Research

Angioplasty improvement effort reduces deaths

Angioplasty patients in Michigan are getting far better care and are suffering far fewer complications than they used to, thanks to a cooperative quality improvement project involving local hospitals and Blue Cross Blue Shield of Michigan (BCBSM).

New research results show just how dramatic the project's effect has been. They also provide information that may help angioplasty patients everywhere.

At the American Heart Association's Scientific Sessions 2003 last week, and in a recent issue of the American Journal of Cardiology, a team led by researchers from the Cardiovascular Center report several significant observational findings from the BCBSM Cardiovascular Consortium.

Researchers presented data showing that in 25,245 artery-clearing procedures performed between July 1997 and September 2002 at five Michigan hospitals, the joint effort improved the delivery of proven medications that can prevent angioplasty complications, reduced the use of potentially toxic dye used during the procedure and reduced the unnecessary use of a blood thinner after the procedure.

These quality improvements, in turn, were associated with a lower risk-adjusted rate of in-hospital death, unplanned bypass surgery, heart attack, kidney failure caused by the toxic dye and requiring dialysis, stroke and a composite measure of post-angioplasty adverse cardiac events. The reductions in all these measures remained statistically significant even after the data were adjusted for patients' individual risk factors.

"These results show just what can be achieved when hospitals cooperate, rather than compete, in a joint effort aimed at improving care," says Dr. Mauro Moscucci, the U-M Health System cardiologist who leads the project in conjunction with BCBSM's Dr. David Share.

The consortium is funded by BCBSM, which now requires membership in the consortium for any hospital that wants to be listed as one of its Cardiac Centers of Excellence.

Eighteen Michigan hospitals, from Detroit and Ann Arbor to Grand Rapids and Flint, participate in the consortium.

Other results from the BCBSM Cardiovascular Consortium were presented at AHA by Moscucci and Cardiovascular Center colleagues Dr. Stanley Chetcuti, Dr. Debabrata Mukherjee and Cecelia Montoye, or published in the Oct. 15 issue of the American Journal of Cardiology. For more information, visit http://www.med.umich.edu/opm/newspage/2003/angioplasty.htm.

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