Cardiologists change their minds — not all at once

What happens when cardiologists learn that a widely performed procedure might not be as helpful as they once thought? Investigators at Emory have taken one of the first detailed looks at how geographical patterns in practice changed after publication of results from a large clinical trial.

The federal government has invested billions of dollars in comparative effectiveness research — comparing different healthcare interventions to determine which works best — with the aim of reducing variations in care. This paper shows that these types of investment can have the desired effect.

Recently Medscape Cardiology talked with lead author Arun Mohan, who is medical director for care coordination at Emory University Hospital, about his work. [You may have missed this news item over the holidays.]

Arun Mohan, MD, MBA

The study whose effect Mohan investigated was COURAGE, whose publication in 2007 changed many cardiologists’ thinking about a common procedure: stenting of a coronary artery, also known as PCI (percutaneous coronary intervention).

COURAGE, a randomized, controlled study involving cheap oakley thousands of patients with stable heart disease, was the first to show that for patients who are having their blood pressure, blood http://www.troakley.com/ clotting and cholesterol controlled with drugs, PCI doesn’t provide any mortality benefit. In contrast, a consensus remains that PCI is helpful for patients with acute coronary syndrome (heart attack or unstable angina/chest pain from exertion).

After the COURAGE study was published in 2007, the use of PCI in patients with stable disease declined and the geographical variation also declined, the researchers found. However, geographical variation in the use of PCI for stable heart disease remained more than twice as high as its use for acute coronary syndrome, they found.

More here.

Posted on by Quinn Eastman in Heart Leave a comment

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Quinn Eastman

Science Writer, Research Communications qeastma@emory.edu 404-727-7829 Office

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