A study published in the Journal of the American Heart Association has found that those who had a heart attack when their cardiologists were away at big cardiology conferences fared better.
According to the study by doctors at Harvard Medical School, those who had heart attacks when interventional cardiologists were away at academic conferences were more likely to survive in the month after the event than those who had the attacks on non-conference days.
Dr Anupama Jena, lead author of the study was quoted saying: “Many medical interventions deliver no mortality benefit, and the fact that mortality actually falls for heart attack patients during these conference dates raises important questions about how care might differ during these periods.”
The researchers found that patients did better for acute cardiovascular conditions such as cardiac arrest and heart failure on the dates of the American Heart Association and the American College of Cardiology meetings. The comparison was with patients suffering similar conditions on non-conference dates within five weeks either side of the conferences.
Although there was no difference in mortality for patients with heart attacks, stenting rates in such cases decreased by a third during the dates when interventional cardiologists were attending conferences. The study has raised questions over the use of stents if a patient is stable, while acknowledging that in cases where the heart attack was caused by a blocked artery the priority is to get it unblocked at the earliest.
While some cardiologists have attributed this finding to chance, the researchers argued that interventional cardiologists who attended conferences tended to use intensive interventions for patients, which probably did more harm than good, instead of taking a more holistic approach or opting to manage the treatment with medications. Interestingly, in the study, the greatest increase in survival rates was among patients who were seen by an interventional cardiologist but did not receive a stent.
The research raises the question of what the doctors who stay behind during these conferences do differently to achieve superior results and how the ones who attend conference could learn from them.
The findings of this study buttress others in the past that have suggested that a substantial number of cardiac procedures may not just be unnecessary but actually be harmful to patients.
