CardioExchange Archive

January 16th, 2014

Are All Carotid Stenting Systems Equal?

Jay Giri, MD, MPH and Robert W. Yeh, MD MSc MBA

Jay Giri and Robert W. Yeh discuss their research group’s analysis of patient-registry data on embolic protection devices that are commonly used in carotid artery stenting.

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September 18th, 2013

Disparities in Rate of Inappropriate Use of PCI

Paul S. Chan, MD, MS

Paul Chan answers questions about his new study in JACC that found a surprising pattern of both overuse and underuse of PCI among different populations in the US.

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September 18th, 2013

Both Overuse and Underuse Explain Disparities in Coronary Revascularization

Larry Husten, PHD

A new study finds that groups who have often been found to receive less medical care — non-whites, women, and people without private insurance or who are from urban and rural areas — are less likely to undergo coronary revascularization. But the same study finds that this disparity may be in no small part due to […]

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September 16th, 2013

Combining Randomized Trials And Registries: A New Paradigm

John S Rumsfeld, MD, PhD

Ultimately, we need clinical trials to know what drugs and medical devices work. Without them, we will not have the evidence we need for clinical practice guidelines, and clinical care will not evolve. But traditional clinical trial approaches are not sustainable – too expensive and too inefficient. The new hope for clinical trials is to […]

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September 4th, 2013

Too Much Emphasis on Door-to-Balloon Time?

Larry Husten, PHD

One of the great medical advances in recent years has been the improved treatment of acute myocardial infarction. As the enormous benefits of earlier reperfusion became evident, medical systems in many parts of the world aimed to treat increasing numbers of patients in a shorter time frame. The door-to-balloon (D2B) time as a performance measure […]

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May 14th, 2013

Study Questions Role of Dual-Chamber ICDs for Primary Prevention

Larry Husten, PHD

The majority of patients who receive an ICD for primary prevention without a pacing indication have a dual-chamber ICD implanted. Although there are a number of theoretical advantages with dual-chamber devices, they are more likely to cause complications than single-chamber devices. Although CMS requires providers to justify the medical necessity of dual-chamber devices, current guidelines […]

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March 25th, 2012

Is it Impossible to Break into Clinical Research? Debunking a Common Misperception

Jeremiah Depta, MD

Using the National Cardiovascular Data Registry to identify and pursue good research opportunities

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February 8th, 2012

Prominent Interventionalists Attack Appropriate Use Criteria for PCI

Larry Husten, PHD

A group of leading interventional cardiologists has launched an attack on the growing role of appropriate use criteria (AUC) for PCI in the U.S. They argue that severe flaws in current guidelines render unreliable attempts to assess the rate of appropriate procedures. In a paper published in JACC: Cardiovascular Interventions, Steven Marso and colleagues (Paul Teirstein, Dean […]

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August 9th, 2011

New Study Finds Wide Variation Among Hospitals in Diagnostic Yield for Angiography

Larry Husten, PHD

Last year a report in the New England Journal of Medicine from the National Cardiovascular Data Registry (NCDR) raised concerns about the low diagnostic yield for diagnostic coronary angiography. Now a new analysis of the NCDR registry appearing in the Journal of the American College of Cardiology finds a great deal of variability among hospitals […]

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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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