Abstract 1289: Variation in the Rate of ‘Normal’ Elective Diagnostic Catheterization: A Potential Quality Metric? Results From the National Cardiovascular Data Registry (NCDR)
Background: The rate of finding ‘normal’ coronary arteries (no or minimal coronary disease; NL COR) at elective diagnostic cardiac catheterization has been suggested as a measure of the ability to predict risk and select patients. However, the rate of NL COR and variability in this rate among US hospitals is unknown.
Methods: We included patients without prior MI, PCI, or CABG, undergoing elective, diagnostic cath for exclusion of CAD using the NCDR Registry. NL COR was defined as patients with all stenoses <20% in all normal-sized, major coronary vessels.
Results: In 2005– 8, 577,425 patients met criteria at 865 sites. Median age was 61 years, 53% were male, 27% had diabetes, 71% hypertension and 63% dyslipidemia. At angiography, 221,210 (38%) had NL COR, of whom 25% had stable angina and 64% had positive noninvasive test results. Rates of NL COR varied widely among hospitals with an interquartile range of 32.0% to 45.6% %. (See figure⇓) However, NL COR rates were not related to hospital location (urban/rural), ownership (public/private), teaching program presence or geographical region.
Conclusions: Over a third of those undergoing elective cardiac catheterization in the US had NL COR. This rate varied markedly between hospitals. This degree of variation raises the possibility that NL COR rates may be useful for benchmarking and quality improvement strategies to improve catheterization utilization.