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, w
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Johns Hopkins Medical Institutions