Researchers at Penn State College of Medicine in collaboration with several other universities have found that more than 80 percent of complications from angioplasty procedures occur within 18 hours of treatment.
"This is important information for hospitals that keep patients several days. They may not need to keep patients this long," says Ian Gilchrist, M.D., associate professor of medicine at Penn State College of Medicine and a cardiologist at the Penn State Milton S. Hershey Medical Center.
Gilchrist and his colleagues presented their work titled, "Temporal Spectrum of Ischemic Complications with Percutaneous Coronary Intervention: The ESPRIT Experience," Nov. 14 at the American Heart Association meeting in New Orleans. The research was conducted on data collected during a clinical trial testing the dose needed for an intravenous platelet inhibitor medicine.
"For years physicians would say there is about a 10 percent complication rate for angioplasty or stenting. We wanted to find out exactly when in those 30 days the problems occurred," he adds. Complications occurred in 178 patients in the trial and included heart attack, the need for additional surgery, or death. The researchers found that 82 percent of those complication occurred within 18 hours with most of these complications occurring right at the time of the procedure.
"We found that despite the use of stents or antiplatelet therapy, complications are still common with the procedure. Also, all of the patients enrolled in the trial had to be relatively stable, so the extremely ill patients did not even participate," says Gilchrist.
The ESPRIT trial is testing the dose needed for an intravenous platelet inhibitor medicine, called eptifibatide. The medication is designed to reduce blood clots that commonly cause complications during heart procedures. The study enrolled 2,064 patients.
Gilchrist adds future research needs to be focused on high- and low-risk subsets of patients to target early complications and focus the intensity and length of therapy based on the needs of the individual patient.
About 500,000 angioplasty procedures are performed each year in the United States to help people with heart disease.