TY  - BOOK
AU  - Ben-Dor, Itsik
AU  - Case, Brian C
AU  - Geiser, Katherine M
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Comparison of coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria
SN  - 1522-1946
PY  - 2019///
KW  - *Clinical Decision-Making
KW  - *Eligibility Determination/st [Standards]
KW  - *Guideline Adherence/st [Standards]
KW  - *Myocardial Ischemia/th [Therapy]
KW  - *Patient Selection
KW  - *Percutaneous Coronary Intervention/st [Standards]
KW  - *Practice Guidelines as Topic/st [Standards]
KW  - *Practice Patterns, Physicians'/st [Standards]
KW  - Aged
KW  - Decision Support Techniques
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Myocardial Ischemia/dg [Diagnostic Imaging]
KW  - Percutaneous Coronary Intervention/ae [Adverse Effects]
KW  - Registries
KW  - Retrospective Studies
KW  - Risk Assessment
KW  - Risk Factors
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
N2  - 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
UR  - https://dx.doi.org/10.1002/ccd.27895
ER  -