Comparing the Classification of Percutaneous Coronary Interventions Using the 2012 and 2017 Appropriate Use Criteria: Insights From 245,196 Patients in the NCDR CathPCI Registry
Authors' conclusion
In this contemporary analysis of patients undergoing PCI in the United States, only fair agreement between the 2012 and updated 2017 AUC was observed.
Study context
- Population
- Elective percutaneous coronary intervention (PCI) cases in the NCDR CathPCI registry, March 1, 2018 to June 30, 2021
- Participants
- 245,196 cases1,669 centres
- Exposure
- 2017 AUC vs 2012 AUC classification of PCI appropriateness
- Outcome
- Concordance of PCI appropriateness classification (Cohen's Kappa)
Methodological detailsmulticentre, 1669 centres
- Multicentre
- 1669 centres
Main finding
As reported in the abstract
- Overall fair agreement, Cohen's kappa
- 0.40 (95% CI 0.396-0.403)
- 2012 AUC: appropriate
- 44%
- 2012 AUC: uncertain
- 28%
- 2012 AUC: inappropriate
- 16%
- 2017 AUC: appropriate
- 34%
- 2017 AUC: may be appropriate
- 56%
- 2017 AUC: rarely appropriate
- 4%
Observational data: associations, not effects.
Further findings
Not mappable PCI
Characteristics of reclassified PCI
- Became non-appropriate vs remained appropriate: more likely asymptomatic, less likely on anti-anginals, less likely complex lesions
- Became appropriate vs became non-appropriate: more atypical and non-anginal symptoms, less likely positive functional tests
Safety
Procedural related outcomes
- Similar across all groups
Original publication
Comparing the Classification of Percutaneous Coronary Interventions Using the 2012 and 2017 Appropriate Use Criteria: Insights From 245,196 Patients in the NCDR CathPCI Registry. Am Heart J. Published 9 October 2022. doi:10.
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