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AHCPR Heart Attack Study Published in New England Journal of Medicine

Press Release Date: August 30, 1995

A study in the August 31 New England Journal of Medicine comparing two States' use of diagnostic procedures and treatments for heart attack finds that in the State where angiography (x-ray exam of blood vessels to the heart) is performed more often, the patients appeared to have no greater advantage in terms of survival or health-related quality of life than those patients in the state with fewer angiographies.

The study, "Variation in the Use of Cardiac Procedures After Acute Myocardial Infarction," looked at Medicare patients aged 65-79 admitted in 1990 to hospitals in New York, where the rate of cardiac procedures is low, and in Texas, where the rate is high. The researchers used data from Medicare files, hospital records and the patients to compare rates for angiography, cardiac catheterization and coronary-artery bypass surgery.

The study also found that patients treated in Texas were significantly more likely than those treated in New York to undergo catheterization either in the hospital or within 90 days of admission. According to the researchers, this may result from differences in the expectations of New York and Texas physicians regarding the benefits of catheterization for patients at lower risk of another heart attack.

The research was conducted by Edward Guadagnoli, Ph.D., Paul J. Hauptman, M.D., John Z. Ayanian, M.D., M.P.P., Chris L. Pashos, PhD, Barbara J. McNeil, M.D., Ph.D., and Paul D. Cleary, Ph.D., at the Health Care Policy Department, Harvard Medical School.

The study was supported by AHCPR as part of a large-scale, multidisciplinary Patient Outcomes Research Team (PORT) project on the consequences of variation in treatment for acute myocardial infarction. AHCPR will release the final PORT report in September.

For more information on this or other AHCPR-funded research on quality of care, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855 ; or Salina Prasad, (301) 427-1864. The public affairs contact at Harvard Medical School is Keren R. McGinity, (617) 432-0441.

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