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Campus News
School of Public
Health Improving Cardiac Care
by Tavonna Goodman
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| 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.
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