CIP Bajpai News

Is Daily Aspirin Therapy Right for You?

Is Daily Aspirin Therapy Right for You?

“Daily aspirin therapy can be a lifesaving option.” Says Enakshi Bajpai, D.O., Cardiologist at Inspira Health and member of the Cardiac Partners at Cooper and Inspira network. “But it isn’t for everyone. It’s important to understand the benefits and the risks before beginning any type of antiplatelet drug.”

If you’ve had a heart attack or stroke, your doctor will likely recommend you take a daily aspirin unless you have a serious allergy or history of bleeding. If you have a high risk of having a first heart attack, your doctor will likely recommend aspirin after a comprehensive evaluation of your individual condition.

How can aspirin prevent a heart attack or stroke?

Dr. Bajpai explains, “Aspirin interferes with your blood’s clotting action. When you bleed, your blood’s clotting cells, called platelets, build up at the site of your wound. The platelets help form a plug that seals the opening in your blood vessel to stop bleeding. But this clotting can also happen within the vessels that supply your heart and brain with blood. This prevents blood flow and can cause a heart attack or stroke. Aspirin therapy reduces the clumping action of platelets — possibly preventing those types of cardiovascular attacks.”

Am I a candidate for a daily aspirin regimen?

Your doctor might suggest daily aspirin therapy if you meet certain criteria, such as:

  • Fall in the proper age rage, generally between 50 – 69 years of age.
  • You’ve already had a heart attack or stroke.
  • You’ve never had a heart attack but are at high risk for one based on other factors.
  • You haven’t had a heart attack, but have had a stent placed, had coronary bypass surgery, or complications from angina.
  • You suffer from diabetes.

“Although aspirin has been recommended in the past for certain groups of people without a history of heart attack, there’s some disagreement among experts about whether the benefits of aspirin outweigh its potential risks.” States Bajpai.  And according to the Food and Drug Administration, the benefits of daily aspirin therapy don’t outweigh the risk of bleeding in people with a low risk of heart attacks. The higher your risk of heart attack, the more likely it is that the benefits of daily aspirin outweigh the risk of bleeding.

What are the risks?

“Because aspirin thins the blood, it can cause several complications.” says Bajpai. Tell your doctor if any of these situations apply to you. 

  • Have a known aspirin allergy or intolerance
  • Are at risk for gastrointestinal bleeding or hemorrhagic stroke
  • Drink alcohol regularly
  • Are undergoing any simple medical or dental procedures
  • Are over the age of 70

There is a risk of developing stomach problems, including stomach bleeding, for people who take aspirin regularly. Alcohol use can increase these gastrointestinal risks. Dr. Bajpai recommends, “If you are told to take aspirin, ask your doctor if it is safe for you to drink alcohol in moderation.”

The bottom line…

While aspirin may be able to help certain patients in specific situations, there are many other things an at-risk patient can do to mitigate their risk of having a first, or repeat, heart attack or stroke. Healthy lifestyle changes, increased levels of exercise and good sleep patterns are all ways to improve your cardiovascular health. If after these good habits are established and a patient’s health does not improve, it may then be time to discuss adding aspirin therapy to your daily routine. But as Dr. Bajpai knows, “The best way to know if you can benefit from aspirin therapy is to ask your health care provider. Never start daily aspirin therapy on your own!”

If you are curious to know if you might benefit from daily aspirin therapy, make an appointment with a Cardiac Partners specialist near you by calling 833.SJHEART (754-3278).

Zinn Unwala

Impella Cardiac Device Helps Patients Recover Closer to Home

The doctors at Inspira Medical Centers Woodbury and Vineland have a new tool in their arsenal to help a damaged heart pump enough blood to support major organs, while also giving the heart time to recover, according to Ashfaque Unwala, MD, cardiac catheterization medical director, Inspira Woodbury.

The Impella Ventricular Support System draws blood out of the heart and pumps it into the aorta, partially or fully bypassing the left ventricle and providing increased blood flow to critical organs in heart attack patients. The device is used most often in patients with cardio- genic shock, which happens when a person’s heart suddenly stops pumping enough blood to meet the body’s needs. This can cause severe organ damage or even death.

“One of the things we have noticed over the last few years is the high percentage of patients who come in with cardiogenic shock,’’ said Andrew Zinn, MD, cardiac catheterization medical director, Inspira Medical Center Vineland. “In the past, we’ve been able to stabilize these patients, but we’ve had to rapidly transfer them to other institutions.“ Zinn added.

As Inspira primarily treats heart attack patients — not those scheduled for complex surgery

— the Impella is used to stabilize patients’ hearts as they recover from a heart attack and/or cardiogenic shock. “Far too often, these patients have been having a heart attack for several hours before coming to the hospital,’’ Unwala explained. “This enables us to support the patient while recovering from a heart attack.’’

Previously, doctors would use a balloon pump or other devices, but those generated less blood flow than what can be achieved with the Impella, Unwala said, adding that the Impella is also easier to manage. “This helps to maintain the functions of the brain, kidneys and other organs,’’ he added. The device is implanted non-surgically into the left side of a patient’s heart through a small incision in a major artery in the leg or through a small incision in an artery in the chest, Dr. Unwala explained. Inspira officials said the procedure will be widely available at both Inspira Woodbury and Vineland this fall, after all protocols are put in place and all staff are trained.

“From the nursing standpoint, we are seeing the evolution of improving care at our facilities with evidence-based practices, especially for cardiac care,’’ said Michele Zucconi, R.N., administrative director, critical care, Inspira Vineland. “This is just one example and it means our patients can get the best treatment locally and be close to their family and other support systems. This is in keeping with our philosophy of treating the patient as a whole.’’

M. Scott Dawson, M.D., is a cardiologist with Inspira Medical Group

Dr. M. Scott Dawson Wins Top Honors for His Award Winning Essay

M. Scott Dawson, M.D., a board-certified cardiologist with Cardiac Partners at Cooper and Inspira, recently earned first place in the Saint Joseph’s University Pedro Arrupe Center’s Graduate Ethics Essay Competition. His writing focused on expanding access to elective angioplasties, a divisive topic in New Jersey. 

His essay titled: New Jersey’s Ethical Dilemma: Restrictive Privileges for Elective Angioplasties, reviews the multiple factors that have led to the continued restrictions, and the benefits that would be realized if, the restrictions were lifted. Dawson’s paper was commended for the substance of its application of ethical concepts to the issue.

“As the region’s leading network of cardiology specialists, Cardiac Partners providers know that our care cannot stop at the patient’s bedside. With five of the eight counties in the Southern New Jersey region seriously lacking in patient access to elective angioplasty procedures, it’s up to us to advance the conversation on a patients moral and ethical right to receive the best care possible, in their community”. says Dr. Dawson. He continues, “My essay offers us all an opportunity to step back and evaluate the obligation each of us – patients, physicians, hospital systems and insurance providers alike – has to the success of our healthcare model. Cardiac Partners is proud to be leading the way in both patient care and advocacy.”

The Saint Joseph’s Ethics Paper Competition is open to all graduate students at the university. Dr. Dawson, along with 13 other organizational leaders from Inspira Health, are currently enrolled in an Advanced Graduate Certificate Program in partnership with the Haub School of Business at Saint Joseph’s. In this program, executive students participate in six university courses as a part of the Pharmaceutical & Healthcare Marketing MBA track.

To read the award-winning essay by Dr. Dawson visit: https://sites.sju.edu/arrupe/student-ethics-competitions/ [sites.sju.edu]

MitraClip

Cooper University Health Care Becomes Region’s Only Hospital to Offer MitraClip Procedure

Heart Valve Device Offers New Options for Patients

Until recently, high-risk heart patients with a severe form of leaky mitral valve disorder, called mitral regurgitation, and who were deemed too frail or sick to undergo open heart surgery had few treatment choices.

Janah Aji, MD, FACC

Janah Aji, MD, FACC

Cooper University Health Care now offers a new treatment option for these patients with the FDA-approved MitraClip device. A medical team including Janah Aji, MD, FACCSajjad A. Sabir, MD, and Georges I. Kaddissi, MD, FACC, performed the first commercial-use procedures using the MitraClip in mid-April, making Cooper the only South Jersey health system offering this treatment.

“We are very fortunate to be able to offer this treatment to patients,” said Dr. Aji, who serves as director of the Cooper Cardiac Catheterization Laboratory. “It can be a life-changing option for patients suffering with severe mitral regurgitation. Following this procedure, patients who have severe heart failure symptoms due to this condition will experience significant improvement in shortness of breath and fatigue.”

Sajjad A Sabir, MD

Sajjad A Sabir, MD

Cooper was instrumental in clinical trials for the MitraClip and was one of 75 leading heart centers in the United States that participated it the COAPT trial that lead to the FDA approval of this device for patients with functional mitral regurgitation.

Mitral regurgitation affects millions of people worldwide. It is the most common type of heart valve defect, affecting one in 10 people aged 75 and older. The condition occurs when the heart’s mitral valve does not close completely, causing blood to leak backward into the left atrium with every heartbeat.  Mitral regurgitation requires the heart to work harder to maintain an adequate forward flow of blood.  Over time, that can lead to serious heart rhythm problems, stroke, heart failure, and death.

The MitraClip device, manufactured by Abbott Vascular, is a small clip that is attached to a patient’s mitral valve. It treats mitral regurgitation by allowing the valve to close more completely, helping to restore normal blood flow through the heart.

Georges I Kaddissi, MD, FACC

Georges I Kaddissi, MD, FACC

“As a high volume cardiac center, the Cooper Heart Institute has long been a leader in clinical trials and utilization of new devices for the treatment of structural heart conditions,” said Dr. Sabir, director of the Cooper Structural Heart Disease Program. “Cooper is proud to be a leader in testing and using these new devices which are rapidly expanding options for patients with these conditions.”

The Cooper Heart Institute is the most comprehensive heart care center in southern New Jersey, earning national recognition for its superior quality and world-renowned team of cardiovascular experts. Cooper was recognized as a top performing hospital for treating congestive heart failure in U.S. News & World Report’s 2018-2019 Best Hospitals survey. At Cooper, patients have access to a full spectrum of heart care from prevention and diagnosis to cutting-edge technology and innovative treatment.

In 2018, Cooper and Inspira Health Network formed a joint venture to integrate cardiac services. This affiliation, called Cardiac Partners at Cooper and Inspira, provides patients in the South Jersey region with access to more coordinated cardiac services across the continuum of care.

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Wendy A. Marano
Public Relations Manager
marano-wendy@cooperhealth.edu
856.382.6463

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Cooper University Health Care First Hospital in Eastern U.S. to Treat Central Sleep Apnea With Newly Approved Device

(CAMDEN) – A medical team at Cooper University Health Care recently was the first in the eastern United States to treat a patient with central sleep apnea (CSA) with a new implantable device to stimulate breathing. Cooper is currently one of only 24 sites in the United States treating CSA with the remedē® System, developed by medical technology company Respicardia, Inc. The remedē® System received FDA-approval in 2017 and is the first commercially available device to treat CSA.  

“CSA is a serious breathing disorder that disrupts the normal breathing pattern during sleep and negatively affects quality of life and overall cardiovascular health,” said John A. Andriulli, DO, FACC, an electrophysiologist at Cooper and director of the Arrhythmia Device Program at the Cooper Heart Institute. “It often occurs in cardiac patients, especially those with severe congestive heart failure, and is associated with a significantly greater risk for morbidity and mortality.”

A multidisciplinary team led by Dr. Andriulli along with Ramya Lotano, MD, FCCP, a pulmonologist and sleep expert, performed Cooper’s first  commercial remedē® procedure in a patient with CSA. 

CSA is different from the more commonly known obstructive sleep apnea, which is caused by upper airway obstruction. CSA results from the brain’s inability to send appropriate signals to the respiratory muscles to stimulate breathing. Treatment of the CSA patient is more challenging because the signal to the body to inhale is not being transmitted from the breathing center in the brain.

The remedē System is a pacemaker-like, battery-powered device that is placed under the skin in the upper chest area during a minimally invasive outpatient procedure by a cardiologist. The device has two small leads (wires): one that senses breathing, and one that stimulates the respiratory muscles to work when irregular breathing is detected. 

“This new device is offering real hope to CSA patients who previously had very few options,” said Dr. Andriulli. “It can reduce the effects of CSA by improving sleep and, most importantly, the patient’s quality of life. Improved quality of sleep often leads to improvement in symptoms of heart disease and other medical problems.”  

Cooper was involved in clinical trials for the device and is currently the only hospital in New Jersey to offer this treatment for CSA. 

10-4 WATCHMAN-Implanted

Cooper University Health Care First in the Region to Implant Next-Generation Watchman FLXTM Device

(CAMDEN, NJ) — Cooper is one of approximately 40 sites in the United States and the only hospital in the Philadelphia region participating in a clinical trial for Boston Scientific’s Watchman FLXTM device. The Watchman FLX is the next generation of a potentially life-changing catheter-based (or non-surgically delivered) device designed to close the left atrial appendage in order to reduce the risk of stroke in certain patients with atrial fibrillation (AFib). 

The Cooper structural heart team, including Janah Aji, MD, FACC, director of the Cooper Cardiac Catheterization Laboratory, and George E. Mark, MD, FACC, of The Heart House, successfully performed three cases on September 27, 2018. 

AFib is an irregular heartbeat that can cause blood to pool and form clots in the left atrial appendage (LAA), a small pouch on the left side of the heart. For patients with non-valvular AFib, the LAA is the source of the majority of those stroke-causing blood clots. According to the American Heart Association, at least 2.7 million Americans are living with AFib. People with atrial fibrillation are five- to seven-times more likely to have a stroke than the general population. 

“The Watchman FLX is being studied for its ability to provide doctors with greater flexibility and safety while positioning the device in the LAA,” explained Cooper cardiologist Sajjad A. Sabir, MD, director of the Cooper Structural Heart Disease Program. “Earlier generation devices are still effective for treating the LAA; however, they aren’t appropriate for all patients due to anatomical variations. The Watchman FLX has a number of new features which may make it a viable option for even more patients.”

As a high volume cardiac center, Cooper has long been a leader in clinical trials and utilization of new devices for the treatment of structural heart conditions. In 2006, Cooper was one of only a select group of hospitals in the United States, including the Mayo Clinic and the Cleveland Clinic, to take part in the pilot study for the first generation WATCHMANTM device which was FDA-approved for commercial use in 2015. Cooper was the first in South Jersey and the Philadelphia region to implant the WatchmanTM following its approval. 

In 2017, Cooper was also one of the first hospitals in the United States to participate in a clinical trial (which is currently ongoing) comparing the effectiveness of the St. Jude Medical’s AMPLATZER™ Amulet™ cardiac implant versus WATCHMAN™ device. Both devices are intended to prevent clots from entering the bloodstream, where they can travel to the brain and cause strokes. 

“For decades, most people with atrial fibrillation have been treated with long term blood-thinner therapy,” said Dr. Sabir. “While blood thinners can reduce the risk of stroke, they can also create complications, such as internal bleeding. Cooper is proud to be a leader in testing and using these new devices which are rapidly expanding options for patients with these conditions.”  

The Cooper Heart Institute is the most comprehensive heart care center in southern New Jersey, and in January, Cooper and Inspira Health Network formed a joint venture to integrate cardiac services. This affiliation, called Cardiac Partners, provides patients in the South Jersey region with access to more coordinated cardiac services across the continuum of care. 

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Cooper University Health Care Recognized as a Top Performing Hospital For Congestive Heart Failure in National Rankings

(Camden, NJ) – Cooper University Health Care was recognized as a top performing hospital for treating congestive heart failure in U.S. News & World Report’s 2018-2019 Best Hospitals survey.  

“As a leading academic health system, the Cooper Heart Institute is known for its comprehensive cardiac services,” said Kevin M. O’Dowd, JD, Co-President of Cooper University Health Care. “This designation confirms Cooper’s commitment to providing the highest level of inpatient and outpatient cardiac services in South Jersey.”

“Heart disease is the number one health issue in our nation, and congestive heart failure alone affects more than 5 million Americans,” said Anthony J. Mazzarelli, MD, JD, MBE, Co-President of Cooper. “When people choose Cooper for their heart care, they can have confidence knowing that they will receive the highest quality, personalized care they deserve.” 

“This designation as a top performing hospital is the direct result of our dedicated team of cardiac specialists, advanced practice providers, nurses, and support staff,” said Phillip A. Koren, MD, FACC, FSCAI, medical director of the Cooper Heart Institute. 

The Cooper Heart Institute is the most comprehensive heart care center in southern New Jersey, earning national recognition for its superior quality and world-renowned team of cardiovascular experts. At Cooper, patients have access to a full spectrum of heart care from prevention and diagnosis to cutting-edge technology and innovative treatment

In January, Cooper and Inspira Health Network formed a joint venture to integrate cardiac services. This affiliation, called Cardiac Partners, provides patients in the South Jersey region with access to more coordinated cardiac services across the continuum of care. 

About Cooper University Health Care

Cooper University Health Care is a leading health care provider and the only state-designated Level 1 Trauma Center in South Jersey.  With a network of more than 100 medical offices throughout the region, Cooper is home to MD Anderson Cancer Center at Cooper and the Children’s Regional Hospital at Cooper.  Cooper offers signature programs in cardiology, critical care, neurosciences, pediatrics, orthopaedics, and surgical specialties.  

About U.S. News & World Report Best Hospitals Rankings

The U.S. News & World Report Best Hospitals rankings are intended to help patients with rare or life-threatening conditions make informed decisions about where to receive care. This year’s U.S. News & World Report Best Hospitals list ranks hospitals in 16 specialties: cancer; cardiology and heart surgery; diabetes and endocrinology; ear, nose and throat; gastroenterology and gastrointestinal surgery; geriatrics; gynecology; nephrology; neurology and neurosurgery; ophthalmology; orthopedics; pulmonology; psychiatry; rehabilitation; rheumatology; and urology.  This is the 29th year for the survey.

The rankings — which compare more than 4,500 medical centers across the country — are based primarily on objective measures, such as risk-adjusted survival and readmission rates, volume, patient experience, patient safety, and quality of nursing.

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Cooper Cardiologist Named Medical Director of Cardiac Services at Premier Cadbury of Cherry Hill

(Camden, NJ) – Fredric L. Ginsberg, MD, FACC, FACCP, a clinical cardiologist and co-medical director of the Cooper Heart Institute, has been named medical director of cardiac services at Premier Cadbury of Cherry Hill.  Premier Cadbury is a continuing care retirement community that offers independent living, assisted living, memory care, and sub-acute rehabilitation, as well as long-term care. 

In his new role, Dr. Ginsberg will oversee Cadbury’s cardiac program for individuals undergoing treatment and rehabilitation for heart failure and other cardiac conditions. Dr. Ginsberg will work collaboratively with Premier Cadbury’s team of nurse practitioners; physical, occupational, and speech therapists; and social services staff to provide cardiac patients with a comprehensive plan of care. The goals of the program are to help patients better manage their disease, reduce hospital readmissions and emergency room visits, and shorten length of stays in the hospital setting. 

At Cooper, Dr. Ginsberg provides clinical services and shares administrative oversight for the Cooper Heart Institute, the most comprehensive heart care center in southern New Jersey. In January, Cooper and Inspira Health Network formed a joint venture to integrate cardiac services. This affiliation, called Cardiac Partners, provides patients in the South Jersey region with access to more coordinated cardiac services across the continuum of care. 

“We are pleased to collaborate with Cooper to offer high-quality cardiac care to our residents, and look forward to expanding our offerings in the future,” said Meredith Becker, MHSA, LNHA, executive director of Premier Cadbury of Cherry Hill.

About Cooper University Health Care

Cooper University Health Care is a leading health care provider and the only state-designated Level 1 Trauma Center in South Jersey.  With a network of more than 100 medical offices throughout the region, Cooper is home to MD Anderson Cancer Center at Cooper and the Children’s Regional Hospital at Cooper.  Cooper offers signature programs in cardiology, critical care, neurosciences, pediatrics, orthopaedics, and surgical specialties.  

About Premier Cadbury

Premier Cadbury offers a full continuum of care, from temporary respite care, to long-term skilled nursing, to hospice services, as well as exceptional short-term rehabilitation and a range of specialty programs and complex clinical services. Since acquiring Cadbury Senior Lifestyles in 2016, Premier Healthcare has invested in numerous improvements and expanded services for residents. These include renovations, staff training to serve higher acuity residents, and community partnerships with health care providers.

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Cooper and Inspira Join Forces to Create the Largest Cardiac Care Program in South Jersey

(Camden and Mullica Hill, NJ) – Cooper University Health Care and Inspira Health Network today announced that they have formed a joint venture to completely integrate cardiac services called Cardiac Partners. This affiliation will provide patients in the South Jersey region with access to more coordinated and comprehensive cardiac services across the continuum of care. The combination of the two systems’ complementary heart services will make Cardiac Partners the largest cardiac program in South Jersey.  

“This collaboration will expand access to the most advanced cardiac care for more South Jersey residents,” said Adrienne Kirby, PhD, FACHE, president and chief executive officer at Cooper. “Cardiac Partners will increase efficiencies, reduce clinical variation, and allow us to provide the highest-quality care to patients with better coordination through a full range of cardiac services from diagnosis to advanced cardiac surgery to rehabilitation.”

As the health care landscape continues to change, this innovative business model will allow Cooper and Inspira to serve more cardiac patients, operate more efficiently, increase patient satisfaction, and allow more patients to stay in New Jersey for the most advanced, high-quality cardiac care.

“Our two organizations have a long history of working together in other clinical areas and have tremendous respect for each other’s expertise and commitment,” said John DiAngelo, president and chief executive officer at Inspira. “This new cardiac program will further enhance the care we deliver to our patients, building upon our 100+ year legacy.”

Patients will be able to select the cardiac physician of their choice from more than 65 physicians at both institutions. Patients will have access to nurses who can answer their questions and help navigate them to the right care. To make an appointment with Cardiac Partners patients may call 1-833-SJHEART (754-3278) or visit www.CardiacPartners.org.

About Cooper University Health Care

Cooper University Health Care is a leading academic health care provider and the only state-designated Level 1 Trauma Center in South Jersey with a mission to serve, to heal, to educate.  With more than 630 physicians, more than 7,000 employees, and a network of more than 100 medical offices and four urgent care centers throughout the region, Cooper offers signature programs in cardiology, critical care, neurosciences, pediatrics, orthopaedics, and surgical specialties. The Cooper Health Sciences campus is home to Cooper University Hospital, MD Anderson Cancer Center at Cooper, Children’s Regional Hospital at Cooper, and Cooper Medical School of Rowan University.  For more information about Cooper University Health Care, visit CooperHealth.org.  

About Inspira Health Network

Inspira Health Network is a charitable nonprofit health care organization serving communities across southern New Jersey. The network, which traces its roots to 1899, comprises three hospitals, a comprehensive cancer center, several multi-specialty health centers and a total of more than 150 access points. These include urgent care; outpatient imaging and rehabilitation; numerous specialty centers, including sleep medicine, cardiac testing, digestive health and wound care; home care and hospice; and more than 30 primary and specialty physician practices in Gloucester, Cumberland, Salem and Camden counties.

Together with its medical staff of more than 1,100 physicians and other care providers, as well as more than 5,700 employees, Inspira Health Network provides evidence-based care to help each patient achieve the best possible outcome. Accredited by DNV Healthcare, the network’s clinical and support staffs are focused on providing quality care in a safe environment. For more information about Inspira Health Network, visit www.InspiraHealthNetwork.org or call 1-800-INSPIRA.