Cath Lab Digest - November 2007 - (Page 46)

46 CLINICAL AND INDUSTRY NEWS NOVEMBER 2007 Five-Gene Genetic Risk Score cont. After adjusting for traditional risk factors, those individuals with a highrisk GRS had a 57% increased risk of incident CHD, which is similar to the magnitude of risk for CHD associated with smoking, hypertension, hypercholesterolemia, or obesity. The study results appeared in the October 2007 edition of Genetics in Medicine, and are available on the journal’s website at http://www.geneticsinmedicine.org. The lead author was Lance Bare, PhD, Associate Director of Cardiovascular Disease at Celera, and the collaborators on the work were investigators from the University of Texas Health Science Center, the Texas Heart Institute, the University of Minnesota, the Cleveland Clinic Foundation, and the University of San Francisco, CA. “Physicians need a better assessment of an individual's risk for coronary heart disease than that obtained using traditional risk factors alone,” said James T. Willerson, MD, President of The University of Texas Health Science Center at Houston, and President-elect Texas Heart Institute, and a co-author on the study. “Applying the results of this research study towards the development of a diagnostic test to determine genetic risk for coronary heart disease could lead to more effective prevention and treatment for patients.” “The identification of this Genetic Risk Score is a result of a broad collaboration over the past several years involving multiple large studies,” said Thomas J. White, PhD, Chief Scientific Officer at Celera. About the Genetic Risk Score. For each of the five variants, the participant’s GRS was increased by 1 if the participant was homozygous (had two copies of the variant) for the risk variant, unchanged if heterozygous (one copy), and decreased by 1 if the individual did not carry the risk variant. Therefore, individuals carrying all 10 possible risk variants were assigned a GRS of 5 and those carrying no risk variants were assigned a GRS of -5. A high GRS was defined as a GRS of 3 or higher. Approximately 4 percent of the Caucasian cohort in the ARIC study was classified as high risk, and this high-risk group had a 52-percent higher CHD event rate compared to the rest of the individuals. A similar trend was observed for AfricanAmerican participants in the study. About Atherosclerosis Risk in Communities Study (ARIC). The Atherosclerosis Risk in Communities Study (ARIC), sponsored by the National Heart, Lung and Blood Institute (NHLBI), is a large-scale, long-term prospective study with 13 years of follow-up that is being conducted to investigate associations of established and suspected coronary heart disease risk factors with CHD in men and women from four American communities. The project has two components: community surveillance of morbidity and mortality and repeated examinations of a representative cohort of men and women in each community. The community surveillance involves abstracting hospital records and death certificates and investigating out-of-hospital deaths. The 15,792 members of the cohort include African-American and Caucasian males and females, who were 45 to 64 years old at baseline. ■ Bioabsorbable Stents Expected to Enter Coronary Stent Market in 2012 M illennium Research Group forecasts that the bioabsorbable stent, expected to enter the market in 2012, will be used in almost 4% of stent procedures in its first year of use. This device is expected to replace the drug-eluting stent (DES) as the gold standard treatment for patients with coronary artery disease, according to Millennium Research Group’s Emerging Technologies for the Diagnosis and Treatment of Coronary Artery Disease 2008 report. Depending on the outcome of ongoing research efforts, bioabsorbable stents could capture over 80% of stent procedures within 5 years of their release. Fueling this growth will be bioabsorbable stents’ lowered requirement for antiplatelet therapy. Patients find longterm drug regimens to be burdensome, and a small percentage of patients are physically unable to be put on antithrombotic drugs due to allergies or other complications. The introduction of bare-metal stents (BMS) in the early 1990s revolutionized the practice of interventional cardiology around the world. Restenosis was, however, a significant obstacle to obtaining effective and long-lasting results with these devices. As a result, firms sought further improvements in stent technology. The 2003 launch of DES in the U.S. reduced restenosis rates to below 10%. Nevertheless, DES use has decreased significantly since recent clinical studies associated metallic stents with late stent thrombosis. The discovery of the heightened late stent thrombosis risk has increased the demand for new variations of DES, such as polymer-free stents, bioabsorbable polymer-coated stents, and above all, fully bioabsorbable stents. In addition to bioabsorbable stents, the Emerging Technologies for the Diagnosis and Treatment of Coronary Artery Disease 2008 report also covers polymer-free and bioabsorbable polymer-coated stents, synthetic coronary artery bypass grafts, remote catheter navigation technolo- gy, novel diagnostic imaging technologies, and therapeutic angiogenesis using gene and stem cell therapy. This report includes coverage of industry competitors, including Abbott Vascular, Advanced Cell Technology Inc., Bioabsorbable Therapeutics Inc., Biosensors, BIOTRONIK, Boston Scientific, Cardium Therapeutics, CardioVascular BioTherapeutics Inc., Cytori Therapeutics, Hansen Medical, InfraReDx, MIV Therapeutics, OrbusNeich, REVA Medical, Sahajanand Medical Technologies, Sorin Group, Stereotaxis, Terumo, Thermocore Medical, and more. More information is available on www.mrg.net. ■ Mortality Rates 71% Lower at Top-Rated Hospitals: HealthGrades Annual Hospital-Quality Study P atients have on average a 71 percent lower chance of dying at the nation’s top-rated hospitals compared with the lowest-rated hospitals across 18 procedures and conditions analyzed in the tenth annual HealthGrades Hospital Quality in America Study, issued by HealthGrades, the healthcare ratings company. The study, which documents a wide variation in the quality of care between the highest-performing hospitals and all others, also found that if all hospitals performed at the level of hospitals rated with five stars by HealthGrades, 266,604 Medicare lives could potentially have been saved over the three years studied. The HealthGrades study of patient outcomes at the nation’s approximately 5,000 hospitals covers more than 41 million Medicare hospitalization records over the years 2004 to 2006. The study examines procedures and conditions ranging from heart attack to pneumonia to valve-replacement sur- gery. Based on the study, HealthGrades made available its 2008 quality ratings for virtually every hospital in the country at www.healthgrades.com, a website designed to help individuals research and compare local healthcare providers. According to the study, mortality rates at America’s hospitals have improved 11.8 percent from 2004 to Continued on next page http://www.geneticsinmedicine.org http://www.geneticsinmedicine.org http://www.mrg.net http://www.healthgrades.com

Table of Contents Feed for the Digital Edition of Cath Lab Digest - November 2007

Henry Ford Heart and Vascular Institute Treating Patients with Complex Vascular Disease with a Multi-Disciplinary Approach Improving Patient Compliance with Antiplatelet Medications Clinical Editor’s Corner Cath Lab Nurse/Tech Vascular Access and Closure Using the StarClose® Device The Clinical and Economic Impact of Measuring Fractional Flow Reserve FFR and Choosing an Optimal Revascularization Strategy Finally! The New Registered Cardiac Electrophysiology Specialist (RCES) Credential Use of a Mobile Lab to ‘Test the Waters’ at a Rural Hospital Remembering a Cardiac Cath Lab History ACVP• Membership Page What Do You Think? The Ten-Minute Interview with… Ernie Livingston, RN, BSN SICP* Chapter Updates Who’s in Charge? Working to Eliminate Bottlenecks: Florida Hospital’s Cardiac Cath Lab Achieves Greater Efficiency and Higher Satisfaction Preserving Left Ventricular Function during Percutaneous Coronary Intervention Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Making the Most of Your First Impression: Interviewing Tips and Techniques CEU Education Center Clinical & Industry News Meetings Calendar

Cath Lab Digest - November 2007

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