Objective of this retrospective, pilot study is to first explore in Italy, – 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), – appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation.
Of the 401 mappable PCIs, 38.7% (95% CI 33.9 to 43.6) were classified as appropriate, 47.6% (95% CI 42.7 to 52.6) as uncertain and 13.7% (95% CI 10.5% to 17.5%) as inappropriate. Therefore, the Authors conclude that the use of heart team approaches and adherence to guideline recommendations on coronary revascularisation in a real-world setting is limited. The study documents the feasibility of measuring appropriateness and guideline adherence in clinical practice and identifies substantial opportunities for quality improvement.
- Leonardi S, Marino M, Crimi G, Maiorana F, Rizzotti D, Lettieri C, Bettari L, Zuccari M, Sganzerla P, Tresoldi S, Adamo M, Ghiringhelli S, Sponzilli C, Pasquetto G, Pavei A, Pedon L, Bassan L, Bollati M, Camisasca P, Trabattoni D, Brancati M, Poli A, Panciroli C, Lettino M, Tarelli G, Tarantini G, De Luca L, Varbella F, Musumeci G, De Servi S. APpropriAteness of percutaneous Coronary interventions in patients with ischaemic HEart disease in Italy: the APACHE pilot study. BMJ Open 2017 Sep 5;7(9):e016909. doi: 10.1136/bmjopen-2017-016909. Go to PubMed