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Comparison of coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria.

by Case, Brian C; Geiser, Katherine M; Torguson, Rebecca; Pichard, Augusto D; Satler, Lowell F; Waksman, Ron; Ben-Dor, Itsik.
Citation: Catheterization & Cardiovascular Interventions. 2018 Oct 02.Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.Published: ; 2018ISSN: 1522-1946.Full author list: Case BC; Geiser KM; Torguson R; Pichard AD; Satler LF; Waksman R; Ben-Dor I.UI/PMID: 30280475.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1002/ccd.27895 (Click here) ORCID: Case, Brian C http://orcid.org/0000-0001-5355-9594Satler, Lowell F http://orcid.org/0000-0001-6446-2683Waksman, Ron http://orcid.org/0000-0002-4063-9226 (Click here) | (Click here) | (Click here) Abbreviated citation: Catheter Cardiovasc Interv. 2018 Oct 02.Local Holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006.Abstract: OBJECTIVES: To compare coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria (AUC).Abstract: 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.Abstract: 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.Abstract: 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.Abstract: 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.Abstract: Copyright (c) 2018 Wiley Periodicals, Inc.

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