In the study, which appeared in the October 27 issue of the Journal of the American Medical Association, researchers analyzed data on patients who underwent coronary angioplasty, with or without placement of a stent, between 1999 and 2001. This procedure uses a balloon to expand clogged arteries and, in some cases, leaves behind a small wire-mesh tube called a stent to hold the artery open. Approximately 2 million angioplasties are performed worldwide each year.

Researchers found that hospitals that offered coronary angioplasty but did not have a cardiac surgery unit experienced a 29 percent increase in mortality over hospitals that did have a cardiac surgery unit.

"Patients undergoing percutaneous coronary intervention in hospitals without cardiac surgery were more likely to die," according to the study's authors.

The study raised several concerns. First, in hospitals without cardiac backup, it appeared that coronary angioplasty was performed more often for non-acute treatment of heart attacks. This was troubling, according to the article, because most of the debate on the availability of angioplasty centers on the treatment of acute heart attacks.

Second, the study called into question the growing trend of hospitals to offer coronary angioplasty even without cardiac units. According to the authors, hospitals are opening coronary angioplasty units to stay competitive and increase patient care. However, the practical result may be to decrease patient care because of the increased danger of coronary angioplasty in a facility with no backup cardiac surgery center.

"Clearly, if these findings are true and representative, it is necessary to reconsider and perhaps curtail expanding the availability of [coronary angioplasty]," writes Dr. W. Douglas Weaver in an editorial accompanying the study.

Copyright 2000-2004 HeartCenterOnline, Inc.

To read related news stories, click on any of the following:
Heart procedure results have improved for elderly
Early treatment ups survival after heart attack
Personality affects effectiveness of stents
Drugs, surgery comparable for angina in elderly

For additional information, visit HeartCenterOnline's:
Balloon Angioplasty Center
Bypass Surgery Center