Angioplasty not always appropriately used on non-acute patients

A study in the Journal of the American Medical Association has found for some stable patients, angioplasty is inappropriately used.

For the study, researchers compared data for more than 500,000 patients treated across the country between July 2009 and September 2010 with guidelines developed by in 2009 to determine whether hospitals were appropriately using the procedure.  Angioplasty is estimated to cost $20,000, according to the Wall Street Journal.

Key findings from the study:

  • For acute patients suffering a heart attack, which account for 70% of angioplasty cases, the procedure was appropriate almost 99% of the time. 
  • For more stable patients, the procedure was found to be inappropriate 12% of the time, and the benefits were uncertain 38% of the time.
  • There was wide variation across hospitals, with one quarter having an inappropriate case rate of 6% or less and another 25% performing 16% or more inappropriate cases.

The authors conclude that a better understanding of the reasons that inappropriate PCIs occur and reduction in their variation across hospitals should be targets for quality improvement.

(Sources: Journal of the American Medical Association, http://jama.ama-assn.org, July 2011; Wall Street Journal, http://online.wsj.com, July 6, 2011; The Advisory Board Daily Briefing, http://advisory.com, July 6, 2011)