Mount Sinai Hospital Earns Highest Ratings in New York State Report on Coronary Angioplasty

NEW YORK, May 6 /PRNewswire/ -- For patients with heart disease, it is crucial to have a doctor and hospital with a strong record of success in performing complex procedures. Among 53 hospitals across the state, Mount Sinai Hospital in Manhattan – along with two of its doctors – has been singled out by the New York State Department of Health as having the most successful record in performing angioplasty, one of the most common interventions to clear blocked coronary arteries.

In a report released on April 22, "Percutaneous Coronary Interventions (PCI) in New York State 2005-2007," the Department of Health provides statistics on deaths within 30 days following PCI, more commonly known as angioplasty. In the three-year period, 53 non-federal hospitals across the state were performing the procedure, and only one of them – Mount Sinai – received a "double-star" rating for a risk-adjusted mortality rate significantly lower than the statewide rate in both emergency cases and overall cases.

In addition, Dr. Samin K. Sharma, Director of Mount Sinai's Cardiac Catheterization Laboratory, and Dr. Annapoorna Kini, its Associate Director, were two of only five doctors who were awarded individual double-star ratings for significantly lower risk-adjusted mortality rates than the statewide average.

Mount Sinai Hospital performed by far the most angioplasties of any hospital – more than 13,000 – in the three-year period studied in the Department of Health report, and only one other doctor statewide came close to performing the number of procedures completed by Drs. Sharma and Kini, who performed 3,722 and 2,780 angioplasties, respectively. That volume reflects the hospital's expertise and experience in the procedure, and because of its ability to successfully handle complex cases, about a third of its patients are referred from outside Mount Sinai's patient base.

"Mount Sinai has the busiest Cardiac Catheterization Laboratory in the state and treats the most complex cases, which makes the low mortality rating even more impressive," said Dr. Sharma. "We are committed to providing the best patient care, and are proud to have achieved such a stellar rating in patient safety."

Added Dr. Kini, "Despite the high volume of cardiac patients we treat, our team consistently provides top-notch patient care. This report's results reflect our dedication to quality and safety, and we look forward to maintaining our outstanding ratings in future reports."

The Mount Sinai cath lab's low mortality rate can be attributed to the seamless technical skills of its doctors and the attention they pay to minute details before, during, and after each procedure. A comprehensive procedure manual of more than 150 pages details specific protocols for every aspect of a procedure for everyone involved, from the nursing staff to the attending physicians. It outlines not only standard procedures but also protocols for dealing with complications that might occur, such as a patient kidney malfunction or allergic reaction. What's more, each month, the entire staff meets to discuss and analyze any new issues that may have arisen, and the manual is updated to address them.

The Mount Sinai team also stays at the leading edge of new technology that improves its procedures. In angioplasty, a catheter with a tiny balloon is threaded from an artery in the leg or arm to the site of a blocked vessel in the heart, where the balloon is inflated to clear the artery. When the blockage is calcified, it makes the artery difficult to open. In those cases, the Mount Sinai cath lab has become adept at using the Rotablator, a high-speed spinning device that breaks up and clears the calcification so the balloon can open the artery. The Rotablator, or rotational atherectomy, is used in 9-10% of angioplasties at Mount Sinai, versus just 1-2% of cases nationwide.

"That method makes a complex case simple," Dr. Sharma noted. "And because of our expertise in handling difficult angioplasty procedures, we have developed an excellent reputation, so that other doctors and hospitals send their complex cases to us. We like those cases, too, because we know we can do a good job and make a difference for those patients."

The Department of Health has been assessing angioplasty results of hospitals across the state for more than 15 years, with the first PCI report released in 1996. The reports analyze statistics including observed mortality rates and expected mortality rates for each hospital and each doctor, and compute a risk-adjusted mortality rate that accounts for providers treating more or fewer high-risk patients. A "confidence interval" is also calculated to adjust outcomes based on the volume of procedures performed. Mount Sinai Hospital and Dr. Sharma have received double-star ratings for significantly lower than average mortality several times in the previous nine reports. Since the latest study, Mount Sinai Hospital has performed close to 15,000 angioplasties and continues to maintain excellent mortality rates.

Dr. Samin Sharma is Professor of Medicine (Cardiology) at Mount Sinai Medical Center, Director of the Cath Lab and Intervention, and Co-Director of the Cardiovascular Institute, Mount Sinai Heart. He performs more than 1,500 complex coronary interventions annually (the highest in the country), and according to New York State Department of Health reports, he has the highest angioplasty success rate (mortality less than 0.3 percent) for an interventional cardiologist in the state since 1994.

Dr. Sharma serves on the Cardiac Advisory Board of New York State for coronary interventions, and received the Governor's Award of Excellence in 2006 for his outstanding contributions to medicine. He has received "Best Doctors" status from U.S. News and World Report and has been included in "Top Physicians" lists by Consumer Research Council of America and Castle Connelly magazines.

Dr. Annapoorna Kini is Associate Professor of Medicine (Cardiology) at Mount Sinai Medical Center and Associate Director of the Cath Lab. She performs more than 1000 coronary interventions annually (the highest number by a female interventionalist in the U.S.) with an extremely low complication rate of less than 0.3 percent, and is well known for successfully performing complex coronary interventions in patients with advanced heart disease with excellent long-term results. Dr. Kini serves as Director of Mount Sinai's Interventional Cardiology Fellowship Program, and also as the site Principal Investigator for numerous multi-center trials, including the National Institutes of Health (NIH) sponsored COPES trial.

The Mount Sinai Medical Center is a 1,171-bed, tertiary- and quaternary-care teaching facility acclaimed internationally for excellence in clinical care. Founded in 1852, The Mount Sinai Medical Center encompasses The Mount Sinai Hospital and Mount Sinai School of Medicine. In 2009, Mount Sinai Hospital treated nearly 60,000 inpatients and handled close to 530,000 outpatient visits. The hospital ranks 19th in U.S. News & World Report's 2009-2010 "America's Best Hospitals" issue.

More information on Mount Sinai Hospital is available at www.mountsinai.org.

The complete New York State Department of Health PCI report is available at http://www.health.state.ny.us/statistics/diseases/cardiovascular/docs/pci_2005-2007.pdf.

SOURCE Mount Sinai Hospital