The Benefits of a PCI Registry: An Update

Summary

This article reports on the progress and challenges in establishing a percutaneous coronary intervention registry. To date, there are no multicenter, national, or Caribbean data in a PCI registry—only single-center data or anecdotal reports.

  • Cardiology Clinical Trials
  • Interventional Techniques & Devices

Godfrey Aleong, MD, FESC, Eric Williams Medical Science Complex, Trinidad, West Indies, reported on the progress and challenges in establishing a percutaneous coronary intervention (PCI) registry. To date, there are no multicenter, national, or Caribbean data in a PCI registry—only single-center data or anecdotal reports. Cath labs that perform PCI in the English-speaking Caribbean include those in the Bahamas, Barbados, Jamaica, Trinidad and Tobago, and Guyana. Within Trinidad and Tobago, there are 4 centers that perform catheterizations, three in the Port of Spain, one in San Fernando, and none in Tobago.

The aim of the PCI Registry is to create both a national and Caribbean registry that will link all centers. The data that are collected will provide effective and pertinent information about the patients and PCI procedures that are performed in the region and, in so doing, will increase the understanding of cardiovascular disease and the effect of PCI in the regional population.

The registry will contain important and accurate information that will generate research, such as a recent report on a comparison of 6-year clinical outcomes of sirolimus- and paclitaxel-eluting stents, based on data from three “real-world” registries in an academic hospital [Simsek C et al. J Invasive Cardiol 2011].

The Caribbean registry will provide the region with the information that it needs to participate in international trials and help the region develop a worldwide reputation. It would include centers in the Bahamas, Jamaica, Barbados, Trinidad and Tobago, and Guyana that are connected to a database via the Internet (Figure 1).

Figure 1.

Cath Labs Connected via Internet Database.

Reproduced with permission from G. Aleong, MD, FESC.

Data that are collected would include:

  • Patient demographics (such as the county and country) and characteristics (age, ethnicity, gender, cardiac risk factors, symptoms, previous cardiac history, and cardiac medications)

  • Stenosis characteristics (American Heart Association classification)

  • Procedure data/information (wire types, balloons, and stents used; whether stenosis was predilated or postdilated and to what pressures; ancillary equipment used, such as intravascular ultrasound, and fractional flow reserve

  • Complications

  • 9-month clinical follow-up

Donation by individuals of their protected health information (PHI) for evidence-based research potentially benefits all individuals with diseases through improved understanding of disease patterns. However, without large numbers of people who donate their PHI to disease registries that are designed for research, it is difficult to discover complex patterns, create more specific evidence-based management techniques that can identify new opportunities in disease registry design, or analyze the current stage of a registry [Russler D. J Diabetes Sci Technol 2011]. The newly created United States Nationwide Health Information Network provides a good example of how to design, develop, maintain, and update a registry.

Creating a registry will take commitment, communication, and participation. Dr. Aleong encouraged all centers that perform PCI in the region to participate in making a registry a reality. The creation and maintenance of a PCI registry is one of the most important efforts that can be undertaken; it will provide an invaluable source of information on a national basis and throughout the Caribbean. “It will supply the needed data that are currently lacking in our region and place us in a better position internationally,” he concluded.

View Summary