University of Pittsburgh Medical Center studies presented at ACC meeting in New Orleans

Pittsburgh, March 4 - Researchers at the University of Pittsburgh Medical Center Cardiovascular Institute are presenting more than two dozen research studies at the upcoming meeting of the American College of Cardiology, March 7-10 in New Orleans.

Among these are the following:

Age as a risk factor for angioplasty complications

Although new technology may allow for the treatment of more complex disease in sicker patients, there remains an increased risk for major complications among the elderly while undergoing angioplasty, according to a study of 2,301 patients in the National Heart Lung and Blood Institute Registry. Presented by Howard Cohen, M.D., associate professor of medicine and associate director of cardiac catheterization labs at the Cardiovascular Institute, University of Pittsburgh Medical Center, the study found that being over the age of 65 was independently predictive of heart attack, coronary artery bypass and death. The study also found that older (age 65 to 80) patients and elderly (over 80 years) patients were more likely to have prior bypass surgery, a history of congestive heart failure, more complex heart disease and more severe non-cardiac disease.

Expanded organ donor program can help maximize donor resources

A one-year study of the use of an expanded donor program at the University of Pittsburgh Medical Center has found that patients receiving donor hearts previously deemed unsuitable for transplant have a short-term outcome comparable to patients receiving optimal donors hearts. Such a program can help maximize limited donor resources, according to Srinivas Murali, M.D., principal investigator in the study, associate professor of medicine and director of heart failure and transplantation at the Cardiovascular Institute, University of Pittsburgh Medical Center. Hearts in the expanded donor program were previously deemed unsuitable because of older donor age, presence of coronary artery disease, and presence of left ventricular dysfunction. There were no differences between conventional donor and expanded donor recipients in gender and race distribution, cause of heart failure, and incidence of diabetes. The study found that one-year survival was comparable in the two groups: 93 percent of the expanded donor recipients and 90 percent for the conventional donor recipients.

Patients with permanent pacemakers at greater risk for non-sudden death

A study has found an increased risk of non-sudden death in patients with congestive heart failure who are implanted with a permanent pacemaker than those patients without a pacemaker. The study, by Venkateshwar K. Gottipaty, M.D., assistant professor of medicine in the Cardiovascular Institute at the University of Pittsburgh Medical Center, examined patients in the national Vesnarinone Evaluation of Survival Trial (VEST) who had pacemakers and compared mortality rates to similar patients without pacemakers. Patients in both groups were similar in their age, sex, and heart ejection fraction. Mortality due to sudden death was equal at 14 percent in the two groups. However, non-sudden death for patients with pacemakers was 23 percent and only 14 percent for patients without pacemakers. According to Dr. Gottipaty this may be because the need for pacemakers sub-selects a group of patients with worse underlying disease or the need for pacing itself results in the increased mortality rate.

Patients on heart assist devices show improved heart function

Patients with heart failure, who are placed on the left or right ventricular assist devices as a bridge to heart transplantation, show improvement in their functional capacity while on the devices, according to a study by Srinivas Murali, M.D., associate professor of medicine and director of heart failure and cardiac transplantation at the Cardiovascular Institute, University of Pittsburgh Medical Center. In his study, Dr. Murali examined the maximal exercise capacity of 15 patients who were supported by the pneumatic Thoratec left or both left and right ventricular assist devices and 19 patients who were supported by the electric Novacor left ventricular assist device for 30 days. He found that functional capacity of patients improved regardless of the type of device used or whether one or both sides of the heart were supported. He also found a greater extent of improvement in younger patients and in those who underwent device insertion earlier in the course of their end-stage heart failure.