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The risks of waiting for cardiac catheterization: a prospective study
Madhu K Natarajan1, Shamir R Mehta, Douglas H Holder
1Division of Cardiology, Population Health Research Institute, McMaster University, Hamilton, Ont. natarajm@ccc.mcmaster.ca
Summary
Patients awaiting cardiac catheterization face significant delays and adverse events like death and heart failure. Identifying high-risk patients, such as those with aortic stenosis, can improve outcomes through earlier access to procedures.
Area of Science:
- Cardiology
- Clinical Outcomes Research
Background:
- Limited data exists on characteristics and outcomes of patients awaiting cardiac catheterization.
- Cardiac catheterization is a crucial diagnostic and therapeutic procedure.
Purpose of the Study:
- Quantify waiting times, morbidity, and mortality for patients awaiting cardiac catheterization.
- Identify predictors of cardiac events during the waiting period.
Main Methods:
- Prospective study using a central waiting list registry in a regional center.
- 8030 consecutive patients (inpatients and outpatients) referred for cardiac catheterization were monitored.
- Major cardiac outcomes (death, myocardial infarction, heart failure) were documented.
Main Results:
- Median wait times were 6 days for inpatients and 60 days for outpatients.
- 1.4% of patients experienced major adverse cardiac events (death, myocardial infarction, heart failure).
- Predictors included increasing age, severe heart failure symptoms, aortic stenosis, and reduced left ventricular ejection fraction.
Conclusions:
- Patients awaiting cardiac catheterization are at risk for preventable adverse events.
- Findings support prioritizing high-risk patients (e.g., aortic stenosis, reduced ejection fraction) for earlier access.
- Study provides a benchmark for evaluating capacity and prioritization strategies.