Comparing cardiac treatments
[black small square] A recent study compared coronary angioplasty with fibrinolytic therapy in acute myocardial infarction (AMI). Researchers noted that primary angioplasty is viewed as a better treatment than fibrinolysis for patients admitted to hospitals with angioplasty facilities, but questioned whether the same holds true for patients who require transportation from one hospital to another where invasive treatment is possible.
Researchers compared data from 1,572 randomly assigned patients with AMI, who received either angioplasty or accelerated treatment with intravenous alteplase. They concluded that a reperfusion strategy involving transferring patients to a center where they could receive primary angioplasty was more effective than on-site fibrinolysis, but stipulated that the transfer should take 2 hours or less.
Source: Anderson, R., et al.: "A Comparison of Coronary Angioplasty with Fibrinolytic Therapy in Acute Myocardial Infarction," The New England Journal of Medicine. 349:733-742, Aug. 21, 2003.
Readmission a concern with heart surgery
[black small square] A recent study aimed to pinpoint specific readmission predictors following coronary artery bypass graft (CABG) surgery. Researchers studied causes of readmission within 30 days after CABG surgery for the period of one year in New York state. Out of 16,325 CABG patients, 12.9% were readmitted postsurgery. Postsurgical infection and heart failure were the most common reasons. The researchers noted that certain patient characteristics make readmission more likely, including older age, greater body surface area, and female gender. After allowing for these, they noted that physicians performing fewer than 100 CABG surgeries a year and hospitals with higher post-heart surgery mortality rates contributed to higher readmission rates. Additionally, discharge to an acute care facility or nursing home and a hospital stay longer than 5 days increased the rate of readmission.
Source: Hannan, E., et al.: "Predictors of Readmission for Complications of Coronary Artery Bypass Graft Surgery," The Journal of the American Medical Association. 290:773-780, 2003.