CardioExchange Archive

August 30th, 2011

No Benefit for Routine Counterpulsation Found in CRISP AMI

Larry Husten, PHD

Routine use of intra-aortic balloon counterpulsation (IABC) in STEMI patients who do not have cardiogenic shock does not reduce infarct size, according to a new trial. Results from the CRISP AMI (Counterpulsation to Reduce Infarct Size Pre-PCI Acute Myocardial Infarction) trial were presented at the European Society of Cardiology meeting in Paris by Manesh Patel […]

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August 23rd, 2011

Door-to-Balloon Time Closes In On 1 Hour

Larry Husten, PHD

The door-to-balloon (D2B) time has fallen substantially since the launch of the D2B Alliance campaign in 2006, according to a new report in Circulation. Harlan Krumholz (editor-in-chief of CardioExchange) and colleagues analyzed data reported to CMS from the beginning of 2005 through September 2010. D2B dropped from 96 minutes in 2005 to 64 minutes in the first 9 months of […]

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August 1st, 2011

A Set of Calculators for Estimating Readmission Risk

Harlan M. Krumholz, MD, SM

If you are interested in a tool that estimates the readmission risk of a patient who has been hospitalized for acute myocardial infarction, heart failure, or pneumonia, you can find one at www.readmissionscore.org. Readmission rates are increasingly a focus of quality-of-care efforts in the U.S., including those initiated by the Centers for Medicare and Medicaid […]

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July 11th, 2011

OAT Had Little Impact on Clinical Practice

Larry Husten, PHD

Once again, a study finds that cardiologists don’t always pay attention to the literature and guidelines. In 2006, the Occluded Artery Trial (OAT) showed no benefit for routine PCI in patients with persistently occluded infarct-related arteries identified at least one day after an MI. But the study appears to have had minimal impact on clinical […]

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June 23rd, 2011

The Elusive 30-Minute “Door-In to Door-Out” Benchmark for Primary PCI Transfers

CardioExchange Editors, Staff

The editors at CardioExchange have again asked a panel of experts to respond to a clinically important study. This time it was a retrospective cohort study, published in JAMA, of door-in to door-out (DIDO) times for patients with ST-segment-elevation MI who had been admitted to one hospital and then were transferred to another center for […]

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June 21st, 2011

Study Finds Critical Delay in Most MI Patients Transferred for Primary PCI

Larry Husten, PHD

MI patients who arrive at hospitals unable to perform primary PCI need to be promptly transferred to another hospital in order to receive the full benefits of reperfusion. Unfortunately, these patients often have prolonged door-to-balloon times. A key element in the delay is the time spent at the first hospital, referred to as the door-in […]

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June 13th, 2011

Increased Mortality Found in MI Patients During Ambulance Diversion

Larry Husten, PHD

MI patients who are diverted to other emergency departments (EDs) while their local EDs are closed have an increased risk for death, according to a new study published in JAMA. Yu-Chu Shen and Renee Hsia analyzed data on all Medicare patients with MI from four California counties who were admitted to the hospital between 2000 […]

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May 10th, 2011

Trial REVEALs No Benefit and Some Concerns with Erythropoietin After Primary PCI

Larry Husten, PHD

Erythropoietin alfa failed to reduce infarct size and was associated with more cardiovascular events when given after successful PCI in STEMI patients, according to results from the REVEAL (Reduction of Infarct Expansion and Ventricular Remodeling With Erythropoietin After Large Myocardial Infarction) trial published in JAMA. In the trial, which included a dose-escalation safety phase and a […]

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March 22nd, 2011

Study Explores Lowering the Troponin Diagnostic Threshold

Larry Husten, PHD

Lowering the troponin diagnostic threshold can significantly improve outcomes after MI, claim Scottish investigators in a report published in JAMA. More than 2,000 patients with suspected ACS were studied. Sixty-four percent of patients had troponin concentrations below 0.05 ng/mL, 8% had concentrations from 0.05 to 0.19 ng/mL, and 28% had concentrations 0.20 ng/mL or higher. […]

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March 14th, 2011

The Common Thread Among Top-Performing Hospitals

Leslie Curry, PhD, MPH

A qualitative study just published in the Annals of Internal Medicine outlines some important distinctions between hospitals that have the lowest AMI mortality rates in the U.S and those that have the highest. The key factor? A supportive organizational culture. Here, study investigator Leslie Curry, PhD, MPH walks us through what that means and how […]

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