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Adherence to Angioplasty/Stent Guidelines Lacking: Study
Date:7/11/2011

MONDAY, July 11 (HealthDay News) -- Many U.S. hospitals don't follow recently revised guidelines for the appropriate use of balloon angioplasty and stenting in patients who have a blocked coronary artery after a heart attack, a new study finds.

A U.S. National Heart, Lung, and Blood Institute study released in 2006, called the Occluded Artery Trial (OAT), found that angioplasty and stenting -- known as percutaneous coronary intervention (PCI) -- had little effect on patients with blocked coronary arteries that were detected more than 24 hours after a heart attack. As a result, the American Heart Association and American College of Cardiology revised their guidelines for PCI in such situations.

In this study, researchers analyzed data from 28,780 patient visits at 896 U.S. hospitals between 2005 and 2008 in order to determine whether clinical practice changed after the release of the study findings and the updated guidelines.

PCI was performed on 11,083 patients before the OAT study was published, 7,838 between the release of the study and guideline changes, and 9,859 after the guidelines were revised, the investigators found.

After they factored in other variables, the study authors found no overall significant decrease in the monthly rate of PCI performed for coronary blockages either after the OAT results were published or after the guidelines were updated.

"In conclusion, among this large cross-section of hospitals in the United States we found only modest evidence that the results of the OAT and its incorporation into major guideline revisions have influenced cardiology and interventional cardiology practice over the subsequent one to two years," wrote Dr. Marc W. Deyell, of the University of British Columbia in Vancouver, Canada, and colleagues.

"Percutaneous coronary intervention of total occlusions identified greater than 24 hours after [heart attack] remains commonplace despite little evidence t
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