Head: Prof Stephen Duffy [Bio]

The General Cardiology Unit remains extremely busy with acute coronary syndrome and other general cardiology presentations. Data from the ongoing Melbourne Interventional Group (MIG) registry, which now has more than 20,000 patient procedures entered, and in which The Alfred has participated since 2005, show that more than 70% of percutaneous coronary interventions (PCI) are in patients with acute coronary syndromes. The Alfred has also agreed to participate in the newly initiated Victorian Cardiac Outcomes Registry (VCOR) which will collect percutaneous coronary intervention data in parallel with MIG, but will expand to include device implants. Prof Stephen Duffy is on the Steering Committee for both the MIG and VCOR registries.

The department also continues to participate in important international trials of novel antiplatelet and anticoagulant therapies in stable and unstable coronary artery disease.  Ongoing investigator-initiated studies in patients with coronary artery disease include studies by Dr. Shaw and colleagues of vitamin D and its relationship to coronary disease and vascular function. Drs. Duffy and Shaw are the local Co-Principal Investigators on multinational ISCHEMIA study which will compare optimal medical management to coronary revascularization plus optimal medical management in patients with demonstrated significant myocardial ischaemia.

Other studies by Prof. Kaye and Dr. Duffy include a novel device that can reduce the amount of X-ray contrast given to patients undergoing PCI, particularly in the setting of acute coronary syndromes. X-ray contrast can have adverse effects on renal function, with contrast-induced nephropathy (or acute kidney injury) occurring in 10-15% of patients.

Out-of-hospital cardiac arrest (OHCA) is a common lethal health problem. Over the last decade several clinical trials have highlighted the importance of post-resuscitative care in optimizing survival and neurological recovery. Recently, there have been significant advances in management including recommendations related to regional systems of care, application of therapeutic hypothermia and the utilization of investigative procedures including emergent coronary angiography, cardiac support devices and other tools which provide prognostic information. Dr Dion Stub has recently completed his PhD studies (supervised by Prof. Kaye, Dr. Duffy and Prof. Stephen Bernard) in this important area, and has published extensively on how better outcomes can be achieved by improved systems of care including a recently published a position paper advocating for ‘cardiac arrest centres’ in Australia, along the lines of trauma centres, to optimise patient outcomes in this extremely ill group of patients.

For research output please see publications list by year.

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