Percutaneous transluminal coronary angioplasty in New York State: risk factors and outcomes

Article Abstract:

Percutaneous transluminal coronary angioplasty (PTCA) may be an effective and safe treatment for patients with coronary heart disease. This procedure involves the use of a balloon-tipped catheter to enlarge the opening of a narrowed coronary artery. Among 5,827 patients who underwent PTCA at 31 hospitals in New York State between Jan and Jun 1991, 3.2% suffered a major complication and less than 1% died. One percent of the patients had a heart attack, and 2.1% had to have an emergency coronary bypass operation. The PTCA procedure was successful in 88% of the patients in whom one blood vessel was dilated and 77% of those in whom two blood vessels were dilated. Patients with blood circulation disorders, whose hearts pumped decreased amounts of blood to the body, or who were in shock, had a higher risk of developing complications. Female patients were more likely to develop complications than were male patients.

Usage, Surgery, Coronary heart disease

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Coronary angioplasty volume-outcome relationships for hospitals and cardiologists

Article Abstract:

Mortality rates from coronary angioplasty appear to be lower in hospitals where cardiologists perform large numbers of coronary angioplasty procedures. Researchers analyzed data from a New York State registry on 62,670 patients who had coronary angioplasty at 31 hospitals in the state between 1991 and 1994. The overall mortality rate was 0.9% but in hospitals that performed fewer than 600 procedures annually, the rate was slightly higher at 0.96%. The rate was 1.03% among cardiologists who performed fewer than 75 procedures annually. Patients in these groups were also more likely to have coronary bypass during their stay in the hospital.

Patient outcomes, Mortality, Practice, Cardiologists

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The critical question of procedure volume minimums for coronary angioplasty

Article Abstract:

Cardiologists should take notice that laboratories that perform few coronary balloon angioplasty procedures have a higher rate of serious complications such as heart attack and death. A 1995 study showed that clinics that perform at least 400 procedures per year have low complication rates. Many clinics perform under 200 such procedures per year. Using 400 for the number of procedures, mortality can be reduced two-fold, with a 10-fold reduction in emergency bypass grafting, and an 18-fold decrease in heart attacks related to the angioplasty procedure.

Health aspects, Editorial, Complications and side effects, Cardiac catheterization, Heart catheterization, Angioplasty

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