RISKS AND BENEFITS OF CORONARY ANGIOPLASTY - THE PATIENTS PERSPECTIVE- A PRELIMINARY-STUDY

Objectives-To describe what cardiac patients in Northern Ireland under stand to be the benefits of coronary angioplasty and assess the extent to which they have been able to make informed choices about their tre atment. Design-An interview based questionnaire survey completed after the patients had undergone coronary angiography, within hours of trea tment counselling. Subjects-150 patients consecutively recruited from two regional cardiology centres in Belfast, Northern Ireland. Main out come measures-The perceived complication rate and the perceived gain i n life expectancy from coronary angioplasty. Results-Although most sub jects had asked the consultant questions, 70% (n=104) thought that the y contributed negligibly or not at all to the treatment decision. Alth ough 75% (n=112) recalled discussing the complication rate from the pr ocedure, only 27% accurately estimated this rate (as between 0.5 and 1 .5%). Eighty eight per cent (n=131) thought that their mortality risks would be substantially or greatly reduced by having the procedure. Th e patients anticipated a gain in life expectancy of some 10 years (med ian) and this was significantly in excess of the potential gain in Lif e expectancy which dietary prudence to lower blood cholesterol, not sm oking, and taking more exercise might produce (median 5 years respecti vely; P<0.0001, Wilcoxon matched pairs signed rank test). Conclusions- Patients vastly overrate the capacity of angioplasty to control their disease: angioplasty is seen as more effective than risk factor modifi cation.