Reality not Reflected
The article provides a well intentioned description, where wishful thinking is mistaken for reality—or rather, “the desired state of affairs” is mistaken for “the real state of affairs”—and does not reflect clinical reality. Members of the German Cardiac Society would confirm this. The indication for invasive primary diagnostic evaluation and stent implantation, as well as for follow-up after stenting, can be assumed to be directly proportional to the number of cardiac catheter laboratories, as the steadily increasing numbers show. Most specialists will be clear that in a scenario of 880 000 catheterizations in 2010—the world record per 1000 population in an industrialized country—competition and financial considerations are the main motivation, rather than guidelines or even patients. And, to remind readers, cardiac catheterization is never trivial but a serious intervention. Possible complications—even if these are rare—include arterial hemorrhage, aortic dissection, or pulmonary embolism.
Prof. Dr. med. Ulrich Hake, Mainz
|1.||Rassaf T, Steiner S, Kelm M: Postoperative care and follow up after coronary stenting. Dtsch Arztebl Int 2013; 110(5): 72–82. VOLLTEXT|