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The Emergency Cardiology Group

The ACRE project was featured on the ABC radio AM news and current affairs programme this morning.

You can listen to the story featuring interviews with Will Parsonage and Terry George from Nambour Hospital here.

Nambour was where the ACRE project pilot was rolled out and the results of the pilot project have been published here.

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The Emergency Cardiology Group

Will Parsonage writes…Next week I’ll be presenting on some of our clinical redesign work at this meeting under the title ‘NEATs, SLICs and ACREs’. It is a great opportunity to present to a much wider audience on the rationale, method and outcome of the project we have been conducting with the team at Nambour Hospital to translate our research into practice around patients presenting to emergency departments with chest pain.

The full program for the meeting is here.

I will post a copy of the presentation here following the meeting or for more information please contact me through the blog.

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Cross blogged from our Emergency Cardiology Site…

The Emergency Cardiology Group

There has been lots of media interest in our paper ‘Validation of high-sensitivity troponin I in a 2-h diagnostic strategy to assess 30-day outcomes in emergency-department patients with possible acute coronary syndrome‘ that went online in in the Journal of the American College of Cardiology in the last few days.

Those in Queensland may have heard reference to the study on the ABC Radio news this morning and Louise Cullen has been interviewed today by ABC Radio National and Channel Nine.

We may have lost out to Black Caviar on the Channel Nine News though…

A copy of the press release from the Queensland Government is available here: RBWH media release – improved testing for potential heart attack patient.

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The Emergency Cardiology Group

A/Prof Louise Cullen writes…

The minefield of differences in troponin assays confuses clinicians, in an area of medicine that is already complex. Determining which patients presenting to Emergency Departments (EDs) with symptoms of possible Acute Coronary Syndromes actually have this underlying diagnosis is challenging. Current guidelines recommend lengthy assessment processes generally not achievable in acceptable time frames for patients to remain in the ED, and thus encourage Emergency Physicians to admit ‘all’ who present with possible symptoms of ACS.

Add to this mix the variability in analytical characteristics between troponin assays and information on change values (deltas) and it seems to many clinicians that this is simply getting too tough.

Our latest paper Delta troponin for the early diagnosis of AMI in emergency patients with chest pain’ in the International Journal of Cardiology highlights how early (0 and 2hr post ED presentation) troponin values may be used to…

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This sort of thing has been bugging me for ages…

Old CardioBrief

Don’t believe the the hype! That’s the cardinal rule to obey when reading health news. “Breakthroughs” and “cures” are rare, and should always be viewed with caution and skepticism.

This week was a great example. Last Sunday, the New York Times, the major networks, and a host of other media outlets (including this one) reported on a paper in  Nature Medicine about the discovery of a novel and potentially significant pathway linking red meat to heart disease. Briefly, the research suggested that carnitine, which is found naturally in high concentrations in red meat, can lead to atherosclerosis when it is converted by gut bacteria to a chemical called TMAO. Almost immediately I received a lot of comment from experts who raised serious questions about the research. Then today, a separate study was published with an entirely different perspective on carnitine. Although the two studies don’t directly contradict each other, they…

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Things don’t always get the attention they deserve…

Duchamp's FountainOne of the triumphs of the recent ACC 2013 meeting was the the host city of San Francisco and the meeting venue, the Moscone Centre, which is central to downtown San Francisco and it’s associated attractions. One of the notable attractions is the San Francisco Museum of Modern Art (MoMA) right next door to Moscone. In a spare couple of hours during the meeting it was great to be able to call in there for some diversion.

There I was delighted to find one of the replicas of Duchamp’s 1917 work ‘Fountain’ pictured above. If it looks like a urinal that’s because that is what it was. This is no ordinary urinal but one that in 2004 was voted one of the most influential modern art works of all time (and therefore possibly one of the most important works in the MoMA). Duchamp’s 1917 original was lost but celebrated by a series of replicas – this one, in the MoMA quietly celebrating the 50th anniversary of its creation in 1963. Unceremoniously placed on a non-descript, plain white plinth garners a level of inattention that I am sure the artist would perhaps have appreciated. I took the short movie below to illustrate this (you can see ‘Fountain’ centre frame on the white box).

It was in no way my intention, but a matter of fact, that I didn’t attend any of the late breaking clinical trial sessions at the recent ACC meeting. In fact, I admit to taking at least 24 hours to figure out what an LBCT actually was (a new mode of cardiac imaging that had passed me by?).

I enjoyed blogging some of the less travelled sessions of the meeting (Day 1, Day 2, Day 3). So I feel I did my bit for some of the things that don’t get the attention they deserve but for those in need of a good summary of the headline trials, that did garner most of the attention, here are a few suggestions.

Here is perhaps the definitive video summary of the key trials from the heart.org’s Cardiology Show

...and here a more personal view from Melissa Walton-Shirleys “Heartfelt’ blog, also on the heart.org

…and in a slightly different format a slideshow of the key findings of the major trials that were presented at the meeting.

Plenty to be getting on with there…