Implementation of a Multidimensional Strategy to Reduce Post-PCI Bleeding Risk.

Area of Science:

• Cardiovascular Medicine
• Quality Improvement Initiatives
• Interventional Cardiology

Background:

• The American College of Cardiology (ACC) launched the Reduce the Risk: PCI Bleed Campaign, a hospital-based quality improvement initiative.
• The campaign aimed to decrease bleeding events following percutaneous coronary intervention (PCI).
• It provided evidence-based tools for hospitals to adapt and implement.

Purpose of the Study:

• To evaluate the effectiveness of the ACC Reduce the Risk: PCI Bleed Campaign.
• To assess the association between campaign participation and post-PCI bleeding rates.
• To compare bleeding outcomes in campaign participant hospitals versus non-participant hospitals.

Main Methods:

• Utilized data from 8,757,737 procedures in the National Cardiovascular Data Registry (2015-2021).
• Compared bleeding outcomes between 195 campaign hospitals and 1384 non-campaign hospitals.
• Employed multivariable hierarchical logistic regression to analyze adjusted associations and examined prespecified subgroups.

Main Results:

• Campaign participation was linked to a significant reduction in post-PCI bleeding (adjusted odds ratio, 0.61).
• Hospitals participating in the campaign demonstrated a greater decrease in bleeding events compared to non-participants.
• Reductions were observed in patients with non-ST-segment-elevation acute coronary syndrome and ST-segment-elevation myocardial infarction, but not in patients without acute coronary syndrome.

Conclusions:

• Participation in the ACC Reduce the Risk: PCI Bleed Campaign significantly reduced post-PCI bleeding events.
• National quality improvement efforts, like this campaign, can substantially impact PCI outcomes.
• The findings highlight the success of targeted interventions in improving cardiovascular procedure safety.