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New Insights Into Who's At Risk With Angioplasty
Date:3/31/2010

Guidelines based on national data point to those heart patients needing closest monitoring

WEDNESDAY, March 31 (HealthDay News) -- Who's most at risk when undergoing the common, artery-opening procedure known as angioplasty?

A major U.S. study may have come up with some answers -- risk factors that doctors can use to gauge the odds of death after angioplasty, also known as "percutaneous coronary intervention" (PCI).

"This is the largest representation of PCI practice in the country," said study co-author Dr. Sunil V. Rao, assistant professor of medicine at Duke University in Durham, N.C. "It is a nice cross-section of what is happening nationwide," he said.

The study, using data on nearly 600,000 procedures done between 2004 and 2007, found an overall in-hospital death rate of 1.27 percent. But the rate differed sharply among people undergoing angioplasty for different reasons.

For example, someone having elective (not emergency) angioplasty to prevent a possible heart attack or other cardiac problem faced a 0.65 percent risk of dying within 30 days. But the death risk was 4.81 percent -- nearly one chance in 20 -- for someone given the procedure because of a severe heart attack.

A number of other risk-predicting scores are available, Rao said, but the new one has the major advantage of being based on national experience. "It overcomes individual practice bias," he said. "Other studies have been done in single medical centers."

The journal report lists nine characteristics that influence the risk of death, starting with age and going on to such matters as previous heart failure; the presence of peripheral arterial disease (blockages in leg arteries); chronic lung disease; measures of kidney function; and the type of heart attack for which the procedure might be done.

It is not possible to look at the list and quickly assess a patient's risk, Rao said. Instead, you have to app
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