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Campus News

School of Public Health Improving Cardiac Care

by Tavonna Goodman

Edward Hannan
Edward Hannan

Researchers at the University at Albany’s School of Public Health are working under the direction of Distinguished Professor Edward Hannan to improve access to coronary angioplasty and coronary artery bypass graft (CABG) surgery, two of the world’s most commonly performed procedures. Hannan chairs the Department of Health Policy, Management, and Behavior.

Angioplasty and coronary artery bypass graft surgery (CABG) are treatments for coronary artery disease (CAD), which is a narrowing of the coronary arteries that can lead to heart attacks. During angioplasty, a physician inserts an uninflated balloon-tipped catheter through the artery to the heart. Once at the site of the plaque blockage, the balloon is inflated, pushing the plaque against the artery wall to improve flow of oxygenated blood through the artery. During CABG, the surgeon takes a segment of a healthy blood vessel from another part of the body and uses it to create a detour for oxygen-rich blood to bypass the blocked portion of the coronary artery.

The new work is an outgrowth of a 1999 study conducted by Hannan and a team of researchers, which concluded that African-American cardiac patients were recommended at a significantly lower rate for angioplasty and CABG than other patients.

The Cardiac Services Program (CSP), comprised of the School of Public Health, Research Foundation and staff from the New York State Department of Health, seeks to increase awareness among referring cardiologists in regard to which patients are being recommended for angioplasty and CABG surgery.

The CSP has issued questionnaires to cardiologists who perform cardiac catheterizations at 10 New York State hospitals. Cardiac catheterization is one of the most accurate tests in the diagnosis of CAD. It is the test used to determine whether a patient is appropriate for either CABG surgery or angioplasty.

“There are 75 hospitals in New York State that perform diagnostic cardiac catheterization. There are currently 37 hospitals in New York State that perform CABG and angioplasty. A patient could be diagnosed at one of the 75 hospitals and referred to one of the 37 hospitals that perform angioplasty and bypass surgery,” explained Kimberly Cozzens, cardiac initiatives research manager for the Cardiac Services Program.

Physicians are instructed to complete a questionnaire for each cardiac patient they treat. The first part of the form asks for the patient’s biographical information such as name, age, and race. Next, physicians are asked to summarize the patient’s medical information. In the last section, the physician indicates what treatment he/she recommended for the patient.

CSP then determines if the recommendation is in accordance with national guidelines developed by the State Cardiac Advisory Committee (CAC), a statewide commissioner’s advisory body comprised of cardiologists and cardiac surgeons.

Hannan, the principal investigator on these studies, said, “The work provides physicians with information on which specific patients are appropriate for surgery and angioplasty so that they can consider why they did not recommend it and so that they can think about changing their practice patterns based on national guidelines. It is hoped that the study will result in more patients who need CABG surgery and angioplasty obtaining these procedures as a result of heightening the awareness of referring physicians regarding which patients are appropriate for the procedures.”

“The Department of Health has funded [this study] in conjunction with some other work for a total of $650,000,” according to Hannan.