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Newly Adopted Guidelines Promise To Lower The Risk Of Recurrent Heart Attacks For OHSU Cardiac Patients

OHSU has signed on to a program that utilizes the 'teachable moment' after an acute coronary event to drive home the lesson that long-term lifestyle changes along with appropriate medications can reduce the odds of another event

The American Heart Association (AHA) has recognized Oregon Health & Science University Hospital as an official participant in the AHA's Get With The Guidelines coronary artery disease (GWTG-CAD) program, an initiative designed to lower the risk of recurrent heart attacks and other coronary events.

Some 450,000 of the 1.1 million heart attacks or other coronary events Americans suffer each year are recurrent events, according to the AHA.  The AHA cites evidence-based studies that demonstrate many patients discharged from hospitals do not receive optimal preventive therapies. Heart attack survivors have a 1.5 to 15 times higher chance of illness and death than the rest of the population. They face a substantial risk of another heart attack, sudden death, angina pectoris, heart failure and stroke. GWTG-CAD is a national hospital-based program designed to close the treatment gap between acute care and secondary prevention. It establishes a process that the AHA estimates could save as many as 80,000 lives annually nationwide if implemented at least 80 percent of the time.

GWTG-CAD helps ensure that an aggressive protocol of risk- reduction therapies is initiated before patients are discharged. These include cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers, smoking cessation and weight management counseling, if appropriate, and referrals for cardiac rehabilitation. Participation in the program means that OHSU is mobilizing care teams and assessing its acute treatment and discharge protocols against a store of baseline data in order to achieve continuous long-term improvements in the quality of care it provides cardiac patients.

"Oregon Health & Science University is dedicated to making our cardiac unit among the best in the country," said Dr. Sanjiv Kaul, M.D., professor and head of cardiovascular medicine in the OHSU School of Medicine as well as member of a national committee that advises the AHA on research funding. "Implementing the American Heart Association's Get With The Guidelines coronary artery disease program will help us accomplish that by making it easier for our professionals to improve the long-term outcome for our cardiac patients."

GWTG-CAD aims at leveraging the "teachable moment" when the patient is most likely to listen to and follow the guidance of health care providers. Studies-such as UCLA's Cardiac Hospitalization Atherosclerosis Management Program and the Scandinavian Simvastatin Survival Study-show that patients who have just suffered a heart attack or have undergone an angioplasty to widen clogged arteries are highly motivated to make lifestyle changes and are more likely to comply with therapies prescribed at discharge.

 "The full implementation of secondary prevention guidelines is a critical step in saving the lives of coronary patients," said Gray Ellrodt, M.D., American Heart Association volunteer chairman for the national GWTG-CAD program. "The American Heart Association's Get With The Guidelines program is designed to help hospitals like Oregon Health & Science University Hospital implement appropriate evidence-based guidelines for care and protocols that will reduce the number of recurrent events and death in these patients."

GWTG-CAD standards, outlined in the American Heart Association/American College of Cardiology secondary prevention guidelines, help improve care by identifying, developing and mobilizing hospital care teams and, when appropriate, by developing and implementing new care maps and discharge protocols that are in line with AHA guidelines.

The AHA's GWTG-CAD program, developed with support from an unrestricted educational grant from Merck & Co., Inc. and the Merck/Schering-Plough Pharmaceutical Partnership, is being implemented in hospitals around the country. Currently, 597 hospitals nationwide participate in the program, 64 of them in the 10-state Pacific Mountain region (Oregon, Washington, Idaho, Montana, Wyoming, Colorado, Arizona, New Mexico, Hawaii and Alaska).

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Oregon Health & Science University is Oregon's only health and research university. As part of its multifaceted public mission, OHSU strives for excellence in scholarship, research, clinical practice and  community service. OHSU includes four schools, two hospitals, numerous primary and specialty care clinics, multiple research centers and institutes and dozens of community service programs. OHSU's fundamental purpose is to improve the well-being of people in Oregon and beyond.


For more information on the American Heart Association Get With The Guidelines program, visit www.americanheart.org/getwiththeguidelines. For information on cardiology programs and research at OHSU, go to www.ohsuhealth.com/htaz/cardiac and to www.ohsu.edu/heart

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