FN Clarivate Analytics Web of Science VR 1.0 PT J AU Holm, J Vidlund, M Vanky, F Friberg, O Hakanson, E Walther, S Svedjeholm, R AF Holm, J. Vidlund, M. Vanky, F. Friberg, O. Hakanson, E. Walther, S. Svedjeholm, R. TI EuroSCORE II and N-terminal pro-B-type natriuretic peptide for risk evaluation: an observational longitudinal study in patients undergoing coronary artery bypass graft surgery SO BRITISH JOURNAL OF ANAESTHESIA LA English DT Article DE acute coronary syndrome; coronary artery bypass surgery; natriuretic peptides; risk assessment ID CARDIAC-SURGERY; HEART-FAILURE; DYSFUNCTION; PREDICTOR; MORTALITY; DEATH AB Background. Postoperative heart failure remains the major cause of death after cardiac surgery. As N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a predictor for postoperative heart failure, the aim was to evaluate if preoperative NT-proBNP could provide additional prognostic information to the recently launched EuroSCORE II. Methods. A total of 365 patients with acute coronary syndrome (ACS) undergoing isolated coronary artery bypass graft (CABG) surgery were studied prospectively. Preoperative NT-proBNP and EuroSCORE II were evaluated with regard to severe circulatory failure after operation according to prespecified criteria. To assess what clinical outcomes are indicated by NT-proBNP levels in different risk categories, the patients were stratified according to EuroSCORE II. Based on receiver operating characteristics analysis, these cohorts were assessed with regard to preoperative NT-proBNP below or above 1028 ng litre(-1). The follow-up time averaged 4.4 (0.7) yr. Results. Preoperative NT-proBNP >= 1028 ng litre(-1) [odds ratio (OR) 9.9,95% confidence interval (CI) 1.01-98.9; P=0.049] and EuroSCORE II (OR 1.24, 95% CI 1.06-1.46; P=0.008) independently predicted severe circulatory failure after operation. In intermediate-risk patients (EuroSCORE II 2.0-10.0), NT-proBNP >= 1028 ng litre(-1) was associated with a higher incidence of severe circulatory failure (6.6% vs 0%; P=0.007), renal failure (14.8% vs 5.4%; P=0.03), stroke (6.6% vs 0.7%; P=0.03), longer intensive care unit stay [37 (35) vs 27 (38) h; P=0.002], and worse long-term survival. Conclusions. Combining EuroSCORE II and preoperative NT-proBNP appears to improve risk prediction with regard to severe circulatory failure after isolated CABG for ACS. NT-proBNP may be particularly useful in patients at intermediate risk according to EuroSCORE II. C1 [Holm, J.; Vanky, F.; Hakanson, E.; Walther, S.; Svedjeholm, R.] Linkoping Univ, Linkoping Univ Hosp, Dept Cardiothorac Surg & Anaesthesia, SE-58185 Linkoping, Sweden. [Vidlund, M.; Friberg, O.] Orebro Univ Hosp, Dept Cardiothorac Surg & Anaesthesia, SE-70185 Orebro, Sweden. C3 Linkoping University; Orebro University RP Holm, J (通讯作者),Linkoping Univ, Linkoping Univ Hosp, Dept Cardiothorac Surg & Anaesthesia, SE-58185 Linkoping, Sweden. EM jonas.holm@lio.se RI Friberg, Örjan/AAQ-8685-2020; Friberg, Orjan/GXH-9180-2022 OI Friberg, Orjan/0000-0003-2708-1376; Vanky, Farkas/0000-0003-1005-091X FU Swedish Heart-Lung Foundation [20030595]; Capio Research Foundation [2005-1021, 2006-1203]; Linkoping University; Ostergotlands Lans Landsting FX This work was supported by grants from the Swedish Heart-Lung Foundation (20030595), Capio Research Foundation (2005-1021;2006-1203), Linkoping University, and Ostergotlands Lans Landsting. 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J. Anaesth. PD JUL PY 2014 VL 113 IS 1 BP 75 EP 82 DI 10.1093/bja/aeu088 PG 8 WC Anesthesiology WE Science Citation Index Expanded (SCI-EXPANDED) SC Anesthesiology GA AK7HG UT WOS:000338598700011 PM 24727704 OA Bronze DA 2023-05-13 ER PT J AU Mendoza, KS AF Mendoza, Kelly S. TI Optimizing Cardiovascular Care With Mineralocorticoid Receptor Antagonists SO JNP- THE JOURNAL FOR NURSE PRACTITIONERS LA English DT Article DE aldosterone antagonists; heart failure; mineralocorticoid receptor antagonists; myocardial infarction; potassium-sparing diuretics; resistant hypertension ID ELEVATION MYOCARDIAL-INFARCTION; HEART-FAILURE; DOUBLE-BLIND; RESISTANT HYPERTENSION; PRACTICE GUIDELINES; SPIRONOLACTONE; EPLERENONE; MANAGEMENT; DYSFUNCTION; STATEMENT AB Mineralocorticoid receptor antagonists (MRAs) block the action of aldosterone at receptors in the kidneys, causing increased sodium and water excretion in exchange for potassium retention. There are 4 treatment groups in the cardiovascular population that have shown benefit with MRA therapy: resistant hypertension, post acute coronary syndromes, heart failure with reduced ejection fraction, and heart failure with preserved ejection fraction. Serum potassium and kidney function should be monitored closely, especially if a patient is on a concomitant angiotensin-converting enzyme inhibitor, an angiotensin II receptor blocker, or direct renin inhibitor therapy. C1 [Mendoza, Kelly S.] Univ Maryland, Sch Pharm, Pain Management & Palliat Care, Baltimore, MD 21201 USA. C3 University System of Maryland; University of Maryland Baltimore RP Mendoza, KS (通讯作者),Univ Maryland, Sch Pharm, Pain Management & Palliat Care, Baltimore, MD 21201 USA. EM ksmendoza11@gmail.com CR Adamopoulos C, 2009, EUR J HEART FAIL, V11, P1099, DOI 10.1093/eurjhf/hfp136 Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2713, DOI [10.1016/j.jacc.2014.10.011, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.09.017] [Anonymous], ALD SPIR PACK INS [Anonymous], INSPR EPL PACK INS Calhoun DA, 2008, HYPERTENSION, V51, P1403, DOI 10.1161/HYPERTENSIONAHA.108.189141 Mancia G, 2014, BLOOD PRESSURE, V23, P3, DOI 10.3109/08037051.2014.868629 Montalescot G, 2014, EUR HEART J, V35, P2295, DOI 10.1093/eurheartj/ehu164 O'Gara PT, 2013, CIRCULATION, V127, pE362, DOI 10.1161/CIR.0b013e3182742cf6 Pitt B, 2003, NEW ENGL J MED, V348, P1309, DOI 10.1056/NEJMoa030207 Pitt B, 1999, NEW ENGL J MED, V341, P709, DOI 10.1056/NEJM199909023411001 Pitt B, 2014, NEW ENGL J MED, V370, P1383, DOI 10.1056/NEJMoa1313731 SPRINT Research Group, 2015, N Engl J Med, V373, P2103, DOI 10.1056/NEJMoa1511939 Struthers AD, 2004, EUR J HEART FAIL, V6, P539, DOI 10.1016/j.ejheart.2004.04.013 Struthers A, 2008, CLIN CARDIOL, V31, P153, DOI 10.1002/clc.20324 Vaclavik J, 2014, MEDICINE, V93, DOI 10.1097/MD.0000000000000162 Weber MA, 2014, J HYPERTENS, V32, P3, DOI [10.1111/jch.12237, 10.1097/HJH.0000000000000065] Williams B, 2015, LANCET, V386, P2059, DOI 10.1016/S0140-6736(15)00257-3 Yancy CW, 2016, CIRCULATION, V134, pE282, DOI 10.1161/CIR.0000000000000435 Yusuf S, 2003, LANCET, V362, P777, DOI 10.1016/S0140-6736(03)14285-7 Zannad F, 2011, NEW ENGL J MED, V364, P11, DOI 10.1056/NEJMoa1009492 Zhang J, 2012, EUR HEART J, V33, P644 NR 21 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1555-4155 EI 1878-058X J9 JNP-J NURSE PRACT JI JNP-J. Nurse Pract. PD FEB PY 2017 VL 13 IS 2 BP 156 EP 161 DI 10.1016/j.nurpra.2016.11.003 PG 6 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA EL9FZ UT WOS:000394927000012 DA 2023-05-13 ER PT J AU Ferrero, TG Alvarez, BA Cordero, A Martinez, JM Antonio, CC Sestayo-Fernandez, M Bouzas-Cruz, N Muinos, PA Casas, CA Garcia, OO Arias, FGR Dominguez, MP Fortuny, AT Alvarez, DI Bermejo, RA Veloso, PR Alvarez, BC Acuna, JMG Zuazola, P Escribano, D Lage, R Sampedro, FG Juanatey, JRG AF Gonzalez Ferrero, Teba Alvarez Alvarez, Belen Cordero, Alberto Martinon Martinez, Jesus Cacho Antonio, Carla Sestayo-Fernandez, Manuela Bouzas-Cruz, Noelia Muinos, Pablo Antunez Abou Jokh Casas, Charigan Otero Garcia, Oscar Garcia-Rodeja Arias, Federico Perez Dominguez, Marta Torrelles Fortuny, Abel Iglesias Alvarez, Diego Agra Bermejo, Rosa Rigueiro Veloso, Pedro Cid Alvarez, Belen Garcia Acuna, Jose Maria Zuazola, Pilar Escribano, David Lage, Ricardo Gude Sampedro, Francisco Gonzalez Juanatey, Jose Ramon TI Early angiography in elderly patients with non-ST-segment elevation acute coronary syndrome: The cardio CHUS-HUSJ registry SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article ID DELAYED INVASIVE INTERVENTION; UNSTABLE ANGINA-PECTORIS; MYOCARDIAL-INFARCTION; TERM OUTCOMES; STRATEGY; OLDER; AGE; MANAGEMENT; COHORT; CARE AB Background: In elderly patients with non-ST elevation acute coronary syndrome (NSTEACS), while routine invasive management is established in high-risk NSTEACS patients, there is still uncertainty regarding the optimal timing of the procedure. Methods: This study analyzes the association of early coronary angiography with all-cause mortality, cardiovascular mortality, heart failure (HF) hospitalization, and major adverse cardiovascular events (MACE) in patients older than 75 years old with NSTEACS. This retrospective observational study included 7811 consecutive NSTEACS patients who were examined between the years 2003 and 2017 at two Spanish university hospitals. There were 2290 patients older than 75 years old. We compared their baseline characteristics according to the early invasive strategy used (coronarography <= 24 h vs. coronarography >24 h) after the diagnosis of NSTEACS. Results: Among the study participants, 1566 patients (68.38%) underwent early invasive coronary intervention. The mean follow-up period was 46 months (interquartile range 18-71 months). This association was also maintained after propensity score matching: early invasive strategy was significantly related to lower all-cause mortality [HR 0.61 (95% CI 0.51-0.71)], cardiovascular mortality [HR 0.52 (95% CI 0.43-0.63)], and MACE [HR 0.62 (CI 95% 0.54-0.71)]. Concusions: In a contemporary real-world registry of elderly NSTEACS patients, early invasive management significantly reduced all-cause mortality, cardiovascular mortality, and MACE during long-term follow-up. Brief summary: In this real-world retrospective observational study that included 2451 patients older than 75 years old, 1566 patients (68.38%) underwent early invasive coronary intervention. After performing a propensity score matching, the early invasive strategy was still associated with lower all-cause mortality [HR (hazard ratio) 0.61, 95% CI (95% confidence interval) (0.51-0.71)], cardiovascular mortality [HR 0.52 (95%CI 0.43-0.63)], and MACE [HR 0.62 (95%CI 0.54-0.71)] during long-term follow-up. C1 [Gonzalez Ferrero, Teba; Alvarez Alvarez, Belen; Martinon Martinez, Jesus; Cacho Antonio, Carla; Sestayo-Fernandez, Manuela; Bouzas-Cruz, Noelia; Muinos, Pablo Antunez; Abou Jokh Casas, Charigan; Otero Garcia, Oscar; Garcia-Rodeja Arias, Federico; Perez Dominguez, Marta; Torrelles Fortuny, Abel; Iglesias Alvarez, Diego; Agra Bermejo, Rosa; Rigueiro Veloso, Pedro; Cid Alvarez, Belen; Garcia Acuna, Jose Maria; Lage, Ricardo; Gonzalez Juanatey, Jose Ramon] Univ Clin Hosp Santiago de Compostela, Cardiol Dept, Santiago De Compostela, Spain. [Gonzalez Ferrero, Teba; Alvarez Alvarez, Belen; Cordero, Alberto; Cacho Antonio, Carla; Sestayo-Fernandez, Manuela; Bouzas-Cruz, Noelia; Muinos, Pablo Antunez; Abou Jokh Casas, Charigan; Otero Garcia, Oscar; Garcia-Rodeja Arias, Federico; Perez Dominguez, Marta; Torrelles Fortuny, Abel; Iglesias Alvarez, Diego; Agra Bermejo, Rosa; Rigueiro Veloso, Pedro; Cid Alvarez, Belen; Garcia Acuna, Jose Maria; Zuazola, Pilar; Escribano, David; Lage, Ricardo; Gonzalez Juanatey, Jose Ramon] Biomed Res Networking Ctr Cardiovasc Dis CIBERCV, Alicante, Spain. [Cordero, Alberto; Zuazola, Pilar; Escribano, David] Univ Hosp San Juan, Cardiol Dept, Alicante, Spain. [Gude Sampedro, Francisco] Univ Clin Hosp Santiago de Compostela, Epidemiol Dept, Santiago De Compostela, Spain. C3 Complexo Hospitalario Universitario de Santiago de Compostela; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; Complexo Hospitalario Universitario de Santiago de Compostela RP Ferrero, TG (通讯作者),Complejo Hosp Univ Santiago de Compostela, Cardiol Dept, Rua Choupana S-N, Santiago De Compostela 15703, Spain. EM tebagf@gmail.com OI Lage Fernandez, Ricardo/0000-0002-8779-7723; Gonzalez Juanatey, Jose Ramon/0000-0001-9681-3388; Sestayo-Fernandez, Manuela/0000-0002-7109-816X CR Alvarez BA, 2020, REV ESP CARDIOL, V73, P35, DOI [10.1016/j.rec.2019.02.015, 10.1016/j.recesp.2019.02.019] Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2713, DOI [10.1016/j.jacc.2014.10.011, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.09.017] Arora S., 2018, J AM HEART ASSOC, V7, P2000 Bauer T, 2007, EUR HEART J, V28, P2873, DOI 10.1093/eurheartj/ehm464 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 Damman P, 2012, HEART, V98, P207, DOI 10.1136/heartjnl-2011-300453 Ekerstad N, 2011, CIRCULATION, V124, P2397, DOI 10.1161/CIRCULATIONAHA.111.025452 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Kaura A, 2020, LANCET, V396, P623, DOI 10.1016/S0140-6736(20)30930-2 Kofoed KF, 2018, CIRCULATION, V138, P2741, DOI 10.1161/CIRCULATIONAHA.118.037152 Loh JP, 2014, AM J CARDIOL, V113, P1794, DOI 10.1016/j.amjcard.2014.03.007 Mehta SR, 2009, NEW ENGL J MED, V360, P2165, DOI 10.1056/NEJMoa0807986 Milosevic A, 2016, JACC-CARDIOVASC INTE, V9, P541, DOI 10.1016/j.jcin.2015.11.018 Nunez JE, 2004, REV ESP CARDIOL, V57, P842, DOI 10.1016/S1885-5857(06)60649-X Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Sanchis J., 2020, REV ESP CARDIOL, P30280 Savonitto S, 2012, JACC-CARDIOVASC INTE, V5, P906, DOI 10.1016/j.jcin.2012.06.008 Skolnick AH, 2007, J AM COLL CARDIOL, V49, P1790, DOI 10.1016/j.jacc.2007.01.066 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 Zaman MJ, 2014, EUR HEART J, V35, P1551, DOI 10.1093/eurheartj/ehu039 NR 20 TC 3 Z9 3 U1 3 U2 4 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD MAR 15 PY 2022 VL 351 BP 8 EP 14 DI 10.1016/j.ijcard.2021.12.028 EA FEB 2022 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZE0OE UT WOS:000758590800002 PM 34942303 DA 2023-05-13 ER PT J AU Jiang, HQ Holm, J Friberg, O Vanky, F Vidlund, M Tajik, B Yang, YQ Svedjeholm, R AF Jiang, Huiqi Holm, Jonas Friberg, Orjan Vanky, Farkas Vidlund, Marten Tajik, Bashir Yang, Yanqi Svedjeholm, Rolf TI Utility of NT-proBNP as an objective marker of postoperative heart failure after coronary artery bypass surgery: a prospective observational study SO PERIOPERATIVE MEDICINE LA English DT Article DE Natriuretic peptide; Heart failure; Postoperative care; Coronary artery bypass surgery ID BRAIN NATRIURETIC PEPTIDE; VENOUS OXYGEN-SATURATION; CARDIAC-OUTPUT SYNDROME; VENTRICULAR DYSFUNCTION; MORTALITY; ASSOCIATION; PREDICTORS; INFUSION; IMPACT; DEATH AB Background: Postoperative heart failure (PHF) is the main cause for mortality after cardiac surgery but unbiased evaluation of PHF is difficult. We investigated the utility of postoperative NT-proBNP as an objective marker of PHF after coronary artery bypass surgery (CABG). Methods: Prospective study on 382 patients undergoing isolated CABG for acute coronary syndrome. NT-proBNP was measured preoperatively, the first (POD1) and third postoperative morning (POD3). A blinded Endpoints Committee used prespecified criteria for PHF. Use of circulatory support was scrutinized. Results: After adjusting for confounders PHF was associated with 1.46 times higher NT-proBNP on POD1 (p = 0.002), 1.54 times higher on POD3 (p < 0.0001). In severe PHF, NT-proBNP was 2.18 times higher on POD1 (p = 0.001) and 1.81 times higher on POD3 (p = 0.019). Postoperative change of NT-proBNP was independently associated with PHF (OR 5.12, 95% CI 1.86-14.10, p = 0.002). The use of inotropes and ICU resources increased with incremental quartiles of postoperative NT-proBNP. Conclusions: Postoperative NT-proBNP can serve as an objective marker of the severity of postoperative myocardial dysfunction. Due to overlap in individuals, NT-proBNP is useful mainly for comparisons at cohort level. As such, it provides a tool for study purposes when an unbiased assessment of prevention or treatment of PHF is desirable. C1 [Jiang, Huiqi; Holm, Jonas; Vanky, Farkas; Tajik, Bashir; Yang, Yanqi; Svedjeholm, Rolf] Linkoping Univ, Fac Med & Hlth Sci, Dept Cardiothorac Surg & Anesthesia, Dept Hlth Med & Caring Sci, SE-58185 Linkoping, Sweden. [Jiang, Huiqi; Yang, Yanqi] Sun Yat Sen Univ Med Sci, Sun Yat Sen Mem Hosp, Dept Cardiothorac Surg, Guangzhou, Guangdong, Peoples R China. [Friberg, Orjan; Vidlund, Marten] Orebro Univ, Fac Med & Hlth, Dept Cardiothorac & Vasc Surg, Orebro, Sweden. C3 Linkoping University; Sun Yat Sen University; Orebro University RP Svedjeholm, R (通讯作者),Linkoping Univ, Fac Med & Hlth Sci, Dept Cardiothorac Surg & Anesthesia, Dept Hlth Med & Caring Sci, SE-58185 Linkoping, Sweden. EM rolf.svedjeholm@regionostergotland.se RI Friberg, Orjan/GXH-9180-2022 OI Friberg, Orjan/0000-0003-2708-1376 FU Swedish Heart-Lung Foundation [20030595, 20140633]; Region Ostergotland [LIO-443891, LIO693091]; Linkoping University FX This work was supported by grants from The Swedish Heart-Lung Foundation [20030595, 20140633]; and Region Ostergotland [LIO-443891, LIO693091]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No relationship with industry exists. Open Access funding provided by Linkoping University. 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Secondary prevention is effective for reducing morbidity and mortality, but evidence-based targets are seldom reached and new interventional methods are needed. The present study is a feasibility study of a telephone-based secondary preventive programme in an unselected ACS cohort. Methods: The NAILED (Nurse-based Age-independent Intervention to Limit Evolution of Disease) ACS trial is a prospective randomized controlled trial. All eligible patients admitted for ACS were randomized to usual follow-up by a general practitioner or telephone follow-up by study nurses. The intervention was made by continuous telephone contact, with counseling on healthy living and titration of medicines to reach target values for blood pressure and blood lipids. Exclusion criteria were limited to physical inability to follow the study design or participation in another study. Results: A total of 907 patients were assessed for inclusion. Of these, 661 (72.9 %) were included and randomized, 100 (11 %) declined participation, and 146 (16.1 %) were excluded. The main reasons for exclusion were participation in another trial, dementia, and advanced disease. "Excluded" and "declining" patients were significantly older with more co-morbidity, decreased functional status, and had more seldom received education above compulsory school level than "included" patients. Non-participants had a higher 1-year mortality than participants. Conclusions: Nurse-led telephone-based follow-up after ACS can be applied to a large proportion in an unselected clinical setting. Reasons for non-participation, which were associated with increased mortality, include older age, multiple co-morbidities, decreased functional status and low level of education. C1 [Huber, Daniel; Henriksson, Robin; Jakobsson, Stina; Stenfors, Nikolai; Mooe, Thomas] Umea Univ, Dept Publ Hlth & Clin Med, Ctr Med Ostersund, Umea, Sweden. C3 Umea University RP Huber, D (通讯作者),Umea Univ, Dept Publ Hlth & Clin Med, Ctr Med Ostersund, Umea, Sweden. EM daniel.huber@regionjh.se RI Stenfors, Nikolai/AAK-5334-2020 OI Stenfors, Nikolai/0000-0002-1684-1301; Huber, Daniel/0000-0002-9817-5436; Henriksson, Robin/0000-0001-9571-5946 FU Research and Development Unit; Region Jamtland Harjedalen; Swedish Heart-Lung Foundation FX We would like to acknowledge the thoroughly and effective work done by our study nurses. This study was supported by grants from the Research and Development Unit, Region Jamtland Harjedalen, and the Swedish Heart-Lung Foundation. CR Bejan-Angoulvant T, 2010, J HYPERTENS, V28, P1366, DOI 10.1097/HJH.0b013e328339f9c5 Bergstrom G, 2015, INT J CARDIOL, V182, P141, DOI 10.1016/j.ijcard.2014.12.060 Bernocchi P, 2014, BMC MED INFORM DECIS, V14, DOI 10.1186/1472-6947-14-52 Bhatt DL, 2006, JAMA-J AM MED ASSOC, V295, P180, DOI 10.1001/jama.295.2.180 Bjorck L, 2009, EUR HEART J, V30, P1046, DOI 10.1093/eurheartj/ehn554 Cacoub PP, 2011, HEART, V97, P660, DOI 10.1136/hrt.2010.213710 Chow CK, 2013, JAMA-J AM MED ASSOC, V310, P959, DOI 10.1001/jama.2013.184182 Clark AM, 2010, EUR J CARDIOV PREV R, V17, P261, DOI 10.1097/HJR.0b013e32833090ef Gielen S, 2014, EUR HEART J, V35, P307, DOI 10.1093/eurheartj/eht551 Jelinek M, 2009, HEART LUNG CIRC, V18, P388, DOI 10.1016/j.hlc.2009.06.001 Jelinek MV, 2014, INT J CARDIOL, V171, P346, DOI 10.1016/j.ijcard.2013.12.022 Jernberg T, 2011, JAMA-J AM MED ASSOC, V305, P1677, DOI 10.1001/jama.2011.522 Kotb A, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0096581 Kotseva K, 2015, EUR J PREV CARDIOL, DOI DOI 10.1177/2047487315569401 Mooe T, 2014, JMIR RES PROTOC, V3, DOI 10.2196/resprot.3466 Neubeck L, 2009, EUR J CARDIOV PREV R, V16, P281, DOI 10.1097/HJR.0b013e32832a4e7a Perk Joep, 2012, Int J Behav Med, V19, P403, DOI [10.1016/j.atherosclerosis.2012.05.007, 10.1093/eurheartj/ehs092, 10.1007/s12529-012-9242-5] Rockson SG, 2007, CARDIOVASC DRUG THER, V21, P375, DOI 10.1007/s10557-007-6043-1 Rossini R, 2013, AM J CARDIOL, V112, P150, DOI 10.1016/j.amjcard.2013.03.006 Smith SC, 2012, CIRCULATION, V126, P2769, DOI 10.1161/CIR.0b013e318267e99f Strandberg TE, 2014, JAMA-J AM MED ASSOC, V312, P1136, DOI 10.1001/jama.2014.10924 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] WINKLEBY MA, 1992, AM J PUBLIC HEALTH, V82, P816, DOI 10.2105/AJPH.82.6.816 Yusuf S, 2011, LANCET, V378, P1231, DOI 10.1016/S0140-6736(11)61215-4 NR 24 TC 8 Z9 8 U1 0 U2 10 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND EI 1745-6215 J9 TRIALS JI Trials PD FEB 15 PY 2016 VL 17 AR 85 DI 10.1186/s13063-016-1203-x PG 8 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA DD6JM UT WOS:000370030500001 PM 26876722 OA Green Published, gold DA 2023-05-13 ER PT J AU Ulvenstam, A Kajermo, U Modica, A Jernberg, T Soderstrom, L Mooe, T AF Ulvenstam, Anders Kajermo, Ulf Modica, Angelo Jernberg, Tomas Soderstrom, Lars Mooe, Thomas TI Incidence, Trends, and Predictors of Ischemic Stroke 1 Year After an Acute Myocardial Infarction SO STROKE LA English DT Article DE cerebral infarction; epidemiology; risk factors ID ACUTE CORONARY SYNDROMES; RISK-FACTORS; CLOPIDOGREL; ASPIRIN; EVENTS AB Background and Purpose Ischemic stroke after acute myocardial infarction is an important complication. It is unknown whether the risk has changed because the treatment of acute myocardial infarction has improved during the past decade. There is also conflicting data about predictors of stroke risk. Methods To obtain the 1-year incidence of stroke after acute myocardial infarction, the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions database for the years 1998 to 2008 was merged with the Swedish National Patient Register (NPR). The time trend was studied by dividing the entire time period into 5 separate periods. Independent predictors were identified using a multivariable Cox proportional hazards regression model. Results Between 1998 and 2008, 7185 of 173 233 patients with acute myocardial infarction had an ischemic stroke within 1 year (4.1%). There was a 20% relative risk reduction during the study period (1998-2000 versus 2007-2008) relative risk 0.80 (95% confidence interval, 0.75-0.86; P<0.001. Independent predictors of stroke were age, female sex, ST-segment-elevation myocardial infarction, previous stroke, previous diabetes mellitus, heart failure at admission, angiotensin-converting enzyme inhibitor treatment and atrial fibrillation. Reperfusion treatment with fibrinolysis and percutaneous coronary intervention and treatment with aspirin, P2Y12-inhibitors, and statins predicted a reduced risk of stroke. Conclusions The risk of ischemic stroke within a year after myocardial infarction is substantial but has clearly been reduced during the studied time period. The major predictive factors found to correlate well with previous investigations. Reperfusion treatment, thrombocyte aggregation inhibition, and lipid lowering are the main contributors to the observed risk reduction. C1 [Ulvenstam, Anders; Modica, Angelo] Ostersund Hosp, S-83296 Froson, Sweden. [Kajermo, Ulf] Skaraborg Hosp Skovde, Skovde, Sweden. [Jernberg, Tomas] Karolinska Inst, Dept Med, Solna, Sweden. [Soderstrom, Lars] Ostersund Hosp, Unit Res Educ & Dev, S-83296 Froson, Sweden. [Ulvenstam, Anders; Kajermo, Ulf; Modica, Angelo; Mooe, Thomas] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. C3 Karolinska Institutet; Umea University RP Ulvenstam, A (通讯作者),Ostersund Hosp, Tonsattarvagen 9, S-83296 Froson, Sweden. EM anders.ulvenstam@jll.se OI Jernberg, Tomas/0000-0003-1695-379X; Soderstrom, Lars/0000-0002-6474-6501 FU Research and Development Unit in Jamtland FX This study was granted financial support from the Research and Development Unit in Jamtland. CR Albaker O, 2011, CEREBROVASC DIS, V32, P471, DOI 10.1159/000330344 [Anonymous], 1988, LANCET, V2, P349 Budaj A, 2005, CIRCULATION, V111, P3242, DOI 10.1161/CIRCULATIONAHA.104.512806 Chen ZM, 2005, LANCET, V366, P1607, DOI 10.1016/s0140-6736(05)67660-x Dutta M, 2006, CEREBROVASC DIS, V22, P331, DOI 10.1159/000094847 Janszky I, 2012, SLEEP MED, V13, P237, DOI 10.1016/j.sleep.2011.07.019 Jernberg T., 2011, SWEDEHEART 2011 ANN, P16 Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Kajermo U, 2014, STROKE, V45, P1324, DOI 10.1161/STROKEAHA.113.001963 Koster M, 2013, NEUROEPIDEMIOLOGY, V40, P240, DOI 10.1159/000345953 Lewsey J, 2010, BMC MED, V8, DOI 10.1186/1741-7015-8-23 Ludvigsson JF, 2011, BMC PUBLIC HEALTH, V11, DOI 10.1186/1471-2458-11-450 Mooe T, 1997, STROKE, V28, P762, DOI 10.1161/01.STR.28.4.762 Olesen J, 2012, EUR J NEUROL, V19, P155, DOI 10.1111/j.1468-1331.2011.03590.x Sabatine MS, 2005, NEW ENGL J MED, V352, P1179, DOI 10.1056/NEJMoa050522 Sacco RL, 2008, NEW ENGL J MED, V359, P1238, DOI 10.1056/NEJMoa0805002 Saczynski JS, 2008, ARCH INTERN MED, V168, P2104, DOI 10.1001/archinte.168.19.2104 Sampson UK, 2007, EUR HEART J, V28, P685, DOI 10.1093/eurheartj/ehl197 Schwartz GG, 2001, JAMA-J AM MED ASSOC, V285, P1711, DOI 10.1001/jama.285.13.1711 Stenestrand U, 2001, JAMA-J AM MED ASSOC, V285, P430, DOI 10.1001/jama.285.4.430 Tanne D, 1997, J AM COLL CARDIOL, V30, P1484, DOI 10.1016/S0735-1097(97)00330-6 Van de Graaff EV, 2006, STROKE, V37, P2546, DOI 10.1161/01.STR.0000240495.99425.0f Wienbergen H, 2001, AM J CARDIOL, V87, P782, DOI 10.1016/S0002-9149(00)01505-8 Witt BJ, 2006, AM J MED, V119, DOI 10.1016/j.amjmed.2005.10.058 Witt BJ, 2005, ANN INTERN MED, V143, P785, DOI 10.7326/0003-4819-143-11-200512060-00006 Yusuf S, 2001, NEW ENGL J MED, V345, P494 NR 26 TC 30 Z9 32 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0039-2499 EI 1524-4628 J9 STROKE JI Stroke PD NOV PY 2014 VL 45 IS 11 BP 3263 EP 3268 DI 10.1161/STROKEAHA.114.005770 PG 6 WC Clinical Neurology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA AS6CD UT WOS:000344351500032 PM 25236874 DA 2023-05-13 ER PT J AU Cardinal-Fernandez, P Ortiz, G Chang, CH Kao, KC Bertreau, E Philipponnet, C Casero-Alonso, VM Souweine, B Charbonney, E Guerin, C AF Cardinal-Fernandez, Pablo Ortiz, Guillermo Chang, Chih-Hao Kao, Kuo-Chin Bertreau, Emmanuelle Philipponnet, Carole Manuel Casero-Alonso, Victor Souweine, Bertrand Charbonney, Emmanuel Guerin, Claude TI Predicting the Impact of Diffuse Alveolar Damage through Open Lung Biopsy in Acute Respiratory Distress Syndrome-The PREDATOR Study SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE acute respiratory distress syndrome; diffuse alveolar damage; acute respiratory failure ID MECHANICALLY VENTILATED PATIENTS; INJURY; SUBPHENOTYPES; MANAGEMENT; MORTALITY; SURVIVAL; SAFETY AB The aim of this retrospective and international study is to identify those clinical variables associated with diffuse alveolar damage (DAD), and to explore the impact of DAD on hospital mortality risk. Inclusion criteria were: adult patients with acute respiratory distress syndrome (ARDS) undergoing open lung biopsy (OLB) during their intensive care unit (ICU) management. The main end-points were: DAD and hospital mortality. In the training (n = 193) and validation cohorts (n = 65), the respiratory rate (odd ratio (OR) 0.956; confidence interval (CI) 95% 0.918; 0.995) and coronary ischemia (OR 5.974; CI95% 1.668; 21.399) on the day of ARDS had an average area under the receiver operating characteristic curve (AUROC) of 0.660 (CI95% 0.585; 0.736) and 0.562 (0.417; 0.706), respectively. PEEP (OR 1.131; CI95% 1.051; 1.218) and coronary ischemia (OR 6.820; CI95% 1.856; 25.061) on the day of OLB had an average AUROC of 0.696 (CI95% 0.621; 0.769) and 0.534 (CI95% 0.391; 0.678), respectively, to predict DAD. DAD (OR 2.296; CI95% 1.228; 4.294), diabetes mellitus requiring insulin (OR 0.081; CI95% 0.009; 0.710) and the respiratory rate (OR 1.045; CI95% 1.001; 1.091) on the day of ARDS had an average AUROC of 0.659 (CI95% 0.583; 0.737) and 0.513 (CI95% 0.361; 0.664) to predict hospital mortality and DAD (OR 2.081; CI95% 1.053; 4.114), diabetes mellitus requiring insulin (OR 0.093; CI95% 0.009; 0.956), PaCO2 (OR 1.051; CI95% 1.019; 1.084), and platelets count (OR 0.999; CI95% 0.999; 0.999) the day of OLB had an average AUROC of 0.778 (CI95% 0.710; 0.843) and 0.634 (CI95%0.481; 0.787) to predict hospital mortalty in the training and validation cohorts, respectively. In conclusion, DAD could not to be predicted clinically and was significantly associated with hospital mortality. C1 [Cardinal-Fernandez, Pablo] Hosp Univ HM Sanchinarro, Madrid 28050, Spain. [Cardinal-Fernandez, Pablo] Fdn HM, Madrid 28050, Spain. [Ortiz, Guillermo] Univ Bosque, Bogota, Colombia. [Ortiz, Guillermo] Univ Barcelona, Barcelona 08007, Spain. [Chang, Chih-Hao; Kao, Kuo-Chin] Chang Gung Mem Hosp, Taoyuan 33005, Taiwan. [Bertreau, Emmanuelle; Guerin, Claude] Reanimat Med Hop Croix Rousse, F-69004 Lyon, France. [Philipponnet, Carole; Souweine, Bertrand] Reanimat Med, F-63000 Clermont Ferrand, France. [Manuel Casero-Alonso, Victor] Univ Castilla La Mancha, Stat Area, Ciudad Real 13071, Spain. [Charbonney, Emmanuel] HSCM, Ctr Rech, 5400 Boul Gouin Ouest, Montreal, PQ H4J 1C5, Canada. [Guerin, Claude] Univ Lyon, Lyon East Fac Med, F-69100 Lyon, France. [Guerin, Claude] INSERM, F-955 Creteil, France. [Guerin, Claude] Hosp Civils Lyon, F-69003 Lyon, France. C3 Universidad El Bosque; University of Barcelona; Chang Gung Memorial Hospital; CHU Lyon; Universidad de Castilla-La Mancha; Universite de Montreal; Institut National de la Sante et de la Recherche Medicale (Inserm); CHU Lyon RP Guerin, C (通讯作者),Reanimat Med Hop Croix Rousse, F-69004 Lyon, France.; Guerin, C (通讯作者),Univ Lyon, Lyon East Fac Med, F-69100 Lyon, France.; Guerin, C (通讯作者),INSERM, F-955 Creteil, France.; Guerin, C (通讯作者),Hosp Civils Lyon, F-69003 Lyon, France. EM pablocardinal@hotmail.com; ortiz_guillermo@hotmail.com; ma7384@cgmh.org.tw; kck0502@cgmh.org.tw; emmanuelle.bertreau@chu-lyon.fr; cphilipponnet@chu-clermontferrand.fr; VictorManuel.Casero@uclm.es; bsouweine@chu-clermontferrand.fr; emmanuel.charbonney@umontreal.ca; claude.guerin@chu-lyon.fr RI souweine, bertrand/HHR-8972-2022; Casero-Alonso, Víctor/AAC-1320-2020; guerin, claude/H-5692-2014; GUERIN, CLAUDE/IAP-4956-2023 OI Casero-Alonso, Víctor/0000-0001-8165-5858; guerin, claude/0000-0003-4700-6672; Chang, Chih-Hao/0000-0001-9573-969X; Cardinal, Pablo/0000-0002-4459-8919; Philipponnet, Carole/0000-0002-6116-1452; Ortiz, Guillermo/0000-0002-3374-5709; Kao, Kuo-Chin/0000-0002-8777-1638 CR Amato MBP, 2015, NEW ENGL J MED, V372, P747, DOI 10.1056/NEJMsa1410639 Aublanc M, 2017, CURR OPIN CRIT CARE, V23, P24, DOI 10.1097/MCC.0000000000000373 Baumann HJ, 2008, SURGERY, V143, P426, DOI 10.1016/j.surg.2007.06.003 Bellani G, 2016, JAMA-J AM MED ASSOC, V315, P788, DOI 10.1001/jama.2016.0291 Calfee CS, 2018, LANCET RESP MED, V6, P691, DOI 10.1016/S2213-2600(18)30177-2 Cardinal-Fernandez P, 2017, ANN AM THORAC SOC, V14, P844, DOI 10.1513/AnnalsATS.201609-728PS Cardinal-Fernandez P, 2016, J CRIT CARE, V34, P31, DOI 10.1016/j.jcrc.2016.03.015 Cardinal-Fernandez P, 2016, CHEST, V149, P1155, DOI 10.1016/j.chest.2016.02.635 Cardinal-Fernandez P, 2016, TRANSL RES, V169, P102, DOI 10.1016/j.trsl.2015.11.004 Cardinal-Fernandez P, 2015, CHEST, V147, P7, DOI 10.1378/chest.14-0874 Cardinal-Fernandez P, 2013, SHOCK, V39, P255, DOI 10.1097/SHK.0b013e3182866ff9 Charbonney E, 2009, J CRIT CARE, V24, P122, DOI 10.1016/j.jcrc.2008.01.008 D'Alessio FR, 2018, METHODS MOL BIOL, V1809, P341, DOI 10.1007/978-1-4939-8570-8_22 Delucchi K, 2018, THORAX, V73, P439, DOI 10.1136/thoraxjnl-2017-211090 Depuydt PO, 2016, INTENS CARE MED, V42, P411, DOI 10.1007/s00134-015-3945-4 Dong YR, 2013, SPRINGERPLUS, V2, DOI 10.1186/2193-1801-2-222 Famous KR, 2017, AM J RESP CRIT CARE, V195, P331, DOI 10.1164/rccm.201603-0645OC Forel JM, 2015, INTENS CARE MED, V41, P1, DOI 10.1007/s00134-014-3524-0 Gattinoni L, 2016, INTENS CARE MED, V42, P1567, DOI 10.1007/s00134-016-4505-2 Gerard L, 2018, CRIT CARE MED, V46, P907, DOI 10.1097/CCM.0000000000003081 Gu WJ, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0090426 Guerin C, 2015, INTENS CARE MED, V41, P222, DOI 10.1007/s00134-014-3583-2 Kao KC, 2015, CRIT CARE, V19, DOI 10.1186/s13054-015-0949-y Larsson A, 2017, ANN TRANSL MED, V5, DOI 10.21037/atm.2017.06.56 Libby LJ, 2014, ANN THORAC SURG, V98, P1254, DOI 10.1016/j.athoracsur.2014.05.029 Lorente JA, 2015, INTENS CARE MED, V41, P1921, DOI 10.1007/s00134-015-4046-0 Izquierdo-Garcia JL, 2019, INTENS CARE MED, V45, P1318, DOI 10.1007/s00134-019-05634-w Marini JJ, 2016, INTENS CARE MED, V42, P1597, DOI 10.1007/s00134-016-4534-x Matute-Bello G, 2011, AM J RESP CELL MOL, V44, P725, DOI 10.1165/rcmb.2009-0210ST McNeil JB, 2018, AM J RESP CRIT CARE, V197, P1027, DOI 10.1164/rccm.201707-1474OC Nin N, 2017, INTENS CARE MED, V43, P200, DOI 10.1007/s00134-016-4611-1 Ortiz G, 2019, MED INTENSIVA, V43, P139, DOI 10.1016/j.medin.2018.01.007 Ortiz G, 2019, ARCH BRONCONEUMOL, V55, P31, DOI 10.1016/j.arbres.2018.03.006 Palakshappa JA, 2015, CHEST, V148, P1073, DOI 10.1378/chest.15-0076 Papazian L, 1998, ANESTHESIOLOGY, V88, P935, DOI 10.1097/00000542-199804000-00013 Papazian L, 2016, INTENS CARE MED, V42, P674, DOI 10.1007/s00134-016-4324-5 Park J, 2018, KOREAN J INTERN MED, V33, P532, DOI 10.3904/kjim.2016.346 Philipponnet C, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0196795 Ranieri VM, 2012, JAMA-J AM MED ASSOC, V307, P2526, DOI 10.1001/jama.2012.5669 Rios Fernando, 2017, Rev. bras. ter. intensiva, V29, P354, DOI [10.5935/0103-507X.20170044, 10.5935/0103-507x.20170044] Thille AW, 2017, CRIT CARE, V21, DOI 10.1186/s13054-017-1852-5 Tonelli AR, 2014, INTENS CARE MED, V40, P769, DOI 10.1007/s00134-014-3272-1 van Buuren S, 2011, J STAT SOFTW, V45, P1 White IR, 2011, STAT MED, V30, P377, DOI 10.1002/sim.4067 Wong AK, 2015, ANN AM THORAC SOC, V12, P1226, DOI 10.1513/AnnalsATS.201502-077BC Zhang ZH, 2017, ANN TRANSL MED, V5, DOI 10.21037/atm.2017.09.39 Zhang ZH, 2016, ANN TRANSL MED, V4, DOI 10.3978/j.issn.2305-5839.2015.12.63 NR 47 TC 9 Z9 9 U1 0 U2 2 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 2077-0383 J9 J CLIN MED JI J. Clin. Med. PD JUN PY 2019 VL 8 IS 6 AR 829 DI 10.3390/jcm8060829 PG 16 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA II7CG UT WOS:000475349300073 PM 31212621 OA Green Published, gold DA 2023-05-13 ER PT J AU Prabhakaran, D Singh, K Roth, GA Banerjee, A Pagidipati, NJ Huffman, MD AF Prabhakaran, Dorairaj Singh, Kavita Roth, Gregory A. Banerjee, Amitava Pagidipati, Neha J. Huffman, Mark D. TI Cardiovascular Diseases in India Compared With the United States SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE epidemiology; health policy; health systems; review ID ACUTE CORONARY SYNDROMES; RISK-FACTORS; BLOOD-PRESSURE; MIDDLE-INCOME; SOUTH ASIANS; MYOCARDIAL-INFARCTION; CONTROLLED-TRIAL; COHORT PROFILE; DIABETES CARE; HEALTH-CARE AB This review describes trends in the burden of cardiovascular diseases (CVDs) and risk factors in India compared with the United States; provides potential explanations for these differences; and describes strategies to improve cardiovascular health behaviors, systems, and policies in India. The prevalence of CVD in India has risen over the past 2 decades due to population growth, aging, and a stable age-adjusted CVD mortality rate. Over the same time period, the United States has experienced an overall decline in age-adjusted CVD mortality, although the trend has begun to plateau. These improvements in CVD mortality in the United States are largely due to favorable population-level risk factor trends, specifically with regard to tobacco use, cholesterol, and blood pressure, although improvements in secondary prevention and acute care have also contributed. To realize similar gains in reducing premature death and disability from CVD, India needs to implement population- level policies while strengthening and integrating its local, regional, and national health systems. Achieving universal health coverage that includes financial risk protection should remain a goal to help all Indians realize their right to health. (C) 2018 by the American College of Cardiology Foundation. C1 [Prabhakaran, Dorairaj; Singh, Kavita] Publ Hlth Fdn India, Gurgaon, India. [Prabhakaran, Dorairaj; Singh, Kavita] Ctr Chron Dis Control, Gurgaon, India. [Prabhakaran, Dorairaj] London Sch Hyg & Trop Med, London, England. [Roth, Gregory A.] Univ Washington, Sch Med, Inst Hlth Metr & Evaluat, Seattle, WA USA. [Roth, Gregory A.] Univ Washington, Sch Med, Div Cardiol, Seattle, WA USA. [Banerjee, Amitava] UCL, Farr Inst Hlth Informat, London, England. [Pagidipati, Neha J.] Duke Univ, Sch Med, Dept Med, Durham, NC 27706 USA. [Huffman, Mark D.] Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA. C3 Public Health Foundation of India; University of London; London School of Hygiene & Tropical Medicine; Institute for Health Metrics & Evaluation; University of Washington; University of Washington Seattle; University of Washington; University of Washington Seattle; RLUK- Research Libraries UK; University of London; University College London; Duke University; Northwestern University; Feinberg School of Medicine RP Prabhakaran, D (通讯作者),Publ Hlth Fdn India, Ctr Chron Dis Control, London Sch Hyg & Trop Med, Plot 47,Sect 44, Gurgaon 122002, India. EM dprabhakaran@phfi.org RI Prabhakaran, Dorairaj/B-4147-2011; Banerjee, Amitava/D-4381-2014 OI Prabhakaran, Dorairaj/0000-0002-3172-834X; Banerjee, Amitava/0000-0001-8741-3411 FU Merck Sharp Dohme; Eli Lilly; GlaxoSmithKline; Torrent; Sun Pharmaceuticals; National Heart, Lung, and Blood Institute, Fogarty International Center, National Cancer Institute; Wellcome Trust; Indian Council of Medical Research; Amgen; Sanofi; Regeneron; Novartis; Alexion; National Heart, Lung, and Blood Institute [R00HL107749]; World Heart Federation; Boehringer Ingelheim; American Heart Association; Verily; AstraZeneca FX The Public Health Foundation of India received unrestricted educational grants from Merck Sharp & Dohme, Eli Lilly, GlaxoSmithKline, Torrent, and Sun Pharmaceuticals for primary care physician training programs. Dr. Prabhakaran has received support from the National Heart, Lung, and Blood Institute, Fogarty International Center, National Cancer Institute, Wellcome Trust, and the Indian Council of Medical Research; and has received honorarium from Torrent for serving on the data safety and monitory board. Dr. Pagidipati has received grant support from Amgen, Sanofi, Regeneron, Novartis, and Alexion. Dr. Huffman has received support from the National Heart, Lung, and Blood Institute (R00HL107749) and the World Heart Federation, the latter to serve as senior program advisor for the World Heart Federation's Emerging Leaders program, which is supported by unrestricted educational grants from Boehringer Ingelheim and Novartis, with previous support by AstraZeneca and Bupa; and has received grant support from the American Heart Association, Verily, and AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. 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Am. Coll. Cardiol. PD JUL 3 PY 2018 VL 72 IS 1 BP 79 EP 95 DI 10.1016/j.jacc.2018.04.042 PG 17 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA GK7YT UT WOS:000436432000011 PM 29957235 OA Green Accepted, Green Submitted DA 2023-05-13 ER PT J AU Zi, WJ Song, JX Qiu, ZM Kong, WL Huang, JC Luo, WD Liu, S Sang, HF Yang, J Li, LY Tian, Y Hu, JR Saver, JL Nogueira, RG Li, FL Yang, QW AF Zi, Wenjie Song, Jiaxing Qiu, Zhongming Kong, Weilin Huang, Jiacheng Luo, Weidong Liu, Shuai Sang, Hongfei Yang, Jie Li, Linyu Tian, Yan Hu, Jinrong Saver, Jeffrey L. Nogueira, Raul G. Li, Fengli Yang, Qingwu CA RESCUE BT 2 Trial Investigators TI RESCUE BT 2, a multicenter, randomized, double-blind, double-dummy trial of intravenous tirofiban in acute ischemic stroke: Study rationale and design SO INTERNATIONAL JOURNAL OF STROKE LA English DT Article; Early Access DE Platelet glycoprotein IIb/IIa inhibitor; tirofiban; acute ischemic stroke; randomized controlled trial ID GLYCOPROTEIN IIB/IIIA RECEPTOR; HEALTH-CARE PROFESSIONALS; EARLY MANAGEMENT; GUIDELINES; OCCLUSION; SAFETY AB Background: Tirofiban is a glycoprotein IIb/IIIa receptor inhibitor that has been shown to be effective in the treatment of acute coronary syndromes. However, it remains unknown whether it improves outcomes in patients with acute ischemic stroke. Objective: This trial investigates the efficacy and safety of tirofiban compared with aspirin for acute ischemic stroke within 24 h after symptom onset. Methods and design: The Efficacy and Safety of Tirofiban Compared with Aspirin in the Treatment of Acute Ischemic Stroke (RESCUE BT 2) Trial is an investigator-initiated, prospective, randomized, double-blind, double-dummy, multi-center clinical trial. Up to 1158 eligible patients will be consecutively randomized to receive antiplatelet therapy with tirofiban or aspirin in 1:1 ratio across approximately 100 stroke centers in China. Outcomes: The primary endpoint is the proportion of patients with excellent functional outcomes defined as a modified Rankin scale score of 0 to 1 at 90 days after randomization. Lead safety endpoints include mortality at 90 days and symptomatic intracerebral hemorrhage within 48 h after treatment. C1 [Zi, Wenjie; Song, Jiaxing; Qiu, Zhongming; Kong, Weilin; Huang, Jiacheng; Luo, Weidong; Liu, Shuai; Sang, Hongfei; Yang, Jie; Li, Linyu; Tian, Yan; Hu, Jinrong; Li, Fengli; Yang, Qingwu] Third Mil Med Univ, Army Med Univ, Xinqiao Hosp, Dept Neurol, Chongqing, Peoples R China. [Zi, Wenjie; Song, Jiaxing; Qiu, Zhongming; Kong, Weilin; Huang, Jiacheng; Luo, Weidong; Liu, Shuai; Sang, Hongfei; Yang, Jie; Li, Linyu; Tian, Yan; Hu, Jinrong; Li, Fengli; Yang, Qingwu] Third Mil Med Univ, Army Med Univ, Affiliated Hosp 2, Chongqing, Peoples R China. [Saver, Jeffrey L.] UCLA, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. [Nogueira, Raul G.] Univ Pittsburgh, UPMC Stroke Inst, Dept Neurol & Neurosurg, Pittsburgh, PA USA. C3 Army Medical University; Army Medical University; University of California System; University of California Los Angeles; University of California Los Angeles Medical Center; David Geffen School of Medicine at UCLA; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh RP Li, FL; Yang, QW (通讯作者),Third Mil Med Univ, Army Med Univ, Xinqiao Hosp, Dept Neurol, Chongqing, Peoples R China.; Li, FL; Yang, QW (通讯作者),Third Mil Med Univ, Army Med Univ, Affiliated Hosp 2, Chongqing, Peoples R China. EM lifengli01@yeah.net; yangqwmlys@163.com OI Qiu, Zhongming/0000-0002-1622-9526 FU National Natural Science Foundation of China [82090040, 82071323]; Lunan Pharmaceutical Group Co., Ltd., China FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This clinical trial is sponsored by (1) Lunan Pharmaceutical Group Co., Ltd., China and (2) National Natural Science Foundation of China (Nos 82090040, 82071323). The sponsors had no role in the study design, data collection, analysis, and interpretation, and in drafting and submitting this article. CR Bazzino O, 1998, NEW ENGL J MED, V338, P1488 Cranston JS, 2017, STROKE, V48, P2946, DOI 10.1161/STROKEAHA.117.017496 Feng L, 2016, EXP THER MED, V11, P1011, DOI 10.3892/etm.2016.2995 Jauch EC, 2013, STROKE, V44, P870, DOI 10.1161/STR.0b013e318284056a Johnson CO, 2019, LANCET NEUROL, V18, P439, DOI 10.1016/S1474-4422(19)30034-1 Lin L, 2017, J NEUROL SCI, V383, P175, DOI 10.1016/j.jns.2017.10.041 Powers WJ, 2019, STROKE, V50, pE344, DOI 10.1161/STR.0000000000000211 Siebler M, 2011, STROKE, V42, P2388, DOI 10.1161/STROKEAHA.110.599662 Torbey MT, 2008, NEW ENGL J MED, V359, P2839, DOI 10.1056/NEJMc082179 Torgano G, 2010, CEREBROVASC DIS, V29, P275, DOI 10.1159/000275503 Wu CJ, 2019, STROKE, V50, P3481, DOI 10.1161/STROKEAHA.119.026240 Wu SM, 2019, LANCET NEUROL, V18, P394, DOI 10.1016/S1474-4422(18)30500-3 Yang M, 2019, DRUGS, V79, P515, DOI 10.1007/s40265-019-01078-0 Yu YJ, 2018, EUR REV MED PHARMACO, V22, P2888, DOI 10.26355/eurrev_201805_14991 Zhang L, 2003, CIRCULATION, V107, P2837, DOI 10.1161/01.CIR.0000068374.57764.EB Zou GY, 2004, AM J EPIDEMIOL, V159, P702, DOI 10.1093/aje/kwh090 NR 16 TC 0 Z9 0 U1 0 U2 4 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1747-4930 EI 1747-4949 J9 INT J STROKE JI Int. 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Stroke DI 10.1177/17474930221122681 EA SEP 2022 PG 6 WC Clinical Neurology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 4I8HH UT WOS:000850814800001 PM 35993176 DA 2023-05-13 ER PT J AU Sundstrom, BW Bang, A Karlsson, T Winge, K Lundberg, C Herlitz, J AF Sundstrom, Birgitta Wireklint Bang, Angela Karlsson, Thomas Winge, Karin Lundberg, Camilla Herlitz, Johan TI Anxiolytics in patients suffering a suspected acute coronary syndrome: Multi-centre randomised controlled trial in Emergency Medical Service SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Chest pain; Anxiety; Cardiology nursing; Emergency Medical Services; Benzodiazepine ID ACUTE MYOCARDIAL-INFARCTION; PLACEBO-CONTROLLED TRIAL; CHEST-PAIN; DOUBLE-BLIND; DIAZEPAM; METOPROLOL; MIDAZOLAM; FENTANYL; RELIEF AB Background: The prehospital treatment of pain and discomfort among patients who suffer from acute coronary syndrome (ACS) needs a treatment strategy which combines relief of pain with relief of anxiety. Aim: The aim of the present study was to evaluate the impact on pain and anxiety of the combination of an anxiolytic and an analgesic as compared with an analgesic alone in the prehospital setting of suspected ACS. Methods: A multi-centre randomised controlled trial compared the combination of Midazolam (Mi) + Morphine (Mo) and Mo alone. All measures took part: Prior to randomisation, 15 min thereafter and on admission to a hospital. Inclusion criteria were: 1) pain raising suspicion of ACS and 2) pain score = 4. Primary endpoint: Pain score after 15 min. Results: In all, 890 patients were randomised to Mi + Mo and 873 to Mo alone. Pain was reduced from a median of 6 to 4 and finally to 3 in both groups. The mean dose of Mo was 5.3 mg in Mi + Mo and 6.0 mg in Mo alone (p < 0.0001). Anxiety was reported in 66% in Mi + Mo and in 64% in Mo alone at randomisation (NS); 15 min thereafter in 31% and 39% (p = 0.002) and finally in 12% and 26% respectively (p < 0.0001). On admission to a hospital nausea or vomiting was reported in 9% in Mi + Mo and in 13% in Mo alone (p = 0.003). Drowsiness differed; 15% and 14% were drowsy in Mi + Mo versus 2% and 3% in Mo alone respectively (p < 0.001). Conclusion: Despite the fact that the combination of anxiolytics and analgesics as compared with analgesics alone reduced anxiety and the requirement of Morphine in the prehospital setting of acute coronary syndrome, this strategy did not reduce patients' estimation of pain (primary endpoint). More effective pain relief among these patients is warranted. (C) 2013 Elsevier Ireland Ltd. All rights reserved. C1 [Sundstrom, Birgitta Wireklint; Bang, Angela; Herlitz, Johan] Univ Boras, Sch Hlth Sci, Res Ctr PreHospen, Prehosp Res Ctr Western Sweden, SE-50190 Boras, Sweden. [Karlsson, Thomas] Sahlgrens Acad, Dept Mol & Clin Med, Gothenburg, Sweden. [Karlsson, Thomas] Sahlgrens Univ Hosp, S-41345 Gothenburg, Sweden. [Winge, Karin; Lundberg, Camilla] Sodra Alvsborg Hosp, Emergency Med Serv Syst, Boras, Sweden. C3 University of Boras; University of Gothenburg; Sahlgrenska University Hospital RP Sundstrom, BW (通讯作者),Univ Boras, Sch Hlth Sci, SE-50190 Boras, Sweden. EM birgitta.wireklint.sundstrom@hb.se OI Winge, Kristian/0000-0001-8354-9143 FU University of Boras; Health & Medical Care Committee of the Regional Executive Board, Region Vastra Gotaland and Sparbanksstiftelsen Sjuharad, Sweden FX This study was funded by the University of Boras, The Health & Medical Care Committee of the Regional Executive Board, Region Vastra Gotaland and Sparbanksstiftelsen Sjuharad, Sweden. CR American College of Cardiology/American Heart Association, 2004, CIRCULATION, V110, pe82 Baris S, 2001, CAN J CARDIOL, V17, P277 Baumann BM, 2000, ACAD EMERG MED, V7, P878, DOI 10.1111/j.1553-2712.2000.tb02065.x Chen ZM, 2005, LANCET, V366, P1622 De Jong Marla J, 2004, Eur J Cardiovasc Nurs, V3, P129, DOI 10.1016/j.ejcnurse.2004.01.004 DIXON RA, 1980, BRIT HEART J, V43, P535 Gardtman M, 1999, AM HEART J, V137, P821, DOI 10.1016/S0002-8703(99)70405-9 Guanghui L, 2010, HEART S3, V96, pA89 HERLITZ J, 1986, CLIN CARDIOL, V9, P423, DOI 10.1002/clc.4960090907 Herlitz J, 2011, INT J CARDIOL, V149, P147, DOI 10.1016/j.ijcard.2010.10.012 HESS L, 1989, COR VASA, V31, P411 Khan Mohammad Asghar, 2010, J Ayub Med Coll Abbottabad, V22, P32 Leys C, 2010, J EXP SOC PSYCHOL, V46, P684, DOI 10.1016/j.jesp.2010.02.007 McGrath P, 1996, PAIN, V64, P435, DOI 10.1016/0304-3959(95)00171-9 McLean Samuel A, 2004, Prehosp Emerg Care, V8, P155, DOI 10.1016/j.prehos.2003.12.006 MELSOM M, 1976, BRIT HEART J, V38, P804, DOI 10.1136/hrt.38.8.804 ROSSETTI E, 1994, J CARDIOVASC PHARM, V24, P55, DOI 10.1097/00005344-199407000-00010 Van de Werf F, 2008, EUR HEART J, V29, P2909, DOI 10.1093/eurheartj/ehn416 VRANA M, 1991, Cor et Vasa, V33, P428 Vrana M, 1987, Czech Med, V10, P142 Zedigh C, 2010, CORONARY ARTERY DIS, V21, P113, DOI 10.1097/MCA.0b013e32832fa9e5 NR 21 TC 6 Z9 6 U1 0 U2 4 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD OCT 9 PY 2013 VL 168 IS 4 BP 3580 EP 3587 DI 10.1016/j.ijcard.2013.05.067 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 242EG UT WOS:000326219600072 PM 23727103 DA 2023-05-13 ER PT J AU Westmoreland, AH AF Westmoreland, Andrew H. TI Managing Acute Coronary Syndrome During Medical Air Evacuation from a Remote Location at Sea SO AVIATION SPACE AND ENVIRONMENTAL MEDICINE LA English DT Article DE trazodone; stress-induced cardiomyopathy; ST segment elevation; myocardial infarction; Operation Enduring Freedom AB Background: Coronary emergencies at sea requiring air evacuation are not uncommon. On board a Nimitz-class aircraft carrier while in a remote location, an active duty sailor suffered a myocardial infarction. A medical evacuation by helicopter was necessary. Transfer proved difficult due to the ship's location, poor flying conditions, and the patient's deteriorating condition. This case stresses the importance of expeditious diagnosis, treatment, and air transfer to shore-based facilities capable of providing definitive coronary care. Case Report: A 33-yr-old man recently started on trazodone due to depression complained of chest pain. The patient was hemodynamically unstable and electrocardiogram showed ST segment elevation and Q waves in the anterior, inferior, and lateral leads. He was air-lifted to the nearest accepting facility with cardiac catheterization capabilities, which was over 300 miles away. Poor weather conditions hindered the pilot's ability to fly the original course. The patient remained critical and medication choices were limited. Even with all of these obstacles, everyone involved performed his or her duties admirably. The patient's condition improved by the time the helicopter landed. He was then rushed by ambulance to the hospital's coronary care unit, where he was successfully treated. Discussion: This case highlights the need to keep a high index of suspicion when patients complain of chest pain, regardless of age. It is of the utmost importance that individuals capable of thinking and acting quickly are assigned to medical evacuation teams, and that they continue to train regularly, as coronary events at sea are not uncommon. C1 [Westmoreland, Andrew H.] US Navy, Naval Air Stn Oceana, Virginia Beach, VA USA. RP Westmoreland, AH (通讯作者),USN, 105 Isabella Ln 102, Virginia Beach, VA 23462 USA. EM fsnavy33@yahoo.com CR Antman EM, 2001, HARRISONS PRINCIPLES, P1389 Fagiolini A, 2012, CNS DRUGS, V26, P1033, DOI 10.1007/s40263-012-0010-5 Hollander J.E., 2004, EMERGENCY MED COMPRE, V6th ed., P343 Jaremin B, 1997, Int J Occup Med Environ Health, V10, P405 Jaremin Bogdan, 2003, Int Marit Health, V54, P26 Leonard CE, 2011, PHARMACOEPIDEM DR S, V20, P903, DOI 10.1002/pds.2181 Lyon AR, 2008, NAT CLIN PRACT CARD, V5, P22, DOI 10.1038/ncpcardio1066 Sanchez-Jimenez EF, 2013, WORLD J CARDIOL, V5, P228, DOI 10.4330/wjc.v5.i7.228 Vinsonneau U, 2012, AM J EMERG MED, V30, P1591, DOI 10.1016/j.ajem.2011.10.013 Wojcik-Stasiak M, 2011, INT MARIT HEALTH, V62, P110 NR 10 TC 1 Z9 1 U1 0 U2 15 PU AEROSPACE MEDICAL ASSOC PI ALEXANDRIA PA 320 S HENRY ST, ALEXANDRIA, VA 22314-3579 USA SN 0095-6562 EI 1943-4448 J9 AVIAT SPACE ENVIR MD JI Aviat. Space Environ. Med. PD JAN PY 2014 VL 85 IS 1 BP 71 EP 74 DI 10.3357/ASEM.3792.2014 PG 4 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Sport Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Public, Environmental & Occupational Health; General & Internal Medicine; Sport Sciences GA AD1MA UT WOS:000332996900014 PM 24754214 DA 2023-05-13 ER PT J AU van Diepen, S Lin, M Bakal, JA McAlister, FA Kaul, P Katz, JN Fordyce, CB Southern, DA Graham, MM Wilton, SB Newby, LK Granger, CB Ezekowitz, JA AF van Diepen, Sean Lin, Meng Bakal, Jeffrey A. McAlister, Finlay A. Kaul, Padma Katz, Jason N. Fordyce, Christopher B. Southern, Danielle A. Graham, Michelle M. Wilton, Stephen B. Newby, L. Kristin Granger, Christopher B. Ezekowitz, Justin A. TI Do stable non-ST-segment elevation acute coronary syndromes require admission to coronary care units? SO AMERICAN HEART JOURNAL LA English DT Article ID CHARLSON COMORBIDITY INDEX; MYOCARDIAL-INFARCTION; PROGNOSTIC VALUE; VENTRICULAR-ARRHYTHMIAS; HOSPITAL MORTALITY; TRENDS; OUTCOMES; COST; VALIDITY AB Background Clinical practice guidelines recommend admitting patients with stable non-ST-segment elevation acute coronary syndrome (NSTE ACS) to telemetry units, yet up to two-thirds of patients are admitted to higher-acuity critical care units (CCUs). The outcomes of patients with stable NSTE ACS initially admitted to a CCU vs a cardiology ward with telemetry have not been described. Methods We used population-based data of 7,869 patients hospitalized with NSTE ACS admitted to hospitals in Alberta, Canada, between April 1, 2007, and March 31, 2013. We compared outcomes among patients initially admitted to a CCU (n = 5,141) with those admitted to cardiology telemetry wards (n = 2,728). Results Patients admitted to cardiology telemetry wards were older (median 69 vs 65 years, P < .001) and more likely to be female (37.2% vs 32.1%, P < .001) and have a prior myocardial infarction (14.3% vs 11.5%, P < .001) compared with patients admitted to a CCU. Patients admitted directly to cardiology telemetry wards had similar hospital stays (6.2 vs 5.7 days, P = .29) and fewer cardiac procedures (40.3% vs 48.5%, P b.001) compared with patients initially admitted to CCUs. There were no differences in the frequency of in-hospital mortality (1.3% vs 1.2%, adjusted odds ratio [aOR] 1.57, 95% CI 0.98-2.52), cardiac arrest (0.7% vs 0.9%, aOR 1.37, 95% CI 0.94-2.00), 30-day all-cause mortality (1.6% vs 1.5%, aOR 1.50, 95% CI 0.82-2.75), or 30-day all-cause postdischarge readmission (10.6% vs 10.8%, aOR 1.07, 95% CI 0.90-1.28) between cardiology telemetry ward and CCU patients. Results were similar across low-, intermediate-, and high-risk Duke Jeopardy Scores, and in patients with non-ST-segment myocardial infarction or unstable angina. Conclusions There were no differences in clinical outcomes observed between patients with NSTE ACS initially admitted to a ward or a CCU. These findings suggest that stable NSTE ACS may be managed appropriately on telemetry wards and presents an opportunity to reduce hospital costs and critical care capacity strain. C1 [van Diepen, Sean] Univ Alberta, Div Crit Care, Edmonton, AB, Canada. [van Diepen, Sean] Univ Alberta, Div Cardiol, Edmonton, AB, Canada. [van Diepen, Sean; Bakal, Jeffrey A.; McAlister, Finlay A.; Kaul, Padma; Ezekowitz, Justin A.] Canadian Vigour Ctr, Edmonton, AB, Canada. [Lin, Meng; Bakal, Jeffrey A.; McAlister, Finlay A.] Univ Alberta, Dept Med, Alberta SPOR Support Unit, Edmonton, AB, Canada. [McAlister, Finlay A.] Univ Alberta, Dept Med, Div Gen Internal Med, Edmonton, AB, Canada. [Katz, Jason N.] Univ N Carolina, Div Cardiol, Chapel Hill, NC USA. [Katz, Jason N.] Univ N Carolina, Div Pulm Crit Care Med, Chapel Hill, NC USA. [Fordyce, Christopher B.; Newby, L. Kristin; Granger, Christopher B.] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA. [Southern, Danielle A.] Univ Calgary, OBrien Inst Publ Hlth, Calgary, AB, Canada. [Southern, Danielle A.] Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada. [Graham, Michelle M.] Univ Alberta, Dept Med, Div Cardiol, Edmonton, AB, Canada. [Wilton, Stephen B.] Univ Calgary, Libin Cardiovasc Inst Alberta, Calgary, AB, Canada. C3 University of Alberta; University of Alberta; University of Alberta; University of Alberta; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina; University of North Carolina Chapel Hill; Duke University; University of Calgary; University of Calgary; University of Alberta; Libin Cardiovascular Institute Of Alberta; University of Calgary RP van Diepen, S (通讯作者),Univ Alberta Hosp, 2C2 Cardiol Walter MacKenzie Ctr,8440-11 St, Edmonton, AB T6G 2B7, Canada. EM sv9@ualberta.ca RI Wilton, Stephen/HOH-4991-2023; Southern, Danielle A/GRY-7207-2022; Bakal, Jeff/ABE-4051-2021; Ezekowitz, Justin/C-4579-2013; McAlister, Finlay/C-4151-2013 OI Southern, Danielle A/0000-0002-0006-0033; Ezekowitz, Justin/0000-0002-2724-4086; Kaul, Padma/0000-0003-2239-3944; Bakal, Jeffrey/0000-0002-3658-2554; McAlister, Finlay/0000-0001-7435-3341 FU Alberta Innovates-Health Solutions; University of Alberta; St Jude Medical; Alberta Health Services; Boehringer Ingelheim; Arca Biopharma FX F.A.M. is supported by Alberta Innovates-Health Solutions and the University of Alberta Chair in Cardiovascular Outcomes. J.A.E. is supported by a salary award from Alberta Innovates-Health Solutions.; S.v.D., M.L., J.A.B., F.A.M., P.K., J.N.K., C.B.F., D.A.S., M.M.G., J.A.E.: none. S.B.W.: research grants from St Jude Medical and Alberta Health Services and consulting fees from Boehringer Ingelheim and Arca Biopharma. L.K.N., C.B.G.: disclosures are publically available at https://dcri.org/about-us/conflict-of-interest. 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Heart J. PD MAY PY 2016 VL 175 BP 184 EP 192 DI 10.1016/j.ahj.2015.11.020 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DL5CP UT WOS:000375655200023 PM 27179739 DA 2023-05-13 ER PT J AU Davis, WT Montrief, T Koyfman, A Long, B AF Davis, William T. Montrief, Tim Koyfman, Alex Long, Brit TI Dysrhythmias and heart failure complicating acute myocardial infarction: An emergency medicine review SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Review DE Acute myocardial infarction; Dysrhythmia; Heart block; Atrial fibrillation; Bradycardia; Ventricular tachycardia; Heart failure; Cardiogenic shock ID ST-SEGMENT ELEVATION; VENTRICULAR SEPTAL RUPTURE; ACUTE CORONARY SYNDROMES; CARDIOGENIC-SHOCK; ATRIOVENTRICULAR-BLOCK; ATRIAL-FIBRILLATION; CARDIOPULMONARY-RESUSCITATION; ASSOCIATION GUIDELINES; PULMONARY-HYPERTENSION; SYNDROMES INSIGHTS AB Introduction Patients with acute myocardial infarction (AMI) may suffer several complications after the acute event, including dysrhythmias and heart failure (HF). These complications place patients at risk for morbidity and mortality. Objective: This narrative review evaluates literature and guideline recommendations relevant to the acute emergency department (ED) management of AMI complicated by dysrhythmia or HF, with a focus on evidence-based considerations for ED interventions. Discussion: Limited evidence exists for ED management of dysrhythmias in AMI due to relatively low prevalence and frequent exclusion of patients with active cardiac ischemia from clinical studies. Management decisions for bradycardia in the setting of AMI are determined by location of infarction, timing of the dysrhythmia, rhythm assessment, and hemodynamic status of the patient. Atrial fibrillation is common in the setting of AMI, and caution is warranted in acute rate control for rapid ventricular rate given the possibility of compensation for decreased ventricular function. Regular wide complex tachycardia in the setting of AMI should be managed as ventricular tachycardia with electrocardioversion in the majority of cases. Management directed towards HF from left ventricular dysfunction in AMI consists of noninvasive positive pressure ventilation, nitroglycerin therapy, and early cardiac catheterization. Norepinephrine is the first line vasopressor for patients with cardiogenic shock and hypoperfusion on clinical examination. Early involvement of a multi-disciplinary team is recommended when caring for patients in cardiogenic shock. Conclusions: This review discusses considerations of ED management of dysrhythmias and HF associated with AMI. Published by Elsevier Inc. C1 [Davis, William T.; Long, Brit] Brooke Army Med Ctr, Dept Emergency Med, 3841 Roger Brooke Dr, Ft Sam Houston, TX 78234 USA. [Montrief, Tim] Univ Miami, Jackson Mem Hosp, Miller Sch Med, Dept Emergency Med, 1611 NW 12th Ave, Miami, FL 33136 USA. [Koyfman, Alex] Univ Texas Southwestern Med Ctr Dallas, Dept Emergency Med, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. 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J. Emerg. Med. PD AUG PY 2019 VL 37 IS 8 BP 1554 EP 1561 DI 10.1016/j.ajem.2019.04.047 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA IM3WT UT WOS:000477927100028 PM 31060863 DA 2023-05-13 ER PT J AU Kim, K Lee, TA Touchette, DR DiDomenico, RJ Ardati, AK Walton, SM AF Kim, Kibum Lee, Todd A. Touchette, Daniel R. DiDomenico, Robert J. Ardati, Amer K. Walton, Surrey M. TI Comparison of 6-Month Costs Between Oral Antiplatelet Agents Following Acute Coronary Syndrome SO JOURNAL OF MANAGED CARE & SPECIALTY PHARMACY LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; GUIDELINE FOCUSED UPDATE; 2013 ACCF/AHA GUIDELINE; ISCHEMIC-HEART-DISEASE; ASSOCIATION TASK-FORCE; RESOURCE UTILIZATION; ACC/AHA GUIDELINE; AMERICAN-COLLEGE; INTERVENTION; CLOPIDOGREL AB BACKGROUND: In patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI), newer antiplatelet agents prasugrel and ticagrelor have lower rates of cardiovascular events when compared with clopidogrel. However, it is unclear whether there are differences in economic outcomes when comparing these agents in ACS-PCI patients. OBJECTIVE: To assess aggregated costs and medical resource utilization among ACS-PCI patients prescribed prasugrel, ticagrelor, or generic clopidogrel, using a large commercial insurance claims database. METHODS: Costs attributable to any medical and pharmacy service and resource utilization including number of admissions, length of hospital stay, emergency room visits, and office visits over the 180-day postdischarge period were compared. All-cause and cardiovascular health care costs and resource utilization were separately analyzed for patients enrolled in the data over the continuous follow-up (CFU) period, and for patients continuously taking their initial treatment for 6 months (CTX). Potential confounders collected over a 6-month baseline assessment period were controlled for, using a generalized linear model. RESULTS: Over the 180-day follow-up, prasugrel and ticagrelor patients underwent fewer admissions (rate ratio [RR] = 0.87, 95% CI = 0.80-0.95) from CFU and RR = 0.81, 95% CI = 0.71-0.89 from CTX) compared with clopidogrel patients. The newer agent cohort incurred more overall health care costs than the generic clopidogrel group, with added costs of $957 (95% CI = $236-$1,725) in the CFU group and $1,122 (95% CI = $455-$ 1,865) in the CTX group, which were smaller than the increase in all-cause outpatient pharmacy costs associated with the newer agents versus clopidogrel (CFU: $1,175, 95% CI = $1,079-$1,278 and CTX: $1,360, 95% CI = $1,256-$1,487). Overall, there was no statistically significant difference in the economic outcomes associated with prasugrel and ticagrelor. There were, however, significant correlations between all-cause and cardiovascular-related outcomes. CONCLUSIONS: The higher price of prasugrel and ticagrelor was partially offset by a decrease in hospital admission compared with generic clopidogrel over a 6-month postdischarge period. Aggregated medical costs and resource utilization were not significantly different between prasugrel and ticagrelor patients. Copyright (C) 2018, Academy of Managed Care Pharmacy. All rights reserved. C1 [Kim, Kibum] Univ Utah, Pharmacotherapy Outcomes Res Ctr, Salt Lake City, UT USA. [Kim, Kibum] Univ Utah, Dept Pathol, Salt Lake City, UT USA. [Lee, Todd A.; Touchette, Daniel R.; Walton, Surrey M.] Univ Illinois, Coll Pharm, Dept Pharm Syst Outcomes & Policy, Chicago, IL USA. [Lee, Todd A.; Touchette, Daniel R.; DiDomenico, Robert J.; Walton, Surrey M.] Univ Illinois, Ctr Pharmacoepidemiol & Pharmacoecon Res, Chicago, IL USA. [DiDomenico, Robert J.] Univ Illinois, Coll Pharm, Dept Pharm Practice, Chicago, IL USA. [Ardati, Amer K.] Univ Illinois, Coll Med, Div Cardiol, Chicago, IL USA. C3 Utah System of Higher Education; University of Utah; Utah System of Higher Education; University of Utah; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital RP Walton, SM (通讯作者),833 S Wood St,MC 871, Chicago, IL 60612 USA. EM walton@uic.edu RI DiDomenico, Robert J./AAU-2128-2021; DiDomenico, Robert J./AFV-5274-2022 OI DiDomenico, Robert J./0000-0002-9374-8012; DiDomenico, Robert J./0000-0002-9374-8012; KIM, KIBUM/0000-0002-8676-7434 FU Cardinal Health; Sunovion Pharmaceuticals; Takeda; Pfizer; Bristol-Myers Squibb; Baxter; Merck; Genentech; Primus; Abbott FX No funding was received for this study. DiDomenico has received an honorarium from Amgen for preparation of a heart failure drug monograph for Pharmacy Practice News and serves as an advisory board member for a heart failure program at Otsuka America Pharmaceuticals and for Novartis Pharmaceuticals. Touchette has received unrestricted grant funding from Cardinal Health, Sunovion Pharmaceuticals, and Takeda and has served as a consultant to and director of the American College of Clinical Pharmacy Practice-Based Research Network on a study funded by Pfizer. Walton has served as a paid consultant for Bristol-Myers Squibb, Baxter, Merck, Genentech, Primus, Takeda, and Abbott. The other authors have nothing to disclose. 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PD AUG PY 2018 VL 24 IS 8 BP 800 EP 812 DI 10.18553/jmcp.2018.24.8.800 PG 13 WC Health Care Sciences & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Pharmacology & Pharmacy GA GO6EY UT WOS:000440131000008 PM 30058986 OA Bronze DA 2023-05-13 ER PT J AU Zanchin, T Temperli, F Karagiannis, A Zanchin, C Rasanen, M Koskinas, KC Stortecky, S Hunziker, L Praz, F Blochlinger, S Moro, C Moschovitis, A Seiler, C Billinger, M Heg, D Pilgrim, T Valgimigli, M Windecker, S Raber, L AF Zanchin, Thomas Temperli, Fabrice Karagiannis, Alexios Zanchin, Christian Rasanen, Markus Koskinas, Konstantinos C. Stortecky, Stefan Hunziker, Lukas Praz, Fabien Blochlinger, Stefan Moro, Christina Moschovitis, Ails Seiler, Christian Billinger, Michael Heg, Dik Pilgrim, Thomas Valgimigli, Marco Windecker, Stephan Raber, Lorenz TI Frequency, Reasons, and Impact of Premature Ticagrelor Discontinuation in Patients Undergoing Coronary Revascularization in Routine Clinical Practice Results From the Bern Percutaneous Coronary Intervention Registry SO CIRCULATION-CARDIOVASCULAR INTERVENTIONS LA English DT Article DE clopidogrel; dyspnea; percutaneous coronary intervention; tertiary care centers; ticagrelor ID ANTIPLATELET TREATMENT; CLOPIDOGREL; THERAPY; ADHERENCE; TOLERABILITY; PREDICTORS; ANTAGONIST; PRASUGREL; INSIGHTS; ASPIRIN AB Background-Although ticagrelor has improved clinical outcomes among patients with acute coronary syndrome compared with clopidogrel, adherence to this new antiplatelet agent in real-world practice has not been fully investigated. Methods and Results-Between November 2011 and June 2014, 1278 of 4831 consecutive patients (26.5%) undergoing percutaneous coronary intervention at a tertiary care center were treated with ticagrelor. Premature ticagrelor cessation was categorized into (1) change, when ticagrelor was replaced by prasugrel; (2) de-escalation, when ticagrelor was replaced by clopidogrel; and (3) premature discontinuation, when ticagrelor was discontinued without P2Y12 inhibitor replacement. Of 1278 patients treated with ticagrelor, premature treatment cessation occurred in 212 patients (17%). De-escalation to clopidogrel was the most frequent scenario (57%; n=120), followed by premature discontinuation (28%; n=60) and change to prasugrel (15%; n=32). Reasons for ticagrelor cessation included adverse effects (49%), initiation of oral anticoagulation (19%), and unspecified general practitioner preference (10%). Most frequent adverse effects leading to premature ticagrelor cessation were bleeding (41%), dyspnea (29%), and gastrointestinal symptoms (18%). Premature ticagrelor cessation was not associated with an increased risk of cardiac death, myocardial infarction, or stroke (hazard ratio, 0.73; 95% confidence interval: 0.40-1.32; P=0.29). Conclusions-Premature ticagrelor cessation in routine clinical practice occurred in 1 of 6 patients and was primarily related to adverse effects among which bleeding and dyspnea were the most frequent. Although premature ticagrelor cessation was not associated with adverse cardiovascular outcomes, this finding requires careful interpretation in view of the modest sample size. C1 [Zanchin, Thomas; Temperli, Fabrice; Zanchin, Christian; Rasanen, Markus; Koskinas, Konstantinos C.; Stortecky, Stefan; Hunziker, Lukas; Praz, Fabien; Blochlinger, Stefan; Moro, Christina; Moschovitis, Ails; Seiler, Christian; Billinger, Michael; Heg, Dik; Pilgrim, Thomas; Valgimigli, Marco; Windecker, Stephan; Raber, Lorenz] Bern Univ Hosp, Dept Cardiol, CH-3010 Bern, Switzerland. [Karagiannis, Alexios] Univ Bern, CTU Bern, Bern, Switzerland. [Karagiannis, Alexios] Univ Bern, Inst Social & Prevent Med, Bern, Switzerland. C3 University of Bern; University Hospital of Bern; University of Bern; University of Bern RP Raber, L (通讯作者),Bern Univ Hosp, Dept Cardiol, CH-3010 Bern, Switzerland. EM lorenz.raeber@insel.ch RI Valgimigli, Marco/AAE-9103-2019; Pilgrim, Thomas/AAS-9120-2021; Stortecky, Stefan/AAS-9140-2021 OI Valgimigli, Marco/0000-0002-4353-7110; Pilgrim, Thomas/0000-0001-8721-4068; Markus, Rasanen/0000-0003-4048-4591; Hunziker, Lukas/0000-0003-0081-8518; Praz, Fabien/0000-0001-5416-165X; Stortecky, Stefan/0000-0002-5076-0177; Heg, Dik/0000-0002-8766-7945 FU Bern University Hospital, Switzerland; Swiss National Science Foundation [323530_171146] FX This study was funded by intramural grants of Bern University Hospital, Switzerland. Dr Zanchin is funded by an MD-PhD Grant from the Swiss National Science Foundation (grant no. 323530_171146). CR Angiolillo DJ, 2017, CIRCULATION, V136, P1955, DOI 10.1161/CIRCULATIONAHA.117.031164 Angiolillo DJ, 2014, J AM COLL CARDIOL, V63, P1500, DOI 10.1016/j.jacc.2013.11.032 Ariotti S, 2017, CURR CARDIOL REP, V19, DOI 10.1007/s11886-017-0810-9 Becker RC, 2011, EUR HEART J, V32, P2933, DOI 10.1093/eurheartj/ehr422 Boggon R, 2011, EUR HEART J, V32, P2376, DOI 10.1093/eurheartj/ehr340 Bonaca MP, 2016, JAMA CARDIOL, V1, P425, DOI 10.1001/jamacardio.2016.1017 Bonaca MP, 2015, NEW ENGL J MED, V372, P1791, DOI 10.1056/NEJMoa1500857 Cannon CP, 2007, J AM COLL CARDIOL, V50, P1844, DOI 10.1016/j.jacc.2007.07.053 Chowdhury R, 2013, EUR HEART J, V34, P2940, DOI 10.1093/eurheartj/eht295 Cuisset T, 2017, EUR HEART J, V38, P3070, DOI 10.1093/eurheartj/ehx175 Cutlip DE, 2015, JACC-CARDIOVASC INTE, V8, P404, DOI 10.1016/j.jcin.2014.10.017 De Luca L, 2017, EUROINTERVENTION, V13, P459, DOI 10.4244/EIJ-D-17-00092 Ferreira-Gonzalez I, 2010, CIRCULATION, V122, P1017, DOI 10.1161/CIRCULATIONAHA.110.938290 Fosbol EL, 2016, CIRC-CARDIOVASC INTE, V9, DOI 10.1161/CIRCINTERVENTIONS.115.003602 Franchi F, 2016, JACC-CARDIOVASC INTE, V9, P1089, DOI 10.1016/j.jcin.2016.02.039 Gencer B, 2015, EUR J INTERN MED, V26, P56, DOI 10.1016/j.ejim.2014.12.014 Granger CB, 2016, JAMA CARDIOL, V1, P381, DOI 10.1001/jamacardio.2016.1018 Hiatt WR, 2017, NEW ENGL J MED, V376, P32, DOI 10.1056/NEJMoa1611688 Husted S, 2006, EUR HEART J, V27, P1038, DOI 10.1093/eurheartj/ehi754 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Johnston SC, 2016, NEW ENGL J MED, V375, P35, DOI 10.1056/NEJMoa1603060 Mehran R, 2013, LANCET, V382, P1714, DOI 10.1016/S0140-6736(13)61720-1 Pourdjabbar A, 2017, THROMB HAEMOSTASIS, V117, P303, DOI 10.1160/TH16-04-0340 Rasmussen JN, 2007, JAMA-J AM MED ASSOC, V297, P177, DOI 10.1001/jama.297.2.177 Shore S, 2014, AM HEART J, V167, P810, DOI 10.1016/j.ahj.2014.03.023 Sibbing D, 2017, LANCET, V390, P1747, DOI 10.1016/S0140-6736(17)32155-4 Spitzer E, 2016, EUROINTERVENTION, V12, P1135, DOI 10.4244/EIJV12I9A185 Storey RF, 2011, EUR HEART J, V32, P2945, DOI 10.1093/eurheartj/ehr231 Storey RF, 2010, J AM COLL CARDIOL, V56, P185, DOI 10.1016/j.jacc.2010.01.062 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Windecker S, 2014, EUR HEART J, V35, P2541, DOI [10.5603/KP.2014.0224, 10.1093/eurheartj/ehu278, 10.1093/ejcts/ezu366] Zanchin T, 2016, CIRC-CARDIOVASC INTE, V9, DOI 10.1161/CIRCINTERVENTIONS.115.003202 NR 32 TC 33 Z9 34 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1941-7640 EI 1941-7632 J9 CIRC-CARDIOVASC INTE JI Circ.-Cardiovasc. Interv. PD MAY PY 2018 VL 11 IS 5 AR e006132 DI 10.1161/CIRCINTERVENTIONS.117.006132 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GJ7KY UT WOS:000435567100002 PM 29748219 OA Bronze DA 2023-05-13 ER PT J AU McKinney, J Pitcher, I Fordyce, CB Yousefi, M Yeo, TJ Ignaszewski, A Isserow, S Chan, S Ramanathan, K Taylor, CM AF McKinney, James Pitcher, Ian Fordyce, Christopher B. Yousefi, Masoud Yeo, Tee Joo Ignaszewski, Andrew Isserow, Saul Chan, Sammy Ramanathan, Krishnan Taylor, Carolyn M. TI Prevalence and Associated Clinical Characteristics of Exercise-Induced ST-Segment Elevation in Lead aVR SO PLOS ONE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; SIGNIFICANT LEFT MAIN; HEART-ASSOCIATION; PRACTICE GUIDELINES; AMERICAN-COLLEGE; ARTERY STENOSIS; TASK-FORCE; DISEASE; ELECTROCARDIOGRAPHY AB Background Exercise-induced ST-segment elevation (STE) in lead aVR may be an important indicator of prognostically important coronary artery disease (CAD). However, the prevalence and associated clinical features of exercise-induced STE in lead aVR among consecutive patients referred for exercise stress electrocardiography (ExECG) is unknown. Methods All consecutive patients receiving a Bruce protocol ExECG for the diagnosis of CAD at a tertiary care academic center were included over a two-year period. Clinical characteristics, including results of coronary angiography, were compared between patients with and without exercise-induced STE in lead aVR. Results Among 2227 patients undergoing ExECG, exercise-induced STE >= 1.0mm in lead aVR occurred in 3.4% of patients. Patients with STE in lead aVR had significantly lower Duke Treadmill Scores (DTS) (-0.5 vs. 7.0, p<0.01) and a higher frequency of positive test results (60.2% vs. 7.3%, p<0.01). Furthermore, patients with STE in lead aVR were more likely to undergo subsequent cardiac catheterization than those without STE in lead aVR (p<0.01, odds ratio = 4.2). Conclusions Among patients referred for ExECG for suspected CAD, exercise-induced STE in lead aVR was associated with a higher risk DTS, an increased likelihood of a positive ExECG, and referral for subsequent coronary angiography. These results suggest that exercise-induced STE in lead aVR may represent a useful ECG feature among patients undergoing ExECG in the risk stratification of patients. C1 [McKinney, James; Pitcher, Ian; Fordyce, Christopher B.; Ignaszewski, Andrew; Isserow, Saul; Chan, Sammy; Ramanathan, Krishnan; Taylor, Carolyn M.] Univ British Columbia, Vancouver, BC, Canada. [Fordyce, Christopher B.] Duke Clin Res Inst, Durham, NC USA. [Yousefi, Masoud] Vancouver Coastal Hlth Res Inst, Clin Res Unit, Vancouver, BC, Canada. [Yeo, Tee Joo] Natl Univ Heart Ctr, Singapore, Singapore. [Ignaszewski, Andrew; Chan, Sammy; Ramanathan, Krishnan; Taylor, Carolyn M.] St Pauls Hosp, Div Cardiol, Vancouver, BC, Canada. C3 University of British Columbia; Duke University; Vancouver Coastal Health Research Institute; National University of Singapore; St. Paul's Hospital RP McKinney, J (通讯作者),Univ British Columbia, Vancouver, BC, Canada. EM jmckinney@sportscardiologybc.org RI Stefanadis, Christodoulos/ABH-2232-2020 OI Stefanadis, Christodoulos/0000-0001-5974-6454; Taylor, Carolyn/0000-0002-3540-1491; Yeo, Tee Joo/0000-0002-2462-6257; Mckinney, James/0000-0003-1093-1792 FU Providence Health Boehlringer Ingelheim Physicians Scholar; University of British Columbia Cardiology Academic Practice Plan Clinical Investigator Award FX Dr. Carolyn M. Taylor received funding as a Providence Health Boehlringer Ingelheim Physicians Scholar and University of British Columbia Cardiology Academic Practice Plan Clinical Investigator Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. CR Barrabes JA, 2003, CIRCULATION, V108, P814, DOI 10.1161/01.CIR.0000084553.92734.83 Bourque JM, 2015, JACC-CARDIOVASC IMAG, V8, P1309, DOI 10.1016/j.jcmg.2015.09.006 CHAHINE RA, 1976, CIRCULATION, V54, P209, DOI 10.1161/01.CIR.54.2.209 Douglas PS, 2015, NEW ENGL J MED, V372, P1291, DOI 10.1056/NEJMoa1415516 Engelen DJ, 1999, J AM COLL CARDIOL, V34, P389, DOI 10.1016/S0735-1097(99)00197-7 Fihn SD, 2012, J AM COLL CARDIOL, V60, P2564, DOI 10.1016/j.jacc.2012.07.012 Fletcher GF, 2013, CIRCULATION, V128, P873, DOI 10.1161/CIR.0b013e31829b5b44 Gaitonde RS, 2003, AM J CARDIOL, V92, P846, DOI 10.1016/S0002-9149(03)00898-1 Gibbons RJ, 2002, CIRCULATION, V106, P1883, DOI 10.1161/01.CIR.0000034670.06526.15 GORGELS APM, 1993, AM J CARDIOL, V72, P999, DOI 10.1016/0002-9149(93)90852-4 Hirano T, 2006, CIRC J, V70, P525, DOI 10.1253/circj.70.525 Kammerlander M, 2014, PIXELRULER Katircibasi MT, 2008, INT J CARDIOL, V128, P240, DOI 10.1016/j.ijcard.2007.05.022 Kosuge M, 2006, AM J CARDIOL, V97, P334, DOI 10.1016/j.amjcard.2005.08.049 Kosuge M, 2005, AM J CARDIOL, V95, P1366, DOI 10.1016/j.amjcard.2005.01.085 Levine GN, 2011, J AM COLL CARDIOL, V58, pE44, DOI 10.1016/j.jacc.2011.08.007 MARK DB, 1987, ANN INTERN MED, V106, P793, DOI 10.7326/0003-4819-106-6-793 Michaelides AP, 1999, INT J CARDIOL, V71, P49, DOI 10.1016/S0167-5273(99)00115-1 Montalescot G, 2013, EUR HEART J, V34, P2949, DOI 10.1093/eurheartj/eht296 MUSE, 2009, CARD INF SYST Neill J, 2007, EUR J NUCL MED MOL I, V34, P338, DOI 10.1007/s00259-006-0188-1 Ozmen N, 2010, KARDIOL POL, V68, P1107 Taglieri N, 2011, AM J CARDIOL, V108, P21, DOI 10.1016/j.amjcard.2011.02.341 Uthamalingam S, 2011, JACC-CARDIOVASC IMAG, V4, P176, DOI 10.1016/j.jcmg.2010.11.014 Wong CK, 2010, EUR HEART J, V31, P1845, DOI 10.1093/eurheartj/ehq161 Yamaji H, 2001, J AM COLL CARDIOL, V38, P1348, DOI 10.1016/S0735-1097(01)01563-7 Yan AT, 2007, AM HEART J, V154, P71, DOI 10.1016/j.ahj.2007.03.037 NR 27 TC 2 Z9 2 U1 0 U2 3 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD JUL 28 PY 2016 VL 11 IS 7 AR e0160185 DI 10.1371/journal.pone.0160185 PG 8 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA DT5IL UT WOS:000381516100127 PM 27467388 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Auscher, S Logstrup, BB Moller, JE Vinther, KH Lambrechtsen, J Egstrup, K AF Auscher, Soren Logstrup, Brian Bridal Moller, Jacob Eifer Vinther, Kristina Hoeg Lambrechtsen, Jess Egstrup, Kenneth TI Effects of Intensive Statin Therapy on Left Ventricular Function in Patients with Myocardial Infarction and Abnormal Glucose Tolerance SO CARDIOLOGY LA English DT Article DE Acute myocardial infarction; Abnormal glucose tolerance; Intensive statin therapy; Left ventricular function ID ACUTE CORONARY SYNDROMES; SPECKLE-TRACKING ECHOCARDIOGRAPHY; ATORVASTATIN PRETREATMENT; STRESS HYPERGLYCEMIA; RANDOMIZED-TRIAL; INTERVENTION; METABOLISM; STRAIN; HEART; CARDIOLOGY AB Objectives: Abnormal glucose tolerance in patients with acute myocardial infarction (AMI) is associated with greater mortality and adverse cardiovascular effects. As statins possess a range of beneficial pleiotropic effects on the cardiovascular system, we sought to assess the cardioprotective effects of statins on left ventricular function in patients with AMI in relation to glycometabolic state. Methods: In a prospective, randomized trial, 140 patients with AMI were randomized to intensive statin therapy receiving statin loading with 80 mg of rosuvastatin followed by 40 mg daily or standard statin therapy. Patients were assessed with an oral glucose tolerance test and their left ventricular (LV) function was assessed with speckle-tracking echocardiography measuring regional longitudinal systolic strain (RLSS) in the infarct area. Results: Overall RLSS in the infarct area improved by a mean (+/- SD) of -4.22% (+/- 5.19) in the intensive-care group and -2.48% (+/- 4.01) in the usual-care group after 1 month (p = 0.047). In patients with abnormal glucose tolerance, RLSS improved by -5.01% (+/- 5.28) in the intensive-care group and -2.15% (+/- 4.22) in the usual-care group (p = 0.01). Conclusions: Early high-dose statin treatment improved RLSS in the infarct area in patients with AMI, and a trend of greater improvement was seen in patients with abnormal glucose tolerance. (C) 2017 S. Karger AG, Basel C1 [Auscher, Soren; Vinther, Kristina Hoeg; Lambrechtsen, Jess; Egstrup, Kenneth] Svendborg Hosp, OUH, Dept Med Res, Svendborg, Denmark. [Logstrup, Brian Bridal] Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark. [Moller, Jacob Eifer] Odense Univ Hosp, Dept Cardiol, Odense, Denmark. C3 University of Southern Denmark; Odense University Hospital; Aarhus University; University of Southern Denmark; Odense University Hospital RP Auscher, S (通讯作者),Dept Med Res, Valdemarsgade 53, DK-5700 Svendborg, Denmark. EM sorenauscher@sol.dk RI Lambrechtsen, Jess/M-3822-2014 OI Lambrechtsen, Jess/0000-0002-9976-9981; Moller, Jacob Eifer/0000-0003-2873-5845 CR Akira M, 2006, CIRC J, V70, P1643 Amundsen BH, 2006, J AM COLL CARDIOL, V47, P789, DOI 10.1016/j.jacc.2005.10.040 Antoni ML, 2010, EUR HEART J, V31, P1640, DOI 10.1093/eurheartj/ehq105 Bartnik M, 2007, J INTERN MED, V262, P145, DOI 10.1111/j.1365-2796.2007.01831.x Bartnik M, 2004, EUR HEART J, V25, P1990, DOI 10.1016/j.ehj.2004.09.021 Bassand JP, 2007, EUR HEART J, V28, P1598, DOI 10.1093/eurheartj/ehm161 Briel M, 2006, JAMA-J AM MED ASSOC, V295, P2046, DOI 10.1001/jama.295.17.2046 Capes SE, 2000, LANCET, V355, P773, DOI 10.1016/S0140-6736(99)08415-9 Cerqueira MD, 2002, CIRCULATION, V105, P539, DOI 10.1161/hc0402.102975 Collins R, 2002, LANCET, V360, P7, DOI 10.1016/S0140-6736(02)09327-3 DSC, NAT REC TREATM PAT A Esposito K, 2002, CIRCULATION, V106, P2067, DOI 10.1161/01.CIR.0000034509.14906.AE Fan Y, 2012, CLIN EXP PHARMACOL P, V39, P938, DOI 10.1111/1440-1681.12014 Gjesdal O, 2008, CIRC-CARDIOVASC IMAG, V1, P189, DOI 10.1161/CIRCIMAGING.108.784900 Hahn JY, 2011, AM HEART J, V162, P1026, DOI 10.1016/j.ahj.2011.08.011 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hofsten DE, 2009, JACC-CARDIOVASC IMAG, V2, P592, DOI 10.1016/j.jcmg.2009.03.007 Ishihara M, 2003, AM HEART J, V146, P674, DOI 10.1016/S0002-8703(03)00167-4 Jessani SS, 2009, ANN MED, V41, P608, DOI 10.1080/07853890903159256 Leone AM, 2008, INT J CARDIOL, V130, P457, DOI 10.1016/j.ijcard.2008.05.036 Logstrup BB, 2009, JACC-CARDIOVASC IMAG, V2, P1159, DOI 10.1016/j.jcmg.2009.06.012 Ludman A, 2009, PHARMACOL THERAPEUT, V122, P30, DOI 10.1016/j.pharmthera.2009.01.002 Norhammar A, 2002, LANCET, V359, P2140, DOI 10.1016/S0140-6736(02)09089-X Patti G, 2007, J AM COLL CARDIOL, V49, P1272, DOI 10.1016/j.jacc.2007.02.025 Pedersen TR, 2004, ATHEROSCLEROSIS SUPP, V5, P81, DOI 10.1016/j.atherosclerosissup.2004.08.027 Post S, 2012, CATHETER CARDIO INTE, V80, P756, DOI 10.1002/ccd.23449 Ray KK, 2005, AM J CARDIOL, V96, p54F, DOI 10.1016/j.amjcard.2005.06.027 Sanada S, 2004, CIRCULATION, V110, P2143, DOI 10.1161/01.CIR.0000143830.59419.73 Scirica BM, 2006, J AM COLL CARDIOL, V47, P2326, DOI 10.1016/j.jacc.2006.03.034 Sjoli B, 2009, JACC-CARDIOVASC IMAG, V2, P24, DOI 10.1016/j.jcmg.2008.10.007 Thygesen K, 2007, EUR HEART J, V28, P2525 Wang ZZ, 2013, J CARDIOVASC PHARM T, V18, P327, DOI 10.1177/1074248412474346 Webster KA, 2008, CURR HYPERTENS REP, V10, P78, DOI 10.1007/s11906-008-0015-0 WHO IDF., 2006, REPORT WHOIDF CONSUL NR 34 TC 2 Z9 2 U1 0 U2 2 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0008-6312 EI 1421-9751 J9 CARDIOLOGY JI Cardiology PD AUG PY 2017 VL 138 IS 1 BP 16 EP 25 DI 10.1159/000469657 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FD6XU UT WOS:000407672000005 PM 28514784 DA 2023-05-13 ER PT J AU Ukawa, N Ikai, H Imanaka, Y AF Ukawa, Naoto Ikai, Hiroshi Imanaka, Yuichi TI Trends in hospital performance in acute myocardial infarction care: a retrospective longitudinal study in Japan SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE quality indicators; public disclosure; multilevel model; quality improvement ID QUALITY-OF-CARE; ACUTE CORONARY SYNDROMES; MORTALITY-RATES; CASE VOLUME; OUTCOMES AB To elucidate the hospital characteristics associated with hospital performance and time trends in acute myocardial infarction (AMI) care using multilevel multivariable analysis of longitudinal data. Retrospective longitudinal study. One hundred and fourteen hospitals in Japan. A total of 26 210 AMI patients admitted between 2008 and 2011. A composite score was calculated from five AMI process measures. Hospital performances and time trends were then investigated based on this composite score. Using generalized linear mixed models with random intercepts (indicating hospital baseline performance) and random slopes (indicating trends in improvement), we analyzed the associations between performance and the following factors: hospital ownership, AMI case volume, number of cardiovascular specialists per AMI patient and participation in a public disclosure program. Hospitals that demonstrated high performance in the composite score were significantly associated with high AMI case volume, municipal ownership and agreement to named disclosure of hospital performance. The following factors were significantly associated with time trends of improvement in performance: public and private ownership, AMI case volume and number of cardiovascular specialists per AMI patient. In addition, higher performances were associated with diminished improvement. Time trends in improvement were related to baseline performance and several hospital characteristics. Furthermore, hospitals that had agreed to named disclosure of performance were more likely to have better quality of care at the initial point of public disclosure. These findings can inform the decision-making process for quality improvement, and allow a greater understanding and interpretation of disclosed performances in quality measures. C1 [Ukawa, Naoto; Ikai, Hiroshi; Imanaka, Yuichi] Kyoto Univ, Grad Sch Med, Dept Healthcare Econ & Qual Management, Kyoto 6068501, Japan. C3 Kyoto University RP Imanaka, Y (通讯作者),Kyoto Univ, Sch Publ Hlth, Grad Sch Med, Dept Healthcare Econ & Qual Management,Sakyo Ku, Yoshida Konoe Cho, Kyoto 6068501, Japan. EM imanaka-y@umin.net RI Yuichi, Imanaka/GYR-2098-2022 OI Yuichi, Imanaka/0000-0003-4613-2159 FU Ministry of Health, Labour and Welfare of Japan, and a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science; Grants-in-Aid for Scientific Research [25253033] Funding Source: KAKEN FX This study was supported in part by a Health Sciences Research Grant from the Ministry of Health, Labour and Welfare of Japan, and a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science. The sponsors had no role in design or conduct of the study; collection, management, analysis or interpretation of the data; or preparation, review or approval of the manuscript. 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J. Qual. Health Care PD OCT PY 2014 VL 26 IS 5 BP 516 EP 523 DI 10.1093/intqhc/mzu073 PG 8 WC Health Care Sciences & Services; Health Policy & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA AS3KA UT WOS:000344175000003 PM 25107593 OA Bronze DA 2023-05-13 ER PT J AU Li, ZX Miao, H Zhang, SY Fan, JY Yan, Y Gong, W Zheng, W Wang, X Que, B Ai, H Zhang, LX Nie, SP AF Li, Zexuan Miao, Hua Zhang, Siyu Fan, Jingyao Yan, Yan Gong, Wei Zheng, Wen Wang, Xiao Que, Bin Ai, Hui Zhang, Lixin Nie, Shaoping TI The value of nurse-led anthropometric and oropharyngeal measurements combined with STOP-Bang questionnaire in screening for obstructive sleep apnea in patients with acute coronary syndrome: a prospective cohort study SO BMC PULMONARY MEDICINE LA English DT Article DE Anthropometric measurements; Oropharyngeal; STOP-Bang questionnaire; Obstructive sleep apnea; Acute coronary syndrome ID SCALE; RISK AB Background Obstructive sleep apnea (OSA) is a modifiable risk factor for acute coronary syndrome (ACS), with high prevalence but low diagnostic rates. Therefore, it is particularly important to develop strategies for better screening for OSA in newly admitted ACS patients. Methods From March 2017 to October 2019, consecutive eligible patients with ACS underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea-hypopnea index (AHI) >= 15 events/h. All anthropometric and oropharyngeal parameters are measured by specialist nurses. Results Finally, 761 ACS patients were recruited in the present study. Prevalence of moderate/severe OSA was 53.2% based on diagnostic criteria of AHI >= 15. Correlation analysis illustrated that AHI was positively correlated with anthropometric characteristics. In the multivariate model, only micrognathia (OR 2.02, 95% CI 1.02-4.00, P = 0.044), waist circumference (OR 1.08, 95% CI 1.04-1.11, P < 0.001), and STOP-BANG Questionnaire (SBQ) score (OR 1.45, 95% CI 1.27-1.66, P < 0.001) were independently associated with the prevalence of OSA. Receiver operating characteristic curve (ROC) analysis showed that the area under curve (AUC) of multivariable joint diagnosis (waist circumference, micrognathia combined with SBQ) was significantly better than the AUC of Epworth Sleepiness Scale (ESS) and SBQ (p < 0.0001 and p = 0.0002, respectively), and the results showed that AUC was 0.728. Under the optimal truncation value, the sensitivity was 73%, and the specificity was 61%, which was higher than the single index. Finally, we also constructed a nomogram model based on multiple logistic regression, to easily determine the probability of OSA in ACS patients. Conclusions The new screening tool has greater power than single questionnaire or measurements in screening of OSA among ACS patients. C1 [Li, Zexuan; Miao, Hua; Fan, Jingyao; Yan, Yan; Gong, Wei; Zheng, Wen; Wang, Xiao; Que, Bin; Ai, Hui; Zhang, Lixin; Nie, Shaoping] Capital Med Univ, Beijing Anzhen Hosp, Ctr Coronary Artery Dis, Div Cardiol, 2 Anzhen Rd, Beijing 100029, Peoples R China. [Li, Zexuan; Miao, Hua; Fan, Jingyao; Yan, Yan; Gong, Wei; Zheng, Wen; Wang, Xiao; Que, Bin; Ai, Hui; Zhang, Lixin; Nie, Shaoping] Natl Clin Res Ctr Cardiovasc Dis, Beijing, Peoples R China. [Zhang, Siyu] Qingdao Special Servicemen Recuperat Ctr PLA Navy, Qingdao, Shandong, Peoples R China. C3 Capital Medical University RP Zhang, LX; Nie, SP (通讯作者),Capital Med Univ, Beijing Anzhen Hosp, Ctr Coronary Artery Dis, Div Cardiol, 2 Anzhen Rd, Beijing 100029, Peoples R China.; Zhang, LX; Nie, SP (通讯作者),Natl Clin Res Ctr Cardiovasc Dis, Beijing, Peoples R China. EM Lixinzhang513@163.com; spnie@ccmu.edu.cn FU National Key R&D Program of China [2020YFC2004800]; National Natural Science Foundation of China [81870322]; Natural Science Foundation of Beijing, China [7191002, 7222046]; Beijing Nova Program [Z201100006820087] FX This study was supported by grants from National Key R&D Program of China (2020YFC2004800), National Natural Science Foundation of China (81870322), the Natural Science Foundation of Beijing, China (7191002, 7222046), Beijing Nova Program (Z201100006820087). 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PD NOV 3 PY 2022 VL 22 IS 1 AR 396 DI 10.1186/s12890-022-02200-x PG 11 WC Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC Respiratory System GA 5X5PE UT WOS:000878650800002 PM 36329414 OA Green Submitted, Green Published, gold DA 2023-05-13 ER PT J AU Lin, YJ Cheng, MC Lo, MH Chien, SJ AF Lin, Ying-Jui Cheng, Ming-Chou Lo, Mao-Hung Chien, Shao-Ju TI Early Differentiation of Kawasaki Disease Shock Syndrome and Toxic Shock Syndrome in a Pediatric Intensive Care Unit SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE Kawasaki disease shock syndrome; toxic shock syndrome; echocardiography; anemia; thrombocytosis ID LYMPH-NODE SYNDROME; TRICUSPID REGURGITATION; EPIDEMIOLOGIC FEATURES; RISK-FACTORS; ACUTE-PHASE; CHILDREN; DYSFUNCTION; DIAGNOSIS; ETIOLOGY; ADULTS AB Background: Kawasaki disease shock syndrome (KDSS) and toxic shock syndrome (TSS) can present as shock and fever with skin rash, but the management of these 2 groups of patients is different. This report proposes to help clinicians earlier distinguish these 2 diseases and expedite institution of appropriate therapy. Methods: We retrospectively reviewed the medical records of patients admitted to the pediatric intensive care unit with the diagnosis of KDSS or TSS from January 2000 through December 2010. Clinical, laboratory and echocardiographic data were collected for analysis of differences between them. Results: Seventeen patients met the inclusion criteria of KDSS and 16 had a confirmed diagnosis of TSS. The mean age of the KDSS group was significantly younger than that of the TSS group (36.841.1 vs. 113.3 +/- 55.6 months, P < 0.001). Significantly lower hemoglobulin and age-adjusted hemoglobulin concentrations were noted in the KDSS group [Hb, age-adjusted Z score, -1.88 (range, -3.9 to 3.9) vs. 0.89 (range, -6.4 to 10.8), P = 0.006]. The median platelet count of the KDSS group was nearly twice that of the TSS group [312x10(3) per L (range, 116-518) vs. 184.5x10(3) per L (range: 31-629), P = 0.021]. Echocardiographic abnormalities, such as valvulitis (mitral or tricuspid regurgitation) and coronary artery lesions, were significantly more common in the KDSS group (P = 0.022). Conclusions: Echocardiography, anemia and thrombocytosis are useful early differentiating features between KDSS and TSS patients. C1 Kaohsiung Chang Gung Mem Hosp, Dept Pediat, Kaohsiung, Taiwan. Chang Gung Univ, Coll Med, Kaohsiung, Taiwan. C3 Chang Gung Memorial Hospital; Chang Gung University RP Chien, SJ (通讯作者),Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Pediat, 123 Ta Pei Rd, Kaohsiung, Taiwan. EM ma4695@gmail.com; csjdc@cgmh.org.tw FU Kaohsiung Chang Gung Memorial Hospital, Taiwan [CMRPG8C0941, CMRPG8C0942] FX This study was supported in part by grants CMRPG8C0941 and CMRPG8C0942 from the Kaohsiung Chang Gung Memorial Hospital, Taiwan. The institutes had no influence on the collection, analysis and interpretation of the data or on the preparation of the manuscript. 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PD NOV PY 2015 VL 34 IS 11 BP 1163 EP 1167 DI 10.1097/INF.0000000000000852 PG 5 WC Immunology; Infectious Diseases; Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Immunology; Infectious Diseases; Pediatrics GA CU4WF UT WOS:000363530500004 PM 26222065 DA 2023-05-13 ER PT J AU Bobescu, E Covaciu, A Rus, H Rogozea, LM Badea, M Marceanu, LG AF Bobescu, Elena Covaciu, Alexandru Rus, Horatiu Rogozea, Liliana Marcela Badea, Mihaela Marceanu, Luigi Geo TI Low Response to Clopidogrel in Coronary Artery Disease SO AMERICAN JOURNAL OF THERAPEUTICS LA English DT Article DE coronary artery disease; low response to clopidogrel; low response to aspirin; risk factors; oxidative stress; endothelial dysfunction; hypercoagulability ID TREATMENT PLATELET REACTIVITY; OXIDATIVE STRESS BIOMARKERS; OF-CARE ANALYSIS; STENT THROMBOSIS; CARDIOVASCULAR EVENTS; CLINICAL-OUTCOMES; HEART-DISEASE; AGGREGATION; ATHEROSCLEROSIS; HYPERACTIVITY AB Background: In patients with coronary artery disease, cardiovascular mortality and other acute events showed a clear correlation with risk factors and biomarkers including platelet activation. Study Question of This Research: Which was the incidence of low response to clopidogrel and its correlation with risk factors and biomarkers in coronary artery disease? Study Design: Four hundred patients (pts) with coronary artery disease-stable angina (SA) and acute coronary syndrome-were divided into 8 groups of study, consistent with low response to clopidogrel and the type of coronary artery disease. Low response to clopidogrel-defined as adenosine diphosphate test-ADP-test of >46 U by multiple electrode platelet aggregometry was evaluated in correlation with cardiovascular risk factors and biomarkers of oxidative stress, endothelial dysfunction, hypercoagulability, high platelet reactivity. Results: In coronary artery disease, low response to clopidogrel significantly correlated with older than 65 years, smoking, hypertension, diabetes mellitus, body mass index of >25, previous aspirin treatment (P < 0.05), high value of total and low-density lipoprotein cholesterol, low value of high-density lipoprotein cholesterol, low response to aspirin, high mean platelets volume and von Willebrand factor activity, low flow-mediated vasodilatation, total antioxidant status (P < 0.01) and only in patients with SA of male gender (P < 0.01). The incidence of other hypercoagulability biomarkers, such as reduced values of S protein, C protein, antithrombin III, and V Factor Leiden resistance to activated protein C, was very low and not correlated with low response to clopidogrel. Conclusions: In coronary artery disease, low response to clopidogrel significantly correlated with the most of old cardiovascular risk factors, with previous aspirin treatment, low response to aspirin, higher mean platelets volume, higher von Willebrand factor activity, lower flow-mediated vasodilatation, and lower total antioxidant status values and only in patients with SA of male gender. C1 [Bobescu, Elena; Covaciu, Alexandru; Rus, Horatiu; Marceanu, Luigi Geo] Transilvania Univ Brasov, Dept Med & Surg Specialties, Fac Med, Brasov, Romania. [Bobescu, Elena; Rus, Horatiu] Clin Cty Emergency Hosp Brasov, Dept Cardiol, Brasov, Romania. [Covaciu, Alexandru] Clin Cty Emergency Hosp Oradea, Dept Cardiol, Oradea, Romania. [Rogozea, Liliana Marcela; Badea, Mihaela] Transilvania Univ Brasov, Dept Fundamental Prophylact & Clin Disciplines, Fac Med, Brasov, Romania. C3 Transylvania University of Brasov; Transylvania University of Brasov RP Covaciu, A (通讯作者),Transilvania Univ Brasov, Fac Med, Str Nicolae Balcescu 56, Brasov 500019, Romania. EM alexandru.covaciu92@gmail.com RI Bobescu, Elena/ABD-6951-2020; MARCEANU, LUIGI GEO/AAA-6977-2019; Rus, Horatiu/AAO-5706-2021; Bobescu, Elena/AAC-6840-2021; Badea, Mihaela/Z-1490-2018 OI Bobescu, Elena/0000-0002-0945-9067; MARCEANU, LUIGI GEO/0000-0003-3988-1266; Bobescu, Elena/0000-0002-0945-9067; Badea, Mihaela/0000-0003-4824-2175 CR Alegria-Barrero E, 2010, E J ESC COUNC CARDIO, V8 Althoff TF, 2010, THROMB RES, V125, pE190, DOI 10.1016/j.thromres.2010.01.003 Aradi D, 2014, J AM COLL CARDIOL, V63, P1061, DOI 10.1016/j.jacc.2013.12.023 Aradi D, 2014, EUR HEART J, V35, P209, DOI 10.1093/eurheartj/eht375 Aradi D, 2013, INT J CARDIOL, V167, P2140, DOI 10.1016/j.ijcard.2012.05.100 Bobescu E, 2010, EUR HEART J, V31, P971 Bobescu E, 2010, EUR HEART J SUPPL, V12, pF19 Bobescu E, 2007, STRESUL OXIDATIV SIN, P35 Bobescu E, 2009, MODALITATI TERAPEUTI, P29 Bobescu E, 2008, REV ROMANA MED LAB, V11, P29 Bobescu E, 2019, AM J THER, V26, pE563, DOI 10.1097/MJT.0000000000000869 Bobescu E, 2016, INT C INTERD MANAG D, P109 Bobescu E, 2008, REV ROMANA MED LAB, V13, P7 Bonello L, 2010, J AM COLL CARDIOL, V56, P919, DOI 10.1016/j.jacc.2010.04.047 Brar SS, 2011, J AM COLL CARDIOL, V58, P1945, DOI 10.1016/j.jacc.2011.06.059 Charakida M, 2010, EUR HEART J, V31, P2854, DOI 10.1093/eurheartj/ehq340 D'Ascenzo F, 2014, BIOMED RES INT, V2014, DOI 10.1155/2014/610296 Dima L, 2014, REV ROMANA BIOETICA, V12 Eshtehardi P, 2010, AM HEART J, V159, P891, DOI 10.1016/j.ahj.2010.02.025 Freedman JE, 2008, ARTERIOSCL THROM VAS, V28, pS11, DOI 10.1161/ATVBAHA.107.159178 Gori AM, 2016, EUR J INTERN MED, V30, P49, DOI 10.1016/j.ejim.2015.12.003 Gurbel PA, 2007, J AM COLL CARDIOL, V50, P1822, DOI 10.1016/j.jacc.2007.07.051 Hartwig JH, 1999, THROMB HAEMOSTASIS, V82, P392 Hirsh J, 2008, GUIDELINES ANTITHROM, P17 Kirtane AJ, 2012, J AM COLL CARDIOL, V59, pE292, DOI 10.1016/S0735-1097(12)60293-9 Kleiman NS, 2016, J AM COLL CARDIOL, V68, P294, DOI 10.1016/j.jacc.2016.04.055 Kuliczkowski W, 2016, BLOOD COAGUL FIBRIN, V27, P151, DOI 10.1097/MBC.0000000000000396 Lenk E, 2013, J INT FED CLIN CHEM, V24, P1 MARTIN JF, 1991, LANCET, V338, P1409, DOI 10.1016/0140-6736(91)92719-I Marzilli M, 2011, HEART METAB, V50, P3 Marzilli M, 2012, J AM COLL CARDIOL, V60, P951, DOI 10.1016/j.jacc.2012.02.082 Morel O, 2009, ATHEROSCLEROSIS, V204, P636, DOI 10.1016/j.atherosclerosis.2008.10.039 Paniccia R, 2015, VASC HEALTH RISK MAN, V11, P133, DOI 10.2147/VHRM.S44469 Parodi G, 2011, JAMA-J AM MED ASSOC, V306, P1215, DOI 10.1001/jama.2011.1332 Popescu IG, 2018, ROM J MORPHOL EMBRYO, V59, P1001 Purcaru D, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0110139 Ruggeri ZM, 2006, BLOOD, V108, P1903, DOI 10.1182/blood-2006-04-011551 Sibbing D, 2010, J THROMB HAEMOST, V8, P250, DOI 10.1111/j.1538-7836.2009.03709.x Sibbing D, 2010, J AM COLL CARDIOL, V56, P317, DOI 10.1016/j.jacc.2010.03.048 Sibbing D, 2010, THROMB HAEMOSTASIS, V103, P151, DOI 10.1160/TH09-05-0284 Sibbing D, 2009, J AM COLL CARDIOL, V53, P849, DOI 10.1016/j.jacc.2008.11.030 Stewart S, 2017, NAT REV CARDIOL, V14, P654, DOI 10.1038/nrcardio.2017.76 Stone GW, 2013, LANCET, V382, P614, DOI 10.1016/S0140-6736(13)61170-8 Tantry US, 2013, J AM COLL CARDIOL, V62, P2261, DOI 10.1016/j.jacc.2013.07.101 Wang N, 2016, BLOOD, V127, P1949, DOI 10.1182/blood-2016-01-631259 Wurtz M, 2014, PLATELETS, V25, P628, DOI 10.3109/09537104.2013.849804 Yeboah J, 2009, CIRCULATION, V120, P502, DOI 10.1161/CIRCULATIONAHA.109.864801 NR 47 TC 7 Z9 7 U1 0 U2 11 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1075-2765 EI 1536-3686 J9 AM J THER JI Am. 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PD MAR-APR PY 2020 VL 27 IS 2 BP E133 EP E141 DI 10.1097/MJT.0000000000001099 PG 9 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA LA9AP UT WOS:000524232900001 PM 31688068 DA 2023-05-13 ER PT J AU Shoji, S Kohsaka, S Kumamaru, H Nishimura, S Ishii, H Amano, T Fushimi, K Miyata, H Ikari, Y AF Shoji, Satoshi Kohsaka, Shun Kumamaru, Hiraku Nishimura, Shiori Ishii, Hideki Amano, Tetsuya Fushimi, Kiyohide Miyata, Hiroaki Ikari, Yuji TI Risk prediction models in patients undergoing percutaneous coronary intervention: A collaborative analysis from a Japanese administrative dataset and nationwide academic procedure registry SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Percutaneous coronary intervention; Risk model; Administrative claims data; Nationwide registry; C-statistics ID IN-HOSPITAL MORTALITY; ACUTE MYOCARDIAL-INFARCTION; PERFORMANCE; GUIDELINE; ADMISSION; IMPACT AB Background: Contemporary guidelines emphasize the importance of risk stratification in improving the quality of care for patients undergoing percutaneous coronary intervention (PCI). We aimed to investigate whether adding information from a procedure-based academic registry to administrative claims data would improve the per-formance of risk prediction model.Methods: We combined two nationally representative administrative and clinical databases. The study cohort comprised 43,095 patients; 18,719 and 23, 525 with acute [ACS] and chronic [CCS] coronary syndrome, respectively. Each population was randomly divided into the logistic regression model (derivation cohort, 80%) and model validation (validation cohort, 20%) groups. The performances of the following models were compared using C-statistics: (1) variables restricted to baseline claims data (model #1), (2) clinical registry data (model #2), and (3) expanded to both claims and clinical registry data (model #3). The primary outcomes were in -hospital mortality and bleeding.Results: The primary outcomes occurred in 3.7% (in-hospital mortality)/5.0% (bleeding) of patients with ACS and 0.21%/0.95% of CCS patients. For each event, the model performance was 0.65 (95% confidence interval [CI], 0.60-0.69) /0.67 (0.63-0.71) in ACS and 0.52 (0.35-0.76) /0.62 (0.54-0.70) for CCS patients in model #1, 0.83Conclusions: Combining clinical information from the academic registry with claims databases improved its performance in predicting adverse events. C1 [Shoji, Satoshi] Hino Municipal Hosp, Dept Cardiol, Tokyo, Japan. [Shoji, Satoshi; Kohsaka, Shun] Keio Univ, Dept Cardiol, Sch Med, Tokyo, Japan. [Kumamaru, Hiraku; Nishimura, Shiori; Miyata, Hiroaki] Univ Tokyo, Dept Healthcare Qual Assessment, Grad Sch Med, Tokyo, Japan. [Ishii, Hideki] Gunma Univ, Dept Cardiovasc Med, Grad Sch Med, Maebashi, Japan. [Amano, Tetsuya] Aichi Med Univ, Dept Cardiol, Nagakute, Aichi, Japan. [Fushimi, Kiyohide] Tokyo Med & Dent Univ, Grad Sch Med, Dept Hlth Policy & Informat, Tokyo, Japan. [Ikari, Yuji] Tokai Univ, Dept Cardiol, Sch Med, Tokyo, Kanagawa, Japan. [Shoji, Satoshi; Kohsaka, Shun] Keio Univ, Dept Cardiol, Sch Med, 35 Shinanomachi,Shinjuku Ku, Tokyo 1608582, Japan. C3 Keio University; University of Tokyo; Gunma University; Aichi Medical University; Tokyo Medical & Dental University (TMDU); Tokai University; Keio University RP Shoji, S; Kohsaka, S (通讯作者),Keio Univ, Dept Cardiol, Sch Med, 35 Shinanomachi,Shinjuku Ku, Tokyo 1608582, Japan. EM sk@keio.jp FU Japan Society for the Promotion of Science [20H03915, 16KK0186, 20K22883]; Japanese Association of Cardiovascular Intervention and Therapeutics FX This study was funded by the Japan Society for the Promotion of Science (grant numbers 20H03915, 16H05215, 16KK0186, and 20K22883). The J-PCI registry is led and supported by the Japanese Association of Cardiovascular Intervention and Therapeutics. CR Alghanem F, 2020, AM J EMERG MED, V38, P89, DOI 10.1016/j.ajem.2019.04.030 Azzalini L, 2019, CAN MED ASSOC J, V191, pE299, DOI 10.1503/cmaj.181186 Brennan JM, 2013, JACC-CARDIOVASC INTE, V6, P790, DOI 10.1016/j.jcin.2013.03.020 Bucholz EM, 2016, J AM COLL CARDIOL, V67, P2378, DOI 10.1016/j.jacc.2016.03.507 Castro-Dominguez YS, 2021, J AM COLL CARDIOL, V78, P216, DOI 10.1016/j.jacc.2021.04.067 Chen CY, 2013, J AM COLL CARDIOL, V61, P2142, DOI 10.1016/j.jacc.2013.02.043 D'Ascenzo F, 2021, LANCET, V397, P199, DOI 10.1016/S0140-6736(20)32519-8 Heinze G, 2018, BIOMETRICAL J, V60, P431, DOI 10.1002/bimj.201700067 Inohara T, 2020, J AM COLL CARDIOL, V76, P1328, DOI 10.1016/j.jacc.2020.07.037 Inohara T, 2017, JACC-CARDIOVASC INTE, V10, P918, DOI 10.1016/j.jcin.2017.02.015 Inohara T, 2016, J AM COLL CARDIOL, V67, P1715, DOI 10.1016/j.jacc.2016.01.049 Isogai T, 2015, INT J CARDIOL, V179, P315, DOI 10.1016/j.ijcard.2014.11.070 Jalbert JJ, 2016, CIRC-CARDIOVASC QUAL, V9, P275, DOI 10.1161/CIRCOUTCOMES.115.002336 January CT, 2014, J AM COLL CARDIOL, V64, pE1, DOI [10.1016/j.jacc.2014.02.537, 10.1016/j.jacc.2014.03.022] Jena AB, 2013, CIRCULATION, V128, P2754, DOI 10.1161/CIRCULATIONAHA.113.004074 Kharrazi H, 2017, MED CARE, V55, P789, DOI 10.1097/MLR.0000000000000754 Khera R, 2021, JAMA CARDIOL, V6, P633, DOI 10.1001/jamacardio.2021.0122 Kumamaru H, 2016, EMERG THEMES EPIDEMI, V13, DOI 10.1186/s12982-016-0047-x Matsui H, 2017, RESP RES, V18, DOI 10.1186/s12931-017-0552-7 Neumann FJ, 2019, EUR HEART J, V40, P79, DOI 10.1093/eurheartj/ehy855 Sandhu AT, 2021, CIRC-CARDIOVASC QUAL, V14, DOI 10.1161/CIRCOUTCOMES.119.006461 Sandhu AT, 2019, JAMA CARDIOL, V4, P1077, DOI 10.1001/jamacardio.2019.3221 Setoguchi S, 2014, CIRC-CARDIOVASC QUAL, V7, P475, DOI 10.1161/CIRCOUTCOMES.113.000294 Shahian DM, 2004, ANN THORAC SURG, V78, P1868, DOI 10.1016/j.athoracsur.2004.05.054 Silva GC, 2020, JAMA INTERN MED, V180, P347, DOI 10.1001/jamainternmed.2019.5970 Tsai TT, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.114.001380 Wu CT, 2006, J AM COLL CARDIOL, V47, P654, DOI 10.1016/j.jacc.2005.09.071 Yamana H, 2017, J EPIDEMIOL, V27, P476, DOI 10.1016/j.je.2016.09.009 NR 28 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD JAN 1 PY 2023 VL 370 BP 90 EP 97 DI 10.1016/j.ijcard.2022.10.144 EA DEC 2022 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 7K2TF UT WOS:000905137600016 PM 36306945 DA 2023-05-13 ER PT J AU Dupre, CM Libman, R Dupre, SI Katz, JM Rybinnik, I Kwiatkowski, T AF Dupre, Callum M. Libman, Richard Dupre, Samuel I. Katz, Jeffrey M. Rybinnik, Igor Kwiatkowski, Thomas TI Stroke Chameleons SO JOURNAL OF STROKE & CEREBROVASCULAR DISEASES LA English DT Article DE Acute stroke; stroke mimic; syncope; hypertensive encephalopathy; hypertensive emergency; psychosis ID EMERGENCY AB Background: Many conditions called "stroke mimics" may resemble acute stroke. The converse of the "stroke mimic" is a presentation suggestive of another condition, which actually represents stroke. These would be "stroke chameleons." The recognition of a chameleon as stroke has implications for therapy and quality of care. Methods: We performed a retrospective chart review, including all cases for 1 year in which patients had a stroke missed on hospital presentation. Initial erroneous diagnoses were compared for all patients correctly admitted with those diagnoses to determine positive predictive value (PPV) for each chameleon. Results: Ninetyfour cases were identified as chameleons where brain imaging revealed acute stroke. The common chameleons were initially diagnosed as altered mental status (AMS) (29, 31%), syncope (15, 16%), hypertensive emergency (12, 13%), systemic infection (10, 11%), and suspected acute coronary syndrome (ACS) (9, 10%). The total number of patients who were diagnosed with these conditions over the same year were AMS (393), syncope (326), hypertensive emergency (144), systemic infection (753), and suspected ACS (817) (total N = 2528). For each chameleon diagnosis, the PPV of each presentation for acute stroke was AMS (7%), syncope (4%), hypertensive emergency (8%), systemic infection (1%), and suspected ACS (1%). Conclusions: Stroke chameleons may result in patients not receiving appropriate care. The largest proportions of chameleons were AMS, syncope, hypertensive emergency, systemic infection, and suspected ACS. Patients diagnosed with hypertensive emergency or AMS had an 8% and 7% chance of having an acute stroke. Physicians should consider stroke in patients with these diagnoses with a lower threshold to obtain neuroimaging with subsequent appropriate management. C1 [Dupre, Callum M.; Libman, Richard; Katz, Jeffrey M.; Rybinnik, Igor] North Shore Long Isl Jewish Med Ctr, Dept Neurol, New Hyde Pk, NY USA. [Dupre, Samuel I.] Frostburg State Univ, Dept Biol, Frostburg, MD 21532 USA. [Kwiatkowski, Thomas] Hofstra North Shore LIJ Sch Med, Dept Emergency Med, New Hyde Pk, NY USA. C3 Northwell Health; University System of Maryland; Frostburg State University; Hofstra University; Northwell Health RP Libman, R (通讯作者),Long Isl Jewish Med Ctr, Dept Neurol, 270-05 76th Ave, New Hyde Pk, NY 11040 USA. EM rlibman@lij.edu OI kwiatkowski, thomas/0000-0002-6169-4216 CR Benbadis S R, 1994, J Stroke Cerebrovasc Dis, V4, P216, DOI 10.1016/S1052-3057(10)80093-X Carrera E, 2006, NEUROLOGY, V66, P1817, DOI 10.1212/01.wnl.0000219679.95223.4c DAVIDSON E, 1991, CLIN CARDIOL, V14, P141, DOI 10.1002/clc.4960140210 Gorson KC, 1996, NEUROLOGY, V46, P548, DOI 10.1212/WNL.46.2.548 Grau AJ, 1998, NEUROLOGY, V50, P196, DOI 10.1212/WNL.50.1.196 Huff JS, 2002, EMERG MED CLIN N AM, V20, P583, DOI 10.1016/S0733-8627(02)00012-3 KOTHARI RU, 1995, STROKE, V26, P2238, DOI 10.1161/01.STR.26.12.2238 LaBresh KA, 2008, ARCH INTERN MED, V168, P411, DOI 10.1001/archinternmed.2007.101 LIBMAN RB, 1995, ARCH NEUROL-CHICAGO, V52, P1119, DOI 10.1001/archneur.1995.00540350113023 Manolio TA, 2003, CURR HYPERTENS REP, V5, P255, DOI 10.1007/s11906-003-0029-6 Parvizi J, 2003, BRAIN, V126, P1524, DOI 10.1093/brain/awg166 Qureshi AI, 2008, CIRCULATION, V118, P176, DOI 10.1161/CIRCULATIONAHA.107.723874 RICHARDS A, 1988, J NEUROL NEUROSUR PS, V51, P416, DOI 10.1136/jnnp.51.3.416 Schmahmann JD, 2003, STROKE, V34, P2264, DOI 10.1161/01.STR.0000087786.38997.9E Zampaglione B, 1996, HYPERTENSION, V27, P144, DOI 10.1161/01.HYP.27.1.144 NR 15 TC 35 Z9 38 U1 0 U2 1 PU ELSEVIER PI AMSTERDAM PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS SN 1052-3057 EI 1532-8511 J9 J STROKE CEREBROVASC JI J. Stroke Cerebrovasc. Dis. PD FEB PY 2014 VL 23 IS 2 BP 374 EP 378 DI 10.1016/j.jstrokecerebrovasdis.2013.07.015 PG 5 WC Neurosciences; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 302DT UT WOS:000330582500041 PM 23954604 DA 2023-05-13 ER PT J AU Shirakabe, A Hata, N Kobayashi, N Shinada, T Tomita, K Tsurumi, M Matsushita, M Okazaki, H Yamamoto, Y Yokoyama, S Asai, K Mizuno, K AF Shirakabe, Akihiro Hata, Noritake Kobayashi, Nobuaki Shinada, Takuro Tomita, Kazunori Tsurumi, Masafumi Matsushita, Masato Okazaki, Hirokake Yamamoto, Yoshiya Yokoyama, Shinya Asai, Kuniya Mizuno, Kyoichi TI Prognostic Impact of Acute Kidney Injury in Patients With Acute Decompensated Heart Failure SO CIRCULATION JOURNAL LA English DT Article DE Acute heart failure; Mortality; Renal function ID WORSENING RENAL-FUNCTION; GLOMERULAR-FILTRATION-RATE; ACUTE CORONARY SYNDROME; SENSITIVITY TROPONIN-T; BASE-LINE CREATININE; CARDIORENAL SYNDROME; RIFLE CRITERIA; MEDICARE BENEFICIARIES; HOSPITALIZED-PATIENTS; SERUM CREATININE AB Background: The relationship between acute kidney injury (AKI) in the acute phase of acute decompensated heart failure (ADHF) and patient outcome has not yet been reported. Methods and Results: Data for 625 patients with ADHF admitted to the intensive care unit were analyzed. No AKI occurred in 281 patients (no AKI) during the first 5 days. The AKI patients were assigned to 3 groups based on the timing: AKI present on admission and stable risk, injury, failure, loss, and endstage (RIFLE) class (stable early AKI; n=125), stepped-up RIFLE class (worsening early AKI; n=49), or AKI that occurred after admission (late AKI; n=170). The AKI patients were grouped into another 3 groups based on severity: class R (risk; n=214), class I (injury; n=73), or class F (failure; n=57). A multivariate logistic regression model found class I, class F, late AKI and worsening early AKI to be independently associated with in-hospital mortality. Kaplan-Meier survival curves showed that the survival rate in any-cause death during 2 years was significantly lower in class I, class F and the worsening early-AKI group, and there were significantly more HF events in class F and the worsening early-AKI group. There were significantly more class I and class F patients in the worsening early-AKI group. Conclusions: The presence of AKI on admission, worsening of AKI, and severe AKI (class I or class F) are associated with a poorer prognosis for ADHF patients. (Circ J 2013; 77: 687-696) C1 [Shirakabe, Akihiro; Hata, Noritake; Kobayashi, Nobuaki; Shinada, Takuro; Tomita, Kazunori; Tsurumi, Masafumi; Matsushita, Masato; Okazaki, Hirokake; Yamamoto, Yoshiya; Yokoyama, Shinya] Chiba Hokusoh Hosp, Nippon Med Sch, Div Intens Care Unit, Chiba 2701694, Japan. [Asai, Kuniya; Mizuno, Kyoichi] Nippon Med Sch, Dept Cardiovasc Med, Tokyo 113, Japan. C3 Nippon Medical School; Nippon Medical School RP Shirakabe, A (通讯作者),Chiba Hokusoh Hosp, Nippon Med Sch, ICU, 1715 Kamagari, Chiba 2701694, Japan. EM s6042@nms.ac.jp RI Kobayashi, Nobuaki/J-4222-2019 OI Kobayashi, Nobuaki/0000-0001-6757-4779 CR Akhter MW, 2004, AM J CARDIOL, V94, P957, DOI 10.1016/j.amjcard.2004.06.041 Bagshaw SM, 2008, NEPHROL DIAL TRANSPL, V23, P1569, DOI 10.1093/ndt/gfn009 Bagshaw SM, 2009, NEPHROL DIAL TRANSPL, V24, P2739, DOI 10.1093/ndt/gfp159 Bellomo R, 2004, CRIT CARE, V8, pR204, DOI 10.1186/cc2872 Bellomo R, 2007, INTENS CARE MED, V33, P409, DOI 10.1007/s00134-006-0478-x Bock JS, 2010, CIRCULATION, V121, P2592, DOI 10.1161/CIRCULATIONAHA.109.886473 Cohn JN, 2001, NEW ENGL J MED, V345, P1667, DOI 10.1056/NEJMoa010713 Cowie MR, 2006, EUR HEART J, V27, P1216, DOI 10.1093/eurheartj/ehi859 Damman K, 2007, J CARD FAIL, V13, P599, DOI 10.1016/j.cardfail.2007.04.008 Forman DE, 2004, J AM COLL CARDIOL, V43, P61, DOI 10.1016/j.jacc.2003.07.031 Geisberg C, 2006, CLEV CLIN J MED, V73, P485, DOI 10.3949/ccjm.73.5.485 Gheorghiade M, 2005, CIRCULATION, V112, P3958, DOI 10.1161/CIRCULATIONAHA.105.590091 Gottlieb SS, 2002, J CARD FAIL, V8, P136, DOI 10.1054/jcaf.2002.125289 Hata N, 2010, EUR J HEART FAIL, V12, P32, DOI 10.1093/eurjhf/hfp169 Heywood JT, 2004, HEART FAIL REV, V9, P195, DOI 10.1007/s10741-005-6129-4 Iseki K, 2008, INTERNAL MED, V47, P681, DOI 10.2169/internalmedicine.47.0906 Khwaja A, 2012, NEPHRON CLIN PRACT, V120, pC179, DOI 10.1159/000339789 Kobayashi N, 2011, CIRC J, V75, P2853, DOI 10.1253/circj.CJ-11-0640 Kobayashi N, 2011, CIRC J, V75, P2862, DOI 10.1253/circj.CJ-11-0724 Kociol RD, 2010, AM J CARDIOL, V105, P1786, DOI 10.1016/j.amjcard.2010.01.361 Krumholz HM, 2000, AM J CARDIOL, V85, P1110, DOI 10.1016/S0002-9149(00)00705-0 Levey AS, 1999, ANN INTERN MED, V130, P461, DOI 10.7326/0003-4819-130-6-199903160-00002 Lopes JA, 2008, CRIT CARE, V12, DOI 10.1186/cc6997 Mathew TH, 2007, MED J AUSTRALIA, V187, P459, DOI 10.5694/j.1326-5377.2007.tb01357.x Mehta RL, 2007, CRIT CARE, V11, DOI 10.1186/cc5713 Nieminen MS, 2005, AM J CARDIOL, V96, p5G, DOI 10.1016/j.amjcard.2005.07.015 Owan TE, 2006, J CARD FAIL, V12, P257, DOI 10.1016/j.cardfail.2006.02.007 Patel UD, 2010, AM HEART J, V160, P132, DOI 10.1016/j.ahj.2010.03.033 Schoolwerth AC, 2001, CIRCULATION, V104, P1985, DOI 10.1161/hc4101.096153 Shirakabe A, 2012, INT HEART J, V53, P313, DOI 10.1536/ihj.53.313 Shlipak MG, 2004, CIRCULATION, V110, P1514, DOI 10.1161/01.CIR.0000143547.55093.17 Smith GL, 2003, J CARD FAIL, V9, P13, DOI 10.1054/jcaf.2003.3 Tang WHW, 2010, HEART, V96, P255, DOI 10.1136/hrt.2009.166256 Uchino S, 2006, CRIT CARE MED, V34, P1913, DOI 10.1097/01.CCM.0000224227.70642.4F Zavada J, 2010, NEPHROL DIAL TRANSPL, V25, P3911, DOI 10.1093/ndt/gfp766 NR 35 TC 62 Z9 65 U1 0 U2 9 PU JAPANESE CIRCULATION SOC PI TOYKO PA 18TH FLOOR IMPERIAL HOTEL TOWER, 1-1-1 UCHISAIWAI-CHO CHIYODA-KU, TOYKO, 100-0011, JAPAN SN 1346-9843 J9 CIRC J JI Circ. J. PD MAR PY 2013 VL 77 IS 3 BP 687 EP 696 DI 10.1253/circj.CJ-12-0994 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 134IF UT WOS:000318202900023 PM 23207958 OA gold DA 2023-05-13 ER PT J AU Taniguchi, K Takashima, S Iida, R Ota, K Nitta, M Sakane, K Fujisaka, T Ishizaka, N Umegaki, O Uchiyama, K Takasu, A AF Taniguchi, Kohei Takashima, Syogo Iida, Ryo Ota, Koshi Nitta, Masahiko Sakane, Kazushi Fujisaka, Tomohiro Ishizaka, Nobukazu Umegaki, Osamu Uchiyama, Kazuhisa Takasu, Akira TI Takotsubo cardiomyopathy caused by acute respiratory stress from extubation A case report SO MEDICINE LA English DT Article DE apical ballooning syndrome; broken heart syndrome; extubation; stress cardiomyopathy; takotsubo cardiomyopathy ID APICAL BALLOONING SYNDROME; LEFT-VENTRICULAR DYSFUNCTION AB Rational: Takotsubo cardiomyopathy (TCM) is a transient systolic dysfunction of the left ventricular apex without stenosis of coronary arteries and is induced by various psychological and physical factors. TCM sometimes causes lethal complications such as arrhythmia, thrombogenesis, and even cardiac rupture, and thus it should be diagnosed appropriately and managed carefully. Intensive care unit (ICU) patients are exposed to overstress during the treatment process and therefore can are at potential risk for TCM. Patient concerns: The patient was diagnosed as having pneumonia because of influenza A virus mixed with bacteria and underwent intensive care with intubation and mechanical ventilation in the ICU. His respiratory condition soon improved, and so extubation was carried out; however, redeterioration with pulmonary edema occurred at half of a day following extubation. Diagnosis: The chest x-ray revealed pulmonary edema. The electrocardiogram pattern significantly changed with time, and the echocardiogram showed weakness of wall motion around the left ventricular apex. Hence, to confirm the diagnosis, we performed cardiac catheterization immediately, with the results showing a Takotsubo-like form at the systolic phase without significant stenosis of the coronary arteries. Intervention: The patient was reintubated with administration of catecholamine for decreasing blood pressure caused by left ventricular dysfunction. Also, diuretics for pulmonary edema and anticoagulants for prevention of thrombogenesis were administered. Outcomes: As the respiratory condition improved with stabilization of cardiovascular hemodynamics, reextubation was done at ICU day 11 and was discharged from the ICU at ICU day 15. The patient was subsequently treated for pneumonia after leaving the ICU but suffered from repetitive aspiration pneumonia and was finally transferred to another hospital at hospital day 111. Lessons: TCM should be considered especially under the situation of intensive care, and prompt diagnosis should be followed by appropriate management. C1 [Taniguchi, Kohei; Iida, Ryo; Ota, Koshi; Nitta, Masahiko; Takasu, Akira] Osaka Med Coll, Dept Emergency Med, Osaka, Japan. [Taniguchi, Kohei; Iida, Ryo; Uchiyama, Kazuhisa] Osaka Med Coll, Dept Gen & Gastroenterol Surg, Osaka, Japan. [Takashima, Syogo] Osaka Med Coll, Clin Training Ctr, Osaka, Japan. [Sakane, Kazushi; Fujisaka, Tomohiro; Ishizaka, Nobukazu] Osaka Med Coll, Dept Cardiol, Osaka, Japan. [Umegaki, Osamu] Osaka Med Coll, Dept Crit Care Med, Osaka, Japan. C3 Osaka Medical College; Osaka Medical College; Osaka Medical College; Osaka Medical College; Osaka Medical College RP Taniguchi, K (通讯作者),Osaka Med Coll, Dept Emergency Med, Daigaku Machi, Takatsuki, Osaka 5698686, Japan. EM sur144@osaka-med.ac.jp OI Takasu, Akira/0000-0003-3430-0119; Taniguchi, Kohei/0000-0003-0648-1370 CR Ako J, 2006, AM J MED, V119, P10, DOI 10.1016/j.amjmed.2005.08.022 Donohue D, 2005, HEART FAIL REV, V10, P311, DOI 10.1007/s10741-005-8555-8 El-Sayed AM, 2012, AM J CARDIOL, V110, P1368, DOI 10.1016/j.amjcard.2012.06.041 IGA K, 1989, JPN CIRC J, V53, P813, DOI 10.1253/jcj.53.813 Kosuge M, 2010, J AM COLL CARDIOL, V55, P2514, DOI 10.1016/j.jacc.2009.12.059 Kume T, 2005, CIRC J, V69, P934, DOI 10.1253/circj.69.934 Lyon AR, 2008, NAT CLIN PRACT CARD, V5, P22, DOI 10.1038/ncpcardio1066 Pilgrim TM, 2008, INT J CARDIOL, V124, P283, DOI 10.1016/j.ijcard.2007.07.002 Sharkey SW, 2010, J AM COLL CARDIOL, V55, P333, DOI 10.1016/j.jacc.2009.08.057 Summers MR, 2010, J AM COLL CARDIOL, V55, P700, DOI 10.1016/j.jacc.2009.10.031 Watanabe H, 2005, JAMA-J AM MED ASSOC, V294, P305, DOI 10.1001/jama.294.3.305 Wittstein IS, 2005, NEW ENGL J MED, V352, P539, DOI 10.1056/NEJMoa043046 NR 12 TC 1 Z9 1 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7974 EI 1536-5964 J9 MEDICINE JI Medicine (Baltimore) PD DEC PY 2017 VL 96 IS 48 AR e8946 DI 10.1097/MD.0000000000008946 PG 4 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA FS2VD UT WOS:000419636400070 PM 29310390 OA Green Published, gold DA 2023-05-13 ER PT J AU Komajda, M Cosentino, F Ferrari, R Laroche, C Maggioni, A Steg, PG Tavazzi, L Kerneis, M Valgimigli, M Gale, CP AF Komajda, Michel Cosentino, Francesco Ferrari, Roberto Laroche, Cecile Maggioni, Aldo Steg, Philippe Gabriel Tavazzi, Luigi Kerneis, Mathieu Valgimigli, Marco Gale, Chris P. CA CICD Investigators Grp TI The ESC-EORP Chronic Ischaemic Cardiovascular Disease Long Term (CICD LT) registry SO EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES LA English DT Article DE Chronic coronary disease; Registry; Clinical outcomes; Demographics; Medications AB Aims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Chronic Ischaemic Cardiovascular Disease Long Term (CICD LT) registry aims to study the clinical profile, treatment modalities, and outcomes of patients diagnosed with CICD in a contemporary environment in order to assess whether these patients at high cardiovascular (CV) risk are treated according to ESC guidelines on prevention or on stable coronary disease and to determine mid- and tong-term outcomes and their determinants in this population. Methods and results Nine thousand one hundred and seventy-four patients over 18 years with documented CICD defined by a history acute coronary syndrome with/without ST elevation, previous coronary revascularization, or stable coronary artery disease were enrolled between 1 May 2015 and 31 July 2018. Individual patient data on clinical profile, biology, and treatment modalities were collected across 154 centres from 20 ESC countries. Two years of follow-up is scheduled in order to determine the following clinical outcomes: all-cause and CV death, all-cause and CV hospitalizations, changes in medications, and quality of life using the EuroQol5D-5L score. Conclusion The CICD LT is an international registry of care and outcomes of patients hospitalized with CICD which will provide insights into the contemporary profile and management of patients with this common disease. C1 [Komajda, Michel] St Joseph Hosp, Dept Cardiol, Paris, France. [Cosentino, Francesco] Karolinska Inst, Unit Cardiol, Stockholm, Sweden. [Cosentino, Francesco] Karolinska Univ Hosp Solna, Stockholm, Sweden. [Ferrari, Roberto] Univ Ferrara, Ctr Cardiol Univ Ferrara, Ferrara, Italy. [Ferrari, Roberto; Tavazzi, Luigi] GVM Care & Res, Maria Cecilia Hosp, Cotignola, Italy. [Laroche, Cecile; Maggioni, Aldo] European Soc Cardiol, EURObservat Res Programme, Sophia Antipolis, France. [Maggioni, Aldo] ANMCO Res Ctr, Florence, Italy. [Steg, Philippe Gabriel] Univ Paris, Hop Bichat, AP HP, Paris, France. [Kerneis, Mathieu] Sorbonne Univ, ICAN Inst CardioMetab & Nutr, Hop Pitie Salpetriere, AP HP,INSERM UMRS1166,Inst Cardiol,ACTION Study G, Paris, France. [Valgimigli, Marco] Bern Univ Hosp, Inselspital, Bern, Switzerland. [Gale, Chris P.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, W Yorkshire, England. [Gale, Chris P.] Univ Leeds, Leeds Inst Data Analyt, Leeds, W Yorkshire, England. [Gale, Chris P.] Leeds Teaching Hosp NHS Trust, Dept Cardiol, Leeds, W Yorkshire, England. C3 UDICE-French Research Universities; Universite Paris Cite; Hopital Paris Saint-Joseph; Karolinska Institutet; Karolinska Institutet; Karolinska University Hospital; University of Ferrara; Maria Cecilia Hospital; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO); Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; University of Bern; University Hospital of Bern; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds RP Komajda, M (通讯作者),St Joseph Hosp, Dept Cardiol, Paris, France. EM mkomajda@hpsj.fr RI Zelveian, Parounak/P-8603-2017; Figliozzi, Stefano/AAU-2182-2020; Maggioni, Aldo Pietro/AAL-5334-2020; Tukish, Olga Viktorovna/S-2362-2016; Ryabov, V V/F-2153-2014; Simoni, Leonard/AAW-6529-2021; De Rosa, Salvatore/J-6350-2012; Soltowska, Alicja M/T-7672-2018; Thieme, Marcus/P-3085-2016; Mazilu, Laura/S-5111-2018; Rivera-Caravaca, José Miguel/O-5611-2016; PAREPA, IRINEL/Z-5727-2019; Bektasheva, Erkaiym/H-8645-2017; Chumachek, Elena/D-1966-2016; Mirrakhimov, Erkin/E-6900-2017; jaroch, joanna/T-9491-2018; Brodskaya, Tatiana/P-3984-2015; Efremova, Elena/F-5845-2014 OI Zelveian, Parounak/0000-0002-6513-6772; Figliozzi, Stefano/0000-0003-2991-1548; Maggioni, Aldo Pietro/0000-0003-2764-6779; Tukish, Olga Viktorovna/0000-0002-7661-5808; Ryabov, V V/0000-0002-4358-7329; Simoni, Leonard/0000-0003-2422-8619; De Rosa, Salvatore/0000-0001-5388-942X; Soltowska, Alicja M/0000-0001-6141-0503; Mazilu, Laura/0000-0001-6195-4500; Rivera-Caravaca, José Miguel/0000-0003-0492-6241; PAREPA, IRINEL/0000-0002-7571-9015; Chumachek, Elena/0000-0002-6740-8321; Mirrakhimov, Erkin/0000-0003-2982-6108; Ohlow, Marc-Alexander/0000-0001-9674-2129; Emberson, Jonathan/0000-0001-7792-9422; PARVU, Irina/0009-0008-3198-1055; piotrowicz, Katarzyna/0000-0003-0669-7665; Chalikias, George/0000-0003-4331-730X; jaroch, joanna/0000-0002-9002-4932; Cosentino, Francesco/0000-0002-6967-5685; Kermani-Alghoraishi, Mohammad/0000-0002-3701-3572; Gale, Chris/0000-0003-4732-382X; Zapolski, Tomasz/0000-0001-9808-8853; TAVAZZI, LUIGI/0000-0003-4448-5209; Przybylski, Andrzej/0000-0002-8136-7589; Brodskaya, Tatiana/0000-0002-9836-6339; Budaj, Andrzej/0000-0002-6395-2098; Efremova, Elena/0000-0002-7579-4824; Valgimigli, Marco/0000-0002-4353-7110; Kerneis, Mathieu/0000-0002-7141-5209; STEG, Philippe Gabriel/0000-0001-6896-2941 FU Abbott Vascular Int. (2011-21); Amgen Cardiovascular (2009-18); AstraZeneca (2014-21); Bayer (2009-18); Boehringer Ingelheim (2009-19); Boston Scientific (2009-12); Bristol Myers Squibb; Alliance Daiichi Sankyo Europe GmbH; Eli Lilly and Company (2011-17); Edwards (2016-19); Gedeon Richter Plc. (2014-17); Menarini Int. Op. (2009-12); Novartis Pharma AG (2014-20); ResMed (2014-16); Sanofi (2009-11); SERVIER (2010-21); Vifor (2019-22); Pfizer Alliance (2011-16); MSDMerck Co. (2011-14) FX Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011-21), Amgen Cardiovascular (2009-18), AstraZeneca (2014-21), Bayer (2009-18), Boehringer Ingelheim (2009-19), Boston Scientific (2009-12), The Bristol Myers Squibb and Pfizer Alliance (2011-16), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011-17), Edwards (2016-19), Gedeon Richter Plc. (2014-17), Menarini Int. Op. (2009-12), MSDMerck & Co. (2011-14), Novartis Pharma AG (2014-20), ResMed (2014-16), Sanofi (2009-11), SERVIER (2010-21), and Vifor (2019-22). CR Daly CA, 2005, EUR HEART J, V26, P996, DOI 10.1093/eurheartj/ehi171 Komajda M, 2018, EUR J PREV CARDIOL, V25, P377, DOI 10.1177/2047487317751955 Komajda M, 2016, EUR HEART J, V37, P152, DOI 10.1093/eurheartj/ehv437 Leal J, 2006, EUR HEART J, V27, P1610, DOI 10.1093/eurheartj/ehi733 Murray CJL, 1997, LANCET, V349, P1498, DOI 10.1016/S0140-6736(96)07492-2 Steg PG, 2007, JAMA-J AM MED ASSOC, V297, P1197, DOI 10.1001/jama.297.11.1197 Steg PG, 2014, JAMA INTERN MED, V174, P1651, DOI 10.1001/jamainternmed.2014.3773 Tunstall-Pedoe H, 1999, LANCET, V353, P1547, DOI 10.1016/S0140-6736(99)04021-0 NR 8 TC 1 Z9 1 U1 0 U2 11 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 2058-5225 EI 2058-1742 J9 EUR HEART J-QUAL CAR JI Eur. Heart J.-Qual. Care Clin. Outcomes PD JAN PY 2021 VL 7 IS 1 BP 28 EP 33 DI 10.1093/ehjqcco/qcz057 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA QE5ND UT WOS:000616252700005 PM 31605146 OA Green Published DA 2023-05-13 ER PT J AU Bohula, EA Katz, JN van Diepen, S Alviar, CL Baird-Zars, VM Park, JG Barnett, CF Bhattal, G Barsness, GW Burke, JA Cremer, PC Cruz, J Daniels, LB DeFilippis, A Granger, CB Hollenberg, S Horowitz, JM Keller, N Kontos, MC Lawler, PR Menon, V Metkus, TS Ng, J Orgel, R Overgaard, CB Phreaner, N Roswell, RO Schulman, SP Snell, RJ Solomon, MA Ternus, B Tymchak, W Vikram, F Morrow, DA Morrow, DA Katz, JN van Diepen, S Solomon, MA Bohula, EA Baird-Zars, V Cange, A Murphy, SA Silva, D Schenone, A Rutkowski, K Ricketti, D Trujillo, J Ibrahim, K Rahman, F Cornell, K Jentzer, JC Barnett, CF Ahmed, S Barrett, L Pokharel, S Keller, N Ng, J Atallah, I Jahan, N Jones, K Lawler, PR Tsang, K van Diepen, S Tymchak, W Hogg, N Gargus, N Leach, DD Long, S Bostick, J Mohammed, M Daniels, LB Phreaner, N Anzenberg, P Belza, C Getz, T Gonzalez, J Marsal, J Sedighi, R Toomu, A Toomu, S Vincent, S Dangerfield, C Ozen, Z Prosser, E Wade, T Dow, S Vo, C AF Bohula, Erin A. Katz, Jason N. van Diepen, Sean Alviar, Carlos L. Baird-Zars, Vivian M. Park, Jeong-Gun Barnett, Christopher F. Bhattal, Gurjaspreet Barsness, Gregory W. Burke, James A. Cremer, Paul C. Cruz, Jennifer Daniels, Lori B. DeFilippis, Andrew Granger, Christopher B. Hollenberg, Steven Horowitz, James M. Keller, Norma Kontos, Michael C. Lawler, Patrick R. Menon, Venu Metkus, Thomas S. Ng, Jason Orgel, Ryan Overgaard, Christopher B. Phreaner, Nicholas Roswell, Robert O. Schulman, Steven P. Snell, R. Jeffrey Solomon, Michael A. Ternus, Bradley Tymchak, Wayne Vikram, Fnu Morrow, David A. Morrow, David A. Katz, Jason N. van Diepen, Sean Solomon, Michael A. Bohula, Erin A. Baird-Zars, Vivian Cange, Abby Murphy, Sabina A. Silva, D. Schenone, Aldo Rutkowski, K. Ricketti, Daniel Trujillo, John Ibrahim, Khalil Rahman, Faisal Cornell, Kristen Jentzer, Jacob C. Barnett, Christopher F. Ahmed, S. Barrett, L. Pokharel, Shreejana Keller, Norma Ng, J. Atallah, Issam Jahan, Nusrat Jones, K. Lawler, Patrick R. Tsang, K. van Diepen Tymchak, Wayne Hogg, N. Gargus, Nathan Leach, Dana D. Long, S. Bostick, J. Mohammed, M. Daniels, Llori B. Phreaner, Nicholas Anzenberg, Paula Belza, Caitlyn Getz, Taelor Gonzalez, J. Marsal, J. Sedighi, R. Toomu, Avinash Toomu, S. Vincent, S. Dangerfield, Cristie Ozen, Z. Prosser, E. Wade, T. Dow, S. Vo, Chau CA Critical Care Cardiology Trials TI Demographics, Care Patterns, and Outcomes of Patients Admitted to Cardiac Intensive Care Units: The Critical Care Cardiology Trials Network Prospective North American Multicenter Registry of Cardiac Critical Illness SO JAMA CARDIOLOGY LA English DT Article ID SOFA SCORE; ASSOCIATION; ORGANIZATION; EVOLUTION AB IMPORTANCE Single-center and claims-based studies have described substantial changes in the landscape of care in the cardiac intensive care unit (CICU). Professional societies have recommended research to guide evidence-based CICU redesigns. OBJECTIVE To characterize patients admitted to contemporary, advanced CICUs. DESIGN, SETTING, AND PARTICIPANTS This study established the Critical Care Cardiology Trials Network (CCCTN), an investigator-initiated multicenter network of 16 advanced, tertiary CICUs in the United States and Canada. For 2 months in each CICU, data for consecutive admissions were submitted to the central data coordinating center (TIMI Study Group). The data were collected and analyzed between September 2017 and 2018. MAIN OUTCOMES AND MEASURES Demographics, diagnoses, management, and outcomes. RESULTS Of 3049 participants, 1132 (37.1%) were women, 797 (31.4%) were individuals of color, and the median age was 65 years (25th and 75th percentiles, 55-75 years). Between September 2017 and September 2018, 3310 admissions were included, among which 2557 (77.3%) were for primary cardiac problems, 337 (10.2%) for postprocedural care, 253 (7.7%) for mixed general and cardiac problems, and 163 (4.9%) for overflow from general medical ICUs. When restricted to the initial 2 months of medical CICU admissions for each site, the primary analysis population included 3049 admissions with a high burden of noncardiovascular comorbidities. The top 2 CICU admission diagnoses were acute coronary syndrome (969 [31.8%]) and heart failure (567 [18.6%]); however, the proportion of acute coronary syndrome was highly variable across centers (15%-57%). The primary indications for CICU care included respiratory insufficiency (814 [26.7%]), shock (643 [21.1%]), unstable arrhythmia (521 [17.1%]), and cardiac arrest (265 [8.7%]). Advanced CICU therapies or monitoring were required for 1776 patients (58.2%), including intravenous vasoactive medications (1105 [36.2%]), invasive hemodynamic monitoring (938 [30.8%]), and mechanical ventilation (652 [21.4%]). The overall CICU mortality rate was 8.3% (95% CI, 7.3%-9.3%). The CICU indications that were associated with the highest mortality rates were cardiac arrest (101 [38.1%]), cardiogenic shock (140 [30.6%]), and the need for renal replacement therapy (51 [34.5%]). Notably, patients admitted solely for postprocedural observation or frequent monitoring had a mortality rate of 0.2% to 0.4%. CONCLUSIONS AND RELEVANCE In a contemporary network of tertiary care CICUs, respiratory failure and shock predominated indications for admission and carried a poor prognosis. While patterns of practice varied considerably between centers, a substantial, low-risk population was identified. Multicenter collaborative networks, such as the CCCTN, could be used to help redesign cardiac critical care and to test new therapeutic strategies. C1 [Bohula, Erin A.; Cange, Abby; Murphy, Sabina A.] TIMI Study Grp, 350 Longwood Ave,First Off Floor, Boston, MA 02115 USA. [Bohula, Erin A.; Baird-Zars, Vivian M.; Park, Jeong-Gun; Morrow, David A.] Harvard Med Sch, Levine Cardiac Intens Care Unit, TIMI Study Grp, Cardiovasc Div,Dept Med,Brigham & Womens Hosp, Boston, MA 02115 USA. [Katz, Jason N.; Orgel, Ryan; Dangerfield, Cristie; Ozen, Z.; Prosser, E.; Wade, T.] Univ N Carolina, Chapel Hill, NC 27515 USA. [van Diepen, Sean; Tymchak, Wayne] Univ Alberta, Dept Med, Dept Crit Care Med, Edmonton, AB, Canada. [Alviar, Carlos L.; Bhattal, Gurjaspreet; Gargus, Nathan; Leach, Dana D.; Long, S.; Bostick, J.; Mohammed, M.; Daniels, Llori B.] Univ Florida, Gainesville, FL USA. [Barnett, Christopher F.] Medstar Washington Hosp Ctr, Dept Cardiol, Washington, DC USA. [Barsness, Gregory W.; Ternus, Bradley; Jentzer, Jacob C.] Mayo Clin, Rochester, MN USA. [Burke, James A.; Vikram, Fnu; Cornell, Kristen] Lehigh Valley Hlth Network, Allentown, PA USA. [Cremer, Paul C.; Menon, Venu; Schenone, Aldo; Rutkowski, K.; Ricketti, Daniel] Cleveland Clin Fdn, 9500 Euclid Ave, Cleveland, OH 44195 USA. [Cruz, Jennifer; Hollenberg, Steven; Trujillo, John] Cooper Univ Hosp, Camden, NJ USA. [Daniels, Lori B.; Phreaner, Nicholas] Univ Calif San Diego, Sulpizio Cardiovasc Ctr, La Jolla, CA 92093 USA. [DeFilippis, Andrew; Vincent, S.] Univ Louisville, Louisville, KY 40292 USA. [Granger, Christopher B.] Duke Univ, Durham, NC USA. [Keller, Norma; Ng, Jason; Roswell, Robert O.; Ng, J.] New York Univ Langone Hlth, New York, NY USA. [Kontos, Michael C.; Dow, S.; Vo, Chau] Virginia Commonwealth Univ, Richmond, VA USA. [Lawler, Patrick R.; Overgaard, Christopher B.] Univ Toronto, Toronto Gen Hosp, Peter Munk Cardiac Ctr, Toronto, ON, Canada. [Metkus, Thomas S.; Schulman, Steven P.; Ibrahim, Khalil; Rahman, Faisal] Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA. [Snell, R. Jeffrey; Atallah, Issam; Jahan, Nusrat; Jones, K.] Rush Univ, Med Ctr, Chicago, IL 60612 USA. [Solomon, Michael A.] NHLBI, Clin Ctr, NIH, Bldg 10, Bethesda, MD 20892 USA. [Solomon, Michael A.] NHLBI, Cardiol Branch, Crit Care Med Dept, NIH, Bldg 10, Bethesda, MD 20892 USA. [Morrow, David A.; Bohula, Erin A.; Baird-Zars, Vivian; Cange, Abby; Murphy, Sabina A.; Silva, D.] Brigham & Womens Hosp, Boston, MA 02115 USA. [Katz, Jason N.] Univ Chapel Hill, Chapel Hill, NC USA. [van Diepen, Sean; Tymchak, Wayne; Hogg, N.] Univ Alberta, Edmonton, AB, Canada. [Solomon, Michael A.] NHLBI, Bldg 10, Bethesda, MD 20892 USA. [Barnett, Christopher F.; Ahmed, S.; Barrett, L.; Pokharel, Shreejana] Medstar Washington Hosp Ctr, Washington, DC USA. [Lawler, Patrick R.; Tsang, K.] Toronto Gen Hosp, Toronto, ON, Canada. [Daniels, Llori B.; Phreaner, Nicholas; Anzenberg, Paula; Belza, Caitlyn; Getz, Taelor; Gonzalez, J.; Marsal, J.; Sedighi, R.; Toomu, Avinash; Toomu, S.] Univ Calif San Diego, La Jolla, CA 92093 USA. C3 Harvard University; Brigham & Women's Hospital; Harvard University; Brigham & Women's Hospital; Harvard Medical School; University of North Carolina; University of North Carolina Chapel Hill; University of Alberta; State University System of Florida; University of Florida; MedStar Washington Hospital Center; Mayo Clinic; Lehigh Valley Health Network; Cleveland Clinic Foundation; Cooper University Hospital; University of California System; University of California San Diego; University of Louisville; Duke University; New York University; Virginia Commonwealth University; University of Toronto; Peter Munk Cardiac Centre; University Health Network Toronto; Toronto General Hospital; Johns Hopkins University; Johns Hopkins Medicine; Rush University; National Institutes of Health (NIH) - USA; NIH Clinical Center (CC); NIH National Heart Lung & Blood Institute (NHLBI); National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI); Harvard University; Brigham & Women's Hospital; University of Alberta; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI); MedStar Washington Hospital Center; University of Toronto; University Health Network Toronto; Toronto General Hospital; University of California System; University of California San Diego RP Bohula, EA (通讯作者),TIMI Study Grp, 350 Longwood Ave,First Off Floor, Boston, MA 02115 USA.; Bohula, EA (通讯作者),Brigham & Womens Hosp, Cardiovasc Div, 350 Longwood Ave,First Off Floor, Boston, MA 02115 USA. EM ebohula@bwh.harvard.edu RI Hollenberg, Steven/AAR-4522-2020; Barnett, Christopher/AAD-9872-2022; Bohula, Erin/AAW-7276-2020; Menon, Venu/AAF-1871-2019; Daniels, Lori/AAR-2641-2021 OI Hollenberg, Steven/0000-0003-1293-8496; Barnett, Christopher/0000-0003-1095-5794; Morrow, David/0000-0002-9589-5382; Roswell, Robert/0000-0003-4358-6534; Daniels, Lori/0000-0002-4841-9922; Solomon, Michael/0000-0001-7400-6614 CR Alviar CL, 2018, J AM COLL CARDIOL, V72, P1532, DOI 10.1016/j.jacc.2018.06.074 Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Bonnefoy-Cudraz E, 2018, EUR HEART J-ACUTE CA, V7, P80, DOI 10.1177/2048872617724269 Ferreira FL, 2001, JAMA-J AM MED ASSOC, V286, P1754, DOI 10.1001/jama.286.14.1754 Holland EM, 2017, J AM COLL CARDIOL, V69, P1999, DOI 10.1016/j.jacc.2017.02.033 Katz JN, 2016, J AM COLL CARDIOL, V68, P67, DOI 10.1016/j.jacc.2016.04.036 Katz JN, 2010, CRIT CARE MED, V38, P375, DOI 10.1097/CCM.0b013e3181cb0a63 KILLIP T, 1967, AM J CARDIOL, V20, P457, DOI 10.1016/0002-9149(67)90023-9 Morrow DA, 2012, CIRCULATION, V126, P1408, DOI 10.1161/CIR.0b013e31826890b0 O'Gara PT, 2015, J AM COLL CARDIOL, V65, P1877, DOI 10.1016/j.jacc.2015.03.027 O'Malley RG, 2013, EUR HEART J-ACUTE CA, V2, P3, DOI 10.1177/2048872612472063 Ratcliffe JA, 2014, CORONARY ARTERY DIS, V25, P60, DOI 10.1097/MCA.0000000000000043 Sinha SS, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.117.003616 van Diepen S, 2018, AM HEART J, V202, P84, DOI 10.1016/j.ahj.2018.05.003 van Diepen S, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.117.003864 van Diepen S, 2015, CRIT CARE MED, V43, P128, DOI 10.1097/CCM.0000000000000609 Vincent JL, 1998, CRIT CARE MED, V26, P1793, DOI 10.1097/00003246-199811000-00016 Watson RA, EUR HEART J ACUTE CA Wong GC, 2017, CAN J CARDIOL, V33, P1, DOI 10.1016/j.cjca.2016.10.021 NR 19 TC 83 Z9 83 U1 1 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 2380-6583 EI 2380-6591 J9 JAMA CARDIOL JI JAMA Cardiol. PD SEP PY 2019 VL 4 IS 9 BP 928 EP 935 DI 10.1001/jamacardio.2019.2467 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JC5OG UT WOS:000489332200017 PM 31339509 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Gualandro, DM Puelacher, C Mueller, C AF Gualandro, Danielle M. Puelacher, Christian Mueller, Christian TI High-sensitivity cardiac troponin in acute conditions SO CURRENT OPINION IN CRITICAL CARE LA English DT Review DE high-sensitivity cardiac troponin; mortality; myocardial infarction; noncardiac surgery; severe sepsis ID ACUTE MYOCARDIAL-INFARCTION; VASCULAR-SURGERY PATIENTS; ACUTE CORONARY SYNDROMES; CRITICALLY-ILL PATIENTS; NONCARDIAC SURGERY; SEPTIC SHOCK; PROGNOSTIC VALUE; HEART-FAILURE; T ASSAY; ARTERY-DISEASE AB Purpose of review We aim to help clinicians to use and interpret high-sensitivity cardiac troponins (cTns) in different acute care settings. This guidance is timely and relevant as high-sensitivity cTns are currently replacing conventional cTn assays in most parts of the world. Recent findings cTn I and T are structural proteins unique to the heart. Detection of cTn in peripheral blood indicates cardiomyocyte injury. Although acute myocardial infarction is a very common, dangerous, but treatable and therefore clinically important cause of cardiomyocyte injury, multiple other acute conditions are associated with substantial amounts of cardiomyocyte injury and corresponding elevations in cTn. These include acute heart failure, tachyarrhythmias, pulmonary embolism, sepsis, shock, and noncardiac surgery. Recent advances in assay technology have led to more sensitive and precise cTn assays that now allow the detection and exact quantification of cardiomyocyte injury also in many predominately noncardiac acute conditions. Summary In all of these, elevated levels of high-sensitivity cTn are associated with increased mortality risk. In some of these, concepts are evolving as to how the pathophysiological signal of cardiomyocyte injury could be used to alter patient management and potentially improve outcomes. C1 [Gualandro, Danielle M.] Univ Sao Paulo, Sch Med, Dept Cardiol, Heart Inst InCor, Sao Paulo, Brazil. [Puelacher, Christian; Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland. [Puelacher, Christian; Mueller, Christian] Univ Basel Hosp, CRIB, CH-4031 Basel, Switzerland. C3 Universidade de Sao Paulo; University of Basel; University of Basel RP Mueller, C (通讯作者),Univ Basel Hosp, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland. EM chmueller@uhbs.ch RI Müller, Christian/AAB-4783-2022; Gualandro, Danielle M/G-8386-2012 OI Müller, Christian/0000-0002-1120-6405; Gualandro, Danielle M/0000-0001-9041-6250 FU Swiss National Science Foundation; Swiss Heart Foundation; Cardiovascular Research Foundation Basel; 8sense; Abbott; ALERE; Beckman Coulter; Brahms; Critical Diagnostics; Nanosphere; Roche; Siemens; University Hospital Basel FX Disclosures: Professor Mueller has received research grants from the Swiss National Science Foundation and the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, 8sense, Abbott, ALERE, Beckman Coulter, Brahms, Critical Diagnostics, Nanosphere, Roche, Siemens, and the University Hospital Basel, as well as speaker/consulting honoraria from Abbott, ALERE, Astra Zeneca, Brahms, Cardiorentis, BG Medicine, Biomerieux, Lilly, Novartis, Pfizer, Roche, and Siemens. 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Opin. Crit. Care PD OCT PY 2014 VL 20 IS 5 BP 472 EP 477 DI 10.1097/MCC.0000000000000132 PG 6 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AP1OB UT WOS:000341839100002 PM 25159476 DA 2023-05-13 ER PT J AU Rubbo, B Fitzpatrick, NK Denaxas, S Daskalopoulou, M Yu, N Patel, RS Hemingway, H AF Rubbo, Bruna Fitzpatrick, Natalie K. Denaxas, Spiros Daskalopoulou, Marina Yu, Ning Patel, Riyaz S. Hemingway, Harry CA UK Biobank Follow-Up Outcomes TI Use of electronic health records to ascertain, validate and phenotype acute myocardial infarction: A systematic review and recommendations SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Review DE Electronic health records; Myocardial infarction; Acute coronary syndrome; Validation studies; Phenotype; Clinical coding ID INTERNATIONAL-CLASSIFICATION; HOSPITAL MORTALITY; CASE DEFINITIONS; DISEASE; EPIDEMIOLOGY; CHALLENGES; DEATHS; TRENDS; MONICA; CODES AB Electronic health records (EHRs) offer the opportunity to ascertain clinical outcomes at large scale and low cost, thus facilitating cohort studies, quality of care research and clinical trials. For acute myocardial infarction (AMI) the extent to which different EHR sources are accessible and accurate remains uncertain. Using MEDLINE and EMBASE we identified thirty three studies, reporting a total of 128658 patients, published between January 2000 and July 2014 that permitted assessment of the validity of AMI diagnosis drawn from EHR sources against a reference such as manual chart review. In contrast to clinical practice, only one study used EHR-derived markers of myocardial necrosis to identify possible AMI cases, none used electrocardiogram findings and one used symptoms in the form of free text combined with coded diagnosis. The remaining studies relied mostly on coded diagnosis. Thirty one studies reported positive predictive value (PPV) >= 70% between AMI diagnosis from both secondary care and primary care EHRs and the reference. Among fifteen studies reporting EHR-derived AMI phenotypes, three cross-referenced ST-segment elevation AMI diagnosis (PPV range 71-100%), two non-ST-segment elevation AMI (PPV 91.0, 92.1%), three non-fatal AMI (PPV range 82-92.2%) and six fatal AMI (PPV range 64-91.7%). Clinical coding of EHR-derived AMI diagnosis in primary care and secondary care was found to be accurate in different clinical settings and for different phenotypes. However, markers of myocardial necrosis, ECG and symptoms, the cornerstones of a clinical diagnosis, are underutilised and remain a challenge to retrieve from EHRs. (C) 2015 The Authors. Published by Elsevier Ireland Ltd. C1 [Rubbo, Bruna; Fitzpatrick, Natalie K.; Denaxas, Spiros; Yu, Ning; Patel, Riyaz S.; Hemingway, Harry] UCL, Farr Inst Hlth Informat Res, London NW1 2DA, England. [Daskalopoulou, Marina] Royal Free Hosp NHS Trust, Dept Infect & Populat Hlth, London, England. [Patel, Riyaz S.] Univ Coll London NHS Trust, Heart Hosp, London, England. C3 RLUK- Research Libraries UK; University of London; University College London; RLUK- Research Libraries UK; University of London; University College London; RLUK- Research Libraries UK; University of London; University College London; University College London Hospitals NHS Foundation Trust RP Rubbo, B (通讯作者),UCL, Farr Inst Hlth Informat Res, 222 Euston Rd, London NW1 2DA, England. EM b.rubbo@ucl.ac.uk RI Atkinson, Mark/K-1813-2013; Hemingway, Harry/C-1219-2009 OI Atkinson, Mark/0000-0003-4237-3588; Daskalopoulou, Marina/0000-0001-9927-0358; Lyons, Ronan/0000-0001-5225-000X; Brayne, Carol/0000-0001-5307-663X; Brophy, Sinead/0000-0001-7417-2858; Denaxas, Spiros/0000-0001-9612-7791; Sudlow, Cathie/0000-0002-7725-7520; Rubbo, Bruna/0000-0002-1629-8601; Hemingway, Harry/0000-0003-2279-0624 FU British Heart Foundation [FS/14/76/30933, RG/08/014/24067] Funding Source: researchfish; Economic and Social Research Council [ES/L007517/1] Funding Source: researchfish; Medical Research Council [MR/L003120/1, MR/K006584/1, MC_U137686860, MR/K006525/1] Funding Source: researchfish; National Institute for Health Research [CL-2011-11-003, NF-SI-0512-10165] Funding Source: researchfish; ESRC [ES/L007517/1] Funding Source: UKRI; MRC [MR/K006525/1, MR/L003120/1, MC_U137686860] Funding Source: UKRI CR Abraham M., 2010, CPT 2011 STANDARD ED Alpert JS, 2001, J AM COLL CARDIOL, V37, P973 [Anonymous], 1995, J Clin Epidemiol, V48, P1441 Barchielli A, 2012, J EPIDEMIOL COMMUN H, V66, P462, DOI 10.1136/jech.2010.110908 Blumenthal D, 2010, NEW ENGL J MED, V362, P382, DOI 10.1056/NEJMp0912825 Chung SC, 2014, LANCET, V383, P1305, DOI 10.1016/S0140-6736(13)62070-X Coloma PM, 2013, BMJ OPEN, V3, DOI 10.1136/bmjopen-2013-002862 Denny JC, 2010, BIOINFORMATICS, V26, P1205, DOI 10.1093/bioinformatics/btq126 Dugas M, 2009, J AM MED INFORM ASSN, V16, P400, DOI 10.1197/jamia.M2882 Fetter RB, 1980, MED CARE, V18, DOI DOI 10.1371/JOURNAL.PONE.0152669 Ford I, 2007, NEW ENGL J MED, V357, P1477, DOI 10.1056/NEJMoa065994 French JK, 2004, HEART, V90, P99, DOI 10.1136/heart.90.1.99 Friedman DJ, 2013, AM J PUBLIC HEALTH, V103, P1560, DOI 10.2105/AJPH.2013.301220 Frobert O, 2013, NEW ENGL J MED, V369, P1587, DOI 10.1056/NEJMoa1308789 Gronski Lisa, 2012, Crit Pathw Cardiol, V11, P74, DOI 10.1097/HPC.0b013e31824c0459 Heriot GS, 2010, INTERN MED J, V40, P626, DOI 10.1111/j.1445-5994.2009.01985.x Herrett E., 2013, BMJ, V346 HofmansOkkes IM, 1996, FAM PRACT, V13, P294, DOI 10.1093/fampra/13.3.294 Hripcsak G, 2013, J AM MED INFORM ASSN, V20, P117, DOI 10.1136/amiajnl-2012-001145 HSIA DC, 1988, NEW ENGL J MED, V318, P352, DOI 10.1056/NEJM198802113180604 Julious SA, 2005, STAT MED, V24, P3383, DOI 10.1002/sim.2164 Kristoffersen DT, 2012, BMC HEALTH SERV RES, V12, DOI 10.1186/1472-6963-12-364 Krumholz HM, 2000, CIRCULATION, V101, P1483 Liberati A, 2009, BMJ-BRIT MED J, V339, DOI [10.1371/journal.pmed.1000097, 10.1136/bmj.b2700, 10.1136/bmj.b4037, 10.7326/0003-4819-151-4-200908180-00136] Luepker RV, 2003, CIRCULATION, V108, P2543, DOI 10.1161/01.CIR.0000100560.46946.EA Luo AK, 2007, J MED GENET, V44, P161, DOI 10.1136/jmg.2006.045732 McCormick N, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0092286 Metcalfe A, 2013, HEALTH SERV RES, V48, P290, DOI 10.1111/j.1475-6773.2012.01440.x Newcombe RG, 1998, STAT MED, V17, P857, DOI 10.1002/(SICI)1097-0258(19980430)17:8<857::AID-SIM777>3.0.CO;2-E Newton KM, 2013, J AM MED INFORM ASSN, V20, pE147, DOI 10.1136/amiajnl-2012-000896 ONEIL M, 1995, METHOD INFORM MED, V34, P187 Pagidipati NJ, 2013, CIRCULATION, V127, P749, DOI 10.1161/CIRCULATIONAHA.112.128413 Pathak J, 2013, J AM MED INFORM ASSN, V20, pE206, DOI 10.1136/amiajnl-2013-002428 Psaty BM, 2009, CIRC-CARDIOVASC GENE, V2, P73, DOI 10.1161/CIRCGENETICS.108.829747 Rapsomaniki E., 2014, P EUR SOC CARD C LAT Rapsomaniki E, 2014, LANCET, V383, P1899, DOI 10.1016/S0140-6736(14)60685-1 Ritchie MD, 2013, CIRCULATION, V127, P1377, DOI 10.1161/CIRCULATIONAHA.112.000604 Roger VL, 2002, J CLIN EPIDEMIOL, V55, P593, DOI 10.1016/S0895-4356(02)00390-6 Sapsford RJ, 2003, QJM-INT J MED, V96, P203, DOI 10.1093/qjmed/hcg030 Sedlak T, 2013, ANN NONINVAS ELECTRO, V18, P389, DOI 10.1111/anec.12050 SLEE VN, 1978, ANN INTERN MED, V88, P424, DOI 10.7326/0003-4819-88-3-424 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Stroup DF, 2000, JAMA-J AM MED ASSOC, V283, P2008, DOI 10.1001/jama.283.15.2008 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 TUNSTALLPEDOE H, 1994, CIRCULATION, V90, P583, DOI 10.1161/01.CIR.90.1.583 Ward JA, 2013, CIRCULATION, V128 Weber GM, 2014, JAMA-J AM MED ASSOC, V311, P2479, DOI 10.1001/jama.2014.4228 Yeh RW, 2010, NEW ENGL J MED, V362, P2155, DOI 10.1056/NEJMoa0908610 NR 48 TC 40 Z9 40 U1 0 U2 25 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD MAY 6 PY 2015 VL 187 BP 705 EP 711 DI 10.1016/j.ijcard.2015.03.075 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA CI6WT UT WOS:000354905600185 PM 25966015 OA hybrid DA 2023-05-13 ER PT J AU Coll, PP Roche, V Olsen, JS Voit, JH Bowen, E Kumar, M AF Coll, Patrick P. Roche, Vivyenne Olsen, Jaclyn S. Voit, Jessica H. Bowen, Emily Kumar, Manish TI The Prevention of Cardiovascular Disease in Older Adults SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Review DE cardiovascular disease; older; prevention ID PERIPHERAL ARTERIAL-DISEASE; ASSOCIATION TASK-FORCE; ELEVATION MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; 2013 ACCF/AHA GUIDELINE; ISCHEMIC-HEART-DISEASE; BYPASS GRAFT-SURGERY; AMERICAN-COLLEGE; PHYSICAL-ACTIVITY; STATIN THERAPY AB Cardiovascular disease (CVD) is common in older adults. CVD is a significant cause of both death and disability in old age. Though the prevention and treatment of CVD have been extensively studied, historically older adults and especially those older than 75 years have been underrepresented in clinical investigations designed to determine the best way to prevent or treat CVD. As a result, geriatrics clinicians frequently need to decide which interventions to recommend for their patients by extrapolation from existing data, which may or may not be applicable to the patients they are caring for. This narrative review summarizes existing data regarding the prevention of three common CVDs in older adults: stroke, coronary artery disease, and peripheral artery disease. Special emphasis is given to the prevention of CVD in those aged 75 years or older. C1 [Coll, Patrick P.] Univ Connecticut Hlth Ctr, Dept Family Med, Farmington, CT USA. [Coll, Patrick P.; Olsen, Jaclyn S.; Kumar, Manish] Univ Connecticut Hlth Ctr, Ctr Aging, Farmington, CT USA. [Roche, Vivyenne; Voit, Jessica H.; Bowen, Emily] UT Southwestern Med Ctr, Dept Internal Med, Div Geriatr, Dallas, TX USA. C3 University of Connecticut; University of Connecticut; University of Texas System; University of Texas Southwestern Medical Center Dallas RP Coll, PP (通讯作者),263 Farmington Ave, Farmington, CT 06030 USA. 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PD MAY PY 2020 VL 68 IS 5 BP 1098 EP 1106 DI 10.1111/jgs.16353 EA FEB 2020 PG 9 WC Geriatrics & Gerontology; Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA LO3QF UT WOS:000511501600001 PM 32031247 DA 2023-05-13 ER PT J AU Esmonde, S Sharma, D Peace, A AF Esmonde, Sean Sharma, Divyesh Peace, Aaron TI Antiplatelet agents in uncertain clinical scenarios - a bleeding nightmare SO CARDIOVASCULAR DIAGNOSIS AND THERAPY LA English DT Review DE Antiplatelet; dual antiplatelet therapy (DAPT); bleeding; elderly; anticoagulation ID PERCUTANEOUS CORONARY INTERVENTION; DRUG-ELUTING STENTS; NONVALVULAR ATRIAL-FIBRILLATION; RESEARCH CONSORTIUM DEFINITION; TRIPLE ANTITHROMBOTIC THERAPY; INDIVIDUAL PARTICIPANT DATA; CARDIOLOGY WORKING GROUP; LONG-TERM MORTALITY; ARTERY-DISEASE; PLATELET REACTIVITY AB Despite over 40 years since the first percutaneous coronary intervention (PCI) was performed, the optimal dual antiplatelet therapy (DAPT) regime poses a significant challenge for clinicians, especially in certain scenarios. DAPT is the standard of care in PCI following an acute coronary syndrome (ACS) or for elective patients with obstructive coronary artery disease (CAD). There remains significant uncertainty regarding DAPT in patients at high risk of bleeding, such as the elderly and patients requiring anticoagulation. More and more clinicians are faced with a dilemma of weighing risks and benefits from the increasing list of potent, new antiplatelet agents and direct oral anticoagulants (DOACs) in a growing, aging population. Historically, most studies failed to recognize bleeding risk, instead focusing on ischemic risk. In recent years however, bleeding has been recognized as a very significant driver of morbidity and mortality in patients undergoing PCI. There is a paucity of data in this cohort leading to divergent and sometimes conflicting recommendations, largely based on expert consensus of opinion. In the current review, we critically evaluate the available evidence in these uncertain scenarios. C1 [Esmonde, Sean; Sharma, Divyesh; Peace, Aaron] Western Hlth & Social Care Trust, Altnagelvin Area Hosp, Dept Cardiol, Derry Londonderry, North Ireland. [Peace, Aaron] Ulster Univ, Northern Ireland Ctr Stratified Med, C TRIC, Derry Londonderry, North Ireland. C3 Ulster University RP Peace, A (通讯作者),Altnagelvin Hosp, Dept Cardiol, Derry Londonderry BT47 6SB, North Ireland. 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Diagn. Ther. PD OCT PY 2018 VL 8 IS 5 SI SI BP 647 EP 662 DI 10.21037/cdt.2018.06.09 PG 16 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GY5KO UT WOS:000448614200008 PM 30498688 OA Green Published DA 2023-05-13 ER PT J AU Alexopoulos, D Mpahara, A Kassimis, G AF Alexopoulos, Dimitrios Mpahara, Aikaterini Kassimis, George TI Omitting aspirin in PCI patients: Myth or reality? SO CARDIOVASCULAR DRUGS AND THERAPY LA English DT Review DE Aspirin; Percutaneous coronary intervention; Anticoagulation; Dual antiplatelet therapy ID PERCUTANEOUS CORONARY INTERVENTION; DUAL ANTIPLATELET THERAPY; DRUG-ELUTING STENTS; COLLABORATIVE METAANALYSIS; ANTITHROMBOTIC THERAPY; ATRIAL-FIBRILLATION; CLINICAL-OUTCOMES; P2Y(12) RECEPTOR; CLOPIDOGREL; PLATELET AB In the current era of percutaneous coronary intervention (PCI), with the use of contemporary drug-eluting stents, refined techniques, and adjunctive pharmacotherapy, the role of aspirin peri-PCI remains undisputable. Beyond the initial period, dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y(12) receptor inhibitor for 6 months in stable coronary artery disease and 12 months in acute coronary syndromes is the standard of care. However, concerns regarding bleeding adverse events caused by aspirin have led to shortened DAPT duration or even omission of aspirin. Aspirin free-strategies have been increasingly encountered in several studies and showed a significant reduction in bleeding events, without any sign of increased ischemic risk. Individualization of DAPT duration particularly in high bleeding risk patients appears therefore mandatory, making aspirin not necessary in several cases. Moreover, recent randomized trials have shed light on how to treat PCI patients in the presence of concomitant anticoagulant treatment with P2Y(12) monotherapy and excluding aspirin. These aspirin-free strategies have been proved safer than the "older" standard triple antithrombotic treatment, without compromising safety. Ongoing studies may further dispel the myths and establish real facts regarding post-PCI-tailored treatment with or without aspirin. C1 [Alexopoulos, Dimitrios; Mpahara, Aikaterini] Natl & Kapodistrian Univ Athens, Dept Cardiol 2, Attikon Univ Hosp, Sch Med, Rimini 1, Athens 12462, Greece. [Kassimis, George] Aristotle Univ Thessaloniki, Dept Cardiol 2, Hippokrat Hosp, Sch Med, Thessaloniki, Greece. C3 Athens Medical School; National & Kapodistrian University of Athens; University Hospital Attikon; Aristotle University of Thessaloniki RP Alexopoulos, D (通讯作者),Natl & Kapodistrian Univ Athens, Dept Cardiol 2, Attikon Univ Hosp, Sch Med, Rimini 1, Athens 12462, Greece. 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Drugs Ther. PD DEC PY 2019 VL 33 IS 6 BP 711 EP 724 DI 10.1007/s10557-019-06916-7 PG 14 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA KI7LD UT WOS:000511530400010 PM 31811419 DA 2023-05-13 ER PT J AU Hamilton-Craig, C Fifoot, A Hansena, M Pincus, M Chan, J Walters, DL Branch, KR AF Hamilton-Craig, Christian Fifoot, Allison Hansena, Mark Pincus, Matthew Chan, Jonathan Walters, Darren L. Branch, Kelley R. TI Diagnostic performance and cost of CT angiography versus stress ECG - A randomized prospective study of suspected acute coronary syndrome chest pain in the emergency department (CT-COMPARE) SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Coronary CT; Exercise ECG; Diagnostic performance; Acute coronary syndrome ID COMPUTED TOMOGRAPHIC ANGIOGRAPHY; DECISION-ANALYTIC MODEL; NEW-ZEALAND GUIDELINES; ARTERY-DISEASE; LOW-RISK; TRIAL; INDIVIDUALS; AUSTRALIA; ACCURACY; STANDARD AB Background: Coronary CT angiography (CCTA) has high sensitivity, with 3 recent randomized trials favorably comparing CCTA to standard-of-care. Comparison to exercise stress ECG (ExECG), the most available and least expensive standard-of-care worldwide, has not been systematically tested. Methods: CT-COMPARE was a randomized, single-center trial of low-intermediate risk chest pain subjects undergoing CCTA or ExECG after the first negative troponin. From March 2010 to April 2011, 562 patients randomized to either dual-source CCTA (n = 322) or ExECG (n = 240). Primary endpoints were diagnostic performance for ACS, and hospital cost at 30 days. Secondary endpoints were time-to-discharge, admission rates, and downstream resource utilization. Results: ACS occurred in 24 (4%) patients. ExECG had 213 negative studies and 27 (26%) positive studies for ACS with sensitivity of 83% [95% CI: 36, 99.6%], specificity of 91% [CI: 86, 94%], and ROC AUC of 0.87 [CI: 0.70, 1]. CCTA (>50% stenosis considered positive) had 288 negative studies and 18/35 (51%) positive studies with a sensitivity of 100% [CI: 81.5, 100], specificity of 94% [CI: 91.2, 96.7%], and ROC of 0.97 [CI: 0.92, 1.0; p = 0.2]. Despite CCTA having higher odds of downstream testing (OR 2.0), 30 day per-patient cost was significantly lower for CCTA ($2193 vs $2704, p < 0.001). Length of stay for CCTA was significantly reduced (13.5 h [95% CI: 11.2-15.7], ExECG 19.7 h [95% CI: 17.4-22.1], p < 0.0005), which drove the reduction in cost. No patient had post-discharge cardiovascular events at 30 days. Conclusions: CCTA had improved diagnostic performance compared to ExECG, combined with 35% relative reduction in length-of-stay, and 20% reduction in hospital costs. These data lend further evidence that CCTA is useful as a first line assessment in emergency department chest pain. (C) 2014 The Authors. Published by Elsevier Ireland Ltd. C1 [Hamilton-Craig, Christian; Fifoot, Allison; Hansena, Mark; Pincus, Matthew; Chan, Jonathan; Walters, Darren L.] Prince Charles Hosp, Heart & Lung Inst, Brisbane, Qld, Australia. [Hamilton-Craig, Christian; Walters, Darren L.] Univ Queensland, Brisbane, Qld, Australia. [Chan, Jonathan] Griffith Univ, Populat & Social Hlth Res Program, Nathan, Qld 4111, Australia. [Hamilton-Craig, Christian; Branch, Kelley R.] Univ Washington, Seattle, WA 98195 USA. C3 Prince Charles Hospital; University of Queensland; Griffith University; University of Washington; University of Washington Seattle RP Hamilton-Craig, C (通讯作者),Prince Charles Hosp, Heart & Lung Inst, Brisbane, Qld, Australia. RI Walters, Darren L/A-7069-2011; Hamilton-Craig, Christian/E-8225-2010 OI Chan, Jonathan/0000-0002-3224-5753; Hamilton-Craig, Christian/0000-0001-7702-7234; Branch, Kelley/0000-0003-2362-6498 FU Queensland Emergency Medicine Research Foundation [QEMRF-EMSS-2009-022]; Smart Futures Fellowship Early Career Grant (Queensland State Government) [ISF783]; Washington-Queensland Trans-Pacific Fellowship fund; National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) [5KL2RR025015-02]; NIH Roadmap for Medical Research FX The study was supported by grants from 1) the Queensland Emergency Medicine Research Foundation (#QEMRF-EMSS-2009-022), 2) the Smart Futures Fellowship Early Career Grant (Queensland State Government #ISF783), 3) the Washington-Queensland Trans-Pacific Fellowship fund and 4) Grant Number 5KL2RR025015-02 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. The grant bodies had no input on study design, data analysis or writing. 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J. Cardiol. PD DEC 20 PY 2014 VL 177 IS 3 BP 867 EP 873 DI 10.1016/j.ijcard.2014.10.090 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AU6EX UT WOS:000345697200060 PM 25466568 DA 2023-05-13 ER PT J AU Smulyan, H Pinals, RS Pinals, L Villarreal, D AF Smulyan, Harold Pinals, Robert S. Pinals, Lisa Villarreal, Daniel TI Wireless: The Life and Death of Guglielmo Marconi SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article DE Radio; Heart disease; Italian Cardiology AB With little training in physics, Guglielmo Marconi developed the invention that stunned the world by wirelessly connecting ships and continents. Ten years before his death, he sustained a myocardial infarction followed by unmistakable angina pectoris. His personality and unhappy family life limited his ability to cope with his disease and to deal with Italy's most respected physicians. But their descriptions of his diagnosis and management are surprisingly few. Poor record keeping, intentional news suppression of his failing health or limited medical opportunities could be the reason for this lack of information. He died in 1937 when the value of electrocardiograms and X-rays were recognized (he had neither), but therapeutic options were severely limited. To gain insight into his care, we compared contemporary Italian understanding of coronary heart disease to British and American teachings. When he died of an acute coronary syndrome, heart failure and dysrhythmias, he was attended only by medical staff, but by none of his large family. C1 [Smulyan, Harold; Villarreal, Daniel] SUNY Upstate Med Univ, 90 Presidential Plaza, Syracuse, NY 13208 USA. [Pinals, Robert S.] Rutgers State Univ, Robert Wood Johnson Med Sch, New Brunswick, NJ USA. [Pinals, Lisa] Tufts Univ, Dept Elect & Comp Engn, Medford, MA 02155 USA. C3 State University of New York (SUNY) System; State University of New York (SUNY) Upstate Medical Center; Rutgers State University New Brunswick; Rutgers State University Medical Center; Tufts University RP Smulyan, H (通讯作者),SUNY Upstate Med Univ, 90 Presidential Plaza, Syracuse, NY 13208 USA. EM smulyanh@upstate.edu CR [Anonymous], 1936, TIMES, P1 Berti GB, 1998, FRUGONI CESARE DIZON, V50 Frugoni C., 1934, LEZIONID CLIN MED Frugoni C., 1974, RICORDI E INCONTRI Marconi D., 1962, MY FATHER Osler WS, 1935, PRINCIPLES PRACTICE Pozzi A., 1947, COME LI HO VISITI LO Rl Cecil, 1937, TXB MED Sarkar TK, 2006, HISTORY OF WIRELESS, P1, DOI 10.1002/0471783021 Weightman Gavin, 2003, SIGNOR MARCONIS MAGI NR 10 TC 0 Z9 0 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9629 EI 1538-2990 J9 AM J MED SCI JI Am. J. Med. Sci. PD JUN PY 2017 VL 353 IS 6 BP 511 EP 515 DI 10.1016/j.amjms.2016.12.022 PG 5 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA EY1YK UT WOS:000403764200006 PM 28641712 DA 2023-05-13 ER PT J AU Mehta, S Botelho, R Rodriguez, D Fernandez, FJ Ossa, MM Zhang, T Kostela, JC Reynbakh, O Falcao, B Velasquez, AH Oliveros, E Pena, C AF Mehta, Sameer Botelho, Roberto Rodriguez, Daniel Fernandez, Francisco J. Ossa, Maria M. Zhang, Tracy Kostela, Jennifer C. Reynbakh, Olga Falcao, Breno Velasquez, Alicia Henao Oliveros, Estefania Pena, Camilo TI A Tale of Two Cities: STEMI Interventions in Developed and Developing Countries and the Potential of Telemedicine to Reduce Disparities in Care SO JOURNAL OF INTERVENTIONAL CARDIOLOGY LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; 12-LEAD ELECTROCARDIOGRAM; TREATMENT DELAY; TIME; SYSTEMS; THROMBOLYSIS; MANAGEMENT; MORTALITY; AMBULANCE AB Objectives: To utilize telemedicine as a foundation platform for creating population-based STEMI networks. Background: Disparate acute myocardial infarction (AMI) management occurs in developed and developing countries on account of differences in infrastructure resources. As a result, developed countries utilize primary percutaneous coronary intervention (PCI) and second- and third-generation thrombolytic therapy, in contrast to developing countries, which primarily rely on earlier-generation thrombolytic therapy and basic medical management. Reducing the vast gap in AMI care between developed and developing countries is an abysmally slow process. Methods: Remote access, telemedicine IT platforms, expert EKG interpretation, teleconsultation, and a strict quality assurance process are incorporated into a population-based AMI network. Results: Lumen Americas Telemedicine Infarct Network (LATIN) is an applied hub-and-spoke strategy, which creates a telemedicine-based STEMI management network across large populations. Primary PCI with targeted door-to-balloon times is the preferred strategy for the hub sites. Telemedicine-guided accurate EKG interpretation and teleconsultation are applied at the spoke sites. An integrated IT platform is used to navigate an effective prehospital triage system. The pilot phase has created 100 LATIN sites in Brazil and Colombia. Conclusion: Telemedicine provides an attractive strategy to reduce the gaps that presently exist in managing AMI in developed and developing countries. (J Interven Cardiol 2014;27:155-166) C1 [Mehta, Sameer; Ossa, Maria M.; Zhang, Tracy; Velasquez, Alicia Henao] Univ Miami, Miller Sch Med, Miami, FL 33136 USA. [Mehta, Sameer; Ossa, Maria M.; Zhang, Tracy] Lumen Fdn, Miami, FL USA. [Botelho, Roberto] Lumen Fdn, Uberlandia, MG, Brazil. [Rodriguez, Daniel] Lumen Fdn, Medellin, Colombia. [Fernandez, Francisco J.; Falcao, Breno] Lumen Fdn, Sao Paulo, Brazil. [Kostela, Jennifer C.] Lumen Fdn, Queens, NY USA. [Reynbakh, Olga] Lumen Fdn, Moscow, Russia. [Oliveros, Estefania] Lumen Fdn, Philadelphia, PA USA. [Pena, Camilo] Lumen Fdn, San Antonio, TX USA. C3 University of Miami RP Mehta, S (通讯作者),185 Shore Dr South, Miami, FL 33133 USA. EM sameer.lumenglobal@gmail.com RI Falcão, Breno/AAN-1248-2020 OI Falcão, Breno/0000-0003-4228-3451; Rodriguez, Daniel/0000-0002-5989-602X CR Adams RJ, 2004, CIRCULATION, V110, P2512, DOI 10.1161/01.CIR.0000134791.68010.FA Amit G, 2007, INT J CARDIOL, V119, P355, DOI 10.1016/j.ijcard.2006.08.009 Antman EM, 2008, CIRCULATION, V117, P296, DOI 10.1161/CIRCULATIONAHA.107.188209 Ayrik C, 2006, ADV THER, V23, P244, DOI 10.1007/BF02850130 Bhatt DL, 2013, NEW ENGL J MED, V368, P1446, DOI 10.1056/NEJMe1302670 Brown JP, 2008, AM J CARDIOL, V101, P158, DOI 10.1016/j.amjcard.2007.07.082 Brunetti ND, 2011, TELEMED E-HEALTH, V17, P727, DOI 10.1089/tmj.2011.0053 Brunetti ND, 2010, EUR J CARDIOV PREV R, V17, P615, DOI 10.1097/HJR.0b013e328331f9e5 Clemmensen P, 2010, J ELECTROCARDIOL, V43, P615, DOI 10.1016/j.jelectrocard.2010.06.012 Solla DJF, 2013, CIRC-CARDIOVASC QUAL, V6, P9, DOI 10.1161/CIRCOUTCOMES.112.967505 Gershlick AH, 2005, NEW ENGL J MED, V353, P2758, DOI 10.1056/NEJMoa050849 Hailey David, 2004, J Telemed Telecare, V10 Suppl 1, P36, DOI 10.1258/1357633042614195 Henry TD, 2006, J AM COLL CARDIOL, V47, P1339, DOI 10.1016/j.jacc.2005.05.101 Herlitz J, 2010, INT J CARDIOL, V141, P236, DOI 10.1016/j.ijcard.2008.11.176 Ilczak T, 2012, COMM COM INF SC, V329, P87 Ingarfield Sharyn L, 2005, Emerg Med Australas, V17, P218 Le May MR, 2003, CIRCULATION, V108, P2624, DOI 10.1161/01.CIR.0000097120.26062.FE McCabe JM, 2012, ARCH INTERN MED, V172, P864, DOI 10.1001/archinternmed.2012.945 Mehta Sameer, 2012, Interv Cardiol Clin, V1, P479, DOI 10.1016/j.iccl.2012.06.001 Morrison LJ, 2000, JAMA-J AM MED ASSOC, V283, P2686, DOI 10.1001/jama.283.20.2686 Pan American Health Organization, 2009, BAS IND BROWS IND CO Pan American Health Organization/World Health Organization, 2012, HLTH INF AN HLTH SIT Rokos IC, 2006, AM HEART J, V152, P661, DOI 10.1016/j.ahj.2006.06.001 Schoos MM, 2012, EUR HEART J-ACUTE CA, V1, P200, DOI 10.1177/2048872612455143 Sejersten M, 2008, AM J CARDIOL, V101, P941, DOI 10.1016/j.amjcard.2007.11.038 Steg PG, 2006, HEART, V92, P1378, DOI 10.1136/hrt.2006.101972 Terkelsen CJ, 2005, EUR HEART J, V26, P770, DOI 10.1093/eurheartj/ehi100 Thuresson M, 2008, AM HEART J, V156, P170, DOI 10.1016/j.ahj.2008.01.020 Ting HH, 2008, CIRCULATION, V118, P1066, DOI 10.1161/CIRCULATIONAHA.108.190402 Ting HH, 2007, CIRCULATION, V116, P729, DOI 10.1161/CIRCULATIONAHA.107.699934 Welsh RC, 2012, J THROMB THROMBOLYS, V34, P126, DOI 10.1007/s11239-012-0697-7 NR 31 TC 7 Z9 7 U1 0 U2 9 PU WILEY-HINDAWI PI LONDON PA ADAM HOUSE, 3RD FL, 1 FITZROY SQ, LONDON, WIT 5HE, ENGLAND SN 0896-4327 EI 1540-8183 J9 J INTERV CARDIOL JI J. Interv. Cardiol. PD APR PY 2014 VL 27 IS 2 BP 155 EP 166 DI 10.1111/joic.12117 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AE1UA UT WOS:000333754500009 PM 24697949 DA 2023-05-13 ER PT J AU Ashburn, NP Snavely, AC Allen, BR Christenson, RH Herrington, DM Hiestand, BC Miller, CD Stopyra, JP Mahler, SA AF Ashburn, Nicklaus P. Snavely, Anna C. Allen, Brandon R. Christenson, Robert H. Herrington, David M. Hiestand, Brian C. Miller, Chadwick D. Stopyra, Jason P. Mahler, Simon A. TI Monocyte chemoattractant protein-1 is not predictive of cardiac events in patients with non-low-risk chest pain SO EMERGENCY MEDICINE JOURNAL LA English DT Article DE cardiac care; acute coronary syndrome; acute myocardial infarct; diagnosis; chest ID EMERGENCY-DEPARTMENT PATIENTS; ACCELERATED DIAGNOSTIC PATHWAYS; ACUTE CORONARY SYNDROMES; PLASMA-LEVELS; ATHEROSCLEROSIS; ASSOCIATION; MULTICENTER; PERFORMANCE; VALIDATION; GUIDELINES AB Background Prior studies suggest monocyte chemoattractant protein-1 (MCP-1) may be useful for risk stratifying ED patients with chest pain. We hypothesise that MCP-1 will be predictive of 90-day major adverse cardiovascular events (MACEs) in non-low-risk patients. Methods A case-control study was nested within a prospective multicentre cohort (STOP-CP), which enrolled adult patients being evaluated for acute coronary syndrome at eight US EDs from 25 January 2017 to 06 September 2018. Patients with a History, ECG, Age, and Risk factor score (HEAR score) >= 4 or coronary artery disease (CAD), a non-ischaemic ECG, and non-elevated contemporary troponins at 0 and 3 hours were included. Cases were patients with 90-day MACE (all-cause death, myocardial infarction or revascularisation). Controls were patients without MACE selected with frequency matching using age, sex, race, and HEAR score or the presence of CAD. Serum MCP-1 was measured. Sensitivity and specificity were determined for cut-off points of 194 pg/mL, 200 pg/mL, 238 pg/mL and 281 pg/mL. Logistic regression adjusting for age, sex, race, and HEAR score/presence of CAD was used to determine the association between MCP-1 and 90-day MACE. A separate logistic model also included high-sensitivity troponin (hs-cTnT). Results Among 40 cases and 179 controls, there was no difference in age (p=0.90), sex (p=1.00), race (p=0.85), or HEAR score/presence of CAD (p=0.89). MCP-1 was similar in cases (median 191.9 pg/mL, IQR: 161.8-260.1) and controls (median 196.6 pg/mL, IQR: 163.0-261.1) (p=0.48). At a cut-off point of 194 pg/mL, MCP-1 was 50.0% (95% CI 33.8% to 66.2%) sensitive and 46.9% (95% CI 39.4% to 54.5%) specific for 90-day MACE. After adjusting for covariates, MCP-1 was not associated with 90-day MACE at any cut-off point (at 194 pg/mL, OR 0.88 (95% CI 0.43 to 1.79)). When including hs-cTnT in the model, MCP-1 was not associated with 90-day MACE at any cut-off point (at 194 pg/mL, OR 0.85 (95% CI 0.42 to 1.73)). Conclusion MCP-1 is not predictive of 90-day MACE in patients with non-low-risk chest pain. C1 [Ashburn, Nicklaus P.; Snavely, Anna C.; Hiestand, Brian C.; Miller, Chadwick D.; Stopyra, Jason P.; Mahler, Simon A.] Wake Forest Sch Med, Dept Emergency Med, Winston Salem, NC 27157 USA. [Ashburn, Nicklaus P.; Herrington, David M.] Wake Forest Sch Med, Dept Cardiol, Winston Salem, NC 27157 USA. [Snavely, Anna C.] Wake Forest Sch Med, Dept Biostat & Data Sci, Winston Salem, NC 27157 USA. [Allen, Brandon R.] Univ Florida, Coll Med, Dept Emergency Med, Gainesville, FL USA. [Christenson, Robert H.] Univ Maryland, Sch Med, Dept Pathol, Baltimore, MD 21201 USA. [Mahler, Simon A.] Wake Forest Sch Med, Dept Epidemiol & Prevent & Implementat Sci, Winston Salem, NC 27157 USA. C3 Wake Forest University; Wake Forest University; Wake Forest University; State University System of Florida; University of Florida; University System of Maryland; University of Maryland Baltimore; Wake Forest University RP Ashburn, NP (通讯作者),Wake Forest Sch Med, Dept Emergency Med, Winston Salem, NC 27157 USA. EM N.Ashburn@wakehealth.edu OI Ashburn, Nicklaus/0000-0002-3466-8813 FU Emergency Medicine Foundation - Roche Diagnostics FX This project was funded by the Emergency Medicine Foundation. STOP--CP was funded by Roche Diagnostics. CR Allen BR, 2021, CIRCULATION, V143, P1659, DOI 10.1161/CIRCULATIONAHA.120.049298 [Anonymous], HUMAN CCL2 MCP 1 QUA Body R, 2020, EMERG MED J, V37, P8, DOI 10.1136/emermed-2019-208898 Body R, 2017, EMERG MED J, V34, P349, DOI 10.1136/emermed-2016-205983 Christenson E, 2013, CORONARY ARTERY DIS, V24, P698, DOI 10.1097/MCA.0000000000000047 Christenson RH, 2017, J APPL LAB MED, V1, P544, DOI 10.1373/jalm.2016.022640 de Lemos JA, 2003, CIRCULATION, V107, P690, DOI 10.1161/01.CIR.0000049742.68848.99 de Lemos JA, 2007, J AM COLL CARDIOL, V50, P2117, DOI 10.1016/j.jacc.2007.06.057 Deo R, 2004, J AM COLL CARDIOL, V44, P1812, DOI 10.1016/j.jacc.2004.07.047 Fitzgerald RL, 2019, CLIN CHIM ACTA, V495, P522, DOI 10.1016/j.cca.2019.05.026 Gonzalez-Quesada C, 2009, CURR ATHEROSCLER REP, V11, P131, DOI 10.1007/s11883-009-0021-y Gosling J, 1999, J CLIN INVEST, V103, P773, DOI 10.1172/JCI5624 Greenslade JH, 2018, ANN EMERG MED, V71, P439, DOI 10.1016/j.annemergmed.2017.10.030 Hollander JE, 2004, ANN EMERG MED, V44, P589, DOI 10.1016/j.annemergmed.2004.08.009 Hoogeveen RC, 2005, ATHEROSCLEROSIS, V183, P301, DOI 10.1016/j.atherosclerosis.2005.03.007 Jossi S, 2006, INTERN MED J, V36, P325, DOI 10.1111/j.1445-5994.2006.01073.x Mahler SA, 2018, CIRCULATION, V138, P2456, DOI 10.1161/CIRCULATIONAHA.118.036528 Mahler Simon A, 2018, Crit Pathw Cardiol, V17, P105, DOI 10.1097/HPC.0000000000000140 Mahler SA, 2015, CIRC-CARDIOVASC QUAL, V8, P195, DOI 10.1161/CIRCOUTCOMES.114.001384 Mahler SA, 2013, INT J CARDIOL, V168, P795, DOI 10.1016/j.ijcard.2012.10.010 Mitchell AM, 2006, ACAD EMERG MED, V13, P803, DOI 10.1197/j.aem.2006.03.553 Mitchell AM, 2006, ANN EMERG MED, V47, P438, DOI 10.1016/j.annemergmed.2005.10.013 NELKEN NA, 1991, J CLIN INVEST, V88, P1121, DOI 10.1172/JCI115411 Schecter AD, 1997, J BIOL CHEM, V272, P28568, DOI 10.1074/jbc.272.45.28568 SIMEL DL, 1991, J CLIN EPIDEMIOL, V44, P763, DOI 10.1016/0895-4356(91)90128-V Stopyra J, 2020, HEART, V106, P977, DOI 10.1136/heartjnl-2019-316426 Stopyra JP, 2019, ACAD EMERG MED, V26, P41, DOI 10.1111/acem.13504 Than M, 2014, EMERG MED AUSTRALAS, V26, P34, DOI 10.1111/1742-6723.12164 THYGESEN K, 2018, J AM COLL CARDIOL, V72, P2231, DOI [DOI 10.1016/J.JACC.2018.08.1038, 10.1016/j.jacc.2018.08.1038] von Elm E, 2007, LANCET, V370, P1453, DOI 10.1016/S0140-6736(07)61602-X NR 30 TC 0 Z9 0 U1 0 U2 0 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1472-0205 EI 1472-0213 J9 EMERG MED J JI Emerg. Med. J. PD NOV PY 2022 VL 39 IS 11 BP 853 EP 858 DI 10.1136/emermed-2021-211266 EA DEC 2021 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 5T7XX UT WOS:000733805800001 PM 34933919 OA Green Accepted DA 2023-05-13 ER PT J AU Xu, CB Dong, MY Sun, LZ Deng, YY Zhou, J Yuan, ZY AF Xu, Chenbo Dong, Mengya Sun, Lizhe Deng, Yangyang Zhou, Juan Yuan, Zuyi TI Sex differences in the impact of day/night distribution of ST-segment elevation myocardial infarction onset on in-hospital outcomes: findings from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project SO SLEEP MEDICINE LA English DT Article DE Myocardial infarction; Circadian rhythm; Sex differences; Outcomes ID TIME-OF-DAY; CIRCADIAN VARIATION; RHYTHMS AB Background: Circadian system plays an important role in cardiovascular health. Experimental studies have also identified sex differences in circadian system. We aim to explore the impact of sex on the association between symptom-onset pattern of STEMI and in-hospital adverse outcomes in Chinese population. Methods: Data were used from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project. 18271 STEMI patients undergoing primary percutaneous coronary intervention entered the study, including 14785 (80.9%) men and 3486 (19.1%) women. The outcomes included allcause mortality and a composite of major adverse cardiovascular and cerebrovascular events (MACCE) during hospitalization. Results: Most participants experienced STEMI onset during 06:00 h to noon, and there was no difference in onset pattern between men and women (p 1/4 0.582). Logistic regression showed that, after adjustment for cardiovascular risk factors, symptom onset time was significantly associated with in-hospital mortality in men, but not in women or the total population. The odds ratios (ORs) for male patients were 1.86 (95% CI 1.05 to 3.27) for midnight to 06:00 h, 1.58 (95% CI 0.95 to 2.64) for 06:00 h to noon, and 0.80 (95% CI 0.49 to 1.73) for 18:00 h to midnight as compared with STEMI presenting during noon to 18:00 h. But symptom onset time was not associated with MACCE in both sexes or the entire cohort. Conclusions: These findings show that STEMI onset time was independently associated with in-hospital mortality in male Chinese patients, indicating that sex should be taken into account in studying impact of circadian system on myocardial infarction. (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). C1 [Xu, Chenbo; Sun, Lizhe; Deng, Yangyang; Zhou, Juan; Yuan, Zuyi] Xi An Jiao Tong Univ, Dept Cardiovasc Med, Affiliated Hosp 1, Xian, Shaanxi, Peoples R China. [Dong, Mengya] Shaanxi Prov Peoples Hosp, Dept Cardiovasc Med, Xian, Peoples R China. [Zhou, Juan] Key Lab Mol Cardiol Shaanxi Prov, Xian, Shaanxi, Peoples R China. [Yuan, Zuyi] Xi An Jiao Tong Univ, Key Lab Environm & Genes Related Dis, Minist Educ, Xian, Shaanxi, Peoples R China. [Deng, Yangyang; Zhou, Juan; Yuan, Zuyi] Xi An Jiao Tong Univ, Dept Cardiovasc Med, Affiliated Hosp 1, 277 Yanta West Rd, Xian 710061, Shaanxi, Peoples R China. C3 Xi'an Jiaotong University; Xi'an Medical University; Xi'an Jiaotong University; Xi'an Jiaotong University RP Deng, YY; Zhou, J; Yuan, ZY (通讯作者),Xi An Jiao Tong Univ, Dept Cardiovasc Med, Affiliated Hosp 1, 277 Yanta West Rd, Xian 710061, Shaanxi, Peoples R China. EM yangyang1122@mail.xjtu.edu.cn; Jzhou_xjtu@126.com; zuyiyuan@mail.xjtu.edu.cn FU Pfizer FX The Improving Care for Cardiovascular Disease in China (CCC) -ACS project is a program of the American Heart Association and the Chinese Society of Cardiology. The American Heart Association has been funded by Pfizer for quality improvement initiative through an independent grant for leaning and change. We acknowledge the contribution of all the investigators and hospitals participating in the CCC project. Chenbo Xu also wants to thank Dr. Mengge Zhou, Yueyan Xing and Dr. Fangzheng Lin for their valuable help. 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PD JUL PY 2022 VL 95 BP 112 EP 119 DI 10.1016/j.sleep.2022.04.011 EA MAY 2022 PG 8 WC Clinical Neurology WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology GA 1V6NP UT WOS:000806204400012 PM 35569328 OA hybrid DA 2023-05-13 ER PT J AU Jackson, NR Zeigler, K Torrez, M Makino, Y Adolphi, NL Lathrop, S Decker, L Dvorscak, L Proe, L Paul, ID Zumwalt, R Jarrell, H AF Jackson, Nicole R. Zeigler, Karen Torrez, Mary Makino, Yohsuke Adolphi, Natalie L. Lathrop, Sarah Decker, Lauren Dvorscak, Lauren Proe, Lori Paul, Ian D. Zumwalt, Ross Jarrell, Heather TI New Mexico's COVID-19 Experience SO AMERICAN JOURNAL OF FORENSIC MEDICINE AND PATHOLOGY LA English DT Article DE COVID-19; forensic pathology; autopsy; Native American; New Mexico ID CLINICAL DIAGNOSES; VIRUS; PATHOGENS AB The 2019 novel coronavirus disease (COVID-19) has spread worldwide, infiltrating, infecting, and devastating communities in all locations of varying demographics. An overwhelming majority of published literature on the pathologic findings associated with COVID-19 is either from living clinical cohorts or from autopsy findings of those who died in a medical care setting, which can confound pure disease pathology. A relatively low initial infection rate paired with a high biosafety level enabled the New Mexico Office of the Medical Investigator to conduct full autopsy examinations on suspected COVID-19-related deaths. Full autopsy examination on the first 20 severe acute respiratory syndrome coronavirus 2-positive decedents revealed that some extent of diffuse alveolar damage in every death due to COVID-19 played some role. The average decedent was middle-aged, male, American Indian, and overweight with comorbidities that included diabetes, ethanolism, and atherosclerotic and/or hypertensive cardiovascular disease. Macroscopic thrombotic events were seen in 35% of cases consisting of pulmonary thromboemboli and coronary artery thrombi. In 2 cases, severe bacterial coinfections were seen in the lungs. Those determined to die with but not of severe acute respiratory syndrome coronavirus 2 infection had unremarkable lung findings. C1 [Jackson, Nicole R.; Zeigler, Karen; Torrez, Mary; Adolphi, Natalie L.; Lathrop, Sarah; Decker, Lauren; Dvorscak, Lauren; Proe, Lori; Paul, Ian D.; Zumwalt, Ross; Jarrell, Heather] Univ New Mexico, Off Med Investigator, Albuquerque, NM 87131 USA. [Makino, Yohsuke] Univ Tokyo, Dept Forens Med, Tokyo, Japan. [Makino, Yohsuke] Chiba Univ, Dept Forens Radiol & Imaging, Chiba, Japan. C3 University of New Mexico; University of Tokyo; Chiba University RP Jackson, NR (通讯作者),Cook Cty Med Examiners Off, 2121 W Harrison St, Chicago, IL 60612 USA. EM NRJackson@salud.unm.edu; karen.m.zeigler@gmail.com; maryt37@gmail.com; ymakino-tky@umin.ac.jp; nadolphi@salud.unm.edu; slathrop@salud.unm.edu; ldecker@salud.unm.edu; LDvorsca@salud.unm.edu; lproe@salud.unm.edu; iandpaul@yahoo.com; rzumwalt@salud.unm.edu; hjarrell@salud.unm.edu RI Jackson, Nicole R/HMD-3496-2023; Adolphi, Natalie Louise/AGR-8511-2022; Jackson, Nicole R/HLH-8034-2023 OI Jackson, Nicole R/0000-0003-1442-2610; Adolphi, Natalie Louise/0000-0002-4899-3801; CR Abu-Rumeileh S, 2021, J NEUROL, V268, P1133, DOI 10.1007/s00415-020-10124-x Ackermann M, 2020, NEW ENGL J MED, V383, P120, DOI 10.1056/NEJMoa2015432 Almeida J D, 1967, J Gen Virol, V1, P175, DOI 10.1099/0022-1317-1-2-175 Avadhanula V, 2006, J VIROL, V80, P1629, DOI 10.1128/JVI.80.4.1629-1636.2006 Avadhanula V, 2007, J MED MICROBIOL, V56, P1133, DOI 10.1099/jmm.0.47086-0 Barton LM, 2020, AM J CLIN PATHOL, V153, P725, DOI [10.1093/ajcp/aqaa062, 10.1093/AJCP/AQAA062] Bradley BT, 2020, LANCET, V396, P320, DOI 10.1016/S0140-6736(20)31305-2 Brundage JF, 2006, LANCET INFECT DIS, V6, P303, DOI 10.1016/S1473-3099(06)70466-2 Buja LM, 2020, CARDIOVASC PATHOL, V48, DOI 10.1016/j.carpath.2020.107233 Centers for Disease Control and Prevention, NATL VITAL STAT REPO Centers for Disease Control and Prevention, CDC COVID DAT TRACK Cox MJ, 2020, LANCET MICROBE, V1, pE11, DOI 10.1016/S2666-5247(20)30009-4 De Michele S, 2020, AM J CLIN PATHOL, V154, P748, DOI 10.1093/ajcp/aqaa156 European Centre for Disease Prevention and Control, 2011, EV AUT PATH PATH FIN Fox SE, 2020, LANCET RESP MED, V8, P681, DOI 10.1016/S2213-2600(20)30243-5 HAMRE D, 1966, P SOC EXP BIOL MED, V121, P190, DOI 10.3181/00379727-121-30734 Kakol M, 2021, J RURAL HEALTH, V37, P197, DOI 10.1111/jrh.12451 Kim D, 2020, JAMA-J AM MED ASSOC, V323, P2085, DOI 10.1001/jama.2020.6266 Konopka KE, 2020, HISTOPATHOLOGY, V77, P570, DOI 10.1111/his.14180 Konopka KE, 2020, CHEST, V158, pE99, DOI 10.1016/j.chest.2020.04.032 Langford BJ, 2020, CLIN MICROBIOL INFEC, V26, P1622, DOI 10.1016/j.cmi.2020.07.016 Martines RB, 2020, EMERG INFECT DIS, V26, P2005, DOI 10.3201/eid2609.202095 MARTINEZMALDONADO M, 1991, CIRCULATION, V83, P1467, DOI 10.1161/01.CIR.83.4.1467 MCINTOSH K, 1967, P NATL ACAD SCI USA, V57, P933, DOI 10.1073/pnas.57.4.933 Morris DE, 2017, FRONT MICROBIOL, V8, DOI 10.3389/fmicb.2017.01041 New Mexico Department of Health COVID-19 in New Mexico, STAT RAC ETHN BREA Paniz-Mondolfi A, 2020, J MED VIROL, V92, P699, DOI 10.1002/jmv.25915 Poudel A, 2018, J DIABETES RES, V2018, DOI 10.1155/2018/2742565 Rapkiewicz AV, 2020, ECLINICALMEDICINE, V24, DOI 10.1016/j.eclinm.2020.100434 Reichard RR, 2020, ACTA NEUROPATHOL, V140, P1, DOI 10.1007/s00401-020-02166-2 Roosen J, 2000, MAYO CLIN PROC, V75, P562, DOI 10.4065/75.6.562 SARODE VR, 1993, HUM PATHOL, V24, P194, DOI 10.1016/0046-8177(93)90300-6 Sauter JL, 2020, HISTOPATHOLOGY, V77, P915, DOI 10.1111/his.14201 Schaefer IM, 2020, MODERN PATHOL, V33, P2104, DOI 10.1038/s41379-020-0595-z TYRRELL DAJ, 1965, BMJ-BRIT MED J, V1, P1467, DOI 10.1136/bmj.1.5448.1467 World Health Organization, WHO COR DIS COVID 19 Yan L, 2020, ARCH PATHOL LAB MED, V144, P1041, DOI 10.5858/arpa.2020-0217-SA Zhu N, 2020, NEW ENGL J MED, V382, P727, DOI 10.1056/NEJMoa2001017 NR 38 TC 4 Z9 4 U1 0 U2 13 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0195-7910 EI 1533-404X J9 AM J FOREN MED PATH JI Am. J. Forensic Med. Pathol. PD MAR PY 2021 VL 42 IS 1 BP 1 EP 8 DI 10.1097/PAF.0000000000000664 PG 8 WC Medicine, Legal; Pathology WE Science Citation Index Expanded (SCI-EXPANDED) SC Legal Medicine; Pathology GA QH3OW UT WOS:000618186600001 PM 33416234 OA Green Published DA 2023-05-13 ER PT J AU Guddati, AK Joy, PS Kumar, G AF Guddati, Achuta Kumar Joy, Parijat Saurav Kumar, Gagan TI Analysis of outcomes of percutaneous coronary intervention in metastatic cancer patients with acute coronary syndrome over a 10-year period SO JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY LA English DT Article DE Survival; Metastatic cancer; CAD; PCI; Outcomes ID ELEVATION MYOCARDIAL-INFARCTION; MANAGEMENT; DISEASE AB Background Early medical palliative care has been shown to improve overall survival of patients with metastatic cancer, but the role of cardiac surgical interventions in such patients is not clear. The limited life expectancy of these patients often poses a dilemma to clinicians and involves a detailed analysis of the risks and benefits of such interventions. This study examines the outcomes of percutaneous coronary intervention (PCI) in patients with metastatic cancer. Methods The National Inpatient Database of USA was used to identify patients aged >= 18 years who had a diagnosis of metastatic cancer and acute coronary syndrome (ACS) between 2000 and 2009 using ICD-9-CM codes. These were categorized into ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). The utilization of PCI was also identified using ICD-9-CM codes. The outcomes studied were in-hospital mortality, length of hospital stay and discharge disposition. The association between various outcomes and use of cardiac catheterization was assessed using multivariate regression models. Results There were 49,515 patients with metastatic disease who were discharged with a diagnosis of ACS. Of these, 15,964 had STEMI and 33,551 had NSTEMI. 3981 patients (24.9 %) with STEMI and 3209 patients (9.6 %) with NSTEMI received percutaneous coronary intervention. Caucasian male patients under age 65 years were more likely to receive PCI in the setting of an ACS. The hospital characteristics associated with higher use of PCI included academic affiliation, large bedsize, private for-profit hospitals and Midwestern and Western regions of USA. The adjusted odds of receiving PCI in this group of patient have gradually increased by 1.14 every year in last decade (95 % CI 1.11-1.16). The beneficial effect of PCI on in-hospital mortality has declined in NSTEMI such that by 2009, there was no significant difference between patients who received PCI and those who did not receive PCI. This has remained unchanged for STEMI patients. Conclusions In metastatic cancer patients with ACS, the rate of PCI has increased over the last decade. In the current era, metastatic cancer patients with NSTEMI may perform equally well without PCI in terms of in-hospital mortality. The decision to provide such care may be considered on an individual basis based on the extent of their medical comorbidity and tumor burden. C1 [Guddati, Achuta Kumar] Suny Downstate Med Ctr, Div Hematol Oncol, 450 Clarkson Ave, Brooklyn, NY 11203 USA. [Joy, Parijat Saurav] Univ Iowa, Dept Internal Med, Univ Iowa Hosp & Clin, Iowa City, IA 52242 USA. [Kumar, Gagan] Phoebe Putney Mem Hosp, Dept Crit Care, Albany, GA 31701 USA. C3 State University of New York (SUNY) System; State University of New York (SUNY) Downstate Medical Center; University of Iowa RP Guddati, AK (通讯作者),Suny Downstate Med Ctr, Div Hematol Oncol, 450 Clarkson Ave, Brooklyn, NY 11203 USA. 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Cancer Res. Clin. Oncol. PD FEB PY 2016 VL 142 IS 2 BP 471 EP 479 DI 10.1007/s00432-015-2056-5 PG 9 WC Oncology WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology GA DD8JR UT WOS:000370173300014 PM 26498773 DA 2023-05-13 ER PT J AU ter Hoeve, N Sunamura, M Stam, HJ van Domburg, RT van den Berg-Emons, RJG AF ter Hoeve, Nienke Sunamura, Madoka Stam, Henk J. van Domburg, Ron T. van den Berg-Emons, Rita J. G. TI A secondary analysis of data from the OPTICARE randomized controlled trial investigating the effects of extended cardiac rehabilitation on functional capacity, fatigue, and participation in society SO CLINICAL REHABILITATION LA English DT Article DE Participation (WHO ICF); physical fitness; lifestyle change; acute coronary syndrome; behavioral ID 6-MINUTE WALK TEST; CORONARY-ARTERY-DISEASE; PHYSICAL-ACTIVITY; SEVERITY SCALE; SEDENTARY TIME; INTERVENTION; ASSOCIATION; VALIDITY; EPIDEMIOLOGY; RELIABILITY AB Objective: In this secondary analysis of data from the OPTICARE trial, we compared the effects of two behavioral interventions integrated into cardiac rehabilitation to standard rehabilitation with regard to functional capacity, fatigue, and participation in society. Design: This is a randomized controlled trial. Setting: This study was conducted in a cardiac rehabilitation setting. Subjects: A total of 740 patients with acute coronary syndrome were recruited for this study. Interventions: Patients were randomized to (1) three months of standard rehabilitation; (2) cardiac rehabilitation plus nine months after-care with face-to-face group lifestyle counseling; or (3) cardiac rehabilitation plus nine months after-care with individual lifestyle telephone counseling. Main measures: Functional capacity (6-minute walk test), fatigue (Fatigue Severity Scale), and participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation) were measured at randomization, 3, 12, and 18 months. Results: Additional face-to-face sessions resulted at 12 months in 12.49 m more on the 6-minute walk test compared to standard rehabilitation (P = .041). This difference was no longer present at 18 months. Prevalence of fatigue decreased from 30.2% at baseline to 11.9% at 18 months compared to an improvement from 37.3% to 24.9% after standard rehabilitation (between-group difference: odds ratio = 0.47; P = .010). The additional improvements in functional capacity seemed to be mediated by increases in daily physical activity. No mediating effects were found for fatigue. No additional improvements were seen for participation in society. Additional telephonic sessions did not result in additional intervention effects. Conclusion: Extending cardiac rehabilitation with a face-to-face behavioral intervention resulted in additional long-term improvements in fatigue and small improvements in functional capacity up to 12 months. A telephonic behavioral intervention provided no additional benefits. C1 [ter Hoeve, Nienke; Sunamura, Madoka] Capri Cardiac Rehabil, Rotterdam, Netherlands. [ter Hoeve, Nienke; Stam, Henk J.; van den Berg-Emons, Rita J. G.] Erasmus MC, Dept Rehabil Med, POB 2040, NL-3000 CA Rotterdam, Netherlands. [van Domburg, Ron T.] Erasmus MC, Dept Cardiol, Rotterdam, Netherlands. C3 Erasmus University Rotterdam; Erasmus MC; Erasmus University Rotterdam; Erasmus MC RP ter Hoeve, N (通讯作者),Erasmus MC, Dept Rehabil Med, POB 2040, NL-3000 CA Rotterdam, Netherlands. EM n.terhoeve@erasmusmc.nl OI van den Berg-Emons, Rita/0000-0001-6433-3398; ter Hoeve, Nienke/0000-0002-7447-3025 FU Capri Cardiac Rehabilitation Rotterdam (The Netherlands); Zilveren Kruis healthcare insurance company (The Netherlands) FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This investigator-initiated study was cofinanced by Capri Cardiac Rehabilitation Rotterdam (The Netherlands), who financed the face-to-face counseling intervention, and the Zilveren Kruis healthcare insurance company (The Netherlands), who financed the telephonic counseling intervention. 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Rehabil. PD AUG PY 2019 VL 33 IS 8 BP 1355 EP 1366 DI 10.1177/0269215519842216 PG 12 WC Rehabilitation WE Science Citation Index Expanded (SCI-EXPANDED) SC Rehabilitation GA IH1GR UT WOS:000474239800009 PM 30983387 OA Green Published, hybrid DA 2023-05-13 ER PT J AU de Oliveira, CPMS Stefano, JT Alvares-da-Silva, MR AF Marques Souza de Oliveira, Claudia Pinto Stefano, Jose Tadeu Alvares-da-Silva, Mario Reis TI Cardiovascular risk, atherosclerosis and metabolic syndrome after liver transplantation: a mini review SO EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY LA English DT Review DE atherosclerosis; cardiovascular risk; diabetes mellitus; dyslipidemia; hypertension; immunosuppression; inappropriate diet; liver transplantation; metabolic syndrome; sedentary ID CORONARY-HEART-DISEASE; NONALCOHOLIC STEATOHEPATITIS; HEPATITIS-C; EVENTS; RECIPIENTS; PREVALENCE; MANAGEMENT; METAANALYSIS; ASSOCIATION; PREDICTION AB Liver transplantation is the standard of care for acute and chronic end-stage liver disease. Advances in medical therapy and surgical techniques have transformed the long-term survival of liver-transplant (LT) recipients. The prevalence of post-transplant cardiovascular complications has been rising with increased life expectancy after liver transplantation. Currently, deaths related to cardiovascular complications are one of the main causes of long-term mortality in LT recipients, as cardiovascular disease is the reason of 19-42% of non-liver-related mortality after transplant. On the other hand, metabolic syndrome is common among LT recipients before and after transplantation. In fact, their components (abdominal obesity, diabetes mellitus, hypertension and dyslipidemia) are often exacerbated by transplant-specific factors, such as immunosuppression, inappropriate diet, smoking and a sedentary lifestyle, and add a significant risk of developing atherosclerosis. These aspects are discussed in this article. C1 [Marques Souza de Oliveira, Claudia Pinto; Stefano, Jose Tadeu] Univ Sao Paulo, Sch Med, Dept Gastroenterol, Clin Div,Hepatol Branch LIM 07, Sao Paulo, Brazil. [Alvares-da-Silva, Mario Reis] Univ Fed Rio Grande do Sul, Sch Med, Div Gastroenterol, Porto Alegre, RS, Brazil. C3 Universidade de Sao Paulo; Universidade Federal do Rio Grande do Sul RP de Oliveira, CPMS (通讯作者),Univ Sao Paulo, Sch Med, Dept Gastroenterol, Clin Div,Hepatol Branch LIM 07, Sao Paulo, Brazil. EM cpm@usp.br RI STEFANO, JOSE TADEU/AGR-5605-2022; Oliveira, Claudia PMS/D-1216-2014; Stefano, José Tadeu/AAH-5419-2020; Stefano, Jose T/H-4792-2013; Alvares-da-Silva, Mario Reis/L-3910-2014 OI Stefano, José Tadeu/0000-0002-0218-1920; Alvares-da-Silva, Mario Reis/0000-0002-5001-246X CR Afzali A, 2012, LIVER TRANSPLANT, V18, P29, DOI 10.1002/lt.22435 Albeldawi M, 2012, LIVER TRANSPLANT, V18, P370, DOI 10.1002/lt.22468 Alvares-da-Silva MR, 2012, J HEPATOL, V56, pS75, DOI 10.1016/S0168-8278(12)60186-X Anastacio LR, 2011, NUTRITION, V27, P931, DOI 10.1016/j.nut.2010.12.017 Claes K, 2012, NEPHROL DIAL TRANSPL, V27, P850, DOI 10.1093/ndt/gfr238 Coss E, 2011, LIVER TRANSPLANT, V17, P23, DOI 10.1002/lt.22140 Desai S, 2010, LIVER INT, V30, P948, DOI 10.1111/j.1478-3231.2010.02274.x Everhart JE, 1998, LIVER TRANSPLANT SUR, V4, P285, DOI 10.1002/lt.500040402 Grundy SM, 1998, CIRCULATION, V97, P1876, DOI 10.1161/01.CIR.97.18.1876 Grundy SM, 2004, CIRCULATION, V110, P227, DOI 10.1161/01.CIR.0000133317.49796.0E Hanouneh IA, 2008, LIVER TRANSPLANT, V14, P1287, DOI 10.1002/lt.21524 Hryniewiecka E, 2011, TRANSPL P, V43, P3029, DOI 10.1016/j.transproceed.2011.07.011 Laish I, 2011, LIVER TRANSPLANT, V17, P15, DOI 10.1002/lt.22198 Laryea M, 2007, LIVER TRANSPLANT, V13, P1109, DOI 10.1002/lt.21126 Madhwal S, 2012, LIVER TRANSPLANT, V18, P1140, DOI 10.1002/lt.23508 Miller LW, 2002, AM J TRANSPLANT, V2, P807, DOI 10.1034/j.1600-6143.2002.20902.x Munoz S J, 1995, Liver Transpl Surg, V1, P29 MUNOZ SJ, 1991, TRANSPL P, V23, P1480 Newsome PN, 2012, GUT, V61, P484, DOI 10.1136/gutjnl-2011-300886 Oliveira CPMS, 2013, INT J CARDIOL, V164, P221, DOI 10.1016/j.ijcard.2011.07.016 Pagadala M, 2009, LIVER TRANSPLANT, V15, P1662, DOI 10.1002/lt.21952 Raval Z, 2011, J AM COLL CARDIOL, V58, P223, DOI 10.1016/j.jacc.2011.03.026 Ridker PM, 2007, J AM COLL CARDIOL, V49, P2129, DOI 10.1016/j.jacc.2007.02.052 Rike AH, 2008, CLIN TRANSPLANT, V22, P229, DOI 10.1111/j.1399-0012.2007.00779.x Segev DL, 2008, LIVER TRANSPLANT, V14, P512, DOI 10.1002/lt.21396 Sheiner PA, 2000, TRANSPLANTATION, V69, P781 Stravitz RT, 2011, CLIN LIVER DIS, V15, P821, DOI 10.1016/j.cld.2011.08.007 Watt KD, 2011, LIVER TRANSPLANT, V17, pS38, DOI 10.1002/lt.22386 Watt KDS, 2010, J HEPATOL, V53, P199, DOI 10.1016/j.jhep.2010.01.040 Wilson PWF, 1998, CIRCULATION, V97, P1837, DOI 10.1161/01.CIR.97.18.1837 NR 30 TC 13 Z9 13 U1 0 U2 4 PU EXPERT REVIEWS PI LONDON PA UNITEC HOUSE, 3RD FL, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON N3 1QB, ENGLAND SN 1747-4124 J9 EXPERT REV GASTROENT JI Expert Rev. 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PD MAY PY 2013 VL 7 IS 4 BP 361 EP 364 DI 10.1586/EGH.13.19 PG 4 WC Gastroenterology & Hepatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Gastroenterology & Hepatology GA 138YS UT WOS:000318548700014 PM 23639094 DA 2023-05-13 ER PT J AU Casper, EA El Wakeel, LM Saleh, MA El-Hamamsy, MH AF Casper, Eman Ahmed El Wakeel, Lamiaa Mohamed Saleh, Mohamed Ayman El-Hamamsy, Manal Hamed TI Management of pharmacotherapy-related problems in acute coronary syndrome: Role of clinical pharmacist in cardiac rehabilitation unit SO BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY LA English DT Article DE cardiac rehabilitation; clinical pharmacist; drug-related problems; quality of life ID SECONDARY PREVENTION; MYOCARDIAL-INFARCTION; MEDICATION ADHERENCE; AMERICAN-COLLEGE; HEART-DISEASE; INTERVENTION; THERAPY; ELEVATION; SERVICES; IMPACT AB Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and negatively impacts healthcare costs, productivity and quality of life. Polymorbidity and polypharmacy predispose ACS patients to medication discrepancies between cardiologist-prescribed medication and drug use by the patient, drug-related problems (DRPs) and inadequate drug adherence. This study aimed to evaluate the impact of clinical pharmacist-provided services on the outcome of ACS patients. This was a prospective, randomized, controlled study on ACS patients participating in a cardiac rehabilitation programme. Forty ACS patients were randomly assigned to either control group, who received standard medical care, or intervention group, who received standard medical care plus clinical pharmacist-provided services. Services included DRP management, clinical assessment and enforcing the patient education and adherence. For both groups, the following were assessed at baseline and after 3 months: DRPs, adherence (assessed by 8-item Morisky Adherence Questionnaire), patient's knowledge (assessed by Coronary Artery Disease Questionnaire), 36-Short Form Health Survey (SF-36), heart rate, systolic and diastolic blood pressure, low-density lipoprotein (LDL), total cholesterol (TC) and fasting blood glucose (FBG). After 3 months, there was a significant difference between the intervention and control groups in the per cent change of DRPs (median: -100 vs 5.882, P = 0.0001), patient's adherence score (median: 39.13 vs -14.58, P = 0.0001), knowledge score (median: 30.28 vs -5.196, P = 0.0001), SF-36 scores, heart rate (mean: -10.04 vs 6.791, P = 0.0001), diastolic blood pressure (mean: -17.87 vs 10.45, P = 0.0001), systolic blood pressure (mean: -16.22 vs 4.751, P = 0.0001), LDL (median: -25.73 vs -0.2538, P = 0.0071), TC (median: -14.62 vs 4.123, P = 0.0005) and FBG (median: -11.42 vs 5.422, P = 0.0098). Clinical pharmacists can play an important role as part of a cardiac rehabilitation team through patient education and interventions to minimize DRPs. C1 [Casper, Eman Ahmed; El Wakeel, Lamiaa Mohamed] Ain Shams Univ, Dept Clin Pharm, Fac Pharm, Cairo, Egypt. [Saleh, Mohamed Ayman] Ain Shams Univ, Ain Shams Univ Hosp, Dept Cardiol, Cardiac Rehabil Unit,Fac Med, Cairo, Egypt. [El-Hamamsy, Manal Hamed] King Abdulaziz Univ, Dept Clin Pharm, Fac Pharm, Jeddah, Saudi Arabia. C3 Egyptian Knowledge Bank (EKB); Ain Shams University; Egyptian Knowledge Bank (EKB); Ain Shams University; King Abdulaziz University RP El Wakeel, LM (通讯作者),Ain Shams Univ, Dept Clin Pharm, Fac Pharm, Cairo, Egypt. 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Pharmacol. Toxicol. PD JUL PY 2019 VL 125 IS 1 BP 44 EP 53 DI 10.1111/bcpt.13210 PG 10 WC Pharmacology & Pharmacy; Toxicology WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy; Toxicology GA IC9GW UT WOS:000471290900006 PM 30739389 DA 2023-05-13 ER PT J AU Ross, ES Sakakibara, BM Mackay, MH Whitehurst, DGT Singer, J Toma, M Corbett, KK Van Spall, HGC Rutherford, K Gheorghiu, B Code, J Lear, SA AF Ross, Emily S. Sakakibara, Brodie M. Mackay, Martha H. Whitehurst, David G. T. Singer, Joel Toma, Mustafa Corbett, Kitty K. Van Spall, Harriette G. C. Rutherford, Kimberly Gheorghiu, Bobby Code, Jillianne Lear, Scott A. TI The Use of SMS Text Messaging to Improve the Hospital-to-Community Transition in Patients With Acute Coronary Syndrome (Txt2Prevent): Results From a Pilot Randomized Controlled Trial SO JMIR MHEALTH AND UHEALTH LA English DT Article DE SMS text messaging; mHealth; acute coronary syndrome; cardiovascular disease ID ACUTE MYOCARDIAL-INFARCTION; QUALITY-OF-LIFE; MEDICATION ADHERENCE; HEART-DISEASE; CARDIOVASCULAR-DISEASE; FOLLOW-UP; HEALTH; OUTCOMES; RISK; INTERVENTIONS AB Background: Acute coronary syndrome (ACS) is a leading cause of hospital admission in North America. Many patients with ACS experience challenges after discharge that impact their clinical outcomes and psychosocial well-being. SMS text messaging has the potential to provide support to patients during this postdischarge period. Objective: This study pilot tested a 60-day SMS text messaging intervention (Txt2Prevent) for patients with ACS. The primary objective was to compare self-management domains between usual care and usual care plus Txt2Prevent. The secondary objectives were to compare medication adherence, health-related quality of life, self-efficacy, and health care resource use between groups. The third objective was to assess the feasibility of the study protocol and the acceptability of the intervention. Methods: This was a randomized controlled trial with blinding of outcome assessors. We recruited 76 patients with ACS from St. Paul's Hospital in Vancouver, Canada, and randomized them to 1 of 2 groups within 7 days of discharge. The Txt2Prevent program included automated 1-way SMS text messages about follow-up care, self-management, and healthy living. Data were collected during the index admission and at 60 days after randomization. The primary outcome was measured with the Health Education Impact Questionnaire (heiQ). Other outcomes included the EQ-5D-5L, EQ-5D-5L Visual Analog Scale, a modified Sullivan Cardiac Self-Efficacy Scale, and Morisky Medication Adherence Scale scores, and self-reported health care resource use. Analyses of covariance were used to test the effect of group assignment on follow-up scores (controlling for baseline) and were considered exploratory in nature. Feasibility was assessed with descriptive characteristics of the study protocol. Acceptability was assessed with 2 survey questions and semistructured interviews. Results: There were no statistically significant differences between the groups for the heiQ domains (adjusted mean difference [Txt2Prevent minus usual care] for each domain-Health-directed activity: -0.13, 95% CI-0.39 to 0.13, P=.31; Positive and active engagement in life: 0.03, 95% CI-0.19 to 0.25, P=.76; Emotional distress: 0.04, 95% CI-0.22 to 0.29, P=.77; Self-monitoring and insight: -0.14, 95% CI-0.33 to 0.05, P=.15; Constructive attitudes and approaches: -0.10, 95% CI-0.36 to 0.17, P=.47; Skill technique and acquisition: 0.05, 95% CI-0.18 to 0.27, P=.69; Social integration and support: -0.12, 95% CI-0.34 to 0.10, P=.27; and Health services navigation: -0.05, 95% CI-0.29 to 0.19, P=.69). For the secondary outcomes, there were no statistically significant differences in adjusted analyses except in 1 self-efficacy domain (Total plus), where the Txt2Prevent group had lower scores (mean difference -0.36, 95% CI-0.66 to -0.50, P=.03). The study protocol was feasible, but recruitment took longer than expected. Over 90% (29/31 [94%]) of participants reported they were satisfied with the program. Conclusions: The Txt2Prevent study was feasible to implement; however, although exploratory, there were no differences between the 2 groups in adjusted analyses except for 1 self-efficacy domain. As the intervention appeared acceptable, there is potential in using SMS text messages in this context. The design of the intervention may need to be reconsidered to have more impact on outcome measures. C1 [Ross, Emily S.; Lear, Scott A.] Simon Fraser Univ, Dept Biomed Physiol & Kinesiol, Burnaby, BC, Canada. [Sakakibara, Brodie M.] Univ British Columbia Okanagan, Ctr Chron Dis Prevent & Management, Kelowna, BC, Canada. [Sakakibara, Brodie M.] Univ British Columbia, Dept Occupat Sci & Occupat Therapy, Vancouver, BC, Canada. [Mackay, Martha H.] Univ British Columbia, Sch Nursing, Vancouver, BC, Canada. [Mackay, Martha H.; Singer, Joel] Ctr Hlth Evaluat & Outcome Sci, Vancouver, BC, Canada. [Whitehurst, David G. T.; Corbett, Kitty K.; Lear, Scott A.] Simon Fraser Univ, Fac Hlth Sci, Burnaby, BC, Canada. [Whitehurst, David G. T.] Vancouver Coastal Hlth Res Inst, Ctr Clin Epidemiol & Evaluat, Vancouver, BC, Canada. [Singer, Joel] Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada. [Toma, Mustafa] Providence Hlth Care, Div Cardiol, Vancouver, BC, Canada. [Corbett, Kitty K.] Univ Waterloo, Sch Publ Hlth Sci, Waterloo, ON, Canada. [Van Spall, Harriette G. C.] McMaster Univ, Dept Med, Hamilton, ON, Canada. [Van Spall, Harriette G. C.] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada. [Van Spall, Harriette G. C.] Populat Hlth Res Inst, Hamilton, ON, Canada. [Rutherford, Kimberly] Univ British Columbia, Dept Family Practice, Vancouver, BC, Canada. [Gheorghiu, Bobby] Canada Hlth Infoway, Toronto, ON, Canada. [Code, Jillianne] Univ British Columbia, Dept Curriculum & Pedag, Vancouver, BC, Canada. [Lear, Scott A.] St Pauls Hosp, Providence Hlth Care, Div Cardiol, Hlth Heart Program, B180-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada. C3 Simon Fraser University; University of British Columbia; University of British Columbia Okanagan; University of British Columbia; University of British Columbia; Simon Fraser University; Vancouver Coastal Health Research Institute; University of British Columbia; University of Waterloo; McMaster University; McMaster University; Population Health Research Institute; University of British Columbia; University of British Columbia; St. Paul's Hospital RP Lear, SA (通讯作者),St Pauls Hosp, Providence Hlth Care, Div Cardiol, Hlth Heart Program, B180-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada. EM slear@providencehealth.bc.ca RI Code, Jillianne R/A-2273-2010 OI Code, Jillianne R/0000-0002-3096-1289; Van Spall, Harriette Gillian Christine/0000-0002-8370-4569; Mackay, Martha/0000-0002-0290-9715; Rutherford, Kimberly/0000-0002-1449-8298; Singer, Joel/0000-0002-7220-4382; Whitehurst, David/0000-0002-7890-6756 FU Canadian Institutes of Health Research (CIHR) through a Catalyst Grant for eHealth Innovations [316822]; CIHR; Michael Smith Foundation for Health Research (MSFHR) Scholar Award; MSFHR Scholar Award; CIHR Embedded Clinician Researcher Salary Award; Ontario Ministry of Health and LongTerm Care's Health System Research Fund FX The study received funding from the Canadian Institutes of Health Research (CIHR) through a Catalyst Grant for eHealth Innovations (application number 316822) . ER was supported to do this work by a Canada Graduate Scholarships-Master's Program from CIHR. BS is supported by a Michael Smith Foundation for Health Research (MSFHR) Scholar Award. MM is supported by an MSFHR Scholar Award and a CIHR Embedded Clinician Researcher Salary Award. HV is supported by funding from CIHR and the Ontario Ministry of Health and LongTerm Care's Health System Research Fund. SL holds the Pfizer/Heart and Stroke Foundation Chair in Cardiovascular Research Prevention at St. Paul's Hospital, Vancouver, Canada. We acknowledge Mr Daniel Sheinin who was involved in the software development, Ms Nisa Onsel and Ms Joanna Mendell for randomizing study participants, Dr Terry Lee for his statistical advice, the EuroQol Group for their support with the online questionnaire (EQ5D5L) , Ms Anosha Afaq for her assistance with data entry, and members of the clinical advisory committee, including Ms Alyson HaganJohnson (patient partner) and Mr Leon Jung (community pharmacist) . We also thank the hospital staff who assisted with recruitment as well as our study participants. Use of the MMAS is protected by US copyright laws. Permission for use is required. 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APPENDIX 4 MYOCARDIA NR 69 TC 3 Z9 3 U1 2 U2 4 PU JMIR PUBLICATIONS, INC PI TORONTO PA 130 QUEENS QUAY East, Unit 1100, TORONTO, ON M5A 0P6, CANADA SN 2291-5222 J9 JMIR MHEALTH UHEALTH JI JMIR mHealth uHealth PD MAY 5 PY 2021 VL 9 IS 5 AR e24530 DI 10.2196/24530 PG 17 WC Health Care Sciences & Services; Medical Informatics WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services; Medical Informatics GA TD0AS UT WOS:000668999500035 PM 33988519 OA gold, Green Published DA 2023-05-13 ER PT J AU Chen, SI Wang, Y Dreyer, R Strait, KM Spatz, ES Xu, X Smolderen, KG Desai, NR Lorenze, NP Lichtman, JH Spertus, JA D'Onofrio, G Bueno, H Masoudi, FA Krumholz, HM AF Chen, Serene I. Wang, Yongfei Dreyer, Rachel Strait, Kelly M. Spatz, Erica S. Xu, Xiao Smolderen, Kim G. Desai, Nihar R. Lorenze, Nancy P. Lichtman, Judith H. Spertus, John A. D'Onofrio, Gail Bueno, Hector Masoudi, Frederick A. Krumholz, Harlan M. TI Insurance and Prehospital Delay in Patients <= 55 Years With Acute Myocardial Infarction SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE CORONARY SYNDROME; HOSPITAL PRESENTATION; SEEKING TREATMENT; SYMPTOM ONSET; HEALTH-CARE; TRENDS; HEART; TIME; ASSOCIATION; MORTALITY AB This prospective study assessed whether gender differences in health insurance help explain gender differences in delay in seeking care for patients in the US, with acute myocardial infarction (AMI). We also assessed gender differences in such prehospital delay for AMI in Spain, a country with universal insurance. We used data from 2,951 US and 496 Spanish patients aged 18 to 55 years with AMI. US patients were grouped by insurance status: adequately insured, underinsured, or uninsured. For each country, we assessed the association between gender and prehospital delay (symptom onset to hospital arrival). For the US cohort, we modeled the relation between insurance groups and delay of >12 hours. US women were less likely than men to be uninsured but more likely to be underinsured, and a larger proportion of women than,men experienced delays of >12 hours (38% vs 29%). We found no association between insurance status and delays of >12 hours hi men or women. Only 17.3% of Spanish patients had delays of >12 hours, and there were no significant gender differences. In conclusion, women were more likely than men to delay, although it was not explained by differences in insurance status. The lack of gender differences in prehospital delays in Spain suggests that these differences may vary by health care system and culture. (C) 2015 Elsevier Inc. All rights reserved. C1 [Chen, Serene I.] Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. [Wang, Yongfei; Dreyer, Rachel; Strait, Kelly M.; Spatz, Erica S.; Desai, Nihar R.; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Wang, Yongfei; Spatz, Erica S.; Desai, Nihar R.; Lorenze, Nancy P.; Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. [Xu, Xiao] Yale Univ, Sch Med, Dept Obstet Gynecol & Reprod Sci, New Haven, CT USA. [D'Onofrio, Gail] Yale Univ, Sch Med, Dept Emergency Med, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Robert Wood Johnson Fdn Clin Scholars Program, New Haven, CT 06510 USA. [Smolderen, Kim G.; Spertus, John A.] Univ Missouri, Sch Med, Dept Biomed & Hlth Informat, Kansas City, MO 64108 USA. [Smolderen, Kim G.; Spertus, John A.] St Lukes Mid Amer Heart Inst, Kansas City, MO USA. [Lichtman, Judith H.] Yale Univ, Sch Publ Hlth, Dept Chron Dis Epidemiol, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA. [Bueno, Hector] CNIC, Madrid, Spain. [Bueno, Hector] Hosp Univ 12 Octubre, Inst Invest I 12, Madrid, Spain. [Bueno, Hector] Hosp Univ 12 Octubre, Dept Cardiol, Madrid, Spain. [Bueno, Hector] Univ Complutense Madrid, E-28040 Madrid, Spain. [Masoudi, Frederick A.] Univ Colorado Anschutz Med Campus, Dept Med, Div Cardiol, Aurora, CO USA. C3 Yale University; Yale University; Yale University; Yale University; Yale University; Robert Wood Johnson Foundation (RWJF); Yale University; University of Missouri System; University of Missouri Kansas City; Saint Luke's Mid America Heart Institute; Yale University; Yale University; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Hospital Universitario 12 de Octubre; Hospital Universitario 12 de Octubre; Complutense University of Madrid; University of Colorado System; University of Colorado Anschutz Medical Campus RP Krumholz, HM (通讯作者),Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, 20 York St, New Haven, CT 06504 USA. EM harlan.krumholz@yale.edu RI , Harlan/AAI-2875-2020; Masoudi, Frederick/Q-7467-2019; Spertus, John/ABD-3075-2021; Bueno, Hector/I-3910-2015 OI Bueno, Hector/0000-0003-0277-7596; Smolderen, Kim/0000-0001-6104-6254; Dreyer, Rachel/0000-0003-2861-1383 FU National Heart, Lung, and Blood Institute (Bethesda, Maryland) [5 R01 HL081153]; Fondo de Investigaciones Sanitarias del Instituto Carlos DI (Madrid, Spain) [PI 081614]; Ministry of Science and Technology; Centro Nacional de Investigaciones Cardiovasculares (Madrid, Spain); (Center for Cardiovascular Outcomes Research at Yale University) from the National Heart, Lung, and Blood Institute [U01 HL105270-05] FX The VIRGO study was supported by 5 R01 HL081153 from the National Heart, Lung, and Blood Institute (Bethesda, Maryland). Infarto de Miocardio en la Mujer Joven was supported in Spain by a grant from the Fondo de Investigaciones Sanitarias del Instituto Carlos DI (Madrid, Spain) (PI 081614), Ministry of Science and Technology, and additional funds from the Centro Nacional de Investigaciones Cardiovasculares (Madrid, Spain). Dr. Krumholz is supported by U01 HL105270-05 (Center for Cardiovascular Outcomes Research at Yale University) from the National Heart, Lung, and Blood Institute. 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Crespi, Tiziano Pino, Fabio Perazzo, Paolo Mazzocchi, Marco Giorgino, Riccardo De Angelis, Giuseppe Ielasi, Alfonso De Blasio, Giuseppe Turiel, Maurizio TI SARS-CoV-2 Aiming for the Heart: A Multicenter Italian Perspective About Cardiovascular Issues in COVID-19 SO FRONTIERS IN PHYSIOLOGY LA English DT Article DE cardiovascular system; coronavirus; SARS-CoV-2; COVID-19; infections; virulence; host-pathogen interactions; quality of health care ID ACUTE RESPIRATORY SYNDROME; DISEASE 2019 COVID-19; DENDRITIC CELLS; PLAQUE RUPTURE; INFECTION; ACE2; INFLAMMATION; PATHOGENESIS; COAGULATION; TISSUE AB The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the high fatality rate of coronavirus disease 2019 (COVID-19) have been putting a strain on the world since December 2019. Infected individuals exhibit unpredictable symptoms that tend to worsen if age is advanced, a state of malnutrition persists, or if cardiovascular comorbidities are present. Once transmitted, the virus affects the lungs and in predisposed individuals can elicit a sequela of fatal cardiovascular consequences. We aim to present the pathophysiology of COVID-19, emphasizing the major cellular and clinical manifestations from a cardiological perspective. As a roaming viral particle or more likely via the Trojan horse route, SARS-CoV-2 can access different parts of the body. Cardiovascular features of COVID-19 can count myocardial injuries, vasculitis-like syndromes, and atherothrombotic manifestations. Deviations in the normal electrocardiogram pattern could hide pericardial effusion or cardiac inflammation, and dispersed microthrombi can cause ischemic damages, stroke, or even medullary reflex dysfunctions. Tailored treatment for reduced ejection fraction, arrhythmias, coronary syndromes, macrothrombosis and microthrombosis, and autonomic dysfunctions is mandatory. Confidently, evidence-based therapies for this multifaceted nevertheless purely cardiological COVID-19 will emerge after the global assessment of different approaches. C1 [Briguglio, Matteo] IRCCS Orthoped Inst Galeazzi, Sci Direct, Milan, Italy. [Porta, Mauro] IRCCS Orthoped Inst Galeazzi, Neurol Unit, Milan, Italy. [Zuffada, Francesca] ICCS Ist Clin Citta Studi, Cardiol Unit, Milan, Italy. [Bona, Alberto R.] ICCS Ist Clin Citta Studi, Neurosurg Unit, Milan, Italy. [Crespi, Tiziano; Pino, Fabio; Perazzo, Paolo; Mazzocchi, Marco] IRCCS Orthoped Inst Galeazzi, Intens Care Unit, Milan, Italy. [Giorgino, Riccardo] Univ Milan, Residency Program Orthoped & Traumatol, Milan, Italy. [De Angelis, Giuseppe] ASST Rhodense, Cardiol Unit, Rho, Italy. [Ielasi, Alfonso] Ist Clin St Ambrogio, Cardiol Unit, Milan, Italy. [De Blasio, Giuseppe; Turiel, Maurizio] IRCCS Orthoped Inst Galeazzi, Cardiol Unit, Milan, Italy. C3 University of Milan RP Briguglio, M (通讯作者),IRCCS Orthoped Inst Galeazzi, Sci Direct, Milan, Italy. 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Physiol. PD NOV 6 PY 2020 VL 11 AR 571367 DI 10.3389/fphys.2020.571367 PG 11 WC Physiology WE Science Citation Index Expanded (SCI-EXPANDED) SC Physiology GA OS9ZP UT WOS:000590515000001 PM 33240098 OA Green Published, gold DA 2023-05-13 ER PT J AU Martensson, S Gyrd-Hansen, D Prescott, E Andersen, PK Gislason, G Jacobsen, RK Osler, M AF Martensson, Solvej Gyrd-Hansen, Dorte Prescott, Eva Andersen, Per Kragh Gislason, Gunnar Jacobsen, Rikke Kart Osler, Merete TI Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina? SO EUROINTERVENTION LA English DT Article DE acute coronary syndrome; case fatality; social inequality; socioeconomic; time waited ID CARDIAC PROCEDURES; MORTALITY; DEPRIVATION; REVASCULARIZATION; INTERVENTION; OUTCOMES; SURGERY; INCOME; CARE AB Aims: Our aim was to investigate whether there is social inequality in access to invasive examination and treatment, and whether access explains social inequality in case fatality in a nationwide sample of patients admitted for the first time with unstable angina or non-ST-elevation myocardial infarction (NSTEMI) in Denmark. Methods and results: All patients admitted for the first time with NSTEMI (n=16,625) or unstable angina (n=8,800) from 2001 to 2009 in Denmark were included. We measured time from admission to coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The outcomes were 30-day and one-year case fatality. We found social inequality in access to CAG and one-year case fatality for both NSTEMI and unstable angina patients, but the time waited for CAG did not explain the social inequality in case fatality. Conclusions: Despite nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved by the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark. C1 [Martensson, Solvej; Jacobsen, Rikke Kart; Osler, Merete] Res Ctr Prevent & Hlth, Glostrup, Capital Region, Denmark. [Gyrd-Hansen, Dorte] Univ Southern Denmark, COHERE, Dept Econ & Business, Odense, Denmark. [Gyrd-Hansen, Dorte] Univ Southern Denmark, Dept Publ Hlth, Odense, Denmark. [Prescott, Eva] Bispebjerg Hosp, Dept Cardiol, Copenhagen, Denmark. [Andersen, Per Kragh] Univ Copenhagen, Inst Publ Hlth, Dept Biostat, Copenhagen, Denmark. [Gislason, Gunnar] Univ Southern Denmark, Natl Inst Publ Hlth, Copenhagen, Denmark. [Gislason, Gunnar] Univ Copenhagen, Gentofte Hosp, Dept Cardiol, Hellerup, Denmark. [Osler, Merete] Univ Copenhagen, Inst Publ Hlth, Copenhagen, Denmark. C3 University of Southern Denmark; University of Southern Denmark; University of Copenhagen; Bispebjerg Hospital; University of Copenhagen; University of Southern Denmark; University of Copenhagen; Herlev & Gentofte Hospital; University of Copenhagen RP Martensson, S (通讯作者),Glostrup Univ Hosp, Res Ctr Prevent & Hlth, Nordre Ringvej 57,Bldg 84-85, DK-2600 Glostrup, Capital Region, Denmark. EM solvej.maartensson@regionh.dk RI Osler, Merete/AAF-7885-2019; Prescott, Eva/AAJ-7441-2020; Gislason, Gunnar/B-7561-2009 OI Gislason, Gunnar/0000-0002-0548-402X; Osler, Merete/0000-0002-6921-220X; Jacobsen, Rikke Kart/0000-0003-4677-2973; Prescott, Eva/0000-0002-4134-0349 FU Danish Heart Association [10-04-R78-A2806-22609]; Health Insurance Foundation [2011B037]; Fabrikant Ejner Willumsens Mindelegat og Aase og Ejner Danielsens Foundation; Novo Nordisk Fonden [NNF12OC1015957] Funding Source: researchfish FX This work was supported by the Danish Heart Association [grant number 10-04-R78-A2806-22609], The Health Insurance Foundation [grant number 2011B037], Fabrikant Ejner Willumsens Mindelegat og Aase og Ejner Danielsens Foundation. 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Background Transitioning from disease-centred to person-centred care requires great effort but can improve patient safety. Design A quasi-experimental study with data collection preceding and 12 months after a PC inpatient care intervention. Methods The study consecutively recruited adult patients (2014, n = 263; 2015/2016, n = 221) admitted to an inpatient care unit. The patients reported experiences of care at discharge and their perceived pain at admission and discharge. Medical records were reviewed to gather data on medications, planned care and clinical observations. The study is reported according to TREND guidelines. Results At discharge, patients receiving PC inpatient care reported competent medical-technical care. Patients receiving PC inpatient care reported more effective pain relief. Updated prescribed medications at the ward were maintained, and patients were made aware of planned medical care to higher extent during PC inpatient care. The assessment of pulse and body temperature was maintained, but fewer elective care patients had their blood pressure taken during PC inpatient care. Weight assessment was not prioritised during usual or PC inpatient care. Conclusions Patients receiving PC inpatient care reported that they were given the best possible care and had less pain at discharge. The PC inpatient care included improved documentation and communication of planned medical care to the patients. Vital signs were more frequently recorded for patients admitted for acute care than patients admitted for elective care. PC inpatient care had no effect on frequency of weight measurements. Relevance to clinical practice PC inpatient care seems beneficial for the patients. Aspects of patient safety such as prescribed medications were maintained, and PC inpatient care seems to enhance the continuity of care. Inpatient clinical observations need further evaluation as healthcare transitions from disease-centred to person-centred care. C1 [Jakobsson, Sofie; Ung, Eva Jakobsson] Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Box 457, S-40530 Gothenburg, Sweden. [Jakobsson, Sofie; Ringstrom, Gisela; Simren, Magnus; Ung, Eva Jakobsson] Univ Gothenburg, Ctr Person Centred Care GPCC, Gothenburg, Sweden. [Ringstrom, Gisela; Andersson, Eva; Eliasson, Bjorn; Johannsson, Gudmundur; Simren, Magnus; Ung, Eva Jakobsson] Sahlgrens Univ Hosp, Dept Med, Reg Astra Gotaland, Gothenburg, Sweden. [Ringstrom, Gisela; Eliasson, Bjorn; Johannsson, Gudmundur; Simren, Magnus] Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal Med & Clin Nutr, Gothenburg, Sweden. C3 University of Gothenburg; University of Gothenburg; Sahlgrenska University Hospital; University of Gothenburg RP Jakobsson, S (通讯作者),Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Box 457, S-40530 Gothenburg, Sweden. EM sofie.jakobsson@fhs.gu.se OI Jakobsson, Sofie/0000-0001-5223-6363 FU Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden FX We acknowledge funding from the Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden. CR Barker LA, 2011, INT J ENV RES PUB HE, V8, P514, DOI 10.3390/ijerph8020514 Britten N, 2017, HEALTH EXPECT, V20, P407, DOI 10.1111/hex.12468 Bunkenborg G, 2013, J ADV NURS, V69, P1466, DOI 10.1111/jan.12003 Considine J, 2015, J CLIN NURS, V24, P300, DOI 10.1111/jocn.12641 Dellenborg L, 2019, ADV HEALTH SCI EDUC, V24, P353, DOI 10.1007/s10459-018-09869-y Dudas K, 2013, EUR J CARDIOVASC NUR, V12, P521, DOI 10.1177/1474515112472270 Ekman I, 2012, EUR HEART J, V33, P1112, DOI 10.1093/eurheartj/ehr306 Ekman I, 2011, EUR J CARDIOVASC NUR, V10, P248, DOI 10.1016/j.ejcnurse.2011.06.008 Feldthusen C, 2016, ARCH PHYS MED REHAB, V97, P26, DOI 10.1016/j.apmr.2015.09.022 Fors A, 2017, INT J CARDIOL, V249, P42, DOI 10.1016/j.ijcard.2017.08.069 Fors A, 2015, INT J CARDIOL, V187, P693, DOI 10.1016/j.ijcard.2015.03.336 Fuhrmann L, 2008, RESUSCITATION, V77, P325, DOI 10.1016/j.resuscitation.2008.01.009 Henoch I, 2014, RES NURS HEALTH, V37, P512, DOI 10.1002/nur.21624 Herdman M, 2011, QUAL LIFE RES, V20, P1727, DOI 10.1007/s11136-011-9903-x Institute of Medicine (US) Committee on Quality of Health Care in America, 2001, CROSSING QUALITY CHA Jakobsson S, 2019, J ADV NURS, V75, P1678, DOI 10.1111/jan.13953 Jakobsson S, 2018, SCAND J CARING SCI, V32, P1168, DOI 10.1111/scs.12562 Larsson BW, 2002, J CLIN NURS, V11, P681, DOI 10.1046/j.1365-2702.2002.00640.x Ludvigsen ES, 2016, J CLIN NURS, V25, P3229, DOI 10.1111/jocn.13346 Massey D, 2017, NURS OPEN, V4, P6, DOI 10.1002/nop2.53 McCormack B., 2016, PERSON CTR PRACTICE Moore L, 2017, SCAND J CARING SCI, V31, P662, DOI 10.1111/scs.12376 Munroe B, 2018, J CLIN NURS, V27, pE269, DOI 10.1111/jocn.13932 Nguyen O, 2017, J GEN INTERN MED, V32, P42, DOI 10.1007/s11606-016-3826-8 OConnell MB, 2018, J CLIN NURS, V27, P705, DOI 10.1111/jocn.14020 Odell M, 2009, J ADV NURS, V65, P1992, DOI 10.1111/j.1365-2648.2009.05109.x Santana MJ, 2018, HEALTH EXPECT, V21, P429, DOI 10.1111/hex.12640 Scrutton J., 2015, STATE PLAY PERSON CT Wallstrom S, 2018, EUR J CARDIOVASC NUR, V17, P576, DOI 10.1177/1474515118758139 WILDE B, 1994, SCAND J CARING SCI, V8, P39, DOI 10.1111/j.1471-6712.1994.tb00223.x WILLIAMS A, 1990, HEALTH POLICY, V16, P199 Wolf A, 2017, BMJ OPEN, V7, DOI 10.1136/bmjopen-2017-016491 NR 32 TC 2 Z9 2 U1 0 U2 12 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0962-1067 EI 1365-2702 J9 J CLIN NURS JI J. Clin. Nurs. PD FEB PY 2020 VL 29 IS 3-4 BP 602 EP 612 DI 10.1111/jocn.15120 EA DEC 2019 PG 11 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA KA6MY UT WOS:000501834400001 PM 31769572 DA 2023-05-13 ER PT J AU Arbov, E Tayara, A Wu, SW Rich, TC Wagener, BM AF Arbov, Eli Tayara, Alia Wu, Songwei Rich, Thomas C. Wagener, Brant M. TI COVID-19 and Long-Term Outcomes: Lessons from Other Critical Care Illnesses and Potential Mechanisms SO AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY LA English DT Article DE SARS-CoV-2; chronic critical illness; cytokine storm; mitochondrial dysfunction; amyloids ID ACQUIRED PNEUMONIA; SEPSIS; CONSEQUENCES; DYSFUNCTION; IMPACT AB Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that is currently causing a pandemic and has been termed coronavirus disease (COVID-19). The elderly or those with preexisting conditions like diabetes, hypertension, coronary heart disease, chronic obstructive pulmonary disease, cerebrovascular disease, or kidney dysfunction are more likely to develop severe cases when infected. Patients with COVID-19 admitted to the ICU have higher mortality than non-ICU patients. Critical illness has consistently posed a challenge not only in terms of mortality but also in regard to long-term outcomes of survivors. Patients who survive acute critical illness including, but not limited to, pulmonary and systemic insults associated with acute respiratory distress syndrome, pneumonia, systemic inflammation, and mechanical ventilation, will likely suffer from post-ICU syndrome, a phenomenon of cognitive, psychiatric, and/or physical disability after treatment in the ICU. Post-ICU morbidity and mortality continue to be a cause for concern when considering large-scale studies showing 12-month mortality risks of 11.8-21%. Previous studies have demonstrated that multiple mechanisms, including cytokine release, mitochondrial dysfunction, and even amyloids, may lead to end-organ dysfunction in patients. We hypothesize that COVID-19 infection will lead to post-ICU syndrome via potentially similar mechanisms as other chronic critical illnesses and cause long-term morbidity and mortality in patients. We consider a variety of mechanisms and questions that not only consider the short-term impact of the COVID-19 pandemic but its long-term effects that may not yet be imagined. C1 [Arbov, Eli] Morehouse Sch Med, Atlanta, GA 30310 USA. [Tayara, Alia] Univ S Alabama, Dept Biomed Sci, Mobile, AL USA. [Tayara, Alia] Univ S Alabama, Honors Coll, Mobile, AL USA. [Rich, Thomas C.] Univ S Alabama, Dept Pharmacol, Mobile, AL USA. [Rich, Thomas C.] Univ S Alabama, Ctr Lung Biol, Mobile, AL USA. [Wu, Songwei; Wagener, Brant M.] Univ Alabama Birmingham, Div Mol & Translat Biomed, Dept Anesthesiol & Perioperat Med, Birmingham, AL 35294 USA. [Wagener, Brant M.] Univ Alabama Birmingham, Div Crit Care Med, Dept Anesthesiol & Perioperat Med, Birmingham, AL 35294 USA. C3 Morehouse School of Medicine; University of South Alabama; University of South Alabama; University of South Alabama; University of South Alabama; University of Alabama System; University of Alabama Birmingham; University of Alabama System; University of Alabama Birmingham RP Wagener, BM (通讯作者),Univ Alabama Birmingham, Div Mol & Translat Biomed, Dept Anesthesiol & Perioperat Med, Birmingham, AL 35294 USA.; Wagener, BM (通讯作者),Univ Alabama Birmingham, Div Crit Care Med, Dept Anesthesiol & Perioperat Med, Birmingham, AL 35294 USA. EM bwagener@uabmc.edu OI Wagener, Brant/0000-0001-7889-1526 FU Foundation for Anesthesia Education and Research Summer Fellowship Program FX The authors thank the Foundation for Anesthesia Education and Research Summer Fellowship Program for the opportunity to perform this work from a long distance despite the COVID-19 pandemic. 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J. Respir. Cell Mol. Biol. PD SEP PY 2022 VL 67 IS 3 BP 275 EP 283 DI 10.1165/rcmb.2021-0374PS PG 9 WC Biochemistry & Molecular Biology; Cell Biology; Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC Biochemistry & Molecular Biology; Cell Biology; Respiratory System GA 4J6UL UT WOS:000851401200004 PM 35348443 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Kataja, A Tarvasmaki, T Lassus, J Kober, L Sionis, A Spinar, J Parissis, J Carubelli, V Cardoso, J Banaszewski, M Marino, R Nieminen, MS Mebazaa, A Harjola, VP AF Kataja, Anu Tarvasmaki, Tuukka Lassus, Johan Kober, Lars Sionis, Alessandro Spinar, Jindrich Parissis, John Carubelli, Valentina Cardoso, Jose Banaszewski, Marek Marino, Rossella Nieminen, Markku S. Mebazaa, Alexandre Harjola, Veli-Pekka TI Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Cardiogenic shock; acute coronary syndromes; acute heart failure; altered mental status; delirium; acidosis ID CRITICALLY-ILL PATIENTS; INTENSIVE-CARE-UNIT; RISK-FACTORS; HEART-FAILURE; DELIRIUM; OUTCOMES; METAANALYSIS; ASSOCIATION; PREVALENCE; MANAGEMENT AB Background: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock. Methods: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study. Clinical picture, biochemical variables, and short-term mortality were compared between patients presenting with altered and normal mental status. Results: Altered mental status was detected in 147 (68%) patients, whereas 68 (32%) patients had normal mental status. Patients with altered mental status were older (68 vs. 64 years, p=0.04) and more likely to have an acute coronary syndrome than those with normal mental status (85% vs. 74%, p=0.04). Altered mental status was associated with lower systolic blood pressure (76 vs. 80 mmHg, p=0.03) and lower arterial pH (7.27 vs. 7.35, p<0.001) as well as higher levels of blood lactate (3.4 vs. 2.3 mmol/l, p<0.001) and blood glucose (11.4 vs. 9.0 mmol/l, p=0.01). Low arterial pH (adjusted odds ratio 1.6 (1.1-2.2), p=0.02) was the only factor independently associated with altered mental status. Ninety-day mortality was significantly higher (51% vs. 22%, p<0.001) among patients with altered mental status. Conclusions: Altered mental status is a common clinical sign of systemic hypoperfusion in cardiogenic shock and is associated with poor outcome. It is also associated with several biochemical findings that reflect inadequate tissue perfusion, of which low arterial pH is independently associated with altered mental status. C1 [Kataja, Anu; Tarvasmaki, Tuukka; Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Div Emergency Med, Helsinki, Finland. [Lassus, Johan; Nieminen, Markku S.] Univ Helsinki, Helsinki Univ Hosp, Heart & Lung Ctr, Cardiol, Helsinki, Finland. [Kober, Lars] Copenhagen Univ Hosp, Rigshosp, Div Heart Failure Pulm Hypertens & Heart Transpla, Copenhagen, Denmark. [Sionis, Alessandro] Univ Barcelona, Hosp Santa Creu & St Pau, Biomed Res Inst IIB St Pau, Intens Cardiac Care Unit,Cardiol Dept, Barcelona, Spain. [Spinar, Jindrich] Univ Hosp Brno, Internal Cardiol Dept, Brno, Czech Republic. [Spinar, Jindrich] Masaryk Univ, Brno, Czech Republic. [Parissis, John] Attikon Univ Hosp, Heart Failure Clin, Athens, Greece. [Carubelli, Valentina] Univ & Civil Hosp Brescia, Div Cardiol, Dept Med & Surg Specialties, Radiol Sci & Publ Hlth, Brescia, Italy. [Cardoso, Jose] Univ Porto, Dept Cardiol, CINTESIS Ctr Hlth Technol & Serv Res, Fac Med,Sao Joao Med Ctr, Oporto, Portugal. [Banaszewski, Marek] Inst Cardiol, Intens Cardiac Therapy Clin, Warsaw, Poland. [Marino, Rossella] Univ Rome Sapienza, Dept Med Sci & Translat Med, Emergency Dept, St Andrea Hosp, Rome, Italy. [Mebazaa, Alexandre] Hop Lariboisiere, AP HP, INSERM, U942, Paris, France. [Mebazaa, Alexandre] Univ Paris Diderot, Paris, France. C3 University of Helsinki; Helsinki University Central Hospital; University of Helsinki; Helsinki University Central Hospital; Rigshospitalet; University of Copenhagen; Hospital of Santa Creu i Sant Pau; University of Barcelona; University Hospital Brno; Masaryk University Brno; University Hospital Attikon; Sao Joao Hospital; Universidade do Porto; Institute of Cardiology - Poland; Sapienza University Rome; Azienda Ospedaliera Sant'Andrea; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; UDICE-French Research Universities; Universite Paris Cite RP Kataja, A (通讯作者),Helsinki Univ Hosp, Div Emergency Med, POB 340, Helsinki 00029, Finland. EM anu.kataja@helsinki.fi RI Sionis, Alessandro/V-6869-2017; Silva-Cardoso, Jose/L-8033-2013 OI Sionis, Alessandro/0000-0003-0843-9512; Kober, Lars/0000-0002-6635-1466; Silva-Cardoso, Jose/0000-0002-9774-9864; Lassus, Johan/0000-0003-4033-3232; Mebazaa, Alexandre/0000-0001-8715-7753; Carubelli, Valentina/0000-0002-9430-9820 FU Aarne Koskelo Foundation; Finnish Cardiac Foundation FX This work was supported by the Aarne Koskelo Foundation and the Finnish Cardiac Foundation. 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Heart J.-Acute Cardiovasc. Care PD FEB PY 2018 VL 7 IS 1 BP 38 EP 44 DI 10.1177/2048872617702505 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FV5SP UT WOS:000424643000005 PM 28403620 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Nascimento, BR Brant, LCC Marino, BCA Passaglia, LG Ribeiro, ALP AF Nascimento, Bruno R. Caldeira Brant, Luisa C. Marino, Barbara C. A. Passaglia, Luiz Guilherme Ribeiro, Antonio Luiz P. TI Implementing myocardial infarction systems of care in low/middle-income countries SO HEART LA English DT Review DE acute myocardial infarction; healthcare delivery; systemic review; heart disease ID ST-SEGMENT-ELEVATION; ACUTE CORONARY SYNDROMES; EMERGENCY CARE; TASK-FORCE; LOW-MIDDLE; MANAGEMENT; OUTCOMES; INTERVENTION; HEALTH; BRAZIL AB Ischaemic heart disease is the leading cause of death worldwide, with an increasing trend from 6.1 million deaths in 1990 to 9.5 million in 2016, markedly driven by rates observed in low/middle-income countries (LMIC). Improvements in myocardial infarction (MI) care are crucial for reducing premature mortality. We aimed to evaluate the main challenges for adequate MI care in LMIC, and possible strategies to overcome these existing barriers. Reperfusion is the cornerstone of MI treatment, but worldwide around 30% of patients are not reperfused, with even lower rates in LMIC. The main challenges are related to delays associated with patient education, late diagnosis and inadequate referral strategies, health infrastructure and insufficient funding. The implementation of regional MI systems of care in LMIC, systematising timely reperfusion strategies, access to intensive care, risk stratification and use of adjunctive medications have shown some successful strategies. Telemedicine support for remote ECG, diagnosis and organisation of referrals has proven to be useful, improving access to reperfusion even in prehospital settings. Organisation of transport and referral hubs based on anticipated delays and development of MI excellence centres have also resulted in better equality of care. Also, education of healthcare staff and task shifting may potentially widen access to optimal therapy. In conclusion, efforts have been made for the implementation of MI systems of care in LMIC, aiming to address particularities of the health systems. However, the increasing impact of MI in these countries urges the development of further strategies to improve reperfusion and reduce system delays. C1 [Nascimento, Bruno R.; Caldeira Brant, Luisa C.; Ribeiro, Antonio Luiz P.] Univ Fed Minas Gerais, Hosp Clin, Serv Cardiol & Cirurgia Cardiovasc, Belo Horizonte, MG, Brazil. [Nascimento, Bruno R.; Caldeira Brant, Luisa C.; Ribeiro, Antonio Luiz P.] Univ Fed Minas Gerais, Hosp Clin, Ctr Telessaude, Belo Horizonte, MG, Brazil. [Nascimento, Bruno R.; Caldeira Brant, Luisa C.; Passaglia, Luiz Guilherme; Ribeiro, Antonio Luiz P.] Univ Fed Minas Gerais, Fac Med, Dept Clin Med, Belo Horizonte, MG, Brazil. [Marino, Barbara C. A.] Hosp Madre Teresa, Serv Cardiol, Belo Horizonte, MG, Brazil. [Marino, Barbara C. A.] PUC MG, Fac Med, Belo Horizonte, MG, Brazil. C3 Universidade Federal de Minas Gerais; Universidade Federal de Minas Gerais; Universidade Federal de Minas Gerais; Pontificia Universidade Catolica de Minas Gerais RP Nascimento, BR (通讯作者),Univ Fed Minas Gerais, Hosp Clin, Ctr Telessaude, Ave Prof Alfredo Balena 110,2nd Floor, BR-3013010 Belo Horizonte, MG, Brazil. EM ramosnas@gmail.com RI Nacimento, Bruno Ramos/F-8066-2013; Brant, Luisa/ABD-8402-2020; Ribeiro, Antonio L/C-2707-2009 OI Nacimento, Bruno Ramos/0000-0002-5586-774X; Brant, Luisa/0000-0002-7317-1367; Ribeiro, Antonio L/0000-0002-2740-0042; Passaglia, Luiz/0000-0001-8260-9212 FU CNPq (Bolsa de produtividade em pesquisa) [310679/2016-8]; FAPEMIG (Programa Pesquisador Mineiro) [PPM-00428-17]; CNPq (Instituto de Avaliacao de Tecnologias em Saude-IATS) [465518/2014-1] FX ALPR was supported in part by CNPq (Bolsa de produtividade em pesquisa, 310679/2016-8, and Instituto de Avaliacao de Tecnologias em Saude-IATS, 465518/2014-1) and by FAPEMIG (Programa Pesquisador Mineiro, PPM-00428-17). 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Objective: To investigate adverse cardiovascular outcomes of an early versus a conservative invasive strategy in a national cohort of patients with ACSs. Design: Retrospective cohort study. Setting: Administrative health care data on hospitalizations, procedures, and outcomes abstracted from the Danish national registries and covering all acute invasive procedures in patients presenting with an ACS. Patients: 19 704 propensity score-matched patients hospitalized with a first ACS between 1 January 2005 and 31 December 2011. Measurements: Risk for cardiac death or rehospitalization for MI within 60 days of hospitalization. Results: Compared with a conservative approach, early invasive strategies were associated with a lower risk for cardiac death (cumulative incidence, 5.9% vs. 7.6%; adjusted hazard ratio [HR], 0.75 [95% CI, 0.66 to 0.84]; P < 0.001). Similar results were found for rehospitalization for MI (cumulative incidence, 3.4% vs. 5.0%; adjusted odds ratio, 0.67 [CI, 0.58 to 0.77]; P < 0.001) and all-cause death (cumulative incidence, 7.3% vs. 10.6%; adjusted HR, 0.65 [CI, 0.59 to 0.72]; P < 0.001). Limitation: Potential residual confounding due to lack of core clinical variables. Conclusion: In this real-world cohort of patients with a first hospitalization for an ACS, the use of an early invasive treatment strategy was associated with a lower risk for cardiac death and rehospitalization for MI compared with a conservative invasive approach. Primary Funding Source: Department of Cardiology, University Hospital Gentofte. C1 [Hansen, Kim Wadt; Galatius, Soren] Bispebjerg Hosp, Dept Cardiol, DK-2400 Copenhagen, Denmark. [Sorensen, Rikke; Jensen, Jan Skov] Gentofte Univ Hosp, Dept Cardiol, DK-2900 Hellerup, Denmark. [Madsen, Mette] Univ Copenhagen, Dept Publ Hlth, DK-1014 Copenhagen, Denmark. [Madsen, Jan Kyst] Holbaek Univ Hosp, Emergency Dept, DK-4300 Holbaek, Denmark. [von Kappelgaard, Lene Mia] Univ Copenhagen, Natl Inst Publ Hlth, DK-1353 Copenhagen, Denmark. [Mortensen, Poul Erik] Odense Univ Hosp, Dept Thorac Surg, DK-5000 Odense, Denmark. [Lange, Theis] Univ Copenhagen, Sect Biostat, Dept Publ Hlth, DK-1014 Copenhagen, Denmark. C3 University of Copenhagen; Bispebjerg Hospital; University of Copenhagen; Herlev & Gentofte Hospital; University of Copenhagen; University of Copenhagen; University of Southern Denmark; Odense University Hospital; University of Copenhagen RP Hansen, KW (通讯作者),Bispebjerg Hosp, Dept Cardiol, Bldg 67,Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark. EM kim.wadt.hansen@regionh.dk RI Hansen, Kim/HKN-4416-2023; Madsen, Mette/HMV-1125-2023 OI Lange, Theis/0000-0001-6807-8347; Sorensen, Rikke/0000-0001-9238-6681 FU Department of Cardiology, University Hospital Gentofte FX Department of Cardiology, University Hospital Gentofte. 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Intern. Med. PD NOV 17 PY 2015 VL 163 IS 10 BP 737 EP + DI 10.7326/M15-0303 PG 24 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CX5MQ UT WOS:000365746400016 PM 26502223 DA 2023-05-13 ER PT J AU Meloni, L Montisci, R Pippia, V Sancassiani, F Carta, MG AF Meloni, Luigi Montisci, Roberta Pippia, Valentina Sancassiani, Federica Carta, Mauro G. TI Alexithymia affects the time from symptom onset to calling the emergency system in STEMI patients referred for primary PCI SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE STEMI; Emergency medical system; Primary PCI; Delay in seeking care; Alexithymia ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; PREHOSPITAL DELAY; CARE; SCALE; SEEKING; INTERVENTION; VALIDITY; IMPROVES; TRIAL AB Background: STEMI programs have been found to reduce the time to reperfusion but do not address the time delay caused by patients. In this study we sought to assess whether and to what extent alexithymia, defined as the inability to recognize and describe somatic feelings appropriately, impacts on this delay. Methods: Ninety-five STEMI patients referred by the Emergency Medical System(EMS) to our hospital for primary percutaneous coronary intervention were studied. The time from symptom onset to the EMS call (time to call) as well as the time from the EMS call to the first intervention that restored patency of the culprit vessel (system delay) and the total ischemic time was calculated in patients categorized into two groups according to the Toronto Alexithymia scale (TAS-20): patients with higher alexithymia scores (>= 61), and patients with lower scores of alexithymia (<61). Results: According to the TAS-20, we identified 27 patients as being alexithymic and 68 patients as not. The time to call and the total ischemic time were longer in alexithymic compared to non alexithymic patients (respectively, 159 min vs 35 min, and 258.5 vs 139, p = 0.001), while the system delay was similar in both groups. Conclusions: Alexithymia is one trait of the patient personality which appears to have negative implications in the setting of a STEMI network by interfering with prompt seeking of care. This information could help in guiding novel strategies to motivate patients to call EMS quickly and further shorten the total ischemic time. (C) 2016 Elsevier Ireland Ltd. All rights reserved. C1 [Meloni, Luigi; Montisci, Roberta; Pippia, Valentina] Univ Cagliari, Clin Cardiol, Osped San Giovanni Dio, AOU Cagliari,Dept Med Sci M Aresu, I-09124 Cagliari, Italy. [Sancassiani, Federica; Carta, Mauro G.] Univ Cagliari, Ctr Consultat Liaison Psychiat & Psychosomat, Dept Publ Hlth, Osped San Giovanni di Dio, I-09124 Cagliari, Italy. C3 Presidio Ospedaliero San Giovanni di Dio; University of Cagliari; University of Cagliari RP Meloni, L (通讯作者),Univ Cagliari, Clin Cardiol, Osped San Giovanni Dio, AOU Cagliari,Dept Med Sci M Aresu, I-09124 Cagliari, Italy. EM luigimeloni@medicina.unica.it RI Montisci, Roberta/HKW-3498-2023 OI Montisci, Roberta/0000-0002-7218-6751; SANCASSIANI, FEDERICA/0000-0002-7963-5281 CR BAGBY RM, 1994, J PSYCHOSOM RES, V38, P23, DOI 10.1016/0022-3999(94)90005-1 Beresnevaite M, 2000, PSYCHOTHER PSYCHOSOM, V69, P117, DOI 10.1159/000012378 Carta MG, 2013, PSYCHOTHER PSYCHOSOM, V82, P190, DOI 10.1159/000341181 DelliFraine J, 2013, AM HEART J, V165, P926, DOI 10.1016/j.ahj.2013.02.005 Dracup K, 2009, CIRC-CARDIOVASC QUAL, V2, P144, DOI 10.1161/CIRCOUTCOMES.109.855635 Dracup K, 2009, CIRC-CARDIOVASC QUAL, V2, P524, DOI 10.1161/CIRCOUTCOMES.109.852608 FRANZOSI MG, 1995, ARCH INTERN MED, V155, P1481, DOI 10.1001/archinte.1995.00430140035003 Jacobs AK, 2007, CIRCULATION, V116, P217, DOI 10.1161/CIRCULATIONAHA.107.184043 Kainth A, 2004, EMERG MED J, V21, P506, DOI 10.1136/emj.2003.013276 Kalla K, 2006, CIRCULATION, V113, P2398, DOI 10.1161/CIRCULATIONAHA.105.586198 KENYON LW, 1991, CIRCULATION, V84, P1969, DOI 10.1161/01.CIR.84.5.1969 Le HN, 2002, EMOTION, V2, P341, DOI 10.1037//1528-3542.2.4.341 Luepker RV, 2000, JAMA-J AM MED ASSOC, V284, P60, DOI 10.1001/jama.284.1.60 Lumley MA, 2007, J PERS ASSESS, V89, P230, DOI 10.1080/00223890701629698 Meloni L, 2016, J CARDIOVASC MED, V17, P494, DOI 10.2459/JCM.0000000000000285 Moriguchi Y, 2007, BIOPSYCHOSOC MED, V1, DOI 10.1186/1751-0759-1-7 Moser DK, 2006, CIRCULATION, V114, P168, DOI 10.1161/CIRCULATIONAHA.106.176040 Nguyen HL, 2010, CIRC-CARDIOVASC QUAL, V3, P590, DOI 10.1161/CIRCOUTCOMES.110.957878 O'Carroll RE, 2001, J PSYCHOSOM RES, V51, P611, DOI 10.1016/S0022-3999(01)00265-3 PASINI A, 1992, COMPR PSYCHIAT, V33, P42, DOI 10.1016/0010-440X(92)90078-5 Pedersen SH, 2009, J AM COLL CARDIOL, V54, P2296, DOI 10.1016/j.jacc.2009.06.056 SIFNEOS PE, 1973, PSYCHOTHER PSYCHOSOM, V22, P255, DOI 10.1159/000286529 Sullivan MD, 2009, CIRC-CARDIOVASC QUAL, V2, P148, DOI 10.1161/CIRCOUTCOMES.108.825471 TAYLOR GJ, 1988, PSYCHOSOM MED, V50, P500, DOI 10.1097/00006842-198809000-00006 Taylor GJ, 2003, J PSYCHOSOM RES, V55, P277, DOI 10.1016/S0022-3999(02)00601-3 Ting HH, 2009, CIRC-CARDIOVASC QUAL, V2, P522, DOI 10.1161/CIRCOUTCOMES.109.912188 NR 26 TC 9 Z9 9 U1 0 U2 5 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD SEP 15 PY 2016 VL 219 BP 428 EP 432 DI 10.1016/j.ijcard.2016.06.038 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DS5JG UT WOS:000380817400073 PM 27372605 DA 2023-05-13 ER PT J AU Levi, M Hunt, BJ AF Levi, M. Hunt, B. J. TI A critical appraisal of point-of-care coagulation testing in critically ill patients SO JOURNAL OF THROMBOSIS AND HAEMOSTASIS LA English DT Review DE critical care; hemorrhage; platelet aggregation inhibitors; point-of-care systems; thoracic surgery; thrombosis ID PLATELET-FUNCTION TESTS; TRAUMATIC COAGULOPATHY; POSTPARTUM HEMORRHAGE; STENT IMPLANTATION; CARDIAC-SURGERY; INTENSIVE-CARE; THROMBOELASTOGRAPHY; THROMBELASTOGRAPHY; TRANSFUSION; REACTIVITY AB Derangement of the coagulation system is a common phenomenon in critically ill patients, who may present with severe bleeding and/or conditions associated with a prothrombotic state. Monitoring of this coagulopathy can be performed with conventional coagulation assays; however, point-of-care tests have become increasingly attractive, because not only do they yield a more rapid result than clinical laboratory testing, but they may also provide a more complete picture of the condition of the hemostatic system. There are many potential areas of study and applications of point-of-care hemostatic testing in critical care, including patients who present with massive blood loss, patients with a hypercoagulable state (such as in disseminated intravascular coagulation), and monitoring of antiplatelet treatment for acute arterial thrombosis, mostly acute coronary syndromes. However, the limitations of near-patient hemostatic testing has not been fully appreciated, and are discussed here. The currently available evidence indicates that point-of-care tests may be applied to guide appropriate blood product transfusion and the use of hemostatic agents to correct the hemostatic defect or to ameliorate antithrombotic treatment. Disappointingly, however, only in cardiac surgery is there adequate evidence to show that application of near-patient thromboelastography leads to an improvement in clinically relevant outcomes, such as reductions in bleeding-related morbidity and mortality, and cost-effectiveness. More research is required to validate the utility and cost-effectiveness of near-patient hemostatic testing in other areas, especially in traumatic bleeding and postpartum hemorrhage. C1 [Levi, M.] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1105 AZ Amsterdam, Netherlands. [Hunt, B. J.] Kings Coll Univ, Thrombosis & Haemostasis, London, England. [Hunt, B. J.] Guys & St Thomas NHS Fdn Trust, Lupus & Pathol, Haematol, London, England. C3 University of Amsterdam; Academic Medical Center Amsterdam; Guy's & St Thomas' NHS Foundation Trust RP Levi, M (通讯作者),Univ Amsterdam, Acad Med Ctr E2, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands. EM m.m.levi@amc.uva.nl RI Levi, Marcel/AAZ-8559-2020 FU Haemonetics FX B. J. Hunt attended a key opinion leaders meeting in 2012 sponsored by Haemonetics. M. Levi states that he has no conflict of interest. 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Thromb. Haemost. PD NOV PY 2015 VL 13 IS 11 BP 1960 EP 1967 DI 10.1111/jth.13126 PG 8 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA CW1VB UT WOS:000364778700003 PM 26333113 OA Bronze DA 2023-05-13 ER PT J AU Mathewkutty, S Sethi, SS Aneja, A Shah, K Iyengar, RL Hermann, L Khakimov, S Razzouk, L Esquitin, R Vedanthan, R Benjamin, TA Grace, M Nisenbaum, R Ramanathan, K Ramanathan, L Chesebro, J Farkouh, ME AF Mathewkutty, Shiny Sethi, Sanjum S. Aneja, Ashish Shah, Kshitij Iyengar, Rupa L. Hermann, Luke Khakimov, Sayyar Razzouk, Louai Esquitin, Ricardo Vedanthan, Rajesh Benjamin, Terrie-Ann Grace, Marie Nisenbaum, Rosane Ramanathan, Krishnan Ramanathan, Lakshmi Chesebro, James Farkouh, Michael E. TI Biomarkers After Risk Stratification in Acute Chest Pain (from the BRIC Study) SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE CORONARY SYNDROMES; NATRIURETIC PEPTIDE; EMERGENCY-DEPARTMENT; ST-ELEVATION; MYOCARDIAL-INFARCTION; CT ANGIOGRAPHY; CYSTATIN-C; OUTCOMES; DIAGNOSIS; ISCHEMIA AB Current models incompletely risk-stratify patients with acute chest pain. In this study, N-terminal pro-B-type natriuretic peptide and cystatin C were incorporated into a contemporary chest pain triage algorithm in a clinically stratified population to improve acute coronary syndrome discrimination. Adult patients with chest pain presenting without myocardial infarction (n = 382) were prospectively enrolled from 2008 to 2009. After clinical risk stratification, N-terminal pro-B-type natriuretic peptide and cystatin C were measured and standard care was performed. The primary end point was the result of a clinical stress test. The secondary end point was any major adverse cardiac event at 6 months. Associations were determined through multivariate stratified analyses. In the low-risk group, 76 of 78 patients with normal levels of the 2 biomarkers had normal stress test results (negative predictive value 97%). Normal biomarkers predicted normal stress test results with an odds ratio of 10.56 (p = 0.006). In contrast, 26 of 33 intermediate-risk patients with normal levels of the 2 biomarkers had normal stress test results (negative predictive value 79%). Biomarkers and stress test results were not associated in the intermediate-risk group (odds ratio 2.48, p = 0.09). There were 42 major adverse cardiac events in the overall cohort. No major adverse cardiac events occurred at 6 months in the low-risk subgroup that underwent stress testing. In conclusion, N-terminal pro-B-type natriuretic peptide and cystatin C levels predict the results of stress tests in low-risk patients with chest pain but should not be substituted for stress testing in intermediate-risk patients. There is potential for their use in the early discharge of low-risk patients after clinical risk stratification. (C) 2013 Elsevier Inc. All rights reserved. (Am J Cardiol 2013;111:493-498) C1 [Mathewkutty, Shiny; Sethi, Sanjum S.; Iyengar, Rupa L.; Khakimov, Sayyar; Vedanthan, Rajesh; Farkouh, Michael E.] Mt Sinai Sch Med, Zena & Michael Wiener Cardiovasc Inst, New York, NY 10029 USA. [Hermann, Luke] Mt Sinai Sch Med, Dept Emergency Med, New York, NY USA. [Grace, Marie; Ramanathan, Lakshmi] Mt Sinai Sch Med, Dept Pathol, New York, NY USA. [Aneja, Ashish] Case Western Reserve Univ, Metrohlth Campus, Heart & Vasc Ctr, Cleveland, OH 44106 USA. [Shah, Kshitij] James J Peters VA Med Ctr, Dept Med, Bronx, NY USA. [Razzouk, Louai] NYU, Div Cardiol, New York, NY USA. [Esquitin, Ricardo] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Div Cardiol, Boston, MA 02215 USA. [Benjamin, Terrie-Ann] Cleveland Clin, Dept Med, Cleveland, OH 44106 USA. [Nisenbaum, Rosane] Univ Toronto, Ctr Res Inner City Hlth, Toronto, ON, Canada. [Nisenbaum, Rosane] Univ Toronto, Appl Hlth Res Ctr, Toronto, ON, Canada. [Nisenbaum, Rosane] Univ Toronto, Keenan Res Ctr, Li Ka Shing Knowledge Inst, St Michaels Hosp, Toronto, ON, Canada. [Nisenbaum, Rosane] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada. [Ramanathan, Krishnan] Univ British Columbia, St Pauls Hosp, Div Cardiol, Vancouver, BC V5Z 1M9, Canada. [Chesebro, James] Univ Massachusetts, Sch Med, Div Cardiovasc Med, Worcester, MA USA. [Farkouh, Michael E.] Univ Toronto, Peter Munk Cardiac Ctr, Toronto, ON, Canada. [Farkouh, Michael E.] Univ Toronto, Li Ka Shing Knowledge Inst, Toronto, ON, Canada. C3 Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Case Western Reserve University; MetroHealth System; US Department of Veterans Affairs; Veterans Health Administration (VHA); James J. Peters VA Medical Center; New York University; Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; Cleveland Clinic Foundation; University of Toronto; University of Toronto; University of Toronto; Li Ka Shing Knowledge Institute; Saint Michaels Hospital Toronto; University of Toronto; St. Paul's Hospital; University of British Columbia; University of Massachusetts System; University of Massachusetts Worcester; University of Toronto; Peter Munk Cardiac Centre; University of Toronto; Li Ka Shing Knowledge Institute RP Farkouh, ME (通讯作者),Mt Sinai Sch Med, Zena & Michael Wiener Cardiovasc Inst, New York, NY 10029 USA. EM michael.farkouh@mssm.edu RI Sethi, Sanjum S./AAO-2601-2020; Aneja, Ashish/Z-1379-2019 OI Sethi, Sanjum S./0000-0002-3438-7034; Razzouk, Louai/0000-0002-0306-6182; Vedanthan, Rajesh/0000-0001-7138-2382; Esquitin, Ricardo/0000-0002-3475-3671 FU Radiometer (Bronshoj, Denmark); Ontario Ministry of Health and Long-Term Care, Toronto, Ontario, Canada FX This study was sponsored partly by Radiometer (Bronshoj, Denmark).; Dr. Nisenbaum gratefully acknowledges the support of the Ontario Ministry of Health and Long-Term Care, Toronto, Ontario, Canada. The views expressed in this publication are the views of the investigators and do not necessarily reflect the views of the Ontario Ministry of Health and Long-Term Care. 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PD FEB 15 PY 2013 VL 111 IS 4 BP 493 EP 498 DI 10.1016/j.amjcard.2012.10.032 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 095GN UT WOS:000315322800006 PM 23218997 OA Green Accepted DA 2023-05-13 ER PT J AU Sobczyk, D Nycz, K Andruszkiewicz, P AF Sobczyk, Dorota Nycz, Krzysztof Andruszkiewicz, Pawel TI Validity of a 5-minute focused echocardiography with A-F mnemonic performed by non-echocardiographers in the management of patients with acute chest pain SO CARDIOVASCULAR ULTRASOUND LA English DT Article DE Acute coronary syndrome; Emergency room; Focused echocardiography; Emergency echocardiography; A-F mnemonic ID LIMITED TRANSTHORACIC ECHOCARDIOGRAM; OF-CARE ECHOCARDIOGRAPHY; CARDIAC ULTRASOUND; AMERICAN-COLLEGE; POINT; FEASIBILITY; ASSOCIATION; PHYSICIAN AB Study objective: To validate the practicality of focused echocardiography with A-F mnemonic performed by non-specialists in patients with suspected acute coronary syndrome (ACS). Design: This prospective observational study was conducted in the Emergency Room within 12 months period. Study population consisted of consecutive patients with preliminary diagnosis of an ACS. The following data were analyzed: demographics, clinical condition, medical history, ECG, transthoracic echocardiography (TTE) and levels of cardiac necrotic markers. TTE was performed within the first 15 minutes after the admission by the resident on-call. TTE images were interpreted and reported with mnemonic A-F. All studies were recorded and reviewed within 24 hours by the cardiologist. Results: 1312 consecutive patients were enrolled to the study. TTE with A-F mnemonic revealed: RWMAs in 82,87% patients with confirmed ACS, other significant cardiac pathologies were found in 2,21% in ACS and 46,52% in non-ACS groups respectively. On the basis of these findings, 20 (1,92%) ACS and 29 (10,62%) non-ACS group patients underwent target operative treatment. Survey showed that both echocardiographic image acquisition and its interpretation with A-F mnemonic, took less than 5 minutes in 95% of cases. Residents found A-F mnemonic algorithm simple and useful. No differences were found in key findings between TTE performed by resident and the cardiologist. Conclusion: Focused echocardiography with A-F mnemonic allows both confirmation of acute myocardial ischemia and detection of the other life-threatening cardiac conditions resulting in proper bedside decision of directed treatment. Mnemonic based TTE enables reliable examination by properly trained residents. C1 [Sobczyk, Dorota; Nycz, Krzysztof] John Paul 2 Hosp, Dept Intervent Cardiol, PL-31202 Krakow, Poland. [Andruszkiewicz, Pawel] Med Univ Warsaw, Clin Anaesthesiol & Intens Care 2, Warsaw, Poland. C3 Medical University of Warsaw RP Sobczyk, D (通讯作者),John Paul 2 Hosp, Dept Intervent Cardiol, Pradnicka 80, PL-31202 Krakow, Poland. 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Ultrasound PD MAR 26 PY 2015 VL 13 AR 16 DI 10.1186/s12947-015-0010-y PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CE5WZ UT WOS:000351907800001 PM 25880201 OA Green Published, gold DA 2023-05-13 ER PT J AU Yousuf, T Nakhle, A Rawal, H Harrison, D Maini, R Irimpen, A AF Yousuf, Tariq Nakhle, Asaad Rawal, Harsh Harrison, Daniel Maini, Rohit Irimpen, Anand TI Special Article - Natural disasters and acute myocardial infarction SO PROGRESS IN CARDIOVASCULAR DISEASES LA English DT Review DE Natural disaster; Cardiovascular disease; Myocardial infarction ID HURRICANE KATRINA; CARDIOVASCULAR EVENTS; HOSPITAL ADMISSIONS; JAPAN EARTHQUAKE; MORTALITY; IMPACT; CHRONOBIOLOGY; EPIDEMIOLOGY; ASSOCIATION; DEPRESSION AB Natural disasters are devastating to not only our physical property but also to our health. There have been several studies over the last few decades that have correlated different types of natural disasters with acute myocardial infarctions (AMIs). Since the early 1930's singular meteorological events have been reported to have some association and effect on cardiovascular (CV) mortality and morbidity. Multiple natural disasters regardless of location have repeatedly reported a significant increase in the incidence of acute coronary syndromes (ACS). Each event was associated with similar mechanisms, which increase the overall CV mortality. The most prominent of those being neurohormonal activation, total scarcity of supplies and access to health care, poverty, stress, increased incidence of smoking and drug abuse. Increased incidence of associated infections added to the burden of ACS. We know natural disasters are inevitable; however, disaster preparedness is surely a reliable way to help curb their devastating effects on human life. In this manuscript, the authors present many forms of natural disasters and their association with acute myocardial infarction (AMI). (c) 2020 Elsevier Inc. All rights reserved. C1 [Yousuf, Tariq; Nakhle, Asaad; Harrison, Daniel; Maini, Rohit; Irimpen, Anand] Tulane Univ, Inst Heart & Vasc, Sch Med, Sect Cardiol,Dept Med, 1430 Tulane Ave,SL-48, New Orleans, LA 70112 USA. [Rawal, Harsh] Medstar Washington Hosp Ctr, Medstar Heart & Vasc Inst, 110 Irving St NW, Washington, DC 20010 USA. [Irimpen, Anand] Southeast Louisiana Vet Hlth Care Syst, Dept Cardiol, 2400 Canal St, New Orleans, LA 70112 USA. C3 Tulane University; MedStar Washington Hospital Center RP Yousuf, T (通讯作者),Tulane Univ, Sch Med, 1430 Tulane Ave,SL-48, New Orleans, LA 70112 USA. 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Cardiovasc. Dis. PD JUL-AUG PY 2020 VL 63 IS 4 BP 510 EP 517 DI 10.1016/j.pcad.2020.05.003 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OA8ME UT WOS:000578034100016 PM 32417189 DA 2023-05-13 ER PT J AU Singh, RJ Chen, S Ganesh, A Hill, MD AF Singh, Ravinder-Jeet Chen, Shuo Ganesh, Aravind Hill, Michael D. TI Long-term neurological, vascular, and mortality outcomes after stroke SO INTERNATIONAL JOURNAL OF STROKE LA English DT Review DE Acute stroke therapy; depression; ischemic stroke; long-term outcome; mortality; prognosis; recurrence; stroke; thrombolysis ID PRIMARY INTRACEREBRAL HEMORRHAGE; ACUTE CORONARY SYNDROMES; 1ST CEREBRAL INFARCTION; ACUTE ISCHEMIC-STROKE; 1ST-EVER STROKE; FOLLOW-UP; RECURRENT STROKE; RISK-FACTORS; MYOCARDIAL-INFARCTION; GLOBAL BURDEN AB Background Despite improved survival and short-term (90-day) outcomes of ischemic stroke patients, only sparse data exist describing the sustained benefits of acute stroke care interventions and long-term prognosis of stroke survivors. Aim We review the contemporary literature assessing long-term (5 years or more) outcomes after stroke and acute stroke treatment. Summary of review Acute stroke unit care and intravenous thrombolysis have sustained benefits over longer follow-up, but few data exist on the long-term outcome after endovascular thrombectomy (EVT). A large proportion of stroke survivors face challenges of residual disability and neuropsychiatric sequelae (especially affective disorders and epilepsy) which affects their quality of life and is associated with poorer prognosis due to increase in stroke recurrences/mortality. Nearly, a quarter of stroke survivors have a recurrent stroke at 5 years, and nearly double that at 10 years. Mortality after recurrent stroke is high, and half of the stroke survivors are deceased at 5 years after stroke and three fourth at 10 years. Long-term all-cause mortality is largely due to conditions other than stroke. Both stroke recurrence and long-term mortality are affected by several modifiable risk factors, and thus amenable to secondary prevention strategies. 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Motovska, Zuzana Studencan, Martin Mimoso, Jorge Becker, David Alexopoulos, Dimitrios Kereseselidze, Zviad Stojkovic, Sinisa Zelveian, Parounak Goda, Artan Mirrakhimov, Erkin Bajraktari, Gani Farhan, Hasan Ali Serpytis, Pranas Raungaard, Bent Marandi, Toomas Moore, Alice May Quinn, Martin Karjalainen, Pasi Paavo Tatu-Chitoiu, Gabriel Gale, Chris P. Maggioni, Aldo P. Weidinger, Franz CA ESC TI Care of patients with ST-elevation myocardial infarction: an international analysis of quality indicators in the acute coronary syndrome STEMI Registry of the EURObservational Research Programme and ACVC and EAPCI Associations of the European Society of Cardiology in 11 462 patients SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article; Early Access DE ST-segment elevation myocardial infarction; Primary percutaneous coronary intervention; Quality indicators; Guidelines; Observational studies; Registry; Reperfusion therapy ID ACUTE CARDIOVASCULAR CARE; HEART SURVEY; REPERFUSION THERAPY; MEDITERRANEAN BASIN; POSITION PAPER; MANAGEMENT; ESC; GUIDELINES; MORTALITY; OUTCOMES AB Aims To use quality indicators to study the management of ST-segment elevation myocardial infarction (STEMI) in different regions. Methods and results Prospective cohort study of STEM I within 24 h of symptom onset (11 462 patients, 196 centres, 26 European Society of Cardiology members, and 3 affiliated countries). The median delay between arrival at a percutaneous cardiovascular intervention (PCI) centre and primary PCI was 40 min (interquartile range 20-74) with 65.8% receiving PCI within guideline recommendation of 60 min. A third of patients (33.2%) required transfer from their initial hospital to one that could perform emergency PCI for whom only 27.2% were treated within the quality indicator recommendation of 120 min. Radial access was used in 56.6% of all primary PCI, but with large geographic variation, from 76.4 to 9.1%. Statins were prescribed at discharge to 98.7% of patients, with little geographic variation. Of patients with a history of heart failure or a documented left ventricular ejection fraction <= 40%, 84.0% were discharged on an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and 88.7% were discharged on beta-blockers. Conclusion Care for STEMI shows wide geographic variation in the receipt of timely primary PCI, and is in contrast with the more uniform delivery of guideline-recommended pharmacotherapies at time of hospital discharge. [GRAPHICS] . C1 [Ludman, Peter] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England. [Zeymer, Uwe] Klinikum Stadt Ludwigshafen, Ludwigshafen, Germany. [Zeymer, Uwe] Inst Herzinfarktforsch, Ludwigshafen, Germany. [Danchin, Nicolas] Hop Europeen Georges Pompidou, Serv Cardiol Paris, Paris, France. [Kala, Petr] Masaryk Univ, Univ Hosp Brno, Dept Internal Med & Cardiol, Med Fac, Brno, Czech Republic. [Laroche, Cecile; Gale, Chris P.; Maggioni, Aldo P.] European Soc Cardiol, EURObservat Res Programme, Sophia Antipolis, France. [Sadeghi, Masoumeh] Isfahan Univ Med Sci, Cardiac Rehabil Res Ctr, Cardiovasc Res Inst, Esfahan, Iran. [Caporale, Roberto] Annunziata Civil Hosp, Intervent Cardiol Unit, Cosenza, Italy. [Shaheen, Sameh Mohamed] Ain Shams Univ, Cairo, Egypt. [Legutko, Jacek] Jagiellonian Univ Med Coll, John Paul 2 Hosp, Dept Intervent Cardiol, Inst Cardiol, Krakow, Poland. [Iakobishvili, Zaza] Rabin Med Ctr, Petah Tiqwa, Israel. [Alhabib, Khalid F.] King Saud Univ, Coll Med, King Fahad Cardiac Ctr, Dept Cardiac Sci, Riyadh, Saudi Arabia. [Motovska, Zuzana] Charles Univ Prague, Cardioctr, Fac Med 3, Prague, Czech Republic. [Motovska, Zuzana] Univ Hosp Kralovske Vinohrady, Prague, Czech Republic. [Studencan, Martin] Teaching Hosp JA Reiman, Cardioctr Presov, Presov, Slovakia. [Mimoso, Jorge] Ctr Hosp & Univ Algarve, Faro, Portugal. [Becker, David] Semmelweis Univ, Heart & Vasc Ctr, Budapest, Hungary. [Alexopoulos, Dimitrios] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Athens, Greece. [Kereseselidze, Zviad] Chapidze Emergency Cardiol Ctr, Tbilisi, Georgia. [Stojkovic, Sinisa] Univ Belgrade, Fac Med, Belgrade, Serbia. [Stojkovic, Sinisa] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia. [Zelveian, Parounak] Sci Res Inst Cardiol, Yerevan, Armenia. [Goda, Artan] Univ Hosp Ctr Mother Theresa, Cardiol 1, Tirana, Albania. [Goda, Artan] Univ Hosp Ctr Mother Theresa, Cardiol 2, Tirana, Albania. [Mirrakhimov, Erkin] Kyrgyz State Med Acad, Bishkek, Kyrgyzstan. [Mirrakhimov, Erkin] Natl Ctr Cardiol & Internal Med, Bishkek, Kyrgyzstan. [Bajraktari, Gani] Univ Prishtina Hasan Prishtina, Univ Clin Ctr Kosova, Med Fac, Prishtina, Kosovo. [Farhan, Hasan Ali] Baghdad Heart Ctr, Med City, Iraqi Board Med Specializat, Sci Council Cardiol, Baghdad, Iraq. [Serpytis, Pranas] Vilnius Univ, Fac Med, Vilnius, Lithuania. [Raungaard, Bent] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark. [Marandi, Toomas] North Estonia Med Ctr, Ctr Cardiol, Tartu, Estonia. [Marandi, Toomas] Univ Tartu, Dept Cardiol, Tartu, Estonia. [Moore, Alice May] Mater Dei Hosp, Msida, Malta. [Quinn, Martin] St Vincents Univ Hosp, Dublin 4, Ireland. [Karjalainen, Pasi Paavo] Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland. [Karjalainen, Pasi Paavo] Univ Helsinki, Helsinki, Finland. [Tatu-Chitoiu, Gabriel] Spitalul Clin Urgenta Floreasca, Bucharest, Romania. [Gale, Chris P.] Univ Leeds, Leeds Teaching Hosp NHS Trust, Leeds Inst Cardiovasc & Metab Med, Dept Cardiol, Leeds, W Yorkshire, England. [Maggioni, Aldo P.] Heart Care Fdn, ANMCO Res Ctr, Florence, Italy. [Weidinger, Franz] Hosp Rudolfstiftung, Vienna, Austria. C3 RLUK- Research Libraries UK; University of Birmingham; Ludwigshafen Hospital; Institute Heart Attack Research; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Europeen Georges-Pompidou - APHP; Masaryk University Brno; University Hospital Brno; Isfahan University Medical Science; Egyptian Knowledge Bank (EKB); Ain Shams University; Jagiellonian University; Collegium Medicum Jagiellonian University; Rabin Medical Center; King Saud University; Charles University Prague; University Hospital Vinohrady; Semmelweis University; National & Kapodistrian University of Athens; University Hospital Attikon; University of Belgrade; Clinical Centre of Serbia; University Hospital Center Mother Teresa (QSUT); University Hospital Center Mother Teresa (QSUT); Kyrgyz State Medical Academy; Ministry of Health - Kyrgyzstan; Ministry of Health - Kyrgyzstan; Universiteti i Prishtines; Vilnius University; Aalborg University; Aalborg University Hospital; University of Tartu; University College Dublin; Saint Vincent's University Hospital; University of Helsinki; Helsinki University Central Hospital; University of Helsinki; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO); Rudolfstiftung Hospital RP Ludman, P (通讯作者),Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England. EM peter.ludman@uhb.nhs.uk RI Bendary, Ahmed/AAH-3619-2019; Yaseen, Israa/AAH-9041-2021; Farhan, Hasan Ali/AAW-3073-2021; iorio, riccardo/HSG-8628-2023; Simoni, Leonard/AAW-6529-2021; Mirrakhimov, Erkin/E-6900-2017 OI Bendary, Ahmed/0000-0002-0161-3779; Yaseen, Israa/0000-0002-3575-7359; Farhan, Hasan Ali/0000-0002-6061-4966; Simoni, Leonard/0000-0003-2422-8619; Gale, Chris/0000-0003-4732-382X; Mirrakhimov, Erkin/0000-0003-2982-6108 FU Abbott Vascular Int.; Amgen Cardiovascular; AstraZeneca; Bayer AG; Boehringer Ingelheim; Boston Scientific; Bristol Myers Squibb; Daiichi Sankyo Europe GmbH; Alliance Daiichi Sankyo Europe GmbH; Eli Lilly and Company; Gedeon Richter Plc.; Menarini Int. Op.; MSD-Merck Co.; Novartis Pharma AG; ResMed; Sanofi; SERVIER; Vifor; Pfizer Alliance; Edwards FX Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011-21), Amgen Cardiovascular (2009-18), AstraZeneca (2014-21), Bayer AG (2009-18), Boehringer Ingelheim (2009-19), Boston Scientific (2009-12), The Bristol Myers Squibb and Pfizer Alliance (2011-19), Daiichi Sankyo Europe GmbH (2011-20), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2014-17), Edwards (2016-19), Gedeon Richter Plc. (2014-16), Menarini Int. Op. (2009-12), MSD-Merck & Co. (2011-14), Novartis Pharma AG (2014-20), ResMed (2014-16), Sanofi (2009-11), SERVIER (2009-21), and Vifor (2019-22). CR Bebb O, 2017, EUR HEART J, V38, P974, DOI 10.1093/eurheartj/ehx008 Fox KAA, 2002, EUR HEART J, V23, P1177, DOI 10.1053/euhj.2001.3081 Hall M, 2018, EUR HEART J, V39, P3798, DOI 10.1093/eurheartj/ehy517 Hasdai D, 2002, EUR HEART J, V23, P1190, DOI 10.1053/euhj.2002.3193 Ibanez B, 2018, EUR HEART J, V39, P119, DOI 10.1093/eurheartj/ehx393 Komajda Michel, 2017, Eur J Heart Fail, V19, P1414, DOI 10.1002/ejhf.887 Kristensen SD, 2014, EUR HEART J, V35, P1957, DOI 10.1093/eurheartj/eht529 Lenfant C, 2003, NEW ENGL J MED, V349, P868, DOI 10.1056/NEJMsa035507 Mandelzweig L, 2006, EUR HEART J, V27, P2285, DOI 10.1093/eurheartj/ehl196 Pedersen F, 2014, J AM COLL CARDIOL, V64, P2101, DOI 10.1016/j.jacc.2014.08.037 Puymirat E, 2013, EUR HEART J-ACUTE CA, V2, P359, DOI 10.1177/2048872613497341 Schiele F, 2005, EUR HEART J, V26, P873, DOI 10.1093/eurheartj/ehi107 Schiele F, 2021, EUR HEART J-ACUTE CA, V10, P224, DOI 10.1093/ehjacc/zuaa037 Schiele F, 2017, EUR HEART J-ACUTE CA, V6, P34, DOI 10.1177/2048872616643053 Stabile G, 2018, HEART RHYTHM, V15, P1675, DOI 10.1016/j.hrthm.2018.04.011 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Nguyen T, 2017, BMJ OPEN, V7, DOI 10.1136/bmjopen-2017-017008 Widimsky P, 2010, EUR HEART J, V31, P943, DOI 10.1093/eurheartj/ehp492 Windecker S, 2014, EUR HEART J, V35, P2541, DOI [10.5603/KP.2014.0224, 10.1093/eurheartj/ehu278, 10.1093/ejcts/ezu366] Zeymer U, 2020, EUR HEART J-QUAL CAR, V6, P100, DOI 10.1093/ehjqcco/qcz042 Zeymer U, 2019, EUR HEART J-ACUTE CA, V8, P63, DOI 10.1177/2048872617745008 Zeymert U, 2021, EUR HEART J, V42, P4536, DOI 10.1093/eurheartj/ehab342 Zusman O, 2019, HEART, V105, P820, DOI 10.1136/heartjnl-2018-314197 NR 23 TC 0 Z9 0 U1 7 U2 7 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 2048-8726 EI 2048-8734 J9 EUR HEART J-ACUTE CA JI Eur. Heart J.-Acute Cardiovasc. Care DI 10.1093/ehjacc/zuac143 EA NOV 2022 PG 16 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 7B1CR UT WOS:000898880900001 PM 36346109 DA 2023-05-13 ER PT J AU Perne, A Schmidt, FP Hochadel, M Giannitsis, E Darius, H Maier, LS Schmitt, C Heusch, G Voigtlander, T Mudra, H Gori, T Senges, J Munzel, T AF Perne, A. Schmidt, F. P. Hochadel, M. Giannitsis, E. Darius, H. Maier, L. S. Schmitt, C. Heusch, G. Voigtlaender, T. Mudra, H. Gori, T. Senges, J. Muenzel, T. CA German Chest Pain Unit Registry TI Admission heart rate in relation to presentation and prognosis in patients with acute myocardial infarction Treatment regimens in German chest pain units SO HERZ LA English DT Article DE Acute myocardial infarction; Heart rate; Mortality; Chest Pain Unit; Outcome ID ACUTE CORONARY SYNDROMES; SYSTOLIC DYSFUNCTION BEAUTIFUL; ARTERY-DISEASE; ATRIAL-FIBRILLATION; CONTROLLED-TRIAL; CPU-REGISTRY; RISK-FACTOR; MORTALITY; ASSOCIATION; IVABRADINE AB Higher heart rates on admission have been associated with poor outcomes in patients with an acute coronary syndrome in previous cohorts. Whether such a linear relationship still exists in contemporary high-level care is unclear. Prospectively collected data from patients presenting with myocardial infarction (MI) in centers participating in the Chest Pain Unit (CPU) Registry between December 2008 and July 2014 were analyzed. Patients were classified according to their initial heart rate (I: < 50; II: 50-69; III: 70-89; IV: a parts per thousand yenaEuro parts per thousand 90 bpm). A total of 6,168 patients out of 30,339 patients presenting to 38 centers were included in the study. Patients in group IV had more comorbidities, while patients in group I more often had a history of MI. Patients in the lowest heart rate group presented significantly earlier to the hospital (4 h 31 min vs. 7 h 37 min; p < 0.05) and had the highest rate of interventions. The overall survival after 3 months was significantly worse in group IV after adjusting for baseline variables. In the subgroup analysis, heart rate was a prognostic factor in the non-ST-segment elevation MI group but not in the ST-segment elevation MI group. The correlation between heart rate and major adverse cardiac events followed a J-shaped curve with worst outcomes in the lowest and highest heart rate groups. Patients admitted to a dedicated CPU with the diagnosis of MI and a heart rate > 90 bpm experience reduced survival at 3 months despite optimal treatment. Patients with bradycardia also seem to be at increased risk for cardiovascular events despite much earlier presentation and treatment. C1 [Perne, A.; Schmidt, F. P.; Gori, T.; Muenzel, T.] Johannes Gutenberg Univ Mainz, Dept Med 2, D-55122 Mainz, Germany. [Hochadel, M.; Senges, J.] Heidelberg Univ, Inst Myocardial Infarct Res Fdn Ludwigshafen, Heidelberg, Germany. [Giannitsis, E.] Univ Heidelberg Hosp, Dept Med 3, Heidelberg, Germany. [Darius, H.] Vivantes Klinikum Neukolln, Dept Cardiol Angiol & Intens Care Med, Berlin, Germany. [Maier, L. S.] Univ Hosp Regensburg, Dept Med 2, Regensburg, Germany. [Schmitt, C.] Municipal Hosp Karlsruhe, Clin Cardiol & Angiol, Karlsruhe, Germany. [Heusch, G.] Univ Duisburg Essen, West German Heart & Vasc Ctr, Inst Pathophysiol, Essen, Germany. [Voigtlaender, T.] Cardioangiol Ctr Bethanien, Frankfurt, Germany. [Mudra, H.] Stadt Klinikum Munchen GmbH, Klinikum Neuperlach, Dept Cardiol Pneumol & Internal Intens Care Med, Munich, Germany. [Muenzel, T.] 2 Med Clin Cardiol Angiol & Intens Care, Langenbeckstr 1, D-55131 Mainz, Germany. C3 Johannes Gutenberg University of Mainz; Ruprecht Karls University Heidelberg; Ruprecht Karls University Heidelberg; VIivantes Klinikum Neukolln; University of Regensburg; Municipal Hospital Karlsruhe; University of Duisburg Essen; Munchen Klinik RP Munzel, T (通讯作者),2 Med Clin Cardiol Angiol & Intens Care, Langenbeckstr 1, D-55131 Mainz, Germany. EM tmuenzel@uni-mainz.de RI Maier, Lars/AAQ-8313-2021; Munzel, Thomas/A-2912-2014; Gori, Tommaso/F-1575-2012; Heusch, Gerd/ABE-6675-2020 OI Maier, Lars/0000-0001-9915-4429; Munzel, Thomas/0000-0001-5503-4150; Heusch, Gerd/0000-0001-7078-4160 FU German Heart Foundation of the German Chest Pain Unit Registry FX We are indebted to all study participants, the German Cardiac Society, especially its CPU chapter, as well as the staff of the Institute for Myocardial Infarction Research Foundation Ludwigshafen. Furthermore, we thank the German Heart Foundation for their support of the German Chest Pain Unit Registry. CR Asaad Nidal, 2014, Acute Card Care, V16, P49, DOI 10.3109/17482941.2014.889312 Bangalore S, 2010, EUR HEART J, V31, P552, DOI 10.1093/eurheartj/ehp397 Facila L, 2012, WORLD J CARDIOL, V4, P15, DOI 10.4330/wjc.v4.i1.15 Fox K, 2008, LANCET, V372, P807, DOI 10.1016/S0140-6736(08)61170-8 Fox K, 2008, LANCET, V372, P817, DOI 10.1016/S0140-6736(08)61171-X Fox K, 2014, NEW ENGL J MED, V371, P1091, DOI 10.1056/NEJMoa1406430 GOSSELINK ATM, 1995, J AM COLL CARDIOL, V26, P1516, DOI 10.1016/0735-1097(95)00340-1 Greenland P, 1999, AM J EPIDEMIOL, V149, P853 HJALMARSON A, 1990, AM J CARDIOL, V65, P547, DOI 10.1016/0002-9149(90)91029-6 Illmann A, 2014, CLIN RES CARDIOL, V103, P29, DOI 10.1007/s00392-013-0619-5 Jensen MT, 2013, INT J CARDIOL, V168, P3802, DOI 10.1016/j.ijcard.2013.06.034 Jensen MT, 2013, EUR RESPIR J, V42, P341, DOI 10.1183/09031936.00072212 Jensen MT, 2013, HEART, V99, P882, DOI 10.1136/heartjnl-2012-303375 Kovar D, 2004, CLIN CARDIOL, V27, P80, DOI 10.1002/clc.4960270207 Maier LS, 2013, INT J CARDIOL, V168, P1651, DOI 10.1016/j.ijcard.2013.03.009 McMurray JJV, 2012, EUR J HEART FAIL, V14, P803, DOI 10.1093/eurjhf/hfs105 Parodi G, 2010, ATHEROSCLEROSIS, V211, P255, DOI 10.1016/j.atherosclerosis.2010.02.017 Post F, 2012, CLIN RES CARDIOL, V101, P983, DOI 10.1007/s00392-012-0487-4 Post F, 2012, EUR HEART J, V33, P682 Seronde MF, 2014, AM J MED, V127, P954, DOI 10.1016/j.amjmed.2014.06.034 Thygesen K, 2007, EUR HEART J, V28, P2525 Zhang YH, 2002, AM J PHYSIOL-HEART C, V282, pH1102, DOI 10.1152/ajpheart.00738.2001 NR 22 TC 11 Z9 14 U1 0 U2 3 PU URBAN & VOGEL PI MUNICH PA NEUMARKTER STRASSE 43, D-81673 MUNICH, GERMANY SN 0340-9937 EI 1615-6692 J9 HERZ JI Herz PD MAY PY 2016 VL 41 IS 3 BP 233 EP 240 DI 10.1007/s00059-015-4355-7 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DJ9VF UT WOS:000374560400009 PM 26411426 DA 2023-05-13 ER PT J AU Milicic, M Soldatovic, I Nezic, D Jovic, M Stojkovic, VM Vukovic, P Milojevic, P AF Milicic, Miroslav Soldatovic, Ivan Nezic, Dusko Jovic, Miomir Stojkovic, Vera Maravic Vukovic, Petar Milojevic, Predrag TI Remote ischemic preconditioning in patients undergoing coronary bypass grafting following acute coronary syndrome without ST elevation SO VOJNOSANITETSKI PREGLED LA English DT Article DE coronary artery bypass; ischemic preconditioning; myocardial; myocardial revascularization; non-st elevated myocardial infarction; troponon i; treatment outcome ID REDUCES MYOCARDIAL INJURY; CARDIAC-SURGERY; HEART; TRIAL AB Background/Aim. A protection of heart and other organs from ischemic-reperfusion injuries can be provided by remote ischemic preconditioning (RIPC) by brief episodes of ischemia and reperfusion in distant tissues. The aim of this study was to assess effects of RIPC on early outcomes in patients underwent coronary bypass surgery (CABG) following acute coronary syndrome without persistent ST segment elevation (NSTEMI ACS). Methods. This trial included 42 patients randomized into two groups: the group 1 received RIPC and the group 2 was without RIPC (control group). Pre-, intra- and postoperative parameters were compared but primary endpoint was myocardial injury reflected as value of troponin I measured preoperatively and 1, 6, 12, 24, 48 and 72 h postoperatively. The secondary endpoints were hemodynamic parameters, blood loss, intensive care unit stay, mortality etc. Results. The groups 1 and 2 were similar in preoperative characteristics including age, New York Heart Association (NYHA) class, EuroSCORE II, left ventricular ejection fraction. The only significant difference between groups was for triple vessel coronary disease with dominance in the RIPC group [20 (100%) vs. 17 (77.3%),p = 0.049]. Cardiopulmonary bypass time [mean (+/- standard deviation): 83.0 (22.9) vs. 67.0 (17.4) minutes, p = 0.015], cross clamp time [57.9 (15.4) vs. 44.3 (14.3) minutes, p = 0.005] and number of conduits [median (25-75th percentile): 23.5(34 vs. 3(2-3), p = 0.002] were different. Other intra- and postoperative variables did not differ between groups. There were no differences in C reactive protein levels and postoperative hemodynamic parameters. Average troponin values in all time points revealed no significant differences between groups (p(0h) = 0.740,p(1h) = 0.212,p(6h)= 0.504,p(12h)= 0.597, p(24h) = 0.562, p(48h) = 0.465 and p(72h) = 0.715, respectively). Furthermore, there were no significant differences in adverse events, hospital stay and mortality between groups. Conclusion. Treatment with RIPC during CABG following NSTEMI ACS did not provide better myocardial protection and hemodynamics characteristics but further larger randomized studies are needed t. prove its real value. C1 [Milicic, Miroslav; Nezic, Dusko; Stojkovic, Vera Maravic; Vukovic, Petar; Milojevic, Predrag] Univ Belgrade, Fac Med, Dedinje Cardiovasc Inst, Dept Cardiac Surg, Milana Tepica 1, Belgrade 11000, Serbia. [Jovic, Miomir] Univ Belgrade, Fac Med, Dedinje Cardiovasc Inst, Dept Anesthesia, Belgrade, Serbia. [Soldatovic, Ivan] Univ Belgrade, Fac Med, Dept Med Stat & Informat, Belgrade, Serbia. C3 University of Belgrade; University of Belgrade; University of Belgrade RP Milicic, M (通讯作者),Univ Belgrade, Fac Med, Dedinje Cardiovasc Inst, Dept Cardiac Surg, Milana Tepica 1, Belgrade 11000, Serbia. EM milicic.mima@gmail.com OI Soldatovic, Ivan/0000-0003-4893-1683; Nezic, Dusko/0000-0001-5854-0331; Maravic-Stojkovic, Vera/0000-0003-4682-0883 CR Ali ZA, 2007, CIRCULATION, V116, pI98, DOI 10.1161/circulationaha.106.679167 Cheung MMH, 2006, J AM COLL CARDIOL, V47, P2277, DOI 10.1016/j.jacc.2006.01.066 Ghosh S, 2003, J THORAC CARDIOV SUR, V126, P133, DOI 10.1016/S0022-5223(02)73293-5 Hausenloy DJ, 2015, NEW ENGL J MED, V373, P1408, DOI 10.1056/NEJMoa1413534 Hausenloy DJ, 2007, LANCET, V370, P575, DOI 10.1016/S0140-6736(07)61296-3 Kharbanda RK, 2009, LANCET, V374, P1557, DOI 10.1016/S0140-6736(09)61421-5 Kharbanda RK, 2002, CIRCULATION, V106, P2881, DOI 10.1161/01.CIR.0000043806.51912.9B Li L, 2010, J SURG RES, V164, pE21, DOI 10.1016/j.jss.2010.06.016 Meybohm P, 2015, NEW ENGL J MED, V373, P1397, DOI 10.1056/NEJMoa1413579 Rahman IA, 2010, CIRCULATION, V122, pS53, DOI 10.1161/CIRCULATIONAHA.109.926667 Ranasinghe I, 2011, AM J CARDIOL, V108, P617, DOI 10.1016/j.amjcard.2011.04.005 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Thielmann M, 2013, LANCET, V382, P597, DOI 10.1016/S0140-6736(13)61450-6 Thielmann M, 2010, BASIC RES CARDIOL, V105, P657, DOI 10.1007/s00395-010-0104-5 Venugopal V, 2009, HEART, V95, P1567, DOI 10.1136/hrt.2008.155770 Walsh M, 2016, CAN MED ASSOC J, V188, P329, DOI 10.1503/cmaj.150632 Xie JJ, 2012, HEART, V98, P384, DOI 10.1136/heartjnl-2011-300860 Young PJ, 2012, BASIC RES CARDIOL, V107, DOI 10.1007/s00395-012-0256-6 NR 18 TC 1 Z9 1 U1 0 U2 0 PU MILITARY MEDICAL ACAD-INI PI BELGRADE PA CRNOTRAVSKA 17, PO BOX 33-35, BELGRADE, 11040, SERBIA SN 0042-8450 EI 2406-0720 J9 VOJNOSANIT PREGL JI Vojnosanit. Pregl. PY 2020 VL 77 IS 10 BP 1017 EP 1023 DI 10.2298/VSP180414179M PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA OU6PO UT WOS:000591648600002 OA gold DA 2023-05-13 ER PT J AU Redfors, B Angeras, O Ramunddal, T Petursson, P Haraldsson, I Dworeck, C Odenstedt, J Ioaness, D Ravn-Fischer, A Wellin, P Sjoland, H Tokgozoglu, L Tygesen, H Frick, E Roupe, R Albertsson, P Omerovic, E AF Redfors, Bjorn Angeras, Oskar Ramunddal, Truls Petursson, Petur Haraldsson, Inger Dworeck, Christian Odenstedt, Jacob Ioaness, Dan Ravn-Fischer, Annika Wellin, Peder Sjoland, Helen Tokgozoglu, Lale Tygesen, Hans Frick, Erik Roupe, Rickard Albertsson, Per Omerovic, Elmir TI Trends in Gender Differences in Cardiac Care and Outcome After Acute Myocardial Infarction in Western Sweden: A Report From the Swedish Web System for Enhancement of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE acute myocardial infarction; evidence-based treatment; gender; non-ST-segment elevation myocardial infarction; ST-segment elevation myocardial infarction ID ACUTE CORONARY SYNDROMES; ST-SEGMENT ELEVATION; WOMEN; MORTALITY; MEN; INTERVENTION; MANAGEMENT; SEX; GUIDELINES; REGISTRY AB Background-Cardiovascular disease is the most common cause of death for both genders. Debates are ongoing as to whether gender-specific differences in clinical course, diagnosis, and management of acute myocardial infarction (MI) exist. Methods and Results-We compared all men and women who were treated for acute MI at cardiac care units in Vastra Gotaland, Sweden, between January 1995 and October 2014 by obtaining data from the prospective SWEDEHEART (Swedish Web-System for Enhancement of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) registry. We performed unadjusted and adjusted Cox proportional hazards and logistic regression analyses on complete case data and on imputed data sets. Overall, 48 118 patients (35.4% women) were diagnosed with acute MI. Women as a group had better age-adjusted prognosis than men, but this survival benefit was absent for younger women (aged <60 years) and for women with ST-segment elevation MI. Compared with men, younger women and women with ST-segment elevation MI were more likely to develop prehospital cardiogenic shock (adjusted odds ratio 1.67, 95% CI 1.30 to 2.16, P<0.001 and adjusted odds ratio 1.31, 95% CI 1.16 to 1.48, P<0.001) and were less likely to be prescribed evidence-based treatment at discharge (P<0.001 for beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, statins, and P2Y(12) antagonists). Differences in treatment between the genders did not decrease over the study period (P>0.1 for all treatments). Conclusions-Women on average have better adjusted prognosis than men after acute MI; however, younger women and women with ST-segment elevation MI have disproportionately poor prognosis and are less likely to be prescribed evidence-based treatment. C1 [Redfors, Bjorn; Angeras, Oskar; Ramunddal, Truls; Petursson, Petur; Haraldsson, Inger; Dworeck, Christian; Odenstedt, Jacob; Ioaness, Dan; Ravn-Fischer, Annika; Wellin, Peder; Sjoland, Helen; Albertsson, Per; Omerovic, Elmir] Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden. [Tygesen, Hans] Sodra Alvsborgs Sjukhus, Dept Cardiol, Boras, Sweden. [Frick, Erik] Skaraborg Hosp, Dept Cardiol, Skovde, Sweden. [Roupe, Rickard] Allingsas Hosp, Dept Cardiol, Allingsas, Sweden. [Tokgozoglu, Lale] Hacettepe Univ Hosp, Dept Cardiol, Ankara, Turkey. C3 Sahlgrenska University Hospital; Hacettepe University RP Redfors, B (通讯作者),Bruna Straket 16, S-41345 Gothenburg, Sweden. EM bjorn.redfors@wlab.gu.se RI Redfors, Björn/Z-6367-2019; Demchuk, Andrew M/E-1103-2012; Dworeck, Christian/N-1123-2014 OI Redfors, Björn/0000-0002-4155-4451; Demchuk, Andrew M/0000-0002-4930-7789; Dworeck, Christian/0000-0002-2012-5818 FU AFA Insurance [AFA 110115]; Swedish Heart and Lung Foundation [HLF 20120670]; Swedish Scientific Research Council [VR 2008-2487]; ALF Vastra Gotaland; University of Gothenburg, Sweden [ALFGBG 141131] FX This work was supported by AFA Insurance [AFA 110115]; Swedish Heart and Lung Foundation [HLF 20120670]; Swedish Scientific Research Council [VR 2008-2487]; ALF Vastra Gotaland; and University of Gothenburg, Sweden [ALFGBG 141131]. 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Sahebkar, Amirhossein TI COVID-19 and cardiac injury: clinical manifestations, biomarkers, mechanisms, diagnosis, treatment, and follow up SO EXPERT REVIEW OF ANTI-INFECTIVE THERAPY LA English DT Review DE SARS-CoV-2; Covid-19; heart damage; elderly; underlying disease; prevalent comorbidity ID ANGIOTENSIN-CONVERTING ENZYME-2; DISEASE 2019 COVID-19; CORONAVIRUS; MYOCARDITIS; PNEUMONIA; OUTCOMES; ACE2; IDENTIFICATION; INFLAMMATION; INFECTION AB Introduction Coronavirus disease 2019 (COVID-19) has the characteristics of high transmission, diverse clinical manifestations, and a long incubation period. In addition to infecting the respiratory system, COVID-19 also has adverse effects on the cardiovascular system. COVID-19 causes acute myocardial injuries, as well as chronic damage to the cardiovascular system. Areas covered The present review is aimed at providing current information on COVID-19 and the cardiovascular system. PubMed, Scopus, Science direct, and Google Scholar were searched. Expert opinion It is suggested that heart injury caused by COVID-19 infection might be an important cause of severe clinical phenotypes or adverse events in affected patients. Myocardial damage is closely related to the severity of the disease and even the prognosis in patients with COVID-19. In addition to disorders that are caused by COVID-19 on the cardiovascular system, more protection should be employed for patients with preexisting cardiovascular disease (CVD). Hence, it is very important that once relevant symptoms appear, patients with COVID-19 be rapidly treated to reduce mortality. Thus, early measurements of cardiac damageviabiomarkers following hospitalization for COVID-19 infections in a patient with preexisting CVD are recommended, together with careful monitoring of any myocardial injury that might be caused by the infection. ICU: An intensive care unit;2019-nCoV: 2019 novel coronavirus;ACEI: ACE inhibitor;ACS: Acute coronary syndrome;ARDS: Acute respiratory distress syndrome;AT(1)R: Ang II type 1 receptor;ATP: Adenosine triphosphate;ACC: American College of Cardiology;ACE: Angiotensin converting enzyme;Ang II: Angiotensin II;ARB: Angiotensin II receptor blocker;AV block: Atrioventricular block;CAD: Coronary artery disease;CVD: Cardiovascular disease;CT: Computerized tomography;CHF: Congestive heart failure;CHD: Coronary heart disease;CK-MB: Creatine kinase isoenzyme-MB;CRP: C-reactive protein;cTnI: Cardiac troponin I;EAT: Epicardial adipose tissue;ECMO: Extracorporeal membrane oxygenation;FDA: Food and Drug Administration;G-CSF: Granulocyte colony-stimulating factor;HFrEF: HF with a reduced ejection fraction;synhACE2: Human isoform of ACE2;IL: Interleukin;IABP: Intra-aortic balloon counterpulsation;IP10: Interferon gamma-induced protein 10 kDa;LPC: Lysophosphatidylcholine;Mas: Mitochondrial assembly receptor;MCP1: Monocyte chemoattractant protein-1;MERS: Middle East respiratory syndrome;MIP1a: macrophage inflammatory protein 1a:MOF: Multiple organ failure;MI: Myocardial infarction;MRI: Magnetic resonance imaging;MYO: Myohe-moglobin;NT-proBNP: N-terminal pro-brain natriuretic peptide;PCPS: Percutaneous cardiopulmonary assistance;rhACE2: Recombinant human ACE2;SARS: Severe acute respiratory syndrome;Th: T helper;RAS: Renin-angiotensin system;TNF-alpha: Tumor necrosis factor-alpha;WHO: World Health Organization. C1 [Tajbakhsh, Amir] Shiraz Univ Med Sci, Pharmaceut Sci Res Ctr, Shiraz, Iran. [Hayat, Seyed Mohammad Gheibi] Shahid Sadoughi Univ Med Sci, Sch Med, Dept Med Genet, Yazd, Iran. [Taghizadeh, Hajar] Shiraz Univ Med Sci, Sch Med, Shiraz, Iran. [Akbari, Ali] Shiraz Univ Med Sci, Sch Med, Dept Anesthesiol, Shiraz, Iran. [Inabadi, Masoumeh] Islamic Azad Univ, Dept Biol, Jahrom Branch, Jahrom, Iran. [Savardashtaki, Amir] Shiraz Univ Med Sci, Epilepsy Res Ctr, Shiraz, Iran. [Savardashtaki, Amir] Shiraz Univ Med Sci, Sch Adv Med Sci & Technol, Dept Med Biotechnol, Shiraz 7136281407, Iran. [Johnston, Thomas P.] Univ Missouri, Sch Pharm, Div Pharmacol & Pharmaceut Sci, Kansas City, MO 64110 USA. [Sahebkar, Amirhossein] Mashhad Univ Med Sci, Biotechnol Res Ctr, Pharmaceut Technol Inst, Mashhad, Razavi Khorasan, Iran. [Sahebkar, Amirhossein] Mashhad Univ Med Sci, Neurogen Inflammat Res Ctr, Mashhad, Razavi Khorasan, Iran. [Sahebkar, Amirhossein] Polish Mothers Mem Hosp Res Inst PMMHRI, Lodz, Poland. C3 Shiraz University of Medical Science; Tehran University of Medical Sciences; Shiraz University of Medical Science; Shiraz University of Medical Science; Islamic Azad University; Shiraz University of Medical Science; Shiraz University of Medical Science; University of Missouri System; University of Missouri Kansas City; Mashhad University Medical Science; Mashhad University Medical Science RP Savardashtaki, A (通讯作者),Shiraz Univ Med Sci, Sch Adv Med Sci & Technol, Dept Med Biotechnol, Shiraz 7136281407, Iran.; Sahebkar, A (通讯作者),Mashhad Univ Med Sci, Sch Med, Dept Med Biotechnol, Mashhad, Razavi Khorasan, Iran. 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Anti-Infect. Ther. PD MAR 4 PY 2021 VL 19 IS 3 BP 345 EP 357 DI 10.1080/14787210.2020.1822737 EA SEP 2020 PG 13 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA QU2US UT WOS:000573157400001 PM 32921216 DA 2023-05-13 ER PT J AU Sandoval, Y Jaffe, AS AF Sandoval, Yader Jaffe, Allan S. TI Type 2 Myocardial Infarction JACC Review Topic of the Week SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Review DE acute myocardial infarction; cardiac troponin; myocardial injury; type 2 myocardial infarction; Universal Definition of Myocardial Infarction ID ACUTE CORONARY SYNDROME; CARDIAC TROPONIN-I; OPTIMIZING PLATELET INHIBITION; 3RD UNIVERSAL DEFINITION; LONG-TERM MORTALITY; CLASSIFICATION-SYSTEM; CLINICAL-FEATURES; PRASUGREL-THROMBOLYSIS; THERAPEUTIC OUTCOMES; ASSESS IMPROVEMENT AB Acute myocardial infarction (MI) can occur from increased myocardial oxygen demand and/or reduced supply in the absence of acute atherothrombotic plaque disruption; a condition called type 2 myocardial infarction (T2MI). As with any MI subtype, there must be clinical evidence of myocardial ischemia to make the diagnosis. This condition is increasingly diagnosed due to the increasing sensitivity of cardiac troponin assays and is associated with adverse short-term and long-term prognoses. Limited data exist defining optimal management strategies because T2MI is a heterogeneous entity with varying etiologies and triggers. Thus, these patients require individualized care. A major barrier is the absence of a uniform definition that can be operationalized with high reproducibility. This document provides a synthesis of the data about T2MI to assist clinicians' understanding of its pathobiology, when to deploy the diagnosis, and its associated treatments. It also clarifies prognosis, identifies gaps in knowledge, and provides recommendations for moving forward. (C) 2019 by the American College of Cardiology Foundation. C1 [Sandoval, Yader; Jaffe, Allan S.] Mayo Clin, Dept Cardiovasc Dis, Gonda 468,200 1st SW, Rochester, MN 55905 USA. [Jaffe, Allan S.] Mayo Clin, Dept Lab Med & Pathol, Gonda 468,200 1st SW, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic RP Jaffe, AS (通讯作者),Mayo Clin, Dept Cardiovasc Dis, Gonda 468,200 1st SW, Rochester, MN 55905 USA.; Jaffe, AS (通讯作者),Mayo Clin, Dept Lab Med & Pathol, Gonda 468,200 1st SW, Rochester, MN 55905 USA. 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Am. Coll. Cardiol. PD APR 16 PY 2019 VL 73 IS 14 BP 1846 EP 1860 DI 10.1016/j.jacc.2019.02.018 PG 15 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HS4VD UT WOS:000463866300014 PM 30975302 OA Bronze DA 2023-05-13 ER PT J AU Jennings, C Astin, F AF Jennings, Catriona Astin, Felicity TI A multidisciplinary approach to prevention SO EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY LA English DT Article DE Interdisciplinary; multidisciplinary; team-working; patient-centred care; nurse-led; cardiovascular prevention and rehabilitation; cardiovascular disease ID ACUTE CORONARY SYNDROME; RISK-FACTOR MANAGEMENT; LIFE-STYLE; CARDIOVASCULAR RISK; PROGRAM; DISEASE; INTERVENTIONS; INDIVIDUALS; MORTALITY; COUNTRIES AB Cardiovascular disease accounts for 17,500 deaths globally, representing nearly half of all non-communicable disease deaths. The World Health Organization has set nine lifestyle, risk factor and medicines targets to achieve by 2025 with the aim of reducing premature mortality from non-communicable diseases by 25%. In order to succeed in this, we need to equip our global health professional workforce with the skills to support patients and their families with making lifestyle changes and being in concordance with cardioprotective medication regimes at every opportunity. Success depends on collegiate working through effective interdisciplinary team-based care characterised by shared goals, clear roles, mutual trust, effective communication and measurable processes and outcomes, with the patient and family at the centre of care. Nurses are the largest sector of the health professional workforce and their role in prevention should be optimised. Nurse coordinated care is proven to be effective, especially where they work in an interdisciplinary way with other health professionals such as doctors, pharmacists and psychologists, who provide equally important expertise for supporting holistic care. Successful care models are those that comprehensively target all adverse lifestyles and risk factors that are responsible for the development of cardiovascular disease. These characteristics should be reflected in the standards and core components of prevention and rehabilitation programmes. C1 [Jennings, Catriona] Imperial Coll London, Natl Heart & Lung Inst, London, England. [Astin, Felicity] Univ Huddersfield, Sch Human & Hlth Sci, Ctr Appl Res Hlth, Huddersfield, W Yorkshire, England. [Astin, Felicity] Calderdale & Huddersfield NHS Fdn Trust, Huddersfield, W Yorkshire, England. C3 RLUK- Research Libraries UK; Imperial College London; University of Huddersfield RP Jennings, C (通讯作者),Imperial Coll London, 3rd Floor,ICTEM L Block,Hammersmith Campus, London W12 0NN, England. EM c.jennings@imperial.ac.uk RI Astin, Felicity/F-8713-2016; Astin, Felicity/HHM-2624-2022 OI Astin, Felicity/0000-0002-8055-3072; CR Astin F, 2015, EUR J CARDIOVASC NUR, V14, P190, DOI 10.1177/1474515115572048 Astin F, 2014, BMC CARDIOVASC DISOR, V14, DOI 10.1186/1471-2261-14-96 BERNARDBONNIN AC, 1995, J ALLERGY CLIN IMMUN, V95, P34, DOI 10.1016/S0091-6749(95)70150-8 Blechman NL, 2016, CLIN GERIATR MED, V32, P373, DOI 10.1016/j.cger.2016.01.010 British Association for Cardiovascular Prevention and Rehabilitation, 2017, BACPR STANDARDS CORE, V3rd British Heart Foundation, 2016, NAT AUD CARD REH ANN Clark CE, 2010, BMJ-BRIT MED J, V341, DOI 10.1136/bmj.c3995 Cohen A, 2014, JAMA INTERN MED, V174, P40, DOI 10.1001/jamainternmed.2013.11342 Connolly SB, 2017, HEART, V103, P840, DOI 10.1136/heartjnl-2016-310477 CROI, FIGHT HEART DIS STRO ESC Council on Cardiovascular Nursing and Allied Professions, 2015, BE GUID SMART IN Europe Society of Cardiology, EUR CARD DIS RISK AS Gibson I, 2014, EUR J PREV CARDIOL, V21, P366, DOI 10.1177/2047487313498831 He Ya-ping, 2012, Zhonghua Xin Xue Guan Bing Za Zhi, V40, P1037 Jennings C., 2013, THESIS IMPERIAL COLL Jorstad HT, 2013, HEART, V99, P1421, DOI 10.1136/heartjnl-2013-303989 Kotseva K, 2017, GLOB HEART, V12, P315, DOI 10.1016/j.gheart.2015.11.003 Kotseva K, 2015, J AM COLL CARDIOL, V66, P1634, DOI 10.1016/j.jacc.2015.07.061 Kotseva K, 2016, EUR J PREV CARDIOL, V23, P636, DOI 10.1177/2047487315569401 Kotseva K, 2013, EUR J PREV CARDIOL, V20, P817, DOI 10.1177/2047487312449591 Krebs J. 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J. Prev. Cardiol. PD JUN PY 2017 VL 24 SU 3 BP 77 EP 87 DI 10.1177/2047487317709118 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA EX9UV UT WOS:000403604800011 PM 28618913 OA Green Submitted, Green Accepted DA 2023-05-13 ER PT J AU Du, H Liu, WJ Zhou, LH AF Du, H. Liu, W. J. Zhou, L. -H. TI Study on application of GRACE scoring system on nursing of ACS patients SO EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES LA English DT Article DE GRACE scoring system; Specialized nursing mode; ACS; Remedy achievement ratio ID ACUTE CORONARY SYNDROME; RISK SCORE; PREDICTION; EVENTS; PCI AB OBJECTIVE: The aim of this study is to analyze application effects of specialized emergency nursing mode based on Global Registry Acute Coronary Events (GRACE) scoring system on Acute Coronary System (ACS) patients. PATIENTS AND METHODS: 135 ACS cases in this hospital of the same period were selected and they were divided into control group (65 cases) and observation group (70 cases) according to random number method and their order of hospitalization. The standard specialized nursing mode was applied in the control group while specialized nursing mode based on GRACE scoring system was applied in observation group to compare treatment effects. RESULTS: We found that average time of Door-to-Balloon, surgery time and length of stay in observation group were shortened and the occurrence rate of complications during and after surgery was significantly lowered. The remedy achievement ratio and satisfaction scores on nursing are increased and differences were of statistical significance (p < 0.05). CONCLUSIONS: The stratified nursing was used to ACS patients based on GRACE scoring system, which was able to significantly increase remedy achievement ratio and decrease complications and, therefore, nursing quality is improved. C1 [Liu, W. J.] Yantai Yuhuangding Hosp, Gynecol Ward 1, Yantai, Shandong, Peoples R China. [Du, H.; Zhou, L. -H.] Yantai Yuhuangding Hosp, Cardiol Ward, Yantai, Shandong, Peoples R China. RP Liu, WJ (通讯作者),Yantai Yuhuangding Hosp, Gynecol Ward 1, Yantai, Shandong, Peoples R China. EM wenjuan_liu1@163.com CR [Anonymous], 2005, CIRCULATION S1, V112, pIII Arslanian-Engoren Cynthia, 2004, J Cardiovasc Nurs, V19, P280 Avci BK, 2015, KARDIOL POL, V73, P592, DOI 10.5603/KP.a2015.0030 Aytekin V, 2007, ANATOL J CARDIOL, V7, P14 Carlton EW, 2016, EMERG MED J, V33, P99, DOI 10.1136/emermed-2015-204780 Faustino A, 2014, REV PORT CARDIOL, V33, P617, DOI 10.1016/j.repc.2014.01.025 Guenancia C, 2015, HEART VESSELS Li SS, 2015, AM HEART J, V169, P349, DOI 10.1016/j.ahj.2014.12.005 Littnerova S, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0123215 Liu XJ, 2015, CARDIOVASC DIABETOL, V14, DOI 10.1186/s12933-015-0274-4 Raposeiras-Roubin S, 2015, J CARDIOL, V66, P224, DOI 10.1016/j.jjcc.2014.12.015 Rossini R, 2014, G ITAL CARDIOL, V15, P378, DOI 10.1714/1582.17284 Sprockel John Jaime, 2015, Crit Pathw Cardiol, V14, P25, DOI 10.1097/HPC.0000000000000034 Zhou BD, 2015, J GERIATR CARDIOL, V12, P246, DOI 10.11909/j.issn.1671-5411.2015.03.008 Zhou D, 2015, ANATOL J CARDIOL, V15, P995, DOI 10.5152/AnatolJCardiol.2015.6174 NR 15 TC 0 Z9 0 U1 1 U2 3 PU VERDUCI PUBLISHER PI ROME PA VIA GREGORIO VII, ROME, 186-00165, ITALY SN 1128-3602 J9 EUR REV MED PHARMACO JI Eur. Rev. Med. Pharmacol. Sci. PD APR PY 2016 VL 20 IS 7 BP 1333 EP 1338 PG 6 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA DN2PA UT WOS:000376904300020 PM 27097955 DA 2023-05-13 ER PT J AU Gallagher, R Roach, K Belshaw, J Kirkness, A Sadler, L Warrington, D AF Gallagher, Robyn Roach, Kellie Belshaw, Julie Kirkness, Ann Sadler, Leonie Warrington, Darrell TI A pre-test post-test study of a brief educational intervention demonstrates improved knowledge of potential acute myocardial infarction symptoms and appropriate responses in cardiac rehabilitation patients SO AUSTRALIAN CRITICAL CARE LA English DT Article DE Chest symptoms; Patient delay; Knowledge; Intervention; Acute myocardial infarction ID ACUTE CORONARY SYNDROME; HEART-ATTACK; PREHOSPITAL DELAY; HEALTH LITERACY; PRIMARY ANGIOPLASTY; ARTERY-DISEASE; TIME; AUSTRALIA; REASONS; TRENDS AB Background: Patient delay in recognizing and responding to potential acute myocardial infarction (AMI) symptoms is an international issue. Cardiac rehabilitation provides an ideal opportunity to deliver an intervention. Aims: This study examines an individual educational intervention on knowledge of heart attack warning signs and specific chest pain action plans for people with coronary heart disease. Methods: Cardiac rehabilitation participants at five hospitals were assessed at program entry and tailored education was provided using the Heart Foundation of Australia's Heart Attack Warning Signs campaign educational tool. Participants (n = 137) were reassessed at program conclusion (six to eight weeks). Results: Study participants had a mean age of 64.48 years (SD 12.22), were predominantly male (78%) and most commonly presented with a current referral diagnosis of a percutaneous coronary intervention (PCI) (80%) and/or AMI (60%). There were statistically significant improvements in the reporting of 11 of the 14 warning signs of heart attack, with patients reporting 2.56 more warning signs on average at outcome (p < .0001). Patients reported more heart attack warning signs if they had completed high school education (beta = 1.14) or had better knowledge before the intervention (beta = .57). There were statistically significant improvements in reporting of all appropriate actions in response to potential AMI symptoms, with patients reporting an average of 1.3 more actions at outcome (p < .001), with no change in the median time they would tolerate symptoms (p = .16). Conclusions: A brief education session using a single standardised tool and adapted to a patient assessment is effective in improving knowledge of potential AMI symptoms and appropriate responses in cardiac rehabilitation up to two months following. (C) 2012 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved. C1 [Gallagher, Robyn] Univ Technol Sydney, Fac Nursing Midwifery & Hlth, Sydney, NSW 2007, Australia. [Roach, Kellie; Kirkness, Ann] Royal N Shore Hosp, Sydney, NSW, Australia. [Roach, Kellie; Kirkness, Ann] Ryde Hosp, Eastwood, NSW, Australia. [Belshaw, Julie] Hornsby Ku Ring Gai Hosp, Sydney, NSW, Australia. [Sadler, Leonie] Manly Hosp, Manly, NSW, Australia. [Warrington, Darrell] Gosford Hosp, Gosford, NSW, Australia. [Warrington, Darrell] Wyong Hosp, Wyong, NSW, Australia. C3 University of Technology Sydney; Royal North Shore Hospital; University of Sydney RP Gallagher, R (通讯作者),Univ Technol Sydney, Fac Nursing Midwifery & Hlth, POB 123, Broadway, NSW 2007, Australia. EM Robyn.Gallagher@uts.edu.au FU NSW Health Nursing and Midwifery Office Innovations Scholarship FX The authors of this paper would like to thank NSW Health Nursing and Midwifery Office Innovations Scholarship for funding the study and Ms Elizabeth Armari for assistance with data entry and editing. 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Crit. Care PD MAY PY 2013 VL 26 IS 2 BP 49 EP 54 DI 10.1016/j.aucc.2012.01.002 PG 6 WC Critical Care Medicine; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine; Nursing GA 150PL UT WOS:000319403100003 PM 22366084 DA 2023-05-13 ER PT J AU Kassaian, SE Masoudkabir, F Sezavar, H Mohammadi, M Pourmoghaddas, A Kojouri, J Ghaffari, S Sanaati, H Alaeddini, F Pourmirza, B Mir, E AF Kassaian, Seyed Ebrahim Masoudkabir, Farzad Sezavar, Hashem Mohammadi, Mohammad Pourmoghaddas, Ali Kojouri, Javad Ghaffari, Samad Sanaati, Hamidreza Alaeddini, Farshid Pourmirza, Bahin Mir, Elham CA IPACE2 Registry Investigators TI Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2) SO BMJ OPEN LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; BASE-LINE CHARACTERISTICS; EURO HEART SURVEY; GLOBAL REGISTRY; MEDITERRANEAN BASIN; PRACTICE GUIDELINES; HOSPITAL MORTALITY; NATIONAL REGISTRY; ST-ELEVATION; TRENDS AB Objectives To assess contemporary data on characteristics, management and 1-year postdischarge outcomes in Iranian patients hospitalised with acute coronary syndrome (ACS). Setting 11 tertiary care hospitals in 5 major cities in the Islamic Republic of Iran. Participants Patients aged 20 and 80years discharged alive with confirmed diagnosis of ACS including ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and high-risk unstable angina (HR-UA). Primary and secondary outcome measures Patients were followed up regarding the use of medications and the end points of the study at 1month and 1year after discharge. The primary end point of the study was 1-year postdischarge major adverse cardiac and cerebrovascular events (MACCEs), defined as mortality (cardiac and non-cardiac), ACS and cerebrovascular attack (stroke and/or transient ischaemic attack). The secondary end points were hospital admission because of congestive heart failure, revascularisation by coronary artery bypass grafting surgery or percutaneous coronary intervention (PCI), and major and minor bleeds. Results A total of 1799 patients (25.7% STEMI and 74.3% HR-UA/NSTEMI) discharged alive with confirmed diagnosis of ACS were included in the final analysis. During hospitalisation, the majority of the patients received aspirin (98.6%), clopidogrel (91.8%), anticoagulants (93.4%), statins (94.3%) and -blockers (89.3%). Reperfusion therapy was performed in 62.6% of patients with STEMI (46.3% thrombolytic therapy and 17.3% primary PCI). The mean door-to-balloon and door-to-needle times were 82.9 and 45.6min, respectively. In our study, 64.7% and 79.5% of the patients in HR-UA/NSTEMI and STEMI groups, respectively, underwent coronary angiography. During the 12months after discharge, MACCEs occurred in 15.0% of all patients. Conclusions Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications. C1 [Kassaian, Seyed Ebrahim; Masoudkabir, Farzad] Univ Tehran Med Sci, Tehran Heart Ctr, Dept Cardiol, Tehran, Iran. [Sezavar, Hashem] Iran Univ Med Sci, Rasul e Akram Hosp, Dept Cardiol, Tehran, Iran. [Mohammadi, Mohammad] Javad Al Aemmeh Heart Hosp & Res Ctr, Dept Cardiol, Mashhad, Iran. [Pourmoghaddas, Ali] Isfahan Univ Med Sci, Khorshid Hosp, Dept Cardiol, Esfahan, Iran. [Kojouri, Javad] Shiraz Univ Med Sci, Cardiovasc Res Ctr, Shiraz, Iran. [Ghaffari, Samad] Tabriz Univ Med Sci, Cardiovasc Res Ctr, Tabriz, Iran. [Sanaati, Hamidreza] Iran Univ Med Sci, Dept Cardiol, Rajaie Cardiovasc Med & Res Ctr, Tehran, Iran. [Alaeddini, Farshid] Univ Tehran Med Sci, Dept Res, Tehran Heart Ctr, Tehran, Iran. [Pourmirza, Bahin; Mir, Elham] Sanofi Iran Med Dept, Tehran, Iran. C3 Tehran University of Medical Sciences; Iran University of Medical Sciences; Isfahan University Medical Science; Shiraz University of Medical Science; Tabriz University of Medical Science; Iran University of Medical Sciences; Tehran University of Medical Sciences RP Kassaian, SE (通讯作者),Univ Tehran Med Sci, Tehran Heart Ctr, Dept Cardiol, Tehran, Iran. EM ekassaian@yahoo.com RI sezavar, seyed hashem/L-1323-2018; Kojuri, Javad/D-2830-2018; Mohammadi, MohammadReza/A-2863-2019; pourmoghadas, ali/B-7437-2018 OI sezavar, seyed hashem/0000-0003-3365-5129; Kojuri, Javad/0000-0001-8909-897X; pourmoghadas, ali/0000-0002-5684-0426; Masoudkabir, Farzad/0000-0001-8098-7121; Ghaffari, Samad/0000-0001-6806-9387 FU Sanofi-Aventis Groupe Iran Affiliate FX This study was sponsored by Sanofi-Aventis Groupe Iran Affiliate. 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C. M. Zwart, Dorien L. M. Erkelens, Daphne C. A. De Groot, Esther van Smeden, Maarten Hoes, Arno W. Damoiseaux, Roger A. M. J. Rutten, Frans H. TI Gender-stratified analyses of symptoms associated with acute coronary syndrome in telephone triage: a cross-sectional study SO BMJ OPEN LA English DT Article DE primary care; telemedicine; myocardial infarction ID MYOCARDIAL-INFARCTION; SEX-DIFFERENCES; CARE; AGE; OUTCOMES; WOMEN; HEART; TIME AB Objectives To identify clinical variables that are associated with the diagnosis acute coronary syndrome (ACS) in women and men with chest discomfort who contact out-of-hours primary care (OHS-PC) by telephone, and to explore whether there are indications whether these variables differ among women and men. Design Cross-sectional study in which we compared patient and call characteristics of triage call recordings between women with and without ACS, and men with and without ACS. Setting Nine OHS-PC in the Netherlands. Participants 993 women and 802 men who called OHS-PC for acute chest discomfort (pain, pressure, tightness or discomfort) between 2014 and 2016. Primary outcome measure Diagnosis of ACS retrieved from the patient's medical record in general practice, including hospital specialists' discharge letters. Results Among 1795 patients (mean age 58.8 (SD 19.5) years, 55.3% women), 15.0% of men and 8.6% of women had an ACS. In both sexes, retrosternal chest pain was associated with ACS (women with ACS vs without 62.3% vs 40.3%, p=0.002; men with ACS vs without 52.5% vs 39.7%, p=0.032; gender interaction, p=0.323), as was pressing/heavy/tightening pain (women 78.6% vs 61.5%, p=0.011; men 82.1% vs 57.4%, p=<0.001; gender interaction, p=0.368) and radiation to the arm (women 75.6% vs 45.9%, p<0.001; men 56.0% vs 34.8%, p<0.001; gender interaction, p=0.339). Results indicate that only in women were severe pain (65.4% vs 38.1%, p=0.006; gender interaction p=0.007) and radiation to jaw (50.0% vs 22.9%, p=0.007; gender interaction p=0.015) associated with ACS. Ambulances were dispatched equally in women (72.9%) and men with ACS (70.0%). Conclusion Our results indicate there were more similarities than differences in symptoms associated with the diagnosis ACS for women and men. Important exceptions were pain severity and radiation of pain in women. Whether these differences have an impact on predicting ACS needs to be further investigated with multivariable analyses. C1 [Wouters, Loes T. C. M.; Zwart, Dorien L. M.; Erkelens, Daphne C. A.; De Groot, Esther; Hoes, Arno W.; Damoiseaux, Roger A. M. J.; Rutten, Frans H.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [van Smeden, Maarten] Julius Ctr Hlth Sci & Primary Care, Epidemiol, Utrecht, Netherlands. C3 Utrecht University; Utrecht University Medical Center RP Wouters, LTCM (通讯作者),Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. EM L.T.C.Wouters-2@umcutrecht.nl RI Zwart, Dorien LM/F-5916-2015; van Smeden, Maarten/Y-7034-2019 OI van Smeden, Maarten/0000-0002-5529-1541; Erkelens, Daphne Carmen Aimee/0000-0002-5846-5201; de Groot, Esther/0000-0003-0388-385X FU department of general practice of the University Medical Centre Utrecht; foundation the Netherlands Triage Standard; foundation 'Stoffels-Hornstra'; Dutch Heart Foundation/Dutch Cardiovascular Alliance FX This study was funded by an unrestricted grant from (1) the department of general practice of the University Medical Centre Utrecht; (2) a personal promotion grant of D L Zwart, MD, PhD; (3) the foundation the Netherlands Triage Standard; and (4) the foundation 'Stoffels-Hornstra'. It is also part of the IMPRESS study funded by the Dutch Heart Foundation/Dutch Cardiovascular Alliance. 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However, the long-term mortality of transferred patients compared with patients solely treated at the presenting hospital has not been evaluated. Here, we assess the long-term mortality of patients who undergo interhospital transfer during their acute myocardial infarction admission. Methods We evaluated 40 482 patients with a ICD10-AM diagnosis of acute myocardial infarction admitted to hospitals in New South Wales, Australia, from 2004 to 2008, of whom 10 107 (25%) were transferred. We compared in-hospital and mortality up to 5.5 years postdischarge among transferred and non-transferred patients. We created a 1: 1 propensity score matched cohort (n=16 854; 8427 per group) to account for selection bias. Results In the matched cohort, transferred patients were more likely to undergo revascularisation (55.6% vs 13.7%, RR 4.05; 95% CI 3.83 to 4.29) and had lower mortality at 30 days (3.5% vs 5.7%, HR 0.60; 95% CI 0.52 to 0.70), 1 year (7.5% vs 12.6%, HR 0.58; 95% CI 0.52 to 0.64) and at the end of follow-up (15.3% vs 22.5%, HR 0.65; 95% CI 0.61 to 0.70) than patients treated in presenting hospitals. With the exception of transfers originating from revascularisation capable hospitals, these findings were consistent across a range of subgroups, including patients of all ages, ST-elevation myocardial infarction and non ST-elevation myocardial infarction patients, and transfers originating from hospitals in regional and major city areas. Sensitivity analyses showed that these findings are unlikely to be due to survival bias or to confounding by unmeasured variables. Conclusions Patients hospitalised for an acute myocardial infarction who are transferred to one or more hospitals for specialised care have higher rates of coronary revascularisation and experience lower long-term mortality. C1 [Ranasinghe, Isuru] Univ Adelaide, Adelaide, SA, Australia. [Ranasinghe, Isuru; Barzi, Federica; Brieger, David; Gallagher, Martin] George Inst Global Hlth, Sydney, NSW, Australia. [Barzi, Federica; Gallagher, Martin] Univ Sydney, Sydney, NSW 2006, Australia. [Brieger, David; Gallagher, Martin] Concord Repatriat & Gen Hosp, Sydney, NSW, Australia. C3 University of Adelaide; George Institute for Global Health; University of Sydney; University of Sydney; Concord Repatriation General Hospital RP Ranasinghe, I (通讯作者),Univ Adelaide, Queen Elizabeth Hosp, Discipline Med, 28 Woodville Rd, Adelaide, SA 5011, Australia. EM isuru.ranasinghe@adelaide.edu.au RI Barzi, Federica/AAI-7465-2021 OI Barzi, Federica/0000-0001-7427-0167; Ranasinghe, Isuru/0000-0003-0982-1561; Gallagher, Martin/0000-0001-9187-6187; Brieger, David/0000-0001-6115-0326 FU early career fellowship; National Health and Medical Research Council; National Heart Foundation of Australia [1054353] FX IR is supported by an early career fellowship co-funded by the National Health and Medical Research Council and the National Heart Foundation of Australia (Grant ID 1054353). 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A. ten Berg, Jurrien M. TI Platelet Function Testing and Tailored Antiplatelet Therapy SO JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH LA English DT Article DE Platelet function testing; Tailored antiplatelet therapy; P2Y12 receptor inhibitors; Clopidogrel; Prasugrel; Ticagrelor ID PERCUTANEOUS CORONARY INTERVENTION; VASODILATOR-STIMULATED PHOSPHOPROTEIN; ELEVATION MYOCARDIAL-INFARCTION; PATIENTS SHOWING RESISTANCE; ASPIRIN AND/OR RESISTANCE; ASSOCIATION TASK-FORCE; OF-CARE ASSAY; BLEEDING EVENTS; CYP2C19-ASTERISK-2 AND-ASTERISK-17; CLOPIDOGREL NONRESPONDERS AB Dual antiplatelet therapy, consisting of aspirin and a P2Y12 receptor inhibitor, has dramatically reduced the incidence of atherothrombotic events for patients with acute coronary syndrome and those undergoing a percutaneous coronary intervention (PCI). However, the platelet inhibitory effect of clopidogrel, the most commonly used P2Y12 inhibitor, is variable between patients. Patients exhibiting high platelet reactivity (HPR) despite clopidogrel treatment are at higher risk of recurrent atherothrombotic events after PCI. In order to reduce the incidence of HPR, the more potent P2Y12 receptor inhibitors prasugrel and ticagrelor are used. However, these drugs increase the risk of bleeding. As there is evidence of a therapeutic window for platelet inhibition, platelet function tests could be helpful for tailoring antiplatelet therapy based on the patient's thrombotic and bleeding risk. In the present article, we review the most commonly used platelet function tests and the current evidence for tailoring of antiplatelet therapy in PCI patients. C1 [Janssen, Paul W. A.; ten Berg, Jurrien M.] St Antonius Hosp Nieuwegein, Dept Cardiol, NL-3430 EM Nieuwegein, Netherlands. C3 St. Antonius Hospital Utrecht RP ten Berg, JM (通讯作者),St Antonius Hosp Nieuwegein, Dept Cardiol, POB 2500, NL-3430 EM Nieuwegein, Netherlands. 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Cardiovasc. Transl. Res. PD JUN PY 2013 VL 6 IS 3 SI SI BP 316 EP 328 DI 10.1007/s12265-013-9458-z PG 13 WC Cardiac & Cardiovascular Systems; Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Research & Experimental Medicine GA 143CX UT WOS:000318845000003 PM 23543615 DA 2023-05-13 ER PT J AU Kwok, CS Amin, AP Shah, B Kinnaird, T Alkutshan, R Balghith, M Ratib, K Nolan, J Bagur, R Mamas, MA AF Kwok, Chun Shing Amin, Amit P. Shah, Binita Kinnaird, Tim Alkutshan, Raed Balghith, Muhammad Ratib, Karim Nolan, James Bagur, Rodrigo Mamas, Mamas A. TI Cost of coronary syndrome treated with percutaneous coronary intervention and 30-day unplanned readmission in the United States SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE adverse events; cost; percutaneous coronary intervention; readmissions ID ACCESS SITE; OUTCOMES; TRENDS; ASSOCIATION; PREDICTORS; BURDEN; CARE AB Objectives This study aimed to examine the cost of coronary syndrome treated with percutaneous coronary intervention (PCI) and 30-day unplanned readmissions. Background There is limited understanding of the hospital cost of index PCI and 30-day unplanned readmissions. Methods Patients undergoing PCI between 2010 and 2014 in the U.S. Nationwide Readmission Database were included. The primary outcome was total cost defined by cost of index PCI and first unplanned readmission within 30 days. Results This analysis included 2,294,244 patients who underwent PCI, and the mean cost was $23,541 +/- $20,730 (similar to$10.8 billion/year). There was a modest increase in cost over the study years of 17.5%. Of the 9.4% with an unplanned readmission within 30 days, the mean total cost was $35,333 +/- 24,230 versus $22,323 +/- 19,941 for those not readmitted. The variables most strongly associated with the highest quartile of cost were heart failure (adjusted odds ratio (aOR) 25.60 [95% CI 21.59-30.35]), need for circulatory support (aOR 11.62 [10.13-13.32]), periprocedural coronary artery bypass graft (CABG, aOR 585.08 [357.85-956.58]), and readmission within 30 days (aOR 24.49 [22.40-26.77]). An acute kidney injury (AKI; 8.5%), major bleed (0.8%), vascular injury (0.8%), or need for periprodedural CABG (1.4%) had an average increased cost of $21,935; $30,898; $27,875; and $43,005, respectively, compared to PCI without adverse outcome. Conclusions The annual 30-day hospital cost of PCI is approximately $10.8 billion, and the costs associated with in-hospital adverse events, particularly the need for AKI and periprocedural CABG, were significant. C1 [Kwok, Chun Shing; Nolan, James; Bagur, Rodrigo; Mamas, Mamas A.] Keele Univ, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England. [Kwok, Chun Shing; Ratib, Karim; Nolan, James; Mamas, Mamas A.] Royal Stoke Univ Hosp, Stoke On Trent, Staffs, England. [Amin, Amit P.] Washington Sch Med, St Louis, MO USA. [Shah, Binita] NYU, Sch Med, VA New York Harbor Healthcare Syst, Manhattan Campus, New York, NY USA. [Kinnaird, Tim] Univ Hosp Wales, Cardiff, S Glam, Wales. [Alkutshan, Raed] Royal Commiss Hlth Serv Program, Jubail Ind City, Saudi Arabia. [Balghith, Muhammad] King Saud Bin Abdulaziz Univ Hlth Sci, Riyadh, Saudi Arabia. C3 Keele University; Royal Stoke University Hospital; Washington University (WUSTL); New York University; RLUK- Research Libraries UK; Cardiff University; King Saud Bin Abdulaziz University for Health Sciences RP Kwok, CS (通讯作者),Keele Univ, Ctr Prognosis Res, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England. EM shingkwok@doctors.org.uk RI Mamas, Mamas Andreas/A-2549-2019; Bagur, Rodrigo/I-5298-2015 OI Mamas, Mamas Andreas/0000-0001-9241-8890; Bagur, Rodrigo/0000-0003-1888-9429; Shah, Binita/0000-0001-8872-8001 FU Biomedical Laboratory Research & Development Service of the VA Office of Research and Development [iK2CX001074]; Biosensors International Group; Research and Development Department at the Royal Stoke Hospital FX Biomedical Laboratory Research & Development Service of the VA Office of Research and Development, Grant/Award Number: iK2CX001074; Biosensors International Group; Research and Development Department at the Royal Stoke Hospital CR Amin AP, 2017, JACC-CARDIOVASC INTE, V10, P342, DOI 10.1016/j.jcin.2016.11.049 Amin AP, 2013, JACC-CARDIOVASC INTE, V6, P827, DOI 10.1016/j.jcin.2013.04.014 Epstein AJ, 2011, JAMA-J AM MED ASSOC, V305, P1769, DOI 10.1001/jama.2011.551 Holmes DR, 2008, JACC-CARDIOVASC INTE, V1, P34, DOI 10.1016/j.jcin.2007.10.001 Kwok CS, 2018, SCI REP-UK, V8, DOI 10.1038/s41598-018-29303-y Kwok CS, 2018, CIRC-CARDIOVASC INTE, V11, DOI 10.1161/CIRCINTERVENTIONS.117.005866 Kwok CS, 2018, JACC-CARDIOVASC INTE, V11, P665, DOI 10.1016/j.jcin.2018.01.248 Kwok CS, 2018, AM J CARDIOL, V121, P810, DOI 10.1016/j.amjcard.2017.12.032 Kwok CS, 2017, AM J CARDIOL, V120, P723, DOI 10.1016/j.amjcard.2017.05.049 Mamas MA, 2018, CIRC-CARDIOVASC QUAL, V11, DOI 10.1161/CIRCOUTCOMES.117.004482 Mamas MA, 2016, CIRCULATION, V133, P1655, DOI 10.1161/CIRCULATIONAHA.115.018083 Mamas MA, 2015, AM J CARDIOL, V116, P364, DOI 10.1016/j.amjcard.2015.04.047 Masoudi FA, 2017, J AM COLL CARDIOL, V69, P1427, DOI 10.1016/j.jacc.2016.12.005 Nair Prashant, 2006, EuroIntervention, V2, P363 Pandey A, 2016, JACC-HEART FAIL, V4, P935, DOI 10.1016/j.jchf.2016.07.003 Potter BJ, 2017, J AM COLL CARDIOL, V69, P203 Potts J, 2018, AM J CARDIOL, V122, P712, DOI 10.1016/j.amjcard.2018.05.003 Schumer EM, 2016, TEX HEART I J, V43, P214, DOI 10.14503/THIJ-14-4978 Singh M, 2015, J AM COLL CARDIOL, V65, P2225, DOI 10.1016/j.jacc.2015.03.567 Sjauw KD, 2009, J AM COLL CARDIOL, V54, P2430, DOI 10.1016/j.jacc.2009.09.018 Stathopoulos I, 2009, HELL J CARDIOL, V50, P379 Tanguturi VK, 2016, CIRC-CARDIOVASC QUAL, V9, P600, DOI 10.1161/CIRCOUTCOMES.116.003086 Tripathi A, 2017, CIRC-CARDIOVASC INTE, V10, DOI 10.1161/CIRCINTERVENTIONS.117.005925 Tsai TT, 2014, JACC-CARDIOVASC INTE, V7, P1, DOI 10.1016/j.jcin.2013.06.016 Vora AN, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.116.004819 Wasfy JH, 2014, CIRC-CARDIOVASC INTE, V7, P97, DOI 10.1161/CIRCINTERVENTIONS.113.000988 Witzke Christian F, 2004, J Invasive Cardiol, V16, P257 Yost GW, 2013, JACC-CARDIOVASC INTE, V6, P237, DOI 10.1016/j.jcin.2012.10.015 NR 28 TC 3 Z9 3 U1 1 U2 3 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1522-1946 EI 1522-726X J9 CATHETER CARDIO INTE JI Catheter. Cardiovasc. Interv. PD JAN 1 PY 2021 VL 97 IS 1 BP 80 EP 93 DI 10.1002/ccd.28660 EA DEC 2019 PG 14 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PT1CR UT WOS:000504350500001 PM 31876371 OA Green Accepted DA 2023-05-13 ER PT J AU Wongsalap, Y Kengkla, K Poolpun, D Saokaew, S AF Wongsalap, Yuttana Kengkla, Kirati Poolpun, Duangkamon Saokaew, Surasak TI Trends in optimal medical therapy at discharge and clinical outcomes in patients with acute coronary syndrome in Thailand SO JOURNAL OF CARDIOLOGY LA English DT Article DE Optimal medical therapy; Acute coronary syndrome; Trend; Predictor; Mortality; Major adverse cardiac events ID ELEVATION MYOCARDIAL-INFARCTION; RECURRENT ISCHEMIC EVENTS; FOLLOW-UP; SECONDARY PREVENTION; MORTALITY; REGISTRY; ATORVASTATIN; PRESCRIPTION; PREDICTORS; IMPACT AB Background: Optimal medical therapy (OMT) is recommended for patients with acute coronary syndrome (ACS) at discharge. This study aimed to assess temporal trends of OMT prescription as a five-drug regimen at discharge and its association with clinical outcomes in patients with ACS in Thailand. Methods: A retrospective cohort study was conducted in a tertiary-care medical center in Thailand. Data were collected from an electronic medical database. Patients were categorized into OMT or nonOMT groups based on their discharge medications. OMT was defined as a combination of aspirin and P2Y12 inhibitors, statins, beta-blockers, and angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers. The primary outcome was 1-year all-cause mortality. The secondary outcome was major adverse cardiac events (MACE) which was defined as a composite of non-fatal myocardial infarction, nonfatal stroke, and all-cause mortality. The prescription trends were also estimated. A multivariate Cox's proportional hazard model was used to assess the association of OMT prescriptions at discharge with all-cause mortality and MACE. Results: A total of 3531 patients discharged with ACS [mean age, 69.5 (SD 12.4) years; 58.3% male] were identified. Only 42.6% were discharged with OMT. The rates of OMT prescriptions did not change over time. However, the prescription of OMT with high-intensity statin was significantly increased from 5.0% in 2013 to 38.3% in 2018 ( p for trend < 0.001). Multivariable analyses indicated that OMT significantly reduced all-cause mortality (adjusted HR: 0.77; 95%CI: 0.63-0.95; p = 0.012) and MACE (adjusted HR 0.84; 95%CI: 0.71-0.99; p = 0.044). Subgroup analysis indicated that patients receiving OMT with high-intensity statins exhibited survival benefits (adjusted HR: 0.72; 95%CI: 0.56-0.92; p = 0.008). Conclusions: The five-drugs comprising OMT were associated with a reduction in all-cause mortality and MACE in patients with ACS. Nevertheless, OMT prescribing remains underused and could be enhanced in the real-world setting. (c) 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. C1 [Wongsalap, Yuttana; Kengkla, Kirati; Saokaew, Surasak] Univ Phayao, Sch Pharmaceut Sci, Phayao, Thailand. [Wongsalap, Yuttana; Kengkla, Kirati; Saokaew, Surasak] Univ Phayao, Sch Pharmaceut Sci, Dept Pharmaceut Care, Div Pharm Practice, Phayao, Thailand. [Wongsalap, Yuttana; Kengkla, Kirati; Saokaew, Surasak] Univ Phayao, Ctr Hlth Outcomes Res & Therapeut Safety Cohorts, Sch Pharmaceut Sci, Phayao 56000, Thailand. [Wongsalap, Yuttana; Kengkla, Kirati; Saokaew, Surasak] Univ Phayao, Sch Pharmaceut Sci, Unit Excellence Clin Outcomes Res & Integrat UNIC, Phayao, Thailand. [Poolpun, Duangkamon] Buddhachinaraj Reg Hosp, Dept Pharm, Phitsanulok, Thailand. [Saokaew, Surasak] Monash Univ Malaysia, Biomed Res Adv Ctr, Sch Pharm, Biofunct Mol Exploratory Res Grp, Bandar Sunway, Selangor Darul, Malaysia. [Saokaew, Surasak] Monash Univ Malaysia, Jeffrey Cheah Sch Med & Hlth Sci, Microbiome & Bioresource Res Strength, Novel Bacteria & Drug Discovery Res Grp, Bandar Sunway, Selangor Darul, Malaysia. C3 University of Phayao; University of Phayao; University of Phayao; University of Phayao; Monash University; Monash University Sunway; Monash University; Monash University Sunway RP Saokaew, S (通讯作者),Univ Phayao, Ctr Hlth Outcomes Res & Therapeut Safety Cohorts, Sch Pharmaceut Sci, Phayao 56000, Thailand. EM saokaew@gmail.com RI ; Saokaew, Assoc. Prof. Dr. Surasak/J-6041-2015 OI Kengkla, Kirati/0000-0001-6726-5706; Wongsalap, Yuttana/0000-0003-4487-9814; Saokaew, Assoc. Prof. Dr. Surasak/0000-0002-1382-0660 FU School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand [PHAR63001]; University of Phayao under Unit of Excellence on Clinical Outcomes Research and Integration (UNICORN) [FF64-UoE003] FX The study was partially funded by a grant from School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand [grant number: PHAR63001] and University of Phayao under Unit of Excellence on Clinical Outcomes Research and Integration (UNICORN) [grant number: FF64-UoE003]. 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Mallat, Ziad Cheriyan, Joseph TI Low-dose interleukin 2 for the reduction of vascular inflammation in acute coronary syndromes (IVORY): protocol and study rationale for a randomised, double-blind, placebo-controlled, phase II clinical trial SO BMJ OPEN LA English DT Article ID REGULATORY T-CELLS; MYOCARDIAL-INFARCTION; PLAQUE INFLAMMATION; F-18-FDG UPTAKE; PET; ATHEROSCLEROSIS; DALCETRAPIB; AUTOIMMUNE; DARAPLADIB; THERAPY AB Introduction Inflammation plays a critical role in the pathogenesis of atherosclerosis, the leading cause of ischaemic heart disease (IHD). Studies in preclinical models have demonstrated that an increase in regulatory T cells (Tregs), which have a potent immune modulatory action, led to a regression of atherosclerosis. The Low-dose InterLeukin 2 (IL-2) in patients with stable ischaemic heart disease and Acute Coronary Syndromes (LILACS) study, established the safety of low-dose IL-2 and its biological efficacy in IHD. The IVORY trial is designed to assess the effects of low-dose IL-2 on vascular inflammation in patients with acute coronary syndromes (ACS). Methods and analysis In this study, we hypothesise that low-dose IL-2 will reduce vascular inflammation in patients presenting with ACS. This is a double-blind, randomised, placebo-controlled, phase II clinical trial. Patients will be recruited across two centres, a district general hospital and a tertiary cardiac centre in Cambridge, UK. Sixty patients with ACS (unstable angina, non-ST elevation myocardial infarction or ST elevation myocardial infarction) with high-sensitivity C reactive protein (hsCRP) levels >2 mg/L will be randomised to receive either 1.5x10(6) IU of low-dose IL-2 or placebo (1:1). Dosing will commence within 14 days of admission. Dosing will comprise of an induction and a maintenance phase. 2-Deoxy-2-[fluorine-18] fluoro-D-glucose (F-18-FDG) positron emission tomography/CT (PET/CT) scans will be performed before and after dosing. The primary endpoint is the change in mean maximum target to background ratios (TBRmax) in the index vessel between baseline and follow-up scans. Changes in circulating T-cell subsets will be measured as secondary endpoints of the study. The safety and tolerability of extended dosing with low-dose IL-2 in patients with ACS will be evaluated throughout the study. Ethics and dissemination The Health Research Authority and Health and Care Research Wales, UK (19/YH/0171), approved the study. Written informed consent is required to participate in the trial. The results will be reported through peer-reviewed journals and conference presentations. C1 [Sriranjan, Rouchelle; Zhao, Tian Xiao; Tarkin, Jason; Rudd, James H. F.; Mallat, Ziad] Univ Cambridge, Dept Med, Div Cardiovasc Med, Cambridge, England. [Hubsch, Annette; Helmy, Joanna; Vamvaka, Evangelia; Jalaludeen, Navazh; Cacciottolo, Paul; Cheriyan, Joseph] Univ Cambridge, Dept Med, Div Expt Med & Immunotherapeut EMIT, Cambridge, England. [Bond, Simon; Templin, Heike] Cambridge Univ Hosp NHS Fdn Trust, Cambridge Clin Trials Unit, Cambridge, England. [Hoole, Stephen P.] Papworth Hosp NHS Fdn Trust, Cardiol, Cambridge, England. [Knott, Philip; Buckenham, Samantha] Cambridge Univ Hosp NHS Fdn Trust, Dept Clin Immunol, Cambridge, England. [Warnes, Victoria; Bird, Nick; Cheow, Heok] Cambridge Univ Hosp NHS Fdn Trust, Dept Nucl Med, Cambridge, England. C3 RLUK- Research Libraries UK; University of Cambridge; RLUK- Research Libraries UK; University of Cambridge; RLUK- Research Libraries UK; University of Cambridge; Papworth Hospital; RLUK- Research Libraries UK; University of Cambridge; RLUK- Research Libraries UK; University of Cambridge RP Sriranjan, R (通讯作者),Univ Cambridge, Dept Med, Div Cardiovasc Med, Cambridge, England. EM rfss2@cam.ac.uk OI Mallat, Ziad/0000-0003-0443-7878 FU Medical Research Council [MR/N028015/1]; British Heart Foundation Cambridge Centre of Excellence [RCAG/521] FX This work was funded by the Medical Research Council (grant no MR/N028015/1) and the British Heart Foundation Cambridge Centre of Excellence (RCAG/521). Setup, running of the study and decision to publish results are independent of the funders. 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This study aimed to describe characteristics of Chinese patients who recently experienced an ACS event and were on lipid-lowering treatment, yet failing to reach targeted goal. Methods: A multicenter, cross-sectional study was conducted to recruit 2,034 Chinese patients who experienced an ACS (ST segment elevation myocardial infarction [STEMI], non-STEMI, or unstable angina) event within the past 4-40 weeks and were on statin treatment (>2 weeks) from March 2015 to December 2016. All eligible patients underwent a fasting lipid test after enrollment and data on medical history were collected. Results: The mean age of 1,994 eligible patients was 61.0 +/- 9.84 years. Among them, 1,493 (74.9%) patients received intensive statin therapy (defined as atorvastatin 40 or 80 mg, or rosuvastatin 20 mg per protocol) and 499 (25.0%) patients were on maximum tolerated dose statin. Of the 1,994 eligible subjects, 1,273 (63.8%) patients did not achieve the lipid goal at the time of enrollment. Among the not-at-goal patients, 910 (71.5%) received intensive statin therapy; the majority (73.4%) of them were male; the mean age was 61.2 +/- 10.1 years old; 699 (54.9%) patients had a history of hypertension; 25.3% had diabetes mellitus; and 29.5% were current smokers. The mean low-density lipoprotein-cholesterol (LDL-C), non-high-density lipoprotein-cholesterol (non-HDL-C), and ApoB levels at enrollment of this group of patients were 2.460 +/- 0.7139 mmol/L, 3.094 +/- 0.8861 mmol/L, and 0.840 +/- 0.3015 g/L, respectively. Conclusion: The study result demonstrates that overall more than half of the patients who recently (4-40 weeks) experienced ACS who were treated did not reach the guideline-recommended LDL-C and non-HDL-C goal. These results highlight the potential necessity for a new drug beyond statins to further reduce disease burden in the future. C1 [Jiang, Jie; Huo, Yong] Peking Univ First Hosp, Dept Cardiol, Beijing 100034, Peoples R China. [Zhou, Yu-Ie] Beijing Anzhen Hosp, Dept Cardiol, Beijing 100029, Peoples R China. [Li, Jian-Jun] Fuwai Hosp, Dept Cardiol, Beijing 100037, Peoples R China. [Ge, Jun-Bo] Fudan Univ, Zhongshan Hosp, Dept Cardiol, Shanghai 200032, Peoples R China. [Feng, Ying-Qing] Guangdong Gen Hosp, Dept Cardiol, Guangzhou 510080, Guangdong, Peoples R China. C3 Peking University; Capital Medical University; Chinese Academy of Medical Sciences - Peking Union Medical College; Fu Wai Hospital - CAMS; Fudan University; Guangdong Academy of Medical Sciences & Guangdong General Hospital RP Huo, Y (通讯作者),Peking Univ First Hosp, 8 XishikuDajie, Beijing 100034, Peoples R China. EM yonghuo54@gmail.com FU Sanofi; Sanofi, China FX Sanofi was the sponsor of the study, and was responsible for the design of the study, collecting and managing data, and performing all statistical analyses. The authors are grateful to all the investigators and patients who participated in this study. Medical writing support under authors' direction was provided by Dhanya Mukundan, MDS and Priyanka Bannikoppa, PhD (Indegene, Bangalore) as funded by Sanofi, China. 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Clin. Risk Manag. PY 2018 VL 14 BP 2255 EP 2264 DI 10.2147/TCRM.S178318 PG 10 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA HA5WA UT WOS:000450349100002 PM 30532548 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Piga, M Casula, L Perra, D Sanna, S Floris, A Antonelli, A Cauli, A Mathieu, A AF Piga, M. Casula, L. Perra, D. Sanna, S. Floris, A. Antonelli, A. Cauli, A. Mathieu, A. TI Population-based analysis of hospitalizations in a West-European region revealed major changes in hospital utilization for patients with systemic lupus erythematosus over the period 2001-2012 SO LUPUS LA English DT Article DE Systemic lupus erythematosus; hospitalization; health care; epidemiology; prevalence; renal disorders; neuropsychiatric disorders; cardiovascular diseases; acute coronary syndrome; infections ID ADMINISTRATIVE DATA; DISEASE PREVALENCE; MORTALITY; DEATH; CLASSIFICATION; NEPHRITIS; RITUXIMAB; CRITERIA; DAMAGE; COSTS AB Objective The objective of this paper is to evaluate hospital admissions in systemic lupus erythematosus (SLE) patients through a retrospective population-based study analyzing hospitalization data during 2001-2012 in Sardinia, an Italian region with universal health system coverage. Methods Data on the hospital discharge records with the ICD-9-CM code for SLE (710.0) were obtained from the Department of Health and Hygiene and analyzed, mostly focusing on primary and non-primary diagnosis and Diagnosis-Related Group (DRG) code. In order to establish the significance of the annual trend for number and type of primary and non-primary discharge diagnosis, the two-tailed Cochran-Armitage test for trend was applied. In order to estimate SLE prevalence, data from administrative database and medical records were assembled. Results This study included 6222 hospitalizations in 1675 patients (87% women). Hospitalizations with SLE as primary diagnosis were 3782 (58.0%) and significantly decreased during the study period. The annual number of renal, hematologic and neuropsychiatric disorders as non-primary diagnosis associated with SLE remained constant; however, their percentage increased (p<0.0001) because of a declining number of admissions for SLE without associated diagnosis and without complications. Hospitalizations with SLE as non-primary diagnosis showed a significant upward trend in number and percentage of cerebrovascular accident (p=0.0004), acute coronary syndrome (p=0.0004) and chronic renal failure (p=0.0003) as underlying primary diagnosis, while complications of pregnancy, labor and childbirth (p=0.3375), malignancies (p=0.6608) and adverse drug reactions (p=0.2456) did not show statistically significant changes. Infections showed an increasing trend between 2001 and 2012 but did not reach statistical significance (p=0.0304). After correction for hospitalization (93.8%) and survival (91.1%) rates calculated over the study period, the 2012 SLE prevalence in Sardinia was estimated to be 99.3 per 100,000 inhabitants. Conclusions While overall hospitalizations for SLE patients declined, those for cerebrovascular accident, acute coronary syndrome and chronic renal failure as underlying primary diagnosis increased during the study period. C1 [Piga, M.; Casula, L.; Perra, D.; Sanna, S.; Floris, A.; Cauli, A.; Mathieu, A.] Univ Clin AOU Cagliari, Rheumatol Unit, I-09042 Cagliari, Italy. [Casula, L.; Antonelli, A.] Sardinian Reg Govt, Reg Epidemiol Observ, Dept Hlth & Hyg, Cagliari, Italy. C3 University of Cagliari RP Piga, M (通讯作者),Univ Clin AOU Cagliari, Rheumatol Unit, SS 554, I-09042 Cagliari, Italy. EM matteopiga@alice.it RI Floris, Alberto/AAW-4954-2020 OI Floris, Alberto/0000-0002-9154-0576; Piga, Matteo/0000-0002-1126-8315 FU Sardinia Regional Government FX Matteo Piga gratefully acknowledges Sardinia Regional Government for its financial support (P.O.R. Sardegna F.S.E. Operational Programme of the Autonomous Region of Sardinia, European Social Fund 2007-2013-Axis IV Human Resources, Objective l.3, Line of Activity l.3.1). 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Westerhout, Cynthia M. Granger, Christopher B. Armstrong, Paul W. TI Influence of Clinical Trials of Acute Coronary Syndrome Beyond the Primary Hypothesis A Systematic Review SO JAMA CARDIOLOGY LA English DT Review ID ELEVATION MYOCARDIAL-INFARCTION; ST-SEGMENT ELEVATION; ASSOCIATION TASK-FORCE; 2011 ACCF/AHA/SCAI GUIDELINE; EUROPEAN-SOCIETY; FOCUSED UPDATE; SCIENTIFIC IMPACT; MANAGEMENT; INTERVENTION; CLOPIDOGREL AB IMPORTANCE Conducting a clinical trial involves significant risks, time, and resources. The return on investment for these trials, measured by advancing health care and contributions to the scientific literature, is often uncertain. OBJECTIVE To assess the long-term effects of major clinical trials of acute coronary syndromes contemporary to the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial, which did not achieve its primary objective. EVIDENCE REVIEW The Cochrane Central Register of Controlled Trials database was screened for clinical trials of acute coronary syndromes (including unstable angina, ST-elevation myocardial infarction, and non-ST-elevation myocardial infarction) with more than 1000 participants and primary results published between January 1, 2005, and December 31, 2009, in Circulation, European Heart Journal, JAMA, Journal of the American College of Cardiology, The Lancet, and The New England Journal of Medicine. For identified trials, bibliographic information, citations, trial name, registration, inclusion diagnosis, intervention type, sample size, primary outcome result, sponsor information, and academic involvement were extracted. To identify secondary analyses, bibliographic information for citing articles, their citations, and their abstracts were extracted. Clinical practice guideline bibliographies for citations of trial publications were reviewed, and the class and level of evidence of resulting recommendations were extracted. FINDINGS Of 784 records screened, 30 were primary publications of 25 clinical trials. Through December 31, 2018, these trials were cited a median of 497 times (interquartile range [IQR], 424-931 citations). Trials that did not achieve their primary objective had fewer primary citations (the number of times that each published journal article with the primary [main] results of a trial was cited) (median, 443 [IQR, 396-468] vs 868 [IQR, 645-1774] citations, P = .006). The frequency of secondary analyses peaked within 5 years of the primary trial at 643. Trials that did not achieve the primary objective had fewer secondary analyses (median, 15 [IQR, 5-31] vs 18 [IQR, 10-43] analyses, P = .44) that were not cited significantly less often (median, 484 [IQR, 191-1299] vs 1124 [IQR, 410-4283] citations, P = .16). All trials were cited by at least 1 clinical practice guideline. CONCLUSIONS AND RELEVANCE This review found that trials that achieved the primary objective were frequently cited. Secondary research activity did not differ by primary result, and the primary trials and secondary analyses contributed to clinical practice recommendations. These data show the long-term importance of clinical trials regardless of primary outcome result. C1 [Luoma, Leiah M.; Westerhout, Cynthia M.; Armstrong, Paul W.] Univ Alberta, Canadian Virtual Coordinating Ctr Global Collabor, Edmonton, AB, Canada. [Granger, Christopher B.] Duke Univ, Duke Clin Res Inst, Durham, NC USA. C3 University of Alberta; Duke University RP Armstrong, PW (通讯作者),Univ Alberta, Canadian Virtual Coordinating Ctr Global Collabor, Katz Grp Ctr Pharm & Hlth Res 4 120, Edmonton, AB T6G 2E1, Canada. EM paul.armstrong@ualberta.ca OI Luoma, Leiah/0000-0003-0448-1385 FU Alexion Pharmaceuticals Inc; Proctor Gamble FX Dr Granger reported receiving grants and personal fees from Alexion Pharmaceuticals Inc and Proctor & Gamble during the conduct of the study; receiving grants and personal fees from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Janssen Pharmaceuticals, Novartis AG, and Pfizer; receiving grants from AKROS, Apple, Daiichi-Sankyo, GlaxoSmithKline, Medtronic Foundation, and the US Food and Drug Administration; and receiving personal fees from AbbVie, Bayer Corporation, Boston Scientific Corporation, CeleCor Therapeutics, Correvio, Espero BioPharma, Medscape, Medtronic Inc, Merck and Company Inc, the National Institutes of Health, NovoNordisk, and Roche Diagnostics. Dr Armstrong reported receiving grants from Boehringer Ingelheim, CSL Limited, and Sanofi-Aventis Recherche & Developpement and receiving grants and personal fees from Bayer Corporation and Merck and Company Inc outside the submitted work. No other disclosures were reported. 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PD NOV PY 2020 VL 5 IS 11 BP 1286 EP 1297 DI 10.1001/jamacardio.2020.2855 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PA1UL UT WOS:000595415800018 PM 32745162 DA 2023-05-13 ER PT J AU Chinwong, D Patumanond, J Chinwong, S Siriwattana, K Gunaparn, S Hall, JJ Phrommintikul, A AF Chinwong, Dujrudee Patumanond, Jayanton Chinwong, Surarong Siriwattana, Khanchai Gunaparn, Siriluck Hall, John Joseph Phrommintikul, Arintaya TI Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: a real-life cohort in Thailand SO THERAPEUTICS AND CLINICAL RISK MANAGEMENT LA English DT Article DE LDL-C goal attainment; achieving LDL-C goal; statins; acute coronary syndrome; composite cardiovascular events ID LIPID-LOWERING TREATMENT; LDL-C GOAL; STATIN THERAPY; HYPERCHOLESTEROLEMIC PATIENTS; MEDICATION ADHERENCE; ESC/EAS GUIDELINES; BLOOD CHOLESTEROL; ELDERLY-PATIENTS; DISEASE RISK; IMPROVE-IT AB Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of cardiovascular disease or mortality; however, the LDL-C goal for therapy in acute coronary syndrome (ACS) patients is controversial and varies among guidelines. This study aimed to assess the effect of reaching an LDL-C goal of <70 mg/dL (<1.8 mmol/L) on first composite cardiovascular outcomes in routine clinical practice in Thailand. Methods: A retrospective cohort study was conducted using medical charts and the electronic hospital database of patients diagnosed with ACS and treated with statins at a tertiary care hospital in Thailand between 2009 and 2012. After admission, patients were followed from the date of LDL-C goal assessment until the first event of composite cardiovascular outcomes (nonfatal ACS, nonfatal stroke, or all-cause death). Cox proportional hazard models adjusted for potential confounders were used. Results: Of 405 patients, mean age was 65 years (60% males). Twenty-seven percent of the patients attained an LDL-C goal of <70 mg/dL, 38% had LDL-C between 70 and 99 mg/dL, and 35% had LDL-C >= 100 mg/dL. Forty-six patients experienced a composite cardiovascular outcome. Compared with patients with an LDL-C >= 100 mg/dL, patients achieving an LDL-C of <70 mg/dL were associated with a reduced composite cardiovascular outcome (adjusted hazard ratio [HR]=0.42; 95% confidence interval [CI]=0.18-0.95; P-value=0.037), but patients with an LDL-C between 70 and 99 mg/dL had a lower composite cardiovascular outcome, which was not statistically significant (adjusted HR=0.73; 95% CI=0.37-1.42; P-value=0.354). Conclusion: ACS patients who received statins and achieved an LDL-C of <70 mg/dL had significantly fewer composite cardiovascular outcomes, confirming "the lower the better" and the benefit of treating to LDL-C target in ACS patient management. C1 [Chinwong, Dujrudee; Chinwong, Surarong] Chiang Mai Univ, Fac Pharm, Dept Pharmaceut Care, Chiang Mai 50200, Thailand. [Chinwong, Dujrudee] Chiang Mai Univ, Fac Med, Clin Epidemiol Program, Chiang Mai 50200, Thailand. [Patumanond, Jayanton] Thammasat Univ, Fac Med, Ctr Excellence Appl Epidemiol, Pathum Thani, Thailand. [Siriwattana, Khanchai] Nakornping Hosp, Div Med, Chiang Mai, Thailand. [Gunaparn, Siriluck; Phrommintikul, Arintaya] Chiang Mai Univ, Fac Med, Dept Internal Med, Chiang Mai 50200, Thailand. [Hall, John Joseph] Univ Newcastle, Fac Hlth, Sch Med & Publ Hlth, Ctr Clin Epidemiol & Biostat, Callaghan, NSW 2308, Australia. C3 Chiang Mai University; Chiang Mai University; Thammasat University; Chiang Mai University; University of Newcastle RP Phrommintikul, A (通讯作者),Chiang Mai Univ, Fac Med, Dept Internal Med, Chiang Mai 50200, Thailand. EM arintayap@gmail.com RI Chinwong, Surarong/AAK-4324-2021; Phrommintikul, Arintaya/X-1881-2019 OI Phrommintikul, Arintaya/0000-0003-3986-1951; Hall, John/0000-0001-9839-5626 FU Graduate School, Chiang Mai University, Thailand; Australian Government FX This study was partially supported by the Graduate School, Chiang Mai University, Thailand. We thank the authorities of the Maharaj Nakorn Chiang Mai Hospital for their permission to use their data. The authors thank Claudia Koller for her assistance with editing this manuscript. Dujrudee Chinwong would like to express her gratitude to the Australian Government for awarding her with a 2014 Endeavour Research Fellowship undertaking at the University of Newcastle, Australia. 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PY 2015 VL 11 BP 659 EP 667 DI 10.2147/TCRM.S78745 PG 9 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA CG9KX UT WOS:000353635100002 PM 25987839 OA gold, Green Published DA 2023-05-13 ER PT J AU Santos, VB Melo, LME de Assis, ARV de Moraes, JB Lopes, CT Lopes, JD de Barros, ALBL AF Santos, Vinicius Batista Maximo e Melo, Luize Viegas de Assis, Ana Raquel de Moraes, Juliana Brito Lopes, Camila Takao Lopes, Juliana de Lima Bottura Leite de Barros, Alba Lucia TI Decreasing length of limb immobilisation following nonelective transfemoral percutaneous coronary intervention: A randomised clinical trial SO JOURNAL OF CLINICAL NURSING LA English DT Article DE acute care; coronary heart disease; nursing intervention ID CARDIAC-CATHETERIZATION; EARLY AMBULATION; SHEATH REMOVAL; BACK-PAIN; ANGIOGRAPHY; COMPLICATIONS; MOBILIZATION; POSITION; PATIENT; MANAGEMENT AB Aims and objectives To assess the intensity and frequency of pain, use of analgesic drugs, and the incidence of paraesthesia, urinary retention and vascular complications upon decreasing affected limb immobilisation from 4-2 hrs after sheath removal in patients submitted to transfemoral percutaneous coronary intervention (PCI). Background After sheath removal from the femoral artery following urgent or emergency PCI, patients are maintained with limb immobilisation for a mean period of 4 hr. Design Randomised clinical trial (RCT) based on the CONSORT guidelines. Method Randomised clinical trial was performed in patients with Acute Coronary Syndrome submitted to transfemoral PCI. The intervention group was submitted to a supine position with the head of the bed elevated (30-degree angle) with affected limb immobilisation for 2 hr after sheath removal and the control group for 4 hrs. The outcomes were pain complaints, need for analgesic drugs, incidence of paraesthesia, urinary retention and vascular complications. The outcomes were assessed immediately, 6, 12 and 24 hr after release from limb immobilisation before the patients were released from bed rest. Results A total of 150 patients (75 in each group) participated in the study. No significant differences in outcomes were observed between the groups, except in relation to the haematoma formation that was higher in the intervention group. Conclusion A reduced length of limb immobilisation after sheath removal following PCI does not change the frequency and intensity of pain, need of analgesic drugs, urinary retention and paraesthesia. The incidence of haematoma was higher in the intervention group, without significant clinical manifestations. Relevance to clinical practice The results of this study can be considered for patients submitted to elective, urgent or emergency PCI, who have a lower risk of complications, thereby allowing for decreased periods of limb immobilisation. C1 [Santos, Vinicius Batista; Lopes, Camila Takao; Lopes, Juliana de Lima; Bottura Leite de Barros, Alba Lucia] Fed Univ Sao Paulo UNIFESP, Paulista Nursing Sch, 754 Napoleao Barros St,Room 309, BR-02124050 Sao Paulo, SP, Brazil. [Maximo e Melo, Luize; Viegas de Assis, Ana Raquel; de Moraes, Juliana Brito] Hosp Sao Paulo, Coronary Care Unit, Sao Paulo, Brazil. C3 Universidade Federal de Sao Paulo (UNIFESP) RP Santos, VB (通讯作者),Fed Univ Sao Paulo UNIFESP, Paulista Nursing Sch, 754 Napoleao Barros St,Room 309, BR-02124050 Sao Paulo, SP, Brazil. EM v.santos@unifesp.br RI Lopes, Camila Takáo/O-1078-2015; Santos, Vinicius Batista/C-1404-2019 OI Lopes, Camila Takáo/0000-0002-6243-6497; Santos, Vinicius Batista/0000-0001-5130-5523; Lopes, Juliana de Lima/0000-0001-6915-6781 CR Abdollahi Ali Akbar, 2015, J Caring Sci, V4, P125, DOI 10.15171/jcs.2015.013 Afazel MR, 2014, NURS MIDWIFERY STUD, V3, DOI 10.17795/nmsjournal24606 Augustin AC, 2010, INT J NURS STUD, V47, P939, DOI 10.1016/j.ijnurstu.2010.01.004 Bakhshi F, 2014, J NURS RES, V22, P45, DOI 10.1097/jnr.0000000000000020 Bayindir SK, 2017, PAIN RES MANAG, V2017, P1, DOI 10.1155/2017/6594782 Benjamin EJ, 2018, CIRCULATION, V137, pe67 Chair SY, 2008, ANADOLU KARDIYOL DER, V8, P81 Chair SY, 2012, ANATOL J CARDIOL, V12, P222, DOI 10.5152/akd.2012.065 Chair SY, 2007, J CLIN NURS, V16, P212, DOI 10.1111/j.1365-2702.2006.01599.x Chair SY, 2003, J ADV NURS, V42, P470, DOI 10.1046/j.1365-2648.2003.02646.x Erol F, 2015, TURK KARDIYOL DERN A, V43, P513, DOI 10.5543/tkda.2015.30356 Guyton A., 2016, TXB MED PHYSL, DOI [10.1016/j.yrtph.2006.05.001, DOI 10.1016/J.YRTPH.2006.05.001] Hoglund J, 2011, EUR J CARDIOVASC NUR, V10, P130, DOI 10.1016/j.ejcnurse.2010.05.005 Ibanez B, 2017, EUR HEART J, V2017, P2569, DOI DOI 10.1093/EURHEARTJ/EHX393 Kim K, 2013, EUR J CARDIOVASC NUR, V12, P429, DOI 10.1177/1474515112462519 Korsgaard Ove, 2015, BUILD NAT NFS Larsen EN, 2014, EUR J CARDIOVASC NUR, V13, P466, DOI 10.1177/1474515113516702 Matte R, 2016, REV LAT-AM ENFERM, V24, DOI 10.1590/1518-8345.0725.2796 Mohammady M, 2014, J CLIN NURS, V23, P1476, DOI 10.1111/jocn.12313 Moser D. K., 2008, CARDIAC NURSING COMP Nerlekar N, 2016, CIRC-CARDIOVASC INTE, V9, DOI 10.1161/CIRCINTERVENTIONS.116.004729 Ostelo RWJG, 2008, SPINE, V33, P90, DOI 10.1097/BRS.0b013e31815e3a10 Pollard SD, 2003, HEART, V89, P447, DOI 10.1136/heart.89.4.447 Rezaei-Adaryani M, 2009, INT J NURS STUD, V46, P1047, DOI 10.1016/j.ijnurstu.2009.02.004 Schiks IEJM, 2009, J CLIN NURS, V18, P1862, DOI 10.1111/j.1365-2702.2008.02587.x Sinatra R, 2010, PAIN MED, V11, P1859, DOI 10.1111/j.1526-4637.2010.00983.x Steffenino Giuseppe, 2006, Eur J Cardiovasc Nurs, V5, P31, DOI 10.1016/j.ejcnurse.2005.06.001 Stone PA, 2014, J VASC SURG, V60, P1359, DOI 10.1016/j.jvs.2014.07.035 Tagney Jenny, 2005, Nurs Crit Care, V10, P167 Tongsai S, 2012, INT J NURS STUD, V49, P1084, DOI 10.1016/j.ijnurstu.2012.03.012 Valentin V., 2015, RADIAL VERSUS FEMORA, V8, P6, DOI [10.1016/j.jcin.2014.11.017, DOI 10.1016/J.JCIN.2014.11.017] Valiee S, 2016, J VASC NURS, V34, P106, DOI 10.1016/j.jvn.2016.05.001 Walker S, 2008, J CARDIOVASC NURS, V23, P407, DOI 10.1097/01.JCN.0000317452.72402.7c NR 33 TC 3 Z9 3 U1 4 U2 16 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0962-1067 EI 1365-2702 J9 J CLIN NURS JI J. Clin. Nurs. PD SEP PY 2019 VL 28 IS 17-18 BP 3140 EP 3148 DI 10.1111/jocn.14860 PG 9 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA IS0QZ UT WOS:000481858000009 PM 30938903 DA 2023-05-13 ER PT J AU Versaci, F Gaspardone, A Danesi, A Ferranti, F Mancone, M Mariano, E Rotolo, FL Musto, C Proietti, I Berni, A Trani, C Sergi, SC Speciale, G Tanzilli, G Tomai, F Di Giosa, A Marchegiani, G Romagnoli, E Cavarretta, E Carnevale, R Frati, G Biondi-Zoccai, G AF Versaci, Francesco Gaspardone, Achille Danesi, Alessandro Ferranti, Fabio Mancone, Massimo Mariano, Enrica Rotolo, Francesco L. Musto, Carmine Proietti, Igino Berni, Andrea Trani, Carlo Sergi, Sonia Cristina Speciale, Giulio Tanzilli, Gaetano Tomai, Fabrizio Di Giosa, Alessandro Marchegiani, Giada Romagnoli, Enrico Cavarretta, Elena Carnevale, Roberto Frati, Giacomo Biondi-Zoccai, Giuseppe TI Interplay between COVID-19, pollution, and weather features on changes in the incidence of acute coronary syndromes in early 2020 SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Acute coronary syndrome; Climate; COVID-19; Environment; Pollution; Weather AB Background: Coronavirus disease 2019 (COVID-19) has caused an unprecedented change in the apparent epidemiology of acute coronary syndromes (ACS). However, the interplay between this disease, changes in pollution, climate, and aversion to activation of emergency medical services represents a challenging conundrum. We aimed at appraising the impact of COVID-19, weather, and environment features on the occurrence of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) in a large Italian region and metropolitan area. Methods and results: Italy was hit early on by COVID-19, such that state of emergency was declared on January 31, 2020, and national lockdown implemented on March 9, 2020, mainly because the accrual of cases in Northern Italy. In order to appraise the independent contribution on changes in STEMI and NSTEMI daily rates of COVID-19, climate and pollution, we collected data on these clinical events from tertiary care cardiovascular centers in the Lazio region and Rome metropolitan area. Multilevel Poisson modeling was used to appraise unadjusted and adjusted effect estimates for the daily incidence of STEMI and NSTEMI cases. The sample included 1448 STEM and 2040 NSTEMI, with a total of 2882 PCI spanning 6 months. Significant reductions in STEMI and NSTEMI were evident already in early February 2020 (all p<0.05), concomitantly with COVID-19 spread and institution of national countermeasures. Changes in STEMI and NSTEMI were inversely associated with daily COVID-19 tests, cases, and/or death (p<0.05). In addition, STEMI and NSTEMI incidences were associated with daily NO2, PM10, and O3 concentrations, as well as temperature (p<0.05). Multi-stage and multiply adjusted models highlighted that reductions in STEMI were significantly associated with COVID-19 data (p<0.001), whereas changes in NSTEMI were significantly associated with both NO2 and COVID-19 data (both p<0.001). Conclusions: Reductions in STEMI and NSTEMI in the COVID-19 pandemic may depend on different concomitant epidemiologic and pathophysiologic mechanisms. In particular, recent changes in STEMI may depend on COVID-19 scare, leading to excess all-cause mortality, or effective reduced incidence, whereas reductions in NSTEMI may also be due to beneficial reductions in NO2 emissions in the lockdown phase. (C) 2020 Elsevier B.V. All rights reserved. C1 [Versaci, Francesco] Osped S Maria Goretti, Emodinam & Cardiol, UOC UTIC, Latina, Italy. [Gaspardone, Achille] S Eugenio Hosp, Div Cardiol, Rome, Italy. [Danesi, Alessandro] S Spirito Hosp, Div Cardiol, Rome, Italy. [Ferranti, Fabio] GB Grassi Hosp, Div Cardiol, Rome, Italy. [Mancone, Massimo; Tanzilli, Gaetano] Sapienza Univ Rome, Umberto I Hosp, Dept Clin Anesthesiol & Cardiovasc Sci, Rome, Italy. [Mariano, Enrica] Tor Vergata Univ, Rome, Italy. [Rotolo, Francesco L.] San Pietro Fatebenefratelli Hosp, Intervent Cardiol Unit, Rome, Italy. [Musto, Carmine] San Camillo Hosp, Intervent Cardiol Unit, Rome, Italy. [Proietti, Igino] MG Vannini Hosp, Div Cardiol, Rome, Italy. [Berni, Andrea] St Andrea Hosp, Dept Cardiovasc Dis, Rome, Italy. [Trani, Carlo; Romagnoli, Enrico] Fdn Policlin Univ Agostino Gemelli, IRCCS, Rome, Italy. [Sergi, Sonia Cristina] Policlin Casilino, Div Cardiol, Rome, Italy. [Speciale, Giulio] S Filippo Hosp, Div Cardiol, Rome, Italy. [Tomai, Fabrizio] Aurelia Hosp, Div Cardiol, Rome, Italy. [Di Giosa, Alessandro; Marchegiani, Giada] ARPA Lazio, Rome, Italy. [Cavarretta, Elena; Carnevale, Roberto; Frati, Giacomo; Biondi-Zoccai, Giuseppe] Sapienza Univ Rome, Dept Med Surg Sci & Biotechnol, Corso Repubbl 79, I-04100 Latina, Italy. [Cavarretta, Elena; Carnevale, Roberto; Biondi-Zoccai, Giuseppe] Mediterranea Cardioctr, Naples, Italy. [Frati, Giacomo] IRCCS NEUROMED, Pozzilli, Italy. C3 Sant'Eugenio Hospital; Sapienza University Rome; University Hospital Sapienza Rome; University of Rome Tor Vergata; Sapienza University Rome; Azienda Ospedaliera Sant'Andrea; Catholic University of the Sacred Heart; IRCCS Policlinico Gemelli; Regional Environmental Protection Agency - Italy; Sapienza University Rome; IRCCS Neuromed RP Biondi-Zoccai, G (通讯作者),Sapienza Univ Rome, Dept Med Surg Sci & Biotechnol, Corso Repubbl 79, I-04100 Latina, Italy. EM giuseppe.biondizoccai@uniroma1.it RI Romagnoli, Enrico/M-7725-2017; Gaspardone, Achille/AAC-1762-2022; Biondi-Zoccai, Giuseppe/C-9670-2012 OI Romagnoli, Enrico/0000-0003-1611-7708; Biondi-Zoccai, Giuseppe/0000-0001-6103-8510 CR Anderez DO, 2020, SENSORS-BASEL, V20, DOI 10.3390/s20174967 Biondi Zoccai G, 2020, MINERVA CARDIOANGIOL, V68, P61, DOI 10.23736/S0026-4725.20.05250-0 Biondi-Zoccai G, 2021, EUR J PREV CARDIOL, V28, P1501, DOI 10.1177/2047487320928450 Braiteh N, 2020, AM HEART J, V226, P147, DOI 10.1016/j.ahj.2020.05.009 Calcagno S, 2020, MINERVA CARDIOANGIOL, V68, P282, DOI 10.23736/S0026-4725.20.05122-1 Cavarretta E, 2020, J CARDIOTHOR VASC AN, V34, P2346, DOI 10.1053/j.jvca.2020.06.035 Claeys MJ, 2021, ACTA CARDIOL, V76, P863, DOI 10.1080/00015385.2020.1796035 Coker ES, 2020, ENVIRON RESOUR ECON, V76, P611, DOI 10.1007/s10640-020-00486-1 De Filippo O, 2020, NEW ENGL J MED, V383, P88, DOI 10.1056/NEJMc2009166 Driggin E, 2020, J AM COLL CARDIOL, V75, P2352, DOI 10.1016/j.jacc.2020.03.031 Frontera A, 2020, J INFECTION, V81, P255, DOI 10.1016/j.jinf.2020.05.031 Garcia S, 2021, CATHETER CARDIO INTE, V98, P217, DOI 10.1002/ccd.29154 Garg PK, 2020, EUR J PREV CARDIOL, V27, P1440, DOI 10.1177/2047487319885196 Gluckman TJ, 2020, JAMA CARDIOL, V5, P1419, DOI 10.1001/jamacardio.2020.3629 He SS, 2021, ENVIRON CHEM LETT, V19, P17, DOI 10.1007/s10311-020-01069-8 Hennig F, 2020, EUR J PREV CARDIOL, V27, P965, DOI 10.1177/2047487319854818 Huang L, 2020, GEOHEALTH, V4, DOI 10.1029/2020GH000272 Juni P, 2020, CAN MED ASSOC J, V192, pE566, DOI 10.1503/cmaj.200920 Kulkarni P, 2020, CURR CARDIOL REV, V16, P173, DOI 10.2174/1573403X16666200621154842 Kulkarni P, 2020, POSTGRAD MED J, V96, P436, DOI 10.1136/postgradmedj-2020-137895 Kwon OK, 2019, EUR J PREV CARDIOL, V26, P1208, DOI 10.1177/2047487319835984 Mafham MM, 2020, LANCET, V396, P381, DOI 10.1016/S0140-6736(20)31356-8 Marullo AG, 2020, MINERVA CARDIOANGIOL, V68, P368, DOI 10.23736/S0026-4725.20.05328-1 Mountantonakis SE, 2020, J AM COLL CARDIOL, V76, P1271, DOI 10.1016/j.jacc.2020.07.021 Novelli L, 2021, PANMINERVA MED, V63, P51, DOI 10.23736/S0031-0808.20.04063-X Nudi R, 2021, PANMINERVA MED, V63, P62, DOI 10.23736/S0031-0808.20.04188-9 Ogen Y, 2020, SCI TOTAL ENVIRON, V726, DOI 10.1016/j.scitotenv.2020.138605 Protezione Civile, EM COR RISP NAZ Rodriguez-Urrego D, 2020, ENVIRON POLLUT, V266, DOI 10.1016/j.envpol.2020.115042 Salas RN, 2020, NEW ENGL J MED, V383, DOI 10.1056/NEJMp2022011 Schill Y., 2020, WATER AIR SOIL POLL, V3, P1, DOI [DOI 10.1007/S11270-007-9372-6, DOI 10.1007/s11270-007-9372-6] Shakoor A, 2020, AIR QUAL ATMOS HLTH, V13, P1335, DOI 10.1007/s11869-020-00888-6 Versaci F, 2020, MINERVA CARDIOANGIOL, DOI DOI 10.23736/S0026-472520.05343-8 Versaci F, 2020, PANMINERVA MED, V62, P252, DOI 10.23736/S0031-0808.20.04161-0 Versaci F, 2019, INT J CARDIOL, V294, P1, DOI 10.1016/j.ijcard.2019.07.006 Wang LQ, 2020, ENVIRON CHEM LETT, V18, P1713, DOI 10.1007/s10311-020-01028-3 Wathore R, 2020, SCI TOTAL ENVIRON, V749, DOI 10.1016/j.scitotenv.2020.141486 Yang WY, 2017, EUR J PREV CARDIOL, V24, P1416, DOI 10.1177/2047487317715109 NR 38 TC 10 Z9 10 U1 4 U2 8 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD APR 15 PY 2021 VL 329 BP 251 EP 259 DI 10.1016/j.ijcard.2020.12.059 EA MAR 2021 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA RJ4WI UT WOS:000637601100052 PM 33387558 OA Green Published DA 2023-05-13 ER PT J AU Garlo, KG White, WB Bakris, GL Zannad, F Wilson, CA Kupfer, S Vaduganathan, M Morrow, DA Cannon, CP Charytan, DM AF Garlo, Katherine G. White, William B. Bakris, George L. Zannad, Faiez Wilson, Craig A. Kupfer, Stuart Vaduganathan, Muthiah Morrow, David A. Cannon, Christopher P. Charytan, David M. TI Kidney Biomarkers and Decline in eGFR in Patients with Type 2 Diabetes SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article DE chronic kidney disease; diabetes mellitus; progression of chronic renal failure; randomized controlled trials; Cystatin C; Lipocalin-2; Acute Coronary Syndrome; glomerular filtration rate; Diabetes Mellitus; Type 2; Factor IX; risk factors; kidney; proteinuria; Renal Insufficiency; Chronic; Cohort Studies; Biomarkers; renal dialysis ID GELATINASE-ASSOCIATED LIPOCALIN; STAGE RENAL-DISEASE; CARDIOVASCULAR OUTCOMES; URINARY BIOMARKERS; NEPHROPATHY; PROGRESSION; ALISKIREN; MELLITUS; INJURY; TRIAL AB Background and objectives Biomarkers may improve identification of individuals at risk of eGFR decline who may benefit from intervention or dialysis planning. However, available biomarkers remain incompletely validated for risk stratification and prediction modeling. Design, setting, participants, & measurements We examined serum cystatin C, urinary kidney injury molecule-1 (uKIM-1), and urinary neutrophil gelatinase-associated lipocalin (UNGAL) in 5367 individuals with type 2 diabetes mellitus and recent acute coronary syndromes enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial. Baseline concentrations and 6-month changes in biomarkers were also evaluated. Cox proportional regression was used to assess associations with a 50% decrease in eGFR, stage 5 CKD (eGFR<15 ml/min per 1.73 m(2)), or dialysis. Results eGFR decline occurred in 98 patients (1.8%) over a median of 1.5 years. All biomarkers individually were associated with higher risk of eGFR decline (P<0.001). However, when adjusting for baseline eGFR, proteinuria, and clinical factors, only baseline cystatin C (adjusted hazard ratio per 1 SD change, 1.66; 95% confidence interval, 1.41 to 1.96; P<0.001) and 6-month change in urinary neutrophil gelatinase-associated lipocalin (adjusted hazard ratio per 1 SD change, 1.07; 95% confidence interval, 1.02 to 1.12; P=0.004) independently associated with CKD progression. A base model for predicting kidney function decline with nine standard risk factors had strong discriminative ability (C-statistic 0.93). The addition of baseline cystatin C improved discrimination (C-statistic 0.94), but it failed to reclassify risk categories of individuals with and without eGFR decline. Conclusions The addition of cystatin C or biomarkers of tubular injury did not meaningfully improve the prediction of eGFR decline beyond common clinical factors and routine laboratory data in a large cohort of patients with type 2 diabetes and recent acute coronary syndrome. C1 [Garlo, Katherine G.; Cannon, Christopher P.; Charytan, David M.] Baim Inst Clin Res, Div Cardiometab Trials, Boston, MA USA. [Garlo, Katherine G.; Charytan, David M.] Brigham & Womens Hosp, Dept Med, Renal Div, 75 Francis St, Boston, MA 02115 USA. [White, William B.] Univ Connecticut, Sch Med, Div Hypertens & Clin Pharmacol, Calhoun Cardiol Ctr, Farmington, CT USA. [Bakris, George L.] Univ Chicago, Sch Med, Dept Med, Chicago, IL USA. [Bakris, George L.] Univ Chicago, Sch Med, Amer Soc Hypertens, Comprehens Hypertens Ctr, Chicago, IL USA. [Zannad, Faiez] Univ Lorraine, Dept Med, Nancy, France. [Zannad, Faiez] CHU Nancy, Nancy, France. [Wilson, Craig A.; Kupfer, Stuart] Takeda Dev Ctr Amer Inc, Div Cardiovasc & Metab Dis, Deerfield, IL USA. [Vaduganathan, Muthiah; Morrow, David A.; Cannon, Christopher P.] Brigham & Womens Hosp, Div Cardiovasc Med, 75 Francis St, Boston, MA 02115 USA. [Vaduganathan, Muthiah; Morrow, David A.; Cannon, Christopher P.] Harvard Med Sch, Boston, MA USA. C3 Harvard University; Brigham & Women's Hospital; University of Connecticut; University of Chicago; University of Chicago; Universite de Lorraine; CHU de Nancy; Takeda Pharmaceutical Company Ltd; Takeda Development Center Americas, Inc.; Harvard University; Brigham & Women's Hospital; Harvard University; Harvard Medical School RP Garlo, KG (通讯作者),Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA. EM kgarlo@bwh.harvard.edu RI Zannad, Faiez/K-4649-2019; Cannon, Christopher P/AAY-7644-2020 OI Cannon, Christopher P/0000-0003-4596-2791; charytan, david/0000-0002-7695-3583 FU Takeda FX We thank the individuals involved in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) study which was sponsored by Takeda. 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J. Am. Soc. Nephrol. PD MAR 7 PY 2018 VL 13 IS 3 BP 398 EP 405 DI 10.2215/CJN.05280517 PG 8 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA FY8IQ UT WOS:000427108100008 PM 29339356 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Desta, L Jernberg, T Lofman, I Hofman-Bang, C Hagerman, I Spaak, J Persson, H AF Desta, Liyew Jernberg, Tomas Lofman, Ida Hofman-Bang, Claes Hagerman, Inger Spaak, Jonas Persson, Hans TI Incidence, Temporal Trends, and Prognostic Impact of Heart Failure Complicating Acute Myocardial Infarction The SWEDEHEART Registry (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies): A Study of 199,851 Patients Admitted With Index Acute Myocardial Infarctions, 1996 to 2008 SO JACC-HEART FAILURE LA English DT Article DE epidemiology; heart failure; myocardial infarction; prognosis ID ACUTE CORONARY SYNDROMES; EVENT RATES; ELDERLY-PATIENTS; MONICA PROJECT; RISK-FACTORS; SURVIVAL; DETERMINANTS; POPULATIONS; MORTALITY; DEATH AB OBJECTIVES The aim of this study was to examine temporal trends in the incidence and outcomes of heart failure (HF) complicating acute myocardial infarction (AMI) in a large national cohort. BACKGROUND There are limited and conflicting data concerning temporal trends in the incidence and prognostic implication of in-hospital HF that complicates AMI. METHODS The nationwide coronary care unit registry SWEDEHEART (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) records baseline characteristics, treatments, and outcome of consecutive patients with AMIs admitted to all hospitals in Sweden. The diagnosis of HF requires the presence of crackles (Killip class >= II) or the use of intravenous diuretic agents or intravenous inotropes. This study included 199,851 patients admitted for index AMIs between 1996 and 2008. RESULTS The incidence of HF declined from 46% to 28% (p < 0.001). This decrease was more pronounced in patients with ST-segment elevation myocardial infarctions and left bundle branch block (from 50% to 28%) compared with those with non-ST-segment elevation myocardial infarctions (from 42% to 28%) (p < 0.001). The in-hospital, 30-day, and 1-year mortality rates for patients who developed HF during the index myocardial infarction decreased over the years from 19% to 13%, from 23% to 17%, and from 36% to 31%, respectively (p < 0.001 for all). Thirteen-year survival analysis showed higher mortality in patients with HF compared with those without HF (adjusted hazard ratio: 2.1; 95% confidence interval: 2.06 to 2.13). CONCLUSIONS A marked decrease was found in the incidence of HF complicating AMI between 1996 and 2008. However, HF continues to worsen the early-, intermediate-, and long-term adverse prognostic risk after AMI. (C) 2015 by the American College of Cardiology Foundation. C1 [Desta, Liyew; Hofman-Bang, Claes; Spaak, Jonas; Persson, Hans] Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, S-18288 Stockholm, Sweden. [Jernberg, Tomas; Lofman, Ida; Hagerman, Inger] Karolinska Univ Hosp, Dept Cardiol, Huddinge, Sweden. C3 Danderyds Hospital; Karolinska Institutet; Karolinska Institutet; Karolinska University Hospital RP Desta, L (通讯作者),Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Cardiol Sect, S-18288 Stockholm, Sweden. EM liyew.desta@ds.se RI Demchuk, Andrew M/E-1103-2012 OI Demchuk, Andrew M/0000-0002-4930-7789; Spaak, Jonas/0000-0002-2135-1294; Jernberg, Tomas/0000-0003-1695-379X FU board of the Swedish Heart Failure Registry; Swedish Heart and Lung Foundation FX Drs. Desta and Persson have received grant funding from the board of the Swedish Heart Failure Registry and the Swedish Heart and Lung Foundation, respectively. None of the sponsors participated in the design or conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. CR Ezekowitz JA, 2009, J AM COLL CARDIOL, V53, P13, DOI 10.1016/j.jacc.2008.08.067 Flynn MR, 2005, EUR HEART J, V26, P308, DOI 10.1093/eurheartj/ehi079 Fox KAA, 2007, JAMA-J AM MED ASSOC, V297, P1892, DOI 10.1001/jama.297.17.1892 Guidry UC, 1999, CIRCULATION, V100, P2054, DOI 10.1161/01.CIR.100.20.2054 Hellermann JP, 2005, EUR J HEART FAIL, V7, P119, DOI 10.1016/j.ejheart.2004.04.011 Hellermann JP, 2003, AM J EPIDEMIOL, V157, P1101, DOI 10.1093/aje/kwg078 Jernberg T, 2011, JAMA-J AM MED ASSOC, V305, P1677, DOI 10.1001/jama.2011.522 Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Kuulasmaa K, 2000, LANCET, V355, P675, DOI 10.1016/S0140-6736(99)11180-2 Meier MA, 2002, ARCH INTERN MED, V162, P1585, DOI 10.1001/archinte.162.14.1585 Najafi F, 2007, EUR J HEART FAIL, V9, P879, DOI 10.1016/j.ejheart.2007.05.014 Najafi F, 2009, EUR J HEART FAIL, V11, P472, DOI 10.1093/eurjhf/hfp029 PERSSON H, 1995, EUR HEART J, V16, P496, DOI 10.1093/oxfordjournals.eurheartj.a060942 Rosengren A, 2012, EUR HEART J, V33, P562, DOI 10.1093/eurheartj/ehr364 Rosvall M, 2010, SCAND J PUBLIC HEALT, V38, P533, DOI 10.1177/1403494810365109 Salomaa V, 1999, J CARDIOVASC RISK, V6, P69 Shafazand M, 2011, EUR J HEART FAIL, V13, P135 Sjogren A, 1970, Acta Med Scand Suppl, V510, P1 Spencer FA, 1999, J AM COLL CARDIOL, V34, P1378, DOI 10.1016/S0735-1097(99)00390-3 Steg PG, 2004, CIRCULATION, V109, P494, DOI 10.1161/01.CIR.0000109691.16944.DA Stenestrand U, 2001, JAMA-J AM MED ASSOC, V285, P430, DOI 10.1001/jama.285.4.430 TUNSTALLPEDOE H, 1994, CIRCULATION, V90, P583, DOI 10.1161/01.CIR.90.1.583 Vaur L, 1999, AM HEART J, V137, P49, DOI 10.1016/S0002-8703(99)70459-X Velagaleti RS, 2008, CIRCULATION, V118, P2057, DOI 10.1161/CIRCULATIONAHA.108.784215 Wallentin L, 2000, LANCET, V356, P9, DOI 10.1016/S0140-6736(00)02427-2 WHITE HD, 1987, CIRCULATION, V76, P44, DOI 10.1161/01.CIR.76.1.44 Wilhelmsen L, 2008, J INTERN MED, V263, P636, DOI 10.1111/j.1365-2796.2008.01931.x NR 27 TC 88 Z9 91 U1 0 U2 6 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 2213-1779 EI 2213-1787 J9 JACC-HEART FAIL JI JACC-Heart Fail. PD MAR PY 2015 VL 3 IS 3 BP 234 EP 242 DI 10.1016/j.jchf.2014.10.007 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CX4EC UT WOS:000365650600007 PM 25742760 OA Bronze DA 2023-05-13 ER PT J AU Tornvall, P Collste, O Pettersson, H AF Tornvall, P. Collste, O. Pettersson, H. TI Prevalence and cumulative incidence of cancer, and mortality in patients with Takotsubo syndrome with focus on the index event SO QJM-AN INTERNATIONAL JOURNAL OF MEDICINE LA English DT Article ID PREDICTORS; RISK AB Background: It has been suggested that Takotsubo syndrome (TS) is associated with cancer but previous studies have limitations. Aim: To make a comprehensive analysis of prevalence and cumulative incidence of cancer, and mortality among TS patients with focus on the index event. Design: A register-based case-control study. Methods: The first new cancer occurrences (International Classification of Diseases C00-C75, C81-C96) were compared between 505 patients with TS without obstructive coronary artery disease (CAD) and four age- and gender-matched controls comprising patients with acute coronary syndrome with obstructive CAD (CAD controls), respectively, with chest-pain without obstructive CAD at coronary angiography (controls without CAD). Results: The prevalence of cancer before the index event was non-significantly (P=0.052) higher in TS patients (15.8%) than in CAD controls (11.5%), respectively, higher (P=0.028) than in controls without CAD (11.1%). There were no differences between the groups in cumulative incidence of cancer after the index event but a higher mortality in TS patients who developed cancer when compared with controls without CAD that developed cancer after the index event (P=0.018). Conclusions: There is an increased prevalence of first diagnosed cancer in TS patients before the index event but no increased cumulative incidence of cancer after the index event. The results does not support investigation for the possibility of a malignancy specifically in TS patients but in the event of cancer this patient group might need special care. However, if there is lack of a clear stressor it could be of importance to investigate the possibility of a malignancy. C1 [Tornvall, P.; Collste, O.; Pettersson, H.] Karolinska Inst, Sodersjukhuset, Dept Clin Sci & Educ, Sjukhusbacken 10, S-11883 Stockholm, Sweden. C3 Karolinska Institutet; Sodersjukhuset Hospital RP Tornvall, P (通讯作者),Karolinska Inst, Sodersjukhuset, Dept Clin Sci & Educ, Sjukhusbacken 10, S-11883 Stockholm, Sweden. EM per.tornvall@ki.se FU Swedish Heart and Lung Foundation [20150612] FX The present study was supported by the Swedish Heart and Lung Foundation with grant number 20150612. CR Brunetti ND, 2019, HEART FAIL REV, V24, P481, DOI 10.1007/s10741-019-09773-6 Burgdorf C, 2008, EUR J HEART FAIL, V10, P1015, DOI 10.1016/j.ejheart.2008.07.008 Desai R, 2019, AM J CARDIOL, V123, P667, DOI 10.1016/j.amjcard.2018.11.006 El-Sayed AM, 2012, AM J CARDIOL, V110, P1368, DOI 10.1016/j.amjcard.2012.06.041 Girardey M, 2016, CIRC J, V80, P2192, DOI 10.1253/circj.CJ-16-0388 Kim H, 2018, INT J CARDIOL, V267, P22, DOI 10.1016/j.ijcard.2018.04.139 Lyon AR, 2016, EUR J HEART FAIL, V18, P8, DOI 10.1002/ejhf.424 Moller C, 2018, EUR J HEART FAIL, V20, P816, DOI 10.1002/ejhf.868 Rinde LB, 2017, EUR J EPIDEMIOL, V32, P193, DOI 10.1007/s10654-017-0231-5 Sattler K, 2018, QJM-INT J MED, V111, P473, DOI 10.1093/qjmed/hcy089 Sattler K, 2017, INT J CARDIOL, V238, P159, DOI 10.1016/j.ijcard.2017.02.093 Tornvall P, 2016, J AM COLL CARDIOL, V67, P1931, DOI 10.1016/j.jacc.2016.02.029 NR 12 TC 1 Z9 1 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1460-2725 EI 1460-2393 J9 QJM-INT J MED JI QJM-An Int. J. Med. PD NOV PY 2019 VL 112 IS 11 BP 861 EP 867 DI 10.1093/qjmed/hcz186 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA JP3LH UT WOS:000498168500007 PM 31346617 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Plat, FM Peters, YAS Loots, FJ de Groot, CJA Eckhardt, T Keizer, E Giesen, P AF Plat, Fredrik M. Peters, Yvonne A. S. Loots, Feike J. de Groot, Corline J. A. Eckhardt, Thomas Keizer, Ellen Giesen, Paul TI Ambulance dispatch versus general practitioner home visit for highly urgent out-of-hours primary care SO FAMILY PRACTICE LA English DT Article DE Access to care; emergency medicine; family health; primary care; quality of care; urgent care ID ACUTE CORONARY SYNDROME; TELEPHONE TRIAGE; INAPPROPRIATE USE; EMERGENCY; NETHERLANDS; SERVICES; GPS AB Background. Patients with life-threatening conditions who contact out-of-hours primary care either receive a home visit from a GP of a GP cooperative (GPC) or are handed over to the ambulance service. Objective. The objective of this study was to determine whether highly urgent visits, after a call to the GPC, are delivered by the most appropriate healthcare provider: GPC or ambulance service. Methods. We performed a cross-sectional study using patient record data from a GPC and ambulance service in an urban district in The Netherlands. During a 21-month period, all calls triaged as life-threatening (U1) to the GPCs were included. The decision to send an ambulance or not was made by the triage nurse following a protocolized triage process. Retrospectively, the most appropriate care was judged by the patient's own GP, using a questionnaire. Results. Patient and care characteristics from 1081 patients were gathered: 401 GPC visits, 570 ambulance responses and 110 with both ambulance and GPC deployment. In 598 of 1081 (55.3%) cases, questionnaires were returned by the patients' own GP. About 40% of all visits could have been carried out with a lower urgency in retrospect, and almost half of all visits should have received a different type of care or different provider. In case of ambulance response, 60.7% concerned chest pain. Conclusion. Research should be done on the process of triage and allocation of care to optimize labelling complaints with the appropriate urgency and to deploy the appropriate healthcare provider, especially for patients with chest pain. C1 [Plat, Fredrik M.; Peters, Yvonne A. S.; Loots, Feike J.; Keizer, Ellen; Giesen, Paul] Radboud Univ Nijmegen, Radboud Inst Hlth Sci, Sci Ctr Qual Healthcare IQ Healthcare, Med Ctr, POB 9101, NL-6500 HB Nijmegen, Netherlands. [de Groot, Corline J. A.] Mobile Doctors Serv Fdn Haaglanden Stichting Mobi, The Hague, Netherlands. [Eckhardt, Thomas] Municipal Hlth Serv Haaglanden Gemeentelijke Gezo, The Hague, Netherlands. C3 Radboud University Nijmegen RP Plat, FM (通讯作者),Radboud Univ Nijmegen, Radboud Inst Hlth Sci, Sci Ctr Qual Healthcare IQ Healthcare, Med Ctr, POB 9101, NL-6500 HB Nijmegen, Netherlands. EM erik.plat@radboudumc.nl RI Giesen, P.H.J./L-4325-2015; Keizer, E/I-1902-2015; Loots, Feike J/F-7866-2016; Peters, Yvonne AS/F-3096-2016; Plat, Erik FM/C-2154-2018 OI Keizer, E/0000-0001-8244-741X; Loots, Feike J/0000-0003-4984-0484; Plat, Erik FM/0000-0003-0764-4717; Kubickova, Karolina/0000-0002-9556-3185 FU Mobile Doctors Service Foundation Haaglanden (Stichting Mobiele Artsen Service Haaglanden); Municipal Health Service Haaglanden (Gemeentelijke Gezondheidsdienst Haaglanden) FX This study was financially supported by the Mobile Doctors Service Foundation Haaglanden (Stichting Mobiele Artsen Service Haaglanden) and by the Municipal Health Service Haaglanden (Gemeentelijke Gezondheidsdienst Haaglanden). 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Pr. PD AUG PY 2018 VL 35 IS 4 BP 440 EP 445 DI 10.1093/fampra/cmx121 PG 6 WC Primary Health Care; Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA GO2JA UT WOS:000439794800013 PM 29272417 OA Bronze DA 2023-05-13 ER PT J AU Feazel, L Schlichting, AB Bell, GR Shane, DM Ahmed, A Faine, B Nugent, A Mohr, NM AF Feazel, Leah Schlichting, Adam B. Bell, Gregory R. Shane, Dan M. Ahmed, Azeemuddin Faine, Brett Nugent, Andrew Mohr, Nicholas M. TI Achieving regionalization through rural interhospital transfer SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Review ID ELEVATION MYOCARDIAL-INFARCTION; HEALTH INFORMATION EXCHANGE; 2013 ACCF/AHA GUIDELINE; CRITICALLY-ILL PATIENTS; ASSOCIATION TASK-FORCE; TRAUMA-CENTER CARE; AMERICAN-COLLEGE; INSURANCE STATUS; CORONARY ANGIOPLASTY; FIBRINOLYTIC THERAPY AB Regionalization of emergency medical care aims to provide consistent and efficient high-quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires interhospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital; capacity at the receiving hospital; and financial, geographic, and patient-preference considerations. Although transfer to a comprehensive center has proven benefits for some conditions, the transfer process is not without risk. These risks include clinical deterioration, limited resource availability during transport, vehicular crashes, time delays for time-sensitive care, poor communication between providers, and neglect of patient preferences. This article reviews the transfer decision, financial implications, risks, and considerations for patients undergoing rural interhospital transfer. We identify several strategies that should be considered for development of the regionalized emergency health care system of the future and identify areas where further research is necessary. (C) 2015 Elsevier Inc. All rights reserved. C1 [Feazel, Leah; Mohr, Nicholas M.] Univ Iowa, Carver Coll Med, Iowa City, IA 52242 USA. [Schlichting, Adam B.; Bell, Gregory R.; Ahmed, Azeemuddin; Nugent, Andrew; Mohr, Nicholas M.] Univ Iowa, Carver Coll Med, Dept Emergency Med, Iowa City, IA 52242 USA. [Schlichting, Adam B.] Univ Iowa, Carver Coll Med, Dept Internal Med, Div Pulm Crit Care & Occupat Med, Iowa City, IA 52242 USA. [Shane, Dan M.] Coll Publ Hlth, Dept Hlth Management & Policy, Iowa City, IA USA. [Faine, Brett] Univ Iowa Hosp & Clin, Dept Pharm, Iowa City, IA 52242 USA. [Mohr, Nicholas M.] Univ Iowa, Carver Coll Med, Dept Anesthesia, Div Crit Care, Iowa City, IA 52242 USA. C3 University of Iowa; University of Iowa; University of Iowa; University of Iowa; University of Iowa RP Mohr, NM (通讯作者),Univ Iowa, Carver Coll Med, 200 Hawkins Dr,1008 RCP, Iowa City, IA 52242 USA. EM nicholas-mohr@uiowa.edu RI Mohr, Nicholas/N-1112-2017 OI Mohr, Nicholas/0000-0003-0497-5828; Faine, Brett/0000-0002-5759-9857; Bell, Gregory/0000-0002-0356-638X; Nugent, Andrew/0000-0002-9867-0429; Ahmed, Azeemuddin/0000-0003-4629-2347 FU Emergency Medicine Foundation FX Dr Mohr is supported by a grant from the Emergency Medicine Foundation. 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J. Emerg. Med. PD SEP PY 2015 VL 33 IS 9 BP 1288 EP 1296 DI 10.1016/j.ajem.2015.05.032 PG 9 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA CQ9GG UT WOS:000360920700037 PM 26087707 DA 2023-05-13 ER PT J AU Haasenritter, J Biroga, T Keunecke, C Becker, A Donner-Banzhoff, N Stadje, R Viniol, A Bosner, S AF Haasenritter, Joerg Biroga, Tobias Keunecke, Christian Becker, Annette Donner-Banzhoff, Norbert Stadje, Rebekka Viniol, Annika Boesner, Stefan TI Causes of chest pain in primary care - a systematic review and meta-analysis SO CROATIAN MEDICAL JOURNAL LA English DT Review ID CORONARY-HEART-DISEASE; INITIAL DIAGNOSIS; GENERAL-PRACTICE; FAMILY-PRACTICE; PREVALENCE; EMERGENCY; SYMPTOMS; EPISODES AB Aim To investigate the frequencies of different and relevant underlying etiologies of chest pain in general practice. Methods We systematically searched PubMed and EMBASE. Two reviewers independently rated the eligibility of publications and assessed the risk of bias of included studies. We extracted data to calculate the relative frequencies of different underlying conditions and investigated the variation across studies using forest plots, I-2, tau(2), and prediction intervals. With respect to unexplained heterogeneity, we provided qualitative syntheses instead of pooled estimates. Results We identified 11 eligible studies comprising about 6500 patients. The overall risk of bias was rated as low in 6 studies comprising about 3900 patients. The relative frequencies of different conditions as the underlying etiologies of chest pain reported by these studies ranged from 24.5 to 49.8% (chest wall syndrome), 13.8 to 16.1% (cardiovascular diseases), 6.6 to 11.2% (stable coronary heart disease), 1.5 to 3.6% (acute coronary syndrome/myocardial infarction), 10.3 to 18.2% (respiratory diseases), 9.5 to 18.2% (psychogenic etiologies), 5.6 to 9.7% (gastrointestinal disorders), and 6.0 to 7.1% (esophageal disorders). Conclusion This information may be of practical value for general practitioners as it provides the pre-test probabilities for a range of underlying diseases and may be suitable to guide the diagnostic process. C1 [Haasenritter, Joerg; Biroga, Tobias; Keunecke, Christian; Becker, Annette; Donner-Banzhoff, Norbert; Stadje, Rebekka; Viniol, Annika; Boesner, Stefan] Philipps Univ Marburg, Dept Gen Practice Family Med, D-35043 Marburg, Germany. C3 Philipps University Marburg RP Haasenritter, J (通讯作者),Philipps Univ Marburg, Dept Gen Practice Family Med, Karl von Frisch Str 4, D-35043 Marburg, Germany. 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PD OCT PY 2015 VL 56 IS 5 BP 422 EP 430 DI 10.3325/cmj.2015.56.422 PG 9 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CW5GL UT WOS:000365023600003 PM 26526879 OA gold, Green Submitted, Green Published DA 2023-05-13 ER PT J AU Arrebola-Moreno, M Petrova, D Garcia-Retamero, R Rivera-Lopez, R Jordan-Martinez, L Arrebola, JP Ramirez-Hernandez, JA Catena, A AF Arrebola-Moreno, Mercedes Petrova, Dafina Garcia-Retamero, Rocio Rivera-Lopez, Ricardo Jordan-Martinez, Laura Pedro Arrebola, Juan Antonio Ramirez-Hernandez, Jose Catena, Andres TI Psychological and cognitive factors related to prehospital delay in acute coronary syndrome: A systematic review SO INTERNATIONAL JOURNAL OF NURSING STUDIES LA English DT Review DE Acute coronary syndrome; Emotions; Knowledge; Prehospital delay; Symptoms; Systematic review ID ACUTE MYOCARDIAL-INFARCTION; SEEKING HEALTH-CARE; GENDER-DIFFERENCES; DECISION DELAY; COPING STRATEGIES; SYMPTOMS; TIME; PREDICTORS; STATEMENT; ATTITUDES AB Background: In acute coronary syndrome the time elapsed between the start of symptoms and the moment the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek medical attention after symptoms have started. Objective: To conduct a systematic review with meta-analysis of the relationship between nine frequently investigated psychological and cognitive factors and prehospital delay. Design: A protocol was preregistered in PROSPERO [CRD42018094198] and a systematic review was conducted following PRISMA guidelines. Data sources: The following databases were searched for quantitative articles published between 1997 and 2019: Medline (PubMed), Web of Science, Scopus, Psych Info, PAIS, and Open grey. Review methods: Study risk of bias was assessed with the NIH Quality Assessment Tool for Observational, Cohort, and Cross-Sectional Studies. A best evidence synthesis was performed to summarize the findings of the included studies. Results: Forty-eight articles, reporting on 57 studies from 23 countries met the inclusion criteria. Studies used very diverse definitions of prehospital delay and analytical practices, which precluded meta-analysis. The best evidence synthesis indicated that there was evidence that patients who attributed their symptoms to a cardiac event (n = 37), perceived symptoms as serious (n = 24), or felt anxiety in response to symptoms (n = 15) reported shorter prehospital delay, with effect sizes indicating important clinical differences (e.g., 1.5-2 h shorter prehospital delay). In contrast, there was limited evidence for a relationship between prehospital delay and knowledge of symptoms (n = 18), concern for troubling others (n = 18), fear (n = 17), or embarrassment in asking for help (n = 14). Conclusions: The current review shows that symptom attribution to cardiac events and some degree of perceived threat are fundamental to speed up help-seeking. In contrast, social concerns and barriers in seeking medical attention (embarrassment or concern for troubling others) may not be as important as initially thought. The current review also shows that the use of very diverse methodological practices strongly limits the integration of evidence into meaningful recommendations. We conclude that there is urgent need for common guidelines for prehospital delay study design and reporting. (C) 2020 The Author(s). Published by Elsevier Ltd. C1 [Arrebola-Moreno, Mercedes; Garcia-Retamero, Rocio; Catena, Andres] Univ Granada, Mind Brain & Behav Res Ctr CIMCYC, Granada, Spain. [Petrova, Dafina] Escuela Andaluza Salud Publ, Granada, Spain. [Petrova, Dafina; Rivera-Lopez, Ricardo; Jordan-Martinez, Laura; Pedro Arrebola, Juan; Antonio Ramirez-Hernandez, Jose] Inst Invest Biosanitaria Ibs GRANADA, Granada, Spain. [Petrova, Dafina; Pedro Arrebola, Juan] CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain. [Garcia-Retamero, Rocio] Max Planck Inst Human Dev, Harding Ctr Risk Literacy, Berlin, Germany. [Rivera-Lopez, Ricardo; Jordan-Martinez, Laura; Antonio Ramirez-Hernandez, Jose] Virgen Nieves Univ Hosp, Cardiol Dept, Granada, Spain. [Pedro Arrebola, Juan] Univ Granada, Dept Prevent Med & Publ Hlth, Granada, Spain. C3 University of Granada; Escuela Andaluza de Salud Publica; Instituto de Investigacion Biosanitaria IBS Granada; CIBER - Centro de Investigacion Biomedica en Red; CIBERESP; Max Planck Society; Hospital Universitario Virgen de las Nieves; University of Granada RP Petrova, D (通讯作者),Cuesta Observ 4, Granada 18011, Spain. EM dafina.petrova.easp@juntadeandalucia.es RI Catena, Andres/I-2159-2015; Garcia-Retamero, Rocio/J-7040-2014 OI Catena, Andres/0000-0002-0775-5751; Garcia-Retamero, Rocio/0000-0001-9140-8519; Rivera-Lopez, Ricardo/0000-0002-0787-9383; Arrebola, Juan P./0000-0002-8643-2423; Petrova, Dafina/0000-0002-0346-6776 FU Juan de la Cierva Fellowship from the Spanish Ministry of Science [FJCI-2016-28279]; Ministerio de Economia y Competitividad (Spain) [PSI2014-51842-R]; Andalusian Regional Goverment [SOMM17-6103-UGR]; European Regional Development Fund (ERDF) [SOMM17-6103-UGR]; Ministerio de Economia, Industria y Competitividad, Spain [RYC-2016-20155] FX This research is part of the project "PySCA: Study of the impact of psychological factors in acute coronary syndrome"(Principal Investigator: JARH). Dr. Dafina Petrova was supported by a Juan de la Cierva Fellowship (FJCI-2016-28279) from the Spanish Ministry of Science. Financial support was partially provided by the Ministerio de Economia y Competitividad (Spain) (PSI2014-51842-R). We would also like to acknowledge the support of the Andalusian Regional Goverment and the European Regional Development Fund (ERDF) to the Brain, Behavior, and Health Scientific Excellence Unit (SC2), ref: SOMM17-6103-UGR. Dr. J.P. Arrebola is employed in the Ramon y Cajal program (RYC-2016-20155, Ministerio de Economia, Industria y Competitividad, Spain).The authors declare independence from these funding agencies and do not have conflicts of interest including financial interests, activities, relationships, and affiliations. We would like to thank Yolanda Ramirez Casas for her help with data collection. This research is part of the PhD thesis of Mercedes Arrebola Moreno (Programa de Doctorado en Psicologia, Universidad de Granada). 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J. Nurs. Stud. PD AUG PY 2020 VL 108 AR 103613 DI 10.1016/j.ijnurstu.2020.103613 PG 15 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA LZ5IG UT WOS:000541257000008 PM 32473396 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Dhir, S Dhir, A AF Dhir, Shalini Dhir, Achal TI Cardiovascular Risk Assessment for Noncardiac Surgery: Are We Ready for Biomarkers? SO JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA LA English DT Review DE biomarkers; cardiovascular system; perioperative care; prognosis; heart failure ID SENSITIVITY CARDIAC TROPONIN; PERIOPERATIVE MYOCARDIAL INJURY; BRAIN NATRIURETIC PEPTIDE; 3RD UNIVERSAL DEFINITION; ACUTE CORONARY SYNDROME; ISCHEMIC-HEART-DISEASE; CREATINE KINASE-MB; PROGNOSTIC VALUE; EUROPEAN-SOCIETY; TASK-FORCE AB Biomarkers aided perioperative cardiac assessment is a relatively new concept. Cardiac biomarkers with historical significance (aspartate transaminase, dehydrogenase, creatinine kinase and myoglobin) have paved the way for traditional biomarkers (cardiac troponin, C-reactive protein, lipoprotein). Contemporary biomarkers like natriuretic peptides (BNP and ProBNP) are validated risk markers in both acute and chronic cardiac diseases and are showing remarkable promise in predicting serious cardiovascular complications after non-cardiac surgery. This review is intended to provide a critical overview of traditional and contemporary biomarkers for perioperative cardiovascular assessment and management. This review also discusses the potential utility of newer biomarkers like galectin-3, sST-2, GDF-15, TNF-alpha, MiRNAs and many others that can predict inflammation, cardiac remodeling, injury and endogenous stress and need further investigations to establish their clinical utility. Though promising, biomarker led perioperative care is still in infancy and it has not been determined that it can improve clinical outcomes. (C) 2019 Elsevier Inc. All rights reserved. C1 [Dhir, Shalini; Dhir, Achal] Western Univ, Dept Anesthesia & Perioperat Med, London, ON, Canada. C3 Western University (University of Western Ontario) RP Dhir, S (通讯作者),Univ Hosp, London Hlth Sci Ctr, Dept Anesthesia & Perioperat Med, 339 Windermere Rd, London, ON N6A 5A5, Canada. 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Cardiothorac. Vasc. Anesth. PD JUL PY 2020 VL 34 IS 7 BP 1914 EP 1924 DI 10.1053/j.jvca.2019.10.014 PG 11 WC Anesthesiology; Cardiac & Cardiovascular Systems; Respiratory System; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Anesthesiology; Cardiovascular System & Cardiology; Respiratory System GA LV0DX UT WOS:000538116100036 PM 31866221 DA 2023-05-13 ER PT J AU Imazio, M Klingel, K Kindermann, I Brucato, A De Rosa, FG Adler, Y De Ferrari, GM AF Imazio, Massimo Klingel, Karin Kindermann, Ingrid Brucato, Antonio De Rosa, Francesco Giuseppe Adler, Yehuda De Ferrari, Gaetano Maria TI COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis? SO HEART LA English DT Review DE myocarditis; acute coronary syndromes; pericardial effusion; thromboembolic pulmonary vascular disease AB The initial mechanism for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is the binding of the virus to the membrane-bound form of ACE2, which is mainly expressed in the lung. Since the heart and the vessels also express ACE2, they both could become targets of the virus. However, at present the extent and importance of this potential involvement are unknown. Cardiac troponin levels are significantly higher in patients with more severe infections, patients admitted to intensive care units or in those who have died. In the setting of COVID-19, myocardial injury, defined by an increased troponin level, occurs especially due to non-ischaemic myocardial processes, including severe respiratory infection with hypoxia, sepsis, systemic inflammation, pulmonary thrombosis and embolism, cardiac adrenergic hyperstimulation during cytokine storm syndrome, and myocarditis. At present, there are limited reports on definite diagnosis of myocarditis caused by SARS-CoV-2 in humans and limited demonstration of the virus in the myocardium. In conclusion, although the heart and the vessels are potential targets in COVID-19, there is currently limited evidence on the direct infection of the myocardium by SARS-CoV-2. Additional pathological studies and autopsy series will be very helpful to clarify the potentiality of COVID-19 to directly infect the myocardium and cause myocarditis. C1 [Imazio, Massimo] Univ Cardiol, AOU Citta Salute Sci Torino, I-10126 Turin, Italy. [Imazio, Massimo] Univ Torino, Dept Publ Hlth & Pediat, Turin, Italy. [Klingel, Karin] Univ Hosp Tuebingen, Cardiopathol, Tubingen, Germany. [Kindermann, Ingrid] Saarland Univ, Med Ctr, Dept Internal Med Cardiol Angiol & Intens Care, Homburg, Germany. [Brucato, Antonio] Univ Milan, Fatebenefratelli Hosp, Dept Biomed & Clin Sci, Milan, Italy. [Brucato, Antonio] Univ Milan, Milan, Italy. [De Rosa, Francesco Giuseppe] Univ Turin, Univ Infect Dis, Turin, Piedmont, Italy. [Adler, Yehuda] Coll Law & Business, Ramat Gan, Israel. [Adler, Yehuda] Tel Aviv Univ, Sackler Fac Med, Ramat Gan, Israel. [De Ferrari, Gaetano Maria] Univ Cardiol, AOU Citta Salute Sci Torino, Turin, Italy. [De Ferrari, Gaetano Maria] Univ Cardiol, Dept Med Sci, Turin, Turkey. C3 A.O.U. Citta della Salute e della Scienza di Torino; University of Turin; Eberhard Karls University of Tubingen; Eberhard Karls University Hospital; Universitatsklinikum des Saarlandes; University of Milan; University of Milan; University of Turin; Tel Aviv University; Sackler Faculty of Medicine; A.O.U. Citta della Salute e della Scienza di Torino RP Imazio, M (通讯作者),Univ Cardiol, AOU Citta Salute Sci Torino, I-10126 Turin, Italy.; Imazio, M (通讯作者),Univ Torino, Dept Publ Hlth & Pediat, Turin, Italy. 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These syndromes are characterized by vasoplegia and ischemia-reperfusion phenomenom. Adenosine is a strong endogenous vasodilating agent, which may be involved in blood pressure failure during CPB induced by severe SIRS. Ischemia-modified albumin (IMA) is considered as a sensitive marker of tissue ischemia. We examined whether the IMA or adenosine plasma concentrations (APCs) change during a severe SIRS-induced blood pressure failure during CPB. Materials and Methods: Plasma concentration and IMA (median [range]) were measured before, during, and after surgery in 86 patients who underwent coronary revascularization under CBP and were correlated to postoperative clinical course. Results: Preoperative APC values (1.45 [0.52-2.11] mu mol L-1 vs 0.36 [0.12-0.66] mu mol L-1) and IMA (144 [91-198] IU mL(-1) vs 109 [61-183] U mL(-1)) were significantly increased in patients presenting postoperative severe SIRS. Mean durations of mechanical ventilation, stay in the intensive care unit, and requirement of vasoactive drugs were significantly higher in patients with higher APC and IMA, but APC was the best predictive marker a postoperative severe. Conclusions: Adenosine plasma concentration and IMA concentration are associated with postoperative severe SIRS after CPB. (C) 2013 Elsevier Inc. All rights reserved. C1 [Nee, Laetitia; Blayac, Dorothee; Bellezza, Maurice; Kerbaul, Francois] Grp Hosp La Timone, Pole Anesthesie Reanimat, Marseille 05, France. [Nee, Laetitia; Bruzzese, Laurie; Fromonot, Julien; Kipson, Nathalie; Lejeune, Pierre Jean; Guieu, Regis; Kerbaul, Francois] Aix Marseille Univ, UMR MD2, F-13284 Marseille, France. [Giorgi, Roch; Fromonot, Julien; Lejeune, Pierre Jean] Aix Marseille Univ, EA 3283, Fac Med, LERTIM, F-13284 Marseille 05, France. [Garibaldi, Vlad] Timone Univ Hosp, Dept Cardiac Surg, Marseille, France. [Guieu, Regis] Grp Hosp La Timone, Biochim Lab, Marseille 05, France. C3 UDICE-French Research Universities; Aix-Marseille Universite; UDICE-French Research Universities; Aix-Marseille Universite; UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille RP Guieu, R (通讯作者),Aix Marseille Univ, UMR MD2, F-13284 Marseille, France. 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Crit. Care PD OCT PY 2013 VL 28 IS 5 BP 747 EP 755 DI 10.1016/j.jcrc.2013.02.014 PG 9 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 217QM UT WOS:000324374700030 PM 23639429 DA 2023-05-13 ER PT J AU Sanfelix-Gimeno, G Peiro, S Ferreros, I Perez-Vicente, R Librero, J Catala-Lopez, F Ortiz, F Tortosa-Nacher, V AF Sanfelix-Gimeno, Gabriel Peiro, Salvador Ferreros, Inma Perez-Vicente, Raquel Librero, Julian Catala-Lopez, Ferran Ortiz, Francisco Tortosa-Nacher, Vicent TI Adherence to Evidence-Based Therapies After Acute Coronary Syndrome: A Retrospective Population-Based Cohort Study Linking Hospital, Outpatient, and Pharmacy Health Information Systems in Valencia, Spain SO JOURNAL OF MANAGED CARE PHARMACY LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; QUALITY-OF-LIFE; ISCHEMIC-HEART-DISEASE; LONG-TERM MORTALITY; SECONDARY PREVENTION; MEDICATION ADHERENCE; AFTER-DISCHARGE; ARTERY-DISEASE; DRUG THERAPIES; BETA-BLOCKERS AB BACKGROUND: Pharmacological secondary prevention in patients after an acute coronary syndrome (ACS) has contributed substantially to reductions in cardiovascular morbidity and mortality and, overall, has undergone important improvements in recent years. Nevertheless, there is still a considerable adherence gap and opportunity for improvement. OBJECTIVE: To assess, in a cohort of patients who survived an ACS, adherence to commonly prescribed secondary prevention drugs, factors associated to adherence, and variations among health care delivery areas. METHODS: We combined the medical and pharmacy databases from a regional public health service in Valencia, Spain, to construct a population-based cohort of patients discharged alive after an emergency admission for an ACS to any hospital of the Valencia Health Agency in 2008. We evaluated medication adherence by determining the proportion of days covered (PDC) for each therapeutic group (antiplatelet agents, beta-blockers, angiotensin antagonists, and statins) in the 9 months following hospital discharge. Fully adherent patients were defined as those having enough treatment to cover 75% (PDC75) of the follow-up period. RESULTS: The study cohort consisted of 7,462 patients. PDC75 was reached by 69.9% of patients taking antiplatelet agents, 43.3% taking beta-blockers, 45.4% taking angiotensin antagonists, and 58.8% taking statins. Approximately 18% of patients did not reach PDC75 with any treatment, while 47.6% did so for 3 or more therapeutic groups. Lower adherence was found in diagnoses other than myocardial infarction. Other factors associated with nonadherence were older age, women, having copayment, foreign born, and most comorbidities (except for hypertension and hyperlipidemia, which were inversely associated, and diabetes and peripheral disease, which were not significantly associated). Health care delivery areas showed certain variability in their performance on these adherence measures that remained after the adjustment for covariates, although confidence intervals overlapped except between areas at the extremes. CONCLUSIONS: The proportion of fully adherent patients remains suboptimal, and important improvements are still possible in secondary prevention of ischemic heart disease. The combination of electronic health information systems may be very useful for monitoring adherence and evaluating the effectiveness of adherence and other quality improvement interventions. J Manag Care Pharm. 2013;19(3):247-57 Copyright (C) 2013, Academy of Managed Care Pharmacy. All rights reserved. C1 [Sanfelix-Gimeno, Gabriel; Peiro, Salvador; Ferreros, Inma; Librero, Julian] Ctr Publ Hlth Res CSISP FISABIO, Hlth Serv Res Unit, Red Invest Serv Salud Enfermedades Cron REDISSEC, Valencia, Spain. [Perez-Vicente, Raquel; Catala-Lopez, Ferran] Ctr Publ Hlth Res CSISP FISABIO, Hlth Serv Res Unit, Valencia, Spain. [Ortiz, Francisco; Tortosa-Nacher, Vicent] Valencia Hlth Agcy, Healthcare Assurance Serv, Red Invest Serv Salud Enfermedades Cron REDISSEC, Valencia, Spain. RP Sanfelix-Gimeno, G (通讯作者),Ctr Super Invest Salud Publ, Hlth Serv Res Unit, Avda Cataluna 21, Valencia 46020, Spain. EM sanfelix_gab@gva.es RI Sanfélix-Gimeno, Gabriel/E-9140-2012; Librero, Julian/F-4947-2017; Catalá-López, Ferrán/N-6018-2018; Peiro, Salvador/H-5778-2017 OI Sanfélix-Gimeno, Gabriel/0000-0001-7098-4576; Librero, Julian/0000-0002-4859-9054; Catalá-López, Ferrán/0000-0002-3833-9312; Peiro, Salvador/0000-0002-3902-569X FU Department of Health of the Valencia Government [678/2007, 011/2011] FX This study was financed by grants 678/2007 and 011/2011 from the Department of Health of the Valencia Government. 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Manag. Care Pharm. PD APR PY 2013 VL 19 IS 3 BP 247 EP 257 DI 10.18553/jmcp.2013.19.3.247 PG 11 WC Health Care Sciences & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Pharmacology & Pharmacy GA 125HM UT WOS:000317530900004 PM 23537459 OA Bronze DA 2023-05-13 ER PT J AU Anchah, L Hassali, MA Lim, MSH Ibrahim, MIM Sim, KH Ong, TK AF Anchah, Lawrence Hassali, Mohamed Azmi Lim, Melissa Siaw Han Ibrahim, Mohamed Izham Mohamed Sim, Kui Hian Ong, Tiong Kiam TI Health related quality of life assessment in acute coronary syndrome patients: the effectiveness of early phase I cardiac rehabilitation SO HEALTH AND QUALITY OF LIFE OUTCOMES LA English DT Article DE Clinical pharmacy; Cardiac rehabilitation programme; Quality of life; SF-36; Acute coronary syndrome ID ACUTE MYOCARDIAL-INFARCTION; HOSPITAL DISCHARGE; COST-EFFECTIVENESS; DISEASE PATIENTS; CONTROLLED-TRIAL; HEART-DISEASE; POPULATION; DEPRESSION; EXERCISE; SF-36 AB Background: Acute Coronary Syndrome (ACS) is one of the most burdensome cardiovascular diseases in terms of the cost of interventions. The Cardiac Rehabilitation Programme (CRP) is well-established in improving clinical outcomes but the assessment of actual clinical improvement is challenging, especially when considering pharmaceutical care (PC) values in phase I CRP during admission and upon discharge from hospital and phase II outpatient interventions. This study explores the impact of pharmacists' interventions in the early stages of CRP on humanistic outcomes and follow-up at a referral hospital in Malaysia. Methods: We recruited 112 patients who were newly diagnosed with ACS and treated at the referral hospital, Sarawak General Hospital, Malaysia. In the intervention group (modified CRP), all medication was reviewed by the clinical pharmacists, focusing on drug indication; understanding of secondary prevention therapy and adherence to treatment strategy. We compared the "pre-post" quality of life (QoL) of three groups (intervention, conventional and control) at baseline, 6 months and 12 months post-discharge with Malaysian norms. QoL data was obtained using a validated version of Short-Form 36 Questionnaire (SF-36). Analysis of variance (ANOVA) with repeated measure tests was used to compare the mean differences of scores over time. Results: A pre-post quasi-experimental non-equivalent group comparison design was applied to 112 patients who were followed up for one year. At baseline, the physical and mental health summaries reported poor outcomes in all three groups. However, these improved gradually but significantly over time. After the 6-month follow-up, the physical component summary reported in the modified CRP (MCRP) participants was higher, with a mean difference of 8.02 (p = 0.015) but worse in the mental component summary, with a mean difference of -4.13. At the 12-month follow-up, the MCRP participants performed better in their physical component (PCS) than those in the CCRP and control groups, with a mean difference of 11.46 (p = 0.008), 10.96 (p = 0.002) and 6.41 (p = 0.006) respectively. Comparing the changes over time for minimal important differences (MICD), the MCRP group showed better social functioning than the CCRP and control groups with mean differences of 20.53 (p = 0.03), 14.47 and 8.8, respectively. In role emotional subscales all three groups showed significant improvement in MCID with mean differences of 30.96 (p = 0.048), 31.58 (p = 0.022) and 37.04 (p < 0.001) respectively. Conclusion: Our results showed that pharmaceutical care intervention significantly improved HRQoL. The study also highlights the importance of early rehabilitation in the hospital setting. The MCRP group consistently showed better QoL, was more highly motivated and benefitted most from the CRP. C1 [Anchah, Lawrence] Sarawak Heart Ctr, Dept Pharm, Kota Samarahan 94300, Sarawak, Malaysia. [Hassali, Mohamed Azmi] Univ Sains Malaysia, Sch Pharmaceut Sci, Discipline Social & Adm Pharm, George Town 11800, Malaysia. [Lim, Melissa Siaw Han] Sarawak Gen Hosp, Clin Res Ctr, Kuching 94300, Sarawak, Malaysia. [Ibrahim, Mohamed Izham Mohamed] Qatar Univ, Coll Pharm, Social & Adm Pharm, POB 2713, Doha, Qatar. [Sim, Kui Hian; Ong, Tiong Kiam] Sarawak Heart Ctr, Dept Cardiol, Kota Samarahan 94300, Sarawak, Malaysia. C3 Universiti Sains Malaysia; Qatar University RP Anchah, L (通讯作者),Sarawak Heart Ctr, Dept Pharm, Kota Samarahan 94300, Sarawak, Malaysia. EM lawrenceanchah@gmail.com RI Lim, Melissa Siaw Han/AAE-8443-2022; Anchah, Lawrence/U-3296-2019; Hassali, Mohamed Azmi/A-6895-2011 OI Lim, Melissa Siaw Han/0000-0003-0974-0905; Anchah, Lawrence/0000-0002-3510-1181; Hassali, Mohamed Azmi/0000-0001-9575-403X FU Malaysia Ministry of Health MRG grant FX The clinical research was supported by Malaysia Ministry of Health MRG grant. 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Life Outcomes PD JAN 13 PY 2017 VL 15 AR 10 DI 10.1186/s12955-016-0583-7 PG 14 WC Health Care Sciences & Services; Health Policy & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA EL7RL UT WOS:000394818200001 PM 28086784 OA Green Published, gold DA 2023-05-13 ER PT J AU Tycinska, A Gierlotka, M Bugajski, J Deja, M Depukat, R Gruchala, M Grzesk, G Kasprzak, JD Kubica, J Kucewicz-Czech, E Leszek, P Plonka, J Sobkowicz, B Straburzynska-Migaj, E Wilk, K Zawislak, B Zymlinski, R Stepinska, J AF Tycinska, Agnieszka Gierlotka, Marek Bugajski, Jaroslaw Deja, Marek Depukat, Rafal Gruchala, Marcin Grzesk, Grzegorz Kasprzak, Jaroslaw D. Kubica, Jacek Kucewicz-Czech, Ewa Leszek, Przemyslaw Plonka, Joanna Sobkowicz, Bozena Straburzynska-Migaj, Ewa Wilk, Katarzyna Zawislak, Barbara Zymlinski, Robert Stepinska, Janina TI Levosimendan in the treatment of patients with acute cardiac conditions An expert opinion of the Association of Intensive Cardiac Care of the Polish Cardiac Society SO KARDIOLOGIA POLSKA LA English DT Article DE levosimendan; inodilator; inotropic agents; acute heart failure; chronic advanced systolic heart failure ID ACUTE HEART-FAILURE; RIGHT-VENTRICULAR FUNCTION; GLOMERULAR-FILTRATION-RATE; CRITICALLY-ILL PATIENTS; MYOCARDIAL-INFARCTION; INTRAVENOUS LEVOSIMENDAN; CONTINUOUS-INFUSION; CALCIUM SENSITIZER; DOUBLE-BLIND; PULMONARY-HYPERTENSION AB Levosimendan is a new inodilator which involves 3 main mechanisms: increases the calcium sensitivity of cardiomyocytes, acts as a vasodilator due to the opening of potassium channels, and has a cardioprotective effect. Levosimendan is mainly used in the treatment of acute decompensated heart failure (class IIb recommendation according to the European Society of Cardiology guidelines). However, numerous clinical trials indicate the validity of repeated infusions of levosimendan in patients with stable heart failure as a bridge therapy to heart transplantation, and in patients with accompanying right ventricular heart failure and pulmonary hypertension. Due to the complex mechanism of action, including the cardioprotective and anti-aggregating effect, the use of levosimendan may be particularly beneficial in acute coronary syndromes, preventing the occurrence of acute heart failure. There are data indicating that levosimendan administered prior to cardiac surgery may improve outcomes in patients with severely impaired left ventricular function. The multidirectional mechanism of action also affects other organs and systems. The positive effect of levosimendan in the treatment of cardiorenal and cardiohepatic syndromes has been shown. It has a safe and predictable profile of action, does not induce tolerance, and shows no adverse effects affecting patients survival or prognosis. However, with inconclusive results of previous studies, there is a need for a well-designed multicenter randomized placebo-controlled study, including an adequately large group of outpatients with chronic advanced systolic heart failure. C1 [Tycinska, Agnieszka; Sobkowicz, Bozena; Wilk, Katarzyna] Med Univ Bialystok, Dept Cardiol, Ul M Sklodowskiej Curie 24A, PL-15276 Bialystok, Poland. [Gierlotka, Marek; Bugajski, Jaroslaw; Plonka, Joanna] Univ Opole, Univ Hosp Opole, Inst Med Sci, Dept Cardiol, Opole, Poland. [Deja, Marek] Med Univ Silesia, Fac Med Sci Katowice, Dept Cardiac Surg, Katowice, Poland. [Depukat, Rafal] Univ Hosp, Dept Cardiol & Cardiovasc Intervent, Krakow, Poland. [Gruchala, Marcin] Med Univ Gdansk, Dept Cardiol 1, Gdansk, Poland. [Grzesk, Grzegorz] Nicolaus Copernicus Univ, Fac Hlth Sci, Dept Cardiol & Clin Pharmacol, Coll Med, Bydgoszcz, Poland. [Kasprzak, Jaroslaw D.] Med Univ Lodz, Bieganski Hosp, Dept & Chair Cardiol 1, Lodz, Poland. [Kubica, Jacek] Nicolaus Copernicus Univ, Coll Med, Dept Cardiol & Internal Med, Bydgoszcz, Poland. [Kucewicz-Czech, Ewa] Med Univ Silesia, Dept Cardiac Anaesthesiol & Intens Therapy, Katowice, Poland. [Leszek, Przemyslaw] Natl Inst Cardiol, Dept Heart Failure & Transplantol, Warsaw, Poland. [Straburzynska-Migaj, Ewa] Poznan Univ Med Sci, Univ Hosp Lords Transfigurat, Dept Cardiol 1, Poznan, Poland. [Zawislak, Barbara] Univ Hosp, Intens Cardiac Care Unit, Krakow, Poland. [Zymlinski, Robert] Wroclaw Med Univ, Dept Heart Dis, Wroclaw, Poland. [Zymlinski, Robert] Univ Hosp, Ctr Heart Dis, Wroclaw, Poland. [Stepinska, Janina] Natl Inst Cardiol, Dept Intens Cardiac Therapy, Warsaw, Poland. C3 Medical University of Bialystok; University of Opole; Medical University Silesia; Jagiellonian University; Collegium Medicum Jagiellonian University; Fahrenheit Universities; Medical University Gdansk; Nicolaus Copernicus University; Medical University Lodz; Nicolaus Copernicus University; Medical University Silesia; Institute of Cardiology - Poland; Poznan University of Medical Sciences; Jagiellonian University; Collegium Medicum Jagiellonian University; Wroclaw Medical University; Institute of Cardiology - Poland RP Tycinska, A (通讯作者),Med Univ Bialystok, Dept Cardiol, Ul M Sklodowskiej Curie 24A, PL-15276 Bialystok, Poland. EM agnieszka.tycinska@gmail.com RI Grześk, Grzegorz/AAS-6549-2021; Kubica, Jacek/D-6906-2014; Zymliński, Robert/ABD-5483-2021; Malyszko, Jolanta/GSM-7177-2022; Gierlotka, Marek/U-6969-2019 OI Grześk, Grzegorz/0000-0001-6669-5931; Kubica, Jacek/0000-0001-8250-754X; Malyszko, Jolanta/0000-0001-8701-8171; Gierlotka, Marek/0000-0001-5639-2128; Zymlinski, Robert/0000-0003-1483-7381; Leszek, Przemyslaw/0000-0003-4529-2687; Kasprzak, Jaroslaw D/0000-0002-5850-8187; Plonka, Joanna/0000-0003-1442-5432 CR Abdelrahman AM, 2019, TOXICOL REP, V6, P232, DOI 10.1016/j.toxrep.2019.02.006 Alibaz-Oner F, 2013, KARDIOL POL, V71, P1036, DOI 10.5603/KP.2013.0258 Allou N, 2019, ANN INTENSIVE CARE, V9, P24 Altenberger J, 2014, EUR J HEART FAIL, V16, P898, DOI 10.1002/ejhf.118 Alvarez J, 2013, ANAESTH INTENS CARE, V41, P719, DOI 10.1177/0310057X1304100606 Antila S, 2004, BRIT J CLIN PHARMACO, V57, P412, DOI 10.1111/j.1365-2125.2003.02043.x Antila S, 2007, CLIN PHARMACOKINET, V46, P535, DOI 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Pol. PD AUG 25 PY 2020 VL 78 IS 7-8 BP 825 EP 834 DI 10.33963/KP.15551 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA NE7RM UT WOS:000562800100047 PM 32788567 OA gold DA 2023-05-13 ER PT J AU Jackson, M Callaghan, S Stapleton, J Bolton, S Austin, D Muir, DF Sutton, AGC Wright, RA Williams, PD Hall, JA Carter, J de Belder, MA Swanson, N AF Jackson, Matthew Callaghan, Sarah Stapleton, John Bolton, Sarah Austin, David Muir, Douglas F. Sutton, Andrew G. C. Wright, Robert A. Williams, Paul D. Hall, Jim A. Carter, Justin de Belder, Mark A. Swanson, Neil TI Rapid Aspirin Desensitization is Safe and Feasible in Patients With Stable and Unstable Coronary Artery Disease: A Single-Center Experience SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS LA English DT Article DE antithrombotic-myocardial infarction; atherosclerosis; nonantiarrhythmic-cardiac pharmacology ID INTERVENTION; HYPERSENSITIVITY; GUIDELINES; DIAGNOSIS; THERAPY; UPDATE AB Aims: There are limited data on aspirin (ASA) desensitization for patients with coronary disease. We present our experience with a rapid nurse-led oral desensitization regimen in patients with aspirin sensitivity undergoing coronary angiography. Methods: This single-center retrospective observational study includes patients with a history of ASA sensitivity undergoing coronary angiography with intent to perform percutaneous coronary intervention (PCI). Results: Between January 2012 and January 2017, 24 patients undergoing coronary angiography for stable coronary disease (7 cases) or acute coronary syndromes (non-ST-segment myocardial infarction [NSTEMI; 8 cases], STEMI [9 cases]) underwent aspirin desensitization having reported previous reactions to aspirin. At initial presentation, previous sensitivity reactions were reported as: mucocutaneous reactions in 17 patients (urticaria in 3 [13%], nonurticarial rash in 6 [25%], angio-oedema in 8 [33%]), respiratory sensitivity in 4 (17%), and systemic anaphylactoid reactions in 3 (13%). Seventeen (71%) patients underwent PCI. Desensitization was acutely successful in 22 (92%) patients and unsuccessful in 2 (8%) patients who both had a single short-lived episode of acute bronchospasm treated successfully with nebulized salbutamol. Fifteen successfully desensitized patients completed 12 months of aspirin; no patient had recurrent hypersensitivity reaction. Aspirin was stopped prior to 12 months in 7 patients (replaced by warfarin [1 case], no antiplatelet or single antiplatelet clinically indicated and clopidogrel chosen [4 cases], patient choice without evidence of recurrent hypersensitivity [1 case], and death due to cardiogenic shock following STEMI [1 case]). Conclusion: A rapid aspirin desensitization protocol is safe and effective across a broad spectrum of hypersensitivity reactions and clinical presentations. C1 [Jackson, Matthew; Callaghan, Sarah; Stapleton, John; Bolton, Sarah; Austin, David; Muir, Douglas F.; Sutton, Andrew G. C.; Wright, Robert A.; Williams, Paul D.; Hall, Jim A.; Carter, Justin; de Belder, Mark A.; Swanson, Neil] James Cook Univ Hosp, Dept Cardiol, Middlesbrough, Cleveland, England. C3 James Cook University Hospital RP Jackson, M (通讯作者),James Cook Univ Hosp, Marton Rd, Middlesbrough TS4 3BW, Cleveland, England. 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Baumbach, Andreas Behr, Elijah R. Berti, Sergio Bueno, Hector Capodanno, Davide Cappato, Riccardo Chieffo, Alaide Collet, Jean-Philippe Cuisset, Thomas de Simone, Giovanni Delgado, Victoria Dendale, Paul Dudek, Dariusz Edvardsen, Thor Elvan, Arif Gonzalez-Juanatey, Jose R. Gori, Mauro Grobbee, Diederick Guzik, Tomasz J. Halvorsen, Sigrun Haude, Michael Heidbuchel, Hein Hindricks, Gerhard Ibanez, Borja Karam, Nicole Katus, Hugo Klok, Fredrikus A. Konstantinides, Stavros, V Landmesser, Ulf Leclercq, Christophe Leonardi, Sergio Lettino, Maddalena Marenzi, Giancarlo Mauri, Josepa Metra, Marco Morici, Nuccia Mueller, Christian Petronio, Anna Sonia Polovina, Marija M. Potpara, Tatjana Praz, Fabien Prendergast, Bernard Prescott, Eva Price, Susanna Pruszczyk, Piotr Rodriguez-Leor, Oriol Roffi, Marco Romaguera, Rafael Rosenkranz, Stephan Sarkozy, Andrea Scherrenberg, Martijn Seferovic, Petar Senni, Michele Spera, Francesco R. Stefanini, Giulio Thiele, Holger Tomasoni, Daniela Torracca, Lucia Touyz, Rhian M. Wilde, Arthur A. Williams, Bryan CA European Soc Cardiology TI ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2-care pathways, treatment, and follow-up SO EUROPEAN HEART JOURNAL LA English DT Article DE ACE2; Acute coronary syndromes; Arrhythmias; Biomarkers; Cardiogenic shock; COVID-19; Heart failure; Myocarditis; Venous thromboembolism; Pulmonary embolism; Thrombosis ID ONSET ATRIAL-FIBRILLATION; RESUSCITATION COUNCIL GUIDELINES; ANGIOTENSIN-CONVERTING ENZYME-2; ACUTE RESPIRATORY SYNDROME; AORTIC-VALVE-REPLACEMENT; HEART-RATE-VARIABILITY; II RECEPTOR BLOCKERS; ST-SEGMENT ELEVATION; MERS-COV INFECTION; MYOCARDIAL-INFARCTION AB Aims Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities. [GRAPHICS] . C1 [Baigent, Colin] Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Oxford, England. [Windecker, Stephan] Bern Univ Hosp, Dept Cardiol, Inselspital, Bern, Switzerland. [Andreini, Daniele; Bartorelli, Antonio L.; Marenzi, Giancarlo] IRCCS, Ctr Cardiol Monzino, Milan, Italy. [Andreini, Daniele] Univ Milan, Cardiovasc Sect, Dept Clin Sci & Community Hlth, Milan, Italy. [Arbelo, Elena] Univ Barcelona, Hosp Clin, Cardiol Dept, Arrhythmia Sect, Barcelona, Spain. [Arbelo, Elena] Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain. [Arbelo, Elena; Bueno, Hector; Ibanez, Borja; Rodriguez-Leor, Oriol] Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Madrid, Spain. [Arbelo, Elena] EHRA, Cardiogenet Focus Grp, ECGen, Sophia Antipolis, France. [Barbato, Emanuele; de Simone, Giovanni] Univ Naples Federico II, Dept Adv Biomed Sci, Naples, Italy. [Barbato, Emanuele] Onze Lieve Vrouw Hosp, Cardiovasc Ctr Aalst, Aalst, Belgium. [Bartorelli, Antonio L.] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy. [Bartorelli, Antonio L.] Univ Milan, Dept Biomed & Clin Sci Luigi Sacco, Milan, Italy. [Baumbach, Andreas] Queen Mary Univ London, William Harvey Res Inst, Ctr Cardiovasc Med & Devices, London, England. [Baumbach, Andreas] Barts Heart Ctr, London, England. [Baumbach, Andreas] Yale Univ, Sch Med, New Haven, CT USA. [Behr, Elijah R.] St Georges Univ London, ECGen, Cardiogenet Focus Grp, Cardiol Clin Acad Grp,Inst Mol & Clin Sci,EHRA, London, England. [Behr, Elijah R.; Wilde, Arthur A.] European Reference Network Rare & Low Prevalence, London, England. [Berti, Sergio] Osped Cuore G Pasquinucci, Fdn Toscana G Monasterio, Dipartimento Cardiotorac, UOC Cardiol Diagnost & Interventist, Massa, Italy. [Bueno, Hector; Ibanez, Borja] Ctr Nacl Invest Cardiovasc CNIC, Madrid, Spain. [Bueno, Hector] Hosp Univ 12 Octubre, Cardiol Dept, Madrid, Spain. [Bueno, Hector] Hosp 12 Octubre Imasl2, Inst Invest Sanitaria, Madrid, Spain. [Capodanno, Davide] Univ Catania, AOU Policlin G Rodolico San Marco, Div Cardiol, Catania, Italy. [Cappato, Riccardo] IRCCS Grp MultiMed, Arrhythmia & Electrophysiol Ctr, Milan, Italy. [Chieffo, Alaide] Ist Sci San Raffaele, Milan, Italy. [Collet, Jean-Philippe] Sorbonne Univ, Pitie Salpetriere Hosp, AP HP, ACTION Study Grp,Inst Cardiol, Paris, France. [Cuisset, Thomas] CHU Timone, Dept Cardiol, Marseille, France. [Cuisset, Thomas] INSERM, UMR1062, Nutr Obes & Risk Thrombosis, Marseille, France. [Cuisset, Thomas] Aix Marseille Univ, Fac Med, Marseille, France. [de Simone, Giovanni] Federico II Univ Hosp, Hypertens Res Ctr, Naples, Italy. [Delgado, Victoria] Leiden Univ Med Ctr, Heart Lung Ctr, Leiden, Netherlands. [Dendale, Paul] Jessa Hosp, Heart Ctr Hasselt, Hasseit, Belgium. [Dendale, Paul; Scherrenberg, Martijn] Uhasselt, Fac Med & Life Sci, Diepenbeek, Belgium. [Dudek, Dariusz] Jagiellonian Univ Med Coll, Inst Cardiol, Krakow, Poland. [Dudek, Dariusz] Maria Cecilia Hosp, GVM Care & Res, Ravenna, RA, Italy. [Edvardsen, Thor] Oslo Univ Hosp, Rikshosp, Dept Cardiol, Oslo, Norway. [Elvan, Arif] Isala Heart Ctr, Zwolle, Netherlands. [Gonzalez-Juanatey, Jose R.] Univ Santiago de Compostela, Cardiol Dept, Univ Hosp, IDIS,CIBERCV, Santiago De Compostela, Spain. [Gori, Mauro; Senni, Michele] Papa Giovanni XXIII Hosp Bergamo, Cardiovasc Dept, Bergamo, Italy. [Gori, Mauro; Senni, Michele] Papa Giovanni XXIII Hosp Bergamo, Cardiol Unit, Bergamo, Italy. [Grobbee, Diederick] Univ Med Ctr Utrecht, Julius Global Hlth, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [Guzik, Tomasz J.; Touyz, Rhian M.] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland. [Guzik, Tomasz J.] Jagiellonian Univ Coll Med, Dept Med, Krakow, Poland. [Halvorsen, Sigrun] Oslo Univ Hosp, Dept Cardiol, Oslo, Norway. [Halvorsen, Sigrun] Univ Oslo, Oslo, Norway. [Haude, Michael] Lukaskrankenhaus GmbH, Stadt Kliniken Neuss, Med Clin 1, Neuss, Germany. [Heidbuchel, Hein; Sarkozy, Andrea; Spera, Francesco R.] Univ Hosp Antwerp, Dept Cardiol, Antwerp, Belgium. [Heidbuchel, Hein; Sarkozy, Andrea; Spera, Francesco R.] Univ Antwerp, Antwerp, Belgium. [Hindricks, Gerhard] Univ Hosp Leipzig, Heart Ctr Leipzig, Dept Internal Med Cardiol Electrophysiol, Leipzig, Germany. [Hindricks, Gerhard] Leipzig Heart Inst LHI, Leipzig, Germany. [Ibanez, Borja] Ctr Invest Biomed Red Enfermedades Cardiovasc CNI, Madrid, Spain. [Karam, Nicole] Univ Paris, PARCC, INSERM, Paris, France. [Katus, Hugo] Hop Europeen Georges Pompidou, Paris, France. [Katus, Hugo] Univ Hosp Heidelberg, Dept Internal Med, Heidelberg, Germany. [Klok, Fredrikus A.] Leiden Univ Med Ctr, Dept Thrombosis & Hemostasis, Leiden, Netherlands. [Konstantinides, Stavros, V] Johannes Gutenberg Univ Mainz, Ctr Thrombosis & Hemostasis, Mainz, Germany. [Konstantinides, Stavros, V] Democritus Univ Thrace, Dept Cardiol, Alexandroupolis, Greece. [Landmesser, Ulf] Charite Univ Med Berlin, Dept Cardiol, Berlin, Germany. [Landmesser, Ulf] German Ctr Cardiovasc Res DZHK, Berlin Inst Hlth BIH, Partner Site Berlin, Berlin, Germany. [Leclercq, Christophe] Univ Rennes, CHU Rennes, INSERM, LTSI UMR 1099, Rennes, France. [Leonardi, Sergio] Univ Pavia, Pavia, Italy. [Leonardi, Sergio] Fdn IRCCS Policlin S Matteo, Pavia, Italy. [Lettino, Maddalena] ASST Monza, San Gerardo Hosp, Cardiothorac & Vasc Dept, Monza, Italy. [Mauri, Josepa; Rodriguez-Leor, Oriol] Hosp Badalona Germans Trias & Pujol, Inst Cor, Badalona, Spain. [Mauri, Josepa] Govt Catalonia, Hlth Dept, Barcelona, Spain. [Metra, Marco; Tomasoni, Daniela] ASST Spedali Civili Brescia, Inst Cardiol, Brescia, Italy. [Metra, Marco] Univ Brescia, Dept Med & Surg Special, Radiol Sci & Publ Hlth, Brescia, Italy. [Morici, Nuccia] ASST Grande Osped Metropolitano Niguarda, Cardio Ctr, Unita Cure Intens Cardiol & Gasperis, Milan, Italy. [Morici, Nuccia] Univ Milan, Dipartimento Sci Clin & Comunita, Milan, Italy. [Mueller, Christian] Univ Hosp Basel, Cardiovasc Res Inst Basel CRIB, Basel, Switzerland. [Mueller, Christian] Univ Basel, Basel, Switzerland. [Petronio, Anna Sonia] Univ Pisa, Cardiothorac & Vasc Dept, Osped Cisanello, Pisa, Italy. [Polovina, Marija M.; Seferovic, Petar] Univ Belgrade, Fac Med, Belgrade, Serbia. [Polovina, Marija M.] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia. [Potpara, Tatjana] Univ Belgrade, Sch Med, Belgrade, Serbia. [Potpara, Tatjana] Clin Ctr Serbia, Cardiol Clin, Dept Intens Arrhythmia Care, Belgrade, Serbia. [Praz, Fabien] Univ Hosp Bern, Dept Cardiol, Bern, Switzerland. [Prendergast, Bernard] St Thomas Hosp, London, England. [Prendergast, Bernard] Cleveland Clin London, London, England. [Prescott, Eva] Bispebjerg Hosp, Dept Cardiol, Copenhagen, Denmark. [Price, Susanna] Royal Brompton Hosp, London, England. [Price, Susanna] Imperial Coll, Natl Heart & Lung Inst, London, England. [Pruszczyk, Piotr] Med Univ Warsaw, Dept Internal Med & Cardiol, Warsaw, Poland. [Roffi, Marco] Geneva Univ Hosp, Dept Cardiol, Geneva, Switzerland. [Romaguera, Rafael] Hosp Univ Bellvitge IDIBELL, Serv Cardiol, Barcelona, Spain. [Rosenkranz, Stephan] Univ Cologne, Heart Ctr, Clin Internal Med Cardiol 3, Cologne, Germany. [Rosenkranz, Stephan] Univ Cologne, CCRC Heart Ctr, Cologne Cardiovasc Res Ctr CCRC, Cologne, Germany. [Rosenkranz, Stephan] Univ Cologne, Ctr Mol Med Cologne CMMC, Cologne, Germany. [Scherrenberg, Martijn] Jessa Hosp, Heart Ctr Hasselt, Hasselt, Belgium. [Seferovic, Petar] Serbian Acad Arts & Sci, Belgrade, Serbia. [Stefanini, Giulio; Torracca, Lucia] Humanitas Univ, Dept Biomed Sci, Pieve Emanuele Milan, Italy. [Stefanini, Giulio; Torracca, Lucia] Humanitas Res Hosp IRCCS, Rozzano Milan, Germany. [Thiele, Holger] Univ Leipzig, Heart Ctr Leipzig, Dept Internal Med Cardiol, Leipzig, Germany. [Tomasoni, Daniela] Univ Brescia, Dept Med & Surg Special Radiol Sci & Publ Hlth, Brescia, Italy. [Wilde, Arthur A.] EHRA, ECGen, Cardiogenet Focus Grp, London, England. [Wilde, Arthur A.] Univ Amsterdam, Amsterdam UMC, Heart Ctr, Amsterdam, Netherlands. [Wilde, Arthur A.] Amsterdam Cardiovasc Sci, Dept Clin Cardiol, Amsterdam, Netherlands. [Williams, Bryan] UCL, Inst Cardiovasc Sci, London, England. C3 University of Bern; University Hospital of Bern; IRCCS Centro Cardiologico Monzino; University of Milan; University of Barcelona; Hospital Clinic de Barcelona; University of Barcelona; Hospital Clinic de Barcelona; IDIBAPS; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; University of Naples Federico II; Cardiovascular Center Aalst; University of Milan; University of Milan; Luigi Sacco Hospital; RLUK- Research Libraries UK; University of London; Queen Mary University London; Yale University; St Georges University London; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Hospital Universitario 12 de Octubre; University of Catania; Vita-Salute San Raffaele University; IRCCS Ospedale San Raffaele; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Aix-Marseille Universite; UDICE-French Research Universities; Aix-Marseille Universite; University of Naples Federico II; Leiden University; Leiden University Medical Center (LUMC); Hasselt University; Jagiellonian University; Collegium Medicum Jagiellonian University; Maria Cecilia Hospital; University of Oslo; National Hospital Norway; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; Universidade de Santiago de Compostela; ASST Papa Giovanni XXIII; ASST Papa Giovanni XXIII; Utrecht University; Utrecht University Medical Center; RLUK- Research Libraries UK; University of Glasgow; Jagiellonian University; Collegium Medicum Jagiellonian University; University of Oslo; University of Oslo; University of Antwerp; University of Antwerp; Heart Center Leipzig GMBH; Leipzig University; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; Assistance Publique Hopitaux Paris (APHP); Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Cite; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Europeen Georges-Pompidou - APHP; Ruprecht Karls University Heidelberg; Leiden University; Leiden University Medical Center (LUMC); Johannes Gutenberg University of Mainz; Democritus University of Thrace; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Berlin Institute of Health; German Centre for Cardiovascular Research; CHU Rennes; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Rennes; University of Pavia; IRCCS Fondazione San Matteo; San Gerardo Hospital; Hospital Germans Trias i Pujol; Hospital Spedali Civili Brescia; University of Brescia; University of Milan; University of Basel; University of Basel; University of Pisa; University of Belgrade; Clinical Centre of Serbia; University of Belgrade; Clinical Centre of Serbia; University of Bern; University Hospital of Bern; Guy's & St Thomas' NHS Foundation Trust; Cleveland Clinic Foundation; University of Copenhagen; Bispebjerg Hospital; Royal Brompton Hospital; RLUK- Research Libraries UK; Imperial College London; Medical University of Warsaw; University of Geneva; Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Bellvitge University Hospital; University of Cologne; University of Cologne; University of Cologne; Serbian Academy of Sciences & Arts; Humanitas University; Heart Center Leipzig GMBH; Leipzig University; University of Brescia; University of Amsterdam; RLUK- Research Libraries UK; University of London; University College London RP Baigent, C (通讯作者),Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Oxford, England.; Windecker, S (通讯作者),Bern Univ Hosp, Dept Cardiol, Inselspital, Bern, Switzerland. EM colin.baigent@ndph.ox.ac.uk; stephan.windecker@insel.ch RI Guzik, Tom/HZL-3361-2023; Ibáñez, Borja/J-6993-2014; Stefanini, Giulio/GZG-4754-2022; Edvardsen, Thor/F-4079-2012; BUENO, HECTOR/GQP-1780-2022; Bueno, Hector/I-3910-2015; Scherrenberg, Martijn/HTS-2637-2023; Arbelo, Elena/GRS-2793-2022; Arbelo, Elena/GMX-0351-2022; Delgado, Victoria/AAL-4731-2021; Torracca, Lucia/AAB-1973-2022; Leonardi, Sergio/K-4334-2018 OI Ibáñez, Borja/0000-0002-5036-254X; Stefanini, Giulio/0000-0002-3558-6967; Edvardsen, Thor/0000-0002-3800-765X; Bueno, Hector/0000-0003-0277-7596; Delgado, Victoria/0000-0002-9841-2737; Torracca, Lucia/0000-0003-2689-9440; Behr, Elijah/0000-0002-8731-2853; Karam, Nicole/0000-0002-3861-6914; Williams, Bryan/0000-0002-8094-1841; Rodriguez-Leor, Oriol/0000-0003-2657-5657; Leonardi, Sergio/0000-0002-4800-6132; cappato, riccardo/0000-0003-0615-9525 CR Abrams MP, 2020, J CARDIOVASC ELECTR, V31, P3086, DOI 10.1111/jce.14772 Abrams Mark P, 2020, HeartRhythm Case Rep, V6, P858, 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Heart J. PD MAR 14 PY 2022 VL 43 IS 11 SI SI BP 1059 EP 1103 DI 10.1093/eurheartj/ehab697 EA NOV 2021 PG 45 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZS4OV UT WOS:000768447300008 OA Green Published, Green Submitted DA 2023-05-13 ER PT J AU Wasfy, JH Hidrue, MK Yeh, RW Armstrong, K Dec, GW Pomerantsev, EV Fifer, MA Ferris, TG AF Wasfy, Jason H. Hidrue, Michael K. Yeh, Robert W. Armstrong, Katrina Dec, G. William, Jr. Pomerantsev, Eugene V. Fifer, Michael A. Ferris, Timothy G. TI Differences Among Cardiologists in Rates of Positive Coronary Angiograms SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE coronary angiography; outcomes research; variation analysis ID ARTERY-DISEASE; PHYSICIANS; MANAGEMENT; YIELD AB Background-Understanding the sources of variation for high-cost services has the potential to improve both patient outcomes and value in health care delivery. Nationally, the overall diagnostic yield of coronary angiography is relatively low, suggesting overutilization. Understanding how individual cardiologists request catheterization may suggest opportunities for improving quality and value. We aimed to assess and explain variation in positive angiograms among referring cardiologists. Methods and Results-We identified all cases of diagnostic coronary angiography at Massachusetts General Hospital from January 1, 2012, to June 30, 2013. We excluded angiograms for acute coronary syndrome. For each angiogram, we identified clinical features of the patients and characteristics of the requesting cardiologists. We also identified angiogram positivity, defined as at least 1 epicardial coronary stenosis >= 50% luminal narrowing. We then constructed a series of mixed-effects logistic regression models to analyze predictors of positive coronary angiograms. We assessed variation by physician in the models with median odds ratios. Over this time period, 5015 angiograms were identified. We excluded angiograms ordered by cardiologists requesting <10 angiograms. Among the remaining 2925 angiograms, 1450 (49.6%) were positive. Significant predictors of positive angiograms included age, male patients, and peripheral arterial disease. After adjustment for clinical variables only, the median odds ratio was 1.23 (95% CI 1.0-1.36), consistent with only borderline clinical variation after adjustment. In the full clinical and nonclinical model, the median odds ratio was 1.07 (95% CI 1.07-1.20), also consistent with clinically insignificant variation. Conclusions-Substantial variation exists among requesting cardiologists with respect to positive and negative coronary angiograms. After adjustment for clinical variables, there was only borderline clinically significant variation. These results emphasize the importance of risk adjustment in reporting related to quality and value. C1 [Wasfy, Jason H.; Hidrue, Michael K.; Ferris, Timothy G.] Harvard Univ, Sch Med, Massachusetts Gen Phys Org, Boston, MA USA. [Wasfy, Jason H.; Yeh, Robert W.; Dec, G. William, Jr.; Pomerantsev, Eugene V.; Fifer, Michael A.] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Cardiol Div,Dept Med, Boston, MA USA. [Armstrong, Katrina; Ferris, Timothy G.] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Med, Boston, MA USA. [Ferris, Timothy G.] Partners Healthcare, Boston, MA USA. C3 Harvard University; Harvard Medical School; Massachusetts General Hospital; Harvard University; Harvard Medical School; Massachusetts General Hospital; Harvard University; Harvard Medical School; Massachusetts General Hospital; Partners Healthcare System RP Wasfy, JH (通讯作者),Massachusetts Gen Hosp, Massachusetts Gen Phys Org, BUL-205,55 Fruit St, Boston, MA 02114 USA. EM jwasfy@mgh.harvard.edu RI Yeh, Robert/AAJ-3463-2020 FU Massachusetts General Hospital Physicians Organization Fellowship in Health Policy and Management FX This work was funded by the Massachusetts General Hospital Physicians Organization Fellowship in Health Policy and Management. 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Am. Heart Assoc. PD OCT PY 2015 VL 4 IS 10 AR e002393 DI 10.1161/JAHA.115.002393 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CV3IO UT WOS:000364153000034 PM 26475298 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Haneya, A Philipp, A Von Suesskind-Schwendi, M Diez, C Hirt, SW Kolat, P Attmann, T Schoettler, J Zausig, Y Ried, M Schmid, C AF Haneya, Assad Philipp, Alois Von Suesskind-Schwendi, Marietta Diez, Claudius Hirt, Stephan W. Kolat, Philipp Attmann, Tim Schoettler, Jan Zausig, York Ried, Michael Schmid, Christof TI Impact of Minimized Extracorporeal Circulation on Outcome in Patients With Preoperative Anemia Undergoing Coronary Artery Bypass Surgery SO ASAIO JOURNAL LA English DT Article DE anemia; minimized extracorporeal circulation; coronary artery bypass grafting; cardiopulmonary bypass ID ACUTE KIDNEY INJURY; CARDIOPULMONARY BYPASS; CARDIAC-SURGERY; GRAFT-SURGERY; RISK-FACTOR; LOW HEMATOCRIT; TRANSFUSION; MULTICENTER; MORTALITY; SURVIVAL AB Preoperative anemia and low hematocrit during cardiopulmonary bypass have been associated with worse outcome in patients undergoing cardiac surgery. The minimized extracorporeal circulation (MECC) allows a reduction of the negative effects associated with conventional extracorporeal circulation (CECC). In this study, the impact of the MECC on outcome of anemic patients after coronary artery bypass grafting (CABG) was assessed. Between January 2004 and December 2011, 1,945 consecutive patients with preoperative anemia underwent isolated CABG using CECC (44.8%) or MECC (55.2%). The cutoff point for anemia was 13 g/dl for men and 12 g/dl for women. The postoperative creatine kinase and lactate levels were significantly lower in the MECC group (p < 0.001). There was no difference in postoperative blood loss between the groups. However, the intraoperative and postoperative transfusion requirements were significantly lower in the MECC group (p < 0.05). Furthermore, MECC patients had lower incidences of postoperative acute renal failure, and low cardiac output syndrome, shorter intensive care unit lengths of stay and reduced 30-day mortality (p < 0.05). In conclusion, a reduced postoperative mortality, lower transfusion requirements, and less renal and myocardial damage encourage the use of MECC for CABG, especially in the specific high-risk subgroup of patients with anemia. C1 [Haneya, Assad; Philipp, Alois; Von Suesskind-Schwendi, Marietta; Diez, Claudius; Hirt, Stephan W.; Kolat, Philipp; Ried, Michael; Schmid, Christof] Univ Med Ctr Regensburg, Dept Cardiothorac Surg, D-93053 Regensburg, Germany. [Zausig, York] Univ Med Ctr Regensburg, Dept Anesthesiol, D-93053 Regensburg, Germany. [Attmann, Tim; Schoettler, Jan] Univ Hosp Schleswig Holstein, Dept Cardiovasc Surg, Kiel, Germany. C3 University of Regensburg; University of Regensburg; University of Kiel; Schleswig Holstein University Hospital RP Haneya, A (通讯作者),Univ Med Ctr Regensburg, Dept Cardiothorac Surg, Franz Josef Strauss Allee 11, D-93053 Regensburg, Germany. EM assadhaneya@web.de RI Ried, Michael/AAC-4518-2022; Haneya, Assad/ABE-6281-2020; Haneya, Assad/Q-7748-2017 OI Ried, Michael/0000-0002-2365-4803; CR Beattie WS, 2009, ANESTHESIOLOGY, V110, P574, DOI 10.1097/ALN.0b013e31819878d3 Bell ML, 2008, ANN THORAC SURG, V86, P1415, DOI 10.1016/j.athoracsur.2008.07.088 Benedetto U, 2009, J THORAC CARDIOV SUR, V138, P1450, DOI 10.1016/j.jtcvs.2009.03.042 Benedetto U, 2009, ANN THORAC SURG, V88, P529, DOI 10.1016/j.athoracsur.2009.03.072 Boening A, 2011, ANN THORAC SURG, V92, P805, DOI 10.1016/j.athoracsur.2011.02.076 Bunkelgrun M, 2008, AM J CARDIOL, V101, P1196, DOI 10.1016/j.amjcard.2007.11.072 Santo L, 2009, J THORAC CARDIOV SUR, V138, P965, DOI 10.1016/j.jtcvs.2009.05.013 Diez C, 2009, ASAIO J, V55, P602, DOI 10.1097/MAT.0b013e3181bbcd3e Fromes Y, 2002, EUR J CARDIO-THORAC, V22, P527, DOI 10.1016/S1010-7940(02)00372-X Habib RH, 2003, J THORAC CARDIOV SUR, V125, P1438, DOI 10.1016/S0022-5223(02)73291-1 Haneya A, 2011, ASAIO J, V57, P501, DOI 10.1097/MAT.0b013e318236e7af Haneya A, 2009, EUR J CARDIO-THORAC, V36, P844, DOI 10.1016/j.ejcts.2009.05.045 Immer FF, 2007, ANN THORAC SURG, V84, P1515, DOI 10.1016/j.athoracsur.2007.05.069 Karkouti K, 2005, ANN THORAC SURG, V80, P1381, DOI 10.1016/j.athoracsur.2005.03.137 Karkouti K, 2005, J THORAC CARDIOV SUR, V129, P391, DOI 10.1016/j.jtcvs.2004.06.028 Karkouti K, 2008, CIRCULATION, V117, P478, DOI 10.1161/CIRCULATIONAHA.107.718353 Karkouti K, 2009, CIRCULATION, V119, P495, DOI 10.1161/CIRCULATIONAHA.108.786913 Koch CG, 2006, ANN THORAC SURG, V81, P1650, DOI 10.1016/j.athoracsur.2005.12.037 Kulier A, 2007, CIRCULATION, V116, P471, DOI 10.1161/CIRCULATIONAHA.106.653501 McKechnie RS, 2004, CIRCULATION, V110, P271, DOI 10.1161/01.CIR.0000134964.01697.C7 Munos E, 2011, PERFUSION-UK, V26, P123, DOI 10.1177/0267659110395650 Murphy GJ, 2007, CIRCULATION, V116, P2544, DOI 10.1161/CIRCULATIONAHA.107.698977 Patel KV, 2009, HAEMATOL-HEMATOL J, V94, P1, DOI 10.3324/haematol.2008.001289 Philipp A, 2002, J EXTRA-CORP TECHNOL, V34, pA215 Prasser C, 2007, PERFUSION-UK, V22, P245, DOI 10.1177/0267659107083242 Puehler T, 2010, THORAC CARDIOV SURG, V58, P204, DOI 10.1055/s-0029-1241028 Ranucci M, 2006, TEX HEART I J, V33, P300 Reinecke H, 2003, EUR HEART J, V24, P2142, DOI 10.1016/j.ehj.2003.09.008 Roques F, 2003, EUR HEART J, V24, P881, DOI 10.1016/S0195-668X(02)00799-6 Sabatine MS, 2005, CIRCULATION, V111, P2042, DOI 10.1161/01.CIR.0000162477.70955.5F Sarnak MJ, 2002, J AM COLL CARDIOL, V40, P27, DOI 10.1016/S0735-1097(02)01938-1 Scott BH, 2008, ANN CARD ANAESTH, V11, P15, DOI 10.4103/0971-9784.38444 Skrabal CA, 2007, ASAIO J, V53, P32, DOI 10.1097/01.mat.0000249868.96923.1e Tang YD, 2006, CIRCULATION, V113, P2454, DOI 10.1161/CIRCULATIONAHA.105.583666 van Straten AHM, 2009, CIRCULATION, V120, P118, DOI 10.1161/CIRCULATIONAHA.109.854216 WHO, 2001, IR DEF AN ASS PREV C NR 36 TC 5 Z9 6 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1058-2916 EI 1538-943X J9 ASAIO J JI Asaio J. PD MAY-JUN PY 2013 VL 59 IS 3 BP 269 EP 274 DI 10.1097/MAT.0b013e3182894351 PG 6 WC Engineering, Biomedical; Transplantation WE Science Citation Index Expanded (SCI-EXPANDED) SC Engineering; Transplantation GA 300OD UT WOS:000330472400012 PM 23644614 OA Bronze DA 2023-05-13 ER PT J AU Bainey, KR Kaul, P Armstrong, PW Savu, A Westerhout, CM Norris, CM Brass, N Traboulsi, D O'Neill, B Nagendran, J Ali, I Knudtson, M Welsh, RC AF Bainey, Kevin R. Kaul, Padma Armstrong, Paul W. Savu, Anamaria Westerhout, Cynthia M. Norris, Colleen M. Brass, Neil Traboulsi, Dean O'Neill, Blair Nagendran, Jayan Ali, Imtiaz Knudtson, Merril Welsh, Robert C. TI Hospital variation in treatment and outcomes in acute coronary syndromes: Insights from the Alberta Contemporary Acute Coronary Syndrome Patients Invasive Treatment Strategies (COAPT) study SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; DRUG-ELUTING STENTS; RANDOMIZED-TRIALS; ELDERLY-PATIENTS; WOMEN; INTERVENTION; METAANALYSIS; MANAGEMENT; THERAPY; NETWORK AB Background: We examined variation in hospital treatment and its relationship to clinical outcome in a large population-based cohort of ACS patients within a single payer-government funded health care system. Methods: Patients hospitalized in 106 hospitals in Alberta, Canada with a primary diagnosis of ACS were included (July 1, 2010-March 31, 2013) with comparisons made across the three cardiac catheterization-capable hospitals (Sites A-C). Cox proportional-hazard regression models were used to examine the multivariable-adjusted association between site and 1-year death or repeat cardiovascular (CV) hospitalization (primary endpoint). Results: Of 14,155 patients, 1938 (13.7%) were admitted to a community hospital without transfer to an invasive hospital (10.7% in-hospital death). The remaining were admitted (n = 4514, 36.9%) or transferred (n = 7703, 63.1%) to an invasive hospital (A: 5480; B:3621; C:3116) where 11,247 (92.1%) underwent catheterization.Comorbidities and angiographic disease burden differed across sites. Variation in 30-day revascularization (PCI:71.3%, 72.0%, 68.7%, p < 0.001; CABG: 6.2%, 6.4%, 9.3%, p < 0.001) and drug-eluting stent use for PCI (24.3%, 54.6%, 50.5%, p < 0.001) were observed. After adjustment for patient demographics and comorbidities, variation in rates of 1-year death or CV hospitalization was observed among those with 30-day revascularization (p(interaction) < 0.001; B versus A: HR 0.78, 95% CI 0.66-0.91; C versus A: HR 0.77, 95% CI 0.65-0.91; B versus C: HR 1.01, 95% CI 0.84-1.21). Conclusions: Despite a government funded health system, we have shown variation in hospital treatment exists. Following adjustment hospital site was associated with differences in clinical outcome within 1 year. Hence, further efforts may be warranted to help address potential disparities in ACS care. (C) 2017 Elsevier B.V. All rights reserved. C1 [Bainey, Kevin R.; Kaul, Padma; Armstrong, Paul W.; Savu, Anamaria; Westerhout, Cynthia M.; Welsh, Robert C.] Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada. [Bainey, Kevin R.; Kaul, Padma; Armstrong, Paul W.; Norris, Colleen M.; O'Neill, Blair; Nagendran, Jayan; Welsh, Robert C.] Univ Alberta, Mazankowski Alberta Heart Inst, Edmonton, AB, Canada. [Bainey, Kevin R.; Kaul, Padma; Armstrong, Paul W.; Welsh, Robert C.] Univ Alberta, Dept Med, Edmonton, AB, Canada. [Brass, Neil; Traboulsi, Dean; Ali, Imtiaz; Knudtson, Merril] Univ Alberta, CK Hui Heart Ctr, Edmonton, AB, Canada. [Brass, Neil; Traboulsi, Dean; Ali, Imtiaz; Knudtson, Merril] Libin Cardiovasc Inst, Calgary, AB, Canada. [Traboulsi, Dean; Ali, Imtiaz; Knudtson, Merril] Univ Calgary, Calgary, AB, Canada. C3 University of Alberta; University of Alberta; University of Alberta; University of Alberta; Libin Cardiovascular Institute Of Alberta; University of Calgary RP Welsh, RC (通讯作者),Univ Alberta Hosp, Mazankowski Alberta Heart Inst, 2C2 Walter C Mackenzie, Edmonton, AB T6G 2B7, Canada. EM Robert.Welsh@albertahealthservices.ca RI Welsh, Robert/ABH-3526-2021; Bainey, Kevin/ABA-4046-2021 OI Welsh, Robert/0000-0003-2613-9142; O'Neill, Blair/0000-0003-2652-8869; Westerhout, Cynthia/0000-0003-1082-5981; Norris, Colleen/0000-0002-6793-9333; Armstrong, Paul/0000-0002-0460-3445; Kaul, Padma/0000-0003-2239-3944; Savu, Anamaria/0000-0001-8070-4195 FU Astra Zeneca research grant FX The analysis of registry data was performed at the Canadian VIGOUR Centre (University of Alberta, Edmonton, Canada), which received partial funding from an unrestricted Astra Zeneca research grant. 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J. Cardiol. PD AUG 15 PY 2017 VL 241 BP 70 EP 75 DI 10.1016/j.ijcard.2017.04.109 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FA5AO UT WOS:000405455200013 PM 28495247 DA 2023-05-13 ER PT J AU Arnold, SV Masoudi, FA Rumsfeld, JS Li, Y Jones, PG Spertus, JA AF Arnold, Suzanne V. Masoudi, Frederick A. Rumsfeld, John S. Li, Yan Jones, Philip G. Spertus, John A. TI Derivation and Validation of a Risk Standardization Model for Benchmarking Hospital Performance for Health-Related Quality of Life Outcomes After Acute Myocardial Infarction SO CIRCULATION LA English DT Article DE myocardial infarction; quality of life; risk factors ID ACUTE CORONARY SYNDROME; HEART-FAILURE; AMERICAN-COLLEGE; MORTALITY; ANGINA; ASSOCIATION; PREDICTORS; OUTPATIENTS; ELEVATION; PROGRAMS AB Background Before outcomes-based measures of quality can be used to compare and improve care, they must be risk-standardized to account for variations in patient characteristics. Despite the importance of health-related quality of life (HRQL) outcomes among patients with acute myocardial infarction (AMI), no risk-standardized models have been developed. Methods and Results We assessed disease-specific HRQL using the Seattle Angina Questionnaire at baseline and 1 year later in 2693 unselected AMI patients from 24 hospitals enrolled in the Translational Research Investigating Underlying disparities in acute Myocardial infarction Patients' Health status (TRIUMPH) registry. Using 57 candidate sociodemographic, economic, and clinical variables present on admission, we developed a parsimonious, hierarchical linear regression model to predict HRQL. Eleven variables were independently associated with poor HRQL after AMI, including younger age, previous coronary artery bypass graft surgery, depressive symptoms, and financial difficulties (R-2=20%). The model demonstrated excellent internal calibration and reasonable calibration in an independent sample of 1890 AMI patients in a separate registry, although the model slightly overpredicted HRQL scores in the higher deciles. Among the 24 TRIUMPH hospitals, 1-year unadjusted HRQL scores ranged from 67-89. After risk-standardization, HRQL score variability narrowed substantially (range=79-83), and the group of hospital performance (bottom 20%/middle 60%/top 20%) changed in 14 of the 24 hospitals (58% reclassification with risk-standardization). Conclusions In this predictive model for HRQL after AMI, we identified risk factors, including economic and psychological characteristics, associated with HRQL outcomes. Adjusting for these factors substantially altered the rankings of hospitals as compared with unadjusted comparisons. Using this model to compare risk-standardized HRQL outcomes across hospitals may identify processes of care that maximize this important patient-centered outcome. C1 [Arnold, Suzanne V.; Li, Yan; Jones, Philip G.; Spertus, John A.] St Lukes Mid Amer Heart Inst, Kansas City, MO 64111 USA. [Arnold, Suzanne V.; Spertus, John A.] Univ Missouri, Kansas City, MO 64110 USA. [Masoudi, Frederick A.; Rumsfeld, John S.] Univ Colorado, Div Cardiol, Denver, CO 80202 USA. C3 Saint Luke's Mid America Heart Institute; University of Missouri System; University of Missouri Kansas City; University of Colorado System; University of Colorado Denver RP Arnold, SV (通讯作者),St Lukes Mid Amer Heart Inst, 4401 Wornall Rd, Kansas City, MO 64111 USA. EM suz.v.arnold@gmail.com RI Masoudi, Frederick/Q-7467-2019; Spertus, John/ABD-3075-2021 FU National Institutes of Health (National Heart, Lung, Blood Institute): Washington University School of Medicine SCCOR Grant [P50HL077113-01] FX TRIUMPH was sponsored by a grant from the National Institutes of Health (National Heart, Lung, Blood Institute): Washington University School of Medicine SCCOR Grant #P50HL077113-01. The funding organization did not play a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. 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Methods: A total of 121 patients with type 2 diabetes were divided into diabetic group, diabetic patients with coronary heart disease group (patients with stable angina pectoris and acute coronary syndrome group and combined group), another 50 healthy controls were analyzed between the clinical data, according to the number of coronary lesions, Gensini score group and multiple regression analysis of diabetes mellitus PCT and Hcy levels in patients with coronary artery disease. Results: There was a statistically significant difference in diabetes course, BMI, Glu, HbA1c, Hcy, PCT between the T2DM-CHD groups compared with the C and T2MD groups. Gensini scores of the SAP and ACS groups were significantly positively correlated with Hcy and PCT levels (r = 0.137, r = 0.232, r = 0.526, r = 0.545, p < 0.05). Two, three coronary lesions group Hcy and PCT levels were higher than those of the C group (p < 0.05). Multivariate logistic regression analysis showed that HbA1c (OR 1.58, 95% CI 1.16-2.80, p = 0.016), Hcy (odds ratio [OR] 2.27, 95% CI 1.24-2.53, p = 0.002) and PCT (OR 1.86, 95% CI 1.29-3.98, p = 0.024) were the independent influence factor of Gensini score in T2DM-CHD patients. Conclusion: This study shows that the severity of CADs with the increase of PCT and Hcy levels in patients with T2DM-CHD. It is of great value in predicting CADs. Copyright (C) 2019, Taiwan Society of Geriatric Emergency & Critical Care Medicine. C1 [Ji, Jinrui; Liu, Yang; Liu, Hengliang; Hao, Zhenxuan; Liu, Jing; Chen, Qi] Southern Med Univ, Zhengzhou Peoples Hosp, Dept Cardiol, Zhengzhou 450002, Henan, Peoples R China. C3 Southern Medical University - China RP Liu, HL (通讯作者),Zhengzhou Peoples Hosp, Dept Cardiol, Zhengzhou 450002, Henan, Peoples R China. EM cnhengliangliu@163.com FU Science and Technical Innovation Personnel of Zhengzhou [096SYJH331144] FX This study was funded by the Science and Technical Innovation Personnel of Zhengzhou (096SYJH331144). 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J. Gerontol. PD SEP PY 2019 VL 13 IS 3 BP 226 EP 230 DI 10.6890/IJGE.201909_13(3).0009 PG 5 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Geriatrics & Gerontology GA JB5KT UT WOS:000488602100010 DA 2023-05-13 ER PT J AU Natsukawa, T Maeda, N Fukuda, S Yamaoka, M Fujishima, Y Nagao, H Sato, F Nishizawa, H Sawano, H Hayashi, Y Funahashi, T Kai, T Shimomura, I AF Natsukawa, Tomoaki Maeda, Norikazu Fukuda, Shiro Yamaoka, Masaya Fujishima, Yuya Nagao, Hirofumi Sato, Fumi Nishizawa, Hitoshi Sawano, Hirotaka Hayashi, Yasuyuki Funahashi, Tohru Kai, Tatsuro Shimomura, Iichiro TI Significant Association of Serum Adiponectin and Creatine Kinase-MB Levels in ST-Segment Elevation Myocardial Infarction SO JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS LA English DT Article DE Adiponectin; Myocardial infarction; Acute coronary syndrome; CK-MB; Infarct size ID PERCUTANEOUS CORONARY INTERVENTION; ISCHEMIA-REPERFUSION INJURY; PLASMA ADIPONECTIN; T-CADHERIN; PROGNOSTIC IMPLICATIONS; CDH13; PROTEIN; ISCHEMIA/REPERFUSION; TISSUE; SIZE AB Aims: Adiponectin, an adipocyte-specific secretory protein, abundantly exists in the blood stream while its concentration paradoxically decreases in obesity. Hypoadiponectinemia is one of risks of cardiovascular diseases. However, impact of serum adiponectin concentration on acute ischemic myocardial damages has not been fully clarified. The present study investigated the association of serum adiponectin and creatine kinase (CK)-MB levels in subjects with ST-segment elevation myocardial infarction (STEMI). Methods: This study is a physician-initiated observational study and is also registered with the University Hospital Medical Information Network (Number: UMIN 000014418). Patients were admitted to Senri Critical Care Medical Center, given a diagnosis of STEMI, and treated by primary percutaneous coronary intervention (PCI). Finally, 49 patients were enrolled and the association of serum adiponectin, CK-MB, and clinical features were mainly analyzed. Results: Serum adiponectin levels decreased rapidly and reached the bottom at 24 hours after recanalization. Such reduction of serum adiponectin was inversely correlated with the area under the curve (AUC) of serum CK-MB (p=0.013). Serum adiponectin concentrations were inversely correlated with AUC of serum CK-MB. In multivariate analysis, serum adiponectin concentration on admission (p=0.002) and collateral (p=0.037) were significantly and independently correlated with serum AUC of CK-MB. Conclusion: Serum AUC of CK-MB in STEMI subjects was significantly associated with serum adiponectin concentration on admission and reduction of serum adiponectin levels from baseline to bottom. The present study may provide a possibility that serum adiponectin levels at acute phase are useful in the prediction for prognosis after PCI-treated STEMI subjects. C1 [Natsukawa, Tomoaki; Maeda, Norikazu; Fukuda, Shiro; Yamaoka, Masaya; Fujishima, Yuya; Nagao, Hirofumi; Sato, Fumi; Nishizawa, Hitoshi; Funahashi, Tohru; Shimomura, Iichiro] Osaka Univ, Grad Sch Med, Dept Metab Med, Osaka, Japan. [Natsukawa, Tomoaki; Sawano, Hirotaka; Hayashi, Yasuyuki; Kai, Tatsuro] Osaka Saiseikai Senri Hosp, Senri Crit Care Med Ctr, Osaka, Japan. [Maeda, Norikazu; Funahashi, Tohru] Osaka Univ, Grad Sch Med, Dept Metab & Atherosclerosis, Osaka, Japan. C3 Osaka University; Osaka University RP Maeda, N (通讯作者),Osaka Univ, Dept Metab Med, Dept Metab & Atherosclerosis, Grad Sch Med, 2-2-B5 Yamada Oka, Suita, Osaka 5650871, Japan. EM norikazu_maeda@endmet.med.osaka-u.ac.jp FU Takeda Science Foundation; [25461386]; [26293221] FX We thank Kayoko Ohashi for excellent technical assistance, especially in measurement of adiponectin. This work was supported in part by a Grant-in-Aid for Scientific Research (C) no. 25461386 (to N.M.), a Grant-in-Aid for Scientific Research (B) no. 26293221 (to T.F.), and Takeda Science Foundation (to N.M.). We also thank Dr. Matthew Lukies for English proofreading. 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Atheroscler. Thromb. PY 2017 VL 24 IS 8 BP 793 EP 803 DI 10.5551/jat.38232 PG 11 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FF0JO UT WOS:000408588200005 PM 28100880 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Luiz, T Kumpch, M Gruttner, J Madler, C Viergutz, T AF Luiz, Thomas Kumpch, Marc Gruettner, Joachim Madler, Christian Viergutz, Tim TI Prehospital CPAP Therapy by Emergency Physicians in Patients with Acute Respiratory Failure due to Acute Cardiogenic Pulmonary Edema or Acutely Exacerbated COPD SO IN VIVO LA English DT Article DE Continuous positive airway pressure; CPAP; Boussignac; cardiogenic pulmonary edema; chronic obstructive pulmonary disease; COPD; emergency medical services ID POSITIVE AIRWAY PRESSURE; NONINVASIVE VENTILATION; HEART-FAILURE; PRACTICAL USE; MORTALITY; SYSTEM; CARE; INTUBATION; IMPACT AB Background: Acute respiratory failure is a frequent cause of emergency medical missions. Continuous positive airway pressure (CPAP) therapy could be particularly beneficial, avoiding risks associated with intubation and invasive ventilation. Hardly any data exist from Germany on this matter. Patients and Methods: CPAP therapy with the Boussignac system as additional measure was introduced in cases of acute cardiogenic pulmonary edema (ACPE) or decompensated chronic obstructive pulmonary disease (COPD) in a physician-supported emergency medical services system (EMS). Results: A total of 57 patients, 35 with ACPE and 22 with COPD, received CPAP. Oxygen saturation improved from 81.6% to 94.8%, and respiration rate from 26.9/min to 18.9/min (p<0.001). Seven patients (12.2%) needed secondary intubation [COPD: one patient; ACPE: six patients, including three with acute coronary syndrome (ACS)]. Conclusion: In physician-supported EMS, CPAP using the Boussignac system is an effective additional measure for ACPE or COPD. For causal ACS, the risk of therapy failure increases. C1 [Luiz, Thomas; Kumpch, Marc; Madler, Christian] Westpfalz Hosp, Clin Anaesthesiol Intens Care & Emergency Med 1, Kaiserslautern, Germany. [Gruettner, Joachim] Heidelberg Univ, Med Fac Mannheim, Univ Med Ctr Mannheim, Emergency Dept, Mannheim, Germany. [Viergutz, Tim] Heidelberg Univ, Med Fac Mannheim, Univ Med Ctr Mannheim, Clin Anaesthesiol & Operat Intens Care Med, Mannheim, Germany. C3 Ruprecht Karls University Heidelberg; Ruprecht Karls University Heidelberg RP Luiz, T (通讯作者),Westpfalz Klinikum GmbH, Klin Anasthesie Intens & Notfallmed 1, Hellmut Hartert Str 1, D-67655 Kaiserslautern, Germany. 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Keipp Bogoch, Isaac I. McGeer, Allison Frobert, Ole Loeb, Mark Vardeny, Orly Solomon, Scott D. Udell, Jacob A. TI Influenza Vaccination to Reduce Cardiovascular Morbidity and Mortality in Patients With COVID-19 JACC State-of-the-Art Review SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Review DE acute myocardial infarction; cardioprotection; heart failure; influenza vaccination ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; HEART-FAILURE; SEASONAL INFLUENZA; T-CELL; SECONDARY PREVENTION; IMMUNE-RESPONSES; FLU VACCINATION; ACUTE INFECTION; UNITED-STATES AB Viral respiratory infections are risk factors for cardiovascular disease (CVD). Underlying CVD is also associated with an increased risk of complications following viral respiratory infections, including increased morbidity, mortality, and health care utilization. Globally, these phenomena are observed with seasonal influenza and with the current coronavirus disease 2019 (COVID-19) pandemic. Persons with CVD represent an important target population for respiratory virus vaccines, with capacity developed within 3 large ongoing influenza vaccine cardiovascular outcomes trials to determine the potential cardioprotective effects of influenza vaccines. In the context of COVID-19, these international trial networks may be uniquely positioned to redeploy infrastructure to study therapies for primary and secondary prevention of COVID-19. Here, we describe mechanistic links between influenza and COVID-19 infection and the risk of acute cardiovascular events, summarize the data to date on the potential cardioprotective effects of influenza vaccines, and describe the ongoing influenza vaccine cardiovascular outcomes trials, highlighting important lessons learned that are applicable to COVID-19. (C) 2020 by the American College of Cardiology Foundation. C1 [Behrouzi, Bahar; Campoverde, Maria Viviana Araujo; Udell, Jacob A.] Womens Coll Hosp, Dept Med, Cardiovasc Div, Toronto, ON, Canada. [Behrouzi, Bahar; Campoverde, Maria Viviana Araujo; McGeer, Allison; Udell, Jacob A.] Univ Toronto, Fac Med, Toronto, ON, Canada. [Behrouzi, Bahar; McGeer, Allison; Udell, Jacob A.] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada. [Liang, Kyle] Womens Coll Hosp, Womens Coll Hosp Inst Hlth Syst Solut & Virtual C, Toronto, ON, Canada. [Talbot, H. Keipp] Vanderbilt Univ, Dept Med & Hlth Policy, Med Ctr, Nashville, TN USA. [Bogoch, Isaac I.] Toronto Gen Hosp, Div Gen Internal Med & Infect Dis, Univ Hlth Network, Toronto, ON, Canada. [McGeer, Allison] Sinai Hlth Syst, Div Microbiol, Toronto, ON, Canada. [Frobert, Ole] Orebro Univ, Fac Hlth, Dept Cardiol, Orebro, Sweden. [Loeb, Mark] McMaster Univ, Dept Pathol & Mol Med, Hamilton, ON, Canada. [Loeb, Mark] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada. [Vardeny, Orly] Minneapolis Vet Affairs Hlth Care Syst, Ctr Care Delivery & Outcomes Res, Minneapolis, MN USA. [Solomon, Scott D.] Harvard Univ, Div Cardiovasc Med, Brigham & Womens Hosp, Boston, MA USA. [Udell, Jacob A.] Toronto Gen Hosp, Peter Munk Cardiac Ctr, Toronto, ON, Canada. C3 University of Toronto; Womens College Hospital; University of Toronto; University of Toronto; University of Toronto; Womens College Hospital; Vanderbilt University; University of Toronto; University Health Network Toronto; Toronto General Hospital; University of Toronto; Sinai Health System Toronto; Lunenfeld Tanenbaum Research Institute; Orebro University; McMaster University; McMaster University; US Department of Veterans Affairs; Veterans Health Administration (VHA); Minneapolis VA Health Care System; Harvard University; Brigham & Women's Hospital; University of Toronto; Peter Munk Cardiac Centre; University Health Network Toronto; Toronto General Hospital RP Udell, JA (通讯作者),Womens Coll Hosp, Dept Med, Cardiovasc Div, Toronto, ON, Canada.; Udell, JA (通讯作者),Univ Toronto, Fac Med, Toronto, ON, Canada.; Udell, JA (通讯作者),Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada.; Udell, JA (通讯作者),Toronto Gen Hosp, Peter Munk Cardiac Ctr, Toronto, ON, Canada. EM jay.udell@utoronto.ca RI Behrouzi, Bahar/AAJ-6259-2021; Bogoch, Isaac/AAS-9631-2020 OI Frobert, Ole/0000-0002-5846-345X FU University of Toronto MD/PhD studentship award; Heart & Stroke/Richard Lewar Centre of Excellence in Cardiovascular Research; CANHEART SPOR Graduate Studentship Award; Secretaria de Educacion Superior, Ciencia, Tecnologia e Innovacion (SENESCYT) 2018 Programa de Becas Internacionales; Sanofi Pasteur; Merck; Orebro University, Faculty of Health, Department of Cardiology; National Institutes of Health; Amgen; Alnylam; Lone Star Heart; National Institutes of Health/National Heart, Lung, and Blood Institute; Theracos; Heart and Stroke Foundation of Canada National New Investigator-Ontario Clinician Scientist Award; Ontario Ministry of Research, Innovation and Science Early Researcher Award; Women's College Research Institute; Department of Medicine, Women's College Hospital; Novartis; Sanofi; Pfizer; Seqirus; Bellerophon; Bayer; Bristol Myers Squibb; Celladon; Cytokinetics; Eidos; Gilead; GlaxoSmithKline; Ionis; Mesoblast; MyoKardia; AstraZeneca FX Ms. Behrouzi has been supported in part by a University of Toronto MD/PhD studentship award and a Heart & Stroke/Richard Lewar Centre of Excellence in Cardiovascular Research and CANHEART SPOR Graduate Studentship Award. Mrs. Araujo Campoverde has been supported by Secretaria de Educacion Superior, Ciencia, Tecnologia e Innovacion (SENESCYT) 2018 Programa de Becas Internacionales. Dr. Talbot has served on the Data Safety and Monitoring Board for Seqirus. Dr. Bogoch has consulted for BlueDot, a social benefit company that predicts the spread of infectious diseases of global health significance. Dr. McGeer has received research grants to her institution from Pfizer, Sanofi Pasteur, Merck, and Seqirus; and has consulted for Sanofi Pasteur, Seqirus, GlaxoSmithKline, Merck, Pfizer, Cidara, and Medicago. Dr. Frobert has been supported by Orebro University, Faculty of Health, Department of Cardiology; and has received unrestricted grant support for the IAMI study from Sanofi Pasteur. Dr. Loeb has consulted for Sanofi Pasteur, Seqirus, and Medicago; has received research funding from Seqirus; and has received influenza vaccine in-kind from Sanofi Pasteur. Dr. Vardeny has received grant support from the National Institutes of Health and AstraZeneca; and has provided consulting for Sanofi Pasteur, Novartis, and Amgen. Dr. Solomon has received research grants from Alnylam, Amgen, AstraZeneca, Bellerophon, Bayer, Bristol Myers Squibb, Celladon, Cytokinetics, Eidos, Gilead, GlaxoSmithKline, Ionis, Lone Star Heart, Mesoblast, MyoKardia, National Institutes of Health/National Heart, Lung, and Blood Institute, Novartis, Sanofi Pasteur, and Theracos; and has consulted for Akros, Alnylam, Amgen, Arena, AstraZeneca, Bayer, Bristol Myers Squibb, Cardior, Cardurion, Corvia, Cytokinetics, Daiichi-Sankyo, Gilead, GlaxoSmithKline, Ironwood, Merck, Myokardia, Novartis, Roche, Sanofi Pasteur, Takeda, Theracos, Quantum Genetics, AoBiome, Janssen, Cardiac Dimensions, Tenaya, Dinaqor, and Tremeau. Dr. Udell has been supported by a Heart and Stroke Foundation of Canada National New Investigator-Ontario Clinician Scientist Award, an Ontario Ministry of Research, Innovation and Science Early Researcher Award, as well as by Women's College Research Institute and the Department of Medicine, Women's College Hospital; has received grant support to his institutions from AstraZeneca, Novartis, and Sanofi; has served as a consultant for Amgen, Boehringer Ingelheim, Janssen, Merck, Novartis, and Sanofi; and has received honoraria from Boehringer Ingelheim and Janssen. 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Am. Coll. Cardiol. PD OCT 13 PY 2020 VL 76 IS 15 BP 1777 EP 1794 DI 10.1016/j.jacc.2020.08.028 PG 18 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OD0DF UT WOS:000579524400009 PM 33032740 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Erkelens, DCA Wouters, LTCM Zwart, DLM Damoiseaux, RAMJ De Groot, E Hoes, AW Rutten, FH AF Erkelens, Daphne C. A. Wouters, Loes T. C. M. Zwart, Dorien L. M. Damoiseaux, Roger A. M. J. De Groot, Esther Hoes, Arno W. Rutten, Frans H. TI Optimisation of telephone triage of callers with symptoms suggestive of acute cardiovascular disease in out-of-hours primary care: observational design of the Safety First study SO BMJ OPEN LA English DT Article ID MALPRACTICE CLAIMS; PATIENT SAFETY; CHEST-PAIN; EMERGENCY; NETHERLANDS; INTERVIEWS; FREQUENCY; SOFTWARE; SERVICES; LESSONS AB Introduction In the Netherlands, the 'Netherlands Triage Standard' (NTS) is frequently used as digital decision support system for telephone triage at out-of-hours services in primary care (OHS-PC). The aim of the NTS is to guarantee accessible, efficient and safe care. However, there are indications that current triage is inefficient, with overestimation of urgency, notably in suspected acute cardiovascular disease. In addition, in primary care settings the NTS has only been validated against surrogate markers, and diagnostic accuracy with clinical outcomes as the reference is unknown. In the Safety First study, we address this gap in knowledge by describing, understanding and improving the diagnostic process and urgency allocation in callers with symptoms suggestive of acute cardiovascular disease, in order to improve both efficiency and safety of telephone triage in this domain. Methods and analysis An observational study in which 3000 telephone triage recordings (period 2014-2016) will be analysed. Information is collected from the recordings including caller and symptom characteristics and urgency allocation. The callers' own general practitioners are contacted for the final diagnosis of each contact. We included recordings of callers with symptoms suggestive of acute coronary syndrome (ACS) or transient ischaemic attack (TIA)/stroke. With univariable and multivariable logistic regression analyses the diagnostic accuracy of caller and symptom characteristics will be analysed in terms of predictive values with urgency level, and ACS and TIA/stroke as outcomes, respectively. To further improve our understanding of the triage process at OHS-PC, we will carry out additional studies applying both quantitative and qualitative methods: (i) case-control study on serious adverse events (SAE), (ii) conversation analysis study and (iii) interview study with triage nurses. Ethics and dissemination The Medical Ethics Committee Utrecht, the Netherlands endorsed this study (National Trial Register identification: NTR7331). Results will be disseminated at scientific conferences, regional educational sessions and publication in peer-reviewed journals. C1 [Erkelens, Daphne C. A.; Wouters, Loes T. C. M.; Zwart, Dorien L. M.; Damoiseaux, Roger A. M. J.; De Groot, Esther; Hoes, Arno W.; Rutten, Frans H.] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. C3 Utrecht University; Utrecht University Medical Center RP Erkelens, DCA (通讯作者),Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. EM D.C.A.Erkelens@umcutrecht.nl RI Zwart, Dorien LM/F-5916-2015 OI Damoiseaux, Roger/0000-0001-8052-0302; de Groot, Esther/0000-0003-0388-385X FU Department of General Practice of the University Medical Centre Utrecht; foundation 'Netherlands Triage Standard'; foundation 'Stoffels-Hornstra' FX This work was supported by the Department of General Practice of the University Medical Centre Utrecht, Associate Professorship-promotion grant of DLMZ, MD, PhD, the foundation 'Netherlands Triage Standard' and the foundation 'Stoffels-Hornstra'. 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Hypothesis: The aim of this study was to evaluate the survival and occurrence of cardiovascular events in patients without diagnosis at the end of management of chest pain with high-sensitivity troponin (Tn) elevation. Method: All consecutive patients who came to the cardiac emergency room of Poitiers University Hospital between January 1, 2014, and August 7, 2015, for chest pain and Tn elevation were included. The primary endpoint was the number of undiagnosed patients; secondary endpoints included survival and major adverse cardiac events. Results: A total of 1001 patients (695 male; mean age, 68 +/- 16 years) who had chest pain and Tn elevation were included. Median follow-up was 24.5 (IQR, 14.7-29.5) months. Forty-seven (4.7%) patients remained without diagnosis. Compared with patients with diagnosis, these patients were younger (53.6 +/- 19.7 years; P < 0.0001) and had less hypertension (29.8%; P < 0.0001), diabetes (4.3%; P = 0.0016), and history of coronary artery disease (6.4%; P < 0.0001). No patients died or experienced MACE in 6-month follow-up. Survival curves showed the probability of survival was excellent, not only at 6 months, but also at 36 months (P = 0.0025). Conclusions: Less than 5% of patients referred for chest pain and with high-sensitivity Tn elevation remained without diagnosis after adapted care in the chest pain unit. Their 6-month prognosis was excellent. C1 [Lordet, Vincent; Lesbordes, Matthieu; Garcia, Rodrigue; Varroud-Vial, Nicolas; Christiaens, Luc; Levesque, Sebastien] CHU Poitiers, Dept Cardiol, Poitiers, France. [Ingrand, Pierre] Poitiers Univ, Dept Epidemiol & Biostat, INSERM, CIC 1402, Poitiers, France. C3 CHU Poitiers; Universite de Poitiers; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Poitiers RP Lordet, V (通讯作者),Univ Poitiers Hosp, F-86000 Poitiers, France. 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Cardiol. PD JUL PY 2018 VL 41 IS 7 BP 953 EP 958 DI 10.1002/clc.22984 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GO5CH UT WOS:000440035100014 PM 29802723 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Bugiardini, R Manfrini, O Stakic, MM Cenko, E Boytsov, S Merkely, B Becker, D Dilic, M Vasiljevic, Z Koller, A Badimon, L AF Bugiardini, Raffaele Manfrini, Olivia Stakic, Marta Majstorovic Cenko, Edina Boytsov, Sergei Merkely, Bela Becker, David Dilic, Mirza Vasiljevic, Zorana Koller, Akos Badimon, Lina TI Exploring In-hospital Death from Myocardial Infarction in Eastern Europe SO CURRENT VASCULAR PHARMACOLOGY LA English DT Article DE Acute myocardial infarction; STEMI; mortality rate; reperfusion therapy; Serbia; Bosnia and Herzegovina; Russian Federation; Hungary ID ACUTE CORONARY SYNDROMES; ACUTE ST-ELEVATION; REPERFUSION THERAPY; GLOBAL REGISTRY; FIBRINOLYSIS; EVENTS; GENDER AB Introduction: The aim of the current study was to investigate the outcomes of coronary reperfusion therapies and ST-segment elevation myocardial infarction (STEMI) in patients of Eastern countries with economies in transition. Methods and Results: We received STEMI registry data from 4 countries: Bosnia and Herzegovina, Hungary, Russian Federation, and Serbia. The overall population consisted of 23,486 consecutive patients admitted to hospitals from January 1st to December 31st 2009. Registry data and statistics from the Organization for Economic Cooperation and Development (OECD) countries for the same period were used for comparison (2009- 2010). In-hospital mortality was between 4% and 5% in the Western countries. In comparison mortality data were significantly larger in Serbia (10.8%) and Bosnia and Herzegovina (11.2%), intermediate in Russian Federation (7.2%) and similar in Hungary (5.0%). The rates of primary percutaneous coronary intervention (primary PCI) were very low in Bosnia and Herzegovina (18.3%), low in Russian Federation (20.6%) and Serbia (22%), and high in Hungary (70%). Major risk factors for death appear to be lack of reperfusion therapy, longer time delay from symptoms onset to hospital presentation as well as the higher percentage of patients with clinical presentation in Killip class III/ IV. Conclusion: In-hospital STEMI case-fatality rates ranges widely in the former Eastern Bloc countries. Beyond the quality of care provided in hospitals, differences in time delay from symptoms onset to hospital admission may strongly influence STEMI patients' outcome. C1 [Bugiardini, Raffaele; Manfrini, Olivia; Stakic, Marta Majstorovic; Cenko, Edina] Univ Bologna, Dipartimento Med Specialist Diagnost & Sperimenta, I-40138 Bologna, Italy. [Boytsov, Sergei] Natl Res Ctr Prevent Med, Moscow, Russia. [Merkely, Bela; Becker, David] Semmelweis Univ, Ctr Heart, H-1085 Budapest, Hungary. [Dilic, Mirza] Univ Inst Cardiovasc Dis, Sarajevo, Bosnia & Herceg. [Vasiljevic, Zorana] Univ Med Fac Belgrade, Clin Ctr Serbia, Cardiol Clin, Belgrade, Serbia. [Koller, Akos] New York Med Coll, Dept Physiol, Valhalla, NY 10595 USA. [Koller, Akos] Univ Pecs, Szentagothai Res Ctr, Pecs, Hungary. [Badimon, Lina] CiberOBN, Hosp Santa Creu & Sant Pau, Cardiovasc Res Ctr ICCC CSIC, Barcelona, Spain. C3 University of Bologna; National Medical Research Center for Therapy & Preventive Medicine; Semmelweis University; Clinical Centre of Serbia; New York Medical College; University of Pecs; CIBER - Centro de Investigacion Biomedica en Red; CIBEROBN; Consejo Superior de Investigaciones Cientificas (CSIC); CSIC - Institut Catala de Ciencies Cardiovasculars (ICCC); Hospital of Santa Creu i Sant Pau RP Manfrini, O (通讯作者),Univ Bologna, Dipartimento Med Specialist Diagnost & Sperimenta, Via Massarenti 9,Padiglione 11, I-40138 Bologna, Italy. EM olivia.manfrini@unibo.it RI Cenko, Edina/L-6438-2015; Ákos, Koller/Q-4672-2019; Dilic, Mirza/AAS-8445-2020; MANFRINI, OLIVIA/AAM-9442-2020; Bugiardini, Raffaele/L-6446-2015; Dilic, Mirza/ABM-7248-2022; BADIMON, LINA/S-2950-2019; Boytsov, Sergey/AAK-5354-2021; Boytsov, Sergey A/M-4486-2014; Badimon, Lina/O-4711-2014 OI Cenko, Edina/0000-0001-8102-3324; MANFRINI, OLIVIA/0000-0002-5652-2401; Bugiardini, Raffaele/0000-0002-6819-6818; Boytsov, Sergey/0000-0001-6998-8406; Boytsov, Sergey A/0000-0001-6998-8406; Badimon, Lina/0000-0002-9162-2459 CR Allender S., 2008, EUROPEAN CARDIOVASCU [Anonymous], 1988, LANCET, V2, P349 Armstrong PW, 2003, CIRCULATION, V107, P2533, DOI 10.1161/01.CIR.0000072930.64775.DC Bainey KR, 2009, HEART, V95, P1331, DOI 10.1136/hrt.2008.160390 Brieger D, 2004, CHEST, V126, P461, DOI 10.1378/chest.126.2.461 Bueno H, 2011, EUR HEART J, V32, P51, DOI 10.1093/eurheartj/ehq375 Bugiardini R, 2010, CURR VASC PHARMACOL, V8, P276, DOI 10.2174/157016110790887018 Cohen M, 2005, J THROMB THROMBOLYS, V19, P155, DOI 10.1007/s11239-005-1524-1 Cohen M, 2003, CIRCULATION, V108, P14, DOI 10.1161/01.CIR.0000086952.14979.32 Decarli A, 1987, RIV STATISTICA APPLI, V20, P397 Eagle KA, 2002, LANCET, V359, P373, DOI 10.1016/S0140-6736(02)07595-5 Eagle KA, 2008, EUR HEART J, V29, P609, DOI 10.1093/eurheartj/ehn069 Fefer P, 2009, AM J CARDIOL, V103, P149, DOI 10.1016/j.amjcard.2008.08.050 Greenberg H, 2005, HLTH AFF Hanssen M, 2012, HEART, V98, P699, DOI 10.1136/heartjnl-2012-301700 Holloway RG, 2007, JAMA-J AM MED ASSOC, V298, P802, DOI 10.1001/jama.298.7.802 Khare RK, 2010, ACAD EMERG MED, V17, P793, DOI 10.1111/j.1553-2712.2010.00821.x Krumholz HM, 1998, JAMA-J AM MED ASSOC, V280, P623, DOI 10.1001/jama.280.7.623 O'Connor GT, 1999, JAMA-J AM MED ASSOC, V281, P627, DOI 10.1001/jama.281.7.627 OECD, 2011, HLTH GLANC 2011 OECD Polonski L, 2011, KARDIOL POL, V69, P1109 Radovanovic D, 2010, SWISS MED WKLY, V140, P314, DOI smw-12986 Radovanovic D, 2010, HEART, V96, P917, DOI 10.1136/hrt.2009.192302 Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184 Zeymer U, 2008, THROMB HAEMOSTASIS, V99, P155, DOI 10.1160/TH07-09-0556 Zhang Y, 2011, J ZHEJIANG UNIV-SC B, V12, P629, DOI 10.1631/jzus.B1101010 NR 26 TC 33 Z9 33 U1 0 U2 21 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y-2, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1570-1611 EI 1875-6212 J9 CURR VASC PHARMACOL JI Current Vascular Pharmacology PY 2014 VL 12 IS 6 BP 903 EP 909 DI 10.2174/157016111206141210122150 PG 7 WC Pharmacology & Pharmacy; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy; Cardiovascular System & Cardiology GA AW4WJ UT WOS:000346278000016 PM 23607683 DA 2023-05-13 ER PT J AU Figura, A Kuhlmann, SL Rose, M Slagman, A Schenk, L Mockel, M AF Figura, Andrea Kuhlmann, Stella L. Rose, Matthias Slagman, Anna Schenk, Liane Moeckel, Martin TI Mental health conditions in older multimorbid patients presenting to the emergency department for acute cardiac symptoms: Cross-sectional findings from the EMASPOT study SO ACADEMIC EMERGENCY MEDICINE LA English DT Article DE acute coronary syndrome; anxiety disorder; chest pain; depression; emergency department; mental health condition ID CORONARY-HEART-DISEASE; GENERALIZED ANXIETY DISORDER; PANIC DISORDER; CHEST-PAIN; DEPRESSIVE SYMPTOMS; META-REGRESSION; PRIME-MD; CARE; QUESTIONNAIRE; ASSOCIATION AB Background This study aimed to (1) examine the proportion of patients presenting to an emergency department (ED) for acute cardiac symptoms with comorbid mental health conditions (MHCs) comprising current depression, generalized anxiety disorder, and panic disorder; (2) compare cardiac patients with and without MHCs regarding sociodemographic, medical, and psychological characteristics; and (3) examine recognition and treatment rates of MHCs. Methods Multimorbid patients, aged >= 50 years, presenting to an inner-city ED with acute cardiac symptoms including chest pain, dyspnea, and palpitations, completed validated self-report instruments assessing MHCs and a questionnaire collecting psychosocial and medical information. In addition, routine medical data were extracted from the electronic health record. Results A total of 641 patients were included in the study. Mean (+/- SD) age was 68.8 (+/- 10.8) years and 41.7% were female. Based on screening instruments, 28.4% of patients were affected with comorbid MHCs. Patients reported clinically significant symptoms of depression (23.3% PHQ-9 >= 10), generalized anxiety disorder (12.2% GAD-7 >= 10), and panic disorder (4.7% PHQ-PD). Patients with MHCs were more likely to be younger, female, lower educated, and unemployed. The presence of MHCs was associated with higher cardiac symptom burden and subjective treatment urgency as well as more psychosocial distress (PHQ-stress) and impaired quality of life (SF-12v2). Of all patients, 15.6% were identified with new or unrecognized MHCs. Conclusions MHCs are prevalent in nearly one-third of patients presenting with cardinal cardiac symptoms. Thus, the ED visit offers an opportunity to identify and refer patients with MHCs to appropriate and timely care after exclusion of life-threatening conditions. C1 [Figura, Andrea; Rose, Matthias] Charite Univ Med Berlin, Dept Psychosomat Med, Charite Pl 1, D-10117 Berlin, Germany. [Kuhlmann, Stella L.; Slagman, Anna; Moeckel, Martin] Charite Univ Med Berlin, Dept Psychosomat Med, Div Emergency & Acute Med, Campus VirchowKlinikum,Campus Charite Mitte, Berlin, Germany. [Schenk, Liane] Charite Univ Med Berlin, Inst Med Sociol & Rehabil Sci, Berlin, Germany. C3 Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin RP Figura, A (通讯作者),Charite Univ Med Berlin, Dept Psychosomat Med, Charite Pl 1, D-10117 Berlin, Germany. EM andrea.figura@charite.de RI Mockel, Martin/AAC-2600-2019 OI Mockel, Martin/0000-0002-7691-3709; Slagman, Anna/0000-0003-2608-0347; Figura, Andrea/0000-0002-1240-1501; Kuhlmann, Stella/0000-0001-7163-552X FU German Ministry of Education and Research (Bundesministerium fur Bildung und Forschung [BMBF]) [01GY1604] FX This work was supported by the German Ministry of Education and Research (Bundesministerium fur Bildung und Forschung [BMBF]) grant number 01GY1604 to the Charite-Universitatsmedizin Berlin and principal investigator Professor Martin Mockel. The funding body had no role in the design and conduct of the study, data collection, analysis, and interpretation of the data nor in the preparation, review, and approval of the manuscript. 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Emerg. Med. PD NOV PY 2021 VL 28 IS 11 BP 1262 EP 1276 DI 10.1111/acem.14349 EA AUG 2021 PG 15 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Emergency Medicine GA XC3JM UT WOS:000688437500001 PM 34309134 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Amann, U Kirchberger, I Heier, M von Scheidt, W Kuch, B Peters, A Meisinger, C AF Amann, Ute Kirchberger, Inge Heier, Margit von Scheidt, Wolfgang Kuch, Bernhard Peters, Annette Meisinger, Christa TI Acute myocardial infarction in the elderly: Treatment strategies and 28-day-case fatality from the MONICA/KORA myocardial infarction registry SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE myocardial infarction; aged; myocardial reperfusion; mortality ID ACUTE CORONARY SYNDROMES; HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; AGE-RELATED DIFFERENCES; INVASIVE STRATEGY; SCIENTIFIC STATEMENT; CLINICAL CARDIOLOGY; MANAGEMENT; OUTCOMES; SOCIETY AB ObjectivesAim of this observational study was to analyze today's real-life treatment strategies in elderly patients with an acute myocardial infarction (AMI) and to assess the association between 28-day-case fatality and invasive strategy (percutaneous coronary intervention/coronary artery bypass grafting). BackgroundElderly patients increasingly constitute a large proportion of the AMI population. MethodsThe present study is an analysis of all patients aged 75-84 years, who were enrolled in the German population-based MONICA/KORA MI registry between 2009 and 2012 and who were defined as nonfatal at least 24 hours surviving AMI cases according to MONICA definition. Multivariable logistic regression analyses were conducted for the total study population and stratified by type of AMI (ST-segment elevation MI [STEMI], Non-ST-segment elevation MI [NSTEMI], and bundle branch block [BBB]). ResultsOut of the 1,191 elderlies, 61.9% were treated invasively. In the multivariable analysis, the odds ratio (OR) for 28-day-case fatality in patients treated with invasive versus conservative strategy was 0.43 (95% CI 0.27-0.69). Stratified analyses revealed an OR of 0.27 (95% CI 0.13-0.56) for patients with NSTEMI. In patients with STEMI or BBB also a positive trend for invasive strategy was observed (OR 0.40; 95% CI 0.13-1.27 and OR 0.76; 95% CI 0.16-3.66, respectively). ConclusionsInvasive revascularization therapy was independently associated with short-term survival in elderly patients, particularly in those with NSTEMI. (c) 2015 Wiley Periodicals, Inc. C1 [Amann, Ute; Kirchberger, Inge; Heier, Margit; Meisinger, Christa] Cent Hosp Augsburg, MONICA KORA Myocardial Infarct Registry, Stenglinstr 2, D-86156 Augsburg, Germany. [Amann, Ute; Kirchberger, Inge; Heier, Margit; Peters, Annette; Meisinger, Christa] German Res Ctr Environm Hlth GmbH, Helmholtz Zentrum Munchen, Inst Epidemiol 2, Neuherberg, Germany. [von Scheidt, Wolfgang; Kuch, Bernhard] Cent Hosp Augsburg, Dept Internal Med Cardiol 1, Augsburg, Germany. [Kuch, Bernhard] Hosp Nordlingen, Dept Internal Med Cardiol, Nordlingen, Germany. C3 Helmholtz Association; Helmholtz-Center Munich - German Research Center for Environmental Health RP Amann, U (通讯作者),Cent Hosp Augsburg, MONICA KORA Myocardial Infarct Registry, Stenglinstr 2, D-86156 Augsburg, Germany. EM ute.amann@helmholtz-muenchen.de RI Meisinger, Christine/B-5358-2014; Peters, Annette/A-6117-2011; Heier, Margit/AAT-5280-2020 OI Peters, Annette/0000-0001-6645-0985; Meisinger, Christa/0000-0002-9026-6544; Amann, Ute/0000-0001-5913-6031 FU Helmholtz Zentrum Munchen; German Research Center for Environmental Health; German Federal Ministry of Education, Science, Research and Technology; State of Bavaria; German Federal Ministry of Health FX The KORA research platform and the MONICA Augsburg studies were initiated and financed by the Helmholtz Zentrum Munchen, German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education, Science, Research and Technology and by the State of Bavaria. Since the year 2000, the collection of MI data has been co-financed by the German Federal Ministry of Health to provide population-based MI morbidity data for the official German Health Report (see www.gbe-bund.de). Steering partners of the MON-ICA/KORA Infarction Registry, Augsburg, include the KORA research platform, Helmholtz Zentrum Munchen and the Department of Internal Medicine I, Cardiology, Central Hospital of Augsburg. 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Cardiovasc. Interv. PD MAR PY 2016 VL 87 IS 4 BP 680 EP 688 DI 10.1002/ccd.26159 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DI0QO UT WOS:000373202200020 PM 26333143 OA Green Submitted DA 2023-05-13 ER PT J AU Uscinska, E Sobkowicz, B Lisowska, A Sawicki, R Dabrowska, M Szmitkowski, M Musial, WJ Tycinska, AM AF Uscinska, Ewa Sobkowicz, Bozena Lisowska, Anna Sawicki, Robert Dabrowska, Milena Szmitkowski, Maciej Musial, Wlodzimierz J. Tycinska, Agnieszka M. TI Predictors of Long-Term Mortality in Patients Hospitalized in an Intensive Cardiac Care Unit A Special Role of Anemia and Iron Status SO INTERNATIONAL HEART JOURNAL LA English DT Article DE ICCU patients; Hemoglobin; Serum iron concentration; Late mortality; Risk factors ID ACUTE MYOCARDIAL-INFARCTION; PERCUTANEOUS CORONARY INTERVENTION; DECOMPENSATED HEART-FAILURE; CHRONIC KIDNEY-DISEASE; FERRIC CARBOXYMALTOSE; CLINICAL-OUTCOMES; ACQUIRED ANEMIA; DEFICIENCY; TRANSFUSION; ADMISSION AB Patients admitted to an intensive cardiac care unit (ICCU) are a heterogeneous population with a high mortality rate. The aim of our study was to investigate which clinical, biochemical, and echocardiographic parameters routinely assessed may affect long-term mortality in a non-selected ICCU population. A total of 392 patients hospitalised between 2008-2011 (mean age, 70 +/- 13.8 years, 43% women) were consecutively and prospectively assessed with the following admission diagnoses: 168 with acute coronary syndromes (ACS), 122 with acute decompensated heart failure (ADHF), and 102 with other acute cardiac disorders. Patients were treated according to the current European Society of Cardiology (ESC) guidelines. During a mean 29.3 (+/- 18.9) months of observation, 152 (38.8%) patients died and 7.9% of the patients needed a red blood cell transfusion (RBC Tx). Patients who died were significantly older and had lower baseline levels of hemoglobin (Hb), serum iron concentration (SIC), total iron binding capacity (TIBC), cholesterol, and left ventricular ejection fraction (LVEF), as well as lower eGFR values, and higher white blood cell (WBC) counts and C-reactive protein (CRP) levels (P < 0.05). Predictors of death in multivariate regression analysis were age, Hb, LVEF, WBC, and CRP. The most powerful factor was hospitalisation for non-ACS. The risk of long-term mortality increased with decreasing levels of Hb (P < 0.001), SIC (P = 0.001), TIBC (P = 0.009), and the need for RBC Tx (P < 0.001), as well as the diagnosis of ADHF (P < 0.001) and the absence of ACS (P = 0.007). In ICCU patients, age, Hb, parameters of iron status, and LVEF are strong predictors of long-term mortality. Among the ICCU population, patients with ACS diagnosis have better survival. C1 [Uscinska, Ewa; Sobkowicz, Bozena; Lisowska, Anna; Sawicki, Robert; Musial, Wlodzimierz J.; Tycinska, Agnieszka M.] Med Univ Bialystok, Dept Cardiol, Ul Sklodowskiej Curie 24a, PL-15276 Bialystok, Poland. [Dabrowska, Milena] Med Univ Bialystok, Dept Hematol Diagnost, PL-15276 Bialystok, Poland. [Szmitkowski, Maciej] Med Univ Bialystok, Dept Biochem Diagnost, PL-15276 Bialystok, Poland. C3 Medical University of Bialystok; Medical University of Bialystok; Medical University of Bialystok RP Tycinska, AM (通讯作者),Med Univ Bialystok, Dept Cardiol, Ul Sklodowskiej Curie 24a, PL-15276 Bialystok, Poland. EM agnieszka.tycinska@gmail.com RI Malyszko, Jolanta/GSM-7177-2022; Tycinska, Agnieszka/U-7935-2018; Dąbrowska, Milena/T-8686-2018 OI Malyszko, Jolanta/0000-0001-8701-8171; Tycinska, Agnieszka/0000-0001-7855-7261; Dąbrowska, Milena/0000-0001-6996-6899; Lisowska, Anna/0000-0001-7794-3320; Sobkowicz, Bozena/0000-0002-3297-3320 FU Medical University in Bialystok, Poland [123-53714L] FX This work is supported by Medical University in Bialystok, Poland, No 123-53714L. 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Heart J. PD JAN PY 2016 VL 57 IS 1 BP 67 EP 72 DI 10.1536/ihj.15-249 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DG6RK UT WOS:000372213600012 PM 26673443 OA Bronze DA 2023-05-13 ER PT J AU Villmann, JM Burkhardt, R Teren, A Villmann, T Thiery, J Drogies, T AF Villmann, Josepha-Maria Burkhardt, Ralph Teren, Andrej Villmann, Thomas Thiery, Joachim Drogies, Tim TI Atherosclerosis, myocardial infarction and primary hemostasis: Impact of platelets, von Willebrand factor and soluble glycoprotein VI SO THROMBOSIS RESEARCH LA English DT Article DE Primary hemostasis; Acute coronary syndrome; Platelets; Mean platelet volume; Soluble glycoprotein VI; von-Willebrand-factor ID CORONARY-ARTERY-DISEASE; GPVI-FC; VOLUME; ACTIVATION; MECHANISMS; PARAMETERS; FIBRINOGEN; THROMBOSIS; SEVERITY; ADHESION AB Introduction: Little is known about peril constellations in primary hemostasis contributing to an acute myocardial infarction (MI) in patients with already manifest atherosclerosis. The study aimed to establish a predicting model based on six biomarkers of primary hemostasis: platelet count, mean platelet volume, hematocrit, soluble glycoprotein VI, fibrinogen and von Willebrand factor ratio. Materials and methods: The biomarkers were measured in 1.491 patients with manifest atherosclerosis of the Leipzig (LIFE) heart study. Three groups were divided: patients with coronary artery disease (900 patients) and patients with atherosclerosis and either ST-elevated MI (404 patients) or Non-ST-elevated MI (187 patients). Correlations were analyzed by non-linear analysis with Self Organizing Maps. Classification and discriminant analysis was performed using Learning Vector Quantization. Results and conclusions. The combination of hemostatic biomarkers is regarded as valuable tool for identifying patients with atherosclerosis at risk for MI. Nevertheless, our study contradicts this belief. The biomarkers did not allow to establish a predicting model usable in daily patient care. Good specificity and sensitivity for the detection of MI was only reached in models including acute phase parameters (specificity 0,9036, sensitivity 0,7937 in men; 0,8977 and 0,8133 in women). In detail, hematocrit and soluble glycoprotein VI were significantly different between the groups. Significant dissimilarities were also found for fibrinogen (in men) and von Willebrand factor ratio. In contrast, the most promising parameters mean platelet volume and platelet count showed no difference, which is an important contribution to the controversy concerning them as new risk and therapy targets for MI. C1 [Villmann, Josepha-Maria; Burkhardt, Ralph; Thiery, Joachim; Drogies, Tim] Univ Hosp Leipzig, Inst Lab Med Clin Chem & Mol Diagnost, Paul List Str 13-15, D-04103 Leipzig, Germany. [Villmann, Josepha-Maria; Teren, Andrej; Thiery, Joachim; Drogies, Tim] Univ Leipzig, LIFE Leipzig Res Ctr Civilizat Dis, Leipzig, Germany. [Teren, Andrej] Leipzig Heart Ctr, Leipzig, Germany. [Villmann, Thomas] Univ Appl Sci Mittweida, Computat Intelligence Grp, Mittweida, Germany. C3 Leipzig University; Leipzig University; Heart Center Leipzig GMBH RP Drogies, T (通讯作者),Univ Hosp Leipzig, Inst Lab Med Clin Chem & Mol Diagnost, Paul List Str 13-15, D-04103 Leipzig, Germany. EM tim.drogies@mzla.de RI Burkhardt, Ralph/F-5221-2013 OI Burkhardt, Ralph/0000-0003-1924-1202; Drogies, Tim/0000-0003-3180-5816 FU Saxon State Ministry for Higher Education, Research and the Arts; LIFE - Leipzig Research Center for Civilization Diseases, University Leipzig [LIFE-206 D32]; European Union; European Regional Development Fund (ERDF); Free State of Saxony FX The work was funded by Saxon State Ministry for Higher Education, Research and the Arts and supported by LIFE - Leipzig Research Center for Civilization Diseases, University Leipzig (LIFE-206 D32). LIFE is funded by the European Union, by the European Regional Development Fund (ERDF) and by the Free State of Saxony within the framework of the excellence initiative. 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Res. PD AUG PY 2019 VL 180 BP 98 EP 104 DI 10.1016/j.thromres.2019.06.014 PG 7 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA IK8TY UT WOS:000476869700018 PM 31276978 DA 2023-05-13 ER PT J AU Montrief, T Davis, WT Koyfman, A Long, B AF Montrief, Tim Davis, William T. Koyfman, Alex Long, Brit TI Mechanical, inflammatory, and embolic complications of myocardial infarction: An emergency medicine review SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Review DE Myocardial infarction; Acute coronary syndrome; Complications; Mechanical complications ID VENTRICULAR FREE-WALL; PERCUTANEOUS CORONARY INTERVENTION; ST-SEGMENT ELEVATION; ACUTE MITRAL REGURGITATION; LONG-TERM SURVIVAL; SEPTAL RUPTURE; CARDIOGENIC-SHOCK; CARDIAC RUPTURE; HEART-FAILURE; PERICARDIAL-EFFUSION AB Introduction: Despite the declining incidence of coronary heart disease (CHD) in the United States, acute myocardial infarction (AMI) remains an important clinical entity, with many patients requiring emergency department (ED) management for mechanical, inflammatory, and embolic complications. Objective: This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of post myocardial infarction mechanical, inflammatory, and embolic complications. Discussion: While 30-day mortality rate after AMI has decreased in the past two decades, it remains significantly elevated at 7.8%, owing to a wide variety of subacute complications evolving over weeks. Mechanical complications such as ventricular live wall rupture, ventricular septal rupture, mitral valve regurgitation, and formation of left ventricular aneurysms carry significant morbidity. Additional complications include ischemic stroke, heart failure, renal failure, and cardiac dysrhythmias. This review provides several guiding principles for management of these complications. Understanding these complications and an approach to the management of various complications is essential to optimizing patient care. Conclusions: Mechanical, inflammatory, and embolic complications of AMI can result in significant morbidity and mortality. Physicians must rapidly diagnose these conditions while evaluating for other diseases. In addition to understanding the natural progression of disease and performing a focused physical examination, an electrocardiogram and bedside echocardiogram provide quick, noninvasive determinations of the underlying pathophysiology. Management varies by presentation and etiology, but close consultation with cardiology and cardiac surgery is recommended. Published by Elsevier Inc. C1 [Montrief, Tim] Univ Miami, Jackson Mem Hosp, Miller Sch Med, Dept Emergency Med, 1611 NW 12th Ave, Miami, FL 33136 USA. [Davis, William T.; Long, Brit] Brooke Army Med Ctr, Dept Emergency Med, 3841 Roger Brooke Dr, Ft Sam Houston, TX 78234 USA. [Koyfman, Alex] Univ Texas Southwestern Med Ctr Dallas, Dept Emergency Med, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. 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J. Emerg. Med. PD JUN PY 2019 VL 37 IS 6 BP 1175 EP 1183 DI 10.1016/j.ajem.2019.04.003 PG 9 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA IB2OS UT WOS:000470109200031 PM 30987913 DA 2023-05-13 ER PT J AU Wijesekera, VA Mullany, DV Tjahjadi, CA Walters, DL AF Wijesekera, Vishva A. Mullany, Daniel V. Tjahjadi, Catherina A. Walters, Darren L. TI Routine angiography in survivors of out of hospital cardiac arrest with return of spontaneous circulation: a single site registry SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Cardiac arrest; Myocardial infarction; OOHCA; Angiography; Therapeutic hypothermia ID EUROPEAN RESUSCITATION COUNCIL; ACUTE CORONARY SYNDROMES; CARDIOPULMONARY-RESUSCITATION; SUDDEN-DEATH; CARE; HEART AB Background: Coronary revascularization in resuscitated out of hospital cardiac arrest (OOHCA) patients has been associated with improved survival. Methods: This was a retrospective review of patients with OOHCA between 01/07/2007 and 31/03/2009 surviving to hospital admission. Cardiac risk factors, demographics, treatment times, electrocardiogram (ECG), angiographic findings and in-hospital outcomes were recorded. Results: Of the 78 patients, 63 underwent coronary angiography. Traditional cardiac risk factors were common in this group. Chest pain occurred in 33.3% pre-arrest, 59.0% were initially treated at a peripheral hospital, 83.3% had documented ventricular tachycardia or ventricular fibrillation, 55.1% had specific ECG changes, 65.4% had acute myocardial infarction (AMI) as the cause of OOHCA and the majority had multi-vessel disease. ST elevation strongly predicted AMI. The in-hospital survival was 67.9% with neurological deficit in 13.2% of survivors. The group of patients who had an angiogram were more likely to have AMI as a cause of cardiac arrest (71.4% vs 40.0%, p = 0.01) and more likely to have survived to discharge (74.6% vs 40.0%, p < 0.01). Poor outcome was associated with older age, cardiogenic shock, longer transfer times, diabetes, renal impairment and a long duration to return of spontaneous circulation. Conclusions: Acute myocardial infarction was the commonest cause of OOHCA and a high rate of survival to discharge was seen with a strategy of routine angiography and revascularization. C1 [Wijesekera, Vishva A.; Tjahjadi, Catherina A.; Walters, Darren L.] Prince Charles Hosp, Heart Lung Inst, Brisbane, Qld 4032, Australia. [Mullany, Daniel V.] Prince Charles Hosp, Dept Intens Care, Brisbane, Qld 4032, Australia. C3 Prince Charles Hospital; Prince Charles Hospital RP Wijesekera, VA (通讯作者),Prince Charles Hosp, Heart Lung Inst, Brisbane, Qld 4032, Australia. EM vwijesekera@outlook.com RI Wijesekera, Vishva A/G-3259-2014; Mullany, Daniel V/C-7927-2018; Mullany, Dan/AAU-2664-2021; Walters, Darren L/A-7069-2011 OI Wijesekera, Vishva A/0000-0002-3722-3377; Mullany, Daniel V/0000-0002-9119-0676; Mullany, Dan/0000-0002-9119-0676; CR Anyfantakis ZA, 2009, AM HEART J, V157, P312, DOI 10.1016/j.ahj.2008.09.016 Arntz HR, 2010, RESUSCITATION, V81, P1353, DOI 10.1016/j.resuscitation.2010.08.016 Bendz B, 2004, RESUSCITATION, V63, P49, DOI 10.1016/j.resuscitation.2004.04.006 Boersma E, 2002, LANCET, V359, P189, DOI 10.1016/S0140-6736(02)07442-1 Cheung Winston, 2006, Crit Care Resusc, V8, P321 Dekker LRC, 2006, CIRCULATION, V114, P1140, DOI 10.1161/CIRCULATIONAHA.105.606145 Dumas F, 2010, CIRC-CARDIOVASC INTE, V3, P200, DOI 10.1161/CIRCINTERVENTIONS.109.913665 Eknoyan G, 2002, AM J KIDNEY DIS, V39, pS14, DOI 10.1053/ajkd.2002.30939 Grundy SM, 2002, CIRCULATION, V106, P3143, DOI 10.1161/circ.106.25.3143 Hreybe H, 2007, PACE, V30, P1262, DOI 10.1111/j.1540-8159.2007.00848.x Int Liaison Comm Resuscitation, 2005, RESUSCITATION, V67, P181, DOI 10.1016/j.resuscitation.2005.09.010 Jacobs I, 2004, CIRCULATION, V110, P3385, DOI 10.1161/01.CIR.0000147236.85306.15 KANNEL WB, 1985, J AM COLL CARDIOL, V5, pB141, DOI 10.1016/S0735-1097(85)80545-3 Larsen JM, 2012, RESUSCITATION, V83, P1427, DOI 10.1016/j.resuscitation.2012.08.337 MYERBURG RJ, 2008, BRAUNWALDS HEART DIS, P933 Nichol G, 2008, JAMA-J AM MED ASSOC, V300, P1423, DOI 10.1001/jama.300.12.1423 O'Connor RE, 2010, CIRCULATION, V122, P8422, DOI 10.1161/CIRCULATIONAHA.110.985549 REICHENBACH DD, 1977, AM J CARDIOL, V39, P865, DOI 10.1016/S0002-9149(77)80041-6 Spaulding CM, 1997, NEW ENGL J MED, V336, P1629, DOI 10.1056/NEJM199706053362302 Sunde K, 2007, RESUSCITATION, V73, P29, DOI 10.1016/j.resuscitation.2006.08.016 Thygesen K, 2012, CIRCULATION, V126, P2020, DOI 10.1161/CIR.0b013e31826e1058 Werling M, 2007, RESUSCITATION, V73, P40, DOI 10.1016/j.resuscitation.2006.08.018 Zanuttini D, 2012, AM J CARDIOL, V110, P1723, DOI 10.1016/j.amjcard.2012.08.006 Zipes DP, 1998, CIRCULATION, V98, P2334, DOI 10.1161/01.CIR.98.21.2334 NR 24 TC 14 Z9 14 U1 0 U2 2 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-2261 J9 BMC CARDIOVASC DISOR JI BMC Cardiovasc. 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PD MAR 3 PY 2014 VL 14 AR 30 DI 10.1186/1471-2261-14-30 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AF2JV UT WOS:000334539300001 PM 24580723 OA gold, Green Published DA 2023-05-13 ER PT J AU He, XN Wang, YM Cong, HL Lu, CZ Wu, J AF He, Xiaoning Wang, Yumei Cong, Hongliang Lu, Chengzhi Wu, Jing TI Impact of Optimal Medical Therapy at Discharge on One-year Direct Medical Costs in Patients with Acute Coronary Syndromes: A Retrospective, Observational Database Analysis in China SO CLINICAL THERAPEUTICS LA English DT Article DE acute coronary syndromes; China; costs; health care resource utilization; medication ID MYOCARDIAL-INFARCTION; PREDICTORS; PRESCRIPTION; ADHERENCE; OUTCOMES; REGISTRY AB Purpose: This study was conducted to examine the use of optimal medical therapy (OMT), consisting of an antiplatelet, a beta-blocker, an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB), and a statin combined, after hospital discharge and its relationship with direct medical costs in patients with acute coronary syndromes (ACS) in Tianjin, China. Methods: Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database (2011-2015). Data from adult patients with >= 1 hospitalization for ACS between January 2012 and December 2014 were included. Medications including antiplatelets, beta-blockers, ACEIs/ARBs, and statins at discharge were recorded, with OMT defined as the use of all 4 indicated medications. Propensity-score matching was conducted to form matched OMT and non-OMT cohorts based on baseline differences. All cause and ACS-related health care resource utilization and direct medical costs during a 12-month follow-up period were assessed and compared between cohorts. Generalized linear modeling was conducted to assess the association between OMT at discharge and direct medical costs. Findings: A total of 22,041 patients were identified (mean age, 64.7 [10.7] years; 45.6% female), of whom 15.1% (3336) received OMT at discharge. The OMT cohort had fewer patients hospitalized for any cause during follow-up compared with the matched non-OMT cohort (38.1% vs 43.2%; P < 0.001), which was further associated with fewer hospitalizations (1.55 vs 1.64; P = 0.019) and shorter annualized length of stay (15.9 vs 17.2 d; P = 0.041). Despite higher costs of outpatient services (9958 vs 10,060 Chinese yuan [CNY] [P = 0.006]; adjusted difference, +456 CNY [P = 0.004]) (year-2014 1 USD = 6.20 CNY), the OMT cohort had significantly lower all-cause total costs (20,771 vs 22,877 CNY [P = 0.174]; adjusted difference, -2089 CNY [P = 0.006]), driven by lower costs of inpatient services (10,813 vs 12,817 CNY [P < 0.001]; adjusted difference, -2184 CNY [P = 0.001]). The difference in ACS-related total costs between the 2 cohorts was not statistically significant (8535 vs 9304 CNY [P = 0.128]; adjusted difference, -558 CNY [P = 0.214]). Implications: Receiving OMT at discharge was associated with fewer hospitalizations and lower all cause direct medical costs in these patients with ACS in China. Strategies are needed to improve OMT prescribing rates at discharge, which would lead to better clinical prognosis and total cost-savings among patients with ACS in China. (C) 2019 Elsevier Inc. All rights reserved. C1 [He, Xiaoning; Wang, Yumei; Wu, Jing] Tianjin Univ, Sch Pharmaceut Sci & Technol, 92 Weijin Rd, Tianjin 300072, CO, Peoples R China. [Cong, Hongliang] Tianjin Chest Hosp, Tianjin, Peoples R China. [Lu, Chengzhi] Tianjin First Ctr Hosp, Tianjin, Peoples R China. C3 Tianjin University RP Wu, J (通讯作者),Tianjin Univ, Sch Pharmaceut Sci & Technol, 92 Weijin Rd, Tianjin 300072, CO, Peoples R China. EM jingwu@tju.edu.cn OI Wu, Jing/0000-0002-6012-2785 FU Sanofi China FX The study was funded by Sanofi China. The authors have indicated that they have no other conflicts of interest with regard to the content of this article. 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TI Differences in Short-Term Versus Long-Term Outcomes of Older Black Versus White Patients With Myocardial Infarction Findings From the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of American College of Cardiology/American Heart Association Guidelines (CRUSADE) SO CIRCULATION LA English DT Article DE continental population groups; healthcare disparities; myocardial infarction; patient outcome assessment ID ACUTE CORONARY SYNDROMES; RACIAL-DIFFERENCES; ETHNIC-DIFFERENCES; ELDERLY-PATIENTS; MANAGEMENT; QUALITY; CARE; REVASCULARIZATION; MORTALITY; VETERANS AB Background-Blacks are less likely than whites to receive coronary revascularization and evidence-based therapies after acute myocardial infarction, yet the impact of these differences on long-term outcomes is unknown. Methods and Results-We linked Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of American College of Cardiology/American Heart Association Guidelines (CRUSADE) registry data to national Medicare claims, creating a longitudinal record of care and outcomes among 40 500 patients with non-ST-segment- elevation myocardial infarction treated at 446 hospitals to examine mortality and readmission rates (mean follow-up, 2.4 years) among black and white patients. Relative to whites (n= 37 384), blacks (n= 3116) were more often younger and female; more often had diabetes mellitus and renal failure; and received less aggressive interventions, including cardiac catheterization (60.7% versus 54.0%; P<0.001), percutaneous coronary intervention (32.1% versus 23.8%; P<0.001), and coronary bypass surgery (9.2% versus 5.7%; P<0.001). Although blacks had lower 30-day mortality (9.1% versus 9.9%; adjusted hazard ratio, 0.80; 95% confidence interval, 0.71-0.92), they had higher observed mortality at 1 year (27.9% versus 24.5%; P<0.001), although this was not significant after adjustment on long-term follow-up (hazard ratio, 1.00; 95% confidence interval, 0.94-1.07). Black patients also had higher 30-day (23.6% versus 20.0%; P<0.001) and 1-year (62.0% versus 54.6%; P<0.001) all-cause readmission, but these differences were no longer significant after risk adjustment on 30-day (hazard ratio, 1.02; 95% confidence interval, 0.92-1.13) and long-term (hazard ratio, 1.05; 95% confidence interval, 1.00-1.11) follow-up. Conclusions-Although older blacks with an acute myocardial infarction had lower initial mortality rates than whites, this early survival advantage did not persist during long-term follow-up. The reasons for this are multifactorial but may include differences in comorbidities and postdischarge care. C1 [Mathews, Robin; Chen, Anita Y.; Thomas, Laine; Wang, Tracy Y.; Thomas, Kevin L.; Roe, Matthew T.; Peterson, Eric D.] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC 27705 USA. [Chin, Chee Tang] Natl Heart Ctr Singapore, Singapore, Singapore. C3 Duke University; National Heart Centre Singapore RP Peterson, ED (通讯作者),Duke Univ, Med Ctr, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA. EM Peter016@mc.duke.edu RI Peterson, Eric David/ABF-5033-2021 FU Millennium Pharmaceuticals; Schering-Plough Corp; Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership FX The CRUSADE registry was funded by Millennium Pharmaceuticals, Schering-Plough Corp, and the Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership. 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Norton, Sally A. Quinn, Jill R. Quill, Timothy E. TI A Place to Get Worse Perspectives on Avoiding Hospitalization From Patients With End-Stage Cardiopulmonary Disease SO JOURNAL OF HOSPICE & PALLIATIVE NURSING LA English DT Article DE cardiopulmonary disease; chronic illness; death and dying; home care; qualitative ID CHRONIC HEART-FAILURE; SEEKING MEDICAL-CARE; ELDERLY-PATIENTS; LUNG-CANCER; DELAY; SYMPTOMS; HEALTH; DIAGNOSIS; REASONS; DEATH AB Much of what is known about delay in seeking medical care has been from patients with acute coronary syndromes. Less is known about why patients living with chronic cardiopulmonary illnesses delay seeking care for worsening symptoms. The aim of this study was to describe the perspectives of patients with end-stage heart failure or chronic obstructive pulmonary disease about their timing in seeking medical care for worsening symptoms. Two semistructured interviews were conducted with 20 participants and were audio recorded and transcribed verbatim. Avoiding the hospital was the central theme among participants in this study. Returning to the hospital invoked an underlying fear, symbolizing negative things. These included a perceived hassle and setback associated with hospitalization and a fear of not returning home following another admission, either from loss of independence or death. This study sheds light on findings from previous research that delay results from the inability to recognize worsening symptoms. Participants in this study clearly recognized worsening symptoms, yet waited to seek care until it was unbearable in effort to avoid the hospital. The incorporation of palliative alongside disease-driven care within this population would alleviate symptoms, which could decrease the need for emergent care and subsequent hospitalization. C1 [Lowey, Susan E.] SUNY Coll Brockport, Brockport, NY 14420 USA. [Norton, Sally A.; Quinn, Jill R.] Univ Rochester, Sch Nursing, New York, NY USA. [Quill, Timothy E.] Univ Rochester, Sch Med & Dent, Rochester, NY USA. [Quill, Timothy E.] Strong Palliat Care, Palliat Care Div, Rochester, NY USA. C3 State University of New York (SUNY) System; State University of New York (SUNY) Brockport; University of Rochester; University of Rochester RP Lowey, SE (通讯作者),350 New Campus Dr, Brockport, NY 14420 USA. EM slowey@brockport.edu OI Norton, Sally/0000-0001-7686-6327 FU National Institutes of Health/National Institute of Nursing Research Ruth L. Kirschstein National Research Service Award [1F-31NR011125]; Sigma Theta Tau International Honor Society Small Grant [09-00832] FX This work was supported by a National Institutes of Health/National Institute of Nursing Research Ruth L. Kirschstein National Research Service Award (1F-31NR011125) and Sigma Theta Tau International Honor Society Small Grant (09-00832). 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B., 2013, SAGE, V3rd, DOI DOI 10.1080/1034912X.2016.1228856 Moser DK, 2006, CIRCULATION, V114, P168, DOI 10.1161/CIRCULATIONAHA.106.176040 Nieuwenhuis MMW, 2011, J CARD FAIL, V17, P657, DOI 10.1016/j.cardfail.2011.04.004 Patel H, 2007, EUR J HEART FAIL, V9, P702, DOI 10.1016/j.ejheart.2006.11.002 Ryan G. W., 2003, FIELD METHOD, V15, P85, DOI DOI 10.1177/1525822X02239569 Setoguchi S, 2010, AM HEART J, V160, P139, DOI 10.1016/j.ahj.2010.03.038 Stromberg A, 2008, EUR J HEART FAIL, V10, P608, DOI 10.1016/j.ejheart.2008.04.011 Tod Angela Mary, 2010, Nurs Stand, V24, P35 NR 25 TC 10 Z9 10 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1522-2179 EI 1539-0705 J9 J HOSP PALLIAT NURS JI J. Hosp. Palliat. Nurs. PD AUG PY 2014 VL 16 IS 6 BP 338 EP 345 DI 10.1097/NJH.0000000000000081 PG 8 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA AL2HA UT WOS:000338945300003 PM 25328448 OA Green Accepted DA 2023-05-13 ER PT J AU Bouisset, F Gerbaud, E Bataille, V Coste, P Puymirat, E Belle, L Delmas, C Cayla, G Motreff, P Lemesle, G Aissaoui, N Blanchard, D Schiele, F Simon, T Danchin, N Ferrieres, J AF Bouisset, Frederic Gerbaud, Edouard Bataille, Vincent Coste, Pierre Puymirat, Etienne Belle, Loic Delmas, Clement Cayla, Guillaume Motreff, Pascal Lemesle, Gilles Aissaoui, Nadia Blanchard, Didier Schiele, Francois Simon, Tabassome Danchin, Nicolas Ferrieres, Jean CA FAST MI Investigators TI Percutaneous Myocardial Revascularization in Late-Presenting Patients With STEMI SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE acute coronary syndrome; acute myocardial infarction; immortal time bias; latecomer; percutaneous coronary revascularization ID ST-SEGMENT ELEVATION; TRANSLUMINAL CORONARY ANGIOPLASTY; TISSUE-PLASMINOGEN-ACTIVATOR; COLLATERAL BLOOD-FLOW; INTENSIVE-CARE UNITS; INFARCT SIZE; MECHANICAL REPERFUSION; PREINFARCTION ANGINA; FRENCH REGISTRY; TASK-FORCE AB BACKGROUND The optimal management of patients with ST-segment elevation myocardial infarction (STEMI) presenting late->12 hours following symptom onset-is still under debate. OBJECTIVES The purpose of this study was to describe characteristics, temporal trends, and impact of revascularization in a large population of latecomer STEMI patients. METHODS The authors analyzed the data of 3 nationwide observational studies from the FAST-MI (French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction) program, conducted over a 1-month period in 2005, 2010, and 2015. Patients presenting between 12 and 48 hours after symptom onset were classified as latecomers. RESULTS A total of 6,273 STEMI patients were included in the 3 cohorts, 1,169 (18.6%) of whom were latecomers. After exclusion of patients treated with fibrinolysis and patients deceased within 2 days after admission, 1,077 patients were analyzed, of whom 729 (67.7%) were revascularized within 48 hours after hospital admission. At 30-day follow-up, all cause death rate was significantly lower among revascularized latecomers (2.1% vs 7.2%; P < 0.001). After a median follow-up of 58 months, the rate of all-cause death was 30.4 (95% CI: 25.7-35.9) per 1,000 patient-years in the revascularized latecomers group vs 78.7 (95% CI: 67.2-92.3) per 1,000 patient-years in the nonrevascularized latecomers group (P < 0.001). In multivariate analysis, revascularization of latecomer STEMI patients was independently associated with a significant reduction of mortality occurrence during follow-up (HR: 0.65 [95% CI: 0.50-0.84]; P = 0.001). CONCLUSIONS Coronary revascularization of latecomer STEMI patients is associated with better short and long-term clinical outcomes. (C) 2021 by the American College of Cardiology Foundation. C1 [Bouisset, Frederic; Bataille, Vincent; Delmas, Clement; Ferrieres, Jean] Toulouse Rangueil Univ Hosp, Dept Cardiol, INSERM, UMR 1295, Toulouse, France. [Gerbaud, Edouard; Coste, Pierre] Hop Cardiol Haut Leveque, Cardiol Intens Care Unit & Intervent Cardiol, Pessac, France. [Bataille, Vincent] Associat Diffus Med Prevent, Toulouse, France. [Puymirat, Etienne; Danchin, Nicolas] Univ Paris 05, Hop Europeen Georges Pompidou, AP HP, Dept Cardiol,INSERM U 970, Paris, France. [Belle, Loic] Ctr Hosp Annecy Genevois, Dept Cardiol, Epagny Metz Tessy, France. [Cayla, Guillaume] Univ Montpellier, CHU Nimes, Nimes, France. [Motreff, Pascal] Auvergne Univ, Univ Hosp Clermont Ferrand, Dept Cardiol, UMR 6284, Clermont Ferrand, France. [Lemesle, Gilles] Lille Reg Univ Hosp, Dept Cardiol, Lille, France. [Aissaoui, Nadia] Hop Europeen Georges Pompidou, AP HP, Dept Crit Care, Paris, France. [Blanchard, Didier] Clin St Gatien, Tours, France. [Schiele, Francois] Univ Hosp Jean Minjoz, Dept Cardiol, Besancon, France. [Simon, Tabassome] Hop St Antoine, AP HP, Dept Clin Pharmacol, Paris, France. [Simon, Tabassome] Univ Pierre & Marie Curie UPMCParis 06, INSERM U698, Unite Rech Clin, Paris, France. C3 CHU de Toulouse; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Toulouse; Universite Toulouse III - Paul Sabatier; CHU Bordeaux; UDICE-French Research Universities; Universite de Bordeaux; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Europeen Georges-Pompidou - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Centre Hospitalier Annecy Genevois; Universite de Montpellier; CHU de Nimes; CHU Clermont Ferrand; Universite Clermont Auvergne (UCA); Universite de Lille - ISITE; CHU Lille; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Europeen Georges-Pompidou - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Universite de Franche-Comte; CHU Besancon; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm) RP Ferrieres, J (通讯作者),Toulouse Rangueil Univ Hosp, Dept Cardiol, INSERM, UMR 1295, Toulouse, France. EM jean.ferrieres@univ-tlse3.fr OI Bataille, Vincent/0000-0002-5780-2333 FU Amgen; AstraZeneca; Bayer; Bristol Myers Squibb; Boehringer Ingelheim; Daiichi Sankyo; Eli Lilly; Merck Sharpand Dohme; Pfizer; Sanofi; Boston Sci-entific; Medtronic; Abbott; Biotronik; Maquet; Abiomed; Terumo; GlaxoSmithKline; Novartis; Akcea; Amarin; Servier FX The French Society of Cardiology received grants for supporting the FAST-MI program from Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Merck Sharpand Dohme, Pfizer, and Sanofi. None of the companies had a role in the design and conduct of the study, data collection, and manage-ment. They were not involved in the analysis and interpretation of the data, nor in the preparation, review, or approval of the manu-script. Dr Bouisset has received personal fees from Merck Sharp and Dohme, Abbott, Bayer, B-Braun, and Amgen. Dr Gerbaud has served as a consultant for Terumo. Prof Coste has received personal fees from Amgen, Sanofi, Servier, AstraZeneca, and Abiomed. Prof Puy-mi rat has received fees for lectures and/or consulting from Amgen, AstraZeneca, Bayer, Biotronik, Bristol Myers Squibb, Boehringer Ingelheim, Daiichi Sankyo, Lilly, Merck Sharp and Dohme, The Medicine Company, Sanofi, St Jude Medical, Servier, and Siemens. Dr Belle has received unrestricted grants for research from Boston Sci-entific, Medtronic, Abbott, and Biotronik; and has received speaker fees from and served as a consultant for AstraZeneca and Merck Sharp and Dohme. Dr Delmas has received consulting fees from Boston Scientific; has received grants/research support from Maquet, Abiomed, Abbott, and Terumo; and has received lecture fees from Abiomed, Thoratec, and Abbott. Prof Cayla has received speaker or congress fees and research grants/consultant fees/lectures fees from Amgen, AstraZeneca, Abbott, Bayer, Biotronik, Bristol Myers Squibb, Pfizer, and Sanofi-Aventis. Prof Motreff has received consulting fees from Terumo and Abbott Medical. Prof Lemesle has received personal fees from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Merck Sharp and Dohme, Daiichi-Sankyo, Lilly, Mylan, Novartis, Novo Nordisk, Pfizer, Sanofi Aventis, and Servier. Prof Schiele has received personal fees from Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Merck Sharp and Dohme, Pfizer, and Sanofi. Prof Simon has received grants from AstraZeneca, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Merck Sharp and Dohme, Novartis, and Sanofi; and has received personal fees for board membership and/or consultancy and/or lectures from AstraZeneca, Bristol Myers Squibb, Sanofi, and Novartis. Prof Danchin has received grants, speaker fees, consulting fees, or nonfinancial support from Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Intercept, Novo-Nordisk, Pfizer, Sanofi, and Servier. Prof Ferrieres has received grants and personal fees from Akcea, Amarin, Amgen, Merck Sharp and Dohme, Sanofi, and Servier. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. 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Am. Coll. Cardiol. PD SEP 28 PY 2021 VL 78 IS 13 BP 1291 EP 1305 DI 10.1016/j.jacc.2021.07.039 EA SEP 2021 PG 15 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA US8MY UT WOS:000697681100005 PM 34556314 OA Bronze DA 2023-05-13 ER PT J AU Romano, M AF Romano, Massimo TI Facilitating supportive care in cardiac intensive care units SO CURRENT OPINION IN SUPPORTIVE AND PALLIATIVE CARE LA English DT Review DE advance care planning; cardiac intensive care unit; end of life; heart failure; palliative care ID PALLIATIVE CARE; DECISION-MAKING; EDITORS CHOICE; LIFE; END; ASSOCIATION; DEFINITION; ILLNESS AB Purpose of review The number of patients who die in the hospital in the Western world is high, and 20-30% of them are admitted to an ICU in the last month of life, including those in cardiac ICUs (CICUs) where invasive procedures are performed and mortality is high. Palliative consultation is provided in only a few cases. The ethical and decisional aspects associated with the advanced stages of illness are very rarely discussed. Recent findings The epidemiological and clinical landscape of CICUs has changed in the last decade; the incidence of acute coronary syndromes has decreased, whereas noncardiovascular diseases, comorbidities, the patients' age and clinical and therapeutic complexity have increased. The use of advanced and invasive treatments, such as mechanical ventilation, mechanical circulatory support and renal replacement therapies, has increased. This evolution increases the possibility of developing a life-threatening clinical event. Summary This review aimed to analyze the main epidemiological, clinical, ethical and training aspects that can facilitate the introduction of supportive/palliative care programs in the CICU to improve symptom management during the advanced/terminal stages of illness, and address such issues as advance care planning, withdrawing/withholding life-sustaining treatments, deactivation of implantable defibrillators and palliative sedation. C1 [Romano, Massimo] Univ Milan, Interdept Univ Res Ctr Palliat Care, Via Ambrogio Alciati 11, I-20146 Milan, Italy. C3 University of Milan RP Romano, M (通讯作者),Univ Milan, Interdept Univ Res Ctr Palliat Care, Via Ambrogio Alciati 11, I-20146 Milan, Italy. EM max.romano51@gmail.com RI Romano', Massimo/GLR-3417-2022 CR Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 Berg DD, 2019, CIRC-CARDIOVASC QUAL, V12, DOI 10.1161/CIRCOUTCOMES.119.005618 Bohula EA, 2019, JAMA CARDIOL, V4, P928, DOI 10.1001/jamacardio.2019.2467 Bonnefoy-Cudraz E, 2018, EUR HEART J-ACUTE CA, V7, P80, DOI 10.1177/2048872617724269 Brusca SB, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011721 Caulley L, 2018, NEW ENGL J MED, V378, P2339, DOI 10.1056/NEJMclde1800817 Chuzi S, 2019, J PAIN SYMPTOM MANAG, V57, P100, DOI 10.1016/j.jpainsymman.2018.09.023 Crousillat DR, 2018, J AM COLL CARDIOL, V71, P1391, DOI 10.1016/j.jacc.2018.02.019 Garetto F, 2018, CNS DRUGS, V32, P951, DOI 10.1007/s40263-018-0576-7 Geller BJ, 2018, J AM COLL CARDIOL, V72, P1171, DOI 10.1016/j.jacc.2018.07.024 Goldfarb M, 2019, J INTENSIVE CARE MED, V34, P537, DOI 10.1177/0885066617741873 Gristina GR, 2018, MINERVA ANESTESIOL, V84, P756, DOI 10.23736/S0375-9393.18.12299-1 Guidet B, 2018, INTENS CARE MED, V44, P1598, DOI 10.1007/s00134-018-5312-8 Hill Andrea D, 2019, CMAJ Open, V7, pE306, DOI 10.9778/cmajo.20180097 Hillman K, 2018, CURR OPIN CRIT CARE, V24, P415, DOI 10.1097/MCC.0000000000000529 James Fiona R, 2018, J Intensive Care Soc, V19, P247, DOI 10.1177/1751143717746566 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2018, AM J CARDIOL, V122, P1773, DOI 10.1016/j.amjcard.2018.08.011 Jentzer JC, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008169 Katz JN, 2016, J AM COLL CARDIOL, V68, P67, DOI 10.1016/j.jacc.2016.04.036 Kjedsen CL, 2018, NURS CRIT CARE, V23, P75 Maciver J, 2018, CURR OPIN CARDIOL, V33, P202, DOI 10.1097/HCO.0000000000000484 Nakagawa S, 2018, J PALLIAT MED, V21, P1284, DOI 10.1089/jpm.2018.0112 Nakagawa S, 2019, J PALLIAT MED, V22, P432, DOI 10.1089/jpm.2018.0393 Paladino J, 2019, JAMA-J AM MED ASSOC, V322, P1345, DOI 10.1001/jama.2019.11533 Pomare C, 2019, J EVAL CLIN PRACT, V25, P176, DOI 10.1111/jep.13079 Rietjens Judith A C, 2017, Lancet Oncol, V18, pe543, DOI 10.1016/S1470-2045(17)30582-X Salomon S, 2018, J PAIN SYMPTOM MANAG, V55, P1350, DOI 10.1016/j.jpainsymman.2017.12.490 Sathitratanacheewin S, 2018, J PAIN SYMPTOM MANAG, V55, P75, DOI 10.1016/j.jpainsymman.2017.08.032 Sobanski PZ, 2020, CARDIOVASC RES, V116, P12, DOI 10.1093/cvr/cvz200 Sulmasy DP, 2018, THEOR MED BIOETH, V39, P171, DOI 10.1007/s11017-018-9441-4 Taylor DR, 2018, POSTGRAD MED J, V94, P238, DOI 10.1136/postgradmedj-2018-135581 Teno JM, 2018, JAMA-J AM MED ASSOC, V320, P264, DOI 10.1001/jama.2018.8981 Trussler A, 2019, AM J CARDIOL, V124, P1064, DOI 10.1016/j.amjcard.2019.07.007 Vallabhajosyula S, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.011954 Warraich HJ, 2019, J AM COLL CARDIOL, V74, P591, DOI 10.1016/j.jacc.2019.05.038 Warraich HJ, 2019, JAMA NETW OPEN, V2, DOI 10.1001/jamanetworkopen.2019.2375 Watson R.A., 2018, EUR HEART J-ACUTE CA, DOI 10.1177/2048872618789053 Wordingham Sara E, 2019, AMA J Ethics, V21, pE435, DOI 10.1001/amajethics.2019.435 NR 39 TC 3 Z9 3 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1751-4258 EI 1751-4266 J9 CURR OPIN SUPPORT PA JI Curr. Opin Support Palliat. Car. PD MAR PY 2020 VL 14 IS 1 BP 19 EP 24 DI 10.1097/SPC.0000000000000479 PG 6 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA MT9RB UT WOS:000555304200004 PM 31815767 DA 2023-05-13 ER PT J AU Hochman, DM Feinstein, RE Stauter, EC AF Hochman, Daniel M. Feinstein, Robert E. Stauter, Erinn C. TI An Office-Based Approach to Emotional and Behavioral Risk Factor Reduction for Cardiovascular Disease SO CARDIOLOGY IN REVIEW LA English DT Review DE cardiovascular disease; behavior; risk factors ID CORONARY-HEART-DISEASE; ACUTE MYOCARDIAL-INFARCTION; ALCOHOL-CONSUMPTION; PHYSICAL-ACTIVITY; PRIMARY-CARE; PROGNOSTIC ASSOCIATION; METABOLIC SYNDROME; 52 COUNTRIES; WEIGHT-LOSS; MORTALITY AB There are many psychological risk factors for cardiovascular disease, and the ability to reduce mortality depends on an ability to integrate care of these risk factors with traditional Framingham cardiovascular risk and use them both in routine practice. The aim of this article is to provide an update of all the major emotional and behavioral cardiovascular risk factors along with a practical treatment model for implementation. First, we provide a review of major emotional and behavioral cardiovascular risk factors, the associated primary effect, and proposed mechanism of action. Second, we provide an office-based approach to cardiovascular risk factor reduction and methods of reducing barriers to implementation, called Prevention Oriented Primary Care-Abridged. The approach integrates several forms of detection, assessment using the 3As (ask, assess, assist), and Stages of Change approaches, and subsequent efficient and targeted treatment with either Motivational Interviewing or further office intervention. A case example is provided to help illustrate this process. C1 [Hochman, Daniel M.; Feinstein, Robert E.] Univ Colorado, Dept Psychiat, Denver Sch Med, Aurora, CO 80045 USA. [Stauter, Erinn C.] Mental Hlth Ctr Denver, Aurora, CO USA. C3 University of Colorado System; University of Colorado Anschutz Medical Campus RP Hochman, DM (通讯作者),Univ Colorado, Dept Psychiat, 13001 East 17th Pl,Room W2174,Mail Stop F546, Aurora, CO 80045 USA. 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PD SEP-OCT PY 2013 VL 21 IS 5 BP 213 EP 221 DI 10.1097/CRD.0b013e3182918f57 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA 202GJ UT WOS:000323201800001 PM 23535528 DA 2023-05-13 ER PT J AU de Grandsaigne, HT Bouisset, F Porterie, J Biendel, C Marcheix, B Lairez, O Labaste, F Elbaz, M Galinier, M Delmas, C AF Treille de Grandsaigne, Henri Bouisset, Frederic Porterie, Jean Biendel, Caroline Marcheix, Bertrand Lairez, Olivier Labaste, Francois Elbaz, Meyer Galinier, Michel Delmas, Clement TI Incidence, management, and prognosis of post-ischaemic ventricular septal defect: Insights from a 12-year tertiary centre experience SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Article DE acute cardiac care; acute coronary syndrome; mortality; complication; epidemiology ID EXTRACORPOREAL MEMBRANE-OXYGENATION; ACUTE MYOCARDIAL-INFARCTION; MECHANICAL COMPLICATIONS; OUTCOMES AB BackgroundAmong mechanical complications of acute myocardial infarction, ventricular septal defect (VSD) is uncommon but still serious. The evolution of emergency coronary revascularisation paradoxically decreased our knowledge of this disease, making it even rarer. AimTo describe ischaemic VSD incidence, management, and associated in-hospital and 1-year outcomes over a 12-years period. MethodsA retrospective single-centre register of patients managed for ischaemic VSD between January 2009 and December 2020. ResultsNinety-seven patients were included representing 8 patients/ years and an incidence of 0.44% of ACS managed. The majority of the patients were 73-years-old males (n = 54, 56%) with STEMI presentation (n = 75, 79%) and already presented with Q necrosis on ECG (n = 70, 74%). Forty-nine (51%) patients underwent PCI, 60 (62%) inotrope/vasopressors infusion, and 70 (72%) acute mechanical circulatory support (IABP 62%, ECMO 13%, and Impella (R) 3%). VSD surgical repair was performed for 44 patients (45%) and 1 patient was transplanted. In-hospital mortality was 71%, and 86% at 1 year, without significant improvement over the decade. Surgery appears to be a protective factor [0.51 (0.28-0.94) p = 0.003], whereas age [1.06 (1.03-1.09), p < 0.001] and lactate [1.16 (1.09-1.23), p < 0.001] were linked to higher 1-year mortality. None of the patients that were managed medically survived 1 year. ConclusionPost-ischaemic VSD is a rare but serious complication still associated with high mortality. Corrective surgery is associated with better survival, however, timing, patient selection, and a place for mechanical circulatory support need to be defined. C1 [Treille de Grandsaigne, Henri; Biendel, Caroline; Galinier, Michel; Delmas, Clement] Rangueil Univ Hosp, Intens Cardiac Care Unit, Toulouse, France. [Treille de Grandsaigne, Henri; Bouisset, Frederic; Biendel, Caroline; Lairez, Olivier; Elbaz, Meyer; Galinier, Michel; Delmas, Clement] Rangueil Univ Hosp, Cardiol Dept, Toulouse, France. [Porterie, Jean; Marcheix, Bertrand] Rangueil Univ Hosp, Cardiovasc Surg Dept, Toulouse, France. [Labaste, Francois] Rangueil Univ Hosp, Dept Anesthesiol, Intens Care Med & Perioperat Med, Toulouse, France. C3 CHU de Toulouse; Universite de Toulouse; Universite Toulouse III - Paul Sabatier; CHU de Toulouse; Universite de Toulouse; Universite Toulouse III - Paul Sabatier; CHU de Toulouse; Universite de Toulouse; Universite Toulouse III - Paul Sabatier; CHU de Toulouse; Universite de Toulouse; Universite Toulouse III - Paul Sabatier RP Delmas, C (通讯作者),Rangueil Univ Hosp, Intens Cardiac Care Unit, Toulouse, France.; Delmas, C (通讯作者),Rangueil Univ Hosp, Cardiol Dept, Toulouse, France. 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Cardiovasc. Med. PD DEC 6 PY 2022 VL 9 AR 1066308 DI 10.3389/fcvm.2022.1066308 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 7C5CC UT WOS:000899829800001 PM 36561773 OA gold, Green Published DA 2023-05-13 ER PT J AU Alghamdi, A Alotaibi, A Alharbi, M Reynard, C Body, R AF Alghamdi, Abdulrhman Alotaibi, Ahmed Alharbi, Meshal Reynard, Charles Body, Richard TI Diagnostic Performance of Prehospital Point-of-Care Troponin Tests to Rule Out Acute Myocardial Infarction: A Systematic Review SO PREHOSPITAL AND DISASTER MEDICINE LA English DT Review DE biomarkers; chest pain; myocardial infarction; paramedic ID ACUTE CORONARY SYNDROME; ACUTE CHEST-PAIN; BIOCHEMICAL MARKERS; HOSPITAL ADMISSION; DAMAGE PRIOR; INTEGRATION; SUSPICION; OUTCOMES; TRIAGE AB Introduction: Chest pain is one of the most common reasons for 999 calls and transfers to the emergency department (ED). In these patients, acute myocardial infarction (AMI) is often the diagnosis that clinicians are seeking to exclude. However, only a minority of those patients have AMI, causing a substantial financial burden to health services. Cardiac troponin (cTn) is the reference standard biomarker for the diagnosis of AMI. Several commercially available point-of-care (POC) cTn assays are portable and could feasibly be used in an ambulance. The aim of this paper is to systematically review existing evidence for the use of POC cTn assays in the prehospital setting to rule out AMI. Methods: A systematic search was conducted on EMBASE, MEDLINE, and CINAHL Plus databases, reference lists, and relevant grey literature, including combinations of the relevant terms. Papers published in English language since the year 2000 were eligible for inclusion. A narrative synthesis of the evidence was then undertaken. Results: The initial search and cross-referencing revealed a total of 350 papers, of which 243 were excluded. Seven papers were included in the systematic literature review. Conclusion: Current evidence does not support the use of POC troponin assays to exclude AMI due to issues with diagnostic accuracy and insufficient high-quality evidence. C1 [Alghamdi, Abdulrhman; Alotaibi, Ahmed; Reynard, Charles; Body, Richard] Univ Manchester, Div Cardiovasc Sci, 46 Grafton St, Manchester M13 9PL, Lancs, England. [Alghamdi, Abdulrhman; Alotaibi, Ahmed; Alharbi, Meshal] King Saud bin Abdulaziz Univ Hlth Sci, Coll Appl Med Sci, Riyadh, Saudi Arabia. [Alharbi, Meshal] Univ Leicester, Div Cardiovasc Sci, Leicester, Leics, England. [Reynard, Charles; Body, Richard] Manchester Univ NHS Fdn Trust, Emergency Dept, Manchester, Lancs, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; King Saud Bin Abdulaziz University for Health Sciences; RLUK- Research Libraries UK; University of Leicester RP Alghamdi, A (通讯作者),Univ Manchester, Div Cardiovasc Sci, 46 Grafton St, Manchester M13 9PL, Lancs, England. EM ghamdia@ksau-hs.edu.sa RI Body, Richard/C-2736-2010; Alghamdi, Abdulrhman/AAM-9278-2020 OI Body, Richard/0000-0001-9089-8130; Alghamdi, Abdulrhman/0000-0002-8292-5212; Reynard, Charles/0000-0002-7534-2668 FU Abbott Point of Care (Priceton, New Jersey USA) FX Abdulrhman Alghamdi and Richard Body received funding from Abbott Point of Care (Priceton, New Jersey USA) and donation of reagents from Roche Diagnostics International Ltd. (Risch-Rotkreuz, Switzerland) and LumiraDx (Waltham, Massachusetts USA) for another research project. Richard Body received speaker fees from Singulex (Alameda, California USA), Roche (consultancy and research grant), Abbott Point of Care (speaker fee and research grant), FABPulous BV (Netherlands; consultancy), and Alere (Waltham, Massachusetts USA; donation of reagents for research). 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PD OCT PY 2020 VL 35 IS 5 BP 567 EP 573 AR PII S1049023X20000850 DI 10.1017/S1049023X20000850 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA NK8HH UT WOS:000566971400016 PM 32641173 OA Green Submitted DA 2023-05-13 ER PT J AU Chao, CT Wang, J Wu, HY Huang, JW Chien, KL AF Chao, Chia-Ter Wang, Jui Wu, Hon-Yen Huang, Jenq-Wen Chien, Kuo-Liong TI Age modifies the risk factor profiles for acute kidney injury among recently diagnosed type 2 diabetic patients: a population-based study SO GEROSCIENCE LA English DT Article DE Acute kidney injury; Diabetes mellitus; Geriatrics; Risk factors ID PERCUTANEOUS CORONARY INTERVENTION; ACUTE-RENAL-FAILURE; ESTIMATED GFR; OLDER-ADULTS; ASSOCIATION; METFORMIN; DISEASE; CARE; CLASSIFICATION; METAANALYSIS AB The incidence of acute kidney injury (AKI) rises with age and is associated with multiple risk factors. Here, we compared the risk factors for AKI between younger and older incident diabetic patients to examine the trends in risk alteration for individual factors across different age groups. Between 2007 and 2013, we selected all incident type 2 diabetic adults from the Taiwan National Health Insurance registry, stratified based on age: young (< 65 years), old (>= 65 but < 75 years), and older-old (>= 75 years). All factors with potential renal influence (e.g., comorbidities, medications, and diagnostics/procedures) were recorded during the study period, with a nested case-controlled approach utilized to identify independent risk factors for AKI in each age group. Totally, 930,709 type 2 diabetic patients were categorized as young (68.7%), old (17.7%), or older-old (13.6%). Older-old patients showed a significantly higher incidence of AKI than the old and the young groups. Cardiovascular morbidities (hypertension, atrial fibrillation, acute coronary syndrome, and cerebrovascular disease) were shown to increase the risk of AKI, although the risk declined with increasing age. Chronic obstructive pulmonary disease and receiving cardiac catheterization elevated the risk of AKI preferentially in the older-old/old and older-old group, respectively, while the administration of angiotensin-converting enzyme/alpha-blocker and angiotensin receptor blocker/calcium channel blocker reduced the risk of AKI preferentially in the older-old and older-old/old group, respectively. In conclusion, our findings highlight the importance of devising age-specific risk factor panels for AKI in patients with recently diagnosed type 2 diabetes. C1 [Chao, Chia-Ter] Natl Taiwan Univ Hosp, Dept Med, BeiHu Branch, Taipei, Taiwan. [Chao, Chia-Ter] Natl Taiwan Univ Hosp, Dept Med, Jin Shan Branch, New Taipei, Taiwan. [Chao, Chia-Ter] Natl Taiwan Univ, Sch Med, Grad Inst Toxicol, Taipei, Taiwan. [Chao, Chia-Ter; Wu, Hon-Yen; Huang, Jenq-Wen] Natl Taiwan Univ Hosp & Coll Med, Dept Internal Med, Taipei, Taiwan. [Chao, Chia-Ter] Natl Taiwan Univ Hosp, Geriatr & Community Med Res Ctr, BeiHu Branch, Taipei, Taiwan. [Wang, Jui; Wu, Hon-Yen; Chien, Kuo-Liong] Natl Taiwan Univ, Coll Publ Hlth, Inst Epidemiol & Prevent Med, 17 Xu Zhou Rd, Taipei 100, Taiwan. [Wu, Hon-Yen] Far Eastern Mem Hosp, New Taipei, Taiwan. C3 National Taiwan University; National Taiwan University Hospital; National Taiwan University; National Taiwan University Hospital; National Taiwan University; National Taiwan University; National Taiwan University Hospital; National Taiwan University; National Taiwan University Hospital; National Taiwan University; Far Eastern Memorial Hospital RP Chien, KL (通讯作者),Natl Taiwan Univ, Coll Publ Hlth, Inst Epidemiol & Prevent Med, 17 Xu Zhou Rd, Taipei 100, Taiwan. EM klchien@ntu.edu.tw RI Chao, Chia-Ter/H-7994-2019 OI Chao, Chia-Ter/0000-0003-2892-7986; Wang, Jui/0000-0003-4800-5276; HUANG, JENQ-WEN/0000-0001-8011-2317 FU National Taiwan University Hospital BeiHu branch FX The study is financially sponsored by National Taiwan University Hospital BeiHu branch. 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Therefore, the aim of this study was to describe the healthcare resource use and calculate direct healthcare costs for TS, from hospitalisation to 6 months after discharge, and explore the distribution of costs between TS and other diagnoses among patients with TS. Method, participants and setting Cohort study investigating direct healthcare costs from hospitalisation, open specialised outpatient and primary care. Healthcare resource use during 6 months after diagnosis with TS was collected for 58 consecutive patients from the Regional Patient Register. Incidence-based direct healthcare costs, in 2015 values, were calculated using diagnosis-related group weights and unit costs from national statistics on healthcare costs. Results The mean length of hospital stay was 10.2 days, index 6.4 and re-admissions 3.8 days. The mean number of follow-up encounters per patient was 15.6, of which two-thirds was specialised outpatient and onethird was primary care. This resulted in an average cost of (sic)10 360. Of this, costs of (sic)8026 (77.5%) occurred during encounters for which at least one of the registered conditions was cardiovascular. Costs differed little according to background characteristics. Conclusion This study shows that patients utilise hospital, specialised outpatient and primary care after discharge for TS. Most direct healthcare costs relate to cardiac diagnoses. Patients with TS would probably benefit from a supportive follow-up programme after discharge from hospital. C1 [Wallstrom, Sara; Ekman, Inger; Ulin, Kerstin; Gyllensten, Hanna] Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden. [Wallstrom, Sara; Ekman, Inger; Ulin, Kerstin; Gyllensten, Hanna] Univ Gothenburg, Sahlgrenska Acad, Ctr Person Ctr Care, Gothenburg, Sweden. [Omerovic, Elmir] Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden. [Omerovic, Elmir] Univ Gothenburg, Sahlgrenska Acad, Dept Mol & Clin Med, Gothenburg, Sweden. C3 University of Gothenburg; University of Gothenburg; Sahlgrenska University Hospital; University of Gothenburg RP Wallstrom, S (通讯作者),Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden.; Wallstrom, S (通讯作者),Univ Gothenburg, Sahlgrenska Acad, Ctr Person Ctr Care, Gothenburg, Sweden. EM sara.wallstrom@gu.se RI Gyllensten, Hanna/H-7378-2016 OI Gyllensten, Hanna/0000-0001-6890-5162; Wallstrom, Sara/0000-0001-7579-4974 FU Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden; Swedish Government's grant for Strategic Research Areas, Care Sciences (Application to Swedish Research Council) [2009-1088]; University of Gothenburg, Sweden; Swedish Heart and Lung Association [E093/13, E088/14, E127/15]; Emelle Fund [161/14]; Royal and Hvitfeldtska Foundation FX This work was supported by the Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden. GPCC is funded by the Swedish Government's grant for Strategic Research Areas, Care Sciences (Application to Swedish Research Council No. 2009-1088) and co-funded by the University of Gothenburg, Sweden. It was also supported in accordance to the Swedish agreement between the government and the county councils concerning economic support for providing an infrastructure for research and education of doctors (ALF). Swedish Heart and Lung Association (E093/13, E088/14 and E127/15), the Emelle Fund (161/14) and, Royal and Hvitfeldtska Foundation also contributed to the funding of the study. 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The rationale of this study was to determine the importance of 1st set of Troponin I in relation to age, duration of chest pain and left ventricular ejection fraction (LVEF) in patients presenting with acute ST elevation myocardial infarction along with the treatment protocol followed in emergency. It was a cross sectional prospective observational study which was conducted at a tertiary care hospital, at the Cardiology department for a period of 12 months. All patients regardless of gender, aged between 30-80 years with co-morbidities were included presenting with acute STEMI. A total of 150 patients were included in this study with a mean age of 61.2 +/- 10.3 years out of which males were (71%). Around 61% of the people presented to emergency >12 hours after onset of chest pain. There was non-significant difference in the treatment protocol given to all patients. For statistical analysis SPSS 21 was applied and significant relationship was observed between age, duration of chest pain and LVEF (p value <0.05). It was seen in our population that people older than 50 years tend to present to emergency department late with chest pain symptoms which results in a linear rising relationship with Troponin I and with increasing Troponin I there was significant reduction seen in LVEF. C1 [Sheikh, Kaleem Ullah; Sarfaraz, Abeer] Liaquat Natl Hosp & Med Coll, Karachi, Pakistan. [Sarfaraz, Sana; Ikram, Rahela] Univ Karachi, Fac Pharm & Pharmaceut Sci, Dept Pharmacol, Karachi, Pakistan. [Bano, Tanveer] Jinnah Univ Women, Karachi, Pakistan. C3 University of Karachi RP Sarfaraz, A (通讯作者),Liaquat Natl Hosp & Med Coll, Karachi, Pakistan. 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PD NOV PY 2020 VL 33 IS 6 SU S BP 2793 EP 2799 DI 10.36721/PJPS.2020.33.6.SUP.2793-2799.1 PG 7 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA RE6WH UT WOS:000634291200012 PM 33879439 DA 2023-05-13 ER PT J AU Boccara, F Lang, S Meuleman, C Ederhy, S Mary-Krause, M Costagliola, D Capeau, J Cohen, A AF Boccara, Franck Lang, Sylvie Meuleman, Catherine Ederhy, Stephane Mary-Krause, Murielle Costagliola, Dominique Capeau, Jacqueline Cohen, Ariel TI HIV and Coronary Heart Disease Time for a Better Understanding SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE atherosclerosis; chronic inflammation; coronar heart disease; human immunodeficiency virus; immune activation ID HUMAN-IMMUNODEFICIENCY-VIRUS; ACUTE MYOCARDIAL-INFARCTION; ACTIVE ANTIRETROVIRAL THERAPY; INTIMA-MEDIA THICKNESS; CLINICAL-TRIALS GROUP; C-REACTIVE PROTEIN; INFECTED PATIENTS; ARTERY-DISEASE; CARDIOVASCULAR-DISEASE; GENERAL-POPULATION AB Cardiovascular disease, and particularly coronary heart disease, is an emerging area of concern in the HIV population. Since the advent of efficient antiretroviral therapies and the consequent longer patient life span, an increased risk for myocardial infarction has been observed in HIV-infected patients compared with the general population in Western countries. The pathophysiology of this accelerated atherosclerotic process is complex and multifactorial. Traditional cardiovascular risk factors-overrepresented in the HIV population-associated with uncontrolled viral replication and exposure to antiretroviral drugs (per se or through lipid and glucose disturbances) could promote acute ischemic events. Thus, despite successful antiviral therapy, numerous studies suggest a role of chronic inflammation, together with immune activation, that could lead to vascular dysfunction and atherothrombosis. It is time for physicians to prevent coronary heart disease in this high-risk population through the use of tools employed in the general population. Moreover, the lower median age at which acute coronary syndromes occur in HIV-infected patients should shift prevention to include patients <45 years of age. Available cardiovascular risk scores in the general population usually fail to screen young patients at risk for myocardial infarction. Moreover, the novel vascular risk factors identified in HIV-related atherosclerosis, such as chronic inflammation, immune activation, and some antiretroviral agents, are not taken into account in the available risk scores, leading to underestimation of cardiovascular risk in the HIV population. Cardiovascular prevention in HIV-infected patients is a challenge for both cardiologists and physicians involved in HIV care. We require new tools to assess this higher risk and studies to determine whether intensive primary prevention is warranted. (J Am Coll Cardiol 2013; 61: 511-23) (C) 2013 by the American College of Cardiology Foundation C1 [Boccara, Franck; Lang, Sylvie; Meuleman, Catherine; Ederhy, Stephane; Cohen, Ariel] Univ Paris, St Antoine Hosp, Dept Cardiol, F-75252 Paris, France. [Boccara, Franck; Capeau, Jacqueline] Univ Paris, Coll Med, INSERM, F-75252 Paris, France. [Mary-Krause, Murielle; Costagliola, Dominique] INSERM, Paris, France. [Mary-Krause, Murielle; Costagliola, Dominique] Univ Paris, Coll Med, F-75252 Paris, France. C3 UDICE-French Research Universities; Sorbonne Universite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Cite RP Cohen, A (通讯作者),St Antoine Univ Hosp, Dept Cardiol, 184 Rue Faubourg St Antoine, F-75571 Paris 12, France. EM franck.boccara@sat.aphp.fr; ariel.cohen@sat.aphp.fr RI Lang, Sylvie/B-8989-2013; Costagliola, Dominique/H-5849-2011 OI Costagliola, Dominique/0000-0003-0765-0869; ederhy, stephane/0000-0002-0792-2521 FU Abbott; Boehringer-Ingelheim; Bristol-Myers Squibb; Gilead Sciences; GlaxoSmithKline; Janssen-Cilag; Merck-Sharpe Dohme-Chibret; Roche FX Dr. Costagliola reports that he is a consultant to Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Janssen-Cilag, Merck-Sharpe & Dohme-Chibret, and Roche; has received research grant support from Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Janssen-Cilag, Merck-Sharpe & Dohme-Chibret, and Roche; and speaker's fees and lecture payments from Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Janssen-Cilag, Merck-Sharpe & Dohme-Chibret, and Roche; and has received payment for the development of educational presentations from Bristol-Myers Squibb. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. 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Am. Coll. Cardiol. PD FEB 5 PY 2013 VL 61 IS 5 BP 511 EP 523 DI 10.1016/j.jacc.2012.06.063 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 086BZ UT WOS:000314659300002 PM 23369416 DA 2023-05-13 ER PT J AU Heidlebaugh, M Kurz, MC Turkelson, CL Sawyer, KN AF Heidlebaugh, Michael Kurz, Michael C. Turkelson, Carman L. Sawyer, Kelly N. TI Full Neurologic Recovery and Return of Spontaneous Circulation Following Prolonged Cardiac Arrest Facilitated by Percutaneous Left Ventricular Assist Device SO THERAPEUTIC HYPOTHERMIA AND TEMPERATURE MANAGEMENT LA English DT Article ID EXTRACORPOREAL LIFE-SUPPORT; ACUTE MYOCARDIAL-INFARCTION; INTRAAORTIC BALLOON PUMP; EMERGENCY CARDIOPULMONARY BYPASS; CORONARY PERFUSION-PRESSURE; RANDOMIZED CLINICAL-TRIAL; CARDIOGENIC-SHOCK; CARDIOVASCULAR CARE; IMPELLA 2.5; RESUSCITATION AB Sudden cardiac arrest is associated with high early mortality, which is largely related to postcardiac arrest syndrome characterized by an acute but often transient decrease in left ventricular (LV) function. The stunned LV provides poor cardiac output, which compounds the initial global insult from hypoperfusion. If employed early, an LV assist device (LVAD) may improve survival and neurologic outcome; however, traditional methods of augmenting LV function have significant drawbacks, limiting their usefulness in the periarrest period. Full cardiac support with cardiopulmonary bypass is not always readily available but is increasingly being studied as a tool to intensify resuscitation. There have been no controlled trials studying the early use of percutaneous LVADs (pLVADs) in pericardiac arrest patients or intra-arrest as a bridge to return of spontaneous circulation. This article presents a case study and discussion of a patient who arrested while undergoing an elective coronary angioplasty and suffered prolonged cardiopulmonary resuscitation. During resuscitation, treatment included placement of a pLVAD and initiation of therapeutic hypothermia. The patient made a rapid and full recovery. C1 [Heidlebaugh, Michael; Sawyer, Kelly N.] William Beaumont Hosp, Dept Emergency Med, Royal Oak, MI 48073 USA. [Kurz, Michael C.] Univ Alabama Birmingham, Dept Emergency Med, Birmingham, AL USA. [Turkelson, Carman L.] William Beaumont Hosp, Nursing Educ & Res, Royal Oak, MI 48073 USA. C3 Beaumont Health; University of Alabama System; University of Alabama Birmingham; Beaumont Health RP Sawyer, KN (通讯作者),William Beaumont Hosp, Dept Emergency Med, 3601 W 13 Mile Rd, Royal Oak, MI 48073 USA. 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Hypothermia Temp. Manag. PD DEC 1 PY 2014 VL 4 IS 4 BP 168 EP 172 DI 10.1089/ther.2014.0008 PG 5 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CG6YG UT WOS:000353448200004 PM 25184627 DA 2023-05-13 ER PT J AU Hsue, PY Waters, DD AF Hsue, Priscilla Y. Waters, David D. TI HIV infection and coronary heart disease: mechanisms and management SO NATURE REVIEWS CARDIOLOGY LA English DT Review ID T-CELL-ACTIVATION; COMBINATION ANTIRETROVIRAL THERAPY; IMMUNODEFICIENCY-VIRUS-INFECTION; ACUTE MYOCARDIAL-INFARCTION; C-REACTIVE PROTEIN; CAROTID-ARTERY-DISEASE; INTIMA-MEDIA THICKNESS; CARDIOVASCULAR-DISEASE; DOUBLE-BLIND; METABOLIC SYNDROME AB Antiretroviral therapy has largely transformed HIV infection into a chronic disease condition. As such, physicians and other providers caring for individuals living with HIV infection need to be aware of the potential cardiovascular complications of HIV infection and the nuances of how HIV infection increases the risk of cardiovascular diseases, including acute myocardial infarction, stroke, peripheral artery disease, heart failure and sudden cardiac death, as well as how to select available therapies to reduce this risk. In this Review, we discuss the epidemiology and clinical features of cardiovascular disease, with a focus on coronary heart disease, in the setting of HIV infection, which includes a substantially increased risk of myocardial infarction even when the HIV infection is well controlled. We also discuss the mechanisms underlying HIV-associated atherosclerotic cardiovascular disease, such as the high rates of traditional cardiovascular risk factors in patients with HIV infection and HIV-related factors, including the use of antiretroviral therapy and chronic inflammation in the setting of effectively treated HIV infection. Finally, we highlight available therapeutic strategies, as well as approaches under investigation, to reduce the risk of cardiovascular disease and lower inflammation in patients with HIV infection. C1 [Hsue, Priscilla Y.; Waters, David D.] Univ Calif San Francisco, Zuckerberg San Francisco Gen Hosp, San Francisco, CA 94143 USA. C3 University of California System; University of California San Francisco RP Hsue, PY (通讯作者),Univ Calif San Francisco, Zuckerberg San Francisco Gen Hosp, San Francisco, CA 94143 USA. 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Rev. Cardiol. PD DEC PY 2019 VL 16 IS 12 BP 745 EP 759 DI 10.1038/s41569-019-0219-9 PG 15 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JN5DC UT WOS:000496918000011 PM 31182833 OA Green Accepted, Green Submitted DA 2023-05-13 ER PT J AU George, S Onwordi, ENC Gamal, A Zaman, A AF George, Sudhakar Onwordi, Eunice N. C. Gamal, Amr Zaman, Azfar TI Development of New Antithrombotic Regimens for Patients with Acute CoronarySyndrome SO CLINICAL DRUG INVESTIGATION LA English DT Review ID DUAL ANTIPLATELET THERAPY; FACTOR XA INHIBITOR; ESC WORKING GROUP; ATRIAL-FIBRILLATION; ORAL ANTICOAGULANTS; DOUBLE-BLIND; PLATELET INHIBITION; LATE CONSEQUENCES; ARTERY-DISEASE; POSITION PAPER AB Patients with acute coronary syndrome (ACS) require long-term antithrombotic intervention to reduce the risk of further ischemic events; dual antiplatelet therapy with a P2Y(12) inhibitor and acetylsalicylic acid (ASA) is the current standard of care. However, pivotal clinical trials report that patients receiving this treatment have a residual risk of approximately 10% for further ischemic events. The development of non-vitaminK antagonist oral anticoagulants (NOACs) has renewed interest in a dual pathway' strategy, targeting both the coagulation cascade and platelet component of thrombus formation. In the phase III ATLASACS2TIMI51 trial, a triple therapy' approach (NOAC plus dual antiplatelet therapy) showed reduced ischemic events with rivaroxaban 2.5mg twice daily, albeit at an increased risk of bleeding. Two studies have investigated the role of NOACs in combination with a P2Y(12) inhibitor, with or without ASA, in reducing bleeding risk in patients with atrial fibrillation undergoing percutaneous coronary intervention; two further studies are underway. Although these trials will help to inform optimal treatment protocols for secondary prevention of ACS, an individualized approach to treatment will be needed, taking account of the high frequency of co-morbid conditions found in this patient population. C1 [George, Sudhakar] Keele Univ, Inst Appl Clin Sci, Keele Cardiovasc Res Grp, Keele, Staffs, England. [George, Sudhakar] Keele Univ, Inst Primary Care & Hlth Sci, Ctr Prognosis Res, Keele, Staffs, England. [Onwordi, Eunice N. C.] Queen Alexandra Hosp, Portsmouth, Hants, England. [Gamal, Amr; Zaman, Azfar] Newcastle Univ, Freeman Hosp, Dept Cardiol, Newcastle Upon Tyne, Tyne & Wear, England. C3 Keele University; Keele University; Portsmouth Hospitals NHS Trust; Queen Alexandra Hospital; N8 Research Partnership; RLUK- Research Libraries UK; Newcastle University - UK; Newcastle Freeman Hospital RP Zaman, A (通讯作者),Newcastle Univ, Freeman Hosp, Dept Cardiol, Newcastle Upon Tyne, Tyne & Wear, England. EM azfar.zaman@nuth.nhs.uk RI Gamal, Amr S./AAQ-2460-2020 OI Gamal, Amr S./0000-0003-4587-5030 FU Bayer AG FX Editorial assistance for the preparation of this manuscript was funded by Bayer AG. 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Drug Invest. PD JUN PY 2019 VL 39 IS 6 BP 495 EP 502 DI 10.1007/s40261-019-00769-6 PG 8 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA IC1UE UT WOS:000470744100001 PM 30972665 OA Green Published, Green Accepted, hybrid DA 2023-05-13 ER PT J AU Jiang, XD Guo, S Zhang, WM AF Jiang, Xuan-Dong Guo, Shan Zhang, Wei-Min TI Acute myocardial infarction induced by eosinophilic granulomatosis with polyangiitis: A case report SO WORLD JOURNAL OF CLINICAL CASES LA English DT Article DE Acute myocardial infarction; Eosinophilic granulomatosis with polyangiitis; Churg-Strauss syndrome; Heart failure; Asthma; Case report ID CHURG-STRAUSS AB BACKGROUND Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem disease characterized by allergic rhinitis, asthma, and a significantly high eosinophil count in the peripheral blood. It mainly involves the arterioles and venules. When the coronary arteries are invaded, it can lead to acute myocardial infarction (AMI), acute heart failure, and other manifestations that often lead to death in the absence of timely treatment. CASE SUMMARY A 69-year-old man was admitted to the emergency department due to chest pain for more than 1 h. He had a past history of bronchial asthma and chronic obstructive pulmonary disease and was diagnosed with AMI and heart failure. Thrombus aspiration of the left circumflex artery and percutaneous transluminal coronary angioplasty were performed immediately. After surgery, the patient was admitted to the intensive care unit. The patient developed eosinophilia, and medical history taking revealed fatigue of both thighs 1 mo prior. Local skin numbness and manifestations of peripheral nerve involvement were found on the lateral side of the right thigh. Skin biopsy of the lower limbs pathologically confirmed EGPA. The patient was treated with methylprednisolone combined with intravenous immunoglobulin and was discharged after 21 d. On follow-up at 7 d after discharge, heart failure recurred. The condition improved after cardiotonic and diuretic treatment, and the patient was discharged. CONCLUSION Asthma, impaired cardiac function, and eosinophilia are indicative of EGPA. Delayed diagnosis often leads to heart involvement and death. C1 [Jiang, Xuan-Dong; Guo, Shan; Zhang, Wei-Min] Wenzhou Med Univ, Intens Care Unit, Affiliated Dongyang Hosp, 60 Wuning West Rd, Jinhua 322100, Zhejiang, Peoples R China. C3 Wenzhou Medical University RP Zhang, WM (通讯作者),Wenzhou Med Univ, Intens Care Unit, Affiliated Dongyang Hosp, 60 Wuning West Rd, Jinhua 322100, Zhejiang, Peoples R China. EM jalzhan@163.com CR Chai JT, 2018, EUR HEART J-CASE REP, V2, DOI 10.1093/ehjcr/yty075 Comarmond C, 2013, ARTHRITIS RHEUM-US, V65, P270, DOI 10.1002/art.37721 Groh M, 2015, EUR J INTERN MED, V26, P545, DOI 10.1016/j.ejim.2015.04.022 Gue YX, 2019, EUR HEART J-CASE REP, V3, DOI 10.1093/ehjcr/ytz041 MASI AT, 1990, ARTHRITIS RHEUM, V33, P1094, DOI 10.1002/art.1780330806 Neumann T, 2009, MEDICINE, V88, P236, DOI 10.1097/MD.0b013e3181af35a5 Pecoraro A, 2017, INT IMMUNOPHARMACOL, V45, P13, DOI 10.1016/j.intimp.2017.01.025 Sada KE, 2014, MOD RHEUMATOL, V24, P640, DOI 10.3109/14397595.2013.857582 Schiefermueller J, 2017, CLIN MED, V17, P180, DOI 10.7861/clinmedicine.17-2-180 Sinico RA, 2009, BEST PRACT RES CL RH, V23, P355, DOI 10.1016/j.berh.2009.02.004 Szczeklik W, 2013, CLIN REV ALLERG IMMU, V44, P39, DOI 10.1007/s12016-011-8266-y Tsurikisawa N, 2017, J RHEUMATOL, V44, P1206, DOI 10.3899/jrheum.161436 NR 12 TC 1 Z9 1 U1 0 U2 0 PU BAISHIDENG PUBLISHING GROUP INC PI PLEASANTON PA 7041 Koll Center Parkway, Suite 160, PLEASANTON, CA, UNITED STATES SN 2307-8960 J9 WORLD J CLIN CASES JI World J. Clin. Cases PD DEC 6 PY 2021 VL 9 IS 34 BP 10702 EP 10707 DI 10.12998/wjcc.v9.i34.10702 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA YU2OH UT WOS:000751886200033 PM 35005004 OA gold, Green Published DA 2023-05-13 ER PT J AU Dondo, TB Hall, M Timmis, AD Gilthorpe, MS Alabas, OA Batin, PD Deanfield, JE Hemingway, H Gale, CP AF Dondo, Tatendashe B. Hall, Marlous Timmis, Adam D. Gilthorpe, Mark S. Alabas, Oras A. Batin, Phillip D. Deanfield, John E. Hemingway, Harry Gale, Chris P. TI Excess mortality and guideline-indicated care following non-ST-elevation myocardial infarction SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE NSTEMI; excess mortality; National Health Service; evidence-based medicine; MINAP; electronic health records ID ACUTE CORONARY SYNDROMES; LONG-TERM MORTALITY; QUALITY-OF-CARE; NATIONAL REGISTRY; INTERVENTION; OUTCOMES; PATIENT; EVENTS; TRENDS; DEATH AB Background: Adherence to guideline-indicated care for the treatment of non-ST-elevation myocardial infarction (NSTEMI) is associated with improved outcomes. We investigated the extent and consequences of non-adherence to guideline-indicated care across a national health system. Methods: A cohort study (ClinicalTrials.gov identifier: NCT02436187) was conducted using data from the Myocardial Ischaemia National Audit Project (n=389,057 NSTEMI, n=247 hospitals, England and Wales, 2003-2013). Accelerated failure time models were used to quantify the impact of non-adherence on survival according to dates of guideline publication. Results: Over a period of 1,079,044 person-years (median 2.2 years of follow-up), 113,586 (29.2%) NSTEMI patients died. Of those eligible to receive care, 337,881 (86.9%) did not receive one or more guideline-indicated intervention; the most frequently missed were dietary advice (n=254,869, 68.1%), smoking cessation advice (n=245,357, 87.9%), P2Y12 inhibitors (n=192,906, 66.3%) and coronary angiography (n=161,853, 43.4%). Missed interventions with the strongest impact on reduced survival were coronary angiography (time ratio: 0.18, 95% confidence interval (CI): 0.17-0.18), cardiac rehabilitation (time ratio: 0.49, 95% CI: 0.48-0.50), smoking cessation advice (time ratio: 0.53, 95% CI: 0.51-0.57) and statins (time ratio: 0.56, 95% CI: 0.55-0.58). If all eligible patients in the study had received optimal care at the time of guideline publication, then 32,765 (28.9%) deaths (95% CI: 30,531-33,509) may have been prevented. Conclusion: The majority of patients hospitalised with NSTEMI missed at least one guideline-indicated intervention for which they were eligible. This was significantly associated with excess mortality. Greater attention to the provision of guideline-indicated care for the management of NSTEMI will reduce premature cardiovascular deaths. C1 [Dondo, Tatendashe B.; Hall, Marlous; Gilthorpe, Mark S.; Alabas, Oras A.; Gale, Chris P.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, W Yorkshire, England. [Timmis, Adam D.] Barts Hlth, Natl Inst Hlth Biomed Res Unit, London, England. [Batin, Phillip D.] Mid Yorkshire Hosp NHS Trust, Dept Cardiol, Dewsbury, England. [Deanfield, John E.] UCL, Natl Inst Cardiovasc Outcomes Res, London, England. [Hemingway, Harry] UCL, Farr Inst, London, England. [Gale, Chris P.] York Teaching Hosp NHS Fdn Trust, York, N Yorkshire, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; Barts Health NHS Trust; RLUK- Research Libraries UK; University of London; University College London; RLUK- Research Libraries UK; University of London; University College London RP Gale, CP (通讯作者),Univ Leeds, Leeds Inst Cardiovasc & Metab Med, MRC Bioinformat Unit, Level 11,Worsley Bldg,Clarendon Way, Leeds LS2 9JT, W Yorkshire, England. EM c.p.gale@leeds.ac.uk RI Hall, Marlous/O-9985-2019; Gilthorpe, Mark S/C-1240-2008; Hemingway, Harry/C-1219-2009 OI Hall, Marlous/0000-0003-1246-2627; Gilthorpe, Mark S/0000-0001-8783-7695; Deanfield, John/0000-0001-8806-6052; Dondo, Tatendashe/0000-0002-8337-8425; Gale, Chris/0000-0003-4732-382X; Hemingway, Harry/0000-0003-2279-0624; Alabas, Oras/0000-0003-2002-0781 FU British Heart Foundation [PG/13/81/30474]; National Institute for Health Research [NIHR-CTF-2014-03-03]; British Heart Foundation [PG/13/81/30474] Funding Source: researchfish; Medical Research Council [MR/K006584/1] Funding Source: researchfish; National Institute for Health Research [NF-SI-0513-10130, NIHR-CTF-2014-03-03] Funding Source: researchfish FX This work was supported by the British Heart Foundation (Project Grant PG/13/81/30474) and the National Institute for Health Research (NIHR-CTF-2014-03-03). CR Alexander KP, 2005, JAMA-J AM MED ASSOC, V294, P3108, DOI 10.1001/jama.294.24.3108 Alwan AD, 2011, B WORLD HEALTH ORGAN, V89, P545 Bramlage P, 2010, HEART, V96, P604, DOI 10.1136/hrt.2009.188607 Briffa T, 2009, BMJ-BRIT MED J, V338, DOI 10.1136/bmj.b36 Bugiardini R, 2014, CURR VASC PHARMACOL, V12, P903, DOI 10.2174/157016111206141210122150 Chew DP, 2009, HEART, V95, P1844, DOI 10.1136/hrt.2009.174276 DH Vascular Programme Team, TREATM HEART ATT NAT Fox KAA, 2007, HEART, V93, P177, DOI 10.1136/hrt.2005.084830 Fox KAA, 2008, NAT CLIN PRACT CARD, V5, P580, DOI 10.1038/ncpcardio1302 Fox KAA, 2007, JAMA-J AM MED ASSOC, V297, P1892, DOI 10.1001/jama.297.17.1892 Gale CP, 2012, EUR HEART J, V33, P630, DOI 10.1093/eurheartj/ehr381 Hall M, 2016, HEART, V102, P313, DOI 10.1136/heartjnl-2015-308616 Hall M, 2015, EUR HEART J-QUAL CAR, V1, P85, DOI 10.1093/ehjqcco/qcv011 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Herrett E, 2010, HEART, V96, P1264, DOI 10.1136/hrt.2009.192328 Laut KG, 2013, EUROINTERVENTION, V9, P469, DOI 10.4244/EIJV9I4A76 Lloyd-Jones DM, 2003, AM J CARDIOL, V92, P1155, DOI 10.1016/j.amjcard.2003.07.022 NICE, UNST ANG NSTEMI EARL Nichols M., 2012, EUROPEAN CARDIOVASCU Nichols M, 2014, EUR HEART J, V35, P2950, DOI 10.1093/eurheartj/ehu299 Peterson ED, 2006, JAMA-J AM MED ASSOC, V295, P1912, DOI 10.1001/jama.295.16.1912 Peterson ED, 2008, AM HEART J, V156, P1045, DOI 10.1016/j.ahj.2008.07.028 Rasmussen JN, 2007, JAMA-J AM MED ASSOC, V297, P177, DOI 10.1001/jama.297.2.177 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Rogers WJ, 2008, AM HEART J, V156, P1026, DOI 10.1016/j.ahj.2008.07.030 Simms AD, 2015, EUR HEART J-ACUTE CA, V4, P241, DOI 10.1177/2048872614548602 Simms AD, 2013, HEART, V99, P35, DOI 10.1136/heartjnl-2012-302632 Smolina K, 2012, BRIT MED J, V344, DOI 10.1136/bmj.d8059 Veinot TC, 2012, SOC SCI MED, V75, P1800, DOI 10.1016/j.socscimed.2012.07.011 White HD, 2008, LANCET, V372, P570, DOI 10.1016/S0140-6736(08)61237-4 NR 30 TC 27 Z9 27 U1 0 U2 1 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 2048-8726 EI 2048-8734 J9 EUR HEART J-ACUTE CA JI Eur. Heart J.-Acute Cardiovasc. Care PD AUG PY 2017 VL 6 IS 5 BP 412 EP 420 DI 10.1177/2048872616647705 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FE7VE UT WOS:000408414200006 PM 27142174 OA Green Submitted, Bronze, Green Accepted DA 2023-05-13 ER PT J AU Scheuermeyer, FX Grunau, B Raju, R Choy, S Naoum, C Blanke, P Hague, C Heilbron, B Taylor, C Kalla, D Christenson, J Innes, G Hanakova, M Leipsic, J AF Scheuermeyer, Frank X. Grunau, Brian Raju, Rekha Choy, Stephen Naoum, Christopher Blanke, Philipp Hague, Cameron Heilbron, Brett Taylor, Carolyn Kalla, Daniel Christenson, Jim Innes, Grant Hanakova, Michaela Leipsic, Jonathon TI Safety and efficiency of outpatient versus emergency department-based coronary CT angiography for evaluation of patients with potential ischemic chest pain SO JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY LA English DT Article DE Coronary CT angiography; Ischemic chest pain ID COMPUTED TOMOGRAPHIC ANGIOGRAPHY; RISK PATIENTS; DISCHARGE AB Background: While coronary CT angiography (coronary CTA) may be comparable to standard care in diagnosing acute coronary syndrome (ACS) in emergency department (ED) chest pain patients, it has traditionally been obtained prior to ED discharge and a strategy of delayed outpatient coronary CTA following an ED visit has not been evaluated. Objective: To investigate the safety of discharging stable ED patients and obtaining outpatient CCTA. Methods: At two urban Canadian EDs, patients up to 65 years with chest pain but no findings indicating presence of ACS were further evaluated depending upon time of presentation: (1) ED-based coronary CTA during normal working hours, (2) or outpatient coronary CTA within 72 hours at other times. All data were collected prospectively. The primary outcome was the proportion of patients who had an outpatient coronary CTA ordered and had a predefined major adverse cardiac event (MACE) between ED discharge and outpatient CT; secondary outcome was the ED length of stay in both groups. Results: From July 1, 2012 to June 30, 2014, we enrolled 521 consecutive patients: 350 with outpatient CT and 171 with ED-based CT. Demographics and risk factors were similar in both cohorts. No outpatient CT patients had a MACE prior to coronary CTA. (0.0%, 95% CI 0 to 0.9%) The median length of stay for ED-based evaluation was 6.6 hours (interquartile range 5.4 to 8.3 hours) while the outpatient group had a median length of stay of 7.0 hours (IQR 6.0 to 9.8 hours, n.s.). Conclusions: In ED chest pain patients with a low risk of ACS, performing coronary CTA as an outpatient may be a safe strategy. (C) 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved. C1 [Scheuermeyer, Frank X.; Grunau, Brian; Kalla, Daniel; Christenson, Jim; Hanakova, Michaela] St Pauls Hosp, Dept Emergency Med, Vancouver, BC V6Z 1Y6, Canada. [Scheuermeyer, Frank X.; Grunau, Brian; Raju, Rekha; Choy, Stephen; Naoum, Christopher; Blanke, Philipp; Hague, Cameron; Heilbron, Brett; Taylor, Carolyn; Kalla, Daniel; Christenson, Jim; Hanakova, Michaela; Leipsic, Jonathon] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada. [Raju, Rekha; Choy, Stephen; Naoum, Christopher; Blanke, Philipp; Hague, Cameron; Leipsic, Jonathon] St Pauls Hosp, Dept Radiol, Vancouver, BC V6Z 1Y6, Canada. [Heilbron, Brett; Taylor, Carolyn] St Pauls Hosp, Dept Med, Div Cardiol, Vancouver, BC V6Z 1Y6, Canada. [Scheuermeyer, Frank X.] Mt St Josephs Hosp, Dept Emergency Med, Vancouver, BC, Canada. [Innes, Grant] Foothills Prov Gen Hosp, Dept Emergency Med, Calgary, AB T2N 2T9, Canada. [Innes, Grant] Univ Calgary, Calgary, AB, Canada. C3 St. Paul's Hospital; University of British Columbia; St. Paul's Hospital; St. Paul's Hospital; University of Calgary; University of Calgary RP Leipsic, J (通讯作者),St Pauls Hosp, Dept Med Imaging, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada. EM jleipsic@providencehealth.bc.ca RI Leipsic, Jonathon/ABE-6194-2020 OI Taylor, Carolyn/0000-0002-3540-1491; Grunau, Brian/0000-0003-4103-1383 CR Goldstein JA, 2007, J AM COLL CARDIOL, V49, P863, DOI 10.1016/j.jacc.2006.08.064 Hamilton-Craig C, 2014, INT J CARDIOL, V177, P867, DOI 10.1016/j.ijcard.2014.10.090 Hoffmann U, 2012, NEW ENGL J MED, V367, P299, DOI 10.1056/NEJMoa1201161 Hollander JE, 2009, ANN EMERG MED, V53, P295, DOI 10.1016/j.annemergmed.2008.09.025 Jones RL, 2014, J CARDIOVASC COMPUT, V8, P375, DOI 10.1016/j.jcct.2014.08.003 Litt HI, 2012, NEW ENGL J MED, V366, P1393, DOI 10.1056/NEJMoa1201163 Raff GL, 2014, J CARDIOVASC COMPUT, V8, P254, DOI 10.1016/j.jcct.2014.06.002 Scheuermeyer FX, 2012, ANN EMERG MED, V59, P256, DOI 10.1016/j.annemergmed.2011.10.016 Staniak HL, 2014, J CARDIOVASC COMPUT, V8, P359, DOI 10.1016/j.jcct.2014.08.001 NR 9 TC 7 Z9 7 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1934-5925 J9 J CARDIOVASC COMPUT JI J. Cardiovasc. Comput. Tomogr. PD NOV-DEC PY 2015 VL 9 IS 6 BP 534 EP 537 DI 10.1016/j.jcct.2015.08.001 PG 4 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA CZ2RJ UT WOS:000366952000005 PM 26310589 DA 2023-05-13 ER PT J AU Khanji, MY Ricci, F Patel, RS Chahal, AA Bhattacharyya, S Galusko, V Narula, J Ionescu, A AF Khanji, Mohammed Y. Ricci, Fabrizio Patel, Riyaz S. Chahal, Anwar A. Bhattacharyya, Sanjeev Galusko, Victor Narula, Jagat Ionescu, Adrian TI Special Article - The role of hand-held ultrasound for cardiopulmonary assessment during a pandemic SO PROGRESS IN CARDIOVASCULAR DISEASES LA English DT Review DE COVID-19; Hand-held ultrasound; Echocardiography; Pandemic; Cardiovascular imaging; Coronavirus ID ECHOCARDIOGRAPHY; STANDARD; TIME AB During the COVID-19 pandemic, we are likely to see a significant increase in the requests for rapid assessment of cardiac function, due to the frequent pre-existence of cardiac pathologies in patients admitted to hospital, and to the emergence of specific cardiac manifestations of this infection, such as myocarditis, sepsis related cardiomyopathy, stress induced cardiomyopathy and acute coronary syndromes. Hand-held, point-of-care ultrasound (HH-POCUS) is particularly suited for the provision of rapid, focused, integrated assessments of the heart and lungs. We present a review of the indications and protocols for focused HH-POCUS use in an acute setting and formulate proposals for streamlining their application in the COVID-19 context towards guiding optimum management of these patients while at the same time allowing adherence to robust infection control measures to provide safety to both the patient and our clinical staff. (C) 2020 Elsevier Inc. All rights reserved. C1 [Khanji, Mohammed Y.; Patel, Riyaz S.; Chahal, Anwar A.; Bhattacharyya, Sanjeev] Barts Hlth NHS Trust, Barts Heart Ctr, London EC1A 7BE, West Smithfield, England. [Khanji, Mohammed Y.] Queen Mary Univ London, Ctr Adv Cardiovasc Imaging & Res, William Harvey Res Inst, London EC1A 7BE, England. [Ricci, Fabrizio] Univ G dAnnunzio, Inst Adv Biomed Technol, Dept Neurosci Imaging & Clin Sci, I-66100 Chieti, Italy. [Ricci, Fabrizio] Lund Univ, Dept Clin Sci, Jan Waldenstroms Gata 35, S-20502 Malmo, Sweden. [Chahal, Anwar A.] Mayo Clin, Dept Cardiovasc Dis, Rochester, MN 55902 USA. [Chahal, Anwar A.] Univ Penn, Dept Cardiol, Philadelphia, PA 19104 USA. [Galusko, Victor] Kings Coll Hosp London, Dept Cardiol, London SE5 9RS, England. [Narula, Jagat] Icahn Sch Med Mt Sinai, Dept Cardiol, Mt Sinai Heart, 1190 5th Ave, New York, NY 10029 USA. [Ionescu, Adrian] Swansea Bay Hlth Board, Morriston Cardiac Reg Ctr, Swansea SA6 6NL, W Glam, Wales. C3 Barts Health NHS Trust; RLUK- Research Libraries UK; University of London; Queen Mary University London; G d'Annunzio University of Chieti-Pescara; Lund University; Mayo Clinic; University of Pennsylvania; King's College Hospital NHS Foundation Trust; King's College Hospital; Icahn School of Medicine at Mount Sinai RP Khanji, MY (通讯作者),Barts Hlth NHS Trust, Dept Cardiol, Newham Univ Hosp, Glen Rd, London E13 8SL, England. EM m.khanji@qmul.ac.uk; fabrizioricci@hotmail.it; riyaz.patel12@nhs.net; DrAChahal@doctors.org.uk; sanjeev.bhattacharyya@nhs.net; vgalusko91@gmail.com; jagat.narula@mountsinai.org; Adrian.Ionescu@wales.nhs.uk RI Bhattacharyya, Sanjeev/HTM-7725-2023; Ricci, Fabrizio/L-5529-2017; Chahal, Anwar A/AAH-6473-2021 OI Ricci, Fabrizio/0000-0002-1401-6623; FU British Heart Foundation Intermediate Fellowship [FS/14/76/30933] FX Dr. Patel is funded by a British Heart Foundation Intermediate Fellowship (FS/14/76/30933). 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Cardiovasc. Dis. PD SEP-OCT PY 2020 VL 63 IS 5 BP 690 EP 695 DI 10.1016/j.pcad.2020.07.003 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OZ5OX UT WOS:000594976100018 PM 32659342 OA Green Published DA 2023-05-13 ER PT J AU Graham, G AF Graham, Garth TI Racial and Ethnic Differences in Acute Coronary Syndrome and Myocardial Infarction Within the United States: From Demographics to Outcomes SO CLINICAL CARDIOLOGY LA English DT Review ID WHITE PATIENTS; RISK-FACTORS; CARDIOVASCULAR-DISEASE; HEART-DISEASE; DISPARITIES; REVASCULARIZATION; MORTALITY; RACE; CARE; INSIGHTS AB In the United States, different races, ethnicities, and their subgroups experience disparities regarding acute coronary syndrome (ACS) and myocardial infarction (MI). This review highlights these differences across 4 stages that comprise the ACS/MI narrative: (1) patient demographics, (2) patient comorbidities and health risks, (3) treatments and their delays, and (4) outcomes. Overall, black and Hispanic ACS/MI patients are more likely to present with comorbidities, experience longer delays before treatment, and suffer worse outcomes when compared with non-Hispanic white patients. More specifically, across the studies analyzed, black and Hispanic ACS/MI patients were consistently more likely to be younger or female, or to have hypertension or diabetes, than non-Hispanic white patients. ACS/MI disparities also exist among Asian populations, and these are briefly outlined. However, black, Hispanic, and non-Hispanic white ACS/MI patients were the 3 most-studied racial and ethnic groups, indicating that additional studies of other minority groups, such as Native Americans, Asian populations, and black and Hispanic subgroups, are needed for their utility in reducing disparities. Despite notable improvement in ACS/MI treatment quality measures over recent decades, disparities persist. Causes are complex and extend beyond the healthcare system to culture and patients' personal characteristics; sophisticated solutions will be required. Continued research has the potential to further reduce or eliminate disparities in the comorbidities, delays, and treatments surrounding ACS and MI, extending healthy lifespans of many underserved and minority populations, while reducing healthcare costs. C1 [Graham, Garth] Univ Connecticut, Sch Med, Dept Med, Farmington, CT USA. [Graham, Garth] Aetna Inc, Aetna Fdn, Hartford, CT USA. C3 University of Connecticut RP Graham, G (通讯作者),151 Farmington Ave, Hartford, CT 06156 USA. 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Cardiol. PD MAY PY 2016 VL 39 IS 5 BP 299 EP 306 DI 10.1002/clc.22524 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA DR5DJ UT WOS:000379922900008 PM 27028198 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Lewandrowski, KB AF Lewandrowski, Kent B. TI Cardiac Markers of Myocardial Necrosis: A History and Discussion of Milestones and Emerging New Trends SO CLINICS IN LABORATORY MEDICINE LA English DT Article DE Cardiac markers; Biomarkers; Troponin; Creatine kinase; CK-MB; High-sensitivity troponin; Lactate dehydrogenase isoenzymes; Myoglobin ID TROPONIN ASSAYS; UNIVERSAL DEFINITION; INFARCTION; BIOMARKERS; MYOGLOBIN AB Laboratory testing for blood-based biomarkers of myocardial injury has steadily evolved over the past 60 years. Initial assays were cumbersome and were neither sensitive nor specific for myocardial necrosis. 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PD MAR PY 2014 VL 34 IS 1 BP 31 EP + DI 10.1016/j.cll.2013.11.001 PG 12 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA AB8QG UT WOS:000332054500004 PM 24507785 DA 2023-05-13 ER PT J AU Fan, FF Li, YX Zhang, Y Li, JP Liu, J Hao, YC Smith, SC Fonarow, GC Taubert, KA Ge, JB Zhao, D Huo, Y Li, B Xu, BA Han, GS Li, B Liu, B Yu, B Wang, CQ Gao, CY Lai, CL Bin, C Huang, L Wu, D Tang, FK Xiao, J Ma, GS Tao, GZ Li, GQ Fu, GS Li, HW Wang, H Wang, HF Ye, JF Li, JH Jiang, J Wang, JF Chen, JY Liu, JM Li, JX Li, L Jiang, L Meng, LJ Li, L Tao, L Wu, LR Tian, M Han, MH Chen, MS Xie, P Dong, PS Zhong, QQ Chang, R Jia, SB Nie, SP Liu, XH He, SH Ma, SX Xin, SL Ma, SR Luo, SX Li, TC Mao, W Jiang, WH Liu, WJ Lin, WH Fu, XH Zhao, XX Cheng, XS Qi, XY Zhao, XS Han, YL Zheng, Y Liu, Y Guo, Y Hao, YL Lin, YZ Ma, YT Li, YD Sun, YM Zhao, YL Hou, YQ Zheng, ZQ Zhang, Z Ji, ZG Yang, ZY Yang, ZJ Yang, ZM Wang, ZR Song, ZY Yuan, ZY Li, AH Yang, BS Luo, CD Zhang, CY Wu, CY Peng, DQ Xu, DW Xu, G Sang, GS Zhang, GX Chen, GX Lin, HL Jiang, H Luan, H Zhang, H Liu, HL Liu, H Tao, JH Liu, JW Ding, JW Li, JF Yan, JC Wei, JR Su, JZ Tang, J Fan, JX Guan, J Ge, JB Chen, KH Wu, K Ji, L Ma, LK Tang, LL Wei, L Zhang, M Chen, KM Chen, MH Wang, NF Zhang, PY Qu, P Hou, P Zhang, P Wu, Q Xie, Q Lin, R Ye, SW Li, SB Yang, TL Wu, TG Wang, W Huang, WJ Xu, WT Su, X Yang, XJ Ma, XC Sun, XF Chen, XP Chen, XP Chen, XM Tang, XS Li, X Liu, XB Wang, Y Wang, YG Guo, YS Yang, YZ Huang, Y Sun, YX Jin, YZ Xu, ZS Ouyang, ZW Li, ZQ He, ZF Ji, Z Su, ZQ Ou, ZH AF Fan, Fangfang Li, Yuxi Zhang, Yan Li, Jianping Liu, Jing Hao, Yongchen Smith, Sidney C., Jr. Fonarow, Gregg C. Taubert, Kathryn A. Ge, Junbo Zhao, Dong Huo, Yong Li, Bao Xu, Biao Han, Guangshu Li, Bin Liu, Bin Yu, Bo Wang, Changqian Gao, Chuanyu Lai, Chunlin Bin, Cui Huang, Lan Wu, Di Tang, Fakuan Xiao, Jun Ma, Genshan Tao, Guizhou Li, Guoqing Fu, Guosheng Li, Hongwei Wang, Honhju Wang, Huifeng Ye, Jianfeng Li, Jianhao Jiang, Jie Wang, Jingfeng Chen, Jiyan Liu, Junming Li, Junxia Li, Lang Jiang, Li Meng, Lijun Li, Ling Tao, Ling Wu, Lirong Tian, Miao Han, Minghua Chen, Moshui Xie, Ping Dong, Pingshuan Zhong, Qiaoqing Chang, Rong Jia, Shaobin Nie, Shaoping Liu, Xiaohui He, Shenghu Ma, Shixin Xin, Shuanli Ma, Shuren Luo, Suxin Li, Tianchang Mao, Wei Jiang, Weihong Liu, Weijun Lin, Wenhua Fu, Xianghua Zhao, Xianxian Cheng, Xiaoshu Qi, Xiaoyong Zhao, Xingsheng Han, Yaling Zheng, Yang Liu, Yin Guo, Ying Hao, Yinglu Lin, Yingzhong Ma, Yitong Li, Yongdong Sun, Yuemin Zhao, Yulan Hou, Yuqing Zheng, Zeqi Zhang, Zheng Ji, Zhenguo Yang, Zhenyu Yang, Zhijian Yang, Zhiming Wang, Zhirong Song, Zhiyuan Yuan, Zuyi Li, Aihua Yang, Bosong Luo, Caidong Zhang, Chunyan Wu, Chunyang Peng, Daoquan Xu, Dawen Xu, Gang Sang, Gengsheng Zhang, Guixia Chen, Guoxiong Lin, Hailong Jiang, Hong Luan, Hong Zhang, Hong Liu, Hualing Liu, Hui Tao, Jianhong Liu, Jianwen Ding, Jiawang Li, Jifu Yan, Jinchuan Wei, Jinru Su, Jinzi Tang, Jiong Fan, Juexin Guan, Jun Ge, Junbo Chen, Kaihong Wu, Keng Ji, Lang Ma, Likun Tang, Lilong Wei, Lin Zhang, Man Chen, Kaiming Chen, Manhua Wang, Ningfu Zhang, Peiying Qu, Peng Hou, Ping Zhang, Ping Wu, Qiang Xie, Qiang Lin, Rong Ye, Shaowu Li, Shuangbin Yang, Tianlun Wu, Tongguo Wang, Wei Huang, Weijian Xu, Weiting Su, Xi Yang, Xiangjun Ma, Xiaochuan Sun, Xiaofei Chen, Xiaoping Chen, Xiaoping Chen, Ximing Tang, Xingsheng Li, Xue Liu, Xuebo Wang, Yan Wang, Yanggan Guo, Yansong Yang, Yanzong Huang, Yi Sun, Yingxian Jin, Yuanzhe Xu, Zesheng Ouyang, Zewei Li, Zhanquan He, Zhaofa Ji, Zheng Su, Zhenqi Ou, Zhihong CA CCC-ACS Investigators TI Chest Pain Center Accreditation Is Associated With Improved In-Hospital Outcomes of Acute Myocardial Infarction Patients in China: Findings From the CCC-ACS Project SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE accreditation; acute myocardial infarction; chest pain center; China; in-hospital outcomes ID CARE; DISEASE AB Background-Chest pain center (CPC) accreditation plays an important role in the management of acute myocardial infarction (AMI). However, no evidence shows whether the outcomes of AMI patients are improved with CPC accreditation in China. Methods and Results-This retrospective analysis is based on a predesigned nationwide registry, CCC-ACS (Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome). The primary outcome was major adverse cardiovascular events (MACE), including all-cause death, reinfarction, stent thrombosis, stroke, and heart failure. A total of 15 344 AMI patients, from 40 CPC-accredited hospitals, were enrolled, including 7544 admitted before and 7800 after accreditation. In propensity score matching, 6700 patients in each group were matched. The incidence of 7-day MACE (6.7% versus 8.0%; P-0.003) and all-cause death (1.1% versus 1.6%; P-0.021) was lower after accreditation. In multivariate adjusted mixed-effects Cox proportional hazards models, CPC accreditation was associated with significantly decreased risk of MACE (hazard ratio: 0.78; 95% CI, 0.68-0.91) and all-cause death (hazard ratio: 0.71; 95% Cl, 0.51-0.99). The risk of MACE and all-cause death both followed a reverse J-shaped trend: the risk of MACE and all-cause death decreased gradually after achieving CPC accreditation, with minimal risk occurring in the first year, but increased in the second year and after. Conclusions-Based on a large-scale national registry data set, CPC accreditation was associated with better in-hospital outcomes for AMI patients. However, the benefits seemed to attenuate over time, and reaccreditation may be essential for maintaining AMI care quality and outcomes. C1 [Fan, Fangfang; Li, Yuxi; Zhang, Yan; Li, Jianping; Hao, Yinglu] Peking Univ First Hosp, Dept Cardiol, Beijing, Peoples R China. [Liu, Jing; Zhao, Dong; Hao, Yinglu] Beijing Inst Heart Lung & Blood Vessel Dis, Capital Med Univ Beijing Anzhen Hosp, Dept Epidemiol, Beijing, Peoples R China. [Smith, Sidney C., Jr.] Univ N Carolina, Div Cardiol, Chapel Hill, NC USA. [Fonarow, Gregg C.] Univ Calif Los Angeles, Geffen Sch Med, Div Cardiol, Los Angeles, CA USA. [Taubert, Kathryn A.] Amer Heart Assoc, Dept Int Sci, Basel, Switzerland. [Ge, Junbo] Fudan Univ, Shanghai Inst Cardiovascular Dis, Zhongshan Hosp, Dept Cardiol, Shanghai, Peoples R China. [Li, Bao] Shanxi Cardiovascular Hosp, Shanxi, Peoples R China. [Xu, Biao; Han, Guangshu] Affiliated Hosp Nanjing Univ Med Sch, Nanjing Drum Tower Hosp, Nanjing, Jiangsu, Peoples R China. [Li, Bin] Hainan Gen Hosp, Haikou, Hainan, Peoples R China. [Liu, Bin] Second Hosp Jilin Univ, Jilin, Jilin, Peoples R China. [Yu, Bo] Harbin Med Univ, 2nd Affiliated Hosp, Harbin, Heilongjiang, Peoples R China. [Wang, Changqian] Shanghai Jiao Tong Univ, Sch Med, 9 Hosp Affiliated, Shanghai, Peoples R China. [Gao, Chuanyu] Henan Prov Peoples Hosp, Haikou, Hainan, Peoples R China. [Lai, Chunlin] Shanxi Prov Peoples Hosp, Shanxi, Peoples R China. [Bin, Cui; Huang, Lan] Third Mil Med Univ, Xinqiao Hosp, Chongqing, Peoples R China. [Wu, Di] China Meitan Gen Hosp, Beijing, Peoples R China. [Tang, Fakuan; Xiao, Jun] 309 Hosp Chinese Peoples Liberat Army, Beijing, Peoples R China. [Ma, Genshan] Southeast Univ, Zhongda Hosp, Nanjing, Jiangsu, Peoples R China. [Tao, Guizhou] Liaoning Med Univ, First Affiliated Hosp, Shenyang, Liaoning, Peoples R China. [Li, Guoqing] Xinjiang Uygur Autonomous Region Peoples Hosp, Xinjiang, Peoples R China. [Fu, Guosheng] Zhejiang Univ, Sir Run Run Shaw 0 Hosp, Coll Med, Hangzhou, Zhejiang, Peoples R China. [Li, Hongwei] Capital Med Univ, Beijing Friendship Hosp, Beijing, Peoples R China. [Wang, Honhju] Bengbu Med Coll, First Affiliated Hosp, Bengbu, Peoples R China. [Wang, Huifeng] Gen Hosp TISCO, Beijing, Peoples R China. [Ye, Jianfeng] Dongguan Peoples Hosp, Wanjiang, Peoples R China. [Li, Jianhao] Panyu Hosp Chinese Med, Guangzhou, Guangdong, Peoples R China. [Jiang, Jie] Peking Univ, First Hosp, Beijing, Peoples R China. [Wang, Jingfeng] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Guangdong, Peoples R China. [Chen, Jiyan] Guangdong Gen Hosp, Guangzhou, Guangdong, Peoples R China. [Liu, Junming] Hosp Xinjiang Prod & Construction Corps, Xinjiang, Peoples R China. [Li, Junxia] Mil Gen Hosp Beijing PLA, Beijing, Peoples R China. [Li, Lang] Guangxi Med Univ, First Affiliated Hosp, Nanning, Peoples R China. [Jiang, Li] Shanghai Jiao Tong Univ, Sch Med, Tongren Hosp Affiliated, Shanghai, Peoples R China. [Meng, Lijun] Binzou City Ctr Hosp, Qingdao, Shandong, Peoples R China. [Li, Ling] Zhengzhou Univ, First Affiliated Hosp, Zhengzhou, Henan, Peoples R China. [Tao, Ling] Xijing Hosp, Shaanxi, Peoples R China. [Wu, Lirong] Guizhou Med Univ, Affiliated Hosp, Guiyang, Guizhou, Peoples R China. [Tian, Miao] Peoples Liberat Army Gen Hosp, First Affiliated Hosp, Beijing, Peoples R China. [Han, Minghua] Second Peoples Hosp Yunnan Prov, Kunming, Yunnan, Peoples R China. [Chen, Moshui] Haikou Peoples Hosp, Haikou, Hainan, Peoples R China. [Xie, Ping] Gansu Prov Hosp, Lanzhou, Gansu, Peoples R China. [Dong, Pingshuan] Henan Univ Sci & Technol, First Affiliated Hosp, Luoyang, Henan, Peoples R China. [Zhong, Qiaoqing] Chenzhou First Peoples Hosp, Chenzhou, Henan, Peoples R China. [Chang, Rong] Peoples Hosp Qinghai Prov, Xining, Qinghai, Peoples R China. [Jia, Shaobin] Ningxia Med Univ, Affiliated Hosp, Ningxia, Peoples R China. [Nie, Shaoping; Liu, Xiaohui] Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China. [He, Shenghu] North Jiangsu Peoples Hosp, Nanjing, Jiangsu, Peoples R China. [Ma, Shixin] Shanghai Sixth Peoples Hosp, Shanghai, Peoples R China. [Xin, Shuanli] First Hosp Handan, Handan, Hebei, Peoples R China. [Ma, Shuren] Huaian First Peoples Hosp, Huaian, Jiangsu, Peoples R China. [Luo, Suxin] Chongqing Med Univ, First Affiliated Hosp, Chongqing, Peoples R China. [Li, Tianchang] Navy Gen Hosp, Beijing, Peoples R China. [Mao, Wei] Zhejiang Prov Hosp TCM, Hangzhou, Zhejiang, Peoples R China. [Jiang, Weihong] Third Xiangya Hosp Cent South Univ, Changsha, Hunan, Peoples R China. [Liu, Weijun] Qinghai Univ, Affiliated Hosp, Xining, Qinghai, Peoples R China. [Lin, Wenhua] Teda Int Cardiovascular Hosp, Tianjin, Peoples R China. [Fu, Xianghua] Second Hosp Hebei Med Univ, Shijiazhuang, Hebei, Peoples R China. [Zhao, Xianxian] Changhai Hosp Shanghai, Shanghai, Peoples R China. [Cheng, Xiaoshu] Nanchang Univ, Second Affiliated Hosp, Nanchang, Jiangxi, Peoples R China. [Qi, Xiaoyong] Hebei Gen Hosp, Hebei, Peoples R China. [Zhao, Xingsheng] Inner Mongolia Peoples Hosp, Beijing, Peoples R China. [Han, Yaling] Gen Hosp Shenyang Mil Region, Shenyang, Liaoning, Peoples R China. [Zheng, Yang] First Hosp Jilin Univ, Jilin, Jilin, Peoples R China. [Liu, Yin] Tianjin Chest Hosp, Tianjin, Peoples R China. [Guo, Ying] Hunan Prov Peoples Hosp, Changsha, Hunan, Peoples R China. [Hao, Yinglu] Peoples Hosp Yuxi City, Yuxi, Yunnan, Peoples R China. [Lin, Yingzhong] Peoples Hosp Guangxi Zhuang Autonomous Region, Nanning, Peoples R China. [Ma, Yitong] Xinjiang Med Univ, First Teaching Hosp, Xinjiang, Peoples R China. [Li, Yongdong] Baogang Hosp, Baotou, Peoples R China. [Sun, Yuemin] Tianjin Med Univ Gen Hosp, Tianjin, Peoples R China. [Zhao, Yulan] Zhengzhou Univ, Second Affiliated Hosp, Zhengzhou, Peoples R China. [Hou, Yuqing] Nanfang Hosp Southern Med Univ, Nanfang, Peoples R China. [Zheng, Zeqi] Nanchang Univ, First Affiliated Hosp, Nanchang, Jiangxi, Peoples R China. [Zhang, Zheng] Lanzhou Univ, First Affiliated Hosp, Lanzhou, Gansu, Peoples R China. [Ji, Zhenguo] Third Hosp Shijiazhuang, Shijiazhuang, Hebei, Peoples R China. [Yang, Zhenyu] Wuxi Peoples Hosp, Wuxi, Jiangsu, Peoples R China. [Yang, Zhijian] Jiangsu Prov Hosp, Nanjing, Jiangsu, Peoples R China. [Yang, Zhiming] Second Hosp Shanxi Med Univ, Taiyuan, Shanxi, Peoples R China. [Wang, Zhirong] Affiliated Hosp Xuzhou Med Coll, Xuzhou, Jiangsu, Peoples R China. [Song, Zhiyuan] Third Mil Med Univ, Southwest Hosp, Chongqing, Peoples R China. [Yuan, Zuyi] First Affiliated Hosp Xian Jiaotong Univ, Xian, Shaanxi, Peoples R China. [Li, Aihua] Yangzhou First Peoples Hosp, Yangzhou, Jiangsu, Peoples R China. [Yang, Bosong] Hosp 463 Chinese Peoples Liberat Army, Beijing, Peoples R China. [Luo, Caidong] Cent Hosp Mianyang, Chengdu, Sichuan, Peoples R China. [Zhang, Chunyan] Liaocheng Peoples Hosp, Liaocheng, Shandong, Peoples R China. [Wu, Chunyang] Yancheng Third Peoples Hosp, Yancheng, Jiangsu, Peoples R China. [Peng, Daoquan] Second Xiangya Hosp Cent South Univ, Changsha, Hunan, Peoples R China. [Xu, Dawen] Cent Hosp Panzhihua, Panzhihua, Peoples R China. [Xu, Gang] First Hosp Qiqihaer City, Qiqihar, Heilongjiang, Peoples R China. [Sang, Gengsheng] Third Peoples Hosp Bengbu, Bengbu, Anhui, Peoples R China. [Zhang, Guixia] First Hosp Jiamusi, Jiamusi, Peoples R China. [Chen, Guoxiong] Zhoushan Peoples Hosp, Zhoushan, Zhejiang, Peoples R China. [Lin, Hailong] Dalian Municipal Cent Hosp, Dalian, Peoples R China. [Jiang, Hong] Wuhan Univ, Renmin Hosp, Wuhan, Hubei, Peoples R China. [Luan, Hong] Ningxia Peoples Hosp, Ningxia, Peoples R China. [Zhang, Hong] First Peoples Hosp Yunnan Prov, Kunhua Hosp, Kunming, Yunnan, Peoples R China. [Liu, Hualing] Cent Hosp Zhoukou, Zhoukou, Henan, Peoples R China. [Liu, Hui] Anyang Dist Hosp, Anyang, Peoples R China. [Tao, Jianhong] Sichuan Prov Peoples Hosp, Chengdu, Sichuan, Peoples R China. [Liu, Jianwen] Mudanjiang Cardiovascular Dis Hosp, Mudanjiang, Peoples R China. [Ding, Jiawang] Yichang Cent Hosp, Yichang, Peoples R China. [Li, Jifu] Qilu Hosp Shandong Univ, Jinan, Shandong, Peoples R China. [Yan, Jinchuan] Affiliated Hosp Jiangsu Univ, Zhenjiang, Jiangsu, Peoples R China. [Wei, Jinru] First Peoples Hosp Nanning City, Nanning, Peoples R China. [Su, Jinzi] Fujian Med Univ, First Affiliated Hosp, Fuzhou, Fujian, Peoples R China. [Tang, Jiong] Chengdu Third Peoples Hosp, Chengdu, Sichuan, Peoples R China. [Fan, Juexin] Yantaishan Hosp, Yantai, Shandong, Peoples R China. [Guan, Jun] Qingdao Municipal Hosp, Qingdao, Shandong, Peoples R China. [Ge, Junbo] Fudan Univ, Zhongshan Hosp Affiliated, Shanghai, Peoples R China. [Chen, Kaihong] Longyan First Hosp, Longyan, Fujian, Peoples R China. [Wu, Keng] Affiliated Hosp Guangdong Med Coll, Zhanjiang, Guangdong, Peoples R China. [Ji, Lang] Jiangxi Prov Peoples Hosp, Nanchang, Jiangxi, Peoples R China. [Ma, Likun] Anhui Prov Hosp, Hefei, Anhui, Peoples R China. [Tang, Lilong] Xiangtan City Cent Hosp, Xiangtan, Peoples R China. [Wei, Lin] First Hosp Haerbin City, Harbin, Heilongjiang, Peoples R China. [Zhang, Man; Chen, Kaiming] Cent Hosp Affiliated Shenyang Med Coll, Shenyang, Peoples R China. [Chen, Manhua] Cent Hosp Wuhan, Wuhan, Hubei, Peoples R China. [Wang, Ningfu] Hangzhou First Peoples Hosp, Hangzhou, Zhejiang, Peoples R China. [Zhang, Peiying] Cent Hosp Xuzhou, Xuzhou, Jiangsu, Peoples R China. [Qu, Peng] Second Hosp Dalian Med Univ, Dalian, Peoples R China. [Hou, Ping] Liaoning Univ Tradit Chinese Med, First Affiliated Hosp, Shenyang, Liaoning, Peoples R China. [Zhang, Ping] Beijing Tsinghua Changgung Hosp, Beijing, Peoples R China. [Wu, Qiang] Guizhou Prov Peoples Hosp, Guiyang, Guizhou, Peoples R China. [Xie, Qiang] Xiamen Univ, First Affiliated Hosp, Xiamen, Fujian, Peoples R China. [Lin, Rong] Quanzhou First Hosp, Quanzhou, Fujian, Peoples R China. [Ye, Shaowu] Wuzhou Peoples Hosp, Wuzhou, Peoples R China. [Li, Shuangbin] Cent Hosp Jilin, Jilin, Jilin, Peoples R China. [Yang, Tianlun] Xiangya Hosp Cent South Univ, Changsha, Hunan, Peoples R China. [Wu, Tongguo] Guangzhou Red Cross Hosp, Guangzhou, Guangdong, Peoples R China. [Wang, Wei] First Affiliated Hosp Guangzhou Med Coll, Guangzhou, Guangdong, Peoples R China. [Huang, Weijian] Wenzhou Med Univ, First Affiliated Hosp, Wenzhou, Peoples R China. [Xu, Weiting] Soochow Univ, Second Affiliated Hosp, Suzhou, Peoples R China. [Su, Xi] Wuhan Asia Heart Hosp, Wuhan, Hubei, Peoples R China. [Yang, Xiangjun] Soochow Univ, First Affiliated Hosp, Suzhou, Peoples R China. [Ma, Xiaochuan] Affiliated Hosp Yanan Univ, Yanan, Shaanxi, Peoples R China. [Sun, Xiaofei] First Peoples Hosp Jining, Jining, Shandong, Peoples R China. [Chen, Xiaoping] Cent Hosp Taiyuan, Taiyuan, Shanxi, Peoples R China. [Chen, Xiaoping] Sichuan Univ, West China Hosp, Chengdu, Sichuan, Peoples R China. [Chen, Ximing] Guangzhou Med Univ, Third Affiliated Hosp, Guangzhou, Guangdong, Peoples R China. [Tang, Xingsheng] Wannan Med Coll, First Affiliated Hosp, Wannan, Peoples R China. [Li, Xue] Tangdu Hosp Fourth Mil Med Univ, Xian, Shaanxi, Peoples R China. [Liu, Xuebo] Tongji Univ, Shanghai East Hosp Affiliated, Shanghai, Peoples R China. [Wang, Yan] Xiamen Cardiovascular Dis Hosp, Xiamen, Fujian, Peoples R China. [Wang, Yanggan] Wuhan Univ, Zhongnan Hosp, Wuhan, Hubei, Peoples R China. [Guo, Yansong] Fujian Prov Hosp, Fuzhou, Fujian, Peoples R China. [Yang, Yanzong] Dalian Med Univ, First Affiliated Hosp, Dalian, Peoples R China. [Huang, Yi] First Peoples Hosp Changde, Changde, Hunan, Peoples R China. [Sun, Yingxian] China Med Univ, First Affiliated Hosp, Beijing, Peoples R China. [Jin, Yuanzhe] Fourth Affiliated Hosp China Med Univ, Beijing, Peoples R China. [Xu, Zesheng] Cangzhou Cent Hosp, Cangzhou, Hebei, Peoples R China. [Ouyang, Zewei] Cent Hosp Shaoyang, Shaoyang, Hunan, Peoples R China. [Li, Zhanquan] Peoples Hosp Liaoning Prov, Shenyang, Liaoning, Peoples R China. [He, Zhaofa] First Affiliated Hosp Jiamusi Univ, Jiamusi, Peoples R China. [Ji, Zheng] Tangshan Gongren Hosp, Tangshan, Hebei, Peoples R China. [Su, Zhenqi] Huaibei Miners Gen Hosp, Huaibei, Anhui, Peoples R China. [Ou, Zhihong] Linyi Peoples Hosp, Linyi, Shandong, Peoples R China. C3 Peking University; University of North Carolina; University of North Carolina Chapel Hill; University of California System; University of California Los Angeles; University of California Los Angeles Medical Center; David Geffen School of Medicine at UCLA; Fudan University; Nanjing University; Harbin Medical University; Wenzhou Medical University; Shanghai Jiao Tong University; Zhengzhou University; Shanxi People's Hospital; Army Medical University; Southeast University - China; Jinzhou Medical University; Zhejiang University; Capital Medical University; Bengbu Medical College; Shanxi Medical University; Peking University; Sun Yat Sen University; Guangdong Academy of Medical Sciences & Guangdong General Hospital; Guangxi Medical University; Shanghai Jiao Tong University; Zhengzhou University; Air Force Military Medical University; Guizhou Medical University; Chinese People's Liberation Army General Hospital; Henan University of Science & Technology; Ningxia Medical University; Capital Medical University; Shanghai Jiao Tong University; Chongqing Medical University; Sixth Medical Center of Chinese PLA General Hospital; Zhejiang Chinese Medical University; Qinghai University; Naval Medical University; Nanchang University; Xinjiang Medical University; Tianjin Medical University; Zhengzhou University; Nanchang University; Lanzhou University; Jiangnan University; Nanjing Medical University; Shanxi Medical University; Xuzhou Medical University; Army Medical University; Central South University; Wuhan University; Sichuan Provincial People's Hospital; Shandong University; Fujian Medical University; Qingdao Municipal Hospital; Fudan University; Guangdong Medical University; Dalian Medical University; Liaoning University of Traditional Chinese Medicine; Xiamen University; Central South University; Wenzhou Medical University; Soochow University - China; Soochow University - China; Sichuan University; Guangzhou Medical University; Wannan Medical College; Tongji University; Wuhan University; Fujian Provincial Hospital; Dalian Medical University RP Huo, Y (通讯作者),Peking Univ First Hosp, Dept Cardiol, Beijing, Peoples R China. EM huoyong@263.net.cn RI wang, jing/GRS-7509-2022; li, li/GPX-3938-2022; meng, li/GVT-2063-2022; lin, yuxi/HKF-6212-2023; Fan, Fang/GRO-2696-2022; li, long/HOF-6990-2023; Zhao, D/AAX-5040-2021; meng, li/HTQ-7341-2023; ding, jiawang/M-8804-2014; wang, jing/HJA-5384-2022; li, li/HII-4157-2022; Li, Li/AEM-3636-2022; fan, fang/GQY-9173-2022; LI, LI QING/GRR-8855-2022; li, li/AAT-2097-2020; LI, LI/GVS-5344-2022 OI Li, Yuxi/0000-0003-1556-598X FU Pfizer FX The CCC-ACS (Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome) project is a collaborative program of the American Heart Association (AHA) and Chinese Society of Cardiology. The AHA was funded by Pfizer for the quality-improvement initiative through an independent grant for learning and change. 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PD NOV 5 PY 2019 VL 8 IS 21 AR e013384 DI 10.1161/JAHA.119.013384 PG 33 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JN6HI UT WOS:000496996800037 PM 31630594 OA gold, Green Published DA 2023-05-13 ER PT J AU Haas, S Camm, AJ Bassand, JP Angchaisuksiri, P Cools, F Corbalan, R Gibbs, H Jacobson, B Koretsune, Y Mantovani, LG Misselwitz, F Panchenko, E Ragy, HI Stepinska, J Turpie, AGG Sawhney, JPS Steffel, J Lim, TW Pieper, KS Virdone, S Verheugt, FWA Kakkar, AK Luciardi, HL Gibbs, H Brodmann, M Cools, F Barretto, ACP Connolly, SJ Spyropoulos, A Eikelboom, J Corbalan, R Hu, DY Jansky, P Nielsen, JD Ragy, H Raatikainen, P Le Heuzey, JY Darius, H Keltai, M Kakkar, S Sawhney, JPS Agnelli, G Ambrosio, G Koretsune, Y Diaz, CJS Ten Cate, H Atar, D Stepinska, J Panchenko, E Lim, TW Jacobson, B Oh, S Vinolas, X Rosenqvist, M Steffel, J Angchaisuksiri, P Oto, A Parkhomenko, A Al Mahmeed, W Fitzmaurice, D Hu, DY Chen, KN Zhao, YS Zhang, HQ Chen, JZ Cao, SP Wang, DW Yang, YJ Li, WH Yin, YH Tao, GZ Yang, P Chen, YM He, SH Wang, Y Wang, Y Fu, GS Li, X Wu, TG Cheng, XS Yan, XW Zhao, RP Chen, MS Xiong, LG Chen, P Jiao, Y Guo, Y Xue, L Wang, FZ Li, H Yang, ZM Bai, CL Chen, J Chen, JY Chen, X Feng, S Fu, QH Gao, XJ Guo, WN He, RH He, XA Hu, XS Huang, XF Li, B Li, J Li, L Li, YH Liu, TT Liu, WL Liu, YY Lu, ZC Luo, XL Ma, TY Peng, JQ Sheng, X Shi, XJ Sun, YH Tian, G Wang, K Wang, L Wu, RN Xie, Q Xu, RY Yang, JS Yang, LL Yang, Q Ye, Y Yu, HY Yu, JH Yu, T Zhai, H Zhan, Q Zhang, GS Zhang, Q Zhang, R Zhang, Y Zheng, WY Zhou, B Zhou, ZH Zhu, XY Kakkar, S Sawhney, JPS Jadhav, P Durgaprasad, R Shankar, AGR Rajput, RK Bhargava, K Sarma, R Srinivas, A Roy, D Nagamalesh, UM Chopda, M Kishore, R Kulkarni, G Chandwani, P Pothiwala, RA Purayil, MP Shah, S Chawla, K Kothiwale, VA Raghuraman, B Vijayaraghavan, G Vijan, VM Bantwal, G Bisne, V Khan, A Gupta, JB Kumar, S Jain, D Abraham, S Adak, D Barai, A Begum, H Bhattacharjee, P Dargude, M Davies, D Deshpande, B Dhakrao, P Dhyani, V Duhan, S Earath, M Ganatra, A Giradkar, S Jain, V Karthikeyan, R Kasala, L Kaur, S Krishnappa, S Lawande, A Lokesh, B Madarkar, N Meena, R More, P Naik, D Prashanth, K Rao, M Rao, NM Sadhu, N Shah, D Sharma, M Shiva, P Singhal, S Suresh, S Vanajakshamma, V Panse, SG Koretsune, Y Kanamori, S Yamamoto, K Kumagai, K Katsuda, Y Sadamatsu, K Toyota, F Mizuno, Y Misumi, I Noguchi, H Ando, S Suetsugu, T Minamoto, M Oda, H Shiraishi, K Adachi, S Chiba, K Norita, H Tsuruta, M Koyanagi, T Ando, H Higashi, T Okada, K Azakami, S Komaki, S Kumeda, K Murayama, T Matsumura, J Oba, Y Sonoda, R Goto, K Minoda, K Haraguchi, Y Suefuji, H Miyagi, H Kato, H Nakamura, T Nakamura, T Nandate, H Zaitsu, R Fujiura, Y Yoshimura, A Numata, H Ogawa, J Tatematsu, H Kamogawa, Y Murakami, K Wakasa, Y Yamasawa, M Maekawa, H Abe, S Kihara, H Tsunoda, S Saito, K Saito, K Fudo, T Obunai, K Tachibana, H Oba, I Kuwahata, T Higa, S Gushiken, M Eto, T Yoshida, H Ikeda, D Fujiura, Y Ishizawa, M Nakatsuka, M Murata, K Ogurusu, C Shimoyama, M Akutsu, M Takamura, I Hoshino, F Yokota, N Iwao, T Tsuchida, K Takeuchi, M Hatori, Y Kitami, Y Nakamura, Y Oyama, R Ageta, M Oda, H Go, Y Mishima, K Unoki, T Morii, S Shiga, Y Sumi, H Nagatomo, T Sanno, K Fujisawa, K Atsuchi, Y Nagoshi, T Seto, T Tabuchi, T Kameko, M Nii, K Oshiro, K Takezawa, H Nagano, S Miyamoto, N Iwaki, M Nakamura, Y Fujii, M Okawa, M Abe, M Abe, M Abe, M Saito, T Mito, T Nagao, K Minami, J Mita, T Sakuma, I Taguchi, T Marusaki, S Doi, H Tanaka, M Fujito, T Matsuta, M Kusumoto, T Kakinoki, S Ashida, K Yoshizawa, N Agata, J Arasaki, O Manita, M Ikemura, M Fukuoka, S Murakami, H Matsukawa, S Hata, Y Taniguchi, T Ko, T Kubo, H Imamaki, M Akiyama, M Inagaki, M Odakura, H Ueda, T Katsube, Y Nakata, A Watanabe, H Techigawara, M Igarashi, M Taga, K Kimura, T Tomimoto, S Shibuya, M Nakano, M Ito, K Seo, T Hiramitsu, S Hosokawa, H Hoshiai, M Hibino, M Miyagawa, K Horie, H Sugishita, N Shiga, Y Soma, A Neya, K Yoshida, T Yoshida, T Mizuguchi, M Ishiguro, M Minagawa, T Wada, M Mukawa, H Okuda, F Nagasaka, S Abe, Y Adachi, S Adachi, S Adachi, T Akahane, K Amano, T Aoki, K Aoyama, T Arai, H Arima, S Arino, T Asano, H Asano, T Azuma, J Baba, T Betsuyaku, T Chibana, H Date, H Doiuchi, J Emura, Y Endo, M Fujii, Y Fujiki, R Fujisawa, A Fujisawa, Y Fukuda, T Fukui, T Furukawa, N Furukawa, T Furumoto, W Goto, T Hamaoka, M Hanazono, N Hasegawa, K Hatsuno, T Hayashi, Y Higuchi, K Hirasawa, K Hirayama, H Hirose, M Hirota, S Honda, M Horie, H Ido, T Iiji, O Ikeda, H Ikeda, K Ikeoka, K Imaizumi, M Inaba, H Inoue, T Iseki, F Ishihara, A Ishioka, N Ito, N Iwase, T Kakuda, H Kamata, J Kanai, H Kanda, H Kaneko, M Kano, H Kasai, T Kato, T Kato, Y Kawada, Y Kawai, K Kawakami, K Kawakami, S Kawamoto, T Kawano, S Kim, J Kira, T Kitazawa, H Kitazumi, H Kito, T Kobayashi, T Koeda, T Kojima, J Komatsu, H Komatsu, I Koshibu, Y Kotani, T Kozuka, T Kumai, Y Kumazaki, T Maeda, I Maeda, K Maruyama, Y Matsui, S Matsushita, K Matsuura, Y Mineoi, K Mitsuhashi, H Miura, N Miyaguchi, S Miyajima, S Miyamoto, H Miyashita, A Miyata, S Mizuguchi, I Mizuno, A Mori, T Moriai, O Morishita, K Murai, O Nagai, S Nagai, S Nagata, E Nagata, H Nakagomi, A Nakahara, S Nakamura, M Nakamura, R Nakanishi, N Nakayama, T Nakazato, R Nanke, T Nariyama, J Niijima, Y Niinuma, H Nishida, Y Nishihata, Y Nishino, K Nishioka, H Nishizawa, K Niwa, I Nomura, K Nomura, S Nozoe, M Ogawa, T Ohara, N Okada, M Okamoto, K Okita, H Okuyama, M Ono, H Ono, T Pearce, YO Oriso, S Ota, A Otaki, E Saito, Y Sakai, H Sakamoto, N Sakamoto, Y Samejima, Y Sasagawa, Y Sasaguri, H Sasaki, A Sasaki, T Sato, K Sato, K Sawano, M Seki, S Sekine, Y Seta, Y Sezaki, K Shibata, N Shiina, Y Shimono, H Shimoyama, Y Shindo, T Shinohara, H Shinohe, R Shinozuka, T Shirai, T Shiraiwa, T Shozawa, Y Suga, T Sugimoto, C Suzuki, K Suzuki, K Suzuki, S Suzuki, S Suzuki, S Suzuki, Y Tada, M Taguchi, A Takagi, T Takagi, Y Takahashi, K 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Worthy, V CA GARFIELD-AF Investigators TI Predictors of NOAC versus VKA use for stroke prevention in patients with newly diagnosed atrial fibrillation: Results from GARFIELD-AF SO AMERICAN HEART JOURNAL LA English DT Article ID ANTITHROMBOTIC TREATMENT PATTERNS; ANTAGONIST ORAL ANTICOAGULANTS; VITAMIN-K ANTAGONISTS; RENAL-FUNCTION; DRUG-USE; 1ST YEAR; WARFARIN; DABIGATRAN; OUTCOMES; TRENDS AB Introduction A principal aim of the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) was to document changes in treatment practice for patients with newly diagnosed atrial fibrillation during an era when non-vitamin K antagonist oral anticoagulants (NOACs) were becoming more widely adopted. In these analyses, the key factors which determined the choice between NOACs and vitamin K antagonists (VKAs) are explored. Methods Logistic least absolute shrinkage and selection operator regression determined predictors of NOAC and VKA use. Data were collected from 24,137 patients who were initiated on AC +/- antiplatelet (AP) therapy (NOAC [51.4%] or VKA [48.6%]) between April 2013 and August 2016. Results The most significant predictors of AC therapy were country, enrolment year, care setting at diagnosis, AF type, concomitant AP, and kidney disease. Patients enrolled in emergency care or in the outpatient setting were more likely to receive a NOAC than those enrolled in hospital (OR 1.16 [95% CI: 1.04-1.30], OR: 1.15 [95% CI: 1.05-1.25], respectively). NOAC prescribing seemed to be favored in lower-risk groups, namely, patients with paroxysmal AF, normotensive patients, and those with moderate alcohol consumption, but also the elderly and patients with acute coronary syndrome. By contrast, VKAs were preferentially used in patients with permanent AF, moderate to severe kidney disease, heart failure, vascular disease, and diabetes and with concomitant AP. Conclusion GARFIELD-AF data highlight marked heterogeneity in stroke prevention strategies globally. Physicians are adopting an individualized approach to stroke prevention where NOACs are favored in patients with a lower stroke risk but also in the elderly and patients with acute coronary syndrome. C1 [Haas, Sylvia] Tech Univ Munich, Munich, Germany. [Camm, A. John] St Georges Univ London, Cardiol Clin Acad Grp, Mol & Clin Sci Res Inst, London, England. [Bassand, Jean-Pierre] Univ Besancon, Besancon, France. [Bassand, Jean-Pierre; Pieper, Karen S.; Virdone, Saverio; Kakkar, Ajay K.] Thrombosis Res Inst, London, England. [Angchaisuksiri, Pantep] Mahidol Univ, Romathibodi Hosp, Bangkok, Thailand. [Cools, Frank] AZ Klina, Brasschaat, Belgium. [Corbalan, Ramon] Catholic Univ, Santiago, Chile. [Gibbs, Harry] Alfred Hosp, Melbourne, Vic, Australia. [Jacobson, Barry] NHLS, Johannesburg, South Africa. [Jacobson, Barry] Univ Witwatersrand, Charlotte Maxeke Hosp, Johannesburg, South Africa. [Koretsune, Yukihiro] Natl Hosp Org, Osaka Natl Hosp, Osaka, Japan. [Mantovani, Lorenzo G.] Univ Milano Bicocca, Milan, Italy. [Misselwitz, Frank] Bayer AG, Pharmaceut, Berlin, Germany. [Panchenko, Elizaveta] Russian Cardiol Res & Prod Ctr, Dept Atherothrombosis, 3-D Cherepkovskaya Str,15A, Moscow, Russia. [Ragy, Hany Ibrahim] Natl Heart Inst, Cairo, Egypt. [Stepinska, Janina] Inst Cardiol, Warsaw, Poland. [Turpie, Alexander G. G.] McMaster Univ, Hamilton, ON, Canada. [Sawhney, Jitendra P. S.] Sir Ganga Ram Hosp, New Delhi, India. [Steffel, Jan] Univ Hosp Zurich, Zurich, Switzerland. [Lim, Toon Wei] NUHCS, 1E Kent Ridge Rd,NUHS Tower Block,Level 9, Singapore, Singapore. [Pieper, Karen S.] Duke Clin Res Inst, Durham, NC USA. [Verheugt, Freek W. A.] OLVG, Amsterdam, Netherlands. [Kakkar, Ajay K.] UCL, London, England. C3 Technical University of Munich; St Georges University London; Universite de Franche-Comte; Thrombosis Research Institute; Mahidol University; Pontificia Universidad Catolica de Chile; Florey Institute of Neuroscience & Mental Health; National Health Laboratory Service; University of Witwatersrand; Osaka National Hospital; University of Milano-Bicocca; Bayer AG; National Medical Research Center of Cardiology; Institute of Cardiology - Poland; McMaster University; University of Zurich; University Zurich Hospital; National University of Singapore; Duke University; RLUK- Research Libraries UK; University of London; University College London RP Haas, S (通讯作者),Tech Univ Munich, Munich, Germany. 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Heart J. PD JUL PY 2019 VL 213 BP 35 EP 46 DI 10.1016/j.ahj.2019.03.013 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ID3SY UT WOS:000471598600005 PM 31128503 OA Green Accepted, Green Published, hybrid DA 2023-05-13 ER PT J AU Wechkunanukul, K Grantham, H Teubner, D Hyun, KK Clark, RA AF Wechkunanukul, Kannikar Grantham, Hugh Teubner, David Hyun, Karice K. Clark, Robyn A. TI Presenting characteristics and processing times for culturally and linguistically diverse (CALD) patients with chest pain in an emergency department: Time, Ethnicity, and Delay (TED) Study II SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Chest pain; Acute coronary syndromes; Culturally and linguistically diverse; Ethnicity; Emergency department; Emergency medical service ID ACUTE CORONARY SYNDROME; SEEKING TREATMENT; HEALTH-CARE; MI PATIENTS; IMMIGRANTS AB Background: To date there has been limited published data presenting the characteristics and timeliness of the management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients presenting with chest pain. This study aimed to describe the presenting characteristics and processing times for CALD patients with chest pain compared to the Australian-born population, and current guidelines. Methods: This study was a cross sectional analysis of a cohort of patients who presented with chest pain to the metropolitan hospital between 1 July 2012 and 30 June 2014. Results: Of the total study population (n = 6640), 1241 (18.7%) were CALD and 5399 (81.3%) were Australian born. CALD patients were significantly older than Australian-born patients (mean age 62 vs 56 years, p < 0.001). There were no differences in the proportion of patients who had central chest pain (74.9% vs 75.7%, p = 0.526); ambulance utilisation (41.7% vs 41.1%, p = 0.697); and time to initial treatment in ED (21 vs 22 min, p = 0.375). However, CALD patients spent a significantly longer total time in ED (5.4 vs 4.3 h, p < 0.001). There was no difference in guideline concordance between the two groups with low rates of 12.5% vs 13%, p = 0.556. Nonetheless, CALD patients were 22% (95% CI, 0.65, 0.95, p = 0.015) less likely to receive the guideline management for chest pain. Conclusions: The initial emergency care was equally provided to all patients in the context of a low rate of concordance with three chest pain related standards from the two guidelines. Nonetheless, CALD patients spent a longer time in ED compared to the Australian-born group. (C) 2016 Elsevier Ireland Ltd. All rights reserved. C1 [Wechkunanukul, Kannikar; Clark, Robyn A.] Flinders Univ S Australia, Sch Nursing & Midwifery, GPO BOX 2100, Adelaide, SA 5001, Australia. [Grantham, Hugh; Teubner, David] Flinders Univ S Australia, Paramed Dept, GPO BOX 2100, Adelaide, SA 5001, Australia. [Hyun, Karice K.] Univ Sydney, Sydney Med Sch, George Inst Global Hlth, Div Cardiovasc, Level 10,King George 5 Bldg,83-117 Missenden Rd, Camperdown, NSW 2050, Australia. C3 Flinders University South Australia; Flinders University South Australia; George Institute for Global Health; University of Sydney RP Wechkunanukul, K (通讯作者),Flinders Univ S Australia, Sch Nursing & Midwifery, GPO BOX 2100, Adelaide, SA 5001, Australia. EM kannikar.w@flinders.edu.au; hugh.grantham@flinders.edu.au; david.teubner@flinders.edu.au; khyun@georgeinstitute.org.au; robyn.clark@flinders.edu.au RI Clark, Robyn A/D-1604-2009; Wechkunanukul, Kannikar/M-2242-2018 OI Clark, Robyn A/0000-0002-5063-2618; Hyun, Karice/0000-0002-0164-7725; Wechkunanukul, Hannah/0000-0002-2901-1606; Grantham, Hugh/0000-0003-1700-190X CR Abdelnoor M, 2012, VASC HEALTH RISK MAN, V8, P505, DOI 10.2147/VHRM.S33627 Acute Coronary Syndrome Guidelines Working Group, 2006, MED J AUSTRALIA, V184, pS7 Anderson KO, 2009, J PAIN, V10, P1187, DOI 10.1016/j.jpain.2009.10.002 World Medical Association, 2013, JAMA, V310, P2191, DOI 10.1001/jama.2013.281053 Australian bureau of Statistics, 2015, CONTRACT Australian Bureau of Statistics, 2011, UND MIGR OUTC ENH VA Australian Commission on Safety and Quality in Health Care, 2014, AC COR SYNDR CLIN CA Australian Goverment Department of Human Services, 2015, WAITING Australian Institute of Health and Welfare, 2014, AUSTR HOSP STAT 2013, V58 Boersma E, 1996, LANCET, V348, P771, DOI 10.1016/S0140-6736(96)02514-7 Bray JE, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.001927 Chew DP, 2013, MED J AUSTRALIA, V199, P185, DOI 10.5694/mja12.11854 CHIU M, 2010, CAN MED ASSOC J, V182, pE301, DOI DOI 10.1503/cmaj.091676 Coventry LL, 2015, HEART LUNG CIRC, V24, P943, DOI 10.1016/j.hlc.2015.02.026 Coventry LL, 2015, HEART LUNG CIRC, V24, P796, DOI 10.1016/j.hlc.2015.01.015 De Luca G, 2004, CIRCULATION, V109, P1223, DOI 10.1161/01.CIR.0000121424.76486.20 Department of Health (DOH), 2013, MAX LEV NITR AGR PRO Derose KP, 2007, HEALTH AFFAIR, V26, P1258, DOI 10.1377/hlthaff.26.5.1258 Derose KP, 2009, MED CARE RES REV, V66, P355, DOI 10.1177/1077558708330425 DRACUP K, 1995, SOC SCI MED, V40, P379, DOI 10.1016/0277-9536(94)00278-2 Engebretson J, 2008, J PROF NURS, V24, P172, DOI 10.1016/j.profnurs.2007.10.012 Ethnic Communities' Council of Victoria, 2012, ECCV GLOSS TERMS FECCA, 2015, OLD PEOPL CALD BACKG Gushulak BD, 2004, CAN J PUBLIC HEALTH, V95, pI27, DOI 10.1007/BF03403662 Henderson Sean O., 2002, Ethnicity and Disease, V12, P38 Hutchings CB, 2004, AM HEART J, V147, P35, DOI 10.1016/S0002-8703(03)00510-6 Hyun K., 2014, GLOB HEART, V9, P127 King KM, 2009, AM J CARDIOL, V103, P1368, DOI 10.1016/j.amjcard.2009.01.344 King-Shier KM, 2015, EUR J CARDIOVASC NUR, V14, P240, DOI 10.1177/1474515114529690 Lebrun LA, 2012, SOC SCI MED, V74, P1062, DOI 10.1016/j.socscimed.2011.11.031 Moser DK, 2006, CIRCULATION, V114, P168, DOI 10.1161/CIRCULATIONAHA.106.176040 Mozaffarian D, 2015, CIRCULATION, V131, pE29, DOI 10.1161/CIR.0000000000000152 National Health and Medical Research Council, 2006, CULT COMP HLTH GUID Nichols M PK, 2014, AUSTR HEART DIS STAT Niska Richard, 2010, Natl Health Stat Report, P1 NORRVING B., 2011, GLOBAL ATLAS CARDIOV Rawshani A, 2014, INT J CARDIOL, V176, P859, DOI 10.1016/j.ijcard.2014.08.004 Renzaho A, 2007, HEALTH INF MANAG J, V36, P26, DOI 10.1177/183335830703600206 Sobralske M, 2006, J AM ACAD NURSE PRAC, V18, P348, DOI 10.1111/j.1745-7599.2006.00144.x Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Taylor David McD, 2005, Emerg Med Australas, V17, P204 Ting HH, 2010, ARCH INTERN MED, V170, P1834, DOI 10.1001/archinternmed.2010.385 Wechkunanukul K., 2014, JBI DATABASE SYST RE, V12, P21 Wechkunanukul K., 2015, HEART LUNG CIRC S3, V24, pS162 Wechkunanukul K., 2016, AUST CRIT CARE NR 45 TC 4 Z9 4 U1 0 U2 2 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD OCT 1 PY 2016 VL 220 BP 901 EP 908 DI 10.1016/j.ijcard.2016.06.244 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA DT6GM UT WOS:000381582000171 PM 27404505 DA 2023-05-13 ER PT J AU Gc, VS Alshurafa, M Sturgess, DJ Ting, J Gregory, K Goncalves, ASO Whitty, JA AF Gc, Vijay S. Alshurafa, Mohamad Sturgess, David J. Ting, Joseph Gregory, Kye Goncalves, Ana Sofia Oliveira Whitty, Jennifer A. TI Cost-minimisation analysis alongside a pilot study of early Tissue Doppler Evaluation of Diastolic Dysfunction in Emergency Department Non-ST Elevation Acute Coronary Syndromes (TEDDy-NSTEACS) SO BMJ OPEN LA English DT Article ID CHEST-PAIN; ECHOCARDIOGRAPHY; ANGIOGRAPHY; GUIDELINES; MANAGEMENT; AUSTRALIA; OUTCOMES; SOCIETY AB Objective To estimate the cost implications of early angiography for patients with suspected non-ST elevation acute coronary syndrome (NSTEACS) using tissue Doppler imaging (TDI). Design A decision tree model was used to synthesise data from the pilot study and literature sources. Sensitivity analyses tested the impact of assumptions incorporated into the analysis. Setting Emergency department (ED), Brisbane, Australia. Participants Patients with suspected NSTEACS. Interventions TDI as a diagnostic tool for triaging patients within 4 hours of presentation in addition to conventional risk stratification, compared with conventional risk stratification alone. Data sources Resource used for diagnosis and management were recorded prospectively and costed for 51 adults who had echocardiography within 24 hours of admission. Costs for conventional care were based on observed data. Cost estimates for the TDI intervention assumed patients classified as high risk at TDI (E/e'>14) progressed early to angiography with an associated 1-day reduction in length of stay. Primary outcome measures Costs until discharge from the Australian healthcare perspective in 2016-2017 prices. Results Findings suggest that using TDI as a diagnostic tool for triaging patients with suspected NSTEACS is likely to be cost saving by $A1090 (95% credible interval: $A573 to $A1703) per patient compared with conventional care. The results are mainly driven by the assumed reduction in length of stay due to the inclusion of early TDI in clinical decision-making. Conclusions This pilot study indicates that compared with conventional risk stratification, triaging patients presenting with suspected NSTEACS with TDI within 4 hours of ED presentation has potential cost savings. Findings assume a reduction in hospital stay is achieved for patients considered to be high risk at TDI. Larger, comparative studies with longer follow-up are needed to confirm the clinical effectiveness of TDI as a diagnostic strategy for NSTEACS, the assumed reduction in hospital stay and any cost saving. C1 [Gc, Vijay S.] Univ York, Ctr Hlth Econ, York, N Yorkshire, England. [Gc, Vijay S.; Goncalves, Ana Sofia Oliveira; Whitty, Jennifer A.] Univ East Anglia, Norwich Med Sch, Norwich, Norfolk, England. [Alshurafa, Mohamad; Sturgess, David J.; Ting, Joseph; Gregory, Kye] Univ Queensland, Mater Res Inst, South Brisbane, Qld, Australia. C3 N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of York - UK; RLUK- Research Libraries UK; University of East Anglia; Mater Research; University of Queensland RP Whitty, JA (通讯作者),Univ East Anglia, Norwich Med Sch, Norwich, Norfolk, England. EM Jennifer.Whitty@uea.ac.uk RI Gonçalves, Ana Sofia Oliveira/ABF-5704-2020; Ting, Joseph Y/A-7779-2012; Gonçalves, Sofia/HCI-2120-2022; Gc, Vijay/E-7443-2011; Oliveira Gonçalves, Ana Sofia/CAG-8084-2022; Sturgess, David/G-2965-2011 OI Ting, Joseph Y/0000-0002-7807-9543; Gc, Vijay/0000-0003-0365-2605; Oliveira Gonçalves, Ana Sofia/0000-0002-5678-4137; Sturgess, David/0000-0002-4364-0038; Alshurafa, Mohamad/0000-0002-2817-0410 FU Emergency Medicine Foundation (Australia) Queensland Programme FX This work was supported by a grant from the Emergency Medicine Foundation (Australia) Queensland Programme. 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Aspirin therapy has proven clinical effectiveness in the prevention and treatment of CVD and is one of the most widely used drugs nationwide. However, despite the medication's popularity and utility, adherence to a proper aspirin regimen is suboptimal, resulting in adverse health outcomes and increased health care costs. Our review outlines current knowledge on aspirin therapy adherence, causes of nonadherence, and strategies available to increase adherence to aspirin and medications in general. We demonstrate that, indeed, aspirin adherence rates are suboptimal, ranging from 72% to 92%, and that a combination of patient- and medication-related factors contribute to nonadherence. A multidimensional approach involving patient education and medication innovations to reduce aspirin side effects is imperative to improving rates of aspirin therapy adherence. C1 [Duffy, Danielle] Thomas Jefferson Univ, Jefferson Med Coll, Div Cardiol, Philadelphia, PA 19107 USA. [Kelly, Erik] Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA. [Trang, Amanda] Thomas Jefferson Univ, Div Internal Med, Thomas Jefferson Univ Hosp, Philadelphia, PA 19107 USA. [Whellan, David] Thomas Jefferson Univ, Jefferson Med Coll, Jefferson Coordinating Ctr Clin Res, Philadelphia, PA 19107 USA. [Mills, Geoffrey] Thomas Jefferson Univ, Jefferson Med Coll, Dept Family & Community Med, Philadelphia, PA 19107 USA. [Mills, Geoffrey] Thomas Jefferson Univ, Jefferson Med Coll, Dept Physiol, Philadelphia, PA 19107 USA. C3 Jefferson University; Jefferson University; Jefferson University; Jefferson University; Jefferson University; Jefferson University RP Duffy, D (通讯作者),Thomas Jefferson Univ, Jefferson Med Coll, Div Cardiol, Philadelphia, PA 19107 USA. FU Pozen, Inc (Chapel Hill, NC) FX Pozen, Inc (Chapel Hill, NC) provided funding for coordination and editorial support of a review on the general topic of aspirin adherence. Content and direction were the sole discretion of the authors without review by Pozen employees. Scientific editorial support was provided by Courtney Zeni, PhD (QSci Communications, King of Prussia, PA). 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Med. PD JAN PY 2014 VL 126 IS 1 BP 18 EP 28 DI 10.3810/pgm.2014.01.2721 PG 11 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AX2SY UT WOS:000346795800002 PM 24393748 DA 2023-05-13 ER PT J AU Lau, KK Wong, YK Chang, RSK Teo, KC Hon, SFK Chan, KH Wat, KL Cheung, RTF Li, LSW Siu, CW Ho, SL Tse, HF AF Lau, K. K. Wong, Y. K. Chang, R. S. K. Teo, K. C. Hon, S. F. K. Chan, K. H. Wat, K. L. Cheung, R. T. F. Li, L. S. W. Siu, C. W. Ho, S. L. Tse, H. F. TI Visit-to-visit systolic blood pressure variability predicts all-cause and cardiovascular mortality after lacunar infarct SO EUROPEAN JOURNAL OF NEUROLOGY LA English DT Article DE blood pressure variability; lacunar infarct; mortality ID HEALTH-CARE PROFESSIONALS; MYOCARDIAL-INFARCTION; STROKE; RISK; IMPACT AB Background and purposeBoth blood pressure (BP) and its variability (BPV) are established risk factors for development of atherosclerotic disease and are associated with an increased risk for cardiovascular and all-cause mortality. The prognostic implications of outpatient clinic visit-to-visit BPV amongst patients with lacunar infarction are nevertheless unknown. MethodsThe clinical outcome of 281 patients with lacunar infarction was prospectively followed up. The average BP and BPV, as determined by the standard deviation of the systolic and diastolic BP, were recorded during a mean 136 outpatient clinic visits. ResultsThe mean age of the population was 70 +/- 10years. After a mean 78 +/- 18months follow-up, 65 patients died (23%), 31% (20/65) due to cardiovascular causes; 14% and 7% developed recurrent stroke and acute coronary syndrome. After adjusting for age, sex, mean systolic and diastolic BP, cardiovascular risk factors and comorbidities, patients with a systolic BPV of the third tertile had significantly higher risk of all-cause mortality [hazard ratio (HR) 1.97, 95% confidence interval (CI) 1.02-3.80, P=0.04) and cardiovascular mortality (HR 7.64, 95% CI 1.65-35.41, P<0.01) than those with systolic BPV of the first tertile. Nevertheless, systolic BPV did not predict recurrent stroke or acute coronary syndrome. Diastolic BPV did not predict various adverse clinical outcomes. ConclusionsVisit-to-visit systolic BPV predicts long-term all-cause and cardiovascular mortality after lacunar infarct, independent of conventional risk factors including average BP control. C1 [Lau, K. K.; Wong, Y. K.; Chang, R. S. K.; Teo, K. C.; Hon, S. F. K.; Chan, K. H.; Cheung, R. T. F.; Ho, S. L.] Univ Hong Kong, Div Neurol, Dept Med, Hong Kong, Hong Kong, Peoples R China. [Wat, K. L.; Siu, C. W.; Tse, H. F.] Univ Hong Kong, Div Cardiol, Dept Med, Hong Kong, Hong Kong, Peoples R China. [Li, L. S. W.] Univ Hong Kong, Div Rehabil Med, Dept Med, Hong Kong, Hong Kong, Peoples R China. C3 University of Hong Kong; University of Hong Kong; University of Hong Kong RP Tse, HF (通讯作者),Univ Hong Kong, Div Cardiol, Dept Med, Hong Kong, Hong Kong, Peoples R China. EM slho@hku.hk; hftse@hkucc.hku.hk RI Siu, Chung Wah/C-6947-2011; Ho, Shu-Leong/AFK-8146-2022; Tse, Hung-Fat/C-4426-2009; Lau, Gary Kui Kai/D-7944-2011 OI Tse, Hung-Fat/0000-0002-9578-7808; Lau, Gary Kui Kai/0000-0002-8657-2418; Tse, Hung Fat/0000-0003-4665-7887; Teo, Kay-Cheong/0000-0002-3291-2958 FU University of Hong Kong FX The authors acknowledge an RGC Direct Allocation Grant of the University of Hong Kong. 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J. Neurol. PD FEB PY 2014 VL 21 IS 2 BP 319 EP 325 DI 10.1111/ene.12310 PG 7 WC Clinical Neurology; Neurosciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology GA 287MZ UT WOS:000329547200024 PM 24267182 OA Green Submitted DA 2023-05-13 ER PT J AU Sepehrvand, N Zheng, YG Armstrong, PW Welsh, RC Ezekowitz, JA AF Sepehrvand, Nariman Zheng, Yinggan Armstrong, Paul W. Welsh, Robert C. Ezekowitz, Justin A. TI Identifying Low-risk Patients for Early Discharge From Emergency Department Without Using Subjective Descriptions of Chest Pain: Insights From Providing Rapid Out of Hospital Acute Cardiovascular Treatment (PROACT) 3 and 4 Trials SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; CARE-UNIT ADMISSION; DIAGNOSTIC PROTOCOL; MISSED DIAGNOSES; INTENSIVE-CARE; TROPONIN-I; VALIDATION; SCORE; PREDICTION AB Background: Several accelerated diagnostic protocols (ADPs) have been developed to allow emergency department (ED) physicians to identify appropriate patients for safe early discharge after presentation with symptom of chest pain. Most ADPs require chest pain to be described and modify the algorithm based on the subjective chest pain characteristics. We investigated the performance of three established major ADPs simplified by eliminating the need for chest pain as a descriptor. Methods: We pooled patients from PROACT-3 and -4 trials, in which patients presenting to emergency medical services with chest pain or dyspnea were enrolled. The simplified Vancouver Chest Pain Rule (sVCPR), the simplified Emergency Department Assessment of Chest Pain Score (sEDACS) ADP and the Accelerated Diagnostic protocol to Assess Patients with chest pain using contemporary troponins as the only biomarker (ADAPT-ADP) were compared using the sensitivity, specificity, and positive and negative predictive values (NPV). The primary outcome of interest was 30-day major adverse cardiac events (MACE); the diagnosis of acute coronary syndrome (ACS) occurring within 30 days after ED presentation was also explored. Results: A total of 1,081 patients were included (median age = 67 years, 53% male, median GRACE score = 113) of which 222 ACS diagnoses and 150 cardiac events occurred within 30 days after index ED presentation. The sVCPR, sEDACS >= 3, and ADAPT-ADP, respectively, identified 9.7, 13.3, and 4.1% of patients as low risk with a sensitivity and NPV of 100% for the primary outcome of 30-day MACE. The sEDACS-ADP identified 24.2% of patients as low risk with a cut-point score of 4 (sensitivity of 98.0% and NPV of 98.8%). The sVCPR, sEDACS >= 3, and ADAPT-ADP, respectively, had NPVs of 98.1, 95.8, and 93.3% in identifying patients at higher risk of ACS diagnosis within 30 days after index ED visit. Conclusion: The diagnostic protocols performed well without their chest pain characteristics component. Further studies are suggested to explore the performance of ADPs when these simplified ADPs are combined with high-sensitive troponin assays. C1 [Sepehrvand, Nariman; Zheng, Yinggan; Armstrong, Paul W.; Welsh, Robert C.; Ezekowitz, Justin A.] Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada. [Welsh, Robert C.; Ezekowitz, Justin A.] Mazankowski Alberta Heart Inst, Edmonton, AB, Canada. C3 University of Alberta RP Ezekowitz, JA (通讯作者),Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada.; Ezekowitz, JA (通讯作者),Mazankowski Alberta Heart Inst, Edmonton, AB, Canada. EM jae2@ualberta.ca RI Welsh, Robert/ABH-3526-2021; Ezekowitz, Justin/C-4579-2013; Sepehrvand, Nariman/E-2016-2016 OI Ezekowitz, Justin/0000-0002-2724-4086; Armstrong, Paul/0000-0002-0460-3445; Sepehrvand, Nariman/0000-0003-0346-3484; Welsh, Robert/0000-0003-2613-9142 FU Heart and Stroke Foundation of Canada; University Hospital Foundation; Mazankowski Alberta Heart Institute; Alberta Health Services; Alere Inc.; Alberta Innovates [201500148] Funding Source: researchfish FX PROACT-3 and -4 trials were supported by the Heart and Stroke Foundation of Canada, the University Hospital Foundation, the Mazankowski Alberta Heart Institute, Alberta Health Services, and Alere Inc. 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PD JUN PY 2017 VL 24 IS 6 BP 691 EP 700 DI 10.1111/acem.13183 PG 10 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA FA2BC UT WOS:000405244600005 PM 28261896 OA Bronze DA 2023-05-13 ER PT J AU James, P Kasthuri, R Kruse-Jarres, R Soni, A Kulkarni, R Bidlingmaier, C Chitlur, M Fogarty, P Gomez, K Holm, PA Mahlangu, J Mancuso, ME Mingot-Castellano, ME Dolan, G AF James, Paula Kasthuri, Raj Kruse-Jarres, Rebecca Soni, Amit Kulkarni, Roshni Bidlingmaier, Christoph Chitlur, Meera Fogarty, Patrick Gomez, Keith Holm, Pal Andre Mahlangu, Johnny Mancuso, Maria Elisa Eva Mingot-Castellano, Maria Dolan, Gerry TI Global Emerging HEmophilia Panel (GEHEP): A Multinational Collaboration for Advancing Hemophilia Research and Treatment SO TRANSFUSION MEDICINE AND HEMOTHERAPY LA English DT Review DE Blood coagulation disorder; Clinical research; GEHEP; International cooperation; Hemophilia ID CARE AB GEHEP, established in 2009, is an independent, multi-institutional, international consortium of early,career hematology specialists in the field of hemophilia and other inherited bleeding disorders. The main objective of the group, whose members practice at institutions in North America, Europe, and South Africa, is to advance hemophilia care by providing a forum for mentored collaborative research, developing programs for improving clinical care, and promoting academic career development of junior faculty. GEHEP members collect and document anonymized data on intra- and interinstitutional differences in patient populations, diagnosis, and treatment in the field of hemophilia and other bleeding disorders. To facilitate sharing of aggregated data among GEHEP members, a global protocol was developed and approved by most members' local institutional review board. Current GEHEP research initiatives are varied, encompassing work in pediatric and adult patients. GEHEP members have presented research at international meetings on the initiation of prophylaxis in children, use of immune tolerance induction in adults, and prevalence of acute coronary syndromes in older patients with hemophilia. The main goal of the continuing work of GEHEP is to advance the care of patients with hemophilia worldwide. C1 [James, Paula] Queens Univ, Kingston, ON K7L 2V6, Canada. [Kasthuri, Raj] Univ N Carolina, Chapel Hill, NC USA. [Kruse-Jarres, Rebecca] Tulane Univ, Sch Med, New Orleans, LA 70112 USA. [Soni, Amit] Childrens Hosp Orange Cty, Orange, CA 92668 USA. [Kulkarni, Roshni] Michigan State Univ, E Lansing, MI 48824 USA. [Bidlingmaier, Christoph] Munich Hemophilia Ctr, Munich, Germany. [Chitlur, Meera] Childrens Hosp Michigan, Detroit, MI 48201 USA. [Fogarty, Patrick] Univ Penn, Philadelphia, PA 19104 USA. [Gomez, Keith] Royal Free Hosp, London NW3 2QG, England. [Holm, Pal Andre] Univ Hosp, Rikshosp, Oslo, Norway. [Mahlangu, Johnny] Johannesburg Hosp, Johannesburg, South Africa. [Mancuso, Maria Elisa] Angelo Bianchi Bonomi Hemophilia Ctr, Milan, Italy. [Eva Mingot-Castellano, Maria] Reg Univ Hosp Carlos Haya, Malaga, Spain. [Dolan, Gerry] Univ Nottingham Hosp, Nottingham NG7 2UH, England. C3 Queens University - Canada; University of North Carolina; University of North Carolina Chapel Hill; Tulane University; Childrens Hospital of Orange County; Michigan State University; Children's Hospital of Michigan; University of Pennsylvania; University of London; RLUK- Research Libraries UK; University College London; Royal Free London NHS Foundation Trust; UCL Medical School; University of Oslo; National Hospital Norway; University of Witwatersrand; RLUK- Research Libraries UK; University of Nottingham RP James, P (通讯作者),Queens Univ, Dept Med, Etherington Hall,Room 2025,94 Stuart St, Kingston, ON K7L 2V6, Canada. EM jamesp@queensu.ca RI Mancuso, Maria Elisa/AAT-4785-2020; Chitlur, Meera/G-2913-2015; Mahlangu, Johnny/H-7558-2019 OI Mancuso, Maria Elisa/0000-0002-7113-4028; Mahlangu, Johnny/0000-0001-5781-7669; Bidlingmaier, Christoph/0000-0003-3755-0930; Gomez, Keith/0000-0002-8934-0700; Mingot Castellano, Maria Eva/0000-0001-9083-855X; Kasthuri, Raj/0000-0001-6672-3082 FU Bayer Health Care FX Medical writing assistance was provided by Karen L. Zimmermann of Complete Healthcare Communications, Inc., and was funded by Bayer Health Care. CR BIDLINGMAIER C, 2012, HAEMOPHILIA S3, V18, P15 Chitlur M, 2010, WORLD FED HEM JUL 10 Evatt BL, 2006, HAEMOPHILIA, V12, P13, DOI 10.1111/j.1365-2516.2006.01256.x Fogarty PF, 2012, SCI STAND COMM ISTH Kruse-Jarres R, 2010, HAEMOPHILIA, V16, P75 Liverpool UK., 2010, WORLD FED HEM JUL 10 National Hemophilia Foundation, HEM A O'Mahony B, 2005, SEMIN THROMB HEMOST, V31, P561, DOI 10.1055/s-2005-922228 Peyvandi F, 2006, HAEMOPHILIA, V12, P82, DOI 10.1111/j.1365-2516.2006.01263.x Ruiz-Saez A, 2012, HEMATOLOGY, V17, pS141, DOI 10.1179/102453312X13336169156492 White GC, 2001, THROMB HAEMOSTASIS, V85, P560, DOI 10.1055/s-0037-1615621 NR 11 TC 5 Z9 6 U1 0 U2 9 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1660-3796 EI 1660-3818 J9 TRANSFUS MED HEMOTH JI Transfus. Med. Hemother. PY 2013 VL 40 IS 5 BP 352 EP 355 DI 10.1159/000354843 PG 4 WC Hematology; Immunology WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Immunology GA 229ZR UT WOS:000325306900008 PM 24273489 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Muhlbacher, AC Bethge, S AF Muehlbacher, Axel C. Bethge, Susanne TI Reduce Mortality Risk Above All Else: A Discrete-Choice Experiment in Acute Coronary Syndrome Patients SO PHARMACOECONOMICS LA English DT Article ID CARE DECISION-MAKING; PULMONARY-FUNCTION; CONJOINT-ANALYSIS; CLOPIDOGREL; TICAGRELOR; OUTCOMES; DYSPNEA; PLATO AB Background and Objective Cardiovascular disease is the main cause of death in Germany and other industrialized countries. However, until now, little has been known about how people with acute coronary syndrome (ACS) value aspects of their medical treatment. The objective of this study was to evaluate patients' preferences regarding different antiplatelet medication options following an ACS. Method After identification of patient-relevant treatment attributes (a literature review and qualitative interviews), a discrete-choice experiment (DCE) including five patient-relevant attributes was conducted. The DCE used a forced-choice approach in which no "opt out" was present, as no treatment is not an option after ACS. The attribute and level combinations were created using a fractional-factorial NGene design with priors. Data analysis was performed using a random-effects logit model. An additional generalized linear latent and mixed models (GLLAMM) analysis was performed to evaluate subgroup differences. Results ACS patients (N = 683) participated in computer-assisted personal interviews. Preference analysis showed a clear dominance of the attribute "mortality risk" (coefficient: 0.803). Ranked second was "side effect: dyspnea" (coefficient: 0.550) followed by "risk of a new myocardial infarction" (coefficient: 0.464) and "side effect: bleeding" (coefficient: 0.400). "Frequency of intake" was less important (coefficient: 0.025). Within the 3-class GLLAMM, the variables "marital status" (p = 0.008), "highest level of education" (p = 0.003), and "body-mass index" (according to World Health Organization cluster; p = 0.014) showed a significant impact on the estimated class probabilities. Conclusion Our study found "mortality risk" to be of the highest value for patients. Patient-centered care and decision making requires consideration of patient preferences; moreover, the information on preferences can be used to develop effective therapies after an ACS. The data generated will enable healthcare decision makers and stakeholders to understand patient preferences to promote patients' benefit. C1 [Muehlbacher, Axel C.; Bethge, Susanne] Hsch Neubrandenburg, IGM Inst Gesundheitsokon & Med Management, D-17033 Neubrandenburg, Germany. [Muehlbacher, Axel C.] Gesell Empir Beratung GmbH GEB, Freiburg, Germany. RP Bethge, S (通讯作者),Hsch Neubrandenburg, IGM Inst Gesundheitsokon & Med Management, Brodaer Str 2, D-17033 Neubrandenburg, Germany. EM muehlbacher@hs-nb.de; bethge@hs-nb.de RI Mühlbacher, Axel/AAZ-6577-2020 OI Mühlbacher, Axel/0000-0003-4402-9211 FU AstraZeneca GmbH, Germany FX This study was funded by AstraZeneca GmbH, Germany. AM and SB declare no conflict of interest. CR Behan MW, 2010, CURR OPIN CARDIOL, V25, P321, DOI 10.1097/HCO.0b013e328338f7b5 Ben-Akiva M., 1985, TRANSPORTATION STUDI Bridges JFP, 2011, VALUE HEALTH, V14, P403, DOI 10.1016/j.jval.2010.11.013 Glaeske G, 2012, DTSCH ARZTEBL INT, V109, P115, DOI 10.3238/arztebl.2012.0115 HAMM CW, 2004, POCKET LEITLINIEN AK Helm R, 2008, PRAFERENZMESSUNG MET Hensher D.A., 2005, APPL CHOICE ANAL PRI, DOI DOI 10.1017/CBO9781316136232 Hoer A, 2012, VERSORGUNG KOSTEN VE Institut fur Qualitat und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), 2014, ALLG METH ENTW VERS Institut fur Qualitat und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), 2010, PRAS BEI AK KOR DOK Johansson G, 2004, CHEST, V125, P916, DOI 10.1378/chest.125.3.916 Johnson FR, 2008, PATIENT, V1, P245, DOI [10.2165/1312067-200801040-00003, 10.2165/01312067-200801040-00003] Kelm M, 2005, INTERNIST, V46, P265, DOI 10.1007/s00108-005-1357-1 LANCASTER KJ, 1966, J POLIT ECON, V74, P132, DOI 10.1086/259131 Lancsar E, 2008, PHARMACOECONOMICS, V26, P661, DOI 10.2165/00019053-200826080-00004 Louviere JJ, 2008, J CONSUM RES, V35, P360, DOI 10.1086/586913 LOWEL H, 2006, GESUNDHEITSBERICHTER, V33 McFadden D., 1974, ZAREMBKA, V1974, P105 Muhlbacher AC, 2013, APPL HEALTH ECON HEA, V11, P163, DOI 10.1007/s40258-013-0023-3 Muhlbacher A, 2013, GESUNDHEITSOKON QUAL, V4, P159 Orme BK, 2010, GETTING STARTED CONJ, P57 Post F, 2010, INTERNIST, V51, P953, DOI 10.1007/s00108-009-2536-2 Ryan M, 2008, ECON NON-MARK GOOD, V11, P1, DOI 10.1007/978-1-4020-5753-3 Statistisches Bundesamt, 2011, DIAGN KRANK AB 2000 Statistisches Bundesamt, 2012, GES Storey RF, 2010, J AM COLL CARDIOL S1, V55 Storey RF, 2011, EUR HEART J, V32, P2945, DOI 10.1093/eurheartj/ehr231 Storey RF, 2011, AM J CARDIOL, V108, P1542, DOI 10.1016/j.amjcard.2011.07.015 Storey RF, 2010, J AM COLL CARDIOL, V56, P185, DOI 10.1016/j.jacc.2010.01.062 U. 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Department of Health and Human Services, 2007, GUID REV REP UN PROB Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 NR 31 TC 11 Z9 11 U1 0 U2 13 PU ADIS INT LTD PI NORTHCOTE PA 5 THE WAREHOUSE WAY, NORTHCOTE 0627, AUCKLAND, NEW ZEALAND SN 1170-7690 EI 1179-2027 J9 PHARMACOECONOMICS JI Pharmacoeconomics PD JAN PY 2015 VL 33 IS 1 BP 71 EP 81 DI 10.1007/s40273-014-0223-1 PG 11 WC Economics; Health Care Sciences & Services; Health Policy & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Business & Economics; Health Care Sciences & Services; Pharmacology & Pharmacy GA AX8IG UT WOS:000347152700008 PM 25342231 DA 2023-05-13 ER PT J AU Mogharab, V Ostovar, M Ruszkowski, J Hussain, SZM Shrestha, R Yaqoob, U Aryanpoor, P Nikkhoo, AM Heidari, P Jahromi, AR Rayatdoost, E Ali, A Javdani, F Farzaneh, R Ghanaatpisheh, A Habibzadeh, SR Foroughian, M Ahmadi, SR Akhavan, R Abbasi, B Shahi, B Hakemi, A Bolvardi, E Bagherian, F Motamed, M Boroujeni, ST Jamalnia, S Mangouri, A Paydar, M Mehrasa, N Shirali, D Sanmarchi, F Saeed, A Jafari, NA Babou, A Kalani, N Hatami, N AF Mogharab, Vahid Ostovar, Mahshid Ruszkowski, Jakub Hussain, Syed Zohaib Maroof Shrestha, Rajeev Yaqoob, Uzair Aryanpoor, Poorya Nikkhoo, Amir Mohammad Heidari, Parasta Jahromi, Athar Rasekh Rayatdoost, Esmaeil Ali, Anwar Javdani, Farshid Farzaneh, Roohie Ghanaatpisheh, Aref Habibzadeh, Seyed Reza Foroughian, Mahdi Ahmadi, Sayyed Reza Akhavan, Reza Abbasi, Bita Shahi, Behzad Hakemi, Arman Bolvardi, Ehsan Bagherian, Farhad Motamed, Mahsa Boroujeni, Sina Taherzadeh Jamalnia, Sheida Mangouri, Amir Paydar, Maryam Mehrasa, Neda Shirali, Dorna Sanmarchi, Francesco Saeed, Ayesha Jafari, Narges Azari Babou, Ali Kalani, Navid Hatami, Naser TI Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses SO GLOBALIZATION AND HEALTH LA English DT Review DE COVID-19; SARS-COV-2; Pandemic; Emergency department ID ACUTE MYOCARDIAL-INFARCTION; ACUTE APPENDICITIS; ISCHEMIC-STROKE; MEDICAL-CARE; IMPACT; MANAGEMENT; OUTCOMES; DIAGNOSIS; TIME; POPULATION AB Background Apart from infecting a large number of people around the world and causing the death of many people, the COVID-19 pandemic seems to have changed the healthcare processes of other diseases by changing the allocation of health resources and changing people's access or intention to healthcare systems. Objective To compare the incidence of endpoints marking delayed healthcare seeking in medical emergencies, before and during the pandemic. Methods Based on a PICO model, medical emergency conditions that need timely intervention was selected to be evaluated as separate panels. In a systematic literature review, PubMed was quarried for each panel for studies comparing the incidence of various medical emergencies before and during the COVID-19 pandemic. Markers of failure/disruption of treatment due to delayed referral were included in the meta-analysis for each panel. Result There was a statistically significant increased pooled median time of symptom onset to admission of the acute coronary syndrome (ACS) patients; an increased rate of vasospasm of aneurismal subarachnoid hemorrhage; and perforation rate in acute appendicitis; diabetic ketoacidosis presentation rate among Type 1 Diabetes Mellitus patients; and rate of orchiectomy among testicular torsion patients in comparison of pre-COVID-19 with COVID-19 cohorts; while there were no significant changes in the event rate of ruptured ectopic pregnancy and median time of symptom onset to admission in the cerebrovascular accident (CVA) patients. Conclusions COVID-19 has largely disrupted the referral of patients for emergency medical care and patient-related delayed care should be addressed as a major health threat. C1 [Mogharab, Vahid] Jahrom Univ Med Sci, Dept Pediat, Jahrom, Iran. [Ostovar, Mahshid; Aryanpoor, Poorya; Nikkhoo, Amir Mohammad; Heidari, Parasta; Jahromi, Athar Rasekh; Rayatdoost, Esmaeil; Javdani, Farshid; Ghanaatpisheh, Aref; Paydar, Maryam; Kalani, Navid; Hatami, Naser] Jahrom Univ Med Sci, Res Ctr Noncommunicable Dis, Jahrom, Iran. [Ruszkowski, Jakub] Med Univ Gdansk, Fac Med, Dept Nephrol Transplantol & Internal Med, Gdansk, Poland. [Ruszkowski, Jakub] Med Univ Gdansk, Fac Med, Dept Pathophysiol, Gdansk, Poland. [Hussain, Syed Zohaib Maroof] Norfolk & Norwich Univ Hosp, Norwich, Norfolk, England. [Shrestha, Rajeev] Green Pasteur Hosp, Palliat Care & Chron Dis Unit, Pokhara, Nepal. [Yaqoob, Uzair] Hamdard Univ Hosp Karachi, Surg Dept, Karachi, Pakistan. [Ali, Anwar] Cent South Univ, Xiangya Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Changsha, Peoples R China. [Ali, Anwar] Cent South Univ, Xiangya Sch Publ Hlth, Hunan Prov Key Lab Clin Epidemiol, Changsha, Peoples R China. [Farzaneh, Roohie; Habibzadeh, Seyed Reza; Foroughian, Mahdi; Ahmadi, Sayyed Reza; Akhavan, Reza; Hakemi, Arman; Bolvardi, Ehsan] Mashhad Univ Med Sci, Fac Med, Dept Emergency Med, Mashhad, Razavi Khorasan, Iran. [Abbasi, Bita] Mashhad Univ Med Sci, Fac Med, Dept Radiol, Mashhad, Razavi Khorasan, Iran. [Shahi, Behzad] Zahedan Univ Med Sci, Fac Med, Dept Emergency Med, Zahedan, Iran. [Bagherian, Farhad] Babol Univ Med Sci, Dept Emergency Med, Babol, Iran. [Motamed, Mahsa; Boroujeni, Sina Taherzadeh] Univ Tehran Med Sci, Dept Psychiat, Tehran, Iran. [Jamalnia, Sheida] Shiraz Univ Med Sci, Med Journalism Dept, Shiraz, Iran. [Mangouri, Amir] Univ Tehran Med Sci, Sina Hosp, Dept Gen Surg, Div Vasc Surg & Endovasc Therapy,Vasc Surg & Endo, Tehran, Iran. [Mehrasa, Neda; Shirali, Dorna] Shiraz Azad Univ, Dent Branch, Shiraz, Iran. [Sanmarchi, Francesco] Univ Bologna, Dept Biomed & Neuromotor Sci, Alma Mater Studiorum, Bologna, Italy. [Saeed, Ayesha] Govt Coll Univ, Dept Biochem, Faisalabad, Pakistan. [Jafari, Narges Azari] Kashan Univ Med Sci, Neurosci Res Dept Ctr, Kashan, Iran. [Babou, Ali] Gulf Med Univ, Coll Pharm, Pharmaceut Sci Dept, Ajman, U Arab Emirates. C3 Fahrenheit Universities; Medical University Gdansk; Fahrenheit Universities; Medical University Gdansk; Norfolk & Norwich University Hospitals NHS Foundation Trust; Norfolk & Norwich University Hospital; Central South University; Central South University; Mashhad University Medical Science; Mashhad University Medical Science; Zahedan University of Medical Sciences; Babol University of Medical Sciences; Tehran University of Medical Sciences; Shiraz University of Medical Science; Tehran University of Medical Sciences; University of Bologna; Government College University Faisalabad RP Kalani, N; Hatami, N (通讯作者),Jahrom Univ Med Sci, Res Ctr Noncommunicable Dis, Jahrom, Iran. 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10.12998/wjcc.v8.i19.4349 NR 141 TC 10 Z9 10 U1 0 U2 3 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND EI 1744-8603 J9 GLOBALIZATION HEALTH JI Global. Health PD JUN 8 PY 2022 VL 18 IS 1 AR 58 DI 10.1186/s12992-022-00836-2 PG 18 WC Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Public, Environmental & Occupational Health GA 1Y7KJ UT WOS:000808318700001 PM 35676714 OA gold, Green Published DA 2023-05-13 ER PT J AU Redon, P Shahzad, A Iqbal, T Wijns, W AF Redon, Pau Shahzad, Atif Iqbal, Talha Wijns, William TI Development of a New Detection Algorithm to Identify Acute Coronary Syndrome Using Electrochemical Biosensors for Real-World Long-Term Monitoring SO BIOENGINEERING-BASEL LA English DT Article DE cardiac biomarkers; risk stratification algorithm; wearable device; electrochemical sensor; long-time monitoring AB Electrochemically based technologies are rapidly moving from the laboratory to bedside applications and wearable devices, like in the field of cardiovascular disease. Major efforts have focused on the biosensor component in contrast with those employed in creating more suitable detection algorithms for long-term real-world monitoring solutions. The calibration curve procedure presents major limitations in this context. The objective is to propose a new algorithm, compliant with current clinical guidelines, which can overcome these limitations and contribute to the development of trustworthy wearable or telemonitoring solutions for home-based care. A total of 123 samples of phosphate buffer solution were spiked with different concentrations of troponin, the gold standard method for the diagnosis of the acute coronary syndrome. These were classified as normal or abnormal according to established clinical cut-off values. Off-the-shelf screen-printed electrochemical sensors and cyclic voltammetry measurements (sweep between -1 and 1 V in a 5 mV step) was performed to characterize the changes on the surface of the biosensor and to measure the concentration of troponin in each sample. A logistic regression model was developed to accurately classify these samples as normal or abnormal. The model presents high predictive performance according to specificity (94%), sensitivity (92%), precision (92%), recall (92%), negative predictive value (94%) and F-score (92%). The area under the curve of the precision-recall curve is 97% and the positive and negative likelihood ratios are 16.38 and 0.082, respectively. Moreover, high discriminative power is observed from the discriminate odd ratio (201) and the Youden index (0.866) values. The promising performance of the proposed algorithm suggests its capability to overcome the limitations of the calibration curve procedure and therefore its suitability for the development of trustworthy home-based care solutions. C1 [Redon, Pau; Wijns, William] CURAM SFI Res Ctr Med Devices, Galway H91 W2TY, Ireland. [Redon, Pau; Shahzad, Atif; Iqbal, Talha] Natl Univ Ireland Galway, Sch Med, Smart Sensors Lab, Galway H91 TK33, Ireland. [Shahzad, Atif] Univ Birmingham, Ctr Syst Modelling & Quantitat Biomed, Inst Metab & Syst Res, Birmingham B15 2TT, W Midlands, England. [Wijns, William] Univ Hosp Galway, Saolta Univ Healthcare Grp, Newcastle Rd, Galway H91 YR71, Ireland. C3 RLUK- Research Libraries UK; University of Birmingham RP Redon, P (通讯作者),CURAM SFI Res Ctr Med Devices, Galway H91 W2TY, Ireland.; Redon, P (通讯作者),Natl Univ Ireland Galway, Sch Med, Smart Sensors Lab, Galway H91 TK33, Ireland. EM pau.redonlurbe@nuigalway.ie; atif.shahzad@nuigalway.ie; talha.iqbal@nuigalway.ie; william.wijns@nuigalway.ie RI Shahzad, Atif/AAA-1178-2021 OI Shahzad, Atif/0000-0002-4741-4302 FU European Union [713690]; Science Foundation Ireland (SFI); European Regional Development Fund [13/RC/2073, 15/RP/2765] FX This project has received funding from the European Union's Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No 713690 as well as from the Science Foundation Ireland (SFI) and the European Regional Development Fund under the Grant Numbers 13/RC/2073 and 15/RP/2765. 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Montalescot, Gilles CA ACCOAST Investigators TI Predictors of bleeding in patients with acute coronary syndromes treated with prasugrel SO HEART LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; CLOPIDOGREL PRETREATMENT; PLATELET INHIBITION; EUROPEAN-SOCIETY; DOSE CLOPIDOGREL; ESC GUIDELINES; TASK-FORCE; INTERVENTION; THROMBOLYSIS; ANTIPLATELET AB Background When considering antiplatelet therapy for acute coronary syndrome (ACS), it is essential to balance benefits (less thrombotic/ischaemic events) versus bleeding risks related to intense platelet inhibition via antagonism of P2Y(12) receptors. This analysis aimed to identify predictors of bleeding events among A Comparison of Prasugrel at the Time of PCI or as Pretreatment at the Time of Diagnosis in Patients with NSTEACS (ACCOAST) study population. Methods and results The ACCOAST study randomised 4033 patients with non-ST-segment elevation myocardial infarction (NSTEMI) to (A) a 30 mg prasugrel loading dose (LD) followed by coronary angiography with an additional 30 mg prasugrel at the time of percutaneous coronary intervention (PCI) or (B) a placebo LD followed by a 60 mg prasugrel at the time of PCI. Patients received standard of care, including use of aspirin. Independent predictors of Thrombolysis in Myocardial Infarction (TIMI) major bleeding not related to coronary artery bypass grafting (CABG) within 7 days were assessed using stepwise Cox proportional model for time to first occurrence of the event. Non-CABG-related TIMI major or minor bleeding was similarly analysed. Non-CABG-related TIMI major bleeding occurred in 36 (0.9%) patients, and TIMI major or minor bleeding occurred in 81 (2.0%) patients. Independent predictors for TIMI major bleeding alone were pretreatment with prasugrel LD (HR 3.02; 95% CI 1.42 to 6.43), femoral access (HR 2.45; 95% CI 1.11 to 5.38), female sex (HR 2.57; 95% CI 1.32 to 5.00), placement of > 1 stent (HR 2.50; 95% CI 1.26 to 4.95) and age (HR 1.05; 95% CI 1.02 to 1.09). Pretreatment with prasugrel LD (HR 3.05; 95% CI 1.84 to 5.07), femoral access (HR 3.06; 95% CI 1.74 to 5.38), female sex (HR 2.62; 95% CI 1.67 to 4.12), performed PCI (HR 2.21; 95% CI 1.23 to 3.99), therapy with glycoprotein IIb/IIIa inhibitors (HR 1.88; 95% CI 1.06 to 3.33) and age (increased bleed per year of age HR 1.04; 95% CI 1.02 to 1.06) were independent predictors of TIMI major or minor bleeding through 7 days. Conclusions Pretreatment, age, gender and procedural variables predicted bleeding risk in patients with NSTEMI. C1 [Widimsky, Petr; Motovska, Zuzana] Charles Univ Prague, Fac Med 3, Cardioctr, Prague 10000 10, Czech Republic. [Bolognese, Leonardo] Azienda Osped, Cardiovasc & Neurol Dept, Arezzo, Italy. [Dudek, Dariusz] Jagiellonian Univ, Inst Cardiol, Coll Med, Univ Hosp, Krakow, Poland. [Hamm, Christian] Univ Giessen Germany, Bad Nauheim & Med Clin, Kerckhoff Heart & Thoraxctr, Bad Nauheim, Germany. [Tanguay, Jean-Francois] Univ Montreal, MD Intervent Cardiol & Res Program, Montreal, PQ, Canada. [ten Berg, Jurrien] St Antonius Hosp, Dept Cardiol, Nieuwegein, Netherlands. [Brown, Eileen; LeNarz, LeRoy; Miller, Debra L.] Eli Lilly & Co, Lilly Corp Ctr, Indianapolis, IN 46285 USA. [Montalescot, Gilles] Univ Paris 06, CHU Pitie Salpetriere, AP HP, Inst Cardiol,ACT Study Grp, Paris, France. C3 Charles University Prague; Jagiellonian University; Collegium Medicum Jagiellonian University; Kerckhoff Clinic; Universite de Montreal; St. Antonius Hospital Utrecht; Eli Lilly; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP RP Motovska, Z (通讯作者),Charles Univ Prague, Fac Med 3, Cardioctr, Ruska 87, Prague 10000 10, Czech Republic. 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Taubert, Kathryn A. Morgan, Louise Yang, Na Zhou, Mengge Zhao, Dong CA CCC-ACS Investigators TI Prehospital statin use and low-density lipoprotein cholesterol levels at admission in acute coronary syndrome patients with history of myocardial infarction or revascularization: Findings from the Improving Care for Cardiovascular Disease in China (CCC) project SO AMERICAN HEART JOURNAL LA English DT Article ID DYSLIPIDEMIA; PREVENTION; PREVALENCE; GUIDELINES; MANAGEMENT; THERAPY AB Background Lowering low-density lipoprotein cholesterol (LDL-C) by statins is a key strategy for secondary prevention of acute coronary syndrome (ACS). However, few studies have examined prehospital statin use and admission LDL-C levels in ACS patients with history of myocardial infarction (MI) or revascularization. This study aimed to assess use of prehospital statins and LDL-C levels at admission in ACS patients with history of MI or revascularization. Methods Improving Care for Cardiovascular Disease in China project was a nationwide registry, with 192 participating hospitals reporting details of clinical information of ACS patients from November 2014. By May 2018, 80,282 patients with ACS were included. LDL-C levels were obtained from the initial admission lipid testing. Results Of the 80,282 ACS patients, 6,523 with a history of MI or revascularization were enrolled. Among them, 50.8% were receiving lipid-lowering therapy before hospitalization (statin monotherapy in 98.4%, combination in 1.2%). A total of 30.1% of patients had LDL-C < 70 mg/dL at admission. In patients receiving prehospital statins, 36.1% had LDL-C < 70 mg/dL compared to 24.0% without prehospital statins (P < .001). At discharge, 91.8% of patients were treated with statin monotherapy, 90.7% at moderate doses irrespective of prehospital statin use and LDL-C levels at admission. Conclusions Among ACS patients with history of MI or revascularization, half were not being treated with statin therapy prior to admission, and most had not attained LDL-C < 70 mg/dL despite prehospital statin use. There is an important opportunity to provide intensive statin or combination lipid-lowering therapy to these very high risk patients. C1 [Xing, Yueyan; Liu, Jing; Hao, Yongchen; Liu, Jun; Yang, Na; Zhou, Mengge; Zhao, Dong] Capital Med Univ, Beijing Anzhen Hosp,Key Lab Remodeling Related Ca, Beijing Inst Heart Lung & Blood Vessel Dis,Dept E, Minist Educ,Beijing Municipal Key Lab Clin Epidem, 2 Anzhen Rd, Beijing 100029, Peoples R China. [Huo, Yong] Peking Univ, Hosp 1, Dept Cardiol, Beijing, Peoples R China. [Smith, Sidney C., Jr.] Univ N Carolina, Div Cardiol, Chapel Hill, NC 27515 USA. [Ge, Junbo] Fudan Univ, Zhongshan Hosp, Shanghai Inst Cardiovasc Dis, Dept Cardiol, Shanghai, Peoples R China. [Ma, Changsheng] Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, Beijing, Peoples R China. [Han, Yaling] Gen Hosp Shenyang Mil Reg, Cardiovasc Res Inst, Shenyang, Liaoning, Peoples R China. [Han, Yaling] Gen Hosp Shenyang Mil Reg, Dept Cardiol, Shenyang, Liaoning, Peoples R China. [Fonarow, Gregg C.] Univ Calif Los Angeles, David Geffen Sch Med, Div Cardiol, Los Angeles, CA 90095 USA. [Taubert, Kathryn A.] Amer Heart Assoc, Dept Int Sci, Basel, Switzerland. [Morgan, Louise] Amer Heart Assoc, Int Qual Improvement Dept, Dallas, TX USA. C3 Capital Medical University; Peking University; University of North Carolina; University of North Carolina Chapel Hill; Fudan University; Capital Medical University; University of California System; University of California Los Angeles; University of California Los Angeles Medical Center; David Geffen School of Medicine at UCLA RP Zhao, D (通讯作者),Capital Med Univ, Beijing Anzhen Hosp,Key Lab Remodeling Related Ca, Beijing Inst Heart Lung & Blood Vessel Dis,Dept E, Minist Educ,Beijing Municipal Key Lab Clin Epidem, 2 Anzhen Rd, Beijing 100029, Peoples R China. EM deezhao@vip.sina.com RI Fonarow, Gregg C/D-5988-2014; Zhao, D/AAX-5040-2021; Liu, Jing/AAH-8079-2021 OI Fonarow, Gregg C/0000-0002-3192-8093; Liu, Jing/0000-0002-3311-0818; Han, Yaling/0000-0003-4569-6737 FU Pfizer FX The Improving Care for Cardiovascular Disease in China project is a collaborative program of the American Heart Association and Chinese Society of Cardiology. The American Heart Association was funded by Pfizer for quality improvement initiatives through an independent grant for learning and change. Pfizer had no involvement in the study design, data collection, data analysis, preparation of this manuscript, and the decision to submit the article for publication. CR Atkins ER, 2017, INT J CARDIOL, V241, P444, DOI 10.1016/j.ijcard.2017.03.057 Authors/Task Force Members:, 2016, Atherosclerosis, V253, P281, DOI 10.1016/j.atherosclerosis.2016.08.018 Baigent C, 2005, LANCET, V366, P1267, DOI 10.1016/S0140-6736(05)67394-1 Bi YF, 2009, AM HEART J, V157, P509, DOI 10.1016/j.ahj.2008.09.026 Cannon CP, 2015, NEW ENGL J MED, V372, P2387, DOI 10.1056/NEJMoa1410489 Hao YC, 2016, AM HEART J, V179, P107, DOI 10.1016/j.ahj.2016.06.005 Hirsh BJ, 2015, J AM COLL CARDIOL, V66, P184, DOI 10.1016/j.jacc.2015.05.030 Jellinger PS, 2017, ENDOCR PRACT, V23, P479, DOI 10.4158/EP171764.GL Junren Z., 2016, CHINESE CIRCUL J, V31, P937, DOI DOI 10.3969/J.ISSN.1000-3614.2016.10.001 Law MR, 2002, ARCH INTERN MED, V162, P2405, DOI 10.1001/archinte.162.21.2405 Pitt B, 2008, J AM COLL CARDIOL, V51, P1440, DOI [10.1016/j.jacc.2007.11.075, 10.1016/j.jacc.2007.11.015] Sabatine MS, 2017, NEW ENGL J MED, V376, P1713, DOI [10.1056/NEJMoa1615664, 10.4997/JRCPE.2017.212] Stone NJ, 2014, CIRCULATION, V129, pS1, DOI 10.1161/01.cir.0000437738.63853.7a Taguchi I, 2018, CIRCULATION, V137, P1997, DOI 10.1161/CIRCULATIONAHA.117.032615 Yusuf S, 2011, LANCET, V378, P1231, DOI 10.1016/S0140-6736(11)61215-4 Zhang LH, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0150806 Zhang M, 2018, INT J CARDIOL, V260, P196, DOI 10.1016/j.ijcard.2017.12.069 Zhao SP, 2014, ATHEROSCLEROSIS, V235, P463, DOI 10.1016/j.atherosclerosis.2014.05.916 NR 18 TC 13 Z9 17 U1 3 U2 9 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 EI 1097-6744 J9 AM HEART J JI Am. Heart J. PD JUN PY 2019 VL 212 BP 120 EP 128 DI 10.1016/j.ahj.2019.02.019 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HY8PN UT WOS:000468402300013 PM 30986750 DA 2023-05-13 ER PT J AU Wilcox, HM Vickery, AW Emery, JD AF Wilcox, Helen M. Vickery, Alistair W. Emery, Jon D. TI Cardiac troponin testing for diagnosis of acute coronary syndromes in primary care SO MEDICAL JOURNAL OF AUSTRALIA LA English DT Article AB Objective: To examine the use of cardiac troponin (cTn) testing for acute coronary syndrome (ACS) diagnosis in primary care. Design and setting: Prospective cohort study; general practitioner-initiated cTn tests conducted from 24 September 2009 to 3 September 2010 in Perth, Western Australia. Patient outcomes were obtained from linked data sources for up to 12 months after the final test. Clinical information and outcomes were compared with data from emergency department patients with ACS symptoms. Participants: 369 patients with samples collected at community laboratories. Requesting GPs provided the clinical context for testing. Main outcome measures: Cardiovascular risk status, symptoms prompting cTn testing; estimated ACS likelihood and referral decision before and after testing; result turnaround time; hospital presentations, procedures and mortality. Results: Of the 328 GPs who received a survey request, 124 (37.8%) responded. 122 of 124 test results (98.4%) were negative. Based on clinical risk factors, 71 of 104 patients (68.2%) were at high or intermediate risk of ACS. 69 of 124 patients (55.6%) had typical ischaemic pain and 62 of 124 patients (50.0%) were tested within 48 hours of symptom onset (23.4% within 12 hours, with no serial testing). Test results affected GPs' estimation of ACS likelihood (P < 0.01) but not their referral decisions (P = 0.23). 94 of 355 patients (26.5%) presented to hospital with cardiovascular symptoms or diagnoses during follow-up; 27 of 355 patients (7.6%) had at least one ACS, 13 of 255 (3.7%) within 30 days of testing. Conclusions: GP-initiated cTn testing involves patients at high risk of ACS. ACS and associated adverse outcomes can occur in patients undergoing testing, even when the cTn test result is negative. Potential gaps exist in physicians' understanding of the limitations of cTn testing, and cTn test results have minimal influence on their management of patients. GPs may benefit from guidance about ordering cTn testing. C1 [Wilcox, Helen M.; Vickery, Alistair W.] Univ Western Australia, Perth, WA, Australia. [Emery, Jon D.] Univ Melbourne, Melbourne, Vic, Australia. C3 University of Western Australia; University of Melbourne RP Wilcox, HM (通讯作者),Univ Western Australia, Perth, WA, Australia. EM helen.wilcox@uwa.edu.au CR Aldous S, 2012, NEW ZEAL MED J, V125, P36 Anderson JL, 2007, J AM COLL CARDIOL, V50, P652, DOI 10.1016/j.jacc.2007.02.028 Aroney CN, 2006, MED J AUSTRALIA, V184, pS1 Briffa T, 2009, BMJ-BRIT MED J, V338, DOI 10.1136/bmj.b36 Bruyninckx R, 2008, BRIT J GEN PRACT, V58, P105, DOI 10.3399/bjgp08X277014 Buntinx F, 2011, BRIT J GEN PRACT, V61, P43, DOI 10.3399/bjgp11X548974 Chew DP, 2011, HEART LUNG CIRC, V20, P487, DOI 10.1016/j.hlc.2011.03.008 Cullen L, 2010, EMERG MED AUSTRALAS, V22, P35, DOI 10.1111/j.1742-6723.2010.01256.x Deloitte Access Economics, 2011, ACS PERSP IMP SEC PR Hafiz AM, 2013, AM J EMERG MED, V31, P922, DOI 10.1016/j.ajem.2013.03.005 Law Kate, 2006, N Z Med J, V119, pU2082 Lozzi L, 2005, INTERN MED J, V35, P668, DOI 10.1111/j.1445-5994.2005.00957.x MacDonald PS, 2013, MED J AUSTRALIA, V199, P147, DOI 10.5694/mja13.10842 Macdonald SPJ, 2013, EMERG MED J, V30, P149, DOI 10.1136/emermed-2011-200667 Makeham MAB, 2008, AUST FAM PHYSICIAN, V37, P625 Marshall GA, 2014, MED J AUSTRALIA, V201, P155, DOI 10.5694/mja13.00173 National Centre for Classification in Health, 2010, INT STAT CLASS DIS R, V7 National Centre for Classification in Health, 2010, AUSTR CLASS HLTH INT Parsonage WA, 2013, MED J AUSTRALIA, V199, P30, DOI 10.5694/mja12.11171 Royal Australian College of General Practitioners, 2010, STAND GEN PRACT Tanner Helen, 2006, N Z Med J, V119, pU1927 Taylor David McD, 2005, Emerg Med Australas, V17, P204 Thygesen K, 2012, EUR HEART J, V33, P2252, DOI 10.1093/eurheartj/ehs154 NR 23 TC 2 Z9 2 U1 0 U2 0 PU AUSTRALASIAN MED PUBL CO LTD PI PYRMONT PA LEVEL 2, 26-32 PYRMONT BRIDGE RD, PYRMONT, NSW 2009, AUSTRALIA SN 0025-729X EI 1326-5377 J9 MED J AUSTRALIA JI Med. J. Aust. PD OCT 19 PY 2015 VL 203 IS 8 BP 336 EP + DI 10.5694/mja14.01154 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA VA9DQ UT WOS:000410621500024 PM 26465699 OA Bronze DA 2023-05-13 ER PT J AU Rayes, HA Vallabhajosyula, S Barsness, GW Anavekar, NS Go, RS Patnaik, MS Kashani, KB Jentzer, JC AF Rayes, Hamza A. Vallabhajosyula, Saraschandra Barsness, Gregory W. Anavekar, Nandan S. Go, Ronald S. Patnaik, Mrinal S. Kashani, Kianoush B. Jentzer, Jacob C. TI Association between anemia and hematological indices with mortality among cardiac intensive care unit patients SO CLINICAL RESEARCH IN CARDIOLOGY LA English DT Article DE Red cell distribution width; Anemia; Mean corpuscular volume; Cardiac intensive care unit; Coronary care unit; Mortality ID CELL DISTRIBUTION WIDTH; ACUTE CORONARY SYNDROMES; ACUTE HEART-FAILURE; CLONAL HEMATOPOIESIS; METAANALYSIS; DEFINITION; PREDICTORS; ELEVATION; RISK AB Background Anemia and elevated red cell distribution width (RDW) or mean corpuscular volume (MCV) are associated with an adverse prognosis in patients with cardiovascular disease and critical illness. Limited data exist regarding these associations in unselected cardiac intensive care unit (CICU) patients. Methods Retrospective cohort study of CICU patients between January 1, 2007, and December 31, 2015, with a hemoglobin (Hb) level measured at admission. Multivariable regression was performed to determine predictors of hospital mortality, and Kaplan-Meier analysis was used to determine post-discharge survival. Results We included 9644 patients with a mean age of 67.5 +/- 15.1 years, including 3604 (37.4%) females. The median (IQR) values of Hb, MCV and RDW were 12.2 g/dL (10.6, 13.7), 90.7 fL (87.3, 94.2) fL, and 14.1% (13.3, 15.8), respectively. Anemia (admission Hb < 12 g/dL) was present in 4434 (46%) patients. A total of 845 (8.8%) patients died in the hospital. Patients with anemia had higher hospital mortality (11.3% vs. 6.6%, unadjusted OR 1.82, 95% CI 1.58-2.10, p < 0.001). After multivariable regression, admission Hb and MCV were not significantly associated with hospital mortality (both p > 0.1), while admission RDW (adjusted OR 1.12 per 1%, 95% CI 1.07-1.18, p < 0.001) was significantly associated with hospital mortality. Hospital survivors with lower Hb, higher MCV, or higher RDW had lower post-discharge survival. Conclusion Elevated RDW on admission was independently associated with higher hospital mortality in CICU patients. These data emphasize the importance of hematologic abnormalities for mortality risk stratification in CICU populations. Graphic abstract C1 [Rayes, Hamza A.; Vallabhajosyula, Saraschandra; Kashani, Kianoush B.; Jentzer, Jacob C.] Mayo Clin, Dept Med, Div Pulm & Crit Care Med, 200 First St SW, Rochester, MN 55905 USA. [Vallabhajosyula, Saraschandra; Barsness, Gregory W.; Anavekar, Nandan S.; Jentzer, Jacob C.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Go, Ronald S.; Patnaik, Mrinal S.] Mayo Clin, Div Hematol & Oncol, Dept Med, Rochester, MN USA. [Kashani, Kianoush B.] Mayo Clin, Div Nephrol & Hypertens, Dept Med, Rochester, MN USA. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic RP Jentzer, JC (通讯作者),Mayo Clin, Dept Med, Div Pulm & Crit Care Med, 200 First St SW, Rochester, MN 55905 USA.; Jentzer, JC (通讯作者),Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. EM hamzarayes@outlook.com; vallabhajosyula.saraschandra@mayo.edu; barsness.gregory@mayo.edu; anavekar.nandan@mayo.edu; go.ronald@mayo.edu; patnaik.mrinal@mayo.edu; kashani.kianoush@mayo.edu; jentzer.jacob@mayo.edu RI Vallabhajosyula, Saraschandra/I-9707-2019; Rayes, Hamza/AAY-9873-2020 OI Vallabhajosyula, Saraschandra/0000-0002-1631-8238; Jentzer, Jacob/0000-0002-6366-2859 CR Abrahan LL, 2018, CARDIOL RES, V9, P144, DOI 10.14740/cr732w Backhaus T, 2018, CLIN RES CARDIOL, V107, P371, DOI 10.1007/s00392-017-1192-0 Bazick HS, 2011, CRIT CARE MED, V39, P1913, DOI 10.1097/CCM.0b013e31821b85c6 Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 Brener SJ, 2017, AM J CARDIOL, V119, P1710, DOI 10.1016/j.amjcard.2017.02.052 Cappellini MD, 2015, SEMIN HEMATOL, V52, P261, DOI 10.1053/j.seminhematol.2015.07.006 Chandra S, 2011, BMJ OPEN, V1, DOI 10.1136/bmjopen-2011-000216 Cheng YL, 2016, AM J CARDIOL, V117, P399, DOI 10.1016/j.amjcard.2015.11.011 Fujita B, 2015, CLIN BIOCHEM, V48, P1048, DOI 10.1016/j.clinbiochem.2015.07.011 Goldfarb M, 2019, J INTENSIVE CARE MED, V34, P537, DOI 10.1177/0885066617741873 Harrison AM, 2013, CRIT CARE RES PRACT, V2013, DOI 10.1155/2013/975672 Hayden SJ, 2012, AM J RESP CRIT CARE, V185, P1049, DOI 10.1164/rccm.201110-1915CI Hebert PC, 2001, CRIT CARE MED, V29, P227, DOI 10.1097/00003246-200102000-00001 Hu YG, 2017, KIDNEY BLOOD PRESS R, V42, P1193, DOI 10.1159/000485866 Huang YL, 2016, ANN TRANSL MED, V4, DOI 10.21037/atm.2016.03.42 Jaiswal S, 2017, NEW ENGL J MED, V377, P111, DOI 10.1056/NEJMoa1701719 Jentzer JC, 2018, AM J CARDIOL, V122, P1773, DOI 10.1016/j.amjcard.2018.08.011 Jentzer JC, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008169 Kajimoto K, 2015, EUR HEART J-ACUTE CA, V4, P568, DOI 10.1177/2048872614554199 Kwok CS, 2016, AM J CARDIOL, V118, P610, DOI 10.1016/j.amjcard.2016.05.059 Lawler PR, 2013, AM HEART J, V165, P143, DOI 10.1016/j.ahj.2012.10.024 Libby P, 2019, J AM COLL CARDIOL, V74, P567, DOI 10.1016/j.jacc.2019.06.007 Luo RB, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0167000 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Thygesen K, 2018, KARDIOL POL, V76, P1383, DOI [10.1161/CIR.0000000000000617, 10.1016/j.gheart.2018.08.004, 10.5603/KP.2018.0203] Tonietto TA, 2018, CLIN BIOCHEM, V55, P15, DOI 10.1016/j.clinbiochem.2018.03.010 Ueda T, 2013, CIRC J, V77, P2766, DOI 10.1253/circj.CJ-13-0718 Uemura Y, 2016, J CARDIOL, V67, P268, DOI 10.1016/j.jjcc.2015.05.011 Uscinska E, 2016, INT HEART J, V57, P67, DOI 10.1536/ihj.15-249 von Haehling S, 2019, JACC-HEART FAIL, V7, P36, DOI 10.1016/j.jchf.2018.07.015 Wienbergen H, 2019, CLIN RES CARDIOL, V108, P93, DOI 10.1007/s00392-018-1327-y Zou H, 2005, J R STAT SOC B, V67, P301, DOI 10.1111/j.1467-9868.2005.00503.x NR 32 TC 14 Z9 14 U1 1 U2 1 PU SPRINGER HEIDELBERG PI HEIDELBERG PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY SN 1861-0684 EI 1861-0692 J9 CLIN RES CARDIOL JI Clin. Res. Cardiol. PD MAY PY 2020 VL 109 IS 5 BP 616 EP 627 DI 10.1007/s00392-019-01549-0 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA LG9BD UT WOS:000528386100009 PM 31535171 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Thelin, J Borna, C Erlinge, D Ohlin, B AF Thelin, Johan Borna, Catharina Erlinge, David Ohlin, Bertil TI The combination of high sensitivity troponin T and copeptin facilitates early rule-out of ACS: a prospective observational study SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Copeptin; High sensitivity troponin; Acute coronary syndrome; Emergency department ID ACUTE MYOCARDIAL-INFARCTION; CORONARY-ARTERY-DISEASE; EARLY-DIAGNOSIS; RAPID RULE; EMERGENCY-DEPARTMENT; CHEST-PAIN AB Background: The combination of the new high sensitivity troponin T (hsTnT) assays and copeptin, a biomarker of endogenous stress, has been suggested to have the potential of early rule-out of acute coronary syndrome (ACS). The aim of this study was to examine the ability of this combination to rule out ACS in patients presenting with chest pain and to compare the diagnostic performance to hsTnT alone. Method: In this prospective observational study, patients with chest pain admitted for observation were consecutively included. Patients presenting with ST elevation were excluded. Copeptin and hsTnT were analyzed at admission and hsTnT was thereafter determined approximately every 3rd hour as long as clinically indicated. The follow-up period was 60 days. A combined primary endpoint of ACS, non-elective percutanous coronary intervention, non-elective coronary artery bypass surgery and death of all causes was used. Results: 478 patients were included. 107 (22%) patients were diagnosed with ACS during hospital stay. 70 (14%) had non-ST-segment elevation myocardial infarction (NSTEMI) and 37 (8%) had unstable angina pectoris (UAP). The combination of hsTnT >14 ng/L or copeptin >= 14 pmol/L at admission identified ACS with a higher sensitivity than hsTnT alone: 0.83 (95% confidence interval (CI): 0.74-0.89) versus 0.69 (95% CI: 0.59-0.77), p < 0.001. Negative predictive values (NPV) 91% (95% CI: 86-94) versus 89% (95% CI: 84-92). A repeated hsTnT analyzed 3-4 hours after admission resulted in a sensitivity of: 0.77 (95% CI: 0.65-0.86), p = 0.031 for comparison with the combination analyzed at admission. Conclusions: In patients presenting with chest pain admitted for observation, the combination of hsTnT and copeptin analyzed at admission had a significantly higher sensitivity to diagnose ACS than hsTnT alone. We report a sensitivity of 83% and a NPV of 91% for the combination of hsTnT and copeptin and we conclude that biomarkers alone are not sufficient to rule out ACS. However, the combination of hsTnT and copeptin seems to have a significantly higher sensitivity to identify ACS than a repeated hsTnT test, and thus enables an earlier risk stratification of chest pain patients. This can be time-saving and beneficial for the individual patient by contributing to early decisions on treatment, need of further assessment and level of care. C1 [Thelin, Johan; Borna, Catharina; Erlinge, David; Ohlin, Bertil] Lund Univ, Dept Clin Sci Lund, Lund, Sweden. [Thelin, Johan; Borna, Catharina; Erlinge, David; Ohlin, Bertil] Skanes Univ Sjukhus, S-22185 Lund, Sweden. C3 Lund University RP Thelin, J (通讯作者),Lund Univ, Dept Clin Sci Lund, Lund, Sweden. EM johan.thelin@skane.se OI Thelin, Johan/0000-0002-6101-4946 FU Region Skane (the county council of southern Sweden) FX Karin Olsson contributed to the design of the study and the statistic analysis. Kerstin Roos contributed to collect data and to coordinate blood sample analysis. Charlotte Becker contributed as an expert in laboratory medicine. This study was performed as a quality and development project within Region Skane (the county council of southern Sweden). CR Charpentier S, 2012, ACAD EMERG MED, V19, P517, DOI 10.1111/j.1553-2712.2012.01350.x Chenevier-Gobeaux C, 2013, INT J CARDIOL, V166, P198, DOI 10.1016/j.ijcard.2011.10.098 Forberg JL, 2006, BMC EMERG MED, V6, DOI 10.1186/1471-227X-6-6 Freund Y, 2012, INTENS CARE MED, V38, P733, DOI 10.1007/s00134-012-2520-5 Giannitsis E, 2011, CLIN CHEM, V57, P1452, DOI 10.1373/clinchem.2010.161265 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hochholzer W, 2010, AM HEART J, V160, P583, DOI 10.1016/j.ahj.2010.06.010 Keller T, 2010, J AM COLL CARDIOL, V55, P2096, DOI 10.1016/j.jacc.2010.01.029 Keller T, 2009, NEW ENGL J MED, V361, P868, DOI 10.1056/NEJMoa0903515 Liebetrau C, 2013, CLIN CHEM, V59, P566, DOI 10.1373/clinchem.2012.194001 Lotze U, 2011, VASC HEALTH RISK MAN, V7, P509, DOI 10.2147/VHRM.S21753 Meune C, 2011, ARCH CARDIOVASC DIS, V104, P4, DOI 10.1016/j.acvd.2010.11.002 Morgenthaler NG, 2008, TRENDS ENDOCRIN MET, V19, P43, DOI 10.1016/j.tem.2007.11.001 Potocki M, 2012, HEART, V98, P558, DOI 10.1136/heartjnl-2011-301269 Ray P, 2012, AM J EMERG MED, V30, P440, DOI 10.1016/j.ajem.2011.12.008 Reichlin T, 2009, J AM COLL CARDIOL, V54, P60, DOI 10.1016/j.jacc.2009.01.076 Reiter M, 2011, EUR HEART J, V32, P1379, DOI 10.1093/eurheartj/ehr033 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] Wallentin L, 2000, LANCET, V356, P9, DOI 10.1016/S0140-6736(00)02427-2 NR 20 TC 27 Z9 29 U1 0 U2 8 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-2261 J9 BMC CARDIOVASC DISOR JI BMC Cardiovasc. Disord. PD JUN 18 PY 2013 VL 13 DI 10.1186/1471-2261-13-42 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 173XA UT WOS:000321114500001 PM 23777442 OA Green Published, gold DA 2023-05-13 ER PT J AU Asha, SE Chan, ACF Walter, E Kelly, PJ Morton, RL Ajami, A Wilson, RD Honneyman, D AF Asha, Stephen Edward Chan, Adam Chiu Fat Walter, Elizabeth Kelly, Patrick J. Morton, Rachael L. Ajami, Allan Wilson, Roger Denis Honneyman, Daniel TI Impact from point-of-care devices on emergency department patient processing times compared with central laboratory testing of blood samples: a randomised controlled trial and cost-effectiveness analysis SO EMERGENCY MEDICINE JOURNAL LA English DT Article ID ACUTE CORONARY SYNDROMES; LENGTH; STAY; MORTALITY; MARKERS; PAIN AB Objective To determine if time to disposition decisions for emergency department (ED) patients can be reduced when blood tests are processed using point-of-care (POC) devices and to conduct a cost-effectiveness analysis of POC compared with laboratory testing. Methods This randomised trial enrolled adults suspected of an acute coronary syndrome or presenting with conditions considered to only require blood tests available by POC. Participants were randomised to have blood tests processed by POC or laboratory. Outcomes measured were time to disposition decision and ED length-of-stay (LOS). The cost-effectiveness analysis calculated the total and mean costs per ED presentation, as well as total and mean benefits in time saved to disposition decision. Results There were 410 POC participants and 401 controls. The mean times to a disposition decision for POC versus controls were 3.24 and 3.50 h respectively, a difference of 7.6% (95% CI 0.4% to 14.3%, p=0.04), and 4.32 and 4.52 h respectively for ED LOS, a difference of 4.4% (95% CI -2.7% to 11.0%, p=0.21). Improved processing time was greatest for participants enrolled by senior staff with a reduction in time to disposition decision of 19.1% (95% CI 7.3% to 29.4%, p<0.01) and ED LOS of 15.6% (95% CI 4.9% to 25.2%, p=0.01). Mean pathology costs were $12 higher in the POC group (95% CI $7 to $18) and the incremental cost-effectiveness ratio was $113 per hour saved in time to disposition decision for POC compared with standard laboratory testing. Conclusions Small improvements in disposition decision time were achieved with POC testing for a moderate increase in cost. Greatest benefit may be achieved when POC is targeted to senior medical staff. C1 [Asha, Stephen Edward; Chan, Adam Chiu Fat; Walter, Elizabeth; Ajami, Allan; Honneyman, Daniel] St George Hosp, Emergency Dept, Sydney, NSW 2217, Australia. [Asha, Stephen Edward; Chan, Adam Chiu Fat; Wilson, Roger Denis] Univ New S Wales, Fac Med, Sydney, NSW, Australia. [Kelly, Patrick J.; Morton, Rachael L.] Univ Sydney, Sydney Sch Publ Hlth, Sydney, NSW 2006, Australia. [Wilson, Roger Denis] NSW Hlth Pathol, South Eastern Area Lab Serv, Sydney, NSW, Australia. C3 St George Hospital; University of New South Wales Sydney; University of Sydney RP Asha, SE (通讯作者),St George Hosp, Emergency Dept, Gray St, Sydney, NSW 2217, Australia. EM stephen.asha@sesiahs.health.nsw.gov.au RI Morton, Rachael L/P-8077-2014; Morton, Rachael L/AAB-7420-2020; Kelly, Patrick/AAC-4226-2022 OI Morton, Rachael L/0000-0001-7834-0572; Kelly, Patrick/0000-0003-2912-1706; Kelly, Patrick/0000-0002-5015-0977 FU NSW Department of Health (Ministerial Taskforce on Emergency Care 'Taking the pressure of public hospitals'); St George Hospital FX Funding for this study was provided by a grant from the NSW Department of Health (Ministerial Taskforce on Emergency Care 'Taking the pressure of public hospitals' project grants 2011/12) and from the St George Hospital. CR [Anonymous], 2008, ACCESS BLOCK OVERCRO [Anonymous], 2012, HLTH CAR SYST MEET O [Anonymous], 2012, NEAT THE BAS Drummond MF, 2005, METHODS EC EVALUATIO, P74 Geelhoed GC, 2012, MED J AUSTRALIA, V196, P122, DOI 10.5694/mja11.11159 Goodacre SW, 2011, HEART, V97, P190, DOI 10.1136/hrt.2010.203166 Guttmann A, 2011, BMJ-BRIT MED J, V342, DOI 10.1136/bmj.d2983 Kendall J, 1998, BRIT MED J, V316, P1052 Lee-Lewandrowski E, 2003, ARCH PATHOL LAB MED, V127, P456 Loten C, 2010, EMERG MED J, V27, P194, DOI 10.1136/emj.2008.069427 Murray RP, 1999, J EMERG MED, V17, P811, DOI 10.1016/S0736-4679(99)00107-9 Parvin CA, 1996, CLIN CHEM, V42, P711 Pines JM, 2008, ANN EMERG MED, V51, P1, DOI 10.1016/j.annemergmed.2007.07.008 Renaud B, 2008, ACAD EMERG MED, V15, P216, DOI 10.1111/j.1553-2712.2008.00069.x Richardson DB, 2006, MED J AUSTRALIA, V184, P213, DOI 10.5694/j.1326-5377.2006.tb00204.x Ryan RJ, 2009, ANN EMERG MED, V53, P321, DOI 10.1016/j.annemergmed.2008.06.464 Singer AJ, 2008, ACAD EMERG MED, V15, P324, DOI 10.1111/j.1553-2712.2008.00065.x Singer AJ, 2005, ANN EMERG MED, V45, P587, DOI 10.1016/j.annemergmed.2004.11.020 NR 18 TC 40 Z9 40 U1 0 U2 5 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1472-0205 EI 1472-0213 J9 EMERG MED J JI Emerg. Med. J. PD SEP PY 2014 VL 31 IS 9 BP 714 EP 719 DI 10.1136/emermed-2013-202632 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AN7NF UT WOS:000340786600005 PM 23748157 OA Green Submitted DA 2023-05-13 ER PT J AU Etaher, A Nguyen, TL Saad, YM Frost, S Ferguson, I Juergens, CP Chew, D French, JK AF Etaher, Aisha Nguyen, Tuan L. Saad, Yousef M. Frost, Steven Ferguson, Ian Juergens, Craig P. Chew, Derek French, John K. TI Mortality at 5 Years Among Very Elderly Patients Undergoing High Sensitivity Troponin T Testing for Suspected Acute Coronary Syndromes SO HEART LUNG AND CIRCULATION LA English DT Article DE High sensitivity troponin T; Myocardial injury; Type-2 MI; Very elderly; Late mortality ID ACUTE MYOCARDIAL-INFARCTION; GLOBAL REGISTRY; EARLY-DIAGNOSIS; RENAL-FUNCTION; CHEST-PAIN; AGE; RISK; ELEVATION; ASSAY; CARE AB Background Patients aged >= 80 years old often present to Emergency Departments (ED) with symptoms potentially due to an acute coronary syndrome (ACS). This study aimed to evaluate associations between baseline level(s) of high sensitivity troponin T (HsTnT), adjudicated diagnoses and outcomes. Methods Consecutive patients aged >= 80 years were studied, who presented to the ED at Liverpool Hospital, NSW, Australia during the 4 months period March to June 2014 (inclusive) with symptoms suggestive of an ACS, and who had at least one HsTnT assay performed. Diagnoses were based on the fourth universal definition of MI (myocardial infarction) including type-1 MI, type-2 MI, acute myocardial injury, chronic myocardial injury; the rest were termed "other diagnoses". Patients were categorised by baseline HsTnT levels 1) <= 14 ng/L, 2) 15-29 ng/L, 3) 30-49 ng/L and 4) >= 50 ng/L. Results Of 2,773 patients screened, 545 were aged >= 80 years (median age 85 [IQR 82-88]); median follow-up was 32 months (IQR 5-56). The respective rates of adjudicated diagnoses were type-I MI 3.1%, type-2 MI 13%, acute myocardial injury 9.5%, chronic myocardial injury 56% and 18.6% had other diagnoses. Mortality rates increased, irrespective of adjudicated diagnoses with increasing HsTnT levels (ng/ L): 17% (16/96) for <= 14; 35% (67/194) for 15-29; 51% (65/127) for 30-49; and 64% (82/128) for >= 50 ng/L; log rank p <= 0.001. On multi-variable analyses, after adjusting for potential confounding factors including age, hypertension, chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD), MI type was not associated with late mortality. Conclusions Among patients aged >= 80 years higher HsTnT levels, irrespective of adjudicated diagnoses, were associated with increased mortality. Most very elderly patients presenting with symptoms suggestive of an ACS undergoing HsTnT testing in EDs had elevated levels most commonly due to chronic myocardial injury. Whether any interventions can modify outcomes require prospective evaluation. C1 [Etaher, Aisha; Nguyen, Tuan L.; Saad, Yousef M.; Frost, Steven; Juergens, Craig P.; French, John K.] Liverpool Hosp, Dept Cardiol, Sydney, NSW, Australia. [Etaher, Aisha; Nguyen, Tuan L.; Saad, Yousef M.; Ferguson, Ian; Juergens, Craig P.; French, John K.] Univ New South Wales, Fac Med, Sydney, NSW, Australia. [Nguyen, Tuan L.; Ferguson, Ian] Liverpool Hosp, Dept Emergency, Sydney, NSW, Australia. [Frost, Steven; French, John K.] Ingham Inst Appl Med Res, Sydney, NSW, Australia. [Frost, Steven] Western Sydney Univ, Sydney, NSW, Australia. [Chew, Derek] Flinders Univ South Australia, Coll Med & Publ Hlth, Adelaide, SA, Australia. C3 Liverpool Hospital; University of New South Wales Sydney; Liverpool Hospital; Ingham Institute for Applied Medical Research; Western Sydney University; Flinders University South Australia RP French, JK (通讯作者),Liverpool Hosp, Dept Cardiol, Elizabeth St,Locked Bag 7103T, Liverpool Bc, NSW 1871, Australia. 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PD NOV PY 2020 VL 29 IS 11 BP 1696 EP 1703 DI 10.1016/j.hlc.2020.02.015 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OM0VS UT WOS:000585748900021 PM 32439246 DA 2023-05-13 ER PT J AU Filgueiras, NM Feitosa, GS Solla, DJF Argolo, FC Guimaraes, PO Paiva, ID Carvalho, LGM Teixeira, LS Rios, MND Camara, SF Novais, VO Barbosa, LD Ballalai, CS De Lucia, CV Granger, CB Newby, LK Lopes, RD AF Filgueiras Filho, Nivaldo Menezes Feitosa Filho, Gilson Soares Fontoura Solla, Davi Jorge Argolo, Felipe Coelho Guimaraes, Patricia Oliveira Paiva Filho, Ivan de Mattos Mutti Carvalho, Larissa Gordilho Teixeira, Larissa Silva de Oliveira Rios, Marcos Nogueira Camara, Sergio Figueiredo Novais, Victor Oliveira Barbosa, Leonardo de Souza Ballalai, Constance Silva De Lucia, Carolina Vitoria Granger, Christopher B. Newby, L. Kristin Lopes, Renato D. TI Implementation of a Regional Network for ST-Segment-Elevation Myocardial Infarction (STEMI) Care and 30-Day Mortality in a Low-to Middle-Income City in Brazil: Findings From Salvador's STEMI Registry (RESISST) SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE Brazil; mortality; regional care; registry; ST-segment-elevation myocardial infarction ID ACUTE CORONARY SYNDROMES; REPERFUSION STRATEGIES; TASK-FORCE; MANAGEMENT; GUIDELINES; OUTCOMES; TRENDS; TIMES; ESC AB Background-Few data exist on regional systems of care for the treatment of ST-segment-elevation myocardial infarction (STEMI) in developing countries. Our objective was to describe temporal trends in 30-day mortality and identify predictors of mortality among STEMI patients enrolled in a prospective registry in Brazil. Methods and Results-From January 2011 to June 2013, 520 patients who received initial STEMI care at 23 nonspecialized public health units or hospitals, some of whom were transferred to a public cardiology referral center, were identified through a regional STEMI network supported by telemedicine and the local prehospital emergency medical service. We stratified patients into five 6-month periods based on presentation date. Mean age (+/- SD) of patients was 62.0 (+/- 12.2) years, and 55.6% were men. The mean Global Registry of Acute Coronary Events (GRACE) score was 145 (+/- 34). Overall mortality at 30 days was 15.0%. Use of dual antiplatelet therapy and statins increased significantly from baseline (January 2011) to period 5 (June 2013): 61.8% to 93.6% (P < 0.001) and 60.4% to 79.7% (P < 0.001), respectively. Rates of primary reperfusion also increased (29.1%-53.8%; P < 0.001), and more patients were transferred to the referral center (44.7%-76.3%; P = 0.001). Thirty-day mortality rates decreased from 19.8% to 5.1% (P < 0.001). In multivariable analysis, factors independently associated with 30-day mortality were higher GRACE score, history of previous stroke, lack of transfer to the referral center, and lack of use of optimized medical therapy. Conclusions-Implementation of a regional STEMI system was associated with lower mortality and higher use of evidence-based therapies. C1 [Filgueiras Filho, Nivaldo Menezes] Univ Fed Estado Sao Paulo, Sao Paulo, Brazil. [Filgueiras Filho, Nivaldo Menezes] Univ Estado Bahia, Salvador, BA, Brazil. [Filgueiras Filho, Nivaldo Menezes; Ballalai, Constance Silva; De Lucia, Carolina Vitoria] Univ Salvador, Rede Laureate, Salvador, BA, Brazil. [Feitosa Filho, Gilson Soares] Escola Bahiana Med & Saude Publ, Salvador, BA, Brazil. [Fontoura Solla, Davi Jorge; Argolo, Felipe Coelho; Paiva Filho, Ivan de Mattos; Mutti Carvalho, Larissa Gordilho; Teixeira, Larissa Silva; de Oliveira Rios, Marcos Nogueira; Camara, Sergio Figueiredo; Novais, Victor Oliveira; Barbosa, Leonardo de Souza] Serv Atendimento Movel Urgencia SAMU 192, Salvador, BA, Brazil. [Guimaraes, Patricia Oliveira; Granger, Christopher B.; Newby, L. Kristin; Lopes, Renato D.] Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA. C3 Universidade Estadual Paulista; Universidade Federal de Sao Paulo (UNIFESP); Universidade do Estado Bahia; Universidad de El Salvador; Universidade Salvador (UNIFACS); Escola Bahiana de Medicina e Saude Publica; Duke University RP Lopes, RD (通讯作者),Duke Clin Res Inst, Box 3850,2400 Pratt St, Durham, NC 27705 USA. EM renato.lopes@dm.duke.edu RI Solla, Davi/GWU-9718-2022; Argolo, Felipe/GNM-6637-2022; Solla, Davi/E-6988-2013 OI Argolo, Felipe/0000-0001-5686-8712; Teixeira, Larissa/0000-0002-2234-1952; Camara, Sergio/0000-0001-7057-0322; Solla, Davi/0000-0002-5092-6595 FU Telemedicine Center (Telemedicina da Bahia) FX A scientific scholarship was offered by the Telemedicine Center (Telemedicina da Bahia) for each medical student. CR Berwanger O, 2012, JAMA-J AM MED ASSOC, V307, P2041, DOI 10.1001/jama.2012.413 Bonnefoy E, 2009, EUR HEART J, V30, P1598, DOI 10.1093/eurheartj/ehp156 Dauerman HL, 2015, CIRC-CARDIOVASC INTE, V8, DOI DOI 10.1161/CIRCINTERVENTIONS.114.002450 Departamento de Informatica do SUS. 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Am. Heart Assoc. PD JUL 17 PY 2018 VL 7 IS 14 AR e008624 DI 10.1161/JAHA.118.008624 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HD8KE UT WOS:000452803800014 PM 29980522 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Ipek, G Kurmus, O Koseoglu, C Onuk, T Gungor, B Kirbas, O Karatas, MB Keskin, M Borklu, EB Hayiroglu, MI Tanik, O Oz, A Bolca, O AF Ipek, Gokturk Kurmus, Ozge Koseoglu, Cemal Onuk, Tolga Gungor, Baris Kirbas, Ozgur Karatas, Mehmet B. Keskin, Muhammed Borklu, Edibe Betul Hayiroglu, Mert Ilker Tanik, Ozan Oz, Ahmet Bolca, Osman TI Predictors of in-hospital mortality in octogenarian patients who underwent primary percutaneous coronary intervention after ST segment elevated myocardial infarction SO GERIATRICS & GERONTOLOGY INTERNATIONAL LA English DT Article DE In-hospital mortality; octogenarian; primary percutaneous coronary intervention; risk factors; ST segment elevated myocardial infarction ID ELDERLY-PATIENTS; GUIDELINES; MANAGEMENT; REGISTRY; SAFETY; STENTS; CARE; AGE AB AimOctogenarian patients have higher mortality and morbidity rates after acute coronary syndromes. Risk factors for in-hospital mortality in the primary percutaneous coronary intervention (PCI) era were underrepresented in previous studies. In the present study, we aimed to assess the risk factors of in-hospital mortality after primary PCI in this population. MethodsWe analyzed 2353 patients who underwent primary PCI after ST segment elevated myocardial infarction (STEMI). Patients were divided into two groups according to aged: 80years (octogenarian) and <80years (control). Risk factors for in-hospital mortality were analyzed in the whole group and octogenarian patients. ResultsWe found that octogenarians have 10.6-fold higher mortality risk after STEMI. After a univariate and multivariate analysis, acute stent thrombosis was the most explicit risk factor for in-hospital mortality in the octogenarian group (OR 21.13, 95% CI 2.11-102.76, P<0.001). Additionally, anterior myocardial infarction (OR 4.90, 95% CI 1.90-22.10, P=0.04), ventricular arrhythmias (OR 15.64, 95% CI 2.81-87.12, P=0.002), multivessel disease (OR 6.5, 95% CI 1.11-38.85, P=0.04), ejection fraction <30% (OR 1.24, 95% CI 0.26-6.00, P=0.04) and KILLIP score 2 (OR 1.20, 95% CI 0.20- 7.41, P=0.01) were also significantly associated with mortality. ConclusionsAcute stent thrombosis, anterior MI, heart failure, low ejection fraction, ventricular arrhythmias and multivessel disease are the independent risk factors for in-hospital mortality among octogenarian patients after primary PCI. Geriatr Gerontol Int 2017; 17: 584-590. C1 [Ipek, Gokturk; Onuk, Tolga; Gungor, Baris; Karatas, Mehmet B.; Keskin, Muhammed; Borklu, Edibe Betul; Hayiroglu, Mert Ilker; Tanik, Ozan; Oz, Ahmet; Bolca, Osman] Siyami Ersek Cardiothorac Surg Ctr, Dept Cardiol, Istanbul, Turkey. [Kurmus, Ozge; Koseoglu, Cemal; Kirbas, Ozgur] Ataturk Training & Res Hosp, Dept Cardiol, Ankara, Turkey. C3 Dr. Siyami Ersek Cardiac & Vascular Surgery Training & Research Hospital; Ankara Ataturk Training & Research Hospital RP Ipek, G (通讯作者),75 Francis St, Boston, MA 02115 USA. EM gokturkipek@hotmail.com RI Ipek, Gokturk/O-9063-2016; HayÄroğlu, Mert Ä°lker/AEX-7656-2022; kurmuş, özge/N-5101-2017; Gungor, Baris/AAI-8284-2020; HayÄroğlu, Mert Ä°lker/AAF-9975-2022; Hayiroglu, Mert İlker/AAQ-3365-2021; Keskin, Muhammed/W-8229-2018 OI kurmuş, özge/0000-0003-2067-7492; Gungor, Baris/0000-0002-8883-117X; Hayiroglu, Mert İlker/0000-0001-6515-7349; Keskin, Muhammed/0000-0002-4938-0097; KARATAS, MEHMET BARAN/0000-0001-7578-8451 CR Alexander KP, 2005, J AM COLL CARDIOL, V46, P1479, DOI 10.1016/j.jacc.2005.05.084 Batchelor WB, 2000, J AM COLL CARDIOL, V36, P723, DOI 10.1016/S0735-1097(00)00777-4 Caretta G, 2014, CLIN CARDIOL, V37, P523, DOI 10.1002/clc.22313 Chen QW, 2010, ARCH GERONTOL GERIAT, V51, P312, DOI 10.1016/j.archger.2010.01.007 COCKCROFT DW, 1976, NEPHRON, V16, P31, DOI 10.1159/000180580 de Belder A, 2014, J AM COLL CARDIOL, V63, P1371, DOI 10.1016/j.jacc.2013.10.053 Gale CP, 2012, EUR HEART J, V33, P630, DOI 10.1093/eurheartj/ehr381 Gao L, 2014, CLIN INTERV AGING, V9, P1241, DOI 10.2147/CIA.S62642 Gottlieb S, 2011, ARCH GERONTOL GERIAT, V52, P118, DOI 10.1016/j.archger.2010.02.015 Hassam SE, 2006, J AM COLL CARDIOL, V47, P2413, DOI 10.1016/j.jacc.2005.11.091 Jaguszewski M, 2015, CLIN RES CARDIOL, V104, P51, DOI 10.1007/s00392-014-0756-5 Jokhadar M, 2009, CLIN INTERV AGING, V4, P435 Kvakkestad KM, 2015, EUR HEAR J ACUTE CAR, P1 Moonen LAA, 2010, NETH HEART J, V18, P129, DOI 10.1007/BF03091751 Renilla A, 2013, GERIATR GERONTOL INT, V13, P146, DOI 10.1111/j.1447-0594.2012.00876.x Sadeghi HM, 2003, J AM COLL CARDIOL, V42, P428, DOI 10.1016/S0735-1097(03)00657-0 Sakai K, 2012, CATHETER CARDIO INTE, V79, P50, DOI 10.1002/ccd.22810 Shanmugam VB, 2015, J GERIATR CARDIOL, V12, P174, DOI 10.11909/j.issn.1671-5411.2015.02.012 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Stone GW, 2007, NEW ENGL J MED, V356, P998, DOI 10.1056/NEJMoa067193 Vandecasteele EH, 2013, CLIN RES CARDIOL, V102, P837, DOI 10.1007/s00392-013-0600-3 Velders MA, 2014, AM HEART J, V167, DOI 10.1016/j.ahj.2014.01.013 Wang TY, 2012, J AM COLL CARDIOL, V59, P105, DOI 10.1016/j.jacc.2011.10.853 NR 23 TC 5 Z9 5 U1 2 U2 4 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1444-1586 EI 1447-0594 J9 GERIATR GERONTOL INT JI Geriatr. Gerontol. Int. PD APR PY 2017 VL 17 IS 4 BP 584 EP 590 DI 10.1111/ggi.12759 PG 7 WC Geriatrics & Gerontology; Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA ES3RR UT WOS:000399447200007 PM 27090995 DA 2023-05-13 ER PT J AU Barreto, JA Wang, YF Rathore, SS Spatz, ES Ross, JS Curtis, JP Nallamothu, BI Normand, SLT Krumholz, HM AF Barreto Filho, Jose Augusto Wang, Yongfei Rathore, Saif S. Spatz, Erica S. Ross, Joseph S. Curtis, Jeptha P. Nallamothu, Brahmajee I. Normand, Sharon-Lise T. Krumholz, Harlan M. TI Transfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction SO JAMA INTERNAL MEDICINE LA English DT Article ID ACUTE CORONARY SYNDROME; ASSOCIATION TASK-FORCE; QUALITY-OF-CARE; CARDIAC PROCEDURES; UNITED-STATES; RISK; STRATEGIES; MANAGEMENT; INTERVENTION; ANGIOPLASTY AB IMPORTANCE It is unknown whether hospital transfer rates for patients with acute myocardial infarction admitted to nonprocedure hospitals (facilities that do not provide catheterization) vary and whether these rates further influence revascularization rates, length of stay, and mortality. OBJECTIVES To examine hospital differences in transfer rates for elderly patients with acute myocardial infarction across nonprocedure hospitals and to determine whether these rates are associated with revascularization rates, length of stay, and mortality. DESIGN. SETTING. AND PARTICIPANTS We used Medicare claims data from January 1, 2006, to December 31, 2008, to assess transfer rates in nonprocedure hospitals, stratified according to transfer rates as low (<= 20%), mid-low (>20%-30%), mid-high (>30%-40%), or high (>40%). Data were analyzed for 55 962 Medicare fee-for-service patients admitted to 901 nonprocedure US hospitals with more than 25 admissions per year for acute myocardial infarction. MAIN OUTCOMES AND MEASURES We compared rates of catheterization, percutaneous coronary intervention, and coronary artery bypass graft surgery during hospitalization and within 60 days, as well as hospital total length of stay, across groups. We measured risk-standardized mortality rates at 30 days and 1 year. RESULTS The median transfer rate was 29.4% (interquartile range [25th-75th percentile], 21.8%-37.8%). Higher transfer rates were associated with higher rates of catheterization (P<.001), percutaneous coronary intervention (P<.001), and coronary artery bypass graft surgery (P<.001). Median length of stay was not meaningfully different across the groups. There was no meaningful evidence of associations between transfer rates and risk-standardized mortality at 30 days (mean [SD], 22.3% [2.6%], 22.1% [2.3%], 22.3% [2.4%], and 21.7% [2.1%], respectively; P=.054) or 1 year (43.9% [2.3%], 43.6% [2.2%], 43.5% [2.4%], and 42.8% [2.2%], respectively; P<.001) for low, mid-low, mid-high, and high transfer groups. CONCLUSIONS AND RELEVANCE Nonprocedure hospitals vary substantially in their use of the transfer process for elderly patients admitted with acute myocardial infarction. High-transfer hospitals had greater use of invasive cardiac procedures after admission compared with low-transfer hospitals. However, higher transfer rates were not associated with a significantly lower risk-standardized mortality rate at 30 days. Moreover, at 1 year there was only a 1.1% difference (42.8% vs 43.9%) between hospitals with higher and lower transfer rates. These findings suggest that, as a single intervention, promoting the transfer of patients admitted with acute myocardial infarction may not improve hospital outcomes. C1 [Barreto Filho, Jose Augusto] Univ Fed Sergipe, Div Cardiol, Aracaju, Sergipe, Brazil. [Wang, Yongfei; Spatz, Erica S.; Curtis, Jeptha P.; Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. [Wang, Yongfei; Curtis, Jeptha P.; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Rathore, Saif S.] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA. [Ross, Joseph S.; Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. [Ross, Joseph S.] Yale Univ, Sch Med, Dept Internal Med, Gen Internal Med Sect, New Haven, CT 06510 USA. [Nallamothu, Brahmajee I.] Vet Affairs Ann Arbor Hlth Serv Res & Dev Serv, Ctr Clin Management Res, Ann Arbor, MI USA. [Nallamothu, Brahmajee I.] Univ Michigan, Sch Med, Dept Internal Med, Div Cardiovasc Med, Ann Arbor, MI USA. [Nallamothu, Brahmajee I.] Univ Michigan, Sch Med, Ctr Healthcare Outcomes & Policy, Inst Healthcare Policy & Innovat, Ann Arbor, MI USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Krumholz, Harlan M.] Yale Univ, Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA. C3 Universidade Federal de Sergipe; Yale University; Yale University; Harvard University; Massachusetts General Hospital; Yale University; Yale University; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Ann Arbor Healthcare System; University of Michigan System; University of Michigan; University of Michigan System; University of Michigan; Harvard University; Harvard Medical School; Harvard University; Harvard T.H. Chan School of Public Health; Yale University RP Krumholz, HM (通讯作者),Yale Ctr Outcomes Res & Evaluat, 1 Church St,Ste 200, New Haven, CT 06510 USA. EM harlan.krumholz@yale.edu RI , Harlan/AAI-2875-2020 OI Ross, Joseph/0000-0002-9218-3320; Normand, Sharon-Lise/0000-0001-7027-4769 FU National Heart, Lung, and Blood Institute [1U01HL105270-04]; Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Ministry of Education, Brazil [3436-10-1]; Federal University of Sergipe, Sergipe, Brazil; National Institute on Aging [K08 AG032886]; American Federation for Aging Research through the Paul B. Beeson Career Development Award Program [K08 AG038336] FX This study was funded by grant 1U01HL105270-04 (Center for Cardiovascular Outcomes Research at Yale University) from the National Heart, Lung, and Blood Institute. Dr Barreto-Filho is supported by grant 3436-10-1 from the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Ministry of Education, Brazil, and the Federal University of Sergipe, Sergipe, Brazil. Dr Ross is supported by grants K08 AG032886 and K08 AG038336 from the National Institute on Aging and by the American Federation for Aging Research through the Paul B. Beeson Career Development Award Program, respectively. 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Med. PD FEB PY 2014 VL 174 IS 2 BP 213 EP 222 DI 10.1001/jamainternmed.2013.11944 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AD2FM UT WOS:000333049200014 PM 24296747 DA 2023-05-13 ER PT J AU Wong, YK Stearn, S Moore, S Hale, B AF Wong, Yuk-ki Stearn, Shelley Moore, Sally Hale, Beverley TI Angina at Low heart rate And Risk of imminent Myocardial infarction (the ALARM study): a prospective, observational proof-of-concept study SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Unstable angina; Myocardial infarction; Myocardial preinfarction syndrome; Acute coronary syndrome; Heart rate ID EXERCISE; DELAY; CARE AB Background: Myocardial infarction (MI) is often preceded by unstable angina. Helping patients identify the onset of unstable angina rather than MI may result in earlier treatment and improve outcomes. Unstable angina is angina occurring at a lower-than-usual workload. Since heart rate (HR) is correlated with degree of exertion, we hypothesised that angina occurring at low HR is a warning signal for unstable angina and MI. Methods: In this prospective study, 111 patients with acute coronary syndrome (ACS) or prognostically significant coronary disease were recruited. Each patient's HR was measured using a portable electrocardiogram (ECG) recorder after regular class III exercise on the Canadian Cardiovascular Society Angina Grading Scale and the cumulative moving average and three-sigma (standard deviation) range were calculated for each new measurement. The HR was subsequently measured at the beginning of angina; a HR lower than the preceding three-sigma ranges for class III or anginal HR was regarded as a 'warning signal'. The proportion of warning signals associated with ACS occurring in the following 2 weeks was compared with that for non-warning signals. Results: Nine cases of ACS occurred in eight patients. Two cases were preceded by warning signals; a signal marked the onset of ACS in a third patient, and four patients failed to make anginal ECG recordings. There were 591 documented episodes of angina during the study and ECGs were available for 383 (64.8 %) of these of which 55 were warning signals. Of these warning signals, 4 occurred in the 2 weeks preceding ACS, compared with 4 of 328 non-warning signals (odds ratio, 6.4; 95 % confidence interval, 1.5-26.2; p = 0.01; positive predictive value, 7.3 %; negative predictive value, 98.8 %). Conclusions: Low HR angina may identify unstable angina and serve as an early warning for MI. In addition, angina that does not occur at a low heart rate indicates that ACS is very unlikely. C1 [Wong, Yuk-ki; Stearn, Shelley; Moore, Sally] Western Sussex Hosp NHS Fdn Trust, St Richards Hosp, Dept Cardiol, Chichester PO19 4SE, W Sussex, England. [Hale, Beverley] Univ Chichester, Stat & Res, Chichester, England. C3 University of Chichester RP Wong, YK (通讯作者),Western Sussex Hosp NHS Fdn Trust, St Richards Hosp, Dept Cardiol, Spitalfield Lane, Chichester PO19 4SE, W Sussex, England. EM yuk-ki.wong@wsht.nhs.uk OI Wong, Yuk-ki/0000-0001-7347-7377 FU Department of Health under the NIHR Research for Innovation, Speculation and Creativity (RISC) Programme [RC-PG-0308-10219]; National Institute for Health Research [RC-PG-0308-10219] Funding Source: researchfish FX This article represents independent research funded by the Department of Health under the NIHR Research for Innovation, Speculation and Creativity (RISC) Programme (grant number RC-PG-0308-10219). The views expressed in this publication are those of the authors and not necessarily those of the NHS or the Department of Health. We thank Michal Ong, Steven Dixon, and Suneil Aggarwal for help with reading the ECGs. We also thank all of our patients, who recorded almost 30,000 ECGs. CR Anderson JL, 2007, J AM COLL CARDIOL, V50, P652, DOI 10.1016/j.jacc.2007.02.028 Birkhead JS, 2004, HEART, V90, P1004, DOI 10.1136/hrt.2004.034470 CAMPEAU L, 1976, CIRCULATION, V54, P522, DOI 10.1161/circ.54.3.947585 HIGGINBOTHAM MB, 1986, CIRC RES, V58, P281, DOI 10.1161/01.RES.58.2.281 Khavandi A, 2007, BMJ-BRIT MED J, V335, P3, DOI 10.1136/bmj.39262.691343.47 KOUVARAS G, 1987, Q J MED, V64, P679 MADSEN JK, 1985, BRIT HEART J, V54, P27 Natl Heart Lung Blood Inst, 1998, J THROMB THROMBOLYS, V6, P47 Saczynski JS, 2008, AM J CARDIOL, V102, P1589, DOI 10.1016/j.amjcard.2008.07.056 SOLOMON HA, 1969, CIRCULATION, V40, P463, DOI 10.1161/01.CIR.40.4.463 Spencer FA, 2010, EUR HEART J, V31, P1328, DOI 10.1093/eurheartj/ehq057 STOWERS M, 1970, BRIT HEART J, V32, P833 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] Wong YK, 2003, HEART, V89, P1416, DOI 10.1136/heart.89.12.1416 WOOD P, 1961, BRIT MED J, V1, P1779, DOI 10.1136/bmj.1.5242.1779 NR 15 TC 1 Z9 1 U1 0 U2 3 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-2261 J9 BMC CARDIOVASC DISOR JI BMC Cardiovasc. Disord. PD NOV 14 PY 2015 VL 15 AR 148 DI 10.1186/s12872-015-0140-z PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CW4YC UT WOS:000365001500003 PM 26573587 OA Green Accepted, Green Published, gold DA 2023-05-13 ER PT J AU Dionne, A Friedman, KG Young, CC Newhams, MM Kucukak, S Jackson, AM Fitzgerald, JC Smallcomb, LS Heidemann, S McLaughlin, GE Irby, K Bradford, TT Horwitz, SM Loftis, LL Soma, VL Rowan, CM Kong, M Halasa, NB Tarquinio, KM Schwarz, AJ Hume, JR Gertz, SJ Clouser, KN Carroll, CL Wellnitz, K Cullimore, ML Doymaz, S Levy, ER Typpo, KV Lansell, AN Butler, AD Kuebler, JD Zambrano, LD Campbell, AP Patel, MM Randolph, AG Newburger, JW AF Dionne, Audrey Friedman, Kevin G. Young, Cameron C. Newhams, Margaret M. Kucukak, Suden Jackson, Ashley M. Fitzgerald, Julie C. Smallcomb, Laura S. Heidemann, Sabrina McLaughlin, Gwenn E. Irby, Katherine Bradford, Tamara T. Horwitz, Steven M. Loftis, Laura L. Soma, Vijaya L. Rowan, Courtney M. Kong, Michele Halasa, Natasha B. Tarquinio, Keiko M. Schwarz, Adam J. Hume, Janet R. Gertz, Shira J. Clouser, Katharine N. Carroll, Christopher L. Wellnitz, Kari Cullimore, Melissa L. Doymaz, Sule Levy, Emily R. Typpo, Katri, V Lansell, Amanda N. Butler, Andrew D. Kuebler, Joseph D. Zambrano, Laura D. Campbell, Angela P. Patel, Manish M. Randolph, Adrienne G. Newburger, Jane W. CA Overcoming COVID-19 Investigator TI Tachyarrhythmias During Hospitalization for COVID-19 or Multisystem Inflammatory Syndrome in Children and Adolescents SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE COVID-19; multisystem inflammatory syndrome in children (MIS-C); tachyarrhythmia ID SCIENTIFIC STATEMENT; ARRHYTHMIAS; MANAGEMENT; DIAGNOSIS AB Background Cardiac complications related to COVID-19 in children and adolescents include ventricular dysfunction, myocarditis, coronary artery aneurysm, and bradyarrhythmias, but tachyarrhythmias are less understood. The goal of this study was to evaluate the frequency, characteristics, and outcomes of children and adolescents experiencing tachyarrhythmias while hospitalized for acute severe COVID-19 or multisystem inflammatory syndrome in children. Methods and Results This study involved a case series of 63 patients with tachyarrhythmias reported in a public health surveillance registry of patients aged <21 years hospitalized from March 15, 2020, to December 31, 2021, at 63 US hospitals. Patients with tachyarrhythmias were compared with patients with severe COVID-19-related complications without tachyarrhythmias. Tachyarrhythmias were reported in 22 of 1257 patients (1.8%) with acute COVID-19 and 41 of 2343 (1.7%) patients with multisystem inflammatory syndrome in children. They included supraventricular tachycardia in 28 (44%), accelerated junctional rhythm in 9 (14%), and ventricular tachycardia in 38 (60%); >1 type was reported in 12 (19%). Registry patients with versus without tachyarrhythmia were older (median age, 15.4 [range, 10.4-17.4] versus 10.0 [range, 5.4-14.8] years) and had higher illness severity on hospital admission. Intervention for treatment of tachyarrhythmia was required in 37 (59%) patients and included antiarrhythmic medication (n=31, 49%), electrical cardioversion (n=11, 17%), cardiopulmonary resuscitation (n=8, 13%), and extracorporeal membrane oxygenation (n=9, 14%). Patients with tachyarrhythmias had longer hospital length of stay than those who did not, and 9 (14%) versus 77 (2%) died. Conclusions Tachyarrhythmias were a rare complication of acute severe COVID-19 and multisystem inflammatory syndrome in children and adolescents and were associated with worse clinical outcomes, highlighting the importance of close monitoring, aggressive treatment, and postdischarge care. C1 [Dionne, Audrey; Friedman, Kevin G.; Newburger, Jane W.] Harvard Med Sch, Boston Childrens Hosp, Dept Cardiol, Dept Pediat, Boston, MA 02115 USA. [Young, Cameron C.; Newhams, Margaret M.; Kucukak, Suden; Randolph, Adrienne G.] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA. [Jackson, Ashley M.; Zambrano, Laura D.; Campbell, Angela P.; Patel, Manish M.] Ctr Dis Control & Prevent, COVID 19 Response, Atlanta, GA USA. [Fitzgerald, Julie C.] Univ Penn, Dept Anesthesiol & Crit Care, Div Crit Care, Perelman Sch Med, Philadelphia, PA USA. [Smallcomb, Laura S.] Med Univ South Carolina, Dept Pediat, Charleston, SC USA. [Heidemann, Sabrina] Cent Michigan Univ, Dept Pediat, Div Pediat Crit Care Med, Detroit, MI USA. [McLaughlin, Gwenn E.] Univ Miami, Dept Pediat, Div Pediat Crit Care Med, Miller Sch Med, Miami, FL USA. [Irby, Katherine] Arkansas Childrens Hosp, Dept Pediat, Sect Pediat Crit Care, Little Rock, AR USA. [Bradford, Tamara T.] Louisiana State Univ, Dept Pediat, Div Cardiol, Hlth Sci Ctr, New Orleans, LA USA. [Bradford, Tamara T.] Childrens Hosp New Orleans, New Orleans, LA USA. [Horwitz, Steven M.] Rutgers Robert Wood Johnson Med Sch, Dept Pediat, Div Pediat Crit Care Med, New Brunswick, NJ USA. [Loftis, Laura L.] Texas Childrens Hosp, Dept Pediat, Sect Crit Care Med, Houston, TX USA. [Soma, Vijaya L.] NYU, Dept Pediat, Div Infect Dis, Grossman Sch Med, New York, NY USA. [Soma, Vijaya L.] Hassenfeld Childrens Hosp, New York, NY USA. [Rowan, Courtney M.] Indiana Univ Sch Med, Riley Hosp Children, Dept Pediat, Div Pediat Crit Care Med, Indianapolis, IN USA. [Kong, Michele] Univ Alabama Birmingham, Dept Pediat, Div Pediat Crit Care Med, Birmingham, AL USA. [Halasa, Natasha B.] Vanderbilt Univ, Dept Pediat, Div Pediat Infect Dis, Med Ctr, Nashville, TN USA. [Tarquinio, Keiko M.] Emory Univ, Dept Pediat, Div Crit Care Med, Childrens Healthcare Atlanta,Sch Med, Atlanta, GA USA. [Schwarz, Adam J.] CHOC Childrens Hosp, Div Crit Care Med, Orange, CA USA. [Hume, Janet R.] Univ Minnesota, Div Pediat Crit Care, Masonic Childrens Hosp, Minneapolis, MN USA. [Gertz, Shira J.] Cooperman Bamabas Med Ctr, Dept Pediat, Div Pediat Crit Care, Livingston, NJ USA. [Clouser, Katharine N.] Hackensack Meridian Sch Med, Dept Pediat, Hackensack, NJ USA. [Carroll, Christopher L.] Connecticut Childrens Med Ctr, Div Crit Care, Hartford, CT USA. [Wellnitz, Kari] Univ Iowa, Stead Family Dept Pediat, Div Pediat Crit Care, Carver Coll Med, Iowa City, IA USA. [Cullimore, Melissa L.] Childrens Hosp & Med Ctr, Dept Pediat, Div Pediat Crit Care, Omaha, NE USA. [Doymaz, Sule] SUNY Downstate Hlth Sci Univ, Dept Pediat, Div Pediat Crit Care, Brooklyn, NY USA. [Levy, Emily R.] Mayo Clin, Div Pediat Infect Dis, Dept Pediat & Adolescent Med, Rochester, MN USA. [Levy, Emily R.] Mayo Clin, Div Pediat Crit Care Med, Dept Pediat & Adolescent Med, Rochester, MN USA. [Typpo, Katri, V] Univ Arizona, Dept Pediat, Div Pediat Crit Care, Tucson, AZ USA. [Lansell, Amanda N.] Rainbow Babies & Childrens Hosp, Div Pediat Hosp Med, Cleveland, OH USA. [Butler, Andrew D.] St Christophers Hosp Children, Div Pediat Crit Care, Philadelphia, PA USA. [Kuebler, Joseph D.] Univ Rochester, Golisano Childrens Hosp, Dept Pediat, Div Pediat Crit Care, Rochester, NY USA. [Randolph, Adrienne G.] Harvard Med Sch, Dept Anaesthesia, Boston, MA 02115 USA. [Randolph, Adrienne G.] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA. C3 Harvard University; Boston Children's Hospital; Harvard Medical School; Harvard University; Boston Children's Hospital; Centers for Disease Control & Prevention - USA; University of Pennsylvania; Pennsylvania Medicine; Medical University of South Carolina; Central Michigan University; University of Miami; Arkansas Children's Hospital; Louisiana State University System; Louisiana State University Health Sciences Center New Orleans; Children's Hospital of New Orleans; Rutgers State University New Brunswick; Rutgers State University Medical Center; Baylor College of Medicine; New York University; Indiana University System; Indiana University Bloomington; James Whitcomb Riley Hospital Children; University of Alabama System; University of Alabama Birmingham; Vanderbilt University; Children's Healthcare of Atlanta (CHOA); Emory University; University of Minnesota System; University of Minnesota Twin Cities; Connecticut Children's Medical Center; University of Iowa; Mayo Clinic; Mayo Clinic; University of Arizona; Case Western Reserve University; Case Western Reserve University Hospital; University Hospitals of Cleveland; Rainbow Babies & Children's Hospital; University of Rochester; Harvard University; Harvard Medical School; Harvard University; Harvard Medical School RP Dionne, A (通讯作者),Harvard Med Sch, Childrens Hosp, Dept Cardiol, 300 Longwood Ave, Boston, MA 02115 USA. EM audrey.dionne@cardio.chboston.org RI Gertz, Shira J/AAT-2711-2020 OI Gertz, Shira/0000-0001-8119-6006; Hume, Janet/0000-0002-8891-6800; Smallcomb, Laura/0000-0002-2372-6790; Young, Cameron/0000-0001-7323-4834 FU Centers for Disease Control and Prevention [75D30120C07725] FX This study was funded by the Centers for Disease Control and Prevention under a contract to Boston Children's Hospital (#75D30120C07725). The Centers for Disease Control and Prevention was involved with the design and conduct of the public health investigation and review and approval of the manuscript. They did not collect or manage the data, and they did not analyze the data for this subanalysis or assist with interpretation or prepare the manuscript. CR Anderson BR, 2014, AM J CARDIOL, V114, P1400, DOI 10.1016/j.amjcard.2014.07.074 Bialek S, 2020, MMWR-MORBID MORTAL W, V69, P422, DOI 10.15585/mmwr.mm6914e4 Coromilas EJ., 2021, CIRC-ARRHYTHMIA ELEC, V14 Dherange P, 2020, JACC-CLIN ELECTROPHY, V6, P1193, DOI 10.1016/j.jacep.2020.08.002 Dong Yuanyuan, 2020, Pediatrics, V145, DOI 10.1542/peds.2020-0702 Dufort EM, 2020, NEW ENGL J MED, V383, P347, DOI 10.1056/NEJMoa2021756 Feldstein LR, 2021, JAMA-J AM MED ASSOC, V325, P1074, DOI 10.1001/jama.2021.2091 Feldstein LR, 2020, NEW ENGL J MED, V383, P334, DOI 10.1056/NEJMoa2021680 Irfan O, 2021, ARCH DIS CHILD, V106, P440, DOI 10.1136/archdischild-2020-321385 Law YM, 2021, CIRCULATION, V144, pE123, DOI 10.1161/CIR.0000000000001001 Lu XX, 2020, NEW ENGL J MED, V382, P1663, DOI 10.1056/NEJMc2005073 Matics TJ, 2017, JAMA PEDIATR, V171, DOI 10.1001/jamapediatrics.2017.2352 McCrindle BW., 2017, CIRCULATION, V135, pe927, DOI [10.1161/CIR.0000000000000484, DOI 10.1161/CIR.0000000000000484] Miyake CY, 2014, AM J CARDIOL, V113, P535, DOI 10.1016/j.amjcard.2013.10.021 Riphagen S, 2020, LANCET, V395, P1607, DOI [10.1016/S0140-6736(20)31094-1, 10.1016/50140-6736(20)31094-1] Rosier L, 2020, J CLIN MED, V9, DOI 10.3390/jcm9030848 Shi SB, 2020, JAMA CARDIOL, V5, P802, DOI 10.1001/jamacardio.2020.0950 Whittaker E, 2020, JAMA-J AM MED ASSOC, V324, P259, DOI 10.1001/jama.2020.10369 Zheng YY, 2020, NAT REV CARDIOL, V17, P259, DOI 10.1038/s41569-020-0360-5 NR 19 TC 1 Z9 1 U1 1 U2 1 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA EI 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD OCT 18 PY 2022 VL 11 IS 20 AR e025915 DI 10.1161/JAHA.122.025915 PG 31 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 5K4QW UT WOS:000869713100028 PM 36250670 OA gold, Green Published DA 2023-05-13 ER PT J AU Nguyen, JT Vakil, K Adabag, S Westanmo, A Madlon-Kay, R Ishani, A Garcia, S McFalls, EO AF Nguyen, Jennifer T. Vakil, Kairav Adabag, Selcuk Westanmo, Anders Madlon-Kay, Richard Ishani, Areef Garcia, Santiago McFalls, Edward O. TI Hospital Readmission Rates Following AMI: Potential Interventions to Improve Efficiency SO SOUTHERN MEDICAL JOURNAL LA English DT Article DE acute myocardial infarction; outcomes; readmissions; revascularization; utilization ID ACUTE MYOCARDIAL-INFARCTION; LENGTH-OF-STAY; VETERANS AFFAIRS HOSPITALS; 30-DAY READMISSION; OLDER PATIENTS; MORTALITY; REHOSPITALIZATION; ASSOCIATION; PREDICTORS; TRENDS AB Objectives: Quality of care utilization measures for patients admitted to the hospital with an acute myocardial infarction (AMI) include length of stay (LOS) and 30-day readmission rates. Our aim was to test whether efforts resulting in reduced LOS in patients diagnosed as having AMI would result in a higher risk of readmission within 30 days of hospital discharge and whether specific interventions could be targeted to reduce readmissions. Methods: Using data supplied by the Veterans Affairs Inpatient Evaluation Center, we analyzed both the readmissions within 30 days of an AMI and LOS and determined the timing of readmissions and associated diagnoses. Results: During 2013-2015, 35 (13.3%) of 263 patients with AMI were readmitted within 30 days of discharge compared with 19 (13.4%) of 142 patients during 2016 (not significant). During the same time, LOS was <3 days in most patients. From 2013 to 2015, the initial hospital time was 6 +/- 6 days, whereas time out of the hospital before readmission was 11 +/- 8 days; these times did not differ from 2016. Initial therapeutic decisions were based on coronary anatomy in >90% of patients with a decision to proceed with revascularization inmost patients. Diagnoses during readmission to the hospital were also similar during early and later time periods and most frequently were a result of either coronary artery bypass grafting-related complications from the initial hospitalization or elective coronary artery bypass grafting. Acute coronary syndrome-related diagnoses and recurrent noncardiac causes of chest pain also were common diagnoses during both time periods and did not involve extensive workup during the readmission. Conclusions: Readmissions for patients with AMI were stable during a 4-year period, at a time that efforts to reduce LOS were emphasized. Because a significant proportion of readmissions involved noncardiac sources of chest pain, improved communication between the emergency department and in-patient cardiology services at the time of triage may be a feasible way to improve efficiency of utilization. C1 [Nguyen, Jennifer T.; Vakil, Kairav; Adabag, Selcuk; Westanmo, Anders; Madlon-Kay, Richard; Ishani, Areef; Garcia, Santiago; McFalls, Edward O.] Vet Affairs Med Ctr, Cardiol, Minneapolis, MN USA. C3 US Department of Veterans Affairs; Veterans Health Administration (VHA); Minneapolis VA Health Care System RP McFalls, EO (通讯作者),VA Med Ctr, Cardiol 111C, 1 Vet Dr, Minneapolis, MN 55417 USA. EM mcfal001@umn.edu RI Nguyen, Jennifer/GVS-4347-2022 CR Brown JR, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.113.000714 Chen HY, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.002291 Desai MM, 2009, CIRC-CARDIOVASC QUAL, V2, P500, DOI 10.1161/CIRCOUTCOMES.108.832949 Doll JA, 2016, J AM HEART ASSOC, V5, DOI 10.1161/JAHA.116.003205 Doll JA, 2015, AM HEART J, V170, P855, DOI 10.1016/j.ahj.2015.08.001 Donze J, 2013, JAMA INTERN MED, V173, P632, DOI 10.1001/jamainternmed.2013.3023 Hansen LO, 2011, ANN INTERN MED, V155, P520, DOI 10.7326/0003-4819-155-8-201110180-00008 Hess CN, 2013, CIRCULATION, V128, P1206, DOI 10.1161/CIRCULATIONAHA.113.004569 Kaboli PJ, 2012, ANN INTERN MED, V157, P837, DOI 10.7326/0003-4819-157-12-201212180-00003 Krumholz HM, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0160492 Lambert-Kerzner A, 2012, CIRC-CARDIOVASC QUAL, V5, P571, DOI 10.1161/CIRCOUTCOMES.111.962290 Li Q, 2015, BMC CARDIOVASC DISOR, V15, DOI 10.1186/1471-2261-15-9 Nuti SV, 2016, JAMA-J AM MED ASSOC, V315, P582, DOI 10.1001/jama.2016.0278 Saczynski JS, 2010, AM J MED, V123, P1007, DOI 10.1016/j.amjmed.2010.05.018 Sangu PV, 2012, HEART, V98, P1728, DOI 10.1136/heartjnl-2012-302532 Stefan MS, 2013, J GEN INTERN MED, V28, P377, DOI 10.1007/s11606-012-2229-8 Tisminetzky M, 2015, AM J MED, V128, P760, DOI 10.1016/j.amjmed.2015.01.022 Tung YC, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0170061 Wasfy JH, 2017, ANN INTERN MED, V166, P324, DOI 10.7326/M16-0185 NR 19 TC 4 Z9 4 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0038-4348 EI 1541-8243 J9 SOUTH MED J JI South.Med.J. PD FEB PY 2018 VL 111 IS 2 BP 93 EP 97 DI 10.14423/SMJ.0000000000000768 PG 5 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA FU8FJ UT WOS:000424088400006 PM 29394425 DA 2023-05-13 ER PT J AU Hulten, E Goehler, A Bittencourt, MS Bamberg, F Schlett, CL Truong, QA Nichols, J Nasir, K Rogers, IS Gazelle, SG Nagurney, JT Hoffmann, U Blankstein, R AF Hulten, Edward Goehler, Alexander Bittencourt, Marcio Sommer Bamberg, Fabian Schlett, Christopher L. Truong, Quynh A. Nichols, John Nasir, Khurram Rogers, Ian S. Gazelle, Scott G. Nagurney, John T. Hoffmann, Udo Blankstein, Ron TI Cost and Resource Utilization Associated With Use of Computed Tomography to Evaluate Chest Pain in the Emergency Department The Rule Out Myocardial Infarction Using Computer Assisted Tomography (ROMICAT) Study SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE acute coronary syndrome; chest pain; multidetector computed tomography; economics ID CORONARY-ARTERY-DISEASE; AMERICAN-HEART-ASSOCIATION; CT ANGIOGRAPHY; CLINICAL-OUTCOMES; DIAGNOSTIC PERFORMANCE; MAGNETIC-RESONANCE; PROGNOSTIC VALUE; EARLY TRIAGE; TASK-FORCE; PERFUSION AB Background Coronary computed tomographic angiography (cCTA) allows rapid, noninvasive exclusion of obstructive coronary artery disease (CAD). However, concern exists whether implementation of cCTA in the assessment of patients presenting to the emergency department with acute chest pain will lead to increased downstream testing and costs compared with alternative strategies. Our aim was to compare observed actual costs of usual care (UC) with projected costs of a strategy including early cCTA in the evaluation of patients with acute chest pain in the Rule Out Myocardial Infarction Using Computer Assisted Tomography I (ROMICAT I) study. Methods and Results We compared cost and hospital length of stay of UC observed among 368 patients enrolled in the ROMICAT I study with projected costs of management based on cCTA. Costs of UC were determined by an electronic cost accounting system. Notably, UC was not influenced by cCTA results because patients and caregivers were blinded to the cCTA results. Costs after early implementation of cCTA were estimated assuming changes in management based on cCTA findings of the presence and severity of CAD. Sensitivity analysis was used to test the influence of key variables on both outcomes and costs. We determined that in comparison with UC, cCTA-guided triage, whereby patients with no CAD are discharged, could reduce total hospital costs by 23% (P<0.001). However, when the prevalence of obstructive CAD increases, index hospitalization cost increases such that when the prevalence of 50% stenosis is >28% to 33%, the use of cCTA becomes more costly than UC. Conclusions cCTA may be a cost-saving tool in acute chest pain populations that have a prevalence of potentially obstructive CAD <30%. However, increased cost would be anticipated in populations with higher prevalence of disease. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00990262. C1 [Hulten, Edward; Bittencourt, Marcio Sommer; Blankstein, Ron] Brigham & Womens Hosp, Dept Med, Div Cardiovasc, Noninvas Cardiovasc Imaging Program, Boston, MA 02115 USA. [Hulten, Edward; Bittencourt, Marcio Sommer; Blankstein, Ron] Brigham & Womens Hosp, Dept Radiol, Cardiovasc Div, Noninvas Cardiovasc Imaging Program, Boston, MA 02115 USA. [Hulten, Edward; Bittencourt, Marcio Sommer; Blankstein, Ron] Harvard Univ, Sch Med, Boston, MA USA. [Goehler, Alexander; Schlett, Christopher L.; Nichols, John; Nagurney, John T.; Hoffmann, Udo] Massachusetts Gen Hosp, Cardiac MR PET CT Program, Boston, MA 02114 USA. [Truong, Quynh A.] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA. [Goehler, Alexander] Yale Univ, Dept Radiol, New Haven, CT USA. [Bamberg, Fabian] Univ Munich, Klinikum Grosshadern, Dept Clin Radiol, D-80539 Munich, Germany. [Schlett, Christopher L.] Univ Heidelberg Hosp, Dept Diagnost & Intervent Radiol, Heidelberg, Germany. [Nasir, Khurram] Baptist Hlth South Florida, Miami, FL USA. [Rogers, Ian S.] Stanford Univ, Div Cardiovasc Med, Stanford, CA 94305 USA. [Gazelle, Scott G.] Massachusetts Gen Hosp, Inst Technol Assessment, Boston, MA 02114 USA. [Gazelle, Scott G.] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA. C3 Harvard University; Brigham & Women's Hospital; Harvard University; Brigham & Women's Hospital; Harvard University; Harvard Medical School; Harvard University; Massachusetts General Hospital; Harvard University; Massachusetts General Hospital; Yale University; University of Munich; Ruprecht Karls University Heidelberg; Stanford University; Harvard University; Massachusetts General Hospital; Harvard University; Massachusetts General Hospital RP Hulten, E (通讯作者),Brigham & Womens Hosp, Noninvas Cardiovasc Imaging Program, 75 Francis St, Boston, MA 02115 USA. EM ehulten@partners.org RI Bittencourt, Marcio Sommer/C-1444-2011; Hulten, Edward/AAA-9435-2019 OI Bittencourt, Marcio Sommer/0000-0002-3711-1754; Hulten, Edward/0000-0001-9281-0032; Schlett, Christopher/0000-0002-1576-1481 FU National Institutes of Health (NIH) [R01 HL080053]; Siemens Medical Solutions; GE Healthcare; NIH [K23HL098370, L30HL093896] FX This work was supported by the National Institutes of Health (NIH) R01 HL080053 and supported in part by Siemens Medical Solutions and GE Healthcare. Dr Truong was supported by NIH grants K23HL098370 and L30HL093896. 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Qual. Outcomes PD SEP PY 2013 VL 6 IS 5 BP 514 EP 524 DI 10.1161/CIRCOUTCOMES.113.000244 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 219RM UT WOS:000324526400005 PM 24021693 OA Green Accepted DA 2023-05-13 ER PT J AU Guglin, M Nazif, K AF Guglin, Maya Nazif, Kutaiba TI New onset nonischemic cardiomyopathy post liver transplantation SO HEART FAILURE REVIEWS LA English DT Article DE Cardiomyopathy; Takotsubo; Liver transplantation ID ACUTE HEART-FAILURE; TAKOTSUBO CARDIOMYOPATHY; POSTREPERFUSION SYNDROME; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; HEPATIC TRANSPLANTATION; INTERVAL PROLONGATION; STRESS CARDIOMYOPATHY; COMPLICATIONS; REPERFUSION; CIRRHOSIS AB A new onset acute heart failure (HF) with a sudden drop in the left ventricular ejection fraction (LVEF) post orthotopic liver transplant (LT) is a rare but a potentially fatal complication. Because in most of the cases there is no evidence of coronary thrombosis, it can be classified as nonischemic cardiomyopathy. More specifically, clinical presentation of this syndrome shares many features with stress-induced or takotsubo cardiomyopathy. The known factors that predispose these patients to acute HF during or shortly after LT include cirrhotic cardiomyopathy, rapid hemodynamic changes during LT surgery, and the large concentrations of catecholamines, either administered or released endogenously during surgery. The hemodynamic changes during surgery, such as the drop in preload during the anhepatic phase (occasionally requiring massive transfusions and vasopressors) and subsequent increase in preload with acidic and hyperkalemic plasma in the reperfusion phase, lead to rapid electrolyte and hemodynamic shifts. In several cases, intraoperative onset of HF, with or without ventricular arrythmia, could be timed to the reperfusion phase (and occasionally in the anhepatic and pre-anhepatic phases). In other cases, the HF syndrome started hours to days post-surgery. Recovery of cardiac function occurred in the majority of patients during the same admission; however, these patients generally need significantly longer hospitalizations and aggressive supportive care (occasionally requiring mechanical ionotropic and ventilatory support). If recover, the patients have a similar 1-year mortality as those LT patients that did not have this complication. Because no reliable risk stratification currently exists, intraoperative transesophageal echocardiography might be the most dependable way of detecting and addressing this syndrome promptly. Given the mechanism of takotsubo cardiomyopathy, beta-blockade and a preferential use of non-catecholaminergic vasopressors may be a reasonable way to manage this syndrome. C1 [Guglin, Maya; Nazif, Kutaiba] Indiana Univ Sch Med, Krannert Inst Cardiol, 1801 Senate Blvd Suite 2000, Indianapolis, IN 46202 USA. C3 Indiana University System; Indiana University Bloomington RP Guglin, M (通讯作者),Indiana Univ Sch Med, Krannert Inst Cardiol, 1801 Senate Blvd Suite 2000, Indianapolis, IN 46202 USA. 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Rev. PD SEP PY 2022 VL 27 IS 5 SI SI BP 1829 EP 1836 DI 10.1007/s10741-021-10196-5 EA NOV 2021 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 3V7AU UT WOS:000720618700001 PM 34799813 DA 2023-05-13 ER PT J AU Vernon, ST Coffey, S D'Souza, M Chow, CK Kilian, J Hyun, K Shaw, JA Adams, M Roberts-Thomson, P Brieger, D Figtree, GA AF Vernon, Stephen T. Coffey, Sean D'Souza, Mario Chow, Clara K. Kilian, Jens Hyun, Karice Shaw, James A. Adams, Mark Roberts-Thomson, Philip Brieger, David Figtree, Gemma A. TI ST-Segment-Elevation Myocardial Infarction (STEMI) Patients Without Standard Modifiable Cardiovascular Risk Factors-How Common Are They, and What Are Their Outcomes? SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE atherosclerosis; mortality; risk factor; ST-segment-elevation myocardial infarction ID CORONARY-HEART-DISEASE; PARTICULATE MATTER; GLOBAL REGISTRY; TASK-FORCE; MORTALITY; ATHEROSCLEROSIS; PREDICTION; ADULTS; ARTERY; ASSOCIATION AB Background-Programs targeting the standard modifiable cardiovascular risk factors (SMuRFs: hypertension, diabetes mellitus, hypercholesterolemia, smoking) are critical to tackling coronary heart disease at a community level. However, myocardial infarction in SMuRF-less individuals is not uncommon. This study uses 2 sequential large, multicenter registries to examine the proportion and outcomes of SMuRF-less ST-segment-elevation myocardial infarction (STEMI) patients. Methods and Results-We identified 3081 STEMI patients without a prior history of cardiovascular disease in the Australian GRACE (Global Registry of Acute Coronary Events) and CONCORDANCE (Cooperative National Registry of Acute Coronary Syndrome Care) registries, encompassing 42 hospitals, between 1999 and 2017. We examined the proportion that were SMuRF-less as well as outcomes. The primary outcome was in-hospital mortality, and the secondary outcome was major adverse cardiovascular events (death, myocardial infarction, or heart failure, during the index admission). Multivariate regression models were used to identify predictors of major adverse cardiovascular events. Of STEMI patients without a prior history of cardiovascular disease 19% also had no history of SMuRFs. This proportion increased from 14% to 23% during the study period (P=0.0067). SMuRF-less individuals had a higher in-hospital mortality rate than individuals with 1 or more SMuRFs. There were no clinically significant differences in major adverse cardiovascular events at 6 months between the 2 groups. Conclusions-A substantial and increasing proportion of STEMI presentations occur independently of SMuRFs. Discovery of new markers and mechanisms of disease beyond standard risk factors may facilitate novel preventative strategies. Studies to assess longer-term outcomes of SMuRF-less STEMI patients are warranted. C1 [Vernon, Stephen T.; Figtree, Gemma A.] Northern Sydney Local Hlth Dist, Royal North Shore Hosp, Kolling Inst, Cardiothorac & Vasc Hlth, St Leonards, NSW, Australia. [Vernon, Stephen T.; Figtree, Gemma A.] Northern Sydney Local Hlth Dist, Royal North Shore Hosp, Dept Cardiol, St Leonards, NSW, Australia. [Vernon, Stephen T.; Figtree, Gemma A.] Univ Sydney, Charles Perkins Ctr, Sydney, NSW, Australia. [D'Souza, Mario] Univ Sydney, Sch Publ Hlth, Clin Res Ctr, Sydney Local Hlth Dist, Sydney, NSW, Australia. [Chow, Clara K.; Hyun, Karice] Univ Sydney, Westmead Appl Res Ctr, Fac Med & Hlth, Sydney, NSW, Australia. [Coffey, Sean] Univ Otago, Dunedin Sch Med, Dunedin, New Zealand. [Chow, Clara K.] Westmead Hosp, Dept Cardiol, Sydney, NSW, Australia. [Kilian, Jens] Bankstown Hosp, Sydney, NSW, Australia. [Shaw, James A.] Alfred Hosp, Dept Cardiovasc Med, Melbourne, Vic, Australia. [Adams, Mark] Royal Prince Alfred Hosp, Dept Cardiol, Sydney, NSW, Australia. [Roberts-Thomson, Philip] Univ Tasmania, Menzies Inst Med Res, Hobart, Tas, Australia. [Roberts-Thomson, Philip] Royal Hobart Hosp, Hobart, Tas, Australia. [Brieger, David] Concord Repatriat Gen Hosp, Dept Cardiol, Sydney, NSW, Australia. C3 Royal North Shore Hospital; University of Sydney; Kolling Institute of Medical Research; Royal North Shore Hospital; University of Sydney; University of Sydney; University of Sydney; University of Otago; University of Sydney; Florey Institute of Neuroscience & Mental Health; University of Sydney; University of Tasmania; Menzies Institute for Medical Research; Royal Hobart Hospital; Concord Repatriation General Hospital RP Figtree, GA (通讯作者),Royal North Shore Hosp, Kolling Inst Med Res, Cardiothorac & Vasc Hlth, Level 12, St Leonards, NSW 2065, Australia. EM gemma.figtree@sydney.edu.au OI Hyun, Karice/0000-0002-0164-7725; Brieger, David/0000-0001-6115-0326 FU University of Sydney Postgraduate Research Scholarship - Heart Research Australia; National Health and Medical Research Council practitioner fellowship [APP11359290]; Heart Research Australia; Sanofi Aventis; Heart Foundation of Australia; Sanofi; Astra Zeneca; Eli Lilly; Boehringer Ingelheim; Merck Sharp and Dohme/Schering Plough Joint Venture FX The authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article. The first author is supported by a University of Sydney Postgraduate Research Scholarship funded by Heart Research Australia. The senior author is supported by a National Health and Medical Research Council practitioner fellowship (grant number APP11359290) and Heart Research Australia. GRACE was supported by an unrestricted grant from Sanofi Aventis. The CONCORDANCE Registry is funded by unrestricted grants from the Heart Foundation of Australia, Sanofi, Astra Zeneca, Eli Lilly, Boehringer Ingelheim, and the Merck Sharp and Dohme/Schering Plough Joint Venture. CR AIHW, 2014, CARD DIS DIAB CHRON, V2 Alliance NVDP, 2012, GUID MAN ABS CARD DI Canto JG, 2011, JAMA-J AM MED ASSOC, V306, P2120, DOI 10.1001/jama.2011.1654 Corretti MC, 2002, J AM COLL CARDIOL, V39, P257, DOI 10.1016/S0735-1097(01)01746-6 DAWBER T. 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Am. Heart Assoc. PD NOV 5 PY 2019 VL 8 IS 21 AR e013296 DI 10.1161/JAHA.119.013296 PG 17 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JN6HI UT WOS:000496996800045 PM 31672080 OA Green Accepted, Green Published, gold DA 2023-05-13 ER PT J AU Nagashima, Z Tsukahara, K Morita, S Endo, T Sugano, T Hibi, K Himeno, H Fukui, K Umemura, S Kimura, K AF Nagashima, Zenko Tsukahara, Kengo Morita, Satoshi Endo, Tsutomu Sugano, Teruyasu Hibi, Kiyoshi Himeno, Hideo Fukui, Kazuki Umemura, Satoshi Kimura, Kazuo TI Platelet reactivity in the early and late phases of acute coronary syndromes according to cytochrome P450 2C19 phenotypes SO JOURNAL OF CARDIOLOGY LA English DT Article DE Genetics; Platelet inhibitors; Coronary heart disease; Stent ID ELUTING STENT IMPLANTATION; ACUTE MYOCARDIAL-INFARCTION; OF-CARE ASSAY; ANTIPLATELET THERAPY; CLINICAL-OUTCOMES; CYP2C19 GENOTYPE; RANDOMIZED-TRIAL; CLOPIDOGREL RESPONSIVENESS; PROGNOSTIC-SIGNIFICANCE; CARDIOVASCULAR EVENTS AB Background: It remains unknown whether the time course of the antiplatelet effects of clopidogrel differs according to cytochrome P450 (CYP) 2C19 phenotype in Japanese patients with acute coronary syndromes (ACS). Methods and results: Platelet reactivity was serially assessed by VerifyNow-P2Y12 assay (Accumetrics, San Diego, CA, USA). Results were expressed as P2Y12-reaction-units (PRU) in 177 patients with ACS who underwent stent implantation and received aspirin plus a 300-mg loading dose of clopidogrel followed by 75 mg/day. High on-clopidogrel treatment platelet reactivity (HTPR) was defined as PRU > 235. On the basis of the CYP2C19*2 and *3 alleles, 46 patients (26.0%) were classified as extensive metabolizers (EM), 103 (58.2%) as intermediate metabolizers (IM), and 28 (15.8%) as poor metabolizers (PM). At <7 days, the PRU level (232 +/- 102 vs. 279 +/- 70, 308 +/- 67, p<0.001) and the incidence of HTPR (49% vs. 74%, 86%, p = 0.001) was lower in EM than in IM and PM. At 14-28 days the effects of CYP2C19 polymorphisms on PRU levels increased in a stepwise fashion (168 +/- 99 vs. 213 +/- 77 vs. 278 +/- 69, p < 0.001), and EM and IM had lower percentages of HTPR than PM (28%, 37% vs. 73%, p < 0.001). There was no significant difference in the cumulative frequency of 12-month adverse cardiovascular events among 3 phenotypes (16.5%, 14.1%, 9.2%; p = 0.67). Conclusion: About three quarters of Japanese patients with ACS carried CYP2C19 variant alleles. The majority of IM and PM had increased platelet reactivity during the early phase of ACS. Although HTPR was frequently observed even 14-28 days after standard maintenance doses of clopidogrel in PM, the incidence of adverse outcomes did not differ, irrespective of CYP2C19 genotype. (c) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. C1 [Nagashima, Zenko; Tsukahara, Kengo; Hibi, Kiyoshi; Kimura, Kazuo] Yokohama City Univ, Med Ctr, Div Cardiol, Yokohama, Kanagawa 2320024, Japan. [Morita, Satoshi] Yokohama City Univ, Dept Biostat & Epidemiol, Yokohama, Kanagawa 232, Japan. [Morita, Satoshi] Univ Med Ctr, Dept Biostat & Epidemiol, Yokohama, Kanagawa, Japan. [Endo, Tsutomu] Saiseikai Yokohama City Southern Hosp, Div Cardiol, Yokohama, Kanagawa, Japan. [Sugano, Teruyasu; Umemura, Satoshi] Yokohama City Univ, Sch Med, Dept Med Sci & Cardiorenal Med, Yokohama, Kanagawa 232, Japan. [Himeno, Hideo] Fujisawa City Hosp, Div Cardiol, Fujisawa, Kanagawa, Japan. [Fukui, Kazuki] Kanagawa Cardiovasc & Resp Dis Ctr, Div Cardiol, Yokohama, Kanagawa, Japan. C3 Yokohama City University; Yokohama City University; Yokohama City University; Kanagawa Cardiovascular & Respiratory Center RP Tsukahara, K (通讯作者),Yokohama City Univ, Med Ctr, Div Cardiol, Minami Ku, 4-57 Urafune Cho, Yokohama, Kanagawa 2320024, Japan. EM k-tsuka@urahp.yokohama-cu.ac.jp FU Daiichi Sankyo Co., Ltd. FX The work was supported by a grant from Daiichi Sankyo Co., Ltd. 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Cardiol. PD SEP-OCT PY 2013 VL 62 IS 3-4 BP 158 EP 164 DI 10.1016/j.jjcc.2013.03.006 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 233US UT WOS:000325595600004 PM 23886632 OA Bronze DA 2023-05-13 ER PT J AU Minneboo, M Lachman, S Snaterse, M Jorstad, HT ter Riet, G Boekholdt, SM Reimer, WJMSO Peters, RJG AF Minneboo, Madelon Lachman, Sangeeta Snaterse, Marjolein Jorstad, Harald T. ter Riet, Gerben Boekholdt, S. Matthijs Reimer, Wilma J. M. Scholte op Peters, Ron J. G. CA RESPONSE-2 Study Grp TI Community-Based Lifestyle Intervention in Patients With Coronary Artery Disease The RESPONSE-2 Trial SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE comprehensive lifestyle intervention; coronary artery disease; health behavior; improvement of physical activity; nurse-coordinated care; RESPONSE-2; secondary prevention; smoking cessation; weight reduction ID COORDINATED PREVENTION PROGRAM; 6-MINUTE WALK TEST; CARDIOVASCULAR-DISEASE; HEART-DISEASE; SECONDARY PREVENTION; RISK REDUCTION; INDIVIDUALS; ASSOCIATION; MANAGEMENT; GUIDELINE AB BACKGROUND Among patients with coronary artery disease (CAD), improvement of lifestyle-related risk factors (LRFs) reduces cardiovascular morbidity and mortality. However, modification of LRFs is highly challenging. OBJECTIVES This study sought to evaluate the impact of combining community-based lifestyle programs with regular hospital-based secondary prevention. METHODS The authors performed a randomized controlled trial of nurse-coordinated referral of patients and their partners to 3 widely available community-based lifestyle programs, in 15 hospitals in the Netherlands. Patients admitted for acute coronary syndrome and/or revascularization, with >= 1 LRF (body mass index> 27 kg/m(2), self-reported physical inactivity, and/or smoking) were included. All patients received guideline-based usual care. The intervention was based on 3 lifestyle programs for weight reduction, increasing physical activity, and smoking cessation. The primary outcome was the proportion of success at 12 months, defined as improvement in >= 1 qualifying LRF using weight (>= 5% reduction), 6-min-walking distance (>= 10% improvement), and urinary cotinine (200 ng/ml detection limit) without deterioration in the other 2. RESULTS The authors randomized 824 patients. Complete data on the primary outcome were available in 711 patients. The proportion of successful patients in the intervention group was 37% (133 of 360) compared with 26% (91 of 351) in the control group (p = 0.002; risk ratio: 1.43; 95% confidence interval: 1.14 to 1.78). In the intervention group, partner participation was associated with a significantly greater success rate (46% vs. 34%; p = 0.03). CONCLUSIONS Among patients with coronary artery disease, nurse-coordinated referral to a comprehensive set of community-based, widely available lifestyle interventions, with optional partner participation, leads to significant improvements in LRFs. (RESPONSE-2: Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists 2; NTR3937) (C) 2017 by the American College of Cardiology Foundation. C1 [Minneboo, Madelon; Lachman, Sangeeta; Jorstad, Harald T.; Boekholdt, S. Matthijs; Reimer, Wilma J. M. Scholte op; Peters, Ron J. G.] Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands. [Snaterse, Marjolein; Reimer, Wilma J. M. Scholte op] Amsterdam Univ Appl Sci, Fac Hlth, ACHIEVE Ctr Appl Res, Amsterdam, Netherlands. [ter Riet, Gerben] Acad Med Ctr, Dept Gen Practice, Amsterdam, Netherlands. C3 University of Amsterdam; Academic Medical Center Amsterdam; University of Amsterdam; Academic Medical Center Amsterdam RP Minneboo, M (通讯作者),Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands. RI Riet, Gerben ter/A-6943-2011 OI Riet, Gerben ter/0000-0002-2231-7637; Jorstad, Harald/0000-0003-3617-3256; Boekholdt, Matthijs/0000-0002-0861-0765; Minneboo, Madelon/0000-0001-7647-5051 FU Weight Watchers International, Inc. (New York, New York); Philips Consumer Lifestyle (the Netherlands); anonymous private fund (Amsterdam, the Netherlands); Pfizer; Sanofi; Boehringer Ingelheim; Amgen; AstraZeneca FX The RESPONSE-2 trial was sponsored by Weight Watchers International, Inc. (New York, New York), Philips Consumer Lifestyle (the Netherlands), and an anonymous private fund (Amsterdam, the Netherlands). The sponsors had no role in the design, data collection, data analysis, data interpretation, and writing of the manuscript. Dr. Boekholdt has received personal fees from Pfizer. Dr. Peters has received personal fees from Sanofi, Boehringer Ingelheim, Amgen, and AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Minneboo and Lachman contributed equally to this work. 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Am. Coll. Cardiol. PD JUL 18 PY 2017 VL 70 IS 3 BP 318 EP 327 DI 10.1016/j.jacc.2017.05.041 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA FA0GU UT WOS:000405110300003 PM 28705312 DA 2023-05-13 ER PT J AU Gao, Y Masoudi, FA Hu, S Li, J Zhang, HB Li, X Desai, NR Krumholz, HM Jiang, LX AF Gao, Yan Masoudi, Frederick A. Hu, Shuang Li, Jing Zhang, Haibo Li, Xi Desai, Nihar R. Krumholz, Harlan M. Jiang, Lixin CA China PEACE Collaborative Grp TI Trends in Early Aspirin Use Among Patients With Acute Myocardial Infarction in China, 2001-2011: The China PEACE-Retrospective AMI Study SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE acute myocardial infarction; aspirin; quality of care ID CURRENT CLINICAL-PRACTICE; ACUTE CORONARY SYNDROMES; COST-EFFECTIVENESS; PRACTICE PATTERNS; MANAGEMENT AB Background-Aspirin is an effective, safe, and inexpensive early treatment of acute myocardial infarction (AMI) with few barriers to administration, even in countries with limited healthcare resources. However, the rates and recent trends of aspirin use for the early treatment of AMI in China are unknown. Methods and Results-Using data from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction (China PEACE-Retrospective AMI Study), we identified a cohort of 14 041 patients with AMI eligible for early aspirin therapy. Early use of aspirin for AMI increased over time (78.4% in 2001, 86.5% in 2006, and 90.0% in 2011). However, about 15% of hospitals had a rate of use of <80% in 2011. Treatment was less likely in patients who were older, presented with cardiogenic shock at admission, presented without chest discomfort, had a final diagnosis of non-ST-segment elevation acute myocardial infarction, or did not receive reperfusion therapy. Hospitalization in rural regions was also associated with aspirin underuse. Conclusions-Despite improvements in early use of aspirin for AMI in China, there remains marked variation in practice and opportunities for improvement that are concentrated in some hospitals and patient groups. C1 [Gao, Yan; Hu, Shuang; Li, Jing; Zhang, Haibo; Li, Xi; Jiang, Lixin] Chinese Acad Med Sci, Natl Clin Res Ctr Cardiovasc Dis, State Key Lab Cardiovasc Dis, Natl Ctr Cardiovasc Dis,Fuwai Hosp, Beijing 100730, Peoples R China. [Masoudi, Frederick A.] Univ Colorado, Div Cardiol, Aurora, CO USA. [Desai, Nihar R.; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. C3 Chinese Academy of Medical Sciences - Peking Union Medical College; Fu Wai Hospital - CAMS; University of Colorado System; University of Colorado Anschutz Medical Campus; Yale University RP Jiang, LX (通讯作者),Fuwai Hosp, Natl Clin Res Ctr Cardiovasc Dis, 167 Beilishi Rd, Beijing 100037, Peoples R China. EM jiangl@fwoxford.org RI Zhang, Haibo/HLP-9266-2023; Masoudi, Frederick/Q-7467-2019; , Harlan/AAI-2875-2020 OI Li, Xi/0000-0003-2249-688X FU National Health and Family Planning Commission of the People's Republic of China [201202025]; National Heart, Lung, and Blood Institute [U01 HL105270-03] FX This work was supported by the National Health and Family Planning Commission of the People's Republic of China (grant number 201202025) and the National Heart, Lung, and Blood Institute (HMK grant number U01 HL105270-03 [Center for Cardiovascular Outcomes Research at Yale University]). The sponsors had no role in the conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation or approval of the manuscript. CR [Anonymous], 1988, LANCET, V2, P349 Baigent C, 2002, BMJ-BRIT MED J, V324, P71, DOI 10.1136/bmj.324.7329.71 Becker RC, 2000, J THROMB THROMBOLYS, V9, P207, DOI 10.1023/A:1018706425864 Cao Q, 2012, INT J HEALTH SERV, V42, P177, DOI 10.2190/HS.42.2.b Dharmarajan K, 2013, CIRC-CARDIOVASC QUAL, V6, P732, DOI 10.1161/CIRCOUTCOMES.113.000441 Gao R, 2008, HEART, V94, P554, DOI 10.1136/hrt.2007.119750 Gaspoz J, 2002, NEW ENGL J MED, V346, P1800, DOI 10.1056/NEJM200206063462309 Goldberg RJ, 2009, CIRCULATION, V119, P1211, DOI 10.1161/CIRCULATIONAHA.108.814947 GUNNAR RM, 1990, J AM COLL CARDIOL, V16, P249, DOI 10.1016/0735-1097(90)90575-A KRUMHOLZ HM, 1995, CIRCULATION, V92, P2841, DOI 10.1161/01.CIR.92.10.2841 Li J, 2014, LANCET IN PRESS Liu Qun, 2009, Zhonghua Xinxueguanbing Zazhi, V37, P213, DOI 10.3760/cma.j.issn.0253-3758.2009.03.004 National Bureau of Statistics of China, CHIN STAT YB 2011 Puymirat E, 2013, EUR HEART J-ACUTE CA, V2, P359, DOI 10.1177/2048872613497341 Roe MT, 2010, J AM COLL CARDIOL, V56, P254, DOI 10.1016/j.jacc.2010.05.008 The World Bank, HLTH HARM LIF CHIN S Wang MA, 2014, CIRC-CARDIOVASC QUAL, V7, P78, DOI 10.1161/CIRCOUTCOMES.113.000674 Zhang LJ, 2009, CHINESE MED J-PEKING, V122, P502, DOI 10.3760/cma.j.issn.0366-6999.2009.05.004 NR 18 TC 14 Z9 15 U1 0 U2 14 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD OCT PY 2014 VL 3 IS 5 AR e001250 DI 10.1161/JAHA.114.001250 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CM0VL UT WOS:000357396800031 PM 25304853 OA Green Submitted, Green Published DA 2023-05-13 ER PT J AU Khan, IQ Siddiqui, E Waheed, S Khursheed, M Khan, BA Kazi, SG Daniyal, M AF Khan, Irum Qamar Siddiqui, Emaduddin Waheed, Shahan Khursheed, Munawar Khan, Badar Afzal Kazi, Sayyeda Ghazala Daniyal, Muhammad TI Clinical Decision Unit, an extension of emergency department: An experience and advantage in a tertiary care centre SO JOURNAL OF THE PAKISTAN MEDICAL ASSOCIATION LA English DT Article DE CDU; ED ID STAY OBSERVATION WARD; CHEST PAIN; INPATIENT; ACCIDENT; SAFETY AB Objective: To evaluate the clinical decision unit of a tertiary care health facility and to see the disease pattern. Methodology: The cross-sectional retrospective study was conducted at the Department of Emergency Medicine, Aga Khan University Hospital, Karachi, from September to October 2011, and comprised data of patients admitted to the clinical decision unit from January to December 2010. The protocols were developed for 7 diseases: acute coronary syndrome, ureteric colic, abdominal pain, bronchial asthma, gastroenteritis with dehydration, headache, and minor head injury. Data-collection proforma recorded demographics, dates of admission, presenting complaints at triage, diagnosis at admission, final disposition and bounce back of the patients. Data was analysed using Microsoft Excel 2007. Results: Of the 1515 patients whose data was analysed, 824(54%) were males. The overall age ranged from newborns to 93 years. Further, 904(60%) patients had presented to the triage counter as P3 category. Acute gastroenteritis was the most common complaint 240(15.84%). Of the total, 1311(87%) were sent home from the clinical decision unit; 39(2.8%) of them bounced back with the same complaint. Overall, 2(0.2%) adult patients expired. Conclusion: The unit evaluated had a productive initial year. Acute gastroenteritis was the most common protocol in use, but other protocols should also be developed to address local needs. C1 [Khan, Irum Qamar; Siddiqui, Emaduddin; Waheed, Shahan; Khursheed, Munawar; Khan, Badar Afzal; Kazi, Sayyeda Ghazala; Daniyal, Muhammad] Aga Khan Univ Hosp, Dept Emergency Med, Karachi, Pakistan. C3 Aga Khan University RP Khan, IQ (通讯作者),Aga Khan Univ Hosp, Dept Emergency Med, Karachi, Pakistan. 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Pak. Med. Assoc. PD FEB PY 2020 VL 70 IS 2 BP 293 EP 298 DI 10.5455/JPMA.296221 PG 6 WC Medicine, General & Internal; Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Research & Experimental Medicine GA KN4PS UT WOS:000514821200013 PM 32063623 OA gold DA 2023-05-13 ER PT J AU Montisci, A Palmieri, V Liu, JE Vietri, MT Cirri, S Donatelli, F Napoli, C AF Montisci, Andrea Palmieri, Vittorio Liu, Jennifer E. Vietri, Maria T. Cirri, Silvia Donatelli, Francesco Napoli, Claudio TI Severe Cardiac Toxicity Induced by Cancer Therapies Requiring Intensive Care Unit Admission SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Review DE anthracycline; mechanical circulatory support; heart failure; heart transplant; cancer; chemotherapy; chemotherapy toxicity ID VENTRICULAR EJECTION FRACTION; BRAIN NATRIURETIC PEPTIDE; ANTHRACYCLINE-INDUCED CARDIOTOXICITY; CHEMOTHERAPY-INDUCED CARDIOMYOPATHY; DECOMPENSATED HEART-FAILURE; BREAST-CANCER; TROPONIN-I; EUROPEAN-ASSOCIATION; AMERICAN-SOCIETY; DOPPLER-ECHOCARDIOGRAPHY AB A steadying increase of cancer survivors has been observed as a consequence of more effective therapies. However, chemotherapy regimens are often associated with significant toxicity, and cardiac damage emerges as a prominent clinical issue. Many mechanisms sustain chemotherapy-induced cardiac toxicity: direct myocyte damage, arrhythmia induction, coronary vasospasm, and accelerated atherosclerosis. Anthracyclines are the most studied cardiotoxic drugs and represent a clinical model for cardiac damage induced by chemotherapy. In patients suffering from advanced heart failure (HF) because of chemotherapy-related cardiomyopathy, when refractory to optimal medical therapy, mechanical circulatory support or heart transplantation represents an effective treatment. Here, the main mechanisms of cardiac toxicity induced by cancer therapies are analyzed, with a focus on patients requiring intensive care unit (ICU) admission during the course of the disease because of acute cardiac toxicity, takotsubo syndrome, and acute-on-chronic HF in patients suffering from chemotherapy-induced cardiomyopathy. In a subset of patients, cardiac toxicity can be acute and life-threatening, leading to overt cardiogenic shock. The management of critically ill cancer patients poses a unique challenge and requires a multidisciplinary approach. Moreover, no etiologic therapy is available, and only supportive measures can be implemented. C1 [Montisci, Andrea] Azienda Sociosanit Terr ASST Spedali Civili, Div Cardiothorac Intens Care, Brescia, Italy. [Palmieri, Vittorio] Osped Colli Monaldi Cotugno CTO, Dept Cardiac Surg & Transplantat, Naples, Italy. [Liu, Jennifer E.] Mem Sloan Kettering Canc Ctr, Dept Med Cardiol Serv, 1275 York Ave, New York, NY 10021 USA. [Vietri, Maria T.] Univ Campania Luigi Vanvitelli, Dept Precis Med, Naples, Italy. [Cirri, Silvia] Ist Clin St Ambrogio, Dept Anesthesia & Intens Care, Milan, Italy. [Donatelli, Francesco] Univ Milan, Dept Cardiac Surg, Milan, Italy. [Napoli, Claudio] Univ Campania Luigi Vanvitelli, Univ Dept Adv Clin & Surg Sci, Clin Dept Internal Med & Specialist, Naples, Italy. [Napoli, Claudio] Ist Ricovero & Cura Carattere Sci Synlab Diagnost, Naples, Italy. C3 Memorial Sloan Kettering Cancer Center; Universita della Campania Vanvitelli; University of Milan; Universita della Campania Vanvitelli RP Montisci, A (通讯作者),Azienda Sociosanit Terr ASST Spedali Civili, Div Cardiothorac Intens Care, Brescia, Italy. EM montisci.andrea@yahoo.it RI Donatelli, Francesco/G-9311-2012; Montisci, Andrea/AAB-7167-2022 OI Donatelli, Francesco/0000-0003-2839-0373; Montisci, Andrea/0000-0003-3150-399X FU University of Milan FX Funds for open access publication fee are provided by the University of Milan. 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Cardiovasc. Med. PD SEP 3 PY 2021 VL 8 AR 713694 DI 10.3389/fcvm.2021.713694 PG 15 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA UR1TV UT WOS:000696538900001 PM 34540917 OA Green Published, gold DA 2023-05-13 ER PT J AU Rocha, JA Cardoso, JC Freitas, A Allison, TG Azevedo, LF AF Rocha, J. Afonso Cardoso, Jose Carlos Freitas, Alberto Allison, Thomas G. Azevedo, Luis F. TI Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015 SO PLOS ONE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; IMMEDIATE THROMBOLYSIS; HOSPITAL READMISSION; EUROPEAN-SOCIETY; TRANSPORT; MORTALITY; OUTCOMES; MODELS AB Aims Assess trends and factors associated with interhospital transfers (IHT) and 30-day acute coronary syndrome (ACS) rehospitalizations in a national administrative database of patients admitted with an ACS between 2000-2015. Methods and results Cohort study of patients hospitalized with ACS from 2000 to 2015, using a validated linkage algorithm to identify and link patient-level sequential hospitalizations occurring within 30 days from first admission (considering all hospitalizations within the 30-day timeframe as belonging to the same ACS episode of care-ACS-EC). From 212,481 ACS-EC, 42,670 (20.1%) had more than one hospitalization. ACS-EC hospitalization rates decreased throughout the study period (2000: 207.7/100.000 person-years to 2015: 185,8/100,000 person-years, p for trend <0.05). Proportion of IHT increased from 10.5% in 2000 to 20.1% in 2015 compared to a reduction in both planned and unplanned 30-day ACS rehospitalization from 9.0% in 2000 to 2.7% in 2015. After adjusting for patient and first admission hospital's characteristics, compared to 2000-2003, in 2012-2015 the odds of IHT increased by 3.81 (95%CI: 3.65-3.98); the odds of unplanned and planned 30-day ACS rehospitalization decreased by 0.36 (95%CI: 0.33; 0.39) and 0.47 (95%CI: 0.43; 0.53), respectively. Female sex, older age and the presence and severity of comorbidities were associated with lower likelihood of being transferred or having a planned 30-day ACS rehospitalization. Unplanned 30-day ACS rehospitalization was more likely in patients with higher comorbidity burden. Conclusion IHT and 30-day ACS rehospitalization reflect coronary referral network efficiency and access to specialized treatment. Identifying factors associated with higher likelihood of IHT and 30-day ACS rehospitalization may allow heightened surveillance and interventions to reduce rehospitalizations and inequities in access to specialized treatment. C1 [Rocha, J. Afonso] Ctr Hosp Univ Sao Joao, Dept Phys Med & Rehabil, Cardiovasc Rehabil Unit, Porto, Portugal. [Rocha, J. Afonso; Freitas, Alberto; Azevedo, Luis F.] Univ Porto, Fac Med, Ctr Hlth Technol & Serv Res CINTESIS, Porto, Portugal. [Cardoso, Jose Carlos] Ctr Hosp Univ Sao Joao, Dept Cardiol, Porto, Portugal. [Cardoso, Jose Carlos] Univ Porto, Fac Med, Porto, Portugal. [Freitas, Alberto; Azevedo, Luis F.] Univ Porto, Fac Med, Dept Community Med Informat & Hlth Decis Sci MEDC, Porto, Portugal. [Allison, Thomas G.] Mayo Sch Med & Sci, Rochester, MN USA. [Rocha, J. Afonso] Ctr Hosp Univ Sao Joao, Dept Phys Med & Rehabil, Porto, Portugal. C3 Universidade do Porto; Universidade do Porto; Universidade do Porto RP Rocha, JA (通讯作者),Ctr Hosp Univ Sao Joao, Dept Phys Med & Rehabil, Cardiovasc Rehabil Unit, Porto, Portugal.; Rocha, JA (通讯作者),Univ Porto, Fac Med, Ctr Hlth Technol & Serv Res CINTESIS, Porto, Portugal.; Rocha, JA (通讯作者),Ctr Hosp Univ Sao Joao, Dept Phys Med & Rehabil, Porto, Portugal. EM afonso.rocha@chsj.min-saude.pt RI Azevedo, Luís/J-7819-2012; Freitas, Alberto/AAH-3193-2019; Freitas, Alberto/C-1972-2012 OI Azevedo, Luís/0000-0002-8421-2937; Freitas, Alberto/0000-0003-2113-9653; Freitas, Alberto/0000-0003-2113-9653; ROCHA, J AFONSO/0000-0003-0824-4598 FU FCT - Fundacao para a Ciencia e a Tecnologia, I.P., within CINTESIS, RD Unit [UIDB/4255/2020] FX This article was supported by National Funds through FCT - Fundacao para a Ciencia e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020). 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Kinnaird, Tim Anderson, Richard Rashid, Muhammad Martin, Glen P. Freeman, Phillip Kwok, Chun Shing Myint, Phyo K. Zaman, Azfar G. Mamas, Mamas A. TI Combinations of bleeding and ischemic risk and their association with clinical outcomes in acute coronary syndrome SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE GRACE; CRUSADE; Risk scores; Outcomes; Treatment ID ST-SEGMENT-ELEVATION; ACUTE MYOCARDIAL-INFARCTION; TASK-FORCE; STRATIFICATION; MANAGEMENT; CRUSADE; INTERVENTION; GUIDELINES; MORTALITY; SCORES AB Background: Clinical predictors of future ischemic events in patients with acute coronary syndrome (ACS) are also risk factors for bleeding, with patients often at high-risk of both outcomes. We aimed to define the clinical outcomes and provision of guideline-recommended care in ACS management for different combinations of ischemic and bleeding risk defined using a combined GRACE and CRUSADE score. Methods: A retrospective observational analysis of a national ACS database was performed for patients with ACS admitted to three tertiary centres from January 2010 to March 2016. Patients were stratified into 9 groups based on possible CRUSADE-GRACE risk combinations. Multiple logistic regression was used to estimate adjusted odds ratios (ORs [95% CI]) for outcomes (in-hospital net adverse cardiac events (NACE), in-hospital all-cause mortality, 30-day mortality and treatment strategy). Results: A total of 17,701 patients were included in the analysis. We observed a graded risk of mortality and adverse events in the high-risk GRACE strata (Groups 3, 6 and 9). Almost a third of patients with ACS were at a 'dual high-risk' (Group 9, 32%) and were independently associated with higher in-hospital NACE (composite of cardiac mortality, all-cause bleeding and re-infarction): aOR 6.33 [3.55, 11.29], all-cause mortality: aOR 14.17 [5.27, 38.1], all-cause bleeding: aOR 4.82 [1.96, 11.86], and 30-day mortality: aOR 10.79 [5.33, 21.81]. This group was also the least likely to be offered coronary angiography (aOR 0.24 [0.20, 0.29]) and dual anti-platelet therapy (aOR 0.26 [0.20, 0.34]). Conclusions: One in five patients presenting with an ACS are high ischemic and high bleeding risk, and these patients are more likely to experience poor clinical outcomes and reduced odds of receiving guideline-recommended therapy. (C) 2019 Elsevier B.V. All rights reserved. C1 [Mohamed, Mohamed O.; Rashid, Muhammad; Kwok, Chun Shing; Mamas, Mamas A.] Keele Univ, Keele Cardiovasc Res Grp, Inst Appl Clin Sci, Stoke On Trent, Staffs, England. [Mohamed, Mohamed O.; Rashid, Muhammad; Kwok, Chun Shing; Mamas, Mamas A.] Keele Univ, Keele Cardiovasc Res Grp, Inst Primary Care & Hlth Sci, Stoke On Trent, Staffs, England. [Mohamed, Mohamed O.; Rashid, Muhammad; Mamas, Mamas A.] Univ Hosp North Midlands, Royal Stoke Hosp, Dept Cardiol, Stoke On Trent, Staffs, England. [Kinnaird, Tim; Anderson, Richard] Univ Hosp Wales, Dept Cardiol, Cardiff, S Glam, Wales. [Martin, Glen P.] Univ Manchester, Manchester Acad Hlth Sci Ctr, Fac Biol Med & Hlth, Manchester, Lancs, England. [Freeman, Phillip] Aalborg Univ Hosp, Aalborg, Denmark. [Myint, Phyo K.] Univ Aberdeen, Inst Appl Hlth Sci, Ageing Clin & Expt Res ACER Team, Aberdeen, Scotland. [Zaman, Azfar G.] Newcastle Univ, Freeman Hosp, Dept Cardiol, Newcastle Upon Tyne, Tyne & Wear, England. [Zaman, Azfar G.] Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England. C3 Keele University; Keele University; Royal Stoke University Hospital; RLUK- Research Libraries UK; Cardiff University; N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; Aalborg University; Aalborg University Hospital; RLUK- Research Libraries UK; University of Aberdeen; N8 Research Partnership; RLUK- Research Libraries UK; Newcastle University - UK; Newcastle Freeman Hospital; N8 Research Partnership; RLUK- Research Libraries UK; Newcastle University - UK RP Mamas, MA (通讯作者),Keele Univ, Inst Primary Care & Hlth Sci, Ctr Prognosis Res, Stoke On Trent, Staffs, England. EM mamasmamas1@yahoo.co.uk RI Anderson, Richard/S-2020-2019; Martin, Glen/I-7824-2019; Mohamed, Mohamed Osama/O-8339-2019; Mamas, Mamas Andreas/A-2549-2019 OI Martin, Glen/0000-0002-3410-9472; Mohamed, Mohamed Osama/0000-0002-9678-5222; Mamas, Mamas Andreas/0000-0001-9241-8890; Freeman, Phillip/0000-0003-1769-251X FU National Institute for Health Research (NIHR) Academic Clinical Fellowship grant FX MOM is funded by a National Institute for Health Research (NIHR) Academic Clinical Fellowship grant. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. 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PD SEP 1 PY 2019 VL 290 BP 7 EP 14 DI 10.1016/j.ijcard.2019.05.035 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA IC2YR UT WOS:000470826500002 PM 31133430 OA Green Submitted, Green Accepted DA 2023-05-13 ER PT J AU Tehrani, BN Basir, MB Kapur, NK AF Tehrani, Behnam N. Basir, Mir B. Kapur, Navin K. TI Acute myocardial infarction and cardiogenic shock: Should we unload the ventricle before percutaneous coronary intervention? SO PROGRESS IN CARDIOVASCULAR DISEASES LA English DT Review DE Cardiogenic shock; Acute myocardial infarction; Left ventricular unloading; Mechanical circulatory support; Myocardial scar ID MECHANICAL CIRCULATORY SUPPORT; INTRAAORTIC BALLOON COUNTERPULSATION; IN-HOSPITAL MORTALITY; GLUCOSE-INSULIN-POTASSIUM; SINGLE-CENTER EXPERIENCE; END-DIASTOLIC PRESSURE; LONG-TERM BENEFIT; ASSIST DEVICE; HEART-FAILURE; BLOOD-FLOW AB Despite early reperfusion and coordinated systems of care, cardiogenic shock (CS) remains the number one cause of morbidity and in-hospital mortality following acute myocardial infarction (AMI). CS isa complex clinical syndrome that begins with hemodynamic instability and can progress to multi-organ failure and profound hemo-metabolic compromise. To improve outcomes, a clear understanding of the treatment objectives in CS and developing time-sensitive management strategies aimed at stabilizing hemodynamics and restoring myocardial perfusion are critical. Left ventricular (LV) load has been identified as an independent predictor of heart failure and mortality following AMI. Decades of preclinical and clinical research have identified several effective LV unloading strategies. Recent initiatives from single and multi-center registries and more recently the Door to Unload (DTU)-STEMI pilot study have provided valuable insight to developing a standardized treatment approach to AMI, based on early invasive hemodynamics and tailored circulatory support to unload the LV. To follow is a review of the pathophysiology and prevalence of shock, limitations of current therapies, and the preclinical and translational basis for incorporating LV unloading into contemporary AMI and shock care. (C) 2020 Elsevier Inc. All rights reserved. C1 [Tehrani, Behnam N.] Inova Heart & Vasc Inst, Falls Church, VA USA. [Basir, Mir B.] Henry Ford Med Ctr, Detroit, MI USA. [Kapur, Navin K.] Tufts Med Ctr, CardioVasc Ctr, Boston, MA 02111 USA. C3 Inova Fairfax Hospital; Henry Ford Health System; Tufts Medical Center RP Kapur, NK (通讯作者),Tufts Univ, Sch Med, Proger Bldg,6th Floor,800 Washington St,Box 70, Boston, MA 02111 USA. 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Cardiovasc. Dis. PD SEP-OCT PY 2020 VL 63 IS 5 BP 607 EP 622 DI 10.1016/j.pcad.2020.09.001 PG 16 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OZ5OX UT WOS:000594976100009 PM 32920027 DA 2023-05-13 ER PT J AU Qamar, A Bhatt, DL AF Qamar, Arman Bhatt, Deepak L. TI Optimizing the Use of Cangrelor in the Real World SO AMERICAN JOURNAL OF CARDIOVASCULAR DRUGS LA English DT Review ID PERCUTANEOUS CORONARY INTERVENTION; ELEVATION MYOCARDIAL-INFARCTION; ACHIEVE OPTIMAL MANAGEMENT; ANTIPLATELET THERAPY; PLATELET INHIBITION; STANDARD THERAPY; STENT THROMBOSIS; CLOPIDOGREL PRETREATMENT; CHAMPION PHOENIX; ISCHEMIC EVENTS AB Thrombotic events such as myocardial infarction or stent thrombosis are the major cause of adverse outcomes in patients undergoing percutaneous coronary intervention (PCI). While current antiplatelet agents, anticoagulants, and PCI techniques have reduced the risk of thrombotic events in PCI-treated patients, a considerable hazard still remains. Cangrelor is an intravenous P2Y12 receptor antagonist that provides a rapid onset and maximal platelet inhibition, which is quickly reversible. In the large-scale CHAMPION PHOENIX trial, cangrelor was shown to reduce ischemic events significantly, including myocardial infarction and stent thrombosis, without increasing the risk of severe bleeding across the full spectrum of patients undergoing PCI, with substantial benefits in all patient subgroups examined. The pharmacologic profile of cangrelor makes it a valuable addition to the armamentarium of physicians providing care to a broad range of patients with coronary artery disease. Cangrelor is currently approved for reducing thrombotic events in patients undergoing PCI who have not been pretreated with a P2Y12 receptor inhibitor and are not receiving a glycoprotein IIb/IIIa inhibitor. Future studies are needed to determine the role of cangrelor in other clinical settings, such as upstream therapy in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS), and as a bridge to coronary artery bypass graft (CABG) or other non-cardiac surgeries in patients who require ongoing adenosine diphosphate receptor blockade. C1 [Qamar, Arman; Bhatt, Deepak L.] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA. C3 Harvard University; Brigham & Women's Hospital; Harvard Medical School RP Bhatt, DL (通讯作者),Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA. EM dlbhattmd@post.harvard.edu FU Amarin; Amgen; AstraZeneca; Bristol-Myers Squibb; Eisai; Ethicon; Forest Laboratories; Ischemix; Medtronic; Pfizer; Roche; Sanofi Aventis; Medicines Company FX Dr. Deepak L. Bhatt discloses the following relationships: advisory board-Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, Regado Biosciences; board of directors-Boston VA Research Institute, Society of Cardiovascular Patient Care; Chair-American Heart Association Quality Oversight Committee; data monitoring committees-Duke Clinical Research Institute, Harvard Clinical Research Institute, Mayo Clinic, Population Health Research Institute; honoraria-American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), Harvard Clinical Research Institute (clinical trial steering committee), HMP Communications (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), Population Health Research Institute (clinical trial steering committee), Slack Publications (Chief Medical Editor, Cardiology Today's Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees); other-Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair); research funding-Amarin, Amgen, AstraZeneca, Bristol-Myers Squibb, Eisai, Ethicon, Forest Laboratories, Ischemix, Medtronic, Pfizer, Roche, Sanofi Aventis, The Medicines Company (including for his role as co-Chair and co-PI of the CHAMPION trials); royalties-Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald's Heart Disease); site co-investigator-Biotronik, Boston Scientific, St. Jude Medical; trustee-American College of Cardiology; unfunded research-FlowCo, PLx Pharma, Takeda. Dr. Arman Qamar declares no competing interests. 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Drugs PD FEB PY 2017 VL 17 IS 1 BP 5 EP 16 DI 10.1007/s40256-016-0192-1 PG 12 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA EI7FD UT WOS:000392662300001 PM 27677505 DA 2023-05-13 ER PT J AU Silverio, A Cavallo, P De Rosa, R Galasso, G AF Silverio, Angelo Cavallo, Pierpaolo De Rosa, Roberta Galasso, Gennaro TI Big Health Data and Cardiovascular Diseases: A Challenge for Research, an Opportunity for Clinical Care SO FRONTIERS IN MEDICINE LA English DT Review DE electronic health records; big data; cardiovascular disease; heart failure; acute coronary syndromes; coronary artery disease ID PERCUTANEOUS CORONARY INTERVENTION; DRUG-ELUTING STENTS; BARE-METAL STENTS; SMOKING-CESSATION; FOLLOW-UP; EVENTS; RISK; IMPLANTATION; VARENICLINE; ANGIOGRAPHY AB Cardiovascular disease (CVD) accounts for the majority of death and hospitalization, health care expenditures and loss of productivity in developed country. CVD research, thus, plays a key role for improving patients' outcomes as well as for the sustainability of health systems. The increasing costs and complexity of modern medicine along with the fragmentation in healthcare organizations interfere with improving quality care and represent a missed opportunity for research. The advancement in diagnosis, therapy and prognostic evaluation of patients with CVD, indeed, is frustrated by limited data access to selected small patient populations, not standardized nor computable definition of disease and lack of approved relevant patient-centered outcomes. These critical issues results in a deep mismatch between randomized controlled trials and real-world setting, heterogeneity in treatment response and wide inter-individual variation in prognosis. Big data approach combines millions of people's electronic health records (EHR) from different resources and provides a new methodology expanding data collection in three direction: high volume, wide variety and extreme acquisition speed. Large population studies based on EHR holds much promise due to low costs, diminished study participant burden, and reduced selection bias, thus offering an alternative to traditional ascertainment through biomedical screening and tracing processes. By merging and harmonizing large data sets, the researchers aspire to build algorithms that allow targeted and personalized CVD treatments. In current paper, we provide a critical review of big health data for cardiovascular research, focusing on the opportunities of this largely free data analytics and the challenges in its realization. C1 [Silverio, Angelo; De Rosa, Roberta; Galasso, Gennaro] Univ Hosp San Giovanni di Dio & Ruggi Aragona, Cardiovasc & Thorac Dept, Cardiol Unit, Salerno, Italy. 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Med. PD FEB 25 PY 2019 VL 6 AR 36 DI 10.3389/fmed.2019.00036 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA HM8PH UT WOS:000459742800001 PM 30873409 OA Green Published, gold DA 2023-05-13 ER PT J AU Lopes, RD Becker, RC Newby, LK Peterson, ED Hylek, EM Giugliano, R Granger, CB Mahaffey, KW Carvalho, AC Berwanger, O Giraldez, RR Feitosa, GS Barbosa, MM Moreira, MDV Kalil, RAK Freitas, M Guerra, JCD Barros, MVL Rodrigues, TD Lopes, AC Garcia, DA AF Lopes, Renato D. Becker, Richard C. Newby, L. Kristin Peterson, Eric D. Hylek, Elaine M. Giugliano, Robert Granger, Christopher B. Mahaffey, Kenneth W. Carvalho, Antonio C. Berwanger, Otavio Giraldez, Roberto R. Feitosa-Filho, Gilson Soares Barbosa, Marcia M. Moreira, Maria da Consolacao V. Kalil, Renato A. K. Freitas, Marildes de Campos Guerra, Joao Carlos Lins Barros, Marcio Vinicius Rodrigues, Thiago da Rocha Lopes, Antonio C. Garcia, David A. TI Highlights from the fifth international symposium of thrombosis and anticoagulation (ISTA V), october 18-19, 2012, Belo Horizonte, Minas Gerais, Brazil SO JOURNAL OF THROMBOSIS AND THROMBOLYSIS LA English DT Review DE Thrombosis; Antithrombotic therapy; Guidelines; Clinical research ID ACUTE CORONARY SYNDROMES; ELEVATION MYOCARDIAL-INFARCTION; NONVALVULAR ATRIAL-FIBRILLATION; MECHANICAL CIRCULATORY SUPPORT; HOSPITALIZED MEDICAL PATIENTS; HEALTH-CARE PROFESSIONALS; CONGESTIVE-HEART-FAILURE; ANTITHROMBOTIC THERAPY; RANDOMIZED EVALUATION; ISCHEMIC-STROKE AB To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Fifth International Symposium of Thrombosis and Anticoagulation was held in Belo Horizonte, Minas Gerais, Brazil, on October 18-19, 2012. This scientific program was developed by clinicians for clinicians and was promoted by three major clinical research institutes: the Brazilian Clinical Research Institute, the Duke Clinical Research Institute of the Duke University School of Medicine, and Hospital do Coracao Research Institute. Comprising 2 days of academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, thought-leaders, and dedicated clinician-scientists. This paper summarizes the symposium proceedings. C1 [Lopes, Renato D.; Becker, Richard C.; Newby, L. Kristin; Peterson, Eric D.; Granger, Christopher B.; Mahaffey, Kenneth W.] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC 27705 USA. [Lopes, Renato D.; Carvalho, Antonio C.; Lopes, Antonio C.] Univ Fed Sao Paulo, Paulista Sch Med, Sao Paulo, Brazil. [Hylek, Elaine M.] Boston Univ, Boston, MA 02215 USA. [Giugliano, Robert] Brigham & Womens Hosp, Boston, MA 02115 USA. [Berwanger, Otavio] Heart Hosp, Hosp Coracao Res Inst, Sao Paulo, Brazil. [Giraldez, Roberto R.] Univ Sao Paulo, Sch Med, Sao Paulo, Brazil. [Feitosa-Filho, Gilson Soares] Bahiana Sch Med & Publ Hlth, Salvador, BA, Brazil. [Barbosa, Marcia M.] Socor Hosp, Ecoctr, Belo Horizonte, MG, Brazil. [Moreira, Maria da Consolacao V.] Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil. [Kalil, Renato A. K.] Fed Univ Hlth Sci Porto Alegre, Porto Alegre, RS, Brazil. [Freitas, Marildes] Joao XXIII Hosp, Belo Horizonte, MG, Brazil. [de Campos Guerra, Joao Carlos] Albert Einstein Hosp, Sao Paulo, Brazil. [Lins Barros, Marcio Vinicius] Materdei Hosp, Belo Horizonte, MG, Brazil. [Rodrigues, Thiago da Rocha] Felicio Rocho Hosp, Belo Horizonte, MG, Brazil. [Garcia, David A.] Univ New Mexico, Hlth Sci Ctr, Albuquerque, NM 87131 USA. C3 Duke University; Universidade Federal de Sao Paulo (UNIFESP); Boston University; Harvard University; Brigham & Women's Hospital; Universidade de Sao Paulo; Universidade de Sao Paulo; Universidade Federal de Minas Gerais; Hospital Israelita Albert Einstein; University of New Mexico; University of New Mexico's Health Sciences Center RP Lopes, RD (通讯作者),Duke Univ, Med Ctr, Duke Clin Res Inst, POB 3850,2400 Pratt St,Room 0311,Terrace Level, Durham, NC 27705 USA. EM renato.lopes@duke.edu RI Barros, Marcio/GXF-3499-2022; Peterson, Eric David/ABF-5033-2021; Granger, Christopher B/D-3458-2014; Giraldez, Roberto RCV/E-2498-2012; Giugliano, Robert/N-7233-2017 OI Granger, Christopher B/0000-0002-0045-3291; Giugliano, Robert/0000-0003-4110-7675; Hylek, Elaine/0000-0001-8263-8304 FU Bristol-Myers Squibb; Bayer Health Care; Daiichi Sankyo; Hospital do Coracao Research Institute; Hospital TotalCor FX The Fifth International Symposium of Thrombosis and Anticoagulation (ISTA V) was sponsored by unrestricted Grants from Bristol-Myers Squibb, Bayer Health Care, Daiichi Sankyo, Hospital do Coracao Research Institute, and Hospital TotalCor. The symposium was organized by the Brazilian Clinical Research Institute, and the chairmen of the meeting thank Cecilia Jahnel, Marcia M. Barbosa, Maria da Consolacao V. Moreira, and Larissa Velano for all of their assistance in organizing the event. 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P2001, DOI 10.1056/NEJMoa0706482 Xian Y, 2012, JAMA-J AM MED ASSOC, V307, P2600, DOI 10.1001/jama.2012.6756 You JJ, 2012, CHEST S, V141, pe531S Yusuf S, 2006, NEW ENGL J MED, V354, P1464 Zacharski LR, 2007, JAMA-J AM MED ASSOC, V297, P603, DOI 10.1001/jama.297.6.603 NR 100 TC 0 Z9 0 U1 0 U2 5 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0929-5305 EI 1573-742X J9 J THROMB THROMBOLYS JI J. Thromb. Thrombolysis PD JUL PY 2013 VL 36 IS 1 BP 115 EP 130 DI 10.1007/s11239-013-0906-z PG 16 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Hematology GA 164WK UT WOS:000320442000019 PM 23494487 DA 2023-05-13 ER PT J AU Valgimigli, M AF Valgimigli, Marco TI Identifying responsiveness to oral P2Y(12) receptor blockers: platelet function assays and genetic tests SO JOURNAL OF CARDIOVASCULAR MEDICINE LA English DT Article DE P2Y(12) receptor blockers; platelet function test; tailoring therapy ID PERCUTANEOUS CORONARY INTERVENTION; PATIENTS SHOWING RESISTANCE; ASPIRIN AND/OR RESISTANCE; OF-CARE ASSAY; MYOCARDIAL-INFARCTION; ANTIPLATELET THERAPY; TAILORING TREATMENT; CLINICAL-OUTCOMES; CLOPIDOGREL; REACTIVITY AB Some patients with acute coronary syndromes and/or who are undergoing percutaneous coronary interventions (PCI) remain at risk for cardiovascular events despite antiplatelet treatment with clopidogrel. This may be due, at least in part, to high residual on-treatment platelet reactivity (PR). Given the potential seriousness of an incomplete response to treatment, there is a need for a simple, rapid and reproducible point-of-care method to determine the patient's response to clopidogrel in order to tailor treatment in routine clinical practice. Among the available assays to measure the degree of platelet inhibition, the VerifyNow P2Y(12) system is a simple test based on agglutination of fibrinogen-coated beads. Numerous studies have used this system to assess on-clopidogrel PR in an attempt to define a reliable cut-off for identifying patients at risk for a cardiovascular event. Despite substantial evidence to support a role for PR testing in routine clinical practice to stratify the risk of cardiovascular events in patients who undergo PCI, definitive clinical evidence is still lacking for the utility using PR data to tailor clopidogrel treatment. Issues include the risk profile of patients enrolled in studies, the timing of assessment of PR and the fact that PR has been shown to change over time. Genetic susceptibility may explain some of the variability in PR, and genetic testing could provide additional information for clinical decision-making. Nevertheless, until new evidence from well designed clinical studies is available, the implementation of current treatment guidelines and the administration of newer, more potent oral P2Y(12) receptor blockers remains the standard-of-care. C1 [Valgimigli, Marco] Azienda Osped Univ S Anna, Cardiovasc Inst, Ferrara, Italy. C3 University of Ferrara; Arcispedale Sant'Anna RP Valgimigli, M (通讯作者),Erasmus MC, Thoraxctr, Ba 587, Rotterdam, Netherlands. EM m.valgimigli@erasmusmc.nl RI Valgimigli, Marco/AAE-9103-2019 OI Valgimigli, Marco/0000-0002-4353-7110 FU AstraZeneca (Italy) FX The author would like to thank Rod McNab of inScience Communications, Springer Healthcare, who provided assistance with English-language editing. This assistance was funded by AstraZeneca (Italy). The author has no conflicts of interest to declare. This article was published in a supplement sponsored by AstraZeneca (Italy). CR Aleil B, 2008, JACC-CARDIOVASC INTE, V1, P631, DOI 10.1016/j.jcin.2008.09.004 Angiolillo DJ, 2007, CIRCULATION, V115, P708, DOI 10.1161/CIRCULATIONAHA.106.667741 Angiolillo DJ, 2007, J AM COLL CARDIOL, V49, P1505, DOI 10.1016/j.jacc.2006.11.044 Brar SS, 2011, J AM COLL CARDIOL, V58, P1945, DOI 10.1016/j.jacc.2011.06.059 Campo G, 2008, J THROMB HAEMOST, V6, P1824, DOI 10.1111/j.1538-7836.2008.03112.x Campo G, 2011, J AM COLL CARDIOL, V57, P2474, DOI 10.1016/j.jacc.2010.12.047 Campo G, 2010, J AM COLL CARDIOL, V56, P1447, DOI 10.1016/j.jacc.2010.03.103 Campo G, 2010, J THROMB THROMBOLYS, V30, P319, DOI 10.1007/s11239-010-0457-5 Cayla G, 2011, JAMA-J AM MED ASSOC, V306, P1765, DOI 10.1001/jama.2011.1529 Fontana P, 2008, THROMB RES, V121, P463, DOI 10.1016/j.thromres.2007.06.012 Gurbel PA, 2003, AM J CARDIOL, V91, P1123, DOI 10.1016/S0002-9149(03)00163-2 Marcucci R, 2009, CIRCULATION, V119, P237, DOI 10.1161/CIRCULATIONAHA.108.812636 Mega JL, 2010, LANCET, V376, P1312, DOI 10.1016/S0140-6736(10)61273-1 Mega JL, 2010, JAMA-J AM MED ASSOC, V304, P1821, DOI 10.1001/jama.2010.1543 Parodi G, 2011, JAMA-J AM MED ASSOC, V306, P1215, DOI 10.1001/jama.2011.1332 Patti G, 2008, J AM COLL CARDIOL, V52, P1128, DOI 10.1016/j.jacc.2008.06.038 Price MJ, 2008, EUR HEART J, V29, P992, DOI 10.1093/eurheartj/ehn046 Price MJ, 2011, JAMA-J AM MED ASSOC, V305, P1097, DOI 10.1001/jama.2011.290 Sibbing D, 2009, EUR HEART J, V30, P916, DOI 10.1093/eurheartj/ehp041 Sibbing D, 2009, J AM COLL CARDIOL, V53, P849, DOI 10.1016/j.jacc.2008.11.030 Trenk D, 2012, J AM COLL CARDIOL, P59, DOI 10.1016/j.jacc.2012.1002.1026 Valgimigli M, 2009, CIRCULATION, V119, P3215, DOI 10.1161/CIRCULATIONAHA.108.833236 Wallentin L, 2010, LANCET, V376, P1320, DOI 10.1016/S0140-6736(10)61274-3 NR 23 TC 5 Z9 6 U1 0 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1558-2027 EI 1558-2035 J9 J CARDIOVASC MED JI J. Cardiovasc. Med. PD DEC PY 2013 VL 14 SU 1 BP S8 EP S15 DI 10.2459/JCM.0b013e328364bd25 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 282RT UT WOS:000329191100002 PM 24378839 DA 2023-05-13 ER PT J AU Meng, ZY Zhao, YX Zheng, XF He, Y AF Meng, Zhongyuan Zhao, Yaxin Zheng, Xifeng He, Yan TI The Relationship Between AKI in Patients With STEMI and Short-Term Mortality: A Propensity Score Matching Analysis SO ANGIOLOGY LA English DT Article DE acute myocardial infarction; acute kidney injury; propensity score matching analysis ID ACUTE KIDNEY INJURY; ACUTE MYOCARDIAL-INFARCTION; WORSENING RENAL-FUNCTION; CORONARY SYNDROME PATIENTS; PROGNOSTIC IMPORTANCE; OUTCOMES; DISEASE; TRANSIENT; ASSOCIATION; DYSFUNCTION AB Acute myocardial infarction (AMI) in patients with acute kidney injury (AKI) is associated with poor long-term outcome. However, the short-term prognosis of AKI in patients with ST-elevation AMI (STEMI) needs to be explored further. We assessed this relationship between these patients and short-term mortality in relation to AKI and chronic kidney disease (CKD). All data were extracted from the Medical Information Mart for Intensive Care III database. The primary outcome was 28-day mortality. Kaplan-Meier curves, logistic regression models, and propensity score matching analysis were used to evaluate the associations between AKI in patients with STEMI and outcomes. A total of 1031 patients with STEMI met the inclusion criteria. For 28-day mortality, in the multivariable logistic regression models, the odds ratio (95% CI) of group 2 (AKI but no CKD) and group 3 (AKI in the presence of CKD) were 3.24 (1.46-7.18) and 4.57 (1.83-11.37), respectively, compared with group 1 (no AKI and no CKD). Comorbid AKI increased the risk of short-term mortality among patients with STEMI, especially for those with AKI in the presence of CKD. C1 [Meng, Zhongyuan; Zhao, Yaxin; Zheng, Xifeng; He, Yan] Guangxi Med Univ, Affiliated Hosp 1, Dept Geriatr Cardiol, Nanning 530021, Guangxi, Peoples R China. C3 Guangxi Medical University RP He, Y (通讯作者),Guangxi Med Univ, Affiliated Hosp 1, Dept Geriatr Cardiol, Nanning 530021, Guangxi, Peoples R China. 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Bagshaw, Sean M. Peperstraete, Harlinde Herck, Ingrid Decruyenaere, Johan Hoste, Eric A. J. TI Acute Kidney Injury in Cardiorenal Syndrome Type 1 Patients: A Systematic Review and Meta-Analysis SO CARDIORENAL MEDICINE LA English DT Review DE Cardiorenal syndrome; Type 1; Acute kidney injury; Meta-analysis ID WORSENING RENAL-FUNCTION; DECOMPENSATED HEART-FAILURE; ACUTE MYOCARDIAL-INFARCTION; LONG-TERM OUTCOMES; CARDIAC-SURGERY; SERUM CREATININE; PROGNOSTIC VALUE; RIFLE CRITERIA; RISK-FACTORS; IMPACT AB Background: We evaluated the epidemiology and outcome of acute kidney injury (AKI) in patients with cardiorenal syndrome type 1 (CRS-1) and its subgroups: acute heart failure (AHF), acute coronary syndrome (ACS) and after cardiac surgery (CS). Summary: We performed a systematic review and meta-analysis. CRS-1 was defined by AKI (based on RIFLE, AKIN and KDIGO), worsening renal failure (WRF) and renal replacement therapy (RRT). We investigated the three most common clinical causes of CRS-1: AHF, ACS and CS. Out of 332 potential papers, 64 were eligible - with AKI used in 41 studies, WRF in 25 and RRT in 20. The occurrence rate of CRS-1, defined by AKI, WRF and RRT, was 25.4, 22.4 and 2.6%, respectively. AHF patients had a higher occurrence rate of CRS-1 compared to ACS and CS patients (AKI: 47.4 vs. 14.9 vs. 22.1%), but RRT was evenly distributed among the types of acute cardiac disease. AKI was associated with an increased mortality rate (risk ratio = 5.14, 95% CI 3.81-6.94; 24 studies and 35,227 patients), a longer length of stay in the intensive care unit [LOSICU] (median duration = 1.37 days, 95% CI 0.41-2.33; 9 studies and 10,758 patients) and a longer LOS in hospital [LOShosp] (median duration = 3.94 days, 95% CI 1.74-6.15; 8 studies and 35,227 patients). Increasing AKI severity was associated with worse outcomes. The impact of CRS-1 defined by AKI on mortality was greatest in CS patients. RRT had an even greater impact compared to AKI (mortality risk ratio = 9.2, median duration of LOSICU = 10.6 days and that of LOShosp = 20.2 days). Key Messages: Of all included patients, almost one quarter developed AKI and approximately 3% needed RRT. AHF patients experienced the highest occurrence rate of AKI, but the impact on mortality was greatest in CS patients. (C) 2015 S. Karger AG, Basel C1 [Vandenberghe, Wim; Peperstraete, Harlinde; Herck, Ingrid; Decruyenaere, Johan; Hoste, Eric A. J.] Univ Ghent, Ghent Univ Hosp, Dept Intens Care Med, BE-9000 Ghent, Belgium. [Gevaert, Sofie] Univ Ghent, Ghent Univ Hosp, Dept Cardiol, BE-9000 Ghent, Belgium. [Hoste, Eric A. J.] Res Fdn Flanders FWO, Brussels, Belgium. [Kellum, John A.] Univ Pittsburgh, Ctr Crit Care Nephrol, Pittsburgh, PA USA. [Kellum, John A.; Hoste, Eric A. J.] Univ Pittsburgh, Sch Med, Clin Res Invest & Syst Modelling Acute Illness CR, Dept Crit Care Med, Pittsburgh, PA USA. [Bagshaw, Sean M.] Univ Alberta, Div Crit Care Med, Fac Med & Dent, Edmonton, AB, Canada. C3 Ghent University; Ghent University Hospital; Ghent University; Ghent University Hospital; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; University of Alberta RP Vandenberghe, W (通讯作者),Univ Ghent, Univ Hosp Ghent, ICU, BE-9000 Ghent, Belgium. 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PY 2016 VL 6 IS 2 BP 116 EP 128 DI 10.1159/000442300 PG 13 WC Cardiac & Cardiovascular Systems; Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Urology & Nephrology GA DF6EL UT WOS:000371448600004 PM 26989397 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Indraratna, P Biswas, U Liu, HIM Redmond, SJ Yu, JNF Lovell, NH Ooi, SY AF Indraratna, Praveen Biswas, Uzzal Liu, Hueiming Redmond, Stephen J. Yu, Jennifer Lovell, Nigel H. Ooi, Sze-Yuan TI Process Evaluation of a Randomised Controlled Trial for TeleClinical Care, a Smartphone-App Based Model of Care SO FRONTIERS IN MEDICINE LA English DT Article DE process evaluation; digital health; mHealth; acute coronary syndrome; heart failure; smartphone ID SHORT MESSAGE SERVICE; HEART-FAILURE; MEDICATION ADHERENCE; MYOCARDIAL-INFARCTION; MANAGEMENT; REHOSPITALIZATION; READMISSIONS; MORTALITY; DISEASE AB BackgroundA novel smartphone app-based model of care (TeleClinical Care - TCC) for patients with acute coronary syndrome (ACS) and heart failure (HF) was evaluated in a two-site, pilot randomised control trial of 164 participants in Sydney, Australia. The program included a telemonitoring system whereby abnormal blood pressure, weight and heart rate readings were monitored by a central clinical team, who subsequently referred clinically significant alerts to the patients' usual general practitioner (GP, also known as primary care physician in the United States), HF nurse or cardiologist. While the primary endpoint, 30-day readmissions, was neutral, intervention arm participants demonstrated improvements in readmission rates over 6 months, cardiac rehabilitation (CR) completion and medication compliance. A process evaluation was designed to identify contextual factors and mechanisms that influenced the results, as well as strategies of improving site and participant recruitment and the delivery of the intervention, for a planned larger effectiveness trial of over 1,000 patients across the state of New South Wales, Australia (TCC-Cardiac). MethodsMultiple data sources were used in this mixed-methods process evaluation, including interviews with four TCC team members, three GPs and three cardiologists. CR completion rates, HF outreach service (HFOS) referrals and cardiologist follow-up appointments were audited. A patient questionnaire was also analysed for evidence of improved self-care as a hypothesised mechanism of the TCC app. An implementation research logic model was used to synthesise our findings. ResultsRates of HFOS referral (83 vs. 72%) and cardiologist follow-up (96 vs. 93%) were similarly high in the intervention and control arms, respectively. Team members were largely positive towards their orientation and training, but highlighted several implementation strategies that could be optimised for TCC-Cardiac: streamlining of the enrolment process, improving the reach of the trial by screening patients in non-cardiac wards, and ensuring team members had adequate time to recruit (>15 h per week). GPs and cardiologists viewed the intervention acceptably regarding potential benefit of closely monitoring, and responding to abnormalities for their patients, though there were concerns of the potential additional workload generated by alerts that did not merit clinical intervention. Clear delineation of which clinician (GP or cardiologist) was primarily responsible for alert management was also recommended, as well as a preference to receive regular summary data. Several patients commented on the mechanisms of improved self-management because of TCC, which could have led to the outcome of improved medication compliance. DiscussionUse of TCC was associated with several benefits, including higher patient engagement and completion rates with CR. The conduct and delivery of TCC-Cardiac will be improved by the findings of this process evaluation to optimise recruitment, and establishing the roles of GPs and cardiologists as part of the model. C1 [Indraratna, Praveen; Yu, Jennifer; Ooi, Sze-Yuan] Prince Wales Hosp, Dept Cardiol, Sydney, NSW, Australia. [Indraratna, Praveen; Yu, Jennifer; Ooi, Sze-Yuan] Univ New South Wales UNSW, Prince Wales Clin Sch, Sydney, NSW, Australia. [Biswas, Uzzal; Redmond, Stephen J.; Lovell, Nigel H.] Univ New South Wales UNSW, Grad Sch Biomed Engn, Sydney, NSW, Australia. [Liu, Hueiming] George Inst Global Hlth, Ctr Hlth Syst Sci, Sydney, NSW, Australia. [Redmond, Stephen J.] Univ Coll Dublin, Sch Elect & Elect Engn, Dublin, Ireland. [Lovell, Nigel H.; Ooi, Sze-Yuan] Univ New South Wales UNSW, Tyree Inst Hlth Engn, Sydney, NSW, Australia. C3 University of New South Wales Sydney; University of New South Wales Sydney; George Institute for Global Health; University of Sydney; University College Dublin; University of New South Wales Sydney RP Indraratna, P (通讯作者),Prince Wales Hosp, Dept Cardiol, Sydney, NSW, Australia.; Indraratna, P (通讯作者),Univ New South Wales UNSW, Prince Wales Clin Sch, Sydney, NSW, Australia. EM praveen@unsw.edu.au RI Yu, Jennifer/GXM-6987-2022; Lovell, Nigel H/AGF-6679-2022 OI Lovell, Nigel H/0000-0003-1637-1079 FU NHMRC [RG181711]; National Heart Foundation of Australia [102356]; Prince of Wales Hospital FX Prince of Wales Hospital (internal department funding)-for conduct of the TCC RCT. Prince ofWalesHospital Foundationfor conduct of the TCC RCT. UNSWSydney-for conduct of the TCC RCT. NHMRC (scholarship for author PI) (Grant Number: RG181711). National Heart Foundation of Australia (scholarship for author PI) (Award ID: 102356). 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Med. PD FEB 8 PY 2022 VL 8 AR 780882 DI 10.3389/fmed.2021.780882 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA ZG8GB UT WOS:000760490400001 PM 35211483 OA gold, Green Published DA 2023-05-13 ER PT J AU Lepoutre, T Rousseau, MF Ahn, SA Gruson, D AF Lepoutre, Thibault Rousseau, Michel F. Ahn, Sylvie A. Gruson, D. TI Measurement Nt-proBNP Circulating Concentrations in Heart Failure Patients with a New Point-Of-Care Assay SO CLINICAL LABORATORY LA English DT Article DE cardiac markers; natriuretic peptides; NYHA; severity ID ACUTE CORONARY SYNDROMES; NATRIURETIC PEPTIDE; PERFORMANCE AB Background: BNP (Brain Natriuretic Peptide) and Nt-proBNP (N-terminal-pro-Brain Natriuretic Peptide) are valuable markers for the diagnosis and prognosis of heart failure (HF). The AQT90 (R) FLEX is a newly released random access analyzer for point-of-care (POCT) measurement. The aim of our study was to determine Nt-proBNP concentrations in HF patients with the POCT assay. Methods: Nt-proBNP levels were measured in seventy seven HF patients and in thirty seven healthy volunteers. The results were compared with a central laboratory assay. Results: Nt-proBNP levels measured with the AQT90 (R) FLEX were significantly correlated with the comparison Nt-proBNP assay and were related to HF severity. Conclusions: Nt-proBNP testing with the AQT 90 (R) FLEX analyzer is comparable to the central lab assay and may offer the advantages of POCT testing for the diagnosis and prognosis of heart failure. C1 [Lepoutre, Thibault; Gruson, D.] Clin Univ St Luc, Dept Lab Med, B-1200 Brussels, Belgium. [Gruson, D.] Clin Univ St Luc, Inst Rech Expt & Clin, Pole Rech Endocrinol Diabet & Nutr, B-1200 Brussels, Belgium. [Gruson, D.] Catholic Univ Louvain, B-1200 Brussels, Belgium. [Rousseau, Michel F.; Ahn, Sylvie A.] Clin Univ St Luc, Div Cardiol, B-1200 Brussels, Belgium. C3 Universite Catholique Louvain; Cliniques Universitaires Saint-Luc; Universite Catholique Louvain; Cliniques Universitaires Saint-Luc; Universite Catholique Louvain; Universite Catholique Louvain; Cliniques Universitaires Saint-Luc RP Gruson, D (通讯作者),Catholic Univ Louvain, Pole Rech Endocrinol Diabet & Nutr, 54 Ave Hippocrate, B-1200 Brussels, Belgium. EM damien.gruson@uclouvain.be CR Alehagen U, 2008, EUR J HEART FAIL, V10, P260, DOI 10.1016/j.ejheart.2008.01.005 Berger R, 2002, CIRCULATION, V105, P2392, DOI 10.1161/01.CIR.0000016642.15031.34 de Lemos JA, 2001, NEW ENGL J MED, V345, P1014, DOI 10.1056/NEJMoa011053 Hjortshoj S, 2011, CLIN CHIM ACTA, V412, P370, DOI 10.1016/j.cca.2010.11.015 Januzzi JL, 2005, AM J CARDIOL, V95, P948, DOI 10.1016/j.amjcard.2004.12.032 Jernberg T, 2002, J AM COLL CARDIOL, V40, P437, DOI 10.1016/S0735-1097(02)01986-1 Lubien E, 2002, CIRCULATION, V105, P595, DOI 10.1161/hc0502.103010 Maisel AS, 2002, NEW ENGL J MED, V347, P161, DOI 10.1056/NEJMoa020233 Rawlins ML, 2005, AM J CLIN PATHOL, V123, P439, DOI 10.1309/PDJ2RMM80FVRDH7W Tang WHW, 2008, CLIN BIOCHEM, V41, P210, DOI 10.1016/j.clinbiochem.2007.07.002 Tomonaga Y, 2011, BMC FAM PRACT, V12, DOI 10.1186/1471-2296-12-12 Yeo KTJ, 2003, CLIN CHIM ACTA, V338, P107, DOI 10.1016/j.cccn.2003.08.016 NR 12 TC 8 Z9 8 U1 0 U2 5 PU CLIN LAB PUBL PI HEIDELBERG PA IM BREITSPIEL 15, HEIDELBERG, D-69126, GERMANY SN 1433-6510 J9 CLIN LAB JI Clin. Lab. PY 2013 VL 59 IS 7-8 BP 831 EP 835 DI 10.7754/Clin.Lab.2012.120418 PG 5 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA 278TS UT WOS:000328913300016 PM 24133913 DA 2023-05-13 ER PT J AU Kashour, TS Joury, A Alotaibi, AM Althagafi, M Almufleh, AS Hersi, A Thalib, L AF Kashour, Tarek Seifaw Joury, Abdulaziz Alotaibi, Abdullah M. Althagafi, Mahmoud Almufleh, Aws S. Hersi, Ahmad Thalib, Lukman TI Quality of assessment and counselling offered by community pharmacists and medication sale without prescription to patients presenting with acute cardiac symptoms: a simulated client study SO EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY LA English DT Article DE Community pharmacies; Simulated-client; Acute coronary syndrme; Acute heart failure; Counselling ID ACUTE MYOCARDIAL-INFARCTION; SELF-MEDICATION; PREHOSPITAL DELAY; ANTIBIOTIC USE; SAUDI-ARABIA; CARE; POPULATION; PREVALENCE; MORTALITY; PATTERNS AB Self-medication is common worldwide. However, the prevalence of sale of prescription medications without prescription and the quality of assessment and counselling provided by community pharmacists to cardiac patients is unknown. We sought to determine the prevalence of prescription medication sales and explore how pharmacists assess and counsel patients with acute cardiac conditions. Six hundred community pharmacies in the two largest cities in Saudi Arabia were selected. Two simulated clients presented either an acute coronary syndrome (ACS) scenario or an acute heart failure (AHF) scenario to the pharmacists. Descriptive statistics and regression models were used to analyse and present the collected data. Of 600 pharmacies, 379 (63.2 %) sold various prescription medications to simulated patients without prescription. Assessment and counselling provided by pharmacists were inadequate. Almost a quarter of pharmacists did not ask simulated patients any questions; 52 % asked one or two questions; and only 24 % asked three or more questions. Only 28 pharmacists (4.7 %) inquired about drug allergies; 48.5 % instructed simulated patients on the dosage and frequency of the sold medications; 21.6 % provided instruction on treatment duration; and 19.4 % gave instructions on dose, frequency, and duration of treatment. Compared to AHF, ACS simulated patients were more likely to be asked about other symptoms and comorbidities (59.7 % vs. 48.7 %, p = 0.007 and 46.3 % vs. 37.3 %, p = 0.005, respectively) and were more likely to be advised to go to hospital (70.3 % vs. 56.3 %, p < 0.001). The sale of prescription medications by community pharmacists to simulated cardiac patients without prescription is very common; assessment and counselling qualities are suboptimal. C1 [Kashour, Tarek Seifaw; Joury, Abdulaziz; Althagafi, Mahmoud; Almufleh, Aws S.; Hersi, Ahmad] King Saud Univ, Coll Med, Dept Cardiac Sci, POB 7805, Riyadh 11472, Saudi Arabia. [Alotaibi, Abdullah M.] King Abdulaziz Univ, Fac Med, Jeddah 21413, Saudi Arabia. [Thalib, Lukman] Qatar Univ, CAS, Dept Hlth Sci, Doha, Qatar. C3 King Saud University; King Abdulaziz University; Qatar University RP Kashour, TS (通讯作者),King Saud Univ, Coll Med, Dept Cardiac Sci, POB 7805, Riyadh 11472, Saudi Arabia. EM tkashour@gmail.com RI Hersi, Ahmad/ABC-9266-2020 OI Thalib, Lukman/0000-0002-1211-6495; Joury, Abdulaziz/0000-0002-6936-8888 CR Al-Azzam Sayer I., 2007, International Journal of Occupational Medicine and Environmental Health, V20, P373, DOI 10.2478/v10001-007-0038-9 Al-Ghamdi S, 2002, J HOSP INFECT, V50, P115, DOI 10.1053/jhin.2001.1149 Al-Hassan M, 2010, INT J PHARMACEUT, V9, P2 Al-Mohamadi A, 2013, SAUDI PHARM J, V21, P13, DOI 10.1016/j.jsps.2011.11.003 Alghanim S. 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J. Clin. Pharmacol. PD MAR PY 2016 VL 72 IS 3 BP 321 EP 328 DI 10.1007/s00228-015-1981-1 PG 8 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Pharmacology & Pharmacy GA DD9QW UT WOS:000370261700008 PM 26592495 DA 2023-05-13 ER PT J AU Krzysztofik, JM Sokolski, M Kosowski, M Zimoch, W Lis, A Klepuszewski, M Kasperczak, M Proniak, M Reczuch, K Banasiak, W Jankowska, EA Ponikowski, P AF Krzysztofik, Justyna M. Sokolski, Mateusz Kosowski, Michal Zimoch, Wojciech Lis, Adrian Klepuszewski, Maciej Kasperczak, Michal Proniak, Marcin Reczuch, Krzysztof Banasiak, Waldemar Jankowska, Ewa A. Ponikowski, Piotr TI Acute heart failure in patients admitted to the emergency department with acute myocardial infarction SO KARDIOLOGIA POLSKA LA English DT Article DE acute cardiac care; acute decompensated heart failure; acute myocardial infarction; acute heart failure; heart failure ID CORONARY SYNDROMES OBSERVATIONS; HOSPITALIZATION; REGISTRY; TRENDS; RISK; PREDICTORS; MORTALITY; OUTCOMES; DISEASE; IMPACT AB Background: Acute heart failure (AHF), occurring as a complication of ongoing acute myocardial infarction (AMI), is a common predictor of worse clinical outcome. Much less is known about the unique subpopulation of patients who present these two life-threatening conditions in the emergency department (ED). Aim: The aim of the study was to establish the prevalence of coexistence of AHF with AMI in the ED, to identify clinical factors associated with the higher prevalence of AHF at very early onset of AMI, and to assess the prognostic impact of the presence of AHF with AMI. Methods: A prospective study of 289 consecutive patients (mean age: 68 +/- 11 years, 61% men) admitted to our institution (via the ED) with the diagnosis of AMI between May and October 2012 and followed-up for 2.5 years. Results: Acute heart failure was diagnosed in 13% of patients in the ED. In multivariable analysis, female sex, chronic obstructive pulmonary disease, and chronic kidney disease significantly increased the risk of developing AHF together with AMI (all p < 0.05). Patients with AHF were hospitalised for longer (9.2 +/- 6.1 vs. 6.3 +/- 4.5 days, p < 0.001), had higher in-hospital cardiovascular mortality (8% vs. 0%, p < 0.001), and all-cause (34% vs. 15%, p = 0.004) and cardiovascular mortality (26% vs. 9%, p = 0.002) during long-term follow-up. Conclusions: Despite good logistic-and evidence-based treatment, AHF is present in one in eight patients with AMI at the time of admission to the ED. Particularly poor outcomes characterise critically ill patients; therefore, great effort should be undertaken to improve their care. C1 [Krzysztofik, Justyna M.; Sokolski, Mateusz; Kosowski, Michal; Zimoch, Wojciech; Reczuch, Krzysztof; Banasiak, Waldemar; Ponikowski, Piotr] Wroclaw Med Univ, Dept Heart Dis, Wroclaw, Poland. [Krzysztofik, Justyna M.; Sokolski, Mateusz; Kosowski, Michal; Zimoch, Wojciech; Reczuch, Krzysztof; Jankowska, Ewa A.; Ponikowski, Piotr] Clin Mil Hosp, Ctr Heart Dis, Dept Cardiol, Ul Weigla 5, PL-53114 Wroclaw, Poland. [Lis, Adrian; Klepuszewski, Maciej; Kasperczak, Michal; Proniak, Marcin] Wroclaw Med Univ, Students Sci Org, Lab Appl Res Cardiovasc Syst, Wroclaw, Poland. [Jankowska, Ewa A.] Wroclaw Med Univ, Dept Heart Dis, Lab Appl Res Cardiovasc Syst, Wroclaw, Poland. C3 Wroclaw Medical University; Wroclaw Medical University; Wroclaw Medical University RP Krzysztofik, JM (通讯作者),Clin Mil Hosp, Ctr Heart Dis, Dept Cardiol, Ul Weigla 5, PL-53114 Wroclaw, Poland. EM justyna.krzysztofik@gmail.com RI Jankowska, Ewa A/O-6358-2015; Kosowski, Michał/ABD-4589-2021; Ponikowski, Piotr/O-6454-2015; Reczuch, Krzysztof/ABI-1216-2020; Jankowska, Ewa A/AAY-3040-2020; Sokolski, Mateusz/AAG-8727-2019; Jankowska, Ewa/ABD-4073-2021 OI Jankowska, Ewa A/0000-0002-9202-432X; Kosowski, Michał/0000-0001-8911-5303; Ponikowski, Piotr/0000-0002-3391-7064; Reczuch, Krzysztof/0000-0002-1699-739X; Jankowska, Ewa A/0000-0002-9202-432X; Sokolski, Mateusz/0000-0001-9925-3566; Kasperczak, Michal/0000-0001-8396-3045; Zimoch, Wojciech/0000-0003-4693-491X; Sokolska, Justyna/0000-0002-4759-5879; Lis, Adrian/0000-0002-4540-4450 FU Wroclaw Medical University in Poland statutory activities of the Department of Heart Diseases [ST-723] FX Wroclaw Medical University in Poland statutory activities of the Department of Heart Diseases in 2012-2015, ST-723. CR Ahmed A, 2009, AM J CARDIOL, V103, P1374, DOI 10.1016/j.amjcard.2009.01.347 Ali AS, 1999, AM HEART J, V138, P1133, DOI 10.1016/S0002-8703(99)70080-3 Alsheikh-Ali AA, 2009, EUR J HEART FAIL, V11, P1135, DOI 10.1093/eurjhf/hfp151 Antoni ML, 2012, AM J CARDIOL, V109, P187, DOI 10.1016/j.amjcard.2011.08.029 Butler J, 2008, J AM COLL CARDIOL, V52, P435, DOI 10.1016/j.jacc.2008.04.037 Chen J, 2013, CIRCULATION, V128, P2577, DOI 10.1161/CIRCULATIONAHA.113.003668 Franco E, 2011, EUR J INTERN MED, V22, P533, DOI 10.1016/j.ejim.2011.07.009 Hasdai D, 2003, AM HEART J, V145, P73, DOI 10.1067/mhj.2003.53 Heywood JT, 2007, J CARD FAIL, V13, P422, DOI 10.1016/j.cardfail.2007.03.011 Joseph SM, 2009, TEX HEART I J, V36, P510 Macchia A, 2007, EUR J HEART FAIL, V9, P942, DOI 10.1016/j.ejheart.2007.06.004 Manola S, 2009, CROAT MED J, V50, P449, DOI 10.3325/cmj.2009.50.449 McManus DD, 2011, AM J CARDIOL, V107, P353, DOI 10.1016/j.amjcard.2010.09.026 Nunez-Gil IJ, 2010, EUR J INTERN MED, V21, P439, DOI 10.1016/j.ejim.2010.06.003 Perkiomaki JS, 2010, ANN NONINVAS ELECTRO, V15, P250, DOI 10.1111/j.1542-474X.2010.00372.x Petrie CJ, 2012, CLIN RES CARDIOL, V101, P29, DOI 10.1007/s00392-011-0360-x Shafazand M, 2011, EUR J HEART FAIL, V13, P135, DOI 10.1093/eurjhf/hfq205 Shah RV, 2012, CIRC-HEART FAIL, V5, P693, DOI 10.1161/CIRCHEARTFAILURE.112.968180 Spencer FA, 2002, CIRCULATION, V105, P2605, DOI 10.1161/01.CIR.0000017861.00991.2F Steg PG, 2004, CIRCULATION, V109, P494, DOI 10.1161/01.CIR.0000109691.16944.DA Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184 Torabi A, 2008, EUR HEART J, V29, P859, DOI 10.1093/eurheartj/ehn096 Voors AA, 2009, EUR HEART J, V30, P1187, DOI 10.1093/eurheartj/ehp098 Wu AH, 2010, EUR J HEART FAIL, V12, P566, DOI 10.1093/eurjhf/hfq043 NR 24 TC 2 Z9 5 U1 1 U2 4 PU POLISH CARDIAC SOC PI WARSZAWA PA UL STAWKI 3 A LOK 1-2, WARSZAWA, POLAND SN 0022-9032 EI 1897-4279 J9 KARDIOL POL JI Kardiol. Pol. PY 2017 VL 75 IS 4 BP 306 EP 315 DI 10.5603/KP.a2016.0178 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ES7RN UT WOS:000399748200002 PM 27995597 DA 2023-05-13 ER PT J AU Zhang, DF Song, XT Raposeiras-Roubin, S Abu-Assi, E Henriques, JPS D'Ascenzo, F Saucedo, J Gonzalez-Juanatey, JR Wilton, SB Kikkert, WJ Nunez-Gil, I Ariza-Sole, A Alexopoulos, D Liebetrau, C Kawaji, T Moretti, C Huczek, Z Nie, SP Fujii, T Correia, L Kawashiri, M Southern, D Kalpak, O AF Zhang, Dongfeng Song, Xiantao Raposeiras-Roubin, Sergio Abu-Assi, Emad Simao Henriques, Jose Paulo D'Ascenzo, Fabrizio Saucedo, Jorge Gonzalez-Juanatey, Jose Ramon Wilton, Stephen B. Kikkert, Wouter J. Nunez-Gil, Ivan Ariza-Sole, Albert Alexopoulos, Dimitrios Liebetrau, Christoph Kawaji, Tetsuma Moretti, Claudio Huczek, Zenon Nie, Shaoping Fujii, Toshiharu Correia, Luis Kawashiri, Masa-aki Southern, Danielle Kalpak, Oliver CA Bleeding Complications Multicenter TI Evaluation of optimal medical therapy in acute myocardial infarction patients with prior stroke SO THERAPEUTIC ADVANCES IN CHRONIC DISEASE LA English DT Article DE acute myocardial infarction; optimal medical therapy; percutaneous coronary intervention; stroke ID HEALTH-CARE PROFESSIONALS; TRANSIENT ISCHEMIC ATTACK; ACUTE CORONARY SYNDROMES; SCIENTIFIC STATEMENT; CLINICAL CARDIOLOGY; KIDNEY-DISEASE; ASSOCIATION; RISK; PREDICTORS; REGISTRY AB Background: Treatment of acute myocardial infarction (AMI) patients with prior stroke is a common clinical dilemma. Currently, the application of optimal medical therapy (OMT) and its impact on clinical outcomes are not clear in this patient population. Methods: We retrieved 765 AMI patients with prior stroke who underwent percutaneous coronary intervention (PCI) during the index hospitalization from the international multicenter BleeMACS registry. All of the subjects were divided into two groups based on the prescription they were given prior to discharge. Baseline characteristics and procedural variables were compared between the OMT and non-OMT groups. Mortality, re-AMI, major adverse cardiovascular events (MACE), and bleeding were followed-up for 1 year. Results: Approximately 5% of all patients presenting with AMI were admitted to the hospital for ischemic stroke. Although the prescription rate of each OMT medication was reasonably high (73.3%-97.3%), 47.7% lacked at least one OMT medication. Patients receiving OMT showed a significantly decreased occurrence of mortality (4.5% vs 15.1%, p < 0.001), re-AMI (4.2% vs 9.3%, p = 0.004), and the composite endpoint of death/re-AMI (8.6% vs 20.5%, p < 0.001) compared to those without OMT. No significant difference was observed between the groups regarding bleeding. After adjusting for confounding factors, OMT was the independent protective factor of 1-year mortality, while age was the independent risk factors. Conclusions: OMT at discharge was associated with a significantly lower 1-year mortality of patients with AMI and prior stroke in clinical practice. However, OMT was provided to just half of the eligible patients, leaving room for substantial improvement. C1 [Zhang, Dongfeng; Song, Xiantao] Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, 2 Anzhen Rd, Beijing 100029, Peoples R China. [Raposeiras-Roubin, Sergio; Abu-Assi, Emad] Univ Hosp Alvaro, Dept Cardiol, Vigo, Spain. [Simao Henriques, Jose Paulo; Kikkert, Wouter J.] Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands. [D'Ascenzo, Fabrizio; Moretti, Claudio] Univ Turin, Div Cardiol, Dept Med Sci, AOU Citta Salute Sci, Turin, Italy. [Saucedo, Jorge] North Shore Univ Hosp, Dept Cardiol, Chicago, IL USA. [Gonzalez-Juanatey, Jose Ramon] Univ Clin Hosp Santiago de Compostela, Dept Cardiol, Santiago De Compostela, Spain. [Wilton, Stephen B.; Southern, Danielle] Libin Cardiovasc Inst Alberta, Calgary, AB, Canada. [Nunez-Gil, Ivan] Cardiovascular Inst, Hosp Clin Univ San Carlos, Intervent Cardiol, Madrid, Spain. [Ariza-Sole, Albert] Univ Hosp Bellvitge, Dept Cardiol, Barcelona, Spain. [Alexopoulos, Dimitrios] Patras Univ Hosp, Dept Cardiol, Patras, Greece. [Liebetrau, Christoph] Kerckhoff Heart & Thorax Ctr, Dept Cardiol, Bad Nauheim, Germany. [Kawaji, Tetsuma] Mitsubishi Kyoto Hosp, Dept Cardiol, Kyoto, Japan. [Huczek, Zenon] Med Univ Warsaw, Dept Cardiol, Warsaw, Poland. [Nie, Shaoping] Inst Heart Lung & Blood Vessel Dis, Beijing, Peoples R China. [Fujii, Toshiharu] Tokai Univ, Sch Med, Div Cardiovasc Med, Dept Cardiol, Tokyo, Japan. [Correia, Luis] Hosp Sao Rafael, Dept Cardiol, Salvador, BA, Brazil. [Kawashiri, Masa-aki] Kanazawa Univ, Grad Sch Med Sci, Dept Cardiol, Kanazawa, Ishikawa, Japan. [Kalpak, Oliver] Univ Clin Cardiol, Intervent Cardiol, Skopje, North Macedonia. C3 Capital Medical University; University of Amsterdam; Academic Medical Center Amsterdam; A.O.U. Citta della Salute e della Scienza di Torino; University of Turin; Complexo Hospitalario Universitario de Santiago de Compostela; Libin Cardiovascular Institute Of Alberta; Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Bellvitge University Hospital; University of Barcelona; University of Patras; Kerckhoff Clinic; Medical University of Warsaw; Tokai University; Kanazawa University RP Song, XT (通讯作者),Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, 2 Anzhen Rd, Beijing 100029, Peoples R China. EM xiantao_song@163.com RI Mooradian, Arshag/IAP-5640-2023; Kalpak, Oliver/L-3298-2019; Fujii, Toshiharu/GNH-5200-2022; Southern, Danielle A/GRY-7207-2022; Wilton, Stephen/HOH-4991-2023; NUÑEZ GIL, IVAN JAVIER/AAD-6950-2020; Kalpak, Oliver/H-1958-2017 OI Kalpak, Oliver/0000-0002-5484-6234; Fujii, Toshiharu/0000-0002-0011-3051; Southern, Danielle A/0000-0002-0006-0033; NUÑEZ GIL, IVAN JAVIER/0000-0002-1779-3102; Kalpak, Oliver/0000-0002-5484-6234; RAPOSEIRAS-ROUBIN, SERGIO/0000-0002-6462-4715; , IIS Galicia Sur/0000-0003-3812-7413 FU capital health research and development of special [2018-2-2063] FX The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the capital health research and development of special (grant number 2018-2-2063). 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Adv. Chronic Dis. PD SEP PY 2021 VL 12 AR 20406223211046999 DI 10.1177/20406223211046999 PG 11 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA WB7MZ UT WOS:000703754600001 PM 34729148 OA Green Published, gold DA 2023-05-13 ER PT J AU Layfield, C Rose, J Alford, A Snyder, SR Apple, FS Chowdhury, FM Kontos, MC Newby, LK Storrow, AB Tanasijevic, M Leibach, E Liebow, EB Christenson, RH AF Layfield, Christopher Rose, John Alford, Aaron Snyder, Susan R. Apple, Fred S. Chowdhury, Farah M. Kontos, Michael C. Newby, L. Kristin Storrow, Alan B. Tanasijevic, Milenko Leibach, Elizabeth Liebow, Edward B. Christenson, Robert H. TI Effectiveness of practices for improving the diagnostic accuracy of Non ST Elevation Myocardial Infarction in the Emergency Department: A Laboratory Medicine Best Practices (TM) systematic review SO CLINICAL BIOCHEMISTRY LA English DT Review DE Acute coronary syndrome; Cardiac troponin; Non-ST-segment elevation; Myocardial infarction ID POINT-OF-CARE; ACUTE CORONARY SYNDROMES; TROPONIN-I ASSAY; SENSITIVITY CARDIAC TROPONIN; CHEST-PAIN SYMPTOMS; RELATIVE CHANGES; 99TH PERCENTILE; RAPID DIAGNOSIS; WHOLE-BLOOD; MANAGEMENT AB Objectives: This article is a systematic review of the effectiveness of four practices (assay selection, decision point cardiac troponin (cTn) threshold selection, serial testing, and point of care testing) for improving the diagnostic accuracy Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) in the Emergency Department. Design and methods: The CDC-funded Laboratory Medicine Best Practices (LMBP) Initiative systematic review method for quality improvement practices was used. Results: The current ACC/AHA guidelines recommend using cardiac troponin assays with a 99th percentile upper reference limit (URL) diagnostic threshold to diagnose NSTEMI. The evidence in this systematic review indicates that contemporary sensitive cTn assays meet the assay profile requirements (sensitivity, specificity, PPV, and NPV) to more accurately diagnose NSTEMI than alternate tests. Additional biomarkers did not increase diagnostic effectiveness of cTn assays. Sensitivity, specificity, and NPV were consistently high and low PPV improved with serial sampling. Evidence for use of point of care cTn testing was insufficient to make recommendation, though some evidence suggests that use may result in reduction to patient length of stay and costs. Conclusions: Based on the review of and the LMBP(TM) A-6 Method criteria, we recommend the use of cardiac troponin assays without additional biomarkers using the 99th percentile URL as the clinical diagnostic threshold for the diagnosis of NSTEMI. We recommend serial sampling with one sample at presentation and at least one additional second sample taken at least 6 h later to identify a rise or fall in the troponin level. No recommendation is made either for or against the use of point of care tests. Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention/the Agency for Toxic Substances and Disease Registry (CDC/ATSDR). (C) 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved. C1 [Layfield, Christopher; Rose, John; Alford, Aaron] Battelle Mem Inst, Baltimore, MD 21209 USA. [Apple, Fred S.] Hennepin Cty Med Ctr, Minneapolis, MN 55415 USA. [Apple, Fred S.] Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. [Chowdhury, Farah M.; Leibach, Elizabeth] Ctr Dis Control & Prevent CDC, Atlanta, GA USA. [Kontos, Michael C.] Virginia Commonwealth Univ, Med Ctr, Richmond, VA 23284 USA. [Newby, L. Kristin] Duke Univ, Med Ctr, Durham, NC 27706 USA. [Storrow, Alan B.] Vanderbilt Univ, Med Ctr, Nashville, TN USA. [Tanasijevic, Milenko] Brigham & Womens Hosp, Boston, MA 02115 USA. [Tanasijevic, Milenko] Harvard Univ, Sch Med, Cambridge, MA 02138 USA. [Christenson, Robert H.] Univ Maryland, Sch Med, College Pk, MD USA. C3 Hennepin County Medical Center; University of Minnesota System; University of Minnesota Twin Cities; Centers for Disease Control & Prevention - USA; Virginia Commonwealth University; Duke University; Vanderbilt University; Harvard University; Brigham & Women's Hospital; Harvard University; University System of Maryland; University of Maryland College Park RP Layfield, C (通讯作者),Battelle Mem Inst, 6115 Falls Rd,Suite 200, Baltimore, MD 21209 USA. EM layfieldc@battelle.org RI Liebow, Edward/AAW-9351-2020 FU CDC [SP0700-00-D-3180] FX CDC funding for the Laboratory Medicine Best Practices Initiative to Battelle Centers for Public Health Research and Evaluation under contract No. SP0700-00-D-3180, Delivery Order 0723. 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Biochem. PD MAR PY 2015 VL 48 IS 4-5 BP 204 EP 212 DI 10.1016/j.clinbiochem.2015.01.014 PG 9 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA CD3YE UT WOS:000351018900003 PM 25661303 OA Green Accepted DA 2023-05-13 ER PT J AU Papakonstantinou, PE Malliou, A Chlouverakis, G Kallergis, E Mavrakis, H Parthenakis, F Vardas, PE Simantirakis, EN AF Papakonstantinou, Panteleimon E. Malliou, Angelliki Chlouverakis, Gregory Kallergis, Eleftherios Mavrakis, Hercules Parthenakis, Frangiskos Vardas, Panos E. Simantirakis, Emmanuel N. TI Impact of Sustained Cardiac Tachyarrhythmias Recorded in Coronary Intensive Care Unit on Short- and Long-Term Mortality and Duration of Hospitalization SO JOURNAL OF INTENSIVE CARE MEDICINE LA English DT Article DE arrhythmias; tachyarrhythmias; ventricular arrhythmias; ventricular tachycardia; supraventricular tachycardia; coronary intensive care unit ID 2015 ESC GUIDELINES; VENTRICULAR-ARRHYTHMIAS; ATRIAL-FIBRILLATION; EUROPEAN-SOCIETY; HEART-FAILURE; TASK-FORCE; MANAGEMENT; PREVENTION AB Background: Studies conducted in coronary intensive care units (CICUs) have demonstrated that tachyarrhythmias are associated with increased mortality after acute coronary syndromes (ACSs). However, the data for tachyarrhythmias occurred in CICUs due to a variety of cardiovascular disorders are limited. Methods: We conducted a single-center prospective observational study, which included consecutive CICU patients (January 1, 2014 to May 31, 2018). We recorded the ventricular arrhythmias (VAs), supraventricular tachycardias (SVTs), and days of CICU hospitalization. The patients were followed up for 6 months after CICU discharge. Results: A total of 943 patients (age: 66.37 +/- 15.4 years; 673 males [71.4%]) were included. Patients with tachyarrhythmias had higher in-CICU mortality (8.0% vs 4.1%, P = .029, odds ratio [OR]: 2.04, 95% confidence interval [CI]: 1.08-3.86) and higher 6-month all-cause mortality (12.8% vs 6.1%, P = .002, OR: 2.27, 95% CI: 1.35-3.83) than those who did not develop tachyarrhythmias. Ventricular arrhythmias was significantly associated with higher all-cause mortality than no tachyarrhythmia (15.4% vs 6.1%; P = .001) or SVTs (15.4% vs 7.0%; P = .001). The mean duration of hospitalization for the patients with tachyarrhythmias was 3.89 +/- 4.90 days, while for the patients without was 2.79 +/- 3.31 days (P < .001). Patients without ACS had higher short- and long-term mortality compared to patients with ACS (9.2% vs 2.9%, P < .001 and 12.9% vs 4.9%, P < .001). Conclusions: Tachyarrhythmias were associated with prolonged CICU hospitalization, while non-ACS cardiovascular disorders and the occurrence of VAs were associated with increased short- and long-term mortality. C1 [Papakonstantinou, Panteleimon E.; Malliou, Angelliki; Kallergis, Eleftherios; Mavrakis, Hercules; Parthenakis, Frangiskos; Vardas, Panos E.; Simantirakis, Emmanuel N.] Univ Crete, Univ Hosp Heraklion, Sch Med, Dept Cardiol, Iraklion, Crete, Greece. [Chlouverakis, Gregory] Univ Crete, Sch Med, Biostat Lab, Iraklion, Greece. C3 University Hospital of Heraklion; University of Crete; University of Crete RP Simantirakis, EN (通讯作者),Univ Hosp Heraklion, Dept Cardiol, Iraklion 71110, Crete, Greece. EM esimant@hotmail.com RI vardas, panos/ABF-7144-2020; Papakonstantinou, Panteleimon/J-9892-2019; Vardas, Panos/AAD-5219-2022; Vardas, Panos/AAP-5694-2021 OI Papakonstantinou, Panteleimon/0000-0003-4691-7183; FU Special Account for Research Grants of the University of Crete FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was supported by the Special Account for Research Grants of the University of Crete. 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PD JUL PY 2021 VL 36 IS 7 BP 775 EP 782 AR 0885066620918790 DI 10.1177/0885066620918790 EA APR 2020 PG 8 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA SJ7SO UT WOS:000527548600001 PM 32274959 DA 2023-05-13 ER PT J AU Mennuni, M Gulizia, MM Alunni, G Amico, AF Bovenzi, FM Caporale, R Colivicchi, F Di Lenarda, A Di Tano, G Egman, S Fattirolli, F Gabrielli, D Geraci, G Gregorio, G Mureddu, GF Nardi, F Radini, D Riccio, C Rigo, F Sicuro, M Urbinati, S Zuin, G AF Mennuni, Mauro Gulizia, Michele Massimo Alunni, Gianfranco Amico, Antonio Francesco Bovenzi, Francesco Maria Caporale, Roberto Colivicchi, Furio Di Lenarda, Andrea Di Tano, Giuseppe Egman, Sabrina Fattirolli, Francesco Gabrielli, Domenico Geraci, Giovanna Gregorio, Giovanni Mureddu, Gian Francesco Nardi, Federico Radini, Donatella Riccio, Carmine Rigo, Fausto Sicuro, Marco Urbinati, Stefano Zuin, Guerrino TI ANMCO Position Paper: hospital discharge planning: recommendations and standards SO EUROPEAN HEART JOURNAL SUPPLEMENTS LA English DT Article DE Discharge planning; Multidimensional evaluation; Multidisciplinary team; Therapeutic reconciliation ID ACUTE CORONARY SYNDROME; ACUTE MYOCARDIAL-INFARCTION; SECONDARY PREVENTION; MEDICATION RECONCILIATION; HEART-DISEASE; HIGH-RISK; PATIENT; CARE; MULTIDISCIPLINARY; INTERVENTIONS AB The hospital discharge is often poorly standardized and affected by discontinuity and fragmentation of care, putting patients at high risk of both post-discharge adverse events and early readmission. The present ANMCO document reviews the modifiable components of the hospital discharge process related to adverse events or re-hospitalizations and suggests the optimal methods for redesigning the whole discharge process. The key principles for proper hospital discharge or transfer of care acknowledge that the hospital discharge: aEuro cent aEuro integral is not an isolated event, but a process that has to be planned as soon as possible after the admission, ensuring that the patient and the caregiver understand and contribute to the planned decisions, as equal partners; aEuro cent aEuro integral is facilitated by a comprehensive systemic approach that begins with a multidimensional evaluation process; aEuro cent aEuro integral must be organized by an operator who is responsible for the coordination of all phases of the hospital patient journey, involving afterward the general practitioner and transferring to them the information and responsibility at discharge; aEuro cent aEuro integral is the result of an integrated multidisciplinary team approach; aEuro cent aEuro integral appropriately uses the transitional and intermediate care services; aEuro cent aEuro integral is carried out in an organized system of care and continuum of services; and aEuro cent aEuro integral programs the passage of information to after-discharge services. C1 [Mennuni, Mauro] Osped L Parodi Delfino, Cardiol Dept UTIC, Piazza Aldo Moro, I-00034 Colleferro, RM, Italy. [Gulizia, Michele Massimo] Azienda Rilievo Nazl & Alta Specializzaz Garibald, Osped Garibaldi Nesima, Cardiol Dept, Catania, Italy. [Alunni, Gianfranco] Osped Assisi, Integrated Heart Failure Unit, Assisi, PG, Italy. [Amico, Antonio Francesco] Osped San Giuseppe da Copertino, CCU Cardiol Dept, Copertino, LE, Italy. [Bovenzi, Francesco Maria] Nuovo Osped San Luca, Cardiovasc Dis Dept, Lucca, Italy. [Caporale, Roberto] Osped Santissima Annunziata, Intervent Cardiol Dept, Cosenza, Italy. [Colivicchi, Furio] Osped San Filippo Neri, CCU Cardiol Dept, Rome, Italy. [Di Lenarda, Andrea; Radini, Donatella] AAS1 Triestina, Cardiovasc Ctr, Trieste, Italy. [Di Tano, Giuseppe] UO Cardiol, Cardiol Unit, Cremona, Italy. [Egman, Sabrina] ISMETT, Cardiol Unit, Palermo, Italy. [Fattirolli, Francesco] AOU Careggi, Cardiol Rehabil Dept, Florence, Italy. [Gabrielli, Domenico] Osped Civile Augusto Murri, Cardiol Unit, Fermo, Italy. [Geraci, Giovanna] AOR Villa Sofia Cervello, Cardiol Unit, PO Cervello, Palermo, Italy. [Gregorio, Giovanni] Osped San Luca, CCU Cardiol Dept, Vallo Della Lucania, SA, Italy. [Mureddu, Gian Francesco] AO San Giovanni Addolorata, Cardiol & Cardiac Rehabil Dept, Rome, Italy. [Nardi, Federico] Osped Castelli, Cardiol Dept, Verbania, Italy. [Riccio, Carmine] Azienda Osped S Anna & S Sebastiano, Caserta, Italy. [Rigo, Fausto; Zuin, Guerrino] Osped Angelo, Cardiol Unit, Venice, VE, Italy. [Sicuro, Marco] Osped Gen Reg PO U Parini, Cardiol & Cardiac Care Unit, Aosta, Italy. [Urbinati, Stefano] Osped Bellaria, Cardiol Unit, Bologna, Italy. C3 Presidio Ospedaliero Garibaldi-Nesima; San Filippo Neri Hospital; IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT); University of Florence; Azienda Ospedaliero Universitaria Careggi; ULSS 3 Serenissima; Ospedale dell'Angelo Mestre RP Mennuni, M (通讯作者),Osped L Parodi Delfino, Cardiol Dept UTIC, Piazza Aldo Moro, I-00034 Colleferro, RM, Italy. EM mauromennuni@tiscali.it RI Gabrielli, Domenico/AAC-1130-2022; Rigo, Fausto/ABG-9721-2021; Di Lenarda, Andrea/AAC-2377-2022 OI Di Lenarda, Andrea/0000-0001-8482-4872; Colivicchi, Furio/0000-0001-7187-2234; Riccio, Carmine/0000-0003-0160-3674 CR Abrignani Maurizio Giuseppe, 2014, Monaldi Arch Chest Dis, V82, P93 Afilalo J, 2014, J AM COLL CARDIOL, V63, P747, DOI 10.1016/j.jacc.2013.09.070 Alfandre DJ, 2009, MAYO CLIN PROC, V84, P255, DOI 10.1016/S0025-6196(11)61143-9 Ammenwerth E, 2003, J AM MED INFORM ASSN, V10, P69, DOI 10.1197/jamia.M1118 Angelino Elisabetta, 2012, Monaldi Arch Chest Dis, V78, P79 [Anonymous], 2012, Jt Comm Perspect, V32, P3 [Anonymous], 2011, Sentinel Event Alert, P1 Ansmann L, 2012, INT J QUAL HEALTH C, V24, P501, DOI 10.1093/intqhc/mzs048 Apker J, 2007, ACAD EMERG MED, V14, P884, DOI 10.1197/j.aem.2007.06.037 Arora VM, 2009, J HOSP MED, V4, P433, DOI 10.1002/jhm.573 Assessorato della Salute Regione Siciliana, 2017, RACC REG AD COM CON Auer R, 2008, CIRCULATION, 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Heart J. Suppl. PD MAY PY 2017 VL 19 IS D BP D244 EP D255 DI 10.1093/eurheartj/sux011 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA FD3EQ UT WOS:000407416700015 PM 28751845 OA Green Published, Green Submitted, hybrid DA 2023-05-13 ER PT J AU Anand, A Cudmore, S Robertson, S Stephen, J Haga, K Weir, CJ Murray, SA Boyd, K Gunn, J Iqbal, J MacLullich, A Shenkin, SD Fox, KAA Mills, N Denvir, MA AF Anand, Atul Cudmore, Sarah Robertson, Shirley Stephen, Jacqueline Haga, Kristin Weir, Christopher J. Murray, Scott A. Boyd, Kirsty Gunn, Julian Iqbal, Javaid MacLullich, Alasdair Shenkin, Susan D. Fox, Keith A. A. Mills, Nicholas Denvir, Martin A. TI Frailty assessment and risk prediction by GRACE score in older patients with acute myocardial infarction SO BMC GERIATRICS LA English DT Article DE Frailty; Risk prediction; Myocardial infarction; Acute coronary syndrome ID ACUTE CORONARY SYNDROME; CARDIAC REHABILITATION; OUTCOMES; EVENTS; MARKER; CARE AB Background Risk prediction after myocardial infarction is often complex in older patients. The Global Registry of Acute Coronary Events (GRACE) model includes clinical parameters and age, but not frailty. We hypothesised that frailty would enhance the prognostic properties of GRACE. Methods We performed a prospective observational cohort study in two independent cardiology units: the Royal Infirmary of Edinburgh, UK (primary cohort) and the South Yorkshire Cardiothoracic Centre, Sheffield, UK (external validation). The study sample included 198 patients >= 65 years old hospitalised with type 1 myocardial infarction (primary cohort) and 96 patients >= 65 years old undergoing cardiac catheterisation for myocardial infarction (external validation). Frailty was assessed using the Clinical Frailty Scale (CFS). The GRACE 2.0 estimated risk of 12-month mortality, Charlson comorbidity index and Karnofsky disability scale were also determined for each patient. Results Forty (20%) patients were frail (CFS >= 5). These individuals had greater comorbidity, functional impairment and a higher risk of death at 12 months (49% vs. 9% in non-frail patients, p < 0.001). The hazard of 12-month all-cause mortality nearly doubled per point increase in CFS after adjustment for age, sex and comorbidity (Hazard Ratio [HR] 1.90, 95% CI 1.47-2.44, p < 0.001). The CFS had good discrimination for mortality by Receiver Operating Characteristic (ROC) curve analysis (Area Under the Curve [AUC] 0.81, 95% CI 0.72-0.89) and enhanced the GRACE estimate (AUC 0.86 vs. 0.80 without CFS, p = 0.04). At existing GRACE thresholds, the CFS resulted in a Net Reclassification Improvement (NRI) of 0.44 (95% CI 0.28-0.60, p < 0.001), largely through reductions in risk estimates amongst non-frail patients. Similar findings were observed in the external validation cohort (NRI 0.46, 95% CI 0.23-0.69, p < 0.001). Conclusions The GRACE score overestimated mortality risk after myocardial infarction in these cohorts of older patients. The CFS is a simple guided frailty tool that may enhance prediction in this setting. These findings merit evaluation in larger cohorts of unselected patients. C1 [Anand, Atul; Fox, Keith A. A.; Mills, Nicholas; Denvir, Martin A.] Univ Edinburgh, BHF Ctr Cardiovasc Sci, Room SU 305 Chancellors Bldg, Edinburgh EH16 4SB, Midlothian, Scotland. [Anand, Atul; MacLullich, Alasdair; Shenkin, Susan D.] Univ Edinburgh, Geriatric Med Res Grp, Edinburgh, Midlothian, Scotland. [Cudmore, Sarah; Robertson, Shirley; Haga, Kristin] Royal Infirm Edinburgh NHS Trust, Edinburgh Heart Ctr, Dept Cardiol, Edinburgh, Midlothian, Scotland. [Stephen, Jacqueline; Weir, Christopher J.] Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Edinburgh Clin Trials Unit, Edinburgh, Midlothian, Scotland. [Murray, Scott A.; Boyd, Kirsty] Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Primary Palliat Care Res Grp, Edinburgh, Midlothian, Scotland. [Gunn, Julian; Iqbal, Javaid] Northern Gen Hosp, South Yorkshire Cardiothorac Ctr, Sheffield, S Yorkshire, England. C3 RLUK- Research Libraries UK; University of Edinburgh; RLUK- Research Libraries UK; University of Edinburgh; RLUK- Research Libraries UK; University of Edinburgh; Royal Infirmary of Edinburgh; RLUK- Research Libraries UK; University of Edinburgh; RLUK- Research Libraries UK; University of Edinburgh; Northern General Hospital RP Anand, A (通讯作者),Univ Edinburgh, BHF Ctr Cardiovasc Sci, Room SU 305 Chancellors Bldg, Edinburgh EH16 4SB, Midlothian, Scotland.; Anand, A (通讯作者),Univ Edinburgh, Geriatric Med Res Grp, Edinburgh, Midlothian, Scotland. EM atul.anand@ed.ac.uk RI Denvir, Martin A/ABA-3141-2021; Fox, keith A A/I-3742-2013; Shenkin, Susan/GWZ-3174-2022; Anand, Atul/ABC-1393-2020 OI Anand, Atul/0000-0002-6428-4554; Weir, Christopher/0000-0002-6494-4903; Mills, Nicholas/0000-0003-0533-7991; Shenkin, Susan/0000-0001-7375-4776; MacLullich, Alasdair/0000-0003-3159-9370 FU Marie Curie Research [A15867]; Chief Scientist Office [PCL/18/05]; NHS Lothian via the Edinburgh Clinical Trials Unit; British Heart Foundation [FS/16/14/32023] FX This study was funded by Marie Curie Research (Project Grant A15867). The funder was not involved in the design of the study, data collection, analysis, interpretation, writing of the manuscript or decision to submit for publication. Dr. Anand is supported by a clinical lectureship from the Chief Scientist Office (PCL/18/05). Prof. Weir was supported in this work by NHS Lothian via the Edinburgh Clinical Trials Unit. Prof. Mills is supported by the Butler Senior Research Fellowship (FS/16/14/32023) from the British Heart Foundation. 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PD MAR 13 PY 2020 VL 20 IS 1 AR 102 DI 10.1186/s12877-020-1500-9 PG 9 WC Geriatrics & Gerontology; Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA KV5FC UT WOS:000520507300001 PM 32164580 OA Green Published, gold DA 2023-05-13 ER PT J AU Dakhil, ZA Farhan, HA AF Dakhil, Zainab Atiyah Farhan, Hasan Ali TI Dropping risk stratification with subsequent treatment-risk paradox in non ST elevation acute coronary syndromes: a clinical audit in Iraq SO BMC HEALTH SERVICES RESEARCH LA English DT Article DE Audit; Guideline adherence; Healthcare policy; Middle East; Risk scores ID OUTCOMES; MANAGEMENT; INSIGHTS; STRATEGY AB Background Risk stratification is the cornerstone in managing patients with Non-ST Elevation Acute Coronary Syndromes (NSTE-ACS) and can attenuate the unjustified variability in treatment and guide the intervention decision notwithstanding its impact on better healthcare resources use. This study sought to disclose real adherence to guidelines in risk stratification of NSTE-ACS patients and in adopting intervention decision in practice. Methods Multicentre prospective study recruited NSTE-ACS patients. Baseline characteristics were collected, TIMI (Thrombolysis in Myocardial Infarction) and GRACE (Global Registry of Acute Coronary Events) scores were calculated, management strategy as well as timing to intervention were recorded. Results n. = 150, 72% of them were males, mean age was (59 +/- 12.32) years. TIMI score was calculated in 5.3% of patients with none of them had GRACE score calculated. Invasive strategy was adopted in 85.24 and 82.7% of low GRACE and TIMI risk categories respectively, while invasive approach used in 42.85 and 40% of high GRACE and TIMI risk categories respectively. The immediate intervention in less than 2 hours was more to be used in low-risk categories while the high-risk and very high-risk patients whom were managed invasively were catheterized within >72 h; or more frequently to be non-catheterized at all. Sixty percent of those with acute heart failure, 80.76% of those with ongoing chest pain, 85% of those with dynamic ST changes same as 80% of those with cardiogenic shock were treated conservatively. Using multivariable analysis older age, ongoing chest pain and cardiogenic shock predicted conservative approach. Conclusions There is striking underuse of risk scores in practice that can contribute to treatment-risk paradox in managing NSTE-ACS in form of depriving those with higher risk from invasive strategy despite being the most beneficiaries. The paradox did not only involve the very high-risk patients but also the very high-risk criteria like ongoing chest pain and cardiogenic shock predicted conservative approach, this highlights that the entire approach to patients with NSTE-ACS should be reconsidered, regardless of the use of risk scores in clinical practice. Audit programs activation in middle eastern countries can inform policymakers to put a limit to the treatment-risk paradox for better cardiovascular care and outcomes. C1 [Dakhil, Zainab Atiyah] Univ Baghdad, Dept Med, AI Kindy Coll Med, Baghdad, Iraq. [Farhan, Hasan Ali] Iraqi Scentif Council Cardiol, Iraqi Board Med Specializat, Baghdad, Iraq. [Farhan, Hasan Ali] Baghdad Heart Ctr Med City, Baghdad, Iraq. C3 University of Baghdad RP Dakhil, ZA (通讯作者),Univ Baghdad, Dept Med, AI Kindy Coll Med, Baghdad, Iraq. 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Res. PD SEP 26 PY 2021 VL 21 IS 1 AR 1015 DI 10.1186/s12913-021-07034-7 PG 9 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA UW1AY UT WOS:000699899100002 PM 34565377 OA Green Published, gold DA 2023-05-13 ER PT J AU Nilsson, S Wallbing, U Alfven, G Dalenius, K Fors, A Golsater, M Rosvall, PA Wigert, H Lundberg, M AF Nilsson, Stefan Wallbing, Ulrika Alfven, Gosta Dalenius, Kristina Fors, Andreas Golsater, Marie Rosvall, Per-Ake Wigert, Helena Lundberg, Mari TI Development of the Help Overcoming Pain Early (HOPE) Programme Built on a Person-Centred Approach to Support School Nurses in the Care of Adolescents with Chronic Pain-A Feasibility Study SO CHILDREN-BASEL LA English DT Article DE adolescent; chronic pain; person-centred care; school health care; stress ID ACUTE CORONARY SYNDROME; SEX-DIFFERENCES; HEALTH-SERVICES; MUSCLE PAIN; CHILDREN; SYMPTOMS; STRESS; DISABILITY; COMPLAINTS; CHILDHOOD AB Chronic pain and its consequences are major global health challenges, and the prevalence is increasing worldwide among adolescents. Adolescents spend most of their waking hours in school; however, there is limited research available on how school nurses can address chronic pain among adolescents in the Swedish school context. Therefore, we designed a person-centred intervention, known as Help Overcoming Pain Early (HOPE), to enable school nurses to offer adolescents strategies to manage their stress and pain. We used the Medical Research Council (MRC) framework for developing and designing this new complex intervention. For this study, we describe two of the four phases: (a) development and (b) feasibility and piloting. The final version of the HOPE programme consists of (i) an educational package for school nurses in the areas person-centred care, stress and pain education/management and gender perspective; and (ii) an intervention package for adolescents with chronic pain. The programme consists of four sessions during which adolescents with chronic pain have person-centred dialogues with a school nurse. The HOPE programme is based on the existing evidence of managing chronic pain and on the assumption that school nurses can support adolescents with chronic pain by using person-centred care. C1 [Nilsson, Stefan; Wallbing, Ulrika; Alfven, Gosta; Fors, Andreas; Wigert, Helena] Univ Gothenburg, Inst Hlth & Care Sci, S-40530 Gothenburg, Sweden. [Nilsson, Stefan; Wallbing, Ulrika; Alfven, Gosta; Fors, Andreas; Wigert, Helena] Univ Gothenburg, Ctr Person Ctr Care, Sahlgrenska Acad, S-40530 Gothenburg, Sweden. [Wallbing, Ulrika] Karolinska Inst, Dept Neurobiol Care & Sci & Soc, Div Physiotherapy, S-14152 Huddinge, Sweden. [Alfven, Gosta] Karolinska Inst, Clintec, S-14152 Huddinge, Sweden. [Dalenius, Kristina] Lerums Kommun, Sektor Larande, S-44380 Lerum, Sweden. [Fors, Andreas] Narhalsan Res & Dev Primary Hlth Care, SE-41118 Gothenburg, Sweden. [Golsater, Marie] Child Hlth Care & Futurum, S-55185 Jonkoping, Sweden. [Golsater, Marie] Jonkoping Univ, Sch Hlth & Welf, CHILD Res Grp, S-55111 Jonkoping, Sweden. [Rosvall, Per-Ake] Umea Univ, Dept Appl Educ Sci, S-90187 Umea, Sweden. [Lundberg, Mari] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Hlth & Rehabil, S-40530 Gothenburg, Sweden. C3 University of Gothenburg; University of Gothenburg; Karolinska Institutet; Karolinska Institutet; Futurum; Jonkoping University; Umea University; University of Gothenburg RP Nilsson, S (通讯作者),Univ Gothenburg, Inst Hlth & Care Sci, S-40530 Gothenburg, Sweden.; Nilsson, S (通讯作者),Univ Gothenburg, Ctr Person Ctr Care, Sahlgrenska Acad, S-40530 Gothenburg, Sweden. EM stefan.nilsson.4@gu.se OI Golsater, Marie/0000-0002-0156-6677; Nilsson, Stefan/0000-0002-8847-9559 FU GPCC, Sweden; Swedish government's grant for Strategic Research Areas, Care Sciences (Swedish Research Council) [2009-1088]; University of Gothenburg, Sweden FX This research was funded by GPCC, Sweden. GPCC is funded by the Swedish government's grant for Strategic Research Areas, Care Sciences (Swedish Research Council application no. 2009-1088). This study was also co-funded by the University of Gothenburg, Sweden. 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adult cardiology; myocardial infarction ID ACUTE MYOCARDIAL-INFARCTION; HYPERGLYCEMIA; INTERVENTION; OUTCOMES; INSULIN AB Objective The aim in this study was to stratify maximum blood glucose levels to identify the the best cut-off value of glucose levels to predict mortality in acute coronary syndrome (ACS) patients, regardless of whether they had diabetes. Design A retrospective cohort study. Setting All clinical data were obtained from the 'Medical Information Mart for Intensive Care III' database. Participants A total of 3078 patients with ACS were included in the study. We divided the patients into four levels based on their maximum blood glucose levels (glucose(max)), then analysed the relationship between each group with mortality. Results Among enrolled patients, 2780 and 298 were survivors and non-survivors, respectively. Blood glucose levels and mortality showed a 'tick' type relationship, with levels 3 and 4 found to be closely associated with increased hospital mortality (p<0.05), relative to level 1 (<6.1 mmol/L), used as the reference group. No significant association was observed in mortality between level 2 and level 1 (p=0.095). In addition, we found a gradual increase in OR for level 2 (OR: 2.42, 95% CI 0.86 to 6.80, p=0.095), level 3 (OR: 4.33, 95% CI 1.55 to 12.13, p=0.005) and level 4 (OR: 7.27, 95% CI 2.56 to 20.62, p<0.001), relative to level 1. Based on receiver operating characteristic curves, the optimal cut-off value for predicting mortality were 11.5 (area under curve (AUC)=0.724), 11.2 (AUC=0.729), 13.4 (AUC=0.638), 15.8 (AUC=0.717) and 11.3 mmol/L (AUC=0.764) in all ACS, acute myocardial infarction, unstable angina, diabetes and non-diabetes patients, respectively. The results of subgroup analysis suggested that in patients with significantly elevated blood glucose, the mortality of non-diabetes was higher than patients with diabetes (OR: 0.42, 95% CI 0.31 to 0.57, p<0.001). Conclusion Overall, glucose(max) >= 11.5 mmol/L had a significant association with increased mortality in patients with ACS. Non-diabetes ACS patients need a more robust blood glucose management strategy compared with diabetes counterparts. C1 [Qian, Jun; Che, Lin; Chen, Fei; Liu, Xuebo] Tongji Univ, Shanghai Tongji Hosp, Dept Cardiol, Sch Med, Shanghai, Peoples R China. [Kuang, Lijun] Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Ultrasound,Luwan Branch, Shanghai, Peoples R China. C3 Tongji University; Shanghai Jiao Tong University RP Chen, F; Liu, XB (通讯作者),Tongji Univ, Shanghai Tongji Hosp, Dept Cardiol, Sch Med, Shanghai, Peoples R China. EM riverapt@126.com; liuxb70@126.com FU National Natural Science Foundation of China [81670403]; Shanghai Science and Technology Committee [18411950300, 19XD1403300, 19411963200] FX This study was supported by the National Natural Science Foundation of China (Grant No. 81670403), Shanghai Science and Technology Committee (NO. 18411950300, 19XD1403300, and 19411963200). 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With improvements in technology, point-of-care testing (POCT) systems facilitate the efficient and high-throughput evaluation of biomarkers, such as troponin (cTn), brain natriuretic peptide (BNP) and neutrophil gelatinase-associated lipocalin (NGAL). In this context, POCT may help ED physicians to confirm a diagnosis of conditions, such as acute coronary syndrome, heart failure or kidney damage. Compared with classic laboratory methods, the use of cTn, BNP, and NGAL POCT has shown comparable sensitivity, specificity and failure rate, but with the potential to provide prompt and accurate diagnosis, shorten hospital stay, and alleviate the burden on the ED. Despite this potential, the full advantages of rapid delivery results will only be reached if POCT is implemented within hospital standardized procedures and ED staff receive appropriate training. C1 [Di Somma, Salvatore; Zampini, Giorgio; Vetrone, Francesco; Magrini, Laura; Cardelli, Patrizia] Univ Roma La Sapienza, St Andrea Hosp, Dept Med Sci & Translat Med, I-00189 Rome, Italy. [Soto-Ruiz, Karina M.] Baylor Coll Med, Houston, TX 77030 USA. [Ronco, Claudio] San Bortolo Hosp, Int Renal Res Inst IRRIV, Dept Nephrol Dialysis & Transplantat, Vicenza, Italy. [Maisel, Alan] Univ Calif San Diego, Med Ctr, Div Cardiol, San Diego, CA 92103 USA. [Peacock, Frank W.] Emergency Med Baylor Coll Med, Houston, TX USA. C3 Sapienza University Rome; Azienda Ospedaliera Sant'Andrea; Baylor College of Medicine; ULSS 8 Berica; Ospedale San Bortolo di Vicenza; University of California System; University of California San Diego RP Di Somma, S (通讯作者),Univ Roma La Sapienza, St Andrea Hosp, Dept Med Sci & Translat Med, Via Grottarossa 1035-1039, I-00189 Rome, Italy. 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Chem. Lab. Med. PD OCT PY 2014 VL 52 IS 10 BP 1401 EP 1407 DI 10.1515/cclm-2014-0267 PG 7 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA AO9NX UT WOS:000341683500004 PM 24864300 OA Green Submitted DA 2023-05-13 ER PT J AU Williams, BA Riangwiwat, T Voyce, S Blankenship, JC AF Williams, Brent A. Riangwiwat, Tanawan Voyce, Stephen Blankenship, James C. TI Burden and Predictors of Chest Pain-Related Health-Care Utilization Following Percutaneous Coronary Intervention SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID MEDICAL THERAPY; RECURRENT ANGINA; REVASCULARIZATION; INSIGHTS; PECTORIS; PATIENT; HEART AB Chest pain (CP) has been reported in 20% to 40% of patients 1 year after percutaneous coronary intervention (PCI), though rates of post-PCI health-care utilization (HCU) for CP in nonclinical trial populations are unknown. Furthermore, the contribution of noncardiac factors - such as pulmonary, gastrointestinal, and psychological - to post-PCI CP HCU is unclear. Accordingly, the objectives of this study were to describe long-term trajectories and identify predictors of post-PCI CP-related HCU in real-world patients undergoing PCI for any indication. This retrospective cohort study included patients receiving PCI for any indication from 2003 to 2017 through a single integrated healthcare system. Post-PCI CP-related HCU tracked through electronic medical records included (1) office visits, (2) emergency department (ED) visits, and (3) hospital admissions with CP or angina as the primary diagnosis. The strongest predictors of CP-related HCU were identified from >100 candidate variables. Among 6386 patients followed an average of 6.7 years after PCI, 73% received PCI for acute coronary syndrome (ACS), 19% for stable angina, and 8% for other indications. Post-PCI CP-related HCU was common with 26%, 16%, and 5% of patients having >= 1 office visits, ED visits, and hospital admissions for CP within 2 years of PCI. The following factors were significant predictors of all 3 CP outcomes: ACS presentation, documented CP >7 days prior to the index PCI, anxiety, depression, and syncope. In conclusion, CP-related HCU following PCI was common, especially within the first 2 years. The strongest predictors of CP-related HCU included coronary disease attributes and psychological factors. (C) 2021 Elsevier Inc. All rights reserved. C1 [Williams, Brent A.; Riangwiwat, Tanawan; Voyce, Stephen] Geisinger Hlth Syst, Danville, PA 17822 USA. [Blankenship, James C.] Univ New Mexico, Albuquerque, NM 87131 USA. C3 Geisinger Health System; University of New Mexico RP Williams, BA (通讯作者),Geisinger Hlth Syst, Danville, PA 17822 USA. EM bawilliams2@geisinger.edu OI riangwiwat, tanawan/0000-0002-8098-6257; Voyce, Stephen/0000-0002-2646-2129 FU Gilead Sciences, Inc. FX This study was funded by Gilead Sciences, Inc. Funding agency is located in Foster City, CA. CR Abdallah MS, 2017, J AM COLL CARDIOL, V69, P2039, DOI 10.1016/j.jacc.2017.02.031 Alexander KP, 2008, AM J CARDIOL, V102, P1301, DOI 10.1016/j.amjcard.2008.07.006 Arnold SV, 2016, CIRC-CARDIOVASC QUAL, V9, P554, DOI 10.1161/CIRCOUTCOMES.116.002781 Arnold SV, 2015, EUR HEART J-QUAL CAR, V1, P23, DOI 10.1093/ehjqcco/qcv010 Arnold SV, 2009, CIRC-CARDIOVASC QUAL, V2, P344, DOI 10.1161/CIRCOUTCOMES.108.829523 Ben-Yehuda O, 2016, CATHETER CARDIO INTE, V88, P1017, DOI 10.1002/ccd.26365 Bhatt DL, 2018, JAMA-J AM MED ASSOC, V319, P2127, DOI 10.1001/jama.2018.5281 Boden WE, 2007, NEW ENGL J MED, V356, P1503, DOI 10.1056/NEJMoa070829 Borden WB, 2011, JAMA-J AM MED ASSOC, V305, P1882, DOI 10.1001/jama.2011.601 Camm AJ, 2015, INT J CARDIOL, V201, P200, DOI 10.1016/j.ijcard.2015.08.045 Fanaroff AC, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.007007 Gaglia MA, 2016, AM J CARDIOL, V117, P526, DOI 10.1016/j.amjcard.2015.11.036 Holubkov R, 2002, AM HEART J, V144, P826, DOI 10.1067/mhj.2002.125505 Izzoi P, 2012, EUR HEART J-ACUTE CA, V1, P158, DOI 10.1177/2048872612449111 Manolis AJ, 2016, INT J CARDIOL, V220, P445, DOI 10.1016/j.ijcard.2016.06.150 Masoudi FA, 2013, J AM COLL CARDIOL, V62, P1931, DOI 10.1016/j.jacc.2013.05.099 Niccoli G, 2017, INT J CARDIOL, V248, P14, DOI 10.1016/j.ijcard.2017.07.105 Pinho-Gomes AC, 2018, J AM COLL CARDIOL, V71, P591, DOI 10.1016/j.jacc.2017.11.068 Qintar M, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.006405 Shafiq A, 2016, AM HEART J, V175, P94, DOI 10.1016/j.ahj.2016.02.015 Venkitachalam L, 2009, CIRC-CARDIOVASC QUAL, V2, P607, DOI 10.1161/CIRCOUTCOMES.109.869131 Vora AN, 2016, CIRC-CARDIOVASC INTE, V9, DOI 10.1161/CIRCINTERVENTIONS.115.003070 Weintraub WS, 2016, JAMA INTERN MED, V176, P1190, DOI 10.1001/jamainternmed.2016.3071 NR 23 TC 1 Z9 1 U1 1 U2 2 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD DEC 1 PY 2021 VL 160 BP 31 EP 39 DI 10.1016/j.amjcard.2021.07.051 EA NOV 2021 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA WV8IX UT WOS:000717475200005 PM 34740394 DA 2023-05-13 ER PT J AU Schoenmakers, S Snijder, P Verdijk, RM Kuiken, T Kamphuis, SSM Koopman, LP Krasemann, TB Rousian, M Broekhuizen, M Steegers, EAP Koopmans, MPG Fraaij, PLA Reiss, IKM AF Schoenmakers, Sam Snijder, Pauline Verdijk, Robert M. Kuiken, Thijs Kamphuis, Sylvia S. M. Koopman, Laurens P. Krasemann, Thomas B. Rousian, Melek Broekhuizen, Michelle Steegers, Eric A. P. Koopmans, Marion P. G. Fraaij, Pieter L. A. Reiss, Irwin K. M. TI Severe Acute Respiratory Syndrome Coronavirus 2 Placental Infection and Inflammation Leading to Fetal Distress and Neonatal Multi-Organ Failure in an Asymptomatic Woman SO JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY LA English DT Article DE fetal distress; inflammation; Kawasaki-like syndrome; placenta; SARS-CoV-2 ID KAWASAKI-DISEASE; TRANSMISSION; COVID-19 AB Background. In general, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is not considered to be an increased risk for severe maternal outcomes but has been associated with an increased risk for fetal distress. Maternal-fetal transmission of SARS-CoV-2 was initially deemed uncertain; however, recently a few cases of vertical transmission have been reported. The intrauterine mechanisms, besides direct vertical transmission, leading to the perinatal adverse outcomes are not well understood. Methods. Multiple maternal, placental, and neonatal swabs were collected for the detection of SARS-CoV-2 using real-time quantitative polymerase chain reaction (RT-qPCR). Serology of immunoglobulins against SARS-CoV-2 was tested in maternal, umbilical cord, and neonatal blood. Placental examination included immunohistochemical investigation against SARS-CoV-2 antigen expression, with SARS-CoV-2 ribonucleic acid (RNA) in situ hybridization and transmission electron microscopy. Results. RT-qPCRs of the oropharynx, maternal blood, vagina, placenta, and urine were all positive over a period of 6 days, while breast milk, feces, and all neonatal samples tested negative. Placental findings showed the presence of SARS-CoV-2 particles with generalized inflammation characterized by histiocytic intervillositis with diffuse perivillous fibrin depositions with damage to the syncytiotrophoblasts. Conclusions. Placental infection by SARS-CoV-2 leads to fibrin depositions hampering fetal-maternal gas exchange with resulting fetal distress necessitating a premature emergency cesarean section. Postpartum, the neonate showed a fetal or pediatric inflammatory multisystem-like syndrome with coronary artery ectasia temporarily associated with SARS-CoV-2 for which admittance and care on the neonatal intensive care unit (NICU) were required, despite being negative for SARS-CoV-2. This highlights the need for awareness of adverse fetal and neonatal outcomes during the current coronavirus disease 2019 pandemic, especially considering that the majority of pregnant women appear asymptomatic. C1 [Schoenmakers, Sam; Rousian, Melek; Steegers, Eric A. P.] Erasmus MC, Dept Obstet & Gynaecol, Dr Molewaterpl 40,3015 GD,PO 2060, NL-3000 CR Rotterdam, Netherlands. [Snijder, Pauline; Broekhuizen, Michelle; Reiss, Irwin K. M.] Erasmus MC, Dept Neonatol, Rotterdam, Netherlands. [Verdijk, Robert M.] Erasmus MC, Dept Pathol, Rotterdam, Netherlands. [Kuiken, Thijs; Koopmans, Marion P. G.; Fraaij, Pieter L. A.] Erasmus MC, Dept Virosci, Rotterdam, Netherlands. [Kamphuis, Sylvia S. M.; Fraaij, Pieter L. A.] Erasmus MC, Dept Pediat Infectiol Immunol & Rheumatol, Rotterdam, Netherlands. [Koopman, Laurens P.; Krasemann, Thomas B.] Erasmus MC, Dept Pediat Cardiol, Rotterdam, Netherlands. [Broekhuizen, Michelle] Erasmus MC, Dept Pharmacol & Vasc Med, Rotterdam, Netherlands. C3 Erasmus University Rotterdam; Erasmus MC; Erasmus University Rotterdam; Erasmus MC; Erasmus University Rotterdam; Erasmus MC; Erasmus University Rotterdam; Erasmus MC; Erasmus University Rotterdam; Erasmus MC; Erasmus University Rotterdam; Erasmus MC; Erasmus University Rotterdam; Erasmus MC RP Schoenmakers, S (通讯作者),Erasmus MC, Dept Obstet & Gynaecol, Dr Molewaterpl 40,3015 GD,PO 2060, NL-3000 CR Rotterdam, Netherlands. EM s.schoenmakers@erasmusmc.nl RI Schoenmakers, Sam/ACO-9196-2022; Koopmans, Marion/Y-9170-2019; Kamphuis, Sylvia/AAJ-8195-2020; Fraaij, Pieter/AAU-9783-2021 OI Koopmans, Marion/0000-0002-5204-2312; Kamphuis, Sylvia/0000-0002-1964-352X; Krasemann, Thomas/0000-0003-4900-1576 FU European Union Commission COVID 19 grant [RECoVER 101003589] FX This work was supported by the European Union Commission COVID 19 grant (RECoVER 101003589) to P.F. 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PD MAY PY 2021 VL 10 IS 5 BP 556 EP 561 DI 10.1093/jpids/piaa153 PG 6 WC Infectious Diseases; Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Infectious Diseases; Pediatrics GA SS1GN UT WOS:000661489700002 PM 33367801 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Mokhtar, AT Baghaffar, A Jackson, SD Horne, D AF Mokhtar, Ahmed T. Baghaffar, Abdullah Jackson, Simon D. Horne, David TI When is the optimal time to discontinue clopidogrel before in-hospital coronary bypass surgery? A closer look at the current literature SO JOURNAL OF CARDIAC SURGERY LA English DT Review DE antiplatelet; bleeding; clopidogrel; surgery ID ELEVATION MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; ANTIPLATELET THERAPY; ORAL ANTIPLATELET; GRAFT-SURGERY; AMERICAN-COLLEGE; UNSTABLE ANGINA; 2012 UPDATE; ASPIRIN; TICAGRELOR AB Background Clopidogrel and other P2Y12 inhibitors have become the standard of care among patients presenting with acute coronary syndromes. A substantial proportion of these patients require surgical revascularization during index hospitalization. Hypothesis Guidelines recommend a 5-day waiting period off clopidogrel before coronary artery bypass grafting (CABG) to reduce hemorrhagic complications. These recommendations are not routinely followed in clinical practice, while recent studies also propose shorter waiting periods off clopidogrel for patients awaiting in-hospital CABG. Methods A preliminary PubMed search was conducted using the following MeSH terms under the publication type "Hemorrhage:" "Clopidogrel," AND "Coronary Artery Bypass." Relevant studies and guidelines were then reviewed and selected based on a predetermined criteria. Studies that formulated the current recommendations for stopping clopidogrel preoperative to CABG are discussed in detail this review. Results A comprehensive review of recent evidence illustrates mixed bleeding and transfusion outcomes among CABG patients with preoperative exposure to clopidogrel in less than 5 days. Conclusions The optimal discontinuation time of clopidogrel before CABG is still poorly defined. The recommendation of a 5-day washout period for clopidogrel should be reconsidered to be on par with current clinical practice. C1 [Mokhtar, Ahmed T.; Jackson, Simon D.] Dalhousie Univ, Dept Med, Div Cardiol, Halifax, NS, Canada. [Mokhtar, Ahmed T.] King Abdulaziz Univ, Dept Med, Jeddah, Saudi Arabia. [Baghaffar, Abdullah; Horne, David] Dalhousie Univ, Dept Surg, Div Cardiac Surg, Halifax, NS, Canada. C3 Dalhousie University; King Abdulaziz University; Dalhousie University RP Horne, D (通讯作者),IWK, Div Cardiovasc Surg, 2nd Floor Childrens Site,POB 9700, Halifax, NS B3K 6R8, Canada. EM David.horne@iwk.nshealth.ca OI Mokhtar, Ahmed/0000-0002-6685-1137 CR Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2713, DOI [10.1016/j.jacc.2014.10.011, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.09.017] Amsterdam EA, 2014, CIRCULATION, V130, P2354, DOI 10.1161/CIR.0000000000000133 Berger JS, 2008, J AM COLL CARDIOL, V52, P1693, DOI 10.1016/j.jacc.2008.08.031 Biancari F, 2012, J THORAC CARDIOV SUR, V143, P665, DOI 10.1016/j.jtcvs.2011.01.069 Braunwald E, 2002, J AM COLL CARDIOL, V40, P1366, DOI 10.1016/S0735-1097(02)02336-7 Cao C, 2014, J THORAC CARDIOV SUR, V148, P3092, DOI 10.1016/j.jtcvs.2014.04.054 Chen ZM, 2005, LANCET, V366, P1607, DOI 10.1016/s0140-6736(05)67660-x Chu MWA, 2004, ANN THORAC SURG, V78, P1536, DOI 10.1016/j.athoracsur.2004.03.028 Chua D, 2005, NEW ENGL J MED, V352, P2647 Collet JP, 2004, CIRCULATION, V110, P2361, DOI 10.1161/01.CIR.0000145171.89690.B4 DiNicolantonio JJ, 2013, INT J CARDIOL, V168, P1739, DOI 10.1016/j.ijcard.2013.06.135 Ebrahimi R, 2009, J AM COLL CARDIOL, V53, P1965, DOI 10.1016/j.jacc.2009.03.006 Ferraris VA, 2012, ANN THORAC SURG, V94, P1761, DOI 10.1016/j.athoracsur.2012.07.086 Firanescu CE, 2009, EUR J CARDIO-THORAC, V36, P856, DOI 10.1016/j.ejcts.2009.05.032 Fox KAA, 2007, HEART, V93, P177, DOI 10.1136/hrt.2005.084830 Fox KAA, 2004, CIRCULATION, V110, P1202, DOI 10.1161/01.CIR.0000140675.85342.1B Hansson EC, 2016, EUR HEART J, V37, P189, DOI 10.1093/eurheartj/ehv381 Held C, 2011, J AM COLL CARDIOL, V57, P672, DOI 10.1016/j.jacc.2010.10.029 Herman CR, 2010, ANN THORAC SURG, V89, P397, DOI 10.1016/j.athoracsur.2009.10.051 Hillis LD, 2011, J AM COLL CARDIOL, V58, pE123, DOI 10.1016/j.jacc.2011.08.009 Hirsh J, 2004, ARCH INTERN MED, V164, P2106, DOI 10.1001/archinte.164.19.2106 Hobl EL, 2014, J AM COLL CARDIOL, V63, P630, DOI 10.1016/j.jacc.2013.10.068 Kim JHJ, 2008, AM HEART J, V156, P886, DOI 10.1016/j.ahj.2008.06.034 Leong JY, 2005, ANN THORAC SURG, V80, P928, DOI 10.1016/j.athoracsur.2005.03.074 Leunissen TC, 2016, VASC PHARMACOL, V77, P19, DOI 10.1016/j.vph.2015.12.002 Levine GN, 2005, CATHETER CARDIO INTE, V66, P149, DOI 10.1002/ccd.20469 Mahla E, 2012, CIRC-CARDIOVASC INTE, V5, P261, DOI 10.1161/CIRCINTERVENTIONS.111.967208 McLean DS, 2007, J THROMB THROMBOLYS, V24, P85, DOI 10.1007/s11239-007-0016-x Mega JL, 2015, LANCET, V386, P281, DOI 10.1016/S0140-6736(15)60243-4 Mehta RH, 2006, J AM COLL CARDIOL, V48, P281, DOI 10.1016/j.jacc.2006.04.029 Mishkel GJ, 1999, J AM COLL CARDIOL, V34, P1884, DOI 10.1016/S0735-1097(99)00443-X Nijjer SS, 2011, EUR HEART J, V32, P2970, DOI 10.1093/eurheartj/ehr151 O'Donoghue M, 2006, CIRCULATION, V114, pE600, DOI 10.1161/CIRCULATIONAHA.106.643171 Parikh SV, 2010, JACC-CARDIOVASC INTE, V3, P419, DOI 10.1016/j.jcin.2010.01.012 Purkayastha S, 2006, HEART, V92, P531, DOI 10.1136/hrt.2004.058396 Reed GW, 2015, CLIN CARDIOL, V38, P92, DOI 10.1002/clc.22357 Savcic M, 1999, SEMIN THROMB HEMOST, V25, P15 Steinhubl SR, 2002, JAMA-J AM MED ASSOC, V288, P2411, DOI 10.1001/jama.288.19.2411 Tanguay JF, 2013, CAN J CARDIOL, V29, P1334, DOI 10.1016/j.cjca.2013.07.001 Varenhorst C, 2012, J AM COLL CARDIOL, V60, P1623, DOI 10.1016/j.jacc.2012.07.021 Vorobcsuk A, 2012, INT J CARDIOL, V156, P34, DOI 10.1016/j.ijcard.2010.10.034 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Weidinger F, 2016, EUR HEART J, V37, P198, DOI 10.1093/eurheartj/ehv469 Windecker S., 2014, EUR HEART J, V35, P2541, DOI [10.1093/eurheartj/ehu278, DOI 10.1093/EURHEARTJ/EHU278] Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 Wurtz M, 2013, J THROMB HAEMOST, V11, P1627, DOI 10.1111/jth.12318 Yusuf S, 2001, NEW ENGL J MED, V345, P494 NR 47 TC 0 Z9 0 U1 0 U2 5 PU WILEY-HINDAWI PI LONDON PA ADAM HOUSE, 3RD FL, 1 FITZROY SQ, LONDON, WIT 5HE, ENGLAND SN 0886-0440 EI 1540-8191 J9 J CARDIAC SURG JI J. Card. Surg. PD FEB PY 2020 VL 35 IS 2 BP 413 EP 421 DI 10.1111/jocs.14371 EA DEC 2019 PG 9 WC Cardiac & Cardiovascular Systems; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Surgery GA KF3VO UT WOS:000500589600001 PM 31803992 OA gold DA 2023-05-13 ER PT J AU Ellis, KL Pang, J Chieng, D Bell, DA Burnett, JR Schultz, CJ Hillis, GS Watts, GF AF Ellis, Katrina L. Pang, Jing Chieng, David Bell, Damon A. Burnett, John R. Schultz, Carl J. Hillis, Graham S. Watts, Gerald F. TI Elevated lipoprotein(a) and familial hypercholesterolemia in the coronary care unit: Between Scylla and Charybdis SO CLINICAL CARDIOLOGY LA English DT Article ID MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; TARGETING APOLIPOPROTEIN(A); ARTERY-DISEASE; RISK-FACTORS; DOUBLE-BLIND; PREVALENCE; IMPACT; IDENTIFICATION; PREDICTORS AB BackgroundElevated lipoprotein(a) (Lp[a]) and familial hypercholesterolemia (FH) are inherited lipid disorders. Their frequencies, coexistence, and associations with premature coronary artery disease (CAD) in patients admitted to the coronary care unit (CCU) remain to be defined. HypothesisElevated Lp(a) and FH are commonly encountered among CCU patients and independently associated with increased premature CAD risk. MethodsPlasma Lp(a) concentrations were measured in consecutive patients admitted to the CCU with an acute coronary syndrome (ACS) or prior history of CAD for 6.5months. Elevated Lp(a) was defined as concentrations 0.5g/L. Patients with LDL-C5mmol/L exhibited phenotypic FH. Premature CAD was diagnosed in those age<60years, and the relationship between this and elevated Lp(a) and FH was determined by logistic regression. Results316 patients were screened; 163 (51.6%) had premature CAD. Overall, elevated Lp(a) and FH were identified in 27.0% and 11.6% of patients, respectively. Both disorders were detected in 4.4% of individuals. Elevated Lp(a) (32.0% vs 22.2%; P=0.019) and FH phenotype (15.5% vs 8.0%; P=0.052) were more common with premature vs nonpremature CAD. Elevated Lp(a) alone conferred a 1.9-fold, FH alone a 3.2-fold, and the combination a 5.3-fold increased risk of premature CAD (P=0.005). ConclusionsElevated Lp(a) and phenotypic FH were commonly encountered and more frequent with premature CAD. The combination of both disorders is especially associated with increased CAD risk. Patients admitted to the CCU with ACS or previously documented CAD should be routinely screened for elevated Lp(a) and FH. C1 [Ellis, Katrina L.; Pang, Jing; Bell, Damon A.; Burnett, John R.; Schultz, Carl J.; Hillis, Graham S.; Watts, Gerald F.] Univ Western Australia, Sch Med, Perth, WA, Australia. [Ellis, Katrina L.] Univ Western Australia, Sch Biomed Sci, Perth, WA, Australia. [Chieng, David; Bell, Damon A.; Schultz, Carl J.; Hillis, Graham S.; Watts, Gerald F.] Royal Perth Hosp, Dept Cardiol, Perth, WA, Australia. [Burnett, John R.] Royal Perth Hosp, Dept Clin Biochem, PathWest Lab Med WA, Perth, WA, Australia. [Burnett, John R.] Fiona Stanley Hosp Network, Perth, WA, Australia. C3 University of Western Australia; University of Western Australia; Royal Perth Hospital; University of Western Australia; Royal Perth Hospital RP Watts, GF (通讯作者),Royal Perth Hosp, Dept Cardiol, Lipid Disorders Clin, POB X2213, Perth, WA 6847, Australia.; Watts, GF (通讯作者),Univ Western Australia, Fac Med & Hlth Sci, Sch Med, POB X2213, Perth, WA 6847, Australia. EM gerald.watts@uwa.edu.au RI Pang, Jing/T-6397-2019; Watts, Gerald/HII-8530-2022; Schultz, Carl/G-3557-2011 OI Pang, Jing/0000-0002-9700-6948; Schultz, Carl/0000-0002-0847-4361; Ellis, Katrina/0000-0002-8871-2672; Watts, Gerald/0000-0003-2276-1524; Bell, Damon/0000-0002-6592-6184 FU Royal Perth Hospital Medical Research Foundation; Raine Medical Research Foundation FX Royal Perth Hospital Medical Research Foundation, Grant/Award number: N/A; Raine Medical Research Foundation, Grant/Award number: N/A CR Ademi Z, 2014, J CLIN LIPIDOL, V8, P390, DOI 10.1016/j.jacl.2014.05.008 Alonso R, 2016, ATHEROSCLEROSIS, V254, P249, DOI 10.1016/j.atherosclerosis.2016.08.038 Alonso R, 2014, J AM COLL CARDIOL, V63, P1983, DOI 10.1016/j.jacc.2014.01.063 Catapano AL, 2016, ATHEROSCLEROSIS, V253, P281, DOI 10.1016/j.atherosclerosis.2016.08.018 Chan DC, 2015, INT J CARDIOL, V201, P633, DOI 10.1016/j.ijcard.2015.08.146 Clarke R, 2009, NEW ENGL J MED, V361, P2518, DOI 10.1056/NEJMoa0902604 Ellis KL, 2017, PROG LIPID RES, V68, P57, DOI 10.1016/j.plipres.2017.09.001 Ellis KL, 2016, NAT REV ENDOCRINOL, V12, P467, DOI 10.1038/nrendo.2016.69 Erqou S, 2009, JAMA-J AM MED ASSOC, V302, P412, DOI 10.1001/jama.2009.1063 FRIEDEWALD WT, 1972, CLIN CHEM, V18, P499 Haralambos K, 2015, ATHEROSCLEROSIS, V240, P190, DOI 10.1016/j.atherosclerosis.2015.03.003 Jacobson TA, 2015, J CLIN LIPIDOL, V9, P129, DOI 10.1016/j.jacl.2015.02.003 Jansen ACM, 2004, J INTERN MED, V256, P482, DOI 10.1111/j.1365-2796.2004.01405.x Kamstrup PR, 2008, CIRCULATION, V117, P176, DOI 10.1161/CIRCULATIONAHA.107.715698 Kamstrup PR, 2009, JAMA-J AM MED ASSOC, V301, P2331, DOI 10.1001/jama.2009.801 Khera AV, 2016, NEW ENGL J MED, V375, P2349, DOI 10.1056/NEJMoa1605086 Khera AV, 2016, J AM COLL CARDIOL, V67, P2578, DOI 10.1016/j.jacc.2016.03.520 Kinpara K, 2011, CLIN CHIM ACTA, V412, P1783, DOI 10.1016/j.cca.2011.05.036 Langsted A, 2016, LANCET DIABETES ENDO, V4, P577, DOI 10.1016/S2213-8587(16)30042-0 Lazaro P, 2017, J CLIN LIPIDOL, V11, P260, DOI 10.1016/j.jacl.2017.01.002 Li S, 2016, J CLIN LIPIDOL, V10, P1344, DOI 10.1016/j.jacl.2016.08.013 Lloyd-Jones DM, 2010, CIRCULATION, V121, P586, DOI 10.1161/CIRCULATIONAHA.109.192703 Marcovina SM, 2000, CLIN CHEM, V46, P1956 Mortensen MB, 2016, J CLIN LIPIDOL, V10, P1145, DOI 10.1016/j.jacl.2016.06.002 Nanchen D, 2016, CIRCULATION, V134, P698, DOI 10.1161/CIRCULATIONAHA.116.023007 Nordestgaard BG, 2013, EUR HEART J, V34, P3478, DOI 10.1093/eurheartj/eht273 Nordestgaard BG, 2010, EUR HEART J, V31, P2844, DOI 10.1093/eurheartj/ehq386 Pang J, 2015, J CLIN LIPIDOL, V9, P703, DOI 10.1016/j.jacl.2015.07.005 Perak AM, 2016, CIRCULATION, V134, P9, DOI 10.1161/CIRCULATIONAHA.116.022335 de Isla LP, 2017, CIRCULATION, V135, P2133, DOI 10.1161/CIRCULATIONAHA.116.024541 Perrot N, 2017, ATHEROSCLEROSIS, V256, P47, DOI 10.1016/j.atherosclerosis.2016.11.010 Rallidis LS, 2016, ATHEROSCLEROSIS, V249, P17, DOI 10.1016/j.atherosclerosis.2016.03.023 Rerup SA, 2016, AM HEART J, V181, P35, DOI 10.1016/j.ahj.2016.08.001 Tsimikas S, 2015, LANCET, V386, P1472, DOI 10.1016/S0140-6736(15)61252-1 Viney NJ, 2016, LANCET, V388, P2239, DOI 10.1016/S0140-6736(16)31009-1 Weiss MC, 2017, J CLIN LIPIDOL, V11, P1177, DOI 10.1016/j.jacl.2017.07.005 Zafrir B, 2016, J CLIN LIPIDOL, V10, P1338, DOI 10.1016/j.jacl.2016.08.010 NR 37 TC 22 Z9 22 U1 0 U2 1 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0160-9289 EI 1932-8737 J9 CLIN CARDIOL JI Clin. Cardiol. PD MAR PY 2018 VL 41 IS 3 BP 378 EP 384 DI 10.1002/clc.22880 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GB1YA UT WOS:000428846300018 PM 29480541 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Collet, JP Cayla, G Ennezat, PV Leclercq, F Cuisset, T Elhadad, S Henry, P Belle, L Cohen, A Silvain, J Barthelemy, O Beygui, F Diallo, A Vicaut, E Montalescot, G AF Collet, Jean-Philippe Cayla, Guillaume Ennezat, Pierre-Vladimir Leclercq, Florence Cuisset, Thomas Elhadad, Simon Henry, Patrick Belle, Loic Cohen, Ariel Silvain, Johanne Barthelemy, Olivier Beygui, Farzin Diallo, Abdourahmane Vicaut, Eric Montalescot, Gilles CA AMERICA Investigators TI Systematic detection of polyvascular disease combined with aggressive secondary prevention in patients presenting with severe coronary artery disease: The randomized AMERICA Study SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Myocardial infarction; Atherothrombosis; Coronary artery disease ID MYOCARDIAL-INFARCTION; VASCULAR-DISEASE; RISK-FACTORS; DOUBLE-BLIND; EVENT RATES; PREVALENCE; ASSOCIATION; OUTCOMES; METAANALYSIS; OUTPATIENTS AB Background: The prevalence and associated-risk of asymptomatic multisite artery disease (MSAD) in high risk coronary patients are unknown. Whether systematic identification and aggressive management of asymptomatic MSAD is clinically relevant in high risk coronary patients has not been evaluated. Methods: We randomly assigned 521 high risk coronary patients defined by the presence of three-vessel coronary disease (n=304) or recent acute coronary syndrome beyond the age of 75 years (n=215) to either a strategy of systematic detection of asymptomatic MSAD combined with an aggressive secondary prevention (n = 263) or to a more conventional strategy based on treatment of coronary artery disease only with standard of care (n = 258). The primary end point was the time to first occurrence of death, any organ failure or ischemic event leading to re-hospitalization through two years of follow-up. Results: The pro-active strategy identified asymptomatic MSAD in 21.7% of patients with few revascularizations (3.6%); the pro-active pharmacological secondary prevention was obtained in >85% of patients and life-style changes in <60% of patients. At 2-year follow-up, the primary end point occurred in 44.9% of patients in the pro-active group and 43.0% of patients in the conventional group (HR 1.03; 95% confidence interval [CI], 0.80 to 1.34]. The rate of major bleeding did not differ significantly between groups (4.6% vs 5.0%; HR, 0.97; 95% CI, 0.40 to 1.91). Conclusion: In high risk coronary patients, there is no apparent benefit of a systematic detection of asymptomatic extra-coronary atherothrombotic disease and intensified treatment over a 2-year follow-up period. (c) 2017 Elsevier B.V. All rights reserved. C1 [Collet, Jean-Philippe; Silvain, Johanne; Barthelemy, Olivier; Montalescot, Gilles] Sorbonne Univ Paris 6, Hop Pitie Salpetriere, AP HP, ACTION Study Grp,Inst Cardiol,INSERM UMRS 1166, Paris, France. [Cayla, Guillaume] Univ Montpellier, CHU Caremeau, ACTION Study Grp, Cardiol, Nimes, France. [Ennezat, Pierre-Vladimir] CHU La Tronche, Pole Thorax & Vaisseaux, Cardiol, Grenoble, France. [Leclercq, Florence] CHU Montpellier, Hop Arnaud de Villeneuve, Cardiol, Montpellier, France. [Cuisset, Thomas] CHU Timone, Dept Cardiol, F-13385 Marseille, France. [Cuisset, Thomas] Aix Marseille Univ, INSERM UMR1062, INRA UMR1260, Nutr Obes & Risk Thrombosis,Fac Med, F-13385 Marseille, France. [Elhadad, Simon] CH Lagny Marne Vallee, Cardiol, Jossigny, France. [Henry, Patrick] CHU Lariboisiere, AP HP, Cardiol, Paris, France. [Belle, Loic] Ctr Hosp Annecy, Cardiol, Metz Tessy, France. [Cohen, Ariel] CHU St Antoine, AP HP, Cardiol, Paris, France. [Beygui, Farzin] Hop Cote Nacre, Cardiol, Caen, France. [Diallo, Abdourahmane; Vicaut, Eric] Hop Lariboisiere, AP HP, Unite Rech Clin, ACTION Study Grp, Paris, France. [Diallo, Abdourahmane; Vicaut, Eric] Univ Paris 07, Paris, France. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Universite de Montpellier; CHU de Nimes; CHU Grenoble Alpes; Universite de Montpellier; CHU de Montpellier; UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille; INRAE; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Centre Hospitalier Annecy Genevois; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; CHU de Caen NORMANDIE; Universite de Caen Normandie; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; UDICE-French Research Universities; Universite Paris Cite RP Collet, JP (通讯作者),Pitie Salpetriere Univ Hosp, Bur 236, Inst Cardiol, ACTION Study Grp, 47 Blvd Hop, F-75013 Paris, France. EM jean-philippe.collet@psl.aphp.fr RI ; SILVAIN, Johanne/C-7521-2016 OI ELHADAD, Simon/0000-0002-3540-0616; SILVAIN, Johanne/0000-0002-1901-2808 FU Academic Allies in Cardiovascular Trials Initiatives and Organized Networks; Institut de l'Atherothrombose; AMERICA [NCT00445835] FX Academic Allies in Cardiovascular Trials Initiatives and Organized Networks and Institut de l'Atherothrombose; AMERICA ClinicalTrials. gov number, NCT00445835. CR Aboyans V., 2015, PANVASCULAR MED, P4779, DOI [10.1007/978-3-642-37393-0_213-1, DOI 10.1007/978-3-642-37078-6_213] Aboyans V, 2018, EUR HEART J, V39, P763, DOI 10.1093/eurheartj/ehx095 Alberts MJ, 2009, EUR HEART J, V30, P2318, DOI 10.1093/eurheartj/ehp355 Beygui F, 2016, J AM COLL CARDIOL, V67, P1917, DOI 10.1016/j.jacc.2016.02.033 Bhatt DL, 2006, JAMA-J AM MED ASSOC, V295, P180, DOI 10.1001/jama.295.2.180 Bonaca MP, 2015, NEW ENGL J MED, V372, P1791, DOI 10.1056/NEJMoa1500857 Bonaca MP, 2013, CIRCULATION, V127, P1522, DOI 10.1161/CIRCULATIONAHA.112.000679 Cannon CP, 2015, NEW ENGL J MED, V372, P2387, DOI 10.1056/NEJMoa1410489 Cohen A, 2014, JAMA INTERN MED, V174, P40, DOI 10.1001/jamainternmed.2013.11342 Collet JP, 2005, ARCH MAL COEUR VAISS, V98, P31 CUPPLES LA, 1993, AM HEART J, V125, P863, DOI 10.1016/0002-8703(93)90182-9 Ferrieres J, 2006, INT J CARDIOL, V112, P302, DOI 10.1016/j.ijcard.2005.09.024 Ford ES, 2007, NEW ENGL J MED, V356, P2388, DOI 10.1056/NEJMsa053935 Gellert C, 2012, ARCH INTERN MED, V172, P837, DOI 10.1001/archinternmed.2012.1397 Johnston SC, 2016, NEW ENGL J MED, V375, P35, DOI 10.1056/NEJMoa1603060 Laclaustra M, 2016, J AM COLL CARDIOL, V67, P1263, DOI 10.1016/j.jacc.2015.12.056 Martin BJ, 2012, CIRCULATION, V126, P677, DOI 10.1161/CIRCULATIONAHA.111.066738 Montalescot G, 2014, EUR HEART J, V35, P2295, DOI 10.1093/eurheartj/ehu164 Naylor AR, 2009, EUR J VASC ENDOVASC, V37, P379, DOI 10.1016/j.ejvs.2008.12.011 Pfisterer M, 2003, JAMA-J AM MED ASSOC, V289, P1117, DOI 10.1001/jama.289.9.1117 Poredos P, 2007, ANGIOLOGY, V58, P309, DOI 10.1177/0003319707302494 SALASIDIS GC, 1995, J VASC SURG, V21, P154, DOI 10.1016/S0741-5214(95)70254-7 Savji N, 2013, J AM COLL CARDIOL, V61, P1736, DOI 10.1016/j.jacc.2013.01.054 SCHWARTZ LB, 1995, J VASC SURG, V21, P146, DOI 10.1016/S0741-5214(95)70253-9 Steg PG, 2007, JAMA-J AM MED ASSOC, V297, P1197, DOI 10.1001/jama.297.11.1197 Steinvil A, 2011, J AM COLL CARDIOL, V57, P779, DOI 10.1016/j.jacc.2010.09.047 Subherwal S, 2012, CIRC-CARDIOVASC QUAL, V5, P541, DOI 10.1161/CIRCOUTCOMES.111.964379 Tendera M, 2012, TURK KARDIYOL DERN A, V40, P5, DOI 10.1093/eurheartj/ehr211 Udell JA, 2016, EUR HEART J, V37, P390, DOI 10.1093/eurheartj/ehv443 Wald NJ, 1999, BMJ-BRIT MED J, V319, P1562, DOI 10.1136/bmj.319.7224.1562 Williams B, 2015, LANCET, V386, P2059, DOI 10.1016/S0140-6736(15)00257-3 Wilson WM, 2011, AM J CARDIOL, V108, P936, DOI 10.1016/j.amjcard.2011.05.024 Windecker S, 2014, EUR HEART J, V35, P2541, DOI [10.5603/KP.2014.0224, 10.1093/eurheartj/ehu278, 10.1093/ejcts/ezu366] NR 33 TC 19 Z9 21 U1 0 U2 2 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD MAR 1 PY 2018 VL 254 BP 36 EP 42 DI 10.1016/j.ijcard.2017.11.081 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FV4AB UT WOS:000424514800006 PM 29407124 DA 2023-05-13 ER PT J AU Stokes, EA Doble, B Pufulete, M Reeves, BC Bucciarelli-Ducci, C Dorman, S Greenwood, JP Anderson, RA Wordsworth, S AF Stokes, Elizabeth A. Doble, Brett Pufulete, Maria Reeves, Barnaby C. Bucciarelli-Ducci, Chiara Dorman, Stephen Greenwood, John P. Anderson, Richard A. Wordsworth, Sarah TI Cardiovascular magnetic resonance in emergency patients with multivessel disease or unobstructed coronary arteries: a cost-effectiveness analysis in the UK SO BMJ OPEN LA English DT Article ID ACUTE-MYOCARDIAL-INFARCTION; ST-SEGMENT ELEVATION; FRACTIONAL FLOW RESERVE; CHEST-PAIN; STRESS ECHOCARDIOGRAPHY; DIAGNOSTIC-VALUE; INTERVENTION; TROPONIN; ANGIOGRAPHY; MANAGEMENT AB Objective To identify the key drivers of cost-effectiveness for cardiovascular magnetic resonance (CMR) when patients activate the primary percutaneous coronary intervention (PPCI) pathway. Design Economic decision models for two patient subgroups populated from secondary sources, each with a 1 year time horizon from the perspective of the National Health Service (NHS) and personal social services in the UK. Setting Usual care (with or without CMR) in the NHS. Participants Patients who activated the PPCI pathway, and for Model 1: underwent an emergency coronary angiogram and PPCI, and were found to have multivessel coronary artery disease. For Model 2: underwent an emergency coronary angiogram and were found to have unobstructed coronary arteries. Interventions Model 1 (multivessel disease) compared two different ischaemia testing methods, CMR or fractional flow reserve (FFR), versus stress echocardiography. Model 2 (unobstructed arteries) compared CMR with standard echocardiography versus standard echocardiography alone. Main outcome measures Key drivers of costeffectiveness for CMR, incremental costs and qualityadjusted life years (QALYs) and incremental costeffectiveness ratios. Results In both models, the incremental costs and QALYs between CMR (or FFR, Model 1) versus no CMR (stress echocardiography, Model 1 and standard echocardiography, Model 2) were small (CMR: - pound 64 (95% CI - pound 232 to pound 187)/FFR: pound 360 (95% CI - pound 116 to pound 844) and CMR/FFR: 0.0012 QALYs (95% CI -0.0076 to 0.0093)) and ( pound 98 (95% CI - pound 199 to pound 488) and 0.0005 QALYs (95% CI -0.0050 to 0.0077)), respectively. The diagnostic accuracy of the tests was the key driver of cost-effectiveness for both patient groups. Conclusions If CMR were introduced for all subgroups of patients who activate the PPCI pathway, it is likely that diagnostic accuracy would be a key determinant of its cost-effectiveness. Further research is needed to definitively answer whether revascularisation guided by CMR or FFR leads to different clinical outcomes in acute coronary syndrome patients with multivessel disease. C1 [Stokes, Elizabeth A.; Doble, Brett; Wordsworth, Sarah] Univ Oxford, Hlth Econ Res Ctr, Nuffield Dept Populat Hlth, Oxford, England. [Pufulete, Maria; Reeves, Barnaby C.] Univ Bristol, Bristol Trials Ctr, Bristol Med Sch, Clin Trials & Evaluat Unit, Bristol, Avon, England. [Pufulete, Maria; Reeves, Barnaby C.; Bucciarelli-Ducci, Chiara] Univ Hosp Bristol NHS Fdn Trust, NIHR Bristol Biomed Res Ctr, Bristol, Avon, England. [Pufulete, Maria; Reeves, Barnaby C.; Bucciarelli-Ducci, Chiara] Univ Bristol, Bristol, Avon, England. [Bucciarelli-Ducci, Chiara; Dorman, Stephen] Univ Hosp Bristol NHS Fdn Trust, Bristol Heart Inst, Bristol, Avon, England. [Greenwood, John P.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, W Yorkshire, England. [Anderson, Richard A.] Univ Hosp Wales, Cardiff, S Glam, Wales. C3 RLUK- Research Libraries UK; University of Oxford; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Bristol; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; RLUK- Research Libraries UK; Cardiff University RP Stokes, EA (通讯作者),Univ Oxford, Hlth Econ Res Ctr, Nuffield Dept Populat Hlth, Oxford, England. EM elizabeth.stokes@ndph.ox.ac.uk RI Bucciarelli-Ducci, Chiara/ABE-8891-2020; Pufulete, Maria/AFK-9264-2022 OI Pufulete, Maria/0000-0002-1775-1949; Greenwood, John/0000-0002-2861-0914; Doble, Brett/0000-0002-4948-8831; Reeves, Barnaby/0000-0002-5101-9487; Bucciarelli-Ducci, Chiara/0000-0002-2515-0852; Wordsworth, Sarah/0000-0002-2361-3040 FU National Institute for Health Research (NIHR) Health Services and Delivery Research Programme [11/2003/58]; NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust; University of Bristol FX This study was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research Programme (ref 11/2003/58). Maria Pufulete, Barnaby C Reeves, Chiara Bucciarelli-Ducci and the Cardiac MRI Unit are also partly funded through the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. CR Aasa M, 2010, AM HEART J, V160, P322, DOI 10.1016/j.ahj.2010.05.008 [Anonymous], 2017, AM COLL CARDIOLOGY A [Anonymous], 2013, GUID METH TECHN APPR Antony R, 2011, J CARDIOVASC MAGN R, V13, DOI 10.1186/1532-429X-13-57 Assomull RG, 2007, EUR HEART J, V28, P1242, DOI 10.1093/eurheartj/ehm113 Bhattacharyya S, 2014, EUR HEART J-CARD IMG, V15, P158, DOI 10.1093/ehjci/jet082 Brierley RC, 2018, BMJ OPEN, V8, DOI 10.1136/bmjopen-2017-018987 Cardarelli F, 2009, AM J CARDIOL, V103, P766, DOI 10.1016/j.amjcard.2008.11.033 Chopard R, 2011, ARCH CARDIOVASC DIS, V104, P509, DOI 10.1016/j.acvd.2011.05.004 Codreanu A, 2007, J MAGN RESON IMAGING, V25, P957, DOI 10.1002/jmri.20897 Daniel M, 2017, AM J CARDIOL, V120, P341, DOI 10.1016/j.amjcard.2017.05.001 Dastidar AG, 2017, JACC-CARDIOVASC IMAG, V10, P1204, DOI 10.1016/j.jcmg.2016.11.010 Dastidar AG, 2016, HEART, V102, P239, DOI 10.1136/heartjnl-2014-306963 Department of Health, 2016, NAT SCHED REF COSTS Dokainish H, 2005, J AM COLL CARDIOL, V45, P19, DOI 10.1016/j.jacc.2004.09.056 Gerbaud E, 2012, INT J CARDIOVAS IMAG, V28, P783, DOI 10.1007/s10554-011-9879-1 Goldstein JA, 2000, NEW ENGL J MED, V343, P915, DOI 10.1056/NEJM200009283431303 Gurunathan S, 2016, HEART, V102, pA94, DOI 10.1136/heartjnl-2016-309890.132 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Joint Formularly Committee, 2017, BRIT NAT FORM Kang WY, 2011, INT J CARDIOL, V146, P207, DOI 10.1016/j.ijcard.2009.07.001 Kumar A, 2009, MAYO CLIN PROC, V84, P917, DOI 10.1016/S0025-6196(11)60509-0 Laissy JP, 2005, RADIOLOGY, V237, P75, DOI 10.1148/radiol.2371041322 Larsen AI, 2005, AM J CARDIOL, V95, P261, DOI 10.1016/j.amjcard.2004.09.014 Lee JH, 2009, AM J CARDIOL, V104, P182, DOI 10.1016/j.amjcard.2009.03.010 Leurent G, 2011, ARCH CARDIOVASC DIS, V104, P161, DOI 10.1016/j.acvd.2011.01.005 Lindahl B, 2017, CIRCULATION, V135, P1481, DOI 10.1161/CIRCULATIONAHA.116.026336 Lockie T, 2011, J AM COLL CARDIOL, V57, P70, DOI 10.1016/j.jacc.2010.09.019 Meryon I, 2010, INT J CLIN PRACT, V64, P1245, DOI 10.1111/j.1742-1241.2010.02394.x Nam J, 2015, COST EFFECT RESOUR A, V13, DOI 10.1186/s12962-015-0045-9 Palmer S, 2002, COST EFFECTIVENESS M Pasupathy S, 2015, CIRCULATION, V131, P861, DOI 10.1161/CIRCULATIONAHA.114.011201 Pathik B, 2016, EUR HEART J-CARD IMG, V17, P1146, DOI 10.1093/ehjci/jev289 Rasoul S, 2009, CORONARY ARTERY DIS, V20, P415, DOI 10.1097/MCA.0b013e32832e5c4c Roongsritong C, 2004, CHEST, V125, P1877, DOI 10.1378/chest.125.5.1877 Sarda L, 2001, J AM COLL CARDIOL, V37, P786, DOI 10.1016/S0735-1097(00)01201-8 Smits PC, 2017, NEW ENGL J MED, V376, P1234, DOI 10.1056/NEJMoa1701067 Stensaeth KH, 2011, INT J CARDIOVAS IMAG, V27, P355, DOI 10.1007/s10554-010-9671-7 The Center for the Evaluation of Value and Risk in Health Tufts Medical Center, COST EFF AN CEA REG Toma M, 2010, EUR HEART J, V31, P1701, DOI 10.1093/eurheartj/ehq129 Tonino PAL, 2010, J AM COLL CARDIOL, V55, P2816, DOI 10.1016/j.jacc.2009.11.096 Tornvall P, 2015, ATHEROSCLEROSIS, V241, P87, DOI 10.1016/j.atherosclerosis.2015.04.816 Vlaar PJ, 2011, J AM COLL CARDIOL, V58, P692, DOI 10.1016/j.jacc.2011.03.046 Watkins S, 2009, CIRCULATION, V120, pA2T0, DOI 10.1161/CIRCULATIONAHA.109.872358 NR 44 TC 1 Z9 1 U1 0 U2 0 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 2044-6055 J9 BMJ OPEN JI BMJ Open PD AUG PY 2019 VL 9 IS 7 AR e025700 DI 10.1136/bmjopen-2018-025700 PG 13 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA IW8US UT WOS:000485269700246 PM 31300495 OA Green Published, gold DA 2023-05-13 ER PT J AU Norman, T Young, J Jones, JS Egan, G Pickering, J Du Toit, S Hamilton, F Miller, R Frampton, C Devlin, G George, P Than, M AF Norman, Tim Young, Joanna Jones, Jo Scott Egan, Gishani Pickering, John Du Toit, Stephen Hamilton, Fraser Miller, Rory Frampton, Chris Devlin, Gerard George, Peter Than, Martin TI Implementation and evaluation of a rural general practice assessment pathway for possible cardiac chest pain using point-of-care troponin testing: a pilot study SO BMJ OPEN LA English DT Article DE primary care; protocols & guidelines; myocardial infarction; coronary heart disease ID HIGH-SENSITIVITY TROPONIN; ACUTE CORONARY SYNDROME; EMERGENCY-DEPARTMENT; DIAGNOSTIC PROTOCOL; NEW-ZEALAND; EPIDEMIOLOGY; ASSOCIATION; VALIDATION; MANAGEMENT; SYMPTOMS AB Objectives To assess the feasibility and acceptability, and additionally to preliminarily evaluate, the effectiveness and safety of an accelerated diagnostic chest pain pathway in rural general practice using point-of-care troponin to identify patients at low risk of acute myocardial infarction, avoiding unnecessary patient transfer to hospital and enabling early discharge home. Design A prospective observational pilot evaluation. Setting Twelve rural general (family) practices in the Midlands region of New Zealand. Participants Patients aged >= 18 years who presented acutely to rural general practice with suspected ischaemic chest pain for whom the doctor intended transfer to hospital for serial troponin measurement. Outcome measures The proportion of patients managed using the low-risk pathway without transfer to hospital and without 30-day major adverse cardiac event (MACE); pathway adherence; rate of 30-day MACE; patient satisfaction with care; and agreement between point-of-care and laboratory measured troponin concentrations. Results A total of 180 patients were assessed by the pathway. The pathway classified 111 patients (61.7%) as low-risk and all were managed in rural general practice with no 30-day MACE (0%, 95% CI 0.0% to 3.3%). Adherence to the low-risk pathway was 95.5% (106 out of 111). Of the 56 patients classified as non-low-risk and referred to hospital, 9 (16.1%) had a 30-day MACE. A further 13 non-low-risk patients were not transferred to hospital, with no events. The sensitivity of the pathway for 30-day MACE was 100.0% (95% CI 70.1% to 100%). Of low-risk patients, 94% reported good to excellent satisfaction with care. Good concordance was observed between point-of-care and duplicate laboratory measured troponin concentrations. Conclusions The use of an accelerated diagnostic chest pain pathway incorporating point-of-care troponin in a rural general practice setting was feasible and acceptable, with preliminary results suggesting that it may safely and effectively reduce the urgent transfer of low-risk patients to hospital. C1 [Norman, Tim; Jones, Jo Scott; Egan, Gishani; Hamilton, Fraser; Miller, Rory] Pinnacle Midlands Hlth Network, Project Off, Hamilton, New Zealand. [Norman, Tim] Univ Waikato, Dept Populat Hlth, Hamilton, New Zealand. [Young, Joanna] Canterbury Dist Hlth Board, Dept Cardiol, Christchurch, New Zealand. [Pickering, John; Than, Martin] Canterbury Dist Hlth Board, Emergency Dept, Christchurch, New Zealand. [Pickering, John] Univ Otago Christchurch, Dept Med, Christchurch, New Zealand. [Du Toit, Stephen] Waikato Dist Hlth Board, Dept Clin Chem, Hamilton, New Zealand. [Hamilton, Fraser; Devlin, Gerard] Heart Fdn New Zealand, Auckland, New Zealand. [Miller, Rory] Univ Otago, Dept Med, Dunedin Campus, Dunedin, New Zealand. [Frampton, Chris] Univ Otago Christchurch, Christchurch Sch Med & Hlth Sci, Christchurch, New Zealand. [Devlin, Gerard] Waikato Dist Hlth Board, Dept Cardiol, Hamilton, New Zealand. [George, Peter] MedLab Pathol, Sydney, NSW, Australia. C3 University of Waikato; University of Otago; University of Otago; University of Otago RP Than, M (通讯作者),Canterbury Dist Hlth Board, Emergency Dept, Christchurch, New Zealand. EM martin@thanstedman.onmicrosoft.com RI Pickering, John/ABC-8089-2021; Miller, Rory/O-5212-2019 OI Pickering, John/0000-0001-9475-0344; Miller, Rory/0000-0002-4221-6892 FU Heart Foundation of New Zealand [1708]; Waikato Medical Research Foundation [275] FX The work was supported by grants from the Heart Foundation of New Zealand (1708) and the Waikato Medical Research Foundation (275). Abbott Point of Care, New Zealand provided i-STAT analysers to each of the participating practices, consumables and training for the point-of-care cardiac troponin I testing. 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Shah, Sunil M. DeWilde, Stephen Harris, Tess Victor, Christina R. Cook, Derek G. TI Increased Risk of Acute Cardiovascular Events After Partner Bereavement A Matched Cohort Study SO JAMA INTERNAL MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; CONJUGAL BEREAVEMENT; SIGNIFICANT PERSON; OLDER-PEOPLE; MORTALITY; DEATH; HEALTH; OUTCOMES; QUALITY; IMPACT AB IMPORTANCE The period immediately after bereavement has been reported as a time of increased risk of cardiovascular events. However, this risk has not been well quantified, and few large population studies have examined partner bereavement. OBJECTIVE To compare the rate of cardiovascular events between older individuals whose partner dies with those of a matched control group of individuals whose partner was still alive on the same day. DESIGN, SETTING, AND PARTICIPANTS Matched cohort study using a UK primary care database containing availale data of 401 general practices from February 2005 through September 2012. In all, 30 447 individuals aged 60 to 89 years at study initiation who experienced partner bereavement during follow-up were matched by age, sex, and general practice with the nonbereaved control group (n = 83 588) at the time of bereavement. EXPOSURES Partner bereavement. MAIN OUTCOMES AND MEASURES The primary outcome was occurrence of a fatal or nonfatal myocardial infarction (MI) or stroke within 30 days of bereavement. Secondary outcomes were non-MI acute coronary syndrome and pulmonary embolism. All outcomes were compared between the groups during prespecified periods after bereavement (30, 90, and 365 days). Incidence rate ratios (IRRs) from a conditional Poisson model were adjusted for age, smoking status, deprivation, and history of cardiovascular disease. RESULTS Within 30 days of their partner's death, 50 of the bereaved group (0.16%) experienced an MI or a stroke compared with 67 of the matched nonbereaved controls (0.08%) during the same period (IRR, 2.20 [95% CI, 1.52-3.15]). The increased risk was seen in bereaved men and women and attenuated after 30 days. For individual outcomes, the increased risk was found separately for MI (IRR, 2.14 [95% CI, 1.20-3.81]) and stroke (2.40 [1.22-4.71]). Associations with rarer events were also seen after bereavement, including elevated risk of non-MI acute coronary syndrome (IRR, 2.20 [95% CI, 1.12-4.29]) and pulmonary embolism (2.37 [1.18-4.75]) in the first 90 days. CONCLUSIONS AND RELEVANCE This study provides further evidence that the death of a partner is associated with a range of major cardiovascular events in the immediate weeks and months after bereavement. Understanding psychosocial factors associated with acute cardiovascular events may provide opportunities for prevention and improved clinical care. C1 [Carey, Iain M.; Shah, Sunil M.; DeWilde, Stephen; Harris, Tess; Cook, Derek G.] St Georges Univ London, Div Populat Hlth Sci & Educ, London SW17 0RE, England. [Victor, Christina R.] Brunel Univ, Sch Hlth Sci & Social Care, Uxbridge UB8 3PH, Middx, England. C3 St Georges University London; Brunel University RP Shah, SM (通讯作者),St Georges Univ London, Div Populat Hlth Sci & Educ, London SW17 0RE, England. EM sushah@sgul.ac.uk RI Cook, Derek G/C-3271-2008; Carey, Iain M/O-6973-2014 OI Carey, Iain M/0000-0003-1099-8460; DeWilde, Stephen/0000-0002-4238-4474; Cook, Derek/0000-0002-9723-5759; Victor, Christina/0000-0002-4213-3974; Harris, Tess/0000-0002-8671-1553 FU Dunhill Medical Trust [R169/0710]; The Dunhill Medical Trust [R169/0710] Funding Source: researchfish FX This study was supported by The Dunhill Medical Trust (grant R169/0710). 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PD APR PY 2014 VL 174 IS 4 BP 598 EP 605 DI 10.1001/jamainternmed.2013.14558 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA AI4NK UT WOS:000336841900023 PM 24566983 DA 2023-05-13 ER PT J AU Erlinge, D Koul, S Eriksson, P Schersten, F Omerovic, E Linder, R Ostlund, OP Wallentin, L Frobert, O James, S AF Erlinge, David Koul, Sasha Eriksson, Peter Schersten, Fredrik Omerovic, Elmir Linder, Rikard Ostlund, Olof Petter Wallentin, Lars Frobert, Ole James, Stefan TI Bivalirudin versus heparin in non-ST and ST-segment elevation myocardial infarction-a registry-based randomized clinical trial in the SWEDEHEART registry (the VALIDATE-SWEDEHEART trial) SO AMERICAN HEART JOURNAL LA English DT Article ID PERCUTANEOUS CORONARY INTERVENTION; SIROLIMUS-ELUTING STENTS; ASSOCIATION TASK-FORCE; POLYMER-COATED STENT; UNFRACTIONATED HEPARIN; THROMBUS ASPIRATION; UNSELECTED PATIENTS; ACCESS SITE; SAFE-PCI; SORT AB Background The optimal anticoagulant for patients with acute coronary syndrome treated with percutaneous coronary intervention (PCI) has not been validated in current practice of radial approach and pretreatment with potent P2Y12 inhibitors. Several studies have indicated increased bleeding rate and, in some instances, even increased mortality by the routine use of heparin and glycoprotein IIb/IIIa inhibitors compared to bivalirudin. Direct comparison of bivalirudin versus heparin alone has yielded contradictory results depending on study designs. Methods/design The VALIDATE-SWEDEHEART trial is a multicenter, prospective, randomized, registry-based, controlled, and open-label clinical trial in patients with ST-segment elevation myocardial infarction (STEMI) or non-STEMI undergoing PCI pretreated with ticagrelor, prasugrel, or cangrelor. We hypothesize that bivalirudin is superior to heparin alone in reducing death, myocardial infarction, and major bleeding events at 180 days (primary end point). The trial will enroll 3,000 patients with STEMI and 3,000 patients with non-STEMI undergoing PCI. The trial will use a hybrid registry-based randomized clinical trial design where inclusion, randomization, and baseline data collection are performed using The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry. The primary composite end point (death, myocardial infarction, or major bleeding events at 180 days) will be identified through active screening after 7 and 180 days and adjudicated by a blinded central end point committee. Secondary end points and long-term outcomes will be recorded from national registries. Conclusion The VALIDATE-SWEDEHEART trial is founded on a nationwide clinical registry and uses a hybrid registry-based randomized clinical trial (RRCT) design methodology to evaluate efficacy and safety of bivalirudin as compared to heparin alone for acute coronary syndrome, in a large population receiving contemporary recommended therapies including predominantly radial invasive approach and pretreatment with potent P2Y12 inhibitors. C1 [Erlinge, David; Koul, Sasha; Schersten, Fredrik] Lund Univ, Dept Cardiol, Clin Sci, Lund, Sweden. [Eriksson, Peter] Umea Univ, Dept Cardiol, Umea, Sweden. [Omerovic, Elmir] Sahlgrenska Univ, Dept Cardiol, Gothenburg, Sweden. [Linder, Rikard] Karolinska Univ, Dept Cardiol, Stockholm, Sweden. [Ostlund, Olof Petter; Wallentin, Lars; James, Stefan] Uppsala Univ, Dept Med Sci, Uppsala, Sweden. [Ostlund, Olof Petter; Wallentin, Lars; James, Stefan] Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden. [Frobert, Ole] Univ Orebro, Dept Cardiol, Fac Hlth, SE-70182 Orebro, Sweden. C3 Lund University; Umea University; Karolinska Institutet; Karolinska University Hospital; Uppsala University; Uppsala University; Orebro University RP Erlinge, D (通讯作者),Lund Univ, Skane Univ Hosp, Dept Cardiol, S-22185 Lund, Sweden. EM david.erlinge@med.lu.se RI James, Stefan K/J-4554-2014; Demchuk, Andrew M/E-1103-2012 OI Demchuk, Andrew M/0000-0002-4930-7789; Ostlund, Ollie/0000-0001-8028-2308; Frobert, Ole/0000-0002-5846-345X CR Bangalore S, 2014, BMJ-BRIT MED J, V349, DOI 10.1136/bmj.g6419 Bhatt DL, 2013, NEW ENGL J MED, V368, P1303, DOI 10.1056/NEJMoa1300815 Briguori C, 2015, JACC-CARDIOVASC INTE, V8, P414, DOI 10.1016/j.jcin.2014.10.015 Christiansen EH, 2013, LANCET, V381, P661, DOI 10.1016/S0140-6736(12)61962-X Clemmensen P, 2015, JACC-CARDIOVASC INTE, V8, P214, DOI 10.1016/j.jcin.2014.11.002 Dangas GD, 2011, CIRCULATION, V123, P1745, DOI 10.1161/CIRCULATIONAHA.110.981688 Frobert O, 2013, NEW ENGL J MED, V369, P1587, DOI 10.1056/NEJMoa1308789 Frobert O, 2010, AM HEART J, V160, P1042, DOI 10.1016/j.ahj.2010.08.040 Galloe AM, 2008, JAMA-J AM MED ASSOC, V299, P409, DOI 10.1001/jama.299.4.409 Hambraeus K, 2014, SCAND CARDIOVASC J, V48, P1, DOI 10.3109/14017431.2014.931551 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Han YL, 2015, JAMA-J AM MED ASSOC, V313, P1336, DOI 10.1001/jama.2015.2323 Hess CN, 2013, AM HEART J, V166, P421, DOI 10.1016/j.ahj.2013.06.013 James S, 2012, HEART, V98, P1329, DOI 10.1136/heartjnl-2012-301727 Jensen LO, 2012, CIRCULATION, V125, P1246, DOI 10.1161/CIRCULATIONAHA.111.063644 Jneid H, 2012, J AM COLL CARDIOL, V60, P645, DOI 10.1016/j.jacc.2012.06.004 Kastrati A, 2011, NEW ENGL J MED, V365, P1980, DOI 10.1056/NEJMoa1109596 Koul S, 2014, BMC CARDIOVASC DISOR, V14, DOI 10.1186/1471-2261-14-189 Koutouzis M, 2011, HEART, V97, P1484, DOI 10.1136/hrt.2011.224709 Lauer MS, 2013, NEW ENGL J MED, V369, P1579, DOI 10.1056/NEJMp1310102 Lincoff AM, 2003, JAMA-J AM MED ASSOC, V289, P853, DOI 10.1001/jama.289.7.853 Montalescot G, 2001, NEW ENGL J MED, V344, P1895, DOI 10.1056/NEJM200106213442503 Montalescot G, 2014, NEW ENGL J MED, V371, P1016, DOI 10.1056/NEJMoa1407024 Montalescot G, 2011, LANCET, V378, P693, DOI 10.1016/S0140-6736(11)60876-3 O'Gara PT, 2013, J AM COLL CARDIOL, V61, P485, DOI [10.1016/j.jacc.2012.11.018, 10.1161/CIR.0b013e3182742c84] Patti G, 2012, AM J CARDIOL, V110, P478, DOI 10.1016/j.amjcard.2012.04.017 Rao SV, 2014, JACC-CARDIOVASC INTE, V7, P857, DOI 10.1016/j.jcin.2014.04.007 Rasmussen K, 2010, LANCET, V375, P1090, DOI 10.1016/S0140-6736(10)60208-5 Raungaard B, 2015, LANCET, V385, P1527, DOI 10.1016/S0140-6736(14)61794-3 Schulz S, 2014, EUR HEART J, V35, P2285, DOI 10.1093/eurheartj/ehu182 Shahzad A, 2014, LANCET, V384, P1849, DOI 10.1016/S0140-6736(14)60924-7 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Steg PG, 2013, NEW ENGL J MED, V369, P2207, DOI 10.1056/NEJMoa1311096 Stone GW, 2008, NEW ENGL J MED, V358, P2218, DOI 10.1056/NEJMoa0708191 Stone GW, 2006, NEW ENGL J MED, V355, P2203, DOI 10.1056/NEJMoa062437 Valgimigli M, 2015, NEW ENGL J MED, V373, P997, DOI 10.1056/NEJMoa1507854 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Windecker S., 2014, EUR HEART J, V35, P2541, DOI [10.1093/eurheartj/ehu278, DOI 10.1093/EURHEARTJ/EHU278] Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 NR 39 TC 28 Z9 31 U1 0 U2 5 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 EI 1097-6744 J9 AM HEART J JI Am. Heart J. PD MAY PY 2016 VL 175 BP 36 EP 46 DI 10.1016/j.ahj.2016.02.007 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DL5CP UT WOS:000375655200006 PM 27179722 DA 2023-05-13 ER PT J AU White-Williams, C Rossi, LP Bittner, VA Driscoll, A Durant, RW Granger, BB Graven, LJ Kitko, L Newlin, K Shirey, M AF White-Williams, Connie Rossi, Laura P. Bittner, Vera A. Driscoll, Andrea Durant, Raegan W. Granger, Bradi B. Graven, Lucinda J. Kitko, Lisa Newlin, Kim Shirey, Maria CA Amer Heart Assoc Council Cardiovas Council Clinical Cardiology Council Epidemiology Prevention TI Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association SO CIRCULATION LA English DT Article DE AHA Scientific Statements; health personnel; heart failure; social determinants of health ID SELF-MANAGEMENT INTERVENTIONS; QUALITY-OF-LIFE; CARDIAC REHABILITATION PARTICIPATION; ACUTE CORONARY SYNDROME; SOCIOECONOMIC-STATUS; CARDIOVASCULAR-DISEASE; MEDICATION ADHERENCE; AFRICAN-AMERICANS; FOOD INSECURITY; PALLIATIVE CARE AB Heart failure is a clinical syndrome that affects >6.5 million Americans, with an estimated 550 000 new cases diagnosed each year. The complexity of heart failure management is compounded by the number of patients who experience adverse downstream effects of the social determinants of health (SDOH). These patients are less able to access care and more likely to experience poor heart failure outcomes over time. Many patients face additional challenges associated with the cost of complex, chronic illness management and must make difficult decisions about their own health, particularly when the costs of medications and healthcare appointments are at odds with basic food and housing needs. This scientific statement summarizes the SDOH and the current state of knowledge important to understanding their impact on patients with heart failure. Specifically, this document includes a definition of SDOH, provider competencies, and SDOH assessment tools and addresses the following questions: (1) What models or frameworks guide healthcare providers to address SDOH? (2) What are the SDOH affecting the delivery of care and the interventions addressing them that affect the care and outcomes of patients with heart failure? (3) What are the opportunities for healthcare providers to address the SDOH affecting the care of patients with heart failure? We also include a case study (Data Supplement) that highlights an interprofessional team effort to address and mitigate the effects of SDOH in an underserved patient with heart failure. C1 [White-Williams, Connie] Univ Alabama, Med Ctr, Tuscaloosa, AL 35487 USA. [Rossi, Laura P.] Simmons Univ, Coll Nat Hlth & Behav Sci Nursing, Boston, MA USA. [Bittner, Vera A.; Durant, Raegan W.] Univ Alabama Birmingham, Birmingham, AL USA. [Driscoll, Andrea] Deakin Univ, Sch Nursing & Midwifery, Geelong, Vic 3217, Australia. [Granger, Bradi B.] Duke Transit Nursing Inst, Durham, NC USA. [Graven, Lucinda J.] Florida State Univ, Coll Nursing, Tallahassee, FL 32306 USA. [Kitko, Lisa] Penn State Univ, Coll Nursing, University Pk, PA 16802 USA. [Newlin, Kim] Sutter Hlth, Sacramento, CA USA. [Shirey, Maria] Univ Alabama Birmingham, Sch Nursing, Birmingham, AL USA. C3 University of Alabama System; University of Alabama Tuscaloosa; Simmons University; University of Alabama System; University of Alabama Birmingham; Deakin University; State University System of Florida; Florida State University; Pennsylvania Commonwealth System of Higher Education (PCSHE); Pennsylvania State University; Pennsylvania State University - University Park; University of Alabama System; University of Alabama Birmingham RP White-Williams, C (通讯作者),Univ Alabama, Med Ctr, Tuscaloosa, AL 35487 USA. 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2023-05-13 ER PT J AU Alexopoulos, D Xenogiannis, I Vlachakis, P Tantry, U Gurbel, PA AF Alexopoulos, Dimitrios Xenogiannis, Iosif Vlachakis, Panagiotis Tantry, Udaya Gurbel, Paul A. TI Peri-Procedural Platelet Reactivity in Percutaneous Coronary Intervention SO THROMBOSIS AND HAEMOSTASIS LA English DT Article DE coronary angioplasty; anti-platelet treatment; platelet reactivity ID ELEVATION MYOCARDIAL-INFARCTION; GLYCOPROTEIN IIB/IIIA INHIBITORS; DRUG-ELUTING STENTS; ADJUST ANTIPLATELET THERAPY; REAL-WORLD PATIENTS; CARDIOVASCULAR EVENTS; ARTERY-DISEASE; DOUBLE-BLIND; CLINICAL-OUTCOMES; RANDOMIZED-TRIAL AB Platelet activation and aggregation play a pivotal role in thrombotic complications occurring during percutaneous coronary intervention (PCI), and peri-PCI anti-platelet therapy represents a standard of care. High platelet reactivity prior to PCI has been correlated with an increased incidence of peri-procedural myonecrosis. Pre-PCI platelet reactivity predicts post-PCI platelet reactivity and has a prognostic impact on subsequent ischaemic and bleeding events, so as the platelet inhibition measured post-PCI. Many anti-platelet treatment strategies, including aspirin, glycoprotein IIb/IIIa inhibitors, P2Y(12) receptor blockers and vorapaxar, are being used in the routine clinical practice to modify platelet reactivity at each stage, e.g. pre-, during and post-PCI. Anti-platelet strategies with a 'stronger and faster' pharmacodynamic effect than clopidogrel have been mostly adopted in patients with acute coronary syndromes. However, several issues regarding the anti-platelet treatment such as benefits/risks of anti-platelet therapy pre-treatment and duration, and definite association between speed and potency of various anti-platelet agents and clinical outcomes remain controversial. We believe that a better understanding of peri-PCI platelet reactivity and its relations to outcomes may lead to the development of more effective and safe treatment strategies. C1 [Alexopoulos, Dimitrios; Xenogiannis, Iosif; Vlachakis, Panagiotis] Natl & Capodistrian Univ Athens Med Sch, Attikon Univ Hosp, Dept Cardiol 2, Athens, Greece. [Tantry, Udaya; Gurbel, Paul A.] Inova Heart & Vasc Inst, Inova Ctr Thrombosis Res & Drug Dev, Fairfax, VA USA. C3 University Hospital Attikon; Inova Fairfax Hospital RP Alexopoulos, D (通讯作者),Attikon Univ Hosp, Dept Cardiol 2, Rimini 1, Athens 12462, Greece. 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Haemost. PD JUL PY 2018 VL 118 IS 7 BP 1131 EP 1140 DI 10.1055/s-0038-1649484 PG 10 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA GL2VW UT WOS:000436984900004 PM 29864784 OA Bronze DA 2023-05-13 ER PT J AU Busch, AM Tooley, EM Dunsiger, S Chattillion, EA Srour, JF Pagoto, SL Kahler, CW Borrelli, B AF Busch, Andrew M. Tooley, Erin M. Dunsiger, Shira Chattillion, Elizabeth A. Srour, John Fani Pagoto, Sherry L. Kahler, Christopher W. Borrelli, Belinda TI Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial SO BMC PUBLIC HEALTH LA English DT Article DE Smoking; Cessation; Acute coronary syndrome; Depression; Mood; Behavioral activation ID BREATH CARBON-MONOXIDE; CORONARY-HEART-DISEASE; DEPRESSIVE SYMPTOMS; OPTIMAL CUTOFF; SHORT-FORM; MORTALITY; ASSOCIATION; NICOTINE; SMOKERS; INTERVENTIONS AB Background: Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC). Methods: Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or SC. The nicotine patch was offered in both conditions. Smoking, mood, and stress outcomes were collected at end-of-treatment and 24-week follow-up. Results: Fifty-nine participants (28 BAT-CS, 31 SC) were recruited over 42 weeks, and assessment completion was above 80% in both conditions. Treatment acceptability and fidelity were high. At 24 week follow-up adjusted odds ratios favoring BAT-CS were 1.27 (95% CI: 0.41-3.93) for 7-day point prevalence abstinence and 1.27 (95% CI: 0.42-3.82) for continuous abstinence. Time to first smoking lapse was significantly longer in BAT-CS (62.4 vs. 31.8 days, p = 0.03). At 24-weeks, effect sizes for mood and stress outcomes ranged from eta(2)(partial) of. 07-.11, with significant between treatment effects for positive affect, negative affect, and stress. Conclusions: The design of this study proved feasible and acceptable. Results provide preliminary evidence that combining behavioral activation with standard smoking cessation counseling could be efficacious for this high risk population. A larger trial with longer follow-up is warranted. C1 [Busch, Andrew M.; Dunsiger, Shira] Miriam Hosp, Providence, RI 02906 USA. [Busch, Andrew M.; Chattillion, Elizabeth A.; Srour, John Fani] Brown Univ, Warren Alpert Med Sch, Providence, RI 02912 USA. [Tooley, Erin M.] Roger Williams Univ, Bristol, RI 02809 USA. [Dunsiger, Shira; Kahler, Christopher W.] Brown Univ, Sch Publ Hlth, Providence, RI 02912 USA. [Chattillion, Elizabeth A.] Providence VA Med Ctr, Providence, RI USA. [Srour, John Fani] Rhode Isl Hosp, Providence, RI USA. [Pagoto, Sherry L.] Univ Massachusetts, Sch Med, Worcester, MA USA. [Borrelli, Belinda] Boston Univ, Henry M Goldman Sch Dent Med, Boston, MA 02215 USA. [Busch, Andrew M.] Minneapolis Med Res Fdn Inc, 701 Pk Ave,S9-309, Minneapolis, MN 55415 USA. C3 Lifespan Health Rhode Island; Miriam Hospital; Brown University; Brown University; US Department of Veterans Affairs; Veterans Health Administration (VHA); Providence VA Medical Center; Lifespan Health Rhode Island; Rhode Island Hospital; University of Massachusetts System; University of Massachusetts Worcester; Boston University; Minneapolis Medical Research Foundation RP Busch, AM (通讯作者),Miriam Hosp, Providence, RI 02906 USA.; Busch, AM (通讯作者),Brown Univ, Warren Alpert Med Sch, Providence, RI 02912 USA.; Busch, AM (通讯作者),Minneapolis Med Res Fdn Inc, 701 Pk Ave,S9-309, Minneapolis, MN 55415 USA. EM Andrew.Busch@hcmed.org OI Busch, Andrew/0000-0002-3577-5960; Borrelli, Belinda/0000-0002-0859-796X FU National Heart, Lung, and Blood Institute of the National Institutes of Health [K23-HL107391] FX Data collection for this study was supported the National Heart, Lung, and Blood Institute of the National Institutes of Health under award number K23-HL107391. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. 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Gore, Joel McManus, Richard H. Awad, Hamza Waring, Molly E. Allison, Jeroan Saczynski, Jane S. Kiefe, Catarina I. Fox, Keith A. A. Anderson, Frederick A. McManus, David D. CA TRACE-CORE Investigators TI Performance of the GRACE Risk Score 2.0 Simplified Algorithm for Predicting 1-Year Death After Hospitalization for an Acute Coronary Syndrome in a Contemporary Multiracial Cohort SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; GLOBAL REGISTRY; MANAGEMENT; STRATIFICATION; PHYSICIANS; MORTALITY; TROPONIN; OUTCOMES AB The GRACE Risk Score is a well-validated tool for estimating short- and long-term risk in acute coronary syndrome (ACS). GRACE Risk Score 2.0 substitutes several variables that may be unavailable to clinicians and, thus, limit use of the GRACE Risk Score. GRACE Risk Score 2.0 performed well in the original GRACE cohort. We sought to validate its performance in a contemporary multiracial ACS cohort, in particular in black patients with ACS. We evaluated the performance of the GRACE Risk Score 2.0 simplified algorithm for predicting 1-year mortality in 2,131 participants in Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE), a multiracial cohort of patients discharged alive after an ACS in 2011 to 2013 from 6 hospitals in Massachusetts and Georgia. The median age of study participants was 61 years, 67% were men, and 16% were black. Half (51%) of the patients experienced a non-ST-segment elevation myocardial infarction (NSTEMI) and 18% STEMI. Eighty patients (3.8%) died within 12 months of discharge. The GRACE Risk Score 2.0 simplified algorithm demonstrated excellent model discrimination for predicting 1-year mortality after hospital discharge in the TRACE-CORE cohort (c-index = 0.77). The c-index was 0.94 in patients with STEMI, 0.78 in those with NSTEMI, and 0.87 in black patients with ACS. In conclusion, the GRACE Risk Score 2.0 simplified algorithm for predicting 1-year mortality exhibited excellent model discrimination across the spectrum of ACS types and racial/ethnic subgroups and, thus, may be a helpful tool to guide routine clinical care for patients with ACS. (C) 2016 Elsevier Inc. All rights reserved. C1 [Huang, Wei; FitzGerald, Gordon; Anderson, Frederick A.] Univ Massachusetts, Dept Surg, Ctr Outcomes Res, Worcester, MA 01605 USA. [Goldberg, Robert J.; McManus, Richard H.; Waring, Molly E.; Allison, Jeroan; Kiefe, Catarina I.] Univ Massachusetts, Dept Quantitat Hlth Sci, Worcester, MA USA. [Gore, Joel; McManus, David D.] Univ Massachusetts, Sch Med, Dept Med, Worcester, MA USA. [Awad, Hamza] Mercer Univ, Sch Med, Dept Community Med, Macon, GA 31207 USA. [Saczynski, Jane S.] Northeastern Univ, Dept Pharm & Hlth Syst Sci, Boston, MA 02115 USA. [Fox, Keith A. A.] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland. C3 University of Massachusetts System; University of Massachusetts Worcester; University of Massachusetts System; University of Massachusetts Worcester; University of Massachusetts System; University of Massachusetts Worcester; Mercer University; Northeastern University; RLUK- Research Libraries UK; University of Edinburgh RP Huang, W (通讯作者),Univ Massachusetts, Dept Surg, Ctr Outcomes Res, Worcester, MA 01605 USA. EM wei.huang@umassmed.edu RI Fox, keith A A/I-3742-2013 OI Huang, Wei/0000-0003-3009-4741; Waring, Molly E./0000-0002-9884-9824; Fox, Keith/0000-0002-0140-2752 FU National Institutes of Health, National Heart, Lung, and Blood Institute (Washington, DC) [1U01HL105268-01]; University of Edinburgh ACS Risk Working Group (Edinburgh, United Kingdom) [003] FX TRACE-CORE is supported by a National Institutes of Health, National Heart, Lung, and Blood Institute (Washington, DC) grant 1U01HL105268-01. This project is additionally supported by an award from the University of Edinburgh ACS Risk Working Group (Edinburgh, United Kingdom, Project reference no. 003). CR Alnasser SMA, 2015, AM J MED, V128, P766, DOI 10.1016/j.amjmed.2014.12.007 Anderson JL, 2007, CIRCULATION, V116, pE148, DOI 10.1161/CIRCULATIONAHA.107.181940 Chen HY, 2015, AM J CARDIOL, V116, P24, DOI 10.1016/j.amjcard.2015.03.035 Eagle KA, 2004, JAMA-J AM MED ASSOC, V291, P2727, DOI 10.1001/jama.291.22.2727 Fox KAA, 2006, BMJ-BRIT MED J, V333, P1091, DOI 10.1136/bmj.38985.646481.55 Fox KAA, 2014, BMJ OPEN, V4, DOI 10.1136/bmjopen-2013-004425 Fujii T, 2014, CIRC J, V78, P2950, DOI 10.1253/circj.CJ-14-0808 Goldberg RJ, 2015, AM J MED, V128, P1087, DOI 10.1016/j.amjmed.2015.05.002 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Green AR, 2007, J GEN INTERN MED, V22, P1231, DOI 10.1007/s11606-007-0258-5 HARRELL FE, 1982, JAMA-J AM MED ASSOC, V247, P2543, DOI 10.1001/jama.247.18.2543 Hosmer Jr DW, 2008, APPL SURVIVAL ANAL R, P903 Keller T, 2009, NEW ENGL J MED, V361, P868, DOI 10.1056/NEJMoa0903515 May S, 2004, LIFETIME DATA ANAL, V10, P283, DOI 10.1023/B:LIDA.0000036393.29224.1d Ohman EM, 2000, JAMA-J AM MED ASSOC, V284, P876, DOI 10.1001/jama.284.7.876 Sandoval Y, 2016, AM J MED, V129, P354, DOI 10.1016/j.amjmed.2015.12.005 Sonel AF, 2005, CIRCULATION, V111, P1225, DOI 10.1161/01.CIR.0000157732.03358.64 Venkat A, 2003, ACAD EMERG MED, V10, P1199, DOI 10.1197/S1069-6563(03)00490-1 Waring ME, 2012, CIRC-CARDIOVASC QUAL, V5, pE44, DOI 10.1161/CIRCOUTCOMES.112.965418 NR 19 TC 35 Z9 37 U1 0 U2 4 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 15 PY 2016 VL 118 IS 8 BP 1105 EP 1110 DI 10.1016/j.amjcard.2016.07.029 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EA0ZX UT WOS:000386319200002 PM 27561191 OA Green Accepted DA 2023-05-13 ER PT J AU Tobbia, P Brodie, BR Stuckey, T McLaurin, BT Cox, DA Fahy, M Xu, K Mehran, R Stone, GW AF Tobbia, Patrick Brodie, Bruce R. Stuckey, Thomas McLaurin, Brent T. Cox, David A. Fahy, Martin Xu, Ke Mehran, Roxana Stone, Gregg W. TI Are Adverse Events Following an Invasive Strategy in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes More Frequent at US Sites Versus Non-US Sites? Analysis From the ACUITY Trial SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE PCI; NSTEACS; geographical variations; bivalirudin ID MYOCARDIAL-INFARCTION; UNSTABLE ANGINA; TASK-FORCE; TRENDS; MULTICENTER; VARIABILITY; PREVENTION; CARDIOLOGY; OUTCOMES; RATES AB ObjectiveTo compare outcomes between US and non-US (OUS) sites in patients with non ST-elevation acute coronary syndromes (NSTEACS) and to evaluate potential reasons for differences in outcomes. BackgroundThere are little data comparing outcomes at US versus OUS sites in patients with NSTEACS managed with an invasive strategy. MethodsThe ACUITY trial randomized 13,819 patients with NSTEACS in 17 countries to an invasive approach with one of three strategies: (1) heparin plus glycoprotein platelet inhibitors (GPI), (2) bivalirudin plus GPI, or (3) bivalirudin alone. ResultsUS patients were more often female, were younger, heavier, and had more diabetes, prior myocardial infarction (MI), and prior bypass surgery. US patients were less often treated with percutaneous coronary intervention but had more frequent drug-eluting stent use. US patients had lower mortality and higher MI rates at 30 days and 1 year and higher composite ischemic outcome at 30 days. After adjusting for differences in baseline variables, US patients had higher rates of MI and composite ischemic outcome at 30 days and higher rates of MI at 1 year {HR [95% confidence interval (CI)] = 1.36 [1.18-1.56], P < 0.0001} with no differences in mortality. There were no differences in treatment effects comparing bivalirudin with the other strategies between US and OUS sites. ConclusionsUS versus OUS patients with NSTEACS had higher adjusted rates of MI and ischemia. The reasons for these differences are not clear but may be due to unmeasured confounders, different thresholds for event reporting, or valid differences in systems of care which may impact outcomes. (c) 2012 Wiley Periodicals, Inc. C1 [Tobbia, Patrick; Brodie, Bruce R.; Stuckey, Thomas] LeBauer Cardiovasc Res Fdn, Greensboro, NC USA. [Tobbia, Patrick; Brodie, Bruce R.; Stuckey, Thomas] Cone Hlth, Greensboro, NC USA. [McLaurin, Brent T.] AnMed Hlth, Anderson, SC USA. [Cox, David A.] Lehigh Valley Hlth Network, Allentown, PA USA. [Fahy, Martin; Xu, Ke; Mehran, Roxana; Stone, Gregg W.] Columbia Univ, Med Ctr, New York, NY USA. [Fahy, Martin; Xu, Ke; Mehran, Roxana; Stone, Gregg W.] Cardiovasc Res Fdn, New York, NY USA. C3 LeBauer-Brodie Center for Cardiovascular Research & Education; Lehigh Valley Health Network; Columbia University; Cardiovascular Research Foundation (CRF) RP Brodie, BR (通讯作者),313 Meadowbrook Terrace, Greensboro, NC 27408 USA. EM bbrodie89@gmail.com RI Mehran, Roxana/ABF-4160-2021 FU Medicines Company, Parsippany, NJ; Boston Scientific Company, Natick, MA FX Grant sponsors: The Medicines Company, Parsippany, NJ; Boston Scientific Company, Natick, MA CR Akkerhuis KM, 2000, EUR HEART J, V21, P371, DOI 10.1053/euhj.1999.1743 Anderson JL, 2011, CIRCULATION, V123, pE426, DOI 10.1161/CIR.0b013e318212bb8b Antman EM, 2000, JAMA-J AM MED ASSOC, V284, P835, DOI 10.1001/jama.284.7.835 Bassand JP, 2007, EUR HEART J, V28, P1598, DOI 10.1093/eurheartj/ehm161 Cannon CP, 2001, NEW ENGL J MED, V344, P1879, DOI 10.1056/NEJM200106213442501 Fox KAA, 2000, EUR HEART J, V21, P1433, DOI 10.1053/euhj.1999.1983 Fox KAA, 2002, LANCET, V360, P743, DOI 10.1016/S0140-6736(02)09894-X Furman MI, 2001, J AM COLL CARDIOL, V37, P1571, DOI 10.1016/S0735-1097(01)01203-7 Holmes DR, 1997, LANCET, V349, P75, DOI 10.1016/S0140-6736(96)03031-0 Lansky AJ, 2010, CIRC-CARDIOVASC INTE, V3, P602, DOI 10.1161/CIRCINTERVENTIONS.110.959080 Mehta SR, 2005, JAMA-J AM MED ASSOC, V293, P2908, DOI 10.1001/jama.293.23.2908 Raisch DW, 2001, CLIN THER, V23, P2011, DOI 10.1016/S0149-2918(01)80153-3 Roger VL, 2010, CIRCULATION, V121, P863, DOI 10.1161/CIRCULATIONAHA.109.897249 Rogers WJ, 2008, AM HEART J, V156, P1026, DOI 10.1016/j.ahj.2008.07.030 Singh M, 2006, J AM COLL CARDIOL, V47, P34, DOI 10.1016/j.jacc.2005.07.066 Stone GW, 2006, NEW ENGL J MED, V355, P2203, DOI 10.1056/NEJMoa062437 Stone GW, 2004, AM HEART J, V148, P764, DOI 10.1016/j.ahj.2004.04.036 1999, LANCET, V354, P708 NR 18 TC 2 Z9 2 U1 0 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1522-1946 EI 1522-726X J9 CATHETER CARDIO INTE JI Catheter. Cardiovasc. Interv. PD OCT 1 PY 2013 VL 82 IS 4 BP E365 EP E374 DI 10.1002/ccd.24587 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 283ZJ UT WOS:000329285200003 PM 22887494 DA 2023-05-13 ER PT J AU Sung, SH Chen, TC Cheng, HM Lee, JC Lang, HC Chen, CH AF Sung, Shih-Hsien Chen, Tzu-Ching Cheng, Hao-Min Lee, Jia-Chun Lang, Hui-Chu Chen, Chen-Huan TI Comparison of Clinical Outcomes in Patients Undergoing Coronary Intervention with Drug-Eluting Stents or Bare-Metal Stents: A Nationwide Population Study SO ACTA CARDIOLOGICA SINICA LA English DT Article DE Bare-metal stent; Drug-eluting stent; Propensity score ID RANDOMIZED CONTROLLED-TRIAL; COST-EFFECTIVENESS; METAANALYSIS; EFFICACY; SAFETY; REVASCULARIZATION; REGISTRY; THERAPY AB Background: The aim of this propensity score-matched cohort study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI). Methods: We conducted a retrospective cohort study based on the National Health Insurance program. Patients who had undergone coronary stenting between Jan. 2007 and Dec. 2008 were recruited and monitored until the end of 2010. Subjects with either BMS or DES were matched 2:1 by propensity score, which adjusted for age, sex, stent number and Charlson comorbidity index (CCl). The Kaplan-Meier method and Cox regression models were used for prognostic analyses. Results: Among a total of 966 patients with a mean age of 66 years, 644 subjects had BMS and 322 subjects had DES. The incidence of myocardial infarction (MI) and death were significantly lower in the DES group as compared with the BMS group for the three-year follow-up duration. With adjustments for age, sex, premium-based monthly salary, levels of hospital care, stent number, CCI, medications, and acute coronary syndrome presentation in the index hospitalization, use of DES rather than BMS was associated with reduced adverse coronary events (hazard ratio and 95% confidence interval: 0.55, 0.38-0.81 in the whole population, and 0.44, 0.26-0.73 in the subgroup patients with stable coronary artery disease). Conclusions: Implantation of DES was related to better outcomes than for BMS, in terms of reducing MI and mortality after PCI. The survival benefit for patients with DES was even greater in patients with stable coronary artery disease. C1 [Sung, Shih-Hsien] Taipei Vet Gen Hosp, Dept Med, Taipei, Taiwan. [Cheng, Hao-Min; Lee, Jia-Chun; Chen, Chen-Huan] Taipei Vet Gen Hosp, Dept Med Educ, 201,Sec 2,Shih Pai Rd, Taipei, Taiwan. [Cheng, Hao-Min; Lee, Jia-Chun] Taipei Vet Gen Hosp, Lab Evidence Based Healthcare, Taipei, Taiwan. [Sung, Shih-Hsien; Cheng, Hao-Min; Chen, Chen-Huan] Natl Yang Ming Univ, Cardiovasc Res Ctr, Taipei, Taiwan. [Sung, Shih-Hsien; Cheng, Hao-Min; Chen, Chen-Huan] Natl Yang Ming Univ, Dept Med, Taipei, Taiwan. [Sung, Shih-Hsien; Cheng, Hao-Min; Chen, Chen-Huan] Natl Yang Ming Univ, Dept Publ Hlth, Taipei, Taiwan. [Chen, Tzu-Ching; Lang, Hui-Chu] Natl Yang Ming Univ, Inst Hosp & Hlth Care Adm, Taipei, Taiwan. [Chen, Tzu-Ching] Mackay Mem Hosp, Dept Med Res, Taipei, Taiwan. C3 Taipei Veterans General Hospital; Taipei Veterans General Hospital; Taipei Veterans General Hospital; National Yang Ming Chiao Tung University; National Yang Ming Chiao Tung University; National Yang Ming Chiao Tung University; National Yang Ming Chiao Tung University; Mackay Memorial Hospital RP Chen, CH (通讯作者),Taipei Vet Gen Hosp, Dept Med Educ, 201,Sec 2,Shih Pai Rd, Taipei, Taiwan. 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Sin. PD JAN PY 2017 VL 33 IS 1 BP 10 EP 19 DI 10.6515/ACS20160608A PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EH8SO UT WOS:000392042800002 PM 28115802 DA 2023-05-13 ER PT J AU Bhatt, P Parikh, P Patel, A Parikh, R Patel, A Mehta, JL Parikh, K AF Bhatt, Parloop Parikh, Parth Patel, Aditi Parikh, Roosha Patel, Apurva Mehta, Jawahar L. Parikh, Keyur TI Unique Aspects of Coronary Artery Disease in Indian Women SO CARDIOVASCULAR DRUGS AND THERAPY LA English DT Article DE Coronary artery disease; Depression; Gender difference; Clinical outcomes; Quality of life ID MYOCARDIAL-INFARCTION; RISK-FACTORS; DEPRESSION; COUNTRIES; HEART AB Epidemiologic and clinical research suggests important gender-related differences in the prevalence, presentation, associated conventional and non-conventional risk factors, management and outcomes of coronary heart disease (CHD) patients. Adequate data is not available for Indian population where prevalence of CHD and depression is high. We conducted an observational, single-center, study from January 2010 to December 2011 on 10450 consecutive patients visiting a tertiary care center, Ahmedabad, Gujarat, India who presented with complaints related to CHD. Of these, 6867 patients had coronary artery disease (CAD) as confirmed by angiographic investigation; 5678 were males, and 1189 were females with similar mean age. As compared to males, females had higher prevalence of hypertension, diabetes and obesity while males had higher prevalence of smoking. Invasive treatment options like Coronary Artery Bypass Grafting (p < 0.001) and Percutaneous Coronary Intervention (p = 0.001) were used less often to treat females, and medical therapy (p < 0.001) was the preferred treatment option irrespective of the contributing risk factors/extent of CAD. Depression was observed in 39.8 % of acute coronary syndrome patients (n = 1648) as assessed by MARDS scale. It was higher in female patients and in low socioeconomic strata (p < 0.001).At 12 and 36 months, rates of revascularization (p < 0.001) and mortality (p < 0.005) were higher with poor quality of life (QoL) (P < 0.001) in depressed CAD patients. In India, women appear to have a higher prevalence of hypertension, diabetes, obesity, and family history of CHD. Yet women get invasive treatments less often than men. Depression is also more common in women and is associated with poor QoL and early mortality than men. C1 [Bhatt, Parloop] LM Coll Pharm, Dept Pharmacol, Ahmadabad 380060, Gujarat, India. [Parikh, Parth; Patel, Aditi; Parikh, Keyur] Care Inst Med Sci, Ahmadabad, Gujarat, India. [Parikh, Roosha; Patel, Apurva] Cleveland Clin, Cleveland, OH 44106 USA. [Mehta, Jawahar L.] Univ Arkansas Med Sci, Little Rock, AR 72205 USA. C3 Cleveland Clinic Foundation; University of Arkansas System; University of Arkansas Medical Sciences RP Bhatt, P (通讯作者),LM Coll Pharm, Dept Pharmacol, Ahmadabad 380060, Gujarat, India. EM parloop72@gmail.com RI Mehta, JL/AAG-7572-2020; Bhatt, Parloop A/Q-9511-2019; Mehta, jl/AAB-8832-2019 OI Mehta, jl/0000-0003-0384-2097 CR [Anonymous], 2011, GLOB STAT REP NCD [Anonymous], SOC REV GUJ 2012 201 Appels A, 1997, J PSYCHOSOM RES, V43, P443, DOI 10.1016/S0022-3999(97)00158-X Bivanco-Lima D, 2013, REV ASSOC MED BRAS, V59, P298, DOI 10.1016/j.ramb.2012.12.006 Carney RM, 2002, J PSYCHOSOM RES, V53, P897, DOI 10.1016/S0022-3999(02)00311-2 Everson-Rose SA, 2005, ANNU REV PUBL HEALTH, V26, P469, DOI 10.1146/annurev.publhealth.26.021304.144542 Gupta R, 2012, WORLD J CARDIOL, V4, P112, DOI 10.4330/wjc.v4.i4.112 Kessler RC, 2003, J AFFECT DISORDERS, V74, P5, DOI 10.1016/S0165-0327(02)00426-3 Keyhani S, 2008, HYPERTENSION, V51, P1149, DOI 10.1161/HYPERTENSIONAHA.107.107342 Kubzansky LD, 2000, J PSYCHOSOM RES, V48, P323, DOI 10.1016/S0022-3999(99)00091-4 Leifheit-Limson EC, 2010, CIRC-CARDIOVASC QUAL, V3, P143, DOI 10.1161/CIRCOUTCOMES.109.899815 Lett HS, 2007, HEALTH PSYCHOL, V26, P418, DOI 10.1037/0278-6133.26.4.418 Lichtman JH, 2008, CIRCULATION, V118, P1768, DOI 10.1161/CIRCULATIONAHA.108.190769 Mark H, 2008, J AM COLL CARDIOL, V52, P2163 O'Donnell MJ, 2010, LANCET, V376, P112, DOI 10.1016/S0140-6736(10)60834-3 Parashar S, 2006, ARCH INTERN MED, V166, P2035, DOI 10.1001/archinte.166.18.2035 Pilote L, 2007, CAN MED ASSOC J, V176, pS1, DOI 10.1503/cmaj.051455 Regitz-Zagrosek V, 2006, NAT REV DRUG DISCOV, V5, P425, DOI 10.1038/nrd2032 Serrano CV, 2011, VASC HEALTH RISK MAN, V7, P159, DOI 10.2147/VHRM.S10783 Shah AJ, 2014, AM HEART ASS, V3 Thomas AJ, 2004, J AFFECT DISORDERS, V79, P81, DOI 10.1016/S0165-0327(02)00349-x Thombs BD, 2006, J GEN INTERN MED, V21, P30, DOI 10.1111/j.1525-1497.2005.00269.x von Kanel R, 2012, SWISS MED WKLY, V142, DOI 10.4414/smw.2012.13502 Yusuf S, 2004, LANCET, V364, P937, DOI 10.1016/S0140-6736(04)17018-9 NR 24 TC 9 Z9 10 U1 0 U2 6 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0920-3206 EI 1573-7241 J9 CARDIOVASC DRUG THER JI Cardiovasc. Drugs Ther. PD AUG PY 2015 VL 29 IS 4 BP 369 EP 376 DI 10.1007/s10557-015-6594-5 PG 8 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA CP3UH UT WOS:000359807400007 PM 26005100 DA 2023-05-13 ER PT J AU Langabeer, JR Henry, TD Kereiakes, DJ DelliFraine, J Emert, J Wang, Z Stuart, L King, R Segrest, W Moyer, P Jollis, JG AF Langabeer, James R., II Henry, Timothy D. Kereiakes, Dean J. DelliFraine, Jami Emert, Jamie Wang, Zheng Stuart, Leilani King, Richard Segrest, Wendy Moyer, Peter Jollis, James G. TI Growth in Percutaneous Coronary Intervention Capacity Relative to Population and Disease Prevalence SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE acute coronary syndrome; cardiovascular disease prevalence; percutaneous coronary intervention ID ELEVATION MYOCARDIAL-INFARCTION; UNITED-STATES; TASK-FORCE; CARE; SYSTEM; REGIONALIZATION; TIME; ASSOCIATION; STRATEGIES; HOSPITALS AB Background-The access to and growth of percutaneous coronary intervention (PCI) has not been fully explored with regard to geographic equity and need. Economic factors and timely access to primary PCI provide the impetus for growth in PCI centers, and this is balanced by volume standards and the benefits of regionalized care. Methods and Results-Geospatial and statistical analyses were used to model capacity, growth, and access of PCI hospitals relative to population density and myocardial infarction (MI) prevalence at the state level. Longitudinal data were obtained for 2003-2011 from the American Hospital Association, the U.S. Census, and the Centers for Disease Control and Prevention (CDC) with geographical modeling to map PCI locations. The number of PCI centers has grown 21.2% over the last 8 years, with 39% of all hospitals having interventional cardiology capabilities. During the same time, the US population has grown 8.3%, from 217 million to 235 million, and MI prevalence rates have decreased from 4.0% to 3.7%. The most densely concentrated states have a ratio of 8.1 to 12.1 PCI facilities per million of population with significant variability in both MI prevalence and average distance between PCI facilities. Conclusions-Over the last decade, the growth rate for PCI centers is 1.5x that of the population growth, while MI prevalence is decreasing. This has created geographic imbalances and access barriers with excess PCI centers relative to need in some regions and inadequate access in others. C1 [Langabeer, James R., II; DelliFraine, Jami; Emert, Jamie; Wang, Zheng] Univ Texas Hlth Sci Ctr Houston, Houston, TX 77030 USA. [Henry, Timothy D.] Abbott NW Hosp, Minneapolis Heart Inst Fdn, Minneapolis, MN 55407 USA. [Kereiakes, Dean J.] Christ Hosp Heart & Vasc Ctr, Cincinnati, OH USA. [Stuart, Leilani; Segrest, Wendy] Amer Heart Assoc, Dallas, TX USA. [King, Richard] UT Southwestern Med Ctr, Dallas, TX USA. [Moyer, Peter] Boston Univ, Sch Med, Boston, MA 02118 USA. [Jollis, James G.] Duke Univ, Med Ctr, Durham, NC USA. C3 University of Texas System; University of Texas Health Science Center Houston; Minneapolis Heart Institute Foundation; Christ Hospital - Ohio; University of Texas System; University of Texas Southwestern Medical Center Dallas; Boston University; Duke University RP Langabeer, JR (通讯作者),Univ Texas Hlth Sci Ctr Houston, 1200 Herman Pressler,RAS W-310, Houston, TX 77030 USA. EM James.R.Langabeer@uth.tmc.edu OI Langabeer, James/0000-0002-2304-4853 CR Aguirre FV, 2008, CIRCULATION, V117, P1145, DOI 10.1161/CIRCULATIONAHA.107.728519 American Hospital Association Annual Survey, 2011, AM HOSP ASS ANN SURV Blankenship JC, 2011, J AM COLL CARDIOL, V57, P272, DOI 10.1016/j.jacc.2010.06.056 Bradley EH, 2012, J AM COLL CARDIOL, V60, P607, DOI 10.1016/j.jacc.2012.03.067 Buckley JW, 2008, AM HEART J, V155, P668, DOI 10.1016/j.ahj.2007.10.051 Carr BG, 2010, ACAD EMERG MED, V17, P1354, DOI 10.1111/j.1553-2712.2010.00940.x Centers for Disease Control and Prevention (CDC), 2011, NAT CARD DIS SURV DA Clark RA, 2012, CIRCULATION, V125, P2006, DOI 10.1161/CIRCULATIONAHA.111.083394 Concannon TW, 2013, CIRC-CARDIOVASC QUAL, V6, P400, DOI 10.1161/CIRCOUTCOMES.111.000019 Concannon TW, 2012, CIRC-CARDIOVASC QUAL, V5, P14, DOI 10.1161/CIRCOUTCOMES.111.963868 Concannon TW, 2010, CIRC-CARDIOVASC QUAL, V3, P506, DOI 10.1161/CIRCOUTCOMES.109.908541 Dehmer GJ, 2007, CATHETER CARDIO INTE, V69, P471, DOI 10.1002/ccd.21097 Graham KJ, 2012, CIRCULATION, V125, P2035, DOI 10.1161/CIRCULATIONAHA.111.084509 Harold JG, 2013, CIRCULATION, V128, P436, DOI 10.1161/CIR.0b013e318299cd8a Henry TD, 2007, CIRCULATION, V116, P721, DOI 10.1161/CIRCULATIONAHA.107.694141 Henry TD, 2010, CIRC-CARDIOVASC QUAL, V3, P441, DOI 10.1161/CIRCOUTCOMES.110.958421 Jollis JG, 2012, CIRCULATION, V126, P189, DOI 10.1161/CIRCULATIONAHA.111.068049 Keeley EC, 2003, LANCET, V361, P13, DOI 10.1016/S0140-6736(03)12113-7 Kereiakes DJ, 2004, CIRCULATION, V109, P821, DOI 10.1161/01.CIR.0000119802.71603.A0 McManus DD, 2011, AM J MED, V124, P40, DOI 10.1016/j.amjmed.2010.07.023 Nallamothu BK, 2006, CIRCULATION, V113, P1189, DOI 10.1161/CIRCULATIONAHA.105.596346 Nallamothu BK, 2007, NEW ENGL J MED, V357, P1631, DOI 10.1056/NEJMra065985 O'Gara PT, 2013, CIRCULATION, V127, P529, DOI 10.1161/CIR.0b013e3182742c84 Porter ME, 2009, NEW ENGL J MED, V361, P109, DOI 10.1056/NEJMp0904131 Pose PN, 2010, EUR HEART J, V31, P1985, DOI 10.1093/eurheartj/ehq151 Rathore SS, 2006, J AM COLL CARDIOL, V47, P1346, DOI 10.1016/j.jacc.2005.11.053 Thiemann DR, 1999, NEW ENGL J MED, V340, P1640, DOI 10.1056/NEJM199905273402106 Topol EJ, 2003, CIRCULATION, V107, P1463, DOI 10.1161/01.CIR.0000063680.45780.A0 U.S. Census Bureau, 2011, 2000 2010 INT POP ES NR 29 TC 61 Z9 61 U1 0 U2 2 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD DEC PY 2013 VL 2 IS 6 AR e000370 DI 10.1161/JAHA.113.000370 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 296IG UT WOS:000330177900025 PM 24166491 OA gold, Green Published, Green Submitted DA 2023-05-13 ER PT J AU Emmiler, M Ayoglu, RU Tekinalp, OH Arslan, S AF Emmiler, Mustafa Ayoglu, Raif Umut Tekinalp, Omer Haldun Arslan, Sakir TI Off-pump coronary artery bypass grafting under clopidogrel treatment SO TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article DE Atrial fibrillation; clopidogrel; ejection fraction; myocardial protection; off-pump coronary artery bypass grafting ID ATRIAL-FIBRILLATION; CARDIAC-SURGERY; RISK-FACTOR; ANTIPLATELET; COMBINATION; OUTCOMES; ASPIRIN; THERAPY AB Background: This study aims to compare the myocardial damage, inflammation and early postoperative morbidity and mortality following coronary artery bypass grafting in patients receiving and not receiving clopidogrel preoperatively. Methods: Between April 2008 and May 2014, 91 patients who underwent isolated off-pump coronary artery bypass grafting due to acute coronary syndrome were included. Of these patients, 48 (13 females, 35 males; mean age 65.3 +/- 8.3 years; range, 52 to 79 years) received clopidogrel (clopidogrel group) and 43 (10 females, 33 males; mean age 63.1 +/- 7.7 years; range, 49 to 76 years) did not use clopidogrel before surgery (control group). Levels of creatine phosphokinase-myocardial band, troponin I, C-reactive protein, and the amount of intraoperative blood loss, transfusion requirements, postoperative chest tube output, the length of hospital and intensive care unit stay, postoperative ejection fraction, and the incidence of postoperative atrial fibrillation of both groups were analyzed. Results: Postoperative troponin I and C-reactive protein levels were significantly lower in the clopidogrel group (p<0.01). A significantly lower number of patients in the clopidogrel group developed postoperative atrial fibrillation (13% vs 30%; p<0.05). However, postoperative chest tube output was significantly higher in the clopidogrel group, than the control group (883.2 +/- 256.9 mL vs 766.7 +/- 218.4 mL; p<0.02). Conclusion: Although preoperative clopidogrel use increases chest tube output after emergency off-pump coronary artery bypass grafting, this increase is tolerable. During and after surgery, protective effects of clopidogrel can be achieved, such as reduced postoperative troponin levels and reduced postoperative atrial fibrillation development. Preoperative clopidogrel use does not preclude early coronary artery bypass grafting. C1 [Emmiler, Mustafa; Ayoglu, Raif Umut; Tekinalp, Omer Haldun] Antalya Training & Res Hosp, Dept Cardiovasc Surg, Antalya, Turkey. [Arslan, Sakir] Antalya Training & Res Hosp, Dept Cardiol, Antalya, Turkey. C3 Akdeniz University; Antalya Training & Research Hospital; Antalya Training & Research Hospital RP Emmiler, M (通讯作者),Antalya Egitim & Arastirma Hastanesi, Kalp & Damar Cerrahisi Klin, TR-07100 Antalya, Turkey. EM dremmiler@yahoo.com RI arslan, sakir/A-3933-2017; Ayoğlu, Raif Umut/D-2910-2019 OI arslan, sakir/0000-0002-2907-4957; Ayoğlu, Raif Umut/0000-0002-9983-5280 CR Almassi GH, 1997, ANN SURG, V226, P501, DOI 10.1097/00000658-199710000-00011 Aranki SF, 1996, CIRCULATION, V94, P390, DOI 10.1161/01.CIR.94.3.390 Aronson D, 2007, AM J CARDIOL, V100, P755, DOI 10.1016/j.amjcard.2007.04.014 Aviles RJ, 2003, CIRCULATION, V108, P3006, DOI 10.1161/01.CIR.0000103131.70301.4F Banach M, 2006, CIRC J, V70, P438, DOI 10.1253/circj.70.438 Erdem K, 2012, TURK GOGUS KALP DAMA, V20, P755, DOI 10.5606/tgkdc.dergisi.2012.150 Gansera B, 2003, THORAC CARDIOV SURG, V51, P185 HERBERT JM, 1993, CARDIOVASC DRUG REV, V11, P180, DOI 10.1111/j.1527-3466.1993.tb00275.x Hongo RH, 2002, J AM COLL CARDIOL, V40, P231, DOI 10.1016/S0735-1097(02)01954-X Jauhar R, 1999, AM J CARDIOL, V84, P726, DOI 10.1016/S0002-9149(99)00420-8 KANNEL WB, 1982, NEW ENGL J MED, V306, P1018, DOI 10.1056/NEJM198204293061703 Karabulut H, 2004, EUR J CARDIO-THORAC, V25, P419, DOI 10.1016/j.ejcts.2003.11.037 Leon MB, 1998, NEW ENGL J MED, V339, P1665, DOI 10.1056/NEJM199812033392303 Maisel WH, 2001, ANN INTERN MED, V135, P1061, DOI 10.7326/0003-4819-135-12-200112180-00010 Mehta RH, 2006, J AM COLL CARDIOL, V48, P281, DOI 10.1016/j.jacc.2006.04.029 MENDES LA, 1995, J AM COLL CARDIOL, V25, P198, DOI 10.1016/0735-1097(94)00329-O Moulton MJ, 1996, J THORAC CARDIOV SUR, V111, P1037, DOI 10.1016/S0022-5223(96)70380-X Quinn MJ, 2002, CIRCULATION, V106, P379, DOI 10.1161/01.CIR.0000019581.22812.B2 Sedrakyan A, 2006, STROKE, V37, P2759, DOI 10.1161/01.STR.0000245081.52877.f2 Vivekananthan DP, 2004, AM J CARDIOL, V94, P358, DOI 10.1016/j.amjcard.2004.04.035 WHITE HD, 1984, CIRCULATION, V70, P479, DOI 10.1161/01.CIR.70.3.479 Yende S, 2001, CRIT CARE MED, V29, P2271, DOI 10.1097/00003246-200112000-00006 NR 22 TC 0 Z9 0 U1 0 U2 1 PU BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK PI ATASEHIR PA ORNEK MH DR SUPHI EZGI SK SARAY APT NO 11 D 6, ATASEHIR, ISTANBUL 34704, TURKEY SN 1301-5680 J9 TURK GOGUS KALP DAMA JI Turk Gogus Kalp Damar Cerrahisi Derg. PD OCT PY 2016 VL 24 IS 4 BP 659 EP 665 DI 10.5606/tgkdc.dergisi.2016.13286 PG 7 WC Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Surgery GA EC4PA UT WOS:000388114100008 DA 2023-05-13 ER PT J AU Gual, M Ariza-Sole, A Formiga, F Carrillo, X Baneras, J Tizon, H Garcia-Picart, J Cardenas, M Regueiro, A Tomas, C Rojas, S Munoz-Camacho, JF Rosas, A Sanchez-Salado, JC Lorente, V Roura, G Alegre, O Gomez-Hospital, JA Lidon, RM Cequier, A AF Gual, Miquel Ariza-Sole, Albert Formiga, Francesc Carrillo, Xavier Baneras, Jordi Tizon, Helena Garcia-Picart, Joan Cardenas, Merida Regueiro, Ander Tomas, Carlos Rojas, Sergio Munoz-Camacho, Juan F. Rosas, Alba Sanchez-Salado, Jose C. Lorente, Victoria Roura, Gerard Alegre, Oriol Gomez-Hospital, Joan A. Lidon, Rosa M. Cequier, Angel CA Codi Infart Registry Investigators TI Diabetes mellitus is not independently associated with mortality in elderly patients with ST-segment elevation myocardial infarction. Insights from theCodi Infartregistry SO CORONARY ARTERY DISEASE LA English DT Article DE diabetes mellitus; elderly; mortality; ST-segment elevation myocardial infarction ID ACUTE CORONARY SYNDROME; LONG-TERM MORTALITY; RISK; OUTCOMES; TRENDS; IMPACT; CARE AB Background Diabetes mellitus predicts poorer outcomes in patients with acute coronary syndrome (ACS), but the magnitude of this association in patients at older ages remains controversial. Methods Data were extracted from theCodi Infartdatabase. All consecutive patients with diagnosis of ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) between 2010 and 2015 were included. We assessed the impact of diabetes mellitus on 30-day and one-year mortality in patients aged less than and at least 75 years. Results A total of 12 792 cases were registered, of whom 3023 (23.6%) were aged at least 75 years. About 20% patients had previous diabetes mellitus diagnosis. Patients aged at least 75 years had higher prevalence of comorbidities, higher proportion of heart failure at admission, a more extensive coronary artery disease and significant delay to reperfusion (P< 0.001). Diabetes mellitus was associated with higher 30-day mortality both in young [odds ratio (OR) 1.97, 95% confidence interval (CI): 1.43-2.70] and in elderly patients (OR 1.43, 95% CI: 1.07-1.91). After adjusting for potential confounders, this association remained significant in young patients (OR 1.47, 95% CI: 1.00-2.16,P= 0.047), but not in the elderly (OR 1.14,P= 0.43). Likewise, a crude association between diabetes mellitus and one-year mortality was observed in both groups (young patients: HR = 1.93; 95% CI: 1.51-2.46; older patients: HR = 1.33; 95% CI: 1.08-1.64). However, after adjusting for potential confounders, this association remained significant in younger patients (HR = 1.46; 95% CI: 1.13-1.89;P< 0.001), but not in the elderly (HR = 1.16;P= 0.17). Conclusion A significant proportion of these nonselected patients with STEMI had previous diabetes mellitus. The association between diabetes mellitus and outcomes is different according to age. C1 [Gual, Miquel; Ariza-Sole, Albert; Formiga, Francesc; Sanchez-Salado, Jose C.; Lorente, Victoria; Roura, Gerard; Alegre, Oriol; Gomez-Hospital, Joan A.; Cequier, Angel] Hosp Univ Bellvitge, Barcelona, Spain. [Carrillo, Xavier] Hosp Univ Germans Trias i Pujol Badalona, Barcelona, Spain. [Baneras, Jordi; Lidon, Rosa M.] Hosp Univ Vall dHebron, Barcelona, Spain. [Tizon, Helena] Hosp Mar, Barcelona, Spain. [Tizon, Helena] IMIM Inst Hosp del Mar Invest Med, Grp Recerca Biomed Malalties Cor, Barcelona, Spain. [Garcia-Picart, Joan] Hosp Santa Creu & Sant Pau, Barcelona, Spain. [Cardenas, Merida] Hosp Unversitari Josep Trueta, Girona, Spain. [Regueiro, Ander] Hosp Clin & Provicial, Barcelona, Spain. [Tomas, Carlos] Hosp Arnau Vilanova, Lleida, Spain. [Rojas, Sergio] Hosp Joan 23, Tarragona, Spain. [Munoz-Camacho, Juan F.] Hosp Mutua Terrassa, Barcelona, Spain. [Rosas, Alba] Generalitat Catalunya, Dept Salut, Barcelona, Spain. C3 Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Bellvitge University Hospital; University of Barcelona; Hospital Universitari Vall d'Hebron; Institut Hospital del Mar d'Investigacions Mediques (IMIM); Hospital del Mar; Institut Hospital del Mar d'Investigacions Mediques (IMIM); Hospital del Mar; Hospital of Santa Creu i Sant Pau; University Hospital Arnau de Vilanova; Universitat Rovira i Virgili; Hospital Universitario Mutua Terrassa RP Ariza-Sole, A (通讯作者),Bellvitge Univ Hosp, Cardiol Dept, Feixa Llarga S-N, Barcelona 08907, Spain. EM aariza@bellvitgehospital.cat RI Bañeras, Jordi/AGQ-4877-2022; Tomás-Querol, Carlos/HOA-9369-2023; formiga, Francesc/ABD-7976-2020 OI Bañeras, Jordi/0000-0002-7395-0862; Tomás-Querol, Carlos/0000-0001-6134-0277; formiga, Francesc/0000-0002-3587-298X; Tizon-Marcos, Helena/0000-0001-7942-9413; Carrillo, Xavier/0000-0001-6691-8859 FU Departament de Salut. Generalitat de Catalunya FX This project has received a research grant from Departament de Salut. Generalitat de Catalunya. 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PD JAN PY 2020 VL 31 IS 1 BP 1 EP 6 DI 10.1097/MCA.0000000000000821 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA NC6RQ UT WOS:000561345000001 PM 31658142 DA 2023-05-13 ER PT J AU Yeh, IJ Liu, KT AF Yeh, I-Jeng Liu, Kuan-Ting TI ST segment elevation associated with hydrochloric acid ingestion A case report SO MEDICINE LA English DT Article DE electrocardiography; hydrochloric acid; intoxication; ST elevation myocardial infarction ID MYOCARDIAL-INFARCTION AB Rationale: Electrocardiography (ECG) was used to diagnose acute coronary syndrome, but many other diseases may also result in ST segment change. We report one case of ingested hydrochloric acid present with ST segment elevation in the ECG. However, subsequent coronary angiography did not reveal significant coronary occlusion. Patient concerns: An 83-year-old female was transferred to our emergency department (ED) from the branch hospital due to ingestion of toilet bowl cleaner containing 9.5% hydrochloric acid. She complained about chest pain and 12-lead ECG showed ST segment elevation at lead II, III, and aVF. The blood examinations revealed elevation of aspartate transaminase (69 IU/L), thrombocytopenia (62,000/mL), and acidosis (pH 7.311, pCO(2) 27 mm Hg, HCO3 13.3 mmol/L). Creatine kinase-MB and troponin I did not elevate then. Diagnoses: After transferred to our ED, coronary angiography was done within 1 hour. Angiography showed 60% stenosis in the segment 7 of left anterior descending coronary artery and 30% nonsignificant stenosis in the segment 2 of right coronary artery, with no apical ballooning. No significant lesion consistent with ST segment elevation myocardial infarction was found. Interventions: Conservative treatment was chosen. Outcomes: Bradycardia was followed by cardiac arrest that developed 4hours later. Cardiopulmonary resuscitation was applied and the patient became shock status after return of spontaneous circulation. The patient was admitted to the intensive care unit and expired on next day. Lessons: Patients of ingested hydrochloric acid present with ST segment elevation in the ECG may not indicate coronary artery disease. This ECG finding may be a poor prognostic index in such patients. C1 [Yeh, I-Jeng; Liu, Kuan-Ting] Kaohsiung Med Univ Hosp, Dept Emergency Med, Kaohsiung, Taiwan. [Liu, Kuan-Ting] Kaohsiung Med Univ, Coll Med, Inst Clin Med, Kaohsiung, Taiwan. [Liu, Kuan-Ting] Kaohsiung Med Univ, Coll Med, Sch Med, Kaohsiung, Taiwan. C3 Kaohsiung Medical University; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Medical University RP Liu, KT (通讯作者),100,Tzyou 1st Rd, Kaohsiung 807, Taiwan. EM ttiinngg@ms2.hinet.net RI liu, kt/AFU-9413-2022 OI Liu, Kuan-Ting/0000-0002-1355-5019 CR Asada S, 2006, INT J CARDIOL, V109, P411, DOI 10.1016/j.ijcard.2005.05.036 Chen TY, 2012, AM J MED SCI, V344, P499, DOI 10.1097/MAJ.0b013e318259b86b Islamoglu Y, 2012, CARDIOL J, V19, P86, DOI 10.5603/CJ.2012.0014 Kaneko Y, 2013, INTERNAL MED, V52, P2287, DOI 10.2169/internalmedicine.52.0795 Sari I, 2008, AM J EMERG MED, V26 Yanturali S, 2005, MT SINAI J MED, V72, P409 NR 6 TC 1 Z9 1 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0025-7974 EI 1536-5964 J9 MEDICINE JI Medicine (Baltimore) PD NOV PY 2017 VL 96 IS 47 AR e8819 DI 10.1097/MD.0000000000008819 PG 2 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA FP5FP UT WOS:000417645700077 PM 29381986 OA Green Published, gold DA 2023-05-13 ER PT J AU Peydro, ED Sevilla, NS Segarra, MTT Palau, VM Torrijos, JS Sales, JC AF Dalli Peydro, Ernesto Sanz Sevilla, Nuria Tuzon Segarra, Maria T. Miro Palau, Vicente Sanchez Torrijos, Jorge Cosin Sales, Juan TI A randomized controlled clinical trial of cardiac telerehabilitation with a prolonged mobile care monitoring strategy after an acute coronary syndrome SO CLINICAL CARDIOLOGY LA English DT Article DE cardiac rehabilitation; coronary heart disease; secondary prevention; telemedicine; telerehabilitation ID REHABILITATION; RISK; COUNTRIES; COVID-19 AB Background Center-based cardiac rehabilitation (CBCR) improves health outcomes but has some limitations. We designed and validated a telerehabilitation system to overcome these barriers. Methods We included 67 low-risk acute coronary syndrome patients in a randomized controlled trial allocated 1:1 to a 10-month cardiac telerehabilitation (CTR) program or an 8-week CBCR program. Patients underwent ergospirometry, blood tests, anthropometric measurements, IPAQ, PREDIMED, HADS, and EQ-5D questionnaires at baseline and 10 months. Data collectors were blinded to the treatment groups. Results The intention-to-treat analysis included 31 patients in the CTR group and 28 patients in the CBCR group. The primary outcome showed increased physical activity according to the IPAQ survey in the CTR group compared to the CBCR group (median increase 1726 METS-min/week vs. 636, p = .045). Mean VO2max increased 1.62 ml/(kg min) (95% confidence interval [CI]: 0.56-2.69, p < .004) from baseline in the CTR group, and 0.60 mL/(kg min) (p = .40) in the CBCR group. Mean apoB/apoA-I ratio decreased 0.13 (95% CI: -0.03 to 0.24, p = .017) in the CTR group, with no significant change in the CBCR group (p = .092). The median non-HDL cholesterol increased by 7.3 mg/dl (IQR: -2.4 to 18.6, p = .021) in the CBCR group, but the increase was not significant in the CTR group (p = .080). Adherence to a Mediterranean diet, psychological distress, and quality of life showed greater improvement in the CTR group than in the CBCR group. Return-to-work time was reduced with the telerehabilitation strategy. Conclusion This system allows minimal in-hospital training and prolonged follow-up. This strategy showed better results than CBCR. C1 [Dalli Peydro, Ernesto; Tuzon Segarra, Maria T.; Sanchez Torrijos, Jorge; Cosin Sales, Juan] Hosp Arnau Vilanova, Dept Cardiol, C Turia 71-3, Valencia 46008, Spain. [Sanz Sevilla, Nuria] Univ Hosp Doctor Peset, Dept Phys Med & Rehabil, Valencia, Spain. [Miro Palau, Vicente] Univ Hosp La Fe, Dept Cardiol, Valencia, Spain. RP Peydro, ED (通讯作者),Hosp Arnau Vilanova, Dept Cardiol, C Turia 71-3, Valencia 46008, Spain. EM ernestodallip@gmail.com OI Dalli Peydro, Ernesto/0000-0002-4340-6620 FU Trilema Salud Foundation FX Trilema Salud Foundation CR Ambrosetti M, 2021, EUR J PREV CARDIOL, V28, P460, DOI 10.1177/2047487320913379 Martinez-Gonzalez MA, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0043134 Brouwers RWM, 2020, NETH HEART J, V28, P443, DOI 10.1007/s12471-020-01432-y Buckingham SA, 2016, OPEN HEART, V3, DOI 10.1136/openhrt-2016-000463 Bueno-Notivol J, 2021, INT J CLIN HLTH PSYC, V21, DOI 10.1016/j.ijchp.2020.07.007 Clark AM, 2010, EUR J CARDIOV PREV R, V17, P261, DOI 10.1097/HJR.0b013e32833090ef Colbert JD, 2015, EUR J PREV CARDIOL, V22, P979, DOI 10.1177/2047487314545279 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 Craig CL, 2003, MED SCI SPORT EXER, V35, P1381, DOI 10.1249/01.MSS.0000078924.61453.FB de Luis D, 2020, NUTR HOSP, V37, P1232, DOI 10.20960/nh.03307 Ekblom O, 2021, EUR J PREV CARDIOL Ellis JJ, 2005, CURR MED RES OPIN, V21, P1209, DOI 10.1185/030079905X56349 Eysenbach G, 2011, J MED INTERNET RES, V13, DOI 10.2196/jmir.1923 Frederix I, 2015, J MED INTERNET RES, V17, DOI 10.2196/jmir.4799 Holme I, 2008, ANN MED, V40, P456, DOI 10.1080/07853890801964955 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Johannesen CDL, 2021, J AM COLL CARDIOL, V77, P1439, DOI 10.1016/j.jacc.2021.01.027 Knuuti J, 2020, EUR HEART J, V41, P407, DOI 10.1093/eurheartj/ehz425 Kotseva K, 2019, EUR J PREV CARDIOL, V26, P824, DOI 10.1177/2047487318825350 Kraal JJ, 2017, EUR J PREV CARDIOL, V24, P1260, DOI 10.1177/2047487317710803 Ramachandran HJ, 2021, EUR J PREV CARDIOL Reibis R, 2019, EUR J PREV CARDIOL, V26, P1358, DOI 10.1177/2047487319839263 Scherrenberg M, 2021, EUR J PREV CARDIOL, V28, P520, DOI 10.1093/eurjpc/zwaa107 Thomas RJ, 2019, CIRCULATION, V140, pE69, DOI 10.1161/CIR.0000000000000663 Wanner Miriam, 2016, Prev Med Rep, V3, P250, DOI 10.1016/j.pmedr.2016.03.003 Yusuf S, 2004, LANCET, V364, P937, DOI 10.1016/S0140-6736(04)17018-9 ZIGMOND AS, 1983, ACTA PSYCHIAT SCAND, V67, P361, DOI 10.1111/j.1600-0447.1983.tb09716.x NR 27 TC 2 Z9 2 U1 1 U2 7 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0160-9289 EI 1932-8737 J9 CLIN CARDIOL JI Clin. Cardiol. PD JAN PY 2022 VL 45 IS 1 BP 31 EP 41 DI 10.1002/clc.23757 EA DEC 2021 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA YO5PZ UT WOS:000734018600001 PM 34952989 OA Green Published DA 2023-05-13 ER PT J AU Demandt, JPA Koks, A Haest, R Heijmen, E Thijssen, E Otterspoor, LC van Veghel, D El Farissi, M Eerdekens, R Vervaat, F Pijls, NHJ Veer, MVT Tonino, PAL Dekker, LRC Vlaar, PJ AF Demandt, Jesse P. A. Koks, Arjan Haest, Rutger Heijmen, Eric Thijssen, Eric Otterspoor, Luuk C. van Veghel, Dennis El Farissi, Mohamed Eerdekens, Rob Vervaat, Fabienne Pijls, Nico H. J. Veer, Marcel V. T. Tonino, Pim A. L. Dekker, Lukas R. C. Vlaar, Pieter J. TI Prehospital triage of patients with suspected non-ST-segment elevation acute coronary syndrome: Rationale and design of the TRIAGE-ACS study SO CONTEMPORARY CLINICAL TRIALS LA English DT Article DE NSTE-ACS; Prehospital; Risk assessment; Triage; PreHEART score; EMS ID MYOCARDIAL-INFARCTION; CHEST-PAIN AB Background: Patients with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) are currently transported and admitted to the nearest emergency department (ED) for risk stratification, diagnostic workup and treatment. Although such patients with NSTE-ACS can benefit from direct transfer to a PCI center for early invasive treatment, no reliable prehospital triage tools are available. Recently, the PreHEART score has been validated in the PreHEART study for prehospital triage of patients with suspected NSTE-ACS. Methods: The primary objective of the TRIAGE-ACS study, a prospective cohort study, is to determine whether prehospital triage using the PreHEART score can significantly reduce time from first medical contact to final diagnostics and revascularization in patients in need of coronary revascularization. The first cohort (control cohort; n = 500) is observatory and is used as a reference group for the second cohort. In the second cohort (interventional cohort; n = 500) patients are stratified in the ambulance for direct transfer to either a PCI or a non-PCI center, based on the PreHEART score. These two cohorts will be compared with each other. In total, 1000 patients will be included. Follow-up for endpoints will be performed by reviewing the medical record after 30 days, 1 year, and 2 years. Conclusion: The TRIAGE-ACS study is the first prospective study to investigate the impact of prehospital triage using the PreHEART score on time to final invasive diagnostics and treatment in patients with NSTE-ACS in need of revascularization by transferring high risk patients directly to a PCI center and patients at a low risk of having an NSTE-ACS to a non-PCI center. Such triage strategy could potentially result in optimization of regional care for all ACS patients. C1 [Demandt, Jesse P. A.; Otterspoor, Luuk C.; Eerdekens, Rob; Vervaat, Fabienne; Pijls, Nico H. J.; Veer, Marcel V. T.; Tonino, Pim A. L.; Dekker, Lukas R. C.; Vlaar, Pieter J.] Catharina Hosp, Dept Cardiol, Eindhoven, Netherlands. [Koks, Arjan] GGD Reg Ambulance Serv, Eindhoven, Netherlands. [Haest, Rutger] St Anna Hosp, Dept Cardiol, Geldrop, Netherlands. [Heijmen, Eric] Elkerliek Hosp, Dept Cardiol, Helmond, Netherlands. [Thijssen, Eric] Maxima Med Ctr, Dept Cardiol, Veldhoven, Netherlands. [Haest, Rutger; Heijmen, Eric; Thijssen, Eric; Dekker, Lukas R. C.] Netherlands Heart Network NHN, Eindhoven, Netherlands. [Demandt, Jesse P. A.] Catharina Hosp, Dept Cardiol, Michelangelolaan, NL-5623 EJ Eindhoven, Netherlands. C3 Catharina Hospital; Maxima Medical Center; Catharina Hospital RP Demandt, JPA (通讯作者),Catharina Hosp, Dept Cardiol, Eindhoven, Netherlands.; Demandt, JPA (通讯作者),Catharina Hosp, Dept Cardiol, Michelangelolaan, NL-5623 EJ Eindhoven, Netherlands. EM jesse.demandt@catharinaziekenhuis.nl RI Otterspoor, Luuk/GSO-2731-2022 OI Dekker, Lukas/0000-0002-8166-3716 FU ZonMw , the Dutch Organisation for Health Research and Development [10070012010001] FX The TRIAGE-ACS study is funded by ZonMw, the Dutch Organisation for Health Research and Development, grant program "Topspecialistische Zorg en Onderzoek", grant number 10070012010001. CR Backus BE, 2013, INT J CARDIOL, V168, P2153, DOI 10.1016/j.ijcard.2013.01.255 Backus Barbra E, 2010, Crit Pathw Cardiol, V9, P164, DOI 10.1097/HPC.0b013e3181ec36d8 Bonello L, 2016, JACC-CARDIOVASC INTE, V9, P2267, DOI 10.1016/j.jcin.2016.09.017 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 de Winter RJ, 2005, NEW ENGL J MED, V353, P1095, DOI 10.1056/NEJMoa044259 Hoedemaker NPG, 2019, NETH HEART J, V27, P191, DOI 10.1007/s12471-019-1229-2 Ibanez Borja, 2017, Rev Esp Cardiol (Engl Ed), V70, P1082, DOI 10.1016/j.rec.2017.11.010 Keeley EC, 2003, LANCET, V361, P13, DOI 10.1016/S0140-6736(03)12113-7 Knuuti J, 2020, EUR HEART J, V41, P407, DOI 10.1093/eurheartj/ehz425 Kofoed KF, 2018, CIRCULATION, V138, P2741, DOI 10.1161/CIRCULATIONAHA.118.037152 Thang ND, 2014, AM J EMERG MED, V32, P601, DOI 10.1016/j.ajem.2014.03.006 Thang ND, 2012, AM J EMERG MED, V30, P1788, DOI 10.1016/j.ajem.2012.02.014 Pedersen CK, 2019, SCAND J TRAUMA RESUS, V27, DOI 10.1186/s13049-019-0659-6 Rasmussen MB, 2019, EUR HEART J-ACUTE CA, V8, P299, DOI 10.1177/2048872617745893 Sagel D, 2021, EMERG MED J, V38, P814, DOI 10.1136/emermed-2020-210212 Thygesen K., J AM COLL CARDIOL, V72, P2231 Tolsma R.T., 2021, EUR HEART J-ACUTE CA, V16 Van Steenbergen G.J., 2021, POTENTIAL IMPROVEMEN van Veghel HPA, 2022, INT J HEALTHCARE MAN, V15, P1, DOI 10.1080/20479700.2020.1810464 Vlaar PJ, 2008, CIRCULATION, V118, P1828, DOI 10.1161/CIRCULATIONAHA.107.749531 NR 20 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1551-7144 EI 1559-2030 J9 CONTEMP CLIN TRIALS JI Contemp. Clin. Trials PD AUG PY 2022 VL 119 AR 106854 DI 10.1016/j.cct.2022.106854 EA JUL 2022 PG 5 WC Medicine, Research & Experimental; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 3V1QF UT WOS:000841435700010 PM 35863696 DA 2023-05-13 ER PT J AU Rossello, X Huo, Y Pocock, S Van de Werf, F Chin, CT Danchin, N Lee, SWL Medina, J Vega, A Bueno, H AF Rossello, Xavier Huo, Yong Pocock, Stuart Van de Werf, Frans Chin, Chee Tang Danchin, Nicolas Lee, Stephen W-L Medina, Jesus Vega, Ana Bueno, Hector TI Global geographical variations in ST-segment elevation myocardial infarction management and post-discharge mortality SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE ST-segment elevation myocardial infarction; Early management; Reperfusion therapy; Regional variation; Postdischarge mortality; Risk ID ACUTE CORONARY SYNDROMES; TERM-FOLLOW-UP; LOW-INCOME COUNTRIES; CARDIOVASCULAR-DISEASE; REPERFUSION THERAPY; MIDDLE-INCOME; OUTCOMES; EPICOR; DISPARITIES; PATTERNS AB Background: There is a shortage of information on regional variations in ST-segment elevation myocardial infarction (STEMI) management and prognosis at a global level. We aimed to compare patient profiles, in-hospital management and post-discharge mortality across several world regions. Methods: In total, 11,559 patients with STEMI were enrolled in two prospective studies of acute coronary syndrome survivors: EPICOR (4943 patients from 555 hospitals in 20 countries in Europe and Latin America recruited between September 2010 and March 2011) and EPICOR Asia (6616 patients from 218 hospitals in eight Asian countries recruited between June 2011 and May 2012). Comparisons were performed by eight pre-defined regions: Northern Europe (NE), Southern Europe (SE), Eastern Europe (EE), Latin America (LA), China (CN), India (IN), Southeast Asia (SA), and South Korea/Hong Kong/Singapore (KS). Results: Reperfusion therapy rates ranged between 53.9% (IN) and 81.2% (SE), primary percutaneous coronary intervention (PCI) between 24.8% (IN) and 65.6% (NE) and fibrinolysis between 8.1% (CN) and 34.2% (SA). Median time to primary PCI (h) ranged from 3.9 (NE) to 20.9 (IN) and to fibrinolysis from 2.4 (SE) to 6.3 (IN). Two-year mortality ranged between 2.5% in NE and 7.4% in LA. Regional variations in mortality persisted after adjustment for reperfusion therapy and known prognostic factors. Conclusions: Among patients with STEMI, there is a wide regional variation in clinical profiles, hospital care and mortality. Substantial room for improvement remains at a global level for increasing reperfusion rates, reducing delays and post-discharge mortality in patients with STEMI. (C) 2017 The Authors. Published by Elsevier Ireland Ltd. C1 [Rossello, Xavier; Pocock, Stuart] London Sch Hyg & Trop Med, London, England. [Huo, Yong] Peking Univ, Hosp 1, Dept Cardiol, Beijing, Peoples R China. [Van de Werf, Frans] Univ Hosp Leuven, Leuven, Belgium. [Chin, Chee Tang] Natl Heart Ctr Singapore, Singapore, Singapore. [Danchin, Nicolas] Hop Europeen Georges Pompidou, Paris, France. [Danchin, Nicolas] Rene Descartes Univ, Paris, France. [Lee, Stephen W-L] Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China. [Medina, Jesus; Vega, Ana] AstraZeneca, Global Med Affairs, Med Evidence & Observat Res, Madrid, Spain. [Bueno, Hector] CNIC, Melchor Fernandez Almagro 3, Madrid 28029, Spain. [Bueno, Hector] Hosp Univ 12 Octubre, Inst Invest I 12, Madrid, Spain. [Bueno, Hector] Hosp Univ 12 Octubre, Dept Cardiol, Madrid, Spain. [Bueno, Hector] Univ Complutense Madrid, Madrid, Spain. C3 University of London; London School of Hygiene & Tropical Medicine; Peking University; KU Leuven; University Hospital Leuven; National Heart Centre Singapore; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Europeen Georges-Pompidou - APHP; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Europeen Georges-Pompidou - APHP; University of Hong Kong; AstraZeneca; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Hospital Universitario 12 de Octubre; Hospital Universitario 12 de Octubre; Complutense University of Madrid RP Bueno, H (通讯作者),CNIC, Melchor Fernandez Almagro 3, Madrid 28029, Spain. EM hbueno@cnic.es RI Danchin, Nicolas/AAN-8291-2020; Bueno, Hector/I-3910-2015; Rossello, Xavier/P-5838-2019 OI Bueno, Hector/0000-0003-0277-7596; Rossello, Xavier/0000-0001-6783-8463; Van de Werf, Frans/0000-0001-9479-7767 FU AstraZeneca FX Editorial support was provided by Prime (Knutsford, Cheshire, UK), funded by AstraZeneca. Dr. J.P.S. Sawhney reviewed the draft and suggested some references. CR Alexander T, 2017, JAMA CARDIOL, V2, P498, DOI 10.1001/jamacardio.2016.5977 Alexander T, 2016, EUR HEART J, V37, P2449, DOI 10.1093/eurheartj/ehw279 Bucholz EM, 2016, NEW ENGL J MED, V375, P1332, DOI 10.1056/NEJMoa1513223 Bueno H, 2016, EUR HEART J-ACUTE CA, V5, P3, DOI 10.1177/2048872614565912 Bueno H, 2013, AM HEART J, V165, P8, DOI 10.1016/j.ahj.2012.10.018 Chung SC, 2015, BMJ-BRIT MED J, V351, DOI 10.1136/bmj.h3913 Chung SC, 2014, LANCET, V383, P1305, DOI 10.1016/S0140-6736(13)62070-X Eagle KA, 2002, LANCET, V359, P373, DOI 10.1016/S0140-6736(02)07595-5 Fox KAA, 2003, EUR HEART J, V24, P1414, DOI 10.1016/S0195-668X(03)00315-4 Gershlick AH, 2013, LANCET, V382, P624, DOI 10.1016/S0140-6736(13)61454-3 Giugliano RP, 2001, EUR HEART J, V22, P1702, DOI 10.1053/euhj.2001.2583 Huo Y, 2015, CLIN CARDIOL, V38, P511, DOI 10.1002/clc.22431 Khatib R, 2016, LANCET, V387, P61, DOI 10.1016/S0140-6736(15)00469-9 Kristensen SD, 2014, EUR HEART J, V35, P1957, DOI 10.1093/eurheartj/eht529 Laut KG, 2013, EUROINTERVENTION, V9, P469, DOI 10.4244/EIJV9I4A76 Li J, 2015, LANCET, V385, P441, DOI 10.1016/S0140-6736(14)60921-1 Mahaffey KW, 2011, CIRCULATION, V124, P544, DOI 10.1161/CIRCULATIONAHA.111.047498 O'Connor GT, 1999, JAMA-J AM MED ASSOC, V281, P627, DOI 10.1001/jama.281.7.627 O'Gara PT, 2013, J AM COLL CARDIOL, V61, pE78, DOI [10.1016/j.jacc.2012.11.019, 10.1161/01.cir.0000440804.93914.d8, 10.1161/CIR.0b013e3182742cf6] Peterson ED, 2009, CIRC-CARDIOVASC QUAL, V2, P491, DOI 10.1161/CIRCOUTCOMES.108.847145 Pocock S., 2017, EUR HEART J IN PRESS Pocock Stuart, 2015, Eur Heart J Acute Cardiovasc Care, V4, P509, DOI 10.1177/2048872614554198 Reed SD, 2006, AM HEART J, V152, P500, DOI 10.1016/j.ahj.2006.02.032 Schiele F, 2017, EUR HEART J-ACUTE CA, V6, P34, DOI 10.1177/2048872616643053 Spatz ES, 2016, JAMA CARDIOL, V1, P255, DOI 10.1001/jamacardio.2016.0382 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 von Elm E, 2007, ANN INTERN MED, V147, P573, DOI 10.7326/0003-4819-147-8-200710160-00010 Vos T, 2015, LANCET, V386, P743, DOI 10.1016/S0140-6736(15)60692-4 Yeh RW, 2012, CIRC-CARDIOVASC QUAL, V5, P197, DOI 10.1161/CIRCOUTCOMES.111.962456 Yusuf S, 2001, CIRCULATION, V104, P2855, DOI 10.1161/hc4701.099488 Yusuf S, 2011, LANCET, V378, P1231, DOI 10.1016/S0140-6736(11)61215-4 NR 31 TC 73 Z9 77 U1 1 U2 7 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD OCT 15 PY 2017 VL 245 BP 27 EP 34 DI 10.1016/j.ijcard.2017.07.039 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FH6LS UT WOS:000411288700005 PM 28750924 OA Green Published, hybrid, Green Accepted DA 2023-05-13 ER PT J AU Ventura, M Belleudi, V Sciattella, P Di Domenicantonio, R Di Martino, M Agabiti, N Davoli, M Fusco, D AF Ventura, Martina Belleudi, Valeria Sciattella, Paolo Di Domenicantonio, Riccardo Di Martino, Mirko Agabiti, Nera Davoli, Marina Fusco, Danilo TI High quality process of care increases one-year survival after acute myocardial infarction (AM I): A cohort study in Italy SO PLOS ONE LA English DT Article ID ST-SEGMENT ELEVATION; TO-BALLOON TIME; ACUTE CORONARY SYNDROMES; LONG-TERM SURVIVAL; OBSTRUCTIVE PULMONARY-DISEASE; PRIMARY ANGIOPLASTY; MEDICAL THERAPY; SECONDARY PREVENTION; HOSPITAL MORTALITY; TASK-FORCE AB Background The relationship between guideline adherence and outcomes in patients with acute myocardial infarction (AMI) has been widely investigated considering the emergency, acute, post acute phases separately, but the effectiveness of the whole care process is not known. Aim The study aim was to evaluate the effect of the multicomponent continuum of care on 1-year survival after AMI. Methods We conducted a cohort study selecting all incident cases of AMI from health information systems during 2011-2014 in the Lazio region. Patients' clinical history was defined by retrieving previous hospitalizations and drugs prescriptions. For each subject the probability to reach the hospital and the conditional probabilities to survive to 30 days from admission and to 31-365 days post discharge were estimated through multivariate logistic models. The 1-year survival probability was calculated as the product of the three probabilities. Quality of care indicators were identified in terms of emergency timeliness (time between residence and the nearest hospital), hospital performance in treatment of acute phase (number/timeliness of PCI on STEMI) and drug therapy in post-acute phase (number of drugs among anti platelet, (beta-blockers, ACE inhibitors/ARBs, statins). The 1-year survival Probability Ratio (PR) and its Bootstrap Confidence Intervals (BCI) between who were exposed to the highest level of quality of care (timeliness<10', hospitalization in high performance hospital, complete drug therapy) and who exposed to the worst (timeliness >= 10', hospitalization in low performance hospital, suboptimal drug therapy) were calculated fora mean-severity patient and varying gender and age. PRs for patients with diabetes and COPD were also evaluated. Results We identified 38,517 incident cases of AMI. The out-of-hospital mortality was 27.6%. Among the people arrived in hospital, 42.9% had a hospitalization for STEMI with 11.1% of mortality in acute phase and 5.4% in post-acute phase. For a mean-severity patient the PR was 1.19 (BCI 1.14-1.24). The ratio did not change by gender, while it moved from 1.06 (BCI 1.05-1.08) for age<65 years to 1.62 (BCI 1.45-1.80) for age >85 years. For patients with diabetes and COPD a slight increase in PRs was also observed. Conclusions The 1-year survival probability post AMI depends strongly on the quality of the whole multi component continuum of care. Improving the performance in the different phases, taking into account the relationship among these, can lead to considerable saving of lives, in particular for the elderly and for subjects with chronic diseases. C1 [Ventura, Martina; Belleudi, Valeria; Di Domenicantonio, Riccardo; Di Martino, Mirko; Agabiti, Nera; Davoli, Marina; Fusco, Danilo] Lazio Reg Hlth Serv, Dept Epidemiol, Rome, Italy. [Sciattella, Paolo] Sapienza Univ Rome, Dept Stat Sci, Rome, Italy. C3 Sapienza University Rome RP Agabiti, N (通讯作者),Lazio Reg Hlth Serv, Dept Epidemiol, Rome, Italy. EM n.agabiti@deplazio.it RI belleudi, valeria/AAR-4553-2021; Fusco, Danilo/AAB-8646-2019; Belleudi, Valeria/J-9070-2016; Di Domenicantonio, Riccardo/HII-5605-2022; Di Domenicantonio, Riccardo/H-7867-2018; Agabiti, Nera/K-1053-2016 OI belleudi, valeria/0000-0002-8286-443X; Fusco, Danilo/0000-0003-1759-5621; Belleudi, Valeria/0000-0002-8286-443X; Di Domenicantonio, Riccardo/0000-0002-9726-0786; Agabiti, Nera/0000-0003-3385-1197; SCIATTELLA, PAOLO/0000-0002-8364-1895 CR Agarwal M, 2017, AM J CARDIOL, V119, P1555, DOI 10.1016/j.amjcard.2017.02.024 Kirchberger I, 2014, AM J CARDIOL, V114, P329, DOI 10.1016/j.amjcard.2014.04.046 Amann U, 2014, CLIN RES CARDIOL, V103, P655, DOI 10.1007/s00392-014-0688-0 [Anonymous], 2017, TECHNICAL REPORT [Anonymous], 2017, LAZIO REGIONAL OUTCO Aylin P, 2007, BMJ-BRIT MED J, V334, P1044, DOI 10.1136/bmj.39168.496366.55 Bates ER, 2013, NEW ENGL J MED, V369, P889, DOI 10.1056/NEJMp1308772 Belleudi V, 2016, BMC PUBLIC HEALTH, V16, DOI 10.1186/s12889-016-3019-8 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DOI 10.1136/hrt.2007.123612 White HD, 2008, LANCET, V372, P570, DOI 10.1016/S0140-6736(08)61237-4 Yan AT, 2007, AM HEART J, V154, P1108, DOI 10.1016/j.ahj.2007.07.040 Yan AT, 2004, AM J CARDIOL, V94, P25, DOI 10.1016/j.amjcard.2004.03.024 Yudi MB, 2016, INT J CARDIOL, V224, P72, DOI 10.1016/j.ijcard.2016.09.003 NR 66 TC 4 Z9 4 U1 1 U2 5 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD FEB 20 PY 2019 VL 14 IS 2 AR e0212398 DI 10.1371/journal.pone.0212398 PG 15 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA HM2OT UT WOS:000459307000058 PM 30785928 OA gold, Green Published, Green Submitted DA 2023-05-13 ER PT J AU Sinkovic, A Markota, A Krasevec, M Suran, D Marinsek, M AF Sinkovic, Andreja Markota, Andrei Krasevec, Manja Suran, David Marinsek, Martin TI The Role of Environmental PM2.5 in Admission Acute Heart Failure in ST-Elevation Myocardial Infarction patients-An Observational Retrospective Study SO INTERNATIONAL JOURNAL OF GENERAL MEDICINE LA English DT Article DE admission acute heart failure; ST-elevation myocardial infarction; air pollution; PM2.5 ID PARTICULATE AIR-POLLUTION; ACUTE CORONARY SYNDROMES; CLINICAL CHARACTERISTICS; CARE-UNIT; ASSOCIATION; GUIDELINES; MANAGEMENT; DISEASE; EVENTS; RISK AB Background: Air pollution with increased concentrations of fine (<2.5 mu m) particulate matter (PM2.5) increases the risk of cardiovascular morbidity and mortality. Even short-term increase of PM2.5 may help trigger ST-elevation myocardial infarction (STEMI) and heart failure (HF) in susceptible individuals, even in areas with good air quality. Purpose: To evaluate the role of PM2.5 levels >20 mu g/m(3) in admission acute HF in STEMI patients. Materials and Methods: In 290 STEMI patients with the leading reperfusion strategy primary percutaneous coronary intervention (PPCI), we retrospectively studied independent predictors of admission acute HF and included admission demographic and clinical data as well as ambient PM2.5 levels >= 20 mu g/m(3). We defined admission acute HF in STEMI patients as classes II-IV by Killip Kimball classification. Results: Acute admission HF was observed in 34.5% of STEMI patients. PPCI was performed in 87.1% of acute admission HF patients and in 94.7% non-HF patients (p= 0.037). Significant independent predictors of acute admission HF were prior diabetes (OR 2.440, 95% CI 1.100 to 5.400, p=0.028), admission LBBB (OR 10.190, 95% CI 1.160 to 89.360, p=0.036), prior resuscitation (OR 2.530, 95% CI 1.010 to 6.340, p=0.048), admission troponin I >= 5 mu g/l (OR 3.390, 95% CI 1.740 to 6.620, p<0.001), admission eGFR levels (0.61, 95% CI 0.52 to 0.72, p < 0.001), and levels of PM2.5 >= 20 mu g/m(3) (OR 2.140, 95% CI 1.005 to 4.560, p=0.049) one day before admission. Conclusion: Temporary short-term increase in PM2.5 levels (>= 20 mu g/m(3)) one day prior to admission in an area with mainly good air quality was among significant independent predictors of acute admission HF in STEMI patients. C1 [Sinkovic, Andreja; Markota, Andrei; Marinsek, Martin] Univ Clin Ctr Maribor, Dept Med Intens Care, Ljubljanska 5, Maribor 2000, Slovenia. [Krasevec, Manja] Univ Maribor, Med Fac, Maribor, Slovenia. [Suran, David] Univ Clin Ctr Maribor, Dept Cardiol, Maribor, Slovenia. C3 University of Maribor; University of Maribor; University of Maribor RP Sinkovic, A (通讯作者),Univ Clin Ctr Maribor, Dept Med Intens Care, Ljubljanska 5, Maribor 2000, Slovenia. EM andreja.sinkovic@guest.arnes.si RI Šuran, David/HNR-9408-2023; Sinkovic, Andreja/E-8457-2015 OI Krasevec, Manja/0000-0002-9481-8713; Suran, David/0000-0002-4073-9286 CR [Anonymous], CHEM ANALYTIC LAB EN ARSO Okolje, KAK ZRAK SLOV 2018 Bai L, 2019, ENVIRON INT, V132, DOI 10.1016/j.envint.2019.105004 Brook RD, 2010, CIRCULATION, V121, P2331, DOI 10.1161/CIR.0b013e3181dbece1 Cesaroni G, 2014, BMJ-BRIT MED J, V348, DOI 10.1136/bmj.f7412 Chen RJ, 2012, AM J EPIDEMIOL, V175, P1173, DOI 10.1093/aje/kwr425 Cinar T, 2019, CORONARY ARTERY DIS, V30, P569, DOI 10.1097/MCA.0000000000000776 European Environment Agency, 2018, REP INT THIN AIR ART Franklin BA, 2015, CURR PROB CARDIOLOGY, V40, P207, DOI 10.1016/j.cpcardiol.2015.01.003 Harjola VP, 2020, EUR J HEART FAIL, V22, P1298, DOI 10.1002/ejhf.1831 Hayiroglu MI, 2019, HEART LUNG CIRC, V28, P237, DOI 10.1016/j.hlc.2017.10.023 Hayiroglu MI, 2018, TURK KARDIYOL DERN A, V46, P10, DOI 10.5543/tkda.2017.11126 Ibanez B, 2018, EUR HEART J, V39, P119, DOI 10.1093/eurheartj/ehx393 Jeger RV, 2017, CLIN CARDIOL, V40, P907, DOI 10.1002/clc.22745 KILLIP T, 1967, AM J CARDIOL, V20, P457, DOI 10.1016/0002-9149(67)90023-9 Levey AS, 2009, ANN INTERN MED, V150, P604, DOI 10.7326/0003-4819-150-9-200905050-00006 Lim SS, 2012, LANCET, V380, P2224, DOI 10.1016/S0140-6736(12)61766-8 Milojevic A, 2014, HEART, V100, P1093, DOI 10.1136/heartjnl-2013-304963 Mustafic H, 2012, JAMA-J AM MED ASSOC, V307, P713, DOI 10.1001/jama.2012.126 Peters A, 2001, EUR HEART J, V22, P1198, DOI 10.1053/euhj.2000.2483 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Pope CA, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.002506 Puymirat E, 2012, JAMA-J AM MED ASSOC, V308, P998, DOI 10.1001/2012.jama.11348 Shah ASV, 2013, LANCET, V382, P1039, DOI 10.1016/S0140-6736(13)60898-3 Steg PG, 2004, CIRCULATION, V109, P494, DOI 10.1161/01.CIR.0000109691.16944.DA Townsend N, 2016, EUR HEART J, V37, P3232, DOI [10.1093/eurheartj/ehw334, 10.1093/eurheartj/ehy342] Wang CC, 2015, INT J ENV RES PUB HE, V12, P8187, DOI 10.3390/ijerph120708187 Wellenius GA, 2012, ARCH INTERN MED, V172, P229, DOI 10.1001/archinternmed.2011.732 NR 28 TC 0 Z9 0 U1 0 U2 8 PU DOVE MEDICAL PRESS LTD PI ALBANY PA PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND EI 1178-7074 J9 INT J GEN MED JI Int. J. Gen. Med. PY 2021 VL 14 BP 8473 EP 8479 DI 10.2147/IJGM.S340301 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA XA8XL UT WOS:000720923400006 PM 34819753 OA gold, Green Published DA 2023-05-13 ER PT J AU Richards, SH Dickens, C Anderson, R Richards, DA Taylor, RS Ukoumunne, OC Turner, KM Gandhi, M Kuyken, W Gibson, A Davey, A Warren, F Winder, R Campbell, J AF Richards, Suzanne H. Dickens, Chris Anderson, Rob Richards, David A. Taylor, Rod S. Ukoumunne, Obioha C. Turner, Katrina M. Gandhi, Manish Kuyken, Willem Gibson, Andrew Davey, Antoinette Warren, Fiona Winder, Rachel Campbell, John TI Assessing the effectiveness of Enhanced Psychological Care for patients with depressive symptoms attending cardiac rehabilitation compared with treatment as usual (CADENCE): a pilot cluster randomised controlled trial SO TRIALS LA English DT Article DE Depression; Coronary heart disease; Multimorbidity; Behavioural activation; Mental health care coordination; Cardiac rehabilitation; Randomised controlled trial; Qualitative interviews ID CORONARY-HEART-DISEASE; QUALITY-OF-LIFE; BEHAVIORAL ACTIVATION; PROGNOSTIC ASSOCIATION; CARDIOVASCULAR EVENTS; MYOCARDIAL-INFARCTION; PSYCHIATRIC-DISORDER; RISK-FACTOR; MORTALITY; METAANALYSIS AB Background: Around 17% of people attending UK cardiac rehabilitation programmes have depression. Optimising psychological wellbeing is a rehabilitation goal, but provision of psychological care is limited. We developed and piloted an Enhanced Psychological Care (EPC) intervention embedded within cardiac rehabilitation, aiming to test key areas of uncertainty to inform the design of a definitive randomised controlled trial (RCT) and economic evaluation. Methods: An external pilot randomised controlled trial (RCT) randomised eight cardiac rehabilitation teams (clusters) to either usual care of cardiac rehabilitation provision (UC), or EPC in addition to UC. EPC comprised mental health care coordination and patient-led behavioural activation with nurse support. Adults eligible for cardiac rehabilitation following an acute coronary syndrome and identified with new-onset depressive symptoms during an initial nurse assessment were eligible. Measures were performed at baseline and 5- and 8-month follow-ups and compared between EPC and UC. Team and participant recruitment and retention rates, and participant outcomes (clinical events, depression, anxiety, health-related quality of life, patient experiences, and resource use) were assessed. Results: Eight out of twenty teams were recruited and randomised. Of 614 patients screened, 55 were eligible and 29 took part (5%, 95% CI 3 to 7% of those screened), with 15 patient participants cluster randomised to EPC and 14 to UC. Nurse records revealed that 8/15 participants received the maximum number of EPC sessions offered; and 4/15 received no sessions. Seven out of fifteen EPC participants were referred to another NHS psychological service compared to none in UC. We followed up 27/29 participants at 5 months and 17/21 at 8 months. The mean difference (EPC minus UC) in depressive symptoms (Beck Depression Inventory) at follow-up (adjusting for baseline score) was 1.7 (95% CI -3.8 to 7.3; N = 26) at 5 months and 4.4 (95% CI -1.4 to 10.2; N = 17) at 8 months. Discussion: While valued by patients and nurses, organisational and workload constraints are significant barriers to EPC implementation. There remains a need to develop and test new models of psychological care within cardiac rehabilitation. Our study offers important data to inform the design of future trials of similar interventions. C1 [Richards, Suzanne H.; Dickens, Chris; Anderson, Rob; Richards, David A.; Taylor, Rod S.; Davey, Antoinette; Warren, Fiona; Winder, Rachel; Campbell, John] Univ Exeter, Sch Med, St Lukes Campus, Exeter EX1 2LU, Devon, England. [Richards, Suzanne H.] Univ Leeds, Inst Hlth Sci, Level 10 Worsley Bldg, Leeds LS2 9JN, W Yorkshire, England. [Ukoumunne, Obioha C.] Univ Exeter, Sch Med, NIHR Collaborat Leadership Appl Hlth Res & Care S, St Lukes Campus, Exeter EX1 2LU, Devon, England. [Turner, Katrina M.] Univ Bristol, Populat Hlth Sci, Canynge Hall,Whatley Rd, Bristol BS8 2PS, Avon, England. [Turner, Katrina M.] Univ Hosp Bristol NHS Fdn Trust, NIHR CLAHRC West, Bristol, Avon, England. [Gandhi, Manish] Royal Devon & Exeter NHS Fdn Trust, Barrack Rd, Exeter EX2 5DW, Devon, England. [Kuyken, Willem] Univ Oxford, Univ Dept Psychiat, Warneford Hosp, Oxford 0X3 7JX, England. [Gibson, Andrew] Univ West England, Hlth & Social Sci, Frenchay Campus,Coldharbour Lane, Bristol BS16 1QY, Avon, England. C3 RLUK- Research Libraries UK; University of Exeter; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; RLUK- Research Libraries UK; University of Exeter; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Exeter; RLUK- Research Libraries UK; University of Oxford; University of West England RP Richards, SH (通讯作者),Univ Exeter, Sch Med, St Lukes Campus, Exeter EX1 2LU, Devon, England.; Richards, SH (通讯作者),Univ Leeds, Inst Hlth Sci, Level 10 Worsley Bldg, Leeds LS2 9JN, W Yorkshire, England. EM s.h.richards@leeds.ac.uk RI Taylor, Rod/R-9581-2019; Kuyken, Willem/ABC-5152-2021; Richards, David A/B-4807-2009; Warren, Fiona/AGE-5194-2022 OI Taylor, Rod/0000-0002-3043-6011; Richards, David A/0000-0002-8821-5027; Warren, Fiona/0000-0002-3833-0182; Campbell, John/0000-0002-6752-3493; Winder, Rachel/0000-0002-9926-1280; Turner, Katrina/0000-0002-6375-2918; Kuyken, Willem/0000-0002-8596-5252; Richards, Suzanne/0000-0003-1416-0569 FU UK NIHR Health Technology Assessment Programme [12/189/06]; Royal Devon and Exeter NHS Foundation Trust; University of Exeter Medical School; University of Leeds; University of Bristol; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West (CLAHRC West) at University Hospitals Bristol NHS Foundation Trust; NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula; University of the West of England; Oxford University FX This project was funded by the UK NIHR Health Technology Assessment Programme (project number 12/189/06). The Royal Devon and Exeter NHS Foundation Trust is acting as trial sponsor. The Funding Agency and trial sponsors have not been substantively involved in the design, or data acquisition for this research, nor the drafting of this manuscript; the views and opinions expressed in this paper are those of the authors and do not necessarily reflect those of the Health Technology Assessment Programme, NIHR, NHS or the Department of Health.r Rob Anderson, John Campbell, Christopher Dickens, David Richards, Suzanne Richards, Rod Taylor, Obioha Ukoumunne and Fiona Warren were centrally funded by the University of Exeter Medical School. Suzanne Richards was also centrally funded by the University of Leeds during the drafting of this manuscript. Katrina Turner is funded by the University of Bristol, Andrew Gibson by the University of the West of England and Willem Kuyken by Oxford University. Katrina Turner is also supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West (CLAHRC West) at University Hospitals Bristol NHS Foundation Trust. Manish Gandhi is funded by the Royal Devon and Exeter NHS Foundation Trust. Antoinette Davey and Rachel Winder were employed by the University of Exeter Medical School on the above funding award. David Richards, Rod Taylor and Obioha Ukoumunne are also supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula. CR Addis ME, 2004, OVERCOMING DEPRESSIO Attkisson C C, 1982, Eval Program Plann, V5, P233, DOI 10.1016/0149-7189(82)90074-X Barth J, 2004, PSYCHOSOM MED, V66, P802, DOI 10.1097/01.psy.0000146332.53619.b2 Beck A. 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A. Shakhnovich, R. M. Tereschenko, S. N. Erlikh, A. D. Pevsner, D., V Gulyan, R. G. TI Features of Parenteral Anticoagulant Therapy in Patients With Myocardial Infarction According to the Russian Register of Acute Myocardial Infarction - REGION-IM SO KARDIOLOGIYA LA English DT Article DE Cardiovascular diseases; ischemic heart disease; acute coronary syndrome; myocardial infarction; registry of acute myocardial infarction; parenteral anticoagulant therapy ID ACUTE CORONARY SYNDROME; ST-SEGMENT ELEVATION; EURO HEART SURVEY; UNFRACTIONATED HEPARIN; COST-EFFECTIVENESS; TASK-FORCE; FONDAPARINUX; ENOXAPARIN; MANAGEMENT; INTERVENTION AB Aim To study specific features of the parenteral anticoagulant therapy for acute myocardial infarction (MI) in the Russian Federation and to evaluate the consistency of the prescribed parenteral anticoagulant therapy with the effective clinical guidelines. Material and Methods REGION-MI, the Russian rEGIstry for acute myOcardial iNfarction, is a multicenter observational study. This registry includes all patients admitted to hospitals with a documented diagnosis of ST-elevation acute MI (STEMI) and non- ST-elevation acute MI (NSTEMI) based on the criteria of the Forth Universal Definition of MI of the European Society of Cardiology. Risk of bleeding was assessed with the Academic Research Consortium for High Bleeding Risk (ARC-HBR) scale, and risk of major bleeding in patients with NSTEMI was additionally assessed with the CRUSADE scale. Results From November 01, 2020 through April 03, 2022, 5025 patients were included into the REGIONMI registry. At primary vascular departments, 70.5 % of patients were administered unfractionated heparin (NFH); at regional vascular centers, 37.1% of patients were administered NFH, 29.6 % enoxaparin, 20,2 % NFH in combination with enoxaparin, 6.8 % fondaparinux, 4.2% NFH in combination with fondaparinux, and 1.9 % nadroparin. At the prehospital stage, NFH was used as an anticoagulant support for the thrombolytic therapy (TLT) in 84% of patients, and lowmolecular heparins (LMH) were used in 16 %. At the hospital stage, UFH was administered to 64.4 % of patients, and enoxaparin was administered to 23.9 % of patients. Among the patients who had undergone primary percutaneous coronary intervention (PCI), 40 % received NFH, 25 % enoxaparin, 22% NFH in combination with enoxaparin, 7 % fondaparinux, and 4 % NFH in combination with fondaparinux. In conservative and invasive tactics of therapy for NSTEMI, NFH was also administered more frequently (43 and 43%, respectively), followed by (according to frequency of administration) enoxaparin (36 and 34%, respectively), NFH in combination with enoxaparin (10 and 16 %, respectively), fondaparinux (7 and 6 %, respectively), and NFH in combination with fondaparinux (3 and 1%, respectively). Conclusion According to the Russian registry of acute MI, REGION-MI, with all strategies for the treatment of MI, parenteral anticoagulants are not prescribed in full consistency with clinical guidelines. The most frequently used parenteral anticoagulant is NFH. Despite the high efficacy and safety of fondaparinux, the frequency of its administration remains unjustifiably low not only in the Russian Federation but also in other countries. The same can be said about the administration of enoxaparin to patients who had received TLT. Attention should be paid to physicians' awareness of recent clinical guidelines, to minimize the prehospital treatment with parenteral anticoagulants, to limit this treatment to the TLT support, and to provide continuity between all stages of medical care. C1 [Boytsov, S. A.; Shakhnovich, R. M.; Tereschenko, S. N.; Pevsner, D., V; Gulyan, R. G.] Chazov Natl Med Res Ctr Cardiol, Moscow, Russia. [Erlikh, A. D.] Bauman Municipal Clin Hosp 29, Moscow, Russia. RP Gulyan, RG (通讯作者),Chazov Natl Med Res Ctr Cardiol, Moscow, Russia. EM rimmagulyan5@mail.ru OI Shakhnovich, Roman/0000-0003-3248-0224; Pevzner, Dmitry/0000-0002-5290-0065; Erlikh, Alexey/0000-0003-0607-2673 FU Amgen; AstraZeneca; Boehringer Ingelheim; Novartis; Aspen; Sanofi; Abbott; Akrikhin; Evroservice; P-PHARM FX We thank Aston Consulting for technical organization and management of the REGION-MI registry and, particularly, Natalia Yurievna Dmitrieva for the statistical and analytical data processing. The authors thank Amgen, AstraZeneca, Boehringer Ingelheim, Novartis, Aspen, Sanofi, Abbott, Akrikhin, Evroservice, and P-PHARM for their support of the REGION-MI registry. CR Almendro-Delia M, 2021, INT J CARDIOL, V332, P29, DOI 10.1016/j.ijcard.2021.02.081 Averkov O.V., 2020, RUSS J CARDIOL, V25, P251 [Барбараш О.Л. Barbarash O.L.], 2021, [Российский кардиологический журнал, Russian Journal of Cardiology, Rossiiskii kardiologicheskii zhurnal], V26, P149, DOI 10.15829/1560-4071-2021-4449 Boytsov SA, 2021, KARDIOLOGIYA, V61, P41, DOI 10.18087/cardio.2021.6.n1595 Caldeira D, 2019, REV PORT CARDIOL, V38, P809, DOI 10.1016/j.repc.2019.02.015 Capodanno D, 2016, EUR HEART J-ACUTE CA, V5, P253, DOI 10.1177/2048872615572599 Cassese S, 2015, EUROINTERVENTION, V11, P196, DOI 10.4244/EIJY14M08_01 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 Hernandez JMD, 2017, BMC CARDIOVASC DISOR, V17, DOI 10.1186/s12872-017-0636-9 Erlikh A.D., 2018, ATHEROTHROMBOSIS, V1, P26 Erlinge D, 2016, AM HEART J, V175, P36, DOI 10.1016/j.ahj.2016.02.007 Gabriel Ruvin S, 2007, Expert Rev Cardiovasc Ther, V5, P851, DOI 10.1586/14779072.5.5.851 Ibanez B, 2018, EUR HEART J, V39, P119, DOI 10.1093/eurheartj/ehx393 Kossovsky MP, 2012, SWISS MED WKLY, V142, DOI 10.4414/smw.2012.13536 Mandelzweig L, 2006, EUR HEART J, V27, P2285, DOI 10.1093/eurheartj/ehl196 Montalescot G, 2011, LANCET, V378, P693, DOI 10.1016/S0140-6736(11)60876-3 O'Gara PT, 2013, J AM COLL CARDIOL, V61, pE78, DOI [10.1016/j.jacc.2012.11.019, 10.1161/01.cir.0000440804.93914.d8, 10.1161/CIR.0b013e3182742cf6] Pepe C, 2012, ARQ BRAS CARDIOL, V99, P613, DOI 10.1590/S0066-782X2012005000060 Permsuwan U, 2015, HEART LUNG CIRC, V24, P860, DOI 10.1016/j.hlc.2015.02.018 Puymirat E, 2013, EUR HEART J-ACUTE CA, V2, P359, DOI 10.1177/2048872613497341 Silvain J, 2012, BMJ-BRIT MED J, V344, DOI 10.1136/bmj.e553 Soeiro AD, 2016, ARQ BRAS CARDIOL, V107, P239, DOI 10.5935/abc.20160127 Steg PG, 2010, JAMA-J AM MED ASSOC, V304, P1339, DOI 10.1001/jama.2010.1320 Szummer K, 2015, JAMA-J AM MED ASSOC, V313, P707, DOI 10.1001/jama.2015.517 TELFORD AM, 1981, LANCET, V1, P1225 Terres JAR, 2015, BMC CARDIOVASC DISOR, V15, DOI 10.1186/s12872-015-0175-1 WALLENTIN L, 1990, LANCET, V336, P827 Washam JB, 2015, CIRCULATION, V131, P1123, DOI 10.1161/CIR.0000000000000183 Wester A, 2020, CIRC-CARDIOVASC INTE, V13, DOI 10.1161/CIRCINTERVENTIONS.119.008671 Yusuf S, 2006, JAMA-J AM MED ASSOC, V295, P1519 Yusuf S, 2006, NEW ENGL J MED, V354, P1464 NR 31 TC 0 Z9 0 U1 0 U2 0 PU RUSSIAN HEART FAILURE SOC PI MOSCOW PA 215, 5, BEREGOVOY PROEZD, MOSCOW, 121087, RUSSIA SN 0022-9040 J9 KARDIOLOGIYA JI Kardiologiya PY 2022 VL 62 IS 10 BP 3 EP 15 DI 10.18087/cardio.2022.10.n2238 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 7A7NJ UT WOS:000898637700001 PM 36384404 DA 2023-05-13 ER PT J AU Gierlotka, M Gasior, M Tajstra, M Hawranek, M Osadnik, T Wilczek, K Kalarus, Z Lekston, A Zembala, M Polonski, L AF Gierlotka, Marek Gasior, Mariusz Tajstra, Mateusz Hawranek, Michal Osadnik, Tadeusz Wilczek, Krzysztof Kalarus, Zbigniew Lekston, Andrzej Zembala, Marian Polonski, Lech TI Outcomes of invasive treatment in very elderly Polish patients with non-ST-segment-elevation myocardial infarction from 2003-2009 (from the PL-ACS registry) SO CARDIOLOGY JOURNAL LA English DT Article DE NSTEMI; elderly; percutaneous coronary intervention; mortality; temporal trends ID ACUTE CORONARY SYNDROMES; CLINICAL CARDIOLOGY; EUROPEAN-SOCIETY; GLOBAL REGISTRY; TASK-FORCE; FOLLOW-UP; MANAGEMENT; REVASCULARIZATION; STRATEGIES; CARE AB Background: Elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) are rarely included in randomized trials due to concomitant diseases. As a result, invasive treatment and aggressive pharmacotherapy are used less frequently in this group. The aim of the study was to analyze the impact of invasive treatment used for elderly patients (>= 80 years) with NSTEMI from 2003-2009 and its impact on 24-month outcomes. Methods: We peiformed analysis of 13,707 elderly patients, out of 78,422 total NSTEMI patients, enrolled in the prospective, nationwide, Polish Registry of Acute Coronary Syndromes (PL-ACS) from 2003 to 2009. Results: The percentage of elderly NSTEMI population was 17.5%. Invasive treatment received 24% of them. In-hospital complications (stroke, reinfarction and death) were significantly less frequent in the invasive group, with the exception of major bleeding, which occurred almost three times more frequently (2.9% vs. 1.1%, p < 0.0001) in the invasive group. The 24-month mortality was lower (29.4% vs. 50.4%, p < 0.0001) in the invasive group and remained so after matching patients by the propensity score method (31.1% vs. 40.9%, p < 0.0001). From 2003 to 2009 the use of thienopyridines, beta-blockers and statins rose significantly. The frequency of invasive strategy increased significantly, from 10% in to over 50% in 2009. The frequency of major bleeding increased twofold, however a significant reduction in the 24-month mortality was observed over the years. Conclusions: Elderly patients with NSTEMI benefit significantly from invasive strategies and modern pharmacotherapy recommended by treatment guidelines. Nevertheless, this approach is associated with an increased incidence of major bleeding. (Cardiol J 2013; 20, 1: 34 43) C1 [Gierlotka, Marek; Gasior, Mariusz; Tajstra, Mateusz; Hawranek, Michal; Osadnik, Tadeusz; Wilczek, Krzysztof; Kalarus, Zbigniew; Lekston, Andrzej; Zembala, Marian; Polonski, Lech] Med Univ Silesia, Silesian Ctr Heart Dis, PL-41800 Zabrze, Poland. C3 Medical University Silesia; Silesian Center for Heart Diseases RP Gierlotka, M (通讯作者),Med Univ Silesia, Silesian Ctr Heart Dis, Ul Curie Sklodowskiej 9, PL-41800 Zabrze, Poland. EM marek.gierlotka@sccs.pl RI Hawranek, Michał/AAQ-7056-2020; Osadnik, Tadeusz/P-5844-2014; Gierlotka, Marek/U-6969-2019; Tajstra, Mateusz MT/R-6890-2016 OI Osadnik, Tadeusz/0000-0002-3202-6972; Gierlotka, Marek/0000-0001-5639-2128; Kalarus, Zbigniew/0000-0003-3921-7234; Hawranek, Michal/0000-0002-8061-9975 FU Polish Ministry of Health FX This manuscript is the result of an unfunded analysis of the PL-ACS Registry database. However, the Polish Registry of Acute Coronary Syndromes PL-ACS is supported by an unrestricted grant from the Polish Ministry of Health. The sponsor was not involved in data collection, data management, and review of the manuscript before submission, had no role in the design or conduct of this study, data analysis, interpretation of the data, manuscript preparation, or approval of the manuscript. 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J. PD JAN PY 2013 VL 20 IS 1 BP 34 EP 43 DI 10.5603/CJ.2013.0007 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 113DZ UT WOS:000316648000007 PM 23558809 OA gold DA 2023-05-13 ER PT J AU Tanios, BY Itani, HS Zimmerman, DL AF Tanios, Bassem Y. Itani, Houssam S. Zimmerman, Deborah L. TI Clopidogrel Use in End- Stage Kidney Disease SO SEMINARS IN DIALYSIS LA English DT Review ID PERCUTANEOUS CORONARY INTERVENTION; ELEVATION MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; OF-CARE ASSAY; PLATELET REACTIVITY; ANTIPLATELET THERAPY; CLINICAL-OUTCOMES; P2Y(12) RECEPTOR; RENAL-FUNCTION; HEMODIALYSIS AB Clopidogrel irreversibly binds to the P2Y12 platelet receptor and acts as a potent inhibitor of platelet activation and aggregation. It is currently recommended for the prevention of cardiovascular events in patients with acute coronary syndromes, recent ischemic stroke, and peripheral arterial disease. Clopidogrel is a prodrug requiring hepatic conversion into its active metabolite. In the general population, genetic polymorphisms in the CYP2C19 gene interfering with hepatic conversion and the ABCB1 gene interfering with gut absorption of clopidogrel, account for the large interindividual response to clopidogrel and clopidogrel resistance. Chronic kidney disease (CKD) and ESKD are independent risk factors for clopidogrel resistance; 50-80% of patients with ESKD have high on-treatment residual platelet reactivity when treated with clopidogrel. This may partially explain the abysmal outcomes for patients with kidney disease post coronary intervention. Several assays are used to determine residual on-treatment platelet reactivity; however, their use in tailoring the suitability of clopidogrel treatment in patients with ESKD is unclear. Although clopidogrel decreased cardiovascular events in the general population after acute coronary syndromes and percutaneous intervention in the CURE and CREDO trials, a reanalysis of these studies in patients with CKD (eGFR <60ml/minute) showed either a reduced or no benefit from clopidogrel treatment. ESKD patients were not represented in these two large trials; this is true for most of the trials that established clopidogrel as an integral part of the therapeutic armamentarium for cardiovascular disease. Furthermore, clopidogrel has been associated with an increased risk of death, death from bleeding, and hospitalization for bleeding in patients with ESKD. In conclusion, current evidence suggests that ESKD patients may not derive the same benefits from clopidogrel therapy as the general population and this therapy may be associated with harm. Properly designed observational studies and randomized controlled trials are needed to establish the role of clopidogrel in patients with ESKD, the use of platelet assays to tailor therapy, and the role of other antiplatelet agents such as prasugrel or ticagrelor in patients who exhibit high on-treatment residual platelet reactivity. C1 [Tanios, Bassem Y.] Univ Paris Sud, Dept Nephrol, F-94275 Le Kremlin Bicetre, France. [Itani, Houssam S.; Zimmerman, Deborah L.] Univ Ottawa, Dept Med, Ottawa Hosp, Div Nephrol, Ottawa, ON, Canada. [Zimmerman, Deborah L.] Ottawa Hosp Res Inst, Kidney Res Ctr, Ottawa, ON, Canada. C3 UDICE-French Research Universities; Universite Paris Saclay; University of Ottawa; Ottawa Hospital Research Institute; University of Ottawa; Ottawa Hospital Research Institute RP Zimmerman, DL (通讯作者),1967 Riverside Dr, Ottawa, ON K1H 7W9, Canada. EM dzimmerman@ottawahospital.on.ca OI Tanios, Bassem/0000-0002-8323-6910 FU Department of Medicine at the Ottawa Hospital FX Dr Zimmerman receives salary support from the Department of Medicine at the Ottawa Hospital. The authors thank Drs. Elianna Saidenberg and John Dawdy for their thoughtful review and comments on this manuscript. 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Dial. PD MAY-JUN PY 2015 VL 28 IS 3 BP 276 EP 281 DI 10.1111/sdi.12338 PG 6 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA CH4BO UT WOS:000353976200014 PM 25476742 DA 2023-05-13 ER PT J AU Szychta, W Majstrak, F Opolski, G Filipiak, KJ AF Szychta, Wojciech Majstrak, Franciszek Opolski, Grzegorz Filipiak, Krzysztof J. TI Change in the clinical profile of patients referred for coronary artery bypass grafting from 2004 to 2008. Trends in a single-centre study SO KARDIOLOGIA POLSKA LA English DT Article DE coronary artery bypass grafting; coronary artery disease; comorbidities; epidemiology ID RISK-FACTORS; SURGERY; MORTALITY; SOCIETY; DISEASE; HEART AB Background and aims: The aim of this study is to describe the changes that occurred between 2004 and 2008 in the profile of patients referred for off-pump surgical treatment of coronary artery disease, by determining changes in their clinical characteristics, surgical procedures, and their results. Methods and results: This study is a retrospective evaluation of 2827 consecutive patients treated in the units of the 1st Chair of Cardiology of the Medical University of Warsaw from 2004 to 2008. We identified and retrieved 133 preoperative, intraoperative, and postoperative parameters. The statistical analysis was performed on measurable data in the analysed subgroups, but the relationship between immeasurable data was also examined. Significant declines in duration of hospitalisation, systolic and diastolic blood pressure on admission, left ventricular ejection fraction, stable coronary disease on admission, relationship between venous and arterial conduits used as graft, and in-hospital infections were observed. Meanwhile, the prevalence of arterial hypertension, of chronic pulmonary diseases, smoke, neurological dysfunction, heart rate on admission, diagnosis of two-and three-vessel disease and acute coronary syndrome/unstable angina, additive and logistic EuroScore, and average number of postoperative days in intensive care unit increased. More operations were performed as urgent/emergency cases, with higher numbers of grafts - which were more often arterial - per patient. An increase of length of the operation, blood loss and need for transfusion were observed as well as increased need for reoperation for bleeding. Conclusions: Patients referred for coronary artery surgery are becoming higher-risk patients with a greater number of comorbidities, and surgical techniques are becoming progressively more sophisticated. C1 [Szychta, Wojciech; Opolski, Grzegorz; Filipiak, Krzysztof J.] Med Univ Warsaw, Chair & Dept Cardiol 1, PL-02097 Warsaw, Poland. [Majstrak, Franciszek] Med Univ Warsaw, Dept Cardiac Surg, Chair Cardiol 1, Warsaw, Poland. C3 Medical University of Warsaw; Medical University of Warsaw RP Szychta, W (通讯作者),Med Univ Warsaw, Chair & Dept Cardiol 1, Ul Banacha 1A, PL-02097 Warsaw, Poland. EM wszychta@wp.pl OI Opolski, Grzegorz/0000-0003-4744-2554 FU Medical University of Warsaw FX The Medical University of Warsaw, in the form of a doctoral scholarship, granted this work for Wojciech Szychta from 01.10.2010 to 31.11.2013 on the basis of a resolution of the Senate of the Medical University of Warsaw 25/2009 dated 27 April 2009 (Case No: APD1-023-133/2010). 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Pol. PY 2015 VL 73 IS 7 BP 493 EP 501 DI 10.5603/KP.a2015.0055 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CP8GP UT WOS:000360131000004 PM 25761791 DA 2023-05-13 ER PT J AU Shechter, M Rubinstein, R Goldenberg, I Matetzki, S AF Shechter, Michael Rubinstein, Roy Goldenberg, Ilan Matetzki, Shlomi CA ACSIS TI Comparison of Outcomes of Acute Coronary Syndrome in Patients >= 80 Years Versus Those < 80 Years in Israel from 2000 to 2013 SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; ELDERLY-PATIENTS; PRACTICE GUIDELINES; GLOBAL REGISTRY; MANAGEMENT; AGE; TRENDS; CARDIOLOGY; CARE AB Although patients >= 80 years old constitute the fastest-growing segment of the population and have a high prevalence of coronary artery disease, few data exist regarding the outcome of octogenarians with acute coronary syndrome (ACS). In a retrospective study based on data of 13,432 ACS patients who were enrolled in the ACS Israel Survey, we first evaluated the, clinical outcome of 1,731 ACS patients >= 80 years (13%) compared with 11,701 ACS patients <80 years (87%) hospitalized during 2000 to 2013. Second, we evaluated the clinical outcome of patients years hospitalized during the 2000 to 2006 ("early") period (n = 1,037) compared with those of the same age group of patients hospitalized during the 2008 to 2013 ("late") period (n = 694). Implementation of the ACS AHA/ACC/ESC therapeutic guidelines was lower in ACS patients years compared with patients <80 years. Multivariate Cox regression analysis demonstrated a worse 1-year survival rate in the ACS patients 80 years compared with those <80 years. During the late period, patients years - were more frequently treated with guideline-recommended therapies compared with patients from the same age group who were hospitalized in the early period. Multivariate Cox regression analysis demonstrated a better 1-year survival rate of patients >= 80 years during the late period compared with the early period (hazard ratio 1.17, 95% confidence interval 1.15 to 1.61; p = 0.01). In addition, adverse outcome rates of ACS patients >= 80 years were significantly higher compared with those of patients <80 years. However, survival rates of ACS patients years were improved over,the 200 to 2013 period. (C) 2017 Elsevier Inc. All rights reserved. C1 [Shechter, Michael; Goldenberg, Ilan; Matetzki, Shlomi] Chaim Sheba Med Ctr, Leviev Heart Ctr, Tel Hashomer, Israel. [Shechter, Michael; Rubinstein, Roy; Goldenberg, Ilan; Matetzki, Shlomi] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel. C3 Chaim Sheba Medical Center; Tel Aviv University; Sackler Faculty of Medicine RP Shechter, M (通讯作者),Chaim Sheba Med Ctr, Leviev Heart Ctr, Tel Hashomer, Israel.; Shechter, M (通讯作者),Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel. EM shechtes@netvision.net.il CR Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Avezum A, 2005, AM HEART J, V149, P67, DOI 10.1016/j.ahj.2004.06.003 Chin CT, 2014, AM HEART J, V167, P36, DOI 10.1016/j.ahj.2013.10.008 Devlin G, 2008, EUR HEART J, V29, P1275, DOI 10.1093/eurheartj/ehn124 Fach A, 2015, AM J CARDIOL, V116, P1802, DOI 10.1016/j.amjcard.2015.09.022 Forman DE, 2010, AM J CARDIOL, V106, P1382, DOI 10.1016/j.amjcard.2010.07.008 Gale CP, 2014, HEART, V100, P582, DOI 10.1136/heartjnl-2013-304517 Gale CP, 2012, EUR HEART J, V33, P630, DOI 10.1093/eurheartj/ehr381 Jneid H, 2012, CIRCULATION, V126, P875, DOI 10.1161/CIR.0b013e318256f1e0 Kornowski R, 2011, CATHETER CARDIO INTE, V78, P537, DOI 10.1002/ccd.23345 Menezes AR, 2012, J GERIATR CARDIOL, V9, P68, DOI 10.3724/SP.J.1263.2012.00068 O'Gara PT, 2013, CIRCULATION, V127, P529, DOI 10.1161/CIR.0b013e3182742c84 OCONNOR GT, 1989, CIRCULATION, V80, P234, DOI 10.1161/01.CIR.80.2.234 Rosengren A, 2006, EUR HEART J, V27, P789, DOI 10.1093/eurheartj/ehi774 Schiele F, 2009, EUR HEART J, V30, P987, DOI 10.1093/eurheartj/ehn601 Schoenenberger AW, 2008, J AM GERIATR SOC, V56, P510, DOI 10.1111/j.1532-5415.2007.01589.x Schoenenberger AW, 2016, EUR HEART J, V37, P1304, DOI 10.1093/eurheartj/ehv698 Segev A, 2012, EUROINTERVENTION, V8, P465, DOI 10.4244/EIJV8I4A73 Skolnick AH, 2007, J AM COLL CARDIOL, V49, P1790, DOI 10.1016/j.jacc.2007.01.066 Smith LG, 2013, EUR HEART J, V34, P3191, DOI 10.1093/eurheartj/eht196 Vujcic IS, 2013, BMC CARDIOVASC DISOR, V13, DOI 10.1186/1471-2261-13-112 Yeh RW, 2010, NEW ENGL J MED, V362, P2155, DOI 10.1056/NEJMoa0908610 Zaman MJ, 2014, EUR HEART J, V35, P1551, DOI 10.1093/eurheartj/ehu039 NR 23 TC 4 Z9 5 U1 1 U2 3 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 15 PY 2017 VL 120 IS 8 BP 1230 EP 1237 DI 10.1016/j.amjcard.2017.07.003 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FL0FQ UT WOS:000413887400002 PM 28822560 DA 2023-05-13 ER PT J AU Kwok, CS Lundberg, G Al-Faleh, H Sirker, A Van Spall, HGC Michos, ED Rashid, M Mohamed, M Bagur, R Mamas, MA AF Kwok, Chun Shing Lundberg, Gina Al-Faleh, Hussam Sirker, Alex Van Spall, Harriette G. C. Michos, Erin D. Rashid, Muhammad Mohamed, Mohamed Bagur, Rodrigo Mamas, Mamas A. TI Relation of Frailty to Outcomes in Patients With Acute Coronary Syndromes SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID SHORT-TERM OUTCOMES; ELDERLY-PATIENTS; OLDER PATIENTS; INSIGHTS; DISEASE; ADULTS AB This study examines a national cohort of patients with a diagnosis of acute coronary syndrome (ACS) for the prevalence of frailty, temporal changes over time, and its association with treatments and clinical outcomes. The National Inpatient Sample database was used to identify US adults with a diagnosis of ACS between 2004 and 2014. Frailty risk was determined using a validated Hospital Frailty Risk Score based on ICD-9 codes using the cutoffs <5, 5 to 15, and >15 for low- (LRS), intermediate- (IRS), and high-risk (HRS) frailty scores, respectively. Logistic regression assessed associations of frailty with clinical outcomes, adjusted for patient co-morbidities and hospital characteristics. From 7,398,572 hospital admissions with ACS between 2004 and 2014, 86.5% of patients had LRS, 13.4% had an IRS, and 0.1% had an HRS. From 2004 to 2014, the prevalence of IRS and HRS patients increased from 8.1% to 18.2% and 0.03% to 0.18%, respectively (p <0.001 for both). The proportion of patients treated with percutaneous coronary intervention was greatest among patients with lowest frailty risk scores (LRS 42.9%, IRS 21.0%, and HRS 14.6%). Comparing HRS to LRS, there was a significant increase in bleeding complications (odds ratio [OR] 2.34, 95% confidence interval [CI] 2.03 to 2.69), vascular complications (OR 2.08, 95% CI 1.79 to 2.41), in-hospital stroke (OR 7.84, 95% CI 6.93 to 8.86), and in-hospital death (OR 2.57, 95% CI 2.18 to 3.04). Risk of frailty is common among patients with ACS, is increasing in prevalence, and is associated with differential management strategies, and outcomes during hospitalization. Increased awareness could facilitate frailty-tailored care to minimize the risk of adverse outcomes. (C) 2019 Elsevier Inc. All rights reserved. C1 [Kwok, Chun Shing; Rashid, Muhammad; Mohamed, Mohamed; Bagur, Rodrigo; Mamas, Mamas A.] Keele Univ, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England. [Kwok, Chun Shing; Mohamed, Mohamed; Mamas, Mamas A.] Royal Stoke Univ Hosp, Dept Cardiol, Stoke On Trent, Staffs, England. [Lundberg, Gina] Emory Univ, Sch Med, Emory Womens Heart Ctr, Atlanta, GA USA. [Al-Faleh, Hussam] Secur Forces Hosp, Dept Cardiol & Cardiovasc Surg, Riyadh, Saudi Arabia. [Sirker, Alex] Univ Coll Hosp, Dept Cardiol, London, England. [Van Spall, Harriette G. C.] McMaster Univ, Dept Med, Hamilton, ON, Canada. [Van Spall, Harriette G. C.] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada. [Michos, Erin D.] Johns Hopkins Univ, Ciccarone Ctr Prevent Heart Dis, Baltimore, MD USA. C3 Keele University; Royal Stoke University Hospital; Emory University; Security Forces Hospital - Saudi Arabia; RLUK- Research Libraries UK; University of London; University College London; McMaster University; McMaster University; Johns Hopkins University RP Mamas, MA (通讯作者),Keele Univ, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England.; Mamas, MA (通讯作者),Royal Stoke Univ Hosp, Dept Cardiol, Stoke On Trent, Staffs, England. EM mamasmamas1@yahoo.co.uk RI Bagur, Rodrigo/I-5298-2015; Mamas, Mamas Andreas/A-2549-2019; Mohamed, Mohamed Osama/O-8339-2019 OI Bagur, Rodrigo/0000-0003-1888-9429; Mamas, Mamas Andreas/0000-0001-9241-8890; Mohamed, Mohamed Osama/0000-0002-9678-5222; Van Spall, Harriette Gillian Christine/0000-0002-8370-4569; Michos, Erin/0000-0002-5547-5084; Lundberg, Gina/0000-0002-8011-7094 FU Research and Development Department at the Royal Stoke Hospital; Biosensors International FX The study was supported by a grant from the Research and Development Department at the Royal Stoke Hospital. The first author's PhD tuition is supported by Biosensors International. 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J. Cardiol. PD OCT 1 PY 2019 VL 124 IS 7 BP 1002 EP 1011 DI 10.1016/j.amjcard.2019.07.003 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JC2CM UT WOS:000489084600002 PM 31421814 DA 2023-05-13 ER PT J AU Huczek, Z Filipiak, KJ Kochman, J Michalak, M Grabowski, M Opolski, G AF Huczek, Zenon Filipiak, Krzysztof J. Kochman, Janusz Michalak, Marcin Grabowski, Marcin Opolski, Grzegorz TI Increased risk of minor bleeding and antiplatelet therapy cessation in patients with acute coronary syndromes and low on-aspirin platelet reactivity. A prospective cohort study SO JOURNAL OF THROMBOSIS AND THROMBOLYSIS LA English DT Article DE Aspirin; Bleeding; Platelet reactivity; VerifyNow ID MYOCARDIAL-INFARCTION; FUNCTION TESTS; IMPACT; CLOPIDOGREL; EVENTS; TRIALS; CLASSIFICATIONS; AGGREGATION; DEFINITIONS; INHIBITION AB Bleeding negatively affects prognosis and adherence to antiplatelet therapy after acute coronary syndromes (ACSs). The potential association of on-aspirin platelet reactivity and bleeding is not established. We sought to determine whether low on-aspirin platelet reactivity (LAPR) is associated with bleeding events and antiplatelet therapy compliance in patients with ACSs receiving coronary stenting. On-aspirin platelet reactivity was measured by the VerifyNow (TM) Aspirin assay (Accumetrics Inc., San Diego, CA, USA) in 531 patients with ACS. Cut-offs for LAPR were calculated by receiver-operating characteristic curve (ROC) analysis. Bleeding was reported according to Bleeding Academic Research Consortium (BARC) definition. The end-points were minor bleeding (BARC types 1 or 2), major bleeding (BARC types 3 or 5) and antiplatelet therapy cessation during 6-months follow-up. By ROC analysis the VerifyNow (TM) Aspirin assay was able to distinguish between patients with and without minor bleeding (area under the curve [AUC] 0.66, 95 % confidence interval [CI] 0.62-0.70, P < 0.0001) whereas major bleeding could not be predicted by the assay (AUC 0.54, 95 % CI 0.49-0.58, P = 0.473). By logistic regression, LAPR was associated with increased risk of minor bleeding (odds ratio [OR] 4.32, 95 % CI 2.78-6.71, P < 0.0001) but not major bleeding (OR 2.05, 95 % CI 0.83-5.06, P = 0.117). Antiplatelet therapy discontinuation was more frequent in patients with LAPR as compared to those with no LAPR (21.6 vs. 9.1 %, P = 0.0008). In conclusion, early point-of-care on-aspirin platelet reactivity testing in ACS may identify patients with increased risk of minor bleeding events and subsequent discontinuation of antiplatelet therapy. The possible impact of LAPR on major bleeding needs to be determined in larger trials. C1 [Huczek, Zenon; Filipiak, Krzysztof J.; Kochman, Janusz; Michalak, Marcin; Grabowski, Marcin; Opolski, Grzegorz] Med Univ Warsaw, Chair & Dept Cardiol 1, PL-02097 Warsaw, Poland. C3 Medical University of Warsaw RP Huczek, Z (通讯作者),Med Univ Warsaw, Chair & Dept Cardiol 1, 1A Banacha St, PL-02097 Warsaw, Poland. EM zenon.huczek@wum.edu.pl RI Grabowski, Marcin/M-3872-2018; Michalak, Marcin/R-9684-2018 OI Grabowski, Marcin/0000-0003-3306-0301; Michalak, Marcin/0000-0003-4220-0855; Huczek, Zenon/0000-0002-5912-2649; Kochman, Janusz/0000-0001-8239-8726; Opolski, Grzegorz/0000-0003-4744-2554 FU Polish Ministry of Science and Higher Education [N402 4400 33] FX This study was supported by unrestricted Grant from the Polish Ministry of Science and Higher Education (No. N402 4400 33). 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Thromb. Thrombolysis PD JUL PY 2013 VL 36 IS 1 BP 22 EP 30 DI 10.1007/s11239-012-0808-5 PG 9 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Hematology GA 164WK UT WOS:000320442000005 PM 22987197 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Jaguszewski, M Ghadri, JR Diekmann, J Bataiosu, RD Hellermann, JP Sarcon, A Siddique, A Baumann, L Stahli, BE Luscher, TF Maier, W Templin, C AF Jaguszewski, Milosz Ghadri, Jelena-R. Diekmann, Johanna Bataiosu, Roxana D. Hellermann, Jens P. Sarcon, Annahita Siddique, Asim Baumann, Lukas Staehli, Barbara E. Luescher, Thomas F. Maier, Willibald Templin, Christian TI Acute coronary syndromes in octogenarians referred for invasive evaluation: treatment profile and outcomes SO CLINICAL RESEARCH IN CARDIOLOGY LA English DT Article DE Acute coronary syndrome; Octogenarians; Invasive treatment ID ACUTE MYOCARDIAL-INFARCTION; HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; AGE-RELATED DIFFERENCES; ELDERLY-PATIENTS; CARDIAC-CATHETERIZATION; CARDIOVASCULAR EVENTS; SCIENTIFIC STATEMENT; CLINICAL CARDIOLOGY; GLOBAL REGISTRY AB With increasing life expectancy in the western world, the aging population will compose a significant portion of the demographic. Notably, cardiovascular disease is particularly prevalent in the elderly population. The aim of the present study is to investigate the outcomes of octogenarians referred for urgent coronary angiography in the setting of acute coronary syndromes (ACS). Between June 2007 and June 2012, consecutive patients with ACS were referred for evaluation and percutaneous intervention. Subsequently, the in-hospital death and major adverse cardiovascular events (MACE) at 30 days were analyzed. Multivariate analysis was performed to identify the predictors for death and MACE. In patients a parts per thousand yen80 years (n = 296) ST-segment elevation myocardial infarction (STEMI) occurred in 46.6 %, non-ST-segment elevation myocardial infarction (NSTEMI) in 45.9 %, and 7.4 % had unstable angina. On the other hand, in patients < 80 years (n = 2,316) STEMI was observed in 53.4 %, NSTEMI in 37.8 % and unstable angina in 9.0 %. The primary end-point of total mortality was significantly higher in octogenarians (7.4 vs. 4.5 %, p = 0.026). Similarly, the secondary end-point comprising overall MACE rate was significantly higher among the elderly (12.5 vs. 7.3 %, p = 0.002). Within the group of octogenarians, no relation between age and outcomes was noted (for death: OR 0.99, 95 % CI 0.84-1.16, p = 0.915; and for MACE: OR 1.10, 95 % CI 0.88-1.36, p = 0.412); however, in patients < 80 years, age was related to outcomes (for death: OR 1.05, 95 % CI, 1.02-1.08, p = 0.003; and for MACE: OR 1.03, 95 % CI, 1.01-1.05, p = 0.011). In a multivariate analysis, systolic blood pressure (OR 0.97 95 % CI 0.94-0.99, p = 0.0058), maximal value of creatine kinase (OR 1.00, 95 % CI 1.00-1.00, p = 0.033), and maximal value of NT-proBNP (OR 1.00, 95 % CI 1.00-1.00, p = 0.0225) were independent predictors for death, while systolic blood pressure (OR 0.98, 95 % CI 0.96-0.99, p = 0.0384) and maximal value of C-reactive protein (OR 1.01, 95 % CI 1.00-1.01, p = 0.0265) were associated with overall MACE. Here we confirm that in-hospital death and MACE rate remain significantly elevated in octogenarians in spite of implementation of modern therapies. However, our real-world registry strongly suggests that early revascularization appears safe and effective in elderly patients. Furthermore, we have identified that systolic blood pressure, creatine kinase, NT-proBNP, and C-reactive protein are strong predictors for outcomes in octogenarians. C1 [Jaguszewski, Milosz; Ghadri, Jelena-R.; Diekmann, Johanna; Bataiosu, Roxana D.; Siddique, Asim; Baumann, Lukas; Staehli, Barbara E.; Luescher, Thomas F.; Maier, Willibald; Templin, Christian] Univ Zurich Hosp, Dept Cardiol, Univ Heart Ctr, CH-8091 Zurich, Switzerland. [Hellermann, Jens P.] Altstatten Hosp, Div Cardiol, Altstatten, Switzerland. [Sarcon, Annahita] Univ Calif Davis, Med Ctr, Sacramento, CA 95817 USA. C3 University of Zurich; University Zurich Hospital; University of California System; University of California Davis RP Templin, C (通讯作者),Univ Zurich Hosp, Dept Cardiol, Univ Heart Ctr, Raemistr 100, CH-8091 Zurich, Switzerland. EM milosz.jaguszewski@usz.ch; Christian.Templin@usz.ch RI Jaguszewski, Milosz/AAL-3169-2020; Hellermann, Jens/ABB-2889-2020; Jaguszewski, Milosz/D-3800-2015 OI Jaguszewski, Milosz/0000-0002-2555-593X; Diekmann, Johanna/0000-0002-7008-3601 FU Swiss National Research Foundation [33CM30-124112/1]; AstraZeneca (Baar, Switzerland); Biosensors (Morges, Switzerland); Eli Lilly (Geneva, Switzerland); Eli Lilly (Indianapolis, USA); Medtronic (Tolachenaz, Switzerland); St. Jude (Brussels, Belgium) FX This study was supported in part by the Swiss National Research Foundation (Special Programme University Medicine Nr. 33CM30-124112/1) and unrestricted Grants by AstraZeneca (Baar, Switzerland), Biosensors (Morges, Switzerland), Eli Lilly (Geneva, Switzerland and Indianapolis, USA), Medtronic (Tolachenaz, Switzerland), and St. Jude (Brussels, Belgium). 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Res. Cardiol. PD JAN PY 2015 VL 104 IS 1 BP 51 EP 58 DI 10.1007/s00392-014-0756-5 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AZ4RI UT WOS:000348209900006 PM 25142902 OA Green Submitted, Green Accepted DA 2023-05-13 ER PT J AU Wang, Y Yan, BP Liew, D Lee, VWY AF Wang, Y. Yan, B. P. Liew, D. Lee, V. W. Y. TI Cost-effectiveness of cytochrome P450 2C19*2 genotype-guided selection of clopidogrel or ticagrelor in Chinese patients with acute coronary syndrome SO PHARMACOGENOMICS JOURNAL LA English DT Article ID DRIVEN ANTIPLATELET THERAPY; CYP2C19 GENOTYPE; STENT THROMBOSIS; DECISION-MAKING; MYOCARDIAL-INFARCTION; CLINICAL-OUTCOMES; ASIAN PATIENTS; BARE-METAL; POLYMORPHISMS; METABOLISM AB The choice of antiplatelet therapy among Asian populations for the treatment of acute coronary syndrome (ACS) is complicated owing to the high prevalence of cytochrome P450 2C19 (CYP2C19) genetic polymorphism that has been associated with reduced efficacy of clopidogrel. Ticagrelor is a potent but more expensive alternative antiplatelet agent that is not affected by CYP2C19 polymorphism. This study aimed to evaluate the cost-effectiveness, from the Hong Kong health-care provider's perspective, of CYP2C19*2 genotype-guided selection of antiplatelet therapy compared with the universal use of clopidogrel or ticagrelor among ACS patients who undergo percutaneous coronary intervention (PCI). In the present study, a two-part model consisting of a 1-year decision tree and a lifetime Markov model was built to simulate the progress of a typical cohort of 60-year-old Chinese patients until age 85 years and compare three treatment strategies: (i) generic clopidogrel or ticagrelor based on CYP2C19*2 genotype, (ii) universal use of generic clopidogrel or (iii) universal use of ticagrelor for all patients. Incremental cost-effectiveness ratios (ICERs) of <1 gross domestic product per capita locally (US dollar (USD) 42 423/quality-adjusted life year (QALY)) were considered cost-effective. Base-case results showed universal ticagrelor use was cost-effective compared with universal clopidogrel, but was dominated by genotype-guided treatment. Genotype-guided treatment was cost-effective compared with universal clopidogrel use (ICER of USD2560/QALY). Sensitivity analysis demonstrated that with the cost of genotype testing up to USD400, CYP2C19*2 genotype-guided antiplatelet treatment remained a cost-effective strategy compared with either universal use of generic clopidogrel or ticagrelor in post-PCI ACS patients in Hong Kong. C1 [Wang, Y.; Lee, V. W. Y.] Chinese Univ Hong Kong, Fac Med, Sch Pharm, Room 801p, Hong Kong, Hong Kong, Peoples R China. [Yan, B. P.] Chinese Univ Hong Kong, Prince Wales Hosp, Div Cardiol, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China. [Liew, D.] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia. C3 Chinese University of Hong Kong; Chinese University of Hong Kong; Prince of Wales Hospital; Monash University RP Lee, VWY (通讯作者),Chinese Univ Hong Kong, Fac Med, Sch Pharm, Room 801p, Hong Kong, Hong Kong, Peoples R China. EM vivianlee@cuhk.edu.hk RI YUN, WANG/AAJ-9229-2020; Lee, Vivian WY/B-9389-2008; Yan, Bryan P/P-5928-2015; Lee, Vivian WY/ABE-2416-2021; YUN, WANG/AEQ-2146-2022 OI YUN, WANG/0000-0001-7650-6241; Lee, Vivian WY/0000-0001-5802-8899; Lee, Vivian WY/0000-0001-5802-8899; YUN, WANG/0000-0001-7650-6241; Liew, Danny/0000-0002-0131-623X; WANG, YUN/0000-0001-9438-5586 FU Hong Kong Research Grant Council General Research Fund [478709] FX This study is funded by a Hong Kong Research Grant Council General Research Fund (reference 478709). All authors contributed extensively to the work presented in this paper. We acknowledge the contribution of Dr Lally Lai Yee Chan for identifying and collecting the unit costs used in the analysis. The abstract of this manuscript was published at an international meeting. 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PD JAN PY 2018 VL 18 IS 1 BP 113 EP 120 DI 10.1038/tpj.2016.94 PG 8 WC Genetics & Heredity; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Genetics & Heredity; Pharmacology & Pharmacy GA FW5TI UT WOS:000425381100016 PM 28117433 DA 2023-05-13 ER PT J AU Zuo, ML Xiang, SB Bhattacharyya, S Chen, QY Zeng, J Li, CM Deng, Y Siu, C Yin, LX AF Zuo, Mingliang Xiang, Shoubo Bhattacharyya, Sanjib Chen, Qiuyi Zeng, Jie Li, Chunmei Deng, Yan Siu, Chungwah Yin, Lixue TI Management strategies and outcomes of acute coronary syndrome (ACS) during Covid-19 pandemic SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE COVID-19; Acute coronary syndrome; Pandemic; Management; Outcomes ID ACUTE MYOCARDIAL-INFARCTION; METAANALYSIS AB Background The COVID-19 outbreak represents a significant challenge to international health. Several studies have reported a substantial decrease in the number of patients attending emergency departments with acute coronary syndromes (ACS) and there has been a concomitant rise in early mortality or complications during the COVID-19 pandemic. A modified management system that emphasizes nearby treatment, safety, and protection, alongside a closer and more effective multiple discipline collaborative team was developed by our Chest Pain Center at an early stage of the pandemic. It was therefore necessary to evaluate whether the newly adopted management strategies improved the clinical outcomes of ACS patients in the early stages of the COVID-19 pandemic. Methods Patients admitted to our Chest Pain Center from January 25th to April 30th, 2020 based on electronic data in the hospitals ACS registry, were included in the COVID-19 group. Patients admitted during the same period (25 January to 30 April) in 2019 were included in the pre-COVID-19 group. The characteristics and clinical outcomes of the ACS patients in the COVID-19 period group were compared with those of the ACS patients in the pre-COVID-19 group. Multivariate logistic regression analyses were used to identify the risk factors associated with clinical outcomes. Results The number of patients presenting to the Chest Pain Center was reduced by 45% (p = 0.01) in the COVID-19 group, a total of 223 ACS patients were included in the analysis. There was a longer average delay from the onset of symptom to first medical contact (FMC) (1176.9 min vs. 625.2 min, p = 0.001) in the COVID-19 period group compared to the pre-COVID-19 group. Moreover, immediate percutaneous coronary intervention (PCI) (80.1% vs. 92.3%, p = 0.008) was performed less frequently on ACS patients in the COVID-19 group compared to the pre-COVID-19 group. However, more ACS patients received thrombolytic therapy (5.8% vs. 0.6%, p = 0.0052) in the COVID-19 group than observed in the pre-COVID-19 group. Interestingly, clinical outcome did not worsen in the COVID-19 group when cardiogenic shock, sustained ventricular tachycardia, ventricular fibrillation or use of mechanical circulatory support (MCS) were compared against the pre-COVID-19 group (13.5% vs. 11.6%, p = 0.55). Only age was independently associated with composite clinical outcomes (HR = 1.3; 95% CI 1.12-1.50, p = 0.003). Conclusion This retrospective study showed that the adverse outcomes were not different during the COVID-19 pandemic compared to historical control data, suggesting that newly adopted management strategies might provide optimal care for ACS patients. Larger sample sizes and longer follow-up periods on this issue are needed in the future. C1 [Zuo, Mingliang; Chen, Qiuyi; Li, Chunmei; Deng, Yan; Yin, Lixue] Univ Elect Sci & Technol China, Sichuan Acad Med Sci & Sichuan Prov Peoples Hosp, Dept Cardiovasc Ultrasound & Noninvas Cardiol, Chengdu 610072, Peoples R China. [Xiang, Shoubo] Sichuan Univ, West China Hosp, Chengdu, Peoples R China. [Bhattacharyya, Sanjib] Southwest Univ, Coll Pharmaceut Sci, Chongqing, Peoples R China. [Siu, Chungwah] Univ Hong Kong, Queen Mary Hosp, Dept Med, Cardiol Div, Room 1929,Block K,102 Pokfulam Rd, Hong Kong, Peoples R China. [Zeng, Jie] Univ Elect Sci & Technol China, Sichuan Acad Med Sci & Sichuan Prov Peoples Hosp, Dept Cardiol, Chengdu, Peoples R China. C3 Sichuan Provincial People's Hospital; University of Electronic Science & Technology of China; Sichuan University; Southwest University - China; University of Hong Kong; Sichuan Provincial People's Hospital; University of Electronic Science & Technology of China RP Yin, LX (通讯作者),Univ Elect Sci & Technol China, Sichuan Acad Med Sci & Sichuan Prov Peoples Hosp, Dept Cardiovasc Ultrasound & Noninvas Cardiol, Chengdu 610072, Peoples R China.; Siu, C (通讯作者),Univ Hong Kong, Queen Mary Hosp, Dept Med, Cardiol Div, Room 1929,Block K,102 Pokfulam Rd, Hong Kong, Peoples R China. EM cwdsiu@hkucc.hku.hk; yinlixue_cardiac@163.com RI Li, Chun/HKW-1738-2023 FU Applied Basic Research Programs of Science and Technology Commission Foundation of Sichuan Province [2019YJ0580] FX This study was funded by Applied Basic Research Programs of Science and Technology Commission Foundation of Sichuan Province (No. 2019YJ0580). The funder had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the article for publication. 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Disord. PD MAY 25 PY 2022 VL 22 IS 1 AR 242 DI 10.1186/s12872-022-02680-z PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 1R4EP UT WOS:000803324300003 PM 35614403 OA Green Published, gold DA 2023-05-13 ER PT J AU Eggers, KM Jernberg, T Lindahl, B AF Eggers, Kai M. Jernberg, Tomas Lindahl, Bertil TI Cardiac Troponin Elevation in Patients Without a Specific Diagnosis SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE cardiac troponin; chest pain; risk prediction; troponinemia ID CARDIOVASCULAR RISK; CHEST-PAIN; SENSITIVITY; PREDICTION AB BACKGROUND Cardiac troponin (cTn) elevation is a common finding in acutely admitted patients, even in the absence of acute coronary syndrome. In some of these patients, no etiology of cTn elevation can be identified. The term troponinemia is sometimes used to describe this scenario. OBJECTIVES This study aimed to investigate the associations of cTn levels with clinical findings and long-term outcome in acutely admitted patients with suspected acute coronary syndrome who had been discharged without a specified diagnosis. METHODS Retrospective registry-based cohort study investigating 48,872 patients (SWEDEHEART [Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies] registry). Patients were stratified into cohorts with cTn levels less than or equal to the assay-specific 99th percentile and separated by assay-specific cTn tertiles in case of higher levels. RESULTS A cTn level >99th percentile was noted in 9,800 (20.1%) patients. The prevalence of cardiovascular risk factors as well as cardiovascular and noncardiovascular comorbidities increased across higher cTn strata. In total, 7,529 (15.4%) patients had a major adverse event (MAE), defined as the composite of all-cause mortality, myocardial infarction, readmission for heart failure, or stroke (median follow-up 4.9 years). MAE risk was associated with higher cTn strata (hazard ratio for highest assay-specific cTn tertile: 2.59; 95% confidence interval: 2.39 to 2.80; hazard ratio in patients without cardiovascular comorbidities, renal dysfunction, left ventricular dysfunction, or significant coronary stenosis: 3.57; 95% confidence interval: 2.30 to 5.54). CONCLUSIONS cTn elevation is associated with cardiovascular and noncardiovascular comorbidities and predicts major adverse events in acutely admitted patients, in whom no definite diagnosis could have been established. The term troponinemia is trivializing and should be avoided. Instead, careful work-up is required in these patients. (c) 2019 by the American College of Cardiology Foundation. C1 [Eggers, Kai M.; Lindahl, Bertil] Uppsala Univ, Dept Med Sci, Uppsala, Sweden. [Eggers, Kai M.; Lindahl, Bertil] Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden. [Jernberg, Tomas] Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden. C3 Uppsala University; Uppsala University; Danderyds Hospital; Karolinska Institutet RP Eggers, KM (通讯作者),Uppsala Univ, Dept Med Sci, Cardiol, S-75185 Uppsala, Sweden. EM kai.eggers@ucr.uu.se OI Jernberg, Tomas/0000-0003-1695-379X FU Swedish Foundation of Strategic Research; Abbott Laboratories; bioMerieux Clinical Diagnostics FX The TOTAL-AMI project has received funding from the Swedish Foundation of Strategic Research. Dr. Eggers has received a research grant from Abbott Laboratories. Dr. Lindahl has served as a consultant for Roche Diagnostics, Thermo Fisher Scientific, bioMerieux Clinical Diagnostics, and Philips Healthcare; and has received research grants from bioMerieux Clinical Diagnostics. Dr. Jernberg has reported that he has no relationships relevant to the contents of this paper to disclose. CR Aimo A, 2018, CIRCULATION, V137, P286, DOI 10.1161/CIRCULATIONAHA.117.031560 Arunachalam K, 2016, AM J MED, V129, pE43, DOI 10.1016/j.amjmed.2015.08.042 Blankenberg S, 2016, EUR HEART J, V37, P2428, DOI 10.1093/eurheartj/ehw172 Eggers KM, 2016, EUR HEART J, V37, P2417, DOI 10.1093/eurheartj/ehw029 Fabbri A, 2012, AM J EMERG MED, V30, P61, DOI 10.1016/j.ajem.2010.09.022 Ford I, 2016, J AM COLL CARDIOL, V68, P2719, DOI 10.1016/j.jacc.2016.10.020 Giannitsis E, 2013, NAT REV CARDIOL, V10, P623, DOI 10.1038/nrcardio.2013.129 Goff D. C., 2014, J AM COLL CARDIOL, V63, P25, DOI DOI 10.1161/01.CIR.0000437741.48606.98 Hochholzer W, 2011, CLIN CHEM, V57, P1318, DOI 10.1373/clinchem.2011.162073 Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Mair J, 2018, EUR HEART J-ACUTE CA, V7, P553, DOI 10.1177/2048872617748553 Mair J, 2018, EUR HEART J-ACUTE CA, V7, P577, DOI 10.1177/2048872617708973 Nejatian A, 2017, J AM COLL CARDIOL, V69, P2622, DOI 10.1016/j.jacc.2017.03.586 Omland T, 2017, CLIN CHEM, V63, P165, DOI 10.1373/clinchem.2016.255190 Omstedt A, 2016, EUR HEART J-ACUTE CA, V5, P441, DOI 10.1177/2048872615626654 Piepoli MF, 2016, EUR HEART J, V37, P2315, DOI 10.1093/eurheartj/ehw106 Pokharel Y, 2017, EUR J PREV CARDIOL, V24, P628, DOI 10.1177/2047487316683071 Stripe B, 2013, JAMA INTERN MED, V173, P2088, DOI 10.1001/jamainternmed.2013.11109 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Twerenbold R, 2017, J AM COLL CARDIOL, V70, P996, DOI 10.1016/j.jacc.2017.07.718 NR 20 TC 57 Z9 58 U1 0 U2 9 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0735-1097 EI 1558-3597 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD JAN 8 PY 2019 VL 73 IS 1 BP 1 EP 9 DI 10.1016/j.jacc.2018.09.082 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HG5KE UT WOS:000455014900001 PM 30621937 DA 2023-05-13 ER PT J AU Drivelegka, P Jacobsson, LTH Lindstroem, U Bengtsson, K Dehlin, M AF Drivelegka, Panagiota Jacobsson, Lennart T. H. Lindstroem, Ulf Bengtsson, Karin Dehlin, Mats TI Incident Gout and Risk of First-Time Acute Coronary Syndrome: A Prospective, Population-Based Cohort Study in Sweden SO ARTHRITIS CARE & RESEARCH LA English DT Article; Early Access ID MYOCARDIAL-INFARCTION; SONOGRAPHIC ASSESSMENT; INDEPENDENT IMPACT; GENERAL-POPULATION; URIC-ACID; MORTALITY; HYPERURICEMIA; COMORBIDITIES; INFLAMMATION; DISEASE AB ObjectiveTo investigate the risk of first-time acute coronary syndrome (ACS) in a large cohort of primary and secondary care patients with incident gout compared to the general population. MethodsUsing register data for the period 2007-2017, we conducted a prospective, population-based cohort with 20,146 patients with incident gout (mean age 65.6 years; 67.4% male) and 83,517 matched population controls without prior history of coronary heart disease. We calculated incidence rates (IRs) and hazard ratios (HRs) adjusted for baseline comorbidities and dispensed prescriptions. In a sensitivity analysis, we included gout cases and controls with no previously diagnosed comorbidity (6,075 cases and 44,091 controls). ResultsThe IR of first-time ACS was significantly increased in the gout cohort compared to controls (9.1 versus 6.3 of 1,000 person-years). Unadjusted Cox regression showed that gout patients had higher risk of first-time ACS compared to controls (HR 1.44 [95% confidence interval (95% CI) 1.33-1.56]), with a higher HR in women (HR 1.64 [95% CI 1.41-1.90]) than in men (HR 1.36 [95% CI, 1.24-1.50]). In multivariable analysis, the risk diminished but remained significant (HR 1.15 [95% CI 1.06-1.25]). The risk was similar in the sensitivity analysis (HR 1.20 [95% CI 1.01-1.44]) and still higher in women (HR 1.34 [95% CI 0.86-2.08]) than in men (HR 1.18 [95% CI 0.97-1.44]). ConclusionPatients with incident gout have a 44% increased risk of first-time ACS, higher in women than in men. This risk is largely explained by the underlying comorbidities, but there is still a modestly increased risk that may be due to gout-related factors. C1 [Drivelegka, Panagiota; Jacobsson, Lennart T. H.; Lindstroem, Ulf; Bengtsson, Karin; Dehlin, Mats] Univ Gothenburg, Sahlgrenska Acad, Gothenburg, Sweden. C3 University of Gothenburg RP Drivelegka, P (通讯作者),Univ Gothenburg, Sahlgrenska Acad, Gothenburg, Sweden. EM panagiota.drivelegka@vgregion.se FU Swedish government; county councils (ALF-agreement ) [ALFGBG-825511]; Health & Medical Care Committee of the Region Vaestra Goeta-land, Research and Development Centre Gothenburg; Soedra Bohuslaen,Reumatikerfoerbundet FX Supported by the Swedish state under agreement between the Swedish government and the county councils (ALF-agreement grant ALFGBG-825511), the Health & Medical Care Committee of the Region Vaestra Goeta-land, Research and Development Centre Gothenburg, and Soedra Bohuslaen,Reumatikerfoerbundet CR Bergmark BA, 2022, LANCET, V399, P1347, DOI 10.1016/S0140-6736(21)02391-6 Choi HK, 2007, CIRCULATION, V116, P894, DOI 10.1161/CIRCULATIONAHA.107.703389 Chowalloor P, 2020, INT J RHEUM DIS, V23, P661, DOI 10.1111/1756-185X.13811 Clarson LE, 2015, EUR J PREV CARDIOL, V22, P335, DOI 10.1177/2047487313514895 Clarson LE, 2015, ANN RHEUM DIS, V74, P642, DOI 10.1136/annrheumdis-2014-205252 Culleton BF, 1999, ANN INTERN MED, V131, P7, DOI 10.7326/0003-4819-131-1-199907060-00003 De Caterina R, 2016, THROMB HAEMOSTASIS, V116, P1012, DOI 10.1160/TH16-03-0246 De Vera MA, 2010, ANN RHEUM DIS, V69, P1162, DOI 10.1136/ard.2009.122770 Dehlin M, 2020, NAT REV RHEUMATOL, V16, P380, DOI 10.1038/s41584-020-0441-1 Dehlin M, 2015, BMC MUSCULOSKEL DIS, V16, DOI 10.1186/s12891-015-0614-2 Drivelegka P, 2018, ARTHRITIS RES THER, V20, DOI 10.1186/s13075-018-1596-x Filippucci E, 2010, CLIN EXP RHEUMATOL, V28, P2 Fisher MC, 2017, ANN RHEUM DIS, V76, DOI 10.1136/annrheumdis-2016-210588 Hayden Melvin R, 2004, Nutr Metab (Lond), V1, P10, DOI 10.1186/1743-7075-1-10 Janssens HJEM, 2003, FAM PRACT, V20, P413, DOI 10.1093/fampra/cmg413 Keenan T, 2016, J AM COLL CARDIOL, V67, P407, DOI 10.1016/j.jacc.2015.10.086 Krishnan E, 2006, ARTHRITIS RHEUM-US, V54, P2688, DOI 10.1002/art.22014 Krishnan E, 2010, RHEUMATOLOGY, V49, P1229, DOI 10.1093/rheumatology/keq037 Kristensen LE, 2015, ARTHRIT CARE RES, V67, P1137, DOI 10.1002/acr.22555 Kuo CF, 2016, ANN RHEUM DIS, V75, P210, DOI 10.1136/annrheumdis-2014-206410 Kuo CF, 2013, RHEUMATOLOGY, V52, P111, DOI 10.1093/rheumatology/kes169 Li X, 2019, PLOS MED, V16, DOI 10.1371/journal.pmed.1002937 Liu SC, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0134088 Ludvigsson JF, 2009, EUR J EPIDEMIOL, V24, P659, DOI 10.1007/s10654-009-9350-y Okafor ON, 2017, PHARMACOL THERAPEUT, V172, P139, DOI 10.1016/j.pharmthera.2016.12.004 Perez-Ruiz F, 2014, ANN RHEUM DIS, V73, P177, DOI 10.1136/annrheumdis-2012-202421 Primatesta P, 2011, BMC MUSCULOSKEL DIS, V12, DOI 10.1186/1471-2474-12-103 Ridker PM, 2017, NEW ENGL J MED, V377, P1119, DOI 10.1056/NEJMoa1707914 Roddy E, 2013, JOINT BONE SPINE, V80, P295, DOI 10.1016/j.jbspin.2012.09.017 Schieir O, 2017, ANN RHEUM DIS, V76, P1396, DOI 10.1136/annrheumdis-2016-210275 Seminog OO, 2013, RHEUMATOLOGY, V52, P2251, DOI 10.1093/rheumatology/ket293 Sieper J, 2009, ANN RHEUM DIS, V68, P1, DOI 10.1136/ard.2008.104018 Singh JA, 2018, ARTHRITIS RES THER, V20, DOI 10.1186/s13075-018-1606-z So A, 2010, J CLIN INVEST, V120, P1791, DOI 10.1172/JCI42344 Statistiska C., 2012, FOLKMANGDEN EFTER RE Tardif JC, 2019, NEW ENGL J MED, V381, P2497, DOI 10.1056/NEJMoa1912388 Zhu YY, 2012, AM J MED, V125, P679, DOI 10.1016/j.amjmed.2011.09.033 NR 37 TC 0 Z9 0 U1 0 U2 0 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 2151-464X EI 2151-4658 J9 ARTHRIT CARE RES JI Arthritis Care Res. DI 10.1002/acr.25018 EA DEC 2022 PG 8 WC Rheumatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Rheumatology GA 7K4QE UT WOS:000905268400001 PM 36094855 OA hybrid DA 2023-05-13 ER PT J AU Carney, RM Freedland, KE Steinmeyer, BC Rubin, EH Ewald, G AF Carney, Robert M. Freedland, Kenneth E. Steinmeyer, Brian C. Rubin, Eugene H. Ewald, Gregory TI Collaborative care for depression symptoms in an outpatient cardiology setting: A randomized clinical trial SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Outpatient cardiology; Depression; Collaborative care ID ACUTE CORONARY SYNDROME; AMERICAN-HEART-ASSOCIATION; SMOKING-CESSATION; CARDIAC EVENTS; OUTCOMES; MANAGEMENT; DISEASE; RECOMMENDATIONS; INTERVENTION; METAANALYSIS AB Background: Depression is a risk factor for morbidity and mortality in patients with coronary heart disease. Finding effective methods for identifying and treating depression in these patients is a high priority. The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Methods: Two hundred-one patients seen in an outpatient cardiology clinic who screened positive for depression during an outpatient visit were randomized to receive either CC or UC. Recommendations for depression treatment and ongoing support and monitoring of depression symptoms were provided to CC patients and their primary care physicians (PCPs) for up to 6 months. Results: There were no differences between the arms in mean Beck Depression Inventory-II scores(CC, 15.9; UC, 17.4; p = .45) or in depression remission rates(CC, 32.5%; UC, 26.2%; p = 0.34) after 6 months, or in the number of hospitalizations after 12 months (p = 0.73). There were fewer deaths among the CC (1/100) than UC patients (8/101) (p = 0.03). Conclusions: This trial did not show that CC produces better depression outcomes than UC. Screening led to a higher rate of depression treatment than was expected in the UC group, and delays in obtaining depression treatment from PCPs may have reduced treatment effectiveness for the CC patients. A different strategy for depression treatment following screening in outpatient cardiology services is needed. (C) 2016 Elsevier Ireland Ltd. All rights reserved. C1 [Carney, Robert M.; Freedland, Kenneth E.; Steinmeyer, Brian C.; Rubin, Eugene H.] Washington Univ, Sch Med, Dept Psychiat, St Louis, MO 63108 USA. [Ewald, Gregory] Washington Univ, Sch Med, Dept Med, St Louis, MO 63108 USA. C3 Washington University (WUSTL); Washington University (WUSTL) RP Carney, RM (通讯作者),Washington Univ, Sch Med, 4320 Forest Pk Ave,Suite 301, St Louis, MO 63108 USA. EM carneyr@bmc.wustl.edu FU Agency for Healthcare Research and Quality (AHRQ), Bethesda, Maryland [RO1HS018335] FX This research study was supported by Grant Number RO1HS018335, Agency for Healthcare Research and Quality (AHRQ), Bethesda, Maryland. The funding agency was not directly involved in the study design, the collection, analysis, and interpretation of data, or the writing of the manuscript. 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PD SEP 15 PY 2016 VL 219 BP 164 EP 171 DI 10.1016/j.ijcard.2016.06.045 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA DS5JG UT WOS:000380817400029 PM 27327502 OA Green Accepted DA 2023-05-13 ER PT J AU Fabbri, A Marchesini, G Carbone, G Cosentini, R Ferrari, A Chiesa, M Bertini, A Rea, F AF Fabbri, Andrea Marchesini, Giulio Carbone, Giorgio Cosentini, Roberto Ferrari, Annamaria Chiesa, Mauro Bertini, Alessio Rea, Federico CA Italian Soc Emergency Med SIMEU TI ACUTE HEART FAILURE IN THE EMERGENCY DEPARTMENT: THE SAFE-SIMEU EPIDEMIOLOGICAL STUDY SO JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE acute heart failure; emergency department; clinical characteristics; epidemiology ID BASE-LINE CHARACTERISTICS; MANAGEMENT; REGISTRY; ADHERE; POPULATION; VALIDATION; DIAGNOSIS; OUTCOMES; SOCIETY; COHORT AB Background: Patients with acute heart failure (AHF) have high rates of attendance to emergency departments (EDs), with significant health care costs. Objectives: We aimed to describe the clinical characteristics of patients attending Italian EDs for AHF and their diagnostic and therapeutic work-up. Methods: We carried out a retrospective analysis on 2683 cases observed in six Italian EDs for AHF (January 2011 to June 2012). Results: The median age of patients was 84 years (interquartile range 12), with females accounting for 55.8% of cases (95% confidence interval [CI] 53.5-57.6%). A first episode of AHF was recorded in 55.3% (95% CI 55.4-57.2%). Respiratory disease was the main precipitating factor (approximately 30% of cases), and multiple comorbidities were recorded in > 50% of cases (history of acute coronary syndrome, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, valvular heart disease). The treatment was based on oxygen (69.7%; 67.9-71.5%), diuretics (69.2%; 67.9-71.5%), nitroglycerin (19.7%; 18.3-21.4%), and noninvasive ventilation (15.2%; 13.8-16.6%). Death occurred within 6 h in 2.5% of cases (2.0-3.1%), 6.4% (5.5-7.3%) were referred to the care of their general practitioners within a few hours from ED attendance or after short-term (< 24 h) observation 13.9% (12.6-15.2%); 60.4% (58.5-62.2%) were admitted to the hospital, and 16.8% (15.4-18.3%) were cared for in intensive care units according to disease severity. Conclusions: Our study reporting the "real-world'' clinical activity indicates that subjects attending the Italian EDs for AHF are rather different from those reported in international registries. Subjects are older, with a higher proportion of females, and high prevalence of cardiac and noncardiac comorbidities. (C) 2017 Elsevier Inc. All rights reserved. C1 [Fabbri, Andrea] Morgagni Pierantoni Hosp, Dept Emergency Med, Forli, Italy. [Marchesini, Giulio] Univ Bologna, S Orsola Malpighi Hosp, Dept Med & Surg Sci Clin Dietet, Bologna, Italy. [Carbone, Giorgio] Gradenigo Hosp, Dept Emergency Med, Turin, Italy. [Cosentini, Roberto] Osp Maggiore Policlin, Fdn Ca Granda, Dept Emergency Med, Milan, Italy. [Ferrari, Annamaria] Osped S Maria Nuova, Dept Emergency Med, Reggio Emilia, Italy. [Chiesa, Mauro] Osped S Antonio, Azienda Osped, Dept Emergency Med, Padua, Italy. [Bertini, Alessio] Azienda Osped Univ Pisana, Dept Emergency Med, Pisa, Italy. [Rea, Federico] Univ Milano Bicocca, Dept Stat & Quantitat Methods, Milan, Italy. C3 IRCCS Azienda Ospedaliero-Universitaria di Bologna; University of Bologna; Humanitas Hospital Gradenigo; IRCCS Ca Granda Ospedale Maggiore Policlinico; ULSS 6 Euganea; Ospedale Sant'antonio Padova; University of Padua; Azienda Ospedaliera - Universita di Padova; University of Pisa; Azienda Ospedaliero Universitaria Pisana; University of Milano-Bicocca RP Fabbri, A (通讯作者),Azienda USL Romagna Forli, Emergency Dept, Via C Forlanini 34, I-47121 Forli, Italy. RI Fabbri, Andrea/K-9994-2016 OI Fabbri, Andrea/0000-0002-9837-4638; Marchesini, Giulio/0000-0003-2407-9860; REA, FEDERICO/0000-0001-7988-5101; Bertini, Alessio/0000-0001-9642-8295; Fabbri, Andrea/0000-0002-0366-1336 FU SIMEU (Societa Italiana di Medicina d'Emergenza-Urgenza) FX The study was supported by SIMEU (Societa Italiana di Medicina d'Emergenza-Urgenza). The funding source had no role in design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors thank all the participating centres of the SIMEU (Societa Italiana di Medicina d'Emergenza-Urgenza) study group for their valuable contributions. 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Emerg. Med. PD AUG PY 2017 VL 53 IS 2 BP 178 EP 185 DI 10.1016/j.jemermed.2017.03.030 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA FE0VZ UT WOS:000407939100007 PM 28501384 DA 2023-05-13 ER PT J AU Slot, MHEB van der Heijden, GJMG Stelpstra, SD Hoes, AW Rutten, FH AF Slot, Madeleine H. E. Bruins van der Heijden, Geert J. M. G. Stelpstra, Saskia D. Hoes, Arno W. Rutten, Frans H. TI Point-of-care tests in suspected acute myocardial infarction: A systematic review SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Review DE Acute myocardial infarction; Diagnosis; Biomarkers; Point of care test; Systematic review ID ACID-BINDING PROTEIN; ACUTE CORONARY SYNDROME; CREATINE-KINASE-MB; CARDIAC TROPONIN-I; ISCHEMIA-MODIFIED ALBUMIN; CHEST-PAIN PATIENTS; WHOLE-BLOOD; EARLY-DIAGNOSIS; CLINICAL-PERFORMANCE; RISK STRATIFICATION AB Background: A review of cardiac point-of-care (POC) tests used to detect or exclude acute myocardial infarction (AMI) with a focus on test performance within 6 hours after the start of symptoms. Methods: A systematic review of articles on the diagnostic accuracy of point of care (POC) tests in patients suspected of AMI from the PubMed database from January 1st 1990 to December 1st 2012. Results: Our search yielded 42 studies evaluating POC tests. Troponin (Tn) was investigated in 29 studies, and creatine kinase-myocardial band isoenzyme (CK-MB), myoglobin, and heart-type fatty acid-binding protein (H-FABP) each in 13 studies. Eight studies used a multimarker approach. In 14 studies results were presented or could be recalculated for test results within 6 hours of symptomonset or with a median time from symptoms onset to testing of 3 hours. In this time frame the negative predictive value (NPV) ranged from 31 to 97% with single testing, and from 59 to 100% with a multi-marker approach. Just one study satisfied to all items used for methods appraisal. Conclusions: The ideal POC test for the diagnosis of AMI within 6 hours after the onset of symptoms does not yet exist. Evaluated POC tests were in general of poor methodological quality and reported toomany false negatives to be considered as save for the assessment of patients suspected of AMI. A POC test of high-sensitive troponin could possibly fill the gap in the early hours after symptom onset, especially in those with non-definitive electrocardiography. (C) 2013 Elsevier Ireland Ltd. All rights reserved. C1 [Slot, Madeleine H. E. Bruins; Stelpstra, Saskia D.; Hoes, Arno W.; Rutten, Frans H.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, NL-3508 GA Utrecht, Netherlands. [van der Heijden, Geert J. M. G.] Univ Amsterdam, Dept Social Dent, NL-1081 LA Amsterdam, Netherlands. C3 Utrecht University; Utrecht University Medical Center; Academic Center for Dentistry Amsterdam; University of Amsterdam RP Rutten, FH (通讯作者),Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, POB 85500, NL-3508 GA Utrecht, Netherlands. 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J. Cardiol. PD OCT 15 PY 2013 VL 168 IS 6 BP 5355 EP 5362 DI 10.1016/j.ijcard.2013.08.002 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 242EN UT WOS:000326220300045 PM 24001699 DA 2023-05-13 ER PT J AU Armaganijan, LV Alexander, KP Huang, Z Tricoci, P Held, C Van de Werf, F Armstrong, PW Aylward, PE White, HD Moliterno, DJ Wallentin, L Chen, E Harrington, RA Strony, J Mahaffey, KW Lopes, RD AF Armaganijan, Luciana V. Alexander, Karen P. Huang, Zhen Tricoci, Pierluigi Held, Claes Van de Werf, Frans Armstrong, Paul W. Aylward, Philip E. White, Harvey D. Moliterno, David J. Wallentin, Lars Chen, Edmond Harrington, Robert A. Strony, John Mahaffey, Kenneth W. Lopes, Renato D. TI Effect of age on efficacy and safety of vorapaxar in patients with non-ST-segment elevation acute coronary syndrome: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial SO AMERICAN HEART JOURNAL LA English DT Article ID HEALTH-CARE PROFESSIONALS; HEART-ASSOCIATION COUNCIL; ELDERLY-PATIENTS; MYOCARDIAL-INFARCTION; SCIENTIFIC STATEMENT; GERIATRIC-CARDIOLOGY; GLOBAL REGISTRY; OUTCOMES; COLLABORATION; TICAGRELOR AB Background Antithrombotic therapy plays an important role in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE ACS) but is associated with bleeding risk. Advanced age may modify the relationship between efficacy and safety. Methods Efficacy and safety of vorapaxar (a protease-activated receptor 1 antagonist) was analyzed across ages as a continuous and a categorical variable in the 12,944 patients with NSTE ACS enrolled in the TRACER trial. To evaluate the effect of age, Cox regression models were developed to estimate hazard ratios (HRs) with the adjustment of other baseline characteristics and randomized treatment for the primary efficacy composite of cardiovascular death, myocardial infarction (MI), stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization, and the primary safety composite of moderate or severe Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) bleeding. Results The median age of the population was 64 years (25th, 75th percentiles = 58, 71). Also, 1,791 patients (13.8%) were <= 54 years of age, 4,968 (38.4%) were between 55 and 64 years, 3,979 (30.7%) were between 65 and 74 years, and 2,206 (17.1%) were 75 years or older. Older patients had higher rates of hypertension, renal insufficiency, and previous stroke and worse Killip class. The oldest age group (>= 75 years) had substantially higher 2-year rates of the composite ischemic end point and moderate or severe GUSTO bleeding compared with the youngest age group (<= 54 years). The relationships between treatment assignment (vorapaxar vs placebo) and efficacy outcomes did not vary by age. For the primary efficacy end point, the HRs (95% CIs) comparing vorapaxar and placebo in the 4 age groups were as follows: 1.12 (0.88-1.43), 0.88 (0.76-1.02), 0.89 (0.76-1.04), and 0.88 (0.74-1.06), respectively (P value for interaction = .435). Similar to what was observed for efficacy outcomes, we did not observe any interaction between vorapaxar and age on bleeding outcomes. For the composite of moderate or severe bleeding according to the GUSTO classification, the HRs (95% CIs) comparing vorapaxar and placebo in the 4 age groups were 1.73 (0.89-3.34), 1.39 (1.04-1.86), 1.10 (0.85-1.42), and 1.73 (1.29-2.33), respectively (P value for interaction = .574). Conclusion Older patients had a greater risk for ischemic and bleeding events; however, the efficacy and safety of vorapaxar in NSTE ACS were not significantly influenced by age. C1 [Armaganijan, Luciana V.] Brazilian Clin Res Inst, Sao Paulo, Brazil. [Alexander, Karen P.; Huang, Zhen; Tricoci, Pierluigi; Lopes, Renato D.] Duke Clin Res Inst, Durham, NC USA. [Held, Claes; Wallentin, Lars] Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden. [Held, Claes; Wallentin, Lars] Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden. [Van de Werf, Frans] Univ Hosp Leuven, Dept Cardiol, Leuven, Belgium. [Armstrong, Paul W.] Univ Alberta, Edmonton, AB, Canada. [Aylward, Philip E.] Flinders Univ & Med Ctr, South Australian Hlth & Med Res Inst, Adelaide, SA, Australia. [White, Harvey D.] Green Lane Cardiovasc Serv, Auckland, New Zealand. [Moliterno, David J.] Gill Heart Inst, Lexington, KY USA. [Moliterno, David J.] Univ Kentucky, Lexington, KY USA. [Chen, Edmond] Bayer HealthCare Pharmaceut Inc, Whippany, NJ USA. [Harrington, Robert A.; Mahaffey, Kenneth W.] Stanford Univ, Dept Med, Stanford, CA 94305 USA. [Strony, John] Johnson & Johnson, New Brunswick, NJ USA. C3 Duke University; Uppsala University; Uppsala University; KU Leuven; University Hospital Leuven; University of Alberta; Flinders University South Australia; South Australian Health & Medical Research Institute (SAHMRI); University of Kentucky; Bayer AG; Bayer Healthcare Pharmaceuticals; Stanford University; Johnson & Johnson; Johnson & Johnson USA RP Lopes, RD (通讯作者),Box 3850,2400 Pratt St,Room 0311 Terrace Level, Durham, NC 27705 USA. EM renato.lopes@duke.edu RI Held, Claes/AAA-3973-2021 OI Held, Claes/0000-0001-9402-7404; Armstrong, Paul/0000-0002-0460-3445; Aylward, Philip/0000-0002-5358-8552 FU Merck Co, Inc. FX The TRACER trial was supported by Merck & Co, Inc. CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Alexander KP, 2010, CIRCULATION, V121, P1960, DOI 10.1161/CIRCULATIONAHA.109.853135 Alexander KP, 2005, J AM COLL CARDIOL, V46, P1479, DOI 10.1016/j.jacc.2005.05.084 Armstrong PW, 2010, JACC-CARDIOVASC INTE, V3, P1178, DOI 10.1016/j.jcin.2010.09.011 Avezum A, 2005, AM HEART J, V149, P67, DOI 10.1016/j.ahj.2004.06.003 Berger PB, 2010, CIRCULATION, V121, P2575, DOI 10.1161/CIRCULATIONAHA.109.895342 Bonaca MP, 2015, NEW ENGL J MED, V372, P1791, DOI 10.1056/NEJMoa1500857 Brieger D, 2007, AM HEART J, V153, P960, DOI 10.1016/j.ahj.2007.03.035 Gharacholou S Michael, 2006, Curr Heart Fail Rep, V3, P51, DOI 10.1007/s11897-006-0002-1 Husted S, 2012, CIRC-CARDIOVASC QUAL, V5, P680, DOI 10.1161/CIRCOUTCOMES.111.964395 Januzzi JL, 2003, AM J CARDIOL, V91, P457, DOI 10.1016/S0002-9149(02)03247-2 Kragholm K, 2016, CIRCULATION, V133, P1560, DOI 10.1161/CIRCULATIONAHA.115.017299 Lopes RD, 2008, EUR HEART J, V29, P1827, DOI 10.1093/eurheartj/ehn236 Lopes RD, 2013, INT J CARDIOL, V167, P2580, DOI 10.1016/j.ijcard.2012.06.053 Lopes RD, 2009, J AM COLL CARDIOL, V53, P1021, DOI 10.1016/j.jacc.2008.12.021 Magnani G, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.114.001505 Rauscher FM, 2003, CIRCULATION, V108, P457, DOI 10.1161/01.CIR.0000082924.75945.48 Tricoci P, 2012, NEW ENGL J MED, V366, P20, DOI 10.1056/NEJMoa1109719 NR 19 TC 5 Z9 5 U1 0 U2 10 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 EI 1097-5330 J9 AM HEART J JI Am. Heart J. PD AUG PY 2016 VL 178 BP 176 EP 184 DI 10.1016/j.ahj.2016.05.012 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DT6JK UT WOS:000381590300021 PM 27502866 DA 2023-05-13 ER PT J AU Vora, AN Wang, TY Hellkamp, AS Thomas, L Henry, TD Goyal, A Roe, MT AF Vora, Amit N. Wang, Tracy Y. Hellkamp, Anne S. Thomas, Laine Henry, Timothy D. Goyal, Abhinav Roe, Matthew T. TI Differences in Short- and Long-Term Outcomes Among Older Patients With ST-Elevation Versus Non-ST-Elevation Myocardial Infarction With Angiographically Proven Coronary Artery Disease SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE long-term outcome; myocardial infarction; non-ST-segment-elevation acute coronary syndrome; ST-segment-elevation myocardial infarction ID HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; SEGMENT-ELEVATION; SCIENTIFIC STATEMENT; CLINICAL CARDIOLOGY; AMERICAN-COLLEGE; TASK-FORCE; COLLABORATION; INTERVENTION; CLOPIDOGREL AB Background Among older patients with acute myocardial infarction (MI), it remains uncertain whether there is a time-dependent difference in the risk of recurrent mortality and nonfatal cardiovascular and cerebrovascular events for those with ST-segment-elevation MI (STEMI) compared with those with non-ST-segment-elevation MI. Methods and Results Older patients 65 years with acute MI and significant coronary artery disease identified with coronary angiography from the ACTION Registry-GWTG (Get With the Guidelines) were linked to Medicare claims data from 2007 to 2010. We examined the unadjusted cumulative incidence of each outcome studied from hospital discharge through 2 years with log-rank tests and then performed a piece-wise proportional hazards modeling with 2 time periods: discharge to 90 days and 90 days to 2 years. Among the 46199 patients linked with Medicare data, 17287 (37.4%) presented with STEMI. Through 2 years, the unadjusted cumulative incidence of all-cause mortality (16.0% versus 19.8%; P<0.001) and the composite outcome (21.9% versus 27.9%; P<0.001) was lower for STEMI patients. Within the first 90 days, unadjusted rates of mortality (5.5% versus 5.3%) and the composite outcome (7.9% versus 8.1%) were similar but diverged from 90 days to 2 years (mortality, 11.1% versus 15.4%; P<0.001; composite outcome, 15.2% versus 21.5%; P<0.001). After multivariable adjustment, the adjusted risks of mortality and the composite outcome through 90 days were higher for STEMI patients, whereas risks of mortality and the composite outcome were attenuated from 90 days through 2 years. Conclusions Among older acute MI patients with angiographically confirmed coronary artery disease discharged alive, STEMI patients (compared with non-ST-segment-elevation MI patients) were found to have a lower frequency of unadjusted postdischarge mortality and composite cardiovascular and cerebrovascular outcomes through 2 years after hospital discharge. This analysis provides unique insight into differential short- and long-term risks of ischemic cardiovascular and cerebrovascular outcomes by MI classification among older MI patients with confirmed coronary artery disease surviving to hospital discharge. C1 [Vora, Amit N.; Wang, Tracy Y.; Hellkamp, Anne S.; Thomas, Laine; Roe, Matthew T.] Duke Univ, Med Ctr, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA. [Henry, Timothy D.] Cedars Sinai Heart Inst, Los Angeles, CA USA. [Goyal, Abhinav] Emory Univ, Sch Med, Atlanta, GA USA. C3 Duke University; Cedars Sinai Medical Center; Emory University RP Vora, AN (通讯作者),Duke Univ, Med Ctr, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA. EM a.vora@duke.edu FU National Institutes of Health (NIH) [T32 HL069749, L30 HL124592]; AstraZeneca; Daiichi Sankyo; Gilead Sciences; GlaxoSmithKline; Lilly; Boston Scientific; Regeneron; Eli Lilly Company; Sanofi-Aventis; Daiichi-Sankyo; Amgen; Familial Hypercholesterolemia Foundation; Society of Chest Pain Centers; American College of Emergency Physicians; Society of Hospital Medicine FX Dr Vora was funded by National Institutes of Health (NIH) T-32 training grant T32 HL069749 and L30 HL124592; however, no relationships exist related to the analysis presented. Dr Wang reports research funding from AstraZeneca, Daiichi Sankyo, Gilead Sciences, GlaxoSmithKline, Lilly, Boston Scientific, and Regeneron (all significant) and consulting for Astra Zeneca and Eli Lilly (significant). Dr Roe reports research funding from Eli Lilly & Company, Sanofi-Aventis, Daiichi-Sankyo, Amgen, and the Familial Hypercholesterolemia Foundation; educational activities or lectures for AstraZeneca and Bristol Myers Squibb; consulting for AstraZeneca, Eli Lilly and Company, Merck and Co, Janssen Pharmaceuticals, Elsevier Publishers, and Bristol Myers Squibb. ACTION Registry-GWTG is an initiative of the American College of Cardiology Foundation and the American Heart Association, with partnering support from the Society of Chest Pain Centers, the American College of Emergency Physicians, and the Society of Hospital Medicine. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; and decision to submit the article for publication. The other authors report no conflicts. CR Alexander JH, 2011, NEW ENGL J MED, V365, P699, DOI 10.1056/NEJMoa1105819 Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2713, DOI [10.1016/j.jacc.2014.10.011, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.09.017] Armstrong PW, 1998, CIRCULATION, V98, P1860, DOI 10.1161/01.CIR.98.18.1860 Brennan JM, 2014, CIRC-CARDIOVASC QUAL, V7, pA26 Chan MY, 2009, CIRCULATION, V119, P3110, DOI 10.1161/CIRCULATIONAHA.108.799981 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 Chin CT, 2014, AM HEART J, V167, P36, DOI 10.1016/j.ahj.2013.10.008 Christiansen EC, 2013, AM J CARDIOL, V112, P330, DOI 10.1016/j.amjcard.2013.03.031 GRAY RJ, 1988, ANN STAT, V16, P1141, DOI 10.1214/aos/1176350951 Hammill BG, 2009, AM HEART J, V157, P995, DOI 10.1016/j.ahj.2009.04.002 Hicks KA, 2015, J AM COLL CARDIOL, V66, P403, DOI 10.1016/j.jacc.2014.12.018 Hlatky MA, 2014, CIRC-CARDIOVASC QUAL, V7, P157, DOI 10.1161/CIRCOUTCOMES.113.000373 Korea Meteorological Administration (KMA), 2011, QUAL CONTR MAN NAT C Masoudi FA, 2013, J AM COLL CARDIOL, V62, P1931, DOI 10.1016/j.jacc.2013.05.099 Mega JL, 2012, NEW ENGL J MED, V366, P9, DOI 10.1056/NEJMoa1112277 Messenger JC, 2012, J AM COLL CARDIOL, V60, P1484, DOI 10.1016/j.jacc.2012.07.020 Newell MC, 2012, CATHETER CARDIO INTE, V79, P57, DOI 10.1002/ccd.23479 Newell MC, 2011, AM HEART J, V161, P664, DOI 10.1016/j.ahj.2010.12.018 O'Gara PT, 2013, J AM COLL CARDIOL, V61, pE78, DOI [10.1016/j.jacc.2012.11.019, 10.1161/01.cir.0000440804.93914.d8, 10.1161/CIR.0b013e3182742cf6] Peterson ED, 2010, HEART, V96, P1798, DOI 10.1136/hrt.2010.200261 Peterson ED, 2009, CIRC-CARDIOVASC QUAL, V2, P491, DOI 10.1161/CIRCOUTCOMES.108.847145 Roe MT, 2013, CIRC-CARDIOVASC QUAL, V6, P323, DOI 10.1161/CIRCOUTCOMES.113.000120 Roe MT, 2011, AM HEART J, V162, DOI 10.1016/j.ahj.2011.08.010 Roe MT, 2005, ARCH INTERN MED, V165, P1630, DOI 10.1001/archinte.165.14.1630 Schwartz GG, 2012, NEW ENGL J MED, V367, P2089, DOI 10.1056/NEJMoa1206797 Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 ZEGER SL, 1986, BIOMETRICS, V42, P121, DOI 10.2307/2531248 NR 31 TC 30 Z9 32 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1941-7705 EI 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD SEP PY 2016 VL 9 IS 5 BP 513 EP 522 DI 10.1161/CIRCOUTCOMES.115.002312 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DX5ZL UT WOS:000384461300006 PM 27601458 OA Bronze DA 2023-05-13 ER PT J AU Zegre-Hemsey, JK Burke, LA DeVon, HA AF Zegre-Hemsey, Jessica K. Burke, Larisa A. DeVon, Holli A. TI Patient-reported symptoms improve prediction of acute coronary syndrome in the emergency department SO RESEARCH IN NURSING & HEALTH LA English DT Article DE acute coronary syndrome; electrocardiography; emergency nursing; prehospital delay; symptoms ID ASSOCIATION TASK-FORCE; CLINICAL-DATA STANDARDS; KEY DATA ELEMENTS; PREHOSPITAL DELAY; MYOCARDIAL-INFARCTION; AMERICAN-COLLEGE; WRITING COMMITTEE; ARTERY-DISEASE; TIME; RISK AB Early diagnosis is critical in the management of patients with acute coronary syndrome (ACS), particularly ST-elevation myocardial infarction (STEMI), because effective therapies are time-dependent. Aims of this secondary analysis were to determine: (i) the prognostic value of symptoms for an ACS diagnosis in conjunction with electrocardiographic (ECG) and troponin results; and (ii) if any of 13 symptoms were associated with prehospital delay in those presenting to the emergency department (ED) with potential ACS. Patients receiving a cardiac evaluation in the ED were eligible for the study. Thirteen patient-reported symptoms were assessed in triage. Prehospital delay time was calculated as the time from symptom onset until registration in the ED. A total of 1,064 patients were enrolled in five EDs. The sample was 62% male, 70% white, and had a mean age of 60.2 years. Of 474 participants diagnosed with ACS, 118 (25%) had STEMI; 251 (53%) had non-ST elevation myocardial infarction (NSTEMI); and 105 (22%) had unstable angina. Sweating (OR=1.42 CI [1.01, 2.00]) and shoulder pain (OR=1.64 CI [1.13, 2.38]) added to the predictive value of an ACS diagnosis when combined with ECG and troponin results. Shortness of breath (OR=0.71 CI [0.50, 1.00]) and unusual fatigue (OR=0.60 CI [0.42, 0.84]) were predictive of a non-ACS diagnosis. Sweating predicted shorter prehospital delay (HR=1.35, CI [1.10, 1.67]); shortness of breath (HR=0.73 CI [0.60, 0.89]) and unusual fatigue (HR=0.72, CI [0.57, 0.90]) were associated with longer prehospital delay. Patient-reported symptoms are significantly associated with ACS diagnoses and prehospital delay. Sweating and shoulder pain combined with ECG signs of ischemia may improve the timely detection of ACS in the ED. C1 [Zegre-Hemsey, Jessica K.] Univ N Carolina, Sch Nursing, Carrington Hall,Campus Box 7460, Chapel Hill, NC 27599 USA. [Burke, Larisa A.] Univ Illinois, Coll Nursing, Off Res Facilitat, Chicago, IL USA. [DeVon, Holli A.] Univ Illinois, Coll Nursing, Biobehav Hlth Sci, Chicago, IL USA. C3 University of North Carolina; University of North Carolina Chapel Hill; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital RP Zegre-Hemsey, JK (通讯作者),Univ N Carolina, Sch Nursing, Carrington Hall,Campus Box 7460, Chapel Hill, NC 27599 USA. EM jzhemsey@email.unc.edu OI Zegre-Hemsey, Jessica/0000-0002-5650-0464 FU National Institutes for Nursing Research [R01NR012012]; National Center for Advancing Translational Sciences, National Institutes of Health [KL2TR001109] FX National Institutes for Nursing Research, Grant number: R01NR012012; National Center for Advancing Translational Sciences, National Institutes of Health, Grant number: KL2TR001109 CR Allison PD, 2001, MISSING DATA, V136 Alpert JS, 2000, J AM COLL CARDIOL, V36, P959, DOI 10.1016/S0735-1097(00)00804-4 Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2713, DOI [10.1016/j.jacc.2014.10.011, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.09.017] Arora G, 2015, CURR CARDIOL REP, V17, DOI 10.1007/s11886-014-0557-5 Asparouhov T., 2014, CONTINUOUS TIME SURV, P1 Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Body R, 2010, RESUSCITATION, V81, P281, DOI 10.1016/j.resuscitation.2009.11.014 Bruyninckx R, 2008, BRIT J GEN PRACT, V58, P105, DOI 10.3399/bjgp08X277014 Bugiardini R, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.005968 Cannon CP, 2013, J AM COLL CARDIOL, V61, P992, DOI 10.1016/j.jacc.2012.10.005 Cullen L, 2013, HEART LUNG CIRC, V22, P844, DOI 10.1016/j.hlc.2013.03.074 DeVon HA, 2003, NURS RES, V52, P108, DOI 10.1097/00006199-200303000-00007 DeVon HA, 2008, AM J CRIT CARE, V17, P14 DeVon HA, 2017, J CARDIOVASC NURS, V32, P383, DOI 10.1097/JCN.0000000000000351 DeVon HA, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.113.000586 DeVon HA, 2010, RES NURS HEALTH, V33, P386, DOI 10.1002/nur.20395 DeVon HA, 2010, J CARDIOVASC NURS, V25, P106, DOI 10.1097/JCN.0b013e3181bb14a0 Doggen CJM, 2016, BMC EMERG MED, V16, DOI 10.1186/s12873-015-0065-y El-Menyar A, 2011, J CARDIOL, V57, P165, DOI 10.1016/j.jjcc.2010.11.008 Fanaroff AC, 2015, JAMA-J AM MED ASSOC, V314, P1955, DOI 10.1001/jama.2015.12735 Hess CN, 2016, CIRCULATION, V133, P493, DOI 10.1161/CIRCULATIONAHA.115.017001 Hicks KA, 2015, J AM COLL CARDIOL, V66, P403, DOI 10.1016/j.jacc.2014.12.018 Hosmer D. W., 2011, APPL SURVIVAL ANAL Karam N, 2016, CIRCULATION, V134, P2074, DOI 10.1161/CIRCULATIONAHA.116.022954 McKee G, 2013, INT J CARDIOL, V168, P2706, DOI 10.1016/j.ijcard.2013.03.022 Menees DS, 2013, NEW ENGL J MED, V369, P901, DOI 10.1056/NEJMoa1208200 Moser DK, 2007, J CARDIOVASC NURS, V22, P326, DOI 10.1097/01.JCN.0000278963.28619.4a O'Donnell S, 2014, J EMERG MED, V46, P507, DOI 10.1016/j.jemermed.2013.08.038 O'Gara PT, 2013, J AM COLL CARDIOL, V61, P485, DOI [10.1016/j.jacc.2012.11.018, 10.1161/CIR.0b013e3182742c84] Ouellet GM, 2017, J AM GERIATR SOC, V65, P2391, DOI 10.1111/jgs.15102 Pelter MM, 2012, AM J EMERG MED, V30, P1822, DOI 10.1016/j.ajem.2012.03.002 Pelter MM, 2010, J CARDIOVASC NURS, V25, P115, DOI 10.1097/JCN.0b013e3181bb14b3 Rosenfeld AG, 2015, HEART LUNG, V44, P368, DOI 10.1016/j.hrtlng.2015.05.008 Savonitto S, 1999, JAMA-J AM MED ASSOC, V281, P707, DOI 10.1001/jama.281.8.707 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Ting HH, 2009, CIRC-CARDIOVASC QUAL, V2, P522, DOI 10.1161/CIRCOUTCOMES.109.912188 White H, 2014, CURR CARDIOL REP, V16, DOI 10.1007/s11886-014-0492-5 Worrall-Carter L, 2017, J CARDIOVASC NURS, V32, P112, DOI 10.1097/JCN.0000000000000300 Wu JR, 2011, J CARDIOVASC NURS, V26, P184, DOI 10.1097/JCN.0b013e3181efea66 NR 39 TC 5 Z9 6 U1 1 U2 5 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0160-6891 EI 1098-240X J9 RES NURS HEALTH JI Res. Nurs. Health PD OCT PY 2018 VL 41 IS 5 BP 459 EP 468 DI 10.1002/nur.21902 PG 10 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA GX3WX UT WOS:000447659000006 PM 30168588 OA Green Accepted DA 2023-05-13 ER PT J AU Shijubou, N Sumi, T Kamada, K Sawai, T Yamada, Y Ikeda, T Nakata, H Mori, Y Chiba, H AF Shijubou, Naoki Sumi, Toshiyuki Kamada, Koki Sawai, Takeyuki Yamada, Yuichi Ikeda, Tatsuru Nakata, Hisashi Mori, Yuji Chiba, Hirofumi TI Fulminant amebic colitis in a patient with concomitant cytomegalovirus infection after systemic steroid therapy: A case report SO WORLD JOURNAL OF CLINICAL CASES LA English DT Article DE Amebiasis; Intestinal; Colitis; Cytomegalovirus; Glucocorticoids; Perforation; Case report ID PERFORATION; COLON AB BACKGROUND Amebic colitis is an infection caused by Entamoeba histolytica and most commonly observed in regions with poor sanitation. It is also seen as a sexually transmitted disease in developed countries. While amebic colitis usually has a chronic course with repeated exacerbations and remissions, it may also manifest as a fulminant form that rapidly progresses and leads to severe, life-threatening complications, such as intestinal perforation, peritonitis, and sepsis, that have a high mortality rate. CASE SUMMARY A 68-year-old man was admitted to our hospital with chest pain and acute dyspnea. He was diagnosed with acute coronary syndrome, acute heart failure, and bacterial pneumonia. His respiratory condition worsened despite receiving intensive care and intravenous antibiotics. On the fifth day of hospitalization, he was diagnosed with acute respiratory distress syndrome and was started on steroid therapy. He subsequently developed bloody stools and was diagnosed with cytomegalovirus (CMV) enterocolitis based on biopsy results and a peripheral blood CMV pp65 antigenemia test result. Although we started antiviral therapy with ganciclovir, which was successful in reducing his antigen titers, he continued to have bloody diarrhea. Three weeks after initiation of ganciclovir therapy and six weeks after his admission, the patient died from intestinal perforation. We only posthumously diagnosed him with amebic colitis and CMV enterocolitis based on autopsy findings of transmural necrosis of the entire colon with massive ameba infiltration. CONCLUSION We urge clinicians to consider Entamoeba histolytica infection if severe colitis progresses after steroid therapy. Preemptive treatment is recommended then. C1 [Shijubou, Naoki; Sumi, Toshiyuki; Kamada, Koki; Yamada, Yuichi; Nakata, Hisashi; Mori, Yuji] Hakodate Goryoukaku Hosp, Dept Resp Med, 38-3 Goryoukaku Cho, Hakodate, Hokkaido 0408611, Japan. [Shijubou, Naoki; Sumi, Toshiyuki; Kamada, Koki; Sawai, Takeyuki; Chiba, Hirofumi] Sapporo Med Univ, Sch Med, Dept Resp Med & Allergol, Sapporo, Hokkaido 0608556, Japan. [Ikeda, Tatsuru] Hakodate Goryoukaku Hosp, Dept Pathol & Diag, Hakodate, Hokkaido 0408611, Japan. C3 Sapporo Medical University RP Shijubou, N (通讯作者),Hakodate Goryoukaku Hosp, Dept Resp Med, 38-3 Goryoukaku Cho, Hakodate, Hokkaido 0408611, Japan. EM shjibou.1229@gmail.com CR ADAMS EB, 1977, MEDICINE, V56, P315, DOI 10.1097/00005792-197707000-00003 Centers forDiseaseControlandPrevention(CDC)., 1994, MMWR MORB MORTAL WKL, V42, pI Chun J, 2015, INTEST RES, V13, P50, DOI 10.5217/ir.2015.13.1.50 GATHIRAM V, 1987, S AFR MED J, V72, P669 Haque R, 2003, NEW ENGL J MED, V348, P1565, DOI 10.1056/NEJMra022710 Haque R, 2001, J INFECT DIS, V183, P1787, DOI 10.1086/320740 Kobayashi T, 2017, J CLIN MICROBIOL, V55, P313, DOI 10.1128/JCM.01757-16 Lino Katia, 2018, Braz. J. 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Cases PD MAY 26 PY 2021 VL 9 IS 15 DI 10.12998/wjcc.v9.i15.3726 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA SE6RW UT WOS:000652200000028 PM 34046476 OA gold, Green Published DA 2023-05-13 ER PT J AU Choi, SW Choi, DH Kim, HW Ku, YH Ha, SI Park, G AF Choi, Seo-Won Choi, Dong-Hyun Kim, Hyun-Wook Ku, Yo-Han Ha, Sung-Il Park, Geon TI Clinical outcome prediction from mean platelet volume in patients undergoing percutaneous coronary intervention in Korean cohort: Implications of more simple and useful test than platelet function testing SO PLATELETS LA English DT Article DE Acute coronary syndrome; cardiac death; mean platelet volume; percutaneous coronary intervention ID OF-CARE ASSAY; ANTIPLATELET THERAPY; CARDIOVASCULAR PATIENTS; STENT IMPLANTATION; ASPIRIN RESISTANCE; ARTERY-DISEASE; METAANALYSIS; EVENTS; RESPONSIVENESS; REACTIVITY AB The aim of this study was to determine the associations of the mean platelet volume (MPV) with the development of adverse outcomes after percutaneous coronary intervention (PCI) and platelet reactivity. MPV and platelet function testing were analysed in 208 patients who underwent PCI. The primary endpoint was cardiac death. The secondary endpoint analysed was cardiovascular events (CVE): the composite of myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis (ST). The median MPV level, aspirin reaction unit (ARU), P2Y12 reaction units (PRU) and P2Y12% inhibition (PI%) of clopidogrel were 8.55 (IQR 8.00-9.18) fl, 401.0 (IQR 389.3-442.0) ARU, 222.0 (IQR 169.0-272.3) PRU and 22 (IQR 9-38)%, respectively. We observed that high values of MPV were associated with elevated ARU (r = 0.165, p = 0.017) and decreased PI% (r = -0.167, p = 0.016). There were 10 events of cardiac death, 3 MI (including 1 event of ST), and 8 TVR during a mean of 7.6 months of follow-up. The Kaplan-Meier analysis revealed that the higher MPV group (>= 8.55 fl, median) had a significantly higher cardiac death rate compared to the lower MPV group (<8.55 fl) (7.7% vs. 1.9%, log-rank: p = 0.035). However, aspirin or clopidogrel resistance (>550 ARU, <40 PI%, respectively) did not predict cardiac death. When the MPV cut-off level was set to 8.55 fl using the receiver operating characteristic curve, the sensitivity was 80% and the specificity was 51.5% for differentiating between the group with cardiac death and the group without cardiac death. This value was more useful in patients with clinical diagnosis of acute coronary syndrome (ACS). Furthermore, ACS patients with an MPV over 8.55 fl had high cardiac death and CVE risk without atorvastatin loading before PCI (Log-Rank = 0.0031, 0.0023, respectively). The results of this study show that MPV was a predictive marker for cardiac death after PCI; its predictive power for cardiac death was more useful in patients with ACS. C1 [Choi, Seo-Won; Choi, Dong-Hyun; Kim, Hyun-Wook] Chosun Univ, Sch Med, Dept Internal Med, Kwangju 501759, South Korea. [Ku, Yo-Han] Yeosu Chonnam Hosp, Dept Internal Med, Yeosu 1201, South Korea. [Ha, Sung-Il] Chosun Univ, Grad Sch, Dept Med, Kwangju 501759, South Korea. [Park, Geon] Chosun Univ, Sch Med, Dept Lab Med, Kwangju 501759, South Korea. [Park, Geon] Chosun Univ, Sch Med, Res Ctr Resistant Cells, Kwangju 501759, South Korea. C3 Chosun University; Chosun University; Chosun University; Chosun University RP Choi, DH (通讯作者),Chosun Univ, Coll Med, 375 Seo Suk Dong, Kwangju 501759, South Korea. EM dhchoi@chosun.ac.kr FU Clinical Medicine Research Institute at Chosun University Hospital FX The present study was supported by grants from the Clinical Medicine Research Institute at Chosun University Hospital (2012). 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PD JAN 19 PY 2021 VL 77 IS 2 BP 205 EP 223 DI 10.1016/j.jacc.2020.11.002 EA JAN 2021 PG 19 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA PU0BV UT WOS:000608973900012 PM 33446314 OA hybrid DA 2023-05-13 ER PT J AU Primessnig, U Pieske, BM Sherif, M AF Primessnig, Uwe Pieske, Burkert M. Sherif, Mohammad TI Increased mortality and worse cardiac outcome of acute myocardial infarction during the early COVID-19 pandemic SO ESC HEART FAILURE LA English DT Article DE Acute myocardial infarction; Covid-19; SARS-CoV-2; STEMI; NSTEMI; Percutaneous coronary intervention ID ST-SEGMENT ELEVATION; OF-CARDIOLOGY ACC; CARDIOVASCULAR ANGIOGRAPHY; INTERVENTIONS SCAI; AMERICAN-COLLEGE; MANAGEMENT; SOCIETY; STATEMENT AB Aims: This study aimed to evaluate the impact of coronavirus disease 2019 (Covid-19) outbreak on admissions for acute myocardial infarction (AMI) and related mortality, severity of presentation, major cardiac complications and outcome in a tertiary-care university hospital in Berlin, Germany. Methods and results: In a single-centre cross-sectional observational study, we included 355 patients with AMI containing ST-elevation or non-ST-elevation myocardial infarction (STEMI or NSTEMI), admitted for emergency cardiac catheterization between January and April 2020 and the equivalent time in 2019. During the early phase of the Covid-19 pandemic (e-COV) in Berlin (March and April 2020), admissions for AMI halved compared with those in the pre-Covid-19 time (January and February 2020; pre-COV) and with those in the corresponding months in 2019. However, mortality for AMI increased substantially from 5.2% pre-COV to 17.7% (P < 0.05) during e-COV. Severity of presentation for AMI was more pronounced during e-COV [increased levels of cardiac enzymes, reduced left ventricular ejection fraction (LVEF), an increase in the need of inotropic support by 25% (P < 0.01)], while patients' demographic and angiographic characteristics did not differ between pre-COV and e-COV. Time from symptom onset to first medical contact was prolonged in all AMI during e-COV (presentation > 72 h +21% in STEMI, p = 0.04 and presentation > 72 h in NSTEMI +22%, p = 0.02). Door to balloon time was similar in STEMI patients, while time from first medical contact to revascularization was significantly delayed in NSTEMI patients (p = 0.02). Major cardiac complications after AMI occurred significantly more often, and cardiac recovery was worse in e-COV than in pre-COV, demonstrated by a significantly lower LVEF (39 +/- 16 vs. 46 +/- 16, p < 0.05) at hospital discharge and substantially higher NTproBNP levels. Conclusions: The Covid-19 outbreak affects hospital admissions for acute coronary syndromes. During the first phase of the pandemia, significantly less patients with AMI were admitted, but those admitted presented with a more severe phenotype and had a higher mortality, more complications, and a worse short-term outcome. Therefore, our data indicate that Covid-19 had relevant impact on non-infectious disease states, such as acute coronary syndromes. C1 [Primessnig, Uwe; Pieske, Burkert M.; Sherif, Mohammad] Charite Univ Med Berlin, Dept Internal Med & Cardiol, Campus Virchow Klinikum, Augustenburger Pl 1, D-13353 Berlin, Germany. [Primessnig, Uwe; Pieske, Burkert M.] DZHK German Ctr Cardiovasc Res, Partner Site, Berlin, Germany. [Primessnig, Uwe; Pieske, Burkert M.] Berlin Inst Hlth BIH, Berlin, Germany. C3 Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; German Centre for Cardiovascular Research; Berlin Institute of Health RP Primessnig, U (通讯作者),Charite Univ Med Berlin, Dept Internal Med & Cardiol, Campus Virchow Klinikum, Augustenburger Pl 1, D-13353 Berlin, Germany. EM uwe.primessnig@charite.de RI Pieske, Burkert/M-8089-2016 OI Pieske, Burkert/0000-0002-6466-5306; Sherif, Mohammad/0000-0001-6999-5067 CR Bai Y, 2020, JAMA-J AM MED ASSOC, V323, P1406, DOI [10.1001/jama.2020.2565, 10.1056/NEJMoa2001316] Cucinotta Domenico, 2020, Acta Biomed, V91, P157, DOI 10.23750/abm.v91i1.9397 De Rosa S, 2020, EUR HEART J, V41, P2083, DOI 10.1093/eurheartj/ehaa409 Gagliano A, 2020, DISASTER MED PUBLIC, V14, P372, DOI 10.1017/dmp.2020.51 Garcia S, 2020, J AM COLL CARDIOL, V75, P2871, DOI 10.1016/j.jacc.2020.04.011 Guan W, 2020, NEW ENGL J MED, V382, P1708, DOI 10.1056/NEJMoa2002032 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Indolfi Ciro, 2020, JACC Case Rep, V2, P1414, DOI 10.1016/j.jaccas.2020.03.012 Mahmud E, 2020, CATHETER CARDIO INTE, V96, P336, DOI 10.1002/ccd.28946 Mahmud E, 2020, J AM COLL CARDIOL, V76, P1375, DOI 10.1016/j.jacc.2020.04.039 McCloskey B, 2020, LANCET, V395, P1096, DOI 10.1016/S0140-6736(20)30681-4 Onder G, 2020, JAMA-J AM MED ASSOC, V323, P1775, DOI 10.1001/jama.2020.4683 Rodriguez-Leor O, 2020, REC-INTERV CARDIOL, V2, P82, DOI 10.24875/RECICE.M20000123 Solomon MD, 2020, NEW ENGL J MED, V383, P691, DOI 10.1056/NEJMc2015630 Stefanini GG, 2020, CIRCULATION, V141, P2113, DOI 10.1161/CIRCULATIONAHA.120.047525 Stefanini GG, 2020, CIRCULATION, V141, P1597, DOI 10.1161/CIRCULATIONAHA.120.047070 Tam CCF, 2021, CATHETER CARDIO INTE, V97, pE194, DOI 10.1002/ccd.28943 Tam CCF, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006631 Welt FGP, 2020, J AM COLL CARDIOL, V75, P2372, DOI 10.1016/j.jacc.2020.03.021 Wijns W, 2018, EUR HEART J, V39, P1075, DOI 10.1093/eurheartj/ehy069 NR 20 TC 44 Z9 44 U1 0 U2 2 PU WILEY PERIODICALS, INC PI SAN FRANCISCO PA ONE MONTGOMERY ST, SUITE 1200, SAN FRANCISCO, CA 94104 USA SN 2055-5822 J9 ESC HEART FAIL JI ESC Heart Fail. PD FEB PY 2021 VL 8 IS 1 BP 333 EP 343 DI 10.1002/ehf2.13075 EA DEC 2020 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PX9BV UT WOS:000595854400001 PM 33283476 OA Green Published, gold DA 2023-05-13 ER PT J AU Vuilliomenet, T Gebhard, C Bizzozero, C Glauser, S Blum, S Buser, A Bolliger, D Grapow, MTR Siegemund, M AF Vuilliomenet, Thierry Gebhard, Caroline Bizzozero, Chiara Glauser, Salome Blum, Steffen Buser, Andreas Bolliger, Daniel Grapow, Martin T. R. Siegemund, Martin TI Discontinuation of dual antiplatelet therapy and bleeding in intensive care in patients undergoing urgent coronary artery bypass grafting: a retrospective analysis SO INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY LA English DT Article DE Coronary artery bypass grafting; Dual antiplatelet therapy; Acute coronary syndrome; Bleeding; Blood products ID PLATELET INHIBITION; P2Y(12) INHIBITORS; CLOPIDOGREL; TICAGRELOR; COMPLICATIONS; PRASUGREL; OUTCOMES; SURGERY; PRETREATMENT AB OBJECTIVES: Our goal was to evaluate the impact of the discontinuation times of dual antiplatelet therapy with clopidogrel, prasugrel or ticagrelor on postoperative bleeding rates and the use of blood products in patients undergoing isolated urgent coronary artery bypass grafting (CABG). METHODS: We retrospectively analysed 334 patients with acute coronary syndrome undergoing urgent CABG at the University Hospital Basel. A total of 262 patients continued to take dual antiplatelet therapy during the surgery (72 received clopidogrel; 68, prasugrel; and 122, ticagrelor). They were stratified by the discontinuation time of dual antiplatelet therapy (<24 h, 24-48 h, 48-72 h and >72 h). Seventy-two patients taking acetylsalicylic acid (ASA) as monotherapy served as a comparison group. RESULTS: Median postsurgical bleeding rates were significantly higher with ticagrelor if it was discontinued <24 h [1220 ml, interquartile range (IQR) 978-1520 ml; P < 0.001], 24-48 h (1200 ml, IQR 800-1550 ml; P < 0.001) and 48-72 h (1100 ml, IQR 845-1245 ml; P = 0.036) but not if discontinued >72 h (700 ml, IQR 520-825 ml; P = 0.22) and with prasugrel if discontinued <24 h (1320 ml, IQR 900-1950 ml; P < 0.001) but not if discontinued 24-48 h (1050 ml, IQR 638-1438 ml; P = 0.089) or >72 h (750 ml, IQR 488-1040; P = 0.63) compared to ASA monotherapy (800 ml, IQR 593-1043 ml). The postsurgical use of blood products compared to ASA monotherapy (0, IQR 0-2 units) was significantly higher with ticagrelor and prasugrel if discontinued <24 h (2.5 units, IQR 0-6; P < 0.001 and 2 units, IQR 1-6; P < 0.001, respectively). CONCLUSIONS: Discontinuation of ticagrelor and prasugrel for more than 72 h before urgent CABG was not associated with higher bleeding rates compared to treatment with ASA monotherapy. In contrast, discontinuation for less than 24 h was associated with higher use of blood products. For ticagrelor, this study supports evidence and recent guidelines proposing a shorter discontinuation time of 3 days and raises the question of whether the same could be true for prasugrel. C1 [Vuilliomenet, Thierry; Gebhard, Caroline; Bizzozero, Chiara; Glauser, Salome; Bolliger, Daniel; Siegemund, Martin] Univ Hosp Basel, Dept Anaesthesiol & Surg Intens Care, Spitalstr 21, CH-4031 Basel, Switzerland. [Blum, Steffen] Univ Hosp Basel, Dept Cardiol, Basel, Switzerland. [Buser, Andreas] Univ Hosp Basel, Dept Haematol, Basel, Switzerland. [Grapow, Martin T. R.] Univ Hosp Basel, Dept Cardiac Surg, Basel, Switzerland. C3 University of Basel; University of Basel; University of Basel; University of Basel RP Siegemund, M (通讯作者),Univ Hosp Basel, Dept Anaesthesiol & Surg Intens Care, Spitalstr 21, CH-4031 Basel, Switzerland. EM martin.siegemund@usb.ch RI Buser, Andreas S/A-2660-2008; Siegemund, Martin/AAM-8929-2020; Gebhard, Caroline/HTR-8636-2023 OI Buser, Andreas S/0000-0002-7942-6746; Siegemund, Martin/0000-0002-2013-4140; CR Becker RC, 2011, EUR HEART J, V32, P2933, DOI 10.1093/eurheartj/ehr422 Cao C, 2014, J THORAC CARDIOV SUR, V148, P3092, DOI 10.1016/j.jtcvs.2014.04.054 Gherli R, 2016, JAMA CARDIOL, V1, P921, DOI 10.1001/jamacardio.2016.3028 Goodnough LT, 2013, J THORAC CARDIOV SUR, V145, P1077, DOI 10.1016/j.jtcvs.2012.07.059 Guida P, 2014, J THORAC CARDIOV SUR, V148, P3049, DOI 10.1016/j.jtcvs.2014.07.039 Gurbel PA, 2003, CIRCULATION, V107, P2908, DOI 10.1161/01.CIR.0000072771.11429.83 Hansson EC, 2016, EUR HEART J, V37, P189, DOI 10.1093/eurheartj/ehv381 Hansson EC, 2014, EUR J CARDIO-THORAC, V46, P699, DOI 10.1093/ejcts/ezt662 Held C, 2011, J AM COLL CARDIOL, V57, P672, DOI 10.1016/j.jacc.2010.10.029 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 King S, 2016, VASC PHARMACOL, V78, P10, DOI 10.1016/j.vph.2015.07.008 Mahla E, 2012, CIRC-CARDIOVASC INTE, V5, P261, DOI 10.1161/CIRCINTERVENTIONS.111.967208 Minne L, 2008, CRIT CARE, V12, DOI 10.1186/cc7160 Pagano D, 2018, EUR J CARDIO-THORAC, V53, P79, DOI 10.1093/ejcts/ezx325 Parodi G, 2011, JAMA-J AM MED ASSOC, V306, P1215, DOI 10.1001/jama.2011.1332 Roffi M, 2015, EUR HEART J, DOI [10.1093/eur-heartj/ehv320, DOI 10.1093/EURHEARTJ/EHR236] Sibbing D, 2016, EUR HEART J, V37, P1284, DOI 10.1093/eurheartj/ehv717 Smith PK, 2012, J AM COLL CARDIOL, V60, P388, DOI 10.1016/j.jacc.2012.03.030 Valgimigli M, 2017, KARDIOL POL, V75, P1217, DOI 10.5603/KP.2017.0224 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Wallentin L, 2009, EUR HEART J, V30, P1964, DOI 10.1093/eurheartj/ehp296 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 NR 22 TC 5 Z9 7 U1 1 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1569-9293 EI 1569-9285 J9 INTERACT CARDIOV TH JI Interact Cardiovasc. Thorac. Surg. PD MAY PY 2019 VL 28 IS 5 BP 665 EP 673 DI 10.1093/icvts/ivy330 PG 9 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA JI0ZX UT WOS:000493196800001 PM 30535154 OA Bronze DA 2023-05-13 ER PT J AU Zhang, DW Wang, SL Wang, PL Du, JP Gao, ZY Wang, CL Xu, H Shi, DZ AF Zhang, Da-Wu Wang, Shao-Li Wang, Pei-Li Du, Jian-Peng Gao, Zhu-Ye Wang, Cheng-Long Xu, Hao Shi, Da-Zhuo TI The efficacy of Chinese herbal medicines on acute coronary syndrome with renal insufficiency after percutaneous coronary intervention SO JOURNAL OF ETHNOPHARMACOLOGY LA English DT Article DE Acute coronary syndrome; Renal insufficiency; Herbal medicine; Clinical trials; Endpoint ID CHRONIC KIDNEY-DISEASE; ELEVATION MYOCARDIAL-INFARCTION; ST-SEGMENT ELEVATION; EVIDENCE-BASED CARE; NATIONAL REGISTRY; HEART-DISEASE; DOUBLE-BLIND; MULTICENTER; GUIDELINES; THERAPIES AB Ethnopharmacological relevance: Fufang Chuanxiong capsule consists of Angelica sinensis radix and Chuanxiong rhizome, which are used in the traditional Chinese medicine for the treatment of coronary artery disease, and Xinyue capsule is composed of panax quinquefolius saponin extracted from leaves and stems of Panax quinquefolium L, which has the functions of anti-myocardial ischemia, improving myocardial energy metabolism and inhibiting apoptosis of cardiomyocytes. Objective: To observe the role of Chinese herbal medicines in the cardiovascular outcome among patients with acute coronary syndrome (ACS) and renal insufficiency after percutaneous coronary intervention (PCI). Methods: The subjects came from the 5C trial (chictr.org number: chictr-trc-07000021), post-PCI patients suffered from ACS with mild-to-moderate renal insufficiency (30 mL.min(-1).1.73 m(-2) < estimated glomerular filtration rate <= 89 mL.min(-1).1.73 m(-2)) included. The study population consisted of 215 subjects in the control group who were treated with western medicine standard therapy, and 211 subjects in the treatment group who were treated with Chinese herbal medicines (Fufang Chuanxiong Capsule and Xinyue Capsule) for 6 months on the basis of western medicine standard therapy. All were followed for 1 year. The primary endpoint included the composite of cardiac death, nonfatal recurrent myocardial infarction, and ischemia-driven revascularization. Secondary endpoint included the composite of stroke, congestive heart failure, and readmission for ACS. The serum creatinine and estimated glomerular filtration rate (eGFR) were evaluated. Results: After 1 year follow-up of two groups, there were 16 cases of primary endpoint in the control group and 6 cases of primary endpoint in the treatment group [absolute risk reduction (ARR): 0.046, 95%CI: 0.004-0.088; relative risk (RR): 0.38, 95%CI: 0.15-0.96, P = 0.040]. There were 15 cases of secondary endpoint in the control group and 5 cases of secondary endpoint in the treatment (ARR: 0.041, 95%CI: 0.006-0.086; RR: 0.34, 95%CI: 0.13-0.92, P = 0.033). The eGFR in the treatment group was significantly higher than that in the control group (75.19 +/- 16.74 mL min(-1).1.73 m(-2) VS 72.03 +/- 14.96 mL min(-1).1.73 m(-2), P < 0.05). The eGFR in the treatment group was significantly higher after the intervention with Chinese herbal medicines than that before intervention (72.27 +/- 11.83 mL min(-1).1.73 m(-2) VS 75.19 +/- 16.74 mL min(-1).1.73 m(-2), P < 0.05). Conclusion: Chinese herbal medicines plus western medicine standard therapy improved clinical outcomes in patients with ACS and mild-to-moderate renal insufficiency. Additionally, this study also demonstrated Chinese herbal medicines were useful in deferring decline of renal function. C1 [Zhang, Da-Wu; Wang, Pei-Li; Du, Jian-Peng; Gao, Zhu-Ye; Wang, Cheng-Long; Xu, Hao; Shi, Da-Zhuo] China Acad Chinese Med Sci, Xiyuan Hosp, Cardiovasc Dis Ctr, Xiyuan Caochang 1, Beijing 100091, Peoples R China. [Wang, Shao-Li] China Acad Chinese Med Sci, Guanganmen Hosp, Beijing 100053, Peoples R China. C3 China Academy of Chinese Medical Sciences; Xiyuan Hospital, CACMS; China Academy of Chinese Medical Sciences; Guang'anmen Hospital, CACMS RP Shi, DZ (通讯作者),China Acad Chinese Med Sci, Xiyuan Hosp, Cardiovasc Dis Ctr, Xiyuan Caochang 1, Beijing 100091, Peoples R China. EM shidazhuo@126.com RI xu, haodong/IAM-9132-2023; xu, hao/GWQ-7394-2022 FU Supporting Program of the "Eleventh Five-Year Plan" for Sci & Tech Research of China (China) [2006BA104A01]; National Natural Science Foundation (China) [81303128] FX We thank all of the research assistants and clinical coordinators for their dedication to clinical trial coordination, data collection, and management. This study was supported by grants from the Supporting Program of the "Eleventh Five-Year Plan" for Sci & Tech Research of China (China) (grant no. 2006BA104A01), and National Natural Science Foundation (China) (grant no. 81303128). 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Ethnopharmacol. PD FEB 10 PY 2020 VL 248 AR 112354 DI 10.1016/j.jep.2019.112354 PG 6 WC Plant Sciences; Chemistry, Medicinal; Integrative & Complementary Medicine; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Plant Sciences; Pharmacology & Pharmacy; Integrative & Complementary Medicine GA JW8QY UT WOS:000503312800051 PM 31689480 DA 2023-05-13 ER PT J AU Qato, K Harriman, D Cao, DC He, Q Eton, D McCormick, S Nathan, S Lopez, J Skelly, CL AF Qato, Khalil Harriman, David Cao, Dingcai He, Qi Eton, Darwin McCormick, Sue Nathan, Sandeep Lopez, John Skelly, Christopher L. TI Contemporary Outcomes in Vascular Patients Who Require Preoperative Coronary Stent SO ANNALS OF VASCULAR SURGERY LA English DT Article ID DRUG-ELUTING STENTS; NONCARDIAC SURGERY; COMPLICATIONS; THERAPY; DISEASE; EVENTS AB Background: The documented risks of preoperative coronary revascularization prior to vascular surgery have led to a marked reduction in the role of percutaneous coronary intervention (PCI) during preoperative risk stratification. However, many patients with peripheral arterial disease are first identified immediately after a PCI for an acute coronary syndrome. We sought to determine the risks associated with these patients who then go on to have a peripheral arterial intervention (open operation or endovascular procedure). We hypothesized that there was no difference in outcomes in patients whose medical condition required PCI with coronary stent placement prior to a vascular operation compared with a control cohort of nonstented patients who underwent a vascular operation alone. We report the vascular operative outcomes in a contemporary cohort of vascular patients who had PCI with coronary stent placement for an acute event. Methods: We performed a retrospective cohort analysis, utilizing administrative data, of 3,678 vascular patients from 2005 to 2010 at a tertiary care hospital. Two groups were defined: patients with preoperative PCI and coronary stent placement within 1 year prior to vascular operation (N = 101, mean age 66 +/- 1.22 years, 51.5% men); and patients with no PCI prior to vascular operation (N = 3,577, mean age 60 +/- 0.27 years, 46.37% men). Cardiovascular risk factors and complications derived from ICD-9 codes were used to parse data after open peripheral vascular surgery, endovascular repair, or amputation. Primary outcomes were death, nonfatal myocardial infarction, major adverse cardiac event (MACE, defined as death, myocardial infarction, or subsequent coronary revascularization) or bleeding. Results: Univariate analysis showed significant differences in both demographic and outcome analysis in patients with and without prior coronary stent. Patients with a recent PCI followed by a vascular procedure were more likely to undergo an endovascular procedure (75.3% vs. 64.5%, odds ratio = 1.67, P = 0.028). These patients also had 11 of 20 cardiovascular risk factors, significantly higher than in those without a prior PCI. Multivariate subgroup analysis indicated that patients with a prior coronary stent were more likely to have an episode of congestive heart failure (CHF) after 1 year of surgery (16.8%, P = 0.045). In addition, an acute cardiac ischemic event was more likely within 1 year (2.0%, P = 0.036) and beyond 1 year (4.0%, P = 0.022) of surgery. Importantly, there was no significant increase in death, myocardial infarction, MACE, or bleeding in patients with a preoperative coronary stent. Conclusions: Patients who underwent PCI with coronary stent and then went on to require a vascular procedure had significantly more cardiovascular (CV) risk factors and were more likely to have an endovascular procedure than those patients without preoperative PCI. When controlling for CV risk factors and procedure type, there was no significant difference in death, MI, MACE, or bleeding complications between the groups. C1 [Qato, Khalil] New York Med Coll, Valhalla, NY 10595 USA. [Harriman, David] Univ Chicago, Med Ctr, Ctr Qual, Chicago, IL 60637 USA. [Cao, Dingcai] Univ Illinois, Chicago, IL USA. [He, Qi; Eton, Darwin; McCormick, Sue; Skelly, Christopher L.] Univ Chicago, Dept Surg, Chicago, IL 60637 USA. [Nathan, Sandeep] Univ Chicago, Dept Med, Chicago, IL 60637 USA. [Lopez, John] Loyola Univ, Chicago Med Ctr, Chicago, IL 60611 USA. C3 New York Medical College; University of Chicago; University of Chicago Medical Center; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Chicago; University of Chicago; Loyola University Chicago RP Skelly, CL (通讯作者),Univ Chicago, Med Ctr, Ctr Qual, 5841 South Maryland Ave,MC 5028, Chicago, IL 60637 USA. EM cskelly@surgery.bsd.uchicago.edu RI Skelly, Christopher/ABD-6187-2020 OI Eton, Darwin/0000-0001-5937-1971 FU National Institutes of Health [NIH K-08-HL091053]; American Vascular Association/American College of Surgeons; National Heart, Lung, and Blood Institute (NHLBI) FX C.L.S. was funded by the National Institutes of Health (NIH K-08-HL091053) and by a jointly sponsored Mentored Clinical Scientist Development Award from the American Vascular Association/American College of Surgeons and National Heart, Lung, and Blood Institute (NHLBI). CR Barash P, 2010, BRIT J ANAESTH, V105, pI3, DOI 10.1093/bja/aeq318 Berger PB, 2010, NEW ENGL J MED, V362, P1441, DOI 10.1056/NEJMe1002553 Boden WE, 2007, NEW ENGL J MED, V356, P1503, DOI 10.1056/NEJMoa070829 Fleisher LA, 2007, CIRCULATION, V116, P1971, DOI 10.1161/CIRCULATIONAHA.107.185700 HERTZER NR, 1984, ANN SURG, V199, P223, DOI 10.1097/00000658-198402000-00016 King S, 2008, J AM COLL CARDIOL, V51, P72 McFalls EO, 2004, NEW ENGL J MED, V351, P2795, DOI 10.1056/NEJMoa041905 OWEIDA SW, 1990, J VASC SURG, V12, P310, DOI 10.1067/mva.1990.22293 Piper WD, 2003, AM HEART J, V145, P1022, DOI 10.1016/S0002-8703(03)00079-6 Poldermans D, 2007, J AM COLL CARDIOL, V49, P1763, DOI 10.1016/j.jacc.2006.11.052 Reddy PR, 2005, AM J CARDIOL, V95, P755, DOI 10.1016/j.amjcard.2004.11.029 Roger VL, 2011, CIRCULATION, V123, pE18, DOI 10.1161/CIR.0b013e3182009701 Schouten O, 2007, J AM COLL CARDIOL, V49, P122, DOI 10.1016/j.jacc.2006.10.004 van Kuijk JP, 2009, AM J CARDIOL, V104, P1229, DOI 10.1016/j.amjcard.2009.06.038 NR 14 TC 2 Z9 2 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0890-5096 J9 ANN VASC SURG JI Ann. Vasc. Surg. PD JUL PY 2013 VL 27 IS 5 BP 646 EP 654 DI 10.1016/j.avsg.2012.07.024 PG 9 WC Surgery; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Surgery; Cardiovascular System & Cardiology GA 179AZ UT WOS:000321490200015 PM 23541775 OA Green Accepted DA 2023-05-13 ER PT J AU Wu, X Liu, G Lu, J Zheng, XX Cui, JG Zhao, XY Huang, XH AF Wu, Xi Liu, Gang Lu, Jie Zheng, Xin-Xin Cui, Jin-Gang Zhao, Xue-Yan Huang, Xiao-Hong TI Administration of Ticagrelor and Double-Dose Clopidogrel Based on Platelet Reactivity Determined by VerifyNow-P2Y12 for Chinese Subjects After Elective PCI SO INTERNATIONAL HEART JOURNAL LA English DT Article DE High platelet reactivity; CYP2C19 ID PERCUTANEOUS CORONARY INTERVENTION; RECURRENT CARDIOVASCULAR EVENTS; ACUTE MYOCARDIAL-INFARCTION; OF-CARE ASSAY; ANTIPLATELET THERAPY; INCREASED RISK; ATHEROTHROMBOTIC EVENTS; STENT IMPLANTATION; RANDOMIZED-TRIAL; ARTERY-DISEASE AB Previous studies have identified high on treatment platelet reactivity (HTPR) as a potent factor predicting ischemic events for patients with coronary heart disease. We assessed the efficacy and safety of ticagrelor (90 mg twice-daily) and double-dose of clopidogrel (150 mg once-daily) among Chinese patients for electiVe percutaneous coronary intervention. We enrolled 40 patients with HTPR from among 317 patients with non-Sr-segment elevation acute coronary syndromes after a successful elective percutaneous coronary intervention (PCI). Platelet reactivity was measured by VerifyNow P2Y12 assay. Platelet reactivity was significantly lower for both groups when compared with baseline platelet reactivity after medication adjustment (all P < 0.001). The mean platelet reactivity units (PRU) was significantly lower for the ticagrelor group compared with that of the clopidogrel group over time (all P < 0.001). The differences in the rate of sustained HTPR at different time points between the two groups were significant (2 hours: 0% versus 60%; 8 hours: 5.6% versus 50%; 24 hours: 5.9% versus 43.8%, all P < 0.05). Genetic variation of CYP2C19*2 had no impact on PRU means or rate of HTPR in the ticagrelor group (P > 0.05). During the 30 -day follow-up, no MACE occurred in any patient, and the overall risk of bleeding showed no difference between the two groups (35% versus 21%, P = 0.48). Our results suggest that ticagrelor may achieve a more rapid and greater platelet inhibition than double-dose clopidogrel. Further studies are still needed to assess the differences in efficacy and safety between ticagrelor and double-dose clopidogrel administration for Chinese patients post elective PCI. C1 [Wu, Xi; Lu, Jie; Zheng, Xin-Xin; Cui, Jin-Gang; Zhao, Xue-Yan; Huang, Xiao-Hong] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, Dept Cardiol, 167 BeiLiShi Rd, Beijing 100037, Peoples R China. [Wu, Xi; Lu, Jie; Zheng, Xin-Xin; Cui, Jin-Gang; Zhao, Xue-Yan; Huang, Xiao-Hong] Peking Union Med Coll, 167 BeiLiShi Rd, Beijing 100037, Peoples R China. [Liu, Gang] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Cardiol, Guangzhou, Guangdong, Peoples R China. C3 Chinese Academy of Medical Sciences - Peking Union Medical College; Fu Wai Hospital - CAMS; Chinese Academy of Medical Sciences - Peking Union Medical College; Peking Union Medical College; Sun Yat Sen University RP Huang, XH (通讯作者),Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, Dept Cardiol, 167 BeiLiShi Rd, Beijing 100037, Peoples R China.; Huang, XH (通讯作者),Peking Union Med Coll, 167 BeiLiShi Rd, Beijing 100037, Peoples R China. EM huangxh_fuwai@163.com OI Wu, Xi/0000-0002-4280-4715 FU Science and Technology Project of the Beijing Municipal Science and Technology Commission [2013-BKJ10] FX This study was supported by a grant from the Science and Technology Project of the Beijing Municipal Science and Technology Commission (2013-BKJ10 to Huang Xiao-Hong). CR Alexopoulos D, 2012, J AM COLL CARDIOL, V60, P193, DOI 10.1016/j.jacc.2012.03.050 Angiolillo DJ, 2007, CIRCULATION, V115, P708, DOI 10.1161/CIRCULATIONAHA.106.667741 Bliden KP, 2007, J AM COLL CARDIOL, V49, P657, DOI 10.1016/j.jacc.2006.10.050 BOVILL EG, 1991, ANN INTERN MED, V115, P256, DOI 10.7326/0003-4819-115-4-256 Breet NJ, 2010, J THROMB HAEMOST, V8, P2140, DOI 10.1111/j.1538-7836.2010.04017.x Cuisset T, 2006, J THROMB HAEMOST, V4, P542, DOI 10.1111/j.1538-7836.2005.01751.x DiNicolantonio JJ, 2013, INT J CARDIOL, V169, P145, DOI 10.1016/j.ijcard.2013.08.085 Dobesh PP, 2014, PHARMACOTHERAPY, V34, P1077, DOI 10.1002/phar.1477 Gajda SN, 2015, ADV CLIN EXP MED, V24, P687, DOI 10.17219/acem/27922 Gurbel PA, 2005, J AM COLL CARDIOL, V46, P1820, DOI 10.1016/j.jacc.2005.07.041 Gurbel PA, 2010, CIRCULATION, V121, P1188, DOI 10.1161/CIRCULATIONAHA.109.919456 Husted S, 2009, CARDIOVASC THER, V27, P259, DOI 10.1111/j.1755-5922.2009.00096.x Kohli P, 2013, CIRCULATION, V127, P673, DOI 10.1161/CIRCULATIONAHA.112.124248 Levine GN, 2011, J AM COLL CARDIOL, V58, pE44, DOI 10.1016/j.jacc.2011.08.007 Marcucci R, 2009, CIRCULATION, V119, P237, DOI 10.1161/CIRCULATIONAHA.108.812636 Matetzky S, 2004, CIRCULATION, V109, P3171, DOI 10.1161/01.CIR.0000130846.46168.03 Mehta SR, 2010, NEW ENGL J MED, V363, P930, DOI 10.1056/NEJMoa0909475 Nishio R, 2015, INT HEART J, V56, P389, DOI 10.1536/ihj.15-044 Patti G, 2005, CIRCULATION, V111, P2099, DOI 10.1161/01.CIR.0000161383.06692.D4 Patti G, 2008, J AM COLL CARDIOL, V52, P1128, DOI 10.1016/j.jacc.2008.06.038 Price MJ, 2008, EUR HEART J, V29, P992, DOI 10.1093/eurheartj/ehn046 Price MJ, 2011, JAMA-J AM MED ASSOC, V305, P1097, DOI 10.1001/jama.2011.290 Rao SV, 2005, AM J CARDIOL, V96, P1200, DOI 10.1016/j.amjcard.2005.06.056 Steg PG, 2013, CIRCULATION, V128, P1055, DOI 10.1161/CIRCULATIONAHA.113.002589 Valgimigli M, 2009, CIRCULATION, V119, P3215, DOI 10.1161/CIRCULATIONAHA.108.833236 van Giezen JJJ, 2009, J THROMB HAEMOST, V7, P1556, DOI 10.1111/j.1538-7836.2009.03527.x Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Zhang HZ, 2014, PLATELETS, V25, P292, DOI 10.3109/09537104.2013.815341 Zhang J, 2014, INT HEART J, V55, P213, DOI 10.1536/ihj.13-322 NR 29 TC 2 Z9 3 U1 0 U2 5 PU INT HEART JOURNAL ASSOC PI TOKYO PA UNIV TOKYO, GRADUATE SCHOOL MEDICINE, DEPT CARDIOVASCULAR MEDICINE, HONGO 7-3-1, BUNKYO-KU, TOKYO, 113-8655, JAPAN SN 1349-2365 EI 1349-3299 J9 INT HEART J JI Int. Heart J. PD MAR PY 2017 VL 58 IS 2 BP 167 EP 173 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EX8VA UT WOS:000403527100004 PM 28321022 OA gold DA 2023-05-13 ER PT J AU Solomon, MD Go, AS Shilane, D Boothroyd, DB Leong, TK Kazi, DS Chang, TI Hlatky, MA AF Solomon, Matthew D. Go, Alan S. Shilane, David Boothroyd, Derek B. Leong, Thomas K. Kazi, Dhruv S. Chang, Tara I. Hlatky, Mark A. TI Comparative Effectiveness of Clopidogrel in Medically Managed Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE acute coronary syndrome(s); clopidogrel; outcomes ID ACUTE CORONARY SYNDROMES; CARDIOVASCULAR EVENTS; ANTIPLATELET THERAPY; ASPIRIN; INTERVENTION; DISEASE; TRENDS; RISK; CARE; PRETREATMENT AB Objectives This study sought to examine the effectiveness of clopidogrel in real-world, medically managed patients with unstable angina (UA) or non-ST-segment elevation myocardial infarction (NSTEMI). Background Although clinical trials have demonstrated the efficacy of clopidogrel to reduce cardiovascular (CV) morbidity and mortality in medically managed patients with UA or NSTEMI, the effectiveness of clopidogrel in actual clinical practice is less certain. Methods A retrospective cohort study was conducted of Kaiser Permanente Northern California members without known coronary artery disease or prior clopidogrel use who presented with UA or NSTEMI between 2003 and 2008 and were medically managed (i.e., no percutaneous coronary intervention or coronary artery bypass grafting during the index hospitalization or within 7 days post-discharge). Over 2 years of follow-up, we measured the association between clopidogrel use and all-cause mortality, hospital stay for MI, and a composite endpoint of death or MI using propensity-matched multivariable Cox analyses. Results We identified 16,365 patients with incident UA (35%) or NSTEMI (65%); 36% of these patients were prescribed clopidogrel within 7 days of discharge. In 8,562 propensity score-matched patients, clopidogrel users had lower rates of all-cause mortality (8.3% vs. 13.0%; p < 0.01; adjusted hazard ratio [HR]: 0.63; 95% confidence interval [CI]: 0.54 to 0.72) and the composite of death or MI (13.5% vs. 17.4%; p < 0.01; HR: 0.74, CI: 0.66 to 0.84), but not MI alone (6.7% vs. 7.2%; p - 0.30; HR: 0.93, CI: 0.78 to 1.11), compared with nonusers of clopidogrel. The association between clopidogrel use and the composite of death or MI was significant only among patients presenting with NSTEMI (HR: 0.67; CI: 0.59 to 0.76; p(int) < 0.01), not among those presenting with UA (HR: 1.25; CI: 0.94 to 1.67). Conclusions In a large, community-based cohort of patients who were medically managed after UA/NSTEMI, clopidogrel use was associated with a lower risk of death and MI, particularly among patients with NSTEMI. (J Am Coll Cardiol 2014; 63: 2249-57) (C) 2014 by the American College of Cardiology Foundation C1 [Solomon, Matthew D.; Go, Alan S.; Leong, Thomas K.] Kaiser Permanente No Calif, Div Res, Oakland, CA USA. [Solomon, Matthew D.; Go, Alan S.; Shilane, David; Boothroyd, Derek B.; Chang, Tara I.; Hlatky, Mark A.] Stanford Univ, Sch Med, Stanford, CA 94305 USA. [Go, Alan S.; Kazi, Dhruv S.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Kazi, Dhruv S.] San Francisco Gen Hosp, San Francisco, CA 94110 USA. C3 Kaiser Permanente; Stanford University; University of California System; University of California San Francisco; San Francisco General Hospital Medical Center RP Solomon, MD (通讯作者),Kaiser Permanente, Oakland Med Ctr, 3600 Broadway, Oakland, CA 94611 USA. EM Matthew.D.Solomon@kp.org RI Go, Alan S./AAE-7745-2019 OI Boothroyd, Derek Brian/0000-0001-5387-6995; Hlatky, Mark/0000-0003-4686-9441 FU American Heart Association, Dallas, Texas [0875162N]; Genentech FX From the *Division of Research, Kaiser Permanente Northern California, Oakland, California; dagger Stanford University School of Medicine, Stanford, California; double dagger University of California, San Francisco, San Francisco, California; and the San Francisco General Hospital, San Francisco California. This work is supported by grant 0875162N from the American Heart Association, Dallas, Texas. Dr. Go is the recipient of a research grant from Genentech. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Deepak L. Bhatt, MD, MPH, served as Guest Editor for this paper. 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Am. Coll. Cardiol. PD JUN 3 PY 2014 VL 63 IS 21 BP 2249 EP 2257 DI 10.1016/j.jacc.2014.02.586 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AI0UC UT WOS:000336564500009 PM 24703914 DA 2023-05-13 ER PT J AU Hernandez-Suarez, DF Melin, K Marin-Maldonado, F Nunez, HJ Gonzalez, AF Gonzalez-Sepulveda, L Rivas-Tumanyan, S Naik, H Ruano, G Scott, SA Duconge, J AF Hernandez-Suarez, Dagmar F. Melin, Kyle Marin-Maldonado, Frances Nunez, Hector J. Gonzalez, Ariel F. Gonzalez-Sepulveda, Lorena Rivas-Tumanyan, Sona Naik, Hetanshi Ruano, Gualberto Scott, Stuart A. Duconge, Jorge TI Implementing a pharmacogenetic-driven algorithm to guide dual antiplatelet therapy (DAPT) in Caribbean Hispanics: protocol for a non-randomised clinical trial SO BMJ OPEN LA English DT Article DE coronary heart disease; coronary intervention; clinical pharmacology; genetics ID PERCUTANEOUS CORONARY INTERVENTION; OF-FUNCTION POLYMORPHISM; PLATELET REACTIVITY; CLOPIDOGREL RESPONSIVENESS; STENT THROMBOSIS; CYP2C19 GENOTYPE; DETERMINANTS; GLYCOPROTEIN; ASSOCIATION; PRASUGREL AB Introduction Minority populations in the USA are disproportionately affected by cardiovascular conditions. Reduced responsiveness to clopidogrel among carriers of CYP2C19 variants has been reported in patients with either coronary artery disease (CAD) or acute coronary syndrome (ACS) after the percutaneous coronary intervention (PCI). Previous studies have evaluated CYP2C19 genotyping-guided antiplatelet therapy in selected populations; however, this has yet to be tested among Hispanics. Given the paucity of clinical research on CYP2C19 and antiplatelet clinical outcomes in Hispanics, our study will test the safety and efficacy of a genetic-driven treatment algorithm to guide dual antiplatelet therapy (DAPT) in Caribbean Hispanics. Methods and analysis This is a multicentre, prospective, non-randomised clinical trial that proposes an assessment of pharmacogenomic-guided DAPT in post-PCI Caribbean Hispanic patients with ACS or CAD. We will recruit 250 patients to be compared with a matched non-concurrent cohort of 250 clopidogrel-treated patients (standard-of-care). Major adverse cardiovascular events (MACEs) such as all-cause death, myocardial infarction (MI), stroke, coronary revascularisation, stent thrombosis and bleedings over 6 months will be the study endpoints. Among the recruited, high-risk patients will be escalated to ticagrelor and low-risk patients will remain on clopidogrel. The primary objective is to determine whether genetic-guided therapy is superior to standard of care. The secondary objective will determine if clopidogrel treatment in low-risk patients is not associated with a higher rate of MACEs compared with escalated antiplatelet therapy in high-risk patients. Patients will be enrolled up to the group's completion. Ethics and dissemination Approval was obtained from the Institutional Review Board of the University of Puerto Rico Medical Sciences Campus (protocol # A4070417). The study will be carried out in compliance with the Declaration of Helsinki and International Conference on Harmonization Good Clinical Practice Guidelines. Findings will be published in a peer-reviewed journal and controlled access to experimental data will be available. C1 [Hernandez-Suarez, Dagmar F.; Nunez, Hector J.; Gonzalez, Ariel F.] Univ Puerto Rico, Sch Med, Div Cardiovasc Med, Med Sci Campus, San Juan, PR 00936 USA. [Melin, Kyle] Univ Puerto Rico, Dept Pharm Practice, Sch Pharm, Med Sci Campus, San Juan, PR 00936 USA. [Marin-Maldonado, Frances] Univ Puerto Rico, Acad Affairs Deanship, RCMI Program, Med Sci Campus, San Juan, PR 00936 USA. [Gonzalez-Sepulveda, Lorena; Rivas-Tumanyan, Sona] Puerto Rico Clin & Translat Res Consortium PRCTRC, Res Design & Biostat Core, Med Sci Campus, San Juan, PR USA. [Naik, Hetanshi; Scott, Stuart A.] Icahn Sch Med Mt Sinai, Dept Genet & Genom Sci, New York, NY 10029 USA. [Ruano, Gualberto] Hartford Hosp, Inst Living, Hartford, CT 06115 USA. [Duconge, Jorge] Univ Puerto Rico, Dept Pharmaceut Sci, Sch Pharm, Med Sci Campus, San Juan, PR 00936 USA. C3 University of Puerto Rico; University of Puerto Rico Medical Sciences Campus; University of Puerto Rico; University of Puerto Rico Medical Sciences Campus; University of Puerto Rico; University of Puerto Rico Medical Sciences Campus; University of Puerto Rico; University of Puerto Rico Medical Sciences Campus; Icahn School of Medicine at Mount Sinai; Hartford Hospital; University of Puerto Rico; University of Puerto Rico Medical Sciences Campus RP Duconge, J (通讯作者),Univ Puerto Rico, Dept Pharmaceut Sci, Sch Pharm, Med Sci Campus, San Juan, PR 00936 USA. EM jorge.duconge@upr.edu RI ; Melin, Kyle/U-5209-2017 OI Hernandez-Suarez, Dagmar F./0000-0003-1850-9078; Naik, Hetanshi/0000-0002-5894-7390; Melin, Kyle/0000-0002-4698-8021 FU Center for Collaborative Research in Health Disparities (RCMI-CCRHD) from NIMHD, National Institutes of Health (NIH) [U54 MD007600-31]; NIMHD; National Institute of Allergy and Infectious Diseases (NIAID) [U54MD007587] FX This work was supported by the Center for Collaborative Research in Health Disparities (RCMI-CCRHD) grant #U54 MD007600-31 from NIMHD, National Institutes of Health (NIH). PRCTRC's Research Design and Biostatistics Core service is supported by the NIMHD and the National Institute of Allergy and Infectious Diseases (NIAID) under award # U54MD007587. The funding sources for this trial had no role in the design of the study and will not have any role in the performance of the research. 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Despite angiotensin-converting enzyme 2 serving as the portal for infection, the continuation of clinically indicated renin-angiotensin-aldosterone blockers is recommended according to the present evidence. Fibrinolytic therapy can be considered a reasonable option for the relatively stable ST segment elevation myocardial infarction (STEMI) patient with suspected or known COVID-19. However, primary percutaneous coronary intervention is still the standard of care in patients with definite STEMI if personal protective equipment is available and cardiac catheterization laboratory has a good infection control. In patients with elevated cardiac enzymes, it is very important to differentiate patients with Type 2 myocardial infarction or myocarditis from those with true acute coronary syndromes because invasive percutaneous intervention management in the former may be unnecessary, especially if they are hemodynamically stable. Finally, patients with baseline QT prolongation or those taking QT prolonging drugs must be cautious when treating with lopinavir/ritonavir and hydroxychloroquine for COVID-19. C1 [Lee, Wen-Hsien; Chen, Ying-Chih; Chen, Szu-Chia; Chen, Chang-Jen; Kuo, Chao -Hung; Su, Ho-Ming] Kaohsiung Municipal Siaogang Hosp, Dept Internal Med, 482 Shan Ming Rd, Kaohsiung 812, Taiwan. [Lee, Wen-Hsien; Chen, Szu-Chia; Hsu, Po -Chao; Tsai, Wei -Chung; Chu, Chun-Yuan; Lee, Chee-Siong; Lin, Tsung-Hsien; Voon, Wen-Chol; Kuo, Chao -Hung; Su, Ho-Ming] Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung, Taiwan. [Hsu, Po -Chao; Tsai, Wei -Chung; Chu, Chun-Yuan; Lee, Chee-Siong; Lin, Tsung-Hsien; Voon, Wen-Chol] Kaohsiung Med Univ Hosp, Div Cardiol, Dept Internal Med, Kaohsiung, Taiwan. [Su, Ho-Ming] Kaohsiung Med Univ, Regenerat Med & Cell Therapy Res Ctr, Kaohsiung, Taiwan. 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J. Med. Sci. PY 2020 VL 17 IS 10 BP 1340 EP 1344 DI 10.7150/ijms.46484 PG 5 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA MG3LL UT WOS:000545935500007 PM 32624690 OA gold, Green Published DA 2023-05-13 ER PT J AU Siner, JM Connors, GR AF Siner, Jonathan M. Connors, Geoffrey R. TI Protocol-Based Care versus Individualized Management of Patients in the Intensive Care Unit SO SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review DE intensive care unit; protocol; protocol-based medicine; early goal-directed therapy; spontaneous breathing trials ID GOAL-DIRECTED THERAPY; SURVIVING SEPSIS CAMPAIGN; ACUTE CORONARY SYNDROMES; SEPTIC SHOCK; MULTIFACETED INTERVENTION; INTERNATIONAL GUIDELINES; ANTIMICROBIAL THERAPY; CLINICAL-PRACTICE; FLUID-MANAGEMENT; TRIAL AB The delivery of evidence-based care in the high-acuity environment of the intensive care unit can be challenging. In an effort to help turn guidelines and standards of care into consistent and uniform practice, physicians and hospitals turn toward protocol-based medical care. A protocol can help guide a practitioner to make correct interventions, at the right time, and in the proper order when managing a given disease. But to be considered a success, a protocol must meet several standards. A protocol must facilitate consistent practice, guiding the practitioner to deliver care more consistently than without the protocol. A good protocol must also be in alignment with the provider's general practice and beliefs to assure wide adoption and complete penetrance. Finally, the protocol must deliver the most medically correct care-neither simplifying nor overcomplicating health care delivery. In addition to the care the protocol delivers, it must overcome other barriers to gain acceptance. These include concerns about protocol usage among medical trainees, physician concern regarding loss of autonomy, and the ceiling effect protocol-driven care places on expert practitioners, among other concerns. The aim of this article is to critically appraise what it means for a protocol to be considered successful with an aim toward improving protocol design and implementation in the future. C1 [Siner, Jonathan M.; Connors, Geoffrey R.] Yale Univ, Sch Med, Dept Internal Med, Sect Pulm Crit Care & Sleep Med, 300 Cedar St,TAC 441 South,POB 208057, New Haven, CT 06520 USA. C3 Yale University RP Siner, JM (通讯作者),Yale Univ, Sch Med, Dept Internal Med, Sect Pulm Crit Care & Sleep Med, 300 Cedar St,TAC 441 South,POB 208057, New Haven, CT 06520 USA. 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Respir. Crit. Care Med. PD DEC PY 2015 VL 36 IS 6 BP 870 EP 877 DI 10.1055/s-0035-1566157 PG 8 WC Critical Care Medicine; Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Respiratory System GA CW8UV UT WOS:000365275800008 PM 26595047 DA 2023-05-13 ER PT J AU Demirkiran, A Everaars, H Amier, RP Beijnink, C Bom, MJ Gotte, MJW van Loon, RB Selder, JL van Rossum, AC Nijveldt, R AF Demirkiran, Ahmet Everaars, Henk Amier, Raquel P. Beijnink, Casper Bom, Michiel J. Gotte, Marco J. W. van Loon, Ramon B. Selder, Jasper L. van Rossum, Albert C. Nijveldt, Robin TI Cardiovascular magnetic resonance techniques for tissue characterization after acute myocardial injury SO EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING LA English DT Review DE microvascular injury; intramyocardial haemorrhage; cardiovascular magnetic resonance imaging; infarct tissue characterization; acute myocardial infarction ID ST-SEGMENT ELEVATION; LATE GADOLINIUM ENHANCEMENT; ACUTE CORONARY SYNDROME; MICROVASCULAR OBSTRUCTION; FUNCTIONAL RECOVERY; PROGNOSTIC VALUE; INFARCTION IMPLICATIONS; ISCHEMIC AREA; EDEMA; CMR AB The annual incidence of hospital admission for acute myocardial infarction lies between 90 and 312 per 100 000 inhabitants in Europe. Despite advances in patient care 1 year mortality after ST-segment elevation myocardial infarction (STEMI) remains around 10%. Cardiovascular magnetic resonance imaging (CMR) has emerged as a robust imaging modality for assessing patients after acute myocardial injury. In addition to accurate assessment of left ventricular ejection fraction and volumes, CMR offers the unique ability of visualization of myocardial injury through a variety of imaging techniques such as late gadolinium enhancement and T2-weighted imaging. Furthermore, new parametric mapping techniques allow accurate quantification of myocardial injury and are currently being exploited in large trials aiming to augment risk management and treatment of STEMI patients. Of interest, CMR enables the detection of microvascular injury (MVI) which occurs in approximately 40% of STEMI patients and is a major independent predictor of mortality and heart failure. In this article, we review traditional and novel CMR techniques used for myocardial tissue characterization after acute myocardial injury, including the detection and quantification of MVI. Moreover, we discuss clinical scenarios of acute myocardial injury in which the tissue characterization techniques can be applied and we provide proposed imaging protocols tailored to each scenario. C1 [Demirkiran, Ahmet; Everaars, Henk; Amier, Raquel P.; Bom, Michiel J.; Gotte, Marco J. W.; van Loon, Ramon B.; Selder, Jasper L.; van Rossum, Albert C.; Nijveldt, Robin] Vrije Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Cardiol, Amsterdam Cardiovasc Sci, De Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands. [Beijnink, Casper; Nijveldt, Robin] Radboudumc, Dept Cardiol, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands. C3 Vrije Universiteit Amsterdam; Radboud University Nijmegen RP Nijveldt, R (通讯作者),Vrije Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Cardiol, Amsterdam Cardiovasc Sci, De Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands.; Nijveldt, R (通讯作者),Radboudumc, Dept Cardiol, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands. EM Robin@nijveldt.net RI Demirkıran, Ahmet/ABY-1528-2022; Nijveldt, Robin/N-8683-2017 OI Demirkıran, Ahmet/0000-0001-8104-3296; Nijveldt, Robin/0000-0003-1530-6363; Everaars, Henk/0000-0002-4521-0664; van Rossum, Albert C./0000-0003-1714-4652; Beijnink, Casper/0000-0003-1777-9586 FU post-doctoral International Research Fellowship Programme by Scientific and Technological Research Council of Turkey [53325897-115.02-170549] FX First author, Ahmet Demirkiran has received a research grant from the post-doctoral International Research Fellowship Programme by Scientific and Technological Research Council of Turkey. REF: 53325897-115.02-170549. 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TI Editor's Choice - Impact of initial hospital diagnosis on mortality for acute myocardial infarction: A national cohort study SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE MINAP; mortality; NSTEMI; STEMI; acute myocardial infarction ID ACUTE CORONARY SYNDROMES; TROPONIN-I; OUTCOMES; DEATH; INTERVENTION; PATIENT; CARE AB Aims: Early and accurate diagnosis of acute myocardial infarction is central to successful treatment and improved outcomes. We aimed to investigate the impact of the initial hospital diagnosis on mortality for patients with acute myocardial infarction. Methods and results: Cohort study using data from the Myocardial Ischaemia National Audit Project of patients discharged with a final diagnosis of ST-elevation myocardial infarction (STEMI, n=221,635) and non-STEMI (NSTEMI, n=342,777) between 1 April 2004 and 31 March 2013 in all acute hospitals (n = 243) in England and Wales. Overall, 168,534 (29.9%) patients had an initial diagnosis which was not the same as their final diagnosis. After multivariable adjustment, for STEMI a change from an initial diagnosis of NSTEMI (time ratio 0.97, 95% confidence interval 0.92-1.01) and chest pain of uncertain cause (0.98, 0.89-1.07) was not associated with a significant reduction in time to death, whereas for other initial diagnoses the time to death was significantly reduced by 21% (0.78, 0.74-0.83). For NSTEMI, after multivariable adjustment, a change from an initial diagnosis of STEMI was associated with a reduction in time to death of 10% (time ratio 0.90, 95% confidence interval 0.83-0.97), but not for chest pain of uncertain cause (0.99, 0.96-1.02). Patients with NSTEMI who had other initial diagnoses had a significant 14% reduction in their time to death (time ratio 0.86, 95% confidence interval 0.84-0.88). STEMI and NSTEMI with other initial diagnoses had low rates of pre-hospital electrocardiograph (24.3% and 21.5%), aspirin on hospitalisation (61.6% and 48.5%), care by a cardiologist (60.0% and 51.5%), invasive coronary procedures (38.8 % and 29.2%), cardiac rehabilitation (68.9% and 62.6%) and guideline indicated medications at time of discharge from hospital. Had the 3.3% of patients with STEMI and 17.9% of NSTEMI who were admitted with other initial diagnoses received an initial diagnosis of STEMI and NSTEMI, then 33 and 218 deaths per year might have been prevented, respectively. Conclusion: Nearly one in three patients with acute myocardial infarction had other diagnoses at first medical contact, who less frequently received guideline indicated care and had significantly higher mortality rates. There is substantial potential, greater for NSTEMI than STEMI, to improve outcomes through earlier and more accurate diagnosis of acute myocardial infarction. C1 [Wu, Jianhua] Univ Leeds, Fac Med & Hlth, Div Clin & Translat Res, Leeds, W Yorkshire, England. [Gale, Chris P.; Hall, Marlous; Dondo, Tatendashe B.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Fac Med & Hlth, Leeds, W Yorkshire, England. [Gale, Chris P.; Oliver, Ged] York Teaching Hosp NHS Fdn Trust, Dept Cardiol, York, N Yorkshire, England. [Metcalfe, Elizabeth] Univ Southampton, Sch Social Sci, Southampton, Hants, England. [Batin, Phil D.] Mid Yorkshire Hosp NHS Trust, Dept Cardiol, Wakefield, England. [Hemingway, Harry] UCL, Farr Inst, London, England. [Timmis, Adam] Barts Hlth, Natl Inst Hlth Biomed Res Unit, London, England. [West, Robert M.] Univ Leeds, Leeds Inst Hlth Sci, Fac Med & Hlth, Leeds, W Yorkshire, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; RLUK- Research Libraries UK; University of Southampton; RLUK- Research Libraries UK; University of London; University College London; Barts Health NHS Trust; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds RP Gale, CP (通讯作者),Leeds Inst Cardiovasc & Metab Med, MRC Bioinformat Ctr, Level 11,Worsley Bldg,Clarendon Way, Leeds LS2 9JT, W Yorkshire, England. EM c.p.gale@leeds.ac.uk RI Hall, Marlous/O-9985-2019; Wu, Jianhua/G-1080-2019; Hemingway, Harry/C-1219-2009 OI Hall, Marlous/0000-0003-1246-2627; Wu, Jianhua/0000-0001-6093-599X; Hemingway, Harry/0000-0003-2279-0624; Dondo, Tatendashe/0000-0002-8337-8425; Gale, Chris/0000-0003-4732-382X FU British Heart Foundation [PG/13/81/30474]; National Institute for Health Research [NIHR-CTF-2014-03-03]; British Heart Foundation [PG/13/81/30474] Funding Source: researchfish; Medical Research Council [HDR-9003, HDR-9002, HDR-9006, MR/K006584/1] Funding Source: researchfish; National Institute for Health Research [NIHR-CTF-2014-03-03] Funding Source: researchfish FX This work was supported by the British Heart Foundation (Project Grant PG/13/81/30474), the National Institute for Health Research (NIHR-CTF-2014-03-03). 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Heart J.-Acute Cardiovasc. Care PD MAR PY 2018 VL 7 IS 2 BP 139 EP 148 DI 10.1177/2048872616661693 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GC5BA UT WOS:000429799200006 PM 27574333 OA Bronze DA 2023-05-13 ER PT J AU Ho, PM Lambert-Kerzner, A Carey, EP Fahdi, IE Bryson, CL Melnyk, SD Bosworth, HB Radcliff, T Davis, R Mun, H Weaver, J Barnett, C Baron, A Del Giacco, EJ AF Ho, P. Michael Lambert-Kerzner, Anne Carey, Evan P. Fahdi, Ibrahim E. Bryson, Chris L. Melnyk, S. Dee Bosworth, Hayden B. Radcliff, Tiffany Davis, Ryan Mun, Howard Weaver, Jennifer Barnett, Casey Baron, Anna Del Giacco, Eric J. TI Multifaceted Intervention to Improve Medication Adherence and Secondary Prevention Measures After Acute Coronary Syndrome Hospital Discharge A Randomized Clinical Trial SO JAMA INTERNAL MEDICINE LA English DT Article ID THERAPY; DISCONTINUATION; PREVALENCE; PREDICTORS; MORTALITY; OUTCOMES AB IMPORTANCE Adherence to cardioprotective medication regimens in the year after hospitalization for acute coronary syndrome (ACS) is poor. OBJECTIVE To test a multifaceted intervention to improve adherence to cardiac medications. DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, 253 patients from 4 Department of Veterans Affairs medical centers located in Denver (Colorado), Seattle (Washington); Durham (North Carolina), and Little Rock (Arkansas) admitted with ACS were randomized to the multifaceted intervention (INT) or usual care (UC) prior to discharge. INTERVENTIONS The INT lasted for 1 year following discharge and comprised (1) pharmacist-led medication reconciliation and tailoring; (2) patient education; (3) collaborative care between pharmacist and a patient's primary care clinician and/or cardiologist; and (4) 2 types of voice messaging (educational and medication refill reminder calls). MAIN OUTCOMES AND MEASURES The primary outcome of interest was proportion of patients adherent to medication regimens based on a mean proportion of days covered (PDC) greater than 0.80 in the year after hospital discharge using pharmacy refill data for 4 cardioprotective medications (clopidogrel, beta-blockers, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors [statins], and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers [ACEI/ARB]). Secondary outcomes included achievement of blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) level targets. RESULTS Of 253 patients, 241 (95.3%) completed the study (122 in INT and 119 in UC). In the INT group, 89.3% of patients were adherent compared with 73.9% in the UC group (P =.003). Mean PDC was higher in the INT group (0.94 vs 0.87; P<.001). A greater proportion of intervention patients were adherent to clopidogrel (86.8% vs 70.7%; P=.03), statins (93.2% vs 71.3%; P<.001), and ACEI/ARB (93.1% vs 81.7%; P=.03) but not beta-blockers (88.1% vs 84.8%; P=.59). There were no statistically significant differences in the proportion of patients who achieved BP and LDL-C level goals. CONCLUSIONS AND RELEVANCE A multifaceted intervention comprising pharmacist-led medication reconciliation and tailoring, patient education, collaborative care between pharmacist and patients' primary care clinician and/or cardiologist, and voice messaging increased adherence to medication regimens in the year after ACS hospital discharge without improving BP and LDL-C levels. Understanding the impact of such improvement in adherence on clinical outcomes is needed prior to broader dissemination of the program. C1 [Ho, P. Michael; Lambert-Kerzner, Anne; Carey, Evan P.; Davis, Ryan; Baron, Anna] VA Eastern Colorado Hlth Care Syst, Denver, CO USA. [Ho, P. Michael] Univ Colorado, Dept Med, Denver, CO USA. [Ho, P. Michael] Colorado Cardiovasc Outcomes Res Grp, Denver, CO USA. [Carey, Evan P.; Baron, Anna] Univ Colorado, Colorado Sch Publ Hlth, Dept Biostat & Informat, Aurora, CO USA. [Fahdi, Ibrahim E.; Weaver, Jennifer; Barnett, Casey; Del Giacco, Eric J.] John L McClellan Mem Vet Adm Med Ctr, Little Rock, AR USA. [Bryson, Chris L.; Mun, Howard] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Melnyk, S. Dee; Bosworth, Hayden B.] Durham Vet Affairs Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. [Bosworth, Hayden B.] Duke Univ, Sch Nursing, Durham, NC USA. [Bosworth, Hayden B.] Duke Univ, Dept Med, Div Gen Internal Med, Durham, NC USA. [Bosworth, Hayden B.] Duke Univ, Dept Psychiat & Behav Sci, Durham, NC USA. [Radcliff, Tiffany] Texas A&M Sch Rural Publ Hlth, Dept Hlth Policy & Management, College Stn, TX USA. C3 University of Colorado System; University of Colorado Anschutz Medical Campus; University of Colorado Denver; Colorado School of Public Health; University of Colorado System; University of Colorado Anschutz Medical Campus; US Department of Veterans Affairs; Veterans Health Administration (VHA); Vet Affairs Puget Sound Health Care System; US Department of Veterans Affairs; Veterans Health Administration (VHA); Durham VA Medical Center; Duke University; Duke University; Duke University; Texas A&M University System; Texas A&M University College Station; Texas A&M Health Science Center RP Ho, PM (通讯作者),Denver VA Med Ctr, Dept Med, 1055 Clermont St 111B, Denver, CO 80220 USA. EM Michael.ho@va.gov RI Radcliff, Tiffany/HSI-4649-2023 OI Radcliff, Tiffany/0000-0003-4482-8056 FU Veterans Health Administration Health Service Research & Development (HSR&D) Investigator initiated Award [IIR 08-302]; senior career scientist award (Research Career Scientist Award VA HSRD) [08-027] FX This study was funded by a Veterans Health Administration Health Service Research & Development (HSR&D) Investigator initiated Award (grant IIR 08-302). Dr Bosworth was supported by a senior career scientist award (Research Career Scientist Award VA HSR&D 08-027). CR Choudhry NK, 2011, NEW ENGL J MED, V365, P2088, DOI 10.1056/NEJMsa1107913 Cutrona SL, 2012, J AM PHARM ASSOC, V52, P381, DOI 10.1331/JAPhA.2012.10211 Cutrona SL, 2010, AM J MANAG CARE, V16, P929 Cutrona SL, 2010, J GEN INTERN MED, V25, P1090, DOI 10.1007/s11606-010-1387-9 Fihn SD, 2011, ARCH INTERN MED, V171, P1471, DOI 10.1001/archinternmed.2011.372 Ho PM, 2006, ARCH INTERN MED, V166, P1842, DOI 10.1001/archinte.166.17.1842 Ho PM, 2009, CIRCULATION, V119, P3028, DOI 10.1161/CIRCULATIONAHA.108.768986 Jackevicius CA, 2002, JAMA-J AM MED ASSOC, V288, P462, DOI 10.1001/jama.288.4.462 Jackevicius CA, 2008, CIRCULATION, V117, P1028, DOI 10.1161/CIRCULATIONAHA.107.706820 Lambert-Kerzner A, 2012, CIRC-CARDIOVASC QUAL, V5, P571, DOI 10.1161/CIRCOUTCOMES.111.962290 Mansoor SM, 2013, J CARDIOVASC PHARM T, V18, P19, DOI 10.1177/1074248412442001 Rasmussen JN, 2007, JAMA-J AM MED ASSOC, V297, P177, DOI 10.1001/jama.297.2.177 Smith DH, 2008, ARCH INTERN MED, V168, P477, DOI 10.1001/archinternmed.2007.132 Smith SC, 2011, CIRCULATION, V124, P2458, DOI 10.1161/CIR.0b013e318235eb4d Spertus JA, 2006, CIRCULATION, V113, P2803, DOI 10.1161/CIRCULATIONAHA.106.618066 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] NR 16 TC 182 Z9 186 U1 2 U2 28 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 2168-6106 EI 2168-6114 J9 JAMA INTERN MED JI JAMA Intern. Med. PD FEB PY 2014 VL 174 IS 2 BP 186 EP 193 DI 10.1001/jamainternmed.2013.12944 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AD2FM UT WOS:000333049200008 PM 24247275 DA 2023-05-13 ER PT J AU Conradie, A Atherton, J Chowdhury, E Duong, M Schwarz, N Worthley, S Eccleston, D AF Conradie, Andre Atherton, John Chowdhury, Enayet Duong, MyNgan Schwarz, Nisha Worthley, Stephen Eccleston, David TI Health-Related Quality of Life (HRQoL) and the Effect on Outcome in Patients Presenting with Coronary Artery Disease and Treated with Percutaneous Coronary Intervention (PCI): Differences Noted by Sex and Age SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE acute coronary syndrome; PCI; quality of life; clinical outcomes; sex; MACE ID ACUTE MYOCARDIAL-INFARCTION; GENDER-DIFFERENCES; FOLLOW-UP; IMPACT; QUESTIONNAIRE; MORTALITY; EVENTS; ANGINA AB Background and aim: poor quality of life (QoL) has been identified as an independent risk factor for mortality and major cardiac events (MACE) in patients with cardiovascular disease (CVD). The aim of this study was to assess health-related quality of life (HRQoL) at baseline and its association with outcome in patients with coronary artery disease presenting for percutaneous coronary intervention (PCI). The outcome was measured by mortality and MACE at 1-year, and whether there was any difference for sex and different age groups. Methods and results: all patients prospectively enrolled into the GenesisCare Outcome Registry (GCOR) over a 11-year period were included in the study. The EQ-5D-5L and VAS patient survey were used for assessment of baseline HRQoL. Of the 15,198 patients, only 6591 (43.4%) completed the self-assessment. Women had significantly more impairment of all five dimensions of the EQ-5D-5L survey, and their self-reported QoL was significantly lower than men (68.3 in women vs. 71.9 in men, p < 0.001). Poor QoL was strongly associated with increased mortality (HR 2.85; 95% CI 1.76 to 4.62, p < 0.001) and MACE (HR 1.40; 95% CI 1.10 to 1.79, p = 0.01). A similar trend was noted for women and men, but did not reach significance in women due to the smaller number of female patients. Conclusion: poor HRQoL is associated with subsequent mortality and MACE in patients undergoing PCI. By not assessing quality of life as a standard of care, an opportunity is lost to identify high-risk patients who may benefit from targeted interventions to improve health outcomes. C1 [Conradie, Andre] Friendly Soc Private Hosp, Bundaberg, Qld 4670, Australia. [Atherton, John] Royal Brisbane & Womens Hosp, Brisbane, Qld 4029, Australia. [Chowdhury, Enayet; Duong, MyNgan; Schwarz, Nisha] GenesisCare, Leabrook, SA 5068, Australia. [Worthley, Stephen] North Shore Cardiol, St Leonards, NSW 2065, Australia. [Eccleston, David] Melbourne Private Hosp, Parkville, Vic 3052, Australia. C3 Royal Brisbane & Women's Hospital RP Conradie, A (通讯作者),Friendly Soc Private Hosp, Bundaberg, Qld 4670, Australia. EM andre.conradie@genesiscare.com OI Chowdhury, Enayet/0000-0002-9709-794X CR Avramovic M, 2012, ARTIF ORGANS, V36, P581, DOI 10.1111/j.1525-1594.2011.01429.x Benzer W, 2016, HERZ, V41, P138, DOI 10.1007/s00059-015-4351-y Boini S, 2006, INT J CARDIOL, V113, P215, DOI 10.1016/j.ijcard.2005.11.016 Chandra A, 2019, JACC-HEART FAIL, V7, P862, DOI 10.1016/j.jchf.2019.05.015 Chandra A, 2018, JAMA CARDIOL, V3, P498, DOI 10.1001/jamacardio.2018.0398 Claessen BE, 2012, J INVASIVE CARDIOL, V24, P484 Clayton JA, 2016, JAMA-J AM MED ASSOC, V316, P1863, DOI 10.1001/jama.2016.16405 Dreyer RP, 2016, EUR HEART J-ACUTE CA, V5, P43, DOI 10.1177/2048872615568967 Dyer MTD, 2010, HEALTH QUAL LIFE OUT, V8, DOI 10.1186/1477-7525-8-13 Gijsberts CM, 2015, OPEN HEART, V2, DOI 10.1136/openhrt-2014-000231 Hansen TB, 2015, EUR J PREV CARDIOL, V22, P882, DOI 10.1177/2047487314535682 Hess CN, 2016, CIRCULATION, V133, P493, DOI 10.1161/CIRCULATIONAHA.115.017001 Ho PM, 2008, AM HEART J, V155, P855, DOI 10.1016/j.ahj.2007.11.032 Hobbs FDR, 2002, EUR HEART J, V23, P1867, DOI 10.1053/euhj.2002.3255 Inglis SC, 2013, INT J CARDIOL, V167, P2149, DOI 10.1016/j.ijcard.2012.05.099 Kang K, 2017, INT J NURS STUD, V73, P1, DOI 10.1016/j.ijnurstu.2017.04.010 Kefale B, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0212184 Kittiskulnam P, 2016, SEMIN NEPHROL, V36, P305, DOI 10.1016/j.semnephrol.2016.05.007 Lenzen MJ, 2007, HEART, V93, P339, DOI 10.1136/hrt.2005.086868 Maksimovic M, 2014, ANGIOLOGY, V65, P501, DOI 10.1177/0003319713488640 Mommersteeg PMC, 2009, AM HEART J, V157, P208, DOI 10.1016/j.ahj.2008.09.020 Muhammad I, 2016, INT J NURS PRACT, V22, P4, DOI 10.1111/ijn.12356 Norris CM, 2017, J WOMENS HEALTH, V26, P50, DOI 10.1089/jwh.2016.5744 Norris CM, 2010, GENDER MED, V7, P330, DOI 10.1016/j.genm.2010.07.005 Oldridge N, 1998, J Cardiopulm Rehabil, V18, P95, DOI 10.1097/00008483-199803000-00002 Oldridge N, 2014, EUR J PREV CARDIOL, V21, P90, DOI 10.1177/2047487312450544 Oldridge N, 2014, EUR J PREV CARDIOL, V21, P98, DOI 10.1177/2047487312450545 Oreopoulos A, 2010, INT J OBESITY, V34, P1434, DOI 10.1038/ijo.2010.73 Pedersen SS, 2007, PSYCHOSOMATICS, V48, P331, DOI 10.1176/appi.psy.48.4.331 Pedersen SS, 2011, QUAL LIFE RES, V20, P559, DOI 10.1007/s11136-010-9775-5 Pelletier R, 2016, J AM COLL CARDIOL, V67, P127, DOI 10.1016/j.jacc.2015.10.067 Peterson Pamela N, 2006, BMC Cardiovasc Disord, V6, P41, DOI 10.1186/1471-2261-6-41 Pettersen KI, 2008, INT J CARDIOL, V130, P449, DOI 10.1016/j.ijcard.2007.10.016 Pocock SJ, 2000, J AM COLL CARDIOL, V35, P907, DOI 10.1016/S0735-1097(99)00637-3 Rieckmann N, 2020, HEALTH QUAL LIFE OUT, V18, DOI 10.1186/s12955-020-01312-4 Rumsfeld JS, 2013, CIRCULATION, V127, P2233, DOI 10.1161/CIR.0b013e3182949a2e Sach TH, 2007, INT J OBESITY, V31, P189, DOI 10.1038/sj.ijo.0803365 Uchmanowicz I, 2015, NURSING-RES REV, V5, P23, DOI 10.2147/NRR.S75161 Uchmanowicz I, 2013, ACTA DIABETOL, V50, P217, DOI 10.1007/s00592-011-0280-2 Wu J, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0097294 Yuval Rita, 2007, Eur J Cardiovasc Nurs, V6, P287 NR 41 TC 0 Z9 0 U1 2 U2 2 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 2077-0383 J9 J CLIN MED JI J. Clin. Med. PD SEP PY 2022 VL 11 IS 17 AR 5231 DI 10.3390/jcm11175231 PG 16 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 4K4YZ UT WOS:000851958500001 PM 36079161 OA Green Published, gold DA 2023-05-13 ER PT J AU Forsyth, R Sun, ZH Reid, C Moorin, R AF Forsyth, Rene Sun, Zhong-Hua Reid, Christopher Moorin, Rachael TI Inter-hospital transfers and door-to-balloon times for STEMI: a single centre cohort study SO JOURNAL OF GERIATRIC CARDIOLOGY LA English DT Article DE Acute coronary syndrome; Door-to-balloon times; Inter-hospital transfers; ST-segment elevation myocardial infarction ID ELEVATION MYOCARDIAL-INFARCTION; PERCUTANEOUS CORONARY INTERVENTION; NATIONAL HEART FOUNDATION; PRIMARY ANGIOPLASTY; PREHOSPITAL ELECTROCARDIOGRAM; MANAGEMENT; CARE; REPERFUSION; STRATEGIES; GUIDELINES AB Background Key performance indices such as door-to-balloon times have long been recognized as quality metrics in reducing time to care for patients with acute coronary syndromes (ACS). In the situation where patients do not present to a facility capable of 24/7 percutaneous coronary interventions (PCI) delays in time to therapy can exceed the recommendation of 90 min or less. This study aimed to evaluate the impact of transfers on performance indices for patients diagnosed with ST-segment elevation myocardial infarction (STEMI). Methods Over a seven month collection period, all patients presenting with symptoms suggestive of ACS and admitted for PCI were studied. Patients were divided into dichotomous groups of direct presentations or transfers from a secondary non-PCI capable hospital with key times recorded, including symptom-onset, first hospital and PCI-capable hospital arrival and balloon inflation times to evaluate time of treatment for STEMI patients. Results Of the 87 patients diagnosed with STEM, transferred patients experienced statistically significant delays in symptom-onset to the PCI-capable hospital (PCI-H) arrival (215 vs. 95 min, P < 0.001), symptom-onset to balloon inflation (225 vs. 160 min, P = 0.009) and first hospital arrival to balloon inflation times (106 vs. 56 min, P < 0.001). Only 28% (n = 9) of transferred patients underwent balloon inflation within 90 min from first hospital arrival, while 60% (n = 19) did within 120 min, although all received balloon inflation within 90 min from arrival at the PCI-H. After controlling for confounding factors of socio-economic status, presentation date/ time and diagnostic category, transferred patients experienced an average 162% longer delays from symptom-onset to PCI-H door arrival, and 98% longer delays in symptom-onset to balloon inflation; compared to patients who present directly to the PCI-H. No statistically significant differences were noted between transferred and direct patients when measured from PCI-H door-to-balloon times. Conclusions This study shows that transferred patients experience a greater overall system delay, compared to patients who present directly for PCI, significantly increasing their time to treatment and therefore infarct times. Despite the majority of transfers experiencing pre-hospital activation, their treatment hospital arrival to balloon times are no less than direct presenters after controlling for confounding factors, further compounding the overall delay to therapy. C1 [Forsyth, Rene; Sun, Zhong-Hua] Curtin Univ, Dept Med Radiat Sci, Perth, WA, Australia. [Reid, Christopher] NHMRC Ctr Res Excellence Cardiovasc Outcomes Impr, Sch Publ Hlth, Perth, WA, Australia. [Reid, Christopher] Monash Univ, Ctr Res Excellence Therapeut, Melbourne, Vic, Australia. [Moorin, Rachael] Curtin Univ, Sch Publ Hlth, Perth, WA, Australia. [Moorin, Rachael] Univ Western Australia, Sch Populat & Global Hlth, Crawley, Australia. C3 Curtin University; Monash University; Curtin University; University of Western Australia RP Sun, ZH (通讯作者),Curtin Univ, Dept Med Radiat Sci, Perth, WA, Australia. EM z.sun@curtin.edu.au RI Sun, Zhonghua/B-3125-2010; Reid, Christopher M/AAP-8135-2021 OI Sun, Zhonghua/0000-0002-7538-4761; Reid, Christopher/0000-0001-9173-3944 CR Anderson JL, 2007, J AM COLL CARDIOL, V50, P652, DOI 10.1016/j.jacc.2007.02.028 Andrade Pedro Beraldo de, 2012, Rev. Bras. Cardiol. 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Geriatr. Cardiol. PY 2020 VL 17 IS 6 BP 321 EP 329 DI 10.11909/j.issn.1671-5411.2020.06.001 PG 9 WC Cardiac & Cardiovascular Systems; Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Geriatrics & Gerontology GA PE0VH UT WOS:000598090600003 PM 32670362 DA 2023-05-13 ER PT J AU Chan, NC Eikelboom, JW Ginsberg, JS Lauw, MN Vanassche, T Weitz, JI Hirsh, J AF Chan, Noel C. Eikelboom, John W. Ginsberg, Jeffrey S. Lauw, Mandy N. Vanassche, Thomas Weitz, Jeffrey I. Hirsh, Jack TI Role of phenotypic and genetic testing in managing clopidogrel therapy SO BLOOD LA English DT Article ID PERCUTANEOUS CORONARY INTERVENTION; ADVERSE CLINICAL-OUTCOMES; SINGLE NUCLEOTIDE POLYMORPHISMS; TREATMENT PLATELET REACTIVITY; PRASUGREL VS. CLOPIDOGREL; SURROGATE END-POINTS; CYP2C19 GENOTYPE; CARDIOVASCULAR EVENTS; DOSE CLOPIDOGREL; ANTIPLATELET TREATMENT AB The P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are administered in fixed doses without laboratory monitoring. Randomized trials in acute coronary syndrome have shown that prasugrel and ticagrelor are more effective than standard-dose clopidogrel. Nonetheless, standard-dose clopidogrel remains widely used because it causes less bleeding and is less expensive. Patients treated with standard-dose clopidogrel have substantial variability in platelet inhibition, which is partly explained by genetic polymorphisms encoding CYP2C19, the hepatic enzyme involved in biotransformation of clopidogrel to its active metabolite. Some advocate tailoring P2Y12 inhibitor therapy according to the results of routine laboratory testing. Although there is good evidence for analytic, biological, and clinical validity of several phenotypic and genotypic biomarkers, the benefit of a management strategy that incorporates routine biomarker testing over standard of care without such testing remains unproven. Appropriately designed, adequately powered trials are needed but face the challenges of feasibility, cost, and the progressive switch from clopidogrel to prasugrel or ticagrelor. C1 [Chan, Noel C.; Eikelboom, John W.; Lauw, Mandy N.; Vanassche, Thomas] Populat Hlth Res Inst, Hamilton, ON L8L 2X2, Canada. [Eikelboom, John W.; Ginsberg, Jeffrey S.; Weitz, Jeffrey I.] Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada. [Eikelboom, John W.; Ginsberg, Jeffrey S.; Weitz, Jeffrey I.; Hirsh, Jack] McMaster Univ, Dept Med, Hamilton, ON, Canada. [Lauw, Mandy N.] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1105 AZ Amsterdam, Netherlands. C3 Population Health Research Institute; McMaster University; McMaster University; University of Amsterdam; Academic Medical Center Amsterdam RP Eikelboom, JW (通讯作者),Populat Hlth Res Inst, 237 Barton St E, Hamilton, ON L8L 2X2, Canada. EM eikelbj@mcmaster.ca RI Weitz, Jeffrey/AAD-1929-2019; Eikelboom, John/AAG-6117-2019; Vanassche, Thomas/GQZ-9004-2022; ginsberg, jeffrey s/ABC-1065-2020 OI Weitz, Jeffrey/0000-0002-1092-7550; Eikelboom, John/0000-0003-4126-1285; Vanassche, Thomas/0000-0002-7404-8918; Chan, Noel/0000-0001-9491-6172 FU Haematology Society of Australia and New Zealand FX N.C.C. is supported by an educational grant from the Haematology Society of Australia and New Zealand. 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Future longitudinal observational studies may help to answer these important questions; however, because CTDs are rare, collaboration between clinicians with similar research interests is needed to ensure sufficiently large cohorts are available to address these issues. Here, we review the evidence available for CV risk in CTDs and discuss the benefits of longitudinal observational studies in identifying CV outcomes. Structured care protocols for the management of CV risk in CTDs are lacking. We propose a target-based approach to assessing and managing CV risk in CTDs. (C) 2016 Elsevier Ltd. All rights reserved. C1 [O'Sullivan, Miriam; Bruce, Ian N.; Symmons, Deborah P. M.] Univ Manchester, Ctr Musculoskeletal Res, Arthritis Res UK Ctr Epidemiol, Stopford Bldg,Oxford Rd, Manchester M13 9PT, Lancs, England. [O'Sullivan, Miriam; Bruce, Ian N.; Symmons, Deborah P. 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PD FEB PY 2016 VL 30 IS 1 BP 81 EP 94 DI 10.1016/j.berh.2016.03.003 PG 14 WC Rheumatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Rheumatology GA DS2KS UT WOS:000380599000007 PM 27421218 OA Green Submitted DA 2023-05-13 ER PT J AU Kuhn, L Page, K Rahman, MA Worrall-Carter, L AF Kuhn, Lisa Page, Karen Rahman, Muhammad Aziz Worrall-Carter, Linda TI Gender difference in treatment and mortality of patients with ST-segment elevation myocardial infarction admitted to Victorian public hospitals: A retrospective database study SO AUSTRALIAN CRITICAL CARE LA English DT Article DE Database; Equity; Gender; Mortality; Reperfusion; Retrospective; STEMI; Women ID ACUTE CORONARY SYNDROMES; ISCHEMIC-HEART-DISEASE; NEW-ZEALAND GUIDELINES; SEX-DIFFERENCES; CARDIOVASCULAR-DISEASE; NATIONAL-HEART; CLINICAL-OUTCOMES; AMERICAN-COLLEGE; MANAGEMENT; WOMEN AB Background: Death from acute coronary syndrome (ACS) is avoidable with early reperfusion therapy, however, evidence suggests inequity in women's ACS treatment within a number of international healthcare systems, when compared to men's. Research indicates mortality rates are higher in some age groups of women when compared to men for the sub-group of ACS known as ST-segment elevation myocardial infarction (STEMI). Objective: To determine whether patient sex was associated with patterns of reperfusion treatment variation or increased inhospital mortality in patients with STEMI. Methods: We undertook retrospective analyses on a government database for patients admitted to Victorian public hospitals with STEMI. Patients were categorised into two age groups: 18-64 and 65-84 years (inclusive), to determine whether patient sex and these age groups influenced treatment from 2005 to 2008 and mortality from 2005 to 2010. Results: Both younger and older women received less frequent angioplasty with stent and more often received no reperfusion treatment than men in corresponding younger and older age groups (p = 0.006 and p < 0.001, respectively). Overall, women in both age groups were more likely to die inhospital than men from equivalent age groups with STEMI (p < 0.001, both groups). Conclusions: Proportionately, both younger and older women received less interventional reperfusion therapy for STEMI than their male cohorts, and died more often during admission than men. Further research needs to be undertaken to verify the findings and causes, and guide future research to ensure application of evidence to treatment in patients with STEMI. (C) 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved. C1 [Kuhn, Lisa; Rahman, Muhammad Aziz; Worrall-Carter, Linda] Australian Catholic Univ, Sch Nursing Midwifery & Paramed Victoria, St Vincents Ctr Nursing Res, Fac Hlth Sci, Melbourne, Vic, Australia. [Page, Karen] Heart Fdn Australia, Equ & Secondary Prevent, Melbourne, Vic, Australia. [Rahman, Muhammad Aziz; Worrall-Carter, Linda] Australian Catholic Univ, Fac Hlth Sci, Cardiovasc Res Ctr CvRC, Melbourne, Vic, Australia. C3 Australian Catholic University; Australian Catholic University RP Kuhn, L (通讯作者),Deakin Univ, Sch Nursing & Midwifery, Burwood Highway, Burwood, Vic 3125, Australia. EM l.kuhn@bigpond.net.au RI Rahman, Muhammad Aziz/B-3380-2009 OI Rahman, Muhammad Aziz/0000-0003-1665-7966; Kuhn, Lisa/0000-0002-2421-2003 FU Australian Postgraduate Award; Royal College of Nursing; Australia National Research and Scholarship Fund FX Lisa Kuhn was supported by an Australian Postgraduate Award with Stipend and a grant from the Royal College of Nursing, Australia National Research and Scholarship Fund. The authors would like to thank Brooke MacPherson, formerly Data Analysis staff at the Victorian Department of Health (DoH) and her colleagues for working with Lisa to extract the necessary data from the DoH administered dataset. 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Crit. Care PD NOV PY 2015 VL 28 IS 4 BP 196 EP 202 DI 10.1016/j.aucc.2015.01.004 PG 7 WC Critical Care Medicine; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine; Nursing GA CV3DN UT WOS:000364138700008 PM 25697372 DA 2023-05-13 ER PT J AU Nadlacki, B Horton, D Hossain, S Hariharaputhiran, S Ngo, L Ali, A Aliprandi-Costa, B Ellis, CJ Adams, RJT Visvanathan, R Ranasinghe, I AF Nadlacki, Bora Horton, Dennis Hossain, Sadia Hariharaputhiran, Saranya Ngo, Linh Ali, Anna Aliprandi-Costa, Bernadette Ellis, Chris J. Adams, Robert J. T. Visvanathan, Renuka Ranasinghe, Isuru TI Long term survival after acute myocardial infarction in Australia and New Zealand, 2009-2015: a population cohort study SO MEDICAL JOURNAL OF AUSTRALIA LA English DT Article DE Mortality; Acute coronary syndrome; Survival analysis; Population health ID ACUTE CORONARY SYNDROME; NATIONAL AUDITS; MANAGEMENT; MORTALITY; OUTCOMES; DIAGNOSIS; THERAPY AB Objective To assess long term survival and patient characteristics associated with survival following acute myocardial infarction (AMI) in Australia and New Zealand. Design Cohort study. Setting, participants All patients admitted with AMI (ICD-10-AM codes I21.0-I21.4) to all public and most private hospitals in Australia and New Zealand during 2009-2015. Main outcome measure All-cause mortality up to seven years after an AMI. Results 239 402 initial admissions with AMI were identified; the mean age of the patients was 69.3 years (SD, 14.3 years), 154 287 were men (64.5%), and 64 335 had ST-elevation myocardial infarction (STEMI; 26.9%). 7-year survival after AMI was 62.3% (STEMI, 70.8%; non-ST-elevation myocardial infarction [NSTEMI], 59.2%); survival exceeded 85% for people under 65 years of age, but was 17.4% for those aged 85 years or more. 120 155 patients (50.2%) underwent revascularisation (STEMI, 72.2%; NSTEMI, 42.1%); 7-year survival exceeded 80% for patients in each group who underwent revascularisation, and was lower than 45% for those who did not. Being older (85 years or older v 18-54 years: adjusted hazard ratio [aHR], 10.6; 95% CI, 10.1-11.1) or a woman (aHR, 1.15; 95% CI, 1.13-1.17) were each associated with greater long term mortality during the study period, as was prior heart failure (aHR, 1.79; 95% CI, 1.76-1.83). Several non-cardiac conditions and geriatric syndromes common in these patients were independently associated with lower long term survival, including major and metastatic cancer, cirrhosis and end-stage liver disease, and dementia. Conclusion AMI care in Australia and New Zealand is associated with high rates of long term survival; 7-year rates exceed 80% for patients under 65 years of age and for those who undergo revascularisation. Efforts to further improve survival should target patients with NSTEMI, who are often older and have several comorbid conditions, for whom revascularisation rates are low and survival after AMI poor. C1 [Nadlacki, Bora; Adams, Robert J. T.] Flinders Univ S Australia, Adelaide, SA, Australia. [Horton, Dennis] Data Decis CRC, Adelaide, SA, Australia. [Hossain, Sadia; Hariharaputhiran, Saranya; Ali, Anna; Visvanathan, Renuka] Univ Adelaide, Adelaide, SA, Australia. [Ngo, Linh; Ranasinghe, Isuru] Prince Charles Hosp, Brisbane, Qld, Australia. [Ngo, Linh; Ranasinghe, Isuru] Univ Queensland, Brisbane, Qld, Australia. [Aliprandi-Costa, Bernadette] Australian Commiss Safety & Quality Healthcare, Sydney, Nsw, Australia. [Ellis, Chris J.] Auckland City Hosp, Auckland, New Zealand. [Visvanathan, Renuka] Queen Elizabeth Hosp, Adelaide, SA, Australia. C3 Flinders University South Australia; Commonwealth Scientific & Industrial Research Organisation (CSIRO); University of Adelaide; Prince Charles Hospital; University of Queensland; Auckland City Hospital RP Ranasinghe, I (通讯作者),Prince Charles Hosp, Brisbane, Qld, Australia.; Ranasinghe, I (通讯作者),Univ Queensland, Brisbane, Qld, Australia. EM i.ranasinghe@uq.edu.au RI Adams, Robert/GPW-8528-2022; Ngo, Linh/ABH-7071-2020 OI Ngo, Linh/0000-0002-4058-0412; Hossain, Sadia/0000-0003-4034-5911 FU National Heart Foundation of Australia [101186] FX Linh Ngo holds a University of Queensland Research Training Program scholarship, Anna Ali a University of Adelaide Faculty of Health Sciences Divisional Scholarship, and Isuru Ranasinghe a National Heart Foundation of Australia Future Leader Fellowship (101186). CR Alabas OA, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.007123 Aliprandi-Costa B, 2019, HEART LUNG CIRC, V28, P1000, DOI 10.1016/j.hlc.2018.05.191 Aliprandi-Costa B, 2011, MED J AUSTRALIA, V195, P116, DOI 10.5694/j.1326-5377.2011.tb03237.x Australian Institute of Health Welfare, DEATHS AUSTR Bhatt DL, 2014, CIRC RES, V114, P1929, DOI 10.1161/CIRCRESAHA.114.302737 Bradley EH, 2006, NEW ENGL J MED, V355, P2308, DOI 10.1056/NEJMsa063117 Brieger DB, 2015, MED J AUSTRALIA, V203, DOI 10.5694/mja15.00504 Chew DP, 2016, MED J AUSTRALIA, V205, P128, DOI 10.5694/mja16.00368 Chew DP, 2013, MED J AUSTRALIA, V199, P185, DOI 10.5694/mja12.11854 Damluji AA, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013686 Devlin G, 2016, NEW ZEAL MED J, V129, P10 Elliott J, 2017, NEW ZEAL MED J, V130, P17 Ellis C, 2015, INTERN MED J, V45, P497, DOI 10.1111/imj.12739 Ellis CJ, 2019, HEART LUNG CIRC, V28, P245, DOI 10.1016/j.hlc.2017.10.015 Fox KAA, 2010, J AM COLL CARDIOL, V55, P2435, DOI 10.1016/j.jacc.2010.03.007 Henderson T, 2006, MED CARE, V44, P1011, DOI 10.1097/01.mlr.0000228018.48783.34 Independent Hospital Pricing Authority, ICD 10 AM ACHI ACS Keeley EC, 2003, LANCET, V361, P13, DOI 10.1016/S0140-6736(03)12113-7 Keller T, 2009, NEW ENGL J MED, V361, P868, DOI 10.1056/NEJMoa0903515 Pope GC, 2004, HEALTH CARE FINANC R, V25, P119 Ranasinghe I, 2015, HEART, V101, P1032, DOI 10.1136/heartjnl-2014-306966 Ranasinghe I, 2012, CIRC-CARDIOVASC QUAL, V5, P429, DOI 10.1161/CIRCOUTCOMES.112.965111 Redfern J, 2014, HEART, V100, P1281, DOI 10.1136/heartjnl-2013-305296 Roe MT, 2011, AM HEART J, V162, DOI 10.1016/j.ahj.2011.08.010 Smolina K, 2012, CIRC-CARDIOVASC QUAL, V5, P532, DOI 10.1161/CIRCOUTCOMES.111.964700 Stats NZ Tatauranga Aotearoa, LIF EXP NZ ABR PER L Szummer K, 2018, EUR HEART J, V39, P3766, DOI 10.1093/eurheartj/ehy554 Szummer K, 2017, EUR HEART J, V38, P3056, DOI 10.1093/eurheartj/ehx515 NR 28 TC 10 Z9 10 U1 0 U2 0 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0025-729X EI 1326-5377 J9 MED J AUSTRALIA JI Med. J. Aust. PD JUN PY 2021 VL 214 IS 11 BP 519 EP 525 DI 10.5694/mja2.51085 EA MAY 2021 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA SV1WA UT WOS:000650959100001 PM 33997979 DA 2023-05-13 ER PT J AU Fierro, JJ Cave, B Khouzam, RN AF Fierro, Joseph J. Cave, Brandon Khouzam, Rami N. TI P2Y12 inhibitors: do they increase cancer risk? SO ANNALS OF TRANSLATIONAL MEDICINE LA English DT Review DE Dual antiplatelet therapy (DAPT); dual anti platelet; cancer ID DUAL ANTIPLATELET THERAPY; CLOPIDOGREL; TICAGRELOR; MORTALITY; ASPIRIN; PREVENTION; PRASUGREL; DURATION AB Treatment with dual antiplatelet therapy (DAPT), typically combining a P2Y12 inhibitor with aspirin, is the standard of care for the prevention of coronary stent thrombosis, especially post revascularization and in the setting of acute coronary syndromes (ACS). Determining the appropriate duration has been debated as prolonged courses have been associated with reduced thrombotic complications. Despite proven benefit, there have been reports of a potential cancer risk associated with DAPT following the FDA's review of the TRITON-TIMI 38 trial and the DAPT trial. The latter revealed an increased risk of non-cardiovascular death, which was driven by more bleeding and cancer-related deaths. This further clouds the decision if longer courses of DAPT should be recommended. Several trials and meta-analyses have been conducted to further review this cancer risk with P2Y12 inhibitors. This manuscript intends to evaluate current literature to determine if there is a risk of cancer for patients on DAPT and its consequences in the management of cardiovascular disease. C1 [Fierro, Joseph J.] James A Haley Vet Hosp, Dept Pharm, 13000 Bruce B Downs Blvd 119, Tampa, FL 33612 USA. [Cave, Brandon] Methodist Univ Hosp, Dept Pharm, Memphis, TN USA. [Khouzam, Rami N.] Univ Tennessee, Hlth Sci Ctr, Div Cardiovasc Dis, Dept Internal Med, Memphis, TN USA. C3 US Department of Veterans Affairs; Veterans Health Administration (VHA); James A. Haley Veterans Hospital; University of Tennessee System; University of Tennessee Health Science Center RP Fierro, JJ (通讯作者),James A Haley Vet Hosp, Dept Pharm, 13000 Bruce B Downs Blvd 119, Tampa, FL 33612 USA. EM Joseph.Fierro@va.gov CR [Anonymous], 2019, FDA DRUG SAFETY COMM Bhatt DL, 2006, NEW ENGL J MED, V354, P1706, DOI 10.1056/NEJMoa060989 Bibbins-Domingo K, 2016, ANN INTERN MED, V164, P836, DOI 10.7326/M16-0577 Bonaca MP, 2015, NEW ENGL J MED, V372, P1791, DOI 10.1056/NEJMoa1500857 Elmariah S, 2018, CIRC-CARDIOVASC INTE, V11, DOI 10.1161/CIRCINTERVENTIONS.117.005795 Elmariah S, 2015, LANCET, V385, P792, DOI 10.1016/S0140-6736(14)62052-3 Elwood PC, 2009, LANCET, V373, P1301, DOI 10.1016/S0140-6736(09)60243-9 Gebremeskel S, 2015, INT J CANCER, V136, P234, DOI 10.1002/ijc.28947 Hicks BM, 2015, PHARMACOEPIDEM DR S, V24, P830, DOI 10.1002/pds.3807 Kotronias R, 2017, DRUG SAFETY, V40, P229, DOI 10.1007/s40264-016-0481-2 Leader A, 2017, AM J MED, V130, P826, DOI 10.1016/j.amjmed.2017.01.022 Levine GN, 2016, J AM COLL CARDIOL, V68, P1082, DOI 10.1016/j.jacc.2016.03.513 Marciniak, 2019, PRASUGREL CANC Mauri L, 2014, NEW ENGL J MED, V371, P2155, DOI 10.1056/NEJMoa1409312 Raposeiras-Roubin S, 2019, THROMB RES, V174, P51, DOI 10.1016/j.thromres.2018.12.014 Roe MT, 2016, EUR HEART J, V37, P412, DOI 10.1093/eurheartj/ehv611 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Watters DA, 2018, ANESTH ANALG, V126, P1329, DOI 10.1213/ANE.0000000000002771 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 NR 19 TC 3 Z9 4 U1 0 U2 5 PU AME PUBL CO PI SHATIN PA FLAT-RM C 16F, KINGS WING PLAZA 1, NO 3 KWAN ST, SHATIN, HONG KONG 00000, PEOPLES R CHINA SN 2305-5839 EI 2305-5847 J9 ANN TRANSL MED JI ANN. TRANSL. MED. PD SEP PY 2019 VL 7 IS 17 SI SI AR 409 DI 10.21037/atm.2019.07.90 PG 5 WC Oncology; Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology; Research & Experimental Medicine GA IW7JU UT WOS:000485165800009 PM 31660308 OA Green Published, gold DA 2023-05-13 ER PT J AU Bellut, H Guillemet, L Bougouin, W Charpentier, J Salem, OB Llitjos, JF Paul, M Valade, S Spagnolo, S Lamhaut, L Chiche, JD Marijon, E Pene, F Varenne, O Mira, JP Dumas, F Cariou, A AF Bellut, Hugo Guillemet, Lucie Bougouin, Wulfran Charpentier, Julien Salem, Omar Ben Hadj Llitjos, Jean-Francois Paul, Marine Valade, Sandrine Spagnolo, Shirley Lamhaut, Lionel Chiche, Jean-Daniel Marijon, Eloi Pene, Frederic Varenne, Olivier Mira, Jean-Paul Dumas, Florence Cariou, Alain TI Early recurrent arrhythmias after out-of-hospital cardiac arrest associated with obstructive coronary artery disease: Analysis of the PROCAT registry SO RESUSCITATION LA English DT Article DE Cardiac arrest; Acute coronary syndrome; Arrhythmia recurrence; Prophylaxis anti arrhythmic treatment ID ACUTE MYOCARDIAL-INFARCTION; PRIMARY VENTRICULAR-FIBRILLATION; EUROPEAN-RESUSCITATION-COUNCIL; PROPHYLACTIC LIDOCAINE; RANDOMIZED-TRIAL; DOUBLE-BLIND; CARE; SURVIVAL; DEATH; DYSFUNCTION AB Objective: After out-of-hospital cardiac arrest (OHCA) associated with obstructive coronary artery disease (CAD), the risk of recurrence during the early period is unclear and the indication for anti-arrhythmic treatment is debated. We assessed the incidence and predisposing factors for severe cardiac arrhythmias in this population. Design: Retrospective study in a cardiac arrest center. Settings: The primary endpoint was the occurrence of major cardiac arrhythmias from hospital admission to intensive care unit (ICU) discharge in patients admitted after an OHCA associated with obstructive CAD. A major arrhythmia was defined as any arrhythmic event (auricular or ventricular) associated with cardiac arrest recurrence and/or severe arterial hypotension. Secondary outcomes were time from ICU admission to arrhythmia occurrence and all-cause in-ICU mortality. Risk factors for recurrence of a major arrhythmia were assessed using multivariate analysis. Patients: We included all consecutive OHCA patients resuscitated from ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) as initial rhythm associated with obstructive CAD, and who had a successful primary percutaneous coronary intervention. Intervention: None. Measurements and main results: Among 256 patients, a major arrhythmia occurred in 29 (11.3%), within the first 24 h in 79.3% of cases and were mostly VF (44.8%). Mortality rate was significantly increased in patients with major arrhythmia recurrence (69% vs 41%; p = 0.006). Factor significantly associated with recurrence of severe arrhythmia was male gender (OR 0.32 [0.12-0.92]; p = 0.034). Treatment with prophylactic anti-arrhythmic in the ICU was not associated with a change in the risk of recurrence (OR 0.85 [0.21-3.65], p = 0.82). Conclusion: An early recurrence of major arrhythmia was observed in more than 10% of post-cardiac arrest patients. These events happened mostly within the first 24 h. The interest of prophylactic anti-arrhythmic treatment remains to be evaluated in this population. C1 [Bellut, Hugo; Guillemet, Lucie; Bougouin, Wulfran; Charpentier, Julien; Salem, Omar Ben Hadj; Llitjos, Jean-Francois; Paul, Marine; Valade, Sandrine; Spagnolo, Shirley; Chiche, Jean-Daniel; Pene, Frederic; Mira, Jean-Paul; Cariou, Alain] Cochin Hosp, AP HP, Med Intens Care Unit, Paris, France. [Guillemet, Lucie; Bougouin, Wulfran; Salem, Omar Ben Hadj; Llitjos, Jean-Francois; Paul, Marine; Lamhaut, Lionel; Chiche, Jean-Daniel; Marijon, Eloi; Pene, Frederic; Varenne, Olivier; Mira, Jean-Paul; Dumas, Florence; Cariou, Alain] Paris Descartes Univ, Sorbonne Paris Cite, Med Sch, Paris, France. [Marijon, Eloi] Hop Europeen Georges Pompidou, AP HP, Cardiol Dept, Paris, France. [Varenne, Olivier] Cochin Hosp, AP HP, Cardiol Dept, Paris, France. [Dumas, Florence] Cochin Hosp, AP HP, Emergency Dept, Paris, France. [Lamhaut, Lionel] Hop Necker Enfants Malad, AP HP, SAMU 75, Paris, France. [Bougouin, Wulfran; Lamhaut, Lionel; Marijon, Eloi; Varenne, Olivier; Dumas, Florence; Cariou, Alain] INSERM, U970, Paris Cardiovasc Res Ctr, Team 4, Paris, France. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Broca - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Europeen Georges-Pompidou - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Broca - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Broca - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Cite RP Guillemet, L (通讯作者),Cochin Hosp, AP HP, Med Intens Care Unit, Paris, France. EM lucie.guillemet@aphp.fr RI Bougouin, Wulfran/AAS-7565-2021; JF, Llitjos/GRS-3317-2022; Lamhaut, Lionel/AAM-8449-2021; Chiche, Jean-Daniel/P-5220-2017 OI Lamhaut, Lionel/0000-0003-4160-9456; Chiche, Jean-Daniel/0000-0002-6433-6254 FU French Ministry of Health (CRC BDD 2017) FX The PROCAT registry is financially supported by a grant from the French Ministry of Health (CRC BDD 2017) CR Alexander JH, 1999, AM HEART J, V137, P799, DOI 10.1016/S0002-8703(99)70402-3 [Anonymous], NEW ENGL J MED, DOI 10.1056/NEJM1985101731316111018-1018 Berdowski J, 2010, RESUSCITATION, V81, P1479, DOI 10.1016/j.resuscitation.2010.08.006 Berdowski J, 2010, CIRCULATION, V122, P1101, DOI 10.1161/CIRCULATIONAHA.110.958173 Bougouin W, 2014, INTENS CARE MED, V40, P846, DOI 10.1007/s00134-014-3252-5 Bougouin W, 2014, EUR HEART J, V35, P116, DOI 10.1093/eurheartj/eht453 Cairns JA, 1997, LANCET, V349, P675, DOI 10.1016/S0140-6736(96)08171-8 Casey E, 2009, CRIT CARE, V13, pP64, DOI [10.1186/cc7228, DOI 10.1186/CC7228] Chelly J, 2012, RESUSCITATION, V83, P1444, DOI 10.1016/j.resuscitation.2012.08.321 Connolly SJ, 1997, LANCET, V350, P1417 Cummins RO, 1997, CIRCULATION, V95, P2213, DOI 10.1161/01.CIR.95.8.2213 Dargie HJ, 2001, LANCET, V357, P1385, DOI 10.1016/s0140-6736(00)04560-8 Dumas F, 2010, CIRC-CARDIOVASC INTE, V3, P200, DOI 10.1161/CIRCINTERVENTIONS.109.913665 Freemantle N, 1999, BMJ-BRIT MED J, V318, P1730, DOI 10.1136/bmj.318.7200.1730 Kolettis Theofilos M., 2014, Journal of Basic and Clinical Physiology and Pharmacology, V25, P143, DOI 10.1515/jbcpp-2013-0117 Kolettis TM, 2013, CURR OPIN PHARMACOL, V13, P210, DOI 10.1016/j.coph.2013.01.001 Koster RW, 2008, RESUSCITATION, V78, P252, DOI 10.1016/j.resuscitation.2008.03.231 KOSTER RW, 1985, NEW ENGL J MED, V313, P1105, DOI 10.1056/NEJM198510313131801 Kudenchuk PJ, 2013, RESUSCITATION, V84, P1512, DOI 10.1016/j.resuscitation.2013.05.022 LIE KI, 1974, NEW ENGL J MED, V291, P1324, DOI 10.1056/NEJM197412192912504 LIE KI, 1978, AM J CARDIOL, V42, P486, DOI 10.1016/0002-9149(78)90945-1 Marti-Carvajal AJ, 2015, COCHRANE DATABASE OF Nolan JP, 2015, RESUSCITATION, V95, P202, DOI 10.1016/j.resuscitation.2015.07.018 Ohlow MA, 2012, AM J EMERG MED, V30, P580, DOI 10.1016/j.ajem.2011.02.029 Sadowski ZP, 1999, AM HEART J, V137, P792, DOI 10.1016/S0002-8703(99)70401-1 Salinas P, 2015, WORLD J CARDIOL, V7, P423, DOI 10.4330/wjc.v7.i7.423 Solomon SD, 2005, NEW ENGL J MED, V352, P2581, DOI 10.1056/NEJMoa043938 van Alem AP, 2003, RESUSCITATION, V59, P181, DOI 10.1016/S0300-9572(03)00208-9 Wildi K, 2015, EUR HEART J-ACUTE CA, V4, P359, DOI 10.1177/2048872614557230 NR 29 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0300-9572 EI 1873-1570 J9 RESUSCITATION JI Resuscitation PD AUG PY 2019 VL 141 BP 81 EP 87 DI 10.1016/j.resuscitation.2019.05.034 PG 7 WC Critical Care Medicine; Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Emergency Medicine GA IK5IC UT WOS:000476617900010 PM 31185259 OA Green Published DA 2023-05-13 ER PT J AU Caldeira, D Pereira, H Marques, A Alegria, S Calisto, J da Silva, PC Ribeiro, VG Silva, JC Seixo, F Abreu, PFE Teles, RC Fernandes, R Carvalho, HC AF Caldeira, Daniel Pereira, Helder Marques, Ana Alegria, Sofia Calisto, Joao da Silva, Pedro Canas Ribeiro, Vasco Gama Silva, Joao Carlos Seixo, Filipe Abreu, Pedro Farto e Teles, Rui Campante Fernandes, Renato Carvalho, Henrique Cyrne CA Investigators Portuguese Registry PRIC TI Adjuvant antithrombotic therapy in ST-elevation myocardial infarction: Contemporaneous Portuguese cross-sectional data SO REVISTA PORTUGUESA DE CARDIOLOGIA LA English DT Article DE Myocardial infarction; Antiplatelet; Anticoagulant; Antithrombotic; Adjuvant ID DUAL ANTIPLATELET THERAPY; SEGMENT ELEVATION; 2017 ESC; CORONARY; GUIDELINES; MANAGEMENT; STENT; LIFE AB Introduction: The standard of care for acute ST-elevation myocardial infarction (STEMI) includes the activation of a STEMI care network, the administration of adjuvant medical therapy, and reperfusion through primary percutaneous coronary intervention (PCI). While primary PCI is nowadays the first option for the treatment of patients with STEMI, antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize their clinical outcomes. Objective: The aim of this study was to describe contemporaneous real-world patterns of use of antithrombotic treatments in Portugal for STEMI patients undergoing primary PCI. Methods: An observational, retrospective cross-sectional study was performed for the year 2016, based on data from two national registries: the Portuguese Registry on Acute Coronary Syndromes (ProACS) and the Portuguese Registry on Interventional Cardiology (PRIC). Data on oral antiplatelet and procedural intravenous antithrombotic drugs were retrieved. Results: In 2016, the ProACS enrolled 534 STEMI patients treated with primary PCI, while the PRIC registry reported data on 2625 STEMI patients. Of these, 99.6% were treated with aspirin and 75.6% with dual antiplatelet therapy (mostly clopidogrel). GP IIb/IIIa inhibitors (mostly abciximab) were used in 11.6% of cases. Heparins were used in 80% of cases (78% unfractionated heparin [UFH] and 2% low molecular weight heparin). None of the patients included in the registry were treated with cangrelor, prasugrel or bivalirudin. Missing data are one of the main limitations of the registries. Conclusions: In 2016, according to data from these national registries, almost all patients with STEMI were treated with aspirin and 76% with dual antiplatelet agents, mostly clopidogrel. GP IIb/IIIa inhibitors were used in few patients, and UFH was the most prevalent parenteral anticoagulant drug. (C) 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. C1 [Caldeira, Daniel; Pereira, Helder; Marques, Ana; Alegria, Sofia] Hosp Garcia de Orta, Cardiol Dept, Almada, Portugal. [Caldeira, Daniel] Univ Lisbon, Fac Med, Lab Farmacol Clin & Terapeut, CAML,CCUL, Lisbon, Portugal. [Calisto, Joao] Ctr Hosp & Univ Coimbra HUC, Coimbra, Portugal. [da Silva, Pedro Canas] Ctr Hosp Lisboa Norte EPE, Hosp Santa Maria, Lisbon, Portugal. [Ribeiro, Vasco Gama] Ctr Hosp Vila Nova Gaia Espinho Hosp Eduardo Sant, Porto, Portugal. [Silva, Joao Carlos] Ctr Hosp Sao Joao, Porto, Portugal. [Seixo, Filipe] Ctr Hosp Setubal, Hosp Sao Bernardo, Setubal, Portugal. [Abreu, Pedro Farto e] Hosp Prof Doutor Fernando da Fonseca, Amadora, Portugal. [Teles, Rui Campante] Ctr Hosp Lisboa Ocident, Hosp Santa Cruz, Lisbon, Portugal. [Fernandes, Renato] Hosp Espirito Santo, Evora, Portugal. [Carvalho, Henrique Cyrne] Ctr Hosp Porto, Hosp Santo Antonio, Porto, Portugal. C3 Hospital Garcia de Orta; Universidade de Lisboa; Universidade de Coimbra; Centro Hospitalar e Universitario de Coimbra (CHUC); Centro Hospitalar de Lisboa Ocidental, EPE; Universidade de Lisboa; Hospital Santa Maria; Sao Joao Hospital; Centro Hospitalar de Lisboa Ocidental, EPE; Universidade de Lisboa RP Caldeira, D (通讯作者),Hosp Garcia de Orta, Cardiol Dept, Almada, Portugal.; Caldeira, D (通讯作者),Univ Lisbon, Fac Med, Lab Farmacol Clin & Terapeut, CAML,CCUL, Lisbon, Portugal. EM dgcaldeira@hotmail.com RI Caldeira, Daniel/AAJ-7974-2020; Pereira, Helder/B-6870-2014 OI Caldeira, Daniel/0000-0002-2520-5673; Cyrne Carvalho, Henrique/0000-0001-9316-1687; Pereira, Helder/0000-0001-8656-4883 CR Anastasius M, 2017, INT J CARDIOL, V240, P30, DOI 10.1016/j.ijcard.2017.04.077 De Luca L, 2015, EUR HEART J-ACUTE CA, V4, P441, DOI 10.1177/2048872614560505 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Kaifoszova Z, 2016, EUROINTERVENTION, V12, P14, DOI 10.4244/EIJV12I1A3 Pereira H, 2018, BMC CARDIOVASC DISOR, V18, DOI 10.1186/s12872-018-0794-4 Pereira H, 2014, REV PORT CARDIOL, V33, P363, DOI 10.1016/j.repc.2014.02.013 Rakowski T, 2018, J THROMB THROMBOLYS, V45, P151, DOI 10.1007/s11239-017-1579-9 Santos AR, 2014, REV PORT CARDIOL, V33, P67, DOI 10.1016/j.repc.2013.07.015 Santos Jose Ferreira, 2009, Rev Port Cardiol, V28, P1465 Schomig A, 1996, NEW ENGL J MED, V334, P1084, DOI 10.1056/NEJM199604253341702 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Yanamala CM, 2017, CORONARY ARTERY DIS, V28, P315, DOI 10.1097/MCA.0000000000000489 NR 12 TC 4 Z9 4 U1 0 U2 1 PU ELSEVIER ESPANA SLU PI BARCELONA PA AV JOSEP TARRADELLAS, 20-30, 1ERA PLANTA, BARCELONA, CP-08029, SPAIN SN 0870-2551 EI 0304-4750 J9 REV PORT CARDIOL JI Rev. Port. Cardiol. PD NOV PY 2019 VL 38 IS 11 BP 809 EP 814 DI 10.1016/j.repc.2019.02.015 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KN4VC UT WOS:000514835700010 PM 32007322 OA gold, Green Published DA 2023-05-13 ER PT J AU Tsai, KC Lin, RF Lee, C Li, AH AF Tsai, Kuang-Chau Lin, Ray F. Lee, Chieh Li, Ai-Hsien TI An alternative tool for triaging patients with possible acute coronary symptoms before admission to a chest pain unit SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Acute coronary syndrome; Chest pain unit; Observation unit; Triage; Emergency department ID ELEVATION MYOCARDIAL-INFARCTION; ACUTE CARDIAC ISCHEMIA; EMERGENCY-DEPARTMENT; EVENTS; RULE AB Objective: This study aimed to develop a triage tool to more effectively triage possible ACS patients presenting to the emergency department (ED) before admission to a protocol-driven chest pain unit (CPU). Methods: Seven hundred ninety-three clinical cases, randomly selected from 7962 possible ACS cases, were used to develop and test an ACS triage model using cluster analysis and stepwise logistic regression. Results: The ACS triage model, logit (suspected ACS patient)= -5.283 + 1.894 x chest pain + 1.612 x age + 1.222 x male + 0.958 x proximal radiation pain + 0.962 x shock + 0.519 x acute heart failure, with a threshold value set at 2.5, was developed to triage patients. Compared to four existing methods, the chest-pain strategy, the Zarich's strategy, the flowchart, and the heart broken index (HBI), the ACS triage model had better performance. Conclusion: This study developed an ACS triage model for triaging possible ACS patients. The model could be used as a rapid tool in EDs to reduce the workloads of ED nurses and physicians in relation to admissions to the CPU. (c) 2017 Elsevier Inc. All rights reserved. C1 [Tsai, Kuang-Chau] Far Eastern Mem Hosp, Dept Emergency, 21 Sec 2,Nanya S Rd, New Taipei 220, Taiwan. [Lin, Ray F.; Lee, Chieh] Yuan Ze Univ, Dept Ind Engn & Management, 135 Yuan Tung Rd, Chungli 32003, Taiwan. [Li, Ai-Hsien] Far Eastern Mem Hosp, Dept Cardiol, 21 Sec 2,Nanya S Rd, New Taipei 220, Taiwan. C3 Far Eastern Memorial Hospital; Yuan Ze University; Far Eastern Memorial Hospital RP Lin, RF (通讯作者),Yuan Ze Univ, Dept Ind Engn & Management, 135 Yuan Tung Rd, Chungli 32003, Taiwan. EM juifeng@saturn.yzu.edu.tw RI Lin, Ray F./L-8179-2013 OI Lin, Ray Fong/0000-0002-8368-5783 FU Taiwan Ministry of Science and Technology [MOST103-2221-E-155-053-MY3] FX We thank the Taiwan Ministry of Science and Technology (MOST103-2221-E-155-053-MY3) for their grant support. We also thank Rachel Pang, Pei-Li Chung, and Ming-Fen Guo for data collection. CR Amsterdam EA, 2010, CIRCULATION, V122, P1756, DOI 10.1161/CIR.0b013e3181ec61df Anderson JL, 2007, J AM COLL CARDIOL, V50, P652, DOI 10.1016/j.jacc.2007.02.028 Anderson JL, 2011, J AM COLL CARDIOL, V57, pE215, DOI 10.1016/j.jacc.2011.02.011 Blankenship JC, 2007, AM J CARDIOL, V100, P944, DOI 10.1016/j.amjcard.2007.04.031 Brieger D, 2004, CHEST, V126, P461, DOI 10.1378/chest.126.2.461 Diercks DB, 2006, AM J EMERG MED, V24, P1, DOI 10.1016/j.ajem.2005.05.016 Douglas PS, 1996, NEW ENGL J MED, V334, P1311, DOI 10.1056/NEJM199605163342007 Durand E, 2015, ESC TXB INTENSIVE AC, P56 Fan CM, 2010, J EMERGENCY MED, V12, P107 Farkouh ME, 2009, MEDICINE, V88, P307, DOI 10.1097/MD.0b013e3181b98782 Hess EP, 2012, CIRC-CARDIOVASC QUAL, V5, P251, DOI 10.1161/CIRCOUTCOMES.111.964791 Hess EP, 2012, ANN EMERG MED, V59, P115, DOI 10.1016/j.annemergmed.2011.07.026 Hsu J-C, 2011, AM HEART ASS 2011 SC JAYES RL, 1992, J CLIN EPIDEMIOL, V45, P621, DOI 10.1016/0895-4356(92)90134-9 Lopez B, 2011, EMERG MED J, V28, P841, DOI 10.1136/emj.2010.096602 Pope JH, 2000, NEW ENGL J MED, V342, P1163, DOI 10.1056/NEJM200004203421603 Rosenfeld AG, 2015, HEART LUNG, V44, P368, DOI 10.1016/j.hrtlng.2015.05.008 Sanchez M, 2007, AM J EMERG MED, V25, P865, DOI 10.1016/j.ajem.2006.12.025 Simon EL, 2014, J EMERG MED, V46, P734, DOI 10.1016/j.jemermed.2013.08.089 Zarich Stuart W, 2004, J Interv Cardiol, V17, P191, DOI 10.1111/j.1540-8183.2004.00383.x NR 20 TC 3 Z9 3 U1 1 U2 10 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0735-6757 EI 1532-8171 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD JUL PY 2018 VL 36 IS 7 BP 1222 EP 1230 DI 10.1016/j.ajem.2017.12.026 PG 9 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA GL0EC UT WOS:000436636000018 PM 29338968 DA 2023-05-13 ER PT J AU Berg, DD Bonaca, MP Braunwald, E Corbalan, R Goto, S Kiss, RG Murphy, SA Scirica, BM Spinar, J Morrow, DA AF Berg, David D. Bonaca, Marc P. Braunwald, Eugene Corbalan, Ramon Goto, Shinya Kiss, Robert G. Murphy, Sabina A. Scirica, Benjamin M. Spinar, Jindrich Morrow, David A. TI Outcomes in Stable Patients With Previous Atherothrombotic Events Receiving Vorapaxar Who Experience a New Acute Coronary Event (from TRA2 degrees P-TIMI 50) SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID THROMBIN-RECEPTOR ANTAGONIST; SECONDARY PREVENTION AB Vorapaxar is a first-in-class protease-activated receptor-1 antagonist indicated for secondary prevention in stable patients with previous myocardial infarction (MI) or peripheral artery disease and no cerebrovascular disease. Vorapaxar is not recommended for initiation in the acute phase of acute coronary syndromes (ACS) because of an unfavorable balance between bleeding and efficacy when started in that setting. The aim of this analysis was to investigate outcomes in patients who experienced a new ACS while receiving vorapaxar for long-term secondary prevention. Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic ischemic Events-Thrbmbolysis In Myocardial Infarction 50 was a randomized, double-blind, placebo-controlled trial of vorapaxar (n = 26,449). We evaluated bleeding and ischemic events during the acute care of patients with a new ACS during the trial. During a median follow-up of 30 months, 799 patients (8.9%) randomized to vorapaxar and 913 (10.0%) to placebo had a new ACS event (p = 0.003); 87% and 86%, respectively, were on study therapy at the time of the event. In a landmark analysis through 7 days after ACS, the rates of Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) severe bleeding were 0.8% versus 0.8% (hazard ratio [HR] 0.99, 95% CI 0.33 to 2.94) and GUSTO moderate/severe bleeding were 2.5% versus 1.6% (HR 1.59, 95% CI 0.78 to 3.24) with vorapaxar versus placebo. The effect of vorapaxar on cardiovascular death, MI, or stroke (2.4% vs 4.4%; HR 0.54, 95% CI 0,31 to 0.93; p = 0.027) was consistent with the, overall trial result. In conclusion, in patients who experience a new ACS event while receiving vorapaxar for secondary prevention, continuing therapy was associated with favorable efficacy without excess severe bleeding during the period of acute ACS management. (C) 2016 Elsevier Inc. All rights reserved. C1 [Berg, David D.; Bonaca, Marc P.; Braunwald, Eugene; Murphy, Sabina A.; Scirica, Benjamin M.; Morrow, David A.] Harvard Univ, Brigham & Womens Hosp, Cardiovasc Div, TIMI Study Grp,Dept Med,Med Sch, Boston, MA 02115 USA. [Corbalan, Ramon] Catholic Univ Chile, Dept Cardiol, Sch Med, Santiago, Chile. [Goto, Shinya] Tokai Univ, Sch Med, Dept Med, Isehara, Kanagawa 25911, Japan. [Kiss, Robert G.] Mil Hosp, Dept Cardiol, Budapest, Hungary. [Spinar, Jindrich] Univ Hosp, Dept Cardiol, Brno, Czech Republic. C3 Harvard University; Brigham & Women's Hospital; Harvard Medical School; Pontificia Universidad Catolica de Chile; Tokai University; University Hospital Brno RP Morrow, DA (通讯作者),Harvard Univ, Brigham & Womens Hosp, Cardiovasc Div, TIMI Study Grp,Dept Med,Med Sch, Boston, MA 02115 USA. EM dmorrow@partners.org RI Goto, Shinya/AAU-6045-2020; Bonaca, Marc/AAJ-2397-2021 OI Goto, Shinya/0000-0002-6821-1504; Bonaca, Marc/0000-0002-9860-3584; Berg, David/0000-0002-0366-5492 FU Merck and Co. FX TRA2 degrees P-TIMI 50 (http://www.clinicaltrials.gov, NCT00526474) was supported by Merck and Co. CR Leger AJ, 2006, CIRCULATION, V114, P1070, DOI 10.1161/CIRCULATIONAHA.105.574830 Magnani G, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.114.001505 Morrow DA, 2012, NEW ENGL J MED, V366, P1404, DOI 10.1056/NEJMoa1200933 Morrow DA, 2009, AM HEART J, V158, P335, DOI 10.1016/j.ahj.2009.06.027 Tricoci P, 2012, NEW ENGL J MED, V366, P20, DOI 10.1056/NEJMoa1109719 NR 5 TC 5 Z9 5 U1 1 U2 8 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD APR 1 PY 2016 VL 117 IS 7 BP 1055 EP 1058 DI 10.1016/j.amjcard.2015.12.052 PG 4 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DI5FH UT WOS:000373523800004 PM 26876014 DA 2023-05-13 ER PT J AU Solla, DJF Paiva, ID Delisle, JE Braga, AA de Moraes, JBDX Filgueiras, NM Carvalho, ME Martins, MS Neto, OM Roberto, P Roriz, PD AF Fontoura Solla, Davi Jorge Paiva Filho, Ivan de Mattos Delisle, Jacques Edouard Braga, Alecianne Azevedo de Moura Xavier de Moraes, Joao Batista, Jr. Filgueiras, Nivaldo Menezes Carvalho, Marcela Embirucu Martins, Mariana Steque Manganotti Neto, Orlando Roberto Filho, Paulo Roriz, Pollianna de Souza TI Integrated Regional Networks for ST-Segment-Elevation Myocardial Infarction Care in Developing Countries The Experience of Salvador, Bahia, Brazil SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE acute myocardial infarction; regional health; planning; telemedicine; reperfusion; population ID ACUTE CORONARY SYNDROMES; EURO HEART SURVEY; REPERFUSION THERAPY; INTERHOSPITAL TRANSFER; MEDITERRANEAN BASIN; NATIONAL POLICY; REGISTRY; INTERVENTION; MANAGEMENT; SYSTEM AB Background-Regionalized integrated networks for ST-segment-elevation myocardial infarction (STEMI) care have been proposed as a step forward in overcoming real-world obstacles, but data are lacking on its performance in developing countries. We describe an integrated regional STEMI network in Salvador, Bahia, Brazil. Methods and Results-The network was created in 2009. It was coordinated by the prehospital emergency medical service and encompassed the public emergency system (prehospital mobile units, community-based emergency units, general hospitals, and cardiology reference centers). The 12-lead ECGs are interpreted via telemedicine. This network operates as follows: The Telemedicine Center sends each ECG suggestive of STEMI to a Regional STEMI Alert Team, which, together with emergency medical services, offers support for thrombolysis or immediate transfer for primary percutaneous coronary intervention. In 14 months, there were 433 suspected victims, of which in 287 (76.5%) the STEMI could be confirmed (age, 62.1+/-12.5 years; 63.4% men). Most of them were self-transported. The median pain-to-admission time was 180 minutes (interquartile range, 90-473 minutes), and the median admission-to-ECG time was 159.5 minutes (interquartile range, 83.5-340 minutes). The median interval time between the ECG and the telemedicine report was 31 minutes (interquartile range, 21-44 minutes). For those who sought medical attention and had an ECG performed within 12 hours after symptoms onset (n=119), the reperfusion rate was 75.6% (34.4% by thrombolysis and 65.6% by primary percutaneous coronary intervention). Conclusions-Regional STEMI networks may be feasible in developing countries. Preliminary results showed this network to be effective, achieving primary reperfusion rates comparable with those reported internationally despite the obstacles faced. (Circ Cardiovasc Qual Outcomes. 2013; 6: 9-17.) C1 [Fontoura Solla, Davi Jorge] Univ Fed Bahia, Salvador, BA, Brazil. [Fontoura Solla, Davi Jorge; Paiva Filho, Ivan de Mattos; Braga, Alecianne Azevedo; Filgueiras, Nivaldo Menezes; Carvalho, Marcela Embirucu; Martins, Mariana Steque; Manganotti Neto, Orlando; Roberto Filho, Paulo; Roriz, Pollianna de Souza] Serv Aide Med Urgente, Salvador, BA, Brazil. [Delisle, Jacques Edouard] Telemed Bahia, Salvador, BA, Brazil. [de Moura Xavier de Moraes, Joao Batista, Jr.] Agamenon Magalhaes Hosp, Recife, PE, Brazil. C3 Universidade Federal da Bahia RP Solla, DJF (通讯作者),Rua Marechal Floriano 41,Apt 101 Canela, BR-40320350 Salvador, BA, Brazil. EM davisolla@hotmail.com RI Solla, Davi/E-6988-2013 OI Solla, Davi/0000-0002-5092-6595 FU city of Salvador, Bahia; Telemedicina da Bahia FX The Integrated Regional STEMI Network of Salvador, Bahia was planned and initiated under the auspices of responsible health politicians of the city of Salvador, Bahia.; D.J. 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Outcomes PD JAN PY 2013 VL 6 IS 1 BP 9 EP 17 DI 10.1161/CIRCOUTCOMES.112.967505 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 071ZN UT WOS:000313637500006 PM 23233748 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Naruse, H Ishii, J Takahashi, H Kitagawa, F Nishimura, H Kawai, H Muramatsu, T Harada, M Yamada, A Fujiwara, W Hayashi, M Motoyama, S Sarai, M Watanabe, E Izawa, H Ozaki, Y AF Naruse, Hiroyuki Ishii, Junnichi Takahashi, Hiroshi Kitagawa, Fumihiko Nishimura, Hideto Kawai, Hideki Muramatsu, Takashi Harada, Masahide Yamada, Akira Fujiwara, Wakaya Hayashi, Mutsuharu Motoyama, Sadako Sarai, Masayoshi Watanabe, Eiichi Izawa, Hideo Ozaki, Yukio TI Urinary Liver-Type Fatty-Acid-Binding Protein Predicts Long-Term Adverse Outcomes in Medical Cardiac Intensive Care Units SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE liver-type fatty-acid-binding protein; long-term outcomes; cardiac intensive care units; acute kidney injury ID ACUTE KIDNEY INJURY; BIOMARKERS; CREATININE; CURVE AB We prospectively investigated the prognostic value of urinary liver-type fatty-acid-binding protein (L-FABP) levels on hospital admission, both independently and in combination with serum creatinine-defined acute kidney injury (AKI), to predict long-term adverse outcomes in 1119 heterogeneous patients (mean age; 68 years) treated at medical (non-surgical) cardiac intensive care units (CICUs). Patients with stage 5 chronic kidney disease were excluded from the study. Of these patients, 47% had acute coronary syndrome and 38% had acute decompensated heart failure. The creatinine-defined AKI was diagnosed according to the "Kidney Disease: Improving Global Outcomes" criteria. The primary endpoint was a composite of all-cause death or progression to end-stage kidney disease, indicating the initiation of maintenance dialysis therapy or kidney transplantation. Creatinine-defined AKI occurred in 207 patients, with 44 patients having stage 2 or 3 disease. During a mean follow-up period of 41 months after enrollment, the primary endpoint occurred in 242 patients. Multivariate Cox regression analyses revealed L-FABP levels as independent predictors of the primary endpoint (p < 0.001). Adding L-FABP to a baseline model with established risk factors further enhanced reclassification and discrimination beyond that of the baseline model alone, for primary-endpoint prediction (both; p < 0.01). On Kaplan-Meier analyses, increased L-FABP (>= 4th quintile value of 9.0 ng/mL) on admission or presence of creatinine-defined AKI, correlated with an increased risk of the primary endpoint (p < 0.001). Thus, urinary L-FABP levels on admission are potent and independent predictors of long-term adverse outcomes, and they might improve the long-term risk stratification of patients admitted at medical CICUs, when used in combination with creatinine-defined AKI. C1 [Naruse, Hiroyuki; Ishii, Junnichi; Kitagawa, Fumihiko] Fujita Hlth Univ, Sch Med, Dept Joint Res Lab Clin Med, Toyoake, Aichi 4701192, Japan. [Takahashi, Hiroshi] Fujita Hlth Univ, Sch Med, Div Stat, Toyoake, Aichi 4701192, Japan. [Nishimura, Hideto; Kawai, Hideki; Muramatsu, Takashi; Harada, Masahide; Yamada, Akira; Motoyama, Sadako; Sarai, Masayoshi; Watanabe, Eiichi; Ozaki, Yukio] Fujita Hlth Univ, Sch Med, Dept Cardiol, Toyoake, Aichi 4701192, Japan. [Fujiwara, Wakaya; Hayashi, Mutsuharu; Izawa, Hideo] Bantane Hosp, Dept Cardiol, Nagoya, Aichi 4548509, Japan. C3 Fujita Health University; Fujita Health University; Fujita Health University RP Ishii, J (通讯作者),Fujita Hlth Univ, Sch Med, Dept Joint Res Lab Clin Med, Toyoake, Aichi 4701192, Japan. EM hnaruse@fujita-hu.ac.jp; jishii@fujita-hu.ac.jp; hirotaka@fujita-hu.ac.jp; fkitaga@fujita-hu.ac.jp; hidetonishimura0621@gmail.com; hidekikawai@xc4.so-net.ne.jp; takam@fujita-hu.ac.jp; mharada@fujita-hu.ac.jp; a-yamada@fujita-hu.ac.jp; wakayafj@fujita-hu.ac.jp; muhayasi@med.nagoya-u.ac.jp; sadakom@fujita-hu.ac.jp; msarai@fujita-hu.ac.jp; enwatan@mtj.biglobe.ne.jp; izawa@fujita-hu.ac.jp; ozakiyuk@fujita-hu.ac.jp RI Kawai, Hideki/HJI-7311-2023 OI Kawai, Hideki/0000-0003-2924-3615; Harada, Masahide/0000-0002-2345-9557 FU JSPS KAKENHI [17K08995]; Grants-in-Aid for Scientific Research [17K08995] Funding Source: KAKEN FX This work was supported by JSPS KAKENHI (17K08995). 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Clin. Med. PD FEB PY 2020 VL 9 IS 2 AR 482 DI 10.3390/jcm9020482 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA KT2DG UT WOS:000518823000194 PM 32050627 OA Green Published, gold DA 2023-05-13 ER PT J AU Pereira, NL Farkouh, ME So, D Lennon, R Geller, N Mathew, V Bell, M Bae, JH Jeong, MH Chavez, I Gordon, P Abbott, JD Cagin, C Baudhuin, L Fu, YP Goodman, SG Hasan, A Iturriaga, E Lerman, A Sidhu, M Tanguay, JF Wang, LW Weinshilboum, R Welsh, R Rosenberg, Y Bailey, K Rihal, C AF Pereira, Naveen L. Farkouh, Michael E. So, Derek Lennon, Ryan Geller, Nancy Mathew, Verghese Bell, Malcolm Bae, Jang-Ho Jeong, Myung Ho Chavez, Ivan Gordon, Paul Abbott, J. Dawn Cagin, Charles Baudhuin, Linnea Fu, Yi-Ping Goodman, Shaun G. Hasan, Ahmed Iturriaga, Erin Lerman, Amir Sidhu, Mandeep Tanguay, Jean-Francois Wang, Liewei Weinshilboum, Richard Welsh, Robert Rosenberg, Yves Bailey, Kent Rihal, Charanjit TI Effect of Genotype-Guided Oral P2Y12 Inhibitor Selection vs Conventional Clopidogrel Therapy on Ischemic Outcomes After Percutaneous Coronary Intervention: The TAILOR-PCI Randomized Clinical Trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID CARDIOVASCULAR EVENTS; TICAGRELOR; VARIANTS; GENE AB Key PointsQuestionDoes CYP2C19 genotype-guided prescription of oral P2Y12 inhibitor therapy after percutaneous coronary intervention (PCI) improve ischemic outcomes in patients with acute coronary syndromes and stable coronary artery disease? FindingsIn this randomized clinical trial that included 5302 patients undergoing PCI and included 1849 patients with CYP2C19 loss-of-function alleles in the primary analysis, genotype-guided selection of oral P2Y12 inhibitor therapy, compared with conventional therapy using clopidogrel, resulted in no significant difference in a composite end point of cardiovascular death, myocardial infarction, stroke, stent thrombosis, or severe recurrent ischemia at 12 months (4.0% vs 5.9%, respectively; hazard ratio, 0.66). MeaningAmong patients with CYP2C19 loss-of-function alleles who underwent PCI, genotype-guided selection of an oral P2Y12 inhibitor, compared with conventional clopidogrel therapy, did not significantly reduce ischemic events based on the treatment effect that the study was powered to detect at 12 months. ImportanceAfter percutaneous coronary intervention (PCI), patients with CYP2C19*2 or *3 loss-of-function (LOF) variants treated with clopidogrel have increased risk of ischemic events. Whether genotype-guided selection of oral P2Y12 inhibitor therapy improves ischemic outcomes is unknown. ObjectiveTo determine the effect of a genotype-guided oral P2Y12 inhibitor strategy on ischemic outcomes in CYP2C19 LOF carriers after PCI. Design, Setting, and ParticipantsOpen-label randomized clinical trial of 5302 patients undergoing PCI for acute coronary syndromes (ACS) or stable coronary artery disease (CAD). Patients were enrolled at 40 centers in the US, Canada, South Korea, and Mexico from May 2013 through October 2018; final date of follow-up was October 2019. InterventionsPatients randomized to the genotype-guided group (n=2652) underwent point-of-care genotyping. CYP2C19 LOF carriers were prescribed ticagrelor and noncarriers clopidogrel. Patients randomized to the conventional group (n=2650) were prescribed clopidogrel and underwent genotyping after 12 months. Main Outcomes and MeasuresThe primary end point was a composite of cardiovascular death, myocardial infarction, stroke, stent thrombosis, and severe recurrent ischemia at 12 months. A secondary end point was major or minor bleeding at 12 months. The primary analysis was in patients with CYP2C19 LOF variants, and secondary analysis included all randomized patients. The trial had 85% power to detect a minimum hazard ratio of 0.50. ResultsAmong 5302 patients randomized (median age, 62 years; 25% women), 82% had ACS and 18% had stable CAD; 94% completed the trial. Of 1849 with CYP2C19 LOF variants, 764 of 903 (85%) assigned to genotype-guided therapy received ticagrelor, and 932 of 946 (99%) assigned to conventional therapy received clopidogrel. The primary end point occurred in 35 of 903 CYP2C19 LOF carriers (4.0%) in the genotype-guided therapy group and 54 of 946 (5.9%) in the conventional therapy group at 12 months (hazard ratio [HR], 0.66 [95% CI, 0.43-1.02]; P=.06). None of the 11 prespecified secondary end points showed significant differences, including major or minor bleeding in CYP2C19 LOF carriers in the genotype-guided group (1.9%) vs the conventional therapy group (1.6%) at 12 months (HR, 1.22 [95% CI, 0.60-2.51]; P=.58). Among all randomized patients, the primary end point occurred in 113 of 2641 (4.4%) in the genotype-guided group and 135 of 2635 (5.3%) in the conventional group (HR, 0.84 [95% CI, 0.65-1.07]; P=.16). Conclusions and RelevanceAmong CYP2C19 LOF carriers with ACS and stable CAD undergoing PCI, genotype-guided selection of an oral P2Y12 inhibitor, compared with conventional clopidogrel therapy without point-of-care genotyping, resulted in no statistically significant difference in a composite end point of cardiovascular death, myocardial infarction, stroke, stent thrombosis, and severe recurrent ischemia based on the prespecified analysis plan and the treatment effect that the study was powered to detect at 12 months. Trial RegistrationClinicalTrials.gov Identifier: NCT01742117 This open-label randomized trial compares the effect of a genotype-guided oral P2Y12 inhibitor selection strategy vs conventional clopidogrel prescribing on 12-month ischemic outcomes after percutaneous coronary intervention (PCI) in CYP2C19*2/CYP2C19*3 loss-of-function allele carriers with acute coronary syndromes and stable cardiovascular disease. C1 [Pereira, Naveen L.; Bell, Malcolm; Lerman, Amir; Rihal, Charanjit] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Farkouh, Michael E.] Univ Toronto, Peter Munk Cardiac Ctr, Toronto, ON, Canada. [Farkouh, Michael E.] Univ Toronto, Heart & Stroke Richard Lewar Ctr, Toronto, ON, Canada. [So, Derek] Univ Ottawa, Inst Heart, Ottawa, ON, Canada. [Lennon, Ryan; Bailey, Kent] Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA. [Geller, Nancy; Fu, Yi-Ping; Hasan, Ahmed; Iturriaga, Erin; Rosenberg, Yves] NHLBI, NIH, Bldg 10, Bethesda, MD 20892 USA. [Mathew, Verghese] Loyola Univ, Dept Med, Maywood, IL USA. [Bae, Jang-Ho] Konyang Univ, Div Cardiol, Dept Internal Med, Taejon, South Korea. [Jeong, Myung Ho] Chonnam Natl Univ, Heart Res Ctr, Gwangju, South Korea. [Chavez, Ivan] Minneapolis Heart Inst Fdn, Dept Cardiol, Minneapolis, MN USA. [Gordon, Paul] Miriam Hosp, Div Cardiol, Providence, RI 02906 USA. [Abbott, J. Dawn] Rhode Isl Hosp, Div Cardiol, Providence, RI USA. [Cagin, Charles] Mayo Clin Hlth Syst La Crosse, La Crosse, WI USA. [Baudhuin, Linnea] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN USA. [Goodman, Shaun G.] Univ Toronto, St Michaels Hosp, Toronto, ON, Canada. [Goodman, Shaun G.] Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada. [Sidhu, Mandeep] Albany Med Ctr, Dept Med, Div Cardiol, Albany, NY USA. [Sidhu, Mandeep] Albany Med Coll, Albany, NY 12208 USA. [Tanguay, Jean-Francois] Montreal Heart Inst, Montreal, PQ, Canada. [Tanguay, Jean-Francois] Univ Montreal, Montreal, PQ, Canada. [Wang, Liewei; Weinshilboum, Richard] Mayo Clin, Dept Mol Pharmacol & Expt Therapeut, Rochester, MN USA. [Welsh, Robert] Mazankowski Alberta Heart Inst, Dept Med, Edmonton, AB, Canada. [Welsh, Robert] Univ Alberta, Edmonton, AB, Canada. C3 Mayo Clinic; University of Toronto; Peter Munk Cardiac Centre; University of Toronto; University of Ottawa; University of Ottawa Heart Institute; Mayo Clinic; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI); Loyola University Chicago; Konyang University; Konyang University Hospital; Chonnam National University; Minneapolis Heart Institute Foundation; Lifespan Health Rhode Island; Miriam Hospital; Lifespan Health Rhode Island; Rhode Island Hospital; Mayo Clinic; University of Toronto; Saint Michaels Hospital Toronto; University of Alberta; Albany Medical College; Albany Medical College; Universite de Montreal; Universite de Montreal; Mayo Clinic; University of Alberta RP Pereira, NL (通讯作者),Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. EM pereira.naveen@mayo.edu RI Abbott, J/AAU-4065-2021 FU NIH [U01HL128606, U01HL128626] FX Funding for this research was provided by the NIH (grants U01HL128606 and U01HL128626). 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Am. Med. Assoc. PD AUG 25 PY 2020 VL 324 IS 8 BP 761 EP 771 DI 10.1001/jama.2020.12443 PG 11 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA NM6UD UT WOS:000568230000022 PM 32840598 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Yang, CJ Wang, HY Chou, TC Chang, CJ AF Yang, Chia-Jui Wang, Hsiu-Yin Chou, Tse-Chih Chang, Chee-Jen TI Prevalence and related drug cost of comorbidities in HIV-infected patients receiving highly active antiretroviral therapy in Taiwan: A cross-sectional study SO JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION LA English DT Article DE Cost-burden; Epidemiology; Healthcare; Prevention; Taiwan ID RITONAVIR-BOOSTED ATAZANAVIR; QUALITY-OF-LIFE; CARDIOVASCULAR-DISEASE; CUMULATIVE EXPOSURE; METABOLIC SYNDROME; RISK; TENOFOVIR AB Background: To determine the prevalence of chronic comorbidities and associated medication costs in Taiwanese HIV patients in order to increase awareness of the disease burden among healthcare providers and patients. Methods: HIV-diagnosed patients receiving highly active antiretroviral therapy (HAART; 2010-2013) were identified from the Taiwan National Health Insurance Research Database with the corresponding International Classification of Diseases, ninth revision (ICD-9) code. Comorbidities (type II diabetes mellitus, hypertension, dyslipidemia, major depressive disorder, acute coronary syndrome, and cholelithiasis/nephrolithiasis) were identified according to ICD-9 or relevant medication use. Comorbidity medication and associated costs were identified using the drug classification code from the Anatomical Therapeutic Chemical classification system code series and series outpatient prescriptions. Results: Of 20,726 HIV-diagnosed Taiwanese patients (2010-2013), 13,142 receiving HAART were analyzed. Prevalence of all chronic comorbidities was significantly greater (p < 0.0001) in patients aged >= 40 years versus <40 years (diabetes mellitus, 14.95% vs. 3.30%; hypertension, 46.73% vs. 26.83%; dyslipidemia, 34.93% vs. 18.37%; depression, 23.75% vs. 19.88%; acute coronary syndrome, 1.16% vs. 0.21%; nephrolithiasis/cholelithiasis, 7.26% vs. 4.56%; >2 comorbidities, 24.80% vs. 7.21%). An increase in comorbidity medication spending (2010 vs. 2013 medication costs) was observed (antidyslipidemia, $88,878 vs. $168,180; antihyperglycemia, $32,372 vs. $73,518; antidepressants, $78,220 vs. $125,971; sedatives, $60,009 vs. $85,055; antihypertension, $47,115 vs. $95,134), contributing to overall treatment costs increasing almost two-fold from 2010 to 2013. Conclusions: Among HIV-infected Taiwanese patients receiving HAART, significant increases in comorbidity prevalence with age, along with rising comorbidity medication costs, suggest the need for preventative as well as chronic care. Copyright (C) 2019, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. C1 [Yang, Chia-Jui] Far Eastern Mem Hosp, Dept Internal Med, New Taipei, Taiwan. [Yang, Chia-Jui] Natl Yang Ming Univ, Sch Med, Taipei, Taiwan. [Wang, Hsiu-Yin] Janssen Pharmaceut, Med Affairs, Taipei, Taiwan. [Chou, Tse-Chih; Chang, Chee-Jen] Chang Gung Univ, Clin Informat & Med Stat Res Ctr, Taoyuan, Taiwan. [Chang, Chee-Jen] Chang Gung Univ, Grad Inst Clin Med Sci, 259,Wenhua 1st Rd, Taoyuan, Taiwan. C3 Far Eastern Memorial Hospital; National Yang Ming Chiao Tung University; Johnson & Johnson; Janssen Pharmaceuticals; Chang Gung University; Chang Gung University RP Chang, CJ (通讯作者),Chang Gung Univ, Grad Inst Clin Med Sci, 259,Wenhua 1st Rd, Taoyuan, Taiwan. EM cjchang@mail.cgu.edu.tw RI Yang, Chia Jui/HSG-0777-2023 OI Yang, Chia Jui/0000-0002-5925-2064 FU Janssen Pharmaceuticals, Taiwan FX This work was sponsored by Janssen Pharmaceuticals, Taiwan. 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Microbiol. Immunol. Infect. PD OCT PY 2019 VL 52 IS 5 BP 720 EP 727 DI 10.1016/j.jmii.2019.05.011 PG 8 WC Immunology; Infectious Diseases; Microbiology WE Science Citation Index Expanded (SCI-EXPANDED) SC Immunology; Infectious Diseases; Microbiology GA JA6PA UT WOS:000487963100006 PM 31358463 OA gold DA 2023-05-13 ER PT J AU Fedson, DS AF Fedson, David S. TI Treating influenza with statins and other immunomodulatory agents SO ANTIVIRAL RESEARCH LA English DT Review DE Influenza; Statins; Immunomodulatory agents; Metabolic syndrome; Public health ID PROLIFERATOR-ACTIVATED-RECEPTOR; ACUTE LUNG INJURY; ACUTE MYOCARDIAL-INFARCTION; PERCUTANEOUS CORONARY INTERVENTION; CONVERTING ENZYME-INHIBITORS; SYSTEMIC CYTOKINE RESPONSES; MOLECULAR-PATTERNS DAMPS; BLOOD-STREAM INFECTIONS; CRITICALLY-ILL PATIENTS; ACUTE CHEST SYNDROME AB Statins not only reduce levels of LDL-cholesterol, they counteract the inflammatory changes associated with acute coronary syndrome and improve survival. Similarly, in patients hospitalized with laboratory-confirmed seasonal influenza, statin treatment is associated with a 41% reduction in 30-day mortality. Most patients of any age who are at increased risk of influenza mortality have chronic low-grade inflammation characteristic of metabolic syndrome. Moreover, differences in the immune responses of children and adults seem responsible for the low mortality in children and high mortality in adults seen in the 1918 influenza pandemic and in other acute infectious and non-infectious conditions. These differences probably reflect human evolutionary development. Thus the host response to influenza seems to be the major determinant of outcome. Outpatient statins are associated with reductions in hospitalizations and deaths due to sepsis and pneumonia. Inpatient statins are also associated with reductions in short-term pneumonia mortality. Other immunomodulatory agents - ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), PPAR gamma and PPAR alpha, agonists (glitazones and fibrates) and AMPK agonists (metformin) - also reduce mortality in patients with pneumonia (ACEIs, ARBs) or in mouse models of influenza (PPAR and AMPK agonists). In experimental studies, treatment has not increased virus replication. Thus effective management of influenza may not always require targeting the virus with vaccines or antiviral agents. Clinical investigators, not systems biologists, have been the first to suggest that immunomodulatory agents might be used to treat influenza patients, but randomized controlled trials will be needed to provide convincing evidence that they work To guide the choice of which agent(s) to study, we need new types of laboratory research in animal models and clinical and epidemiological research in patients with critical illness. These studies will have crucial implications for global public health. During the 2009 H1N1 influenza pandemic, timely and affordable supplies of vaccines and antiviral agents were unavailable to more than 90% of the world's people. In contrast, statins and other immunomodulatory agents are currently produced as inexpensive generics, global supplies are huge, and they would be available to treat patients in any country with a basic health care system on the first pandemic day. Treatment with statins and other immunomodulatory agents represents a new approach to reducing mortality caused by seasonal and pandemic influenza. This article forms part of a symposium in Antiviral Research on "Treatment of influenza: targeting the virus or the host". (C) 2013 Elsevier B.V. All rights reserved. RP Fedson, DS (通讯作者),57 Chemin Lavoir, F-01630 Sergy Haut, France. 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PD SEP PY 2013 VL 99 IS 3 BP 417 EP 435 DI 10.1016/j.antiviral.2013.06.018 PG 19 WC Pharmacology & Pharmacy; Virology WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy; Virology GA 253RZ UT WOS:000327108300026 PM 23831494 DA 2023-05-13 ER PT J AU Aldous, SJ AF Aldous, Sally J. TI Cardiac biomarkers in acute myocardial infarction SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Review DE Troponin; High-sensitivity troponin; Myocardial infarction; Prognostic utility; cardiac biomarkers; Novel biomarkers ID BRAIN NATRIURETIC PEPTIDE; ACUTE CORONARY SYNDROME; ISCHEMIA-MODIFIED ALBUMIN; LEFT-VENTRICULAR FUNCTION; ACID-BINDING PROTEIN; SERUM TROPONIN-T; GROWTH-DIFFERENTIATION FACTOR-15; EARLY RISK STRATIFICATION; SOLUBLE CD40 LIGAND; CREATINE-KINASE-MB AB Each year, a large number of patients are seen in the Emergency Department with presentations necessitating investigation for possible acute myocardial infarction. Patients can be stratified by symptoms, risk factors and electrocardiogram results but cardiac biomarkers also have a prime role both diagnostically and prognostically. This review summarizes both the history of cardiac biomarkers as well as currently available (established and novel) assays. Cardiac troponin, our current "gold standard" biomarker criterion for the diagnosis of myocardial infarction has high sensitivity and specificity for this diagnosis and therapies instituted in patients with elevated troponin have been shown to influence outcomes. Other markers of myocardial necrosis, inflammation and neurohormonal activity have also been shown to have either diagnostic or prognostic utility, but none have been shown to be superior to troponin. The measurement of multiple biomarkers and the use of point of care markers may accelerate current diagnostic protocols for the assessment of such patients. (C) 2012 Elsevier Ireland Ltd. All rights reserved. C1 [Aldous, Sally J.] Christchurch Hosp, Christchurch, New Zealand. C3 Christchurch Hospital New Zealand RP Aldous, SJ (通讯作者),Christchurch Hosp, Dept Cardiol, Riccarton Rd, Christchurch, New Zealand. 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J. Cardiol. PD APR 15 PY 2013 VL 164 IS 3 BP 282 EP 294 DI 10.1016/j.ijcard.2012.01.081 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 112NT UT WOS:000316599700013 PM 22341694 DA 2023-05-13 ER PT J AU Dusi, V De Ferrari, GM Pugliese, L Schwartz, PJ AF Dusi, Veronica De Ferrari, Gaetano Maria Pugliese, Luigi Schwartz, Peter J. TI Cardiac Sympathetic Denervation in Channelopathies SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Review DE sudden cardiac death; cardiac sympathetic denervation; long QT syndrome; catecholaminergic polymorphic ventricular tachycardia; cardiac autonomic nervous system ID LONG-QT SYNDROME; POLYMORPHIC VENTRICULAR-TACHYCARDIA; NITRIC-OXIDE SYNTHASE; IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; LIFE-THREATENING ARRHYTHMIAS; VAGUS NERVE-STIMULATION; PLASMA NEUROPEPTIDE-Y; ACUTE MYOCARDIAL-INFARCTION; HEART-RATE-VARIABILITY; CORONARY-CARE UNIT AB Left cardiac sympathetic denervation (LCSD) is a surgical antiadrenergic intervention with a strong antiarrhythmic effect, supported by preclinical as well as clinical data. The mechanism of action of LCSD in structurally normal hearts with increased arrhythmic susceptibility (such as those of patients with channelopathies) is not limited to the antagonism of acute catecholamines release in the heart. LCSD also conveys a strong anti-fibrillatory action that was first demonstrated over 40 years ago and provides the rationale for its use in almost any cardiac condition at increased risk of ventricular fibrillation. The molecular mechanisms involved in the final antiarrhythmic effect of LCSD turned out to be much broader than anticipated. Beside the vagotonic effect at different levels of the neuraxis, other new mechanisms have been recently proposed, such as the antagonism of neuronal remodeling, the antagonism of neuropeptide Y effects, and the correction of neuronal nitric oxide synthase (nNOS) imbalance. The beneficial effects of LCSD have never been associated with a detectable deterioration of cardiac performance. Finally, patients express a high degree of satisfaction with the procedure. In this review, we focus on the rationale, results and our personal approach to LCSD in patients with channelopathies such as long QT syndrome and catecholaminergic polymorphic ventricular tachycardia. C1 [Dusi, Veronica; De Ferrari, Gaetano Maria] Univ Pavia, Sect Cardiol, Dept Mol Med, Pavia, Italy. [Dusi, Veronica; De Ferrari, Gaetano Maria] Fdn IRCCS Policlin San Matteo, Cardiac Intens Care Unit, Arrhythmia & Electrophysiol & Expt Cardiol, Pavia, Italy. [Pugliese, Luigi] Fdn IRCCS Policlin San Matteo, Unit Gen Surg 2, Dept Surg, Pavia, Italy. [Schwartz, Peter J.] IRCCS, Ist Auxol Italiano, Ctr Cardiac Arrhythmias Genet Origin, Milan, Italy. [Schwartz, Peter J.] IRCCS, Ist Auxol Italiano, Lab Cardiovasc Genet, Milan, Italy. C3 University of Pavia; IRCCS Fondazione San Matteo; IRCCS Fondazione San Matteo; IRCCS Istituto Auxologico Italiano; IRCCS Istituto Auxologico Italiano RP Schwartz, PJ (通讯作者),IRCCS, Ist Auxol Italiano, Ctr Cardiac Arrhythmias Genet Origin, Milan, Italy.; Schwartz, PJ (通讯作者),IRCCS, Ist Auxol Italiano, Lab Cardiovasc Genet, Milan, Italy. EM p.schwartz@auxologico.it RI De Ferrari, Gaetano M/K-5188-2016; Dusi, Veronica/AAC-2135-2022; Pugliese, Luigi/AAC-1168-2019 OI De Ferrari, Gaetano M/0000-0003-4940-0876; Pugliese, Luigi/0000-0002-0537-4787; Dusi, Veronica/0000-0002-2290-3126 FU European Union's Horizon 2020 research and innovation programme under acronym ESCAPE-NET [733381] FX This work has received funding from the European Union's Horizon 2020 research and innovation programme under acronym ESCAPE-NET, registered under grant agreement No 733381. The authors are grateful to Pinuccia De Tomasi for expert editorial support. 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Cardiovasc. Med. PD MAR 26 PY 2019 VL 6 AR 27 DI 10.3389/fcvm.2019.00027 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HX1ZR UT WOS:000467192100001 PM 30972341 OA Green Published, gold DA 2023-05-13 ER PT J AU Blanco, S Ferrieres, J Bongard, V Toulza, O Sebai, F Billet, S Biendel, C Lairez, O Lhermusier, T Boudou, N Campelo-Parada, F Roncalli, J Galinier, M Carrie, D Elbaz, M Bouisset, F AF Blanco, Stephanie Ferrieres, Jean Bongard, Vanina Toulza, Olivier Sebai, Fatia Billet, Sophie Biendel, Caroline Lairez, Olivier Lhermusier, Thibault Boudou, Nicolas Campelo-Parada, Francisco Roncalli, Jerome Galinier, Michel Carrie, Didier Elbaz, Meyer Bouisset, Frederic TI Prognosis Impact of Frailty Assessed by the Edmonton Frail Scale in the Setting of Acute Coronary Syndrome in the Elderly SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; PATIENTS GREATER-THAN-OR-EQUAL-TO-75 YEARS; ST-ELEVATION; OLDER; AGE; OUTCOMES; CARE; ASSOCIATION; MANAGEMENT; CARDIOLOGY AB Background: Elderly patients represent a large proportion of patients admitted for acute coronary syndrome (ACS). Whether frailty-defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors-may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged >= 80 years admitted for ACS. Methods: This prospective observational study was conducted in patients aged 80 years or older admitted to a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS), which provides a score ranging from 0 (not frail) to 17 (very frail). The population was divided into 3 classes: EFS score 0-3, EFS score 4-6; and EFS score >7. Results: Two hundred thirty-six patients were included, with a mean follow-up duration of 470 days. The mean age was 85.9 years. Seventy-five patients died during the follow-up period. One hundred nineteen patients (50.4%) had an EFS score of 0-3, 68 patients (28.8%) had an EFS score of 4-6, and 49 patients (20.8%) had an EFS score >= 7. The all-cause mortality rate was 17.7% in the EFS 0-3 group, 35.3% in the EFS 4-6 group, and 61.2% in the EFS >= 7 group (P < 0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: the hazard ratio (HR) was 1.53 (95% confidence interval [CI], 0.74-3.16) in the EFS 4-6 group, and the HR was 3.60 (95% CI, 1.70-7.63) in the EFS >= 7 group. Conclusions: Frailty is a strong and independent prognostic factor for midterm all-cause mortality in elderly patients presenting with ACS. C1 [Blanco, Stephanie; Ferrieres, Jean; Sebai, Fatia; Billet, Sophie; Biendel, Caroline; Lairez, Olivier; Lhermusier, Thibault; Boudou, Nicolas; Campelo-Parada, Francisco; Roncalli, Jerome; Galinier, Michel; Carrie, Didier; Elbaz, Meyer; Bouisset, Frederic] Univ Hosp Toulouse, Dept Cardiol, Toulouse, France. [Ferrieres, Jean; Bongard, Vanina] Univ Toulouse 3, INSERM, UMR1027, Toulouse, France. [Ferrieres, Jean; Bongard, Vanina] Univ Hosp Toulouse, Dept Epidemiol, Toulouse, France. [Toulza, Olivier] Univ Hosp Toulouse, Dept Gerontol, Toulouse, France. C3 CHU de Toulouse; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Toulouse; Universite Toulouse III - Paul Sabatier; CHU de Toulouse; CHU de Toulouse RP Bouisset, F (通讯作者),Univ Hosp Toulouse, Dept Cardiol, Rangueil Hosp, TSA 50032, F-31059 Toulouse 9, France. EM bouisset.f@chu-toulouse.fr RI O, Lairez/B-7152-2016; Carrie, Didier/M-5781-2014; Ferrieres, Jean/S-7993-2016 OI O, Lairez/0000-0001-8141-6582; Ferrieres, Jean/0000-0001-6144-1297; GALINIER, Michel/0000-0003-1735-3390; ELBAZ, Meyer/0000-0002-3520-7883; lhermusier, thibault/0000-0002-4260-2339; Campelo-Parada, Francisco/0000-0003-1821-0658; CARRIE, didier/0000-0003-2479-8144 CR Afilalo J, 2014, J AM COLL CARDIOL, V63, P747, DOI 10.1016/j.jacc.2013.09.070 Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Salinas GLA, 2016, INT J CARDIOL, V222, P590, DOI 10.1016/j.ijcard.2016.07.268 Salinas GLA, 2016, EUR HEART J-ACUTE CA, V5, P434, DOI 10.1177/2048872616644909 Devlin G, 2008, EUR HEART J, V29, P1275, DOI 10.1093/eurheartj/ehn124 Ekerstad N, 2011, CIRCULATION, V124, P2397, DOI 10.1161/CIRCULATIONAHA.111.025452 Escaned J, 2007, EUR HEART J, V28, P634, DOI 10.1093/eurheartj/ehl491 Galasso G, 2015, AM J CARDIOL, V115, P576, DOI 10.1016/j.amjcard.2014.12.005 Graham MM, 2013, CAN J CARDIOL, V29, P1610, DOI 10.1016/j.cjca.2013.08.016 Hanssen M, 2012, HEART, V98, P699, DOI 10.1136/heartjnl-2012-301700 Hilmer SN, 2009, AUSTRALAS J AGEING, V28, P182, DOI 10.1111/j.1741-6612.2009.00367.x McCune C, 2015, CARDIOL THER, V4, P95, DOI 10.1007/s40119-015-0047-x Morici N, 2013, AM J CARDIOL, V112, P1, DOI 10.1016/j.amjcard.2013.02.043 O'Neill DE, 2016, CAN J CARDIOL, V32, P1132, DOI 10.1016/j.cjca.2016.05.003 Rittger H, 2012, CATHETER CARDIO INTE, V80, P735, DOI 10.1002/ccd.23426 Rolfson DB, 2006, AGE AGEING, V35, P526, DOI 10.1093/ageing/afl041 Sanchis J, 2015, CAN J CARDIOL, V31, P1462, DOI 10.1016/j.cjca.2015.07.737 Sanchis J, 2014, AM HEART J, V168, P784, DOI 10.1016/j.ahj.2014.07.022 Savonitto S, 2012, JACC-CARDIOVASC INTE, V5, P906, DOI 10.1016/j.jcin.2012.06.008 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 Theou O, 2013, J AM GERIATR SOC, V61, P1537, DOI 10.1111/jgs.12420 Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184 Zaman MJ, 2014, EUR HEART J, V35, P1551, DOI 10.1093/eurheartj/ehu039 NR 24 TC 33 Z9 34 U1 3 U2 12 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0828-282X EI 1916-7075 J9 CAN J CARDIOL JI Can. J. Cardiol. PD JUL PY 2017 VL 33 IS 7 BP 933 EP 939 DI 10.1016/j.cjca.2017.03.026 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FB2PF UT WOS:000405985000013 PM 28668143 DA 2023-05-13 ER PT J AU Feder, SL Schulman-Green, D Geda, M Williams, K Dodson, JA Nanna, MG Allore, HG Murphy, TE Tinetti, ME Gill, TM Chaudhry, SI AF Feder, Shelli L. Schulman-Green, Dena Geda, Mary Williams, Kathleen Dodson, John A. Nanna, Michael G. Allore, Heather G. Murphy, Terrence E. Tinetti, Mary E. Gill, Thomas M. Chaudhry, Sarwat I. TI Physicians' perceptions of the Thrombolysis in Myocardial Infarction (TIMI) risk score in older adults with acute myocardial infarction SO HEART & LUNG LA English DT Article DE Myocardial infarction; Aging; Risk factors; Older adult; Risk stratification model ID ACUTE CORONARY SYNDROMES; STRATIFICATION; CARE; CARDIOLOGY; MORTALITY; OUTCOMES; FRAILTY; EVENTS; TRIALS; WOMEN AB Objectives: To evaluate physician-perceived strengths and limitations of the Thrombolysis in Myocardial Infarction (TIMI) risk scores for use in older adults with acute myocardial infarction (AMI). Background: The TIMI risk scores are risk stratification models developed to estimate mortality risk for patients hospitalized for AMI. However, these models were developed and validated in cohorts underrepresenting older adults (>= 75 years). Methods: Qualitative study using semi-struftured telephone interviews and the constant comparative method for analysis. Results: Twenty-two physicians completed interviews ranging 10-30 min (mean = 18 min). Median sample age was 37 years, with a median of 11.5 years of clinical experience. TIMI strengths included familiarity, ease of use, and validation. Limitations included a lack of risk factors relevant to older adults and model scope and influence. Conclusions: Physicians report that the TIMI models, while widely used in clinical practice, have limitations when applied to older adults. New risk models are needed to guide AMI treatment in this population. (c) 2015 Elsevier Inc. All rights reserved. C1 [Feder, Shelli L.; Schulman-Green, Dena] Yale Univ, Sch Nursing, West Haven, CT 06516 USA. [Geda, Mary; Williams, Kathleen; Allore, Heather G.] Yale Univ, Sch Med, Program Aging, New Haven, CT 06510 USA. [Dodson, John A.] NYU, Sch Med, Dept Med, Leon H Charney Div Cardiol, New York, NY 10016 USA. [Nanna, Michael G.] Yale New Haven Hosp, Dept Internal Med, New Haven, CT 06520 USA. [Murphy, Terrence E.; Gill, Thomas M.] Yale Univ, Sch Med, Div Geriatr, New Haven, CT 06520 USA. [Tinetti, Mary E.] Yale Univ, Sch Publ Hlth, New Haven, CT 06520 USA. [Chaudhry, Sarwat I.] Yale Univ, Sch Med, Dept Gen Internal Med, New Haven, CT 06520 USA. C3 Yale University; Yale University; New York University; Yale University; Yale University; Yale University; Yale University RP Feder, SL (通讯作者),Yale Univ, Sch Nursing, POB 27399, West Haven, CT 06516 USA. EM shelli.feder@yale.edu RI Nanna, Michael/AAG-4777-2020; Gill, Thomas M./H-7043-2019 OI Gill, Thomas M./0000-0002-6450-0368; Allore, Heather/0000-0001-7685-8175; Nanna, Michael/0000-0002-5487-4542; Geda, Mary/0000-0002-9129-4432; Feder, Shelli/0000-0002-8059-9281 FU National Heart, Lung, and Blood Institute of the National Institutes of Health [R01HL115295]; National Institute on Aging [K07AG3587]; Yale Program on Aging/Claude D. Pepper Older Americans Independence Center [P30 AG21342] FX This research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (R01HL115295) and was conducted at the Yale Program on Aging/Claude D. Pepper Older Americans Independence Center (P30 AG21342). Dr. Gill (Yale University) is the recipient of an Academic Leadership Award (K07AG3587) from the National Institute on Aging. 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Lawesson, Sofia Sederholm Karlsson, Jan-Erik Nilsson, Staffan Thylen, Ingela CA SymTime Study Grp TI Characteristics of patients with acute myocardial infarction contacting primary healthcare before hospitalisation: a cross-sectional study SO BMC FAMILY PRACTICE LA English DT Article DE Chest pain; Myocardial infarction; Primary healthcare; Pre-hospital delay ID ACUTE CORONARY SYNDROME; ST-SEGMENT ELEVATION; PREHOSPITAL DELAY; CHEST-PAIN; INVASIVE STRATEGY; GUIDELINES; TIME; ESC; PREDICTORS; MANAGEMENT AB Background: The characteristics of patients with on-going myocardial infarction (MI) contacting the primary healthcare (PHC) centre before hospitalisation are not well known. Prompt diagnosis is crucial in patients with MI, but many patients delay seeking medical care. The aims of this study was to 1) describe background characteristics, symptoms, actions and delay times in patients contacting the PHC before hospitalisation when falling ill with an acute MI, 2) compare those patients with acute MI patients not contacting the PHC, and 3) explore factors associated with a PHC contact in acute MI patients. Methods: This was a cross-sectional multicentre study, enrolling consecutive patients with MI within 24 hours of admission to hospital from Nov 2012 until Feb 2014. Results: A total of 688 patients with MI, 519 men and 169 women, were included; the mean age was 66 +/- 11 years. One in five people contacted PHC instead of the recommended emergency medical services (EMS), and 94% of these patients experienced cardinal symptoms of an acute MI; i.e., chest pain, and/or radiating pain in the arms, and/or cold sweat. Median delay time from symptom-onset-to-decision-to-seek-care was 2:15 hours in PHC patients and 0:40 hours in non-PHC patients (p<0.01). The probability of utilising the PHC before hospitalisation was associated with fluctuating symptoms (OR 1.74), pain intensity (OR 0.90) symptoms during off-hours (OR 0.42), study hospital (OR 3.49 and 2.52, respectively, for two of the county hospitals) and a final STEMI diagnosis (OR 0.58). Conclusions: Ambulance services are still underutilized in acute MI patients. A substantial part of the patients contacts their primary healthcare centre before they are diagnosed with MI, although experiencing cardinal symptoms such as chest pain. There is need for better knowledge in the population about symptoms of MI and adequate pathways to qualified care. Knowledge and awareness amongst primary healthcare professionals on the occurrence of MI patients is imperative. C1 [Andersson, Per O.; Nilsson, Staffan] Linkoping Univ, Primary Hlth Care, Linkoping, Sweden. [Andersson, Per O.; Lawesson, Sofia Sederholm; Karlsson, Jan-Erik; Nilsson, Staffan; Thylen, Ingela] Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden. [Lawesson, Sofia Sederholm; Thylen, Ingela] Linkoping Univ, Dept Cardiol, Linkoping, Sweden. [Karlsson, Jan-Erik] Dept Internal Med, Jonkoping, Region Jonkopin, Sweden. [Andersson, Per O.] Ljungsbro Hlth Care Ctr, Evastigen 9, S-59071 Ljungsbro, Ljungsbro, Sweden. C3 Linkoping University; Linkoping University; Linkoping University RP Andersson, PO (通讯作者),Linkoping Univ, Primary Hlth Care, Linkoping, Sweden.; Andersson, PO (通讯作者),Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.; Andersson, PO (通讯作者),Ljungsbro Hlth Care Ctr, Evastigen 9, S-59071 Ljungsbro, Ljungsbro, Sweden. EM per.o.andersson@liu.se OI andersson, per/0000-0003-1295-7347 FU Medical Research Council of Southeast Sweden (FORSS); Region Ostergotland, ALF FX This study was funded with grants from the Medical Research Council of Southeast Sweden (FORSS) and the Region Ostergotland, ALF. CR Aerts M, 2016, J CLIN EPIDEMIOL Albarqouni L, 2016, PATIENT EDUC COUNS, V99, P1845, DOI 10.1016/j.pec.2016.06.007 Andersson Per O, 2015, BMC Res Notes, V8, P210, DOI 10.1186/s13104-015-1174-0 World Medical Association, 2013, JAMA, V310, P2191, DOI 10.1001/jama.2013.281053 Austin D, 2014, EUR HEART J-ACUTE CA, V3, P214, DOI 10.1177/2048872614527011 Boothroyd LJ, 2014, AM J CARDIOL, V114, P1289, DOI 10.1016/j.amjcard.2014.07.060 Bray JE, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.001927 BUNTINX F, 1991, FAM PRACT, V8, P121, DOI 10.1093/fampra/8.2.121 Dracup K, 2009, CIRC-CARDIOVASC QUAL, V2, P524, DOI 10.1161/CIRCOUTCOMES.109.852608 Fanaroff Alexander C, 2015, JAMA, V314, P1990, DOI 10.1001/jama.2015.12743 Fanaroff AC, 2015, JAMA-J AM MED ASSOC, V314, P1955, DOI 10.1001/jama.2015.12735 Gencer B, 2010, BMC MED, V8, DOI 10.1186/1741-7015-8-9 Haasenritter J, 2012, BMC FAM PRACT, V13, DOI 10.1186/1471-2296-13-81 Hoglund H, 2014, RESUSCITATION, V85, P864, DOI 10.1016/j.resuscitation.2014.03.300 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Johansson I, 2004, HEART LUNG, V33, P291, DOI 10.1016/j.hrtlng.2004.04.002 Katritsis DG, 2011, EUR HEART J, V32, P32, DOI 10.1093/eurheartj/ehq276 Kaul P, 2011, AM HEART J, V161, DOI 10.1016/j.ahj.2010.09.016 Kerr D, 2006, EMERG MED J, V23, P948, DOI 10.1136/emj.2006.038414 Kirchberger I, 2016, J CARDIOVASC NURS Marshall GA, 2014, MED J AUSTRALIA, V201, P155, DOI 10.5694/mja13.00173 McKee G, 2013, INT J CARDIOL, V168, P2706, DOI 10.1016/j.ijcard.2013.03.022 Milasinovic D, 2015, ATHEROSCLEROSIS, V241, P48, DOI 10.1016/j.atherosclerosis.2015.04.808 Mooney M, 2012, EUR J CARDIOVASC NUR, V11, P445, DOI 10.1016/j.ejcnurse.2011.04.003 Navarese EP, 2013, ANN INTERN MED, V158, P261, DOI 10.7326/0003-4819-158-4-201302190-00006 Nilsson G, 2016, BMC CARDIOVASC DISOR, V16, DOI 10.1186/s12872-016-0271-x Nilsson Staffan, 2013, Int J Family Med, V2013, P532093, DOI 10.1155/2013/532093 Nilsson Staffan, 2008, Eur J Gen Pract, V14, P50, DOI 10.1080/13814780802342622 Piepoli Massimo F, 2016, Rev Esp Cardiol (Engl Ed), V69, P939, DOI 10.1016/j.rec.2016.09.009 Steg PG, 2013, HEART, V99, P1156, DOI 10.1136/heartjnl-2013-304498 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Svavarsdottir AE, 1996, CAN FAM PHYSICIAN, V42, P1122 Thylen I, 2015, BMJ OPEN, V5, DOI 10.1136/bmjopen-2014-007059 Ting HH, 2008, ARCH INTERN MED, V168, P959, DOI 10.1001/archinte.168.9.959 Verdon F, 2007, BMC FAM PRACT, V8, DOI 10.1186/1471-2296-8-51 Windecker S, 2015, EUROINTERVENTION, V10, P1024, DOI 10.4244/EIJY14M09_01 NR 36 TC 6 Z9 7 U1 0 U2 8 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND EI 1471-2296 J9 BMC FAM PRACT JI BMC Fam. Pract. PD OCT 10 PY 2018 VL 19 AR 167 DI 10.1186/s12875-018-0849-8 PG 8 WC Primary Health Care; Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA GW7LQ UT WOS:000447149900001 PM 30305077 OA Green Published, gold DA 2023-05-13 ER PT J AU Li, YE Wang, SY Reiter, RJ Ren, J AF Li, Yiran E. Wang, Shuyi Reiter, Russel J. Ren, Jun TI Clinical cardiovascular emergencies and the cellular basis of COVID-19 vaccination: from dream to reality? SO INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES LA English DT Review DE SARS-CoV-2; COVID-19 vaccines; Cardiovascular; Myocarditis; Pericarditis; Thrombotic thrombocytopenia ID SARS-COV-2; OUTCOMES AB Objectives: SARS-CoV-2 is responsible for the global COVID-19 pandemic, with little prevention or treat-ment options. More than 600 million mortalities have been documented from SARS-CoV-2 infection, with the majority of fatalities occurring among elderly patients (aged > 65 years). A number of vaccines have been developed in an effort to restrain the rapid spread of SARS-CoV-2. Considering the widespread administration of these vaccines, substantial side or undesired effects in multiple organ systems have emerged, necessitating essential critical care. Herein, we tabulate the adverse cardiovascular responses resulting from COVID-19 vaccines. Design or Methods: We searched PubMed for articles published through April, 2022, with the terms "SARS-CoV-2", "COVID-19", "cardiovascular", "SARS-CoV-2 vaccines", "COVID-19 vaccines", "myocarditis", "pericarditis", "thrombosis", "thrombocytopenia", "vaccine-induced thrombotic thrombocytopenia", "acute coronary syndrome", "myocardial infarction", "hypertension", "arrythmia", "postural orthostatic tachycar-dia syndrome", "Takotsubo cardiomyopathy", "cardiac arrest" and "death". We mainly selected publica-tions from the past 3 years, but did not exclude widely referenced and highly regarded older publications. Besides, we searched the reference lists of articles identified by above search method and chose those we considered relevant.Results: COVID-19 vaccines evoke rare but fatal thrombotic events, whereas messenger RNA \ 055based vaccines appear to be associated with risks of pericarditis/myocarditis, with the latter being more pre-dominant in young adults following the second dose. Reports of other cardiovascular responses, including hypertension, arrhythmia, acute coronary syndrome, and cardiac arrest, have also been indicated.Conclusion: The undesired cardiovascular complications remain infrequent, giveng the large number of vaccinations inoculated to general population. And lower mortality takes precedence over the undesired cardiovascular complications.(c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.This is an open access article under the CC BY license( http://creativecommons.org/licenses/by/4.0/ ) C1 [Li, Yiran E.; Ren, Jun] Fudan Univ, Zhongshan Hosp, Shanghai Inst Cardiovasc Dis, Dept Cardiol, Shanghai 200032, Peoples R China. [Wang, Shuyi] Tongji Univ, Shanghai Peoples Hosp 10, Dept Emergency, Shanghai 200072, Peoples R China. [Reiter, Russel J.] UT Hlth San Antonio, Dept Cellular & Struct Biol, San Antonio, TX USA. C3 Fudan University; Tongji University; University of Texas System; University of Texas Health San Antonio RP Ren, J (通讯作者),Fudan Univ, Zhongshan Hosp, Shanghai Inst Cardiovasc Dis, Dept Cardiol, Shanghai 200032, Peoples R China. EM jren_aldh2@outlook.com RI Ren, Jun/ACG-5366-2022 OI Ren, Jun/0000-0002-0275-0783 FU Natural Sci- ence Foundation of China; [820 0 0351] FX Funding Work in our groups was supported in part by the Natural Sci- ence Foundation of China (820 0 0351) . 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J. Infect. Dis. PD NOV PY 2022 VL 124 BP 1 EP 10 DI 10.1016/j.ijid.2022.08.026 PG 10 WC Infectious Diseases WE Science Citation Index Expanded (SCI-EXPANDED) SC Infectious Diseases GA 5B6TQ UT WOS:000863702000001 PM 36075372 OA Green Published, gold DA 2023-05-13 ER PT J AU Chakraborty, S Bandyopadhyay, D Amgai, B Sidhu, JS Paudel, R Koirala, S Hajra, A Ghosh, RK Lavie, CJ AF Chakraborty, Sandipan Bandyopadhyay, Dhrubajyoti Amgai, Birendra Sidhu, Jasdeep Singh Paudel, Rabin Koirala, Soniya Hajra, Adrija Ghosh, Raktim K. Lavie, Carl J. TI Does Insurance Effect the Outcome in Patients With Acute Coronary Syndrome?: An Insight from the Most Recent National Inpatient Sample SO CURRENT PROBLEMS IN CARDIOLOGY LA English DT Review ID ACUTE MYOCARDIAL-INFARCTION; PRACTICE GUIDELINES COMMITTEE; ASSOCIATION TASK-FORCE; ETHNIC DISPARITIES; AMERICAN-COLLEGE; UNSTABLE ANGINA; CARE; QUALITY; MANAGEMENT; MORTALITY AB Several studies have shown disparities in outcome in the patients with Acute coronary syndrome (ACS) based on several factors. Treatment might differ based on insurance type. Therefore, we retrospectively analyzed National Inpatient Sample (NIS 2016) data to identify the impact of different types of insurances on mortality outcome in patients admitted with ACS. ICD-CM-10 codes were used to identify hospital discharges with a principal diagnosis of ACS. Observations were stratified based on insurance (Medicare, Medicaid, Private, and No insurance). Primary and secondary outcomes were in-hospital mortality, length of stay and total cost. Any potential confounders were adjusted using multivariate logistic regression. STATA/IC 15.1 Stata Corp LLC was used for analysis. A total of 8,01,195 hospitalizations with the primary diagnosis of ACS were identified, of which 59.2% had Medicare, 9.72% had Medicaid, 26.8% had Private insurance, and 4.3% had no insurance. Higher odds of mortality were seen in the patients with Medicare, Medicaid, and Noninsured group. Adjusted Odds ratio for mortality in Medicare was 1.01 (confidence interval [CI]: 0.94-1.1; P = 0.65), in Medicaid was 1.16 (CI: 1.03-1.30; P = 0.01) and in uninsured group was 1.46 (CI: 1.26-1.69; P <= 0.01). However, the patients with private insurance adjusted odds ratio for mortality were 0.77 (CI: 0.70-0.84; P <= 0.01) compared to the patients with other insurance groups. Above results show that the disparity exists in the outcome of patients admitted with ACS based on their insurance types, particularly for Medicaid patients. We need further studies to understand the root cause of this disparity. 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Probl. Cardiol. PD JAN PY 2021 VL 46 IS 1 AR 100411 DI 10.1016/j.cpcardiol.2019.02.003 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA PA1DZ UT WOS:000595359900001 PM 30917889 DA 2023-05-13 ER PT J AU Lemor, A Hernandez, GA Patel, N Blumer, V Sud, K Cohen, MG De Marchena, E Kini, AS Sharma, SK Alfonso, CE AF Lemor, Alejandro Hernandez, Gabriel A. Patel, Nish Blumer, Vanessa Sud, Karan Cohen, Mauricio G. De Marchena, Eduardo Kini, Annapoorna S. Sharma, Samin K. Alfonso, Carlos E. TI Predictors and etiologies of 30-day readmissions in patients with non-ST-elevation acute coronary syndrome SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE Myocardial infarction; NSTE-ACS; readmission ID SELECTIVE INVASIVE STRATEGIES; MYOCARDIAL-INFARCTION; HOSPITAL READMISSIONS; HEART-FAILURE; REHOSPITALIZATIONS; METAANALYSIS; ASSOCIATION; ROUTINE; TRENDS; WOMEN AB Background Despite improvements in acute care and survival after non-ST-elevation acute coronary syndrome (NSTE-ACS) hospitalization, early readmissions remain common, and have significant clinical and financial impact. Objectives Determine the predictors and etiologies of 30-day readmissions in NSTE-ACS. Method The study cohort was derived from the National Readmission Database 2014 identifying patients with a primary diagnosis of NSTE-ACS using ICD9 code. Results We identified a total of 300,269 patients admitted with NSTE-ACS; 13.4% were readmitted within 30-day. The most common cause of readmission was heart failure (HF) (15.6%), followed by a recurrent myocardial infarction (MI) (10%). Predictors of increased readmissions were age >= 75 years (OR: 1.34, 95% CI: 1.30-1.39), female gender (OR 1.12, 95% CI 1.09-1.16), a Charlson Comorbidity Index (CCI) >3 (OR 2.11, 95% CI: 2.04-2.18), ESRD (OR 2.01, 95% CI 1.89-2.14), CKD (OR: 1.58, 95% CI: 1.51-1.64), length of stay >= 5 days (OR: 1.51, 95% CI 1.46-1.56) and adverse events during the index admission such as AKI (OR:1.31, 95% CI: 1.25-1.36), major bleeding (OR:1.20, 95% CI: 1.12-1.24); whereas admission to a teaching hospital (OR 0.92, 95% CI 0.89-0.95) and PCI (OR 0.70, 95% CI 0.67-0.72) were associated with less likelihood of 30-day readmission. Conclusion Readmission rate at 30-days is high among NSTE-ACS patients and the most common readmission etiologies are HF and recurrent MI. A CCI more than 3 and ESRD were the most significant predictors for readmission; patients undergoing PCI had less odds of readmission. C1 [Lemor, Alejandro; Sud, Karan] St Lukes Mt Sinai West Hosp, Icahn Sch Med Mt Sinai, Dept Med, Internal Med, New York, NY USA. [Hernandez, Gabriel A.] Vanderbilt Univ, Med Ctr, Dept Med, Cardiovasc Div, Nashville, TN USA. [Patel, Nish; Kini, Annapoorna S.; Sharma, Samin K.] Icahn Sch Med Mt Sinai, Dept Med, Cardiovasc Div, New York, NY 10029 USA. [Blumer, Vanessa; Cohen, Mauricio G.; De Marchena, Eduardo; Alfonso, Carlos E.] Univ Miami, Miller Sch Med, Dept Med, Cardiovasc Div, Miami, FL 33136 USA. C3 Icahn School of Medicine at Mount Sinai; Mount Sinai St. Luke's; Mount Sinai West; Vanderbilt University; Icahn School of Medicine at Mount Sinai; University of Miami RP Hernandez, GA (通讯作者),Vanderbilt Univ, Med Ctr, Dept Med, Div Cardiol, 1215 21st Ave South,Med Ctr East Off 5037, Nashville, TN 37232 USA. 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Cardiovasc. Interv. PD FEB 15 PY 2019 VL 93 IS 3 BP 373 EP 379 DI 10.1002/ccd.27838 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HL7IX UT WOS:000458914900021 PM 30280472 DA 2023-05-13 ER PT J AU Charfeddine, S Amor, HI Jdidi, J Torjmen, S Kraiem, S Hammami, R Bahloul, A Kallel, N Moussa, N Touil, I Ghrab, A Elghoul, J Meddeb, Z Thabet, Y Kammoun, S Bouslama, K Milouchi, S Abdessalem, S Abid, L AF Charfeddine, Salma Ibn Hadj Amor, Hassen Jdidi, Jihen Torjmen, Slim Kraiem, Salma Hammami, Rania Bahloul, Amine Kallel, Nesrine Moussa, Nedia Touil, Imen Ghrab, Aiman Elghoul, Jamel Meddeb, Zineb Thabet, Yamina Kammoun, Samir Bouslama, Kamel Milouchi, Sami Abdessalem, Salem Abid, Leila TI Long COVID 19 Syndrome: Is It Related to Microcirculation and Endothelial Dysfunction? Insights From TUN-EndCOV Study SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Article DE COVID-19; long COVID-19 syndrome; endothelial function; microcirculation; endothelium ID PATHOPHYSIOLOGY AB The COVID-19 disease is a multisystem disease due in part to the vascular endothelium injury. Lasting effects and long-term sequelae could persist after the infection and may be due to persistent endothelial dysfunction. Our study focused on the evaluation of endothelial quality index (EQI) by finger thermal monitoring with E4 diagnosis Polymath in a large cohort of long COVID-19 patients to determine whether long-covid 19 symptoms are associated with endothelial dysfunction. This is a cross-sectional multicenter observational study with prospective recruitment of patients. A total of 798 patients were included in this study. A total of 618 patients (77.4%) had long COVID-19 symptoms. The mean EQI was 2.02 +/- 0.99 IC95% [1.95-2.08]. A total of 397 (49.7%) patients had impaired EQI. Fatigue, chest pain, and neuro-cognitive difficulties were significantly associated with endothelium dysfunction with an EQI <2 after adjustment for age, sex, diabetes, hypertension, dyslipidemia, coronary heart disease, and the severity of acute COVID-19 infection. In multivariate analysis, endothelial dysfunction (EQI <2), female gender, and severe clinical status at acute COVID-19 infection with a need for oxygen supplementation were independent risk factors of long COVID-19 syndrome. Long COVID-19 symptoms, specifically non-respiratory symptoms, are due to persistent endothelial dysfunction. These findings allow for better care of patients with long COVID-19 symptoms. C1 [Charfeddine, Salma; Torjmen, Slim; Hammami, Rania; Bahloul, Amine; Kammoun, Samir; Abid, Leila] Hedi Chaker Univ Hosp Sfax, Dept Cardiol, Sfax, Tunisia. [Charfeddine, Salma; Jdidi, Jihen; Torjmen, Slim; Hammami, Rania; Bahloul, Amine; Kallel, Nesrine; Moussa, Nedia; Elghoul, Jamel; Kammoun, Samir; Milouchi, Sami; Abid, Leila] Univ Sfax, Univ Med Sfax, Sfax, Tunisia. [Ibn Hadj Amor, Hassen; Kraiem, Salma] Tahar Sfar Hosp Mahdia, Dept Cardiol, Sfax, Tunisia. [Jdidi, Jihen] Hedi Chaker Univ Hosp Sfax, Dept Prevent Med, Sfax, Tunisia. [Kallel, Nesrine; Moussa, Nedia] Hedi Chaker Univ Hosp Sfax, Dept Pneumol, Sfax, Tunisia. [Touil, Imen] Tahar Sfar Hosp Mahdia, Dept Pneumol, Mahdia, Tunisia. [Ghrab, Aiman; Milouchi, Sami] Habib Bourguiba Hosp Medenine, Dept Cardiol, Sfax, Tunisia. [Elghoul, Jamel] Habib Bourguiba Hosp Medenine, Dept Pneumol, Sfax, Tunisia. [Meddeb, Zineb; Thabet, Yamina; Bouslama, Kamel] Mongi Slim LaMarsa Hosp, Dept Internal Med, Tunis, Tunisia. [Abdessalem, Salem] Clin Pasteur Tunis, Tunis, Tunisia. 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Cardiovasc. Med. PD NOV 30 PY 2021 VL 8 AR 745758 DI 10.3389/fcvm.2021.745758 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA XO0ZU UT WOS:000729924200001 PM 34917659 OA gold, Green Published DA 2023-05-13 ER PT J AU Zheng, B Jiang, J Liu, HL Zhang, J Li, H Su, X Wang, HC Song, ZY Han, YL Lei, H Cong, HL Zhang, Z Ma, YT Wang, JA Xu, B Sun, YX Gao, CY Zheng, Y Liu, B Huang, DJ Li, B Huang, CX Yang, TL Wan, Z Jia, SB Chen, DF Ge, JB Huo, Y AF Zheng, Bo Jiang, Jie Liu, Huiliang Zhang, Jun Li, Hui Su, Xi Wang, Haichang Song, Zhiyuan Han, Yaling Lei, Han Cong, Hongliang Zhang, Zheng Ma, Yitong Wang, Jian'an Xu, Biao Sun, Yingxian Gao, Chuanyu Zheng, Yang Liu, Bin Huang, Dejia Li, Bao Huang, Congxin Yang, Tianlun Wan, Zheng Jia, Shaobin Chen, Dafang Ge, Junbo Huo, Yong TI Efficacy and safety of serial atorvastatin load in Chinese patients undergoing elective percutaneous coronary intervention: results of the ISCAP (Intensive Statin Therapy for Chinese Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention) randomized controlled trial SO EUROPEAN HEART JOURNAL SUPPLEMENTS LA English DT Article DE Atorvastatin; Percutaneous coronary intervention; Periprocedural myocardial infarction ID TREATMENT PLATELET REACTIVITY; CLOPIDOGREL RESPONSIVENESS; OUTCOMES; GENE; ASPIRIN; IMPACT AB Although several studies have suggested that intensive statin pretreatment could reduce the incidence of procedure-related myocardial infarction in western population, the data on the effect in Asian patients have been still limited. The aim of the study was to investigate the efficacy and safety of intensive atorvastatin load in Chinese patients undergoing elective PCI. A total of 1202 patients with stable angina or non-ST-segment elevation acute coronary syndrome (NSTE-ACS) scheduled to undergo PCI received either intensive statin treatment (80 mg atorvastatin daily x 2 days before PCI and 40 mg daily x 30 days after PCI) or usual care. The primary endpoint was incidence of major adverse cardiac events (cardiac death, myocardial infarction, or unexpected target vessel revascularization) within 30 days after PCI. Safety endpoints include the incidence of contrast induced nephropathy (CIN), ALT/AST >3 upper limit of normal (ULN), CK >5 ULN. The incidence of 30-day MACE did not significantly differ between the intensive group and control group (19.4 vs 18.3%, P = 0.63). Multivariate analysis revealed age (OR = 1.024, 95% CI 1.003-1.045, P = 0.023) and total stent length as an independent predictor of 30-day MACE (OR = 1.012, 95% CI 1.007-1.018, P < 0.0001). The incidence of CIN was comparable between intensive group and control group (4.09 vs 4.39%, P = 0.795). No significant differences were observed in other safety profile at all follow-ups between treatment groups. The ISCAP trial demonstrated that serial intensive atorvastatin therapy did not improve the clinical outcome with similar safety profile comparing with usual care among Chinese patients undergoing elective PCI. C1 [Zheng, Bo; Jiang, Jie; Huo, Yong] Peking Univ, Hosp 1, Dept Cardiol, Beijing 100034, Peoples R China. [Liu, Huiliang] Chinese Peoples Armed Police Forces, Gen Hosp, Dept Cardiol, Beijing, Peoples R China. [Zhang, Jun] HeBei Med Univ, Affiliated Hosp, Dept Cardiol, Cangzhou Cent Hosp, Cangzhou, Hebei, Peoples R China. [Li, Hui] Daqing Oilfield Gen Hosp, Dept Cardiol, Harbin, Peoples R China. [Su, Xi] Wuhan Asia Heart Hosp, Dept Cardiol, Wuhan, Hubei, Peoples R China. [Wang, Haichang] Fourth Mil Med Univ, Xijing Hosp, Dept Cardiol, Xian 710032, Shanxi, Peoples R China. [Song, Zhiyuan] Third Mil Med Univ, Southwest Hosp, Dept Cardiol, Chongqing, Peoples R China. [Han, Yaling] Gen Hosp Shenyang Mil Reg, Dept Cardiol, Shenyang, Liaoning, Peoples R China. [Lei, Han] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China. [Cong, Hongliang] Tianjin Chest Hosp, Dept Cardiol, Tianjin, Peoples R China. [Zhang, Zheng] Lanzhou Univ, Affiliated Hosp 1, Dept Cardiol, Lanzhou 730000, Gansu, Peoples R China. [Ma, Yitong] Xinjiang Med Univ, Affiliated Hosp 1, Dept Cardiol, Urumqi, Xinjiang, Peoples R China. [Wang, Jian'an] Zhejiang Univ, Affiliated Hosp 2, Dept Cardiol, Coll Med, Hangzhou 310003, Zhejiang, Peoples R China. [Xu, Biao] Nanjing Univ, Sch Med, Dept Cardiol, Gulou Hosp, Nanjing 210008, Jiangsu, Peoples R China. [Sun, Yingxian] China Med Univ, Hosp 1, Dept Cardiol, Shenyang, Liaoning, Peoples R China. [Gao, Chuanyu] Henan Prov Peoples Hosp, Dept Cardiol, Zhengzhou, Henan, Peoples R China. [Zheng, Yang] Jilin Univ, Hosp 1, Dept Cardiol, Changchun 130023, Jilin, Peoples R China. [Liu, Bin] Jilin Univ, Hosp 2, Dept Cardiol, Changchun 130023, Jilin, Peoples R China. [Huang, Dejia] Sichuan Univ, West China Hosp, Dept Cardiol, Chengdu 610064, Sichuan, Peoples R China. [Li, Bao] Shanxi Cardiovasc Hosp, Dept Cardiol, Taiyuan, Shanxi, Peoples R China. [Huang, Congxin] Wuhan Univ, Renmin Hosp, Dept Cardiol, Wuhan 430072, Hubei, Peoples R China. [Yang, Tianlun] Cent S Univ, Xiangya Hosp, Dept Cardiol, Changsha, Hunan, Peoples R China. [Wan, Zheng] Tianjin Med Univ, Gen Hosp, Dept Cardiol, Tianjin, Peoples R China. [Jia, Shaobin] Ningxia Med Coll, Affiliated Hosp, Dept Cardiol, Ningxia, Yinchuan, Peoples R China. [Chen, Dafang] Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing 100034, Peoples R China. [Ge, Junbo] Fudan Univ, Zhongshan Hosp, Dept Cardiol, Shanghai 200433, Peoples R China. C3 Peking University; Hebei Medical University; Air Force Military Medical University; Army Medical University; Chongqing Medical University; Lanzhou University; Xinjiang Medical University; Zhejiang University; Nanjing University; China Medical University; Zhengzhou University; Jilin University; Jilin University; Sichuan University; Wuhan University; Central South University; Tianjin Medical University; Ningxia Medical University; Peking University; Fudan University RP Huo, Y (通讯作者),Peking Univ, Hosp 1, Dept Cardiol, 8 Xishiku St, Beijing 100034, Peoples R China. EM huoyong@263.net.cn OI Han, Yaling/0000-0003-4569-6737 FU National Key Technology R&D Program in the 12th Five-year Plan of China [2011BAI11B07, 2012ZX093016-002] FX This work was supported by grants from National Key Technology R&D Program in the 12th Five-year Plan of China (Grant number: 2011BAI11B07 & 2012ZX093016-002). 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Heart J. Suppl. PD MAR PY 2015 VL 17 IS B BP B47 EP B56 DI 10.1093/eurheartj/suv021 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CM7LB UT WOS:000357873000004 OA Bronze DA 2023-05-13 ER PT J AU Lim, GEH Tang, A Chin, YH Yong, JN Tan, DR Tay, P Chan, YY Lim, DMW Yeo, JW Chan, KE Devi, K Ong, CEC Foo, RSY Tan, HC Chan, MY Ho, R Loh, PH Chew, NWS AF Lim, Grace En Hui Tang, Ansel Chin, Yip Han Yong, Jie Ning Tan, Darren Tay, Phoebe Chan, Yu Yi Lim, Denzel Ming Wei Yeo, Jun Wei Chan, Kai En Devi, Kamala Ong, Colin Eng Choon Foo, Roger S. Y. Tan, Huay-Cheem Chan, Mark Y. Y. Ho, Roger Loh, Poay Huan Chew, Nicholas W. S. TI A network meta-analysis of 12,116 individuals from randomized controlled trials in the treatment of depression after acute coronary syndrome SO PLOS ONE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; HEART-DISEASE; ELECTROCONVULSIVE-THERAPY; ENHANCING RECOVERY; MAJOR DEPRESSION; MENTAL-HEALTH; FATTY-ACIDS; INTERVENTION; SYMPTOMS; EFFICACY AB BackgroundPost-acute coronary syndrome (ACS) depression is a common but not well understood complication experienced by ACS patients. Research on the effectiveness of various therapies remains limited. Hence, we sought to conduct a network meta-analysis to assess the efficacy of different interventions for post-ACS depression in improving patient outcomes. Methods and findingsThree electronic databases were searched for randomised controlled trials describing different depression treatment modalities in post-ACS patients. Each article was screened based on inclusion criteria and relevant data were extracted. A bivariate analysis and a network meta-analysis was performed using risk ratios (RR) and standardized mean differences (SMD) for binary and continuous outcomes, respectively.A total of 30 articles were included in our analysis. Compared to standard care, psychosocial therapy was associated with the greatest reduction in depression scores (SMD:-1.21, 95% CI: -1.81 to -0.61, p<0.001), followed by cognitive behavioural therapy (CBT) (SMD: -0.75, 95% CI: -0.99 to -0.52, p<0.001), antidepressants (SMD: -0.73, 95% CI: -1.14 to -0.31, p<0.001), and lastly, combination therapy (SMD: -0.15, 95% CI: -0.28 to -0.03, p = 0.016). No treatment modalities was found to be more effective in reducing depression scores when compared to one another. Additional analysis showed that these treatment modalities did not have significant impact on the overall mortality, cardiac mortality and recurrent myocardial infarction. ConclusionThis network meta-analysis found that the treatment effect of the various psychological modalities on depression severity were similar. Future trials on psychological interventions assessing clinical outcomes and improvement in adherence to ACS-specific interventions are needed. C1 [Lim, Grace En Hui] Nanyang Technol Univ, Lee Kong Chian Sch Med, Singapore, Singapore. [Tang, Ansel; Chin, Yip Han; Yong, Jie Ning; Tan, Darren; Tay, Phoebe; Chan, Yu Yi; Lim, Denzel Ming Wei; Yeo, Jun Wei; Chan, Kai En; Foo, Roger S. Y.; Tan, Huay-Cheem; Chan, Mark Y. Y.; Loh, Poay Huan] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore. [Devi, Kamala] Natl Univ Singapore, Alice Lee Ctr Nursing Studies, Yong Loo Lin Sch Med, Singapore, Singapore. [Ong, Colin Eng Choon] Ng Teng Fong Gen Hosp, Dept Emergency Med, Singapore, Singapore. [Foo, Roger S. Y.; Tan, Huay-Cheem; Chan, Mark Y. Y.; Loh, Poay Huan; Chew, Nicholas W. S.] Natl Univ Singapore Hosp, Natl Univ Heart Ctr, Dept Cardiol, Singapore, Singapore. [Ho, Roger] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Psychol Med, Singapore, Singapore. [Ho, Roger] Natl Univ Singapore, Inst Hlth Innovat & Technol iHealthtech, Singapore, Singapore. C3 Nanyang Technological University & National Institute of Education (NIE) Singapore; Nanyang Technological University; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore RP Chin, YH (通讯作者),Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore.; Chew, NWS (通讯作者),Natl Univ Singapore Hosp, Natl Univ Heart Ctr, Dept Cardiol, Singapore, Singapore. 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Montori, Victor M. Shah, Nilay D. Ting, Henry H. Pencille, Laurie J. Demers, Michel Kline, Jeffrey A. Diercks, Deborah B. Hollander, Judd E. Torres, Carlos A. Schaffer, Jason T. Herrin, Jeph Branda, Megan Leblanc, Annie Hess, Erik P. TI Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial SO TRIALS LA English DT Article DE Chest pain; Acute coronary syndrome; Acute myocardial infarction; Unstable angina; Shared decision-making; Emergency department; Healthcare utilization ID STRATIFICATION; VALIDATION; FRAMEWORK; SCORE AB Background: Chest pain is the second most common reason patients visit emergency departments (EDs) and often results in very low-risk patients being admitted for prolonged observation and advanced cardiac testing. Shared decision-making, including educating patients regarding their 45-day risk for acute coronary syndrome (ACS) and management options, might safely decrease healthcare utilization. Methods/Design: This is a protocol for a multicenter practical patient-level randomized trial to compare an intervention group receiving a decision aid, Chest Pain Choice (CPC), to a control group receiving usual care. Adults presenting to five geographically and ethnically diverse EDs who are being considered for admission for observation and advanced cardiac testing will be eligible for enrollment. We will measure the effect of CPC on (1) patient knowledge regarding their 45-day risk for ACS and the available management options (primary outcome); (2) patient engagement in the decision-making process; (3) the degree of conflict patients experience related to feeling uninformed (decisional conflict); (4) patient and clinician satisfaction with the decision made; (5) the rate of major adverse cardiac events at 30 days; (6) the proportion of patients admitted for advanced cardiac testing; and (7) healthcare utilization. To assess these outcomes, we will administer patient and clinician surveys immediately after each clinical encounter, obtain video recordings of the patient-clinician discussion, administer a patient healthcare utilization diary, analyze hospital billing records, review the electronic medical record, and conduct telephone follow-up. Discussion: This multicenter trial will robustly assess the effectiveness of a decision aid on patient-centered outcomes, safety, and healthcare utilization in low-risk chest pain patients from a variety of geographically and ethnically diverse EDs. C1 [Anderson, Ryan T.] Mayo Clin, Coll Med, Mayo Med Sch, Rochester, MN 55905 USA. [Montori, Victor M.; Shah, Nilay D.; Ting, Henry H.; Pencille, Laurie J.; Branda, Megan; Leblanc, Annie; Hess, Erik P.] Mayo Clin, Knowledge & Evaluat Res Unit, Rochester, MN 55905 USA. [Montori, Victor M.] Mayo Clin, Dept Internal Med, Div Endocrinol, Rochester, MN 55905 USA. [Montori, Victor M.; Shah, Nilay D.; Branda, Megan; Leblanc, Annie; Hess, Erik P.] Mayo Clin, Div Healthcare Policy & Res, Dept Hlth Sci, Rochester, MN 55905 USA. [Shah, Nilay D.; Branda, Megan; Leblanc, Annie; Hess, Erik P.] Mayo Clin, Ctr Sci Healthcare Delivery, Rochester, MN 55905 USA. [Ting, Henry H.] Mayo Clin, Div Cardiol, Dept Internal Med, Rochester, MN 55905 USA. [Kline, Jeffrey A.; Schaffer, Jason T.] Indiana Univ, Sch Med, Dept Emergency Med, Indianapolis, IN 46202 USA. [Kline, Jeffrey A.] Indiana Univ, Sch Med, Dept Cellular & Integrat Physiol, Indianapolis, IN 46202 USA. [Diercks, Deborah B.] Univ Calif Davis, Med Ctr, Dept Emergency Med, Sacramento, CA 95817 USA. [Hollander, Judd E.] Univ Penn, Dept Emergency Med, Philadelphia, PA 19104 USA. [Torres, Carlos A.] Mayo Clin, Dept Emergency Med, Jacksonville, FL 32224 USA. [Herrin, Jeph] Yale Univ, Sch Med, Div Cardiol, Dept Internal Med, New Haven, CT 06510 USA. [Herrin, Jeph] Hlth Res & Educ Trust, Chicago, IL 60606 USA. [Leblanc, Annie; Hess, Erik P.] Mayo Clin, Rochester, MN 55905 USA. [Hess, Erik P.] Mayo Clin, Div Emergency Med Res, Dept Emergency Med, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Indiana University System; Indiana University-Purdue University Indianapolis; Indiana University System; Indiana University-Purdue University Indianapolis; University of California System; University of California Davis; University of Pennsylvania; Mayo Clinic; Yale University; Mayo Clinic; Mayo Clinic RP Hess, EP (通讯作者),Mayo Clin, Knowledge & Evaluat Res Unit, 200 First St SW, Rochester, MN 55905 USA. EM Hess.Erik@mayo.edu RI LeBlanc, Annie/AAZ-1381-2020; Torres, Carlos/GRS-7240-2022 OI Montori, Victor/0000-0003-0595-2898; Hollander, Judd/0000-0002-1318-2785 FU Patient Centered Outcomes Research Institute (PCORI) FX The trial was funded by the Patient Centered Outcomes Research Institute (PCORI). 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Luscher, Thomas F. Windecker, Stephan Mach, Francois Gencer, Baris TI Clinical impact of a structured secondary cardiovascular prevention program following acute coronary syndromes: A prospective multicenter healthcare intervention SO PLOS ONE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; CARDIAC REHABILITATION; DISEASE PREVENTION; GUIDELINES; RATES; THERAPIES; MORTALITY AB Background Structured secondary cardiovascular prevention programs (SSCP) following acute coronary syndromes (ACS) may reduce major adverse cardiovascular events (MACE) through better adherence to post-ACS recommendations. Methods Through a prospective multicenter cohort study, we compared the outcomes of two sequential post-ACS patient cohorts, the initial one receiving standard care (SC) followed by one receiving additional interventions (SSCP) aimed at improving patient education as well as healthcare provider and hospital systems. The primary endpoint was MACE at one year. Secondary endpoints included adherence to recommended therapies, attendance to cardiac rehabilitation (CR) and successful achievement of cardiovascular risk factor (CVRF) targets. Results In total, 2498 post-ACS patients from 4 Swiss university hospitals were included: 1210 vs 1288 in the SC and SSCP groups, respectively. The SSCP group demonstrated a significant increase in attendance to CR programs (RR 1.08, 95% CI 1.02-1.14, P = 0.006), despite not achieving the primary MACE endpoint (HR 0.97, 95% CI 0.77-1.22, P = 0.79). After age-stratification, significant reductions in cardiac death, MI and stroke events (HR 0.53, 95% CI 0.30-0.93, P for interaction = 0.016) were observed for SSCP patients <= 65 years old. The SSCP group also scored significantly better for the LDL cholesterol target (RR 1.07, 95% CI 1.02-1.13, P = 0.012), systolic blood pressure target (RR 1.06, 95% CI 1.01-1.13, P = 0.029) and physical activity (RR 1.10, 95% CI 1.01-1.20, P = 0.021). Conclusions The implementation of an SSCP post ACS was associated with an improvement in the control of CVRF and attendance to CR programs, and was also associated with significant reductions in cardiac death, MI and stroke at one year for patients <= 65years old. C1 [Carballo, David; Keller, Pierre-Frederic; Mach, Francois; Gencer, Baris] Geneva Univ Hosp, Div Cardiol, Geneva, Switzerland. [Rodondi, Nicolas] Univ Hosp Bern, Dept Gen Internal Med, Bern, Switzerland. [Rodondi, Nicolas; Auer, Reto] Univ Bern, Inst Primary Hlth Care BIHAM, Bern, Switzerland. [Auer, Reto; Nanchen, David] Univ Lausanne, Dept Ambulatory Care & Community Med, Lausanne, Switzerland. [Carballo, Sebastian] Geneva Univ Hosp, Dept Internal Med, Geneva, Switzerland. [Raber, Lorenz; Windecker, Stephan] Univ Hosp Bern, Dept Cardiol, Bern, Switzerland. [Klingenberg, Roland; Matter, Christian M.; Luscher, Thomas F.] Univ Zurich, Univ Heart Ctr, Dept Cardiol, Zurich, Switzerland. [Heg, Dik] Univ Bern, Inst Social & Prevent Med, Bern, Switzerland. [Heg, Dik] Univ Bern, Dept Clin Res, Clin Trials Unit, Bern, Switzerland. [Juni, Peter] St Michaels Hosp, Appl Hlth Res Ctr, HUB, Li Ka Shing Knowledge Inst, Toronto, ON, Canada. [Muller, Olivier] Lausanne Univ, Div Cardiol, Lausanne, Switzerland. C3 University of Geneva; University of Bern; University Hospital of Bern; University of Bern; University of Lausanne; University of Geneva; University of Bern; University Hospital of Bern; University of Zurich; University of Bern; University of Bern; University of Toronto; Li Ka Shing Knowledge Institute; Saint Michaels Hospital Toronto; University of Lausanne RP Carballo, D (通讯作者),Geneva Univ Hosp, Div Cardiol, Geneva, Switzerland. EM david.carballo@hcuge.ch RI Gencer, Baris/AAO-2305-2020; Juni, Peter/Q-8700-2016; Nanchen, David/AAQ-1118-2021 OI Gencer, Baris/0000-0002-8954-9694; Juni, Peter/0000-0002-5985-0670; Nanchen, David/0000-0002-2493-3505; Muller, Olivier/0000-0003-2441-5799; Heg, Dik/0000-0002-8766-7945; Auer, Reto/0000-0003-4222-4849; Rodondi, Nicolas/0000-0001-9083-6896 FU Swiss National Science Foundation [SNSF 320030-150025, SPUM 33CM30-124112, SPUM 33CM30-140336]; de Reuter Foundation; Gerbex-Bourget Foundation; Geneva University Hospitals; Swiss Heart Foundation; Schmidheiny Foundation; Roche Diagnostics; Eli Lilly; AstraZeneca; Medtronic; Merck Sharpe and Dome (MSD); Sanofi-Aventis; St. Jude Medical FX The work was supported by the Swiss National Science Foundation (SPUM 33CM30-124112 and SPUM 33CM30-140336, Inflammation and acute coronary syndromes (ACS)-Novel strategies for prevention and clinical management), de Reuter Foundation, Gerbex-Bourget Foundation. B.G.'s research is supported by grants from the Geneva University Hospitals, Swiss Heart Foundation, de Reuter Foundation, Gerbex-Bourget Foundation and Schmidheiny Foundation. N.R.'s research is supported by grants from the Swiss National Science Foundation (SNSF 320030-150025). R.A. and N.R.'s research on cardiovascular prevention is supported by grants from the Swiss Heart Foundation. The SPUM consortium was also supported by Roche Diagnostics, Eli Lilly, AstraZeneca, Medtronic, Merck Sharpe and Dome (MSD), Sanofi-Aventis and St. Jude Medical. None of the funding institutions had any role in the design and conduct of the study, collection, management, analysis and interpretation of the data, nor in the preparation, review, or approval of the manuscript. 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Martinez-Selles, Manuel Salamanca, Jorge Sionis, Alessandro Garcia-Pardo, Hector Bueno, Hector Sanchis, Juan Abu-Assi, Emad Gonzalez-Salvado, Violeta Llao, Isaac Alfonso, Fernando CA LONGEVO-SCA Registry Investigators TI Mitral Regurgitation and Prognosis After Non-ST-Segment Elevation Myocardial Infarction in Very Old Patients SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE octogenarians; mitral regurgitation; non-ST-segment elevation myocardial infarction; frailty ID ACUTE CORONARY SYNDROME; EUROPEAN ASSOCIATION; ATRIAL-FIBRILLATION; ELDERLY-PATIENTS; ACUTE-CARE; FRAILTY; HEART; OUTCOMES; ECHOCARDIOGRAPHY; RECOMMENDATIONS AB Background/Objetctives Mitral regurgitation (MR)after an acute coronary syndrome is associated with a poor prognosis. However,the prognostic impact of MR in elderly patients with non-ST-segment elevation myocardialinfarction (NSTEMI) has not been well addressed. Design Prospective registry. Setting and participants The multicenter LONGEVO-SCA prospective registry included 532 unselected NSTEMI patients aged >= 80 years. Measurements MR was quantified using echocardiography during admission in 497 patients. They were classified in two groups: significant (moderate or severe) or not significant MR (absent or mild). We evaluated the impact of MR status on mortality or readmission at 6 months. Results Mean age was 84.3 +/- 4.1 years, and 308 (61.9%) were males. A total of 108 patients (21.7%) had significant MR. Compared with those without significant MR, they were older and showed worse baseline clinical status, with higher frailty, disability, and risk of malnutrition. They also had lower systolic blood pressure, higher heart rate, worse Killip class, lower left ventricular ejection fraction, and higher pulmonary pressure on admission, as well as more often new onset atrial fibrillation (all p values = 0.001). Patients with significant MR also had higher in-hospital mortality (4.6% vs. 1.3%, p = 0.04), longer hospital stay (median 8 [5-12] vs. 6 [4-10] days, p = 0.002), and higher mortality/readmission at 6 months (hazard ratio 1.54, 95% confidence interval 1.09-2.18, p = 0.015). However, after adjusting for potential confounders, this last association was not significant. Conclusions Significant MR is seen in one fifth of octogenarians with NSTEMI. Patients with significant MR have a poor prognosis, mainly determined by their baseline clinical characteristics. J Am Geriatr Soc 67:1641-1648, 2019 C1 [Diez-Villanueva, Pablo; Vera, Alberto; Salamanca, Jorge; Alfonso, Fernando] Hosp Univ La Princesa, Madrid, Spain. [Ariza-Sole, Albert; Alegre, Oriol; Formiga, Francesc; Llao, Isaac] Hosp Univ Bellvitge, Barcelona, Spain. [Lopez-Palop, Ramon] Hosp Univ San Juan, Cardiol Dept, Alicante, Spain. [Marin, Francisco] Hosp Virgen Arrixaca, Murcia, Spain. [Vidan, Maria T.; Martinez-Selles, Manuel] Univ Europea, Univ Complutense, Hosp Gen Univ Gregorio Maranon, CIBERCV, Madrid, Spain. [Sionis, Alessandro] Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Barcelona, Spain. [Garcia-Pardo, Hector] Hosp Univ Rio Hortega, Valladolid, Spain. [Bueno, Hector] Hosp Doce Octubre, Madrid, Spain. [Bueno, Hector] Ctr Nacl Invest Cardiovasc, Madrid, Spain. [Sanchis, Juan] Univ Valencia, Hosp Clin Univ Valencia, INCLIVA, CIBER CV, Valencia, Spain. [Abu-Assi, Emad] Hosp Alvaro Cunqueiro, Vigo, Spain. [Gonzalez-Salvado, Violeta] Hosp Clin Univ Santiago de Compostela, Santiago De Compostela, Spain. C3 Hospital de La Princesa; Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Bellvitge University Hospital; University of Barcelona; Hospital Clinico Universitario Virgen de la Arrixaca; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; Complutense University of Madrid; European University of Madrid; General University Gregorio Maranon Hospital; Autonomous University of Barcelona; Hospital of Santa Creu i Sant Pau; Hospital del Rio Hortega; Hospital Universitario 12 de Octubre; Centro Nacional de Investigaciones Cardiovasculares (CNIC); CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; University of Valencia; Complexo Hospitalario Universitario de Santiago de Compostela RP Diez-Villanueva, P (通讯作者),Hosp Univ La Princesa, Hosp Princesa, Diego Leon 62, Madrid 28006, Spain. EM pablo_diez_villanueva@hotmail.com RI Salamanca, Jorge/AAM-4984-2021; Bueno, Hector/I-3910-2015; Palop, Ramon Lopez/I-2162-2014; Marin, Francisco/AAD-9429-2022; formiga, Francesc/ABD-7976-2020 OI Salamanca, Jorge/0000-0002-5067-5052; Bueno, Hector/0000-0003-0277-7596; Palop, Ramon Lopez/0000-0003-4385-7939; formiga, Francesc/0000-0002-3587-298X; , IIS Galicia Sur/0000-0003-3812-7413; Vera, Alberto/0000-0003-2181-0961; Marin, Francisco/0000-0001-7246-7708 CR Alegre O, 2016, CLIN CARDIOL, V39, P373, DOI 10.1002/clc.22550 Ancoli-Israel S, 2003, SLEEP, V26, P342, DOI 10.1093/sleep/26.3.342 Basic D, 2017, AUSTRALAS J AGEING, V36, pE57, DOI 10.1111/ajag.12458 Bursi F, 2006, AM J MED, V119, P103, DOI 10.1016/j.amjmed.2005.08.025 Bursi F, 2005, CIRCULATION, V111, P295, DOI 10.1161/01.CIR.0000151097.30779.04 Cerqueira MD, 2002, INT J CARDIOVAS IMAG, V18, P539 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 Cho JY, 2013, INT J CARDIOL, V168, P4872, DOI 10.1016/j.ijcard.2013.07.051 De Bonis M, 2016, EUR HEART J, V37, P133, DOI 10.1093/eurheartj/ehv322 Degano IR, 2013, REV ESP CARDIOL, V66, P472, DOI [10.1016/j.rec.2013.01.018, 10.1016/j.recesp.2013.01.019] Diez-Villanueva P, 2019, REV ESP CARDIOL, V72, P63, DOI [10.1016/j.rec.2018.06.035, 10.1016/j.recesp.2018.06.015] Ehlenbach WJ, 2015, J AM GERIATR SOC, V63, P2061, DOI 10.1111/jgs.13663 Feinberg MS, 2000, AM J CARDIOL, V86, P903, DOI 10.1016/S0002-9149(00)01119-X Fox KAA, 2006, BMJ-BRIT MED J, V333, P1091, DOI 10.1136/bmj.38985.646481.55 Gabriel R, 2009, BMC PUBLIC HEALTH, V9, DOI 10.1186/1471-2458-9-360 Gillinov AM, 2005, ANN THORAC SURG, V80, P811, DOI 10.1016/j.athoracsur.2005.03.134 Guralnik JM, 2000, J GERONTOL A-BIOL, V55, pM221, DOI 10.1093/gerona/55.4.M221 Lamas GA, 1997, CIRCULATION, V96, P827 Lancellotti P, 2013, EUR HEART J-CARD IMG, V14, P611, DOI 10.1093/ehjci/jet105 Lang RM, 2015, EUR HEART J-CARD IMG, V16, P233, DOI 10.1093/ehjci/jev014 LAWTON MP, 1969, GERONTOLOGIST, V9, P9, DOI 10.1093/geront/9.1.9 Levine RA, 2005, CIRCULATION, V112, P745, DOI 10.1161/CIRCULATIONAHA.104.486720 Llao I, 2018, EUROINTERVENTION, V14, P336, DOI 10.4244/EIJ-D-18-00099 Gil IJN, 2009, REV ESP CARDIOL, V62, P1267, DOI 10.1016/S0300-8932(09)73079-9 Nunez-Gil IJ, 2013, HEART, V99, P1502, DOI 10.1136/heartjnl-2013-304298 Perez de Isla L, 2007, EUR HEART J, V28, P2866, DOI 10.1093/eurheartj/ehm469 PFEIFFER E, 1975, J AM GERIATR SOC, V23, P433, DOI 10.1111/j.1532-5415.1975.tb00927.x Pizzetti F, 2001, HEART, V86, P527, DOI 10.1136/heart.86.5.527 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Rubenstein LZ, 2001, J GERONTOL A-BIOL, V56, pM366, DOI 10.1093/gerona/56.6.M366 Ryder KM, 1999, AM J CARDIOL, V84, p131R Subherwal S, 2009, CIRCULATION, V119, P1873, DOI 10.1161/CIRCULATIONAHA.108.828541 Van Kan GA, 2008, J NUTR HEALTH AGING, V12, P29, DOI 10.1007/BF02982161 van Kan GA, 2008, J AM MED DIR ASSOC, V9, P71, DOI 10.1016/j.jamda.2007.11.005 Walston J, 2006, J AM GERIATR SOC, V54, P991, DOI 10.1111/j.1532-5415.2006.00745.x Zamorano J, 2005, EUR HEART J, V26, P343, DOI 10.1093/eurheartj/ehi065 NR 36 TC 2 Z9 2 U1 1 U2 10 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 EI 1532-5415 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2019 VL 67 IS 8 BP 1641 EP 1648 DI 10.1111/jgs.15926 PG 8 WC Geriatrics & Gerontology; Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA IN8GQ UT WOS:000478919000016 PM 31045252 DA 2023-05-13 ER PT J AU Abdallah, MS Kosiborod, M Tang, FM Karrowni, WY Maddox, TM McGuire, DK Spertus, JA Arnold, SV AF Abdallah, Mouin S. Kosiborod, Mikhail Tang, Fengming Karrowni, Wassef Y. Maddox, Thomas M. McGuire, Darren K. Spertus, John A. Arnold, Suzanne V. TI Patterns and Predictors of Intensive Statin Therapy Among Patients With Diabetes Mellitus After Acute Myocardial Infarction SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE CORONARY SYNDROMES; ASSOCIATION TASK-FORCE; LIPID-LOWERING THERAPY; CARDIOVASCULAR ANGIOGRAPHY; PULMONARY REHABILITATION; AMERICAN ASSOCIATION; EMERGENCY PHYSICIANS; WRITING COMMITTEE; ST-ELEVATION; ATORVASTATIN AB Intensive statin therapy is a central component of secondary prevention after acute myocardial infarction (AMI), particularly among high-risk patients, such as those with diabetes mellitus (DM). However, the frequency and predictors of intensive statin therapy use after AMI among patients with DM have not been described. We examined patterns of intensive statin therapy use (defined as a statin with expected low-density lipoprotein cholesterol lowering of >50%) at discharge among patients with AMI with known DM enrolled in a 24-site US registry. Predictors of intensive statin therapy use were evaluated using multivariable hierarchical Poisson regression models. Among 1,300 patients with DM after AMI, 22% were prescribed intensive statin therapy at hospital discharge. In multivariable models, ST-elevation ANT (risk ratio [RR] 1.48, 95% confidence interval [CI] 1.29 to 1.70), insurance for medications (RR 1.28, 95% CI 1.00 to 1.63), and higher low-density lipoprotein cholesterol levels (RR 1.05 per 1 mg/dI, 95% CI 1.02 to 1.07) were independent predictors of intensive statin therapy, whereas higher Global Registry of Acute Coronary Events scores were associated with lower rates of intensive statin therapy (RR 0.94 per 10 points, 95% CI 0.91 to 0.98). In conclusion, only 1 in 5 patients with DM was prescribed intensive statin therapy at discharge after an AMI. Predictors of intensive statin therapy use suggest important opportunities to improve quality of care in this patient population. (c) 2014 Elsevier Inc. All rights reserved. C1 [Abdallah, Mouin S.; Kosiborod, Mikhail; Tang, Fengming; Spertus, John A.; Arnold, Suzanne V.] St Lukes Mid Amer Heart Inst, Kansas City, MO 64111 USA. [Abdallah, Mouin S.; Kosiborod, Mikhail; Spertus, John A.; Arnold, Suzanne V.] Univ Missouri, Kansas City, MO 64110 USA. [Karrowni, Wassef Y.] Univ Iowa Hosp & Clin, Iowa City, IA 52242 USA. [Maddox, Thomas M.] Univ Colorado, Sch Med, VA Eastern Colorado Hlth Care Syst, Div Cardiol, Denver, CO USA. [McGuire, Darren K.] Univ Texas SW Med Ctr Dallas, Div Cardiol, Dallas, TX 75390 USA. C3 Saint Luke's Mid America Heart Institute; University of Missouri System; University of Missouri Kansas City; University of Iowa; University of Colorado System; University of Colorado Anschutz Medical Campus; University of Colorado Denver; University of Texas System; University of Texas Southwestern Medical Center Dallas RP Abdallah, MS (通讯作者),St Lukes Mid Amer Heart Inst, Kansas City, MO 64111 USA. EM abdallahm@umkc.edu RI Abdallah, Mouin/AAO-5143-2021; Kosiborod, Mikhail/HDO-1541-2022; McGuire, Darren K./AAL-4172-2021; Spertus, John/ABD-3075-2021 OI Kosiborod, Mikhail/0000-0002-3750-9789; FU National Institutes of Health (National Heart, Lung, Blood Institute): SCCOR Grant [P50HL077113-01] FX TRIUMPH was sponsored by a grant from the National Institutes of Health (National Heart, Lung, Blood Institute): SCCOR Grant #P50HL077113-01. CR Aguilar D, 2004, CIRCULATION, V110, P1572, DOI 10.1161/01.CIR.0000142047.28024.F2 Anderson JL, 2007, CIRCULATION, V116, pE148, DOI 10.1161/CIRCULATIONAHA.107.181940 Armitage J, 2010, LANCET, V376, P1658, DOI 10.1016/S0140-6736(10)60310-8 Arnold SV, 2011, CIRC-CARDIOVASC QUAL, V4, P467, DOI 10.1161/CIRCOUTCOMES.110.960468 Braunwald E, 1997, NEW ENGL J MED, V337, P1360, DOI 10.1056/NEJM199711063371906 Cannon CP, 2004, NEW ENGL J MED, V350, P1495, DOI 10.1056/NEJMoa040583 Chan PS, 2007, CIRCULATION, V115, P2398, DOI 10.1161/CIRCULATIONAHA.106.667683 Chong PH, 2002, ANN PHARMACOTHER, V36, P1907, DOI 10.1345/aph.1C116 de Lemos JA, 2004, JAMA-J AM MED ASSOC, V292, P1307, DOI 10.1001/jama.292.11.1307 Eagle KA, 2004, JAMA-J AM MED ASSOC, V291, P2727, DOI 10.1001/jama.291.22.2727 Fox CS, 2004, DIABETES CARE, V27, P704, DOI 10.2337/diacare.27.3.704 Franklin K, 2004, ARCH INTERN MED, V164, P1457, DOI 10.1001/archinte.164.13.1457 Javed U, 2010, AM HEART J, V160, P1130, DOI 10.1016/j.ahj.2010.08.041 Kearney PM, 2008, LANCET, V371, P117, DOI 10.1016/S0140-6736(08)60104-X Krumholz HM, 2008, CIRCULATION, V118, P2596, DOI 10.1161/CIRCULATIONAHA.108.191099 LaRosa JC, 2005, NEW ENGL J MED, V352, P1425, DOI 10.1056/NEJMoa050461 Lebovitz HE, 2011, DIABETES CARE, V34, pS225, DOI 10.2337/dc11-s225 McGuire DK, 2000, EUR HEART J, V21, P1750, DOI 10.1053/euhj.2000.2317 Mehran R, 2004, J AM COLL CARDIOL, V43, P1348, DOI 10.1016/j.jacc.2003.04.004 Murphy SA, 2007, AM J CARDIOL, V100, P1047, DOI 10.1016/j.amjcard.2007.04.053 Nandish S, 2011, CURR ATHEROSCLER REP, V13, P123, DOI 10.1007/s11883-011-0165-4 Pedersen TR, 2005, JAMA-J AM MED ASSOC, V294, P2437, DOI 10.1001/jama.294.19.2437 Preiss D, 2011, JAMA-J AM MED ASSOC, V305, P2556, DOI 10.1001/jama.2011.860 Sattar N, 2010, LANCET, V375, P735, DOI 10.1016/S0140-6736(09)61965-6 Smith SC, 2011, CIRCULATION, V124, P2458, DOI 10.1161/CIR.0b013e318235eb4d Stone NJ, 2013, CIRCULATION, DOI 10.1016/j.jacc.2013.11.002 Waters DD, 2013, J AM COLL CARDIOL, V61, P148, DOI 10.1016/j.jacc.2012.09.042 West NEJ, 2004, CIRCULATION, V109, P867, DOI 10.1161/01.CIR.0000116750.63158.94 NR 28 TC 13 Z9 13 U1 0 U2 5 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD APR 15 PY 2014 VL 113 IS 8 BP 1267 EP 1272 DI 10.1016/j.amjcard.2013.12.040 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AF3YG UT WOS:000334648000001 PM 24560324 OA Green Accepted DA 2023-05-13 ER PT J AU Breen, T Brueske, B Sidhu, MS Murphree, DH Kashani, KB Barsness, GW Jentzer, JC AF Breen, Thomas Brueske, Benjamin Sidhu, Mandeep S. Murphree, Dennis H. Kashani, Kianoush B. Barsness, Gregory W. Jentzer, Jacob C. TI Abnormal Serum Sodium is Associated With Increased Mortality Among Unselected Cardiac Intensive Care Unit Patients SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE cardiac intensive care unit; coronary care unit; hyponatremia; mortality; sodium ID CRITICALLY-ILL; HEART-FAILURE; APACHE IV; HYPONATREMIA; HYPERNATREMIA; VALIDATION; ADMISSION; SEVERITY; OUTCOMES; DISEASE AB Background Abnormal serum sodium levels have been associated with higher mortality among patients with acute coronary syndromes and heart failure. We sought to describe the association between sodium levels and mortality among unselected cardiac intensive care unit (CICU) patients. Methods and Results We retrospectively reviewed consecutive adult patients admitted to our cardiac intensive care unit from 2007 to 2015. Hyponatremia and hypernatremia were defined as admission serum sodium 145 mEq/L, respectively. In-hospital mortality was assessed by multivariable regression, and postdischarge mortality was evaluated by Cox proportional-hazards analysis. We included 9676 patients with a mean age of 68 +/- 15 years (37.5% females). Hyponatremia occurred in 1706 (17.6%) patients, and hypernatremia occurred in 322 (3.3%) patients; these groups had higher illness severity and a greater number of comorbidities. Risk of hospital mortality was higher with hyponatremia (15.5% versus 7.5%; unadjusted odds ratio, 2.41; 95% CI, 2.06-2.82; P<0.001) or hypernatremia (17.7% versus 8.6%; unadjusted odds ratio, 2.82; 95% CI, 2.09-3.80; P<0.001), with a J-shaped relationship between admission sodium and mortality. After multivariate adjustment, only hyponatremia was significantly associated with in-hospital mortality (adjusted odds ratio, 1.42; 95% CI, 1.14-1.76; P=0.002). Among hospital survivors, risk of postdischarge mortality was higher in patients with hyponatremia (adjusted hazard ratio, 1.28; 95% CI, 1.17-1.41; P<0.001) or hypernatremia (adjusted hazard ratio, 1.36; 95% CI, 1.12-1.64; P=0.002). Conclusions Hyponatremia and hypernatremia on admission to the cardiac intensive care unit are associated with increased unadjusted short- and long-term mortality. Further studies are needed to determine whether correcting abnormal sodium levels can improve outcomes in cardiac intensive care unit patients. C1 [Breen, Thomas] Mayo Clin, Dept Internal Med, Rochester, MN USA. [Murphree, Dennis H.] Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA. [Barsness, Gregory W.; Jentzer, Jacob C.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Kashani, Kianoush B.] Mayo Clin, Dept Internal Med, Div Nephrol & Hypertens, Rochester, MN USA. [Kashani, Kianoush B.; Jentzer, Jacob C.] Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, 200 First St SW, Rochester, MN 55905 USA. [Brueske, Benjamin; Sidhu, Mandeep S.] Albany Med Ctr, Dept Med, Div Cardiol, Albany, NY USA. [Brueske, Benjamin; Sidhu, Mandeep S.] Albany Med Coll, Albany, NY 12208 USA. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Albany Medical College; Albany Medical College RP Jentzer, JC (通讯作者),Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA.; Jentzer, JC (通讯作者),Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, 200 First St SW, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu CR Aakre C, 2017, INT J MED INFORM, V103, P1, DOI 10.1016/j.ijmedinf.2017.04.001 Adrogue HJ, 2000, NEW ENGL J MED, V342, P1493, DOI 10.1056/NEJM200005183422006 Adrogue HJ, 2000, NEW ENGL J MED, V342, P1581, DOI 10.1056/NEJM200005253422107 [Anonymous], CIRCULATION Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 BRATUSCHMARRAIN PR, 1983, DIABETES, V32, P1028, DOI 10.2337/diabetes.32.11.1028 Brueske B, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011814 Chandra S, 2011, BMJ OPEN, V1, DOI 10.1136/bmjopen-2011-000216 Darmon M, 2014, SHOCK, V41, P394, DOI 10.1097/SHK.0000000000000135 De Luca L, 2005, AM J CARDIOL, V96, p19L, DOI 10.1016/j.amjcard.2005.09.066 Eckardt KU, 2012, KIDNEY INT SUPPL, V2, P7, DOI 10.1038/kisup.2012.8 Funk GC, 2010, INTENS CARE MED, V36, P304, DOI 10.1007/s00134-009-1692-0 Gheorghiade M, 2007, ARCH INTERN MED, V167, P1998, DOI 10.1001/archinte.167.18.1998 Gheorghiade M, 2007, EUR HEART J, V28, P980, DOI 10.1093/eurheartj/ehl542 Goldberg A, 2004, AM J MED, V117, P242, DOI 10.1016/j.amjmed.2004.03.022 Goldfarb M, 2019, J INTENSIVE CARE MED, V34, P537, DOI 10.1177/0885066617741873 Herasevich V, 2010, MAYO CLIN PROC, V85, P247, DOI 10.4065/mcp.2009.0479 Imran TF, 2019, INT J CARDIOL, V290, P119, DOI 10.1016/j.ijcard.2019.03.040 Jentzer JC, 2018, AM J CARDIOL, V122, P1773, DOI 10.1016/j.amjcard.2018.08.011 Jentzer JC, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008169 Keegan MT, 2012, CHEST, V142, P851, DOI 10.1378/chest.11-2164 Klopotowski M, 2009, MED SCI MONITOR, V15, pCR477 KNAUS WA, 1985, CRIT CARE MED, V13, P818, DOI 10.1097/00003246-198510000-00009 Kovesdy CP, 2012, CIRCULATION, V125, P677, DOI 10.1161/CIRCULATIONAHA.111.065391 KOZENY GA, 1985, AM HEART J, V109, P290, DOI 10.1016/0002-8703(85)90596-4 LENZ K, 1986, CRIT CARE MED, V14, P913 Lindner G, 2007, AM J KIDNEY DIS, V50, P952, DOI 10.1053/j.ajkd.2007.08.016 Ma QQ, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0193857 Naksuk N, 2017, AM J MED, V130, DOI 10.1016/j.amjmed.2016.08.033 Palevsky PM, 1996, ANN INTERN MED, V124, P197, DOI 10.7326/0003-4819-124-2-199601150-00002 Rocca WA, 2012, MAYO CLIN PROC, V87, P1202, DOI 10.1016/j.mayocp.2012.08.012 Rodriguez M, 2019, CURR CARDIOL REV, V15, P252, DOI 10.2174/1573403X15666190306111812 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Singla I, 2007, AM J CARDIOL, V100, P406, DOI 10.1016/j.amjcard.2007.03.039 Zou H, 2005, J R STAT SOC B, V67, P301, DOI 10.1111/j.1467-9868.2005.00503.x NR 35 TC 18 Z9 19 U1 0 U2 1 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA EI 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD JAN 21 PY 2020 VL 9 IS 2 AR e014140 DI 10.1161/JAHA.119.014140 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KS0KP UT WOS:000518001200020 PM 31914877 OA Green Published, gold DA 2023-05-13 ER PT J AU Bender, R Njue, F Vasikaran, S Lambert, R Rankin, J Hillis, GS Bell, DA AF Bender, Robert Njue, Faith Vasikaran, Samuel Lambert, Ramon Rankin, Jamie Hillis, Graham S. Bell, Damon A. TI Impact of the Australian gender specific thresholds using the Abbott high sensitivity troponin I assay in clinical care SO PATHOLOGY LA English DT Article DE High sensitivity troponin; acute coronary syndrome; diagnosis ID CARDIAC TROPONIN; MYOCARDIAL-INFARCTION; ASSOCIATION; POPULATION; VALIDATION; DIAGNOSIS; MORTALITY; OUTCOMES; COHORT; RISK AB The aim of this study was to ascertain the impact of gender specific hs-TnI thresholds in a clinical setting and determine the clinical characteristics and discharge diagnosis for individuals presenting to the Emergency Department (ED) with elevated troponin I with the Abbott high-sensitivity troponin I (hs-TnI) assay, but non-elevated troponin I on the previous generation assay (STAT TnI-II). Medical records of individuals presenting to the Royal Perth Hospital ED with elevated hs-TnI between 12 November 2013 and 24 December 2013 were retrospectively reviewed. The 99th percentile hs-TnI thresholds were >= 26 ng/L for males and >= 16 ng/L for females. TnI-II assays were performed concomitantly. In total, 1449 individuals [855 (59%) males] had 3580 troponin measurements. hs-TnI was elevated in 1569 (43.8%) measurements. Elevated hs-TnI with normal TnI-II was found in 120 (8.3%) individuals: 77 (64%) females and 43 (36%) males. Eight (6.7%) individuals were diagnosed with acute coronary syndrome (ACS): four (9.3%) males and four (5.2%) females. Other cardiac aetiologies were found in 33 (42%) females and 17 (40%) males. Individuals with elevated hs-TnI had high rates of hypertension (80%), diabetes mellitus (33%), cardiac failure (23%), aspirin use (53%) and lipid lowering therapy (52%). Significantly fewer females than males with discrepant troponin I results had previous ischaemic heart disease. The hsTnI assay identifies 8% more individuals with elevated troponin in an acute setting, with a female predominance (64%). However, only 6.7% of these individuals with multiple cardiovascular risk factors were diagnosed with ACS, a similar to 0.5% increase overall. Outcome studies are required to determine if the Australian hs-TnI thresholds are clinically appropriate. C1 [Bender, Robert; Bell, Damon A.] Royal Perth Hosp, Cardiometabol Serv, Perth, WA, Australia. [Njue, Faith; Rankin, Jamie] Fiona Stanley Hosp, Dept Cardiol, Perth, WA, Australia. [Vasikaran, Samuel; Lambert, Ramon; Bell, Damon A.] Royal Perth & Fiona Stanley Hosp Network, Dept Clin Biochem, PathWest Lab Med WA, Perth, WA, Australia. [Hillis, Graham S.; Bell, Damon A.] Univ Western Australia, Sch Med & Pharmacol, Perth, WA, Australia. [Hillis, Graham S.; Bell, Damon A.] Royal Perth Hosp, Dept Cardiol, Perth, WA, Australia. C3 Royal Perth Hospital; Royal Perth Hospital; University of Western Australia; Royal Perth Hospital; University of Western Australia RP Bell, DA (通讯作者),Royal Perth Hosp, Sch Med & Pharmacol, Dept Internal Med, GPO Box X2213, Perth, WA 6847, Australia. EM damon.bell@uwa.edu.au OI Njue, Faith/0000-0002-1773-2246; Bell, Damon/0000-0002-6592-6184; Vasikaran, Samuel/0000-0002-0831-3031 CR Alpert JS, 2000, J AM COLL CARDIOL, V36, P959, DOI 10.1016/S0735-1097(00)00804-4 Apple FS, 2012, CLIN CHEM, V58, P54, DOI 10.1373/clinchem.2011.165795 Apple FS, 2005, CLIN CHEM, V51, P2198, DOI 10.1373/clinchem.2005.052886 Christenson RH, 2011, PATHOLOGY, V43, P213, DOI 10.1097/PAT.0b013e328343762d Cullen L, 2013, J AM COLL CARDIOL, V62, P1242, DOI 10.1016/j.jacc.2013.02.078 de Lemos JA, 2010, JAMA-J AM MED ASSOC, V304, P2503, DOI 10.1001/jama.2010.1768 deFilippi CR, 2010, JAMA-J AM MED ASSOC, V304, P2494, DOI 10.1001/jama.2010.1708 Koerbin G, 2012, CLIN CHEM LAB MED, V50, P871, DOI 10.1515/cclm-2011-0540 Korley FK, 2014, ACAD EMERG MED, V21, P728, DOI 10.1111/acem.12417 Omland T, 2013, J AM COLL CARDIOL, V61, P1240, DOI 10.1016/j.jacc.2012.12.026 Sandoval Y, 2016, AM J MED, V129, P354, DOI 10.1016/j.amjmed.2015.12.005 Sawyer N, 2014, ANN CLIN BIOCHEM, V51, P476, DOI 10.1177/0004563213499737 Shah ASV, 2015, BMJ-BRIT MED J, V350, DOI 10.1136/bmj.g7873 Sze J, 2016, HEART LUNG CIRC, V25, P217, DOI 10.1016/j.hlc.2015.09.001 Thygesen K, 2012, CIRCULATION, V126, P2020, DOI 10.1161/CIR.0b013e31826e1058 Trambas C, 2016, CLIN CHEM, V62, P831, DOI 10.1373/clinchem.2015.252569 Zeller T, 2014, EUR HEART J, V35, P271, DOI 10.1093/eurheartj/eht406 NR 17 TC 1 Z9 1 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0031-3025 EI 1465-3931 J9 PATHOLOGY JI Pathology PD AUG PY 2017 VL 49 IS 5 BP 514 EP 517 DI 10.1016/j.pathol.2017.03.004 PG 4 WC Pathology WE Science Citation Index Expanded (SCI-EXPANDED) SC Pathology GA FA9OT UT WOS:000405776000010 PM 28689634 DA 2023-05-13 ER PT J AU Brown, DL Durkalski, V Durmer, JS Broderick, JP Zahuranec, DB Levine, DA Anderson, CS Bravata, DM Yaggi, HK Morgenstern, LB Moy, CS Chervin, RD AF Brown, Devin L. Durkalski, Valerie Durmer, Jeffrey S. Broderick, Joseph P. Zahuranec, Darin B. Levine, Deborah A. Anderson, Craig S. Bravata, Dawn M. Yaggi, H. Klar Morgenstern, Lewis B. Moy, Claudia S. Chervin, Ronald D. TI Sleep for Stroke Management and Recovery Trial (Sleep SMART): Rationale and methods SO INTERNATIONAL JOURNAL OF STROKE LA English DT Article DE Stroke; apnea; sleep; continuous positive airway pressure; clinical trial ID AIRWAY PRESSURE TREATMENT; APNEA; DIAGNOSIS AB Rationale Obstructive sleep apnea is common among patients with acute ischemic stroke and is associated with reduced functional recovery and an increased risk for recurrent vascular events. Aims and/or hypothesis The Sleep for Stroke Management and Recovery Trial (Sleep SMART) aims to determine whether automatically adjusting continuous positive airway pressure (aCPAP) treatment for obstructive sleep apnea improves clinical outcomes after acute ischemic stroke or high-risk transient ischemic attack. Sample size estimate A total of 3062 randomized subjects for the prevention of recurrent serious vascular events, and among these, 1362 stroke survivors for the recovery outcome. Methods and design Sleep SMART is a phase III, multicenter, prospective randomized, open, blinded outcome event assessed controlled trial. Adults with recent acute ischemic stroke/transient ischemic attack and no contraindication to aCPAP are screened for obstructive sleep apnea with a portable sleep apnea test. Subjects with confirmed obstructive sleep apnea but without predominant central sleep apnea proceed to a run-in night of aCPAP. Subjects with use (>= 4 h) of aCPAP and without development of significant central apneas are randomized to aCPAP plus usual care or care-as-usual for six months. Telemedicine is used to monitor and facilitate aCPAP adherence remotely. Study outcomes Two separate primary outcomes: (1) the composite of recurrent acute ischemic stroke, acute coronary syndrome, and all-cause mortality (prevention) and (2) the modified Rankin scale scores (recovery) at six- and three-month post-randomization, respectively. Discussion Sleep SMART represents the first large trial to test whether aCPAP for obstructive sleep apnea after stroke/transient ischemic attack reduces recurrent vascular events or death, and improves functional recovery. C1 [Brown, Devin L.; Zahuranec, Darin B.; Morgenstern, Lewis B.] Univ Michigan, Dept Neurol, Div Vasc Neurol, Ann Arbor, MI USA. [Brown, Devin L.] Univ Michigan, Dept Neurol, Div Sleep Med, Ann Arbor, MI USA. [Durkalski, Valerie] Med Univ South Carolina, Dept Publ Hlth Sci, Charleston, SC 29425 USA. [Durmer, Jeffrey S.] Nox Hlth, Johns Creek, GA USA. [Broderick, Joseph P.] Univ Cincinnati, Dept Neurol & Rehabil Med, UC Gardner Neurosci Inst, Cincinnati, OH USA. [Levine, Deborah A.] Univ Michigan, Dept Internal Med, Med Sch, Ann Arbor, MI 48109 USA. [Anderson, Craig S.] UNSW, George Inst Global Hlth, Fac Med, Sydney, NSW, Australia. [Bravata, Dawn M.] Indiana Univ Sch Med, Dept Internal Med & Neurol, Indianapolis, IN 46202 USA. [Bravata, Dawn M.] Regenstrief Inst Hlth Care, Indianapolis, IN USA. [Yaggi, H. Klar] Yale Sch Med, Dept Internal Med, New Haven, CT USA. [Yaggi, H. Klar] Clin Epidemiol Res Ctr, Dept Vet Affairs Connecticut Healthcare Syst, West Haven, CT USA. [Moy, Claudia S.] NINDS, Bldg 36,Rm 4D04, Bethesda, MD 20892 USA. [Chervin, Ronald D.] Univ Michigan, Dept Neurol, Ann Arbor, MI USA. [Chervin, Ronald D.] Univ Michigan, Sleep Disorders Ctr, Ann Arbor, MI USA. C3 University of Michigan System; University of Michigan; University of Michigan System; University of Michigan; Medical University of South Carolina; University System of Ohio; University of Cincinnati; University of Michigan System; University of Michigan; George Institute for Global Health; University of New South Wales Sydney; University of Sydney; Indiana University System; Indiana University Bloomington; Indiana University System; Indiana University-Purdue University Indianapolis; Regenstrief Institute Inc; Yale University; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Connecticut Healthcare System; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS); University of Michigan System; University of Michigan; University of Michigan System; University of Michigan RP Brown, DL (通讯作者),1500 East Med Ctr Dr, Ann Arbor, MI 48109 USA. EM devinb@umich.edu OI Anderson, Craig/0000-0002-7248-4863; Brown, Devin/0000-0002-9815-3421 FU National Institutes of Health [U01NS099043] FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is funded by the National Institutes of Health (U01NS099043). 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J. Stroke PD OCT PY 2020 VL 15 IS 8 BP 923 EP 929 AR 1747493020903979 DI 10.1177/1747493020903979 EA FEB 2020 PG 7 WC Clinical Neurology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA OM4VM UT WOS:000512231700001 PM 32019428 OA Green Accepted, Green Submitted DA 2023-05-13 ER PT J AU Ticinesi, A Nouvenne, A Cerundolo, N Prati, B Parise, A Tana, C Rendo, M Guerra, A Meschi, T AF Ticinesi, Andrea Nouvenne, Antonio Cerundolo, Nicoletta Prati, Beatrice Parise, Alberto Tana, Claudio Rendo, Martina Guerra, Angela Meschi, Tiziana TI Accounting for frailty and multimorbidity when interpreting high-sensitivity troponin I tests in oldest old SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE acute coronary syndrome; comorbidity; disability; geriatric cardiology; oldest old ID ACUTE CORONARY SYNDROME; CARDIAC TROPONIN; EMERGENCY-DEPARTMENT; PROGNOSIS; PERFORMANCE; POPULATION; ADULTS AB Background Older patients evaluated in Emergency Departments (ED) for suspect Myocardial Infarction (MI) frequently exhibit unspecific elevations of serum high-sensitivity troponin I (hs-TnI), making interpretation particularly challenging for emergency physicians. The aim of this longitudinal study was to identify the interaction of multimorbidity and frailty with hs-TnI levels in older patients seeking emergency care. Methods A group of patients aged >= 75 with suspected MI was enrolled in our acute geriatric ward immediately after ED visit. Multimorbidity and frailty were measured with Cumulative Illness Rating Scale (CIRS) and Clinical Frailty Scale (CFS), respectively. The association of hs-TnI with MI (main endpoint) was assessed by calculation of the Area Under the Receiver-Operating Characteristic Curve (AUROC), deriving population-specific cut-offs with Youden test. The factors associated with hs-TnI categories, including MI, CFS and CIRS, were determined with stepwise multinomial logistic regression. The association of hs-TnI with 3-month mortality (secondary endpoint) was also investigated with stepwise logistic regression. Results Among 268 participants (147 F, median age 85, IQR 80-89), hs-TnI elevation was found in 191 cases (71%, median 23 ng/L, IQR 11-65), but MI was present in only 12 cases (4.5%). hs-TnI was significantly associated with MI (AUROC 0.751, 95% CI 0.580-0.922, p = 0.003), with an optimal cut-off of 141 ng/L. hs-TnI levels >= 141 ng/L were significantly associated with CFS (OR 1.58, 95% CI 1.15-2.18, p = 0.005), while levels <141 ng/L were associated with the cardiac subscore of CIRS (OR 1.36, 95% CI 1.07-1.71, p = 0.011). CFS, but not hs-TnI levels, predicted 3-month mortality. Conclusions In geriatric patients with suspected MI, frailty and cardiovascular multimorbidity should be carefully considered when interpreting emergency hs-TnI testing. C1 [Ticinesi, Andrea; Guerra, Angela; Meschi, Tiziana] Univ Parma, Dept Med & Surg, Parma, Italy. [Ticinesi, Andrea; Nouvenne, Antonio; Cerundolo, Nicoletta; Prati, Beatrice; Parise, Alberto; Guerra, Angela; Meschi, Tiziana] Azienda Osped Univ Parma, Geriatr Rehabil Dept, Parma, Italy. [Tana, Claudio] SS Annunziata Hosp, Internal Med Unit, Chieti, Italy. [Tana, Claudio] SS Annunziata Hosp, Geriatr Clin, Chieti, Italy. [Rendo, Martina] Azienda Unita Sanit Locale Parma, Primary Care Dept, Parma, Italy. C3 University of Parma; University of Parma; University Hospital of Parma RP Ticinesi, A (通讯作者),Univ Parma, Dept Med & Surg, Parma, Italy.; Ticinesi, A (通讯作者),Parma Univ Hosp, Geriatr Rehabil Dept, Via Antonio Gramsci 14, I-43126 Parma, Italy. EM andrea.ticinesi@unipr.it RI Tana, Claudio/AFU-7973-2022; Ticinesi, Andrea/K-5017-2016 OI Ticinesi, Andrea/0000-0001-9171-8592; Tana, Claudio/0000-0002-9162-7866 FU Universita degli Studi di Parma within the CRUI-CARE Agreement FX The authors also wish to thank Bianca Linardis, Laura Frosio, Francesca Papaleo, Federica Calavita, Marcello Esposito, Elisa Canossini, and Filippo Pensotti for assistance in patient screening and enrolment, and Tiziana Russo for data managing. Open Access Funding provided by Universita degli Studi di Parma within the CRUI-CARE Agreement. 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Am. Geriatr. Soc. PD FEB PY 2022 VL 70 IS 2 BP 549 EP 559 DI 10.1111/jgs.17566 EA NOV 2021 PG 11 WC Geriatrics & Gerontology; Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA YU0CO UT WOS:000719874300001 PM 34792185 OA Green Published DA 2023-05-13 ER PT J AU Davis, M Lewell, M McLeod, S Dukelow, A AF Davis, Matthew Lewell, Michael McLeod, Shelley Dukelow, Adam TI A PROSPECTIVE EVALUATION OF THE UTILITY OF THE PREHOSPITAL 12-LEAD ELECTROCARDIOGRAM TO CHANGE PATIENT MANAGEMENT IN THE EMERGENCY DEPARTMENT SO PREHOSPITAL EMERGENCY CARE LA English DT Article DE acute coronary syndrome; electrocardiogram; emergency medical services; emergency medicine ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; TIME; INTERVENTION; IMPACT; TRANSMISSION; GUIDELINES; FREQUENCY; ISCHEMIA; THERAPY AB Objective. Retrospective research has shown that 19% of 12-lead prehospital electrocardiograms (prehospital ECGs) had clinically significant abnormalities that were not captured on the initial emergency department (ED) ECG and had the potential to change medical management. The purpose of this study was to prospectively determine how many prehospital ECGs had clinically significant abnormalities not present on the initial ED ECG and determine how many prehospital ECGs changed physician management. Methods. We conducted a 3-month, prospective cohort study of patients who had a 12-lead prehospital ECG completed by EMS prior to arriving at one of two tertiary care EDs. STEMI bypass patients were excluded. Physicians reviewed the prehospital ECG to determine whether there were any clinically significant abnormalities present on the prehospital ECG not captured on the initial ED ECG. Physicians recorded if and how the prehospital ECG changed their management. Results. A total of 281 patients were enrolled. Thirty-five (12.5%; 95% CI: 9.1%, 16.8%) prehospital ECGs showed changes that were not captured on the initial ED ECG (11 ST depression, 5 T-wave inversion [TWI], 2 ST depression and TWI, 12 arrhythmia, 2 arrhythmia with ST depression, 2 ST elevation, 1 unknown). Fifty-two (18.5%; 95% CI: 14.4%, 23.5%) prehospital ECGs influenced physician management. There were 30 (10.7%) instances where physicians were willing to refer the patient to an inpatient service based on information captured on the prehospital ECG, regardless if the initial ED ECG was normal. Conclusions. Prehospital ECGs show clinically significant abnormalities that are not always captured on the initial ED ECG. Prehospital ECGs have the potential to change the management of patients in the ED. C1 [Davis, Matthew; Lewell, Michael; McLeod, Shelley; Dukelow, Adam] Univ Western Ontario, Dept Med, Div Emergency Med, London, ON, Canada. 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Emerg. Care PD JAN-MAR PY 2014 VL 18 IS 1 BP 9 EP 14 DI 10.3109/10903127.2013.825350 PG 6 WC Emergency Medicine; Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine; Public, Environmental & Occupational Health GA 270OO UT WOS:000328328200002 PM 24028608 DA 2023-05-13 ER PT J AU Agarwal, S AF Agarwal, S. TI Platelet function testing in cardiac surgery SO TRANSFUSION MEDICINE LA English DT Review DE bleeding; cardiac surgery; platelet function ID ACUTE CORONARY SYNDROMES; ARTERY-BYPASS SURGERY; CLOPIDOGREL-TREATED PATIENTS; ANTIPLATELET THERAPY; CARDIOPULMONARY BYPASS; MYOCARDIAL-INFARCTION; ADENOSINE-DIPHOSPHATE; ADVERSE OUTCOMES; GRAFT-SURGERY; NONCARDIAC SURGERY AB Bleeding in cardiac surgery is known to cause increased morbidity and mortality. The rise in the use of anti-platelet medication has led to an increase in the number of patients presenting for cardiac surgery with platelet dysfunction, who are at a heightened risk of bleeding. However, the extent of platelet inhibition is well known to differ among individuals. In the past few years, a number of point-of-care platelet function testing devices, which may be able to assess platelet reactivity, have entered the market. This review will examine the devices most commonly studied and the evidence surrounding their use in cardiac surgery and their effect on blood loss. C1 [Agarwal, S.] Liverpool Heart & Chest Hosp, Dept Anaesthesia & Crit Care, Liverpool, Merseyside, England. C3 Liverpool Heart & Chest Hospital RP Agarwal, S (通讯作者),Liverpool Heart & Chest Hosp, Thomas Dr, Liverpool L13 4PE, Merseyside, England. 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Med. PD OCT PY 2016 VL 26 IS 5 BP 319 EP 329 DI 10.1111/tme.12335 PG 11 WC Hematology WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology GA EA6SF UT WOS:000386758500001 PM 27535575 DA 2023-05-13 ER PT J AU Meek, R Braitberg, G Cullen, L Than, M Graudins, A Glynn, D AF Meek, Robert Braitberg, George Cullen, Louise Than, Martin Graudins, Andis Glynn, Deirdre TI Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department SO EMERGENCY MEDICINE AUSTRALASIA LA English DT Article DE acute coronary syndrome; chest pain; emergency department; practice guideline; treatment outcome ID ACUTE CORONARY SYNDROME; RANDOMIZED CONTROLLED-TRIAL; MYOCARDIAL-INFARCTION; PROSPECTIVE VALIDATION; MANAGEMENT; DISCHARGE; PROTOCOL; SCORE; ASSOCIATION; GUIDELINES AB ObjectivesPrimary: to determine incidence of 30 day major adverse cardiac events (MACE) in patients discharged from the ED following assessment using an accelerated diagnostic pathway (ADP). Secondary: to determine incidence of 30 day MACE for all ADP patients. MethodsMonash Health ED patients thought at low risk for acute myocardial infarction (AMI) or hospital admission are assessed using an ADP, based on arrival and 90 min point-of-care (POC) cardiac troponin I and myoglobin concentration. Other patients are assessed using a traditional pathway of arrival and 6 h central lab cardiac troponin I. Choice of pathway is based on the clinical judgement of the attending ED doctor. To investigate the safety of the ADP component, an observational study of all ADP patients presenting from 6 June 2013 to 30 September 2013 was conducted. After 30 days, occurrence of MACE was determined by examination of hospital records or telephone contact with patients who had not returned. ResultsOf 1547 eligible patients, 1384 (89.5%) were followed up. Of the 1143 discharged patients with follow-up information, 30 day MACE occurred in one (0.09%, 95% CI 0.002-0.5). Of all 1547 patients, 60 patients had a MACE detected: 56 AMI during the initial attendance, four AMI post-discharge (one from ED, three after hospital admission). In total, of the 1328 patients who did not have AMI during the target admission and were followed up, 30 day post-discharge MACE occurred in four patients (0.3%, 95% CI 0.08-0.8). ConclusionThe ADP supports safe, early discharge of low-risk chest pain patients from the ED. C1 [Meek, Robert; Braitberg, George; Graudins, Andis; Glynn, Deirdre] Monash Hlth, Monash Emergency Med Program, Melbourne, Vic, Australia. [Meek, Robert; Braitberg, George; Graudins, Andis] Monash Univ, Sch Clin Sci, Monash Hlth, Melbourne, Vic 3004, Australia. [Braitberg, George] Royal Melbourne Hosp, Dept Emergency Med, Melbourne, Vic, Australia. [Braitberg, George] Univ Melbourne, Dept Med, Melbourne, Vic, Australia. [Cullen, Louise] Royal Brisbane & Womens Hosp, Dept Emergency Med, Brisbane, Qld, Australia. [Cullen, Louise] Queensland Univ Technol, Brisbane, Qld 4001, Australia. [Than, Martin] Christchurch Hosp, Dept Emergency Med, Christchurch, New Zealand. [Than, Martin] Univ Otago, Sch Med, Christchurch, New Zealand. C3 Monash University; Royal Melbourne Hospital; University of Melbourne; Royal Brisbane & Women's Hospital; Queensland University of Technology (QUT); Christchurch Hospital New Zealand; University of Otago RP Meek, R (通讯作者),Dandenong Hosp, Emergency Dept, 135 David St, Dandenong, Vic 3175, Australia. 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Med. Australas. PD JUN PY 2016 VL 28 IS 3 BP 279 EP 286 DI 10.1111/1742-6723.12570 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA DN6SX UT WOS:000377207600006 PM 26998819 OA Green Published DA 2023-05-13 ER PT J AU Ishiyama, Y Hoshide, S Mizuno, H Kario, K AF Ishiyama, Yusuke Hoshide, Satoshi Mizuno, Hiroyuki Kario, Kazuomi TI Constipation-induced pressor effects as triggers for cardiovascular events SO JOURNAL OF CLINICAL HYPERTENSION LA English DT Review DE cardiovascular disease; constipation; hemodynamic atherothrombotic syndrome; intestinal microbiota; strain at stool; synergistic resonance hypothesis of blood pressure variability ID BLOOD-PRESSURE; DEFECATION; MANAGEMENT; THERAPIES; MORTALITY; RELEVANCE; FREQUENCY; EXERCISE; DISEASE; DIET AB Constipation is associated with cardiovascular events. Changes to the intestinal microbiota by constipation can induce atherosclerosis, blood pressure rise, and cardiovascular events. Constipation increases with age and often coexists with cardiovascular risk factors. In addition, strain at stool causes blood pressure rise, which can trigger cardiovascular events such as congestive heart failure, arrhythmia, acute coronary disease, and aortic dissection. However, because cardiovascular medical research often focuses on more dramatic interventions, the risk from constipation can be overlooked. Physicians caring for patients with cardiovascular disease should acknowledge constipation and straining with it as important cardiovascular risk, and prematurely intervene to prevent it. The authors review and discuss the relationship between constipation and cardiovascular disease. C1 [Ishiyama, Yusuke; Hoshide, Satoshi; Mizuno, Hiroyuki; Kario, Kazuomi] Jichi Med Univ, Dept Med, Div Cardiovasc Med, Shimotsuke, Tochigi, Japan. C3 Jichi Medical University RP Kario, K (通讯作者),Jichi Med Univ, Sch Med, Dept Med, Div Cardiovasc Med, Shimotsuke, Tochigi, Japan. 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TI Electroanalytical point-of-care detection of gold standard and emerging cardiac biomarkers for stratification and monitoring in intensive care medicine - a review SO MICROCHIMICA ACTA LA English DT Review DE Biosensor; Nanomaterial; Electrochemistry; Electroanalysis; Cardiac biomarkers; Critically ill; Intensive care ID ACID-BINDING-PROTEIN; C-REACTIVE PROTEIN; ACUTE MYOCARDIAL-INFARCTION; BRAIN NATRIURETIC PEPTIDE; REDUCED GRAPHENE OXIDE; NECROSIS-FACTOR-ALPHA; FREE ELECTROCHEMICAL IMMUNOSENSOR; FREE PHOTOELECTROCHEMICAL IMMUNOSENSOR; GROWTH-DIFFERENTIATION FACTOR-15; SANDWICH-TYPE IMMUNOSENSOR AB Determination of specific cardiac biomarkers (CBs) during the diagnosis and management of adverse cardiovascular events such as acute myocardial infarction (AMI) has become commonplace in emergency department (ED), cardiology and many other ward settings. Cardiac troponins (cTnT and cTnI) and natriuretic peptides (BNP and NT-pro-BNP) are the preferred biomarkers in clinical practice for the diagnostic workup of AMI, acute coronary syndrome (ACS) and other types of myocardial ischaemia and heart failure (HF), while the roles and possible clinical applications of several other potential biomarkers continue to be evaluated and are the subject of several comprehensive reviews. The requirement for rapid, repeated testing of a small number of CBs in ED and cardiology patients has led to the development of point-of-care (PoC) technology to circumvent the need for remote and lengthy testing procedures in the hospital pathology laboratories. Electroanalytical sensing platforms have the potential to meet these requirements. This review aims firstly to reflect on the potential benefits of rapid CB testing in critically ill patients, a very distinct cohort of patients with deranged baseline levels of CBs. We summarise their source and clinical relevance and are the first to report the required analytical ranges for such technology to be of value in this patient cohort. Secondly, we review the current electrochemical approaches, including its sub-variants such as photoelectrochemical and electrochemiluminescence, for the determination of important CBs highlighting the various strategies used, namely the use of micro- and nanomaterials, to maximise the sensitivities and selectivities of such approaches. Finally, we consider the challenges that must be overcome to allow for the commercialisation of this technology and transition into intensive care medicine. C1 [Crapnell, Robert D.; Dempsey, Nina C.; Sigley, Evelyn; Banks, Craig E.] Manchester Metropolitan Univ, Fac Sci & Engn, Manchester M1 5GD, Lancs, England. [Tridente, Ascanio] St Helens & Knowsley Teaching Hosp NHS Trust, Whiston Hosp, Intens Care Unit, Warrington Rd, Warrington L35 5DR, Cheshire, England. 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Acta PD APR PY 2022 VL 189 IS 4 AR 142 DI 10.1007/s00604-022-05186-9 PG 48 WC Chemistry, Analytical WE Science Citation Index Expanded (SCI-EXPANDED) SC Chemistry GA ZR7AV UT WOS:000767932000001 PM 35279780 OA hybrid, Green Published, Green Accepted DA 2023-05-13 ER PT J AU Lee, CH Cheng, CL Yang, YHK Chao, TH Chen, JY Liu, PY Lin, CC Chan, SH Tsai, LM Chen, JH Lin, LJ Li, YH AF Lee, Cheng-Han Cheng, Ching-Lan Yang, Yea-Huei Kao Chao, Ting-Hsing Chen, Ju-Yi Liu, Ping-Yen Lin, Chih-Chan Chan, Shih-Hung Tsai, Liang-Miin Chen, Jyh-Hong Lin, Li-Jen Li, Yi-Heng TI Trends in the Incidence and Management of Acute Myocardial Infarction From 1999 to 2008: Get With the Guidelines Performance Measures in Taiwan SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE epidemiology; incidence; myocardial infarction; population ID ACUTE CORONARY SYNDROME; ASSOCIATION TASK-FORCE; HEART-ASSOCIATION; POPULATION TRENDS; HEALTH-INSURANCE; RISK-FACTORS; ELEVATION; OUTCOMES; DISEASE; CARE AB Background-The American Heart Association Get With the Guidelines (GWTG) program has improved care quality of acute myocardial infarction (AMI) with important implications for other countries in the world. This study evaluated the incidence and care of AMI in Taiwan and assessed the compliance of GWTG in Taiwan. Methods and Results-We used the Taiwan National Health Insurance Research Database (1999-2008) to identify hospitalized patients >= 18 years of age presenting with AMI. The temporal trends of annual incidence and care quality of AMI were evaluated. The age-adjusted incidence of AMI (/ 100 000 person-years) increased from 28.0 in 1999 to 44.4 in 2008 (P<0.001). The use of guideline-based medications for AMI was evaluated. The use of dual antiplatelet therapy (DAPT) increased from 65% in 2004 to 83.9% in 2008 (P<0.001). Angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) was used in 72.6% in 2004 and 71.7% in 2008 (P=NS) and beta-blocker was used in 60% in 2004 and 59.7% in 2008 (P=NS). Statin use increased from 32.1% to 50.1% from 2004 to 2008 (P<0.001). The in-hospital mortality decreased from 15.9% in 1999 to 12.3% in 2008 (P<0.0001). Multivariable analysis showed that DAPT, ACE inhibitor/ARB, beta-blocker, and statin use during hospitalization were all associated with reduced in-hospital mortality in our AMI patients. Conclusions-AMI incidence was increasing, but the guideline-based medications for AMI were underutilized in Taiwan. Quality improvement programs, such as GWTG, should be promoted to improve AMI care and outcomes in Taiwan. C1 [Lee, Cheng-Han; Chao, Ting-Hsing; Chen, Ju-Yi; Liu, Ping-Yen; Lin, Chih-Chan; Chan, Shih-Hung; Tsai, Liang-Miin; Chen, Jyh-Hong; Lin, Li-Jen; Li, Yi-Heng] Natl Cheng Kung Univ, Coll Med & Hosp, Dept Internal Med, Tainan 70101, Taiwan. [Cheng, Ching-Lan; Yang, Yea-Huei Kao] Natl Cheng Kung Univ, Coll Med & Hosp, Inst Clin Pharm & Pharmaceut Sci, Tainan 70101, Taiwan. C3 National Cheng Kung University; National Cheng Kung University RP Li, YH (通讯作者),Natl Cheng Kung Univ Hosp, Dept Internal Med, Div Cardiol, 138 Sheng Li Rd, Tainan 70428, Taiwan. EM heng@mail.ncku.edu.tw RI LI, yi/HKO-0480-2023 FU AstraZeneca, Taiwan; National Cheng Kung University Hospital, Tainan, Taiwan [NCKUH-10101002] FX This study was funded by AstraZeneca, Taiwan and National Cheng Kung University Hospital, Tainan, Taiwan (NCKUH-10101002). The funding organizations had no role in the design, performance, or analysis of this study or decision to submit the manuscript for publication. 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Am. Heart Assoc. PD AUG PY 2014 VL 3 IS 4 AR e001066 DI 10.1161/JAHA.114.001066 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AO4HD UT WOS:000341296600048 PM 25112555 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Troxel, AB Asch, DA Mehta, SJ Norton, L Taylor, D Calderon, TA Lim, R Zhu, JS Kolansky, DM Drachman, BM Volpp, KG AF Troxel, Andrea B. Asch, David A. Mehta, Shivan J. Norton, Laurie Taylor, Devon Calderon, Tirza A. Lim, Raymond Zhu, Jingsan Kolansky, Daniel M. Drachman, Brian M. Volpp, Kevin G. TI Rationale and design of a randomized trial of automated hovering for post-myocardial infarction patients: The HeartStrong program SO AMERICAN HEART JOURNAL LA English DT Article ID CONVERTING ENZYME-INHIBITORS; LONG-TERM ADHERENCE; FINANCIAL INCENTIVES; MYOCARDIAL-INFARCTION; MONETARY CONTRACTS; STATIN THERAPY; BETA-BLOCKERS; WEIGHT-LOSS; PRESCRIPTIONS; INTERVENTIONS AB Background Coronary artery disease is the single leading cause of death in the United States, and medications can significantly reduce the rate of repeat cardiovascular events and treatment procedures. Adherence to these medications, however, is very low. Methods HeartStrong is a national randomized trial offering 3 innovations. First, the intervention is built on concepts from behavioral economics that we expect to enhance its effectiveness. Second, the implementation of the trial takes advantage of new technology, including wireless pill bottles and remote feedback, to substantially automate procedures. Third, the trial's design includes an enhancement of the standard randomized clinical trial that allows rapid-cycle innovation and ongoing program enhancement. Results Using a system involving direct data feeds from 6 insurance partners followed by mail, telephone, and email contact, we enrolled 1,509 patients discharged from the hospital with acute myocardial infarction in a 2:1 ratio of intervention:usual care. The intervention period lasts 1 year; the primary outcome is time to first fatal or nonfatal acute vascular event or revascularization, including acute myocardial infarction, unstable angina, stroke, acute coronary syndrome admission, or death. Conclusions Our randomized controlled trial of the HeartStrong program will provide an evaluation of a state-of-the-art behavioral economic intervention with a number of important pragmatic features. These include a tailored intervention responding to patient activity, streamlining of consent and implementation processes using new technologies, outcomes centrally important to patients, and the ability to implement rapid-cycle innovation. C1 [Troxel, Andrea B.; Asch, David A.; Mehta, Shivan J.; Norton, Laurie; Taylor, Devon; Calderon, Tirza A.; Lim, Raymond; Zhu, Jingsan; Kolansky, Daniel M.; Drachman, Brian M.; Volpp, Kevin G.] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. C3 University of Pennsylvania; Pennsylvania Medicine RP Troxel, AB (通讯作者),Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. EM atroxel@mail.med.upenn.edu OI Troxel, Andrea/0000-0002-1393-3075; Asch, David/0000-0002-7970-286X; Volpp, Kevin/0000-0003-1423-4599 FU Center for Medicare & Medicaid Innovation, Health Care Innovation Award [1C1CMS337009]; CVS Caremark; Hawaii Medical Services Association; Humana; Merck; Weight Watchers; Discovery (South Africa) FX The trial is funded with a grant from Center for Medicare & Medicaid Innovation, Health Care Innovation Award 1C1CMS337009.; Dr Troxel serves on the Scientific Advisory Board of VAL Health. Drs Asch and Volpp are principals and owners of VAL Health. Dr Volpp has served as a consultant for CVS Caremark and received grants from CVS Caremark, Hawaii Medical Services Association, Humana, Merck, Weight Watchers, and Discovery (South Africa). 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Rev. Med. PY 2014 VL 65 BP 81 EP 94 DI 10.1146/annurev-med-101712-122545 PG 14 WC Medicine, Research & Experimental WE Book Citation Index– Science (BKCI-S); Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA BA4OD UT WOS:000336053000006 PM 24111889 OA Green Accepted DA 2023-05-13 ER PT J AU Goncalves, SM Gomes, KB Carvalho, MD Magalhaes, HPB Reis, EA Silva, IDO AF Goncalves, Simone M. Gomes, Karina B. Carvalho, Maria das G. Magalhaes, Henrique P. B. Reis, Edna A. Silva, Ieda de Fatima O. TI Effectiveness to identify acute myocardial infarction using the Manchester screening in patients with chest pain at the emergency service SO JOURNAL OF CLINICAL LABORATORY ANALYSIS LA English DT Article DE acute myocardial infarction; cardiac troponin I; creatine kinase MB mass; Manchester Triage System; myoglobin ID ACCURACY; CARE AB BackgroundAmong cardiovascular diseases (CVD), acute coronary syndrome (ACS) is the main manifestation, corresponding to signs and symptoms that occur with ischemia and outcome of angina or acute myocardial infarction (AMI). The aim of this study was to investigate the performance of biochemical markers eligible in a chest pain protocol, using Point of care Test (POCT), in patients in a reference emergency room. MethodsIn this study, 1380 medical records of patients of both genders were evaluated, ranked by applying chest pain protocol using the Manchester Triage System (MTS). Markers for myocardial injury were measured in serial analysis including myoglobin (Mgb), creatine kinase MB fraction mass (CK-MB), and cardiac troponin I (cTnI). ResultsAcute myocardial infarction was predominant in males (P<.001), in patients with hypertension (P<.001), and in those with previous myocardial infarction (P<.026) and significant electrocardiogram (ECG) data for AMI screening (P<.001). A multivariate regression model showed as predictors for AMI the variables ECG data by admittance at the emergency room, previous AMI history, levels of both Mgb at the third hour, and cTnI at the sixth hour after admission. ConclusionThis study showed the importance of a rapid and serial test as a cardiac marker for AMI screening, as well as has indicated the importance of time between the onset of chest pain and admission to the emergency room as an efficient aid in diagnosing this life-threatening disease. C1 [Goncalves, Simone M.; Gomes, Karina B.; Carvalho, Maria das G.; Magalhaes, Henrique P. B.; Silva, Ieda de Fatima O.] Univ Fed Minas Gerais, Fac Farm, Dept Analises Clin & Toxicol, Belo Horizonte, MG, Brazil. [Reis, Edna A.] Univ Fed Minas Gerais, Inst Ciencias Exatas, Dept Estat, Belo Horizonte, MG, Brazil. C3 Universidade Federal de Minas Gerais; Universidade Federal de Minas Gerais RP Silva, IDO (通讯作者),Univ Fed Minas Gerais, Fac Farm, Belo Horizonte, MG, Brazil. EM iedafos@farmacia.ufmg.br RI Reis, Edna/AAZ-1502-2020 OI Silva, Ieda/0000-0002-1843-2632; Braga Gomes, Karina/0000-0002-6870-2063 CR Canto JG, 2012, JAMA-J AM MED ASSOC, V307, P813, DOI 10.1001/jama.2012.199 Chung SC, 2014, LANCET, V383, P1305, DOI 10.1016/S0140-6736(13)62070-X D'Ascenzo F, 2011, AM J CARDIOL, V107, P651, DOI 10.1016/j.amjcard.2010.10.038 Franca Everaldo de, 2006, Arq. Bras. Cardiol., V87, P722, DOI 10.1590/S0066-782X2006001900007 Diercks DB, 2012, AM HEART J, V163, P74, DOI 10.1016/j.ahj.2011.09.028 Figiel L, 2008, KARDIOL POL, V66, P253 Gerdtz M F, 1999, Accid Emerg Nurs, V7, P50, DOI 10.1016/S0965-2302(99)80103-9 Januzzi JL, 2015, AM HEART J, V169, P572, DOI 10.1016/j.ahj.2014.12.023 Lorga AM, 2013, ARQ BRAS CARDIOL, V101, P1, DOI [10.5935/abc.2013S009, 10.5935/abc.2013S006] Dias AM, 2013, EUR HEART J, V34, P951 Ministerio da Saude (MS), PROT SINDR COR AG Thygesen K, 2012, EUR HEART J, V33, P2252, DOI 10.1093/eurheartj/ehs154 van Oeffelen AAM, 2015, EUR J PREV CARDIOL, V22, P180, DOI 10.1177/2047487313503618 Wang JY, 2015, CAN J CARDIOL, V31, P1455, DOI 10.1016/j.cjca.2015.04.007 NR 14 TC 2 Z9 2 U1 2 U2 12 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0887-8013 EI 1098-2825 J9 J CLIN LAB ANAL JI J. Clin. Lab. Anal. PD JUL PY 2018 VL 32 IS 6 AR e22439 DI 10.1002/jcla.22439 PG 5 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA GN3JH UT WOS:000438900600036 PM 29607545 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Hachey, BJ Kontos, MC Newby, LK Christenson, RH Peacock, WF Brewer, KC McCord, J AF Hachey, Brian J. Kontos, Michael C. Newby, L. Kristin Christenson, Robert H. Peacock, W. Frank Brewer, Katherine C. McCord, James TI Trends in Use of Biomarker Protocols for the Evaluation of Possible Myocardial Infarction SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE cardiac biomarkers; myocardial infarction; trends; troponin ID UNIVERSAL DEFINITION; TROPONIN-I; SENSITIVITY; MYOGLOBIN; MARKERS; ASSAY AB Background-Various combinations of creatine kinase-MB, myoglobin, and cardiac troponin I or T (cTnI/cTnT) have been used to evaluate patients with suspected acute coronary syndromes. The current recommendation is to use the 99th percentile of cTnI/cTnT as the sole marker for diagnosis of acute myocardial infarction. Methods and Results-We retrospectively analyzed cardiac marker protocols collected from 824 US hospitals undergoing Chest Pain Center Accreditation through the Society of Cardiovascular Patient Care from 2009 to 2014. Data were obtained by a self-reported survey that addressed cardiac marker(s), sampling time periods, and cut points used for evaluation of suspected acute myocardial infarction. The combination of cTnI or cTnT with creatine kinase-MB was the most commonly used biomarker strategy. Use of cTnI or cTnT as the sole marker increased over time (14-37%; P<0.0001), as did use of the 99th percentile cut point for cTnI/cTnT (30-60%; P<0.0001). Conclusion-There is considerable variation in cardiac marker testing strategies used in US hospitals for evaluation of suspected acute myocardial infarction. Although increasing, 24% of hospitals used a cTn alone strategy, and only 49% used cTn at the recommended 99th percentile cut point. This has important implications for the diagnosis and treatment of patients with acute myocardial infarction. C1 [Hachey, Brian J.] Advocate Illinois Masonic Med Ctr, Dept Cardiol, 836 W Wellington Ave, Chicago, IL 60657 USA. [Kontos, Michael C.] Virginia Commonwealth Univ, Pauley Heart Ctr, Richmond, VA USA. [Newby, L. Kristin] Duke Univ, Dept Cardiol, Durham, NC USA. [Christenson, Robert H.] Univ Maryland, Sch Med, Dept Pathol, Baltimore, MD 21201 USA. [Peacock, W. Frank] Baylor Coll Med, Dept Emergency Med, Houston, TX 77030 USA. [Brewer, Katherine C.] Advocate Illinois Masonic Med Ctr, Dept Res, Chicago, IL 60657 USA. [McCord, James] Henry Ford Hosp, Dept Cardiol, Detroit, MI 48202 USA. C3 Virginia Commonwealth University; Duke University; University System of Maryland; University of Maryland Baltimore; Baylor College of Medicine; Henry Ford Health System; Henry Ford Hospital RP Hachey, BJ (通讯作者),Advocate Illinois Masonic Med Ctr, Dept Cardiol, 836 W Wellington Ave, Chicago, IL 60657 USA. EM brian.hachey@advocatehealth.com CR Alpert JS, 2000, J AM COLL CARDIOL, V36, P959, DOI 10.1016/S0735-1097(00)00804-4 Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2713, DOI [10.1016/j.jacc.2014.10.011, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.09.017] Collinson PO, 2006, ANN CLIN BIOCHEM, V43, P273, DOI 10.1258/000456306777695555 Eggers KM, 2004, AM HEART J, V148, P574, DOI 10.1016/j.ahj.2004.04.030 Fanaroff AC, 2015, JAMA-J AM MED ASSOC, V314, P1955, DOI 10.1001/jama.2015.12735 Hamm CW, 2001, CIRCULATION, V104, P1454, DOI 10.1161/circ.104.13.1454 Jarolim P, 2015, CLIN CHEM LAB MED, V53, P635, DOI 10.1515/cclm-2014-0565 Kavsak PA, 2007, CLIN CHIM ACTA, V380, P213, DOI 10.1016/j.cca.2007.01.001 Larochelle MR, 2014, J GEN INTERN MED, V29, P1468, DOI 10.1007/s11606-014-2919-5 Layfield C, 2015, CLIN BIOCHEM, V48, P204, DOI 10.1016/j.clinbiochem.2015.01.014 Le RD, 2015, AM J EMERG MED, V33, P72, DOI 10.1016/j.ajem.2014.10.017 Mills NL, 2012, BMJ-BRIT MED J, V344, DOI 10.1136/bmj.e1533 Mills NL, 2011, JAMA-J AM MED ASSOC, V305, P1210, DOI 10.1001/jama.2011.338 Pulkki K, 2009, CLIN CHEM LAB MED, V47, P227, DOI 10.1515/CCLM.2009.044 Reichlin T, 2009, NEW ENGL J MED, V361, P858, DOI 10.1056/NEJMoa0900428 Safford MM, 2013, BMC HEALTH SERV RES, V13, DOI 10.1186/1472-6963-13-162 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Zhang L, 2016, J COMMUNITY HOSP INT, V6, DOI 10.3402/jchimp.v6.32816 NR 19 TC 12 Z9 12 U1 1 U2 5 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA EI 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD SEP PY 2017 VL 6 IS 9 AR e005852 DI 10.1161/JAHA.117.005852 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA VJ0HA UT WOS:000521570200005 PM 28939707 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Ohle, R Mc Isaac, S Perry, JJ AF Ohle, Robert Mc Isaac, Sarah Perry, Jeffrey J. TI A simple intervention to reduce your chance of missing an acute aortic dissection SO CANADIAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Aortic dissection; diagnostic accuracy; history taking AB Introduction: Acute aortic dissection (AAD) is a time sensitive, difficult to diagnose, aortic emergency. We sought to explore the quality of history taking in AAD and assess its impact on misdiagnosis. Methods: We studied a retrospective cohort of patients >18 years old who presented to two tertiary care emergency departments from January 1st 2004 - December 31st 2012 and were diagnosed with an acute aortic dissection (AAD) on CT, MRI or TEE. Trained reviewers' extracted data using a standardized data collection form. The definitions of 5 pain characteristics - character, onset, duration, quality, and radiation were defined a priori. Results: Data were collected for 194 cases of acute aortic dissection with a mean age of 65(SD 14.1) and 66.7% male, 34 (17.6%) missed on initial presentation. Only 20(14.8%) patients were asked all 5 questions. The most common initial incorrect diagnosis were acute coronary syndrome (16, 47%), pulmonary embolism (5, 14.7%) and stroke (4, 11.7%). If <2 questions were asked 1 in 5 cases were missed, 4 times greater than if >2 were asked (P < 0.01). Conclusion: Clinicians should ask and document the character, onset, duration, radiation and severity of pain in any patient presenting with chest, abdominal or flank pain. A focused history still remains the keystone to reducing misdiagnosis. C1 [Ohle, Robert] Northern Ontario Sch Med, Hlth Sci North Res Inst, Dept Emergency Med, Sudbury, ON, Canada. [Mc Isaac, Sarah] Northern Ontario Sch Med, Hlth Sci North Res Inst, Dept Anaesthesia, Dept Crit Care, Sudbury, ON, Canada. [Perry, Jeffrey J.] Univ Ottawa, Dept Emergency Med, Ottawa Hosp Res Inst, Ottawa, ON, Canada. C3 Health Sciences North; Northern Ontario School of Medicine; Health Sciences North; Northern Ontario School of Medicine; University of Ottawa; Ottawa Hospital Research Institute RP Ohle, R (通讯作者),Hlth Sci North Res Inst, 41 Ramsey Lake Rd, Sudbury, ON K1Y 4E9, Canada. 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PD SEP PY 2019 VL 21 IS 5 BP 618 EP 621 DI 10.1017/cem.2019.1 PG 4 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA JC5ST UT WOS:000489343900026 PM 30907334 OA Bronze DA 2023-05-13 ER PT J AU Aeyels, D Van Vugt, S Sinnaeve, PR Panella, M Van Zelm, R Sermeus, W Vanhaecht, K AF Aeyels, Daan Van Vugt, Stijn Sinnaeve, Peter R. Panella, Massimiliano Van Zelm, Ruben Sermeus, Walter Vanhaecht, Kris TI Lack of evidence and standardization in care pathway documents for patients with ST-elevated myocardial infarction SO EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE Care pathway; acute coronary syndrome; STEMI; quality indicators; evidence-based practice ID RANDOMIZED CONTROLLED-TRIAL; 2013 ACCF/AHA GUIDELINE; ASSOCIATION TASK-FORCE; CLINICAL PATHWAYS; INTERPROFESSIONAL TEAMWORK; QUALITY; MANAGEMENT; SAFETY; ARTHROPLASTY; OUTCOMES AB Background: Clinical practice variation and the subsequent burden on health care quality has been documented for patients with ST-elevated myocardial infarction (STEMI). Reduction of clinical practice variation is possible by increasing guideline adherence. Care pathway documents can increase guideline adherence by implementing evidence-based key interventions and quality indicators in daily practice. Aims: This study aims to examine guideline adherence of care pathway documents for patients with STEMI. Methods: Lay-out, size and timeframe of submitted care pathways documents were analysed. Two independent reviewers used a checklist to systematically assess the guideline adherence of care pathway documents. The checklist comprised a set of key interventions and quality indicators extracted from evidence and international guidelines. The checklist distinguished the evidence level for each item and was validated by expert consensus. Results were verified by inviting participating hospitals to provide feedback. Results: Fifteen out of 25 invited hospitals submitted care pathway documents for STEMI. The care pathway documents differed in timeframe, lay-out and size. Analysis of the care pathway documents showed important variation in formalizing adherence to evidence: between hospitals, inclusion of 24 key interventions in care pathway documents varied from 13 to 97%. Inclusion of 11 essential quality indicators varied from 0 to 40%. Conclusion: Care pathway documents for patients with STEMI differ considerably in lay-out, timeframe and size. This study showed variation in, and suboptimal inclusion of, evidence-based key interventions and quality indicators in care pathway documents. The use of these care pathway documents might result in suboptimal quality of care for STEMI patients. C1 [Aeyels, Daan; Van Vugt, Stijn; Sermeus, Walter; Vanhaecht, Kris] Univ Leuven, Dept Publ Hlth & Primary Care, Louvain, Belgium. [Aeyels, Daan; Van Zelm, Ruben; Sermeus, Walter; Vanhaecht, Kris] European Pathway Assoc, Louvain, Belgium. [Sinnaeve, Peter R.] Univ Hosp Leuven, Dept Cardiovasc Med, Louvain, Belgium. [Panella, Massimiliano] Amedeo Avogadro Univ Eastern Piedmont, Dept Clin & Expt Med, Louvain, Belgium. [Van Zelm, Ruben] QConsult, Amsterdam, Netherlands. [Vanhaecht, Kris] Univ Hosp Leuven, Dept Qual Management, Louvain, Belgium. C3 KU Leuven; KU Leuven; University Hospital Leuven; University of Eastern Piedmont Amedeo Avogadro; KU Leuven; University Hospital Leuven RP Aeyels, D (通讯作者),Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Ctr Hlth Serv & Nursing Res, Kapucijnenvoer 35, B-3000 Louvain, Belgium. EM daan.aeyels@med.kuleuven.be RI van Vugt, Stijn PG/P-9491-2015; Vanhaecht, Kris/R-9945-2017; Vanhaecht, Kris/ACW-1273-2022; Panella, Massimiliano/AAE-8109-2021; Aeyels, Daan/F-8523-2013; Sermeus, Walter/J-4290-2017 OI van Vugt, Stijn PG/0000-0001-7405-9054; Aeyels, Daan/0000-0002-8367-9084; Sermeus, Walter/0000-0002-5915-1845; PANELLA, Massimiliano/0000-0003-1880-7198; Vanhaecht, Kris/0000-0001-5636-4792; Sinnaeve, Peter/0000-0003-4716-5892 FU AstraZeneca FX We thank AstraZeneca for the provision of unrestricted educational grant to the Care Pathways for Acute Coronary Syndrome (CP4ACS) quality improvement research project. 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J. Cardiovasc. Nurs. PD APR PY 2016 VL 15 IS 3 BP E45 EP E51 DI 10.1177/1474515115580237 PG 7 WC Cardiac & Cardiovascular Systems; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology; Nursing GA DJ2EL UT WOS:000374016400007 PM 25834274 OA Bronze DA 2023-05-13 ER PT S AU Regan, B O'Kennedy, R Collins, D AF Regan, Brian O'Kennedy, Richard Collins, David BE Makowski, GS TI Advances in point-of-care testing for cardiovascular diseases SO ADVANCES IN CLINICAL CHEMISTRY, VOL 104 SE Advances in Clinical Chemistry LA English DT Review; Book Chapter ID CARDIAC TROPONIN-I; ACUTE MYOCARDIAL-INFARCTION; C-REACTIVE PROTEIN; HIGH-SENSITIVITY TROPONIN; RECOMBINANT ANTIBODY FRAGMENTS; APTAMER-BASED BIOSENSORS; CHAIN VARIABLE FRAGMENT; ACUTE CORONARY SYNDROME; LATERAL FLOW ASSAY; EARLY-DIAGNOSIS AB Point-of-care testing (POCT) is a specific format of diagnostic testing that is conducted without accompanying infrastructure or sophisticated instrumentation. Traditionally, such rapid sample-to-answer assays provide inferior analytical performances to their laboratory counterparts when measuring cardiac biomarkers. Hence, their potentially broad applicability is somewhat bound by their inability to detect clinically relevant concentrations of cardiac troponin (cTn) in the early stages of myocardial injury. However, the continuous refinement of biorecognition elements, the optimization of detection techniques, and the fabrication of tailored fluid handling systems to manage the sensing process has stimulated the production of commercial assays that can support accelerated diagnostic pathways. This review will present the latest commercial POC assays and examine their impact on clinical decision-making. The individual elements that constitute POC assays will be explored, with an emphasis on aspects that contribute to economically feasible and highly sensitive assays. Furthermore, the prospect of POCT imparting a greater influence on early interventions for medium to high-risk individuals and the potential to re-shape the paradigm of cardiovascular risk assessments will be discussed. C1 [Regan, Brian; O'Kennedy, Richard; Collins, David] Dublin City Univ, Sch Biotechnol, Dublin, Ireland. [O'Kennedy, Richard] Hamad Bin Khalifa Univ, Qatar Fdn, Res Complex, Doha, Qatar. C3 Dublin City University; Qatar Foundation (QF); Hamad Bin Khalifa University-Qatar RP Regan, B (通讯作者),Dublin City Univ, Sch Biotechnol, Dublin, Ireland. EM brian.regan3@mail.dcu.ie FU European Union's INTERREG VA Programme FX This project is supported by the European Union's INTERREG VA Programme, managed by the Special EU Programmes Body (SEUPB). 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Clin. Chem. PY 2021 VL 104 BP 1 EP 70 DI 10.1016/bs.acc.2020.09.001 PG 70 WC Medical Laboratory Technology WE Book Citation Index– Science (BKCI-S); Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA BS6II UT WOS:000748728800002 PM 34462053 DA 2023-05-13 ER PT J AU Iannattone, PA Zhao, X VanHouten, J Garg, A Huynh, T AF Iannattone, Patrick A. Zhao, Xun VanHouten, Jacob Garg, Akhil Thao Huynh TI Artificial Intelligence for Diagnosis of Acute Coronary Syndromes: A Meta-analysis of Machine Learning Approaches SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Review ID OF-THE-ART; SYSTEMATIC REVIEWS; CARDIAC ISCHEMIA; NEURAL-NETWORKS; CHEST-PAIN; EMERGENCY AB Background: Machine learning (ML) encompasses a wide variety of methods by which artificial intelligence learns to perform tasks when exposed to data. Although detection of myocardial infarction has been facilitated with introduction of troponins, the diagnosis of acute coronary syndromes (ACS) without myocardial damage (without elevation of serum troponin) remains subjective, and its accuracy remains highly dependent on clinical skills of the health care professionals. Application of a ML algorithm may expedite management of ACS for either early discharge or early initiation of ACS management. We aim to summarize the published studies of ML for diagnosis of ACS. Methods: We searched electronic databases, including PubMed, Embase, and Web of Science from inception up to January 13, 2019, for studies that evaluated ML algorithms for the diagnosis of ACS in patients presenting with chest pain. We then used random-effects bivariate meta-analysis models to summarize the studies. Results: We retained 9 studies that evaluated ML in a total of 6292 patients. The prevalence of ACS in the evaluated cohorts ranged from relatively rare (7%) to common (57%). The pooled sensitivity and specificity were 0.95 and 0.90, respectively. The positive predictive values ranged from 0.64 to 1.0, and the negative predictive values ranged from 0.91 to 1.0. The positive and negative likelihood ratios ranged from 1.6 to 33.0 and 0.01 to 0.13, respectively. Conclusions: The excellent sensitivity, negative likelihood ratio, and negative predictive values suggest that ML may be useful as an initial triage tool for ruling out ACS. C1 [Iannattone, Patrick A.] McGill Univ Hlth Ctr, Div Internal Med, Montreal, PQ, Canada. [Zhao, Xun] Univ Montreal, Div Internal Med, Montreal, PQ, Canada. [VanHouten, Jacob] Griffin Hosp, Dept Internal Med, Derby, CT USA. [VanHouten, Jacob] Griffin Hosp, Dept Prevent Med, Derby, CT USA. [Garg, Akhil] McGill Univ, Fac Med, Montreal, PQ, Canada. [Thao Huynh] McGill Univ Hlth Ctr, Div Cardiol, Dept Med, Montreal, PQ, Canada. 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J. Cardiol. PD APR PY 2020 VL 36 IS 4 BP 577 EP 583 DI 10.1016/j.cjca.2019.09.013 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KY8XY UT WOS:000522860600022 PM 32220387 DA 2023-05-13 ER PT J AU Li, PWC Yu, DSF Yan, BP Wong, CW Yue, SCS Chan, CMC AF Li, Polly W. C. Yu, Doris S. F. Yan, Bryan P. Wong, C. W. Yue, Sunny C. S. Chan, Cecilia M. C. TI Effects of a Narrative-Based Psychoeducational Intervention to Prepare Patients for Responding to Acute Myocardial Infarction A Randomized Clinical Trial SO JAMA NETWORK OPEN LA English DT Article ID TO-BALLOON TIME; PREHOSPITAL DELAY; MODEL; COMMUNICATION; EMPOWERMENT; FRAMEWORK; TRENDS; IMPACT; CARE AB IMPORTANCE Despite decades of educational efforts, patients' prolonged delays in seeking care for symptoms of acute myocardial infarction (AMI) remain the greatest obstacle to successful management of the condition. OBJECTIVE To compare the effects of a narrative-based psychoeducational intervention with a didactic educative approach on AMI survivors' intention to seek care for AMI symptoms and on AMI knowledge. DESIGN, SETTING, AND PARTICIPANTS A multisite randomized clinical trial recruited community-dwelling patients aged 18 years or older with a history of AMI from 4 hospitals in Hong Kong from January 1, 2018, to January 22, 2021, and followed up participants for 1 year. INTERVENTIONS An 8-week narrative-based psychoeducational intervention aimed to create a vivid cognitive experience of complex decision-making and modeled desirable behavioral changes through nurse-led, interactive video sessions using model patients. The control group received 4 nurse-led sessions comprising education about AMI and care seeking delivered using a didactic approach. MAIN OUTCOMES AND MEASURES The primary outcome was the behavioral intention between the 2 groups, reflected by participants' attitudes and beliefs about care seeking for AMI measured using the Acute Coronary Syndrome Response Index-Chinese version. The secondary outcome was AMI knowledge. RESULTS Six hundred and eight participants (mean [SD] age, 67.2 [8.3] years; 469 [77.1%] male) were randomized to either the narrative-based psychoeducation group (n = 304) or the didactic education group (n = 304). The psychoeducational intervention group reported greater positive changes than the control group in their attitudes (beta = -1.053 [95% CI, -1.714 to -0.391]; P < .001) and beliefs (beta = -0.686 [95% CI, -1.354 to -0.180]; P = .04) toward care seeking at the 3-month follow-up, and the difference was sustained at 12 months for both attitudes (beta = -0.797 [95% CI, -1.477 to -0.117); P = .02) and beliefs (beta = -0.692 [95% CI, -1.309 to -0.012]; P = .047). There were no significant differences in AMI knowledge between the 2 study groups at the 3-month and 12-month time points. CONCLUSIONS AND RELEVANCE The results of this randomized clinical trial found that a novel approach of narrative-based psychoeducation was effective in improving patients' behavioral intention to seek care for AMI symptoms. Longer-term follow-up to evaluate actual care-seeking behavior and clinical outcomes in patients with AMI is warranted to determine the sustained effects of this intervention. C1 [Li, Polly W. C.; Yu, Doris S. F.] Univ Hong Kong, LKS Fac Med, Sch Nursing, Hong Kong, Peoples R China. [Yan, Bryan P.] Chinese Univ Hong Kong, Fac Med, Dept Med & Therapeut, Hong Kong, Peoples R China. [Wong, C. W.] Pok Oi Hosp, Dept Med & Geriatr, Hong Kong, Peoples R China. [Yue, Sunny C. S.] United Christian Hosp, Dept Med & Geriatr, Hong Kong, Peoples R China. [Chan, Cecilia M. C.] Queen Elizabeth Hosp, Dept Med, Hong Kong, Peoples R China. C3 University of Hong Kong; Chinese University of Hong Kong; United Christian Hospital RP Li, PWC (通讯作者),Univ Hong Kong, Sch Nursing, Pokfulam, 3 Sassoon Rd,5-F,HKUMed Acad Bldg, Hong Kong, Peoples R China. EM pwcli@hku.hk FU Research Grants Council, Hong Kong [24609017] FX This studywas fully supported by grant No. 24609017 from the Research Grants Council, Hong Kong (Dr Li). 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Open PD OCT 28 PY 2022 VL 5 IS 10 AR e2239208 DI 10.1001/jamanetworkopen.2022.39208 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 5S0HL UT WOS:000874882200010 PM 36306128 OA gold, Green Published DA 2023-05-13 ER PT J AU Jiang, CY Wu, SS Wang, M Zhao, XQ Li, HW AF Jiang, Chunyan Wu, Shanshan Wang, Man Zhao, Xueqiao Li, Hongwei TI J-curve relationship between admission SBP and 2-year cardiovascular mortality in older patients admitted for acute coronary syndrome SO JOURNAL OF HYPERTENSION LA English DT Article DE acute coronary syndrome; all-cause mortality; cardiovascular mortality; J-curve; older; SBP ID ACUTE MYOCARDIAL-INFARCTION; PRESENTING BLOOD-PRESSURE; TIMI RISK SCORE; 30-DAY MORTALITY; PROGNOSTIC-SIGNIFICANCE; CARDIOGENIC-SHOCK; 1-YEAR MORTALITY; CARE-UNIT; PREDICTORS; TRIAL AB Objective: To investigate the relationship between admission SBP and subsequent cardiovascular and all-cause mortality in older patients hospitalized for acute coronary syndrome (ACS). Methods: This is a retrospective observational study. Data from the CBD Bank (Cardiovascular Center Beijing Friendship Hospital Database Bank) were used to analyze the cardiovascular and all-cause mortality during hospitalization and over the follow-up period in relation to admission SBP among patients aged at least 65 years admitted for ACS from December 2012 through July 2019. Results were presented according to SBP quartiles: Q1, less than 120 mmHg; Q2, from 120 to 129 mmHg; Q3, from 130 to 143 mmHg; and Q4, at or above 144 mmHg. Results: A total of 6785 patients were included in this cohort study. Mean (SD) patient age was 74.0 (6.5) years, and 47.6% were women. Mean (SD) follow-up time was 2.54 (1.82) years. A nonlinear relation was observed between SBP at admission and cardiovascular and all-cause mortality during hospitalization and over the follow-up period using restricted cubic splines. After adjustment for potential confounders, patients in Q1 had higher risk for 2-year cardiovascular death by Cox proportional hazard model compared with patients in Q2 [hazard ratio, 1.58; 95% confidence interval (CI), 1.12-2.21, P = 0.009], whereas patients in Q3 or Q4 exhibited a trend towards increased risk for 2-year cardiovascular death (hazard ratio, 1.33, 95% CI, 0.95-1.86, P = 0.094, for Q3 vs. Q2; and hazard ratio, 1.28, 95% CI, 0.91-1.82, P = 0.160, for Q4 vs. Q2). Meanwhile, when compared with patients in Q1, patients in Q2 had lower risk for 2-year cardiovascular death (hazard ratio, 0.64; 95% CI, 0.45-0.89, P = 0.009) whereas patients in Q3 or Q4 had similar risk for cardiovascular death (hazard ratio, 0.85, 95% CI, 0.63-1.14, P = 0.272, for Q3 vs. Q1; and hazard ratio, 0.82, 95% CI, 0.59-1.13, P = 0.221, for Q4 vs. Q1). However, low-admission SBP was not an independent predictor of 2-year all-cause mortality in this population. Conclusion: Among patients aged at least 65 years admitted for ACS, there is a J-curve relationship between supine admission SBP and risk for 2-year cardiovascular death, with a nadir at 120-129 mmHg. C1 [Jiang, Chunyan; Li, Hongwei] Capital Med Univ, Beijing Friendship Hosp, Dept Internal Med & Geriatr, Beijing, Peoples R China. [Wu, Shanshan] Capital Med Univ, Beijing Friendship Hosp, Natl Clin Res Ctr Digest Dis, Beijing, Peoples R China. [Wang, Man; Li, Hongwei] Capital Med Univ, Beijing Friendship Hosp, Dept Cardiol, 95 Yongan Rd, Beijing 100050, Peoples R China. [Zhao, Xueqiao] Univ Washington, Clin Atherosclerosis Res Lab, Div Cardiol, Seattle, WA 98195 USA. [Li, Hongwei] Beijing Key Lab Metab Disorder Related Cardiovasc, Beijing, Peoples R China. C3 Capital Medical University; Capital Medical University; Capital Medical University; University of Washington; University of Washington Seattle RP Li, HW (通讯作者),Capital Med Univ, Beijing Friendship Hosp, Dept Cardiol, 95 Yongan Rd, Beijing 100050, Peoples R China. EM lhw19656@sina.com FU Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support [ZYLX201838] FX This study was supported by the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201838). 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PD MAY PY 2021 VL 39 IS 5 BP 926 EP 934 DI 10.1097/HJH.0000000000002737 PG 9 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA SS7QO UT WOS:000661949300015 PM 33201050 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Angeli, F Cavallini, C Verdecchia, P Morici, N Del Pinto, M Petronio, AS Antonicelli, R Murena, E Bossi, I De Servi, S Savonitto, S AF Angeli, Fabio Cavallini, Claudio Verdecchia, Paolo Morici, Nuccia Del Pinto, Maurizio Petronio, Anna Sonia Antonicelli, Roberto Murena, Ernesto Bossi, Irene De Servi, Stefano Savonitto, Stefano TI A Risk Score for Predicting 1-Year Mortality in Patients >= 75 Years of Age Presenting With Non-ST-Elevation Acute Coronary Syndrome SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID INITIALLY CONSERVATIVE TREATMENT; RENAL-FUNCTION ESTIMATION; ELDERLY-PATIENTS; INVASIVE STRATEGY; PERFORMANCE; MODELS; CARE AB Approximately 1/3 of patients with non ST-segment elevation (NSTE) acute coronary syndromes (ACS) are >= 75 years of age. Risk stratification in these patients is generally difficult because supporting evidence is scarce. The investigators developed and validated a simple risk prediction score for 1-year mortality in patients >= 75 years of age presenting with NSTE ACS. The derivation cohort was the Italian Elderly ACS trial, which included 331 patients with NSTE ACS aged >= 75 years. A logistic regression model was developed to predict 1-year mortality. The validation cohort was a registry cohort of 332 patients with NSTE ACS meeting the same inclusion criteria as for the Italian Elderly ACS trial but excluded from the trial for any reason. The risk score included 5 statistically significant covariates: previous vascular event, hemoglobin level, estimated glomerular filtration rate, ischemic electrocardiographic changes, and elevated troponin level. The model allowed a maximum score of 6. The score demonstrated a good discriminating power (C statistic = 0.739) and calibration, even among subgroups defined by gender and age. When validated in the registry cohort, the scoring system confirmed a strong association with the risk for all-cause death. Moreover, a score >= 3 (the highest baseline risk group) identified a subset of patients with NSTE ACS most likely to benefit from an invasive approach. In conclusion, the risk for 1-year mortality in patients >= 75 years of age with NSTE ACS is substantial and can be predicted through a score that can be easily derived at the bedside at hospital presentation. The score may help in guiding treatment strategy. (C) 2015 Elsevier Inc. All rights reserved. C1 [Angeli, Fabio; Cavallini, Claudio; Del Pinto, Maurizio] Osped SM Della Misericordia, Dipartimento Cardiol, Perugia, Italy. [Verdecchia, Paolo] Osped Assisi, Dipartimento Med Interna, Assisi, Italy. [Morici, Nuccia; Bossi, Irene] Osped Niguarda Ca Granda, Dipartimento Cardiotoracovasc, Milan, Italy. [Petronio, Anna Sonia] Azienda Osped Univ Pisana, Dipartimento Cardiotoracovasc, Pisa, Italy. [Antonicelli, Roberto] INRCA Ancona, Dipartimento Cardiol, Ancona, Italy. [Murena, Ernesto] Osped S Maria Delle Grazie, Dipartimento Cardiol, Naples, Italy. [De Servi, Stefano] IRCCS Policlin S Matteo, Dipartimento Cardiotoracovasc, Pavia, Italy. [Savonitto, Stefano] Osped A Manzoni, Dipartimento Cardiovasc, Lecce, Italy. C3 Hospital Santa Maria della Misericordia; IRCCS Ca Granda Ospedale Maggiore Policlinico; Ospedale Niguarda Ca' Granda; University of Pisa; Azienda Ospedaliero Universitaria Pisana; IRCCS INRCA; IRCCS Fondazione San Matteo RP Angeli, F (通讯作者),Osped SM Della Misericordia, Dipartimento Cardiol, Perugia, Italy. EM fangeli@cardionet.it RI Antonicelli, Roberto/AAB-3233-2021; De+Servi, Stefano/AAT-2631-2021; Angeli, Fabio/K-8775-2019 OI Antonicelli, Roberto/0000-0002-5921-1828; Angeli, Fabio/0000-0003-4925-7985 CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alexander KP, 2005, J AM COLL CARDIOL, V46, P1479, DOI 10.1016/j.jacc.2005.05.084 Amsterdam EA., 2014, CIRCULATION, V130, pE344, DOI [10.1016/j.jacc.2014.09.017, DOI 10.1161/CIR.0000000000000134] Angeli F, 2014, CATHETER CARDIO INTE, V83, P686, DOI 10.1002/ccd.25307 Antman EM, 2000, JAMA-J AM MED ASSOC, V284, P835, DOI 10.1001/jama.284.7.835 Carson JL, 2013, AM HEART J, V165, P964, DOI 10.1016/j.ahj.2013.03.001 Centers for Disease Control and Prevention (CDC), 2003, MMWR Morb Mortal Wkly Rep, V52, P101 Chowdhury EK, 2015, AM J HYPERTENS, V28, P380, DOI 10.1093/ajh/hpu160 COCKCROFT DW, 1976, NEPHRON, V16, P31, DOI 10.1159/000180580 Damman P, 2012, HEART, V98, P207, DOI 10.1136/heartjnl-2011-300453 De Luca L, 2014, OPEN HEART, V1, DOI 10.1136/openhrt-2014-000148 Eagle KA, 2004, JAMA-J AM MED ASSOC, V291, P2727, DOI 10.1001/jama.291.22.2727 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Kansagara D, 2013, ANN INTERN MED, V159, P746, DOI 10.7326/0003-4819-159-11-201312030-00007 Maseri A, 1997, CIRCULATION, V96, P4141 Morici N, 2014, INT J CARDIOL, V174, P127, DOI 10.1016/j.ijcard.2013.12.306 Nabais Sergio, 2008, Rev Port Cardiol, V27, P303 Reboldi G, 2013, CEREBROVASC DIS, V35, P187, DOI 10.1159/000345491 Roe MT, 2011, AM HEART J, V162, DOI 10.1016/j.ahj.2011.08.010 Savonitto S, 2008, J CARDIOVASC MED, V9, P217, DOI 10.2459/JCM.0b013e3282f7c8df Savonitto S, 2012, JACC-CARDIOVASC INTE, V5, P906, DOI 10.1016/j.jcin.2012.06.008 Savonitto S, 2008, G ITAL CARDIOL, V9, P314, DOI 10.1814/651.7598 Steyerberg EW, 2003, J CLIN EPIDEMIOL, V56, P441, DOI 10.1016/S0895-4356(03)00047-7 Steyerberg EW, 2010, EPIDEMIOLOGY, V21, P128, DOI 10.1097/EDE.0b013e3181c30fb2 Sullivan LM, 2004, STAT MED, V23, P1631, DOI 10.1002/sim.1742 NR 25 TC 14 Z9 15 U1 0 U2 5 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUL 15 PY 2015 VL 116 IS 2 BP 208 EP 213 DI 10.1016/j.amjcard.2015.04.015 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CM2YK UT WOS:000357548100006 PM 25978978 DA 2023-05-13 ER PT J AU Al Assaad, RG Bachir, R El Sayed, MJ AF Al Assaad, Reem G. Bachir, Rana El Sayed, Mazen J. TI Impact of Ramadan on emergency department visits and on medical emergencies SO EUROPEAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE emergency department; fasting; medical emergencies; Ramadan ID STROKE INCIDENCE; BLOOD-PRESSURE AB Background Fasting during Ramadan is important to Muslims. This study describes changes in emergency department (ED) visits and in frequencies of emergency conditions and impact on clinical outcomes during Ramadan in a tertiary care center in Beirut, Lebanon. Patients and methods Patients presenting to ED during Ramadan 1 month before and 1 month after Ramadan over a 3-year period with specific conditions (acute coronary syndrome, stroke, seizure, diabetes, renal colic, headache or hypertension) were included. Clinical and sociodemographic characteristics, ED volume, diagnoses, and outcomes were examined during two periods (Ramadan vs. non-Ramadan). Multiple logistic regressions were performed to identify the impact of Ramadan on ED bounce-back and mortality at ED discharge. Results A total of 3536 patients were included. The daily average ED volume was higher during non-Ramadan months (145.65 +/- 22.14) compared with Ramadan (128.85 +/- 14.52). The average ED length of stay was higher during Ramadan (5.42 +/- 14.86 vs. 3.96 +/- 4.29 h; P = 0.006). Frequencies and admission rates for the selected diseases were comparable during the two periods, except for patients with acute coronary syndrome or stroke who had lower admission rates during Ramadan. ED bounce-back rates and mortality at ED discharge were higher during Ramadan (odds = 1.34, 95% confidence interval: 1.03-1.74 and odds ratio = 2.88, 95% confidence interval: 1.01-8.27, respectively). Conclusion EDs might experience a decrease in volumes, higher length of stay, and potentially worse outcomes during Ramadan. Changes in the frequencies of ED visits related to common conditions are not expected. Prospective studies documenting fasting status would clarify further the impact of Ramadan. (C) 2018 Wolters Kluwer Health, Inc. All rights reserved. C1 [Al Assaad, Reem G.; Bachir, Rana; El Sayed, Mazen J.] Amer Univ Beirut, Med Ctr, Dept Emergency Med, POB 11-0236, Beirut 11072020, Lebanon. [El Sayed, Mazen J.] Amer Univ Beirut, Med Ctr, Emergency Med Serv & Prehosp Care Program, Beirut, Lebanon. C3 American University of Beirut; American University of Beirut RP El Sayed, MJ (通讯作者),Amer Univ Beirut, Med Ctr, Dept Emergency Med, POB 11-0236, Beirut 11072020, Lebanon. EM melsayed@aub.edu.lb OI El Sayed, Mazen/0000-0001-9679-1131 CR Akhan G, 2000, ACTA NEUROL SCAND, V101, P259, DOI 10.1034/j.1600-0404.2000.101004259.x Al Suwaidi J, 2004, HEART, V90, P695, DOI 10.1136/hrt.2003.012526 Azizi F., 1996, MED J ISLAM REPUB IR, V10, P241 Basiri A., 2004, JPMA Journal of the Pakistan Medical Association, V54, P6 Bener A., 2006, SMJ Singapore Medical Journal, V47, P404 Bener A, 2007, NUTR FOOD SCI, V37, P427, DOI 10.1108/00346650710838081 Gomceli YB, 2008, SEIZURE-EUR J EPILEP, V17, P671, DOI 10.1016/j.seizure.2008.03.008 Imtiaz S, 2015, JCPSP-J COLL PHYSICI, V25, P189, DOI 03.2015/JCPSP.189192 LANGFORD EJ, 1994, J ROY SOC MED, V87, P517 Miladipour AH, 2012, IRAN J KIDNEY DIS, V6, P33 Perk G, 2001, J HUM HYPERTENS, V15, P723, DOI 10.1038/sj.jhh.1001262 Salti I, 2004, DIABETES CARE, V27, P2306, DOI 10.2337/diacare.27.10.2306 STOKHOLM KH, 1991, CLIN PHYSIOL, V11, P513, DOI 10.1111/j.1475-097X.1991.tb00671.x Temizhan A, 1999, INT J CARDIOL, V70, P149, DOI 10.1016/S0167-5273(99)00082-0 Topacoglu H, 2005, INT J CLIN PRACT, V59, P900, DOI 10.1111/j.1742-1241.2005.00460.x NR 15 TC 11 Z9 11 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0969-9546 EI 1473-5695 J9 EUR J EMERG MED JI Eur. J. Emerg. Med. PD DEC PY 2018 VL 25 IS 6 BP 440 EP 444 DI 10.1097/MEJ.0000000000000485 PG 5 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA GZ7DS UT WOS:000449637900015 PM 28704270 DA 2023-05-13 ER PT J AU Ni, R Vaezzadeh, N Zhou, J Weitz, JI Cattaneo, M Gross, PL AF Ni, Ran Vaezzadeh, Nima Zhou, Ji Weitz, Jeffrey I. Cattaneo, Marco Gross, Peter L. TI Effect of Different Doses of Acetylsalicylic Acid on the Antithrombotic Activity of Clopidogrel in a Mouse Arterial Thrombosis Model SO ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY LA English DT Article DE acute coronary; syndrome; arachidonic acid; clopidogrel; mice; prostaglandin I-2 ID PLATELET P2Y(12) RECEPTOR; ADENOSINE-DIPHOSPHATE; FOCUSED UPDATE; ASPIRIN; PROSTACYCLIN; INHIBITION; THROMBOXANE-A2; BIOSYNTHESIS; DIPYRIDAMOLE; TICAGRELOR AB Objective Dual-antiplatelet therapy with acetylsalicylic acid and a P2Y(12) antagonist, such as clopidogrel, is the standard of care for acute coronary syndromes. However, the drugs have divergent effects on the formation of cAMP, an inhibitory second messenger. Thus, by inhibiting the synthesis of prostacyclin, acetylsalicylic acid reduces cAMP formation, whereas clopidogrel potentiates it. Therefore, with higher doses of acetylsalicylic acid, the potentiation of cAMP production by clopidogrel may be attenuated, which could limit the antithrombotic potential of the drug combination. The purpose of this study was to examine this possibility in vivo. Approach and Results Mice were given oral acetylsalicylic acid at varying doses, oral clopidogrel (5 mg/kg body weight), or both. At doses of 0.15 and 0.6 mg/kg, acetylsalicylic acid inhibited arachidonic acid-induced platelet aggregation, but only 0.6 mg/kg acetylsalicylic acid, or higher, decreased the plasma levels of 6-keto-prostaglandin-F-1, the stable metabolite of prostacyclin. When given with clopidogrel, laser injury-induced arterial thrombi were significantly larger with the 0.6 mg/kg dose of acetylsalicylic acid than with the 0.15 mg/kg dose. Thrombi in mice treated with clopidogrel and the 0.15 mg/kg dose of acetylsalicylic acid were smaller than in mice treated with clopidogrel alone, suggesting that acetylsalicylic acid can add to the antithrombotic effect of clopidogrel but that higher doses of acetylsalicylic acid blunt the antithrombotic effect of clopidogrel. Conclusions These findings support the use of lower, prostacyclin-preserving, doses of acetylsalicylic acid in conjunction with clopidogrel. C1 [Ni, Ran; Vaezzadeh, Nima; Zhou, Ji; Weitz, Jeffrey I.; Gross, Peter L.] McMaster Univ, Dept Med, Hamilton, ON, Canada. [Ni, Ran; Vaezzadeh, Nima; Zhou, Ji; Weitz, Jeffrey I.; Gross, Peter L.] Thrombosis & Atherosclerosis Res Inst, 237 Barton St E, Hamilton, ON L8L 2X2, Canada. [Cattaneo, Marco] Univ Milan, Osped San Paolo, Dipartimento Sci Salute, Med 3, Milan, Italy. C3 McMaster University; McMaster University; San Paolo-Polo Universitaria Hospital; University of Milan RP Gross, PL (通讯作者),Thrombosis & Atherosclerosis Res Inst, 237 Barton St E, Hamilton, ON L8L 2X2, Canada. 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Thromb. Vasc. Biol. PD OCT PY 2018 VL 38 IS 10 BP 2338 EP 2344 DI 10.1161/ATVBAHA.118.311404 PG 7 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA GV0KW UT WOS:000445750500012 PM 30354213 OA Bronze DA 2023-05-13 ER PT J AU Alsayegh, F Alkhamis, MA Ali, F Attur, S Fountain-Jones, NM Zubaid, M AF Alsayegh, Faisal Alkhamis, Moh A. Ali, Fatima Attur, Sreeja Fountain-Jones, Nicholas M. Zubaid, Mohammad TI Anemia or other comorbidities? using machine learning to reveal deeper insights into the drivers of acute coronary syndromes in hospital admitted patients SO PLOS ONE LA English DT Article ID GRACE RISK SCORE; BASE-LINE ANEMIA; HEALTH-CARE; MORTALITY; IMPACT; HEART; PATHOGENESIS; HEMORRHAGE; THROMBOSIS; OUTCOMES AB Acute coronary syndromes (ACS) are a leading cause of deaths worldwide, yet the diagnosis and treatment of this group of diseases represent a significant challenge for clinicians. The epidemiology of ACS is extremely complex and the relationship between ACS and patient risk factors is typically non-linear and highly variable across patient lifespan. Here, we aim to uncover deeper insights into the factors that shape ACS outcomes in hospitals across four Arabian Gulf countries. Further, because anemia is one of the most observed comorbidities, we explored its role in the prognosis of most prevalent ACS in-hospital outcomes (mortality, heart failure, and bleeding) in the region. We used a robust multi-algorithm interpretable machine learning (ML) pipeline, and 20 relevant risk factors to fit predictive models to 4,044 patients presenting with ACS between 2012 and 2013. We found that in-hospital heart failure followed by anemia was the most important predictor of mortality. However, anemia was the first most important predictor for both in-hospital heart failure, and bleeding. For all in-hospital outcome, anemia had remarkably non-linear relationships with both ACS outcomes and patients' baseline characteristics. With minimal statistical assumptions, our ML models had reasonable predictive performance (AUCs > 0.75) and substantially outperformed commonly used statistical and risk stratification methods. Moreover, our pipeline was able to elucidate ACS risk of individual patients based on their unique risk factors. Fully interpretable ML approaches are rarely used in clinical settings, particularly in the Middle East, but have the potential to improve clinicians' prognostic efforts and guide policymakers in reducing the health and economic burdens of ACS worldwide. C1 [Alsayegh, Faisal; Ali, Fatima; Attur, Sreeja; Zubaid, Mohammad] Kuwait Univ, Fac Med, Hlth Sci Ctr, Dept Med, Kuwait, Kuwait. [Alkhamis, Moh A.] Kuwait Univ, Fac Publ Hlth, Hlth Sci Ctr, Dept Epidemiol & Biostat, Kuwait, Kuwait. [Fountain-Jones, Nicholas M.] Univ Tasmania, Sch Nat Sci, Hobart, Tas, Australia. [Fountain-Jones, Nicholas M.] Univ Minnesota, Coll Vet Med, Dept Vet Populat Med, St Paul, MN USA. C3 Kuwait University; Kuwait University; University of Tasmania; University of Minnesota System; University of Minnesota Twin Cities RP Alkhamis, MA (通讯作者),Kuwait Univ, Fac Publ Hlth, Hlth Sci Ctr, Dept Epidemiol & Biostat, Kuwait, Kuwait. EM m.alkhamis@ku.edu.kw OI Fountain-Jones, Nicholas/0000-0001-9248-8493; Alkhamis, Mohammad/0000-0001-6451-5247 FU AstraZeneca; Kuwait University [XX02/11] FX Gulf COAST is an investigator-initiated study, financially supported by AstraZeneca and sponsored and overseen by Kuwait University (Project Code XX02/11). Neither Kuwait University nor AstraZeneca had any role in study design, data collection, data analysis or writing of the manuscript. 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Gandek, Barbara Tran, Hoang, V Abu, Hawa McManus, David D. Kiefe, Catarina, I Goldberg, Robert J. TI Barriers to Healthcare Access and to Improvements in Health-Related Quality of Life After an Acute Coronary Syndrome (From TRACE-CORE) SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID HEART-DISEASE; MYOCARDIAL-INFARCTION; OUTCOMES RESEARCH; DEPRESSION; UPDATE; MODEL AB Little is known about how barriers to healthcare access affect health-related quality of life (HRQOL) after an acute coronary syndrome (ACS). In a large cohort of ACS survivors from 6 medical centers in Massachusetts and Georgia enrolled from 2011 to 2013, patients were classified as having any financial barriers, no usual source of care (USOC), or transportation barriers to healthcare based on their questionnaire survey responses. The principal study outcomes included clinically meaningful declines in generic physical and mental HRQOL and in disease-specific HRQOL from 1 to 6 months posthospital discharge. Adjusted relative risks (aRRs) for declines in HRQOL were calculated using Poisson regression models, controlling for several sociodemographic and clinical factors of prognostic importance. In 1,053 ACS survivors, 29.0% had a financial barrier, 14.2% had no USOC, and 8.7% had a transportation barrier. Patients with a financial barrier had greater risks of experiencing a decline in generic physical (aRR 1.48, 95% confidence interval [CI] 1.17, 1.86) and mental (aRR 1.36, 95% CI 1.07, 1.75) HRQOL at 6 months. Patients with 2 or more access barriers had greater risks of decline in generic physical (aRR 1.53, 95% CI 1.20, 1.93) and mental (aRR 1.50, 95% CI 1.17, 1.93) HRQOL compared with those without any healthcare barriers. There was a modest association between lacking a USOC and experiencing a decline in disease-specific HRQOL (aRR 1.46, 95% CI 0.96, 2.22). Financial and other barriers to healthcare access may be associated with clinically meaningful declines in HRQOL after hospital discharge for an ACS. (C) 2018 Published by Elsevier Inc. C1 [Erskine, Nathaniel A.; Gandek, Barbara; Tran, Hoang, V; Abu, Hawa; McManus, David D.; Kiefe, Catarina, I; Goldberg, Robert J.] Univ Massachusetts, Med Sch, Dept Quantitat Hlth Sci, Worcester, MA 01655 USA. [Gandek, Barbara] John Ware Res Grp, Watertown, MA USA. [McManus, David D.] Univ Massachusetts, Med Sch, Dept Med, Div Cardiovasc Med, Worcester, MA USA. C3 University of Massachusetts System; University of Massachusetts Worcester; University of Massachusetts System; University of Massachusetts Worcester RP Goldberg, RJ (通讯作者),Univ Massachusetts, Med Sch, Dept Quantitat Hlth Sci, Worcester, MA 01655 USA. EM robert.goldberg@umassmed.edu RI Tran, Vu Hoang/AAT-9423-2021 OI Tran, Vu Hoang/0000-0003-2870-4133 FU National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NLBI) [1T32HL120823-01, R01HL126911, 1R01HL135219-01]; Patient-Centered Outcomes Research Institute [ME-1310-07682]; NIH National Center for Advancing Translational Sciences [UL1TR0001453-02]; NIH NLBI [U01HL105268] FX The National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NLBI) supported NE (1T32HL120823-01), DM (R01HL126911), and RG (1R01HL135219-01). CK received support from the Patient-Centered Outcomes Research Institute (ME-1310-07682) and the NIH National Center for Advancing Translational Sciences (UL1TR0001453-02). The TRACE-CORE study was funded through NIH NLBI grant U01HL105268. 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J. Cardiol. PD OCT 1 PY 2018 VL 122 IS 7 BP 1121 EP 1127 DI 10.1016/j.amjcard.2018.06.043 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA GZ2UR UT WOS:000449244400002 PM 30107903 OA Green Accepted DA 2023-05-13 ER PT J AU Sanchis, J Nunez, E Ruiz, V Bonanad, C Fernandez, J Cauli, O Garcia-Blas, S Mainar, L Valero, E Rodriguez-Borja, E Chorro, FJ Hermenegildo, C Nunez, J AF Sanchis, Juan Nunez, Eduardo Ruiz, Vicente Bonanad, Clara Fernandez, Julio Cauli, Omar Garcia-Blas, Sergio Mainar, Luis Valero, Ernesto Rodriguez-Borja, Enrique Chorro, Francisco J. Hermenegildo, Carlos Nunez, Julio TI Usefulness of Clinical Data and Biomarkers for the Identification of Frailty After Acute Coronary Syndromes SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Article ID OLDER-ADULTS; ELDERLY-PATIENTS; CARDIOVASCULAR-DISEASE; RISK; MORTALITY; HEALTH; CARE; COMORBIDITIES; INFLAMMATION; COAGULATION AB Background: Frailty predicts mortality after acute coronary syndrome (ACS). The standard frailty scales, such as the Fried score, consist of a variety of questionnaires and physical tests. Our aim was to investigate easily available clinical data and blood markers to predict frailty at discharge, in elderly patients after ACS. Methods: A total of 342 patients older than 65 years, survivors after ACS, were included. A high number of clinical variables were collected. In addition, blood markers potentially linked to frailty and related to the processes of inflammation, coagulation, hormonal dysregulation, nutrition, renal dysfunction, and heart dysfunction were determined. Frailty was evaluated using the Fried score at discharge. The main outcome was frailty defined by a Fried score >= 3 points. Secondary endpoints were mortality and myocardial infarction at 30-month median follow-up. Results: A total of 116 patients were frail. Seven clinical variables or biomarkers predicted frailty: age >= 75 years, female, prior ischemic heart disease, admission heart failure, haemoglobin <= 12.5 g/dL, vitamin D <= 9 ng/mL, and cystatin-C >= 1.2 mg/L. This model based on clinical data and biomarkers showed an excellent discrimination accuracy for frailty (C-statistic = 0.818). During the follow-up, 105 patients died and 137 died or suffered myocardial infarction. The clinical data and biomarker model (C-statistics = 0.730 and 0.691) performed better than the Fried score (C-statistics = 0.676 and 0.650) for death and death or myocardial infarction, respectively. Conclusions: Easy available clinical data and biomarkers can identify frail patients at discharge after ACS and predict outcomes better than the standard Fried's frailty scale. C1 [Sanchis, Juan; Nunez, Eduardo; Bonanad, Clara; Garcia-Blas, Sergio; Mainar, Luis; Valero, Ernesto; Chorro, Francisco J.; Nunez, Julio] Univ Valencia, Sch Med, Hosp Clin Univ, Dept Cardiol, Valencia, Spain. [Ruiz, Vicente; Fernandez, Julio; Cauli, Omar] Univ Valencia, Sch Nursing, Valencia, Spain. [Rodriguez-Borja, Enrique] Hosp Clin Univ, Dept Clin Biochem, Valencia, Spain. [Hermenegildo, Carlos] Univ Valencia, Dept Physiol, Valencia, Spain. C3 University of Valencia; University of Valencia; University of Valencia RP Sanchis, J (通讯作者),Hosp Clin Univ, Dept Cardiol, Blasco Ibanez 17, Valencia 46010, Spain. EM sanchis_juafor@gva.es RI Cauli, Omar/L-6063-2014; Hermenegildo, Carlos/C-5995-2008; Chorro, Francisco J/AAB-6766-2020; Rodriguez Borja, Enrique/D-8035-2018 OI Cauli, Omar/0000-0001-5669-4943; Hermenegildo, Carlos/0000-0002-4015-2645; Nunez, Julio/0000-0003-1672-7119; Rodriguez Borja, Enrique/0000-0002-0339-6704; Fernandez-Garrido, Julio/0000-0001-5195-5227 FU Spain's Ministry of Economy and Competitiveness through the Carlos III Health Institute [HERACLES RD12/0042/0010, RD12/0042/0052]; FEDER; Health Research Fund FIS [PI 11/01595, PI12/00467, PI13/00617] FX This work was supported by grants from Spain's Ministry of Economy and Competitiveness through the Carlos III Health Institute: HERACLES RD12/0042/0010, RD12/0042/0052. FEDER; Health Research Fund FIS PI 11/01595, PI12/00467 and PI13/00617. 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J. Cardiol. PD DEC PY 2015 VL 31 IS 12 BP 1462 EP 1468 DI 10.1016/j.cjca.2015.07.737 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CW9QW UT WOS:000365334300009 PM 26514748 DA 2023-05-13 ER PT J AU Riegel, B Stephens-Shields, A Jaskowiak-Barr, A Daus, M Kimmel, SE AF Riegel, Barbara Stephens-Shields, Alisa Jaskowiak-Barr, Anne Daus, Marguerite Kimmel, Stephen E. TI A behavioral economics-based telehealth intervention to improve aspirin adherence following hospitalization for acute coronary syndrome SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE behavioral economics; loss aversion; medication adherence; myocardial infarction; pharmacoepidemiology; randomized controlled trial; technology; unstable angina ID MEDICATION ADHERENCE; CARDIOVASCULAR-DISEASE AB Purpose A significant number of patients with acute coronary syndrome (ACS) are nonadherent to aspirin after hospital discharge, with an associated increased risk of subsequent cardiovascular events. The purpose of this pilot study was to test the efficacy of a telehealth intervention based on behavioral economics to improve aspirin adherence following hospitalization for ACS. Methods We enrolled 130 participants (c over bar X = 58 +/- 10.7 years of age, 38% female, 45% black) from two hospitals. Patients were eligible if they owned a smartphone and were admitted to the hospital for ACS, prescribed aspirin at discharge, and responsible for administering their own medications. Consenting participants were randomized to the intervention or usual care group. The intervention group was eligible to receive up to $50 per month if they took their medicine daily, with $2 per day deducted if a dose was missed. All participants received an electronic monitoring (EM) pill bottle containing a 90-day supply of aspirin, which was used to measure adherence calculated as the proportion of prescribed drug taken using the EM device. Based on the skewness in the adherence distribution, quantile regression was used to evaluate the effect of the intervention on median adherence over time. Results After 90 days, adherence fell in the control group but remained high in the intervention group (median adherence 81% vs 90%, P = .18). Rehospitalization was higher in the control group (24% vs 13%, P = .17). Conclusion A loss aversion behavioral economics-based telehealth intervention is a promising approach to improving aspirin adherence following hospitalization for ACS. C1 [Riegel, Barbara] Univ Penn, Gerontol, Sch Nursing, 418 Curie Blvd, Philadelphia, PA 19104 USA. [Stephens-Shields, Alisa; Jaskowiak-Barr, Anne] Univ Penn, Perelman Sch Med, Dept Biostat Epidemiol & Informat, Philadelphia, PA 19104 USA. [Daus, Marguerite] Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. [Kimmel, Stephen E.] Univ Penn, Med & Epidemiol, Dept Biostat Epidemiol & Informat, Perelman Sch Med, Philadelphia, PA 19104 USA. C3 University of Pennsylvania; University of Pennsylvania; Pennsylvania Medicine; University of Pennsylvania; University of Pennsylvania; Pennsylvania Medicine RP Riegel, B (通讯作者),Univ Penn, Gerontol, Sch Nursing, 418 Curie Blvd, Philadelphia, PA 19104 USA. EM briegel@nursing.upenn.edu OI Riegel, Barbara/0000-0002-0970-136X FU Wellth, Inc. 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Drug Saf. PD MAY PY 2020 VL 29 IS 5 BP 513 EP 517 DI 10.1002/pds.4988 EA MAR 2020 PG 5 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA LL2PA UT WOS:000522537900001 PM 32237005 OA Green Accepted DA 2023-05-13 ER PT J AU Theidel, U Asseburg, C Giannitsis, E Katus, H AF Theidel, Ulrike Asseburg, Christian Giannitsis, Evangelos Katus, Hugo TI Cost-effectiveness of ticagrelor versus clopidogrel for the prevention of atherothrombotic events in adult patients with acute coronary syndrome in Germany SO CLINICAL RESEARCH IN CARDIOLOGY LA English DT Article DE Cost-effectiveness; Ticagrelor; Acute coronary syndrome; Prevention; Long-term impact; Germany ID MYOCARDIAL-INFARCTION; ISCHEMIC-STROKE; GUIDELINES; ASSOCIATION; OUTCOMES; REGISTRY; ASPIRIN; EUROPE AB The aim of this health economic analysis was to compare the cost-effectiveness of ticagrelor versus clopidogrel within the German health care system. A two-part decision model was adapted to compare treatment with ticagrelor or clopidogrel in a low-dose acetylsalicylic acid (ASA) cohort (a parts per thousand currency sign150 mg) for all ACS patients and subtypes NSTEMI/IA and STEMI. A decision-tree approach was chosen for the first year after initial hospitalization based on trial observations from a subgroup of the PLATO study. Subsequent years were estimated by a Markov model. Following a macro-costing approach, costs were based on official tariffs and published literature. Extensive sensitivity analyses were performed to test the robustness of the model. One-year treatment with ticagrelor is associated with an estimated 0.1796 life-years gained (LYG) and gained 0.1570 quality-adjusted life-years (QALY), respectively, over the lifetime horizon. Overall average cost with ticagrelor is estimated to be EUR 11,815 vs. EUR 11,387 with generic clopidogrel over a lifetime horizon. The incremental cost-effectiveness ratio (ICER) was EUR 2,385 per LYG (EUR 2,728 per QALY). Comparing ticagrelor with Plavix(A (R)) or the lowest priced generic clopidogrel, ICER ranges from dominant to EUR 3,118 per LYG (EUR 3,567 per QALY). These findings are robust under various additional sensitivity analyses. Hence, 12 months of ACS treatment using ticagrelor/ASA instead of clopidogrel/ASA may offer a cost-effective therapeutic option, even when the generic price for clopidogrel is employed. EM theidel@herescon.com RI Asseburg, Christian/AAK-2903-2020 OI Asseburg, Christian/0000-0001-7196-3363 FU AstraZeneca GmbH, Germany; AstraZeneca FX The study was financially supported by AstraZeneca GmbH, Germany.; U. Theidel and C. Asseburg have no conflicts of interest to declare. E. Giannitsis and H. Katus received honoraria for lectures and consultant fees from AstraZeneca. CR [Anonymous], 2010, THRESHOLD VALUES INT [Anonymous], 2012, PREISMELDUNGEN AstraZeneca, 2009, PLATO STUD PLATELET AstraZeneca, 2011, EMEAHC1241 ASTRAZENC Barbieri M, 2005, VALUE HEALTH, V8, P10, DOI 10.1111/j.1524-4733.2005.03070.x Berger K, 2008, CURR MED RES OPIN, V24, P267, DOI 10.1185/030079907X253762 Bruggenjurgen B, 2005, J PUBLIC HEALTH-HEID, V13, P216, DOI 10.1007/s10389-005-0112-3 Bufe A, 2009, HERZ, V479, P484 Cohen M, 2005, CURR MED RES OPIN, V21, P439, DOI 10.1185/030079905X30725 Damm K, 2011, KARDIOLOGE, V5, P122, DOI 10.1007/s12181-011-0328-0 Dyer MTD, 2010, HEALTH QUAL LIFE OUT, V8, DOI 10.1186/1477-7525-8-13 Fitchett D, 2007, CAN J CARDIOL, V23, P663, DOI 10.1016/S0828-282X(07)70229-5 Gemeinsamer Bundesausschuss, 2011, TIC DOSS NUTZ GEM 35 Gesundheitsberichterstattung des Bundes, 2012, ICD10 GES BUND Gesundheitsberichterstattung des Bundes, 2011, ICD10 GES BUND Haeusler KG, 2012, INT J STROKE, V7, P544, DOI 10.1111/j.1747-4949.2011.00672.x Hamm CW, 2004, Z KARDIOL, V93, P324, DOI 10.1007/s00392-004-0109-x Hamm CW, 2004, Z KARDIOL, V93, P72, DOI 10.1007/s00392-004-1064-2 Henriksson M, 2011, VALUE HLTH Institut fur das Entgeltsystem im Krankenhaus, 2011, DRG BROWS Institut fur Qualitat und Wirtschaftlichkeit im Gesundheitswesen, 2009, ARB MOD V1 0 Institut fur Qualitat und Wirtschaftlichkeit im Gesundheitswesen, 2011, TIC NUTZ GEM 35A SG Institut fur Qualitat und Wirtschaftlichkeit im Gesundheitswesen, 2009, ARB KOST V1 0 Janzon M, 2010, CIRCULATION, V122 Kolominsky-Rabas PL, 2006, STROKE, V37, P1179, DOI 10.1161/01.STR.0000217450.21310.90 Lamotte M, 2006, PHARMACOECONOMICS, V24, P155, DOI 10.2165/00019053-200624020-00005 Mahaffey KW, 2011, CIRCULATION, V124, P544, DOI 10.1161/CIRCULATIONAHA.111.047498 Nikolic E, 2013, EUR HEART J, V34, P220, DOI 10.1093/eurheartj/ehs149 Nothen M, 2011, HOHE KOSTEN GESUNDHE Peterson ED, 2006, JAMA-J AM MED ASSOC, V295, P1912, DOI 10.1001/jama.295.16.1912 Robert Koch-Insitut, 2006, KOR HERZKR AK MYOK Rossnagel K, 2005, EUR J NEUROL, V12, P862, DOI 10.1111/j.1468-1331.2005.01091.x [Rote Liste®Service GmbH AstraZeneca], 2011, FACH BRIL Schoffski O, 2007, GESUNDHEITSOKONOMISC Schweikert B, 2009, EUR HEART J, V30, P436, DOI 10.1093/eurheartj/ehn509 Stracke S, 2010, CLIN RES CARDIOL, V99, P627, DOI 10.1007/s00392-010-0160-8 Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), 2010, Eur Heart J, V31, P2501, DOI 10.1093/eurheartj/ehq277 Taylor MJ, 2007, CURR MED RES OPIN, V23, P495, DOI 10.1185/030079906X167462 Theidel U, 2011, GERM ISPOR 14 ANN EU von der Schulenburg JMG, 2007, GESUNDH QUAL, V12, P285, DOI 10.1055/s-2007-963505 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Wiesner G, 2002, Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, V45, P438, DOI 10.1007/s00103-002-0405-4 Winter Y, 2008, NERVENARZT, V79, P918, DOI 10.1007/s00115-008-2505-3 [Wissenschaftliches Insitut der AOK AOK Bundesverband FEISA WidO], 2007, AOK BUND ABSCHL 2007 Zeidler J, 2008, HERZ, V33, P440, DOI 10.1007/s00059-008-3126-0 Zeymer U, 2010, KARDIOLOGE, V4, P231, DOI 10.1007/s12181-010-0273-3 Zobel C, 2012, CLIN RES CARDIOL, V101, P521, DOI 10.1007/s00392-012-0421-9 NR 47 TC 17 Z9 18 U1 0 U2 6 PU SPRINGER HEIDELBERG PI HEIDELBERG PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY SN 1861-0684 EI 1861-0692 J9 CLIN RES CARDIOL JI Clin. Res. Cardiol. PD JUN PY 2013 VL 102 IS 6 BP 447 EP 458 DI 10.1007/s00392-013-0552-7 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 146HU UT WOS:000319081700005 PM 23474908 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Shukha, Y Koren, O Or, T Turgeman, Y Mahamid, M Jabaren, M AF Shukha, Yousef Koren, Ofir Or, Tsafrir Turgeman, Yoav Mahamid, Mahmud Jabaren, Mohamed TI Screening of Abdominal Aortic Aneurysm Using Portable Transthoracic Echocardiography among Patients with Acute Coronary Syndrome SO CARDIOLOGY RESEARCH AND PRACTICE LA English DT Article AB Background. Abdominal aortic aneurysm (AAA) and acute coronary syndrome (ACS) share common risk factors. Objectives. To assess the abdominal aortic diameter (AAD) among patients with ACS using transthoracic echocardiography (TTE). Methods. Patients with ACS admitted to our intensive cardiac care unit from December 2013 to June 2014 were screened prospectively for AAA via AAD measurement in the subcostal TTE view. AAA was defined as an aneurysm with a transverse diameter of >= 30 mm. Results. Sixty seven patients were included. The male-to-female sex ratio was 7: 1. The vast majority of patients were admitted due to STEMI (73%), and the rest were equally divided as NSTEMI and unstable angina. The mean patient age was 58.4 +/- 10.4 years. AAD measurements were feasible in 57 patients (85%); among them, AAA was diagnosed in six patients (10.5%). The average additional time required to measure the abdominal aorta was 4 +/- 1 min. All patients with AAA were men and had a higher prevalence of smoking (83.3% vs. 60.6%, p < 0.003) and a lower incidence of diabetes mellitus than those without aneurysm. The prevalence of AAA tended to be related to age (12.5% in those older than 60 years and 18.7% in those older than 65 years). Conclusions. The overall prevalence of AAA is significantly high among patients with ACS and increases with age. AAA screening as a part of routine cardiac TTE can be easily, rapidly, and feasibly performed and yield accurate findings. AAD measurement in the subcostal view should be implemented as a part of routine TTE in patients with ACS. C1 [Shukha, Yousef] Rambam Med Ctr, Internal Med Dept E, Haifa, Israel. [Koren, Ofir; Or, Tsafrir; Turgeman, Yoav; Jabaren, Mohamed] Emek Med Ctr, Heart Inst, Afula, Israel. [Koren, Ofir; Turgeman, Yoav] Technion Israel Inst Technol, Bruce Rappaport Fac Med, Haifa, Israel. [Mahamid, Mahmud] Shaare Zedek Med Ctr, Gastrointestinal Dis Unit, Jerusalem, Israel. C3 Rambam Health Care Campus; Technion Israel Institute of Technology; Emek Medical Center; Technion Israel Institute of Technology; Rappaport Faculty of Medicine; Hebrew University of Jerusalem; Shaare Zedek Medical Center RP Shukha, Y (通讯作者),Rambam Med Ctr, Internal Med Dept E, Haifa, Israel. EM yshukha@gmail.com RI Koren, Ofir/AAZ-8573-2021; Koren, Ofir/GYU-7333-2022 OI Koren, Ofir/0000-0002-8666-8276; Shukha, Yousef/0000-0002-3353-5883 CR Aggarwal S, 2011, EXP CLIN CARDIOL, V16, P11 Bambgartner I., 2008, J VASC SURG, V48, P808, DOI [10.1016/j.jvs.2008.05.026, DOI 10.1016/J.JVS.2008.05.026] Bergqvist D, 2008, EUR J VASC ENDOVASC, V35, P13, DOI 10.1016/j.ejvs.2007.06.012 Brewster DC, 2003, J VASC SURG, V37, P1106, DOI 10.1067/mva.2003.363 Chiesa R, 2006, ANN VASC SURG, V20, P739, DOI 10.1007/s10016-006-9134-8 Cueff C, 2012, EUR HEART J-CARD IMG, V13, P574, DOI 10.1093/ejechocard/jer260 Dupont A, 2010, AM J CARDIOL, V105, P1545, DOI 10.1016/j.amjcard.2010.01.011 Giaconi Stefano, 2003, Ital Heart J Suppl, V4, P332 GILLUM RF, 1995, J CLIN EPIDEMIOL, V48, P1289, DOI 10.1016/0895-4356(95)00045-3 JOHNSTON KW, 1991, J VASC SURG, V13, P452, DOI 10.1067/mva.1991.26737 Kobzantsev Z., 2019, ISR MED ASSOC J, V10, P526 Lindholt JS, 2008, EUR J VASC ENDOVASC, V36, P167, DOI 10.1016/j.ejvs.2008.03.006 Navas EV, 2012, WORLD J CARDIOL, V4, P31, DOI 10.4330/wjc.v4.i2.31 OURIEL K, 1992, J VASC SURG, V15, P12, DOI 10.1016/0741-5214(92)70008-9 Roshanali F, 2007, ECHOCARDIOGR-J CARD, V24, P685, DOI [10.1111/j.1540-8175.2007.00467.x, 10.1111/j.l540-8175.2007.00467.x] Sprynger M, 2019, ANGIOLOGY, V70, P407, DOI 10.1177/0003319718824940 Thorbjornsen K, 2019, UPSALA J MED SCI, V124, P180, DOI 10.1080/03009734.2019.1648611 Villard C, 2018, MATURITAS, V109, P63, DOI 10.1016/j.maturitas.2017.12.012 NR 18 TC 1 Z9 1 U1 0 U2 1 PU HINDAWI LTD PI LONDON PA ADAM HOUSE, 3RD FLR, 1 FITZROY SQ, LONDON, W1T 5HF, ENGLAND SN 2090-8016 EI 2090-0597 J9 CARDIOL RES PRACT JI Cardiol. Res. Pract. PD JUN 27 PY 2020 VL 2020 AR 9510546 DI 10.1155/2020/9510546 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA MK3JM UT WOS:000548679700002 PM 32676208 OA Green Published, gold DA 2023-05-13 ER PT J AU Dudas, K Bjorck, L Jernberg, T Lappas, G Wallentin, L Rosengren, A AF Dudas, Kerstin Bjorck, Lena Jernberg, Tomas Lappas, Georgios Wallentin, Lars Rosengren, Annika TI Differences between acute myocardial infarction and unstable angina: a longitudinal cohort study reporting findings from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) SO BMJ OPEN LA English DT Article ID CASE-FATALITY RATES; CLINICAL PRESENTATION; RISK-FACTORS; DISEASE MORTALITY; FOLLOW-UP; CORONARY; TERM; SEX; ASSOCIATION; MORBIDITY AB Objectives: The aim of this study was to compare risk factors and comorbidities in patients with a first episode of acute coronary syndrome (ACS), being either acute myocardial infarction (AMI) or unstable angina pectoris (UAP). Design: Cross-sectional and prospective. Setting: The Swedish population. Participants: A total of 145 346 consecutive patients aged 25-105 years included in the Swedish Register of Cardiac Intensive Care Admission (Register of Information and Knowledge about Swedish Heart Intensive Care) and admitted to hospital between 1 January 1996 and 30 June 2009 with a first episode of either AMI or UAP. Primary and secondary outcome measures: Type of ACS and 1-year outcome. Results: Compared with patients with UAP, AMI patients were more likely to be older; men; and former or current smokers; they were also more likely to have had diabetes and peripheral artery disease, but had lower rates of prior heart failure (HF) and fewer cardioprotective medications on admission. Among patients aged <65 years, 1.4% of men and 1.6% of women with UAP died within 1 year in 2003-2006 compared with 4.2% of men and 3.1% of women AMI patients (multiple-adjusted OR 3.54 (99% CI 2.29 to 5.48) in women and 2.65 (99% CI 2.11 to 3.34) in men). Corresponding proportions in patients aged >= 65 years was 7.5% in men and 7.6% in women with UAP and 21.5% in men and 17.8% in women with AMI. Conclusions: In patients with a first-time ACS episode, male sex, slightly older age, smoking, diabetes and peripheral arterial disease (PAD), but fewer cardioprotective medications, were major determinants for presenting with AMI. Despite increasingly active treatment in AMI and more inclusive diagnostic criteria in recent years, persistently worse prognosis was observed in AMI patients. C1 [Dudas, Kerstin] Univ Gothenburg, Inst Hlth & Care Sci, Sahlgrenska Acad, Gothenburg, Sweden. [Bjorck, Lena; Lappas, Georgios; Rosengren, Annika] Univ Gothenburg, Dept Mol & Clin Med, Sahlgrenska Acad, Gothenburg, Sweden. [Jernberg, Tomas] Karolinska Inst, Cardiol Sect, Dept Med, Karolinska Univ Hosp, Stockholm, Sweden. [Wallentin, Lars] Uppsala Clin Res Ctr, Uppsala, Sweden. C3 University of Gothenburg; University of Gothenburg; Karolinska Institutet; Karolinska University Hospital; Uppsala University RP Dudas, K (通讯作者),Univ Gothenburg, Inst Hlth & Care Sci, Sahlgrenska Acad, Gothenburg, Sweden. EM kerstin.dudas@gu.se OI Jernberg, Tomas/0000-0003-1695-379X; Bjorck, Lena/0000-0002-4827-4559 FU Swedish state authority; EpiLife (Goteborg Center for Epidemiologic Studies on Mental and Physical Health Interacting over the Lifecourse) [2006-1506]; Swedish Council for Working Life and Social Research [2010-0362]; Swedish Heart and Lung Foundation [20090390]; Swedish Research Council [521-2010-2984]; Swedish regional authority FX SWEDEHEART/RIKS-HIA is publicly funded by the Swedish state and regional authorities. We thank the staff members in all CCUs in Sweden for their help and cooperation in contributing data to the SWEDEHEART/RIKS-HIA system. This study was supported by EpiLife (Goteborg Center for Epidemiologic Studies on Mental and Physical Health Interacting over the Lifecourse; http://www.epilife.sahlgrenska.gu.se) (grant number 2006-1506) and financed by the Swedish Council for Working Life and Social Research (grant number 2010-0362), as well as by grants from the Swedish Heart and Lung Foundation (grant number 20090390) and the Swedish Research Council (grant number 521-2010-2984). CR Abildstrom SZ, 2003, HEART, V89, P507, DOI 10.1136/heart.89.5.507 AHMED WH, 1993, AM J CARDIOL, V72, P544, DOI 10.1016/0002-9149(93)90349-H Alfredsson J, 2007, HEART, V93, P1357, DOI 10.1136/hrt.2006.102012 Alpert JS, 2000, J AM COLL CARDIOL, V36, P959, DOI 10.1016/S0735-1097(00)00804-4 Arbab-Zadeh A, 2012, CIRCULATION, V125, P1147, DOI 10.1161/CIRCULATIONAHA.111.047431 Bjorck L, 2009, HEART, V95, P1006, DOI 10.1136/hrt.2008.153064 Bjorck L, 2010, ARCH INTERN MED, V170, P1375, DOI 10.1001/archinternmed.2010.203 Bjorck L, 2009, EUR HEART J, V30, P1046, DOI 10.1093/eurheartj/ehn554 BRAUNWALD E, 1989, CIRCULATION, V80, P410, DOI 10.1161/01.CIR.80.2.410 CALVIN JE, 1995, JAMA-J AM MED ASSOC, V273, P136 Capewell S, 2006, HEART, V92, P1563, DOI 10.1136/hrt.2005.085399 Dotevall A, 2005, DIABETIC MED, V22, P1542, DOI 10.1111/j.1464-5491.2005.01696.x Dotevall A, 2007, EUR HEART J, V28, P310, DOI 10.1093/eurheartj/ehl458 Dudas K, 2012, INT J CARDIOL, V155, P400, DOI 10.1016/j.ijcard.2010.10.047 Hamm CW, 2000, CIRCULATION, V102, P118, DOI 10.1161/01.CIR.102.1.118 Hochman JS, 1999, NEW ENGL J MED, V341, P226, DOI 10.1056/NEJM199907223410402 Jernberg T, 2011, JAMA-J AM MED ASSOC, V305, P1677, DOI 10.1001/jama.2011.522 LERNER DJ, 1986, AM HEART J, V111, P383, DOI 10.1016/0002-8703(86)90155-9 Lloyd-Jones DM, 1999, LANCET, V353, P89, DOI 10.1016/S0140-6736(98)10279-9 McGill HC, 2000, CIRCULATION, V102, P374 McGovern PG, 2001, CIRCULATION, V104, P19, DOI 10.1161/01.CIR.104.1.19 MURABITO JM, 1993, CIRCULATION, V88, P2548, DOI 10.1161/01.CIR.88.6.2548 Rosengren A, 2005, HEART, V91, P1141, DOI 10.1136/hrt.2004.051508 Rosengren A, 2004, EUR HEART J, V25, P663, DOI 10.1016/j.ehj.2004.02.023 Stenestrand U, 2001, JAMA-J AM MED ASSOC, V285, P430, DOI 10.1001/jama.285.4.430 Stenestrand U, 2006, JAMA-J AM MED ASSOC, V296, P1749, DOI 10.1001/jama.296.14.1749 TUNSTALLPEDOE H, 1994, CIRCULATION, V90, P583, DOI 10.1161/01.CIR.90.1.583 van Domburg RT, 1998, J AM COLL CARDIOL, V31, P1534, DOI 10.1016/S0735-1097(98)00140-5 VANMILTENBURGVANZIJL AJM, 1995, J AM COLL CARDIOL, V25, P1286, DOI 10.1016/0735-1097(95)00009-S Yusuf S, 2004, LANCET, V364, P937, DOI 10.1016/S0140-6736(04)17018-9 NR 30 TC 13 Z9 13 U1 0 U2 3 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 2044-6055 J9 BMJ OPEN JI BMJ Open PY 2013 VL 3 IS 1 AR e002155 DI 10.1136/bmjopen-2012-002155 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 091XF UT WOS:000315082400058 PM 23288269 OA Green Published, gold DA 2023-05-13 ER PT J AU Orenes-Pinero, E Ruiz-Nodar, JM Esteve-Pastor, MA Quintana-Giner, M Rivera-Caravaca, JM Veliz, A Valdes, M Macias, M Pernias-Escrig, V Vicente-Ibarra, N Carrillo, L Sandin-Rollan, M Candela, E Lozano, T Marin, F AF Orenes-Pinero, Esteban Ruiz-Nodar, Juan M. Asuncion Esteve-Pastor, Maria Quintana-Giner, Miriam Miguel Rivera-Caravaca, Jose Veliz, Andrea Valdes, Mariano Macias, Manuel Pernias-Escrig, Vicente Vicente-Ibarra, Nuria Carrillo, Luna Sandin-Rollan, Miriam Candela, Elena Lozano, Teresa Marin, Francisco TI Therapeutic management and one-year outcomes in elderly patients with acute coronary syndrome SO ONCOTARGET LA English DT Article DE acute coronary syndrome; elderly; antiplatelet therapy; revascularization; follow-up; Gerotarget ID ELEVATION MYOCARDIAL-INFARCTION; HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; SCIENTIFIC STATEMENT; CLINICAL CARDIOLOGY; COLLABORATION; OCTOGENARIANS; INTERVENTION; CLOPIDOGREL; SOCIETY AB Background: Elderly represents a subgroup of high-risk ACS patients due to their advanced age and other comorbidities. Unfortunately, they are also often under-represented in many studies and clinical trials. Furthermore, cardiologists commonly find difficulties in the choice of the antiplatelet treatment and even on whether invasive revascularization should be used. In this study, the management of elderly ACS patients regarding antiplatelet therapy and revascularization procedures will be analyzed. Methods: 1717 ACS patients were consecutively included in this study from 3 tertiary Hospitals in the Southeast of Spain. Of them, 529 (30.8%) were >= 75 years. They were mainly male (60.7%) with a mean age of 81.4 +/- 4.7 years. Clinical characteristics, treatment received (antiaplatelet therapy, revascularization) and outcome were analyzed. Results: Regression analysis showed that being >= 75 years is independently associated with neither performing catheterization (79.6% vs 97.1%), nor revascularization (51.8% vs 72.5%), being the medical conservative treatment the election in these elderly patients (40.6% vs 18.9%) (p < 0.001 for all). Furthermore, ticagrelor prescription were significantly decreased in older patients (11.5% vs 19.6%; p < 0.001). Regarding patients outcome after one-year of follow-up, being >= 75 years was associated with death, major adverse cardiac events (MACE) and major bleeding (all of them p < 0.001). Importantly, nor performing catheterization was independently associated with MACE and death in Cox multivariate analysis in elderly patients. Conclusions: Elderly patients with ACS are undertreated both invasively and pharmacologically, and this fact might be associated with the observed worse outcomes. C1 [Orenes-Pinero, Esteban; Asuncion Esteve-Pastor, Maria; Quintana-Giner, Miriam; Miguel Rivera-Caravaca, Jose; Veliz, Andrea; Valdes, Mariano; Marin, Francisco] Univ Murcia, Hosp Clin Univ Virgen de la Arrixaca, Dept Cardiol, IMIB Arrixaca, Murcia, Spain. [Ruiz-Nodar, Juan M.; Macias, Manuel; Carrillo, Luna; Sandin-Rollan, Miriam; Candela, Elena; Lozano, Teresa] Hosp Gen Univ Alicante, Dept Cardiol, Alicante, Spain. [Pernias-Escrig, Vicente; Vicente-Ibarra, Nuria] Hosp Gen Univ Elche, Dept Cardiol, Alicante, Spain. C3 Hospital Clinico Universitario Virgen de la Arrixaca; University of Murcia; General University Hospital of Alicante RP Orenes-Pinero, E (通讯作者),Univ Murcia, Hosp Clin Univ Virgen de la Arrixaca, Dept Cardiol, IMIB Arrixaca, Murcia, Spain. EM eorenes@um.es RI Rivera-Caravaca, José Miguel/O-5611-2016; Marin, Francisco/AAD-9429-2022; Orenes-Piñero, Esteban/AAG-8752-2019 OI Rivera-Caravaca, José Miguel/0000-0003-0492-6241; Orenes-Piñero, Esteban/0000-0003-3979-6678; Marin, Francisco/0000-0001-7246-7708; Esteve-Pastor, Maria Asuncion/0000-0003-3104-3460 FU Spanish Society of Cardiology (SEC); Instituto Murciano de Investigaciones Biosanitarias Virgen de la Arrixaca (IMIB-Arrixaca, Murcia, Spain) FX This study has been partially supported by a Research Grant from the Spanish Society of Cardiology (SEC). Dr. Orenes-Pinero is supported by a postdoctoral contract from the Instituto Murciano de Investigaciones Biosanitarias Virgen de la Arrixaca (IMIB-Arrixaca, Murcia, Spain). CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Amsterdam EA, 2014, CIRCULATION, V130, P2354, DOI 10.1161/CIR.0000000000000133 Barywani SB, 2015, CLIN INTERV AGING, V10, P1547, DOI 10.2147/CIA.S89127 Cannon CP, 2010, LANCET, V375, P283, DOI 10.1016/S0140-6736(09)62191-7 Capodanno D, 2010, J AM COLL CARDIOL, V56, P1683, DOI 10.1016/j.jacc.2010.04.063 Carroll Kacey A, 2015, Consult Pharm, V30, P265, DOI 10.4140/TCP.n.2015.265 Conrotto F, 2014, AM J CARDIOL, V113, P2007, DOI 10.1016/j.amjcard.2014.03.044 Del Sindaco D, 2010, CLIN INTERV AGING, V5, P381, DOI 10.2147/CIA.S4482 Dodd KS, 2011, J AM GERIATR SOC, V59, P506, DOI 10.1111/j.1532-5415.2010.03305.x Liu Z, 2017, ONCOTARGET, V8, P41582, DOI 10.18632/oncotarget.15078 Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Navas-Carrillo D, 2017, CRIT REV CL LAB SCI, V54, P49, DOI 10.1080/10408363.2016.1241214 O'Gara PT, 2013, J AM COLL CARDIOL, V61, pE78, DOI [10.1016/j.jacc.2012.11.019, 10.1161/01.cir.0000440804.93914.d8, 10.1161/CIR.0b013e3182742cf6] Rivero F, 2016, REV ESP CARDIOL, V69, P279, DOI 10.1016/j.rec.2015.07.029 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Ruiz-Nodar JM, 2010, REV ESP CARDIOL, V63, P390, DOI 10.1016/S0300-8932(10)70059-2 Savonitto S, 2014, REV ESP CARDIOL, V67, P564, DOI 10.1016/j.rec.2014.02.008 Shan L, 2014, CARDIOLOGY, V129, P46, DOI 10.1159/000360603 Silvain J, 2012, EUR HEART J, V33, P1241, DOI 10.1093/eurheartj/ehr407 Sutton MGS, 2000, CIRCULATION, V101, P2981, DOI 10.1161/01.CIR.101.25.2981 Vavalle JP, 2016, INTERV CARDIOL, V1, P51 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 Zaman MJ, 2014, EUR HEART J, V35, P1551, DOI 10.1093/eurheartj/ehu039 NR 24 TC 10 Z9 12 U1 0 U2 6 PU IMPACT JOURNALS LLC PI ORCHARD PARK PA 6666 E QUAKER ST, STE 1, ORCHARD PARK, NY 14127 USA EI 1949-2553 J9 ONCOTARGET JI Oncotarget PD OCT 6 PY 2017 VL 8 IS 46 BP 80182 EP 80191 DI 10.18632/oncotarget.21260 PG 10 WC Oncology; Cell Biology WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology; Cell Biology GA FJ1HN UT WOS:000412465700010 PM 29113294 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Zhang, HL Dong, PS Yang, XM Du, LJ Wang, K Yan, P Zhang, HF Wang, TF Zhao, XK Guo, TF AF Zhang, Hengliang Dong, Pingshuan Yang, Xvming Du, Laijing Wang, Ke Yan, Peng Zhang, Huifeng Wang, Tengfei Zhao, Xikun Guo, Tengfei TI Prognostic indicators of new onset atrial fibrillation in patients with acute coronary syndrome SO CLINICAL CARDIOLOGY LA English DT Article DE ACS; AF; CK-MB; LVEF; NT-proBNP ID NATRIURETIC PEPTIDE; BIOMARKERS; RISK; PREDICTOR AB Background This study aims to estimate prognostic indicators of new onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS) through 3 to 5 years of follow-up. Hypothesis For patients with ACS, some prognostic indicators can be used to predict new onset AF. Methods The Improving Care for Cardiovascular Disease in China-ACS (CCC-ACS) program was launched in 2014 by a collaborative initiative of the American Heart Association and Chinese Society of Cardiology. We enrolled 866 patients with ACS in a telephone follow-up program. We inquired about each patient's general health and invited each patient to our hospital for further consultation. We also performed ambulatory electrocardiography and other relevant examinations. Results A total of 743 ACS patients were included in the study. After 3 to 5 years, 50 (0.67%) patients developed AF. In multivariable Cox models adjusting for AF risk factors in ACS patients, we found that NT-proBNP [hazard ratio (HR) 2.625, 1.654-4.166, P < .05], creatine kinase-MB (CK-MB) (HR 4.279, 1.887-9.703, P < .05), and left ventricular ejection fraction (LVEF) (HR 0.01, 0.001-0.352, P < .05) were significantly associated with AF receiver operating characteristic (ROC) curves were used to determine a cutoff level for AF screening. NT-proBNP using a cutoff of 1705 ng/L resulted in a sensitivity of 58% and a specificity of 89.8%. CK-MB using a cutoff of 142.5 ng/L resulted in a sensitivity of 73.3% and a specificity of 58.3%. Conclusion For patients with ACS, NT-proBNP, CK-MB, and LVEF have a considerable prognostic value for predicting whether AF would be detected during follow-up. C1 Henan Univ Sci & Technol, Affiliated Hosp 1, Luoyang, Peoples R China. Henan Univ Sci & Technol, Coll Clin Med, Luoyang, Peoples R China. C3 Henan University of Science & Technology; Henan University of Science & Technology RP Zhang, HL (通讯作者),Henan Univ Sci & Technol, Coll Clin Med, Affiliated Hosp 1, 24 Jinghua Rd, Luoyang City 471000, Henan, Peoples R China. EM 271674835@qq.com OI Zhang, Hengliang/0000-0002-8174-7215 FU Luoyang science and technology Foundation FX Luoyang science and technology Foundation CR Alonso A, 2013, J AM HEART ASSOC, V2, DOI 10.1161/JAHA.112.000102 Camm AJ, 2012, EUROPACE, V14, P1385, DOI [10.1093/europace/eus305, 10.1093/eurheartj/ehs253] Camm AJ, 2012, AM J CARDIOL, V110, P270, DOI 10.1016/j.amjcard.2012.03.021 Daoud H, 2019, CASE REP CARDIOL, V2019, DOI 10.1155/2019/9347198 de Lemos JA, 2010, JAMA-J AM MED ASSOC, V304, P2503, DOI 10.1001/jama.2010.1768 Fitzmaurice DA, 2007, BRIT MED J, V335, P383, DOI 10.1136/bmj.39280.660567.55 Friberg L, 2013, J Intern Med, V274, P461, DOI 10.1111/joim.12114 Hao YC, 2016, AM HEART J, V179, P107, DOI 10.1016/j.ahj.2016.06.005 Leal JC, 2012, INTERACT CARDIOV TH, V14, P22, DOI 10.1093/icvts/ivr019 Patton KK, 2013, HEART, V99, P1832, DOI 10.1136/heartjnl-2013-304724 Sabatine MS, 2008, CIRCULATION, V117, P1936, DOI 10.1161/CIRCULATIONAHA.107.728022 Schnabel RB, 2010, CIRCULATION, V121, P200, DOI 10.1161/CIRCULATIONAHA.109.882241 Schnabel RB, 2009, LANCET, V373, P739, DOI 10.1016/S0140-6736(09)60443-8 Svennberg E, 2016, INT J CARDIOL, V223, P74, DOI 10.1016/j.ijcard.2016.08.001 Svennberg E, 2015, CIRCULATION, V131, P2176, DOI 10.1161/CIRCULATIONAHA.114.014343 Wang TJ, 2012, CIRCULATION, V126, P1596, DOI 10.1161/CIRCULATIONAHA.112.129437 NR 16 TC 2 Z9 3 U1 0 U2 0 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0160-9289 EI 1932-8737 J9 CLIN CARDIOL JI Clin. Cardiol. PD JUN PY 2020 VL 43 IS 6 BP 647 EP 651 DI 10.1002/clc.23363 EA APR 2020 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA LY5VE UT WOS:000525899800001 PM 32285941 OA Green Published, gold DA 2023-05-13 ER PT J AU Santi, L Farina, G Gramenzi, A Trevisani, F Baccini, M Bernardi, M Cavazza, M AF Santi, Luca Farina, Gabriele Gramenzi, Annagiulia Trevisani, Franco Baccini, Margherita Bernardi, Mauro Cavazza, Mario TI The HEART score with high-sensitive troponin T at presentation: ruling out patients with chest pain in the emergency room SO INTERNAL AND EMERGENCY MEDICINE LA English DT Article DE Chest pain; Heart score; High-sensitive troponin; Clinical decision rules; Acute coronary syndrome ID ACUTE CORONARY SYNDROMES; MYOCARDIAL-INFARCTION; IDENTIFYING PATIENTS; EARLY-DIAGNOSIS; RISK SCORES; VALIDATION; DISCHARGE; ASSAY; CARE AB The HEART score is a simple scoring system, ranging from 0 to 10, specifically developed for risk stratification of patients with undifferentiated chest pain. It has been validated for the conventional troponin, but not for high-sensitive troponin. We assess a modified version of the HEART score using a single high-sensitivity troponin T dosage at presentation, regardless of symptom duration, and with different ECG criteria to evaluate if the patients with a low HEART score could be safely discharged early. The secondary aim was to confirm a statistically significant difference in each HEART score group (low 0-3, intermediate 4-6, high 7-10) in the occurrence of major adverse cardiac events at 30 and 180 days. We retrospectively analyzed the HEART score of 1597 consecutive patients admitted to the Emergency Department of our Hospital for chest pain between January 1 and June 30, 2014. Of these, 190 did not meet the inclusion criteria and 29 were lost to follow-up. None of the 512 (37.2 %) patients with a low HEART score had an event within 180 days. The difference between the cumulative incidences of events in the three HEART score groups was statistically significant (P < 0.0001). We demonstrate that it might be possible to safely discharge Emergency Department chest pain patients with a low modified HEART score after an initial determination of high-sensitive troponin T, without a prolonged observation period or an additional cardiac testing. C1 [Santi, Luca] Alma Mater Studiorum Univ Bologna, Dept Emergency Med Urgenza & Pronto Soccorso, Policlin S Orsola Malpighi, Bologna, Italy. [Farina, Gabriele; Cavazza, Mario] St Orsola Marcello Malpighi Hosp, Dept Emergency Med Urgenza & Pronto Soccorso, Bologna, Italy. [Gramenzi, Annagiulia; Trevisani, Franco; Bernardi, Mauro] Alma Mater Studiorum Univ Bologna, Dept Clin & Surg Sci, Policlin S Orsola Malpighi, Semeiot Med, Bologna, Italy. [Baccini, Margherita] Alma Mater Studiorum Univ Bologna, Dept Clin & Surg Sci, Policlin S Orsola Malpighi, Endocrinol, Bologna, Italy. C3 IRCCS Azienda Ospedaliero-Universitaria di Bologna; University of Bologna; IRCCS Azienda Ospedaliero-Universitaria di Bologna; IRCCS Azienda Ospedaliero-Universitaria di Bologna; University of Bologna; IRCCS Azienda Ospedaliero-Universitaria di Bologna; University of Bologna RP Santi, L (通讯作者),Alma Mater Studiorum Univ Bologna, Dept Emergency Med Urgenza & Pronto Soccorso, Policlin S Orsola Malpighi, Bologna, Italy. EM lucasanti@hotmail.it CR Amsterdam EA, 2010, CIRCULATION, V122, P1756, DOI 10.1161/CIR.0b013e3181ec61df Anderson JL, 2013, J AM COLL CARDIOL, V61, pE179, DOI 10.1016/j.jacc.2013.01.014 Antman EM, 2000, JAMA-J AM MED ASSOC, V284, P835, DOI 10.1001/jama.284.7.835 APGAR V, 1953, Curr Res Anesth Analg, V32, P260 Backus BE, 2013, INT J CARDIOL, V168, P2153, DOI 10.1016/j.ijcard.2013.01.255 Backus Barbra E, 2010, Crit Pathw Cardiol, V9, P164, DOI 10.1097/HPC.0b013e3181ec36d8 BLACKBURN H, 1960, CIRCULATION, V21, P1160, DOI 10.1161/01.CIR.21.6.1160 Carlton EW, 2015, ANN EMERG MED, V66, P635, DOI 10.1016/j.annemergmed.2015.07.006 Giannitsis E, 2010, CLIN CHEM, V56, P254, DOI 10.1373/clinchem.2009.132654 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Keller T, 2009, NEW ENGL J MED, V361, P868, DOI 10.1056/NEJMoa0903515 Kushner FG, 2009, J AM COLL CARDIOL, V54, P2205, DOI 10.1016/j.jacc.2009.10.015 Lee TH, 2000, NEW ENGL J MED, V342, P1187, DOI 10.1056/NEJM200004203421607 Lyon R, 2007, RESUSCITATION, V74, P90, DOI 10.1016/j.resuscitation.2006.11.023 Mahler SA, 2013, INT J CARDIOL, V168, P795, DOI 10.1016/j.ijcard.2012.10.010 Mahler Simon A, 2011, Crit Pathw Cardiol, V10, P128, DOI 10.1097/HPC.0b013e3182315a85 O'Connor RE, 2010, CIRCULATION, V122, P8422, DOI 10.1161/CIRCULATIONAHA.110.985549 Poldervaart JM, 2013, BMC CARDIOVASC DISOR, V13, DOI 10.1186/1471-2261-13-77 Pope JH, 2000, NEW ENGL J MED, V342, P1163, DOI 10.1056/NEJM200004203421603 Prasad V, 2012, ARCH INTERN MED, V172, P1506, DOI 10.1001/archinternmed.2012.4037 Reichlin T, 2009, NEW ENGL J MED, V361, P858, DOI 10.1056/NEJMoa0900428 Six AJ, 2008, NETH HEART J, V16, P191, DOI 10.1007/BF03086144 Six A Jacob, 2013, Crit Pathw Cardiol, V12, P121, DOI 10.1097/HPC.0b013e31828b327e Than M, 2011, LANCET, V377, P1077, DOI 10.1016/S0140-6736(11)60310-3 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Yan AT, 2007, EUR HEART J, V28, P1072, DOI 10.1093/eurheartj/ehm004 Zhelev Z, 2015, BMJ-BRIT MED J, V350, DOI 10.1136/bmj.h15 NR 28 TC 22 Z9 23 U1 1 U2 6 PU SPRINGER-VERLAG ITALIA SRL PI MILAN PA VIA DECEMBRIO, 28, MILAN, 20137, ITALY SN 1828-0447 EI 1970-9366 J9 INTERN EMERG MED JI Intern. Emerg. Med. PD APR PY 2017 VL 12 IS 3 BP 357 EP 364 DI 10.1007/s11739-016-1461-3 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA ER4KR UT WOS:000398769000011 PM 27178708 DA 2023-05-13 ER PT J AU Kerem, Y Eastvold, JS Faragoi, D Strasburger, D Motzny, SE Kulstad, EB AF Kerem, Yaniv Eastvold, Joshua S. Faragoi, DeAnn Strasburger, Diana Motzny, Sean E. Kulstad, Erik B. TI THE ROLE OF PREHOSPITAL ELECTROCARDIOGRAMS IN THE RECOGNITION OF ST-SEGMENT ELEVATION MYOCARDIAL INFARCTIONS AND REPERFUSION TIMES SO JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE acute coronary syndrome; reperfusion; ECG; prehospital; STEMI ID TO-BALLOON TIME; 12-LEAD ELECTROCARDIOGRAM; EMERGENCY; DELAY; INTERVENTION; CARDIOLOGIST; TRANSPORT; REGISTRY; THERAPY AB Background: Clinical outcomes in ST-segment elevation myocardial infarction (STEMI) are related to reperfusion times. Given the benefit of early recognition of STEMI and resulting ability to decrease reperfusion times and improve mortality, current prehospital recommendations are to obtain electrocardiograms (ECGs) in patients with concern for acute coronary syndrome. Objectives: We sought to determine the effect of wireless transmission of prehospital ECGs on STEMI recognition and reperfusion times. We hypothesized decreased reperfusion times in patients in whom prehospital ECGs were obtained. Methods: We conducted a retrospective, observational study of patients who presented to our suburban, tertiary care, teaching hospital emergency department with STEMI on a prehospital ECG. Results: Ninety-nine patients underwent reperfusion therapy. Patients with prehospital ECGs had a mean time to angioplasty suite of 43 min (95% confidence interval [CI] 31-54). Compared to patients with no prehospital ECG, mean time to angioplasty suite was 49 min (95% CI 41-57), p = 0.035. Patients with prehospital STEMI identification and catheterization laboratory activation had a mean time to angioplasty suite of 33 min (95% CI 25-41), p = 0.007. Patients with prehospital ECGs had a mean door-to-balloon time of 66 min (95% CI 53-79), whereas the control group had a mean door-to-balloon time of 79 min ( 95% CI 67-90), p = 0.024. Patients with prehospital STEMI identification and catheterization laboratory activation had a mean door-to-balloon time of 58 min (95% CI 48-68), p = 0.018. Conclusions: Prehospital STEMI identification allows for prompt catheterization laboratory activation, leading to decreased reperfusion times. (C) 2014 Elsevier Inc. C1 [Kerem, Yaniv] Univ Chicago, Sect Emergency Med, Med Ctr, Chicago, IL 60637 USA. [Eastvold, Joshua S.] Mercy Med Ctr, Dept Emergency Med, Cedar Rapids, IA USA. [Faragoi, DeAnn; Strasburger, Diana; Motzny, Sean E.; Kulstad, Erik B.] Advocate Christ Med Ctr, Dept Emergency Med, Oak Lawn, IL USA. C3 University of Chicago; University of Chicago Medical Center RP Kerem, Y (通讯作者),Univ Chicago, Sect Emergency Med, 5841 S Maryland Ave,MC 5068,Room L539, Chicago, IL 60637 USA. OI Kerem, Yaniv/0000-0002-6855-710X; Kulstad, Erik/0000-0002-9331-8266 CR Adams GL, 2006, AM J CARDIOL, V98, P1160, DOI 10.1016/j.amjcard.2006.05.042 Adams RJ, 2004, CIRCULATION, V110, P2512, DOI 10.1161/01.CIR.0000134791.68010.FA Antman EM, 2008, CIRCULATION, V117, P296, DOI 10.1161/CIRCULATIONAHA.107.188209 Bradley EH, 2006, NEW ENGL J MED, V355, P2308, DOI 10.1056/NEJMsa063117 Brainard AH, 2005, AM J EMERG MED, V23, P351, DOI 10.1016/j.ajem.2005.02.004 Brown JP, 2008, AM J CARDIOL, V101, P158, DOI 10.1016/j.amjcard.2007.07.082 Canto JG, 1997, J AM COLL CARDIOL, V29, P498, DOI 10.1016/S0735-1097(96)00532-3 Curtis JP, 2006, J AM COLL CARDIOL, V47, P1544, DOI 10.1016/j.jacc.2005.10.077 De Luca G, 2004, CIRCULATION, V109, P1223, DOI 10.1161/01.CIR.0000121424.76486.20 Diercks DB, 2009, J AM COLL CARDIOL, V53, P161, DOI 10.1016/j.jacc.2008.09.030 KEREIAKES DJ, 1992, AM HEART J, V123, P835, DOI 10.1016/0002-8703(92)90684-N Moscucci M, 2006, NEW ENGL J MED, V355, P2364, DOI 10.1056/NEJMe068255 Schull MJ, 2004, ANN EMERG MED, V44, P577, DOI 10.1016/j.annemergmed.2004.05.004 Schull MJ, 2003, CAN MED ASSOC J, V168, P277 Sejersten M, 2008, AM J CARDIOL, V101, P941, DOI 10.1016/j.amjcard.2007.11.038 Ting HH, 2008, CIRCULATION, V118, P1066, DOI 10.1161/CIRCULATIONAHA.108.190402 NR 16 TC 11 Z9 13 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0736-4679 EI 1090-1280 J9 J EMERG MED JI J. Emerg. Med. PD FEB PY 2014 VL 46 IS 2 BP 202 EP 207 DI 10.1016/j.jemermed.2013.08.084 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 302CK UT WOS:000330578700019 PM 24268634 DA 2023-05-13 ER PT J AU Cammalleri, V Muscoli, S Benedetto, D Stifano, G Macrini, M Di Landro, A Di Luozzo, M Marchei, M Mariano, EG Cota, L Sergi, D Bezzeccheri, A Bonanni, M Baluci, M De Vico, P Romeo, F AF Cammalleri, Valeria Muscoli, Saverio Benedetto, Daniela Stifano, Giuseppe Macrini, Massimiliano Di Landro, Alessio Di Luozzo, Marco Marchei, Massimo Mariano, Enrica Giuliana Cota, Linda Sergi, Domenico Bezzeccheri, Andrea Bonanni, Michela Baluci, Martino De Vico, Pasquale Romeo, Francesco TI Who Has Seen Patients With ST-Segment-Elevation Myocardial Infarction? First Results From Italian Real-World Coronavirus Disease 2019 SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE acute coronary syndrome; complications; coronavirus; interstitial pneumonia; percutaneous coronary intervention ID TIME AB Background After the coronavirus disease 2019 outbreak, social isolation measures were introduced to contain infection. Although there is currently a slowing down of the infection, a reduction of hospitalizations, especially for myocardial infarction, was observed. The aim of our study is to evaluate the impact of the infectious disease on ST-segment-elevation myocardial infarction (STEMI) care during the coronavirus disease 2019 pandemic, through the analysis of recent cases of patients who underwent percutaneous coronary intervention. Methods and Results Consecutive patients affected by STEMI from March 1 to 31, 2020, during social restrictions of Italian government, were collected and compared with patients with STEMI treated during March 2019. During March 2020, we observed a 63% reduction of patients with STEMI who were admitted to our catheterization laboratory, when compared with the same period of 2019 (13 versus 35 patients). Changes in all time components of STEMI care were notably observed, particularly for longer median time in symptom-to-first medical contact, spoke-to-hub, and the cumulative symptom-to-wire delay. Procedural data and in-hospital outcomes were similar between the 2 groups, whereas the length of hospitalization was longer in patients of 2020. In this group, we also observed higher levels of cardiac biomarkers and a worse left ventricular ejection fraction at baseline and discharge. Conclusions The coronavirus disease 2019 outbreak induced a reduction of hospital access for STEMI with an increase in treatment delay, longer hospitalization, higher levels of cardiac biomarkers, and worse left ventricular function. C1 [Cammalleri, Valeria; Muscoli, Saverio; Benedetto, Daniela; Stifano, Giuseppe; Macrini, Massimiliano; Di Landro, Alessio; Di Luozzo, Marco; Marchei, Massimo; Mariano, Enrica Giuliana; Cota, Linda; Sergi, Domenico; Bezzeccheri, Andrea; Bonanni, Michela; Baluci, Martino; Romeo, Francesco] Tor Vergata Univ Rome, Dept Cardiovasc Dis, Via Montpellier 1, I-00133 Rome, Italy. [De Vico, Pasquale] Tor Vergata Univ Rome, Dept Anesthesia, Rome, Italy. C3 University of Rome Tor Vergata; University of Rome Tor Vergata RP Cammalleri, V (通讯作者),Tor Vergata Univ Rome, Dept Cardiovasc Dis, Via Montpellier 1, I-00133 Rome, Italy. EM v.cammalleri@hotmail.it OI benedetto, daniela/0000-0001-7069-5635; SERGI, DOMENICO/0000-0001-7007-8186 CR Ardati AK, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006661 Chen NS, 2020, LANCET, V395, P507, DOI 10.1016/S0140-6736(20)30211-7 CHRISTIAN TF, 1992, CIRCULATION, V86, P81, DOI 10.1161/01.CIR.86.1.81 De Luca G, 2004, CIRCULATION, V109, P1223, DOI 10.1161/01.CIR.0000121424.76486.20 Garcia S, 2020, J AM COLL CARDIOL, V75, P2871, DOI 10.1016/j.jacc.2020.04.011 Garnier-Crussard A, 2020, J AM GERIATR SOC, V68, P939, DOI 10.1111/jgs.16407 Gerber Y, 2016, CIRC-HEART FAIL, V9, DOI 10.1161/CIRCHEARTFAILURE.115.002460 Granger CB, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.008096 Li LQ, 2020, J MED VIROL, V92, P577, DOI 10.1002/jmv.25757 Nicastri E, 2020, INFECT DIS REP, V12, P3, DOI 10.4081/idr.2020.8543 Rao A, 2010, CATHETER CARDIO INTE, V75, P174, DOI 10.1002/ccd.22257 Ren LL, 2020, CHINESE MED J-PEKING, V133, P1015, DOI 10.1097/CM9.0000000000000722 Sorbello M, 2020, ANAESTHESIA, V75, P724, DOI 10.1111/anae.15049 Tam CCF, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006631 Zhu N, 2020, NEW ENGL J MED, V382, P727, DOI 10.1056/NEJMoa2001017 NR 15 TC 20 Z9 20 U1 0 U2 2 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA EI 2047-9980 J9 J AM HEART ASSOC JI J. Am. Heart Assoc. PD OCT 20 PY 2020 VL 9 IS 19 AR e017126 DI 10.1161/JAHA.120.017126 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OB4EH UT WOS:000578423900004 PM 32901560 OA Green Published DA 2023-05-13 ER PT J AU Rittger, H Stadelmaier, C Kieschnick, T Buber, D Rank, K Vitali-Serdoz, L Bastian, D Waliszewski, M AF Rittger, Harald Stadelmaier, Christoph Kieschnick, Thomas Bueber, Duygu Rank, Kristina Vitali-Serdoz, Laura Bastian, Dirk Waliszewski, Matthias TI Impact of Different Geriatric Conditions on Choice of Therapy and In-Hospital Outcomes in Elderly Patients with Acute Coronary Syndrome SO CLINICAL INTERVENTIONS IN AGING LA English DT Article DE acute coronary syndromes; elderly patients; frailty; interventional treatment ID GLOBAL REGISTRY; MYOCARDIAL-INFARCTION; FRAILTY; OLDER; MANAGEMENT; MORTALITY; STRATEGY; CARE AB Introduction: The clinical benefit of invasive therapy in elderly patients with acute coronary syndrome (ACS) remains unclear. Furthermore, the decision-making process to treat this growing patient group is also debatable. The purpose of this study was to assess the association between elderly ACS patients, the treatment choice and their in-hospital outcomes after non-ST-elevation (NSTE)-ACS in a consecutive series of patients >75 years of age. Methods and Results: Consecutive patients >75 years presenting with NSTE-ACS in our hospital between July 2017 and July 2018 were included during the first 2 days of hospital admission. Demographic data, prior medical history and present medical condition were documented. During day 0 and day 2, geriatric assessments (Clinical Frailty Scale [CFS], Barthel index, Charlson comorbidity index, "timed up and go" test [TUG], Mini-Mental Status Test [MMS], Geriatric Depression Scale [GDS], SF-36 for quality of life, instrumental activities of daily living [IADL], Killip-score, Grace-score and Euro-score) were conducted. After 6 months, patients were re-evaluated. In 106 patients (mean age 81.9 +/- 5.3 years, 57% male gender), 68 patients (64%) were treated interventionally, and 38 patients had conservative treatment (36%). Patients treated with intervention were significantly younger (80.9 +/- 4.7 years vs 83.5 +/- 6.0 years, p=0.015), had a lower rate of prior cerebral events (17.6% vs 26.3%; p=ns) and suffered more often from chronic obstructive pulmonary disease (17.6% vs 34.2%; p=0.050). All other demographic variables were comparable between both groups. The composite clinical endpoint (death, re-infarction, bleeding) was reached in 7 patients (10.3%) of the invasive and in 2 patients (5.3%) of the conservative group. They were not significantly different between both groups. A frailty index, consisting of commonly used parameters of functional impairment in elderly patients, namely, MMS <= 2 at baseline, IADL <= 7, CFS >= 7 and age >= 85 years, significantly predicted conservative treatment. Conclusion: Effective revascularization techniques are still underused in patients of older age in the case of ACS. For decision-making, geriatric tests alone may not predict treatment in those patients, but the combination of different tests may better predict treatment and perhaps the clinical outcomes in those patients. Furthermore, frail patients are at higher risk for not receiving guideline recommended therapy. C1 [Rittger, Harald; Stadelmaier, Christoph; Kieschnick, Thomas; Bueber, Duygu; Rank, Kristina; Vitali-Serdoz, Laura; Bastian, Dirk] Klinikum Furth, Med Klin 1, Furth, Germany. [Waliszewski, Matthias] B Braun Melsungen AG, Med Sci Affairs, Berlin, Germany. [Waliszewski, Matthias] Charite Univ Med Berlin, Dept Internal Med & Cardiol, Campus Virchow, Berlin, Germany. C3 B Braun Melsungen; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin RP Rittger, H (通讯作者),Klinikum Fuerth, Med Klin 1, Jakob Henle Str 1, D-90766 Furth, Germany. EM h.rittger@yahoo.com OI Stadelmaier, Christoph/0000-0002-1670-8455 CR Afilalo J, 2014, J AM COLL CARDIOL, V63, P747, DOI 10.1016/j.jacc.2013.09.070 Alegre O, 2016, CLIN CARDIOL, V39, P373, DOI 10.1002/clc.22550 Salinas GLA, 2017, CLIN CARDIOL, V40, P925, DOI 10.1002/clc.22749 Salinas GLA, 2016, EUR HEART J-ACUTE CA, V5, P434, DOI 10.1177/2048872616644909 Avezum A, 2005, AM HEART J, V149, P67, DOI 10.1016/j.ahj.2004.06.003 Campo G, 2020, J GERONTOL A-BIOL, V75, P1113, DOI 10.1093/gerona/glz123 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 Devlin G, 2008, EUR HEART J, V29, P1275, DOI 10.1093/eurheartj/ehn124 Ekerstad N, 2011, CIRCULATION, V124, P2397, DOI 10.1161/CIRCULATIONAHA.111.025452 FOLSTEIN MF, 1975, J PSYCHIAT RES, V12, P189, DOI 10.1016/0022-3956(75)90026-6 Graham MM, 2013, CAN J CARDIOL, V29, P1610, DOI 10.1016/j.cjca.2013.08.016 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Khandelwal D, 2012, J NUTR HEALTH AGING, V16, P732, DOI 10.1007/s12603-012-0369-5 KILLIP T, 1967, AM J CARDIOL, V20, P457, DOI 10.1016/0002-9149(67)90023-9 LAWTON MP, 1969, GERONTOLOGIST, V9, P179, DOI 10.1093/geront/9.3_Part_1.179 Llao I, 2018, EUROINTERVENTION, V14, P336, DOI 10.4244/EIJ-D-18-00099 MAHONEY F I, 1965, Md State Med J, V14, P61 Nashef SAM, 2012, EUR J CARDIO-THORAC, V41, P734, DOI 10.1093/ejcts/ezs043 Neumann FJ, 2019, EUR HEART J, V40, P87, DOI 10.1093/eurheartj/ehy394 Noriega FJ, 2015, AM HEART J, V170, P938, DOI 10.1016/j.ahj.2015.08.007 Nunez J, 2017, INT J CARDIOL, V228, P456, DOI 10.1016/j.ijcard.2016.11.151 Ofori-Asenso R, 2019, JAMA NETW OPEN, V2, DOI 10.1001/jamanetworkopen.2019.8398 Ofori-Asenso R, 2019, CARDIOVASC DIAGN THE, V9, P250, DOI 10.21037/cdt.2019.04.06 PODSIADLO D, 1991, J AM GERIATR SOC, V39, P142, DOI 10.1111/j.1532-5415.1991.tb01616.x Rockwood K, 2007, J GERONTOL A-BIOL, V62, P722, DOI 10.1093/gerona/62.7.722 Sanchez E, 2011, HEART, V97, P1602, DOI 10.1136/hrt.2011.227504 Sanchis J, 2016, EUR J INTERN MED, V35, P89, DOI 10.1016/j.ejim.2016.07.003 Savonitto S, 2012, JACC-CARDIOVASC INTE, V5, P906, DOI 10.1016/j.jcin.2012.06.008 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 YESAVAGE JA, 1983, J PSYCHIATR RES, V17, P37, DOI 10.1016/0022-3956(82)90033-4 NR 30 TC 1 Z9 1 U1 0 U2 1 PU DOVE MEDICAL PRESS LTD PI ALBANY PA PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND EI 1178-1998 J9 CLIN INTERV AGING JI Clin. Interv. Aging PY 2020 VL 15 BP 723 EP 731 DI 10.2147/CIA.S249017 PG 9 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA LR3LI UT WOS:000535594500001 PM 32546990 OA Green Published, gold DA 2023-05-13 ER PT J AU McRae, MP Rajsri, KS Alcorn, TM McDevitt, JT AF McRae, Michael P. Rajsri, Kritika S. Alcorn, Timothy M. McDevitt, John T. TI Smart Diagnostics: Combining Artificial Intelligence and In Vitro Diagnostics SO SENSORS LA English DT Article DE artificial intelligence; in vitro diagnostics; point of care; lab on a chip; immunoassay; cytology; clinical decision support tool ID RESPIRATORY-DISTRESS-SYNDROME; ACUTE CORONARY SYNDROMES; DECISION-SUPPORT-SYSTEM; OF-CARE PLATFORM; NANO-CHIP SYSTEM; ON-A-CHIP; MULTILAYER PERCEPTRON; CARDIOVASCULAR RISK; NEURAL-NETWORKS; HEART-DISEASE AB We are beginning a new era of Smart Diagnostics-integrated biosensors powered by recent innovations in embedded electronics, cloud computing, and artificial intelligence (AI). Universal and AI-based in vitro diagnostics (IVDs) have the potential to exponentially improve healthcare decision making in the coming years. This perspective covers current trends and challenges in translating Smart Diagnostics. We identify essential elements of Smart Diagnostics platforms through the lens of a clinically validated platform for digitizing biology and its ability to learn disease signatures. This platform for biochemical analyses uses a compact instrument to perform multiclass and multiplex measurements using fully integrated microfluidic cartridges compatible with the point of care. Image analysis digitizes biology by transforming fluorescence signals into inputs for learning disease/health signatures. The result is an intuitive Score reported to the patients and/or providers. This AI-linked universal diagnostic system has been validated through a series of large clinical studies and used to identify signatures for early disease detection and disease severity in several applications, including cardiovascular diseases, COVID-19, and oral cancer. The utility of this Smart Diagnostics platform may extend to multiple cell-based oncology tests via cross-reactive biomarkers spanning oral, colorectal, lung, bladder, esophageal, and cervical cancers, and is well-positioned to improve patient care, management, and outcomes through deployment of this resilient and scalable technology. Lastly, we provide a future perspective on the direction and trajectory of Smart Diagnostics and the transformative effects they will have on health care. C1 [McRae, Michael P.; Rajsri, Kritika S.; McDevitt, John T.] NYU, Dept Mol Pathobiol, Div Biomat, Bioengn Inst,Coll Dent, 433 First Ave Rm 822, New York, NY 10010 USA. [Rajsri, Kritika S.] NYU, Sch Med, Vilcek Inst, Dept Pathol, 160 E 34th St, New York, NY 10016 USA. [Alcorn, Timothy M.] Latham BioPharm Grp, 6810 Deerpath Rd Suite 405, Elkridge, MD 21075 USA. C3 New York University; New York University RP McDevitt, JT (通讯作者),NYU, Dept Mol Pathobiol, Div Biomat, Bioengn Inst,Coll Dent, 433 First Ave Rm 822, New York, NY 10010 USA. EM mcdevitt@nyu.edu RI McDevitt, John T/P-4108-2014 OI McDevitt, John T/0000-0001-8789-9351; Srinivasan Rajsri, Kritika/0000-0003-2877-3542; McRae, Michael/0000-0002-2126-9442 FU Cancer Prevention and Research Institute of Texas; NIH [R01DE031319-01, 5U54EB027690-04, 3 U01 DE017793-02S1, 5 U01 DE017793-2, 1RC2DE020785-01, 4R44DE 025798-02, R01DE024392]; Renaissance Health Service Corporation; Delta Dental of Michigan; Rho Inc. FX Funding was provided by Cancer Prevention and Research Institute of Texas, the NIH (Grant Nos. R01DE031319-01, 5U54EB027690-04, 3 U01 DE017793-02S1, 5 U01 DE017793-2, 1RC2DE020785-01, 4R44DE 025798-02, and R01DE024392), and a portion of the funding being derived from Renaissance Health Service Corporation and Delta Dental of Michigan. Rho Inc., a contract research organization (Chapel Hill, NC, USA), provided statistical, regulatory, data management, and clinical monitoring support, as well as operational management, for the oral cancer validation study. The content is solely the responsibility of the authors and does not necessarily represent or reflect the official views of Texas, the NIH, or the Federal Government. 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2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 Zhu N, 2020, NEW ENGL J MED, V382, P727, DOI 10.1056/NEJMoa2001017 NR 89 TC 1 Z9 1 U1 5 U2 6 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 1424-8220 J9 SENSORS-BASEL JI Sensors PD SEP PY 2022 VL 22 IS 17 AR 6355 DI 10.3390/s22176355 PG 17 WC Chemistry, Analytical; Engineering, Electrical & Electronic; Instruments & Instrumentation WE Science Citation Index Expanded (SCI-EXPANDED) SC Chemistry; Engineering; Instruments & Instrumentation GA 4K3MZ UT WOS:000851859700001 PM 36080827 OA gold, Green Published DA 2023-05-13 ER PT J AU Anand, A Lee, KK Chapman, AR Ferry, AV Adamson, PD Strachan, FE Berry, C Findlay, I Cruikshank, A Reid, A Collinson, PO Apple, FS McAllister, DA Maguire, D Fox, KAA Newby, DE Tuck, C Harkess, R Keerie, C Weir, CJ Parker, RA Gray, A Shah, ASV Mills, NL AF Anand, Atul Lee, Kuan Ken Chapman, Andrew R. Ferry, Amy V. Adamson, Phil D. Strachan, Fiona E. Berry, Colin Findlay, Iain Cruikshank, Anne Reid, Alan Collinson, Paul O. Apple, Fred S. McAllister, David A. Maguire, Donogh Fox, Keith A. A. Newby, David E. Tuck, Chris Harkess, Ronald Keerie, Catriona Weir, Christopher J. Parker, Richard A. Gray, Alasdair Shah, Anoop S. V. Mills, Nicholas L. CA HiSTORIC Investigators TI High-Sensitivity Cardiac Troponin on Presentation to Rule Out Myocardial Infarction SO CIRCULATION LA English DT Article DE biomarkers; chest pain; myocardial infarction; randomized controlled trial; troponin ID VALIDATION; DIAGNOSIS; ALGORITHM; PATHWAYS; OUTCOMES; CARE AB BACKGROUND: High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the safety and efficacy of this approach is uncertain. We investigated whether an early rule-out pathway is safe and effective for patients with suspected acute coronary syndrome. METHODS: We performed a stepped-wedge cluster randomized controlled trial in the emergency departments of 7 acute care hospitals in Scotland. Consecutive patients presenting with suspected acute coronary syndrome between December 2014 and December 2016 were included. Sites were randomized to implement an early rule-out pathway where myocardial infarction was excluded if high-sensitivity cardiac troponin I concentrations were <5 ng/L at presentation. During a previous validation phase, myocardial infarction was ruled out when troponin concentrations were <99th percentile at 6 to 12 hours after symptom onset. The coprimary outcome was length of stay (efficacy) and myocardial infarction or cardiac death after discharge at 30 days (safety). Patients were followed for 1 year to evaluate safety and other secondary outcomes. RESULTS: We enrolled 31 492 patients (59 +/- 17 years of age [mean +/- SD]; 45% women) with troponin concentrations <99th percentile at presentation. Length of stay was reduced from 10.1 +/- 4.1 to 6.8 +/- 3.9 hours (adjusted geometric mean ratio, 0.78 [95% CI, 0.73-0.83]; P(0.001) after implementation and the proportion of patients discharged increased from 50% to 71% (adjusted odds ratio, 1.59 [95% CI, 1.45-1.75]). Noninferiority was not demonstrated for the 30-day safety outcome (upper limit of 1-sided 95% CI for adjusted risk difference, 0.70% [noninferiority margin 0.50%]; F 6 0.068), but the observed differences favored the early rule-out pathway (0.4% [57/14 700] versus 0.3% [56/16 792]). At 1 year, the safety outcome occurred in 2.7% (396/14 700) and 1.8% (307/16 792) of patients before and after implementation (adjusted odds ratio, 1.02 [95% CI, 0.74-1.40]; P=0.894), and there were no differences in hospital reattendance or all-cause mortality. CONCLUSIONS: Implementation of an early rule-out pathway for myocardial infarction reduced length of stay and hospital admission. Although noninferiority for the safety outcome was not demonstrated at 30 days, there was no increase in cardiac events at 1 year. Adoption of this pathway would have major benefits for patients and health care providers. C1 [Anand, Atul; Lee, Kuan Ken; Chapman, Andrew R.; Ferry, Amy V.; Adamson, Phil D.; Strachan, Fiona E.; Fox, Keith A. A.; Newby, David E.; Shah, Anoop S. V.; Mills, Nicholas L.] Univ Edinburgh, BHF Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland. [Tuck, Chris; Harkess, Ronald; Keerie, Catriona; Weir, Christopher J.; Parker, Richard A.] Univ Edinburgh, Edinburgh Clin Trials Unit, Edinburgh, Midlothian, Scotland. [Gray, Alasdair; Shah, Anoop S. V.; Mills, Nicholas L.] Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland. [Adamson, Phil D.] Univ Otago, Christchurch Heart Inst, Christchurch, New Zealand. [Berry, Colin] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland. [McAllister, David A.] Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland. [Findlay, Iain] Royal Alexandra Hosp, Dept Cardiol, Paisley, Renfrew, Scotland. [Cruikshank, Anne; Reid, Alan] Queen Elizabeth Univ Hosp, Dept Biochem, Glasgow, Lanark, Scotland. [Collinson, Paul O.] St Georges Univ Hosp NHS Trust, Dept Clin Blood Sci, London, England. [Collinson, Paul O.] St Georges Univ Hosp NHS Trust, Dept Cardiol, London, England. [Collinson, Paul O.] St Georges Univ London, London, England. [Apple, Fred S.] Hennepin Healthcare, Dept Lab Med & Pathol, Minneapolis, MN USA. [Apple, Fred S.] Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. [Maguire, Donogh] Glasgow Royal Infirm, Emergency Med Dept, Glasgow, Lanark, Scotland. [Gray, Alasdair] Royal Infirm Edinburgh NHS Trust, Emergency Med Res Grp Edinburgh, Edinburgh, Midlothian, Scotland. C3 RLUK- Research Libraries UK; University of Edinburgh; RLUK- Research Libraries UK; University of Edinburgh; RLUK- Research Libraries UK; University of Edinburgh; University of Otago; RLUK- Research Libraries UK; University of Glasgow; RLUK- Research Libraries UK; University of Glasgow; Queen Elizabeth University Hospital (QEUH); St Georges University London; University of Minnesota System; University of Minnesota Twin Cities; RLUK- Research Libraries UK; University of Glasgow; RLUK- Research Libraries UK; University of Edinburgh; Royal Infirmary of Edinburgh RP Mills, NL (通讯作者),Univ Edinburgh, Univ Ctr Cardiovasc Sci, British Heart Fdn, Edinburgh EH16 4SA, Midlothian, Scotland. EM atul.anand@ed.ac.uk; ken.lee@ed.ac.uk; a.r.chapman@ed.ac.uk; Amy.ferry@ed.ac.uk; philip.adamson@ed.ac.uk; f.strachan@ed.ac.uk; colin.berry@glasgow.ac.uk; iain.findlay@ggc.scot.nhs.uk; Anne.Cruickshank@ggc.scot.nhs.uk; alan.reid@ggc.scot.nhs.uk; paul.collinson@stgeorges.nhs.uk; apple004@umn.edu; david.mcallister@glasgow.ac.uk; donogh.maguire@glasgow.ac.uk; k.a.a.fox@ed.ac.uk; d.e.newby@ed.ac.uk; chris.tuck@ed.ac.uk; rharkess@exseed.ed.ac.uk; Catriona.Keerie@ed.ac.uk; christopher.weir@ed.ac.uk; richard.parker@ed.ac.uk; ajg4406@gmail.com; anoopsshah@gmail.com; nick.mills@ed.ac.uk RI Fox, keith A A/I-3742-2013; Adamson, Philip/AAC-3699-2019; Berry, Colin/AAF-5268-2020 OI Adamson, Philip/0000-0002-6177-956X; Berry, Colin/0000-0002-4547-8636; Mills, Nicholas/0000-0003-0533-7991; Anand, Atul/0000-0002-6428-4554; Tuck, Christopher/0000-0003-4994-6342; Doudesis, Dimitrios/0000-0001-6699-9476; Chapman, Andrew/0000-0003-1926-5925; Shah, Anoop/0000-0002-2825-3419; Lowry, Matthew/0000-0001-8972-5136; Weir, Christopher/0000-0002-6494-4903; Keerie, Catriona/0000-0001-5459-6178 FU British Heart Foundation [CH/09/002, PG/15/51/31596, FS/18/25/33454, FS/16/14/32023, RG/20/10/34966, FS/19/17/34172]; British Heart Foundation Research Excellence Awards [RE/18/5/34216, RE/18/6134217]; Scottish Clinical Research Excellence Development Scheme; National Heart Foundation of New Zealand Senior Fellowship [1844]; Wellcome Trust Senior Investigator Award [WT103782AIA]; National Health Service Lothian through the Edinburgh Clinical Trials Unit; Chief Scientist Office [PCL/18/05] FX This trial was funded by the British Heart Foundation (grant PG/15/51/31596) with support from British Heart Foundation Research Excellence Awards (awards RE/18/5/34216 and RE/18/6134217). Dr Anand, Dr Lee, and Dr Chapman are supported by a Clinical Lectureship from the Chief Scientist Office (PCL/18/05), a Clinical Research Training Fellowship from the British Heart Foundation (FS/18/25/33454), and a Clinical Lectureship from the Scottish Clinical Research Excellence Development Scheme, respectively. Dr Newby, Dr Shah, and Dr Mills are supported by the British Heart Foundation through the award of a Chair (chair CH/09/002), an Intermediate Clinical Research Fellowship (fellowship FS/19/17/34172), and the Butler Senior Clinical Research Fellowship and a Program Grant (fellowship FS/16/14/32023 and grant RG/20/10/34966), respectively. Dr Adamson is supported by a National Heart Foundation of New Zealand Senior Fellowship (fellowship 1844). Dr Newby is a recipient of a Wellcome Trust Senior Investigator Award (award WT103782AIA). Dr Weir and R.A. Parker were supported by National Health Service Lothian through the Edinburgh Clinical Trials Unit. The funders played no role in the design, conduct, data collection, analysis, or reporting of the trial. CR Amsterdam EA, 2014, CIRCULATION, V130, P2354, DOI 10.1161/CIR.0000000000000133 Anderson JL, 2017, NEW ENGL J MED, V376, P2053, DOI 10.1056/NEJMra1606915 [Anonymous], 2013, SIGN PUBL Apple FS, 2012, CLIN CHEM, V58, P54, DOI 10.1373/clinchem.2011.165795 Body R, 2016, ACAD EMERG MED, V23, P1004, DOI 10.1111/acem.13012 Body R, 2011, J AM COLL CARDIOL, V58, P1333, DOI 10.1016/j.jacc.2011.06.026 Boeddinghaus J, 2017, CIRCULATION, V135, P1597, DOI 10.1161/CIRCULATIONAHA.116.025661 Bularga A, 2019, CIRCULATION, V140, P1557, DOI 10.1161/CIRCULATIONAHA.119.042866 Carlton EW, 2020, HEART, V106, P1586, DOI 10.1136/heartjnl-2020-316692 Chapman AR, 2020, J AM COLL CARDIOL, V75, P985, DOI 10.1016/j.jacc.2019.12.036 Chapman AR, 2020, CIRCULATION, V141, P161, DOI 10.1161/CIRCULATIONAHA.119.042960 Chapman AR, 2019, HEART, V105, P616, DOI 10.1136/heartjnl-2018-314093 Chapman AR, 2017, JAMA-J AM MED ASSOC, V318, P1913, DOI 10.1001/jama.2017.17488 Chapman AR, 2017, CIRCULATION, V135, P1586, DOI 10.1161/CIRCULATIONAHA.116.025021 Chew DP, 2019, CIRCULATION, V140, P1543, DOI 10.1161/CIRCULATIONAHA.119.042891 Chin CWL, 2014, EUR HEART J, V35, P2312, DOI 10.1093/eurheartj/ehu189 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 Goodacre S, 2005, HEART, V91, P229, DOI 10.1136/hrt.2003.027599 Greenslade J, 2018, CLIN CHEM, V64, P820, DOI 10.1373/clinchem.2017.283887 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hollander JE, 2016, CIRCULATION, V134, P547, DOI 10.1161/CIRCULATIONAHA.116.021886 Kavsak PA, 2016, CLIN CHEM, V62, P887, DOI 10.1373/clinchem.2016.255448 Lindahl B, 2017, HEART, V103, P125, DOI 10.1136/heartjnl-2016-309951 Ljung L, 2019, ANN EMERG MED, V73, P491, DOI 10.1016/j.annemergmed.2018.11.039 Mockel M, 2015, EUR HEART J, V36, P369, DOI 10.1093/eurheartj/ehu178 Neumann JT, 2019, NEW ENGL J MED, V380, P2529, DOI 10.1056/NEJMoa1803377 Newby D, 2015, LANCET, V385, P2383, DOI 10.1016/S0140-6736(15)60291-4 NHS Digital, 2018, SCOTT HEART DIS STAT, P1 Parsonage WA, 2016, HEART, V102, P1279, DOI 10.1136/heartjnl-2016-309270 Pedroza C, 2016, BMC MED RES METHODOL, V16, DOI 10.1186/s12874-016-0217-0 Pickering JW, 2017, ANN INTERN MED, V166, P715, DOI 10.7326/M16-2562 Pickering JW, 2016, HEART, V102, P1270, DOI 10.1136/heartjnl-2015-308505 Probst MA, 2017, WEST J EMERG MED, V18, P253, DOI 10.5811/westjem.2016.10.31171 Reichlin T, 2012, ARCH INTERN MED, V172, P1211, DOI 10.1001/archinternmed.2012.3698 Roffi M, 2016, G ITAL CARDIOL, V17, P831, DOI [10.1714/2464.25804, 10.1093/eurheartj/ehv320] Sandoval Y, 2017, AM J MED, V130, P1076, DOI 10.1016/j.amjmed.2017.02.032 Shah ASV, 2018, LANCET, V392, P919, DOI 10.1016/S0140-6736(18)31923-8 Shah ASV, 2017, BMJ-BRIT MED J, V359, DOI 10.1136/bmj.j4788 Shah ASV, 2015, LANCET, V386, P2481, DOI 10.1016/S0140-6736(15)00391-8 Shah ASV, 2015, BMJ-BRIT MED J, V350, DOI 10.1136/bmj.g7873 Than MP, 2019, CIRCULATION, V140, P899, DOI 10.1161/CIRCULATIONAHA.119.041980 Than MP, 2016, ANN EMERG MED, V68, P93, DOI 10.1016/j.annemergmed.2016.01.001 Thygesen K., 2018, GLOB HEART, V138, P618, DOI 10.1161/CIR.0000000000000617 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Twerenbold R, 2019, J AM COLL CARDIOL, V74, P483, DOI 10.1016/j.jacc.2019.05.046 NR 45 TC 42 Z9 42 U1 2 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0009-7322 EI 1524-4539 J9 CIRCULATION JI Circulation PD JUN 8 PY 2021 VL 143 IS 23 BP 2214 EP 2224 DI 10.1161/circulationaha.120.052380 PG 11 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA SO3CG UT WOS:000658853100010 PM 33752439 OA Green Submitted, Green Accepted, hybrid, Green Published DA 2023-05-13 ER PT J AU Kite, TA Gaunt, H Banning, AS Roberts, E Kovac, J Hudson, I Gershlick, AH AF Kite, T. A. Gaunt, H. Banning, A. S. Roberts, E. Kovac, J. Hudson, I. Gershlick, A. H. TI Clinical outcomes of patients discharged from the Rapid Access Chest Pain Clinic with non-anginal chest pain: A retrospective cohort study SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Rapid Access Chest Pain Clinic; Non-anginal chest pain; Coronary artery disease ID CT CORONARY-ANGIOGRAPHY; SUSPECTED ANGINA; RISK; DIAGNOSES; DISEASE; HEART AB Background: The Rapid Access Chest Pain Clinic (RACPC) has become an important means of assessing patients who present with ischaemic or ischaemia-like symptoms of recent onset. Observations have shown that up to 70% are discharged with a diagnosis of non-anginal chest pain (NACP) and accordingly "reassured". This study aims to describe the actual clinical outcomes of this cohort of patients discharged from the RACPC. Methods: We undertook a single centre retrospective cohort study at a tertiary cardiac hospital. The outcomes of unselected patients diagnosed with NACP and discharged from the RACPC between April 2010 and March 2013 at University Hospitals of Leicester (UHL) were recorded. Re-referrals to cardiology outpatient clinic and emergency hospital admissions for cardiovascular disease within 6 months, and the mortality rate at 12 months, were determined. Results: 7066 patients were seen in the UHL RACPC during the 36-month period. 3253 (46.0%) were diagnosed with NACP and discharged. 7 (0.2%) were diagnosed with coronary artery disease (CAD) and 8 (0.25%) cases of acute coronary syndrome (ACS) identified during the review period. 11 (0.3%) patients died within 12 months of discharge from RACPC. No deaths were attributable to CAD. Conclusions: Comprehensive assessment using risk-stratification criteria in a nurse practitioner-led RACPC can accurately identify patients who are at low-risk for subsequent CAD. Despite contemporary National Institute for Health and Care Excellence (NICE) guidelines that shift focus away from a clinical judgement based approach, this strategy appears to robustly predict favourable outcomes in patients diagnosed with NACP. Crown Copyright (c) 2019 Published by Elsevier B.V. All rights reserved. C1 [Kite, T. A.; Gaunt, H.; Banning, A. S.; Roberts, E.; Kovac, J.; Hudson, I.; Gershlick, A. H.] Univ Leicester, Dept Cardiovasc Sci, Leicester LE3 9QP, Leics, England. [Kite, T. A.; Gaunt, H.; Banning, A. S.; Roberts, E.; Kovac, J.; Hudson, I.; Gershlick, A. H.] Glenfield Hosp, NIHR Leicester Cardiovasc Biomed Res Ctr, Univ Hosp Leicester, Leicester LE3 9QP, Leics, England. [Kite, T. A.; Gaunt, H.; Banning, A. S.; Roberts, E.; Kovac, J.; Hudson, I.; Gershlick, A. H.] Univ Hosp Leicester NHS Trust, Dept Cardiol, Glenfield Hosp, Leicester, Leics, England. C3 RLUK- Research Libraries UK; University of Leicester; RLUK- Research Libraries UK; University of Leicester; University Hospitals of Leicester NHS Trust; Glenfield Hospital; RLUK- Research Libraries UK; University of Leicester; University Hospitals of Leicester NHS Trust; Glenfield Hospital RP Kite, TA (通讯作者),Univ Leicester, Dept Cardiovasc Sci, Leicester LE3 9QP, Leics, England. EM tom.kite@nhs.net RI Kovac, Jan/HMP-2318-2023; Kite, Thomas A./AAV-3581-2021 OI Kovac, Jan/0000-0002-2007-888X; Kite, Tom/0000-0002-6021-5738 CR Adamson PD, 2018, HEART, V104, P4, DOI [10.1136/heartjnl-2017-311706, 10.1136/heartjnl-2017-311508, 10.1136/heartjnl-2016-311037] [Anonymous], 2016, CHALL NAT CT COR ANG Department of Health, 2000, NAT SERV FRAM COR HE Douglas PS, 2015, NEW ENGL J MED, V372, P1291, DOI 10.1056/NEJMoa1415516 Fordyce CB, 2017, JAMA CARDIOL, V2, P400, DOI 10.1001/jamacardio.2016.5501 Lee AJX, 2015, OPEN HEART, V2, DOI 10.1136/openhrt-2014-000151 Nakanishi R, 2011, CIRCULATION, V124 National Institute for Health and Clinical Excellence, 2016, CHEST PAIN REC ONS A National Institute for Health and Clinical Excellence, 2010, CHEST PAIN REC ONS A Newby D, 2015, LANCET, V385, P2383, DOI 10.1016/S0140-6736(15)60291-4 Patterson CM, 2015, HEART, V101, P113, DOI 10.1136/heartjnl-2014-306180 Pope JH, 2000, NEW ENGL J MED, V342, P1163, DOI 10.1056/NEJM200004203421603 Sekhri N, 2007, HEART, V93, P458, DOI 10.1136/hrt.2006.090894 T hygesen K, 2018, EUR HEART J, V2018 Taylor GL, 2008, HEART, V94, P628, DOI 10.1136/hrt.2007.125344 Tenkorang JN, 2006, HEART, V92, P1084, DOI 10.1136/hrt.2005.079376 Williams MC, 2017, HEART, V103, P995, DOI 10.1136/heartjnl-2016-310129 NR 17 TC 1 Z9 1 U1 0 U2 9 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0167-5273 EI 1874-1754 J9 INT J CARDIOL JI Int. J. Cardiol. PD MAR 1 PY 2020 VL 302 BP 1 EP 4 DI 10.1016/j.ijcard.2019.12.008 PG 4 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KH7RC UT WOS:000510846300001 PM 31864788 DA 2023-05-13 ER PT J AU Dennis, M Buscher, H Gattas, D Burns, B Habig, K Bannon, P Patel, S Buhr, H Reynolds, C Scott, S Nair, P Hayman, J Granger, E Lovett, R Forrest, P Coles, J Lowe, DA AF Dennis, Mark Buscher, Hergen Gattas, David Burns, Brian Habig, Karel Bannon, Paul Patel, Sanjay Buhr, Heidi Reynolds, Claire Scott, Sean Nair, Priya Hayman, Jon Granger, Emily Lovett, Ryan Forrest, Paul Coles, Jennifer Lowe, David A. CA Sydney ECMO Res Interest Grp TI Prospective observational study of mechanical cardiopulmonary resuscitation, extracorporeal membrane oxygenation and early reperfusion for refractory cardiac arrest in Sydney: the 2CHEER study SO CRITICAL CARE AND RESUSCITATION LA English DT Article ID TEMPORAL TRENDS; LIFE-SUPPORT; SURVIVAL; OUTCOMES; HYPOTHERMIA; DURATION; TIME; COHORT; TRIAL; ECMO AB Background: Patients with prolonged cardiac arrest that is not responsive to conventional cardiopulmonary resuscitation have poor outcomes. The use of extracorporeal membrane oxygenation (ECMO) in refractory cardiac arrest has shown promising results in carefully selected cases. We sought to validate the results from an earlier extracorporeal cardiopulmonary resuscitation (ECPR) study (the CHEER trial. Methods: Prospective, consecutive patients with refractory in-hospital (INCA) or out-of-hospital cardiac arrest (OHCA) who met predefined inclusion criteria received protocolised care, including mechanical cardiopulmonary resuscitation, initiation of EC MO, and early coronary angiography (if an acute coronary syndrome was suspected). Results: Twenty-five patients were enrolled in the study (11 OHCA, 14 IHCA); the median age was 57 years (interquartile range [IQR], 39-65 years), and 17 patients (68%) were male. ECMO was established in all patients, with a median time from arrest to ECMO support of 57 minutes (IQR, 38-73 min). Percutaneous coronary intervention was performed on 18 patients (72%). The median duration of ECMO support was 52 hours (IQR, 24-108 h). Survival to hospital discharge with favourable neurological recovery occurred in 11/25 patients (44%, of which 72% had IHCA and 27% had OHCA). When adjusting for lactate, arrest to ECMO flow time was predictive of survival (odds ratio, 0.904; P = 0.035). Conclusion: ECMO for refractory cardiac arrest shows promising survival rates if protocolised care is applied in conjunction with predefined selection criteria. C1 [Dennis, Mark; Gattas, David; Burns, Brian; Bannon, Paul; Patel, Sanjay; Hayman, Jon; Forrest, Paul] Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia. [Dennis, Mark; Patel, Sanjay] Royal Prince Alfred Hosp, Dept Cardiol, Sydney, NSW, Australia. [Buscher, Hergen; Reynolds, Claire; Scott, Sean; Nair, Priya; Lowe, David A.] St Vincents Hosp, Dept Intens Care, Sydney, NSW, Australia. [Buscher, Hergen; Scott, Sean; Nair, Priya; Lowe, David A.] St Vincents Hosp Sydney, Ctr Appl Med Res, Sydney, NSW, Australia. [Buscher, Hergen; Nair, Priya] Univ New South Wales, Sydney, NSW, Australia. [Gattas, David; Buhr, Heidi; Coles, Jennifer] Royal Prince Alfred Hosp, Intens Care Serv, Sydney, NSW, Australia. [Burns, Brian; Habig, Karel] New South Wales Ambulance Serv, Greater Sydney Area Helicopter Emergency Med Serv, Sydney, NSW, Australia. [Bannon, Paul] Royal Prince Alfred Hosp, Inst Acad Surg, Sydney, NSW, Australia. [Bannon, Paul] Royal Prince Alfred Hosp, Dept Cardiothorac Surg, Sydney, NSW, Australia. [Hayman, Jon] Royal Prince Alfred Hosp, Dept Emergency Med, Sydney, NSW, Australia. [Granger, Emily] St Vincents Hosp, Dept Cardiothorac Surg, Sydney, NSW, Australia. [Lovett, Ryan] New South Wales Ambulance Serv, Sydney, NSW, Australia. [Forrest, Paul] Royal Prince Alfred Hosp, Dept Anaesthet, Sydney, NSW, Australia. C3 University of Sydney; University of Sydney; St Vincents Hospital Sydney; St Vincents Hospital Sydney; University of New South Wales Sydney; University of Sydney; University of Sydney; University of Sydney; University of Sydney; St Vincents Hospital Sydney; University of Sydney RP Dennis, M (通讯作者),Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia.; Dennis, M (通讯作者),Royal Prince Alfred Hosp, Dept Cardiol, Sydney, NSW, Australia. EM mark.dennis@sydney.edu.au RI Buscher, Hergen/O-8513-2019 OI Buscher, Hergen/0000-0002-4531-6151; Scott, Dr. Sean/0000-0002-8977-9430; Dennis, Mark/0000-0002-1281-1324; Bannon, Paul/0000-0002-3117-7250 CR Australian Resuscitation Council, 2011, EMERG MED AUSTRALAS, V23, P264, DOI 10.1111/j.1742-6723.2011.01422_9.x Australian Resuscitation Council, 2011, EMERG MED AUSTRALAS, V23, P259, DOI 10.1111/j.1742-6723.2011.01422_7.x Bartos JA, 2018, RESUSCITATION, V132, P47, DOI 10.1016/j.resuscitation.2018.08.030 Bembea Melania M, 2013, J Extra Corpor Technol, V45, P26 Bernard SA, 2016, CIRCULATION, V134, P797, DOI 10.1161/CIRCULATIONAHA.116.021989 Beyea MM, 2018, RESUSCITATION, V130, P146, DOI 10.1016/j.resuscitation.2018.07.012 Bradley SM, 2017, AM HEART J, V193, P117, DOI 10.1016/j.ahj.2017.05.018 Chan PS, 2014, CIRCULATION, V130, P1876, DOI 10.1161/CIRCULATIONAHA.114.009711 D'Arrigo S, 2017, RESUSCITATION, V121, P62, DOI 10.1016/j.resuscitation.2017.10.005 Daya MR, 2015, RESUSCITATION, V91, P108, DOI 10.1016/j.resuscitation.2015.02.003 Dennis M, 2017, INT J CARDIOL, V231, P131, DOI 10.1016/j.ijcard.2016.12.003 Fagnoul D, 2013, RESUSCITATION, V84, P1519, DOI 10.1016/j.resuscitation.2013.06.016 Fennessy G, 2016, INTERN MED J, V46, P1172, DOI 10.1111/imj.13039 Goldberger ZD, 2012, LANCET, V380, P1473, DOI 10.1016/S0140-6736(12)60862-9 Gregers E, 2018, CRIT CARE, V22, DOI 10.1186/s13054-018-2176-9 Holmberg MJ, 2018, RESUSCITATION, V131, P91, DOI 10.1016/j.resuscitation.2018.07.029 Hutin A, 2018, RESUSCITATION, V130, P44, DOI 10.1016/j.resuscitation.2018.05.004 KELSEY SF, 1991, CONTROL CLIN TRIALS, V12, P525 Kitamura T, 2016, NEW ENGL J MED, V375, P1649, DOI 10.1056/NEJMsa1600011 Kumar G, 2013, NEW ENGL J MED, V368, P680, DOI 10.1056/NEJMc1215155 Lamhaut L, 2017, RESUSCITATION, V117, P109, DOI 10.1016/j.resuscitation.2017.04.014 Magliocca JF, 2005, J TRAUMA, V58, P1101 Magliocca JF, 2005, J TRAUMA, V58, P1095, DOI 10.1097/01.TA.0000169949.82778.DF Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Mizutani T, 2018, J INTENSIVE CARE, V6, DOI 10.1186/s40560-018-0302-z Nagao K, 2016, CIRCULATION, V133, P1386, DOI 10.1161/CIRCULATIONAHA.115.018788 Nielsen N, 2013, NEW ENGL J MED, V369, P2197, DOI 10.1056/NEJMoa1310519 Patricio D, 2019, CRIT CARE, V23, DOI 10.1186/s13054-019-2320-1 Pozzi M, 2016, INT J CARDIOL, V204, P70, DOI 10.1016/j.ijcard.2015.11.165 Rajan S, 2017, RESUSCITATION, V114, P157, DOI 10.1016/j.resuscitation.2016.12.021 Rajan S, 2016, RESUSCITATION, V105, P45, DOI 10.1016/j.resuscitation.2016.05.004 Rea TD, 2003, CIRCULATION, V107, P2780, DOI 10.1161/01.CIR.0000070950.17208.2A Reynolds JC, 2017, RESUSCITATION, V117, P24, DOI 10.1016/j.resuscitation.2017.05.024 Reynolds JC, 2013, CIRCULATION, V128, P2488, DOI 10.1161/CIRCULATIONAHA.113.002408 Richardson ASC, 2017, RESUSCITATION, V112, P34, DOI 10.1016/j.resuscitation.2016.12.009 Sakamoto T, 2014, RESUSCITATION, V85, P762, DOI 10.1016/j.resuscitation.2014.01.031 Shin TG, 2011, CRIT CARE MED, V39, P1, DOI 10.1097/CCM.0b013e3181feb339 Stub D, 2015, RESUSCITATION, V86, P88, DOI 10.1016/j.resuscitation.2014.09.010 Tanaka D, 2016, ANN THORAC SURG, V101, P1729, DOI 10.1016/j.athoracsur.2015.10.095 Twohig Callum J, 2019, J Intensive Care Soc, V20, P347, DOI 10.1177/1751143719832162 van Diepen S, 2018, J AM HEART ASSOC, V7, DOI [10.1161/JAHA.118.009917, 10.1161/JAHA.117.005716] Wang HE, 2017, RESUSCITATION, V120, P113, DOI 10.1016/j.resuscitation.2017.08.244 Wang PL, 2018, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD007260.pub4 Wengenmayer T, 2017, CRIT CARE, V21, DOI 10.1186/s13054-017-1744-8 Wong MKY, 2014, CIRCULATION, V130, P1883, DOI 10.1161/CIRCULATIONAHA.114.010633 NR 45 TC 26 Z9 26 U1 1 U2 4 PU AUSTRALASIAN MED PUBL CO LTD PI PYRMONT PA LEVEL 2, 26-32 PYRMONT BRIDGE RD, PYRMONT, NSW 2009, AUSTRALIA SN 1441-2772 J9 CRIT CARE RESUSC JI Crit. Care Resusc. PD MAR PY 2020 VL 22 IS 1 BP 26 EP 34 PG 9 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA PZ1WY UT WOS:000612532400004 PM 32102640 DA 2023-05-13 ER PT J AU Wechkunanukul, KH Ullah, S Beilby, J AF Wechkunanukul, Kannikar Hannah Ullah, Shahid Beilby, Justin TI Variation in Seeking Care for Cardiovascular Disease and Ambulance Utilization among Migrants in Australia: Time, Ethnicity, and Delay (TED) Study III SO INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH LA English DT Article DE chest pain; migrant; culturally and linguistically diverse; ethnicity; delay time; decision time; prehospital delay; seeking medical care; ambulance utilization ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; CHEST-PAIN; EMERGENCY-DEPARTMENT; PRESENTING CHARACTERISTICS; PREHOSPITAL DELAY; PATIENT DELAY; HEART-ATTACK; MEDICAL-CARE; SYMPTOMS AB Insight into differences in seeking medical care for chest pain among migrant populations is limited. This study aimed to determine ethnic differences in seeking care behaviors and using ambulances among migrants compared to an Australian-born group. A total of 607 patients presenting with chest pain to a tertiary hospital between 1 July 2012 and 30 June 2014 were randomly selected. Data from the emergency department dataset and medical record reviews were collected and linked for analysis. The migrant group was stratified into nine ethnic groups for analysis based on the Australian Standard Classification of Cultural and Ethnic Groups. The overall median prehospital delay time was 3.7 (1.5, 10.7) h, which ranged from 2.5 (1.0, 10.7) (Southern and Eastern European group) to 6.0 (2.3, 20.6) (Sub-Saharan African group). The median decision time was 2.0 (0.8, 7.9) h, which ranged from 1.5 (Australian-born group) to 4.5 h (Sub-Saharan African group). Five ethnic groups had significantly longer decision times compared to the Australian-born group. Decision time accounted for 58.4% of pre-hospital delay time. Migrant patients were 60% less likely to seek care for chest pain within one hour (odds ratio 0.40, (0.23-0.68), p = 0.001). There was no significant difference in ambulance utilization between migrant and Australian-born groups. In conclusion, ethnic differences in seeking care for chest pain do exist, and ethnicity plays a vital role in a longer delay in seeking care. To reduce the delays and improve patient outcomes, appropriate health campaigns focusing on ethnic differences among migrant populations and normalizing cultural competency into practice are recommended. C1 [Wechkunanukul, Kannikar Hannah] Torrens Univ Australia, Publ Hlth Dept, Adelaide, SA 5000, Australia. [Wechkunanukul, Kannikar Hannah] Flinders Univ S Australia, Coll Nursing & Hlth Sci, Bedford Pk, SA 5042, Australia. [Ullah, Shahid] Flinders Univ S Australia, Coll Med & Publ Hlth, Bedford Pk, SA 5042, Australia. [Beilby, Justin] Torrens Univ Australia, Acad Res, Adelaide, SA 5000, Australia. C3 Torrens University Australia; Flinders University South Australia; Flinders University South Australia; Torrens University Australia RP Wechkunanukul, KH (通讯作者),Torrens Univ Australia, Publ Hlth Dept, Adelaide, SA 5000, Australia.; Wechkunanukul, KH (通讯作者),Flinders Univ S Australia, Coll Nursing & Hlth Sci, Bedford Pk, SA 5042, Australia. EM hannah.wechkunanukul@Torrens.edu.au; shahid.ullah@flinders.edu.au; jbeilby@Torrens.edu.au OI Wechkunanukul, Hannah/0000-0002-2901-1606 CR Ameneh MS, 2013, RAWAL MED J, V38, P109 Aroney CN, 2006, MED J AUSTRALIA, V184, pS1 *AUSTR BUR STAT, 2000, AUSTR STAND CLASS CU Australian Bureau of Statistics, 2015, MIGR AUSTR 2013 2014 Australian Government Department of Human Services, REC HLTH CAR AGR Australian Government Department of Immigration and Border Protection, MULT LANG SERV GUID Ben-Shlomo Y, 2008, HEART, V94, P354, DOI 10.1136/hrt.2007.119412 Bhopal RS, 2012, EUR J PREV CARDIOL, V19, P1250, DOI 10.1177/1741826711425775 Bradby H, 2003, ETHNIC HEALTH, V8, P5, DOI 10.1080/13557850303555 Bray JE, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.001927 Budoff MJ, 2006, ATHEROSCLEROSIS, V187, P343, DOI 10.1016/j.atherosclerosis.2005.09.013 Canto JG, 1998, AM J CARDIOL, V82, P1013, DOI 10.1016/S0002-9149(98)00590-6 Chew DP, 2016, HEART LUNG CIRC, V25, P895, DOI 10.1016/j.hlc.2016.06.789 Coventry LL, 2015, HEART LUNG CIRC, V24, P943, DOI 10.1016/j.hlc.2015.02.026 Cullen L, 2016, EMERG MED J, V33, P390, DOI 10.1136/emermed-2015-204978 DRACUP K, 1995, SOC SCI MED, V40, P379, DOI 10.1016/0277-9536(94)00278-2 EPPLER E, 1994, ANN EMERG MED, V24, P202, DOI 10.1016/S0196-0644(94)70131-8 Federation of Ethnic Communities' Councils of Australia, 2015, REV AUSTR RES OLD PE Finn JC, 2007, MED J AUSTRALIA, V187, P293, DOI 10.5694/j.1326-5377.2007.tb01247.x Gadd M, 2006, BMC PUBLIC HEALTH, V6, DOI 10.1186/1471-2458-6-102 Goldberg RJ, 2009, AM J CARDIOL, V103, P598, DOI 10.1016/j.amjcard.2008.10.038 Henderson Sean O., 2002, Ethnicity and Disease, V12, P38 Herlitz J, 2010, INT J CARDIOL, V141, P236, DOI 10.1016/j.ijcard.2008.11.176 HO MT, 1989, ANN EMERG MED, V18, P727, DOI 10.1016/S0196-0644(89)80004-6 King KB, 2007, HEART LUNG, V36, P235, DOI 10.1016/j.hrtlng.2006.08.008 King KM, 2009, AM J CARDIOL, V103, P1368, DOI 10.1016/j.amjcard.2009.01.344 King-Shier K, 2019, BMJ OPEN, V9, DOI 10.1136/bmjopen-2018-022479 King-Shier KM, 2016, EUR J CARDIOVASC NUR, V15, pE1, DOI 10.1177/1474515115613889 King-Shier KM, 2015, EUR J CARDIOVASC NUR, V14, P240, DOI 10.1177/1474515114529690 Lidin M, 2021, EUR J CARDIOVASC NUR, V20, P752, DOI 10.1093/eurjcn/zvab087 Mahajan S, 2019, JAMA NETW OPEN, V2, DOI 10.1001/jamanetworkopen.2019.17885 McKee G, 2013, INT J CARDIOL, V168, P2706, DOI 10.1016/j.ijcard.2013.03.022 McKinley S, 2011, EMERG MED AUSTRALAS, V23, P153, DOI 10.1111/j.1742-6723.2011.01385.x MEISCHKE H, 1995, ANN EMERG MED, V25, P193, DOI 10.1016/S0196-0644(95)70323-3 Moser DK, 2006, CIRCULATION, V114, P168, DOI 10.1161/CIRCULATIONAHA.106.176040 National Health and Medical Research Council, 2006, CULTURAL COMPETENCY Pattenden J, 2002, BMJ-BRIT MED J, V324, P1006, DOI 10.1136/bmj.324.7344.1006 Perkins-Porras L, 2009, EUR J CARDIOVASC NUR, V8, P26, DOI 10.1016/j.ejcnurse.2008.05.001 Perkins-Porras L, 2008, J BEHAV MED, V31, P498, DOI 10.1007/s10865-008-9174-3 Richards HM, 2002, BRIT MED J, V324, P1308, DOI 10.1136/bmj.324.7349.1308 Rye E, 2019, INTERN MED J, V49, P502, DOI 10.1111/imj.14084 Siddiqi A, 2009, SOC SCI MED, V69, P1452, DOI 10.1016/j.socscimed.2009.08.030 Taylor David McD, 2005, Emerg Med Australas, V17, P204 Ward RA, 1999, J AM SOC NEPHROL, V10, P429 Wechkunanukul Kannikar, 2014, Aust Nurs Midwifery J, V22, P35 Wechkunanukul K, 2017, AUST CRIT CARE, V30, P13, DOI 10.1016/j.aucc.2016.04.002 Wechkunanukul Kannikar, 2016, JBI Database System Rev Implement Rep, V14, P208, DOI 10.11124/JBISRIR-2016-003012 Wechkunanukul K, 2016, INT J CARDIOL, V220, P901, DOI 10.1016/j.ijcard.2016.06.244 Wendler D, 2006, PLOS MED, V3, P201, DOI 10.1371/journal.pmed.0030019 World Health Organization, 2018, CLASS DIG HLTH INT Zerwic JJ, 2003, NURS RES, V52, P159, DOI 10.1097/00006199-200305000-00005 NR 51 TC 0 Z9 0 U1 0 U2 1 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 1660-4601 J9 INT J ENV RES PUB HE JI Int. J. Environ. Res. Public Health PD FEB PY 2022 VL 19 IS 3 AR 1516 DI 10.3390/ijerph19031516 PG 14 WC Environmental Sciences; Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA YY2HB UT WOS:000754613000001 PM 35162538 OA Green Published, gold DA 2023-05-13 ER PT J AU Marcolino, MS Oliveira, JAD Silva, GKME Dias, TD Marino, BCA Antunes, AP Ribeiro, AL Cardoso, CS AF Marcolino, Milena Soriano de Queiroz Oliveira, Joao Antonio Matos e Silva, Grace Kelly Dias, Thatiane Dantas Abreu Marino, Barbara Campos Antunes, Andre Pires Ribeiro, Antonio Luiz Cardoso, Clareci Silva TI Satisfaction of Emergency Physicians with the Care Provided to Patients with Cardiovascular Diseases in the Northern Region of Minas Gerais SO ARQUIVOS BRASILEIROS DE CARDIOLOGIA LA English DT Article DE Cardiovascular Diseases; Myocardial Infartion; Acute Coronary Syndrome; Epidemiology; Health Profile; Quality Indicators; Health Care; Emergency Medical Services ID MORTALITY; MEDICINE AB Background: The dissatisfaction of health professionals in emergency services has a negative influence on both the quality of care provided for acute myocardial infarction (AMI) patients and the retention of those professionals. Objective: To assess physicians' satisfaction with the structure of care and diagnosis at the emergency services in the Northern Region of Minas Gerais before the implementation of the AMI system of care. Methods: This cross-sectional study included physicians from the emergency units of the ambulance service (SAMU) and level II,III and IV regional hospitals. Satisfaction was assessed by using the CARDIOSATIS-Team scale. The median score for each item, the overall scale and the domains were calculated and then compared by groups using the non-parametric Mann-Whitney test. Correlation between time since graduation and satisfaction level was assessed using Spearman correlation. A p value < 0.05 was considered significant. Results: Of the 137 physicians included in the study, 46% worked at SAMU. Most of the interviewees showed overall dissatisfaction with the structure of care, and the median score for the overall scale was 2.0 [interquartile range (IQR) 2.0-4.0]. Most SAMU physicians expressed their dissatisfaction with the care provided (54%), the structure for managing cardiovascular diseases (52%), and the technology available for diagnosis (54%). The evaluation of the overall satisfaction evidenced that the dissatisfaction of SAMU physicians was lower when compared to that of hospital emergency physicians. Level III/IV hospital physicians expressed greater overall satisfaction when compared to level II hospital physicians. Conclusion: This study showed the overall dissatisfaction of the emergency physicians in the region assessed with the structure of care for cardiovascular emergencies. C1 [Marcolino, Milena Soriano; de Queiroz Oliveira, Joao Antonio; Matos e Silva, Grace Kelly; Dias, Thatiane Dantas; Abreu Marino, Barbara Campos; Ribeiro, Antonio Luiz] Univ Fed Minas Gerais, Univ Hosp, Telehlth Ctr, Belo Horizonte, MG, Brazil. [Marcolino, Milena Soriano; de Queiroz Oliveira, Joao Antonio; Ribeiro, Antonio Luiz] Univ Fed Minas Gerais, Med Sch, Belo Horizonte, MG, Brazil. [Antunes, Andre Pires] Univ Estadual Montes Claros, Montes Claros, MG, Brazil. [Cardoso, Clareci Silva] Univ Fed Sao Joao del Rei, Divinopolis, MG, Brazil. C3 Universidade Federal de Minas Gerais; Universidade Federal de Minas Gerais; Universidade Estadual de Montes Claros; Universidade Federal de Sao Joao del-Rei RP Marcolino, MS (通讯作者),Ave Prof Alfredo Balena 190,Sala 246, BR-30130100 Belo Horizonte, MG, Brazil. EM milenamarc@gmail.com RI Marcolino, M. S./H-8934-2016; Ribeiro, Antonio L/C-2707-2009; Cardoso, Clareci S/E-8549-2015; Ribeiro, Ana Cristina/HHN-7466-2022 OI Marcolino, M. S./0000-0003-4278-3771; Ribeiro, Antonio L/0000-0002-2740-0042; Cardoso, Clareci S/0000-0003-0689-1644; Ribeiro, Ana Cristina/0000-0002-0493-8376 FU FAPEMIG; CNPq FX This study was funded by FAPEMIG and CNPq. CR Marino BCA, 2016, ARQ BRAS CARDIOL, V107, P106, DOI 10.5935/abc.20160095 Aguiar HDG, 2011, REV MED MINAS GER S6, V21, pS1 Arora M, 2013, EMERG MED AUSTRALAS, V25, P491, DOI 10.1111/1742-6723.12135 Cardoso CS, 2011, CIENC SAUDE COLETIVA, V16, P1401, DOI 10.1590/S1413-81232011000700075 Carvalho AXY, 2007, DINAMICA MUNICIPIOS Cydulka RK, 2008, ANN EMERG MED, V51, P714, DOI 10.1016/j.annemergmed.2008.01.005 Ferreira Graça Maria Tavares de Melo, 2009, Arq. Bras. Cardiol., V93, P97, DOI 10.1590/S0066-782X2009000800006 Fraga GP, 2014, 10 ANOS DIRETRIZES C, P41 Gawryszewski Ana Raquel Bonder, 2012, Physis, V22, P119 Kuhn G, 2009, ANN EMERG MED, V54, P106, DOI 10.1016/j.annemergmed.2008.12.019 Marcolino MS, 2013, ARQ BRAS CARDIOL, V100, P307, DOI 10.5935/abc.20130054 Marino BCA, 2016, EUR HEART J-QUAL CAR, V2, P215, DOI 10.1093/ehjqcco/qcw020 Marques AJS, 2011, REDE ATENCAO URGENCI Naghavi M, 2015, LANCET, V385, P117, DOI 10.1016/S0140-6736(14)61682-2 Oliveira Graziella Lage, 2011, Rev. bras. epidemiol., V14, P240, DOI 10.1590/S1415-790X2011000200006 Oliveira MLF, 2002, REV CIENCIA CUIDADO, V1, P123 Orozco-Beltran D, 2012, REV ESP CARDIOL, V65, P1079, DOI [10.1016/j.recesp.2012.02.026, 10.1016/j.rec.2012.02.025] Ribeiro MLB, 2014, RELATORIO CFM CRISE Roth GA, 2015, CIRCULATION, V132, P1667, DOI 10.1161/CIRCULATIONAHA.114.008720 Schmidt Morten, 2012, BMJ, V344, pe356, DOI 10.1136/bmj.e356 Shroff GR, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.002460 Stumm EMF, 2009, COGITARE ENFERM, V14, P620 Torres SFS, 2015, REV CARDIOL SOC ESTA, V24, P13 VALLERAND RJ, 1989, CAN PSYCHOL, V30, P662, DOI 10.1037/h0079856 Whitten P, 2005, J Postgrad Med, V51, P294 NR 25 TC 1 Z9 1 U1 0 U2 3 PU ARQUIVOS BRASILEIROS CARDIOLOGIA PI RIO DE JANEIRO PA AVENIDA MARECHAL CAMARA 160-330 CENTRO, RIO DE JANEIRO, RJ 20 020-907, BRAZIL SN 0066-782X EI 1678-4170 J9 ARQ BRAS CARDIOL JI Arq. Bras. Cardiol. PD AUG PY 2018 VL 111 IS 2 BP 151 EP 159 DI 10.5935/abc.20180143 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GS3AV UT WOS:000443441900007 PM 30183981 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Ralapanawa, U Kumarasiri, PVR Jayawickreme, KP Kumarihamy, P Wijeratne, Y Ekanayake, M Dissanayake, C AF Ralapanawa, Udaya Kumarasiri, Pallegoda Vithanage Ranjith Jayawickreme, Kushalee Poornima Kumarihamy, Prabashini Wijeratne, Yapa Ekanayake, Madhushanka Dissanayake, Chandira TI Epidemiology and risk factors of patients with types of acute coronary syndrome presenting to a tertiary care hospital in Sri Lanka SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Acute coronary syndrome; Unstable angina; Non-ST elevation myocardial infarction; ST elevation myocardial infarction; Sri Lanka ID MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; GLOBAL REGISTRY; MANAGEMENT; TRENDS AB Background Acute Coronary Syndrome (ACS) is one of the leading causes of death worldwide and studies have shown higher mortality rates and premature death in South Asian countries. The occurrence and effect of risk factors differ by type ofACS.Epidemiological studies in the Sri Lankan population are limited. Methods This is a cross sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka among patients presenting with ACS. Data was collected by an interviewer administered structured questionnaire and epidemiological patterns and risk factors were analyzed. Results The sample of 300 patients had a mean age of 61.3+/- 12.6 and male sex showed higher association with all three type of ACS compared to female with a P value of 0.001. This study showed higher mean age of 62.2 +/- 11.4 years amongst unstable angina (UA) patients and 61.9 +/- 14.5 years amongst non ST elevation myocardial infarction (NSTEMI) patients compared to 59.2 +/- 11.2 years for ST elevation myocardial infarction (STEMI) patients with no significant statistical difference (P = 0.246). Approximately 55.8% STEMI patients, 39.8% UA and 35.5% NSTEMI patients were smokers indicating a significant association between smoking and STEMI (P = 0.017). Nearly 54.5% STEMI, 35.4% UA and 32.7% NSTEMI patients consumed alcohol and there was a very strong association between alcohol consumption and STEMI (P = 0.006). Almost 51.8% NSTEMI patients, 47.8% UA patients and 29.9% STEMI patients had hypertension(HT) (P = 0.008) indicating significant association of HT with UA and NSTEMI. About 33.6% UA patients and 30.0% NSTEMI patients had DM whilst only 22.1% of STEMI patients had DM of no significance (p = 0.225). Around 15.0% patients with UA, 25.5% with NSTEMI and 11.7% with STEMI had dyslipidemia (P = 0.032). There was a very strong association between a past history of ACS or stable angina with NSTEMI and UA (P = 0.001). Conclusion Smoking and alcohol abuse are significantly associated with STEMI.Patients with NSTEMI or Unstable Angina had higher rates of hypertension and were more likely to have a history of ACS or stable angina than STEMI patients. Patients with NSTEMI were more likely than patients with STEMI or UA to have dyslipidemia. C1 [Ralapanawa, Udaya; Jayawickreme, Kushalee Poornima; Ekanayake, Madhushanka] Univ Peradeniya, Dept Med, Peradeniya, Sri Lanka. [Kumarasiri, Pallegoda Vithanage Ranjith] Univ Peradeniya, Dept Community Med, Peradeniya, Sri Lanka. [Kumarihamy, Prabashini; Wijeratne, Yapa; Dissanayake, Chandira] Teaching Hosp Peradeniya, Peradeniya, Sri Lanka. C3 University of Peradeniya; University of Peradeniya RP Ralapanawa, U (通讯作者),Univ Peradeniya, Dept Med, Peradeniya, Sri Lanka. EM udayapralapanawa@yahoo.com OI Kumarihamy, Prabhashini/0000-0001-6895-7165; Ralapanawa, Udaya/0000-0002-7416-7984; Wijeratne, Yapa/0000-0003-1221-7621 CR Alkhawam H, 2015, CIRCULATION, V132 Ambrose JA, 2004, J AM COLL CARDIOL, V43, P1731, DOI 10.1016/j.jacc.2003.12.047 [Anonymous], 2011, AHA ACC GUIDELINES M [Anonymous], 2014, AHA ACC GUIDELINES M Constantine GR, 1998, POSTGRAD MED J, V74, P405, DOI 10.1136/pgmj.74.873.405 Constantine GR, 1999, POSTGRAD MED J, V75, P718, DOI 10.1136/pgmj.75.890.718 Donahoe SM, 2007, JAMA-J AM MED ASSOC, V298, P765, DOI 10.1001/jama.298.7.765 Eagle KA, 2002, LANCET, V359, P373, DOI 10.1016/S0140-6736(02)07595-5 Fox KAA, 2003, EUR HEART J, V24, P1414, DOI 10.1016/S0195-668X(03)00315-4 Ghaffar A, 2004, BMJ-BRIT MED J, V328, P807, DOI 10.1136/bmj.328.7443.807 Gonzalez-Pacheco H, 2014, THER CLIN RISK MANAG, V10, P815, DOI 10.2147/TCRM.S67945 Hernandez MAL, 2013, HYPERGLYCEMIA DIABET, P169 HUGHES LO, 1989, BRIT MED J, V298, P1345, DOI 10.1136/bmj.298.6684.1345 Joshi P, 2007, JAMA-J AM MED ASSOC, V297, P286, DOI 10.1001/jama.297.3.286 Longmore M, 2014, OXFORD HDB CLIN MED Mahmood SS, 2014, LANCET, V383, P999, DOI 10.1016/S0140-6736(13)61752-3 Medagama A, 2015, BMC CARDIOVASC DISOR, V15, DOI 10.1186/s12872-015-0125-y Medical Statistics Unit Sri Lanka, 2013, ANN HLTH B, V44-46, P184 Mohanan PP, 2013, EUR HEART J, V34, P121, DOI 10.1093/eurheartj/ehs219 Picariello C, 2011, INT J HYPERTENS, V2011, DOI 10.4061/2011/563657 Rajapakse S, 2010, J CLIN PHARM THER, V35, P421, DOI 10.1111/j.1365-2710.2009.01115.x Robertson JO, 2014, JACC-CARDIOVASC INTE, V7, P372, DOI 10.1016/j.jcin.2013.11.017 Rott D, 2006, AM J CARDIOL, V98, P10, DOI 10.1016/j.amjcard.2006.01.043 Shakya A, 2019, NEPAL HEART J, V16, P27, DOI 10.3126/njh.v16i1.23895 Sharma R, 2014, HEART INDIA, V2, P65, DOI [10.4103/2321-449X.140228, DOI 10.4103/2321-449X.140228] Sutton-Tyrrell K, 1998, STROKE, V29, P1116, DOI 10.1161/01.STR.29.6.1116 Towfighi A, 2009, ARCH INTERN MED, V169, P1762, DOI 10.1001/archinternmed.2009.318 U.S. Department of Health and Human Services, 1989, DHHS PUBLICATION Vanhoutte PM, 2009, ACTA PHYSIOL, V196, P193, DOI 10.1111/j.1748-1716.2009.01964.x Weber M, 2011, AM HEART J, V162, P81, DOI [10.1016/j.ahj.2011.04.007, 10.1016/j.ahj.2011.07.029] Yusuf S, 2004, LANCET, V364, P937, DOI 10.1016/S0140-6736(04)17018-9 NR 31 TC 13 Z9 14 U1 0 U2 0 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-2261 J9 BMC CARDIOVASC DISOR JI BMC Cardiovasc. Disord. PD OCT 21 PY 2019 VL 19 IS 1 AR 229 DI 10.1186/s12872-019-1217-x PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JF3TS UT WOS:000491310600002 PM 31638908 OA Green Published, gold DA 2023-05-13 ER PT J AU Hensley, B Huang, C Martinez, CVC Shokoohi, H Liteplo, A AF Hensley, Brooke Huang, Calvin Martinez, Corinna Victoria Cruz Shokoohi, Hamid Liteplo, Andrew TI ULTRASOUND MEASUREMENT OF CAROTID INTIMA-MEDIA THICKNESS AND PLAQUES IN PREDICTING CORONARY ARTERY DISEASE SO ULTRASOUND IN MEDICINE AND BIOLOGY LA English DT Article DE Ultrasound; Carotid; Coronary artery disease ID RISK AB Ultrasound measurement of carotid intima-media thickness (CIMT) and plaque thickness (PT) may be an additional tool for risk stratification of patients with suspected acute coronary syndrome (ACS) in the emergency department (ED). The aim of this study was to evaluate the correlation of CIMT and PT with coronary artery disease (CAD) in risk stratification tests.This prospective observational study was conducted in an academic tertiary care ED. Carotid ultrasound measurements were obtained for emergency patients with suspected ACS. Carotid measurements included PT, mean CIMT and maximum CIMT. The correlations between carotid ultrasound and the results of coronary catheter angiography (CA), coronary computed tomography angiography (CCTA) and stress tests were identified. The convenience sample included 58 patients comprising 39 men and 19 women with a mean age of 60 +/- 12 y. Twenty-two percent (13/58) of patients were positive for CAD, as indicated by results of the cardiac risk stratification tests. Presence of plaque correlated with CCTA findings, with a high specificity (92.8%) for a positive test. Max CIMT predicted abnormal CCTA (area under the curve [AUC] = 0.93, 95% confidence interval: 0.80-1). The correlations with stress test (0.78, 0.46-1) and CA (0.55, 0.28-0.82) were weaker. Presence of carotid plaque correlated significantly with findings of CAD on all risk stratification tests, but especially with CCTA. Carotid ultrasound could have a role in risk stratification in the ED, though more research is needed. (E-mail: brooke.hensley@jhsmiami.org) (c) 2020 World Federation for Ultrasound in Medicine & Biology. All rights reserved. C1 [Hensley, Brooke] Univ Miami, Miller Sch Med, Jackson Mem Hosp, 1611 NW 12th Ave, Miami, FL 33136 USA. [Huang, Calvin; Shokoohi, Hamid; Liteplo, Andrew] Harvard Med Sch, Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA 02115 USA. [Martinez, Corinna Victoria Cruz] Univ Philippines, Coll Med, UP Manila Campus, Manila, Philippines. C3 University of Miami; Harvard University; Harvard Medical School; Massachusetts General Hospital; University of the Philippines System; University of the Philippines Manila RP Hensley, B (通讯作者),Univ Miami, Miller Sch Med, Jackson Mem Hosp, 1611 NW 12th Ave, Miami, FL 33136 USA. EM brooke.hensley@jhsmiami.org OI Hensley, Brooke/0000-0002-2434-492X CR Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2713, DOI [10.1016/j.jacc.2014.10.011, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.09.017] Arbab-Zadeh A, 2012, HEART INT, V7, P4, DOI 10.4081/hi.2012.e2 Banerjee A, 2012, INT J CLIN PRACT, V66, P477, DOI 10.1111/j.1742-1241.2012.02900.x Cohen GI, 2013, JACC-CARDIOVASC IMAG, V6, P1160, DOI 10.1016/j.jcmg.2013.06.007 Ekelund Ulf, 2012, BMC Res Notes, V5, P420, DOI 10.1186/1756-0500-5-420 Irie Y, 2013, DIABETES CARE, V36, P1327, DOI 10.2337/dc12-1327 Loan TTT, 2012, J ATHEROSCLER THROMB, V19, P680, DOI 10.5551/jat.11767 Nambi V, 2010, J AM COLL CARDIOL, V55, P1600, DOI 10.1016/j.jacc.2009.11.075 Niska Richard, 2010, Natl Health Stat Report, P1 Polak JF, 2011, NEW ENGL J MED, V365, P213, DOI 10.1056/NEJMoa1012592 SALONEN JT, 1991, ARTERIOSCLER THROMB, V11, P1245, DOI 10.1161/01.ATV.11.5.1245 Sharma RK, 2010, VASC HEALTH RISK MAN, V6, P307 Svanteson M, 2017, RMD OPEN, V3, DOI 10.1136/rmdopen-2017-000544 Tavakol Morteza, 2012, Glob J Health Sci, V4, P65, DOI 10.5539/gjhs.v4n1p65 NR 14 TC 6 Z9 6 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0301-5629 EI 1879-291X J9 ULTRASOUND MED BIOL JI Ultrasound Med. Biol. PD JUL PY 2020 VL 46 IS 7 BP 1608 EP 1613 DI 10.1016/j.ultrasmedbio.2020.03.004 PG 6 WC Acoustics; Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Acoustics; Radiology, Nuclear Medicine & Medical Imaging GA MF4OF UT WOS:000545323000005 PM 32386846 DA 2023-05-13 ER PT J AU Montone, RA Cosentino, N Graziani, F Gorla, R Buono, MGD La Vecchia, G Rinaldi, R Marenzi, G Bartorelli, AL De Marco, F Testa, L Bedogni, F Trani, C Liuzzo, G Niccoli, G Crea, F AF Montone, Rocco Antonio Cosentino, Nicola Graziani, Francesca Gorla, Riccardo Buono, Marco Giuseppe Del La Vecchia, Giulia Rinaldi, Riccardo Marenzi, Giancarlo Bartorelli, Antonio L. De Marco, Federico Testa, Luca Bedogni, Francesco Trani, Carlo Liuzzo, Giovanna Niccoli, Giampaolo Crea, Filippo TI Precision medicine versus standard of care for patients with myocardial infarction with non-obstructive coronary arteries (MINOCA): rationale and design of the multicentre, randomised PROMISE trial SO EUROINTERVENTION LA English DT Article DE ACS; NSTE-ACS; miscellaneous; NSTEMI ID CATHETERIZATION AB Myocardial infarction with non-obstructive coronary arteries (MINOCA) represents about 6-8% of patients presenting with myocardial infarction (MI), and it is associated with a significant risk of mortality, rehospi-talisation, and angina burden, with high associated socioeconomic costs. It is important to note that multiple mechanisms may be responsible for MINOCA. However, to date, there are few prospective clinical trials on MINOCA and the treatment of these patients is still not defined, most likely because of the multiple under-lying pathogenic mechanisms. The PROMISE trial is a randomised, multicentre, prospective, superiority, phase IV trial that will include 180 MINOCA patients randomised 1:1 to a "precision-medicine approach", consisting of a comprehensive diagnostic workup and pharmacological treatment specific for the underlying cause, versus a "standard of care" approach, consisting of routine diagnostic workup and standard medi-cal treatment for acute coronary syndrome. The aim of this study is to evaluate if the "precision-medicine approach" will improve the angina status, evaluated using the Seattle Angina Questionnaire summary score, at 12 months (primary endpoint). Secondary endpoints include the rate of major adverse cardiovascular events at 12-month follow-up, the related primary and secondary healthcare costs, and the ability of cardiac magnetic resonance to evaluate the different mechanisms of MINOCA. Of importance, the results derived from this trial may pave the way for a new pathophysiology-driven approach with cause-target therapies personalised for the mechanisms of MINOCA (ClinicalTrials.gov: NCT05122780). C1 [Montone, Rocco Antonio; Graziani, Francesca; Liuzzo, Giovanna; Crea, Filippo] Fdn Policlin Univ A Gemelli IRCCS, Dept Cardiovasc Med, Rome, Italy. [Cosentino, Nicola; Marenzi, Giancarlo; Bartorelli, Antonio L.] IRCCS, Ctr Cardiol Monzino, Milan, Italy. [Gorla, Riccardo; De Marco, Federico; Testa, Luca; Bedogni, Francesco] IRCCS Policlin San Donato, Cardiol Unit, Milan, Italy. [Buono, Marco Giuseppe Del; La Vecchia, Giulia; Rinaldi, Riccardo; Trani, Carlo; Liuzzo, Giovanna; Crea, Filippo] Univ Cattolica Sacro Cuore, Dept Cardiovasc & Pulm Sci, Rome, Italy. [Niccoli, Giampaolo] Univ Parma, Dept Med, Parma, Italy. [Montone, Rocco Antonio] Fdn Policlin Univ A Gemelli IRCCS, Dept Cardiovasc Med, Largo A Gemelli 8, I-00168 Rome, Italy. C3 Catholic University of the Sacred Heart; IRCCS Policlinico Gemelli; IRCCS Centro Cardiologico Monzino; IRCCS Policlinico San Donato; Catholic University of the Sacred Heart; IRCCS Policlinico Gemelli; University of Parma; Catholic University of the Sacred Heart; IRCCS Policlinico Gemelli RP Montone, RA (通讯作者),Fdn Policlin Univ A Gemelli IRCCS, Dept Cardiovasc Med, Largo A Gemelli 8, I-00168 Rome, Italy. EM roccoantonio.montone@unicatt.it OI Graziani, Francesca/0000-0002-4520-5689 FU Italian Ministry of Health [GR-2019-12370197] FX Funding This study was cofunded by the ?Ricerca Finalizzata 2019? Grant (GR-2019-12370197) from the Italian Ministry of Health. 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Ectopic proteolytic cleavage of such receptors irreversibly inactivates receptor-mediated intracellular signaling governing cellular functions, further releases soluble fragments into circulation which might modulate functions of target cells. Glycoprotein VI-(GPVI) is a membrane glycoprotein expressed in platelets and megakaryocytes. Platelet GPVI surface expression is enhanced following acute ischemic events like myocardial infarction and cerebral stroke, serves as an imminent diagnostic tool independent of markers of tissue necrosis, and is associated with poor prognosis. Platelets undergo GPVI shedding and thereby contribute to soluble plasma levels of sGPVI, with distinct diagnostic and prognostic attributes. This review summarizes the functional significance and mechanistic basis whereby GPVI surface availability is up-or downregulated on platelets and the impact of GPVI in diagnostic, prognostic, and therapeutic strategies in diseases where platelets play a regulatory role. Further, we also highlight how novel non-invasive platelet-based diagnostic and therapeutic strategies have evolved utilizing GPVI for lesion-directed antithrombotic therapy or to counteract atherosclerotic disposition to ameliorate care of patients particularly in the context of cardio-cerebro-vascular medicine. C1 [Chatterjee, Madhumita; Gawaz, Meinrad] Eberhard Karls Univ Tubingen, Innere Med Kardiol & Kreislauferkrankungen 3, Tubingen, Germany. C3 Eberhard Karls University of Tubingen RP Gawaz, M (通讯作者),Eberhard Karls Univ Tubingen, Innere Med 3, Otfried Muller Str 10, D-72076 Tubingen, Germany. 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Ezekowitz, Justin A. Zygun, David A. Katz, Jason N. Lopes, Renato D. Newby, L. Kristin McAlister, Finlay A. Kaul, Padma TI The high cost of critical care unit over-utilization for patients with NSTE ACS SO AMERICAN HEART JOURNAL LA English DT Article ID ADMISSION; VALIDITY; ICD-9-CM; GUIDE AB Background: There is substantial variability among hospitals in critical care unit (CCU) utilization for patients admitted with non-ST-Segment Elevation Acute Coronary Syndromes (NSTE ACS). We estimated the potential cost saving if all hospitals adopted low CCU utilization practices for patients with NSTE ACS. Methods: National hospital claims data were used to identify all patients with a primary diagnosis of NSTE ACS initially admitted to an acute care hospital between 2007 and 2013. Hospital CCU utilization was classified as low (<30%), medium (30-70%), or high (>70%). Results: Among the 270,564 NSTE ACS hospitalizations (71.6% non-ST-segment elevation myocardial infarction; 28.4% unstable angina) admitted to 261 hospitals, 41.9% (inter-hospital range 0.3%-95.1%) were admitted to a CCU. The proportion of patients admitted to a CCU in low, medium and high utilization hospitals was 16.3%, 49.5%, and high 81.1%, respectively. No differences in adjusted inpatient mortality were observed by hospital CCU utilization. The overall inpatient costs of caring for NSTE ACS were $1.1 billion. CCU care accounted for 45.2% of all hospitalization costs including 22.6%, 49.9%, and 69.0% (P < .001) of costs in low, medium and high utilization centers. The national potential direct cost savings of medium and high CCU utilization centers adopting low NSTE ACS CCU utilization practices was $113.4 million over the study period. Conclusions: In a population-based contemporary cohort, CCU utilization for patients with NSTE ACS varied widely and in-hospital mortality was similar between low, medium and high utilization centers. CCU care accounted for 45% of hospitalization costs; thus, implementing policies and admission practices to align hospital resources with patient care needs have the potential to reduce overall health care costs. (C) 2018 Elsevier Inc. All rights reserved. C1 [van Diepen, Sean; Zygun, David A.] Univ Alberta, Dept Crit Care, Edmonton, AB, Canada. [van Diepen, Sean; Ezekowitz, Justin A.; Kaul, Padma] Univ Alberta, Div Cardiol, Dept Med, Edmonton, AB, Canada. [Tran, Dat T.; Ezekowitz, Justin A.; McAlister, Finlay A.; Kaul, Padma] Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada. [Tran, Dat T.; Zygun, David A.] Univ Alberta, Sch Publ Hlth, Edmonton, AB, Canada. [Katz, Jason N.] Univ N Carolina, Sch Med, Div Cardiol & Pulm, Chapel Hill, NC USA. [Katz, Jason N.] Univ N Carolina, Sch Med, Div Crit Care Med, Chapel Hill, NC USA. [Lopes, Renato D.; Newby, L. Kristin] Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA. [McAlister, Finlay A.] Univ Alberta, Dept Med, Div Gen Internal Med, Edmonton, AB, Canada. C3 University of Alberta; University of Alberta; University of Alberta; University of Alberta; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of Medicine; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of Medicine; Duke University; University of Alberta RP van Diepen, S (通讯作者),Univ Alberta Hosp, Cardiol Walter MacKenzie Ctr 2C2, 8440-11 St, Edmonton, AB T6G 2B7, Canada. EM sv9@ualberta.ca RI Tran, Dat T./G-5362-2015; McAlister, Finlay/C-4151-2013 OI Tran, Dat T./0000-0002-4969-7537; Kaul, Padma/0000-0003-2239-3944; McAlister, Finlay/0000-0001-7435-3341 FU University Hospital Foundation FX This analysis was funded by a grant from the University Hospital Foundation. 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Heart J. PD AUG PY 2018 VL 202 BP 84 EP 88 DI 10.1016/j.ahj.2018.05.003 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GO4MW UT WOS:000439985300013 PM 29906667 DA 2023-05-13 ER PT J AU Martin, J Mazer-Amirshahi, M Pourmand, A AF Martin, Jacob Mazer-Amirshahi, Maryann Pourmand, Ali TI The Impact of Hyperoxia in the Critically Ill Patient: A Review of the Literature SO RESPIRATORY CARE LA English DT Review DE hyperoxia; hypoxia; critical care; emergency department; intensive care unit; acute coronary syndrome ID INTENSIVE-CARE-UNIT; OXYGEN-THERAPY; CARDIAC-ARREST; ARTERIAL HYPEROXIA; RESUSCITATION; ASSOCIATION; MORTALITY; MULTICENTER; OUTCOMES; TENSION AB Oxygen has long been considered a vital and potentially life-saving component of emergency care. Given this, there is widespread and liberal use of supplemental oxygen in hospitals across the United States and throughout the world. Recent research, however, delineates serious deleterious effects at the cellular level, inducing damage to the cardiovascular system, the central nervous system, the pulmonary system, and beyond. A scoping review was conducted to identify and synthesize available research data as it pertains to the clinical effects of hyperoxia in critically ill adult patients in acute care settings. We searched PubMed, MEDLINE, CINAHL, and Scopus databases. We also reviewed the reference lists of included publications. The selection of relevant articles was conducted by 2 researchers at 2 levels of screening. The review identified 30 studies, of which 5 were randomized controlled trials, 2 were prospective cohort studies, and 23 were retrospective cohort studies. A descriptive analysis of study results was performed. Current evidence suggests an association between hyperoxia and increased mortality after cardiac arrest, stroke, and traumatic brain injury, as well as in the setting of sepsis, although there is insufficient evidence to conclude concretely that hyperoxia effects clinical outcomes. As such, there exists a need for additional largescale randomized controlled trials with well-defined parameters for the evaluation of clinical outcomes. Until the completion of such trials, titration of supplemental O-2 to normoxia is advised to avoid the negative effects of both hyperoxia and hypoxia in acutely ill adult patients. C1 [Martin, Jacob; Pourmand, Ali] George Washington Univ, Sch Med & Hlth Sci, Emergency Med Dept, Washington, DC 20037 USA. [Mazer-Amirshahi, Maryann] MedStar Washington Hosp Ctr, Emergency Med Dept, Washington, DC USA. C3 George Washington University; MedStar Washington Hospital Center RP Pourmand, A (通讯作者),George Washington Univ, Dept Emergency Med, Med Ctr, 2120 L St, Washington, DC 20037 USA. 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Care PD AUG 1 PY 2020 VL 65 IS 8 BP 1202 EP 1210 DI 10.4187/respcare.07310 PG 9 WC Critical Care Medicine; Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Respiratory System GA MT4HK UT WOS:000554931300017 PM 32047122 OA Bronze DA 2023-05-13 ER PT J AU Fait, K Vilchinsky, N Dekel, R Levi, N Hod, H Matetzky, S AF Fait, Keren Vilchinsky, Noa Dekel, Rachel Levi, Nitza Hod, Hanoch Matetzky, Shlomi TI Cardiac Disease-Induced Post-traumatic Stress Symptoms (CDI-PTSS) Among Patients' Partners SO STRESS AND HEALTH LA English DT Article DE acute coronary event; illness; partners; post-traumatic stress ID HEART-TRANSPLANTATION; PRIMARY-CARE; DISORDER; SCREEN; IMPACT; RISK AB It is well established that a patient's partner can be deeply affected by the traumatizing nature of the patient's illness. Yet, no study to date has focused on post-traumatic stress symptoms (PTSS) among partners of patients coping with an acute coronary syndrome (ACS). The current study's main aims were to address this gap and to evaluate cardiac disease-induced (CDI) PTSS prevalence in partners of patients who experienced ACS. Patients who experienced ACS and their partners were interviewed by telephone 2 to 6months after patients' hospitalization. All patients and partners were screened for CDI-PTSS. Demographic and medical variables as well as partners' level of exposure to the cardiac event were assessed. Prevalence of CDI-PTSS was higher among partners than among patients. Partners' number of CDI-PTSS was not significantly associated with patients' number of CDI-PTSS or with any of the other explanatory factors measured, except for education level. The preliminary results that arose from the current study point to the vast number of individuals who must act as caregivers for their ill partners while having to cope with their own PTSS. Much effort should be channelled into integrating partners into cardiac recovery programmes. Copyright (c) 2016 John Wiley & Sons, Ltd. C1 [Fait, Keren; Vilchinsky, Noa] Bar Ilan Univ, Dept Psychol, Ramat Gan, Israel. [Dekel, Rachel] Bar Ilan Univ, Louis & Gabi Weisfeld Sch Social Work, Ramat Gan, Israel. [Levi, Nitza; Hod, Hanoch; Matetzky, Shlomi] Chaim Sheba Med Ctr, Leviev Heart Inst, Tel Hashomer, Israel. [Hod, Hanoch; Matetzky, Shlomi] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel. C3 Bar Ilan University; Bar Ilan University; Chaim Sheba Medical Center; Tel Aviv University; Sackler Faculty of Medicine RP Vilchinsky, N (通讯作者),Bar Ilan Univ, Dept Psychol, Ramat Gan, Israel. EM noa.vilchinsky@biu.ac.il FU Israel Heart Fund; Schnitzer Foundation for Research on the Israeli Economy and Society, Bar-llan University FX This study was supported by a grant from the Israel Heart Fund, and the Schnitzer Foundation for Research on the Israeli Economy and Society, Bar-llan University. 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The objective of our study was to provide insight on the diagnostic validity of cardiac CTA (CCTA) to identify obstructive coronary artery disease (CAD) and patients who require urgent intervention, compared with those who require same-admission coronary catheterization (CC), and to help elucidate the necessity of a 24/7 CCTA service. MATERIALS AND METHODS. We retrospectively reviewed 658 consecutive CCTA examinations performed of emergency department (ED) patients who presented with acute chest pain from October 1, 2013, to February 28, 2018. Patients were categorized by CAD severity on CCTA. Using same-admission CC as the reference standard, we assessed CCTA's validity to identify obstructive disease using PPV, NPV, sensitivity, and specificity and CCTA's validity to identify patients who require urgent intervention. The added value of the CCTA findings of subendocardial hypoattenuation and wall motion abnormality was evaluated. CCTA examinations were categorized on the basis of the time of day when scanning was performed. RESULTS. The PPV, NPV, and sensitivity of CCTA to diagnose obstructive CAD were 0.87, 0.79, and 0.95, respectively. Nine percent of the scanned patients underwent percutaneous coronary intervention (PCI) or were referred for urgent coronary artery bypass grafting (CABG). The presence of obstructive CAD on CCTA has a PPV of 0.73 to identify patients deemed to be at higher acute coronary syndrome (ACS) risk to warrant urgent PCI or CABG. Wall motion abnormality increased the PPV to 1.0; subendocardial attenuation increased the PPV to 0.9. The NPV and sensitivity were 0.89 and 0.97, respectively. Of the CCTA examinations, 54% were performed outside regular working hours. Of the patients who received urgent interventions, 62% underwent CCTA examinations performed outside regular working hours. CONCLUSION. CCTA provides high correlation with CC, helps identify individuals with high ACS risk, and is further strengthened by functional analysis; 24/7 CCTA service is warranted. C1 [Abu Mughli, Rawan; Wu, Tong; Murray, Nicolas; Bilawich, Ana-Maria; Khosa, Faisal; Nicolaou, Savvas] Univ British Columbia, Vancouver Gen Hosp, Dept Radiol, 899 W 12th Ave, Vancouver, BC V5Z 1M9, Canada. [Kramer, Adam, I] Univ British Columbia, Vancouver Gen Hosp, Dept Med, Vancouver, BC, Canada. C3 University of British Columbia; University of British Columbia RP Abu Mughli, R (通讯作者),Univ British Columbia, Vancouver Gen Hosp, Dept Radiol, 899 W 12th Ave, Vancouver, BC V5Z 1M9, Canada. 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PD JUL PY 2021 VL 217 IS 1 BP 76 EP 82 DI 10.2214/AJR.20.23402 PG 7 WC Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Radiology, Nuclear Medicine & Medical Imaging GA XE6WV UT WOS:000723526400016 PM 33852334 DA 2023-05-13 ER PT J AU Hsieh, CF Lee, CW Chiang, YT Tsai, FF Su, MI Chen, CY AF Hsieh, Chi-Feng Lee, Chun-Wei Chiang, Yi-Ting Tsai, Fu-Fei Su, Min-, I Chen, Chun-Yen TI Different Effects of Thiazolidinediones on Cardiovascular Events among Type 2 Diabetic Patients Implanted with Bare Metal Stents: A Nationwide Study SO INTERNATIONAL JOURNAL OF GERONTOLOGY LA English DT Article DE bare metal stent; thiazolidinediones; revascularization ID MYOCARDIAL-INFARCTION; HEART-FAILURE; CORONARY ATHEROSCLEROSIS; ROSIGLITAZONE; PIOGLITAZONE; RESTENOSIS; RISK; REVASCULARIZATION; TROGLITAZONE; METAANALYSIS AB Background: This study aimed to evaluate the effect of thiazolidinediones (TZDs) on re-hospitalization rates for revascularization after bare-metal stent (BMS) implantation. Methods: Data from the National Health Insurance Research Database (NHIRD), a government-operated, population-based database, were analyzed from March, 2000 to December, 2006. Type 2 diabetes subjects treated with BMS implantations who used TZDs (either rosiglitazone or pioglitazone) were compared with subjects not on TZDs (non-TZD group) to evaluate the risk of readmission for coronary revascularization. Endpoints were acute coronary syndrome (ACS) and readmission for revascularization (percutaneous coronary intervention or coronary artery bypass graft surgery) after 3, 6, and 12 months. Results: In total, 6911 type 2 diabetes patients were hospitalized for BMS implantation (average follow-up, 294.4 +/- 108.9 days). Rosiglitazone treatment in patients who received BMSs was associated with a higher risk of re-hospitalization for revascularization at 6 and 12 months (hazard ratio (HR) =1.33; 95% CI: 1.08-1.64 and HR = 1.20 95% CI: 1.01-1.43). However, there were no significant differences between the pioglitazone and non-TZD groups. Conclusion: The use of rosiglitazone in type 2 diabetes patients after BMS implantation may increase the risk of re-hospitalization for revascularization. Our study suggests that rosiglitazone should be used cautiously in diabetes patients with BMS implantation. (C) Copyright 2020, Taiwan Society of Geriatric Emergency & Critical Care Medicine. C1 [Hsieh, Chi-Feng; Chiang, Yi-Ting] I Shou Univ, Sch Med Int Students, Kaohsiung, Taiwan. [Lee, Chun-Wei; Chen, Chun-Yen] Mackay Mem Hosp, Mackay Med Coll, Dept Internal Med, Cardiovasc Div, New Taipei, Taiwan. [Lee, Chun-Wei] Mackay Jr Coll Med Nursing & Management, Dept Nursing, New Taipei, Taiwan. [Tsai, Fu-Fei] Tajen Univ, Dept Nursing, Yanpu Township, Ping Tung Count, Taiwan. [Su, Min-, I] Mackay Mem Hosp, Dept Internal Med, Cardiovasc Div, Taitung, Taiwan. C3 I Shou University; Mackay Medical College; Mackay Memorial Hospital; Mackay Junior College of Medicine, Nursing & Management; Mackay Memorial Hospital RP Chen, CY (通讯作者),Mackay Mem Hosp, Dept Internal Med, Cardiovasc Div, 45 Minsheng Rd, New Taipei 25160, Taiwan. EM mwplasma@ms9.hinet.net OI Lee, Chun-Wei/0000-0001-5984-4249 FU National Science Council [NSC99-2320-B-010-018-MY3] FX We thank Professor Weng-Foung Huang from National Yang Ming University for assistance with statistical analysis. 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PD MAY PY 2020 VL 14 IS 2 BP 109 EP 114 DI 10.6890/IJGE.202005_14(2).0004 PG 6 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Geriatrics & Gerontology GA LO3OX UT WOS:000533539600006 DA 2023-05-13 ER PT J AU Rzonca, P Tomaka, P Rzonca, E Galazkowski, R AF Rzonca, Patryk Tomaka, Piotr Rzonca, Ewa Galazkowski, Robert TI Experience of the Polish Medical Air Rescue Service During the First Year of the COVID-19 Pandemic and Measures Taken to Protect Patients, Medical Staff, and Air Crew from SARS-CoV-2 Infection SO MEDICAL SCIENCE MONITOR LA English DT Article DE Air Ambulances; SARS-CoV-2; Severe Acute Respiratory Syndrome Coronavirus 2; Transportation of Patients ID TRANSPORT AB Background: The emergence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and the sudden inflow of patients with severe COVID-19 (coronavirus disease 2019) symptoms increased demand for hospital and pre hospital care, the latter being provided by emergency medical teams. The Polish Medical Air Rescue Services include the Helicopter Emergency Medical Service (HEMS) and the airplane-based Emergency Medical Service (EMS). This study aimed to present the experience of the Polish Medical Air Rescue Service during the first year of the COVID-19 pandemic and measures taken to protect patients, medical staff, and air crew from SARSCoV-2 infection. Material/Methods: We conducted a retrospective analysis of missions completed by the Polish Medical Air Rescue crews with respect to confirmed SARS-CoV-2 cases. We analyzed data from the medical records of the Polish Medical Air Rescue Service, which included flights to accidents and emergencies, and air patient transport missions, where medical assistance was provided to patients with confirmed SARS-CoV-2 infection in the first year of the pandemic in Poland. Results: Among the COVID-19 patients, the most common comorbidity was acute respiratory failure (41.58%). Emergency missions more often concerned older patients with sudden cardiac arrest, dyspnea, upper respiratory tract infection, stroke, and acute coronary syndromes. Conclusions: During the first year of the COVID-19 pandemic in Poland, the Polish Medical Air Rescue Service implemented procedures to protect patients, medical staff, and air crew from SARS-CoV-2 infection. This study highlights the importance of using single-patient isolation units for patient transport between hospitals and for emergency hospital admissions when the SARS-CoV-2 status of the patients were unknown. C1 [Rzonca, Patryk] Med Univ Warsaw, Dept Human Anat, Warsaw, Poland. [Tomaka, Piotr] SP ZOZ Teczna, Dept Anesthesiol & Intens Care, Teczna, Poland. [Rzonca, Ewa] Med Univ Warsaw, Dept Obstet & Gynecol Didact, Warsaw, Poland. [Galazkowski, Robert] Med Univ Warsaw, Dept Emergency Med Serv, Warsaw, Poland. C3 Medical University of Warsaw; Medical University of Warsaw; Medical University of Warsaw RP Rzonca, P (通讯作者),Med Univ Warsaw, Dept Human Anat, Warsaw, Poland. 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Sci. Monitor PD FEB 28 PY 2022 VL 28 AR e935474 DI 10.12659/MSM.935474 PG 10 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA ZQ7PB UT WOS:000767291400001 PM 35221329 OA Green Published DA 2023-05-13 ER PT J AU Elmer, J Polderman, KH AF Elmer, Jonathan Polderman, Kees H. TI Emergency Neurological Life Support: Resuscitation Following Cardiac Arrest SO NEUROCRITICAL CARE LA English DT Article DE Cardiac arrest; Anoxic brain injury; Emergency Neurological Life Support; Prognosis; Resuscitation; Neurocritical care ID TARGETED TEMPERATURE MANAGEMENT; HEART-ASSOCIATION GUIDELINES; RANDOMIZED CONTROLLED-TRIAL; CEREBRAL BLOOD-FLOW; THERAPEUTIC HYPOTHERMIA; COMATOSE SURVIVORS; CARDIOPULMONARY-RESUSCITATION; MILD HYPOTHERMIA; MYOCARDIAL DYSFUNCTION; PREHOSPITAL INDUCTION AB Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication. Secondary brain injury can be attenuated through targeted temperature management (TTM), avoidance of hypoxia and hypotension, avoidance of hyperoxia, hyperventilation or hypoventilation, and treatment of seizures. Most patients remaining comatose after resuscitation from cardiac arrest should undergo TTM. Treatable precipitants of arrest that require emergent intervention include, but are not limited to, acute coronary syndrome, intracranial hemorrhage, pulmonary embolism and major trauma. Accurate neurological prognostication is generally not appropriate for several days after cardiac arrest, so early aggressive care should never be limited based on perceived poor neurological prognosis. C1 [Elmer, Jonathan] Univ Pittsburgh, Sch Med, Dept Emergency Med, Iroquois Bldg,Suite 400A,3600 Forbes Ave, Pittsburgh, PA 15213 USA. [Elmer, Jonathan; Polderman, Kees H.] Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA 15213 USA. C3 Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh RP Elmer, J (通讯作者),Univ Pittsburgh, Sch Med, Dept Emergency Med, Iroquois Bldg,Suite 400A,3600 Forbes Ave, Pittsburgh, PA 15213 USA.; Elmer, J (通讯作者),Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA 15213 USA. 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TI Biologic disease-modifying antirheumatic drugs to treat multisystem inflammatory syndrome in children SO CURRENT OPINION IN RHEUMATOLOGY LA English DT Review DE biologic disease modifying antirheumatic drug; cytokine storm syndrome; intravenous immunoglobulin; Kawasaki disease; multisystem inflammatory syndrome in children ID MACROPHAGE ACTIVATION SYNDROME; HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS; MIS-C; CORONAVIRUS; MECHANISMS; MUTATIONS; COVID-19; STXBP2 AB Purpose of review Multisystem inflammatory syndrome in children (MIS-C) is a postinfectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection primarily affecting children. MIS-C shares features with Kawasaki disease (KD) and cytokine storm syndrome (CSS) frequently requiring intensive care support. Although intravenous immunoglobulin (IVIg) and glucocorticoids (GCs) are effective therapeutics for most, refractory MIS-C is treated with various biologic disease-modifying antirheumatic drugs (bDMARDs). Understanding the clinical features, inflammatory cytokines, and genetic associations provides rationale for bDMARD in treating severe MIS-C. Recent findings Children with MIS-C have clinical KD features and often present in hypovolemic and cardiogenic shock requiring volume repletion (gastrointestinaI losses) and cardiac pressor support (epinephrine). Investigation of MIS-C serum reveals elevated pro-inflammatory cytokines [interleukin (IL)-1, IL-6, IL-18, interferon gamma (IFN gamma), tumor necrosis factor (TNF)], but to a lesser extent than other established CSS. Gene sequencing of MIS-C children identifies heterozygous mutations in CSS associated genes. Treatment of refractory (IVIg and GC) MIS-C with bDMARDs to IL-1, IL-6, and TNF is efficacious for survival as well as resolving cardiac and coronary artery inflammation. MIS-C is a postinfectious complication of SARS-CoV-2 resembling KD and CSS, both genetically and by pro-inflammatory cytokines. MIS-C that is refractory to IVIg and GC is routinely responsive to bDMARDs targeting IL-1, IL-6, and TNF. C1 [Cron, Randy Q.] Univ Alabama Birmingham, Div Pediat Rheumatol, Heersink Sch Med, Birmingham, AL USA. C3 University of Alabama System; University of Alabama Birmingham RP Cron, RQ (通讯作者),Childrens Alabama, Div Rheumatol, 1600 7th Ave S,CPPN Suite G10, Birmingham, AL 35233 USA. EM randycron@uabmc.edu FU Arthritis Foundation, Alabama Chapter Endowed Chair in Pediatric Rheumatology at the University of Alabama at Birmingham FX Dr Cron was supported by the Arthritis Foundation, Alabama Chapter Endowed Chair in Pediatric Rheumatology at the University of Alabama at Birmingham. 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Opin. Rheumatol. PD SEP PY 2022 VL 34 IS 5 BP 274 EP 279 DI 10.1097/BOR.0000000000000889 PG 6 WC Rheumatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Rheumatology GA 3E4AR UT WOS:000829926900006 PM 35791863 DA 2023-05-13 ER PT J AU van Straten, A Hill, J Richards, DA Cuijpers, P AF van Straten, A. Hill, J. Richards, D. A. Cuijpers, P. TI Stepped care treatment delivery for depression: a systematic review and meta-analysis SO PSYCHOLOGICAL MEDICINE LA English DT Review DE Collaborative care; depression; psychological treatment; self-help; stepped care ID ACUTE CORONARY SYNDROME; RANDOMIZED CLINICAL-TRIAL; LOW-INCOME WOMEN; COLLABORATIVE CARE; COST-EFFECTIVENESS; MAJOR DEPRESSION; LATE-LIFE; ANXIETY DISORDERS; PSYCHOSOCIAL-EVALUATION; GENERAL-PRACTITIONERS AB Background. In stepped care models patients typically start with a low-intensity evidence-based treatment. Progress is monitored systematically and those patients who do not respond adequately step up to a subsequent treatment of higher intensity. Despite the fact that many guidelines have endorsed this stepped care principle it is not clear if stepped care really delivers similar or better patient outcomes against lower costs compared with other systems. We performed a systematic review and meta-analysis of all randomized trials on stepped care for depression. Method. We carried out a comprehensive literature search. Selection of studies, evaluation of study quality and extraction of data were performed independently by two authors. Results. A total of 14 studies were included and 10 were used in the meta-analyses (4580 patients). All studies used screening to identify possible patients and care as usual as a comparator. Study quality was relatively high. Stepped care had a moderate effect on depression (pooled 6-month between-group effect size Cohen's d was 0.34; 95% confidence interval 0.20-0.48). The stepped care interventions varied greatly in number and duration of treatment steps, treatments offered, professionals involved, and criteria to step up. Conclusions. There is currently only limited evidence to suggest that stepped care should be the dominant model of treatment organization. Evidence on (cost-) effectiveness compared with high-intensity psychological therapy alone, as well as with matched care, is required. C1 [van Straten, A.; Hill, J.] Univ Exeter, Mood Disorders Ctr, Exeter, Devon, England. [van Straten, A.; Cuijpers, P.] Vrije Univ Amsterdam, Dept Clin Psychol, NL-1081 BT Amsterdam, Netherlands. [van Straten, A.; Cuijpers, P.] EMGO Inst Hlth & Care Res, Amsterdam, Netherlands. [Richards, D. A.] Univ Exeter, Sch Med, Exeter, Devon, England. C3 RLUK- Research Libraries UK; University of Exeter; Vrije Universiteit Amsterdam; Vrije Universiteit Amsterdam; RLUK- Research Libraries UK; University of Exeter RP van Straten, A (通讯作者),Vrije Univ Amsterdam, FPP, Dept Clin Psychol, Boechorststr 1, NL-1081 BT Amsterdam, Netherlands. EM a.van.straten@vu.nl RI van Straten, Annemieke/P-8495-2019; Richards, David A/B-4807-2009; Cuijpers, Pim/G-1703-2013 OI van Straten, Annemieke/0000-0001-6875-2215; Richards, David A/0000-0002-8821-5027; Cuijpers, Pim/0000-0001-5497-2743 FU National Institute for Health Research [NF-SI-0514-10037, NF-SI-0611-10203] Funding Source: researchfish CR ANDREWS G, 2006, NEEDS BASED COSTED S Andrews G, 2010, PLOS ONE, V5, DOI 10.1371/journal.pone.0013196 Apil SRA, 2012, INT J GERIATR PSYCH, V27, P583, DOI 10.1002/gps.2756 Araya R, 2003, LANCET, V361, P995, DOI 10.1016/S0140-6736(03)12825-5 Araya R, 2006, AM J PSYCHIAT, V163, P1379, DOI 10.1176/appi.ajp.163.8.1379 Archer J, 2012, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD006525.pub2 Bennett-Levy J., 2010, OXFORD GUIDE LOW INT, DOI DOI 10.1093/MED:PSYCH/9780199590117.003.0001 Bijl RV, 2003, HEALTH AFFAIR, V22, P122, DOI 10.1377/hlthaff.22.3.122 Bot M, 2010, DIABETIC MED, V27, P1295, DOI 10.1111/j.1464-5491.2010.03119.x Bower P, 2005, BRIT J PSYCHIAT, V186, P11, DOI 10.1192/bjp.186.1.11 Bower P, 2013, BMJ-BRIT MED J, V346, DOI 10.1136/bmj.f540 Bower P, 2006, BRIT J PSYCHIAT, V189, P484, DOI 10.1192/bjp.bp.106.023655 Braamse AMJ, 2010, BMC CANCER, V10, DOI 10.1186/1471-2407-10-361 Buttorff C, 2012, B WORLD HEALTH ORGAN, V90, P813, DOI 10.2471/BLT.12.104133 Clark DM, 2011, INT REV PSYCHIATR, V23, P318, DOI 10.3109/09540261.2011.606803 Cuijpers P, 2010, PSYCHOL MED, V40, P1943, DOI 10.1017/S0033291710000772 Cuijpers P, 2012, JAMA-J AM MED ASSOC, V307, P1033, DOI 10.1001/jama.2012.271 Davidson KW, 2013, JAMA INTERN MED, V173, P997, DOI 10.1001/jamainternmed.2013.915 Davidson KW, 2010, ARCH INTERN MED, V170, P600, DOI 10.1001/archinternmed.2010.29 Dozeman E, 2012, INT PSYCHOGERIATR, V24, P1242, DOI 10.1017/S1041610212000178 Duval S, 2000, BIOMETRICS, V56, P455, DOI 10.1111/j.0006-341X.2000.00455.x Ell K, 2008, J CLIN ONCOL, V26, P4488, DOI 10.1200/JCO.2008.16.6371 Ell K, 2010, DIABETES CARE, V33, P706, DOI 10.2337/dc09-1711 Gellatly J, 2007, PSYCHOL MED, V37, P1217, DOI 10.1017/S0033291707000062 Gunn J, 2006, BMC HEALTH SERV RES, V6, DOI 10.1186/1472-6963-6-88 Hay JW, 2012, VALUE HEALTH, V15, P249, DOI 10.1016/j.jval.2011.09.008 Hedges L. 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Med. PD JAN PY 2015 VL 45 IS 2 BP 231 EP 246 DI 10.1017/S0033291714000701 PG 16 WC Psychology, Clinical; Psychiatry; Psychology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychology; Psychiatry GA CB4SB UT WOS:000349617100002 PM 25065653 OA Green Submitted DA 2023-05-13 ER PT J AU Alviar, CL Miller, PE McAreavey, D Katz, JN Lee, B Moriyama, B Soble, J van Diepen, S Solomon, MA Morrow, DA AF Alviar, Carlos L. Miller, P. Elliott McAreavey, Dorothea Katz, Jason N. Lee, Burton Moriyama, Brad Soble, Jeffrey van Diepen, Sean Solomon, Michael A. Morrow, David A. CA ACC Critical Care Cardiology Worki TI Positive Pressure Ventilation in the Cardiac Intensive Care Unit SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Review DE coronary intensive care unit; heart failure; mechanical ventilation; noninvasive ventilation; pulmonary edema; respiratory failure ID RESPIRATORY-DISTRESS-SYNDROME; END-EXPIRATORY PRESSURE; ACUTE LUNG INJURY; FREQUENCY OSCILLATORY VENTILATION; CONVENTIONAL OXYGEN-THERAPY; CARDIOGENIC PULMONARY-EDEMA; RIGHT-VENTRICULAR FUNCTION; HEART-FAILURE ASSOCIATION; INHALED NITRIC-OXIDE; FLOW NASAL CANNULA AB Contemporary cardiac intensive care units (CICUs) provide care for an aging and increasingly complex patient population. The medical complexity of this population is partly driven by an increased proportion of patients with respiratory failure needing noninvasive or invasive positive pressure ventilation (PPV). PPV often plays an important role in the management of patients with cardiogenic pulmonary edema, cardiogenic shock, or cardiac arrest, and those undergoing mechanical circulatory support. Noninvasive PPV, when appropriately applied to selected patients, may reduce the need for invasive mechanical PPV and improve survival. Invasive PPV can be lifesaving, but has both favorable and unfavorable interactions with left and right ventricular physiology and carries a risk of complications that influence CICU mortality. Effective implementation of PPV requires an understanding of the underlying cardiac and pulmonary pathophysiology. Cardiologists who practice in the CICU should be proficient with the indications, appropriate selection, potential cardiopulmonary interactions, and complications of PPV. (C) 2018 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved. C1 [Alviar, Carlos L.] Univ Florida, Coll Med, Div Cardiovasc Med, Gainesville, FL USA. [Miller, P. Elliott] Yale Univ, Sch Med, Div Cardiovasc Med, New Haven, CT USA. [Miller, P. Elliott; McAreavey, Dorothea; Moriyama, Brad; Solomon, Michael A.] NIH, Crit Care Med, Clin Ctr, Bldg 10, Bethesda, MD 20892 USA. [Katz, Jason N.] Univ N Carolina, Ctr Heart & Vasc Care Chapel Hill, Div Cardiol & Pulm & Crit Care Med, Chapel Hill, NC USA. [Lee, Burton] Univ Pittsburgh, Sch Med, Div Pulm Allergy & Crit Care Med, Pittsburgh, PA USA. [Soble, Jeffrey] Rush Univ, Med Ctr, Div Cardiovasc Med, Chicago, IL USA. [van Diepen, Sean] Univ Alberta, Department Crit Care, Edmonton, AB, Canada. [van Diepen, Sean] Univ Alberta, Div Cardiol, Edmonton, AB, Canada. [Solomon, Michael A.] NHLBI, Cardiovasc Branch, Bldg 10, Bethesda, MD 20892 USA. [Morrow, David A.] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Cardiovasc Div, Boston, MA USA. C3 State University System of Florida; University of Florida; Yale University; National Institutes of Health (NIH) - USA; NIH Clinical Center (CC); University of North Carolina; University of North Carolina Chapel Hill; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Rush University; University of Alberta; University of Alberta; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI); Harvard University; Brigham & Women's Hospital; Harvard Medical School RP Morrow, DA (通讯作者),Brigham & Womens Hosp, Dept Med, Cardiovasc Div, Levine Cardiac Intens Care Unit, 75 Francis St, Boston, MA 02115 USA. EM dmorrow@harvard.edu RI Miller, Elliott/AAM-5774-2021 OI Solomon, Michael/0000-0001-7400-6614 FU Heart Failure and Cardiac Transplant Council FX The authors are grateful for the support of the Heart Failure and Cardiac Transplant Council, Sarah Sears, and Alicia McClarin of the American College of Cardiology. 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PD SEP 25 PY 2018 VL 72 IS 13 BP 1532 EP 1553 DI 10.1016/j.jacc.2018.06.074 PG 22 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GT9ML UT WOS:000444866100012 PM 30236315 DA 2023-05-13 ER PT J AU Yandrapalli, S Malik, A Pemmasani, G Aronow, W Shah, F Lanier, G Cooper, H Jain, D Naidu, S Frishman, W Panza, J AF Yandrapalli, Srikanth Malik, Aaqib Pemmasani, Gayatri Aronow, Wilbert Shah, Falak Lanier, Gregg Cooper, Howard Jain, Diwakar Naidu, Srihari Frishman, William Panza, Julio TI Sex differences in heart failure hospitalisation risk following acute myocardial infarction SO HEART LA English DT Article DE acute coronary syndrome; epidemiology; outcome assessment; health care; heart failure; risk factors ID PERCUTANEOUS CORONARY INTERVENTION; WOMEN; ADHERENCE; MORTALITY; OUTCOMES; GENDER; CARE; MEN; AGE AB Objective We evaluated the sex differences in 6-month heart failure (HF) hospitalisation risk in acute myocardial infarction (AMI) survivors. Methods For this retrospective cohort analysis, adult survivors of an AMI between January and June 2014 were identified from the US Nationwide Readmissions Database. The primary outcome was a HF hospitalisation within 6 months. Secondary outcomes were fatal HF hospitalisation and the composite of index in-hospital HF or 6-month HF hospitalisation. Results Of 237 549 AMI survivors, females (37.9%) were older (70 +/- 14 years vs 65 +/- 13 years; p<0.001), had a higher prevalence of cardiac comorbidities and a lower revascularisation rate compared with males. The primary outcome occurred in 12 934 patients (5.4%), at a 49% higher rate in females (6.8% vs 4.6% in males, p<0.001), which was attenuated to a 19% higher risk after multivariable adjustment. Findings were consistent across subgroups of age, AMI type and major risk factors. In the propensity-matched time-to-event analysis, female sex was associated with a 13% higher risk for 6-month HF readmission (6.4% vs 5.8% in males; HR 1.13, 95% CI 1.05 to 1.21, p<0.001), and the increased risk was evident early on after the AMI. Fatal HF rate was similar between groups (4.7% vs 4.6%, p=0.936), but females had a higher rate of the composite HF outcome (36.2% vs 27.5%, p<0.001). Conclusion In a large all-comers AMI survivors' cohort, females had a higher HF hospitalisation risk that persisted after adjustment for baseline risk differences. This was consistent across several clinically relevant subgroups and was evident early on after the AMI. C1 [Yandrapalli, Srikanth; Malik, Aaqib; Pemmasani, Gayatri; Aronow, Wilbert; Shah, Falak; Lanier, Gregg; Cooper, Howard; Jain, Diwakar; Naidu, Srihari; Panza, Julio] Westchester Med Ctr, Dept Cardiol, Valhalla, NY 10595 USA. [Yandrapalli, Srikanth; Malik, Aaqib; Pemmasani, Gayatri; Aronow, Wilbert; Shah, Falak; Lanier, Gregg; Cooper, Howard; Jain, Diwakar; Naidu, Srihari; Frishman, William; Panza, Julio] New York Med Coll, Valhalla, NY 10595 USA. [Frishman, William] Westchester Med Ctr, Dept Med, Valhalla, NY 10595 USA. C3 Westchester Medical Center; New York Medical College; Westchester Medical Center RP Yandrapalli, S (通讯作者),New York Med Coll, Valhalla, NY 10595 USA.; Yandrapalli, S (通讯作者),Westchester Med Ctr, Cardiol, Valhalla, NY 10595 USA. 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Engstrom, Thomas Schmidt, Henrik Hassager, Christian Moller, Jacob E. Holmvang, Lene TI Outcome in Elderly Patients With Cardiogenic Shock Complicating Acute Myocardial Infarction SO SHOCK LA English DT Article DE Acute coronary syndrome; cardiogenic shock; elderly; tertiary care ID PERCUTANEOUS CORONARY INTERVENTION; ST-SEGMENT-ELEVATION; LONG-TERM SURVIVAL; EARLY REVASCULARIZATION; MANAGEMENT; MORTALITY; REGISTRY; DEFINITION; GUIDELINES; CARDIOLOGY AB Introduction: Despite advances in treatment of patients with cardiogenic shock following acute myocardial infarction (AMICS) in-hospital mortality remains around 50%. Outcome varies among patient subsets and the elderly often have a poor a priori prognosis. We sought to investigate outcome among elderly AMICS patients referred to evaluation and treatment at a tertiary university hospital. Methods: Current analysis was based on the RETROSHOCK registry comprising consecutive AMICS patients admitted to tertiary care. Patients in the registry were individually identified and validated. Results: Of 1,716 admitted patients, 496 (28.9%) patients were >= 75 years old. Older patients were less likely to be admitted directly to a tertiary centre (59.4% vs. 69.9%, P = 0.003), receive mechanical support devices (i.e., Impella (R) (8.9% vs. 15.0%, P = 0.003), and undergo revascularization attempt (76.8% vs. 90.2%, P < 0.001). Thirty-day survivors >= 75 years were characterized by having higher left ventricular ejection fraction (30.2% +/- 12.5% vs. 26.5% +/- 11.8%, P = 0.004) and lower arterial lactate (3.2[2.2-5.2] mmol/L vs. 5.5[3.3-8.2] mmol/L, P < 0.001) at admission. In a multivariable analysis of patients >= 75 years, higher age (HR 1.09, 95% CI 1.05-1.14, P < 0.001), higher heart rate (HR 1.01, 95% CI 1.001-1.014, P = 0.03), and higher lactate (HR 1.11, 95% CI 1.07-1.16, P < 0.001) at admission were associated with an increased risk of 30-day mortality. Conclusion: Among patients >= 75 years with AMICS referred for tertiary specialized treatment, 30-day mortality was 73.4%. Survivors were characterized by lower arterial lactate and heart rate at admission. C1 [Ratcovich, Hanna Louise; Josiassen, Jakob; Joshi, Francis R.; Engstrom, Thomas; Hassager, Christian; Moller, Jacob E.; Holmvang, Lene] Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. [Helgestad, Ole Kristian Lerche; Linde, Louise; Jensen, Lisette Okkels; Moller, Jacob E.] Odense Univ Hosp, Dept Cardiol, Odense, Denmark. [Helgestad, Ole Kristian Lerche; Moller, Jacob E.] Univ Southern Denmark, Odense Patient Data Explorat Network, Odense, Denmark. [Jensen, Lisette Okkels] Univ Southern Denmark, Dept Clin Res, Odense, Denmark. [Ravn, Hanne Berg; Engstrom, Thomas; Hassager, Christian; Holmvang, Lene] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark. [Ravn, Hanne Berg] Copenhagen Univ Hosp, Rigshosp, Dept Cardiothorac Anaesthesia, Copenhagen, Denmark. [Schmidt, Henrik] Odense Univ Hosp, Dept Cardiothorac Anesthesia, Odense, Denmark. C3 Rigshospitalet; University of Copenhagen; University of Southern Denmark; Odense University Hospital; University of Southern Denmark; University of Southern Denmark; University of Copenhagen; Rigshospitalet; University of Copenhagen; University of Southern Denmark; Odense University Hospital RP Ratcovich, HL (通讯作者),Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. EM hanna.louise.nacovich.01@regionh.dk RI ; Ravn, Hanne Berg/K-3118-2016 OI Linde, Louise/0000-0002-7757-2571; Jensen, Lisette Okkels/0000-0002-4838-2429; Hassager, Christian/0000-0002-1199-0981; Ravn, Hanne Berg/0000-0003-4702-5195; Helgestad, Ole Kristian Lerche/0000-0003-3847-8758 FU Abiomed; Murermester Lauritz Peter Christensen og hustru Kirsten Sigrid Christensens foundation; Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens foundation FX Dr Jacob Eifer Moller has received research grant and speakers fee from Abiomed. Dr Hanna Ratcovich has received research grants from Murermester Lauritz Peter Christensen og hustru Kirsten Sigrid Christensens foundation and dSnedkermester Sophus Jacobsen og hustru Astrid Jacobsens foundation. 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A quality indicator is a measurable element of clinical practice performance. This study aimed to propose a set of quality indicators for cardiac rehabilitation following an acute coronary event in the Japanese population and conduct a small-size practice test to confirm feasibility and applicability of the indicators in real-world clinical practice. Design and setting This study used a modified Delphi technique (the RAND/UCLA appropriateness method), a consensus method which involves an evidence review, a face-to-face multidisciplinary panel meeting and repeated anonymous rating. Evidence to be reviewed included clinical practice guidelines available in English or Japanese and existing quality indicators. Performance of each indicator was assessed retrospectively using medical records at a university hospital in Japan. Participants 10 professionals in cardiac rehabilitation for the consensus panel. Results In the literature review, 23 clinical practice guidelines and 16 existing indicators were identified to generate potential indicators. Through the consensus-building process, a total of 30 indicators were assessed and finally 13 indicators were accepted. The practice test (n=39) revealed that 74% of patients underwent cardiac rehabilitation. Median performance of process measures was 93% (IQR 46-100%). Communication with the doctor who referred the patient to cardiac rehabilitation' and continuous participation in cardiac rehabilitation' had low performance (32% and 38%, respectively). Conclusions A modified Delphi technique identified a comprehensive set of quality indicators for cardiac rehabilitation. The single-site, small-size practice test confirmed that most of the proposed indicators were measurable in real-world clinical practice. However, some clinical processes which are not covered by national health insurance in Japan had low performance. Further studies will be needed to clarify and improve the quality of care in cardiac rehabilitation. C1 [Ohtera, Shosuke; Nakayama, Takeo] Kyoto Univ, Grad Sch Med, Dept Hlth Informat, Sch Publ Hlth, Kyoto, Japan. [Kanazawa, Natsuko] Natl Hosp Org, Clin Res Ctr, Tokyo, Japan. [Ozasa, Neiko] Kyoto Univ Hosp, Dept Cardiovasc Med, Kyoto, Japan. [Ueshima, Kenji] Kyoto Univ Hosp, Inst Adv Clin & Translat Sci, Dept EBM Res, Kyoto, Japan. C3 Kyoto University; Kyoto University; Kyoto University RP Ohtera, S (通讯作者),Kyoto Univ, Grad Sch Med, Dept Hlth Informat, Sch Publ Hlth, Kyoto, Japan. EM ohtera.shosuke.2n@kyoto-u.ac.jp RI NAKAYAMA, Takeo/HCH-0537-2022 OI Nakayama, Takeo/0000-0002-7918-6252; Ohtera, Shosuke/0000-0002-8873-3676 FU Ministry of Health, Labour and Welfare Japan [H22-iryou-shitei-042, H24-iryou-shitei-051, H26-iryou-shitei-038]; Grants-in-Aid for Scientific Research [16K21697] Funding Source: KAKEN FX This work was supported by the Ministry of Health, Labour and Welfare Japan as follows: 'Research on roles and possibilities of clinical practice guidelines for dissemination of evidence-based medicine (H22-iryou-shitei-042, 2010-2011)', 'Research on development of clinical practice guidelines based on systematic reviews and promotion of EBM in clinical practice (H24-iryou-shitei-051, 2012-2013)' and 'Research on the subjects of clinical practice guidelines to realise socially accountable healthcare (H26-iryou-shitei-038, 2014-2015)'. 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Cardiac; Critical care; Erythrocyte; Hemoglobin; Intensive care; Practice; Risk factors; Surgery; Transfusion ID ACUTE CORONARY SYNDROMES; ACUTE MYOCARDIAL-INFARCTION; NEAR-INFRARED SPECTROSCOPY; IN-HOSPITAL OUTCOMES; ACUTE LUNG INJURY; CLINICAL-OUTCOMES; INCREASED MORTALITY; SURGERY PATIENTS; HEART-FAILURE; RISK-FACTORS AB Anemia and red blood cell (RBC) transfusion occur frequently in hospitalized patients with cardiac disease. In this narrative review, we report the epidemiology of anemia and RBC transfusion in hospitalized adults and children (excluding premature neonates) with cardiac disease, and on the outcome of anemic and transfused cardiac patients. Both anemia and RBC transfusion are common in cardiac patients, and both are associated with mortality. RBC transfusion is the only way to rapidly treat severe anemia, but is not completely safe. In addition to hemoglobin (Hb) concentration, the determinant(s) that should drive a practitioner to prescribe a RBC transfusion to cardiac patients are currently unclear. In stable acyanotic cardiac patients, Hb level above 70 g/L in children and above 70 to 80 g/L in adults appears safe. In cyanotic children, Hb level above 90 g/L appears safe. The appropriate threshold Hb level for unstable cardiac patients and for children younger than 28 days is unknown. The optimal transfusion strategy in cardiac patients is not well characterized. 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Intensive Care PD JUN 2 PY 2014 VL 4 AR 16 DI 10.1186/2110-5820-4-16 PG 11 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AT8EG UT WOS:000345166100001 PM 25024880 OA Green Published, gold DA 2023-05-13 ER PT J AU Annagur, BB Avci, A Demir, K Uygur, OF AF Annagur, Bilge Burcak Avci, Ahmet Demir, Kenan Uygur, Omer Faruk TI Is there any difference between the early age myocardial infarction and late age myocardial infarction in terms of psychiatric morbidity in patients who have survived acute myocardial infarction? SO COMPREHENSIVE PSYCHIATRY LA English DT Article ID ENDOTHELIAL PROGENITOR CELLS; ACUTE CORONARY SYNDROMES; SECONDARY PREVENTION; PSYCHOSOCIAL RISK; HEALTH ANXIETY; HEART-DISEASE; DEPRESSION; MORTALITY; MANAGEMENT; IMPACT AB Objective: We aimed to compare the rates of psychiatric morbidity in patients who had early age and late age MI in patients who have survived acute myocardial infarction? Methods: One hundred sixteen patients who were hospitalized in the coronary care unit were included in the study. Psychiatric assessment of the patients was carried out within 1-6 months post-Ml. Psychiatric interviews were conducted with the Structured Clinical Interview for DSM-W (SCID-I). Also used were the Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), and Health Anxiety Inventory (HAT). Results: A total of 116 patients were divided into two groups according to age as an early age myocardial infarction group (EA-MI) and a late age myocardial infarction group (LA-MI). The EA-MI group included 24 patients 45 years of age and under. The LA-MI group included 92 patients over 45 years of age. Current psychiatric disorders, lifetime psychiatric disorders and lifetime depressive disorders were significantly more frequent in the EA-MI group than in the LA-MI group. Conclusion: EA-MI patients have experienced a depressive episode prior to the onset of the MI, whereas in the LA-MI group, the patients typically experienced depressive episodes after MI. Our findings suggest that depression may increase the risk of MI at an early age. (C) 2014 Elsevier Inc. All rights reserved. C1 [Annagur, Bilge Burcak; Uygur, Omer Faruk] Selcuk Univ, Dept Psychiat, Fac Med, TR-42075 Konya, Turkey. [Avci, Ahmet; Demir, Kenan] Selcuk Univ, Fac Med, TR-42075 Konya, Turkey. C3 Selcuk University; Selcuk University RP Annagur, BB (通讯作者),Selcuk Univ, Dept Psychiat, Fac Med, TR-42075 Konya, Turkey. EM bilgeannagur@yahoo.com; drahmetavci@yahoo.com; drkenan76@yahoo.com; ofuygur@hotmail.com OI uygur, Omer faruk/0000-0003-2376-5113 CR Asahara T, 1997, SCIENCE, V275, P964, DOI 10.1126/science.275.5302.964 Aydemir O, 2013, NOROPSIKIYATRI ARS, V50, P325, DOI 10.4274/npa.y6383 Barth J, 2004, PSYCHOSOM MED, V66, P802, DOI 10.1097/01.psy.0000146332.53619.b2 Bush DE, 2001, AM J CARDIOL, V88, P337, DOI 10.1016/S0002-9149(01)01675-7 Cannon CP, 2001, J AM COLL CARDIOL, V38, P2114, DOI 10.1016/S0735-1097(01)01702-8 Carney RM, 2008, J AFFECT DISORDERS, V109, P133, DOI 10.1016/j.jad.2007.12.005 Colton Craig W, 2006, Prev Chronic Dis, V3, pA42 Di Stefano R, 2014, J CARDIOVASC MED, V15, P353, DOI 10.2459/JCM.0b013e328365c195 Egred M, 2005, POSTGRAD MED J, V81, P741, DOI 10.1136/pgmj.2004.027532 First MB, 1997, STRUCTURED CLIN INTE FOLLICK MJ, 1988, AM HEART J, V116, P32, DOI 10.1016/0002-8703(88)90246-3 Frasure-Smith N, 2010, POSTGRAD MED J, V86, P193, DOI 10.1136/hrt.2009.186957 Grace SL, 2005, AM J CARDIOL, V96, P1179, DOI 10.1016/j.amjcard.2005.06.052 Hisli N., 1989, PSIKOLOJI DERGISI, V7, P3 HOIT BD, 1986, CIRCULATION, V74, P712, DOI 10.1161/01.CIR.74.4.712 Honig A, 1997, Ned Tijdschr Geneeskd, V141, P196 Jaffe AS, 2006, AM HEART J, V152, P126, DOI 10.1016/j.ahj.2005.10.004 Kent LK, 2009, HARVARD REV PSYCHIAT, V17, P377, DOI 10.3109/10673220903463333 LADWIG KH, 1991, EUR HEART J, V12, P959 Lane D, 2001, PSYCHOSOM MED, V63, P221, DOI 10.1097/00006842-200103000-00005 Lane D, 2000, J PSYCHOSOM RES, V49, P229, DOI 10.1016/S0022-3999(00)00170-7 Lippi G, 2009, SEMIN THROMB HEMOST, V35, P325, DOI 10.1055/s-0029-1222611 Meijer A, 2011, GEN HOSP PSYCHIAT, V33, P203, DOI 10.1016/j.genhosppsych.2011.02.007 Mercuro G, 2011, CURR PHARM DESIGN, V17, P1082, DOI 10.2174/138161211795656954 Moser DK, 1996, PSYCHOSOM MED, V58, P395, DOI 10.1097/00006842-199609000-00001 Myers V, 2012, J PSYCHOSOM RES, V72, P5, DOI 10.1016/j.jpsychores.2011.09.009 Oner N., 1983, DURUMLUK SUREKLI KAY Ozkurkcugil A, 1999, ILAG TEDAVI DERGISI, V12, P233 Rozanski A, 2005, J AM COLL CARDIOL, V45, P637, DOI 10.1016/j.jacc.2004.12.005 RUBERMAN W, 1984, NEW ENGL J MED, V311, P552, DOI 10.1056/NEJM198408303110902 Salkovskis PM, 2002, PSYCHOL MED, V32, P843, DOI 10.1017/S0033291702005822 Strik JJMH, 2004, J PSYCHOSOM RES, V56, P59, DOI 10.1016/S0022-3999(03)00380-5 Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Yang L, 2011, ACTA NEUROPSYCHIATR, V23, P235, DOI 10.1111/j.1601-5215.2011.00577.x NR 34 TC 3 Z9 3 U1 2 U2 5 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0010-440X EI 1532-8384 J9 COMPR PSYCHIAT JI Compr. Psychiat. PD FEB PY 2015 VL 57 BP 10 EP 15 DI 10.1016/j.comppsych.2014.11.001 PG 6 WC Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry GA CB6ND UT WOS:000349742800003 PM 25542816 DA 2023-05-13 ER PT J AU Tungsubutra, W Ngoenjan, D AF Tungsubutra, Wiwun Ngoenjan, Deachart TI Door-to-balloon time and factors associated with delayed door-to-balloon time in ST-segment elevation myocardial infarction at Thailand's largest tertiary referral centre SO JOURNAL OF EVALUATION IN CLINICAL PRACTICE LA English DT Article DE acute coronary syndrome; delay; door-to-balloon time; myocardial infarction; primary percutaneous coronary intervention; Thailand ID SINGLE-CENTER; CHEST-PAIN; MORTALITY; ANGIOPLASTY; STRATEGIES; MANAGEMENT; OUTCOMES; TRIAGE AB Objective To analyse door-to-balloon (DTB) time and to identify factors significantly associated with delayed DTB in patients with ST-segment elevation myocardial infarction (STEMI) at Thailand's largest tertiary referral centre. Background DTB time is considered an important measure of performance quality. Methods This observational study analysed DTB time in patients with STEMI who presented to our institute's emergency department and underwent primary percutaneous coronary intervention (PCI) during June 2008 to May 2011. DTB time greater than 90 minutes was considered delayed. Data were collected to determine which clinical variables were associated with delays. Results One hundred thirty-three patients were included. The mean age of patients was 61.1 +/- 13.2 years, and 71.4% were male. Delayed DTB was observed in 70.7% of patients. Median DTB time was 117 (interquartile range [IQR], 86-168), 66 (IQR, 58-84), and 135 (IQR, 112-194) minutes in all patients, in nondelayed patients, and in delayed patients, respectively. Univariate analysis revealed triage to urgent care (P = 0.001) and presentation during on-call hours (P < 0.001) to be significantly associated with delayed DTB. Patients who were triaged to urgent care had a DTB time of 184 vs 105 minutes for triage to the emergency room. Patients who presented during on-call hours had a DTB time of 128 vs 86 minutes for work hour presentation. Presentation during on-call hours was the only significant predictor of DTB time >90 minutes in multivariate analysis (odds ratio [OR], 7.86; 95% confidence interval [CI], 3.39-18.22; P < 0.001). All patients that were triaged to urgent care were delayed; thus, association between urgent care triage and on-call hour service could not be determined. Conclusions Delayed DTB time occurred in 70.7% of patients. Two key factors that significantly contributed to delayed DTB were patient mistriage to urgent care and presentation during on-call hours. C1 [Tungsubutra, Wiwun; Ngoenjan, Deachart] Mahidol Univ, Siriraj Hosp, Fac Med, Div Cardiol,Dept Med, 2 Wanglang Rd, Bangkok 10700, Thailand. C3 Mahidol University RP Tungsubutra, W (通讯作者),Mahidol Univ, Siriraj Hosp, Fac Med, Div Cardiol,Dept Med, 2 Wanglang Rd, Bangkok 10700, Thailand. EM junetan_md@hotmail.com OI Tungsubutra, Wiwun/0000-0001-7276-6361 FU Faculty of Medicine, Siriraj Hospital, Mahidol University [R015631015] FX Faculty of Medicine, Siriraj Hospital, Mahidol University, Grant/Award Number: R015631015 CR Angeja BG, 2002, AM J CARDIOL, V89, P1156, DOI 10.1016/S0002-9149(02)02296-8 Antman Elliott M., 2004, J Am Coll Cardiol, V44, pE1, DOI 10.1016/j.jacc.2004.07.014 Atzema CL, 2011, AM HEART J, V162, P451, DOI 10.1016/j.ahj.2011.05.015 Bates ER, 2013, NEW ENGL J MED, V369, P889, DOI 10.1056/NEJMp1308772 Berger PB, 1999, CIRCULATION, V100, P14, DOI 10.1161/01.CIR.100.1.14 Blankenship JC, 2010, AM J CARDIOL, V106, P1527, DOI 10.1016/j.amjcard.2010.07.033 Bradley EH, 2006, NEW ENGL J MED, V355, P2308, DOI 10.1056/NEJMsa063117 Cannon CP, 2000, JAMA-J AM MED ASSOC, V283, P2941, DOI 10.1001/jama.283.22.2941 Coyne CJ, 2015, WEST J EMERG MED, V16, P184, DOI 10.5811/westjem.2014.10.23277 Ibanez B, 2018, EUR HEART J, V39, P119, DOI 10.1093/eurheartj/ehx393 Ikemura N, 2017, CIRC J, V81, P815, DOI 10.1253/circj.CJ-16-0905 McNamara RL, 2006, J AM COLL CARDIOL, V47, P2180, DOI 10.1016/j.jacc.2005.12.072 Menees DS, 2013, NEW ENGL J MED, V369, P901, DOI 10.1056/NEJMoa1208200 Miedema MD, 2011, CIRCULATION, V124, P1636, DOI 10.1161/CIRCULATIONAHA.111.033118 Nallamothu BK, 2015, LANCET, V385, P1114, DOI 10.1016/S0140-6736(14)61932-2 Peterson MC, 2012, INT J CARDIOL, V157, P8, DOI 10.1016/j.ijcard.2011.06.042 Sim WJ, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0185186 Solhpour A, 2016, CATHETER CARDIO INTE, V87, P1194, DOI 10.1002/ccd.26230 Srimahachota Suphot, 2007, Journal of the Medical Association of Thailand, V90, P1 Takakuwa KM, 2009, ACAD EMERG MED, V16, P921, DOI 10.1111/j.1553-2712.2009.00493.x TING HH, 1991, AM J MED, V91, P401, DOI 10.1016/0002-9343(91)90158-T Wang TY, 2011, JAMA-J AM MED ASSOC, V305, P2540, DOI 10.1001/jama.2011.862 Wu EB, 2008, CATHETER CARDIO INTE, V71, P152, DOI 10.1002/ccd.21315 Yu ZX, 2014, EMERG MED J, V31, pE35, DOI 10.1136/emermed-2012-201707 NR 24 TC 3 Z9 3 U1 1 U2 5 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1356-1294 EI 1365-2753 J9 J EVAL CLIN PRACT JI J. Eval. Clin. Pract. PD JUN PY 2019 VL 25 IS 3 BP 434 EP 440 DI 10.1111/jep.13061 PG 7 WC Health Care Sciences & Services; Medical Informatics; Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Medical Informatics; General & Internal Medicine GA HY7MC UT WOS:000468318900012 PM 30417495 DA 2023-05-13 ER PT J AU Lopes, RD Gharacholou, SM Holmes, DN Thomas, L Wang, TY Roe, MT Peterson, ED Alexander, KP AF Lopes, Renato D. Gharacholou, S. Michael Holmes, DaJuanicia N. Thomas, Laine Wang, Tracy Y. Roe, Matthew T. Peterson, Eric D. Alexander, Karen P. TI Cumulative Incidence of Death and Rehospitalization Among the Elderly in the First Year after NSTEMI SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Coronary disease; Death; Long-term outcomes; Myocardial infarction; Non-ST-segment elevation myocardial infarction; Rehospitalization ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; LONG-TERM MORTALITY; ST-ELEVATION; MEDICARE BENEFICIARIES; HOSPITAL READMISSION; HEALTH-STATUS; OUTCOMES; CARE; MANAGEMENT AB BACKGROUND: Age is associated with outcomes in non-ST-segment elevation myocardial infarction; however, less is known about rehospitalization or death among elderly survivors. We aimed to evaluate mortality and cause-specific rehospitalization rates in this growing population of older adults with ischemic heart disease. METHODS: We linked 36,711 patients aged >= 65 years who survived an index non-ST-segment elevation myocardial infarction from the CRUSADE registry to Medicare claims data for follow-up. One-year survival estimates were compared by age group-65-79, 80-84, 85-89, and >= 90 years-and Cox models were used to analyze the association between age and 1-year mortality. RESULTS: Death at 1 year increased markedly with age (from 13.3% for 65-79 years to 45.5% for >= 90 years). In contrast, rehospitalization rates at 1 year were similar and high across ages (65-79 years, 52.7%; >= 90 years, 56.5%), with nearly as many noncardiovascular-related as cardiovascular-related rehospitalizations. At 1 year, nonagenarians had substantially higher rates of death with or without preceding rehospitalization and twice the adjusted mortality than the group aged 65-79 years. CONCLUSIONS: Evolving care delivery models should consider the high mortality in older adults after a non-ST-segment elevation myocardial infarction. Contrary to expectations, rehospitalization rates do not rise substantially with advancing age, and rehospitalization is often for noncardiac diagnoses. (C) 2015 Elsevier Inc. All rights reserved. C1 [Lopes, Renato D.; Holmes, DaJuanicia N.; Thomas, Laine; Wang, Tracy Y.; Roe, Matthew T.; Peterson, Eric D.; Alexander, Karen P.] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA. [Gharacholou, S. Michael] Mayo Clin, Div Cardiovasc Dis, Rochester, MN USA. C3 Duke University; Mayo Clinic RP Lopes, RD (通讯作者),Duke Clin Res Inst, Box 3850,2400 Pratt St,Room 0311,Terrace Level, Durham, NC 27705 USA. EM renato.lopes@duke.edu RI Peterson, Eric David/ABF-5033-2021 FU Agency for Healthcare Research and Quality [U19HS021092]; Schering-Plough Corporation; Bristol-Myers Squibb/Sanofi-Aventis Pharmaceuticals Partnership; Millennium Pharmaceuticals FX This work was supported by the Agency for Healthcare Research and Quality (grant no. U19HS021092 to LT, TYW, and EDP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. CRUSADE was funded by the Schering-Plough Corporation. Bristol-Myers Squibb/Sanofi-Aventis Pharmaceuticals Partnership provided additional funding support. Millennium Pharmaceuticals also funded this work. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. 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PD JUN PY 2015 VL 128 IS 6 BP 582 EP 590 DI 10.1016/j.amjmed.2014.12.032 PG 9 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CI6NR UT WOS:000354877200017 PM 25660246 DA 2023-05-13 ER PT J AU Du, LJ Dong, PS Jia, JJ Li, ZG Lai, LH Yang, XM Wang, SX Yang, XS Li, ZJ Shang, XY Fan, XM AF Du, Laijing Dong, Pingshuan Jia, Jingjing Li, Zhiguo Lai, Lihong Yang, Xuming Wang, Shaoxin Yang, Xishan Li, Zhijuan Shang, Xiyan Fan, Ximei TI Impacts of intensive follow-up on the long-term prognosis of percutaneous coronary intervention in acute coronary syndrome patients - a single center prospective randomized controlled study in a Chinese population SO EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY LA English DT Article DE Coronary artery disease; percutaneous coronary intervention; disease management; cardiovascular risk factor; medication adherence ID CARDIAC REHABILITATION; SECONDARY PREVENTION; HEART-DISEASE; CARDIOVASCULAR-DISEASE; CONTROLLED-TRIAL; COST-EFFECTIVENESS; RISK-FACTORS; MEDICATIONS; PREDICTORS; ADHERENCE AB Objectives To investigate the impact of cardiologist-coordinated intensive follow-up on the long-term prognosis of percutaneous coronary intervention in Chinese patients. Methods We recruited 964 patients who had acute coronary syndrome and underwent successful percutaneous coronary intervention in the First Hospital Affiliated to Henan University of Science and Technology, China. Participants were randomly assigned into the intensive follow-up (n=479) and usual follow-up group (control group, n=485). They received secondary prevention education during hospitalization and telephone follow-ups after discharge. The control group received telephone calls from nurses, while the intensive follow-up group received telephone calls and medical consultations from cardiologists. Both groups were followed up for 36 months. Results (1) At 36 months, the proportions of all-cause death, cardiac death and cumulative major adverse cardiovascular events (MACEs) were 5.3%, 4.4% and 18.6% in the intensive follow-up group. These events were significantly lower than in the control group (10.1%, 9.3 % and 28.8% (p=0.004, p=0.003 and p<0.001). (2) Multivariable Cox regression analysis identified intensive follow-up as an independent predictor of survival, cardiac death-free survival and MACE-free survival. (hazard ratio (HR)=0.487, 95% confidence interval (CI) 0.298-0.797, p=0.004; HR=0.466, 95% CI 0.274-0.793, p=0.005; HR=0.614, 95% CI 0.464-0.811, p=0.001). Kaplan-Meier analysis revealed that patients in the intensive follow-up groups had longer survival (log rank=8.565, p=0.003), cardiac death-free survival (log rank=8.769, p=0.003) and MACE-free survival (log rank=15.928, p<0.001). (3) The average medical cost was significantly less in the intensive follow-up group, especially the cost for re-hospitalization (US$582.741753.20 vs. US$999.32 +/- 2434.57, p=0.003). The bleeding events were similar. (4) Patients in the intensive follow-up group had significantly better controls of cardiovascular risk factors and medication adherence. Conclusions A cardiologist-coordinated intensive follow-up program markedly decreased cardiovascular risk factors, reduced medical costs, promoted medication adherence and improved the long-term prognosis of patients after percutaneous coronary intervention in the Chinese population. C1 [Du, Laijing; Dong, Pingshuan; Jia, Jingjing; Li, Zhiguo; Lai, Lihong; Yang, Xuming; Wang, Shaoxin; Yang, Xishan; Li, Zhijuan; Shang, Xiyan; Fan, Ximei] Henan Univ Sci & Technol, Affiliated Hosp 1, Dept Cardiol, Luoyang 471003, Henan, Peoples R China. C3 Henan University of Science & Technology RP Dong, PS (通讯作者),Henan Univ Sci & Technol, Affiliated Hosp 1, Dept Cardiol, Luoyang 471003, Henan, Peoples R China. EM dongpingshuan@163.com FU Program for Science and Technology Innovation of the Henan Province, China [112102310142] FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this study was supported by the Program for Science and Technology Innovation of the Henan Province, China (#112102310142). 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J. Prev. Cardiol. PD JUL PY 2016 VL 23 IS 10 BP 1077 EP 1085 DI 10.1177/2047487315607041 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DP8RD UT WOS:000378764500009 PM 26416996 DA 2023-05-13 ER PT J AU Badreldin, HA Carter, D Cook, BM Qamar, A Vaduganathan, M Bhatt, DL AF Badreldin, Hisham A. Carter, Danielle Cook, Bryan M. Qamar, Annan Vaduganathan, Muthiah Bhatt, Deepak L. TI Safety and Tolerability of Transitioning from Cangrelor to Ticagrelor in Patients Who Underwent Percutaneous Coronary Intervention SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID GLYCOPROTEIN IIB/IIIA INHIBITORS; PLATELET INHIBITION; PCI; STRATEGIES; EVENTS AB The 3 phase 3 CHAMPION (Cangrelor vs Standard Therapy to Achieve Optimal Management of Platelet Inhibition) trials collectively demonstrated the safety of transitioning from cangrelor, a potent, parenteral rapidly-acting P2Y12 inhibitor, to clopidogrel in patients who underwent percutaneous coronary intervention (PCI). However, variation in timing of therapy, site-specific binding, and drug half-lives may theoretically complicate switching to' other oral P2Y12 inhibitors. Since regulatory approval, limited data are available regarding the "real-world" safety and tolerability of transitioning to these more potent oral P21'12 antagonists. From November 2015 to January 2017, we evaluated the clinical profiles and efficacy and safety outcomes in cangrelor-treated patients who underwent PCI transitioned to clopidogrel (n = 42) or ticagrelor (n = 82) at a large, tertiary care center. Most patients receiving cangrelor underwent PCI with a drug-eluting stent for acute coronary syndrome via a radial approach in the background of turfractionated heparin. Stent thrombosis within 48 hours was rare and occurred in 1 patient treated with ticagrelor. Global Use of Strategies to Open Occluded Coronary Arteries defined bleeding occurred in 20% of patients switched to ticagrelor and 29% of patients switched to clopidogrel, but none were severe or life-threatening. In conclusion, rates of stent thrombosis and severe/life-threatening bleeding were low and comparable with those identified in the CHAMPION program, despite use of more potent oral P2Y12 inhibition. (C) 2017 Elsevier Inc. All rights reserved. C1 [Badreldin, Hisham A.; Carter, Danielle; Cook, Bryan M.] Brigham & Womens Hosp, Dept Pharm, 75 Francis St, Boston, MA 02115 USA. [Qamar, Annan; Vaduganathan, Muthiah; Bhatt, Deepak L.] Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA. [Qamar, Annan; Vaduganathan, Muthiah; Bhatt, Deepak L.] Harvard Med Sch, Boston, MA 02115 USA. C3 Harvard University; Brigham & Women's Hospital; Harvard University; Brigham & Women's Hospital; Harvard University; Harvard Medical School RP Bhatt, DL (通讯作者),Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA.; Bhatt, DL (通讯作者),Harvard Med Sch, Boston, MA 02115 USA. EM dlbhattmd@post.harvard.edu RI Cook, Bryan/AAG-3852-2021; Badreldin, Hisham/AAV-2605-2021 OI Cook, Bryan/0000-0001-5277-2692; Badreldin, Hisham/0000-0001-7182-4347; Vaduganathan, Muthiah/0000-0003-0885-1953 CR Bhatt DL, 2013, NEW ENGL J MED, V368, P1303, DOI 10.1056/NEJMoa1300815 Bhatt DL, 2009, NEW ENGL J MED, V361, P2330, DOI 10.1056/NEJMoa0908629 Gutierrez JA, 2016, EUR HEART J, V37, P1122, DOI 10.1093/eurheartj/ehv498 Harrington RA, 2009, NEW ENGL J MED, V361, P2318, DOI 10.1056/NEJMoa0908628 Hochholzer W, 2017, JACC-CARDIOVASC INTE, V10, P121, DOI 10.1016/j.jcin.2016.10.004 Kelly Christopher R, 2017, Crit Pathw Cardiol, V16, P7, DOI 10.1097/HPC.0000000000000098 Rollini F, 2016, NAT REV CARDIOL, V13, P11, DOI 10.1038/nrcardio.2015.113 Vaduganathan M, 2017, JAMA CARDIOL, V2, P127, DOI 10.1001/jamacardio.2016.4556 Vaduganathan M, 2017, J AM COLL CARDIOL, V69, P463, DOI 10.1016/j.jacc.2016.11.017 Vaduganathan M, 2017, J AM COLL CARDIOL, V69, P176, DOI 10.1016/j.jacc.2016.10.055 NR 10 TC 9 Z9 10 U1 0 U2 2 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD AUG 1 PY 2017 VL 120 IS 3 BP 359 EP 361 DI 10.1016/j.amjcard.2017.04.034 PG 3 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FD1PJ UT WOS:000407308900004 PM 28576266 DA 2023-05-13 ER PT J AU Jentzer, JC Baran, DA van Diepen, S Barsness, GW Henry, TD Naidu, SS Bell, MR Holmes, DI AF Jentzer, Jacob C. Baran, David A. van Diepen, Sean Barsness, Gregory W. Henry, Timothy D. Naidu, Srihari S. Bell, Malcolm R. Holmes, David It, Jr. TI Admission Society for Cardiovascular Angiography and Intervention shock stage stratifies post-discharge mortality risk in cardiac intensive care unit patients SO AMERICAN HEART JOURNAL LA English DT Article ID PERCUTANEOUS CORONARY INTERVENTION; LONG-TERM SURVIVAL; ACUTE MYOCARDIAL-INFARCTION; CARDIOGENIC-SHOCK; ARREST; OUTCOMES; VALIDATION AB Background The five-stage Society for Cardiovascular Angiography and Intervention (SCAI) cardiogenic shock classification scheme can stratify hospital mortality risk in patients admitted to the cardiac intensive care unit (CICU). We sought to evaluate the SCAI shock classification for prediction of post-discharge mortality in CICU survivors. Methods We retrospectively analyzed hospital survivors admitted to a single CICU between 2007 and 2015. SCAI CS stages A through E were classified using CICU admission data using a previously published algorithm. All-cause post-discharge mortality was compared across SCAI stages using Kaplan-Meier analysis and Cox proportional hazards models. Results Among 9096 unique hospital survivors, 43.2% had acute coronary syndrome (ACS), 44.6% had heart failure (HF), and 8.7% had cardiac arrest (CA) on admission. The proportion of patients in each SCAI shock stage was: A, 49.1%; B, 30.6%; C, 15.2; D/E 5.2%. Kaplan-Meier survival at 5 years in each SCAI shock stage was: A, 88.2%; B, 81.6%; C, 76.7%; D/E, 71.7% (P < .001 by log-rank). Each higher SCAI shock stage was associated with increased adjusted post-discharge mortality compared to SCAI shock stage A (all P < .001); results were consistent among patients with ACS or HF. Late hemodynamic deterioration after 24 hours, but not an admission diagnosis of CA, was associated with higher post-discharge mortality. Conclusions The SCAI shock classification assessed at the time of CICU admission was predictive of post-discharge mortality risk among hospital survivors, although an admission diagnosis of CA was not. The SCAI shock classification can be used for post-discharge mortality risk stratification. C1 [Jentzer, Jacob C.; Barsness, Gregory W.; Bell, Malcolm R.; Holmes, David It, Jr.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Jentzer, Jacob C.] Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, 200 First St SW, Rochester, MN 55905 USA. [Baran, David A.] Sentara Heart Hosp, Adv Heart Failure Ctr, Norfolk, VA USA. [Baran, David A.] Sentara Heart Hosp, Eastern Virginia Med Sch, Norfolk, VA USA. [van Diepen, Sean] Univ Alberta Hosp, Dept Crit Care Med, Edmonton, AB, Canada. [van Diepen, Sean] Univ Alberta Hosp, Div Cardiol, Dept Med, Edmonton, AB, Canada. [Henry, Timothy D.] Christ Hosp Hlth Network, Carl & Edyth Lindner Ctr Res & Educ, Cincinnati, OH USA. [Naidu, Srihari S.] Westchester Med Ctr, Valhalla, NY USA. [Naidu, Srihari S.] New York Med Coll, Valhalla, NY 10595 USA. C3 Mayo Clinic; Mayo Clinic; Sentara Healthcare; Eastern Virginia Medical School; Sentara Healthcare; University of Alberta; University of Alberta; Christ Hospital - Ohio; Westchester Medical Center; New York Medical College RP Jentzer, JC (通讯作者),Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA.; Jentzer, JC (通讯作者),Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, 200 First St SW, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu OI Baran, David/0000-0002-7754-9953 CR Aakre C, 2017, INT J MED INFORM, V103, P1, DOI 10.1016/j.ijmedinf.2017.04.001 Bagai A, 2013, AM HEART J, V166, P298, DOI 10.1016/j.ahj.2013.05.003 Baran DA, 2019, CATHETER CARDIO INTE, V94, P29, DOI 10.1002/ccd.28329 Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 Berg DD, 2019, CIRC-CARDIOVASC QUAL, P12 Chandra S, 2011, BMJ OPEN, V1, DOI 10.1136/bmjopen-2011-000216 Demirel F, 2015, EUR HEART J-ACUTE CA, V4, P16, DOI 10.1177/2048872614547448 Fordyce CB, 2016, J AM COLL CARDIOL, V67, P1981, DOI 10.1016/j.jacc.2016.02.044 Gupta N, 2014, AM J CARDIOL, V113, P1087, DOI 10.1016/j.amjcard.2013.12.014 Harrison AM, 2013, CRIT CARE RES PRACT, V2013, DOI 10.1155/2013/975672 Hemradj VV, 2016, CLIN CARDIOL, V39, P665, DOI 10.1002/clc.22580 Herasevich V, 2010, MAYO CLIN PROC, V85, P247, DOI 10.4065/mcp.2009.0479 Hochman JS, 2006, JAMA-J AM MED ASSOC, V295, P2511, DOI 10.1001/jama.295.21.2511 Hunziker L, 2019, CIRC-CARDIOVASC INTE, Ve007293, P12 Jentzer JC, 2018, AM J CARDIOL, V122, P1773, DOI 10.1016/j.amjcard.2018.08.011 Jentzer JC, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008169 Jentzer JC, 2019, J AM COLL CARDIOL Kolte D, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.113.000590 Kvakkestad KM, 2018, RESUSCITATION, V122, P41, DOI 10.1016/j.resuscitation.2017.11.047 Lim HS, 2013, INT J CARDIOL, V166, P425, DOI 10.1016/j.ijcard.2011.10.131 Mahmoud AN, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008235 Rocca WA, 2012, MAYO CLIN PROC, V87, P1202, DOI 10.1016/j.mayocp.2012.08.012 Shah M, 2018, INT J CARDIOL, V270, P60, DOI 10.1016/j.ijcard.2018.06.036 Shah RU, 2016, J AM COLL CARDIOL, V67, P739, DOI 10.1016/j.jacc.2015.11.048 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Singh M, 2007, J AM COLL CARDIOL, V50, P1752, DOI 10.1016/j.jacc.2007.04.101 Thiele H, 2018, CIRCULATION van Diepen S, 2017, CIRCULATION, V136, pE232, DOI 10.1161/CIR.0000000000000525 Zimmermann S, 2013, INT J CARDIOL, V166, P236, DOI 10.1016/j.ijcard.2011.11.029 NR 29 TC 33 Z9 33 U1 0 U2 5 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 EI 1097-5330 J9 AM HEART J JI Am. Heart J. PD JAN PY 2020 VL 219 BP 37 EP 46 DI 10.1016/j.ahj.2019.10.012 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JW6YV UT WOS:000503196100005 PM 31710843 DA 2023-05-13 ER PT J AU Sterling, MR Safford, MM Goggins, K Nwosu, SK Schildcrout, JS Wallston, KA Mixon, AS Rothman, RL Kripalani, S AF Sterling, Madeline R. Safford, Monika M. Goggins, Kathryn Nwosu, Sam K. Schildcrout, Jonathan S. Wallston, Kenneth A. Mixon, Amanda S. Rothman, Russell L. Kripalani, Sunil CA Vanderbilt Inpatient Cohort Study TI Numeracy, Health Literacy, Cognition, and 30-Day Readmissions among Patients with Heart Failure SO JOURNAL OF HOSPITAL MEDICINE LA English DT Article ID CONFUSION ASSESSMENT METHOD; DECISION-MAKING; BLOOD-PRESSURE; CARE; HOSPITALIZATION; IMPAIRMENT; MORTALITY; DEATH; RISK; VALIDATION AB BACKGROUND: Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer self-care and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the posthospitalization period. OBJECTIVE: To examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF). DESIGN/SETTING/PATIENTS: The Vanderbilt Inpatient Cohort Study is a prospective longitudinal study of adults hospitalized with acute coronary syndromes and/or ADHF. We studied 883 adults hospitalized with ADHF. MEASUREMENTS: During their hospitalization, a baseline interview was performed in which demographic characteristics, numeracy, health literacy, and cognition were assessed. Through chart review, clinical characteristics were determined. The outcome of interest was 30-day readmission to any acute care hospital. To examine the association between numeracy, health literacy, cognition, and 30-day readmissions, multivariable Poisson (log-linear) regression was used. RESULTS: Of the 883 patients admitted for ADHF, 23.8% (n = 210) were readmitted within 30 days; 33.9% of the study population had inadequate numeracy skills, 24.6% had inadequate/marginal literacy skills, and 53% had any cognitive impairment. Numeracy and cognition were not associated with 30-day readmissions. Though (objective) health literacy was associated with 30-day readmissions in unadjusted analyses, it was not in adjusted analyses. CONCLUSIONS: Numeracy, health literacy, and cognition were not associated with 30-day readmission among this sample of patients hospitalized with ADHF. (C) 2018 Society of Hospital Medicine C1 [Sterling, Madeline R.; Safford, Monika M.] Weill Cornell Med Coll, Dept Med, New York, NY USA. [Sterling, Madeline R.; Safford, Monika M.] Weill Cornell Med Coll, Div Gen Internal Med, New York, NY USA. [Goggins, Kathryn; Mixon, Amanda S.; Rothman, Russell L.; Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Ctr Hlth Serv Res, Nashville, TN USA. [Goggins, Kathryn; Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Ctr Effect Hlth Commun, Nashville, TN USA. [Goggins, Kathryn; Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Ctr Clin Qual & Implementat Res, Nashville, TN USA. [Nwosu, Sam K.; Schildcrout, Jonathan S.] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USA. [Wallston, Kenneth A.] Vanderbilt Univ, Sch Nursing, Nashville, TN 37240 USA. [Mixon, Amanda S.; Rothman, Russell L.; Kripalani, Sunil] Vanderbilt Univ, Dept Med, Div Gen Internal Med & Publ Hlth, Nashville, TN USA. [Mixon, Amanda S.] Tennessee Valley Healthcare Syst Geriatr Res Educ, Dept Vet Affairs, Nashville, TN USA. C3 Cornell University; Weill Cornell Medicine; Cornell University; Weill Cornell Medicine; Vanderbilt University; Vanderbilt University; Vanderbilt University; Vanderbilt University; Vanderbilt University; Vanderbilt University; Geriatric Research Education & Clinical Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Tennessee Valley Healthcare System RP Sterling, MR (通讯作者),Weill Cornell Med Coll, Dept Med, Div Gen Internal Med, 1300 York Ave,POB 46, New York, NY 10065 USA. EM mrs9012@med.cornell.edu OI Rothman, Russsell/0000-0002-1506-3990; Sterling, Madeline/0000-0002-9928-4407 FU National Heart, Lung, and Blood Institute [R01 HL109388]; National Center for Advancing Translational Sciences [UL1 TR000445-06]; Agency for Healthcare Research and Quality [T32HS000066]; Tennessee Valley Healthcare System, Department of Veterans Affairs [CDA 12-168] FX This research was supported by the National Heart, Lung, and Blood Institute (R01 HL109388) and in part by the National Center for Advancing Translational Sciences (UL1 TR000445-06). The content is solely the responsibility of the authors and does not necessarily represent official views of the National Institutes of Health. The authors' funding sources did not participate in the planning, collection, analysis, or interpretation of data or in the decision to submit for publication. Dr. Sterling is supported by T32HS000066 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. Dr. Mixon has a VA Health Services Research and Development Service Career Development Award at the Tennessee Valley Healthcare System, Department of Veterans Affairs (CDA 12-168). This material was presented at the Society of General Internal Medicine Annual Meeting on April 20, 2017, in Washington, DC. 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Hosp. Med. PD MAR PY 2018 VL 13 IS 3 BP 145 EP 151 DI 10.12788/jhm.2932 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA FX8VQ UT WOS:000426374100001 PM 29455228 OA Green Accepted, Bronze DA 2023-05-13 ER PT J AU Alqahtani, F Balla, S Almustafa, A Sokos, G Alkhouli, M AF Alqahtani, Fahad Balla, Sudarshan Almustafa, Ahmad Sokos, George Alkhouli, Mohamad TI Utilization of palliative care in patients hospitalized with heart failure: A contemporary national perspective SO CLINICAL CARDIOLOGY LA English DT Article DE heart failure; palliative care ID DISEASE; LIFE AB Background Despite advances in therapy, heart failure (HF) patients have significant symptom burden and poor quality of life. However, data on palliative care (PC) utilization in this population are scarce. We sought to assess national trends in PC utilization in patients admitted with acute HF. Methods Adults hospitalized with HF without acute coronary syndrome were identified in the National inpatient sample. PC was identified using ICD-9-CM-Code V66.7. Trends in PC utilization, its predictors and its association with length-of-stay and cost were assessed. Results A total of 939 680 HF patients were hospitalized with HF between 2003 and 2014. Of those,1.2% received PC during the hospitalization, with an upward trend in the use of PC over time (0.12% in 2003 to 3.6% in 2014, P < 0.001). Compared with patients who did not receive PC, those who had PC were older (79 +/- 12 vs 69 +/- 16 years), and had higher prevalence of Caucasian race (73.4% vs 51.8%), coronary disease (45.6% vs 39.3%), chronic renal disease (79.3% vs 42.8%), and pulmonary hypertension (28.3% vs 15.1%) (P < 0.001). In-hospital mortality (35.2% vs 2.2%), length-of-stay (9 +/- 13 days vs 6 +/- 6, P < 0.001), cost ($19 984 +/- 42 922 vs $11 921 +/- 18 175), and non-home discharges (46% vs 19.2%) (P < 0.001) were higher in the PC group. In-hospital mortality in PC group trended downward over time (69% in 2003 vs 29% in 2014, P < 0.001). Conclusion PC is being utilized in an increasing but overall small number of patients hospitalized with HF. Further research is needed to identify the optimal role and timing of PC in HF patients. C1 [Alqahtani, Fahad; Balla, Sudarshan; Almustafa, Ahmad; Sokos, George; Alkhouli, Mohamad] West Virginia Univ, Dept Med, Div Cardiol, Morgantown, WV USA. C3 West Virginia University RP Alkhouli, M (通讯作者),West Virginia Univ, Inst Heart & Vasc, 1 Med Dr, Morgantown, WV 26505 USA. EM mohamad.alkhouli@wvumedicine.org RI Balla, Sudarshan/AAG-3857-2022; Balla, Sudarshan/ADC-0582-2022 OI Balla, Sudarshan/0000-0002-7872-3757; Balla, Sudarshan/0000-0002-7872-3757; Alkhouli, Mohamad/0000-0003-3847-0959 CR Albaeni A, 2018, RESUSCITATION, V124, P112, DOI 10.1016/j.resuscitation.2018.01.020 Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Bhatia RS, 2006, NEW ENGL J MED, V355, P260, DOI 10.1056/NEJMoa051530 Chatterjee K, 2018, CRIT CARE MED, V46, P1230, DOI 10.1097/CCM.0000000000003182 Diop MS, 2017, J PALLIAT MED, V20, P84, DOI 10.1089/jpm.2016.0330 Feder SL, 2018, AM J HOSP PALLIAT ME, V35, P959, DOI 10.1177/1049909117747519 Fitzpatrick J, 2018, J PALLIAT MED, V21, P933, DOI 10.1089/jpm.2017.0416 GENTSCH C, 1989, NEUROPSYCHOBIOLOGY, V22, P101, DOI 10.1159/000118601 Hauptman PJ, 2008, AM J MED, V121, P127, DOI 10.1016/j.amjmed.2007.08.035 Kavalieratos D, 2017, J AM COLL CARDIOL, V70, P1919, DOI 10.1016/j.jacc.2017.08.036 Lu MLR, 2017, CLIN CARDIOL, V40, P1020, DOI 10.1002/clc.22760 Mandawat A, 2016, JAMA CARDIOL, V1, P616, DOI 10.1001/jamacardio.2016.1687 Meyers DE, 2016, CAN J CARDIOL, V32, P1148, DOI 10.1016/j.cjca.2016.04.015 Psotka MA, 2017, PROG CARDIOVASC DIS, V60, P215, DOI 10.1016/j.pcad.2017.05.001 Rogers JG, 2017, J AM COLL CARDIOL, V70, P332, DOI 10.1016/j.jacc.2017.05.030 Rose EA, 2001, NEW ENGL J MED, V345, P1435, DOI 10.1056/NEJMoa012175 Rush B, 2017, HEPATOLOGY, V66, P1585, DOI 10.1002/hep.29297 Rush B, 2017, CHEST, V151, P41, DOI 10.1016/j.chest.2016.06.023 Sidebottom AC, 2015, J PALLIAT MED, V18, P134, DOI 10.1089/jpm.2014.0192 Singh T, 2017, STROKE, V48, P2534, DOI 10.1161/STROKEAHA.117.016893 Tsuchihashi-Makaya M, 2009, CIRC J, V73, P1893, DOI 10.1253/circj.CJ-09-0254 Unroe KT, 2011, ARCH INTERN MED, V171, P196, DOI 10.1001/archinternmed.2010.371 Warraich HJ, 2018, JAMA CARDIOL, V3, P917, DOI 10.1001/jamacardio.2018.2678 Widera Eric, 2009, Curr Opin Support Palliat Care, V3, P247, DOI 10.1097/SPC.0b013e3283325024 Wiskar KJ, 2018, AM J HOSP PALLIAT ME, V35, P620, DOI 10.1177/1049909117727455 Xu ZL, 2018, INT HEART J, V59, P503, DOI 10.1536/ihj.17-289 Yancy CW, 2013, J AM COLL CARDIOL, V62, pE147, DOI 10.1016/j.jacc.2013.05.019 Zhou K, 2019, HERZ, V44, P440, DOI 10.1007/s00059-017-4677-8 Ziehm J, 2016, BMC HEALTH SERV RES, V16, DOI 10.1186/s12913-016-1609-x NR 29 TC 9 Z9 9 U1 0 U2 3 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0160-9289 EI 1932-8737 J9 CLIN CARDIOL JI Clin. Cardiol. PD JAN PY 2019 VL 42 IS 1 BP 136 EP 142 DI 10.1002/clc.23119 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HI8DO UT WOS:000456685700020 PM 30447066 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Khan, SA Campbell, AM Lu, YY An, LL Alpert, JS Chen, QM AF Khan, Sher Ali Campbell, Ashley M. Lu, Yingying An, Lingling Alpert, Joseph S. Chen, Qin M. TI N-Acetylcysteine for Cardiac Protection During Coronary Artery Reperfusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Review DE N-acetylcysteine; coronary artery bypass; percutaneous coronary intervention; atrial fibrillation; antioxidants; reactive oxygen species; acute coronary syndrome; stable angina ID POSTOPERATIVE ATRIAL-FIBRILLATION; BYPASS GRAFT-SURGERY; ELEVATION MYOCARDIAL-INFARCTION; LEFT-VENTRICULAR FUNCTION; DOUBLE-BLIND; BLOOD CARDIOPLEGIA; OXIDATIVE STRESS; PULMONARY-FUNCTION; ACETYL CYSTEINE; TROPONIN-I AB Coronary artery reperfusion is essential for the management of symptoms in the patients with myocardial ischemia. However, the benefit of reperfusion often comes at an expense of paradoxical injury, which contributes to the adverse events, and sometimes heart failure. Reperfusion is known to increase the production of reactive oxygen species (ROS). We address whether N-acetylcysteine (NAC) reduces the ROS and alleviates reperfusion injury by improving the clinical outcomes. A literature search for the randomized controlled trials (RCTs) was carried out in the five biomedical databases for testing the effects of NAC in patients undergoing coronary artery reperfusion by percutaneous coronary intervention, thrombolysis, or coronary artery bypass graft. Of 787 publications reviewed, 28 RCTs were identified, with a summary of 2,174 patients. A meta-analysis using the random effects model indicated that NAC administration during or prior to the reperfusion procedures resulted in a trend toward a reduction in the level of serum cardiac troponin (cTn) [95% CI, standardized mean difference (SMD) -0.80 (-1.75; 0.15), p = 0.088, n = 262 for control, 277 for NAC group], and in the incidence of postoperative atrial fibrillation [95% CI, relative risk (RR) 0.57 (0.30; 1.06), p = 0.071, n = 484 for control, 490 for NAC group]. The left ventricular ejection fraction or the measures of length of stay in intensive care unit (ICU) or in hospital displayed a positive trend that was not statistically significant. Among the nine trials that measured ROS, seven showed a correlation between the reduction of lipid peroxidation and improved clinical outcomes. These lines of evidence support the potential benefit of NAC as an adjuvant therapy for cardiac protection against reperfusion injury. C1 [Khan, Sher Ali; Campbell, Ashley M.; Chen, Qin M.] Univ Arizona, Tucson, AZ 85721 USA. [Lu, Yingying] Univ Arizona, Grad Interdisciplinary Program Stat & Data Sci, Tucson, AZ 85721 USA. [An, Lingling] Univ Arizona, Coll Agr & Life Sci, Dept Biosyst Engn, Tucson, AZ 85721 USA. [An, Lingling] Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Dept Epidmiol & Biostat, Tucson, AZ 85721 USA. [Alpert, Joseph S.] Univ Arizona, Coll Med, Dept Med, Tucson, AZ 85721 USA. [Alpert, Joseph S.] Univ Arizona, Coll Med, Sarver Heart Ctr, Tucson, AZ 85721 USA. C3 University of Arizona; University of Arizona; University of Arizona; University of Arizona; University of Arizona; University of Arizona RP Chen, QM (通讯作者),Univ Arizona, Tucson, AZ 85721 USA. EM qchen1@pharmacy.arizona.edu RI Lu, Yingying/IAM-2940-2023 OI Campbell, Ashley/0000-0001-7110-8287; Khan, Sher A/0000-0001-9430-0431 FU NIH [R01 GM125212, R01 GM126165]; University of Arizona College of Pharmacy FX & nbsp;Research works under QC's direction are supported by NIH R01 GM125212, R01 GM126165, Holsclaw Endowment, and The University of Arizona College of Pharmacy start-up fund. 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Cardiovasc. Med. PD NOV 19 PY 2021 VL 8 AR 752939 DI 10.3389/fcvm.2021.752939 PG 16 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA YI2HI UT WOS:000743674800001 PM 34869660 OA Green Published, gold DA 2023-05-13 ER PT J AU Orvad, H Savage, L Smith, T Hamiduzzaman, M Schmidt, D AF Orvad, Helen Savage, Lindsay Smith, Tony Hamiduzzaman, Mohammad Schmidt, David TI Not All STEMI Patients Receive Timely Reperfusion: Considerations for Rural Emergency Departments SO JOURNAL OF MULTIDISCIPLINARY HEALTHCARE LA English DT Article DE coronary care; rural; emergency; thrombolysis ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; NEW-ZEALAND; GUIDELINES; MANAGEMENT; ELEVATION; AUSTRALIA; SOCIETY AB Early reperfusion for ST-elevation myocardial infarction (STEMI) is well known to improve patient outcomes. A review of patient records in one rural health service in New South Wales, Australia, suggested that not all STEMI patients were receiving timely reperfusion. Consequently, the aim of this study was to further investigate factors influencing clinical decision making by primary care providers in relation to rural STEMI patients. This cross-sectional observational study was in two phases, a retrospective audit of patient records and a survey of rural general practitioners (GPs). In the first phase, patients with STEMI who were referred from small rural hospitals to a regional hospital emergency department (ED) were identified through the local health district database. In phase two, information from the database informed questions for a survey distributed to the GP visiting medical officers (VMOs) at small rural hospitals in the region. The survey was designed to ascertain factors that may contribute to delays in the care of STEMI patients. Of the STEMI patients identified (n = 139), 15% (21) who were eligible for medical reperfusion were not administered thrombolysis within 4 hours of triage. Auditing of this group's records found that ECGs were inaccurately interpreted for 76% of the missed STEMI patients. In the survey, about 55% of the GP respondents said they "very much agree" with the statement that they felt competent in STEMI management. Only 64% of the GP VMOs agreed they felt competent in diagnosis and management of a failed thrombolysis and not all respondents were aware of the relevant clinical guideline. Patients with missed STEMI are at higher risk of morbidity and mortality and increased length of stay, adding burden to the patient, carer and health service. Without addressing gaps in service provision and better adherence to clinical guidelines, unacceptable delays in STEMI management in rural health services are likely to continue. C1 [Orvad, Helen] Hunter New England Local Hlth Dist, Tamworth, NSW, Australia. [Savage, Lindsay] Hunter New England Local Hlth Dist, Newcastle, NSW, Australia. [Smith, Tony; Hamiduzzaman, Mohammad] Univ Newcastle, Dept Rural Hlth, Taree, NSW 2430, Australia. [Schmidt, David] Australia Hlth Educ & Training Inst, Hlth Educ & Training Inst, Sydney, NSW, Australia. C3 University of Newcastle RP Smith, T (通讯作者),Univ Newcastle, Dept Rural Hlth, Taree, NSW 2430, Australia. 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Multidiscip. Healthc. PY 2021 VL 14 BP 3103 EP 3108 DI 10.2147/JMDH.S337197 PG 6 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA WW5PQ UT WOS:000717968700002 PM 34785903 OA gold, Green Published DA 2023-05-13 ER PT J AU Franchi, F Rollini, F Park, Y Angiolillo, DJ AF Franchi, Francesco Rollini, Fabiana Park, Yongwhi Angiolillo, Dominick J. TI A Safety Evaluation of Cangrelor in Patients Undergoing PCI SO EXPERT OPINION ON DRUG SAFETY LA English DT Review DE P2Y(12) receptor antagonist; antiplatelet therapy; percutaneous coronary intervention; cangrelor; Acute coronary syndrome ID PERCUTANEOUS CORONARY INTERVENTION; ELEVATION MYOCARDIAL-INFARCTION; PLATELET INHIBITION; ANTIPLATELET THERAPY; ARTERY-DISEASE; STANDARD THERAPY; POOLED ANALYSIS; DOUBLE-BLIND; CLOPIDOGREL; TICAGRELOR AB Introduction: Dual antiplatelet therapy with aspirin and an oral ADP P2Y(12) receptor antagonist is the standard-of-care for treatment of patients undergoing percutaneous coronary intervention (PCI). However, oral P2Y(12) receptor antagonists have several limitations, including inter- and intra-individual response variability, drug-drug interactions, slow onset and offset of action and delayed platelet inhibition in high-risk clinical settings, such as patients with ST-segment elevation myocardial infarction. Areas covered: Cangrelor is an intravenous, direct-acting, reversible, potent P2Y(12) receptor antagonist. It rapidly achieves near complete platelet inhibition and has a very short half-life and a fast offset of action. We conducted a systematic review searching PubMed/MEDLINE for pharmacodynamic/pharmacokinetic studies and clinical trials in which cangrelor was investigated, published from any time up to November 1(st) 2015. For clinical trials, those investigating cangrelor in the setting of PCI were considered for discussion. Expert opinion: Cangrelor is approved by drug regulating authorities worldwide as adjunctive antithrombotic therapy for the full spectrum of patients undergoing PCI, not pre-treated with a P2Y(12) receptor inhibitor and not with intent to receive a glycoprotein IIb/IIIa inhibitor. Its unique pharmacological properties and its favorable safety and efficacy profile make it an attractive treatment strategy, especially in clinical settings where immediate platelet inhibition is required. C1 [Franchi, Francesco; Rollini, Fabiana; Park, Yongwhi; Angiolillo, Dominick J.] Univ Florida, Coll Med Jacksonville, Div Cardiol, Dept Med, Jacksonville, FL 32209 USA. [Park, Yongwhi] Gyeongsang Natl Univ Hosp, Div Cardiol, Jinju, South Korea. C3 State University System of Florida; University of Florida; Gyeongsang National University; Gyeongsang National University Hospital RP Angiolillo, DJ (通讯作者),Univ Florida, Coll Med Jacksonville, 655 West 8th St, Jacksonville, FL 32209 USA. EM dominick.angiolillo@jax.ufl.edu RI Jeong, Young-Hoon/F-3476-2015 OI Jeong, Young-Hoon/0000-0003-0403-3726 FU Sanofi; Eli Lilly; Daiichi-Sankyo; Medicines Company; AstraZeneca; Merck; Abbott Vascular; PLx Pharma; Glaxo Smith Kline; Janssen Pharmaceuticals, Inc.; Osprey Medical, Inc.; Novartis; CSL Behring; Gilead FX DJ Angiolillo received payment as an individual for: a) Consulting fee or honorarium from Sanofi, Eli Lilly, Daiichi-Sankyo, The Medicines Company, AstraZeneca, Merck, Abbott Vascular and PLx Pharma; b) Participation in review activities from CeloNova, and Johnson & Johnson, St. Jude. Institutional payments for grants from Glaxo Smith Kline, Eli Lilly, Daiichi-Sankyo, The Medicines Company, AstraZeneca, Janssen Pharmaceuticals, Inc., Osprey Medical, Inc., Novartis, CSL Behring, and Gilead. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. 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Drug Saf. PD FEB 1 PY 2016 VL 15 IS 2 BP 275 EP 285 DI 10.1517/14740338.2016.1133585 PG 11 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA DE1MH UT WOS:000370390600001 PM 26680584 DA 2023-05-13 ER PT J AU Smith, R Frazer, K Hall, P Hyde, A O'Connor, L AF Smith, Rita Frazer, Kate Hall, Patricia Hyde, Abbey O'Connor, Laserina TI 'Betwixt and between health and illness' - women's narratives following acute coronary syndrome SO JOURNAL OF CLINICAL NURSING LA English DT Article DE acute coronary syndrome; case study research; coronary heart disease; primary/secondary care interface; women's health ID CARDIAC REHABILITATION PROGRAM; HEART-DISEASE; MYOCARDIAL-INFARCTION; PSYCHOLOGICAL ADJUSTMENT; CARDIOVASCULAR-DISEASES; PRIMARY ANGIOPLASTY; SOCIAL SUPPORT; LIFE; PERSPECTIVES; ASSOCIATION AB Aims and Objectives. This study investigated experiences of women with a primary diagnosis of ACS (NSTEMI and Unstable Angina) in the 6-8 week period following discharge from hospital. The aim was to report the experience of the mediating impact of a newly-diagnosed disease.& para;& para;Background. Cardiovascular disease is the main cause of mortality in women. Treatment modalities have improved health outcomes and survival rates, however, quality of life and ongoing morbidity after discharge is not clearly understood from a gender specific perspective.& para;& para;Design. A naturalistic case study design guided this study.& para;& para;Methods. Thirty women participated (n = 30); a within-case followed by a cross case analysis provided meticulous knowledge of each case. Data collection included participant diaries and face to face interviews. Data were analysed using modified analytic induction which allowed the emergence of theoretical insights. The theoretical concepts, liminality and transitioning were used to inform the analysis. Within-methods triangulation captured the depth and breadth of the women's experiences.& para;& para;Results. The data provide an insight into women's experiences following ACS and highlight a need for support structures and services after discharge. Many women reported a period of disrupted normality following discharge from hospital. While a number of women had transitioned towards recovery, many remained in a liminal space 'betwixt and between' health and illness. Cardiac rehabilitation was reported as a positive experience for those who were attending.& para;& para;Conclusions. The findings provide a platform for a wider discourse on the needs of women with ACS in the immediate period after discharge from hospital. Women may benefit from gender-specific, appropriately timed, and targeted interventions to facilitate recovery and adaptation to living with CHD.& para;& para;Relevance to clinical practice. It is essential that secondary prevention services are modelled and tailored to meet the needs of women and evaluated appropriately to ensure positive outcomes. Nursing could have a key role to play in managing and providing this support. C1 [Smith, Rita; Frazer, Kate; Hyde, Abbey; O'Connor, Laserina] Univ Coll Dublin, Sch Nursing Midwifery & Hlth Syst, Dublin, Ireland. [Hall, Patricia] Irish Heart Fdn, Dublin, Ireland. C3 University College Dublin RP Smith, R (通讯作者),Univ Coll Dublin, Sch Nursing Midwifery & Hlth Syst, Dublin, Ireland. 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Clin. Nurs. PD NOV PY 2017 VL 26 IS 21-22 BP 3457 EP 3470 DI 10.1111/jocn.13711 PG 14 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA FP1QS UT WOS:000417389400020 PM 28054410 DA 2023-05-13 ER PT J AU Steg, PG Ducrocq, G AF Steg, Philippe Gabriel Ducrocq, Gregory TI Future of the Prevention and Treatment of Coronary Artery Disease SO CIRCULATION JOURNAL LA English DT Review DE Cholesterol; Coronary artery disease; Inflammation; Prevention ID CARDIOVASCULAR EVENTS; MYOCARDIAL-INFARCTION; SECONDARY PREVENTION; CLINICAL-OUTCOMES; LDL CHOLESTEROL; STATIN THERAPY; BETA-BLOCKERS; RATIONALE; DESIGN; PCSK9 AB With ongoing progress in the prevention and treatment of coronary artery disease (CAD), a continued decrease in prevalence and lethality is expected in high-income countries. Prevention will include lipid-lowering, antithrombotic and anti-inflammatory therapies. With respect to the former, potent, safe and prolonged drugs (such as generic forms of PCSK9 inhibitors relying on monoclonal antibodies or miRNA) should result in a decreased incidence of acute coronary syndromes. Another key aspect will be the ability to identify genetic predictors of CAD and therefore implement targeted personalized prevention early in life. Curative treatment will involve a short course of potent and reversible antithrombotics, but long-term therapy will rely on the ability to stabilize or even regress plaque (eg, using PCSK9 inhibition or modified high-density lipoprotein infusions or anti-inflammatory therapies). Antithrombotic therapy will rely on highly reversible agents (or agents with specific titratable antagonists), and on personalized therapies in which the doses, combinations and duration of therapy will be determined differentially for each patient on the basis of clinical characteristics, genetic profiling and biomarkers. Finally, the need for revascularization in stable CAD will be rare, given the expected progress in prevention. The main challenge, 20 years from now, is likely to be the provision of such effective care at acceptable costs in low-and middle-income countries. C1 [Steg, Philippe Gabriel; Ducrocq, Gregory] French Alliance Cardiovasc Clin Trials FACT, Paris, France. [Steg, Philippe Gabriel; Ducrocq, Gregory] Univ Paris Diderot, INSERM, Bichat Hosp,Fibrosis, AP HP,Inflammat & Remodeling FIRE Dept,U1148, Paris, France. [Steg, Philippe Gabriel] Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Inst Cardiovasc Med & Sci, Natl Heart & Lung Inst, London, England. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; RLUK- Research Libraries UK; Imperial College London; Royal Brompton Hospital RP Steg, PG (通讯作者),Hop Bichat Claude Bernard, Dept Cardiol, 46 Rue Henri Huchard, F-75018 Paris, France. EM gabriel.steg@aphp.fr RI STEG, Philippe Gabriel/Z-1567-2019 OI STEG, Philippe Gabriel/0000-0001-6896-2941 FU Merck; Sanofi; Servier FX Research funds (trust research funds, joint research funds etc) provided by a single company or organization which exceeds an annual total of 1,000,000 yen; - Merck, Sanofi, Servier CR Andersson C, 2014, J AM COLL CARDIOL, V64, P247, DOI 10.1016/j.jacc.2014.04.042 Baigent C, 2010, LANCET, V376, P1670, DOI 10.1016/S0140-6736(10)61350-5 Bangalore S, 2014, CIRC-CARDIOVASC QUAL, V7, P872, DOI 10.1161/CIRCOUTCOMES.114.001073 Bangalore S, 2012, JAMA-J AM MED ASSOC, V308, P1340, DOI 10.1001/jama.2012.12559 Byrne RA, 2015, NEW ENGL J MED, V373, P1969, DOI 10.1056/NEJMe1512331 Cannon CP, 2015, NEW ENGL J MED, V372, P2387, DOI 10.1056/NEJMoa1410489 Collins R, 2009, LANCET, V373, P1849, DOI 10.1016/S0140-6736(09)60503-1 Ellis SG, 2015, NEW ENGL J MED, V373, P1905, DOI 10.1056/NEJMoa1509038 Everett BM, 2013, AM HEART J, V166, P199, DOI 10.1016/j.ahj.2013.03.018 Fitzgerald K, 2014, LANCET, V383, P60, DOI 10.1016/S0140-6736(13)61914-5 Ford ES, 2007, NEW ENGL J MED, V356, P2388, DOI 10.1056/NEJMsa053935 Germano G, 2012, EUR HEART J, V33, P137 Giugliano RP, 2015, J AM COLL CARDIOL, V65, P2638, DOI 10.1016/j.jacc.2015.05.001 Mega JL, 2015, LANCET, V385, P2264, DOI 10.1016/S0140-6736(14)61730-X Montalescot G, 2013, EUR HEART J, V34, P2949, DOI 10.1093/eurheartj/eht296 Nicholls SJ, 2007, JAMA-J AM MED ASSOC, V297, P499, DOI 10.1001/jama.297.5.499 Nidorf SM, 2013, J AM COLL CARDIOL, V61, P404, DOI 10.1016/j.jacc.2012.10.027 Pollack Jr CV, 2015, NEW ENGL J MED, V373, P511, DOI 10.1056/NEJMoa1502000 Ridker PM, 2014, EUR HEART J, V35, P1782, DOI 10.1093/eurheartj/ehu203 Ridker PM, 2011, AM HEART J, V162, P597, DOI 10.1016/j.ahj.2011.06.012 Roberts R, 2014, CIRC RES, V114, P1890, DOI 10.1161/CIRCRESAHA.114.302692 Robinson JG, 2015, NEW ENGL J MED, V372, P1489, DOI 10.1056/NEJMoa1501031 Rohatgi A, 2014, NEW ENGL J MED, V371, P2383, DOI 10.1056/NEJMoa1409065 Sabatine MS, 2016, AM HEART J, V173, P94, DOI 10.1016/j.ahj.2015.11.015 Schwartz GG, 2014, AM HEART J, V168, P682, DOI 10.1016/j.ahj.2014.07.028 Shaw JA, 2008, CIRC RES, V103, P1084, DOI 10.1161/CIRCRESAHA.108.182063 Smeeth L, 2004, NEW ENGL J MED, V351, P2611, DOI 10.1056/NEJMoa041747 Sorbets E, 2014, EUR HEART J, V35, P1760, DOI 10.1093/eurheartj/ehu078 Steg PG, 2014, J AM COLL CARDIOL, V64, P253, DOI 10.1016/j.jacc.2014.04.043 Steg PG, 2013, LANCET, V382, P1981, DOI 10.1016/S0140-6736(13)61615-3 Tunstall-Pedoe H, 1999, LANCET, V353, P1547, DOI 10.1016/S0140-6736(99)04021-0 Wiviott SD, 2015, LANCET, V386, P292, DOI 10.1016/S0140-6736(15)60213-6 Yeh RW, 2016, JAMA-J AM MED ASSOC, V315, P1735, DOI 10.1001/jama.2016.3775 NR 33 TC 24 Z9 25 U1 0 U2 14 PU JAPANESE CIRCULATION SOC PI TOYKO PA 18TH FLOOR IMPERIAL HOTEL TOWER, 1-1-1 UCHISAIWAI-CHO CHIYODA-KU, TOYKO, 100-0011, JAPAN SN 1346-9843 EI 1347-4820 J9 CIRC J JI Circ. J. PD MAY PY 2016 VL 80 IS 5 BP 1067 EP 1072 DI 10.1253/circj.CJ-16-0266 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DN5WP UT WOS:000377142700002 PM 27063295 OA gold DA 2023-05-13 ER PT J AU Abdallah, K Buscetta, A Cooper, K Byeon, J Crouch, A Pink, S Minniti, C Bonham, VL AF Abdallah, Khadijah Buscetta, Ashley Cooper, Kayla Byeon, Julia Crouch, Andrew Pink, Sabrina Minniti, Caterina Bonham, Vence L. TI Emergency Department Utilization for Patients Living With Sickle Cell Disease: Psychosocial Predictors of Health Care Behaviors SO ANNALS OF EMERGENCY MEDICINE LA English DT Article ID HIGH HOSPITAL UTILIZATION; ACUTE CORONARY SYNDROME; MANAGEMENT; SEEKING; ASSOCIATION; NETWORK; VISITS; ADULTS; DELAY; MODEL AB Study objective: Individuals living with sickle cell disease (SCD) often require urgent care; however, some patients hesitate to present to the emergency department (ED), which may increase the risk of serious clinical complications. Our study aims to examine psychosocial, clinical, and demographic factors associated with delaying ED care. Methods: This was a cross-sectional study of 267 adults with SCD from the national INSIGHTS Study. The binary outcome variable asked whether, in the past 12 months, participants had delayed going to an ED when they thought they needed care. Logistic regression was performed with clinical, demographic, and psychosocial measures. Results: Approximately 67% of the participants reported delaying ED care. Individuals who delayed care were more likely to have reported higher stigma experiences (odds ratio [OR]=1.09; 95% confidence interval [CI] 1.03 to 1.16), more frequent pain episodes (OR=1.15; 95% CI 1.01 to 1.32), lower health care satisfaction (OR= 0.74; 95% CI 0.59 to 0.94), and more frequent ED visits (OR=6.07; 95% CI 1.18 to 31.19). Disease severity and demographics, including sex, age, and health insurance status, were not significantly associated with delay in care. Conclusion: Psychosocial factors, including disease stigma and previous negative health care experiences, are associated with delay of ED care in this SCD cohort. There is a need to further investigate the influence of psychosocial factors on the health care-seeking behaviors of SCD patients, as well as the downstream consequences of these behaviors on morbidity and mortality. The resulting knowledge can contribute to efforts to improve health care experiences and patient-provider relationships in the SCD community. C1 [Abdallah, Khadijah; Buscetta, Ashley; Cooper, Kayla; Byeon, Julia; Bonham, Vence L.] NIH, Social & Behav Branch, Natl Human Genome Res Inst, Bethesda, MD 20892 USA. [Crouch, Andrew; Pink, Sabrina; Minniti, Caterina] Albert Einstein Coll Med, Montefiore Med Ctr, Div Hematol, Sickle Cell Ctr, Bronx, NY USA. C3 National Institutes of Health (NIH) - USA; NIH National Human Genome Research Institute (NHGRI); Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine RP Abdallah, K (通讯作者),NIH, Social & Behav Branch, Natl Human Genome Res Inst, Bethesda, MD 20892 USA. EM khadijah.abdallah@nih.gov RI Minniti, Caterina/AAX-3187-2021 FU Division of Intramural Research, National Human Genome Research Institute [ZIAHG200394]; Office of Minority Health of the US Department of Health and Human Services FX By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). This work was supported in part by the Division of Intramural Research, National Human Genome Research InstituteZIAHG200394. Publication of this supplement was supported by the Office of Minority Health of the US Department of Health and Human Services. 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Goes-Neto, Aristoteles Azevedo, Vasco Ghosh, Preetam Barh, Debmalya TI Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms SO VIRUSES-BASEL LA English DT Review DE pathophysiology; adverse effects; systemic effects; COVID-19; molecular mechanism ID CASE SERIES; INFECTION; OUTCOMES; COMORBIDITIES; CORONAVIRUS; PREVALENCE; THROMBOSIS; DISEASE; INJURY AB The COVID-19 pandemic has infected millions worldwide, leaving a global burden for long-term care of COVID-19 survivors. It is thus imperative to study post-COVID (i.e., short-term) and long-COVID (i.e., long-term) effects, specifically as local and systemic pathophysiological outcomes of other coronavirus-related diseases (such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)) were well-cataloged. We conducted a comprehensive review of adverse post-COVID health outcomes and potential long-COVID effects. We observed that such adverse outcomes were not localized. Rather, they affected different human systems, including: (i) immune system (e.g., Guillain-Barre syndrome, rheumatoid arthritis, pediatric inflammatory multisystem syndromes such as Kawasaki disease), (ii) hematological system (vascular hemostasis, blood coagulation), (iii) pulmonary system (respiratory failure, pulmonary thromboembolism, pulmonary embolism, pneumonia, pulmonary vascular damage, pulmonary fibrosis), (iv) cardiovascular system (myocardial hypertrophy, coronary artery atherosclerosis, focal myocardial fibrosis, acute myocardial infarction, cardiac hypertrophy), (v) gastrointestinal, hepatic, and renal systems (diarrhea, nausea/vomiting, abdominal pain, anorexia, acid reflux, gastrointestinal hemorrhage, lack of appetite/constipation), (vi) skeletomuscular system (immune-mediated skin diseases, psoriasis, lupus), (vii) nervous system (loss of taste/smell/hearing, headaches, spasms, convulsions, confusion, visual impairment, nerve pain, dizziness, impaired consciousness, nausea/vomiting, hemiplegia, ataxia, stroke, cerebral hemorrhage), (viii) mental health (stress, depression and anxiety). We additionally hypothesized mechanisms of action by investigating possible molecular mechanisms associated with these disease outcomes/symptoms. Overall, the COVID-19 pathology is still characterized by cytokine storm that results to endothelial inflammation, microvascular thrombosis, and multiple organ failures. C1 [Andrade, Bruno Silva; Siqueira, Sergio; de Assis Soares, Wagner Rodrigues; Rangel, Fernanda de Souza; Freitas, Andria dos Santos; da Silveira, Priscila Ribeiro] Univ Estadual Sudoeste Bahia UESB, Dept Ciencias Biol, Lab Bioinformat & Quim Computac, BR-45206190 Jequie, BA, Brazil. [de Assis Soares, Wagner Rodrigues] Univ Estadual Sudoeste Bahia UESB, Dept Saude 2, BR-45206190 Jequie, BA, Brazil. [Rangel, Fernanda de Souza; Santos, Naiane Oliveira] Univ Estadual Santa Cruz, Programa Posgrad Genet & Biol Mol, BR-45662900 Ilheus, BA, Brazil. [Freitas, Andria dos Santos; Tiwari, Sandeep; Azevedo, Vasco] Univ Fed Minas Gerais, Inst Ciencias Biol, Dept Biol Geral, Lab Genet Celular & Mol, BR-31270901 Belo Horizonte, MG, Brazil. [Alzahrani, Khalid J.] Taif Univ, Coll Appl Med Sci, Dept Clin Labs Sci, POB 11099, At Taif 21944, Saudi Arabia. [Goes-Neto, Aristoteles] Univ Fed Minas Gerais UFMG, Dept Microbiol, Lab Biol Mol & Computac Fungos, Inst Ciencias Biol, BR-31270901 Belo Horizonte, MG, Brazil. [Ghosh, Preetam] Virginia Commonwealth Univ, Dept Comp Sci, Richmond, VA 23284 USA. [Barh, Debmalya] Inst Integrat Omics & Appl Biotechnol IIOAB, Ctr Genom & Appl Gene Technol, Purba Medinipur 721172, W Bengal, India. C3 Universidade Estadual do Sudoeste da Bahia; Universidade Estadual do Sudoeste da Bahia; Universidade Estadual de Santa Cruz; Universidade Federal de Minas Gerais; Taif University; Virginia Commonwealth University RP Barh, D (通讯作者),Inst Integrat Omics & Appl Biotechnol IIOAB, Ctr Genom & Appl Gene Technol, Purba Medinipur 721172, W Bengal, India. EM bandrade@uesb.edu.br; sergio.siqueira@uesb.edu.br; wrasoares@uesb.edu.br; fernandarangelfarma26@gmail.com; naianeoliveira059@gmail.com; andria.sfreitas@gmail.com; prirs91@hotmail.com; sandip_sbtbi@yahoo.com; ak.jamaan@tu.edu.sa; arigoesneto@gmail.com; vascoariston@gmail.com; preetam.ghosh@gmail.com; dr.barh@gmail.com RI Barh, Debmalya/O-4246-2015; Alzahrani, Khalid/AAJ-4886-2021; Andrade, Bruno S/C-8170-2013; Azevedo, Vasco/B-1556-2019 OI Barh, Debmalya/0000-0002-2557-7768; Alzahrani, Khalid/0000-0002-6688-0106; Azevedo, Vasco/0000-0002-4775-2280; Soares, Wagner Rodrigues de Assis Soares/0000-0001-9041-9777; Andrade, Bruno/0000-0002-8031-9454; Ghosh, Preetam/0000-0003-3880-5886; OLIVEIRA SANTOS, NAIANE/0000-0001-5138-9042 CR Abdelmohsen MA, 2020, EGYPT J RADIOL NUC M, V51, DOI 10.1186/s43055-020-00317-9 Acharya S, 2020, IDCases, V22, DOI 10.1016/j.idcr.2020.e00968 Ackermann M, 2020, NEW ENGL J MED, V383, P120, DOI 10.1056/NEJMoa2015432 Aird WC, 2007, CIRC RES, V100, P174, DOI 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Soufer, Robert TI Post-traumatic Stress Disorder and Cardiovascular Disease SO CURRENT CARDIOLOGY REPORTS LA English DT Review DE Post-traumatic stress disorder; Cardiovascular disease; Hypertension; Stress; Anxiety ID ACUTE CORONARY SYNDROME; QUALITY-OF-LIFE; MENTAL STRESS; HEART-DISEASE; ENDOTHELIAL DYSFUNCTION; MYOCARDIAL-INFARCTION; MEDICATION ADHERENCE; SLEEP DISTURBANCES; HEALTH BEHAVIORS; VIETNAM VETERANS AB Post-traumatic stress disorder (PTSD) is a disabling condition that develops consequent to trauma exposure such as natural disasters, sexual assault, automobile accidents, and combat that independently increases risk for early incident cardiovascular disease (CVD) and cardiovascular (CV) mortality by over 50 % and incident hypertension risk by over 30 %. While the majority of research on PTSD and CVD has concerned initially healthy civilian and military veteran samples, emerging research is also demonstrating that PTSD consequent to the trauma of an acute cardiac event significantly increases risk for early recurrence and mortality and that patient experiences in the clinical pathway that are related to the emergency department environment may provide an opportunity to prevent PTSD onset and thus improve outcomes. Future directions for clinical and implementation science concern broad PTSD and trauma screening in the context of primary care medical environments and the testing of PTSD treatments with CVD-related surrogates and endpoints. C1 [Burg, Matthew M.; Soufer, Robert] Yale Univ, Sch Med, Dept Med, Sect Cardiovasc Med, 333 Cedar St, New Haven, CT 06510 USA. [Burg, Matthew M.] Yale Univ, Sch Med, Dept Anesthesiol, New Haven, CT 06510 USA. [Burg, Matthew M.; Soufer, Robert] VA Connecticut Healthcare Syst, Sect Cardiovasc Med, West Haven, CT 06516 USA. C3 Yale University; Yale University; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Connecticut Healthcare System RP Burg, MM (通讯作者),Yale Univ, Sch Med, Dept Med, Sect Cardiovasc Med, 333 Cedar St, New Haven, CT 06510 USA.; Burg, MM (通讯作者),Yale Univ, Sch Med, Dept Anesthesiol, New Haven, CT 06510 USA.; Burg, MM (通讯作者),VA Connecticut Healthcare Syst, Sect Cardiovasc Med, West Haven, CT 06516 USA. 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Cardiol. Rep. PD OCT PY 2016 VL 18 IS 10 AR 94 DI 10.1007/s11886-016-0770-5 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA DW4DM UT WOS:000383592600010 PM 27566327 DA 2023-05-13 ER PT J AU Bunch, AM Leasure, AR Carithers, C Burnette, RE Berryman, MS AF Bunch, Azalea Marie Leasure, A. Renee Carithers, Cathrin Burnette, Robert E., Jr. Berryman, Michael Scott, Sr. TI Implementation of a rapid chest pain protocol in the emergency department: A quality improvement project SO JOURNAL OF THE AMERICAN ASSOCIATION OF NURSE PRACTITIONERS LA English DT Article DE Emergency department; cardiac biomarkers; chest pain; screening; protocol; quality improvement ID ACUTE-CORONARY-SYNDROME; ACUTE MYOCARDIAL-INFARCTION; TIMI RISK SCORE; DIAGNOSTIC PROTOCOL; CARDIAC TROPONINS; PARIHS FRAMEWORK; CARE; VALIDATION; MARKERS; ASSAY AB PurposeThe purpose of this quality improvement (QI) project is to compare the effectiveness of a rapid 90-min chest pain screening and evaluation protocol to a 120-min screening and evaluation protocol in determining patient readiness for hospital admission or discharge home. Data SourcesThe existing chest pain protocol utilized in the emergency department (ED) was revised based on a review of current research changing initial screening and reevaluation times from 120 to 90 min. A prospective comparative study of patients presenting to the ED with chest pain was performed comparing the existing chest pain protocol of 120 min (standard care) with a rapid screening evaluation protocol of 90 min. A total of 128 patients presenting to an ED in Texas with chest pain comprised the sample for this study. ConclusionsThere was a significant difference in the number of minutes between the groups for readiness for disposition. The average time from chest pain evaluation to readiness for disposition home, observation, or admission decreased from an average of 191 min in the standard care group to an average of 118 min in the rapid screening group. Implications for practiceUse of the rapid screening and evaluation protocol decreased the time to disposition by an average of 73 min, which enhanced ED flow without influencing disposition and patient safety. C1 [Bunch, Azalea Marie] TeamHeath Mem Hermann Hlth Care Syst, Emergency Dept, Huntsville, TX USA. [Bunch, Azalea Marie] TeamHeath Mem Hermann Hlth Care Syst, Emergency Dept, The Woodlands, TX USA. [Leasure, A. Renee] Univ Oklahoma, Hlth Sci Ctr, Coll Nursing, Oklahoma City, OK USA. [Carithers, Cathrin] Univ Arkansas Med Sci, Nursing Practice Program, Little Rock, AR 72205 USA. [Burnette, Robert E., Jr.] Mem Hermann, Emergency Dept, Houston, TX USA. [Berryman, Michael Scott, Sr.] Woodlands Fire Dept, The Woodlands, TX USA. C3 University of Oklahoma System; University of Oklahoma Health Sciences Center; University of Arkansas System; University of Arkansas Medical Sciences RP Bunch, AM (通讯作者),2312 Hollowbrook Lane, Conroe, TX 77384 USA. EM msbunch@consolidated.net CR Aldous S, 2012, EMERG MED J, V29, P805, DOI 10.1136/emermed-2011-200222 Aldous SJ, 2012, ACAD EMERG MED, V19, P510, DOI 10.1111/j.1553-2712.2012.01352.x Anderson JL, 2013, J AM COLL CARDIOL, V61, pE179, DOI 10.1016/j.jacc.2013.01.014 Antman EM, 2000, JAMA-J AM MED ASSOC, V284, P835, DOI 10.1001/jama.284.7.835 Chase M, 2006, ANN EMERG MED, V48, P252, DOI 10.1016/j.annemergmed.2006.01.032 Chin CT, 2012, CLIN CARDIOL, V35, P424, DOI 10.1002/clc.21980 Cullen L, 2014, AM J EMERG MED, V32, P129, DOI 10.1016/j.ajem.2013.10.021 Cullen L, 2013, HEART LUNG CIRC, V22, P844, DOI 10.1016/j.hlc.2013.03.074 Dadkhah Shahriar, 2007, Crit Pathw Cardiol, V6, P76, DOI 10.1097/HPC.0b013e318053d1c9 Davidoff F, 2008, QUAL SAF HEALTH CARE, V17, P3, DOI 10.1136/qshc.2008.029066 de Groot B, 2014, EMERG MED J, V31, P882, DOI 10.1136/emermed-2013-202865 de Lemos JA, 2013, JAMA-J AM MED ASSOC, V309, P2262, DOI 10.1001/jama.2013.5809 Diercks DB, 2012, AM HEART J, V163, P74, DOI 10.1016/j.ahj.2011.09.028 Ekelund U, 2007, EMERG MED J, V24, P811, DOI 10.1136/emj.2007.048249 Every NR, 2000, CIRCULATION, V101, P461, DOI 10.1161/01.CIR.101.4.461 Freund Y, 2011, CRIT CARE, V15, DOI 10.1186/cc10270 Go AS, 2014, CIRCULATION, V129, pE28, DOI 10.1161/01.cir.0000441139.02102.80 Goodacre S, 2011, HEALTH TECHNOL ASSES, V15, P1, DOI 10.3310/hta15230 JOISBILOWICH P, 2010, EMERGENCY MED REPORT, V31, P25 Kitson AL, 2008, IMPLEMENT SCI, V3, DOI 10.1186/1748-5908-3-1 Kost GJ, 2010, POINT CARE, V9, P53, DOI 10.1097/POC.0b013e3181d9d45c Kost GJ, 2005, CARDIOL CLIN, V23, P467, DOI 10.1016/j.ccl.2005.08.005 Lee Betsy, 2011, Crit Pathw Cardiol, V10, P64, DOI 10.1097/HPC.0b013e31821c79bd Lee TH, 2000, NEW ENGL J MED, V342, P1187, DOI 10.1056/NEJM200004203421607 Lesneski L, 2000, J Emerg Nurs, V26, P125 Lesneski L, 2010, APPL NURS RES, V23, P185, DOI 10.1016/j.apnr.2008.09.004 Lewandrowski K, 2009, CLIN LAB MED, V29, P561, DOI 10.1016/j.cll.2009.06.007 Lyon R, 2007, RESUSCITATION, V74, P90, DOI 10.1016/j.resuscitation.2006.11.023 McCord J, 2001, CIRCULATION, V104, P1483, DOI 10.1161/hc3801.096336 McCormack B, 2002, J ADV NURS, V38, P94, DOI 10.1046/j.1365-2648.2002.02150.x Morris AC, 2006, HEART, V92, P1333, DOI 10.1136/hrt.2005.080226 Ogrinc G, 2008, QUAL SAF HEALTH CARE, V17, P13, DOI 10.1136/qshc.2008.029058 Ottinger D, 2013, NEONATAL NETW, V32, P365, DOI 10.1891/0730-0832.32.5.365 Parato VM, 2010, ECHOCARDIOGR-J CARD, V27, P597, DOI 10.1111/j.1540-8175.2010.01166.x Pollack CV, 2006, ACAD EMERG MED, V13, P13, DOI 10.1197/j.aem.2005.06.031 Rycroft-Malone J, 2004, J ADV NURS, V47, P81, DOI 10.1111/j.1365-2648.2004.03068.x Rycroft-Malone J, 2004, J NURS CARE QUAL, V19, P297, DOI 10.1097/00001786-200410000-00002 Rycroft-Malone J, 2004, J CLIN NURS, V13, P913, DOI 10.1111/j.1365-2702.2004.01007.x Rycroft-Malone J, 2013, IMPLEMENT SCI, V8, DOI 10.1186/1748-5908-8-28 Schreiber DH, 2012, CLIN BIOCHEM, V45, P1295, DOI 10.1016/j.clinbiochem.2012.06.005 Storrow AB, 2006, POINT CARE, V5, P132, DOI 10.1097/01.poc.0000232334.13428.7a Than M, 2011, LANCET, V377, P1077, DOI 10.1016/S0140-6736(11)60310-3 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Thygesen K, 2012, EUR HEART J, V33, P2252, DOI 10.1093/eurheartj/ehs154 Wu AHB, 2006, POINT CARE, V5, P20, DOI 10.1097/00134384-200603000-00006 NR 45 TC 1 Z9 1 U1 2 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 2327-6886 EI 2327-6924 J9 J AM ASSOC NURSE PRA JI J. 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PD FEB PY 2016 VL 28 IS 2 BP 75 EP 83 DI 10.1002/2327-6924.12260 PG 9 WC Health Care Sciences & Services; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services; Nursing GA DC3ZO UT WOS:000369159500005 PM 25946652 DA 2023-05-13 ER PT J AU Telec, W Krysztofiak, H Sowinska, A Kalmucki, P Monkiewicz, K Wruk, BA Szyszka, A Baszko, A AF Telec, Wojciech Krysztofiak, Helena Sowinska, Anna Kalmucki, Piotr Monkiewicz, Klaudia Wruk, Berenika Anna Szyszka, Andrzej Baszko, Artur TI The long-term benefit of a cardiac rehabilitation program after myocardial infarction in patients under the Managed Care for Acute Myocardial Infarction Survivors (MACAMIS) program in Poland: A single-center study SO KARDIOLOGIA POLSKA LA English DT Article DE acute coronary syndrome; acute myocardial infarction; cardiac rehabilitation; cardio-vascular disease ID PHYSICAL-ACTIVITY; EXERCISE; PARTICIPATION; MORTALITY; FITNESS AB Background: The Managed Care for Acute Myocardial Infarction Survivors (MACAMIS) program introduced for patients after myocardial infarction (MI) consists of 4 modules including early cardiac rehabilitation (CR).Aims: We compared the impact of CR on survival of patients after MI included in the MACAMIS program.Methods: Patients in MACAMIS were divided into subgroups based on being qualified or not qual-ified for CR and on whether they completed or failed to complete CR. We evaluated one-, two-, and three-year mortality.Results: Of 244 patients in MACAMIS, 174 patients were qualified for CR. They were younger, had less advanced coronary artery disease (CAD), higher ejection fraction (EF), and fewer comorbidities. Finally, 102 (58.6%) patients completed CR. These patients were younger and more likely to have STEMI; they were more often treated invasively, with no differences in comorbidity burden. The survival rates at one, two, and three years were 93.6%, 87.8%, and 65.0%, respectively. Patients who qualified for CR had a better prognosis. The mortality rates at one, two, and three years were 2.38% vs. 16.18% (P = 0.0003), 6.71% vs. 25.4% (P = 0.002), and 26.87% vs. 51.35% (P = 0.01), respectively. Patients who completed CR, again, had a significantly better prognosis. The mortality rate was 1% vs. 10.29% (P = 0.009), 4.17% vs. 17.56% (P = 0.002), and 23.33% vs. 40.54% (P = 0.09) in analyzed periods. The only independent factors related to survival were completion of CR and number of comorbidities.Conclusions: Patients with MI in the MACAMIS program had better prognosis when participating in CR. After completing the MACAMIS program, increased mortality was observed in the following years. Despite the flexibility of the CR program, the proportion of patients who qualified and com-pleted CR remained low. C1 [Telec, Wojciech; Szyszka, Andrzej; Baszko, Artur] Poznan Univ Med Sci, Dept Cardiol 2, Poznan, Poland. [Krysztofiak, Helena; Kalmucki, Piotr] HCP Med Ctr, Cardiol Ward, Poznan, Poland. [Sowinska, Anna] Poznan Univ Med Sci, Dept Comp Sci & Stat, Poznan, Poland. [Monkiewicz, Klaudia; Wruk, Berenika Anna] HCP Med Ctr, Cardiac Rehabil Ward, Poznan, Poland. [Baszko, Artur] Poznan Univ Med Sci, Dept Cardiol 2, 28 Czerwca 1956 St 194, PL-61485 Poznan, Poland. C3 Poznan University of Medical Sciences; Poznan University of Medical Sciences; Poznan University of Medical Sciences RP Baszko, A (通讯作者),Poznan Univ Med Sci, Dept Cardiol 2, 28 Czerwca 1956 St 194, PL-61485 Poznan, Poland. EM abaszko@ump.edu.pl RI Szyszka, Andrzej/HPD-1547-2023 CR Anderson L, 2016, COCHRANE DB SYST REV, DOI [10.1002/14651858.CD001800.pub3, 10.1016/j.jacc.2015.10.044] De Luca L, 2020, KARDIOL POL, V78, P850, DOI 10.33963/KP.15529 Dunlay SM, 2014, AM J MED, V127, P538, DOI 10.1016/j.amjmed.2014.02.008 Ernstsen L, 2016, AM J MED, V129, P82, DOI 10.1016/j.amjmed.2015.08.012 Feusette P, 2019, KARDIOL POL, V77, P568, DOI 10.5603/KP.a2019.0038 Gierlotka M, 2015, KARDIOL POL, V73, P142, DOI 10.5603/KP.a2014.0213 Jankowski P, 2021, CIRC-CARDIOVASC QUAL, V14, DOI 10.1161/CIRCOUTCOMES.120.007800 Jankowski P, 2016, KARDIOL POL, V74, P800, DOI 10.5603/KP.2016.0118 Kachur S, 2017, PROG CARDIOVASC DIS, V60, P103, DOI 10.1016/j.pcad.2017.07.002 Kubielas G, 2022, KARDIOL POL, V80, P315, DOI 10.33963/KP.a2022.0035 Lavie CJ, 2015, CIRC RES, V117, P207, DOI 10.1161/CIRCRESAHA.117.305205 Martin BJ, 2013, MAYO CLIN PROC, V88, P455, DOI 10.1016/j.mayocp.2013.02.013 Meillier LK, 2012, SCAND J PUBLIC HEALT, V40, P286, DOI 10.1177/1403494812443600 Morrin L, 2000, J Cardiopulm Rehabil, V20, P115, DOI 10.1097/00008483-200003000-00005 Piotrowicz R, 2021, KARDIOL POL, V79, P215, DOI 10.33963/KP.15824 Santulli G, 2013, JCVD, V1, P1, DOI DOI 10.3390/JCDD1010001 Sunamura M, 2017, NETH HEART J, V25, P618, DOI 10.1007/s12471-017-1039-3 Swift DL, 2013, CIRC J, V77, P281, DOI 10.1253/circj.CJ-13-0007 Windecker S, 2019, EUR HEART J, V40, P204, DOI 10.1093/eurheartj/ehy532 NR 19 TC 0 Z9 0 U1 0 U2 0 PU POLISH CARDIAC SOC-POLSKIE TOWARZYSTWO KARDIOLOGICZNE PI WARSZAWA PA UL STAWKI 3 A LOK 1-2, WARSZAWA, POLAND SN 0022-9032 EI 1897-4279 J9 KARDIOL POL JI Kardiol. Pol. PD SEP 7 PY 2022 VL 80 IS 12 BP 1238 EP 1247 DI 10.33963/KP.a2022.0207 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 7S9GQ UT WOS:000911059500001 PM 36069197 OA gold DA 2023-05-13 ER PT J AU Marquis-Gravel, G Robert-Halabi, M Bainey, KR Tanguay, JF Mehta, SR AF Marquis-Gravel, Guillaume Robert-Halabi, Maxime Bainey, Kevin R. Tanguay, Jean-Francois Mehta, Shamir R. TI The Evolution of Antiplatelet Therapy After Percutaneous Coronary Interventions: A 40-Year Journey SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Review ID UNSTABLE ANGINA; MYOCARDIAL-INFARCTION; FOCUSED UPDATE; DOUBLE-BLIND; TICAGRELOR MONOTHERAPY; CARDIOVASCULAR EVENTS; PLATELET-AGGREGATION; RECEPTOR ANTAGONIST; CLOPIDOGREL; ASPIRIN AB Antiplatelet therapy has a critical role to play in the successful management of patients undergoing percutaneous coronary intervention (PCI). Over the past 40 years, a multitude of participants worldwide have been enrolled in trials evaluating the impact of antiplatelet agents on clinical outcomes. The use of aspirin in unstable angina in the Canadian Aspirin trial was key to establishing the benefit of aspirin in acute coronary syndrome. The Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) trial demonstrated that the P2Y12 inhibitor clopidogrel, when added to aspirin, reduced major cardiovascular events. While the use of antiplatelet agents in coronary artery disease antedates the introduction of PCI and remains the cornerstone of secondary prevention of atherosclerotic cardiovascular disease, strategies aiming to optimise their best use are still constantly evolving. In this review, the major randomised trials shaping current clinical practice for the use of aspirin and P2Y12 inhibitors in patients undergoing PCI are summarised, with a focus on aspirin-free strategies and on the role of P2Y12 inhibitor treatment before PCI, two major topics of ongoing investigation that are critical to patient care but that are not addressed in current practice guidelines. Multiple questions remain regarding the use of antiplatelet agents after PCI, including the personalisation of dosing, intensity, pharmacologic formulation, and duration of antiplatelet therapy based on individual patient characteristics and the optimal treatment of patients at high bleeding risk. C1 [Marquis-Gravel, Guillaume; Robert-Halabi, Maxime; Tanguay, Jean-Francois] Univ Montreal, Montreal Heart Inst, Montreal, PQ, Canada. [Bainey, Kevin R.] Univ Alberta, Mazankowski Alberta Heart Inst, Edmonton, AB, Canada. [Mehta, Shamir R.] McMaster Univ, Populat Hlth Res Inst, Hamilton, ON, Canada. [Mehta, Shamir R.] Hamilton Hlth Sci, Hamilton, ON, Canada. C3 Universite de Montreal; University of Alberta; McMaster University; Population Health Research Institute; McMaster University RP Mehta, SR (通讯作者),Hamilton Hlth Sci, Populat Hlth Res Inst, Gen Div, 237 Barton St E, Hamilton, ON L8L 2X2, Canada. EM smehta@mcmaster.ca FU Fonds de Recherche du Quebec e Sante (FRQS); Montreal Heart Institute Interventional Cardiology Division; Chaire Yves Des Groseillers et Andre Berard de Cardiologie Interventionnelle de l'Universite de Montreal (Yves Des Groseillers and Andre Berard Chair in Interventional Cardiology at the University of Montreal) FX Dr Marquis-Gravel is supported by the Fonds de Recherche du Quebec e Sante (FRQS). Dr Mehta is the Douglas A. Holder/PHRI Chair in Interventional Cardiology at McMaster University.; This article was published as part of a supplement supported by the Montreal Heart Institute Interventional Cardiology Division and the Chaire Yves Des Groseillers et Andre Berard de Cardiologie Interventionnelle de l'Universite de Montreal (Yves Des Groseillers and Andre Berard Chair in Interventional Cardiology at the University of Montreal). 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J. Cardiol. PD OCT PY 2022 VL 38 IS 10 SU 1 BP S79 EP S88 DI 10.1016/j.cjca.2022.02.022 EA OCT 2022 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 5P4CA UT WOS:000873099200009 PM 35231553 DA 2023-05-13 ER PT J AU Cenko, E Badimon, L Bugiardini, R Claeys, MJ De Luca, G de Wit, C Derumeaux, G Dorobantu, M Duncker, DJ Eringa, EC Gorog, DA Hassager, C Heinzel, FR Huber, K Manfrini, O Milicic, D Oikonomou, E Padro, T Trifunovic-Zamaklar, D Vasiljevic-Pokrajcic, Z Vavlukis, M Vilahur, G Tousoulis, D AF Cenko, Edina Badimon, Lina Bugiardini, Raffaele Claeys, Marc J. De Luca, Giuseppe de Wit, Cor Derumeaux, Genevieve Dorobantu, Maria Duncker, Dirk J. Eringa, Etto C. Gorog, Diana A. Hassager, Christian Heinzel, Frank R. Huber, Kurt Manfrini, Olivia Milicic, Davor Oikonomou, Evangelos Padro, Teresa Trifunovic-Zamaklar, Danijela Vasiljevic-Pokrajcic, Zorana Vavlukis, Marija Vilahur, Gemma Tousoulis, Dimitris TI Cardiovascular disease and COVID-19: a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA) SO CARDIOVASCULAR RESEARCH LA English DT Review DE Cardiovascular disease; COVID-19; SARS-CoV-2; cytokines; inflammation; Infection; endothelial dysfunction; microcirculation; thrombosis; Myocardial injury; post-acute COVID-19 ID ANGIOTENSIN-CONVERTING ENZYME; THROMBOEMBOLISM FOLLOWING HOSPITALIZATION; CARDIAC ARREST SYNDROME; MYOCARDIAL INJURY; POSITION PAPER; INFLAMMATORY RESPONSE; SEX-DIFFERENCES; CORONAVIRUS; CARDIOLOGY; EXPRESSION AB The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction, and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and angiotensin-converting enzyme 2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as 'post-acute COVID-19' may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here, we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance. C1 [Cenko, Edina; Bugiardini, Raffaele; Manfrini, Olivia] Univ Bologna, Dept Expt Diagnost & Specialty Med, Via Giuseppe Massarenti 9, I-40134 Bologna, Italy. [Badimon, Lina; Padro, Teresa; Vilahur, Gemma] ICCC Res Inst Hosp Santa Creu & St Pau, Cardiovasc Program, CiberCV, IIB St Pau, Barcelona, Spain. [Claeys, Marc J.] Univ Hosp Antwerp, Dept Cardiol, Edegem, Belgium. [De Luca, Giuseppe] Eastern Piedmont Univ, Cardiovasc Dept Cardiol, Osped Maggiore Carita, Novara, Italy. [de Wit, Cor] Univ Lubeck, Inst Physiol, Lubeck, Germany. [de Wit, Cor] Deutsch Zentrum Herz Kreislauf Forsch DZHK eV Ger, Partner Site Hamburg Kiel Lubeck, Lubeck, Germany. [Derumeaux, Genevieve] UPEC, IMRB U955, Creteil, France. [Derumeaux, Genevieve] Henri Mondor Teaching Hosp, AP HP, Dept Physiol, Creteil, France. [Derumeaux, Genevieve] Federat Hosp Univ SENEC, Creteil, France. [Dorobantu, Maria] Carol Davila Univ Med & Pharm, Bucharest, Romania. [Duncker, Dirk J.] Univ Med Ctr Rotterdam, Thoraxctr, Dept Cardiol, Div Expt Cardiol,Erasmus MC, Rotterdam, Netherlands. [Eringa, Etto C.] Univ Amsterdam, Amsterdam Cardiovasc Sci Inst, Dept Physiol, Med Ctr, Amsterdam, Netherlands. [Eringa, Etto C.] Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Dept Physiol, Maastricht, Netherlands. [Gorog, Diana A.] Imperial Coll, Fac Med, Natl Heart & Lung Inst, London, England. [Gorog, Diana A.] Univ Hertfordshire, Dept Postgrad Med, Hatfield, Herts, England. [Hassager, Christian] Rigshosp, Dept Cardiol, Copenhagen, Denmark. [Hassager, Christian] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark. [Heinzel, Frank R.] Charite Univ Med Berlin, Dept Cardiol, Campus Virchow Klinikum, Berlin, Germany. [Heinzel, Frank R.] DZHK German Ctr Cardiovasc Res, Partner Site Berlin, Berlin, Germany. [Heinzel, Frank R.] Berlin Inst Hlth, Berlin, Germany. [Huber, Kurt] Wilhelminen Hosp, Med Dept 3, Cardiol & Intens Care Med, Vienna, Austria. [Huber, Kurt] Sigmund Freud Univ, Med Sch, Vienna, Austria. [Milicic, Davor] Univ Zagreb, Univ Hosp Ctr Zagreb, Dept Cardiovasc Dis, Zagreb, Croatia. [Oikonomou, Evangelos; Tousoulis, Dimitris] Natl & Kapodistrian Univ Athens, Hippokrat Gen Hosp, Sch Med, Dept Cardiol, Athens, Greece. [Trifunovic-Zamaklar, Danijela] Clin Ctr Serbia, Cardiol Dept, Belgrade, Serbia. [Trifunovic-Zamaklar, Danijela; Vasiljevic-Pokrajcic, Zorana] Univ Belgrade, Fac Med, Belgrade, Serbia. [Vavlukis, Marija] Ss Cyril & Methodius Univ Skopje, Univ Clin Cardiol, Med Fac, Skopje, North Macedonia. C3 University of Bologna; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; University of Antwerp; Azienda Ospedaliera Maggiore della Carita di Novara; University of Eastern Piedmont Amedeo Avogadro; University of Lubeck; Universite Paris-Est-Creteil-Val-de-Marne (UPEC); Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Paul-Brousse - APHP; Universite Paris-Est-Creteil-Val-de-Marne (UPEC); Hopital Universitaire Henri-Mondor - APHP; UDICE-French Research Universities; Universite Paris Cite; Hopital Universitaire Hotel-Dieu - APHP; Carol Davila University of Medicine & Pharmacy; Erasmus University Rotterdam; Erasmus MC; University of Amsterdam; Maastricht University; RLUK- Research Libraries UK; Imperial College London; University of Hertfordshire; Rigshospitalet; University of Copenhagen; University of Copenhagen; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; German Centre for Cardiovascular Research; Berlin Institute of Health; Wilhelminenspital; University of Zagreb; Athens Medical School; National & Kapodistrian University of Athens; Clinical Centre of Serbia; University of Belgrade; Saints Cyril & Methodius University of Skopje RP Cenko, E (通讯作者),Univ Bologna, Dept Expt Diagnost & Specialty Med, Via Giuseppe Massarenti 9, I-40134 Bologna, Italy. EM edina.cenko2@unibo.it RI de Wit, Cor/A-5560-2009; vavlukis, marija/AAK-4746-2021; Cenko, Edina/L-6438-2015; BADIMON, LINA/S-2950-2019; DERUMEAUX, Genevieve A/T-2489-2018; vavlukis, marija/A-2688-2015; Badimon, Lina/O-4711-2014; Bugiardini, Raffaele/L-6446-2015 OI de Wit, Cor/0000-0003-4621-0399; Cenko, Edina/0000-0001-8102-3324; DERUMEAUX, Genevieve A/0000-0003-1471-1631; vavlukis, marija/0000-0002-4479-6691; Dorobantu, Maria/0000-0003-1940-5262; Badimon, Lina/0000-0002-9162-2459; Heinzel, Frank R./0000-0002-4529-5282; Eringa, Etto/0000-0002-9814-5149; Bugiardini, Raffaele/0000-0002-6819-6818; Gorog, Diana/0000-0002-9286-1451; Claeys, Marc/0000-0002-6628-9543 CR Ackermann M, 2020, NEW ENGL J MED, V383, P120, DOI 10.1056/NEJMoa2015432 Ali-Ahmed F, 2020, AM HEART J, V220, P29, DOI 10.1016/j.ahj.2019.08.007 Andelius L, 2021, RESUSC PLUS, V5, DOI 10.1016/j.resplu.2020.100075 [Anonymous], 2017, LANCET, DOI DOI 10.1016/S0140-6736(17)30819-X [Anonymous], 2018, J HYPERTENS, DOI [DOI 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Res. PD DEC 17 PY 2021 VL 117 IS 14 BP 2705 EP 2729 DI 10.1093/cvr/cvab298 PG 25 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZA1UO UT WOS:000755951900009 PM 34528075 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Behera, JR Jain, MK Sahu, SK Patnaik, S AF Behera, Jyoti R. Jain, Mukesh K. Sahu, Sanjay K. Patnaik, Sibabratta TI Multisystem Inflammatory Syndrome in Children Associated with COVID-19: An Interim Review SO JOURNAL OF PEDIATRIC INFECTIOUS DISEASES LA English DT Review DE hyperinflammation; immune enhancement; Kawasaki's disease; autoantibodies ID SARS-COV-2 PIMS-TS; KAWASAKI-DISEASE; INTRAVENOUS IMMUNOGLOBULIN; IMMUNE-COMPLEXES; SHOCK AB The pediatric population is relatively less affected by novel coronavirus disease 2019 (COVID-19) compared with adults, both in numbers and severity. However, evolution of a new entity, named multisystem inflammatory syndrome in children (MIS-C), has led to significant number of children being admitted to hospital, especially to intensive care units. Case definitions of MIS-C have been defined by the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) separately. Autoantibodies and antibody-dependent enhancement (ADE) are the key factors proposed in pathogenesis, leading to immune dysregulation, and cytokine storm. Three distinct clinical types are observed as follows: (1) fever and elevated inflammatory markers with no end-organ damage; (2) shock with severe myocardial dysfunction similar to toxic shock syndrome (155); and (3) with mucocutaneous features like Kawasaki's disease (KD). Cardiovascular and gastrointestinal symptoms are the predominant presentations. Inflammatory markers like C-reactive protein (CRP), ferritin, and interleukin (IL)-6 are raised along with high D-dimer and lactate dehydrogenase (LDH). Echocardiography may demonstrate low left ventricular ejection fraction (<50%) and/or coronary aneurysms. Reverse-transcription polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is usually negative, with most having antibodies against the virus. KD, KD shock syndrome (KDSS), and toxic shock syndrome (TSS) are the important differential diagnoses to be considered. Immunomodulatory therapy is the cornerstone of the management. Intravenous immunoglobulin (IVIg) is preferred, the next option being steroids. Supportive care, antiplatelet, and anticoagulation medications, when indicated, are also vital aspects of treatment plan. The prognosis is favorable with low mortality but meticulous cardiac monitoring and follow-up by a multidisciplinary team is very important. Being an evolving disease, future research may reveal different manifestations, newer diagnostic modalities, and better treatment options. C1 [Behera, Jyoti R.; Jain, Mukesh K.; Sahu, Sanjay K.; Patnaik, Sibabratta] Kalinga Inst Med Sci, Dept Pediat, Bhubaneswar 751024, Odisha, India. C3 Kalinga Institute of Industrial Technology (KIIT) RP Patnaik, S (通讯作者),Kalinga Inst Med Sci, Dept Pediat, Bhubaneswar 751024, Odisha, India. 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Pediatr. Infect. Dis. PD JUL PY 2021 VL 16 IS 04 BP 137 EP 147 DI 10.1055/s-0041-1729182 EA JUN 2021 PG 11 WC Infectious Diseases; Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Infectious Diseases; Pediatrics GA TD4ZY UT WOS:000660241900001 DA 2023-05-13 ER PT J AU Michels, G Hempel, D Pfister, R Janssens, U AF Michels, G. Hempel, D. Pfister, R. Janssens, U. TI Emergency ultrasound and echocardiography in patients with infarct-related cardiogenic shock: Asurvey among members of the German Society of Medical Intensive Care and Emergency Medicine SO MEDIZINISCHE KLINIK-INTENSIVMEDIZIN UND NOTFALLMEDIZIN LA English DT Article DE Cardiogenic shock; Focused echocardiography; Emergency ultrasound; Education in ultrasound; Acute coronary syndrome; Critical care unit ID EUROPEAN ASSOCIATION; CARDIAC ULTRASONOGRAPHY; APPROPRIATE USE; GUIDELINES; MANAGEMENT; DIAGNOSIS; RECOMMENDATIONS; ESC AB Current international and national guidelines promote the use of emergency echocardiography in patients with cardiogenic shock. We assessed whether these recommendations are followed in clinical practice of infarct-related cardiogenic shock patients. For this purpose we conducted aweb-based survey among all members of the German Society of Medical Intensive Care and Emergency Medicine (DGIIN); 40% of the DGIIN members completed the survey. Participants reported that in their department emergency echocardiography/ultrasound is performed on most patients in infarct-related cardiogenic shock presenting to the emergency department/chest pain unit or intensive care unit (58.6% versus 81.4%). Only 33% stated that on patients admitted directly to the catheterization laboratory emergency ultrasound/echocardiography is applied in their institution. Local availability of astandardized algorithm was lacking in the majority of departments (77.2%). Agreat proportion (38.3%) of participants stated that they personally had no formal training in emergency ultrasound. In order to meet the demands of the current guidelines, in addition to integration of ultrasound examinations into diagnostic algorithms, astructured training of all emergency and intensive care physicians is necessary. C1 [Michels, G.; Pfister, R.] Univ Hosp Cologne, Dept Internal Med 3, Kerpener Str 62, D-50937 Cologne, Germany. [Hempel, D.] Univ Hosp Jena, Dept Emergency Med, Jena, Germany. [Janssens, U.] St Antonius Hosp, Dept Cardiol, Eschweiler, Germany. C3 University of Cologne; Friedrich Schiller University of Jena; Saint Antonius Hospital RP Michels, G (通讯作者),Univ Hosp Cologne, Dept Internal Med 3, Kerpener Str 62, D-50937 Cologne, Germany. 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Snavely, Anna C. Ashburn, Nicklaus P. Nelson, R. Darrell. McMurray, Evan L. Hunt, Meagan R. Miller, Chadwick D. Mahler, Simon A. TI EMS blood collection from patients with acute chest pain reduces emergency department length of stay SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Chest pain; Prehospital; EMS; Troponin; Acute coronary syndrome ID SENSITIVITY TROPONIN-T; QUALITY; CARE; DIAGNOSIS; TRIAL; TIME AB Background: Expediting the measurement of serum troponin by leveraging EMS blood collection could reduce the diagnostic time for patients with acute chest pain and help address Emergency Department (ED) overcrowding. However, this practice has not been examined among an ED chest pain patient population in the United States. Methods: A prospective observational cohort study of adults with non-traumatic chest pain without ST-segment elevation myocardial infarction was conducted in three EMS agencies between 12/2016-4/2018. During trans-port, paramedics obtained a patient blood sample that was sent directly to the hospital core lab for troponin mea-surement. On ED arrival HEART Pathway assessments were completed by ED providers as part of standard care. ED providers were blinded to troponin results from EMS blood samples. To evaluate the potential impact on length of stay (LOS), the time difference between EMS blood draw and first clinical ED draw was calculated. To determine the safety of using troponin measures from EMS blood samples, the diagnostic performance of the HEART Pathway for 30-day major adverse cardiac events (MACE: composite of cardiac death, myocardial infarc-tion (MI), coronary revascularization) was determined using EMS troponin plus arrival ED troponin and EMS tro-ponin plus a serial 3-h ED troponin. Results: The use of EMS blood samples for troponin measures among 401 patients presenting with acute chest pain resulted in a mean potential reduction in LOS of 72.5 +/- SD 35.7 min. MACE at 30 days occurred in 21.0% (84/401), with 1 cardiac death, 78 MIs, and 5 revascularizations without MI. Use of the HEART Pathway with EMS and ED arrival troponin measures yielded a NPV of 98.0% (95% CI: 89.6-100). NPV improved to 100% (95% CI: 92.9-100) when using the EMS and 3-h ED troponin measures. Conclusions: EMS blood collection used for core lab ED troponin measures could significantly reduce ED LOS and appears safe when integrated into the HEART Pathway. (c) 2021 Elsevier Inc. All rights reserved. C1 [Stopyra, Jason P.; Snavely, Anna C.; Ashburn, Nicklaus P.; Nelson, R. Darrell.; McMurray, Evan L.; Hunt, Meagan R.; Miller, Chadwick D.; Mahler, Simon A.] Wake Forest Sch Med, Dept Emergency Med, Winston Salem, NC 27101 USA. C3 Wake Forest University RP Stopyra, JP (通讯作者),Wake Forest Sch Med, Dept Emergency Med, Med Ctr Blvd, Winston Salem, NC 27157 USA. EM jstopyra@wakehealth.edu FU Abbott Point of Care, Princeton, NJ USA FX This study was funded by Abbott Point of Care, Princeton, NJ USA. 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J. Emerg. Med. PD SEP PY 2021 VL 47 BP 248 EP 252 DI 10.1016/j.ajem.2021.04.073 EA MAY 2021 PG 5 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA UB8SC UT WOS:000686108000044 PM 33964547 OA Green Accepted DA 2023-05-13 ER PT J AU Stub, D Schmicker, RH Anderson, ML Callaway, CW Daya, MR Sayre, MR Elmer, J Grunau, BE Aufderheide, TP Lin, S Buick, JE Zive, D Peterson, ED Nichol, G AF Stub, Dion Schmicker, Robert H. Anderson, Monique L. Callaway, Clifton W. Daya, Mohamud R. Sayre, Michael R. Elmer, Jonathan Grunau, Brian E. Aufderheide, Tom P. Lin, Steve Buick, Jason E. Zive, Dana Peterson, Eric D. Nichol, Graham CA ROC Investigators TI Association between hospital post-resuscitative performance and clinical outcomes after out-of-hospital cardiac arrest SO RESUSCITATION LA English DT Article DE Cardiac arrest; Resuscitation; Performance score; Post resuscitation care ID PERCUTANEOUS CORONARY INTERVENTION; AMERICAN-HEART-ASSOCIATION; ELEVATION MYOCARDIAL-INFARCTION; INTENSIVE-CARE UNITS; THERAPEUTIC HYPOTHERMIA; TEMPERATURE MANAGEMENT; CARDIOLOGY; SURVIVAL; CARDIOPULMONARY; STATEMENT AB Background: Survival varies among those resuscitated from out-of-hospital cardiac arrest (OHCA). Evidence-based performance measures have been used to describe hospital quality of care in conditions such as acute coronary syndrome and major trauma. It remains unclear if adherence to performance measures is associated with better outcome in patients hospitalized after OHCA. Objectives: To assess whether a composite performance score based on evidence-based guidelines for care of patients resuscitated from OHCA was independently associated with clinical outcomes. Methods: Included were 3252 patients with OHCA who received care at 111 U.S. and Canadian hospitals participating in the Resuscitation Outcomes Consortium (ROC-PRIMED) study between June 2007 and October 2009. We calculated composite performance scores for all patients, aggregated these at the hospital level, then associated them with patient mortality and favorable neurological status at discharge. Results: Composite performance scores varied widely (median [IQR] scores from lowest to highest hospital quartiles, 21% [20%, 25%] vs. 59% [55%, 64%]. Adjusted survival to discharge increased with each quartile of performance score (from lowest to highest: 16.2%, 20.8%, 28.5%, 34.8%, P < 0.01), with similar findings for adjusted rates of good neurologic status. Hospital score was significantly associated with outcome after risk adjustment for established baseline factors (highest vs. lowest adherence quartile: adjusted OR of survival 1.64; 95% CI 1.13, 2.38). Conclusions: Greater survival and favorable neurologic status at discharge were associated with greater adherence to recommended hospital based post-resuscitative care guidelines. Consideration should be given to measuring, reporting and improving hospital adherence to guideline-based performance measures, which could improve outcomes following OHCA. (C) 2015 Elsevier Ireland Ltd. All rights reserved. C1 [Stub, Dion; Schmicker, Robert H.; Sayre, Michael R.; Nichol, Graham] Univ Washington, Seattle, WA 98195 USA. [Stub, Dion] Baker IDI Heart & Diabet Inst, Melbourne, Vic, Australia. [Anderson, Monique L.; Peterson, Eric D.] Duke Univ, Durham, NC USA. [Callaway, Clifton W.; Elmer, Jonathan] Univ Pittsburgh, Pittsburgh, PA USA. [Daya, Mohamud R.; Zive, Dana] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Stub, Dion; Grunau, Brian E.] Univ British Columbia, St Pauls Hosp, Vancouver, BC V5Z 1M9, Canada. [Aufderheide, Tom P.] Med Coll Wisconsin, Milwaukee, WI 53226 USA. [Lin, Steve; Buick, Jason E.] Univ Toronto, Toronto, ON, Canada. [Stub, Dion] Alfred Hosp Melbourne, Melbourne, Vic, Australia. C3 University of Washington; University of Washington Seattle; Baker Heart and Diabetes Institute; Duke University; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Oregon Health & Science University; St. Paul's Hospital; University of British Columbia; Medical College of Wisconsin; University of Toronto RP Nichol, G (通讯作者),Univ Washington, Harborview Ctr Prehosp Emergency Care, Seattle, WA 98195 USA. EM nichol@uw.edu RI Peterson, Eric David/ABF-5033-2021; Sayre, Michael R/E-8383-2017; Daya, Mohamud R/A-9322-2012; Buick, Jason E/K-4816-2013; Nichol, Graham/Z-4996-2019; Lin, Steve/H-3723-2013 OI Sayre, Michael R/0000-0003-0322-3181; Buick, Jason E/0000-0002-1859-1713; Lin, Steve/0000-0002-8644-9719; Stub, Dion/0000-0001-8686-2709; Grunau, Brian/0000-0003-4103-1383 FU NHMRC/NHF early career fellowship [1090302/100516]; University of Washington via the Leonard A Cobb Medic One Foundation Endowed Chair in Prehospital Emergency Care; National Heart Lung Blood Institute, Bethesda, MD. Resuscitation Outcomes Consortium [U01 HL077863-05]; Co-PI; Food and Drug Administration, Silver Spring, MD; Cardiac Science Corp, Waukesha, WI; Heartsine Technologies Inc., Newtown, PA; Philips Healthcare Inc., Bothell, WA; Physio-Control Inc., Redmond, WA; ZOLL Inc., Chelmsford, MA. University of Washington Dynamic AED Registry; Velomedix Inc., Menlo Park, CA; NHLBI; NINDS; Eli Lilly; Janssen; NIH; Laerdal Foundation; Zoll Foundation; National Heart, Lung and Blood Institute [5U01 HL077863, HL077866, HL077867, HL077871, HL077872, HL077873, HL077881, HL077885, HL077887, HL077908]; National Institute of Neurological Disorders and Stroke, U.S. Army Medical Research & Material Command; Canadian Institutes of Health Research (CIHR) - Institute of Circulatory and Respiratory Health, Defence Research and Development Canada; Heart, Stroke Foundation of Canada; American Heart Association FX Dr Stub is supported by a cofounded NHMRC/NHF early career fellowship (#1090302/100516) Award. Prof. Nichol receives salary support from the University of Washington via the Leonard A Cobb Medic One Foundation Endowed Chair in Prehospital Emergency Care. He holds Research Grants from the following: (1) National Heart Lung Blood Institute, Bethesda, MD. Resuscitation Outcomes Consortium (NIH U01 HL077863-05) 2004-2015; Co-PI; (2) Food and Drug Administration, Silver Spring, MD; Cardiac Science Corp, Waukesha, WI; Heartsine Technologies Inc., Newtown, PA; Philips Healthcare Inc., Bothell, WA; Physio-Control Inc., Redmond, WA; ZOLL Inc., Chelmsford, MA. University of Washington Dynamic AED Registry, PI. 2013-2015 (4) Velomedix Inc., Menlo Park, CA. Velocity Pilot Study of Ultrafast Hypothermia in Patients with ST-Elevation Myocardial Infarction, National Co-PI. 2014-2015. *Waived personal compensation. He did not receive any other Research Support. He is not a member of Speakers Bureau and does not hold an Honorary post in any company. He has no other conflict of interest to declare. He received travel reimbursement from Abiomed Inc., Danvers, MA. Dr. Aufderheide research is supported by NHLBI: Resuscitation Outcomes Consortium (ROC), NIH Director's Transformative Research Award; grants from NINDS: Neurological Emergency Treatment Trials (NETT) Network. Prof. Eric Peterson's research is supported by Eli Lilly and Janssen and acts as a consultant to Janssen, Boehringer Ingelheim, Astra Zeneca, Sanofi. Dr. Daya receives NIH research funding. Dr. Elmer receives research funding from NIH, Laerdal Foundation and Zoll Foundation.; The ROC is supported by a series of cooperative agreements to nine regional clinical centers and one Data Coordinating Center (5U01 HL077863-University of Washington Data Coordinating Center, HL077866-Medical College of Wisconsin, HL077867-University of Washington, HL077871-University of Pittsburgh, HL077872-St. Michael's Hospital, HL077873-Oregon Health and Science University, HL077881-University of Alabama at Birmingham, HL077885-Ottawa Hospital Research Institute, HL077887-University of Texas SW Medical Ctr/Dallas, HL077908-University of California San Diego) from the National Heart, Lung and Blood Institute in partnership with the National Institute of Neurological Disorders and Stroke, U.S. Army Medical Research & Material Command, The Canadian Institutes of Health Research (CIHR) - Institute of Circulatory and Respiratory Health, Defence Research and Development Canada and the Heart, Stroke Foundation of Canada and the American Heart Association. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health. 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Methods We compared three groups of patients: group 1, cases from our national historic KD database (KD-HIS), before the SARS-CoV-2 pandemic; group 2, patients with KD admitted to an intensive care unit (KD-ICU) from both our original cohort and the literature, before the SARS-CoV-2 pandemic; and group 3, patients with PIMS from the literature. Results KD-HIS included 425 patients [male:female ratio 1.3, mean age 2.8 years (s.d. 2.4)], KD-ICU 176 patients [male:female ratio 1.3, mean age 3.5 years (s.d. 3.1)] and PIMS 404 patients [male:female ratio 1.4, mean age 8.8 years (s.d. 3.7)]. As compared with KD-HIS patients, KD-ICU and PIMS patients had a higher proportion of cardiac failure, digestive and neurological signs. KD-ICU and PIMS patients also had a lower frequency of typical KD-mucocutaneous signs, lower platelet count, higher CRP and lower sodium level. As compared with KD-HIS and KD-ICU patients, PIMS patients were older and more frequently had myocarditis; they also had fewer coronary abnormalities and lower sodium levels. Unresponsiveness to IVIG was more frequent in KD-ICU than KD-HIS and PIMS patients. Conclusion On clinical grounds, KD-HIS, KD-ICU and PIMS might belong to a common spectrum of non-specific pathogen-triggered hyperinflammatory states. The causes of increasing inflammation severity within the three entities and the different effects on the heart remain to be determined. C1 [Cherqaoui, Bilade; Kone-Paut, Isabelle; Yager, Helene] CHU Bicetre, AP HP, Paediat Rheumatol, Le Kremlin Bicetre, France. [Cherqaoui, Bilade; Kone-Paut, Isabelle; Piram, Maryam] CHU Bicetre, French Reference Ctr Autoinflammatory Dis & Infla, CEREMAIA, Le Kremlin Bicetre, France. [Cherqaoui, Bilade] Univ Paris Saclay, UMR 1173, Infect & Inflammat, INSERM, Montigny Le Bretonneux, France. [Kone-Paut, Isabelle; Piram, Maryam] Univ Paris Saclay, Paris, France. [Le Bourgeois, Fleur] CHU Robert Debre, AP HP, Paediat Intens Care Unit, Paris, France. [Piram, Maryam] Univ Montreal, Paediat Dermatol, CHU St Justine Res Ctr, Montreal, PQ, Canada. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; UDICE-French Research Universities; Universite Paris Cite; Hopital Universitaire Hotel-Dieu - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Bicetre - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Saclay; UDICE-French Research Universities; Universite Paris Saclay; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Universite de Montreal; Centre Hospitalier Universitaire Sainte-Justine RP Cherqaoui, B (通讯作者),CEREMAIA, Paediat Rheumatol, 78 Rue Gen Leclerc, F-94270 Le Kremlin Bicetre, France. 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Deckers, Jaap W. Akkerhuis, K. Martijn van Domburg, Ron T. TI Age-dependent care and long-term (20 year) mortality of 14,434 myocardial infarction patients: Changes from 1985 to 2008 SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Myocardial infarction; Temporal trends; Age; Treatment; Long-term mortality ID ACUTE CORONARY SYNDROME; ST-SEGMENT ELEVATION; RANDOMIZED-TRIAL; GLOBAL REGISTRY; MANAGEMENT; OUTCOMES; POPULATION; SURVIVAL; STRATEGY; THERAPY AB Objectives: To determine whether age-dependent inequalities in care and outcome changed over a 24 year period for patients admitted with a myocardial infarction (MI). Methods: We examined four age groups (<55, 55-65, 65-75, and >75 years) and treatment and mortality in 14,434 consecutive patients admitted for MI to an intensive coronary care unit from 1985 to 2008. Temporal trend analyses were performed by comparing decades of admission (1985-1990 vs. 1990-2000 vs. 2000-2008). Results: A total of 2040 (14%) of the patients were >75 years of age. Older patients more often were female and less often presented with an ST-segment elevation MI (STEMI). Systematic differences in care were present between the age groups: older patients were less likely to receive evidence-based medical care and reperfusion therapy during the last 24 years, although the differences became smaller over time. In 2000-2008, 30-day (adjusted OR 0.28, 95% CI: 0.23-0.34) and 5-year (adjusted HR 0.61, 95% CI: 0.54-0.68) mortality were lower compared to 1985-1990. These temporal trends were equal across all age groups. Hence, the change in mortality over the 24-year study period is similar among the spectrum of ages. Patients aged <55, 55-65, 65-75, and >75 years had a 20-year mortality of 38, 63, 87 and >95%, respectively. Conclusions: Older patients with an MI remained less likely to receive evidence-based care during 24 years of observation. Temporal reductions in mortality were similar among all age groups. The application of proven MI therapies to appropriate patients regardless of age may even further improve these outcomes. (C) 2012 Elsevier Ireland Ltd. All rights reserved. C1 [Nauta, Sjoerd T.; Deckers, Jaap W.; Akkerhuis, K. Martijn; van Domburg, Ron T.] Erasmus MC, Thoraxctr, NL-3015 CE Rotterdam, Netherlands. C3 Erasmus University Rotterdam; Erasmus MC RP van Domburg, RT (通讯作者),Thorax Ctr Rotterdam, Dept Cardiol, Room Ba 561,S Gravendijkwal 230, NL-3015 CE Rotterdam, Netherlands. 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PD AUG 10 PY 2013 VL 167 IS 3 BP 693 EP 697 DI 10.1016/j.ijcard.2012.03.064 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 190DT UT WOS:000322319500022 PM 22465352 OA Bronze DA 2023-05-13 ER PT J AU Cassan, S Rata, M Vallenet, C Fromage, P Champly, F Broin, P Peribois, G Sierra, V Lutz, C Mangin, L Savary, D Ageron, FX Belle, L AF Cassan, Sebastien Rata, Mihaela Vallenet, Claire Fromage, Philippe Champly, Frederic Broin, Patrick Peribois, Guillaume Sierra, Valerie Lutz, Cedric Mangin, Lionel Savary, Dominique Ageron, Francois-Xavier Belle, Loic CA Sca-Alp Investigators TI Early inter-hospital transfer of patients with myocardial infarction without a doctor, paramedic or nurse on board: results from a French regional emergency care network SO BMC EMERGENCY MEDICINE LA English DT Article DE SCA-Alp protocol; Myocardial infarction; Percutaneous coronary intervention; Transfer; France ID CORONARY-ANGIOGRAPHY; ELEVATION; BIVALIRUDIN; MANAGEMENT AB Background: In France, patients with acute coronary syndromes (ACS) are usually transferred from remote hospitals to percutaneous coronary intervention (PCI) centres in mobile intensive care units (MICUs) with on-board medical staff. They are then returned to the remote hospitals by MICU 48 h after PCI. However, MICU transportation and beds in a PCI centre are in short supply. Therefore, we investigated clinical outcomes among intermediate-risk ACS patients who were transferred in private ambulances without an on-board medic or paramedic; and returned to the remote hospital sooner after PCI. Methods: In the French Alps, the RESURCOR network manages `SCA-Alp' transfers using strict management protocols in ambulances with trained drivers and automatic external defibrillators, but without heart rhythm monitoring. We conducted an observational retrospective study that assessed outcomes (death and emergency return to the PCI centre within 48 h) in patients transferred using SCA-Alp. Our population comprised stabilized patients with ST-segment elevation myocardial infarction (STEMI) who returned to the remote hospital within 24-48 h of PCI, and uncomplicated patients with non-ST-segment elevation myocardial infarction (NSTEMI) within 24-72 h of symptom onset who come from and returned to ('round-trip') the remote hospital on the day of PCI (return < 12 h after PCI). Results: Between 2010 and 2014, 101 STEMI and 490 NSTEMI patients were transferred using SCA-Alp. No adverse events occurred during transportation and no deaths were reported. Two of 591 patients (0.3% [95% confidence interval 0.1-1.4%]) experienced a stent thrombosis within 48 h of PCI that required a second urgent PCI; both were event free at 6-month follow-up. Conclusions: Inter-hospital transfer using SCA-Alp is associated with low event rates in intermediate-risk ACS patients, allowing a more streamlined use of medical facilities and freeing-up of beds in PCI centres. C1 [Cassan, Sebastien; Rata, Mihaela; Vallenet, Claire; Fromage, Philippe; Lutz, Cedric; Mangin, Lionel; Savary, Dominique; Ageron, Francois-Xavier; Belle, Loic; Sca-Alp Investigators] Ctr Hosp Alpes Leman, Dept Cardiol, Annemasse, France. [Cassan, Sebastien; Rata, Mihaela; Vallenet, Claire; Fromage, Philippe; Lutz, Cedric; Mangin, Lionel; Savary, Dominique; Ageron, Francois-Xavier; Belle, Loic] Ctr Hosp Alpes Leman, Emergency Dept, Annemasse, France. [Champly, Frederic; Broin, Patrick] Ctr Hosp Sallanches, Emergency Dept, Ctr Hosp Sallanches, Sallanches, France. [Peribois, Guillaume; Sierra, Valerie] Ctr Hosp Thonon, Dept Cardiol, Thonon Les Bains, France. [Peribois, Guillaume; Sierra, Valerie] Ctr Hosp Thonon, Emergency Dept, Thonon Les Bains, France. RP Belle, L (通讯作者),Ctr Hosp Alpes Leman, Dept Cardiol, Annemasse, France.; Belle, L (通讯作者),Ctr Hosp Alpes Leman, Emergency Dept, Annemasse, France. EM loic.belle@wanadoo.fr FU French Ministry of Health [PREPS 2014 14-0040]; Terumo; Abbott; St Jude Medical; Boston; Medtronic; Biotronik FX This study was partly funded by the French Ministry of Health (PREPS 2014 14-0040). The research unit of the hospital of Annecy receive a grant from Terumo, Abbott, St Jude Medical, Boston, Medtronic and Biotronik. The funding bodies had no involvement in the design of the study; in the collection, analysis, and interpretation of data; or in writing the manuscript. CR Adnet F, 2004, RESUSCITATION, V63, P7, DOI 10.1016/j.resuscitation.2004.04.001 Andersen JG, 2013, EUR HEART J-ACUTE CA, V2, P256, DOI 10.1177/2048872613483587 [Anonymous], COMP TERR Bawejski S, 2014, Ann Cardiol Angeiol (Paris), V63, P228, DOI 10.1016/j.ancard.2014.04.001 Belle L., 2005, Annales de Cardiologie et d'Angeiologie, V54, P310, DOI 10.1016/j.ancard.2005.05.020 Debaty G, 2007, ARCH MAL COEUR VAISS, V100, P105 Do DH, 2006, CAN J CARDIOL, V22, P405, DOI 10.1016/S0828-282X(06)70926-6 Estevez-Loureiro R, 2009, REV ESP CARDIOL, V62, P1356, DOI 10.1016/S0300-8932(09)73120-3 Fourny M, 2006, ARCH MAL COEUR VAISS, V99, P798 Fourny M, 2011, AM J EMERG MED, V29, P37, DOI 10.1016/j.ajem.2009.07.008 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Jolly SS, 2009, AM HEART J, V157, P132, DOI 10.1016/j.ahj.2008.08.023 Margheri M, 2001, Ital Heart J, V2, P921 Paul E, 2008, PRESSE MED, V37, P1366, DOI 10.1016/j.lpm.2007.11.019 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Steg PG, 2013, NEW ENGL J MED, V369, P2207, DOI 10.1056/NEJMoa1311096 Stone GW, 2008, NEW ENGL J MED, V358, P2218, DOI 10.1056/NEJMoa0708191 Yayehd K, 2015, EUR HEART J-ACUTE CA, V4, P41, DOI 10.1177/2048872614544856 NR 19 TC 1 Z9 2 U1 1 U2 3 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-227X J9 BMC EMERG MED JI BMC Emerg. Med. PD OCT 28 PY 2019 VL 19 IS 1 AR 60 DI 10.1186/s12873-019-0280-z PG 10 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA KN2WN UT WOS:000514703100001 PM 31660873 OA Green Published, gold DA 2023-05-13 ER PT J AU Alimohammad, HS Ghasemi, Z Shahriar, S Morteza, S Arsalan, K AF Alimohammad, Hasheminia Seyyed Ghasemi, Zahra Shahriar, Salehi Morteza, Sedehi Arsalan, Khaledifar TI Effect of hand and foot surface stroke massage on anxiety and vital signs in patients with acute coronary syndrome: A randomized clinical trial SO COMPLEMENTARY THERAPIES IN CLINICAL PRACTICE LA English DT Article ID STRESS; THERAPY; IMPACT; PAIN AB Background and objectives: Anxiety affects various body systems, which leads to an increase in respiratory rate, heart rate, blood pressure, and myocardial oxygen demand. The aim of this study was to investigate the effect of hand and foot surface stroke massage on the level of anxiety and vital signs in patients with acute coronary syndrome (ACS). Materials and methods: The single-blind clinical trial was performed on 70 patients with ACS. The patients were randomly assigned to the case and control groups. Anxiety levels were controlled 30 min before and 15 min after the intervention. The vital signs were checked in the two groups before, immediately after, 60 min, and 90 min after the intervention. The data were analyzed using SPSS software, descriptive statistics (mean +/- standard deviation), independent t-test, paired t-test, and chi-square test. Results: No significant difference was observed in the patients' levels of anxiety, systolic blood pressure, diastolic blood pressure, respiratory rate, and pulse rate before the intervention. However, after the intervention, the mean changes in the levels of anxiety, blood pressure, heart rate, and respiratory rate were significant. Conclusion: Hand and foot massage can be a useful nursing intervention in attenuating anxiety levels and improving the vital signs in patients. (c) 2018 Published by Elsevier Ltd. C1 [Alimohammad, Hasheminia Seyyed; Ghasemi, Zahra] Shahrekord Univ Med Sci, Community Oriented Nursing Midwifery Res Ctr, Shahrekord, Iran. [Shahriar, Salehi; Morteza, Sedehi; Arsalan, Khaledifar] Shahrekord Univ Med Sci, Shahrekord, Iran. C3 Shahrekord University Medical Sciences; Shahrekord University Medical Sciences RP Ghasemi, Z (通讯作者),Shahrekord Univ Med Sci, Community Oriented Nursing Midwifery Res Ctr, Shahrekord, Iran. EM st-ghasemi.z@skums.ac.ir CR Adib-Hajbaghery M., 2012, IRAN J NURS, V25, P72 Adib-Hajbaghery M, 2015, ARYA ATHEROSCLER, V11, P126 Adib-Hajbaghery Mohsen, 2014, Med J Islam Repub Iran, V28, P47 Ahmadi A, 2015, E MEDITERR HEALTH J, V21, P5 Ahmadian R., 2013, J MIL PSYCHOL, V4, P24 Alevizos M, 2014, ANN ALLERG ASTHMA IM, V112, P309, DOI 10.1016/j.anai.2013.09.017 [Anonymous], 2007, SCI J KURDISTAN U ME Asadollahi Malihe, 2016, J Caring Sci, V5, P187 Bahrami T, 2018, NURS CRIT CARE, V23, P229, DOI 10.1111/nicc.12302 Braun LA, 2012, J THORAC CARDIOV SUR, V144, P1453, DOI 10.1016/j.jtcvs.2012.04.027 Cambron JA, 2006, J ALTERN COMPLEM MED, V12, P65, DOI 10.1089/acm.2006.12.65 Cohen BE, 2013, J CLIN PSYCHIAT, V74, P1063, DOI 10.4088/JCP.12m08291 Crawford C, 2016, PAIN MED, V17, P1353, DOI 10.1093/pm/pnw099 Cronfalk BS, 2009, SUPPORT CARE CANCER, V17, P1203, DOI 10.1007/s00520-008-0575-1 Dulaney-Pena I., 2014, EFFECT PREEVENT SPOR Eguchi E, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0151712 Fakhr-Movahedi A., 2015, J URMIA NURS MIDWIFE, V12, P899 Ghezeljeh TN, 2017, WORLD J PLAST SURG, V6, P40 Gholami-Motlagh Farzaneh, 2016, Iran J Nurs Midwifery Res, V21, P402, DOI 10.4103/1735-9066.185584 Hatefi M., 2015, J CLIN DIAGN RES, V9 Irani M., 2015, J MIDWIFERY REPROD H, V3, P465, DOI [10.22038/jmrh.1999.4856, DOI 10.22038/JMRH.1999.4856] Jalalodini A, 2016, IRAN RED CRESCENT ME, V18, DOI 10.5812/ircmj.36567 Kanitz JL, 2015, COMPLEMENT THER MED, V23, P685, DOI 10.1016/j.ctim.2015.07.008 Kim In-Hong, 2016, J Phys Ther Sci, V28, P2703 Kordi M., 2016, J OBSTET GYNAECOL IN, V19, P1 Nabi H, 2013, EUR HEART J, V34, P2697, DOI 10.1093/eurheartj/eht216 Nalini J. S., 2014, ASIAN J NURS ED RES, V4, P514 Nelemans P. J., 2017, BMJ OPEN, V7, P1 Pinar Rukiye, 2015, Asian Pac J Cancer Prev, V16, P8127 Saatsaz S, 2016, COMPLEMENT THER CLIN, V24, P92, DOI 10.1016/j.ctcp.2016.05.014 Shafiei Z, 2013, J CLINNURS MIDWIFERY, V2, P28 Sripongngam T, 2015, MED SCI MONIT BASIC, V21, P216, DOI 10.12659/MSMBR.894343 Taghizadeh P., 2013, COMPLEMENTARY MED J, V2, P1 Tahmasbi H., 2012, ZAHEDAN J RES MED SC, V14, P51 Vahedian-Azimi A, 2014, TRAUMA MON, V19, DOI 10.5812/traumamon.17031 Wang Hsiao-Lan, 2004, Pain Manag Nurs, V5, P59, DOI 10.1016/j.pmn.2004.01.002 NR 36 TC 11 Z9 11 U1 0 U2 11 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1744-3881 EI 1873-6947 J9 COMPLEMENT THER CLIN JI Complement. Ther. Clin. Pract. PD MAY PY 2018 VL 31 BP 126 EP 131 DI 10.1016/j.ctcp.2018.01.012 PG 6 WC Integrative & Complementary Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Integrative & Complementary Medicine GA GG2KG UT WOS:000432520800019 PM 29705444 DA 2023-05-13 ER PT J AU Sheikh, S Van Cleve, W Kumar, V Peerwani, G Aijaz, S Pathan, A AF Sheikh, Sana Van Cleve, Wil Kumar, Vinod Peerwani, Ghazal Aijaz, Saba Pathan, Asad TI Cases of acute coronary syndrome and presumed cardiac death prior to arrival at an urban tertiary care hospital in Pakistan during the COVID-19 pandemic SO PLOS ONE LA English DT Article AB Background A reduction in overall acute coronary syndrome (ACS) cases, increases in the severity of ACS presentation, and increased rates of out-of-hospital cardiac arrest (OHCA) have been reported from multiple countries during the COVID-19 pandemic. The attributed factors include COVID-19 infection, fear of COVID-19 and resultant avoidance of health care facilities, and restrictions on mobility. Pakistan, a country with a high burden of cardiovascular disease (CVD) and challenges related to health care access, will be expected to demonstrate these same findings. Therefore, we compared ACS hospitalization, ACS severity, and patients who have already died (dead on arrival, or DOA) due to presumed OHCA at a tertiary cardiac hospital during pre-pandemic and intra-pandemic periods in Pakistan. Methods Standardized data elements were extracted from the charts of patients with ACS, and telephonic verbal autopsies (VA) using a validated tool were conducted for patients who were arrived DOA. As a comparison, cases during the same months prior to the COVID-19 were analyzed for respective waves. Events were counted, and proportions and frequencies are reported for each time period. Results A total of 4,480 ACS cases were reviewed; 1,216 cases during March-July 2019, 804 cases in the same months of 2020 (33.8% decrease); 1,304 cases in August 2019-January 2020 and 1,157 in the corresponding months of 2020 and 2021 (11.2% decrease). There was no observed change in the baseline characteristics of patients with ACS or their symptom-to-door time, and in-hospital mortality was unchanged across all time periods. There were 218 DOA cases in pre-pandemic months and 360 cases during the pandemic. The pre- pandemic rate of DOA was 12/1000 emergency patients (95% CI 10-13) compared to 22/1000 (95% CI 22-27) during the pandemic (30/1000in the 1st wave and 17/1000 during 2nd wave). On VA, CVD was found to be the major cause of death during both time periods. Conclusion At a cardiac hospital in Pakistan, the COVID-19 pandemic was associated with a reduction in ACS hospitalization and an increased DOA rate. C1 [Sheikh, Sana; Peerwani, Ghazal; Aijaz, Saba; Pathan, Asad] Tabba Heart Inst, Dept Clin Res Cardiol, Karachi, Pakistan. [Van Cleve, Wil] Univ Washington, Inst Hlth Metr & Evaluat, Dept Anesthesiol & Pain Med, Seattle, WA 98195 USA. [Kumar, Vinod] Tabba Heart Inst, Dept Emergency, Karachi, Pakistan. C3 Institute for Health Metrics & Evaluation; University of Washington; University of Washington Seattle RP Sheikh, S (通讯作者),Tabba Heart Inst, Dept Clin Res Cardiol, Karachi, Pakistan. EM sanasadiqsheikh@gmail.com RI Kumar, P.Vinod/HKP-1552-2023; Kumar, Vinod/HOF-0388-2023 CR [Anonymous], 2020, VERBAL AUTOPSY TOOLS [Anonymous], 2020, PAK COR CAS Baldi Enrico, 2020, Eur Heart J, V41, P3045, DOI 10.1093/eurheartj/ehaa508 Baldi E, 2021, IJC HEART VASC, V35, DOI 10.1016/j.ijcha.2021.100824 Cano-Valderrama O, 2020, BRIT J SURG, V107, pE239, DOI 10.1002/bjs.11667 Chan DZL, 2020, LANCET REG HEALTH-W, V5, DOI 10.1016/j.lanwpc.2020.100056 Coetzee BJ, 2020, GLOB PUBLIC HEALTH, V15, P1093, DOI 10.1080/17441692.2020.1779331 Garcia S, 2020, J AM COLL CARDIOL, V75, P2871, DOI 10.1016/j.jacc.2020.04.011 Guimaraes RB, 2020, ARQ BRAS CARDIOL, V114, P1067, DOI 10.36660/abc.20200358 Hodzic Enisa, 2018, Mater Sociomed, V30, P10, DOI 10.5455/msm.2018.30.10-14 Khan MS, 2021, PLOS ONE, V16, DOI 10.1371/journal.pone.0244936 Kocher KE., 2020, JAMA HLTH FORUM Lai PH, 2020, JAMA CARDIOL, V5, P1154, DOI 10.1001/jamacardio.2020.2488 Lange SJ, 2020, MMWR-MORBID MORTAL W, V69, P795, DOI 10.15585/mmwr.mm6925e2 Marijon E, 2020, LANCET PUBLIC HEALTH, V5, pE437, DOI 10.1016/S2468-2667(20)30117-1 McVaney KE, 2021, ECLINICALMEDICINE, V34, DOI 10.1016/j.eclinm.2021.100815 Moroni Francesco, 2020, JACC Case Rep, V2, P1620, DOI 10.1016/j.jaccas.2020.04.010 Ostergaard L, 2021, AM HEART J, V232, P146, DOI 10.1016/j.ahj.2020.11.004 Papafaklis MI, 2020, CLIN CARDIOL, V43, P1142, DOI 10.1002/clc.23424 Pessoa-Amorim G, 2020, EUR HEART J-QUAL CAR, V6, P210, DOI 10.1093/ehjqcco/qcaa046 Qazi Muhammad Suleman, 2009, J Pak Med Assoc, V59, P10 Singh S, 2021, IJC HEART VASC, V32, DOI 10.1016/j.ijcha.2021.100718 Tan HL, 2020, EUR HEART J, V41, P3055, DOI 10.1093/eurheartj/ehaa599 Verhoeven JI, 2021, NETH HEART J, V29, P188, DOI 10.1007/s12471-021-01560-z NR 24 TC 0 Z9 0 U1 0 U2 0 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD FEB 3 PY 2022 VL 17 IS 2 AR e0263607 DI 10.1371/journal.pone.0263607 PG 12 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA 2V2QB UT WOS:000823694700109 PM 35113963 OA Green Published, gold DA 2023-05-13 ER PT J AU Martin-Latry, K Latry, P Berges, C Coste, P Douard, H Pucheu, Y Couffinhal, T AF Martin-Latry, Karin Latry, Philippe Berges, Camille Coste, Pierre Douard, Herve Pucheu, Yann Couffinhal, Thierry TI One-year care pathway after acute myocardial infarction in 2018: Prescription, medical care and medication adherence, using a French health insurance reimbursement database SO ARCHIVES OF CARDIOVASCULAR DISEASES LA English DT Article DE Myocardial infarction; Medication  adherence; Databases; France; Care pathway ID ACUTE CORONARY SYNDROME; ST-SEGMENT ELEVATION; SECONDARY PREVENTION; PHARMACY RECORDS; CLAIMS DATABASE; THERAPY; PERSISTENCE; MORTALITY; FRANCE; DISCONTINUATION AB Aims. - To describe the myocardial infarction care pathway during the year following hospital discharge, and the use of and adherence to secondary prevention drugs. Methods. - A cohort study was conducted using data from the main French health insur-ance reimbursement database of the ex-Aquitaine region. Information about the medical and pharmaceutical care of hospitalized patients in 2018 was collected for 12 months. Medica-tion adherence was assessed by using the proportion of days covered by the treatment and persistence. Results. - A total of 3015 patients were included, and the mean age was 66 years. Almost 76% of the patients had a reimbursement for BAS (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug), BASI (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug/angiotensin-converting enzyme inhibitor) or AS (combined prescription of antiplatelet/lipid-lowering drug) treatment. Medication adherence was around 83% for aspirin and 75% for lipid-lowering drugs for the 1-year persistence. During the same time, the proportion of days covered was suboptimal. Almost 4% of patients died after leaving hospital, 45% went to a cardiac rehabilitation centre and 23% had at least one hospital readmission, whatever the reason. Patients had a mean number of 11 general practi-tioner consultations during the year. Almost 41% of patients did not have a consultation with a cardiologist, and 38.4% had at least two consultations. Rehabilitation and general practitioner consultations were associated with adherence. Conclusions. - These new results provide clear information on the medical care environment of patients, and help us to improve care transition. Close collaboration between healthcare practitioners is very important in the early stages of outpatient follow-up. (c) 2022 Elsevier Masson SAS. All rights reserved. C1 [Martin-Latry, Karin; Couffinhal, Thierry] Univ Bordeaux, Inserm UMR 1034, Biol Cardiovasc Dis, 1 Ave Magellan, F-33600 Pessac, France. [Martin-Latry, Karin; Berges, Camille; Coste, Pierre; Douard, Herve; Pucheu, Yann; Couffinhal, Thierry] CHU Bordeaux, Serv Malad Coronaires & Vasc, F-33600 Pessac, France. [Latry, Philippe] CNAM TS, Direct Reg Serv Med Assurance Maladie Nouvelle Aq, F-33000 Bordeaux, France. C3 UDICE-French Research Universities; Universite de Bordeaux; CHU Bordeaux; heSam Universite; Conservatoire National Arts & Metiers (CNAM) RP Martin-Latry, K (通讯作者),Univ Bordeaux, Inserm UMR 1034, Biol Cardiovasc Dis, 1 Ave Magellan, F-33600 Pessac, France. EM karin.martin-latry@u-bordeaux.fr RI Couffinhal, Thierry/GYJ-6434-2022; Couffinhal, Thierry/M-6857-2014 OI Couffinhal, Thierry/0000-0002-9217-2533; Berges, Camille/0000-0002-7773-3689 CR Agence technique de l'information sur l'hospitalisation (ATIH), CLASS INT MAL CIM Andrade SE, 2006, PHARMACOEPIDEM DR S, V15, P565, DOI 10.1002/pds.1230 Bezin J, 2014, EUR J CLIN PHARMACOL, V70, P429, DOI 10.1007/s00228-013-1614-5 Bezin J, 2017, PHARMACOEPIDEM DR S, V26, P285, DOI 10.1002/pds.4171 Blin P, 2016, INT J CARDIOL, V219, P387, DOI 10.1016/j.ijcard.2016.06.102 Bourgault C, 2005, J HUM HYPERTENS, V19, P607, DOI 10.1038/sj.jhh.1001873 Bradley CK, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011765 Caetano PA, 2006, CLIN THER, V28, P1411, DOI 10.1016/j.clinthera.2006.09.021 Club Inter Pharmaceutique (CIP), NOS SERVICES Cottin Yves, 2004, J Cardiopulm Rehabil, V24, P38, DOI 10.1097/00008483-200401000-00008 Dibao-Dina C, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0202986 Fox KAA, 2010, EUR HEART J, V31, P2755, DOI 10.1093/eurheartj/ehq326 Gabet A, 2018, ARCH CARDIOVASC DIS, V111, P625, DOI 10.1016/j.acvd.2017.07.003 Gislason GH, 2006, EUR HEART J, V27, P1153, DOI 10.1093/eurheartj/ehi705 Grymonpre R, 2006, MED CARE, V44, P471, DOI 10.1097/01.mlr.0000207817.32496.cb Hamood H, 2015, PHARMACOEPIDEM DR S, V24, P1093, DOI 10.1002/pds.3840 Haute Autorite de sante (HAS), PROGR INF 2007 2010 Hess LM, 2006, ANN PHARMACOTHER, V40, P1280, DOI 10.1345/aph.1H018 Ho PM, 2006, ARCH INTERN MED, V166, P1842, DOI 10.1001/archinte.166.17.1842 Ibanez B, 2018, EUR HEART J, V39, P119, DOI 10.1093/eurheartj/ehx393 Jackevicius CA, 2008, CIRCULATION, V117, P1028, DOI 10.1161/CIRCULATIONAHA.107.706820 Kotseva K, 2018, EUR J PREV CARDIOL, V25, P1242, DOI 10.1177/2047487318781359 Latry P, 2012, EUROINTERVENTION, V7, P1413, DOI 10.4244/EIJV7I12A221 Latry P, 2011, BMC CARDIOVASC DISOR, V11, DOI 10.1186/1471-2261-11-46 Martin-Latry K, 2010, PHARMACOEPIDEM DR S, V19, P256, DOI 10.1002/pds.1912 Neumann A, 2018, CIRC-CARDIOVASC QUAL, V11, DOI 10.1161/CIRCOUTCOMES.117.004356 Pouche M, 2016, ARCH CARDIOVASC DIS, V109, P178, DOI 10.1016/j.acvd.2015.09.009 Puymirat E, 2019, ARCH CARDIOVASC DIS, V112, P459, DOI 10.1016/j.acvd.2019.04.002 Puymirat E, 2014, INT J CARDIOL, V177, P281, DOI 10.1016/j.ijcard.2014.09.023 Sabate E., 2003, ADHERENCE LONG TERM STEINER JF, 1988, MED CARE, V26, P814, DOI 10.1097/00005650-198808000-00007 Steiner JF, 1997, J CLIN EPIDEMIOL, V50, P105, DOI 10.1016/S0895-4356(96)00268-5 STEPHENSON BJ, 1993, JAMA-J AM MED ASSOC, V269, P2779, DOI 10.1001/jama.269.21.2779 Tea V, 2019, EUR J PREV CARDIOL, V26, P411, DOI 10.1177/2047487318808638 Tuppin P, 2009, RESPE, V57, pS87 Tuppin P, 2010, ARCH CARDIOVASC DIS, V103, P363, DOI 10.1016/j.acvd.2010.05.003 Tuppin P, 2009, ARCH CARDIOVASC DIS, V102, P279, DOI 10.1016/j.acvd.2009.02.005 Vynckier P, 2021, CARDIOVASC DRUG THER, V35, P801, DOI 10.1007/s10557-020-07095-6 NR 38 TC 0 Z9 0 U1 1 U2 3 PU ELSEVIER MASSON, CORP OFF PI PARIS PA 65 CAMILLE DESMOULINS CS50083 ISSY-LES-MOULINEAUX, 92442 PARIS, FRANCE SN 1875-2136 EI 1875-2128 J9 ARCH CARDIOVASC DIS JI Arch. Cardiovasc. Dis. PD FEB PY 2022 VL 115 IS 2 BP 78 EP 86 DI 10.1016/j.acvd.2021.12.003 EA FEB 2022 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZE6KH UT WOS:000758988800003 PM 35115266 OA Green Submitted, Bronze DA 2023-05-13 ER PT J AU Jia, Y Li, H Li, DZ Li, FH Li, Q Jiang, Y Gao, YL Wan, Z Cao, Y Zeng, Z Zeng, R AF Jia, Yu Li, Hong Li, Dongze Li, Fanghui Li, Qin Jiang, Ying Gao, Yongli Wan, Zhi Cao, Yu Zeng, Zhi Zeng, Rui TI Prognostic Value of Braden Scale in Patients With Acute Myocardial Infarction From the Retrospective Multicenter Study for Early Evaluation of Acute Chest Pain SO JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE acute myocardial infarction; Braden Scale; frailty; prognosis ID PRESSURE ULCER RISK; CARDIOVASCULAR-DISEASE; HOSPITAL MORTALITY; FRAILTY; OUTCOMES; TRENDS; CARE; PREDICTORS; VALIDITY; REGISTRY AB Background The Braden Scale (BS) is a routine nursing measure used to predict pressure ulcer events; it is recommended as a frailty identification instrument. Objective We aimed to evaluate the predictive utility of the BS in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention. Methods We enrolled 2285 patients with AMI from the Retrospective Multicenter Study for Early Evaluation of Acute Chest Pain. The patients were divided into 3 groups (B1, B2, and B3) according to their BS score (<= 12 vs 13-14 vs >= 15). The primary endpoint was all-cause death. Results There were 264 (12.0%) all-cause deaths during the median follow-up period of 10.5 (7.9-14.2) months. In-hospital and midterm mortality and other adverse outcomes increased with decreases in the BS score. The Kaplan-Meier survival analysis showed that patients with a lower BS score had a lower cumulative survival rate (P < .001). The multivariate Cox regression analysis showed that a decreased BS score was an independent predictor for all-cause mortality (B2 vs B1: hazard ratio, 0.610; 95% confidence interval, 0.440-0.846; P = .003; B3 vs B1: hazard ratio, 0.345; 95% confidence interval, 0.241-0.493; P < .001). Conclusions The BS at admission may be a useful routine nursing measure to evaluate the prognosis of patients with AMI. The BS may be used to stratify risk at early stages and to identify those who may benefit from further assessment and intervention due to frailty syndrome. C1 [Jia, Yu; Li, Hong; Li, Dongze; Li, Qin; Gao, Yongli; Wan, Zhi; Cao, Yu; Zeng, Zhi; Zeng, Rui] Sichuan Univ, West China Hosp, Dept Emergency Med, Chengdu, Peoples R China. [Jia, Yu; Li, Hong; Li, Dongze; Li, Qin; Gao, Yongli; Wan, Zhi; Cao, Yu; Zeng, Zhi; Zeng, Rui] Sichuan Univ, West China Hosp, Disaster Med Ctr, Chengdu, Peoples R China. [Jia, Yu; Li, Hong; Li, Dongze; Li, Qin; Gao, Yongli; Wan, Zhi; Cao, Yu; Zeng, Zhi; Zeng, Rui] Sichuan Univ, West China Hosp, Lab Emergency Med, Chengdu, Peoples R China. [Jia, Yu; Li, Hong; Li, Dongze; Li, Qin; Gao, Yongli; Wan, Zhi; Cao, Yu; Zeng, Zhi; Zeng, Rui] Sichuan Univ, West China Hosp, West China Sch Nursing, Chengdu, Peoples R China. [Li, Fanghui; Jiang, Ying; Zeng, Rui] Sichuan Univ, West China Hosp, Dept Cardiol, 37 Guoxue Rd, Chengdu 610041, Sichuan, Peoples R China. C3 Sichuan University; Sichuan University; Sichuan University; Sichuan University; Sichuan University RP Zeng, R (通讯作者),Sichuan Univ, West China Hosp, Dept Cardiol, 37 Guoxue Rd, Chengdu 610041, Sichuan, Peoples R China. EM zengrui_0524@126.com RI Zeng, Rui/GRY-0646-2022; Li, Dongze/X-5873-2019 OI Zeng, Rui/0000-0003-1188-3198; Li, Dongze/0000-0002-7548-7007 FU Sichuan Science and Technology Program [2020YFS0154, 2019JDRC0105]; 1_3_5 Project for Disciplines of Excellence-Clinical Research Incubation Project, Sichuan University West China Hospital [2018HXFH001, 2018HXFH027, 20HXFH050]; Sichuan University West China Nursing Discipline Development Special Fund Project [HXHL19023] FX This work was supported financially by grants from the Sichuan Science and Technology Program (no. 2020YFS0154 and 2019JDRC0105), the 1_3_5 Project for Disciplines of Excellence-Clinical Research Incubation Project, Sichuan University West China Hospital (no. 2018HXFH001, 2018HXFH027, and 20HXFH050), and the Sichuan University West China Nursing Discipline Development Special Fund Project (HXHL19023). 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PD NOV-DEC PY 2020 VL 35 IS 6 BP E53 EP E61 DI 10.1097/JCN.0000000000000735 PG 9 WC Cardiac & Cardiovascular Systems; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology; Nursing GA QB4YF UT WOS:000614146400005 PM 32740222 DA 2023-05-13 ER PT J AU Shirakabe, A Kobayashi, N Hata, N Yamamoto, M Shinada, T Tomita, K Tsurumi, M Matsushita, M Okazaki, H Yamamoto, Y Yokoyama, S Asai, K Shimizu, W AF Shirakabe, Akihiro Kobayashi, Nobuaki Hata, Noritake Yamamoto, Masanori Shinada, Takuro Tomita, Kazunori Tsurumi, Masafumi Matsushita, Masato Okazaki, Hirotake Yamamoto, Yoshiya Yokoyama, Shinya Asai, Kuniya Shimizu, Wataru TI Prognostic impact of the serum heart-type fatty acid-binding protein (H-FABP) levels in patients admitted to the non-surgical intensive care unit SO CLINICAL RESEARCH IN CARDIOLOGY LA English DT Article DE Biomarker; Cardiovascular disease; Emergency Care; Mortality ID ACUTE MYOCARDIAL-INFARCTION; SENSITIVITY TROPONIN-T; ACUTE CORONARY SYNDROME; PULMONARY-EMBOLISM; SEVERE SEPSIS; SEPTIC SHOCK; CHEST-PAIN; FAILURE; MORTALITY; PREDICT AB Biomarkers predicting adverse outcomes in non-surgical intensive care patients have not been reported. Data for 1,006 emergency department patients were prospectively analyzed. The serum heart-type fatty acid-binding protein (s-H-FABP) level was measured within 10 min of admission. The patients were assigned to intensive care (n = 835) or other departments (n = 171). The intensive care patients were divided into survivors (n = 745) and non-survivors (n = 90) according to the in-hospital mortality and assigned to four groups according to the quartiles of s-H-FABP (Q1, Q2, Q3 and Q4). The s-H-FABP levels were significantly higher in the intensive care patients (12.7 [6.1-38.8] ng/ml versus 5.3 [3.1-9.4] ng/ml) and in the non-survivors (44.9 [23.2-87.6] ng/ml versus 11.5 [5.6-32.6] ng/ml). A Kaplan-Meier curve showed a significantly higher survival rate in Q3 than in Q1 and Q2 and in Q4 than in the other groups. The multivariate Cox regression model identified Q3 (HR 4.646, 95 % CI 1.526-14.146) and Q4 (HR 9.483, 95 % CI 3.152-28.525) as independent predictors of 90-day mortality. The sensitivity and specificity of H-FABP for in-hospital mortality were 81.1 and 66.0 % (AUC 0.775) at 20.95 ng/ml. The in-hospitality rate was significantly higher in the high s-H-FABP patients than in the low s-H-FABP patients in each etiology group. The s-H-FABP level is an effective biomarker for risk stratification in non-surgical intensive care patients. C1 [Shirakabe, Akihiro; Kobayashi, Nobuaki; Hata, Noritake; Yamamoto, Masanori; Shinada, Takuro; Tomita, Kazunori; Tsurumi, Masafumi; Matsushita, Masato; Okazaki, Hirotake; Yamamoto, Yoshiya; Yokoyama, Shinya] Chiba Hokusoh Hosp, Nippon Med Sch, Div Intens Care Unit, Chiba 2701694, Japan. [Asai, Kuniya; Shimizu, Wataru] Nippon Med Sch, Dept Cardiovasc Med, Tokyo 113, Japan. C3 Nippon Medical School; Nippon Medical School RP Shirakabe, A (通讯作者),Chiba Hokusoh Hosp, Nippon Med Sch, Div Intens Care Unit, 1715 Kamagari, Chiba 2701694, Japan. EM s6042@nms.ac.jp RI Salerno, Rebecca/HKM-4100-2023; Kobayashi, Nobuaki/J-4222-2019; Shimizu, Wataru/IAM-9119-2023 OI Kobayashi, Nobuaki/0000-0001-6757-4779; Shimizu, Wataru/0000-0001-9941-8973 CR Arimoto T, 2005, J CARD FAIL, V11, P56, DOI 10.1016/j.cardfail.2004.03.005 Baum H, 1997, CLIN CHEM, V43, P1877 Boscheri A, 2010, AM HEART J, V160, P294, DOI 10.1016/j.ahj.2010.05.010 Chorianopoulos E, 2014, CLIN RES CARDIOL, V103, P65, DOI 10.1007/s00392-013-0624-8 Daniels LB, 2007, J AM COLL CARDIOL, V50, P2357, DOI 10.1016/j.jacc.2007.09.021 Dellas C, 2010, J AM COLL CARDIOL, V55, P2150, DOI 10.1016/j.jacc.2009.10.078 Ecollan P, 2007, INT J CARDIOL, V119, P349, DOI 10.1016/j.ijcard.2006.09.003 Gheorghiade M, 2005, CIRCULATION, V112, P3958, DOI 10.1161/CIRCULATIONAHA.105.590091 GLATZ JFC, 1994, BRIT HEART J, V71, P135 Goto T, 2003, HEART, V89, P1303, DOI 10.1136/heart.89.11.1303 Hallermayer K, 1999, SCAND J CLIN LAB INV, V59, P128 Hazui H, 2005, CIRC J, V69, P958, DOI 10.1253/circj.69.958 Inoue K, 2011, CIRC J, V75, P2813, DOI 10.1253/circj.CJ-11-0598 Jo YH, 2012, AM J EMERG MED, V30, P1749, DOI 10.1016/j.ajem.2012.02.005 Kara K, 2014, CLIN RES CARDIOL, V103, P125, DOI 10.1007/s00392-013-0628-4 Kobayashi N, 2011, CIRC J, V75, P2862, DOI 10.1253/circj.CJ-11-0724 Landesberg G, 2012, EUR HEART J, V33, P895, DOI 10.1093/eurheartj/ehr351 Matsumoto S, 2013, CIRC J, V77, P1026, DOI 10.1253/circj.CJ-12-0999 Niizeki T, 2007, J CARD FAIL, V13, P120, DOI 10.1016/j.cardfail.2006.10.014 Normann J, 2012, AM HEART J, V164, P698, DOI 10.1016/j.ahj.2012.08.003 Reiter M, 2013, HEART, V99, P708, DOI 10.1136/heartjnl-2012-303325 Reynolds T, 2012, BRIT J ANAESTH, V109, P219, DOI 10.1093/bja/aes141 Seino Y, 2003, AM J MED, V115, P185, DOI 10.1016/S0002-9343(03)00325-5 Seino Y, 2004, EUR J HEART FAIL, V6, P295, DOI 10.1016/j.ejheart.2003.12.009 Seino Y, 2004, CIRC J, V68, P144, DOI 10.1253/circj.68.144 Setsuta K, 2002, AM J MED, V113, P717, DOI 10.1016/S0002-9343(02)01394-3 Setsuta K, 2008, CIRC J, V72, P569 TANAKA T, 1991, CLIN BIOCHEM, V24, P195, DOI 10.1016/0009-9120(91)90571-U Tsutamoto T, 2007, EUR J HEART FAIL, V9, P667, DOI 10.1016/j.ejheart.2007.01.003 Twerenbold R, 2012, EUR HEART J, V33, P579, DOI 10.1093/eurheartj/ehr492 Viswanathan K, 2010, J AM COLL CARDIOL, V55, P2590, DOI 10.1016/j.jacc.2009.12.062 Werdan K, 2011, CLIN RES CARDIOL, V100, P661, DOI 10.1007/s00392-011-0292-5 Wilhelm J, 2013, CLIN RES CARDIOL, V102, P735, DOI 10.1007/s00392-013-0584-z Yamamoto T, 2009, BIOTECHNOL LETT, V31, P1695, DOI 10.1007/s10529-009-0065-7 Yamashita T, 2010, J CARDIOL, V55, P377, DOI 10.1016/j.jjcc.2010.01.008 Yan GT, 2009, EUR J PHARMACOL, V616, P244, DOI 10.1016/j.ejphar.2009.06.039 NR 36 TC 3 Z9 4 U1 0 U2 8 PU SPRINGER HEIDELBERG PI HEIDELBERG PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY SN 1861-0684 EI 1861-0692 J9 CLIN RES CARDIOL JI Clin. Res. Cardiol. PD OCT PY 2014 VL 103 IS 10 BP 791 EP 804 DI 10.1007/s00392-014-0717-z PG 14 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AP2NR UT WOS:000341909800004 PM 24817549 DA 2023-05-13 ER PT J AU Vale, N Nordmann, AJ Schwartz, GG de Lemos, J Colivicchi, F den Hartog, F Ostadal, P Macin, SM Liem, AH Mills, EJ Bhatnagar, N Bucher, HC Briel, M AF Vale, Noah Nordmann, Alain J. Schwartz, Gregory G. de Lemos, James Colivicchi, Furio den Hartog, Frank Ostadal, Petr Macin, Stella M. Liem, Anho H. Mills, Edward J. Bhatnagar, Neera Bucher, Heiner C. Briel, Matthias TI Statins for acute coronary syndrome SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS LA English DT Review DE Acute Coronary Syndrome [drug therapy; mortality]; Angina, Unstable [prevention & control]; Cardiovascular Diseases [mortality]; Cause of Death; Drug Administration Schedule; Heart Failure [prevention & control]; Hydroxymethylglutaryl-CoA Reductase Inhibitors [adverse effects; therapeutic use]; Myocardial Infarction [prevention & control]; Myocardial Revascularization [utilization]; Randomized Controlled Trials as Topic; Stroke [prevention & control]; Humans ID ACUTE MYOCARDIAL-INFARCTION; LIPID-LOWERING THERAPY; DOSE ATORVASTATIN TREATMENT; UNSTABLE ANGINA-PECTORIS; PLACEBO-CONTROLLED TRIAL; TERM CLINICAL-OUTCOMES; ADVERSE CARDIAC EVENTS; HEART-DISEASE; DOUBLE-BLIND; JAPAN ASSESSMENT AB Background The early period following the onset of acute coronary syndrome (ACS) represents a critical stage of coronary heart disease, with a high risk of recurrent events and deaths. The short-term effects of early treatment with statins on patient-relevant outcomes in patients suffering from ACS are unclear. This is an update of a review previously published in 2011. Objectives To assess the effects, both harms and benefits, of early administered statins in patients with ACS, in terms of mortality and cardiovascular events. Search methods We updated the searches of CENTRAL (2013, Issue 3), MEDLINE (Ovid) (1946 to April Week 1 2013), EMBASE (Ovid) (1947 to 2013 Week 14), and CINAHL (EBSCO) (1938 to 2013) on 12 April 2013. We applied no language restrictions. We supplemented the search by contacting experts in the field, by reviewing the reference lists of reviews and editorials on the topic, and by searching trial registries. Selection criteria Randomized controlled trials (RCTs) comparing statins with placebo or usual care, with initiation of statin therapy within 14 days following the onset of ACS, follow-up of at least 30 days, and reporting at least one clinical outcome. Data collection and analysis Two authors independently assessed risk of bias and extracted data. We calculated risk ratios (RRs) for all outcomes in the treatment and control groups and pooled data using random-effects models. Main results Eighteen studies (14,303 patients) compared early statin treatment versus placebo or no treatment in patients with ACS. The new search did not identify any new studies for inclusion. There were some concerns about risk of bias and imprecision of summary estimates. Based on moderate quality evidence, early statin therapy did not decrease the combined primary outcome of death, non-fatal myocardial infarction, and stroke at one month (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.80 to 1.08) or four months (RR 0.93, 95% CI 0.81 to 1.06) of follow-up when compared to placebo or no treatment. There were no statistically significant risk reductions from statins for total death, total myocardial infarction, total stroke, cardiovascular death, revascularization procedures, and acute heart failure at one month or at four months, although there were favorable trends related to statin use for each of these endpoints. Moderate quality evidence suggests that the incidence of unstable angina was significantly reduced at four months following ACS (RR 0.76, 95% CI 0.59 to 0.96). There were nine individuals with myopathy (elevated creatinine kinase levels more than 10 times the upper limit of normal) in statin-treated patients (0.13%) versus one (0.015%) in the control groups. Serious muscle toxicity was mostly limited to patients treated with simvastatin 80 mg. Authors' conclusions Based on moderate quality evidence, due to concerns about risk of bias and imprecision, initiation of statin therapy within 14 days following ACS does not reduce death, myocardial infarction, or stroke up to four months, but reduces the occurrence of unstable angina at four months following ACS. Serious side effects were rare. C1 [Vale, Noah] McGill Univ, St Marys Hosp, Montreal, PQ, Canada. [Nordmann, Alain J.] Univ Basel Hosp, Inst Clin Epidemiol & Biostat, CH-4031 Basel, Switzerland. [Schwartz, Gregory G.] VA Med Ctr, Denver, CO USA. [Schwartz, Gregory G.] Univ Colorado, Denver, CO 80202 USA. [de Lemos, James] Univ Texas Southwestern Med Sch, Dallas, TX USA. [Colivicchi, Furio] S Filippo Neri Hosp, Cardiovasc Dept, Rome, Italy. [den Hartog, Frank] Gelderse Vallei Hosp, Dept Cardiol, Ede, Netherlands. [Ostadal, Petr] Na Homolce Hosp, Dept Cardiol, Prague, Czech Republic. [Macin, Stella M.] Inst Cardiol, Coronary Intens Care Unit, Corrientes, Argentina. [Liem, Anho H.] Franciscus Gasthuis Rotterdam, Dept Cardiol, Rotterdam, Netherlands. [Mills, Edward J.] Univ Ottawa, Fac Hlth Sci, Ottawa, ON, Canada. [Bhatnagar, Neera] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada. [Bucher, Heiner C.; Briel, Matthias] Univ Hosp Basel USB, Basel Inst Clin Epidemiol & Biostat, Basel, Switzerland. C3 McGill University; University of Basel; University of Colorado System; University of Colorado Denver; San Filippo Neri Hospital; Gelderse Vallei Hospital; Na Homolce Hospital; Franciscus Gasthuis; University of Ottawa; McMaster University RP Briel, M (通讯作者),Univ Hosp Basel USB, Basel Inst Clin Epidemiol & Biostat, Basel, Switzerland. EM matthias.briel@usb.ch RI Briel, Matthias/AAT-9284-2021; de Lemos, James/ABD-6669-2021 OI Macin, Stella/0000-0002-1869-5918; Colivicchi, Furio/0000-0001-7187-2234; Briel, Matthias/0000-0002-2070-5230 FU Santesuisse, Switzerland; Gottfried and Julia Bangerter-Rhyner-Foundation, Switzerland FX Internal sources; Santesuisse, Switzerland.; Gottfried and Julia Bangerter-Rhyner-Foundation, Switzerland. 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PY 2014 IS 9 AR CD006870 DI 10.1002/14651858.CD006870.pub3 PG 125 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AY5YT UT WOS:000347645800034 PM 25178118 DA 2023-05-13 ER PT J AU Sarak, B Savu, A Kaul, P McAlister, FA Welsh, RC Yan, AT Goodman, SG AF Sarak, Bradley Savu, Anamaria Kaul, Padma McAlister, Finlay A. Welsh, Robert C. Yan, Andrew T. Goodman, Shaun G. TI Lipid Testing, Lipid-Modifying Therapy, and PCSK9 (Proprotein Convertase Subtilisin-Kexin Type 9) Inhibitor Eligibility in 27 979 Patients With Incident Acute Coronary Syndrome SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE acute coronary syndrome; lipids; lipoproteins; myocardial infarction; population ID STATIN THERAPY; CARDIOVASCULAR-DISEASE; LOWERING THERAPY; HIGH-RISK; MANAGEMENT; DYSLIPIDEMIA; POPULATION; PREVENTION; CARE AB Background: While registry-based studies have shown that as many as 1 in 2 patients with stable atherosclerotic cardiovascular disease would be eligible for PCSK9i (proprotein convertase subtilisin-kexin type 9 inhibitor) therapy, this has not been studied in a large population-based postacute coronary syndrome (ACS) cohort. Methods: We examined lipid testing performed in hospital or within 90 days of discharge and lipid-lowering therapies dispensed within 90 days of discharge in patients surviving for at least 1 year after their first ACS between 2012 and 2018 in the province of Alberta, Canada. We estimated the proportion of patients eligible for PCSK9i and the expected benefits of treatment. Results: Of the 27 979 patients (median age 64.0 years, 29.3% female, 28.0% diabetic), 3750 (13.4%) did not have lipid testing in-hospital or within 90 days postdischarge. Untested patients were more likely to be older, female, from rural areas, to have more comorbidities, to already be on cardioprotective therapies, to present with unstable angina, and were less likely to have invasive interventions (all P<0.0001). Of the 24 229 tested, 18 767 (77.5%) had at least one lipid value above guideline-recommended threshold (LDL [low-density lipoprotein] >= 1.8 mmol/L [70 mg/dL] and non-HDL [high-density lipoprotein] >= 2.6 mmol/L [100 mg/dL]), of which 7284 (38.8%) did not have repeat testing within the year after discharge. Lipid testing in hospital was associated with higher rates of initiation or escalation of statin therapy within 90 days of their ACS (adjusted odds ratio, 2.13 [95% CI, 1.97-2.30). In total, 9592 patients (39.6% of the tested cohort) would be eligible for PCSK9i use, which could result in 184 fewer cardiovascular events over 3.4 years, including cardiovascular death, nonfatal ACS (myocardial infarction or unstable angina requiring hospitalization), and ischemic stroke. Conclusions: Within 90 days of incident ACS, approximate to 80% of patients did not meet guideline-recommended lipid thresholds and more than one-third would potentially be eligible for PCSK9i. C1 [Sarak, Bradley; Yan, Andrew T.; Goodman, Shaun G.] Univ Toronto, St Michaels Hosp, Toronto, ON, Canada. [Savu, Anamaria; Kaul, Padma; McAlister, Finlay A.; Welsh, Robert C.; Goodman, Shaun G.] Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada. [Welsh, Robert C.] Univ Alberta Hosp, Mazankowski Alberta Heart Inst, Edmonton, AB, Canada. C3 University of Toronto; Saint Michaels Hospital Toronto; University of Alberta; University of Alberta RP Yan, AT; Goodman, SG (通讯作者),St Michaels Hosp, Div Cardiol, 30 Bond St, Toronto, ON M5B 1W8, Canada. EM andrew.yan@unityhealth.to; goodmans@chrc.net RI Welsh, Robert/ABH-3526-2021; McAlister, Finlay/C-4151-2013 OI Welsh, Robert/0000-0003-2613-9142; Goodman, Shaun/0000-0001-8068-2440; McAlister, Finlay/0000-0001-7435-3341; Kaul, Padma/0000-0003-2239-3944; Savu, Anamaria/0000-0001-8070-4195 FU Canadian VIGOUR Centre, University of Alberta FX We are indebted to all of those who contribute to Alberta Health Services databases and research and to Sue Francis for her assistance in the preparation of this article. This study was supported by the Canadian VIGOUR Centre, University of Alberta. CR Anderson TJ, 2016, CAN J CARDIOL, V32, P1263, DOI 10.1016/j.cjca.2016.07.510 Arbel R, 2019, AM J CARDIOL, V123, P1273, DOI 10.1016/j.amjcard.2019.01.021 Aronow HD, 2001, LANCET, V357, P1063, DOI 10.1016/S0140-6736(00)04257-4 Bittner V, 2019, JAMA CARDIOL, V4, P865, DOI 10.1001/jamacardio.2019.2481 Bradley CK, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011765 Cannon CP, 2017, JAMA CARDIOL, V2, P959, DOI 10.1001/jamacardio.2017.2289 Cannon CP, 2015, NEW ENGL J MED, V372, P2387, DOI 10.1056/NEJMoa1410489 Cannon CP, 2004, NEW ENGL J MED, V350, P1495, DOI 10.1056/NEJMoa040583 Elbarouni B, 2012, AM J CARDIOL, V109, P1418, DOI 10.1016/j.amjcard.2012.01.352 Grundy SM, 2019, J AM COLL CARDIOL, V73, pE285, DOI 10.1016/j.jacc.2018.11.003 Guedeney P, 2022, EUR HEART J, V43, pE17, DOI 10.1093/eurheartj/ehz430 Javed U, 2011, AM HEART J, V161, P418, DOI 10.1016/j.ahj.2010.12.014 Karatasakis A, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.006910 Ko DT, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.118.010007 Ko DT, 2005, AM HEART J, V150, P419, DOI 10.1016/j.ahj.2004.09.057 Koskinas KC, 2019, J AM COLL CARDIOL, V74, P2452, DOI 10.1016/j.jacc.2019.08.010 Kuiper JG, 2017, CLIN THER, V39, P819, DOI 10.1016/j.clinthera.2017.03.001 Lindh M, 2019, EUR HEART J-QUAL CAR, V5, P225, DOI 10.1093/ehjqcco/qcy058 McAlister FA, 2003, ANN INTERN MED, V138, P938, DOI 10.7326/0003-4819-138-11-200306030-00016 Muhlestein JB, 2001, AM J CARDIOL, V87, P257, DOI 10.1016/S0002-9149(00)01354-0 Nielsen SF, 2016, EUR HEART J, V37, P908, DOI 10.1093/eurheartj/ehv641 Reid RJ, 2015, BMC HEALTH SERV RES, V15, DOI 10.1186/s12913-015-0884-2 Sabatine MS, 2018, CIRCULATION, V138, P756, DOI 10.1161/CIRCULATIONAHA.118.034309 Sabatine MS, 2017, NEW ENGL J MED, V376, P1713, DOI [10.1056/NEJMoa1615664, 10.4997/JRCPE.2017.212] Sampson UK, 2012, CURR ATHEROSCLER REP, V14, P1, DOI 10.1007/s11883-011-0219-7 Schwartz GG, 2018, NEW ENGL J MED, V379, P2097, DOI 10.1056/NEJMoa1801174 Schwartz GG, 2001, JAMA-J AM MED ASSOC, V285, P1711, DOI 10.1001/jama.285.13.1711 Stafford RS, 1997, J AM COLL CARDIOL, V29, P139, DOI 10.1016/S0735-1097(96)00441-X Toth PP, 2017, J MED ECON, V20, P555, DOI 10.1080/13696998.2017.1284078 Virani SS, 2017, CIRCULATION, V135, P2572, DOI 10.1161/CIRCULATIONAHA.117.028503 Wang WT, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.006460 Yan AT, 2006, AM J MED, V119, P676, DOI 10.1016/j.amjmed.2005.11.015 NR 32 TC 7 Z9 8 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1941-7705 EI 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD APR PY 2021 VL 14 IS 4 AR e006646 DI 10.1161/CIRCOUTCOMES.120.006646 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA RP2FV UT WOS:000641550400002 PM 33813856 OA Bronze DA 2023-05-13 ER PT J AU O'Keefe-McCarthy, S McGillion, M Clarke, SP McFetridge-Durdle, J AF O'Keefe-McCarthy, Sheila McGillion, Michael Clarke, Sean P. McFetridge-Durdle, Judith TI Pain and Anxiety in Rural Acute Coronary Syndrome Patients Awaiting Diagnostic Cardiac Catheterization SO JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE acute coronary syndrome (ACS); anxiety; nurse knowledge and attitudes; pain; pain management ID QUALITY-OF-LIFE; ACUTE MYOCARDIAL-INFARCTION; 3-YEAR FOLLOW-UP; HEART-DISEASE; CHEST-PAIN; ANGIOPLASTY; SYMPTOMS; ANGINA; IMPACT; RISK AB Context: In rural areas of Canada, people with acute coronary syndromes (ACS) can wait up to 32 hours for transfer for diagnostic cardiac catheterization (CATH). While awaiting CATH, it is critical that pain and anxiety management be optimal to preserve myocardial muscle and minimize the risk of further deterioration. Objectives: The aim of this study was to examine the relationship between clinical management, cardiac pain intensity, and state anxiety for rural ACS patients awaiting diagnostic CATH. Methods: In a prospective, descriptive-correlational repeated-measures design involving 121 ACS rural patients, we examined the associations of analgesic and nitroglycerin administration with cardiac pain intensity (numeric rating scale) and state anxiety (Spielberger State Anxiety Inventory) and also nurses' pain knowledge and attitudes (Toronto Pain Management Inventory-ACS Version and Knowledge and Attitudes Survey Regarding Pain) using linear mixed models. Results: The mean age of patients was 67.6 13, 50% were men, and 60% had unstable angina and the remainder had non-ST-elevated myocardial infarction. During follow-up, cardiac pain intensity scores remained in the mild range from 1.1 +/- 2.2 to 2.4 +/- 2.7. State anxiety ranged from 44.0 +/- 7.2 to 46.2 +/- 6.6. Cumulative analgesic dose was associated with a reduction in cardiac pain by 1.0 points (numeric rating scale, 0-10) (t(108) = -2.5; SE, -0.25; confidence interval, -0.45 to -0.06; P = .013). Analgesic administration was not associated with state anxiety. Over the course of follow-up, ACS patients reported consistently high anxiety scores. Conclusions: Whereas cardiac pain declines in most patients in the early hours after admission, many patients experience a persistent anxious state up to 8hours later, which suggest that development and testing of protocols for anxiety reduction may be needed. More urgently, the development and examination of a treatment intervention, early on in the ACS trajectory, are warranted that targets pain and anxiety for those for whom immediate angioplasty is not possible and who continue to experience cardiac pain and persistent high levels of anxiety. Moreover, a larger prognostic study is required to determine whether high levels of anxiety in rural ACS patients are predictive of major adverse cardiac events. C1 [O'Keefe-McCarthy, Sheila] Ross Mem Hosp, Lindsay, ON K9V 4M8, Canada. [McGillion, Michael] McMaster Univ, Fac Hlth Sci, Heart & Stroke Fdn Michael DeGroote Endowed Chair, Sch Nursing, Hamilton, ON, Canada. [Clarke, Sean P.] Boston Coll, Undergrad Program, William F Connell Sch Nursing, Chestnut Hill, MA 02167 USA. [McFetridge-Durdle, Judith] Florida State Univ, Coll Nursing, Tallahassee, FL 32306 USA. C3 McMaster University; Boston College; State University System of Florida; Florida State University RP O'Keefe-McCarthy, S (通讯作者),Ross Mem Hosp, 10 Angeline St North, Lindsay, ON K9V 4M8, Canada. EM s.okeefe.mccarthy@mail.utoronto.ca OI Clarke, Sean/0000-0003-3063-762X FU Canadian Cardiovascular Nurse Scientists FUTURE Program (CIHR/HSFC), Canadian Pain Society (CPS) Trainee Research Grant; CPS-Nursing Education and Research Award; Registered Nurses Foundation of Ontario; Ontario Graduate Scholarship; Lawrence S. Bloomberg Faculty of Nursing Fellowship; Canadian Association of University Teachers, J.H. Stewart-Reid Memorial Fellowship; University of Toronto Centre for the Study of Pain, Clinical Pain Scientist Scholarship; Registered Nurses Association of Ontario Nursing Research Interest Group, Graduate Scholarship; Royal Bank of Canada Chair in Cardiovascular Nursing, Graduate Student-Stipend, University Health Network, Toronto, Ontario; University of Toronto, Doctoral Dissertation Completion Award; Sigma Theta Tau International Nursing Society, Rising Stars Scholarship FX S. O'Keefe-McCarthy's work was supported by the Canadian Cardiovascular Nurse Scientists FUTURE Program (CIHR/HSFC), Canadian Pain Society (CPS) Trainee Research Grant; CPS-Nursing Education and Research Award; Registered Nurses Foundation of Ontario; Ontario Graduate Scholarship; Lawrence S. Bloomberg Faculty of Nursing Fellowship; Canadian Association of University Teachers, J.H. Stewart-Reid Memorial Fellowship; University of Toronto Centre for the Study of Pain, Clinical Pain Scientist Scholarship; Registered Nurses Association of Ontario Nursing Research Interest Group, Graduate Scholarship; Royal Bank of Canada Chair in Cardiovascular Nursing, Graduate Student-Stipend, University Health Network, Toronto, Ontario; the University of Toronto, Doctoral Dissertation Completion Award; and the Sigma Theta Tau International Nursing Society, Rising Stars Scholarship. 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PD NOV-DEC PY 2015 VL 30 IS 6 BP 546 EP 557 DI 10.1097/JCN.0000000000000203 PG 12 WC Cardiac & Cardiovascular Systems; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology; Nursing GA CU2AA UT WOS:000363322400012 PM 25325373 DA 2023-05-13 ER PT J AU Tycinska, A Grygier, M Biegus, J Czarnik, T Dabrowski, M Depukat, R Gierlotka, M Gil, M Hawranek, M Hirnle, T Jemielity, M Kapelak, B Kralisz, P Kuliczkowski, W Kusmierczyk, M Ligowski, M Lopatowska, P Puslecki, M Swiatkowski, A Trzeciak, P Zawislak, B Zembala, M Zymlinski, R AF Tycinska, Agnieszka Grygier, Marek Biegus, Jan Czarnik, Tomasz Dabrowski, Maciej Depukat, Rafal Gierlotka, Marek Gil, Monika Hawranek, Michal Hirnle, Tomasz Jemielity, Marek Kapelak, Boguslaw Kralisz, Pawel Kuliczkowski, Wiktor Kusmierczyk, Mariusz Ligowski, Marcin Lopatowska, Paulina Puslecki, Mateusz Swiatkowski, Andrzej Trzeciak, Przemyslaw Zawislak, Barbara Zembala, Michal Zymlinski, Robert TI Mechanical circulatory support. An expert opinion of the Association of Intensive Cardiac Care and the Association of Cardiovascular Interventions of the Polish Cardiac Society SO KARDIOLOGIA POLSKA LA English DT Article DE mechanical circulatory support-type and extension; indications and complications; multidisciplinary approach; hemodynamic and echocardiographic monitoring; ventilation and pharmacotherapy ID CARDIOGENIC PULMONARY-EDEMA; EXTRACORPOREAL MEMBRANE-OXYGENATION; NONINVASIVE VENTILATION; MYOCARDIAL-INFARCTION; VENTRICULAR SUPPORT; SHOCK; CONSENSUS; COUNTERPULSATION; DIAGNOSIS; THERAPY AB Mechanical circulatory support (MCS) methods are used in patients with both acute and chronic heart failure, who have exhausted other options for pharmacological or surgical treatments. The purpose of their use is to support, partially or completely, the failed ventricles and ensure adequate organ perfusion, which allows patients to restore full cardiovascular capacity, prolonging their life and effectively improving its quality. The three most popular devices include an intra-aortic balloon pump (IABP), percutaneous assist devices (including Impella, TandemHeart), and venoarterial extracorporeal membrane oxygenation (VA-ECMO). A multidisciplinary approach with the special participation of the Heart Team is required to determine the proper MCS strategy, the choice of the supporting method, and the time of its use. The studies published so far do not allow us to determine which MCS method is the safest and the most effective. Thus, the site experience and accessibility of the method seem to matter most today. MCS finds particular application in patients with acute coronary syndromes complicated by refractory cardiogenic shock, as well as in patients with acute heart failure of the high potential for reversibility. It can also serve as a backup for percutaneous coronary interventions of high risk (complex and high-risk indicated percutaneous coronary intervention [PCI], complex and high-risk indicated PCI [CHIP]). The use of appropriate supportive drugs, precise hemodynamic and echocardiographic monitoring, as well as optimal non-invasive or mechanical ventilation, are extremely important in the management of a patient with MCS. The most serious complications of MCS include bleeding, thromboembolic events, as well as infections, and hemolysis. C1 [Tycinska, Agnieszka; Gil, Monika; Lopatowska, Paulina] Med Univ Bialystok, Dept Cardiol, M Sklodowskiej Curie 24A, PL-15276 Bialystok, Poland. [Grygier, Marek] Poznan Univ Med Sci, Dept Cardiol 1, Poznan, Poland. [Biegus, Jan; Kuliczkowski, Wiktor; Zymlinski, Robert] Wroclaw Med Univ, Inst Heart Dis, Wroclaw, Poland. [Czarnik, Tomasz] Univ Opole, Inst Med Sci, Dept Anesthesiol & Intens Care, Opole, Poland. [Dabrowski, Maciej] Natl Inst Cardiol, Dept Intervent Cardiol & Angiol, Warsaw, Poland. [Depukat, Rafal] Univ Hosp, Dept Anesthesiol & Intens Care, Krakow, Poland. [Gierlotka, Marek] Univ Opole, Inst Med Sci, Dept Cardiol, Opole, Poland. [Hawranek, Michal; Trzeciak, Przemyslaw] Med Univ Silesia, Fac Med Sci Zabrze, Dept Cardiol 3, Katowice, Poland. [Hirnle, Tomasz] Med Univ Bialystok, Dept Cardiac Surg, Bialystok, Poland. [Jemielity, Marek; Ligowski, Marcin; Puslecki, Mateusz] Poznan Univ Med Sci, Dept Cardiac Surg & Transplantol, Poznan, Poland. [Kapelak, Boguslaw] John Paul 2 Hosp, Krakow, Poland. [Kapelak, Boguslaw] Jagiellonian Univ Med Coll, Inst Cardiol, Dept Cardiovasc Surg & Transplantol, Krakow, Poland. [Kralisz, Pawel] Med Univ Bialystok, Dept Invas Cardiol, Bialystok, Poland. [Kusmierczyk, Mariusz] Natl Inst Cardiol, Warsaw, Poland. [Puslecki, Mateusz] Poznan Univ Med Sci, Dept Med Rescue, Poznan, Poland. [Swiatkowski, Andrzej] Silesian Ctr Heart Dis, Dept Cardiol & Angiol 1, Intens Cardiac Care Unit, Zabrze, Poland. [Zawislak, Barbara] Univ Hosp, Intens Cardiac Care Unit, Krakow, Poland. [Zembala, Michal] Silesian Ctr Heart Dis, Dept Cardiac Surg Heart & Lung Transplantat & Mec, Zabrze, Poland. [Zembala, Michal] Pomeranian Med Univ, Szczecin, Poland. C3 Medical University of Bialystok; Poznan University of Medical Sciences; Wroclaw Medical University; University of Opole; Institute of Cardiology - Poland; Jagiellonian University; Collegium Medicum Jagiellonian University; University of Opole; Medical University Silesia; Medical University of Bialystok; Poznan University of Medical Sciences; Jagiellonian University; Collegium Medicum Jagiellonian University; Medical University of Bialystok; Institute of Cardiology - Poland; Poznan University of Medical Sciences; Silesian Center for Heart Diseases; Jagiellonian University; Collegium Medicum Jagiellonian University; Silesian Center for Heart Diseases; Pomeranian Medical University RP Tycinska, A (通讯作者),Med Univ Bialystok, Dept Cardiol, M Sklodowskiej Curie 24A, PL-15276 Bialystok, Poland. EM agnieszka.tycinska@gmail.com RI Zembala, Michal/GNP-2971-2022; Gierlotka, Marek/U-6969-2019; Biegus, Jan/AAF-4207-2021; Czarnik, Tomasz/W-5602-2019; Puslecki, Mateusz/HKN-4768-2023 OI Gierlotka, Marek/0000-0001-5639-2128; Biegus, Jan/0000-0001-9977-7722; Czarnik, Tomasz/0000-0002-6734-978X; Puslecki, Mateusz/0000-0003-0015-2808; Kuliczkowski, Wiktor/0000-0001-6284-0820; Zymlinski, Robert/0000-0003-1483-7381 CR Abrams D, 2018, INTENS CARE MED, V44, P717, DOI 10.1007/s00134-018-5064-5 Al-khadra Y, 2020, CATHETER CARDIO INTE, V95, P503, DOI 10.1002/ccd.28383 [Anonymous], CLIN STUD EXTR LIF S Appelt H, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0227793 Aso S, 2016, CRIT CARE MED, V44, P1974, DOI 10.1097/CCM.0000000000001828 Bass TA, 2015, CIRC-CARDIOVASC INTE, V8, DOI 10.1161/CIRCINTERVENTIONS.115.003405 Bonicolini E, 2019, CRIT CARE, V23, DOI 10.1186/s13054-019-2541-3 Burrell AJC, 2019, J CRIT CARE, V53, P32, DOI 10.1016/j.jcrc.2019.05.011 Burzotta F, 2015, INT J CARDIOL, V201, P684, DOI 10.1016/j.ijcard.2015.07.065 Cecconi M, 2014, INTENS CARE MED, V40, P1795, DOI 10.1007/s00134-014-3525-z Chatterjee K, 2009, CIRCULATION, V119, P147, DOI 10.1161/CIRCULATIONAHA.108.811141 Chen YS, 2008, LANCET, V372, P554, DOI 10.1016/S0140-6736(08)60958-7 Cheng JM, 2009, EUR HEART J, V30, P2102, DOI 10.1093/eurheartj/ehp292 Chioncel O, 2020, EUR J HEART FAIL, V22, P1315, DOI 10.1002/ejhf.1922 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 de Chambrun MP, 2018, CURR OPIN CRIT CARE, V24, P286, DOI 10.1097/MCC.0000000000000520 Desai SR, 2020, J CARDIOTHOR VASC AN, V34, P208, DOI 10.1053/j.jvca.2019.08.024 Drakos Stavros G, 2009, Clin Cardiol, V32, pE4, DOI 10.1002/clc.20488 Enezate T, 2019, AM J CARDIOL, V124, P505, DOI 10.1016/j.amjcard.2019.05.032 Gordon AC, 2012, CHEST, V142, P593, DOI 10.1378/chest.11-2604 Guglin M, 2019, J AM COLL CARDIOL, V73, P698, DOI 10.1016/j.jacc.2018.11.038 Hongisto M, 2017, INT J CARDIOL, V230, P191, DOI 10.1016/j.ijcard.2016.12.175 Kar B, 2011, J AM COLL CARDIOL, V57, P688, DOI 10.1016/j.jacc.2010.08.613 Keebler ME, 2018, JACC-HEART FAIL, V6, P503, DOI 10.1016/j.jchf.2017.11.017 Kenaan M, 2014, CRIT CARE CLIN, V30, P413, DOI 10.1016/j.ccc.2014.03.007 Kirton OC, 2015, J INTENSIVE CARE MED, V30, P30, DOI 10.1177/0885066613498055 Kouraki K, 2011, CLIN RES CARDIOL, V100, P235, DOI 10.1007/s00392-010-0235-6 Lauten A, 2013, CIRC-HEART FAIL, V6, P23, DOI 10.1161/CIRCHEARTFAILURE.112.967224 Makdee O, 2017, ANN EMERG MED, V70, P465, DOI 10.1016/j.annemergmed.2017.03.028 Masip J, 2000, LANCET, V356, P2126, DOI 10.1016/S0140-6736(00)03492-9 Masip J, 2018, EUR HEART J, V39, P17, DOI 10.1093/eurheartj/ehx580 McDonagh TA, 2021, EUR HEART J, V42, P3599, DOI 10.1093/eurheartj/ehab368 Nava S, 2003, AM J RESP CRIT CARE, V168, P1432, DOI 10.1164/rccm.200211-1270OC Nouira S, 2011, INTENS CARE MED, V37, P249, DOI 10.1007/s00134-010-2082-3 Pappalardo F, 2017, EUR J HEART FAIL, V19, P404, DOI 10.1002/ejhf.668 Patel SM, 2019, ASAIO J, V65, P21, DOI 10.1097/MAT.0000000000000767 Renaudier M, 2021, EUR HEART J-ACUTE CA, V10, P62, DOI 10.1177/2048872620915655 Rihal CS, 2015, CATHETER CARDIOVASC Schrage B, 2019, CIRCULATION, V139, P1249, DOI 10.1161/CIRCULATIONAHA.118.036614 Seymour CW, 2016, JAMA-J AM MED ASSOC, V315, P762, DOI 10.1001/jama.2016.0288 Shin TG, 2011, CRIT CARE MED, V39, P1, DOI 10.1097/CCM.0b013e3181feb339 Sorajja P, 2017, CATHETER CARDIO INTE, V89, P1294, DOI 10.1002/ccd.27036 Stevenson LW, 2005, JAMA-J AM MED ASSOC, V294, P1625 Strom JB, 2018, EUROINTERVENTION, V13, pE2152, DOI 10.4244/EIJ-D-17-00947 Tehrani BN, 2019, J AM COLL CARDIOL, V73, P1659, DOI 10.1016/j.jacc.2018.12.084 Thiele H, 2013, LANCET, V382, P1638, DOI 10.1016/S0140-6736(13)61783-3 Thiele H, 2012, NEW ENGL J MED, V367, P1287, DOI 10.1056/NEJMoa1208410 van Diepen S, 2020, JAMA CARDIOL, V5, P965, DOI 10.1001/jamacardio.2020.1274 Vincent JL, 2011, CRIT CARE, V15, DOI 10.1186/cc10291 Wada Y, 2016, J ARRYTHM, V32, P82, DOI 10.1016/j.joa.2015.09.002 NR 50 TC 5 Z9 5 U1 0 U2 2 PU POLISH CARDIAC SOC-POLSKIE TOWARZYSTWO KARDIOLOGICZNE PI WARSZAWA PA UL STAWKI 3 A LOK 1-2, WARSZAWA, POLAND SN 0022-9032 EI 1897-4279 J9 KARDIOL POL JI Kardiol. Pol. PD DEC 29 PY 2021 VL 79 IS 12 BP 1399 EP 1410 DI 10.33963/KP.a2021.0169 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA YA4SQ UT WOS:000738325300001 PM 34861044 OA gold DA 2023-05-13 ER PT J AU Gjesdal, G Braun, OO Smith, JG Schersten, F Tyden, P AF Gjesdal, Grunde Braun, Oscar O. Smith, J. Gustav Schersten, Fredrik Tyden, Patrik TI Blood lactate is a predictor of short-term mortality in patients with myocardial infarction complicated by heart failure but without cardiogenic shock SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Lactate; Acute coronary syndrome; Myocardial infarction; Killip class; Cardiogenic shock ID CARE-UNIT; TRENDS; CLASSIFICATION; VALIDATION AB Background: Mortality in patients with acute myocardial infarction (AMI) has improved substantially with modern therapy including percutaneous coronary interventions (PCI) but remains high in certain subgroups such as patients presenting with overt cardiogenic shock. However, the risk for AMI in patients presenting acutely with signs of heart failure but without cardiogenic shock is less well described. We aimed to identify risk factors for mortality in AMI patients with heart failure without overt cardiogenic shock. Methods: Using data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), we identified patients with operator-registered heart failure (Killip class II-IV), and evaluated predictors of mortality based on clinical factors from review of patient records. Results: A total of 1260 unique patients with acute myocardial infarction underwent PCI in 2014, of which 77 patients (7%) showed signs of heart failure (Killip II-IV) Overall 30-day mortality in patients with Killip class II-IV was 20% (N = 15). In patients classified Killip IV (1%), 30-day mortality was 50% (N = 6). In patients presenting with mild to moderate heart failure (Killlip class II-III), 30-day mortality was 14% (N = 9). In patients with Killip class II-III, lactate >= 2.5 mmol/L was associated with 30-day mortality, whereas systolic blood pressure < 90 mmHg, age, sex and BMI were not. In patients with lactate < 2.5 mmol/L 30-day mortality was 5% (N = 2) whereas mortality was 28% (N = 7) with lactate >= 2.5 mmol/L. This cut-off provided discriminative information on 30-day mortality (area under ROC curve 0.74). Conclusions: In patients with AMI and signs of mild to moderate heart failure, lactate >= 2.5 mmol/L provides additional prognostic information. Interventions to reduce risk may be targeted to these patients. C1 [Braun, Oscar O.] Lund Univ, Dept Cardiol, Clin Sci, SE-22181 Lund, Sweden. [Braun, Oscar O.] Skane Univ Hosp, SE-22181 Lund, Sweden. C3 Lund University; Lund University; Skane University Hospital RP Braun, OO (通讯作者),Lund Univ, Dept Cardiol, Clin Sci, SE-22181 Lund, Sweden.; Braun, OO (通讯作者),Skane Univ Hosp, SE-22181 Lund, Sweden. EM Oscar.Braun@med.lu.se OI O. 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Disord. PD JAN 18 PY 2018 VL 18 AR 8 DI 10.1186/s12872-018-0744-1 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FT2LR UT WOS:000422974400001 PM 29347907 OA gold, Green Published DA 2023-05-13 ER PT J AU Stochkendahl, MJ Mickley, H Vach, W Aziz, A Christensen, HW Hartvigsen, J Hoilund-Carlsen, PF AF Stochkendahl, Mette Jensen Mickley, Hans Vach, Werner Aziz, Ahmed Christensen, Henrik Wulff Hartvigsen, Jan Hoilund-Carlsen, Poul Flemming TI Clinical characteristics, myocardial perfusion deficits, and clinical outcomes of patients with non-specific chest pain hospitalized for suspected acute coronary syndrome: A 4-year prospective cohort study SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Non-specific chest pain; Myocardial perfusion imaging; Coronary artery disease; Prognosis; Risk stratification; Clinical characteristics ID NUCLEAR CARDIOLOGY; DIAGNOSIS; MORTALITY; CARE; PREVENTION; GUIDELINES; PROGNOSIS; DISEASE AB Background: Although the prognostic role of stress SPECT MPI is generally well established, its value in predicting non-fatal cardiac events in patients with acute, non-specific chest pain (NSCP) remains unclear. The aims of this study are 1) to describe the baseline clinical characteristics and prevalence of myocardial perfusion (MP) deficits, by use of an adenosine stress SPECT MPI, in NSCP patients without known CAD discharged after hospitalization for suspected ACS; and 2) to prospectively describe the 4-year clinical outcome in terms of all-cause and cardiac mortality; hospitalization and coronary revascularization procedures; and cardio-vascular events in patients with and without MP deficits. Methods and results: We evaluated a series of 272 consecutive patients with acute NSCP and aged 18-75 years. ICD 10-based registries were used to determine the primary outcome (a composite measure of incident CAD death, ACS, or revascularization) and two secondary outcomes (1. all-cause death; 2. a composite measure of cardiovascular death, ACS, revascularization, or stroke). Forty two (15%) participants had a MP deficit. During follow-up (median 1361 days), 7 participants had a primary event, 4 died, and 20 had a secondary composite event. Annual event rates were 0.70, 0.39 and 2.07, respectively. MP deficits predicted both subsequent primary and composite secondary events (HR: 7.54; 95% CI = [1.69; 33.69] and 2.93 (95% CI = [1.10; 7.81], respectively). Usual clinical cardiac risk classification could not meaningfully differentiate between patients with and without MP deficits. Conclusion: SPECT MPI substantially improved prediction of incident CAD beyond usual clinical procedures and risk classification systems among NSCP patients. (C) 2014 Elsevier Ireland Ltd. All rights reserved. C1 [Stochkendahl, Mette Jensen; Christensen, Henrik Wulff; Hartvigsen, Jan] Nord Inst Chiropract & Clin Biomech, DK-5230 Odense M, Denmark. [Mickley, Hans; Aziz, Ahmed] Odense Univ Hosp, Dept Cardiol, DK-5000 Odense, Denmark. [Vach, Werner] Univ Med Ctr Freiburg, Inst Med Biometry & Med Informat, Clin Epidemiol, Freiburg, Germany. [Hartvigsen, Jan] Univ Southern Denmark, Inst Sports Sci & Clin Biomech, Odense, Denmark. [Hoilund-Carlsen, Poul Flemming] Odense Univ Hosp, Dept Nucl Med, DK-5000 Odense, Denmark. C3 University of Southern Denmark; Odense University Hospital; University of Freiburg; University of Southern Denmark; University of Southern Denmark; Odense University Hospital RP Stochkendahl, MJ (通讯作者),Nord Inst Chiropract & Clin Biomech, Campusvej 55, DK-5230 Odense M, Denmark. EM m.jensen@nikkb.dk RI Vach, Werner/F-2512-2011 OI Vach, Werner/0000-0003-1865-8399; Hoilund-Carlsen, Poul/0000-0001-7420-2367; Wulff Christensen, Henrik/0000-0001-8903-0473; Hartvigsen, Jan/0000-0002-5876-7410; Stochkendahl, Mette Jensen/0000-0003-0297-8267 FU Foundation of Chiropractic Research and Postgraduate Education in Denmark FX Salary for MJS was provided by the Foundation of Chiropractic Research and Postgraduate Education in Denmark. The funding body had no role in designing the study, collection, analyzing and interpreting of data, in writing the report or decision to submit the article for publication. 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J. Cardiol. PD MAR 1 PY 2015 VL 182 BP 126 EP 131 DI 10.1016/j.ijcard.2014.12.054 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CE6DU UT WOS:000351927600046 PM 25577748 DA 2023-05-13 ER PT J AU Alnsasra, H Zahger, D Geva, D Matetzky, S Beigel, R Iakobishvili, Z Alcalai, R Atar, S Shimony, A AF Alnsasra, Hilmi Zahger, Doron Geva, Diklah Matetzky, Shlomi Beigel, Roy Iakobishvili, Zaza Alcalai, Ronny Atar, Shaul Shimony, Avi TI Contemporary Determinants of Delayed Benchmark Timelines in Acute Myocardial Infarction in Men and Women SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ST-SEGMENT ELEVATION; ACUTE CORONARY SYNDROMES; TO-BALLOON TIME; SEX-DIFFERENCES; MEDICAL-CARE; ECG TIME; MANAGEMENT; INTERVENTION; ASSOCIATION; GUIDELINES AB Treatment delays in patients with acute myocardial infarction (AMI) are related to increased morbidity and mortality. Hence, identifying determinants of delay may help reduce time to treatment. Importantly, limited data suggest that there may be sex-related disparities in benchmark timelines. Although guidelines advocate the use of the first medical contact (FMC) rather than hospital admission as the moment from which delays to treatment should be monitored, the latter is still often used for quality purposes. We aimed to identify factors associated with treatment delays, with an emphasis on sex-related disparities. We reviewed data on 3,658 patients with AMI from 2 contemporary, consecutive multicenter surveys. Measured delays were FMC-to-electrocardiogram >10 minutes in ST elevation MI (STEMI) and non-STEM!, FMC-to-primary percutaneous coronary intervention >90 minutes in STEMI, and invasive angiography >72 hours after admission in non-STEMI patients. Timely electrocardiogram was performed in 48% of patients with STEMI and in 39.8% of non-STEMI patients without significant sex-related differences. Independent determinants of delay included atypical chest pain (CP) and presentation during daytime. In patients with STEMI, 37.5% had primary percutaneous coronary intervention in less than 90 minutes without significant sex-related disparities. Independent determinants of delay included atypical CP, night presentation, and diabetes. In non-STEMI patients, independent determinants of delayed invasive approach were female sex, age >75 years, atypical CP, and renal failure. In conclusion, significant treatment delays in patients with AMI are still frequent in contemporary practice, highlighting the need for improvement and guidelines implementation. Predictors of delay identified in our study may facilitate targeting of interventions to improve adherence to guidelines. (C) 2017 Elsevier Inc. All rights reserved. C1 [Alnsasra, Hilmi; Zahger, Doron; Shimony, Avi] Ben Gurion Univ Negev, Fac Hlth Sci, Soroka Univ Med Ctr, Dept Cariol, Beer Sheva, Israel. [Geva, Diklah; Matetzky, Shlomi; Beigel, Roy] Tel Aviv Univ, Sackler Sch Med, Sheba Med Ctr, Dept Cardiol, Tel Aviv, Israel. [Iakobishvili, Zaza] Tel Aviv Univ, Sackler Sch Med, Rabin Med Ctr, Dept Cardiol, Tel Aviv, Israel. [Alcalai, Ronny] Hadassah Hebrew Univ Med Ctr, Dept Cardiol, Jerusalem, Israel. [Atar, Shaul] Bar Ilan Univ, Galilee Med Ctr, Dept Cardiol, Nahariyya, Israel. C3 Ben Gurion University; Soroka Medical Center; Chaim Sheba Medical Center; Tel Aviv University; Sackler Faculty of Medicine; Rabin Medical Center; Tel Aviv University; Sackler Faculty of Medicine; Hebrew University of Jerusalem; Bar Ilan University; Western Galilee Hospital RP Shimony, A (通讯作者),Ben Gurion Univ Negev, Fac Hlth Sci, Soroka Univ Med Ctr, Dept Cariol, Beer Sheva, Israel. 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PD NOV 15 PY 2017 VL 120 IS 10 BP 1715 EP 1719 DI 10.1016/j.amjcard.2017.07.085 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FO2MV UT WOS:000416614300003 PM 28864323 DA 2023-05-13 ER PT J AU Saar, A Marandi, T Ainla, T Fischer, K Blondal, M Eha, J AF Saar, Aet Marandi, Toomas Ainla, Tiia Fischer, Krista Blondal, Mai Eha, Jaan TI The risk-treatment paradox in non-ST-elevation myocardial infarction patients according to their estimated GRACE risk SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Acute myocardial infarction; NSTEMI; Estonia; Registry ID ACUTE CORONARY SYNDROMES; ELDERLY-PATIENTS; GUIDELINE ADHERENCE; GLOBAL REGISTRY; UNSTABLE ANGINA; UNITED-KINGDOM; OUTCOMES; CARE; DISEASE; SWEDEN AB Background: The purpose was to describe the treatment and outcomes of non-ST-elevation myocardial infarction (NSTEMI) in Estonia according to patients estimated mortality risk by the Global Registry of Acute Coronary Events (GRACE) score and investigate if inequalities in treatment had an impact on prognosis. Methods: We performed a linkage between Estonian Myocardial Infarction Registry, Population Registry and Estonian Health Insurance Fund. All NSTEMI patients 2012-2014 were stratified into low (<4%), intermediate (4-12%), or high (>12%) mortality risk according to GRACE. All-cause mortality and composite endpoint of death, recurrent myocardial infarction, stroke or unplanned revascularization were compared between optimally - defined as concomitant in-hospital use of medicines from recommended groups and coronary angiography - and suboptimally managed patients, using the Cox regression. Results: Out of 3803 NSTEMI patients (median age 73 years, 44% women) 20% were classified into low, 35% into intermediate and 45% into high risk category. In these groups, respectively, 62%, 46% and 23% of patients received optimal in-hospital management. Over the mean follow-up of 2.4 years the association between suboptimal inhospital management and outcomes was the following: in the low risk group mortality hazard ratio (HR) 1.6 (95% confidence interval 0.8-32), composite endpoint HR 12 (0.8-1.8); in the intermediate risk group mortality HR 2.4 (1.7-3.3), composite endpoint HR 1.8 (1.4-2.3); and in the high risk group mortality HR 2.2 (1.8-2.8), composite endpoint HR 1.6 (1.3-2.0). Conclusions: Higher risk NSTEMI patients received less guideline-recommended in-hospital management, which was associated with a worse prognosis. (C) 2018 Elsevier B.V. All rights reserved. C1 [Saar, Aet; Marandi, Toomas; Ainla, Tiia; Blondal, Mai; Eha, Jaan] Univ Tartu, Heart Clin, 1a L Puusepa Str, EE-50406 Tartu, Estonia. [Saar, Aet; Marandi, Toomas; Ainla, Tiia; Blondal, Mai] North Estonia Med Ctr, Ctr Cardiol, 191 J Sutiste Str, EE-13419 Tallinn, Estonia. [Marandi, Toomas] North Estonia Med Ctr, Qual Dept, 191 J Sutiste Str, EE-13419 Tallinn, Estonia. [Fischer, Krista] Univ Tartu, Estonian Genome Ctr, 23b Riia Str, EE-51010 Tartu, Estonia. [Eha, Jaan] Tartu Univ Hosp, Heart Clin, 1a L Puusepa Str, EE-50406 Tartu, Estonia. C3 University of Tartu; University of Tartu RP Saar, A (通讯作者),Univ Tartu, Heart Clin, 1a L Puusepa Str, EE-50406 Tartu, Estonia. EM aet.saar@regionaalhaigla.ee; toomas.marandi@regionaalhaigla.ee; tiia.ainla@regionaalhaigla.ee; krista.fischer@ut.ee; mai.blondal@ut.ee; jaan.eha@kliinikum.ee FU Institutional Research Grant from Estonian Research Council [2-7 [IUT 2-7]]; Personal Research Funding from Estonian Research Council [1665 [PUT1665]] FX This work was supported by Institutional Research Grant 2-7 [IUT 2-7] and Personal Research Funding Grant 1665 [PUT1665], both from Estonian Research Council. 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PD DEC 1 PY 2018 VL 272 BP 26 EP 32 DI 10.1016/j.ijcard.2018.08.015 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GV3VI UT WOS:000446025200005 PM 30121176 DA 2023-05-13 ER PT J AU Olomu, AB Stommel, M Holmes-Rovner, MM Prieto, AR Corser, WD Gourineni, V Eagle, KA AF Olomu, Adesuwa B. Stommel, Manfred Holmes-Rovner, Margaret M. Prieto, Andrew R. Corser, William D. Gourineni, Venu Eagle, Kim A. TI Is quality improvement sustainable? Findings of the American college of cardiology's guidelines applied in practice SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE sustainability; adherence to medications; predictors of medication use; quality improvement; quality management; quality indicators; measurement of quality; guidelines; appropriate healthcare; cardiovascular disease; disease categories ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; BYPASS GRAFT-SURGERY; MEDICARE PATIENTS; SEX-DIFFERENCES; GAP PROJECTS; OF-CARE; IMPLEMENTATION; INTERVENTION; MORTALITY AB Objective. (i) To examine the sustainability of an in-hospital quality improvement (QI) intervention, the American College of Cardiology's Guideline Applied to Practice (GAP) in acute myocardial infarction (AMI). (ii) To determine the predictors of physician adherence to AMI guidelines-recommended medication prescribing. Prospective observational study. Five mid-Michigan community hospitals. 516 AMI patients admitted consecutively 1 year after the GAP intervention. These patients were compared with 499 post-GAP patients. The main outcome was adherence to medication use guidelines. Predictors of medication use were determined using multivariable logistic regression analysis. 1 year after GAP implementation, adherence to most medications remained high. We found a significant increase in beta-blocker (BB) use in-hospital (87.9 vs. 72.1%, P < 0.001) whereas cholesterol assessment within 24 h (79.5 vs. 83.6%, P > 0.225) did not change significantly. However, discharge aspirin (83 vs. 90%, P < 0.018) and BB prescriptions (84 vs. 92%, P < 0.016) dropped to preintervention rates. Discharge angiotensin-converting enzyme inhibitor and treatment of patients with low-density lipoprotein of a parts per thousand yen100 were unchanged. Predictors of receiving appropriate medications were male gender (for aspirin and BBs) and treatment with percutaneous coronary intervention compared with coronary artery bypass graft. Notably, prescription rates for discharge medications differed significantly by hospital. Early benefits of the Mid-Michigan GAP intervention on guideline use were only partially sustained at 1 year. Differences in guideline adherence by treatment modality and hospital demonstrate challenges for follow-up phases of GAP. Additional strategies to improve sustainability of QI efforts are urgently needed. C1 [Olomu, Adesuwa B.; Prieto, Andrew R.; Gourineni, Venu] Michigan State Univ, Coll Human Med, Dept Med, E Lansing, MI 48824 USA. [Stommel, Manfred] Michigan State Univ, Coll Nursing, E Lansing, MI 48824 USA. [Holmes-Rovner, Margaret M.] Michigan State Univ, Ctr Eth & Human Life Sci, E Lansing, MI 48824 USA. [Corser, William D.] Michigan State Univ, Inst Hlth Care Studies, Coll Human Med, E Lansing, MI 48824 USA. [Eagle, Kim A.] Michigan State Univ, Dept Internal Med, E Lansing, MI 48824 USA. C3 Michigan State University; Michigan State University College of Human Medicine; Michigan State University; Michigan State University; Michigan State University; Michigan State University College of Human Medicine; Michigan State University RP Olomu, AB (通讯作者),788 Serv Rd,B329 Clin Ctr, E Lansing, MI 48824 USA. EM ade.olomu@hc.msu.edu FU Agency for Health Care Research and Quality (AHRQ) R01 grant [HS10531]; Minority Supplementary grant from AHRQ 'Translating Research: Patient Decision Support/Coaching' [3 RO1 HS10531] FX This work was supported in part by Agency for Health Care Research and Quality (AHRQ) R01 grant (HS10531 to M. H. R., Principal Investigator and A.O., Minority Investigator); and Minority Supplementary grant (3 RO1 HS10531 to M. H. R., Principal Investigator and A.O., Minority Investigator) from AHRQ 'Translating Research: Patient Decision Support/Coaching'. CR Akhter N, 2009, AM HEART J, V157, P141, DOI 10.1016/j.ahj.2008.08.012 Amsterdam EA, 2009, AM HEART J, V158, P748, DOI 10.1016/j.ahj.2009.09.008 Baigent C, 2002, BMJ-BRIT MED J, V324, P71, DOI 10.1136/bmj.324.7329.71 Birtcher Kim K, 2010, Crit Pathw Cardiol, V9, P103, DOI 10.1097/HPC.0b013e3181ed763e Borrelli B, 2005, J CONSULT CLIN PSYCH, V73, P852, DOI 10.1037/0022-006X.73.5.852 Brush JE, 2006, AM HEART J, V152, P379, DOI 10.1016/j.ahj.2005.12.014 Eagle KA, 2006, NAT CLIN PRACT CARD, V3, P163, DOI 10.1038/ncpcardio0499 Eagle KA, 2005, J AM COLL CARDIOL, V46, P1242, DOI 10.1016/j.jacc.2004.12.083 Eagle KA, 2004, AM HEART J, V148, pS49, DOI 10.1016/j.ahj.2004.09.016 Eagle Kim A, 2002, Jt Comm J Qual Improv, V28, P5 Fonarow GC, 2001, CIRCULATION, V103, P38 Gibbons RJ, 2006, ARCH INTERN MED, V166, P1164, DOI 10.1001/archinte.166.11.1164 Gottlieb SS, 1998, NEW ENGL J MED, V339, P489, DOI 10.1056/NEJM199808203390801 Harrold LR, 2003, CARDIOLOGY, V99, P39, DOI 10.1159/000068445 Hillis LD, 2012, J THORAC CARDIOV SUR, V143, P4, DOI 10.1016/j.jtcvs.2011.10.015 Holmes-Rovner M, 2008, J GEN INTERN MED, V23, P1464, DOI 10.1007/s11606-008-0710-1 Homer D, 2002, APPL LOGISTIC REGRES Jackevicius CA, 2008, CIRCULATION, V117, P1028, DOI 10.1161/CIRCULATIONAHA.107.706820 Jneid H, 2008, CIRCULATION, V118, P2803, DOI 10.1161/CIRCULATIONAHA.108.789800 Lewis WR, 2008, ARCH INTERN MED, V168, P1813, DOI 10.1001/archinte.168.16.1813 Marciniak TA, 1998, JAMA-J AM MED ASSOC, V279, P1351, DOI 10.1001/jama.279.17.1351 Mehta RH, 2006, ARCH INTERN MED, V166, P2027, DOI 10.1001/archinte.166.18.2027 Mehta RH, 2002, JAMA-J AM MED ASSOC, V287, P1269, DOI 10.1001/jama.287.10.1269 Mehta RH, 2004, J AM COLL CARDIOL, V43, P2166, DOI 10.1016/j.jacc.2003.08.067 Montoye Cecelia K, 2003, Jt Comm J Qual Saf, V29, P468 Okrainec K, 2006, CAN J CARDIOL, V22, P841, DOI 10.1016/S0828-282X(06)70302-6 Roger VL, 2012, CIRCULATION, V125, pE2, DOI 10.1161/CIR.0b013e31823ac046 Shah ND, 2009, AM J MED, V122, DOI 10.1016/j.amjmed.2008.12.021 Snyder C, 2005, JAMA-J AM MED ASSOC, V293, P2900, DOI 10.1001/jama.293.23.2900 Soumeral SB, 1997, JAMA-J AM MED ASSOC, V277, P115, DOI 10.1001/jama.277.2.115 NR 30 TC 21 Z9 21 U1 0 U2 6 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1353-4505 EI 1464-3677 J9 INT J QUAL HEALTH C JI Int. J. Qual. Health Care PD JUN PY 2014 VL 26 IS 3 BP 215 EP 222 DI 10.1093/intqhc/mzu030 PG 8 WC Health Care Sciences & Services; Health Policy & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA AI7CS UT WOS:000337040000001 PM 24815063 OA Bronze DA 2023-05-13 ER PT J AU Ruiz-Bustillo, S Ivern, C Badosa, N Farre, N Marco, E Bruguera, J Cladellas, M Enjuanes, C Cainzos-Achirica, M Marti-Almor, J Comin-Colet, J AF Ruiz-Bustillo, Sonia Ivern, Consol Badosa, Neus Farre, Nuria Marco, Esther Bruguera, Jordi Cladellas, Merce Enjuanes, Cristina Cainzos-Achirica, Miguel Marti-Almor, Julio Comin-Colet, Josep TI Efficacy of a nurse-led lipid-lowering secondary prevention intervention in patients hospitalized for ischemic heart disease: A pilot randomized controlled trial SO EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE Nurse-led intervention; acute coronary syndrome; cholesterol; ischaemic heart disease; lipids; secondary prevention; statins ID ACUTE MYOCARDIAL-INFARCTION; CARDIOVASCULAR RISK-FACTORS; ST-SEGMENT ELEVATION; PROGRAM; METAANALYSIS; GUIDELINES; MANAGEMENT; ADHERENCE; SAFETY AB Background and aims: Lack of achievement of secondary prevention objectives in patients with ischaemic heart disease remains an unmet need in this patient population. We aimed at evaluating the six-month efficacy of an intensive lipid-lowering intervention, coordinated by nurses and implemented after hospital discharge, in patients hospitalized for an ischaemic heart disease event. Methods: Randomized controlled trial, in which a nurse-led intervention including periodic follow-up, serial lipid level controls, and subsequent optimization of lipid-lowering therapy, if appropriate, was compared with standard of care alone in terms of serum lipid-level control at six months after discharge. Results: The nurse-led intervention was associated with an improved management of low-density lipoprotein (LDL) cholesterol levels compared with standard of care alone: LDL cholesterol levels <= 100 mg/dL were achieved in 97% participants in the intervention arm as compared with 67% in the usual care arm (p value <0.001), the LDL cholesterol <= 70 mg/dL target recommended by the 2016 European Society of Cardiology guidelines was achieved in 62% vs. 37% participants (p value 0.047) and the LDL cholesterol reduction of > 50% recommended by the American College of Cardiology/American Heart Association in 2013 was achieved in 25.6% of participants in the intervention arm as compared with 2.6% in the usual care arm (p value 0.007). The intervention was also associated with improved blood pressure control among individuals with hypertension. Conclusions: Our findings highlight the opportunity that nurse-led, intensive, post-discharge follow-up plans may represent for achieving LDL cholesterol guideline-recommended management objectives in patients with ischaemic heart disease. These findings should be replicated in larger cohorts. C1 [Ruiz-Bustillo, Sonia; Ivern, Consol; Badosa, Neus; Farre, Nuria; Bruguera, Jordi; Cladellas, Merce; Marti-Almor, Julio] Hosp del Mar, Dept Cardiol, Barcelona, Spain. [Ruiz-Bustillo, Sonia; Ivern, Consol; Badosa, Neus; Farre, Nuria; Cladellas, Merce; Marti-Almor, Julio] Autonomous Univ Barcelona, Dept Med, Barcelona, Spain. [Ruiz-Bustillo, Sonia; Ivern, Consol; Badosa, Neus; Farre, Nuria; Bruguera, Jordi; Cladellas, Merce; Marti-Almor, Julio] Hosp del Mar, Biomed Res Inst IMIM, Biomed Res Grp GREC, Barcelona, Spain. [Marco, Esther] Hosp del Mar, Dept Phys Med & Rehabil, Barcelona, Spain. [Enjuanes, Cristina; Cainzos-Achirica, Miguel; Comin-Colet, Josep] Bellvitge Univ Hosp, Barcelona, Spain. [Enjuanes, Cristina; Cainzos-Achirica, Miguel; Comin-Colet, Josep] Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain. [Cainzos-Achirica, Miguel] Johns Hopkins Med Inst, Dept Cardiol, Johns Hopkins Ciccarone Ctr Prevent Heart Dis, Baltimore, MD 21205 USA. [Cainzos-Achirica, Miguel] RTI Hlth Solut, Pharmacoepidemiol & Risk Management, Barcelona, Spain. [Comin-Colet, Josep] Univ Barcelona, Dept Clin Sci, Barcelona, Spain. C3 Institut Hospital del Mar d'Investigacions Mediques (IMIM); Hospital del Mar; Autonomous University of Barcelona; Institut Hospital del Mar d'Investigacions Mediques (IMIM); Hospital del Mar; Institut Hospital del Mar d'Investigacions Mediques (IMIM); Hospital del Mar; Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Bellvitge University Hospital; University of Barcelona; Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Johns Hopkins University; Johns Hopkins Medicine; Research Triangle Institute; University of Barcelona RP Comin-Colet, J (通讯作者),Hosp Univ Bellvitge, Dept Cardiol, 4th Floor Feixa Llarga S-N, Barcelona 08003, Catalonia, Spain. EM josepcomin@gmail.com RI Bustillo, Sonia Ruiz/AAC-1329-2020; Ruiz, Sonia/GRK-0102-2022; Comin-Colet, Josep/AAM-3000-2021; Farre, Nuria/I-2668-2019; Enjuanes, Cristina/ABG-2302-2020; Marco, Ester/T-9829-2018 OI Bustillo, Sonia Ruiz/0000-0002-6074-914X; Comin-Colet, Josep/0000-0001-8780-720X; Farre, Nuria/0000-0003-3110-6572; Enjuanes, Cristina/0000-0002-7916-1223; BADOSA, NEUS/0000-0003-4960-8634; Cladellas, Merce/0000-0001-8537-6012; Julio, Marti Almor/0000-0001-9927-1190; Marco, Ester/0000-0002-3412-0356 FU Hospital del Mar Quality of Care Improvement Program [2012/4727/I] FX This work was financially supported by an unrestricted grant from the Hospital del Mar Quality of Care Improvement Program (2012/4727/I). CR [Anonymous], STAT STAT SOFTW REL1 Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] BENN M, 2017, BMJ-BRIT MED J, V357, DOI DOI 10.1136/BMJ.J1648 Boersma E, 2006, EUR HEART J, V27, P779, DOI 10.1093/eurheartj/ehi810 Byrne D, 2015, Ir Med J, V108, P204 Cainzos-Achirica M, 2015, ANN INTERN MED, V163, P64, DOI 10.7326/M15-0920 Cicolini G, 2014, INT J NURS STUD, V51, P833, DOI 10.1016/j.ijnurstu.2013.10.010 Dallongeville J, 2012, EUR J PREV CARDIOL, V19, P541, DOI 10.1177/1741826711407705 Fichtenberg CM, 2000, NEW ENGL J MED, V343, P1772, DOI 10.1056/NEJM200012143432406 Fulcher J, 2015, LANCET, V385, P1397, DOI 10.1016/S0140-6736(14)61368-4 Harbman P, 2014, INT J NURS STUD, V51, P1542, DOI 10.1016/j.ijnurstu.2014.04.004 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Jorstad HT, 2015, CONTEMP NURSE, V51, P96, DOI 10.1080/10376178.2015.1119032 Jorstad HT, 2013, HEART, V99, P1421, DOI 10.1136/heartjnl-2013-303989 Kotseva K, 2009, EUR J CARDIOV PREV R, V16, P121, DOI 10.1097/HJR.0b013e3283294b1d Le May MR, 2008, NEW ENGL J MED, V358, P231, DOI 10.1056/NEJMoa073102 Naderi SH, 2012, AM J MED, V125, P882, DOI 10.1016/j.amjmed.2011.12.013 Phillips CO, 2005, EUR J HEART FAIL, V7, P333, DOI 10.1016/j.ejheart.2005.01.011 Piepoli MF, 2016, EUR HEART J, V37, P2315, DOI 10.1093/eurheartj/ehw106 Qvist I, 2016, OPEN HEART, V3, DOI 10.1136/openhrt-2015-000335 Reiner Z, 2010, ATHEROSCLEROSIS, V213, P598, DOI 10.1016/j.atherosclerosis.2010.09.014 Robinson JG, 2017, J AM COLL CARDIOL, V69, P471, DOI 10.1016/j.jacc.2016.11.037 Snaterse M, 2017, OPEN HEART, V4, DOI 10.1136/openhrt-2017-000607 Stone NJ, 2014, CIRCULATION, V129, pS1, DOI 10.1161/01.cir.0000437738.63853.7a Wong NY, 2016, INT J QUAL HEALTH C, V28, P758, DOI 10.1093/intqhc/mzw103 NR 25 TC 3 Z9 3 U1 2 U2 20 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1474-5151 EI 1873-1953 J9 EUR J CARDIOVASC NUR JI Eur. J. Cardiovasc. Nurs. PD JUN PY 2019 VL 18 IS 5 BP 366 EP 374 DI 10.1177/1474515119831511 PG 9 WC Cardiac & Cardiovascular Systems; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology; Nursing GA IA8UP UT WOS:000469834300004 PM 30757908 OA Green Accepted DA 2023-05-13 ER PT J AU Avanzini, F Marelli, G Saltafossi, D Longhi, C Carbone, S Carlino, L Planca, E Vilei, V Roncaglioni, MC Riva, E AF Avanzini, Fausto Marelli, Giuseppe Saltafossi, Donata Longhi, Chiara Carbone, Stefania Carlino, Liliana Planca, Enrico Vilei, Veronica Roncaglioni, Maria Carla Riva, Emma CA Desio Diabet Diagram DDD Study Grp TI Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Intensive cardiac care unit; diabetes; hyperglycaemia; insulin infusion protocol; nurse-implemented protocol ID ACUTE CORONARY SYNDROMES; GLUCOSE CONTROL; MYOCARDIAL-INFARCTION; BLOOD-GLUCOSE; CRITICAL ILLNESS; HYPERGLYCEMIA; THERAPY; GUIDELINES; MORTALITY; VARIABILITY AB Objectives: To assess the effectiveness, safety and feasibility of the revised, simplified nurse-managed version of our insulin infusion protocol, adapted to the new recommended glycaemic target of 140 to 180 mg/dL (Desio Diabetes Diagram i.v. 140-180). Methods: All clinical responses to the Desio Diabetes Diagram i.v. 140-180 in use for 3 years were recorded in patients with diabetes or hyperglycaemia admitted to our intensive cardiac care unit. To assess the feasibility, we asked nurses to complete an ad hoc questionnaire anonymously when the new insulin infusion protocol had been in use for 2 years. Results: From December 2010 to December 2013, 276 patients (173 men, median age 75 years) were treated according to the Desio Diabetes Diagram i.v. 140-180. The median time to reach glycaemic target was 4 h (Q1-Q3 2-8) in 128 patients with blood glucose >180 mg/dL and 2 h (Q1-Q3 1-4) in 82 patients with blood glucose <140 mg/dL. Once the target had been reached, insulin infusion was maintained for a median of 38 h (Q1-Q3 24-48) with blood glucose between 140 and 180 mg/dL for 58.3% of the infusion time. Over a total of 11,863 h of infusion, seven blood glucose <70 mg/dL occurred. The Desio Diabetes Diagram i.v. 140-180 protocol was considered easy to use by 93% of nurses. Conclusions: The Desio Diabetes Diagram i.v. 140-180 protocol, fully managed by nurses, with insulin and glucose intravenous infusion proved effective, safe and feasible in maintaining blood glucose between 140 and 180 mg/dL in patients with diabetes or hyperglycaemia admitted to the intensive cardiac care unit for acute cardiac events. C1 [Avanzini, Fausto; Saltafossi, Donata; Longhi, Chiara; Carbone, Stefania; Carlino, Liliana; Planca, Enrico] Osped Desio, Div Cardiol, Desio, Italy. [Avanzini, Fausto; Saltafossi, Donata; Longhi, Chiara; Carbone, Stefania; Carlino, Liliana; Planca, Enrico] Osped Desio, Intens Cardiac Care Unit, Desio, Italy. [Avanzini, Fausto; Roncaglioni, Maria Carla; Riva, Emma] IRCCS, Ist Ric Farmacol Mario Negri, Via Giuseppe La Masa 19, I-20156 Milan, Italy. [Marelli, Giuseppe; Vilei, Veronica] Osped Desio, Diabet & Metab Dis Unit, Desio, Italy. C3 Istituto di Ricerche Farmacologiche Mario Negri IRCCS RP Avanzini, F (通讯作者),IRCCS, Ist Ric Farmacol Mario Negri, Via Giuseppe La Masa 19, I-20156 Milan, Italy. EM fausto.avanzini@marionegri.it RI roncaglioni, maria carla/AAB-1875-2020 OI roncaglioni, maria carla/0000-0002-2029-7847; Avanzini, Fausto/0000-0002-4029-2891; moro, claudio/0000-0003-1538-5401 CR Amer Diabet Associat, 2008, DIABETES CARE, V31, pS61, DOI 10.2337/dc08-S061 [Anonymous], 2015, DIABETES CARE, V38, pS5, DOI 10.2337/dc15-S004 Avanzini F, 2011, DIABETES CARE, V34, P1445, DOI 10.2337/dc10-2023 Avanzini F, 2009, EUR J CARDIOVASC NUR, V8, P182, DOI 10.1016/j.ejcnurse.2008.12.001 Brunkhorst FM, 2008, NEW ENGL J MED, V358, P125, DOI 10.1056/NEJMoa070716 Capes SE, 2000, LANCET, V355, P773, DOI 10.1016/S0140-6736(99)08415-9 Cheung NW, 2006, DIABETES CARE, V29, P765, DOI 10.2337/diacare.29.04.06.dc05-1894 Davidson PC, 2005, DIABETES CARE, V28, P2418, DOI 10.2337/diacare.28.10.2418 Diaz R, 2007, JAMA-J AM MED ASSOC, V298, P2399, DOI 10.1001/jama.298.20.2399 Dungan KM, 2009, LANCET, V373, P1798, DOI 10.1016/S0140-6736(09)60553-5 Finfer S, 2009, NEW ENGL J MED, V360, P1283, DOI 10.1056/NEJMoa0810625 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hargraves JD, 2014, AM J CRIT CARE, V23, P250, DOI 10.4037/ajcc2014236 Hermanides J, 2010, CRIT CARE MED, V38, P838, DOI 10.1097/CCM.0b013e3181cc4be9 Jacobi J, 2012, CRIT CARE MED, V40, P3251, DOI 10.1097/CCM.0b013e3182653269 Krenitsky J, 2011, NUTR CLIN PRACT, V26, P31, DOI 10.1177/0884533610392237 Krikorian A, 2010, CURR OPIN CLIN NUTR, V13, P198, DOI 10.1097/MCO.0b013e32833571db Lipton JA, 2013, EUR HEART J-ACUTE CA, V2, P306, DOI 10.1177/2048872613489304 Malmberg K, 2005, EUR HEART J, V26, P650, DOI 10.1093/eurheartj/ehi199 MALMBERG K, 1995, J AM COLL CARDIOL, V26, P57, DOI 10.1016/0735-1097(95)00126-K McClave SA, 2009, JPEN-PARENTER ENTER, V33, P277, DOI 10.1177/0148607109335234 Mebazaa A, 2013, J AM COLL CARDIOL, V61, P820, DOI 10.1016/j.jacc.2012.11.054 Meynaar IA, 2012, J CRIT CARE, V27, P119, DOI 10.1016/j.jcrc.2011.11.004 Perez Mirza E, 2013, Hosp Pharm, V48, P213, DOI 10.1310/hpj4803-213 Petrov Katerina I, 2012, P T, V37, P283 Preiser JC, 2009, INTENS CARE MED, V35, P1738, DOI 10.1007/s00134-009-1585-2 Ryden L, 2013, EUR HEART J, V34, P3035, DOI 10.1093/eurheartj/eht108 Selker HP, 2012, JAMA-J AM MED ASSOC, V307, P1925, DOI 10.1001/jama.2012.426 Senthinathan A, 2011, BRIT MED J, V343, DOI 10.1136/bmj.d6646 Shetty S, 2012, ENDOCR PRACT, V18, P363, DOI 10.4158/EP11260.OR Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Su G, 2013, DIABETES CARE, V36, P1026, DOI 10.2337/dc12-0925 Van den Berghe G, 2006, NEW ENGL J MED, V354, P449, DOI 10.1056/NEJMoa052521 Van den Berghe G, 2001, NEW ENGL J MED, V345, P1359, DOI 10.1056/NEJMoa011300 van der Horst ICC, 2007, CARDIOVASC DIABETOL, V6, DOI 10.1186/1475-2840-6-2 van der Voort PHJ, 2006, CLIN ENDOCRINOL, V64, P141, DOI 10.1111/j.1365-2265.2006.02437.x Van Herpe T, 2013, DIABETES CARE, V36, P188, DOI 10.2337/dc12-0584 Verges B, 2012, DIABETES METAB, V38, P113, DOI 10.1016/j.diabet.2011.11.003 Vogelzang M, 2008, INTENS CARE MED, V34, P1421, DOI 10.1007/s00134-008-1091-y NR 40 TC 2 Z9 3 U1 1 U2 5 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 2048-8726 EI 2048-8734 J9 EUR HEART J-ACUTE CA JI Eur. Heart J.-Acute Cardiovasc. Care PD APR PY 2016 VL 5 IS 2 BP 117 EP 124 DI 10.1177/2048872615574110 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DF4JQ UT WOS:000371314300003 PM 25735300 DA 2023-05-13 ER PT J AU Schwartz, SP Walker, TC Kihlstrom, M Isani, M Smith, MM Smith, RL McLean, SE Clement, KC Phillips, MR AF Schwartz, Stephanie P. Walker, Tracie C. Kihlstrom, Margaret Isani, Mubina Smith, Melissa M. Smith, Rebecca L. McLean, Sean E. Clement, Katherine C. Phillips, Michael R. TI Extracorporeal Membrane Oxygenation for COVID-19-Associated Multisystem Inflammatory Syndrome in a 5-year-old SO AMERICAN SURGEON LA English DT Article DE extracorporeal membrane oxygenation; COVID-19; multisystem inflammatory syndrome in children; pediatrics; critical care ID CHILDREN AB Severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) is associated with multisystem inflammatory syndrome in children (MIS-C) that ranges from mild symptoms to cardiopulmonary collapse. A 5-year-old girl presented with shock and a rapid decline in left ventricular function requiring intubation. SARS-CoV-2 was diagnosed by viral Polymerase Chain Reaction (PCR), and she received remdesivir and COVID-19 convalescent plasma. Initial echocardiogram (ECHO) demonstrated low normal left ventricular function and mild left anterior descending coronary artery dilation. She remained hypotensive, despite high-dose epinephrine and norepinephrine infusions as well as stress-dose hydrocortisone. Admission SARS-CoV-2 IgG assay was positive, meeting the criteria for MIS-C. An ECHO 9 hours after admission demonstrated a severe decline in left ventricular function. Due to severe cardiogenic shock, she was cannulated for venoarterial extracorporeal support (ECMO). During her ECMO course, she was treated with remdesivir, intravenous methylprednisolone, intravenous immunoglobulin, and anakinra. She was decannulated on ECMO day 7, extubated the following day, and discharged home 2 weeks later without respiratory or cardiac support. The use of ECMO for cardiopulmonary support for pediatric patients with MIS-C is feasible and should be considered early as part of the treatment algorithm for patients with severe cardiopulmonary dysfunction. C1 [Schwartz, Stephanie P.; Walker, Tracie C.; Kihlstrom, Margaret; Smith, Melissa M.; Smith, Rebecca L.; Clement, Katherine C.] Univ N Carolina, Dept Pediat, Div Pediat Crit Care Med, Chapel Hill, NC 27599 USA. [Isani, Mubina; McLean, Sean E.; Phillips, Michael R.] Univ N Carolina, Dept Surg, Div Pediat Surg, Chapel Hill, NC 27599 USA. C3 University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina; University of North Carolina Chapel Hill RP Phillips, MR (通讯作者),Univ N Carolina, Div Pediat Surg, 170 Manning Dr,CB 722, Chapel Hill, NC 27599 USA. EM miphilli@med.unc.edu OI Schwartz, Stephanie/0000-0003-4314-6117 CR Belhadjer Z, 2020, CIRCULATION, V142, P429, DOI 10.1161/CIRCULATIONAHA.120.048360 Castagnoli R, 2020, JAMA PEDIATR, V174, P882, DOI 10.1001/jamapediatrics.2020.1467 Davies P, 2020, LANCET CHILD ADOLESC, V4, P669, DOI 10.1016/S2352-4642(20)30215-7 Dong YY, 2020, PEDIATRICS, V145, DOI 10.1542/peds.2020-0702 Feldstein LR, 2020, NEW ENGL J MED, V383, P334, DOI 10.1056/NEJMoa2021680 Lu XX, 2020, NEW ENGL J MED, V382, P1663, DOI 10.1056/NEJMc2005073 Riphagen S, 2020, LANCET, V395, P1607, DOI [10.1016/S0140-6736(20)31094-1, 10.1016/50140-6736(20)31094-1] Verdoni L, 2020, LANCET, V395, P1771, DOI 10.1016/S0140-6736(20)31103-X NR 8 TC 7 Z9 7 U1 0 U2 2 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0003-1348 EI 1555-9823 J9 AM SURGEON JI Am. Surg. PD FEB PY 2022 VL 88 IS 2 BP 174 EP 176 DI 10.1177/0003134820983198 PG 3 WC Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Surgery GA YD5PL UT WOS:000740488700003 PM 33372818 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Shitole, SG Kayo, N Srinivas, V Alapati, V Nordin, C Southern, W Christia, P Faillace, RT Scheuer, J Kizer, JR AF Shitole, Sanyog G. Kayo, Noel Srinivas, Vankeepuram Alapati, Venkatesh Nordin, Charles Southern, William Christia, Panagiota Faillace, Robert T. Scheuer, James Kizer, Jorge R. TI Clinical Profile, Acute Care, and Middle-Term Outcomes of Cocaine-Associated ST-Segment Elevation Myocardial Infarction in an Inner-City Community SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE CORONARY SYNDROME; CHEST-PAIN; BETA-BLOCKERS; MANAGEMENT; RISK AB Although cocaine is a well-recognized risk factor for coronary disease, detailed information is lacking regarding related behavioral and clinical features of cocaine-associated ST-segment elevation myocardial infarction (STEMI), particularly in socioeconomically disadvantaged urban settings. Nor are systematic or extended follow-up data available on outcomes for cocaine-associated STEMI in the contemporary era of percutaneous coronary intervention. We leveraged a prospective STEMI registry from a large health system serving an inner-city community to characterize the clinical features, acute management, and middle-term out, comes of cocaine-related versus cocaine-unrelated STEMI. Of the 1,003 patients included, 60% were black or Hispanic. Compared with cocaine-unrelated STEMI, cocaine-related STEMI (n = 58) was associated with younger age, male gender, lower socioeconomic score, current smoking, high alcohol consumption, and human immunodeficiency virus seropositivity but less commonly with diabetes or hypertension. Cocaine users less often received drug-eluting stents or beta blockers at discharge. During median follow-up of 2.7 years, rates of death, death or any rehospitalization, and death or cardiovascular rehospitalization did not differ significantly between cocaine users and nonusers but were especially high for death or any hospitalisation in the 2 groups (31.4 vs 32.4 per 100 person-years, p = 0.887). Adjusted hazard ratios for outcomes were likewise not significantly different. In conclusion, in this low-income community, cocaine use occurred in a substantial fraction of STEMI cases, who were younger than their nonuser counterparts but had more prevalent high-risk habits and exhibited similarly high rates of adverse outcomes. These data suggest that programs targeting cocaine abuse and related behaviors could contribute importantly to disease prevention in disadvantaged communities. (C) 2016 Elsevier Inc. All rights reserved. C1 [Shitole, Sanyog G.; Kayo, Noel; Srinivas, Vankeepuram; Alapati, Venkatesh; Nordin, Charles; Southern, William; Scheuer, James; Kizer, Jorge R.] Montefiore Med Ctr, Dept Med, Bronx, NY 10467 USA. [Shitole, Sanyog G.; Kayo, Noel; Srinivas, Vankeepuram; Alapati, Venkatesh; Nordin, Charles; Southern, William; Christia, Panagiota; Faillace, Robert T.; Scheuer, James; Kizer, Jorge R.] Albert Einstein Coll Med, Bronx, NY 10467 USA. [Christia, Panagiota; Faillace, Robert T.] Jacobi Med Ctr, Dept Med, Bronx, NY USA. [Kizer, Jorge R.] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA. C3 Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine; Yeshiva University; Albert Einstein College of Medicine; Jacobi Medical Center; Yeshiva University; Albert Einstein College of Medicine RP Kizer, JR (通讯作者),Montefiore Med Ctr, Dept Med, Bronx, NY 10467 USA.; Kizer, JR (通讯作者),Albert Einstein Coll Med, Bronx, NY 10467 USA.; Kizer, JR (通讯作者),Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA. EM jorge.kizer@einstein.yu.edu OI Kizer, Jorge/0000-0001-9936-7803; Shitole, Sanyog/0000-0002-3831-5118 CR Bellin E, 2010, ACAD MED, V85, P1362 Cahill K, 2014, JAMA-J AM MED ASSOC, V311, P193, DOI 10.1001/jama.2013.283787 Carrillo X, 2011, EUR HEART J, V32, P1244, DOI 10.1093/eurheartj/ehq504 Dattilo PB, 2008, ANN EMERG MED, V51, P117, DOI 10.1016/j.annemergmed.2007.04.015 Day E, 2015, BMJ-BRIT MED J, V350, DOI 10.1136/bmj.h715 Fortney JC, 2011, J BEHAV HEALTH SER R, V38, P221, DOI 10.1007/s11414-010-9224-9 Glauser J, 2007, J EMERG MED, V32, P181, DOI 10.1016/j.jemermed.2006.05.044 Gupta N, 2014, AM J CARDIOL, V113, P749, DOI 10.1016/j.amjcard.2013.11.023 Havranek EP, 2015, CIRCULATION, V132, P873, DOI 10.1161/CIR.0000000000000228 Hollander J E, 1994, Acad Emerg Med, V1, P330 HOLLANDER JE, 1995, ARCH INTERN MED, V155, P1081, DOI 10.1001/archinte.155.10.1081 Karila L, 2008, INT J NEUROPSYCHOPH, V11, P425, DOI 10.1017/S1461145707008097 Karisson G, 2007, CATHETER CARDIO INTE, V69, P955, DOI 10.1002/ccd.21151 McCord J, 2008, CIRCULATION, V117, P1897, DOI 10.1161/CIRCULATIONAHA.107.188950 McKee SA, 2007, AM HEART J, V154, P159, DOI 10.1016/j.ahj.2007.04.004 Mittleman MA, 1999, CIRCULATION, V99, P2737, DOI 10.1161/01.CIR.99.21.2737 National Institute on Drug Abuse, 2010, COC NIDA RES REP SER Patrizi R, 2006, J AM COLL CARDIOL, V47, P2120, DOI 10.1016/j.jacc.2005.12.060 Qureshi AI, 2001, CIRCULATION, V103, P502, DOI 10.1161/01.CIR.103.4.502 Rangel C, 2010, ARCH INTERN MED, V170, P874, DOI 10.1001/archinternmed.2010.115 Roux AVD, 2001, NEW ENGL J MED, V345, P99, DOI 10.1056/NEJM200107123450205 Sahai H, 1996, STAT EPIDEMILOGY MET Schmidt HD, 2015, MOL PSYCHIATR, V20, P1460, DOI 10.1038/mp.2014.134 Schwartz BG, 2010, CIRCULATION, V122, P2558, DOI 10.1161/CIRCULATIONAHA.110.940569 Substance Abuse and Mental Health Services Administration, DAWN 2011 EM DEP DAT Weber JE, 2003, NEW ENGL J MED, V348, P510, DOI 10.1056/NEJMoa022206 NR 26 TC 8 Z9 8 U1 0 U2 4 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD APR 15 PY 2016 VL 117 IS 8 BP 1224 EP 1230 DI 10.1016/j.amjcard.2016.01.019 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DJ1NC UT WOS:000373968500005 PM 26897639 DA 2023-05-13 ER PT J AU Movahed, MR Khan, MF Hashemzadeh, M Hashemzadeh, M AF Movahed, Mohammad Reza Khan, Muhammad F. Hashemzadeh, Mehrtash Hashemzadeh, Mehrnoosh TI Gradual Decline in the Age-Adjusted In-Hospital Mortality Rate From STEMI-Related Cardiogenic Shock Irrespective of Cause, Race or Gender With Persistent Higher Mortality Rates in Women Despite Multivariate Adjustment SO JOURNAL OF INVASIVE CARDIOLOGY LA English DT Article DE epidemiology; cardiovascular disease; coronary artery disease incidence; acute myocardial infarction; acute coronary syndrome; ST-elevation myocardial infarction; shock; cardiogenic shock ID ACUTE MYOCARDIAL-INFARCTION; PERCUTANEOUS CORONARY INTERVENTION; ST-SEGMENT ELEVATION; ONE-YEAR SURVIVAL; TO-BALLOON TIME; EARLY REVASCULARIZATION; UNITED-STATES; INDEPENDENT PREDICTOR; REPERFUSION THERAPY; GLOBAL REGISTRY AB Background. Recent improvements in the care of critically ill patients with cardiogenic shock (CS) should be associated with improved outcomes. The goal of this study was to evaluate the trends of age-adjusted mortality rates for all-cause and ST-elevation myocardial infarction (STEMI)-related CS in the United States. Methods. The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted mortality rate of all-cause and STEMI-related CS from 1996 to 2006. We used specific ICD-9 codes for CS and STEMI based on race and gender. Results. We found a gradual decrease in mortality over the 10-year period in patients suffering from all causes or STEMI-related CS irrespective of gender and race with a persistently higher mortality rates in women and African Americans. However, after multivariate adjustment, only female gender remains associated with persistently higher mortality. The age-adjusted mortality rate from STEMI-related CS in women was 2.2% in 1996, with a gradual reduction to the lowest level of 1.7% in 2006 (P<.01). Likewise, the age-adjusted mortality rate from STEMI-related CS in men was 1.7% in 1996, which declined to the lowest level of 1.4% in 2006 (P<.01). Conclusion. Regardless of gender and race, age-adjusted in-hospital mortality is gradually declining in patients presenting with all causes or STEMI-related CS. However, as compared to men, women suffer from persistently higher mortality rates in the setting of STEMI-related CS despite multivariate adjustment. C1 [Movahed, Mohammad Reza] CareMore Hlth Care Arizona, Tucson, AZ USA. [Movahed, Mohammad Reza; Khan, Muhammad F.] Southern Arizona VA Hlth Care Syst, Div Cardiol, Tucson, AZ USA. [Movahed, Mohammad Reza; Hashemzadeh, Mehrnoosh] Univ Arizona, Sarver Heart Ctr, Div Cardiol, Tucson, AZ USA. [Hashemzadeh, Mehrtash] Long Beach VA Med Ctr, Dept Med, Long Beach, CA USA. C3 US Department of Veterans Affairs; Veterans Health Administration (VHA); Southern Arizona Veterans Affairs Health Care System; University of Arizona RP Movahed, MR (通讯作者),Univ Arizona, Sarver Heart Ctr, Tucson, AZ 85710 USA. 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Invasive Cardiol. PD JAN PY 2014 VL 26 IS 1 BP 7 EP 12 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AK1QA UT WOS:000338188900006 PM 24402804 DA 2023-05-13 ER PT J AU Bucholz, EM Butala, NM Normand, SLT Wang, Y Krumholz, HM AF Bucholz, Emily M. Butala, Neel M. Normand, Sharon-Lise T. Wang, Yun Krumholz, Harlan M. TI Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE acute myocardial infarction; elderly; guidelines; life expectancy; survival ID ACUTE CORONARY SYNDROMES; TO-BALLOON TIME; QUALITY-OF-CARE; ST-ELEVATION; PERFORMANCE-MEASURES; GRUPPO-ITALIANO; MORTALITY; ASPIRIN; THERAPY; SURVIVAL AB BACKGROUND Guideline-based admission therapies for acute myocardial infarction (AMI) significantly improve 30-day survival, but little is known about their association with long-term outcomes. OBJECTIVES This study evaluated the association of 5 AMI admission therapies (aspirin, beta-blockers, acute reperfusion therapy, door-to-balloon [D2B] time <= 90 min, and time to fibrinolysis <= 30 min) with life expectancy and years of life saved after AMI. METHODS We analyzed data from the Cooperative Cardiovascular Project, a study of Medicare beneficiaries hospitalized for AMI, with 17 years of follow-up. Life expectancy and years of life saved after AMI were calculated using Cox proportional hazards regression with extrapolation using exponential models. RESULTS Survival for recipients and non-recipients of the 5 guideline-based therapies diverged early after admission and continued to diverge during 17-year follow-up. Receipt of aspirin, beta-blockers, and acute reperfusion therapy on admission was associated with longer life expectancy of 0.78 (standard error [SE]: 0.05), 0.55 (SE: 0.06), and 1.03 (SE: 0.12) years, respectively. Patients receiving primary percutaneous coronary intervention (PCI) within 90 min lived 1.08 (SE: 0.49) years longer than patients with D2B times >90 min, and door-to-needle (D2N) times <= 30 min were associated with 0.55 (SE: 0.12) more years of life. A dose-response relationship was observed between longer D2B and D2N times and shorter life expectancy after AMI. CONCLUSIONS Guideline-based therapy for AMI admission is associated with both early and late survival benefits, and results in meaningful gains in life expectancy and large numbers of years of life saved in elderly patients. (C) 2016 by the American College of Cardiology Foundation. C1 [Bucholz, Emily M.] Boston Childrens Hosp, Dept Med, Boston, MA USA. [Bucholz, Emily M.] Yale Univ, Sch Med, New Haven, CT USA. [Bucholz, Emily M.] Yale Univ, Sch Publ Hlth, New Haven, CT USA. [Butala, Neel M.] Massachusetts Gen Hosp, Dept Internal Med, Boston, MA 02114 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. [Normand, Sharon-Lise T.; Wang, Yun] Harvard Univ, TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Robert Wood Johnson Fdn Clin Scholars Program, New Haven, CT USA. [Krumholz, Harlan M.] Yale Univ, Sch Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT USA. C3 Harvard University; Boston Children's Hospital; Yale University; Yale University; Harvard University; Massachusetts General Hospital; Harvard University; Harvard Medical School; Harvard University; Harvard T.H. Chan School of Public Health; Yale University; Robert Wood Johnson Foundation (RWJF); Yale University; Yale University RP Krumholz, HM (通讯作者),Yale Univ, Sch Med, Dept Internal Med, 1 Church St,Suite 200, New Haven, CT 06510 USA. EM harlan.krumholz@yale.edu RI , Harlan/AAI-2875-2020 FU NHLBI NIH HHS [U01 HL105270, F30 HL120498] Funding Source: Medline; NIGMS NIH HHS [T32 GM007205] Funding Source: Medline CR Abdelnoor M, 1999, CARDIOLOGY, V91, P119, DOI 10.1159/000006891 Aiyagari V, 2009, STROKE, V40, P2251, DOI 10.1161/STROKEAHA.108.531574 [Anonymous], 1988, LANCET, V2, P349 [Anonymous], 1986, LANCET, V2, P57 Baigent C, 1998, BMJ-BRIT MED J, V316, P1337, DOI 10.1136/bmj.316.7141.1337 Berger PB, 1999, CIRCULATION, V100, P14, DOI 10.1161/01.CIR.100.1.14 Brandler E, 2010, ACAD EMERG MED, V17, P1, DOI 10.1111/j.1553-2712.2009.00625.x Cannon CP, 2000, JAMA-J AM MED ASSOC, V283, P2941, DOI 10.1001/jama.283.22.2941 Centers for Medicare and Medicaid Services, 2014, HOSP COMP Centers for Medicare & Medicaid Services, 2013, PROC CAR MEAS Chatterjee S, 2013, INT J CARDIOL, V168, P915, DOI 10.1016/j.ijcard.2012.10.050 Dargie HJ, 2001, LANCET, V357, P1385, DOI 10.1016/s0140-6736(00)04560-8 Flotta D, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0048923 Franzosi MG, 1998, CIRCULATION, V98, P2659, DOI 10.1161/01.CIR.98.24.2659 Freimark D, 2002, AM J CARDIOL, V89, P381, DOI 10.1016/S0002-9149(01)02256-1 Goel K, 2013, AM HEART J, V165, P451, DOI 10.1016/j.ahj.2012.11.014 Goldberg RJ, 2004, AM J CARDIOL, V93, P288, DOI 10.1016/j.amjcard.2003.10.006 GOLDSTEIN S, 1983, CIRCULATION, V67, P53 HJALMARSON A, 1985, EUR HEART J, V6, P199 HJALMARSON A, 1983, CIRCULATION, V67, P26 Jernberg T, 2011, JAMA-J AM MED ASSOC, V305, P1677, DOI 10.1001/jama.2011.522 Krumholz HM, 1999, ANN INTERN MED, V131, P648, DOI 10.7326/0003-4819-131-9-199911020-00003 KRUMHOLZ HM, 1995, CIRCULATION, V92, P2841, DOI 10.1161/01.CIR.92.10.2841 Krumholz HM, 2006, J AM COLL CARDIOL, V47, P236, DOI 10.1016/j.jacc.2005.10.020 Kuch B, 2011, INT J CARDIOL, V149, P205, DOI 10.1016/j.ijcard.2010.01.010 Li J, 2015, LANCET, V385, P441, DOI 10.1016/S0140-6736(14)60921-1 Longenecker JC, 2013, INT J CARDIOL, V167, P1406, DOI 10.1016/j.ijcard.2012.04.066 Luthi JC, 2005, INT J QUAL HEALTH C, V17, P229, DOI 10.1093/intqhc/mzi024 Marciniak TA, 1998, JAMA-J AM MED ASSOC, V279, P1351, DOI 10.1001/jama.279.17.1351 MARINO P, 1989, J AM COLL CARDIOL, V14, P1149, DOI 10.1016/0735-1097(89)90409-9 McNamara RL, 2006, J AM COLL CARDIOL, V47, P2180, DOI 10.1016/j.jacc.2005.12.072 O'Connor RE, 2010, CIRCULATION S3, V122, pS787 O'Connor RE, 2010, CIRCULATION, V122, pS787, DOI 10.1161/CIRCULATIONAHA.110.971028 Office of Clinical Standards and Quality, 2009, CMS UPD NAT HOSP QUA PEDERSEN TR, 1983, CIRCULATION, V67, P49 Perez MI, 2009, COCHRANE DB SYST REV, V7 Ramunno LD, 1998, EVAL HEALTH PROF, V21, P442, DOI 10.1177/016327879802100404 Rathore SS, 2009, AM J CARDIOL, V104, P1198, DOI 10.1016/j.amjcard.2009.06.034 SAXON SA, 1985, AM J CARDIOL, V56, P461, DOI 10.1016/0002-9149(85)90886-0 Schiele F, 2009, EUR HEART J, V30, P987, DOI 10.1093/eurheartj/ehn601 The Joint Commission, 2014, COR MEAS SETS TOUCHSTONE DA, 1989, J AM COLL CARDIOL, V13, P1506, DOI 10.1016/0735-1097(89)90340-9 U.S. Food and Drug Administration, NITR U.S. Food and Drug Administration, NITR PUMPSPR NITR SP van Domburg RT, 2005, J AM COLL CARDIOL, V46, P15, DOI 10.1016/j.jacc.2005.03.047 VERHEUGT FWA, 1990, AM J CARDIOL, V66, P267, DOI 10.1016/0002-9149(90)90833-M Vermeer NS, 2008, J CLIN PHARM THER, V33, P591, DOI 10.1111/j.1365-2710.2008.00950.x YUSUF S, 1985, PROG CARDIOVASC DIS, V27, P335, DOI 10.1016/S0033-0620(85)80003-7 NR 48 TC 13 Z9 13 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0735-1097 EI 1558-3597 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAY 24 PY 2016 VL 67 IS 20 BP 2378 EP 2391 DI 10.1016/j.jacc.2016.03.507 PG 14 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA DL9JZ UT WOS:000375960200009 PM 27199062 OA Green Accepted, Bronze DA 2023-05-13 ER PT J AU Koh, Y Stehli, J Martin, C Brennan, A Dinh, DT Lefkovits, J Zaman, S AF Koh, Youlin Stehli, Julia Martin, Catherine Brennan, Angela Dinh, Diem T. Lefkovits, Jeffrey Zaman, Sarah TI Does sex predict quality of life after acute coronary syndromes: an Australian, state-wide, multicentre prospective cohort study SO BMJ OPEN LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; GENDER-DIFFERENCES; HEALTH-STATUS; OUTCOMES; WOMEN; RECOVERY; REGISTRY; ACCESS; IMPACT; YOUNG AB Objective Women have reported higher mortality and major adverse cardiovascular events (MACE) following acute coronary syndromes (ACSs) compared with men. With this in mind, we aimed to identify predictors of poor quality of life (QoL) post-ACS as our primary outcome. We examined predictors of MACE, major cerebrovascular events and major bleeding as our secondary outcome. Design Prospective cohort study. Setting 30 metropolitan centres across the Victorian Cardiac Outcomes Registry network. Participants 16 517 patients treated with percutaneous coronary intervention (PCI) for ACS (22.9% females). Selection/inclusion criteria: consecutive patients with successful or attempted PCI for ACS from 2013 to 2016, alive at 30 days post-PCI. Exclusion criteria: patients not fulfilling ACS criteria. At 30 days, 2497 (64.7% females) completed the QoL EQ-5D-3L instrument. Primary and secondary outcome measures QoL, assessed using the EuroQo-5Dimensions (EQ-5D-3L) instrument by telephone at 30 days. Independent predictors of QoL were identified by univariate and multivariate logistic regression analyses. Results Women were significantly older with more diabetes, cerebrovascular disease and renal failure. Regarding the primary outcome, female sex was independently associated with moderate/severe impairment in all EQ-5D-3L domains including mobility (OR 2.38, 95% CI 2.06 to 2.75, p<0.001), personal care (OR 2.14, 95% CI 1.73 to 2.66, p<0.001), activities of daily living (OR 1.84, 95% CI 1.63 to 2.08, p<0.001), pain/discomfort (OR 1.44, 95% CI 1.24 to 1.67, p<0.001) and anxiety/depression (OR 1.49, 95% CI 1.30 to 1.70, p<0.001). Women had significantly lower self-rated Visual Analogue Scale scores (80.0 for both groups, IQR 60-85 vs 70-90, p<0.001). There was no significant difference between the sexes in secondary outcomes. Conclusions Female sex was a predictor of poorer QoL following PCI for ACS including significantly higher pain, anxiety and depression. This was independent of age, comorbidities and ACS presentation. There is a clinical need for a tailored approach in female ACS management, for example, emphasis on management of depressive and anxiety symptoms. C1 [Koh, Youlin; Stehli, Julia] Alfred Hosp, Dept Cardiol, Melbourne, Vic, Australia. [Stehli, Julia] Monash Univ, Fac Med Nursing & Hlth Sci, Clayton, Vic, Australia. [Martin, Catherine] Monash Univ, Dept Epidemiol & Preventat Med, Melbourne, Vic, Australia. [Brennan, Angela; Dinh, Diem T.; Lefkovits, Jeffrey; Zaman, Sarah] Monash Univ, Monash Cardiovasc Res Ctr, Clayton, Vic, Australia. [Lefkovits, Jeffrey] Royal Melbourne Hosp, Dept Cardiol, Melbourne, Vic, Australia. [Zaman, Sarah] Monash Hlth, Monash Heart, Clayton, Vic, Australia. C3 Florey Institute of Neuroscience & Mental Health; Monash University; Monash University; Monash University; Royal Melbourne Hospital RP Zaman, S (通讯作者),Monash Univ, Monash Cardiovasc Res Ctr, Clayton, Vic, Australia.; Zaman, S (通讯作者),Monash Hlth, Monash Heart, Clayton, Vic, Australia. EM Sarah.Zaman@monash.edu RI Stehli, Julia/GRR-8802-2022 OI Dinh, Diem-Thuy/0000-0002-8167-3906 FU National Heart Foundation of Australia [101993] FX SZ has been supported by a fellowship (101993) from the National Heart Foundation of Australia. 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Schmid, Jean-Paul Znoj, Hansjorg Herbert, Claudia Schnyder, Ulrich TI Early Psychological Counseling for the Prevention of Posttraumatic Stress Induced by Acute Coronary Syndrome: The MI-SPRINT Randomized Controlled Trial SO PSYCHOTHERAPY AND PSYCHOSOMATICS LA English DT Article DE Acute coronary care; Behavioral cardiology; Emergency psychiatry; Myocardial infarction; Posttraumatic stress disorder; Prevention; Psychological stress; Trauma stress ID SELF-REPORT MEASURE; MYOCARDIAL-INFARCTION; DISORDER; FREQUENCY; SYMPTOMS; VERSION; LIFE AB Background: Acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) and clinically significant PTSD symptoms (PTSS) are found in 4 and 12% of patients, respectively. We hypothesized that trauma-focused counseling prevents the incidence of ACS-induced PTSS. Methods: Within 48 h of hospital admission, 190 patients with high distress during ACS were randomized to a singlesession intervention of either trauma-focused counseling or an active control intervention targeting the general role of stress in patients with heart disease. Blind interviewer-rated PTSS (primary outcome) and additional health outcomes were assessed at 3 months of follow-up. Trial results about prevalence were compared with data from previous studies on the natural incidence of ACS-induced PTSS/PTSD. Results: Intention-to-treat analyses revealed no difference in interviewer-rated PTSS between trauma-focused counseling (mean, 11.33; 95% Cl, 9.23-13.43) and stress counseling (9.88; 7.36-12.40; p = 0.40), depressive symptoms (6.01, 4.98-7.03, vs. 4.71, 3.65-5.77; p = 0.08), global psychological distress (5.15, 4.07-6.23, vs. 3.80, 2.60-5.00; p = 0.11), and the risk for cardiovascular-related hospitalization/all-cause mortality (OR, 0.67; 95% CI, 0.37-1.23). Self-rated PTSS indicated less beneficial effects with trauma-focused (6.54; 4.95-8.14) versus stress counseling (3.74; 2.39-5.08; p = 0.017). The completer analysis (154 cases) confirmed these findings. The prevalence rates of interviewer-rated PTSD (0.5%, 1/190) and self-rated PTSS were in this trial much lower than in meta-analyses and observation studies from the same cardiology department. Conclusions: Benefits were not seen for trauma-focused counseling when compared with an active control intervention. Nonetheless, in distressed ACS patients, individual, single-session, early psychological counseling shows potential as a means to prevent posttraumatic responses, but trauma-focused early treatments should probably be avoided. (c) 2018 S. Karger AG, Basel C1 [von Kanel, Roland; Princip, Mary; Meister-Langraf, Rebecca E.] Univ Bern, Univ Hosp Bern, Inselspital, Dept Neurol, Bern, Switzerland. [von Kanel, Roland; Princip, Mary; Meister-Langraf, Rebecca E.] Univ Bern, Dept BioMed Res, Bern, Switzerland. [von Kanel, Roland] Clin Barmelweid, Dept Psychosomat Med, Barmelweid, Switzerland. [Barth, Jurgen] Univ Zurich, Complementary & Integrat Med, Zurich, Switzerland. [Princip, Mary] Univ Bern, Univ Hosp Bern, Inselspital, Div Cardiovasc Prevent Rehabil & Sports Med,Dept, Bern, Switzerland. [Meister-Langraf, Rebecca E.] Clienia Schlossli AG, Oetwil Am See, Oetwil Am See, Switzerland. [Schmid, Jean-Paul] Clin Barmelweid, Dept Cardiol, Barmelweid, Switzerland. [Znoj, Hansjorg] Univ Bern, Dept Clin Psychol & Psychotherapy, Bern, Switzerland. [Herbert, Claudia] Oxford Dev Ctr Ltd, Oxford, England. [Schnyder, Ulrich] Univ Zurich, Univ Zurich Hosp, Dept Psychiat & Psychotherapy, Zurich, Switzerland. C3 University of Bern; University Hospital of Bern; University of Bern; University of Zurich; University of Bern; University Hospital of Bern; University of Bern; University of Zurich; University Zurich Hospital RP von Kanel, R (通讯作者),Univ Hosp Zurich, Dept Consultat Liaison Psychiat & Psychosomat Med, CH-8091 Zurich, Switzerland. EM roland.vonkaenel@usz.ch RI von Känel, Roland/B-1811-2019; Barth, Jürgen/F-9987-2011 OI von Känel, Roland/0000-0002-8929-5129; Barth, Jürgen/0000-0001-7096-7178; Schnyder, Ulrich/0000-0003-3556-7990 FU Swiss National Science Foundation [140960]; Teaching and Research Directorate, Bern University Hospital, Switzerland FX The trial was funded by grant No. 140960 from the Swiss National Science Foundation to R.K. (principal investigator), J.-P.S., U.S., H.Z., and J.B. Additional funding came from the Teaching and Research Directorate, Bern University Hospital, Switzerland. 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Psychosom. PY 2018 VL 87 IS 2 BP 75 EP 84 DI 10.1159/000486099 PG 10 WC Psychiatry; Psychology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry; Psychology GA GA9XV UT WOS:000428697100002 PM 29462823 OA Green Accepted DA 2023-05-13 ER PT J AU Huffman, JC Mastromauro, CA Beach, SR Celano, CM DuBois, CM Healy, BC Suarez, L Rollman, BL Januzzi, JL AF Huffman, Jeff C. Mastromauro, Carol A. Beach, Scott R. Celano, Christopher M. DuBois, Christina M. Healy, Brian C. Suarez, Laura Rollman, Bruce L. Januzzi, James L. TI Collaborative Care for Depression and Anxiety Disorders in Patients With Recent Cardiac Events The Management of Sadness and Anxiety in Cardiology (MOSAIC) Randomized Clinical Trial SO JAMA INTERNAL MEDICINE LA English DT Article ID QUALITY-OF-LIFE; CORONARY-HEART-DISEASE; MYOCARDIAL-INFARCTION; CARDIOVASCULAR EVENTS; MAJOR DEPRESSION; SADHART-CHF; RISK-FACTOR; VALIDITY; PREVALENCE; SERTRALINE AB IMPORTANCE Depression and anxiety are associated with adverse cardiovascular outcomes in patients with recent acute cardiac events. There has been minimal study of collaborative care (CC) management models for mental health disorders in high-risk cardiac inpatients, and no prior CC intervention has simultaneously managed depression and anxiety disorders. OBJECTIVE To determine the impact of a low-intensity CC intervention for depression, generalized anxiety disorder, and panic disorder among patients hospitalized for an acute cardiac illness. DESIGN, SETTING, AND PARTICIPANTS Single-blind randomized clinical trial, with study assessors blind to group assignment, from September 2010 through July 2013 of 183 patients admitted to inpatient cardiac units in an urban academic general hospital for acute coronary syndrome, arrhythmia, or heart failure and found to have clinical depression, generalized anxiety disorder, or panic disorder on structured assessment. INTERVENTIONS Participants were randomized to 24 weeks of a low-intensity telephone-based multicomponent CC intervention targeting depression and anxiety disorders (n = 92) or to enhanced usual care (serial notification of primary medical providers; n = 91). The CC intervention used a social work care manager to coordinate assessment and stepped care of psychiatric conditions and to provide support and therapeutic interventions as appropriate. MAIN OUTCOMES AND MEASURES Improvement in mental health-related quality of life (Short Form-12 Mental Component Score [SF-12MCS]) at 24 weeks, compared between groups using a random-effects model in an intent-to-treat analysis. RESULTS Patients randomized to CC had significantly greater estimated mean improvements in SF-12MCS at 24 weeks (11.21 points [from 34.21 to 45.42] in the CC group vs 5.53 points [from 36.30 to 41.83] in the control group; estimated mean difference, 5.68 points [95% CI, 2.14-9.22]; P = .002; effect size, 0.61). Patients receiving CC also had significant improvements in depressive symptoms and general functioning, and higher rates of treatment of a mental health disorder; anxiety scores, rates of disorder response, and adherence did not differ between groups. CONCLUSIONS AND RELEVANCE A novel telephone-based, low-intensity model to concurrently manage cardiac patients with depression and/or anxiety disorders was effective for improving mental health-related quality of life in a 24-week trial. C1 [Huffman, Jeff C.; Mastromauro, Carol A.; Beach, Scott R.; Celano, Christopher M.; DuBois, Christina M.; Healy, Brian C.; Suarez, Laura; Januzzi, James L.] Harvard Univ, Sch Med, Boston, MA USA. [Huffman, Jeff C.; Mastromauro, Carol A.; Beach, Scott R.; Celano, Christopher M.; DuBois, Christina M.; Suarez, Laura] Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02114 USA. [Healy, Brian C.] Massachusetts Gen Hosp, Ctr Biostat, Boston, MA 02114 USA. [Rollman, Bruce L.] Univ Pittsburgh, Div Gen Internal Med, Dept Med, Pittsburgh, PA USA. [Januzzi, James L.] Massachusetts Gen Hosp, Dept Med, Div Cardiol, Boston, MA 02114 USA. C3 Harvard University; Harvard Medical School; Harvard University; Massachusetts General Hospital; Harvard University; Massachusetts General Hospital; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Harvard University; Massachusetts General Hospital RP Huffman, JC (通讯作者),Massachusetts Gen Hosp, Blake 11,55 Fruit St, Boston, MA 02114 USA. EM jhuffman@partners.org RI Januzzi, James/Y-2436-2019 OI Celano, Christopher Michael/0000-0003-0547-2851; DuBois, Christina/0000-0003-2719-2404 FU American Heart Association [10GRNT3450015] FX This research was funded by American Heart Association Grant-in-Aid 10GRNT3450015 (to Dr Huffman). 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Med. PD JUN PY 2014 VL 174 IS 6 BP 927 EP 935 DI 10.1001/jamainternmed.2014.739 PG 9 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA AI4OA UT WOS:000336843500026 PM 24733277 DA 2023-05-13 ER PT J AU Pang, J Li, SCH Chan, DC Sullivan, DR Woodward, AM Watts, GF AF Pang, Jing Li, Stephen C. H. Chan, Dick C. Sullivan, David R. Woodward, Ann-Marie Watts, Gerald F. TI Hypertriglyceridemia: rationale, design and implementation of the Australian Hypertriglyceridemia Registry SO CURRENT OPINION IN ENDOCRINOLOGY DIABETES AND OBESITY LA English DT Review DE design; hypertriglyceridemia; implementation; registries ID ATHEROSCLEROTIC CARDIOVASCULAR-DISEASE; TO-MODERATE HYPERTRIGLYCERIDEMIA; CORONARY-HEART-DISEASE; CONSENSUS STATEMENT; REMNANT CHOLESTEROL; RISK; TRIGLYCERIDES; RECOMMENDATIONS; INDIVIDUALS; ASSOCIATION AB Purpose of review Hypertriglyceridemia (HTG) is a risk factor for atherosclerotic cardiovascular disease (ASCVD), aortic stenosis, hepatic steatosis and pancreatitis. We briefly review the aetiology and treatment of HTG and familial chylomicronemia syndrome (FCS), as well as the implementation of a clinical quality registry for improving care, the Australian Hypertriglyceridemia (AUSTRIG) Registry. Recent findings There is a need to improve the detection of individuals with severe HTG and FCS, who could benefit from more intense and novel treatments to prevent end-organ damage. Patient registries provide valuable data for advancing care of individuals with severe HTG at high risk of acute pancreatitis, steatohepatitis and ASCVD. However, there is a paucity of registries of such patients. We outline the design and implementation of the AUSTRIG Registry. Clinical registries can be employed in many ways for improving outcomes for patients with HTG, through the collation and analysis of data for enabling health service planning, clinical trials and audits, and for better informing and empowering registrants. C1 [Pang, Jing; Chan, Dick C.; Watts, Gerald F.] Univ Western Australia, Fac Hlth & Med Sci, Med Sch, Perth, WA, Australia. [Li, Stephen C. H.] Westmead Hosp, NSW Hlth Pathol, Westmead Hosp, Core Pathol & Clin Chem Pathol West, Perth, NSW, Australia. [Sullivan, David R.] Royal Prince Alfred Hosp, NSW Hlth Pathol, Dept Chem Pathol, Camperdown, NSW, Australia. [Woodward, Ann-Marie; Watts, Gerald F.] Royal Perth Hosp, Lipid Disorders Clin, Dept Cardiol, Perth, Australia. [Woodward, Ann-Marie; Watts, Gerald F.] Royal Perth Hosp, Lipid Disorders Clin, Dept Internal Med, Perth, Australia. C3 University of Western Australia; University of Sydney; University of Sydney; Royal Perth Hospital; Royal Perth Hospital RP Watts, GF (通讯作者),Univ Western Australia, Sch Med, Fac Hlth & Med Sci, Royal Perth Hosp, GPO Box X2213, Perth, WA 6847, Australia. EM gerald.watts@uwa.edu.au RI Watts, Gerald/HII-8530-2022 OI Pang, Jing/0000-0002-9700-6948; Chan, Dick/0000-0001-7658-5197 FU National Health and Medical Research Council (NHMRC) FX J.P. is supported by an Investigator Grant from the National Health and Medical Research Council (NHMRC). We are grateful for support for the registry from Arrowhead and from NSW Health Pathology. 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Opin. Endocrinol. Diabetes Obes. PD APR PY 2022 VL 29 IS 2 BP 131 EP 140 DI 10.1097/MED.0000000000000715 PG 10 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism GA ZG3LY UT WOS:000760161500009 PM 35066540 OA Green Submitted DA 2023-05-13 ER PT J AU Rillig, A Magnussen, C Ozga, AK Suling, A Brandes, A Breithardt, G Camm, AJ Crijns, HJGM Eckardt, L Elvan, A Goette, A Gulizia, M Haegeli, L Heidbuchel, H Kuck, KH Ng, A Szumowski, L van Gelder, I Wegscheider, K Kirchhof, P AF Rillig, Andreas Magnussen, Christina Ozga, Ann-Kathrin Suling, Anna Brandes, Axel Breithardt, Gunter Camm, A. John Crijns, Harry J. G. M. Eckardt, Lars Elvan, Arif Goette, Andreas Gulizia, Michele Haegeli, Laurent Heidbuchel, Hein Kuck, Karl-Heinz Ng, Andre Szumowski, Lukasz van Gelder, Isabelle Wegscheider, Karl Kirchhof, Paulus TI Early Rhythm Control Therapy in Patients With Atrial Fibrillation and Heart Failure SO CIRCULATION LA English DT Article DE acute coronary syndrome; anti-arrhythmia agents; atrial fibrillation; atrial fibrillation ablation; controlled clinical trial; death; heart failure; stroke ID CATHETER ABLATION; DAPA-HF AB BACKGROUND: Even on optimal therapy, many patients with heart failure and atrial fibrillation experience cardiovascular complications. Additional treatments are needed to reduce these events, especially in patients with heart failure and preserved left ventricular ejection fraction. METHODS: This prespecified subanalysis of the randomized EAST-AFNET4 trial (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial) assessed the effect of systematic, early rhythm control therapy (ERC; using antiarrhythmic drugs or catheter ablation) compared with usual care (allowing rhythm control therapy to improve symptoms) on the 2 primary outcomes of the trial and on selected secondary outcomes in patients with heart failure, defined as heart failure symptoms New York Heart Association II to III or left ventricular ejection fraction [LVEF] <50%. RESULTS: This analysis included 798 patients (300 [37.6%] female, median age 71.0 [64.0, 76.0] years, 785 with known LVEF). The majority of patients (n = 442) had heart failure and preserved LVEF (LVEF=50%; mean LVEF 61 +/- 6.3%), the others had heart failure with midrange ejection fraction (n=211; LVEF 40%-49%; mean LVEF 44 +/- 2.9%) or heart failure with reduced ejection fraction (n=132; LVEF<40%; mean LVEF 31 +/- 5.5%). Over the 5.1-year median follow-up, the composite primary outcome of cardiovascular death, stroke, or hospitalization for worsening of heart failure or for acute coronary syndrome occurred less often in patients randomly assigned to ERC (94/396; 5.7 per 100 patient-years) compared with patients randomly assigned to usual care (130/402; 7.9 per 100 patient-years; hazard ratio, 0.74 [0.56-0.97]; P=0.03), not altered by heart failure status (interaction P value=0.63). The primary safety outcome (death, stroke, or serious adverse events related to rhythm control therapy) occurred in 71 of 396 (17.9%) patients with heart failure randomly assigned to ERC and in 87 of 402 (21.6%) patients with heart failure randomly assigned to usual care (hazard ratio, 0.85 [0.62-1.17]; P=0.33). LVEF improved in both groups (LVEF change at 2 years: ERC 5.3 +/- 11.6%, usual care 4.9 +/- 11.6%, P=0.43). ERC also improved the composite outcome of death or hospitalization for worsening of heart failure. CONCLUSIONS: Rhythm control therapy conveys clinical benefit when initiated within 1 year of diagnosing atrial fibrillation in patients with signs or symptoms of heart failure. C1 [Rillig, Andreas; Magnussen, Christina; Kirchhof, Paulus] Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Hamburg, Germany. [Ozga, Ann-Kathrin; Suling, Anna; Wegscheider, Karl] Univ Med Ctr Hamburg Eppendorf, Inst Med Biometry & Epidemiol, Hamburg, Germany. [Rillig, Andreas; Magnussen, Christina; Kuck, Karl-Heinz; Wegscheider, Karl; Kirchhof, Paulus] German Ctr Cardiovasc Res, Partner Site Hamburg Luebeck Kiel, Hamburg, Germany. [Brandes, Axel] Odense Univ Hosp, Dept Cardiol, Odense, Denmark. [Brandes, Axel] Univ Southern Denmark, Dept Clin Res, Odense, Denmark. [Breithardt, Gunter; Eckardt, Lars; Goette, Andreas; Kuck, Karl-Heinz; Wegscheider, Karl; Kirchhof, Paulus] Atrial Fibrillat Network AFNET, Munster, Germany. [Breithardt, Gunter; Eckardt, Lars] Univ Hosp Munster, Dept Cardiol Electrophysiol 2, Munster, Germany. [Camm, A. John] St Georges Univ London, Mol & Clin Sci Res Inst, Cardiol Clin Acad Grp, London, England. [Crijns, Harry J. G. M.] Maastricht Univ, Dept Cardiol, Med Ctr, Maastricht, Netherlands. [Crijns, Harry J. G. M.] Cardiovasc Res Inst Maastricht, Maastricht, Netherlands. [Elvan, Arif] Isala Hosp, Zwolle, Netherlands. [Elvan, Arif] Diagram Res, Zwolle, Netherlands. [Goette, Andreas] St Vincenz Hosp, Paderborn, Germany. [Goette, Andreas] Univ Hosp Magdeburg, Working Grp Mol Electrophysiol, Magdeburg, Germany. [Gulizia, Michele] Garibaldi Nesima Hosp, Catania, Italy. [Haegeli, Laurent] Univ Hosp Zurich, Zurich, Switzerland. [Haegeli, Laurent] Kantonsspital Aarau, Div Cardiol, Med Univ Dept, Aarau, Switzerland. [Heidbuchel, Hein] Univ Hosp Antwerp, Antwerp, Belgium. [Heidbuchel, Hein] Antwerp Univ, Antwerp, Belgium. [Kuck, Karl-Heinz] LANS Cardio, Hamburg, Germany. [Ng, Andre] Univ Leicester, Dept Cardiovasc Sci, Natl Inst Hlth Res, Leicester Biomed Res Ctr,Glenfield Hosp, Leicester, Leics, England. [Szumowski, Lukasz] Natl Inst Cardiol, Arrhythmia Ctr, Warsaw, Poland. [Szumowski, Lukasz] Cardinal Stefan Wyszynski Univ, Med Div, Warsaw, Poland. [van Gelder, Isabelle] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands. [Kirchhof, Paulus] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England. C3 University of Hamburg; University Medical Center Hamburg-Eppendorf; University of Hamburg; University Medical Center Hamburg-Eppendorf; German Centre for Cardiovascular Research; University of Southern Denmark; Odense University Hospital; University of Southern Denmark; University of Munster; St Georges University London; Maastricht University; Maastricht University; University Hospital Magdeburg; Presidio Ospedaliero Garibaldi-Nesima; University of Zurich; University Zurich Hospital; Kantonsspital Aarau AG (KSA); University of Antwerp; University of Antwerp; RLUK- Research Libraries UK; University of Leicester; University Hospitals of Leicester NHS Trust; Glenfield Hospital; Institute of Cardiology - Poland; Cardinal Stefan Wyszynski University in Warsaw; University of Groningen; RLUK- Research Libraries UK; University of Birmingham RP Kirchhof, P (通讯作者),Univ Heart & Vasc Ctr UKE Hamburg, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany. EM p.kirchhof@uke.de RI Brandes, Axel/L-3609-2019 OI Brandes, Axel/0000-0001-9145-6887; Elvan, Arif/0000-0001-8436-8635; Ng, G. Andre/0000-0001-5965-0671; Crijns, Harry/0000-0003-1073-5337; Breithardt, Gunter/0000-0001-7574-8900 FU BMBF (German Ministry of Education and Research, Berlin, Germany) [01 GI 0204]; DZHK (German Center for Cardiovascular Research, Berlin, Germany); AFNET (Atrial Fibrillation Network); European Heart Rhythm Association; St Jude Medical/Abbott; Sanofi; German Heart Foundation; European Union [633196]; AFNET [EU IMI 116074]; British Heart Foundation [FS/13/43/30324, PG/17/30/32961, PG/20/22/35093, AA/18/2/34218]; Leducq Foundation FX EAST-AFNET4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial) was funded in part by BMBF (German Ministry of Education and Research, Berlin, Germany, Grant 01 GI 0204), DZHK (German Center for Cardiovascular Research, Berlin, Germany), AFNET (Atrial Fibrillation Network), European Heart Rhythm Association, St Jude Medical/Abbott, Sanofi, and the German Heart Foundation. Further support came from the European Union (grant agreement No. 633196 [CATCH ME] to Dr Kirchhof and AFNET; grant agreement EU IMI 116074 [BigData@Heart] to Dr Kirchhof), the British Heart Foundation (FS/13/43/30324; PG/17/30/32961; PG/20/22/35093; AA/18/2/34218, all to Dr Kirchhof), and Leducq Foundation to Dr Kirchhof. 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Ruggia-Check, Christina Dujon, Jay E. TI Antiplatelet and anticoagulation medications and the surgical patient SO AMERICAN JOURNAL OF SURGERY LA English DT Article DE Antiplatelet; Anticoagulation; Bleeding; Thrombosis; Novel oral anticoagulants ID BLEEDING COMPLICATIONS; RECEPTOR ANTAGONISTS; WARFARIN; RIVAROXABAN; MANAGEMENT; RISK; THROMBOPROPHYLAXIS; CLOPIDOGREL; ENOXAPARIN; APIXABAN AB BACKGROUND: Acute coronary syndrome affects more than 750,000 Americans per year, and antiplatelet agents are the cornerstones of treatment. Atrial fibrillation affects 2.4 million patients in the United States, and venous thromboembolism occurs in 1 to 2 per 1,000 adults per year. Anticoagulants are commonly prescribed to affected patients. Surgeons are commonly called upon to care for patients taking medications that affect normal coagulation. It is important that the surgical community has a fundamental understanding of these agents' pharmacology, which may impact patients' clinical course. METHODS: A review of recent literature on pharmacologic agents that affect coagulation was performed. RESULTS: A number of medications that alter normal coagulation were reviewed in this article including their pharmacologic properties and reversal strategies. CONCLUSIONS: There are a variety of medications that affect a patient's coagulation ability, including many newer agents on the market. This review provides surgeons with the knowledge needed to assist in caring for individuals receiving these drugs. (C) 2014 Elsevier Inc. All rights reserved. C1 [Yorkgitis, Brian K.] Temple Univ Hosp & Med Sch, Dept Surg, Philadelphia, PA 19140 USA. [Dujon, Jay E.] Temple Univ Hosp & Med Sch, Div Surg Crit Care & Trauma, Philadelphia, PA 19140 USA. [Ruggia-Check, Christina] Temple Univ Hosp & Med Sch, Dept Pharm, Philadelphia, PA 19140 USA. C3 Pennsylvania Commonwealth System of Higher Education (PCSHE); Temple University; Pennsylvania Commonwealth System of Higher Education (PCSHE); Temple University; Pennsylvania Commonwealth System of Higher Education (PCSHE); Temple University RP Yorkgitis, BK (通讯作者),Temple Univ Hosp & Med Sch, Dept Surg, 3401 North Broad St,Suite 450, Philadelphia, PA 19140 USA. 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J. Surg. PD JAN PY 2014 VL 207 IS 1 BP 95 EP 101 DI 10.1016/j.amjsurg.2013.04.004 PG 7 WC Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Surgery GA 268VG UT WOS:000328198100015 PM 24139554 DA 2023-05-13 ER PT J AU Kannan, VD Veazie, PJ AF Kannan, Viji Diane Veazie, Peter J. TI Predictors of Avoiding Medical Care and Reasons for Avoidance Behavior SO MEDICAL CARE LA English DT Article DE patient delay; delay stages; reasons for delay; care avoidance ID ACUTE CORONARY SYNDROME; DOCTOR-PATIENT COMMUNICATION; PREHOSPITAL DELAY-TIME; SEEKING; ACCESS; INTERVENTIONS; DIAGNOSIS; CANCER; DETERMINANTS; DURATION AB Background: Delayed medical care has negative health and economic consequences; interventions have focused on appraising symptoms, with limited success in reducing delay. Objective: To identify predictors of care avoidance and reasons for avoiding care. Methods: Using the Health Information National Trends Survey (2007), we conducted logistic regressions to identify predictors of avoiding medical visits deemed necessary by the respondents; and, we then conducted similar analyses on reasons given for avoidance behavior. Independent variables included geographic, demographic, socioeconomic, personal health, health behavior, health care system, and cognitive characteristics. Results: Approximately one third of adults avoided doctor visits they had deemed necessary. Although unadjusted associations existed, avoiding needed care was not independently associated with geographic, demographic, and socioeconomic characteristics. Avoidance behavior is characterized by low health self-efficacy, less experience with both quality care and getting help with uncertainty about health, having your feelings attended to by your provider, no usual source of care, negative affect, smoking daily, and fatalistic attitude toward cancer. Reasons elicited for avoidance include preference for self-care or alternative care, dislike or distrust of doctors, fear or dislike of medical treatments, time, and money; respondents also endorsed discomfort with body examinations, fear of having a serious illness, and thoughts of dying. Distinct predictors distinguish each of these reasons. Conclusions: Interventions to reduce patient delay could be improved by addressing the health-related behavioral, belief, experiential, and emotional traits associated with delay. Attention should also be directed toward the interpersonal communications between patients and providers. C1 [Kannan, Viji Diane; Veazie, Peter J.] Univ Rochester, Dept Publ Hlth Sci, Rochester, NY 14642 USA. C3 University of Rochester RP Kannan, VD (通讯作者),Univ Rochester, Dept Publ Hlth Sci, 265 Crittenden Blvd CU 420644, Rochester, NY 14642 USA. 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Care PD APR PY 2014 VL 52 IS 4 BP 336 EP 345 DI 10.1097/MLR.0000000000000100 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA AJ0AC UT WOS:000337309800010 PM 24556894 DA 2023-05-13 ER PT J AU Wassie, M Lee, MS Sun, BC Wu, YL Baecker, AS Redberg, RF Ferencik, M Shen, E Musigdilok, V Sharp, AL AF Wassie, Maereg Lee, Ming-Sum Sun, Benjamin C. Wu, Yi-Lin Baecker, Aileen S. Redberg, Rita F. Ferencik, Maros Shen, Ernest Musigdilok, Visanee Sharp, Adam L. TI Single vs Serial Measurements of Cardiac Troponin Level in the Evaluation of Patients in the Emergency Department With Suspected Acute Myocardial Infarction SO JAMA NETWORK OPEN LA English DT Article ID CHEST-PAIN PATIENTS; HIGH-SENSITIVITY; IDENTIFYING PATIENTS; HEART SCORE; RISK SCORES; DIAGNOSIS; DISCHARGE; PERFORMANCE; GUIDELINES AB Importance Chest pain is among the most common reasons for emergency department (ED) presentations. However, most patients are at low risk for acute coronary syndrome (ACS), with low cardiac adverse outcomes rates. Biomarker testing with troponin levels is key in the initial assessment for ACS. Although serial troponin testing can improve the diagnosis of ACS in clinical practice, some patients deemed to be low risk are discharged after a single negative troponin test result. Objective To report the clinical outcomes of patients discharged after a single negative troponin test result compared with patients discharged after serial troponin measurements. Design, Setting, and Participants This is a retrospective cohort study of ED encounters from May 5, 2016, to December 1, 2017, across 15 community EDs within an integrated health care system in southern California. The study cohort includes 27 918 adult ED encounters in which patients were evaluated for suspected ACS with a HEART (history, electrocardiogram, age, risk factors, and troponin) score and an initial conventional troponin-I measurement below the level of detection (<0.02 ng/mL). Statistical analysis was performed from December 1, 2019, to December 1, 2020. Exposure Single troponin test vs multiple troponin tests. Main Outcomes and Measures The primary outcome was acute myocardial infarction or cardiac mortality; secondary outcomes included coronary artery bypass graft, percutaneous coronary intervention, invasive coronary angiography, and unstable angina within 30 days of discharge. A multivariable logistic regression model was performed to evaluate the association between testing strategies and clinical outcomes. Results A total of 27 918 patient encounters (16 212 women [58.1%]; mean [SD] age, 58.7 [15.2] years) were included in the study. Of patients with an initial troponin measurement below the level of detection, 14 459 (51.8%) were discharged after a single troponin measurement, and 13 459 (48.2%) underwent serial troponin tests. After adjustment for cardiac risk factors and comorbidities, there was no statistically significant difference in the primary outcome of acute myocardial infarction or cardiac mortality within 30 days between the 2 groups (single troponin, 56 [0.4%] vs serial troponin, 52 [0.4%]; adjusted odds ratio, 1.41 [95% CI, 0.96-2.07]). Patients discharged after a single troponin test had lower rates of coronary artery bypass graft (adjusted odds ratio, 0.24 [95% CI, 0.11-0.48]) and invasive coronary angiography (adjusted odds ratio, 0.46 [95% CI, 0.38-0.56]). Conclusions and Relevance This study suggests that patients are routinely discharged from the ED after a single negative troponin test result, and when compared with serial troponin testing, a single troponin test appears safe based on current physician decision-making, with no difference in rates of 30-day cardiac mortality and acute myocardial infarction, which are low in both groups. C1 [Wu, Yi-Lin; Baecker, Aileen S.; Shen, Ernest; Musigdilok, Visanee; Sharp, Adam L.] Kaiser Permanente Southern Calif, Dept Res & Evaluat, 100 S Los Robles Ave,Second Floor, Pasadena, CA 91101 USA. [Wassie, Maereg; Lee, Ming-Sum] Kaiser Permanente Southern Calif, Los Angeles Med Ctr, Div Cardiol, Los Angeles, CA USA. [Sun, Benjamin C.] Univ Penn, Leonard Davis Inst Hlth Econ, Dept Emergency Med, Philadelphia, PA 19104 USA. [Redberg, Rita F.] Univ Calif San Francisco, Div Cardiol, San Francisco, CA USA. [Ferencik, Maros] Oregon Hlth & Sci Univ, Knight Cardiovasc Inst, Portland, OR 97201 USA. C3 Kaiser Permanente; Kaiser Permanente; University of California System; University of California Los Angeles; University of California Los Angeles Medical Center; University of Pennsylvania; University of California System; University of California San Francisco; Oregon Health & Science University RP Sharp, AL (通讯作者),Kaiser Permanente Southern Calif, Dept Res & Evaluat, 100 S Los Robles Ave,Second Floor, Pasadena, CA 91101 USA. EM adam.l.sharp@kp.org FU National Institutes of Health (NIH); NIH; National Heart, Lung, and Blood Institute; American Heart Association FX Dr Sun reported receiving grants from the National Institutes of Health (NIH) during the conduct of the study. MrWu reported receiving grants from the NIH during the conduct of the study. Dr Baecker reported receiving grants from the NIH during the conduct of the study. Dr Ferencik reported receiving grants from the NIH and the American Heart Association during the conduct of the study and personal fees from Biograph Consulting outside the submitted work. Dr Sharp reported receiving grants from the National Heart, Lung, and Blood Institute during the conduct of the study. No other disclosures were reported. 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Open PD FEB 23 PY 2021 VL 4 IS 2 AR e2037930 DI 10.1001/jamanetworkopen.2020.37930 PG 11 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA QM7KC UT WOS:000621953000004 PM 33620444 OA Green Published, gold DA 2023-05-13 ER PT J AU Safford, MM Parmar, G Barasch, CS Halanych, JH Glasser, SP Goff, DC Prineas, RJ Brown, TM AF Safford, Monika M. Parmar, Gaurav Barasch, Codrin S. Halanych, Jewell H. Glasser, Stephen P. Goff, David C. Prineas, Ronald J. Brown, Todd M. TI Hospital laboratory reporting may be a barrier to detection of 'microsize' myocardial infarction in the US: an observational study SO BMC HEALTH SERVICES RESEARCH LA English DT Article DE Acute coronary syndrome; Troponin; Quality control ID CORONARY-HEART-DISEASE; TROPONIN-I; UNIVERSAL DEFINITION; CARDIAC TROPONIN; EUROPEAN-SOCIETY; ELEVATION; OUTCOMES; MORTALITY; IMPACT; RISK AB Background: International guidelines recommend that the decision threshold for troponin should be the 99th percentile of a normal population, or, if the laboratory assay is not sufficiently precise at this low level, the level at which the assay achieves a 10% or better coefficient of variation (CV). Our objectives were to examine US hospital laboratory troponin reports to determine whether either the 99th percentile or the 10% CV level were clearly indicated, and whether nonconcordance with these guidelines was a potential barrier to detecting clinically important microscopic or 'microsize' myocardial infarctions (MIs). To confirm past reports of the clinical importance of microsize MIs, we also contrasted in-hospital, 28-day and 1-year mortality among those with microsize and nonmicrosize MI. Methods: In the REasons for Geographic And Racial Differences in Stroke national prospective cohort study (n=30,239), 1029 participants were hospitalized for acute coronary syndrome (ACS) between 2003-2009. For each case, we recorded all thresholds of abnormal troponin on the laboratory report and whether the 99th percentile or 10% CV value were clearly identified. All cases were expert adjudicated for presence of MI. 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Cardiol. PD JAN PY 2014 VL 37 IS 1 BP 48 EP 56 DI 10.1002/clc.22200 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 287LX UT WOS:000329544400004 PM 24105892 OA Green Published DA 2023-05-13 ER PT J AU Guan, WC Venkatesh, AK Bai, XK Xuan, S Li, J Li, X Zhang, HB Zheng, X Masoudi, FA Spertus, JA Krumholz, HM Jiang, LX AF Guan, Wenchi Venkatesh, Arjun K. Bai, Xueke Xuan, Si Li, Jing Li, Xi Zhang, Haibo Zheng, Xin Masoudi, Frederick A. Spertus, John A. Krumholz, Harlan M. Jiang, Lixin CA China PEACE Prospective TI Time to hospital arrival among patients with acutemyocardial infarction in China: a report from China PEACE prospective study SO EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES LA English DT Article DE Time to hospital arrival; Acute myocardial infarction; Access to care ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; PREHOSPITAL DELAY-TIME; SYMPTOM ONSET; CAMPAIGN; TRENDS; IMPACT; EUROQOL AB Aims Few contemporary studies have reported the time between acute myocardial infarction (AMI) symptoms onset and hospital arrival, associated factors, and patient perceptions of AMI symptoms and care seeking. We sought to study these issues using data from China, where AMI hospitalizations are increasing. Methods and results We used data from the China PEACE prospective AMI study of 53 hospitals across 21 provinces in China. Patients were interviewed during index hospitalization for information of symptom onset, and perceived barriers to accessing care. Regression analyses were conducted to explore factors associated with the time between symptom onset and hospital arrival. The final sample included 3434 patients (mean age 61 years). The median time from symptom onset to hospital arrival was 4 h (interquartile range 2-7.5 h). While 94% of patients reported chest pain or chest discomfort, only 43% perceived symptoms as heart-related. In multivariable analyses, time to hospital arrival was longer by 14% and 39% for patients failing to recognize symptoms as cardiac and those with rural medical insurance, respectively (both P < 0.001). Compared with patients with household income over 100 000 RMB, those with income of 10 000-50 000 RMB, and < 10 000 RMB had 16% and 23% longer times, respectively (both P = 0.03). Conclusion We reported an average time to hospital arrival of 4 h for AMI in China, with longer time associated with rural medical insurance, failing to recognize symptoms as cardiac, and low household income. Strategies to improve the timeliness of presentation may be essential to improving outcomes for AMI in China. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT01624909. C1 [Guan, Wenchi; Bai, Xueke; Li, Jing; Li, Xi; Zhang, Haibo; Zheng, Xin; Jiang, Lixin] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, Natl Clin Res Ctr Cardiovasc Dis,State Key Lab Ca, 167 Beilishi Rd, Beijing 100037, Peoples R China. [Guan, Wenchi; Bai, Xueke; Li, Jing; Li, Xi; Zhang, Haibo; Zheng, Xin; Jiang, Lixin] Peking Union Med Coll, 167 Beilishi Rd, Beijing 100037, Peoples R China. [Venkatesh, Arjun K.; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, 1 Church St,Suite 200, New Haven, CT 06510 USA. [Venkatesh, Arjun K.] Yale Univ, Sch Med, Dept Emergency Med, 464 Congress Ave,Ste 260, New Haven, CT 06519 USA. [Xuan, Si] Univ Southern Calif, Sch Pharm, Dept Pharmaceut & Hlth Econ, 635 Downey Way, Los Angeles, CA 90089 USA. [Masoudi, Frederick A.] Univ Colorado Anschutz Med Campus, Div Cardiol, Campus Box B132,12401 East 17th Ave,Room 522, Aurora, CO 80045 USA. [Spertus, John A.] Univ Missouri Kansas City, St Lukes Mid Amer Heart Inst, 4401 Wornall Rd, Kansas City, MO 64111 USA. [Krumholz, Harlan M.] Yale Univ, Sch Publ Hlth, Dept Hlth Policy & Management, 60 Coll St,POB 208034, New Haven, CT 06520 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, 333 Cedar St,SHM I-456 POB 208088, New Haven, CT 06520 USA. C3 Chinese Academy of Medical Sciences - Peking Union Medical College; Fu Wai Hospital - CAMS; Chinese Academy of Medical Sciences - Peking Union Medical College; Peking Union Medical College; Yale University; Yale University; University of Southern California; University of Colorado System; University of Colorado Anschutz Medical Campus; Saint Luke's Mid America Heart Institute; University of Missouri System; University of Missouri Kansas City; Yale University; Yale University RP Jiang, LX (通讯作者),Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, Natl Clin Res Ctr Cardiovasc Dis,State Key Lab Ca, 167 Beilishi Rd, Beijing 100037, Peoples R China.; Jiang, LX (通讯作者),Peking Union Med Coll, 167 Beilishi Rd, Beijing 100037, Peoples R China. EM jiangl@fwoxford.org RI Spertus, John/ABD-3075-2021; Zhang, Haibo/HLP-9266-2023; , Harlan/AAI-2875-2020 OI Li, Xi/0000-0003-2249-688X FU Research Special Fund for Public Welfare Industry of Health from the National Health and Family Planning Commission of China [201502009]; National Key Technology R&D Program from the Ministry of Science and Technology of China [2015BAI12B01, 2015BAI12B02]; 111 Project [B16005] FX This study was supported by the Research Special Fund for Public Welfare Industry of Health (201502009) from the National Health and Family Planning Commission of China, the National Key Technology R&D Program (2015BAI12B01, 2015BAI12B02) from the Ministry of Science and Technology of China and the 111 Project (B16005). The content is solely the responsibility of the authors and does not necessarily represent the official views of these organizations. 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Heart J.-Qual. Care Clin. Outcomes PD JAN PY 2019 VL 5 IS 1 BP 63 EP 71 DI 10.1093/ehjqcco/qcy022 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ID0CP UT WOS:000471351600011 PM 29878087 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Liu, HY Shen, J Li, SE Song, Y Ju, MF AF Liu, Huanya Shen, Jing Li, Sien Song, Ying Ju, Mingfei TI Research on the Health Literacy Status and Compliance Behavior of Patients with Acute Coronary Syndrome SO COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE LA English DT Article AB This study is aimed at assessing the current status of ACS patients' health literacy and medication compliance, analyzing the relationship between the two, and providing ideas for clinically improving the medication compliance of ACS patients and preventing the recurrence of cardiovascular events. ACS patients need long-term medication to prevent vascular restenosis after surgery, and bad living habits and mood swings will affect postoperative recovery, so clinical interventions are needed to help patients establish a healthy lifestyle. The effect of conventional care is not ideal. Therefore, this paper uses regression analysis to analyze the correlation between the health literacy status of ACS patients and the compliance behavior, combines the investigation and experiment to perform regression analysis and uses mathematical statistics to process data. The connection between health literacy level and compliance behavior is discovered via a study, providing a point of reference for future research. C1 [Liu, Huanya; Li, Sien; Song, Ying; Ju, Mingfei] Chengde Med Univ, Emergency Dept, Affiliated Hosp, Chengde 067000, Hebei, Peoples R China. [Shen, Jing] Chengde Med Univ, Internal Med Cardiovasc Dept, Affiliated Hosp, Chengde 067000, Hebei, Peoples R China. C3 Chengde Medical University; Chengde Medical University RP Ju, MF (通讯作者),Chengde Med Univ, Emergency Dept, Affiliated Hosp, Chengde 067000, Hebei, Peoples R China. EM cdjmf@cdmc.edu.cn CR Alexander JH, 2020, CIRCULATION, V141, P1618, DOI 10.1161/CIRCULATIONAHA.120.046534 Bittner VA, 2020, J AM COLL CARDIOL, V75, P133, DOI 10.1016/j.jacc.2019.10.057 Haider A, 2020, EUR HEART J, V41, P1328, DOI 10.1093/eurheartj/ehz898 Hao YC, 2019, CIRCULATION, V139, P1776, DOI 10.1161/CIRCULATIONAHA.118.037655 Jukema JW, 2019, J AM COLL CARDIOL, V74, P1167, DOI 10.1016/j.jacc.2019.03.013 Kaur A, 2020, CARDIOVASC RES, V116, P1113, DOI 10.1093/cvr/cvz302 Kimura K, 2019, CIRC J, V83, P1085, DOI 10.1253/circj.CJ-19-0133 Lee JM, 2019, JACC-CARDIOVASC IMAG, V12, P1032, DOI 10.1016/j.jcmg.2018.01.023 Linde JJ, 2020, J AM COLL CARDIOL, V75, P453, DOI 10.1016/j.jacc.2019.12.012 Metzler B, 2020, EUR HEART J, V41, P1852, DOI 10.1093/eurheartj/ehaa314 Ray KK, 2019, LANCET DIABETES ENDO, V7, P618, DOI 10.1016/S2213-8587(19)30158-5 Sanchez-de-la-Torre M, 2020, LANCET RESP MED, V8, P359, DOI 10.1016/S2213-2600(19)30271-1 Schwartz GG, 2018, NEW ENGL J MED, V379, P2097, DOI 10.1056/NEJMoa1801174 Tong DC, 2020, CIRCULATION, V142, P1890, DOI 10.1161/CIRCULATIONAHA.120.050771 Vaidya K, 2018, JACC-CARDIOVASC IMAG, V11, P305, DOI 10.1016/j.jcmg.2017.08.013 You SC, 2020, JAMA-J AM MED ASSOC, V324, P1640, DOI 10.1001/jama.2020.16167 NR 16 TC 1 Z9 1 U1 2 U2 2 PU HINDAWI LTD PI LONDON PA ADAM HOUSE, 3RD FLR, 1 FITZROY SQ, LONDON, W1T 5HF, ENGLAND SN 1748-670X EI 1748-6718 J9 COMPUT MATH METHOD M JI Comput. Math. Method Med. PD NOV PY 2021 VL 2021 AR 9648708 DI 10.1155/2021/9648708 PG 8 WC Mathematical & Computational Biology WE Science Citation Index Expanded (SCI-EXPANDED) SC Mathematical & Computational Biology GA ZD8NS UT WOS:000758452700025 PM 34790257 OA gold, Green Published DA 2023-05-13 ER PT J AU Jolly, H Freel, EM Isles, C AF Jolly, Hannah Freel, E. Marie Isles, Chris TI Management of hypertensive emergencies and urgencies: narrative review SO POSTGRADUATE MEDICAL JOURNAL LA English DT Review; Early Access DE hypertension; clinical pharmacology; general medicine AB Hypertensive emergencies are distinguished from hypertensive urgencies by the presence of clinical or laboratory target organ damage. The most common forms of target organ damage in developed countries are pulmonary oedema/heart failure, acute coronary syndrome, ischaemic and haemorrhagic stroke. In the absence of randomised trials, it is inevitable that guideline writers differ slightly regarding the speed and extent to which blood pressure should be lowered acutely. An appreciation of cerebral autoregulation is key and should underpin treatment decisions. Hypertensive emergencies, with the notable exception of uncomplicated malignant hypertension, require intravenous antihypertensive medication which is most safely given in high dependency or intensive care settings. Patients with hypertensive urgency are often treated with medications that lower their blood pressure acutely, although there is no evidence to support this practice. This article aims to review current guidelines and recommendations, and to provide user friendly management strategies for the general physician. C1 [Jolly, Hannah; Isles, Chris] Med Units Dumfries & Galloway Royal Infirm, Dumfries DG1 4AP, Scotland. [Freel, E. Marie] Queen Elizabeth Univ Hosp, Med Unit, Glasgow, Lanark, Scotland. C3 Queen Elizabeth University Hospital (QEUH) RP Isles, C (通讯作者),Med Units Dumfries & Galloway Royal Infirm, Dumfries DG1 4AP, Scotland. EM christopher.isles@nhs.scot OI Isles, Chris/0000-0001-7830-7561 CR Acelajado MC, 2011, INT J HYPERTENS, V2011, DOI 10.4061/2011/837817 [Anonymous], 2019, HYP AD DIAGN MAN Astarita A, 2020, J HYPERTENS, V38, P1203, DOI 10.1097/HJH.0000000000002372 Breu AC, 2018, J HOSP MED, V13, P860, DOI 10.12788/jhm.3086 Grassi D, 2008, J CLIN HYPERTENS, V10, P662, DOI 10.1111/j.1751-7176.2008.00001.x Grossman E, 2012, AM J MED, V125, P14, DOI 10.1016/j.amjmed.2011.05.024 Hameed MA, 2016, J HUM HYPERTENS, V30, P83, DOI 10.1038/jhh.2015.38 ISLES CG, 1986, BRIT J CLIN PHARMACO, V21, P377, DOI 10.1111/j.1365-2125.1986.tb05210.x Keith NM, 1939, AM J MED SCI, V197, P332, DOI 10.1097/00000441-193903000-00006 Keith NM, 1928, ARCH INTERN MED, V41, P141, DOI 10.1001/archinte.1928.00130140003001 Khamsai S, 2021, BMC CARDIOVASC DISOR, V21, DOI 10.1186/s12872-021-02119-x LIP GYH, 1994, J HYPERTENS, V12, P1297 Mancia G, 2013, EUR HEART J, V34, P2159, DOI 10.1093/eurheartj/eht151 Manning L, 2014, CURR HYPERTENS REP, V16, DOI 10.1007/s11906-014-0436-x MCGREGOR E, 1986, BRIT MED J, V292, P233, DOI 10.1136/bmj.292.6515.233 Parasher A, 2020, POSTGRAD MED J, V96, P623, DOI 10.1136/postgradmedj-2020-137706 Patel KK, 2016, JAMA INTERN MED, V176, P981, DOI 10.1001/jamainternmed.2016.1509 Peixoto AJ, 2019, NEW ENGL J MED, V381, P1843, DOI 10.1056/NEJMcp1901117 Qureshi AI, 2016, NEW ENGL J MED, V375, P1033, DOI 10.1056/NEJMoa1603460 SINCLAIR AM, 1987, ARCH INTERN MED, V147, P1289, DOI 10.1001/archinte.147.7.1289 van den Born BJH, 2006, J HYPERTENS, V24, P2299, DOI 10.1097/01.hjh.0000249710.21146.38 van den Born BJH, 2019, EUR HEART J-CARD PHA, V5, P37, DOI 10.1093/ehjcvp/pvy032 van der Zee PA, 2014, NETH J MED, V72, P190 Whelton Paul K, 2018, Hypertension, V71, pe13, DOI [10.1016/j.jash.2018.06.010, 10.1161/HYP.0000000000000065] Whitelaw BC, 2014, CLIN ENDOCRINOL, V80, P13, DOI 10.1111/cen.12324 Williams B, 2018, J HYPERTENS, V36, P1953, DOI 10.1097/HJH.0000000000001940 Zhao R, 2015, MEDICINE, V94, DOI 10.1097/MD.0000000000000896 NR 27 TC 1 Z9 1 U1 1 U2 3 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0032-5473 EI 1469-0756 J9 POSTGRAD MED J JI Postgrad. Med. J. DI 10.1136/postgradmedj-2021-140899 EA OCT 2021 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA XJ4RU UT WOS:000726778000001 PM 34670853 DA 2023-05-13 ER PT J AU Helfer, DR Helber, AR Ferko, AR Klein, DD Elchediak, DS Deaner, TS Slagle, D White, WB Buckler, DG Mitchell, OJL Fiorilli, PN Isenberg, D Nomura, J Murphy, KA Sigal, A Saif, H Reihart, MJ Vernon, TM Abella, BS AF Helfer, David R. Helber, Andrew R. Ferko, Aarika R. Klein, Daniel D. Elchediak, Daniel S. Deaner, Traci S. Slagle, Dustin White, William B. Buckler, David G. Mitchell, Oscar J. L. Fiorilli, Paul N. Isenberg, Derek Nomura, Jason Murphy, Kathleen A. Sigal, Adam Saif, Hassam Reihart, Michael J. Vernon, Tawnya M. Abella, Benjamin S. TI Clinical factors associated with significant coronary lesions following out-of-hospital cardiac arrest SO ACADEMIC EMERGENCY MEDICINE LA English DT Article DE cardiac arrest; coronary angiography; coronary artery disease; resuscitation ID ST-ELEVATION; ANGIOGRAPHY; RESUSCITATION; INTERVENTION; SURVIVORS; OUTCOMES; MANAGEMENT; CONSENSUS AB Objectives Out-of-hospital cardiac arrest (OHCA) afflicts >350,000 people annually in the United States. While postarrest coronary angiography (CAG) with percutaneous coronary intervention (PCI) has been associated with improved survival in observational cohorts, substantial uncertainty exists regarding patient selection for postarrest CAG. We tested the hypothesis that symptoms consistent with acute coronary syndrome (ACS), including chest discomfort, prior to OHCAs are associated with significant coronary lesions identified on postarrest CAG. Methods We conducted a multicenter retrospective cohort study among eight regional hospitals. Adult patients who experienced atraumatic OHCA with successful initial resuscitation and subsequent CAG between January 2015 and December 2019 were included. We collected data on prehospital documentation of potential ACS symptoms prior to OHCA as well as clinical factors readily available during postarrest care. The primary outcome in multivariable regression modeling was the presence of significant coronary lesions (defined as >50% stenosis of left main or >75% stenosis of other coronary arteries). Results Four-hundred patients were included. Median (interquartile range) age was 59 (51-69) years; 31% were female. At least one significant stenosis was found in 62%, of whom 71% received PCI. Clinical factors independently associated with a significant lesion included a history of myocardial infarction (adjusted odds ratio [aOR] = 6.5, [95% confidence interval {CI} = 1.3 to 32.4], p = 0.02), prearrest chest discomfort (aOR = 4.8 [95% CI = 2.1 to 11.8], p <= 0.001), ST-segment elevations (aOR = 3.2 [95% CI = 1.7 to 6.3], p < 0.001), and an initial shockable rhythm (aOR = 1.9 [95% CI = 1.0 to 3.4], p = 0.05). Conclusions Among survivors of OHCA receiving CAG, history of prearrest chest discomfort was significantly and independently associated with significant coronary artery lesions on postarrest CAG. This suggests that we may be able to use prearrest symptoms to better risk stratify patients following OHCA to decide who will benefit from invasive angiography. C1 [Helfer, David R.; Helber, Andrew R.; Abella, Benjamin S.] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. [Ferko, Aarika R.; Deaner, Traci S.; Sigal, Adam] Reading Hosp, Dept Emergency Med, Reading, PA USA. [Klein, Daniel D.; Elchediak, Daniel S.; Isenberg, Derek] Temple Univ, Lewis Katz Sch Med, Philadelphia, PA 19122 USA. [Slagle, Dustin; White, William B.; Nomura, Jason; Murphy, Kathleen A.] ChristianaCare, Dept Emergency Med, Delaware, OH USA. [Buckler, David G.] Icahn Sch Med Mt Sinai, Dept Emergency Med, New York, NY 10029 USA. [Mitchell, Oscar J. L.; Abella, Benjamin S.] Univ Penn, Ctr Resuscitat Sci, Dept Emergency Med, 3400 Spruce St, Philadelphia, PA 19104 USA. [Mitchell, Oscar J. L.] Univ Penn, Dept Med, Div Pulm Allergy & Crit Care Med, Philadelphia, PA 19104 USA. [Fiorilli, Paul N.] Univ Penn, Dept Med, Cardiovasc Div, Philadelphia, PA 19104 USA. [Saif, Hassam] Reading Hosp, Dept Cardiol, W Reading, PA USA. [Reihart, Michael J.; Vernon, Tawnya M.] Lancaster Gen Hosp, Lancaster, PA USA. C3 University of Pennsylvania; Pennsylvania Medicine; Pennsylvania Commonwealth System of Higher Education (PCSHE); Temple University; Icahn School of Medicine at Mount Sinai; University of Pennsylvania; Pennsylvania Medicine; University of Pennsylvania; University of Pennsylvania RP Abella, BS (通讯作者),Univ Penn, Ctr Resuscitat Sci, Dept Emergency Med, 3400 Spruce St, Philadelphia, PA 19104 USA. EM benjamin.abella@pennmedicine.upenn.edu OI Nomura, Jason/0000-0002-6843-6690; Buckler, David/0000-0002-6018-8282 FU Emergency Medicine Foundation/Society for Academic Emergency Foundation Medical Student Research Grant; NIH [1R21NS109763]; Becton Dickinson FX This work was supported by an Emergency Medicine Foundation/Society for Academic Emergency Foundation Medical Student Research Grant (DRH) and NIH funding award 1R21NS109763 (BSA). BSA reports research funding and honoraria from Becton Dickinson, honoraria from Stryker Medical, and equity in MD Ally and VOC Health. 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Emerg. Med. PD APR PY 2022 VL 29 IS 4 BP 456 EP 464 DI 10.1111/acem.14416 EA DEC 2021 PG 9 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 0T9OH UT WOS:000724116900001 PM 34767692 DA 2023-05-13 ER PT J AU Kim, JW Dayah, TJ Javaid, A Monlezun, DJ Balanescu, DV Donisan, T Karimzad, K Hakeem, A Boone, DL Palaskas, N Lopez-Mattei, J Kim, PY Durand, JB Song, J Balanescu, SM Yang, EH Herrmann, J Marmagkiolis, K Toutouzas, K Johnson, NP Iliescu, CA AF Kim, Jin Wan Dayah, Tariq J. Javaid, Awad Monlezun, Dominique J. Balanescu, Dinu, V Donisan, Teodora Karimzad, Kaveh Hakeem, Abdul Boone, David L. Palaskas, Nicolas Lopez-Mattei, Juan Kim, Peter Y. Durand, Jean-Bernard Song, Juhee Balanescu, Serban M. Yang, Eric H. Herrmann, Joerg Marmagkiolis, Konstantinos Toutouzas, Konstantinos Johnson, Nils P. Iliescu, Cezar A. TI Reclassification of Treatment Strategy with Fractional Flow Reserve in Cancer Patients with Coronary Artery Disease SO MEDICINA-LITHUANIA LA English DT Article DE cardio-oncology; coronary artery disease; fractional flow reserve; percutaneous coronary intervention; quantitative coronary angiography ID ELEVATION MYOCARDIAL-INFARCTION; GUIDED PCI; FOLLOW-UP; INTERVENTION; ANGIOGRAPHY; MANAGEMENT; SEVERITY; SOCIETY AB Background and Objectives: Cancer and coronary artery disease (CAD) often coexist. Compared to quantitative coronary angiography (QCA), fractional flow reserve (FFR) has emerged as a more reliable method of identifying significant coronary stenoses. We aimed to assess the specific management, safety and outcomes of FFR-guided percutaneous coronary intervention (PCI) in cancer patients with stable CAD. Materials and Methods: FFR was used to assess cancer patients that underwent coronary angiography for stable CAD between September 2008 and May 2016, and were found to have >= 50% stenosis by QCA. Patients with lesions with an FFR > 0.75 received medical therapy alone, while those with FFR <= 0.75 were revascularized. Procedure-related complications, all-cause mortality, nonfatal myocardial infarction, or urgent revascularizations were analyzed. Results: Fifty-seven patients with stable CAD underwent FFR on 57 lesions. Out of 31 patients with >= 70% stenosis as measured by QCA, 14 (45.1%) had an FFR >= 0.75 and lesions were reclassified as moderate and did not receive PCI nor DAPT. Out of 26 patients with <70% stenosis as measured by QCA, 6 (23%) had an FFR < 0.75 and were reclassified as severe and were treated with PCI and associated DAPT. No periprocedural complications, urgent revascularization, acute coronary syndromes, or cardiovascular deaths were noted. There was a 22.8% mortality at 1 year, all cancer related. Patients who received a stent by FFR assessment showed a significant association with decreased risk of all-cause death (HR: 0.37, 95% CI 0.15-0.90, p = 0.03). Conclusions: Further studies are needed to define the optimal therapeutic approach for cancer patients with CAD. Using an FFR cut-off point of 0.75 to guide PCI translates into fewer interventions and can facilitate cancer care. There was an overall reduction in mortality in patients that received a stent, suggesting increased resilience to cancer therapy and progression. C1 [Kim, Jin Wan; Dayah, Tariq J.; Boone, David L.; Johnson, Nils P.; Iliescu, Cezar A.] Univ Texas Hlth Sci Ctr Houston, Dept Cardiol, Houston, TX 77030 USA. [Javaid, Awad] Univ Nevada, Kirk Kerkorian Sch Med, Dept Cardiol, Las Vegas, NV 89154 USA. [Monlezun, Dominique J.; Balanescu, Dinu, V; Donisan, Teodora; Karimzad, Kaveh; Palaskas, Nicolas; Lopez-Mattei, Juan; Kim, Peter Y.; Durand, Jean-Bernard; Iliescu, Cezar A.] Univ Texas MD Anderson Canc Ctr, Dept Cardiol, Houston, TX 77030 USA. [Hakeem, Abdul] Rutgers State Univ, Robert Wood Johnson Hosp, New Brunswick, NJ 08901 USA. [Song, Juhee] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USA. [Balanescu, Serban M.] Carol Davila Univ Med & Pharm, Elias Emergency Univ Hosp, Dept Cardiol, Bucharest 050474, Romania. [Yang, Eric H.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. [Herrmann, Joerg] Mayo Clin, Dept Cardiovasc Dis, Rochester, MN 55905 USA. [Marmagkiolis, Konstantinos] Florida Hosp, Pepin Heart Inst, Tampa, FL 33613 USA. [Toutouzas, Konstantinos] Hippokrateion Hosp, Athens Med Sch, Dept Cardiol 1, Athens 11527, Greece. C3 University of Texas System; University of Texas Health Science Center Houston; Nevada System of Higher Education (NSHE); University of Nevada Las Vegas; University of Texas System; UTMD Anderson Cancer Center; Rutgers State University New Brunswick; Rutgers State University Medical Center; University of Texas System; UTMD Anderson Cancer Center; Carol Davila University of Medicine & Pharmacy; University of California System; University of California Los Angeles; Mayo Clinic; Adventist Health Services; AdventHealth; (AdventHealth) West Florida Division; West Florida Hospital; AdventHealth Tampa; Hippokration General Hospital; National & Kapodistrian University of Athens RP Kim, JW (通讯作者),Univ Texas Hlth Sci Ctr Houston, Dept Cardiol, Houston, TX 77030 USA. EM jin.wan.kim@uth.tmc.edu; tariq.dayah@gmail.com; awadiqbaljavaid@gmail.com; dominique.monlezun@gmail.com; dinu.balanescu@yahoo.com; teodora.donisan@gmail.com; kkarimzad@mdanderson.org; abdul.hakeem@gmail.com; david.l.boone@uth.tmc.edu; nlpalaskas@mdanderson.org; juan.lopezmattei@leehealth.org; pkim123@gmail.com; jdurand@mdanderson.org; jsongl@mdanderson.org; sbalanescu@gmail.com; eric.yang@gmail.com; joerg.hermann@gmail.com; c.marmagiolis@gmail.com; ktoutouz@gmail.com; nilsjohnson@uth.tmc.edu; ciliescu@mdanderson.org RI Johnson, Nils/HJI-9416-2023; Yang, Eric/I-2670-2019 OI Yang, Eric/0000-0003-4889-7454; Iliescu, Cezar/0000-0002-8817-4579; Javaid, Awad/0000-0003-2990-0224; Monlezun, Dominique/0000-0001-7671-1886; Kim, Jin wan/0000-0003-2478-1975 CR Ahn JM, 2017, CIRCULATION, V135, P2241, DOI 10.1161/CIRCULATIONAHA.116.024433 Barbato E, 2016, J AM COLL CARDIOL, V68, P2247, DOI 10.1016/j.jacc.2016.08.055 De Bruyne B, 2014, NEW ENGL J MED, V371, P1208, DOI 10.1056/NEJMoa1408758 De Bruyne B, 2012, NEW ENGL J MED, V367, P991, DOI 10.1056/NEJMoa1205361 Falanga A, 2015, SEMIN THROMB HEMOST, V41, P756, DOI 10.1055/s-0035-1564040 Hamilos M, 2009, CIRCULATION, V120, P1505, DOI 10.1161/CIRCULATIONAHA.109.850073 Iliescu C, 2018, AM J CARDIOL, V122, P1465, DOI 10.1016/j.amjcard.2018.07.033 Iliescu C, 2016, CATHETER CARDIO INTE, V87, P895, DOI 10.1002/ccd.26375 Johnson NP, 2014, J AM COLL CARDIOL, V64, P1641, DOI 10.1016/j.jacc.2014.07.973 Layland J, 2015, EUR HEART J, V36, P100, DOI 10.1093/eurheartj/ehu338 Lugo LM, 2018, J CARDIOL, V72, P94, DOI 10.1016/j.jjcc.2018.03.001 Nijhoff F, 2015, CATHETER CARDIO INTE, V86, pS34, DOI 10.1002/ccd.26060 Pijls NHJ, 1996, NEW ENGL J MED, V334, P1703, DOI 10.1056/NEJM199606273342604 Toth GG, 2016, J AM COLL CARDIOL, V68, P742, DOI 10.1016/j.jacc.2016.05.067 van Nunen LX, 2015, LANCET, V386, P1853, DOI 10.1016/S0140-6736(15)00057-4 Zimmermann FM, 2015, EUR HEART J, V36, P3182, DOI 10.1093/eurheartj/ehv452 NR 16 TC 0 Z9 0 U1 0 U2 1 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND SN 1010-660X EI 1648-9144 J9 MEDICINA-LITHUANIA JI Med. Lith. PD JUL PY 2022 VL 58 IS 7 AR 884 DI 10.3390/medicina58070884 PG 9 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 3J8LA UT WOS:000833641400001 PM 35888603 OA Green Published, gold DA 2023-05-13 ER PT J AU Boland, TA Lee, VH Bleck, TP AF Boland, Torrey A. Lee, Vivien H. Bleck, Thomas P. TI Stress-Induced Cardiomyopathy SO CRITICAL CARE MEDICINE LA English DT Review DE catecholamines; heart failure; neurogenic stress cardiomyopathy; stress-induced cardiomyopathy; tako-tsubo cardiomyopathy; transient left ventricular apical ballooning syndrome ID LEFT-VENTRICULAR DYSFUNCTION; TAKO-TSUBO CARDIOMYOPATHY; BALLOON-PUMP COUNTERPULSATION; ANEURYSMAL SUBARACHNOID HEMORRHAGE; SYMPATHETIC NERVOUS ACTIVITY; CARDIAC TROPONIN-I; TAKOTSUBO CARDIOMYOPATHY; MYOCARDIAL-INFARCTION; ELECTROCARDIOGRAPHIC CHANGES; CLINICAL CHARACTERISTICS AB Objectives: Reversible stress-induced cardiac dysfunction is frequently seen as a complication of a multitude of acute stress states, in particular neurologic injuries. This dysfunction may be difficult to distinguish between that caused by myocardial ischemia and may impact both the treatment strategies and prognosis of the underlying condition. Critical care practitioners should have an understanding of the epidemiology, pathophysiology, clinical characteristics, precipitating conditions, differential diagnosis, and proposed treatments for stress-induced cardiomyopathy. Data Sources: MEDLINE database search conducted from inception to August 2014, including the search terms "tako-tsubo," "stress-induced cardiomyopathy,""neurogenic cardiomyopathy," "neurogenic stress cardiomyopathy," and "transient left ventricular apical ballooning syndrome". In addition, references from pertinent articles were used for a secondary search. Study Selection and Data Extraction: After review of peer-reviewed original scientific articles, guidelines, and reviews resulting from the literature search described above, we made final selections for included references and data based on relevance and author consensus. Data Synthesis: Stress-induced cardiomyopathy occurs most commonly in postmenopausal women. It can be precipitated by emotional stress, neurologic injury, and numerous other stress states. Patients may present with symptoms indistinguishable from acute coronary syndrome or with electrocardiogram changes and wall motion abnormalities on echocardiogram following neurologic injury. Nearly all patients will have an elevated cardiac troponin. The underlying etiology is likely related to release of catecholamines, both locally in the myocardium and in the circulation. Differential diagnosis includes myocardial infarction, myocarditis, neurogenic pulmonary edema, and nonischemic cardiomyopathy. Although the natural course of stress-induced cardiomyopathy is resolution, treatment strategies include sympathetic blockade and supportive care. Conclusions: Stress-induced cardiomyopathy may mimic myocardial infarction and is an important condition to recognize in patients with underlying stress states, particularly neurologic injuries. C1 [Boland, Torrey A.; Lee, Vivien H.; Bleck, Thomas P.] Rush Univ, Med Ctr, Dept Neurol Sci, Chicago, IL 60612 USA. [Bleck, Thomas P.] Rush Univ, Med Ctr, Dept Neurosurg, Chicago, IL 60612 USA. [Bleck, Thomas P.] Rush Univ, Med Ctr, Dept Anesthesiol, Chicago, IL 60612 USA. [Bleck, Thomas P.] Rush Univ, Med Ctr, Dept Internal Med, Chicago, IL 60612 USA. C3 Rush University; Rush University; Rush University; Rush University RP Boland, TA (通讯作者),Rush Univ, Med Ctr, Dept Neurol Sci, Chicago, IL 60612 USA. 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PD MAR PY 2015 VL 43 IS 3 BP 686 EP 693 DI 10.1097/CCM.0000000000000851 PG 8 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CB9PI UT WOS:000349963600034 PM 25565459 DA 2023-05-13 ER PT J AU Crawshaw, J Weinman, J McRobbie, D Auyeung, V AF Crawshaw, Jacob Weinman, John McRobbie, Duncan Auyeung, Vivian TI Initial evaluation of a brief pharmacy-led intervention to modify beliefs about medicines and facilitate adherence among patients hospitalised with acute coronary syndrome SO EUROPEAN JOURNAL OF HOSPITAL PHARMACY LA English DT Article DE ischaemic heart disease; clinical pharmacy; quality in health care; controlled trial; myocardial infarction ID MEDICATION NONADHERENCE; SECONDARY PREVENTION; HEALTH; QUESTIONNAIRE; SATISFACTION; INFORMATION; PERCEPTIONS; DEPRESSION; BEHAVIOR; DISEASE AB Objectives Medication non-adherence is common among patients with acute coronary syndrome (ACS) and is associated with poor clinical outcomes. To date, pharmacists have been underutilised in the delivery of adherence interventions. Across two studies, we assessed the feasibility, acceptability and effectiveness of a novel pharmacy-led intervention for patients hospitalised with ACS. Methods The theory-based intervention was comprised of two personalised sessions addressing perceptual (negative/erroneous treatment beliefs) and practical (suboptimal action planning) barriers to adherence. Study 1: A single-arm, feasibility and acceptability study was conducted to determine proof-of-concept. Pre-post-comparisons using the Beliefs about Medicines Questionnaire-Specific (BMQ-S) were made. Study 2: A non-randomised controlled before-after pilot study was conducted with the intervention delivered by a team of clinical pharmacists. Follow-up data were collected at 6 and 12 weeks post-discharge. Primary outcome measures included the BMQ-S and the Medication Adherence Report Scale 5. Results Study 1: 15 patients received the intervention and reported higher BMQ-S necessity scores post-intervention. The intervention was deemed highly acceptable to patients; therefore, further testing was sought. Study 2: A total of 56 patients were recruited: control (n=29) versus treatment (n=27). At 6-week follow-up, the treatment group had higher BMQ-S necessity scores (M=21.8, SD=3.1) compared with control (M=19.8, SD=2.7; p=0.045), although this effect was not maintained at 12 weeks. No differences were reported in the other outcome measures. Conclusions Although the intervention was acceptable to patients, poor fidelity in delivery raises questions about its feasibility in practice. Furthermore, there was some impact on patients' beliefs about medications but no effect on adherence. These findings demonstrate the importance of conducting feasibility and acceptability studies when developing adherence innovations in clinical care. Future studies should consider enhancing the training process to ameliorate fidelity issues. C1 [Crawshaw, Jacob; Weinman, John; Auyeung, Vivian] Kings Coll London, Inst Pharmaceut Sci, London WC2R 2LS, England. [McRobbie, Duncan] Guys & St Thomas NHS Fdn Truts, Dept Pharm, London, England. C3 RLUK- Research Libraries UK; University of London; King's College London RP Auyeung, V (通讯作者),Kings Coll London, Inst Pharmaceut Sci, London WC2R 2LS, England. EM vivian.auyeung@kcl.ac.uk FU King's College London - University of California, San Francisco FX This work was supported by a King's College London -University of California, San Francisco four-year full-time PhD studentship. 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PD JAN PY 2022 VL 29 IS 1 BP 18 EP 25 DI 10.1136/ejhpharm-2019-002041 PG 8 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA XY9NY UT WOS:000737292300005 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Lasbleiz, A Gaborit, B Soghomonian, A Bartoli, A Ancel, P Jacquier, A Dutour, A AF Lasbleiz, Adele Gaborit, Benedicte Soghomonian, Astrid Bartoli, Axel Ancel, Patricia Jacquier, Alexis Dutour, Anne TI COVID-19 and Obesity: Role of Ectopic Visceral and Epicardial Adipose Tissues in Myocardial Injury SO FRONTIERS IN ENDOCRINOLOGY LA English DT Review DE epicardial adipose tissue; COVID-19; obesity; cardiac injury; adipose tissue; ectopic fat; inflammation; immunity ID CORONARY-ARTERY-DISEASE; COMPUTED-TOMOGRAPHY; CYTOKINE STORM; FLOW RESERVE; RISK-FACTOR; FAT VOLUME; ACE2; INFLAMMATION; CORONAVIRUS; DYSFUNCTION AB In March 2020, the WHO declared coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a global pandemic. Obesity was soon identified as a risk factor for poor prognosis, with an increased risk of intensive care admissions and mechanical ventilation, but also of adverse cardiovascular events. Obesity is associated with adipose tissue, chronic low-grade inflammation, and immune dysregulation with hypertrophy and hyperplasia of adipocytes and overexpression of pro-inflammatory cytokines. However, to implement appropriate therapeutic strategies, exact mechanisms must be clarified. The role of white visceral adipose tissue, increased in individuals with obesity, seems important, as a viral reservoir for SARS-CoV-2 via angiotensin-converting enzyme 2 (ACE2) receptors. After infection of host cells, the activation of pro-inflammatory cytokines creates a setting conducive to the "cytokine storm" and macrophage activation syndrome associated with progression to acute respiratory distress syndrome. In obesity, systemic viral spread, entry, and prolonged viral shedding in already inflamed adipose tissue may spur immune responses and subsequent amplification of a cytokine cascade, causing worse outcomes. More precisely, visceral adipose tissue, more than subcutaneous fat, could predict intensive care admission; and lower density of epicardial adipose tissue (EAT) could be associated with worse outcome. EAT, an ectopic adipose tissue that surrounds the myocardium, could fuel COVID-19-induced cardiac injury and myocarditis, and extensive pneumopathy, by strong expression of inflammatory mediators that could diffuse paracrinally through the vascular wall. The purpose of this review is to ascertain what mechanisms may be involved in unfavorable prognosis among COVID-19 patients with obesity, especially cardiovascular events, emphasizing the harmful role of excess ectopic adipose tissue, particularly EAT. C1 [Lasbleiz, Adele; Gaborit, Benedicte; Soghomonian, Astrid; Dutour, Anne] AP HM, Pole ENDO, Dept Endocrinol Metab Dis & Nutr, Marseille, France. [Lasbleiz, Adele; Gaborit, Benedicte; Ancel, Patricia; Dutour, Anne] Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France. [Bartoli, Axel; Jacquier, Alexis] Aix Marseille Univ, CNRS, CRMBM, Marseille, France. [Bartoli, Axel; Jacquier, Alexis] Hop Univ Timone, AP HM, Dept Med Imaging, Marseille, France. C3 UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille; INRAE; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Aix-Marseille Universite; Centre National de la Recherche Scientifique (CNRS); UDICE-French Research Universities; Aix-Marseille Universite; UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille RP Dutour, A (通讯作者),AP HM, Pole ENDO, Dept Endocrinol Metab Dis & Nutr, Marseille, France.; Dutour, A (通讯作者),Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France. EM Anne.DUTOUR@ap-hm.fr RI Dutour, Anne/AAK-4460-2020; GABORIT, Bénédicte/AAK-3842-2020 OI Dutour, Anne/0000-0002-5844-5884; GABORIT, Bénédicte/0000-0002-4180-158X FU GIRCI (Groupement interregional de recherche clinique et d'innovation) Mediterranee VALO-DATA 2020 FX GIRCI (Groupement interregional de recherche clinique et d'innovation) Mediterranee VALO-DATA 2020. 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Endocrinol. PD AUG 16 PY 2021 VL 12 DI 10.3389/fendo.2021.726967 PG 9 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism GA UM8HK UT WOS:000693566800001 PM 34484128 OA gold, Green Published DA 2023-05-13 ER PT J AU Chan, DN Martin-Ruiz, C Saretzki, G Neely, D Qiu, WL Kunadian, V AF Chan, Danny Martin-Ruiz, Carmen Saretzki, Gabriele Neely, Dermot Qiu, Weiliang Kunadian, Vijay TI The association of telomere length and telomerase activity with adverse outcomes in older patients with non-ST-elevation acute coronary syndrome SO PLOS ONE LA English DT Article ID CARDIOVASCULAR-DISEASE; HEART-DISEASE; MORTALITY; RISK; MEN; PHENOTYPE; PROJECT; BIOLOGY; FRAILTY; HEALTH AB Background Non-ST elevation acute coronary syndrome (NSTEACS) occurs more frequently in older patients with an increased occurrence of recurrent cardiac events following the index presentation. Telomeres are structures consisting of repeated DNA sequences as associated shelterin proteins at the ends of chromosomes. We aim to determine whether telomere length (TL) and telomerase activity (TA) predicted poor outcomes in older patients presenting with NSTEACS undergoing invasive care. Method Older patients undergoing invasive management for NSTEACS were recruited to the ICON1 biomarker study (NCT01933581). Peripheral blood mononuclear cells (PBMC) were recovered on 153 patients. DNA was isolated and mean TL was measured by quantitative PCR expressed as relative T (telomere repeat copy number) to S (single copy gene number) ratio (T/S ratio), and a telomere repeat amplification assay was used to assess TA during index presentation with NSTEACS. Primary clinical outcomes consisted of death, myocardial infarction (MI), unplanned revascularisation, stroke and significant bleeding recorded at 1 year. TL and TA were divided into tertile groups for analysis. Cox proportional hazards regression was performed. Ordinal regression was performed to evaluate the relationship between TL and TA and traditional cardiovascular risk factors at baseline. Results 298 patients were recruited in the ICON- 1 study of which 153 had PBMC recovered. The mean age was 81.0 +/- 4.0 years (64% male). Mean telomere length T/S ratio was 0.47 +/- 0.25 and mean TA was 1.52 +/- 0.61 units. The primary composite outcome occurred in 44 (28.8%) patients. There was no association between short TL or low TA and incidence of the primary composite outcome (Hazard Ratio [HR] 1.50, 95% Confidence Interval [CI] 0.68-3.34, p = 0.32 and HR 1.33, 95% CI 0.52-3.36, p = 0.51 respectively). Conclusion TL and TA are not found to be associated with the incidence of adverse outcomes in older patients presenting with NSTEACS undergoing invasive care. C1 [Chan, Danny; Kunadian, Vijay] Newcastle Univ, Fac Med Sci, Translat & Clin Res Inst, Newcastle Upon Tyne, Tyne & Wear, England. [Chan, Danny; Kunadian, Vijay] Newcastle Upon Tyne Hosp NHS Fdn Trust, Freeman Hosp, Ctr Cardiothorac, Newcastle Upon Tyne, Tyne & Wear, England. [Martin-Ruiz, Carmen] Newcastle Univ, BioScreening Facil, Newcastle Upon Tyne, Tyne & Wear, England. [Saretzki, Gabriele] Newcastle Univ, Ageing Biol Ctr, Newcastle Upon Tyne, Tyne & Wear, England. [Saretzki, Gabriele] Newcastle Univ, Inst Cell & Mol Biosci, Newcastle Upon Tyne, Tyne & Wear, England. [Neely, Dermot] Newcastle Upon Tyne Hosp NHS Foundat Trust, Dept Biochem, Newcastle Upon Tyne, Tyne & Wear, England. [Qiu, Weiliang] Sanofi Genzyme, Framingham, MA USA. C3 N8 Research Partnership; RLUK- Research Libraries UK; Newcastle University - UK; Newcastle Freeman Hospital; Newcastle Upon Tyne Hospitals NHS Foundation Trust; N8 Research Partnership; RLUK- Research Libraries UK; Newcastle University - UK; N8 Research Partnership; RLUK- Research Libraries UK; Newcastle University - UK; N8 Research Partnership; RLUK- Research Libraries UK; Newcastle University - UK; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Sanofi-Aventis; Genzyme Corporation RP Kunadian, V (通讯作者),Newcastle Univ, Fac Med Sci, Translat & Clin Res Inst, Newcastle Upon Tyne, Tyne & Wear, England.; Kunadian, V (通讯作者),Newcastle Upon Tyne Hosp NHS Fdn Trust, Freeman Hosp, Ctr Cardiothorac, Newcastle Upon Tyne, Tyne & Wear, England. EM vijay.kunadian@newcastle.ac.uk OI Kunadian, Vijay/0000-0003-2975-6971; Martin-Ruiz, Carmen/0000-0002-3361-6974 FU National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre based at Newcastleupon-Tyne Hospitals NHS Foundation Trust and Newcastle University; British Heart Foundation [CS/15/7/31679] FX The research is supported by the National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre based at Newcastleupon-Tyne Hospitals NHS Foundation Trust and Newcastle University. VK has received research funding from the British Heart Foundation (CS/15/7/31679). WQ is salaried by Sanofi Genzyme. The funder provided support in the form of salaries for authors VK and WQ but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the `author contributions' section. 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Neal, Joel W. Nguyen, Patricia Davis, Mark M. Salem, Joe-Elie Wu, Sean M. Moslehi, Javid J. Zhu, Han BE Insel, PA TI Immune Checkpoint Inhibitor Cardiotoxicity: Understanding Basic Mechanisms and Clinical Characteristics and Finding a Cure SO ANNUAL REVIEW OF PHARMACOLOGY AND TOXICOLOGY, VOL 61, 2021 SE Annual Review of Pharmacology and Toxicology LA English DT Review; Book Chapter DE immune checkpoint inhibitors; ICIs; cardio-oncology; cardio-immunology; immuno-oncology; myocarditis ID ACUTE CORONARY SYNDROME; CARDIAC TROPONIN-I; T-CELLS; DILATED CARDIOMYOPATHY; COMBINED NIVOLUMAB; CTLA-4; PD-1; MYOCARDITIS; ACTIVATION; IPILIMUMAB AB Immune checkpoint inhibitors (ICIs) attenuate mechanisms of self-tolerance in the immune system, enabling T cell responses to cancerous tissues and revolutionizing care for cancer patients. However, by lowering barriers against self-reactivity, ICIs often result in varying degrees of autoimmunity. Cardiovascular complications, particularly myocarditis but also arrhythmias, pericarditis, and vasculitis, have emerged as significant complications associated with ICIs. In this review, we examine the clinical aspects and basic science principles that underlie ICI-associated myocarditis and other cardiovascular toxicities. In addition, we discuss current therapeutic approaches. We believe a better mechanistic understanding of ICI-associated toxicities can lead to improved patient outcomes by reducing treatment-related morbidity. C1 [Waliany, Sarah; Witteles, Ronald M.; Neal, Joel W.; Nguyen, Patricia; Wu, Sean M.; Zhu, Han] Stanford Univ, Dept Med, Stanford, CA 94305 USA. [Lee, Daniel; Nguyen, Patricia; Wu, Sean M.; Zhu, Han] Stanford Univ, Stanford Cardiovasc Inst, Stanford, CA 94305 USA. [Witteles, Ronald M.; Nguyen, Patricia; Wu, Sean M.; Zhu, Han] Stanford Univ, Sch Med, Div Cardiovasc Med, Stanford, CA 94305 USA. [Neal, Joel W.] Stanford Univ, Sch Med, Div Oncol, Stanford, CA 94305 USA. [Davis, Mark M.] Stanford Univ, Sch Med, Dept Microbiol & Immunol, Stanford, CA 94305 USA. [Davis, Mark M.] Stanford Univ, Sch Med, Howard Hughes Med Inst, Stanford, CA 94305 USA. [Davis, Mark M.] Stanford Univ, Sch Med, Inst Immun Transplantat & Infect, Stanford, CA 94305 USA. [Salem, Joe-Elie] Sorbonne Univ, UNICO GRECO Cardiooncol Program, INSERM, CIC Paris Est 1901,CLIP2 Galilee, F-75013 Paris, France. [Salem, Joe-Elie] Hop La Pitie Salpetriere, AP HP, Dept Pharmacol, F-75013 Paris, France. [Salem, Joe-Elie; Moslehi, Javid J.] Vanderbilt Univ, Med Ctr, Cardiooncol Program, Nashville, TN 37203 USA. [Salem, Joe-Elie; Moslehi, Javid J.] Vanderbilt Univ, Med Ctr, Div Cardiovasc Med, Nashville, TN 37203 USA. C3 Stanford University; Stanford University; Stanford University; Stanford University; Stanford University; Howard Hughes Medical Institute; Stanford University; Stanford University; Assistance Publique Hopitaux Paris (APHP); Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Charles-Foix - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Armand-Trousseau - APHP; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Vanderbilt University; Vanderbilt University RP Moslehi, JJ (通讯作者),Vanderbilt Univ, Med Ctr, Cardiooncol Program, Nashville, TN 37203 USA.; Moslehi, JJ (通讯作者),Vanderbilt Univ, Med Ctr, Div Cardiovasc Med, Nashville, TN 37203 USA. EM javid.moslehi@vumc.org; hanzhu@stanford.edu RI Davis, Matthew C./S-8342-2019; Wu, Sean/ABH-1917-2020 OI Davis, Matthew C./0000-0003-1577-7544; Wu, Sean/0000-0002-0000-3821; Waliany, Sarah/0000-0001-5960-8801; Zhu, Han/0000-0002-2751-7814; Salem, Joe-Elie/0000-0002-0331-3307; Davis, Mark/0000-0001-6868-657X FU Howard Hughes Medical Institute; US National Institutes of Health [R56 HL141466, R01 HL141466] FX M.M.D. has received support from the Howard Hughes Medical Institute. J.J.M. has received support from US National Institutes of Health grants R56 HL141466 and R01 HL141466. 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NR 115 TC 25 Z9 26 U1 0 U2 7 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0897 USA SN 0362-1642 EI 1545-4304 BN 978-0-8243-0461-4 J9 ANNU REV PHARMACOL JI Annu. Rev. Pharmacol. Toxicol. PY 2021 VL 61 BP 113 EP 134 DI 10.1146/annurev-pharmtox-010919-023451 PG 22 WC Pharmacology & Pharmacy; Toxicology WE Book Citation Index– Science (BKCI-S); Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy; Toxicology GA BQ7DU UT WOS:000614642300007 PM 32776859 DA 2023-05-13 ER PT J AU Wang, LC Zhou, Y Qian, C Wang, YG AF Wang, Lechen Zhou, You Qian, Cheng Wang, Yanggan TI Clinical characteristics and improvement of the guideline-based management of acute myocardial infarction in China: a national retrospective analysis SO ONCOTARGET LA English DT Article DE acute myocardial infarction; quality of care; epidemiology; China ID ACUTE CORONARY SYNDROMES; REPERFUSION THERAPY; TEMPORAL TRENDS; ST; OUTCOMES; CARE; ASSOCIATION; SMOKING; DELAY; RISK AB Objective: This study is to document the clinical characteristics and improvement in management of acute myocardial infarction (AMI) in Chinese population. Results: This study included 64,654 patients (23,805 patients in 2011, 40,849 patients in 2013), of which STEMI and NSTEMI account for 85.09% and 14.91%, respectively. From 2011 to 2013, significant improvement has been achieved in the recanalization rate of PCI (96.01% vs. 98.63%, P < 0.001) and in-hospital deaths (4.52% vs. 3.55%, P = 0.038). Although the time of door-to-balloon and the duration of PCI were satisfactorily controlled within 90min and 60min, respectively, the onset-to-FMC time (approximate to 3.5h) and door-to-thrombolysis time (approximate to 1.1h) limited the efficiency of management. The total cost of medical care showed no increase from 2011 to 2013, but the patient's paid Portion decreased from 20.33% to 13.96%. Materials and Methods: The AMI patients admitted in the general hospitals in 2011 and 2013 were retrospectively analyzed according to the data reported to the Single Disease Quality Control Information System issued by Chinese Hospital Association. Conclusion: Compared to the Western countries, STEMI accounted for a larger portion of AMI, and the AMI management in China basically meets the standards of the quality control of guidelines. With improvement of management, there was no increase in the total medical cost, while the patient's paid portion was actually reduced. In future, improvement of transportation strategy and the public medical education are recommended to shorten the onset-to-FMC time to further improve the outcome of AMI patients. C1 [Wang, Lechen; Zhou, You; Qian, Cheng; Wang, Yanggan] Wuhan Univ, Zhongnan Hosp, Dept Cardiol, Wuhan, Peoples R China. [Wang, Lechen; Zhou, You; Qian, Cheng; Wang, Yanggan] Wuhan Univ, Med Res Inst, Wuhan, Peoples R China. C3 Wuhan University; Wuhan University RP Wang, YG (通讯作者),Wuhan Univ, Zhongnan Hosp, Dept Cardiol, Wuhan, Peoples R China.; Wang, YG (通讯作者),Wuhan Univ, Med Res Inst, Wuhan, Peoples R China. EM wb000813@whu.edu.cn FU National Natural Science Foundation of China [NSFC 81270304, NSFC 81420108004] FX This work was supported by grants from the National Natural Science Foundation of China [NSFC 81270304 and NSFC 81420108004 to Wang Y]. 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Secondary cardiovascular risk reduction therapy (consisting of an aspirin, a beta-blocker, an ACE inhibitor or an angiotensin II receptor blocker and a statin) is needed for all patients with ACS. Less than 80% of patients with ACS in Qatar use this combination after discharge. This study is aimed to evaluate the effectiveness of clinical pharmacist-delivered intervention at discharge and tailored followup postdischarge on decreasing hospital readmissions, emergency department (ED) visits and mortality among patients with ACS. Methods and analysis: A prospective, randomised controlled trial will be conducted at the Heart Hospital in Qatar. Patients are eligible for enrolment if they are at least 18 years of age and are discharged from any non-surgical cardiology service with ACS. Participants will be randomised into 1 of 3 arms: (1) 'control' arm which includes patients discharged during weekends or after hours; (2) 'clinical pharmacist delivered usual care at discharge' arm which includes patients receiving the usual care at discharge by clinical pharmacists; and (3) 'clinical pharmacist-delivered structured intervention at discharge and tailored follow-up 'postdischarge' arm which includes patients receiving intensive structured discharge interventions in addition to 2 follow-up sessions by intervention clinical pharmacists. Outcomes will be measured by blinded research assistants at 3, 6 and 12 months after discharge and will include: all-cause hospitalisations and cardiac-related hospital readmissions (primary outcome), all-cause mortality including cardiac-related mortality, ED visits including cardiac-related ED visits, adherence to medications and treatment burden. Percentage of readmissions between the 3 arms will be compared on intent-to-treat basis using chi(2) test with Bonferroni's adjusted pairwise comparisons if needed. Ethics and dissemination: The study was ethically approved by the Qatar University and the Hamad Medical Corporation Institutional Review Boards. The results shall be disseminated in international conferences and peer-reviewed publications. C1 [Zidan, Amani; Awaisu, Ahmed; Kheir, Nadir; El Hajj, Maguy Saffouh] Qatar Univ, Coll Pharm, Clin Pharm & Practice Sect, Doha, Qatar. [Mahfoud, Ziyad] Weill Cornell Med Qatar, Doha, Qatar. [Kaddoura, Rasha; AlYafei, Sumaya] Hamad Med Corp, Heart Hosp, Doha, Qatar. C3 Qatar University; Qatar Foundation (QF); Weill Cornell Medical College Qatar; Hamad Medical Corporation RP El Hajj, MS (通讯作者),Qatar Univ, Coll Pharm, Clin Pharm & Practice Sect, Doha, Qatar. EM maguyh@qu.edu.qa RI Awaisu, Ahmed/AAU-3959-2020; Kaddoura, Rasha/GLU-4599-2022 OI Awaisu, Ahmed/0000-0002-9029-8925; Kaddoura, Rasha/0000-0003-2613-9759; Mahfoud, Ziyad/0000-0003-4098-6401; El Hajj, Maguy/0000-0003-0770-4679; Kheir, Nadir/0000-0002-0295-3505 FU Qatar University [QUUG-CPH-CPH-14/15-2] FX The work was supported by Qatar University Internal grant number QUUG-CPH-CPH-14/15-2. CR Anderson JL, 2007, J AM COLL CARDIOL, V50, P652, DOI 10.1016/j.jacc.2007.02.028 [Anonymous], 2006, DEV PHARM PRACTICE F Bailey TC, 2007, ARCH INTERN MED, V167, P586, DOI 10.1001/archinte.167.6.586 Bassand JP, 2007, EUR HEART J, V28, P1598, DOI 10.1093/eurheartj/ehm161 Bi YF, 2009, AM HEART J, V157, P509, DOI 10.1016/j.ahj.2008.09.026 Blenkinsopp A, 2003, J PUBLIC HEALTH MED, V25, P144, DOI 10.1093/pubmed/fdg030 Boockvar Kenneth S, 2006, Am J Geriatr Pharmacother, V4, P236, DOI 10.1016/j.amjopharm.2006.09.003 Cleeman JI, 2001, JAMA-J AM MED ASSOC, V285, P2486, DOI 10.1001/jama.285.19.2486 Coleman EA, 2004, ANN INTERN MED, V141, P533, DOI 10.7326/0003-4819-141-7-200410050-00009 Crotty Maria, 2004, Am J Geriatr Pharmacother, V2, P257, DOI 10.1016/j.amjopharm.2005.01.001 Dipiro JT, 2014, PHARMACOTHERAPY PATH Dudas V, 2001, AM J MED, V111, P26, DOI 10.1016/S0002-9343(01)00966-4 El-Menyar A, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0070066 Forster AJ, 2003, ANN INTERN MED, V138, P161, DOI 10.7326/0003-4819-138-3-200302040-00007 Gehi AK, 2007, ARCH INTERN MED, V167, P1798, DOI 10.1001/archinte.167.16.1798 Halasyamani L, 2006, J HOSP MED, V1, P354, DOI 10.1002/jhm.129 Hiratzka LF, 2007, CIRCULATION, V116, pI207, DOI 10.1161/CIRCULATIONAHA.106.681247 Ho PM, 2006, ARCH INTERN MED, V166, P1842, DOI 10.1001/archinte.166.17.1842 HORWITZ RI, 1990, LANCET, V336, P542, DOI 10.1016/0140-6736(90)92095-Y Jack BW, 2009, ANN INTERN MED, V150, P178, DOI 10.7326/0003-4819-150-3-200902030-00007 Jones K, 2013, BMJ-BRIT MED J, V347, DOI 10.1136/bmj.f6544 Kripalani S, 2009, VALUE HEALTH, V12, P118, DOI 10.1111/j.1524-4733.2008.00400.x Kumbhani DJ, 2013, AM J MED, V126, P693, DOI 10.1016/j.amjmed.2013.01.033 Kumbhani DJ, 2013, AM J MED, V126, DOI 10.1016/j.amjmed.2012.02.025 Kushner FG, 2009, J AM COLL CARDIOL, V54, P2205, DOI 10.1016/j.jacc.2009.10.015 Lee JK, 2006, JAMA-J AM MED ASSOC, V296, P2563, DOI 10.1001/jama.296.21.joc60162 Lewis SJ, 2010, INT J CLIN PRACT, V64, P604, DOI 10.1111/j.1742-1241.2009.02258.x Makaryus AN, 2005, MAYO CLIN PROC, V80, P991, DOI 10.4065/80.8.991 Mohammed S, 2014, ASSESSMENT PATIENT A Mukherjee D, 2004, CIRCULATION, V109, P745, DOI 10.1161/01.CIR.0000112577.69066.CB Naderi SH, 2012, AM J MED, V125, P882, DOI 10.1016/j.amjmed.2011.12.013 Ponniah A, 2007, J CLIN PHARM THER, V32, P343, DOI 10.1111/j.1365-2710.2007.00827.x Rublee DA, 2012, AM J THER, V19, P24, DOI 10.1097/MJT.0b013e3181ee707e Sangu PV, 2012, HEART, V98, P1728, DOI 10.1136/heartjnl-2012-302532 Schnipper JL, 2006, ARCH INTERN MED, V166, P565, DOI 10.1001/archinte.166.5.565 Smith SC, 2006, J AM COLL CARDIOL, V47, P2130, DOI 10.1016/j.jacc.2006.04.026 Smith SC, 2011, J AM COLL CARDIOL, V58, P2432, DOI 10.1016/j.jacc.2011.10.824 Spertus JA, 2006, CIRCULATION, V113, P2803, DOI 10.1161/CIRCULATIONAHA.106.618066 Van de Werf F, 2008, EUR HEART J, V29, P2909, DOI 10.1093/eurheartj/ehn416 Tran VT, 2014, BMC MED, V12, DOI 10.1186/1741-7015-12-109 Wei L, 2002, HEART, V88, P229, DOI 10.1136/heart.88.3.229 Wei L, 2004, PHARMACOEPIDEM DR S, V13, P761, DOI 10.1002/pds.963 WHO, 2013, CARD DIS 2 CARD DIS Wiggins BS, 2013, PHARMACOTHERAPY, V33, P558, DOI 10.1002/phar.1231 Witt BJ, 2005, ANN INTERN MED, V143, P785, DOI 10.7326/0003-4819-143-11-200512060-00006 Yan AT, 2007, AM HEART J, V154, P1108, DOI 10.1016/j.ahj.2007.07.040 NR 46 TC 6 Z9 6 U1 0 U2 2 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 2044-6055 J9 BMJ OPEN JI BMJ Open PY 2016 VL 6 IS 11 AR e012141 DI 10.1136/bmjopen-2016-012141 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA EG8JQ UT WOS:000391303400212 PM 27864247 OA Green Published, gold DA 2023-05-13 ER PT J AU Alhabib, KF Gamra, H Almahmeed, W Hammoudeh, A Benkheddah, S Al Jarallah, M Al-Motarreb, A Alquraishi, M Sobhy, M Yousif, MG Alkindi, F Fellat, N Amin, MI Ali, M Al Saleh, A Ullah, A Zannad, F AF Alhabib, Khalid F. Gamra, Habib Almahmeed, Wael Hammoudeh, Ayman Benkheddah, Salim Al Jarallah, Mohammad Al-Motarreb, Ahmed Alquraishi, Mothanna Sobhy, Mohamed Yousif, Magdi G. Alkindi, Fahad Fellat, Nadia Amin, Mohammad, I Ali, Muhammad Al Saleh, Ayman Ullah, Anhar Zannad, Faiez TI Acute myocardial infarction and acute heart failure in the Middle East and North Africa: Study design and pilot phase study results from the PEACE MENA registry SO PLOS ONE LA English DT Article ID ACUTE CORONARY SYNDROMES; BASE-LINE CHARACTERISTICS; ST-SEGMENT ELEVATION; LONG-TERM OUTCOMES; TASK-FORCE; CARDIOVASCULAR-DISEASES; MANAGEMENT-PRACTICES; EUROPEAN-SOCIETY; GULF REGISTRY; GLOBAL BURDEN AB Background This pilot study describes the overall design and results of the Program for the Evaluation and Management of the Cardiac Events registry for the Middle East and North Africa (MENA) Region. Methods This prospective, multi-center, multi-country study included patients hospitalized with acute myocardial infarction (AMI) and/or acute heart failure (AHF). We evaluated the clinical characteristics, socioeconomic and educational levels, management, in-hospital outcomes, and 30-day mortality rate of patients that were admitted to one tertiary-care center in each of 14 Arab countries in the MENA region. Results Between 22 April and 28 August 2018, 543 AMI and 381AHF patients were enrolled from 14 Arab countries (mean age, 57 +/- 12 years, 82.5% men). Over half of the patients in both study groups had low incomes with limited health care coverage, and limited education. Nearly half of the cohort had a history of diabetes mellitus, hypertension, or hypercholesterolemia. Among patients with ST-elevation myocardial infarctions, 56.4% received primary percutaneous interventions, 24% received thrombolysis, and 19.5% received no acute reperfusion therapy. The main causes of AHF were ischemic heart diseases (55%) and primary valvular heart diseases (15%). The in-hospital and 30-day mortality rates were 2.0% and 3.5%, respectively, for AMI, and 5.4% and 7.0%, respectively, for AHF. Conclusions This pilot study revealed a high prevalence of cardiovascular risk factors in patients with AMI and AHF in Arab countries, and low levels of socioeconomic and educational status. Future phases of the study will improve our understanding of the impact that these factors have on the management and outcomes of cardiac events in these patient populations. C1 [Alhabib, Khalid F.; Al Saleh, Ayman; Ullah, Anhar] King Saud Univ, Coll Med, King Fahad Cardiac Ctr, Dept Cardiac Sci, Riyadh, Saudi Arabia. [Gamra, Habib] Univ Monastir, Fattouma Bourguiba Univ Hosp, Res Lab LR 12SP16, Monastir, Tunisia. [Almahmeed, Wael] Cleveland Clin Abu Dhabi, Heart & Vasc Inst, Abu Dhabi, U Arab Emirates. [Hammoudeh, Ayman] Istishari Hosp, Cardiol Dept, Amman, Jordan. [Benkheddah, Salim] Univ Benyoucef Benkhedda, Mustapha Hosp, Cardiol Dept, Alger Ctre, Algeria. [Al Jarallah, Mohammad] Sabah Al Ahmad Cardia Ctr, Kuwait, Kuwait. [Al-Motarreb, Ahmed] Sanaa Univ, Fac Med, Sanaa, Yemen. [Alquraishi, Mothanna] Ibn Albitar Hosp Cardiac Surg, Baghdad, Iraq. [Sobhy, Mohamed] Int Cardiac Ctr ICC, Alexandria, Egypt. [Yousif, Magdi G.] Sudan Heart Ctr, Khartoum, Sudan. [Alkindi, Fahad] Heart Hosp, Hamad Med Corp, Doha, Qatar. [Fellat, Nadia] IBN SINA Univ Hosp, Rabat, Morocco. [Amin, Mohammad, I] Sh Mohammad Bin Khalifa Cardiac Ctr, Awali, Bahrain. [Ali, Muhammad] Saudi Heart Assoc, Riyadh, Saudi Arabia. [Zannad, Faiez] Univ Lorraine, Ctr Invest Clin Inserm, Inst Lorrain Coeur & Vaisseaux, CHU, Nancy, France. C3 King Saud University; Universite de Monastir; Hopital Fattouma Bourguiba; Cleveland Clinic Foundation; Hamad Medical Corporation; Mohammed V University in Rabat; Ibn sina University Hospital Center of Rabat; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Lorraine RP Alhabib, KF (通讯作者),King Saud Univ, Coll Med, King Fahad Cardiac Ctr, Dept Cardiac Sci, Riyadh, Saudi Arabia. EM khalidalhabib13@hotmail.com RI alkindi, fahad/ABI-6820-2020; Ullah, Anhar/CAJ-2116-2022 OI Ullah, Anhar/0000-0001-6768-2112; Gamra, Habib/0000-0001-8758-5766; Alhabib, Khalid/0000-0002-6692-3874 FU Roche Diagnostic Middle East FZCO FX HG, WA, AH, SB, MJ, AM, MS, MGY, FA, NF, MIA, AS. 30 $ for each submitted online CRF for data collection. funder name: by Roche Diagnostic Middle East FZCO. https://www.rochemiddleeast.com/The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. CR Alhabib KF, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0216551 AlHabib KF, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0147385 AlHabib KF, 2014, EUR J HEART FAIL, V16, P461, DOI 10.1002/ejhf.57 AlHabib KF, 2011, J SAUDI HEART ASSOC, V23, P233, DOI 10.1016/j.jsha.2011.05.004 AlHabib KF, 2012, ANN SAUDI MED, V32, P9, DOI 10.5144/0256-4947.2012.9 Belle L, 2017, ARCH CARDIOVASC DIS, V110, P366, DOI 10.1016/j.acvd.2017.05.001 Dewan P, 2019, JACC-HEART FAIL, V7, P336, DOI 10.1016/j.jchf.2018.11.005 Dickstein K, 2008, EUR HEART J, V29, P2388, DOI 10.1093/eurheartj/ehn309 Dokainish H, 2017, LANCET GLOB HEALTH, V5, pE665, DOI [10.1016/S2214-109X(17)30196-1, 10.1016/s2214-109x(17)30196-1] Ferreira JP, 2019, AM HEART J, V218, P66, DOI 10.1016/j.ahj.2019.08.019 Gheorghiade M, 2005, CIRCULATION, V112, P3958, DOI 10.1161/CIRCULATIONAHA.105.590091 Gheorghiade M, 2009, J AM COLL CARDIOL, V53, P557, DOI 10.1016/j.jacc.2008.10.041 Hunt SA, 2009, J AM COLL CARDIOL, V53, pE1, DOI 10.1016/j.jacc.2008.11.013 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Lopez AD, 2006, LANCET, V367, P1747, DOI 10.1016/S0140-6736(06)68770-9 Moustaghfir A, 2012, ARCH CARDIOVASC DIS, V105, P566, DOI 10.1016/j.acvd.2012.07.002 Najafi F, 2009, EUR J HEART FAIL, V11, P472, DOI 10.1093/eurjhf/hfp029 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Puymirat E, 2012, JAMA-J AM MED ASSOC, V308, P998, DOI 10.1001/2012.jama.11348 Reddy KS, 2004, NEW ENGL J MED, V350, P2438, DOI 10.1056/NEJMp048024 Rosengren A, 2019, LANCET GLOB HEALTH, V7, pE748, DOI 10.1016/S2214-109X(19)30045-2 Rossello X, 2017, INT J CARDIOL, V245, P27, DOI 10.1016/j.ijcard.2017.07.039 Yusuf S, 2001, CIRCULATION, V104, P2746, DOI 10.1161/hc4601.099487 Yusuf S, 2001, CIRCULATION, V104, P2855, DOI 10.1161/hc4701.099488 Zubaid M, 2009, ACTA CARDIOL, V64, P439, DOI 10.2143/AC.64.4.2041607 NR 25 TC 4 Z9 4 U1 0 U2 1 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD JUL 22 PY 2020 VL 15 IS 7 AR e0236292 DI 10.1371/journal.pone.0236292 PG 16 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA MU0WZ UT WOS:000555392700001 PM 32697793 OA Green Published, gold DA 2023-05-13 ER PT J AU Tauriainen, T Kinnunen, EM Koski-Vahala, J Mosorin, MA Airaksinen, J Biancari, F AF Tauriainen, Tuomas Kinnunen, Eeva-Maija Koski-Vahala, Joni Mosorin, Matti-Aleksi Airaksinen, Juhani Biancari, Fausto TI Outcome after procedures for retained blood syndrome in coronary surgery SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY LA English DT Article DE Coronary artery bypass grafting; Coronary artery bypass surgery; Bleeding; Retained blood; Reoperation; Thoracentesis; Pleural drainage ID CHEST TUBE DRAINAGE; PERICARDIAL-EFFUSION; CARDIAC-SURGERY; ARTERY; RISK; SELECTION; IMPACT AB OBJECTIVES: Incomplete drainage of blood from around the heart and lungs can lead to retained blood syndrome (RBS) after cardiac surgery. The aim of this study was to assess the incidence of and the outcome after procedures for RBS in patients undergoing isolated coronary artery bypass grafting (CABG). METHODS: A total of 2764 consecutive patients who underwent isolated CABG from 2006 to 2013 were investigated retrospectively. Patients undergoing any procedure for RBS were compared with patients who did not undergo any procedure for RBS. Multivariate analyses were performed to assess the impact of procedures for RBS on the early outcome. RESULTS: A total of 254 patients (9.2%) required at least one procedure for RBS. Multivariate analysis showed that RBS requiring a procedure for blood removal was associated with significantly increased 30-day mortality [8.3% vs 2.7%, odds ratio (OR) 2.11, 95% confidence interval (95% CI) 1.15-3.86] rates. Procedures for RBS were independent predictors of the need for postoperative antibiotics (51.6% vs 32.1%, OR 2.08, 95% CI 1.58-2.74), deep sternal wound infection/mediastinitis (6.7% vs 2.2%, OR 3.12, 95% CI 1.72-5.66), Kidney Disease: Improving Global Outcomes acute kidney injury (32.7% vs 15.3%, OR 2.50, 95% CI 1.81-3.46), length of stay in the intensive care unit (mean 8.3 vs 2.0 days, beta 1.74, 95% CI 1.45-2.04) and composite major adverse events (21.3% vs 6.9%, OR 3.24, 95% CI 2.24-4.64). These findings were also confirmed in a subgroup of patients with no pre- or postoperative unstable haemodynamic conditions. CONCLUSION: RBS requiring any procedure for blood removal from pericardial and pleural spaces is associated with an increased risk of severe complications after isolated CABG. C1 [Tauriainen, Tuomas; Kinnunen, Eeva-Maija; Koski-Vahala, Joni; Mosorin, Matti-Aleksi; Biancari, Fausto] Oulu Univ Hosp, Dept Surg, POB 21, Oulu 90029, Finland. [Airaksinen, Juhani] Turku Univ Hosp, Ctr Heart, Turku, Finland. C3 University of Oulu; University of Turku RP Biancari, F (通讯作者),Oulu Univ Hosp, Dept Surg, POB 21, Oulu 90029, Finland. EM faustobiancari@yahoo.it RI Airaksinen, Juhani/AAC-7857-2021; Biancari, Fausto/A-1039-2008 OI Airaksinen, Juhani/0000-0002-0193-568X; Biancari, Fausto/0000-0001-5028-8186 CR Ashikhmina EA, 2010, ANN THORAC SURG, V89, P112, DOI 10.1016/j.athoracsur.2009.09.026 Balzer F, 2016, J THORAC CARDIOV SUR, V152, P595, DOI 10.1016/j.jtcvs.2016.03.086 Biancari F, 2015, J CARDIOTHORAC SURG, V10, DOI 10.1186/s13019-015-0292-z Biancari F, 2012, J CARDIOTHOR VASC AN, V26, P550, DOI 10.1053/j.jvca.2012.02.009 Biancari F, 2010, J THORAC CARDIOV SUR, V139, P1158, DOI 10.1016/j.jtcvs.2009.07.012 Boyle EM, 2015, INNOVATIONS, V10, P296, DOI 10.1097/IMI.0000000000000200 Charniot JC, 2007, HEART VESSELS, V22, P16, DOI 10.1007/s00380-006-0930-4 Christensen MC, 2012, J CARDIOTHOR VASC AN, V26, P46, DOI 10.1053/j.jvca.2011.09.021 Dixon B, 2014, J CARDIOTHOR VASC AN, V28, P242, DOI 10.1053/j.jvca.2013.09.010 Ege T, 2004, CHEST, V126, P1559, DOI 10.1378/chest.126.5.1559 Eryilmaz S, 2006, J THORAC CARDIOV SUR, V132, P27, DOI 10.1016/j.jtcvs.2006.01.049 Hall T S, 2001, Ann Thorac Cardiovasc Surg, V7, P352 Imazio M, 2012, CURR OPIN PULM MED, V18, P366, DOI 10.1097/MCP.0b013e32835311a2 Karimov JH, 2013, EUR J CARDIO-THORAC, V44, P1029, DOI 10.1093/ejcts/ezt140 Kuvin JT, 2002, ANN THORAC SURG, V74, P1148, DOI 10.1016/S0003-4975(02)03837-7 Lapar DJ, 2014, ANN THORAC SURG, V98, P527, DOI 10.1016/j.athoracsur.2014.03.039 Levey AS, 1999, ANN INTERN MED, V130, P461, DOI 10.7326/0003-4819-130-6-199903160-00002 Levin A, 2013, KIDNEY INT SUPPL, V3, P5, DOI [10.1038/ki.2013.243, 10.1038/kisup.2012.77] Light RW, 2002, AM J RESP CRIT CARE, V166, P1567, DOI 10.1164/rccm.200203-184OC Meurin P, 2004, CHEST, V125, P2182, DOI 10.1378/chest.125.6.2182 Moulton MJ, 1996, J THORAC CARDIOV SUR, V111, P1037, DOI 10.1016/S0022-5223(96)70380-X Nashef SAM, 2012, EUR J CARDIO-THORAC, V41, P734, DOI 10.1093/ejcts/ezs043 Shalli S, 2009, J CARDIAC SURG, V24, P503, DOI 10.1111/j.1540-8191.2009.00905.x Sirch J, 2016, J THORAC CARDIOV SUR, V151, P832, DOI 10.1016/j.jtcvs.2015.10.015 Sniecinski RM, 2011, J THORAC CARDIOV SUR, V142, P662, DOI 10.1016/j.jtcvs.2011.03.015 UNSWORTHWHITE MJ, 1995, ANN THORAC SURG, V59, P664 Vuylsteke A, 2011, EUR J CARDIO-THORAC, V39, P924, DOI 10.1016/j.ejcts.2010.10.003 NR 27 TC 12 Z9 12 U1 0 U2 4 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1010-7940 EI 1873-734X J9 EUR J CARDIO-THORAC JI Eur. J. Cardio-Thorac. Surg. PD JUN PY 2017 VL 51 IS 6 BP 1078 EP 1085 DI 10.1093/ejcts/ezx015 PG 8 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA FD0FT UT WOS:000407215900010 PM 28329287 OA Bronze, Green Accepted DA 2023-05-13 ER PT J AU Restrepo, MI Faverio, P Anzueto, A AF Restrepo, Marcos I. Faverio, Paola Anzueto, Antonio TI Long-term prognosis in community-acquired pneumonia SO CURRENT OPINION IN INFECTIOUS DISEASES LA English DT Review DE biomarkers; community-acquired pneumonia; outcome ID RESPIRATORY-DISTRESS-SYNDROME; PRACTICE POPULATION COHORT; GERMAN COMPETENCE NETWORK; ACUTE CORONARY SYNDROMES; OLD MANS FRIEND; FOLLOW-UP; INFLAMMATORY MARKERS; SEVERITY ASSESSMENT; ELDERLY-PATIENTS; ACUTE INFECTION AB Purpose of review Pneumonia is considered the leading infectious diseases cause of death and the seventh leading cause of death overall in the US. There is significant interest in understanding the relationship between community-acquired pneumonia (CAP) and mortality. Recent findings Most clinical studies examining patients with CAP have used an arbitrary in-hospital or 30-day mortality as a short-term mortality clinical end point. However, long-term mortality (arbitrary >3 months) factors, incidence, prediction, and implications on patient care are important issues that require further evaluation in patients with CAP. This review focuses on the most recent literature assessing the importance and the frequency of long-term associated outcomes in patients with CAP, the risk factors, and possible implications for future strategies. Multiple risk factors that include age, sex, comorbid conditions, type of pneumonia, and severity of illness are associated with higher long-term mortality. In addition, several biomarkers were demonstrated to be independently associated with long-term mortality. Summary Despite advances in the understanding of long-term mortality among CAP patients, there is still a high unacceptable long-term mortality. Public health programs should address this important gap, considering the high level of complexity factors in patients with CAP. C1 [Restrepo, Marcos I.; Faverio, Paola; Anzueto, Antonio] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Restrepo, Marcos I.; Anzueto, Antonio] S Texas Vet Healthcare Syst, Audie L Murphy Div, San Antonio, TX USA. [Restrepo, Marcos I.] Vet Evidence Based Res Disseminat & Implementat C, San Antonio, TX USA. [Faverio, Paola] Univ Milano Bicocca, Monza, Italy. [Faverio, Paola] San Gerardo Hosp, Dept Resp Med, Monza, Italy. C3 University of Texas System; University of Texas Health San Antonio; US Department of Veterans Affairs; Veterans Health Administration (VHA); Audie L. Murphy Memorial Veterans Hospital; University of Milano-Bicocca; San Gerardo Hospital RP Restrepo, MI (通讯作者),7400 Merton Minter Blvd 11C6, San Antonio, TX 78229 USA. EM restrepom@uthscsa.edu RI Restrepo, Marcos I/H-4442-2014; Faverio, Paola/A-3660-2019 OI faverio, paola/0000-0002-0360-1237 FU National Heart, Lung, and Blood Institute [K23HL096054] FX Dr Restrepo time is partially protected by Award Number K23HL096054 from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, And Blood Institute or the National Institutes of Health. The funding agencies had no role in the preparation, review, or approval of the manuscript. The views expressed in this article are those of the author and do not necessarily represent the views of the Department of Veterans Affairs. 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Opin. Infect. Dis. PD APR PY 2013 VL 26 IS 2 BP 151 EP 158 DI 10.1097/QCO.0b013e32835ebc6d PG 8 WC Infectious Diseases WE Science Citation Index Expanded (SCI-EXPANDED) SC Infectious Diseases GA 097IY UT WOS:000315468400008 PM 23426328 OA Green Accepted DA 2023-05-13 ER PT J AU Zorzi, A Vio, R Rivezzi, F Falzone, PV Giordani, AS Condello, C Dellino, CM Deola, P Gallucci, M Giannattasio, A Licchelli, L Lupasco, D Montonati, C Ravagnin, A Sinigiani, G Torreggiani, G Vianello, R Migliore, F Famoso, G Babuin, L Cacciavillani, L Iliceto, S AF Zorzi, Alessandro Vio, Riccardo Rivezzi, Francesco Falzone, Pasquale V. Giordani, Andrea S. Condello, Chiara Dellino, Carlo M. Deola, Petra Gallucci, Marco Giannattasio, Alessia Licchelli, Luca Lupasco, Diana Montonati, Carolina Ravagnin, Alberto Sinigiani, Giulio Torreggiani, Gianpaolo Vianello, Riccardo Migliore, Federico Famoso, Giulia Babuin, Luciano Cacciavillani, Luisa Iliceto, Sabino TI Characteristics and hospital course of patients admitted for acute cardiovascular diseases during the coronavirus disease-19 outbreak SO JOURNAL OF CARDIOVASCULAR MEDICINE LA English DT Article DE acute cardiovascular care; arrhythmias; cardiology; coronavirus disease-19; heart failure; myocardial infarction; outcome ID ACUTE CORONARY SYNDROME; MYOCARDIAL-INFARCTION; COVID-19; ADMISSIONS; IMPACT AB Introduction During the coronavirus disease-19 (COVID-19) outbreak in spring 2020, people may have been reluctant to seek medical care fearing infection. We aimed to assess the number, characteristics and in-hospital course of patients admitted for acute cardiovascular diseases during the COVID-19 outbreak. Methods We enrolled all consecutive patients admitted urgently for acute myocardial infarction, heart failure or arrhythmias from 1 March to 31 May 2020 (outbreak period) and 2019 (control period). We evaluated the time from symptoms onset to presentation, clinical conditions at admission, length of hospitalization, in-hospital medical procedures and outcome. The combined primary end point included in-hospital death for cardiovascular causes, urgent heart transplant or discharge with a ventricular assist device. Results A similar number of admissions were observed in 2020 (N = 210) compared with 2019 (N = 207). Baseline characteristics of patients were also similar. In 2020, a significantly higher number of patients presented more than 6 h after symptoms onset (57 versus 38%, P < 0.001) and with signs of heart failure (33 versus 20%, P = 0.018), required urgent surgery (13 versus 5%, P = 0.004) and ventilatory support (26 versus 13%, P < 0.001). Hospitalization duration was longer in 2020 (median 10 versus 8 days, P = 0.03). The primary end point was met by 19 (9.0%) patients in 2020 versus 10 (4.8%) in 2019 (P = 0.09). Conclusion Despite the similar number and types of unplanned admissions for acute cardiac conditions during the 2020 COVID-19 outbreak compared with the same period in 2019, we observed a higher number of patients presenting late after symptoms onset as well as longer and more complicated clinical courses. C1 [Zorzi, Alessandro; Vio, Riccardo; Rivezzi, Francesco; Falzone, Pasquale V.; Giordani, Andrea S.; Condello, Chiara; Dellino, Carlo M.; Deola, Petra; Gallucci, Marco; Giannattasio, Alessia; Licchelli, Luca; Lupasco, Diana; Montonati, Carolina; Ravagnin, Alberto; Sinigiani, Giulio; Torreggiani, Gianpaolo; Vianello, Riccardo; Migliore, Federico; Famoso, Giulia; Babuin, Luciano; Cacciavillani, Luisa; Iliceto, Sabino] Univ Padua, Dept Cardiac Thorac & Vasc Sci & Publ Hlth, Via Giustiani 2, I-35128 Padua, Italy. C3 University of Padua RP Zorzi, A (通讯作者),Univ Padua, Dept Cardiac Thorac & Vasc Sci & Publ Hlth, Via Giustiani 2, I-35128 Padua, Italy. EM alessandro.zorzi@unipd.it RI Zorzi, Alessandro/I-9334-2019; Vio, Riccardo/AAK-3339-2021; Migliore, Frederico/AAB-3663-2021 OI Zorzi, Alessandro/0000-0002-3578-0583; Vio, Riccardo/0000-0002-7393-1514; Migliore, Frederico/0000-0001-8574-9421; Licchelli, Luca/0000-0002-0230-0475 CR Abdelaziz HK, 2020, AM HEART J, V226, P45, DOI 10.1016/j.ahj.2020.04.022 De Filippo O, 2020, NEW ENGL J MED, V383, P88, DOI 10.1056/NEJMc2009166 De Rosa S, 2020, EUR HEART J, V41, P2083, DOI 10.1093/eurheartj/ehaa409 Enache B, 2020, CLIN RES CARDIOL, V109, P1577, DOI 10.1007/s00392-020-01687-w Folino AF, 2020, AM HEART J, V226, P26, DOI 10.1016/j.ahj.2020.04.021 Garcia S, 2020, J AM COLL CARDIOL, V75, P2871, DOI 10.1016/j.jacc.2020.04.011 Istitituto superiore di sanita, 2020, CHARACTERISTICS COVI Lantelme P, 2020, ARCH CARDIOVASC DIS, V113, P443, DOI 10.1016/j.acvd.2020.06.001 Metzler B, 2020, EUR HEART J, V41, P1852, DOI 10.1093/eurheartj/ehaa314 Migliore F, 2020, CIRC-ARRHYTHMIA ELEC, V13, DOI 10.1161/CIRCEP.120.008722 Rodriguez-Leor O, 2020, REC INTERV CARDIOL, V2, P82, DOI DOI 10.24875/RECICE.M20000123 Tam CCF, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006631 Toniolo M, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.120.017122 Wilson SJ, 2020, CIRC-CARDIOVASC INTE, V13, DOI 10.1161/CIRCINTERVENTIONS.120.009438 NR 14 TC 12 Z9 12 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1558-2027 EI 1558-2035 J9 J CARDIOVASC MED JI J. Cardiovasc. Med. PD JAN PY 2021 VL 22 IS 1 BP 29 EP 35 DI 10.2459/JCM.0000000000001129 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PZ3AT UT WOS:000612611900006 PM 33186239 OA Bronze DA 2023-05-13 ER PT J AU Go, AS Tan, TC Chertow, GM Ordonez, JD Fan, DJ Law, D Yankulin, L Wojcicki, JM Zheng, SJ Chen, KK Khoshniat-Rad, F Yang, JR Parikh, RV AF Go, Alan S. Tan, Thida C. Chertow, Glenn M. Ordonez, Juan D. Fan, Dongjie Law, David Yankulin, Leonid Wojcicki, Janet M. Zheng, Sijie Chen, Kenneth K. Khoshniat-Rad, Farzien Yang, Jingrong Parikh, Rishi V. TI Primary Nephrotic Syndrome and Risks of ESKD, Cardiovascular Events, and Death: The Kaiser Permanente Nephrotic Syndrome Study SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID RENAL-VEIN THROMBOSIS; VENOUS THROMBOEMBOLISM; PATHOPHYSIOLOGY; EPIDEMIOLOGY; NEPHROPATHY; NETWORK AB Background Little population-based data exist about adults with primary nephrotic syndrome. Methods To evaluate kidney, cardiovascular, and mortality outcomes in adults with primary nephrotic syndrome, we identified adults within an integrated health care delivery system (Kaiser Permanente Northern California) with nephrotic-range proteinuria or diagnosed nephrotic syndrome between 1996 and 2012. Nephrologists reviewed medical records for clinical presentation, laboratory findings, and biopsy results to confirm primary nephrotic syndrome and assigned etiology. We identified a 1:100 time-matched cohort of adults without diabetes, diagnosed nephrotic syndrome, or proteinuria as controls to compare rates of ESKD, cardiovascular outcomes, and death through 2014, using multivariable Cox regression. Results We confirmed 907 patients with primary nephrotic syndrome (655 definite and 252 presumed patients with FSGS [40%], membranous nephropathy [40%], and minimal change disease [20%]). Mean age was 49 years; 43% were women. Adults with primary nephrotic syndrome had higher adjusted rates of ESKD (adjusted hazard ratio [aHR], 19.63; 95% confidence interval [95% CI], 12.76 to 30.20), acute coronary syndrome (aHR, 2.58; 95% CI, 1.89 to 3.52), heart failure (aHR, 3.01; 95% CI, 2.16 to 4.19), ischemic stroke (aHR, 1.80; 95% CI, 1.06 to 3.05), venous thromboembolism (aHR, 2.56; 95% CI, 1.35 to 4.85), and death (aHR, 1.34; 95% CI, 1.09 to 1.64) versus controls. Excess ESKD risk was significantly higher for FSGS and membranous nephropathy than for presumed minimal change disease. The three etiologies of primary nephrotic syndrome did not differ significantly in terms of cardiovascular outcomes and death. Conclusions Adults with primary nephrotic syndrome experience higher adjusted rates of ESKD, cardiovascular outcomes, and death, with significant variation by underlying etiology in the risk for developing ESKD. C1 [Go, Alan S.; Tan, Thida C.; Fan, Dongjie; Khoshniat-Rad, Farzien; Yang, Jingrong; Parikh, Rishi V.] Kaiser Permanente Northern Calif, Div Res, 2000 Broadway, Oakland, CA 94612 USA. [Go, Alan S.] Kaiser Permanente, Bernard J Tyson Sch Med, Dept Hlth Syst Sci, Pasadena, CA USA. [Go, Alan S.; Wojcicki, Janet M.] Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA. [Go, Alan S.; Wojcicki, Janet M.] Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94143 USA. [Go, Alan S.; Wojcicki, Janet M.] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. [Go, Alan S.; Chertow, Glenn M.] Stanford Univ, Sch Med, Dept Med, Stanford, CA 94305 USA. [Ordonez, Juan D.; Law, David; Zheng, Sijie; Chen, Kenneth K.] Kaiser Permanente East Bay, Dept Nephrol, Oakland, CA USA. [Yankulin, Leonid] Kaiser Permanente, San Francisco Med Ctr, Dept Nephrol, Oakland, CA USA. [Wojcicki, Janet M.] Univ Calif San Francisco, Dept Pediat, San Francisco, CA USA. C3 Kaiser Permanente; Kaiser Permanente; University of California System; University of California San Francisco; University of California System; University of California San Francisco; University of California System; University of California San Francisco; Stanford University; Kaiser Permanente; Kaiser Permanente; University of California System; University of California San Francisco RP Go, AS (通讯作者),Kaiser Permanente Northern Calif, Div Res, 2000 Broadway, Oakland, CA 94612 USA. EM Alan.S.Go@kp.org OI Chertow, Glenn/0000-0002-7599-0534; Parikh, Rishi/0000-0002-1115-844X FU Brin Wojcicki Foundation FX This work was supported by the Brin Wojcicki Foundation. 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Am. Soc. Nephrol. PD SEP PY 2021 VL 32 IS 9 BP 2303 EP 2314 DI 10.1681/ASN.2020111583 PG 12 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA YW6HS UT WOS:000753514300022 PM 34362836 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Vyas, A Bash, LD Patel, MD Simpson, RJ AF Vyas, Ami Bash, Lori D. Patel, Mehul D. Simpson, Ross J., Jr. TI Changes in Treatment Patterns and Incremental Health Care Utilization Due to P2Y12-Associated Complications in Patients with Acute Coronary Syndrome SO JOURNAL OF MANAGED CARE & SPECIALTY PHARMACY LA English DT Article ID MYOCARDIAL-INFARCTION; SECONDARY PREVENTION; ISCHEMIC-STROKE; CLOPIDOGREL; TICAGRELOR; INTERVENTION; PRASUGREL; PERSISTENCE; VORAPAXAR; ADHERENCE AB BACKGROUND: P2Y12 antiplatelet therapy (APT) is highly efficacious in reducing the incidence of ischemic events in patients with acute coronary syndrome (ACS); however, it is associated with several adverse complications. Data on P2Y12-associated complications and adherence to APT are sparse. OBJECTIVE: To describe the characteristics, frequency of P2Y12-associated complications, adherence and persistence to P2Y12 APT, and health care utilization among ACS patients on P2Y12 APT. METHODS: This retrospective observational study of the MarketScan Commercial Claims and Encounters Database identified patients aged >= 18 years who were discharged from an ACS hospitalization in 2012-2014 and initiated P2Y12 APT (ticagrelor, prasugrel, or clopidogrel). The proportion of patients within each treatment group who experienced P2Y12-associated complications within 1 year and who were adherent to APT were determined. Frequencies of all-cause health care utilization (i.e., hospitalization, length of stay, emergency room [ER] visits, outpatient visits, cardiac events, and transfusions) were evaluated for each treatment group. Poisson regressions were conducted to evaluate the association between nonadherence with P2Y12 APT and health care utilization, after adjusting for demographics (age and gender), health insurance type, and comorbidities. RESULTS: Among 11,629 ACS patients, most were male; 44.6% had hypertension; 20.6% had diabetes; and 53.4% had hyperlipidemia. Clopidogrel use was common (62.6%), with ticagrelor use less common (9.0%). Among all groups, approximately one third experienced P2Y12-associated complications. One-year adherence to APT was suboptimal (68% overall), with 73.3% adherence among prasugrel users, followed by 71.4% adherence among ticagrelor users and 65.6% adherence among clopidogrel users. Switching was most common with ticagrelor users. Inpatient hospitalizations, cardiac events, and transfusions were more common in clopidogrel users compared with prasugrel and ticagrelor users. Nonadherent patients experienced significantly more hospitalizations, ER visits, and transfusions (1.34, 1.09, and 1.85 [P<0.05], respectively) compared with adherent patients. These trends of association remained consistent across all treatment groups. Also, patients not adherent to ticagrelor experienced 1.9 times as many cardiac events as adherent patients. However, this association was not significant for clopidogrel and prasugrel users. Patients not adherent to P2Y12 APT experienced significantly lower outpatient visits compared with adherent patients. CONCLUSIONS: Complications associated with P2Y12 in ACS patients treated with P2Y12 APT were common, with dyspnea, heart block, and major or life-threatening bleeding as the most common. Adherence was significantly associated with lower health care utilization. Increased adherence to secondary prevention therapy among these very high-risk patients is crucial. Disease management strategies to improve adherence and reduce treatment-associated adverse events through individualized patient care, alternative secondary treatment options, and physician awareness should be designed, implemented, and sustained. Copyright (C)2017, Academy of Managed Care Pharmacy. All rights reserved. C1 [Vyas, Ami] Rutgers State Univ, Sch Publ Hlth, Dept Epidemiol, Piscataway, NJ USA. [Bash, Lori D.; Patel, Mehul D.] Merck & Co Inc, Kenilworth, NJ USA. [Simpson, Ross J., Jr.] Univ N Carolina, Dept Med, Chapel Hill, NC USA. C3 Rutgers State University New Brunswick; Merck & Company; University of North Carolina; University of North Carolina Chapel Hill RP Vyas, A (通讯作者),Univ Rhode Isl, Coll Pharm, Dept Pharm Practice, 7 Greenhouse Rd, Kingston, RI 02881 USA. EM avyas@uri.edu FU Merck Co.; Amgen; Pfizer FX Data analysis was conducted by Merck & Co., the manufacturer of vorapaxar (ZONTIVITY). At the time of this study, Vyas was an employee of Rutgers University, which received grant funding from Merck & Co. for this study, and is now employed with the University of Rhode Island. Patel was employed by Symphony Solutions and the University of North Carolina during the drafting and revising of the manuscript. Bash is employed by Merck & Co. Simpson received consulting fees from Merck & Co. for work on this study and has received fees for research from Amgen and Pfizer. CR Amsterdam EA, 2014, CIRCULATION, V130, P2354, DOI 10.1161/CIR.0000000000000133 Angiolillo DJ, 2008, AM HEART J, V156, pS3, DOI 10.1016/j.ahj.2008.06.003 [Anonymous], 2015, BRILINTA TICAGRELOR Bhatt DL, 2006, NEW ENGL J MED, V354, P1706, DOI 10.1056/NEJMoa060989 Bohula EA, 2015, CIRCULATION, V132, P1871, DOI 10.1161/CIRCULATIONAHA.114.015042 Bonaca MP, 2015, NEW ENGL J MED, V372, P1791, DOI 10.1056/NEJMoa1500857 Bonaca MP, 2014, J AM COLL CARDIOL, V64, P2318, DOI 10.1016/j.jacc.2014.07.997 Burke JP, 2010, CURR MED RES OPIN, V26, P1023, DOI 10.1185/03007991003670563 Desai NR, 2013, CURR CARDIOL REP, V15, DOI 10.1007/s11886-012-0322-6 European Medicines Agency, 2015, ASS REP BRIL PROC NO Gaubert M, 2014, INT J CARDIOL, V173, P120, DOI 10.1016/j.ijcard.2014.02.028 Go AS, 2014, CIRCULATION, V129, pE28, DOI 10.1161/01.cir.0000441139.02102.80 Hansen LG., TRUVEN HLTH WEBSITE Kalyanasundaram A, 2011, NAT REV CARDIOL, V8, P592, DOI 10.1038/nrcardio.2011.128 Kim K, 2017, J MANAG CARE SPEC PH, V23, P57, DOI 10.18553/jmcp.2017.23.1.57 Magnani G, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.114.001505 Mehran R, 2013, LANCET, V382, P1714, DOI 10.1016/S0140-6736(13)61720-1 Morrow DA, 2012, NEW ENGL J MED, V366, P1404, DOI 10.1056/NEJMoa1200933 Nau D., PROPORTION DAYS COVE Nordstrom B, 2013, AM J CARDIOVASC DRUG, V13, P263, DOI 10.1007/s40256-013-0028-1 O'Gara PT, 2013, CIRCULATION, V127, pE362, DOI 10.1161/CIR.0b013e3182742cf6 Serebruany VL, 2010, THROMB HAEMOSTASIS, V103, P259, DOI 10.1160/TH09-10-0695 Simeone J, 2015, AM J CARDIOVASC DRUG, V15, P337, DOI 10.1007/s40256-015-0147-y Spinler SA, 2009, J MANAGE CARE PHARM, V15, P383, DOI 10.18553/jmcp.2009.15.5.383 U. S. Food and Drug Administration, 2009, EFF PRAS AC COR SYND Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 World Health Organization, 2017, CARDIOVASCULAR DIS C Yusuf S, 2001, NEW ENGL J MED, V345, P494 Zhu BJ, 2011, CURR MED RES OPIN, V27, P633, DOI 10.1185/03007995.2010.551657 NR 30 TC 3 Z9 3 U1 0 U2 1 PU ACAD MANAGED CARE PHARMACY PI ALEXANDRIA PA 100 N PITT ST, 400, ALEXANDRIA, VA 22314-3134 USA SN 2376-0540 EI 2376-1032 J9 J MANAG CARE SPEC PH JI J. Manag. Care Spec. Pharm. PD SEP PY 2017 VL 23 IS 9 BP 947 EP 956 DI 10.18553/jmcp.2017.23.9.947 PG 10 WC Health Care Sciences & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Pharmacology & Pharmacy GA FG8WP UT WOS:000410718800005 PM 28854078 OA Bronze DA 2023-05-13 ER PT J AU Breuckmann, F Hochadel, M Darius, H Giannitsis, E Munzel, T Maier, LS Schmitt, C Schumacher, B Heusch, G Voigtlander, T Mudra, H Senges, J AF Breuckmann, Frank Hochadel, Matthias Darius, Harald Giannitsis, Evangelos Muenzel, Thomas Maier, Lars S. Schmitt, Claus Schumacher, Burghard Heusch, Gerd Voigtlaender, Thomas Mudra, Harald Senges, Jochen TI Guideline-adherence and perspectives in the acute management of unstable angina - Initial results from the German chest pain unit registry SO JOURNAL OF CARDIOLOGY LA English DT Article DE Unstable angina; Chest pain unit; Guideline; Timing; Cardiovascular events ID ACUTE CORONARY SYNDROMES; MYOCARDIAL-INFARCTION; EUROPEAN-SOCIETY; CARDIOLOGY ESC; INTERVENTION; CARE; REVASCULARIZATION; MORTALITY; STRATEGY; OUTCOMES AB Background: We investigated the current management of unstable angina pectoris (UAP) in certified chest pain units (CPUs) in Germany and focused on the European Society of Cardiology (ESC) guideline-adherence in the timing of invasive strategies or choice of conservative treatment options. More specifically, we analyzed differences in clinical outcome with respect to guideline-adherence. Method: Prospective data from 1400 UAP patients were collected. Analyses of high-risk criteria with indication for invasive management and 3-month clinical outcome data were performed. Guideline-adherence was tested for a primarily conservative strategy as well as for percutaneous coronary intervention (PCI) within <24 and <72 h after admission. Results: Overall guideline-conforming management was performed in 38.2%. In UAP patients at risk, undertreatment caused by an insufficient consideration of risk criteria was obvious in 78%. Reciprocally, overtreatment in the absence of adequate risk markers was performed in 27%, whereas a guideline-conforming primarily conservative strategy was chosen in 73% of the low-risk patients. Together, the 3-month major adverse coronary and cerebrovascular events (MACCE) were low (3.6%). Nonetheless, guideline-conforming treatment was even associated with significantly lower MACCE rates (1.6% vs. 4.0%, p < 0.05). Conclusion: The data suggest an inadequate adherence to ESC guidelines in nearly two thirds of the patients, particularly in those patients at high to intermediate risk with secondary risk factors, emphasizing the need for further attention to consistent risk profiling in the CPU and its certification process. (c) 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. C1 [Breuckmann, Frank] Arnsberg Med Ctr, Dept Cardiol, Arnsberg, Germany. [Hochadel, Matthias; Senges, Jochen] Heidelberg Univ, Inst Myocardial Infarct Res Fdn Ludwigshafen, Heidelberg, Germany. [Darius, Harald] Vivantes Klinikum Neukolln, Dept Cardiol Angiol & Intens Care Med, Berlin, Germany. [Giannitsis, Evangelos] Univ Heidelberg Hosp, Dept Med 3, Heidelberg, Germany. [Muenzel, Thomas] Johannes Gutenberg Univ Mainz, Dept Med 2, D-55122 Mainz, Germany. [Maier, Lars S.] Univ Hosp Regensburg, Dept Internal Med 2, Regensburg, Germany. [Schmitt, Claus] Municipal Hosp Karlsruhe, Clin Cardiol & Angiol, Karlsruhe, Germany. [Schumacher, Burghard] Westpfalz Klinikum, Dept Med 2, Kaiserslautern, Germany. [Heusch, Gerd] Univ Duisburg Essen, Inst Pathophysiol, Essen, Germany. [Voigtlaender, Thomas] CCB, Frankfurt, Germany. [Mudra, Harald] Stadt Klinikum Munchen GmbH, Klinikum Neuperlach, Dept Cardiol Pneumol & Internal Intens Care Med, Munich, Germany. C3 Ruprecht Karls University Heidelberg; VIivantes Klinikum Neukolln; Ruprecht Karls University Heidelberg; Johannes Gutenberg University of Mainz; University of Regensburg; Municipal Hospital Karlsruhe; Westpfalz-Klinikum GmbH; University of Duisburg Essen; Munchen Klinik RP Breuckmann, F (通讯作者),Stolte Ley 5, D-59759 Arnsberg, Germany. EM fbreuckmann@klinikum-arnsberg.de RI Maier, Lars/AAQ-8313-2021; Munzel, Thomas/A-2912-2014; Heusch, Gerd/ABE-6675-2020 OI Maier, Lars/0000-0001-9915-4429; Munzel, Thomas/0000-0001-5503-4150; Heusch, Gerd/0000-0001-7078-4160; Breuckmann, Frank/0000-0001-7245-8000 CR Achenbach S, 2012, KARDIOLOGE, V6, P283, DOI 10.1007/s12181-012-0436-5 Bahr Raymond D, 2002, J Cardiovasc Manag, V13, P23 Bahr Raymond D, 2002, J Cardiovasc Manag, V13, P26 Bahr Raymond D, 2002, J Cardiovasc Manag, V13, P21 Bahr Raymond D, 2002, J Cardiovasc Manag, V13, P19 Bahr Raymond D, 2002, Prev Cardiol, V5, P16, DOI 10.1111/j.1520-037X.2002.00549.x Bauer T, 2013, INT J CARDIOL, V166, P596, DOI 10.1016/j.ijcard.2011.11.024 Breuckmann F, 2008, KARDIOLOGE, V2, P389, DOI 10.1007/s12181-008-0116-7 Breuckmann F, 2009, HERZ, V34, P218, DOI 10.1007/s00059-009-3212-y Califf RM, 2003, CIRCULATION, V107, P1467, DOI 10.1161/01.CIR.0000065160.19016.26 Damman P, 2012, JACC-CARDIOVASC INTE, V5, P191, DOI 10.1016/j.jcin.2011.10.016 Fox KAA, 2002, EUR HEART J, V23, P1177, DOI 10.1053/euhj.2001.3081 Goodacre S, 2004, BRIT MED J, V328, P254, DOI 10.1136/bmj.37956.664236.EE Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hasdai D, 2002, EUR HEART J, V23, P1190, DOI 10.1053/euhj.2002.3193 Hasin Y, 2005, EUR HEART J, V26, P1676, DOI 10.1093/eurheartj/ehi202 Hwang J, 2013, J CARDIOL, V62, P77, DOI 10.1016/j.jjcc.2013.03.017 Katritsis DG, 2011, EUR HEART J, V32, P32, DOI 10.1093/eurheartj/ehq276 Keller T, 2012, HERZ, V37, P301, DOI 10.1007/s00059-011-3544-2 Keller T, 2010, CLIN RES CARDIOL, V99, P149, DOI 10.1007/s00392-009-0099-9 KILLIP T, 1967, AM J CARDIOL, V20, P457, DOI 10.1016/0002-9149(67)90023-9 Mehta RH, 2006, ARCH INTERN MED, V166, P2027, DOI 10.1001/archinte.166.18.2027 Mehta SR, 2009, NEW ENGL J MED, V360, P2165, DOI 10.1056/NEJMoa0807986 Munzel T, 2011, EUR HEART J, V32, P657 Post F, 2012, CLIN RES CARDIOL, V101, P983, DOI 10.1007/s00392-012-0487-4 Rajpurohit N, 2013, CATHETER CARDIO INTE, V81, P223, DOI 10.1002/ccd.24439 Sorajja P, 2010, J AM COLL CARDIOL, V55, P1416, DOI 10.1016/j.jacc.2009.11.063 Steurer J, 2010, EMERG MED J, V27, P896, DOI 10.1136/emj.2010.092619 Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), 2010, Eur Heart J, V31, P2501, DOI 10.1093/eurheartj/ehq277 Vogel B, 2012, INT J CARDIOL, V159, P198, DOI 10.1016/j.ijcard.2011.02.073 NR 31 TC 20 Z9 20 U1 0 U2 3 PU ELSEVIER PI AMSTERDAM PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS SN 0914-5087 EI 1876-4738 J9 J CARDIOL JI J. Cardiol. PD JUL-AUG PY 2015 VL 66 IS 1-2 BP 108 EP 113 DI 10.1016/j.jjcc.2014.11.003 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CP2CH UT WOS:000359684600021 PM 25497278 OA Bronze DA 2023-05-13 ER PT J AU Miyachi, H Takagi, A Miyauchi, K Yamasaki, M Tanaka, H Yoshikawa, M Saji, M Suzuki, M Yamamoto, T Shimizu, W Nagao, K Takayama, M AF Miyachi, Hideki Takagi, Atsushi Miyauchi, Katsumi Yamasaki, Masao Tanaka, Hiroyuki Yoshikawa, Masatomo Saji, Mike Suzuki, Makoto Yamamoto, Takeshi Shimizu, Wataru Nagao, Ken Takayama, Morimasa TI Current characteristics and management of ST elevation and non-ST elevation myocardial infarction in the Tokyo metropolitan area: from the Tokyo CCU network registered cohort SO HEART AND VESSELS LA English DT Article DE ST elevation myocardial infarction; Non-ST elevation myocardial infarction; In-hospital mortality; Risk factors ID ACUTE CORONARY SYNDROMES; ASSOCIATION TASK-FORCE; STENT THROMBOSIS; UNIVERSAL DEFINITION; INTERVENTION; OUTCOMES; DELAY; GUIDELINES; STRATEGY; CAMPAIGN AB Limited data exists on ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) managed by a well-organized cardiac care network in a metropolitan area. We analyzed the Tokyo CCU network database in 2009-2010. Of 4329 acute myocardial infarction (AMI) patients including STEMI (n = 3202) and NSTEMI (n = 1127), percutaneous coronary intervention (PCI) was performed in 88.8 % of STEMI and 70.4 % of NSTEMI patients. Mean onset-to-door and door-to-balloon times in STEMI patients were shorter than those in NSTEMI patients (167 vs 233 and 60 vs 145 min, respectively, p < 0.001). Coronary artery bypass graft surgery was performed in 4.2 % of STEMI and 11.4 % of NSTEMI patients. In-hospital mortality was significantly higher in STEMI patients than NSTEMI patients (7.7 vs 5.1 %, p < 0.007). Independent correlates of in-hospital mortality were advanced age, low blood pressure, and high Killip classification, statin-treated dyslipidemia and PCI within 24 h were favorable predictors for STEMI. High Killip classification, high heart rate, and hemodialysis were significant predictors of in-hospital mortality, whereas statin-treated dyslipidemia was the only favorable predictor for NSTEMI. In conclusion, patients with MI received PCI frequently (83.5 %) and promptly (door-to-balloon time; 66 min), and had favorable in-hospital prognosis (in-hospital mortality; 7.0 %). In addition to traditional predictors of in-hospital death, statin-treated dyslipidemia was a favorable predictor of in-hospital mortality for STEMI and NSTEMI patients, whereas hemodialysis was the strongest predictor for NSTEMI patients. C1 [Miyachi, Hideki; Takagi, Atsushi; Miyauchi, Katsumi; Yamasaki, Masao; Tanaka, Hiroyuki; Yoshikawa, Masatomo; Saji, Mike; Suzuki, Makoto; Yamamoto, Takeshi; Nagao, Ken; Takayama, Morimasa] Tokyo CCU Network Sci Comm, Tokyo, Japan. [Miyachi, Hideki] Nippon Med Coll Hosp, Div Cardiovasc Intens Care, Bunkyo Ku, 1-1-5 Sendagi, Tokyo 1138603, Japan. [Shimizu, Wataru] Nippon Med Sch, Dept Cardiovascular Med, Tokyo, Japan. C3 Nippon Medical School; Nippon Medical School RP Miyachi, H (通讯作者),Tokyo CCU Network Sci Comm, Tokyo, Japan. EM hidep-@nms.ac.jp RI Saji, Mike/AAF-4407-2019; Shimizu, Wataru/IAM-9119-2023 OI Saji, Mike/0000-0003-2057-109X; Shimizu, Wataru/0000-0001-9941-8973 CR Balzi D, 2013, INTERN EMERG MED, V8, P725, DOI 10.1007/s11739-012-0817-6 Briel M, 2006, JAMA-J AM MED ASSOC, V295, P2046, DOI 10.1001/jama.295.17.2046 Cannon CP, 2000, JAMA-J AM MED ASSOC, V283, P2941, DOI 10.1001/jama.283.22.2941 Daemen J, 2007, LANCET, V369, P667, DOI 10.1016/S0140-6736(07)60314-6 Daida H, 2013, CIRC J, V77, P934, DOI 10.1253/circj.CJ-13-0174 Foley RN, 2013, CLIN J AM SOC NEPHRO, V8, P845, DOI 10.2215/CJN.06840712 Gaspoz JM, 1996, HEART, V76, P150, DOI 10.1136/hrt.76.2.150 Goldberg RJ, 2004, AM J CARDIOL, V93, P288, DOI 10.1016/j.amjcard.2003.10.006 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 HERLITZ J, 1992, EUR HEART J, V13, P171, DOI 10.1093/oxfordjournals.eurheartj.a060142 Hioki H, 2016, HEART VESSELS, V31, P687, DOI 10.1007/s00380-015-0673-1 Huber K, 2005, EUR HEART J, V26, P2063, DOI 10.1093/eurheartj/ehi413 Ishihara M, 2015, CIRC J, V79, P1255, DOI 10.1253/circj.CJ-15-0217 ISIS-1: First International Study of Infarct Survival Collaborative Group, 1986, LANCET, V2, P57, DOI DOI 10.1016/S0140-6736(86)91607-7 Jneid H, 2012, CIRCULATION, V126, P875, DOI 10.1161/CIR.0b013e318256f1e0 Kimura T, 2009, CIRCULATION, V119, P987, DOI 10.1161/CIRCULATIONAHA.108.808311 Kitakaze M, 2007, LANCET, V370, P1483, DOI 10.1016/S0140-6736(07)61634-1 Konishi H, 2016, HEART VESSELS, V31, P441, DOI 10.1007/s00380-014-0624-2 Levey AS, 2007, KIDNEY INT, V72, P247, DOI 10.1038/sj.ki.5002343 Luepker RV, 2000, JAMA-J AM MED ASSOC, V284, P60, DOI 10.1001/jama.284.1.60 Mehta SR, 2009, NEW ENGL J MED, V360, P2165, DOI 10.1056/NEJMoa0807986 Montalescot G, 2007, EUR HEART J, V28, P1409, DOI 10.1093/eurheartj/ehm031 Montalescot G, 2009, JAMA-J AM MED ASSOC, V302, P947, DOI 10.1001/jama.2009.1267 Nakai S, 2012, THER APHER DIAL, V16, P483, DOI 10.1111/j.1744-9987.2012.01143.x Neumann FJ, 2003, JAMA-J AM MED ASSOC, V290, P1593, DOI 10.1001/jama.290.12.1593 O'Gara PT, 2013, J AM COLL CARDIOL, V61, pE78, DOI [10.1016/j.jacc.2012.11.019, 10.1161/01.cir.0000440804.93914.d8, 10.1161/CIR.0b013e3182742cf6] Obayashi T, 2010, CIRC J, V74, P289, DOI 10.1253/circj.CJ-09-0623 Ogawa H, 2013, CIRC J, V77, P231, DOI 10.1253/circj.CJ-66-0053 Patel Manesh R, 2012, J Am Coll Cardiol, V59, P857, DOI 10.1016/j.jacc.2011.12.001 Patti G, 2007, J AM COLL CARDIOL, V49, P1272, DOI 10.1016/j.jacc.2007.02.025 Slottow TLP, 2008, AM J CARDIOL, V102, P298, DOI 10.1016/j.amjcard.2008.03.055 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Takahashi M, 2011, J CARD FAIL, V17, P742, DOI 10.1016/j.cardfail.2011.05.005 TAKANO T, 1981, JPN CIRC J, V45, P623, DOI 10.1253/jcj.45.623 Thygesen K, 2007, EUR HEART J, V28, P2525 Yasue H, 2004, AM J CARDIOL, V93, P969, DOI 10.1016/j.amjcard.2004.01.006 NR 36 TC 59 Z9 60 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0910-8327 EI 1615-2573 J9 HEART VESSELS JI Heart Vessels PD NOV PY 2016 VL 31 IS 11 BP 1740 EP 1751 DI 10.1007/s00380-015-0791-9 PG 12 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EB3NF UT WOS:000387271000002 PM 26758733 OA Green Published, hybrid DA 2023-05-13 ER PT J AU de la Sierra, A Pinto, X Guijarro, C Miranda, JL Callejo, D Cuervo, J Subira, R Rubio, M AF de la Sierra, Alex Pinto, Xavier Guijarro, Carlos Lopez Miranda, Jose Callejo, Daniel Cuervo, Jesus Subira, Rudi Rubio, Marta TI Prevalence, Treatment, and Control of Hypercholesterolemia in High Cardiovascular Risk Patients: Evidences from a Systematic Literature Review in Spain SO ADVANCES IN THERAPY LA English DT Article DE Cardiovascular disease; Control; Drug; Dyslipidemia; Hypercholesterolemia; Prevalence ID DENSITY-LIPOPROTEIN CHOLESTEROL; PERIPHERAL ARTERIAL-DISEASE; ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; LIPID-LOWERING THERAPY; LDL-CHOLESTEROL; VASCULAR RISK; ISCHEMIC-STROKE; HEART-DISEASE; PRIMARY-CARE AB Introduction: Cardiovascular diseases (CVDs) represent a major Public Health burden. High serum cholesterol levels have been linked to major CV risk. The objectives of this study were to review the epidemiology of hypercholesterolemia in high risk CV patients from Spain, by assessing its prevalence, the proportion of diagnosed patients undergoing pharmacological treatment and the degree of attained lipid control. Methods: A systematic literature review was carried out using Medline and two Spanish databases. Manuscripts containing information on hypercholesterolemia in several high CV risk groups [diabetes mellitus (DM), Systematic COronary Risk Evaluation (SCORE) risk >5, or documented CVD], published between January 2010 and October 2014, were included. Results: Of the 1947 published references initially retrieved, a full-text review was done on 264 manuscripts and 120 were finally included. Prevalence of hypercholesterolemia ranged from 50 to 84% in diabetics, 30-60% in patients with DM or elevated SCORE risk, 64-74% with coronary heart disease, 40-70% in stroke patients, and 60-80% in those with peripheral artery disease. Despite the finding that most of them were on pharmacological treatment, acceptable control of serum lipids was very variable, ranging from 15% to 65%. Among those with heterozygous familial hypercholesterolemia, 95-100% received treatment but less than 50% achieved their therapeutic goals. Conclusions: An elevated prevalence of hypercholesterolemia can be found in targeted groups at high CV risk. Although most patients are receiving pharmacological treatment, rates of lipid control continue to be low, both in primary and secondary prevention. C1 [de la Sierra, Alex] Univ Hosp Mutua Terrassa, Dept Internal Med, Barcelona, Spain. [Pinto, Xavier] Univ Hosp Bellvitge, Lipid Unit, Internal Med Serv, Barcelona, Spain. [Guijarro, Carlos] Univ Hosp Alcorcon Fdn, Internal Med Serv, Madrid, Spain. [Lopez Miranda, Jose] Univ Cordoba, IMIBIC Reina Sofia Univ Hosp, Lipids & Atherosclerosis Unit, Cordoba, Spain. [Lopez Miranda, Jose] Inst Salud Carlos III, CIBER Fisiopatol Obesidad Nutr, Cordoba, Spain. [Lopez Miranda, Jose] Reina Sofia Univ Hosp, IMIBIC Fdn Invest Biomed Cordoba, Cordoba, Spain. [Callejo, Daniel; Cuervo, Jesus] BAP Hlth Outcomes Res, Oviedo, Spain. [Subira, Rudi; Rubio, Marta] Sanofi Iberia, Hlth Econ & Outcomes Res, Barcelona, Spain. C3 Hospital Universitario Mutua Terrassa; Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Bellvitge University Hospital; University of Barcelona; Alcorcon Foundation University Hospital; Universidad de Cordoba; CIBER - Centro de Investigacion Biomedica en Red; CIBEROBN; Instituto de Salud Carlos III RP de la Sierra, A (通讯作者),Univ Hosp Mutua Terrassa, Dept Internal Med, Barcelona, Spain. EM adelasierra@mutuaterrassa.cat RI GUIJARRO, CARLOS/B-3003-2008; Pintó, Xavier/AGI-4297-2022 OI GUIJARRO, CARLOS/0000-0001-8132-9366; Pintó, Xavier/0000-0002-2216-2444; CUERVO, JESUS/0000-0003-0524-6627 FU Sanofi Iberia FX Sponsorship, article processing charges, and the open access charge for this study were funded by Sanofi Iberia. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. 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Ther. PD OCT PY 2015 VL 32 IS 10 BP 944 EP 961 DI 10.1007/s12325-015-0252-y PG 18 WC Medicine, Research & Experimental; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine; Pharmacology & Pharmacy GA CX6FI UT WOS:000365796200006 PM 26499178 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Bonello, L Delmas, C Schurtz, G Leurent, G Bonnefoy, E Aissaoui, N Henry, P AF Bonello, Laurent Delmas, Clement Schurtz, Guillaume Leurent, Guillaume Bonnefoy, Eric Aissaoui, Nadia Henry, Patrick TI Mechanical circulatory support in patients with cardiogenic shock in intensive care units: A position paper of the "Unite de Soins Intensifs de Cardiologie" group of the French Society of Cardiology, endorsed by the "Groupe Atherome et Cardiologie Interventionnelle" of the French Society of Cardiology SO ARCHIVES OF CARDIOVASCULAR DISEASES LA English DT Review DE Cardiogenic shock; Mechanical circulatory support; Intensive care unit; Acute heart failure; Acute coronary syndrome ID EXTRACORPOREAL MEMBRANE-OXYGENATION; ACUTE MYOCARDIAL-INFARCTION; VENTRICULAR ASSIST DEVICE; INTRAAORTIC BALLOON PUMP; LIFE-SUPPORT; CLINICAL-OUTCOMES; CARDIAC-ARREST; MANAGEMENT; METAANALYSIS; SURVIVAL AB Cardiogenic shock (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the pathophysiology of CS, its management has only improved slightly. The prevalence of CS has remained stable over the past decade, but its outcome has seen few improvements, with the 1-month mortality rate still in the range of 40-60%. Inotropes and vasopressors are the first-line therapies for CS, but they are associated with significant hazards, and have well-known deleterious effects. Furthermore, a significant number of patients develop refractory CS with haemodynamic instability, causing critical organ hypoperfusion and/or pulmonary congestion, despite increasing doses of catecholamines. A major change has resulted from the recent advent and availability of potent mechanical circulatory support (MCS) devices. These devices, which ensure sustained blood flow, provide a great and long-awaited opportunity to improve the prognosis of CS. Several efficient MCS devices are now available, including left ventricle-to-aorta circulatory support devices and full pulmonary and circulatory support with venoarterial extracorporeal membrane oxygenation. However, evidence to support their indications, the timing of implantation and the selection of patients and devices is scarce. Because these devices are gaining momentum and are becoming readily available, the "Unite de Soins Intensifs de Cardiologie" group of the French Society of Cardiology aims to propose practical algorithms for the use of these devices, to help intensive care unit and cardiac care unit physicians in this complex area, where evidence is limited. (C) 2018 Elsevier Masson SAS - All rights reserved. C1 [Bonello, Laurent] Hop Nord Marseille, AP HM, Intens Care Unit, Dept Cardiol, F-13015 Marseille, France. [Bonello, Laurent] Aix Marseille Univ, INSERM, Mediterranean Acad Assoc Res & Studies Cardiol MA, UMRS 1076, F-13385 Marseille, France. [Delmas, Clement] Rangueil Univ Hosp, INSERM, Intens Cardiac Care Unit, UMR 1048, F-31400 Toulouse, France. [Delmas, Clement] INSERM, Inst Metab & Cardiovasc Dis I2MC, UMR 1048, F-31432 Toulouse, France. [Schurtz, Guillaume] Inst Coeur Poumon, Cardiac Intens Care Unit, F-59037 Lille, France. [Schurtz, Guillaume] Univ Lille, INSERM, U1011, Inst Pasteur, F-59000 Lille, France. [Leurent, Guillaume] CHU Rennes, Inserm 1414, Clin Invest Ctr Innovat Technol, Dept Cardiol & Malad Vasc, F-35033 Rennes, France. [Bonnefoy, Eric] Univ Lyon 1, Hosp Civils Lyon, Intens Cardiac Care Unit, UMR 5558, F-69622 Bron, France. [Aissaoui, Nadia] Univ Paris 05, Hop Europeen Georges Pompidou, AP HP, Dept Critical Care,Equipe 4,Inserm,U970, F-75015 Paris, France. [Henry, Patrick] Paris Diderot Univ, Lariboisiere Hosp, AP HP, Dept Cardiol, F-75010 Paris, France. C3 UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Aix-Marseille Universite; CHU de Toulouse; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Toulouse; Universite Toulouse III - Paul Sabatier; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Toulouse; Universite Toulouse III - Paul Sabatier; Universite de Lille - ISITE; CHU Lille; Institut National de la Sante et de la Recherche Medicale (Inserm); Le Reseau International des Instituts Pasteur (RIIP); Universite de Lille - ISITE; Institut Pasteur Lille; Universite de Lille; CHU Rennes; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Rennes; Centre National de la Recherche Scientifique (CNRS); CNRS - Institute of Ecology & Environment (INEE); CHU Lyon; UDICE-French Research Universities; Universite Claude Bernard Lyon 1; VetAgro Sup; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Europeen Georges-Pompidou - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP RP Bonello, L (通讯作者),Hop Nord Marseille, AP HM, Serv Cardiol, Chemin Bourrely, F-13015 Marseille, France. 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Cardiovasc. Dis. PD OCT PY 2018 VL 111 IS 10 BP 601 EP 612 DI 10.1016/j.acvd.2018.03.008 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GX2UC UT WOS:000447574600008 PM 29903693 DA 2023-05-13 ER PT J AU Gower, MN Ratner, LR Williams, AK Rossi, JS Stouffer, GA Lee, CR AF Gower, Megan N. Ratner, Lindsay R. Williams, Alexis K. Rossi, Joseph S. Stouffer, George A. Lee, Craig R. TI Clinical Utility of CYP2C19 Genotype-Guided Antiplatelet Therapy in Patients at Risk of Adverse Cardiovascular and Cerebrovascular Events: A Review of Emerging Evidence SO PHARMACOGENOMICS & PERSONALIZED MEDICINE LA English DT Review DE percutaneous coronary intervention; clopidogrel; CYP2C19; precision medicine; pharmacogenetics; stroke ID PERCUTANEOUS CORONARY INTERVENTION; TRANSIENT ISCHEMIC ATTACK; ACUTE MINOR STROKE; TASK-FORCE; GENETIC POLYMORPHISMS; EUROPEAN-SOCIETY; EXPERT CONSENSUS; FOCUSED UPDATE; 2017 ESC; CLOPIDOGREL AB In patients undergoing percutaneous coronary intervention (PCI), the standard of care is dual antiplatelet therapy with a P2Y(12) inhibitor (clopidogrel, prasugrel, or ticagrelor) and aspirin. Current clinical practice guidelines now recommend more potent P2Y(12) inhibitors (prasugrel or ticagrelor) over clopidogrel in acute coronary syndrome (ACS). However, clopidogrel remains the most commonly prescribed P2Y(12) inhibitor in the setting of PCI and is also the preferred agent in the treatment and secondary prevention of stroke. Clopidogrel is a prodrug that requires bioactivation by the CYP2C19 enzyme. It has been shown that clopidogrel use in patients who are CYP2C19 no function allele carriers are associated with impaired antiplatelet inhibition and a higher risk of major adverse cardiovascular and cerebrovascular events. Compared to clopidogrel, prasugrel and ticagrelor clinical response is not impacted by CYP2C19 genotype. Even with a demonstrated increased risk of adverse outcomes in CYP2C19 no function allele carriers treated with clopidogrel, routine implementation of CYP2C19 genotyping to guide antiplatelet therapy selection has remained controversial and has not been widely adopted. Recent results from multiple prospective randomized and nonrandomized clinical trials investigating the use of CYP2C19 genotype-guided antiplatelet therapy following PCI have advanced the evidence base demonstrating the clinical utility of this strategy. Multiple recent studies have examined the effects of CYP2C19 genotype on clopidogrel outcomes in the setting of stroke and neurointerventional procedures. In this review, we discern the clinical utility of using CYP2C19 genotype testing to guide antiplatelet therapy prescribing by evaluating the impact of CYP2C19 genotypeguided selection of antiplatelet therapy on clinical outcomes, summarizing emerging data from cardiovascular and neurology clinical studies, and discussing implications for clinical practice guidelines, remaining knowledge gaps and future research directions. C1 [Gower, Megan N.; Ratner, Lindsay R.; Williams, Alexis K.; Lee, Craig R.] UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, Chapel Hill, NC 27599 USA. [Stouffer, George A.] UNC Sch Med, Div Cardiol, Chapel Hill, NC USA. [Rossi, Joseph S.; Stouffer, George A.; Lee, Craig R.] Univ North Carolina Chapel Hill, UNC McAllister Heart Inst, Chapel Hill, NC 27599 USA. C3 University of North Carolina School of Medicine; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of Medicine RP Lee, CR (通讯作者),UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, Chapel Hill, NC 27599 USA.; Lee, CR (通讯作者),Univ North Carolina Chapel Hill, UNC McAllister Heart Inst, Chapel Hill, NC 27599 USA. 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PERS MED JI Pharmacogn. Pers. Med. PY 2020 VL 13 BP 239 EP 252 DI 10.2147/PGPM.S231475 PG 14 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA MU1WL UT WOS:000555463500001 PM 32821149 OA gold, Green Published DA 2023-05-13 ER PT J AU Huang, ZX Lu, Y Dong, W AF Huang, Zhengxing Lu, Yi Dong, Wei TI Utilizing electronic health records to predict multi-type major adverse cardiovascular events after acute coronary syndrome SO KNOWLEDGE AND INFORMATION SYSTEMS LA English DT Article DE Major adverse cardiovascular event prediction; Acute coronary syndrome; Electronic health record; Multi-label classification; Relational regularization ID RISK STRATIFICATION; MYOCARDIAL-INFARCTION; HOSPITAL MORTALITY; EHR DATA; DISEASE; SCORE; REGULARIZATION; VALIDATION; MODELS AB Acute coronary syndrome (ACS), as a leading cause of death worldwide, is responsible for over 1.5 million hospital admissions in China each year. Major adverse cardiovascular event (MACE) after ACS often occurs suddenly resulting in high mortality and morbidity. Timely and accurate prediction of MACE after ACS could assist clinicians to pay more attention to high-risk patients and improve the quality and efficiency of care accordingly. Traditional prediction of MACE after ACS is based on aggressive medical therapy and guideline-driven treatment of a small set of coronary risk factors and is designed to predict one specific type of MACE. With the rapid development of electronic health records (EHR), more and more data-driven approaches have been proposed to explore the huge potentials of EHR data. However, existing data-driven approaches have typically been conducted by building one common predictive model and neglecting the relations among multi-type MACEs. In this paper, we propose a novel boosted regularized multi-label learning approach for multi-type MACE prediction. In detail, we formulate the prediction problem of multi-type MACE as a multi-label classification problem and incorporate the relational information among multi-type MACEs into modeling by using regularization terms to encode the corresponding relational information. In addition and to address the problem that some types of MACE are rarely occur, we utilize a boosting weighted sampling strategy to iteratively select a small subset of patient samples to train new multi-type MACE prediction models that can correct the previously wrongly predicted patient samples. A case study was conducted on a real ACS clinical dataset consisting of 2930 patient samples and collected from a Chinese hospital to validate the effectiveness of the proposed model. The performance of our best model remains robust and reaches 0.7 and 0.640 for both ischemic and hemorrhagic event prediction, respectively, in terms of AUC, and had over 2.7% and 23.1% performance gain in comparison with the state-of-the-art GRACE and CRUSADE model, respectively. The experimental results show the efficiency of our model in improving the performances on multi-type MACE prediction after ACS, by comparing with both traditional ACS risk stratification models which are widely adopted in the medical domain and state-of-the-art multi-label learning methods without efforts on incorporating the relational information of multi-type MACE into learning. In addition, we illustrate some interesting results pertaining to predictive risk factors to specific types of MACE, some of which are not only consistent with existing medical domain knowledge, but also contain suggestive hypotheses that could be validated by further investigations in the medical domain. C1 [Huang, Zhengxing; Lu, Yi] Zhejiang Univ, Coll Biomed Engn & Instrument Sci, Hangzhou, Zhejiang, Peoples R China. [Dong, Wei] Chinese Peoples Liberat Army Gen Hosp, Dept Cardiol, Beijing, Peoples R China. C3 Zhejiang University; Chinese People's Liberation Army General Hospital RP Huang, ZX (通讯作者),Zhejiang Univ, Coll Biomed Engn & Instrument Sci, Hangzhou, Zhejiang, Peoples R China. EM zhengxinghuang@zju.edu.cn; 21515091@zju.edu.cn; 301dongw@sina.com FU National Nature Science Foundation of China [61672450] FX This work was supported by the National Nature Science Foundation of China under Grant No 61672450. The authorwould like to give special thanks to all expertswho cooperated in the evaluation of the proposed method. In addition, the authors would like to thank the editor and the anonymous reviewers for their constructive comments on an earlier draft of this paper. 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As secondary objective, we considered NEWS performance in two subgroups of patients: sudden cardiac events (acute coronary syndromes and arrhythmic events), and chronic respiratory insufficiency. Methods: We conducted a perspective cohort single centre study on 2,677 unselected patients consecutively admitted from July 2013 to March 2015 in the Internal Medicine ward of the hospital of Trento, Italy. The NEWS was mandatory collected on ward admission. We defined three risk categories for clinical deterioration: low score (NEWS 0-4), medium score (NEWS 5-6), and high score (NEWS >= 7). Following-adverse outcomes were considered: total and early (<72 hours) in-hospital mortality, urgent transfers to a higher intensity of care. A logistic regression model quantified the -association between outcomes and NEWS. Results: For patients with NEWS >4 vs patients with NEWS <4, the risk of early death increased from 12 to 36 times, total mortality from 3.5 to 9, and urgent transfers from 3.5 to 7. In patients with sudden cardiac events, lower scores were significantly associated with higher risk of transfer to a higher intensity of care. In patients affected by chronic hypoxaemia, adverse outcomes occurred less in medium and high score categories of NEWS. Conclusions: National Early Warning Score assessed on ward admission may enable risk stratification of clinical deterioration and can be a good predictor of in-hospital serious adverse outcomes, although sudden cardiac events and chronic hypoxaemia could constitute some limits. C1 [Spagnolli, Walter; Cozzio, Susanna; Vettorato, Elisa] Osped Sanata Chiara UO Med Interna, Azienda Prov Sevizi Sanit, Trento, Italy. [Rigoni, Marta; Torri, Emanuele; Nollo, Giandomenico] Fdn Bruno Kessler, Healthcare Res & Innovat Program, Trento, Italy. [Torri, Emanuele] Autonomous Prov Trento, Dipartimento Salute & Solidarieta Sociale, Trento, Italy. [Nollo, Giandomenico] Univ Trento, Dipartimento Ingn Ind, Trento, Italy. C3 Santa Chiara Hospital; Fondazione Bruno Kessler; University of Trento RP Rigoni, M (通讯作者),IRCS FBK, Trento, Italy. EM mrigoni@fbk.eu RI Smith, Gary B/A-8235-2013 OI Nollo, Giandomenico/0000-0002-9837-083X; Rigoni, Marta/0000-0002-0530-9491 FU Healthcare Research Implementation Program of Autonomous Province of Trento, Italy FX This study was partially funded by Healthcare Research Implementation Program of Autonomous Province of Trento, Italy. The involvement of the funder was in study design, data analysis, and article preparation. 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J. Clin. Pract. PD MAR-APR PY 2017 VL 71 IS 3-4 AR e12934 DI 10.1111/ijcp.12934 PG 8 WC Medicine, General & Internal; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Pharmacology & Pharmacy GA EQ3SX UT WOS:000397994200007 PM 28276182 OA gold DA 2023-05-13 ER PT J AU AlFaleh, HF Thalib, L Kashour, T Hersi, A Mimish, L Elasfar, AA Almasood, A Al Ghamdi, S Ghabashi, A Malik, A Hussein, GA Al-Murayeh, M Abuosa, A Al Habeeb, W Al Habib, KF AF AlFaleh, Hussam F. Thalib, Lukman Kashour, Tarek Hersi, Ahmad Mimish, Layth Elasfar, Abdelfatah A. Almasood, Ali Al Ghamdi, Saleh Ghabashi, Abdullah Malik, Asif Hussein, Gamal A. Al-Murayeh, Mushabab Abuosa, Ahmed Al Habeeb, Waleed Al Habib, Khalid F. TI Sex Differences in Patients With Acute Decompensated Heart Failure: Insights From the Heart Function Assessment Registry Trial in Saudi Arabia SO ANGIOLOGY LA English DT Article DE acute heart failure; gender; survival ID GENDER-RELATED DIFFERENCES; ACUTE CORONARY SYNDROME; QUALITY-OF-CARE; CLINICAL CHARACTERISTICS; OUTCOMES; TERM; MANAGEMENT; SURVIVAL; RISK; PREVALENCE AB We assessed sex-specific differences in clinical features and outcomes of patients with acute heart failure (AHF). The Heart function Assessment Registry Trial in Saudi Arabia (HEARTS), a prospective registry, enrolled 2609 patients with AHF (34.2% women) between 2009 and 2010. Women were older and more likely to have risk factors for atherosclerosis, history of heart failure (HF), and rheumatic heart and valve disease. Ischemic heart disease was the prime cause for HF in men and women but more so in men (P < .001). Women had higher rates of hypertensive heart disease and primary valve disease (P < .001, for both comparisons). Men were more likely to have severe left ventricular systolic dysfunction. On discharge, a higher use of angiotensin-converting enzyme inhibitors, -blockers, and aldosterone inhibitors was observed in men (P < .001 for all comparisons). Apart from higher atrial fibrillation in women and higher ventricular arrhythmias in men, no differences were observed in hospital outcomes. The overall survival did not differ between men and women (hazard ratio: 1.0, 95% confidence interval: 0.8-1.2, P = .981). Men and women with AHF differ significantly in baseline clinical characteristics and management but not in adverse outcomes. C1 [AlFaleh, Hussam F.; Kashour, Tarek; Hersi, Ahmad; Al Habeeb, Waleed; Al Habib, Khalid F.] King Saud Univ, Dept Cardiac Sci, Coll Med, Riyadh, Saudi Arabia. [Thalib, Lukman] Kuwait Univ, Hlth Sci Ctr, Fac Med, Kuwait, Kuwait. [Mimish, Layth] King Abdulaziz Univ, King Abdulaziz Univ Hosp, Dept Med, Jeddah, Saudi Arabia. [Elasfar, Abdelfatah A.] King Fahd Med City, King Salman Heart Ctr, Div Cardiol, Riyadh, Saudi Arabia. [Almasood, Ali] Prince Sultan Cardiac Ctr, Div Cardiol, Riyadh, Saudi Arabia. [Al Ghamdi, Saleh] Madina Cardiac Ctr, Div Cardiol, Al Madina Al Munawarah, Saudi Arabia. [Ghabashi, Abdullah] Prince Sultan Cardiac Ctr, Div Cardiol, Al Hufuf, Saudi Arabia. [Malik, Asif] North West Armed Forces Hosp, Tabuk, Saudi Arabia. [Hussein, Gamal A.] King Fahad Gen Hosp, Dept Med, Jeddah, Saudi Arabia. [Al-Murayeh, Mushabab] Armed Forces Hosp Southern Reg, Khamis Mushayt, Saudi Arabia. [Abuosa, Ahmed] Natl Guard Hosp, Div Cardiol, Jeddah, Saudi Arabia. C3 King Saud University; Kuwait University; King Abdulaziz University; King Abdulaziz University Hospital - Jeddah; King Fahad Medical City; Prince Sultan Cardiac Center; Prince Sultan Cardiac Center; King Fahd Hospital Jeddah RP AlFaleh, HF (通讯作者),King Saud Univ, Coll Med, King Khalid Univ Hosp, Dept Cardiac Sci, POB 7805, Riyadh 11472, Saudi Arabia. EM halfaleh@ksu.edu.sa RI Hersi, Ahmad/ABC-9266-2020 OI Thalib, Lukman/0000-0002-1211-6495; Al-Murayeh, Mushabab/0000-0002-7025-5311 FU deanship of scientific research at King Saud university, Riyadh, Saudi Arabia [RG -1436-013]; Servier; AstraZeneca; College of Medicine Research Center at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: HEARTS was financially co-sponsored by the deanship of scientific research at King Saud university, Riyadh, Saudi Arabia (Research group number: RG -1436-013) as well as Servier and AstraZeneca, who had no role in data extraction or analyses, the writing of the manuscript, or the decision to submit the manuscript for publication. The College of Medicine Research Center at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, provided ethical approval and partial funding. 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Methods and results: Consecutive 754 patients who were admitted to the intensive care unit (ICU) in our hospital from January 2007 to March 2012 and given a diagnosis of ADHF were eligible for retrospective entry into the registry. Lactate level was measured on admission from routine arterial blood sample and we investigated by comparing the lactate level and parameters of conventional in-hospital mortality predictors. Among the patients, 88(12%) died during hospitalization. The lactate level had great power to predict in-hospital mortality, as suggested by the c-statistics of 0.71. The occurrence of in-hospital death was more pronounced in patients with high levels of lactate (>3.2 mmol/l) and the tendency was observed in patients in both the acute coronary syndrome (ACS) group and non-ACS group. In multivariate analysis, elevated lactate levels remained an independent predictor of in-hosPital death (odds ratio, 2.14; 95% confidence interval, 1.10-4.21; p = 0.03). Conclusions: Elevated levels of arterial lactate on admission were related to worse in-hospital mortality in patients with ADHF either with or without ACS, suggesting that the presence of high lactate in patients who enter the ICU with ADHF could help stratify the initial risk of early mortality. (C) 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. C1 [Kawase, Tomoharu; Higashihara, Tasuku; Okubo, Yousaku; Takahashi, Lisa; Kagawa, Yuzo; Yamane, Kenichi; Mito, Shinji; Tamekiyo, Hiromichi; Otsuka, Masaya; Okimoto, Tomokazu; Muraoka, Yuji; Masaoka, Yoshiko; Shiode, Nobuo; Hayashi, Yasuhiko] Tsuchiya Gen Hosp, Dept Cardiol, Hiroshima 7308655, Japan. [Toyofuku, Mamoru] Japanese Red Cross Wakayama Med Ctr, Div Cardiol, Wakayama, Japan. RP Kawase, T (通讯作者),Tsuchiya Gen Hosp, Dept Cardiol, Naka Ku, 3-30 Nakajimacho, Hiroshima 7308655, Japan. 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Cardiol. PD JAN-FEB PY 2015 VL 65 IS 1-2 BP 164 EP 170 DI 10.1016/j.jjcc.2014.05.006 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CB4FI UT WOS:000349583200028 PM 24970716 OA Bronze DA 2023-05-13 ER PT J AU Pursnani, A Celeng, C Schlett, CL Maythofer, T Zakroysky, P Lee, H Ferencik, M Fleg, JL Bamberg, F Wiviott, SD Truong, QA Udelson, JE Nagurney, JT Hoffmann, U AF Pursnani, Amit Celeng, Csilla Schlett, Christopher L. Maythofer, Thomas Zakroysky, Pearl Lee, Hang Ferencik, Maros Fleg, Jerome L. Bamberg, Fabian Wiviott, Stephen D. Truong, Quynh A. Udelson, James E. Nagurney, John T. Hoffmann, Udo TI Use of Coronary Computed Tomographic Angiography Findings to Modify Statin and Aspirin Prescription in Patients With Acute Chest Pain SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID INTERNATIONAL MULTICENTER REGISTRY; ARTERY-DISEASE; PROGNOSTIC VALUE; CT ANGIOGRAPHY; EMERGENCY-DEPARTMENT; SYMPTOMATIC PATIENTS; CLINICAL-OUTCOMES; RISK-FACTORS; ATHEROSCLEROSIS; METAANALYSIS AB Coronary CT angiography (CCTA) is used in patients with low-intermediate chest pain presenting to the emergency department for its reliability in excluding acute coronary syndrome (ACS). However, its influence on medication modification in this setting is unclear. We sought to determine whether knowledge of CCTA-based coronary artery disease (CAD) was associated with change in statin and aspirin prescription. We used the CCTA arm of the Rule Out Myocardial Infarction using Computed Angiographic Tomography II multicenter, randomized control trial (R-II) and comparison cohort from the observational Rule Out Myocardial Infarction using Computed Angiographic Tomography I cohort (R-I). In R-II, subjects were randomly assigned to CCTA to guide decision making, whereas in R-I patients underwent CCTA with results blinded to caregivers and managed according to standard care. Our final cohort consisted of 277 subjects from R-I and 370 from R-II. ACS rate was similar (6.9% vs 6.2% respectively, p = 0.75). For subjects with CCTA-detected obstructive CAD without ACS, initiation of statin was significantly greater after disclosure of CCTA results (0% in R-I vs 20% in R-II, p = 0.009). Conversely, for subjects without CCTA-detected. CAD, aspirin prescription was lower with disclosure of CCTA results (16% in R-I vs 4.8% in R-II, p = 0.001). However, only 68% of subjects in R-II with obstructive CAD were discharged on statin and 65% on aspirin. In conclusion, physician knowledge of CCTA results leads to improved alignment of aspirin and statin with the presence and severity of CAD although still many patients with CCTA-detected CAD are not discharged on aspirin or statin. Our findings suggest opportunity for practice improvement when CCTA is performed in the emergency department. (C) 2016 Elsevier Inc. All rights reserved. C1 [Pursnani, Amit; Celeng, Csilla; Maythofer, Thomas; Ferencik, Maros; Truong, Quynh A.; Hoffmann, Udo] Harvard Univ, Sch Med, Dept Radiol, Div Cardiol,Cardiac Magnet Resonance Positron Emi, Boston, MA 02115 USA. [Nagurney, John T.] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Div Emergency Med, Boston, MA USA. [Schlett, Christopher L.] Univ Heidelberg Hosp, Dept Diagnost & Intervent Radiol, Heidelberg, Germany. [Zakroysky, Pearl; Lee, Hang] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Biostat Ctr, Boston, MA USA. [Fleg, Jerome L.] NHLBI, Div Cardiovasc Sci, Bldg 10, Bethesda, MD 20892 USA. [Bamberg, Fabian] Univ Munich, Klinikum Grosshadern, Dept Clin Radiol, D-80539 Munich, Germany. [Wiviott, Stephen D.] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Cardiovasc, Boston, MA 02115 USA. [Udelson, James E.] Tufts Med Ctr, Div Cardiol, Boston, MA USA. [Udelson, James E.] Tufts Med Ctr, Ctr Cardiovasc, Boston, MA USA. C3 Harvard University; Harvard Medical School; Harvard University; Harvard Medical School; Massachusetts General Hospital; Ruprecht Karls University Heidelberg; Harvard University; Harvard Medical School; Massachusetts General Hospital; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI); University of Munich; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Tufts Medical Center; Tufts Medical Center RP Pursnani, A (通讯作者),Harvard Univ, Sch Med, Dept Radiol, Div Cardiol,Cardiac Magnet Resonance Positron Emi, Boston, MA 02115 USA. EM amit.pursnani@gmail.com RI Celeng, Csilla/T-8249-2019; Pursnani, Amit/HTO-6710-2023; Wiviott, Stephen/HIK-2534-2022 OI Schlett, Christopher/0000-0002-1576-1481; Mayrhofer, Thomas/0000-0001-6287-5185 FU National Institutes of Health/ National Heart Lung Blood Institute (Bethesda, Maryland) [U01HL092040, U01HL092022, 5K24HL113128] FX The study was supported by the grants U01HL092040, U01HL092022 and 5K24HL113128 from National Institutes of Health/ National Heart Lung Blood Institute (Bethesda, Maryland). CR Al-Mallah MH, 2014, EUR HEART J-CARD IMG, V15, P267, DOI 10.1093/ehjci/jet148 Bamberg F, 2011, J AM COLL CARDIOL, V57, P2426, DOI 10.1016/j.jacc.2010.12.043 Cheezum MK, 2013, JACC-CARDIOVASC IMAG, V6, P574, DOI 10.1016/j.jcmg.2012.11.016 Chow BJW, 2011, CIRC-CARDIOVASC IMAG, V4, P463, DOI 10.1161/CIRCIMAGING.111.964155 Fihn SD, 2012, J AM COLL CARDIOL, V60, pE44, DOI 10.1016/j.jacc.2012.07.013 Hachamovitch R, 2012, J AM COLL CARDIOL, V59, P462, DOI 10.1016/j.jacc.2011.09.066 Hadamitzky M, 2013, EUR HEART J, V34, P3277, DOI 10.1093/eurheartj/eht293 Hoffmann U, 2012, NEW ENGL J MED, V367, P299, DOI 10.1056/NEJMoa1201161 Hoffmann U, 2012, AM HEART J, V163, P330, DOI 10.1016/j.ahj.2012.01.028 Hulten EA, 2011, J AM COLL CARDIOL, V57, P1237, DOI 10.1016/j.jacc.2010.10.011 LaBounty TM, 2009, AM J CARDIOL, V104, P873, DOI 10.1016/j.amjcard.2009.05.024 Min JK, 2007, J AM COLL CARDIOL, V50, P1161, DOI 10.1016/j.jacc.2007.03.067 Ostrom MP, 2008, J AM COLL CARDIOL, V52, P1335, DOI 10.1016/j.jacc.2008.07.027 Schlett CL, 2011, JACC-CARDIOVASC IMAG, V4, P481, DOI 10.1016/j.jcmg.2010.12.008 Smith SC, 2011, J AM COLL CARDIOL, V58, P2432, DOI 10.1016/j.jacc.2011.10.824 Villines TC, 2011, J AM COLL CARDIOL, V58, P2533, DOI 10.1016/j.jacc.2011.10.851 NR 16 TC 3 Z9 3 U1 0 U2 6 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 EI 1879-1913 J9 AM J CARDIOL JI Am. J. Cardiol. PD FEB 1 PY 2016 VL 117 IS 3 BP 319 EP 324 DI 10.1016/j.amjcard.2015.10.052 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DC4ME UT WOS:000369194200001 PM 26762723 OA Green Accepted DA 2023-05-13 ER PT J AU Trent, SA Johnson, MA Morse, EA Havranek, EP Haukoos, JS AF Trent, Stacy A. Johnson, Michael A. Morse, Erica A. Havranek, Edward P. Haukoos, Jason S. TI Patient, provider, and environmental factors associated with adherence to cardiovascular and cerebrovascular clinical practice guidelines in the ED SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; ACUTE ISCHEMIC-STROKE; TO-BALLOON TIME; QUALITY-OF-CARE; AMERICAN-COLLEGE; ST-ELEVATION; EARLY MANAGEMENT; TASK-FORCE; MORTALITY; THROMBOLYSIS AB Objectives: Myocardial infarction and stroke are two of the leading causes of death in the U.S. Both diseases have clinical practice guidelines (CPGs) specific to the emergency department (ED) that improve patient outcomes. Our primary objectives were to estimate differences in ED adherence across CPGs for these diseases and identify patient, provider, and environmental factors associated with adherence. Methods: Design: Retrospective study at 3 hospitals in Colorado using standard medical record review. Population: Consecutive adults (>= 18) hospitalized for acute coronary syndrome (ACS), ST-elevation myocardial infarction (STEMI), or acute ischemic stroke (AIS), who were admitted to the hospital from the ED and for whom the ED diagnosed or initiated treatment. Outcome: ED adherence to the CPG (primary); in-hospital mortality and length-of-stay (secondary). Analysis: Multivariable logistic regression using generalized estimating equations was used. Results: Among 1053 patients, ED care was adherent in 84% with significant differences in adherence between CPGs (p < 0.001) and across institutions (p - 0.04). When patients presented with atypical chief complaints. the odds of receiving adherent care was 0.6 (95% CI 0.4-0.9). When the primary ED diagnosis was associated but not specific to the CPG, the odds of receiving adherent care was 0.5 (95% CI 0.3-0.9) and 0.3 (95% CI 02-0.5) for unrelated primary diagnoses. Conclusions: Adherence to ED CPGs for ACS. STEMI and AIS differs significantly between cardiovascular and cerebrovascular diseases and is more likely to occur when the diagnosis is highly suggested by the patient's complaint and acknowledged as the primary diagnosis by the treating ED physician. (C) 2017 Elsevier Inc. All rights reserved. C1 [Trent, Stacy A.; Johnson, Michael A.; Morse, Erica A.; Haukoos, Jason S.] Denver Hlth Med Ctr, Dept Emergency Med, Denver, CO USA. [Trent, Stacy A.; Haukoos, Jason S.] Univ Colorado, Sch Med, Dept Emergency Med, Aurora, CO USA. [Johnson, Michael A.] Univ Calif Davis, Dept Emergency Med, Sacramento, CA 95817 USA. [Morse, Erica A.] Kaiser Permanente Colorado, St Josephs Hosp, Dept Emergency Med, Denver, CO USA. [Havranek, Edward P.] Denver Hlth Med Ctr, Dept Med, Denver, CO USA. [Havranek, Edward P.] Univ Colorado, Div Cardiol, Sch Med, Aurora, CO USA. [Haukoos, Jason S.] Colorado Sch Publ Hlth, Dept Epidemiol, Aurora, CO USA. C3 Denver Health Medical Center; University of Colorado System; University of Colorado Anschutz Medical Campus; University of California System; University of California Davis; Denver Health Medical Center; Kaiser Permanente; Denver Health Medical Center; University of Colorado System; University of Colorado Anschutz Medical Campus; Colorado School of Public Health RP Trent, SA (通讯作者),777 Bannock St,Mail Code 0108, Denver, CO 80204 USA. EM stacy.trent@dhha.org RI Trent, Stacy/AAW-9531-2021 FU Agency for Healthcare Research and Quality [F32HS022400] FX Supported, in part, by the Agency for Healthcare Research and Quality (F32HS022400) to Dr. Trent. 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Health United States, 2017, CHARTB LONG TERM TRE Tsai CL, 2010, ACAD EMERG MED, V17, P940, DOI 10.1111/j.1553-2712.2010.00832.x Vora AN, 2015, JAMA INTERN MED, V175, P207, DOI 10.1001/jamainternmed.2014.6573 Wardlaw JM, 2014, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD000213.pub3 Zachrison KS, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.116.003148 NR 33 TC 4 Z9 4 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0735-6757 EI 1532-8171 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD AUG PY 2018 VL 36 IS 8 BP 1397 EP 1404 DI 10.1016/j.ajem.2017.12.062 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA GN5MK UT WOS:000439103800013 PM 29402689 OA Green Accepted DA 2023-05-13 ER PT J AU Jackson, R Al-Hussaini, A Joseph, S van Soest, G Wood, A Macaya, F Gonzalo, N Cade, J Caixeta, A Hlinomaz, O Leinveber, P O'Kane, P Garcia-Guimaraes, M Cortese, B Samani, NJ Escaned, J Alfonso, F Johnson, T Adlam, D AF Jackson, Robert Al-Hussaini, Abtehale Joseph, Shiju van Soest, Gijs Wood, Alice Macaya, Fernando Gonzalo, Nieves Cade, Jamil Caixeta, Adriano Hlinomaz, Ota Leinveber, Pavel O'Kane, Peter Garcia-Guimaraes, Marcos Cortese, Bernardo Samani, Nilesh J. Escaned, Javier Alfonso, Fernando Johnson, Thomas Adlam, David TI Spontaneous Coronary Artery Dissection Pathophysiological Insights From Optical Coherence Tomography SO JACC-CARDIOVASCULAR IMAGING LA English DT Article DE intracoronary imaging; optical coherence tomography; spontaneous coronary artery dissection ID FIBROMUSCULAR DYSPLASIA; PREVALENCE; DIAGNOSIS; IMAGE; OCT AB OBJECTIVES This study used optical coherence tomography to investigate the mechanism of false lumen (FL) formation in spontaneous coronary artery dissection (SCAD) by studying: 1) differences between fenestrated and nonfenestrated SCAD; 2) vasa vasorum density; and 3) light attenuation characteristics of the FL. BACKGROUND SCAD is an increasingly recognized cause of acute coronary syndromes, characterized by FL formation and compression of the true lumen (TL). The mechanisms underlying FL formation remain poorly understood. METHODS A total of 65 SCAD patients (68 vessels) who underwent acute OCT imaging as part of routine clinical care were included. Images were classified by the absence or presence of a connection (fenestration) between the TL and FL. Indexed measurements of TL stenosis, external elastic lamina (EEL) area, FL area, and light attenuation of the FL were assessed. Vasa vasorum densities of SCAD cases were compared with those in control non-SCAD myocardial infarction cases. RESULTS In nonfenestrated cases, there was significantly larger expansion of the EEL area (9.1% vs. -1.9%; p<0.05) and a larger FL area (73.6% vs. 53.2%, respectively; p<0.05) in dissected segments. No significant differences were found between vasa vasorum density in SCAD and those in control subjects. The FL contents were heterogeneous but attenuated less light than whole blood or thrombus (4.28 +/- 0.55 mm(-1) vs. 5.08 +/- 0.56 mm(-1); p < 0.05; vs. 4.96 +/- 0.56 mm(-1); p < 0.05). CONCLUSIONS These observational data suggest that the absence of a fenestration leads to increased FL pressure and compression of the TL. Although vasa vasorum may still be implicated in pathogenesis, increased vasa vasorum density could be an epiphenomenon of vascular healing. (C) 2019 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved. C1 [Jackson, Robert; Al-Hussaini, Abtehale; Joseph, Shiju; Wood, Alice; Samani, Nilesh J.; Adlam, David] Glenfield Hosp, Dept Cardiovasc Sci, Leicester, Leics, England. [Jackson, Robert; Al-Hussaini, Abtehale; Joseph, Shiju; Wood, Alice; Samani, Nilesh J.; Adlam, David] Glenfield Hosp, Leicester Biomed Res Ctr, Natl Inst Hlth Res, Leicester, Leics, England. [Al-Hussaini, Abtehale] Royal Brompton Hosp, Dept Cardiol, London, England. [van Soest, Gijs] Univ Med Ctr Rotterdam, Erasmus MC, Rotterdam, Netherlands. [Macaya, Fernando; Gonzalo, Nieves; Escaned, Javier] Hosp Clin San Carlos, Madrid, Spain. [Macaya, Fernando; Gonzalo, Nieves; Escaned, Javier] Univ Complutense, Madrid, Spain. [Macaya, Fernando] Kings Coll Hosp London, Dept Cardiol, London, England. [Cade, Jamil; Caixeta, Adriano] Hosp Israelita Albert Einstein, Dept Cardiol, Sao Paulo, SP, Brazil. [Hlinomaz, Ota; Leinveber, Pavel] St Annes Univ Hosp, Int Clin Res Ctr, Brno, Czech Republic. [Hlinomaz, Ota; Leinveber, Pavel] Masaryk Univ, Brno, Czech Republic. [O'Kane, Peter] Bournemouth Hosp, Dept Cardiol, Bournemouth, Dorset, England. [Garcia-Guimaraes, Marcos; Alfonso, Fernando] Hosp Univ La Princesa, Dept Cardiol, Madrid, Spain. [Cortese, Bernardo] San Carlo Clin, Milan, Italy. [Johnson, Thomas] Bristol Royal Infirm & Gen Hosp, Bristol Heart Inst, Dept Cardiol, Bristol, Avon, England. C3 RLUK- Research Libraries UK; University of Leicester; University Hospitals of Leicester NHS Trust; Glenfield Hospital; RLUK- Research Libraries UK; University of Leicester; University Hospitals of Leicester NHS Trust; Glenfield Hospital; Royal Brompton Hospital; Erasmus University Rotterdam; Erasmus MC; Hospital Clinico San Carlos; Complutense University of Madrid; King's College Hospital NHS Foundation Trust; King's College Hospital; Hospital Israelita Albert Einstein; St Anne's University Hospital Brno (FNUSA-ICRC); Masaryk University Brno; Hospital de La Princesa; Bristol Royal Infirmary; RLUK- Research Libraries UK; University of Bristol RP Adlam, D (通讯作者),Univ Leicester, Glenfield Hosp, Dept Cardiovasc Sci, Groby Rd, Leicester LE3 9QP, Leics, England. EM da134@le.ac.uk RI Macaya, Fernando/AFA-1218-2022; Garcia-Guimaraes, Marcos/AAC-2189-2019; van Soest, Gijs/B-4881-2008; Leinveber, Pavel/I-3347-2016; Escaned, Javier/I-5424-2017; Cortese, Bernardo/M-4374-2016; Cade, Jamil/I-4270-2015 OI Macaya, Fernando/0000-0003-1770-3004; Garcia-Guimaraes, Marcos/0000-0001-8509-6184; Leinveber, Pavel/0000-0001-7267-4408; Cortese, Bernardo/0000-0002-5808-7810; Johnson, Thomas/0000-0003-4638-601X; Wood, Alice/0000-0003-4208-6802; Cade, Jamil/0000-0001-5047-0690 FU British Heart Foundation; National Institute for Health Research (NIHR) rare disease translational collaboration; Leicester NIHR Biomedical Research Centre; Beat Spontaneous Coronary Artery Dissection (SCAD) organization; St. Jude Medical; AstraZeneca; Terumo Corp; Fundacion Interhospitalaria Investigacion Cardiovascular; Abbott Vascular FX Supported by the British Heart Foundation, the National Institute for Health Research (NIHR) rare disease translational collaboration, the Leicester NIHR Biomedical Research Centre, and the Beat Spontaneous Coronary Artery Dissection (SCAD) organization. Dr. Joseph has received support from St. Jude Medical. Dr Adlam has received support from St. Jude Medical and AstraZeneca. Drs. Johnson and O'Kane are compensated speakers and consultants for Abbott Vascular and Terumo Corp. Dr. Van Soest has received research support and royalties from Terumo Corp. Dr. Macaya has received support from Fundacion Interhospitalaria Investigacion Cardiovascular. Dr. Gonzalo has received speaker fees for educational events sponsored by Abbott Vascular. Dr. Escaned is a compensated speaker and consultant for Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. CR Al-Hussaini A, 2017, HEART, V103, P1043, DOI 10.1136/heartjnl-2016-310320 Alfonso F, 2012, J AM COLL CARDIOL, V59, P1073, DOI 10.1016/j.jacc.2011.08.082 Alfonso F, 2009, EUR HEART J, V30, P385, DOI 10.1093/eurheartj/ehn441 Barber-Chamoux N, 2016, CARDIOVASC REVASCULA, V17, P138, DOI 10.1016/j.carrev.2016.01.009 Fedorov A, 2012, MAGN RESON IMAGING, V30, P1323, DOI 10.1016/j.mri.2012.05.001 Gnanadesigan M, 2017, INT J CARDIOVAS IMAG, V33, P5, DOI 10.1007/s10554-016-0968-z Kwon TG, 2016, JACC-CARDIOVASC IMAG, V9, P891, DOI 10.1016/j.jcmg.2015.11.030 Mori H, 2016, CIRC-CARDIOVASC INTE, V9, DOI 10.1161/CIRCINTERVENTIONS.116.004549 Paulo M, 2013, JACC-CARDIOVASC IMAG, V6, P830, DOI 10.1016/j.jcmg.2013.02.010 Prasad M, 2015, AM J CARDIOL, V115, P1672, DOI 10.1016/j.amjcard.2015.03.011 Ramalho AR, 2017, JACC-CARDIOVASC INTE, V10, P413, DOI 10.1016/j.jcin.2016.10.028 Saw J, 2016, J AM COLL CARDIOL, V68, P297, DOI 10.1016/j.jacc.2016.05.034 Saw J, 2016, CIRCULATION, V133, P1548, DOI 10.1161/CIRCULATIONAHA.115.020282 Saw J, 2014, CIRC-CARDIOVASC INTE, V7, P645, DOI 10.1161/CIRCINTERVENTIONS.114.001760 Saw J, 2013, CATHETER CARDIO INTE, V82, pE879, DOI 10.1002/ccd.24640 Saw J, 2013, JACC-CARDIOVASC INTE, V6, P44, DOI 10.1016/j.jcin.2012.08.017 Schneider CA, 2012, NAT METHODS, V9, P671, DOI 10.1038/nmeth.2089 The Blender Foundation, BLEND PROJ FREE OP 3 Tweet MS, 2016, CURR CARDIOL REP, V18, DOI 10.1007/s11886-016-0737-6 van Soest G, 2010, J BIOMED OPT, V15, DOI 10.1117/1.3280271 Vizzi V, 2013, INT J CARDIOL, V167, P2344, DOI 10.1016/j.ijcard.2012.11.039 Vrints CJM, 2010, HEART, V96, P801, DOI 10.1136/hrt.2008.162073 Yip A, 2015, CARDIOVASC DIAGN THE, V5, P37, DOI 10.3978/j.issn.2223-3652.2015.01.08 NR 23 TC 56 Z9 58 U1 2 U2 8 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1936-878X EI 1876-7591 J9 JACC-CARDIOVASC IMAG JI JACC-Cardiovasc. Imag. PD DEC PY 2019 VL 12 IS 12 BP 2475 EP 2488 DI 10.1016/j.jcmg.2019.01.015 PG 14 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA JT0NG UT WOS:000500693700015 PM 30878439 OA Bronze DA 2023-05-13 ER PT J AU Kim, K Lee, TA Touchette, DR DiDomenico, RJ Ardati, AK Walton, SM AF Kim, Kibum Lee, Todd A. Touchette, Daniel R. DiDomenico, Robert J. Ardati, Amer K. Walton, Surrey M. TI Contemporary Trends in Oral Antiplatelet Agent Use in Patients Treated with Percutaneous Coronary Intervention for Acute Coronary Syndrome SO JOURNAL OF MANAGED CARE & SPECIALTY PHARMACY LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; RESOURCE UTILIZATION; COST-EFFECTIVENESS; FOCUSED UPDATE; CLOPIDOGREL; PRASUGREL; MANAGEMENT; TICAGRELOR; GUIDELINE AB BACKGROUND: Recent trials demonstrated the efficacy of prasugrel and ticagrelor compared with clopidogrel in the reduction of cardiovascular complications in patients with acute coronary syndrome (ACS). However, it is unclear how use of the 3 antiplatelet medications has changed in commercially insured patients since the advent of the new agents. OBJECTIVES: To (a) describe the adoption of prasugrel and ticagrelor in patients who received percutaneous coronary intervention (PCI) for the onset of ACS and (b) explore patient factors associated with the selection of the drug to provide insight into utilization patterns of these antiplatelet agents. METHODS: Patients who received a new dispensing of an antiplatelet agent following a hospitalization for a PCI administered for ACS were identified from insurance claims between 2009 and 2013. Demographics and comorbid conditions were determined based on a 6-month period before the ACS event. Longitudinal trends in antiplatelet agent selection were illustrated using descriptive statistics segmented by month and quarter. Using logistic regressions with stepwise model selection, factors associated with use of the newer medications, as well as with the selection between ticagrelor and prasugrel, were identified. RESULTS: The analysis included 66,335 subjects. The use of clopidogrel decreased from 100% to roughly 65% of total antiplatelet agent use by the end of 2011 and leveled off thereafter. The introduction of ticagrelor in 2011 coincided with a drop in prasugrel initiation from 35%-18% by December 2013. The use of new agents as opposed to use of clopidogrel was associated with younger age (<65 years), male gender, and a diagnosis of ST-elevation myocardial infarction. In addition, conditions increasing mortality and risk of cardiovascular complication were associated with higher odds of using clopidogrel. The odds of using ticagrelor over prasugrel increased with older age and history of a cerebrovascular event. CONCLUSIONS: In 2013, clopidogrel remained the most prescribed agent. Meanwhile, ticagrelor had gradually replaced a substantial portion of prasugrel initiation. Further investigation into outcomes associated with the newer agents, as well as reasons behind the conservative use of the anti platelet agents, is warranted. Copyright (C) 2017, Academy of Managed Care Pharmacy. All rights reserved. C1 [Kim, Kibum] Univ Utah, Pharmacotherapy Outcomes Res Ctr, Salt Lake City, UT USA. [Kim, Kibum] Univ Utah, Dept Pathol, Salt Lake City, UT USA. [Lee, Todd A.; Touchette, Daniel R.; Walton, Surrey M.] Univ Illinois, Coll Pharm, Dept Pharm Syst Outcomes & Policy, Chicago, IL 60680 USA. [Lee, Todd A.; Touchette, Daniel R.; Walton, Surrey M.] Univ Illinois, Ctr Pharmacoepidemiol & Pharmacoecon Res, Chicago, IL 60680 USA. [DiDomenico, Robert J.] Univ Illinois, Coll Pharm, Ctr Pharmacoepidemiol & Pharmacoecon Res, Chicago, IL 60680 USA. [DiDomenico, Robert J.] Univ Illinois, Coll Pharm, Dept Pharm Practice, Chicago, IL 60680 USA. [Ardati, Amer K.] Univ Illinois, Coll Med, Div Cardiol, Chicago, IL 60680 USA. C3 Utah System of Higher Education; University of Utah; Utah System of Higher Education; University of Utah; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital RP Walton, SM (通讯作者),833 S Wood St,MC 871, Chicago, IL 60612 USA. EM walton@uic.edu RI DiDomenico, Robert J./AFV-5274-2022; DiDomenico, Robert J./AAU-2128-2021 OI DiDomenico, Robert J./0000-0002-9374-8012; DiDomenico, Robert J./0000-0002-9374-8012; Lee, Todd/0000-0003-3619-5367; KIM, KIBUM/0000-0002-8676-7434 FU Patient-Centered Outcomes Research Institute; Cardinal Health and Sunovion Pharmaceuticals; Pfizer FX No funding was received for the conduct of this study. DiDomenico received an honorarium from Amgen for the preparation of a heart failure drug monograph for Pharmacy Practice News and was a co-investigator on funded research for the Patient-Centered Outcomes Research Institute. DiDomenico also serves as an advisory board member for a heart failure program at Otsuka America Pharmaceuticals and as an advisory board member at Novartis Pharmaceuticals. Touchette has received unrestricted grant funding from Cardinal Health and Sunovion Pharmaceuticals and has also served as a consultant to and director of the American College of Clinical Pharmacy Practice Based Research Network on a study funded by Pfizer. None of the authors of this study are involved in financial or personal relationships with agencies, institutions, or organizations that inappropriately influenced the statistical analysis plan or interpretation of the results. 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Manag. Care Spec. Pharm. PD JAN PY 2017 VL 23 IS 1 BP 57 EP 63 DI 10.18553/jmcp.2017.23.1.57 PG 7 WC Health Care Sciences & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Pharmacology & Pharmacy GA EH6UH UT WOS:000391908900007 PM 28025925 OA Green Submitted, Bronze DA 2023-05-13 ER PT J AU Nicolas, J Beerkens, F Cao, DV Sartori, S Pivato, CA Qiu, HB Giustino, G Chiarito, M Claessen, BE Zhang, ZJ Nardin, M Razuk, V Jones, D Camaj, A Power, D Banashefski, B Sweeny, J Baber, U Dangas, G Sharma, SK Kini, A Mehran, R AF Nicolas, Johny Beerkens, Frans Cao, Davide Sartori, Samantha Pivato, Carlo Andrea Qiu, Hanbo Giustino, Gennaro Chiarito, Mauro Claessen, Bimmer E. Zhang, Zhongjie Nardin, Matteo Razuk, Victor Jones, Davis Camaj, Anton Power, David Banashefski, Bryana Sweeny, Joseph Baber, Usman Dangas, George Sharma, Samin K. Kini, Annapoorna Mehran, Roxana TI Performance of the academic research consortium high-bleeding risk criteria in patients undergoing PCI for acute myocardial infarction SO JOURNAL OF THROMBOSIS AND THROMBOLYSIS LA English DT Article DE ARC-HBR; High bleeding risk; Percutaneous coronary intervention ID PERCUTANEOUS CORONARY INTERVENTION; DUAL-ANTIPLATELET THERAPY; MORTALITY; IMPACT; OUTCOMES; REVASCULARIZATION; DEFINITION; VALIDATION; DISEASE; STENTS AB Patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) are at increased risk for thrombotic and bleeding complications compared to patients with chronic coronary syndrome (CCS). The academic research consortium (ARC) recently suggested a set of criteria to identify patients at high bleeding risk (HBR). We sought to evaluate the performance of the ARC-HBR criteria among patients undergoing PCI according to clinical presentation. We included all consecutive patients undergoing PCI at a tertiary-care center. Patients were deemed at HBR if they fulfilled >= 1 major or >= 2 minor ARC-HBR criteria. The primary bleeding endpoint was a composite of in-hospital or post-discharge bleeding at 1-year follow-up. Secondary outcomes included all-cause death and myocardial infarction. Out of 6068 patients, 1391 (22.9 %) presented with AMI and were more often at HBR than those with CCS (46.9 % vs. 43.0 %, p = 0.01). HBR patients had a higher risk for the primary bleeding endpoint than non-HBR, irrespective of the clinical indication for PCI (AMI: 19.5 % vs. 5.5 %; HR 3.86, 95 % CI 2.63-5.69; CCS: 6.8 % vs. 2.6 %; HR 2.65, 95 % CI 1.92-3.68; p-interaction = 0.11). Secondary outcomes followed a similar trend. After multivariable adjustment, AMI presentation remained significantly associated with increased risk for bleeding at 1 year (HR 1.64, 95 % CI 1.13-2.38, p = 0.01). The ARC-HBR criterion associated with the highest bleeding risk was severe/end-stage chronic kidney disease in AMI and moderate/severe anemia in CCS. The ARC-HBR framework successfully identified AMI and CCS patients with increased risk for bleeding complications at 1 year post-PCI. C1 [Nicolas, Johny; Beerkens, Frans; Cao, Davide; Sartori, Samantha; Qiu, Hanbo; Giustino, Gennaro; Chiarito, Mauro; Zhang, Zhongjie; Nardin, Matteo; Razuk, Victor; Jones, Davis; Camaj, Anton; Power, David; Banashefski, Bryana; Sweeny, Joseph; Dangas, George; Sharma, Samin K.; Kini, Annapoorna; Mehran, Roxana] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY 10017 USA. [Beerkens, Frans; Razuk, Victor; Jones, Davis] Icahn Sch Med Mt Sinai, Dept Med, New York, NY 10017 USA. [Pivato, Carlo Andrea; Chiarito, Mauro] Humanitas Univ, Dept Biomed Sci, Via Rita Levi Montalcini 4, I-20090 Milan, Italy. [Pivato, Carlo Andrea; Chiarito, Mauro] IRCCS Humanitas Res Hosp, Manzoni 56, I-20089 Milan, Italy. [Claessen, Bimmer E.] Amsterdam Univ Med Ctr, Dept Cardiol, Amsterdam, Netherlands. [Baber, Usman] Univ Oklahoma, Hlth Sci Ctr, Dept Cardiol, Oklahoma City, OK 73104 USA. [Mehran, Roxana] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, Ctr Intervent Cardiovasc Res & Clin Trials, Box 1030,1 Gustave L Levy Pl, New York, NY 10029 USA. C3 Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Humanitas University; University of Oklahoma System; University of Oklahoma Health Sciences Center; Icahn School of Medicine at Mount Sinai RP Mehran, R (通讯作者),Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY 10017 USA.; Mehran, R (通讯作者),Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, Ctr Intervent Cardiovasc Res & Clin Trials, Box 1030,1 Gustave L Levy Pl, New York, NY 10029 USA. EM roxana.mehran@mountsinai.org RI Mehran, Roxana/ABF-4160-2021; Cao, Davide/ADH-5447-2022; Nicolas, Johny/AAB-6000-2021; Pivato, Carlo Andrea/ABE-8122-2020; Chiarito, Mauro/AAC-6819-2022; Zhang, Zhongjie/HKO-3922-2023 OI Cao, Davide/0000-0001-7755-4069; Nicolas, Johny/0000-0002-3015-3361; Pivato, Carlo Andrea/0000-0001-5195-8815; Chiarito, Mauro/0000-0002-9333-2658; Zhang, Zhongjie/0000-0002-9615-0518; Power, David/0000-0002-5409-1943; Beerkens, Frans/0000-0001-6596-5055 CR Alcock RF, 2013, INT J CARDIOL, V167, P1343, DOI 10.1016/j.ijcard.2012.04.011 Baber U, 2020, EUR HEART J, V41, P3533, DOI 10.1093/eurheartj/ehaa670 Baber U, 2016, J AM COLL CARDIOL, V67, P2224, DOI 10.1016/j.jacc.2016.02.064 Bhatt DL, 2021, INT J CARDIOL, V337, P1, DOI 10.1016/j.ijcard.2021.05.012 Cao D, 2020, J AM COLL CARDIOL, V75, P2711, DOI 10.1016/j.jacc.2020.03.070 Capodanno D, 2018, J AM COLL CARDIOL, V72, P2915, DOI 10.1016/j.jacc.2018.09.057 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 Cordero A, 2020, THROMB RES, V196, P516, DOI 10.1016/j.thromres.2020.10.013 Corpataux N, 2020, EUR HEART J, V41, P3743, DOI 10.1093/eurheartj/ehaa671 Crea F, 2017, CIRCULATION, V136, P1155, DOI 10.1161/CIRCULATIONAHA.117.029870 Franchini M, 2007, CLIN LAB, V53, P63 Genereux P, 2015, J AM COLL CARDIOL, V66, P1036, DOI 10.1016/j.jacc.2015.06.1323 Kazi DS, 2015, J AM COLL CARDIOL, V65, P1411, DOI 10.1016/j.jacc.2015.01.047 Loh JP, 2014, AM HEART J, V168, P248, DOI 10.1016/j.ahj.2014.05.018 Manoukian SV, 2007, J AM COLL CARDIOL, V49, P1362, DOI 10.1016/j.jacc.2007.02.027 Mehran R, 2011, JACC-CARDIOVASC INTE, V4, P654, DOI 10.1016/j.jcin.2011.02.011 Mehta SK, 2009, CIRC-CARDIOVASC INTE, V2, P222, DOI 10.1161/CIRCINTERVENTIONS.108.846741 National Cardiovascular Data Registry (NCDR), 2011, NCDR CATHPCI REG V4 Ndrepepa G, 2008, J AM COLL CARDIOL, V51, P690, DOI 10.1016/j.jacc.2007.10.040 Nicolas J, 2021, INT J CARDIOL, V338, P83, DOI 10.1016/j.ijcard.2021.06.025 Palmerini T, 2017, J AM COLL CARDIOL, V69, P2011, DOI 10.1016/j.jacc.2017.02.029 Pilgrim T, 2012, CIRC-CARDIOVASC INTE, V5, P202, DOI 10.1161/CIRCINTERVENTIONS.111.965749 Rao SV, 2013, JACC-CARDIOVASC INTE, V6, P897, DOI 10.1016/j.jcin.2013.04.016 Rao SV, 2006, J AM COLL CARDIOL, V47, P809, DOI 10.1016/j.jacc.2005.09.060 Sandoval Y, 2018, EUR HEART J-ACUTE CA, V7, P120, DOI 10.1177/2048872616658591 Sarnak MJ, 2019, J AM COLL CARDIOL, V74, P1823, DOI 10.1016/j.jacc.2019.08.1017 Tabata N, 2018, EUR HEART J-QUAL CAR, V4, P290, DOI 10.1093/ehjqcco/qcx047 Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Ueki Y, 2020, EUROINTERVENTION, V16, P371, DOI 10.4244/EIJ-D-20-00052 Urban P, 2019, CIRCULATION, V140, P240, DOI 10.1161/CIRCULATIONAHA.119.040167 Valgimigli M, 2017, EUR HEART J, V38, P804, DOI 10.1093/eurheartj/ehw525 Vieira-de-Abreu A, 2012, SEMIN IMMUNOPATHOL, V34, P5, DOI 10.1007/s00281-011-0286-4 NR 32 TC 8 Z9 8 U1 0 U2 1 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0929-5305 EI 1573-742X J9 J THROMB THROMBOLYS JI J. Thromb. Thrombolysis PD JAN PY 2022 VL 53 IS 1 BP 20 EP 29 DI 10.1007/s11239-021-02534-z EA AUG 2021 PG 10 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Hematology GA YQ3CK UT WOS:000681143700002 PM 34347202 DA 2023-05-13 ER PT J AU Kaul, P Savu, A Hamza, S Knudtson, ML Bainey, K Brass, N Armstrong, PW Welsh, RC AF Kaul, Padma Savu, Anamaria Hamza, Shereen Knudtson, Merril L. Bainey, Kevin Brass, Neil Armstrong, Paul W. Welsh, Robert C. TI Outcomes of medically managed patients with myocardial infarction SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Myocardial infarction; medical management; onsite facilities ID ST-SEGMENT ELEVATION; ACUTE CORONARY SYNDROMES; ASSOCIATION TASK-FORCE; QUALITY-OF-CARE; EUROPEAN-SOCIETY; UNSTABLE ANGINA; CURRENT STATE; REVASCULARIZATION; GUIDELINES; HOSPITALS AB Aims: The purpose of this study was to compare outcomes associated with medical management of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction patients presenting to hospitals with and without onsite catheterization facilities. Methods All patients (n=25,921) with ST-elevation myocardial infarction (n=10,563) or non-ST-elevation myocardial infarction (n=15,358) in Alberta, Canada between April 2010-March 2016 were categorized according to availability of catheterization facilities at the hospital they presented to and their management strategy (medically managed without coronary angiography or medically managed after coronary angiography). Results: Overall, 51% presented to hospitals without catheterization facilities; and 34% were managed medically (18% without coronary angiography, and 16% after coronary angiography). Rates of medical management were higher at hospitals without versus those with catheterization facilities (43% vs. 24%, p<0.01). However, both the rate of presentation to hospitals without catheterization facilities (70% non-ST-elevation myocardial infarction, 24% ST-elevation myocardial infarction, p<0.01) and medical management (45% non-ST-elevation myocardial infarction, 18% ST-elevation myocardial infarction, p<0.01) differed by myocardial infarction type. The lack of catheterization facilities at the presenting hospital had no association with in-hospital mortality in patients medically managed without coronary angiography, but was associated with a lower risk of mortality among patients medically managed after coronary angiography. However, the latter benefit was restricted to non-ST-elevation myocardial infarction patients only (adjusted hazard ratio 0.43, 95% confidence interval: 0.25-0.76). Conclusion: The availability of catheterization facilities at the hospital at which non-ST-elevation myocardial infarction and ST-elevation myocardial infarction patients presented influenced their likelihood of being medically managed, but was not associated with adverse short- or long-term mortality outcomes. C1 [Kaul, Padma; Bainey, Kevin; Armstrong, Paul W.; Welsh, Robert C.] Univ Alberta, Dept Med, 2-132 Li Ka Shing Ctr, Edmonton, AB T6G 2E1, Canada. [Kaul, Padma; Savu, Anamaria; Hamza, Shereen; Bainey, Kevin; Armstrong, Paul W.; Welsh, Robert C.] Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada. [Knudtson, Merril L.] Univ Calgary, Dept Med, Calgary, AB, Canada. [Brass, Neil] Alberta Hlth Serv, Wainwright, AB, Canada. C3 University of Alberta; University of Alberta; University of Calgary; Alberta Health Services (AHS) RP Kaul, P (通讯作者),Univ Alberta, Dept Med, 2-132 Li Ka Shing Ctr, Edmonton, AB T6G 2E1, Canada. EM pkaul@ualberta.ca RI Welsh, Robert/ABH-3526-2021; Bainey, Kevin/ABA-4046-2021 FU Astra Zeneca FX The analysis of registry data was performed at the Canadian VIGOUR Centre (University of Alberta, Edmonton, Canada), which received partial funding from an unrestricted Astra Zeneca research grant. 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Heart J.-Acute Cardiovasc. Care PD SEP PY 2019 VL 8 IS 6 BP 571 EP 581 DI 10.1177/2048872618812135 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA IW4IB UT WOS:000484942800011 PM 30421616 OA Bronze DA 2023-05-13 ER PT J AU Mejia, OAV Borgomoni, GB Silveira, LMV Guerreiro, GP Falcao, ATG Goncharov, M Dallan, LRP Oliveira, MAP de Sousa, AG Nakazone, MA Tiveron, MG Campagnucci, VP Silva, PGMDE Dallan, LAO Lisboa, LAF Jatene, FB AF Mejia, Omar A. V. Borgomoni, Gabrielle B. Silveira, Lucas M. V. Guerreiro, Gustavo P. Falcao Filho, Alexandre. T. G. Goncharov, Maxim Dallan, Luis R. P. Oliveira, Marco A. P. de Sousa, Alexandre G. Nakazone, Marcelo A. Tiveron, Marcos G. Campagnucci, Valquiria P. Silva, Pedro G. M. Dallan, Luis A. O. Lisboa, Luiz A. F. Jatene, Fabio B. CA REPLICCAR Study Grp TI The arrival of COVID-19 in Brazil and the impact on coronary artery bypass surgery SO JOURNAL OF CARDIAC SURGERY LA English DT Article DE coronary artery bypass grafting; COVID-19; mortality; outcomes ID CARDIAC-SURGERY; OUTCOMES AB Background and Aim of the Study This study analyzed the arrival of coronavirus disease 2019 (COVID-19) in Brazil and its impact on coronary artery bypass grafting (CABG) surgery. Methods Patients undergoing isolated CABG in six hospitals in Brazil were divided into two periods: pre-COVID-19 (March-May 2019, N = 468) and COVID-19 era (March-May 2020, N = 182). Perioperative data were included on a dedicated REDCap platform. Patients with clinical and tomographic criteria and/or PCR (+) for severe acute respiratory syndrome coronavirus 2 infection were considered COVID-19 (+). Logistic regression analysis was performed to create a multiple predictive model for mortality after CABG in COVID-19 era. Results Compared to 2019, in 2020, CABG surgeries had a 2.8-fold increased mortality risk (95% confidence interval [CI]: 1-7.6, p = .041), patients who evolved with COVID-19 had a 11-fold increased mortality risk (95% CI: 2.2-54.9, p < .003), rates of morbidities and readmission to the intensive care unit. The surgical volume was decreased by 60%. The model to predict mortality after CABG in the COVID-19 era was validated with good calibration (Hosmer-Lemeshow = 1.43) and discrimination (receiver operating characteristic = 0.78). Conclusion The COVID-19 pandemic had an adverse impact on mortality, morbidity and volume of patients undergoing CABG. C1 [Mejia, Omar A. V.; Borgomoni, Gabrielle B.; Silveira, Lucas M. V.; Guerreiro, Gustavo P.; Falcao Filho, Alexandre. T. G.; Goncharov, Maxim; Dallan, Luis R. P.; Dallan, Luis A. O.; Lisboa, Luiz A. F.; Jatene, Fabio B.] Inst Coracao Hosp Clin, Fac Med Estado Sao Paulo InCor, Dept Cardiovasc Surg, Sao Paulo, SP, Brazil. [Mejia, Omar A. V.; Silva, Pedro G. M.] Hosp Samaritano Paulista, Dept Cardiovasc Surg, Sao Paulo, SP, Brazil. [Oliveira, Marco A. P.; de Sousa, Alexandre G.] Beneficencia Portuguesa Sao Paulo, Dept Cardiovasc Surg, Sao Paulo, SP, Brazil. [Nakazone, Marcelo A.] Hosp Base Sao Jose do Rio Preto, Dept Cardiovasc Surg, Sao Jose De Rio Preto, SP, Brazil. [Tiveron, Marcos G.] Irmandade Santa Casa Misericordia Marilia, Dept Cardiovasc Surg, Marilia, SP, Brazil. [Campagnucci, Valquiria P.] Irmandade Santa Casa Misericordia Sao Paulo, Dept Cardiovasc Surg, Sao Paulo, SP, Brazil. RP Mejia, OAV (通讯作者),Dr Eneas de Carvalho Aguiar 44, BR-05403900 Sao Paulo, SP, Brazil. EM omar.mejia@incor.usp.br RI Guerreiro, Gustavo/AAI-6946-2021; LISBOA, LUIZ AUGUSTO F./E-1162-2012; Borgomoni, Gabrielle Barbosa/AAZ-9408-2020; Nakazone, Marcelo Arruda/H-2719-2012 OI Guerreiro, Gustavo/0000-0001-9117-8741; LISBOA, LUIZ AUGUSTO F./0000-0002-2137-0604; Borgomoni, Gabrielle Barbosa/0000-0002-9243-7407; Nakazone, Marcelo Arruda/0000-0002-0449-7056; Mejia, Omar/0000-0002-1635-4984; dallan, luis alberto/0000-0002-8655-8966 FU FAPESP [16/15163-0]; Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [16/15163-0] Funding Source: FAPESP FX To the REPLICCAR Study Group and the Brazilian Ministry of Health, National Council for Scientific and Technological Development (CNPq), Sao Paulo Research Foundation (FAPESP) and Sao Paulo State Health Secretariat (SES-SP) in scope of the research program for Unified Health System, shared management (PPSUS), which allowed the development of this study within the FAPESP Process No 16/15163-0. The study REPLICCAR II (Registro Paulista de Cirurgia Cardiovascular) study received funding support by FAPESP (process 16/15163-0). This sub-study of REPLICCAR II did not obtain any funding.This analysis has not been presented or disseminated at any scientific/other events/meetings. CR Aiken LH, 2002, JAMA-J AM MED ASSOC, V288, P1987, DOI 10.1001/jama.288.16.1987 [Anonymous], 2020, AM COLL SURG, V15, P0230235 [Anonymous], 2020, BBC NEWS, P1 [Anonymous], 2020, ITV NEWS, P1 Bakaeen FG, 2020, J THORAC CARDIOV SUR, V160, P722, DOI 10.1016/j.jtcvs.2020.04.101 Chen N, 2020, LANCET, V395, P507, DOI DOI 10.1016/S0140-6736(20)30211-7 Chikwe J, 2020, ANN THORAC SURG, V110, P725, DOI 10.1016/j.athoracsur.2020.05.004 COVIDsurg Collaborative, 2020, LANCET, V396, P27, DOI 10.1016/S0140-6736(20)31182-X Doglietto F, 2020, JAMA SURG, V155, P691, DOI 10.1001/jamasurg.2020.2713 Engelman DT, 2020, ANN THORAC SURG, V110, pE142, DOI 10.1016/j.athoracsur.2020.05.002 Engelman DT., 2020, ANN THORAC SURG, V160, P447, DOI DOI 10.1016/j.athoracsur.2020.04.007 Gaudino M, 2020, CIRCULATION, V142, P300, DOI 10.1161/CIRCULATIONAHA.120.047865 Gershengorn HB, 2017, JAMA INTERN MED, V177, P388, DOI 10.1001/jamainternmed.2016.8457 Guo T, 2020, JAMA CARDIOL, V5, P811, DOI 10.1001/jamacardio.2020.1017 Haft JW, 2020, ANN THORAC SURG, V110, P697, DOI [10.1016/j.athoracsur.2020.04.003, 10.1016/j.jtcvs.2020.04.011] Hewitt J, 2020, LANCET PUBLIC HEALTH, V5, pE444, DOI 10.1016/S2468-2667(20)30146-8 Lei SQ, 2020, ECLINICALMEDICINE, V21, DOI 10.1016/j.eclinm.2020.100331 Lobdell KW, 2016, ANN THORAC SURG, V102, P1052, DOI 10.1016/j.athoracsur.2016.08.051 Madjid M, 2020, JAMA CARDIOL, V5, P831, DOI 10.1001/jamacardio.2020.1286 Orlandi BMM, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0223343 McNeely C, 2016, ANN THORAC SURG, V102, P132, DOI 10.1016/j.athoracsur.2016.01.016 Mitchell Ge., 2020, NURSING TIME, V2020, P4 Nahshon C, 2020, WORLD J SURG, V44, P2477, DOI 10.1007/s00268-020-05575-2 Nguyen Long H, 2020, medRxiv, DOI [10.1016/S2468-2667(20)30164-X, 10.1101/2020.04.29.20084111] Patel V, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.120.017042 Ssentongo P, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0238215 Windecker S, 2014, EUR HEART J, V35, P2541, DOI [10.5603/KP.2014.0224, 10.1093/eurheartj/ehu278, 10.1093/ejcts/ezu366] Wood DA., 2020, CAN J CARDIOL, V110, P733, DOI DOI 10.1016/j.cjca.2020.04.031 Yan YL, 2020, BMJ OPEN DIAB RES CA, V8, DOI 10.1136/bmjdrc-2020-001343 Yates MT, 2020, INTERACT CARDIOV TH, V31, P483, DOI 10.1093/icvts/ivaa143 NR 30 TC 3 Z9 3 U1 0 U2 2 PU WILEY-HINDAWI PI LONDON PA ADAM HOUSE, 3RD FL, 1 FITZROY SQ, LONDON, WIT 5HE, ENGLAND SN 0886-0440 EI 1540-8191 J9 J CARDIAC SURG JI J. Card. Surg. PD SEP PY 2021 VL 36 IS 9 BP 3070 EP 3077 DI 10.1111/jocs.15712 EA JUN 2021 PG 8 WC Cardiac & Cardiovascular Systems; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Surgery GA TW6DP UT WOS:000658022600001 PM 34091941 OA gold DA 2023-05-13 ER PT J AU Angelini, P Postalian, A Hernandez-Vila, E Uribe, C Costello, B AF Angelini, Paolo Postalian, Alexander Hernandez-Vila, Eduardo Uribe, Carlo Costello, Briana TI COVID-19 and the Heart: Could Transient Takotsubo Cardiomyopathy Be Related to the Pandemic by Incidence and Mechanisms? SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Article DE COVID-19; takotsubo cardiomyopathy; acetylcholine; acute coronary syndrome (ACS); coronary vasospasm; endothelial dysfunction ID MYOCARDIAL INJURY; KAWASAKI-DISEASE; DIAGNOSIS; SARS-COV-2; INFECTION; TROPONIN; OUTCOMES AB Typical emergency hospital care during the COVID-19 pandemic has centered on pulmonary-focused services. Nonetheless, patients with COVID-19 frequently develop complications associated with the dysfunction of other organs, which may greatly affect prognosis. Preliminary evidence suggests that cardiovascular involvement is relatively frequent in COVID-19 and that it correlates with significant worsening of clinical status and mortality in infected patients. In this article, we summarize current knowledge on the cardiovascular effects of COVID-19. In particular, we focus on the association between COVID-19 and transient takotsubo cardiomyopathy (TTC)-two conditions that preliminarily seem epidemiologically associated-and we highlight cardiovascular changes that may help guide future investigations toward full discovery of this new, complex disease entity. We hypothesize that coronary endothelial dysfunction, along with septic state, inflammatory storm, hypercoagulability, endothelial necrosis, and small-vessel clotting, may represent a fundamental hidden link between COVID-19 and TTC. Furthermore, given the likelihood that new genetic mutations of coronaviruses or other organisms will cause similar pandemics and endemics in the future, we must be better prepared so that a substantial complication such as TTC can be more accurately recognized, its pathophysiology better understood, and its treatment made more justifiable, timely, and effective. C1 [Angelini, Paolo; Postalian, Alexander; Uribe, Carlo; Costello, Briana] Texas Heart Inst, Ctr Clin Res, Houston, TX 77030 USA. [Angelini, Paolo; Postalian, Alexander] Baylor St Lukes Med Ctr, CHI St Lukes Hlth, Dept Cardiol, Houston, TX 77030 USA. [Angelini, Paolo; Hernandez-Vila, Eduardo] Baylor Coll Med, Dept Internal Med, Div Cardiol, Houston, TX 77030 USA. C3 Texas Heart Institute; Baylor College of Medicine RP Angelini, P (通讯作者),Texas Heart Inst, Ctr Clin Res, Houston, TX 77030 USA.; Angelini, P (通讯作者),Baylor St Lukes Med Ctr, CHI St Lukes Hlth, Dept Cardiol, Houston, TX 77030 USA.; Angelini, P (通讯作者),Baylor Coll Med, Dept Internal Med, Div Cardiol, Houston, TX 77030 USA. 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Cardiovasc. Med. PD JUN 27 PY 2022 VL 9 AR 919715 DI 10.3389/fcvm.2022.919715 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 2U2UA UT WOS:000823014300001 PM 35833183 OA gold, Green Published DA 2023-05-13 ER PT J AU Shetabi, K Ullah, R Patel, R Wilson, T Siddiqua, T Olet, S Ammar, KA Jahangir, A Allaqaband, SQ Bajwa, T Jan, MF AF Shetabi, Kambiz Ullah, Rafath Patel, Raj Wilson, Thomas Siddiqua, Tasneem Olet, Susan Ammar, Khawaja Afzal Jahangir, Arshad Allaqaband, Suhail Q. Bajwa, Tanvir Jan, M. Fuad TI Contemporary practice pattern of revascularization in a large tertiary care referral center in non-ST elevation myocardial infarction: A propensity-matched 10-year experience SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE ACS/NSTEMI; early intervention; delayed intervention; health care outcomes; Non-ST-segment myocardial infarction; percutaneous coronary intervention; propensity-matched ID ACUTE CORONARY SYNDROMES; DELAYED INVASIVE INTERVENTION; UNSTABLE ANGINA; CONSERVATIVE TREATMENT; ARTERY-DISEASE; IMMEDIATE; METAANALYSIS; STRATEGIES; ANGIOPLASTY; THERAPY AB Objectives: We sought to compare the effects of early versus delayed percutaneous coronary intervention (PCI) on the outcomes at 1 year in patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI). Background: Prompt reperfusion in NSTEMI remains controversial. Randomized studies have shown conflicting results regarding the benefits of early intervention versus delayed intervention (defined as intervention performed within 24 hr vs. 24-72 hr of presentation, respectively). This study was conducted to determine the clinical outcomes post PCI in a large tertiary care center. Methods: A propensity-matched group of 1,640 NSTEMI patients [62.4% males (n = 1,023), median age 65 years] was studied for a composite of death, myocardial infarction (MI), stroke, and heart failure in 1 year as a primary endpoint after PCI. Patients were divided into an early intervention group (EIG) and delayed intervention group (DIG). Timing of PCI was determined by the treating interventional cardiologist. Results: The primary outcome was significantly lower in the EIG than DIG (20.4% vs. 24.9%, P = 0.029), which was mainly derived from mortality benefit in the EIG. There was no difference in occurrence of death, MI, stroke, or heart failure between the groups at 30 days. Conclusions: An earlier PCI in patients with NSTEMI is associated with a significant reduction in the composite outcome of death, MI, heart failure, or stroke at 1 year compared with delayed PCI. Based on this large cohort of patients from a real-world referral center, contemporary reperfusion practices in NSTEMI may need to be re-examined with a bias toward early intervention. C1 [Shetabi, Kambiz; Wilson, Thomas; Ammar, Khawaja Afzal; Jahangir, Arshad; Allaqaband, Suhail Q.; Bajwa, Tanvir; Jan, M. Fuad] Aurora Sinai Aurora St Lukes Med Ctr, Aurora Cardiovasc Serv, 2801 W Kinnickinnic River Pkwy,Ste 840, Milwaukee, WI 53215 USA. [Ullah, Rafath; Patel, Raj; Siddiqua, Tasneem] Aurora Sinai Aurora St Lukes Med Ctr, Dept Internal Med, Milwaukee, WI USA. [Olet, Susan] Aurora Hlth Care, Aurora Res Inst, Milwaukee, WI USA. RP Jan, MF (通讯作者),Aurora Sinai Aurora St Lukes Med Ctr, Aurora Cardiovasc Serv, 2801 W Kinnickinnic River Pkwy,Ste 840, Milwaukee, WI 53215 USA. 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Cardiovasc. Interv. PD FEB 1 PY 2019 VL 93 IS 2 BP 256 EP 263 DI 10.1002/ccd.27839 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HM7DP UT WOS:000459637800020 PM 30265421 DA 2023-05-13 ER PT J AU Tang, L Wang, ZJ Hu, XQ Fang, ZF Zheng, ZF Zeng, JP Jiang, LP Ouyang, F Liu, CH Zeng, GF Guo, YH Zhou, SH AF Tang, Liang Wang, Zhao-Jun Hu, Xin-Qun Fang, Zhen-Fei Zheng, Zhao-Fen Zeng, Jian-Ping Jiang, Lu-Ping Ouyang, Fan Liu, Chang-Hui Zeng, Gao-Feng Guo, Yong-Hong Zhou, Sheng-Hua TI Impact of the COVID-19 Pandemic on ST-Elevation Myocardial Infarction Management in Hunan Province, China: A Multi-Center Observational Study SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Article DE COVID-19; ST-segment elevation myocardial infarction; primary percutaneous coronary intervention; thrombolysis; outcomes ID ACUTE CORONARY SYNDROME; SEGMENT ELEVATION; STATEMENT; INSIGHTS; OUTCOMES; SOCIETY; STEMI AB BackgroundThis study aimed to investigate the impact of the COVID-19 pandemic on ST-segment elevation myocardial infarction (STEMI) care in China. MethodsWe conducted a multicenter, retrospective cohort study in Hunan province (adjacent to the epidemic center), China. Consecutive patients presenting with STEMI within 12 h of symptom onset and receiving primary percutaneous coronary intervention, pharmaco-invasive strategy and only thrombolytic treatment, were enrolled from January 23, 2020 to April 8, 2020 (COVID-19 era group). The same data were also collected for the equivalent period of 2019 (pre-COVID-19 era group). ResultsA total of 610 patients with STEMI (COVID-19 era group n = 286, pre-COVID-19 era group n = 324) were included. There was a decline in the number of STEMI admissions by 10.5% and STEMI-related PCI procedures by 12.7% in 2020 compared with the equivalent period of 2019. The key time intervals including time from symptom onset to first medical contact, symptom onset to door, door-to-balloon, symptom onset to balloon and symptom onset to thrombolysis showed no significant difference between these two groups. There were no significant differences for in-hospital death and major adverse cardiovascular events between these two groups. ConclusionDuring the COVID-19 pandemic outbreak in China, we observed a decline in the number of STEMI admissions and STEMI-related PCI procedures. However, the key quality indicators of STEMI care were not significantly affected. Restructuring health services during the COVID-19 pandemic has not significantly adversely influenced the in-hospital outcomes. C1 [Tang, Liang; Wang, Zhao-Jun; Hu, Xin-Qun; Fang, Zhen-Fei; Zhou, Sheng-Hua] Cent South Univ, Dept Cardiol, Xiangya Hosp 2, Changsha, Peoples R China. [Zheng, Zhao-Fen] Hunan Normal Univ, Hunan Prov Peoples Hosp, Affiliated Hosp 1, Changsha, Peoples R China. [Zeng, Jian-Ping] Xiangtan Cent Hosp, Xiangtan, Peoples R China. [Jiang, Lu-Ping] Changsha Cent Hosp, Changsha, Peoples R China. [Ouyang, Fan] Zhuzhou Cent Hosp, Zhuzhou, Peoples R China. [Liu, Chang-Hui] Univ South China, Affiliated Hosp 1, Hengyang, Peoples R China. [Zeng, Gao-Feng] Univ South China, Affiliated Hosp 2, Hengyang, Peoples R China. [Guo, Yong-Hong] Cent South Univ, Dept Geriatr, Xiangya Hosp 2, Changsha, Peoples R China. C3 Central South University; Hunan Normal University; University of South China; University of South China; Central South University RP Zhou, SH (通讯作者),Cent South Univ, Dept Cardiol, Xiangya Hosp 2, Changsha, Peoples R China.; Guo, YH (通讯作者),Cent South Univ, Dept Geriatr, Xiangya Hosp 2, Changsha, Peoples R China. EM guoyonghong@csu.edu.cn; zhoushenghua_guo@163.com RI zhou, sheng/GYJ-6012-2022; Ouyang, Fan/GQI-3203-2022 FU Yu-Ying Plan of the Central South University [502034007]; Key Research and Development Program of Hunan Province [2019SK2022] FX Funding This work was supported in part by a grant from the Yu-Ying Plan of the Central South University (No. 502034007) and the Key Research and Development Program of Hunan Province (No. 2019SK2022). 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Cardiovasc. Med. PD MAR 31 PY 2022 VL 9 AR 851214 DI 10.3389/fcvm.2022.851214 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 0P3PU UT WOS:000784133400001 PM 35433881 OA Green Published, gold DA 2023-05-13 ER PT J AU Nathan, AS Geng, Z Eberly, LA Eneanya, ND Dayoub, EJ Khatana, SAM Kolansky, DM Kobayashi, TJ Tuteja, S Fanaroff, AC Giri, J Groeneveld, PW AF Nathan, Ashwin S. Geng, Zhi Eberly, Lauren A. Eneanya, Nwamaka Dayoub, Elias J. Khatana, Sameed Ahmed M. Kolansky, Daniel M. Kobayashi, Taisei J. Tuteja, Sony Fanaroff, Alexander C. Giri, Jay Groeneveld, Peter W. TI Identifying Racial, Ethnic, and Socioeconomic Inequities in the Use of Novel P2Y(12) Inhibitors After Percutaneous Coronary Intervention SO JOURNAL OF INVASIVE CARDIOLOGY LA English DT Article DE antiplatelet; inequities ID HEALTH DISPARITIES; CARE; PHYSICIANS; CLOPIDOGREL; RACE AB Background. Novel P2Y(12) inhibitors prasugrel and ticagrelor were approved for patients with acute coronary syndrome (ACS) in 2009 and 2011, respectively. We assessed the association of racial, ethnic, and socioeconomic factors with initiation of and adherence to novel P2Y(12) inhibitors in a commercially insured population. Methods. We performed a retrospective cohort analysis of adults undergoing percutaneous coronary intervention with placement of a drug-eluting stent, stratified by ACS status, between January 2008 and December 2016 using Clinformatics Data Mart (OptumInsight). We estimated multivariable logistic regression models to identify factors associated with the initiation of clopidogrel vs novel P2Y(12) inhibitors as well as subsequent 6-month medication adherence, assessed via pharmacy records. Results. A total of 55,664 patients were included in the analysis. Hispanic ethnicity was independently associated with the initiation of clopidogrel compared with novel P2Y(12) inhibitors among ACS patients (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.04-1.36; P<.01). ACS patients with an annual median household income of over $100,000 were less likely to be started on clopidogrel when compared with those who earned less than $40,000 (OR, 0.67; 95% CI, 0.61-0.75; P<.01). Black race, Hispanic ethnicity, and lower household income were each associated with significantly reduced odds of P2Y(12) inhibitor adherence. Conclusion. Hispanic ethnicity and lower household income were associated with novel P2Y(12) inhibitor initiation, and non-White race and ethnicity were associated with lower P2Y(12) inhibitor adherence over 6-month follow-up. These findings highlight continued inequity of care, even in an insured population, and point to a need for new strategies to close these gaps. C1 [Nathan, Ashwin S.; Eberly, Lauren A.; Kolansky, Daniel M.; Kobayashi, Taisei J.; Fanaroff, Alexander C.] Hosp Univ Penn, Cardiovasc Div, 3400 Spruce St, Philadelphia, PA 19104 USA. [Nathan, Ashwin S.; Geng, Zhi; Dayoub, Elias J.; Khatana, Sameed Ahmed M.; Kolansky, Daniel M.; Fanaroff, Alexander C.; Giri, Jay; Groeneveld, Peter W.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Nathan, Ashwin S.; Eberly, Lauren A.; Dayoub, Elias J.; Khatana, Sameed Ahmed M.; Fanaroff, Alexander C.; Giri, Jay; Groeneveld, Peter W.] Univ Penn, Penn Cardiovasc Outcomes Qual & Evaluat Res, Cardiovasc Inst, Philadelphia, PA 19104 USA. [Eneanya, Nwamaka] Hosp Univ Penn, Div Nephrol, 3400 Spruce St, Philadelphia, PA 19104 USA. [Dayoub, Elias J.] Hosp Univ Penn, Perelman Sch Med, Div Gen Internal Med, 3400 Spruce St, Philadelphia, PA 19104 USA. [Tuteja, Sony] Univ Penn, Dept Med, Philadelphia, PA 19104 USA. [Kobayashi, Taisei J.; Giri, Jay; Groeneveld, Peter W.] Corporal Michael J Crescenz VA Med Ctr, Philadelphia, PA USA. C3 University of Pennsylvania; Pennsylvania Medicine; University of Pennsylvania; University of Pennsylvania; University of Pennsylvania; Pennsylvania Medicine; University of Pennsylvania; Pennsylvania Medicine; University of Pennsylvania RP Nathan, AS (通讯作者),Hosp Univ Penn, Cardiovasc Med Div, Perelman Ctr, South Tower,11th Floor 3400 Civic Ctr Blvd, Philadelphia, PA 19104 USA. EM ashwin.nathan@pennmedicine.upenn.edu OI Kobayashi, Taisei/0000-0002-3081-6225 CR [Anonymous], 2014, CALC PROP DAYS COV P Armstrong K, 2007, AM J PUBLIC HEALTH, V97, P1283, DOI 10.2105/AJPH.2005.080762 Aslan M, 2018, 24787 NBER Benkert R, 2008, J AM ACAD NURSE PRAC, V20, P273, DOI 10.1111/j.1745-7599.2008.00317.x Capers Q, 2014, J RACIAL ETHN HEALTH, V1, P171, DOI 10.1007/s40615-014-0021-7 Choudhry NK, 2014, HEALTH AFFAIR, V33, P863, DOI 10.1377/hlthaff.2013.0654 DAHLGREN G, 2006, WHO COLLABORATIVE CT Dayoub EJ, 2019, CIRC-CARDIOVASC INTE, V12, DOI 10.1161/CIRCINTERVENTIONS.118.007434 Dayoub EJ, 2018, JAMA INTERN MED, V178, P943, DOI 10.1001/jamainternmed.2018.0783 Elixhauser A, 1998, MED CARE, V36, P8, DOI 10.1097/00005650-199801000-00004 Eneanya ND, 2016, J HEALTH CARE POOR U, V27, P1427, DOI 10.1353/hpu.2016.0133 Essien UR, 2018, JAMA CARDIOL, V3, P1174, DOI 10.1001/jamacardio.2018.3945 Fiscella K, 2004, ACAD MED, V79, P1139, DOI 10.1097/00001888-200412000-00004 Gaffney A, 2020, HEALTH AFFAIR, V39, P33, DOI 10.1377/hlthaff.2019.00481 Hall WJ, 2015, AM J PUBLIC HEALTH, V105, pE60, DOI 10.2105/AJPH.2015.302903 He YL, 2010, CIRC-CARDIOVASC QUAL, V3, P98, DOI 10.1161/CIRCOUTCOMES.109.875658 Johnson RL, 2004, AM J PUBLIC HEALTH, V94, P2084, DOI 10.2105/AJPH.94.12.2084 Jones CP, 2000, AM J PUBLIC HEALTH, V90, P1212, DOI 10.2105/AJPH.90.8.1212 Levine GN, 2016, J AM COLL CARDIOL, V68, P1082, DOI 10.1016/j.jacc.2016.03.513 Magnani JW, 2018, CIRCULATION, V138, pE48, DOI 10.1161/CIR.0000000000000579 Nathan AS, 2019, CIRC-CARDIOVASC QUAL, V12, DOI 10.1161/CIRCOUTCOMES.119.005600 Nelson A, 2002, J NATL MED ASSOC, V94, P666 Palacio AM, 2015, J GEN INTERN MED, V30, P469, DOI 10.1007/s11606-014-3139-8 Penner LA, 2016, J HEALTH CARE POOR U, V27, P1503, DOI 10.1353/hpu.2016.0115 Penner LA, 2009, J BLACK PSYCHOL, V35, P180, DOI 10.1177/0095798409333585 Powell W, 2019, BEHAV MED, V45, P102, DOI 10.1080/08964289.2019.1585327 Shi LY, 2010, J HEALTH CARE POOR U, V21, P1169, DOI 10.1353/hpu.2010.0928 Stanley A, 2008, J URBAN HEALTH, V85, P555, DOI 10.1007/s11524-008-9282-y Trinacty CM, 2009, BMC HEALTH SERV RES, V9, DOI 10.1186/1472-6963-9-24 van Ryn M, 2000, SOC SCI MED, V50, P813, DOI 10.1016/S0277-9536(99)00338-X Vega WA, 2009, EPIDEMIOL REV, V31, P99, DOI 10.1093/epirev/mxp008 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Wang TY, 2019, JAMA-J AM MED ASSOC, V321, P44, DOI 10.1001/jama.2018.19791 Whitehead M, 2006, CONCEPTS PRINCIPLE 1 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 NR 35 TC 4 Z9 4 U1 0 U2 0 PU H M P COMMUNICATIONS PI MALVERN PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA SN 1042-3931 EI 1557-2501 J9 J INVASIVE CARDIOL JI J. Invasive Cardiol. PD MAR PY 2022 VL 34 IS 3 BP E171 EP + PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 2C2CT UT WOS:000810683200003 PM 35037896 DA 2023-05-13 ER PT J AU Seixas, AC Sousa, A Costa, JDR Moreira, AC Costa, R Damiani, L Neto, CC Maldonado, G Cano, M Sousa, JE AF Seixas, Ana Cristina Sousa, Amanda Costa, Jose de Ribamar, Jr. Moreira, Adriana Costa Costa, Ricardo Damiani, Lucas Neto, Cantidio Campos Maldonado, Galo Cano, Manuel Eduardo Sousa, J. TI Impact of PCI Appropriateness in the Long-Term Outcomes of Consecutive Patients Treated With Second-Generation Drug-Eluting Stents SO JOURNAL OF INVASIVE CARDIOLOGY LA English DT Article DE appropriateness criteria; drug-eluting stents; registry ID PERCUTANEOUS CORONARY INTERVENTION; USE CRITERIA; REVASCULARIZATION; EVENTS AB Background. Appropriate use criteria (AUC) for coronary revascularization were developed to deliver high-quality care; however, the prognostic impact of these criteria remains unclear. We sought to assess the outcomes of patients treated with second-generation drug-eluting stent (DES) classified according to the updated American College of Cardiology Foundation/American Heart Association/Society for Cardiac Angiography and Intervention AUC for percutaneous coronary intervention (PCI). Methods. Between January 2012 and December 2013, a total of 1108 consecutive patients treated only with second-generation DES were categorized according to the AUC in three groups, using the new proposed terminology: appropriate ("A"); uncertain ("U"); and inappropriate ("I"). Major adverse cardiac event (MACE, defined as cardiac death, non-fatal myocardial infarction, and ischemia-driven target-lesion revascularization) and stent thrombosis up to 3 years were compared. Results. PCI was categorized as A in 33.8%, U in 46.8%, and I in 19.4% of all cases. PCI-A patients had a higher prevalence of acute coronary syndromes, while PCI-I involved the treatment of more diabetics and patients with stable coronary disease. There were no differences in procedural complications among the three groups, with comparable rates of in-hospital MACE (9.3% for A vs 9.0% for U vs 7.0% for I; P=.70) and 2-year MACE (13.9% for A vs 9.0% for U vs 8.6% for I; P=.40). In the multivariable analysis, AUC classification was not associated with adverse outcomes. Conclusions. In this contemporary cohort of patients treated with second-generation DES implantation, AUC did not impact 3-year clinical follow-up. C1 [Seixas, Ana Cristina; Sousa, Amanda; Costa, Jose de Ribamar, Jr.; Moreira, Adriana Costa; Costa, Ricardo; Damiani, Lucas; Neto, Cantidio Campos; Maldonado, Galo; Cano, Manuel; Eduardo Sousa, J.] Hosp Coracao HCOR, Sao Paulo, Brazil. [Seixas, Ana Cristina; Sousa, Amanda; Costa, Jose de Ribamar, Jr.; Costa, Ricardo; Neto, Cantidio Campos; Maldonado, Galo; Cano, Manuel; Eduardo Sousa, J.] IDPC, Sao Paulo, Brazil. C3 Hospital do Coracao - HCor RP Seixas, AC (通讯作者),Av Dr Dante Pazzanese,500 Vila Mariana, BR-04012180 Sao Paulo, SP, Brazil. 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Invasive Cardiol. PD SEP PY 2017 VL 29 IS 9 BP 290 EP 296 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FR4LQ UT WOS:000419037300007 PM 28623668 DA 2023-05-13 ER PT J AU Elmer, J Coppler, PJ May, TL Hirsch, K Faro, J Solanki, P Brown, M Puyana, JS Rittenberger, JC Callaway, CW AF Elmer, Jonathan Coppler, Patrick J. May, Teresa L. Hirsch, Karen Faro, John Solanki, Pawan Brown, McKenzie Puyana, Jacob S. Rittenberger, Jon C. Callaway, Clifton W. TI Unsupervised learning of early post-arrest brain injury phenotypes SO RESUSCITATION LA English DT Article DE Cardiac arrest; Precision medicine; Unsupervised learning; Clustering; Phenotype; Outcomes ID TARGETED TEMPERATURE MANAGEMENT; HOSPITAL CARDIAC-ARREST; EUROPEAN RESUSCITATION COUNCIL; COMATOSE SURVIVORS; THERAPEUTIC HYPOTHERMIA; ADVISORY STATEMENT; CARE; PROGNOSTICATION; ASSOCIATION; SOCIETY AB Introduction: Trials may be neutral when they do not appropriately target the experimental intervention. We speculated multimodality assessment of early hypoxic-ischemic brain injury would identify phenotypes likely to benefit from therapeutic interventions. Methods: We performed a retrospective study including comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA) by one of 126 emergency medical services or in-hospital arrest at one of 26 hospitals from 2011 to 2019. All patients were ultimately transported to a single tertiary center for care including standardized initial neurological examination, brain imaging and electroencephalography; targeted temperature management (TTM); hemodynamic optimization targeting mean arterial pressure (MAP) >80 mmHg; and, coronary angiography for clinical suspicion for acute coronary syndrome. We used unsupervised learning to identify brain injury phenotypes defined by admission neurodiagnostics. We tested for interactions between phenotype and TTM, hemodynamic management and cardiac catheterization in models predicting recovery. Results: We included 1086 patients with mean (SD) age 58 (17) years of whom 955 (88%) were resuscitated from OHCA. Survival to hospital discharge was 27%, and 248 (23%) were discharged with Cerebral Performance Category (CPC) 1-3. We identified 5 clusters defining distinct brain injury phenotypes, each comprising 14% to 30% of the cohort with discharge CPC 1-3 in 59% to <1%. We found significant interactions between cluster and TTM strategy (P = 0.01), MAP (P < 0.001) and coronary angiography (P = 0.04) in models predicting outcomes. Conclusions: We identified patterns of early hypoxic-ischemic injury based on multiple diagnostic modalities that predict responsiveness to several therapeutic interventions recently tested in neutral clinical trials. C1 [Elmer, Jonathan; Coppler, Patrick J.; Brown, McKenzie; Puyana, Jacob S.; Callaway, Clifton W.] Univ Pittsburgh, Sch Med, Dept Emergency Med, Pittsburgh, PA USA. [Elmer, Jonathan] Univ Pittsburgh, Dept Crit Care Med, Sch Med, Pittsburgh, PA USA. [Elmer, Jonathan] Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. [May, Teresa L.] Maine Med Ctr, Dept Crit Care Med, Portland, ME 04102 USA. [Hirsch, Karen] Stanford Univ, Dept Neurol, Sch Med, Stanford, CA 94305 USA. [Faro, John] Univ Cincinnati, Coll Med, Cincinnati, OH USA. [Solanki, Pawan] Univ Buffalo, Dept Anesthesiol, Buffalo, NY USA. [Rittenberger, Jon C.] Guthrie Robert Packer Hosp Emergency Med Residenc, Sayre, PA USA. C3 Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Maine Medical Center; Stanford University; University System of Ohio; University of Cincinnati; State University of New York (SUNY) System; State University of New York (SUNY) Buffalo RP Elmer, J (通讯作者),Iroquois Bldg,Suite 400A,3600 Forbes Ave, Pittsburgh, PA 15213 USA. EM elmerjp@upmc.edu RI May, Teresa/HGF-0566-2022 OI Hirsch, Karen/0000-0002-5474-3243 FU NIH [5K23NS097629] FX Dr. Elmer's research time is supported by the NIH through grant 5K23NS097629. The authors report no conflicts of interest and have no other relevant declarations. 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Young, Gary J. Burgess, James F., Jr. Baker, Errol Mohr, David C. Charns, Martin P. Kaboli, Peter J. TI Sustainability of Quality Improvement Following Removal of Pay-for-Performance Incentives SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE inpatients; physician incentive plans; quality improvement; quality indicators; reimbursement; incentive; salaries; fringe benefits ID IMPACT; CARE AB Although pay-for-performance (P4P) has become a central strategy for improving quality in US healthcare, questions persist about the effectiveness of these programs. A key question is whether quality improvement that occurs as a result of P4P programs is sustainable, particularly if incentives are removed. To investigate sustainability of performance levels following removal of performance-based incentives. Observational cohort study that capitalized on a P4P program within the Veterans Health Administration (VA) that included adoption and subsequent removal of performance-based incentives for selected inpatient quality measures. The study sample comprised 128 acute care VA hospitals where performance was assessed between 2004 and 2010. VA system managers set annual performance goals in consultation with clinical leaders, and report performance scores to medical centers on a quarterly basis. These scores inform performance-based incentives for facilities and their managers. Bonuses are distributed based on the attainment of these performance goals. Seven quality of care measures for acute coronary syndrome, heart failure, and pneumonia linked to performance-based incentives. Significant improvements in performance were observed for six of seven quality of care measures following adoption of performance-based incentives and were maintained up to the removal of the incentive; subsequently, the observed performance levels were sustained. This is a quasi-experimental study without a comparison group; causal conclusions are limited. The maintenance of performance levels after removal of a performance-based incentive has implications for the implementation of Medicare's value-based purchasing initiative and other P4P programs. Additional research is needed to better understand human and system-level factors that mediate sustainability of performance-based incentives. C1 [Benzer, Justin K.; Young, Gary J.; Burgess, James F., Jr.; Baker, Errol; Mohr, David C.; Charns, Martin P.] VA Boston Healthcare Syst 152 M, Ctr Org Leadership & Management Res COLMR, Boston, MA 02130 USA. [Benzer, Justin K.; Burgess, James F., Jr.; Baker, Errol; Mohr, David C.; Charns, Martin P.] Boston Univ, Sch Publ Hlth, Boston, MA USA. [Young, Gary J.] Northeastern Univ, Ctr Hlth Policy & Healthcare Res, Boston, MA 02115 USA. [Kaboli, Peter J.] Iowa City VA Healthcare Syst, Comprehens Access & Delivery Res & Evaluat CADRE, Iowa City, IA USA. [Kaboli, Peter J.] Univ Iowa, Dept Internal Med, Carver Coll Med, Iowa City, IA 52242 USA. C3 Boston University; Northeastern University; US Department of Veterans Affairs; Veterans Health Administration (VHA); Iowa City VA Health Care System; University of Iowa RP Benzer, JK (通讯作者),VA Boston Healthcare Syst 152 M, Ctr Org Leadership & Management Res COLMR, 150 South Huntington Ave, Boston, MA 02130 USA. EM Justin.benzer@va.gov RI Mohr, David/ABD-4341-2020 OI Mohr, David/0000-0002-3184-6338; Charns, Martin/0000-0002-7102-5331; Kaboli, Peter/0000-0003-0993-0952; Benzer, Justin/0000-0001-5151-2127 FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service [IIR 08-067-1]; Robert Wood Johnson Foundation FX The work reported herein was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (IIR 08-067-1) and an Investigator Award in Health Policy to Gary Young from the Robert Wood Johnson Foundation. The authors had full access to and take full responsibility for the integrity of the data. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The authors would like to thank Terry Duncan for consultation on implementing time series models in MPLUS. CR Bokhour BG, 2006, MED CARE RES REV, V63, p73S, DOI 10.1177/1077558705283645 Christianson JB, 2008, MED CARE RES REV, V65, p5S, DOI 10.1177/1077558708324236 Chung S, 2010, AM J MANAG CARE, V16, pE35 Doran T, 2006, NEW ENGL J MED, V355, P375, DOI 10.1056/NEJMsa055505 Glasgow JM, 2012, BMJ QUAL SAF, V21, P663, DOI 10.1136/bmjqs-2011-000243 Glasgow JM, 2010, JT COMM J QUAL PATIE, V36, P533, DOI 10.1016/S1553-7250(10)36081-8 HANNAN EL, 1994, JAMA-J AM MED ASSOC, V271, P761, DOI 10.1001/jama.271.10.761 Hibbard JH, 2005, HEALTH AFFAIR, V24, P1150, DOI 10.1377/hlthaff.24.4.1150 Hysong SJ, 2011, MED CARE, V49, P883, DOI 10.1097/MLR.0b013e318222a36c Kizer KW, 2009, ANNU REV PUBL HEALTH, V30, P313, DOI 10.1146/annurev.publhealth.29.020907.090940 Lester H, 2010, BMJ-BRIT MED J, V340, DOI 10.1136/bmj.c1898 Lindenauer PK, 2007, NEW ENGL J MED, V356, P486, DOI 10.1056/NEJMsa064964 Millett C, 2007, CAN MED ASSOC J, V176, P1705, DOI 10.1503/cmaj.061556 Rosenthal MB, 2005, JAMA-J AM MED ASSOC, V294, P1788, DOI 10.1001/jama.294.14.1788 Smith MA, 2012, HEALTH AFFAIR, V31, P570, DOI 10.1377/hlthaff.2011.0853 Werner RM, 2010, HEALTH AFFAIR, V29, P1319, DOI 10.1377/hlthaff.2008.0770 NR 16 TC 25 Z9 25 U1 1 U2 31 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 EI 1525-1497 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JAN PY 2014 VL 29 IS 1 BP 127 EP 132 DI 10.1007/s11606-013-2572-4 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services; General & Internal Medicine GA 284WR UT WOS:000329352900026 PM 23929219 OA Green Published DA 2023-05-13 ER PT J AU Koziel, P Jankowski, P Kosior, DA Sowa, P Szostak-Janiak, K Krzykwa, A Sawicka, E Haberka, M Setny, M Kaminski, K Gasior, Z Kubica, A De Bacquer, D De Backer, G Kotseva, K Wood, D Czarnecka, D Pajak, A AF Koziel, Pawel Jankowski, Piotr Kosior, Dariusz A. Sowa, Pawel Szostak-Janiak, Karolina Krzykwa, Agnieszka Sawicka, Emilia Haberka, Maciej Setny, Malgorzata Kaminski, Karol Gasior, Zbigniew Kubica, Aldona De Bacquer, Dirk De Backer, Guy Kotseva, Kornelia Wood, David Czarnecka, Danuta Pajak, Andrzej TI Smoking cessation in patients with established coronary artery disease: data from the POLASPIRE survey SO KARDIOLOGIA POLSKA LA English DT Article DE coronary artery disease; secondary prevention; smoking ID SECONDARY PREVENTION; HEART; CARE AB BACKGROUND Smoking cessation in patients with coronary artery disease (CAD) is related to decreased risk of cardiovascular events. AIMS To evaluate factors related to persistent smoking in patients with established coronary artery disease. METHODS Patients aged 80 years or younger and hospitalized for acute coronary syndrome or a myocardial revascularization procedure were interviewed 6 to 18 months after the recruiting event. Medical history, smoking behavior, and exposure to environmental smoke were assessed during the interview. Self-reported smoking status was validated by carbon monoxide in exhaled air measurement. Persistent smoking was defined as smoking at the time of interview among those who smoked during the month prior to the recruiting event. RESULTS We analyzed the data of 1034 patients, including 764 (73.9%) who reported smoking at any time in the past and 296 (28.6%) who smoked within 1 month before the recruiting hospitalization. At the time of the interview, the overall smoking rate was 17.2%, whereas 54.7% of patients were persistent smokers. Secondhand smoke exposure and duration of smoking were associated with lower likelihood whereas older age, high socioeconomic status, cardiac rehabilitation following a cardiovascular event, and consultation with a cardiologist were associated with higher likelihood of smoking cessation. CONCLUSIONS Over half of all smokers hospitalized for CAD are still smoking 6 to 18 months after discharge. Older age, secondhand smoking, low socioeconomic status, lack of consultation with a cardiologist, and cardiac rehabilitation following hospitalization were related to persistent smoking. Our findings may help develop strategies aimed at assisting smoking cessation in patients with CAD. C1 [Koziel, Pawel; Jankowski, Piotr; Czarnecka, Danuta] Jagiellonian Univ, Inst Cardiol, Med Coll, Dept Cardiol Intervent Electrocardiol & Hypertens, Ul Jakubowskiego 2, PL-30688 Krakow, Poland. [Jankowski, Piotr] Polish Mothers Mem Hosp Res Inst, Lodz, Poland. [Kosior, Dariusz A.] Cardinal Stefan Wyszynski Univ, Med Coll, Fac Med, Warsaw, Poland. [Kosior, Dariusz A.; Krzykwa, Agnieszka; Setny, Malgorzata] Minist Interior & Adm, Cent Res Hosp, Electrophysiol Lab, Dept Cardiol & Hypertens, Warsaw, Poland. [Sowa, Pawel; Sawicka, Emilia; Kaminski, Karol] Med Univ Bialystok, Dept Populat Med & Civilizat Dis Prevent, Biaystok, Poland. [Szostak-Janiak, Karolina; Haberka, Maciej; Gasior, Zbigniew] Med Univ Silesia, Dept Cardiol, Katowice, Poland. [Kubica, Aldona] Nicolaus Copernicus Univ, Coll Med, Dept Hlth Promot, Bydgoszcz, Poland. [De Bacquer, Dirk; De Backer, Guy] Univ Ghent, Dept Publ Hlth & Primary Care, Ghent, Belgium. [Kotseva, Kornelia] Imperial Coll Healthcare NHS Trust, London, England. [Kotseva, Kornelia; Wood, David] Natl Univ Ireland Galway, Natl Inst Prevent Cardiol, Galway, Ireland. [Wood, David] Imperial Coll London, Natl Heart & Lung Inst, Cardiovasc Med, London, England. [Pajak, Andrzej] Jagiellonian Univ, Dept Clin Epidemiol & Populat Studies, Med Coll, Inst Publ Hlth, Krakow, Poland. C3 Jagiellonian University; Collegium Medicum Jagiellonian University; Polish Mother's Memorial Hospital - Research Institute; Cardinal Stefan Wyszynski University in Warsaw; Medical University of Bialystok; Medical University Silesia; Nicolaus Copernicus University; Ghent University; Ghent University Hospital; RLUK- Research Libraries UK; Imperial College London; Ollscoil na Gaillimhe-University of Galway; RLUK- Research Libraries UK; Imperial College London; Jagiellonian University; Collegium Medicum Jagiellonian University RP Jankowski, P (通讯作者),Jagiellonian Univ, Inst Cardiol, Med Coll, Dept Cardiol Intervent Electrocardiol & Hypertens, Ul Jakubowskiego 2, PL-30688 Krakow, Poland. EM piotrjankowski@interia.pl RI De Bacquer, Dirk/HGU-3191-2022; Kaminski, Karol/J-4515-2014; Kubica, Aldona/D-6444-2014 OI Sawicka, Emilia/0000-0002-8306-1882; Jankowski, Piotr/0000-0001-6223-8821; Kaminski, Karol/0000-0002-9465-2581; Kubica, Aldona/0000-0002-4608-0881; Kosior, Dariusz/0000-0002-7821-4442 CR Aittokallio J, 2020, EUR J PREV CARDIOL, V27, P2308, DOI 10.1177/2047487319894883 Cahill K, 2013, COCHRANE DB SYST REV, DOI [10.1002/14651858.CD006103.pub6, 10.1002/14651858.CD009329.pub2] Critchley J, 2004, COCHRANE DB SYST REV, DOI [10.1002/14651858.CD003041.pub2, DOI 10.1002/14651858.CD003041.PUB2] De Bacquer D, 2020, HEART Gakidou E, 2017, LANCET, V390, P1345, DOI 10.1016/S0140-6736(17)32366-8 Goettler D, 2020, BMC CARDIOVASC DISOR, V20, DOI 10.1186/s12872-020-01429-w Jankowski P, 2009, ZESZ NAUK OCHR ZDR Z, VVII, P44 Jankowski P, 2020, EUR HEART J, V41 Jankowski P, 2020, CARDIOL J, V27, P533, DOI 10.5603/CJ.a2020.0072 Jankowski P, 2018, ARCH MED SCI, V14, P979, DOI 10.5114/aoms.2017.65236 Jankowski P, 2017, KARDIOL POL, V75, P409, DOI 10.5603/KP.2017.0066 Khoramdad M, 2020, IUBMB LIFE, V72, P677, DOI 10.1002/iub.2207 Kotseva K, 2019, EUR J PREV CARDIOL, V26, P824, DOI 10.1177/2047487318825350 Kotseva K, 2017, GLOB HEART, V12, P315, DOI 10.1016/j.gheart.2015.11.003 Livingstone-Banks J, 2019, COCHRANE DB SYST REV, V10 Peksa JW, 2020, POL ARCH INTERN MED, V130, P860, DOI 10.20452/pamw.15542 Piepoli MF, 2016, EUR HEART J, V37, P2315, DOI 10.1093/eurheartj/ehw106 Prugger C, 2014, EUR HEART J, V35, P590, DOI 10.1093/eurheartj/eht538 Radaeli A, 2019, INT J ENV RES PUB HE, V16, DOI 10.3390/ijerph16214136 Siudak Z, 2018, KARDIOL POL, V76, P125, DOI 10.5603/KP.a2017.0167 Snaterse M, 2018, INT J CARDIOL, V258, P1, DOI 10.1016/j.ijcard.2018.01.064 Tutka P, 2019, ADDICTION, V114, P1951, DOI 10.1111/add.14721 Windle SB, 2018, CMAJ, V190, P347 ZIGMOND AS, 1983, ACTA PSYCHIAT SCAND, V67, P361, DOI 10.1111/j.1600-0447.1983.tb09716.x NR 24 TC 4 Z9 4 U1 1 U2 1 PU POLSKIE TOWARZYSTOWO KARDIOLOGICZNE PI WARSZAWA PA UL STAWKI 3 A LOK 1-2, WARSZAWA, POLAND SN 0022-9032 EI 1897-4279 J9 KARDIOL POL JI Kardiol. Pol. PD APR 23 PY 2021 VL 79 IS 4 BP 418 EP 425 DI 10.33963/KP.15854 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA RS5XG UT WOS:000643851100010 PM 33687865 OA gold, Green Published DA 2023-05-13 ER PT J AU Mondal, P Aljizeeri, A Small, G Malhotra, S Harikrishnan, P Affandi, JS Buechel, RR Dwivedi, G Al-Mallah, MH Jain, D AF Mondal, Pratik Aljizeeri, Ahmed Small, Gary Malhotra, Saurabh Harikrishnan, Prakash Affandi, Jacquita S. Buechel, Ronny R. Dwivedi, Girish Al-Mallah, Mouaz H. Jain, Diwakar TI Coronary artery disease in patients with human immunodeficiency virus infection SO JOURNAL OF NUCLEAR CARDIOLOGY LA English DT Review DE Coronary artery disease; human immunodeficiency virus; anti-retroviral therapy; echocardiography; myocardial perfusion imaging; cardiac magnetic resonance imaging; positron emission tomography; coronary computed tomography angiogram ID ACTIVE ANTIRETROVIRAL THERAPY; POSITRON-EMISSION-TOMOGRAPHY; ACUTE MYOCARDIAL-INFARCTION; WALL-MOTION ABNORMALITIES; VENTRICULAR SYSTOLIC DYSFUNCTION; CARDIOVASCULAR RISK-FACTORS; HORMONE-RELEASING FACTOR; HIV-INFECTION; HEART-DISEASE; PROGNOSTIC VALUE AB The life expectancy of people infected with human immunodeficiency virus (HIV) is rising due to better access to combination anti-retroviral therapy (ART). Although ART has reduced acquired immune deficiency syndrome (AIDS) related mortality and morbidity, there has been an increase in non-AIDS defining illnesses such as diabetes mellitus, hypercholesterolemia and coronary artery disease (CAD). HIV is a disease marked by inflammation which has been associated with specific biological vascular processes increasing the risk of premature atherosclerosis. The combination of pre-existing risk factors, atherosclerosis, ART, opportunistic infections and coagulopathy contributes to rising CAD incidence. The prevalence of CAD has emerged as a major contributor of morbidity in these patients due to longer life expectancy. However, ART has been associated with lipodystrophy, dyslipidemia, insulin resistance, diabetes mellitus and CAD. These adverse effects, along with drug-drug interactions when ART is combined with cardiovascular drugs, result in significant challenges in the care of this group of patients. Exercise tolerance testing, echocardiography, myocardial perfusion imaging, coronary computed tomography angiography and magnetic resonance imaging help in the diagnosis of CAD and heart failure and help predict cardiovascular outcomes in a manner similar to non-infected individuals. This review will highlight the pathogenesis and factors that link HIV to CAD, presentation and treatment of HIV-patients presenting with CAD and review briefly the cardiac imaging modalities used to identify this entity and help prognosticate future outcomes. C1 [Mondal, Pratik; Jain, Diwakar] New York Med Coll, Westchester Med Ctr, Dept Cardiol, 100 Woods Rd, Valhalla, NY 10595 USA. [Mondal, Pratik; Jain, Diwakar] New York Med Coll, Westchester Med Ctr, Nucl Cardiovasc Imaging Lab, 100 Woods Rd, Valhalla, NY 10595 USA. [Aljizeeri, Ahmed] Minist Natl Guard Hlth Affaire, King Abdulaziz Cardiac Ctr, Riyadh, Saudi Arabia. [Aljizeeri, Ahmed] King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia. [Aljizeeri, Ahmed] King Saud Bin Abdulaziz Univ Hlth Sci, Riyadh, Saudi Arabia. [Small, Gary] Univ Ottawa, Heart Inst, Div Cardiol, Ottawa, ON, Canada. [Malhotra, Saurabh] Cook Cty Hlth, Div Cardiol, Chicago, IL USA. [Malhotra, Saurabh] Rush Med Coll, Div Cardiol, Chicago, IL 60612 USA. [Harikrishnan, Prakash] Augusta Univ, Med Ctr, Div Cardiol, Augusta, GA USA. [Affandi, Jacquita S.] Curtin Univ, Sch Publ Hlth, Perth, WA, Australia. [Buechel, Ronny R.] Univ Hosp Zurich, Dept Nucl Med, Cardiac Imaging, Zurich, Switzerland. [Dwivedi, Girish] Fiona Stanley Hosp, Murdoch, WA, Australia. [Dwivedi, Girish] Harry Perkins Inst Med Res, Murdoch, WA, Australia. [Dwivedi, Girish] Univ Western Australia, Crawley, WA, Australia. [Al-Mallah, Mouaz H.] Houston Methodist Hosp, Houston Methodist DeBakey Heart & Vasc Ctr, Houston, TX 77030 USA. C3 New York Medical College; Westchester Medical Center; New York Medical College; Westchester Medical Center; King Saud Bin Abdulaziz University for Health Sciences; King Abdulaziz Cardiac Center (KACC); Ministry of National Guard - Health Affairs; King Saud Bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center (KAIMRC); King Saud Bin Abdulaziz University for Health Sciences; University of Ottawa; University of Ottawa Heart Institute; Rush University; University System of Georgia; Augusta University; Curtin University; University of Zurich; University Zurich Hospital; Harry Perkins Institute of Medical Research; University of Western Australia; The Methodist Hospital System; The Methodist Hospital - Houston; Methodist DeBakey Heart & Vascular Center RP Jain, D (通讯作者),New York Med Coll, Westchester Med Ctr, Dept Cardiol, 100 Woods Rd, Valhalla, NY 10595 USA.; Jain, D (通讯作者),New York Med Coll, Westchester Med Ctr, Nucl Cardiovasc Imaging Lab, 100 Woods Rd, Valhalla, NY 10595 USA. 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PD APR PY 2021 VL 28 IS 2 BP 510 EP 530 DI 10.1007/s12350-020-02280-4 EA AUG 2020 PG 21 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA RT8CL UT WOS:000561250300001 PM 32820424 DA 2023-05-13 ER PT J AU Chalghoum, A Noichri, Y Dandana, A Baudin, B Miled, A Ferchichi, S AF Chalghoum, Abdelkader Noichri, Yosri Dandana, Azza Baudin, Bruno Miled, Abdelhedi Ferchichi, Salima TI Pathological interactions between the endothelin-1 and the angiotensin-converting enzyme among Tunisian coronary patients SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Acute coronary syndrome; Endothelin-1; Angiotensin-converting enzyme; Risk factors; Metabolic interactions ID HEART-DISEASE; METABOLIC INTERACTIONS; CARDIOVASCULAR RISK; APOLIPOPROTEIN-B; HYPERHOMOCYSTEINEMIA; POLYMORPHISMS; SENSITIVITY; POPULATION; PREVENTION; SEVERITY AB Background: The correct understanding of the biochemical and metabolic interactions between coronary risk factors contribute to the exploration of cardiovascular pathophysiology and improves therapeutic care. The aim of this study was to explore the endothelin-1 (ET-1) concentration and the angiotensin converting enzyme (ACE) activity among Tunisian patients with coronary heart disease, and to investigate the metabolic relationships between these two markers,. and to assess the possible relationship between them and the different risk factors. In this present study, ET-1 concentration was determined by an analytical method (High Performance Chromatography, coupled by Mass Spectrometry), ACE activity was measured by a kinetic method for patients and healthy controls. These subjects (157 patients and 142 controls) beneficed also by a biochemical exploration (lipid, apolipoproteins and glucose profiles) to quantify cardiovascular risk. Results: A statistically significant increase of the ET-1 concentration was found among patients compared to healthy controls (15.2 +/- 5.3 nM vs 7.1 +/- 2.7 nM, p < 0,00001). For the ACE activity, in spite the treatment of the majority of patients (97%) with ACE inhibitors, this activity was statistically elevated in patients compared to healthy subjects (86.7 +/- 25.4 IU/L vs 42.8 +/- 12.1 IU/L, p < 0.00001). Furthermore, a statistically positive correlation was identified between these two cardiac markers (r = 0.68 p < 0.00001). Conclusion: The study of the metabolic relationship between the ET-1 and ACE among coronary patients reveals other therapeutics targets. C1 [Chalghoum, Abdelkader; Noichri, Yosri; Dandana, Azza; Miled, Abdelhedi; Ferchichi, Salima] Farhat HACHED Hosp, Lab Biochem, St Doctor Moreau, Sousse 4000, Tunisia. [Chalghoum, Abdelkader] Ctr Biotechnol Borj Cedria, Valorizat & Technol Transfer Space, HamamLif 2050, Tunisia. [Baudin, Bruno] St Antoine Hosp, Dept Biochem, 184 St Faubourg St Antoine, F-75571 Paris 12, France. C3 Universite de Sousse; Hopital Farhat Hached; Centre de Biotechnologie de Borj Cedria RP Chalghoum, A (通讯作者),Farhat HACHED Hosp, Lab Biochem, St Doctor Moreau, Sousse 4000, Tunisia.; Chalghoum, A (通讯作者),Ctr Biotechnol Borj Cedria, Valorizat & Technol Transfer Space, HamamLif 2050, Tunisia. EM Abdelkader.chalghoum@yahoo.fr RI Baudin, Bruno/T-6728-2018 OI Chalghoum, Abdelkder/0000-0002-1985-7763; Ferchichi, Salima/0000-0002-1532-066X FU Laboratory of Biochemistry "A" Hospital Saint Antoine, Paris, France; research organization in Tunisia (Ministry of Public Health); research organization in Tunisia (Ministry of Higher Education and Scientific Research) FX Our study was funded by research organizations in Tunisia (Ministry of Public Health and Ministry of Higher Education and Scientific Research) with a scientific and financial cooperation of the Laboratory of Biochemistry "A" Hospital Saint Antoine, Paris, France. 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PD NOV 29 PY 2016 VL 16 AR 244 DI 10.1186/s12872-016-0417-x PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EF1CY UT WOS:000390063900005 PM 27894250 OA Green Published, gold DA 2023-05-13 ER PT J AU Kosaki, R Minoura, Y Ogura, K Oishi, Y Tanaka, L Arai, K Nomura, K Sakai, K Sekimoto, T Nisikura, T Tsujita, H Kondo, S Tsukamoto, S Hamazaki, Y Kobayashi, Y AF Kosaki, Ryota Minoura, Yoshino Ogura, Kunihiro Oishi, Yosuke Tanaka, Lisa Arai, Ken Nomura, Kosuke Sakai, Koshiro Sekimoto, Teruo Nisikura, Tenjin Tsujita, Hiroaki Kondo, Seita Tsukamoto, Shigeto Hamazaki, Yuji Kobayashi, Youichi TI Thrombomodulin can predict the incidence of second events in patients with acute coronary syndrome: Single-center, retrospective cohort study SO JOURNAL OF CARDIOLOGY LA English DT Article ID C-REACTIVE PROTEIN; ELEVATION MYOCARDIAL-INFARCTION; TERM CARDIOVASCULAR EVENTS; ENDOTHELIAL DYSFUNCTION; PROGNOSTIC VALUE; SOLUBLE THROMBOMODULIN; NATRIURETIC PEPTIDE; DISEASE; RESTENOSIS; SENSITIVITY AB Background: Plasma levels of atherothrombosis-related markers such as endothelial biomarkers have been reported to predict the risk of first acute coronary syndrome (ACS) events. Percutaneous coronary intervention (PCI) by balloon angioplasty and stenting established as a treatment for ACS enabled early discharge and early clinic care. The procedure of PCI, however, may itself be associated with arterial injury with endothelial dysfunction. The clinical significance of those biomarkers for second events in patients after PCI has not yet been completely understood to identify patients who need strict follow-up. Methods: After the exclusion of 100 patients (60 deaths during hospitalization, 40 severe renal failure), 400 ACS patients (291 males, 71.1 +/- 13.0 years) who had undergone successful PCI followed by biomarker assessment within the first postoperative hour were enrolled. We evaluated atherothrombosis-related biomarkers: thrombomodulin (TM), C-reactive protein (CRP), and D-dimer, prothrombin fragment F1+2, and plasminogen activator inhibitor-1, other than those assessed by routine biochemical tests. The outcome after PCI in ACS patients was assessed by the incidence of major adverse cardiovascular events (MACEs). Results: MACEs occurred in 112 patients during the follow-up period (813.9 +/- 474.8 days). As in previous reports, patients with MACEs showed decreased left ventricular ejection fraction (LVEF) by echocardiography, elevated brain natriuretic peptide and HbA1c than patients without MACEs. Not only these markers but also TM were significantly associated with MACEs in multivariate analysis. There were no significant correlations between MACEs and CRP. The association between TM and MACEs was especially high (odds ratio 2.73) and unaffected by the stage of cardiac (<= 40, 40 < LVEF <= 55, 55 < %) or renal function (<= 40, 40 < creatinine clearance <= 75, 75 < ml/min). Conclusions: TM is independently associated with MACEs and may be predictive of second events in patients after PCI for ACS. ACS patients with high TM value need strict follow up. (C) 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. C1 [Kosaki, Ryota; Minoura, Yoshino; Ogura, Kunihiro; Oishi, Yosuke; Tanaka, Lisa; Arai, Ken; Nomura, Kosuke; Sakai, Koshiro; Sekimoto, Teruo; Nisikura, Tenjin; Tsujita, Hiroaki; Kondo, Seita; Tsukamoto, Shigeto; Hamazaki, Yuji; Kobayashi, Youichi] Showa Univ, Div Cardiol, Dept Med, Sch Med, Tokyo, Japan. C3 Showa University RP Minoura, Y (通讯作者),Showa Univ, Div Cardiol, Dept Med, Sch Med,Shinagawa Ku, 1-5-8 Hatanodai, Tokyo 1428666, Japan. 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Cardiol. PD NOV-DEC PY 2018 VL 72 IS 5-6 BP 494 EP 500 DI 10.1016/j.jjcc.2018.05.006 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HF6WQ UT WOS:000454379400021 PM 29887328 OA Bronze DA 2023-05-13 ER PT J AU Gotberg, M Christiansen, EH Gudmundsdottir, I Sandhall, L Omerovic, E James, SK Erlinge, D Frobert, O AF Gotberg, Matthias Christiansen, Evald H. Gudmundsdottir, Ingibjorg Sandhall, Lennart Omerovic, Elmir James, Stefan K. Erlinge, David Frobert, Ole TI Instantaneous Wave-Free Ratio versus Fractional Flow Reserve guided intervention (iFR-SWEDEHEART): Rationale and design of a multicenter, prospective, registry-based randomized clinical trial SO AMERICAN HEART JOURNAL LA English DT Article ID PERCUTANEOUS CORONARY INTERVENTION; THROMBUS ASPIRATION; ANGIOGRAPHY; ADENOSINE; STENOSIS; CLASSIFICATION; ANGIOPLASTY; SEVERITY; INDEX AB Background Instantaneous wave-free ratio (iFR) is a new hemodynamic resting index for assessment of coronary artery stenosis severity. iFR uses high frequency sampling to calculate a gradient across a coronary lesion during a period of diastole. The index has been tested against fractional flow reserve (FFR) and found to have an overall classification agreement of 80% to 85%. Whether the level of disagreement is clinically relevant is unknown. Clinical outcome data on iFR are scarce. This study is a registry-based randomized clinical trial, which is a novel strategy using health quality registries as on-line platforms for randomization, case record forms, and follow-up. Design/Methods iFR-SWEDEHEART is a multicenter, prospective, randomized, controlled, clinical open-label clinical trial. Two thousand patients with stable angina or acute coronary syndrome and an indication for physiology-guided assessment of one or more coronary stenoses will be randomized 1: 1 to either iFR- or FFR-guided intervention. The randomization will be conducted online in the Swedish web-based system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies (SWEDEHEART) registry. The trial has a non-inferiority design, with a primary combined end point of all-cause death, non-fatal myocardial infarction, and unplanned revascularization at 12 months. End points will be identified through national registries and undergo central blind adjudication to ensure data quality. Discussion The iFR-SWEDEHEART trial is an registry-based randomized clinical trial evaluating the safety and efficacy of the diagnostic method iFR compared to FFR. C1 [Gotberg, Matthias; Erlinge, David] Lund Univ, Skane Univ Hosp, Dept Cardiol, S-22185 Lund, Sweden. [Christiansen, Evald H.] Aarhus Univ Hosp, Dept Cardiol, Skejby, Denmark. [Gudmundsdottir, Ingibjorg] Reykjavik Univ Hosp, Dept Cardiol, Reykjavik, Iceland. [Sandhall, Lennart] Helsingborg Cty Hosp, Dept Radiol, Helsingborg, Sweden. [Omerovic, Elmir] Sahlgrenska Univ, Dept Cardiol, Gothenburg, Sweden. [James, Stefan K.] Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden. [James, Stefan K.] Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden. [Frobert, Ole] Univ Orebro, Fac Hlth, Dept Cardiol, SE-70182 Orebro, Sweden. C3 Lund University; Skane University Hospital; Aarhus University; Landspitali National University Hospital; Helsingborgs Hospital; Uppsala University; Uppsala University; Orebro University RP Gotberg, M (通讯作者),Lund Univ, Skane Univ Hosp, Dept Cardiol, S-22185 Lund, Sweden. EM matthias.gotberg@med.lu.se RI Demchuk, Andrew M/E-1103-2012; James, Stefan K/J-4554-2014 OI Demchuk, Andrew M/0000-0002-4930-7789; Frobert, Ole/0000-0002-5846-345X; Gudmundsdottir, Ingibjorg/0000-0001-5475-5044; Gotberg, Matthias/0000-0002-0912-7927 FU Volcano Corporation FX For trial sponsorship, administration, data management, statistical analyses, and adjudication, the Uppsala Clinical Research Center of Uppsala University Hospital, Sweden received an unrestricted research grant from the Volcano Corporation. The source of funding has no access to the study data and no roles in the design, conduct, or reporting of the study, but will provide training and study sites with consoles. The source of funding supported the creation of the manuscript through the unrestricted research grant. The authors are solely responsible for the design, conduct of this study, all study analyses, the drafting and editing of the manuscript, and its final contents. 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Heart J. PD NOV PY 2015 VL 170 IS 5 BP 945 EP 950 DI 10.1016/j.ahj.2015.07.031 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CV7EG UT WOS:000364434600015 PM 26542503 DA 2023-05-13 ER PT J AU Jentzer, JC Wiley, B Bennett, C Murphree, DH Keegan, MT Gajic, O Kashani, KB Barsness, GW AF Jentzer, Jacob C. Wiley, Brandon Bennett, Courtney Murphree, Dennis H. Keegan, Mark T. Gajic, Ognjen Kashani, Kianoush B. Barsness, Gregory W. TI Early noncardiovascular organ failure and mortality in the cardiac intensive care unit SO CLINICAL CARDIOLOGY LA English DT Article DE cardiac critical care; cardiac intensive care unit; mortality; organ failure; sequential organ failure assessment (SOFA) score ID ACUTE PHYSIOLOGY; HOSPITAL MORTALITY; ASSESSMENT SCORE; SOFA SCORE; APACHE IV; ILLNESS; EPIDEMIOLOGY; VALIDATION; SEVERITY; PATTERNS AB Background: Noncardiac organ failure has been associated with worse outcomes among a cardiac intensive care unit (CICU) population. Hypothesis: We hypothesized that early organ failure based on the sequential organ failure assessment (SOFA) score would be associated with mortality in CICU patients. Methods: Adult CICU patients from 2007 to 2015 were reviewed. Organ failure was defined as any SOFA organ subscore >= 3 on the first CICU day. Organ failure was evaluated as a predictor of hospital mortality and postdischarge survival after adjustment for illness severity and comorbidities. Results: We included 10 004 patients with a mean age of 67 +/- 15 years (37% female). Admission diagnoses included acute coronary syndrome in 43%, heart failure in 46%, cardiac arrest in 12%, and cardiogenic shock in 11%. Organ failure was present in 31%, including multiorgan failure in 12%. Hospital mortality was higher in patients with organ failure (22% vs 3%, adjusted OR 3.0, 95% CI 2.5-3.7, P < .001). After adjustment, each failing organ system predicted twofold higher odds of hospital mortality (adjusted OR 1.9, 95% CI 1.1-2.1, P < .001). Mortality risk was highest with cardiovascular, coagulation and liver failure. Among hospital survivors, organ failure was associated with higher adjusted postdischarge mortality risk (P < .001); multiorgan failure did not confer added long-term mortality risk. Conclusions: Early noncardiovascular organ failure, especially multiorgan failure, is associated with increased hospital mortality in CICU patients, and this risk continues after hospital discharge, emphasizing the need to promote early recognition of organ failure in CICU patients. C1 [Jentzer, Jacob C.; Wiley, Brandon; Bennett, Courtney; Barsness, Gregory W.] Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA. [Jentzer, Jacob C.; Wiley, Brandon; Bennett, Courtney; Gajic, Ognjen; Kashani, Kianoush B.] Mayo Clin, Div Pulm & Crit Care Med, Dept Internal Med, Rochester, MN 55905 USA. [Murphree, Dennis H.] Mayo Clin, Dept Hlth Sci Res, Rochester, MN 55905 USA. [Keegan, Mark T.] Mayo Clin, Dept Anesthesiol & Perioperat Med, Rochester, MN 55905 USA. [Kashani, Kianoush B.] Mayo Clin, Div Nephrol & Hypertens, Dept Internal Med, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic RP Jentzer, JC (通讯作者),Mayo Clin, Dept Cardiovasc Med, Med, 200 First St SW, Rochester, MN 55905 USA.; Jentzer, JC (通讯作者),Mayo Clin, Div Pulm & Crit Care Med, Dept Internal Med, Med, 200 First St SW, Rochester, MN 55905 USA. 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Cardiol. PD MAY PY 2020 VL 43 IS 5 BP 516 EP 523 DI 10.1002/clc.23339 EA JAN 2020 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA LQ0EF UT WOS:000510062000001 PM 31999370 OA Green Published, gold DA 2023-05-13 ER PT J AU Wang, Y Nichol, MB Yan, BP Wu, J Tomlinson, B Lee, VWY AF Wang, Yun Nichol, Michael B. Yan, Bryan P. Y. Wu, Joanne Tomlinson, Brian Lee, Vivian W. Y. TI Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA SO BMJ OPEN LA English DT Article ID CARDIOVASCULAR-DISEASE RISK; FOCUSED UPDATE; HEALTH-CARE; INSURANCE-COVERAGE; CLINICAL-OUTCOMES; TASK-FORCE; ADHERENCE; MANAGEMENT; CHOLESTEROL; GUIDELINES AB Objectives The objective was to explore the differences in medication use pattern of lipid-lowering drug (LLD) and antiplatelet agents among post-percutaneous coronary intervention patients with acute coronary syndrome aged <65 in Hong Kong (HK) and the USA. Design Retrospective study. Setting This study used deidentified claims data from Clinformatics Data Mart database (OptumInsight, Eden Prairie, Minnesota, USA) and electronic health records from HK Hospital Authority Clinical Data Analysis and Reporting System database. Participants We used 1 year prescription records of LLDs and antiplatelet agents among 1013 USA patients and 270 HK Chinese patients in 2011-2013. Primary and secondary outcome measures Continuity was investigated on the assumption that one defined daily dose represented 1 day treatment. Medication possession ratio method was used to evaluate the adherence. Multivariate-adjusted logistic regressions were constructed to compare the good continuity and adherence levels in the merged database with the cutoffs set at 80%, and Cox proportional hazard models were built using the time to discontinuation as the dependent variable, to assess the persistence level. Results HK Chinese patients were less adherent (67.41% vs 84.60%, adjusted odds ratio (AOR) for Americans over Chinese= 2.23 (95% CI= 1.60 to 3.12), p< 0.001) to antiplatelet agents compared with American patients but better adherent to statins (90.00% vs 78.18%, AOR= 0.37 (0.23 to 0.58), p< 0.001). The discontinuation with statins was more common in American patients (13.33% vs 34.25%, adjusted hazard ratio (AHR)= 2.95 (2.05 to 4.24), p< 0.001). Low-to-moderate potency statins and clopidogrel were favoured by our HK local physicians, while American patients received higher doses of statins and prasugrel. Conclusions We seemed to find HK physicians tended to prescribe cheaper and lower doses of statins and antiplatelet agents when compared with the privately insured patients in the USA, though the adherence and persistence levels of HK patients with statins were relatively good. C1 [Wang, Yun] Monash Univ, Peninsula Clin Sch, Clayton, Vic, Australia. [Nichol, Michael B.; Wu, Joanne] Univ Southern Calif, Sol Price Sch Publ Policy, Los Angeles, CA USA. [Yan, Bryan P. Y.; Tomlinson, Brian] Chinese Univ Hong Kong, Fac Med, Dept Med & Therapeut, Hong Kong, Peoples R China. [Yan, Bryan P. Y.; Tomlinson, Brian] Prince Wales Hosp, Hosp Author, Hong Kong, Peoples R China. [Lee, Vivian W. 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Spaak, Jonas TI Systematic underutilisation of secondary preventive drugs in patients with acute coronary syndrome and reduced renal function SO EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY LA English DT Article DE Myocardial infarction; chronic kidney disease; adherence; persistence; compliance ID CHRONIC KIDNEY-DISEASE; CONVERTING-ENZYME-INHIBITORS; ELEVATION MYOCARDIAL-INFARCTION; STATIN THERAPY; RECOMMENDED THERAPIES; CLINICAL-PRACTICE; ELDERLY PATIENTS; BETA-BLOCKERS; OUTCOMES; INSUFFICIENCY AB Aims: The high risk of recurrent events in patients with reduced renal function following an acute coronary syndrome (ACS) may in part be due to suboptimal secondary prevention. We aimed to describe the association between renal dysfunction and the prescription, initiation and persistent use of secondary prevention during the first year after a first ACS. Methods: We identified all patients admitted to any Swedish coronary care unit for a first ACS between 2005 and 2010 (n = 77,432). In 75,129 patients, creatinine levels were available in order to obtain the estimated glomerular filtration rate (eGFR). Persistent use of prescribed drugs was determined for 1 year using the National Prescription Registry, with complete coverage of all prescribed and dispensed drugs in Sweden. Results: After adjustment for relative and absolute contraindications, compared to patients with eGFR >= 60 mL/min/1.73 m(2), patients with eGFR 30-59 had higher odds of not being prescribed acetylsalicylic acid (ASA; odds ratio [ OR]: 1.56, 95% confidence interval [ CI]: 1.47-1.67), statins (OR: 2.94, 95% CI: 2.86-3.13) or beta-blockade (OR: 1.25, 95% CI: 1.18-1.32). Patients with eGFR 30-59 were more likely to discontinue treatment with ASA (hazard ratio [HR]: 1.59, 95% CI: 1.42-1.56), statins (HR: 1.35, 95% CI: 1.29-1.41), angiotensin-converting enzyme inhibitors and angiotensin-II receptor blockers (HR: 1.37, 95% CI: 1.31-1.43) or beta-blockade (HR: 1.22, 95% Cl: 1.18-1.27). Patients with eGFR < 30 showed a similar pattern in both prescription and discontinuation. Conclusion: High-risk ACS patients with reduced renal function are less likely to be prescribed secondary prevention drugs at discharge, are less likely to initiate treatment when being prescribed these drugs, are less likely to be persistent in the use of these drugs and more often discontinue treatment. C1 [Khedri, Masih; Spaak, Jonas] Karolinska Inst, Danderyd Univ Hosp, Div Cardiovasc Med, Dept Clin Sci, Stockholm, Sweden. [Szummer, Karolina; Jernberg, Tomas] Karolinska Inst, Dept Med, Cardiol Sect, Huddinge, Sweden. [Carrero, Juan-Jesus; Evans, Marie] Karolinska Inst, Div Renal Med, CLINTEC, Stockholm, Sweden. [Jernberg, Tomas] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden. [Jacobson, Stefan H.] Karolinska Inst, Danderyd Univ Hosp, Div Nephrol, Dept Clin Sci, Stockholm, Sweden. C3 Danderyds Hospital; Karolinska Institutet; Karolinska Institutet; Karolinska Institutet; Karolinska Institutet; Danderyds Hospital; Karolinska Institutet RP Spaak, J (通讯作者),Danderyd Hosp, Dept Cardiol, S-18288 Stockholm, Sweden. EM jonas.spaak@ki.se OI Jernberg, Tomas/0000-0003-1695-379X; Khedri, Masih/0000-0002-5787-1283; Evans, Marie/0000-0001-8650-5795; Spaak, Jonas/0000-0002-2135-1294 FU Swedish Strategic Research Foundation (SSF); Swedish Heart and Lung Foundation; Swedish Research Council; Stockholm County Council (ALF projects); Stockholm City Council FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was a part of the national TOTAL-AMI project, supported by the Swedish Strategic Research Foundation (SSF). The project also received support from the Swedish Heart and Lung Foundation, the Swedish Research Council and the Stockholm County Council (ALF projects). ME and KS acknowledge support from the Stockholm City Council post-doctorate grants for clinical researchers. 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J. Prev. Cardiol. PD MAY PY 2017 VL 24 IS 7 BP 724 EP 734 DI 10.1177/2047487317693950 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EU4OO UT WOS:000401009600008 PM 28195517 DA 2023-05-13 ER PT J AU Erne, P Radovanovic, D Seifert, B Bertel, O Urban, P AF Erne, Paul Radovanovic, Dragana Seifert, Burkhardt Bertel, Osmund Urban, Philip CA AMIS Plus Investigators TI Outcome of patients admitted with acute coronary syndrome on palliative treatment: insights from the nationwide AMIS Plus Registry 1997-2014 SO BMJ OPEN LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION AB Objective: Compliance with guidelines is increasingly used to benchmark the quality of hospital care, however, very little is known on patients admitted with acute coronary syndromes (ACS) and treated palliatively. This study aimed to evaluate the baseline characteristics and outcomes of these patients. Design: Prospective cohort study. Setting: Eighty-two Swiss hospitals enrolled patients from 1997 to 2014. Participants: All patients with ACS enrolled in the AMIS Plus registry (n=45 091) were analysed according to three treatment groups: palliative treatment, defined as use of aspirin and analgesics only and no reperfusion; conservative treatment, defined as any treatment including antithrombotics or anticoagulants, heparins, P2Y(12) inhibitors, GPIIb/IIIa but no pharmacological or mechanical reperfusion; and reperfusion treatment (thrombolysis and/or percutaneous coronary intervention during initial hospitalisation). The primary outcome measure was in-hospital mortality and the secondary measure was 1-year mortality. Results: Of the patients, 1485 (3.3%) were palliatively treated, 11 119 (24.7%) were conservatively treated and 32 487 (72.0%) underwent reperfusion therapy. In 1997, 6% of all patients were treated palliatively and this continuously decreased to 2% in 2013. Baseline characteristics of palliative patients differed in comparison with conservatively treated and reperfusion patients in age, gender and comorbidities (all p<0.001). These patients had more in-hospital complications such as postadmission onset of cardiogenic shock (15.6% vs 5.2%; p<0.001), stroke (1.8% vs 0.8%; p=0.001) and a higher in-hospital mortality (25.8% vs 5.6%; p<0.001). The subgroup of patients followed 1 year after discharge (n= 8316) had a higher rate of reinfarction (9.2% vs 3.4%; p=0.003) and mortality (14.0% vs 3.5%; p<0.001). Conclusions: Patients with ACS treated palliatively were older, sicker, with more heart failure at admission and very high in-hospital mortality. While refraining from more active therapy may often constitute the most humane and appropriate approach, we think it is important to also evaluate these patients and include them in registries and outcome evaluations. C1 [Erne, Paul; Radovanovic, Dragana] Univ Zurich, Epidemiol Biostat & Prevent Inst, AMIS Plus Data Ctr, Zurich, Switzerland. [Erne, Paul] Clin St Anna, Dept Cardiol, Luzern, Switzerland. [Erne, Paul] Univ Zurich Hosp, CH-8091 Zurich, Switzerland. [Seifert, Burkhardt] Univ Zurich, Epidemiol Biostat & Prevent Inst, Dept Biostat, Zurich, Switzerland. [Bertel, Osmund] Klin Pk, Ctr Cardiol, Zurich, Switzerland. [Urban, Philip] Hop La Tour, Cardiovasc Dept, Geneva, Switzerland. C3 University of Zurich; University of Zurich; University Zurich Hospital; University of Zurich RP Erne, P (通讯作者),Univ Zurich, Epidemiol Biostat & Prevent Inst, AMIS Plus Data Ctr, Zurich, Switzerland. EM paul.erne@erne-net.ch RI Jeger, Raban/ABG-1678-2021; Iglesias, Juan F./ABB-1115-2020; Radovanovic, Dragana/F-7908-2013 OI Jeger, Raban/0000-0003-1290-5491; Iglesias, Juan F./0000-0002-1669-6036; Radovanovic, Dragana/0000-0002-9507-6272; Seifert, Burkhardt/0000-0002-5829-2478; Maggiorini, Marco/0000-0001-8180-2117 FU Swiss Heart Foundation; Abbot AG, Switzerland; AMGEN Switzerland AG, Switzerland; Astra-Zeneca AG, Switzerland; Bayer (Schweiz) AG, Switzerland; Biotronik AG, Switzerland; Bristol-Myers Squibb AG, Switzerland; Daiichi-Sankyo/Lilly AG, Switzerland; Johnson & Johnson AG-Cordis Division, Switzerland; A Menarini AG, Switzerland; Merck Sharp & Dohme-Chibret AG, Switzerland; Medtronic AG, Switzerland; Pfizer AG, Switzerland; SISMedical AG, Switzerland; St. Jude Medical, Switzerland; Takeda Pharma AG, Switzerland; Vascular Medical AG, Switzerland FX The AMIS Plus registry is funded by unrestricted grants from the Swiss Heart Foundation and from Abbot AG, Switzerland; AMGEN Switzerland AG, Switzerland; Astra-Zeneca AG, Switzerland; Bayer (Schweiz) AG, Switzerland; Biotronik AG, Switzerland; Bristol-Myers Squibb AG, Switzerland; Daiichi-Sankyo/Lilly AG, Switzerland; Johnson & Johnson AG-Cordis Division, Switzerland; A Menarini AG, Switzerland; Merck Sharp & Dohme-Chibret AG, Switzerland; Medtronic AG, Switzerland; Pfizer AG, Switzerland; SISMedical AG, Switzerland; St. Jude Medical, Switzerland; Takeda Pharma AG, Switzerland; Vascular Medical AG, Switzerland. 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Gonzalo, Nieves Jimenez-Quevedo, Pilar Perez-Vizcayno, Maria-Jose Escaned, Javier Fernandez-Ortiz, Antonio TI Clinical Profile and 30-Day Mortality of Invasively Managed Patients with Suspected Acute Coronary Syndrome During the COVID-19 Outbreak SO INTERNATIONAL HEART JOURNAL LA English DT Article DE Myocardial infarction; SARS-CoV-2 PCR; Percutaneous coronary intervention ID MYOCARDIAL-INFARCTION; INFECTION AB The COVID-19 pandemic severely disrupted cardiovascular care during the spring of 2020 in Europe. Our study analyzed the clinical profile, COVID-19 impact, and 30-day prognosis of invasively managed patients with acute coronary syndrome (ACS) compared to a historical cohort. All invasively managed ACS patients from March 1st to April 30th, 2020 were compared to a cohort from the same timeframe of 2019 (n = 316). COVID-19 confirmed cases were defined by a positive SARS-CoV-2 polymerase chain reaction (PCR) test (CoV+). The primary outcome was all-cause 30-day mortality and multivariable predictors of this outcome. A 40.4% reduction in ACS patients was noted (198 cases in 2019 to 118 in 2020), and 11% of 2020 ACS patients were CoV+. Baseline characteristics were similar between groups. There were significantly more inhospital patients with ACS (15.3% versus 6.1%, P = 0.007), and fewer patients were found to have a culprit lesion (58.5% versus 74.2%, P = 0.004) in 2020 compared to 2019. Thirty-day mortality in 2020 (7%) was not different from that in 2019 (4.2%), P = 0.294, but it was significantly higher in CoV+ patients (23.1%) compared to that in negative SARS-CoV-2 PCR test (CoV-) patients (5%), P = 0.047, in the 2020 group. In the multivariate analysis, CoV+ was an independent mortality predictor (OR = 9.8, 95% CI = 1.48-64.78), along with the left ventricular ejection fraction (LVEF) (OR = 0.91, 95% CI = 0.86-0.97), P = 0.0006. This study found increased 30-day mortality of invasively managed CoV+ ACS patients compared to that of CoV- patients during the 2020 COVID-19 spring outbreak. In the multivariable analysis, a SARS-CoV-2 positive test was independently associated with 30-day mortality. Further investigations of the underlying physiopathological relations between COVID-19 and ACS are warranted. C1 [Salinas, Pablo; Travieso, Alejandro; Vergara-Uzcategui, Carlos; Tirado-Conte, Gabriela; Macaya, Fernando; Mejia-Renteria, Hernan; Nombela-Franco, Luis; Nunez-Gil, Ivan J.; Gonzalo, Nieves; Jimenez-Quevedo, Pilar; Perez-Vizcayno, Maria-Jose; Escaned, Javier; Fernandez-Ortiz, Antonio] Hosp Clin San Carlos IdISSC, Inst Invest Sanitaria, Dept Cardiol, Hosp Clin San Carlos, Madrid, Spain. C3 Hospital Clinico San Carlos RP Salinas, P (通讯作者),Hosp Clin San Carlos, Dept Cardiol, Prof Martin Lagos Sn, Madrid 28046, Spain. EM salinas.pablo@gmail.com RI Nombela-Franco, Luis/AAX-7568-2021; Tirado, Gabriela/HTP-4308-2023; NUÑEZ GIL, IVAN JAVIER/AAD-6950-2020; Macaya, Fernando/AFA-1218-2022 OI Nombela-Franco, Luis/0000-0003-3438-8907; Tirado, Gabriela/0000-0002-7093-3936; NUÑEZ GIL, IVAN JAVIER/0000-0002-1779-3102; Macaya, Fernando/0000-0003-1770-3004 CR Ashraf S, 2020, EUR HEART J, V41, P2089, DOI 10.1093/eurheartj/ehaa454 Baldi E, 2020, NEW ENGL J MED, V383, P496, DOI 10.1056/NEJMc2010418 Chieffo Alaide, 2020, Eur Heart J, V41, P1839, DOI 10.1093/eurheartj/ehaa381 De Filippo O, 2020, NEW ENGL J MED, V383, P88, DOI 10.1056/NEJMc2009166 De Rosa S, 2020, EUR HEART J, V41, P2083, DOI 10.1093/eurheartj/ehaa409 Frank RC, 2019, NEW ENGL J MED, V380, DOI 10.1056/NEJMc1901647 FURNIVAL GM, 1974, TECHNOMETRICS, V16, P499, DOI 10.2307/1267601 Helms J, 2020, INTENS CARE MED, V46, P1089, DOI 10.1007/s00134-020-06062-x III IdSC, 2020, SITUACION COVID 19 E Madjid M, 2021, JAMA CARDIOL, V6, P360, DOI 10.1001/jamacardio.2020.5794 Metzler B, 2020, EUR HEART J, V41, P1852, DOI 10.1093/eurheartj/ehaa314 Ministerio de Sanidad, CONS BIEN SOC CIUD E Muscente F, 2020, EUR HEART J SUPPL, V22, pE68, DOI 10.1093/eurheartj/suaa064 Nijjer SS, 2020, HEART, V106, P1609, DOI 10.1136/heartjnl-2020-317143 Olson DR, 2020, MMWR-MORBID MORTAL W, V69, P603, DOI 10.15585/mmwr.mm6919e5 Range G, 2020, EUR HEART J-QUAL CAR, V6, P223, DOI 10.1093/ehjqcco/qcaa034 Rodriguez-Leor O, 2020, REC-INTERV CARDIOL, V2, P82, DOI 10.24875/RECICE.M20000123 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Romaguera R, 2020, REC-INTERV CARDIOL, DOI [10.24875/RECICE.M20000121, DOI 10.24875/RECICE.M20000121] Salinas P, 2020, RECIC Slottow TLP, 2007, CATHETER CARDIO INTE, V69, P1064, DOI 10.1002/ccd.21179 Stefanini GG, 2020, CIRCULATION, V141, P2113, DOI 10.1161/CIRCULATIONAHA.120.047525 THYGESEN K, 2018, J AM COLL CARDIOL, V72, P2231, DOI [DOI 10.1016/J.JACC.2018.08.1038, 10.1016/j.jacc.2018.08.1038] Vejpongsa P, 2019, AM J MED, V132, P1173, DOI 10.1016/j.amjmed.2019.05.002 Xu SQ, 2020, LANCET, V395, P1321, DOI 10.1016/S0140-6736(20)30845-X Yousefzai Rayan, 2020, JACC Case Rep, V2, P1614, DOI 10.1016/j.jaccas.2020.04.018 NR 26 TC 8 Z9 9 U1 0 U2 3 PU INT HEART JOURNAL ASSOC PI TOKYO PA UNIV TOKYO, GRADUATE SCHOOL MEDICINE, DEPT CARDIOVASCULAR MEDICINE, HONGO 7-3-1, BUNKYO-KU, TOKYO, 113-8655, JAPAN SN 1349-2365 EI 1349-3299 J9 INT HEART J JI Int. Heart J. PD MAR PY 2021 VL 62 IS 2 BP 274 EP 281 DI 10.1536/ihj.20-574 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA RN2TN UT WOS:000640204400008 PM 33731529 OA gold DA 2023-05-13 ER PT J AU Lattuca, B Cayla, G Silvain, J Cuisset, T Leclercq, F Manzo-Silberman, S Saint-Etienne, C Delarche, N El Mahmoud, R Carrie, D Souteyrand, G Kerneis, M Hauguel-Moreau, M Zeitouni, M Guedeney, P Diallo, A Collet, JP Vicaut, E Montalescot, G AF Lattuca, Benoit Cayla, Guillaume Silvain, Johanne Cuisset, Thomas Leclercq, Florence Manzo-Silberman, Stephane Saint-Etienne, Christophe Delarche, Nicolas El Mahmoud, Rami Carrie, Didier Souteyrand, Geraud Kerneis, Mathieu Hauguel-Moreau, Marie Zeitouni, Michel Guedeney, Paul Diallo, Abdourahmane Collet, Jean-Philippe Vicaut, Eric Montalescot, Gilles CA ACTION Study Grp TI Bleeding in the Elderly: Risk Factors and Impact on Clinical Outcomes After an Acute Coronary Syndrome, a Sub-study of the Randomized ANTARCTIC Trial SO AMERICAN JOURNAL OF CARDIOVASCULAR DRUGS LA English DT Article ID ST-SEGMENT-ELEVATION; HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; DRUG-ELUTING STENTS; MYOCARDIAL-INFARCTION; ANTIPLATELET THERAPY; SCIENTIFIC STATEMENT; EUROPEAN-SOCIETY; OPEN-LABEL; PREDICTORS AB Background Elderly patients are at high-risk of bleeding, but are under-represented in clinical trials. Objectives The aims were to determine the incidence and the predictive factors of bleeding and to assess the impact of bleeding on further ischemic outcomes in elderly patients after acute coronary syndrome (ACS) treated with percutaneous coronary intervention. Methods From the 877 patients aged >= 75 years included in the ANTARCTIC randomized trial, data on Bleeding Academic Research Consortium (BARC) bleeding complications and major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, myocardial infarction, and stroke, were collected over 1 year. Results Clinically relevant bleeding events (BARC types 2, 3, or 5) were observed in 20.6% of patients (n = 181) at 1 year, of which, one third occurred in the first month. Anemia (adjusted hazard ratio [adj.HR] 3.98, 95% confidence interval [CI] 1.41-11.22; p = 0.009), severe chronic renal failure (adj.HR 1.83, 95% CI 1.12-2.98; p = 0.015), and femoral access (adj.HR 2.54, 95% CI 1.71-3.77; p < 0.001) were independently associated with clinically relevant bleeding events, while age > 85 years (adj.HR 2.22, 95% CI 1.14-4.30; p = 0.018) was independently associated with major bleeding events (BARC types 3 or 5). Patients with a clinically relevant bleeding event had a higher rate of MACE at 1 year (adj.HR 2.04, 95% CI 1.24-3.38; p = 0.005), with a particularly strong effect on stroke (adj.HR 5.55, 95% CI 2.04-15.06; p < 0.001). Conclusions Clinically relevant bleeding events were observed in one out of five elderly patients undergoing stenting for an ACS and were strongly associated with further stroke occurrence. Rather than the antiplatelet therapy, comorbidities and an age > 85 years predicted bleeding outcomes in this elderly population. C1 [Lattuca, Benoit; Silvain, Johanne; Kerneis, Mathieu; Hauguel-Moreau, Marie; Zeitouni, Michel; Guedeney, Paul; Collet, Jean-Philippe; Montalescot, Gilles] Sorbonne Univ, Univ Hosp, Pitie Salpetriere,AP HP, INSERM,UMRS 1166,Cardiol Inst,ACTION Study Grp, 47-83 Bld Hop, F-75013 Paris, France. [Lattuca, Benoit; Cayla, Guillaume] Montpellier Univ, Nimes Univ Hosp, Cardiol Dept, ACTION Study Grp, Nimes, France. [Cuisset, Thomas] Aix Marseille Univ, CHU La Timone, ACTION Study Grp, Cardiol Dept,INSERM,UMR1062,INRA,UMR1260, Marseille, France. [Leclercq, Florence] Montpellier Univ, CHU Montpellier, Cardiol Dept, Montpellier, France. [Manzo-Silberman, Stephane] CHU Lariboisiere, AP HP, INSERM, Cardiol Dept,UMRS 942, Paris, France. [Saint-Etienne, Christophe] CHU Tours, Cardiol Dept, Tours, France. [Delarche, Nicolas] Hop Francois Mitterrand, Cardiol Dept, Pau, France. [El Mahmoud, Rami] Hop Ambroise Pare, Cardiol Dept, Boulogne, France. [Carrie, Didier] Univ Paul Sabatier Toulouse 3, CHU Rangueil, Cardiol Dept, Toulouse, France. [Souteyrand, Geraud] CHU Gabriel Montpied, Cardiol Dept, Clermont Ferrand, France. [Diallo, Abdourahmane; Vicaut, Eric] Lariboisiere Univ Hosp, Epidemiol & Clin Res Unit, ACTION Study Grp, Paris, France. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Universite de Montpellier; CHU de Nimes; INRAE; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille; Universite de Montpellier; CHU de Montpellier; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; CHU Tours; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; CHU de Toulouse; Universite de Toulouse; Universite Toulouse III - Paul Sabatier; CHU Clermont Ferrand; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Lariboisiere-Fernand-Widal - APHP RP Montalescot, G (通讯作者),Sorbonne Univ, Univ Hosp, Pitie Salpetriere,AP HP, INSERM,UMRS 1166,Cardiol Inst,ACTION Study Grp, 47-83 Bld Hop, F-75013 Paris, France. EM gilles.montalescot@aphp.fr RI Manzo-Silberman, Stéphane/ABB-9864-2021; guedeney, paul/HLX-5541-2023 FU Eli Lilly and Company; Daiichi Sankyo; Stentys; Accriva Diagnostics; Medtronic; Fondation Coeur et Recherche FX The ANTARCTIC trial was conducted by the non-profit academic research organization Allies in Cardiovascular Trials, Initiatives, and Organized Networks (ACTION, https://www.action-groupe.org).There was no specific funding for this sub-study, but the ANTARCTIC trial was supported by Eli Lilly and Company, Daiichi Sankyo, Stentys, Accriva Diagnostics, Medtronic, and Fondation Coeur et Recherche. CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Baber U, 2016, J AM COLL CARDIOL, V67, P2224, DOI 10.1016/j.jacc.2016.02.064 Cantor WJ, 2015, AM HEART J, V170, P880, DOI 10.1016/j.ahj.2015.08.011 Cao D, 2020, J AM COLL CARDIOL, V75, P2711, DOI 10.1016/j.jacc.2020.03.070 Cayla G, 2016, LANCET, V388, P2015, DOI 10.1016/S0140-6736(16)31323-X Cayla G, 2014, AM HEART J, V168, P674, DOI 10.1016/j.ahj.2014.07.026 CHESEBRO JH, 1987, CIRCULATION, V76, P142, DOI 10.1161/01.CIR.76.1.142 Costa F, 2019, J AM COLL CARDIOL, V73, P741, DOI 10.1016/j.jacc.2018.11.048 Crimi G, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.010956 Eikelboom JW, 2006, CIRCULATION, V114, P774, DOI 10.1161/CIRCULATIONAHA.106.612812 Giustino G, 2017, J AM COLL CARDIOL, V70, P1846, DOI 10.1016/j.jacc.2017.08.018 Hochholzer W, 2011, CIRCULATION, V123, P2681, DOI 10.1161/CIRCULATIONAHA.110.002683 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Lattuca B, 2019, DRUG AGING, V36, P531, DOI 10.1007/s40266-019-00663-y Lopes RD, 2012, EUR HEART J, V33, P2044, DOI 10.1093/eurheartj/ehs012 Manoukian SV, 2007, J AM COLL CARDIOL, V49, P1362, DOI 10.1016/j.jacc.2007.02.027 Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Montalescot G, 2006, NEW ENGL J MED, V355, P1006, DOI 10.1056/NEJMoa052711 Moscucci M, 2003, EUR HEART J, V24, P1815, DOI 10.1016/S0195-668X(03)00485-8 Natsuaki M, 2019, CIRC-CARDIOVASC INTE, V12, DOI 10.1161/CIRCINTERVENTIONS.119.008307 Ndrepepa G, 2014, CATHETER CARDIO INTE, V83, P182, DOI 10.1002/ccd.25189 Numasawa Y, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011017 Pfisterer M, 2001, LANCET, V358, P951 Roffi M, 2015, REV ESP CARDIOL, V68, P1125, DOI 10.1016/j.rec.2015.10.009 Schoenenberger AW, 2016, EUR HEART J, V37, P1304, DOI 10.1093/eurheartj/ehv698 Schulman S, 2005, J THROMB HAEMOST, V3, P692, DOI 10.1111/j.1538-7836.2005.01204.x Sibbing D, 2018, EUR HEART J, V39, P2749, DOI 10.1093/eurheartj/ehy332 Steg PG, 2011, EUR HEART J, V32, P1854, DOI 10.1093/eurheartj/ehr204 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 TOPOL E, 1993, NEW ENGL J MED, V329, P673, DOI 10.1056/nejm199309023291001 Ueki Y, 2020, EUROINTERVENTION, V16, P371, DOI 10.4244/EIJ-D-20-00052 Urban P, 2019, EUR HEART J, V40, P2632, DOI 10.1093/eurheartj/ehz372 Varenne O, 2018, LANCET, V391, P41, DOI 10.1016/S0140-6736(17)32713-7 Widimsky P, 2015, HEART, V101, P1219, DOI 10.1136/heartjnl-2015-307686 NR 35 TC 3 Z9 3 U1 0 U2 2 PU ADIS INT LTD PI NORTHCOTE PA 5 THE WAREHOUSE WAY, NORTHCOTE 0627, AUCKLAND, NEW ZEALAND SN 1175-3277 EI 1179-187X J9 AM J CARDIOVASC DRUG JI Am. J. Cardiovasc. Drugs PD NOV PY 2021 VL 21 IS 6 BP 681 EP 691 DI 10.1007/s40256-021-00468-8 EA JUN 2021 PG 11 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA WS5DG UT WOS:000668429000001 PM 34191259 DA 2023-05-13 ER PT J AU Wagenvoort, LME Willemsen, RTA Konings, KTS Stoffers, HEJH AF Wagenvoort, L. M. E. Willemsen, R. T. A. Konings, K. T. S. Stoffers, H. E. J. H. TI Interpretations of and management actions following electrocardiograms in symptomatic patients in primary care: a retrospective dossier study SO NETHERLANDS HEART JOURNAL LA English DT Article DE Electrocardiography; General practice; Quality of health care; Clinical skills; Diagnosis; Cross-sectional studies ID ATRIAL-FIBRILLATION; PRACTITIONERS; ACCURACY; ECG; ARRHYTHMIAS AB Background The electrocardiogram (ECG) has become a popular tool in primary care. The clinical value of the ECG depends on the appropriateness of the indication and the interpretation skills of the general practitioner (GP). Objectives To describe the use of electrocardiography in primary care and to assess the performance of GPs in interpreting ECGs and making subsequent management decisions. Methods Three hundred ECGs, recorded during daily practice in symptomatic patients by 14 GPs who regularly perform electrocardiography, were selected. Corresponding data of the indications, interpretations and subsequent management actions were extracted from the associated medical records. A panel consisting of an expert GP and a cardiologist reviewed the ECGs and specified their agreement with the findings and actions of the study GPs. Results The most common indications were suspicion of a rhythm abnormality (43.7%), ischaemic heart disease (42.7%) and patient reassurance (14.3%). The study GPs interpreted 53.3% of the ECGs as showing no (new or acute) abnormality, whereas supraventricular rhythm disorders (12.3%), conduction disorders (7.7%) and repolarisation disorders (7.0%) were the most frequently reported pathological findings. Overall, the expert panel disagreed with the interpretations of the study GPs in 16.2% of cases, and with the GPs' management actions in 11.7%. Learning goals for GPs performing electrocardiography could be formulated for acute coronary syndrome, rhythm disorders, pulmonary embolism, reassurance, left ventricular hypertrophy and premature ventricular complexes. Conclusion GPs who feel competent in electrocardiography performed well in the opinion of the expert panel. We formulated various learning objectives for GPs performing electrocardiography. C1 [Wagenvoort, L. M. E.; Willemsen, R. T. A.; Konings, K. T. S.; Stoffers, H. E. J. H.] Maastricht Univ, Dept Family Med, Care & Publ Hlth Res Inst CAPHRI, Maastricht, Netherlands. C3 Maastricht University RP Willemsen, RTA (通讯作者),Maastricht Univ, Dept Family Med, Care & Publ Hlth Res Inst CAPHRI, Maastricht, Netherlands. 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Heart J. PD OCT PY 2019 VL 27 IS 10 BP 498 EP 505 DI 10.1007/s12471-019-01306-y PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JC3JJ UT WOS:000489174700006 PM 31301001 OA gold, Green Published DA 2023-05-13 ER PT J AU Hyde, EK Martin, DE Rieger, KL Malone, R AF Hyde, Emily K. Martin, Donna E. Rieger, Kendra L. Malone, Reece TI "Just think of it as sexercise" - healthcare providers' perceptions about sexual health education in cardiac rehabilitation programs SO DISABILITY AND REHABILITATION LA English DT Article DE Sexual health; sexual well-being; acute coronary syndrome; cardiac rehabilitation; quality of life ID ACUTE MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; POSITIVE PSYCHOLOGY; NURSES PERCEPTIONS; HEART-ASSOCIATION; UNITED-STATES; KNOWLEDGE; MANAGEMENT; GUIDELINE AB Purpose Sexual health education (SHE) is an important rehabilitation component for acute coronary syndrome (ACS) survivors but is not routinely provided. This study's purpose was to explore healthcare providers' experiences of providing SHE to ACS survivors in cardiac rehabilitation programs to identify best practices. Methods This qualitative study used convenience sampling and an interpretive descriptive design. Inclusion criteria were a healthcare provider employed within a cardiac rehabilitation program in a Western Canadian province. Eight cardiac rehabilitation healthcare providers volunteered to participate. The first author conducted semi-structured, digitally recorded interviews that were transcribed verbatim. The interviews were guided by a semi-structured interview guide anchored in the strengths-based, sex positive guiding frameworks. A reflective journal and socio-demographic forms served as additional data sources. Data were analyzed using open, axial, and selective coding as well as constant comparative analysis. Credibility was ensured through peer-reviewed evaluation criteria. Results Eight healthcare providers participated in the study. Participants equated sexuality and sexual health with physical activity and physical health. Findings identified philosophical perspectives and several barriers and facilitators that impact SHE provision. Participants offered strategies that may be used in practice and their recommendations provide a beginning foundation to improve cardiac rehabilitation programs and the health of ACS survivors. Conclusion Healthcare providers in cardiac rehabilitation programs described their SHE experiences as "just think of it as sexercise." Facilitation of SHE is important as previous studies found that SHE may reduce fear, depression, and anxiety and increase the return to sexual activity among ACS survivors. C1 [Hyde, Emily K.; Martin, Donna E.; Rieger, Kendra L.] Univ Manitoba, Coll Nursing, Rady Fac Hlth Sci, Winnipeg, MB, Canada. [Rieger, Kendra L.] Trinity Western Univ, Sch Nursing, Langley, MB, Canada. [Malone, Reece] Sexual Consultants & Support Serv Manitoba Inc, Winnipeg, MB, Canada. C3 University of Manitoba; Trinity Western University RP Hyde, EK (通讯作者),Univ Manitoba, Helen Glass Ctr Nursing, 89 Curry Pl, Winnipeg, MB R3T 2N2, Canada. EM emily.hyde@umanitoba.ca RI Rieger, RN, PhD, Kendra L./C-4046-2017 OI Rieger, RN, PhD, Kendra L./0000-0002-4864-2833; Hyde, Emily/0000-0003-2296-8584 FU Manitoba Centre for Nursing and Health Research FX This work is financially supported by the Manitoba Centre for Nursing and Health Research. 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Rehabil. PD DEC 4 PY 2022 VL 44 IS 25 BP 7854 EP 7860 DI 10.1080/09638288.2021.2001052 EA NOV 2021 PG 7 WC Rehabilitation WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Rehabilitation GA 7K5ML UT WOS:000718764100001 PM 34779688 DA 2023-05-13 ER PT J AU Walpot, J Hokken, R Pasteuning, WH AF Walpot, Jeroen Hokken, Raymond Pasteuning, W. Hans TI Increased myocardial-specific markers and abnormal electrocardiographic patterns after marathon running: A retrospective observational study to estimate the burden on the health care system SO EXPERIMENTAL & CLINICAL CARDIOLOGY LA English DT Article DE Acute coronary syndrome; ECG changes; Marathon running; Serum cardiac troponin ID SUDDEN CARDIAC DEATH; MAGNETIC-RESONANCE; CORONARY ATHEROSCLEROSIS; PROGNOSTIC RELEVANCE; TROPONIN RELEASE; HIGH-SCHOOL; EXERCISE; RUNNERS; PREVALENCE; RISK AB OBJECTIVES: To estimate the burden of admissions to the Department of Emergency Medicine because of suspicion of cardiovascular problems due to marathon running METHODS: A retrospective observational study was performed. On October 1, 2011, a coast marathon was organized in the referral area of the authors' hospital. Data regarding the number of participants and number of runners prematurely leaving the marathon were collected. According to the list of participants, the number of participant marathon runners who were inhabitants of the referral area of the authors' hospital was determined. RESULTS: There were 1295 participants in the marathon. A total of 160 runners left the marathon prematurely. Of the latter, none were admitted to the hospital because of cardiovascular complaints. Of the 1135 participants who completed the marathon, 578 were inhabitants of the referral area of our hospital. Over a period of 8 h after finishing the marathon, there were four (0.7%) admissions to the emergency department because of cardiovascular problems due to marathon running. The mean age was 47.7 years (range 41 to 53 years) and all four patients were men. None of the patients was known to have a cardiovascular history and they did not use medication. All patients presented with electrocardiographic (ECG) abnormalities and/or increased cardiac troponin levels. Three of the four patients were referred because of chest pain complaints; anamnesis was suggestive for angina pectoris in one of these patients. ECG abnormalities were found in all patients and cardiac troponin I was above the cut-off value in three of four patients (range 0.2 g/L to 4.6 g/L; normal < 0.1 g/L). In three of the four patients, an echocardiographic study was performed within the first 24 h of admission. There were no relevant structural abnormalities and systolic and diastolic function were preserved. One patient developed sustained ventricular tachycardia and was referred for urgent coronary angiography, which revealed single-vessel disease with a 95% stenotic lesion of the proximal left anterior descending artery. Of the remaining three patients, coronary artery stenoses were excluded. CONCLUSION: These data show that 0.7% of the runners completing the marathon were admitted to the emergency department because of cardiovascular problems after marathon running. All these patients presented with abnormal ECG patterns and/or increased troponin levels. Furthermore, in one of the four patients with chest pain complaints, the findings were caused by an acute coronary syndrome due to a severe coronary artery lesion. C1 [Walpot, Jeroen] Admiraal De Ruyter Ziekenhuis, Dept Cardiol, NL-4380 DD Vlissingen, Netherlands. Admiraal De Ruyter Ziekenhuis, Dept Cardiol, Goes, Netherlands. RP Walpot, J (通讯作者),Admiraal De Ruyter Ziekenhuis, Dept Cardiol, Koudekerkseweg 88,Postbus 3200, NL-4380 DD Vlissingen, Netherlands. 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Clin. Cardiol. PD FAL PY 2013 VL 18 IS 3 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AN6TS UT WOS:000340731300001 DA 2023-05-13 ER PT J AU Sedlak, TL Gao, M Lee, M Humphries, KH Cairns, JA AF Sedlak, Tara L. Gao, Min Lee, May Humphries, Karin H. Cairns, John A. TI Outcomes and Transfer Patterns for First Non-ST-Elevation Myocardial Infarction (NSTEMI): Comparisons Between Community and Tertiary Care Hospitals SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE CORONARY SYNDROMES; CONSERVATIVE TREATMENT; UNSTABLE ANGINA; STRATEGIES; REVASCULARIZATION; INTERVENTION; MANAGEMENT; FACILITIES; REGISTRY; DISEASE AB Background: Transfer patterns, procedure rates, and outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI) presenting to Canadian community hospitals are not well understood. Methods: We documented all patients admitted to British Columbia (BC) hospitals with a primary diagnosis of NSTEMI between 2007 and 2008. Patients were divided by admitting hospital type into tertiary care hospitals, nonremote community hospitals, and remote community hospitals. The aims were to compare transfer rates and time to transfer to a tertiary hospital as well as procedure rates and outcomes at index admission, at 30 days, and at 1 year. Results: The mean transfer rates to a tertiary hospital were 72.6% for nonremote and 57.1% for remote community hospitals (P < 0.001). Times to and rates of cardiac procedures differed significantly among these 3 hospital types. Admission to a nonremote or remote community hospital was associated with similar 1-year mortality compared with admission to a tertiary care hospital (nonremote hospitals, adjusted odds ratio [OR], 0.87; P = 0.26; remote hospitals, adjusted OR, 1.19; P = 0.33). At 1 year, admission to a nonremote community hospital was associated with a lower composite outcome of death or readmission for acute myocardial infarction (AMI) (adjusted OR, 0.80; P = 0.04). Conclusions: One-year mortality rates were not different between patients with NSTEMI admitted to BC community and tertiary care hospitals; however, the rate of readmission for AMI/death was significantly less in patients admitted to nonremote community hospitals. This should prompt the evaluation of key outcomes in NSTEMI in other community hospital settings. C1 [Sedlak, Tara L.; Cairns, John A.] Vancouver Gen Hosp, Vancouver, BC, Canada. [Gao, Min; Lee, May; Humphries, Karin H.] St Pauls Hosp, Providence Hlth Care Res Inst, Vancouver, BC V6Z 1Y6, Canada. C3 University of British Columbia; St. Paul's Hospital RP Sedlak, TL (通讯作者),Level 9,2775 Laurel St, Vancouver, BC V5Z 1M9, Canada. EM tara.sedlak@vch.ca RI Cairns, John/AAI-8744-2021 CR Alter DA, 2003, J AM COLL CARDIOL, V42, P410, DOI 10.1016/S0735-1097(03)00640-5 BC Vital Statistics Agency, 2012, DAT EXTR BC VIT STAT British Columbia Ministry of Health, DISCH ABSTR DAT HOSP British Columbia Ministry of Health, CONS FIL MSP REG PRE Canadian Institute for Health Information, HLTH IND INT TOOL Cannon CP, 2001, NEW ENGL J MED, V344, P1879, DOI 10.1056/NEJM200106213442501 de Winter RJ, 2005, NEW ENGL J MED, V353, P1095, DOI 10.1056/NEJMoa044259 Farkouh ME, 2012, NEW ENGL J MED, V367, P2375, DOI 10.1056/NEJMoa1211585 Fox KAA, 2002, LANCET, V360, P743, DOI 10.1016/S0140-6736(02)09894-X Gyenes GT, 2013, CAN J CARDIOL, V29, P1429, DOI 10.1016/j.cjca.2013.04.035 Hassan A, 2009, CAN J CARDIOL, V25, P207, DOI 10.1016/S0828-282X(09)70062-5 McManus DD, 2011, AM J MED, V124, P40, DOI 10.1016/j.amjmed.2010.07.023 Mehta SR, 2009, NEW ENGL J MED, V360, P2165, DOI 10.1056/NEJMoa0807986 Mohr FW, 2013, LANCET, V381, P629, DOI 10.1016/S0140-6736(13)60141-5 O'Donoghue M, 2008, JAMA-J AM MED ASSOC, V300, P71, DOI 10.1001/jama.300.1.71 Pilote L, 2004, CAN J CARDIOL, V20, P491 Roe MT, 2008, AM HEART J, V156, P185, DOI 10.1016/j.ahj.2008.01.033 Van de Werf F, 2005, BRIT MED J, V330, P441, DOI 10.1136/bmj.38335.390718.82 Wright RS, 2011, CIRCULATION, V123, P2022, DOI 10.1161/CIR.0b013e31820f2f3e 1999, LANCET, V354, P708 NR 20 TC 3 Z9 4 U1 0 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0828-282X EI 1916-7075 J9 CAN J CARDIOL JI Can. J. Cardiol. PD DEC PY 2014 VL 30 IS 12 BP 1562 EP 1569 DI 10.1016/j.cjca.2014.09.008 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AU4ME UT WOS:000345584400021 PM 25475461 DA 2023-05-13 ER PT J AU Kimenai, DM Lindahl, B Chapman, AR Baron, T Gard, A Wereski, R Meex, SJR Jernberg, T Mills, NL Eggers, KM AF Kimenai, Dorien M. Lindahl, Bertil Chapman, Andrew R. Baron, Tomasz Gard, Anton Wereski, Ryan Meex, Steven J. R. Jernberg, Tomas Mills, Nicholas L. Eggers, Kai M. TI Sex differences in investigations and outcomes among patients with type 2 myocardial infarction SO HEART LA English DT Article DE myocardial infarction; acute coronary syndrome; risk factors ID TROPONIN; CLASSIFICATION; STATEMENT; WOMEN AB Objectives Type 2 myocardial infarction (MI) is a heterogenous condition and whether there are differences between women and men is unknown. We evaluated sex differences in clinical characteristics, investigations and outcomes in patients with type 2 MI. Methods In the Swedish Web based system for Enhancement and Development of Evidence based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) registry, we compared patients admitted to coronary care units with a diagnosis of type 1 or type 2 MI. Sex-stratified Cox regression models evaluated the association with all-cause death in men and women separately. Results We included 57 264 (median age 73 years, 65% men) and 6485 (median age 78 years, 50% men) patients with type 1 and type 2 MI, respectively. No differences were observed in the proportion of men and women with type 2 MI who underwent echocardiography and coronary angiography, but women were less likely than men to have left ventricular (LV) impairment and obstructive coronary artery disease (CAD). Compared with type 1 MI, patients with type 2 MI had higher risk of death regardless of sex (men: adjusted HR 1.55 (95% CI 1.44 to 1.67); women: adjusted HR 1.34 (95% CI 1.24 to 1.45)). In those with type 2 MI, the risk of death was lower for women than men (adjusted HR 0.85 (95% CI 0.76 to 0.92) (men, reference)). Conclusions Type 2 MI occurred in men and women equally and we found no evidence of sex bias in the selection of patients for cardiac investigations. Patients with type 2 MI had worse outcomes, but women were less likely to have obstructive CAD or severe LV impairment and were more likely to survive than men. C1 [Kimenai, Dorien M.; Mills, Nicholas L.] Univ Edinburgh, Usher Inst, Edinburgh EH16 4SA, Midlothian, Scotland. [Lindahl, Bertil] Uppsala Univ, Uppsala Clin, Res Ctr, Uppsala, Sweden. [Lindahl, Bertil; Baron, Tomasz; Gard, Anton; Eggers, Kai M.] Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden. [Chapman, Andrew R.; Wereski, Ryan; Mills, Nicholas L.] Univ Edinburgh, BHF, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland. [Meex, Steven J. R.] Maastricht Univ, Med Ctr, Cent Diagnost Lab, Maastricht, Netherlands. [Meex, Steven J. R.] Maastricht Univ, CARIM, Sch Cardiovasc Dis, Maastricht, Netherlands. [Jernberg, Tomas] Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Stockholm, Sweden. C3 RLUK- Research Libraries UK; University of Edinburgh; Uppsala University; Uppsala University; RLUK- Research Libraries UK; University of Edinburgh; Maastricht University; Maastricht University; Maastricht University Medical Centre (MUMC); Danderyds Hospital; Karolinska Institutet RP Kimenai, DM (通讯作者),Univ Edinburgh, Usher Inst, Edinburgh EH16 4SA, Midlothian, Scotland. EM dorien.kimenai@ed.ac.uk OI Chapman, Andrew/0000-0003-1926-5925; Mills, Nicholas/0000-0003-0533-7991 FU Swedish Foundation of Strategic Research; Health Data Research UK; HDR UK Ltd by the UK Medical Research Council [HDR-5012]; Engineering and Physical Sciences Research Council; Economic and Social Research Council, Department of Health and Social Care (England); Chief Scientist Office of the Scottish Government Health and Social Care Directorates; Health and Social Care Research and Development Division (Welsh Government); Public Health Agency (Northern Ireland); British Heart Foundation; Wellcome Trust; British Heart Foundation [FS/16/14/32023, RG/20/10/34966, RE/18/5/34216] FX The TOTAL--AMI project has received funding from the Swedish Foundation of Strategic Research. The study was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-5012) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and the Wellcome Trust. NLM is supported by the British Heart Foundation through a Senior Clinical Research Fellowship (FS/16/14/32023), Programme Grant (RG/20/10/34966) and a Research Excellence Award (RE/18/5/34216). 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Current guidelines recommend an LDL-C target of <70 mg/dL (<1.8 mmol/L) for acute coronary syndrome (ACS) patients, and the first-line treatment to lower lipids is statin therapy. Despite current guidelines and the efficacious lipid-lowering agents available, about half of patients at very high risk, including ACS patients, fail to achieve their LDL-C goal. This study assessed LDL-C goal attainment according to use of high and low potency statins in routine practice in Thailand. Methods: A retrospective cohort study was performed by retrieving data from medical records and the electronic hospital database for a tertiary care hospital in Thailand between 2009 and 2011. Included were ACS patients treated with statins at baseline and with follow-up of LDL-C levels. Patients were divided into high or low potency statin users, and the proportion reaching the LDL-C goal of. 70 mg/dL was determined. A Cox proportional hazard model was applied to determine the relationship between statin potency and LDL-C goal attainment. Propensity score adjustment was used to control for confounding by indication. Results: Of 396 ACS patients (60% males, mean age 64.3 +/- 11.6 years), 229 (58%) were treated with high potency statins and 167 (42%) with low potency statins. A quarter reached their target LDL-C goal (25% for patients on high potency statins and 23% on low potency statins). High potency statins were not associated with increased LDL-C goal attainment (adjusted hazards ratio 1.22, 95% confidence interval 0.79-1.88; P=0.363). Conclusion: There was no significant effect of high potency statins on LDL-C goal attainment. Moreover, this study showed low LDL-C goal attainment for patients on either low or high potency statins. The reasons for the low LDL-C goal attainment rate warrants further investigation. C1 [Chinwong, Dujrudee; Chinwong, Surarong] Chiang Mai Univ, Fac Med, Dept Pharmaceut Care, Chiang Mai 50200, Thailand. [Chinwong, Dujrudee] Chiang Mai Univ, Fac Med, Clin Epidemiol Program, Chiang Mai 50200, Thailand. [Patumanond, Jayanton] Thammasat Univ, Fac Med, Ctr Excellence Appl Epidemiol, Pathum Thani, Thailand. [Siriwattana, Khanchai] Nakornping Hosp, Div Med, Chiang Mai, Thailand. [Gunaparn, Siriluck; Phrommintikul, Arintaya] Chiang Mai Univ, Fac Med, Dept Internal Med, Chiang Mai 50200, Thailand. [Hall, John Joseph] Univ Newcastle, Fac Hlth, Sch Med & Publ Hlth, Ctr Clin Epidemiol & Biostat, Callaghan, NSW 2308, Australia. C3 Chiang Mai University; Chiang Mai University; Thammasat University; Chiang Mai University; University of Newcastle RP Phrommintikul, A (通讯作者),Chiang Mai Univ, Fac Med, Dept Internal Med, Chiang Mai 50200, Thailand. EM arintayap@gmail.com RI Chinwong, Surarong/AAK-4324-2021; Phrommintikul, Arintaya/X-1881-2019 OI Phrommintikul, Arintaya/0000-0003-3986-1951; Hall, John/0000-0001-9839-5626 FU Graduate School, Chiang Mai University, Thailand FX The authors thank the Graduate School, Chiang Mai University, Thailand, for its financial support of this study, the authorities of Maharaj Nakorn Chiang Mai Hospital for their permission to use the data, Claudia Koller for assistance with editing this manuscript, and Yodi Christiani, Research Centre for Gender, Health and Ageing, University of Newcastle, for her valuable suggestions regarding preparation of the manuscript. 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Clin. Risk Manag. PY 2015 VL 11 BP 127 EP 136 DI 10.2147/TCRM.S75608 PG 10 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA AZ5UF UT WOS:000348285400002 PM 25670902 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Poss, J Desch, S Thiele, H AF Poess, Janine Desch, Steffen Thiele, Holger TI Shock management in acute myocardial infarction SO EUROINTERVENTION LA English DT Article DE assist devices; cardiogenic shock; intra-aortic balloon pump; myocardial infarction; revascularisation; treatment ID PERCUTANEOUS CORONARY INTERVENTION; INTRAAORTIC BALLOON COUNTERPULSATION; VENTRICULAR ASSIST DEVICES; CARDIOGENIC-SHOCK; EARLY REVASCULARIZATION; HEART-FAILURE; CIRCULATORY SUPPORT; TASK-FORCE; THERAPY; TRIAL AB Aims: This manuscript outlines the treatment of cardiogenic shock (CS) complicating acute myocardial infarction (AMI), focusing on new therapeutic strategies from the interventional cardiologist's perspective. Methods and results: CS is a life-threatening complication of AMI occurring in 10% of AMI patients. It can be defined as a state of critical tissue and end-organ hypoperfusion due to reduced cardiac contractility. Early revascularisation is the most important therapeutic measure. Its widespread use has caused a decline in the incidence of CS. However, despite optimal treatment, the mortality rate of CS is still approaches 50%. It is now understood that CS not only involves the heart but the whole circulatory system. In order to increase the survival rates of CS patients, the right decisions have to be taken regarding the optimal revascularisation strategy, treatment with inotropes and vasopressors, mechanical left ventricular support, management of multiorgan dysfunction syndrome, additional intensive care treatment, triage among alternative hospital care levels, and allocation of clinical resources. Conclusions: CS mortality remains unacceptably high. In the light of very limited evidence regarding most treatment modalities, there is a clear need for adequately designed studies in order to answer the numerous unsettled issues. C1 [Poess, Janine; Desch, Steffen; Thiele, Holger] Univ Hosp Schleswig Holstein, Dept Internal Med Cardiol Angiol Intens Care Med, D-23538 Lubeck, Germany. C3 University of Kiel; Schleswig Holstein University Hospital RP Thiele, H (通讯作者),Univ Hosp Schleswig Holstein, Med Clin 2, Campus Lubeck,Ratzeburger Allee 160, D-23538 Lubeck, Germany. EM holger.thiele@uksh.de RI Thiele, Holger/ABE-6792-2020 OI Thiele, Holger/0000-0002-0169-998X FU Maquet Cardiovascular; Teleflex Medical FX S. Desch has received lecture fees from Maquet Cardiovascular. H. Thiele received institutional unrestricted grants from Maquet Cardiovascular and Teleflex Medical. J. Poess has no conflicts of interest to declare. 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Dyke, Cornelius M. Angiolillo, Dominick J. Ramaiahm, Chandrashekar Price, Matthew Brtko, Miroslav Welsby, Ian Chandna, Harish Holmes, David R. Voeltz, Michele Tummala, Pradyumna Hutyra, Martin Manoukian, Steven V. Prats, Jayne Todd, Meredith Liu, Tiepu Chronos, Nicholas Dietrich, Markus Montalescot, Gilles Cannon, Louis A. Topol, Eric J. TI Safety and Efficacy of Cangrelor, an Intravenous, Short-Acting Platelet Inhibitor in Patients Requiring Coronary Artery Bypass Surgery SO HEART SURGERY FORUM LA English DT Article ID OF-CARE ASSAY; MYOCARDIAL-INFARCTION; ANTIPLATELET THERAPY; CLOPIDOGREL; REACTIVITY; ASPIRIN; INTERVENTION; WITHDRAWAL; RESISTANCE; ANTIBODY AB Objective: Oral P2Y(12) platelet receptor inhibitors are a cornerstone of reducing complications in patients with acute coronary syndromes or coronary stents. Guidelines advocate discontinuing treatment with P2Y(12) platelet receptor inhibitors before surgery. Cangrelor, a short-acting, reversible, intravenously administered P2Y(12) platelet inhibitor is effective in achieving appropriate platelet inhibition in patients who are awaiting coronary artery bypass grafting (CABG) and require P2Y(12) inhibition. The objective of this study was to assess the effects of preoperative cangrelor on the incidence of perioperative complications, which are currently unknown. Methods: Patients (n = 210) requiring preoperative clinical administration of thienopyridine therapy were randomized in a multicenter, double-blinded study to receive cangrelor or placebo while awaiting CABG after discontinuation of the thienopyridine. Optimal platelet reactivity, which was defined as <240 P2Y(12) platelet reaction units, was measured with serial point-of-care testing (VerifyNow). Pre- and postoperative outcomes, bleeding values, and transfusion rates were compared. To quantify potential risk factors for bleeding, we developed a multivariate logistic model. Results: The differences between the groups in bleeding and perioperative transfusion rates were not significantly different. The rate of CABG-related bleeding was 11.8% (12/102) in cangrelor-treated patients and 10.4% (10/96) in the placebo group (P = .763). Transfusion rates for the groups were similar. Serious postoperative adverse events for the cangrelor and placebo groups were 7.8% (8/102) and 5.2% (5/96), respectively (P = .454). Conclusions: Compared with placebo, bridging patients with cangrelor prior to CABG effectively maintains platelet inhibition without increasing post-CABG complications, including bleeding and the need for transfusions. These data suggest cangrelor treatment is a potential strategy for bridging patients requiring P2Y(12) receptor inhibition while they await surgery. C1 [Firstenberg, Michael S.] Northeast Ohio Med Univ, Akron City Hosp, Dept Cardiothorac Surg, Akron, OH 44309 USA. [Dyke, Cornelius M.; Voeltz, Michele] Sanford Med Ctr, Dept Cardiovasc Surg, Fargo, ND USA. [Angiolillo, Dominick J.] Univ Florida, Dept Cardiol, Jacksonville, FL USA. [Ramaiahm, Chandrashekar] Univ Kentucky, Dept Surg, Lexington, KY USA. [Price, Matthew; Topol, Eric J.] Scripps Clin, Dept Cardiol, La Jolla, CA 92037 USA. [Price, Matthew; Topol, Eric J.] Scripps Translat Sci Inst, La Jolla, CA USA. [Brtko, Miroslav] Univ Hosp, Dept Cardiac Surg, Hradec Kralove, Czech Republic. [Welsby, Ian] Duke Univ, Durham, NC USA. [Chandna, Harish] Detar Hosp, Dept Cardiol, Victoria, TX USA. [Holmes, David R.] Mayo Clin, Dept Cardiol, Rochester, MN USA. [Tummala, Pradyumna] Northeast Georgia Heart Ctr, Dept Cardiol, Gainesville, GA USA. [Hutyra, Martin] Fac Hosp Olomouc, Internal Clin 1, Olomouc, Czech Republic. [Manoukian, Steven V.] Sarah Cannon Res Inst, Nashville, TN USA. [Prats, Jayne; Todd, Meredith; Liu, Tiepu; Dietrich, Markus] Medicines Co, Parsippany, NJ USA. [Chronos, Nicholas] St Josephs Translat Res Inst, Atlanta, GA USA. [Montalescot, Gilles] Grp Hosp Pitie Salpetriere, Dept Cardiol, F-75634 Paris, France. [Cannon, Louis A.] Northern Michigan Hosp, Cardiac & Vasc Res Ctr, Petoskey, MI USA. C3 Northeast Ohio Medical University (NEOMED); Sanford Health; State University System of Florida; University of Florida; University of Kentucky; Scripps Research Institute; Scripps Research Institute; University Hospital Hradec Kralove; Duke University; Mayo Clinic; University Hospital Olomouc; Sarah Cannon Research Institute; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite RP Firstenberg, MS (通讯作者),Northeast Ohio Med Univ, Akron City Hosp, Dept Cardiothorac Surg, Akron, OH 44309 USA. EM Michael.firstenberg@osumc.edu RI Brtko, Miroslav/ABE-3493-2020; Price, Matthew/AAJ-7679-2020 OI Brtko, Miroslav/0000-0002-9577-9736; Price, Matthew/0000-0002-7892-2430; Topol, Eric/0000-0002-1478-4729 CR AGUIRRE FV, 1995, CIRCULATION, V91, P2882, DOI 10.1161/01.CIR.91.12.2882 Anderson JL, 2011, J AM COLL CARDIOL, V57, pE215, DOI 10.1016/j.jacc.2011.02.011 Angiolillo DJ, 2012, JAMA-J AM MED ASSOC, V307, P265, DOI 10.1001/jama.2011.2002 Bennett-Guerrero E, 2005, J THORAC CARDIOV SUR, V130, P1567, DOI 10.1016/j.jtcvs.2005.07.052 Bhatt DL, 2009, NEW ENGL J MED, V361, P2330, DOI 10.1056/NEJMoa0908629 Biancari F, 2011, J THORAC CARDIOVASC, V143, P665 Bonello L, 2010, J AM COLL CARDIOL, V56, P919, DOI 10.1016/j.jacc.2010.04.047 Chen ZM, 2005, LANCET, V366, P1607, DOI 10.1016/s0140-6736(05)67660-x Collet JP, 2004, CIRCULATION, V110, P2361, DOI 10.1161/01.CIR.0000145171.89690.B4 ESPOSITO RA, 1983, J THORAC CARDIOV SUR, V85, P346 Gao CJ, 2011, BLOOD, V117, P4946, DOI 10.1182/blood-2010-09-307751 Giugliano RP, 2009, NEW ENGL J MED, V360, P2176, DOI 10.1056/NEJMoa0901316 Gurbel PA, 2003, CIRCULATION, V107, P2908, DOI 10.1161/01.CIR.0000072771.11429.83 Harrington RA, 2009, NEW ENGL J MED, V361, P2318, DOI 10.1056/NEJMoa0908628 Lewis BS, 2005, AM HEART J, V150, P1177, DOI 10.1016/j.ahj.2005.01.044 Malinin A, 2006, METHOD FIND EXP CLIN, V28, P315, DOI 10.1358/mf.2006.28.5.990205 Marcucci R, 2009, CIRCULATION, V119, P237, DOI 10.1161/CIRCULATIONAHA.108.812636 Michelson AD, 2004, CIRCULATION, V110, pE489, DOI 10.1161/01.CIR.0000147228.29325.F9 Nijjer SS, 2011, EUR HEART J, V32, P2970, DOI 10.1093/eurheartj/ehr151 Norgard NB, 2009, EXPERT OPIN INV DRUG, V18, P1219, DOI 10.1517/13543780903136708 Patti G, 2008, J AM COLL CARDIOL, V52, P1128, DOI 10.1016/j.jacc.2008.06.038 Price MJ, 2008, EUR HEART J, V29, P992, DOI 10.1093/eurheartj/ehn046 Sabatine MS, 2005, NEW ENGL J MED, V352, P1179, DOI 10.1056/NEJMoa050522 Sambu N, 2011, THROMB HAEMOSTASIS, V105, P211, DOI 10.1160/TH10-08-0554 Yusuf S, 2001, NEW ENGL J MED, V345, P494 NR 25 TC 4 Z9 8 U1 0 U2 8 PU FORUM MULTIMEDIA PUBLISHING, LLC PI CHARLOTTESVILLE PA 375 GREENBRIER DR, CHARLOTTESVILLE, VA 22901 USA SN 1098-3511 EI 1522-6662 J9 HEART SURG FORUM JI Heart Surg. Forum PD APR PY 2013 VL 16 IS 2 BP E60 EP E69 DI 10.1532/HSF98.20121103 PG 10 WC Cardiac & Cardiovascular Systems; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Surgery GA 133QL UT WOS:000318154000001 PM 23625478 DA 2023-05-13 ER PT J AU Ha, NT Hendrie, D Moorin, R AF Ninh Thi Ha Hendrie, Delia Moorin, Rachael TI Impact of population ageing on the costs of hospitalisations for cardiovascular disease: a population-based data linkage study SO BMC HEALTH SERVICES RESEARCH LA English DT Article DE Cardiovascular disease; Health expenditures; Population ageing; Data linkage ID HEALTH-CARE EXPENDITURE; AUSTRALIA; AGE; MORBIDITY; MORTALITY; GROWTH AB Background: Cardiovascular disease (CVD) is the most costly disease in Australia. Measuring the impact of ageing on its costs is needed for planning future healthcare budget. The aim of this study was to measure the impact of changes in population age structure in Western Australia (WA) on the costs of hospitalisation for CVD. Methods: All hospitalisation records for CVD occurring in WA in 1993/94 and 2003/04 inclusive were extracted from the WA Hospital Morbidity Data System (HMDS) via the WA Data Linkage System. Inflation adjusted hospitalisation costs using 2012 as the base year was assigned to all episodes of care using Australian Refined Diagnosis Related Group (AR-DRG) costing information. The component decomposition method was used to measure the contribution of ageing and other factors to the increase of hospitalisation costs for CVD. Results: Between 1993/94 and 2003/04, population ageing contributed 23% and 30% respectively of the increase in CVD hospitalisation costs for men and women. The impact of ageing on hospitalisation costs was far greater for chronic conditions than acute coronary syndrome (ACS) and stroke. Conclusions: Given the impact of ageing on hospitalisation costs, and the disparity between chronic and acute conditions, disease-specific factors should be considered in planning for future healthcare expenditure. C1 [Ninh Thi Ha] Inst Publ Hlth Ho Chi Minh City, Dept Community Hlth, Ho Chi Minh City, Vietnam. [Hendrie, Delia] Curtin Univ, Sch Publ Hlth, Perth, WA 6845, Australia. [Moorin, Rachael] Curtin Univ, Fac Hlth Sci, Perth, WA 6845, Australia. C3 Curtin University; Curtin University RP Ha, NT (通讯作者),Inst Publ Hlth Ho Chi Minh City, Dept Community Hlth, 159 Hung Phu St,Dist 8, Ho Chi Minh City, Vietnam. EM ninh.ha05@gmail.com RI Moorin, Rachael/AAQ-3650-2020; Ha, Thi Ninh/AAE-3366-2021 OI Moorin, Rachael/0000-0001-8742-7151; Ha, Thi Ninh/0000-0002-2789-5604; Hendrie, Delia/0000-0001-5022-5281 CR AIHW, 2011, CARD DIS SER, V53 AIHW, 2012, HLTH WELF EXP SER, V47, P10 Alemayehu B, 2004, HEALTH SERV RES, V39, P627, DOI 10.1111/j.1475-6773.2004.00248.x [Anonymous], 2010, POPULATION AGE SEX A Banham D, 2011, POPUL HEALTH METR, V9, DOI 10.1186/1478-7954-9-13 Breyer F, 2010, OXFORD REV ECON POL, V26, P674, DOI 10.1093/oxrep/grq032 Carreras M, 2013, BMC HEALTH SERV RES, V13, DOI 10.1186/1472-6963-13-440 Commonwealth Department of Health and Ageing, NAT HOSP COST DAT CO Cooper C, 1999, DEP HLTH AGED CARE O, V7 Dai DF, 2012, ANTIOXID REDOX SIGN, V16, P1492, DOI 10.1089/ars.2011.4179 Dormont B, 2006, HEALTH ECON, V15, P947, DOI 10.1002/hec.1165 Gandjour A, 2005, APPL HEALTH ECON HEA, V4, P1, DOI 10.2165/00148365-200504010-00001 Gray A, 2005, AGE HORIZONS, P15 Herwartz H, 2003, HEALTH ECON, V12, P113, DOI 10.1002/hec.700 Holman CDJ, 1999, AUST NZ J PUBL HEAL, V23, P453, DOI 10.1111/j.1467-842X.1999.tb01297.x Karavidas A, 2010, HELL J CARDIOL, V51, P421 Kildemoes HW, 2006, HEALTH POLICY, V75, P298, DOI 10.1016/j.healthpol.2005.03.013 Kuwabara K, 2008, J HEALTH SERV RES PO, V13, P26, DOI 10.1258/jhsrp.2007.007009 Lynch C, 2007, AUST HEALTH REV, V31, P571, DOI 10.1071/AH070571 Martini EM, 2007, HEALTH SERV RES, V42, P201, DOI 10.1111/j.1475-6773.2006.00607.x MENDELSON DN, 1993, HEALTH AFFAIR, V12, P119, DOI 10.1377/hlthaff.12.1.119 Najafi F, 2006, B WORLD HEALTH ORGAN, V84, P722, DOI 10.2471/BLT.06.031286 Nedkoff LJ, 2011, CIRC-CARDIOVASC QUAL, V4, P557, DOI 10.1161/CIRCOUTCOMES.110.960005 OConnell JM, 1996, HEALTH ECON, V5, P573, DOI 10.1002/(SICI)1099-1050(199611)5:6<573::AID-HEC231>3.0.CO;2-L Productivity Commission, 2005, EC IMPL AG AUSTR RES Schofield Deborah J, 2006, Aust Health Rev, V30, P507 Tchoe B, 2010, INT J ENV RES PUB HE, V7, P3235, DOI 10.3390/ijerph7083235 Woodall J, 2008, HLTH CARE EXPENDITUR Yamamoto DH, 2013, HLTH CARE COST I IND, V2013-1, pi NR 29 TC 15 Z9 16 U1 0 U2 16 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD NOV 13 PY 2014 VL 14 AR 554 DI 10.1186/s12913-014-0554-9 PG 7 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA CB5AH UT WOS:000349639400001 PM 25392132 OA gold, Green Published DA 2023-05-13 ER PT J AU Anderson, ML Peterson, ED Peng, SA Wang, TY Ohman, EM Bhatt, DL Saucedo, JF Roe, MT AF Anderson, Monique L. Peterson, Eric D. Peng, S. Andrew Wang, Tracy Y. Ohman, E. Magnus Bhatt, Deepak L. Saucedo, Jorge F. Roe, Matthew T. TI Differences in the Profile, Treatment, and Prognosis of Patients With Cardiogenic Shock by Myocardial Infarction Classification A Report From NCDR SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE myocardial infarction; outcome assessment; shock, cardiogenic ID ST-SEGMENT ELEVATION; ACUTE CORONARY SYNDROMES; EARLY REVASCULARIZATION; QUALITY IMPROVEMENT; TEMPORAL TRENDS; MANAGEMENT STRATEGIES; SURVIVAL BENEFIT; ELDERLY-PATIENTS; OUTCOMES; INTERVENTION AB Background-Cardiogenic shock is a deadly complication of an acute myocardial infarction (MI). We sought to characterize differences in patient features, treatments, and outcomes of cardiogenic shock by MI classification: ST-segment-elevation MI (STEMI) versus non-ST-segment elevation MI (NSTEMI). Methods and Results-We compared differences in care by the shock status of 235 541 patients with STEMI and NSTEMI treated at 392 US hospitals from 2007 to 2011. Cardiogenic shock occurred in 12.2% of patients with STEMI versus 4.3% of patients with NSTEMI. Compared with STEMI shock, NSTEMI shock was more likely in patients who were older and predominantly women; had diabetes mellitus, hypertension, previous heart failure, MI, or peripheral arterial disease; and who received coronary artery bypass grafting (11.6% versus 21.2%; P<0.0001) but less likely to have received percutaneous coronary intervention (84.2% versus 35.3%; P<0.0001). Compared with patients with STEMI presenting with shock at admission, patients with NSTEMI presenting with shock had longer delays to percutaneous coronary intervention (1.2 versus 3.2 hours) and coronary artery bypass grafting (7.9 versus 55.9 hours). Cardiogenic shock in patients with STEMI was associated with a lower mortality risk (33.1% shock versus 2.0% no shock; adjusted odds ratio, 14.1; 95% confidence interval, 13.0-15.4; interaction P value <0.0001) compared with patients with NSTEMI (40.8% shock versus 2.3% no shock, odds ratio, 19.0; 95% confidence interval, 17.1-21.2). Conclusions-Cardiogenic shock is associated with high mortality in patients with STEMI and NSTEMI. However, urgent revascularization is more commonly pursued in patients with STEMI presenting with shock than in patients with NSTEMI. More research is needed to improve the outcomes for patients with MI presenting with shock, particularly those presenting with NSTEMI. C1 [Anderson, Monique L.; Peterson, Eric D.; Peng, S. Andrew; Wang, Tracy Y.; Ohman, E. Magnus; Roe, Matthew T.] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA. [Bhatt, Deepak L.] Harvard Univ, Brigham & Womens Hosp, Sch Med, VA Boston Healthcare Syst, Boston, MA 02115 USA. [Saucedo, Jorge F.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. C3 Duke University; Harvard University; Brigham & Women's Hospital; Harvard Medical School; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Boston Healthcare System; University of Oklahoma System; University of Oklahoma Health Sciences Center RP Anderson, ML (通讯作者),7022 North Pavil DUMC,POB 17969, Durham, NC 27715 USA. EM monique.anderson@duke.edu RI Peterson, Eric David/ABF-5033-2021 FU American College of Cardiology Foundation's NCDR FX This research was supported by the American College of Cardiology Foundation's NCDR. The views expressed in this article represent those of the author(s) and do not necessarily represent the official views of the NCDR or its associated professional societies identified at www.ncdr.com. CR Abbott JD, 2007, AM J CARDIOL, V100, P190, DOI 10.1016/j.amjcard.2007.02.083 Abdel-Qadir HM, 2011, CIRC-CARDIOVASC QUAL, V4, P440, DOI 10.1161/CIRCOUTCOMES.110.959262 Amin AP, 2009, J INVASIVE CARDIOL, V21, P305 Amsterdam EA, 2009, AM HEART J, V158, P748, DOI 10.1016/j.ahj.2009.09.008 Anderson JL, 2007, CIRCULATION, V116, pE148, DOI 10.1161/CIRCULATIONAHA.107.181940 Babaev A, 2005, JAMA-J AM MED ASSOC, V294, P448, DOI 10.1001/jama.294.4.448 Bhatt DL, 2004, JAMA-J AM MED ASSOC, V292, P2096, DOI 10.1001/jama.292.17.2096 Carnendran L, 2001, EUR HEART J, V22, P472, DOI 10.1053/euhj.2000.2312 Chin CT, 2011, AM HEART J, V161, DOI 10.1016/j.ahj.2010.10.004 Dauerman HL, 2002, AM J CARDIOL, V90, P838, DOI 10.1016/S0002-9149(02)02704-2 Dzavik V, 2005, AM HEART J, V149, P1128, DOI 10.1016/j.ahj.2005.03.045 Fang J, 2004, AM J CARDIOL, V94, P1281, DOI 10.1016/j.amjcard.2004.07.113 Farkouh ME, 2006, CLIN CARDIOL, V29, P204, DOI 10.1002/clc.4960290507 Gierlotka M, 2012, AM J CARDIOL, V109, P779, DOI 10.1016/j.amjcard.2011.10.041 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hochman JS, 1999, NEW ENGL J MED, V341, P625, DOI 10.1056/NEJM199908263410901 Hochman JS, 1999, AM HEART J, V137, P313, DOI 10.1053/hj.1999.v137.95352 Hochman JS, 2006, JAMA-J AM MED ASSOC, V295, P2511, DOI 10.1001/jama.295.21.2511 Holmes DR, 1999, CIRCULATION, V100, P2067, DOI 10.1161/01.CIR.100.20.2067 Jacobs AK, 2000, J AM COLL CARDIOL, V36, P1091, DOI 10.1016/S0735-1097(00)00888-3 Jeger RV, 2008, ANN INTERN MED, V149, P618, DOI 10.7326/0003-4819-149-9-200811040-00005 Jeger Raban V, 2011, Acute Card Care, V13, P14, DOI 10.3109/17482941.2010.538696 Jeger RV, 2006, EUR HEART J, V27, P664, DOI 10.1093/eurheartj/ehi729 Lim HS, 2009, JACC-CARDIOVASC INTE, V2, P146, DOI 10.1016/j.jcin.2008.11.006 O'Gara PT, 2013, J AM COLL CARDIOL, V61, pE78, DOI [10.1016/j.jacc.2012.11.019, 10.1161/01.cir.0000440804.93914.d8, 10.1161/CIR.0b013e3182742cf6] Peterson ED, 2010, HEART, V96, P1798, DOI 10.1136/hrt.2010.200261 Peterson ED, 2009, CIRC-CARDIOVASC QUAL, V2, P491, DOI 10.1161/CIRCOUTCOMES.108.847145 Roe MT, 2005, ARCH INTERN MED, V165, P1630, DOI 10.1001/archinte.165.14.1630 Shahian DM, 2009, ANN THORAC SURG, V88, pS2, DOI 10.1016/j.athoracsur.2009.05.053 Tricoci P, 2006, AM J CARDIOL, V98, P1172, DOI 10.1016/j.amjcard.2006.05.047 ZEGER SL, 1986, BIOMETRICS, V42, P121, DOI 10.2307/2531248 NR 31 TC 87 Z9 91 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1941-7705 EI 1941-7713 J9 CIRC-CARDIOVASC QUAL JI Circ.-Cardiovasc. Qual. Outcomes PD NOV PY 2013 VL 6 IS 6 BP 708 EP 715 DI 10.1161/CIRCOUTCOMES.113.000262 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 298ZA UT WOS:000330362400020 PM 24221834 OA Bronze DA 2023-05-13 ER PT J AU Abellas-Sequeiros, RA Raposeiras-Roubin, S Abu-Assi, E Gonzalez-Salvado, V Iglesias-Alvarez, D Redondo-Dieguez, A Gonzalez-Ferreiro, R Ocaranza-Sanchez, R Pena-Gil, C Garcia-Acuna, JM Gonzalez-Juanatey, JR AF Abellas-Sequeiros, R. A. Raposeiras-Roubin, S. Abu-Assi, E. Gonzalez-Salvado, V. Iglesias-Alvarez, D. Redondo-Dieguez, A. Gonzalez-Ferreiro, R. Ocaranza-Sanchez, R. Pena-Gil, C. Garcia-Acuna, J. M. Gonzalez-Juanatey, J. R. TI Mehran contrast nephropathy risk score: Is it still useful 10 years later? SO JOURNAL OF CARDIOLOGY LA English DT Article DE Renal function; Coronary angiography; Contrast ID PERCUTANEOUS CORONARY INTERVENTION; PREDICTION; HYDRATION; MORTALITY; DIURESIS; OUTCOMES; MARKER; IMPACT AB Background: Nowadays, contrast-induced nephropathy (CIN) is the third cause of acquired acute renal impairment in hospital. CIN is related to increased in-hospital morbidity, mortality, costs of medical care, and long admissions. Because of this, we hypothesized it would be useful to determine the risk of CIN with scores such as the Mehran score. The aim of this study was to validate the Mehran score in a contemporary cohort of Spanish patients with acute coronary syndrome (ACS). Methods: We assessed the calibration and discriminatory capacity of Mehran score to predict CIN in a cohort of 1520 patients with a definitive diagnosis of ACS and who underwent coronary angiography between March 2008 and June 2012. We excluded patients on chronic dialysis and those without data of contrast volume. The calibration of the model was assessed with the Hosmer-Lemeshow goodness-of-fit test and discriminatory capacity was assessed by C-statistic, which is equivalent to the area under the receiver-operating characteristic curve. Results: From the total group, 118 patients (7.8%) developed CIN. They were older, with higher rates of diabetes (DM) and hypertension and worse renal function and anemia (p < 0.001). The odds ratios for different score components in Mehran's population versus our study were similar except for DM, hypotension, and intra-aortic balloon pump (1.6%, 2.68%, 2.55% vs 0.9%, 1.89%, and 2.86%, respectively). Calibration and discriminatory capacity of Mehran score were excellent with a Hosmer-Lemeshow p = 0.7, C-statistic value >0.8. Conclusions: Mehran risk score has been validated in our study as a good score for predicting CIN in patients with ACS who underwent coronary angiography. According to this, we support its use in patients hospitalized for ACS in order to identify the ones at risk, and to optimize CIN prophylactic therapy prior to and after catheterization. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. C1 [Abellas-Sequeiros, R. A.] Univ Clin Hosp Santiago de Compostela, Dept Cardiol, Choupana S-N, Santiago De Compostela 15706, A Coruna, Spain. [Abellas-Sequeiros, R. A.] Univ Clin Hosp Santiago de Compostela, Coronary Care Unit, Choupana S-N, Santiago De Compostela 15706, A Coruna, Spain. C3 Complexo Hospitalario Universitario de Santiago de Compostela; Complexo Hospitalario Universitario de Santiago de Compostela RP Abellas-Sequeiros, RA (通讯作者),Univ Clin Hosp Santiago de Compostela, Dept Cardiol, Choupana S-N, Santiago De Compostela 15706, A Coruna, Spain.; Abellas-Sequeiros, RA (通讯作者),Univ Clin Hosp Santiago de Compostela, Coronary Care Unit, Choupana S-N, Santiago De Compostela 15706, A Coruna, Spain. EM albaabellas@gmail.com RI Iglesias-Álvarez, Diego/AFO-3277-2022; ACUÑA, JOSE MARIA GARCIA/Z-1972-2019; ROUBIN, SERGIO RAPOSEIRAS/Y-8641-2019 OI ACUÑA, JOSE MARIA GARCIA/0000-0003-0119-1710; Gonzalez Juanatey, Jose Ramon/0000-0001-9681-3388; Pena-Gil, Carlos/0000-0002-5263-5572; Iglesias, Diego/0000-0002-6896-9593; RAPOSEIRAS-ROUBIN, SERGIO/0000-0002-6462-4715; Gonzalez Ferreiro, Rocio/0000-0001-8312-4874 CR Abu-Assi E, 2010, CIRCULATION, V121, P2419, DOI 10.1161/CIRCULATIONAHA.109.925594 Bartholomew BA, 2004, AM J CARDIOL, V93, P1515, DOI 10.1016/j.amjcard.2004.03.008 Briguori C, 2014, LANCET, V383, P1786, DOI 10.1016/S0140-6736(14)60753-4 Chen SL, 2008, INT J CARDIOL, V126, P407, DOI 10.1016/j.ijcard.2007.05.004 Fu NK, 2013, ANGIOLOGY, V64, P188, DOI 10.1177/0003319712467224 Gao YM, 2014, CLIN EXP NEPHROL, V18, P892, DOI 10.1007/s10157-014-0942-9 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Gurm HS, 2013, J AM COLL CARDIOL, V61, P2242, DOI 10.1016/j.jacc.2013.03.026 Gurm HS, 2012, JACC-CARDIOVASC INTE, V5, P98, DOI 10.1016/j.jcin.2011.09.019 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 HANLEY JA, 1982, RADIOLOGY, V143, P29, DOI 10.1148/radiology.143.1.7063747 LEMESHOW S, 1982, AM J EPIDEMIOL, V115, P92, DOI 10.1093/oxfordjournals.aje.a113284 Leoncini M, 2014, J AM COLL CARDIOL, V63, P71, DOI 10.1016/j.jacc.2013.04.105 Maeder M, 2004, J AM COLL CARDIOL, V44, P1763, DOI 10.1016/j.jacc.2004.06.075 Marenzi G, 2004, J AM COLL CARDIOL, V44, P1780, DOI 10.1016/j.jacc.2004.07.043 Marenzi G, 2012, JACC-CARDIOVASC INTE, V5, P90, DOI 10.1016/j.jcin.2011.08.017 Mehran R, 2004, J AM COLL CARDIOL, V44, P1393, DOI 10.1016/j.jacc.2004.06.068 Mehran R, 2010, J AM COLL CARDIOL, V55, P2210, DOI 10.1016/j.jacc.2009.12.051 Ota H, 2013, J CARDIOL, V62, P277, DOI 10.1016/j.jjcc.2013.05.002 Rihal CS, 2002, CIRCULATION, V105, P2259, DOI 10.1161/01.CIR.0000016043.87291.33 Solomon R, 2014, J CARDIOL, V63, P9, DOI 10.1016/j.jjcc.2013.10.001 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Subherwal S, 2009, CIRCULATION, V119, P1873, DOI 10.1161/CIRCULATIONAHA.108.828541 Tziakas D, 2013, INT J CARDIOL, V163, P46, DOI 10.1016/j.ijcard.2011.05.079 NR 24 TC 33 Z9 39 U1 0 U2 3 PU ELSEVIER PI AMSTERDAM PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS SN 0914-5087 EI 1876-4738 J9 J CARDIOL JI J. Cardiol. PD MAR-APR PY 2016 VL 67 IS 3-4 BP 262 EP 267 DI 10.1016/j.jjcc.2015.05.007 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DK2CR UT WOS:000374722700008 PM 26169247 OA Bronze DA 2023-05-13 ER PT J AU Rokyta, R Pechman, V Tousek, P Pudil, R Lhotska, J Widimsky, P AF Rokyta, R. Pechman, V. Tousek, P. Pudil, R. Lhotska, J. Widimsky, P. TI Routine pretreatment with abciximab versus standard periprocedural therapy in mechanically ventilated cardiogenic shock patients undergoing primary percutaneous coronary intervention: Subanalysis of the PRAGUE-7 study SO EXPERIMENTAL & CLINICAL CARDIOLOGY LA English DT Article DE Abciximab; Acute coronary syndrome; Cardiogenic shock; Intensive care; Mechanical ventilation; Percutaneous coronary intervention ID ACUTE MYOCARDIAL-INFARCTION; RANDOMIZED-TRIAL; CLOPIDOGREL; MANAGEMENT; OUTCOMES; REVASCULARIZATION; REGISTRY; TRENDS; DEATH; INDEX AB BACKGROUND: The clinical outcome of patients with myocardial infarction (MI) complicated by cardiogenic shock (CS) who require mechanical ventilation (MV) is poor. OBJECTIVE: To analyze the impact of abciximab pretreatment in this high-risk population of MI patients. METHODS: The present study was a retrospective subanalysis of the multicentre randomized Routine Upfront Abciximab Versus Standard Peri-Procedural Therapy in Patients Undergoing Percutaneous Coronary Intervention for Cardiogenic Shock (PRAGUE-7) study, which included 80 MI patients in CS undergoing primary percutaneous coronary intervention (PCI). Patients were randomly assigned into group A (routine pretreatment with an abciximab bolus followed by a 1 h abciximab infusion) and group B (standard therapy). The subanalysis included 37 patients requiring MV. Seventeen patients were in group A and 20 were in group B. The primary end point (death/stroke/reinfarction/new severe renal failure) at 30 days, procedural success (thrombosis in myocardial infarction [TIMI] flow) and frequency of bleeding were assessed. The chi(2) and Student's t tests were used for statistical analysis; P<0.05 was considered to be statistically significant. RESULTS: The primary end point occurred in nine (53%) patients in group A and 12 (60%) patients in group B (P=0.66). TIMI flow after primary PCI was higher in group A (2.75 versus 2.31; P<0.05). Major bleeding occurred in 12% of patients in group A versus 10% of patients in group B (P=0.86). Minor or minimal bleeding was more common in group A (29%) compared with group B (5%; P<0.05). CONCLUSION: The results of the present study suggest that routine pretreatment with abciximab before primary PCI in mechanically ventilated patients with MI complicated by cardiogenic shock was associated with better angiographic results but also with a higher incidence of bleeding. C1 [Rokyta, R.; Pechman, V.; Lhotska, J.] Univ Hosp Plzen, Dept Cardiol, Fac Med, Plzen 32300, Czech Republic. [Tousek, P.; Widimsky, P.] Charles Univ Prague, Cardioctr, Fac Med 3, Univ Hosp Vinohrady, Prague, Czech Republic. [Pudil, R.] Charles Univ Prague, Dept Internal Med, Univ Hosp, Hradec Kralove, Czech Republic. C3 University Hospital Plzen; Charles University Prague; University Hospital Vinohrady; Charles University Prague; University Hospital Hradec Kralove RP Pechman, V (通讯作者),Univ Hosp Plzen, Alej Svobody 13, Plzen 32300, Czech Republic. EM pechman@fnplzen.cz RI Pudil, Radek/J-7004-2018; Widimsky, Petr/P-8088-2016; Rokyta, Richard/U-1576-2017; Tousek, Petr/P-3455-2016 OI Pudil, Radek/0000-0002-4042-7100; Widimsky, Petr/0000-0001-5686-7752; Rokyta, Richard/0000-0003-2273-2766; Tousek, Petr/0000-0002-2598-3635 FU Charles University [P36]; Ministry of Health, Czech Republic [00669806] FX The study was supported by the Charles University Research Fund (project number P36) and the project Ministry of Health, Czech Republic for conceptual development of research organization 00669806 - Faculty Hospital in Pilsen. 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Clin. Cardiol. PD SUM PY 2013 VL 18 IS 2 BP 81 EP 84 PG 4 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 191UU UT WOS:000322439400015 PM 23940425 DA 2023-05-13 ER PT J AU Reardon, L Scheels, WJ Singer, AJ Reardon, RF AF Reardon, Lindsay Scheels, William J. Singer, Adam J. Reardon, Robert F. TI Feasibility and accuracy of speckle tracking echocardiography in emergency department patients SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-for-Academic-Emergency-Medicine (SAEM) CY MAY 15-18, 2018 CL Indianapolis, IN SP Soc Acad Emergency Med DE Point-of-care ultrasound; Echocardiography; Emergency ultrasound; Speckle tracking echocardiography; Strain echocardiography ID ACUTE CORONARY SYNDROME; STRAIN ECHOCARDIOGRAPHY AB Background: Speckle tracking echocardiography (STE) is a novel technology that measures regional wall-motion abnormalities thatmay speed diagnosis and intervention of acute coronary occlusion in Emergency Department (ED) patients with non-ST elevation ACS (NSTE-ACS). STE provides an objective measurement of myocardial strain that is superior to visual assessment of wall motion when performed as part of a point-of-care (POC) echocardiogram. We determined the feasibility and preliminary accuracy of POC STE operated by emergency providers when compared to comprehensive echocardiography or final diagnosis of ACS. Methods: We retrospectively reviewed 187 emergency provider POC echocardiograms with STE from 7/2014-5/ 2016 for suspected ACS at a large academic trauma center. Feasibility of POC STE was determined by calculating the percentage of complete exams (adequate apical 4-chamber and parasternal short axis views) out of all STE exams. Wethen used two different criterion standards for calculating diagnostic accuracy of STE: comprehensive echocardiogramswithwallmotion abnormalities or formal diagnosis of ACS based on elevated cardiac troponins, unstable angina, percutaneous coronary intervention, or coronary artery stenosis N70% on catheterization. Results: Of 187 STE studies performed, 75 (40%) were considered complete. Ultrasound-experienced providers had higher rates of complete exams (65% vs. 35%, P= 0.01). 16 of 75 exams (21%) were positive for myocardial strain, and of these 16 (100%) were admitted, 12 (75%) had positive troponins, 6 (46%) had positive comprehensive echocardiograms, and 3 (19%) had PCI or N70% stenotic lesion on catheterization. Compared with comprehensive echocardiography, POC STE had 35% sensitivity, 70% specificity, 46% positive predictive value (PPV), and 59% negative predictive value (NPV). Compared with formal diagnosis of ACS, POC STE had 29% sensitivity, 88% specificity, 75% positive predictive value (PPV), and 51% negative predictive value (NPV). Conclusion: STE is a potentially feasible adjunct to standard bedside echocardiography in ED patients with suspected ACS when operated by experienced ultrasound-trained physicians in the ED. This data shows STE performed by emergency providers is not yet sensitive enough alone to diagnose ACS, and has low accuracy when compared to comprehensive echocardiography. However, the PPV and specificity improve when performed by expert ultrasound-trained providers. STE should be considered for inclusion in the Emergency Ultrasound Fellowship curriculum. Published by Elsevier Inc. C1 [Reardon, Lindsay; Scheels, William J.; Reardon, Robert F.] Hennepin Cty Med Ctr, Dept Emergency Med, Minneapolis, MN 55415 USA. [Reardon, Lindsay; Singer, Adam J.] SUNY Stony Brook, Dept Emergency Med, HSC L4-080, Stony Brook, NY 11794 USA. [Scheels, William J.] Med Coll Wisconsin, Dept Emergency Med, Milwaukee, WI 53226 USA. C3 Hennepin County Medical Center; State University of New York (SUNY) System; State University of New York (SUNY) Stony Brook; Medical College of Wisconsin RP Reardon, L (通讯作者),SUNY Stony Brook, Dept Emergency Med, HSC L4-080, Stony Brook, NY 11794 USA. EM Lindsay.Reardon@stonybrookmedicine.edu; WJScheels@mcw.edu; Adam.Singer@stonybrookmedicine.edu; Robert.Reardon@hcmed.org CR Ammar KA, 2012, ECHOCARDIOGR-J CARD, V29, P861, DOI 10.1111/j.1540-8175.2012.01712.x Bansal Manish, 2013, Indian Heart J, V65, P117, DOI 10.1016/j.ihj.2012.12.004 Caspar T, 2017, INT J CARDIOL, V236, P91, DOI 10.1016/j.ijcard.2017.02.068 Chan J, 2017, J AM SOC ECHOCARDIOG, V30, P1081, DOI 10.1016/j.echo.2017.06.010 Dahlslett T, 2014, J AM SOC ECHOCARDIOG, V27, P512, DOI 10.1016/j.echo.2014.01.019 Eek C, 2010, EUR J ECHOCARDIOGR, V11, P501, DOI 10.1093/ejechocard/jeq008 Favot M, 2016, WEST J EMERG MED, V17, P54, DOI 10.5811/westjem.2015.12.28521 Grenne B, 2010, HEART, V96, P1550, DOI 10.1136/hrt.2009.188391 Mor-Avi V, 2011, J AM SOC ECHOCARDIOG, V24, P277, DOI 10.1016/j.echo.2011.01.015 National Academies of Sciences Engineering and Medicine, 2017, NATL MALARIA ELIMINA, P1 Rowland-Fisher A, 2016, AM J EMERG MED, V34, DOI 10.1016/j.ajem.2016.02.017 Sjoli B, 2009, JACC-CARDIOVASC IMAG, V2, P24, DOI 10.1016/j.jcmg.2008.10.007 NR 12 TC 8 Z9 8 U1 1 U2 6 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0735-6757 EI 1532-8171 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD DEC PY 2018 VL 36 IS 12 BP 2254 EP 2259 DI 10.1016/j.ajem.2018.08.074 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S) SC Emergency Medicine GA HB4MM UT WOS:000451027100021 PM 30322665 DA 2023-05-13 ER PT J AU Princip, M Pazhenkottil, AP Barth, J Schnyder, U Znoj, H Schmid, JP Langraf-Meister, RE von Kaenel, R Ledermann, K AF Princip, Mary Pazhenkottil, Aju P. Barth, Juergen Schnyder, Ulrich Znoj, Hansjoerg Schmid, Jean-Paul Langraf-Meister, Rebecca E. von Kaenel, Roland Ledermann, Katharina TI Effect of Early Psychological Counseling for the Prevention of Posttraumatic Stress Induced by Acute Coronary Syndrome at Long-Term Follow-Up SO FRONTIERS IN PSYCHIATRY LA English DT Article DE posttraumatic stress symptoms; myocardial infarction; early prevention; counseling; acute trauma stress; acute coronary care; behavioral cardiology ID SELF-REPORT MEASURE; MYOCARDIAL-INFARCTION; CARDIAC-DISEASE; DISORDER; PTSD; SYMPTOMS; INTERVENTION; INVENTORY AB ObjectivePsychological consequences of myocardial infarction (MI) are substantial, as 4% of all MI patients develop posttraumatic stress disorder (PTSD) and 12% clinically relevant posttraumatic stress symptoms (PTSS). The study investigated the course and development within 12 months of MI-induced PTSS to gain novel insights in potentially delayed response to early trauma-focused counseling aimed at preventing the incidence of MI-induced PTSS. MethodsIn the MI-SPRINT two-group randomized controlled trial, 190 MI-patients were randomly allocated to receive a single-session intervention of either trauma-focused counseling or an active control intervention targeting the general role of stress in patients with heart disease. Blind interviewer-rated PTSS (primary outcome) and additional health outcomes were assessed at 12-month follow-up. Results12-month follow-up of outcomes were available for 106 (55.8%) of 190 participants: In the entire sample, one patient (0 center dot 5%, 1/190) who received trauma-focused counseling developed full PTSD. There was no significant difference between trauma-focused counseling and stress counseling regarding total score of interviewer-rated PTSS (p > 0.05). The only group difference emerged in terms of more severe hyperarousal symptoms in the trauma-focused counseling group in the ITT analysis, but not in the completer analysis. ConclusionsNo benefits were found for trauma-focused counseling after 12 months when compared with an active control intervention. PTSD prevalence in the present study was low highlighting a potential beneficial effect of both interventions. Further studies are needed to determine the most accurate approach of counseling. C1 [Princip, Mary; Pazhenkottil, Aju P.; Schnyder, Ulrich; Langraf-Meister, Rebecca E.; von Kaenel, Roland; Ledermann, Katharina] Univ Zurich, Univ Hosp Zurich, Dept Consultat Liaison Psychiat & Psychosomat Med, Zurich, Switzerland. [Pazhenkottil, Aju P.] Univ Zurich, Univ Hosp Zurich, Dept Cardiol, Zurich, Switzerland. [Pazhenkottil, Aju P.] Univ Zurich, Univ Hosp Zurich, Dept Nucl Med, Cardiac Imaging, Zurich, Switzerland. [Barth, Juergen] Univ Zurich, Univ Hosp Zurich, Inst Complementary & Integrat Med, Zurich, Switzerland. [Znoj, Hansjoerg] Univ Bern, Dept Clin Psychol & Psychotherapy, Bern, Switzerland. [Schmid, Jean-Paul] Dept Cardiol, Clin Gais, Gais, Switzerland. [Langraf-Meister, Rebecca E.] Clienia Schlossli AG, Oetwil See, Switzerland. [Ledermann, Katharina] Univ Fribourg, Dept Clin & Hlth Psychol, Fribourg, Switzerland. C3 University of Zurich; University Zurich Hospital; University of Zurich; University Zurich Hospital; University of Zurich; University Zurich Hospital; University of Zurich; University Zurich Hospital; University of Bern; University of Fribourg RP Princip, M (通讯作者),Univ Zurich, Univ Hosp Zurich, Dept Consultat Liaison Psychiat & Psychosomat Med, Zurich, Switzerland. EM mary.princip@usz.ch OI Pazhenkottil, Aju/0000-0002-8847-2154 FU Swiss National Science Foundation [140960]; Teaching and Research Directorate, Bern University Hospital, Switzerland FX Funding The MI-SPRINT study is funded by the Swiss National Science Foundation (Project Number 140960, principal investigator: RK). Additional financial support comes from the Teaching and Research Directorate, Bern University Hospital, Switzerland. The funding bodies had no influence on the study design, in the writing of the manuscript, and in the decision to submit the manuscript for publication. 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Psychiatry PD MAY 30 PY 2022 VL 13 AR 846397 DI 10.3389/fpsyt.2022.846397 PG 8 WC Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry GA 2D1EK UT WOS:000811298800001 PM 35711604 OA Green Published, gold DA 2023-05-13 ER PT J AU Mantel, A Holmqvist, M Jernberg, T Wallberg-Jonsson, S Askling, J AF Mantel, Angla Holmqvist, Marie Jernberg, Tomas Wallberg-Jonsson, Solveig Askling, Johan TI Long-term outcomes and secondary prevention after acute coronary events in patients with rheumatoid arthritis SO ANNALS OF THE RHEUMATIC DISEASES LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; POPULATION-BASED COHORT; IMPAIRED PROGNOSIS; THERAPY; ADHERENCE; RISK; DISCONTINUATION; METAANALYSIS; MORTALITY; DISEASE AB Objectives Patients with rheumatoid arthritis (RA) are at increased risk of acute coronary syndrome (ACS) and suffer from poorer short-term outcomes after ACS. The aims of this study were to assess long-term outcomes in patients with RA with ACS compared with non-RA patients with ACS, and to investigate whether the use of secondary preventive drugs could explain any differences in ACS outcome. Methods We performed a cohort study based on 1135 patients with RA and 3184 non-RA patients who all developed an incident ACS between 2007 and 2010. We assessed 1-year and overall relative risks for ACS recurrence and mortality, as well as prescriptions of standard of care secondary preventive drugs. Results The risk of ACS recurrence, and of mortality, was increased in RA, both at 1 year after adjusting for baseline comorbidities (HR=1.30(95% CI 1.04 to 1.62) and 1.38(95% CI 1.20 to 1.59), respectively) and throughout the complete (mean 2 years) followup (HR=1.27(95% CI 1.06 to 1.52) and 1.50(95% CI 1.34 to 1.68), respectively). Among certain subgroups of ACS, there was a tendency of lower usage of statins, whereas there were no apparent differences in others. The increased rates of ACS recurrence and mortality remained in subgroup analyses of individuals whose prescription pattern indicated both adequate initiation and persistence to secondary preventive treatments. Conclusions Patients with RA suffer from an increased risk of ACS recurrence and of death following ACS compared with general population, which in the present study could not readily be explained by differences in usage of secondary preventive drugs. C1 [Mantel, Angla; Holmqvist, Marie; Askling, Johan] Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden. [Holmqvist, Marie; Askling, Johan] Karolinska Univ Hosp, Dept Rheumatol, Stockholm, Sweden. [Jernberg, Tomas] Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden. [Wallberg-Jonsson, Solveig] Umea Univ Hosp, Dept Publ Hlth & Clin Med Rheumatol, Umea, Sweden. C3 Karolinska Institutet; Karolinska Institutet; Karolinska University Hospital; Danderyds Hospital; Karolinska Institutet; Umea University RP Mantel, A (通讯作者),Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden. EM angla.mantel@ki.se RI Holmqvist, Marie/D-4508-2017; Mantel, Angla/HZI-2528-2023 OI Holmqvist, Marie/0000-0001-8996-5260; Askling, Johan/0000-0003-0433-0616; Jernberg, Tomas/0000-0003-1695-379X FU Swedish Research Council; Swedish Foundation for Strategic Research; Stockholm County Council (ALF); Heart Lung Foundation; Swedish Cancer Society; Karolinska Institutet (Strategic Research Area Epidemiology) FX The Swedish Research Council, The Swedish Foundation for Strategic Research, Stockholm County Council (ALF), The Heart Lung Foundation, The Swedish Cancer Society, Karolinska Institutet (Strategic Research Area Epidemiology). Funders had no impact on the design or interpretation of the study or its results. 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Rheum. Dis. PD DEC PY 2017 VL 76 IS 12 BP 2017 EP 2024 DI 10.1136/annrheumdis-2017-211608 PG 8 WC Rheumatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Rheumatology GA FO7NA UT WOS:000417061500016 PM 28823986 DA 2023-05-13 ER PT J AU Watson, RA Bohula, EA Gilliland, TC Sanchez, PA Berg, DD Morrow, DA AF Watson, Ryan A. Bohula, Erin A. Gilliland, Thomas C. Sanchez, Pablo A. Berg, David D. Morrow, David A. TI Editor's Choice-Prospective registry of cardiac critical illness in a modern tertiary care Cardiac Intensive Care Unit SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Cardiac Intensive Care Unit; critical care; shock; cardiac arrest ID ASSOCIATION; ORGANIZATION; MORTALITY; EVOLUTION AB Background: The changing landscape of care in the Cardiac Intensive Care Unit (CICU) has prompted efforts to redesign the structure and organization of advanced CICUs. Few studies have quantitatively characterized current demographics, diagnoses, and outcomes in the contemporary CICU. Methods: We evaluated patients in a prospective observational database, created to support quality improvement and clinical care redesign in an AHA Level 1 (advanced) CICU at Brigham and Women's Hospital, Boston, MA, USA. All consecutive patients (N=2193) admitted from 1 January 2015 to 31 December 2017 were included at the time of admission to the CICU. Results: The median age was 65 years (43% >70 years) and 44% of patients were women. Non-cardiovascular comorbidities were common, including chronic kidney disease (27%), pulmonary disease (22%), and active cancer (13%). Only 7% of CICU admissions were primarily for an acute coronary syndrome, which was the seventh most common individual diagnosis. The top three reasons for admission to the CICU were shock/hypotension (26%), cardiopulmonary arrest (11%), or primary arrhythmia without arrest (9%). Respiratory failure was a primary or major secondary reason for triage to the CICU in 17%. In-hospital mortality was 17.6%. Conclusions: In a tertiary, academic, advanced CICU, patients are elderly with a high burden of non-cardiovascular comorbid conditions. Care has shifted from ACS toward predominantly shock and cardiac arrest, as well as non-ischemic conditions, and the mortality of these conditions is high. These data may be useful to guide cardiac critical care redesign. C1 [Watson, Ryan A.] Thomas Jefferson Univ Hosp, Dept Med, Div Cardiol, Philadelphia, PA 19107 USA. [Bohula, Erin A.; Morrow, David A.] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA. [Gilliland, Thomas C.; Sanchez, Pablo A.] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA. [Berg, David D.] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Div Cardiol, Boston, MA 02115 USA. C3 Jefferson University; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Brigham & Women's Hospital; Harvard Medical School RP Morrow, DA (通讯作者),TIMI Study Grp, 60 Fenwood Rd,Suite 7022, Boston, MA 02115 USA. EM dmorrow@bwh.harvard.edu RI Bohula, Erin/AAW-7276-2020 OI Berg, David/0000-0002-0366-5492; Sanchez, Pablo/0000-0002-6324-5086 CR Aday AW, 2013, EUR HEART J-ACUTE CA, V2, P299, DOI 10.1177/2048872613501986 Bonnefoy-Cudraz E, 2018, EUR HEART J-ACUTE CA, V7, P80, DOI 10.1177/2048872617724269 Casella G, 2010, J CARDIOVASC MED, V11, P450, DOI 10.2459/JCM.0b013e328335233e Goldfarb M, J INTENSIVE CARE MED, V2017, p885066617741873 Hassager C, 2015, CRIT CARE MED, V43, P247, DOI 10.1097/CCM.0000000000000653 Holland EM, 2017, J AM COLL CARDIOL, V69, P1999, DOI 10.1016/j.jacc.2017.02.033 JULIAN DG, 1987, BRIT HEART J, V57, P497 Katz JN, 2016, J AM COLL CARDIOL, V68, P67, DOI 10.1016/j.jacc.2016.04.036 Katz JN, 2010, CRIT CARE MED, V38, P375, DOI 10.1097/CCM.0b013e3181cb0a63 KILLIP T, 1967, AM J CARDIOL, V20, P457, DOI 10.1016/0002-9149(67)90023-9 LOWN B, 1967, J AMER MED ASSOC, V199, P188, DOI 10.1001/jama.199.3.188 Morrow DA, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.117.004010 Morrow DA, 2012, CIRCULATION, V126, P1408, DOI 10.1161/CIR.0b013e31826890b0 Na SJ, 2016, J AM COLL CARDIOL, V68, P2637, DOI 10.1016/j.jacc.2016.09.947 O'Gara PT, 2015, J AM COLL CARDIOL, V65, P1877, DOI 10.1016/j.jacc.2015.03.027 O'Malley RG, 2013, EUR HEART J-ACUTE CA, V2, P3, DOI 10.1177/2048872612472063 Ratcliffe JA, 2014, CORONARY ARTERY DIS, V25, P60, DOI 10.1097/MCA.0000000000000043 Silverman MG, 2016, AM HEART J, V175, P172, DOI 10.1016/j.ahj.2016.01.009 Sinha SS, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.117.003616 van Diepen S, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.117.003864 van Diepen S, 2015, CRIT CARE MED, V43, P128, DOI 10.1097/CCM.0000000000000609 Wong GC, 2017, CAN J CARDIOL, V33, P1, DOI 10.1016/j.cjca.2016.10.021 NR 22 TC 15 Z9 15 U1 0 U2 0 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 2048-8726 EI 2048-8734 J9 EUR HEART J-ACUTE CA JI Eur. Heart J.-Acute Cardiovasc. Care PD DEC PY 2019 VL 8 IS 8 BP 755 EP 761 DI 10.1177/2048872618789053 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JT5NZ UT WOS:000501037700010 PM 30033736 OA Bronze DA 2023-05-13 ER PT J AU Kao, TW Huang, CC AF Kao, Ting-Wei Huang, Chin-Chou TI Inflammatory Burden and Immunomodulative Therapeutics of Cardiovascular Diseases SO INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES LA English DT Review DE cardiovascular disease; gut microbiota; nephropathy; inflammation ID C-REACTIVE PROTEIN; ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; HEART-FAILURE; RISK; DIFFERENTIATION; INTERLEUKIN-6; CHOLESTEROL; SIMVASTATIN; INHIBITION AB Phenotyping cardiovascular illness and recognising heterogeneities within are pivotal in the contemporary era. Besides traditional risk factors, accumulated evidence suggested that a high inflammatory burden has emerged as a key characteristic modulating both the pathogenesis and progression of cardiovascular diseases, inclusive of atherosclerosis and myocardial infarction. To mechanistically elucidate the correlation, signalling pathways downstream to Toll-like receptors, nucleotide oligomerisation domain-like receptors, interleukins, tumour necrosis factor, and corresponding cytokines were raised as central mechanisms exerting the effect of inflammation. Other remarkable adjuvant factors include oxidative stress and secondary ferroptosis. These molecular discoveries have propelled pharmaceutical advancements. Statin was suggested to confer cardiovascular benefits not only by lowering cholesterol levels but also by attenuating inflammation. Colchicine was repurposed as an immunomodulator co-administered with coronary intervention. Novel interleukin-1 beta and -6 antagonists exhibited promising cardiac benefits in the recent trials as well. Moreover, manipulation of gut microbiota and associated metabolites was addressed to antagonise inflammation-related cardiovascular pathophysiology. The gut-cardio-renal axis was therein established to explain the mutual interrelationship. As for future perspectives, artificial intelligence in conjunction with machine learning could better elucidate the sequencing of the microbiome and data mining. Comprehensively understanding the interplay between the gut microbiome and its cardiovascular impact will help identify future therapeutic targets, affording holistic care for patients with cardiovascular diseases. C1 [Kao, Ting-Wei] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100225, Taiwan. [Huang, Chin-Chou] Taipei Vet Gen Hosp, Dept Med, Div Cardiol, Taipei 112201, Taiwan. [Huang, Chin-Chou] Natl Yang Ming Chiao Tung Univ, Sch Med, Taipei 112304, Taiwan. [Huang, Chin-Chou] Natl Yang Ming Chiao Tung Univ, Inst Pharmacol, Sch Med, Taipei 112304, Taiwan. [Huang, Chin-Chou] Natl Yang Ming Chiao Tung Univ, Cardiovasc Res Ctr, Taipei 112304, Taiwan. C3 National Taiwan University; National Taiwan University Hospital; Taipei Veterans General Hospital; National Yang Ming Chiao Tung University; National Yang Ming Chiao Tung University; National Yang Ming Chiao Tung University RP Huang, CC (通讯作者),Taipei Vet Gen Hosp, Dept Med, Div Cardiol, Taipei 112201, Taiwan.; Huang, CC (通讯作者),Natl Yang Ming Chiao Tung Univ, Sch Med, Taipei 112304, Taiwan.; Huang, CC (通讯作者),Natl Yang Ming Chiao Tung Univ, Inst Pharmacol, Sch Med, Taipei 112304, Taiwan.; Huang, CC (通讯作者),Natl Yang Ming Chiao Tung Univ, Cardiovasc Res Ctr, Taipei 112304, Taiwan. EM twkao315@gmail.com; cchuang4@vghtpe.gov.tw OI Kao, Ting-Wei/0000-0002-1069-4558 FU Taipei Veterans General Hospital, Taipei, Taiwan, ROC [111EA-014, V111C-086, V111D63-002-MY2-1]; Ministry of Science and Technology, Taiwan, ROC [MOST108-2314-B-075-062-MY3] FX This work was supported by research grants 111EA-014, V111C-086, and V111D63-002-MY2-1 from Taipei Veterans General Hospital, Taipei, Taiwan, ROC, and research grant MOST108-2314-B-075-062-MY3 from the Ministry of Science and Technology, Taiwan, ROC. The funders had no role in the data collection or preparation of the manuscript. 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TI Signalling pathways and mechanisms of protection in pre- and postconditioning: historical perspective and lessons for the future SO BRITISH JOURNAL OF PHARMACOLOGY LA English DT Review ID PROTEIN-KINASE-C; ACUTE MYOCARDIAL-INFARCTION; PERMEABILITY TRANSITION PORE; PERCUTANEOUS CORONARY INTERVENTION; PLATELET-ACTIVATING-FACTOR; ISCHEMIA-REPERFUSION INJURY; K-ATP CHANNELS; GLYCOPROTEIN-IIB/IIIA INHIBITION; GLYCOGEN-SYNTHASE KINASE-3-BETA; MITOCHONDRIAL ROS GENERATION AB Ischaemic pre- and postconditioning are potent cardioprotective interventions that spare ischaemic myocardium and decrease infarct size after periods of myocardial ischaemia/reperfusion. They are dependent on complex signalling pathways involving ligands released from ischaemic myocardium, G-protein-linked receptors, membrane growth factor receptors, phospholipids, signalling kinases, NO, PKC and PKG, mitochondrial ATP-sensitive potassium channels, reactive oxygen species, TNF- and sphingosine-1-phosphate. The final effector is probably the mitochondrial permeability transition pore and the signalling produces protection by preventing pore formation. Many investigators have worked to produce a roadmap of this signalling with the hope that it would reveal where one could intervene to therapeutically protect patients with acute myocardial infarction whose hearts are being reperfused. However, attempts to date to show efficacy of such an intervention in large clinical trials have been unsuccessful. Reasons for this inability to translate successes in the experimental laboratory to the clinical arena are evaluated in this review. It is suggested that all patients with acute coronary syndromes currently presenting to the hospital and being treated with platelet P2Y(12) receptor antagonists, the current standard of care, are indeed already benefiting from protection from the conditioning pathways outlined earlier. If that proves to be the case, then future attempts to further decrease infarction will have to rely on interventions which protect by a different mechanism. Linked ArticlesThis article is part of a themed section on Conditioning the Heart - Pathways to Translation. To view the other articles in this section visit C1 [Cohen, Michael V.; Downey, James M.] Univ S Alabama, Dept Physiol, Coll Med, Mobile, AL 36688 USA. [Cohen, Michael V.] Univ S Alabama, Dept Med, Coll Med, Mobile, AL 36688 USA. C3 University of South Alabama; University of South Alabama RP Cohen, MV (通讯作者),Univ S Alabama, Dept Physiol, Coll Med, MSB 3050, Mobile, AL 36688 USA. 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J. Pharmacol. PD APR PY 2015 VL 172 IS 8 SI SI BP 1913 EP 1932 DI 10.1111/bph.12903 PG 20 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA CE7PH UT WOS:000352033300002 PM 25205071 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Nguyen, HL Ha, DA Phan, DT Nguyen, QN Nguyen, VL Nguyen, NH Nguyen, H Goldberg, RJ AF Nguyen, Hoa L. Duc Anh Ha Dat Tuan Phan Quang Ngoc Nguyen Viet Lan Nguyen Nguyen Hanh Nguyen Ha Nguyen Goldberg, Robert J. TI Sex Differences in Clinical Characteristics, Hospital Management Practices, and In-Hospital Outcomes in Patients Hospitalized in a Vietnamese Hospital with a First Acute Myocardial Infarction SO PLOS ONE LA English DT Article ID ACUTE-CORONARY-SYNDROME; GENDER-DIFFERENCES; EARLY MORTALITY; HEART-DISEASE; ST ELEVATION; WOMEN; REGISTRY; MEN; SURVIVAL; TRENDS AB Background: Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI) at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. Methods: The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. Results: The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years) and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%). During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI) compared with men (57% vs. 74%), and women were more likely to have developed heart failure compared with men (19% vs. 10%). Women experienced higher in-hospital case-fatality rates (CFRs) than men (13% vs. 4%) and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89), and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09). Conclusions: Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted. C1 [Nguyen, Hoa L.; Nguyen Hanh Nguyen; Ha Nguyen] Inst Populat Hlth & Dev, Hanoi, Vietnam. [Nguyen, Hoa L.] Univ Oxford, Clin Res Unit, Ho Chi Minh City, Vietnam. [Duc Anh Ha] Minist Hlth, Hanoi, Vietnam. [Dat Tuan Phan; Quang Ngoc Nguyen; Viet Lan Nguyen] Viet Nam Natl Heart Inst, Hanoi, Vietnam. [Goldberg, Robert J.] Univ Massachusetts, Sch Med, Dept Quantitat Hlth Sci, Worcester, MA USA. C3 RLUK- Research Libraries UK; University of Oxford; University of Massachusetts System; University of Massachusetts Worcester RP Nguyen, HL (通讯作者),Inst Populat Hlth & Dev, Hanoi, Vietnam. EM hoanguyen@phad.org RI Nguyen, Hoa/AAA-5685-2020 OI Nguyen, Hoa/0000-0002-4998-8510 FU Global Health Office, University of Massachusetts Medical School, Worcester, MA, USA FX This study was funded by the Global Health Office, University of Massachusetts Medical School, Worcester, MA, USA. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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Patients were divided into two cohorts, each covering a two-year time period; the initial prescription of ticagrelor (20 Dec 2011) was used as a cut-off point. Patients in the early cohort (n=23,447) were treated with clopidogrel, while those in the later cohort (n=24,227), were treated with either clopidogrel (47.9%) or ticagrelor (52.1%). Kaplan-Meier analyses were used to assess the risk of ischemic stroke over time, with multivariable Cox regression analyses used to identify predictors of ischemic stroke.ResultsOf 47,674 patients, there were 1203 cases of ischemic stroke. Cumulative Kaplan-Meier incidence estimates of ischemic stroke after one year were 2.8% vs. 2.4% for the early and late cohorts, respectively (p=0.001). Older age, hypertension, diabetes, previous stroke, congestive heart failure, atrial fibrillation, and ST-elevation myocardial infarction were associated with an increased risk of ischemic stroke. Percutaneous coronary intervention and statins at discharge were associated with a decreased risk of ischemic stroke, as was higher estimated glomerular filtration rate. Membership of the late cohort correlated with a 13% reduction in the relative risk of ischemic stroke.ConclusionsThe introduction of ticagrelor as well as an improved management of AMI was associated with a lower rate of ischemic stroke in a relatively unselected AMI population. C1 [Henriksson, Robin; Ulvenstam, Anders; Mooe, Thomas] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. [Henriksson, Robin; Ulvenstam, Anders; Soderstrom, Lars; Mooe, Thomas] Unit Res Educ & Dev, Ostersund, Region Jamtland, Sweden. C3 Umea University RP Henriksson, R (通讯作者),Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden.; Henriksson, R (通讯作者),Unit Res Educ & Dev, Ostersund, Region Jamtland, Sweden. EM robin.henriksson@umu.se OI Henriksson, Robin/0000-0001-9571-5946 FU Unit of Research, Education and Development, Region Jamtland Harjedalen [JLL-474211] FX This study was supported by grants to TM from the Unit of Research, Education and Development, Region Jamtland Harjedalen (JLL-474211). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. CR Al Suwaidi J, 2012, BMC CARDIOVASC DISOR, V12, DOI 10.1186/1471-2261-12-64 Bonaca MP, 2015, NEW ENGL J MED, V372, P1791, DOI 10.1056/NEJMoa1500857 Brammas A, 2013, STROKE, V44, P3050, DOI 10.1161/STROKEAHA.113.001434 Budaj A, 2005, CIRCULATION, V111, P3242, DOI 10.1161/CIRCULATIONAHA.104.512806 Cannon CP, 2010, LANCET, V375, P283, DOI 10.1016/S0140-6736(09)62191-7 Hachet O, 2014, STROKE, V45, P3514, DOI 10.1161/STROKEAHA.114.006707 Herlitz J, 2008, INT J CARDIOL, V128, P342, DOI 10.1016/j.ijcard.2007.06.018 Husted S, 2006, EUR HEART J, V27, P1038, DOI 10.1093/eurheartj/ehi754 Husted S, 2012, CIRC-CARDIOVASC QUAL, V5, P680, DOI 10.1161/CIRCOUTCOMES.111.964395 Jakobsson S, 2014, CIRC-CARDIOVASC QUAL, V7, P95, DOI 10.1161/CIRCOUTCOMES.113.000311 Jernberg T, 2015, SWEDEHEART ANN REPOR Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Joshi NV, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.001956 Karlsson F, 2009, AM J KIDNEY DIS, V54, P262, DOI 10.1053/j.ajkd.2009.04.023 Levey AS, 2009, ANN INTERN MED, V150, P604, DOI 10.7326/0003-4819-150-9-200905050-00006 Lindholm D, 2014, EUR HEART J, V35, P2083, DOI 10.1093/eurheartj/ehu160 Ludvigsson JF, 2011, BMC PUBLIC HEALTH, V11, DOI 10.1186/1471-2458-11-450 Mooe Thomas, 2002, Expert Rev Neurother, V2, P177, DOI 10.1586/14737175.2.2.177 Naderi N, 2014, INT J CARDIOL, V175, P323, DOI 10.1016/j.ijcard.2014.05.024 Preusch MR, 2016, DRUG DES DEV THER, V10, P2691, DOI 10.2147/DDDT.S105718 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Saczynski JS, 2008, ARCH INTERN MED, V168, P2104, DOI 10.1001/archinte.168.19.2104 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Storey RF, 2007, J AM COLL CARDIOL, V50, P1852, DOI 10.1016/j.jacc.2007.07.058 Tang XF, 2014, ATHEROSCLEROSIS, V233, P568, DOI 10.1016/j.atherosclerosis.2014.01.017 Thygesen K, 2007, EUR HEART J, V28, P2525 Udell JA, 2016, EUR HEART J, V37, P390, DOI 10.1093/eurheartj/ehv443 Ulvenstam A, 2014, STROKE, V45, P3263, DOI 10.1161/STROKEAHA.114.005770 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Witt BJ, 2006, AM J MED, V119, DOI 10.1016/j.amjmed.2005.10.058 Witt BJ, 2005, ANN INTERN MED, V143, P785, DOI 10.7326/0003-4819-143-11-200512060-00006 NR 31 TC 2 Z9 2 U1 0 U2 1 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-2261 J9 BMC CARDIOVASC DISOR JI BMC Cardiovasc. Disord. PD MAR 4 PY 2019 VL 19 AR 51 DI 10.1186/s12872-019-1030-6 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HN9HL UT WOS:000460510400002 PM 30832574 OA Green Published, gold DA 2023-05-13 ER PT J AU Martensson, S Gyrd-Hansen, D Prescott, E Andersen, PK Jacobsen, RK Osler, M AF Martensson, Solvej Gyrd-Hansen, Dorte Prescott, Eva Andersen, Per Kragh Jacobsen, Rikke Kart Osler, Merete TI Socio-economic position and time trends in invasive management and case fatality after acute myocardial infarction in Denmark SO EUROPEAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID ACUTE CORONARY SYNDROMES; MORTALITY PREDICTION RULES; HEALTH-CARE; INTERVENTION; INEQUALITIES; THERAPY; DISEASE; EQUITY; DANISH AB Background: Lower case fatality and increased use of evidence-based invasive management incl. coronary angiography (CAG) have been reported for patients admitted with acute myocardial infarction (AMI) in the last 25 years. This article seeks to investigate whether these advances have benefitted patients in all socio-economic groups and how this has impacted on inequality in case fatality. Methods: Forty three thousand eight hundred and forty three patients admitted with AMI in the period from 2001 to 2009 were included. Socio-economic position was measured using individual information on education. Age-standardized cumulative incidence of CAG within 1, 3 and 30 days along with age-standardized case fatality within 30 and 365 days were estimated. Cox regression models were used to model the relative inequality over time. Results: Use of CAG within 1, 3 and 30 days increased for all educational groups over time and the inequality in CAG within 1 and 3 days seen in the beginning of the time frame was eliminated. Case fatality decreased in all educational groups and the relative inequality in 30 days case fatality decreased for women but not 365 days case fatality. No change was seen for inequality in case fatality for men. Conclusion: Increased use of CAG within the evidence based time frame was observed along with a decrease in inequality. However, a reduction in inequality was only observed for short term case fatality, and only for women. These results suggest that inequality in case fatality is not primarily driven by inequality in invasive management of AMI. C1 [Martensson, Solvej; Jacobsen, Rikke Kart; Osler, Merete] Capital Reg Denmark, Res Ctr Prevent & Hlth, Glostrup, Denmark. [Gyrd-Hansen, Dorte] Univ Southern Denmark, COHERE, Dept Econ & Business, Odense, Denmark. [Prescott, Eva] Bispebjerg Hosp, Dept Cardiol, Copenhagen, Denmark. [Andersen, Per Kragh] Univ Copenhagen, Inst Publ Hlth, Dept Biostat, Copenhagen, Denmark. [Osler, Merete] Univ Copenhagen, Dept Publ Hlth, Inst Publ Hlth, Copenhagen, Denmark. C3 University of Southern Denmark; University of Copenhagen; Bispebjerg Hospital; University of Copenhagen; University of Copenhagen RP Martensson, S (通讯作者),Capital Reg Denmark, Res Ctr Prevent & Hlth, Glostrup, Denmark. EM solvej.maartensson@regionh.dk RI Prescott, Eva/AAJ-7441-2020; Osler, Merete/AAF-7885-2019 OI Prescott, Eva/0000-0002-4134-0349; Osler, Merete/0000-0002-6921-220X; Jacobsen, Rikke Kart/0000-0003-4677-2973 FU Danish Heart Association [10-04-R78-A2806-22609]; Health Insurance Foundation [2011B037]; Fabrikant Ejner Willumsens Mindelegat og Aase og Ejner Danielsens Foundation FX This work was supported by the Danish Heart Association [grant number 10-04-R78-A2806-22609], The Health Insurance Foundation [grant number 2011B037], Fabrikant Ejner Willumsens Mindelegat og Aase og Ejner Danielsens Foundation. CR Alter DA, 2006, ANN INTERN MED, V144, P82, DOI 10.7326/0003-4819-144-2-200601170-00005 Andersen HR, 2003, NEW ENGL J MED, V349, P733, DOI 10.1056/NEJMoa025142 Bajekal M, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0059608 Bavry AA, 2006, J AM COLL CARDIOL, V48, P1319, DOI 10.1016/j.jacc.2006.06.050 Bernheim SM, 2007, AM HEART J, V153, P313, DOI 10.1016/j.ahj.2006.10.037 Danish National Board of Health, TREATM PROT UNST ANG Danish Society of Cardiology, 2011, NATL CARD TREATM GUI Ernstsen L, 2012, BMC PUBLIC HEALTH, V12, DOI 10.1186/1471-2458-12-266 Ford ES, 2007, NEW ENGL J MED, V356, P2388, DOI 10.1056/NEJMsa053935 Fox KAA, 2002, LANCET, V360, P743, DOI 10.1016/S0140-6736(02)09894-X Fox KAA, 2007, JAMA-J AM MED ASSOC, V297, P1892, DOI 10.1001/jama.297.17.1892 Hetemaa T, 2003, J EPIDEMIOL COMMUN H, V57, P178, DOI 10.1136/jech.57.3.178 Hjerteforeningen, 2012, ELSK HJERT RES 2012 Katritsis DG, 2011, EUR HEART J, V32, P32, DOI 10.1093/eurheartj/ehq276 Lammintausta A, 2012, ANN EPIDEMIOL, V22, P87, DOI 10.1016/j.annepidem.2011.10.012 Maeng M, 2010, AM J CARDIOL, V105, P1528, DOI 10.1016/j.amjcard.2010.01.005 Martensson S, 2014, BMJ OPEN, V4, DOI 10.1136/bmjopen-2013-004052 Mehta SR, 2009, NEW ENGL J MED, V360, P2165, DOI 10.1056/NEJMoa0807986 Oliver A, 2004, J EPIDEMIOL COMMUN H, V58, P655, DOI 10.1136/jech.2003.017731 Peterson ED, 2008, AM HEART J, V156, P1045, DOI 10.1016/j.ahj.2008.07.028 Rasmussen JN, 2007, CARDIOVASC DRUG THER, V21, P449, DOI 10.1007/s10557-007-6058-7 Rasmussen JN, 2007, J EPIDEMIOL COMMUN H, V61, P1091, DOI 10.1136/jech.2006.055525 Schmidt M, 2012, BMJ-BRIT MED J, V344, DOI 10.1136/bmj.e356 Tu JV, 2001, J AM COLL CARDIOL, V37, P992, DOI 10.1016/S0735-1097(01)01109-3 Vermeulen MJ, 2007, J CLIN EPIDEMIOL, V60, P971, DOI 10.1016/j.jclinepi.2006.12.009 NR 25 TC 5 Z9 6 U1 0 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1101-1262 EI 1464-360X J9 EUR J PUBLIC HEALTH JI Eur. J. Public Health PD FEB 1 PY 2016 VL 26 IS 1 BP 146 EP 152 DI 10.1093/eurpub/ckv156 PG 7 WC Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Public, Environmental & Occupational Health GA DJ8QZ UT WOS:000374478800028 PM 26342131 OA Bronze DA 2023-05-13 ER PT J AU Alves, L Polanczyk, CA AF Alves, Leonardo Polanczyk, Carisi Anne TI Hospitalization for Acute Myocardial Infarction: A Population-Based Registry SO ARQUIVOS BRASILEIROS DE CARDIOLOGIA LA English DT Article DE Myocardial/mortality; Hospitalization; Epidemiology; Risk Factors; Prevention and Control; Percutaneous Coronary Intervention ID ACUTE CORONARY SYNDROMES; CARDIOVASCULAR-DISEASE; TRENDS; MORTALITY; OUTCOMES; HEALTH; CARE; REPERFUSION; EUROPE AB Background: ST-segment elevation myocardial infarction (STEMI) is one of the main clinical manifestations of ischemic heart disease. Population-based data are relevant to better understand the current epidemiology of this condition. Objective: To describe the incidence, therapeutic management, hospital clinical outcomes and cardiovascular events in the first year of follow-up of individuals hospitalized for STEMI. Methods: Population-based prospective cohort study with consecutive registries of hospitalization for STEMI in a city in southern Brazil from 2011 to 2014. It included patients with STEMI who presented acute myocardial ischemia symptoms in the last 72 hours. A p-value < 0.05 was considered significant. Results: The annual incidence of STEMI hospitalizations was 108 cases per 100,000 inhabitants. Adjusted incidence was higher among older individuals (relative risk 64.9; 95% CI 26.9-156.9; p for linear trend < 0.001) and among men (relative risk 2.8; 95% CI 2.3-3.3; p < 0.001). There were 530 hospitalizations in the period under evaluation and the reperfusion rate reached 80.9%. Hospital mortality and the one-year follow-up cardiovascular event rate were, respectively, 8.9% and 6.1%. The oldest patients had higher hospital mortality (relative risk 3.72; 95% CI 1.57-8.82; p for linear trend = 0.002) and more one-year follow-up cardiovascular events (hazard ratio 2.35; 95% CI 1.12-4.95; p = 0.03). Conclusion: This study shows that both the therapeutic approach and hospital mortality are similar to the ones found in developed countries. However, the hospitalization rate was higher in these countries. C1 [Alves, Leonardo; Polanczyk, Carisi Anne] Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil. [Alves, Leonardo] Univ Fed Rio Grande, Rio Grande, RS, Brazil. [Alves, Leonardo] Hosp Santa Casa Rio Grande, Hosp Cardiol, Rio Grande, RS, Brazil. [Polanczyk, Carisi Anne] Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil. C3 Universidade Federal do Rio Grande do Sul; Universidade Federal do Rio Grande RP Alves, L (通讯作者),Univ Fed Rio Grande, Dept Med, Gen Osorio, BR-96201900 Rio Grande, RS, Brazil. EM leoalvesrg@gmail.com OI Alves, Leonardo/0000-0003-4184-7083; Polanczyk, Carisi/0000-0002-2447-2577 CR Alves L, 2010, ARQ BRAS CARDIOL, V95, P179, DOI 10.1590/S0066-782X2010005000075 [Anonymous], 2007, MICR ACC REL 12 0 Associacao Brasileira de Empresas de Pesquisa, 2010, CRIT CLASS EC BRAS Barreto FHJAS, 2017, J AM COLL CARDIOL, V69, P1267 Bassanesi SL, 2008, ARQ BRAS CARDIOL, V90, P403 Bhatnagar A, 2017, CIRC RES, V121, P162, DOI 10.1161/CIRCRESAHA.117.306458 Bhatt DL, 2015, J AM COLL CARDIOL, V66, P2230, DOI 10.1016/j.jacc.2015.07.010 Caccavo Alberto, 2007, Rev. argent. cardiol., V75, P185 Chacon-Diaz M, 2018, ARCH CARDIOL MEX, V88, P403, DOI 10.1016/j.acmx.2017.11.009 Fang J, 2010, AM J MED, V123, P259, DOI 10.1016/j.amjmed.2009.08.018 Ferreira Graça Maria Tavares de Melo, 2009, Arq. Bras. 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Bras. Cardiol. PD NOV PY 2020 VL 115 IS 5 BP 916 EP 923 DI 10.36660/abc.20190573 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PB5VL UT WOS:000596388300021 PM 32965396 OA gold, Green Published DA 2023-05-13 ER PT J AU Jakobsson, S Graipe, A Huber, D Bjorklund, F Mooe, T AF Jakobsson, Stina Graipe, Anna Huber, Daniel Bjorklund, Fredrik Mooe, Thomas TI The Risk of Ischemic Stroke after an Acute Myocardial Infarction in Patients with Decreased Renal Function SO CEREBROVASCULAR DISEASES LA English DT Article DE Ischemic stroke; Myocardial infarction; Chronic kidney disease ID CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; ACUTE CORONARY SYNDROMES; CARDIAC PROCEDURES; OUTCOMES; PREDICTORS; POPULATION; REGISTRY; IMPACT; DEATH AB Background: Data on the incidence, trends over time and predictors of ischemic stroke after an acute myocardial infarction (AMI) are sparse for patients with chronic kidney disease (CKD). Methods: Data for unselected AMI patients were obtained from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) between 2003 and 2010. Patients with and without CKD were compared. Multiple logistic regression was performed to identify predictors of ischemic stroke during the hospitalization for AMI, Kaplan-Meier analysis was used to analyze the 1-year postdischarge ischemic stroke trends over time and Cox regression analysis was used to identify predictors. Results: Of 118,434 AMI patients, 40,679 had CKD. The CKD patients had more extensive previous cardiovascular disease and received less reperfusion and secondary preventive therapies than the patients without CKD. An inhospital ischemic stroke occurred in 2.3 and 1.2% of CKD and non-CKD patients, respectively. The incidence of ischemic stroke during hospitalization for AMI was stable during the study period. The occurrence of ischemic stroke after hospital discharge decreased between 2003-2004 and 2009-2010 from 4.1 to 2.5% in CKD patients and from 2.0 to 1.3% in non-CKD patients, respectively. Percutaneous coronary intervention (PCI) and statins were independently associated with a reduced risk of stroke after discharge from hospital. Conclusions: Ischemic stroke is a more common complication after an AMI in CKD patients than in non-CKD patients, but the risk has decreased in recent years. The increased use of PCI and statins may have contributed to this reduction. (C) 2014 S. Karger AG, Basel C1 [Jakobsson, Stina; Graipe, Anna; Huber, Daniel; Bjorklund, Fredrik; Mooe, Thomas] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. C3 Umea University RP Jakobsson, S (通讯作者),Umea Univ, Dept Publ Hlth & Clin Med, Storgatan 42,4 Tr, SE-83130 Ostersund, Sweden. EM stina.jakobsson@medicin.umu.se OI Huber, Daniel/0000-0002-9817-5436 FU Research and Development Unit of the Jamtland County Council; Heart Foundation of Northern Sweden FX This study was supported by grants from the Research and Development Unit of the Jamtland County Council and the Heart Foundation of Northern Sweden. 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Dis. PD AUG PY 2014 VL 37 IS 6 BP 460 EP 469 DI 10.1159/000363616 PG 10 WC Clinical Neurology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA CD1GT UT WOS:000350823700010 PM 25073588 DA 2023-05-13 ER PT J AU Sirmans, SM Parish, RC Blake, S Wang, XJ AF Sirmans, Susan M. Parish, Roy C. Blake, Sandra Wang, Xiaojun TI Epidemiology and Comorbidities of Polycystic Ovary Syndrome in an Indigent Population SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Article DE polycystic ovary syndrome; cardiovascular risk factors; anxiety; bipolar disorders; depression; eating disorders; infertility; obstructive sleep apnea ID IMPAIRED GLUCOSE-TOLERANCE; OBSTRUCTIVE SLEEP-APNEA; INCREASED PREVALENCE; BIPOLAR DISORDER; COMMUNITY SAMPLE; INCREASED RISK; OBESE WOMEN; CORONARY; HEALTH; ATHEROSCLEROSIS AB Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The aims of this study were to provide an estimate of the prevalence of PCOS in clinical practice; compare the risk of established cardiovascular risk factors, cardiovascular disease, and other comorbid conditions in women with PCOS to that of age-and race-matched controls; and explore the total costs of care that can be attributed to PCOS. Methods: Louisiana Medicaid claims data were used to identify women with PCOS or its defining features and a control group in a ratio of 1: 3. The prevalence of PCOS, cardiovascular risk factors (diabetes, dyslipidemia, dysmetabolic syndrome, glucose intolerance, hypertension, and obesity), key comorbidities (anxiety, bipolar disorders, depression, eating disorders, infertility, obstructive sleep apnea), and diagnosed cardiovascular disease were measured. Results: During 2010, the prevalence of PCOS was 0.88%. Women with PCOS were more likely to have a diagnosis of diabetes (odds ratio [OR], 4.35; 95% confidence interval [CI], 3.63-5.21), dyslipidemia (OR, 3.56; 95% CI, 3.04-4.19), dysmetabolic syndrome (OR, 23.46; 95% CI, 13.64-40.36), glucose intolerance (OR, 5.46; 95% CI, 3.10-9.60), hypertension (OR, 2.76; 95% CI, 2.41-3.18), obesity (OR, 5.79; 95% CI, 5.07-6.62), infertility (OR, 23.42; 95% CI, 10.63-51.61), obstructive sleep apnea (OR, 6.47; 95% CI, 3.62-11.55), anxiety (OR, 1.76; 95% CI, 1.53-2.04), bipolar disorders (OR, 1.94; 95% CI, 1.55-2.44), and depression (OR, 2.22; 95% CI, 1.94-2.54) than did controls. Average total costs of care for the year was $5551 in the PCOS group and $3496 in the control group. After controlling for the effects of other variables, the average total cost of care for PCOS was $637 higher than that of the control group. Other variables that contributed significantly to the total costs of care included race, age, acute myocardial infarction, transient ischemic attack, peripheral artery disease, anxiety, depression, bipolar disorders, hypertension, diabetes, and dyslipidemia. Conclusions: Although the clinical burden of PCOS is high, it is diagnosed less frequently in clinical practice compared with systematic screening studies. This is concerning considering that PCOS is associated with cardiovascular risk factors and other comorbidities. Mean total costs of care for the PCOS group was higher than the mean total costs of care for the control group. Polycystic ovary syndrome is independently associated with an increase in mean total costs of care. C1 [Sirmans, Susan M.; Parish, Roy C.] Univ Louisiana Monroe, Sch Pharm, Baton Rouge, LA 70806 USA. [Parish, Roy C.] Louisiana State Univ, Sch Med, Dept Internal Med, Hlth Sci Ctr, Shreveport, LA USA. [Blake, Sandra; Wang, Xiaojun] Univ Louisiana Monroe, Coll Pharm, Off Outcomes Res, Baton Rouge, LA 70806 USA. C3 University of Louisiana System; University of Louisiana Monroe; Louisiana State University System; Louisiana State University Health Sciences Center at Shreveport; University of Louisiana System; University of Louisiana Monroe RP Sirmans, SM (通讯作者),Univ Louisiana Monroe, Sch Pharm, 3849 N Blvd, Baton Rouge, LA 70806 USA. EM sirmans@ulm.edu FU Tom and Mayme Scott Endowed Chair FX Supported by existing funds from the Tom and Mayme Scott Endowed Chair. CR Alvarez-Blasco F, 2006, ARCH INTERN MED, V166, P2081, DOI 10.1001/archinte.166.19.2081 Amer Diabet Assoc, 2013, DIABETES CARE, V36, pS11, DOI 10.2337/dc13-S011 Azziz R, 2005, J CLIN ENDOCR METAB, V90, P4650, DOI 10.1210/jc.2005-0628 Azziz R, 2004, J CLIN ENDOCR METAB, V89, P2745, DOI 10.1210/jc.2003-032046 Carmina E, 2006, Am J Med, V119, DOI 10.1016/j.amjmed.2005.10.059 Christian RC, 2003, J CLIN ENDOCR METAB, V88, P2562, DOI 10.1210/jc.2003-030334 Dokras A, 2012, STEROIDS, V77, P338, DOI 10.1016/j.steroids.2011.12.008 Dokras A, 2012, FERTIL STERIL, V97, P225, DOI 10.1016/j.fertnstert.2011.10.022 Dokras A, 2011, OBSTET GYNECOL, V117, P145, DOI 10.1097/AOG.0b013e318202b0a4 Ehrmann DA, 1999, DIABETES CARE, V22, P141, DOI 10.2337/diacare.22.1.141 Fogel RB, 2001, J CLIN ENDOCR METAB, V86, P1175, DOI 10.1210/jc.86.3.1175 Guzick DS, 1996, AM J OBSTET GYNECOL, V174, P1224, DOI 10.1016/S0002-9378(96)70665-8 Hollinrake E, 2007, FERTIL STERIL, V87, P1369, DOI 10.1016/j.fertnstert.2006.11.039 Jedel E, 2011, PSYCHONEUROENDOCRINO, V36, P1470, DOI 10.1016/j.psyneuen.2011.04.001 Kerchner A, 2009, FERTIL STERIL, V91, P207, DOI 10.1016/j.fertnstert.2007.11.022 Klipstein KG, 2006, J AFFECT DISORDERS, V91, P205, DOI 10.1016/j.jad.2006.01.011 Knochenhauer ES, 1998, J CLIN ENDOCR METAB, V83, P3078, DOI 10.1210/jc.83.9.3078 Legro RS, 1999, J CLIN ENDOCR METAB, V84, P165, DOI 10.1210/jc.84.1.165 Lo JC, 2006, J CLIN ENDOCR METAB, V91, P1357, DOI 10.1210/jc.2005-2430 March WA, 2010, HUM REPROD, V25, P544, DOI 10.1093/humrep/dep399 MCCLUSKEY S, 1991, FERTIL STERIL, V55, P287 Mehrabian F, 2011, ENDOKRYNOL POL, V62, P238 MERIKANGAS KR, 1989, ARCH GEN PSYCHIAT, V46, P1137 Orio F, 2004, J CLIN ENDOCR METAB, V89, P4588, DOI 10.1210/jc.2003-031867 Pierpoint T, 1998, J CLIN EPIDEMIOL, V51, P581, DOI 10.1016/S0895-4356(98)00035-3 Rassi A, 2010, COMPR PSYCHIAT, V51, P599, DOI 10.1016/j.comppsych.2010.02.009 Shaw LJ, 2008, J CLIN ENDOCR METAB, V93, P1276, DOI 10.1210/jc.2007-0425 Shroff R, 2007, J CLIN ENDOCR METAB, V92, P4609, DOI 10.1210/jc.2007-1343 Sirmans SM, 2012, ANN PHARMACOTHER, V46, P403, DOI 10.1345/aph.1Q514 Talbott EO, 2004, J CLIN ENDOCR METAB, V89, P6061, DOI 10.1210/jc.2003-032110 Talbott EO, 2004, J CLIN ENDOCR METAB, V89, P5454, DOI 10.1210/jc.2003-032237 Talbott EO, 2008, VASC HEALTH RISK MAN, V4, P453, DOI 10.2147/VHRM.S1452 Tehrani FR, 2011, REPROD BIOL ENDOCRIN, V9, DOI 10.1186/1477-7827-9-39 Vgontzas AN, 2001, J CLIN ENDOCR METAB, V86, P517, DOI 10.1210/jc.86.2.517 Vryonidou A, 2005, J CLIN ENDOCR METAB, V90, P2740, DOI 10.1210/jc.2004-2363 Yildiz BO, 2012, HUM REPROD, V27, P3067, DOI 10.1093/humrep/des232 NR 36 TC 39 Z9 43 U1 1 U2 11 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1081-5589 EI 1708-8267 J9 J INVEST MED JI J. Investigative Med. PD AUG PY 2014 VL 62 IS 6 BP 868 EP 874 DI 10.1097/01.JIM.0000446834.90599.5d PG 7 WC Medicine, General & Internal; Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Research & Experimental Medicine GA AN1WC UT WOS:000340373700018 PM 24844662 DA 2023-05-13 ER PT J AU Nielsen, PB Witzel, S AF Nielsen, Pernille Bjornholt Witzel, Simone TI Regular control at the general practitioner is positively correlated with patient satisfaction with chronic care management SO DANISH MEDICAL JOURNAL LA English DT Article ID PERCEPTIONS; QUALITY; TRIAL AB INTRODUCTION: The aim of the study is to identify how disease management programmes for patients with a chronic disease work. This issue is explored from the patients' perspective. Specifically, we study how transition and coordination are related to the patient's perception of quality of care, with a particular focus on the general practitioner's (GP) role. METHODS: The study is based on a survey conducted among patients with Type 2 diabetes, chronic obstructive pulmonary disease (COPD) or acute coronary syndrome (ACS) in the Central Denmark Region in 2011 and 2012. Data are analysed using logistic regression models. RESULTS: A total of 4,174 patients answered the questionnaire. The response rate was 43%. Whether the patient attends regular visits with the GP or not has a significant influence on both the patient's overall perception of the healthcare sector and on the patient's perception of the organisation of care. Variation among patient groups was identified and COPD patients had the least positive overall perception of the care received. CONCLUSIOS: Patients who visit their GP for regular control both have a better overall perception of the healthcare sector and are more likely to think that their treatment is well organised. Patients with COPD have a less positive score than patients with ACS and diabetes. C1 [Nielsen, Pernille Bjornholt; Witzel, Simone] Cent Denmark Reg, Publ Hlth & Qual Improvement, Aarhus, Denmark. RP Nielsen, PB (通讯作者),Cent Denmark Reg, Publ Hlth & Qual Improvement, Aarhus, Denmark. EM pernille.bjornholt@stab.rm.dk CR [Anonymous], 2012, FORL TYP 2 DIAB HJER [Anonymous], 2009, REG MER BORG MINDR P [Anonymous], 2010, ENH BRUG LANDSD UND [Anonymous], 2014, ENH EV BRUG LANDSD U Buch MS, 2012, FORLOBSKODINATION PA Collins K, 2003, SOC SCI MED, V57, P2465, DOI 10.1016/S0277-9536(03)00098-4 Danish Health Authority, 2008, FORL KRON SYGD GEN R Draborg E, 2009, DOKUMENTATIONRAPPORT Globerman, 2001, HLTH CARE MAN REV, V26, P87 Globerman, 2001, HLTH CARE MAN REV, V26, P56 Katon W, 2001, GEN HOSP PSYCHIAT, V23, P138, DOI 10.1016/S0163-8343(01)00136-0 Martin Helle Max, 2010, ER STYR PA MIG SAMME Sandoval GA, 2006, INT J QUAL HEALTH C, V18, P266, DOI 10.1093/intqhc/mzl014 Saultz JW, 2004, ANN FAM MED, V2, P445, DOI 10.1370/afm.91 Smidth M, 2013, BMC FAM PRACT, V14, DOI 10.1186/1471-2296-14-147 Smith SM, 2012, BMJ-BRIT MED J, V345, DOI 10.1136/bmj.e5205 Sofaer S, 2005, ANNU REV PUBL HEALTH, V26, P513, DOI 10.1146/annurev.publhealth.25.050503.153958 Sofaer S, 2009, MED CARE RES REV, V66, p75S, DOI 10.1177/1077558708327945 van der Heijden MMP, 2012, BMC PUBLIC HEALTH, V12, DOI 10.1186/1471-2458-12-331 Witzel S, 2015, FOLKESUNDHED KVALITE NR 20 TC 2 Z9 2 U1 0 U2 0 PU DANISH MEDICAL ASSOC PI COPENHAGEN PA TRONDHJEMSGADE 9, DK-2100 COPENHAGEN, DENMARK SN 2245-1919 J9 DAN MED J JI Dan. Med. J. PD MAR PY 2016 VL 63 IS 3 AR A5200 PG 5 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA DL1TH UT WOS:000375414800003 DA 2023-05-13 ER PT J AU Parry, M Bjornnes, AK Clarke, H Cooper, L Gordon, A Harvey, P Lalloo, C Leegaard, M LeFort, S McFetridge-Durdle, J McGillion, M O'Keefe-McCarthy, S Price, J Stinson, J Victor, JC Watt-Watson, J AF Parry, Monica Bjornnes, Ann Kristin Clarke, Hance Cooper, Lynn Gordon, Allan Harvey, Paula Lalloo, Chitra Leegaard, Marit LeFort, Sandra McFetridge-Durdle, Judith McGillion, Michael O'Keefe-McCarthy, Sheila Price, Jennifer Stinson, Jennifer Victor, J. Charles Watt-Watson, Judy TI Self-management of cardiac pain in women: an evidence map SO BMJ OPEN LA English DT Article ID ACUTE CORONARY SYNDROME; ISCHEMIC-HEART-DISEASE; SEEKING MEDICAL-CARE; QUALITY-OF-LIFE; MYOCARDIAL-INFARCTION; CHEST-PAIN; SYNDROME-X; SCIENTIFIC STATEMENT; SEX-DIFFERENCES; DELAY-TIME AB Objective To describe the current evidence related to the self-management of cardiac pain in women using the process and methodology of evidence mapping. Design and setting Literature search for studies that describe the self-management of cardiac pain in women greater than 18 years of age, managed in community, primary care or outpatient settings, published in English or a Scandinavian language between 1 January 1990 and 24 June 2016 using AMED, CINAHL, ERIC, EMBASE, MEDLINE, Proquest, PsychInfo, the Cochrane Library, Scopus, Swemed+, Web of Science, the Clinical Trials Registry, International Register of Controlled Trials, MetaRegister of Controlled Trials, theses and dissertations, published conference abstracts and relevant websites using GreyNet International, ISI proceedings, BIOSIS and Conference papers index. Two independent reviewers screened using predefined eligibility criteria. Included articles were classified according to study design, pain category, publication year, sample size, per cent women and mean age. Interventions Self-management interventions for cardiac pain or non-intervention studies that described views and perspectives of women who self-managed cardiac pain. Primary and secondary outcomes measures Outcomes included those related to knowledge, self-efficacy, function and health-related quality of life. Results The literature search identified 5940 unique articles, of which 220 were included in the evidence map. Only 22% (n=49) were intervention studies. Sixty-nine per cent (n=151) of the studies described cardiac pain related to obstructive coronary artery disease (CAD), 2% (n=5) non-obstructive CAD and 15% (n=34) postpercutaneous coronary intervention/cardiac surgery. Most were published after 2000, the median sample size was 90 with 25%-100% women and the mean age was 63 years. Conclusions Our evidence map suggests that while much is known about the differing presentations of obstructive cardiac pain in middle-aged women, little research focused on young and old women, non-obstructive cardiac pain or self-management interventions to assist women to manage cardiac pain. PROSPERO registration number CRD42016042806. C1 [Parry, Monica; Bjornnes, Ann Kristin; Stinson, Jennifer; Watt-Watson, Judy] Univ Toronto, Lawrence S Bloomberg Fac Nursing, Toronto, ON, Canada. [Bjornnes, Ann Kristin; Leegaard, Marit] Oslo & Akershus Univ, Coll Appl Sci, Inst Nursing & Hlth Promot, Oslo, Norway. [Clarke, Hance] Univ Hlth Network, Pain Res Unit, Toronto, ON, Canada. [Cooper, Lynn] Canadian Pain Coalit, Toronto, ON, Canada. [Gordon, Allan] Mt Sinai Hosp, Wasser Pain Management Ctr, Toronto, ON, Canada. [Harvey, Paula] Womens Coll Hosp, Dept Med, Toronto, ON, Canada. [Harvey, Paula; Price, Jennifer] Womens Coll Hosp, Womens Coll Res Inst, Toronto, ON, Canada. [Lalloo, Chitra; Stinson, Jennifer] Hosp Sick Children, Peter Gilgan Ctr Res & Learning, Toronto, ON, Canada. [LeFort, Sandra] Mem Univ Newfoundland, Sch Nursing, St John, NF, Canada. [McFetridge-Durdle, Judith] Florida State Univ, Coll Nursing, Tallahassee, FL 32306 USA. [McGillion, Michael] McMaster Univ, Sch Nursing, Hamilton, ON, Canada. [O'Keefe-McCarthy, Sheila] BrockUniv, Fac Appl Sci, Dept Nursing, Toronto, ON, Canada. [Victor, J. Charles] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada. C3 University of Toronto; Oslo Metropolitan University (OsloMet); University of Toronto; University Health Network Toronto; University of Toronto; Sinai Health System Toronto; University of Toronto; Womens College Hospital; University of Toronto; Womens College Hospital; University of Toronto; Hospital for Sick Children (SickKids); Memorial University Newfoundland; State University System of Florida; Florida State University; McMaster University; University of Toronto RP Parry, M (通讯作者),Univ Toronto, Lawrence S Bloomberg Fac Nursing, Toronto, ON, Canada. EM monica.parry@utoronto.ca RI Cooper, Lynn Kerene/GMW-4135-2022; Bjornnes, Ann/P-8121-2019; Parry, Monica/L-3691-2017 OI Parry, Monica/0000-0002-6941-1380; Bjornnes, Ann Kristin/0000-0002-5356-3873 FU Canadian Institutes of Health Research Knowledge Synthesis Grant [362774]; Tom Kierans International Post-Doctoral Fellowship from the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada FX This study was funded by a Canadian Institutes of Health Research Knowledge Synthesis Grant 362774. AKB was supported by a Tom Kierans International Post-Doctoral Fellowship from the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada. 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HEALTHC P, V3, P49, DOI 10.2147/RMHP.S8288 Wechkunanukul K, 2017, AUST CRIT CARE, V30, P13, DOI 10.1016/j.aucc.2016.04.002 Wenger NK, 2016, J NUCL CARDIOL, V23, P976, DOI 10.1007/s12350-016-0593-1 NR 75 TC 5 Z9 5 U1 1 U2 7 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 2044-6055 J9 BMJ OPEN JI BMJ Open PD NOV PY 2017 VL 7 IS 11 AR e018549 DI 10.1136/bmjopen-2017-018549 PG 14 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA FT1MA UT WOS:000422898800215 PM 29175891 OA gold, Green Published DA 2023-05-13 ER PT J AU Setny, M Jankowski, P Krzykwa, A Kaminski, KA Gasior, Z Haberka, M Czarnecka, D Pajak, A Koziel, P Szostak-Janiak, K Sawicka, E Stachurska, Z Kosior, DA AF Setny, Malgorzata Jankowski, Piotr Krzykwa, Agnieszka Kaminski, Karol A. Gasior, Zbigniew Haberka, Maciej Czarnecka, Danuta Pajak, Andrzej Koziel, Pawel Szostak-Janiak, Karolina Sawicka, Emilia Stachurska, Zofia Kosior, Dariusz A. TI Management of Dyslipidemia in Women and Men with Coronary Heart Disease: Results from POLASPIRE Study SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE coronary artery disease; hypercholesterolemia; lipid goal attainment; secondary prevention in women ID RISK-FACTOR CONTROL; GENDER-DIFFERENCES; MYOCARDIAL-INFARCTION; EUROPEAN-SOCIETY; SEX-DIFFERENCES; STATIN THERAPY; WORKING GROUP; LDL-C; REDUCTION; METAANALYSIS AB Cardiovascular diseases (CVDs) are the leading cause of death in Poland. Starting from 1992, a gradual decrease in mortality due to CVDs has been observed, which is less noticeable in women. Following this notion, we assessed sex differences in the implementation of ESC recommendations regarding lipid control and the use of statins as part of secondary CVDs prevention in 1236 patients with acute coronary syndrome or elective coronary revascularization within the last 6-24 months. During hospitalization women had more frequently abnormal TC levels than men (p = 0.035), with overall higher TC levels (p = 0.009) and lower HDL-C levels (p = 0.035). In the oldest group, they also had more frequently elevated LDL-C levels (p = 0.033). Similar relationships were found during the follow-up visit. In addition, women less often achieved the secondary lipid therapeutic goal for non-HDL-C (p = 0.009). At discharge from hospital women were less frequently prescribed statins (p = 0.001), which included high-intensity statins (p = 0.002). At the follow-up visit the use of high-intensity statins was still less frequent in women (p = 0.02). We conclude that women generally have less optimal lipid profiles than men and are less likely to receive high-intensity statins. There is a need for more organized care focused on the management of risk factors. C1 [Setny, Malgorzata] Minist Interior & Adm, Cent Res Hosp, Clin Cardiol Ctr, PL-02507 Warsaw, Poland. [Jankowski, Piotr; Czarnecka, Danuta; Koziel, Pawel] Jagiellonian Univ, Coll Med, Inst Cardiol, Dept Cardiol Intervent Electrocardiol & Hypertens, PL-31008 Krakow, Poland. [Jankowski, Piotr] Polish Mothers Mem Hosp Res Inst, PL-93338 Lodz, Poland. [Krzykwa, Agnieszka; Kosior, Dariusz A.] Minist Interior & Adm, Cent Res Hosp, Electrophysiol Lab, Dept Cardiol & Hypertens, PL-02507 Warsaw, Poland. [Kaminski, Karol A.; Sawicka, Emilia; Stachurska, Zofia] Med Univ Bialystok, Dept Populat Med & Lifestyle Dis Prevent, PL-15089 Bialystok, Poland. [Gasior, Zbigniew; Haberka, Maciej; Szostak-Janiak, Karolina] Med Univ Silesia, Dept Cardiol, PL-40055 Katowice, Poland. [Pajak, Andrzej] Jagiellonian Univ, Coll Med, Inst Publ Hlth, Dept Epidemiol & Populat Studies, PL-31066 Krakow, Poland. [Kosior, Dariusz A.] Cardinal Stefan Wyszynski Univ, PL-01815 Warsaw, Poland. C3 Jagiellonian University; Collegium Medicum Jagiellonian University; Polish Mother's Memorial Hospital - Research Institute; Medical University of Bialystok; Medical University Silesia; Jagiellonian University; Collegium Medicum Jagiellonian University; Cardinal Stefan Wyszynski University in Warsaw RP Setny, M (通讯作者),Minist Interior & Adm, Cent Res Hosp, Clin Cardiol Ctr, PL-02507 Warsaw, Poland.; Kosior, DA (通讯作者),Minist Interior & Adm, Cent Res Hosp, Electrophysiol Lab, Dept Cardiol & Hypertens, PL-02507 Warsaw, Poland.; Kosior, DA (通讯作者),Cardinal Stefan Wyszynski Univ, PL-01815 Warsaw, Poland. EM malgorzata.setny@cskmswia.pl; piotrjankowski@interia.pl; pawlakagnieszka@interia.pl; fizklin@wp.pl; zgasior@ptkardio.pl; mhaberka@op.pl; danuta.czarnecka@uj.edu.pl; andrzej.pajak@uj.edu.pl; tragez88@wpl.pl; karolinaszostak@gmail.com; emiliasawickak@gmail.com; zofia.stachurska@umb.edu.pl; dariusz.kosior@cskmswia.pl RI ; Kaminski, Karol/J-4515-2014 OI Sawicka, Emilia/0000-0002-8306-1882; Jankowski, Piotr/0000-0001-6223-8821; Kaminski, Karol/0000-0002-9465-2581; Kosior, Dariusz/0000-0002-7821-4442 FU Jagiellonian University Medical College; Medical University of Silesia; Cardinal Stefan Wyszynski University FX The study was funded by structural grants of Jagiellonian University Medical College, Medical University of Silesia and Cardinal Stefan Wyszynski University. 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Clin. Med. PD JUN PY 2021 VL 10 IS 12 AR 2594 DI 10.3390/jcm10122594 PG 13 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA SY8DZ UT WOS:000666113000001 PM 34208351 OA gold, Green Published DA 2023-05-13 ER PT J AU Christoph, M Herold, J Berg-Holldack, A Rauwolf, T Ziemssen, T Schmeisser, A Weinert, S Ebner, B Said, S Strasser, RH Braun-Dullaeus, RC AF Christoph, Marian Herold, Joerg Berg-Holldack, Anna Rauwolf, Thomas Ziemssen, Tjalf Schmeisser, Alexander Weinert, Soenke Ebner, Bernd Said, Samir Strasser, Ruth H. Braun-Dullaeus, Ruediger C. TI Effects of the PPAR gamma agonist pioglitazone on coronary atherosclerotic plaque composition and plaque progression in non-diabetic patients: a double-center, randomized controlled VH-IVUS pilot-trial SO HEART AND VESSELS LA English DT Article DE Cardiovascular disease; Thiazolidinediones; Intravascular ultrasonography; Atherosclerotic plaque progression, atherosclerotic plaque composition ID TYPE-2 DIABETES-MELLITUS; BARE-METAL STENT; PREVENTION; RISK; REPRODUCIBILITY; IMPLANTATION; GLIMEPIRIDE AB Despite the advanced therapy with statins, antithrombotics and antihypertensive agents, the medical treatment of coronary artery disease is less than optimal. Therefore, additional therapeutic anti-atherosclerotic options are desirable. This VH-IVUS study (intravascular ultrasonography with virtual histology) was performed to assess the potential anti-atherogenic effect of the PPAR gamma agonist pioglitazone in non-diabetic patients. A total of 86 non-culprit atherosclerotic lesions in 54 patients with acute coronary syndrome were observed in a 9-month prospective, double-blind, and placebo-controlled IVUS study. Patients were randomized to receive either 30 mg pioglitazone (Pio) or placebo (Plac). As primary efficacy parameter, the change of relative plaque content of necrotic core was determined by serial VH-IVUS analyses. Main secondary endpoint was the change of total plaque volume. In contrast to placebo, in the pioglitazone-treated group, the relative plaque content of necrotic core decreased significantly (Pio -1.3 +/- 6.9 % vs. Plac +2.6 +/- 6.5 %, p < 0.01). In comparison to the placebo group, the plaques in pioglitazone-treated patients showed significantly greater reduction of the total plaque volume (Pio -16.1 +/- 26.4 mm(3) vs. Plac -1.8 +/- 30.9 mm(3), p = 0.02). Treatment with a PPAR gamma agonist in non-diabetic patients results in a coronary artery plaque stabilization on top of usual medical care. C1 [Christoph, Marian; Berg-Holldack, Anna; Ebner, Bernd; Strasser, Ruth H.] Univ Dresden, Ctr Heart, Univ Hosp, D-01307 Dresden, Germany. [Herold, Joerg; Rauwolf, Thomas; Schmeisser, Alexander; Weinert, Soenke; Said, Samir; Braun-Dullaeus, Ruediger C.] Univ Magdeburg, Internal Med, Div Cardiol Angiol & Pneumol, D-39106 Magdeburg, Germany. [Ziemssen, Tjalf] Univ Hosp, Dept Neurol, Dresden, Germany. C3 Technische Universitat Dresden; Carl Gustav Carus University Hospital; University of Hamburg; University Medical Center Hamburg-Eppendorf; Otto von Guericke University; Technische Universitat Dresden; Carl Gustav Carus University Hospital RP Christoph, M (通讯作者),Univ Dresden, Ctr Heart, Univ Hosp, Fetscherstr 76, D-01307 Dresden, Germany. EM marian.christoph@mailbox.tu-dresden.de RI Braun-Dullaeus, Ruediger C/G-1844-2013; Ziemssen, Tjalf/J-2017-2019; herold, joerg/AAD-9745-2020 OI Braun-Dullaeus, Ruediger C/0000-0003-3888-6532; Ziemssen, Tjalf/0000-0001-8799-8202; Weinert, Sonke/0000-0002-7201-0836 FU DFG (Deutsche Forschungsgemeinschaft, German Research Foundation) [SFB 854 (Sonderforschungsbereich)]; Takeda Pharmaceutical Company Limited FX This work was supported by the DFG (Deutsche Forschungsgemeinschaft, German Research Foundation) SFB 854 (Sonderforschungsbereich, collaborative research centre).; We thank the Laboratory for experimental cardiology, Heart Center Dresden headed by David Poitz for blinded analyses of the IVUS studies. This work was supported by Takeda Pharmaceutical Company Limited. 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The antiplatelet effect and safety of prasugrel was compared to that of double-dose clopidogrel in patients with stable coronary artery disease or acute coronary syndrome (ACS) exhibiting HTPR on clopidogrel and treated with PCI, using multiple electrode aggregometry (MEA) to assess platelet reactivity. Of 923 patients screened, 237 (25.7%) exhibited HTPR. Of these, 106 were eligible for participation in a randomized trial comparing two intensified antiplatelet regimen: 52 were assigned to double maintenance-dose clopidogrel and 54 to standard-dose prasugrel. At 1 month, tailoring antiplatelet therapy improved platelet inhibition to a level considered as therapeutic in 73.1% of patients. Prasugrel entailed greater platelet inhibition (p = 0.02) and a lower rate of persisting HTPR at follow-up compared to double-dose clopidogrel (HTPR persisted in 20.4% and 42% respectively, p = 0.02). Within the 30-day follow-up, no major bleeds were observed and the incidence of major adverse cardiovascular events (MACE) was similar in the two treatment arms. Prasugrel demonstrated superiority to double-dose clopidogrel in overcoming HTPR and reducing platelet activity. Intensifying antiplatelet therapy in both ACS and stable angina pectoris (SAP) patients exhibiting HTPR prior to PCI was well tolerated. C1 [Dridi, Nadia Paarup; Clemmensen, Peter; Radu, Maria Dumitrela; Qayyum, Abbas; Pedersen, Frants; Helqvist, Steffen; Saunamaki, Kari; Kelbaek, Henning; Jorgensen, Erik; Engstrom, Thomas; Holmvang, Lene] Univ Copenhagen, Rigshosp, Dept Cardiol, DK-1168 Copenhagen, Denmark. [Johansson, Par Ingemar; Stissing, Trine] Univ Copenhagen, Rigshosp, Transfus Med Sect, DK-1168 Copenhagen, Denmark. C3 Rigshospitalet; University of Copenhagen; Rigshospitalet; University of Copenhagen RP Dridi, NP (通讯作者),Rigshosp, Dept Cardiol, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. EM npdridi@gmail.com RI Johansson, Pär I/P-9283-2015; Johansson, Pär/GQB-1032-2022 OI Johansson, Pär I/0000-0001-9778-5964; Johansson, Pär/0000-0001-9778-5964; Engstrom, Thomas/0000-0001-5436-9194; Saunamaki, Kari/0000-0001-5953-5243 CR Alexopoulos D, 2012, J AM COLL CARDIOL, V60, P193, DOI 10.1016/j.jacc.2012.03.050 Angiolillo DJ, 2010, J AM COLL CARDIOL, V56, P1017, DOI 10.1016/j.jacc.2010.02.072 Becker RC, 2011, EUR HEART J, V32, P2933, DOI 10.1093/eurheartj/ehr422 Bonello L, 2011, J AM COLL CARDIOL, V58, P467, DOI 10.1016/j.jacc.2011.04.017 Bonello L, 2010, J AM COLL CARDIOL, V56, P919, DOI 10.1016/j.jacc.2010.04.047 Collet JP, 2012, NEW ENGL J MED, V367, P2100, DOI 10.1056/NEJMoa1209979 Cuisset T, 2006, J THROMB HAEMOST, V4, P542, DOI 10.1111/j.1538-7836.2005.01751.x Cutlip DE, 2011, JACC-CARDIOVASC INTE, V4, P554, DOI 10.1016/j.jcin.2011.01.011 Dewilde WJM, 2013, LANCET, V381, P1107, DOI 10.1016/S0140-6736(12)62177-1 Erlinge D, 2013, J AM COLL CARDIOL, V62, P577, DOI 10.1016/j.jacc.2013.05.023 Erlinge D, 2012, J AM COLL CARDIOL, V60, P2032, DOI 10.1016/j.jacc.2012.08.964 Franken CC, 2013, THROMB HAEMOSTASIS, V110, P131, DOI 10.1160/TH13-01-0021 Geisler T, 2008, J THROMB HAEMOST, V6, P54 Grove EL, 2011, J THROMB HAEMOST, V9, P185, DOI 10.1111/j.1538-7836.2010.04115.x Gurbel PA, 2005, CIRCULATION, V111, P1153, DOI 10.1161/01.CIR.0000157138.02645.11 Gurbel PA, 2012, JAMA-J AM MED ASSOC, V308, P1785, DOI 10.1001/jama.2012.17312 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hochholzer W, 2006, J AM COLL CARDIOL, V48, P1742, DOI 10.1016/j.jacc.2006.06.065 Jernberg T, 2006, EUR HEART J, V27, P1166, DOI 10.1093/eurheartj/ehi877 Johnston LR, 2013, PLATELETS, V24, P303, DOI 10.3109/09537104.2012.694086 Kaiser AFC, 2012, PLATELETS, V23, P359, DOI 10.3109/09537104.2011.624211 Mega JL, 2011, JAMA-J AM MED ASSOC, V306, P2221, DOI 10.1001/jama.2011.1703 Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Mehta SR, 2010, LANCET, V376, P1233, DOI 10.1016/S0140-6736(10)61088-4 Montalescot G, 2010, THROMB HAEMOSTASIS, V103, P213, DOI 10.1160/TH09-07-0482 Montalescot G, 2009, LANCET, V373, P723, DOI 10.1016/S0140-6736(09)60441-4 Neubauer H, 2011, BMC MED, V9, DOI 10.1186/1741-7015-9-3 Pena A, 2009, CIRCULATION, V119, P2854, DOI 10.1161/CIRCULATIONAHA.108.857722 Price MJ, 2012, JAMA-J AM MED ASSOC, V308, P1806, DOI 10.1001/jama.2012.34011 Price MJ, 2011, JAMA-J AM MED ASSOC, V305, P1097, DOI 10.1001/jama.2011.290 Sibbing D, 2007, BLOOD COAGUL FIBRIN, V18, P335, DOI 10.1097/MBC.0b013e3280d21aed Sibbing D, 2010, THROMB HAEMOSTASIS, V103, P151, DOI 10.1160/TH09-05-0284 Sibbing D, 2009, J AM COLL CARDIOL, V53, P849, DOI 10.1016/j.jacc.2008.11.030 Siller-Matula JM, 2013, INT J CARDIOL, V167, P2018, DOI 10.1016/j.ijcard.2012.05.040 Siller-Matula JM, 2009, THROMB HAEMOSTASIS, V102, P397, DOI 10.1160/TH08-10-0669 Stellbaum C, 2012, CARDIOVASC REVASCULA, V13, P159, DOI 10.1016/j.carrev.2012.02.009 Trenk D, 2012, J AM COLL CARDIOL, V59, P2159, DOI 10.1016/j.jacc.2012.02.026 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Wiviott SD, 2007, CIRCULATION, V116, P2923, DOI 10.1161/CIRCULATIONAHA.107.740324 Wurtz M, 2012, THROMB RES, V129, P56, DOI 10.1016/j.thromres.2011.08.019 NR 40 TC 20 Z9 22 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 530 WALNUT STREET, STE 850, PHILADELPHIA, PA 19106 USA SN 0953-7104 EI 1369-1635 J9 PLATELETS JI Platelets PY 2014 VL 25 IS 7 BP 506 EP 512 DI 10.3109/09537104.2013.845874 PG 7 WC Cell Biology; Hematology WE Science Citation Index Expanded (SCI-EXPANDED) SC Cell Biology; Hematology GA AS4ER UT WOS:000344226500005 PM 24245960 DA 2023-05-13 ER PT J AU Chae, MK Kim, EK Jung, KY Shin, TG Sim, MS Jo, IJ Song, KJ Chang, SA Bin Song, Y Hahn, JY Choi, SH Gwon, HC Lee, SH Kim, SM Eo, H Choe, YH Choi, JH AF Chae, Minjung Kathy Kim, Eun Kyoung Jung, Ka-Young Shin, Tae Gun Sim, Min Seob Jo, Ik-Joon Song, Keun Jeong Chang, Sung-A. Bin Song, Young Hahn, Joo-Yong Choi, Seung Hyuk Gwon, Hyeon-Cheol Lee, Sang-Hoon Kim, Sung Mok Eo, Hong Choe, Yeon Hyeon Choi, Jin-Ho TI Triple rule-out computed tomography for risk stratification of patients with acute chest pain SO JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY LA English DT Article DE Triple rule-out computed tomography; Chest pain; Acute cardiac care ID CORONARY CT ANGIOGRAPHY; INTERMEDIATE CARDIAC RISK; EMERGENCY-DEPARTMENT; ARTERY-DISEASE; HEART-ASSOCIATION; AMERICAN-COLLEGE; PROGNOSTIC VALUE; TASK-FORCE; PREDICTION; PROTOCOL AB Aims: Clinical evidence supporting triple rule-out computed tomography (TRO-CT) for rapid screening of cardiovascular disease is limited. We investigated the clinical value of TRO-CT in patients with acute chest pain. Methods: We retrospectively enrolled 1024 patients who visited the emergency department (ED) with acute chest pain and underwent TRO-CT using a 128-slice CT system. TRO-CT was classified as "positive" if it revealed clinically significant cardiovascular disease including obstructive coronary artery disease, pulmonary thromboembolism, or acute aortic syndrome. The clinical endpoint was occurrence of a major adverse cardiovascular event (MACE) within 30 days, defined by a composite of all cause death, myocardial infarction, revascularization, major cardiovascular surgery, or thrombolytic therapy. Clinical risk scores for acute chest pain including TIMI, GRACE, Diamond-Forrester, and HEART were determined and compared to the TRO-CT findings. Results: TRO-CT revealed clinically significant cardiovascular disease in 239 patients (23.3%). MACE occurred in 119 patients (49.8%) with positive TRO-CT and in 7 patients (0.9%) with negative TRO-CT (p < 0.001). Sensitivity, specificity, positive predictive value, and negative predictive value of TRO-CT was 95%, 88%, 54%, and 99%, respectively. TRO-CT was a better discriminator between patients with vs. without events as compared to clinical risk scores (c-statistics = 0.91 versus 0.64 to 0.71; integrated discrimination improvement = 0.31 to 0.37; p < 0.001 for all comparisons). Patients with a negative TRO-CT showed shorter ED stay times and admission rates compared to patients with positive TRO-CT, irrespective of clinical risk scores (p < 0.001 for all comparisons). Conclusion: Triple rule-out CT has high predictive performance for 30-day MACE and permits rapid triage and low admission rates irrespective of clinical risk scores. (C) 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved. C1 [Chae, Minjung Kathy] Ajou Univ Hosp, Dept Emergency Med, Suwon, South Korea. [Jung, Ka-Young; Shin, Tae Gun; Sim, Min Seob; Jo, Ik-Joon; Song, Keun Jeong; Choi, Jin-Ho] Sungkyunkwan Univ, Dept Emergency Med, Cardiac & Vasc Ctr, Samsung Med Ctr,Sch Med, Seoul, South Korea. [Kim, Eun Kyoung; Chang, Sung-A.; Bin Song, Young; Hahn, Joo-Yong; Choi, Seung Hyuk; Gwon, Hyeon-Cheol; Lee, Sang-Hoon; Choi, Jin-Ho] Sungkyunkwan Univ, Dept Med, Cardiac & Vasc Ctr, Samsung Med Ctr,Sch Med, Seoul, South Korea. [Kim, Sung Mok; Eo, Hong; Choe, Yeon Hyeon] Sungkyunkwan Univ, Dept Radiol, Cardiac & Vasc Ctr, Samsung Med Ctr,Sch Med, Seoul, South Korea. C3 Ajou University; Ajou University Hospital; Sungkyunkwan University (SKKU); Samsung Medical Center; Sungkyunkwan University (SKKU); Samsung Medical Center; Sungkyunkwan University (SKKU); Samsung Medical Center RP Choi, JH (通讯作者),Sungkyunkwan Univ, Dept Emergency Med, Dept Internal Med, Samsung Med Ctr,Sch Med, 81 Irwon Ro, Seoul 135710, South Korea. EM jhchoimd@gmail.com RI kim, sungmok/D-6143-2017; Hahn, Joo-Yong/AAU-7250-2020; Shin, Tae Gun/GSD-5866-2022; Choe, Yeon Hyeon/F-1422-2010 OI Hahn, Joo-Yong/0000-0002-4412-377X; Choe, Yeon Hyeon/0000-0002-9983-048X; Chae, Minjung Kathy/0000-0002-6927-8970; Chang, Sung-A/0000-0001-5124-605X; Kim, Sung Mok/0000-0001-5190-2328 FU Samsung Biomedical Research Institute grant [GL1B33211]; Heart Vascular and Stroke Institute of Samsung Medical Center FX This study was supported by Samsung Biomedical Research Institute grant [GL1B33211] and Heart Vascular and Stroke Institute of Samsung Medical Center. 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PD JUL-AUG PY 2016 VL 10 IS 4 BP 291 EP 300 DI 10.1016/j.jcct.2016.06.002 PG 10 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA DY3SN UT WOS:000385014800005 PM 27375202 DA 2023-05-13 ER PT J AU Fahimi, K Abbasi, A Zahedi, M Amanpour, F Ebrahimi, H AF Fahimi, Kosar Abbasi, Ali Zahedi, Mahdi Amanpour, Farzaneh Ebrahimi, Hossein TI The effects of multimedia education on postoperative delirium in patients undergoing coronary artery bypass graft: A randomized clinical trial SO NURSING IN CRITICAL CARE LA English DT Article DE coronary artery bypass graft; delirium; intensive care unit; multimedia; patient education; postoperative care; preoperative education ID CONFUSION ASSESSMENT METHOD; SURGERY; INTERVENTION; PREVENTION; PREDICTOR; KNOWLEDGE; OUTCOMES; ANXIETY; STAY AB Background Patients undergoing cardiac surgeries are at high risk of developing delirium. Aims and objectives The present study aimed to determine the effects of multimedia education on postoperative delirium in patients undergoing a coronary artery bypass graft. Design This study was a randomized clinical trial. Methods In this study, 110 patients undergoing a coronary artery bypass graft were assigned to two groups, control and intervention. Patients in the intervention group received multimedia education, and those in the control group received routine training. The inclusion criteria were experiencing the coronary artery bypass graft for the first time and non-development of post-operative cardiogenic shock or myocardial rupture. After measuring the level of consciousness, patients were examined in terms of delirium using the confusion assessment method for the ICU scale twice a day from admission to discharge from the ICU. The data were statistically analysed using chi(2) test and Fisher ' s exact test. Results Patients of both groups were matched in terms of demographics. The highest incidence of delirium was observed on the first day after surgery in the intervention group (14.5%) and in the morning of the second day after surgery (29.1%) in the control group. Moreover, there was a significant difference between the two groups in the incidence of delirium in the morning of the second, third, and fourth days after surgery as it was higher in the control group over these days. Conclusion Considering the lower incidence of post-operative delirium in patients who experienced multimedia education rather than control group, the use of this non-pharmaceutical method is recommended to prevent delirium in such patients. Relevance to clinical practice Delirium is also an acute organic brain syndrome that often leads to complicated conditions after cardiac surgeries. Fortunately, delirium is a preventable issue. The implementation of multimedia education as a non-pharmacological approach had positive effects on patients ' delirium. C1 [Fahimi, Kosar] Golestan Univ Med Sci, Shahid Sayyad Shirazi Hosp, Gorgan, Golestan, Iran. [Abbasi, Ali] Shahroud Univ Med Sci, Sch Nursing & Midwifery, Dept Nursing, Shahroud, Iran. [Zahedi, Mahdi] Golestan Univ Med Sci, Ischem Disorders Res Ctr, Gorgan, Golestan, Iran. [Amanpour, Farzaneh] Shahroud Univ Med Sci, Bahar Hosp, Clin Res Dev Unit, Shahroud, Iran. [Ebrahimi, Hossein] Shahroud Univ Med Sci, Randomized Controlled Trial Res Ctr, 7th Sq, Shahroud, Iran. C3 Golestan University of Medical Sciences; Shahroud University Medical Sciences; Golestan University of Medical Sciences; Shahroud University Medical Sciences; Shahroud University Medical Sciences RP Ebrahimi, H (通讯作者),Shahroud Univ Med Sci, Randomized Controlled Trial Res Ctr, 7th Sq, Shahroud, Iran. EM ebrahimi@shmu.ac.ir RI Ebrahimi, Hossein/Q-5049-2018; Abbasi, Dr Ali/HJP-6760-2023 OI Abbasi, Dr Ali/0000-0003-0482-6208; Ebrahimi, Hossein/0000-0001-5731-7103 CR Artemiou P, 2015, KARDIOCHIR TORAKOCHI, V12, P126, DOI 10.5114/kitp.2015.52853 Avendano-Cespedes A, 2016, MATURITAS, V86, P86, DOI 10.1016/j.maturitas.2016.02.002 Balas MC, 2009, CHEST, V135, P18, DOI 10.1378/chest.08-1456 Bellelli G, 2008, J AM MED DIR ASSOC, V9, P281, DOI 10.1016/j.jamda.2007.08.014 Burkhart CS, 2010, J CARDIOTHOR VASC AN, V24, P555, DOI 10.1053/j.jvca.2010.01.003 Changizi A, 2013, ZAHEDAN J RES MED SC, V15, P33 Chen CCH, 2017, JAMA SURG, V152, P827, DOI 10.1001/jamasurg.2017.1083 Chevillon C, 2015, AM J CRIT CARE, V24, P164, DOI 10.4037/ajcc2015658 Curtis JR, 2012, CONTEMP CLIN TRIALS, V33, P1245, DOI 10.1016/j.cct.2012.06.010 Dallimore RK, 2017, SINGAP MED J, V58, P562, DOI 10.11622/smedj.2016084 Daly BJ, 2010, CHEST, V138, P1340, DOI 10.1378/chest.10-0292 Demircelik MB, 2016, APPL NURS RES, V29, P5, DOI 10.1016/j.apnr.2015.03.014 Ely EW, 2001, CRIT CARE MED, V29, P1370, DOI 10.1097/00003246-200107000-00012 Ely EW, 2004, JAMA-J AM MED ASSOC, V291, P1753, DOI 10.1001/jama.291.14.1753 European Delirium Association, 2014, BMC Med, V12, P141, DOI 10.1186/s12916-014-0141-2 Fong TG, 2009, NAT REV NEUROL, V5, P210, DOI 10.1038/nrneurol.2009.24 FRANCIS J, 1990, JAMA-J AM MED ASSOC, V263, P1097, DOI 10.1001/jama.263.8.1097 Girard TD, 2010, CRIT CARE MED, V38, P1513, DOI 10.1097/CCM.0b013e3181e47be1 Gottesman RF, 2010, ANN NEUROL, V67, P338, DOI 10.1002/ana.21899 Hshieh TT, 2015, JAMA INTERN MED, V175, P512, DOI 10.1001/jamainternmed.2014.7779 Ihrig A, 2012, PATIENT EDUC COUNS, V87, P239, DOI 10.1016/j.pec.2011.08.014 Inouye SK, 2014, LANCET, V383, P911, DOI 10.1016/S0140-6736(13)60688-1 Inouye SK, 1999, NEW ENGL J MED, V340, P669, DOI 10.1056/NEJM199903043400901 Kardan Barzoki E., 2016, IRAN J CARDIOVASC NU, V4, P6 Koster S, 2012, ANN THORAC SURG, V93, P705, DOI 10.1016/j.athoracsur.2011.07.006 Lundstrom M, 2007, AGING CLIN EXP RES, V19, P178 Marcantonio ER, 2012, JAMA-J AM MED ASSOC, V308, P73, DOI 10.1001/jama.2012.6857 Ouimet S, 2007, INTENS CARE MED, V33, P66, DOI 10.1007/s00134-006-0399-8 Pisani MA, 2009, AM J RESP CRIT CARE, V180, P1092, DOI 10.1164/rccm.200904-0537OC 전수란, 2016, [Korean J Women Health Nurs, 여성건강간호학회지], V22, P39, DOI 10.4069/kjwhn.2016.22.1.39 Roger VL, 2011, CIRCULATION, V123, pE18, DOI 10.1161/CIR.0b013e3182009701 Steiner LA, 2011, EUR J ANAESTH, V28, P628, DOI 10.1097/EJA.0b013e328349b7f5 Wei LA, 2008, J AM GERIATR SOC, V56, P823, DOI 10.1111/j.1532-5415.2008.01674.x Wilson EAH, 2012, PATIENT EDUC COUNS, V89, P7, DOI 10.1016/j.pec.2012.06.007 Yin B, 2015, J BONE JOINT SURG AM, V97A, P964, DOI 10.2106/JBJS.N.01174 Zare, 2011, ZUMS J, V19, P78 Zhang WY, 2015, J CRIT CARE, V30, P606, DOI 10.1016/j.jcrc.2015.02.003 Zhang WY, 2017, Int J Nurs Sci, V4, P81, DOI 10.1016/j.ijnss.2017.02.002 Zolfaghari M, 2012, J HAYAT, V18, P67 NR 39 TC 7 Z9 8 U1 0 U2 7 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1362-1017 EI 1478-5153 J9 NURS CRIT CARE JI Nurs. Crit. Care PD NOV PY 2020 VL 25 IS 6 BP 346 EP 352 DI 10.1111/nicc.12473 PG 7 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA OT9VE UT WOS:000591185300004 PM 31532055 DA 2023-05-13 ER PT J AU Gargiulo, G Valgimigli, M Capodanno, D Bittl, JA AF Gargiulo, Giuseppe Valgimigli, Marco Capodanno, Davide Bittl, John A. TI State of the art: duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation - past, present and future perspectives SO EUROINTERVENTION LA English DT Review DE dual antiplatelet therapy; percutaneous coronary intervention; randomised trials ID DRUG-ELUTING STENTS; PERIPHERAL ARTERIAL-DISEASE; BARE-METAL STENTS; RANDOMIZED EVALUATION; BLEEDING OUTCOMES; CLINICAL-OUTCOMES; RISK PATIENTS; DOUBLE-BLIND; CLOPIDOGREL; ASPIRIN AB Evidence from studies published more than 10 years ago suggested that patients receiving first-generation drug-eluting stents (DES) needed dual antiplatelet therapy (DAPT) for at least 12 months. Current evidence from randomised controlled trials (RCT) reported within the past five years suggests that patients with stable ischaemic heart disease who receive newer-generation DES need DAPT for a minimum of three to six months. Patients who undergo stenting for an acute coronary syndrome benefit from DAPT for at least 12 months, but a Bayesian network meta-analysis confirms that extending DAPT beyond 12 months confers a trade-off between reduced ischaemic events and increased bleeding. However, the network meta-analysis finds no credible increase in all-cause mortality if DAPT is lengthened from three to six months to 12 months (posterior median odds ratio [OR] 0.98; 95% Bayesian credible interval [BCI]: 0.73-1.43), from 12 months to 18-48 months (OR 0.87; 95% BCI: 0.64-1.17), or from three to six months to 18-48 months (OR 0.86; 95% BCI: 0.63-1.21). Future investigation should focus on identifying scoring systems that have excellent discrimination and calibration. Although predictive models should be incorporated into systems of care, most decisions about DAPT duration will be based on clinical judgement and patient preference. C1 [Gargiulo, Giuseppe; Valgimigli, Marco] Univ Bern, Bern Univ Hosp, Dept Cardiol, Bern, Switzerland. [Gargiulo, Giuseppe] Federico II Univ Naples, Dept Adv Biomed Sci, Naples, Italy. [Capodanno, Davide] Univ Catania, Ferrarotto Hosp, Cardiac Thorac Vasc Dept, Catania, Italy. [Bittl, John A.] Munroe Reg Med Ctr, 1500 SE 1st Ave, Ocala, FL 34471 USA. C3 University of Bern; University Hospital of Bern; University of Naples Federico II; University of Catania RP Bittl, JA (通讯作者),Munroe Reg Med Ctr, 1500 SE 1st Ave, Ocala, FL 34471 USA. EM jabittl@mac.com RI Capodanno, Davide/AAP-4949-2020; Valgimigli, Marco/AAE-9103-2019; GARGIULO, Giuseppe/AAC-2336-2022; Gargiulo, Giuseppe/AAC-2356-2022 OI Valgimigli, Marco/0000-0002-4353-7110; GARGIULO, Giuseppe/0000-0003-4395-6742; FU Cardiopath FX G. Gargiulo is supported by a research grant from Cardiopath. The other authors have no conflicts of interest to declare. 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Ali, Jamshed Rahman, Nasir Tipoo, Fateh Ali Samad, Zainab Fatimi, Saulat Hasnain Bukhari, Saira Faheem, Osman TI Impact of COVID-19 on Cardiovascular Disease Presentation, Emergency Department Triage and Inpatient Cardiology Services in a Low- to Middle-Income Country-Perspective from a Tertiary Care Hospital of Pakistan SO GLOBAL HEART LA English DT Article DE COVID-19; Cardiovascular diseases; Epidemiology; Low-Middle Income Country; Global Health; Cardiovascular Intervention AB Aims: To identify the changes in cardiovascular disease presentation, emergency room triage and inpatient diagnostic and therapeutic pathways. Methods: We conducted a retrospective cohort study at the Aga Khan University Hospital, Karachi. We collected data for patients presenting to the emergency department with cardiovascular symptoms between March-July 2019 (pre-COVID period) and March-July 2020 (COVID period). The comparison was made to quantify the differences in demographics, clinical characteristics, admission, diagnostic and therapeutic procedures, and in-hospital mortality between the two periods. Results: Of 2976 patients presenting with cardiac complaints to the emergency department (ED), 2041(69%) patients presented during the pre-COVID period, and 935 (31%) patients presented during the COVID period. There was significant reduction in acute coronary syndrome (ACS) (8% [95% CI 4-11], p < 0.001) and heart failure (down arrow 6% [95% CI 3-8], p < 0.001). A striking surge was noted in Type II Myocardial injury (up arrow 18% [95% CI 20-15], p < 0.001) during the pandemic. There was reduction in cardiovascular admissions (coronary care unit p < 0.01, coronary step-down unit p = 0.03), cardiovascular imaging (p < 0.001), and procedures (percutaneous coronary intervention p = 0.04 and coronary angiography p = 0.02). No significant difference was noted in mortality (4.7% vs. 3.7%). The percentage of patients presenting from rural areas declined significantly during the COVID period (18% vs. 14%, p = 0.01). In the subgroup analysis of sex, we noticed a falling trend of intervention performed in females during the COVID period (8.2% male vs. 3.3 % female). Conclusions: This study shows a significant decline in patients presenting with Type I myocardial infarction (MI) and a decrease in cardiovascular imaging and procedures during the COVID period. There was a significant increase noted in Type II MI. C1 [Adnan, Ghufran; Shams, Pirbhat; Ali, Jamshed; Rahman, Nasir; Tipoo, Fateh Ali; Bukhari, Saira; Faheem, Osman] Aga Khan Univ Hosp, Dept Med, Sect Cardiol, Karachi, Pakistan. [Khan, Maria A.] Aga Khan Univ Hosp, Dept Biostat & Epidemiol, Epidemiol & Biostat, Karachi, Pakistan. [Samad, Zainab] Aga Khan Univ, Dept Med, Sect Cardiol, Karachi, Pakistan. [Fatimi, Saulat Hasnain] Aga Khan Univ Hosp, Dept Surg, Sect Cardiothorac Surg, Karachi, Pakistan. C3 Aga Khan University; Aga Khan University; Aga Khan University; Aga Khan University RP Faheem, O (通讯作者),Aga Khan Univ Hosp, Dept Med, Sect Cardiol, Karachi, Pakistan. 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Heart PY 2021 VL 16 IS 1 BP 1 EP 8 DI 10.5334/gh.1084 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA XV4EE UT WOS:000734896200001 PM 35141127 OA gold, Green Published DA 2023-05-13 ER PT J AU Sarajlic, P Simonsson, M Jernberg, T Back, M Hofmann, R AF Sarajlic, Philip Simonsson, Moa Jernberg, Tomas Back, Magnus Hofmann, Robin TI Incidence, associated outcomes, and predictors of upper gastrointestinal bleeding following acute myocardial infarction: a SWEDEHEART-based nationwide cohort study SO EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY LA English DT Article DE Upper gastrointestinal bleeding; Predictors; Acute myocardial infarction; Registry ID ACUTE CORONARY SYNDROME; DUAL ANTIPLATELET THERAPY; VALIDATION; GUIDELINES; MORTALITY; EVENTS; SCORE; RISK AB Aims Of all spontaneous bleeding complications in patients with acute myocardial infarction (MI), upper gastrointestinal bleeding (UGIB) is common and of specific interest since it could be prevented by several prophylactic measures. We aimed to determine the incidence, associated outcomes, and predictors of UGIB following acute MI. Methods and results All patients with acute MI enrolled in the SWEDEHEART (Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies) registry from January 2007 to June 2016 and discharged alive on any antithrombotic therapy (n = 149 477) were followed regarding UGIB for 1 year. Associated outcomes were determined by Cox proportional hazards regression with UGIB as a time-dependent covariate, adjusting for baseline characteristics, invasive treatment, and medical treatment at discharge. Predictors of UGIB were determined by logistic regression and machine learning models. At 1 year, UGIB had occurred in 2230 patients (cumulative incidence 1.5%) and was significantly associated with an increased risk of all-cause death [hazard ratio (HR) 2.86, 95% confidence interval (CI) 2.58-3.16] and stroke (HR 1.80, 95% CI 1.32-2.45) but not with recurrent MI (HR 1.17, 95% CI 0.97-1.42). The most important predictors of UGIB were haemoglobin, age, systolic blood pressure, blood glucose, smoking status, previous upper gastrointestinal bleeding, and antithrombotic and gastroprotective treatment. Conclusion After acute MI, readmission because of UGIB is common and significantly associated with poor prognosis. By using machine learning in addition to traditional logistic regression, new predictors of UGIB, such as blood glucose and smoking status, were identified. C1 [Sarajlic, Philip; Back, Magnus] Karolinska Inst, Dept Med, Stockholm, Sweden. [Simonsson, Moa; Jernberg, Tomas] Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Stockholm, Sweden. [Simonsson, Moa; Back, Magnus] Karolinska Univ Hosp, Div Valvular & Coronary Dis, Theme Heart & Vessels, Stockholm, Sweden. [Hofmann, Robin] Soder Sjukhuset, Karolinska Inst, Div Cardiol, Dept Clin Sci & Educ, Stockholm, Sweden. C3 Karolinska Institutet; Danderyds Hospital; Karolinska Institutet; Karolinska Institutet; Karolinska University Hospital; Karolinska Institutet; Sodersjukhuset Hospital RP Simonsson, M (通讯作者),Eugeniavagen 23, S-17164 Stockholm, Sweden. EM moa.simonsson@sll.se RI Sarajlic, Philip/AAZ-2227-2020; Back, Magnus/E-4879-2011 OI Sarajlic, Philip/0000-0002-8690-7994; Back, Magnus/0000-0003-0853-5141; Simonsson, Moa/0000-0002-3775-0839; Jernberg, Tomas/0000-0003-1695-379X; Hofmann, Robin/0000-0002-8907-895X FU TClinical Scientist Training Program; Swedish Heart-Lung Foundation [HLF 2018-0187]; Swedish Research Council [2019-00414]; Region Stockholm [K 2017-4577] FX TClinical Scientist Training Program (to P. S.); Swedish Heart-Lung Foundation (HLF 2018-0187 to R. H.); the Swedish Research Council (2019-00414); Region Stockholm (K 2017-4577). CR Bhatt DL, 2010, NEW ENGL J MED, V363, P1909, DOI 10.1056/NEJMoa1007964 Bilal M, 2020, GASTROINTEST ENDOSC, V92, P65, DOI 10.1016/j.gie.2020.01.039 Buccheri S, 2019, EXPERT OPIN DRUG SAF, V18, P1171, DOI 10.1080/14740338.2019.1680637 Chey WD, 2017, AM J GASTROENTEROL, V112, P212, DOI 10.1038/ajg.2016.563 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 Costa F, 2017, LANCET, V389, P1025, DOI 10.1016/S0140-6736(17)30397-5 Doyle BJ, 2009, J AM COLL CARDIOL, V53, P2019, DOI 10.1016/j.jacc.2008.12.073 Eikelboom JW, 2006, CIRCULATION, V114, P774, DOI 10.1161/CIRCULATIONAHA.106.612812 Hoedemaker NPG, 2019, EUR HEART J-CARD PHA, V5, P127, DOI 10.1093/ehjcvp/pvy030 Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Kikkert WJ, 2015, INT J CARDIOL, V184, P128, DOI 10.1016/j.ijcard.2015.01.041 Kim BK, 2020, JAMA-J AM MED ASSOC, V323, P2407, DOI 10.1001/jama.2020.7580 Koskinas KC, 2015, CIRC-CARDIOVASC INTE, V8, DOI 10.1161/CIRCINTERVENTIONS.114.002053 Ludvigsson JF, 2011, BMC PUBLIC HEALTH, V11, DOI 10.1186/1471-2458-11-450 Magnani G, 2021, J AM HEART ASSOC, V10, DOI 10.1161/JAHA.120.017008 Malfertheiner P, 2017, GUT, V66, P6, DOI 10.1136/gutjnl-2016-312288 Mehran R, 2019, NEW ENGL J MED, V381, P2032, DOI 10.1056/NEJMoa1908419 Nikolsky E, 2009, J AM COLL CARDIOL, V54, P1293, DOI 10.1016/j.jacc.2009.07.019 Ozaydin N, 2013, BMC PUBLIC HEALTH, V13, DOI 10.1186/1471-2458-13-1215 Raposeiras-Roubin S, 2018, INT J CARDIOL, V254, P10, DOI 10.1016/j.ijcard.2017.10.103 Ruff CT, 2014, LANCET, V383, P955, DOI 10.1016/S0140-6736(13)62343-0 Sarajlic P, 2021, JACC-BASIC TRANSL SC, V6, P403, DOI 10.1016/j.jacbts.2021.02.005 Sehested TSG, 2019, EUR HEART J, V40, P1963, DOI 10.1093/eurheartj/ehz104 Sibbing D, 2017, LANCET, V390, P1747, DOI 10.1016/S0140-6736(17)32155-4 Simonsson M, 2020, EUR HEART J, V41, P833, DOI 10.1093/eurheartj/ehz593 Subherwal S, 2009, CIRCULATION, V119, P1873, DOI 10.1161/CIRCULATIONAHA.108.828541 Urban P, 2019, EUR HEART J, V40, P2632, DOI 10.1093/eurheartj/ehz372 Valgimigli M, 2018, EUR HEART J, V39, P213, DOI 10.1093/eurheartj/ehx419 Valgimigli M, 2017, EUR HEART J, V38, P804, DOI 10.1093/eurheartj/ehw525 Vane JR, 2003, THROMB RES, V110, P255, DOI 10.1016/S0049-3848(03)00379-7 Yeh RW, 2016, JAMA-J AM MED ASSOC, V315, P1735, DOI 10.1001/jama.2016.3775 NR 31 TC 19 Z9 19 U1 4 U2 5 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 2055-6837 EI 2055-6845 J9 EUR HEART J-CARD PHA JI EUR. HEART J.-CARDIOVASC. PHARMACOTHER. PD AUG 11 PY 2022 VL 8 IS 5 BP 483 EP 491 DI 10.1093/ehjcvp/pvab059 PG 9 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA 3R3HO UT WOS:000838807700011 PM 34423350 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Zelias, A Stepinska, J Andres, J Trabka-Zawicki, A Sadowski, J Zmudka, K AF Zelias, Aleksander Stepinska, Janina Andres, Janusz Trabka-Zawicki, Aleksander Sadowski, Jerzy Zmudka, Krzysztof TI Ten-year experience of an invasive cardiology centre with out-of-hospital cardiac arrest patients admitted for urgent coronary angiography SO KARDIOLOGIA POLSKA LA English DT Article DE out-of-hospital cardiac arrest; coronary angiography; percutaneous coronary intervention; survival; neurological outcome ID EUROPEAN-RESUSCITATION-COUNCIL; ACUTE MYOCARDIAL-INFARCTION; AMERICAN-HEART-ASSOCIATION; TASK-FORCE; GUIDELINES; INTERVENTION; CARDIOPULMONARY; STATEMENT; SURVIVORS; SURGERY AB Background and aim: The aim of the study was to evaluate survival and neurological function of out-of-hospital cardiac arrest (OHCA) patients admitted for urgent coronary angiography (UCA) with a view to percutaneous coronary intervention (PCI). Methods: Hospital records of OHCA patients admitted to an invasive cardiology centre (providing 24 h a day/7 days a week service) in 2000-2010 were reviewed retrospectively, and similar data collected in 2011 were reviewed prospectively. Reports from the pre-hospital phase from emergency medical services (EMS) in Krakow were also analysed. Long-term follow-up data were collected by retrieving records from other hospitals (for patients transferred after UCA/PCI) and by phone calls to patients or their relatives. Results: In 2000-2011, 405 OHCA patients were admitted for UCA/PCI. Most (78%) had ventricular fibrillation (VF) or ventricular tachycardia (VT) as the primary mechanism of cardiac arrest (asystole: 13%, pulseless electrical activity: 3%, unknown: 6%). The mean patient age was 61 (range 20-85) years, and 81% were males. On admission, about 70% of patients were unconscious and 11% were in cardiogenic shock. The mean resuscitation time (time to return of spontaneous circulation [ROSC]) was 26.7 (range 1-126) min. ST-T changes seen in an electrocardiogram recorded after ROSC included ST elevation and depression in 52% of cases, only ST depression in 21% of cases, only ST elevation in 17% of cases, unspecific changes (due to intraventricular conduction disturbances) in 7% of cases, negative T waves in 3% of cases, and no changes in 0.5% of cases. Coronary angiography revealed acute coronary occlusion in 48% of cases, critical coronary stenosis (> 90%) in 26% of cases, other significant coronary lesions (> 50% stenosis) in 15% of cases, and non-significant lesions in 11% of cases. An acute coronary syndrome (ACS) was diagnosed in 82% of patients (75% STEMI, 25% NSTEMI), and other cardiac cause (mostly ischaemic cardiomyopathy) was identified in 13% of patients. Among OHCA patients diagnosed with ACS, PCI was performed in 90% and additional 4% underwent coronary artery bypass grafting. Overall success rate of PCI, defined as TIMI 3 flow plus residual stenosis < 50% and resolution of ST elevation after PCI by > 30%, was 70%. Survival to hospital discharge in the entire group of OHCA patients was 63% and 30-day survival with good neurological outcomes (defined as Cerebral Performance Category 1 or 2) was 49%. Among patients who were initially unconscious, those figures were 52% and 33%, respectively. During long-term follow-up (up to 12 years), 49% of patients were alive and 42% had good neurological function (87% of those who survived). In multivariate analysis, independent predictors of survival with good neurological outcomes were preserved consciousness on admission, absence of shock, cardiac arrest witnessed by medical personnel, VF/VT as a primary mechanism of cardiac arrest, and preserved renal function. Successful PCI predicted survival until hospital discharge only when the neurological status of the patients was not taken into account. Conclusions: The most important cause of OHCA is coronary artery disease, in particular ACS. UCA and PCI seem to be important elements of appropriate post-resuscitation care because such treatment could improve survival but it is still unclear whether PCI might influence neurological outcomes as well. C1 [Zelias, Aleksander; Trabka-Zawicki, Aleksander; Zmudka, Krzysztof] Jagiellonian Univ, John Paul II Hosp, Coll Med, Inst Cardiol,Clin Intervent Cardiol, PL-31202 Krakow, Poland. [Stepinska, Janina] Inst Cardiol, Dept Cardiac Intens Care, Warsaw, Poland. [Andres, Janusz] Jagiellonian Univ, Coll Med, Dept Anaesthesiol & Intens Care, PL-31202 Krakow, Poland. [Sadowski, Jerzy] Jagiellonian Univ, John Paul II Hosp, Coll Med, Dept Cardiovasc Surg & Transplantol, PL-31202 Krakow, Poland. C3 Jagiellonian University; Collegium Medicum Jagiellonian University; Institute of Cardiology - Poland; Jagiellonian University; Collegium Medicum Jagiellonian University; Jagiellonian University; Collegium Medicum Jagiellonian University RP Zelias, A (通讯作者),Jagiellonian Univ, John Paul II Hosp, Coll Med, Inst Cardiol,Clin Intervent Cardiol, Ul Pradnicka 80, PL-31202 Krakow, Poland. EM aazelias@gmail.com OI Zelias, Aleksander/0000-0002-6938-4896 CR Anyfantakis ZA, 2009, AM HEART J, V157, P312, DOI 10.1016/j.ahj.2008.09.016 Atwood C, 2005, RESUSCITATION, V67, P75, DOI 10.1016/j.resuscitation.2005.03.021 CUMMINS RO, 1991, CIRCULATION, V84, P960, DOI 10.1161/01.CIR.84.2.960 Dumas F, 2010, CIRC-CARDIOVASC INTE, V3, P200, DOI 10.1161/CIRCINTERVENTIONS.109.913665 Garot P, 2007, CIRCULATION, V115, P1354, DOI 10.1161/CIRCULATIONAHA.106.657619 Gorjup V, 2007, RESUSCITATION, V72, P379, DOI 10.1016/j.resuscitation.2006.07.013 Lettieri C, 2009, AM HEART J, V157, P569, DOI 10.1016/j.ahj.2008.10.018 Noc M, 2008, CRIT CARE MED, V36, pS454, DOI 10.1097/CCM.0b013e31818a8ae6 Nolan JP, 2010, RESUSCITATION, V81, P1219, DOI 10.1016/j.resuscitation.2010.08.021 Nolan JP, 2008, RESUSCITATION, V79, P350, DOI 10.1016/j.resuscitation.2008.09.017 Reynolds Joshua C, 2009, J Intensive Care Med, V24, P179, DOI 10.1177/0885066609332725 Roger VL, 2012, CIRCULATION, V125, P188, DOI 10.1161/CIR.0b013e3182456d46 Rudner R, 2004, RESUSCITATION, V61, P315, DOI 10.1016/j.resuscitation.2004.01.020 SHEEHAN FH, 1987, CIRCULATION, V75, P817, DOI 10.1161/01.CIR.75.4.817 Sideris G, 2011, RESUSCITATION, V82, P1148, DOI 10.1016/j.resuscitation.2011.04.023 Spaulding CM, 1997, NEW ENGL J MED, V336, P1629, DOI 10.1056/NEJM199706053362302 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), 2010, Eur Heart J, V31, P2501, DOI 10.1093/eurheartj/ehq277 Zipes DP, 2006, HDB CLIN PRACTICE NR 19 TC 23 Z9 25 U1 0 U2 1 PU POLSKIE TOWARZYSTOWO KARDIOLOGICZNE PI WARSZAWA PA UL STAWKI 3 A LOK 1-2, WARSZAWA, POLAND SN 0022-9032 EI 1897-4279 J9 KARDIOL POL JI Kardiol. Pol. PY 2014 VL 72 IS 8 BP 687 EP 699 DI 10.5603/KP.a2014.0088 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AO3QB UT WOS:000341247300003 PM 24846357 OA Green Submitted DA 2023-05-13 ER PT J AU Burlacu, A Artene, B Covic, A AF Burlacu, Alexandru Artene, Bogdan Covic, Adrian TI A Narrative Review on Thrombolytics in Advanced CKD: Is it an Evidence-Based Therapy? SO CARDIOVASCULAR DRUGS AND THERAPY LA English DT Review DE Thrombolysis; Fibrinolysis; Advanced chronic kidney disease; Acute ischemic stroke; Acute myocardial infarction; Pulmonary embolism ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; ACUTE ISCHEMIC-STROKE; CHRONIC KIDNEY-DISEASE; TISSUE-PLASMINOGEN-ACTIVATOR; HEALTH-CARE PROFESSIONALS; ST-SEGMENT ELEVATION; PULMONARY-EMBOLISM; RENAL DYSFUNCTION; TASK-FORCE AB PurposeA timely pharmacoinvasive strategy consisting of thrombolytic therapy (TT) plays a pivotal role in three major scenarios: acute ischemic stroke (AIS), acute myocardial infarction (STEMI), and massive pulmonary embolism (PE). Presence of advanced chronic kidney disease (CKD) (estimated glomerular filtration rate <30mL/min/1.73m2), known to disturb thrombotic/thrombolytic equilibrium, causes difficulties for clinicians in evaluating risk-benefit balance, as current guidelines do not address the relationship between TT and the advanced CKD. This narrative review aims to evaluate the most important scientific resources regarding the evidences, benefits, and risks of using thrombolytics in advanced CKD.MethodsWe searched the electronic database of PubMed for studies evaluating the relationship between renal dysfunction and TT in patients with STEMI, AIS, and massive PE. Randomized controlled trials (RCTs), observational studies including prospective or retrospective cohort studies, reviews, meta-analyses, and guidelines were included if referring to TT for one of the three scenarios in advanced CKD.ResultsProthrombotic conditions in CKD, associated with an increased risk of hemorrhages, can affect the safety and efficacy of TT. Concerns regarding in-hospital bleeding events and poor clinical outcomes subsequent to TT in advanced CKD continue to cause underutilization or delaying routine reperfusion therapy.ConclusionsThe impact of TT on the outcomes of advanced CKD patients is poorly understood to date, with scarce data available in current guidelines and conflicting results from observational studies. Until evidence-based data from RCTs will be obtained, the clinical challenge of maximizing benefits for this high-risk subgroup lays in the hands of practicing clinicians. C1 [Burlacu, Alexandru; Artene, Bogdan] Cardiovasc Dis Inst, Dept Intervent Cardiol, Iasi, Romania. [Burlacu, Alexandru; Artene, Bogdan; Covic, Adrian] Univ Med & Pharm Gr T Popa, Iasi, Romania. [Covic, Adrian] Grigore T Popa Univ Med & Pharm, Nephrol Dept, Iasi, Romania. C3 Grigore T Popa University of Medicine & Pharmacy; Grigore T Popa University of Medicine & Pharmacy RP Artene, B (通讯作者),Cardiovasc Dis Inst, Dept Intervent Cardiol, Iasi, Romania.; Artene, B (通讯作者),Univ Med & Pharm Gr T Popa, Iasi, Romania. EM bogdan.artene@yahoo.com RI Covic, Adrian C/G-5017-2016; Burlacu, Alexandru/AAM-4168-2020; Artene, Bogdan/AAJ-5912-2021 OI Covic, Adrian C/0000-0002-9985-2486; Burlacu, Alexandru/0000-0002-3424-1588; Artene, Bogdan/0000-0002-3201-1105 CR Abraham P, 2018, OPEN HEART, V5, DOI 10.1136/openhrt-2017-000735 Agrawal V, 2010, NEPHROL DIAL TRANSPL, V25, P1150, DOI 10.1093/ndt/gfp619 Anavekar NS, 2004, NEW ENGL J MED, V351, P1285, DOI 10.1056/NEJMoa041365 Anderson JL, 2013, J AM COLL CARDIOL, V61, pE179, DOI 10.1016/j.jacc.2013.01.014 [Anonymous], 2013, MYOC INF ST SEGM EL Antman EM, 2000, EUR HEART J, V21, P1944, DOI 10.1053/euhj.2000.2243 Bayley M, 2008, CAN MED ASSOC J, V179, P1247, DOI 10.1503/cmaj.081536 Bivard A, 2013, J STROKE, V15, P90, DOI 10.5853/jos.2013.15.2.90 Braunwald E, 2000, EUR HEART J, V21, P2005 Cannon CP, 1998, CIRCULATION, V98, P2805, DOI 10.1161/01.CIR.98.25.2805 Cannon CP, 1997, CIRCULATION, V95, P351 Capodanno D, 2012, CIRCULATION, V125, P2649, DOI 10.1161/CIRCULATIONAHA.111.084996 Carr SJ, 2017, STROKE, V48, P2605, DOI 10.1161/STROKEAHA.117.017808 Chao TH, 2013, EUR NEUROL, V70, P316, DOI 10.1159/000353296 Chew DP, 2016, HEART LUNG CIRC, V25, P895, DOI 10.1016/j.hlc.2016.06.789 Coca SG, 2006, JAMA-J AM MED ASSOC, V296, P1377, DOI 10.1001/jama.296.11.1377 Demaerschalk BM, 2016, STROKE, V47, P581, DOI 10.1161/STR.0000000000000086 Fitchett DH, 2011, CAN J CARDIOL, V27, pS402, DOI 10.1016/j.cjca.2011.08.107 Foundation S, 2017, CLIN GUID STROK MAN Gensicke H, 2013, NEUROLOGY, V81, P1780, DOI 10.1212/01.wnl.0000435550.83200.9e Gibson CM, 2003, J AM COLL CARDIOL, V42, P1535, DOI 10.1016/j.jacc.2003.06.001 Go AS, 2004, NEW ENGL J MED, V351, P1296, DOI 10.1056/NEJMoa041031 Hacke W, 2008, CEREBROVASC DIS, V25, P457, DOI 10.1159/000131083 Hao ZL, 2014, MEDICINE, V93, DOI 10.1097/MD.0000000000000286 Hassine M, 2014, ACTA CARDIOL, V69, P245, DOI 10.1080/AC.69.3.3027826 Herzog CA, 1999, KIDNEY INT, V56, pS130, DOI 10.1046/j.1523-1755.1999.07132.x Hirano T, 2013, CONTRIB NEPHROL, V179, P110, DOI 10.1159/000346729 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Jaff MR, 2011, CIRCULATION, V123, P1788, DOI 10.1161/CIR.0b013e318214914f Jalal DI, 2010, SEMIN THROMB HEMOST, V36, P34, DOI 10.1055/s-0030-1248722 Jung JM, 2015, J NEUROL SCI, V358, P345, DOI 10.1016/j.jns.2015.09.353 Konstantinides SV, 2016, J AM COLL CARDIOL, V67, P976, DOI 10.1016/j.jacc.2015.11.061 Konstantinides SV, 2014, EUR HEART J, V35, P3033, DOI 10.1093/eurheartj/ehu283 Kumar G, 2012, CLIN J AM SOC NEPHRO, V7, P1584, DOI 10.2215/CJN.00250112 Newsome BB, 2005, AM J KIDNEY DIS, V46, P595, DOI 10.1053/j.ajkd.2005.06.008 O'Gara PT, 2013, J AM COLL CARDIOL, V61, P485, DOI [10.1016/j.jacc.2012.11.018, 10.1161/CIR.0b013e3182742c84] Palacio S, 2011, CLIN J AM SOC NEPHRO, V6, P1089, DOI 10.2215/CJN.10481110 Pantoni L, 2014, CEREBROVASC DIS, V37, P5, DOI 10.1159/000356796 Patel B, 2017, J THROMB THROMBOLYS, V44, P324, DOI 10.1007/s11239-017-1545-6 Power A, 2013, NEPHRON CLIN PRACT, V124, P167, DOI 10.1159/000357155 Powers WJ, 2018, STROKE, V49, pE46, DOI 10.1161/STR.0000000000000158 Roberts JK, 2014, ADV CHRONIC KIDNEY D, V21, P472, DOI 10.1053/j.ackd.2014.08.005 Rudd AG, 2017, CLIN MED, V17, P154, DOI 10.7861/clinmedicine.17-2-154 Russo JJ, 2017, AM HEART J, V193, P46, DOI 10.1016/j.ahj.2017.07.015 Santopinto JJ, 2003, HEART, V89, P1003, DOI 10.1136/heart.89.9.1003 Shah HH, 2000, INT J ARTIF ORGANS, V23, P77, DOI 10.1177/039139880002300203 Sharifi M, 2013, AM J CARDIOL, V111, P273, DOI 10.1016/j.amjcard.2012.09.027 Sharma S, 2013, EUR HEART J, V34, P354, DOI 10.1093/eurheartj/ehs300 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Szummer K, 2010, J INTERN MED, V268, P40, DOI 10.1111/j.1365-2796.2009.02204.x Toyoda K, 2014, LANCET NEUROL, V13, P823, DOI 10.1016/S1474-4422(14)70026-2 Van de Werf F, 2008, EUR HEART J, V29, P2909, DOI 10.1093/eurheartj/ehn416 Wein T, 2018, INT J STROKE, V13, P420, DOI 10.1177/1747493017743062 Windecker S, 2014, EUR HEART J, V35, P2541, DOI [10.5603/KP.2014.0224, 10.1093/eurheartj/ehu278, 10.1093/ejcts/ezu366] NR 54 TC 2 Z9 2 U1 0 U2 7 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0920-3206 EI 1573-7241 J9 CARDIOVASC DRUG THER JI Cardiovasc. Drugs Ther. PD OCT PY 2018 VL 32 IS 5 BP 463 EP 475 DI 10.1007/s10557-018-6824-8 PG 13 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA HC4CA UT WOS:000451748900007 PM 30187347 DA 2023-05-13 ER PT J AU Shoji, S Kohsaka, S Kumamaru, H Yamaji, K Nishimura, S Ishii, H Amano, T Fushimi, K Miyata, H Ikari, Y AF Shoji, Satoshi Kohsaka, Shun Kumamaru, Hiraku Yamaji, Kyohei Nishimura, Shiori Ishii, Hideki Amano, Tetsuya Fushimi, Kiyohide Miyata, Hiroaki Ikari, Yuji TI Cost reduction associated with transradial access in percutaneous coronary intervention: A report from a Japanese nationwide registry SO LANCET REGIONAL HEALTH-WESTERN PACIFIC LA English DT Article DE Percutaneous coronary intervention; Transradial access; Cost; Nationwide registry; Percutaneous coronary intervention (PCI) remains ID UNIVERSAL HEALTH-CARE; FEMORAL ACCESS; OUTCOMES; DISEASE; TRENDS AB Background Percutaneous coronary intervention (PCI) is increasingly performed via transradial access (TRA). This study aimed to investigate the clinical and economic benefits of TRA compared with transfemoral access (TFA) under universal healthcare coverage system in Japan. Methods A total of 36,153 patients (acute coronary syndrome [ACS], 15,266; stable ischemic heart disease [SIHD], 20,052) across 714 institutions in the Japanese nationwide PCI registry (J-PCI) in 2015 were analyzed (mean age 69.9 11.1 years and 23.6% female). Cost was defined as the total amount of healthcare resources used to care for the patient during hospitalization. Propensity score matching analysis was conducted to balance the baseline charac-teristics of patients undergoing TRA and TFA. Findings The median total cost of PCI was JPY 1,341,176 (interquartile range, 959,052), with higher expenses for ACS (JPY 1,772,116 [1,117,107]) compared with SIHD (JPY 1,119,153 [540,440]) patients. Most patients underwent PCI via TRA (73.8%), and after propensity score matching, TRA was associated with a reduced risk of in-hospital death and bleeding (0.88% vs. 1.91% [P < 0.0001] and 2.18% vs. 4.53% [P < 0.0001] in ACS, and 0.10% vs. 0.28% [P = 0.070] and 0.53% vs. 1.72% [P < 0.0001] in SIHD, respectively), which led to lower costs in both ACS (JPY 1,699,279 [1,164,554] for TRA vs. JPY 1,931,255 [1,070,222] for TFA; P < 0.0001), and SIHD (JPY 1,102,352 [505,904] for TRA vs. JPY 1,311,525 [706,450] for TFA; P < 0.0001) patients. Interpretation In this direct cost analysis of a nationwide registry, the use of TRA was associated with cost saving for both ACS and SIHD patients.Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. C1 [Shoji, Satoshi] Hino Municipal Hosp, Dept Cardiol, Tokyo, Japan. [Shoji, Satoshi; Kohsaka, Shun] Keio Univ Sch Med, Dept Cardiol, Tokyo, Japan. [Kumamaru, Hiraku; Nishimura, Shiori; Miyata, Hiroaki] Univ Tokyo, Dept Healthcare Qual Assessment, Grad Sch Med, Tokyo, Japan. [Yamaji, Kyohei] Kyoto Univ, Dept Cardiovasc Med, Kyoto, Japan. [Ishii, Hideki] Gunma Univ, Dept Cardiovasc Med, Grad Sch Med, Maebashi, Japan. [Amano, Tetsuya] Aichi Med Univ, Dept Cardiol, Nagakute, Aichi, Japan. [Fushimi, Kiyohide] Tokyo Med & Dent Univ, Grad Sch Med, Dept Hlth Policy & Informat, Tokyo, Japan. [Ikari, Yuji] Tokai Univ, Dept Cardiol, Sch Med, Isehara, Kanagawa, Japan. [Kohsaka, Shun] Keio Univ, Dept Cardiol, Sch Med, 35 Shinanomachi Shinjuku Ku, Tokyo 1608582, Japan. C3 Keio University; University of Tokyo; Kyoto University; Gunma University; Aichi Medical University; Tokyo Medical & Dental University (TMDU); Tokai University; Keio University RP Kohsaka, S (通讯作者),Keio Univ, Dept Cardiol, Sch Med, 35 Shinanomachi Shinjuku Ku, Tokyo 1608582, Japan. EM sk@keio.jp FU Japan Society for the Promotion of Science; Japan Agency for Medical Research and Development [AMED] [20H03915, 16H05215, 16KK0186, 20K22883, 21K08064]; National Clinical Database [16lk1010004h0002]; Japanese Association of Cardiovascular Intervention and Therapeutics FX This study was funded by the Japan Society for the Promotion of Science (grant nos. 20H03915, 16H05215, 16KK0186, 20K22883, and 21K08064), Japan Agency for Medical Research and Development [AMED] (grant number 16lk1010004h0002), and the National Clinical Database. 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Health-W. Pac. PD NOV PY 2022 VL 28 AR 100555 DI 10.1016/j.lanwpc.2022.100555 EA AUG 2022 PG 11 WC Health Care Sciences & Services; Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 4Y0HE UT WOS:000861214800001 PM 35996698 OA Green Published, gold DA 2023-05-13 ER PT J AU Karunakar, P Ramamoorthy, JG Anantharaj, A Parameswaran, N Biswal, N Dhodapkar, R Bhaskar, M Basu, D Das, S Gunalan, A AF Karunakar, Pediredla Ramamoorthy, Jaikumar G. Anantharaj, Avinash Parameswaran, Narayanan Biswal, Niranjan Dhodapkar, Rahul Bhaskar, Maanasa Basu, Debdatta Das, Sindhusuta Gunalan, Anitha TI Clinical profile and outcomes of multisystem inflammatory syndrome in children (MIS-C): Hospital-based prospective observational study from a tertiary care hospital in South India SO JOURNAL OF PAEDIATRICS AND CHILD HEALTH LA English DT Article DE coronary artery abnormalities; Kawasaki disease; left ventricular systolic dysfunction; macrophage activation syndrome; MIS-C; SARS CoV-2 ID SARS-COV-2; ASSOCIATION AB Aim To study the clinical profile and outcomes in children with multisystem inflammatory syndrome in children (MIS-C). Methods Children aged 1 month to 15 years presenting with MIS-C (May 2020 to November 2021) were enrolled. Clinical, laboratory, echocardiography parameters and outcomes were analysed. Results Eighty-one children (median age 60 months (24-100)) were enrolled. Median duration of fever was 5 days (3-7). Twenty-nine (35.8%) had shock (severe MIS-C) including 23 (28.3%) requiring inotropes (median duration = 25 h (7.5-33)). Ten required mechanical ventilation, 12 had acute kidney injury and 1 child died. Left ventricular (LV) dysfunction was seen in 38 (46.9%), 16 (19.7%) had coronary artery abnormalities (CAA) and 13 (20%) had macrophage activation syndrome. Sixty-one (75.3%) were SARS CoV-2 positive (10 by RT-PCR and 51 by serology). Sixty-eight (83.9%) received immunomodulators. Younger age was significantly associated with CAA (P value = 0.05). Older age, LV dysfunction, SARS CoV-2 positivity, low platelet count and elevated serum ferritin were significantly associated with severe MIS-C (univariate analysis). Younger age was an independent predictor of CAA (P = 0.05); older age (P = 0.043) and low platelet count (P = 0.032) were independent predictors of severe MIS-C (multivariate logistic regression analysis). Conclusion Our patients had diverse clinical manifestations with a good outcome. Younger age was significantly associated with CAA. Older age, LV dysfunction, low platelet count and elevated serum ferritin were significantly associated with severe MIS-C. Younger age is an independent predictor of CAA. Older age and low platelet count are independent predictors of severe MIS-C. C1 [Karunakar, Pediredla; Ramamoorthy, Jaikumar G.; Parameswaran, Narayanan; Biswal, Niranjan] Jawaharlal Inst Postgrad Med Educ & Res, Dept Pediat, Pondicherry, India. [Anantharaj, Avinash] Jawaharlal Inst Postgrad Med Educ & Res, Dept Cardiol, Pondicherry 605006, India. [Dhodapkar, Rahul; Bhaskar, Maanasa; Das, Sindhusuta; Gunalan, Anitha] Jawaharlal Inst Postgrad Med Educ & Res, Dept Microbiol, Pondicherry, India. [Basu, Debdatta] Jawaharlal Inst Postgrad Med Educ & Res, Dept Pathol, Pondicherry, India. C3 Jawaharlal Institute of Postgraduate Medical Education & Research; Jawaharlal Institute of Postgraduate Medical Education & Research; Jawaharlal Institute of Postgraduate Medical Education & Research; Jawaharlal Institute of Postgraduate Medical Education & Research RP Anantharaj, A (通讯作者),Jawaharlal Inst Postgrad Med Educ & Res, Dept Cardiol, Pondicherry 605006, India. EM avinboxer@gmail.com RI Karunakar, Pediredla/AHB-6973-2022 OI Karunakar, Pediredla/0000-0002-8347-3342; Parameswaran, Narayanan/0000-0002-8297-5789 FU JIPMER [JIP/Res/Intramural/Phs1/2020-21] FX This study was funded by an intramural grant by JIPMER to Dr Avinash Anantharaj (JIP/Res/Intramural/Phs1/2020-21) dated 05-10-2020, which is gratefully acknowledged. CR Carter MJ, 2020, NAT MED, V26, P1701, DOI 10.1038/s41591-020-1054-6 Centers for Disease Control and Prevention Health Alert Network (HAN), 2020, MULT INFL SYNDR CHIL Chandran J, 2021, INDIAN PEDIATR, V58, P955, DOI 10.1007/s13312-021-2330-3 Dhanalakshmi K, 2020, INDIAN PEDIATR, V57, P1010, DOI 10.1007/s13312-020-2025-1 Dhar D, 2022, PEDIATR RES, V91, P1334, DOI 10.1038/s41390-021-01545-z Dufort EM, 2020, NEW ENGL J MED, V383, P347, DOI 10.1056/NEJMoa2021756 Feldstein LR, 2020, NEW ENGL J MED, V383, P334, DOI 10.1056/NEJMoa2021680 Ganguly M, 2022, INT J RHEUM DIS, V25, P27, DOI 10.1111/1756-185X.14236 Hoste L, 2021, EUR J PEDIATR, V180, P2019, DOI 10.1007/s00431-021-03993-5 Jain S, 2020, INDIAN PEDIATR, V57, P1015, DOI 10.1007/s13312-020-2026-0 Jiang L, 2020, LANCET INFECT DIS, V20, pE276, DOI 10.1016/S1473-3099(20)30651-4 Kashyap H, 2021, INDIAN J PEDIATR, V88, P1053, DOI 10.1007/s12098-021-03832-3 Kaushik S, 2020, J PEDIATR-US, V224, P24, DOI 10.1016/j.jpeds.2020.06.045 Kleinman ME, 2010, CIRCULATION, V122, pS876, DOI 10.1161/CIRCULATIONAHA.110.971101 Kobayashi T, 2016, J AM SOC ECHOCARDIOG, V29, P794, DOI 10.1016/j.echo.2016.03.017 Lang RM, 2015, EUR HEART J-CARD IMG, V16, P233, DOI 10.1093/ehjci/jev014 McCrindle BW, 2017, CIRCULATION, V135, pE927, DOI 10.1161/CIR.0000000000000484 Mehra B, 2021, INDIAN J CRIT CARE M, V25, P1174, DOI 10.5005/jp-journals-10071-23996 Radia T, 2021, PAEDIATR RESPIR REV, V38, P51, DOI 10.1016/j.prrv.2020.08.001 Ravelli A, 2016, ANN RHEUM DIS, V75, P481, DOI 10.1136/annrheumdis-2015-208982 Shah STK, 2020, INDIAN J PEDIATR, V87, P671, DOI 10.1007/s12098-020-03440-7 Sinaei R, 2021, INDIAN J PEDIATR, V88, P484, DOI 10.1007/s12098-020-03617-0 Solanki R., 2021, MED J ARMED FORCES I, DOI [10.1016/.mjafi.2021.10.017, DOI 10.1016/.MJAFI.2021.10.017] Sugunan S, 2021, INDIAN PEDIATR, V58, P718, DOI 10.1007/s13312-021-2277-4 Rosanova MT, 2021, INDIAN PEDIATR, V58, P639, DOI 10.1007/s13312-021-2259-6 Tiwari A, 2021, BMJ PAEDIATR OPEN, V5, DOI 10.1136/bmjpo-2021-001195 Whittaker E, 2020, JAMA-J AM MED ASSOC, V324, P259, DOI 10.1001/jama.2020.10369 NR 27 TC 2 Z9 2 U1 3 U2 4 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1034-4810 EI 1440-1754 J9 J PAEDIATR CHILD H JI J. Paediatr. Child Health PD NOV PY 2022 VL 58 IS 11 BP 1964 EP 1971 DI 10.1111/jpc.16129 EA JUL 2022 PG 8 WC Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Pediatrics GA 6C9XA UT WOS:000829003300001 PM 35869845 DA 2023-05-13 ER PT J AU Abdullah, AS Salama, A Ibrahim, H Eigbire, G Hoefen, R Alweis, R AF Abdullah, Abdullah Sayied Salama, Amr Ibrahim, Hisham Eigbire, George Hoefen, Ryan Alweis, Richard TI Palliative Care in Myocardial Infarction: Patient Characteristics and Trends of Service Utilization in a National Inpatient Sample SO AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE LA English DT Article DE myocardial infarction; acute coronary syndrome palliative care; end of life; National Inpatient Sample; ICD code ID HEART-FAILURE; OUTCOMES; CONSULTATION; VALIDATION; CODE AB Introduction: Myocardial infarction (MI) remains a leading cause of mortality. Palliative care (PC) has recently expanded in scope to include noncancer-related conditions. There is little data available regarding the use of PC in critical MI patients. Methods: We used discharge data from the National Inpatient Sample for the years 2012 to 2014. We examined discharges with a primary diagnosis of MI. We measured the rate of PC referral, trend in utilization during the study period and possible predictors of PC utilization. Results: Among 1 667 520 discharges of those patients >= 18 years of age and with a primary diagnosis of MI, use of PC was seen in 2.5% of all patients and in 24% of patients who died. In a multivariable logistic regression, we found the presence of cancer, cardiogenic shock, dementia, stroke, hemiplegia, the use of circulatory support, and mechanical ventilation were associated with higher likelihood of PC referral. Palliative care referral increased during the study period, odds ratio of 1.18 per year (95% confidence interval: 1.14-1.21; P value <.001). Palliative care was not associated with prolonged length of stay. Conclusion: Several comorbidities were associated with the use of PC, most notably the use of mechanical ventilation and the presence of metastatic cancer. There was a trend of increasing use of PC during the study period. C1 [Abdullah, Abdullah Sayied; Salama, Amr; Eigbire, George; Alweis, Richard] Rochester Reg Hlth, Unity Hosp, Dept Med, 1555 Long Pond Rd, Rochester, NY 14626 USA. [Ibrahim, Hisham] Univ Iowa Hosp & Clin, Dept Cardiol, Iowa City, IA 52242 USA. [Hoefen, Ryan] Rochester Reg Hlth, Sands Constellat Heart Inst, Rochester, NY USA. [Alweis, Richard] Univ Rochester, Sch Med & Dent, Dept Med, Rochester, NY 14642 USA. [Alweis, Richard] Rochester Inst Technol, Sch Hlth Sci, Rochester, NY 14623 USA. C3 University of Iowa; University of Rochester; Rochester Institute of Technology RP Abdullah, AS (通讯作者),Rochester Reg Hlth, Unity Hosp, Dept Med, 1555 Long Pond Rd, Rochester, NY 14626 USA. EM abdullah.abdullah@rochesterregoinal.org RI Abdullah, Abdullah Sayied/J-8709-2019; SALAMA, AMR/AAQ-3322-2021 OI Abdullah, Abdullah Sayied/0000-0002-7697-3701; Salama, Amr/0000-0001-5757-1654 CR Albaeni A, 2018, RESUSCITATION, V124, P112, DOI 10.1016/j.resuscitation.2018.01.020 [Anonymous], HCUP DAT Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Chen HY, 2014, J AM GERIATR SOC, V62, P1451, DOI 10.1111/jgs.12941 Erne P, 2015, BMJ OPEN, V5, DOI 10.1136/bmjopen-2014-006218 Feder SL, 2018, AM J HOSP PALLIAT ME, V35, P959, DOI 10.1177/1049909117747519 FISHER ES, 1992, AM J PUBLIC HEALTH, V82, P243, DOI 10.2105/AJPH.82.2.243 Guddati AK, 2016, J CANCER RES CLIN, V142, P471, DOI 10.1007/s00432-015-2056-5 Higginson IJ, 2014, LANCET RESP MED, V2, P979, DOI 10.1016/S2213-2600(14)70226-7 Houchens R, 2014, NATIONWIDE INPATIENT Hua M, 2017, J PALLIAT MED, V20, P372, DOI 10.1089/jpm.2016.0363 Kavalieratos D, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.113.000544 Kelley AS, 2015, NEW ENGL J MED, V373, P747, DOI 10.1056/NEJMra1404684 Khera R, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.117.003846 May P, 2018, JAMA INTERN MED, V178, P820, DOI 10.1001/jamainternmed.2018.0750 McManus David D, 2012, Clin Epidemiol, V4, P115, DOI 10.2147/CLEP.S30883 McNamara RL, 2016, J AM COLL CARDIOL, V68, P626, DOI 10.1016/j.jacc.2016.05.049 Patel B, 2019, AM J HOSP PALLIAT ME, V36, P147, DOI 10.1177/1049909118796195 Rush B, 2017, CHEST, V151, P41, DOI 10.1016/j.chest.2016.06.023 Saeed F, 2018, J PAIN SYMPTOM MANAG, V56, P1, DOI 10.1016/j.jpainsymman.2018.03.014 Singh M, 2008, HEART, V94, P1424, DOI 10.1136/hrt.2007.126649 Starks H, 2013, J PALLIAT MED, V16, P1215, DOI 10.1089/jpm.2013.0163 Subahi A, 2018, CARDIOVASC REVASC ME Wiskar K, 2017, J INTERN MED, V282, P445, DOI 10.1111/joim.12657 Wiskar KJ, 2018, AM J HOSP PALLIAT ME, V35, P620, DOI 10.1177/1049909117727455 NR 25 TC 4 Z9 4 U1 0 U2 4 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1049-9091 EI 1938-2715 J9 AM J HOSP PALLIAT ME JI Am. J. Hosp. Palliat. Med. PD AUG PY 2019 VL 36 IS 8 BP 722 EP 726 DI 10.1177/1049909119832818 PG 5 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA IK6UB UT WOS:000476723200009 PM 30803244 DA 2023-05-13 ER PT J AU van der Sluijs, JFV Castelijns, H Eijsbroek, V Rijnders, CAT van Marwijk, HWJ van der Feltz-Cornelis, CM AF van der Sluijs, Jonna F. van Eck Castelijns, Hilde Eijsbroek, Vera Rijnders, Cees A. Th. van Marwijk, Harm W. J. van der Feltz-Cornelis, Christina M. TI Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis SO GENERAL HOSPITAL PSYCHIATRY LA English DT Review DE Collaborative care; Depression; Chronic medical disorder; Systematic review; Meta-analysis; Physical outcomes; Illness burden; Comorbidity ID ACUTE CORONARY SYNDROME; RANDOMIZED CONTROLLED-TRIAL; MENTAL-HEALTH CONDITIONS; COST-EFFECTIVENESS; ANXIETY DISORDERS; MAJOR DEPRESSION; LOW-INCOME; PSYCHIATRIC-DISORDERS; MANAGEMENT; SYMPTOMS AB Objective: Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so. Methods: Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively. Results: Twenty RCTs were included, with N = 4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95% CI 1.47; 1.83), d = 0.27 (95% CI 0.21; 0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences. Conclusions: CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed. C1 [van der Sluijs, Jonna F. van Eck; van der Feltz-Cornelis, Christina M.] GGz Breburg, Clin Ctr Excellence Body Mind & Hlth, POB 770, NL-5000 AT Tilburg, Netherlands. [van der Sluijs, Jonna F. van Eck; van der Feltz-Cornelis, Christina M.] Tilburg Univ, Tranzo Dept, Tilburg, Netherlands. [van der Sluijs, Jonna F. van Eck; Eijsbroek, Vera; Rijnders, Cees A. Th.] GGz Breburg, Dept Residency Training, Tilburg, Netherlands. [Castelijns, Hilde] PsyQ Tilburg Parnassia Grp, Ctr Mental Hlth Care, Tilburg, Netherlands. [van Marwijk, Harm W. J.] Univ Manchester, Inst Populat Hlth, Ctr Primary Care, Manchester, Lancs, England. [van Marwijk, Harm W. J.] VU Univ Med Ctr VUmc, Dept Gen Practice & Elderly Care Med, Inst Hlth & Care Res, Amsterdam, Netherlands. [van Marwijk, Harm W. J.] VU Univ Med Ctr VUmc, EMGO, Inst Hlth & Care Res, Amsterdam, Netherlands. C3 Tilburg University; Parnassia Psychiatric Institute; N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; Vrije Universiteit Amsterdam; VU UNIVERSITY MEDICAL CENTER; Vrije Universiteit Amsterdam; VU UNIVERSITY MEDICAL CENTER RP van der Feltz-Cornelis, CM (通讯作者),GGz Breburg, Clin Ctr Excellence Body Mind & Hlth, POB 770, NL-5000 AT Tilburg, Netherlands. EM C.M.vdrFeltz@uvt.nl RI Van Marwijk, Harm/K-6306-2013; Van der Feltz-Cornelis, Christina/R-7107-2016 OI Van Marwijk, Harm/0000-0001-6206-485X; Van der Feltz-Cornelis, Christina/0000-0001-6925-8956 FU Eli Lilly FX JES, HC, VE, CR and HvM declare that they have no conflicts of interest. In the last 3 years, CFC received unrestricted grants from Eli Lilly and from ACHMEA for unrelated research. 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Wetherell JL, 2013, BRIT J PSYCHIAT, V203, P65, DOI 10.1192/bjp.bp.112.118547 Woltmann E, 2012, AM J PSYCHIAT, V169, P790, DOI 10.1176/appi.ajp.2012.11111616 NR 94 TC 25 Z9 26 U1 1 U2 11 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0163-8343 EI 1873-7714 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD JAN-FEB PY 2018 VL 50 BP 1 EP 14 DI 10.1016/j.genhosppsych.2017.08.003 PG 14 WC Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry GA FV1RU UT WOS:000424343000001 PM 28957682 OA Green Submitted DA 2023-05-13 ER PT J AU Haerizadeh, M Moise, N Chang, BP Edmondson, D Kronish, IM AF Haerizadeh, Mytra Moise, Nathalie Chang, Bernard P. Edmondson, Donald Kronish, Ian M. TI Depression and doctor-patient communication in the emergency department SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE Doctor-patient communication; Depression; Cardiovascular disease; Emergency department ID CORONARY-ARTERY-DISEASE; RISK-FACTOR; CARE; SYMPTOMS; LANGUAGE; HEART AB Objective: Depression may adversely affect health outcomes by influencing doctor-patient communication. We aimed to determine the association between depressive symptoms and doctor-patient communication among patients presenting to the emergency department (ED) with a suspected acute coronary syndrome (ACS). Method: We enrolled a consecutive sample of 500 patients evaluated for ACS symptoms from the ED of an urban medical center. Depressive symptoms (8-item Patient Health Questionnaire, PHQ-8) and doctor-patient communication in the ED (Interpersonal Processes of Care) were assessed during hospitalization. Logistic regression was used to determine the association between depressive symptoms and doctor-patient communication, adjusting for age, sex, race, ethnicity, education, language, health insurance status and comorbidities. Results: Compared to nondepressed patients, depressed patients (PHQ-8 >= 10) were more likely (P<.05) to report suboptimal communication on five of seven communication domainsA clarity, elicitation of concerns, explanations, patient-centered decision making and discrimination. A greater proportion of depressed versus nondepressed patients reported suboptimal overall communication (39.8% versus 22.9%, P<.001). In adjusted analyses, depressed patients remained more likely to report suboptimal doctor-patient communication (adjusted odds ratio 2.42, 95% confidence interval 1.52-3.87; P<.001). Conclusions: Depressed patients with ACS symptoms reported less optimal doctor-patient communication in the ED than nondepressed patients. Research is needed to determine whether subjectively rated differences in communication are accompanied by observable differences. (C) 2016 Elsevier Inc. All rights reserved. C1 [Haerizadeh, Mytra; Moise, Nathalie; Edmondson, Donald; Kronish, Ian M.] Columbia Univ, Med Ctr, Ctr Behav Cardiovasc Hlth, 622 W 168th St, New York, NY 10032 USA. [Chang, Bernard P.] Columbia Univ, Dept Emergency Med, Med Ctr, 622 W 168th St, New York, NY 10032 USA. C3 Columbia University; Columbia University RP Kronish, IM (通讯作者),Ctr Behav Cardiovasc Hlth, 622 W 168th St,PH9-311, New York, NY 10032 USA. EM ik2293@cumc.columbia.edu RI Chang, Bernard P./AAI-1139-2019; Edmondson, Donald/G-7486-2016 OI Moise, Nathalie/0000-0002-5660-5573; CHANG, BERNARD/0000-0001-8800-7140; Edmondson, Donald/0000-0002-4518-8196 FU National Heart, Lung and Blood Institute [HL117832, HL123369, HL 128310]; NHLBI [T35HL007616-35] FX This work was supported by grants HL117832, HL123369 and HL 128310 from the National Heart, Lung and Blood Institute. Ms. Haerizadeh received additional support from NHLBI (grant T35HL007616-35). 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Hosp. Psych. PD SEP-OCT PY 2016 VL 42 BP 49 EP 53 DI 10.1016/j.genhosppsych.2016.06.004 PG 5 WC Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry GA DX1PZ UT WOS:000384140700010 PM 27638972 OA Green Accepted, Green Submitted DA 2023-05-13 ER PT J AU Patel, MR Norgaard, BL Fairbairn, TA Nieman, K Akasaka, T Berman, DS Raff, GL Koweek, LMH Pontone, G Kawasaki, T Sand, NPR Jensen, JM Amano, T Poon, M Ovrehus, KA Sonck, J Rabbat, MG Mullen, S De Bruyne, B Rogers, C Matsuo, H Bax, JJ Leipsic, J AF Patel, Manesh R. Norgaard, Bjarne Linde Fairbairn, Timothy A. Nieman, Koen Akasaka, Takashi Berman, Daniel S. Raff, Gilbert L. Koweek, Lynne M. Hurwitz Pontone, Gianluca Kawasaki, Tomohiro Sand, Niels Peter Ronnow Jensen, Jesper M. Amano, Tetsuya Poon, Michael Ovrehus, Kristian A. Sonck, Jeroen Rabbat, Mark G. Mullen, Sarah De Bruyne, Bernard Rogers, Campbell Matsuo, Hitoshi Bax, Jeroen J. Leipsic, Jonathon TI 1-Year Impact on Medical Practice and Clinical Outcomes of FFRCT The ADVANCE Registry SO JACC-CARDIOVASCULAR IMAGING LA English DT Article DE clinical outcomes; clinical practice; coronary computed tomography angiography; FFRCT; fractional flow reserve; major adverse cardiac events ID FRACTIONAL FLOW RESERVE; CORONARY; ANGIOGRAPHY AB OBJECTIVES The 1-year data from the international ADVANCE (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care) Registry of patients undergoing coronary computed tomography angiography (CTA) was used to evaluate the relationship of fractional flow reserve derived from coronary CTA (FFRCT) with downstream care and clinical outcomes. BACKGROUND Guidelines for management of chest pain using noninvasive imaging pathways are based on short- to intermediate-term outcomes. METHODS Patients (N = 5,083) evaluated for clinically suspected coronary artery disease and in whom atherosclerosis was identified by coronary CTA were prospectively enrolled at 38 international sites from July 15, 2015, to October 20, 2017. Demographics, symptom status, coronary CTA and FFRCT findings and resultant site-based treatment plans, and clinical outcomes through 1 year were recorded and adjudicated by a blinded core laboratory. Major adverse cardiac events (MACE), death, myocardial infarction (MI), and acute coronary syndrome leading to urgent revascularization were captured. RESULTS At 1 year, 449 patients did not have follow-up data. Revascularization occurred in 1,208 (38.40%) patients with an FFRCT <= 0.80 and in 89 (5.60%) with an FFRCT >0.80 (relative risk [RR]: 6.87; 95% confidence interval [CI]: 5.59 to 8.45; p < 0.001). MACE occurred in 55 patients, 43 events occurred in patients with an FFRCT <= 0.80 and 12 occurred in those with an FFRCT >0.80 (RR: 1.81; 95% CI: 0.96 to 3.43; p = 0.06). Time to first event (all-cause death or MI) occurred in 38 (1.20%) patients with an FFRCT <= 0.80 compared with 10 (0.60%) patients with an FFRCT >0.80 (RR: 1.92; 95% CI: 0.96 to 3.85; p = 0.06). Time to first event (cardiovascular death or MI) occurred cardiovascular death or MI occurred more in patients with an FFRCT <= 0.80 compared with patients with an FFRCT >0.80 (25 [0.80%] vs. 3 [0.20%]; RR: 4.22; 95% CI: 1.28 to 13.95; p = 0.01). CONCLUSIONS The 1-year outcomes from the ADVANCE FFRCT Registry show low rates of events in all patients, with less revascularization and a trend toward lower MACE and significantly lower cardiovascular death or MI in patients with a negative FFRCT compared with patients with abnormal FFRCT values. (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Wave [ADVANCE]; NCT02499679) (C) 2020 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. C1 [Patel, Manesh R.; Koweek, Lynne M. Hurwitz] Duke Univ, Med Ctr, Sch Med, Div Cardiol,Dept Med,Duke Clin Res Inst, Durham, NC 27710 USA. [Norgaard, Bjarne Linde; Jensen, Jesper M.] Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark. [Fairbairn, Timothy A.] Univ Liverpool, Liverpool Heart & Chest Hosp, Dept Cardiol, Liverpool, Merseyside, England. [Nieman, Koen] Stanford Univ, Dept Cardiovasc Med, Stanford, CA 94305 USA. [Nieman, Koen] Stanford Univ, Dept Radiol, Stanford, CA 94305 USA. [Akasaka, Takashi] Wakayama Med Univ, Dept Cardiovasc Med, Wakayama, Japan. [Berman, Daniel S.] Cedars Sinai Heart Inst, Dept Imaging, Div Nucl Imaging, Los Angeles, CA USA. [Raff, Gilbert L.] Beaumont Acad Heart & Vasc Grp, Div Cardiol, Royal Oak, MI USA. [Pontone, Gianluca] Ctr Cardiol Monzino, Milan, Italy. [Kawasaki, Tomohiro] Shin Koga Hosp, Cardiovasc Ctr, Fukuoka, Japan. [Sand, Niels Peter Ronnow; Ovrehus, Kristian A.] Univ Southern Denmark, Univ Hosp SouthWest DK, Inst Reg Hlth Res, Cardiac Res Unit, Odense, Denmark. [Amano, Tetsuya] Aichi Med Univ, Dept Cardiol, Nagakute, Aichi, Japan. [Poon, Michael] Northwell Hlth, Dept Noninvas Cardiac Imaging, New York, NY USA. [Sonck, Jeroen] OLV Clin, Cardiovasc Ctr Aalst, Aalst, Belgium. [Sonck, Jeroen] Univ Naples Federico II, Dept Adv Biomed Sci, Naples, Italy. [Rabbat, Mark G.] Loyola Univ, Div Cardiol, Chicago, IL 60611 USA. [Mullen, Sarah; Rogers, Campbell] HeartFlow Inc, Redwood City, CA USA. [De Bruyne, Bernard] Onze Lieve Vrouw Hosp, Cardiovasc Ctr, Aalst, Belgium. [Matsuo, Hitoshi] Gifu Heart Ctr, Dept Cardiovasc Med, Gifu, Japan. [Bax, Jeroen J.] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands. [Leipsic, Jonathon] Univ British Columbia, St Pauls Hosp, Providence Hlth Care, Dept Radiol, Vancouver, BC, Canada. C3 Duke University; Aarhus University; Liverpool Heart & Chest Hospital; N8 Research Partnership; RLUK- Research Libraries UK; University of Liverpool; Stanford University; Stanford University; Wakayama Medical University; Cedars Sinai Medical Center; IRCCS Centro Cardiologico Monzino; University of Southern Denmark; Aichi Medical University; Northwell Health; Cardiovascular Center Aalst; University of Naples Federico II; Loyola University Chicago; Cardiovascular Center Aalst; Leiden University; Leiden University Medical Center (LUMC); Leiden University - Excl LUMC; St. Paul's Hospital; University of British Columbia RP Patel, MR (通讯作者),Duke Univ, Duke Clin Res Inst, Duke Heart Ctr, 2400 Pratt St, Durham, NC 27710 USA. EM manesh.patel@duke.edu RI Patel, Manesh/AAC-5385-2019; Leipsic, Jonathon/ABE-6194-2020; Rabbat, Mark/AAS-9710-2021 OI sonck, jeroen/0000-0002-9744-8244; Fairbairn, Tim/0000-0003-1491-6231; Jensen, Jesper Moller/0000-0002-4179-4471; Pontone, Gianluca/0000-0002-1339-6679 FU HeartFlow, Inc.; HeartFlow; Bayer; Janssen; National Heart, Lung, and Blood Institute; Siemens; Siemens Healthineers; GE Healthcare; Bayer Healthcare; Bracco; Medtronic; Cardiopath PhD program FX The ADVANCE Registry was funded by HeartFlow, Inc. Dr. Patel has received research grants from HeartFlow, Bayer, Janssen, and the National Heart, Lung, and Blood Institute; and has served on the advisory board for HeartFlow, Bayer, and Janssen. Dr. Norgaard has received unrestricted institutional research grants from Siemens and HeartFlow. Dr. Fairbairn has served on the Speakers Bureau for HeartFlow. Dr. Nieman has received institutional research support from Siemens Healthineers, HeartFlow, GE Healthcare, and Bayer Healthcare. Dr. Berman has received unrestricted research support from HeartFlow. Dr. Hurwitz Koweek has received research support and speaking fees from HeartFlow and Siemens. Dr. Pontone has received institutional research grant and/or honorarium as consultant/speaker from GE Healthcare, Bracco, Medtronic, Bayer, and HeartFlow. Dr. Sonck has received research grant support from the Cardiopath PhD program. Dr. Rabbat has served as a consultant for HeartFlow. Dr. Mullen is an employee of and owns equity in HeartFlow. Dr. De Bruyne has received consulting fees from Abbott, Opsens, and Boston Scientific; and is a shareholder for Siemens, GE Healthcare, Bayer, Philips, HeartFlow, Edwards Lifesciences, and Sanofi. Dr. Rogers is employee of and owns equity in HeartFlow. Dr. Leipsic has served as a consultant for and owns stock options in Circle CVI and HeartFlow. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. CR Chang HJ, 2019, JACC-CARDIOVASC IMAG, V12, P1303, DOI 10.1016/j.jcmg.2018.09.018 Chinnaiyan KM, 2017, J CARDIOVASC COMPUT, V11, P62, DOI 10.1016/j.jcct.2016.12.002 De Bruyne B, 2014, NEW ENGL J MED, V371, P1208, DOI 10.1056/NEJMoa1408758 Douglas PS, 2015, EUR HEART J, V36, P3359, DOI 10.1093/eurheartj/ehv444 Douglas PS, 2015, NEW ENGL J MED, V372, P1291, DOI 10.1056/NEJMoa1415516 Driessen RS, 2019, J AM COLL CARDIOL, V73, P161, DOI 10.1016/j.jacc.2018.10.056 Fairbairn TA, 2018, EUR HEART J, V39, P3701, DOI 10.1093/eurheartj/ehy530 Fihn SD, 2014, J AM COLL CARDIOL, V64, P1929, DOI 10.1016/j.jacc.2014.07.017 Lu MT, 2017, JACC-CARDIOVASC IMAG, V10, P1350, DOI 10.1016/j.jcmg.2016.11.024 Newby DE, 2018, NEW ENGL J MED, V379, P924, DOI 10.1056/NEJMoa1805971 Norgaard BL, 2018, J AM COLL CARDIOL, V72, P2123, DOI 10.1016/j.jacc.2018.07.043 Patel MR, 2010, NEW ENGL J MED, V362, P886, DOI 10.1056/NEJMoa0907272 Williams MC, 2019, J AM COLL CARDIOL, V73, P291, DOI 10.1016/j.jacc.2018.10.066 NR 13 TC 124 Z9 135 U1 2 U2 10 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1936-878X EI 1876-7591 J9 JACC-CARDIOVASC IMAG JI JACC-Cardiovasc. Imag. PD JAN PY 2020 VL 13 IS 1 BP 97 EP 105 DI 10.1016/j.jcmg.2019.03.003 PN 1 PG 9 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA KA4RJ UT WOS:000505784200015 PM 31005540 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Ryan, K Greenslade, J Dalton, E Chu, K Brown, AFT Cullen, L AF Ryan, Kimberley Greenslade, Jaimi Dalton, Emily Chu, Kevin Brown, Anthony F. T. Cullen, Louise TI Factors associated with triage assignment of emergency department patients ultimately diagnosed with acute myocardial infarction SO AUSTRALIAN CRITICAL CARE LA English DT Article DE Chest pain; Emergency department; Emergency nursing; Myocardial infarction; Triage ID ACUTE CORONARY SYNDROMES; ATYPICAL SYMPTOMS; TREATMENT ONSET; HEART-DISEASE; CHEST-PAIN; SEX AB Background: The objective of this study was to explore factors associated with the triage category assigned by the triage nurse for patients ultimately diagnosed with acute myocardial infarction. Methods: This was a retrospective analysis of 12 months of data, on adult emergency department patients ultimately diagnosed with acute myocardial infarction. Data were obtained from hospital databases and included patient demographics, patient clinical characteristics and nurses' experience. Results: Of the 153 patients, 20% (95% CI: 14-27%) were given a lower urgency triage category than recommended by international guidelines. Compared to patients who were triaged Australasian Triage Category 1 or 2, patients with an Australasian Triage Category 3-5 were older (mean age 76 versus 68 years), more likely to be female (63% versus 32%), more likely to present without chest pain (93% versus 35%) and less likely to have a cardiac history (3.3% versus 17.9%). A slightly higher proportion of patients Australasian Triage Category 3-5 were triaged by an experienced nurse (50%) compared to patients categorised Australasian Triage Category 1-2 (35.2%) but this finding did not reach statistical significance. Conclusions: One in five presentations was given a lower urgency triage category than recommended by international guidelines, potentially leading to delays in medical treatment. The absence of chest pain was the defining characteristic in this group of patients, along with other factors identified by previous research such as being of female sex and elderly. (C) 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved. C1 [Ryan, Kimberley; Greenslade, Jaimi; Dalton, Emily; Chu, Kevin; Brown, Anthony F. T.; Cullen, Louise] Royal Brisbane & Womens Hosp, Dept Emergency Med, Brisbane, Qld 4006, Australia. [Greenslade, Jaimi; Chu, Kevin; Brown, Anthony F. T.; Cullen, Louise] Univ Queensland, Sch Med, St Lucia, Qld 4067, Australia. [Greenslade, Jaimi; Cullen, Louise] Queensland Univ Technol, Sch Publ Hlth, Kelvin Grove 4059, Australia. C3 Royal Brisbane & Women's Hospital; University of Queensland; Queensland University of Technology (QUT) RP Ryan, K (通讯作者),Royal Brisbane & Womens Hosp, Dept Emergency Med, Butterfield St, Herston, Qld 4006, Australia. EM kimberley.ryan@health.qld.gov.au RI Cullen, Louise/ABC-9266-2021; Greenslade, Jaimi/D-7832-2011; Cullen, Louise A/D-2274-2013 OI Cullen, Louise/0000-0001-6611-8229; Greenslade, Jaimi/0000-0002-6970-5573; Cullen, Louise A/0000-0001-6611-8229; Brown, Anthony/0000-0002-1448-0899; Ryan, Kimberley/0000-0002-8188-9977; Chu, Kevin/0000-0002-1709-7174 FU Royal Brisbane and Women's Foundation [2010-kr] FX The Royal Brisbane and Women's Foundation (2010-kr) had reviewed and granted $15,000 towards this research project as a Nurse Initiative Research Grant in February 2010. CR ACEM, 2008, GUID IMPL AUSTR TRIA Atzema CL, 2010, AM J EMERG MED, V28, P694, DOI 10.1016/j.ajem.2009.03.010 Australasian College for Emergency Medicine (ACEM), 2013, POL AUSTR TRIAG SCAL Brieger D, 2004, CHEST, V126, P461, DOI 10.1378/chest.126.2.461 Canto JG, 2012, JAMA-J AM MED ASSOC, V307, P813, DOI 10.1001/jama.2012.199 De Luca G, 2008, PROG CARDIOVASC DIS, V50, P352, DOI 10.1016/j.pcad.2007.11.004 DOHA, 2009, EM TRIAG ED KIT Gillis NK, 2014, J EMERG NURS, V40, P270, DOI 10.1016/j.jen.2013.03.003 Goel PKSS, 2012, INDIAN HEART J, V6403, P295 Grosmaitre P, 2013, ARCH CARDIOVASC DIS, V106, P586, DOI 10.1016/j.acvd.2013.04.010 Keeley E, 2007, N ENGL J MED, V356 Kuhn L, 2014, INT EMERG NURS, V22, P88, DOI 10.1016/j.ienj.2013.08.002 Kuhn L, 2013, AUSTRALAS EMERG NURS, V16, P160, DOI 10.1016/j.aenj.2013.08.002 Luepker RV, 2003, CIRCULATION, V108, P2543, DOI 10.1161/01.CIR.0000100560.46946.EA Macdonald SPJ, 2011, EMERG MED AUSTRALAS, V23, P717, DOI 10.1111/j.1742-6723.2011.01480.x Mathur S., 2002, CARDIOVASCULAR DIS S, V20 Neill K, 1987, J INTENSIVE CARE MED, V2, P25 Providencia R, 2011, EMERG MED J, V28, P212, DOI 10.1136/emj.2009.081497 Ross DW, 2014, PREHOSP EMERG CARE, V18, P450, DOI 10.3109/10903127.2014.883000 Sammons SS, 2012, THESIS Santos A, 2014, EMERG MED J, V31 Than M, 2011, LANCET, V377, P1077, DOI 10.1016/S0140-6736(11)60310-3 NR 22 TC 10 Z9 10 U1 0 U2 15 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1036-7314 EI 1878-1721 J9 AUST CRIT CARE JI Aust. Crit. Care PD FEB PY 2016 VL 29 IS 1 BP 23 EP 26 DI 10.1016/j.aucc.2015.05.001 PG 4 WC Critical Care Medicine; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine; Nursing GA DC0KC UT WOS:000368904800005 PM 26008175 DA 2023-05-13 ER PT J AU Povsic, TJ Roe, MT Ohman, EM Steg, PG James, S Plotnikov, A Mundl, H Welsh, R Bode, C Gibson, CM AF Povsic, Thomas J. Roe, Matthew T. Ohman, Erik Magnus Steg, Philippe Gabriel James, Stefan Plotnikov, Alexei Mundl, Hardi Welsh, Robert Bode, Christoph Gibson, Charles Michael TI A randomized trial to compare the safety of rivaroxaban vs aspirin in addition to either clopidogrel or ticagrelor in acute coronary syndrome: The design of the GEMINI-ACS-1 phase II study SO AMERICAN HEART JOURNAL LA English DT Article ID DUAL ANTIPLATELET THERAPY; ACUTE MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; HIGH-RISK PATIENTS; ACS-TIMI 46; DOUBLE-BLIND; ANTICOAGULANT-THERAPY; STENT IMPLANTATION; AMERICAN-COLLEGE; CLINICAL-TRIALS AB Dual antiplatelet therapy (DAPT), the combination of aspirin and a P2Y12 inhibitor, given for 12 months remains the standard of care after presentation with acute coronary syndrome (ACS) because it has been shown to be associated with a significant reduction in ischemic events compared with aspirin monotherapy. The factor Xa inhibitor rivaroxaban was shown to be associated with a significant reduction in the composite of cardiovascular death, myocardial infarction, and stroke, and resulted in a nominal reduction in cardiovascular death, when added to background DAPT in the ATLAS ACS 2-TIMI 51 trial; however, there was excessive bleeding with this "triple-therapy" approach. The combination of rivaroxaban with P2Y12 inhibition in a "dual-pathway" approach may be an effective therapeutic regimen for the treatment of ACS, given the known importance of P2Y12 inhibition after stenting and intriguing data that the combination of an anticoagulant with clopidogrel after stenting in patients with atrial fibrillation appears an attractive option to this patient population. GEMINI-ACS-1 is a prospective, randomized, double-dummy, double-blind, active-controlled trial that will assess the safety of dual antithrombotic therapy (rivaroxaban [2.5 mg twice daily] + P2Y12 inhibitor) as compared with DAPT (aspirin [100 mg] + P2Y12 inhibitor) within 10 days of an ACS event in 3,000 patients. Patients will be randomized in a 1: 1 ratio stratified by intended P2Y12 inhibitor use (clopidogrel 75 mg daily or ticagrelor 90 mg twice daily), with 1500 patients expected in each P2Y12 inhibitor strata. The primary end point is Thrombolysis in Myocardial Infarction clinically significant bleeding (major, minor, or requiring medical attention). The exploratory efficacy determination will be a composite of cardiovascular death, myocardial infarction, ischemic stroke, and stent thrombosis. GEMINI-ACS-1 will assess the safety and feasibility of dual antithrombotic therapy with rivaroxaban and a P2Y12 inhibitor compared with conventional DAPT for the treatment for patients with recent ACS. C1 [Povsic, Thomas J.; Roe, Matthew T.; Ohman, Erik Magnus] Duke Univ, Div Cardiol, Durham, NC USA. [Povsic, Thomas J.; Roe, Matthew T.; Ohman, Erik Magnus] Duke Med, Duke Clin Res Inst, Durham, NC USA. [Steg, Philippe Gabriel] Univ Paris Diderot, Sorbonne Paris Cite, FACT, DHU,FIRE,AP HP, Paris, France. [Steg, Philippe Gabriel] INSERM, U1148, Paris, France. [Steg, Philippe Gabriel] Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, NHLI, London, England. [James, Stefan] Uppsala Univ, Uppsala Clin Res Ctr, Dept Med Sci & Cardiol, Uppsala, Sweden. [Plotnikov, Alexei] Janssen Res & Dev, Raritan, NJ USA. [Mundl, Hardi] Bayer HealthCare, Wuppertal, Germany. [Welsh, Robert] Mazankowski Alberta Heart Inst, Edmonton, AB, Canada. [Welsh, Robert] Univ Alberta, Edmonton, AB, Canada. [Bode, Christoph] Univ Freiburg, Hugstetter Str 55, D-79106 Freiburg, Germany. [Gibson, Charles Michael] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Cardiovasc Div,Dept Med, Boston, MA 02215 USA. C3 Duke University; Duke University; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Avicenne - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; Hopital Universitaire Raymond-Poincare - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Beaujon - APHP; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Cochin - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Necker-Enfants Malades - APHP; Hopital Universitaire Robert-Debre - APHP; Hopital Universitaire Saint-Louis - APHP; Assistance Publique Hopitaux Paris (APHP); Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Cite; RLUK- Research Libraries UK; Imperial College London; Royal Brompton Hospital; Uppsala University; Johnson & Johnson; Janssen Pharmaceuticals; Bayer AG; Bayer Healthcare Pharmaceuticals; University of Alberta; University of Freiburg; Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School RP Povsic, TJ (通讯作者),Duke Univ, Med Ctr, Box 103208, Durham, NC 27708 USA. EM Thomas.povsic@duke.edu RI Welsh, Robert/ABH-3526-2021; Gibson, C. Michael/AAE-8212-2019; STEG, Philippe Gabriel/Z-1567-2019; James, Stefan K/J-4554-2014 OI Welsh, Robert/0000-0003-2613-9142; STEG, Philippe Gabriel/0000-0001-6896-2941 FU Janssen Research Development; Bayer HealthCare FX GEMINI-ACS-1 is funded by Janssen Research & Development and Bayer HealthCare. 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Heart J. PD APR PY 2016 VL 174 BP 120 EP 128 DI 10.1016/j.ahj.2016.01.004 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DH1IV UT WOS:000372538500018 PM 26995378 OA Green Submitted, Green Published, hybrid DA 2023-05-13 ER PT J AU Nasi, LA Ferreira-Da-Silva, AL Martins, SCO Furtado, MV Almeida, AG Brondani, R Wirth, L Kluck, M Polanczyk, CA AF Nasi, Luiz A. Ferreira-Da-Silva, Andre L. Martins, Sheila C. O. Furtado, Mariana V. Almeida, Andrea G. Brondani, Rosane Wirth, Leticia Kluck, Marisa Polanczyk, Carisi A. TI Implementation of a Dedicated Cardiovascular and Stroke Unit in a Crowded Emergency Department of a Tertiary Public Hospital in Brazil: Effect on Mortality Rates SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID PAIN OBSERVATION UNIT; MYOCARDIAL-INFARCTION; CARE; OUTCOMES; DISEASE; TRENDS; TRIAL AB BackgroundEmergency department (ED) care for acute vascular diseases faces the challenge of overcrowding. A vascular unit is a specialized, protocol-oriented unit in the ED with a team trained to manage acute vascular disorders, including stroke, coronary syndromes, pulmonary embolism (PE), and aortic diseases. ObjectivesThe objective was to compare case fatality rates for selected cardiovascular conditions before and after the implementation of a vascular unit. MethodsPatients with the selected diagnoses admitted to the ED in two different time periods, 2002 through 2005 (before unit opening) and 2007 to 2010 (after vascular unit opening), were identified by ICD-10 codes, and their electronic records were reviewed. Case fatality rates were calculated and compared for both time periods. ResultsThe period prior to unit implementation (2002 through 2005) included 4,164 patients, and the vascular unit period (2007 to 2010) included 6,280 patients. Overall, the case fatality rate for acute vascular conditions decreased from 9% to 7.3% with vascular unit implementation (p=0.002). The in-hospital mortality rates for acute coronary syndrome (ACS) dropped from 6% to 3.8% (p=0.003), and for acute PE dropped from 32.1% to 10.8% (p<0.001). The stroke case-fatality rate did not decrease despite improvements in the quality of stroke health care indicators. ConclusionsThe vascular unit strategy has the potential to reduce overall mortality for most acute vascular conditions. (C) 2013 by the Society for Academic Emergency Medicine Resumen IntroduccionLa atencion del servicio de urgencias (SU) a las enfermedades vasculares agudas se enfrenta al reto de la saturacion. Una unidad vascular es una unidad protocolizada y especializada en el SU con un equipo formado para el manejo de los trastornos vasculares agudos, que incluye el ictus, los sindromes coronarios, el embolismo de pulmon (EP) y las enfermedades aorticas. ObjetivosComparar las tasas de mortalidad para las enfermedades cardiovasculares seleccionadas antes y despues de la implementacion de la unidad vascular. MetodologiaLos pacientes con los diagnosticos seleccionados ingresados en el SU en dos periodos de tiempo diferentes, de 2002 a 2005 (antes de la apertura de la unidad) y de 2007 a 2010 (tras la apertura de la unidad vascular), se identificaron por los codigos CIE-10 y se revisaron sus historias clinicas electronicas. Las tasas de mortalidad se calcularon y compararon entre ambos periodos de tiempo. ResultadosEl periodo previo a la implementacion de la unidad (2002 a 2005) incluyo 4.164 pacientes, y el periodo de la unidad vascular (2007 a 2010) incluyo 6.280 pacientes. Globalmente, la tasa de mortalidad para enfermedades vasculares agudas se redujo de forma significativa de un 9% a un 7,3% con la implementacion de la unidad vascular (p=0,002). Los porcentajes de mortalidad intrahospitalaria para el sindrome coronario agudo descendieron de un 6% a un 3,8% (p=0,003), y los porcentajes para EP agudo descendieron de un 32,1% a un 10,8% (p<0,001). La tasa de mortalidad de ictus no descendio a pesar de las mejoras en la calidad de los indicadores de atencion sanitaria del ictus. ConclusionesLa estrategia de la unidad vascular tiene el potencial de reducir la mortalidad global para la mayoria de las enfermedades vasculares agudas. C1 [Nasi, Luiz A.; Polanczyk, Carisi A.] Univ Fed Rio Grande do Sul, Dept Internal Med, BR-90046900 Porto Alegre, RS, Brazil. [Ferreira-Da-Silva, Andre L.] Hosp Clin Porto Alegre, Dept Internal Med, Porto Alegre, RS, Brazil. [Martins, Sheila C. O.; Almeida, Andrea G.; Brondani, Rosane] Hosp Clin Porto Alegre, Dept Neurol, Porto Alegre, RS, Brazil. [Furtado, Mariana V.] Hosp Clin Porto Alegre, Dept Cardiol, Porto Alegre, RS, Brazil. [Wirth, Leticia] Hosp Clin Porto Alegre, Dept Emergency Med, Porto Alegre, RS, Brazil. [Kluck, Marisa] Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil. C3 Universidade Federal do Rio Grande do Sul RP Ferreira-Da-Silva, AL (通讯作者),Hosp Clin Porto Alegre, Dept Internal Med, Porto Alegre, RS, Brazil. 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PD JAN PY 2014 VL 21 IS 1 BP 40 EP 46 DI 10.1111/acem.12291 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 284BL UT WOS:000329290900006 PM 24552523 DA 2023-05-13 ER PT J AU Leung, YK Cheng, NM Chan, CPY Lee, A Wong, JKT Yan, BPY Ahuja, AT Graham, CA Rainer, TH AF Leung, Yuk-ki Cheng, Nga-man Chan, Cangel Pui-yee Lee, Anna Wong, Jeffrey Ka-tak Yan, Bryan Ping-yen Ahuja, Anil Tejbhan Graham, Colin Alexander Rainer, Timothy Hudson TI EARLY EXCLUSION OF MAJOR ADVERSE CARDIAC EVENTS IN EMERGENCY DEPARTMENT CHEST PAIN PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY SO JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE acute coronary syndrome; chest pain; diagnosis; major adverse cardiac event ID ACUTE MYOCARDIAL-INFARCTION; DIAGNOSTIC PROTOCOL; RISK-STRATIFICATION; HEART SCORE; TROPONIN-I; VALIDATION; DISCHARGE; MARKER AB Background: The current evaluation of patients with chest pain presenting to an emergency department (ED) with suspected acute coronary syndrome (ACS) is a lengthy process involving serial measurements of troponin. Objective: We aimed to validate the diagnostic accuracy of a Thrombolysis in Myocardial Infarction (TIMI) score with single high-sensitive cardiac troponin T (hs-cTnT) for early rule out of 30-day major adverse cardiac events (MACE), and to compare the TIMI score with combinations of heart-type fatty acid binding protein (H-FABP) and a modified HEART (history, electrocardiogram, age, risk factors, troponin) score. Methods: We recruited 602 consecutive adult patients with chest pain and suspected ACS in the ED. Each patient had TIMI and HEART scores, and a point-of-care H-FABP test. Results: MACE occurred in 42 (7.0%) patients within 30 days. A low risk for 30-day MACE was identified by a modified TIMI score of 0 in 65 (11%) patients, and by a HEART score <= 2 in 96 (16%) patients. No MACE occurred in these groups, giving both scores a sensitivity of 100% (95% confidence interval [CI] 91.6-100%), and specificity of 11.6% (95% CI 9.2-14.5%) and 17.1% (95% CI 14.2-20.5%), respectively. Use of combined TIMI and HEART scores improved the specificity further to 22.0% (95% CI 18.7-25.6%) without lowering sensitivity. Early H-FABP measurement > 7 mu g/L had a sensitivity of 41.5% (95% CI 27.8-56.6%) and a specificity of 91.1% (95% CI 88.4-93.2%) for predicting 30-day MACE. Conclusions: A modified TIMI score of 0 or a HEART score of <= 2, incorporating a single hs-cTnT level, will identify patients with low risk of 30-dayMACE for early discharge within 2 h of ED arrival. (C) 2017 Elsevier Inc. All rights reserved. C1 [Leung, Yuk-ki; Cheng, Nga-man; Chan, Cangel Pui-yee; Graham, Colin Alexander; Rainer, Timothy Hudson] Prince Wales Hosp, Accid & Emergency Med Acad Unit, Main Clin Block & Trauma Ctr, Shatin, Hong Kong, Peoples R China. [Lee, Anna] Chinese Univ Hong Kong, Dept Anaesthesia & Intens Care, Hong Kong, Hong Kong, Peoples R China. [Wong, Jeffrey Ka-tak; Ahuja, Anil Tejbhan] Chinese Univ Hong Kong, Dept Imaging & Intervent Radiol, Hong Kong, Hong Kong, Peoples R China. [Yan, Bryan Ping-yen] Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China. C3 Chinese University of Hong Kong; Prince of Wales Hospital; Chinese University of Hong Kong; Chinese University of Hong Kong; Chinese University of Hong Kong RP Graham, CA (通讯作者),Chinese Univ Hong Kong, Accid & Emergency Med Acad Unit, Clin Block & Trauma Ctr, Prince Wales Hosp, 2-F, Shatin, Hong Kong, Peoples R China. RI Yan, Bryan P/P-5928-2015; Rainer, Timothy/I-2591-2013; Ahuja, Anil T/H-4031-2017; Lee, Anna/B-2773-2009; Graham, Colin A/B-4535-2013 OI Rainer, Timothy/0000-0003-3355-3237; Ahuja, Anil T/0000-0002-0726-5402; Lee, Anna/0000-0003-2864-0045; Graham, Colin A/0000-0002-4381-7470 FU Health and Medical Research Fund (HMRF) of Hong Kong [10110121] FX This work was supported by a Health and Medical Research Fund (HMRF) of Hong Kong (grant number 10110121). The funding committee had no role in the study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit the article for publication. CR Abramson Joseph H, 2011, Epidemiol Perspect Innov, V8, P1, DOI 10.1186/1742-5573-8-1 Amsterdam EA, 2010, CIRCULATION, V122, P1756, DOI 10.1161/CIR.0b013e3181ec61df Backus BE, 2013, INT J CARDIOL, V168, P2153, DOI 10.1016/j.ijcard.2013.01.255 Backus Barbra E, 2010, Crit Pathw Cardiol, V9, P164, DOI 10.1097/HPC.0b013e3181ec36d8 Body R, 2011, LANCET, V377, P1049, DOI 10.1016/S0140-6736(11)60392-9 Carlton EW, 2015, ANN EMERG MED, V66, P635, DOI 10.1016/j.annemergmed.2015.07.006 Carlton EW, 2015, HEART, V101, P1041, DOI 10.1136/heartjnl-2014-307288 CDARS Hospital Authority, 2013, CLIN DAT AN REP SYST Chan CPY, 2004, Z KARDIOL, V93, P388, DOI 10.1007/s00392-004-0080-6 Cullen L, 2014, CLIN BIOCHEM, V47, P321, DOI 10.1016/j.clinbiochem.2013.11.019 Cullen L, 2013, J AM COLL CARDIOL, V62, P1242, DOI 10.1016/j.jacc.2013.02.078 Giannitsis E., 2009, EUR CARDIOL, V5, P44 Gimenez MR, 2014, EUR HEART J, V35, P2303, DOI 10.1093/eurheartj/ehu188 Goodacre S, 2005, HEART, V91, P229, DOI 10.1136/hrt.2003.027599 Haaf P, 2014, EUR HEART J, V35, P365, DOI 10.1093/eurheartj/eht218 ICH Expert Working Group, ICH TOP E6 GUID GOOD Kelly AM, 2014, INT J EMERG MED, V7, DOI 10.1186/s12245-014-0042-3 Kip KE, 2008, J AM COLL CARDIOL, V51, P701, DOI 10.1016/j.jacc.2007.10.034 Ko HF, 2013, HONG KONG J EMERG ME, V20, P261, DOI 10.1177/102490791302000501 Marcoon Shannon, 2013, Crit Pathw Cardiol, V12, P1, DOI 10.1097/HPC.0b013e31827377e1 McCord J, 2001, CIRCULATION, V104, P1483, DOI 10.1161/hc3801.096336 Nakata T, 2003, CARDIOLOGY, V99, P96, DOI 10.1159/000069726 Ng SM, 2001, AM J CARDIOL, V88, P611, DOI 10.1016/S0002-9149(01)01801-X Rainer TH, 2016, INT J CARDIOL, V220, P299, DOI 10.1016/j.ijcard.2016.05.057 Santi L, 2017, INTERN EMERG MED, V12, P357, DOI 10.1007/s11739-016-1461-3 Than M, 2011, LANCET, V377, P1077, DOI 10.1016/S0140-6736(11)60310-3 Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Thygesen K, 2012, EUR HEART J, V33, P2252, DOI 10.1093/eurheartj/ehs154 Williams J.R., 2008, WORLD MED J, V54, P120, DOI [10.2471/BLT.08.050955, DOI 10.2471/BLT.08.050955] NR 29 TC 7 Z9 8 U1 1 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0736-4679 EI 1090-1280 J9 J EMERG MED JI J. Emerg. Med. PD SEP PY 2017 VL 53 IS 3 BP 287 EP 294 DI 10.1016/j.jemermed.2017.05.006 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA FM1BJ UT WOS:000414705500006 PM 28992867 OA Green Accepted DA 2023-05-13 ER PT J AU Cziraky, MJ Reddy, VS Luthra, R Xu, Y Wilhelm, K Power, TP Fisher, MD AF Cziraky, Mark J. Reddy, Vanessa S. Luthra, Rakesh Xu, Yaping Wilhelm, Kenneth Power, Thomas P. Fisher, Maxine D. TI Clinical Outcomes and Medication Adherence in Acute Coronary Syndrome Patients With and Without Type 2 Diabetes Mellitus: A Longitudinal Analysis 2006-2011 SO JOURNAL OF MANAGED CARE & SPECIALTY PHARMACY LA English DT Article ID MYOCARDIAL-INFARCTION; PLATELET INHIBITION; HEART-DISEASE; MORTALITY; PROGNOSIS; IMPACT AB BACKGROUND: The presence of type 2 diabetes mellitus magnifies the risks associated with acute coronary syndrome (ACS), increasing the risk of recurrent cardiovascular events (CVEs) and doubling the risk of death. Managing cardiovascular risk factors has little effect on lowering the mortality risk in patients with type 2 diabetes. OBJECTIVE: To evaluate the relationship between type 2 diabetes mellitus and subsequent CVEs and medication adherence following ACS hospitalization. METHODS: Patients with ACS were identified using ICD-9-CM codes for acute myocardial infarction or unstable angina. The risk of subsequent CVEs was assessed at 1 and 3 years after the index ACS event based on type 2 diabetes status, adjusting for baseline demographic characteristics, comorbidities, medication use, and index ACS characteristics. RESULTS: Of 140,903 patients with ACS (mean age 66.8 years, 58.6% male), 27.4% had type 2 diabetes. During follow-up, 22.0% had subsequent CVEs (26.2% type 2 diabetes, 19.0% nondiabetes). After adjusting for other covariates, type 2 diabetes was associated with increased risk of subsequent CVEs by 9.7% at 1 year and 10.2% at 3 years (both P<0.001). Most patients were not revascularized at first recurrence after index ACS discharge (79.2% type 2 diabetes, 77.5% nondiabetes). Patients with type 2 diabetes had statistically significant higher adherence rates for antiplatelet agents at 1 year and antihypertensives at 1 and 3 years versus nondiabetes patients. Persistence was higher in the type 2 diabetes group for antihypertensives and in the nondiabetes group for antiplatelet agents and statins. CONCLUSIONS: This analysis demonstrates that patients with type 2 diabetes have a higher risk of subsequent CVEs following an initial event versus those without diabetes, despite evidence of higher treatment persistence for certain medications. Adherence rates remained suboptimal, suggesting a continuing need for patient education. Copyright (C) 2015, Academy of Managed Care Pharmacy. All rights reserved. C1 [Cziraky, Mark J.; Luthra, Rakesh] HealthCore, Delaware, OH USA. [Fisher, Maxine D.] Real World Evidence, Vector Oncol, Memphis, TN USA. [Power, Thomas P.] AIM Specialty Hlth, Deerfield, IL USA. [Xu, Yaping; Wilhelm, Kenneth] Employees Genentech, San Francisco, CA USA. C3 Roche Holding; Genentech RP Cziraky, MJ (通讯作者),800 Delaware Ave,5th Fl, Wilmington, DE 19801 USA. EM mcziraky@healthcore.com FU Genentech FX Funding for this study was provided by Genentech. Cziraky is an employee of HealthCore, and at the time of this study, Luthra and Fisher were employees of HealthCore, an independent research organization that received funding from Genentech, for the conduct of this study. Reddy is an employee of F. Hoffmann-La Roche. Xu and Wilhelm are employees of Genentech. Power is an employee of AIM Specialty Health, a wholly owned subsidiary of WellPoint CR Amed S, 2011, DIABETIC MED, V28, P424, DOI 10.1111/j.1464-5491.2011.03238.x Amer Diabet Assoc, 2013, DIABETES CARE, V36, pS67, DOI [10.2337/dc13-S067, 10.2337/dc14-S081, 10.2337/dc10-S011, 10.2337/dc13-S011, 10.2337/dc11-S062, 10.2337/dc10-S062, 10.2337/dc11-S011, 10.2337/dc12-s064] Amsterdam EA, 2014, J AM COLL CARDIOL, V64, pE139, DOI [10.1016/j.jacc.2014.09.017, 10.1016/j.jacc.2014.09.016] Bartnik M, 2005, EUR HEART J, V2, P144 Buysman E, 2011, CURR MED RES OPIN, V27, P1709, DOI 10.1185/03007995.2011.598500 Cuisset T, 2011, ARCH CARDIOVASC DIS, V104, P306, DOI 10.1016/j.acvd.2011.03.091 Donnan PT, 2002, DIABETIC MED, V19, P448, DOI 10.1046/j.1464-5491.2002.00711.x Goraya TY, 2002, J AM COLL CARDIOL, V40, P946, DOI 10.1016/S0735-1097(02)02065-X Grundy SM, 1999, CIRCULATION, V100, P1134, DOI 10.1161/01.CIR.100.10.1134 Haffner SM, 1998, NEW ENGL J MED, V339, P229, DOI 10.1056/NEJM199807233390404 James S, 2010, EUR HEART J, V31, P3006, DOI 10.1093/eurheartj/ehq325 KOLANSKY DM, 2009, AM J MANAG CARE S, V15, pS36 Lloyd-Jones D, 2010, CIRCULATION, V121, P948, DOI 10.1161/CIRCULATIONAHA.109.192666 Malmberg K, 2000, CIRCULATION, V102, P1014, DOI 10.1161/01.CIR.102.9.1014 Norhammar A, 2010, EUROINTERVENTION, V5, P891, DOI 10.4244/ O'Gara PT, 2013, CIRCULATION, V127, pE362, DOI 10.1161/CIR.0b013e3182742cf6 Stone GW, 2011, NEW ENGL J MED, V364, P226, DOI 10.1056/NEJMoa1002358 Taylor KS, 2013, DIABETES CARE, V36, P2366, DOI 10.2337/dc12-1513 Wiviott SD, 2008, CIRCULATION, V118, P1626, DOI 10.1161/CIRCULATIONAHA.108.791061 Zhao Z, 2020, J MED ECON, V13, P748 Zhu BJ, 2011, CURR MED RES OPIN, V27, P633, DOI 10.1185/03007995.2010.551657 NR 21 TC 8 Z9 8 U1 0 U2 3 PU ACAD MANAGED CARE PHARMACY PI ALEXANDRIA PA 100 N PITT ST, 400, ALEXANDRIA, VA 22314-3134 USA SN 2376-0540 EI 2376-1032 J9 J MANAG CARE SPEC PH JI J. Manag. Care Spec. Pharm. PD JUN PY 2015 VL 21 IS 6 BP 470 EP 477 DI 10.18553/jmcp.2015.21.6.470 PG 8 WC Health Care Sciences & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Pharmacology & Pharmacy GA CJ8QW UT WOS:000355769600002 PM 26011548 OA Bronze DA 2023-05-13 ER PT J AU Sliman, H Jaffe, R Rubinshtein, R Karkabi, B Zissman, K Flugelman, MY Zafrir, B AF Sliman, Hussein Jaffe, Ronen Rubinshtein, Ronen Karkabi, Basheer Zissman, Keren Flugelman, Moshe Y. Zafrir, Barak TI Clinical features and outcomes of revascularization in very old patients with left main coronary artery disease SO CORONARY ARTERY DISEASE LA English DT Article DE coronary artery disease; left main coronary artery disease; older adults; percutaneous coronary intervention; revascularization ID ELEVATION MYOCARDIAL-INFARCTION; HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; SCIENTIFIC STATEMENT; BYPASS-SURGERY; RANDOMIZED-TRIAL; PROGNOSTIC VALUE; GLOBAL REGISTRY; 5-YEAR OUTCOMES; SYNTAX SCORE AB Background Coronary artery disease (CAD) is often more extensive in older adults and may involve multivessel and left main coronary artery (LMCA) disease. Elderly patients are commonly excluded from clinical trials, and limited real-world data exist on the management of LMCA disease in the very old. We aimed to investigate clinical features and outcomes of very old patients undergoing revascularization due to LMCA disease. Patients and methods A retrospective single-center analysis of patients at least 80 years (n = 139) who underwent revascularization owing to CAD involving unprotected LMCA stenosis more than 50% was conducted. Subsequent major adverse cardiovascular events (MACE: myocardial infarction, stroke, and all-cause death) and repeat revascularizations were recorded, and their relation to revascularization procedure was studied. Results Percutaneous coronary intervention (PCI) was performed in 74 patients and coronary artery bypass surgery (CABG) in 65. Most patients (80%) had multivessel disease involving at least 2 additional coronary arteries. PCI was associated with older age, higher rates of baseline disability, previous revascularization, reduced ventricular function, significant aortic stenosis, and presentation with acute coronary syndrome, compared with CABG. Cumulative 3-year MACE rates were higher in patients undergoing PCI versus CABG (P = 0.009). After multivariable adjustment, predictors of MACE included presentation with ST-segment elevation myocardial infarction (STEMI) [hazard ratio (HR) = 2.39; 95% confidence interval: 1.24-4.63; P = 0.010], revascularization by PCI compared with CABG [HR = 2.21 (1.18-4.15); P = 0.013], baseline disability [HR = 2.17 (1.20-3.91); P = 0.010], and distal LMCA disease [HR = 1.87 (1.04-3.38); P = 0.038]. The difference in 3-year MACE between PCI and CABG was not observed in a propensity-score analysis of 90 patients matched 1: 1 for baseline disability, STEMI, and aortic stenosis (P = 0.797). Conclusion In very old patients undergoing coronary revascularization owing to LMCA disease, PCI was associated with worse cardiovascular outcomes compared with CABG, influenced by a more severe and comorbid population selected for PCI. Baseline disability, presentation with STEMI, and distal LMCA bifurcation disease were additional independent outcome predictors. C1 [Sliman, Hussein; Jaffe, Ronen; Rubinshtein, Ronen; Karkabi, Basheer; Zissman, Keren; Flugelman, Moshe Y.; Zafrir, Barak] Lady Davis Carmel Med Ctr, Dept Cardiol, 7 Michal St, Haifa, Israel. [Jaffe, Ronen; Rubinshtein, Ronen; Karkabi, Basheer; Flugelman, Moshe Y.; Zafrir, Barak] Technion Israel Inst Technol, Fac Med, Haifa, Israel. C3 Clalit Health Services; Carmel Medical Center; Technion Israel Institute of Technology; Rappaport Faculty of Medicine RP Zafrir, B (通讯作者),Lady Davis Carmel Med Ctr, Dept Cardiol, 7 Michal St, Haifa, Israel. EM barakzmd@gmail.com RI Zafrir, Barak/AAF-3423-2020 OI Zafrir, Barak/0000-0002-2391-8397 CR Ahn JM, 2015, J AM COLL CARDIOL, V65, P2198, DOI 10.1016/j.jacc.2015.03.033 Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Austin PC, 2014, STAT MED, V33, P1242, DOI 10.1002/sim.5984 Capodanno D, 2009, JACC-CARDIOVASC INTE, V2, P731, DOI 10.1016/j.jcin.2009.06.003 Dai XM, 2016, J GERIATR CARDIOL, V13, P101, DOI 10.11909/j.issn.1671-5411.2016.02.012 Dai XM, 2016, J GERIATR CARDIOL, V13, P109, DOI 10.11909/j.issn.1671-5411.2016.02.013 Devlin G, 2008, EUR HEART J, V29, P1275, DOI 10.1093/eurheartj/ehn124 Farooq V, 2013, J AM COLL CARDIOL, V61, P282, DOI 10.1016/j.jacc.2012.10.017 Fleg JL, 2013, CIRCULATION, V128, P2422, DOI 10.1161/01.cir.0000436752.99896.22 Forman DE, 2018, J AM COLL CARDIOL, V71, P2149, DOI 10.1016/j.jacc.2018.03.022 Gershlick AH, 2018, JACC-CARDIOVASC INTE, V11, P1224, DOI 10.1016/j.jcin.2018.03.040 Giacoppo D, 2017, JAMA CARDIOL, V2, P1079, DOI 10.1001/jamacardio.2017.2895 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Harskamp RE, 2015, CURR CARDIOL REP, V17, DOI 10.1007/s11886-015-0574-z Kandzari DE, 2018, CIRC-CARDIOVASC INTE, V11, DOI 10.1161/CIRCINTERVENTIONS.118.007007 Kobayashi Y, 2018, J AM COLL CARDIOL, V72, P1321, DOI 10.1016/j.jacc.2018.06.069 Kobayashi Y, 2016, J AM COLL CARDIOL, V67, P1701, DOI 10.1016/j.jacc.2016.01.056 Levine GN, 2011, CIRCULATION, V124, pE574, DOI 10.1161/CIR.0b013e31823ba622 Makikallio T, 2016, LANCET, V388, P2742 Morice MC, 2014, CIRCULATION, V129, P2388, DOI 10.1161/CIRCULATIONAHA.113.006689 Naganuma T, 2013, JACC-CARDIOVASC INTE, V6, P1242, DOI 10.1016/j.jcin.2013.08.005 Neumann FJ, 2019, EUR HEART J, V40, P87, DOI 10.1093/eurheartj/ehy394 Park SJ, 2011, NEW ENGL J MED, V364, P1718, DOI 10.1056/NEJMoa1100452 Ramadan R, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008151 Sappa R, 2017, INT J CARDIOL, V249, P112, DOI 10.1016/j.ijcard.2017.09.025 Stone GW, 2016, NEW ENGL J MED, V375, P2223, DOI 10.1056/NEJMoa1610227 Thoemmes F, 2011, PROPENSITY SCORE MAT Xia TL, 2018, BMC PUBLIC HEALTH, V18, DOI 10.1186/s12889-018-5049-x NR 29 TC 5 Z9 5 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0954-6928 EI 1473-5830 J9 CORONARY ARTERY DIS JI Coronary Artery Dis. PD DEC PY 2019 VL 30 IS 8 BP 584 EP 589 DI 10.1097/MCA.0000000000000744 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KF6BS UT WOS:000509325800005 PM 30985483 DA 2023-05-13 ER PT J AU Ma, JJ Wang, JL Zheng, W Zheng, JQ Wang, H Wang, GM Zhang, H Xu, F Chen, YG AF Ma, Jingjing Wang, Jiali Zheng, Wen Zheng, Jiaqi Wang, Hao Wang, Guangmei Zhang, He Xu, Feng Chen, Yuguo TI Usage of ambulance transport and influencing factors in acute coronary syndrome: a cross-sectional study at a tertiary centre in China SO BMJ OPEN LA English DT Article ID EMERGENCY MEDICAL-SERVICES; ACUTE MYOCARDIAL-INFARCTION; CHEST-PAIN; PREHOSPITAL DELAY; CARE; PATIENT; REASONS; HELP AB Objectives The aim of this study was to explore the choice of transportation mode to hospital in patients with acute coronary syndrome (ACS) and to determine the factors influencing the use of ambulance. Design, setting and participants This cross-sectional study was conducted in a tertiary and teaching hospital in China. The study was carried out between 24 August 2015 and 24 July 2016. A total of 828 patients with ACS presented at the emergency department (ED) were included. The study population was dichotomised according to their primary mode of transport (ambulance or self-transport) to hospital. Social demographics, cardiovascular history, risk factors, prehospital medications, clinical characteristics and symptom characteristics were collected. Multivariable logistic regression was used to examine the factors associated with ambulance use. Results We found that only 179 (21.6%) patients with ACS chose taking ambulance to hospital. Factors associated with ambulance use were single (OR 1.66, 95% CI 1.07 to 2.57), taking Suxiaojiuxin pills (OR 1.91, 1.31 to 2.80) or nitrates (OR 2.91, 1.70 to 4.99) before going to hospital, diagnosed as ST-elevation myocardial infarction (STEMI) (OR 2.43, 1.45 to 4.05), with persistent symptoms (OR 1.95, 1.33 to 2.86) and symptoms accompanied with vomiting (OR 2.35, 1.19 to 4.62). The patients who had symptoms precipitated or aggravated by exercise (OR 0.37, 0.14 to 0.98) tended to choose self-transport. Conclusion The usage of ambulance in patients with ACS presenting to the ED was low in China. Factors like single, taking Suxiaojiuxin pills or nitrates before going to hospital, diagnosed as STEMI, accompanied with vomiting and persistent symptoms were independently associated with ambulance use. Future education programmes should focus on these factors and increase people's knowledge on ACS and the benefits of ambulance use. C1 [Ma, Jingjing; Wang, Jiali; Zheng, Wen; Zheng, Jiaqi; Wang, Hao; Wang, Guangmei; Zhang, He; Xu, Feng; Chen, Yuguo] Shandong Univ, Qilu Hosp, Dept Emergency, Jinan, Shandong, Peoples R China. [Ma, Jingjing; Wang, Jiali; Zheng, Wen; Zheng, Jiaqi; Wang, Hao; Wang, Guangmei; Zhang, He; Xu, Feng; Chen, Yuguo] Shandong Univ, Qilu Hosp, Chest Pain Ctr, Jinan, Shandong, Peoples R China. [Ma, Jingjing; Wang, Jiali; Zheng, Wen; Zheng, Jiaqi; Wang, Hao; Wang, Guangmei; Zhang, He; Xu, Feng; Chen, Yuguo] Shandong Univ, Qilu Hosp, Key Lab Emergency & Crit Care Med Shandong Prov, Jinan, Shandong, Peoples R China. [Ma, Jingjing; Wang, Jiali; Zheng, Wen; Zheng, Jiaqi; Wang, Hao; Wang, Guangmei; Zhang, He; Xu, Feng; Chen, Yuguo] Shandong Univ, Chinese Minist Educ, Qilu Hosp, Key Lab Cardiovasc Remodeling & Funct Res, Jinan, Shandong, Peoples R China. [Ma, Jingjing; Wang, Jiali; Zheng, Wen; Zheng, Jiaqi; Wang, Hao; Wang, Guangmei; Zhang, He; Xu, Feng; Chen, Yuguo] Shandong Univ, Qilu Hosp, Chinese Minist Publ Hlth, Jinan, Shandong, Peoples R China. C3 Shandong University; Shandong University; Shandong University; Shandong University; Shandong University RP Chen, YG (通讯作者),Shandong Univ, Qilu Hosp, Dept Emergency, Jinan, Shandong, Peoples R China.; Chen, YG (通讯作者),Shandong Univ, Qilu Hosp, Chest Pain Ctr, Jinan, Shandong, Peoples R China.; Chen, YG (通讯作者),Shandong Univ, Qilu Hosp, Key Lab Emergency & Crit Care Med Shandong Prov, Jinan, Shandong, Peoples R China.; Chen, YG (通讯作者),Shandong Univ, Chinese Minist Educ, Qilu Hosp, Key Lab Cardiovasc Remodeling & Funct Res, Jinan, Shandong, Peoples R China.; Chen, YG (通讯作者),Shandong Univ, Qilu Hosp, Chinese Minist Publ Hlth, Jinan, Shandong, Peoples R China. EM chen919085@sdu.edu.cn FU Taishan Scholar Program of Shandong Province [ts20130911]; Taishan Young Scholar Program of Shandong Province; Key Technology Research and Development Program of Science and Technology of Shandong Province [2014kjhm0102]; Department of Science and Technology of Shandong Province [2014GSF11811, 2016GSF201235, 2016ZDJS07A14]; Evaluation and Management of Patients with Acute Chest Pain in China (EMPACT) [201525] FX This study was supported by Taishan Scholar Program of Shandong Province (ts20130911), Taishan Young Scholar Program of Shandong Province, Key Technology Research and Development Program of Science and Technology of Shandong Province (2014kjhm0102), Department of Science and Technology of Shandong Province (2014GSF11811, 2016GSF201235, 2016ZDJS07A14), Evaluation and Management of Patients with Acute Chest Pain in China (EMPACT) (201525). 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Rickli, Hans Bertel, Osmund Puhan, Milo A. Erne, Paul CA AMIS Plus Investigators TI Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002-2012 SO HEART LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; SCIENTIFIC STATEMENT; GERIATRIC-CARDIOLOGY; CLINICAL CARDIOLOGY; RISK ADJUSTMENT; MORTALITY; DISEASE; REVASCULARIZATION AB Objective This study aimed to assess the impact of individual comorbid conditions as well as the weight assignment, predictive properties and discriminating power of the Charlson Comorbidity Index (CCI) on outcome in patients with acute coronary syndrome (ACS). Methods A prospective multicentre observational study (AMIS Plus Registry) from 69 Swiss hospitals with 29 620 ACS patients enrolled from 2002 to 2012. The main outcome measures were in-hospital and 1-year follow-up mortality. Results Of the patients, 27% were female (age 72.1 +/- 12.6 years) and 73% were male (64.2 +/- 12.9 years). 46.8% had comorbidities and they were less likely to receive guideline-recommended drug therapy and reperfusion. Heart failure (adjusted OR 1.88; 95% CI 1.57 to 2.25), metastatic tumours (OR 2.25; 95% CI 1.60 to 3.19), renal diseases (OR 1.84; 95% CI 1.60 to 2.11) and diabetes (OR 1.35; 95% CI 1.19 to 1.54) were strong predictors of in-hospital mortality. In this population, CCI weighted the history of prior myocardial infarction higher (1 instead of -0.4, 95% CI -1.2 to 0.3 points) but heart failure (1 instead of 3.7, 95% CI 2.6 to 4.7) and renal disease (2 instead of 3.5, 95% CI 2.7 to 4.4) lower than the benchmark, where all comorbidities, age and gender were used as predictors. However, the model with CCI and age has an identical discrimination to this benchmark (areas under the receiver operating characteristic curves were both 0.76). Conclusions Comorbidities greatly influenced clinical presentation, therapies received and the outcome of patients admitted with ACS. Heart failure, diabetes, renal disease or metastatic tumours had a major impact on mortality. CCI seems to be an appropriate prognostic indicator for in-hospital and 1-year outcomes in ACS patients. C1 [Radovanovic, Dragana] Univ Zurich, Inst Social & Prevent Med, AMIS Plus Data Ctr, CH-8001 Zurich, Switzerland. [Seifert, Burkhardt; Puhan, Milo A.] Univ Zurich, Inst Social & Prevent Med, Div Biostat, CH-8001 Zurich, Switzerland. [Urban, Philip] Hop La Tour, Cardiovasc Dept, Geneva, Switzerland. [Eberli, Franz R.] Stadtspital Triemli, Div Cardiol, Zurich, Switzerland. [Rickli, Hans] Kantonsspital St Gallen, Div Cardiol, St Gallen, Switzerland. [Bertel, Osmund] Klin Pk, Ctr Cardiol, Zurich, Switzerland. [Erne, Paul] Luzerner Kantonsspital Luzern, Dept Cardiol, Luzerner, Switzerland. C3 University of Zurich; University of Zurich; Triemli Hospital; Kantonsspital St. Gallen; Lucerne Cantonal Hospital RP Radovanovic, D (通讯作者),Univ Zurich, Inst Social & Prevent Med, AMIS Plus Data Ctr, Hirschengraben 84, CH-8001 Zurich, Switzerland. EM dragana.radovanovic@uzh.ch RI Jeger, Raban/ABG-1678-2021; Radovanovic, Dragana/F-7908-2013; Puhan, Milo/ABE-6298-2020 OI Jeger, Raban/0000-0003-1290-5491; Radovanovic, Dragana/0000-0002-9507-6272; Puhan, Milo/0000-0003-4721-1879; Seifert, Burkhardt/0000-0002-5829-2478; Maggiorini, Marco/0000-0001-8180-2117 FU Swiss Heart Foundation; Abbot AG, Switzerland; Astra-Zeneca AG, Switzerland; Bayer (Schweiz) AG, Switzerland; Biotronik AG, Switzerland; Bristol-Myers Squibb AG, Switzerland; Daiichi-Sankyo/Lilly AG, Switzerland; Johnson & Johnson AG-Cordis Division, Switzerland; A Menarini AG, Switzerland; Merck Sharp & Dohme-Chibret AG, Switzerland; Medtronic AG, Switzerland; Pfizer AG, Switzerland; St. Jude Medical, Switzerland; Takeda Pharma AG, Switzerland FX The AMIS Plus registry is funded by unrestricted grants from the Swiss Heart Foundation and from Abbot AG, Switzerland; Astra-Zeneca AG, Switzerland; Bayer (Schweiz) AG, Switzerland; Biotronik AG, Switzerland; Bristol-Myers Squibb AG, Switzerland; Daiichi-Sankyo/Lilly AG, Switzerland; Johnson & Johnson AG-Cordis Division, Switzerland; A Menarini AG, Switzerland; Merck Sharp & Dohme-Chibret AG, Switzerland; Medtronic AG, Switzerland; Pfizer AG, Switzerland; St. Jude Medical, Switzerland; Takeda Pharma AG, Switzerland. The sponsors did not play any role in the design, data collection, analysis, or interpretation of the registry. CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alexander KP, 2007, CIRCULATION, V115, P2570, DOI 10.1161/CIRCULATIONAHA.107.182616 Boyd CM, 2005, JAMA-J AM MED ASSOC, V294, P716, DOI 10.1001/jama.294.6.716 Boyd CM, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0041601 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 Fassa AA, 2010, CARDIOVASC MED, V13, P155 Fried L, 2001, AM J KIDNEY DIS, V37, P337, DOI 10.1053/ajkd.2001.21300 Goldstein LB, 2004, STROKE, V35, P1941, DOI 10.1161/01.STR.0000135225.80898.1c Grunau GL, 2006, J CLIN EPIDEMIOL, V59, P274, DOI 10.1016/j.jclinepi.2005.08.007 Jeger RV, 2008, ANN INTERN MED, V149, P618, DOI 10.7326/0003-4819-149-9-200811040-00005 Lichtman JH, 2007, CIRCULATION, V116, P1925, DOI 10.1161/CIRCULATIONAHA.107.722090 Nunez JE, 2004, REV ESP CARDIOL, V57, P842, DOI 10.1016/S1885-5857(06)60649-X Palau P, 2012, CLIN CARDIOL, V35, P237, DOI 10.1002/clc.20996 Quan HD, 2011, AM J EPIDEMIOL, V173, P676, DOI 10.1093/aje/kwq433 Radovanovic D, 2010, SWISS MED WKLY, V140, P314, DOI smw-12986 Radovanovic D, 2010, HEART, V96, P917, DOI 10.1136/hrt.2009.192302 Sachdev M, 2004, J AM COLL CARDIOL, V43, P576, DOI 10.1016/j.jacc.2003.10.031 Schneeweiss S, 2003, HEALTH SERV RES, V38, P1103, DOI 10.1111/1475-6773.00165 Schoenenberger AW, 2008, J AM GERIATR SOC, V56, P510, DOI 10.1111/j.1532-5415.2007.01589.x Singh M, 2011, CIRC-CARDIOVASC QUAL, V4, P496, DOI 10.1161/CIRCOUTCOMES.111.961375 Stauffer JC, 2012, SWISS MED WKLY, V142, DOI 10.4414/smw.2012.13573 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Steg PG, 2007, ARCH INTERN MED, V167, P68, DOI 10.1001/archinte.167.1.68 Thygesen K, 2007, EUR HEART J, V28, P2525 Tinetti ME, 2004, NEW ENGL J MED, V351, P2870, DOI 10.1056/NEJMsb042458 NR 25 TC 188 Z9 192 U1 0 U2 8 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1355-6037 EI 1468-201X J9 HEART JI Heart PD FEB 15 PY 2014 VL 100 IS 4 BP 288 EP 294 DI 10.1136/heartjnl-2013-304588 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AA6CP UT WOS:000331186700006 PM 24186563 OA Green Submitted, Bronze DA 2023-05-13 ER PT J AU Holmes, DR Krucoff, MW Mullin, C Mikdadi, G Presser, D Wohns, D Kaplan, A Ciuffo, A Eberly, AL Iteld, B Fischell, DR Fischell, T Keenan, D John, S Gibson, M AF Holmes, David R., Jr. Krucoff, Mitchell W. Mullin, Chris Mikdadi, Ghiath Presser, Dale Wohns, David Kaplan, Andrew Ciuffo, Allen Eberly, Arthur L., III Iteld, Bruce Fischell, David R. Fischell, Tim Keenan, David John, Sasha Gibson, Michael TI Implanted Monitor Alerting to Reduce Treatment Delay in Patients With Acute Coronary Syndrome Events SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE implantable cardiac monitor; ischemia monitoring; pre-hospital delay; silent myocardial infarction; supply-side ischemia; symptom-to-door time ID ACUTE MYOCARDIAL-INFARCTION; TO-BALLOON TIME; HOSPITAL PRESENTATION; PREHOSPITAL DELAY; SYMPTOM ONSET; TRENDS; MORTALITY; INTERVENTION; PREDICTORS AB BACKGROUND Increased pre-hospital delay during acute coronary syndrome (ACS) events contributes to worse outcome. OBJECTIVES The purpose of this study was to assess the effectiveness of an implanted cardiac monitor with real-time alarms for abnormal ST-segment shifts to reduce pre-hospital delay during ACS events. METHODS In the ALERTS (AngeLmed Early Recognition and Treatment of STEMI) pivotal study, subjects at high risk for recurrent ACS events (n = 907) were randomized to control (Alarms OFF) or treatment groups for 6 months, after which alarms were activated in all subjects (Alarms ON). Emergency department (ED) visits with standard-of-care cardiac test results were independently adjudicated as true-or false-positive ACS events. Alarm-to-door (A2D) and symptom-to-door (S2D) times were calculated for true-positive ACS ED visits triggered by 3 possible prompts: alarm only, alarms thorn symptoms, or symptoms only. RESULTS The Alarms ON group showed reduced delays, with 55% (95% confidence interval [CI]: 46% to 63%) of ED visits for ACS events <2 h compared with 10% (95% CI: 2% to 27%) in the Alarms OFF group (p < 0.0001). Results were similar when restricted to myocardial infarction (MI) events. Median pre-hospital delay for MI was 12.7 h for Alarms OFF and 1.6 h in Alarms ON subjects (p < 0.0089). Median A2D delay was 1.4 h for asymptomatic MI. Median S2D delay for symptoms-only MI (no alarm) in Alarms ON was 4.3 h. CONCLUSIONS Intracardiac monitoring with real-time alarms for ST-segment shift that exceeds a subject's self-normative ischemia threshold level significantly reduced the proportion of pre-hospital delays >2 h for ACS events, including asymptomatic MI, compared with symptoms-only ED visits in Alarms OFF. (C) 2019 Published by Elsevier on behalf of the American College of Cardiology Foundation. C1 [Holmes, David R., Jr.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Krucoff, Mitchell W.] Duke Univ, Med Ctr, Durham, NC USA. [Krucoff, Mitchell W.] Duke Clin Res Inst, Durham, NC USA. [Mullin, Chris] North Amer Sci Associates Inc, Toledo, OH USA. [Mikdadi, Ghiath] Heart Clin Hammond, Hammond, LA USA. [Presser, Dale] Innovat Med Res LLC, Covington, LA USA. [Wohns, David] Spectrum Hlth Frederik Meijer Heart & Vasc Inst, Grand Rapids, MI USA. [Kaplan, Andrew] Banner Heart Hosp, Mesa, AZ USA. [Ciuffo, Allen] Sentara Healthcare Norfolk, Norfolk, VA USA. [Eberly, Arthur L., III] Greenville Mem Hosp, Greenville, SC USA. [Iteld, Bruce] Louisiana Heart Ctr, Hammond, LA USA. [Fischell, David R.; Fischell, Tim; Keenan, David; John, Sasha] Angel Med Syst, Eatontown, NJ USA. [Gibson, Michael] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Med, Div Cardiovasc Med, Boston, MA 02115 USA. C3 Mayo Clinic; Duke University; Duke University; Banner Research; Banner Health; Sentara Healthcare; Greenville Health System; Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School RP Holmes, DR (通讯作者),Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. 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Am. Coll. Cardiol. PD OCT 22 PY 2019 VL 74 IS 16 BP 2047 EP 2055 DI 10.1016/j.jacc.2019.07.084 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JD3SA UT WOS:000489895000005 PM 31623762 DA 2023-05-13 ER PT J AU Rattka, M Baumhardt, M Dreyhaupt, J Rothenbacher, D Thiessen, K Markovic, S Rottbauer, W Imhof, A AF Rattka, Manuel Baumhardt, Michael Dreyhaupt, Jens Rothenbacher, Dietrich Thiessen, Kevin Markovic, Sinisa Rottbauer, Wolfgang Imhof, Armin TI 31 days of COVID-19-cardiac events during restriction of public life-a comparative study SO CLINICAL RESEARCH IN CARDIOLOGY LA English DT Article DE COVID-19; Cardiac events; Acute coronary syndrome; Epidemiology ID ACUTE MYOCARDIAL-INFARCTION; MANAGEMENT; TRIGGERS; ANGER AB Aims The coronavirus SARS-CoV-2 outbreak led to the most recent pandemic of the twenty-first century. To contain spread of the virus, many nations introduced a public lockdown. How the pandemic itself and measures of social restriction affect hospital admissions due to acute cardiac events has rarely been evaluated yet. Methods and Results German public authorities announced measures of social restriction between March 21st and April 20th, 2020. During this period, all patients suffering from an acute cardiac event admitted to our hospital (N = 94) were assessed and incidence rate ratios (IRR) of admissions for acute cardiac events estimated, and compared with those during the same period in the previous three years (2017-2019, N = 361). Admissions due to cardiac events were reduced by 22% as compared to the previous years (n = 94 vs. an average of n = 120 per year for 2017-2019). Whereas IRR for STEMI 1.20 (95% CI 0.67-2.14) and out-of-hospital cardiac arrest IRR 0.82 (95% CI 0.33-2.02) remained similar, overall admissions with an IRR of 0.78 (95% CI 0.62-0.98) and IRR for NSTEMI with 0.46 (95% CI 0.27-0.78) were significantly lower. In STEMI patients, plasma concentrations of high-sensitivity troponin T at admission were significantly higher (644 ng/l, IQR 372-2388) compared to 2017-2019 (195 ng/l, IQR 84-1134; p = 0.02). Conclusion The SARS-CoV-2 pandemic and concomitant social restrictions are associated with reduced cardiac events admissions to our tertiary care center. From a public health perspective, strategies have to be developed to assure patients are seeking and getting medical care and treatment in time during SARS-CoV-2 pandemic. C1 [Rattka, Manuel; Baumhardt, Michael; Thiessen, Kevin; Markovic, Sinisa; Rottbauer, Wolfgang; Imhof, Armin] Univ Hosp Ulm Med Ctr, Clin Internal Med 2, Albert Einstein Allee 23, D-89081 Ulm, Germany. [Dreyhaupt, Jens; Rothenbacher, Dietrich] Ulm Univ, Inst Epidemiol & Med Biometry, Ulm, Germany. C3 Ulm University RP Imhof, A (通讯作者),Univ Hosp Ulm Med Ctr, Clin Internal Med 2, Albert Einstein Allee 23, D-89081 Ulm, Germany. EM armin.imhof@uniklinik-ulm.de RI Markovic, Sinisa/GOE-5539-2022; Markovic, Sinisa/AAX-3181-2020; Thiessen, Kevin/GRJ-1209-2022 OI Markovic, Sinisa/0000-0001-9708-0702; Imhof, Armin/0000-0001-7452-303X; Rattka, Manuel/0000-0002-3269-3871; Thiessen, Kevin/0000-0002-0590-1460 FU University Hospital of Ulm; University of Ulm, Germany FX \Local funding by University Hospital of Ulm and University of Ulm, Germany. 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Res. Cardiol. PD DEC PY 2020 VL 109 IS 12 SI SI BP 1476 EP 1482 DI 10.1007/s00392-020-01681-2 EA JUN 2020 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OX4ZR UT WOS:000537644100001 PM 32494921 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Ding, YY Kader, B Christiansen, CL Berlowitz, DR AF Ding, Yew Y. Kader, Boris Christiansen, Cindy L. Berlowitz, Dan R. TI Hemoglobin Level and Hospital Mortality Among ICU Patients With Cardiac Disease Who Received Transfusions SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE acute coronary syndrome; acute myocardial infarction; heart failure; risk adjustment ID BLOOD-CELL TRANSFUSION; ACUTE LUNG INJURY; INTENSIVE-CARE-UNIT; ACUTE MYOCARDIAL-INFARCTION; CRITICALLY-ILL PATIENTS; CLINICAL-OUTCOMES; ANEMIA; IMPACT; MULTICENTER; THRESHOLD AB BACKGROUND There is a paucity of randomized clinical trial data on the use of red blood cell (RBC) transfusion in critically ill patients, specifically in the setting of cardiac disease. OBJECTIVES This study examined how hemoglobin (Hgb) level and cardiac disease modify the relationship of RBC transfusion with hospital mortality. The aim was to estimate the Hgb level threshold below which transfusion would be associated with reduced hospital mortality. METHODS We performed secondary data analyses of Veterans Affairs intensive care unit (ICU) episodes across 5 years. Logistic regression quantified the effect of transfusion on hospital mortality while adjusting for nadir Hgb level, demographic characteristics, admission information, comorbid conditions, and ICU admission diagnoses. RESULTS Among 258,826 ICU episodes, 12.4% involved transfusions. Hospital death occurred in 11.6%. Without comorbid heart disease, transfusion was associated with decreased adjusted hospital mortality when Hgb was approximately < 7.7 g/dl, but transfusion increased mortality above this Hgb level. Corresponding Hgb level thresholds were approximately 8.7 g/dl when comorbid heart disease was present and approximately 10 g/dl when the ICU admission diagnosis was acute myocardial infarction (AMI). Sensitivity analysis using additional adjustment for selected blood tests in a subgroup of 182,792 ICU episodes lowered these thresholds by approximately 1 g/dl. CONCLUSIONS Transfusion of critically ill patients was associated with reduced hospital mortality when Hgb level was < 8 to 9 g/dl in the presence of comorbid heart disease. This Hgb level threshold for transfusion was 9 to 10 g/dl when AMI was the ICU admission diagnosis. (C) 2015 by the American College of Cardiology Foundation. C1 [Ding, Yew Y.] Tan Tock Seng Hosp, Dept Geriatr Med, Singapore, Singapore. [Ding, Yew Y.] Tan Tock Seng Hosp, Inst Geriatr & Act Ageing, Singapore, Singapore. [Ding, Yew Y.] Natl Healthcare Grp, Hlth Serv & Outcomes Res, Singapore, Singapore. [Kader, Boris; Christiansen, Cindy L.; Berlowitz, Dan R.] CHOIR, Bedford, MA USA. [Kader, Boris; Christiansen, Cindy L.; Berlowitz, Dan R.] Boston Univ, Sch Publ Hlth, Boston, MA USA. C3 Tan Tock Seng Hospital; Tan Tock Seng Hospital; Boston University RP Berlowitz, DR (通讯作者),Edith Nourse Rogers Mem Hosp, CHOIR, VA Bedford Hosp, 152,Bldg 70,200 Springs Rd, Bedford, MA 01730 USA. EM yew_yoong_ding@ttsh.com.sg; dan.berlowitz@va.gov RI Ding, Yuyan/HWQ-3664-2023; ding, yy/HHS-9589-2022 OI Berlowitz, Dan/0000-0002-8783-5611 FU National Medical Research Council of Singapore FX Dr. Ding was funded by the National Medical Research Council of Singapore for his research fellowship in Boston. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. 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