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

o support its use in stable patients and new clinical practice guidelines recommending against it," the researchers reported in the July 11 online edition of the journal Archives of Internal Medicine.

The findings mean that many patients may be undergoing an expensive procedure that does not help them, the study authors explained in a journal news release about the report, which is part of the journal's Less Is More series.

A number of factors, including difficulties in changing doctors' and patients' beliefs and behaviors, may play a role in the lack of adherence to the revised guidelines, Dr. Mauro Moscucci, from the University of Miami's Miller School of Medicine, pointed out in a commentary accompanying the study.

The findings add to the spotlight being placed on procedures that increase health care costs without providing a clear benefit to patients, he noted.

"While the debate on health care reform is ongoing, health care expenditures in the United States are continuing to escalate. Thus, we must heed the call to professional responsibility aimed at the elimination of tests and treatments that do not result in any benefit for our patients, and for which the net effects will be added costs, waste and possible harm," Moscucci said.

Commenting on the study, Dr. Barry Kaplan, vice chairman of cardiology at North Shore University Hospital in Manhasset, N.Y., and Long Island Jewish Medical Center in New Hyde Park, N.Y., had this to say: "The guidelines were updated based on the OAT results in December 2007. In all medical fields there is usually a one- to two-year lag between the changes in recommendations by agencies such as AHA and ACC and adoption and acceptance of these guideline changes by practicing physicians. This study examined trends from 2005 to 2008 and may have been done too early in order to capture a change in practice."

In addition, "this study does not account for technological advances in PCI and
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