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Quality management cardiology

Tom Kai Ming Wang, Kok-Lam Chow, Aaron Lin, Alexei Chataline, Harvey White, Matthew Dawes, Greg Gamble, Chris Ellis
AIMS: To review the number, characteristics and clinical management of suspected ACS patients admitted to cardiology and non-cardiology services at Auckland City Hospital, to assess differences between these services and to assess the number who would potentially be enrolled in the All New Zealand Acute Coronary Syndrome (ACS) Quality Improvement Programme (ANZACS-QI) database. METHODS: Auckland City Hospital patient data was extracted from the Australia and New Zealand ACS 'SNAPSHOT' audit, performed over 14 days in May 2012...
March 9, 2018: New Zealand Medical Journal
(no author information available yet)
In recent years, wide ranging biomedical innovation has provided powerful new approaches for prevention, diagnosis and management of diseases. In order to translate such innovation into effective practice, physicians must frequently update their knowledge base and skills through continuing medical education and training. Medical Professional Societies, run as not-for-profit organizations led by peers, are uniquely placed to deliver balanced, disease oriented and patient centred education. The medical industry has a major role in the development of new, improved technology, devices and medication...
February 28, 2018: European Heart Journal
Yan C Duarte Vera, Silvia V Cáceres Vinueza, Jorge E Daher Nader, Joffre F Lara Terán
INTRODUCTION: A review is presented on the evolution of the pharmacological treatment of heart failure (HF) in the last 25 years, from the concept of treatment with vasodilators to the blocking or inhibition of the renin angiotensin aldosterone system. Beta-adrenergic inhibition and its important contribution in the reduction of morbidity and mortality due to HF will be discussed along with the role of the natriuretic peptides. One of the most important studies in the cardiology area, and specifically in the management of HF, is presented, in which an approach is demonstrated of the modulator of the neurohumoral systems that are activated in these patients...
February 28, 2018: Archivos de Cardiología de México
Riccardo Asteggiano, Peter Bramlage, Dimitrios J Richter
Background Transcatheter aortic valve implantation (TAVI) continues to gain popularity in the management of patients with severe aortic stenosis (SAS). Distribution of resources to maximise appropriate use remains a priority. Design & methods To determine the current perceptions and behaviours regarding SAS patient management, an 18-point multiple-choice questionnaire was distributed to European Society of Cardiology (ESC) Council for Cardiology Practice (CCP) e-journal and/or electronic newsletter subscribers...
January 1, 2018: European Journal of Preventive Cardiology
Dany Jaffuel, Nicolas Molinari, Philippe Berdague, Atul Pathak, Michel Galinier, Marion Dupuis, Jean-Etienne Ricci, Jean-Pierre Mallet, Arnaud Bourdin, François Roubille
AIMS: Sleep-disordered breathing (SDB) is a highly prevalent co-morbidity in patients with chronic heart failure (CHF) and can play a detrimental role in the pathophysiology course of CHF. However, the best way to manage SDB in CHF remains a matter of debate. Sacubitril-valsartan has been included in the 2016 European Society of Cardiology guidelines as an alternative to angiotensin-converting enzyme inhibitors to further reduce the risk of progression of CHF, CHF hospitalization, and death in ambulatory patients...
February 22, 2018: ESC Heart Failure
Malin Johansson Östbring, Tommy Eriksson, Göran Petersson, Lina Hellström
BACKGROUND: Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes. OBJECTIVE: This study aims to evaluate the effects on treatment goals of an intervention designed to improve patient adherence and treatment quality in secondary prevention of coronary heart disease...
February 20, 2018: JMIR Research Protocols
Jordan Wooley, Holly Neatherlin, Cecile Mahoney, John J Squiers, Deborah Tabachnick, Mitta Suresh, Eleanor Huff, Sukhdeep S Basra, J Michael DiMaio, David L Brown, Michael J Mack, Elizabeth M Holper
The Centers for Medicare and Medicaid Services National Coverage Determination requires centers performing transcatheter aortic valve implantation (TAVI) to report clinical outcomes up to 1 year. Many sites encounter challenges in obtaining complete 1-year follow-up. We report our process to address this challenge. A multidisciplinary process involving clinical personnel, data and quality managers, and research coordinators was initiated to collect TAVI data at baseline, 30 days, and 1 year. This process included (1) planned clinical follow-up of all patients at 30 days and 1 year; (2) query of health-care system-wide integrated data warehouse (IDW) to ascertain last date of clinical contact within the system for all patients; (3) online obituary search, cross-referencing for unique patient identifiers to determine if mortality occurred in remaining unknown patients; and (4) phone calls to remaining unknown patients or patients' families...
January 2, 2018: American Journal of Cardiology
Linda Long, Lindsey Anderson, Alice M Dewhirst, Jingzhou He, Charlene Bridges, Manish Gandhi, Rod S Taylor
BACKGROUND: A previous Cochrane review has shown that exercise-based cardiac rehabilitation (CR) can benefit myocardial infarction and post-revascularisation patients. However, the impact on stable angina remains unclear and guidance is inconsistent. Whilst recommended in the guidelines of American College of Cardiology/American Heart Association and the European Society of Cardiology, in the UK the National Institute for Health and Care Excellence (NICE) states that there is "no evidence to suggest that CR is clinically or cost-effective for managing stable angina"...
February 2, 2018: Cochrane Database of Systematic Reviews
Masao Daimon, Makoto Akaishi, Toshihiko Asanuma, Shuji Hashimoto, Chisato Izumi, Shiro Iwanaga, Hiroya Kawai, Hiroyuki Toide, Akihiro Hayashida, Hirotsugu Yamada, Mitsushige Murata, Yutaka Hirano, Kengo Suzuki, Satoshi Nakatani
Echocardiography plays a pivotal role as an imaging modality in the modern cardiology practice. Information derived from echocardiography is definitely helpful for a patient care. The Japanese Society of Echocardiography has promoted echocardiography for a routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure it, we believe equipment in good conditions and a comfortable environment are important for both a patient and an examiner...
January 23, 2018: Journal of Echocardiography
Michel Komajda, Mathieu Kerneis, Luigi Tavazzi, Serban Balanescu, Francesco Cosentino, Alberto Cremonesi, Roberto Ferrari, Serge Kownator, Hanna Szwed, Iveta Mintale, Zoran Olivari, Harald Rittger, Evgeny V Shlyakhto, Rimvydas Slapikas, Philippe Gabriel Steg, Marco Valgimigli, Eric Van Belle, Konstantinos Tsioufis, Wojciech Majda, Cécile Laroche, Aldo P Maggioni
Aim Chronic ischaemic cardiovascular disease (CICD) remains a leading cause of morbidity and mortality worldwide. The CICD Pilot Registry enrolled 2420 patients across 10 European Society of Cardiology countries prospectively to describe characteristics, management strategies and clinical outcomes in this setting. We report here the six-month outcomes. Methods and results From the overall population, 2203 patients were analysed at six months. Fifty-eight patients (2.6%) died after inclusion; 522 patients (23...
January 1, 2018: European Journal of Preventive Cardiology
Ashok Kumar, B C Kalmath, Georgi Abraham, Johann Christopher, Pln Kaparthi, Louie Fischer, Neeta Deshpande, N K Mishra, Praveen Raj, Rajesh Javerani, Ramesh Goyal, Reefa Dsouza, Shashank R Joshi
Despite maintaining mean blood pressure at optimal levels, cardiovascular complications still occur in hypertensive patients. Blood pressure variability (BPV) has been implicated as a prominent factor responsible for incurring this additional risk. In this review we attempted to generate a consensus on the importance of BPV in the hypertension management and to evaluate different therapeutic options available to reduce BPV. Panel comprising of 11 leading experts from India in different areas of clinical practice (including nephrology, diabetes and endocrinology, cardiology, and critical care medicine) was convened...
December 2017: Journal of the Association of Physicians of India
Stefano Fumagalli, Salah A Said, Cecile Laroche, Debbie Gabbai, Serena Boni, Niccolò Marchionni, Giuseppe Boriani, Aldo P Maggioni, Agata Musialik-Lydka, Adam Sokal, Jens Petersen, Harry J G M Crijns, Gregory Y H Lip
Aims: Diabetes mellitus (DM) is one of the most important cardiovascular (CV) risk factors. The aim of this study was to evaluate clinical correlates of DM, including management and outcomes, in the EURObservational Research Programme (EORP) - Atrial Fibrillation (AF) General Pilot (EORP-AF) Registry of the European Society of Cardiology. Methods and Results: We studied consecutive patients (N = 3101) enrolled in 70 centers of 9 European countries between February 2012 and March 2013, and compared diabetics with non-diabetics during a one-year follow-up...
December 22, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
Kornelia Kotseva
The Joint European Societies (JES) guidelines on cardiovascular disease (CVD) prevention published in 1994, 1998, 2003, 2007, 2012 and 2016 defined lifestyle and risk factors targets for patients with coronary or other atherosclerotic disease and people at high risk of developing CVD. Guideline implementation in Europe has been evaluated with four cross-sectional EUROASPIRE surveys starting in mid-1990s. The results showed poor lifestyle and risk factor management in patients with CHD and in high CVD risk people with high prevalences of smoking, obesity, central obesity and diabetes...
December 2017: Cardiovascular Diagnosis and Therapy
Richard Naspro, Lori B Lerner, Roberta Rossini, Michele Manica, Henry H Woo, Ross J Calopedos, Cecilia M Cracco, Cesare M Scoffone, Thomas R Herrmann, Jean J de la Rosette, Jean-Nicolas Cornu, Luigi F DA Pozzo
INTRODUCTION: The number of patients on chronic anticoagulant or antiplatelet therapy requiring endoscopic urological surgery is increasing worldwide. Therefore, there is a strong demand to standardize the peri-operative treatment of this cohort of patients, both from a surgical and cardiological point of view, balancing the risks of bleeding versus thrombosis, and the important possible clinical and medical legal repercussions therein. EVIDENCE ACQUISITION: Although literature is scarce and the quality of evidence quite low, in line with other surgical specialties, guidelines and recommendations for the management of urological patients have begun to emerge...
December 14, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Joseph A Ladapo, Matthew J Budoff, David Sharp, Jane Z Kuo, Lin Huang, Bruce Maniet, Lee Herman, Mark Monane
BACKGROUND: Diagnosing obstructive coronary artery disease (CAD) is challenging in elderly adults, and current diagnostic approaches for CAD expose these individuals to risks from contrast dye and invasive procedures. DESIGN: A Registry to Evaluate Patterns of Care Associated with the Use of Corus CAD in Real World Clinical Care Settings (PRESET; NCT01677156), pragmatic clinical trial. SETTING: Community, 21 primary care practices. PARTICIPANTS: Of 566 stable, nonacute outpatients presenting with symptoms suggestive of obstructive CAD, the 176 who were aged 65 and older (median age 70, 61% female) were the current study participants...
February 2018: Journal of the American Geriatrics Society
Robert Tulloh, Kostas Dimopoulos, Robin Condliffe, Paul Clift
BACKGROUND: Pulmonary arterial hypertension (PAH) is a well-recognised complication of adult congenital heart disease (CHD). However, management is not currently standardised between centres and specific guidelines are lacking. In order to identify and understand the unmet needs related to PAH associated with CHD (PAH-CHD), a survey of physicians was performed. METHODS: An electronic survey was sent to two physician groups: (1) cardiologists registered in a UK cardiology directory; (2) specialist pulmonary hypertension (PH) physicians known to manage patients with adult PAH-CHD...
November 13, 2017: Heart, Lung & Circulation
M Haude
After 5 years the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have released an update on the guidelines for the management of valvular heart diseases. In recent years published results of randomized trials in patients with aortic valve stenosis have resulted in updated recommendations for catheter-based prosthesis implantation (TAVI), which is now extended to patients presenting without a low risk for conventional surgical valve replacement. In mitral or tricuspid valvular disease, the recommendations for catheter-based therapies are less strong because of a lack of supportive scientific data...
December 2017: Herz
Steven A Farmer, Paul N Casale, Linda D Gillam, John S Rumsfeld, Shari Erickson, Neil M Kirschner, Kevin de Regnier, Bruce R Williams, R Shawn Martin, Mark B McClellan
Importance: The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD)...
November 22, 2017: JAMA Cardiology
Meghan Rombeek, Stefanie De Jesus, Luis Altamirano-Diaz, Eva Welisch, Harry Prapavessis, Jamie A Seabrook, Kambiz Norozi
Background: Both obesity and congenital heart disease (CHD) are risk factors for the long-term cardiovascular health of children and adolescents. The addition of smart mobile technology to conventional lifestyle counseling for weight management offers great potential to appeal to technologically literate youth and can address a large geographical area with minimal burden to participants. This pilot study seeks to examine the influence of a 1-year lifestyle intervention on nutrition and physical activity-related health outcomes in overweight or obese children and adolescents with CHD...
2017: Pilot and Feasibility Studies
John Cordina, Gillian E Mead
BACKGROUND: Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects. OBJECTIVES: To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk of stroke, peripheral embolism, and mortality...
November 15, 2017: Cochrane Database of Systematic Reviews
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