CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

September 7th, 2010

Patients Still Overestimate Benefits of Elective PCI

Patients who undergo elective PCI continue to overestimate the procedure’s benefits, according to a small study published in the Annals of Internal Medicine. Michael Rothberg and colleagues surveyed 153 patients and 27 cardiologists at a single academic center and found that 88% of the patients thought PCI would reduce their risk for MI and 82% thought it would reduce their risk for fatal MI. By contrast, most of the cardiologists believed that PCI’s benefits in stable patients like these would be limited to symptom relief.

In an accompanying editorial, Alicia Fernandez writes that informed consent needs to be greatly improved: “Informed consent requires us to do more than tell our patients about the risks of the treatments we offer them. We need to make sure our patients also fully understand the anticipated benefits.”

Note to readers: Rick Lange has started a discussion on this topic in the Interventional Cardiology section of CardioExchange. Click here to join the discussion.


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3 Responses to “Patients Still Overestimate Benefits of Elective PCI”

  1. Richard Kones, MD PhD says:
    September 7, 2010 at 8:16 pm

    This is a big issue. People believe PCI (and CABG) will entitle them to go on with their unhealthy habits for years to come, a “license to eat” and be as inactive as possible. Part of a mass delusion about health care, responsibility. Those consents should be explicit and say something like: “this is a temporary measure which does not alter the basic disease, most likely giving you more time during which you have an opportunity to do something more fundamental…”

  2. William L Blanchet, MD says:
    September 7, 2010 at 11:06 pm

    Really?

    If the Cardiologists are up to date with the literature, why are they offering elective PCI to patients without symptoms?

    The fundamental problem is that cardiologists don’t really believe the literature and continue to recommend pointless elective PCI to patients who have no potential for benefit.

  3. Josh Busch, MD says:
    September 10, 2010 at 6:00 pm

    I agree, it is critical to explain to people in clinic in advance, not on the cath lab table, that a stent won’t change their risk of mi, their mortality, or morbidity, just alleviate symptoms. We always try to maximize meds before PCI. I agree though that the major problem is that many cardiologists ‘feel better’ stenting some lesion because they are doing something..