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Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings

BACKGROUND: Previous research has found that patients with acute cardiovascular conditions treated in teaching hospitals have lower 30‐day mortality during dates of national cardiology meetings. METHODS AND RESULTS: We analyzed 30‐day mortality among Medicare beneficiaries hospitalized with acute my...

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Autores principales: Jena, Anupam B., Olenski, Andrew, Blumenthal, Daniel M., Yeh, Robert W., Goldman, Dana P., Romley, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907570/
https://www.ncbi.nlm.nih.gov/pubmed/29523525
http://dx.doi.org/10.1161/JAHA.117.008230
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author Jena, Anupam B.
Olenski, Andrew
Blumenthal, Daniel M.
Yeh, Robert W.
Goldman, Dana P.
Romley, John
author_facet Jena, Anupam B.
Olenski, Andrew
Blumenthal, Daniel M.
Yeh, Robert W.
Goldman, Dana P.
Romley, John
author_sort Jena, Anupam B.
collection PubMed
description BACKGROUND: Previous research has found that patients with acute cardiovascular conditions treated in teaching hospitals have lower 30‐day mortality during dates of national cardiology meetings. METHODS AND RESULTS: We analyzed 30‐day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (overall, ST‐segment–elevation myocardial infarction, and non–ST‐segment–elevation myocardial infarction) from January 1, 2007, to November 31, 2012, in major teaching hospitals during dates of a major annual interventional cardiology meeting (Transcatheter Cardiovascular Therapeutics) compared with identical nonmeeting days in the ±5 weeks. Treatment differences were assessed. We used a database of US physicians to compare interventional cardiologists who practiced and did not practice during meeting dates (“stayers” and “attendees,” respectively) in terms of demographic characteristics and clinical and research productivity. Unadjusted and adjusted 30‐day mortality rates were lower among patients admitted during meeting versus nonmeeting dates (unadjusted, 15.3% [482/3153] versus 16.7% [5208/31 556] [P=0.04]; adjusted, 15.4% versus 16.7%; difference −1.3% [95% confidence interval, −2.7% to −0.1%] [P=0.05]). Rates of interventional cardiologist involvement were similar between dates (59.5% versus 59.8% of hospitalizations; P=0.88), as were percutaneous coronary intervention rates (30.2% versus 29.1%; P=0.20). Mortality reductions were largest among patients with non–ST‐segment–elevation myocardial infarction not receiving percutaneous coronary intervention (16.9% versus 19.5% adjusted 30‐day mortality; P=0.008). Compared with stayers, attendees were of similar age and sex, but had greater publications (18.9 versus 6.3; P<0.001), probability of National Institutes of Health funding (5.3% versus 0.4%; P<0.001), and clinical trial leadership (10.3% versus 3.9%; P<0.001), and they performed more percutaneous coronary interventions annually (85.6 versus 63.3; P<0.001). CONCLUSIONS: Hospitalization with acute myocardial infarction during Transcatheter Cardiovascular Therapeutics meeting dates was associated with lower 30‐day mortality, predominantly among patients with non–ST‐segment–elevation myocardial infarction who were medically managed.
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spelling pubmed-59075702018-05-01 Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings Jena, Anupam B. Olenski, Andrew Blumenthal, Daniel M. Yeh, Robert W. Goldman, Dana P. Romley, John J Am Heart Assoc Original Research BACKGROUND: Previous research has found that patients with acute cardiovascular conditions treated in teaching hospitals have lower 30‐day mortality during dates of national cardiology meetings. METHODS AND RESULTS: We analyzed 30‐day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (overall, ST‐segment–elevation myocardial infarction, and non–ST‐segment–elevation myocardial infarction) from January 1, 2007, to November 31, 2012, in major teaching hospitals during dates of a major annual interventional cardiology meeting (Transcatheter Cardiovascular Therapeutics) compared with identical nonmeeting days in the ±5 weeks. Treatment differences were assessed. We used a database of US physicians to compare interventional cardiologists who practiced and did not practice during meeting dates (“stayers” and “attendees,” respectively) in terms of demographic characteristics and clinical and research productivity. Unadjusted and adjusted 30‐day mortality rates were lower among patients admitted during meeting versus nonmeeting dates (unadjusted, 15.3% [482/3153] versus 16.7% [5208/31 556] [P=0.04]; adjusted, 15.4% versus 16.7%; difference −1.3% [95% confidence interval, −2.7% to −0.1%] [P=0.05]). Rates of interventional cardiologist involvement were similar between dates (59.5% versus 59.8% of hospitalizations; P=0.88), as were percutaneous coronary intervention rates (30.2% versus 29.1%; P=0.20). Mortality reductions were largest among patients with non–ST‐segment–elevation myocardial infarction not receiving percutaneous coronary intervention (16.9% versus 19.5% adjusted 30‐day mortality; P=0.008). Compared with stayers, attendees were of similar age and sex, but had greater publications (18.9 versus 6.3; P<0.001), probability of National Institutes of Health funding (5.3% versus 0.4%; P<0.001), and clinical trial leadership (10.3% versus 3.9%; P<0.001), and they performed more percutaneous coronary interventions annually (85.6 versus 63.3; P<0.001). CONCLUSIONS: Hospitalization with acute myocardial infarction during Transcatheter Cardiovascular Therapeutics meeting dates was associated with lower 30‐day mortality, predominantly among patients with non–ST‐segment–elevation myocardial infarction who were medically managed. John Wiley and Sons Inc. 2018-03-09 /pmc/articles/PMC5907570/ /pubmed/29523525 http://dx.doi.org/10.1161/JAHA.117.008230 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Jena, Anupam B.
Olenski, Andrew
Blumenthal, Daniel M.
Yeh, Robert W.
Goldman, Dana P.
Romley, John
Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings
title Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings
title_full Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings
title_fullStr Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings
title_full_unstemmed Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings
title_short Acute Myocardial Infarction Mortality During Dates of National Interventional Cardiology Meetings
title_sort acute myocardial infarction mortality during dates of national interventional cardiology meetings
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907570/
https://www.ncbi.nlm.nih.gov/pubmed/29523525
http://dx.doi.org/10.1161/JAHA.117.008230
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