Patient outcomes when cardiologists are away at national meetings

December 22, 2014

Having some cardiologists away from the hospital attending national cardiology meetings did not appear to negatively affect Medicare patients admitted for heart conditions, according to a report published online by JAMA Internal Medicine.

Thousands of cardiologists take time off work each year to attend these meetings but how that might affect patients was unknown.

Anupam B. Jena, M.D., Ph.D., of Harvard Medical School, Boston, and coauthors analyzed differences in 30-day mortality and treatment such as angioplasty (also known as percutaneous coronary intervention, PCI) among Medicare patients hospitalized for heart attack (acute myocardial infarction, AMI), heart failure or cardiac arrest from 2002 to 2011 during the dates of two national cardiology meetings compared with identical nonmeeting dates in the three weeks before and after conferences.

Study results show that 30-day mortality in teaching hospitals was lower among high-risk patients with heart failure or cardiac arrest who were admitted during meeting vs. nonmeeting dates (heart failure, 17.5 percent vs. 24.8 percent and cardiac arrest, 59.1 percent vs. 69.4 percent). While mortality for high-risk heart attack patients in teaching hospitals was similar between meeting and nonmeeting dates (39.2 percent vs. 38.5 percent), PCI rates were lower during meeting vs. nonmeeting dates (20.8 percent vs. 28.2 percent) without any observed effect on mortality.

No mortality or utilization differences existed for low-risk patients in teaching hospitals or for high- or low-risk patients in nonteaching hospitals.

The authors speculate about several explanations for their findings including the physician composition of those who provided hospital coverage while others were away and declines in intensity of care which may include foregoing interventions where the risk-benefit tradeoff was less clear for high-risk patients such as with PCI.

"Our finding that substantially lower PCI rates for high-risk patients with AMI admitted to teaching hospitals during cardiology meetings are not associated with improved survival suggests potential overuse of PCI in this population," the authors write.

The authors acknowledge the major limitation of their study is an inability to establish why high-risk patients with heart failure and cardiac arrest experienced lower 30-day mortality when admitted during national cardiology meetings.

"We observed lower 30-day mortality among patients with high-risk heart failure or cardiac arrest admitted to major teaching hospitals during the dates of two national cardiology meetings, as well as substantially lower PCI rates among high-risk patients with AMI, without any detriment to survival. One explanation for these findings is that the intensity of care provided during meeting dates is lower and that for high-risk patients with cardiovascular disease, the harms of this care may unexpectedly outweigh the benefits," the study concludes.

Editor's Note:

In a related editor's note, Rita F. Redberg, M.D., M.Sc., editor-in-chief of JAMA Internal Medicine, writes: "It is reassuring that patient outcomes do not suffer while many cardiologists are away. More important, this analysis may help us to understand how we could lower mortality throughout the year."
(JAMA Intern Med. Published online December 22, 2014. doi:10.1001/jamainternmed.2014.6781. Available pre-embargo to the media at

Editor's Note: Study authors made conflict of interest, funding and support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact author Anupam B. Jena, M.D., Ph.D., call David Cameron at 617-432-0441 or email

To place an electronic embedded link in your story: The link will be live at the embargo time:

The JAMA Network Journals

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to