Patients' and Cardiologists' Beliefs About a Common Heart Procedure. Ann Intern Med. 2010;153:I-46. doi: 10.7326/0003-4819-153-5-201009070-00001
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Published: Ann Intern Med. 2010;153(5):I-46.
Coronary artery disease involves blockages in the blood vessels of the heart that result in low blood flow to the heart muscle. Low blood flow can lead to a type of chest pain called angina or, if severe enough, to heart attack. Treatment for coronary artery disease includes medicines and more invasive treatments, such as bypass surgery or percutaneous coronary intervention (PCI). With PCI, doctors insert small balloons or tunnels (stents) attached to flexible tubes (catheters) into the large blood vessels in the patient's groin and thread them up into the heart. The stent and catheter are passed through the blocked vessels, a process that opens up the vessels. Information from high-quality studies shows that compared with medications, PCI reduces angina symptoms, but it does not reduce a person's chances of having or dying of a heart attack. However, some patients and doctors mistakenly believe that PCI does more than just reduce symptoms.
To learn about patients' and cardiologists' beliefs about the benefits of PCI.
153 patients who had given permission to have PCI if other testing showed blockages in the heart vessels. Twenty-seven cardiologists who had either referred patients for the testing or performed it were also studied.
The researchers surveyed patients and cardiologists about whether they thought PCI would improve angina symptoms or reduce the chances of having a heart attack or dying of a heart attack.
Almost three quarters of surveyed patients believed that PCI would reduce their risk for heart attack, whereas most cardiologists believed that PCI only relieved angina.
The study took place at a single hospital, and the researchers did not receive the detailed information about the counseling that the patients did before agreeing to PCI.
Cardiologists' beliefs about PCI agree with information from studies, but patients believe the benefits will be greater than studies have shown. Discussions with patients before PCI should more clearly explain the benefits of the procedure compared with those of medications alone.
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