COMMUNITY HOSPITALS CAN SAFELY PERFORM ELECTIVE ANGIOPLASTY

Contact: Beth Casteel, bcasteel@acc.org, 240-328-4549

CHICAGO (March 25, 2012) — New evidence shows that with appropriate preparation, angioplasty can be safely and effectively performed at community hospitals without on-site cardiac surgery units, according to research presented today at the American College of Cardiology’s 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.

The study is the first randomized controlled trial to investigate elective angioplasty (or percutaneous coronary intervention, which includes stenting and balloon angioplasty) in community hospitals in the United States. Results showed no difference in death rates among patients undergoing elective angioplasty at facilities with and without on-site cardiac surgery units. There were also no significant differences in rates of complications such as bleeding, renal failure and stroke.

“The study shows that under certain circumstances, non-primary angioplasty can be performed safely and effectively at hospitals without on-site cardiac surgery,” said Thomas Aversano, MD, associate professor of cardiology at Johns Hopkins University and the study’s lead investigator.

Until a recent guideline change by the American College of Cardiology and the American Heart Association, community hospitals without cardiac surgery units performed only emergency angioplasties. Patients needing elective angioplasty were transferred to facilities with on-site cardiac surgery units.

“The study supports and reinforces the [new] guidelines,” said Dr. Aversano, adding that the findings can help hospitals and healthcare planners more efficiently allocate financial and human resources.

The ability for community hospitals to offer elective angioplasty benefits patients, said Dr. Aversano. Other studies have shown that patients are often reluctant to transfer to a hospital that may be farther away or more expensive than their community hospital. “It’s not just a question of patient convenience — it’s also a question of access,” he said.  

The study randomly assigned 18,867 patients to receive elective angioplasty either at a facility with on-site cardiac surgery or at one of 60 community hospitals that had undergone special preparations to perform the procedure. The researchers tracked patient outcomes for nine months.

To participate in the study, community hospitals were required to complete a formal angioplasty development program to prepare their staff and establish policies and protocols in what Dr. Aversano called a “system-wide approach.”  

The community hospitals also had to demonstrate a capacity to perform at least 200 angioplasties per year. For most participating hospitals, meeting the study requirements took significant effort, as hospitals ramped up from providing a low volume of emergency angioplasties — or no angioplasties at all — to supporting frequent elective angioplasties.

“The thing I found most impressive was the degree of dedication from the staff at these community hospitals,” said Dr. Aversano. “All of them were incredibly dedicated to the success of this program, to their hospital and to the care of the people in their community. It was quite remarkable.”

This study was self-funded by the sites participating in the trial. Dr. Aversano reports no conflicts of interest.  

Dr. Aversano will be available to the media on Sunday, March 25 at 9:45 a.m. in McCormick Place North Level 1, Hall C1.

Dr. Aversano will present the study “Outcomes of Non-Primary PCI at Hospitals With and Without On-site Cardiac Surgery: CPORT-E Trial. Final Medical Outcomes” on Sunday, March 25 at 8 a.m. in McCormick Place North: Main Tent.    

About the American College of Cardiology
The American College of Cardiology (www.cardiosource.org) is a 40,000-member nonprofit medical society comprised of physicians, surgeons, nurses, physician assistants, pharmacists and practice managers. The College transforms cardiovascular care and improves heart health as it supports and advocates for quality improvement, patient-centered care, payment innovation and professionalism. The ACC bestows credentials upon cardiovascular specialists who meet its stringent qualifications and leads the formulation of health policy, standards and guidelines. It provides professional education, supports and disseminates cardiovascular research, and operates national registries to measure and promote quality.

The ACC’s Annual Scientific Session brings together cardiologists and cardiovascular specialists from around the world each year to share the newest discoveries in treatment and prevention.

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