Author + information
- Received July 7, 2019
- Revision received October 21, 2019
- Accepted November 3, 2019
- Published online January 6, 2020.
- Thomas M. Maddox, MD, MSca,b,∗ (, )@medtmaddox@Dr_BowTie65,
- Yang Song, MSc,
- Joseph Allend,
- Paul S. Chan, MD, MSce,
- Adeela Khan, MPHd,
- Jane J. Lee, PhDc,
- Joshua Mitchell, MDa,
- William J. Oetgen, MD, MBAd,
- Angelo Ponirakis, PhDd,
- Claire Segawa, MPHd,
- John A. Spertus, MD, MPHe,
- Fran Thorpe, DrPH, MPHd,
- Salim S. Virani, MD, PhDf and
- Frederick A. Masoudi, MD, MSPHg
- aDivision of Cardiology, Washington University School of Medicine, St. Louis, Missouri
- bHealthcare Innovation Lab, BJC HealthCare/Washington University School of Medicine; St. Louis, Missouri
- cBaim Institute for Clinical Research, Boston, Massachusetts
- dAmerican College of Cardiology, Washington, DC
- eMid-America Heart Institute, Kansas City, Missouri
- fMichael E. DeBakey Veterans Affairs Medical Center, Section of Cardiovascular Medicine, Baylor College of Medicine, Houston, Texas
- gDivision of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- ↵∗Address for correspondence:
Dr. Thomas M. Maddox, Cardiovascular Division, Washington University School of Medicine, Campus Box 8086, 660 South Euclid Avenue, St. Louis, Missouri 63110-1093.
• The NCDR PINNACLE registry tracks management and quality of 4 common cardiovascular conditions: HF, CAD, AF, and HTN.
• By 2017, the registry contained information on 6,040,996 patients, cared for by 8,853 providers in 724 practices. Between 2013 and 2017, care processes for PINNACLE patients generally improved.
• PINNACLE registry participation should be considered by practices seeking to monitor and improve practice patterns.
• The PINNACLE registry should continue to monitor current practice patterns and opportunities for improvement.
The National Cardiovascular Data Registry PINNACLE (Practice Innovation and Clinical Excellence) Registry is the largest outpatient cardiovascular practice registry in the world. It tracks real-world management and quality of 4 common cardiovascular conditions: heart failure, coronary artery disease, atrial fibrillation, and hypertension. In 2013, the PINNACLE Registry contained information on 2,898,505 patients, cared for by 4,859 providers in 431 practices. By 2017, the registry contained information on 6,040,996 patients, cared for by 8,853 providers in 724 practices. During this time period, care processes for PINNACLE patients generally improved. Among patients with heart failure, combined beta-blocker and renin-angiotensin antagonist medication rates increased from 60.7% to 72.8%. Among patients with coronary artery disease, statin medication rates increased from 66% to 80.1%. Among patients with atrial fibrillation, oral anticoagulation rates increased from 52.7% to 65.2%. In contrast, blood pressure control rates among patients with hypertension were largely stable. PINNACLE data also fueled a variety of quality measurement programs and 51 peer-reviewed publications.
The American College of Cardiology provided the funding for this work. Dr. Maddox has received current grant funding from the National Institutes of Health, National Center for Advancing Translational Sciences (1U24TR002306-01: A National Center for Digital Health Informatics Innovation); has served as a consultant for Creative Educational Concepts, Inc.; has received honoraria payments in the past 3 years from Brown University, Washington State Clinical Outcomes Assessment Program, Virginia Mason, University of Utah, New York Presbyterian, Westchester Medical Center, Sentara Heart Hospital, and the Henry Ford Health System; is currently employed as a cardiologist and executive director of the Healthcare Innovation Lab at BJC HealthCare/Washington University School of Medicine, during which he is advising Myia Labs, for which his employer is receiving equity compensation in the company but he is receiving no individual compensation from the company; is also a compensated director for a New Mexico-based foundation, the JF Maddox Foundation; and has been a consultant for Atheneum Partners. Dr. Allen is an employee of the American College of Cardiology. Dr. Chan has served as a consultant for Optum Rx. Ms. Khan has received honorarium from Boehringer Ingelheim (participating in stakeholder panel to conduct a quality landscape scan and identify potential quality measurement approaches to address gaps in care for the population with diabetes AND cardiovascular disease). Dr. Spertus has received research grants from the American College of Cardiology Foundation and Bayer; has served as a consultant for Bayer, Novartis, AstraZeneca, Janssen, Cytokinetics, MyoKardia, V-wave, Corvia, and United Healthcare Scientific Advisory Board; has served on the boards of Blue Cross Blue Shield of Kansas City, Health Outcomes Sciences, and Cardiology Outcomes; has equity and/or intellectual property at Health Outcomes Sciences; has copyrights to the SAQ, KCCQ, and PAQ symptom assessment tools; and has served as PI of the Analytic Center for the National Cardiovascular Data Registry. Dr. Virani has received grant funding from the Department of Veterans Affairs and World Heart Federation; and has received honorarium from the American College of Cardiology (Associate Editor for Innovations). Dr. Masoudi has received institutional compensation for his role as Chief Scientific Advisor, National Cardiovascular Data Registry, with the American College of Cardiology. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 7, 2019.
- Revision received October 21, 2019.
- Accepted November 3, 2019.
- 2020 American College of Cardiology Foundation
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