TY - JOUR
T1 - Variation in Arterial Access for Invasive Coronary Procedures in New Zealand
T2 - A National Analysis (ANZACS-QI 5)
AU - the ANZACS-QI investigators
AU - Barr, P.
AU - Smyth, D.
AU - Harding, S. A.
AU - El-Jack, S.
AU - Williams, Michael J.A.
AU - Devlin, G.
AU - Stewart, J.
AU - Flynn, Charmaine
AU - Lee, Mildred
AU - Kerr, Andrew J.
AU - Aitken, Andrew
AU - Evison, Karen
AU - Larsen, Peter
AU - Marshall, Kim
AU - Simmonds, Mark
AU - Stewart, Ralph
AU - White, Harvey
AU - Masson, Sarah
AU - Rhodes, Maxine
AU - Jenkins, Michelle
AU - Faatui, John
AU - Newcombe, R.
AU - Scott, T.
AU - Armstrong, G.
AU - Khan, A.
AU - Gladding, P.
AU - Patel, H.
AU - Edwards, C.
AU - Donald, J.
AU - Webster, M.
AU - Ormiston, J.
AU - Ruygrok, P.
AU - Ellis, C.
AU - Coverdale, A.
AU - Scott, D.
AU - Kay, P.
AU - Sutton, T.
AU - Harrison, W.
AU - Emerson, C.
AU - Nunn, C.
AU - Pasupati, S.
AU - Nair, R.
AU - Menon, M.
AU - Charleson, H.
AU - Sebastian, C.
AU - Heald, S.
AU - Fisher, R.
AU - Wade, C.
AU - Nairn, L.
AU - Davidson, L.
N1 - Funding Information:
A comprehensive national cardiac registry, the All New Zealand Acute Coronary Syndrome – Quality Improvement (ANZACS-QI) program, funded by the Ministry of Health, was implemented in New Zealand in 2013, under the auspices of the New Zealand branch of the Cardiac Society of Australia and New Zealand. The present study uses data from this registry to review arterial access practices and in-hospital outcomes across all hospitals and among all cardiologists performing ICA within New Zealand's public sector.
Funding Information:
This research project was supported by the Health Research Council [grant number 11/800]. Dr Barr was supported by the Middlemore Hospital Cardiac Trust. The ANZACS-QI registry is supported by funding from the NZ Ministry of Health.
Publisher Copyright:
© 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Background: Radial arterial access (RA) and femoral arterial access (FA) rates for invasive coronary angiography (ICA) vary widely internationally. The European Society of Cardiology (ESC) suggests default RA is feasible. We aim to investigate the variation in RA rates across all New Zealand public hospitals. Methods and Results: Patient characteristics, procedural details, and inpatient outcome data were collected in the All New Zealand Acute Coronary Syndrome - Quality Improvement (ANZACS-QI) registry on consecutive patients undergoing ICA over five months. Of the 5894 ICAs 81% were via RA. Hospitals averaged 25 - 176 procedures/month (46.5% - 96.4% via RA). Operators averaged 17 procedures/month. Those performing more than 20 ICAs/month had RA rates between 61% - 99%. Of the 75 operators, 69% met the ESC recommendation. After multivariable adjustment higher operator (RR 1.12, CI 1.09 - 1.30) and hospital (RR 1.21, CI 1.15 - 1.28) volume were independent predictors of RA. Those with prior CABG (RR 0.51, CI 0.45 - 0.57), STEMI <12 h (RR 0.91, CI 0.87 - 0.96), and female sex (RR 0.96, CI 0.94 - 0.99) were less likely to receive RA. Conclusions: New Zealand has a high RA rate for ICAs. Rates vary substantially between both operators and centres. Radial arterial was highest amongst the highest volume operators and centres.
AB - Background: Radial arterial access (RA) and femoral arterial access (FA) rates for invasive coronary angiography (ICA) vary widely internationally. The European Society of Cardiology (ESC) suggests default RA is feasible. We aim to investigate the variation in RA rates across all New Zealand public hospitals. Methods and Results: Patient characteristics, procedural details, and inpatient outcome data were collected in the All New Zealand Acute Coronary Syndrome - Quality Improvement (ANZACS-QI) registry on consecutive patients undergoing ICA over five months. Of the 5894 ICAs 81% were via RA. Hospitals averaged 25 - 176 procedures/month (46.5% - 96.4% via RA). Operators averaged 17 procedures/month. Those performing more than 20 ICAs/month had RA rates between 61% - 99%. Of the 75 operators, 69% met the ESC recommendation. After multivariable adjustment higher operator (RR 1.12, CI 1.09 - 1.30) and hospital (RR 1.21, CI 1.15 - 1.28) volume were independent predictors of RA. Those with prior CABG (RR 0.51, CI 0.45 - 0.57), STEMI <12 h (RR 0.91, CI 0.87 - 0.96), and female sex (RR 0.96, CI 0.94 - 0.99) were less likely to receive RA. Conclusions: New Zealand has a high RA rate for ICAs. Rates vary substantially between both operators and centres. Radial arterial was highest amongst the highest volume operators and centres.
KW - Access site
KW - Cardiac catheterisation
KW - Radial artery catheter
UR - http://www.scopus.com/inward/record.url?scp=84949254670&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84949254670&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2015.10.009
DO - 10.1016/j.hlc.2015.10.009
M3 - Article
C2 - 26672436
AN - SCOPUS:84949254670
SN - 1443-9506
VL - 25
SP - 451
EP - 458
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 5
ER -