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Editor's Note
February 2015

Cardiac Patient Outcomes During National Cardiology Meetings

JAMA Intern Med. 2015;175(2):245. doi:10.1001/jamainternmed.2014.6801

While at the large cardiology conventions, my colleagues and I have often joked that the convention center would be the safest place in the world to have a heart attack.

Jena et al1 have turned that analysis around and looked at outcomes for hospitalized cardiac patients during the time that thousands of cardiologists are at the convention. Contrary to the a priori hypothesis that care would be compromised by so many of the top cardiologists being gone, they find that adjusted mortality for high-risk heart failure and cardiac arrest is lower at teaching hospitals during the cardiology meetings than during the rest of the year. And although patients were less likely to get a percutaneous coronary intervention for a myocardial infarction during the convention times, there was no associated decrement on myocardial infarction–associated mortality.

How should we interpret these findings? One possibility is that more interventions in high-risk patients with heart failure and cardiac arrest leads to higher mortality. Indeed, some high-risk interventions, such as balloon pumps or ventricular assist devices, are being used in populations in which they are not shown to improve outcomes, and recent reports have raised concerns about high rates of fatal complications from pump thrombosis and other problems.2,3

It is reassuring that patient outcomes do not suffer while many cardiologists are away. More important, this analysis1 may help us to understand how we could lower mortality throughout the year.

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Conflict of Interest Disclosures: None reported.

References
1.
Jena  AB, Prasad  V, Goldman  DP, Romley  J.  Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings [published online December 22, 2014]. JAMA Intern Med. doi:10.1001/jamainternmed.2014.6781.
2.
Thiele  H, Zeymer  U, Neumann  F; IABP-SHOCK II Trial Investigators.  Intra-aortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012;367(14):1287-1296.PubMedArticle
3.
Starling  RC, Moazami  N, Silvestry  SC,  et al.  Unexpected abrupt increase in left ventricular assist device thrombosis. N Engl J Med. 2014;370(1):33-40.PubMedArticle
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