Comparison of coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria.
Citation: Catheterization & Cardiovascular Interventions. 93(4):620-625, 2019 03 01.PMID: 30280475Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 FactorsYear: 2019Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:- 1522-1946
- Case, Brian C Satler, Lowell F Waksman, Ron:
- http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 Case, Brian C Satler, Lowell F Waksman, Ron:
- http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 Case, Brian C Satler, Lowell F Waksman, Ron:
- http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226 http://orcid.org/0000-0001-5355-9594 http://orcid.org/0000-0001-6446-2683 http://orcid.org/0000-0002-4063-9226
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 30280475 | Available | 30280475 |
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