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Medical News & Perspectives
April 3, 2002

Clinical Evidence for Critical Cardiac Care

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JAMA. 2002;287(13):1638-1639. doi:10.1001/jama.287.13.1638-JMN0403-3-1

Las Vegas, Nev—Medical therapy for people with heart disease improves as clinicians put into practice the results of data from clinical trials, experts said at the 40th Anniversary Symposium on Critical Care, Trauma, and Emergency Medicine, presented here by the University of Southern California School of Medicine.

"Myocardial infarction (MI) is still the big killer," said Joseph E. Parrillo, MD, professor of medicine and director of cardiovascular disease and critical care at Robert Wood Johnson Medical School, Camden, NJ. Each year in the United States, 1.5 million MIs occur, with a 10% mortality rate in hospitalized patients, said Parrillo, and a 30% to 35% overall MI mortality due to sudden, out-of-hospital deaths. He said that although modern MI care is based on evidence and results from large trials, "patients in clinical trials are highly selected—not like those coming into your hospital." Randomized controlled trials are valuable, he noted: "They are wonderful additions to the armamentarium of clinical decision making, but it is important to understand their limitations."

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