Will JAMA heart stent article start another Wall Street stampede?

July 5, 2011 by MassDevice staff

A new study questioning the appropriateness of cardiac stents and angioplasty balloons may have a ripple effect on The Street.

JAMA

A footnote in a study published in the Journal of the American Medical Assn. about percutaneous coronary interventions may have a ripple effect on Wall Street.

The study gathered data on more than 500,000 PCIs conducted at more than 1,000 U.S. hospitals between July 2009 and September 2010. The researchers determined the appropriateness of each procedure based on the 2009 coronary revascularization appropriate use criteria, a whitesheet generated and endorsed by medical professional societies in 2009 amid growing debate over proper use of PCIs.

While the study found that nearly 85 percent of all procedures were necessary and appropriate and only about 4 percent could be definitely determined inappropriate, that 4 percent figure could echo among the canyons of Wall Street. A similar JAMA article published in January, on the rate of appropriate cardiac rhythm management device implantations, is partially credited for driving a slump in procedure volumes for CRM devices.

The new study on PCIs considered 500,154 procedures, dividing them into acute indications and elective procedures. Among the acute category, which made up nearly 73 percent of the whole, nearly all cases fell within the guidelines. About 1 percent were designated inappropriate and less than half a percent were considered uncertain.

Within the elective category, about half were labeled appropriate, less than 12 percent were considered inappropriate and 38 percent were uncertain.

Across the entire study, less than 5 percent of stent and angioplasty balloon procedures were found to be inappropriate. The 11.2 percent that couldn't be pegged as within or without the guidelines, however, could send a ripple effect along The Street among med-tech investors.

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