Reducing Heart Failure Hospital Readmissions: A Systematic Review of Disease Management Programs.

The recent enactment of the Patient Protection and Affordable Care Act which established the federal Hospital Readmissions Reduction Program (HRRP) has accelerated efforts to develop heart failure (HF) disease management programs (DMPs) that reduce readmissions in patients hospitalized for HF. This systematic review identified randomized controlled trials of HF DMPs which included home care, outpatient clinic interventions, structured telephone support, and non-invasive and invasive telemonitoring. These different types of DMPs have been associated with conflicting results.

Efficacy and safety of transulnar coronary angiography and interventions--a single center experience.

Objectives: To evaluate the efficacy and long-term safety of transulnar approach in complex coronary interventions.

Background: The success rate of transulnar approach in complex coronary interventions and its long-term safety remains to be proven.

Methods: We conducted a retrospective chart review of patients undergoing transulnar coronary angiography and interventions at our institution from January 2004 through July 2009.

Development and validation of a risk calculator for prediction of cardiac risk after surgery.

Background: Perioperative myocardial infarction or cardiac arrest is associated with significant morbidity and mortality. The Revised Cardiac Risk Index is currently the most commonly used cardiac risk stratification tool; however, it has several limitations, one of which is its relatively low discriminative ability. The objective of the present study was to develop and validate a predictive cardiac risk calculator.

Impact of statin use on heart failure mortality.

Background: There is conflicting data regarding the mortality benefit of statins in patients with heart failure. The objectives of our study were to determine whether statin therapy is associated with decreased all-cause mortality and to assess the effect of incremental duration of therapy.

Methods: We studied 10,510 consecutive patients from the Veterans Affairs health system with a diagnosis of heart failure from January 2002 through December 2006.

Transient midventricular ballooning: a case report and review of the literature.

Background: We describe a case of transient left midventricular ballooning in 68-year-old male patient presented with picture of acute coronary syndrome.

Case Presentation: The left ventriculogram showed mid ventricular akinesis and dilatation along with hypercontractile apex and basal segments. Follow up echocardiogram after one month showed resolution of wall motions abnormalities and normalization of the left ventricular function.

Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease.

Purposes: To compare an intensive smoking cessation intervention against usual care in hospitalized high-risk smokers with acute cardiovascular disease.

Methods: A total of 209 hospitalized smokers were randomized to the intensive intervention (n = 109) or to usual care (n = 100). Usual care consisted only of counseling and printed educational material provided prior to hospital discharge.

Pharmacological management of atrial fibrillation following cardiac surgery.

Atrial fibrillation (AF) is the most common complication following coronary artery bypass graft surgery (CABG). Post-CABG AF occurs most commonly on the second postoperative day and declines in incidence thereafter. A number of risk factors have been found to be associated with a higher frequency of post-CABG AF.

Nesiritide for heart failure: impact on costs and complications.

Decompensated heart failure accounts for approximately 1 million hospitalizations in the USA each year with an estimated cost of US$11,000 per hospitalization. Despite this prevalence and cost burden, relatively few therapies for decompensated heart failure have been developed over the past 30 years. Although once the mainstay of treatment of decompensated heart failure, the use of positive inotropic agents has fallen into disfavor.

Impact of nesiritide on health care resource utilization and complications in patients with decompensated heart failure.

Study Objective: To determine the impact of nesiritide on health care resource utilization and complications in patients hospitalized with decompensated heart failure.

Design: Retrospective case-control study.

Setting: United States hospitals.