The researchers from the University of Michigan Cardiovascular Center had found that the risk of major complications from angioplasty and related procedures lowers when doctors perform a large number of those procedures // each year. The paper is published in the Journal of the American College of Cardiology.
In fact, the risk of major cardiovascular problems was 63 percent higher among patients treated by doctors who performed less than 90 procedures each year, compared with those who did more than 90.
However, the study found no difference in the risk of death before leaving the hospital among patients treated by low- and high-volume doctors. And, it found that a few doctors who performed fewer angioplasties each year still had very good patient outcomes, suggesting that “practice makes perfect” isn’t the whole story for the minimally invasive procedures known as percutaneous coronary interventions (PCI).
The researchers say their data, from 18,504 artery-opening procedures done in 14 Michigan hospitals by 165 physicians during 2002, reflects current angioplasty care, including advanced clot-preventing drugs and devices called stents that hold arteries open after they’re cleared. Both advances, and better technology for deploying stents within an artery, have helped make PCI procedures safer.
The relationship between physician volumes and patient outcomes is not as strong as it used to be, but it’s still present, said the researchers. While a cutoff number may not be enough by itself to predict how well a patient will do, it’s still a useful tool.
In fact, the new study suggests that 90 procedures a year may be a better threshold than 75, the current standard used by national heart groups.
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