Implementation of a Multidimensional Strategy to Reduce Post-PCI Bleeding Risk

Andrea L. Price, Amit P. Amin, Susan Rogers, John C. Messenger, Issam D. Moussa, Julie M. Miller, Jonathan Jennings, Frederick A. Masoudi, J. Dawn Abbott, Rebecca Young, Daniel M. Wojdyla, Sunil V. Rao

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The American College of Cardiology Reduce the Risk: PCI Bleed Campaign was a hospital-based quality improvement campaign designed to reduce post-percutaneous coronary intervention (PCI) bleeding events. The aim of the campaign was to provide actionable evidence-based tools for participants to review, adapt, and adopt, depending upon hospital resources and engagement. METHODS: We used data from 8 757 737 procedures in the National Cardiovascular Data Registry between 2015 and 2021 to compare patient and hospital characteristics and bleeding outcomes among campaign participants (n=195 hospitals) and noncampaign participants (n=1384). Post-PCI bleeding risk was compared before and after campaign participation. Multivariable hierarchical logistic regression was used to determine the adjusted association between campaign participation and post-PCI bleeding events. Prespecified subgroups were examined. RESULTS: Campaign hospitals were more often higher volume teaching facilities located in urban or suburban locations. After adjustment, campaign participation was associated with a significant reduction in the rate of bleeding (bleeding: adjusted odds ratio, 0.61 [95% CI, 0.53–0.71]). Campaign hospitals had a greater decrease in bleeding events than noncampaign hospitals. In a subgroup analysis, the reduction in bleeding was noted in non–ST-segment–elevation acute coronary syndrome and ST-segment–elevation myocardial infarction patients, but no significant reduction was seen in patients without acute coronary syndrome. CONCLUSIONS: Participation in the American College of Cardiology Reduce the Risk: PCI Bleed Campaign was associated with a significant reduction in post-PCI bleeding. Our results underscore that national quality improvement efforts can be associated with a significant impact on PCI outcomes.

Original languageEnglish (US)
Pages (from-to)E013003
JournalCirculation: Cardiovascular Interventions
Volume17
Issue number3
DOIs
StatePublished - Mar 2024

Keywords

  • evidence based practice
  • healthcare delivery
  • hospitals
  • percutaneous coronary intervention
  • quality improvement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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