Study: Patients Who Undergo Angioplasty May be at Risk for Further Hospitalization

Study: Patients Who Undergo Angioplasty May be at Risk for Further HospitalizationA new study has found that about one in 10 patients who undergo angioplasty for the treatment of clogged heart arteries will have to return to the hospital within the following month, while another study concluded that the risk for rehospitalization after the procedure remains up to three years after the initial angioplasty or stent placement procedure.

The studies were published in a recent issue of the Archives of Internal Medicine, and indicate better methods for identifying and treating high-risk patients are needed.

The first study analyzed more than 15,000 people who had the procedure to treat blocked heart arteries, and found that 9.4 percent of these individuals had to be readmitted to the hospital within 30 days of being released. The study also found that these patients were also more likely to die within a year of re-admittance compared to those who did not have to be hospitalized a second time. Results showed that females, those with unstable angina and patients covered by Medicare were the most likely to return for further care.

"I wouldn't have thought the rehospitalization rate would be that high, but it gives us an opportunity to study those factors that we could change," said study author Dr. David Holmes, a cardiologist at Mayo Clinic in Rochester, Minnesota.

Holmes added that many of the factors that led to rehospitalization can be addressed and changed.

"Maybe we need to change how we provide information so that they go out understanding what medications they need to take and what the warning signs are that should make them come back," Holmes explained, adding that coronary artery disease is a chronic condition that should be monitored more closely, and doctors need to better treat the rest of the problem once the patient has been released from the hospital.

According to the National Heart Lung and Blood Institute, Coronary Angioplasty is used to open clogged or narrowed heart arteries to improve blood flow. The procedure is used to fend off atherosclerosis, a condition in which plaque builds on arteries causing them to harden.

Angioplasty is performed on more than 1 million people in the U.S. every year, and although complications aren't common, they have been known to occur, spurring further research to be conducted to make the procedure safer.

In the second study, researchers found that among 11,118 patients, a rate of up to 20 percent readmission was noted after three years. The 7,867 patients who were rehospitalized were admitted for heart failure, heart attack or serious bleeds.

"Hospital admissions are frequent, both in the first year and in the following years after," said study author Dr. Gianluca Campo, a cardiologist at the Azienda Ospedaliera-Universitaria di Ferrara in Ferrara, Italy. "The most dangerous adverse events are heart failure and bleeding events. These complications have a strong negative impact on long-term mortality."

Dr. Adrian F. Hernandez, a cardiologist at Duke University, says hospitals may have the power to prevent rehospitalization if the necessary steps are taken to identify high-risk individuals earlier. Hernandez stated it was the hospital's duty to perform such tests, urging care centers to "understand the holes" in their systems, and posed the question "Do you even know your readmission rates, and can you develop metrics around readmission?" in a recent editorial.

Hernandez insisted that patients should have an appropriate follow-up schedule, ideally within seven to 10 days of leaving the hospital.