Please login or register to print this page.

News & Views

US HOSPITALS MISSING CORONARY ARTERY DISEASE

Rates of finding obstructive coronary artery disease (CAD) at elective coronary angiography vary considerably amongst hospitals, those with lower rates being in need of quality improvement, according to a study published recently in the Journal of the American College of Cardiology.1

Authors led by Dr Pamela S Douglas, Duke University School of Medicine, North Carolina, analysed data from 565,504 patients with no prior myocardial infarction (MI) or revascularisation undergoing elective coronary angiography.  They evaluated the rates of obstructive CAD discovered at elective coronary angiography at 691 US hospitals using CathPCI Registry data from 2005 to 2008.

Rates varied from 23% to 100%, sites with lower rates being more likely to perform procedures on younger patients, those with low Framingham risk, with no or atypical symptoms (p < 0.0001), and with a negative, equivocal, or unperformed functional status assessment.

Hospitals with lower rates of finding obstructive CAD also less frequently prescribed aspirin, beta-blockers, platelet inhibitors, and statins (all p < 0.0001). The CAD rate was found to be lower at facilities with small-volume catheterisation laboratories, and was not associated with hospital ownership or teaching program status.

The authors say that, in the absence of nonclinical or institutional factors, “local clinical practice patterns may be the most influential factor in guiding use of diagnostic coronary angiography and could be a target for quality-improvement efforts, including appropriate use criteria development”.

References

1 Douglas PS, Patel MR, Bailey SR, et al. Hospital Variability in the Rate of Finding Obstructive Coronary Artery Disease at Elective, Diagnostic Coronary Angiography. JACC 2011;58:801–9.

Published on: September 7, 2011

Members Area

Log in or Register now.

SEARCH THE SITE

RSS FEED

Subscribe to our RSS feed
home

GET EXCLUSIVE UPDATES

Sign up for our regular email newsletters & be the first to know about fresh articles and site updates.

RECENT COMMENTS

    None Found

ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

You are not logged in

You need to be a member to print this page.
Sign up for free membership, or log in.

You are not logged in

You need to be a member to download PDF's.
Sign up for free membership, or log in.