STEMIs and Coumadin: Are they an unsafe combination?

Therapeutic anticoagulation may be a surrogate marker for increased MACE in the setting of a STEMI. Consideration should be given to transradial access for patients on anticoagulation. Triple therapy (DAPT plus anticoagulant) should be minimized.

Metabolic biomarkers for predicting cardiovascular disease.

Cardiac and peripheral vascular biomarkers are increasingly becoming targets of both research and clinical practice. As of 2008, cardiovascular-related medical care accounts for greater than 20% of all the economic costs of illness in the United States. In the age of burgeoning financial pressures on the entire health care system, never has it been more important to try to understand who is at risk for cardiovascular disease in order to prevent new events.

Differences in risk factors for lower extremity arterial occlusive disease.

Background: Patients undergoing lower extremity revascularization have associated cardiovascular risks: smoking, hypertension, dyslipidemia, and diabetes. This study evaluated the impact of cardiovascular risk factors on proximal versus distal arterial occlusive disease in patients undergoing lower extremity revascularization as adjusted to a control group without vascular disease.

Study Design: We performed a retrospective, case-control study that included 151 patients undergoing lower extremity revascularization and 229 patients undergoing knee and hip replacement (controls).

Primary care experiences of medicare beneficiaries, 1998 to 2000.

Objective: To examine changes in the quality of primary care experienced and reported by Medicare beneficiaries from 1998 to 2000.

Design: Longitudinal observational study.

Setting: Thirteen states with large, mature Medicare HMO markets.

Prescription drug coverage and seniors: how well are states closing the gap?

As policymakers debate adding a drug benefit to Medicare, many states are attempting to provide drug coverage for low-income seniors through Medicaid and state-funded pharmacy assistance programs. This 2001 survey of seniors in eight states finds marked differences among states in the percentage of seniors with coverage and in the sources providing coverage. Among low-income seniors, a range of 20 percent (New York and California) to 38 percent (Michigan and Texas) lacked drug coverage.

Primary care quality in the Medicare Program: comparing the performance of Medicare health maintenance organizations and traditional fee-for-service medicare.

Background: Since 1972, Medicare beneficiaries have had the option of enrolling in a Medicare-qualified health maintenance organization (HMO). Little information exists to inform beneficiaries' choices between the traditional fee-for-service (FFS) Medicare program and an HMO.

Objectives: To compare the primary care received by seniors in Medicare HMOs with that of seniors in the traditional FFS Medicare program, and among HMOs, and to examine performance differences associated with HMO model-type and profit status.