• Jordan B Strom, James M McCabe, Stephen W Waldo, Duane S Pinto, Kevin F Kennedy, Dmitriy N Feldman, and Robert W Yeh.
• From the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.B.S., D.S.P., R.W.Y.); Division of Cardiology, University of Washington, Seattle (J.M.M.); Department of Medicine, Veterans Affairs Eastern Colorado Health Care System, Denver (S.W.W.); Division of Cardiology, St. Luke's/Mid America Heart Institute, Kansas City, MO (K.F.K.); and Greenberg Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital (D.N.F.).
• Circ Cardiovasc Interv. 2017 May 1; 10 (5).

BackgroundIn 2010, New York State began excluding selected patients with cardiac arrest and coma from publicly reported mortality statistics after percutaneous coronary intervention. We evaluated the effects of this exclusion on rates of coronary angiography, revascularization, and mortality among patients with acute myocardial infarction and cardiac arrest.Methods And ResultsUsing statewide hospitalization files, we identified discharges for acute myocardial infarction and cardiac arrest January 2003 to December 2013 in New York and several comparator states. A difference-in-differences approach was used to evaluate the likelihood of coronary angiography, revascularization, and in-hospital mortality before and after 2010. A total of 26 379 patients with acute myocardial infarction and cardiac arrest (5619 in New York) were included. Of these, 17 141 (65%) underwent coronary angiography, 12 183 (46.2%) underwent percutaneous coronary intervention, and 2832 (10.7%) underwent coronary artery bypass grafting. Before 2010, patients with cardiac arrest in New York were less likely to undergo percutaneous coronary intervention compared with referent states (adjusted relative risk, 0.79; 95% confidence interval, 0.73-0.85; P<0.001). This relationship was unchanged after the policy change (adjusted relative risk, 0.82; 95% confidence interval, 0.76-0.89; interaction P=0.359). Adjusted risks of in-hospital mortality between New York and comparator states after 2010 were also similar (adjusted relative risk, 0.94; 95% confidence interval, 0.87-1.02; P=0.152 for post- versus pre-2010 in New York; adjusted relative risk, 0.88; 95% confidence interval, 0.84-0.92; P<0.001 for comparator states; interaction P=0.103).ConclusionsExclusion of selected cardiac arrest cases from public reporting was not associated with changes in rates of percutaneous coronary intervention or in-hospital mortality in New York. Rates of revascularization in New York for cardiac arrest patients were lower throughout.© 2017 American Heart Association, Inc.

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