Traci Klein (@traciklein)
Activity by Traci Klein
A Mayo Clinic task force challenges some recommendations in the updated guideline for cholesterol treatment unveiled by the American College of Cardiology (ACC) and American Heart Association (AHA) in 2013. The task force concludes, based on current evidence, that not all patients encouraged to take cholesterol-lowering medications, such as statins, may benefit from them and that the guideline missed some important conditions that might benefit from medication.
Furthermore, the task force believes an emphasis needs to be placed on an individualized treatment approach with each patient and exercising shared decision-making.
Recommendations of the task force, made up of Mayo Clinic experts in cardiology, endocrinology and preventive medicine, with no conflicts of interest or links to the drug industry, will be published Aug. 14 in Mayo Clinic Proceedings. An editorial will accompany the paper. Mayo Clinic physicians are adopting the task force’s guideline.
“The ACC/AHA cholesterol guideline was last updated in 2001, so it needed to be updated. We agree with many points of the guideline, but there are some key areas where we do not completely agree or we wanted to expand and provide more guidance,” says Francisco Lopez-Jimenez, M.D., task force chairman and director of preventive cardiology at Mayo Clinic in Rochester, Minnesota.
Journalists: Sound bites with Dr. Kullo and Dr. Lopez-Jimenez are available in the downloads, as well as animations of statins' effects in the bloodstream and carotid artery plaque formation.
ROCHESTER, Minn. — Physicians using body mass index (BMI) to diagnose children as obese may be missing 25 percent of kids who have excess body fat despite a normal BMI, which can be a serious concern for long-term health, according to a Mayo Clinic study published online today in Pediatric Obesity.
The researchers found that BMI has high specificity in identifying pediatric obesity, meaning BMI accurately identifies children who are obese, but has a moderate sensitivity, meaning the BMI tool misses children who actually should be considered obese, according to the percent of fat in their bodies.
“If we are using BMI to find out which children are obese, it works if the BMI is high, but what about the children who have a normal BMI but do have excess fat? Those parents may get a false sense of reassurance that they do not need to focus on a better weight for their children,” says Francisco Lopez-Jimenez, M.D., senior study author and director of preventive cardiology at Mayo Clinic, Rochester, Minn.
American College of Cardiology
Washington — March 29, 2014 — Patients who attended cardiac rehabilitation and used a smartphone-based app to record daily measurements such as weight and blood pressure had greater improvements in those cardiovascular risk factors; they also were less likely to be readmitted to the hospital within 90 days of discharge, compared with patients who only attended cardiac rehabilitation, Mayo Clinic researchers found.
Journalists: Soundbites and b-roll with Dr. Widmer are available in the downloads.
Only 20 percent of the patients who attended cardiac rehab and used the app were readmitted to the hospital or visited the emergency department within 90 days, compared with 60 percent of those in the control group, researchers discovered.
ROCHESTER, Minn. — Feb. 6, 2014 — More people who have known coronary heart disease die from other causes — such as cancer, and lung and neurological diseases — than heart disease, compared with 20 years ago, according to a Mayo Clinic study published online Feb. 10 in Circulation, an American Heart Association journal.
Journalists: Sound bites with Dr. Gulati and b-roll of a cath lab are available in the downloads.
The researchers evaluated the trends in cause-specific, long-term mortality from 1991 to 2008 in patients at Mayo Clinic in Rochester who underwent percutaneous coronary intervention (PCI), a procedure used to open clogged heart arteries. They broke the study population into three eras: 1991 to 1996, 1997 to 2002, and 2003 to 2008. Cardiac deaths predominated in the first era and were about equal with non-cardiac deaths in the middle era. In the final era — the modern-era (2003 to 2008) — non-cardiac deaths dominated.
ROCHESTER, Minn. — Jan. 21, 2014 — More people die and emergency hospital treatment takes longer for heart attack victims who arrive at the hospital during off-hours (nights and weekends), compared with patients who arrive during regular daily hours, according to a Mayo Clinic study published online in the British Medical Journal on Jan. 21.
Journalists: Sound bites with Dr. Sorita are available in the downloads.
Mayo Clinic researchers analyzed results of 48 studies published between 2001 and 2013 involving 1.8 million patients in the United States, Europe and Canada to assess the effect of off-hour hospital arrival for heart attack patients.
Low-dose dopamine or low-dose nesiritide tested in hospitalized heart failure patients
DALLAS — Two drugs tested in a larger trial did not improve kidney function in acute heart failure patients, contrary to results of smaller studies. The results were presented today at the American Heart Association's Scientific Sessions 2013 in Dallas and simultaneously published in the Journal of the American Medical Association. Previous smaller studies showed that low-dose dopamine or low-dose nesiritide could improve kidney function and reduce fluid overload that is often present in hospitalized acute heart failure patients by increasing urine production.
MULTIMEDIA ALERT: Video of Dr. Horng Chen will be available for download on the Mayo Clinic News Network.
In the Renal Optimization Strategies Evaluation in Acute Heart Failure (ROSE-AHF) randomized 26-site trial in the U.S. and Canada, researchers analyzed data on 360 hospitalized acute heart failure patients with kidney dysfunction from September 2010 to March 2013. Compared to placebo, researchers found that neither dopamine nor nesiritide, when also used with diuretic (water pills) therapy, was better at increasing urine volume or improving levels of serum cystatin-C, an indicator of kidney function, at the end of a 72-hour treatment.
"Kidney-enhancing therapies in acute heart failure continue to elude us," says Horng Chen, M.B., B.Ch., lead author and Mayo Clinic cardiologist. "In the past five years, all the major acute heart failure therapeutic clinical trials have not demonstrated beneficial effects of the therapies tested. This could be partly because the definition of acute heart failure is broad, and hence it includes a diverse group of patients."
Therefore, one take-away from the results of ROSE-AHF is that future studies in acute heart failure may need to target specific subgroups of these patients. For example, some patients have preserved ejection fraction, where the heart's lower chambers are stiff and cannot relax enough to fill fully between beats, and others may have reduced ejection fraction, where the heart is weak, Dr. Chen says.
Heart failure occurs when the heart doesn't pump blood as well as it should. Acute heart failure — when heart failure patients require hospitalization — is the most common cause of hospitalization in patients 65 years and older in the U.S., according to the American Heart Association.
Mayo Clinic study examines costs following operating room and recovery improvement efforts
ROCHESTER, Minn. — Sept. 30, 2013 — The total hospital cost of mitral valve repair surgery — from the time a patient is admitted to the hospital until release — is similar, whether performed through small port incisions using robotic equipment or via the conventional open-chest method, a Mayo Clinic study of 370 patients found. Importantly, robotic surgeries were just as safe as conventional open procedures, but patients who underwent robotic mitral valve repair recovered more rapidly and returned home earlier than patients who had open-chest surgery, the study found. The results of the study also reflect systems innovation efforts designed to reduce the cost of high-technology cardiac care. The findings will be published online Oct. 1 in Mayo Clinic Proceedings.
MULTIMEDIA ALERT: Video of Dr. Rakesh Suri will be available for download on the Mayo Clinic News Network.
"These results reflect an important opportunity to decrease cost and improve quality of U.S. health care when technologically complex procedures are performed by well-trained, high-volume teams capable of leveraging the potential of less invasive approaches for patient benefit," says lead author Rakesh Suri, M.D., D.Phil., a cardiovascular surgeon at Mayo Clinic in Rochester. [...]
Physicians, nurses at Mayo Clinic in Minnesota also monitor patients by computerized system
ROCHESTER, Minn. — Sept. 5, 2013 — Critically ill patients are benefiting from a new program designed to improve care and shorten hospital stays. Mayo Clinic's Enhanced Critical Care program offers 24/7 remote monitoring of the sickest patients at six Mayo Clinic Health System hospitals.
MULTIMEDIA ALERT: Click here to retrieve video and photography from the Mayo Clinic News Network.
Patients will continue to receive care from the local care team, but physicians and nurses in an operations center in Rochester will monitor patients' vital signs and other health data on a computerized system able to detect subtle changes in a patient's condition. High definition video cameras and computer screens will allow operations center staff to communicate with patients, their families and the care team. [...]