HVI Analytics: Leveraging Big Data to Identify Opportunities to Improve

WINTER 2020 UPMC HEART AND VASCULAR INSTITUTE

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are identified that leadto better outcomes, they can then be applied systemically at all UPMC facilities for heart and vascular care. with UPMC Clinical Analytics, which is headed Marroquin. Dr. by The HVI also employsteam a statisticians of proficient in the sophisticated analyses required to decipher big data sets. Harnessing the Power theof EHR Although the EHR was not specifically created for physicians use learn to to and improve, it houses a wealth information. of invested in transforming the utility the of analytics program. clinical the through EHR Business application tools sit on the EHR and allow Mulukutla Dr. visualize to inpatient, pharmacy, and laboratoryoutpatient, data and toggle between differentof ways viewing this data in real Mulukutla time. Dr. and his analytics team can stratify patients condition,by patient by characteristics, or by operational aspects. With such a large system is there providers, different many so and inherent variability using in care. However, clinical analytics, this variability can be used differences When opportunities. identify to improve care.improve In the HVI analytics division, MulukutlaDr. oversees clinical data specialists and data managers who develop programs draw out to information that the clinicians request and help them visualize it. The HVI analytics division partners closely

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Cardiology. - . various office locations. perform clinicians These UPMC is home one to the of nation’s largest cardiology divisions, more with than 100 cardiologists working at the 40 hospitals in the UPMC system and Suresh Mulukutla, MD Suresh

standing relationship with data.” He data.” with relationship standing - U.S. News & World Report record (EHR). more than 23,000 diagnostic and interven tional procedures each In the process, year. they generate a massive quantity clinical of data, which is stored in the electronic health HVI Analytics: Leveraging Big Data Big Leveraging Analytics: HVI Improve to Opportunities Identify to Patient Care and Oscar Marroquin, MD, a cardiologist in the HVI and chief clinical analytics officer, UPMC Health Services Division, recognized the opportunity replicate to the power the of NHLBI multicenter registry within UPMC. Mulukutla,According Dr. to clinical analytics allows “integrate us to and harmonize all theof data across the health system,” and provides a host opportunities of to and pathologies cardiac understand interventional cardiologist in the UPMC Heart and Vascular Institute (HVI), is the Director Analytics of forthe HVI MulukutlaDr. and his team integrate inpatient and outpatient data from across the UPMC system, aggregate this data, and use it to identify opportunities care. improve to When Mulukutla Dr. first participated in the National Heart, Lung, and Blood Institute (NHLBI) Dynamic Registry in the early 2000s, he began what he describes as a “long HEART ANDVASCULAR

Affiliated with the University of Pittsburgh School of Medicine, UPMC Presbyterian Shadyside is ranked among America’s Best Hospitals by

UPDATE Geroscience: Frontiers in the the in Frontiers Geroscience: UPMC Physician Resources UPMC Physician 2020 Conferences Vascular Institute Vascular New Supporting LeadershipNew Role at Aging Institute Biology of Aging to Identify Opportunities to Improve Patient Care Estes Joins UPMC Heart and HVI Analytics: Leveraging Big Data Daniel Forman, MD, Assumes MD, Forman, Daniel

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CAD - CABG also 2 year mortalityyear - matched groups matched (Continued on Page 7) - CAD and diabetes or heart failure - world conditions with contemporary contemporary with conditions world - cardiovascular events. Prior data supported directing patients with MV CABG.to Mulukutla’s Dr. study provided an importantanalysis outcomes of under real treatment options and suggests that more considered be CABG should ability dissect to the vast data available from the EHR at UPMC and studied outcomes after treatment MV of in more than 6,000 patients at five UPMC readmissions, hospital Mortality, hospitals. and major adverse cardiovascular events (MACE) compared were after CABG and propensity two in PCI moreof than 800 patients who would be eligible for either Mulukutla therapy. Dr. and his colleagues found that CABG had a mortality benefit in theoverall one population (estimated 11.5% for PCI of and for CABG, 7.2% 0.001) < p and in every subset population comorbidities the of independent examined diabetes of and heart failure. resulted in fewer readmissions (38.4% vs. 28.1%, p < 0.001), fewer patients who required revascularization (6.7% vs. 1.0%, p < 0.001), and fewer adverse

vascular

CAD). CoronaryCAD). artery bypass CAD, and the optimal treatment is still - - and with differingcomorbidities. MulukutlaDr. and his team, in collaboration with Arman Kilic, MD, from the Department the leveraged Surgery, Cardiothoracic of examined in detail is patients with artery coronary disease multivessel (MV grafting (CABG) and percutaneous coronary intervention (PCI) are both safe and established treatment options for MV a matter debate. of Multiple factors drive the decision which of therapy use, to but there been have studies few directly comparing the outcomes CABG of and PCI in routine clinical practice in patients with cardiac disease varying of complexity has the potential speed to up this process. For example, the HVI clinical analytics division can narrow down the data identify to groups patients of with high cardio risk who also meet may specific criteriato be eligible for novel therapies. MV-CAD, in Projects (AFib), Fibrillation Atrial Intervention Valvular and One population that HVI analytics has normally can take months or years. The use clinicalof analytics and large EHR data sets

scale - (Continued from Page 1) Page from (Continued

world practice - AFib clinical analytics dashboard. This tool allows patient populations be to identified and analyzedto, among other things, find individuals who may not be receiving optimal anticoagulation therapy minimize to their stroke risk. Figure 1. within a day. Translating published data data published Translating day. a within from clinical trials real into who had undergone a coronary placement, stent as such intervention, who also diabetes have and heart failure. Now this information can be compiled For example, in the past, it would take weeks compile to a list UPMC of patients UPMC physicians during a given period for the condition in question and then rates, hospitalization in differences examine mortality, and other outcomes measures. specific patient populations withconditions interestof for analysis. They can quickly determine how many patients are seen by hospitals lack either the integrated data or the patient volume available at UPMC. The HVI analytics division can select differences is essential. UPMC is unique in its support helping of physicians use data from the EHR. Additionally, many other identify opportunities. Additionally, knowing which measures are themost helpful and tease how to out subtle volume also is a tool. The incredible volume volume incredible The tool. a is also volume data Mulukutlaof that Dr. and his colleagues can access their to is success. key Variability in care is a challenge but allows them to There are several challenges to large challenges to several are There data mining from the EHR. The sheer volumedata of is one challenge; this data HVI Analytics HVI

Figure 2. Valve Disease Population. This dashboard illustrates the HVI ability to identify patients with various valvular heart disease conditions across the health system.

Figure 3. Hospital-Hospital Transfers. Evaluation of patients who are transferred between facilities allows for optimization of care and to ensure that patients are transferred to facilities that can best accommodate their care needs.

aging aging approved - (Continued on Page 5) . approved compounds approved - - anti new, for molecules approved uses,” Finkel. says Dr. The diabetes drug metformin will be analyzed in an internally led study in the setting elective of surgery with adults. older applicable in modifying processes of of processes modifying in applicable aging,” Finkel. says Dr. In the domainbasic of science research, the laboratories the of Aging Institute are looking at such things as the connections between autophagy and mitophagy and or eliminating their removing roles in damaged proteins or organelles from the body and how this contribute may agingto itself. Other aspects research of will be focused on DNA damage repair, processes, mitochondrial folding protein inflammation and research, telomere and and its role in aging processes, among others. For the testing FDA of already projects are compounds, several in the planning phases, and the efforts from a broad perspective will be spear headed Anne by B. Newman, MD, and Daniel Forman, MD Newman“Dr. recently joined the Aging Institute as our clinical and director, she, along Forman, with Dr. who specializes in geriatric cardiology, will be leading many ourof effortsto try andrepurpose FDA if we canif we intervene in, think we will prevent these sorts illnesses of fromin happening the first Finkel.place,” says Dr. The Aging Institute, Finkel which now Dr. leads, has begun expand to its research many pursue to capabilities and focus avenues basic of and translational research with respect the to goals geroscience of large.writ “In the end, approximately will have we 15 different laboratories workingall on various aspects aging of biology, so the work here will be incredibly diverse. Coupledwith the basic science labs will be a high throughput screening facility that will help significantly in our mission developto entirely new classes anti of aging drugs. also hope We repurpose to FDA existing that think we might be beneficial or

specific with some - related component. component. related - related diseases. - specific therapies per se. We are are We se. per therapies specific - related conditions such as Alzheimer’s Alzheimer’s as such conditions related - that underlie the biology aging, of which, Cardiovascular disease, cancer, cancer, disease, Cardiovascular all these — diseases neurodegenerative age powerful a have mostUntil now, the of strategies for treating these broad categories illness of beenhave very disease successes and equivalent number of failures. The approach Finkel that and Dr. colleagues are taking — the geroscience approach — means that, “We are not necessarily looking for or hoping develop to disease interested in the molecules and processes Fundamentally, Finkel and Dr. the groups working on these problems believe that once more we fully understand thebasic mechanisms that drive aging, will be we in a position develop to new drugs that can processes, mechanistic those regulate leading effective to treatmentsfor a wide range age of Approach to A Translational Processes Modifying Aging DiseaseDriving aspects or hallmarks aging, of and it’s certainly complex, “But that is say not to these processes are not regulated or to malleable be sense some in cannot interventions on the cellular or molecular for example, know, level. We in simple organisms that modificationscertainto genes or proteins can profound have effects on both lifespan and health span. Similar modifications whatare we hope accomplishto with human aging and age disease,” Finkel. says Dr. Modifying the Basic Biology Aging of and Pathways know muchWe about the basic biology agingof and its pathways, but significant gaps remain be to explored and understood. the At molecular level, it is known that accumulated nuclear DNA telomeres, the of shortening damage, problems with mitochondria, protein aggregation issues, and a host quality of control mechanisms can go awryas individuals age. there Yes, are multiple Understanding and Understanding

year career with the - regulate the aging process? Moreover, fundamentally by and how understanding Can discover we and basic the understand biological mechanisms and that pathways Toren Finkel,Toren MD, PhD

many dedicated faculty across many Finkel. disciplines,” Dr. says to come Pittsburghto to pursue — to my researchown in the biology aging of front but also help to lead this effort with so the University Pittsburgh of and UPMC to one into grow the of premier basic biology agingof and translational research centers in the world was what really attracted me Blood Institute (NHLBI) immediately preceding his arrival in Pittsburgh. “The support and commitment from both National Institutes Health, of where he was the chief the of Center for Molecular Medicine in theNational Heart, Lung, and Dr. Finkel arrivedDr. at the University of Pittsburgh and UPMC in June 2017 after a distinguished 25 medicine in the Division Cardiology, of and the G. Nicholas Beckwith III and Dorothy B. Beckwith chair in translational medicine. Helping lead to these emerging efforts in is geroscience director the of Aging Institute, professor of age, and ultimately can how we intervene moreto effectively improve and extend one’s quality life of for as long as possible. UPMC and the University Pittsburgh of are investing heavily in the pursuit answers of that will unlock the mysteries and complex processes how of and human why beings related diseases and disabilities that occur as consequences the of biology aging? of This is the fieldof geroscience, and devise the tools and technologies that will allow intervene, us to modulate, or perhaps reverse the full range age of why processeswhy aging of can occur, we Geroscience: Frontiers in the Biology of Aging of Biology the in Frontiers Geroscience:

specific context but one whereby whereby one but context specific - period where they are incapacitated or or incapacitated are they where period debilitated. think We that it has do with to what’s driving the aging process, and again are verywe optimistic about this approach and the research contributing it. to This is a thinking of new way about diseases, not in disease a you modify aging Finkel. itself,” says Dr. There is this observation that people who incrediblyhave long lives generally are relatively free from various morbidities. This theory, called the compression morbidity, of says that if as you extend life, you can also shrink the period time of an individual is morbidities. suffering from “This is sort the of Holy Grail extend — to a person’s life span but compress the time Institute and its Forman. work,” says Dr. “I see it as an exceptional crucible for ideas, and idealistic among energy and insight, dazzling colleagues, which seems certain propelto innovation in the care older of adults.” As the Aging Institute’s first therapeutics, emerging of director he will help organize and lead its program. translational While Forman’s much initial Dr. of research cardiovascular adults older with on focused disease, his studies expanded have to include those with and without cardio principal the is He disorders. vascular investigator a cardiac of rehabilitation trial that will advance strategies better to weakened are who patients older enable and debilitated after hospitalization regainto function, confidence, and is he Simultaneously, independence. leading multiple studies that target physical underlying mechanisms biological decline and novel strategies remedy to them. Body composition, nutrition, and factors the among are inflammation considered in this work. “I am thrilled be to part the of Aging

life in - of - sustain a sufficient quality of life. modify frailty and the propensity for nonspecificinflammatory this that disease belies.” response Emerging Paradigm The Health the Span of While a long life is generally desirable by most individuals, what is an extended length without commensurate quality? Much discussion is now focused on the idea theof health span — the length time of that one remains disease free and able to arthritis or Crohn’s disease can be repurposed in a safe and effective way in older adults. Our hope negate is to or mitochondria and boosted exercise subsequently performance. have These data led multiple to NIH studies and an expanding body work. of extending from novel approaches clinical of care in older adults cellular to and subcellular mechanisms, all with prevailing goals of enhancing function and quality older adults. His expertise in cardiovascular disease and clinical care is complemented by science. cellular pertinent in expertise broad Soon after coming Pittsburgh, to Forman Dr. received funding from the Aging Institute pursueto a novel pilot study nitrite of heart older in failure supplementation patients. The study showed that nitrites improved bioenergetics in skeletal muscle confound standard medications, procedures, in the leadership assessments. His and American CollegeCardiology, of the American the Heart Association, American Geriatrics Society, and theNational Institutes Healthof catalyzed have more novel holistic have and care, patient to approaches sparkedeven funding initiatives further to grow the field. Forman’s researchDr. on older adults at the University Pittsburgh of is multifaceted,

6 levels,6 - Daniel , was named (Continued from Page 4)

as the new Director of Therapeutics Emerging at the Aging Institute of Services UPMC Senior and the University of Pittsburgh. Earlier thisyear, Forman, MD

proposed study metformin of in aging -

inflammatory conditions like rheumatoid rheumatoid like conditions inflammatory agents that been have developed for other a sign bad of things come. are to very We interested in knowing whether biological of whoof is or is not going as live they to become elderly. It’s a marker frailty of and it’s probably one the of best predictors “If you look at markers inflammation, of interleukin example circulating for responses seen in older adults. Other areas focus of will likely look at inflammatory nonspecific the reducing in which will be we part here of at Pitt.” time. There is also a large, multicenter, NIH improved survival or reduced hospitalization “The goal see is to if metformin taken prior including benefits, provides surgery to Geroscience pervasive with age and that commonly other health care challenges that become insights regarding associated frailty, frailty, associated regarding insights comorbidity, cognitive decline, falls, and older adults. Management of a specific specific a of Management adults. older disease process is coupled expanding to that responds the to distinctive needs of integrate geriatric precepts specialty into medicine in order better to achieve care flourished, Forman and Dr. has advanced as a national leader in effortsto broadly his areas expertise. of That program has Hospital in Boston launch to a new geriatric cardiology program that extends from recruited the to University Pittsburgh of four years ago from Brigham and Women’s Section Geriatric of Cardiology, was who also is a professor medicine of in the Division Cardiology of and chair the of A cardiologist and geriatrician, Forman, Dr.

Leadership Role at Aging Institute Aging at Role Leadership Daniel Forman, MD, Assumes New Supporting New Assumes MD, Forman, Daniel

2009, chair of - – Catalin MD Toma, – Samir Saba, MD – Raveen Bazaz, MD – Michael Singh, MD – Timothy C. Wong, MD mentorship trainees to and junior faculty, and research that will guide the evolution of cardiac electrophysiology clinical practice. influence in shaping the clinical practice cardiacof electrophysiology the over decades. three past advanced further been has influence This with involvement deep Estes’s Dr. though the work and task committees force of the American Heart Association (AHA), American CollegeCardiology of (ACC), and Heart Rhythm Society (HRS). His involvement at the national level has earned him many awards and positions, including president HRS of from 2008 the Council Clinical of Cardiology the of AHA, and the special distinction having of won both the American Heart Association and Award Achievement Distinguished Distinguished Leadership Award. In his new role within the UPMC HVI, EstesDr. will continue provide to excellent clinical expertise in the care patients, of – Kathryn Berlacher, MD, MS

is a series short, of and informative, educational

- - and

and surgical disciplines. Current topics in cardiology and cardiothoracic surgery include: Advances in Aortic Aneurysm Repair Prevention Fibrillation andAtrial Stroke Occlusion Total Coronary Treating Effectively Advances in Atrial Fibrillation Treatment Hypertrophic Cardiomyopathy Cardiology Women’s Hypertension Assessment in Primary Care Presented Sean PhD, by D. Stocker, FAHA Arrhythmogenic Cardiomyopathy: Right Ventricular Prediction and Prevention of Sudden Death Presented N.A. by Mark Estes III, MD, FHRS Rounds Video RoundsVideo videosfor created physicians and a variety covering medical of stage with - . Of note, Dr. Estes. Of note, Dr. also has

reviewed manuscriptsreviewed published in impact medical journals such as the - - Journal of the American Medical authored 60 guideline and consensus consensus and guideline 60 authored - cardiology on the world and honors, achievements, numerous awards collected during his impressive career. He has authored more than 250 peer high New England Journal of Medicine the Association co achievement an manuscripts, statement considerable his highlights that nascent fieldof cardiac electrophysiology at Massachusetts General Hospital. In 1983, Estes Dr. was recruited Tufts to New England Medical the Center (now Tufts Medical establish to Center) an Within service. management arrhythmia a short Estes time, Dr. establishedthe (NEAC). Center Arrhythmia England New achieved NEAC the leadership, his Under a leading stature in the Boston area and nationwide recognition for itsimpeccable quality care. of EstesDr. is a recognized leader in year training of focused on the then

long - New New - renowned - , joined the UPMC a professor medicine of in the UPMC Cardiac Electrophysiology Program. joining Before Mark A. Estes, MD, FACC, FHRS Heart Vascular and Institute (HVI) in 2018 as

Frontiers in Cardiac Intensive Care: Critical Illness and Neurodevelopment Presented Justin by MD Yeh, Presented N.A. by Mark Estes III, MD, FHRS Approach Radial Distal Presented Krishnamurty by Tummalapalli, MD V. Atrial Fibrillation Ablation: Focus on Comprehensive on Focus Ablation: Fibrillation Atrial Care of AF Presented Efthymios by Avgerinos, MD, al et Symposium Transradial 2019 the From Presentations Select Presented John by Schindler, MD in Cardiovascular Health Care Presented Arman by Kilic, MD Rounds Grand Vascular Current CME Courses Include: CME Courses Current Learning Machine and Intelligence Artificial For the latest news, events, videos, news, events, latest the For and free CME UPMC and by courses researchers, clinicians presented visit UPMCPhysicianResources.com/Heart UPMC Physician Resources UPMC Physician England Medical followed a by Center, Beth Israel Deaconess Medical Center. EstesDr. then completed his training in Tufts diseases at cardiovascular moving Boston to where he completed his then the at residency medicine internal New England Deaconess Hospital, now academic institutions. academic EstesDr. received his medical degree from the University Cincinnati of in 1977 before of cardiacof arrhythmia specialists who trained under him, many whom of now prestigious at positions leadership key hold director the of New England Cardiac Center in Boston. Estes Dr. is world a master a electrophysiologist, cardiac clinician, and a great mentor a generation to UPMC, Estes Dr. was the decades Estes Joins UPMC Heart and Vascular Institute UPMC Heart Joins Vascular and Estes

132. -

917.

Ann 76. - 480. Charging Quality - 2019; 74(1): 104 Catheter Cardiovasc E12.

2018. 2017; 166(12): 916 edge technology that - derived EHR data to 2014; 64(21): e1 - - 474 108(2): 2019; 2019; 241: 112533. J Am Coll Cardiol. Ann Intern Med. - E103 88(4): 2016; rences and rences Galetsi Katsaliaki P, K, Kumar S. Values, Sanchez CE, Dota A, Badhwar Kliner V, D, January CT, Wann LS, Calkins H, Chen LY, January CT, Wann LS, Alpert JS, Calkins H, Hagland M. UPMC, At Turbo Masri A, Althouse AD, McKibben J, Lee JS, Challenges and Future Directions of Big Data Analytics in Healthcare: A Systematic Review. Soc Sci Med. Multivessel Coronary Artery Disease. Surg. Thorac Smith AJ, Chu D, et al. Revascularization Heart Recommendations Team as an Adjunct Appropriateto Use Criteria for Coronary Complex With Patients in Revascularization Coronary Artery Disease. Interv. Cigarroa JE, Cleveland Jr JC, et al. 2019 AHA/ ACC/HRS Focused Update of the 2014 AHA/ of Management the for Guideline ACC/HRS Patients Fibrillation: Atrial With Report A of Cardiology/American of College American the Heart Association Force Task on Clinical Practice Guidelines and the Heart Rhythm Society. Cigarroa JE, Cleveland Jr JC, et al. 2014 AHA/ of Management the for Guideline ACC/HRS Patients Fibrillation: Atrial With Report A of Cardiology/American of College American the Heart Association Force Task on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. Improvement Efforts Through Data Analytics. Healthcare Innovations. Mulukutla SR. Limitations of Administrative Data for Studying Patients Hospitalized With Heart Failure. Marroquin OC, Thoma et al. Coronary F, Bypass in Revascularization Percutaneous Versus Mulukutla SR, Gleason TG, Sharbaugh M, Sultan I,

7. 3. 4. 5. 6. who not may easy have access the to UPMC outpatient clinics. The results theseof analyses will allow UPMC to strategically and grow provide cardiology care more to patients. HVI analytics and UPMC Clinical Analytics reflect thecombined commitment of UPMC developingto cutting harnesses patient clinicalimprove care and outcomes. Refe Reading Further 1. 2.

day -

day and 30 - up appointments in - . risk for readmission when Using data from the EHR, g Unplanned g - 6 mbattin Conclusion MulukutlaCurrently, Dr. is using the power HVIof analytics address to the important issue improving of patient access to UPMC cardiologists. UPMC is looking for opportunities at an operational level to serve more patients. Using big data from the EHR, Mulukutla Dr. is addressing ways that UPMC can run outpatient clinics to accommodate more patients and locating subpopulations within the community patients at high they are first admitted and intervene before they are discharged. several At UPMC become has planning discharge hospitals, more efficient. Follow the clinic can be scheduled as early as the firstof a day hospital admission. Readmission rates since have declined for cardiology patients. Additionally, these efforts allow UPMC better to use its resources. Larger further andimplementation, analysis, publication these of results are in progress. patients in a smarter developing is by way a assesstool to the risk unplanned of hospital readmission at the outset a hospital of stay. Unplanned readmissions are a big challenge for every hospital, and the UPMC team has focused on lowering seven readmission rates. Mulukutla,Dr. Marroquin, Dr. and their colleagues found that if patients are seen in the clinic within 30 days discharge, of there is a 50% reduction in rehospitalization within 30 days. MulukutlaDr. and colleagues can identify determining the best collaborate to ways help and physicians care primary with themefficiently care for their patients. HVI analytics is developing a process that does not overload busy physicians but allows them directed have to information for these patients Co Readmissions Another example Mulukutla how of Dr. and his colleagues used have data care to for The HVI analytics team currently is

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based based

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3 based guidelines guidelines based scale data mining data scale - -

then contact the primary care providers providers care primary the contact then and facilitate an evaluation the of patients. valvular intervention, the cardiologist can physician. If the EHR can be used identify to patients meeting guideline criteria for a it requires the cardiologist wait for to actions both the by patient and another by that will likely improve the patient’s improve that likely will health; referral from another physician. This is not a proactive approach delivering to care guidelines. Historically, these patients patients these Historically, guidelines. present the to cardiology clinic after a or a defibrillator based on evidence on based defibrillator a or working on identifying patients who would likely benefit from a valvular intervention Similarly, the HVIanalytics division is the patient’s care in light their of AFib and status. therapy anticoagulation contact physicians and ask them evaluate to seen a primary by care doctor or specialist in the UPMC system. His team then will these patients and then access scheduling scheduling access then and patients these information know to when they will next be correct care. Mulukutla Dr. can identify an opportunity is present evaluate to all patients see to if they are receiving the some patients a valid have may reason abstainto from anticoagulation therapy, with anticoagulationwith Although therapy. The EHR is being queried for all patients with AFib who are not being treated clinical guidelines reduce to the risk a of stroke). (CVA, accident cerebrovascular therapy, which isrecommended several by to increaseto the proportion patients of with AFib who are on anticoagulation example is using large using is example that been have put forth professional by societies in cardiovascular medicine. One ensure that UPMC patients are treated evidence to according of Excellence,of in using clinical analytics to Dr. MulukutlaDr. is working with Sandeep Jain, MD, director the of Atrial Fibrillation Center their treatment options. revascularization heart team help may patients make the best decisions regarding A multidisciplinary approach from a a from approach multidisciplinary A frequently for patients with MV HVI Analytics HVI 200 Lothrop St. Pittsburgh, PA 15213-2582

UPMC HVI 2020 Conferences 6th Annual Transradial and Complex Cardiac 17th Annual Pittsburgh Vascular Symposium Interventions Symposium Save the Date: Thursday, May 21 to Save the Date: March 21, 2020 • Pittsburgh, Pa. Saturday, May 23, 2020 • Pittsburgh, Pa.

This one-day CME event will feature a wide range of topics on the transradial This CME conference will provide an evaluation and critique of the current approach to cardiac catheterization/PCI, case-based discussions, and videos and future standards of care in the treatment of the vascular patient. presented by the UPMC Heart and Vascular Institute faculty. Internationally A multidisciplinary panel of national and international speakers will discuss recognized guest lecturers will be featured. updates on the treatment of vascular disease and new innovations in the field.

Additional Information Additional Information For more information, please contact Brenda Smith at 412-647-6816 or For more information, or to register, please contact Mark Byrne at [email protected] or visit UPMC.com/TransradialSymposium. [email protected] or visit UPMC.com/VascularSymposium.

ABOUT THE UPMC HEART AND VASCULAR INSTITUTE UPMC Heart and Vascular Institute 200 Lothrop St. Pittsburgh, PA 15213 1-855-UPMC-HVI (876-2484) The UPMC Heart and Vascular Institute provides comprehensive cardiovascular care for UPMC.com/HVI patients and is helping to advance the field and improve patient outcomes through research. • The Cardiology Division is one of the nation’s largest, with more than 130 cardiologists and For consults and referrals to cardiology 100 PA/CRNPs who span over 20 hospital sites and 40 office locations. Our high-volume or cardiac surgery, please call UPMC’s 24-hour physician OnDemand service practice encompasses more than 23,000 diagnostic and interventional procedures per year, at 1-866-884-8579. and the experts in our Center for Aortic Valve Disease have performed more than 1,200 transcatheter aortic valve replacement (TAVR) procedures to date. To refer a patient to the UPMC Division of Vascular Surgery, • The Cardiac Surgery Division provides a multidisciplinary approach to patient care in an call 412-802-3333. environment that fosters the development and evaluation of innovative surgical techniques and therapies. Our staff, which includes more than 20 cardiac surgeons, are committed to A $20 billion health care provider and insurer, clinical excellence as well as scientific inquiry, and represent a broad range of expertise in Pittsburgh-based UPMC is inventing new models of cardiothoracic surgical procedures. patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates 89,000 employees, 40 hospitals, 700 doctors’ • The Vascular Surgery Division of the UPMC Heart and Vascular Institute offers comprehensive offices and outpatient sites, and a nearly 3.6 million-member arterial, endovascular, and venous care by a team of vascular experts. These professionals Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, work together in the study, development, and implementation of new procedures and devices UPMC contributed $1.2 billion in benefits to its communities, to deliver advanced, comprehensive vascular care. The surgeons of the Vascular Surgery including more care to the region’s most vulnerable citizens than any other health care institution, and paid $587 Division specialize in minimally invasive procedures, which many of our faculty helped to million in federal, state, and local taxes. Working in close pioneer for the treatment of the entire vascular system. collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside on its annual Honor Roll of America’s Best Hospitals and ranks UPMC Children’s To learn more, visit Hospital of Pittsburgh on its Honor Roll of America’s Best UPMCPhysicianResources.com/Heart. Children’s Hospitals. For more information, go to UPMC.com.