Stable Patients Often Get Angioplasty, Despite No Benefit
Many physicians perform percutaneous coronary intervention for non-clinical reasons
TUESDAY, Aug. 14 (HealthDay News) -- Physicians often perform percutaneous coronary intervention on stable heart patients, even though the risks may outweigh the benefits, and they sometimes do so for non-medical reasons, such as to ease a patient's anxiety. The findings are published in the Aug. 13/27 issue of the Archives of Internal Medicine.
Grace Lin, M.D., of the University of California San Francisco, and colleagues conducted focus groups with three sets of California cardiologists, who discussed their reasons for performing the procedure in patients with stable coronary artery disease.
The researchers found that physicians performed the procedure to ease patient anxiety, and for other non-medical reasons, or because they thought it would be beneficial, even though studies suggest it does not lower myocardial infarction or mortality risk in these patients.
"The widespread application of percutaneous coronary intervention in stable coronary artery disease for indications unsupported by evidence may reflect discordance between cardiologists' clinical knowledge and their beliefs about the benefits of percutaneous coronary intervention," the authors write. "Non-clinical factors appear to have substantial influence on physician decision making."
"Their findings provide a sobering first documentation that the practice of medicine pertaining to percutaneous coronary intervention might be far from evidence based," writes Mauro Moscucci, M.D., of the University of Michigan Cardiovascular Center in Ann Arbor, in an editorial.