"Optimism is a kind of heart stimulantthe digitalis of failure."

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Justine Cadet,
News Editor

As the early 19 th Century American publisher Elbert Hubbard suggests, hope can prove as effective as the medicinal materials used to increase cardiac contractility and control heart rates. The plethora of studies presented at this week's annual American College of Cardiology (ACC) conference in Orlando, Fla., may provide that source of optimism for those caregivers treating and managing patients with cardiovascular diseases, particularly heart failure.  

Many of the sessions, studies and poster presentations at ACC09 focused on the necessity of assessing quality of care, using operational metrics and other key performance indicators within hospital and private practice settings, especially in treating the burgeoning population of heart failure patients, whose readmissions rates have crushing financial implications.

As a result, many discussions at the conference revolved around the importance to reimburse for preventive care for this at-risk patient population before they become hospitalized with more advanced heart conditions. "Once that at-risk patient ends up in the hospital with heart failure...we realize we have to pay for it," American Heart Association (AHA) Past-President Dr. Raymond Gibbons told Cardiovascular Business News. Therefore, Gibbons, incoming AHA President Dr. Clyde Yancey and current AHA President Dr. Daniel W. Jones recommended that more attention should be geared toward education initiatives for lifestyle modifications, so this at-risk population can avoid hospitalization altogether.

Before more widespread policies of preventive care become adopted, certain drugs may prove helpful in treating these patients. In fact, one ACC09 late breaking clinical trial found that the use of Corthera's relaxin improved the hospital course of acute patients, prevented heart failure from worsening during hospitalization and shortened hospital stays.

However, once these patients are hospitalized, the provider may not matter, according to an ACC09 poster presentation, which found that urban safety-net hospitals that treat the underserved populations have comparable risk rates of heart failure readmission to non-safety-net hospitals. These findings were promising, as lead author Dr. Jonathan S. Ross told Cardiovascular Business News that they had "anticipated the readmission rates would be slightly higher at the safety-net hospitals, particularly as the economic incentives continue to align toward less reimbursement for the uninsured and underinsured." However, Ross added that there "is much opportunity for improvement everywhere."

Despite some of the negative statistics surrounding the condition, it would be helpful to examine the more promising studies that emerged from ACC09, and remember Goethe's words: "In all things it is better to hope than to despair."

On these topics, or any others, feel free to contact me.

Justine Cadet, News Editor