Author Interviews, General Medicine, Heart Disease, JAMA / 26.08.2014
Coronary Stents and Elective PCI Rates Vary By Hospital
MedicalResearch.com Interview with
Steven M. Bradley, MD, MPH
Veterans Affairs, Eastern Colorado Health CareSystem
Denver, Colorado
Medical Research: What are the main findings of the study?
Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals. Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI.
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