Middle-aged man who could not afford an angioplasty

Area of Science:

• Cardiology
• Health Economics

Background:

• Coronary artery disease (CAD) management often involves percutaneous coronary intervention (PCI).
• Concerns exist regarding the profit-driven overuse of PCI, particularly in India.
• Inappropriate PCI use poses significant financial risks to patients.

Observation:

• A case report details a 55-year-old Indian man recommended for urgent PCI post-myocardial infarction.
• The patient was asymptomatic and outside the primary PCI window.
• The recommended PCI posed a substantial financial risk, potentially leading to insolvency.

Findings:

• The case illustrates the challenges and consequences of inappropriate PCI overuse.
• There is a noted lack of shared decision-making between patients and physicians regarding PCI.
• Assumptions of PCI overuse being evidence-based are questioned.

Implications:

• Highlights the critical need for evidence-based medicine in PCI practices.
• Emphasizes the importance of shared decision-making to prevent patient harm and financial distress.
• Calls for greater scrutiny of PCI indications to align with patient benefit and economic realities.