State Health Department Releases Report On Angioplasty Outcomes

The New York State Department of Health released a comprehensive report summarizing risk factors and outcomes for patients undergoing percutaneous coronary interventions ( PCI ) in New York State. Commonly referred to as " angioplasty " or " coronary stenting, " PCI is a procedure used to clear blocked coronary arteries.

" Percutaneous Coronary Interventions in New York State, 2003-2005, " reports on outcomes of 159, 839 patients undergoing PCI and discharged between January 1, 2003 and December 31, 2005 at 50 New York State hospitals where this procedure is performed. In 2005, latest year for which data are available, there were 56, 058 cases with an overall in-hospital/30-day mortality rate of 0. 88 percent.

The report also includes information on non-emergency patients ( those who aren't in shock, don't have a very low blood pressure and who haven't had a heart attack within 24 hours before the procedure ) as a separate subset. Among this group of 49, 692 non-emergency patients discharged in 2005, in-hospital/ 30-day mortality rate was 0. 60 percent.

Risk-adjusted mortality rates are published for hospitals and physicians performing this procedure.

The report's primary source of data is New York State Percutaneous Coronary Interventions Reporting System. This system gathers information on each patient's demographic and clinical characteristics, information about procedure performed and the outcomes for that patient. Data collection and analysis is conducted under guidance of the New York State Cardiac Advisory Committee, which is comprised of nationally prominent cardiologists, cardiac surgeons and other medical specialists.

In this report, for first time, all analyses use the outcome of in-hospital/30-day mortality. Mortalities include any death occurring in the same hospital stay in which a patient underwent PCI and any death that occurs after hospital discharge but within 30 days of PCI.

" PCIs are among most common procedures performed in United States, " said Dr. Edward Hannan of School for Public Health at the University at Albany, a member of the Cardiac Advisory Committee. " We're confident that New York's annual releases of PCI outcomes contribute to and will continue to improve the excellent quality with which PCIs are being performed in state. "

New York has taken a leadership role in setting standards for cardiac services, monitoring outcomes, and sharing performance data with patients, hospitals, and physicians. Hospitals and doctors involved in care of cardiac patients have worked in cooperation with Department of Health and its Cardiac Advisory Committee to compile accurate and meaningful data for use in enhancing quality of care.

New York was first state in nation to make publicly available information contained in this report and has been releasing its reports for more than 10 years. PCI has become a much more common procedure during that time. In 1995 there were 21, 707 cases, compared to 56, 058 in 2005. At same time mortality rates associated with this procedure have dropped substantially. The in-hospital mortality rate for angioplasty patients in 1995 was 1. 86 percent, compared to 0. 52 percent in 2005.

As part of reporting system, hospitals have ability to track their own data and compare their experience to statewide outcomes.

The report can be obtained on the Department's website.

New York State Department of Health

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Ramipril information.

Ramipril: uses Ramipril belongs to a group of medications called ACE inhibitors. It's used to treat high blood pressure ( hypertension ) . It works by relaxing blood vessels, causing them to widen. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems.

Ramipril is also used to prevent heart problems ( such as heart attacks ) and/or strokes in certain high risk patients, and with other drugs ( e. g. , " water pills " /diuretics, digoxin ) to treat congestive heart failure.

Ramipril: how to use Take Ramipril by mouth, usually once or twice a day; or as directed by your doctor. We may take Ramipril with or without food. Use Ramipril regularly in order to get the most benefit from it. Remember to use it at the same time ( s ) each day.

Swallow capsule form whole. If we can't swallow capsule, open it and sprinkle contents on a small amount ( 4 oz. ) of applesauce or mix with apple juice or water. Swallow or drink entire mixture.

Don't take potassium supplements or salt substitutes containing potassium without talking to your doctor or pharmacist first. This medicine can raise your potassium levels, which rarely can cause serious side effects such as muscle weakness or very slow heartbeats. Tell your doctor immediately if these effects occur.

The dosage is based on your medical condition and response to therapy. For treatment of high blood pressure, it may take several weeks before full benefit of Ramipril occurs or several weeks to months when used for congestive heart failure.

It is important to continue taking Ramipril even if we feel well. Most people with high blood pressure don't feel sick.

Ramipril: other used This section contains uses of Ramipril that aren't listed in approved professional labeling for drug but that may be prescribed by your health care professional. Use Ramipril for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Ramipril may also be used to help protect kidneys from damage due to diabetes.

Ramipril: side effects We may experience dizziness, light-headedness, fatigue, nausea, vomiting, diarrhea, dry cough or blurred vision as your body adjusts to medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed Ramipril because he or she has judged that the benefit to we is greater than risk of side effects. Many people using Ramipril do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Tell your doctor immediately if any of these highly unlikely but very serious side effects occur:

Ramipril may rarely cause serious ( possibly fatal ) liver problems. If we notice any of the following highly unlikely but very serious side effects, seek immediate medical attention:

A serious allergic reaction to Ramipril is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include:

This isn't a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist.

Ramipril: precautions Before taking Ramipril, tell your doctor or pharmacist if you are allergic to it; or to other ACE inhibitors ( e. g. , benazepril, captopril ) ; or if you have any other allergies ( including an allergic reaction after exposure to certain membranes used for blood filtering ) .

Ramipril shouldn't be used if we have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if we have:

Before using Ramipril, tell your doctor or pharmacist your medical history, especially of:

Ramipril may make you dizzy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages.

To minimize dizziness and light-headedness due to lowering of your blood pressure, get up slowly when rising from a seated or lying position. Serious loss of body fluids can also lower your blood pressure and worsen dizziness. Drink adequate fluids to prevent from becoming dehydrated. If we are on restricted fluid intake, consult your doctor for further instructions. Be careful not to become too overheated during exercise which can lead to excessive sweating. Consult your doctor if we experience severe vomiting or diarrhea.

Before having surgery, tell your doctor or dentist that we are taking Ramipril.

Caution is advised when using Ramipril in elderly because they may be more sensitive to its effects, especially dizziness.

Ramipril is not recommended for use during pregnancy due to risk for harm to an unborn baby. Consult your doctor for more details. ( See also Warning section. )

It's not known if Ramipril passes into breast milk. Breast-feeding is not recommended due to the potential harm to the nursing infant. Consult your doctor before breast-feeding.

Ramipril: interactions Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring we for them. Do not start, stop, or change dosage of any medicine before checking with them first.

Before using Ramipril, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of:

A very serious reaction may occur while use Ramipril if you are getting injections for bee/wasp sting allergy ( desensitization ) and are also taking Ramipril. Make sure all your doctors know which medicines you're using.

Check labels on all your medicines ( e. g. , cough-and-cold products, diet aids ) because they may contain ingredients that could increase your heart rate or blood pressure. Ask your pharmacist about safe use of those products.

This document doesn't contain all possible interactions. Therefore, before using Ramipril, tell your doctor or pharmacist of all the products we use. Keep a list of all your medications with you, and share list with your doctor and pharmacist.

Ramipril: overdose If overdose of Ramipril is suspected, contact your local poison control center or emergency room immediately. US residents can call US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: unusually fast or slow heartbeat, severe dizziness, fainting.

Ramipril: notes Don't share Ramipril with others. Lifestyle changes such as stress reduction programs, exercise and dietary changes may increase effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Laboratory and/or medical tests ( e. g. , kidney function, potassium blood level ) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Check your blood pressure regularly while taking this medication, especially when we first start Ramipril or when your dose is changed. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

Ramipril: missed dose If we miss a dose Ramipril, use it as soon as we remember. If it is near time of next dose, skip missed dose and resume your usual dosing schedule. Do not double dose of Ramipril to catch up.

Ramipril: storage Store Ramipril at room temperature between 59-86 degrees F ( 15-30 degrees C ) away from light and moisture. Don't store Ramipril in the bathroom. If you have opened capsule form and mixed it with food or liquid, this mixture can be kept at room temperature for 24 hours or refrigerated for 48 hours. Keep all medicines away from children and pets.

Properly discard Ramipril when it's expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Ramipril: warning Ramipril can cause serious ( possibly fatal ) harm to an unborn baby if used during pregnancy. Therefore, it's important to prevent pregnancy while taking Ramipril. Consult your doctor for more details and to discuss the use of reliable forms of birth control while taking this medication. If we are planning pregnancy, become pregnant, or think we may be pregnant, contact your doctor immediately.

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