4 ways heart centers are improving patient outcomes

From reducing heart risk factors to cutting mortality, heart centers across the country are homing in on ways to improve patient outcomes.

Safety and outcomes are improving at Seattle-based Swedish Heart & Vascular Institute thanks to two rapid response teams for high acuity issues: the cardiogenic shock team and the pulmonary embolism response team.

The shock team brings together an advanced heart failure cardiologist and a cardiovascular critical care attending physician to review a case and determine if it should be escalated. 

"If escalation warranted, a rapid virtual visit is performed with the on-call CT surgeon and interventional cardiologist to determine speed of device delivery, periprocedural management and further escalation pathways if warranted," John Mignone, MD, executive medical director at Swedish, told Becker's.

The results: a 33% reduction for in-hospital mortality rate in cardiogenic shock patients, and  both teams contributed to a 50% reduction in hospital mortality.

Other systems are trying to improve patient outcomes in different ways.

At Ann Arbor, Mich.-based Frankel Cardiovascular Center, more patients are seeing positive changes in risk factors such as blood pressure after using GLP-1 drugs, Eric Brandt, MD, director of preventive cardiology at the center, told Becker's

The system is also seeing an increase in patients with complicated heart diseases and are expanding their surgical complexity to meet their needs.

"With straightforward issues (CAD, aortic stenosis, mitral regurgitation, tricuspid regurgitation) going the way of isolated transcatheter therapies, we see patients with extremely complicated diseases — often very high risk and here with their last chance for hope," Gorav Ailawadi, MD, director of the Frankel Cardiovascular Center and chair of the department of cardiac surgery at Ann Arbor-based University of Michigan Health, told Becker's. "We also are seeing a growth of transcatheter valve therapies with an explosion of patients with tricuspid valve disease."

The advances in therapies are also opening the door to better outcomes.

The advent of focused RNA therapies is remarkable," Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai in Los Angeles, told Becker's. "Imagine an agent that can control hypercholesterolemia with dosing just twice a year — it's here. Once-a-year antihypertensive RNA drugs, now in advanced clinical trials, look promising and are just around the corner. These interference-based drugs are just the tip of the iceberg: We are developing new agents based on natural noncoding RNAs with broad bioactivity, not restricting us to targeting already-known disease pathways. Pills and monoclonals will be in steep decline just one generation from now, replaced by trenchant RNA therapeutics."

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