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Abstract 32: Have Choosing Wisely Recommendations Changed Diagnostic Testing Patterns for Patients With Syncope? [Session Title: Payments, Policy and Practice]
Conclusions: Among patients presenting to the ED with syncope, rates of both high- and low-value diagnostic testing increased between 2009 and 2013, with substantial variation between hospitals. Thus, the 2012 Choosing Wisely recommendations do not appear to have had a significant effect on testing for patients presenting with syncope. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Anderson, T., Thombley, R. L., Lin, G. A. Tags: Session Title: Payments, Policy and Practice Source Type: research

Abstract 31: Contemporary Trends in Industry Payments to Cardiologists: A Three-Year Analysis of the Open Payments Data [Session Title: Payments, Policy and Practice]
Conclusion: The mean annual payment amount per cardiologist decreased from 2014 to 2016; only a few cardiologists were receiving payments of a significant value every year. Further studies are needed to explore the impact of industry-cardiologist relationships on patient care. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Annapureddy, A., Murugiah, K., Minges, K., Curtis, J. Tags: Session Title: Payments, Policy and Practice Source Type: research

Abstract 30: Appropriate Cardiac Catheterization Lab Activation: Comparison Between Various Lab Activating Groups for Acute ST Elevation Myocardial Infarction [Session Title: Improving Quality of Care]
Conclusion: In this study, approximately 1 out of 6.5 STEMI activations was a false-positive. This trend is the same during working as well as off-hours and does not differ between various STEMI activators. Improved and structured communication between cardiology, emergency medicine, and paramedic teams may promote lower false positive rates and positively impact overall delivery of care. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Ahmad, T. A., Basit, A., Hernandez, E. C., Pattison, Z., Ross, L., Munyon, R., Chambers, C. E., Gilchrist, I. C., Kozak, M., Ettinger, S. M. Tags: Session Title: Improving Quality of Care Source Type: research

Abstract 29: Cardiac Surgery Episode Expenditures Associated With Healthcare-Associated Pneumonia [Session Title: Improving Quality of Care]
Conclusion: New onset pneumonia is associated with 30% higher 90-day episode expenditures in CABG, independent of patient case mix. Prevention efforts could reduce excessive hospital inpatient utilization and save payers hundreds of millions of dollars every year. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Thompson, M. P., Harrington, S. D., Strobel, R. J., Cabrera, L., Zhang, M., Wilton, P., Gandhi, D., DeLucia, A., Paone, G., Prager, R. L., Likosky, D. S. Tags: Session Title: Improving Quality of Care Source Type: research

Abstract 28: Variation in High-Value Cardiovascular Diagnostic Testing: Patient, Payer, and Hospital Effects [Session Title: Improving Quality of Care]
Conclusions: Despite adjustment for patient- and payer-level characteristics, there is 1) significant residual variation in use of high-value cardiac testing and 2) correlation in testing rates for AMI and HF patients among hospitals. These results suggest that hospital-level characteristics and care processes may have a strong influence on use of high-value testing. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Kini, V., Ho, P. M., Magid, D., Mosley, B., Khazanie, P., Salcedo, E., Groeneveld, P., Masoudi, F. Tags: Session Title: Improving Quality of Care Source Type: research

Abstract 27: Anti-Anginal Medication Titration Among Patients With Residual Angina 6-Months After Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From OPEN CTO Registry [Session Title: Improving Quality of Care]
Conclusions: One in 5 patients reported angina 6-months after CTO PCI. Although patients with new or residual angina were more likely to have escalation of AAMs in follow-up compared to those without residual symptoms, only one in 7 patients with residual angina had escalation of AAMs. These results were similar in key subgroups. Although it is unclear whether this finding reflects maximal tolerated therapy at baseline or therapeutic inertia, these findings suggest an important potential opportunity to further improve symptom control in complex stable ischemic heart disease. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Sheehy, J. P., Qintar, M., Arnold, S. V., Sapontis, J., Jones, P., Tang, Y., Lombardi, W., Karmpaliotis, D., Moses, J. W., Patterson, C., Cohen, D. J., Amin, A. P., Nicholson, W. J., Spertus, J. A., Grantham, J. A., Salisbury, A. C. Tags: Session Title: Improving Quality of Care Source Type: research

Abstract 26: Left Ventricular Assist Device Evaluation and Education Processes Across Six Programs: Commonalities and Differences [Session Title: Improving Quality of Care]
Conclusion: Despite similar medical challenges and team structure, large variability was observed across LVAD programs, affecting how medical teams and patients made decisions. Standardization of the process at a higher level and communication between programs may help identify best practices and keep programs consistent. In turn, this could lead to better internal communication and education processes and ultimately improve patient care. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Thompson, J. S., Matlock, D. D., Finnigan-Fox, G., Allen, L. A., McIlvennan, C. K., Khazanie, P., Glasgow, R. E., Morris, M. A. Tags: Session Title: Improving Quality of Care Source Type: research

Abstract 25: Accuracy of Patient Identification of Atrial Fibrillation in the Clinic Setting [Session Title: Predicting the Future]
Conclusion: Approximately one of ten patients incorrectly identified themselves as being in AF despite being in sinus rhythm. Without a standardized method to confirm if symptoms truly correlate with AF these patients may be at risk for unnecessary antiarrhythmic therapies. On the contrary, nearly a third of patients were unaware of AF which reemphasizes the incidence of asymptomatic AF. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Turner, J. L., Hardisty, B. E., Kaur, G., Shah, R. U., Chelu, M. G., Han, F. T., Marrouche, N. F., Steinberg, B. A. Tags: Session Title: Predicting the Future Source Type: research

Abstract 24: Association of Opioids and Cardiovascular Comorbidities [Session Title: Predicting the Future]
Conclusion: A significant minority of Veterans serving or returning from recent deployment is on extended duration of opioids and has a higher likelihood of having cardiovascular risk factors and disease. Our results suggest that the association of CVD mortality with opioid usage may be explained by patients on opioids with increased odds of having CVD risk factors. Future prospective studies are warranted to determine if declines in prescription opioid usage in a relatively young population may reduce risk of developing CVD in later decades. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Chui, P. W., Bastian, L. Tags: Session Title: Predicting the Future Source Type: research

Abstract 23: Lower Heart Rate Variability Associated With Incident Coronary Heart Disease and Death in Post-Menopausal Women [Session Title: Predicting the Future]
Conclusion: In post-menopausal women, lower HRV was associated with a modestly higher, but statistically significant, risk for incident cardiovascular events, including fatal and non-fatal myocardial infarction. Factors associated with lower HRV and cardiac autonomic impairment may be candidates for reducing CHD risk, such as better glycemic control and improved physical activity. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Mohamed, A. S., Qureshi, R., Allison, M. A., Manson, J. E., Roberts, M., Eaton, C. Tags: Session Title: Predicting the Future Source Type: research

Abstract 22: Association of Hospital Race and Payer Mix With Inpatient Mortality Among Patients Admitted for Acute Coronary Syndrome, Heart Failure and Arrhythmia [Session Title: Predicting the Future]
Conclusion: Hospital low payer makeup positively associates with odds of inpatient mortality among patients admitted for acute coronary syndrome and arrhythmia. Hospital black makeup inversely associates with odds of inpatient mortality among patients admitted for heart failure. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Srivastava, P. K., Fonarow, G. C., Bahiru, E., Ziaeian, B. Tags: Session Title: Predicting the Future Source Type: research

Abstract 21: Post-Coronary Revascularization Mortality in Diabetes Patients With and Without End-Stage Renal Disease: Do Outcome Disparities Exist? [Session Title: Predicting the Future]
Conclusions: Results suggest existence of SES and racial disparities in in-hospital post-coronary revascularization mortality in CAD-DM patients independently of the type of procedure, presence of ESRD, comorbidities and demographic covariates. Further studies investigating the responsible mechanisms for these outcome disparities – possibly, disparities in the realized access to primary care – are warranted. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Sergeev, A. V. Tags: Session Title: Predicting the Future Source Type: research

Abstract 20: The Effect of Resistance Training on Survival and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis [Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists]
Conclusion: RT is associated with lower all-cause, CV and all-cancer mortality. RT appears to have an additive effect when combined with AE. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Saeidifard, F., Medina Inojosa, J. R., West, C. P., Olson, T. P., Somers, V. K., Prokop, L. J., Lopez-Jimenez, F. Tags: Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists Source Type: research

Abstract 19: Physical Activity After Chronic Total Occlusion PCI and Its Association With Health Status [Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists]
Conclusion: Participation in regular exercise significantly increased 12 months after CTO PCI, and patients who had greater health status benefit after PCI were more likely to exercise regularly at 12 months. CTO PCI may enable CAD patients with limiting symptoms to engage in regular exercise. Further study of the association between health status improvement and exercise after CTO PCI is needed. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Peri-Okonny, P. A., Spertus, J., Grantham, J. A., Kirtane, A. J., Sapontis, J., Lombardi, W., Karmpaliotis, D., Moses, J., Nicholson, W. J. Tags: Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists Source Type: research

Abstract 18: Center Variation in 90-Day Episode Expenditures for Cardiac Surgery - The Role of Healthcare-Associated Pnuemonia [Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists]
Conclusion: New onset pneumonia after cardiac surgery varies widely across hospitals, and counter to conventional wisdom, is not driven by patient risk. Cardiac surgical programs should consider the prevention and management post-operative pneumonia as a component of their overall strategy for reducing 90-day episode payments. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Thompson, M. P., Harrington, S. D., Strobel, R. J., Cabrera, L., Zhang, M., Wilton, P., Gandhi, D., DeLucia, A., Paone, G., Prager, R. L., Likosky, D. S. Tags: Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists Source Type: research