Cardiac Procedures May Vary Due To Physician Preferences

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In the modern world, cardiac patients find relief from cardiac procedures that are commonly performed to treat their cardiac conditions. In this regard, this query is frequently asked, what factors affect these cardiac procedures? This was responded by an article in the Canadian Medical Association Journal (CMAJ). It showed that doctors’ preferences and hospital characteristics influence the kind of procedures done on heart blockages, which results to remarkable variations in rates of bypass, stent or angioplasty procedures.

Notable difference in the ratio of percutaneous coronary interventions to coronary artery bypass graft surgeries (PCI: CABG ratio) was observed. To answer the problems of coronary artery blockages, both procedures are performed. PCI procedures are less invasive than bypass surgeries; moreover, it is currently applied in other conditions like multi-vessel heart disease and multiple coronary concerns. At first, it was used as treatment for single-vessel heart disease. Rates for this procedure became high in Ontario; however, it was noted in some patients with multi-vessel disease that better long-term results are observed in CABG surgery compared with PCI.

Furthermore, to look at heart condition and possible blockages or abnormalities, the Canadian investigators conducted an analysis of 8972 patients who underwent diagnostic procedures like cardiac catheterizations. This was done from April 2006 to March 2007 at 17 hospitals that do the procedures in Ontario. They aimed to know the reason for the PCI: CABG variations.

Moreover, coronary anatomy turned out to be the most essential factor in PCI procedures than CABG surgery. The study team also discovered that there was significant variation in the types of offered procedures, especially among multi-vessel disease patients. According to Dr. Jack Tu from the Institute for Clinical Evaluative Sciences, they noted that there were differences in treatment preferences and practice styles of cardiologists who perform index catheterizations, in relation with the patient management of those with non-emergent multi-vessel disease (who can possibly have recommendation for either PCI or CABG.

The team learned that the recommendation of the doctor responsible for diagnostic catheterization and the hospital were powerful individual predictors of the mode of revascularization. The authors believed that some changes need to be employed to improve transparency and consistency. For example, multidisciplinary teams can be formed involving the interventional cardiologists, cardiac surgeon and referring doctor. The author further emphasized that the cardiac surgeons should have more involvement in clinical decision-making, when patients need to undergo PCI or CABG. The latter should have thorough and full knowledge regarding the advantages and risks of all alternative interventions, so that he can decide without being affected by physician bias.





  1. [...] dealing with cardiac or cardiovascular treatments should first check for the heart rate or the cardiac rhythm using an electrocardiogram (ECG), one every three months. Multaq should not given or stopped [...]

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