Navigation Links
Patient’s Individual Cardiologist Best Judge For Deciding Appropriate Treatment In Chronic Coronary Artery Diseas

A new research conducted at the Heart Institute of the University of Sao Paulo Medical School in Brazil showed that following individual doctor's advice was the key to// getting the best care in case of chronic coronary artery disease.

The findings of the study to be published in the September edition of the Journal of the American College of Cardiology showed that patients assigned to receive their physician-recommended treatment showed a significantly lower incidence of problems.

For the study, researchers reviewed data collected during the Medicine, Angioplasty or Surgery Study II (MASS II) to determine how physician-recommended care affected patient outcomes one year after treatment. All patients were diagnosed with severe coronary artery disease affecting at least two blood vessels but not yet causing a loss of heart function. Coronary artery disease occurs when a buildup of cholesterol in the arteries prevents oxygen-rich blood from nourishing the heart muscle.

"We still currently do not know which is the best therapeutic option for patients with multivessel chronic coronary artery disease and a normal ventricular function," said Whady Hueb, MD, PhD, a cardiologist at the University of Sao Paulo Heart Institute (InCor). "I think our study offers additional information and reassurance for both doctors and patients that, at the end of the decision-making process, what the doctor and patient agree is the best option in most cases really is the best option."

Dr. Hueb is senior author of the new study and principal investigator of MASS II, a randomized, controlled clinic trial looking for new ways to determine the most effective treatments for people with coronary artery disease.

For the study, 611 patients met with their individual cardiologists for evaluation. The physicians examined them and then, after conferring with a second cardiologist, recommended one of the three potential treatments: medicatio n, noninvasive angioplasty using balloons and/or stents to open clogged arteries, or coronary artery bypass graft (CABG) surgery to reroute blood through new vessels grafted into place.

After the cardiologists made their recommendations, the patients were randomly assigned to receive a treatment. After one year, all records were reviewed to determine the percentages of patients who had died, experienced heart attacks or required additional procedures to treat blocked arteries.

According to the research, patients assigned to receive their physician-recommended treatment showed a significantly lower incidence of problems. In contrast, patients assigned to a different course of treatment experienced a statistically significant increase in negative events (p = 0.02).

The most common – and only statistically significant – issue affecting this second group was the need for additional procedures to treat blocked arteries (p = 0.007.) No significant differences were found in either heart attack or death rates.

"Our data are a reminder that physician judgment remains an important predictor of outcomes," said Alexandre C. Pereira, MD, a cardiologist at the University of Sao Paulo Heart Institute and one of the study's co-authors.

"We should always remember that the therapeutic decision option is the final result of a complicated equation that uses both objective and subjective variables, which will not necessarily be acquired by lab tests, imaging exams or objective questions in a clinical questionnaire," Dr. Pereira said. "In this scenario, physician judgment – with all of the subjectivity that it may imply – still appears to be the best test or exam that a patient may have."

Ori Ben-Yehuda, MD, associate professor of medicine and director of coronary care at the University of California, San Diego, Medical Center, was not connected with the research but said it highlights why medicine will always be "an art not a science," and provides an intriguing new avenue for the future research of complicated medical conditions.

"The idea is quite ingenious and has never been done before," said Dr. Ben-Yehuda, a deputy editor of the Journal of the American College of Cardiology and author of an editorial that will accompany publication of the research. "The concept of recording a physician's judgment before conducting the randomization process to allocate patient treatment allows us to evaluate whether there are differences in outcomes based on that judgment.

"In other words, a physician may notice a lot of little things that add up to one big thing," Dr. Ben-Yehuda said. "This big thing may go against the scientific formula routinely used to determine the patient's care. In the final analysis, this research shows that even in this day and age, physician judgment continues to be critical in patient care."

Neither Dr. Hueb nor Dr. Pereira reports any disclosures in connection with this research. MASS II was funded by an internal grant from the University of Sao Paulo Heart Institute.

Source-Eurekalert
AR
'"/>




Related medicine news :

1. Patient’s perception of health status helps in better recover
2. Legalization Of Euthanasia Would Not Affect Patient’s Trus
3. Donor Heart Gives Way for Patient’s Own Hear
4. Surgeons Retrieve ‘Three-Year-Old’ Forceps From Patient’s Abdoen
5. Simple Test Detects Genetic Signs of Lung Cancer in a Patient’s Sputu
6. Charity To Cancer Patient’s Rescu
7. Cancer Patient’s Life Improved With Anti-reflux Valv
8. Individuals with sleep related breathing disorders more prone to heart disease
9. Excess Weight Can Affect Individuals as They Age
10. Hypnosis Can Help Individuals Quit Smoking
11. Good News For Individuals Suffering From Frequent Throat Infections
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:3/24/2017)... York, NY (PRWEB) , ... March 24, 2017 ... ... global scale; from third world countries to hospitals in the United States, it’s ... a conversation on the current obstacles facing infection prevention and offers strategies for ...
(Date:3/24/2017)... , ... March 24, 2017 , ... The iaedp Foundation, ... other medical professionals caring for those suffering from the full spectrum of disordered eating, ... as eating disorders professionals from nearly all 50 states and several countries converged on ...
(Date:3/24/2017)... (PRWEB) , ... March 24, 2017 , ... ... Assili, announce that they are now offering treatments for sleep apnea and TMJ ... dental offices. Sleep apnea , specifically the obstructive type, is increasingly being ...
(Date:3/24/2017)... ... March 24, 2017 , ... Empower Brokerage, ... their training and leads programs. , In February, 2017, Empower Brokerage introduced their ... Performance Partners is designed to teach how to maximize their sales efforts, as ...
(Date:3/24/2017)... ... , ... “The Communion of Saints: A Pastor’s Potpourri of ... across the United States. “The Communion of Saints” is the creation of ... congregations in seven states throughout his long career of devotion to the church. ...
Breaking Medicine News(10 mins):
(Date:3/24/2017)... , Mar. 24, 2017 Research and Markets has ... Report" report to their offering. ... This report analyzes the worldwide markets for Dental Implants in ... Canada , Japan , Europe ... , and Rest of World. Annual estimates and forecasts ...
(Date:3/24/2017)... , March 24, 2017 FinancialBuzz.com ... ... leading publisher of cannabis market research, the legal cannabis market ... CAGR through 2021, despite conflicting signals from the current presidential ... out that the two biggest drivers of growth in this ...
(Date:3/24/2017)... DUBLIN , Mar 24, 2017 Research ... in Drug Discovery and Diagnostics, 2017 - 2035" report to ... The ... current landscape and future outlook of the growing market of deep ... data revolution, deep learning algorithms have emerged as a novel solution ...
Breaking Medicine Technology: