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Comment & Response
August 2015

Changes in Hospitalizations, Treatment Patterns, and Outcomes During Major Cardiovascular Meetings

Author Affiliations
  • 1Department of Medicine, Albert Einstein College of Medicine, New York, New York
  • 2Jacobi Medical Center, Bronx, New York
  • 3North Bronx Healthcare Network, Bronx, New York
  • 4North Central Bronx Hospital, Bronx, New York
JAMA Intern Med. 2015;175(8):1419-1420. doi:10.1001/jamainternmed.2015.1636

To the Editor Jena et al1 found that during the dates of national cardiology meetings there is decreased mortality in high-risk heart failure and cardiac arrest patients. In addition, they noted less use of percutaneous coronary intervention (PCI) in high-risk acute myocardial infarction (AMI) patients. Although they offered several thought-provoking explanations as to why this may occur, a number of other factors need to be considered. It is a strong statement to suggest that certain PCI procedures may be unnecessary or overused during the nonmeeting dates without long-term outcomes. A difference in risk might exist among patients who received PCI compared with those who did not. The thrombolysis in myocardial infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores for patients with AMI are commonly used to assess individual patient risk and the need for urgent intervention, whereas the Agency for Healthcare Research and Quality (AHRQ) tool is not routinely implemented in clinical practice. Therefore, we believe it would be reasonable to compare these risk scores (in-meeting vs nonmeeting dates) to more accurately stratify patients and determine if the decrease in PCI was related to lower risk.2-4