Transitions from the procedural to the outpatient context must have been seamless to provide high-quality cardiovascular care across health care systems, especially for patients having invasive cardiac procedures. For a study, it was determined that patients who had a percutaneous coronary intervention for stable angina at community or Veterans Affairs (VA) hospitals were researched for the relationship between postprocedural follow-up visits and antiplatelet prescriptions and clinical outcomes. Between October 1, 2015, and September 30, 2019, patients who actively received care within the VA Healthcare System and underwent percutaneous coronary intervention for stable angina in a community or VA hospital were identified. Researchers compared mortality in community and VA patients, as well as subgroups of community patients who had a postprocedural follow-up visit within 30 days after the procedure or a prescription for antiplatelet (P2Y12) medication within 120 days of the surgery. Furthermore, 5,133 people were treated at community hospitals, and 7,704 were treated at the VA among the 12,837 patients who survived the first 30 days. Antiplatelet treatment prescriptions were less common in individuals treated in the community (85%) compared with the ones treated in the VA (95%) at 1 year (hazard ratio [HR], 0.46; 95% CI, 0.44–47). Patients treated in the community with a follow-up visit (HR, 1.17; 95% CI, 0.97–1.40) or fill for an antiplatelet treatment (HR, 1.08; 95% CI, 0.90–1.30) had similar death risks compared with VA patients. Patients treated in the community without a follow-up visit had an 86% (HR, 1.86; 95% CI, 1.40–2.48) more significant risk of death, and the ones without an antiplatelet prescription fill had a 144% (HR, 2.44; 95% CI, 1.85–3.21) increased risk of death compared with all VA patients. Patients treated in community facilities had a lower likelihood of receiving antiplatelet prescriptions following the percutaneous coronary intervention, which was associated with an increased risk of mortality, highlighting the necessity of measuring cardiovascular quality throughout health care systems.
Link:www.ahajournals.org/doi/10.1161/JAHA.121.024598
