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Archives for January 2011

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Engage with independent insights, opinions, and analysis from an array of leaders in cardiology.
Avatar of Paul Ridker, MD, MPH

Does CRP Level Modify the Benefit of Statins? Paul Ridker Reacts to New Data (28 Jan 2011)

Paul Ridker, MD, MPH

CardioExchange welcomes Paul M. Ridker, a leading researcher on the value of C-reactive protein (CRP) concentration as a prognostic marker of cardiovascular risk, to respond to the latest data on CRP and statin therapy from the Heart Protection Study (HPS). The New HPS Findings on CRP: The HPS investigators sought to determine whether statin therapy might be especially beneficial to patients with high CRP concentrations. They took the more than 20,000 HPS participants who had been randomized to receive simvastatin (40 mg/day) or placebo for a mean of 5 years… Continue Reading

Avatar of Barry M. Massie, BA (Harvard), MD (Columbia P&S)

The Shame of Removing Reimbursement for End-of-Life Discussions from Health Care Reform (6 Jan 2011)

Barry M. Massie, BA (Harvard), MD (Columbia P&S)

My recent postings have been about heart failure mortality statistics. Dry stuff! It’s not that I am fixated on death, but yesterday, I learned that CMS (Medicare) has decided not to pay for discussions with patients about prognosis and planning end of life care. Reimbursement for such discussions was a key aspect of the health care reform legislation passed this year, and was widely mischaracterized as establishing “death panels.” I cannot imagine a legitimate justification for this rescission to the law. Patients and families are eager for this information, and… Continue Reading

Avatar of Larry Husten, PHD

Study Suggests Large Proportion of ICD Implantations Lack Firm Evidence Base (4 Jan 2011)

John Spertus, MD, MPH

Study Summary by Larry Husten: An analysis in JAMA of the National Cardiovascular Data Registry (NCDR) shows that a substantial proportion of ICD implantations are not supported by a firm evidence base. Sana Al-Khatib and colleagues examined data from 117,707 patients who received ICDs between January 1, 2006 and June 30, 2009, and found that 22.5% of implantations were not evidence based. Newly diagnosed heart failure accounted for more than half of the non-evidence-based implantations. People with MI within 40 days or with NYHA Class IV symptoms accounted for most… Continue Reading

Avatar of Shanti Bansal, MD

Medicare: The MasterCard That Keeps On Giving (3 Jan 2011)

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 on the voyage. Politicians and clergy members desperately urged the sea captains to improve the conditions, but survival rates changed little. But then an economist suggested paying the captains for every prisoner who made… Continue Reading