A Marked Decline in Nonacute and Inappropriate PCI in the U.S.

Since the introduction of appropriate use criteria, nonacute procedures and those deemed inappropriate have declined by 33% and 50%, respectively.

A coalition led by the American College of Cardiology and the American Heart Association first introduced appropriate use criteria (AUC; J Am Coll Cardiol 2012; 59:857) for percutaneous coronary intervention (PCI) in 2009 and released a revision in 2012. In the current analysis, investigators studied data from the National Cardiovascular Data Registry CathPCI registry on 2.7 million PCI procedures in 766 hospitals from July 2009 through 2014. Based on 198 criteria, each PCI was classified as appropriate, inappropriate, or uncertain.

The number of nonacute procedures fell by one third, from 89,704 in 2010 to 59,375 in 2014. In this group, the decline was associated with proportional increases in the number of patients with severe angina, the …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)