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Rural-Urban Disparities in Outcomes of Myocardial Infarction, Heart Failure, and Stroke in the United States
CONCLUSIONS: Clinical, public health, and policy efforts are needed to improve rural-urban gaps in care and outcomes for acute cardiovascular conditions.PMID:35057913 | DOI:10.1016/j.jacc.2021.10.045
Source: Rural Remote Health - January 21, 2022 Category: Rural Health Authors: Em éfah C Loccoh Karen E Joynt Maddox Yun Wang Dhruv S Kazi Robert W Yeh Rishi K Wadhera Source Type: research

Rules of engagement: The delicate dance between vascular surgeons, industrial partners, and patient outcomes
In 1953, Michael E. DeBakey performed the first carotid endarterectomy successfully. It would be almost 60  years until a new technique disrupted the carotid world with as much furor. In 2012, transcarotid artery revascularization (TCAR) burst onto the scene. With its minimally invasive, hybrid appeal and equivalency to carotid endarterectomy stroke risk, TCAR quickly won the hearts of many vascular sur geons. The update of TCAR technology was rapid, increasing dramatically at 15% annually, with a real jolt coming in 2016 when the Centers for Medicare& Medicaid Services allowed coverage for TCAR under the existing nationa...
Source: Journal of Vascular Surgery - November 19, 2021 Category: Surgery Authors: Anahita Dua Tags: Invited commentary Source Type: research

Long-Term Outcomes of In-Stent Restenosis Percutaneous Coronary Intervention among Medicare Beneficiaries.
CONCLUSIONS: ISR PCI was common and associated with significantly higher risk of recurrent long-term major ischemic events compared to patients undergoing de novo lesion PCI. There remains a need for new strategies to minimize ISR. PMID: 32863243 [PubMed - as supplied by publisher]
Source: EuroIntervention - August 31, 2020 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Differential Longitudinal Outcomes Following Percutaneous Coronary Intervention to the Left Internal Mammary Artery and Other Bypass Grafts of the LAD: Findings From the NCDR.
CONCLUSIONS: Despite similar procedural success rates compared with SVG and other graft types, LIMA interventions were independently associated with lower rates of recurrent MI and repeat revascularization at 1 year. PMID: 32479416 [PubMed - in process]
Source: The Journal of Invasive Cardiology - June 3, 2020 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

IP131. Transfemoral Carotid Angioplasty and Stenting With Embolic Protection: A 7-year Retrospective Analysis of a Single-Center Experience
Carotid angioplasty and stenting (CAS) is an excellent, often superior, alternative to carotid endarterectomy (CEA). When performed by experienced operators, both are equivalent in periprocedural risk and stroke prevention. Widespread adoption of CAS in the United States has been impeded by reimbursement regulations mandated by the Centers for Medicare and Medicaid Services (CMS) that favor CEA over CAS for patients with asymptomatic carotid disease. This policy has led to decreased CAS volumes and an increase in percentages of patients receiving CAS for symptomatic vs asymptomatic disease.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Michael B. Silva, Garold Motes, Zulfiqar Faisal. Cheema, Grant Fankhauser, Nikita Tihonov, Jennifer Worsham, Kaled Diab, Charlie Cheng Tags: IP: Interactive Poster Session Source Type: research

Impact of Ezetimibe on the Rate of Cardiovascular-Related Hospitalizations and Associated Costs Among Patients With a Recent Acute Coronary Syndrome: Results From the IMPROVE-IT Trial (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) Original Articles
Conclusions— Addition of ezetimibe to statin therapy in patients with a recent acute coronary syndrome leads to reductions in cardiovascular-related hospitalizations and associated costs, with the greatest cost offsets in high-risk patients. These cost reductions may completely offset the cost of the drug once ezetimibe becomes generic, and may lead to cost savings from the perspective of the healthcare system, if treatment with ezetimibe is targeted to high-risk patients. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique Identifier: NCT00202878
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2017 Category: Cardiology Authors: Pokharel, Y., Chinnakondepalli, K., Vilain, K., Wang, K., Mark, D. B., Davies, G., Blazing, M. A., Giugliano, R. P., Braunwald, E., Cannon, C. P., Cohen, D. J., Magnuson, E. A. Tags: Secondary Prevention, Cost-Effectiveness, Health Services Original Articles Source Type: research

Comparative Effectiveness of Coronary Artery Bypass Grafting (CABG) Surgery and Percutaneous Coronary Intervention (PCI) in Elderly Patients with Diabetes.
CONCLUSIONS: CABG appears to be the preferred revascularization strategy for elderly patients with diabetes and coronary heart disease. However, this result should be interpreted considering study limitations, for example, several patient clinical variables and physician-related factors which may affect procedure outcomes are not available in the data. Clinical decisions should be individualized considering all patient and physician-related factors. PMID: 27479778 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - August 3, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research

Taking Risk: Early Results From Teaching Hospitals’ Participation in the Center for Medicare and Medicaid Innovation Bundled Payments for Care Improvement Initiative
The authors describe observations from the 27 teaching hospitals constituting the Association of American Medical Colleges (AAMC) cohort in the Center for Medicare and Medicaid Innovation (CMMI) Bundled Payments for Care Improvement (BPCI) initiative. CMMI introduced BPCI in August 2011 and selected the first set of participants in January 2013. BPCI participants enter into Medicare payment arrangements for episodes of care for which they take financial risk. The first round of participants entered risk agreements on October 1, 2013 and January 1, 2014. In April 2014, CMMI selected additional participants who started takin...
Source: Academic Medicine - June 30, 2016 Category: Universities & Medical Training Tags: Articles Source Type: research

Abstract 112: Adherence and Persistence with Statins in Patients with ASCVD Session Title: Abstract Poster Session I and Reception
Conclusions: While patients remained on their first statin (or ezetimibe) therapy for a substantial period of time, a large proportion of patients eventually discontinue therapy. Overall, adherence was high, indicating that ASCVD patients are compliant with their LLT. Interventions and new treatments to improve lipid lowering therapy seem necessary in patients with ASCVD.
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: Burke, J. P., Paoli, C. J., McPheeters, J., Gandra, S. R., Simpson, R. J. Tags: Session Title: Abstract Poster Session I and Reception Source Type: research

Use and Outcomes of Triple Therapy Among Older Patients With Acute Myocardial Infarction and Atrial Fibrillation
ConclusionsApproximately 1 in 4 older AF patients undergoing PCI for MI were discharged on triple therapy. Those receiving triple therapy versus DAPT had higher rates of major bleeding without a measurable difference in composite MI, death, or stroke.
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - August 3, 2015 Category: Radiology Source Type: research

Abstract 166: Developing the Veterans Affairs Cardiac Risk Score Session Title: Poster Session I
Conclusion: We demonstrated that an EHR in a specific population could risk-stratify patients as well those from as organized cohort studies and greatly improve calibration. Further, our finding that the ASCVD score greatly underpredicted in our population, while previous work have reported the ASCVD over-predictind in other cohorts, suggests that rather than arguing about which risk tool is best, our patients may be better served by us focusing on calibrating CV risk tools for our specific patient population using their EHR data.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Sussman, J. B., Wiitala, W., Hofer, T., Zawitowski, M., Vijan, S., Hayward, R. Tags: Session Title: Poster Session I Source Type: research

Outcomes After Carotid Artery Stenting in Medicare Beneficiaries, 2005 to 2009
Conclusions and RelevanceCompeting risks may limit the benefits of CAS in certain Medicare beneficiaries, particularly among older and symptomatic patients who have higher periprocedural and long-term mortality risks. The generalizability of trials like the SAPPHIRE or CREST to the Medicare population may be limited, underscoring the need to evaluate real-world effectiveness of carotid stenosis treatments.
Source: JAMA Neurology - January 12, 2015 Category: Neurology Source Type: research

Comparative effectiveness of drug‐eluting stents on long‐term outcomes in elderly patients treated for in‐stent restenosis: A report from the national cardiovascular data registry
Conclusions: There was lower mortality and reduced risk for MI, revascularization, and stroke, but a similar rate of bleeding with DES compared to other modalities. Our results indicate that DES use is a comparatively effective strategy to treat elderly patients with ISR. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - July 3, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Michael A. Kutcher, J. Matthew Brennan, Sunil V. Rao, David Dai, Kevin J. Anstrom, Nowwar Mustafa, Art Sedrakayan, Michael E. Booth, Pamela S. Douglas, John C. Messenger Tags: Original Study Source Type: research

Long-Term Outcomes After Invasive Management for Older Patients With Non-ST-Segment Elevation Myocardial Infarction Original Articles
Conclusions— Older patients with non–ST-segment elevation MI with significant coronary disease face high long-term risks for mortality and nonfatal cardiovascular outcomes after early catheterization that differ by type of revascularization procedure performed. These findings can help guide the design of studies evaluating long-term therapies among elderly post-MI patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Roe, M. T., Li, S., Thomas, L., Wang, T. Y., Alexander, K. P., Ohman, E. M., Peterson, E. D. Tags: Catheter-based coronary interventions: stents, Acute coronary syndromes, Acute myocardial infarction Original Articles Source Type: research