Angina’s natural course supports conservative management
About 40% of patients with angina and stable CAD have resolution of anginal symptoms after one year without coronary revascularisation.
The findings, from 32,691 patients in the prospective observational CLARIFY registry, also showed further annual decreases in angina.
Patients in whom anginal symptoms resolved had a similar rate of 5-year death to patients without angina.
“Regression of symptoms could be explained by a less progressive atheromatous disease, stabilised by the use of secondary prevention drugs such as statins and angiotensin-converting enzyme inhibitors, allowing an eventless collateral development or adaptation,” the study said.
“Conversely, persistence of angina was associated with higher rates of cardiovascular events.”
They said there was a need for new and more effective therapies for angina.
Access improves for minimally invasive therapy for mitral regurgitation
MitraClip (Abbott) is now available on the MBS and funded through private health insurance for the reduction of mitral regurgitation.
The MSAC supported public funding of transvenous/transeptal techniques (TMVr) last year. Funding was supported on a cost-minimisation basis against optimised medical management in patients with degenerative and functional mitral regurgitation.
A CSANZ and ANZSCTS position statement on ‘Operator and Institutional Requirements for Transcatheter Mitral Valve Therapies in Australia’ has recently been published in Heart, Lung and Circulation.
MSAC also recommended establishing a TMVr registry as a condition of listing.
Private Healthcare Australia welcomed the minimally invasive treatment.
“This new device will improve quality of life for hundreds of Australians over the next few years, reducing the need for open heart surgery,” said Dr Rachel David, CEO of Private Healthcare Australia.
Mandatory vaccination needed for all hospital staff
The Morrison government is being urged to make vaccinations compulsory for all hospital staff across Australia and have a roll out plan to provide vaccine every hospital worker.
The peak body representing Catholic not-for-profit hospitals, Catholic Health Australia (CHA), says the Federal government already has a mandatory vaccination scheme for aged care and should put in place a similar scheme for all hospital staff across Australia, public and private.
CHA says its hospitals are already redeploying unvaccinated staff to clinical areas where there is a lower risk of contact with COVID patients and vaccinating staff as and when Commonwealth supplies become available.
“Every year health care staff are required to get vaccinated against the flu and yet there’s no such directive for COVID,” said CHA’s Health Policy Director James Kemp.
National Cabinet should bring in a uniform rule for mandatory COVID vaccination for hospital staff – regardless of whether they work in ED, ICU or any other clinical or support position, he added.
“The high transmissibility of the Delta variant of COVID is putting workers and the people they care for at greater risk as well as putting extra strain on staff,” he said
Mr Kemp said: “Every worker should have a date in their diary to get vaccinated. Every dose that comes into the country should have a hospital worker’s name next to it.”