It seems logical that people who are treated by doctors and hospitals with more experience in angioplasty would have a better outcome. And now a large study has proved just that.

Researchers analyzed the Medicare records of more than 167,000 patients who had angioplasty during the year 1997. They used the need for coronary artery bypass surgery as an indicator of unsuccessful angioplasty; that is, if the patient needed bypass surgery after the angioplasty, then it can be assumed that the angioplasty did not work.

Overall, just 1.87% needed bypass surgery. Patients treated by doctors who performed a greater number of angioplasties had a lower risk than those whose doctors did fewer angioplasties - 1.55% vs 2.25%. How many procedures the hospital performed did not make a difference; that is, the same percentage of people needed bypass surgery whether they had their angioplasty at a low-volume or high-volume hospital. For this study, high-volume was considered more than 1 Medicare procedure per week for a doctor and more than 3/week for the hospital.

However, the mortality rate was higher at hospitals doing fewer such procedures. The overall mortality rate was 3.3%, and there was no difference between doctor volumes on this measure.

More than half of the patients studied had a stent put in (57.7%). As expected, their need for subsequent bypass surgery was less than half that for those not receiving stents (1.2% vs 2.78%).

The take-away from this study: if you are a candidate for angioplasty, check on the experience of the doctor who will be performing the procedure and of the hospital.