TY - JOUR T1 - Can we improve the appropriateness of PCI? JF - Heart JO - Heart SP - 405 LP - 406 DO - 10.1136/heartjnl-2019-316141 VL - 106 IS - 6 AU - Suzanne V Arnold Y1 - 2020/03/01 UR - http://heart.bmj.com/content/106/6/405.abstract N2 - Chronic angina substantially worsens patients’ quality of life1 2 and increases healthcare costs.3 Particularly now, in the post-ISCHEMIA era,4 relief of ischaemic symptoms should be a primary goal of percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD). As such, the appropriateness of PCI most often hinges on the degree of symptom improvement achieved. In their Heart article, Yang et al compared the symptomatic benefit (using the 7-item Seattle Angina Questionnaire (SAQ-7) and Rose Dyspnea Score (RDS)) of patients with stable CAD who were treated with PCI that was judged as appropriate versus maybe appropriate.5 The authors found similar improvement in angina-related health status regardless of the appropriateness status of the PCI and concluded that the current Appropriate Use Criteria (AUC) do not discriminate well between the patients who will versus will not benefit from PCI. They argue that patient-reported outcome measures could be used to improve the current AUC by potentially identifying those patients more likely to benefit from PCI. I note three key conclusions from this paper.The authors found that patients who underwent an appropriate PCI had statistically similar symptom benefit compared with those who underwent a maybe appropriate PCI. In contrast, symptoms prior to PCI were the strongest … ER -