CardioExchange Archive

January 26th, 2011

Study Finds Declining Stroke Rate After CABG

Larry Husten, PHD

Despite the increasing complexity of cases, the risk of stroke after CABG may be declining, according to a new study published in JAMA. Khaldoun Tarakji and colleagues prospectively studied more than 45,000 patients who underwent CABG at the Cleveland Clinic from 1982 through 2009. The overall stroke rate was 1.6%. The stroke rate was highest in […]

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January 3rd, 2011

PLATO CABG Substudy Raises Hope and Questions

Larry Husten, PHD

The much-anticipated CABG substudy from the PLATO (Platelet Inhibition and Patient Outcomes) trial comparing ticagrelor to clopidogrel in ACS patients has been published online in JACC. About 10% of the 18,624 patients enrolled in  PLATO underwent CABG. The substudy reports on the 1,261 who received the study drug within 7 days prior to their surgery. […]

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December 13th, 2010

False-Positive CT Angiogram Leads to Heart Transplant

Larry Husten, PHD

A 52-year old woman with atypical chest pain ended up with a heart transplant after a CT angiogram to “reassure” her sparked a devastating sequence of events. Following a false-positive CT angiogram, the patient underwent coronary angiography and suffered a dissection of the left main coronary artery, followed by emergency CABG, subsequent graft failure, and […]

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November 8th, 2010

Up-Front Clopidogrel Loading Versus Common Sense

John E Brush, MD

From time to time, a sales representative visits my office promoting clopidogrel (Plavix) as a drug that patients who present with unstable angina/non–ST-segment-elevation MI (UA/NSTEMI) should start immediately as an up-front load. That strategy hasn’t been uniformly accepted in my clinician community because of concern about using an irreversible antiplatelet agent to treat patients who […]

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October 13th, 2010

Transfusions and Cardiac Surgery: “A Major Concern”

Larry Husten, PHD

One new study in JAMA demonstrates very wide differences among hospitals in the use of transfusions during cardiac surgery. A second study finds no differences in outcome based on transfusions. Two editorialists write that “continued inappropriate transfusions among hospitals is a major concern.” Bennett-Guerro and colleagues analyzed the Society of Thoracic Surgeons Adult Cardiac Surgery Database to […]

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September 13th, 2010

Three-year SYNTAX Results: Sensible, Not Sensational

Richard A. Lange, MD, MBA

In SYNTAX, 1800 patients with multivessel and/or left main disease were randomized to CABG or PCI with DES after a surgeon and an interventional cardiologist reviewed the coronary angiogram and agreed that either procedure was appropriate. (See the CardioExchange News blog for more study information.) The SYNTAX 3-year results show that patients with a low SYNTAX […]

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September 8th, 2010

U.S. CABG Centers Rated

Physician's First Watch, CardioExchange Staff

Consumer Reports published ratings for 221 CABG centers in the U.S. on Tuesday. The ratings, based on data collected by the Society of Thoracic Surgeons, take into account 11 performance measures — for example, postoperative renal failure, operative mortality, and surgical re-exploration. All centers included in the report volunteered to have their data made public. A New […]

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July 27th, 2010

CABG in the Real World

Larry Husten, PHD

Two studies in Archives of Internal Medicine look at different aspects of CABG in the real world. Auerbach and colleagues analyzed data from more than 80,000 CABG patients and found that quality can be improved and costs reduced by directing patients away from low-volume surgeons and hospitals in favor of higher-volume surgeons and hospitals. However, […]

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