Download - The Importance of Cardiovascular Care
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First Coast Cardiovascular Institute
In Transition To
Jacksonville Clinic !
www.firstcoastcardio.com
CARDIOVASCULAR UPDATES
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CARDIOVASCULAR UPDATES
Yazan khatib, MD FACC, FSCAI, FSVM
!President
Director of Limb Salvage & Endovascular Interventions !
First Coast Cardiovascular Institute
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First Coast Cardiovascular Institute
Most our patients come from Florida, Yet many live all over The U.S.
FCCI
Zip Codes of > 50 patients
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First Coast Cardiovascular Institute
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Areas of Clinical Excellence
Comprehensive Cardiovascular Care
Limb Salvage & Amputation Prevention Institute
Advanced Stroke Prevention Cardiovascular Research
Endovascular Interventions Outreach Services
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First Coast Cardiovascular Institute
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Long Tradition of Achieving & Maintaining the Highest Levels of Accreditation
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First Coast Cardiovascular Institute
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History of being the First
Carotid Stenting ➢ First to perform carotid stenting in
North East Florida
The First to Promote Endovascular Limb Salvage
As a dedicated sub-specialty
Endovascular Intervention
Comprehensive Venous Clinic Research Department
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First Coast Cardiovascular Institute
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Carotid Stenting Outcomes
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Patient Survival by Ankle-BrachialIndex in Cardiovascular Health
Study
0.6
0.7
0.8
0.9
1
0 1 2 3 4 5 6
YEARS
PATI
ENT
SURV
IVAL
ABI>1.0
ABI: 0.9-1.0
ABI: 0.8-0.9
ABI<0.8
Newman et al ATVB 1999;19; 538-545.
Even “Mild” PAD associated with increased mortality.
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Five Year Mortality RatesPVD Versus Cancer
Five Year Mortality Rates
0% 20% 40% 60% 80% 100%
Breast cancer
PAD
Colon/Rectal
Lung Cancer
*Criqui M. Presentation: Vascular Medicine of the Lower Extremities at theAmerican Diabetes Association’s Scientific Sessions June 1999
PAD all comers outcome
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Five Year Mortality RatesPVD Versus Cancer
Five Year Mortality Rates
0% 20% 40% 60% 80% 100%
Breast cancer
PAD
Colon/Rectal
Lung Cancer
*Criqui M. Presentation: Vascular Medicine of the Lower Extremities at theAmerican Diabetes Association’s Scientific Sessions June 1999
Patients with foot ulcers
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Prior Heart Attack
No Prior Heart Attack
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Wt Gain Diabetes, High Cholesterol
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Tobacco Cessation ANTI PLATELET RX (ASA, PLAVIX) “Blood
Thinners” Cholesterol Control LDL<70 & TG <150 BP Control <140/90 (<130/80 IN DM) Weight Control Sugar Control
It not all bad news Much of this is preventable/
reversible
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Reducing CV risk
Proud of our own achievement reducing amputations by half
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Outcome Disparity in Duval County 2006
http://www.FloridaHealthFinder.gov/QueryTool/Default.aspx?DataType=Inpatient “Crude” Salvage Rates by hospital Duval county 2006 DOH data
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SUMMARY
• Cardiovascular disease remains under diagnosed • Early diagnosis is feasible with limited cost • Early prevention and treatment can alter the long term outcome and reverse the poor prognosis • Obesity & Diabetes Epidemic must be addressed • New Technological & Medical Advances are available and still largely under utilized.