(October 14, 2008 - Insidermedicine) Over half of patients aged 65 and older with stable heart vessel disease who undergo percutaneous coronary intervention (PCI) do not undergo testing to demonstrate that the vessels are blocked in the first place, according to research in the Journal of the American Medical Association.

Here are some facts about percutaneous coronary intervention (PCI):

•    It is an invasive procedure designed to open up blockages in the blood vessels that feed the heart.

•    A balloon-tipped catheter is threaded through to the blocked blood vessels. The balloon is then inflated, opening the blood vessels.

•    While PCI can be helpful for some with blocked coronary vessels, it has not been proven to be more beneficial than drug therapy in all cases.

Researchers from the University of California at San Francisco identified those aged 65 and older who had undergone PCI in 2004. They selected a random sample of 20% of these patients to see who had undergone stress testing before the procedure. Stress testing can help confirm the presence of blocked coronary blood vessels.

Only 44.5% of patients had stress testing in the three months before they underwent PCI. Women, those aged 85 and older, and those with a history of congestive heart failure or previous PCI were less likely to undergo stress testing, while being black and having chest pain increased the likelihood. Doctors who performed 150 or more PCIs per year were less likely to send their patients for stress testing beforehand.

Today's research demonstrates how PCI is being performed in patients without documented evidence of blocked blood vessels, questioning whether some of these patients may actually be better served with drug therapy.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.