Patients with heart blockages will be assessed for surgery on a new set of guidelines.
In 2005, more than 1 million Americans had angioplasties, in which a balloon is used to open blockage in an artery, and almost 500,000 had the more invasive heart bypass surgery to restore blood flow.
The nation's largest professional groups of heart doctors, including the American College of Cardiology, said this week that some patients are getting the procedures unnecessarily, while others who need them may be denied. As a result, the groups wrote a new set of guidelines to rate patients based on their symptoms and the severity of their condition.
Dr. Manesh Patel, a cardiologist at Duke University School of Medicine, led the group that wrote the criteria. Patel said the first question that patients need answered is whether they should undergo a procedure to restore blood flow to the heart.
"What we tried to do is assess when it's reasonable to undergo this procedure to improve health, symptoms or length of time that patients live," Patel said.
HOW ARE PATIENTS RATED? Doctors look at a patient's symptoms, plus the results of tests and imaging scans to determine the extent of the blockage and how severe the damage is. Using a grading system, patients are given a score between 1 and 9. Those who score high are most in need of surgical interventions. Those with lower scores are not recommended for the procedure, while the middle group is uncertain.
WHO BENEFITS FROM THE NEW SYSTEM? Patel said patients, insurers and doctors should see more consistency in who gets surgical interventions.
WHAT'S THE DOWN SIDE? Some doctors may chafe at a set of guidelines that may not account for a patient's entire situation, while others may find the criteria too subjective.
BY THE NUMBERS:
1,271,000 angioplasties were done in the United States in 2005, the last year for which data has been compiled.
874,000 men and 397,000 women had angioplasties.
470,000 coronary artery bypass graft operations were done in the United States in 2005.
325,000 bypass surgeries were performed on men and 145,000 on women.
SOURCE: AMERICAN HEART ASSOCIATION
(Distributed by Scripps Howard News Service, www.scrippsnews.com.)
Must credit The News & Observer of Raleigh, N.C.
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