Appropriate Use Criteria Application Reduces Percutaneous Coronary Intervention Incidence

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Under scrutiny, incidence of PCI in New York state decreased from 18.2% to 10.6% between 2010-2014.
Under scrutiny, incidence of PCI in New York state decreased from 18.2% to 10.6% between 2010-2014.

HealthDay News — From 2010 to 2014 there was a decrease in the rate of inappropriate percutaneous coronary interventions (PCIs) performed in New York State, according to a study published in the Journal of the American College of Cardiology.

Edward L. Hannan, PhD, from the State University of New York in Albany, and colleagues applied appropriate use criteria to PCIs performed in New York in patients with acute coronary syndromes or previous coronary artery bypass graft surgery before (2010-2011) and after (2012-2014) efforts were implemented to decrease the rate of inappropriateness.

The researchers found that from 2010-2014 there was a decrease in the percentage of inappropriate PCIs for all patients, from 18.2% to 10.6% (from 15.3% to 6.8% for Medicaid patients and from 18.6% to 11.2% for other patients). For patients with no acute coronary syndrome/no prior coronary artery bypass graft surgery, the total number of PCIs that were rated as inappropriate decreased 69%, from 2,956 patients in 2010 to 911 patients in 2014. There was a 75% decrease among Medicaid patients, from 340 to 84 patients.

"The inappropriateness rate for PCIs and the use of PCI for elective procedures in New York has decreased substantially between 2010 and 2014," the authors write. "This decrease has occurred for a large proportion of PCI hospitals."

Several authors disclosed financial ties to the pharmaceutical industry.

References

  1. Hannan EL, Samadashvili Z, Cozzens K, et al. Changes in percutaneous coronary interventions deemed "inappropriate" by appropriate use criteria. J Am Coll Cardiol. 2017;69(10):1234-1242. doi: 10.1016/j.jacc.2016.12.025
  2. Masoudi FA, Curtis JP, Desai NR. PCI appropriateness in New York. J Am Coll Cardiol. 2017;69(10):1243-1246. doi: 10.1001/j.jacc.2017.01.009
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