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Comment & Response |

Changes in Hospitalizations, Treatment Patterns, and Outcomes During Major Cardiovascular Meetings

Krysthel Engstrom, MD1,2; Robert T. Faillace, MD, ScM1,2,3,4
[+] Author Affiliations
1Department of Medicine, Albert Einstein College of Medicine, New York, New York
2Jacobi Medical Center, Bronx, New York
3North Bronx Healthcare Network, Bronx, New York
4North Central Bronx Hospital, Bronx, New York
JAMA Intern Med. 2015;175(8):1419-1420. doi:10.1001/jamainternmed.2015.1636.
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To the Editor Jena et al1 found that during the dates of national cardiology meetings there is decreased mortality in high-risk heart failure and cardiac arrest patients. In addition, they noted less use of percutaneous coronary intervention (PCI) in high-risk acute myocardial infarction (AMI) patients. Although they offered several thought-provoking explanations as to why this may occur, a number of other factors need to be considered. It is a strong statement to suggest that certain PCI procedures may be unnecessary or overused during the nonmeeting dates without long-term outcomes. A difference in risk might exist among patients who received PCI compared with those who did not. The thrombolysis in myocardial infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores for patients with AMI are commonly used to assess individual patient risk and the need for urgent intervention, whereas the Agency for Healthcare Research and Quality (AHRQ) tool is not routinely implemented in clinical practice. Therefore, we believe it would be reasonable to compare these risk scores (in-meeting vs nonmeeting dates) to more accurately stratify patients and determine if the decrease in PCI was related to lower risk.24

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August 1, 2015
Behnood Bikdeli, MD; Mark D. Siegel, MD
1Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2015;175(8):1419. doi:10.1001/jamainternmed.2015.1633.
August 1, 2015
Taisei Kobayashi, MD; Jay Giri, MD, MPH
1Department of Cardiovascular Medicine, University of Pennsylvania, Philadelphia
JAMA Intern Med. 2015;175(8):1420. doi:10.1001/jamainternmed.2015.1639.
August 1, 2015
Anupam B. Jena, MD, PhD; John Romley, PhD
1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
2Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles
JAMA Intern Med. 2015;175(8):1420-1421. doi:10.1001/jamainternmed.2015.1642.
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