Not All Heart Patients Treated Same

Surgery patients receive less aggressive discharge care than angioplasty patients

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MONDAY, Nov. 8, 2004 (HealthDayNews) -- Patients who have coronary artery bypass surgery receive less aggressive drug care when they're discharged from hospital than patients who've had less invasive angioplasty procedures, says a Duke University study.

Coronary artery bypass patients are prescribed lifesaving drugs such as statins, beta blockers, ACE inhibitors and aspirin far less often than angioplasty patients, concluded the team from the Duke Clinical Research Institute. These drugs have been proven to reduce repeat cardiac events and death.

The study found that 65 percent of angioplasty patients received ACE inhibitors (drugs that relax blood vessels), compared to 44 percent of bypass patients. Cholesterol-lowering statins were prescribed to 76 percent of angioplasty patients and 62 percent of bypass patients.

The researchers, who analyzed data from a U.S. national registry of heart attack patients, did find that bypass patients were more likely than angioplasty patients to be given referrals to cardiac rehabilitation and to receive counseling about healthier eating.

"In general, discharge care given to angioplasty patients is more aggressive and is more consistent with national guidelines than is the discharge care given to the surgical patients," Duke cardiologist Dr. Christopher Dyke said in a prepared statement.

"The disparity between the two groups of patients is inappropriately large, with the usage of ACE inhibitors and statins by surgical patients alarmingly low. These patients tend to be the sickest heart patients and may have the most to gain by receiving these proven therapies," Dyke said.

The study was presented Monday at the American Heart Association's scientific sessions in New Orleans.

More information

The American Medical Association has more about coronary artery bypass surgery.

SOURCE: Duke University Medical Center, news release, Nov. 8, 2004


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