Stents not effective? Study sparks debate pt. 1

U.K. PCI study sparks U.S. debate

On Wednesday, November 1, results from the Objective Randomized Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina (ORBITA) study were published in The Lancet.

The next day, this article was published in the New York Times:

“A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them,” it began… “The new study, published in the Lancet, stunned leading cardiologists by countering decades of clinical experience. The findings raise questions about whether stents should be used so often—or at all—to treat chest pain.”

Without further knowledge, the debate may start right here—the New York Times article had little in the way of medical detail to satisfy invasive cardiovascular professionals and may have further generalized results in a misleading manner.

But let’s hold off on reacting, look at the debate surrounding this particular study and also place the findings in a wider context (part two). Note: this isn’t the first time it has been suggested that stents are overused.

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ACC and AHA Release 10 “Comprehensive” Measures to Combat Sudden Cardiac Death

A new joint report released today by the American College of Cardiology (ACC) and the American Heart Association (AHA) offers practitioners and stakeholders ten evidence-based quality and performance measures to prevent sudden cardiac death (SCD).

“This is the first comprehensive measure set in the area of SCD prevention,” says Sana Al-Khatib, MD, co-chair of the report writing committee in an ACC press release. “Our vision is that these measures will be developed, tested and implemented in clinical practice and that implementation will improve patient care and outcomes.”

Sudden cardiac death a “healthcare crisis”

The American Heart Association reports more than 350,000 out-of-hospital cardiac arrests (OHCA) occurring in 2016 with only 12 percent of people surviving to hospital discharge. These approximate statistics suggest more than 308,000 sudden cardiac deaths per year.

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Two common ways you might misinterpret medical research

Sophisticated statistics in medical research can be hard to translate to layman’s terms, and when they are, these common misinterpretations can be downright misleading.

1. Odds ratios don’t express relative risk.

In 1999, media reports resulting from a study published in the New England Journal of Medicine wrongly suggested that black patients and women were 40 percent less likely than white patients and men, respectively, to undergo cardiac catheterization.

The study’s authors had used odds ratios to describe the significance of their findings—a common practice among statistically sophisticated researchers—which showed that black patients and women were definitely less likely to be referred for invasive procedures than white patients and men, but not how much less likely.

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Answering questions about our education and membership

We’ve gotten a number of excellent and illuminating questions about the Alliance of Cardiovascular Professionals recently—enough to put them together as a blog. We’ve got news, too—we’re updating our online continuing education platform!

Does ACVP offer continuing education online?

“I am a registered cardiac sonography tech. I was wondering if your organization offers any continued education courses online. If so will you please direct me to the right location… I am having such a hard time navigating through these websites. Thanks for your help!”

Yes! ACVP does offer continuing education courses online through CVCEU.ORG.

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