CardioExchange Archive

August 2nd, 2012

DES in Patients at Low Risk for TVR: Is the Benefit Worth the Cost? (Part III)

John Spertus, MD, MPH, Robert W. Yeh, MD MSc MBA, Richard A. Lange, MD, MBA and L. David Hillis, MD

In a recent article in Archives of Internal Medicine, researchers performed an analysis of current use of drug-eluting stents (DES) in patients at various levels of risk for target-vessel revascularization (TVR), and estimated the cost and clinical outcomes of using BMS rather than DES in patients at low risk (see News). To gauge reaction to […]

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February 22nd, 2012

Part 5: Clashing Views of Appropriate Use Criteria for PCI

Paul S. Chan, MD, MS, Steve Marso, MD, John Spertus, MD, MPH and J Aaron Grantham, MD, FACC

In a recent Viewpoint in JACC: Cardiovascular Interventions, Marso and colleagues expressed grave reservations about the application of appropriate use criteria for PCI in a controversial study published last year in JAMA by Chan and colleagues, which found that only half of PCIs performed for nonacute indications were classified as appropriate. Interventional cardiology editors Rick Lange and David Hillis asked CardioExchange members for their […]

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February 21st, 2012

Part 4: Clashing Views of Appropriate Use Criteria for PCI

Steve Marso, MD, J Aaron Grantham, MD, FACC, Paul S. Chan, MD, MS and John Spertus, MD, MPH

In a recent Viewpoint in JACC: Cardiovascular Interventions, Marso and colleagues expressed grave reservations about the application of appropriate use criteria for PCI in a controversial study published last year in JAMA by Chan and colleagues, which found that only half of PCIs performed for nonacute indications were classified as appropriate. Interventional cardiology editors Rick Lange and David Hillis asked CardioExchange members for their […]

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February 17th, 2012

Part 3: Clashing Views of Appropriate Use Criteria for PCI

John Spertus, MD, MPH, Steve Marso, MD, J Aaron Grantham, MD, FACC and Paul S. Chan, MD, MS

In a recent Viewpoint in JACC: Cardiovascular Interventions, Marso and colleagues expressed grave reservations about the application of appropriate use criteria for PCI in a controversial study published last year in JAMA by Chan and colleagues, which found that only half of PCIs performed for nonacute indications were classified as appropriate. Interventional cardiology editors Rick Lange and David Hillis asked CardioExchange members for their […]

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February 16th, 2012

Part 2: Clashing Views of Appropriate Use Criteria for PCI

J Aaron Grantham, MD, FACC, John Spertus, MD, MPH, Steve Marso, MD and Paul S. Chan, MD, MS

In a recent Viewpoint in JACC: Cardiovascular Interventions, Marso and colleagues expressed grave reservations about the application of appropriate use criteria for PCI in a controversial study published last year in JAMA by Chan and colleagues, which found that only half of PCIs performed for nonacute indications were classified as appropriate. Interventional cardiology editors Rick Lange and David Hillis asked CardioExchange members for their […]

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February 15th, 2012

Part 1: Clashing Views of Appropriate Use Criteria for PCI

Paul S. Chan, MD, MS, J Aaron Grantham, MD, FACC, Steve Marso, MD and John Spertus, MD, MPH

In a recent Viewpoint in JACC: Cardiovascular Interventions, Marso and colleagues expressed grave reservations about the application of appropriate use criteria for PCI in a controversial study published last year in JAMA by Chan and colleagues, which found that only half of PCIs performed for nonacute indications were classified as appropriate. Interventional cardiology editors Rick Lange and David Hillis asked CardioExchange […]

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May 11th, 2011

Optimal Medical Therapy and the Lack of COURAGE

William Borden, MD and John Spertus, MD, MPH

We welcome William Borden and John Spertus to answer questions from CardioExchange Editor-in-Chief Harlan Krumholz about their JAMA paper showing that optimal medical therapy (OMT) for patients with coronary artery disease (CAD) did not receive a meaningful boost from the publication of the COURAGE trial, despite the trial’s clear message showing the benefits of OMT. Using […]

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January 4th, 2011

Study Suggests Large Proportion of ICD Implantations Lack Firm Evidence Base

John Spertus, MD, MPH

Study Summary by Larry Husten: An analysis in JAMA of the National Cardiovascular Data Registry (NCDR) shows that a substantial proportion of ICD implantations are not supported by a firm evidence base. Sana Al-Khatib and colleagues examined data from 117,707 patients who received ICDs between January 1, 2006 and June 30, 2009, and found that […]

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November 10th, 2009

Deciding Who Gets Prophylactic ICDs — We Need a Better Way

John Spertus, MD, MPH

The ACC/AHA guidelines endorse prophylactic ICDs for NYHA Class II/III patients with an LV ejection fraction ≤35%, but I’m reluctant to recommend this to my patients who are doing really well. Why put them through the hassle and risk? Will they really benefit, especially if I think they’re just as likely to get an inappropriate […]

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