2020 AHA/ACC Key Data Elements and Definitions for Coronary Revascularization

People meeting at table
  • Heart disease is the leading cause of death in the US; coronary artery disease is the most common type of heart disease.
  • The annual estimated cost of heart disease in the US is $218 billion with a substantial portion related to the cost of hospitalizations for interventional cardiology and cardiac surgery.
  • This report provides consensus-based key data elements and definitions for databases capturing information about coronary revascularization.

Read the full article in Circulation: Cardiovascular Quality and Outcomes

Top ten things to know:

  1. This document presents a clinical lexicon comprising data elements related to coronary revascularization and associated clinical metadata for the purpose of standardizing the language, definitions and terms used for a broad range of cardiovascular applications.
  2. The primary sources reviewed were the "2013 ACCF/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients With Acute Coronary Syndromes and Coronary Artery Disease," the Society of Thoracic Surgeons National Database, publications from the Society for Cardiovascular Angiography and Interventions, and the ACC National Cardiovascular Data Registry. Other contemporary data standards were also identified to harmonize definitions among documents. 
  3. This document adopted the coronary artery nomenclature recommended by the 2014 Cardiovascular Endpoint Events in Clinical Trials Data Standards (Hicks et al.).
  4. To be concordant with the 2017 Hypertension Clinical Guideline (Whelton et al.), the hypertension data element definition was updated to reflect the change in classification of blood pressure. In addition, the data element "Hypertension controlled by medication" was added.
  5. Data elements related to tobacco use were updated to collect more detailed information about lifetime tobacco use, exposure to second-hand smoke, and new tobacco products such as e-cigarettes.
  6. To be concordant with 2017 Appropriate Use Criteria for Coronary Revascularization (Patel et al.), data elements for noninvasive testing were expanded, with an emphasis on differentiating between low risk vs. intermediate or high-risk findings.
  7. Data elements for noninvasive testing modalities (exercise electrocardiogram, radionuclide imaging, stress and resting echocardiogram, coronary artery calcium score, coronary computed tomography angiography) were included.
  8. To be concordant with the 2018 Cholesterol Clinical Guideline (Grundy et al.), the definition for dyslipidemia was updated, and a data element for metabolic syndrome was added.
  9. To reflect the increasing importance of patient-reported outcome measures, data elements for the Rose Dyspnea Scale score and Seattle Angina Questionnaire Short Form summary score were included.
  10. These clinical data standards should be broadly applicable in various settings, including cardiovascular procedure reports, electronic health record systems, clinical studies, patient registries, digital health information technology interoperability, public reporting programs, and medical teaching.