Abstract 6224: Widespread Patient Misconceptions Regarding the Benefits of Elective Percutaneous Corornary Intervention
Although percutaneous intervention (PCI) has been documented to reduce mortality and myocardial infarct size in the setting of an acute coronary syndrome, the benefits of PCI in the elective setting has been limited to angina relief and improved quality of life. Although these benefits are generally understood by cardiologists, patients may have different beliefs regarding the benefits of elective PCI. We investigated patients’ perceptions of benefit from elective PCI. After excluding patients with unstable angina and incomplete data entry, we identified 498 consecutive patients who received an elective PCI between 1/06–10/07 at 2 hospitals in Kansas City. Each subject was mailed a 1-page questionnaire inquiring about what they believed to be their benefits from the elective PCI that they had had in the preceding year. Of the 498 subjects who were asked to participate, 347 responded (70%). The mean age was 69 years, and 76% were men. Of these, 33% believed the PCI was emergent (despite the fact that all were elective), 70% believed the procedure would prevent future heart attacks, 66% believed the PCI would extend their life, 42% believed the PCI saved their life, 42% believed the PCI would improve any abnormality noted on their stress test, and 31% believed the procedure would decrease anginal symptoms. According to the patients, 18% were offered medical therapy as an alternative to PCI, and 13% were offered bypass surgery, while 68% were offered no therapy other than PCI. Patients’ perceived benefits of an elective PCI do not match existing evidence. Better patient education may be needed prior to elective PCIs to elucidate the evidence-based risks and benefits so as to facilitate more truly informed consent.