Cardiology fellows contribute to long list of national presentations

Research is integral to medical training at Christiana Care. Ongoing studies that support better ways to monitor and improve patient care are garnering recognition here and abroad.

Cardiology fellows at Christiana Care were lead authors on half of the 16 abstracts presented at these May meetings:

• Society for General Internal Medicine (SGIM) National Meeting, May 4-5.
• Society for Cardiovascular Angiography and Interventions (SCAI) Conference, May 4-7.
• National Lipid Association (NLA) Annual Meeting, May 11.
• American Heart Association’s Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference (QCOR), May 12-14.

When diagnosing acute heart attack, troponin is the preferred serum marker, but it is still common practice to test for creatine kinase (CK)-MB along with it. Anitha Rajamanickam, M.D., presented at QCOR on her study showing elevated blood levels of CK-MB in the absence of elevated troponin did not change treatment decisions at Christiana Care. Eliminating CK-MB testing potentially could save billions of health care dollars nationwide each year.

Dr. Rajamanickam also presented four studies at SCAI and has eight first author abstracts (two of which are oral presentations) accepted for the European Society of Cardiology 2011 Congress in August.

“The Cardiology program here is very fellow-friendly with every resource at our disposal to do research,” she says. “One of the big reasons I left the Cleveland Clinic to come to Christiana Care, was the opportunity to work with the Center for Outcomes Research, under the direction of Dr. William Weintraub. He is considered to be the father of quality and outcomes science.”

ECGs go cellular

Interventional cardiologists on-call who were once tied to their fax machines can now go roaming thanks to a 3G network hook-up that transmits electrocardiograms (ECGs) to their iPads.

“Now time-sensitive decisions are just a phone call away from just about any location,” says third-year fellow Matthew Grove, D.O., who designed the feasibility study presented at SCAI with Andrew Doorey, M.D. ”We showed that ECGs converted to portable digital files (PDFs) transmit clearly to our iPads, allowing us to zoom in for a closer look at suspicious leads.” Dr. Grove enters Christiana Care’s Interventional Cardiology Fellowship in July.

Treating heart attacks faster

Efforts to shorten the trip from hospital door to cath lab and emergency angioplasty have shaved “door-to-balloon” times at Christiana Care well below the 90-minute national average. Yuanyuan Zhang, M.D., reported at SCAI that training emergency responders to administer ECGs was a real time-saver.

Cardiovascular Research Fellow Doralisa Morrone, M.D., reported at QCOR that from 2004 to 2010 fewer women than men had door-to-balloon times under the 90-minute threshold. However, looking at more recent data (2008-2010), Dr. Zhang found that Christiana Care is closing the gender gap for women with acute heart attacks.

Dr. Morrone also reported that pregnancy related hypertension is an indicator of hypertension later in life, and, at the NLA meeting, on the benefits of combining the cholesterol-lowering drug, ezetimibe (Zetia) with statin therapy.