Story originally printed in the La Crosse Tribune or online at www.lacrossetribune.com
Published - Friday, September 05, 2008
Local doctor develops angioplasty risk scale
It’s no doubt a question worth asking before undergoing angioplasty: What is the risk of dying from this balloon procedure?
Heart specialists have used a risk scale based on information from coronary angio-graphy — an X-ray of the inside of heart arteries done by putting a narrow tube through blood vessels and injecting dye that provides a picture.
But the problem with that risk assessment is the patient often is already sedated and the doctor is prepared to inflate the tiny balloon to open a blocked vessel, said Dr. Mandeep Singh, a Mayo Clinic cardiologist who practices at Franciscan Skemp in La Crosse.
“That’s too late, and it is not right to tell the patient his risk of dying when he is sedated on the table,” Singh said. “That’s why we have put forward a model to assess risk without the use of technology.”
Singh said he developed his own seven-point scale, which uses information gathered from the patient such as age, gender, the incidence of heart attack, cardiac shock, kidney failure, diabetes or heart failure to arrive at a risk score.
Singh and other Mayo researchers tested the scale for its accuracy on a data base of more than 300,000 patients nationwide, calculating the predicted probability of death and comparing how patients actually did after they had the procedure.
Singh said the risk of death from angioplasty is anywhere from 1 percent to 25 percent, depending on risk factors.
“We wanted to develop a model that anyone, not just cardiologists but all physicians, can use to assess risk,” Singh said.
“It’s a very objective portrayal of risk for patients, and now we have to convince our colleagues to use it in everyday practice.”
He said 90 percent of angioplasties are elective and now, with the scale, patients can get accurate information on their risk before they consent to the procedure.
“The challenge now is: Can it fit with patients undergoing bypass?” Singh said.
The study appeared in the premiere issue of Circulation: Cardiovascular Interventions.
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