Cardiologist away? Patients may find they can take heart

Cardiologists used to worry their patients would suffer when they left to attend conferences. Now, a new Harvard study suggests doctors should worry more when they’re on the job.

The study, published Friday in the Journal of the American Heart Associ

ation, found that patients nationwide who had a heart attack during the biggest interventional cardiology conference of the year fared better than those who got sick in the weeks before or after the conference.

It was either a statistical fluke, or interventional cardiologists — who insert stents to open blocked arteries — are sometimes doing their patients more harm than good.

“I’ve always wanted to believe that

any influence I had on anyone was a positive influence,” said interventional cardiologist Kirk Garrat, president of the Society for Cardiovascular Angiography and Interventions, which runs the annual Transcatheter Cardiovascular Therapeutics meeting.

In the study, researchers looked at the 30-day survival rates of Medicare patients who had heart attacks during the five-day event. They found that an additional 1.5% of patients survived heart attacks that occurred during the convention compared with the weeks before and after, said study leader Anupam Jena, an associate professor at Harvard Medical School and Massachusetts General Hospital in Boston.

The difference accounted for thousands of lives saved and couldn’t be explained by the number of emergency stents patients received.

When patients enter a hospital while having a heart attack, some are immediately taken to a catheterization laboratory, said Robert Yeh, an interventional cardiologist and co-author of the study. There, an interventional cardiologist will implant a stent to prop open a blocked artery.

Research has raised questions about whether stents are required if the patient is stable, but if a blocked artery is causing a heart attack, the data are clear: Get that artery unblocked as soon as possible, he said. In other heart attack patients, where the cause is less clear, their disease may be managed by medication, usually overseen by general cardiologists, Yeh said.

Doctors who go to the conference tend to be more academically minded than those who stay home, Garratt said. So were academics spending too much time on research and not enough time practicing medicine? No, the study says.

“These weren’t doctors who sat in their office thinking and designing papers,” Garratt said. “They were taking care of a lot of patients.”