October 15, 2008
Most Angioplasty Patients Not Stressed
U.S. researchers say they've found patients receiving elective angioplasty and stenting aren't first stress tested, as called for in medical guidelines.
Percutaneous coronary intervention, or PCI -- the clinical name for angioplasty and cardiac stenting -- is used to open narrowed coronary arteries. Guidelines published by the American College of Cardiology, the American Heart Association and the Society for Cardiovascular Angiography and Intervention state that, for most patients, vessels to be dilated by PCI must be shown by non-invasive stress tests to be "associated with a moderate to severe degree of ischemia."The researchers said prior studies showed patients undergoing PCI according to the guidelines had better outcomes.
To determine if the guidelines were being followed, researchers from the University of California-San Francisco, the Maine Medical Center and the Dartmouth-Hitchcock Medical Center analyzed data from a random sample of nearly 24,000 Medicare patients 65 years of age or older, who had elective PCI at U.S. hospitals during 2004.
The researchers said they found 44.5 percent of the patients underwent stress testing during the 90 days before the elective PCI procedure.
The study appears in the Journal of the American Medical Association.