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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Patients' and cardiologists' perceptions of the benefits of percutaneous coronary intervention for stable coronary
Michael B Rothberg1, Senthil K Sivalingam, Javed Ashraf
1Baystate Medical Center, Springfield, Massachusetts 01199, USA. Michael.Rothberg@bhs.org
Annals of Internal Medicine
|September 8, 2010
Summary
Patients often misunderstand percutaneous coronary intervention (PCI) benefits, believing it prevents myocardial infarction (MI) when it primarily relieves angina. Improved patient-physician communication is crucial for accurate expectations regarding PCI outcomes.
Area of Science:
- Cardiology
- Medical Education
- Patient Communication
Background:
- Understanding of percutaneous coronary intervention (PCI) benefits is often limited, with patients incorrectly believing it prevents myocardial infarction (MI) and associated mortality, rather than solely alleviating chronic stable angina.
- This misconception highlights a gap in patient education regarding the specific indications and outcomes of PCI.
Purpose of the Study:
- To compare the beliefs of cardiologists and patients regarding the benefits and outcomes of percutaneous coronary intervention (PCI).
- To identify discrepancies in understanding between healthcare providers and patients concerning PCI's role in managing coronary artery disease.
Main Methods:
- A survey was conducted at an academic medical center.
- Participants included 153 patients undergoing elective coronary catheterization and potentially PCI, 10 interventional cardiologists, and 17 referring cardiologists.
- Beliefs about PCI benefits were assessed through patient self-reporting and cardiologist assessments in hypothetical and actual patient scenarios.
Main Results:
- A significant majority of patients (75%) believed PCI would prevent MI, and 88% thought it would reduce MI risk, contrasting with cardiologists' understanding that PCI primarily offers symptom relief.
- Patients were over four times more likely than physicians to believe PCI prevents MI and nearly five times more likely to believe it prevents fatal MI.
- Discrepancies were also noted in reporting pre-PCI angina, with patients less likely than physicians to report it.
Conclusions:
- Cardiologists' perceptions of PCI align with clinical trial evidence, whereas patient beliefs are often misinformed.
- There is a critical need for enhanced pre-procedural counseling to accurately communicate the anticipated benefits of PCI to patients, focusing on symptom relief rather than infarction prevention.
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