Hundreds of lives lost due to variations in common heart procedure

Data collected from a national cardiovascular database has highlighted that changes in the practice of interventional cardiology has led to improved patient outcomes – although these changes have not been applied universally across England and Wales.

Health data scientists analysed the results of 448,853 patients who had received a percutaneous coronary intervention (PCI), a treatment in which stents are used to treat narrowed or blocked arteries, between 2005 and 2012.  This non-surgical treatment can be delivered by inserting a catheter into either a patient’s leg (the transfemoral route) or wrist (the transradial route)

The research team, a partnership between The University of Manchester’s Health eResearch Centre and Keele University found that procedures undertaken through the wrist rapidly increased from 14% to 58% and that this change in practice has contributed to an estimated 450 lives saved over the seven year study window.  Further, adoption of PCI through the wrist varies significantly in different parts of the UK.

By geographically mapping the data the health informaticians were able to further drill down into statistics and identify where utilisation methods varied the most.  The team found that an additional 264 lives could have been saved if the transradial route was more frequently adopted and were able to identify the South East of England as the region with the lowest uptake in transradial PCI delivery.

Lead researcher and Professor in Cardiology Mamas Mamas said: “It is clear from the research that performing PCI through the transradial route is safer and less invasive for patients.  Current research uses large, often national databases to compare different ways of doing the same operation, however, these report don’t explain why the complication rates vary so much across sub-national regions?

“One reason that has been suggested is a lack of training opportunities for more experienced operators.  Certainly a recent survey of 204 cardiologists identified an association between newly qualified surgeons and practitioners using the safer transradial route.”

These findings build on previously published research by the team which showed that performing PCI via the wrist is associated with a 30% reduction in the risk of mortality in high risk groups undergoing these procedures.

Full results are published in Circulation and available here.

ENDS

Notes to editors:

Please contact Stephen Melia, Communications Officer at the Health eResearch Centre to arrange interviews. Email: stephen.melia@manchester.ac.uk Tel: 0161 306 7876 Mob: 07557 310 213

1. The Health eResearch Centre (HeRC) is delivering large scale, population wide health research by harnessing the power of information and technology.

Led by The University of Manchester and bringing together research excellence across the North of England (in partnership with the universities of Lancaster, Liverpool and York) the Health eResearch Centre is increasing the pace of progress in the UK’s health sector by turning under-used health information into new knowledge.

For more information please visit our website www.herc.ac.uk #datasaveslives

2. About Keele University

Keele University, set in over 600 acres, is the largest campus university in the UK and has around 10,000 students on its Staffordshire campus. Keele students are officially the most satisfied in the country with the University consistently placed among the top 10 universities in the UK for student satisfaction since 2011. For two years running, 2014 and 2015, Keele has been first for student satisfaction, as voted for by students in the National Student Survey.

The University is top 10 for graduate employment rates in the UK, with 96% of graduates in employment or further studies within 6 months of graduating. In the most recent national Research Excellence Framework (2014), 97% of Keele research was classified as world leading, or of international importance. The innovations and discoveries of Keele academics are key contributors to wider social and global issues. Keele is a leading world player in many research areas, including primary health care, especially around arthritis and muscular skeletal problems, secondary health care, including stroke medicine, and health related research on insect-borne diseases in the Tropics; in environmental science, astronomy and the life sciences; and in areas of the humanities and social sciences, including music, history and English Literature.