Patients' perception of the percutaneous coronary intervention benefits in stable coronary artery disease
Keywords:Angioplastia Transluminal Percutânea Coronária, Doenças Cardiovasculares, Doença das Coronárias, Percutaneous Transluminal Coronary Angioplasty, Cardiovascular Diseases, Coronary Artery Disease
Background: Percutaneous coronary intervention (PCI) is a common procedure to relieve obstruction of a stenotic coronary artery. Patients' beliefs about the need for the procedure and its effectiveness are shaped by interaction with attending physicians. Therefore, every decision involving the procedure must be taken jointly between the patient and the physician, and the physician must help the subject to understand the probability of the expected benefits and the risks to be faced in the intervention, acting as an experienced partner.
Aim: To assess patients' perception of the benefits and risks of PCI based on information provided by the attending physician. Method: Through a descriptive longitudinal study carried out with patients diagnosed with coronary insufficiency admitted to the HUSF.
Results: When analyzing the expected benefits, in a fraction of the sample, through the performance of PCI, 26% of patients would like to avoid acute myocardial infarction, 26% wanted to reduce their possibility of dying, 10% sought to live longer, 40% wanted to reduce chest pain, 5% would like to take less medication, 25% wanted to decrease dyspnea and 15% did not know how to respond. All patients said that the risks of the procedure were not addressed in the conversation, and only one patient was able to inform possible risks due to prior knowledge.
Conclusion: It was noted the existence of failures in communication between the doctor and the patient, evidenced by the overestimation of benefits and underestimation of risks in performing PCI.
ARMAGANIJAN, D.; BATLOUNI, M. Impacto dos fatores de risco tradicionais. Rev. Soc. Cardiol. Estado de Säo Paulo, p. 686–693, 2000.
BARI 2D STUDY GROUP et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. The New England Journal of Medicine, v. 360, n. 24, p. 2503–2515, 11 jun. 2009.
BODEN, W. E. et al. Optimal medical therapy with or without PCI for stable coronary disease. The New England Journal of Medicine, v. 356, n. 15, p. 1503–1516, 12 abr. 2007.
DE BRUYNE, B. et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. The New England Journal of Medicine, v. 367, n. 11, p. 991–1001, 13 set. 2012.
GUTMAN, J.; GUTMAN, J. The right not to know and coronary angiography: is the common law of Australia consistent with patients’ wishes. Journal of law and medicine, v. 10, n. 2, p. 168–173, 1 nov. 2002.
HEKKENBERG, R. J. et al. Informed consent in head and neck surgery: how much do patients actually remember? The Journal of Otolaryngology, v. 26, n. 3, p. 155–159, jun. 1997.
LAVELLE-JONES, C. et al. Factors affecting quality of informed consent. BMJ (Clinical research ed.), v. 306, n. 6882, p. 885–890, 3 abr. 1993.
MARK, J. S.; SPIRO, H. Informed consent for colonoscopy. A prospective study. Archives of Internal Medicine, v. 150, n. 4, p. 777–780, abr. 1990.
MCNUTT, R. A. Shared medical decision making: problems, process, progress. JAMA, v. 292, n. 20, p. 2516–2518, 24 nov. 2004.
PRILUCK, I. A.; ROBERTSON, D. M.; BUETTNER, H. What patients recall of the preoperative discussion after retinal detachment surgery. American Journal of Ophthalmology, v. 87, n. 5, p. 620–623, maio 1979.
SÃO LEÃO, A. M. O.; VILAGRA, M. M. Perfil dos pacientes submetidos à intervenção coronariana percutânea no serviço de hemodinâmica do hospital universitário sul fluminense, Vassouras-RJ. Revista de saúde, v. 3, n. 1, p. 27–32, 2012.
SIMON, J. et al. The variable effects of angiotensin converting enzyme inhibition on myocardial ischaemia in chronic stable angina. British Heart Journal, v. 62, n. 2, p. 112–117, ago. 1989.
WHITNEY, S. N. A new model of medical decisions: exploring the limits of shared decision making. Medical Decision Making: An International Journal of the Society for Medical Decision Making, v. 23, n. 4, p. 275–280, ago. 2003.
WHITTLE, J. et al. Understanding of the benefits of coronary revascularization procedures among patients who are offered such procedures. American Heart Journal, v. 154, n. 4, p. 662–668, out. 2007.
WOOLF, S. H. et al. Promoting informed choice: transforming health care to dispense knowledge for decision making. Annals of Internal Medicine, v. 143, n. 4, p. 293–300, 16 ago. 2005.
WYMAN, R. M. et al. Current complications of diagnostic and therapeutic cardiac catheterization. Journal of the American College of Cardiology, v. 12, n. 6, p. 1400–1406, dez. 1988.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish in this journal agree to the following terms: The author(s) authorize the publication of the text in the journal; The author(s) guarantee that the contribution is original and unpublished and is not in the process of being evaluated by any other journal(s); The journal is not responsible for the opinions, ideas, and concepts contained in the texts, as these are the sole responsibility of their respective author(s); The editors reserve the right to make adjustments to the text in order to ensure that it adheres to the standards of the journal. Authors retain the copyrights and grant the journal the right of first publication, with the article simultaneously licensed under the Creative Commons Attribution License which allows the sharing of the article with the acknowledgment of authorship and initial publication in this journal. Authors are authorized to take additional contracts separately, for the non-exclusive distribution of the version of the article published in this journal (e.g. publication in an institutional repository or as a book chapter), with the acknowledgment of authorship and initial publication in this journal.
Authors are allowed and encouraged to publish and distribute their work online (e.g. in institutional repositories or on their personal webpage) at any point before or during the editorial process, as this can generate productive changes as well as increase the impact and citation of published work (See The Effect of Free Access at http://opcit.eprints.org/oacitation-biblio.html)