Population Health Research Institute
Coronary Interventional Health Delivery

Coronary Interventional Health Delivery
Exploring new procedures in cardiac care

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An important relationship exists between knowledge learned in research related to coronary interventions and health care delivery. While HCD primarily evaluates the outcomes of CI research, innovative discoveries can also be made when transferring knowledge learned from HCD in order to start new clinical trials.


Overview

The Health Care Delivery (HCD) research program at the Population Health Research Institute is aimed at evaluating how medical and surgical interventions deemed efficacious in clinical trials can be applied in an effective and efficient manner to the general population. The projects to date have been closely related to Coronary Interventions (CI), with expansion to valvular heart disease and evaluation of new technologies such as CT coronary angiography. The Health Care Delivery Team is currently evaluating the role of CT coronary angiography in clinical practice through the conduct of several prospective studies.


Studies


Main Publications

Natarajan MK, Mehta SR, Holder DH, Goodhart DR, Gafni A, Shilton D, Afzal R, Teo K, Yusuf S.  The risks of waiting for cardiac catheterization: A prospective study. CMAJ. 2002; 167(11): 1233-1240.
Natarajan MK, Yusuf S. Primary angioplasty for ST segment elevation myocardial infarction: Ready for prime time? CMAJ.2003; 169:32-35.
Natarajan MK, Gafni A, Yusuf S. Determining optimal population rates of cardiac catheterization: a phantom alternative? CMAJ. 2005 Jul 5; 173(1): 49-52.
Ahmad M, Schwalm JD, Velianou JL, Natarajan MK. Impact of routine in-hospital assessment of low-density lipoprotein levels and standardizedorders on statin therapy in patients undergoing percutaneous coronary interventions. J Invasive Cardiol. 2005 Oct; 17(10): 518-20.
Natarajan MK, Velianou JL, Turpie AG, Mehta SR, Raco D, Goodhart DM, Afzal R, Ginsberg JS.  A randomized pilot study of dalteparin versus unfractionated heparin during percutaneous coronary interventions.  Am Heart J. 2006 Jan;151(1):175.
Labinaz M, Swabey T, Watson R, Natarajan M, Fucile W, Lubelsky B, Sawadsky B, Cohen E, Glasgow K. The CCN Consensus Panel on Access to Urgent PCI for ST Segment Elevation Myocardial Infarction. Delivery of primary percutaneous coronary intervention for the management of acute ST segment elevation myocardial infarction: summary of the Cardiac Care Network of Ontario Consensus Report. Can J Cardiol. 2006 Mar 1; 22(3): 243-50.
Schwalm JD, Ahmad M, Velianou JL, Xie C, Natarajan MK.  Primary and rescue percutaneous coronary intervention with paclitaxel-eluting stent implantation in ST-elevation myocardial infarction.  Am J Cardiol.  2006 May 1;97(9): 1308-10. 
Shubair MM, Prabhakaran P, Pavlova V, Velianou JL, Sharma AM, Natarajan MK.  The relationship of body mass index to outcomes after percutaneous coronary intervention.  J Interv Cardiol. 2006 Oct;19(5): 388-95. 
Sheth T, Dodd J, Hoffmann U, Abbara S, Finn A, Gold HK, Brady TJ, Cury RC.  Coronary stent assessability by 64 slice multi-detector computed tomography.  Catheter Cardiovasc Interv. 2007 Apr 9.
Solomon RJ, Natarajan MK, Doucet S, Sharma SK, Staniloae CS, Katholi RE, Gelormini JL, Labinaz M, Moreyra AE; Investigators of the CARE Study. Cardiac Angiography in Renally Impaired Patients (CARE) study: a randomized double-blind trial of contrast-induced nephropathy in patients with chronic kidney disease.  Circulation.  2007 June 26;115(25): 3189-96.
Gupta D, Natarajan MK, Gafni A, Wang L, Shilton D, Holder D, Yusuf S.  Capacity planning for cardiac catheterization: a case study.  Health Policy.  2007 June;82(1): 1-11.
Caldwell PH, Arthur HM, Natarajan M, Anand SS.  Fears and beliefs of patients regarding cardiac catheterization.  Soc Sci Med. 2007 Sep;65(5): 1038-48.
Arthur HM, Smith KM, Natarajan MK.  Quality of life at referral predicts outcome of elective coronary artery angiogram.  Int J Cardiol.  2008 May 7;126(1): 32-6.
Ahmad M, Schwalm JD, Velianou JL, Pericak D, Natarajan MK.  Comparison of one-year clinical outcomes with paclitaxel-eluting stents versus bare metal stents in everyday practice.  Can J Cardiol.  2008 Oct;24(10): 771-5.
Sheth T, Amlani S, Ellins ML, Mehta S, Velianou J, Cappelli G, Yang S, Natarajan M.  CT coronary angiographic assessment of high risk coronary anatomy in patients with suspected coronary artery disease and intermediate pre-test probability.  Am Heart J.  2008; 155(5):918-23.
Venkatesh V, You J, Ellins ML, Sheth T.  Incremental detection of coronary artery disease by assessment of non-calcified plaque on coronary CT angiography.  Clinical Radiology.  In press.
Mercuri M, Moran GR, Gauthier L, Sheth T, Velianou JL, Natarajan MK; Hamilton Health Sciences Interventional Cardiology Staff.  Radiation dose in interventional cardiology procedures: urgent need for monitoring dose and establishing diagnostic reference levels.  Healthc Q. 2008; 11(1): 76-83.
Mercuri M, Xie C, Valettas N, Natarajan MK.  Multivariate predictors of increased radiation dose during percutaneous coronary intervention.  JACC:  Cardiovascular Interventions [in review].
Jolly SS, Yuan F, Wang X, Lamy A, Welsford M, Velianou J, Teo K, Natarajan MK.  Cost savings of primary percutaneous coronary intervention vs. fibrinolysis in patients with ST elevation myocardial infarction - A contemporary community experience.  JACC  [in review].

 

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