S., Pursnani, S., Kumar, S. & Bagos, P.G. (2013). Percutaneous coronary intervention versus optimal medical therapy for prevention of spontaneous myocardial infarction in subjects with stable ischemic heart disease / clinical perspective. Circulation, 127(7). 769-781. To download, click here »

Coronary Artery Bypass Graft Surgery versus Percutaneous Coronary Intervention with First-Generation Drug-Eluting Stents: A Meta-Analysis of Randomized Controlled Trials

Al-Ali, J., Franck, C., Filion, K.B., & Eisenberg, M.J. (2014). Coronary artery bypass graft surgery versus percutaneous coronary intervention with first-generation drug-eluting stents: a meta-analysis of randomized controlled trials. JACC Cardiovasc Interv. 7(5), 497-506. To download, click here »

Causes of Short-Term Readmission after Percutaneous Coronary Intervention

Wasfy, J.H., Strom, J.B., O’Brien, C., Zai, A.H., Luttrell, J., Kennedy, K.F., Spertus, J.A., Zelevinsky, K., Normand, S.T., Mauri, L., & Yeh, R.W. (2014). Causes of short-term readmission after percutaneous coronary intervention. Circ Cardiovasc Interv. 7(1), 97-103. To download, click here »

Patient Resources

PCI Choice
Materials from Mayo Clinic that visually illustrate the probabilities of risk versus benefit from PCI for stable ischemic heart disease in order to help patients make decisions that best fit their values and preferences. To view, click here »

What Can Angioplasty Do For You?
This Harvard Health Publications article discusses the benefits and risks of angioplasty for stable angina and the outcomes of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial. To view, click here »

This website, hosted by SCAI, aims to better prepare patients and their families to navigate the medical system and actively participate in care. Resources include explanations about what Coronary Artery Disease (CAD) is, common tests and treatments involved as well as worksheets to assist in understanding medication and questions to ask physicians. To view, click here »

Five Things Physicians and Patients Should Question
This Choosing Wisely list, identifying practices commonly used within critical care whose necessity should be questioned and discussed, was prepared as an initiative of the Society of Cardiovascular Angiography and Interventions. To download, click here »