Core Concepts
High rates of ad hoc PCI in stable patients may lead to missed opportunities for multidisciplinary evaluation and more appropriate interventions.
Abstract
The study analyzed over 8,000 catheterization procedures in New York State from 2018-2019, revealing a high rate of ad hoc PCI in stable patients with multivessel disease or left main disease. The study highlights the potential drawbacks of ad hoc PCI, emphasizing the importance of multidisciplinary evaluation for treatment decisions. Variability in ad hoc PCI rates among hospitals and physicians suggests the need for standardization and adherence to guidelines.
Key Highlights:
- 78.4% of PCIs in stable patients with multivessel or left main disease were performed ad hoc.
- Ad hoc PCI eliminates the opportunity for a multidisciplinary heart team evaluation.
- Rates of ad hoc PCI varied among different patient subgroups.
- Study findings suggest potential overutilization of PCI and a lack of appropriate interventions.
- Variability in ad hoc PCI rates across hospitals and physicians indicates room for improvement.
Stats
"Among the stable patients with multivessel disease or left main (LM) disease who had PCI, 78.4% of PCIs were performed in the same session as their diagnostic catheterization procedure."
"The percentage for ad hoc PCI ranged from 58.7% for those with unprotected LM disease to 85.4% for patients with two-vessel PLAD."
Quotes
"Ad hoc PCI can be inadvisable when guidelines indicate that patients can realize better outcomes with CABG surgery." - Edward L. Hannan, PhD, MS
"The article provides a striking example of a difference between guideline-directed practice and real-life practice." - James C. Blankenship, MD