August 3, 2016 - A white paper on treating higher-risk patients with percutaneous coronary intervention (PCI) was recently published in the journal Circulation. Patients with severe coronary artery disease with comorbidities, complex coronary anatomy, and/or poor hemodynamics represent an understudied and potentially underserved patient population. Advances in interventional techniques and technologies, along with improved patient selection, may benefit this population commonly referred to as “complex higher-risk (and indicated) patients” (CHIP).
The authors recommend establishing specialized training programs for interventional cardiologists giving them the cognitive and technical skills to select these patients appropriately and to perform these procedures safely. The authors also suggest conducting a multicenter registry tracking short- and long-term outcomes for higher-risk patients already undergoing more complex procedures which could be used to help shape treatment guidelines.
Dr. Ajay Kirtane was the lead author of the paper. He is an Associate Professor of Medicine at Columbia University Medical Center and Director of the Cardiac Catheterization Laboratories at NewYork-Presbyterian Hospital/Columbia University Medical Center. He also serves as Co-director of Transcatheter Cardiovascular Therapeutics (TCT), the annual scientific symposium of the Cardiovascular Research Foundation.