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Cardiac rehabilitation received full support in the National Service Framework (NSF) for Coronary Heart Disease (CHD). ...

Better care without delay: heart failure Coronary Heart Disease Collaborative Heart failure is a subject that is equally challenging to primary and secondary care physicians but in different ways. These challenges, however, are different faces of the same problem but their presentation can lead to confusion and anxiety among some doctors treating heart failure patients. We continue our series on the Coronary Heart Disease Collaborative (CHDC) and turn our focus in this issue to its work in helping clinical teams improve heart failure services across the country....

Exploring how the CHD Collaborative is helping clinical teams across the country achieve clear improvements in services for patients with coronary heart disease. Each article will focus on one of the Collaborative’s six project areas (seen in the heart right). Here, national clinical leads and other Collaborative staff, who have a particular interest in the acute myocardial infarction pathway, report on some of the work that has been done so far....

Revascularisation and the diabetic patient: the potential role of drug-eluting stents David Barrow David Barrow, a medical journalist with a special interest in interventional cardiology, discusses the potential benefit of drug-eluting stents in relationship to the revascularisation of the diabetic patient. It has been estimated that 13% to 25% of the patients undergoing coronary revas-cularisation procedures have diabetes and the diabetic patient continues to face higher mortality rates than non-diabetic patients after revascularisation. There is much debate on the preferred method of revascularisation in the diabetic patient: percutaneous transluminal intervention (PCI) or coronary artery bypass graft surgery (CABG)....

Waiting for a bypass: a comment from primary care Peter Stott The length of time that patients spend on the waiting list for coronary artery bypass surgery (CABG) is a matter of concern. In one study of 1,049 patients in the South East of the UK, the mean time to specialist consultation was 36 days (SD 43); the time waiting for coronary angiography was 85 days (SD 89); and the mean time on the surgical waiting list for CABG was 133 days (SD 134) – a mean time of 279 days (SD 209; range 1–1,579 days) from GP referral1 to CABG....