(HealthDay News) — Advanced practice providers, including nurse practitioners and physician assistants, deliver a quality of outpatient cardiovascular care that is similar to that provided by physicians, according to a study published in the Journal of the American College of Cardiology.

Salim S. Virani, MD, PhD, from the Michael E. DeBakey Veterans Affairs Medical Center in Houston, and colleagues compared the quality of coronary artery disease (CAD), heart failure, and atrial fibrillation care delivered by physicians and advanced practice providers for outpatient visits (January 1, 2012, through December 31, 2012) using data from the American College of Cardiology’s PINNACLE Registry (883 providers [716 physicians and 167 advanced practice providers] in 41 practices who cared for 459 669 patients).

The researchers found that the mean number of patients seen by advanced practice providers (260.7) was lower than the mean number seen by physicians (581.2). 

Advanced practice providers and physicians had comparable compliance with most CAD, heart failure, and atrial fibrillation measures. Advanced practice providers had a higher rate of smoking cessation screening and intervention (adjusted rate ratio, 1.14) and cardiac rehabilitation referral (rate ratio, 1.4) among CAD patients compared with physicians. 

Results were similar whether the researchers compared practices with both physicians and advanced practice providers or physician-only practices.

“Apart from minor differences, a collaborative care delivery model, using both physicians and [advanced practice providers], may deliver an overall comparable quality of outpatient cardiovascular care compared with a physician-only model,” the authors concluded.

Two authors report financial ties to the pharmaceutical industry.


  1. Virani SS, Maddox TM, Chan PS, et al. Provider Type and Quality of Outpatient Cardiovascular Disease Care: Insights From the NCDR PINNACLE Registry. J Am Coll Cardiol. 2015;66(16):1803-1812.