A129.E1207

JACC March 9, 2010

Volume 55, issue 10A

QUALITY OF CARE AND OUTCOMES ASSESSMENT

INTRODUCING ASCERT: THE AMERICAN COLLEGE OF CARDIOLOGY-THE SOCIETY OF THORACIC SURGEONS COLLABORATION ON THE COMPARATIVE EFFECTIVENESS OF REVASCULARIZATION STRATEGIES

ACC Oral ContributionsGeorgia World Congress Center, Room B404

Tuesday, March 16, 2010, 9:00 a.m.-9:15 a.m.

Session Title: Comparative Effectiveness and OutcomesAbstract Category: Innovative Models for Practice, Education or Research

Presentation Number: 0918-07

Authors: William S. Weintraub, Fred Edwards, Study Co-Investigators, American College of Cardiology Foundation, Washington, DC, The Society of

Thoracic Surgeons, Chicago, IL

The American College of Cardiology Foundation (ACCF) and The Society of Thoracic Surgeons (STS) are embarking on a unique partnership to study

comparative effectiveness of percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery for the treatment of stable

coronary artery disease. The primary endpoint is all-cause mortality during follow-up of five years. Cost-effectiveness analysis will also be performed.

The cohorts will be patients treated with drug eluting or bare metal stents or with CABG. Among 100,681 isolated CABG operations in the STS

Database, 30,459 (30%) had at least one matched diagnostic catheterization procedure in the ACCF Database. For these patients, angiographic

data were highly complete with fewer than 8% missing variables. Both Databases are being probabilistically linked to the Centers for Medicare and

Medicaid Services data to provide long-term outcomes. A subset of 2,000 patients will be evaluated for SYNTAX score. In preliminary tabulations,

approximately 101,000 isolated CABG operations and 186,000 PCI procedures were performed on patients meeting our proposed eligibility criteria

during 2004-2006 at 528 hospitals. After including Centers for Medicare and Medicaid Services data for 2007, we anticipate approximately

102,000 more patients. In an analysis of linked Centers for Medicare and Medicaid Services data with a median follow-up of 562 days for eligible

CABG patients and median 507 days for eligible PCI patients, 8,350 deaths were captured in Centers for Medicare and Medicaid Services for CABG

patients and 13,235 deaths were captured for PCI patients. Kaplan-Meier estimated probabilities of mortality at 12 months were 6.76% (95% CI:

6.59% - 6.92%) for CABG patients and 6.05% (95% CI: 5.93% - 6.18%) for PCI patients. This study will permit extensive assessment of long-term

clinical and economic outcomes after coronary revascularization.

This project is supported by Award Number RC2HL101489 from the National Heart, Lung, and Blood Institute (NHLBI). The content is solely the

responsibility of the authors and does not necessarily represent the official views of the NHLBI or the National Institutes of Health.