Statewide Initiative to Increase Intracoronary Imaging Optimization in PCI: A Report From the BMC2 Registry

Authors

Ryan D Madder
Milan Seth
Devraj Sukul
Prasanthi Yelavarthy
Elizabeth Pielsticker, Henry Ford HealthFollow
John Gribar
Sabina Kumar
Mark Zainea
Kevin Croce
Evan Shlofmitz
Brett Wanamaker
Hitinder S Gurm

Recommended Citation

Madder RD, Seth M, Sukul D, Yelavarthy P, Pielsticker E, Gribar J, Kumar S, Zainea M, Croce K, Shlofmitz E, Wanamaker B, and Gurm HS. Statewide Initiative to Increase Intracoronary Imaging Optimization in PCI: A Report From the BMC2 Registry. J Soc Cardiovasc Angiogr Interv 2025;4(7):103710.

Document Type

Article

Publication Date

7-1-2025

Publication Title

J Soc Cardiovasc Angiogr Interv

Abstract

BACKGROUND: This study assessed the temporal trend in intracoronary imaging (ICI)-guided percutaneous coronary intervention (PCI) concurrent with the implementation of a statewide quality improvement initiative to increase ICI use.

METHODS: The Blue Cross Blue Shield of Michigan Cardiovascular Consortium implemented a formal initiative to increase ICI use for PCI optimization in the state of Michigan between 2020 and 2023. The initiative included focused education for physicians, reporting of comparative institution-level ICI use, and tracking of ICI use as a performance metric. The primary measure of interest was the use of ICI to optimize PCI. A hierarchical Bayesian regression model was created to assess the increase in ICI use over time. The year in which a PCI was performed was included as a variable in the model to delineate the impact of time on the odds of ICI use.

RESULTS: Over the 5-year study period, a total of 140,739 PCIs were performed at 48 nonfederal hospitals in Michigan and represented the study population. A progressive and significant increase in ICI use to optimize PCI was observed from 7.3% in the first year to 44.0% in the fifth year of the study (P < .001 for trend). Significant increases in ICI use were observed for all key subgroups including PCI in left main disease (19.3% to 78.5%; P < .001), stent thrombosis (13.6% to 61.4%; P < .001), and in-stent restenosis (8.7% to 50.6%; P < .001). Each 1-year increase in time was associated with a significant increase in ICI use (adjusted odds ratio, 1.98; 95% credible interval, 1.95-2.00).

CONCLUSIONS: Concurrent with a statewide quality improvement initiative, a significant increase in ICI use to optimize PCI was observed among patients undergoing PCI in the state of Michigan.

PubMed ID

40933111

Volume

4

Issue

7

First Page

103710

Last Page

103710