DATABASES IN GERIATRIC CARDIOVASCULAR DISEASE AND STROKE

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To address the health and health care implications of a progressively aging society in the 21st century the best and most creative scientific minds must be engaged. This is nowhere more compelling than in cardiovascular disease, the leading cause of health care expenditures and death in the elderly. And given the multiple co-morbidities that are the norm in elderly patients, clinical and research efforts must often cross disciplinary (and NIH) lines in collaborative research and practice. To bridge between the competencies of geriatricians and medical subspecialists has been the objective of an initiative sponsored by the John A. Hartford Foundation entitled, "Integrating Geriatrics into the Medical Subspecialties" (W. Hazzard, PI), focused in 5-day Geriatric Education Retreats (GER's) in which the attendees, academic geriatricians and leaders from a given subspecialty, address issues of education, clinical care, and research at the interface between their domains, generating an agenda of proposed follow-up activities. The present proposal represents a leading item on the agenda developed at the Cardiology GER in August 1996. This will be a conference for which partial funding is requested from the NIA, a conclave entitled, "Existing Databases: Do They Hold Answers to Clinical Questions in Geriatric Cardiology?. This scientific conference will take place April 8-11, 1999 at the Renaissance Hotel in Washington, DC. In attendance will be leading cardiovascular clinical investigators and academic geriatricians from across the USA. These scientists will review existing databases with focus upon eight problem areas: 1) Acute myocardial infarction (Outcomes); 2) Acute myocardial infarction (Treatment - CABG, PTCA, Thrombolysis); 3) Chronic coronary disease; 4) Valve surgery; 5) Pacemakers, EP and ablation devices; 6) Cerebrovascular disease (Carotid endarterectomy, thrombolysis); 7) Congestive heart failure; and 8) Prevention through risk factor modification. Participants will review and discuss these data bases and generate reports on-site in consensus conference format, emphasizing as points of present consensus, opportunities for future research from these existing data bases, and areas requiring further data gathering and analysis. The report will be summarized in leading subspecialty journals and distributed widely throughout the scientific community as a means of further stimulating research in diagnosis and management of cardiovascular disease in the elderly.