Study Reveals Overuse Of Angioplasty Procedures

DETROIT (WWJ) - A study published in the Journal of the American Medical Association takes a closer look at the number of angioplasty procedures being prescribed for those suffering from coronary artery disease.

About 600,000 of those procedures are performed in the United States each year.  Dr. Doug Weaver, a cardiologist with the Henry Ford Health System, spoke to WWJ of how many of these procedures are really necessary.

"In most situations, coronary stents or some sort of intervention is warranted," said Weaver. "Overall, about three percent of patients fell in the inappropriate category which, in analyzed basis, is about 18,000 patients."

Weaver said that one-in-four hospitals surveyed are doing 16 percent or more "inappropriate" cases of angioplasty, compared to a national average of only three percent.

"Coronary stenting is a popular procedure because if you do need a revascularization procedure, you don't have to go to cardiac surgery," said Weaver. "You are really doing it to improve patient symptoms.  If they don't have a lot of symptoms to begin with or the symptoms can be more easily managed, there is probably no reason to do that procedure."

Weaver is chairman of a committee in charge of the National Cardiovascular Data Registry.

"I was happy to see that 70 percent of the patients who were getting the procedure has had a recent heart attack because that is what I will expect.  But 18,000 patients who possibly had a procedure and didn't need one, we can do better than that."

The report suggests that the use of angioplasty treatments for patients varies from hospital to hospital amid rising concern about the overuse of "big-ticket" medical technology.

"Hospitals and physicians have been working hard to improve quality overall and reduce complications associated with any procedure," Weaver said. "The next thing we have to look at is appropriate utilization in the procedure.  This is one step forward, I think, along that quality chain to improve the kind of care that patients are getting who have cardiovascular disease."

Weaver called the report findings "concerning," but said it also gives hospitals a new benchmark from which to measure their performance.