Published November 20, 2014
Outside of heart attacks, U.S. doctors are often too quick to use a common $20,000 procedure to treat patients suffering from coronary artery disease, The Wall Street Journal reported Wednesday, citing a new study.
About 600,000 angioplasty procedures, which usually involve placement of a tiny metal tube called a stent, are done in the U.S. each year. Roughly 70 percent of these procedures were performed on patients suffering symptoms of a heart attack and were not medically controversial.
But the remainder were done on stable patients who suffered mild symptoms or no symptoms at all. Of those, 50 percent were deemed appropriate, 38 percent uncertain and 12 percent inappropriate, the report said.
"One in eight is probably higher than we would like," Paul Chan, a cardiologist at Saint Luke's Mid America Heart and Vascular Institute, Kansas City, Mo., and the study's lead author, said.
The results, published Tuesday in the Journal of the American Medical Association come amid rising concern about the overuse of big ticket medical technology. Such concerns were rising not only in cardiology, but in other major specialties as state and federal governments and health insurers seek to contain health care costs.
Researchers cautioned that the findings were complicated and include some results that were reassuring and others that were troubling. The study was part of an unusual initiative by the American College of Cardiology to examine the extent of unnecessary procedures, in part because of growing concerns in recent years that angioplasty and especially stents were overused.
As health care costs continue to soar, reaching $2.5 trillion in the U.S. in 2009, medical societies were becoming more open to self-scrutiny for fear that the federal government and private health insurers will make medical decisions for them. Some organizations were also mindful that conflicts of interest undermine the credibility of their fields.