CardioExchange Archive

February 23rd, 2011

Air Pollution and Cocaine Among MI Triggers Analyzed in Lancet Study

Larry Husten, PHD

Air pollution is a weak cause of MI, increasing risk by only 5%, but because so many people are exposed to polluted air the population effect is quite large. By contrast, cocaine increases MI risk by 23 times, but does not have nearly as large an effect on the population. These are two of the […]

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February 17th, 2011

Unreasonable Expectations for Quality Improvement

John E Brush, MD

At a recent committee meeting, my hospital’s administration announced new quality measures and targets. Striving for top performance, the board of the hospital system set the bar extraordinarily high. The bonuses of senior management are tied to achieving the targets, so the announcement had everyone’s attention. One target that caught my interest was for achieving a […]

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November 8th, 2010

Non-STEMI Patients Delay Seeking Help Just As Long as STEMI Patients

Larry Husten, PHD

Non-STEMI patients delayed going to the hospital for as long in 2006 as they did in 2001, according to a report published in the Archives of Internal Medicine. Henry Ting and colleagues analyzed data from 104,622 non-STEMI patients enrolled in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of […]

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September 20th, 2010

Encouraging Observational Data on Clopidogrel and PPIs

Larry Husten, PHD

Compared with a PPI alone, the combination of clopidogrel and a PPI does not increase risk for cardiovascular events, according to a large observational study from Denmark published in the Annals of Internal Medicine. Mette Charlot and colleagues analyzed data from 56,406 Danish patients discharged after a first MI and found no difference between the […]

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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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August 20th, 2010

Door to Balloon (D2B) Time: The Wrong Performance Measure?

Richard A. Lange, MD, MBA

The authors of a recently published study evaluated the association between system delay (i.e., time from the patient’s first contact with the health care system to initiation of reperfusion) and outcome in STEMI patients transported by EMS and treated with primary PCI.  Some patients were triaged directly to a PCI center, whereas others were transported to their […]

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August 17th, 2010

Going Beyond Door-to-Balloon by Starting Earlier

Larry Husten, PHD

Efforts to speed delivery of PCI to STEMI patients have focused on shortening the door-to-balloon time. Now a group of Danish researchers propose that efforts to improve care must include assessment of treatment from the time of the patient’s first contact with the emergency medical system. Analyzing historical data from 6209 MI patients who received […]

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August 11th, 2010

Colder Outdoor Temperatures Linked to Increase in MIs

Larry Husten, PHD

Researchers in the U.K. used data from 84,000 MI hospitalizations to assess the relationship between the risk for MI and ambient temperature. In their report in the British Medical Journal, Krishnan Bhaskaran and colleagues found no change in risk associated with higher temperatures, but observed a significant 2% increase in the risk for MI associated […]

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August 9th, 2010

Prior Medication Use Shifts Balance of MIs

Larry Husten, PHD

Patients who present with MI and are taking aspirin, beta-blockers, ACE inhibitors, or statins are more likely to have a non-STEMI than a STEMI, according to findings from a large Swedish registry published in the Archives of Internal Medicine. Lena Björck and colleagues analyzed data from over 100,000 consecutive admissions for MI. Some 61% of STEMI […]

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August 4th, 2010

Three Questions about Ticagrelor: Part 2 — Mori Krantz

Sanjay Kaul, MD

PLATO is one of the most impressive trials in recent years, demonstrating substantial benefits for ticagrelor over clopidogrel in a wide population of ACS patients. However, patients enrolled in the US were found to have no benefit from ticagrelor, and experts have been unable to agree on a cause. Possible factors could include much higher doses […]

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