Location a possible factor in heart attack survival
Recent analysis of hospital data found that odds of heart attack survival may be related to the state in which patients live. Research focused on 1,999 patients from 11 states, chosen to represent regions of the United States. In-hospital mortality rates were highest (around 11%) in New York, California, Maryland, and South Carolina, and lowest (between 8% and 9%) in Oregon, Arizona, Colorado, and Washington state. One possible reason for this variation is the percentage of patients receiving angioplasty. The rate of angioplasty ranged from less than 17% in Maryland to 36% in Colorado. Patients receiving angioplasty had a much lower death rate at 1.8%, compared with the 10.4% rate observed among all patients.
Source: Heart attack survival may depend on where you live. Reuters Health. Available at: http://www.reutershealth.com/archive/2005/12/02/eline/links/20051202elin019.html. Accessed February 1, 2006.
Severe heart failure patients benefit from PCI
Treatment with percutaneous coronary intervention (PCI) improves survival in severe heart failure patients. PCI patient survival rates are much higher than survival rates of those receiving medical therapy alone, researchers say. In an analysis of 306 patients, half received only medical therapy and half were treated with PCI or open-heart surgery. Researchers observed these patients for 3 years, during which 84 patients died. The mortality rate was 15% in the PCI/surgery group and 35% in the medical group. Results are encouraging, but experts note that these treatments, though beneficial to some patients, continue to show relatively poor outcomes. Thus, healthcare providers should focus on efforts to prevent severe heart failure.
Source: PCI or surgery improves survival in patients with severe heart failure. Reuters Health. Available at: http://www.merckmedicus.com/pp/us/hcp/hcp_newsarticle.jsp?newsid=554015&newsgrou. Accessed February 1, 2006.
Low-molecular-weight heparin may not reduce HIT risk
Incidence of heparin-induced thrombocytopenia (HIT) is no less in patients treated with low-molecular-weight heparin (LMWH) than in those treated with unfractionated heparin (UFH). A recent study analyzed HIT in 1,754 patients being treated with LMWH. Thirty-five patients experienced a platelet drop of at least 50%. Patients with prior exposure to heparin developed HIT at a rate 4.9 times higher than others. Based on these results, researchers advise that platelet count be monitored with equal frequency whether nurses are administering LMWH or UFH. A patient's previous exposure to heparin should be taken into account during treatment.
Source: Boggs W. Heparin-induced thrombocytopenia risk no less with low-molecular-weight heparin. Reuters Health. Available at: http://www.reutershealth.com/archive/2005/12/02/professional/links/20051202clin0. Accessed February 1, 2006.
Epidemic strain of C. difficile observed
Increased reports of C. difficile-associated disease suggest the emergence of an epidemic strain, according to two reports released in December 2005. In one report, researchers compared 187 C. difficile isolates occurring since 2001 with 6,000 isolates occurring between 1984 and 1990. They identified the predominant strain, causing 51% of current isolates, as BI/NAP1, a type that comprised only 14 of the historic cases. Current isolates showed resistance to fluoroquinolones. A second report, investigating 1,719 cases occurring between January and June of 2004, found a similar predominant strain in its results. Researchers encourage strict infection-control measures, advising healthcare workers to use soap and water rather than alcohol-based sanitizers during outbreaks, as C. difficile spores aren't affected by alcohol.
Source: New epidemic strain of C. difficile seen emerging in North America. Reuters Health. Available at: http://www.reutershealth.com/archive/2005/12/02/professional/links/20051202publ0. Accessed February 1, 2006.