Unnecessary use of stents declining

From 2010-2014, the unnecessary use of stents to clear blocked coronary arteries fell by 50%. Now researchers are trying to decide if the decline is due to new practice guidelines issued to cardiologists in 2009, or if it is because physicians are upcoding patients’ disease to make the stent deemed necessary.

In 2010, 21,781 or 26% of nonacute cases were classified as inappropriate compared with 7,921 or 13% of those in 2014, a 50% reduction. However, cardiologists’ subjective assessments of patients also suggested higher levels of disease. The number of patients reported as having high-level angina doubled in 2014. At the same time, the percent of nonacute patients diagnosed with disease in more than one vessel, an objective measure of severity, rose only 9%.

“That discordance suggests upcoding,” said Dr. Raymond Gibbons, a cardiologist at the Mayo Clinic.

Source: The Wall Street Journal