Cardiovascular Business - January/February 2008 - (Page 11)

› JaMa: False-positives in cath labs up to 14% The frequency of false-positive cardiac catheterization laboratory activation for suspected sT-segment elevation myocardial infarction (sTeMI) is relatively common in community practice, and therefore must be considered regardless of the recent emphasis on rapid door-to-balloon times, according to study published in the Dec. 19, 2007 issue of the Journal of the american Medical association. The authors believe that the “recent emphasis on rapid door-toballoon times must also consider the consequences of false-positive catheterization laboratory activation.” The findings suggest that “false-positive catheterization laboratory activation may be another quality metric to monitor for a sTeMI program.” (CVD), according to a Framingham Heart Study report published Jan. 7, 2008 online in Circulation: Journal of the American Heart Association. When researchers adjusted for traditional cardiovascular risk factors such as high cholesterol, diabetes and high blood pressure, the risk remained significant with a 62 percent higher risk of a cardiovascular (CV) event in participants with low levels of vitamin D compared to those with higher levels. “What hasn’t been proven yet is that vitamin D deficiency actually causes increased risk of cardiovascular disease. This would require a large randomized trial to show whether correcting the vitamin D deficiency would result in a reduction in cardiovascular risk,” the authors wrote Therefore, the researchers do not recommend physicians check for vitamin D deficiency or that those with a known vitamin D deficiency be treated to prevent heart disease at this time. Clinical Hypertension: treatment protocol justified for new onset hypertension Researchers have determined this protocol is clinically justifiable and cost-effective for treating patients with new-onset stage-1 or lower-level stage-2 hypertension: → a serum creatinine → lipid profile (preferably fasting) → glucose (preferably fasting) → potassium → routine urinalysis, and → ECG Their recommendation is based on a case study published in the January issue of the Journal of Clinical Hypertension. The researchers stated that when considering screening tests for large populations, cost-effective analysis is worthwhile. The authors recommended screening limited to hypertensive patients aged 55 to 75 years at a cost of $34,375 for one quality of life year (QALY). study published in the Jan. 3, 2008 issue of the New England Journal of Medicine. The researchers found that delayed defibrillation was associated with a significantly lower probability of surviving to hospital discharge (22.2 percent vs. 39.3 percent when defibrillation was not delayed). In addition, a graded association was found between increasing time to defibrillation and lower rates of survival to hospital discharge for each minute of delay. Expert guidelines advocate defibrillation within two minutes after an in-hospital cardiac arrest caused by ventricular arrhythmia. aiM: Calcium buildup in arteries may increase heart risks in women A new analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) shows that a third of women considered to be low risk based on the Framingham Risk Score had detectable coronary artery calcium on CT scans and were at increased risk for coronary heart disease compared with those without detectable calcium (Arch Intern Med 2007;167(22):2437-2442). The researchers found that the Framingham Risk Score defines the coronary heart disease risk in 95 percent of women. In lowrisk patients, 32 percent were found to have coronary artery calcium present on cardiac CT imaging. There was a six-fold greater risk for a coronary heart disease event including sudden cardiac death and myocardial infarction in women with any coronary calcium compared with women with no detectable coronary calcium in this low Framingham Risk Score population. NeJM: Delay in defibrillation associated with lower cardiac arrest survival rates Delayed defibrillation is common and is associated with lower rates of survival after in-hospital cardiac arrest, according to a CardiovascularBusiness.com Cardiovascular Business 11 http://CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - January/February 2008

Cardiovascular Business - January/February 2008 Contents The Ticker: Quality Pays in Several Ways Cover Story: The Proof: Why Evidence-based Medicine Improves Cardiac Care Clinical Study Digest: Co-payments and Cath Labs Cardiac PET/CT Fills in Gaps Left by SPECT Tapping into IT to Improve the Office-Based Practice SPECT–Proving Its Value Cardiac Images in the EMR: Just a Click Away The Top 20 Ways to Market Your Cardiac CTA Practice The Big Picture: Medical Displays for Cardiac Images Statins Work But Pharmacoeconomic Caveats Abound Driving Data Protection: Opting for Storage On- or Offsite News & Views Calendar Reader’s Resource

Cardiovascular Business - January/February 2008

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