NCDR UPDATE
New NCDR Risk Stratification
Tool Predicts Adverse Events
For CHD Patients
A
validated model that predicts adverse events
after cardiac catheterization procedures in
adolescents and adults with congenital heart
disease (CHD) was presented at ESC Congress 2016
in Rome.
Ada Stefanescu, MD, et al., used data from
ACC’s NCDR IMPACT Registry to develop and validate the risk stratification tool. After adjusting for
inclusion criteria, they examined 27,293 congenital
cardiac catheterizations in patients over the age of
10, and found that the majority of patients were
adolescents, had a moderate or complex diagnosis
and an elective catheterization.
They further found that the “significant independent predictors” of adverse outcomes were
higher index procedure risk, older age, having had
no prior catheterization or surgeries, pre-procedural
anticoagulation use, history of renal disease, lower
hemoglobin, lower oxygen saturation, and a nonelective procedure. “The C-statistic for our model
was robust at 0.752 in the derivation and 0.750 in
the validation cohort,” they explain.
The authors conclude that “this model can be
used to individualize the risk and benefit discussion
in this special population prior to a catheterization
procedure.” They add that moving forward, “creation
of a user-friendly risk score and validation in another
national or multi-institutional dataset are the next
steps.”
NCDR LAAO Registry Approved By CMS to
Meet NCD Requirements
“The C-statistic for
our model was
robust at 0.752 in the
derivation and 0.750
in the validation
cohort.”
— Ada Stefanescu, MD, et al.
38 CardioSource WorldNews: Interventions
T
he Centers for Medicare and Medicaid
Services (CMS) has identified the LAAO
Registry™ as an approved registry to
meet the requirements of the national coverage determination (NCD) for Medicare patients
undergoing percutaneous left atrial appendage
closure.
Launched in December 2015, the LAAO
Registry is the first national registry capturing
data on left atrial appendage occlusion procedures to assess real-world procedural outcomes,
short and long-term safety, comparative effectiveness and cost effectiveness. Patient-level data
will be submitted by participating hospitals on a
quarterly basis to ACC’s NCDR.
Physicians and hospitals can use these data to
support quality improvement efforts locally and
monitor patterns of care. Registry data will be
used to help develop clinical guidelines leading
to improved patient care. Ultimately, the registry
will provide a better understanding of this population and emerging treatment options.
For more information, visit
ACC.org/LAAORegistry. CMS’ registry
approval is posted on CMS’ website. ■
September/October 2016