1. Good Morning and welcome to our symposium.
I am Dr. Ken Kutscher, and I serve as the Governor of the New
Jersey Chapter of the American College of Cardiology. I am also a
cardiologist at Hunterdon Medical Center and on the faculty of
Robert Wood Johnson University.
As we reflect upon the last month, we need to spend time
remembering those who died during Sandy’s fatal and disastrous
journey across the northeast. It is a sobering to realize how little
we can actually control nature and how much we still need to learn
about science and the human body.
If you look back over the past 40 years, you will see the last
decade’s scientific truism to be the next decade’s falsehood.
When I was an intern in 1977, a patient presenting with an acute
MI was put on bed rest in the CCU with morphine, lidocaine,
nitrates, and defibrillators to shock him out of VT. Then 2 weeks
of bed rest and increased risk of Pulmonary emboli. B-blockers
post MI had yet to be studied and statins were still in the early
research stages. It was uncertain whether the thrombus seen in the
coronary artery during an MI was the primary or secondary to the
event.
Scientific evidence remains the basis for medical advancement, as
the knowledge base and treatment opportunities in medicine
expand. Remember the now refuted dogmas of the past such as
routine prophylactic lidocaine post M or fish oil as add-on therapy.
And who knows if I would have survived my CCU rotation if I had
prescribed B-blockers in CHF.

2. It was only through randomized studies that we now use B-
blockers, ACE inhibitors and aldosterone inhibitors in heart failure.
Statin therapy was proven in the 1980s to be of immense benefit in
CAD. ASA was only proven to be of benefit for CAD in the1980s
through randomized studies. And finally, a decade of research
showing the benefit of thrombolytics and PCI for acute MI has
been followed by randomized studies comparing treatments by
various stents and anti-platelet agents in coronary PCI.
Why is the NJACC sponsoring this symposium for the NJ DOH?
Because the clinical knowledge and conditions have changed since
my fellowship when I watched the LAD close down during an
angioplasty , the patient dying from intractable V Fib arrest,
despite having an open OR and Cardiac Surgeon on standby.
It is due to the advances in the skills of our operators and the
improvement of stents, equipment and drugs that CPORTE, a
study to compare outcomes of appropriate elective PCI in non-
surgical back-up hospitals versus surgical hospitals, was performed
to expand the hypothesis e had obtained superb meta-analysis of
the subject.
New Jersey is not the only state which is addressing this issue of
expanding appropriate elective stenting to non-surgical sites, but
we are in the forefront of presenting an open dialogue with our
panel of national experts and our audience.
We thank Commission O’Dowd and her staff on the NJDOH for
its continued commitment to its CHAP, which enables them to
make decisions ensuring excellence of patient centered cardiac
care on a scientific basis, rather than on political or parochial
interests.

3. It is my honor to introduce our one distinguished speaker from
New Jersey, Charlie Dennis, who miraculously was able to walk
the tightrope of being Chairman of CHAP and working closely
with the NJACC to organize this superb conference. I could recite
his long resume, but if I just did that, you wouldn’t begin to
appreciate Dr. Dennis’ dedication to the care of cardiology patients
in New Jersey. I have served under Dr. Dennis’s leadership on the
CHAP for the past 12 years under 5 governors and 6
Commissioners of Health, as Charlie steered the cardiology ship
through Cardiac Surgery report cards, continued monitoring of
free-standing cardiac cath labs, and primary PCI at hospitals
without surgical backup – and now CPORTE. His fund of
knowledge of cardiology is only surpassed by his integrity and his
overwhelming commitment to our patients.
.