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mariocreanza@wanadoo.nl
medicine forum beginner
Joined: 14 Jun 2006
Posts: 2
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 Posted: Wed Jun 14, 2006 12:34 pm Post subject:
risk while waiting for elective PCI
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Hello,
I am a cardiologist in a tertiary hospital. We have some troubles
because of bed capacity. I am looking for information about risk
stratification in patients waiting for elective PCI. The majority of
patients undergo a PCI in 2-4 weeks. The question is: when would a
patient ( who is stable) remain in hospital until elective PCI or CABG
is performed? How to select the patients who must remain in hospital?
Who knows what is the events rate while waiting for elective PCI or
CABG? |
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Andrew B. Chung, MD/PhD
medicine forum Guru
Joined: 25 Mar 2005
Posts: 8540
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| Posted: Wed Jun 14, 2006 2:21 pm Post subject:
Re: risk while waiting for elective PCI
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mariocreanza@wanadoo.nl wrote:
| Quote: | Hello,
I am a cardiologist in a tertiary hospital.
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Hello Mario.
Welcome to SMC :-)
Sorry about the anti-christians... this is what happens when there is a
physician who is openly Christian. Please forgive all my iniquities.
| Quote: | We have some troubles because of bed capacity.
|
Thankfully, we do not have such troubles here in Atlanta.
All thanks and praises to LORD GOD Almighty, Whom I love with all my
heart, soul, mind, and strength.
| Quote: | I am looking for information about risk
stratification in patients waiting for elective PCI. The majority of
patients undergo a PCI in 2-4 weeks.
|
That is quite a wait. Where are you ?
My guess is that you are not in the U.S.
| Quote: | The question is: when would a
patient ( who is stable) remain in hospital until elective PCI or CABG
is performed?
|
When they fail a sub-max stress test or there is orther clinical
evidence of LM or LM-equivalent disease.
| Quote: | How to select the patients who must remain in hospital?
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By sub-max stress testing.
| Quote: | Who knows what is the events rate while waiting for elective PCI or
CABG?
|
This really depends on your patient population and the wait time. In
my experience, with appropriate aggressive medical management (aspirin
+/- clopidogrel, statin, metoprolol succinate, ramipril, prn NTG,
controlling HBP and Diabetes etc) for an average wait for elective
outpatient cath/poss (catheterization with possible angioplasty) of 1
week, the event rate is less then 1 in 1000.
The following reference describes my patient population:
http://tinyurl.com/l9qmj
Prayerfully in Christ's amazing love,
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://tinyurl.com/m3gnu |
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mariocreanza@wanadoo.nl
medicine forum beginner
Joined: 14 Jun 2006
Posts: 2
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| Posted: Wed Jun 14, 2006 3:03 pm Post subject:
Re: risk while waiting for elective PCI
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I am not interested in any lord
Thanks a lot.
I am from the Netherlands.
Traditionally we are used not to discharge to home patients that are
waiting for a PCI or CABG.
I am not convinced that stable patients must remain in hospital: LM or
LM-equivalent? Ok I degree with you. 3 vesselsdisease?
Do you mean that the submax test must be negative?
With regards. Mario Creanza
SuAndrew B. Chung, MD/PhD schreef:
| Quote: | mariocreanza@wanadoo.nl wrote:
Hello,
I am a cardiologist in a tertiary hospital.
Hello Mario.
Welcome to SMC :-)
Sorry about the anti-christians... this is what happens when there is a
physician who is openly Christian. Please forgive all my iniquities.
We have some troubles because of bed capacity.
Thankfully, we do not have such troubles here in Atlanta.
All thanks and praises to LORD GOD Almighty, Whom I love with all my
heart, soul, mind, and strength.
I am looking for information about risk
stratification in patients waiting for elective PCI. The majority of
patients undergo a PCI in 2-4 weeks.
That is quite a wait. Where are you ?
My guess is that you are not in the U.S.
The question is: when would a
patient ( who is stable) remain in hospital until elective PCI or CABG
is performed?
When they fail a sub-max stress test or there is orther clinical
evidence of LM or LM-equivalent disease.
How to select the patients who must remain in hospital?
By sub-max stress testing.
Who knows what is the events rate while waiting for elective PCI or
CABG?
This really depends on your patient population and the wait time. In
my experience, with appropriate aggressive medical management (aspirin
+/- clopidogrel, statin, metoprolol succinate, ramipril, prn NTG,
controlling HBP and Diabetes etc) for an average wait for elective
outpatient cath/poss (catheterization with possible angioplasty) of 1
week, the event rate is less then 1 in 1000.
The following reference describes my patient population:
http://tinyurl.com/l9qmj
Prayerfully in Christ's amazing love,
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://tinyurl.com/m3gnu |
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Andrew B. Chung, MD/PhD
medicine forum Guru
Joined: 25 Mar 2005
Posts: 8540
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| Posted: Wed Jun 14, 2006 4:03 pm Post subject:
Re: risk while waiting for elective PCI
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mariocreanza@wanadoo.nl wrote:
| Quote: | I am not interested in any lord
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I am sad to read this.
You are welcome.
All thanks and praises belong to GOD, Whom I love with all my heart,
soul, mind, and strength.
| Quote: | I am from the Netherlands.
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Again, welcome to SMC. Where in the Netherlands are you located?
| Quote: | Traditionally we are used not to discharge to home patients that are
waiting for a PCI or CABG.
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Understandably. Then, you should find the earlier reference helpful.
Emory University here in Atlanta is the birthplace of PCI, afterall.
| Quote: | I am not convinced that stable patients must remain in hospital: LM or
LM-equivalent? Ok I degree with you. 3 vesselsdisease?
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Depends on how the do on the submax stress test.
| Quote: | Do you mean that the submax test must be negative?
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Yes. It should be negative before being comfortable with letting them
go home before returning for the cath/poss.
| Quote: | With regards. Mario Creanza
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Many thanks and praises to GOD for your kind heart.
Will be praying for you, dear Mario.
Prayerfully in Christ's amazing love,
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://tinyurl.com/m3gnu |
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Don Kirkman
medicine forum Guru
Joined: 28 Apr 2005
Posts: 726
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| Posted: Thu Jun 15, 2006 10:49 pm Post subject:
Re: risk while waiting for elective PCI
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It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
article <1150294897.283953.278810@c74g2000cwc.googlegroups.com>:
Isn't it misleading [some would call it "lying"] to cite a 1991 journal
article to describe *your* patient population? That article was
published, not compiled, three years before you graduated from medical
school, or were licensed, which was four years later according to the
Georgia state records at
http://www.medicalboard.state.ga.us/bdsearch/index.cgi.
Clements SD Jr, Gatlin S.
Outpatient cardiac catheterization: a report of 3,000 cases.
Clin Cardiol. 1991 Jun;14(6):477-80.
PMID: 1810684 [PubMed - indexed for MEDLINE]
Do you in fact have a patient population? Yes or no.
If yes, are you are able to provide standard of care treatment for them
in the absence of hospital privileges? Yes or no.
--
Don Kirkman |
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Andrew B. Chung, MD/PhD
medicine forum Guru
Joined: 25 Mar 2005
Posts: 8540
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| Posted: Fri Jun 16, 2006 4:46 am Post subject:
Re: risk while waiting for elective PCI
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Don Kirkman wrote:
| Quote: | It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in
article <1150294897.283953.278810@c74g2000cwc.googlegroups.com>:
The following reference describes my patient population:
http://tinyurl.com/l9qmj
Isn't it misleading [some would call it "lying"] to cite a 1991 journal
article to describe *your* patient population?
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No, because I practice cardiology in the Atlanta metropolitan area
which is where this study was based.
| Quote: | That article was
published, not compiled, three years before you graduated from medical
school, or were licensed, which was four years later according to the
Georgia state records at
http://www.medicalboard.state.ga.us/bdsearch/index.cgi.
Clements SD Jr, Gatlin S.
Outpatient cardiac catheterization: a report of 3,000 cases.
Clin Cardiol. 1991 Jun;14(6):477-80.
PMID: 1810684 [PubMed - indexed for MEDLINE]
Do you in fact have a patient population? Yes or no.
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Yes.
| Quote: | If yes, are you are able to provide standard of care treatment for them
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Yes.
Still praying for your tortured soul, dear Don.
Prayerfully in Christ's amazing love,
Andrew
http://tinyurl.com/m3gnu |
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