{"id":560,"date":"2011-07-06T23:30:29","date_gmt":"2011-07-07T03:30:29","guid":{"rendered":"http:\/\/www.ptca.org\/voice\/?p=560"},"modified":"2012-10-26T16:06:01","modified_gmt":"2012-10-26T20:06:01","slug":"a-perspective-on-the-appropriate-use-of-angioplasty-and-stents","status":"publish","type":"post","link":"http:\/\/www.ptca.org\/voice\/2011\/07\/06\/a-perspective-on-the-appropriate-use-of-angioplasty-and-stents-560","title":{"rendered":"A Perspective on the Appropriate Use of Angioplasty and Stents"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" title=\"Ralph Brindis, MD, MPH, FACC\" src=\"http:\/\/www.ptca.org\/images\/brindis_140sq.jpg\" alt=\"Ralph Brindis, MD, MPH, FACC\" width=\"140\" height=\"140\" \/>Dr. Ralph Brindis is the Immediate Past President of the American College of Cardiology and helmed the National Cardiovascular Data Registry (NCDR) since its inception in 1997 &#8212; this is the registry that was the source for the data analyzed and reported in yesterday&#8217;s JAMA study, &#8220;<em><a href=\"2011_0705.html\" target=\"_blank\">Appropriateness of Percutaneous Coronary Intervention<\/a>.<\/em>&#8221;<\/p>\n<p class=\"bodytext\">In my <a href=\"http:\/\/www.ptca.org\/stentcenter\/brindis_interview.html\" target=\"_blank\">exclusive interview with Dr. Brindis<\/a>, I talked with him about the study, his feeling about what it showed, both the positive findings and what he calls &#8220;opportunities for improvement.&#8221; While there was almost 100% adherence to guidelines for acute angioplasties (which made up 71% of the total angioplasties performed) the study also pinpointed the fact that PCIs for non-acute patients had a higher rate of &#8220;inappropriates&#8221;, as defined by the ACC\/SCAI Appropriateness Criteria &#8212; and that this rate varied widely from hospital to hospital. This means that those hospitals with higher than average &#8220;inappropriate&#8221; PCIs needed to look at their cases, their decision-making process and work to bring it closer to the norm.<!--more--><\/p>\n<p class=\"bodytext\">The crazy thing about much of the news reporting about the publication of this study in JAMA is the implication that an &#8220;investigative team uncovered previously unreported data&#8221; and exposed the fact that &#8220;up to half of angioplasties performed may not be beneficial.&#8221;<\/p>\n<p class=\"bodytext\">The fact is that none of this data would exist if it were not for the ACC, SCAI and physicians like Dr. Brindis, who is a co-author of the JAMA study. And the point of the study was specifically to take a &#8220;look-see&#8221; at how PCIs were being done in the U.S. and that look showed only 4% of all PCIs could be classified as &#8220;inappropriate&#8221;. Most importantly, the study showed precisely where the inappropriates were happening, and opened up a discussion about how to reduce that number and improve the use of angioplasty.<\/p>\n<p class=\"bodytext\">Speaking of inappropriate, I&#8217;ll be discussing the inaccurate reporting of this study by most of the mainstream media in an upcoming post, but for now, read over <a href=\"http:\/\/www.ptca.org\/stentcenter\/brindis_interview.html\" target=\"_blank\">our interview with Dr. Brindis<\/a>. (We&#8217;ll be posting a companion piece, talking to the study&#8217;s lead author, Dr. Paul Chan, tomorrow.)<\/p>\n<!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<p>Dr. Ralph Brindis is the Immediate Past President of the American College of Cardiology and helmed the National Cardiovascular Data Registry (NCDR) since its inception in 1997 &#8212; this is the registry that was the source for the data analyzed &hellip; <a href=\"http:\/\/www.ptca.org\/voice\/2011\/07\/06\/a-perspective-on-the-appropriate-use-of-angioplasty-and-stents-560\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,5,11],"tags":[],"class_list":["post-560","post","type-post","status-publish","format-standard","hentry","category-appropriate-use-criteria","category-interviews","category-media-coverage"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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