Navigation Links
Patients fare just as well if their nonemergency angioplasty is performed at hospitals
Date:11/14/2011

Hospitals that do not have cardiac surgery capability can perform nonemergency angioplasty and stent implantation as safely as hospitals that do offer cardiac surgery. That is the finding of the nation's first large, randomized study to assess whether patients do just as well having nonemergency angioplasty performed at smaller, community hospitals that do not offer cardiac surgery.

Results of the study, called the Cardiovascular Patient Outcomes Research Team Elective Angioplasty Study (C-PORT-E), are being presented on Nov. 14, at the American Heart Association's Scientific Sessions 2011. The study, led by Johns Hopkins cardiologist Thomas Aversano, evaluated the outcomes of more than 18,500 patients who were randomly assigned to have heart artery-opening angioplasty or stenting at hospitals with or without cardiac surgery capability.

The study included 60 hospitals in nine states without cardiac surgery backup. In order to participate in the study, those hospitals had to perform a minimum of 200 angioplasty procedures each year and complete a formal angioplasty development program.

Emergency angioplasty is performed during a heart attack, when a vessel needs to be opened right away to restore blood flow in the heart. Nonemergency procedures are offered to patients with blockages that may be causing chest pain.

"Historically, angioplasty has been performed at hospitals that had cardiac surgery backup in case complications from the procedure required emergency surgical intervention. Initially, in the late 1970s, the rate of complications requiring emergency surgery was as high as 15 percent," says Aversano, who is an associate professor of medicine at the Johns Hopkins University School of Medicine. "Today, however, the rate of complications from angioplasty is very low."

During angioplasty, a tiny balloon is inflated within a coronary artery to push away plaque that is causing a blockage in the vessel. Stents, which act like tiny scaffolds, also can be put in place to keep the artery open. In rare cases, the procedure can cause a tear in the vessel or closing of the artery, requiring open-heart surgery to repair the problem.

Data from the study indicated that emergency surgery was rarely needed, and patients in neither group were more likely to have such a complication. Also, the researchers found that the death rate within six weeks for any cause was less than one percent among patients in both groups.

The American Heart Association and the American College of Cardiologists currently recommend that nonemergency angioplasty only be performed within hospitals that offer open-heart surgery.

"Hospitals with cardiac surgery usually have a higher volume of heart-related cases overall, and that's one reason why those hospitals have been thought to offer better quality of care for nonemergency procedures," says Aversano, who adds that until this study, there was a lack of good outcomes data.

The researchers do not believe that every hospital should be performing angioplasty. However, they wanted to know if hospitals that offer emergency angioplasty to open blocked coronary arteries in heart attack patients can also safely perform elective angioplasty.

"It is not reasonable to have doctors, nurses and technicians who are specially trained in performing angioplasty on hand 24/7 just to handle emergency cases," says Aversano. "Also, having the ability to perform elective cases, as well as emergency ones, increases quality that comes with more experience."

About 850,000 angioplasties are performed in the United States each year. Many states restrict hospitals that don't offer cardiac surgery from performing angioplasty, which is a minimally invasive procedure performed by specially trained cardiologists rather than cardiac surgeons. As a result, hospitals feel pressured to create costly cardiac surgery programs so that they can offer angioplasty.

"The goal of our study," says Aversano, "is to give health care planners the best possible information on which to base their decisions about the allocation of resources, so that patients can have access to the highest quality of care."

More data from the CPORT study, focusing on the quality of procedures, are expected to be released early in 2012. Those data will reveal patient outcomes nine months after their angioplasty in terms of death, heart attack, and whether the vessel that was opened by angioplasty or stenting became blocked again, requiring another procedure.


'/>"/>

Contact: Ellen Beth Levitt
eblevitt@jhmi.edu
410-955-5307
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. ICU Patients at Risk for Rare Heart Rhythm Problem
2. Young patients with chronic illnesses find relief in acupuncture
3. For Some Breast Cancer Patients, Shorter Radiation Works Well
4. New Study Uses Adult Stem Cells in Effort to Save Limbs of Patients with Peripheral Arterial Disease
5. Patients with Lethal Lung Disease Finally Receive Recognition by Social Security Administration
6. Behavioral therapy improves sleep and lives of patients with pain
7. Protecting patients: Study shows that Johns Hopkins flu vaccination rates twice national average
8. MSU researcher linking breast cancer patients with alternative therapies
9. New American Heart Association Survey Finds Heart Disease and Stroke Patients Face Significant Barriers in Obtaining Quality, Affordable Care
10. Fishy Smell May Keep Patients From Diabetes Drug
11. AGA offers new recommendations for CRC surveillance for certain patients with IBD
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/29/2016)... ... April 29, 2016 , ... A new study by a ... diaphragmatic hernia have better survival rates if surgery is performed early. Approximately one ... the diaphragm fails to form completely, letting abdominal organs into the chest cavity ...
(Date:4/29/2016)... ... 2016 , ... The Wharton School of the University ... of the 2016 Wharton Business Plan Competition —as well as the Wharton ... the Committee Award for Most ‘Wow Factor,’ making them the first team in ...
(Date:4/29/2016)... ... 29, 2016 , ... World Patent Marketing , a ... invention which aids in proper muscle development. , "The Gym & Exercise Equipment ... of World Patent Marketing. "Globalization has threatened the future growth of the industry ...
(Date:4/29/2016)... ... April 29, 2016 , ... Melanoma is the deadliest type of skin cancer. Although ... the majority of skin cancer deaths. More than 10,000 people are expected to die of ... is 62, it is the one of the most commonly diagnosed cancers in young women. ...
(Date:4/29/2016)... , ... April 29, 2016 , ... New York City based oral and maxillofacial surgeon ... is a very effective way to treat obstructive sleep apnea. Dr. Jamali is proud to ... is a procedure that involves one or both jaw bones. This surgery is performed to ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... India , April 28, 2016 ... Pipeline Review, H1 2016" is a report that ... and helps strengthen R&D pipelines by identifying new ... products. Company Profiles discussed in this ... Industrie Farmaceutiche Riunite Srl, AbbVie Inc., Abiogen Pharma ...
(Date:4/27/2016)... , April 27, 2016   ... 42% Growth in Recurring Consumable Sales  Clinical ... Mauna Kea Technologies (Euronext: MKEA, OTCQX: MKEAY) inventor of ... its sales for the first quarter ended March 31, ... the execution of its commercial strategy. First ...
(Date:4/27/2016)... April 27, 2016 Tie-up with ... initiative to save newborns   Fortis ... & newborns in collaboration with Breast Milk Foundation (BMF), a ... Pasteurized Human Milk Bank, ,Amaara, in Delhi-NCR today. This non-profit ... source for infants and should be available to babies deprived ...
Breaking Medicine Technology: