CardioExchange Archive

August 26th, 2013

Practice Variations and Quality: Ask the “Uber” Expert

Richard A. Lange, MD, MBA and Harlan M. Krumholz, MD, SM

In light of reported variation in practice and outcomes of elective PCI, Rick Lange asks Harlan Krumholz to elaborate on what constitutes high-quality decision making.

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May 6th, 2013

Meta-analysis Finds Same-Day Discharge for Low-Risk PCI May Be Feasible

Larry Husten, PHD

Although elective PCI for most low-risk patients is extremely safe, overnight observation is still standard practice in the U.S., largely due to the lack of evidence demonstrating that same-day discharge is safe. Now a new meta-analysis, published online in the Journal of the American College of Cardiology, provides support for same-day discharge in carefully selected […]

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May 14th, 2012

Selections from Richard Lehman’s Literature Review: Week of May 14th

Richard Lehman, BM, BCh, MRCGP

This week Richard discusses studies of glucose, insulin, and potassium for MI, elective PCI with and without surgical standby, and varenicline and CV risk.

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October 4th, 2011

Is “Stent and Send” Safe for Older Patients?

Richard A. Lange, MD, MBA and L. David Hillis, MD

Should older patients who undergo elective coronary artery stenting be sent home the same day?  Using data from the CathPCI Registry, Rao and colleagues examined outcomes in Medicare-eligible patients who underwent elective, first-time PCI. The investigators identified 107,018 patients (<11% of the million-plus older patients undergoing PCI during 2005–2008 after exclusion of those with ACS or shock and those transferred from another hospital or […]

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October 4th, 2011

Same-Day Discharge After PCI: Safe but Rarely Used

Larry Husten, PHD

Same-day discharge after low-risk PCI is safe but only rarely used, according to a study published in JAMA. Sunil Rao and colleagues analyzed data from 107,018 Medicare patients who underwent PCI at sites taking part in the CathPCI Registry. Only a small percentage (1.25%)  of patients in the study were discharged on the day of the procedure. […]

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July 5th, 2011

Only Half of Nonacute PCIs Deemed Appropriate

Larry Husten, PHD

Only half of all PCIs performed for nonacute cases have a definite indication, according to a report from the National Cardiovascular Data Registry published in JAMA. Paul Chan and colleagues analyzed data from more than half a million PCI procedures performed between July 1, 2009 and September 30, 2010. Out of 500,154 PCIs, they found […]

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January 3rd, 2011

Medicare: The MasterCard That Keeps On Giving

Shanti Bansal, MD

In the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history. At that time, the British government was overburdened with prisoners. A plan was hatched for sea captains to transport many of them to Australia. Due to poor conditions, up to one third died […]

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September 8th, 2010

“Cath Lab, We Have A Problem”?

Richard A. Lange, MD, MBA

According to a recently published study, a huge disconnect apparently exists between patients’ and cardiologists’ beliefs about the benefits of PCI. The patients had been referred for coronary angiography and possible PCI, had discussed PCI with a physician, and had provided informed consent. Most patients (~88%) believed that PCI would reduce their risks of MI, whereas most […]

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September 7th, 2010

Patients Still Overestimate Benefits of Elective PCI

Larry Husten, PHD

Patients who undergo elective PCI continue to overestimate the procedure’s benefits, according to a small study published in the Annals of Internal Medicine. Michael Rothberg and colleagues surveyed 153 patients and 27 cardiologists at a single academic center and found that 88% of the patients thought PCI would reduce their risk for MI and 82% […]

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