Though heart disease is increasing in America, it is taking fewer lives than it used to, says Dr Samin Sharma, director, Cardiac Catheterization Laboratory, Mount Sinai Hospital, New York. Sharma and Dr Annapoorna Kini, the lab's associate director, were among the five recipients this year of the New York State Department of Health's double-star rating for fewer complications in angioplasty.
In a statewide study by the department, Mount Sinai received a double star rating for the most successful record in performing percutaneous coronary interventions or angioplasty, a technique used to clear blocked coronary arteries. Sharma achieved a 0.41 percent rating in both non-emergency cases and overall cases, while Kini achieved a 0.43 percent rating for overall cases.
Sharma performs more than 1,500 complex coronary interventions annually, the largest number in the country, and has the highest angioplasty success rate (mortality < 0.3 percent) since 1994. Kini performs more than 1,000 coronary interventions annually, the highest number by a female interventionalist in the US, with a complication rate of less than 0.3 percent.
"Mount Sinai is the busiest cardiac catheterization laboratory in the state and treats the most complex cases, which makes the low mortality rating even more important," says Sharma, professor of medicine (cardiology) at Mount Sinai Medical Center. Kini, an associate professor (cardiology), says, "The report's rating exemplifies our dedication to quality and safety, and we look forward to making further improvements."
Sharma is setting up a heart hospital in Jaipur, Rajasthan, named Eternal Heart Care Center "to provide the latest and best care in the place where I studied. I owe that to my motherland, which enabled me to be what I am now." He expects the facility to be functional by November. His current lab treats more South Asians than any hospitals in the state.
While the number of Indians going to other hospitals make up about 4 to 5 percent of the total, at Mount Sinai the figure is 18 percent. The lab also employs several South Asian doctors.
Sharma cites the most important reasons for heart problems as a lack of exercise and sedentary lifestyle, obesity and diabetes. Though heart problems increase, new medicines and surgery are effectively challenging it, he says, adding that South Asians are more prone to the disease than people in the general population. He puts it down to genetic reasons, and a tendency for arteries to clog with calcium deposits.
"It could be due to the drinking of milk, lassi etc from childhood. Milk has much calcium in it. (Average) Americans do not drink milk," Sharma says. The result is that calcification of arteries occurs in them much later, when they are 70 to 80 years old; in Indians, it is around 40 to 50 years of age.
Most South Asians, he adds, do not go for regular medical check-ups and learn of their problems only when they get more serious. He says his lab is trying to resolve valve problems without surgery and to come up with gene therapy to deal with heart disease.
The state study was based on the data during 2005-2007. It provides statistics on deaths within 30 days following the procedure. In the three-year period, 53 non-federal New York hospitals were performing the procedure, but only Mount Sinai received a double-star rating.
Captions: Dr Annapoorna Kini, left, and Dr Samin Sharma
