Design: The PCI California Audit Monitored Pilot with Offsite Surgery (PCI-CAMPOS) program is a prospective, multi-center pilot trial allowing elective PCIs at hospitals without on-site cardiovascular surgery in California. The pilot program was established by California Senate Bill No. 891 (SB 891) which was enacted in January 2009 authorizing the California Department of Public Health (CDPH) to set up a pilot program to allow California hospitals without surgery on-site to perform elective PCIs. The PCI-CAMPOS program was designed to compare PCI outcomes at the pilot hospitals with offsite cardiac surgery to PCI outcomes at established California hospitals with onsite cardiac surgery.