Implantable cardioverter defibrillator utilization in the Commonwealth of Massachusetts: (1997-2008)
Norman S. Kato, M.D., Matthew J. Cioffi, M.S., Sharon-Lise T. Normand, Ph.D. Presented at the ACC.11 Scientific Session & Expo. The Implantable cardioverter defibrillator (ICD) used for primary and secondary prevention of sudden cardiac death is well established. Inclusion and exclusion criteria from randomized clinical trials (RCT) influenced the recommendations published in the ACC/AHA clinical practice guidelines. Limited contemporary data are available describing device use in all-payer populations. We tested the hypothesis that ICDs were implanted according to RCT inclusion and exclusion criteria.
Implantable cardioverter defibrillator usage in the commonwealth of Massachusetts – A 10 year study (1998-2008)
Norman S. Kato, M.D., Matthew J. Cioffi, M.S., Sharon-Lise T. Normand, Ph.D. Presented at the American Heart Association Scientific Sessions 2010. There has been a rapid increase in internal cardioverter defibrillator (ICD) use for primary and secondary prevention since FDA approval in 1988. We tested the hypothesis that utilization frequency of ICDs differs by sex in the Commonwealth of Massachusetts.
No Mortality Advantage of “On” versus “Off”-hours Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction: Results from the Massachusetts Data Analysis Center Registry
Cubeddu RJ, Lago RM, Zelevinsky K, Lovett AF, Mendoza I, Crane AM, Witzke CF, Normand S-LT, Pomerantsev E, Palacios IF. Presented at the American Heart Association Scientific Sessions, November 2010. A higher mortality rate has been reported in STEMI admissions during off-hours due to lower availability of primary percutaneous coronary intervention (PCI) and longer door-to-balloon-times (DTB). Our findings, based on large registry data demonstrate that despite longer DTB times, similar rates of in-hospital death, recurrent MI, and periprocedural cardiogenic shock may be expected in STEMI patients admitted during off-hours when primary PCI is performed.
Hospital-quality Following Percutaneous Coronary Intervention: Massachusetts Experience From 2003-2007.
Normand S-LT, Silbaugh TS, Zelevinsky K, Wolf RE, Cioffi M, Lovett A, Resnic FS, Ho KK. Presented at the American College of Cardiology Scientific Sessions, 2010. Little information is available on hospital performance following percutaneous coronary intervention (PCI) using all-comer populations. Using a fully Bayesian approach, Massachusetts has publicly reported all-cause in-hospital mortality (IHM) following PCI procedures performed since 04/01/2003 in all non-federal hospitals. Key clinical factors, including shock, status of PCI, and compassionate use require adjudication. A small number of risk factors have excellent discrimination of in-hospital survivors at the patient level. Estimates of between-hospital variation can be used to quantify performance at the hospital level.