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Prepared by: ACTION Registry-GWTG Results: January – December, 2008.

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Presentation on theme: "Prepared by: ACTION Registry-GWTG Results: January – December, 2008."— Presentation transcript:

1 Prepared by: ACTION Registry-GWTG Results: January – December, 2008

2 Current Site Distribution Last updated: 12/31/08 AK (1) WA (11) OR (9) CA (20) ID (1) NV (1) MT (2) WY (0) CO (7) NM (1) ND (1) SD (1) NE (4) KS (8) OK (4) TX (26) MN (5) IA (6) MO (12) AR (1) LA (2) WI (11) MI (12) MI UT (0) AZ (2) HI (0) IL (23) IN (14) KY (2) TN (10) MS (3) AL (1) GA (10) FL (17) SC (4) NC (23) VA (9) OH (22) WV (1) PA (23) NY (11) MD (10) ME (2) VT (0) NH (1) NJ (4) MA (3) CT (3) DE (0) RI (0) DC (0) Active Sites = 365

3 Baseline Characteristics - STEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008

4 Hospital Presentation Characteristics - STEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008

5 In-Hospital Outcomes - STEMI * Unadjusted mortality # Transfusion among non-CABG patients * Unadjusted mortality # Transfusion among non-CABG patients ACTION Registry-GWTG DATA: January 1 – December 31, 2008

6 Use of Reperfusion Therapy for STEMI STEMI N = 20,998 Reperfusion N = 16,374 (78%) No Reperfusion – No Contraindication Listed N = 1163 (6%) Not Eligible for Reperfusion Therapy Contraindication Listed N= 3,011 (14%) Primary PCI – 86%* Fibrinolytics – 13%* Both PCI + Lytics – 1%* * Among patients receiving reperfusion ACTION Registry-GWTG DATA: January 1 – December 31, 2008

7 DTB = 1 st Door to Balloon for Primary PCI DTN = Door to Needle for Lytics STEMI – Door to Balloon and Door to Needle Times: Cumulative 12 Month Data ACTION Registry-GWTG DATA: January 1 – December 31, 2008

8 STEMI Primary PCI Results - Non-Transfer Patients with DTB 90 mins 73% of the primary PCI patients are not transferred in

9 STEMI Primary PCI Results - DTB Benchmarks for Transfer-In Patients 1 st Door to Balloon < 90 Minutes 1 st Door to Balloon < 120 Minutes 27% of the primary PCI patients are transferred in

10 STEMI Door-to-Balloon Times – Median Times for Transfer In and Non-Transfer In Patients Transfer in DTB TimesNon-Transfer in DTB Times Q Q Q Q4 08 Time (min)

11 STEMI Acute (< 24 hrs) Medications ACTION Registry-GWTG DATA: January 1 – December 31, 2008

12 STEMI Discharge Medications % Use ACTION Registry-GWTG DATA: January 1 – December 31, 2008

13 STEMI Discharge Interventions ACTION Registry-GWTG DATA: January 1 – December 31, 2008

14 Baseline Characteristics - NSTEMI

15 Hospital Presentation Characteristics - NSTEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008

16 In-Hospital Outcomes - NSTEMI * Unadjusted mortality # Transfusion among non-CABG patients * Unadjusted mortality # Transfusion among non-CABG patients ACTION Registry-GWTG DATA: January 1 – December 31, 2008

17 NSTEMI Acute (< 24 hrs) Medications ACTION Registry-GWTG DATA: January 1 – December 31, 2008

18 NSTEMI Acute Medication Overdosing Trends * Infusion (> 15 units/kg/hr) or bolus (> 70 units/kg) # Initial dose (> 1.05 mg/kg) or total 24 hr dose (> 10 mg over recommended) ACTION Registry-GWTG DATA: January 1 – December 31, % 25% 15% 9% 10% 9% 0% 5% 10% 15% 20% 25% 30% Q1 2008Q2 2008Q3 2008Q UFH * LMWH # GP llb-llla

19 NSTEMI Invasive Cardiac Procedures ACTION Registry-GWTG DATA: January 1 – December 31, 2008

20 NSTEMI Revascularization Strategy Trends ACTION Registry-GWTG DATA: January 1 – December 31, % 46% 44% 42% 45% 11% 12% 11% 0% 10% 20% 30% 40% 50% 60% Q1 2008Q2 2008Q3 2008Q Medically ManagedPCICABG

21 NSTEMI Discharge Medications ACTION Registry-GWTG DATA: January 1 – December 31, 2008

22 NSTEMI Discharge Clopidogrel Use by Revascularization Strategies ACTION Registry-GWTG DATA: January 1 – December 31, 2008

23 NSTEMI Discharge Interventions ACTION Registry-GWTG DATA: January 1 – December 31, 2008

24 Baseline Characteristics – STEMI vs. NSTEMI

25 Hospital Presentation Characteristics - STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008

26 In-Hospital Outcomes - STEMI vs. NSTEMI * Unadjusted mortality # Transfusion among non-CABG patients * Unadjusted mortality # Transfusion among non-CABG patients ACTION Registry-GWTG DATA: January 1 – December 31, 2008

27 Non-CABG Major Bleeding and Transfusion – STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008

28 Acute Medications - STEMI vs NSTEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008

29 Discharge Medications - STEMI vs NSTEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008

30 Discharge Interventions – STEMI vs. NSTEMI ACTION Registry-GWTG DATA: January 1 – December 31, 2008


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