This week’s topics include a study on chest pain (or lack thereof) in patients with MI and a trial of cardiovascular family history taking.
Archives for February 2012RSS
A Call for Help to Reduce Readmissions (24 Feb 2012)Harlan M. Krumholz, MD, SM
The national focus on readmissions (e.g., Partnership for Patients) has yet to yield improvements in performance. Many clinicians and hospitals are seeking help in their efforts to reduce readmission rates. Hospital to Home, a national quality improvement initiative led by the American College of Cardiology and the Institute for Healthcare Improvement, has posted a list of links to programs and tools that might be helpful to you. Most recently we posted a link to resources organized by the VA. The VA toolkit includes order sets, pathways, and guidelines. We will… Continue Reading
I am reading the new paper from NRMI in JAMA on the association of age and sex with AMI symptom presentation and am struck by the finding that 35% of the patients did not present with chest pain. This percentage is higher than I have seen elsewhere. In our recent studies, spanning many sites, we have found that almost 90% of the patients present with typical or atypical chest pain. In the GRACE registry, “chest pain was the most common symptom for both men (94%) and women (92%).” The NRMI… Continue Reading
This week’s topics include LVH, pollution and MI, the genetics of cardiomyopathy, atrial fibrillation, and aspirin for primary prevention.
What Are the Lessons of the Riata ICD Lead Recall? (16 Feb 2012)Edward J. Schloss, MD
Let’s enforce a robust, active postmarket surveillance system that will allow doctors in the field to draw their own conclusions about the safety of devices based on much better data without hampering innovation.
Two mortality-risk calculators – one for patients with acute MI and another for those with heart failure – are now available for free at www.mortalityscore.org. The calculators are based on risk models produced by our research group at Yale for the Center for Medicare and Medicaid Services (CMS). The models are derived from Medicare administrative-claims data for AMI and heart failure that the CMS reports publicly on its Hospital Compare website. Because the models were designed to predict 30-day mortality as strongly as possible, they have more variables than we… Continue Reading
A member wants to know what our readers think of two Heart and Stroke Foundation of Canada (HSF) ads. Are they a legitimate way to “wake up” people to the threat of cardiovascular disease? Or unnecessary and counterproductive scare tactics?
This week’s topics include communicating with patients about screening and treatment and the association between blood-pressure-lowering drugs and gout.
Pop Quiz (13 Feb 2012)Westby G Fisher, MD
To celebrate Heart Month, CardioExchange welcomes this fun bit of trivia from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem in Evanston, Illinois, and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes. What does this graph represent? Hint: you were probably on it. Scroll down for the answer. The x axis is weeks (of gestation), the y axis is heart rate…. Continue Reading
What Are You Doing About Readmission Rates? (9 Feb 2012)Harlan M. Krumholz, MD, SM
Today there was news that an insurance company may start incorporating incentives about readmission into its contracts. What are you doing about readmission rates at your institution?