Discrepancies Seen Between Docs, Patients on PCI Beliefs

Most patients think percutaneous coronary intervention will reduce risk of MI
By Eric Metcalf
HealthDay Reporter

TUESDAY, Sept. 7 (HealthDay News) -- Patients undergoing elective coronary catheterization and possible percutaneous coronary intervention (PCI) are generally much more likely than their physicians to believe the procedure will prevent a heart attack, according to research published in the Sept. 7 issue of the Annals of Internal Medicine.

Michael B. Rothberg, M.D., of the Baystate Medical Center in Springfield, Mass., and colleagues analyzed survey data from 153 patients who consented to elective catheterization and possible PCI. In addition, they surveyed 10 interventional cardiologists and 17 referring cardiologists, whose beliefs about PCI in hypothetical situations were assessed. The interventional cardiologists also reported their beliefs for the study subjects on whom PCI was performed.

The researchers found that most of the patients (88 percent) thought that PCI would reduce their risk of a myocardial infarction (MI). The patients were more likely than the physicians to think that PCI would prevent an MI (prevalence ratio, 4.25) or a fatal MI (prevalence ratio, 4.83). When reviewing the scenarios, 63 percent of cardiologists thought that PCI benefits were limited to symptom relief. However, among the physicians who identified no benefit of PCI in two scenarios, 43 percent indicated they would perform the procedure anyway.

The bottom line of the study "is clear: patients' expectations of PCI benefits differed significantly from those of their clinicians. Informed consent requires us to do more than tell our patients about the risks of the treatments we offer them. We need to make sure our patients also fully understand the anticipated benefits," writes the author of an accompanying editorial.

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