Organization, structure and data of the Hellenic Heart Registry on Percutaneous Coronary Interventions: a step forward towards outcomes research.

INTRODUCTION: The Hellenic Heart Registry on Percutaneous Coronary Interventions (HHR-PCI) was a prospective, observational registry of patients with stable angina or acute coronary syndromes who underwent percutaneous coronary intervention (PCI) between January 2008 and October 2010. METHODS: HHR-PCI was a database that used a secure web-based interface for data entry by individual users. All PCI centers and operators were invited to participate. The participating PCI centers were geographically divided into three main regions: Athens Metro Area, Thessaloniki Metro Area, and Rest of Greece. Indications, demographics, procedural characteristics, and in-hospital outcomes (death, myocardial infarction, cerebrovascular accidents) were recorded. RESULTS: Eighteen (18) centers participated in the registry (2008-2010) in a systematic fashion, entering complete data for 3441 patients (males 83.1%, mean age 64.1 years, 5521 lesions). PCI was elective in 47.1% of patients and was used to treat an acute coronary syndrome in 52.5%. There were 742 (21.6%) patients treated for ST-segment elevation myocardial infarction, with 225 (30.3%) receiving primary PCI (mean door-to-balloon time 140 minutes). The mean numbers of stents per lesion and per patient were 1.14 and 1.74, respectively, with drug eluting stents being used in 74.2% of coronary lesions. Periprocedural complications were observed in 105 patients (3.1%), while the incidence of in-hospital death, myocardial infarction, and cerebrovascular event were 0.5%, 1%, and 0.6%, respectively. CONCLUSIONS: HHR-PCI was the first web-based national PCI registry in Greece and has provided useful insights regarding the practice of interventional cardiology in this country. Efforts should be made to maintain and extend this type of PCI registry, with a view to improving quality and outcomes research in the field of interventional cardiology.

Support of daily ECG procedures in a cardiology department via the integration of an existing clinical database and a commercial ECG management system.

BACKGROUND: In the context of HYGEIAnet, the regional health telematics network of Crete, a clinical cardiology database (CARDIS) has been installed in several hospitals. The large number of resting ECGs recorded daily made it a priority to have computerized support for the entire ECG procedure. METHODS: Starting in late 2000, ICS-FORTH and Mortara Instrument, Inc., collaborated to integrate the Mortara E-Scribe/NT ECG management system with CARDIS in order to support daily ECG procedures. CARDIS was extended to allow automatic ordering of daily ECGs via E-Scribe/NT. The ECG order list is downloaded to the electrocardiographs and executed, the recorded ECGs are transmitted to E-Scribe/NT, where confirmed ECG records are linked back to CARDIS. A thorough testing period was used to identify and correct problems. An ECG viewer/printer was extended to read ECG files in E-Scribe/NT format. RESULTS: The integration of E-Scribe/NT and CARDIS, enabling automatic scheduling of ECG orders and immediate availability of confirmed ECGs records for viewing and printing in the clinical database, took approximately 4 man months. The performance of the system is highly satisfactory and it is now ready for deployment in the hospital. CONCLUSIONS: Integration of a commercially available ECG management system with an existing clinical database can provide a rapid, practical solution that requires no major modifications to either software component. The success of this project makes us optimistic about extending CARDIS to support additional examination procedures such as digital coronary angiography and ultrasound examinations.