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Money Affects Angioplasty Outcomes

Poorer patients had worse symptoms before, after surgery

TUESDAY, May 10, 2005 (HealthDay News) -- Money may help safeguard the heart: A new study finds those who struggle to afford health care are more likely to be in worse condition by the time they undergo angioplasty, and have poorer recoveries after the artery-opening surgery, compared to patients with no health insurance worries.

Reporting in the May 10 issue of Circulation, researchers at the University of Missuori, Kansas City, tracked the medical histories of 480 patients whose clogged arteries required either surgical clearance through angioplasty, or surgical re-routing through bypass surgery.

Overall, 35 percent of the patients reported some difficulty in affording medical care, including 31 percent of those undergoing heart bypass and 37 percent of those having angioplasty.

Prior to the procedure, the chest pain frequency scores for financially squeezed angioplasty patients was 14.7 points worse below those of better-off patients. The patients who had trouble affording their health care also had much higher pain scores in the six months following their angioplasty compared to those who had no trouble paying their hospital bills.

A similar pattern was also found in physical limitations and quality-of-life scores among angioplasty patients.

However, financial concerns did not seem to play a role in the pre- or post-surgery symptoms of patients undergoing bypass, the researchers notes.

It's unclear what causes these differences between the two procedures. Previous research has found that angioplasty patients need more medications to control their chest pain than bypass patients, the researchers pointed out.

"Those who had difficulty affording health care may also have had difficulty getting the medications needed to complement their angioplasty, or may have had less access to their cardiologists for recurrent symptoms after the procedure," study author Dr. John Spertus, director of cardiovascular education and outcomes research at Mid America Heart Institute, said in a prepared statement.

"Special attention to the financial status of patients requiring coronary revascularization is probably needed," he added. "Extra social services, safety net programs to ensure access to needed medications and adequate follow-up are all warranted responses to data such as this."

More information

The U.S. National Heart, Lung, and Blood Institute has more about angioplasty.

SOURCE: American Heart Association, news release, May 9, 2005
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