Patients overestimate the potential benefits of elective percutaneous coronary intervention

Although percutaneous coronary intervention (PCI) reduces mortality in the setting of myocardial infarction (MI), recent studies suggest that the benefits of PCI for chronic Coronary Artery Disease (CAD) are predominantly related to angina relief and improved quality of life. Whether patients in the current era understand these benefits of elective PCI, or perceive that they also derive protection against death and MI is unknown.

We surveyed 498 consecutive elective PCI patients a mean of 13.7 months after being treated between 1/06-10/07, 2007, at two hospitals. We used a one-page questionnaire quantifying their perceptions of the benefits from PCI.

Of 498 eligible subjects, 350 responded (70%). The mean age was 67.8 +/- 10.9 years, and 76% were male. One-third believed that their PCI was emergent (despite the fact that all were elective), 71% believed the procedure would prevent future heart attacks, 66% thought it would extend their life, 42% reported that it saved their life, 42% stated that it would improve abnormalities on their stress test, and only 31'% believed it would decrease their angina.

Although considerable attention is given to facilitating informed consent at our center, patients' perceived benefits of elective PCI do not match existing evidence, as they overestimated both the benefits and urgency of their procedures. These findings suggest that an even greater effort at patient education is needed prior to elective PCI to facilitate fully informed decision-making.