How can this site help me?
Mass-DAC’s focus is on improving the quality of cardiac health in the Commonwealth of Massachusetts. In the Public Outreach section, we provide information, in laymen’s terms, about
- coronary artery disease,
- research on cardiac care issues,
- abstracts of public report key points,
- links to cardiac care publications, and
- links to authoritative educational resources at major hospitals and national organizations.
Mass-DAC, started in 2002, is a data-coordinating center responsible to the Massachusetts Department of Public Health for the collection, cleaning, archiving, and analysis of the cardiac data submitted by Massachusetts hospitals. We publish, annually, two reports describing Massachusetts hospital-specific risk-standardized mortality rates for 14 cardiac surgery programs that perform coronary artery bypass graft (CABG) surgery and 24 percutaneous coronary intervention (PCI) angioplasty programs. The reports compare the hospitals on
- 30-day mortalities following Isolated CABG surgeries, and
- in-hospital mortalities following PCIs; splitting the patient population between
- higher risk shock or STEMI patients,
- lower risk no shock and no STEMI patients.
What is coronary artery disease?
For a heart to function properly, it needs an oxygen-rich blood supply and healthy coronary arteries to deliver the blood to the heart. When the coronary arteries are healthy, blood flows easily and the heart muscle gets the oxygen it needs. Coronary artery disease begins when blood flow to the heart is reduced due to plaque buildup. Plaque may build up because of high cholesterol, high blood pressure, smoking, diabetes, genetic predisposition, or other factors. As the plaque buildup increases, the coronary arteries narrow and blood flow to the heart is reduced, often leading to angina.
Angina may be described as squeezing, pressure, heaviness, tightness or pain in your chest, arm pain, or jaw tightness. Theses symptoms may be felt with exertion or while at rest. Angina can be a recurring problem or a sudden, acute health concern, and can be hard to distinguish from other types of chest pain, such as the discomforting pain of indigestion. If you have unexplained chest pain, seek medical attention right away.
If blood flow is completely blocked by the sudden development of a clot within a coronary artery, the presence of the clot usually results in a heart attack or myocardial infarction (MI), which may irreversibly damage the heart muscle. Coronary artery disease is usually treated by one of three methods, from least to most invasive:
- coronary intervention, or
- cardiac surgery.
The choice of treatment depends on the degree of blockage, patient symptoms, and the number of coronary arteries involved. Mass-DAC analyzes data on both coronary interventions and cardiac surgeries.
What is an isolated CABG surgery?
Isolated coronary artery bypass graft (CABG) surgeries are costly procedures that account for the majority of cardiac surgeries performed nationally. CABG surgery is a type of cardiac surgery that creates a new route or bypass around the blocked part of the artery, allowing the blood flow to reach the heart muscle again. During CABG surgery, the blocked coronary arteries are bypassed using some of the patient’s own blood vessels. The internal mammary arteries are commonly used for the bypass, but the saphenous vein in the leg or the radial artery in the arm can also be used. Surgical procedures in which CABG surgery is the only major heart surgery performed are referred to as isolated CABG procedures.
What is a PCI – angioplasty?
PCIs are performed in a catheterization lab where a catheter is inserted to assess and unblock a patient’s coronary artery without having to undergo surgery. Most PCIs involve either a balloon catheter or a stent (including drug eluting stents). The balloon is used to push the blockage against the walls of the artery reducing the narrowing of the artery. The balloon is then removed at the end of the procedure. The stent is a metal mesh tube that is inserted and left in the artery to maintain the opening, preventing the closing of the artery after the procedure. Drug eluting stents are coated with a drug that interferes with the process of restenosis or a buildup of scar tissue which can occur in a small percentage of patients after the intervention.