Researchers applied the newly published cardiac catheterization criteria to a large population of diagnostic catheterization patients, namely those in New York state’s DC database who underwent the procedure between 2010 and 2011. DC was categorized as appropriate, uncertain and inappropriate, based on previous testing and symptoms.
Of the nearly 10,000 patients examined, DC was appropriate for 35.3 percent, uncertain for 39.8 and inappropriate for 24.9 percent. Of patients for whom the procedure was inappropriate, 64 percent had never undergone a stress test. Nearly 90 percent of these patients without a previous stress test were asymptomatic and had low or intermediate global coronary artery disease risk scores.
Inappropriate DC rates at individual hospitals ranged from 8.6 percent to 48.8 percent with a mean of 28.5 percent. Hospital volume was not related to individual hospital-level appropriateness ratios for DC, according to the report.
Cardiac catheterization came under fire during the summer months of 2013, after a study in the Journal of the American Medical Association suggested the procedure was overused in the U.S.
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