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Angioplasty at hospitals without on-site cardiac surgery safe, effective
Date:3/11/2013

on-site cardiac surgery and 917 at hospitals with surgical backup. The mean age of study subjects was 64 years, 32 percent were women, 32 percent had diabetes and 61 percent presented with an acute coronary syndrome.

Rates of major adverse cardiac events, including death, heart attack, repeat angioplasty and stroke, were assessed at 30 days and 12 months post-angioplasty. Rates at 30 days were 9.5 percent for sites without on-site cardiac surgery compared to 9.4 percent for those with surgical services. Outcomes did not differ significantly between the non-surgical and surgical groups for all-cause mortality, heart attack, repeat angioplasty or stroke. At the 12-month follow up, major adverse cardiac events rates were 17.3 percent for sites without on-site surgery compared to 17.8 percent for sites with surgical services available, and rates of mortality, heart attack, repeat angioplasty and stroke did not differ between groups.

A random sample of 376 study subjects was selected to monitor clinical practice patterns between hospitals with and without cardiac surgery on-site. There were no significant differences between the two treatment groups with respect to procedure success rates, completeness of angioplasty or the proportion of lesions classified as meeting ACCF/AHA/SCAI PCI guidelines Class I or II recommendations for anatomic indications to perform PCI.

"While we did not directly compare all PCI procedures at hospitals with and without cardiac surgery, our results suggest that performance of angioplasty in hospitals without cardiac surgery but with the appropriate experience, established angioplasty programs and the required hospital and operator volume, is an acceptable option for patients presenting to these hospitals for care," Dr. Jacobs said.


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Contact: Beth Casteel
bcasteel@acc.org
240-328-4549
American College of Cardiology
Source:Eurekalert

Page: 1 2

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