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Abstract 271: Variations in Troponin Utilization in the Veterans Affairs Health System [Session Title: Poster Session PM]
Conclusions: There is substantial variation across facilities in the variation of abnormal troponin results. We aim to utilize this data to study additional facility-level, clinician-level, and patient-level factors that may be contributing to this variation. Future findings may allow us to identify interventions that can improve quality of care in the workup of acute coronary syndrome across VA facilities. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Chui, P. W., Hauser, R. G. Tags: Session Title: Poster Session PM Source Type: research

Abstract 270: Prediction of Health-Related Quality of Life at 12 Months From Baseline Modifiable Factors in Patients With Heart Failure [Session Title: Poster Session PM]
Conclusion: The findings of this study demonstrate multidimensional, modifiable predictors that interventions can target to improve HRQOL. Clinicians and researchers can target improvement in self-care, HF symptoms, and NYHA functional class to improve HRQOL, and, in turn, to reduce hospitalization rates. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Heo, S., Kim, J., Moser, D. K., Lennie, T. A., Fischer, M., Ounpraseuth, S., Walsh, M. Tags: Session Title: Poster Session PM Source Type: research

Abstract 269: Do Transferred-In Patients Have Longer Lengths of Stay at a Stroke Center? [Session Title: Poster Session PM]
Conclusion: While LOS for patients discharged to SNF was not significantly different between those transferred as compared to those who directly present to our CSC, discharges to ARF were significantly longer among those who were transferred to our CSC. Future efforts should be made to examine potential reasons for prolonged LOS among this group of patients. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Asaithambi, G., Castle, A. L., Kukielka, D., Ho, B. M., Marino, E. H., Hanson, S. K. Tags: Session Title: Poster Session PM Source Type: research

Abstract 268: Is There a Weekend Effect on Telestroke Code Time Metrics? [Session Title: Poster Session PM]
Conclusion: While there were no significant differences in outcomes, the "weekend effect" results in slower door to code activation and door to needle times. Efforts to improve methods in increasing efficiency of care on weekends should be considered. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Asaithambi, G., Castle, A. L., Marino, E. H., Ho, B. M., Hanson, S. K. Tags: Session Title: Poster Session PM Source Type: research

Abstract 267: A Single-page Best Practice Algorithm Reduces Stroke Risk and Improves Arrhythmia Management Decisions in Patients With Acute Atrial Fibrillation: A Quality Improvement Project [Session Title: Poster Session PM]
Conclusions: Using established quality improvement methodology and cost-neutral multi-disciplinary expertise, this novel management algorithm has significantly improved the quality and safety of care for patients with acute AF at NMUH. Prospective analysis of long-term adverse outcomes is now required to establish morbidity or mortality benefit. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Maclean, E., Patel, S., Joseph, O., de Block Golding, D., Maden, S., Boot, J., Denning, M., Rear, R. Tags: Session Title: Poster Session PM Source Type: research

Abstract 266: Preoperative Vancomycin and the Risk of Cardiovascular Implantable Electronic Device Infection: A Cohort Study in a Veteran Population [Session Title: Poster Session PM]
Conclusions: Our study revealed that among patients who received vancomycin as preoperative for CIED placement or revision, there was a three-fold increase in the risk of subsequent CIEDI. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Alzahrani, T., Baddour, L. M., Karasik, P. E. Tags: Session Title: Poster Session PM Source Type: research

Abstract 265: Angiotensin-Converting-Enzyme Inhibition in Stable Coronary Artery Disease and Cardiomyopathy With Mid-range Ejection Fraction: Insights From the PEACE Trial [Session Title: Poster Session PM]
Conclusion: This study unveiled the benefit of ACE inhibitors among patients with cardiomyopathy and mid-range EF. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Alzahrani, T., Tiu, J., Solomon, A., Panjrath, G. Tags: Session Title: Poster Session PM Source Type: research

Abstract 264: Accuracy and Indication of Emergency Department Echocardiography, What Needs to Be Improved? A Single Center Experience [Session Title: Poster Session PM]
Conclusion: In general, FE is a valuable tool which provides accurate assessment of volume status (IVC dimension) and for the most part accurately assessed EF and the presence of a pericardial effusion. However, FE may significantly underestimate EF in 15% of patients. Both LV and RV function and size may be difficult to assess based on time constraints, inadequate echo windows or technical issues with imaging. FE was unable to assess the aortic root accurately in 25% of cases. Despite the limitations of FE (acuity of medical conditions, the relative brevity of the study and modest training in echocardiography undertaken b...
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Adeel, M., Mahmut, A., Shah, A., Borkovich, M., Lancaster, G., Zarich, S. Tags: Session Title: Poster Session PM Source Type: research

Abstract 263: Assessment of the Relationship Between Body Mass Index and Atherosclerotic Cardiovascular Disease Risk in a University Based Residency Training Program: A Quality Improvement Initiative [Session Title: Poster Session PM]
Conclusion: Obesity rates appear to be higher in our patient population in comparison to national estimates but our mathematical model cannot be used to explain any correlation between BMI and ASCVD risk scores. Obesity did not confer an increased ASCVD risk in comparison to being overweight (BMI 25-29.9). However, both overweight and obese patients had a higher likelihood of having a significantly elevated ASCVD risk score. Future aims include initiating a targeted educational intervention for residents in the continuity clinic to ultimately demonstrate that resident driven intervention is an effective way to address obes...
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Chang, E. Y., Farooq, A., Stevens, E. S., Bakinde, N. Tags: Session Title: Poster Session PM Source Type: research

Abstract 262: Preferences for Primary versus Specialty Palliative Care Among Patients With Heart Failure [Session Title: Poster Session PM]
Conclusion: We frequently identified limited and often incorrect understanding of PC. Though once corrected, patients articulated variable preferences for primary vs. specialty PC integration into their existing HF care. Research is needed to identify means of increasing primary and specialty PC delivery in HF in a manner that reflects patient preferences. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Ikejiani, D. Z., Hadler, R. A., Arnold, R. M., Bekelman, D., Moreines, L. T., Harinstein, M., Kavalieratos, D. Tags: Session Title: Poster Session PM Source Type: research

Abstract 261: Global Patterns of Comprehensive Cardiovascular Risk Factor Control in Patients With Type 2 Diabetes Mellitus: Insights From the Global DISCOVER Registry [Session Title: Poster Session PM]
Conclusion: In a global registry of individuals with T2D from 37 countries, comprehensive control of ASCVD risk factors was not achieved in most patients, with wide variability among countries. Better strategies are needed to consistently provide comprehensive cardiovascular risk factor control in patients with T2D to improve long term outcomes. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Patel, K. K., Charbonnel, B., Chen, H., Cid-Rufaza, J., Fenici, P., Hammar, N., Ji, L., Kennedy, K. F., Khunti, K., Kosiborod, M., Pocock, S., Shestakova, M., Shimomura, I., Surmont, F., Watada, H., Gomes, M. B. Tags: Session Title: Poster Session PM Source Type: research

Abstract 260: Restructuring a Failed Cardiac Surgery Program in an Under Served Minority Population County [Session Title: Poster Session PM]
Conclusions: Strict attention to the process and structure fundamentals and details of Cardiac Surgical care in an underserved at risk population can result in acceptable outcomes and quality measures at low program volume. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Brown, J., Dawood, M., Gammie, J. S., Odonkor, P., Siddiqi, I., Gillespie, M., Dominique, G., Bartlett, S. T. Tags: Session Title: Poster Session PM Source Type: research

Abstract 259: Pre-Procedure Checklist and Morning Huddle as Part of Patient Evaluation for Cardiac Catheterisation [Session Title: Poster Session PM]
Conclusions: Although the survey was overwhelmingly positive at baseline, room for improvement was noted. It is anticipated that the intervention will allow the staff an opportunity to speak up when a problem is perceived, and improve communication, by empowering the team during the ‘Morning Huddle’. Our overarching goal is to improve the safety climate in the catheterization laboratory. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Samani, S., Clegg, S., Sheldon, M., Garcia, M. Tags: Session Title: Poster Session PM Source Type: research

Abstract 258: Impact of Community Health Workers in Management of Heart Failure: A Pilot Study [Session Title: Poster Session PM]
Conclusions: This pilot study suggests that CHW may reduce healthcare utilization for patients with heart failure without negatively impacting mortality. Based on these findings, a larger study is warranted to assess the efficacy and cost-efficiency of CHWs in helping to manage patients with heart failure. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Vohra, A. S., Chua, R., Alcain, C. F., Coplan, M. J., Spencer, K. T., Liao, J. K., Tabit, C. E. Tags: Session Title: Poster Session PM Source Type: research

Abstract 257: Improving Digital ECG Acquisition-to-Visualization Time Using EMR and Institutional Standard Operating Procedures [Session Title: Poster Session PM]
Conclusion: A standardized process for ECG acquisition and EMR upload dramatically reduces AtV time allowing for rapid EMR viewing of ECGs. The stepwise improvement in AtV observed in our study stresses the importance of both technical and operational components to this process. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Lambert, C. T., Sobol, T., Kravitz, K., Pengel, S., Bhargava, A., Fares, M., Barzilai, B., Khot, U. N. Tags: Session Title: Poster Session PM Source Type: research