NEW ORLEANS -- The current boom in implanting tubular devices called stents in heart arteries may go bust when hospitals realize they are losing their profit margins, a researcher has concluded in a study presented at the annual meeting of the American Heart Association.

And if that happens, heart care will take several steps backward to the detriment of patients, Duke University Medical Center cardiologist Dr. Eric Peterson warned. "Sadly, hospitals now need to look at how every dollar is spent, and 'stenting' may become a luxury they can't afford."

Cardiologists insert the mesh-like structures to keep arteries open after clogs have been cleared by balloon angioplasty. Because of its effectiveness, stenting has quickly become a popular procedure: This year, it is estimated that 170,000 stents will be inserted in American hearts, compared to almost none five years ago.

Peterson performed a detailed examination of the costs associated with doing an angioplasty alone, or an angioplasty that delivers a stent. Analyzing the results in about 400 patients, he found that stenting costs about $13,000 -- roughly $2,000 to $3,000 more than regular angioplasty.

To many cardiologists and patients, that extra expense is well worth it, because inserting a stent structure in an artery has been proven to reduce the rate of recurrent blockages in the artery, Peterson said.

But, depending on who is paying the bill, he said these procedures may be a bad financial deal for the hospital.

Medicare gives hospitals one price (from $10,000 to $13,000 depending on the kind of hospital) through its payment system to perform either an angioplasty or an angioplasty that delivers a stent. And managed care companies usually may pay much less than that, Peterson said. That means that, rather than making a slight margin off a regular angioplasty, hospitals are losing thousands of dollars every time a stent is used.

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Contact: Karyn George
geeorg016@mc.duke.edu
919-660-1301
Duke University
13-Nov-1996