Cardiologists’ Perception of Risk of Coronary Revascularization Procedures

Coronary angioplasty in octogenarians. Quality of life and costs

“…The background of this phenomenon is probably multifactorial, the major compound being iatrogenic. Both referring physician and interventionalist are reluctant to recommend PTCA for octogenarians since the frequency of complications is estimated to be higher and success rates in multimorbid patients with fragile vessels are lower than in younger patients [3] . The patients themselves, having learned that high age is associated with multimorbidity and frequent pain, are more likely to accept anginal pain than their younger counterparts who are physically more active and thus less tolerant towards stress-induced angina.…”

“…Percutaneous transluminal coronary angioplasty (PTCA) is still not commonly offered to very elderly patients, possibly because of the widespread perception that invasive procedures in these patients entail excessive risk and little benefit [1][2][3] . However, with the improvement in interventional techniques and the increased use of stents, success rates have increased and complications were reduced, particularly in elderly patients [4][5][6] .…”

Job Matters

“…A study comparing cardiologists' perception of risk of coronary procedures found that interventionalists perceive higher risks than noninterventionalists in a substantial number of patients, without an overall difference. 16 Differences in judgments between cardiologists and other internists were also analyzed in a number of studies and mostly showed that neither group was more accurate in risk assessment. 17,18 To our knowledge, there are no studies comparing risk judgment from cardiologists and cardiac surgeons, but we think it improbable that surgeons should be generally more risk-averse than cardiologists.…”

Risk perception and implantable cardioverter defibrillators

“…10 Patients' and physicians' expectation of survival and symptomatic benefit following PCI or coronary artery bypass grafting (CABG) are completely unrelated. 11 Even when formally educated, patients' retention of risk and benefit is minimal by 30 days of follow-up.…”