Development of a unified national database of primary percutaneous coronary intervention centers with co-located emergency departments, 2020

• Published in: The American heart journal 2022-12, Vol.254, p.149-155
• Main Authors: Herscovici, Darya M., Boggs, Krislyn M., Cash, Rebecca E., Espinola, Janice A., Sullivan, Ashley F., Hasegawa, Kohei, Nagurney, John T., Camargo, Carlos A.
• Format: Article
• Language: English
• Subjects: Accreditation; Acute coronary syndromes; Angioplasty; Cardiology; Cardiovascular disease; Chest; Departments; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Heart; Heart attacks; Heterogeneity; Hospitals; Humans; Intubation; Laboratories; Mortality; Myocardial Infarction; Pain; Percutaneous Coronary Intervention; Registries; ST Elevation Myocardial Infarction - surgery; Trauma centers; Treatment Outcome
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2022.08.012

Although primary percutaneous coronary intervention (pPCI) is the preferred intervention for ST-elevation myocardial infarction (STEMI), not all patients are admitted directly to an emergency department (ED) with 24/7/365 pPCI capabilities. This is partly due to a lack of a national system of known pPCI-capable EDs. Our objective was to create a unified, national database of confirmed 24/7/365 pPCI centers co-located in hospitals with EDs. We compiled all hospitals designated as Chest Pain Centers with Primary PCI by the American College of Cardiology's (ACC) National Clinical Data Registry (NCDR), all STEMI Receiving Centers designated by the American Heart Association's (AHA) Mission: Lifeline registry, and all state-designated pPCI-capable hospitals and designation criteria from state departments of health. We matched ACC, AHA, and state-designated facilities to those in the 2019 National ED Inventory (NEDI)-USA database to identify all EDs in pPCI-capable hospitals. Overall, 467 hospitals were recognized as Chest Pain Centers with Primary PCI by ACC, 293 hospitals were recognized as being STEMI Receiving Centers by AHA, and 827 hospitals were confirmed to be pPCI-capable by state designations and operated 24/7/365. Together, there were 1,178 EDs (21% of 5,587 total) co-located in pPCI-capable hospitals operating 24/7/365. There is substantial heterogeneity in cardiac systems of care, with large regional systems existing alongside local state-led initiatives. We created a unified national database of confirmed 24/7/365 pPCI centers co-located in hospitals with EDs. This data set will be valuable for future cardiac systems research and improving access to pPCI.