Adherence of Catheterization Laboratory Cardiologists to American College of Cardiology/American Heart Association Guidelines for Percutaneous Coronary Interventions and Coronary Artery Bypass Graft Surgery What Happens in Actual Practice?

被引:85
作者
Hannan, Edward L. [1 ]
Racz, Michael J. [2 ,3 ]
Gold, Jeffrey [4 ]
Cozzens, Kimberly
Stamato, Nicholas J. [5 ]
Powell, Tia [6 ]
Hibberd, Mary [7 ]
Walford, Gary [8 ]
机构
[1] SUNY Albany, Sch Publ Hlth, Rensselaer, NY 12144 USA
[2] Albany Coll Pharm & Hlth Sci, Albany, NY USA
[3] New York State Dept Hlth, Albany, NY USA
[4] Med Univ Ohio, Toledo, OH USA
[5] United Hlth Serv, Binghamton, NY USA
[6] Montefiore Med Ctr, New York, NY USA
[7] SUNY Stony Brook, Stony Brook, NY 11794 USA
[8] St Josephs Hosp, Syracuse, NY USA
关键词
AHA/ACC guidelines; procedure indications; percutaneous coronary intervention; coronary artery bypass surgery; ELUTING STENT IMPLANTATION; OF-CARDIOLOGY; TASK-FORCE; APPROPRIATENESS; ANGIOGRAPHY; ANGIOPLASTY; COMMITTEE; OUTCOMES; SOCIETY;
D O I
10.1161/CIRCULATIONAHA.109.887539
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-The American College of Cardiology and the American Heart Association have issued guidelines for the use of coronary artery bypass graft surgery (CABG) and percutaneous coronary interventions (PCI) for many years, but little is known about the impact of these evidence-based guidelines on referral decisions. Methods and Results-A cardiac catheterization laboratory database used by 19 hospitals in New York State was used to identify treatment (CABG surgery, PCI, medical treatment, or nothing) recommended by the catheterization laboratory cardiologist for patients undergoing catheterization with asymptomatic/mild angina, stable angina, and unstable angina/non-ST-elevation myocardial infarction between January 1, 2005, and August 31, 2007. The recommended treatment was compared with indications for these patients based on American College of Cardiology/American Heart Association guidelines. Of the 16 142 patients undergoing catheterization who were found to have coronary artery disease, the catheterization laboratory cardiologist was the final source of recommendation for 10 333 patients (64%). Of these 10 333 patients, 13% had indications for CABG surgery, 59% for PCI, and 17% for both CABG surgery and PCI. Of the patients who had indications for CABG surgery, 53% were recommended for CABG and 34% for PCI. Of the patients with indications for PCI, 94% were recommended for PCI. For the patients who had indications for both CABG surgery and PCI, 93% were recommended for PCI and 5% for CABG surgery. Catheterization laboratory cardiologists in hospitals with PCI capability were more likely to recommend patients for PCI than hospitals in which only catheterization was performed. Conclusions-Patients with coronary artery disease receive more recommendations for PCI and fewer recommendations for CABG surgery than indicated in the American College of Cardiology/American Heart Association guidelines. (Circulation. 2010; 121: 267-275.)
引用
收藏
页码:267 / 275
页数:9
相关论文
共 22 条
[1]   Relationship between procedure indications and outcomes of percutaneous coronary interventions by American College of Cardiology/American Heart Association Task Force guidelines [J].
Anderson, HV ;
Shaw, RE ;
Brindis, RG ;
Klein, LW ;
McKay, CR ;
Kutcher, MA ;
Krone, RJ ;
Wolk, MJ ;
Smith, SC ;
Weintraub, WS .
CIRCULATION, 2005, 112 (18) :2786-2791
[2]   A contemporary overview of percutaneous coronary interventions - The American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR) [J].
Anderson, HV ;
Shaw, RE ;
Brindis, RG ;
Hewitt, K ;
Krone, RJ ;
Block, PC ;
McKay, CR ;
Weintraub, WS .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2002, 39 (07) :1096-1103
[3]   Tools for Guiding Clinical Practice From the American Heart Association and the American College of Cardiology What Are They and How Should Clinicians Use Them? [J].
Antman, Elliott M. ;
Peterson, Eric D. .
CIRCULATION, 2009, 119 (09) :1180-1185
[4]   Optimal medical therapy with or without PCI for stable coronary disease [J].
Boden, William E. ;
O'Rourke, Robert A. ;
Teo, Koon K. ;
Hartigan, Pamela M. ;
Maron, David J. ;
Kostuk, William J. ;
Knudtson, Merril ;
Dada, Marcin ;
Casperson, Paul ;
Harris, Crystal L. ;
Chaitman, Bernard R. ;
Shaw, Leslee ;
Gosselin, Gilbert ;
Nawaz, Shah ;
Title, Lawrence M. ;
Gau, Gerald ;
Blaustein, Alvin S. ;
Booth, David C. ;
Bates, Eric R. ;
Spertus, John A. ;
Berman, Daniel S. ;
Mancini, G. B. John ;
Weintraub, William S. ;
Boden, W. ;
O'Rourke, R. ;
Teo, K. ;
Hartigan, P. ;
Weintraub, W. ;
Maron, D. ;
Mancini, J. ;
Weintraub, W. ;
Boden, W. ;
O'Rourke, R. ;
Teo, K. ;
Hartigan, P. ;
Knudtson, M. ;
Maron, D. ;
Bates, E. ;
Blaustein, A. ;
Booth, D. ;
Carere, R. ;
Ellis, S. ;
Gosselin, G. ;
Gau, G. ;
Jacobs, A. ;
King, S., III ;
Kostuk, W. ;
Harris, C. ;
Spertus, J. ;
Peduzzi, P. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (15) :1503-1516
[5]  
Eagle Kim A, 2004, Circulation, V110, pe340
[6]   Drug-eluting stents vs. coronary-artery bypass grafting in multivessel coronary disease [J].
Hannan, Edward L. ;
Wu, Chuntao ;
Walford, Gary ;
Culliford, Alfred T. ;
Gold, Jeffrey P. ;
Smith, Craig R. ;
Higgins, Robert S. D. ;
Carlson, Russell E. ;
Jones, Robert H. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (04) :331-341
[7]   Access to coronary artery bypass surgery by race/ethnicity and gender among patients who are appropriate for surgery [J].
Hannan, EL ;
van Ryn, M ;
Burke, J ;
Stone, D ;
Kumar, D ;
Arani, D ;
Pierce, W ;
Rafii, S ;
Sanborn, TA ;
Sharma, S ;
Slater, J ;
DeBuono, BA .
MEDICAL CARE, 1999, 37 (01) :68-77
[8]   THE APPROPRIATENESS OF USE OF PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN NEW-YORK-STATE [J].
HILBORNE, LH ;
LEAPE, LL ;
BERNSTEIN, SJ ;
PARK, RE ;
FISKE, ME ;
KAMBERG, CJ ;
ROTH, CP ;
BROOK, RH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (06) :761-765
[9]   Analysis of 1-year clinical outcomes in the SIRIUS trial - A randomized trial of a sirolimus-eluting stent versus a standard stent in patients at high risk for coronary restenosis [J].
Holmes, DR ;
Leon, MB ;
Moses, JW ;
Popma, JJ ;
Cutlip, D ;
Fitzgerald, PJ ;
Brown, C ;
Fischell, T ;
Wong, SC ;
Midei, M ;
Snead, D ;
Kuntz, RE .
CIRCULATION, 2004, 109 (05) :634-640
[10]   THE APPROPRIATENESS OF USE OF CORONARY-ARTERY BYPASS GRAFT-SURGERY IN NEW-YORK-STATE [J].
LEAPE, LL ;
HILBORNE, LH ;
PARK, RE ;
BERNSTEIN, SJ ;
KAMBERG, CJ ;
SHERWOOD, M ;
BROOK, RH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (06) :753-760