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Putting Ad Hoc PCI on Pause

Putting Ad Hoc PCI on Pause COMMENTARY cations. Although findings from these trials are largely un- Brahmajee K. Nallamothu, MD, MPH disputed, the use of ad hoc PCI raises challenges for incor- Harlan M. Krumholz, MD, SM porating their lessons into routine practice. Specifically, ad hoc PCI provides less opportunity for pa- D HOC IS A LATIN PHRASE, LITERALLY MEANING “FOR tients and their physicians to thoughtfully consider a range this.” It typically implies a solution designed for of clinically equivalent treatment options after the coro- a particular problem or task—that is, something nary anatomy is known. By making the diagnostic test an Anot broadly generalizable. When the term was in- automatic gateway to the therapeutic procedure, pressure troduced more than 2 decades ago to cardiologists in the is placed on the cardiologist and patient to make immediate context of percutaneous coronary intervention (PCI), it sug- decisions that may favor PCI even in elective settings. In one gested the unique circumstances that justified combining study, for instance, patients with stronger indications for coronary angiography and PCI into the same setting. This coronary artery bypass grafting were more likely to be rec- approach was uncommon in the early years of PCI when ommended surgery after coronary http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Putting Ad Hoc PCI on Pause

JAMA , Volume 304 (18) – Nov 10, 2010

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References (10)

Publisher
American Medical Association
Copyright
Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2010.1509
pmid
21063016
Publisher site
See Article on Publisher Site

Abstract

COMMENTARY cations. Although findings from these trials are largely un- Brahmajee K. Nallamothu, MD, MPH disputed, the use of ad hoc PCI raises challenges for incor- Harlan M. Krumholz, MD, SM porating their lessons into routine practice. Specifically, ad hoc PCI provides less opportunity for pa- D HOC IS A LATIN PHRASE, LITERALLY MEANING “FOR tients and their physicians to thoughtfully consider a range this.” It typically implies a solution designed for of clinically equivalent treatment options after the coro- a particular problem or task—that is, something nary anatomy is known. By making the diagnostic test an Anot broadly generalizable. When the term was in- automatic gateway to the therapeutic procedure, pressure troduced more than 2 decades ago to cardiologists in the is placed on the cardiologist and patient to make immediate context of percutaneous coronary intervention (PCI), it sug- decisions that may favor PCI even in elective settings. In one gested the unique circumstances that justified combining study, for instance, patients with stronger indications for coronary angiography and PCI into the same setting. This coronary artery bypass grafting were more likely to be rec- approach was uncommon in the early years of PCI when ommended surgery after coronary

Journal

JAMAAmerican Medical Association

Published: Nov 10, 2010

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