Major Initiatives
ACS - Global Registry of Acute Coronary Events (GRACE)
Acute coronary syndromes (ACS) represent a major cause of morbidity and mortality throughout the world. The UMHS maintains an on-going registry of consecutive ACS patients. The aim of the ACS registry is to improve the quality of care for patients with ACS by describing differences in, and relationships between, patient characteristics, treatment practices, and in-hospital and post discharge outcomes at hospitals around the world. The UM registry currently contains data on over 4100 consecutive admissions for ACS including six month and 2 year follow-up data.
IRAD - International Registry of Acute Aortic Dissection
The International Registry of Acute Aortic Dissection (IRAD) is evaluating the ongoing management and outcomes of acute aortic dissection. It was established in 1996. Currently, 24 large referral centers in 11 countries participate in the study. The main purpose of IRAD is to assess the etiological factors, modes of presentation, clinical features, treatment, and hospital outcomes of patients with acute aortic dissection around the world. More than 2200 patients have been enrolled in the twelve years of its existance, far and away the largest aortic dissection registry on the planet.
IRAD has become the leading authority on acute aortic dissection, developing the standard mathematical models used to identify risk and outcomes of the disease. Studies to identify new breakthroughs in diagnosis and treatment are underway, such as: the genetic basis of aortic dissection; use of acute and chronic biomarkers for earlier detection; assessing the best surgical approach to perform depending on the circumstance; the consummate medical approach; what is the ideal follow-up regimen; and what is the proper role of the endovascular stent graft for optimal management. The UMHS is the Coordinating Center. IRAD is supported by grants from the UMHS, the Mardigian Foundation and the Varbedian Fund for Aortic Research.
IRAD Sites
IRAD Investigators
IRAD Manuscripts
IRAD Abstracts
FMD – Fibromuscular Dysplasia Registry
Fibromuscular dysplasia is a non-atherosclerotic, non-inflammatory vascular disease that most commonly affects the renal and internal carotid arteries but has been described in almost every arterial bed in the body. It may be entirely asymptomatic and discovered incidentally or it may present with a variety of symptoms.
The prevalence and natural history of FMD in the United States is not known. Since FMD may involve many different organ systems, a number of different specialists may see patients with FMD and patients often have a difficult time finding physicians who have experience in treating patients with fibromuscular dysplasia. These individuals all tell a similar story: it took too long for my condition to be diagnosed; physicians do not know very much about this condition; health care providers do not know how to treat patients with FMD; there is no research being conducted on FMD; and this lack of medical knowledge leads to a tremendous amount of anxiety on the part of the patient and their family members.
One of the missions of the Fibromuscular Dysplasia Society of America (www.fmdsa.org) is to begin an international registry of patients with FMD. MCORRP is the coordinating center for this registry which will begin in calendar year 2009.
MAQI2 – Michigan Anti-Coagulation Quality Improvement Initiative
The MAQI2 is an ongoing, multicenter, regional, collaborative registry of anticoagulation care, which it seeks to improve the safety, quality of care and outcomes of patients requiring anticoagulation. Patients who receive anticoagulant therapy in the outpatient setting at five sites in Michigan (UMHS, Henry Ford Medical Center, Beaumont Hospital in Royal Oak, Detroit Medical Center and West Michigan Heart) will have their de-identified data collected and put into a data registry at the MAQI2 Coordinating Center located within MCORRP. Data collected will include patient demographics, time in therapeutic range (TTR), frequency of adverse events including ED visits and inpatient admissions, and descriptors of the anticoagulation system structure and function.
Risk adjustment models will be developed from the initial data collected. Observed and predicted long-term outcomes will be evaluated. Quality improvement initiatives will be developed and deployed through the collaborative. Observed and risk-adjusted outcomes in the pre and post quality improvement intervention periods will be compared. Elements of Anti-Coagulation Service that correlate with high-quality care and fewer adverse outcomes will be identified and shared with Anti-Coagulation Service providers state-wide.
ACC GAP Initiative in Heart Failures
Led by Anthony DeFranco, M.D., Todd Koelling, M.D., and Cecelia Montoye. MSN, the Greater Flint Health Coalition, and the Michigan Chapter of the American College of Cardiology this inpatient to outpatient GAP program aimed at improving quality in patients hospitalized with heart failure has been implemented in 14 mid-Michigan hospitals. M-CORRP provides the core data analysis support for this project in addition to the physician and nurse leadership. Data analysis in on-going.
Americans are faced with a national epidemic of obesity which often starts in childhood. Poor lifestyle habits developed by our children are resulting in significant increases in chronic diseases including diabetes and heart disease. Project Healthy Schools; a collaboration between community schools and the University provides school children, educators and their families with information and activities to make changes towards a more healthy lifestyle. Since its conception, MCORRP has provided support for measurement of factors related to diet, physical activity and healthy measures such as blood pressure and cholesterol levels.
Five simple goals have been identified: (1) Increase aerobic exercise for each student to at least 150 minutes per week; (2) Increase consumption of fruits and vegetables; (3) Reduce consumption of high-calorie containing beverages; (4) Reduce consumption of high fat and/or fast foods; (5) Reduce television or computer screen time, promoting exercise, reading, or music as alternatives. Project Healthy Schools was initiated in one pilot school, Clague Middle School in 2004-05. In 2005 the program expanded to Forsythe and Slauson Schools, with all five Ann Arbor Public Middle Schools incorporating the program by 2006. The following year the neighboring community, Ypsilanti incorporated the program into their middle schools (2 schools) and in 2008 the Flint/Owosso area Corunna School system was added. Project Healthy Schools collaborates with local and national groups including the Hands-on- Museum, Free-the-Children Foundation, Farm to School Programs, and the Atkins Foundation to promote healthy lifestyle habits and social responsibility among middle schools children.
Project My Heart Your Heart
As we enter the 21st century, the healthcare disparities between the industrialized world and those in underserved nations have become all too apparent. Cardiovascular disease has an increasing impact on morbidity and mortality in many developing countries, many of which already face a disproportionate burden of infections leading to abnormalities of the conduction system. Novel methods of delivering costly electrophysiologic healthcare to impoverished nations are needed.
Project My Heart Your Heart is a joint collaboration between citizens, physicians, and funeral directors in the state of Michigan, the University of Michigan Cardiovascular Center, and the Komfo Anokye Teaching Hospital in Kumasi, Ghana. The purpose of the project is to create a central organization which obtains pacemakers post-mortem and creates a distribution network for safe reuse. The Komfo Anokye Hospital will be a primary recipient of numerous devices as many citizens in Ghana have no access to electrophysiologic healthcare. Collaborations with the University of Pennsylvania, World Medical Relief inc, and the Department of Public Health are further enhancing the impact we will have on global healthcare.
