{"id":27478,"date":"2012-03-25T09:05:37","date_gmt":"2012-03-25T13:05:37","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=27478"},"modified":"2012-03-25T09:05:37","modified_gmt":"2012-03-25T13:05:37","slug":"study-supports-pci-without-on-site-surgical-backup","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/03\/25\/study-supports-pci-without-on-site-surgical-backup\/","title":{"rendered":"Study Supports PCI Without On-Site Surgical Backup"},"content":{"rendered":"<p>Here&#8217;s a great example of genuine medical progress: 10% of the first 50 patients who received balloon angioplasty from the procedure&#8217;s developer, <a title=\"Gruentzig\" href=\"http:\/\/www.emoryhealthcare.org\/heart-center-atlanta\/history\/andreas-gruentzig.html\" target=\"_blank\">Andreas Gr\u00fcntzig<\/a>, required emergency bypass surgery. By 2002 only 0.15% of PCI patients required emergency surgery, leading many to believe that surgical backup was no longer necessary.<\/p>\n<p>Now a large new study provides strong evidence that PCI can, in fact, be performed safely and effectively at hospitals without surgical backup. In a presentation at the American College of Cardiology and\u00a0<a title=\"CPORT-E\" href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1114540\" target=\"_blank\">published simultaneously in the <em>New England Journal of Medicine<\/em><\/a>,\u00a0Thomas Aversano and colleagues in the Cardiovascular Patient Outcomes Research Team (C-PORT) report \u00a0the results of a trial that randomized 18,867 patients to undergo PCI at hospitals with or without surgical backup.<\/p>\n<ul>\n<li>The 6-week mortality rate was 0.9% at hospitals without surgical backup versus 1.0% at hospitals with surgical backup, which was well within the predefined margin of noninferiority of a\u00a00.4% difference in risk (<em>P<\/em>=0.004).<\/li>\n<li>The 9-month composite rate of death, Q-wave MI, or target-vessel revascularization was 12.1% and 11.2%, respectively, which met the predefined margin of noninferiority of a 1.8% difference in risk (<em>P<\/em>=0.05).<\/li>\n<\/ul>\n<p>The authors noted that high-risk patients were excluded from the study, raising the possibility that the study population may differ from the general PCI population. \u201cThe study shows that under certain circumstances, non-primary angioplasty can be performed safely and effectively at hospitals without on-site cardiac surgery,\u201d said Aversano, in\u00a0<a href=\"http:\/\/cardiobrief.files.wordpress.com\/2012\/03\/cport-e-aversano.pdf\">an ACC press release<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Here&#8217;s a great example of genuine medical progress: 10% of the first 50 patients who received balloon angioplasty from the procedure&#8217;s developer, Andreas Gr\u00fcntzig, required emergency bypass surgery. By 2002 only 0.15% of PCI patients required emergency surgery, leading many to believe that surgical backup was no longer necessary. Now a large new study provides [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20,9],"tags":[301,1068],"class_list":["post-27478","post","type-post","status-publish","format-standard","hentry","category-cardiac-surgery","category-interventional-cardiology","tag-pci","tag-surgical-backup"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27478","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=27478"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27478\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=27478"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=27478"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=27478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}