Featured Research

from universities, journals, and other organizations

Artery-opening procedure still widely used in spite of changed guidelines, study finds

Date:
July 11, 2011
Source:
NYU Langone Medical Center / New York University School of Medicine
Summary:
Despite changes in standard treatment practice guidelines issued by the American College of Cardiology, American Heart Association and the European Society of Cardiology several years ago, there has been no meaningful change in the nation's practice of opening completely blocked coronary arteries with balloons and stents in the days after a heart attack, according to a new study.

Despite changes in standard treatment practice guidelines issued by the American College of Cardiology, American Heart Association and the European Society of Cardiology several years ago, there has been no meaningful change in the nation's practice of opening completely blocked coronary arteries with balloons and stents in the days after a heart attack, according to a new study published in the July 11, 2011, issue of Archives of Internal Medicine. The new study concludes that cardiologists in the United States are still performing this procedure late after a heart attack.

"Our new finding is disappointing; a lot of painstakingly gathered clinical trial evidence is being disregarded a few years after its publication and guideline changes," says Judith S. Hochman, MD, the Harold Snyder Family Professor of Cardiology at NYU Langone Medical Center and senior author of the study.

In the new study, Dr. Hochman and her colleagues examined a registry of angioplasty and stent procedures performed in nearly 29,000 patients at nearly 900 hospitals in the United States. The monthly rate of late procedures showed no sign of declining during the period from 2005 to 2008.

"There continues to be reimbursement for the late procedure, and many patients expect their physicians to open their arteries, regardless of the delay, so these physicians may be concerned about malpractice suits if they don't comply," says Dr. Hochman. "However, the existence of national clinical guidelines should protect physicians from that liability."

Dr. Hochman was the lead author of the landmark Occluded Artery Trial (OAT), published in 2006 in the New England Journal of Medicine. It concluded that opening a totally blocked heart attack-related coronary artery more than 24 hours after a heart attack does not reduce patients' chances of death, a second heart attack, or heart failure, compared to more conservative treatment with medication alone and selective use of the opening procedure in a small subset of these patients. "We found evidence in substudies that both groups improved their heart function (ejection fraction) substantially and to the same degree," says Dr. Hochman.

The OAT study finding led to new treatment guidelines in 2007. Dr. Hochman and her colleagues, however, have learned that cardiologists are still doing the procedure in patients 24 hours or more after a heart attack. "It's intuitive that having an open artery is better than having a closed artery, and many people don't want to let go of that belief," she says.


Story Source:

The above story is based on materials provided by NYU Langone Medical Center / New York University School of Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Marc W. Deyell; Christopher E. Buller; Louis H. Miller; Tracy Y. Wang; David Dai; Gervasio A. Lamas; Vankeepuram S. Srinivas; Judith S. Hochman. Impact of National Clinical Guideline Recommendations for Revascularization of Persistently Occluded Infarct-Related Arteries on Clinical Practice in the United States. Archives of Internal Medicine, 2011; DOI: 10.1001/archinternmed.2011.315

Cite This Page:

NYU Langone Medical Center / New York University School of Medicine. "Artery-opening procedure still widely used in spite of changed guidelines, study finds." ScienceDaily. ScienceDaily, 11 July 2011. <www.sciencedaily.com/releases/2011/07/110711164529.htm>.
NYU Langone Medical Center / New York University School of Medicine. (2011, July 11). Artery-opening procedure still widely used in spite of changed guidelines, study finds. ScienceDaily. Retrieved September 23, 2014 from www.sciencedaily.com/releases/2011/07/110711164529.htm
NYU Langone Medical Center / New York University School of Medicine. "Artery-opening procedure still widely used in spite of changed guidelines, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/07/110711164529.htm (accessed September 23, 2014).

Share This



More Health & Medicine News

Tuesday, September 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

More Coverage


Not All U.S. Hospitals Are Following Guidelines for Percutaneous Revascularization Procedures for Some Patients With an Occluded Artery Following a Heart Attack

July 12, 2011 Guideline recommendations for the appropriate use of percutaneous coronary intervention (PCI) for patients who have an occluded coronary artery after having a myocardial infarction (heart attack) ... read more

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins