Comparison of coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria.
Comparison of coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria.
- 2019
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
BACKGROUND: In 2017, the 2012 AUC for coronary revascularization were updated. We examined how applying these new 2017 updates to our previous inappropriate cases would change their appropriateness. CONCLUSIONS: Applying the 2017 AUC led to a statistically higher number of cases being deemed "may be appropriate." The most common cause for the change included the change in requirement for anti-angina regimen and the expanded role of non-invasive modalities. Copyright (c) 2018 Wiley Periodicals, Inc. METHODS: We identified 50 cases of patients who underwent coronary revascularization for stable ischemic heart disease who were deemed inappropriate under the 2012 AUC. Two separate physicians reviewed the cases and applied a new AUC based on the 2017 AUC. Next, if there was a change, the reason was identified. OBJECTIVES: To compare coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria (AUC). RESULTS: Average age was 64, majority being male (29; 58%). Forty-two (84%) were asymptomatic upon presentation. Most cases (27, 54%) dealt with percutaneous coronary intervention (PCI) of the right coronary artery. After applying the 2017 AUC, 34 of the 50 inappropriate failures (68%) would be changed from "inappropriate" to "may be appropriate care." Of the 34 cases, 25 (73.5%) were changed due to the new AUC no longer expecting the patient to be on >=2 anti-angina medications prior to PCI. Of the 34 cases, eight (23.5%) were changed due to the new AUC expanding the use of non-invasive modalities.
English
1522-1946
*Clinical Decision-Making
*Eligibility Determination/st [Standards]
*Guideline Adherence/st [Standards]
*Myocardial Ischemia/th [Therapy]
*Patient Selection
*Percutaneous Coronary Intervention/st [Standards]
*Practice Guidelines as Topic/st [Standards]
*Practice Patterns, Physicians'/st [Standards]
Aged
Decision Support Techniques
Female
Humans
Male
Middle Aged
Myocardial Ischemia/dg [Diagnostic Imaging]
Percutaneous Coronary Intervention/ae [Adverse Effects]
Registries
Retrospective Studies
Risk Assessment
Risk Factors
MedStar Heart & Vascular Institute
Journal Article
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
BACKGROUND: In 2017, the 2012 AUC for coronary revascularization were updated. We examined how applying these new 2017 updates to our previous inappropriate cases would change their appropriateness. CONCLUSIONS: Applying the 2017 AUC led to a statistically higher number of cases being deemed "may be appropriate." The most common cause for the change included the change in requirement for anti-angina regimen and the expanded role of non-invasive modalities. Copyright (c) 2018 Wiley Periodicals, Inc. METHODS: We identified 50 cases of patients who underwent coronary revascularization for stable ischemic heart disease who were deemed inappropriate under the 2012 AUC. Two separate physicians reviewed the cases and applied a new AUC based on the 2017 AUC. Next, if there was a change, the reason was identified. OBJECTIVES: To compare coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria (AUC). RESULTS: Average age was 64, majority being male (29; 58%). Forty-two (84%) were asymptomatic upon presentation. Most cases (27, 54%) dealt with percutaneous coronary intervention (PCI) of the right coronary artery. After applying the 2017 AUC, 34 of the 50 inappropriate failures (68%) would be changed from "inappropriate" to "may be appropriate care." Of the 34 cases, 25 (73.5%) were changed due to the new AUC no longer expecting the patient to be on >=2 anti-angina medications prior to PCI. Of the 34 cases, eight (23.5%) were changed due to the new AUC expanding the use of non-invasive modalities.
English
1522-1946
*Clinical Decision-Making
*Eligibility Determination/st [Standards]
*Guideline Adherence/st [Standards]
*Myocardial Ischemia/th [Therapy]
*Patient Selection
*Percutaneous Coronary Intervention/st [Standards]
*Practice Guidelines as Topic/st [Standards]
*Practice Patterns, Physicians'/st [Standards]
Aged
Decision Support Techniques
Female
Humans
Male
Middle Aged
Myocardial Ischemia/dg [Diagnostic Imaging]
Percutaneous Coronary Intervention/ae [Adverse Effects]
Registries
Retrospective Studies
Risk Assessment
Risk Factors
MedStar Heart & Vascular Institute
Journal Article