CardioExchange Archive

September 20th, 2011

Slow Spots in Transfer of Primary PCI Patients

Larry Husten, PHD

A new study in Circulation helps identify the precise causes for delays that occur when STEMI patients are transferred for primary PCI.

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August 30th, 2011

Intra-Aortic Balloon Counterpulsation (IABP) Burned to a CRISP

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

Intra-aortic balloon counterpulsation (IABP) is a bust in AMI patients without cardiogenic shock, according to the Counterpulsation to Reduce Infarct Size Pre-PCI Acute Myocardial Infarction (CRISP AMI) trial. This open-label, 30-center, randomized, controlled trial was performed to determine if a routine strategy of IABP before primary PCI (and continued for at least 12 hours afterward) would […]

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February 18th, 2011

A Case of Clopidogrel Nonresponsiveness?

Tariq Ahmad, MD, MPH and James Fang, MD

This latest installment in our case discussion series is submitted by Tariq Ahmad, MD, MPH. We encourage members to submit cases that they believe warrant discussion. Selected cases will be presented to the community, and case authors will receive a $100 Amazon gift card. A 70-year-old woman presents to the ED with an anterior STEMI. She […]

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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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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 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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August 3rd, 2010

Three Questions about Ticagrelor: Part 1 — Sanjay Kaul

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 showed no benefit from ticagrelor, and experts have been unable to agree on a cause. Possible factors could include much higher doses of aspirin used […]

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