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 the
|Contact: Ellen Beth Levitt|
Johns Hopkins Medical Institutions