July 9, 2011 · 7:05 pm
Dr. Paul Chan sat down with me recently to talk about the study published this week in JAMA that he served as lead author on. The article, “Appropriateness of Percutaneous Coronary Intervention.” has generated hundreds of news reports about “unnecessary stenting”, “overuse of angioplasty”, etc.
In my exclusive interview with Dr. Chan, we talked about the real meaning of this study, what it was meant to do (benchmark the use of PCI in the U.S.) and how it’s being (mis) interpreted by the press (I’ll be discussing this aspect in a subsequent post). Continue reading →
July 6, 2011 · 11:30 pm
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 — this is the registry that was the source for the data analyzed and reported in yesterday’s JAMA study, “Appropriateness of Percutaneous Coronary Intervention.”
In my exclusive interview with Dr. Brindis, I talked with him about the study, his feeling about what it showed, both the positive findings and what he calls “opportunities for improvement.” 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 “inappropriates”, as defined by the ACC/SCAI Appropriateness Criteria — and that this rate varied widely from hospital to hospital. This means that those hospitals with higher than average “inappropriate” PCIs needed to look at their cases, their decision-making process and work to bring it closer to the norm. Continue reading →
July 5, 2011 · 4:15 pm
A major study of a half-million angioplasties, published today1 in the Journal of the American Medical Association (JAMA), refutes two major myths about angioplasty and stent use in the United States: myth #1, that angioplasty is vastly overused and unnecessary in most cases; and myth #2, that most angioplasty is used in stable patients and therefore has little or no benefit over drugs in reducing death or heart attacks.
Titled “Appropriateness of Percutaneous Coronary Intervention“, this paper is the first comprehensive look at how closely interventional cardiologists in the U.S. are adhering to the practice guidelines for PCI (angioplasty and stenting) most recently published by the professional cardiology and surgical societies in January 2009. Continue reading →