Heart Failure


Coronary Artery Disease Affects Half of Discharges With Comorbid Heart Failure and Stroke at Four Texas Hospitals

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By: James Pitt  Jun. 18, 2018

Coronary artery disease (CAD) is the leading cause of death in the US, killing approximately 370,000 people each year. (Coronary heart disease is a synonym). It occurs when plaque builds up in the arteries that feed the heart itself, a condition called coronary atherosclerosis.

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Data for Selected Large Hospitals Shows HFrEF Contributes to as much as 17% of All 30 Day Readmissions for CABG Surgeries

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By: James Pitt  Jun. 13, 2018

Coronary artery disease is a condition in which plaque reduces blood flow through arteries to the heart. One of the most common treatments is coronary artery bypass grafting (CABG). This is a surgical procedure in which healthy blood vessels are grafted onto the heart to provide an alternate route for blood to flow, bypassing the occluded arteries.

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CHI St. Luke's Heart Transplant In-Hospital Mortality Rate is Near National Average

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By: James Pitt  Jun. 11, 2018

Dexur analysts compared the 20 hospitals with the most CMS inpatient discharges for DRGs 001 and 002 from 2013 to 2016. The national average in-hospital mortality rate for DRG 001 patients was 11.94% from January 2013 to December 2016. St. Luke’s in-hospital mortality rate for these patients was 13% in this period, a 1% difference from national average. The other top 20 hospitals also average slightly higher mortality rates than the national average. The highest was 18% at Stanford Health Care (Stanford, CA), and the lowest 7% at Duke University Health System (Durham, NC).

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HFrEF Incidence is Much Higher in PCI Patients with Major Comorbidities at Large Massachusetts Hospitals

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By: James Pitt  Jun. 04, 2018

Percutaneous coronary intervention (PCI) is a vascular procedure in which physicians place a stent inside a coronary artery to improve blood flow. Along with coronary artery bypass grafts (CABG), PCI is one of the most common procedures for coronary revascularization. However, some patients may need further interventions even after revascularization.

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30 Day All Cause Readmissions for AMI with HFrEF is an Indicator of WCD Value

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By: James Pitt  May. 31, 2018

It is difficult for hospitals to analyze the value of solutions whose effects primarily take place outside the hospital setting. Outpatient treatments such as wearable cardiac defibrillators (WCDs) may benefit patients, but these effects primarily take place outside the hospital. CMS’s HRRP program incentivizes reducing 30 day readmission rates for several conditions, including acute myocardial infarction (AMI).

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ICD Implants with Cardiac Catheterization More Often Involve Major Complications, in New Jersey Hospitals

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By: James Pitt  May. 25, 2018

Implantable cardioverter defibrillators (ICDs) can help protect patients at risk of sudden cardiac arrest. Dexur has previously examined ICD use in Jacksonville, Florida.

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Large Michigan Hospitals Show a Wide Variation in ICU stays for AMI Patients Discharged Alive

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By: James Pitt  May. 23, 2018

Acute myocardial infarction (AMI) - also known as heart attack - is a major cause of mortality. Several antiplatelet drugs are commonly used for patients at risk of AMI. A randomized trial of 13,408 patients published in the Lancet finds acute coronary syndrome patients on ticagrelor had lower mortality than patients on clopidogrel. An observational study in France of 54,097 patients found that patients on ticagrelor had lower mortality and were less likely to have ICU stays than patients on clopidogrel.

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Wearable Cardiac Defibrillators May Help Ease ICD Need in Jacksonville

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By: James Pitt  May. 21, 2018

Sudden cardiac arrest (SCA) is a major public health threat. According to the European Society of Cardiology, there are approximately 17 million cardiovascular disease patient deaths worldwide per year, 25% of which are caused by SCA.

Implantable cardiac defibrillators (ICDs) improve survival from SCA, but many patients are not candidates for ICD implant. One solution for these patients is a wearable cardiac defibrillator (WCD). The 2017 paper “Wearable cardioverter defibrillator: Bridge or alternative to implantation?” reviewed the use of WCDs.

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ThoraTec LVADs Could Be Useful in Hospitals with High HFrEF Incidence Rates in Heart Transplant Patients

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By: James Pitt  May. 14, 2018

Ventricular assist devices (VADs) are implantable pumps used to support heart function. VADs are most frequently used for left-sided heart failure (LVADs). There were experiments with air-powered VADs as early as 1963, but first-generation electric VADs were not available until the FDA approved the ThoraTec HeartMate I in 1995.

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Hospital Size Drives Inverse Correlation Between Length of Stay and 30-Day Readmissions for Heart Failure Patients in Missouri

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By: James Pitt  May. 11, 2018

The Center for Medicare and Medicaid Services (CMS) uses average length of stay (LOS) and 30-day readmission rates as measures of hospital quality. However, improving one measure may come at the expense of the other. A 2013 international study of 6848 heart failure patients found that LOS and readmissions were inversely correlated in their study population.

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