Abstract 371: Role of Advanced Care Providers in Post Percutaneous Coronary intervention Care: Analysis of Clinical Outcomes and Insights from 1 year Cohort Study
Background: Advanced care providers (ACPs) (nurse practitioners/physician assistants) play a significant role in the United States health care. No prior studies have evaluated the role of ACPs in post percutaneous coronary intervention (PCI) care. Aim of this study was to compare clinical outcomes in patients followed by ACPs as compared to cardiologists after PCI.
Methods: In this observational study, we evaluated 381 patients who underwent successful PCI from Jan to Dec '11 and were discharged alive. In this group-practice based model at a tertiary health care center, ACPs independently provide primary cardiac care to patients post PCI, in collaboration with cardiologists. We compared all cause mortality and major adverse cardiovascular (MACE) at one year amongst patients followed by cardiologists (n=164) and ACPs (n=144). We excluded 73 patients who crossed over from one provider type to the other during follow up.
Results: Baseline characters of the study groups are shown in table 1. These patients were similar with regards to baseline co-morbidities, except for a higher proportion of hypertension and prior myocardial infarction/PCI amongst patients followed by ACPs. Both the groups experienced similar mortality (3% [5/164] for cardiologists vs. 6.3% [9/144] for ACPs, p=0.178) and MACE (12% [20/164] for cardiologists vs. 13% [19/144] for ACPs, p=0.792) at 1 year. Individual outcomes are shown in table 2.
Conclusion: In this study, ACPs provided an equally effective care to patients post PCI as compared to cardiologists, with comparable all-cause mortality and MACE. With expanding role of ACPs, more studies are needed to compare other parameters such as cost effectiveness and patient satisfaction.
Author Disclosures: A. Mishra: None. M. Singh: B. Research Grant; Modest; $5000. M. Kamboj: None. A. Sethi: None. D. Stapleton: None.
- © 2014 by American Heart Association, Inc.