Risks and benefits of coronary angioplasty: the patient's perspective: a preliminary study

Objectives-To describe what cardiac patients in Northern Ireland understand to be the benefits of coronary angioplasty and assess the extent to which they have been able to make informed choices about their treatment. Design-An interview based questionnaire survey completed after the patients had undergone coronary angiography, within hours of treatment counselling. Subjects-150 patients consecutively recruited from two regional cardiology centres in Belfast, Northern Ireland. Main outcome measures-The perceived complication rate and the perceived gain in life expectancy from coronary angioplasty. Results-Although most subjects had asked the consultant questions, 70% (n=104) thought that they contributed negligibly or not at all to the treatment decision. Although 75% (n=112) recalled discussing the complication rate from the procedure, 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. The patients anticipated a gain in life expectancy of some 10 years (median) and this was significantly in excess of the potential gain in Life expectancy which dietary prudence to lower blood cholesterol, not smoking, and taking more exercise might produce (median 5 years respectively; 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 modification.