Related Experiment Video
Updated: Jul 14, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Are hospitalizations for percutaneous coronary procedures missed opportunities for teaching rules of secondary
Ricarda Marinigh1, Paolo M Fioretti, Rosa Pecoraro
1Department of Cardiopulmonary Sciences, Azienda Ospedaliero-Universitaria di Udine, Italy. rmarinigh@libero.it
Insights
Cardiologists often prioritize high-tech procedures over secondary prevention. Many patients undergoing percutaneous coronary intervention (PCI) have unmanaged risk factors, indicating a gap in guideline-based care.
Area of Science:
- Cardiology
- Preventive Medicine
- Interventional Cardiology
Background:
- Percutaneous coronary intervention (PCI) is a common revascularization strategy, but its frequent application may overshadow secondary prevention efforts.
- There's a need to assess risk factor profiles and treatment appropriateness in patients undergoing elective coronary procedures.
Purpose of the Study:
- Evaluate individual cardiovascular risk factor profiles in patients undergoing elective coronary procedures.
- Examine the relationship between risk factor correction and hospital admissions for invasive procedures.
- Assess the appropriateness of medical treatment and patient knowledge of risk factor thresholds.
Main Methods:
- 100 patients (71% male, mean age 68) admitted for elective coronary angiography or PCI were assessed.
- Risk factor assessment included evaluation of medication dosages against randomized clinical trial (RCT) effective doses.
- Patients were stratified by admission frequency for coronary angiography and PCI procedures.
Main Results:
- 57% of patients had prior admissions, and 58% had undergone at least one PCI.
- Suboptimal dosages of beta-blockers (25%) and ACE-inhibitors (83%) were common; statin dosages were appropriate in 95%.
- 49% had LDL cholesterol >100 mg/dL, and 9% were active smokers; risk factor control was unrelated to admission frequency.
Conclusions:
- Cardiology readily adopts advanced procedures but often neglects evidence-based risk factor management.
- There is a failure to adequately educate patients on controlling cardiovascular risk factors according to guidelines.
- This gap in secondary prevention persists regardless of the number of invasive cardiovascular procedures performed.
Background And Aims:
Percutaneous coronary intervention (PCI) is the most frequently used revascularization approach, often repeatedly applied. The quest for the ultimate revascularization procedure however may capture cardiologist's attention and lead them to minimize the issue of secondary prevention in their patients. Aims of this study were to assess: 1. The individual risk factor profile, 2. The relation between the risk factors correction and the number of hospital admissions for elective procedures, 3. The appropriateness of medical treatment in patients admitted for elective coronary invasive procedures (diagnostic and interventional). 4. The patients knowledge of threshold values for cardiovascular risk factors.
Patients And Methods:
100 patients (71% males, mean age 68 years) consecutively admitted for elective coronary angiography or PCI. They underwent a classical risk factors assessment and were divided in three groups according to the number of admissions for coronary angiography and in two groups according to the number of PCIs.
Results:
Fifty-seven% of patients had been previously admitted for invasive examination at least three times and 58% had already been treated with at least one PCI. Seventy-one% were treated with beta-blockers but only 25% of them received a dosage found effective in RCTs (randomized clinical trials). Sixty% were treated with ACE-inhibitors and 83% received the dosage found effective in RCTs. Fifty-two% were treated with statins and 95% received a dosage found effective in RCTs. Nine% were still active smokers. Fourty-nine% had a LDL cholesterol level above 100 mg/dL. The percentage of patients not on target was unrelated to the number of hospital admissions for invasive procedures.
Conclusions:
Modern cardiology is quickly embracing high tech procedures and trials results but often fails to spend enough time teaching how to control risk factors according to the recommendations of the evidence-based guidelines, even independently of the number of hospitalizations for invasive cardiovascular procedures.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:26Coronary Artery Disease IV: Preventive Measures
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:21Cardiac Catheterization II: Right Heart Catheterization
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...