Impact of institutional culture on rates of transfusions during cardiovascular procedures: The Michigan experience.

Background: Red blood cell (RBC) transfusions have been associated with morbidity and mortality in both coronary artery bypass grafting (CABG) and percutaneous coronary interventions (PCI). As a mechanism for identifying determinants of RBC practice, we quantified the relationship between a center's PCI and CABG transfusion rate.

Methods: We identified all patients undergoing CABG (n = 16,568) or PCI (n = 94,634) at each of 33 centers from 2010 through 2012 in the state of Michigan and compared perioperative RBC transfusion rates for CABG and PCI at each center.

Preprocedural statin use in patients undergoing percutaneous coronary intervention.

Background: Earlier studies suggest that administering statins prior to percutaneous coronary interventions (PCIs) is associated with lower risk of periprocedural myocardial infarction and contrast-induced nephropathy. Current American College of Cardiology/American Heart Association guidelines recommend routine use of statins prior to PCI. It is unclear how commonly this recommendation is followed in clinical practice and what its effect on outcomes is.

Determining best practice: comparison of three methods of femoral sheath removal after cardiac interventional procedures.

Objective: To test the null hypothesis that there is no significant difference between 3 methods of sheath removal: manual compression, mechanical compression with the Compressar, and mechanical compression with the Femostop.

Methods: The research design was experimental. Ninety patients were randomly assigned using a random-numbers table to undergo one of 3 methods of sheath removal.

Infections in implantable cardioverter defibrillator patients.

Implantable cardioverter defibrillators (ICDs) have been documented as an effective modality in reducing arrhythmic mortality. A serious complication associated with implantation of the device is infection. Few studies have addressed this issue.