FN Clarivate Analytics Web of Science VR 1.0 PT J AU Chen, Y Feng, F Li, M Chang, XN Wei, BH Dong, CM AF Chen, Yu Feng, Fang Li, Min Chang, Xueni Wei, Baohua Dong, Chenming TI Development of a risk stratification-based model for prediction of acute kidney injury in critically ill patients SO MEDICINE LA English DT Article DE acute kidney injury; critically ill patients; predictive model ID BIOMARKERS; SEPSIS; AKI; VALIDATION; MORTALITY; MARKER; SCORE AB Acute kidney injury (AKI) is a complex syndrome with a variety of possible etiologies and symptoms. It is characterized by high mortality and poor recovery of renal function. The incidence and mortality rates of patients with AKI in intensive care units are extremely high. It is generally accepted that early identification and prompt treatment of AKI are essential to improve outcomes. This study aimed to develop a model based on risk stratification to identify and diagnose early stage AKI for improved prognosis in critically ill patients. This was a single-center, retrospective, observational study. Based on relevant literature, we selected 13 risk factors (age, sex, hypertension, diabetes, coronary heart disease, chronic kidney disease, total bilirubin, emergency surgery, mechanical ventilation, sepsis, heart failure, cancer, and hypoalbuminemia) for AKI assessment using the Kidney Disease Improving Global Outcomes (KDIGO) diagnostic criteria. Univariate and multivariate analyses were used to determine risk factors for eventual entry into the predictive model. The AKI predictive model was established using binary logistic regression, and the area under the receiver operating characteristic curve (AUROC or AUC) was used to evaluate the predictive ability of the model and to determine critical values. The AKI predictive model was established using binary logistic regression. The AUROC of the predictive model was 0.81, with a sensitivity of 69.8%, specificity of 83.4%, and positive likelihood ratio of 4.2. A predictive model for AKI in critically ill patients was established using 5 related risk factors: heart failure, chronic kidney disease, emergency surgery, sepsis, and total bilirubin; however, the predictive ability requires validation. C1 [Chen, Yu; Feng, Fang; Li, Min; Chang, Xueni; Wei, Baohua; Dong, Chenming] Lanzhou Univ, Hosp 2, Surg Intens Care Unit 2, Lanzhou, Gansu, Peoples R China. [Chen, Yu] 82,Cuiyingmen, Lanzhou, Gansu, Peoples R China. C3 Lanzhou University RP Chen, Y (通讯作者)，82,Cuiyingmen, Lanzhou, Gansu, Peoples R China. EM lzucy2014@163.com RI min, Li/GQQ-2169-2022 OI Chen, Yu/0000-0003-1447-4410 CR Alge JL, 2015, CLIN J AM SOC NEPHRO, V10, P147, DOI 10.2215/CJN.12191213 Angus DC, 2013, NEW ENGL J MED, V369, P2063, DOI [10.1056/NEJMra1208623, 10.1056/NEJMc1312359] Aqeel SHB, 2017, CLIN KIDNEY J, V10, P759, DOI 10.1093/ckj/sfx087 Bouchard J, 2015, CLIN J AM SOC NEPHRO, V10, P1324, DOI 10.2215/CJN.04360514 Chertow GM, 2005, J AM SOC NEPHROL, V16, P3365, DOI 10.1681/ASN.2004090740 Damman K, 2013, JACC-HEART FAIL, V1, P417, DOI 10.1016/j.jchf.2013.05.007 Di Grande A, 2009, EUR REV MED PHARMACO, V13, P197 Fan PC, 2012, AM J MED SCI, V344, P83, DOI 10.1097/MAJ.0b013e3182373d36 Fisher J, 2017, SHOCK, V48, P313, DOI 10.1097/SHK.0000000000000862 Flechet M, 2017, INTENS CARE MED, V43, P764, DOI 10.1007/s00134-017-4678-3 Hoste E, 2015, INTENS CARE MED, V41, P1411, DOI 10.1007/s00134-015-3934-7 KamTao L. i. 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Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients. The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China. A total of 74 patients received NPPV and 90 patients received CMV. Inclusion criteria included the following: physician-diagnosed AECOPD, spontaneous airway clearance of excessive secretions, arterial blood gas analysis requiring intensive care, moderate-tosevere dyspnea, and a Kelly-Matthay scale score of 3 to 5. Exclusion criteria included the following: preexisting psychiatric/neurological disorders unrelated to HE, upper gastrointestinal bleeding, upper airway obstruction, acute coronary syndromes, preadmission tracheostomy or endotracheal intubation, and urgent endotracheal intubation for cardiovascular, psychomotor agitation, or severe hemodynamic conditions. Intensive care unit participantsweremanaged by NPPV. Participants received standard treatment consisting of controlled oxygen therapy during NPPV-free periods; antibiotics, intravenous doxofylline, corticosteroids (e. g., salbutamol and ambroxol), and subcutaneous low-molecular-weight heparin; and therapy for comorbidities if necessary. Nasogastric tubes were inserted only in participants who developed gastric distension. No pharmacological sedation was administered. The primary and secondary outcome measures included comparative complication rates, durations of ventilation and hospitalization, number of invasive devices/ patient, and in-hospital and 1-year mortality rates. Arterial blood gases and sensorium levels improved significantly within 2 hours in the NPPV group with lower hospital mortality, fewer complications and invasive devices/ patient, and superior weaning off mechanical ventilation. Mechanical ventilation duration, hospital stay, or 1-year mortality was similar between groups. NPPV combined with a noninvasive strategy to clear secretions during the first 2 hours may offer advantages over CMV in treating AECOPD patients complicated by HE. C1 [Wang, Jinrong; Shi, Yi] Southern Med Univ, Guangzhou, Guangdong, Peoples R China. [Wang, Jinrong; Cui, Zhaobo; Liu, Shuhong; Gao, Pan; Guo, Shufen] Harrison Int Peace Hosp, Dept Crit Care Med, Hengshui, Hebei, Peoples R China. [Gao, Xiuling; Li, Peipei] Harrison Int Peace Hosp, Dept Resp & Crit Care Med, Hengshui, Hebei, Peoples R China. [Shi, Yi] Nanjing Mil Command, Nanjing Gen Hosp, Dept Resp & Crit Care Med, Nanjing, Jiangsu, Peoples R China. C3 Southern Medical University - China; Nanjing General Hospital RP Shi, Y (通讯作者)，Southern Med Univ, Guangzhou, Guangdong, Peoples R China.; Cui, ZB (通讯作者)，Harrison Int Peace Hosp, Dept Crit Care Med, Hengshui, Hebei, Peoples R China.; Shi, Y (通讯作者)，Nanjing Mil Command, Nanjing Gen Hosp, Dept Resp & Crit Care Med, Nanjing, Jiangsu, Peoples R China. 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Behnes, M. Ansari, U. Hillenbrand, D. Haghi, D. Hoffmann, U. Papavassiliu, T. Elmas, E. Fastner, C. Becher, T. Baumann, S. Doesch, C. Heggemann, F. Kuschyk, J. Borggrefe, M. Akin, I. TI Comparison and outcome analysis of patients with apical and non-apical takotsubo cardiomyopathy SO QJM-AN INTERNATIONAL JOURNAL OF MEDICINE LA English DT Article ID TAKO-TSUBO CARDIOMYOPATHY; ACUTE MYOCARDIAL-INFARCTION; BALLOONING SYNDROME; DIABETES-MELLITUS; STRESS CARDIOMYOPATHY; CLINICAL-FEATURES; PREVALENCE; FORM; VARIANT; ENTITY AB Background: Takotsubo cardiomyopathy (TTC) is a relevant differential diagnosis in patients presenting with signs of an acute coronary syndrome. Although recent literature has highlighted some salient features of this disorder, there has been little information elucidating the differences in clinical features, electrocardiographic findings, echocardiographic data and TTC-related complications associated with the different variants of TTC. Methods and results: Our institutional database constituted a collective of 114 patients diagnosed with TTC between 2003 and 2015 and these patients were subsequently divided into two groups based on the presence (n = 82, 72%) or absence (n = 32, 28%) of the apical form of TTC. The protocol for our proposed study was approved by the Ethics Committee of the University Medical Centre in Mannheim. It was noticed that the patients presenting with the apical form of TTC belonged to an older age group as compared to those presenting with the non-apical form (61.1 +/- 8.9 years vs. 69.5 +/- 11.2; P < 0.01). The QTc interval prolongation at index-event was observed to be quantifiably greater in the 'apical variant' patients group (484.8 +/- 57ms vs. 464 +/- 34.1 ms; P=0.06). With respect to cardiovascular risk factors, patients with arterial hypertension did have a higher predilection to present with the apical form (63.4% vs. 43.7%; P = 0.06), however, the impact of smoking was less pronounced in this patient group (24.4% vs. 50%, P = 0.01). Furthermore, our study highlighted a significant impact on ejection fraction (EF), with a compromised left ventricular function (3669% vs. 42.469.7%, P < 0.01) and greater involvement of the right ventricle in the apical variant patients group (23% vs. 3%, P = 0.04). Patients with the apical form also showed a greater tendency to develop TTC-related complications such as cardiogenic shock and required longer monitoring and care in comparison. Conclusions: The apical and non-apical variants of TTC are manifestations of the same syndrome. They differ significantly, however, in their clinical presentation, related complications and prognosis. C1 [El-Battrawy, I.; Behnes, M.; Ansari, U.; Hillenbrand, D.; Haghi, D.; Hoffmann, U.; Papavassiliu, T.; Elmas, E.; Fastner, C.; Becher, T.; Baumann, S.; Doesch, C.; Heggemann, F.; Kuschyk, J.; Borggrefe, M.; Akin, I.] Heidelberg Univ, Dept Med 1, Fac Med, Univ Med Ctr Mannheim UMM, Mannheim, Germany. [El-Battrawy, I.; Hoffmann, U.; Papavassiliu, T.; Doesch, C.; Borggrefe, M.; Akin, I.] DZHK German Ctr Cardiovasc Res, Partner Site, Mannheim, Germany. C3 Ruprecht Karls University Heidelberg; German Centre for Cardiovascular Research RP El-Battrawy, I (通讯作者)，Univ Med Ctr Mannheim, Dept Med 1, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany. EM ibrahim.el-battrawy@umm.de RI Ansari, Uzair/AAF-5065-2021; Akin, Ibrahim/AAF-1356-2020; Kuschyk, Jürgen/Q-2150-2015 OI Ansari, Uzair/0000-0003-4856-8570; El-Battrawy, Ibrahim/0000-0002-0139-1045 CR Akashi YJ, 2008, CIRCULATION, V118, P2754, DOI 10.1161/CIRCULATIONAHA.108.767012 Bharathi KS, 2016, INDIAN J ANAESTH, V60, P202, DOI 10.4103/0019-5049.177872 Brinjikji W, 2012, AM HEART J, V164, P215, DOI 10.1016/j.ahj.2012.04.010 de Gregorio C, 2008, INT J CARDIOL, V130, pE78, DOI 10.1016/j.ijcard.2007.11.104 Dote K, 1991, J Cardiol, V21, P203 Elesber A, 2006, AM HEART J, V152, DOI 10.1016/j.ahj.2006.06.007 Haghi D, 2006, HEART, V92, P392, DOI 10.1136/hrt.2005.061044 Hahn JY, 2007, AM HEART J, V154, P1166, DOI 10.1016/j.ahj.2007.08.003 Hurst RT, 2006, J AM COLL CARDIOL, V48, P579, DOI 10.1016/j.jacc.2006.06.015 Ito K, 2001, ANN NUCL MED, V15, P351, DOI 10.1007/BF02988242 Jabara R, 2009, J INVASIVE CARDIOL, V21, P216 Kurisu S, 2011, CLIN CARDIOL, V34, P555, DOI 10.1002/clc.20934 Kurisu S, 2010, CLIN CARDIOL, V33, P42, DOI [10.1002/clc.20700, 10.1002/clc.20726] Madhavan M, 2010, HERZ, V35, P240, DOI 10.1007/s00059-010-3339-x Madias JE, 2016, EUR HEART J-ACUTE CA, V5, P164, DOI 10.1177/2048872615570761 Madias JE, 2016, INT J CARDIOL, V202, P910, DOI 10.1016/j.ijcard.2015.10.017 Madias JE, 2015, AM J CARDIOL, V116, P1648, DOI 10.1016/j.amjcard.2015.09.012 Madias JE, 2015, INT J CARDIOL, V184, P517, DOI 10.1016/j.ijcard.2015.02.108 MORI H, 1993, CARDIOVASC RES, V27, P192, DOI 10.1093/cvr/27.2.192 Movahed MR, 2007, CARDIOVASC REVASCULA, V8, P289, DOI 10.1016/j.carrev.2007.02.001 Nef HM, 2008, J MOL CELL CARDIOL, V44, P395, DOI 10.1016/j.yjmcc.2007.10.015 Patel HM, 2007, CLIN CARDIOL, V30, P14, DOI 10.1002/clc.21 PIERPONT GL, 1984, AM J PHYSIOL, V246, pH824, DOI 10.1152/ajpheart.1984.246.6.H824 Prasad A, 2008, AM HEART J, V155, P408, DOI 10.1016/j.ahj.2007.11.008 Robles P, 2006, CIRCULATION, V113, pE686, DOI 10.1161/CIRCULATIONAHA.105.536490 Sasaki O, 2006, CIRC J, V70, P1220, DOI 10.1253/circj.70.1220 Schneider B, 2014, INT J CARDIOL, V176, P199, DOI 10.1016/j.ijcard.2014.07.002 Shi YK, 2014, LANCET, V383, P1947, DOI 10.1016/S0140-6736(14)60886-2 Templin C, 2015, NEW ENGL J MED, V373, P929, DOI 10.1056/NEJMoa1406761 Tsuchihashi K, 2001, J AM COLL CARDIOL, V38, P11, DOI 10.1016/S0735-1097(01)01316-X Wittstein IS, 2005, NEW ENGL J MED, V352, P539, DOI 10.1056/NEJMoa043046 NR 31 TC 16 Z9 16 U1 0 U2 5 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 DEC PY 2016 VL 109 IS 12 BP 797 EP 802 DI 10.1093/qjmed/hcw092 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA EJ4TO UT WOS:000393210000007 PM 27341847 OA Bronze DA 2023-05-13 ER PT J AU Wang, Q Chair, SY Wong, EML AF Wang, Qun Chair, Sek Ying Wong, Eliza Mi-Ling TI The effects of a lifestyle intervention program on physical outcomes, depression, and quality of life in adults with metabolic syndrome: A randomized clinical trial SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Metabolic syndrome; Lifestyle intervention; Body weight; Depression Quality of life ID ACUTE CORONARY SYNDROME; CARDIOVASCULAR RISK; WEIGHT-LOSS; HOSPITAL ANXIETY; KOREAN ADULTS; HEALTH; EXERCISE; METAANALYSIS; EDUCATION; FITNESS AB Background/objectives: Lifestyle modification is recommended as the primary intervention for metabolic syndrome (MetS). The study was to examine the effects of a lifestyle intervention program (LIP) on physical outcomes, depression, and quality of life (QoL) in Chinese adults with MetS. Methods: A randomized control trial design was used. A three-month LIP guided by the Health Promotion Model was developed, including a lifestyle modification booklet, one session of discharge education, and six telephone follow-ups. Patients with MetS were recruited from the inpatient departments of a hospital and were randomized to receive either the LIP or usual care. The physical outcomes, depression (Depression subscale of Hospital Anxiety and Depression Scale), and QoL (Medical Outcome Study Short Form-12, SF-12) were measured at baseline, one-month (T1) and three-month (T2). The effects of the LIP were examined by the generalized estimating equation (GEE) model. Results: The study recruited 173 participants, with 86 in the intervention group and 87 in the control. Continuous improvements were observed in all the study outcomes in the intervention group. The GEE model revealed significant improvements in body weight (T1: p - 0.017, T2: p - 0.007), body mass index (T1: p - 0.015, T2: p = 0.009), depression (T1: p = 0.027, T2: p < 0.001), and physical aspects of QoL at T2 (p= 0.02). Conclusions: The current LIP was effective in losing body weight, improving depression and QoL ofMetS populations in three-month observation. Considering its low-cost and convenience, the LIP could be applied in clinical practice to improve patient outcomes. (C) 2016 Elsevier Ireland Ltd. All rights reserved. C1 [Wang, Qun; Chair, Sek Ying; Wong, Eliza Mi-Ling] Chinese Univ Hong Kong, Nethersole Sch Nursing, Shatin, Hong Kong, Peoples R China. C3 Chinese University of Hong Kong RP Wang, Q (通讯作者)，Chinese Univ Hong Kong, Room 821,Esther Lee Bldg, Shatin, Hong Kong, Peoples R China. 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J. Cardiol. PD MAR 1 PY 2017 VL 230 BP 461 EP 467 DI 10.1016/j.ijcard.2016.12.084 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA EQ2MQ UT WOS:000397904000073 PM 28040281 DA 2023-05-13 ER PT J AU Saleh, A Hammoudeh, A Tabbalat, R Al-Haddad, I Al-Mousa, E Jarrah, M Izraiq, M Nammas, A Janabi, H Hazaymeh, L Shakhatreh, A Khadder, Y AF Saleh, Akram Hammoudeh, Ayman Tabbalat, Ramzi Al-haddad, Imadd Al-Mousa, Eyass Jarrah, Mohammad Izraiq, Mahmoud Nammas, Assem Janabi, Husham Hazaymeh, Lewa Shakhatreh, Ali Khadder, Youssef TI Incidence and prognosis of stent thrombosis following percutaneous coronary intervention in Middle Eastern patients: The First Jordanian Percutaneous Coronary Intervention Registry (JoPCR1) SO ANNALS OF SAUDI MEDICINE LA English DT Article ID DUAL ANTIPLATELET THERAPY; BARE-METAL STENTS; PREMATURE DISCONTINUATION; POOLED ANALYSIS; PREDICTORS; SIROLIMUS; OUTCOMES; CATHETERIZATION; IMPLANTATION; ASSOCIATION AB BACKGROUND: The incidence, risk factors, and outcome of stent thrombosis (ST) after percutaneous coronary intervention (PCI) in Middle Eastern patients are largely unknown. OBJECTIVE: To determine the incidence, risk factors and outcome in our population. DESIGN: Retrospective study of a prospective multicenter registry of consecutive patients who underwent PCI between January 2013 and February 2014 (JoPCR1). SETTING: 12 tertiary care centers in Amman and Irbid, Jordan. PATIENTS AND METHODS: We collected clinical baseline and follow-up data. MAIN OUTCOME MEASURES: Incidence of stent thrombosis. RESULTS: The mean (standard deviation) age of patients (n=2426) was 59.0 (10.1) years and 20.6% were women. Stents (n=3038) were drug eluting (89.6%), bare metal (9.4%) or bioabsorbable (1.0%). After 1 year, 47 patients (1.97%) had ST, including 44 (94%) definite and 3 (6%) probable ST. Patients who had ST presented with sudden death (n=6; 12.2%) or with a nonfatal event (n=43; 87.8%). Nonfatal events included non-ST-segment elevation acute coronary syndrome (26; 53%), acute ST segment elevation myocardial infarction (n=15; 31%) or heart failure (n=2; 4.1%). ST was associated with significantly higher one-month (22.0% vs. 0.7%) and one-year (12.3% vs. 0.73%) mortality rates compared with patients who did not have ST (P<.001). ST patients were younger (mean age 52.9 years vs. 58.4 years), had heart failure (64% vs. 18%), left ventricular ejection fraction (LVEF) <45% (36% vs. 13%), ST-segment deviation (70% vs. 48%), and elevated cardiac biomarkers blood levels (62% vs. 40%). In the multivariate analysis, the only factor that was significantly associated with ST was the heart failure (OR = 3.5, 95% confidence interval: 1.8, 6.6; P<.0001). CONCLUSIONS: The incidence of ST was not different from that in other regions and was associated with an increased one-year mortality. Younger age, heart failure, low LVEF, ST-segment deviation, and elevated blood levels of cardiac biomarkers were predictors of ST. LIMITATIONS: Possible selection bias, recall bias, and missing or incomplete information. The majority of patients were lost to follow up after the 6th month. The registry may not fully represent PCI practice and outcome in all areas in the country or region. C1 [Saleh, Akram; Hazaymeh, Lewa; Shakhatreh, Ali] Jordan Univ Hosp, Dept Cardiol, Amman, Jordan. [Hammoudeh, Ayman; Al-Mousa, Eyass] Istishari Hosp, Dept Cardiol, Amman, Jordan. [Tabbalat, Ramzi] Alkhalidi Hosp, Dept Cardiol, Amman, Jordan. [Al-haddad, Imadd] Jordan Hosp, Dept Cardiol, Amman, Jordan. [Jarrah, Mohammad] King Abdullah Univ Hosp, Dept Cardiol, Irbid, Jordan. [Izraiq, Mahmoud; Nammas, Assem] Ibn Alyaythem Hosp, Dept Cardiol, Amman, Jordan. [Janabi, Husham] Prince Hamzeh Hosp, Dept Cardiol, Amman, Jordan. [Khadder, Youssef] Univ Jordan, Jordan Univ Sci & Technol Family Med, Sch Med, Irbid, Jordan. C3 University of Jordan; Jordan University of Science & Technology; King Abdullah University Hospital; Jordan University of Science & Technology; University of Jordan RP Saleh, A (通讯作者)，Jordan Univ Hosp, Fac Med, Cardiol, Amman 1122, Jordan. EM a.saleh@ju.edu.jo RI saleh, akram/Q-1831-2019; Tabbalat, Ramzi/AAD-4033-2022 CR Aoki J, 2009, CIRCULATION, V119, P687, DOI 10.1161/CIRCULATIONAHA.108.804203 Armstrong EJ, 2014, JACC-CARDIOVASC INTE, V7, P1105, DOI 10.1016/j.jcin.2014.05.017 Armstrong EJ, 2012, JACC-CARDIOVASC INTE, V5, P131, DOI 10.1016/j.jcin.2011.10.013 Boggon R, 2011, EUR HEART J, V32, P2376, DOI 10.1093/eurheartj/ehr340 Cayla G, 2011, JAMA-J AM MED ASSOC, V306, P1765, DOI 10.1001/jama.2011.1529 Chechi T, 2008, J AM COLL CARDIOL, V51, P2396, DOI 10.1016/j.jacc.2008.01.070 Claessen BE, 2014, JACC-CARDIOVASC INTE, V7, P1081, DOI 10.1016/j.jcin.2014.05.016 Clemmensen P, 2015, JACC-CARDIOVASC INTE, V8, P214, DOI 10.1016/j.jcin.2014.11.002 Collet JP, 2012, NEW ENGL J MED, V367, P2100, DOI 10.1056/NEJMoa1209979 Cook S, 2009, CIRCULATION, V119, P657, DOI 10.1161/CIRCULATIONAHA.108.842757 Cutlip DE, 2001, CIRCULATION, V103, P1967 Cutlip DE, 2007, CIRCULATION, V115, P2344, DOI 10.1161/CIRCULATIONAHA.106.685313 D'Ascenzo F, 2013, INT J CARDIOL, V167, P575, DOI 10.1016/j.ijcard.2012.01.080 de la Torre-Hernandez JM, 2008, J AM COLL CARDIOL, V51, P986, DOI 10.1016/j.jacc.2007.10.057 De Luca G, 2012, ARCH INTERN MED, V172, P611, DOI 10.1001/archinternmed.2012.758 Dehmer GJ, 2012, J AM COLL CARDIOL, V60, P2017, DOI 10.1016/j.jacc.2012.08.966 Ferreira-Gonzalez I, 2012, J AM COLL CARDIOL, V60, P1333, DOI 10.1016/j.jacc.2012.04.057 Ferreira-Gonzalez I, 2010, CIRCULATION, V122, P1017, DOI 10.1161/CIRCULATIONAHA.110.938290 Grines CL, 2007, CIRCULATION, V115, P813, DOI 10.1161/CIRCULATIONAHA.106.180944 Iakovou I, 2005, JAMA-J AM MED ASSOC, V293, P2126, DOI 10.1001/jama.293.17.2126 JACQUES M, 2007, J AM COLL CARDIOL, V50, P501 Jeremias A, 2004, CIRCULATION, V109, P1930, DOI 10.1161/01.CIR.0000127105.99982.21 Kuchulakanti PK, 2006, CIRCULATION, V113, P1108, DOI 10.1161/CIRCULATIONAHA.105.600155 Lagerqvist B, 2009, CIRC-CARDIOVASC INTE, V2, P401, DOI 10.1161/CIRCINTERVENTIONS.108.844985 Moreno R, 2005, J AM COLL CARDIOL, V45, P954, DOI 10.1016/j.jacc.2004.11.065 Ong ATL, 2005, J AM COLL CARDIOL, V45, P947, DOI 10.1016/j.jacc.2004.09.079 Pfisterer M, 2006, J AM COLL CARDIOL, V48, P2584, DOI 10.1016/j.jacc.2006.10.026 Rinaldi MJ, 2008, AM HEART J, V155, P654, DOI 10.1016/j.ahj.2007.11.028 Schuhlen H, 2001, J AM COLL CARDIOL, V37, P2066, DOI 10.1016/S0735-1097(01)01285-2 Silber S, 2014, EUR HEART J, V35, P1949, DOI 10.1093/eurheartj/ehu026 Spaulding C, 2006, NEW ENGL J MED, V355, P1093, DOI 10.1056/NEJMoa062006 Spertus JA, 2006, CIRCULATION, V113, P2803, DOI 10.1161/CIRCULATIONAHA.106.618066 Valgimigli M, 2007, AM J CARDIOL, V99, P1072, DOI 10.1016/j.amjcard.2006.11.062 van Werkum JW, 2009, J AM COLL CARDIOL, V53, P1399, DOI 10.1016/j.jacc.2008.12.055 NR 34 TC 7 Z9 8 U1 0 U2 0 PU K FAISAL SPEC HOSP RES CENTRE PI RIYADH PA PUBLICATIONS OFFICE PO BOX 3354, RIYADH 11211, SAUDI ARABIA SN 0256-4947 EI 1319-9226 J9 ANN SAUDI MED JI Ann. Saudi Med. PD JAN-FEB PY 2016 VL 36 IS 1 BP 17 EP 22 DI 10.5144/0256-4947.2016.17 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA DK8XW UT WOS:000375214000003 PM 26922683 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Maestas, C Lazkani, M Sultan, M Kolli, G Sheikh, M Cherukuri, M AF Maestas, Camila Lazkani, Mohamad Sultan, Michael Kolli, Geetha Sheikh, Maheen Cherukuri, Madhavgopal TI Severe takotsubo cardiomyopathy following orthotopic liver transplantation: A case series SO CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY LA English DT Article DE Takotsubo cardiomyopathy; Cardiomyopathy; Orthotopic liver transplantation ID FAILURE AB Introduction: Acute decompensated heart failure is a known complication following orthotopic liver transplant. Among those, there are some cases of takostubo type cardiomyopathy (TC), commonly referred to as "broken heart syndrome''. While the exact mechanism of TC is unknown, it frequently proceeds a physical or emotional stressor. Here we present a series of seven cases of TC following orthotopic liver transplant. Methods: A retrospective chart review was conducted on 454 patients were identified as having post-operative cardiac dysfunction in the setting of orthotopic liver transplantation. Of those, seven were identified as having TC based on apical ballooning, acute heart failure without evidence of coronary artery disease. All seven underwent pre-operative cardiac evaluation per protocol. Extensive chart review was performed on the seven patients to identify pre and post-operative qualities. Results: At this single institution, TC affected 7/454 patients, reflecting an incidence of 1.5% over the eight year study period. Of the seven patients affected, one expired. Patients represented a mix of emergent and scheduled transplantation in the setting of end stage liver disease (ESLD). Patients had a mix of etiologies related to their ELSD including hepatitis C, alcoholic cirrhosis, and non-alcoholic steatohepatitis. Discussion: It is important to recognize TC as a potential complication following liver transplantation so as to detect cases earlier in the disease course and begin early goal-directed care. (C) 2018 Published by Elsevier Masson SAS. C1 [Maestas, Camila] Banner Univ Med Ctr Phoenix, Dept Internal Med, Phoenix, AZ 85006 USA. [Lazkani, Mohamad; Sultan, Michael] Banner Univ Med Ctr Phoenix, Dept Cardiol, Phoenix, AZ 85006 USA. [Kolli, Geetha; Sheikh, Maheen] Banner Univ Med Ctr Phoenix, Dept Gastroenterol, Phoenix, AZ 85006 USA. [Cherukuri, Madhavgopal] Banner Univ Med Ctr Phoenix, Dept Cardiol, Intervent Cardiol, Phoenix, AZ 85006 USA. RP Maestas, C (通讯作者)，Banner Univ Med Ctr, Dept Internal Med, 1111 E McDowell Rd,LL2, Phoenix, AZ 85006 USA. EM Camila.Meestas@Bannerhealth.com; mohamadlazkani@gmail.com; Michaelsultan@gmail.com; Geetha.Kolli@bannerhealth.com; Maheen.S.Sheikh@gmail.com; Madhavgopal.Cherukuri@bannerhealth.com CR DEE GW, 1995, CLIN TRANSPLANT, V9, P463 Donovan RJ, 2017, DIGEST DIS SCI, V62, P26, DOI 10.1007/s10620-016-4371-3 Dowsley TF, 2012, TRANSPLANTATION, V94, P646, DOI 10.1097/TP.0b013e31825f0f97 Eimer MJ, 2008, AM J CARDIOL, V101, P242, DOI 10.1016/j.amjcard.2007.08.056 Harika R, 2014, BRIT J ANAESTH, V112, P594, DOI 10.1093/bja/aeu029 Hurst RT, 2010, JACC-CARDIOVASC IMAG, V3, P641, DOI 10.1016/j.jcmg.2010.01.009 Lee HR, 2007, LIVER TRANSPLANT, V13, P1343, DOI 10.1002/lt.21169 Lyon AR, 2016, EUR J HEART FAIL, V18, P8, DOI 10.1002/ejhf.424 Saner F, 2009, LIVER INT Saner FH, 2010, LIVER INT, V30, P159, DOI 10.1111/j.1478-3231.2009.02062.x Schnell F, 2009, LIVER TRANSPLANT, V15, P1296, DOI 10.1002/lt.21822 Sussman Martin, 2016, CARDIOVASCULAR J AFR, V27, P1 Pires LJT, 2012, TRANSPL P, V44, P2497, DOI 10.1016/j.transproceed.2012.07.037 Galvan NT, 2018, J TRANSPLANT, V2018, DOI 10.1155/2018/9739236 Tiwari AK, 2008, J CARDIOTHOR VASC AN, V22, P442, DOI 10.1053/j.jvca.2007.11.015 VanWagner LB, 2012, HEPATOLOGY, V56, P1741, DOI 10.1002/hep.25855 Wong F, 1999, CLIN SCI, V97, P259, DOI 10.1042/CS19990026 NR 17 TC 2 Z9 3 U1 0 U2 0 PU ELSEVIER MASSON, CORPORATION OFFICE PI PARIS PA 65 CAMILLE DESMOULINS CS50083 ISSY-LES-MOULINEAUX, 92442 PARIS, FRANCE SN 2210-7401 EI 2210-741X J9 CLIN RES HEPATOL GAS JI Clin. Res. Hepatol. Gastroenterol. PD AUG PY 2019 VL 43 IS 4 BP E48 EP E53 DI 10.1016/j.clinre.2018.11.009 PG 6 WC Gastroenterology & Hepatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Gastroenterology & Hepatology GA IK6RA UT WOS:000476714800002 PM 30853493 DA 2023-05-13 ER PT J AU Wawruch, M Slezakova, V Murin, J Kuzelova, M Dukat, A Zabka, M Leitmann, T Tisonova, J Kallay, Z AF Wawruch, M. Slezakova, V Murin, J. Kuzelova, M. Dukat, A. Zabka, M. Leitmann, T. Tisonova, J. Kallay, Z. TI The use of antiplatelet medication in hospitalised elderly patients SO BRATISLAVA MEDICAL JOURNAL-BRATISLAVSKE LEKARSKE LISTY LA English DT Article DE myocardial infarction; cerebrovascular; stroke; transient ischemic attack; bleeding risk; thrombotic event ID ACUTE CORONARY SYNDROMES; ACUTE MYOCARDIAL-INFARCTION; SECONDARY PREVENTION; ISCHEMIC-STROKE; THERAPY; RISK; HYPERTENSION; PRESCRIPTION; MULTICENTER; DISEASE AB BACKGROUND: The use of antiplatelet agents is strongly recommended for the secondary prevention of ischemic events such as myocardial infarction, stroke/transient ischemic attack (TIA). OBJECTIVES: The aim of our study was to analyse the use of antiplatelet medication in patients after myocardial infarction, stroke/TIA, and patients with both conditions and to identify patient-related characteristics, which determine the use of such drugs in elderly patients. METHODS: Study sample (n = 372) was derived from 2,157 patients admitted to long-term care departments of three municipal hospitals. The study included patients aged >= 65 years after myocardial infarction, stroke/TIA or both. RESULTS: Antiplatelet medications were prescribed in 54.8 % and 68.5 % of patients at hospital admission and discharge, respectively. Hospitalisation led to a significant increase in the use of antiplatelet medication in patients after myocardial infarction and in those with the combination of both events. However, in patients after only stroke/TIA, we did not find any significant difference comparing the use of antiplatelet medication at the time of hospital admission and discharge, respectively. CONCLUSION: Our study revealed that physicians are more aware of the benefits of antiplatelet medication in elderly patients after myocardial infarction or those after both myocardial infarction and stroke/TIA in comparison with patients after only stroke/TIA (Tab. 3, Ref. 32). Text in PDF www.elis.sk. C1 [Wawruch, M.; Slezakova, V; Murin, J.; Kuzelova, M.; Dukat, A.; Zabka, M.; Leitmann, T.; Tisonova, J.; Kallay, Z.] Comenius Univ, Inst Pharmacol & Clin Pharmacol, Fac Med, SK-81372 Bratislava, Slovakia. C3 Comenius University Bratislava RP Wawruch, M (通讯作者)，Comenius Univ, Inst Pharmacol & Clin Pharmacol, Fac Med, Spitalska 24, SK-81372 Bratislava, Slovakia. EM martin.wawruch@gmail.com FU [VEGA 1/0886/14]; [VEGA 1/0939/14] FX This study was supported by grants VEGA 1/0886/14 and VEGA 1/0939/14. The providers of these grants played no role in the design, methods, data collection, analysis and interpretation of the data, preparation of the paper or in the decision to submit the manuscript. We thank Dr. A. Argalasova, Dr. S. Cervenova and D. Klinovsky for their assistance with data collection. 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Med. J. PY 2015 VL 116 IS 9 BP 533 EP 538 DI 10.4149/BLL_2015_102 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CT4UC UT WOS:000362801800004 PM 26435017 OA Bronze DA 2023-05-13 ER PT J AU Elliott, P Cowie, MR Franke, J Ziegler, A Antoniades, C Bax, J Bucciarelli-Ducci, C Flachskampf, FA Hamm, C Jensen, MT Katus, H Maisel, A McDonagh, T Mittmann, C Muntendam, P Nagel, E Rosano, G Twerenbold, R Zannad, F AF Elliott, Perry Cowie, Martin R. Franke, Jennifer Ziegler, Andre Antoniades, Charalambos Bax, Jeroen Bucciarelli-Ducci, Chiara Flachskampf, Frank A. Hamm, Christian Jensen, Magnus T. Katus, Hugo Maisel, Alan McDonagh, Theresa Mittmann, Clemens Muntendam, Pieter Nagel, Eike Rosano, Giuseppe Twerenbold, Raphael Zannad, Faiez TI Development, validation, and implementation of biomarker testing in cardiovascular medicine state-of-the-art: proceedings of the European Society of Cardiology-Cardiovascular Round Table SO CARDIOVASCULAR RESEARCH LA English DT Article DE Biomarker; Heart failure; Myocardial infarction; Pathway; Troponin; Ejection fraction; Magnetic resonance ID CARDIAC TROPONIN-T; ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; BETA-THALASSEMIA MAJOR; MAGNETIC-RESONANCE; EARLY-DIAGNOSIS; RULE-OUT; SENSITIVITY; IRON; ALGORITHM AB Many biomarkers that could be used to assess ejection fraction, heart failure, or myocardial infarction fail to translate into clinical practice because they lack essential performance characteristics or fail to meet regulatory standards for approval. Despite their potential, new technologies have added to the complexities of successful translation into clinical practice. Biomarker discovery and implementation require a standardized approach that includes: identification of a clinical need; identification of a valid surrogate biomarker, stepwise assay refinement, demonstration of superiority over current standard-of-care; development and understanding of a clinical pathway; and demonstration of real-world performance. Successful biomarkers should improve efficacy or safety of treatment, while being practical at a realistic cost. Everyone involved in cardiovascular healthcare, including researchers, clinicians, and industry partners, are important stakeholders in facilitating the development and implementation of biomarkers. This article provides suggestions for a development pathway for new biomarkers, discusses regulatory issues and challenges, and suggestions for accelerating the pathway to improve patient outcomes. Real-life examples of successful biomarkers-high-sensitivity cardiac troponin, T2* cardiovascular magnetic resonance imaging, and echocardiography are used to illustrate the value of a standardized development pathway in the translation of concepts into routine clinical practice. C1 [Elliott, Perry] UCL, Cardiovasc Med, Gower St, London WC1E 6BT, England. [Cowie, Martin R.] Imperial Coll London, Natl Heart & Lung Inst, Cardiol Hlth Serv Res, Dovehouse St, London SW3 6LY, England. [Franke, Jennifer] Boehringer Ingelheim GmbH & Co KG, CardioMetab Resp Med, Therapeut Area, Binger Str 173, D-55216 Ingelheim, Germany. [Ziegler, Andre] Roche Diagnost Int Ltd, RPD Med & Sci Affairs, Global Clin Leader CVD, Bldg 05,10th Floor,Room 1-34,Forrenstr 2, CH-6343 Rotkreuz, Switzerland. [Antoniades, Charalambos] Univ Oxford, Cardiovasc Med, Headley Way, Oxford OX3 9DU, England. [Bax, Jeroen] Leiden Univ, Noninvas Imaging & Echocardiog Lab, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands. [Bucciarelli-Ducci, Chiara] Univ Hosp Bristol NHS Trust, Clin Res & Imaging Ctr CRIC Bristol, Cardiol Noninvas Imaging,Biomed Res Ctr, Bristol Heart Inst,Bristol Natl Inst Hlth Res NIH, Malborough St, Bristol BS2 8HW, Avon, England. [Bucciarelli-Ducci, Chiara] Univ Bristol, Malborough St, Bristol BS2 8HW, Avon, England. [Flachskampf, Frank A.] Uppsala Univ, Dept Med Sci, Cardiol Cardiac Imaging, Ingang 40,Plan 5, S-75185 Ingang, Sweden. [Flachskampf, Frank A.] Akad Sjukhuset, Clin Physiol & Cardiol, Ingang 40,Plan 5, S-75185 Uppsala, Sweden. [Hamm, Christian] Univ Giessen, Internal Med & Cardiol, Campus Kerckhoff,Klinikstr 33, D-35392 Giessen, Germany. [Jensen, Magnus T.] Copenhagen Univ Hosp, Dept Cardiol, Sankt Jakobs Gade 18,4 Tv, DK-2100 Hvidovre, Denmark. [Katus, Hugo] Heidelberg Univ, Dept Internal Med Cardiol 3, Cardiol Angiol Pneumol, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. [Maisel, Alan] Univ Calif San Diego, Div Cardiol, 190 Mar Shores,35, Solana Beach, CA 92075 USA. [McDonagh, Theresa] Kings Coll Hosp London, Clin Lead Heart Failure, Denmark Hill, London SE5 9RS, England. [Mittmann, Clemens] BfArM, Dept Diabet & Cardiovasc Dis, Kurt Georg Kiesinger Allee 3, D-53175 Bonn, Germany. [Muntendam, Pieter] G3 Pharmaceut, POB 0024, Lexington, MA 02420 USA. [Nagel, Eike] Goethe Univ, Inst Expt & Translat Cardiovasc Imaging, Univ Hosp, DZHK German Ctr Cardiovasc Res,Ctr Cardiovasc Ima, Partner Site RheinMain,Haus 1,Theodor Stern Kai 7, D-60590 Frankfurt, Germany. [Rosano, Giuseppe] IRCCS San Raffaele, Dept Med Sci, Via Ardeatina 306-354, I-00179 Rome, Italy. [Rosano, Giuseppe] Univ London, St Georges Hosp, Cardiol, Blackshaw Rd, London SW17 0QT, England. [Twerenbold, Raphael] Univ Hosp Basel, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland. [Zannad, Faiez] Univ Lorraine, FCRIN INI CRCT, CHRU Nancy, Inserm CIC 1433, 4 Rue Morvan, F-54500 Vandoeuvre Les Nancy, France. C3 RLUK- Research Libraries UK; University of London; University College London; RLUK- Research Libraries UK; Imperial College London; Boehringer Ingelheim; Roche Holding; RLUK- Research Libraries UK; University of Oxford; Leiden University; Leiden University Medical Center (LUMC); Leiden University - Excl LUMC; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Bristol; Uppsala University; Uppsala University; Uppsala University Hospital; Justus Liebig University Giessen; University of Copenhagen; Ruprecht Karls University Heidelberg; University of California System; University of California San Diego; King's College Hospital NHS Foundation Trust; King's College Hospital; German Centre for Cardiovascular Research; Goethe University Frankfurt; Goethe University Frankfurt Hospital; IRCCS San Raffaele Pisana; Vita-Salute San Raffaele University; IRCCS Ospedale San Raffaele; St Georges University London; University of London; CHU de Nancy; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Lorraine RP Elliott, P (通讯作者)，St Bartholomews Hosp, London EC1A 7BE, England. EM perry.elliott@ucl.ac.uk RI Rosano, Giuseppe M. C./K-8718-2018; Cowie, Martin R/AAQ-2818-2020; Twerenbold, Raphael/H-3533-2018; Elliott, Perry/AAR-3430-2020 OI Rosano, Giuseppe M. C./0000-0003-4023-2263; Cowie, Martin R/0000-0001-7457-2552; Twerenbold, Raphael/0000-0003-3814-6542; Elliott, Perry/0000-0003-3383-3984; Antoniades, Charalambos/0000-0002-6983-5423; Bucciarelli-Ducci, Chiara/0000-0002-2515-0852 FU European Society of Cardiology FX This work was solely funded by the European Society of Cardiology. 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Res. PD MAY 1 PY 2021 VL 117 IS 5 BP 1248 EP 1256 DI 10.1093/cvr/cvaa272 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA SS1PU UT WOS:000661514200011 PM 32960964 OA Green Published, Green Accepted, Bronze DA 2023-05-13 ER PT J AU Turk-Adawi, K Sarrafzadegan, N Fadhil, I Taubert, K Sadeghi, M Wenger, NK Tan, NS Grace, SL AF Turk-Adawi, Karam Sarrafzadegan, Nizal Fadhil, Ibtihal Taubert, Kathryn Sadeghi, Masoumeh Wenger, Nanette K. Tan, Nigel S. Grace, Sherry L. TI Cardiovascular disease in the Eastern Mediterranean region: epidemiology and risk factor burden SO NATURE REVIEWS CARDIOLOGY LA English DT Review ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; BASE-LINE CHARACTERISTICS; LOW-INCOME COUNTRIES; CARDIAC REHABILITATION; HEART-DISEASE; SAUDI-ARABIA; ARTERY-DISEASE; SCIENTIFIC STATEMENT; MANAGEMENT-PRACTICES AB The Eastern Mediterranean region (EMR) comprises 22 countries or territories spanning from Morocco in the west to Pakistan in the east, and contains a population of almost 600 million people. Like many other developing regions, the burden of disease in the EMR has shifted in the past 30 years from primarily communicable diseases to noncommunicable diseases such as cardiovascular disease (CVD). Cardiovascular mortality in the EMR, mostly attributable to ischaemic heart disease, is expected to increase more dramatically in the next decade than in any other region except Africa. The most prominent CVD risk factors in this region include tobacco consumption, physical inactivity, depression, obesity, hypertension, and diabetes mellitus. Many individuals living in the EMR are unaware of their risk factor status, and even if treated, these risk factors are often poorly controlled. Furthermore, infrequent use of emergency medical services, delays in access to care, and lack of access to cardiac catheterization affects the timely diagnosis of CVD. Treatment of CVD is also suboptimal in this region, consisting primarily of thrombolysis, with insufficient provision of timely revascularization. In this Review, we summarize what is known about CVD burden, risk factors, and treatment strategies for individuals living in the EMR. This information will hopefully aid decision-makers when devising strategies on how to improve CVD prevention and management in this region. C1 [Turk-Adawi, Karam] Qatar Univ, Dept Publ Hlth, Coll Hlth Sci, Al Jamea St, Doha, Qatar. [Sarrafzadegan, Nizal] Isfahan Univ Med Sci, Isfahan Cardiovasc Res Ctr, Cardiovasc Res Inst, Khorram Ave, Esfahan, Iran. [Sarrafzadegan, Nizal] Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada. [Fadhil, Ibtihal] World Hlth Org, Noncommunicable Dis, East Mediterranean Reg Off, Monazamet El Seha El Alamia St, Cairo, Egypt. [Taubert, Kathryn] Amer Heart Assoc, Int Sci & Hlth Strategies, Aeschengraben 14, CH-4051 Basel, Switzerland. [Sadeghi, Masoumeh] Isfahan Univ Med Sci, Cardiovasc Res Inst, Cardiac Rehabil Res Ctr, Khorram Ave, Esfahan, Iran. [Wenger, Nanette K.] Emory Univ, Sch Med, Div Cardiol, Dept Med, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303 USA. [Tan, Nigel S.; Grace, Sherry L.] Univ Hlth Network, 585 Univ Ave, Toronto, ON M5G 2N2, Canada. [Grace, Sherry L.] York Univ, Sch Kinesiol & Hlth Sci, Bethune 368,4700 Keele St, Toronto, ON M3J 1P3, Canada. C3 Qatar University; Isfahan University Medical Science; University of British Columbia; Egyptian Knowledge Bank (EKB); World Health Organization Egypt; World Health Organization; Isfahan University Medical Science; Emory University; University of Toronto; University Health Network Toronto; York University - Canada RP Sarrafzadegan, N (通讯作者)，Isfahan Univ Med Sci, Isfahan Cardiovasc Res Ctr, Cardiovasc Res Inst, Khorram Ave, Esfahan, Iran. EM nsarrafzadegan@gmail.com RI Sadeghi, Masoumeh/AAU-8493-2021; Grace, Sherry L/H-1388-2013; Mohammadifard, Noushin/M-2244-2018; Fadhil, Ibtihal/AAF-4123-2021 OI Sadeghi, Masoumeh/0000-0001-7179-5558; Grace, Sherry L/0000-0001-7063-3610; Mohammadifard, Noushin/0000-0003-1776-1060; Turk-Adawi, Karam/0000-0002-4162-7761 FU Toronto General & Toronto Western Hospital Foundation; Peter Munk Cardiac Centre, University Health Network FX S. L. G. is supported in her work by the Toronto General & Toronto Western Hospital Foundation and the Peter Munk Cardiac Centre, University Health Network. The authors gratefully acknowledge the assistance of Ms Anfal Adawi (York University, Toronto, Canada) in collecting data. The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the views of the American Heart Association. 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Rev. Cardiol. PD FEB PY 2018 VL 15 IS 2 BP 106 EP 119 DI 10.1038/nrcardio.2017.138 PG 14 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA FS7IN UT WOS:000419971200016 PM 28933782 OA Green Submitted DA 2023-05-13 ER PT J AU Yao, H Ekou, A Hadeou, A N'Djessan, JJ Kouame, I N'Guetta, R AF Yao, Hermann Ekou, Arnaud Hadeou, Aurore N'Djessan, Jean-Jacques Kouame, Isabelle N'Guetta, Roland TI Medium and long-term follow-up after ST-segment elevation myocardial infarction in a sub-Saharan Africa population: a prospective cohort study SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE ST-segment elevation acute myocardial infarction; Mortality; Sub-Saharan Africa ID ACUTE CORONARY SYNDROMES; TASK-FORCE; MANAGEMENT; MORTALITY; FIBRINOLYSIS; CLOPIDOGREL; REGISTRY; THERAPY; EVENTS AB BackgroundMajor in-hospital mortality rate in patients with ST-segment Elevation Myocardial Infarction (STEMI) in Sub-Saharan Africa has been reported. Data on follow-up in these patients with STEMI are scarce. We aimed to assess medium and long-term prognosis in patients with STEMI admitted to Abidjan Heart Institute.MethodsProspective cohort study including 260 patients admitted for STEMI to Abidjan Heart Institute, from January 1, 2012 to December 31, 2015. We compared mortality and nonfatal cardiovascular complications in revascularized and non-revascularized groups. Survival curve was generated with the Kaplan-Meier method. Predictors of mortality after STEMI were determined by multivariable Cox regression.ResultsOf the 260 patients followed up on a median period of 39months [28-68months], 94 patients (36.1%) were revascularized and 166 (63.8%) were non-revascularized. Crude all-cause mortality was 10.4%. It was significantly higher in non-revascularized patients (p=0.04). There was no difference in the occurrence of nonfatal cardiovascular complications in the 2 groups. In multivariable Cox regression, age70years, female gender and heart failure were the predictive factors for death after adjustment.ConclusionsSTEMI remains an important cause of mortality in our practice. Healthcare policies should be developed to improve patient care and long-term outcomes. C1 [Yao, Hermann; Ekou, Arnaud; Hadeou, Aurore; N'Djessan, Jean-Jacques; Kouame, Isabelle; N'Guetta, Roland] Abidjan Heart Inst, Intens Care Unit, 01 BPV 206 Abidjan, Abidjan, Cote Ivoire. RP Yao, H (通讯作者)，Abidjan Heart Inst, Intens Care Unit, 01 BPV 206 Abidjan, Abidjan, Cote Ivoire. EM hermannyao@gmail.com OI Yao, Hermann/0000-0002-2834-0934 CR Armstrong PW, 2013, NEW ENGL J MED, V368, P1379, DOI 10.1056/NEJMoa1301092 Bahiru E, 2018, CARDIOVASC J AFR, V29, P225, DOI 10.5830/CVJA-2018-017 Belle L, 2017, ARCH CARDIOVASC DIS, V110, P366, DOI 10.1016/j.acvd.2017.05.001 Bonnefoy E, 2009, EUR HEART J, V30, P1598, DOI 10.1093/eurheartj/ehp156 Bucholz EM, 2014, CIRCULATION, V130, P757, DOI 10.1161/CIRCULATIONAHA.114.009480 Cenko E, 2018, JAMA INTERN MED, V178, P632, DOI 10.1001/jamainternmed.2018.0514 Danchin N, 2014, CIRCULATION, V129, P1629, DOI 10.1161/CIRCULATIONAHA.113.005874 Fiogbe E, 2017, INT J MED REV, V4, P86, DOI [10.29252/ijmr-040306, DOI 10.29252/IJMR-040306] Hannan EL, 2010, AM J CARDIOL, V106, P143, DOI 10.1016/j.amjcard.2010.02.029 Hertz JT, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0096688 Ho PM, 2006, ARCH INTERN MED, V166, P1842, DOI 10.1001/archinte.166.17.1842 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Kakou-Guikahue M, 2016, ARCH CARDIOVASC DIS, V109, P376, DOI 10.1016/j.acvd.2015.12.005 Mboup Mouhamed Cherif, 2014, Pan Afr Med J, V19, P126, DOI 10.11604/pamj.2014.19.126.3155 N'Guetta R, 2018, Ann Cardiol Angeiol (Paris), V67, P244, DOI 10.1016/j.ancard.2018.04.004 N'Guetta R, 2016, Ann Cardiol Angeiol (Paris), V65, P59, DOI 10.1016/j.ancard.2016.01.001 O'Gara PT, 2013, J AM COLL CARDIOL, V61, P485, DOI [10.1016/j.jacc.2012.11.018, 10.1161/CIR.0b013e3182742c84] Peterson ED, 2010, HEART, V96, P1798, DOI 10.1136/hrt.2010.200261 Pouche M, 2016, ARCH CARDIOVASC DIS, V109, P178, DOI 10.1016/j.acvd.2015.09.009 Schamroth C, 2012, CARDIOVASC J AFR, V23, P365, DOI 10.5830/CVJA-2012-017 Shavadia J, 2012, CARDIOVASC J AFR, V23, P318, DOI 10.5830/CVJA-2012-002 Touze J E, 2007, Med Trop (Mars), V67, P541 Townsend N, 2016, EUR HEART J, V37, P3232, DOI [10.1093/eurheartj/ehw334, 10.1093/eurheartj/ehy342] Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Weber M, 2011, AM HEART J, V162, P81, DOI [10.1016/j.ahj.2011.04.007, 10.1016/j.ahj.2011.07.029] WHO, TOP 10 CAUS DEATH Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 Yusuf S, 2014, NEW ENGL J MED, V371, P818, DOI 10.1056/NEJMoa1311890 NR 28 TC 9 Z9 10 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 MAR 20 PY 2019 VL 19 AR 65 DI 10.1186/s12872-019-1043-1 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HQ2CG UT WOS:000462206400001 PM 30894133 OA gold, Green Published DA 2023-05-13 ER PT J AU Lahmann, AL Bongiovanni, D Berkefeld, A Kettern, M Martinez, L Okrojek, R Hoppmann, P Laugwitz, KL Mayr, P Cassese, S Byrne, R Kutner, S Xhepal, E Schunkert, H Kastrati, A Joner, M AF Lahmann, Anna Lena Bongiovanni, Dario Berkefeld, Anna Kettern, Maximilian Martinez, Lucas Okrojek, Rainer Hoppmann, Petra Laugwitz, Karl-Ludwig Mayr, Patrick Cassese, Salvatore Byrne, Robert Kutner, Sebastian Xhepal, Erion Schunkert, Heribert Kastrati, Adnan Joner, Michael TI Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest - A propensity score-matched analysis SO PLOS ONE LA English DT Article ID CARDIOPULMONARY-RESUSCITATION; MYOCARDIAL-INFARCTION; COMATOSE SURVIVORS; OUTCOMES; CATHETERIZATION; CARE; ASSOCIATION; IMPACT; HEART; LIFE AB Background Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death worldwide, with acute coronary syndromes accounting for most of the cases. While the benefit of early revascularization has been clearly demonstrated in patients with ST-segment-elevation myocardial infarction (STEMI), diagnostic pathways remain unclear in the absence of STEMI. We aimed to characterize OHCA patients presenting to 2 tertiary cardiology centers and identify predicting factors associated with survival. Methods We retrospectively analyzed 519 patients after OHCA from February 2003 to December 2017 at 2 centers in Munich, Germany. Patients undergoing immediate coronary angiography (CAG) were compared to those without. Multivariate regression analysis and inverse probability treatment weighting (IPTW) were performed to identify predictors for improved outcome in a matched population. Results Immediate CAG was performed in 385 (74.1%) patients after OHCA with presumed cardiac cause of arrest. As a result of multivariate analysis after propensity score matching, we found that immediate CAG, return of spontaneous circulation (ROSC) at admission, witnessed arrest and former smoking were associated with improved 30-days-survival [(OR, 0.46; 95% CI, 0.26-0.84), (OR, 0.21; 95% CI, 0.10-0.45), (OR, 0.50; 95% CI, 0.26-0.97), (OR, 0.43; 95% CI, 0.23-0.81)], and 1-year-survival [(OR, 0.39; 95% CI, 0.19-0.82), (OR, 0.29; 95% CI, 0.12-0.7), (OR, 0.43; 95% CI, 0.2-1.00), (OR, 0.3; 95% CI, 0.14-0.63)]. Conclusions In our study, immediate CAG, ROSC at admission, witnessed arrest and former smoking were independent predictors of survival in cardiac arrest survivors. Improvement in prehospital management including bystander CPR and best practice post-resuscitation care with optimized triage of patients to an early invasive strategy may help ameliorate overall outcome of this critically-ill patient population. C1 [Lahmann, Anna Lena; Kettern, Maximilian; Martinez, Lucas; Cassese, Salvatore; Byrne, Robert; Kutner, Sebastian; Xhepal, Erion; Schunkert, Heribert; Kastrati, Adnan; Joner, Michael] Tech Univ Munich, German Heart Ctr Munich, Dept Cardiol, Munich, Germany. [Bongiovanni, Dario; Berkefeld, Anna; Okrojek, Rainer; Hoppmann, Petra; Laugwitz, Karl-Ludwig] Tech Univ Munich, Dept Cardiol, Klinikum Rechts Isar, Munich, Germany. [Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan; Joner, Michael] DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany. [Mayr, Patrick] Tech Univ Munich, German Heart Ctr Munich, Dept Anesthesiol, Munich, Germany. C3 German Heart Centre Munich; Technical University of Munich; Technical University of Munich; German Centre for Cardiovascular Research; Munich Heart Alliance; German Heart Centre Munich; Technical University of Munich RP Lahmann, AL (通讯作者)，Tech Univ Munich, German Heart Ctr Munich, Dept Cardiol, Munich, Germany. EM annalena@lahmann.at RI Bongiovanni, Dario/AAB-9161-2021; Mayr, N. Patrick/C-7389-2017; Joner, Michael/AAR-1229-2021; Xhepa, Erion/GQA-5562-2022; Xhepa, Erion/N-4435-2016 OI Bongiovanni, Dario/0000-0002-4162-1482; Mayr, N. Patrick/0000-0002-3549-3007; Xhepa, Erion/0000-0002-0728-2819 CR ABRAMSON NS, 1988, CRIT CARE MED, V16, P1053, DOI 10.1097/00003246-198810000-00019 Adrie C, 2006, EUR HEART J, V27, P2840, DOI 10.1093/eurheartj/ehl335 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 Berdowski J, 2010, RESUSCITATION, V81, P1479, DOI 10.1016/j.resuscitation.2010.08.006 Bernard SA, 2002, NEW ENGL J MED, V346, P557, DOI 10.1056/NEJMoa003289 Blom MT, 2014, CIRCULATION, V130, P1868, DOI 10.1161/CIRCULATIONAHA.114.010905 Bunch TJ, 2003, NEW ENGL J MED, V348, P2626, DOI 10.1056/NEJMoa023053 Camuglia AC, 2014, RESUSCITATION, V85, P1533, DOI 10.1016/j.resuscitation.2014.08.025 Dumas F, 2010, CIRC-CARDIOVASC INTE, V3, P200, DOI 10.1161/CIRCINTERVENTIONS.109.913665 Eisenberg MS, 2001, NEW ENGL J MED, V344, P1304, DOI 10.1056/NEJM200104263441707 GRUBB NR, 1995, LANCET, V346, P417, DOI 10.1016/S0140-6736(95)92784-0 Gupta T, 2014, AM J CARDIOL, V114, P169, DOI 10.1016/j.amjcard.2014.04.021 Hollenbeck RD, 2014, RESUSCITATION, V85, P88, DOI 10.1016/j.resuscitation.2013.07.027 Jacobs I, 2004, RESUSCITATION, V63, P233, DOI 10.1016/j.resuscitation.2004.09.008 Kern KB, 2015, JACC-CARDIOVASC INTE, V8, P1031, DOI 10.1016/j.jcin.2015.02.021 Kragholm K, 2017, NEW ENGL J MED, V376, P1737, DOI 10.1056/NEJMoa1601891 Rittenberger JC, 2011, RESUSCITATION, V82, P1036, DOI 10.1016/j.resuscitation.2011.03.034 Roberts Alexandra, 2014, Nat Rev Cardiol, V11, P374, DOI 10.1038/nrcardio.2014.73 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Soholm H, 2015, CIRC-CARDIOVASC QUAL, V8, P268, DOI 10.1161/CIRCOUTCOMES.115.001767 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Stiell I, 2003, CIRCULATION, V108, P1939, DOI 10.1161/01.CIR.0000095028.95929.B0 Stiell IG, 2004, NEW ENGL J MED, V351, P647, DOI 10.1056/NEJMoa040325 Strote JA, 2012, AM J CARDIOL, V109, P451, DOI 10.1016/j.amjcard.2011.09.036 Wibrandt I, 2015, BMC EMERG MED, V15, DOI 10.1186/s12873-015-0028-3 Zanuttini D, 2012, AM J CARDIOL, V110, P1723, DOI 10.1016/j.amjcard.2012.08.006 NR 27 TC 5 Z9 5 U1 0 U2 4 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 JAN 15 PY 2020 VL 15 IS 1 AR e0218634 DI 10.1371/journal.pone.0218634 PG 13 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA LP5OV UT WOS:000534368000001 PM 31940337 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Pandor, A Pollard, D Chico, T Henderson, R Stevenson, M AF Pandor, Abdullah Pollard, Daniel Chico, Tim Henderson, Robert Stevenson, Matt TI Rivaroxaban for Preventing Atherothrombotic Events in People with Acute Coronary Syndrome and Elevated Cardiac Biomarkers: An Evidence Review Group Perspective of a NICE Single Technology Appraisal SO PHARMACOECONOMICS LA English DT Review ID LOWER CARDIOVASCULAR EVENTS; ACUTE MYOCARDIAL-INFARCTION; ANTI-XA THERAPY; ANTIPLATELET THERAPY; STANDARD THERAPY; DEFINITION; TRIAL AB As part of its Single Technology Appraisal process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures rivaroxaban (Xarelto, Bayer) to submit evidence of the clinical and cost effectiveness of rivaroxaban for the prevention of adverse outcomes in patients after the acute management of acute coronary syndrome (ACS). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology, based upon the company's submission to NICE. The evidence was derived mainly from a randomised, double-blind, phase III, placebo-controlled trial of rivaroxaban (either 2.5 or 5 mg twice daily) in patients with recent ACS [unstable angina, non-ST segment elevation myocardial infarction (NSTEMI) or ST segment elevation myocardial infarction (STEMI)]. In addition, all patients received antiplatelet therapy [aspirin alone or aspirin and a thienopyridine either as clopidogrel (approximately 99 %) or ticlopidine (approximately 1 %) according to national or local guidelines]. The higher dose of rivaroxaban (5 mg twice daily) did not form part of the marketing authorisation. A post hoc subgroup analysis of the licensed patients who had ACS with elevated cardiac biomarkers (that is, patients with STEMI and NSTEMI) without prior stroke or transient ischaemic stroke showed that compared with standard care, the addition of rivaroxaban (2.5 mg twice daily) to existing antiplatelet therapy reduced the composite endpoint of cardiovascular mortality, myocardial infarction or stroke, but increased the risk of major bleeding and intracranial haemorrhage. However, there were a number of limitations in the evidence base that warrant caution in its interpretation. In particular, the evidence may be confounded because of the post hoc subgroup analysis, modified intention-to-treat analyses, high dropout rates and missing vital status data. Results from the company's economic evaluation showed that the deterministic incremental cost-effectiveness ratio (ICER) for rivaroxaban in combination with aspirin plus clopidogrel or with aspirin alone compared with aspirin plus clopidogrel or aspirin alone was A 6203 pound per quality-adjusted life-year (QALY) gained. In contrast, the ERG's preferred base case estimate was A 5622 pound per QALY gained. The ICER did not rise above A 10,000 pound per QALY gained in any of the sensitivity analyses undertaken by the ERG, although the inflexibility of the company's economic model precluded the ERG from formally undertaking all desired exploratory analyses. As such, only a crude exploration of the impact of additional bleeding events could be undertaken. The NICE Appraisal Committee concluded that the ICERs presented were all within the range that could be considered cost effective and that the results of the ERG's exploratory sensitivity and scenario analyses suggested that the ICER was unlikely to increase to the extent that it would become unacceptable. The Appraisal Committee therefore concluded that rivaroxaban in combination with aspirin plus clopidogrel, or with aspirin alone, was a cost-effective use of National Health Service (NHS) resources for preventing atherothrombotic events in people with ACS and elevated cardiac biomarkers. C1 [Pandor, Abdullah; Pollard, Daniel; Stevenson, Matt] Univ Sheffield, Sch Hlth & Related Res ScHARR, 30 Regent St, Sheffield S1 4DA, S Yorkshire, England. [Chico, Tim] Univ Sheffield, Dept Cardiovasc Sci, Sheffield S10 2RX, S Yorkshire, England. [Henderson, Robert] Univ Nottingham Hosp, Trent Cardiac Ctr, Nottingham NG5 1PB, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Sheffield; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Sheffield; RLUK- Research Libraries UK; University of Nottingham RP Pandor, A (通讯作者)，Univ Sheffield, Sch Hlth & Related Res ScHARR, 30 Regent St, Sheffield S1 4DA, S Yorkshire, England. EM a.pandor@sheffield.ac.uk RI Pandor, Abdullah/E-4643-2010 OI Pandor, Abdullah/0000-0003-2552-5260; Pollard, Daniel/0000-0001-5630-0115; , Matt/0000-0002-3099-9877; Chico, Timothy/0000-0002-7458-5481 FU National Institute for Health Research (NIHR) Health Technology Assessment Programme [11/119/01] FX This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment Programme (Project Number 11/119/01). See the HTA programme website for further project information (http://www.hta.ac.uk). This summary of the ERG report was compiled after NICE issued the FAD and has not been externally peer reviewed by PharmacoEconomics. All authors have commented on the submitted manuscript and have given their approval for the final version to be published. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of NICE or the Department of Health. Any errors are the responsibility of the authors. 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Moises, Valdir Ambrosio Fonseca, Francisco A. H. TI Pharmaco-invasive Strategy in Myocardial Infarction: Descriptive Analysis, Presentation of Ischemic Symptoms and Mortality Predictors SO ARQUIVOS BRASILEIROS DE CARDIOLOGIA LA English DT Article DE ST Elevation Myocardial Infarction; Acute Coronay Syndrome; Percutaneous Coronary Intervention; methods; Thrombolytic; Therapy; methods; Angina Pectoris; Hospitalization; Mortality ID ST-SEGMENT-ELEVATION; CORONARY-ARTERY-DISEASE; IN-HOSPITAL MORTALITY; SEX-DIFFERENCES; VENTRICULAR-ARRHYTHMIAS; CARDIOVASCULAR-DISEASE; GENDER-DIFFERENCES; HEART; RISK; WOMEN AB Background: ST-segment elevation myocardial infarction (STEMI) is defined by symptoms accompanied by typical electrocardiogram changes. However, the characterization of ischemic symptoms is unclear, especially in subgroups such as women and the elderly. Objectives: To analyze the typification of ischemic symptoms, temporal metrics and observe the occurrence of in-hospital outcomes, in the analysis of predictive scores, in patients with STEMI, in a drug-invasive strategy. Methods: Study involving 2,290 patients. Types of predefined clinical presentations: typical pain, atypical pain, dyspnea, syncope). We measured the time between the onset of symptoms and demand for care and the interval between arrival at the medical unit and thrombolysis. Odds-ratios (OR; CI-95%) were estimated in a regression model. ROC curves were constructed for mortality predictors. The adopted significance level (alpha) was 5%. Results: Women had a high prevalence of atypical symptoms; longer time between the onset of symptoms and seeking care; delay between arrival at the ER and fibrinolysis. Hospital mortality was 5.6%. Risk prediction by Killip-Kimball classification: AUC: [0.77 (0.73-0.81)] in class >= II. Subgroups studied [OR (CI-95%)]: women [2.06 (1.42-2.99); p=0.01]; chronic renal failure [3.39 (2.13-5.42); p<0.001]; elderly [2.09 (1.37-3.19) p<0.001]; diabetics [1.55 (1.04-2.29); p=0.02]; obese 1.56 [(1.01-2.40); p=0.04], previous stroke [2.01 (1.02-3.96); p=0.04] correlated with higher mortality rates. Conclusion: Despite higher mortality rates in some subgroups, significant disparity persists in women, with delays in symptom recognition and prompt thrombolysis. We highlight the applicability of the Killip-Kimball score in prediction, regardless of the clinical presentation. C1 [Bianco, Henrique Tria; Povoa, Rui; Nogueira Bombig, Maria Teresa; Goncalves Jr, Iran; Luna Filho, Braulio; Aguirre, Ana Caroline; de Marqui Moraes, Pedro Ivo; Almeida, Dirceu; Bacchin, Amanda S.] Univ Fed Sao Paulo, Cardiol, Sao Paulo, SP, Brazil. [Izar, Maria Cristina; Rodrigues Alves, Claudia Maria; Pereira Barbosa, Adriano Henrique; Moreira, Flavio Tocci; Povoa, Fernando Focaccia; Stefanini, Edson; Caixeta, Adriano Mendes; Moises, Valdir Ambrosio; Fonseca, Francisco A. H.] Univ Fed Sao Paulo, Medkina, Escola Paulista Med, Sao Paulo, SP, Brazil. C3 Universidade Federal de Sao Paulo (UNIFESP); Universidade Federal de Sao Paulo (UNIFESP) RP Bianco, HT (通讯作者)，Univ Fed Sao Paulo, Rua Loefgren 1350, BR-04040001 Sao Paulo, SP, Brazil. 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Bras. Cardiol. PY 2022 VL 119 IS 5 BP 691 EP 702 DI 10.36660/abc.20211055 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 6P7TF UT WOS:000891128600001 PM 36453760 OA Green Published, gold DA 2023-05-13 ER PT J AU Liprandi, AS Liprandi, MIS Zaidel, EJ Aisenberg, GM Baranchuk, A Barbosa, ECD Sanchez, GB Alexander, B Zanetti, FTL Santi, RL Munera-Echeverri, AG Perel, P Piskorz, D Ruiz-Mori, CE Saucedo, J Valdez, O Juanatey, JRG Pineiro, DJ Pinto, FJ Quintana, FSW AF Sosa Liprandi, Alvaro Sosa Liprandi, Maria Ines Jose Zaidel, Ezequiel Aisenberg, Gabriel M. Baranchuk, Adrian Duarte Barbosa, Eduardo Costa Borrayo Sanchez, Gabriela Alexander, Bryce Lanas Zanetti, Fernando Tomas Lopez Santi, Ricardo Girleza Munera-Echeverri, Ana Perel, Pablo Piskorz, Daniel Enrique Ruiz-Mori, Carlos Saucedo, Jorge Valdez, Osiris Gonzalez Juanatey, Jose Ramon Jose Pineiro, Daniel Pinto, Fausto J. Wyss Quintana, Fernando Stuardo TI Influenza Vaccination for the Prevention of Cardiovascular Disease in the Americas: Consensus document of the Inter-American Society of Cardiology and the Word Heart Federation SO GLOBAL HEART LA English DT Review DE influenza; influenza vaccination; cardiovascular disease; myocardial infarction; consensus ID COST-EFFECTIVENESS ANALYSIS; ACUTE MYOCARDIAL-INFARCTION; AGED GREATER-THAN-OR-EQUAL-TO-65 YEARS; RECENT RESPIRATORY-INFECTION; ACUTE CORONARY SYNDROMES; REPORTING SYSTEM VAERS; HEALTH-CARE WORKERS; SEASONAL INFLUENZA; UNITED-STATES; SECONDARY PREVENTION AB Background: Cardiovascular mortality is decreasing but remains the leading cause of death worldwide. Respiratory infections such as influenza significantly contribute to morbidity and mortality in patients with cardiovascular disease. Despite of proven benefits, influenza vaccination is not fully implemented, especially in Latin America. Objective: The aim was to develop a regional consensus with recommendations regarding influenza vaccination and cardiovascular disease. Methods: A multidisciplinary team composed by experts in the management and prevention of cardiovascular disease from the Americas, convened by the Inter-American Society of Cardiology (IASC) and the World Heart Federation (WHF), participated in the process and the formulation of statements. The modified RAND/UCLA methodology was used. This document was supported by a grant from the WHF. Results: An extensive literature search was divided into seven questions, and a total of 23 conclusions and 29 recommendations were achieved. There was no disagreement among experts in the conclusions or recommendations. Conclusions: There is a strong correlation between influenza and cardiovascular events. Influenza vaccination is not only safe and a proven strategy to reduce cardiovascular events, but it is also cost saving. We found several barriers for its global implementation and potential strategies to overcome them. C1 [Sosa Liprandi, Alvaro] Univ Buenos Aires, Sch Med, Buenos Aires, DF, Argentina. [Sosa Liprandi, Alvaro; Sosa Liprandi, Maria Ines; Jose Zaidel, Ezequiel] Sanatorio Guemes Hosp Privado, Cardiol Dept, Buenos Aires, DF, Argentina. [Sosa Liprandi, Alvaro; Wyss Quintana, Fernando Stuardo] InterAmer Soc Cardiol, Buenos Aires, DF, Argentina. [Jose Zaidel, Ezequiel] Univ Buenos Aires, Sch Med, Pharmacol Dept, Buenos Aires, DF, Argentina. [Aisenberg, Gabriel M.] Univ Texas Houston, John P & Kathrine G McGovern Sch Med, Houston, TX USA. [Baranchuk, Adrian; Alexander, Bryce] Queens Univ, Kingston Hlth Sci Ctr, Div Cardiol, Kingston, ON, Canada. [Duarte Barbosa, Eduardo Costa] Hosp Sao Francisco Santa Casa, Cardiol Dept, Porto Alegre, RS, Brazil. [Duarte Barbosa, Eduardo Costa] LatinAmer Soc Hypertens, Artery LatAm, Porto Alegre, RS, Brazil. [Borrayo Sanchez, Gabriela] Mexican Natl Assoc Cardiologists, Cardiol Dept, Mexican Social Secur Inst, Mexico City, DF, Mexico. [Lanas Zanetti, Fernando Tomas] Univ La Frontera, Cardiol Dept, CIGES, Temuco, Chile. [Lopez Santi, Ricardo] Hosp Italiano La Plata, Cardiol Dept, Buenos Aires, DF, Argentina. [Lopez Santi, Ricardo; Piskorz, Daniel] Argentine Federat Cardiol, Buenos Aires, DF, Argentina. [Girleza Munera-Echeverri, Ana] Hosp Gen Medellin Luz Castro Gutierrez ESE Medell, Cardiol Dept, Medellin, Colombia. [Perel, Pablo] London Sch Hyg & Trop Med, Dept Noncommunicable Dis Epidemiol, London, England. [Perel, Pablo; Jose Pineiro, Daniel; Pinto, Fausto J.] World Heart Federat, Geneva, Switzerland. [Piskorz, Daniel] British Hosp Rosario, Cardiol Dept, Santa Fe, Argentina. [Enrique Ruiz-Mori, Carlos] INEN, Cardiol Dept, Lima, Peru. [Saucedo, Jorge] Froedtert Hosp & Med Coll, Cardiol Dept, Milwaukee, WI USA. [Valdez, Osiris] Ctr Med Cent Romana, Cardiol Dept, La Romana, Dominican Rep. [Valdez, Osiris] Cent Amer Soc Hypertens, La Romana, Dominican Rep. [Gonzalez Juanatey, Jose Ramon] Univ Santiago de Compostela, Cardiol Dept, Spanish Soc Cardiol, Hosp Clin, Santiago De Compostela, Spain. [Jose Pineiro, Daniel] Univ Buenos Aires, Buenos Aires, DF, Argentina. [Pinto, Fausto J.] Hosp Santa Maria, Cardiol Dept, Porto, Portugal. [Pinto, Fausto J.] Univ Lisbon, Lisbon, Portugal. [Wyss Quintana, Fernando Stuardo] Cardiosolut Guatemala, Guatemala City, Guatemala. C3 University of Buenos Aires; University of Buenos Aires; University of Texas System; University of Texas Health Science Center Houston; Queens University - Canada; Instituto Mexicano del Seguro Social; Universidad de La Frontera; University of London; London School of Hygiene & Tropical Medicine; Complexo Hospitalario Universitario de Santiago de Compostela; Universidade de Santiago de Compostela; University of Buenos Aires; Universidade de Lisboa; Hospital Santa Maria; Universidade de Lisboa RP Liprandi, AS (通讯作者)，Univ Buenos Aires, Sch Med, Buenos Aires, DF, Argentina.; Liprandi, AS (通讯作者)，Sanatorio Guemes Hosp Privado, Cardiol Dept, Buenos Aires, DF, Argentina.; Liprandi, AS (通讯作者)，InterAmer Soc Cardiol, Buenos Aires, DF, Argentina. EM asosaliprandi@fsg.edu.ar RI PINTO, FAUSTO J/GQA-4584-2022; Piskorz, Daniel/AAJ-8751-2020; Pinto, Fausto/G-9363-2015 OI PINTO, FAUSTO J/0000-0002-8034-4529; Piskorz, Daniel/0000-0002-8615-5446; Pinto, Fausto/0000-0002-8034-4529; Costa Duarte Barbosa, Eduardo/0000-0002-4361-936X; Lopez Santi, Ricardo/0000-0002-1713-326X; Sosa Liprandi, Alvaro/0000-0002-2195-5020; Lanas, Fernando/0000-0003-3595-9759; Ruiz, Enrique/0000-0001-8395-8457; Baranchuk, Adrian/0000-0002-3042-6569 FU Sanofi Pasteur FX This research was funded by an unrestricted grant to the Inter-American Society of Cardiology provided by Sanofi Pasteur to the World Heart Federation. Funder had no role in the drafting, evidence review, meetings, or publication process. 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Heart PY 2021 VL 16 IS 1 AR 55 DI 10.5334/gh.1069 PG 24 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA TZ2PS UT WOS:000684318600001 PM 34381676 OA gold, Green Published DA 2023-05-13 ER PT J AU Estarlich, M Tolsa, C Trapero, I Buigues, C AF Estarlich, Marisa Tolsa, Carmen Trapero, Isabel Buigues, Cristina TI Circadian Variations and Associated Factors in Patients with Ischaemic Heart Disease SO INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH LA English DT Article DE myocardial infarction; circadian rhythm; individual risk factors; AMI location; severity ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; ST-SEGMENT ELEVATION; ATRIAL-FIBRILLATION; ANATOMIC LOCATION; MANAGEMENT; RISK; GUIDELINES; PATTERNS; RHYTHMS AB Circadian rhythms have been identified in cardiovascular diseases, and cardiovascular risk factors can modify the circadian rhythm. The purpose of this study was to describe the onset of ischaemic heart disease symptomatology in relation to the date and time, the day of the week of presentation, the season, AMI location and severity and the level of influence of individual patient characteristics in a retrospective cross-sectional study involving 244 ischaemic heart disease patients from the intensive care unit of La Ribera Hospital (Spain). The onset of pain was more frequent in the morning, the season with the highest frequency of ischaemic events was winter, and the lowest incidence was during weekends. Regarding the severity of ischaemic heart disease, the circadian rhythm variables of weekdays vs. weekends and seasons did not show a significant association. The length of hospital stay was associated with the onset of pain in the afternoon. The onset of pain at night was associated with the subendocardial location of the infarction. In conclusion, living in a Mediterranean country, the Spanish population showed a circadian pattern of AMI, where the onset of pain has an influence on AMI location and on the length of hospital stay and is the same in patients with different individual risk factors. C1 [Estarlich, Marisa; Tolsa, Carmen; Trapero, Isabel; Buigues, Cristina] Univ Valencia, Dept Nursing, Valencia 46010, Spain. [Estarlich, Marisa] Univ Jaume 1, FISABIO, Epidemiol & Environm Hlth Joint Res Unit, Ave Catalunya 21, Valencia 46020, Spain. [Estarlich, Marisa] Spanish Consortium Res Epidemiol & Publ Hlth CIBER, Madrid 28001, Spain. [Buigues, Cristina] Univ Valencia, Frailty & Cognit Impairment Grp FROG, Valencia 46010, Spain. C3 University of Valencia; Universitat Jaume I; University of Valencia RP Trapero, I (通讯作者)，Univ Valencia, Dept Nursing, Valencia 46010, Spain. 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Public Health PD DEC PY 2022 VL 19 IS 23 AR 15628 DI 10.3390/ijerph192315628 PG 11 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 6X6NY UT WOS:000896529500001 PM 36497700 OA gold, Green Published DA 2023-05-13 ER PT J AU Sozmen, K Pekel, O Yilmaz, TS Sahan, C Ceylan, A Guler, E Korkmaz, E Unal, B AF Sozmen, Kaan Pekel, Ozlem Yilmaz, Tuba Sevim Sahan, Ceyda Ceylan, Ali Guler, Ercan Korkmaz, Eren Unal, Belgin TI Determinants of inpatient costs of angina pectoris, myocardial infarction, and heart failure in a university hospital setting in Turkey SO ANATOLIAN JOURNAL OF CARDIOLOGY LA English DT Article DE cost of illness; economic analysis; cardiovascular disease; hospital costs; bottom-up approach; generalized linear model ID ACUTE CORONARY SYNDROMES; PRIMARY PREVENTION; RISK-FACTORS; DISEASE; PREVALENCE; POPULATION; SMOKING; ASPIRIN; BURDEN; UPDATE AB Objective: This study aimed to determine the correlates of in-hospital costs for angina pectoris (AP), myocardial infarction (MI), and heart failure (HF) in a university hospital setting. Methods: This is a retrospective cost-of-illness study using data from the records of patients who were admitted with AP, MI, or HF to Dokuz Eylul University Hospital during 2008. Direct medical costs were calculated from the Social Security Institute perspective using a bottom-up approach. Socio-demographic and clinical information was abstracted from patient files. Costs were presented in Turkish lira (TL). A generalized linear model was used in the multivariate analysis. Results: We included 337 in-patients in total in the study. AP was present in 26.4% (n= 89), MI was present in 55.8% (n= 188), and HF was present in 17.8% (n= 60) of patients. MI was the most costly disease (2760 TL), followed by HF (2350 TL) and AP (1881 TL). The largest proportion of the total cost was formed by medical interventions (27.5%), followed by surgery (22.2%). Presence of DM, smoking, diagnosis of MI, HF, need for intensive care, and resulting in death were strong predictors of treatment costs. Conclusion: Both preadmission characteristics of patients (diabetes mellitus, smoking, use of anti-aggregant before admission) and in-patient characteristics (diagnosis, coronary artery bypass grafting, intensive care need, death) predicted the hospital cost of cardiovascular diseases (CVDs) independently. Our results may be used as input for health-economic models and economic evaluations to support the decision-making of reimbursement and the cost-effectiveness of public health interventions in healthcare. C1 [Sozmen, Kaan; Pekel, Ozlem] Minist Hlth Turkey, Prov Publ Hlth Directorate, Izmir, Turkey. [Yilmaz, Tuba Sevim; Sahan, Ceyda; Ceylan, Ali; Guler, Ercan; Korkmaz, Eren; Unal, Belgin] Dokuz Eylul Univ, Fac Med, Dept Publ Hlth, Izmir, Turkey. C3 Ministry of Health - Turkey; Dokuz Eylul University RP Sozmen, K (通讯作者)，Halk Sagligi Mudurlugu, Izmir, Turkey. 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J. Cardiol. PD APR PY 2015 VL 15 IS 4 BP 325 EP 333 DI 10.5152/akd.2014.5320 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CI9RD UT WOS:000355106500011 PM 25413230 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Quinn, T Johnsen, S Gale, CP Snooks, H McLean, S Woollard, M Weston, C AF Quinn, Tom Johnsen, Sigurd Gale, Chris P. Snooks, Helen McLean, Scott Woollard, Malcolm Weston, Clive CA MINAP Steering Grp TI Effects of prehospital 12-lead ECG on processes of care and mortality in acute coronary syndrome: a linked cohort study from the Myocardial Ischaemia National Audit Project SO HEART LA English DT Article ID REPERFUSION THERAPY; OUTCOMES RESEARCH; DECISION-MAKING; INFARCTION; ELECTROCARDIOGRAPHY; MANAGEMENT; IMPLEMENTATION; INSTITUTE; COMMITTEE; REGISTRY AB Objective To describe patterns of prehospital ECG (PHECG) use and determine its association with processes and outcomes of care in patients with ST-elevation myocardial infarction (STEMI) and non-STEMI. Methods Population-based linked cohort study of a national myocardial infarction registry. Results 288 990 patients were admitted to hospitals via emergency medical services (EMS) between 1 January 2005 and 31 December 2009. PHECG use increased overall (51% vs 64%, adjusted OR (aOR) 2.17, 95% CI 2.12 to 2.22), and in STEMI (64% vs 79%, aOR 2.34, 95% CI 2.25 to 2.44). Patients who received PHECG were younger (71 years vs 74 years, P<0.0001); and less likely to be female (33.1% vs 40.3%, OR 0.87, 95% CI 0.86 to 0.89), or to have comorbidities than those who did not. For STEMI, reperfusion was more frequent in those having PHECG (83.5% vs 74.4%, p<0.0001). PHECG was associated with more primary percutaneous coronary intervention patients achieving call-to-balloon time <90 min (27.9% vs 21.4%, aOR 1.38, 95% CI 1.24 to 1.54) and more patients who received fibrinolytic therapy achieving door-to-needle time <30 min (90.6% vs 83.7%, aOR 2.13, 95% CI 1.91 to 2.38). Patients with PHECG exhibited significantly lower 30-day mortality rates than those who did not (7.4% vs 8.2%, aOR 0.94, 95% CI 0.91 to 0.96). Conclusions Findings from this national MI registry demonstrate a survival advantage in STEMI and non-STEMI patients when PHECG was used. C1 [Quinn, Tom; Johnsen, Sigurd; Woollard, Malcolm] Univ Surrey, Fac Hlth & Med Sci, Guildford GU2 7XH, Surrey, England. [Johnsen, Sigurd] Univ Surrey, Surrey Clin Res Ctr, Guildford GU2 7XH, Surrey, England. [Gale, Chris P.] Univ Leeds, Div Epidemiol & Biostat, Leeds, W Yorkshire, England. [Gale, Chris P.] York Teaching Hosp NHS Fdn Trust, Dept Cardiol, York, N Yorkshire, England. [Snooks, Helen; Weston, Clive] Swansea Univ, Coll Med, Swansea, W Glam, Wales. [McLean, Scott] NHS Fife, Kirkcaldy, Fife, Scotland. C3 University of Surrey; University of Surrey; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; Swansea University; University of Dundee RP Quinn, T (通讯作者)，Univ Surrey, Fac Hlth & Med Sci, Guildford GU2 7XH, Surrey, England. EM t.quinn@surrey.ac.uk RI Snooks, Helen A/N-2165-2014 OI Snooks, Helen A/0000-0003-0173-8843; Weston, Clive/0000-0002-8995-8199; Quinn, Tom/0000-0002-5116-0034; Gale, Chris/0000-0003-4732-382X FU British Heart Foundation [PG/11/54/28 996]; British Heart Foundation [PG/11/54/28996] Funding Source: researchfish; National Institute for Health Research [NIHR/CS/009/004] Funding Source: researchfish FX British Heart Foundation project grant PG/11/54/28 996. 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Methods Multicentre, prospective non-interventional study at 20 cardiac rehabilitation in-patient centres across Germany. Results A total of 1408 patients post myocardial infarction were analysed. Patients' mean age was 6211 years and 27.0% were women. ST elevation myocardial infarction (n=657; 48.7%), and non-ST elevation myocardial infarction (n=617; 45.8%) were equally balanced causes for hospitalization, while previous coronary artery bypass grafting was reported in n=134 patients (9.9%). On average, cardiac rehabilitation began 19 +/- 10 days after the index event and lasted for 22 +/- 4 days. At discharge, 96.7% of patients received statins, 13.0% another lipid-lowering medication in addition to a statin, 98.5% antithrombotic drugs and 22.3% antidiabetic medication. The rate of patients with LDL-C on target according to the European Society of Cardiology/European Atherosclerosis Society dyslipidaemia guidelines 2011 (<70mg/dl (1.8mmol/l) or at least 50% reduction of baseline value) was increased from 21.4% at admission to cardiac rehabilitation to 41.9% at discharge after cardiac rehabilitation. Most patients (95.2%) completed the cardiac rehabilitation and 88% returned to their former work at full time. Conclusion During cardiac rehabilitation, the modifiable cardiovascular risk factors, in particular the LDL-C, were substantially improved in patients after myocardial infarction. The great majority were able to return to work. However, less than 50% reached the LDL-C guideline targets during short-term cardiac rehabilitation. C1 [Schwaab, Bernhard] Curschmann Klin, Kardiol Rehabil, Timmendorfer Strand, Germany. [Zeymer, Uwe; Gitt, Anselm] Herzzentrum Ludwigshafen, Med Klin B, Ludwigshafen, Germany. [Zeymer, Uwe; Gitt, Anselm] Stiftung IHF Inst Herzinfarktforsch, Ludwigshafen, Germany. [Jannowitz, Christina] MSD SHARP & DOHME GmbH, Med Abt, Haar, Germany. [Pittrow, David] Tech Univ, Inst Klin Pharmakol, Dresden, Germany. C3 Merck & Company; Merck & Company Germany; Technische Universitat Dresden RP Schwaab, B (通讯作者)，Univ Lubeck, Akad Lehrkrankenhaus, Curschmann Klin, Rehabil Krankenhaus Kardiol Angiol & Diabetol, D-23669 Timmendorfer Strand, Germany. EM prof.schwaab@drguth.de RI Pittrow, David/AAY-5042-2021 FU MSD SHARP & DOHME GmbH, Haar, Germany FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: PATIENT CARE was funded by MSD SHARP & DOHME GmbH, Haar, Germany. 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J. Prev. Cardiol. PD FEB PY 2019 VL 26 IS 3 BP 249 EP 258 DI 10.1177/2047487318817082 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HM6XN UT WOS:000459621600005 PM 30509144 OA Bronze DA 2023-05-13 ER PT J AU Graham, JH Sanchez, RJ Saseen, JJ Mallya, UG Panaccio, MP Evans, MA AF Graham, Jove H. Sanchez, Robert J. Saseen, Joseph J. Mallya, Usha G. Panaccio, Mary P. Evans, Michael A. TI Clinical and economic consequences of statin intolerance in the United States: Results from an integrated health system SO JOURNAL OF CLINICAL LIPIDOLOGY LA English DT Article DE Statin intolerance; Health care costs; LDL-C; High CV risk; Integrated health system ID HIGH-RISK PATIENTS; CARDIOVASCULAR-DISEASE; TASK-FORCE; US ADULTS; FOLLOW-UP; THERAPY; DISCONTINUATION; PREVALENCE; MANAGEMENT; PREVENTION AB BACKGROUND: Although statins are considered safe and effective, they have been associated with statin intolerance (SI) in clinical and observational studies. OBJECTIVE: The objective of this study was to describe the clinical and economic consequences of SI through comparison of an SI cohort of patients with matched controls. METHODS: This study used data extracted from an integrated health system's electronic health records from 2008 to 2014. Adults with SI were matched to controls using a propensity score. Patients were hierarchically classified into 6 mutually exclusive cardiovascular (CV)-risk categories: recent acute coronary syndrome (ACS; <= 12 months preindex), coronary heart disease, ischemic stroke, peripheral artery disease, diabetes, or primary prevention. The study endpoints, low-density lipoprotein cholesterol (LDL-C) goal attainment, medical costs, and time to first CV event were compared using conditional logistic regression, generalized linear, and Cox proportional hazards models, respectively. RESULTS: Patients with SI (n = 5190) were matched with controls (11 = 15,570). Patients with SI incurred higher medical costs and were less likely to reach LDL-C goals than controls. Patients with SI were at higher risk for revascularization procedures in all CV risk categories except ACS, and those in the diabetes risk category were at higher risk for any CV event. There was a lower risk of all-cause death among patients with SI. CONCLUSIONS: Patients with SI were less likely to reach LDL-C goals, incurred higher health care costs, and experienced a higher risk for nonfatal CV events than patients without SI. Alternative management strategies are needed to better treat high CV risk patients. (C) 2016 National Lipid Association. All rights reserved. C1 [Graham, Jove H.; Evans, Michael A.] Geisinger Hlth Syst, 100 N Acad Ave,MC 44-00, Danville, PA 17822 USA. [Sanchez, Robert J.] Regeneron Pharmaceut Inc, 777 Old Saw Mill River Rd, Tarrytown, NY 10591 USA. [Saseen, Joseph J.] Univ Colorado, Anschutz Med Campus, Aurora, CO USA. [Mallya, Usha G.; Panaccio, Mary P.] Sanofi US, Bridgewater, NJ USA. C3 Geisinger Health System; Regeneron; University of Colorado System; University of Colorado Anschutz Medical Campus; Sanofi-Aventis RP Graham, JH (通讯作者)，Geisinger Hlth Syst, 100 N Acad Ave,MC 44-00, Danville, PA 17822 USA. EM jhgraham1@geisinger.edu RI Panaccio, Mary/HTT-4920-2023 FU National Association of Chain Drug Stores Foundation; Biogen, Inc; Intarcia Therapeutics, Inc; Sanofi US; Regeneron Pharmaceuticals, Inc.; Merck; Pfizer; Roche Diagnostics FX Dr Graham has received research support from National Association of Chain Drug Stores Foundation; Biogen, Inc; Intarcia Therapeutics, Inc; Sanofi US; and Regeneron Pharmaceuticals, Inc. Dr Sanchez is employed by and has ownership interest in Regeneron Pharmaceuticals, Inc. Dr Saseen reports no conflicts. Drs Mallya and Panaccio are employed by and have ownership interest in Sanofi US. M.A. Dr Evans has received research support from Merck, Pfizer, and Roche Diagnostics. 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Clin. Lipidol. PD FEB PY 2017 VL 11 IS 1 BP 70 EP 79 DI 10.1016/j.jacl.2016.10.003 PG 10 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA ET2RU UT WOS:000400122600009 PM 28391913 DA 2023-05-13 ER PT J AU Xu, HM Zou, J Ye, XL Han, JY Gao, L Luo, SB Wang, JL Huang, CY Yan, XF Dai, HB AF Xu, Huimin Zou, Jie Ye, Xiaoli Han, Jiayun Gao, Lan Luo, Shunbin Wang, Jingling Huang, Chunyan Yan, Xiaofeng Dai, Haibin TI Impacts of Clinical Pharmacist Intervention on the Secondary Prevention of Coronary Heart Disease: A Randomized Controlled Clinical Study SO FRONTIERS IN PHARMACOLOGY LA English DT Article DE coronary heart disease; coronary artery disease; pharmacist; cardiovascular events; outcome assessment ID LONG-TERM ADHERENCE; MEDICATION ADHERENCE; CARDIOVASCULAR-DISEASE; CONTROLLED-TRIAL; THERAPY; RISK; CARE; MULTIDISCIPLINARY; MANAGEMENT; PROGRAM AB Coronary heart disease (CHD) is one of the leading causes of morbidity and mortality worldwide, and more efforts should be made to reduce the risk of cardiovascular events. This study aimed to investigate the impact of clinical pharmacist intervention on the prognosis of acute coronary syndrome (ACS) in Chinese patients with CHD. Two hundred and forty patients who had ACS were recruited. Participants were randomly assigned to the intervention group (n = 120) or the control group (n = 120). The intervention group received a medication assessment and education by the clinical pharmacist at discharge and telephone follow-ups at 1 week and 1 and 3 months after discharge. The control group received usual care. The primary outcomes of this study were the proportion of patients who had major adverse cardiovascular events (MACEs), including mortality, nonfatal myocardial infarction (MI), stroke, and unplanned cardiac-related rehospitalizations within 6 and 12 months after hospital discharge. Secondary outcome was self-reported medication adherence to evidence-based medications for CHD (antiplatelets, statins, beta-blockers, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers). Of 240 enrolled patients, 238 (98.3%) completed 6-month follow-up, and 235 (97.9%) completed 12-month follow-up. There were no significant differences between intervention and control groups in the percentages of patients who incurred MACEs within the 6-month follow-up (3.3% vs 7.6%, respectively, P = 0.145) or 12-month follow-up (10.9% vs 12.1%, respectively, P = 0.783). Significant improvements were found in the prescribing rates of beta-blockers and all four classes of medications at discharge in the intervention group compared with the control group (P = 0.001 and P = 0.009, respectively). There was no significant difference between the intervention and control groups in the use of all four classes of medications at the 6-month follow-up (48.3% vs 45.8%, respectively, P = 0.691) and 12-month follow-up (47.9% vs 46.6%, respectively, P = 0.836). The use of beta-blockers was nonsignificantly higher in the intervention group than in the control group at the 6-month follow-up (74.2% vs. 64.4%, P = 0.103) and 12-month follow-up (74.8% vs 63.8%, P = 0.068). Clinical pharmacist intervention had no significant effects on reduction in cardiovascular events among patients with CHD. Further studies with larger sample sizes and longer time frames for both intervention and follow-up are needed to validate the role of the clinical pharmacist in the morbidity and mortality of CHD. C1 [Xu, Huimin; Yan, Xiaofeng; Dai, Haibin] Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Pharm, Hangzhou, Zhejiang, Peoples R China. [Zou, Jie] 117th Hosp PLA, Dept Pharm, Hangzhou, Zhejiang, Peoples R China. [Ye, Xiaoli] Hangzhou First Peoples Hosp, Dept Pharm, Hangzhou, Zhejiang, Peoples R China. [Han, Jiayun] Zhejiang Haining Peoples Hosp, Dept Pharm, Jiaxing, Peoples R China. [Gao, Lan] Ganzhou Dist Zhangye Peoples Hosp, Dept Pharm, Zhangye, Peoples R China. [Luo, Shunbin] Lishui City Peoples Hosp, Dept Pharm, Lishui, Peoples R China. [Wang, Jingling] Ningbo Yinzhou 2 Hosp, Dept Pharm, Ningbo, Zhejiang, Peoples R China. [Huang, Chunyan] Wenzhou Med Univ, Affiliated Hosp 3, Dept Pharm, Wenzhou, Peoples R China. C3 Zhejiang University; Wenzhou Medical University RP Dai, HB (通讯作者)，Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Pharm, Hangzhou, Zhejiang, Peoples R China. EM haibindai@zju.edu.cn RI huang, chunyan/HNS-1814-2023 FU National Natural Science Foundation of China [81703479, 81773700]; Health Bureau of Zhejiang Province [WKJ-ZJ-1719]; Special Research Fund of Jiangsu Chia-Tai Tianqing Pharmacy FX This study was supported by research grants from the National Natural Science Foundation of China (81703479 and 81773700), the Health Bureau of Zhejiang Province (WKJ-ZJ-1719), and the Special Research Fund of Jiangsu Chia-Tai Tianqing Pharmacy. The funders had no role in the study design or conduct, data collection and analysis, decision to publish, or the preparation or approval of the manuscript. 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Pharmacol. PD OCT 8 PY 2019 VL 10 AR 1112 DI 10.3389/fphar.2019.01112 PG 8 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA JO3XY UT WOS:000497515300001 PM 31649528 OA Green Published, gold DA 2023-05-13 ER PT J AU Gulati, G Upshaw, J Wessler, BS Brazil, RJ Nelson, J van Klaveren, D Lundquist, CM Park, JG McGinnes, H Steyerberg, EW Van Calster, B Kent, DM AF Gulati, Gaurav Upshaw, Jenica Wessler, Benjamin S. Brazil, Riley J. Nelson, Jason van Klaveren, David Lundquist, Christine M. Park, Jinny G. McGinnes, Hannah Steyerberg, Ewout W. Van Calster, Ben Kent, David M. TI Generalizability of Cardiovascular Disease Clinical Prediction Models: 158 Independent External Validations of 104 Unique Models SO CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES LA English DT Article DE cardiovascular; cardiovascular diseases; clinical decision; decision support techniques; models; risk; validation study ID CORONARY-HEART-DISEASE; IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; IN-HOSPITAL MORTALITY; ELEVATION MYOCARDIAL-INFARCTION; INITIATE LIFESAVING TREATMENT; LIPID-LOWERING TREATMENT; SYNDROME RISK SCORE; PRIMARY PREVENTION; CHINESE POPULATION; ORGANIZED PROGRAM AB Background: While clinical prediction models (CPMs) are used increasingly commonly to guide patient care, the performance and clinical utility of these CPMs in new patient cohorts is poorly understood. Methods: We performed 158 external validations of 104 unique CPMs across 3 domains of cardiovascular disease (primary prevention, acute coronary syndrome, and heart failure). Validations were performed in publicly available clinical trial cohorts and model performance was assessed using measures of discrimination, calibration, and net benefit. To explore potential reasons for poor model performance, CPM-clinical trial cohort pairs were stratified based on relatedness, a domain-specific set of characteristics to qualitatively grade the similarity of derivation and validation patient populations. We also examined the model-based C-statistic to assess whether changes in discrimination were because of differences in case-mix between the derivation and validation samples. The impact of model updating on model performance was also assessed. Results: Discrimination decreased significantly between model derivation (0.76 [interquartile range 0.73-0.78]) and validation (0.64 [interquartile range 0.60-0.67], P<0.001), but approximately half of this decrease was because of narrower case-mix in the validation samples. CPMs had better discrimination when tested in related compared with distantly related trial cohorts. Calibration slope was also significantly higher in related trial cohorts (0.77 [interquartile range, 0.59-0.90]) than distantly related cohorts (0.59 [interquartile range 0.43-0.73], P=0.001). When considering the full range of possible decision thresholds between half and twice the outcome incidence, 91% of models had a risk of harm (net benefit below default strategy) at some threshold; this risk could be reduced substantially via updating model intercept, calibration slope, or complete re-estimation. Conclusions: There are significant decreases in model performance when applying cardiovascular disease CPMs to new patient populations, resulting in substantial risk of harm. Model updating can mitigate these risks. Care should be taken when using CPMs to guide clinical decision-making. C1 [Gulati, Gaurav; Upshaw, Jenica; Wessler, Benjamin S.; Brazil, Riley J.; Nelson, Jason; van Klaveren, David; Lundquist, Christine M.; Park, Jinny G.; McGinnes, Hannah; Kent, David M.] Tufts Med Ctr, Predict Analyt & Comparat Effectiveness PACE Ctr, Inst Clin Res & Hlth Policy Studies ICRHPS, Boston, MA 02111 USA. [Gulati, Gaurav; Upshaw, Jenica; Wessler, Benjamin S.] Tufts Med Ctr, Div Cardiol, Boston, MA 02111 USA. [van Klaveren, David; Steyerberg, Ewout W.; Van Calster, Ben] Leiden Univ, Dept Biomed Data Sci, Med Ctr, Leiden, Netherlands. [Van Calster, Ben] Katholieke Univ Leuven, Dept Dev & Regenerat, Leuven, Belgium. [Van Calster, Ben] Katholieke Univ Leuven, EPI Ctr, Leuven, Belgium. C3 Tufts Medical Center; Tufts Medical Center; Leiden University; Leiden University Medical Center (LUMC); Leiden University - Excl LUMC; KU Leuven; KU Leuven RP Kent, DM (通讯作者)，Tufts Med Ctr, 800 Washington St,Box 63, Boston, MA 02111 USA. EM dkent1@tuftsmedicalcenter.org RI Steyerberg, Ewout W/C-1509-2018; van Klaveren, David/ABF-3020-2021 OI Steyerberg, Ewout W/0000-0002-7787-0122; van Klaveren, David/0000-0002-2096-606X; Nelson, Jason/0000-0003-1113-9326; Wessler, Benjamin/0000-0002-8652-1426; Park, Jinny/0000-0001-8537-5749; Gulati, Gaurav/0000-0002-7701-0878 FU Patient-Centered Outcomes Research Institute (PCORI) Award [ME-1606-35555] FX Research reported in this work was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (ME-1606-35555). 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Qual. Outcomes PD APR PY 2022 VL 15 IS 4 BP 248 EP 260 AR e008487 DI 10.1161/CIRCOUTCOMES.121.008487 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 0N1QM UT WOS:000782620900006 PM 35354282 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Lee, J Dhillon, N Pope, J AF Lee, June Dhillon, Nimrit Pope, Janet TI All-cause hospitalizations in systemic lupus erythematosus from a large Canadian referral centre SO RHEUMATOLOGY LA English DT Article DE SLE; lupus; hospitalization; ICU; infection; flare; CAD (coronary artery disease); length of stay ID INTENSIVE-CARE-UNIT; DISEASE; MORTALITY; MORBIDITY; PREDICTORS; COHORT; COSTS AB Objective. To determine factors affecting morbidity and mortality in a contemporary cohort of hospitalized SLE patients and estimate the rate of SLE hospitalization. Methods. A retrospective chart review was done on all patients admitted to London Health Sciences Centre and St Joseph's Health Centre in London, Ontario, Canada, between January 2006 and June 2009. Results. There were a total of 96 SLE patients meeting inclusion criteria hospitalized during this period resulting in 154 hospitalizations. Average age at diagnosis was 33.3 years (s.d. 13.7) and 46.5 years (s.d. 14.1) at hospitalization; 91.7% of hospitalized patients were female. The most common reasons for hospitalization included disease flare (17.5%), infection (mostly bacterial) (16.2%) and adverse drug reaction (8.1%). Acute coronary syndrome (2.6%) and venous thromboembolic events (1.9%) were less common causes of hospitalization. Mean hospitalization length was 8.5 (s.d. 11.2) days. Intensive care unit (ICU) admission occurred in 22 cases (13.8%) and mortality was significantly higher (27.3% of ICU patients died; P < 0.001). ICU admissions were associated with longer hospitalization [18.6 (s.d. 17.8) days; P = 0.006]. The annual rate of hospitalizations for SLE was estimated as between 8.6% and 18.9% per year depending on the estimated size of the referral area and study year. Conclusion. In this contemporary cohort, SLE flare and infection remain the top reasons for hospitalization. Causes of admission and length of stay are consistent with previous studies conducted in North America. The proportion of ICU admissions was substantially higher in this population and was associated with increased mortality and length of hospitalization. C1 [Lee, June; Dhillon, Nimrit; Pope, Janet] Univ Western Ontario, Schulich Sch Med & Dent, London, ON, Canada. [Pope, Janet] St Josephs Hlth Care, Dept Med, Div Rheumatol, London, ON N6A 4V2, Canada. C3 Western University (University of Western Ontario); Western University (University of Western Ontario) RP Pope, J (通讯作者)，St Josephs Hlth Care, 268 Grosvenor St, London, ON N6A 4V2, Canada. EM janet.pope@sjhc.london.on.ca RI Pope, Janet/G-3342-2011 OI Pope, Janet/0000-0003-1479-5302 FU Department of Medicine, UWO FX Partial funding for this study was from a grant from the Program of Experimental Medicine (POEM), Department of Medicine, UWO. CR Ager M, 2011, 16 C EUR ASS HOSP PH Alzeer AH, 2004, LUPUS, V13, P537, DOI 10.1191/0961203304lu1057oa Bernatsky S, 2007, RHEUMATOLOGY, V46, P1814, DOI 10.1093/rheumatology/kem233 Cervera R, 2003, MEDICINE, V82, P299, DOI 10.1097/01.md.0000091181.93122.55 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 CLARKE AE, 1993, ARTHRITIS RHEUM-US, V36, P1548, DOI 10.1002/art.1780361109 Edwards CJ, 2003, LUPUS, V12, P672, DOI 10.1191/0961203303lu452oa JONES E, 1994, J RHEUMATOL, V21, P728 Krishnan E, 2006, J RHEUMATOL, V33, P1770 Merkel PA, 2007, ANDREOLI CARPENTERS, P813 PETRI M, 1992, J RHEUMATOL, V19, P1559 Teh CL, 2008, INT J RHEUM DIS, V11, P24, DOI 10.1111/j.1756-185X.2008.00325.x Thorburn CM, 2003, ARTHRITIS RHEUM, V48, P2519, DOI 10.1002/art.11241 Urowitz MB, 2008, J RHEUMATOL, V35, P2152, DOI 10.3899/jrheum.080214 Ward MM, 1999, ARTHRITIS RHEUM, V42, P338, DOI 10.1002/1529-0131(199902)42:2<338::AID-ANR17>3.0.CO;2-U Whitelaw DA, 2005, CLIN RHEUMATOL, V24, P223, DOI 10.1007/s10067-004-1007-3 Zhu TY, 2009, ARTHRIT RHEUM-ARTHR, V61, P1159, DOI 10.1002/art.24725 NR 17 TC 80 Z9 84 U1 0 U2 6 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1462-0324 J9 RHEUMATOLOGY JI RHEUMATOLOGY PD MAY PY 2013 VL 52 IS 5 BP 905 EP 909 DI 10.1093/rheumatology/kes391 PG 5 WC Rheumatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Rheumatology GA 133CG UT WOS:000318114400023 PM 23307831 OA Bronze DA 2023-05-13 ER PT J AU Gasior, M Pyka, L Gorol, J Hawranek, M Tajstra, M Slonka, G Kurek, A Krajewski, A Rozentryt, P Gierlotka, M Lekston, A Zembala, M Polonski, L AF Gasior, Mariusz Pyka, Lukasz Gorol, Jaroslaw Hawranek, Michal Tajstra, Mateusz Slonka, Grzegorz Kurek, Anna Krajewski, Adam Rozentryt, Piotr Gierlotka, Marek Lekston, Andrzej Zembala, Marian Polonski, Lech TI COnteMporary Modalities In Treatment of Heart Failure: a report from the COMMIT-HF registry SO KARDIOLOGIA POLSKA LA English DT Article DE heart failure; COMMIT-HF registry; study design; demographics; treatment; prognosis ID UNITED-STATES; EPIDEMIOLOGY; RATIONALE; SURVIVAL; OUTCOMES; CANCER; DESIGN; IMPACT AB Background and aim: Heart failure (HF) has become a global health problem and is a significant burden for health-care systems worldwide. It is reported as the reason for 1-4% of all hospital admissions in developed countries. The prognosis in HF remains unfavourable. Having at our disposal a large group of patients with systolic HF at a high-volume reference cardiovascular centre with the possibility to implement complete diagnostics and therapy we decided to analyse the clinical data, administered therapies, and prognosis in HF patients. Methods: The COMMIT-HF is a single-centre observational study that is underway in the Third Chair and Department of Cardiology of the Silesian Centre for Heart Diseases in Zabrze. The study population is a cohort of adult HF patients with left ventricular ejection fraction (LVEF) <= 35%. Patients with acute coronary syndromes are excluded from the analysis. Complete patient demographics: medical history, hospitalisation data (diagnostic and therapeutic), and in-hospital results are collected. Twelve-month follow-up is based on the information acquired from the national health-care provider. Results: As of 31 December 2013 a group of 1798 patients have been enrolled (mean age 60.9 +/- 12.8 years, 20.3% of subjects female, mean LVEF 26.06 +/- 6.09, ischaemic aetiology 64.5%, atrial fibrillation 33.2%, diabetes mellitus 41.2%, chronic kidney disease stage >= III 29%). A significant proportion of patients underwent invasive procedures (ICD/CRT-D implantation 61.1%, coronary angiography 56.2%, PCI 19.6%, CABG 5.1%, heart transplantation qualification 5.5%, IABP 2.5%). All-cause 12-month morality was 12.5%. HF-related rehospitalisation rate was 28.9%. Conclusions: The COMMIT-HF study will provide valuable information on the HF patient population. Initial analyses show that in this difficult patient population satisfactory long-term results can be achieved. C1 [Gasior, Mariusz; Pyka, Lukasz; Gorol, Jaroslaw; Hawranek, Michal; Tajstra, Mateusz; Slonka, Grzegorz; Kurek, Anna; Krajewski, Adam; Rozentryt, Piotr; Gierlotka, Marek; Lekston, Andrzej; Polonski, Lech] Med Univ Silesia, SMDZ Zabrze, Dept Cardiol 3, Katowice, Poland. [Zembala, Marian] Med Univ Silesia, SMDZ Zabrze, Dept Cardiac Surg & Transplantol, Katowice, Poland. C3 Medical University Silesia; Medical University Silesia RP Pyka, L (通讯作者)，Med Univ Silesia, SMDZ Zabrze, Dept Cardiol 3, Ul M Curie Sklodowskiej 9, PL-41800 Zabrze, Poland. EM wookash.p@gmail.com RI Gierlotka, Marek/U-6969-2019; Hawranek, Michał/AAQ-7056-2020; Tajstra, Mateusz MT/R-6890-2016 OI Gierlotka, Marek/0000-0001-5639-2128; Hawranek, Michal/0000-0002-8061-9975; Rozentryt, Piotr/0000-0002-8979-2205 CR Adams KF, 2005, AM HEART J, V149, P209, DOI 10.1016/j.ahj.2004.08.005 Ambrosy AP, 2014, J AM COLL CARDIOL, V63, P1123, DOI 10.1016/j.jacc.2013.11.053 Bui AL, 2011, NAT REV CARDIOL, V8, P30, DOI 10.1038/nrcardio.2010.165 Cleland JGF, 2000, EUR J HEART FAIL, V2, P123, DOI 10.1016/S1388-9842(00)00081-7 Heidenreich PA, 2013, CIRC-HEART FAIL, V6, P606, DOI 10.1161/HHF.0b013e318291329a Jhund PS, 2009, CIRCULATION, V119, P515, DOI 10.1161/CIRCULATIONAHA.108.812172 Jonsson A, 2010, EUR J HEART FAIL, V12, P25, DOI 10.1093/eurjhf/hfp175 Mosterd A, 2007, HEART, V93, P1137, DOI 10.1136/hrt.2003.025270 Ponikowski P, 2014, ESC HEART FAIL, V1, P4, DOI 10.1002/ehf2.12005 Stewart S, 2001, EUR J HEART FAIL, V3, P315, DOI 10.1016/S1388-9842(00)00141-0 Stewart S, 2010, CIRC-CARDIOVASC QUAL, V3, P573, DOI 10.1161/CIRCOUTCOMES.110.957571 Tsutsui H, 2006, CIRC J, V70, P1617, DOI 10.1253/circj.70.1617 Youn YJ, 2012, CIRC J, V76, P1151, DOI 10.1253/circj.CJ-11-1093 NR 13 TC 17 Z9 17 U1 0 U2 3 PU VIA MEDICA PI GDANSK PA UL SWIETOKRZYSKA 73, 80-180 GDANSK, POLAND SN 0022-9032 EI 1897-4279 J9 KARDIOL POL JI Kardiol. Pol. PY 2016 VL 74 IS 6 BP 523 EP 528 DI 10.5603/KP.a2015.0224 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DQ7AX UT WOS:000379360100002 PM 26596896 OA hybrid DA 2023-05-13 ER PT J AU Ten Have, P Hilt, AD Paalvast, H Eindhoven, DC Schalij, MJ Beeres, SLMA AF Ten Have, P. Hilt, A. D. Paalvast, H. Eindhoven, D. C. Schalij, M. J. Beeres, S. L. M. A. TI Non-ST-elevation myocardial infarction in the Netherlands: room for improvement! SO NETHERLANDS HEART JOURNAL LA English DT Article DE Medication adherence; Myocardial infarction care; Non-ST-elevation myocardial infarction; National claims data ID ACUTE CORONARY SYNDROMES; GUIDELINES; MANAGEMENT; ADHERENCE; BENEFIT AB Aim To analyse non-ST-elevation myocardial infarction (NSTEMI) care in the Netherlands and to identify modifiable factors to improve NSTEMI healthcare. Methods This retrospective cohort study analysed hospital and pharmacy claims data of all NSTEMI patients in the Netherlands in 2015. The effect of percutaneous coronary intervention (PCI) during hospitalisation on 1-year mortality was investigated in the subcohort alive 4 days after NSTEMI. The effect of medical treatment on 1-year mortality was assessed in the subcohort alive 30 days after NSTEMI. The effect of age, gender and co-morbidities was evaluated. PCI during hospitalisation was defined as PCI within 72x202f;h after NSTEMI and optimal medical treatment was defined as the combined use of an aspirin species, P2Y(12) inhibitor, statin, beta-blocker and angiotensin converting enzyme inhibitor/angiotensin II receptor blocker, started within 30 days after NSTEMI. Results Data from 17,997 NSTEMI patients (age 69.6 (SDx202f;= 12.8) years, 64% male) were analysed. Of the patients alive 4 days after NSTEMI, 43% had a PCI during hospitalisation and 1-year mortality was 10%. In the subcohort alive 30 days after NSTEMI, 47% of patients were receiving optimal medical treatment at 30 days and 1-year mortality was 7%. PCI during hospitalisation (odds ratio (OR) 0.42; 95% confidence interval (CI) 0.37-0.48) and optimal medical treatment (OR 0.59; 95% CI 0.51-0.67) were associated with a lower 1-year mortality. Conclusion In Dutch NSTEMI patients, use of PCI during hospitalisation and prescription of optimal medical treatment are modest. As both are independently associated with a lower 1-year mortality, this study provides direction on how to improve the quality of NSTEMI healthcare in the Netherlands. C1 [Ten Have, P.; Paalvast, H.] Zorginst Nederland, Diemen, Netherlands. [Hilt, A. D.; Eindhoven, D. C.; Schalij, M. J.; Beeres, S. L. M. A.] Leiden Univ, Dept Cardiol, Med Ctr, Leiden, Netherlands. C3 Leiden University; Leiden University Medical Center (LUMC); Leiden University - Excl LUMC RP Beeres, SLMA (通讯作者)，Leiden Univ, Dept Cardiol, Med Ctr, Leiden, Netherlands. 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Heart J. PD OCT PY 2020 VL 28 IS 10 BP 537 EP 545 DI 10.1007/s12471-020-01433-x EA JUN 2020 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA NP0SQ UT WOS:000537632400002 PM 32495295 OA Green Published, gold DA 2023-05-13 ER PT J AU Suki, SZ Zuhdi, ASM Yahya, AA Zaharan, NL AF Suki, Siti Z. Zuhdi, Ahmad S. M. Yahya, Abqariyah A. Zaharan, Nur L. TI Intervention and in-hospital pharmacoterapies in octogenarian with acute coronary syndrome: a 10-year retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry SO BMC GERIATRICS LA English DT Article DE Cardiovascular disease; Octogenarians; Mortality; Intervention; Pharmacotherapies; Pharmacoepidemiology ID ELEVATION MYOCARDIAL-INFARCTION; HEART-DISEASE MORTALITY; ELDERLY-PATIENTS; GUIDELINES; OUTCOMES; RISK; CARE AB Background Octogenarians and beyond have often been neglected in the populational study of disease despite being at the highest point of non-modifiable disease risk burden and the fastest-growing age group for the past decade. This study examined the characteristics and in-hospital management of octogenarian patients with acute coronary syndrome (ACS) in a multi-ethnic, middle-income country in South East Asia. Method This retrospective study utilised the Malaysian National Cardiovascular Disease- ACS (NCVD-ACS) registry. Consecutive patient data of those >= 80 years old admitted with ACS at 24 participating hospitals from 2008 to 2017 (n = 3162) were identified. Demographics, in-hospital intervention, and evidence-based pharmacotherapies over the 10-years were examined and compared across groups of interests using the Chi-square test. Multivariate logistic regression was used to calculate the adjusted odds ratio of receiving individual therapies according to patients' characteristics. Results Octogenarians made up 3.8% of patients with ACS in the NCVD-ACS registry (mean age = 84, SD +/- 3.6) from 2008 until 2017. The largest ethnic group was Chinese (44%). Most octogenarians (95%) have multiple cardiovascular risk factors, with hypertension (82%) being the main. Non-ST-elevation myocardial infarction (NSTEMI) predominated (38%, p < 0.001). Within the 10-year, there were positive increments in cardiovascular intervention and pharmacotherapies. Only 10% of octogenarians with ACS underwent percutaneous coronary intervention (PCI), the majority being STEMI patients (17.5%; p < 0.05). More than 80% were prescribed aspirin (91.3%) either alone or combined, dual antiplatelet therapy (DAPT) (83.3%), anticoagulants (89.7%) and statins (89.6%), while less being prescribed angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (47.6%) and beta-blockers (43.0%). Men were more likely to receive PCI than women (adjusted Odds Ratio (aOR): 0.698; 95% CI: 0.490-0.993). NSTEMI (aOR = 0.402, 95% CI: 0.278-0.583) and unstable angina (UA) (aOR = 0.229, 95% CI: 0.143-0.366) were less likely to receive PCI but more likely given anticoagulants (NSTEMI, aOR = 1.543, 95% CI: 1.111-2.142; UA, aOR = 1.610, 95% CI: 1.120-2.314) than STEMI. The presence of cardiovascular risk factors and comorbidities influences management. Conclusion Octogenarians with ACS in this country were mainly treated with cardiovascular pharmacotherapies. As the number of octogenarians with ACS will continue to increase, the country needs to embrace the increasing use of PCI in this group of patients. C1 [Suki, Siti Z.; Zaharan, Nur L.] Univ Malaya, Dept Pharmacol, Kuala Lumpur 50603, Malaysia. [Zuhdi, Ahmad S. M.] Univ Malaya, Dept Med, Cardiol Unit, Kuala Lumpur 50603, Malaysia. [Yahya, Abqariyah A.] Univ Malaya, Dept Social & Prevent Med, Kuala Lumpur 50603, Malaysia. C3 Universiti Malaya; Universiti Malaya; Universiti Malaya RP Zaharan, NL (通讯作者)，Univ Malaya, Dept Pharmacol, Kuala Lumpur 50603, Malaysia. EM nurlisazaharan@um.edu.my RI ., ABQARIYAH BINTI YAHYAAHMAD NOOR/HJH-0193-2022; ZUHDI, AHMAD SYADI MAHMOOD/AAP-4919-2021; Zaharan, Nur Lisa/F-8835-2012; Mahmood Zuhdi, Ahmad Syadi/HIR-1281-2022 OI ZUHDI, AHMAD SYADI MAHMOOD/0000-0002-5349-0301; Zaharan, Nur Lisa/0000-0002-8150-0642; CR Ahmad NA, 2017, BMC PUBLIC HEALTH, V17, DOI 10.1186/s12889-017-4793-7 Ahmad WAW, 2013, INT J CARDIOL, V165, P161, DOI 10.1016/j.ijcard.2011.08.015 Alexander KP, 2005, J AM COLL CARDIOL, V46, P1479, DOI 10.1016/j.jacc.2005.05.084 [Anonymous], 2006, IN REP AC COR SYNDR [Anonymous], 2019, STAT CAUS DEATH MAL [Anonymous], 2021, ANN REP NCVD PCI REG [Anonymous], 2018, STAT CAUS DEATH MAL Arnett DK, 2019, CIRCULATION, V140, pE596, DOI [10.1161/CIR.0000000000000677, 10.1016/j.jacc.2019.03.010, 10.1161/CIR.0000000000000678, 10.1016/j.jacc.2019.03.009] Bainey KR, 2014, CIRC-CARDIOVASC QUAL, V7, P227, DOI 10.1161/CIRCOUTCOMES.113.000422 Cherubini A, 2012, DRUG AGING, V29, P463, DOI 10.2165/11631750-000000000-00000 Department of Statistics M, 2016, POPULATION PROJECTIO Einarson TR, 2018, CARDIOVASC DIABETOL, V17, DOI 10.1186/s12933-018-0728-6 Feldman DN, 2006, AM J CARDIOL, V98, P1334, DOI 10.1016/j.amjcard.2006.06.026 Franchini M, 2006, CRIT REV ONCOL HEMAT, V60, P144, DOI 10.1016/j.critrevonc.2006.06.004 Grundy SM, 2019, J AM COLL CARDIOL, V73, pE285, DOI 10.1016/j.jacc.2018.11.003 Hussein Z, 2015, ANN GLOB HEALTH, V81, P851, DOI 10.1016/j.aogh.2015.12.016 Husted S, 2012, CIRC-CARDIOVASC QUAL, V5, P680, DOI 10.1161/CIRCOUTCOMES.111.964395 Ibrahim WMSW AS, 2017, AGEING POPULATION DE Institute for Public Health Ministry of Health Malaysia, 2019, NAT HLTH MORB SURV 2 Jernberg T, 2015, EUR HEART J, V36, P1163, DOI 10.1093/eurheartj/ehu505 Kojima S, 2018, IJC HEART VASC, V20, P1, DOI 10.1016/j.ijcha.2018.06.003 Lee CY, 2021, PLOS ONE, V16, DOI 10.1371/journal.pone.0246474 Lee MMY, 2021, OPEN HEART, V8, DOI 10.1136/openhrt-2020-001453 Li YH, 2019, ACTA CARDIOL SIN, V35, P1, DOI 10.6515/ACS.201901_35(1).20180716B Manghani Kishu, 2011, Perspect Clin Res, V2, P34, DOI 10.4103/2229-3485.76288 Ministry of Health Malaysia, 2017, CLIN PRACTICE GUIDEL, P182 Numasawa Y, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011017 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] Palmieri L, 2010, AM J PUBLIC HEALTH, V100, P684, DOI 10.2105/AJPH.2008.147173 Pereira M, 2013, CIRC-CARDIOVASC QUAL, V6, P634, DOI 10.1161/CIRCOUTCOMES.113.000264 Reinikainen J, 2015, INT J EPIDEMIOL, V44, P108, DOI 10.1093/ije/dyu235 Roger VL, 2011, CIRCULATION, V123, pE18, DOI 10.1161/CIR.0b013e3182009701 Safurah Jaafar KMN, 2012, MALAYSIA HLTH SYSTEM Shi S, 2008, EUR J CLIN PHARMACOL, V64, P183, DOI 10.1007/s00228-007-0422-1 Tegn N, 2020, OPEN HEART, V7, DOI 10.1136/openhrt-2020-001256 Teh JKL, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0091328 Tokarek T, 2018, CORONARY ARTERY DIS, V29, P573, DOI 10.1097/MCA.0000000000000649 Venkatason P, 2018, EUR J CLIN PHARMACOL, V74, P953, DOI 10.1007/s00228-018-2451-3 Venkatason P, 2016, ANN SAUDI MED, V36, P184, DOI 10.5144/0256-4947.2016.184 von Elm E, 2014, INT J SURG, V12, P1495, DOI 10.1016/j.ijsu.2014.07.013 Wan Ahmad W. A., 2017, ANN REPORT ACUTE COR Wan Ahmad WA, 2018, ANN REPORT NCVD PCI WHO, 2017, CARD DIS CVDS WPA2015, 2015, WORLD POPULATION AGE Zaini A, 2000, DIABETES RES CLIN PR, V50, pS23, DOI 10.1016/S0168-8227(00)00175-3 Zuhdi ASM, 2016, SINGAP MED J, V57, P191, DOI 10.11622/smedj.2015145 NR 46 TC 0 Z9 0 U1 1 U2 1 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND EI 1471-2318 J9 BMC GERIATR JI BMC Geriatr. PD JAN 4 PY 2022 VL 22 IS 1 AR 23 DI 10.1186/s12877-021-02724-7 PG 10 WC Geriatrics & Gerontology; Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA YA8OY UT WOS:000738587000001 PM 34983393 OA gold, Green Published DA 2023-05-13 ER PT J AU Surial, B Burkhart, A Terliesner, N Morgenthaler, M Bachli, E AF Surial, Bernard Burkhart, Andreas Terliesner, Nicolas Morgenthaler, Martina Bachli, Esther TI Adherence to transfusion guidelines: are we prepared for the Smarter Medicine or Choosing Wisely (R) initiative? SO SWISS MEDICAL WEEKLY LA English DT Article DE transfusion; restrictive strategy; haemoglobin; co-morbidities; red blood cells; Switzerland ID RESTRICTIVE TRANSFUSION; BLOOD-TRANSFUSION; CLINICAL-PRACTICE; CELL TRANSFUSION; CRITICALLY-ILL; STRATEGIES; ANEMIA AB OBJECTIVE: To determine, whether a restrictive transfusion strategy is followed in our hospital and to identify differences in activities within departments and patient groups. METHOD: Over a period of 15 months, RBC transfusions were prospectively recorded including the haemoglobin level prior to transfusion and were grouped in the different departments of our hospital (internal medicine ward, department of surgery, emergency room, intensive care unit, gynaecology ward, medical outpatient clinic and oncology outpatient clinic). Indications and co-morbidities were assessed retrospectively by reviewing the patient's charts. RESULTS: There were 1,832 RBC products transfused in total. The overall mean level of haemoglobin before transfusion was 7.61 g/dl (+/- 1.1). These haemoglobin levels differed significantly between the departments (p < 0.001), with the lowest threshold in the internal medicine ward (7.30 g/dl +/- 1.0) compared to the surgery ward (7.73 g/dl +/- 1.0) and to the intensive care unit (7.82 g/dl +/- 0.9). In general, mean pre-transfusion haemoglobin levels did not differ significantly between patients with coronary artery disease (CAD) and patients without (7.64 g/dl +/- 1.0 vs 7.59 g/dl +/- 1.1, p = 0.48). In transfusions for patients with acute coronary syndrome a tendency to a higher transfusion threshold than in patients with stable CAD could be found (7.84 g/dl +/- 0.7 vs 7.58 g/dl +/- 1.0, p = 0.05). Patients with haematological disorders were transfused at a higher threshold when compared to patients without (7.77 g/dl vs 7.56 g/dl, p = 0.006). CONCLUSION: All wards in our analysis are following the current guidelines based on restrictive transfusion strategies. At the same time, we were able to detect significant differences between different departments and patient characteristics. C1 [Surial, Bernard; Burkhart, Andreas; Terliesner, Nicolas; Morgenthaler, Martina; Bachli, Esther] Uster Hosp, Med Clin, CH-8610 Uster, Switzerland. RP Bachli, E (通讯作者)，Uster Hosp, Dept Internal Med, Brunnenstr 42, CH-8610 Uster, Switzerland. EM esther.baechli@spitaluster.ch RI Surial, Bernard/AAF-6261-2019; Surial, Bernard/GRS-2281-2022 OI Surial, Bernard/0000-0002-1402-974X; CR Carson JL, 2013, AM HEART J, V165, P964, DOI 10.1016/j.ahj.2013.03.001 Carson JL, 2012, ANN INTERN MED, V157, P49, DOI 10.7326/0003-4819-157-1-201206190-00429 Carson JL, 2012, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD002042.pub3 Carson JL, 2011, NEW ENGL J MED, V365, P2453, DOI 10.1056/NEJMoa1012452 Corwin HL, 2004, CRIT CARE MED, V32, P39, DOI 10.1097/01.CCM.0000104112.34142.79 Hebert PC, 1999, NEW ENGL J MED, V340, P409, DOI 10.1056/NEJM199902113400601 Hicks LK, 2013, BLOOD, V122, P3879, DOI 10.1182/blood-2013-07-518423 Lacroix J, 2007, NEW ENGL J MED, V356, P1609, DOI 10.1056/NEJMoa066240 Levey AS, 2009, ANN INTERN MED, V150, P604, DOI 10.7326/0003-4819-150-9-200905050-00006 Levey AS, 1999, ANN INTERN MED, V130, P461, DOI 10.7326/0003-4819-130-6-199903160-00002 Murphy MF, 2001, BRIT J HAEMATOL, V113, P24 Retter A, 2013, BRIT J HAEMATOL, V160, P445, DOI 10.1111/bjh.12143 Villanueva C, 2013, NEW ENGL J MED, V368, P11, DOI 10.1056/NEJMoa1211801 Wu WC, 2001, NEW ENGL J MED, V345, P1230, DOI 10.1056/NEJMoa010615 NR 14 TC 8 Z9 8 U1 0 U2 4 PU E M H SWISS MEDICAL PUBLISHERS LTD PI MUTTENZ PA FARNSBURGERSTR 8, CH-4132 MUTTENZ, SWITZERLAND SN 1424-7860 EI 1424-3997 J9 SWISS MED WKLY JI Swiss Med. Wkly. PD JAN 14 PY 2015 VL 145 AR w14084 DI 10.4414/smw.2015.14084 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CB3YM UT WOS:000349565400007 PM 25588021 OA gold DA 2023-05-13 ER PT J AU Shah, AD Bailey, E Williams, T Denaxas, S Dobson, R Hemingway, H AF Shah, Anoop D. Bailey, Emily Williams, Tim Denaxas, Spiros Dobson, Richard Hemingway, Harry TI Natural language processing for disease phenotyping in UK primary care records for research: a pilot study in myocardial infarction and death SO JOURNAL OF BIOMEDICAL SEMANTICS LA English DT Article; Proceedings Paper CT UK Healthcare Text Analytics Conference (HealTAC) CY APR 18-19, 2018 CL Manchester, ENGLAND DE Free text; Myocardial infarction; Primary care; Chest pain; Natural language processing ID TEXT AB Background Free text in electronic health records (EHR) may contain additional phenotypic information beyond structured (coded) information. For major health events - heart attack and death - there is a lack of studies evaluating the extent to which free text in the primary care record might add information. Our objectives were to describe the contribution of free text in primary care to the recording of information about myocardial infarction (MI), including subtype, left ventricular function, laboratory results and symptoms; and recording of cause of death. We used the CALIBER EHR research platform which contains primary care data from the Clinical Practice Research Datalink (CPRD) linked to hospital admission data, the MINAP registry of acute coronary syndromes and the death registry. In CALIBER we randomly selected 2000 patients with MI and 1800 deaths. We implemented a rule-based natural language engine, the Freetext Matching Algorithm, on site at CPRD to analyse free text in the primary care record without raw data being released to researchers. We analysed text recorded within 90 days before or 90 days after the MI, and on or after the date of death. Results We extracted 10,927 diagnoses, 3658 test results, 3313 statements of negation, and 850 suspected diagnoses from the myocardial infarction patients. Inclusion of free text increased the recorded proportion of patients with chest pain in the week prior to MI from 19 to 27%, and differentiated between MI subtypes in a quarter more patients than structured data alone. Cause of death was incompletely recorded in primary care; in 36% the cause was in coded data and in 21% it was in free text. Only 47% of patients had exactly the same cause of death in primary care and the death registry, but this did not differ between coded and free text causes of death. Conclusions Among patients who suffer MI or die, unstructured free text in primary care records contains much information that is potentially useful for research such as symptoms, investigation results and specific diagnoses. Access to large scale unstructured data in electronic health records (millions of patients) might yield important insights. C1 [Shah, Anoop D.; Denaxas, Spiros; Dobson, Richard; Hemingway, Harry] UCL, Hlth Data Res UK London, 222 Euston Rd, London NW1 2DA, England. [Shah, Anoop D.; Denaxas, Spiros; Dobson, Richard; Hemingway, Harry] UCL, Inst Hlth Informat, 222 Euston Rd, London NW1 2DA, England. [Shah, Anoop D.; Denaxas, Spiros; Dobson, Richard; Hemingway, Harry] UCL, Univ Coll London Hosp, Biomed Res Ctr, Natl Inst Hlth Res, 222 Euston Rd, London NW1 2DA, England. [Shah, Anoop D.; Bailey, Emily] Univ Coll London Hosp NHS Fdn Trust, 235 Euston Rd, London NW1 2BU, England. [Williams, Tim] Med & Healthcare Prod Regulatory Agcy, Clin Practice Res Datalink, 10 South Colonnade, London E14 4PU, England. [Dobson, Richard] Kings Coll London, Dept Biostat & Hlth Informat, De Crespigny Pk,Denmark Hill, London SE5 8AF, 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; RLUK- Research Libraries UK; University of London; University College London; University College London Hospitals NHS Foundation Trust; The Medicines & Healthcare Products Regulatory Agency; RLUK- Research Libraries UK; University of London; King's College London RP Shah, AD (通讯作者)，UCL, Hlth Data Res UK London, 222 Euston Rd, London NW1 2DA, England.; Shah, AD (通讯作者)，UCL, Inst Hlth Informat, 222 Euston Rd, London NW1 2DA, England. EM anoop@doctors.org.uk RI Shah, Anoop Dinesh/D-4396-2014; Hemingway, Harry/C-1219-2009; dobson, richard/C-9269-2011 OI Shah, Anoop Dinesh/0000-0002-8907-5724; Hemingway, Harry/0000-0003-2279-0624; dobson, richard/0000-0003-4224-9245; Denaxas, Spiros/0000-0001-9612-7791 FU Wellcome Trust [086091/Z/08/Z, LOND1]; National Institute of Health Research (NIHR) [RP-PG-0407-10314]; Farr Institute of Health Informatics Research - Medical Research Council [K006584/1]; Wellcome Trust Clinical Research Training Fellowship [0938/30/Z/10/Z]; NIHR University College London Hospitals Biomedical Research Centre; THIS Institute; Health Data Research UK - 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; Innovative Medicines Initiative-2 Joint Undertaking [116074]; European Union; EFPIA; National Institute for Health Research University College London Hospitals Biomedical Research Centre; EPSRC [EP/N027280/1] Funding Source: UKRI; ESRC [ES/L007517/1] Funding Source: UKRI; MRC [1940103] Funding Source: UKRI FX The CALIBER project was funded by the Wellcome Trust (086091/Z/08/Z) and the National Institute of Health Research (NIHR) (RP-PG-0407-10314). This study was supported by the Farr Institute of Health Informatics Research, funded by the Medical Research Council (K006584/1) in partnership with other funders. ADS was supported by a Wellcome Trust Clinical Research Training Fellowship (0938/30/Z/10/Z) and is currently supported by the NIHR University College London Hospitals Biomedical Research Centre and a post-doctoral fellowship from THIS Institute. Publication costs are funded by THIS Institute. HH is a National Institute for Health Research (NIHR) Senior Investigator. His work is supported by: 1. Health Data Research UK, which is 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 Wellcome Trust (grant no. LOND1). 2. The BigData@ Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement No. 116074. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA; it is chaired by DE Grobbee and SD Anker, partnering with 20 academic and industry partners and ESC. 3. The National Institute for Health Research University College London Hospitals Biomedical Research Centre. 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PD NOV 12 PY 2019 VL 10 SU 1 AR 20 DI 10.1186/s13326-019-0214-4 PG 10 WC Mathematical & Computational Biology WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S) SC Mathematical & Computational Biology GA JO7SC UT WOS:000497774400001 PM 31711543 OA Green Published, gold DA 2023-05-13 ER PT J AU Fonseca, C Araujo, I Marques, F Bras, D Bettencourt, P AF Fonseca, Candida Araujo, Ines Marques, Filipa Bras, Daniel Bettencourt, Paulo TI A closer look at acute heart failure: Putting Portuguese and European data into perspective SO REVISTA PORTUGUESA DE CARDIOLOGIA LA English DT Review DE Acute heart failure; Portugal; Registries; Acute phase; treatment; Heart failure; Cardiovascular disease; Epidemiology ID EUROBSERVATIONAL RESEARCH-PROGRAM; ONE-YEAR MORTALITY; QUALITY-OF-CARE; ESC-HF PILOT; GUIDELINES; DIAGNOSIS; ASSOCIATION; MANAGEMENT; CARDIOLOGY; REGISTRY AB Introduction and Objectives: Acute heart failure (AHF) is a heterogeneous clinical syndrome requiring urgent therapy. The prognosis is poor after the index hospitalization, with a high risk for rehospitalization and early death. The costs of managing AHF are thus increasing rapidly. A literature review was performed to gather and compare data on prevalence and treatment and to identify gaps in AHF management, based on European and Portuguese studies. Methods: A literature search from 1995 to 2014 was conducted in selected databases (BIOSIS Previews, EMBASE and Ovid MEDLINE). Results and Discussion: Seven Portuguese and nine European studies were analyzed. The mean age of AHF patients was >= 65 years and 30-50% were women. Coronary artery disease (42.3% vs. 61.9%) and hypertension (53.3% vs. 76.7%) were identified as primary etiologies in Europe and in Portugal. Similar proportions of heart failure with preserved ejection fraction were found in the Portuguese (19.9-44.7%) and European (32.8-39.1%) studies. Overall, all-cause mortality rates were comparable (six months: 9.3-25.5% vs. 13.5-27.4%; one year: 15.9-31% vs. 17.4-46.5%), as was in-hospital mortality (5.5-14% vs. 3.8-12%) in Portuguese and European studies, respectively. Length of stay was comparable. The studies were performed in very different hospital settings and data on treatment were scarce. Conclusions: Gaps were identified in treatment and clinical pathways of patients with AHF. Based on the results of this review, collection and investigation of data on the disease and treatment solutions, training in disease management, and improved organization of healthcare should be the subject of further investment. (C) 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved. C1 [Fonseca, Candida; Araujo, Ines; Marques, Filipa] Univ Nova Lisboa, Fac Ciencias Med, NOVA Med Sch, Heart Failure Unit,Dept Internal Med,Ctr Hosp Lis, P-1200 Lisbon, Portugal. [Fonseca, Candida; Araujo, Ines; Marques, Filipa] Univ Nova Lisboa, Fac Ciencias Med, NOVA Med Sch, Day Hosp,Hosp Sao Francisco Xavier,Ctr Hosp Lisbo, P-1200 Lisbon, Portugal. [Bras, Daniel] Novartis Farma, Dept Med, Porto Salvo, Portugal. [Bettencourt, Paulo] Univ Porto, Fac Med, Ctr Hosp Sao Joao, Dept Internal Med, Oporto, Portugal. C3 Universidade Nova de Lisboa; Universidade Nova de Lisboa; Sao Joao Hospital; Universidade do Porto RP Fonseca, C (通讯作者)，Univ Nova Lisboa, Fac Ciencias Med, NOVA Med Sch, Heart Failure Unit,Dept Internal Med,Ctr Hosp Lis, P-1200 Lisbon, Portugal.; Fonseca, C (通讯作者)，Univ Nova Lisboa, Fac Ciencias Med, NOVA Med Sch, Day Hosp,Hosp Sao Francisco Xavier,Ctr Hosp Lisbo, P-1200 Lisbon, Portugal. EM mcandidafonseca@gmail.com RI Bettencourt, Paulo/A-4434-2018; Araújo, Inês/L-7350-2019; Brás, Daniel/AAQ-9816-2021; Bras, Daniel/AAQ-9821-2021 OI Bettencourt, Paulo/0000-0003-1638-3993; Brás, Daniel/0000-0002-0598-3013; Bras, Daniel/0000-0002-0598-3013 CR Bettencourt P, 2004, CIRCULATION, V110, P2168, DOI 10.1161/01.CIR.0000144310.04433.BE Bettencourt P, 2013, INT J CARDIOL, V168, P4985, DOI 10.1016/j.ijcard.2013.07.131 Canesin MF, 2014, EU SOC CARD Ceia F, 2002, EUR J HEART FAIL, V4, P531, DOI 10.1016/S1388-9842(02)00034-X Cleland JGF, 2003, EUR HEART J, V24, P442, DOI 10.1016/S0195-668X(02)00823-0 Cunha FM, 2013, BIOMED RES INT, V2013, P3502 Dharmarajan K, 2013, BMJ-BRIT MED J, V347, DOI 10.1136/bmj.f6571 Dickstein K, 2008, EUR HEART J, V29, P2388, DOI 10.1093/eurheartj/ehn309 Follath F, 2011, INTENS CARE MED, V37, P619, DOI 10.1007/s00134-010-2113-0 Fonseca Candida, 2007, Rev Port Cardiol, V26, P1111 Harjola VP, 2010, EUR J HEART FAIL, V12, P239, DOI 10.1093/eurjhf/hfq002 Heidenreich PA, 2013, CIRC-HEART FAIL, V6, P606, DOI 10.1161/HHF.0b013e318291329a Komajda M, 2003, EUR HEART J, V24, P464, DOI 10.1016/S0195-668X(02)00700-5 Krumholz HM, 2009, CIRC-CARDIOVASC QUAL, V2, P407, DOI 10.1161/CIRCOUTCOMES.109.883256 Levy D, 2002, NEW ENGL J MED, V347, P1397, DOI 10.1056/NEJMoa020265 Logeart D, 2013, EUR J HEART FAIL, V15, P465, DOI 10.1093/eurjhf/hfs189 Maggioni AP, 2013, EUR J HEART FAIL, V15, P1173, DOI 10.1093/eurjhf/hft134 Maggioni AP, 2013, EUR J HEART FAIL, V15, P808, DOI 10.1093/eurjhf/hft050 Maggioni AP, 2010, EUR J HEART FAIL, V12, P1076, DOI 10.1093/eurjhf/hfq154 McMurray JJV, 2012, EUR HEART J, V33, P1787, DOI 10.1093/eurheartj/ehs104 Nieminen MS, 2006, EUR HEART J, V27, P2725, DOI 10.1093/eurheartj/ehl193 O'Connor CM, 2010, AM HEART J, V159, P841, DOI 10.1016/j.ahj.2010.02.023 Oliva F, 2012, EUR J HEART FAIL, V14, P1208, DOI 10.1093/eurjhf/hfs117 Pimenta J, 2010, INT J CARDIOL, V145, P209, DOI 10.1016/j.ijcard.2009.08.001 Pinho-Gomes AC, 2013, REV PORT CARDIOL, V32, P567, DOI 10.1016/j.repc.2012.10.018 Portugal. Direccao-Geral da Saude, 2014, PROG NAC DOENC CER C Rudiger A, 2005, EUR J HEART FAIL, V7, P662, DOI 10.1016/j.ejheart.2005.01.014 Sarmento Pedro Moraes, 2006, Rev Port Cardiol, V25, P13 Zannad F, 2006, EUR J HEART FAIL, V8, P697, DOI 10.1016/j.ejheart.2006.01.001 NR 29 TC 7 Z9 7 U1 0 U2 6 PU ELSEVIER DOYMA SL PI BARCELONA PA TRAVESERA DE GARCIA, 17-21, BARCELONA, 08021, SPAIN SN 0870-2551 EI 0304-4750 J9 REV PORT CARDIOL JI Rev. Port. Cardiol. PD MAY PY 2016 VL 35 IS 5 BP 291 EP 304 DI 10.1016/j.repc.2015.10.011 PG 14 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DL1RQ UT WOS:000375410100007 PM 27118096 OA Green Published, gold DA 2023-05-13 ER PT J AU Ahmed, N Carrick, D Layland, J Oldroyd, KG Berry, C AF Ahmed, Nadeem Carrick, David Layland, Jamie Oldroyd, Keith G. Berry, Colin TI The Role of Cardiac Magnetic Resonance Imaging (MRI) in Acute Myocardial Infarction (AMI) SO HEART LUNG AND CIRCULATION LA English DT Review DE Magnetic resonance imaging (MRI); Acute myocardial infarction (AMI); Infarct size (IS); Myocardial oedema; Myocardial haemorrhage; Microvascular obstruction (MVO) ID ACUTE CORONARY SYNDROME; EMISSION-COMPUTED-TOMOGRAPHY; LEFT-VENTRICULAR FUNCTION; DELAYED ENHANCEMENT; MICROVASCULAR OBSTRUCTION; PROGNOSTIC-SIGNIFICANCE; TRANSMURAL EXTENT; INTERSTUDY REPRODUCIBILITY; QUANTITATIVE ASSESSMENT; REPERFUSION HEMORRHAGE AB Acute myocardial infarction (AMI) is a leading cause of mortality and morbidity in the world, despite the rate having significantly declined over the past decade. The aim of this review is to consider the emerging diagnostic and clinical utility of cardiac MRI in patients with recent AMI. Cardiac MRI has high reproducibility and accuracy, allowing detailed functional assessment and characterisation of myocardial tissue. In addition to traditional measures including infarct size (IS), transmural extent of necrosis and microvascular obstruction (MVO), other infarct characteristics can now be identified using innovative MRI techniques. These novel pathologies include myocardial oedema and myocardial haemorrhage which also have functional and prognostic implications for patients. In addition to its diagnostic utility in ordinary clinical practice, cardiac MRI has been increasingly used to provide information on surrogate outcome measures, such as left ventricular ejection fraction (LVEF) and volumes, in clinical trials. MRI is becoming more available in secondary care, however, the potential clinical utility and cost effectiveness of MRI in post-MI patients remains uncertain. Cardiac MRI is most likely to be useful in high risk patients with risk factors for heart failure (HF). This includes individuals with early signs of pump failure and risk factors for adverse remodelling, such as MVO. This review focuses on the role of cardiac MRI in the assessment of patients with AMI. (Heart, Lung and Circulation 2013;22:243-255) (C) 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved. C1 [Ahmed, Nadeem; Carrick, David; Layland, Jamie; Berry, Colin] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow G12 8QQ, Lanark, Scotland. [Carrick, David; Layland, Jamie; Oldroyd, Keith G.; Berry, Colin] Golden Jubilee Natl Hosp, Dept Cardiol, Glasgow G81 4DY, Lanark, Scotland. C3 RLUK- Research Libraries UK; University of Glasgow; Golden Jubilee Hospital RP Berry, C (通讯作者)，Univ Glasgow, Inst Cardiovasc & Med Sci, 126 Univ Pl, Glasgow G12 8TA, Lanark, Scotland. EM colin.berry@glasgow.ac.uk RI Oldroyd, Keith G/C-2281-2014; Berry, Colin/AAF-5268-2020 OI Oldroyd, Keith G/0000-0002-7842-3463; Berry, Colin/0000-0002-4547-8636 FU British Heart Foundation; Chief Scientist Office; Scottish Diabetes Research Network; Engineering and Physical Sciences Council; Medical Research Scotland; Scottish Funding Council; British Heart Foundation [PG/11/2/28474] Funding Source: researchfish; Chief Scientist Office [SCD/01] Funding Source: researchfish FX Our research is supported by grants from the British Heart Foundation, Chief Scientist Office, Scottish Diabetes Research Network, the Engineering and Physical Sciences Council, Medical Research Scotland, and the Scottish Funding Council. 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PD APR PY 2013 VL 22 IS 4 BP 243 EP 255 DI 10.1016/j.hlc.2012.11.016 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 130AS UT WOS:000317885700001 PM 23279917 DA 2023-05-13 ER PT J AU Wilkins, B Hullikunte, S Simmonds, M Sasse, A Larsen, P Harding, SA AF Wilkins, Ben Hullikunte, Satish Simmonds, Mark Sasse, Alexander Larsen, Peter Harding, Scott A. TI Improving the Prescribing Gap For Guideline Recommended Medications Post Myocardial Infarction SO HEART LUNG AND CIRCULATION LA English DT Article DE Acute myocardial infarction; Secondary prevention; Evidence-based medicine; Guideline adherence ID ACUTE CORONARY SYNDROMES; EVIDENCE-BASED THERAPIES; ASSOCIATION TASK-FORCE; AMERICAN-COLLEGE; SECONDARY PREVENTION; PERFORMANCE-MEASURES; ST-ELEVATION; OUTCOMES; CARE; PREDICTORS AB Background We assessed the effect of a pre-discharge medication checklist on discharge prescription rates of guideline recommended medications following myocardial infarction. In addition, we assessed what proportion of the residual prescribing gap following implementation of the checklist was due to the presence of contraindications. Methods We examined baseline prescription rates of guideline recommended medications in 100 patients discharged from our institution following acute myocardial infarction. We then introduced a pre-discharge checklist and reassessed discharge medications and reasons for non-prescription of guideline recommended medications in 447 patients with acute myocardial infarction. Results We demonstrated a significant gap in the prescription of guideline recommended secondary prevention medications at the time of discharge in our pre-intervention cohort. Introduction of a pre-discharge checklist resulted in a significant improvement in the prescription rates of all guideline recommended secondary prevention medications, with aspirin increasing from 90% to 97% (p = 0.004), Adenosine diphosphate (ADP) receptor antagonist from 84% to 96% (p = 0.0001), B-blocker from 79% to 87% (p = 0.03), statin from 88% to 96% (p = 0.002) and angiotensin converting enzyme (ACE) inhibitor from 58% to 70% (p = 0.03). The residual gap in prescribing was largely explained by the presence of contraindications or absence of an indication in the case of ACE-inhibitors. Once these were taken into account there was a residual gap of 0-4% which represents genuine non-adherence to the guidelines. Conclusions Introduction of a pre-discharge checklist led to significant improvement in prescription rates of all five guideline recommended secondary prevention medications. The residual gap in medication prescription following introduction of the checklist was largely due to the presence of contraindications rather than non-adherence. C1 [Wilkins, Ben; Hullikunte, Satish; Simmonds, Mark; Sasse, Alexander; Harding, Scott A.] Wellington Hosp, Dept Cardiol, Wellington, New Zealand. [Sasse, Alexander; Larsen, Peter; Harding, Scott A.] Wellington Cardiovasc Res Grp, Wellington, New Zealand. [Larsen, Peter] Univ Otago, Wellington, New Zealand. [Harding, Scott A.] Victoria Univ Wellington, Wellington, New Zealand. C3 University of Otago; Victoria University Wellington RP Harding, SA (通讯作者)，Wellington Hosp, Dept Cardiol, Private Bag 7902, Wellington, New Zealand. 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PD FEB PY 2019 VL 28 IS 2 BP 257 EP 262 DI 10.1016/j.hlc.2017.10.025 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HH3ZU UT WOS:000455660200018 PM 29523466 DA 2023-05-13 ER PT J AU Lee, JH Bae, MH Yang, DH Park, HS Cho, Y Jeong, MH Kim, YJ Kim, KS Hur, SH Seong, IW Cho, MC Kim, CJ Chae, SC AF Lee, Jang Hoon Bae, Myung Hwan Yang, Dong Heon Park, Hun Sik Cho, Yongkeun Jeong, Myung Ho Kim, Young Jo Kim, Kee-Sik Hur, Seung Ho Seong, In Whan Cho, Myeong Chan Kim, Chong Jin Chae, Shung Chull CA Korea Acute Myocardial Infarction TI Contemporary Trends of Optimal Evidence-Based Medical Therapy at Discharge for Patients Surviving Acute Myocardial Infarction From the Korea Acute Myocardial Infarction Registry SO CLINICAL CARDIOLOGY LA English DT Article ID QUALITY-OF-CARE; ACUTE CORONARY SYNDROMES; ASSOCIATION TASK-FORCE; ST-SEGMENT ELEVATION; GUIDELINE ADHERENCE; AMERICAN-COLLEGE; ELDERLY-PATIENTS; MANAGEMENT; MORTALITY; IMPROVEMENT AB BackgroundTemporal trends of evidence-based optimal medical therapy (OMT) at discharge after acute myocardial infarction (AMI) have not been investigated in recent years. HypothesisOMT should have been increased in AMI and gap between guidelines and practices in its use should have been narrowed. MethodsWe examined discharge medications of 17,578 post-MI patients who had no documented contraindications to antiplatelet agents, -blockers, angiotensin-converting enzyme inhibitors, or statins across a 6-year period (divided into subperiods of November 2005 to December 2006 [period 1], 2007 [period 2], 2008 [period 3], 2009 [period 4], 2010 [period 5], and January to June 2011 [period 6]) in the Korean AMI Registry. OMT was defined as use of all 4 indicated medications. ResultsMarked increases in OMT (48.6% to 63.2%) were seen irrespective of age and sex, mainly attributed to marked increases in the use of -blockers (70.3% to 83.7%) and statins (76.9% to 82.6%) from period 1 to period 6. The gap in use of OMT between men and women narrowed over time between the first and second 3 periods, but not between the young and the elderly. Advanced age (odds ratio [OR]: 0.88, P = 0.04) was independently associated with underuse of OMT. Adjusted ORs for OMT from period 1 to period 6 were as follows: 1, 1.14 (P = 0.024), 1.21 (P = 0.001), 1.40 (P < 0.001), 1.47 (P < 0.001), and 1.69 (P < 0.001), respectively. ConclusionsDespite gradual increase in OMT over time, the gap between guidelines and practices in use of OMT continues to exist. C1 [Lee, Jang Hoon; Bae, Myung Hwan; Yang, Dong Heon; Park, Hun Sik; Cho, Yongkeun; Chae, Shung Chull] Kyungpook Natl Univ Hosp, Dept Internal Med, Daegu 700721, South Korea. [Jeong, Myung Ho] Chonnam Natl Univ Hosp, Dept Internal Med, Gwangju, South Korea. [Kim, Young Jo] Yeungnam Univ Hosp, Dept Internal Med, Daegu, South Korea. [Kim, Kee-Sik] Daegu Catholic Univ Hosp, Dept Internal Med, Daegu, South Korea. [Hur, Seung Ho] Keimyung Univ, Dept Internal Med, Dongsan Med Ctr, Daegu, South Korea. [Seong, In Whan] Chungnam Natl Univ Hosp, Dept Internal Med, Taejon, South Korea. [Cho, Myeong Chan] Chungbuk Natl Univ, Dept Internal Med, Coll Med, Cheongju, South Korea. [Kim, Chong Jin] Kyung Hee Univ, Dept Internal Med, East West Neo Med Ctr, Seoul, South Korea. C3 Kyungpook National University; Kyungpook National University Hospital; Chonnam National University; Chonnam National University Hospital; Yeungnam University; Yeungnam University Hospital; Catholic University of Daegu; Keimyung University; Chungnam National University; Chungnam National University Hospital; Chungbuk National University; Kyung Hee University RP Chae, SC (通讯作者)，Kyungpook Natl Univ Hosp, Dept Internal Med, 50 Samduk 2 Ga, Daegu 700721, South Korea. EM scchae@knu.ac.kr OI Seong, In-Whan/0000-0003-4628-0258; Jeong, Jin-Ok/0000-0003-0763-4754 CR Allison JJ, 2000, JAMA-J AM MED ASSOC, V284, P1256, DOI 10.1001/jama.284.10.1256 Alpert JS, 2000, J AM COLL CARDIOL, V36, P959, DOI 10.1016/S0735-1097(00)00804-4 Anderson JL, 2007, CIRCULATION, V116, pE148, DOI 10.1161/CIRCULATIONAHA.107.181940 Antman EM, 2008, CIRCULATION, V117, P296, DOI 10.1161/CIRCULATIONAHA.107.188209 Burwen DR, 2003, ARCH INTERN MED, V163, P1430, DOI 10.1001/archinte.163.12.1430 Chen J, 1999, NEW ENGL J MED, V340, P286, DOI 10.1056/NEJM199901283400407 Choudhry NK, 2011, NEW ENGL J MED, V365, P2088, DOI 10.1056/NEJMsa1107913 Fornasini M, 2010, AM J MED, V123, P166, DOI 10.1016/j.amjmed.2009.06.031 Goldberg RJ, 2007, ARCH INTERN MED, V167, P1766, DOI 10.1001/archinte.167.16.1766 Granger CB, 2005, AM J MED, V118, P858, DOI 10.1016/j.amjmed.2005.01.070 Health Insurance Review & Assessment Service, 2013, HIRA INTR FUNCT Health Insurance Review & Assessment Service, COMPR QUAL REP 2012 Jackevicius CA, 2008, CIRCULATION, V117, P1028, DOI 10.1161/CIRCULATIONAHA.107.706820 Kohro T, 2007, CIRC J, V71, P1835, DOI 10.1253/circj.71.1835 Krumholz HM, 1996, ANN INTERN MED, V124, P292, DOI 10.7326/0003-4819-124-3-199602010-00002 Krumholz HM, 1998, JAMA-J AM MED ASSOC, V280, P623, DOI 10.1001/jama.280.7.623 Lee JH, 2010, AM HEART J, V159, P1012, DOI 10.1016/j.ahj.2010.03.009 Lewis WR, 2008, ARCH INTERN MED, V168, P1813, DOI 10.1001/archinte.168.16.1813 McLaughlin TJ, 1996, ARCH INTERN MED, V156, P799, DOI 10.1001/archinte.156.7.799 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 Mukherjee D, 2004, CIRCULATION, V109, P745, DOI 10.1161/01.CIR.0000112577.69066.CB Rathore SS, 2003, AM J MED, V114, P307, DOI 10.1016/S0002-9343(02)01531-0 Ray KK, 2006, EUR HEART J, V27, P2310, DOI 10.1093/eurheartj/ehl180 Shepherd J, 2002, LANCET, V360, P1623, DOI 10.1016/S0140-6736(02)11600-X Simpson E, 2003, AM HEART J, V145, P438, DOI 10.1067/mhj.2003.143 Somma KA, 2012, CIRC-CARDIOVASC QUAL, V5, P654, DOI 10.1161/CIRCOUTCOMES.111.963959 Spencer FA, 2005, AM HEART J, V150, P838, DOI 10.1016/j.ahj.2004.11.005 Yan AT, 2007, AM HEART J, V154, P1108, DOI 10.1016/j.ahj.2007.07.040 Yan RT, 2006, AM HEART J, V151, P352, DOI 10.1016/j.ahj.2005.03.039 NR 30 TC 7 Z9 7 U1 0 U2 2 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 2015 VL 38 IS 6 BP 350 EP 356 DI 10.1002/clc.22396 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CL1DT UT WOS:000356683500004 PM 25962712 OA Green Published DA 2023-05-13 ER PT J AU Morel, O Muller, C Jesel, L Moulin, B Hannedouche, T AF Morel, Olivier Muller, Clotilde Jesel, Laurence Moulin, Bruno Hannedouche, Thierry TI Impaired platelet P2Y12 inhibition by thienopyridines in chronic kidney disease: mechanisms, clinical relevance and pharmacological options SO NEPHROLOGY DIALYSIS TRANSPLANTATION LA English DT Review DE percutaneous coronary; platelet; stent; thienopyridines; thrombosis ID PERCUTANEOUS CORONARY INTERVENTION; CHRONIC-RENAL-FAILURE; DIABETES-MELLITUS PATIENTS; ORAL ANTIPLATELET THERAPY; DRUG-ELUTING STENTS; NITRIC-OXIDE SYNTHESIS; GLYCOPROTEIN-IIB-IIIA; MYOCARDIAL-INFARCTION; HEMODIALYSIS-PATIENTS; ISCHEMIC EVENTS AB Patients with chronic kidney disease (CKD) represent an increasing proportion of the population undergoing percutaneous coronary intervention (PCI) and up to 40% of the patients treated for acute coronary syndrome (ACS). Several studies and registries in the setting of ACS and elective PCI have reported a negative association between CKD and mortality, stent thrombosis, post-procedural ischaemic events and bleeding events. Pharmacological inhibition of the adenosine diphosphate receptor by thienopyridines or ticagrelor and disruption of the cyclooxygenase pathway by aspirin constitute the current standards of care to prevent thrombotic complications following stent-based PCI. In CKD patients, the avoidance of anti-platelet therapy may be driven by the lack of clinical trial data to support its efficacy, by errors or omissions, or by a reluctance to use this therapy in a population characterized by its enhanced bleeding risk. However, there is growing evidence to suggest that a severely decreased glomerular filtration rate per se, independent of the presence of diabetes mellitus, is an important determinant of high residual platelet reactivity under a clopidogrel maintenance dose. Recent reports have emphasized that the impact of impaired platelet inhibition by thienopyridines is of paramount importance in CKD patients, with an enhanced mortality rate in low-responder patients. Pharmacodynamic studies indicate the phosphodiesterase 3 inhibitor, cilostazol, the third generation thienopyridine prasugrel and the reversible P2Y12 antagonist ticagrelor to be potent strategies to overcome this biological resistance. In clinical practice, platelet function testing should be considered in CKD patients undergoing PCI, especially in those who experience thrombotic events despite dual therapy. Newer agents should be contemplated in patients who display higher residual platelet aggregability after standard treatment. Among these, the non-thienopyridine P2Y12 receptor antagonist ticagrelor, which does not require biotransformation, could be the drug of choice in CKD patients with ACS. In this population, ticagrelor has been found to reduce mortality and ischaemic events with an acceptable bleeding risk. C1 [Morel, Olivier; Jesel, Laurence] Univ Strasbourg, Nouvel Hop Civil, Pole Act Medicochirurg Cardiovasc, Strasbourg, France. [Morel, Olivier; Jesel, Laurence] Univ Strasbourg, EA Transplantat & Stress Vasc, Strasbourg, France. [Muller, Clotilde; Moulin, Bruno; Hannedouche, Thierry] Univ Strasbourg, Nouvel Hop Civil, Pole NUDE, Strasbourg, France. C3 CHU Strasbourg; UDICE-French Research Universities; Universites de Strasbourg Etablissements Associes; Universite de Strasbourg; UDICE-French Research Universities; Universites de Strasbourg Etablissements Associes; Universite de Strasbourg; CHU Strasbourg; UDICE-French Research Universities; Universites de Strasbourg Etablissements Associes; Universite de Strasbourg RP Morel, O (通讯作者)，Univ Strasbourg, Nouvel Hop Civil, Pole Act Medicochirurg Cardiovasc, Strasbourg, France. 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Dial. Transplant. PD AUG PY 2013 VL 28 IS 8 BP 1994 EP 2002 DI 10.1093/ndt/gft027 PG 9 WC Transplantation; Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Transplantation; Urology & Nephrology GA 219FC UT WOS:000324490500012 PM 23476040 OA Bronze DA 2023-05-13 ER PT J AU Yang, ZY Xie, ZL Pei, XL Quan, XQ Feng, DG AF Yang, Zhiyuan Xie, Zhouliang Pei, Xueliang Quan, Xiaoqiang Feng, Deguang TI Effect of thrombelastography on timing of coronary artery bypass grafting SO EXPERIMENTAL AND THERAPEUTIC MEDICINE LA English DT Article DE thrombelastography; coronary artery bypass grafting; surgical timing ID DUAL ANTIPLATELET THERAPY; PLATELET-FUNCTION TESTS; CLOPIDOGREL; REACTIVITY; DISEASE; MANAGEMENT; TICAGRELOR; UPDATE AB The guiding value of thrombelastography (TEG) on the selection of surgical timing for patients scheduled for coronary artery bypass grafting (CABG) was investigated. A total of 90 subjects with acute coronary syndrome (ACS) treated between February 2014 and December 2016 in Henan Provincial People's Hospital were recruited. The patients received dual antiplatelet therapy (DAPT) and were scheduled for CABG. Subjects were randomly allocated into two groups, TEG group (n=45) and non TEG group (n=45). Patients in the TEG group withheld medications at 24 h prior to surgery and received TEG examination. Based on maximum amplitude of adenosine diphosphate (MA(ADP)), subjects were further grouped into three sub-groups with MA(ADP) <35 mm, 35-50 mm, and >50 mm, and accordingly received CABG within 1 day, 3-5 days and 5 days later, respectively. Subjects in the control group (non-TEG group) received CABG 5-7 days after medication withdrawal. Chest drainage volume within 24 h after surgery and red blood cell transfusion during perioperative period were compared. Other recorded parameters were incubation period, intensive care unit length of stay, hospital stay, incidence of 30-day adverse events and readmission rate. The average waiting time before CABG for patients of TEG group was shorter compared with the commonly recommended time. The red blood cell transfusions during perioperative period of subjects in TEG group and non-TEG group were significantly different (P=0.23). The median hospital stay of subjects in TEG group was shorter than that of non TEG group (P=0.037). The bleeding amount of patients in TEG group was 220.16 +/- 80.56 ml, which was significantly lower than that of non-TEG group (435.29 +/- 90.16). The difference was statistically significant (P=0.032). The results suggested that TEG assay-based evaluation of platelet function for patients scheduled for CABG reasonably guides surgeons appropriate surgical timing and reduces the amount of time patients wait to be treated. C1 [Yang, Zhiyuan; Xie, Zhouliang; Pei, Xueliang; Quan, Xiaoqiang; Feng, Deguang] Henan Prov Peoples Hosp, Dept Cardiovasc Surg, 7 Weiwu Rd, Zhengzhou 450003, Henan, Peoples R China. C3 Zhengzhou University RP Xie, ZL (通讯作者)，Henan Prov Peoples Hosp, Dept Cardiovasc Surg, 7 Weiwu Rd, Zhengzhou 450003, Henan, Peoples R China. EM xiezhouliang2016@163.com OI Pei, Xueliang/0000-0002-6078-4885 CR Barbieri L, 2016, VASC PHARMACOL, V79, P11, DOI 10.1016/j.vph.2015.10.006 Bochsen Louise, 2007, Thromb J, V5, P3, DOI 10.1186/1477-9560-5-3 Bomb R, 2015, AM J CARDIOL, V116, P148, DOI 10.1016/j.amjcard.2015.03.050 Cheng JWM, 2012, CLIN THER, V34, P1209, DOI 10.1016/j.clinthera.2012.04.005 Dias JD, 2015, ARCH PATHOL LAB MED, V139, P665, DOI 10.5858/arpa.2014-0170-OA Fitchett D, 2009, CAN J CARDIOL, V25, P683, DOI 10.1016/S0828-282X(09)70527-6 Hansson EC, 2017, EUR J CARDIO-THORAC, V51, P633, DOI 10.1093/ejcts/ezw373 James K, 2010, LIVER TRANSPLANT, V16, P38, DOI 10.1002/lt.21933 Janssen PWA, 2017, NETH HEART J, V25, P482, DOI 10.1007/s12471-017-1006-z Karon BS, 2014, CLIN CHEM, V60, P1524, DOI 10.1373/clinchem.2014.226332 Levine GN, 2016, J THORAC CARDIOV SUR, V152, P1243, DOI 10.1016/j.jtcvs.2016.07.044 Pilgrim T, 2014, HEART, V100, P1750, DOI 10.1136/heartjnl-2013-305399 Ramakrishna H, 2017, J CARDIOTHOR VASC AN, V31, P1, DOI 10.1053/j.jvca.2016.10.009 Roffi M, 2016, CURR CARDIOL REP, V18, DOI 10.1007/s11886-016-0722-0 Tang XF, 2015, CHINESE MED J-PEKING, V128, P774, DOI 10.4103/0366-6999.152611 Tantry US, 2013, J AM COLL CARDIOL, V62, P2261, DOI 10.1016/j.jacc.2013.07.101 van Diepen S, 2017, J AM COLL CARDIOL, V69, P119, DOI 10.1016/j.jacc.2016.10.043 Verma S, 2015, BMC SURG, V15, DOI 10.1186/s12893-015-0096-z Yanagawa B, 2015, J THORAC CARDIOV SUR, V150, P1548, DOI 10.1016/j.jtcvs.2015.08.066 Yao Y, 2016, CHINESE MED J-PEKING, V129, P2269, DOI 10.4103/0366-6999.190664 NR 20 TC 6 Z9 6 U1 0 U2 0 PU SPANDIDOS PUBL LTD PI ATHENS PA POB 18179, ATHENS, 116 10, GREECE SN 1792-0981 EI 1792-1015 J9 EXP THER MED JI Exp. Ther. Med. PD AUG PY 2018 VL 16 IS 2 BP 579 EP 584 DI 10.3892/etm.2018.6202 PG 6 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA GR1GO UT WOS:000442280500015 PM 30116315 OA Green Submitted, gold, Green Published DA 2023-05-13 ER PT J AU Li, X Sousa-Casasnovas, I Devesa, C Juarez, M Fernandez-Aviles, F Martinez-Selles, M AF Li, Xin Sousa-Casasnovas, Iago Devesa, Carolina Juarez, Miriam Fernandez-Aviles, Francisco Martinez-Selles, Manuel TI Predictors of in-hospital mortality among cardiogenic shock patients. Prognostic and therapeutic implications SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Cardiogenic shock; INTERMACS; Prognosis; Management ID ACUTE MYOCARDIAL-INFARCTION; CRITICALLY-ILL PATIENTS; VENTRICULAR ASSIST DEVICE; INTERMACS PROFILES; HEART-FAILURE; MANAGEMENT; OUTCOMES; TRENDS; RISK; HYPERGLYCEMIA AB Background: Cardiogenic shock (CS) has a poor prognosis. The heterogeneity in the mortality through different subgroups suggests that some factors can be useful to perform risk stratification and guide management. We aimed to find predictors of in-hospital mortality in these patients. Methods: We analyzed all cases of cardiogenic shock due to medical conditions admitted in our intensive acute cardiovascular care unity from November 2010 till November 2015. Clinical, biochemical and hemodynamic variables were registered, as was the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile at 24 h of CS diagnosis. From a total of 281 patients, 28 died within the first 24 h and were not included in the analysis. Results: A total of 253 patients survived the first 24 h, mean age was 68.8 +/- 14.4 years, and 174 (68.8%) were men. Etiologies: acute coronary syndrome 146 (57.7%), acute heart failure 60 (23.7%), arrhythmias 35 (13.8%), and others 12 (4.8%). A total of 91 patients (36.0%) died during hospitalization. We found the following independent predictors of in-hospital mortality: age (odds ratio [OR] 1.032, 95% confidence interval [CI] 1.003-1.062), blood glucose (OR 1.004, 95% CI 1.001-1.008), heart rate (OR 1.014, 95% CI 1.001-1.028), and INTERMACS profile (OR 0.168, 95% CI 0.107-0.266). Conclusions: In patients with CS the INTERMACS profile at 24 h of diagnosis was associated with higher in-hospital mortality. This and other prognostic variables (age, blood glucose, and heart rate) may be useful for risk stratification and to select appropriate medical or invasive interventions. (C) 2016 Elsevier Ireland Ltd. All rights reserved. C1 [Li, Xin; Sousa-Casasnovas, Iago; Devesa, Carolina; Juarez, Miriam; Fernandez-Aviles, Francisco; Martinez-Selles, Manuel] Hosp Gen Univ Gregorio Maranon, Dept Cardiol, Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain. [Fernandez-Aviles, Francisco; Martinez-Selles, Manuel] Univ Complutense Madrid, Madrid, Spain. [Martinez-Selles, Manuel] Univ Europea Madrid, Madrid, Spain. C3 General University Gregorio Maranon Hospital; Complutense University of Madrid; European University of Madrid RP Martinez-Selles, M (通讯作者)，Hosp Gen Univ Gregorio Maranon, Dept Cardiol, Calle Doctor Esquerdo, Madrid 28007, Spain. EM mmselles@secardiologia.es OI Fernandez-Aviles, Francisco/0000-0001-5501-5275; Martinez-Selles, Manuel/0000-0003-0289-6229 CR Aissaoui N, 2012, EUR HEART J, V33, P2535, DOI 10.1093/eurheartj/ehs264 Alba AC, 2009, J HEART LUNG TRANSPL, V28, P827, DOI 10.1016/j.healun.2009.04.033 Barge-Caballero E, 2013, CIRC-HEART FAIL, V6, P763, DOI 10.1161/CIRCHEARTFAILURE.112.000237 Boyle AJ, 2011, J HEART LUNG TRANSPL, V30, P402, DOI 10.1016/j.healun.2010.10.016 Davies MG, 1997, BRIT J SURG, V84, P920, DOI 10.1002/bjs.1800840707 De Luca L, 2015, EUR J HEART FAIL, V17, P1124, DOI 10.1002/ejhf.339 Falciglia M, 2009, CRIT CARE MED, V37, P3001, DOI 10.1097/CCM.0b013e3181b083f7 Goldberg RJ, 2009, CIRCULATION, V119, P1211, DOI 10.1161/CIRCULATIONAHA.108.814947 Harjola VP, 2015, EUR J HEART FAIL, V17, P501, DOI 10.1002/ejhf.260 Hochman JS, 1999, NEW ENGL J MED, V341, P625, DOI 10.1056/NEJM199908263410901 Hochman JS, 2003, CIRCULATION, V107, P2998, DOI 10.1161/01.CIR.0000075927.67673.F2 Jeger RV, 2008, ANN INTERN MED, V149, P618, DOI 10.7326/0003-4819-149-9-200811040-00005 Katz JN, 2009, AM HEART J, V158, P680, DOI 10.1016/j.ahj.2009.08.005 Kirklin JK, 2015, J HEART LUNG TRANSPL, V34, P1495, DOI 10.1016/j.healun.2015.10.003 Kohsaka S, 2005, ARCH INTERN MED, V165, P1643, DOI 10.1001/archinte.165.14.1643 Krinsley JS, 2003, MAYO CLIN PROC, V78, P1471, DOI 10.4065/78.12.1471 Mebazaa A, 2015, EUR J HEART FAIL, V17, P544, DOI 10.1002/ejhf.289 Mehta RH, 2007, AM J CARDIOL, V99, P793, DOI 10.1016/j.amjcard.2006.10.035 Ponikowski P, 2016, EUR J HEART FAIL, V18, P891, DOI 10.1002/ejhf.592 Reynolds HR, 2008, CIRCULATION, V117, P686, DOI 10.1161/CIRCULATIONAHA.106.613596 Rose EA, 2001, NEW ENGL J MED, V345, P1435, DOI 10.1056/NEJMoa012175 Rudiger A, 2015, EUR J HEART FAIL, V17, P466, DOI 10.1002/ejhf.265 Sander O, 2005, CRIT CARE MED, V33, P81, DOI 10.1097/01.CCM.0000150028.64264.14 Sleeper LA, 2010, AM HEART J, V160, P443, DOI 10.1016/j.ahj.2010.06.024 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Stevenson LW, 2009, J HEART LUNG TRANSPL, V28, P535, DOI 10.1016/j.healun.2009.02.015 Thiele H, 2012, NEW ENGL J MED, V367, P1287, DOI 10.1056/NEJMoa1208410 WERNOVSKY G, 1995, CIRCULATION, V92, P2226, DOI 10.1161/01.CIR.92.8.2226 Windecker S, 2014, EUR HEART J, V35, P2541, DOI [10.5603/KP.2014.0224, 10.1093/eurheartj/ehu278, 10.1093/ejcts/ezu366] Yoshioka D, 2012, CIRC J, V76, P1631, DOI 10.1253/circj.CJ-11-1452 Zeymer U, 2004, EUR HEART J, V25, P322, DOI 10.1016/j.ehj.2003.12.008 NR 31 TC 9 Z9 11 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 DEC 1 PY 2016 VL 224 BP 114 EP 118 DI 10.1016/j.ijcard.2016.09.019 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EF6WH UT WOS:000390471300023 PM 27648979 DA 2023-05-13 ER PT J AU Greenwood, JP Herzog, BA Brown, JM Everett, CC Nixon, J Bijsterveld, P Maredia, N Motwani, M Dickinson, CJ Ball, SG Plein, S AF Greenwood, John P. Herzog, Bernhard A. Brown, Julia M. Everett, Colin C. Nixon, Jane Bijsterveld, Petra Maredia, Neil Motwani, Manish Dickinson, Catherine J. Ball, Stephen G. Plein, Sven TI Prognostic Value of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography in Suspected Coronary Heart Disease: Long-Term Follow-up of a Prospective, Diagnostic Accuracy Cohort Study SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID MYOCARDIAL-PERFUSION ASSESSMENT; ARTERY-DISEASE; MR-IMPACT; TC-99M-TETROFOSMIN SPECT; STRESS PERFUSION; NORMAL EXERCISE; CE-MARC; RISK; TRIAL; MULTICENTER AB Background: There are no prospective, prognostic data comparing cardiovascular magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) in the same population of patients with suspected coronary heart disease (CHD). Objective: To establish the ability of CMR and SPECT to predict major adverse cardiovascular events (MACEs). Design: Annual follow-up of the CE-MARC (Clinical Evaluation of MAgnetic Resonance imaging in Coronary heart disease) study for a minimum of 5 years for MACEs (cardiovascular death, acute coronary syndrome, unscheduled revascularization or hospital admission for cardiovascular cause). (Current Controlled Trials registration: ISRCTN77246133) Setting: Secondary and tertiary care cardiology services. Participants: 752 patients from the CE-MARC study who were being investigated for suspected CHD. Measurements: Prediction of time to MACE was assessed by using univariable (log-rank test) and multivariable (Cox proportional hazards regression) analysis. Results: 744 (99%) of the 752 recruited patients had complete follow-up. Of 628 who underwent CMR, SPECT, and the reference standard test of X-ray angiography, 104 (16.6%) had at least 1 MACE. Abnormal findings on CMR (hazard ratio, 2.77 [95% CI, 1.85 to 4.16]; P < 0.001) and SPECT (hazard ratio, 1.62 [CI, 1.11 to 2.38; P = 0.014) were both strong and independent predictors of MACE. Only CMR remained a significant predictor after adjustment for other cardiovascular risk factors, angiography result, or stratification for initial patient treatment. Limitation: Data are from a single-center observational study (albeit conducted in a high-volume institution for both CMR and SPECT). Conclusion: Five-year follow-up of the CE-MARC study indicates that compared with SPECT, CMR is a stronger predictor of risk for MACEs, independent of cardiovascular risk factors, angiography result, or initial patient treatment. This further supports the role of CMR as an alternative to SPECT for the diagnosis and management of patients with suspected CHD. C1 [Greenwood, John P.; Motwani, Manish; Ball, Stephen G.; Plein, Sven] Univ Leeds, Multidisciplinary Cardiovasc Res Ctr, LIGHT Bldg,Clarendon Way, Leeds LS2 9JT, W Yorkshire, England. [Greenwood, John P.; Motwani, Manish; Ball, Stephen G.; Plein, Sven] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, LIGHT Bldg,Clarendon Way, Leeds LS2 9JT, W Yorkshire, England. [Herzog, Bernhard A.] Heart Clin Lucerne, St Anna Str 32, CH-6006 Luzern, Switzerland. [Brown, Julia M.; Everett, Colin C.; Nixon, Jane] Univ Leeds, Clin Trials Res Unit, Leeds Inst Clin Trials Res, Clarendon Rd, Leeds LS2 9JT, W Yorkshire, England. [Bijsterveld, Petra; Dickinson, Catherine J.] Leeds Gen Infirm, Dept Cardiol, Old X39,Main Site,Great George St, Leeds LS1 3EX, W Yorkshire, England. [Maredia, Neil] James Cook Univ Hosp, Marton Rd, Middlesbrough TS4 3BW, Cleveland, 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; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; Leeds General Infirmary; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; James Cook University Hospital RP Greenwood, JP (通讯作者)，Univ Leeds, Multidisciplinary Cardiovasc Res Ctr, LIGHT Bldg,Clarendon Way, Leeds LS2 9JT, W Yorkshire, England.; Greenwood, JP (通讯作者)，Univ Leeds, Leeds Inst Cardiovasc & Metab Med, LIGHT Bldg,Clarendon Way, Leeds LS2 9JT, W Yorkshire, England. EM j.greenwood@leeds.ac.uk OI Bijsterveld, Petra/0000-0002-9257-5850; Plein, Sven/0000-0002-0997-4384; brown, julia/0000-0002-2719-7064 FU British Heart Foundation; British Heart Foundation [FS/10/62/28409] Funding Source: researchfish FX British Heart Foundation. 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Intern. Med. PD JUL 5 PY 2016 VL 165 IS 1 BP 1 EP + DI 10.7326/M15-1801 PG 11 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA DQ5AD UT WOS:000379215800002 PM 27158921 OA Green Accepted DA 2023-05-13 ER PT J AU Puurunen, M Kiviniemi, T Nammas, W Schlitt, A Rubboli, A Nyman, K Karjalainen, P Kirchhof, P Lip, GYH Airaksinen, JKE AF Puurunen, Marja Kiviniemi, Tuomas Nammas, Wail Schlitt, Axel Rubboli, Andrea Nyman, Kai Karjalainen, Pasi Kirchhof, Paulus Lip, Gregory Y. H. Airaksinen, Juhani K. E. TI Impact of anaemia on clinical outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry SO BMJ OPEN LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; ORAL ANTICOAGULATION; ANTITHROMBOTIC THERAPY; PRIMARY ANGIOPLASTY; STENT IMPLANTATION; CONSENSUS DOCUMENT; MANAGEMENT; ASSOCIATION; MORTALITY; ADMISSION AB Objectives: Anaemia has an adverse impact on the outcome in the general patient population undergoing percutaneous coronary intervention (PCI). The aim of this study was to analyse the impact of anaemia on the 12-month clinical outcome of patients with atrial fibrillation (AF) undergoing PCI and therefore requiring intense antithrombotic treatment. We hypothesised that anaemia might be associated with a worse outcome and more bleeding in these anticoagulated patients. Setting: Data were collected from 17 secondary care centres in Europe. Participants: Consecutive patients with AF undergoing PCI were enrolled in the prospective, multicenter AFCAS (Atrial Fibrillation undergoing Coronary Artery Stenting) registry. Altogether, 929 patients participated in the study. Preprocedural haemoglobin concentration was available for 861 (92.7%; 30% women). The only exclusion criteria were inability or unwillingness to give informed consent. Anaemia was defined as a haemoglobin concentration of <12 g/dL for women and <13 g/dL for men. Outcome measures: The primary endpoint was occurrence of major adverse cardiac and cerebrovascular events (MACCE) or bleeding events. Results: 258/861 (30%) patients had anaemia. Anaemic patients were older, more often had diabetes, higher CHA(2)DS(2)-VASc scores, prior history of heart failure, chronic renal impairment and acute coronary syndrome. Anaemic patients had more MACCE than non-anaemic (29.1% vs 19.4%, respectively, p=0.002), and minor bleeding events (7.0% vs 3.3%, respectively, p=0.028), with a trend towards more total bleeding events (25.2% vs 21.7%, respectively, p=0.059). No difference was observed in antithrombotic regimens at discharge. In multivariate analysis, anaemia was an independent predictor of all-cause mortality at 12-month follow-up (hazard ratio 1.62, 95% CI 1.05 to 2.51, p=0.029). Conclusions: Anaemia was a frequent finding in patients with AF referred for PCI. Anaemic patients had a higher all-cause mortality, more thrombotic events and minor bleeding events. Anaemia seems to be an identification of patients at risk for cardiovascular events and death. C1 [Puurunen, Marja] Finnish Red Cross Blood Serv, Hemostasis Lab, Helsinki, Finland. [Kiviniemi, Tuomas; Nammas, Wail; Airaksinen, Juhani K. E.] Turku Univ Hosp, Ctr Heart, FIN-20520 Turku, Finland. [Kiviniemi, Tuomas; Nammas, Wail; Airaksinen, Juhani K. E.] Univ Turku, Turku, Finland. [Schlitt, Axel] Univ Halle Wittenberg, Fac Med, D-06108 Halle, Germany. [Rubboli, Andrea] Osped Maggiore Bologna, Lab Intervent Cardiol, Div Cardiol, Bologna, Italy. [Nyman, Kai] Cent Finland Cent Hosp, Dept Cardiol, Jyvaskyla, Finland. [Karjalainen, Pasi] Satakunta Cent Hosp, Ctr Heart, Pori, Finland. [Kirchhof, Paulus; Lip, Gregory Y. H.] Hosp Univ Munster, Dept Cardiovasc Med, Munster, Germany. [Kirchhof, Paulus] Univ Birmingham, City Hosp, Ctr Cardiovasc Sci, Birmingham, W Midlands, England. C3 University of Turku; University of Turku; Martin Luther University Halle Wittenberg; AUSL di Bologna; Central Finland Central Hospital; Satakunta Central Hospital; University of Munster; RLUK- Research Libraries UK; University of Birmingham RP Airaksinen, JKE (通讯作者)，Turku Univ Hosp, Ctr Heart, FIN-20520 Turku, Finland. EM juhani.airaksinen@tyks.fi RI Kirchhof, Paulus/AAT-7074-2021; Kiviniemi, Tuomas/A-1107-2016; Nammas, Wail/AAB-5055-2021; Airaksinen, Juhani/AAC-7857-2021; Karjalainen, Pasi/AAE-5260-2019 OI Kirchhof, Paulus/0000-0002-1881-0197; Kiviniemi, Tuomas/0000-0002-0908-3741; Nammas, Wail/0000-0003-3356-5211; Airaksinen, Juhani/0000-0002-0193-568X; Karjalainen, Pasi/0000-0003-2102-5381 FU Finnish Foundation for Cardiovascular Research, Helsinki, Finland FX This study was supported by grants from the Finnish Foundation for Cardiovascular Research, Helsinki, Finland. 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DiNicolantonio, James J. O'Keefe, James H. Lavie, Carl J. TI Alcohol and CV Health: Jekyll and Hyde J-Curves SO PROGRESS IN CARDIOVASCULAR DISEASES LA English DT Review DE Alcohol; Cardiovascular disease; Heart failure; Atrial fibrillation ID CORONARY-HEART-DISEASE; PERIPHERAL ARTERIAL-DISEASE; CARDIOVASCULAR RISK-FACTORS; ACUTE MYOCARDIAL-INFARCTION; RED WINE; ATRIAL-FIBRILLATION; METABOLIC SYNDROME; DRINKING PATTERN; ATHEROSCLEROSIS RISK; INSULIN SENSITIVITY AB A routine of light or moderate alcohol consumption drink/day for women and 1 to 2 drinks/day for men) is associated with a lower risk for all-cause mortality, coronary artery disease (CAD), type 2 diabetes mellitus (T2D), heart failure (HF), and stroke. Conversely, heavy drinking, (>4 drinks/day) is associated with an increased risk for death and cardiovascular (CV) disease (CVD). Excessive alcohol intake trails behind only smoking and obesity among the 3 leading causes of premature deaths in the United States (US). Heavy alcohol use is a common cause of reversible hypertension (HTN), nonischemic dilated cardiomyopathy, atrial fibrillation (AF), and stroke (both ischemic and hemorrhagic). Among males aged 15 to 59 years, alcohol abuse is perhaps the leading cause of premature death. As such, the risk-to-benefit ratio of drinking is less favorable in younger individuals. A daily habit of light to moderate drinking is ideal for those who choose to consume alcohol regularly. Red wine in particular before or during the evening meal is linked with the best long-term CV outcomes. Most of the studies on alcohol and health are observational, and correlation does not prove causation. Health care professionals should not advise nondrinkers to begin drinking because of the paucity of randomized outcome data coupled with the potential for alcohol abuse even among seemingly low risk individuals. (C) 2018 Published by Elsevier Inc. C1 [O'Keefe, Evan L.; Lavie, Carl J.] Univ Queensland, Sch Med, Ochsner Clin Sch, Dept Cardiovasc Dis,John Ochsner Heart & Vasc Ins, New Orleans, LA USA. [DiNicolantonio, James J.; O'Keefe, James H.] St Lukes Mid Amer Heart Inst, 4321 Washington St,Suite 2400, Kansas City, MO 64111 USA. C3 Ochsner Health System; University of Queensland; Saint Luke's Mid America Heart Institute RP O'Keefe, JH (通讯作者)，St Lukes Mid Amer Heart Inst, 4321 Washington St,Suite 2400, Kansas City, MO 64111 USA. 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Cardiovasc. Dis. PD MAY-JUN PY 2018 VL 61 IS 1 BP 68 EP 75 DI 10.1016/j.pcad.2018.02.001 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA GQ5ES UT WOS:000441703300011 PM 29458056 DA 2023-05-13 ER PT J AU Schopka, S Philipp, A Hilker, M Muller, T Zimmermann, M Arlt, M Rupprecht, L Schmid, C Lunz, D AF Schopka, Simon Philipp, Alois Hilker, Michael Mueller, Thomas Zimmermann, Markus Arlt, Matthias Rupprecht, Leopold Schmid, Christof Lunz, Dirk TI Clinical course and long-term outcome following venoarterial extracorporeal life support-facilitated interhospital transfer of patients with circulatory failure SO RESUSCITATION LA English DT Article DE Extracorporeal circulation; Shock; Heart arrest; Cardiopulmonary resuscitation ID MEMBRANE-OXYGENATION SUPPORT; REFRACTORY CARDIOGENIC-SHOCK; ADULT PATIENTS; TRANSPORT; QUALITY; ECMO AB Background: Interhospital transfer of patients experiencing circulatory failure and shock has a significant risk of cardiovascular deterioration and death. Extracorporeal life support (ECLS) is a rescue tool for hemodynamic stabilization that makes patient transportation much safer. Methods: Demographic data, clinical course, and outcome data were reviewed for patients who underwent placement of a venoarterial ECLS in a remote hospital and were transported to our tertiary care facility. Results: 68 patients were transported to our center with ECLS. The majority of these patients (79%) underwent cardiopulmonary resuscitation during or immediately prior to ECLS initiation. The mean patient age was 52 years, and 53 patients were male. The most common underlying diagnosis was acute coronary syndrome (60%). Overall, 23 patients underwent consecutive cardiosurgical procedures, including coronary artery bypass grafting in 12, and left ventricular assist device and biventricular assist device implantation in 11. The median duration of ECLS was 5 days. None of the patients died during transportation. Twelve of the surgically treated patients survived, as well as 21 patients with non-surgical treatment, which resulted in an overall survival of 33 patients (48.5%). Conclusion: ECLS-facilitated patient transfer enables safe interhospital transfer of critically ill patients. In this study, a relevant percentage of patients were in need of a cardiosurgical intervention. The long-term survival rate of these patients supports the further use of this time-, cost-and personnel-demanding strategy. (C) 2015 Elsevier Ireland Ltd. All rights reserved. C1 [Schopka, Simon; Philipp, Alois; Hilker, Michael; Rupprecht, Leopold; Schmid, Christof] Univ Med Ctr, Dept Cardiothorac Surg, Regensburg, Germany. [Mueller, Thomas] Univ Med Ctr, Dept Internal Med 2, Regensburg, Germany. [Lunz, Dirk] Univ Med Ctr, Dept Anaesthesiol, Regensburg, Germany. [Zimmermann, Markus] Univ Med Ctr, Emergency Unit, Regensburg, Germany. [Arlt, Matthias] Kerckhoff Klin, Dept Anaesthesiol, Bad Nauheim, Germany. C3 University of Regensburg; University of Regensburg; University of Regensburg; University of Regensburg; Kerckhoff Clinic RP Schopka, S (通讯作者)，Univ Med Ctr, Dept Cardiothorac Surg, Regensburg, Germany. 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However, adequate drug adherence has always been challenging, and different treatment regimens may lead to divergent outcomes that remain unclear under current myocardial infarction (MI) care standards. This study investigated the association between use of different preventive regimens post-AMI and patients' long-term outcomes. Methods: This cohort study used data files from the Taiwan National Health Insurance Research Database. A total of 77 520 people who were hospitalized with AMI between 2002 and 2015 were assessed. On the basis of medication possession ratio (MPR) to individual medications, eight treatment groups were examined in this study. Receiving therapy was defined as MPR 40%. We investigated the association between different treatment groups and all-cause mortality in 24 months. Results: Overall, 51 322 patients with ST-elevation MI and 26 198 with non-ST-elevation MI were included in the study. Patients received all three preventive medications show the lowest mortality in 24 months follow-up periods among all treatment groups. Patients who did not usage of any of these three preventive medications had the highest mortality in 24 months (adjusted hazard ratio, 1.78; 95% CI, 1.64-1.93). This mortality rate had the same pattern across the three cohort generations (2002-2005, 2006-2010, and 2011-2015). Conclusion: In this large population-based real-world study, usage of three preventive therapies post-MI was associated with the lowest rate of all-cause mortality. C1 [Chen, Chih-Wei; Shih, Chun-Ming; Lin, Feng-Yen; Bi, Wei-Fung; Kao, Yung-Ta; Chiang, Kuang-Hsing; Chan, Chao-Shun; Hsu, Chien-Yi; Yang, Tsung-Lin; Hsiao, Cheng-Yi; Hsiao, Bu-Yuan; Huang, Chun-Yao] Taipei Med Univ Hosp, Dept Internal Med, Div Cardiol, Taipei, Taiwan. [Chen, Chih-Wei; Shih, Chun-Ming; Lin, Feng-Yen; Bi, Wei-Fung; Kao, Yung-Ta; Chiang, Kuang-Hsing; Chan, Chao-Shun; Hsu, Chien-Yi; Yang, Tsung-Lin; Hsiao, Cheng-Yi; Hsiao, Bu-Yuan; Huang, Chun-Yao] Taipei Med Univ Hosp, Cardiovasc Res Ctr, Taipei, Taiwan. [Chen, Chih-Wei; Shih, Chun-Ming; Lin, Feng-Yen; Bi, Wei-Fung; Kao, Yung-Ta; Chiang, Kuang-Hsing; Chan, Chao-Shun; Hsu, Chien-Yi; Yang, Tsung-Lin; Hsiao, Cheng-Yi; Hsiao, Bu-Yuan; Huang, Chun-Yao] Taipei Med Univ, Taipei Heart Inst, Taipei, Taiwan. [Lin, Yi-Cheng] Taipei Med Univ Hosp, Dept Pharm, Taipei, Taiwan. [Lin, Yi-Cheng] Taipei Med Univ, Coll Pharm, Sch Pharm, Taipei, Taiwan. [Shih, Chun-Ming; Lin, Feng-Yen; Chiang, Kuang-Hsing; Hsu, Chien-Yi; Yang, Tsung-Lin; Huang, Chun-Yao] Taipei Med Univ, Coll Med, Sch Med, Dept Internal Med,Div Cardiol, Taipei, Taiwan. [Chen, Wan-Ting; Chien, Li-Nien] Taipei Med Univ, Off Data Ctr, Taipei, Taiwan. [Chien, Li-Nien] Taipei Med Univ, Coll Management, Sch Hlth Care Adm, 250 Wu Xing St, Taipei 110, Taiwan. C3 Taipei Medical University; Taipei Medical University Hospital; Taipei Medical University; Taipei Medical University Hospital; Taipei Medical University; Taipei Medical University; Taipei Medical University Hospital; Taipei Medical University; Taipei Medical University; Taipei Medical University; Taipei Medical University RP Chien, LN (通讯作者)，Taipei Med Univ, Coll Management, Sch Hlth Care Adm, 250 Wu Xing St, Taipei 110, Taiwan.; Huang, CY (通讯作者)，Taipei Med Univ Hosp, Div Cardiol, 252 Wu Xing St, Taipei 110, Taiwan.; Huang, CY (通讯作者)，Taipei Med Univ Hosp, Cardiovasc Res Ctr, Dept Internal Med, 252 Wu Xing St, Taipei 110, Taiwan. EM lnchien@tmu.edu.tw; cyhuang@h.tmu.edu.tw RI chen, want/GRX-0662-2022 OI CHIANG, KUANG-HSING/0000-0003-0376-9862; Hsu, Chien-Yi/0000-0002-9493-7325 CR BALL SG, 1993, LANCET, V342, P821 Bangalore S, 2016, MAYO CLIN PROC, V91, P51, DOI 10.1016/j.mayocp.2015.10.019 Bansilal S, 2016, J AM COLL CARDIOL, V68, P789, DOI 10.1016/j.jacc.2016.06.005 Bosco JLF, 2010, J CLIN EPIDEMIOL, V63, P64, DOI 10.1016/j.jclinepi.2009.03.001 Bucholz EM, 2016, J AM COLL CARDIOL, V67, P2378, DOI 10.1016/j.jacc.2016.03.507 Cheng J, 2014, JAMA INTERN MED, V174, P773, DOI 10.1001/jamainternmed.2014.348 Chiang FT, 2014, J FORMOS MED ASSOC, V113, P794, DOI 10.1016/j.jfma.2013.08.001 Dargie HJ, 2001, LANCET, V357, P1385, DOI 10.1016/s0140-6736(00)04560-8 Dondo TB, 2017, J AM COLL CARDIOL, V69, P2710, DOI 10.1016/j.jacc.2017.03.578 Hamood H, 2015, PHARMACOEPIDEM DR S, V24, P1093, DOI 10.1002/pds.3840 HJALMARSON A, 1983, CIRCULATION, V67, P26 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Johnson ES, 2002, AM J MANAG CARE, V8, pS249 Kearney PM, 2008, LANCET, V371, P117, DOI 10.1016/S0140-6736(08)60104-X KOBER L, 1995, NEW ENGL J MED, V333, P1670, DOI 10.1056/NEJM199512213332503 Korhonen MJ, 2017, J AM COLL CARDIOL, V70, P1543, DOI 10.1016/j.jacc.2017.07.783 Nakatani D, 2013, AM J CARDIOL, V111, P457, DOI 10.1016/j.amjcard.2012.10.026 Ozasa N, 2010, AM J CARDIOL, V106, P1225, DOI 10.1016/j.amjcard.2010.06.048 PFEFFER MA, 1992, NEW ENGL J MED, V327, P669, DOI 10.1056/NEJM199209033271001 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 Skolnick AH, 2007, J AM COLL CARDIOL, V49, P1790, DOI 10.1016/j.jacc.2007.01.066 Steg PG, 2004, CIRCULATION, V109, P494, DOI 10.1161/01.CIR.0000109691.16944.DA Steiner JF, 1997, J CLIN EPIDEMIOL, V50, P105, DOI 10.1016/S0895-4356(96)00268-5 Szummer K, 2019, J AM COLL CARDIOL, V74, P1618, DOI 10.1016/j.jacc.2019.03.531 Vrints CJM, 2008, EUR HEART J, V29, P1213, DOI 10.1093/eurheartj/ehn184 YUSUF S, 1985, PROG CARDIOVASC DIS, V27, P335, DOI 10.1016/S0033-0620(85)80003-7 NR 27 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1726-4901 EI 1728-7731 J9 J CHIN MED ASSOC JI J. Chin. Med. Assoc. PD DEC PY 2021 VL 84 IS 12 BP 1084 EP 1091 DI 10.1097/JCMA.0000000000000621 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA ZB2BL UT WOS:000756653800005 PM 34561408 OA hybrid DA 2023-05-13 ER PT J AU Riehle, L Maier, B Behrens, S Bruch, L Schoeller, R Schuhlen, H Stockburger, M Theres, H Leistner, DM Landmesser, U Frohlich, GM AF Riehle, Leonhard Maier, Birga Behrens, Steffen Bruch, Leonhard Schoeller, Ralph Schuehlen, Helmut Stockburger, Martin Theres, Heinz Leistner, David M. Landmesser, Ulf Froehlich, Georg M. TI Changes in treatment for NSTEMI in women and the elderly over the past 16 years in a large real-world population SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Non-ST-elevation myocardial infarction (NSTEMI); Gender; Elderly; Myocardial infarction; Coronary artery disease; Percutaneous coronary intervention (PCI) ID ACUTE CORONARY SYNDROMES; ELEVATION MYOCARDIAL-INFARCTION; SYMPTOM PRESENTATION; HOSPITAL MORTALITY; AGE; REVASCULARIZATION; STATINS; TRENDS; CARE; ASSOCIATION AB Aims: This study investigates the changes in therapy for Non-ST-Elevation Myocardial Infarction (NSTEMI) over the past 16 years in a large German registry. In particular, the high-risk population of female and elderly patients was analyzed. Methods: In total, 19.383 patients presenting with NSTEMI were included in this study. Patients were stratified by age groups <75 years and >= 75 years and by sex. Four different time periods from 2000-2004, 2005-2008, 2009-2012 and 2013-2016 were compared. Influence on hospital mortality as the primary outcome measure was assessed by logistic regression analysis. Secondary outcome measures included percutaneous coronary intervention (PCI), the use of drug eluting stents (DES), radial access route and major adverse cardiovascular events (MACE), defined as all-cause mortality, stroke, re-infarction, percutaneous re-intervention, intervention-related bleeding, cardiopulmonary resuscitation and new onset of cardiogenic shock or need for mechanical ventilation. Results: Mortality decreased in all age groups between the initial time period and the most recent one (8.9% vs. 4.5%, p < 0.01), particularly in female patients >= 75 years (18.2% in 2000-2004 vs. 7.9% in 2013-2016, p < 0.01). Revascularization rates differed by gender (68.3% in women vs. 78.1% in men, p < 0.01) and by age (64.2% for >= 75 years vs. 80.9% for <75 years, p < 0.01). PCI rates in elderly female patients increased from 28.7% to 69.8% (p < 0.01) from the initial to the latest period. Conclusions: The present study demonstrates, that revascularization rates improved in all patient groups over the study period. However, females and elderly patients still remain less likely to be treated according to current guidelines. (C) 2020 Elsevier B.V. All rights reserved. C1 [Riehle, Leonhard; Leistner, David M.; Landmesser, Ulf; Froehlich, Georg M.] Charite Univ Med Berlin, Berlin, Germany. [Riehle, Leonhard; Leistner, David M.; Landmesser, Ulf; Froehlich, Georg M.] Free Univ Berlin, Berlin, Germany. [Riehle, Leonhard; Leistner, David M.; Landmesser, Ulf; Froehlich, Georg M.] Humboldt Univ, Berlin, Germany. [Riehle, Leonhard; Leistner, David M.; Landmesser, Ulf; Froehlich, Georg M.] Berlin Inst Hlth, Dept Cardiol, Berlin, Germany. [Maier, Birga; Schoeller, Ralph] Berlin Brandenburger Herzinfarktregister, Berlin, Germany. [Behrens, Steffen] Vivantes Humboldt Klinikum, Dept Cardiol, Berlin, Germany. [Behrens, Steffen] Vivantes Klinikum Spandau, Berlin, Germany. [Bruch, Leonhard] Unfallkrankenhaus Berlin, Dept Cardiol, Berlin, Germany. [Schuehlen, Helmut] Vivantes Auguste Viktoria Klinikum, Dept Cardiol, Berlin, Germany. [Stockburger, Martin] Klin Nauen, Dept Cardiol, Nauen, Germany. [Theres, Heinz] Martin Luther Krankenhaus, Dept Cardiol, Berlin, Germany. C3 Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Free University of Berlin; Humboldt University of Berlin; Berlin Institute of Health; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Martin Luther University Halle Wittenberg RP Riehle, L (通讯作者)，Charite Univ Med Berlin, Dept Cardiol, Campus Benjamin Franklin, Hindenburgdamm 30, D-12203 Berlin, Germany. EM leonhard.riehle@charite.de OI Leistner, David/0000-0002-4351-420X; Schuhlen, Helmut/0000-0001-8630-4264 FU Berlin Chamber of Physicians; Charite - Universitatsmedizin Berlin; DRK Kliniken Berlin; Gemeinschaftskrankenhaus Havelhohe; Havelland Kliniken GmbH; Hospital Group of the Statutory Accident Insurance as the resposible body of the Unfallkrankenhaus Berlin; Immanuel Herzzentrum Bernau; Innovation Fund at the Federal Joint Committee; Judisches Krankenhaus Berlin; Maria Heimsuchung Caritas-Klinik Pankow; Oberhavel Kliniken GmbH; Sana Kliniken Brandenburg GmbH; Sankt-Gertrauden-Krankenhaus GmbH; St. Josefs-Krankenhaus Potsdam; Technische Universitat Berlin; Vivantes Netzwerk fur Gesundheit GmbH FX The B2HIR was financially supported by unrestricted grants from the following hospitals and organizations: Berlin Chamber of Physicians, Charite - Universitatsmedizin Berlin, DRK Kliniken Berlin, Gemeinschaftskrankenhaus Havelhohe, Havelland Kliniken GmbH, Hospital Group of the Statutory Accident Insurance as the resposible body of the Unfallkrankenhaus Berlin, Immanuel Herzzentrum Bernau, Innovation Fund at the Federal Joint Committee, Judisches Krankenhaus Berlin, Maria Heimsuchung Caritas-Klinik Pankow, Oberhavel Kliniken GmbH, Sana Kliniken Brandenburg GmbH, Sankt-Gertrauden-Krankenhaus GmbH, St. Josefs-Krankenhaus Potsdam, Technische Universitat Berlin, Vivantes Netzwerk fur Gesundheit GmbH. CR Afilalo J, 2008, J AM COLL CARDIOL, V51, P37, DOI 10.1016/j.jacc.2007.06.063 Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Arenja N, 2013, AM J MED, V126, P515, DOI 10.1016/j.amjmed.2012.11.028 Bassand JP, 2007, EUR HEART J, V28, P1598, DOI 10.1093/eurheartj/ehm161 Bertrand ME, 2002, EUR HEART J, V23, P1809, DOI 10.1053/euhj.2002.3385 Bhardwaj S, 2013, CLIN INTERV AGING, V8, P47, DOI 10.2147/CIA.S29686 Borzecki AM, 2010, MED CARE, V48, P1117, DOI 10.1097/MLR.0b013e3181ef9d53 Canto JG, 2007, ARCH INTERN MED, V167, P2405, DOI 10.1001/archinte.167.22.2405 Canto JG, 2012, JAMA-J AM MED ASSOC, V307, P813, DOI 10.1001/jama.2012.199 D'Agostino RB, 2008, CIRCULATION, V117, P743, DOI 10.1161/CIRCULATIONAHA.107.699579 Dudas K, 2011, CIRCULATION, V123, P46, DOI 10.1161/CIRCULATIONAHA.110.964999 Ebbinghaus J, 2012, INT J CARDIOL, V158, P78, DOI 10.1016/j.ijcard.2011.01.005 Gale CP, 2012, EUR HEART J, V33, P630, DOI 10.1093/eurheartj/ehr381 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Husted S, 2012, CIRC-CARDIOVASC QUAL, V5, P680, DOI 10.1161/CIRCOUTCOMES.111.964395 Jacobson TA, 2006, DRUG SAFETY, V29, P421, DOI 10.2165/00002018-200629050-00005 Khera S, 2015, J AM COLL CARDIOL, V66, P1961, DOI 10.1016/j.jacc.2015.08.865 Kim KS, 2012, DIABETES METAB J, V36, P336 Klenk J, 2007, EUR J PUBLIC HEALTH, V17, P587, DOI 10.1093/eurpub/ckm024 Komocsi A, 2016, INT J CARDIOL, V214, P486, DOI 10.1016/j.ijcard.2016.04.012 Lee PY, 2001, JAMA-J AM MED ASSOC, V286, P708, DOI 10.1001/jama.286.6.708 Leistner DM, 2018, AM J CARDIOL, V122, P537, DOI 10.1016/j.amjcard.2018.04.055 Lindholm D, 2014, EUR HEART J, V35, P2083, DOI 10.1093/eurheartj/ehu160 Mach F, 2018, EUR HEART J, V39, P2526, DOI 10.1093/eurheartj/ehy182 Mozaffarian D., 2015, HEART DIS STROKE STA, P7 Park HW, 2013, INT J CARDIOL, V169, P254, DOI 10.1016/j.ijcard.2013.08.132 Potts J, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0203325 Rajani R, 2011, BR J CARDIOL, V18, P73 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Rosengren A, 2006, EUR HEART J, V27, P789, DOI 10.1093/eurheartj/ehi774 Rosenthal GE, 2000, HEALTH SERV RES, V34, P1449 Seto TB, 2000, ANN INTERN MED, V132, P955, DOI 10.7326/0003-4819-132-12-200006200-00005 Shanmugam VB, 2015, J GERIATR CARDIOL, V12, P174, DOI 10.11909/j.issn.1671-5411.2015.02.012 Smilowitz NR, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.116.003443 Spoon DB, 2014, CIRCULATION, V129, P1286, DOI 10.1161/CIRCULATIONAHA.113.006518 Statistisches Bundesamt, 2018, BEV DEM Steg P.G., 2015, JAMA, V297, P1999 Tang EW, 2007, AM HEART J, V153, P29, DOI 10.1016/j.ahj.2006.10.004 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 Thygesen K, 2007, EUR HEART J, V28, P2525 Ting HH, 2010, ARCH INTERN MED, V170, P1834, DOI 10.1001/archinternmed.2010.385 Wernich A., 1878, DTSCH MED WOCHENSCHR, V4, P97 World Med Assoc, 2013, JAMA-J AM MED ASSOC, V310, P2191, DOI 10.1001/jama.2013.281053 NR 43 TC 5 Z9 5 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 OCT 1 PY 2020 VL 316 BP 7 EP 12 DI 10.1016/j.ijcard.2020.04.021 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OE5OA UT WOS:000580578300002 PM 32507395 DA 2023-05-13 ER PT J AU Zhelev, Z Hyde, C Youngman, E Rogers, M Fleming, S Slade, T Coelho, H Jones-Hughes, T Nikolaou, V AF Zhelev, Zhivko Hyde, Christopher Youngman, Emily Rogers, Morwenna Fleming, Simon Slade, Toby Coelho, Helen Jones-Hughes, Tracey Nikolaou, Vasilis TI Diagnostic accuracy of single baseline measurement of Elecsys Troponin T high-sensitive assay for diagnosis of acute myocardial infarction in emergency department: systematic review and meta-analysis SO BMJ-BRITISH MEDICAL JOURNAL LA English DT Article ID CORONARY-ARTERY-DISEASE; EARLY RULE-OUT; CARDIAC TROPONIN; RELATIVE CHANGES; RAPID RULE; COPEPTIN; PERFORMANCE; ABSOLUTE; PROTEIN; UTILITY AB Objective To obtain summary estimates of the accuracy of a single baseline measurement of the Elecsys Troponin T high-sensitive assay (Roche Diagnostics) for the diagnosis of acute myocardial infarction in patients presenting to the emergency department. Design Systematic review and meta-analysis of diagnostic test accuracy studies. Data sources Medline, Embase, and other relevant electronic databases were searched for papers published between January 2006 and December 2013. Study selection Studies were included if they evaluated the diagnostic accuracy of a single baseline measurement of Elecsys Troponin T high-sensitive assay for the diagnosis of acute myocardial infarction in patients presenting to the emergency department with suspected acute coronary syndrome. Study appraisal and data synthesis The first author screened all titles and abstracts identified through the searches and selected all potentially relevant papers. The screening of the full texts, the data extraction, and the methodological quality assessment, using the adapted QUADAS-2 tool, were conducted independently by two reviewers with disagreements being resolved through discussion or arbitration. If appropriate, meta-analysis was conducted using the hierarchical bivariate model. Results Twenty three studies reported the performance of the evaluated assay at presentation. The results for 14 ng/L and 3-5 ng/L cut-off values were pooled separately. At 14 ng/L (20 papers), the summary sensitivity was 89.5% (95% confidence interval 86.3% to 92.1%) and the summary specificity was 77.1% (68.7% to 83.7%). At 3-5 ng/L (six papers), the summary sensitivity was 97.4% (94.9% to 98.7%) and the summary specificity was 42.4% (31.2% to 54.5%). This means that if 21 of 100 consecutive patients have the target condition (21%, the median prevalence across the studies), 2 (95% confidence interval 2 to 3) of 21 patients with acute myocardial infarction will be missed (false negatives) if 14 ng/L is used as a cut-off value and 18 (13 to 25) of 79 patients without acute myocardial infarction will test positive (false positives). If the 3-5 ng/L cut-off value is used, < 1 (0 to 1) patient with acute myocardial infarction will be missed and 46 (36 to 54) patients without acute myocardial infarction will test positive. Conclusions The results indicate that a single baseline measurement of the Elecsys Troponin T high-sensitive assay could be used to rule out acute myocardial infarction if lower cut-off values such as 3 ng/L or 5 ng/L are used. However, this method should be part of a comprehensive triage strategy and may not be appropriate for patients who present less than three hours after symptom onset. Care must also be exercised because of the higher imprecision of the evaluated assay and the greater effect of lot-to-lot reagent variation at low troponin concentrations. Systematic review registration PROSPERO registration number CRD42013003926. C1 [Zhelev, Zhivko; Hyde, Christopher; Youngman, Emily; Rogers, Morwenna; Coelho, Helen; Jones-Hughes, Tracey; Nikolaou, Vasilis] Univ Exeter, Sch Med, Inst Hlth Res, Exeter, Devon EX2 4SG, England. [Fleming, Simon] Royal Cornwall Hosp, Truro TQ1 3LQ, England. [Slade, Toby] Royal Cornwall Hosp, Emergency Dept, Truro TQ1 3LQ, England. C3 RLUK- Research Libraries UK; University of Exeter; Royal Cornwall Hospital; Royal Cornwall Hospital RP Zhelev, Z (通讯作者)，Univ Exeter, Sch Med, Inst Hlth Res, Exeter, Devon EX2 4SG, England. EM Z.Zhelev@exeter.ac.uk RI Hyde, Christopher/HTQ-3128-2023; Nikolaou, Vasilis/AAC-3174-2020 OI Nikolaou, Vasilis/0000-0002-2768-5340; Christopher, Hyde/0000-0002-7349-0616; Rogers, Morwenna/0000-0002-6039-238X; Zhelev, Zhivko/0000-0002-0106-2401 FU South West Academic Health Science Network (AHSN); National Institute for Health Research (NIHR) Collaboration for Leadership for Applied Health Research and Care for the South West Peninsula FX This research was funded by the South West Academic Health Science Network (AHSN) and the National Institute for Health Research (NIHR) Collaboration for Leadership for Applied Health Research and Care for the South West Peninsula. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health. The AHSN and the NIHR had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. 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Kurtais Taskiran, Ozden Ozyemisci Kabayel, Derya Demirbag Kesiktas, Nur Tikiz, Canan Ozdemir, Hande Alemdaroglu, Ebru Kaya, Basak Bilir Genc, Aysun Sutbeyaz, Serap Tomruk TI COVID-19, cardiac involvement and cardiac rehabilitation: Insights from a rehabilitation perspective - State of the Art SO TURKISH JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Review DE Cardiac disease; cardiac rehabilitation; cardiovascular; COVID-19; SARS-CoV-2 ID AMERICAN-HEART-ASSOCIATION; FIELD WALKING TESTS; SCIENTIFIC STATEMENT; DISQUALIFICATION RECOMMENDATIONS; CARDIOVASCULAR-DISEASE; EXERCISE; ELIGIBILITY; MYOCARDITIS; GUIDELINE; SYSTEM AB Since the beginning of the pandemic, many novel coronavirus disease 2019 (COVID-19) patients have experienced multisystem involvement or become critically ill and treated in intensive care units, and even died. Among these systemic effects, cardiac involvement may have very important consequences for the patient's prognosis and later life. Patients with COVID-19 may develop cardiac complications such as heart failure, myocarditis, pericarditis, vasculitis, acute coronary syndrome, and cardiac arrhythmias or trigger an accompanying cardiac disease. The ratio of COVID-19 cardiac involvement ranges between 7 and 28% in hospitalized patients with worse outcomes, longer stay in the intensive care unit, and a higher risk of death. Furthermore, deconditioning due to immobility and muscle involvement can be seen in post-COVID-19 patients and significant physical, cognitive and psychosocial impairments may be observed in some cases. Considering that the definition of health is "a state of complete physical, mental and social well-being", individuals with heart involvement due to COVID-19 should be rehabilitated by evaluating all these aspects of the disease effect. In the light of the rehabilitation perspective and given the increasing number of patients with cardiac manifestations of COVID-19, in this review, we discuss the rehabilitation principles in this group of patients. C1 [Tur, Birkan Sonel; Aytur, Yesim Kurtais; Genc, Aysun] Ankara Univ, Dept Phys Med & Rehabil, Fac Med, TR-06230 Ankara, Turkey. [Koseoglu, Belma Fusun] TOBB Univ Econ & Technol, Dept Phys Med & Rehabil, Sch Med, Ankara, Turkey. [Gokkaya, Nilufer Kutay Ordu; Alemdaroglu, Ebru] Univ Hlth Sci, Ankara City Hlth Training & Res Hosp, Dept Phys Med & Rehabil, Ankara, Turkey. [Taskiran, Ozden Ozyemisci] Koc Univ, Dept Phys Med & Rehabil, Sch Med, Istanbul, Turkey. [Kabayel, Derya Demirbag; Ozdemir, Hande] Trakya Univ, Dept Phys Med & Rehabil, Fac Med, Edirne, Turkey. [Kesiktas, Nur] Univ Hlth Sci, Istanbul Phys Med & Rehabil Training & Res Hosp, Istanbul, Turkey. [Tikiz, Canan] Manisa Celal Bayar Univ, Dept Phys Med & Rehabil, Fac Med, Manisa, Turkey. [Kaya, Basak Bilir] Turkish Minist Hlth, Erenkoy Phys Therapy & Rehabil Hosp, Istanbul, Turkey. [Sutbeyaz, Serap Tomruk] Univ Hlth Sci, Kayseri City Hlth Training & Res Hosp, Dept Phys Therapy & Rehabil, Kayseri, Turkey. C3 Ankara University; TOBB Ekonomi ve Teknoloji University; University of Health Sciences Turkey; Koc University; Trakya University; Istanbul Physical Medicine & Rehabilitation Training & Research Hospital; University of Health Sciences Turkey; Celal Bayar University; Erenkoy Mental & Neurological Disorders Education & Research Hospital; Ministry of Health - Turkey; University of Health Sciences Turkey RP Tur, BS (通讯作者)，Ankara Univ, Dept Phys Med & Rehabil, Fac Med, TR-06230 Ankara, Turkey. 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0 U1 8 U2 14 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 EI 2587-1250 J9 TURK J PH MED REHAB JI Turk. J. Phys. Med. Rehabil. PY 2022 VL 68 IS 3 BP 317 EP 335 DI 10.5606/tftrd.2022.11435 PG 19 WC Rehabilitation WE Science Citation Index Expanded (SCI-EXPANDED) SC Rehabilitation GA 4G4RZ UT WOS:000849187100002 PM 36475104 OA Green Published DA 2023-05-13 ER PT J AU Szarpak, L Mierzejewska, M Jurek, J Kochanowska, A Gasecka, A Truszewski, Z Pruc, M Blek, N Rafique, Z Filipiak, KJ Denegri, A Jaguszewski, MJ AF Szarpak, Lukasz Mierzejewska, Malgorzata Jurek, Jonasz Kochanowska, Anna Gasecka, Aleksandra Truszewski, Zenon Pruc, Michal Blek, Natasza Rafique, Zubaid Filipiak, Krzysztof J. Denegri, Andrea Jaguszewski, Milosz J. TI Effect of Coronary Artery Disease on COVID-19-Prognosis and Risk Assessment: A Systematic Review and Meta-Analysis SO BIOLOGY-BASEL LA English DT Review DE coronary artery disease; CAD; COVID-19; novel coronavirus; systematic review ID HOSPITAL CARDIAC-ARREST; COVID-19; MORTALITY; OUTCOMES; IMPACT AB Simple Summary As of October 2021, over 245 million people have been infected and nearly 5 million have died due to COVID-19. Atherosclerosis is a lipid-driven chronic inflammation of the arterial wall with coronary artery disease (CAD) that may lead to acute coronary syndrome (ACS), which remains the main cause of death in developed countries. We believe that due to CAD development factors affecting the vessel wall, the SARS-CoV-2 infection may precipitate further advancement of future thromboembolic events by a plaque erosion or rupture. Therefore, this metanalysis aims to unambiguously establish the role of the history of CAD in mortality and severity of COVID-19 disease. Coronary artery disease (CAD) is the leading cause of death worldwide. Patients with pre-existing CAD were shown to have a more severe course of COVID-19, but this association has not been clarified. We performed a meta-analysis to determine the association between CAD and COVID-19 outcomes. We searched Scopus, Medline (PubMed), Web of Science, Embase, and Cochrane databases up to 2 November 2021. There were 62 studies with a total population of 49,286 patients included in the meta-analysis. CAD occurrence in survivor vs. non-survivor groups varied and amounted to 9.2% vs. 22.9%, respectively (OR = 0.33; 95%CI: 0.29 to 0.39; I-2 = 70%; p < 0.001). CAD was also associated with increased severity of COVID-19 disease and was (10.8% vs. 5.6%, respectively, for severe vs. non-severe groups (OR = 2.28; 95%CI: 1.59 to 3.27; I-2 = 72%; p < 0.001). The role of history of CAD in mortality and severe condition in COVID-19 presents itself as prominent-although a risk of bias in retrospective trials needs to be assessed, in case of our meta-analysis the statistically significant results when it comes to higher mortality among patients with CAD compared to non-CAD patients, a more severe condition observed in patients with CAD, and a visibly more frequent admission to intensive care unit in patients with CAD, it seems that an incidence of cardiovascular events plays a role in COVID-19 prognosis. C1 [Szarpak, Lukasz] Maria Sklodowska Curie Med Acad, Inst Outcomes Res, PL-03411 Warsaw, Poland. [Szarpak, Lukasz] Maria Sklodowska Curie Bialystok Oncol Ctr, Res Unit, PL-15026 Bialystok, Poland. [Mierzejewska, Malgorzata; Jurek, Jonasz; Kochanowska, Anna; Gasecka, Aleksandra] Med Univ Warsaw, Chair & Dept Cardiol 1, PL-02091 Warsaw, Poland. [Truszewski, Zenon] Med Univ Warsaw, Dept Emergency Med, PL-02005 Warsaw, Poland. [Pruc, Michal] Polish Soc Disaster Med, Res Unit, PL-05806 Warsaw, Poland. [Blek, Natasza; Filipiak, Krzysztof J.] Maria Sklodowska Curie Med Acad, Inst Clin Med, PL-04311 Warsaw, Poland. [Rafique, Zubaid] Baylor Coll Med, Henry JN Taub Dept Emergency Med, Houston, TX 77030 USA. [Denegri, Andrea] Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Div Cardiol, Policlin Modena, I-41121 Modena, Italy. [Jaguszewski, Milosz J.] Med Univ Gdansk, Dept Cardiol 1, PL-80294 Gdansk, Poland. C3 Medical University of Warsaw; Medical University of Warsaw; Baylor College of Medicine; Universita di Modena e Reggio Emilia; Fahrenheit Universities; Medical University Gdansk RP Szarpak, L (通讯作者)，Maria Sklodowska Curie Med Acad, Inst Outcomes Res, PL-03411 Warsaw, Poland.; Szarpak, L (通讯作者)，Maria Sklodowska Curie Bialystok Oncol Ctr, Res Unit, PL-15026 Bialystok, Poland. EM lukasz.szarpak@uczelniamedyczna.com.pl; mmierzejewska97@gmail.com; jurekjonasz@gmail.com; s073863@student.wum.edu.pl; gaseckaa@gmail.com; ztruszewski@wum.edu.pl; m.pruc@ptmk.org; natasza.blek@gmail.com; zubaidrafique@gmail.com; krzysztof.filipiak@uczelniamedyczna.com.pl; denegriandrea@msn.com; jamilosz@gmail.com RI Jaguszewski, Milosz/AAL-3169-2020; Pruc, Michal/HKF-2573-2023 OI Pruc, Michal/0000-0002-2140-9732; Jurek, Jonasz/0000-0001-9567-8663; Szarpak, Lukasz/0000-0002-0973-5455; Blek, Natasza/0000-0002-3213-7330; Mierzejewska, Malgorzata/0000-0002-2728-1872 CR Andrea C, 2020, HYPERTENSION, V76, pE10, DOI 10.1161/HYPERTENSIONAHA.120.15312 Angeli F, 2021, EUR J INTERN MED, V89, P81, DOI 10.1016/j.ejim.2021.04.007 [Anonymous], 2020, PEDIATR MED RODZ, V16, P9, DOI 10.15557/PiMR.2020.0003 Banerjee A, 2020, LANCET, V395, P1715, DOI 10.1016/S0140-6736(20)30854-0 Bielski K, 2021, CARDIOL J, V28, P816, DOI 10.5603/CJ.a2021.0168 Borkowska MJ, 2021, J CLIN MED, V10, DOI 10.3390/jcm10061209 Cen Y, 2020, CLIN MICROBIOL INFEC, V26, P1242, DOI 10.1016/j.cmi.2020.05.041 Chen Y, 2021, J MED VIROL, V93, P2782, DOI 10.1002/jmv.26617 Dabrowski M., 2020, DISASTER EMERG MED J, V5, P171, DOI 10.5603/DEMJ.a2020.0028 Denegri A, 2021, INTERN EMERG MED, V16, P1451, DOI 10.1007/s11739-020-02578-8 Dzieciatkowski T, 2020, CARDIOL J, V27, P175, DOI 10.5603/CJ.a2020.0055 Fan H, 2020, INT J INFECT DIS, V96, P294, DOI 10.1016/j.ijid.2020.05.024 Forsblom E, 2021, INFECT DIS-NOR, V53, P789, DOI 10.1080/23744235.2021.1936157 Gasecka A, 2021, CARDIOL J, V28, P353, DOI 10.5603/CJ.a2021.0028 Hessami A, 2021, AM J EMERG MED, V46, P382, DOI 10.1016/j.ajem.2020.10.022 Hewitt J, 2020, LANCET PUBLIC HEALTH, V5, pE444, DOI 10.1016/S2468-2667(20)30146-8 Higgins JPT, 2002, STAT MED, V21, P1539, DOI 10.1002/sim.1186 Higgins JPT, 2019, COCHRANE HDB SYSTEMA Hosseini ES, 2020, VIROLOGY, V551, P1, DOI 10.1016/j.virol.2020.08.011 Huff HV, 2020, CLIN INFECT DIS, V71, P2752, DOI 10.1093/cid/ciaa654 Iaccarino G, 2020, HYPERTENSION, V76, P366, DOI 10.1161/HYPERTENSIONAHA.120.15324 Inciardi RM, 2020, JAMA CARDIOL, V5, P819, DOI 10.1001/jamacardio.2020.1096 Kirtipal N, 2020, INFECT GENET EVOL, V85, DOI 10.1016/j.meegid.2020.104502 Knuuti J, 2020, EUR HEART J, V41, P407, DOI 10.1093/eurheartj/ehz425 Krittanawong C, 2020, AM J CARDIOVASC DIS, V10, P479 Kuno T, 2020, AM HEART J, V226, P24, DOI 10.1016/j.ahj.2020.05.005 Libby P, 2005, CIRCULATION, V111, P3481, DOI 10.1161/CIRCULATIONAHA.105.537878 Libby P, 2020, EUR HEART J, V41, P3038, DOI 10.1093/eurheartj/ehaa623 McAlister FA, 2021, J AM HEART ASSOC, V10, DOI 10.1161/JAHA.121.022330 McGuinness LA, 2021, RES SYNTH METHODS, V12, P55, DOI 10.1002/jrsm.1411 Mousseaux E, 2021, DIAGN INTERV IMAG, V102, P717, DOI 10.1016/j.diii.2021.06.007 Nagele MP, 2020, ATHEROSCLEROSIS, V314, P58, DOI 10.1016/j.atherosclerosis.2020.10.014 Page MJ, 2021, J CLIN EPIDEMIOL, V134, P178, DOI 10.1016/j.jclinepi.2021.03.001 Pei, 2020, CHARACTERISTICS DEAT, DOI 10.1101/2020.05.07.20092882 Planek Maria Isabel Camara, 2021, Am Heart J Plus, V11, P100052, DOI 10.1016/j.ahjo.2021.100052 Russo V, 2020, PHARMACOL RES, V159, DOI 10.1016/j.phrs.2020.104965 Scoccia A, 2021, ATHEROSCLEROSIS, V328, P136, DOI 10.1016/j.atherosclerosis.2021.03.041 Singh S, 2021, HYPERTENSION, V78, P165, DOI 10.1161/HYPERTENSIONAHA.121.17328 Sterne JAC, 2016, BMJ-BRIT MED J, V355, DOI 10.1136/bmj.i4919 Szarpak L, 2022, CARDIOL J, V29, P178, DOI 10.5603/CJ.a2021.0155 Szarpak L, 2021, EUR HEART J-QUAL CAR, V7, P618, DOI 10.1093/ehjqcco/qcab067 Szarpak L, 2021, CARDIOL J, V28, P503, DOI 10.5603/CJ.a2021.0043 Vos T, 2016, LANCET, V388, P1545, DOI 10.1016/S0140-6736(16)31678-6 Wang HD, 2016, LANCET, V388, P1459, DOI 10.1016/S0140-6736(16)31012-1 Wichmann D, 2020, ANN INTERN MED, V173, P268, DOI 10.7326/M20-2003 Zhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 NR 46 TC 9 Z9 9 U1 1 U2 2 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 2079-7737 J9 BIOLOGY-BASEL JI Biology-Basel PD FEB PY 2022 VL 11 IS 2 AR 221 DI 10.3390/biology11020221 PG 11 WC Biology WE Science Citation Index Expanded (SCI-EXPANDED) SC Life Sciences & Biomedicine - Other Topics GA ZJ3EM UT WOS:000762191300001 PM 35205088 OA Green Published, gold DA 2023-05-13 ER PT J AU Nappi, F Nappi, P Gambardella, I Singh, SSA AF Nappi, Francesco Nappi, Pierluigi Gambardella, Ivancarmine Singh, Sanjeet Singh Avtaar TI Thromboembolic Disease and Cardiac Thrombotic Complication in COVID-19: A Systematic Review SO METABOLITES LA English DT Review DE SARS-CoV-2 infection; COVID-19; coronary artery thrombosis; neutrophil extracellular traps (NETs) ID ACUTE MYOCARDIAL-INFARCTION; VENOUS THROMBOEMBOLISM; HOSPITALIZED-PATIENTS; ACUTE INFECTION; MANAGEMENT; SARS-COV-2; INFLAMMATION; GUIDELINES; INSIGHTS; THERAPY AB The coronavirus 2019 pandemic has affected many healthcare systems worldwide. While acute respiratory distress syndrome (ARDS) has been well-documented in COVID-19, there are several cardiovascular complications, such as myocardial infarction, ischaemic stroke, and pulmonary embolism, leading to disability and death. The link between COVID-19 and increasing thrombogenicity potentially occurs due to numerous different metabolic mechanisms, ranging from endothelial damage for direct virus infection, associated excessive formation of neutrophil extracellular traps (NETs), pathogenic activation of the renin-angiotensin-aldosterone system (RAAS), direct myocardial injury, and ischemia induced by respiratory failure, all of which have measurable biomarkers. A search was performed by interrogating three databases (MEDLINE; MEDLINE In-Process and Other Non-Indexed Citations, and EMBASE). Evidence from randomized controlled trials (RCT), prospective series, meta-analyses, and unmatched observational studies were evaluated for the processing of the algorithm and treatment of thromboembolic disease and cardiac thrombotic complications related to COVID-19 during SARS-CoV-2 infection. Studies out with the SARS-Cov-2 infection period and case reports were excluded. A total of 58 studies were included in this analysis. The role of the acute inflammatory response in the propagation of the systemic inflammatory sequelae of the disease plays a major part in determining thromboembolic disease and cardiac thrombotic complication in COVID-19. Some of the mechanisms of activation of these pathways, alongside the involved biomarkers noted in previous studies, are highlighted. Inflammatory response led to thromboembolic disease and cardiac thrombotic complications in COVID-19. NETs play a pivotal role in the pathogenesis of the inflammatory response. Despite moving into the endemic phase of the disease in most countries, thromboembolic complications in COVID-19 remain an entity that substantially impacts the health care system, with long-term effects that remain uncertain. Continuous monitoring and research are required. C1 [Nappi, Francesco] Ctr Cardiol Nord, Dept Cardiac Surg, F-93200 St Denis, France. [Nappi, Pierluigi] Univ Messina, Dept Clin & Expt Med, I-98122 Messina, Italy. [Gambardella, Ivancarmine] Weill Cornell Med, Dept Cardiothorac Surg, New York Presbyterian Med Ctr, New York, NY 10065 USA. [Singh, Sanjeet Singh Avtaar] Aberdeen Royal Infirm, Dept Cardiothorac Surg, Aberdeen AB25 2ZN, Scotland. C3 University of Messina; Cornell University; Weill Cornell Medicine; RLUK- Research Libraries UK; University of Aberdeen RP Nappi, F (通讯作者)，Ctr Cardiol Nord, Dept Cardiac Surg, F-93200 St Denis, France. 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TI SARS-CoV-2 Infection in Asymptomatic Patients Hospitalized for Cardiac Emergencies: Implications for Patient Management SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Article DE cardiac emergencies; SARS-CoV-2; COVID-19; personal protective equipment (PPE); screening ID ACUTE CORONARY SYNDROMES AB Background: The coronavirus disease (COVID-19) pandemic imposed diverse challenges on the health care system. Morbidity and mortality of non-COVID-19 emergencies might also have changed because hospitals may not be able to provide optimal care due to restructured resources and uncertainties how to deal with potentially infected patients. It has been recommended to stratify treatment of cardiovascular emergencies according to cardiovascular risk. However, data on the prevalence of asymptomatic SARS-CoV-2 infection in patients presenting with cardiac emergencies remain scarce. Methods: We retrospectively analyzed patients' data from a tertiary cardiology department between April 15 and May 31, 2020. All patients were screened on admission for COVID-19 symptoms using a questionnaire and body temperature measurements. All hospitalized patients were routinely screened using nasopharyngeal swab testing. Results: In total, we counted 710 urgent and emergency admissions. Nasopharyngeal swab tests were available in 689 (97%) patients, 409 and 280 of which presented as urgent and emergency admissions, respectively. Among 280 emergency admissions, none tested positive for SARS-CoV-2. Conclusion: In cardiac emergency patients which were screened negative for COVID-19 symptoms, the prevalence of SARS-CoV-2 infection in regions with a modest overall prevalence is low. This finding might be helpful to better determine timing of emergency procedures and reasonable usage of protective equipment during the COVID-19 crisis and the future. C1 [Kessler, Thorsten; Wiebe, Jens; Schunkert, Heribert; Kastrati, Adnan; Sager, Hendrik B.] Tech Univ Munich, Deutsch Zentrum Herz Kreislauf Forsch DZHK eV, Deutsch Herzzentrum Munchen, Munich Heart Alliance,Klin Herz & Kreislauferkran, Partner Site, Munich, Germany. [Graf, Tobias] Univ Klinikum Schleswig Holstein, Deutsch Zentrum Herz Kreislauf Forsch DZHK eV, Med Klin 2, Partner Site Hamburg Kiel Lubeck, Lubeck, Germany. C3 German Centre for Cardiovascular Research; German Heart Centre Munich; Munich Heart Alliance; Technical University of Munich; German Centre for Cardiovascular Research; University of Hamburg; University Medical Center Hamburg-Eppendorf; University of Kiel; Schleswig Holstein University Hospital RP Sager, HB (通讯作者)，Tech Univ Munich, Deutsch Zentrum Herz Kreislauf Forsch DZHK eV, Deutsch Herzzentrum Munchen, Munich Heart Alliance,Klin Herz & Kreislauferkran, Partner Site, Munich, Germany. EM hendrik.sager@tum.de RI Kessler, Thorsten/AAI-7292-2021; Sager, Hendrik B./AAP-5869-2021; Kessler, Thorsten/O-7426-2015 OI Kessler, Thorsten/0000-0003-3326-1621; Sager, Hendrik B./0000-0002-0197-6553; CR Chieffo A, 2020, EUROINTERVENTION, V16, P233, DOI 10.4244/EIJY20M05_01 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 Gibani MM, 2020, LANCET MICROBE, V1, pE300, DOI 10.1016/S2666-5247(20)30121-X Gudbjartsson DF, 2020, NEW ENGL J MED, V382, P2302, DOI 10.1056/NEJMoa2006100 Guglielmi G, 2020, NATURE, V585, P496, DOI 10.1038/d41586-020-02661-2 Kessler T, 2020, CARDIOVASC RES, V116, P1800, DOI 10.1093/cvr/cvaa192 Piccolo R, 2020, CIRCULATION, V141, P2035, DOI 10.1161/CIRCULATIONAHA.120.047457 Rosenbaum L, 2020, NEW ENGL J MED, V382, P1873, DOI 10.1056/NEJMp2005492 Sutton D, 2020, NEW ENGL J MED, V382, P2163, DOI 10.1056/NEJMc2009316 The European Society for Cardiology, 2020, ESC GUID DIAGN MAN C Wang WL, 2020, JAMA-J AM MED ASSOC, V323, P1843, DOI 10.1001/jama.2020.3786 Wang XW, 2020, JAMA-J AM MED ASSOC, V324, P703, DOI 10.1001/jama.2020.12897 Welt FGP, 2020, J AM COLL CARDIOL, V75, P2372, DOI 10.1016/j.jacc.2020.03.021 NR 14 TC 1 Z9 1 U1 0 U2 2 PU FRONTIERS MEDIA SA PI LAUSANNE PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND SN 2297-055X J9 FRONT CARDIOVASC MED JI Front. Cardiovasc. Med. PD DEC 18 PY 2020 VL 7 AR 599299 DI 10.3389/fcvm.2020.599299 PG 4 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PM7KJ UT WOS:000603972800001 PM 33425999 OA gold, Green Published DA 2023-05-13 ER PT J AU de Miguel-Diez, J Jimenez-Garcia, R de Miguel-Yanes, JM Hernandez-Barrera, V Carabantes-Alarcon, D Zamorano-Leon, JJ Noriega, C Lopez-de-Andres, A AF de Miguel-Diez, Javier Jimenez-Garcia, Rodrigo de Miguel-Yanes, Jose M. Hernandez-Barrera, Valentin Carabantes-Alarcon, David Zamorano-Leon, Jose J. Noriega, Concepcion Lopez-de-Andres, Ana TI Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE COPD; COVID-19; cardiac procedures; hospitalization ID ACUTE CORONARY SYNDROME; UNITED-STATES; INTERVENTIONS; SERVICE; TRENDS; CARE AB (1) Background: The aim of this study was to assess the effects of the COVID-19 pandemic on the use and outcomes of cardiac procedures among people with chronic obstructive pulmonary disease (COPD) in Spain. (2) Methods: We used national hospital discharge data to select patients admitted to hospital with a diagnosis of COPD from 1 January 2019 to 31 December 2020. (3) Results: The number of COPD patients hospitalized in 2019 who underwent a cardiac procedure was 4483, 16.2% higher than in 2020 (n = 3757). The length of hospital stay was significantly lower in 2020 than in 2019 (9.37 vs. 10.13 days; p = 0.004), and crude in-hospital mortality (IHM) was significantly higher (5.32% vs. 4.33%; p = 0.035). Multivariable logistic regression models to assess the differences in IHM from 2019 to 2020 showed Odds Ratio (OR) values over 1, suggesting a higher risk of dying in 2020 compared to in 2019. However, the ORs were only statistically significant for "any cardiac procedure" (1.18, 95% CI 1.03-1.47). The Charlson comorbidity index increased IHM for each of the procedures analyzed. The probability of IHM was higher for women and older patients who underwent coronary artery bypass graft or open valve replacement procedures. Suffering a COVID-19 infection was associated with significantly higher mortality after cardiac procedures. (4) Conclusions: The COVID-19 pandemic limited the access to healthcare for patients with COPD. C1 [de Miguel-Diez, Javier] Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Resp Care Dept, Madrid 28007, Spain. [Jimenez-Garcia, Rodrigo; Carabantes-Alarcon, David; Zamorano-Leon, Jose J.; Lopez-de-Andres, Ana] Univ Complutense Madrid, Fac Med, Dept Publ Hlth & Maternal & Child Hlth, IdISSC, Madrid 28040, Spain. [de Miguel-Yanes, Jose M.] Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Internal Med Dept, Madrid 28007, Spain. [Hernandez-Barrera, Valentin] Univ Rey Juan Carlos, Hlth Sci Fac, Prevent Med & Publ Hlth Teaching & Res Unit, Alcorcon 28922, Spain. [Noriega, Concepcion] Univ Alcala, Fac Med & Hlth Sci, Dept Nursery & Physiotherapy, Alcala De Henares 28871, Spain. C3 Complutense University of Madrid; General University Gregorio Maranon Hospital; Complutense University of Madrid; Complutense University of Madrid; General University Gregorio Maranon Hospital; Universidad Rey Juan Carlos; Universidad de Alcala RP Jimenez-Garcia, R (通讯作者)，Univ Complutense Madrid, Fac Med, Dept Publ Hlth & Maternal & Child Hlth, IdISSC, Madrid 28040, Spain. EM javier.miguel@salud.madrid.org; rodrijim@ucm.es; josemaria.demiguel@salud.madrid.org; valentin.hernandez@urjc.es; dcaraban@ucm.es; josejzam@ucna.es; concha.noriega@uah.es; anailo04@ucm.es RI ; Lopez-de-Andres, Ana/D-4498-2019; Carabantes Alarcon, David/H-6429-2011 OI Hernandez-Barrera, Valentin/0000-0001-5790-1959; de Miguel-Yanes, Jose M./0000-0003-2802-033X; Noriega, Concha/0000-0003-3436-0007; Lopez-de-Andres, Ana/0000-0001-5551-5181; de Miguel-Diez, Javier/0000-0003-4543-573X; Carabantes Alarcon, David/0000-0001-9897-4847 FU Convenio V-PRICIT de la Comunidad de Madrid y la Universidad Complutense deMadrid ("Programa de Excelencia para el Profesorado Universitario") [INV.AY.20.2021.1E126]; Universidad Complutense deMadrid; Grupo de Investigacion en Epidemiologia de las Enfer-medades Cronicas de Alta Prevalencia en Espana [970970] FX This study is a part of the research funded by Convenio V-PRICIT de la Comunidad de Madrid y la Universidad Complutense deMadrid ("Programa de Excelencia para el Profesorado Universitario" INV.AY.20.2021.1E126) and by Universidad Complutense deMadrid. Grupo de Investigacion en Epidemiologia de las Enfer-medades Cronicas de Alta Prevalencia en Espana (970970). 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Clin. Med. PD JUL PY 2022 VL 11 IS 13 AR 3924 DI 10.3390/jcm11133924 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 2V6CL UT WOS:000823931600001 PM 35807209 OA gold, Green Published DA 2023-05-13 ER PT J AU Eastwood, JA Johnson, BD Rutledge, T Bittner, V Whittaker, KS Krantz, DS Cornell, CE Eteiba, W Handberg, E Vido, D Merz, CNB AF Eastwood, Jo-Ann Johnson, B. Delia Rutledge, Thomas Bittner, Vera Whittaker, Kerry S. Krantz, David S. Cornell, Carol E. Eteiba, Wafia Handberg, Eileen Vido, Diane Merz, C. Noel Bairey TI Anginal Symptoms, Coronary Artery Disease, and Adverse Outcomes in Black and White Women: The NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study SO JOURNAL OF WOMENS HEALTH LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; CHEST-PAIN; HEART-DISEASE; HOSPITAL MORTALITY; PSYCHOSOCIAL FACTORS; ETHNIC DISPARITIES; GENDER-DIFFERENCES; RACIAL-DIFFERENCES; RISK-FACTORS; HEALTH-CARE AB Background: Black women are less likely to be evaluated and treated for anginal symptoms, despite a higher premature cardiac mortality rate compared to white women. Our objective was to compare angina symptoms in black versus white women regarding (1) angina symptoms characterization; (2) relationship with obstructive coronary artery disease (CAD); and (3) relationship with subsequent mortality. Methods: A cohort of 466 women (69 black and 397 white) undergoing coronary angiography for suspected ischemia and without prior history of CAD completed symptom checklists. Four symptom clusters (CHEST, UPPER, STOMACH, and TYPICAL TRIGGERS) were derived by factor analysis. All angiograms were analyzed by core lab. Mortality data over 10 years were obtained from National Death Index. Results: (1) Black women had lower mean CHEST cluster scores (0.60 +/- 0.30vs. 0.73 +/- 30, p=0.002), but higher STOMACH scores (0.41 +/- 0.25vs. 0.30 +/- 0.25, p=0.011) than white women. (2) Prevalence and severity of CAD did not differ in black and white women and was not predicted by symptom cluster scores. (3) All-cause mortality rates were 24.9% in blacks versus 14.5% in whites, p=0.007; and cardiovascular mortality 22.5% vs.8.8%, p=0.001. Symptom clusters were not predictive of adverse events in white women. However, black women with a low TYPICAL score had significantly higher mortality compared to those with a high TYPICAL score (43% vs. 10%, p=0.006). Conclusions: Among women undergoing coronary angiography, black women report fewer chest-related and more stomach-related symptoms, regardless of presence or severity of CAD, and these racial symptom presentation differences are linked with the more adverse prognosis observed in the black women. Atypical symptom presentation may be a barrier to appropriate and timely diagnosis and treatment and contribute to poorer outcomes for black women. C1 [Eastwood, Jo-Ann] Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90095 USA. [Eastwood, Jo-Ann; Merz, C. Noel Bairey] Cedars Sinai Heart Inst, Barbra Streisand Womens Heart Ctr, Los Angeles, CA USA. [Johnson, B. Delia; Eteiba, Wafia] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. [Rutledge, Thomas] US Dept Vet Affairs VA San Diego Healthcare Syst, San Diego, CA USA. [Rutledge, Thomas] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. [Bittner, Vera] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA. [Whittaker, Kerry S.; Krantz, David S.] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. [Cornell, Carol E.] Univ Arkansas Med Sci, Dept Hlth Behav & Hlth Educ, Little Rock, AR 72205 USA. [Handberg, Eileen] Univ Florida, Div Cardiovasc Med, Gainesville, FL USA. [Vido, Diane] Allegheny Gen Hosp, Pittsburgh, PA 15212 USA. C3 University of California System; University of California Los Angeles; Cedars Sinai Medical Center; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA San Diego Healthcare System; University of California System; University of California San Diego; University of Alabama System; University of Alabama Birmingham; Uniformed Services University of the Health Sciences - USA; University of Arkansas System; University of Arkansas Medical Sciences; State University System of Florida; University of Florida; Allegheny General Hospital RP Eastwood, JA (通讯作者)，Univ Calif Los Angeles, Sch Nursing, Factor Bldg,Room 4-254,Box 956918,700 Tiverton Av, Los Angeles, CA 90095 USA. EM jeastwoo@sonnet.ucla.edu RI Krantz, David S./L-5364-2015 OI Krantz, David S./0000-0002-1671-1355 FU National Heart, Lung, and Blood Institutes [N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164]; National Institute on Aging [U0164829, U01HL649141, U01HL649241, T32HL69751, 1R03AG032631]; General Clinical Research Center (GCRC) from the National Center for Research Resources [MO1-RR00425]; Gustavus and Louis Pfeiffer Research Foundation, Danville, New Jersey; The Women's Guild of Cedars-Sinai Medical Center, Los Angeles, California; The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, Pennsylvania; QMED, Inc., Laurence Harbor, New Jersey; Edythe L. Broad Women's Heart Research Fellowship, Cedars-Sinai Medical Center; University of California Los Angeles School of Nursing; Barbra Streisand Women's Cardiovascular Research and Education Program, Cedars-Sinai Medical Center FX This work was supported by contracts from the National Heart, Lung, and Blood Institutes, Nos. N01-HV-68161, N01-HV-68162, N01-HV-68163, and N01-HV-68164; grants U0164829, U01HL649141, U01HL649241, T32HL69751, and 1R03AG032631 from the National Institute on Aging; General Clinical Research Center (GCRC) grant MO1-RR00425 from the National Center for Research Resources; and grants from the Gustavus and Louis Pfeiffer Research Foundation, Danville, New Jersey; The Women's Guild of Cedars-Sinai Medical Center, Los Angeles, California; The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, Pennsylvania; and QMED, Inc., Laurence Harbor, New Jersey, as well as the Edythe L. Broad Women's Heart Research Fellowship, Cedars-Sinai Medical Center; the University of California Los Angeles School of Nursing; and the Barbra Streisand Women's Cardiovascular Research and Education Program, Cedars-Sinai Medical Center. 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Womens Health PD SEP 1 PY 2013 VL 22 IS 9 BP 724 EP 732 DI 10.1089/jwh.2012.4031 PG 9 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 211UA UT WOS:000323935400003 OA Green Published DA 2023-05-13 ER PT J AU Staudacher, DL Biever, PM Benk, C Ahrens, I Bode, C Wengenmayer, T AF Staudacher, Dawid L. Biever, Paul M. Benk, Christoph Ahrens, Ingo Bode, Christoph Wengenmayer, Tobias TI Dual Antiplatelet Therapy (DAPT) versus No Antiplatelet Therapy and Incidence of Major Bleeding in Patients on Venoarterial Extracorporeal Membrane Oxygenation SO PLOS ONE LA English DT Article ID 2010 INTERNATIONAL CONSENSUS; CARDIOVASCULAR CARE SCIENCE; ACUTE CORONARY SYNDROMES; LIFE-SUPPORT; CARDIOPULMONARY-RESUSCITATION; TREATMENT RECOMMENDATIONS; PLATELET DYSFUNCTION; ADULT PATIENTS; ANTICOAGULATION; COMPLICATIONS AB Aims Bleeding is a frequent complication in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO). An indication for dual antiplatelet therapy due to coronary stent implantation is present in a considerable number of these patients. The objective of this retrospective study was to evaluate if dual antiplatelet therapy ( DAPT) significantly increases the high intrinsic bleeding risk in patients on VA-ECMO. Methods and Results A total of 93 patients were treated with VA-ECMO between October 2010 and October 2013. Average time on VA-ECMO was 58.9 +/- 1.7 hours. Dual antiplatelet therapy was given to 51.6% of all patients. Any bleeding was recorded in 60.2% of all patients. There was no difference in bleeding incidence in patients on DAPT when compared to those without any antiplatelet therapy including any bleeding (66.7% vs. 57.1%, p = 0.35), BARC3 bleeding (43.8% vs. 33.3%, p = 0.31) or pulmonary bleeding (16.7% vs. 19.0%, p = 0.77). This holds true after adjustment for confounders. Rate of transfusion of red blood cells were similar in patients with or without DAPT (35.4% vs. 28.6%, p = 0.488). Conclusions Bleeding on VA-ECMO is frequent. This registry recorded no statistical difference in bleeding in patients on dual antiplatelet therapy when compared to no antiplatelet therapy. When indicated, DAPT should not be withheld from VA ECMO patients. C1 [Staudacher, Dawid L.; Biever, Paul M.; Ahrens, Ingo; Bode, Christoph; Wengenmayer, Tobias] Univ Freiburg, Ctr Heart, Dept Cardiol & Angiol 1, Freiburg, Germany. [Benk, Christoph] Univ Freiburg, Ctr Heart, Dept Cardiovasc Surg, Freiburg, Germany. C3 University of Freiburg; University of Hamburg; University Medical Center Hamburg-Eppendorf; University of Freiburg; University of Hamburg; University Medical Center Hamburg-Eppendorf RP Staudacher, DL (通讯作者)，Univ Freiburg, Ctr Heart, Dept Cardiol & Angiol 1, Freiburg, Germany. EM dawid.staudacher@universitaets-herzzenrum.de RI Staudacher, Dawid L./AAF-5263-2021; Wengenmayer, Tobias/ABD-7064-2020 OI Staudacher, Dawid L./0000-0002-9423-9682; Wengenmayer, Tobias/0000-0002-3659-0407 FU German Research Foundation (DFG); University of Freiburg FX The article processing charge was funded by the German Research Foundation (DFG) and the University of Freiburg in the funding programme Open Access Publishing.; The article processing charge was funded by the German Research Foundation (DFG) and the University of Freiburg in the funding programme Open Access Publishing. CR Abrams D, 2014, J AM COLL CARDIOL, V63, P2769, DOI 10.1016/j.jacc.2014.03.046 Ang AL, 2009, VOX SANG, V96, P34, DOI 10.1111/j.1423-0410.2008.01110.x Annich GM, 2015, J THROMB HAEMOST, V13, pS336, DOI 10.1111/jth.12963 Aubron C, 2013, CRIT CARE, V17, DOI 10.1186/cc12681 Bein T, 2011, ASAIO J, V57, P164, DOI 10.1097/MAT.0b013e318213f9e0 Bossaert L, 2010, RESUSCITATION, V81, pE175, DOI 10.1016/j.resuscitation.2010.09.001 Brown DJA, 2012, NEW ENGL J MED, V367, P1930, DOI [10.1056/NEJMra1114208, 10.1056/NEJMc1215158] Cheng R, 2014, ANN THORAC SURG, V97, P610, DOI 10.1016/j.athoracsur.2013.09.008 Cheung PY, 2000, CRIT CARE MED, V28, P2584, DOI 10.1097/00003246-200007000-00067 Hansen ML, 2010, ARCH INTERN MED, V170, P1433, DOI 10.1001/archinternmed.2010.271 Heilmann C, 2012, INTENS CARE MED, V38, P62, DOI 10.1007/s00134-011-2370-6 Hou G, 2015, MINERVA CARDIOANGIOL Kalbhenn J, 2015, PERFUSION-UK, V30, P675, DOI 10.1177/0267659115579714 Kane DA, 2010, CIRCULATION, V122, pS241, DOI 10.1161/CIRCULATIONAHA.109.928390 Lequier, 2014, ELSO ANTICOAGULATION Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Morrison LJ, 2010, CIRCULATION, V122, P8345, DOI 10.1161/CIRCULATIONAHA.110.971051 Raja SG, 2006, J CARDIAC SURG, V21, P35, DOI 10.1111/j.1540-8191.2006.00164.x Rubboli A, 2014, J INVASIVE CARDIOL, V26, P563 Sousa-Uva M, 2014, EUR HEART J, V35, P1510, DOI 10.1093/eurheartj/ehu158 Staudacher DL, 2015, SCIENTIFICA, V2015, P1, DOI 10.1155/2015/435878 Staudacher DL, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0140101 Steinlechner B, 2009, ANN THORAC SURG, V87, P131, DOI 10.1016/j.athoracsur.2008.10.027 StephanWindecker, 2015, Rev Esp Cardiol (Engl Ed), V68, P144, DOI 10.1016/j.rec.2014.12.006 Werho DK, 2015, PEDIATR CRIT CARE ME, V16, P276, DOI 10.1097/PCC.0000000000000345 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 NR 26 TC 15 Z9 15 U1 1 U2 4 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 e0159973 DI 10.1371/journal.pone.0159973 PG 9 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA DT5IL UT WOS:000381516100080 PM 27467697 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU George, J Mathur, R Shah, AD Pujades-Rodriguez, M Denaxas, S Smeeth, L Timmis, A Hemingway, H AF George, Julie Mathur, Rohini Shah, Anoop Dinesh Pujades-Rodriguez, Mar Denaxas, Spiros Smeeth, Liam Timmis, Adam Hemingway, Harry TI Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients SO PLOS ONE LA English DT Article ID PERIPHERAL ARTERIAL-DISEASE; CORONARY-HEART-DISEASE; SOUTH ASIANS; SCOTTISH HEALTH; ATHEROSCLEROSIS RISK; LIFETIME RISKS; FOLLOW-UP; STROKE; FAILURE; LINKAGE AB Background While the association of ethnic group with individual cardiovascular diseases has been studied, little is known about ethnic differences in the initial lifetime presentation of clinical cardiovascular disease in contemporary populations. Methods and results We studied 1,068,318 people, aged >= 30 years and free from diagnosed CVD at baseline (90.9% White, 3.6% South Asian and 2.9% Black), using English linked electronic health records covering primary care, hospital admissions, acute coronary syndrome registry and mortality registry (CALIBER platform). During 5.7 years median follow-up between 1997-2010, 95,224 people experienced an incident cardiovascular diagnosis. 69.9% (67.2%-72.4%) of initial presentation in South Asian < 60 yrs were coronary heart disease presentations compared to 47.8% (47.3%-48.3%) in White and 40.1% (36.3%-43.9%) in Black patients. Compared to White patients, Black patients had significantly lower age-sex adjusted hazard ratios (HRs) for initial lifetime presentation of all the coronary disease diagnoses (stable angina HR 0.80 (95% CI 0.68-0.93); unstable angina-0.75 (0.59-0.97); myocardial infarction 0.49 (0.40-0.62)) while South Asian patients had significantly higher HRs (stable angina-1.67 (1.52-1.84); unstable angina 1.82 (1.56-2.13); myocardial infarction-1.67 (1.49-1.87). We found no ethnic differences in initial presentation with heart failure (Black 0.97 (0.79-1.20); S Asian 1.04(0.87-1.26)). Compared to White patients, Black patients were more likely to present with ischaemic stroke (1.24 (0.97-1.58)) and intracerebral haemorrhage (1.44 (0.97-2.12)). Presentation with peripheral arterial disease was less likely for Black (0.63 (0.50-0.80)) and South Asian patients (0.70 ( 0.57-0.86)) compared with White patients. Discussion While we found the anticipated substantial predominance of coronary heart disease presentations in South Asian and predominance of stroke presentations in Black patients, we found no ethnic differences in presentation with heart failure. We consider the public health and research implications of our findings. C1 [George, Julie; Shah, Anoop Dinesh; Pujades-Rodriguez, Mar; Denaxas, Spiros; Hemingway, Harry] UCL, Farr Inst Hlth Informat Res, Biomed Res Ctr, London, England. [George, Julie; Shah, Anoop Dinesh; Pujades-Rodriguez, Mar; Denaxas, Spiros; Hemingway, Harry] UCL, Natl Inst Hlth Res, Biomed Res Ctr, London, England. [Mathur, Rohini; Smeeth, Liam] London Sch Hyg & Trop Med, Noncommunicable Dis Epidemiol, Elect Hlth Records Grp, London, England. [Pujades-Rodriguez, Mar] Univ Leeds, Leeds Inst Biomed & Clin Sci, Leeds, W Yorkshire, England. [Timmis, Adam] Barts Heart Ctr, NIHR Cardiovasc Biomed Res Unit, London, England. C3 RLUK- Research Libraries UK; University of London; University College London; RLUK- Research Libraries UK; University of London; University College London; University of London; London School of Hygiene & Tropical Medicine; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds RP George, J (通讯作者)，UCL, Farr Inst Hlth Informat Res, Biomed Res Ctr, London, England.; George, J (通讯作者)，UCL, Natl Inst Hlth Res, Biomed Res Ctr, London, England. EM j.george@ucl.ac.uk RI Pujades-Rodriguez, Mar/T-1129-2018; Woodward, Mark/D-8492-2015; Mathur, Rohini/C-7788-2013; Shah, Anoop Dinesh/D-4396-2014; Hemingway, Harry/C-1219-2009; Smeeth, Liam/X-5862-2018 OI Pujades-Rodriguez, Mar/0000-0002-1375-1028; Mathur, Rohini/0000-0002-3817-8790; Shah, Anoop Dinesh/0000-0002-8907-5724; Hemingway, Harry/0000-0003-2279-0624; Smeeth, Liam/0000-0002-9168-6022; Denaxas, Spiros/0000-0001-9612-7791 FU National Institute for Health Research [RP-PG-040710314]; Wellcome Trust [WT/086091/Z/08/Z]; Medical Research Council [MR/K006584/1]; Arthritis Research UK; British Heart Foundation; Cancer Research UK; Chief Scientist Office; Economic and Social Research Council; Engineering and Physical Sciences Research Council; National Institute for Health Research; National Institute for Social Care and Health Research (NIHR); Wellcome Trust; Sir Henry Wellcome Postdoctoral Fellowship from the Wellcome Trust [WT/201375/Z/16/Z]; Wellcome Trust Clinical Research Training Fellowship [WT/0938/30/Z/10/Z]; Wellcome Trust Senior Research Fellowship in Clinical Science [WT/098504/Z/12/Z]; NIHR; Medical Research Council [MR/K006584/1] Funding Source: researchfish; National Institute for Health Research [RP-PG-0407-10314] Funding Source: researchfish FX This study was supported by the National Institute for Health Research (RP-PG-040710314) and the Wellcome Trust (WT/086091/Z/08/Z). The study was carried out as part of the CArdiovascular disease research using LInked Bespoke studies and Electronic health Records (CALIBER) programme. HH was supported by an award (grant MR/K006584/1) to establish the Farr Institute of Health Informatics Research London at UCLPartners, from the Medical Research Council, Arthritis Research UK, British Heart Foundation, Cancer Research UK, Chief Scientist Office, Economic and Social Research Council, Engineering and Physical Sciences Research Council, National Institute for Health Research, National Institute for Social Care and Health Research (NIHR), and Wellcome Trust. HH is a NIHR Senior Investigator (NF-SI-0616-10066.). RM was supported by a Sir Henry Wellcome Postdoctoral Fellowship from the Wellcome Trust (WT/201375/Z/16/Z). ADS was supported by a Wellcome Trust Clinical Research Training Fellowship (WT/0938/30/Z/10/Z). LS was supported by a Wellcome Trust Senior Research Fellowship in Clinical Science (WT/098504/Z/12/Z). This article presents independent research funded in part by the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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TI Sequential multiple assignment randomized trial (SMART) with adaptive randomization for quality improvement in depression treatment program SO BIOMETRICS LA English DT Article DE Behavioral intervention; Dynamic treatment regimen; Implementation research; Play-the-winner; Problem-solving therapy; Q-learning ID DESIGN; CALIBRATION; TIMES AB Implementation study is an important tool for deploying state-of-the-art treatments from clinical efficacy studies into a treatment program, with the dual goals of learning about effectiveness of the treatments and improving the quality of care for patients enrolled into the program. In this article, we deal with the design of a treatment program of dynamic treatment regimens (DTRs) for patients with depression post-acute coronary syndrome. We introduce a novel adaptive randomization scheme for a sequential multiple assignment randomized trial of DTRs. Our approach adapts the randomization probabilities to favor treatment sequences having comparatively superior Q-functions used in Q-learning. The proposed approach addresses three main concerns of an implementation study: it allows incorporation of historical data or opinions, it includes randomization for learning purposes, and it aims to improve care via adaptation throughout the program. We demonstrate how to apply our method to design a depression treatment program using data from a previous study. By simulation, we illustrate that the inputs from historical data are important for the program performance measured by the expected outcomes of the enrollees, but also show that the adaptive randomization scheme is able to compensate poorly specified historical inputs by improving patient outcomes within a reasonable horizon. The simulation results also confirm that the proposed design allows efficient learning of the treatments by alleviating the curse of dimensionality. C1 [Cheung, Ying Kuen; Chakraborty, Bibhas] Columbia Univ, Mailman Sch Publ Hlth, Dept Biostatist, New York, NY 10032 USA. [Chakraborty, Bibhas] Duke NUS Grad Med Sch, Ctr Quantitat Med, Singapore 169856, Singapore. [Davidson, Karina W.] Columbia Univ, Med Ctr, Ctr Behav Cardiovasc Hlth, New York, NY 10032 USA. C3 Columbia University; National University of Singapore; Columbia University RP Cheung, YK (通讯作者)，Columbia Univ, Mailman Sch Publ Hlth, Dept Biostatist, 722 W 168th St, New York, NY 10032 USA. EM yc632@columbia.edu RI Davidson, Karina/AAG-2388-2019; Davidson, Karina/GWC-0996-2022 OI Davidson, Karina/0000-0002-9162-477X; Davidson, Karina/0000-0002-9162-477X FU NIH [R01 NS072127] FX We thank the editors and reviewers for their comments that led to an improved article. This work was supported by NIH grant R01 NS072127. CR Barker AD, 2009, CLIN PHARMACOL THER, V86, P97, DOI 10.1038/clpt.2009.68 Chakraborty B, 2013, BIOMETRICS, V69, P714, DOI 10.1111/biom.12052 Cheung K, 2014, AM J PUBLIC HEALTH, V104, pE23, DOI 10.2105/AJPH.2013.301579 Cheung YK, 2008, BIOMETRICS, V64, P940, DOI 10.1111/j.1541-0420.2007.00929.x Cheung YK, 2006, STAT MED, V25, P55, DOI 10.1002/sim.2247 Cohen J., 1988, STAT POWER ANAL BEHA Davidson Karina W, 2013, JAMA Intern Med, V173, P997, DOI 10.1001/jamainternmed.2013.915 Lavori Philip W, 2004, Clin Trials, V1, P9, DOI 10.1191/1740774S04cn002oa Lee J, 2015, J AM STAT ASSOC, V110, P711, DOI 10.1080/01621459.2014.926815 Lee SM, 2011, STAT MED, V30, P2081, DOI 10.1002/sim.4139 Lee SM, 2009, CLIN TRIALS, V6, P227, DOI 10.1177/1740774509105076 Moodie EEM, 2014, STAT BIOSCI, V6, P223, DOI 10.1007/s12561-013-9103-z Murphy SA, 2005, J MACH LEARN RES, V6, P1073 Murphy SA, 2005, STAT MED, V24, P1455, DOI 10.1002/sim.2022 Murphy SA, 2003, J R STAT SOC B, V65, P331, DOI 10.1111/1467-9868.00389 Robins JM., 1997, LATENT VARIABLE MODE, P69 RUBIN DB, 1974, J EDUC PSYCHOL, V66, P688, DOI 10.1037/h0037350 Rush AJ, 2004, CONTROL CLIN TRIALS, V25, P119, DOI 10.1016/S0197-2456(03)00112-0 Schneider LS, 2001, AM J GERIAT PSYCHIAT, V9, P346, DOI 10.1176/appi.ajgp.9.4.346 Thall PF, 2007, STAT MED, V26, P4687, DOI 10.1002/sim.2894 Thall PF, 2007, EUR J CANCER, V43, P859, DOI 10.1016/j.ejca.2007.01.006 Thall PF, 2000, STAT MED, V19, P1011, DOI 10.1002/(SICI)1097-0258(20000430)19:8<1011::AID-SIM414>3.0.CO;2-M Thombs BD, 2008, JAMA-J AM MED ASSOC, V300, P2161, DOI 10.1001/jama.2008.667 Watkins C. J. C. H., 1989, THESIS NR 24 TC 30 Z9 30 U1 0 U2 8 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0006-341X EI 1541-0420 J9 BIOMETRICS JI Biometrics PD JUN PY 2015 VL 71 IS 2 BP 450 EP 459 DI 10.1111/biom.12258 PG 10 WC Biology; Mathematical & Computational Biology; Statistics & Probability WE Science Citation Index Expanded (SCI-EXPANDED) SC Life Sciences & Biomedicine - Other Topics; Mathematical & Computational Biology; Mathematics GA CL2XC UT WOS:000356810000021 PM 25354029 OA Green Accepted DA 2023-05-13 ER PT J AU Kwok, ESH Clapham, G Calder-Sprackman, S AF Kwok, Edmund S. H. Clapham, Glenda Calder-Sprackman, Samantha TI The Impact of COVID-19 Pandemic on Emergency Department Visits at a Canadian Academic Tertiary Care Center SO WESTERN JOURNAL OF EMERGENCY MEDICINE LA English DT Article AB Introduction: Public health response to the coronavirus 2019 (COVID-19) pandemic has emphasized social distancing and stay-at-home policies. Reports of decreased emergency department (ED) visits in non-epicenters of the outbreak have raised concerns that patients with non-COVID-19 emergencies are delaying or avoiding seeking care. We evaluated the impact of the pandemic on ED visits at an academic tertiary care center. Methods: We conducted an observational health records review between January 1-April 22, 2020, comparing characteristics of all ED visits between pre- and post-pandemic declaration by the World Health Organization. Measures included triage acuity, presenting complaints, final diagnoses, disposition, and mortality. We further examined three time-sensitive final diagnoses: stroke; sepsis; and acute coronary syndrome (ACS). Results: In this analysis, we included 44,497 ED visits. Average daily ED visits declined from 458.1 to 289.0 patients/day (-36.9%). For the highest acuity triaged patients there was a drop of 1.1 patients/day (-24.9%). Daily ED visits related to respiratory complaints increased post-pandemic (+14.1%) while ED visits for many other complaints decreased, with the greatest decline in musculoskeletal (-52.5%) and trauma (-53.6%). On average there was a drop of 1.0 patient/day diagnosed with stroke (-17.6%); a drop of 1.6 patients/day diagnosed with ACS (-49.9%); and no change in patients diagnosed with sepsis (pre = 2.8 patients/day; post = 2.9 patients/day). Conclusion: Significant decline in ED visits was observed immediately following formal declaration of the COVID-19 pandemic, with potential for delayed/missed presentations of time-sensitive emergencies. Future research is needed to better examine long-term clinical outcomes of the decline in ED visits during pandemics. C1 [Kwok, Edmund S. H.; Clapham, Glenda; Calder-Sprackman, Samantha] Univ Ottawa, Dept Emergency Med, Ottawa, ON, Canada. [Kwok, Edmund S. H.; Calder-Sprackman, Samantha] Ottawa Hosp, Res Inst, Ottawa, ON, Canada. C3 University of Ottawa; University of Ottawa; Ottawa Hospital Research Institute RP Kwok, ESH (通讯作者)，Ottawa Hosp, Dept Emergency Med, 1053 Carling Ave,Room EM-206,Box 227, Ottawa, ON K1Y 4E9, Canada. EM ekwok@toh.ca CR Bai Y, 2020, JAMA-J AM MED ASSOC, V323, P1406, DOI [10.1001/jama.2020.2565, 10.1056/NEJMoa2001316] Bullard MJ, 2017, CAN J EMERG MED, V19, pS18, DOI 10.1017/cem.2017.365 CDC, 2020, NOV COR 2019 NCOV TR Deerberg-Wittram J, 2020, NEJM CATALYST INNOVA, DOI [10.1056/ CAT.20.0146., DOI 10.1056/CAT.20.0146, 10.1056/CAT.20.0146] Elliott JK., 2020, GLOBAL NEWS CANADA Groenewoudt M, 2014, EUR J EMERG MED, V21, P330, DOI 10.1097/MEJ.0000000000000091 Krumholz HW, 2020, NEW YORK TIMES Mitra G., 2020, CBC NEWS Siegler JE, 2020, J STROKE CEREBROVASC, V29, DOI 10.1016/j.jstrokecerebrovasdis.2020.104953 Solomon MD, 2020, NEW ENGL J MED, V383, P691, DOI 10.1056/NEJMc2015630 StatsCan, 2020, PROV DEATH COUNTS EX Wang HE, 2017, CRIT CARE MED, V45, P1443, DOI 10.1097/CCM.0000000000002538 WHO, 2020, Q A COR Wong LE, 2020, NEJM CATAL INNOV CAR, DOI 10.1056/ CAT.20.0193 World Health Organization, NAM COR DIS COVID 20 World Health Organization, 2020, GLOB HLTH EST 2020 D NR 16 TC 4 Z9 4 U1 0 U2 1 PU WESTJEM PI ORANGE PA C/O SHAHRAM LOTFIPOUR, MD, MPH, 333 CITY BLVD W STE 640, RT 128-01, ORANGE, CA 92868 USA SN 1936-900X EI 1936-9018 J9 WEST J EMERG MED JI West. J. Emerg. Med. PD JUL PY 2021 VL 22 IS 4 BP 851 EP 859 DI 10.5811/westjem.2021.2.49626 PG 9 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA TU9NQ UT WOS:000681356800007 PM 35353999 OA Green Published, gold DA 2023-05-13 ER PT J AU Chen, PF Wang, DN Chen, K Liang, C Reng, YS Yang, J Ding, R Blackwell, J Liao, DN AF Chen, Peng-Fei Wang, Dan-Ning Chen, Kan Liang, Chun Reng, Yu-Sheng Yang, Jing Ding, Ru Blackwell, Jacob Liao, De-Ning TI Outcomes of percutaneous coronary intervention in patients >= 75 years: one-center study in a Chinese patient group SO JOURNAL OF GERIATRIC CARDIOLOGY LA English DT Article DE Outcome; Percutaneous coronary intervention; The elderly ID ELEVATION MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; PATIENTS GREATER-THAN-OR-EQUAL-TO-75 YEARS; CONTRAST-INDUCED NEPHROPATHY; TEMPORAL TRENDS; CARDIOVASCULAR-ANGIOGRAPHY; PRACTICE GUIDELINES; ELDERLY-PATIENTS; RISK SCORE; PREDICTION AB Objective To investigate the clinical and perioperative characteristics of patients >= 75 who undergoing percutaneous coronary intervention (PCI) and to evaluate the risk factors related to short-term post-PCI mortality in this specific patients group. Methods 1,035 consecutive subjects who underwent PCI from December 2011 to November 2013 were divided into four categories: (1) patients with stable angina (SA) >= 75 years (n = 58); (2) patients with SA < 75 years (n = 218); (3) patients with acute coronary syndrome (ACS) >= 75 years (n = 155); (4) patients with ACS < 75 years (n = 604). A multivariable logistic regression analysis was conducted to detect risk factors of six-month mortality in patients >= 75 years who had undergone PCI. Clinical comorbidities, in-hospital biochemical indicators, perioperative data, in-hospital and six-month outcomes were analyzed and compared among the four groups. Results Compared with the younger group, patients >= 75 years were more likely to have hypertension, history of stroke, chronic obstructive pulmonary disease, peripheral vascular disease, cardiogenic shock and malignant arrhythmia, and they were admitted to hospital with relative lower weight, hemoglobin, albumin, triglyceride, higher creatinine, uric acid, urea nitrogen and pro-BNP. Left main artery lesions, multi-vessel, calcified lesions, chronic totally occlusion were also more likely to be seen in the elderly group. Univariate analysis revealed that age >= 85 years, cardiogenic shock or severe arrhythmia at admission, emergency PCI, prior stroke and chronic kidney disease were related to six-month mortality in elderly patients >= 75 years who underwent PCI. Multivariable logistic regression showed that cardiogenic shock or severe arrhythmia at admission, chronic kidney disease and prior stroke were independent risk factors predicting six-month mortality in elderly patients >= 75 years who had undergone PCI. Conclusions Our data showed that, compared with patients under 75 years, elderly patients (>= 75 years) who had undergone PCI had a relative higher risk of mortality, and more often accompanied with multi-comorbidities, severer admission conditions and complex coronary lesions. Better evaluation of risk factors and more intensively care should be taken to patients >= 75 years who had undergone PCI therapy to reduce complications. C1 [Chen, Peng-Fei; Wang, Dan-Ning; Chen, Kan; Liang, Chun; Reng, Yu-Sheng; Yang, Jing; Ding, Ru; Liao, De-Ning] Shanghai Changzheng Hosp, Dept Cardiol, Shanghai, Peoples R China. [Chen, Peng-Fei] 309th Hosp Chinese Peoples Liberat Army, Dept Cardiol, Beijing, Peoples R China. [Blackwell, Jacob] Wake Forest Sch Med, Winston Salem, NC USA. C3 Naval Medical University; Wake Forest University RP Liao, DN (通讯作者)，Shanghai Changzheng Hosp, Dept Cardiol, Shanghai, Peoples R China. EM liao6007@163.com RI HE, Zhiqing/J-8051-2019 OI HE, Zhiqing/0000-0001-8363-1286; Ding, Ru/0000-0002-4214-100X FU Science and Technology Commission of Shanghai Municipality [13411950202] FX This study was supported by the Science and Technology Commission of Shanghai Municipality (No. 13411950202). 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Geriatr. Cardiol. PY 2015 VL 12 IS 6 BP 626 EP 633 PG 8 WC Cardiac & Cardiovascular Systems; Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Geriatrics & Gerontology GA DB4HR UT WOS:000368474600006 PM 26788039 DA 2023-05-13 ER PT J AU Cole, NI Suckling, RJ Swift, PA He, FJ MacGregor, GA Hinton, W van Vlymen, J Hayward, N Jones, S de Lusignan, S AF Cole, Nicholas I. Suckling, Rebecca J. Swift, Pauline A. He, Feng J. MacGregor, Graham A. Hinton, William van Vlymen, Jeremy Hayward, Nicholas Jones, Simon de Lusignan, Simon TI The association between serum sodium concentration, hypertension and primary cardiovascular events: a retrospective cohort study SO JOURNAL OF HUMAN HYPERTENSION LA English DT Article ID PLASMA SODIUM; BLOOD-PRESSURE; HEART-FAILURE; PROGNOSTIC IMPORTANCE; SALT REDUCTION; HYPONATREMIA; METAANALYSIS; ENDOTHELIUM; MORTALITY; RISK AB The mechanisms underlying the adverse cardiovascular effects of increased salt intake are incompletely understood, but parallel increases in serum sodium concentration may be of importance. The aim of this retrospective cohort study was to investigate the relationship between serum sodium, hypertension and incident cardiovascular disease (CVD). Routinely collected primary care data from the Royal College of General Practitioners Research and Surveillance Centre were analysed. A total of 231,545 individuals with a measurement of serum sodium concentration at baseline were included. Exclusion criteria were: age < 40 years; abnormal serum sodium; diabetes mellitus; prior CVD event; stage 5 chronic kidney disease; and liver cirrhosis. The primary outcome was incident CVD (myocardial infarction, acute coronary syndrome, coronary revascularisation, stroke, transient ischaemic attack or new heart failure diagnosis) over 5 years. There was a 'J-shaped' relationship between serum sodium concentration and primary cardiovascular events that was independent of established risk factors, medications and other serum electrolytes. The lowest cardiovascular risk was found with a serum sodium between 141 and 143 mmol/l. Higher serum sodium was associated with increased risk in hypertensive individuals, whereas lower concentrations were associated with increased risk in all individuals. Therefore, alterations in serum sodium concentration may be a useful indicator of CVD risk. Higher serum sodium could have a direct effect on the vasculature, particularly in hypertensive individuals. Lower serum sodium may be a reflection of complex volume and neuroendocrine changes. C1 [Cole, Nicholas I.; Suckling, Rebecca J.; Swift, Pauline A.] Epsom & St Helier Univ Hosp NHS Trust, Renal Dept, London, England. [He, Feng J.; MacGregor, Graham A.] Queen Mary Univ London, Wolfson Inst Preventat Med, London, England. [Hinton, William; van Vlymen, Jeremy; Hayward, Nicholas; Jones, Simon; de Lusignan, Simon] Univ Surrey, Dept Clin & Expt Med, Guildford, Surrey, England. [Jones, Simon] NYU, Div Healthcare Delivery Sci, New York, NY USA. C3 RLUK- Research Libraries UK; University of London; Queen Mary University London; University of Surrey; New York University RP Cole, NI (通讯作者)，Epsom & St Helier Univ Hosp NHS Trust, Renal Dept, London, England. 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PD JAN PY 2019 VL 33 IS 1 BP 69 EP 77 DI 10.1038/s41371-018-0115-5 PG 9 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HH3QB UT WOS:000455633100009 PM 30250270 OA Green Submitted DA 2023-05-13 ER PT J AU Kim, C Kim, CH Jee, H Lim, YJ Kim, YJ AF Kim, Chul Kim, Chul-Hyun Jee, Haemi Lim, Young-Joon Kim, Young-Joo TI Effects of Exercise Type on Hemodynamic Responses and Cardiac Events in ACS Patients SO JOURNAL OF PHYSICAL THERAPY SCIENCE LA English DT Article DE Treadmill; Cycle ergometer; Rate pressure product ID AMERICAN-HEART-ASSOCIATION; MYOCARDIAL OXYGEN-CONSUMPTION; HEALTH-CARE PROFESSIONALS; TREADMILL EXERCISE; BICYCLE EXERCISE; DYNAMIC EXERCISE; ANGINA-PECTORIS; BETA-BLOCKADE; STATEMENT; STANDARDS AB [Purpose] This study investigated the effects of mid, and high exercise intensities on hemodynamic responses and cardiac events during two exercise types of treadmill exercise (TM) and cycle ergometer exercises (CE) in patients with acute coronary syndrome (ACS). [Subjects] Patients who had percutaneous coronary intervention (PCI) for ACS and were participating in cardiac rehabilitation program were included. [Methods] The patients were assessed for hemodynamic responses, cardiac events, and rate of perceived exertion (RPE) with target heart rates of 60% and 85% heart rate reserve (HRR) during TM and CE. [Results] Maximum systolic blood pressure (SBP), diastolic blood pressure (DBP), RPE, and rate pressure product (RPP) measured during CE were significantly higher than their values in TM at the same exercise intensities. The highest SBP was shown at 85% HRR during CE. SBPmax to SBPmax ratios obtained during the graded exercise test (GXT) showed that all % SBPmax were significantly greater in CE than in TM at the same exercise intensities. Out of 102 patients, cardiac events occurred in 8 at 85% HRR during CE, and 1 at 85% HRR during TM. Patients with cardiac events (CE- E) had significantly higher % SBP, % RPP, and RPE at 85% HRR than those without events (CE- NE) during CE. [Conclusion] Prescribing exercise based on the intensity obtained in a treadmill GXT may expose patients to cardiovascular complications such as higher RPP, higher exercise intensity, and cardiac events during CE. C1 [Kim, Chul; Lim, Young-Joon; Kim, Young-Joo] Inje Univ, Sanggye Paik Hosp, Coll Med, Dept Rehabil Med, Seoul 139707, South Korea. [Kim, Chul-Hyun] Soonchunhyang Univ, Dept Sports Med, Asan, South Korea. [Jee, Haemi] Namseoul Univ, Dept Hlth & Fitness Management, Cheonan, South Korea. C3 Inje University; Soonchunhyang University; Namseoul University RP Kim, YJ (通讯作者)，Inje Univ, Sanggye Paik Hosp, Coll Med, Dept Rehabil Med, 761-7,Sanggye 7 Dong, Seoul 139707, South Korea. EM kyj1383@yahoo.com RI Kim, Chul-Hyun/Z-2048-2019 CR ACSM, 2009, ACSMS GUID EX TEST P, P119 ADES PA, 1984, AM J CARDIOL, V54, P1337, DOI 10.1016/S0002-9149(84)80093-4 Ades PA, 2001, NEW ENGL J MED, V345, P892, DOI 10.1056/NEJMra001529 American College of Sports Medicine, 2003, EX MAN PERS CHRON DI, P88 Balady GJ, 2000, CIRCULATION, V102, P1069, DOI 10.1161/01.CIR.102.9.1069 Balogun M O, 1997, Afr J Med Med Sci, V26, P27 BLOMQVIST CG, 1981, CIRC RES, V48, P87 Borg G, 1998, MED SCI SPORTS EXERC, P44 BRAUNWALD E, 1988, HEART DIS TXB CARDIO, P224 Clarys JP, 1988, J SPORT SCI, V6, P229, DOI 10.1080/02640418808729812 COHN JN, 1985, AM J CARDIOL, V55, pD125, DOI 10.1016/0002-9149(85)91067-7 Fletcher GF, 2001, CIRCULATION, V104, P1694, DOI 10.1161/hc3901.095960 FLETCHER GF, 1990, CIRCULATION, V82, P2286, DOI 10.1161/01.CIR.82.6.2286 FOSTER C, 1995, J NUCL CARDIOL, V2, P485, DOI 10.1016/S1071-3581(05)80040-6 Gellish RL, 2007, MED SCI SPORT EXER, V39, P822, DOI 10.1097/mss.0b013e31803349c6 GLASSFORD RG, 1965, J APPL PHYSIOL, V20, P509, DOI 10.1152/jappl.1965.20.3.509 GOBEL FL, 1978, CIRCULATION, V57, P549, DOI 10.1161/01.CIR.57.3.549 Harriss DJ, 2011, INT J SPORTS MED, V32, P819, DOI 10.1055/s-0031-1287829 KARVONEN MJ, 1957, ANN MED EXP BIOL FEN, V35, P307 MACDOUGALL JD, 1985, J APPL PHYSIOL, V58, P785, DOI 10.1152/jappl.1985.58.3.785 Maeder M, 2005, CHEST, V128, P2804, DOI 10.1378/chest.128.4.2804 MCARDLE WD, 1973, MED SCI SPORT EXER, V5, P156 MIYAMURA M, 1972, J APPL PHYSIOL, V32, P185, DOI 10.1152/jappl.1972.32.2.185 MYERS J, 1991, J AM COLL CARDIOL, V17, P1334, DOI 10.1016/S0735-1097(10)80144-5 MYERS JN, 1994, MED SCI SPORT EXER, V26, P1082 Naughton J, 1988, PHYSL BIOMECHANICAL, P86 NELSON RR, 1974, CIRCULATION, V50, P1179, DOI 10.1161/01.CIR.50.6.1179 NORTHRIDGE DB, 1990, BRIT HEART J, V64, P313 Palatini P, 1987, G Ital Cardiol, V17, P680 Pluim BM, 2000, CIRCULATION, V101, P336, DOI 10.1161/01.CIR.101.3.336 Reed J, 2007, ETHNIC DIS, V17, P59 STARLING MR, 1984, AM HEART J, V107, P298, DOI 10.1016/0002-8703(84)90378-8 Yamakado T, 1996, CORONARY ARTERY DIS, V7, P819, DOI 10.1097/00019501-199611000-00005 NR 33 TC 1 Z9 1 U1 0 U2 3 PU SOC PHYSICAL THERAPY SCIENCE PI TOKYO PA C/O PUBLICATION CENTER, 1-24-12 SUGAMO, TOSHIMA-KU, TOKYO, 170-0002, JAPAN SN 0915-5287 EI 2187-5626 J9 J PHYS THER SCI JI J. Phys. Ther. Sci. PD APR PY 2014 VL 26 IS 4 BP 609 EP 614 DI 10.1589/jpts.26.609 PG 6 WC Rehabilitation WE Science Citation Index Expanded (SCI-EXPANDED) SC Rehabilitation GA AM1QF UT WOS:000339621900032 PM 24764644 OA gold, Green Published, Green Submitted DA 2023-05-13 ER PT J AU Marsousi, N Daali, Y Fontana, P Reny, JL Ancrenaz-Sirot, V Calmy, A Rudaz, S Desmeules, JA Samer, CF AF Marsousi, Niloufar Daali, Youssef Fontana, Pierre Reny, Jean-Luc Ancrenaz-Sirot, Virginie Calmy, Alexandra Rudaz, Serge Desmeules, Jules Alexandre Samer, Caroline Flora TI Impact of Boosted Antiretroviral Therapy on the Pharmacokinetics and Efficacy of Clopidogrel and Prasugrel Active Metabolites SO CLINICAL PHARMACOKINETICS LA English DT Article ID PERCUTANEOUS CORONARY INTERVENTION; VIRUS-INFECTED PATIENTS; OF-CARE ASSAY; PLATELET REACTIVITY; CYTOCHROME-P450 3A; P-GLYCOPROTEIN; MYOCARDIAL-INFARCTION; HEALTHY-VOLUNTEERS; RITONAVIR; HIV AB Background and objectivesPrasugrel and clopidogrel are inhibitors of the ADP-P2Y12 platelet receptor used in acute coronary syndrome patients. They require bioactivation via isoenzymes such as cytochrome P450 (CYP)3A4, CYP2C19 and CYP2B6. Ritonavir and cobicistat are potent CYP3A inhibitors, prescribed as pharmacokinetic (PK) enhancers in the treatment of human immunodeficiency virus (HIV) infection.MethodsIn this study, the impact of boosted antiretroviral therapies (ARTs) on the PK of clopidogrel and prasugrel active metabolites (AMs), and on the efficacy of prasugrel and clopidogrel, were evaluated in a randomized crossover clinical trial.ResultsA significantly lower exposure to clopidogrel AM [3.2-fold lower area under the concentration-time curve (AUC) and maximum plasma concentration (C-max)] and prasugrel AM (2.1-fold and 1.7-fold lower AUC and C-max) were demonstrated in HIV-infected patients treated with boosted ARTs compared with healthy controls; however, a differential impact was observed on platelet inhibition between clopidogrel and prasugrel. Clopidogrel 300mg induced adequate (although modest) platelet inhibition in all healthy subjects, while platelet inhibition was insufficient in 44% of HIV patients. On the contrary, prasugrel 60mg induced a potent platelet inhibition in both healthy and HIV-infected subjects.ConclusionPrasugrel appears to remain an adequate antiplatelet agent in HIV-infected patients and could be preferred to clopidogrel in this context, regardless of the metabolic interaction and inhibition of its bioactivation pathways. C1 [Marsousi, Niloufar; Daali, Youssef; Ancrenaz-Sirot, Virginie; Desmeules, Jules Alexandre; Samer, Caroline Flora] Geneva Univ Hosp, Div Clin Pharmacol & Toxicol, Rue Gabrielle Perret Gentil 4, CH-1211 Geneva, Switzerland. [Marsousi, Niloufar; Daali, Youssef; Rudaz, Serge; Desmeules, Jules Alexandre] Univ Geneva, Sch Pharmaceut Sci, Geneva, Switzerland. [Marsousi, Niloufar; Daali, Youssef; Rudaz, Serge; Desmeules, Jules Alexandre] Lausanne Univ, Sch Pharmaceut Sci, Geneva, Switzerland. [Daali, Youssef; Rudaz, Serge; Desmeules, Jules Alexandre; Samer, Caroline Flora] Swiss Ctr Appl Human Toxicol SCAHT, Basel, Switzerland. [Fontana, Pierre; Desmeules, Jules Alexandre; Samer, Caroline Flora] Univ Geneva, Fac Med, Geneva, Switzerland. [Fontana, Pierre] Geneva Univ Hosp, Div Angiol & Haemostasis, Geneva, Switzerland. [Fontana, Pierre; Reny, Jean-Luc] Univ Geneva, Geneva Platelet Grp, Fac Med, Geneva, Switzerland. [Reny, Jean-Luc] Geneva Univ Hosp, Dept Gen Internal Med Rehabil & Geriatr, Geneva, Switzerland. [Calmy, Alexandra] Geneva Univ Hosp, Div Infect Dis, Geneva, Switzerland. C3 University of Geneva; University of Geneva; University of Geneva; University of Geneva; University of Geneva; University of Geneva; University of Geneva RP Samer, CF (通讯作者)，Geneva Univ Hosp, Div Clin Pharmacol & Toxicol, Rue Gabrielle Perret Gentil 4, CH-1211 Geneva, Switzerland.; Samer, CF (通讯作者)，Swiss Ctr Appl Human Toxicol SCAHT, Basel, Switzerland.; Samer, CF (通讯作者)，Univ Geneva, Fac Med, Geneva, Switzerland. EM caroline.samer@hcuge.ch RI Rudaz, Serge/AAB-2861-2021; Fontana, Pierre/M-3702-2014; Samer, Caroline/ABB-2447-2021; Youssef, Daali/I-4735-2019; Calmy, Alexandra/HII-7836-2022 OI Rudaz, Serge/0000-0002-4180-5417; Fontana, Pierre/0000-0003-1546-0774; Samer, Caroline/0000-0001-8178-0616; Youssef, Daali/0000-0002-8391-9383; Reny, Jean-Luc/0000-0002-7528-7363; Calmy, Alexandra/0000-0002-1137-6826 FU Swiss National Science Foundation [FNRS 32003B-156471] FX This clinical study was supported by the Swiss National Science Foundation (FNRS 32003B-156471). The authors wish to thank Dr. Thanh D. Lecompte and Dr. Olivier Nawej Tshikung for their valuable contribution in patient recruitment, as well as the Clinical Research Centre of Geneva University Hospitals, Mrs. Severine Nolli and Mr. Michel Muster for their contribution in the VerifyNow (R) instruments disposition and platelet reactivity analysis. CR Ancrenaz V, 2013, BASIC CLIN PHARMACOL, V112, P132, DOI 10.1111/j.1742-7843.2012.00932.x [Anonymous], 2013, TYB EU SUMM PROD CHA [Anonymous], 2009, EF PROD INF Boccara F, 2008, AIDS, V22, pS19, DOI 10.1097/01.aids.0000327512.76126.6e Boccara F, 2013, J AM COLL CARDIOL, V61, P511, DOI 10.1016/j.jacc.2012.06.063 Cuisset T, 2010, ARCH CARDIOVASC DIS, V103, P39, DOI 10.1016/j.acvd.2009.11.004 Culm-Merdek KE, 2006, CLIN PHARMACOL THER, V79, P243, DOI 10.1016/j.clpt.2005.11.009 Curtis MJ, 2015, BRIT J PHARMACOL, V172, P3461, DOI 10.1111/bph.12856 Daali Y, 2011, METABOLISM, V60, P1584, DOI 10.1016/j.metabol.2011.03.015 Dumond JB, 2010, CLIN PHARMACOL THER, V87, P735, DOI 10.1038/clpt.2009.253 Farid NA, 2007, CLIN PHARMACOL THER, V81, P735, DOI 10.1038/sj.clpt.6100139 Fukushima K, 2013, J PHARM SCI-US, V102, P2044, DOI 10.1002/jps.23545 Godino C, 2009, THROMB J, V7, DOI 10.1186/1477-9560-7-4 Greenblatt DJ, 2000, J ACQ IMMUN DEF SYND, V24, P129 Gurbel PA, 2017, EUR HEART J, V38, P1687, DOI 10.1093/eurheartj/ehw630 Gurbel PA, 2012, JAMA-J AM MED ASSOC, V308, P1785, DOI 10.1001/jama.2012.17312 Hauguel-Moreau M, 2017, EUR HEART J, V38, P1676, DOI 10.1093/eurheartj/ehw583 Hsue PY, 2009, AIDS, V23, P1059, DOI 10.1097/QAD.0b013e32832b514b Kageyama M, 2005, BIOL PHARM BULL, V28, P130, DOI 10.1248/bpb.28.130 Kakuda TN, 2013, HIV MED, V14, P421, DOI 10.1111/hiv.12019 Leunissen TC, 2016, EUR J VASC ENDOVASC, V52, P198, DOI 10.1016/j.ejvs.2016.04.019 Marcucci R, 2009, CIRCULATION, V119, P237, DOI 10.1161/CIRCULATIONAHA.108.812636 Marsousi N, 2016, CLIN PHARMACOL THER, V100, P295, DOI 10.1002/cpt.407 Matetzky S, 2003, ARCH INTERN MED, V163, P457, DOI 10.1001/archinte.163.4.457 Montalescot G, 2009, LANCET, V373, P723, DOI 10.1016/S0140-6736(09)60441-4 Park J, 2010, J CLIN PHARMACOL, V50, P1180, DOI 10.1177/0091270009359524 Perloff MD, 2004, XENOBIOTICA, V34, P133, DOI 10.1080/00498250310001630215 Price MJ, 2008, EUR HEART J, V29, P992, DOI 10.1093/eurheartj/ehn046 Putcharoen O, 2015, DRUG DES DEV THER, V9, P5763, DOI 10.2147/DDDT.S63989 Rehmel JLF, 2006, DRUG METAB DISPOS, V34, P600, DOI 10.1124/dmd.105.007989 Riesmeyer JS, 2012, J CLIN PHARMACOL, V52, P789, DOI 10.1177/0091270011406280 Wiviott SD, 2007, CIRCULATION, V116, P2923, DOI 10.1161/CIRCULATIONAHA.107.740324 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 Xu LH, 2010, ACS MED CHEM LETT, V1, P209, DOI 10.1021/ml1000257 Yeh RF, 2006, JAIDS-J ACQ IMM DEF, V42, P52 NR 35 TC 38 Z9 41 U1 0 U2 7 PU ADIS INT LTD PI NORTHCOTE PA 5 THE WAREHOUSE WAY, NORTHCOTE 0627, AUCKLAND, NEW ZEALAND SN 0312-5963 EI 1179-1926 J9 CLIN PHARMACOKINET JI Clin. Pharmacokinet. PD OCT PY 2018 VL 57 IS 10 BP 1347 EP 1354 DI 10.1007/s40262-018-0637-6 PG 8 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA GS9JY UT WOS:000444035300009 PM 29453687 OA Green Published DA 2023-05-13 ER PT J AU Asao, K Kaminski, J McEwen, LN Wu, XJ Lee, JM Herman, WH AF Asao, Keiko Kaminski, James McEwen, Laura N. Wu, Xiejian Lee, Joyce M. Herman, William H. TI Assessing the burden of diabetes mellitus in emergency departments in the United States: The National Hospital Ambulatory Medical Care Survey (NHAMCS) SO JOURNAL OF DIABETES AND ITS COMPLICATIONS LA English DT Article DE Emergency room; Diagnosis; The National Hospital Ambulatory Medical Care Survey (NHAMCS); Sensitivity; Diagnosis code ID COMMUNITY-ACQUIRED PNEUMONIA; ACUTE CORONARY SYNDROME; DEATH CERTIFICATES; PROSPECTIVE COHORT; VISITS; TRENDS; PREVALENCE; INDIVIDUALS; POPULATION; OUTCOMES AB Objective: To evaluate the performance of three alternative methods to identify diabetes in patients visiting Emergency Departments (EDs), and to describe the characteristics of patients with diabetes who are not identified when the alternative methods are used. Research Design and Methods: We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2009 and 2010. We assessed the sensitivity and specificity of using providers' diagnoses and diabetes medications (both excluding and including biguanides) to identify diabetes compared to using the checkbox for diabetes as the gold standard. We examined the characteristics of patients whose diabetes was missed using multivariate Poisson regression models. Results: The checkbox identified 5,567 ED visits by adult patients with diabetes. Compared to the checkbox, the sensitivity was 12.5% for providers' diagnoses alone, 20.5% for providers' diagnoses and diabetes medications excluding biguanides, and 21.5% for providers' diagnoses and diabetes medications including biguanides. The specificity of all three of the alternative methods was >99%. Older patients were more likely to have diabetes not identified. Patients with self-payment, those who had glucose measured or received IV fluids in the ED, and those with more diagnosis codes and medications, were more likely to have diabetes identified. Conclusions: NHAMCS's providers' diagnosis codes and medication lists do not identify the majority of patients with diabetes visiting EDs. The newly introduced checkbox is helpful in measuring ED resource utilization by patients with diabetes. (c) 2014 Elsevier Inc. All rights reserved. C1 [Asao, Keiko; Kaminski, James; McEwen, Laura N.; Wu, Xiejian; Herman, William H.] Univ Michigan, Dept Internal Med, Div Metab Endocrinol & Diabet, Ann Arbor, MI 48109 USA. [Wu, Xiejian] Eastern Michigan Univ, Coll Hlth & Human Serv, Program Hlth Adm, Ypsilanti, MI 48197 USA. [Lee, Joyce M.] Univ Michigan, Div Pediat Endocrinol, Child Hlth Evaluat & Res Unit, Ann Arbor, MI 48109 USA. [Herman, William H.] Univ Michigan, Dept Epidemiol, Ann Arbor, MI 48109 USA. C3 University of Michigan System; University of Michigan; Eastern Michigan University; University of Michigan System; University of Michigan; University of Michigan System; University of Michigan RP Asao, K (通讯作者)，66 N Pauline St,Ste 633, Memphis, TN 38105 USA. EM kasao@uthsc.edu RI Asao, Keiko/HME-0513-2023; Asao, Keiko/AAH-7058-2020 OI Asao, Keiko/0000-0002-2218-060X FU American Diabetes Association [7-10-MERCK-03]; Stefan S. Fajans GlaxoSmithKline Professorship in Diabetes; Michigan Center for Diabetes Translational Research [P30DK092926] FX There is no conflict of interest for any of the authors. K.A. is the guarantor of this manuscript. This study was supported by the American Diabetes Association 7-10-MERCK-03 (W.H.H. and K.A.) and the Stefan S. Fajans GlaxoSmithKline Professorship in Diabetes (W.H.H.). This work utilized resources from the Michigan Center for Diabetes Translational Research funded by Grant Number P30DK092926. We thank editor(s) of Scribendi, Inc. for help in the preparation of this manuscript. 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Diabetes Complications PD SEP-OCT PY 2014 VL 28 IS 5 BP 639 EP 645 DI 10.1016/j.jdiacomp.2014.02.005 PG 7 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism GA AP0JE UT WOS:000341746800012 PM 24680472 OA Green Accepted DA 2023-05-13 ER PT J AU Huynh, QNP Nguyen, T Truong, TTA Huynh, MNH Nguyen, TH Ghisi, GLD Taxis, K AF Huynh, Quynh Nguyen Phuong Nguyen, Thang Truong, Thu Tran Anh Huynh, My Ngoc Hoang Nguyen, Thao Huong Ghisi, Gabriela Lima De Melo Taxis, Katja TI Vietnamese version of the coronary artery disease education questionnaire-Short version: Translation, adaptation and validation SO JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS LA English DT Article DE adaptation; coronary artery disease; questionnaire; translation; Vietnamese ID PSYCHOMETRIC VALIDATION; KNOWLEDGE AB What is known and objective Coronary artery disease (CAD) is the leading cause of mortality worldwide. Patient education is an essential part of cardiac patients' care targeting self-management behaviour to reduce risk factors and subsequent events. There has been no Vietnamese questionnaire to assess patient's knowledge about CAD; therefore, the purpose of this study was to translate, cross-culturally adapt and validate the Coronary Artery Disease Education Questionnaire-Short Version (CADE-Q SV) for use in Vietnam. Methods Translation and cross-cultural adaption of the tool were carried out in five stages: (a) two independent translations from English into Vietnamese were produced; (b) these two translations were then synthesized; (c) two translators blinded to the outcome measurements independently created separate back translations into English; (d) nine experts reached consensus on all items of the Vietnamese version of the CADE-Q SV; and (e) a pilot study was conducted on 35 patients with acute coronary syndrome (ACS). The validity and reliability of the questionnaires were then evaluated in 117 Vietnamese patients with ACS. The internal consistency and test-retest reliability were assessed by Cronbach's alpha and Cohen's kappa coefficient, respectively. Construct validity was determined by examining the relationship between knowledge scores and patient characteristics. Results The Vietnamese version of CADE-Q SV was created, including 20 items divided into two domains: medical and psychological condition, and nutrition and exercise. There was good equivalence between the original and the Vietnamese versions in all four areas: semantic, idiomatic, experiential and conceptual equivalence. Cronbach's alpha coefficients were acceptable for the questionnaire as a whole (0.78) and for the two domains: medical and psychological condition (0.71) and nutrition and exercise (0.52). All Cohen's kappa coefficients confirmed test-retest reliability (Kappa > 0.600; P < .001). Construct validity was confirmed by a significant correlation of knowledge scores with education level (P = .004). What is new and conclusion The Vietnamese version of CADE-Q SV can be considered a valid and reliable questionnaire to evaluate patient's knowledge of CAD. Further studies could investigate the influence of knowledge scores on adherence to medications and clinical outcomes of patients with CAD. C1 [Huynh, Quynh Nguyen Phuong; Nguyen, Thao Huong] Univ Med & Pharm, Dept Clin Pharm, Ho Chi Minh City, Vietnam. [Nguyen, Thang; Truong, Thu Tran Anh; Huynh, My Ngoc Hoang] Can Tho Univ Med & Pharm, Dept Pharmacol & Clin Pharm, 179 Nguyen Van Cu St, Can Tho City 900000, Vietnam. [Ghisi, Gabriela Lima De Melo] Univ Hlth Network, Cardiovasc Prevent & Rehabil Program, Toronto, ON, Canada. [Taxis, Katja] Univ Groningen, Groningen Res Inst Pharm, Groningen, Netherlands. C3 Hochiminh City University of Medicine & Pharmacy; Can Tho University of Medicine & Pharmacy (CTUMP); University of Toronto; University Health Network Toronto; University of Groningen RP Nguyen, T (通讯作者)，Can Tho Univ Med & Pharm, Dept Pharmacol & Clin Pharm, 179 Nguyen Van Cu St, Can Tho City 900000, Vietnam. EM nthang@ctump.edu.vn RI Taxis, Katja/ABE-2637-2021; Ghisi, Gabriela/ABF-6150-2020; Nguyen, Thao/HNP-2729-2023 OI Taxis, Katja/0000-0001-8539-2004; Ghisi, Gabriela/0000-0001-7946-3718; Nguyen, Thang/0000-0001-7799-4523 CR ALFASFOS N, 2016, HEALTH, V8, P1830, DOI DOI 10.4236/HEALTH.2016.815175 ALMROIJER C, 2006, J CARDIOVASC NURS, V21, P84 Altman DG., 1991, PRACTICAL STAT MED R Ammouri Ali A, 2016, Sultan Qaboos Univ Med J, V16, pe189, DOI 10.18295/squmj.2016.16.02.009 BEATON D, 2007, I WORK HLTH, V45 Beaton DE, 2000, SPINE, V25, P3186, DOI 10.1097/00007632-200012150-00014 Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Dracup K, 2008, ARCH INTERN MED, V168, P1049, DOI 10.1001/archinte.168.10.1049 Ghisi GLD, 2016, PATIENT EDUC COUNS, V99, P443, DOI 10.1016/j.pec.2015.11.002 Ghisi GLD, 2015, PATIENT EDUC COUNS, V98, P378, DOI 10.1016/j.pec.2014.11.019 Ghisi GLD, 2013, EUR J PREV CARDIOL, V20, P291, DOI 10.1177/2047487312437061 GHISI GLD, 2010, ARQ BRAS CARDIOL, V94, P763 Henriksson C, 2011, INT J CARDIOL, V147, P224, DOI 10.1016/j.ijcard.2009.08.019 Kayaniyil S, 2009, PATIENT EDUC COUNS, V75, P99, DOI 10.1016/j.pec.2008.09.005 KHAN MS, 2006, BIOMED CENTRAL CARDI, V6, P1 Nguyen T, 2018, FRONT PHARMACOL, V9, DOI 10.3389/fphar.2018.00656 SHAVER PR, 1991, MEASURES PERSONALITY, V1 Tavakol M, 2011, INT J MED EDUC, V2, P1, DOI 10.5116/ijme.4d27.32ff NR 18 TC 1 Z9 2 U1 0 U2 3 PU WILEY-HINDAWI PI LONDON PA ADAM HOUSE, 3RD FL, 1 FITZROY SQ, LONDON, WIT 5HE, ENGLAND SN 0269-4727 EI 1365-2710 J9 J CLIN PHARM THER JI J. Clin. Pharm. Ther. PD AUG PY 2020 VL 45 IS 4 BP 691 EP 697 DI 10.1111/jcpt.13145 EA APR 2020 PG 7 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Pharmacology & Pharmacy GA MF8KL UT WOS:000529619400001 PM 32356381 OA Green Published, gold DA 2023-05-13 ER PT J AU Chapman, SR Fitzpatrick, RW Aladul, MI AF Chapman, Stephen R. Fitzpatrick, Raymond W. Aladul, Mohammed I. TI Has cost inhibited the uptake of more potent statins in England? SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE atorvastatin; drug use; generics; prescribing pattern; rosuvastatin; simvastatin ID RANDOMIZED CONTROLLED-TRIAL; ACUTE CORONARY SYNDROMES; HMG-COA REDUCTASE; PRIMARY PREVENTION; PRESCRIBING EFFICIENCY; CARDIOVASCULAR-DISEASE; HEART-DISEASE; ATORVASTATIN; SIMVASTATIN; EVENTS AB Background: The use of statins has increased substantially over the last 2 decades in England and represents a significant cost burden to the National Health Service. Therefore, it is important to understand what influences prescribers' choice. Objectives: This study examines the changes in use pattern of all statins in England (19982015). The study focuses on the use of simvastatin and atorvastatin before and after their patent expiry and rosuvastatin, to investigate the impact of the reduced acquisition costs on prescribing. Methods: Interrupted time series analysis of primary care use data from the health and social care information centre database from 1998 to 2015. Results: Primary care expenditure on statins increased by 125% during the period 1998 to 2004 driven by branded simvastatin and atorvastatin. Before 2003, the rate of use of more potent branded atorvastatin exceeds branded simvastatin. Between 2004 and 2011, the less potent but less expensive agent generic simvastatin has the higher utilisation rate (66%). Since 2012, the more potent agent but less expensive generic atorvastatin has the higher utilisation rate (50%). The more potent branded rosuvastatin failed to make a significant impact on the English statins market. Conclusions: The availability of generic statins has reduced overall expenditure significantly. When there is a significant price difference, acquisition cost appears to be the main influencing factor in prescribing statins, but, when costs are similar, potency is a key factor. This suggests that English prescribers are cost sensitive and appear to be prepared to trade marginal benefit for savings. C1 [Chapman, Stephen R.; Fitzpatrick, Raymond W.; Aladul, Mohammed I.] Keele Univ, Sch Pharm, Hornbeam Bldg 3-06, Newcastle Under Lyme ST5 5BG, Staffs, England. C3 Keele University RP Chapman, SR (通讯作者)，Keele Univ, Sch Pharm, Hornbeam Bldg 3-06, Newcastle Under Lyme ST5 5BG, Staffs, England. EM s.r.chapman@keele.ac.uk RI Aladul, Mohammed/AAL-7622-2021; Aladul, Mohammed/T-1441-2019 OI Aladul, Mohammed/0000-0002-7368-3469 CR Armitage J, 2007, LANCET, V370, P1781, DOI 10.1016/S0140-6736(07)60716-8 Bennie M, 2012, EXPERT REV PHARM OUT, V12, P125, DOI [10.1586/erp.11.98, 10.1586/ERP.11.98] Branchi A, 1999, EUR J CLIN PHARMACOL, V55, P499, DOI 10.1007/s002280050663 Cannon CP, 2004, NEW ENGL J MED, V350, P1495, DOI 10.1056/NEJMoa040583 Chaplin S., 2006, PRESCRIBER, V17, P58 Collins R, 2003, LANCET, V361, P529, DOI 10.1016/S0140-6736(03)12475-0 Collins R, 2002, LANCET, V360, P7, DOI 10.1016/S0140-6736(02)09327-3 Cook A, 1998, C BUDGET OFFICE INCR Cooper A, 2008, NATL COLLABORATING C, P3 Davidson MH, 2002, EXPERT OPIN INV DRUG, V11, P125, DOI 10.1517/13543784.11.1.125 Department of health, 2005, PRECR COST AN ENGL 2 Duerden MG, 2010, BRIT J CLIN PHARMACO, V70, P335, DOI 10.1111/j.1365-2125.2010.03718.x Finlayson AE, 2014, GABI J, V3, DOI 10.5639/gabij.2014.0303.030 Fox K F, 2001, Expert Opin Pharmacother, V2, P2079, DOI 10.1517/14656566.2.12.2079 Furberg CD, 2001, TRIALS, V2 Gentile S, 2000, DIABETES OBES METAB, V2, P355, DOI 10.1046/j.1463-1326.2000.00106.x Godman B, 2014, FRONT PHARMACOL, V5, DOI 10.3389/fphar.2014.00106 GRABOWSKI H, 1986, AM ECON REV, V76, P195 Health and social care information centre, NAT PROV INF DAT IT Holdgate GA, 2003, BIOCHEM SOC T, V31, P528, DOI 10.1042/BST0310528 Hudson V, 2014, NAT REV DRUG DISCOV, V13, P807, DOI 10.1038/nrd4475 Kanavos P., 2004, INT GENERIC PHARM PO King DR, 2002, CROAT MED J, V43, P462 Kotseva K, 2009, LANCET, V373, P929, DOI 10.1016/S0140-6736(09)60330-5 Lazar LD, 2011, CIRCULATION, V124, P146, DOI 10.1161/CIRCULATIONAHA.110.986349 Mamdani MM, 2001, CAN MED ASSOC J, V164, P1695 McGuire T., 2011, ENGLAND GERMANY EURO, P11 McTaggart F, 2001, AM J CARDIOL, V87, p28B Moon JC, 2006, BMJ-BRIT MED J, V332, P1344, DOI 10.1136/bmj.332.7554.1344 Mrazek M, 2004, REGULATING PHARM EUR NICE Lipid modification, 2008, LIP MOD CARD RISK AS Nissen SE, 2004, JAMA-J AM MED ASSOC, V291, P1071, DOI 10.1001/jama.291.9.1071 O'Keeffe AG, 2016, CLIN EPIDEMIOL, V8, P123, DOI 10.2147/CLEP.S104258 PEDERSEN TR, 1994, LANCET, V344, P1383 Pedersen TR, 2005, JAMA-J AM MED ASSOC, V294, P2437, DOI 10.1001/jama.294.19.2437 Pettersson B, 2012, HEALTH POLICY, V104, P84, DOI 10.1016/j.healthpol.2011.10.010 Ray KK, 2005, J AM COLL CARDIOL, V46, P1405, DOI 10.1016/j.jacc.2005.03.077 Rogers SL, 2007, CLIN THER, V29, P242, DOI 10.1016/j.clinthera.2007.02.001 Sacks FM, 1996, NEW ENGL J MED, V335, P1001, DOI 10.1056/NEJM199610033351401 Schwartz GG, 2001, JAMA-J AM MED ASSOC, V285, P1711, DOI 10.1001/jama.285.13.1711 Sever PS, 2003, LANCET, V361, P1149, DOI 10.1016/S0140-6736(03)12948-0 Shepherd J, 2008, J AM COLL CARDIOL, V51, P1448, DOI 10.1016/j.jacc.2007.11.072 Smith J, 2011, AUST PRESCR, V34, P169 Soumerai SB, 2004, HEALTH AFFAIR, V23, P135, DOI 10.1377/hlthaff.23.1.135 Teeling M, 2005, BRIT J CLIN PHARMACO, V59, P227, DOI 10.1111/j.1365-2125.2004.02256.x Thai LP, 2016, EXPERT REV PHARM OUT, V1, P1 Tobert JA, 2003, NAT REV DRUG DISCOV, V2, P517, DOI 10.1038/nrd1112 van Woerkom M, 2012, J COMP EFFECT RES, V1, P527, DOI [10.2217/cer.12.52, 10.2217/CER.12.52] Vancheri F, 2016, BMJ OPEN, V6, DOI 10.1136/bmjopen-2015-010500 Wagner AK, 2002, J CLIN PHARM THER, V27, P299, DOI 10.1046/j.1365-2710.2002.00430.x Walley T, 2005, BRIT J CLIN PHARMACO, V60, P543, DOI 10.1111/j.1365-2125.2005.02478.x Ward S, 2007, NIHR HLTH TECHNOLOGY WHO Collaborating Centre for Drug Statistics (WHOCC), 2016, DEF GEN CONS NR 53 TC 5 Z9 5 U1 0 U2 2 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1053-8569 EI 1099-1557 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD AUG PY 2017 VL 26 IS 8 BP 984 EP 991 DI 10.1002/pds.4231 PG 8 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA FG0CJ UT WOS:000409386300014 PM 28612964 OA Green Accepted DA 2023-05-13 ER PT J AU Al-Salameh, A Bucher, S Bauduceau, B Benattar-Zibi, L Berrut, G Bertin, P Corruble, E Danchin, N Derumeaux, G Doucet, J Falissard, B Forette, F Hanon, O Ourabah, R Pasquier, F Pinget, M Becquemont, L Ringa, V AF Al-Salameh, Abdallah Bucher, Sophie Bauduceau, Bernard Benattar-Zibi, Linda Berrut, Gilles Bertin, Philippe Corruble, Emmanuelle Danchin, Nicolas Derumeaux, Genevieve Doucet, Jean Falissard, Bruno Forette, Francoise Hanon, Olivier Ourabah, Rissane Pasquier, Florence Pinget, Michel Becquemont, Laurent Ringa, Virginie TI Sex Differences in the Occurrence of Major Clinical Events in Elderly People with Type 2 Diabetes Mellitus Followed up in the General Practice SO EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES LA English DT Article DE Type 2 Diabetes Mellitus; sex- and gender-related differences; elderly; mortality; cardiovascular disease; hospitalization; primary care ID RISK-FACTORS; FUNCTIONAL IMPAIRMENT; PRIMARY-CARE; 64 COHORTS; ALL-CAUSE; HOSPITALIZATION; MORTALITY; WOMEN; MEN; METAANALYSIS AB Aims The main aim of the present work was to assess if sex influences the occurrence of major clinical events in elderly people with type 2 diabetes followed up in the primary care. Methods 983 subjects aged 65-years with type 2 diabetes were included by 213 general practitioners and followed up prospectively for three years. Major clinical events were recorded every six month. The first endpointwas a composite of all-cause death and majorvascular events (acute coronary syndrome, non-fatal stroke or transient ischemic attack, or revascularization for peripheral artery disease). The second endpoint was all-cause hospitalization. The occurrence of each endpoint was analyzed in orderto estimate the role of sex and determine other predictors of major clinical events. Results At baseline, women were older than men but they had a lower prevalence of coexisting diseases (cardiovascular disease and cancer) and equivalent diabetes control (Glycated hemoglobin A1C: 6.9 %+/- 0.9 vs. 7.0 %+/- 1.1). Overthe follow-up period, women were at lower risk to develop the composite endpoint (HR 0.60, 95% CI 0.40-0.91, p = 0.016) and the hospitalization endpoint (OR 0.71, 95 % CI 0.52-0.96, p = 0.029). Coexisting diseases, functional ability and concomitant medications emerged as significant predictors of both endpoints. Conclusions Elderly women with well-controlled type 2 diabetes were less likely to experience major clinical events than their male counterparts. More studies are needed to determine the reasons for the higher hospitalization rate in men. C1 [Al-Salameh, Abdallah; Bucher, Sophie; Falissard, Bruno; Becquemont, Laurent; Ringa, Virginie] Univ Paris Saclay, Univ Paris Sud, Ctr Rech Epidemiol & Sante Populat CESP, INSERM,Fac Med, Villejuif 94805, France. [Al-Salameh, Abdallah; Becquemont, Laurent] Hop Bicetre, AP HP, Ctr Rech Clin Paris Sud, Le Kremlin Bicetre, France. [Bucher, Sophie; Ourabah, Rissane] Paris Sud Univ, Paris Sud Fac Med, Gen Practice Dept, Le Kremlin Bicetre, France. [Bauduceau, Bernard] Begin Hosp, Endocrinol Dept, St Mande, France. [Benattar-Zibi, Linda] ORPEA CLINEA, Puteaux La Defense, France. [Berrut, Gilles] Nantes Univ Hosp, Clin Gerontol, Nantes, France. [Bertin, Philippe] Limoges Univ Hosp, Rheumatol Dept, Limoges, France. [Corruble, Emmanuelle] Paris Sud Univ, Bicetre Hosp, AP HP, Psychiat Dept,Inserm U 1178,Paris Sud Fac Med, Le Kremlin Bicetre, France. [Danchin, Nicolas] Hop Europeen Georges Pompidou, Cardiol Dept, Paris, France. [Derumeaux, Genevieve] Hosp Civils Lyon, Louis Pradel Hosp, Cardiovasc Funct Explorat, Bron, France. [Doucet, Jean] Rouen Univ, St Julien Univ Hosp, Internal Med Geriatr & Therapeut, Rouen, France. [Forette, Francoise] Paris Descartes Univ, Natl Fdn Gerontol, Paris, France. [Hanon, Olivier] Paris Descartes Univ, Broca Hosp, AP HP, Geriatr Dept,EA 4468, Paris, France. [Pasquier, Florence] Univ Lille Nord France, Lille Univ Hosp, UDSL, EA 1046, Lille, France. [Pinget, Michel] Univ Strasbourg, Strasbourg Univ Hosp, Endocrinol Diabet & Nutr Related Dis, Strasbourg, France. [Pinget, Michel] Univ Strasbourg, European Ctr Study Diabet CeeD, Strasbourg, France. [Becquemont, Laurent] Univ Paris Sud, Pharmacol Dept, Fac Med, Le Kremlin Bicetre, France. [Becquemont, Laurent] Bicetre Univ Hosp, AP HP, Le Kremlin Bicetre, France. C3 Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Saclay; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Antoine-Beclere - APHP; Hopital Universitaire Bicetre - APHP; Hopital Universitaire Paul-Brousse - APHP; UDICE-French Research Universities; Universite Paris Cite; Hopital Universitaire Hotel-Dieu - APHP; Universite Paris Saclay; Assistance Publique Hopitaux Paris (APHP); UDICE-French Research Universities; Universite Paris Saclay; Nantes Universite; CHU de Nantes; CHU Limoges; 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; Universite Paris Saclay; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Europeen Georges-Pompidou - APHP; CHU Lyon; Universite de Rouen Normandie; CHU de Rouen; 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 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; Universite de Lille - ISITE; CHU Lille; Universite de Lille; CHU Strasbourg; UDICE-French Research Universities; Universites de Strasbourg Etablissements Associes; Universite de Strasbourg; UDICE-French Research Universities; Universites de Strasbourg Etablissements Associes; Universite de Strasbourg; UDICE-French Research Universities; Universite Paris Saclay; 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 RP Al-Salameh, A (通讯作者)，Hop Bicetre, Ctr Rech Clin Paris Sud, 78 Ave Gen Leclerc, F-94275 Le Kremlin Bicetre, France. EM abdallah.al-salameh@aphp.fr RI Al-Salameh, Abdallah/S-7043-2016; Hanon, Olivier/GWR-0220-2022; DERUMEAUX, Genevieve A/T-2489-2018; Ringa, Virginie/L-8940-2018; Pasquier, Florence/F-1527-2017 OI Al-Salameh, Abdallah/0000-0002-7951-9926; DERUMEAUX, Genevieve A/0000-0003-1471-1631; Pasquier, Florence/0000-0001-9880-9788; Hanon, Olivier/0000-0002-4697-122X CR Al-Salameh A, 2018, CAN J DIABETES, V42, P365, DOI 10.1016/j.jcjd.2017.08.248 Alegre-Diaz J, 2016, NEW ENGL J MED, V375, P1961, DOI 10.1056/NEJMoa1605368 Alleman S, 2009, SWISS MED WKLY, V139, P576 Amer Diabet Assoc, 2013, DIABETES CARE, V36, P1033, DOI 10.2337/dc12-2625 ARO S, 1994, DIABETES CARE, V17, P1320, DOI 10.2337/diacare.17.11.1320 Assogba FA, 2013, B EPIDEMIOL HEBD, V2013, P454 Barberger-Gateau P, 1999, J AM GERIATR SOC, V47, P456, DOI 10.1111/j.1532-5415.1999.tb07239.x Becquemont L, 2013, THERAPIE, V68, P265, DOI 10.2515/therapie/2013043 Bo S, 2004, J CLIN EPIDEMIOL, V57, P1196, DOI 10.1016/j.jclinepi.2004.02.015 Bucher S, 2015, PRIM CARE DIABETES, V9, P267, DOI 10.1016/j.pcd.2014.07.004 Dong X, 2017, DIABETES-METAB RES, V33, DOI 10.1002/dmrr.2887 Fu H, 2014, J DIABETES COMPLICAT, V28, P477, DOI 10.1016/j.jdiacomp.2014.02.009 Greysen SR, 2015, JAMA INTERN MED, V175, P559, DOI 10.1001/jamainternmed.2014.7756 Gurwitz JH, 2003, JAMA-J AM MED ASSOC, V289, P1107, DOI 10.1001/jama.289.9.1107 Harding JL, 2014, DIABETES CARE, V37, P2579, DOI 10.2337/dc14-0096 KATZ S, 1963, JAMA-J AM MED ASSOC, V185, P914, DOI 10.1001/jama.1963.03060120024016 Khalid JM, 2014, INT J CLIN PRACT, V68, P40, DOI 10.1111/ijcp.12265 Lee JM, 2010, J WOMENS HEALTH, V19, P2033, DOI 10.1089/jwh.2010.2029 Lee SJ, 2006, JAMA-J AM MED ASSOC, V295, P801, DOI 10.1001/jama.295.7.801 Li TC, 2015, METABOLISM, V64, P1013, DOI 10.1016/j.metabol.2015.05.004 Mandereau-Bruno L, 2016, B EPIDEMIOLOGIQUE HE, V38, P676 Mandereau-Bruno L, 2016, B EPIDEMIOLOGIQUE HE, V2016, P668 Moss SE, 1999, ARCH INTERN MED, V159, P2053, DOI 10.1001/archinte.159.17.2053 Onder G, 2002, J AM GERIATR SOC, V50, P1962, DOI 10.1046/j.1532-5415.2002.50607.x Peters SAE, 2015, CURR CARDIOVASC RISK, V9, DOI 10.1007/s12170-015-0462-5 Peters SAE, 2014, DIABETOLOGIA, V57, P1542, DOI 10.1007/s00125-014-3260-6 Peters SAE, 2014, LANCET, V383, P1973, DOI 10.1016/S0140-6736(14)60040-4 Preis SR, 2009, CIRCULATION, V119, P1728, DOI 10.1161/CIRCULATIONAHA.108.829176 Sarwar N, 2010, LANCET, V375, P2215, DOI 10.1016/S0140-6736(10)60484-9 Schneider ALC, 2016, DIABETES CARE, V39, P772, DOI 10.2337/dc15-1335 Seshasai SRK, 2011, NEW ENGL J MED, V364, P829, DOI 10.1056/NEJMoa1008862 Shah AD, 2015, LANCET DIABETES ENDO, V3, P105, DOI 10.1016/S2213-8587(14)70219-0 Tancredi M, 2015, NEW ENGL J MED, V373, P1720, DOI 10.1056/NEJMoa1504347 Tomlin AM, 2008, DIABETES RES CLIN PR, V80, P244, DOI 10.1016/j.diabres.2007.12.017 2018, LANCET DIABETES ENDO, V6, P538 NR 35 TC 1 Z9 1 U1 0 U2 4 PU GEORG THIEME VERLAG KG PI STUTTGART PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY SN 0947-7349 EI 1439-3646 J9 EXP CLIN ENDOCR DIAB JI Exp. Clin. Endocrinol. Diabet. PD MAY PY 2020 VL 128 IS 5 BP 311 EP 318 DI 10.1055/a-0662-5923 PG 8 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Endocrinology & Metabolism GA LK7ZL UT WOS:000531080000005 PM 30134475 DA 2023-05-13 ER PT J AU Leong, WI Chen, LX Yu, P Wei, BH Wang, CC Ying, YL Jiang, J Tong, JJ Zhu, DL Ye, J Lu, YM AF Leong, Waiian Chen, Lianxiang Yu, Ping Wei, Bohua Wang, Cuicui Ying, Yilin Jiang, Jie Tong, Jianjing Zhu, Dingliang Ye, Jing Lu, Yiming TI The Clinical Situation of Point-of-Care Testing and Its Future Development at the Emergency Department in Shanghai SO JALA LA English DT Article DE point-of-care test; laboratory information management system; hospital; clinical; emergency department; turnaround times ID ACUTE CORONARY SYNDROMES; RANDOMIZED CONTROLLED-TRIAL; BIOCHEMICAL MARKERS; HEALTH; CHINA AB We assessed the efficiency of point-of-care (POC) tests in the emergency department (ED) by comparing them with the international standard. We recorded the turnaround times (TATs) for processing laboratory biomarkers to assess laboratory efficiency from 17 EDs in national/regional hospitals. We also compared patient components between national and regional hospitals. Although the 17 enrolled hospitals expanded their EDs, they contained only five POC machines among them. The P-50 (P-25, P-75) of the TATs for POC tests was 47 min (39, 55.5 min) for cardiac troponin T, which was much longer than the international standard (30 min). The TATs of other cardiac biomarkers were also longer than 30 min. The low efficiency of TATs for POC tests was a common feature in both regional and national hospitals (p > 0.05). Myocardial infarction was diagnosed in 61% of investigated ED patients who visited national hospitals, which is more frequently than those diagnosed at regional hospitals (46%, p < 0.05). Chronic heart failure was less frequent at national hospitals (28%) than at regional hospitals (41%, p < 0.05). The patient distribution in this study indicates that patients have the tendency to choose hospitals when they are affected with chest pain. However, the POC panel is rarely used in the ED, which delayed the TAT level and affected laboratory efficiency. This finding indicates a severe problem in the administrative management of EDs. This issue should be addressed in the next version of the medical reform policy. C1 [Leong, Waiian; Chen, Lianxiang; Yu, Ping; Wei, Bohua; Wang, Cuicui; Ying, Yilin; Jiang, Jie; Tong, Jianjing; Ye, Jing; Lu, Yiming] Shanghai Jiao Tong Univ, Dept Emergency Med, Shanghai 200030, Peoples R China. [Zhu, Dingliang] Shanghai Jiao Tong Univ, Dept Hypertens Med, Shanghai 200030, Peoples R China. C3 Shanghai Jiao Tong University; Shanghai Jiao Tong University RP Zhu, DL (通讯作者)，Ruijin Hosp, Shanghai, Peoples R China. EM zhudingliang@sibs.ac.cn; yj11254@rjh.com.cn; luyiming@rjh.om.cn FU National Natural Science Foundation of China [81000875, 81171846, 81270433, 81372099]; Shanghai Foundation for Basic Research of Science and Technology, China [13JC1404001]; Foundation for Committee of Science and Technology in Shanghai [11ZR1422100]; Foundation for City Star of Science and Technology in Shanghai [11QA1404400]; National Clinical Key Subject, China 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 National Natural Science Foundation of China (grant No. 81000875, 81171846, 81270433, 81372099), the Shanghai Foundation for Basic Research of Science and Technology, China (grant No. 13JC1404001), the Foundation for Committee of Science and Technology in Shanghai (grant No. 11ZR1422100), the Foundation for City Star of Science and Technology in Shanghai (grant No. 11QA1404400), and National Clinical Key Subject, China. All of these funding sources were used for data collection, statistical analysis, and service fees. No pharmaceutical company or other agency has paid us to write this article. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. CR Bertsch T, 2010, CLIN LAB, V56, P37 Chen Z, 2009, LANCET, V373, P1322, DOI 10.1016/S0140-6736(09)60753-4 Christenson RH, 2007, CLIN CHEM, V53, P545, DOI 10.1373/clinchem.2006.079749 Di Serio F, 2003, CLIN CHIM ACTA, V333, P185, DOI 10.1016/S0009-8981(03)00184-0 Gong P, 2012, LANCET, V379, P843, DOI 10.1016/S0140-6736(11)61878-3 Goodacre SW, 2011, HEART, V97, P190, DOI 10.1136/hrt.2010.203166 Han JH, 2007, ANN EMERG MED, V49, P145, DOI 10.1016/j.annemergmed.2006.09.027 Meng Q, 2012, LANCET, V379, P805, DOI 10.1016/S0140-6736(12)60278-5 Miller CD, 2010, ANN EMERG MED, V56, P209, DOI 10.1016/j.annemergmed.2010.04.009 Novis DA, 2004, ARCH PATHOL LAB MED, V128, P158 Ryan RJ, 2009, ANN EMERG MED, V53, P321, DOI 10.1016/j.annemergmed.2008.06.464 Takakuwa KM, 2009, CLIN CARDIOL, V32, P498, DOI 10.1002/clc.20626 Tong JJ, 2012, AM J EMERG MED, V30, P1313, DOI 10.1016/j.ajem.2012.05.012 Yip WCM, 2012, LANCET, V379, P833, DOI 10.1016/S0140-6736(11)61880-1 NR 14 TC 0 Z9 0 U1 1 U2 10 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 2211-0682 EI 1540-2452 J9 JALA-J LAB AUTOM JI JALA PD DEC PY 2014 VL 19 IS 6 BP 562 EP 568 DI 10.1177/2211068214545220 PG 7 WC Biochemical Research Methods; Chemistry, Analytical WE Science Citation Index Expanded (SCI-EXPANDED) SC Biochemistry & Molecular Biology; Chemistry GA AU2SN UT WOS:000345468000006 PM 25092349 DA 2023-05-13 ER PT J AU Wang, JS Fogerty, RL Horwitz, LI AF Wang, Jessica S. Fogerty, Robert L. Horwitz, Leora I. TI Effect of therapeutic interchange on medication reconciliation during hospitalization and upon discharge in a geriatric population SO PLOS ONE LA English DT Article ID ADMISSION; SUBSTITUTION; ERRORS; CARE; DISCREPANCIES; PROGRAM; TRANSITIONS; INHIBITORS; HISTORIES; ORDERS AB Background Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange. Methods and findings Secondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009-2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs), histamine H-2-receptor antagonists (H2 blockers), hydroxymethylglutaryl CoA reductase inhibitors (statins), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and inhaled corticosteroids (ICS). There was limited electronic medication reconciliation support available. Main measures were presence and accuracy of therapeutic interchange during hospitalization, and rate of medication reconciliation errors on discharge. We examined charts of 303 patients taking 555 medications at time of admission in the six medication classes of interest. A total of 244 (44.0%) of medications were therapeutically interchanged to an approved formulary drug at admission, affecting 64% of the study patients. Among the therapeutically interchanged drugs, we identified 78 (32.0%) suspected medication conversion errors. The discharge medication reconciliation error rate was 11.5% among the 244 therapeutically interchanged medications, compared with 4.2% among the 311 unchanged medications (relative risk [RR] 2.75, 95% confidence interval [CI] 1.45-5.19). Conclusions Therapeutic interchange was prevalent among hospitalized patients in this study and elevates the risk for potential medication errors during and after hospitalization. Improved electronic systems for managing therapeutic interchange and medication reconciliation may be valuable. C1 [Wang, Jessica S.] Univ Calif San Francisco, Dept Internal Med, San Francisco, CA 94143 USA. [Fogerty, Robert L.] Yale Sch Med, Dept Internal Med, Sect Gen Internal Med, New Haven, CT USA. [Horwitz, Leora I.] NYU, Sch Med, Dept Populat Hlth, Div Healthcare Delivery Sci, New York, NY 10003 USA. [Horwitz, Leora I.] NYU Langone Hlth, Ctr Healthcare Innovat & Delivery Sci, New York, NY 10016 USA. [Horwitz, Leora I.] NYU, Sch Med, Dept Med, Div Gen Internal Med & Clin Innovat, New York, NY 10003 USA. C3 University of California System; University of California San Francisco; Yale University; New York University; NYU Langone Medical Center; New York University RP Horwitz, LI (通讯作者)，NYU, Sch Med, Dept Populat Hlth, Div Healthcare Delivery Sci, New York, NY 10003 USA.; Horwitz, LI (通讯作者)，NYU Langone Hlth, Ctr Healthcare Innovat & Delivery Sci, New York, NY 10016 USA.; Horwitz, LI (通讯作者)，NYU, Sch Med, Dept Med, Div Gen Internal Med & Clin Innovat, New York, NY 10003 USA. EM Leora.Horwitz@nyumc.org RI Horwitz, Leora/ABD-1292-2020 OI Fogerty, Robert/0000-0001-9119-7707 FU CTSA from National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) [UL1 RR024139]; NIH road map for Medical Research; Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine [P30AG021342 NIH/NIA]; John A. Hartford Foundation; American Federation for Aging Research FX This publication was made possible by CTSA Grant Number UL1 RR024139 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH road map for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCATS or NIH. This work was also supported by the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (#P30AG021342 NIH/NIA) and The John A. Hartford Foundation and the American Federation for Aging Research. No funding source had any role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the John A. Hartford Foundation, or the American Federation for Aging Research. 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A systematic survey SO CLINICAL CHEMISTRY AND LABORATORY MEDICINE LA English DT Review DE clinical decision making; clinical outcome; diagnostic applications; evidence; patient management; point-of-care testing; quality of reporting ID RANDOMIZED CONTROLLED-TRIAL; ACUTE CORONARY SYNDROME; TRANS-CUTANEOUS BILIRUBINOMETRY; BLOOD-GAS ANALYZER; TOTAL SERUM BILIRUBIN; CARDIAC TROPONIN-T; PARATHYROID-HORMONE; EMERGENCY-DEPARTMENT; ELECTROLYTE ANALYZER; RISK STRATIFICATION AB Point-of-care testing (POCT) has had rapid technological development and their use is widespread in clinical laboratories to assure reduction of turn-around-time and rapid patient management in some clinical settings where it is important to make quick decisions. Until now the papers published about the POCT have focused on the reliability of the technology used and their analytical accuracy. We aim to perform a systematic survey of the evidence of POCT efficacy focused on clinical outcomes, selecting POCT denoted special analytes characterized by possible high clinical impact. We searched in Medline and Embase. Two independent reviewers assessed the eligibility, extracted study details and assessed the methodological quality of studies. We analyzed 84 studies for five POCT instruments: neonatal bilirubin, procalcitonin, intra-operative parathyroid hormone, troponin and blood gas analysis. Studies were at high risk of bias. Most of the papers (50%) were studies of correlation between the results obtained by using POCT instruments and those obtained by using laboratory instruments. These data showed a satisfactory correlation between methods when similar analytical reactions were used. Only 13% of the studies evaluated the impact of POCT on clinical practice. POCT decreases the time elapsed for making decisions on patient management but the clinical outcomes have never been adequately evaluated. Our work shows that, although POCT has the potential to provide beneficial patient outcome, further studies may be required, especially for defining its real utility on clinical decision making. C1 [Pecoraro, Valentina; Banfi, Giuseppe] IRCCS Galeazzi Orthoped Inst, Clin Epidemiol Unit, Milan, Italy. [Germagnoli, Luca] Unilabs Ticino, Breganzona, Switzerland. [Banfi, Giuseppe] Univ Milan, Dept Biomed Sci Hlth, Milan, Italy. C3 IRCCS Istituto Ortopedico Galeazzi; University of Milan RP Pecoraro, V (通讯作者)，IRCCS Galeazzi Orthoped Inst, Clin Epidemiol Unit, Milan, Italy. 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Chem. Lab. Med. PD MAR PY 2014 VL 52 IS 3 BP 313 EP 324 DI 10.1515/cclm-2013-0386 PG 12 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA AA2SF UT WOS:000330943700008 PM 24038608 DA 2023-05-13 ER PT J AU Bello, NA Agrawal, A Davis, MB Harrington, CM Lindley, KJ Minissian, MB Sharma, G Walsh, MN Park, K AF Bello, Natalie A. Agrawal, Akanksha Davis, Melinda B. Harrington, Colleen M. Lindley, Kathryn J. Minissian, Margo B. Sharma, Garima Walsh, Mary Norine Park, Ki TI Need for Better and Broader Training in Cardio-Obstetrics: A National Survey of Cardiologists, Cardiovascular Team Members, and Cardiology Fellows in Training SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE cardio-obstetrics; continuing medical education; medical knowledge; pregnancy ID UNITED-STATES; WOMEN; PREGNANCY; HYPERTENSION; STRATEGIES; DISEASE AB Background Team-based models of cardio-obstetrics care have been developed to address the increasing rate of maternal mortality from cardiovascular diseases. Cardiovascular clinician and trainee knowledge and comfort with this topic, and the extent of implementation of an interdisciplinary approach to cardio-obstetrics, are unknown. Methods and Results We aimed to assess the current state of cardio-obstetrics knowledge, practices, and services provided by US cardiovascular clinicians and trainees. A survey developed in conjunction with the American College of Cardiology was circulated to a representative sample of cardiologists (N=311), cardiovascular team members (N=51), and fellows in training (N=139) from June 18, 2020, to July 29, 2020. Knowledge and attitudes about the provision of cardiovascular care to pregnant patients and the prevalence and composition of cardio-obstetrics teams were assessed. The widest knowledge gaps on the care of pregnant compared with nonpregnant patients were reported for medication safety (42%), acute coronary syndromes (39%), aortopathies (40%), and valvular heart disease (30%). Most respondents (76%) lack access to a dedicated cardio-obstetrics team, and only 29% of practicing cardiologists received cardio-obstetrics didactics during training. One third of fellows in training reported seeing pregnant women 0 to 1 time per year, and 12% of fellows in training report formal training in cardio-obstetrics. Conclusions Formalized training in cardio-obstetrics is uncommon, and limited access to multidisciplinary cardio-obstetrics teams and large knowledge gaps exist among cardiovascular clinicians. Augmentation of cardio-obstetrics education across career stages is needed to reduce these deficits. These survey results are an initial step toward developing a standard expectation for clinicians' training in cardio-obstetrics. C1 [Bello, Natalie A.] Cedars Sinai Med Ctr, Smidt Heart Inst, Dept Cardiol, 127 S San Vicente Blvd,Suite 3100, Los Angeles, CA 90048 USA. [Agrawal, Akanksha] Emory Univ, Sch Med, Emory Womens Heart Ctr, Emory Heart & Vasc Ctr, Atlanta, GA 30322 USA. [Davis, Melinda B.] Univ Michigan, Div Cardiovasc Med, Ann Arbor, MI 48109 USA. [Harrington, Colleen M.] Univ Massachusetts, Sch Med, Div Cardiovasc Med, Dept Med, Worcester, MA 01605 USA. [Lindley, Kathryn J.] Washington Univ, Dept Med, Cardiovasc Div, St Louis, MO 63110 USA. [Minissian, Margo B.] Cedars Sinai Med Ctr, Cedars Sinai Smidt Heart Inst, Barbra Streisand Womens Heart Ctr, Los Angeles, CA 90048 USA. [Minissian, Margo B.] Cedars Sinai Med Ctr, Geri & Richard Brawerman Nursing Inst, Los Angeles, CA 90048 USA. [Sharma, Garima] Johns Hopkins Univ, Sch Med, Ciccarone Ctr Prevent Cardiovasc Dis, Baltimore, MD USA. [Walsh, Mary Norine] St Vincent Heart Ctr, Div Cardiol, Indianapolis, IN USA. [Park, Ki] Univ Florida, Coll Med, Div Cardiovasc Med, Gainesville, FL USA. C3 Cedars Sinai Medical Center; Emory University; University of Michigan System; University of Michigan; University of Massachusetts System; University of Massachusetts Worcester; Washington University (WUSTL); Cedars Sinai Medical Center; Cedars Sinai Medical Center; Johns Hopkins University; State University System of Florida; University of Florida RP Bello, NA (通讯作者)，Cedars Sinai Med Ctr, Smidt Heart Inst, Dept Cardiol, 127 S San Vicente Blvd,Suite 3100, Los Angeles, CA 90048 USA.; Park, K (通讯作者)，Univ Florida, Div Cardiovasc Med, 1329 SW 16th St,POB 100288, Gainesville, FL 32610 USA. EM natalieann.bello@cshs.org; ki.park@medicine.ufl.edu OI Bello, Natalie/0000-0003-3257-3623; Lindley, Kathryn/0000-0002-8504-0006; Sharma, Garima/0000-0001-7254-2077 FU National Institutes of Health/National Heart, Lung, and Blood Institute [K23 HL136853, R01HL153382] FX Dr Bello receives funding from National Institutes of Health/National Heart, Lung, and Blood Institute: K23 HL136853 and R01HL153382. CR [Anonymous], 2018, Obstet Gynecol, V131, P949, DOI 10.1097/AOG.0000000000002628 Arnett DK, 2019, CIRCULATION, V140, pE596, DOI [10.1161/CIR.0000000000000677, 10.1016/j.jacc.2019.03.010, 10.1161/CIR.0000000000000678, 10.1016/j.jacc.2019.03.009] Bello NA, 2020, J AM COLL CARDIOL, V77, P1813, DOI 10.1016/j.jacc.2021.01.056 Cameron NA, 2020, J AM COLL CARDIOL, V76, P2611, DOI 10.1016/j.jacc.2020.09.601 Centers for Disease Control and Prevention (CSC), TRENDS PREGN REL MOR Creanga AA, 2017, OBSTET GYNECOL, V130, P366, DOI 10.1097/AOG.0000000000002114 Davis MB, 2020, J AM COLL CARDIOL, V77, P1763, DOI 10.1016/j.jacc.2021.02.033 Davis MB, 2019, CIRC-CARDIOVASC QUAL, V12, DOI 10.1161/CIRCOUTCOMES.118.005417 DOria R., 2017, REPORT MATERNAL MORT Drenthen W, 2010, EUR HEART J, V31, P2124, DOI 10.1093/eurheartj/ehq200 Grundy SM, 2019, CIRCULATION, V139, pE1082, DOI 10.1161/CIR.0000000000000625 Hauspurg A, 2019, OBSTET GYNECOL, V134, P685, DOI 10.1097/AOG.0000000000003479 Hoppe KK, 2019, PREGNANCY HYPERTENS, V15, P171, DOI 10.1016/j.preghy.2018.12.007 Kalafat E, 2020, PREGNANCY HYPERTENS, V19, P44, DOI 10.1016/j.preghy.2019.12.001 Lindley KJ, 2021, J AM COLL CARDIOL, V77, P1823, DOI 10.1016/j.jacc.2021.02.025 Lindley KJ, 2020, J AM COLL CARDIOL, V77, P1778, DOI 10.1016/j.jacc.2021.02.026 Magun E, 2020, J AM COLL CARDIOL, V76, P2102, DOI 10.1016/j.jacc.2020.08.071 Mehta LS, 2020, CIRCULATION, V141, pE884, DOI 10.1161/CIR.0000000000000772 Office of the Surgeon General (OSG), 2020, SURG GEN CALL ACT IM Park K, 2020, J AM COLL CARDIOL, V77, P1799, DOI 10.1016/j.jacc.2021.01.057 Petersen EE, 2019, MMWR-MORBID MORTAL W, V68, P423, DOI 10.15585/mmwr.mm6818e1 Regitz-Zagrosek V, 2018, EUR HEART J, V39, P3165, DOI 10.1093/eurheartj/ehy340 Sharma G, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.119.015569 Sharma G, 2020, J AM COLL CARDIOL, V75, P1355, DOI 10.1016/j.jacc.2020.02.019 Smith GN, 2019, OBSTET GYNECOL, V134, P851, DOI 10.1097/AOG.0000000000003363 STRICKLAND RA, 1991, MAYO CLIN PROC, V66, P411, DOI 10.1016/S0025-6196(12)60666-1 U.S. Department of Health and Human Services, HLTH WOM HLTH PREGN NR 27 TC 4 Z9 4 U1 0 U2 0 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 APR 19 PY 2022 VL 11 IS 8 AR e024229 DI 10.1161/JAHA.121.024229 PG 27 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 0O6YQ UT WOS:000783669800023 PM 35435011 OA gold, Green Published DA 2023-05-13 ER PT J AU Diby, FK Adoubi, AK Esse-Diby, MCA Gnaba, AL Zadi, SZ Ouattara, AEP N'Guessan, KE Boidy, K Azagoh-Kouadio, R Nanan, I Doumbia, M Kpon, R Ayegnon, KG Meneas, CG Diomande, M Sall, F Koffi, MN Coulibaly, A Ehui, EA Yao, KM Yapo, JM Ehua, SF Yangni-Angate, HK Simon, P Moulin, T AF Diby, Florent Kouakou Adoubi, Anicet Kassi Esse-Diby, Marie-Clemence Aya Gnaba, Ambroise Loa Zadi, Serge Zadi Ouattara, Adjara Evelyne Pinnin N'Guessan, Kouassi Efrahime Boidy, Kouakou Azagoh-Kouadio, Richard Nanan, Innocent Doumbia, Mamadou Kpon, Roger Ayegnon, Kouakou Gregoire Meneas, Christophe Gueu Diomande, Manga Sall, Fatouma Koffi, Marie-Nina Coulibaly, Abdoulaye Ehui, Elise Appiah Yao, Koffi Mathieu Yapo, Jean Modeste Ehua, Somian Francis Yangni-Angate, Herve Koffi Simon, Pierre Moulin, Thierry TI A Medico-Socio-Economic Analysis of TeleEKG in Ivory Coast SO TELEMEDICINE AND E-HEALTH LA English DT Article DE teleEKG; HBP; ACS; atrial fibrillation; telemedicine ID MYOCARDIAL-INFARCTION; TELEMEDICINE; EXPERIENCE; TELECARDIOLOGY; HEALTH; ECG AB Background:TeleEKG is gradually being integrated into the care offered to the most isolated Ivorian populations, however, no medico-socio-economic analysis of its impact has yet been conducted. Introduction:The aim of this study was to assess the medico-socio-economic impact of a teleEKG network in the provision of cardiology care in Ivory Coast. Methods:A retrospective study of the data transmitted by the 10 centers involved in the pilot phase of the teleEKG project from January 2015 to December 2017. Results:The average ratio between the cost to the patient of performing an electrocardiogram (EKG) according to the traditional practice and using a teleEKG was 3.8 +/- 1.64. The distance avoided by the 6,045 patients was 1,074,090 km (average 177.7 km/patient). The 6,045 teleEKGs carried out over the period of the study produced a total revenue of 36,270,000 XOF (55,290 EUR) or an average revenue per site of 3,627,000 XOF (5,529 EUR). Dyspnea on exertion (22%), and hypertension (21%) were the main indications for performing the EKG, and left ventricular hypertrophy was the most common electrical anomaly detected (19.8%). Acute coronary syndrome with persistent ST segment elevation was diagnosed in 0.7% of cases (40 cases) and atrial fibrillation in 1.12% of cases (68 cases). Discussion:These results confirm the key role telemedicine can play in the treatment of heart conditions in rural populations and the economic sustainability of such telemedicine networks. Conclusions:teleEKG offers economic accessibility to cardiology care for isolated populations in Ivory Coast. C1 [Diby, Florent Kouakou; Adoubi, Anicet Kassi; Gnaba, Ambroise Loa; Ouattara, Adjara Evelyne Pinnin; Ayegnon, Kouakou Gregoire; Meneas, Christophe Gueu; Diomande, Manga; Sall, Fatouma; Koffi, Marie-Nina; Coulibaly, Abdoulaye; Yangni-Angate, Herve Koffi] Bouake Teaching Univ Hosp, Dept Cardiovasc & Thorac Dis, 22 BP 14 99, Bouake 22, Cote Ivoire. [Esse-Diby, Marie-Clemence Aya] Felix Houphouet Boigny Univ Abidjan, Inst Ethnosociol, Lagunes, Cote Ivoire. [Zadi, Serge Zadi] Alassane Ouattara Univ Bouake, Dept Ethnosociol, Bouake, Cote Ivoire. [N'Guessan, Kouassi Efrahime] Univ Artois, Eth & Procedures Law Ctr, Arras, France. [Boidy, Kouakou] Yopougon Univ Hosp, Hematol Dept, Yopougon, Cote Ivoire. [Azagoh-Kouadio, Richard] Angre Univ Hosp, Pediat Dept, Angre, Cote Ivoire. [Nanan, Innocent; Doumbia, Mamadou; Kpon, Roger; Ehua, Somian Francis] Francophone Africa Telemed Network, Abidjan, Cote Ivoire. [Nanan, Innocent; Doumbia, Mamadou; Kpon, Roger; Ehua, Somian Francis] Ivorian Soc Biosci & Med Informat Abidjan, Abidjan, Cote Ivoire. [Kpon, Roger] Dept Swiss Ctr Sci Res, Abidjan, Cote Ivoire. [Ehui, Elise Appiah; Yao, Koffi Mathieu; Yapo, Jean Modeste] Dept ONG Wake Up Africa, Abidjan, Cote Ivoire. [Simon, Pierre; Moulin, Thierry] Adm Dept French Telemed Soc SFTelemed, Paris, France. [Moulin, Thierry] Univ Hosp Besancon, Neurol Dept, Besancon, France. C3 Universite d'Artois; Universite de Franche-Comte; CHU Besancon RP Diby, FK (通讯作者)，Bouake Teaching Univ Hosp, Dept Cardiovasc & Thorac Dis, 22 BP 14 99, Bouake 22, Cote Ivoire. EM diby_florent2002@yahoo.fr OI Reis, AlessanRSS/0000-0001-8486-7469; Moulin, thierry/0000-0002-6639-8117 FU Reseau en Afrique Francophone pour la Telemedecine (RAFT) (Francophone Africa Telemedicine Network) FX This work was supported by the Reseau en Afrique Francophone pour la Telemedecine (RAFT) (Francophone Africa Telemedicine Network). CR Adambounou K, 2013, EUR RESTELEMED, V2, P49 Adoubi KA, 2006, CAHIER SANTE PUBLIQU, V5, P28 [Anonymous], 2013, EUR RES TELEMED Anzouan-kacou JB, 2010, J AFR THORAX VAISSEA, P5 Maciel ALA, 2019, TELEMED E-HEALTH, V25, P199, DOI 10.1089/tmj.2017.0277 Bergmo TS, 2010, J TELEMED TELECARE, V16, P229, DOI 10.1258/jtt.2010.009008 Brunetti N., 2014, EURTEL, V3, P9 Chong W, 1997, J TELEMED TELECAR S1, V3, P106 Dary P, 2012, EUR RESTELEMED, V1, P104 de Waure C, 2012, TELEMED E-HEALTH, V18, P323, DOI 10.1089/tmj.2011.0158 Diby F., 2016, European Research in Telemedicine/La Recherche Europeenne en Telemedecine, V5, P87, DOI 10.1016/j.eurtel.2016.07.001 Diby FK, 2015, EUR RESTELEMED, V4, P109 Escobar-Curbelo L, 2019, TELEMED E-HEALTH, V25, P1033, DOI 10.1089/tmj.2018.0199 Kamsu-Foguem B., 2014, RECHERCHE EUROPEENNE, V3, P117, DOI [DOI 10.1016/J.EURTEL.2014.08.001, 10.1016/j.eurtel.2014.08.001] Kashem A, 2006, TELEMED J E-HEALTH, V12, P439, DOI 10.1089/tmj.2006.12.439 Kolominsky-Rabas PL, 2016, TELEMED E-HEALTH, V22, P798, DOI 10.1089/tmj.2015.0226 Marcolino MS, 2016, TELEMED E-HEALTH, V22, P899, DOI 10.1089/tmj.2015.0234 Mars M, 2012, TELEMED E-HEALTH, V18, P32, DOI 10.1089/tmj.2011.0146 Molinari G, 2004, J TELEMED TELECARE, V10, P249, DOI 10.1258/1357633042026297 Molinari G, 2018, J TELEMED TELECARE, V24, P373, DOI 10.1177/1357633X16689432 Nagayoshi Y, 2016, TELEMED E-HEALTH, V22, P960, DOI 10.1089/tmj.2015.0225 Papai G, 2020, J TELEMED TELECARE, V26, P216, DOI 10.1177/1357633X18814335 Pascal C, 2012, EUROPEAN RES TELEMED, V1, P125, DOI [10.1016/j.eurtel.2012.09.002, DOI 10.1016/J.EURTEL.2012.09.002] Perez-Manchon D, 2017, J TELEMED TELECARE, V23, P558, DOI 10.1177/1357633X16658159 Sanabria TJ, 2012, TELEMED E-HEALTH, V18, P544, DOI 10.1089/tmj.2011.0192 Scalvini S, 2005, J TELEMED TELECARE, V11, P18, DOI 10.1258/1357633054461750 Schwaab B, 2006, J TELEMED TELECARE, V12, P315, DOI 10.1258/135763306778558204 Simon P, 2012, EUR RES TELEMED, V1, P1 Vanagas G, 2008, TELEMED J E-HEALTH, V14, P345, DOI 10.1089/tmj.2007.0060 Vivek C, 2016, J TELEMED TELECARE, V22, P203, DOI 10.1177/1357633X15592734 Wright D, 1999, J TELEMED TELECARE, V5, P107, DOI 10.1258/1357633991932784 NR 31 TC 0 Z9 0 U1 0 U2 2 PU MARY ANN LIEBERT, INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1530-5627 EI 1556-3669 J9 TELEMED E-HEALTH JI Telemed. e-Health PD MAR 1 PY 2021 VL 27 IS 3 BP 286 EP 295 DI 10.1089/tmj.2020.0075 EA SEP 2020 PG 10 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA QT0BI UT WOS:000569261000001 PM 32907516 DA 2023-05-13 ER PT J AU Mirza, AA Al-Sakkaf, MA Mohammed, AA Farooq, MU Al-Ahmadi, ZA Basyuni, MA AF Mirza, Ahmad A. Al-Sakkaf, Mohammed A. Mohammed, Amrallah A. Farooq, Mian U. Al-Ahmadi, Ziad A. Basyuni, Mohammed A. TI Patterns of Inpatient Admissions during Hajj: Clinical conditions, length of stay and patient outcomes at an advanced care centre in Makkah, Saudi Arabia SO PAKISTAN JOURNAL OF MEDICAL SCIENCES LA English DT Article DE Inpatients; Patient Admission; Length of Stay; Quality Improvement; Tertiary Healthcare; Saudi Arabia ID MUSLIM PILGRIMAGE HAJJ; DISEASES; HOSPITALIZATION AB Objectives: This study aimed to describe inpatient clinical conditions at an advanced care facility in Saudi Arabia during the annual Hajj pilgrimage and to determine factors correlating with length of stay (LOS). Methods: This retrospective study was conducted at the King Abdullah Medical City (KAMC), Makkah, Saudi Arabia, and included all inpatients admitted during the annual Hajj pilgrimage between August and October 2015. Demographic, administrative and clinical data were collected from patient charts and analysed. Results: A total of 296 inpatients were included in the study, of which the majority were male (73.6%) and >= 55 years old (77%). Walk-in admissions occurred less frequently than referrals (38.9% versus 61.1%). Most patients (41.6%) were admitted during the peak Hajj period (the 8th-13th days of Dhu al-Hijjah). Acute coronary syndrome was the most prevalent provisional diagnosis (65.2%). In terms of outcomes, 89.2% of the inpatients were discharged in a stable condition, with 37.5% discharged within <= 24 hours of admission. However, 39.9% required admission to the Intensive Care Unit (ICU). Overall, LOS was significantly associated with various factors, including the mode of admission, admission period, admitting department, number of comorbidities and ICU admission (P < 0.050 each). Conclusion: Most of admissions were referrals, and the main Hajj period witnessed the majority of admissions. The vast majority of inpatients eventually discharged in a stable condition. Determinants of the length of hospital stay were the mode of admission, admission period, admitting department, number of comorbidities and ICU admission. C1 [Mirza, Ahmad A.] King Abdulaziz Univ, Fac Med Rabigh, Dept Otolaryngol Head & Neck Surg, Jeddah, Saudi Arabia. [Al-Sakkaf, Mohammed A.] Secur Forces Hosp Program, Dept Surg, Mecca, Saudi Arabia. [Mohammed, Amrallah A.] King Abdullah Med City, Dept Home Hlth Care, Mecca, Saudi Arabia. [Mohammed, Amrallah A.] Zagazig Univ, Fac Med, Dept Med Oncol, Zagazig, Egypt. [Farooq, Mian U.] King Abdullah Med City, Dept Strateg Planning & Inst Adv, Mecca, Saudi Arabia. [Al-Ahmadi, Ziad A.; Basyuni, Mohammed A.] Umm Al Qura Univ, Fac Med, Mecca, Saudi Arabia. C3 King Abdulaziz University; King Abdullah Medical City; Egyptian Knowledge Bank (EKB); Zagazig University; King Abdullah Medical City; Umm Al Qura University RP Mirza, AA (通讯作者)，King Abdulaziz Univ, Fac Med Rabigh, Dept Otolaryngol Head & Neck Surg, Jeddah, Saudi Arabia. EM aamirza1@kau.edu.sa RI Mirza, Ahmad/AAR-3551-2020; Alsakkaf, Mohammed/GZM-4628-2022 FU KAMC-Research Centre FX The authors would like to thank Dr. Hani El-Khatib for his support during the ethical approval application process. In addition, the authors are grateful to Dr. Osama A. Marglani and Dr. Sohail S. Bajammal for their comprehensive review. The authors extend their sincere thanks to KAMC-Research Centre for their support and cooperation. 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J. Med. Sci. PD JUL-AUG PY 2018 VL 34 IS 4 BP 781 EP 786 DI 10.12669/pjms.344.15989 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA GQ8XS UT WOS:000442047500002 PM 30190728 OA gold, Green Published, Green Submitted DA 2023-05-13 ER PT J AU Bezin, J Duong, M Lassalle, R Droz, C Pariente, A Blin, P Moore, N AF Bezin, Julien Duong, Mai Lassalle, Regis Droz, Cecile Pariente, Antoine Blin, Patrick Moore, Nicholas TI The national healthcare system claims databases in France, SNIIRAM and EGB: Powerful tools for pharmacoepidemiology SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE claims database; pharmacoepidemiology; population studies ID NONVALVULAR ATRIAL-FIBRILLATION; ACUTE CORONARY SYNDROME; VITAMIN-K ANTAGONISTS; ROAD TRAFFIC CRASH; FOLLOW-UP; 1ST HOSPITALIZATION; INSURANCE DATABASE; SECONDARY PREVENTION; LINKAGE PROCEDURE; USAGE PATTERNS AB The French health care system is based on universal coverage by one of several health care insurance plans. The SNIIRAM database merges anonymous information of reimbursed claims from all these plans, linked to the national hospital-discharge summaries database system (PMSI) and the national death registry. It now covers 98.8% of the French population, over 66 million persons, from birth (or immigration) to death (or emigration), making it possibly the world's largest continuous homogeneous claims database. The database includes demographic data; health care encounters such as physician or paramedical visits, medicines, medical devices, and lab tests (without results); chronic medical conditions (ICD10 codes); hospitalisations with ICD10 codes for primary, linked and associated diagnoses, date and duration, procedures, diagnostic-related groups, and cost coding; date but currently not cause of death. The power of the database is correlatively great, and its representativeness is near perfect, since it essentially includes the whole country's population. The main difficulty in using the database, beyond its sheer size and complexity, is the administrative process necessary to access it. Recent legislative advances are making this easier. EGB (Echantillon Generaliste de Beneficiaires) is the 1/97th random permanent representative sample of SNIIRAM, with planned 20-year longitudinal data (10 years at this time). Access time is 1 to 3 months, but its power is less (780 000 subjects). This is enough to study common issues with older drugs but may be limited for new products or rare events. C1 [Bezin, Julien; Pariente, Antoine; Moore, Nicholas] Univ Bordeaux, CHU Bordeaux, Dept Med Pharmacol, F-33076 Bordeaux, France. [Bezin, Julien; Duong, Mai; Pariente, Antoine; Moore, Nicholas] INSERM, U1219, F-33076 Bordeaux, France. [Duong, Mai; Lassalle, Regis; Droz, Cecile; Blin, Patrick; Moore, Nicholas] INSERM, CIC1401, Bordeaux PharmacoEpi, F-33076 Bordeaux, France. C3 CHU Bordeaux; UDICE-French Research Universities; Universite de Bordeaux; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite de Bordeaux; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite de Bordeaux RP Moore, N (通讯作者)，Univ Bordeaux, 146 Rue Leo Saignat, F-33076 Bordeaux, France. EM nicholas.moore@u-bordeaux.fr RI Moore, Nicholas/B-2368-2013; Pariente, Antoine/S-9231-2019; Bezin, Julien/T-1916-2019 OI Moore, Nicholas/0000-0003-1212-2817; Pariente, Antoine/0000-0002-7873-5483; Bezin, Julien/0000-0002-2568-1928; Droz-Perroteau, Cecile/0000-0002-7697-1167 FU Bordeaux PharmacoEpi, a research platform of the University of Bordeaux FX This paper was funded internally by Bordeaux PharmacoEpi, a research platform of the University of Bordeaux. The authors wish to thank Alain Weill and Geric Maura (CNAMTS) for their advice and help and all the persons in CNAMTs and in our department that have provided insight into the systems. 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Drug Saf. PD AUG PY 2017 VL 26 IS 8 BP 954 EP 962 DI 10.1002/pds.4233 PG 9 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA FG0CJ UT WOS:000409386300010 PM 28544284 DA 2023-05-13 ER PT J AU Chen, K Wang, J Dai, JZ Luo, AL Tian, YK Guan, ZH Wang, XR AF Chen, Kun Wang, Juan Dai, Jinzhen Luo, Ailin Tian, Yuke Guan, Zhonghui Wang, Xueren TI Anesthetic management of radical nephrectomy in patients with renal cell carcinoma involving renal vein or inferior vena cava SO TUMORI JOURNAL LA English DT Article DE Anesthesia; renal cell carcinoma; inferior vena cava; renal vein ID HYPOTHERMIC CIRCULATORY ARREST; TUMOR THROMBUS; SURGICAL-MANAGEMENT; EXPERIENCE; IVC; THROMBECTOMY; INVOLVEMENT; SURGERY; CANCER AB Objective: To investigate the perioperative anesthetic management of patients diagnosed with renal cell carcinoma (RCC) metastasized into the renal vein or inferior vena cava (IVC) after undergoing radical nephrectomy to provide clinical evidence for rational anesthetic interventions. Methods: A total of 81 patients with RCC extending into the renal vein or IVC, aged 17-73 years, undergoing radical nephrectomy were recruited. Preoperative status, intraoperative management, average operation time, average estimated blood loss, postanesthesia outcomes, and postoperative complications were retrospectively analyzed. Results: The mean operation time was 288 minutes (range 146-825 minutes). The mean estimated blood loss was recorded as 1905 mL (range 200-7000 mL). Among 81 cases, 9 patients (11.1%, 1 level II, 3 level III, and 5 level IV) were switched to undergo cardiopulmonary bypass. Significant hemodynamic fluctuations were observed in 39 patients who presented with level II-IV of tumor thrombus. One patient had pulmonary embolism and died of active cardiopulmonary resuscitation. The mean postoperative hospital stay was 12.8 days. Twenty-five cases with level III-IV tumor thrombus were transferred to the intensive care unit with endotracheal intubation due to massive intraoperative blood loss. The remaining 55 cases were transferred to the postanesthesia care unit 2 hours before being transferred to the ward. One patient had postoperative acute coronary syndrome and was discharged after effective interventions. Conclusion: Anesthetic management and intensive postoperative care play a pivotal role in the success of complete resection of RCC that metastasize into the IVC. C1 [Chen, Kun; Wang, Juan; Dai, Jinzhen; Luo, Ailin; Tian, Yuke; Wang, Xueren] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Anesthesiol, Wuhan 430030, Hubei, Peoples R China. [Guan, Zhonghui] Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA. C3 Huazhong University of Science & Technology; University of California System; University of California San Francisco RP Wang, XR (通讯作者)，Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Anesthesiol, Wuhan 430030, Hubei, Peoples R China. EM xrwang@hust.edu.cn FU NINDS NIH HHS [R01 NS100801] Funding Source: Medline CR Abel EJ, 2014, EUR UROL, V66, P584, DOI 10.1016/j.eururo.2013.10.029 Ali ASM, 2013, UROL ONCOL-SEMIN ORI, V31, P1298, DOI 10.1016/j.urolonc.2011.11.001 Bertini R, 2008, UROLOGY, V71, P957, DOI 10.1016/j.urology.2007.11.122 Bissada NK, 2003, UROLOGY, V61, P89, DOI 10.1016/S0090-4295(02)02119-2 Blute ML, 2004, BJU INT, V94, P33, DOI 10.1111/j.1464-410X.2004.04897.x Casey RG, 2013, SURG-J R COLL SURG E, V11, P295, DOI 10.1016/j.surge.2013.02.007 Ciancio G, 2007, EUR UROL, V51, P988, DOI 10.1016/j.eururo.2006.11.055 Cywinski JB, 2009, ANESTH ANALG, V109, P1413, DOI 10.1213/ANE.0b013e3181b97788 Feng X, 2009, J SURG ONCOL, V100, P159, DOI 10.1002/jso.21303 Fukazawa K, 2014, J CARDIOTHOR VASC AN, V28, P640, DOI 10.1053/j.jvca.2013.04.002 Galvez JA, 2011, ANESTHESIOLOGY, V114, P1212, DOI 10.1097/ALN.0b013e3182065c73 Han ZJ, 2014, WORLD J SURG ONCOL, V12, DOI 10.1186/1477-7819-12-131 Kaplan S, 2002, AM J SURG, V183, P292, DOI 10.1016/S0002-9610(02)00782-1 Katkoori D, 2009, INT BRAZ J UROL, V35, P652, DOI 10.1590/S1677-55382009000600003 Kirkali Z, 2007, EUR UROL, V52, P658, DOI 10.1016/j.eururo.2007.05.009 Kobayashi T, 2004, INT J UROL, V11, P114, DOI 10.1111/j.1442-2042.2004.00743.x Lambert EH, 2007, UROLOGY, V69, P1054, DOI 10.1016/j.urology.2007.02.052 Lawindy SM, 2012, BJU INT, V110, P926, DOI 10.1111/j.1464-410X.2012.11174.x Manassero F, 2011, UROL ONCOL-SEMIN ORI, V29, P745, DOI 10.1016/j.urolonc.2009.09.018 Martinez-Salamanca JI, 2011, EUR UROL, V59, P120, DOI 10.1016/j.eururo.2010.10.001 Shin S, 2013, J VASC SURG, V58, P1021, DOI 10.1016/j.jvs.2013.02.247 Shuch B, 2011, BJU INT, V107, P724, DOI 10.1111/j.1464-410X.2010.09488.x Wagner B, 2009, EUR UROL, V55, P452, DOI 10.1016/j.eururo.2008.07.053 NR 23 TC 1 Z9 1 U1 0 U2 0 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0300-8916 EI 2038-2529 J9 TUMORI J JI Tumori J. PD OCT PY 2019 VL 105 IS 5 BP 411 EP 416 DI 10.1177/0300891619839295 PG 6 WC Oncology WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology GA IW8XX UT WOS:000485278500006 PM 30940005 DA 2023-05-13 ER PT J AU Bolliger, D Lance, MD Siegemund, M AF Bolliger, Daniel Lance, Marcus D. Siegemund, Martin TI Point-of-Care Platelet Function Monitoring: Implications for Patients With Platelet Inhibitors in Cardiac Surgery SO JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA LA English DT Review DE Platelet Function; Coagulation Monitoring; Platelet Inhibitors; Cardiac Surgery ID ACUTE CORONARY SYNDROME; MULTIPLE ELECTRODE AGGREGOMETRY; DUAL ANTIPLATELET THERAPY; LIGHT TRANSMISSION AGGREGOMETRY; CLOPIDOGREL-TREATED PATIENTS; TRANEXAMIC ACID; THROMBUS FORMATION; BYPASS SURGERY; PERIOPERATIVE MANAGEMENT; PREDICTIVE-VALUE AB Although most physicians are comfortable managing the limited anticoagulant effect of aspirin, the recent administration of potent P2Y(12) receptor inhibitors in patients undergoing cardiac surgery remains a dilemma. Guidelines recommend discontinuation of potent P2Y(12) inhibitors 5- to-7 days before surgery to reduce the risk of postoperative hemorrhage. Such a strategy might not be feasible before urgent surgery, due to ongoing myocardial ischemia or in patients at high risk for thromboembolic events. Recently, different point-of-care devices to assess functional platelet quality have become available for clinical use. The aim of this narrative review was to evaluate the implications and potential benefits of platelet function monitoring in guiding perioperative management and therapeutic options in patients treated with antiplatelets, including aspirin or P2Y(12) receptor inhibitors, undergoing cardiac surgery. No objective superiority of one point-of-care device over another was found in a large meta-analysis. Their accuracy and reliability are generally limited in the perioperative period. In particular, preoperative platelet function testing has been used to assess platelet contribution to bleeding after cardiac surgery. However, predictive values for postoperative hemorrhage and transfusion requirements are low, and there is a significant variability between and within these tests. Further, platelet function monitoring has been used to optimize the preoperative waiting period after cessation of dual antiplatelet therapy before urgent cardiac surgery. Furthermore, studies assessing their value in therapeutic decisions in bleeding patients after cardiac surgery are scarce. A general and liberal use of perioperative platelet function testing is not yet recommended. (C) 2020 The Authors. Published by Elsevier Inc. C1 [Bolliger, Daniel] Univ Hosp Basel, Dept Anesthesia Prehosp Emergency Med & Pain Ther, Spitalstr 21, CH-4031 Basel, Switzerland. [Lance, Marcus D.] Hamad Med Corp, Weill Cornell Med Qatar, Dept Anesthesiol Intens Care Unit & Perioperat Me, Doha, Qatar. [Siegemund, Martin] Univ Hosp Basel, Intens Care Med, Basel, Switzerland. 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PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1053-0770 EI 1532-8422 J9 J CARDIOTHOR VASC AN JI J. Cardiothorac. Vasc. Anesth. PD APR PY 2021 VL 35 IS 4 BP 1049 EP 1059 DI 10.1053/j.jvca.2020.07.050 EA FEB 2021 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 QO6OZ UT WOS:000623262300012 PM 32807601 OA hybrid DA 2023-05-13 ER PT J AU Lopes, RD Pieper, KS Stevens, SR Solomon, SD McMurray, JJV Pfeffer, MA Leimberger, JD Velazquez, EJ AF Lopes, Renato D. Pieper, Karen S. Stevens, Susanna R. Solomon, Scott D. McMurray, John J. V. Pfeffer, Marc A. Leimberger, Jeffrey D. Velazquez, Eric J. TI Predicting Outcomes Over Time in Patients With Heart Failure, Left Ventricular Systolic Dysfunction, or Both Following Acute Myocardial Infarction SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE heart failure; left ventricular systolic dysfunction; myocardial infarction; risk factor ID ACUTE CORONARY SYNDROMES; INTERNATIONAL TRIAL; RISK SCORE; CARE UNIT; MORTALITY; PROGNOSIS; PROGNOSTICATION; VALSARTAN AB Background-Most studies of risk assessment or stratification in patients with myocardial infarction (MI) have been static and fail to account for the evolving nature of clinical events and care processes. We sought to identify predictors of mortality, cardiovascular death or nonfatal MI, and cardiovascular death or nonfatal heart failure (HF) over time in patients with HF, left ventricular systolic dysfunction, or both post-MI. Methods and Results-Using data from the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial, we developed models to estimate the association between patient characteristics and the likelihood of experiencing an event from the time of a follow-up visit until the next visit. The intervals are: hospital arrival to discharge or 14 days, whichever occurs first; hospital discharge to 30 days; 30 days to 6 months; and 6 months to 3 years. Models were also developed to predict the entire 3-year follow-up period using baseline information. Multivariable Cox proportional hazards modeling was used throughout with Wald chi-squares as the comparator of strength for each predictor. For the baseline model of overall mortality, the 3 strongest predictors were age (adjusted hazard ratio [HR], 1.35; 95% CI, 1.28-1.42; P<0.0001), baseline heart rate (adjusted HR, 1.17; 95% CI, 1.14-1.21; P<0.0001), and creatinine clearance (<= 100 mL/min; adjusted HR, 0.86; 95% CI, 0.84-0.89; P<0.0001). According to the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices, the updated model had significant improvement over the model with baseline covariates only in all follow-up periods and with all outcomes. Conclusions-Patient information assessed closest to the time of the outcome was more valuable in predicting death when compared with information obtained at the time of the index hospitalization. Using updated patient information improves prognosis over using only the information available at the time of the index event. C1 [Lopes, Renato D.; Pieper, Karen S.; Stevens, Susanna R.; Leimberger, Jeffrey D.; Velazquez, Eric J.] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA. [Solomon, Scott D.; Pfeffer, Marc A.] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA USA. [McMurray, John J. V.] Univ Glasgow, British Heart Fdn, Glasgow G12 8QQ, Lanark, Scotland. C3 Duke University; Harvard University; Brigham & Women's Hospital; Harvard Medical School; RLUK- Research Libraries UK; University of Glasgow RP Lopes, RD (通讯作者)，Duke Clin Res Inst, Room 0311,Terrace Level,2400 Pratt St, Durham, NC 27705 USA. EM renato.lopes@duke.edu RI McMurray, John J.V./B-2467-2013 OI McMurray, John J.V./0000-0002-6317-3975 FU Duke Clinical Research Institute; Novartis FX This work was supported internally by the Duke Clinical Research Institute. The VALIANT trial was funded by Novartis. 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Am. Heart Assoc. PD JUN PY 2016 VL 5 IS 6 AR e003045 DI 10.1161/JAHA.115.003045 PG 23 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EA6CK UT WOS:000386712700019 PM 27353607 OA Green Accepted, Green Submitted, Green Published, gold DA 2023-05-13 ER PT J AU Jeffery, MM Silva, LOJE Bellolio, F Garovic, VD Dempsey, TM Limper, A Cummins, NW AF Jeffery, Molly Moore e Silva, Lucas Oliveira J. Bellolio, Fernanda Garovic, Vesna D. Dempsey, Timothy M. Limper, Andrew Cummins, Nathan W. TI Association of outpatient use of renin-angiotensin-aldosterone system blockers on outcomes of acute respiratory illness during the COVID-19 pandemic: a cohort study SO BMJ OPEN LA English DT Article DE ACE inhibitors; angiotensin receptor blockers; COVID-19; acute viral respiratory illness ID INHIBITORS; HYPERTENSION; MORTALITY AB Objectives Evaluate the associations between patients taking ACE inhibitors and angiotensin receptor blockers (ARBs) and their clinical outcomes after an acute viral respiratory illness (AVRI) due to COVID-19. Design Retrospective cohort. Setting The USA; 2017-2018 influenza season, 2018-2019 influenza season, and 2019-2020 influenza/COVID-19 season. Participants People with hypertension (HTN) taking an ACEi, ARB or other HTN medications, and experiencing AVRI. Main outcome measures Change in hospital admission, intensive care unit (ICU) or coronary care unit (CCU), acute respiratory distress (ARD), ARD syndrome (ARDS) and all-cause mortality, comparing COVID-19 to pre-COVID-19 influenza seasons. Results The cohort included 1 059 474 episodes of AVRI (653 797 filled an ACEi or ARB, and 405 677 other HTN medications). 58.6% were women and 72.9% with age >= 65. The ACEi/ARB cohort saw a larger increase in risk in the COVID-19 influenza season than the other HTN medication cohort for four out of five outcomes, with an additional 1.5 percentage point (pp) increase in risk of an inpatient stay (95% CI 1.2 to 1.9 pp) and of ICU/CCU use (95% CI 0.3 to 2.7 pp) as well as a 0.7 pp (0.1 to 1.2 pp) additional increase in risk of ARD and 0.9 pp (0.4 to 1.3 pp) additional increase in risk of ARDS. There was no statistically significant difference in the absolute risk of death (-0.2 pp, 95% CI -0.4 to 0.1 pp). However, the relative risk of death in 2019/2020 versus 2017/2018 for the ACEi/ARB group was larger (1.40 (1.36 to 1.44)) than for the other HTN medication cohort (1.24 (1.21 to 1.28)). Conclusions People with AVRI using ACEi/ARBs for HTN had a greater increase in poor outcomes during the COVID-19 pandemic than those using other medications to treat HTN. The small absolute magnitude of the differences likely does not support changes in clinical practice. C1 [Jeffery, Molly Moore] Mayo Clin, Dept Emergency Med, Rochester, MN 55902 USA. [Jeffery, Molly Moore] OptumLabs, Eden Prairie, MN 55344 USA. [e Silva, Lucas Oliveira J.; Bellolio, Fernanda] Mayo Clin, Emergency Med, Rochester, MN USA. [Garovic, Vesna D.] Mayo Clin, Div Nephrol & Hypertens, Dept Med, Rochester, MN USA. [Dempsey, Timothy M.] US Air Force, David Grant Med Ctr, Travis AFB, CA USA. [Dempsey, Timothy M.; Limper, Andrew] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN USA. [Limper, Andrew] Mayo Clin, Div Pulm & Crit Care Med, Dept Med, Rochester, MN USA. [Cummins, Nathan W.] Mayo Clin, Div Infect Dis, Dept Med, Rochester, MN USA. C3 Mayo Clinic; Optum; Mayo Clinic; Mayo Clinic; United States Department of Defense; United States Air Force; Mayo Clinic; Mayo Clinic; Mayo Clinic RP Jeffery, MM (通讯作者)，Mayo Clin, Dept Emergency Med, Rochester, MN 55902 USA.; Jeffery, MM (通讯作者)，OptumLabs, Eden Prairie, MN 55344 USA. EM jeffery.molly@mayo.edu RI Jeffery, Molly Moore/GSI-6305-2022 OI Jeffery, Molly Moore/0000-0003-3854-6810; Oliveira J. e Silva, Lucas/0000-0001-5388-9163; Bellolio, Fernanda/0000-0002-1632-4750 CR Alamer A, 2020, PHARMACOL RES, V160, DOI 10.1016/j.phrs.2020.105053 Angeli F, 2022, J CARDIOVASC DEV DIS, V9, DOI 10.3390/jcdd9010015 Baral R, 2020, CURR ATHEROSCLER REP, V22, DOI 10.1007/s11883-020-00880-6 Barochiner J, 2020, J CLIN PHARM THER, V45, P1244, DOI 10.1111/jcpt.13246 Benchimol EI, 2015, PLOS MED, V12, DOI 10.1371/journal.pmed.1001885 Caldeira D, 2020, IJC HEART VASC, V31, DOI 10.1016/j.ijcha.2020.100627 Centers for Disease Control and Prevention, SEAS EST INFL DIS BU Chan CK, 2020, HYPERTENSION, V76, P1563, DOI 10.1161/HYPERTENSIONAHA.120.15989 Cohen JB, 2021, LANCET RESP MED, V9, P275, DOI 10.1016/S2213-2600(20)30558-0 Flacco ME, 2020, HEART, V106, P1519, DOI 10.1136/heartjnl-2020-317336 Greco A, 2020, EUR HEART J-CARD PHA, V6, P335, DOI 10.1093/ehjcvp/pvaa074 Grover A, 2021, EUR HEART J-CARD PHA, V7, P148, DOI 10.1093/ehjcvp/pvaa064 Guo XM, 2020, HYPERTENSION, V76, pE13, DOI 10.1161/HYPERTENSIONAHA.120.15572 Hasan SS, 2020, AM J CARDIOVASC DRUG, V20, P571, DOI 10.1007/s40256-020-00439-5 Jeffery MM, 2020, JAMA INTERN MED, V180, P1328, DOI 10.1001/jamainternmed.2020.3288 Soler MJ, 2022, CLIN KIDNEY J, V15, P79, DOI 10.1093/ckj/sfab161 Killerby ME, 2020, MMWR-MORBID MORTAL W, V69, P790, DOI 10.15585/mmwr.mm6925e1 Kurdi A, 2020, PHARMACOL RES PERSPE, V8, DOI 10.1002/prp2.666 Liu X, 2020, CLIN CARDIOL, DOI 10.1002/clc.23421 Lo KB, 2020, EXPERT REV CARDIOVAS, V18, P919, DOI 10.1080/14779072.2020.1826308 Lopes RD, 2021, JAMA-J AM MED ASSOC, V325, P254, DOI 10.1001/jama.2020.25864 Mackey K, 2020, ANN INTERN MED, V173, P195, DOI 10.7326/M20-1515 National Committee for Quality Assurance, 2019 QUAL RAT SYST Q Patoulias D, 2020, CURR HYPERTENS REP, V22, DOI 10.1007/s11906-020-01101-w Pirola CJ, 2020, J INFECTION, V81, P276, DOI 10.1016/j.jinf.2020.05.052 Pranata R, 2020, DIABETES METAB SYND, V14, P983, DOI 10.1016/j.dsx.2020.06.047 Quan HD, 2005, MED CARE, V43, P1130, DOI 10.1097/01.mlr.0000182534.19832.83 Rizk JG, 2022, DRUGS, V82, P43, DOI 10.1007/s40265-021-01639-2 Salah HM, 2020, J CARDIOVASC PHARM T, V25, P503, DOI 10.1177/1074248420947628 Sato K, 2022, BMC CARDIOVASC DISOR, V22, DOI 10.1186/s12872-022-02565-1 Sheppard JP, 2021, HYPERTENSION, V77, P846, DOI 10.1161/HYPERTENSIONAHA.120.16472 Smith Steven M, 2022, Am Heart J Plus, V13, P100112, DOI 10.1016/j.ahjo.2022.100112 Usman MS, 2020, AM J CARDIOL, V130, P159, DOI 10.1016/j.amjcard.2020.05.038 Vaduganathan M, 2020, NEW ENGL J MED, V382, P1653, DOI 10.1056/NEJMsr2005760 Wallace PJ, 2014, HEALTH AFFAIR, V33, P1187, DOI 10.1377/hlthaff.2014.0038 Wang YX, 2021, J MED VIROL, V93, P1370, DOI 10.1002/jmv.26625 Williamson EJ, 2020, NATURE, V584, P430, DOI 10.1038/s41586-020-2521-4 Wu ZY, 2020, JAMA-J AM MED ASSOC, V323, P1239, DOI 10.1001/jama.2020.2648 Xu JY, 2021, CLIN INFECT DIS, V72, pE901, DOI 10.1093/cid/ciaa1592 Zhang X, 2020, PHARMACOL RES, V158, DOI 10.1016/j.phrs.2020.104927 Zhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 NR 41 TC 2 Z9 2 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 JUL PY 2022 VL 12 IS 7 AR e060305 DI 10.1136/bmjopen-2021-060305 PG 9 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 2U6KW UT WOS:000823268200015 PM 35793915 OA Green Published, gold DA 2023-05-13 ER PT J AU McPherson, JA Wagner, CE Boehm, LM Hall, JD Johnson, DC Miller, LR Burns, KM Thompson, JL Shintani, AK Ely, EW Pandhvaripande, PP AF McPherson, John A. Wagner, Chad E. Boehm, Leanne M. Hall, J. David Johnson, Daniel C. Miller, Leanna R. Burns, Kathleen M. Thompson, Jennifer L. Shintani, Ayumi K. Ely, E. Wesley Pandhvaripande, Pratik P. TI Delirium in the Cardiovascular ICU: Exploring Modifiable Risk Factors SO CRITICAL CARE MEDICINE LA English DT Article DE acute coronary syndrome; benzodiazepines; cardiac surgery; cardiovascular ICU; delirium; restraints ID INTENSIVE-CARE-UNIT; MECHANICALLY VENTILATED PATIENTS; CONFUSION ASSESSMENT METHOD; CRITICALLY-ILL PATIENTS; POSTOPERATIVE COGNITIVE DYSFUNCTION; ACUTE MYOCARDIAL-INFARCTION; CARDIAC-SURGERY DELIRIUM; AGITATION-SEDATION SCALE; BYPASS GRAFT-SURGERY; PRECIPITATING FACTORS AB Objective: Delirium, an acute organ dysfunction, is common among critically ill patients leading to significant morbidity and mortality; its epidemiology in a mixed cardiology and cardiac surgery ICU is not well established. We sought to determine the prevalence and risk factors for delirium among cardiac surgery ICU patients. Design: Prospective observational study. Setting: Twenty-seven-bed medical-surgical cardiac surgery ICU. Patients: Two hundred consecutive patients with an expected cardiac surgery ICU length of stay >24 hrs. Interventions: None. Measurements: Baseline demographic data and daily assessments for delirium using the validated and reliable Confusion Assessment Method for the ICU were recorded, and quantitative tracking of delirium risk factors were conducted. Separate analyses studied the role of admission risk factors for occurrence of delirium during the cardiac surgery ICU stay and identified daily occurring risk factors for the development of delirium on a subsequent cardiac surgery ICU day. Main Results: Prevalence of delirium was 26%, similar among cardiology and cardiac surgical patients. Nearly all (92%) exhibited the hypoactive subtype of delirium. Benzodiazepine use at admission was independently predictive of a three-fold increased risk of delirium (odds ratio 3.1 [1, 9.4], p = 0.04) during the cardiac surgery ICU stay. Of the daily occurring risk factors, patients who received benzodiazepines (2.6 [1.2, 5.7], p = 0.02) or had restraints or devices that precluded mobilization (2.9 [1.3, 6.5], p < 0.01) were more likely to have delirium the following day. Hemodynamic status was not associated with delirium. Conclusions: Delirium occurred in one in four patients in the cardiac surgery ICU and was predominately hypoactive in subtype. Chemical restraints via use of benzodiazepines or the use of physical restraints/restraining devices predisposed patients to a greater risk of delirium, pointing to areas of quality improvement that would be new to the vast majority of cardiac surgery ICUs. (Crit Care Med 2013;41:405-413) C1 [McPherson, John A.] Vanderbilt Univ, Med Ctr, MCE, Dept Med,Cardiovasc Div, Nashville, TN 37205 USA. [Wagner, Chad E.; Hall, J. David; Pandhvaripande, Pratik P.] Vanderbilt Univ, Med Ctr, Dept Anesthesiol, Crit Care Med Div, Nashville, TN 37205 USA. [Boehm, Leanne M.; Ely, E. Wesley] Vanderbilt Univ, Med Ctr, Div Gen Internal Med, Div Pulm Crit Care, Nashville, TN 37205 USA. [Boehm, Leanne M.; Ely, E. Wesley] Vanderbilt Univ, Med Ctr, Ctr Hlth Sci Res, Nashville, TN 37205 USA. [Thompson, Jennifer L.; Shintani, Ayumi K.] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN 37205 USA. [Pandhvaripande, Pratik P.] VA Tennessee Valley Hlth Care Syst, Anesthesia Serv, Nashville, TN USA. [Ely, E. Wesley] VA Tennessee Valley Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Nashville, TN USA. C3 Vanderbilt University; Vanderbilt University; Vanderbilt University; Vanderbilt University; Vanderbilt University; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Tennessee Valley Healthcare System; Geriatric Research Education & Clinical Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Tennessee Valley Healthcare System RP McPherson, JA (通讯作者)，Vanderbilt Univ, Med Ctr, MCE, Dept Med,Cardiovasc Div, 1215 21st Ave S,5th Floor,South Tower, Nashville, TN 37205 USA. EM john.mcpherson@vanderbilt.edu RI Ely, E. Wesley/Z-2018-2019; Boehm, Leanne/R-8510-2018 OI Ely, E. Wesley/0000-0003-3957-2172; McPherson, John/0000-0003-3371-7481; Boehm, Leanne/0000-0003-0127-6677 FU Aspect Medical Systems; National Institutes of Health [AG027472]; VA Clinical Science Research and Development (VA Merit Review Award); VA Career Development Award (CSRD) FX Dr. Wagner has received honoraria from ImaCor. Dr. Wagner has received honoraria from ImaCor. Ms. Boehm has received honoraria from Hospira. Dr. Ely has received a grant from Aspect Medical Systems and honoraria from Pfizer, Eli Lilly, GlaxoSmithKline, and Hospira. Dr. Shintani has received funding from the National Institutes of Health. Dr. Ely is supported by the VA Clinical Science Research and Development (VA Merit Review Award) and the National Institutes of Health (AG027472). Dr. Pandharipande has received honoraria from Hospira and Orion Pharma. Dr. Pandharipande is supported by a VA Career Development Award (CSRD). The remaining authors have not disclosed any potential conflicts of interest. 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Care Med. PD FEB PY 2013 VL 41 IS 2 BP 405 EP 413 DI 10.1097/CCM.0b013e31826ab49b PG 9 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 078NO UT WOS:000314106000024 PM 23263581 OA Green Accepted DA 2023-05-13 ER PT J AU Pergola, V Cabrelle, G Previtero, M Fiorencis, A Lorenzoni, G Dellino, CM Montonati, C Continisio, S Masetto, E Mele, D Marra, MP Giraudo, C Barbiero, G De Conti, G Di Salvo, G Gregori, D Iliceto, S Motta, R AF Pergola, Valeria Cabrelle, Giulio Previtero, Marco Fiorencis, Andrea Lorenzoni, Giulia Dellino, Carlo Maria Montonati, Carolina Continisio, Saverio Masetto, Elisa Mele, Donato Marra, Martina Perazzolo Giraudo, Chiara Barbiero, Giulio De Conti, Giorgio Di Salvo, Giovanni Gregori, Dario Iliceto, Sabino Motta, Raffaella TI Impact of the "atherosclerotic pabulum" on in-hospital mortality for SARS-CoV-2 infection. Is calcium score able to identify at-risk patients? SO CLINICAL CARDIOLOGY LA English DT Article DE cardiovascular risk; chest computed tomography; coronary calcium score; SARS-CoV-2 infection ID CORONARY-ARTERY CALCIUM; CALCIFICATION; PREDICTION; COMPLICATIONS AB Background Although the primary cause of death in COVID-19 infection is respiratory failure, there is evidence that cardiac manifestations may contribute to overall mortality and can even be the primary cause of death. More importantly, it is recognized that COVID-19 is associated with a high incidence of thrombotic complications. Hypothesis Evaluate if the coronary artery calcium (CAC) score was useful to predict in-hospital (in-H) mortality in patients with COVID-19. Secondary end-points were needed for mechanical ventilation and intensive care unit admission. Methods Two-hundred eighty-four patients (63, 25 years, 67% male) with proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who had a noncontrast chest computed tomography were analyzed for CAC score. Clinical and radiological data were retrieved. Results Patients with CAC had a higher inflammatory burden at admission (d-dimer, p = .002; C-reactive protein, p = .002; procalcitonin, p = .016) and a higher high-sensitive cardiac troponin I (HScTnI, p = <.001) at admission and at peak. While there was no association with presence of lung consolidation and ground-glass opacities, patients with CAC had higher incidence of bilateral infiltration (p = .043) and higher in-H mortality (p = .048). On the other side, peak HScTnI >200 ng/dl was a better determinant of all outcomes in both univariate (p = <.001) and multivariate analysis (p = <.001). Conclusion The main finding of our research is that CAC was positively related to in-H mortality, but it did not completely identify all the population at risk of events in the setting of COVID-19 patients. This raises the possibility that other factors, including the presence of soft, unstable plaques, may have a role in adverse outcomes in SARS-CoV-2 infection. C1 [Pergola, Valeria; Previtero, Marco; Fiorencis, Andrea; Dellino, Carlo Maria; Montonati, Carolina; Continisio, Saverio; Mele, Donato; Marra, Martina Perazzolo; Iliceto, Sabino] Univ Padua, Dept Cardiac Vasc Thorac Sci & Publ Hlth, I-35122 Padua, Italy. [Cabrelle, Giulio; Giraudo, Chiara] Univ Padua, Inst Radiol, Dept Med, Padua, Italy. [Lorenzoni, Giulia; Masetto, Elisa; Gregori, Dario] Univ Padua, Dept Cardiac Thorac Vasc Sci & Publ Hlth, Unit Biostat Epidemiol & Publ Hlth, Padua, Italy. [Barbiero, Giulio; De Conti, Giorgio] Padova Univ Hosp, Radiol Unit, Padua, Italy. [Di Salvo, Giovanni] Univ Padua, Dept Womens & Childrens Hlth, Padua, Italy. [Motta, Raffaella] Univ Padua, Dept Med, Unit Adv & Translat Diagnost, Padua, Italy. C3 University of Padua; University of Padua; University of Padua; University of Padua; Azienda Ospedaliera - Universita di Padova; University of Padua; University of Padua RP Pergola, V (通讯作者)，Univ Padua, Dept Cardiac Vasc Thorac Sci & Publ Hlth, I-35122 Padua, Italy. EM valeria.pergola@aopd.veneto.it RI Cabrelle, Giulio/HJI-0431-2023; Pergola, Valeria/AAM-9050-2021 OI Pergola, Valeria/0000-0002-3317-7342; MELE, Donato/0000-0002-2823-4090; Barbiero, Giulio/0000-0002-1157-3635 CR AGATSTON AS, 1990, J AM COLL CARDIOL, V15, P827, DOI 10.1016/0735-1097(90)90282-T Andreini D, 2021, CURR OPIN CARDIOL, V36, P784, DOI 10.1097/HCO.0000000000000917 [Anonymous], 2021, Eur Heart J, V42, P2298, DOI 10.1093/eurheartj/ehab285 Budoff MJ, 2007, J AM COLL CARDIOL, V49, P1860, DOI 10.1016/j.jacc.2006.10.079 Cosyns B, 2020, JACC-CARDIOVASC IMAG, V13, P2698, DOI 10.1016/j.jcmg.2020.09.038 Dillinger JG, 2020, JACC-CARDIOVASC IMAG, V13, P2468, DOI 10.1016/j.jcmg.2020.07.004 Escher R, 2020, THROMB RES, V190, P62, DOI 10.1016/j.thromres.2020.04.014 Ferrante G, 2020, CARDIOVASC RES, V116, P2239, DOI 10.1093/cvr/cvaa193 Fovino LN, 2020, EUR HEART J-CARD IMG, V21, P1055, DOI 10.1093/ehjci/jeaa202 Greenland P, 2004, JAMA-J AM MED ASSOC, V291, P210, DOI 10.1001/jama.291.2.210 Guo T, 2020, JAMA CARDIOL, V5, P811, DOI 10.1001/jamacardio.2020.1017 Gupta VA, 2018, J CRIT CARE, V44, P261, DOI 10.1016/j.jcrc.2017.11.038 Inciardi Riccardo M, 2020, Eur Heart J, V41, P1821, DOI 10.1093/eurheartj/ehaa388 Kaczmarska E, 2013, POSTEP KARDIOL INTER, V9, P9, DOI 10.5114/pwki.2013.34024 Knapper JT, 2016, HEART, V102, P204, DOI 10.1136/heartjnl-2015-308429 Matos J, 2020, EUR RADIOL EXP, V4, DOI 10.1186/s41747-020-00167-0 Nasir K, 2012, CIRC-CARDIOVASC IMAG, V5, P467, DOI 10.1161/CIRCIMAGING.111.964528 Pergola V., 2021, EMJ, V6, P70 Peterson E, 2021, CORONARY ARTERY DIS, V32, P367, DOI 10.1097/MCA.0000000000000934 R. Core Team R, 2015, LANG ENV STAT COMP Sabatino J, 2020, J CLIN MED, V9, DOI 10.3390/jcm9061774 Sakamoto Y., 1986, AKAIKE INFORM CRITER Scoccia A, 2021, ATHEROSCLEROSIS, V328, P136, DOI 10.1016/j.atherosclerosis.2021.03.041 Shemesh J, 2010, RADIOLOGY, V257, P541, DOI 10.1148/radiol.10100383 Slipczuk L, 2021, INT J CARDIOVAS IMAG, V37, P3093, DOI 10.1007/s10554-021-02276-2 Stefanadis C, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.005543 Tartof SY, 2020, ANN INTERN MED, V173, P773, DOI 10.7326/M20-3742 World Health Organization, COR DIS COVID 19 TEC Zhang Yuanyuan, 2021, Cardiol Discov, V1, P233, DOI 10.1097/CD9.0000000000000038 NR 29 TC 2 Z9 2 U1 1 U2 2 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 2022 VL 45 IS 6 BP 629 EP 640 DI 10.1002/clc.23809 EA MAR 2022 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 1X4HP UT WOS:000776826600001 PM 35355295 OA Green Published DA 2023-05-13 ER PT J AU Immohr, MB Sugimura, Y Aubin, H Rellecke, P Boeken, U Lichtenberg, A Akhyari, P AF Immohr, Moritz B. Sugimura, Yukiharu Aubin, Hug Rellecke, Philipp Boeken, Udo Lichtenberg, Artur Akhyari, Payam TI Iron deficiency does not impair the outcome after elective coronary artery bypass and aortic valve procedures SO JOURNAL OF CARDIAC SURGERY LA English DT Article DE anemia; aortic valve stenosis; coronary artery disease; ferritin; iron deficiency; transferrin ID CARDIAC-SURGERY; HEART-FAILURE; GUIDELINES; MANAGEMENT; DIAGNOSIS; ANEMIA AB Background and Aim of the Study Iron deficiency (ID), a common malnutrition, has been linked to impaired prognosis in patients with congestive heart failure. It remains unclear whether ID also affects the outcome after elective cardiac surgery. Methods A total of 378 consecutive patients undergoing either coronary artery bypass grafting (CABG) or surgical aortic valve replacement (SAVR) were prospectively enrolled, and blood samples were taken before surgery for analysis of iron metabolism. Incidence of major adverse cardiovascular and cerebrovascular events (MACCE) was defined as the primary endpoint of the study. Results ID (ferritin < 100 ng/ml or ferritin = 100-299 ng/ml and transferrin saturation < 20%) was common in cardiac surgery patients (ID, n = 265, 70%) and related to significant decreased preoperative hemoglobin values (ID: 13.6 +/- 1.6 g/dl, Non-ID: 14.3 +/- 1.5 g/dl, p < 0.01). We did not observe any differences in the postoperative outcome of the two groups. The incidence of MACCE was 4.9% in patients with ID and 8.8% in Non-ID (p = 0.16). In-hospital mortality (ID: 1.9%, Non-ID: 4.4%, p = 0.17) and stroke (ID: 1.1%, Non-ID: 1.8%, p = 0.64) were also not altered by ID. In addition, intensive care unit and hospital stay, perioperative blood transfusions as well as perioperative morbidities, such as acute kidney injury, low cardiac output syndrome, major bleeding complication, and sternal wound infections were comparable in patients with and without ID. Conclusions The majority of patients undergoing elective CABG or SAVR suffer from ID; however, we found no significant differences in regard to MACCE and postoperative morbidity between ID and non-ID patients. C1 [Immohr, Moritz B.; Sugimura, Yukiharu; Aubin, Hug; Rellecke, Philipp; Boeken, Udo; Lichtenberg, Artur; Akhyari, Payam] Heinrich Heine Univ, Med Sch, Dept Cardiac Surg, Moorenstr 5, D-40225 Dusseldorf, Germany. C3 Heinrich Heine University Dusseldorf RP Lichtenberg, A (通讯作者)，Heinrich Heine Univ, Med Sch, Dept Cardiac Surg, Moorenstr 5, D-40225 Dusseldorf, Germany. EM Artur.Lichtenberg@med.uni-duesseldorf.de RI Immohr, Moritz Benjamin/AAK-8704-2021 OI Immohr, Moritz Benjamin/0000-0003-1051-8105; Boeken, Udo/0000-0001-8128-9659; Sugimura, Yukiharu/0000-0003-0217-7363; Lichtenberg, Artur/0000-0001-8580-6369 FU Heinrich-Heine-University Dusseldorf FX Heinrich-Heine-University Dusseldorf CR Baumgartner H, 2018, EUR HEART J, V39, P1980, DOI [10.1093/eurheartj/ehx636, 10.1093/eurheartj/ehx391] Benjamin EJ, 2019, CIRCULATION, V139, pE56, DOI [10.1161/CIR.0000000000000659, 10.1161/CIR.0000000000000746] Beverborg NG, 2018, CIRC-HEART FAIL, V11, DOI 10.1161/CIRCHEARTFAILURE.117.004519 Bresgen N, 2015, BIOMOLECULES, V5, P808, DOI 10.3390/biom5020808 GBD 2016 Disease and Injury Incidence and Prevalence Collaborators, 2017, Lancet, V390, P1211, DOI 10.1016/S0140-6736(17)32154-2 German EC, 2017, SWISS MED WKLY, V147, DOI 10.4414/smw.2017.14434 Gomez-Ramirez S, 2019, ACTA HAEMATOL-BASEL, V142, P21, DOI 10.1159/000496965 Hoes MF, 2018, EUR J HEART FAIL, V20, P910, DOI 10.1002/ejhf.1154 Klip IT, 2013, AM HEART J, V165, P575, DOI 10.1016/j.ahj.2013.01.017 Lozano R, 2013, LANCET, V381, P628, DOI 10.1016/S0140-6736(12)61728-0 Miles LF, 2018, ANAESTHESIA, V73, P450, DOI 10.1111/anae.14115 Musallam KM, 2018, CURR MED RES OPIN, V34, P81, DOI 10.1080/03007995.2017.1394833 Neumann FJ, 2019, EUROINTERVENTION, V14, P1435, DOI [10.4244/EIJY19M01_01, 10.1093/ejcts/ezy289] Padmanabhan H, 2019, INTERACT CARDIOV TH, V28, P447, DOI 10.1093/icvts/ivy226 Vela JLP, 2018, MED INTENSIVA, V42, P159, DOI 10.1016/j.medin.2017.05.009 Piednoir P, 2011, EUR J ANAESTH, V28, P796, DOI 10.1097/EJA.0b013e32834ad97b Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Pratt JJ, 2016, EUR J HAEMATOL, V96, P618, DOI 10.1111/ejh.12645 Rheude T, 2017, INT J CARDIOL, V244, P93, DOI 10.1016/j.ijcard.2017.06.024 Spahn DR, 2019, LANCET, V393, P2201, DOI 10.1016/S0140-6736(18)32555-8 Stoltzfus Rebecca J., 2003, Food and Nutrition Bulletin, V24, pS99 Task Force on Patient Blood Management for Adult Cardiac Surgery of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Cardiothoracic Anaesthesiology (EACTA), 2018, J Cardiothorac Vasc Anesth, V32, P88, DOI 10.1053/j.jvca.2017.06.026 Wright JA, 2014, FRONT PHARMACOL, V5, DOI 10.3389/fphar.2014.00156 Young JB, 2016, J AM COLL CARDIOL, V68, P459, DOI 10.1016/j.jacc.2016.05.061 NR 24 TC 8 Z9 8 U1 0 U2 3 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 2021 VL 36 IS 2 BP 542 EP 550 DI 10.1111/jocs.15254 EA DEC 2020 PG 9 WC Cardiac & Cardiovascular Systems; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Surgery GA PX3AK UT WOS:000600334200001 PM 33345354 OA gold DA 2023-05-13 ER PT J AU Clark, D Nicholls, SJ St John, J Elshazly, MB Ahmed, HM Khraishah, H Nissen, SE Puri, R AF Clark, Donald, III Nicholls, Stephen J. St John, Julie Elshazly, Mohamed B. Ahmed, Haitham M. Khraishah, Haitham Nissen, Steven E. Puri, Rishi TI Visit-to-Visit Blood Pressure Variability, Coronary Atheroma Progression, and Clinical Outcomes SO JAMA CARDIOLOGY LA English DT Article ID CARDIOVASCULAR EVENTS; ARTERY-DISEASE; HIGH-RISK; ATHEROSCLEROSIS; TORCETRAPIB AB IMPORTANCE Visit-to-visit blood pressure variability (BPV) is associated with cardiovascular events, but mechanisms and therapeutic implications underlying this association are not well understood. OBJECTIVE To examine the association of intraindividual BPV, coronary atheroma progression, and clinical outcomes using serial intravascular ultrasonography. DESIGN, SETTING, AND PARTICIPANTS Post hoc patient-level analysis of 7 randomized clinical trials conducted from 2004 to 2016 involving 3912 patients in multicenter, international, clinic-based primary and tertiary care centers. Adult patients with coronary artery disease who underwent serial intravascular ultrasonography in the setting of a range of medical therapies were included. Data were analyzed between November 2017 and March 2019. EXPOSURES Visit-to-visit BPV measured using intraindividual standard deviation over 3, 6, 12, 18, and 24 months. MAIN OUTCOMES AND MEASURES Percent atheroma volume (PAV) progression and major adverse cardiovascular events (defined as death, myocardial infarction, stroke, urgent revascularization for acute coronary syndrome, and hospitalization for unstable angina). RESULTS Of 3912 patients, the mean (SD) age was 58 (9) years, 1093 (28%) were women, and 3633 (93%) were white. Continuous change in PAV was significantly associated with systolic BPV (beta, .049; 95% CI, 0.021-0.078; P = .001), diastolic BPV (beta, .031; 95% CI, 0.002-0.059; P = .03), and pulse pressure variability (beta, .036; 95% CI, 0.006-0.067; P = .02), without a signal for differential effect greater than or less than a mean BP of 140/90 mmHg. The PAV progression as a binary outcome was significantly associated with systolic BPV (odds ratio, 1.09; 95% CI, 1.01-1.17; P = .02) but not diastolic BPV (odds ratio, 1.04; 95% CI, 0.97-1.11; P = .30) or pulse pressure variability (odds ratio, 1.03; 95% CI, 0.96-1.10; P = .47). Survival curves revealed a significant stepwise association between cumulative major adverse cardiovascular events and increasing quartiles of systolic BPV (Kaplan-Meier estimates for quartiles 1-4: 6.1% vs 8.5% vs 10.1% vs 12.0%, respectively; log-rank P < .001). These distinct stepwise associations were not seen with diastolic BPV or pulse pressure variability. CONCLUSIONS AND RELEVANCE Greater BPV, particularly systolic BPV, is significantly associated with coronary atheroma progression and adverse clinical outcomes. These data suggest maintaining stable blood pressure levels may be important to further improve outcomes in patients with coronary disease. C1 [Clark, Donald, III] Univ Mississippi, Med Ctr, Dept Med, Div Cardiol, Jackson, MS 39216 USA. [Nicholls, Stephen J.] Monash Univ, Monash Cardiovasc Res Ctr, Melbourne, Vic, Australia. [St John, Julie; Ahmed, Haitham M.; Nissen, Steven E.; Puri, Rishi] Cleveland Clin, Dept Cardiovasc Med, C5R, 9500 Euclid Ave, Cleveland, OH 44195 USA. [Elshazly, Mohamed B.] Weill Cornell Med Coll Qatar, Div Cardiol, Dept Med, Doha, Qatar. [Khraishah, Haitham] Beth Israel Deaconess Med Ctr, Dept Med, Div Cardiol, Boston, MA 02215 USA. C3 University of Mississippi; University of Mississippi Medical Center; Monash University; Cleveland Clinic Foundation; Qatar Foundation (QF); Weill Cornell Medical College Qatar; Harvard University; Beth Israel Deaconess Medical Center RP Puri, R (通讯作者)，Cleveland Clin, Dept Cardiovasc Med, C5R, 9500 Euclid Ave, Cleveland, OH 44195 USA. EM purir@ccf.org RI Elshazly, Mohamed/AAS-3981-2020 OI Nicholls, Stephen/0000-0002-9668-4368; Elshazly, Mohamed/0000-0002-5802-692X FU NIGMS NIH HHS [U54 GM115428] Funding Source: Medline CR Andersson OK, 1998, BMJ-BRIT MED J, V317, P167, DOI 10.1136/bmj.317.7152.167 Bangalore S, 2015, J AM COLL CARDIOL, V65, P1539, DOI 10.1016/j.jacc.2015.02.017 Barter PJ, 2007, NEW ENGL J MED, V357, P2109, DOI 10.1056/NEJMoa0706628 Bromfield S, 2013, CURR HYPERTENS REP, V15, P134, DOI 10.1007/s11906-013-0340-9 Diaz KM, 2012, HYPERTENS RES, V35, P55, DOI 10.1038/hr.2011.135 Elshazly MB, 2016, CURR OPIN ENDOCRINOL, V23, P131, DOI 10.1097/MED.0000000000000234 Franklin SS, 2001, CIRCULATION, V103, P1245 Kim JS, 2017, EUR HEART J-CARD PHA, V3, P82, DOI 10.1093/ehjcvp/pvw019 Krakoff LR, 2012, CIRCULATION, V126, P525, DOI 10.1161/CIRCULATIONAHA.112.124750 Lawlor DA, 2011, PLOS ONE, V6, DOI 10.1371/journal.pone.0017792 Mancia G, 2012, CIRCULATION, V126, P569, DOI 10.1161/CIRCULATIONAHA.112.107565 Mauri L, 2018, AM HEART J, V195, P115, DOI 10.1016/j.ahj.2017.09.006 Nagai M, 2011, J AM SOC HYPERTENS, V5, P184, DOI 10.1016/j.jash.2011.03.001 Nicholls SJ, 2016, JAMA-J AM MED ASSOC, V316, P2373, DOI 10.1001/jama.2016.16951 Nicholls SJ, 2013, JAMA-J AM MED ASSOC, V310, P1135, DOI 10.1001/jama.2013.277169 Nicholls SJ, 2010, J AM COLL CARDIOL, V55, P2399, DOI 10.1016/j.jacc.2010.02.026 Nissen SE, 2006, NEW ENGL J MED, V354, P1253, DOI 10.1056/NEJMoa054699 Nissen SE, 2004, JAMA-J AM MED ASSOC, V292, P2217, DOI 10.1001/jama.292.18.2217 Nissen SE, 2004, JAMA-J AM MED ASSOC, V291, P1071, DOI 10.1001/jama.291.9.1071 Nissen SE, 2008, JAMA-J AM MED ASSOC, V299, P1547, DOI 10.1001/jama.299.13.1547 Nissen SE, 2007, NEW ENGL J MED, V356, P1304, DOI 10.1056/NEJMoa070635 Park S, 2016, J AM SOC HYPERTENS, V10, P799, DOI 10.1016/j.jash.2016.08.004 Puri R, 2013, INT J CARDIOL, V168, P670, DOI 10.1016/j.ijcard.2013.03.024 Schoenhagen P, 2003, J AM SOC ECHOCARDIOG, V16, P277, DOI 10.1067/mje.2003.45 Shimbo D, 2013, AM J HYPERTENS, V26, P896, DOI 10.1093/ajh/hpt040 Tajeu GS, 2017, CIRCULATION, V136, P798, DOI 10.1161/CIRCULATIONAHA.117.027362 Wang JQ, 2017, J HYPERTENS, V35, P10, DOI 10.1097/HJH.0000000000001159 NR 27 TC 36 Z9 36 U1 0 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 MAY PY 2019 VL 4 IS 5 BP 437 EP 443 DI 10.1001/jamacardio.2019.0751 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA IE1QV UT WOS:000472161600008 PM 30969323 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Olier, I Sirker, A Hildick-Smith, DJR Kinnaird, T Ludman, P de Belder, MA Baumbach, A Byrne, J Rashid, M Curzen, N Mamas, MA AF Olier, Ivan Sirker, Alex Hildick-Smith, David J. R. Kinnaird, Tim Ludman, Peter de Belder, Mark A. Baumbach, Andreas Byrne, Jonathan Rashid, Muhammad Curzen, Nick Mamas, Mamas A. TI Association of different antiplatelet therapies with mortality after primary percutaneous coronary intervention SO HEART LA English DT Article DE prasugrel; ticagrelor; clopidogrel; antiplatelet drugs; primary PCI ID ELEVATION MYOCARDIAL-INFARCTION; ST-SEGMENT-ELEVATION; ARTERIAL ACCESS SITE; TRITON-TIMI 38; PLATELET INHIBITION; SUBGROUP ANALYSIS; UNITED-KINGDOM; DOUBLE-BLIND; CLOPIDOGREL; TICAGRELOR AB Objectives Prasugrel and ticagrelor both reduce ischaemic endpoints in high-risk acute coronary syndromes, compared with clopidogrel. However, comparative outcomes of these two newer drugs in the context of primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) remains unclear. We sought to examine this question using the British Cardiovascular Interventional Society national database in patients undergoing primary PCI for STEMI. Methods Data from January 2007 to December 2014 were used to compare use of P2Y12 antiplatelet drugs in primary PCI in >89000 patients. Statistical modelling, involving propensity matching, multivariate logistic regression (MLR) and proportional hazards modelling, was used to study the association of different antiplatelet drug use with all-cause mortality. Results In our main MLR analysis, prasugrel was associated with significantly lower mortality than clopidogrel at both 30days (OR 0.87, 95%CI 0.78 to 0.97, P=0.014) and 1year (OR 0.89, 95%CI 0.82 to 0.97, P=0.011) post PCI. Ticagrelor was not associated with any significant differences in mortality compared with clopidogrel at either 30days (OR 1.07, 95%CI 0.95 to 1.21, P=0.237) or 1year (OR 1.058, 95%CI 0.96 to 1.16, P=0.247). Finally, ticagrelor was associated with significantly higher mortality than prasugrel at both time points (30days OR 1.22, 95%CI 1.03 to 1.44, P=0.020; 1year OR 1.19 95%CI 1.04 to 1.35, P=0.01). Conclusions In a cohort of over 89000 patients undergoing primary PCI for STEMI in the UK, prasugrel is associated with a lower 30-day and 1-year mortality than clopidogrel and ticagrelor. Given that an adequately powered comparative randomised trial is unlikely to be performed, these data may have implications for routine care. C1 [Olier, Ivan; Kinnaird, Tim; Rashid, Muhammad; Mamas, Mamas A.] Keele Univ, Inst Primary Care & Hlth Sci, Keele Cardiovasc Res Grp, Ctr Prognosis Res, Stoke On Trent, Staffs, England. [Olier, Ivan] Liverpool John Moores Univ, Dept Appl Math, Liverpool, Merseyside, England. [Sirker, Alex] Univ Coll London Hosp, Heart Hosp, Dept Cardiol, London, England. [Hildick-Smith, David J. R.] Brighton & Sussex Univ Hosp NHS Trust, Sussex Cardiac Ctr, Brighton, E Sussex, England. [Kinnaird, Tim] Univ Hosp Wales, Dept Cardiol, Cardiff, S Glam, Wales. [Ludman, Peter] Queen Elizabeth Hosp Birmingham, Dept Cardiol, Birmingham, W Midlands, England. [de Belder, Mark A.] James Cook Univ Hosp, Dept Cardiol, Middlesbrough, Cleveland, England. [Baumbach, Andreas] Queen Mary Univ, Barts Heart Ctr, London, England. [Byrne, Jonathan] Kings Coll Hosp London, London, England. [Rashid, Muhammad; Mamas, Mamas A.] Univ Hosp North Midlands, Royal Stoke Hosp, Acad Dept Cardiol, Stoke On Trent, Staffs, England. [Curzen, Nick] Univ Southampton, Univ Hosp Southampton, Dept Cardiol, Fac Med, Southampton, Hants, England. C3 Keele University; Liverpool John Moores University; RLUK- Research Libraries UK; University of London; University College London; University College London Hospitals NHS Foundation Trust; Brighton and Sussex University Hospitals NHS Trust; University of Brighton; RLUK- Research Libraries UK; Cardiff University; RLUK- Research Libraries UK; University of Birmingham; James Cook University Hospital; RLUK- Research Libraries UK; University of London; Queen Mary University London; King's College Hospital NHS Foundation Trust; King's College Hospital; Royal Stoke University Hospital; RLUK- Research Libraries UK; University of Southampton RP Mamas, MA (通讯作者)，Keele Univ, Keele Cardiovasc Res Grp, Stoke On Trent ST5 5BG, England. EM mamasmamas1@yahoo.co.uk RI Rashid, Muhammad/L-2156-2019; curzen, nick/AAD-8161-2020; Mamas, Mamas Andreas/A-2549-2019 OI Rashid, Muhammad/0000-0001-9725-1583; Mamas, Mamas Andreas/0000-0001-9241-8890; Olier, Ivan/0000-0002-5679-7501; Curzen, Nick/0000-0001-9651-7829 FU Daiichi Sankyo FX Unrestricted educational grant from Daiichi Sankyo to MAM. CR Alexopoulos D, 2012, CIRC-CARDIOVASC INTE, V5, P797, DOI 10.1161/CIRCINTERVENTIONS.112.972323 Angiolillo DJ, 2014, J AM COLL CARDIOL, V63, P1500, DOI 10.1016/j.jacc.2013.11.032 Bertrand ME, 2000, CIRCULATION, V102, P624, DOI 10.1161/01.CIR.102.6.624 Buuren S, 2011, MICE MULTIVARIATE IM, V45 De H, 2011, J STAT SOFTW, V14, P1 Gawaz M, 2009, NAT REV CARDIOL, V6, P391, DOI 10.1038/nrcardio.2009.76 Hochholzer W, 2005, CIRCULATION, V111, P2560, DOI 10.1161/01.CIR.0000160869.75810.98 Husted S, 2016, AM J THER, V23, pE1876, DOI 10.1097/MJT.0000000000000237 Khan N, 2016, THROMB RES, V143, P141, DOI 10.1016/j.thromres.2016.05.019 Kwok CS, 2015, AM HEART J, V170, P164, DOI 10.1016/j.ahj.2015.04.018 Larmore C, 2016, CATHETER CARDIO INTE, V88, P535, DOI 10.1002/ccd.26279 Ludman PF, 2011, HEART, V97, P1293, DOI 10.1136/heartjnl-2011-300299 Mamas MA, 2016, CIRCULATION, V133, P1655, DOI 10.1161/CIRCULATIONAHA.115.018083 Mamas MA, 2014, J AM COLL CARDIOL, V64, P1554, DOI 10.1016/j.jacc.2014.05.075 Mamas MA, 2013, JACC-CARDIOVASC INTE, V6, P698, DOI 10.1016/j.jcin.2013.03.011 Mamas MA, 2012, HEART, V98, P303, DOI 10.1136/heartjnl-2011-300558 Mehta SR, 2012, J AM COLL CARDIOL, V60, P2490, DOI 10.1016/j.jacc.2012.07.050 Montalescot G, 2009, LANCET, V373, P723, DOI 10.1016/S0140-6736(09)60441-4 Motovska Z, 2016, CIRCULATION, V134, P1603, DOI 10.1161/CIRCULATIONAHA.116.024823 Rafique AM, 2016, JACC-CARDIOVASC INTE, V9, P1036, DOI 10.1016/j.jcin.2016.02.013 Rubin DB, 2009, MULTIPLE IMPUTATION Schomig A, 1996, NEW ENGL J MED, V334, P1084, DOI 10.1056/NEJM199604253341702 Schulz S, 2014, J CARDIOVASC TRANSL, V7, P91, DOI 10.1007/s12265-013-9527-3 Sirker A, 2016, EUR HEART J, V37, P1312, DOI 10.1093/eurheartj/ehv631 Steg PG, 2010, CIRCULATION, V122, P2131, DOI 10.1161/CIRCULATIONAHA.109.927582 Udell JA, 2014, JACC-CARDIOVASC INTE, V7, P604, DOI 10.1016/j.jcin.2014.01.160 Velders MA, 2016, HEART, V102, P617, DOI 10.1136/heartjnl-2015-308963 Wallentin L, 2009, NEW ENGL J MED, V361, P1045, DOI 10.1056/NEJMoa0904327 Wendling P, 2016, PRAGUE 18 PRASUGREL Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 NR 30 TC 39 Z9 45 U1 0 U2 2 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 OCT PY 2018 VL 104 IS 20 BP 1683 EP 1690 DI 10.1136/heartjnl-2017-312366 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GW0AZ UT WOS:000446525200010 PM 29437885 OA Green Accepted DA 2023-05-13 ER PT J AU Hall, M Bebb, OJ Dondo, TB Yan, AT Goodman, SG Bueno, H Chew, DP Brieger, D Batin, PD Farkouh, ME Hemingway, H Timmis, A Fox, KAA Gale, CP AF Hall, Marlous Bebb, Owen J. Dondo, Tatandashe B. Yan, Andrew T. Goodman, Shaun G. Bueno, Hector Chew, Derek P. Brieger, David Batin, Philip D. Farkouh, Michel E. Hemingway, Harry Timmis, Adam Fox, Keith A. A. Gale, Chris P. TI Guideline-indicated treatments and diagnostics, GRACE risk score, and survival for non-ST elevation myocardial infarction SO EUROPEAN HEART JOURNAL LA English DT Article DE Non-ST-elevation myocardial infarction; Quality of care; Mortality; GRACE risk score ID ACUTE CORONARY SYNDROMES; SELECTIVE INVASIVE STRATEGY; GLOBAL REGISTRY; UNSTABLE ANGINA; MORTALITY; OUTCOMES; CARE; INTERVENTION; ASSOCIATION; MANAGEMENT AB Aims To investigate whether improved survival from non-ST-elevation myocardial infarction (NSTEMI), according to GRACE risk score, was associated with guideline-indicated treatments and diagnostics, and persisted after hospital discharge. Methods and results National cohort study (n = 389 507 patients, n= 232 hospitals, MINAP registry), 2003-2013. The primary outcome was adjusted all-cause survival estimated using flexible parametric survival modelling with time-varying covariates. Optimal care was defined as the receipt of all eligible treatments and was inversely related to risk status (defined by the GRACE risk score): 25.6% in low, 18.6% in intermediate, and 11.5% in high-risk NSTEMI. At 30 days, the use of optimal care was associated with improved survival among high [adjusted hazard ratio (aHR) -0.66 95% confidence interval (CI) 0.53-0.86, difference in absolute mortality rate (AMR) per 100 patients (AMR/100-0.19 95% CI -0.29 to -0.08)], and intermediate (aHR =0.74, 95% CI 0.62 0.92; AMR/100= -0.15, 95% CI -0.23 to -0.08) risk NSTEMI. At the end of follow-up (8.4 years, median 2.3 years), the significant association between the use of all eligible guidelineindicated treatments and improved survival remained only for high-risk NSTEMI (aHR= 0.66, 95% CI 0.50-0.96; AMR/100= -0.03, 95% CI -0.06 to -0.01). For low-risk NSTEMI, there was no association between the use of optimal care and improved survival at 30 days (aHR= 0.92, 95% CI 0.69 1.38) and at 8.4 years (aHR= 0.71, 95% CI 0.39 3.74). Conclusion Optimal use of guideline-indicated care for NSTEMI was associated with greater survival gains with increasing GRACE risk, but its use decreased with increasing GRACE risk. C1 [Hall, Marlous; Bebb, Owen J.; Dondo, Tatandashe B.; Gale, Chris P.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Worsley Bldg,Level 11, Leeds LS2 9JT, W Yorkshire, England. [Bebb, Owen J.; Gale, Chris P.] York Teaching Hosp NHS Fdn Trust, Cardiol Dept, Wigginton Rd, York YO31 8HE, N Yorkshire, England. [Yan, Andrew T.; Goodman, Shaun G.] Univ Toronto, Dept Med, Terrence Donnelly Heart Ctr, St Michaels Hosp, 30 Bond St, Toronto, ON M5B 1W8, Canada. [Bueno, Hector] CNIC, Calle Melchor Fernandez Almagro,3 S-N, Madrid 28029, Spain. [Bueno, Hector] Hosp Univ 12 Octubre, Inst Invest I 12, Madrid 28041, Spain. [Bueno, Hector] Hosp Univ 12 Octubre, Cardiol Dept, Madrid 28041, Spain. [Bueno, Hector] Univ Complutense Madrid, Fac Med, Plaza Ramon y Cajal S-N, E-28040 Madrid, Spain. [Chew, Derek P.] Flinders Med Ctr, Cardiol Dept, Flinders Dr, Adelaide, SA 5042, Australia. [Chew, Derek P.] Flinders Univ S Australia, Flinders Dr, Adelaide, SA 5042, Australia. [Brieger, David] Concord Repatriat Gen Hosp, Cardiol Dept, Hosp Rd, Sydney, NSW 2139, Australia. [Batin, Philip D.] Mid Yorkshire Hosp NHS Trust, Cardiol Dept, Aberford Rd, Wakefield WF1 4DG, England. [Farkouh, Michel E.] Univ Toronto, Peter Munk Cardiac Ctr, David Naylor Bldg,6 Queens Pk Cres W, Toronto, ON M5S 3H2, Canada. [Farkouh, Michel E.] Univ Toronto, Heart & Stroke Richard Lewar Ctr, David Naylor Bldg,6 Queens Pk Cres W, Toronto, ON M5S 3H2, Canada. [Hemingway, Harry] UCL, Res Dept Clin Epidemiol, Farr Inst Hlth Informat Res, 222 Euston Rd, London NWE1 2DA, England. [Hemingway, Harry] UCL, Univ Coll London Hosp NHS Fdn, Biomed Res Ctr, Natl Inst Hlth Res, 170 Tottenham Court Rd, London W1T 7HA, England. [Timmis, Adam] Queen Mary Univ, Cardiol Dept, Barts Hlth Ctr, London EC1A 7BE, England. [Fox, Keith A. A.] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh EH8 9YL, Midlothian, Scotland. C3 N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; University of Toronto; Saint Michaels Hospital Toronto; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Hospital Universitario 12 de Octubre; Hospital Universitario 12 de Octubre; Complutense University of Madrid; Flinders Medical Centre; Flinders University South Australia; Concord Repatriation General Hospital; University of Toronto; Peter Munk Cardiac Centre; University of Toronto; 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; RLUK- Research Libraries UK; University of London; Queen Mary University London; RLUK- Research Libraries UK; University of Edinburgh RP Bebb, OJ (通讯作者)，Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Worsley Bldg,Level 11, Leeds LS2 9JT, W Yorkshire, England.; Bebb, OJ (通讯作者)，York Teaching Hosp NHS Fdn Trust, Cardiol Dept, Wigginton Rd, York YO31 8HE, N Yorkshire, England. EM o.bebb@nhs.net RI Hall, Marlous/O-9985-2019; Bueno, Hector/I-3910-2015; Fox, keith A A/I-3742-2013; Kwong, Raymond Y/R-1925-2016; Hemingway, Harry/C-1219-2009 OI Hall, Marlous/0000-0003-1246-2627; Bueno, Hector/0000-0003-0277-7596; Kwong, Raymond Y/0000-0001-8212-0759; Dondo, Tatendashe/0000-0002-8337-8425; Hemingway, Harry/0000-0003-2279-0624; Fox, Keith/0000-0002-0140-2752; Gale, Chris/0000-0003-4732-382X; Chew, Derek/0000-0003-3593-296X; Brieger, David/0000-0001-6115-0326 FU British Heart Foundation [PG/13/81/30474] FX M.H. and T.B.D. were supported by grant (PG/13/81/30474) from the British Heart Foundation. CR Alnasser SMA, 2015, AM J MED, V128, P766, DOI 10.1016/j.amjmed.2014.12.007 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] Anderson JL, 2007, J AM COLL CARDIOL, V50, P652, DOI 10.1016/j.jacc.2007.02.028 Bassand JP, 2007, EUR HEART J, V28, P1598, DOI 10.1093/eurheartj/ehm161 Bebb O, 2017, EUR HEART J, V38, P974, DOI 10.1093/eurheartj/ehx008 Bertrand ME, 2002, EUR HEART J, V23, P1809, DOI 10.1053/euhj.2002.3385 Bradley EH, 2006, JAMA-J AM MED ASSOC, V296, P72, DOI 10.1001/jama.296.1.72 Braunwald E, 2000, J AM COLL CARDIOL, V36, P970, DOI 10.1016/S0735-1097(00)00889-5 Cattle BA, 2011, STAT MED, V30, P2736, DOI 10.1002/sim.4314 Chew DP, 2015, AM HEART J, V170, P995, DOI 10.1016/j.ahj.2015.07.032 Dondo TB, 2016, BMJ OPEN, V6, DOI 10.1136/bmjopen-2016-011600 Dondo TB, 2017, EUR HEART J-ACUTE CA, V6, P412, DOI 10.1177/2048872616647705 FOX KA, 2006, BMJ-BRIT MED J, V333, P1091, DOI DOI 10.1136/BMJ.38985.646481.55 Fox KAA, 2005, LANCET, V366, P914, DOI 10.1016/S0140-6736(05)67222-4 Fox KAA, 2002, LANCET, V360, P743, DOI 10.1016/S0140-6736(02)09894-X Fox KAA, 2010, J AM COLL CARDIOL, V55, P2435, DOI 10.1016/j.jacc.2010.03.007 Goldberg RJ, 2004, AM J CARDIOL, V93, P288, DOI 10.1016/j.amjcard.2003.10.006 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 Hall M, 2016, JAMA-J AM MED ASSOC, V316, P1073, DOI 10.1001/jama.2016.10766 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Henderson RA, 2015, J AM COLL CARDIOL, V66, P511, DOI 10.1016/j.jacc.2015.05.051 Herrett E, 2013, BMJ-BRIT MED J, V346, DOI 10.1136/bmj.f2350 Herrett E, 2010, HEART, V96, P1264, DOI 10.1136/hrt.2009.192328 Jobs A, 2017, LANCET, V390, P737, DOI 10.1016/S0140-6736(17)31490-3 Lee CH, 2008, ARCH INTERN MED, V168, P291, DOI 10.1001/archinternmed.2007.78 Mukherjee D, 2004, CIRCULATION, V109, P745, DOI 10.1161/01.CIR.0000112577.69066.CB Nallamothu BK, 2007, HEART, V93, P1552, DOI 10.1136/hrt.2006.112847 Peterson ED, 2006, JAMA-J AM MED ASSOC, V295, P1912, DOI 10.1001/jama.295.16.1912 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Royal College of Physcians, 2010, UNST ANG NSTEMI EARL Royston P, 2011, FLEXIBLE PARAMETRIC RUBIN DB, 1976, BIOMETRIKA, V63, P581, DOI 10.1093/biomet/63.3.581 Schiele F, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.116.003336 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 Sterne Jonathan A C, 2009, BMJ, V338, pb2393, DOI 10.1136/bmj.b2393 Tang EW, 2007, AM HEART J, V153, P29, DOI 10.1016/j.ahj.2006.10.004 Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Yan AT, 2009, ARCH INTERN MED, V169, P372, DOI 10.1001/archinternmed.2008.563 Zaman MJ, 2014, EUR HEART J, V35, P1551, DOI 10.1093/eurheartj/ehu039 NR 41 TC 47 Z9 50 U1 1 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0195-668X EI 1522-9645 J9 EUR HEART J JI Eur. Heart J. PD NOV 7 PY 2018 VL 39 IS 42 BP 3798 EP + DI 10.1093/eurheartj/ehy517 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HA2GV UT WOS:000450054600012 PM 30202849 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Nielsen, CGA Laut, KG Jensen, LO Ravkilde, J Terkelsen, CJ Kristensen, SD AF Nielsen, Christel G. A. Laut, Kristina G. Jensen, Lisette O. Ravkilde, Jan Terkelsen, Christian J. Kristensen, Steen D. TI Patient delay in patients with ST-elevation myocardial infarction: Time patterns and predictors for a prolonged delay SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Patient delay; health care organization; acute coronary syndrome; primary percutaneous coronary intervention ID PERCUTANEOUS CORONARY INTERVENTION; PREHOSPITAL DELAY; SYSTEM DELAY; IMPACT; ASSOCIATION; MANAGEMENT; SYMPTOMS AB Background and aims: To improve treatment success of ST-elevation myocardial infarction, a minimal delay from symptom onset to reperfusion therapy is crucial. The patient's response to initial symptoms (patient delay) substantially affects the delay. We investigated time patterns of patient delay during a seven-year time period, and aimed to identify key predictors that affect the length of the patient delay. Methods: Data on 5848 patients hospitalized with ST-elevation myocardial infarction and treated with primary percutaneous intervention during the period 2003-2009 were obtained from Danish registry databases. The dependent variable was patient delay (<120 and 120 min). Data were analysed for a possible time trend during the seven-year study period using Jonckheere-Terpstra analysis and we also performed multiple logistical regression to identify predictors of a prolonged patient delay. Results: We observed a decrease in median patient delay from 101 min in 2003 to 85 min in 2009, p=0.018. We identified the age group 55-69 years (odds ratio (OR): 1.27 (95% confidence interval (CI): 1.09-1.47)) and age 70 years (OR: 1.63 (95% CI: 1.40-1.90)), diabetes (OR: 1.26 (95% CI: 1.05-1.50)), female gender (OR: 1.17 (95% CI: 1.03-1.34)) and presentation during the night 22:00-05:59 (OR: 1.92 (95% CI: 1.68-2.20)), as independent risk factors of a patient delay 120 min. Symptom onset between 14:00-21:59 was associated with a shorter patient delay (OR: 0.78 (95% CI 0.68-0.89)). Conclusion: A slight decrease in patient delay during the years from 2003-2009 was observed. High age, diabetes, female gender and symptoms presentation during the night were shown to be independent predictors of prolonged patient delay. C1 [Nielsen, Christel G. A.; Laut, Kristina G.; Terkelsen, Christian J.; Kristensen, Steen D.] Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark. [Jensen, Lisette O.] Odense Univ Hosp, Dept Cardiol, Odense, Denmark. [Ravkilde, Jan] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark. C3 Aarhus University; University of Southern Denmark; Odense University Hospital; Aalborg University; Aalborg University Hospital RP Kristensen, SD (通讯作者)，Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark. EM steendk@dadlnet.dk RI terkelsen, christian/ABD-6294-2021 OI terkelsen, christian juhl/0000-0003-0205-9551; Jensen, Lisette Okkels/0000-0002-4838-2429 FU Novo-Nordic Foundation; Novo Nordisk Fonden [NNF14OC0008817] Funding Source: researchfish FX SDK was supported by a senior research fellowship from the Novo-Nordic Foundation. 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Heart J.-Acute Cardiovasc. Care PD OCT PY 2017 VL 6 IS 7 BP 583 EP 591 DI 10.1177/2048872616676570 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FK1KS UT WOS:000413240400003 PM 27821790 DA 2023-05-13 ER PT J AU Borghesi, M Zilio, F Braito, G Dallago, M Muraglia, S Todaro, D Bonmassari, R AF Borghesi, Marco Zilio, Filippo Braito, Giuseppe Dallago, Michele Muraglia, Simone Todaro, Daniel Bonmassari, Roberto TI How to keep the cath-lab of a COVID-free hub center during the pandemic in a hub and spoke cardiology network: a single center's experience SO MINERVA CARDIOLOGY AND ANGIOLOGY LA English DT Article DE SARS-CoV-2; Coronavirus; Infections; Prevention and control; Myocardial infarction; Emergency medicine AB BACKGROUND: Northern Italy has been one of the most affected area in the world by the novel severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The healthcare system has been overwhelmed by the huge number of patients in need of mechanical ventilation or intensive care, resulting in a delay of treatment of patients with acute coronary syndrome (ACS), due to a crash in STEMI networks and closure of a certain number of hub centers, and to a delay in patients' seeking for medical evaluation for chest pain or angina-equivalent symptoms. METHODS: In the Trentino region, a mountainous area with about 500,000 inhabitants, very close to Lombardy that was the epicenter of the pandemic in Italy, to avoid these dramatic consequences, we developed a new protocol tailored to our specificity to keep our institution, and above all the cath-lab, clean from the SARS-CoV-2 infection, to ensure full operativity for cardiologic emergencies. RESULTS: Applying this protocol during the two months of the peak of the infection in Italy no one of the staff members of the cath-lab, the ICCU or the cardiology ward tested positive to nasal swab for SARS-CoV-2 and the same result was obtained for all the patients admitted to our units. CONCLUSIONS: Our real-world experience shows that during the COVID-19 pandemic, quick activation of an appropriate protocol defining specific pathways for patients with a medical urgency is effective in minimizing healthcare personnel exposure and to preserve full operativity of the hub centers. This issue will be of a crucial importance, now that we are facing the second wave of the pandemic. C1 [Borghesi, Marco; Zilio, Filippo; Braito, Giuseppe; Dallago, Michele; Muraglia, Simone; Todaro, Daniel; Bonmassari, Roberto] Santa Chiara Hosp, Div Intervent Cardiol, Dept Cardiol, Trento, Italy. C3 Santa Chiara Hospital RP Borghesi, M (通讯作者)，Santa Chiara Hosp, Dept Cardiol, Intervent Cardiol, Largo Medaglie dOro 9, I-38122 Trento, Italy. EM marco.borghesi@apss.tn.it CR Anstey DE, 2020, AM HEART J, V227, P74, DOI 10.1016/j.ahj.2020.06.018 Baracchini C, 2020, STROKE, V51, pE154, DOI 10.1161/STROKEAHA.120.030161 Baracchini C, 2020, NEUROL SCI, V41, P1003, DOI 10.1007/s10072-020-04375-9 Bonalumi G, 2020, EUR J CARDIO-THORAC, V57, P1025, DOI 10.1093/ejcts/ezaa151 De Filippo O, 2020, NEW ENGL J MED, V383, P88, DOI 10.1056/NEJMc2009166 De Luca G, 2020, CARDIOVASC DIABETOL, V19, DOI 10.1186/s12933-020-01196-0 De Rosa S, 2020, EUR HEART J, V41, P2083, DOI 10.1093/eurheartj/ehaa409 ESC guidance, 2020, ESC GUIDANCE DIAGNOS 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 Guo T, 2020, JAMA CARDIOL, V5, P811, DOI 10.1001/jamacardio.2020.1017 Katz JN, 2020, J AM COLL CARDIOL, V76, P72, DOI 10.1016/j.jacc.2020.04.029 Mazzone P, 2020, J INTERV CARD ELECTR, V59, P321, DOI 10.1007/s10840-020-00761-7 Onder G, 2020, JAMA-J AM MED ASSOC, V323, P1775, DOI 10.1001/jama.2020.4683 Piccolo R, 2020, CIRCULATION, V141, P2035, DOI 10.1161/CIRCULATIONAHA.120.047457 Roffi M, 2020, CIRCULATION, DOI 10.1161/CIRCULATIONAHA.120.047523 Shi SB, 2020, JAMA CARDIOL, V5, P802, DOI 10.1001/jamacardio.2020.0950 Tam CCF, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006631 Tarantini G, 2020, CIRC-CARDIOVASC INTE, V13, DOI 10.1161/CIRCINTERVENTIONS.120.009279 Tarantini G, 2020, CATHETER CARDIO INTE, V96, P839, DOI 10.1002/ccd.28888 Wood S, 2020, MYSTERY MISSING STEM NR 21 TC 2 Z9 2 U1 0 U2 0 PU EDIZIONI MINERVA MEDICA PI TURIN PA CORSO BRAMANTE 83-85 INT JOURNALS DEPT., 10126 TURIN, ITALY SN 2724-5683 EI 2724-5772 J9 MINERVA CARDIOL ANGI JI Minerva Cardiol. Angiol. PD AUG PY 2022 VL 70 IS 4 BP 468 EP 475 DI 10.23736/S2724-5683.20.05477-8 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA D4BC9 UT WOS:000968189300009 PM 33703854 DA 2023-05-13 ER PT J AU Alexopoulos, D Xanthopoulou, I Plakomyti, TE Theodoropoulos, KC Mavronasiou, E Damelou, A Hahalis, G Davlouros, P AF Alexopoulos, Dimitrios Xanthopoulou, Ioanna Plakomyti, Theodora-Eleni Theodoropoulos, Konstantinos C. Mavronasiou, Eleni Damelou, Anastasia Hahalis, George Davlouros, Periklis TI Pharmacodynamic effect of prasugrel 5 mg vs clopidogrel 150 mg in elderly patients with high on-clopidogrel platelet reactivity SO AMERICAN HEART JOURNAL LA English DT Article ID PERCUTANEOUS CORONARY INTERVENTION; HEART-ASSOCIATION COUNCIL; HEALTH-CARE PROFESSIONALS; SCIENTIFIC STATEMENT; CLINICAL CARDIOLOGY; ACTIVE METABOLITE; OUTCOMES; THERAPY; IMPACT; CYP2C19-ASTERISK-2 AB Background Elderly patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) frequently exhibit high platelet reactivity (HPR) while on clopidogrel. In the elderly cohort, either prasugrel is not recommended or, if used, halving of the dose has been suggested. We aimed to test the hypothesis that in elderly patients exhibiting HPR after standard treatment with clopidogrel, prasugrel-reduced dose (5 mg) could be more effective than high-dose (150 mg) clopidogrel. Methods Consecutive elderly (>= 75 years old) patients with ACS undergoing PCI and loaded with clopidogrel were considered for platelet reactivity (PR) assessment at 24 hours after PCI with the VerifyNow assay (Accumetrics Inc, San Diego, CA), measured in P2Y12 reaction units (PRU). Of 63 screened patients, 30 (47.6%) were found with HPR (defined as PRU >= 230) and 27 of them participated in a prospective, randomized, single-center, single-blind, investigator-initiated, crossover study of platelet inhibition by prasugrel 5 mg/d vs clopidogrel 150 mg/d, with a 15-day treatment period. Results The primary end point of PR at the end of the 2 study periods was lower in patients receiving low-dose prasugrel than those receiving high-dose clopidogrel (least squares estimates 190.8 [95% CI 161.5-220.1] and 240.8 [95% CI 211.0-270.6], respectively; P = .008). The secondary end point of HPR rate at the end of treatment periods was lower for prasugrel (8/24; 33.3%) compared with clopidogrel (16/24; 66.7%), P = .02. Conclusions In elderly patients with ACS undergoing PCI and exhibiting HPR after standard clopidogrel treatment, prasugrel 5 mg/d is significantly more efficacious than clopidogrel 150 mg/d in reducing PR and HPR rate. (Am Heart J 2013;165:73-9.) C1 [Alexopoulos, Dimitrios; Xanthopoulou, Ioanna; Plakomyti, Theodora-Eleni; Theodoropoulos, Konstantinos C.; Mavronasiou, Eleni; Damelou, Anastasia; Hahalis, George; Davlouros, Periklis] Patras Univ Hosp, Dept Cardiol, Patras 26500, Greece. C3 University of Patras RP Alexopoulos, D (通讯作者)，Patras Univ Hosp, Dept Cardiol, Patras 26500, Greece. EM dalex@med.upatras.gr OI DAVLOUROS, PERIKLIS/0000-0002-1439-1992 FU Pharmaserve/EliLilly Co; AstraZeneca FX Dr Alexopoulos reports receipt of speaker fees from Pharmaserve/EliLilly & Co and AstraZeneca. 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 Alexopoulos D, 2011, AM HEART J, V162, P733, DOI 10.1016/j.ahj.2011.07.026 Alexopoulos D, 2011, JACC-CARDIOVASC INTE, V4, P403, DOI 10.1016/j.jcin.2010.12.011 Alexopoulos D, 2012, PLATELETS, V23, P83, DOI 10.3109/09537104.2011.600478 Angiolillo DJ, 2010, J AM COLL CARDIOL, V56, P1017, DOI 10.1016/j.jacc.2010.02.072 [Anonymous], COMP PRAS CLOP VER E Avezum A, 2005, AM HEART J, V149, P67, DOI 10.1016/j.ahj.2004.06.003 Brar SS, 2011, J AM COLL CARDIOL, V58, P1945, DOI 10.1016/j.jacc.2011.06.059 Breet NJ, 2011, NETH HEART J, V19, P279, DOI 10.1007/s12471-011-0105-5 Campo G, 2011, J AM COLL CARDIOL, V57, P2474, DOI 10.1016/j.jacc.2010.12.047 Capodanno D, 2010, J AM COLL CARDIOL, V56, P1683, DOI 10.1016/j.jacc.2010.04.063 Capranzano P, 2011, THROMB HAEMOSTASIS, V106, P1149, DOI 10.1160/TH11-05-0346 Chin CT, 2010, AM HEART J, V160, P16, DOI 10.1016/j.ahj.2010.04.022 Cuisset T, 2011, AM J CARDIOL, V108, P1411, DOI 10.1016/j.amjcard.2011.06.060 European Medicines Agency, EMEA1175612009 Gremmel T, 2010, J THROMB HAEMOST, V8, P37, DOI 10.1111/j.1538-7836.2009.03644.x Gurbel PA, 2012, EUR HEART J, V33, P1187, DOI 10.1093/eurheartj/ehr458 Htun P, 2011, J AM SOC NEPHROL, V22, P627, DOI 10.1681/ASN.2010020220 Kassimis G, 2012, THROMB RES, V129, P441, DOI 10.1016/j.thromres.2011.07.022 Mega JL, 2011, JAMA-J AM MED ASSOC, V306, P2221, DOI 10.1001/jama.2011.1703 Parodi G, 2012, AM J CARDIOL, V109, P214, DOI 10.1016/j.amjcard.2011.08.034 Price MJ, 2011, CIRCULATION, V124, P1132, DOI 10.1161/CIRCULATIONAHA.111.029165 Riesmeyer JS, 2012, J CLIN PHARMACOL, V52, P789, DOI 10.1177/0091270011406280 Silvain J, 2012, EUR HEART J, V33, P1241, DOI 10.1093/eurheartj/ehr407 United States Food and Drug Administration, 2009, FDA APPR DRUG PROD 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 Wiviott SD, 2010, CIRCULATION, V122, P394, DOI 10.1161/CIRCULATIONAHA.109.921502 Wrishko RE, 2009, J CLIN PHARMACOL, V49, P984, DOI 10.1177/0091270009337942 NR 30 TC 11 Z9 12 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 1097-5330 J9 AM HEART J JI Am. Heart J. PD JAN PY 2013 VL 165 IS 1 BP 73 EP 79 DI 10.1016/j.ahj.2012.10.008 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 053LL UT WOS:000312272900014 PM 23237136 DA 2023-05-13 ER PT J AU Tavares, V Carron, PN Yersin, B Taffe, P Burnand, B Pittet, V AF Tavares, Vania Carron, Pierre-Nicolas Yersin, Bertrand Taffe, Patrick Burnand, Bernard Pittet, Valerie TI The probability of having advanced medical interventions is associated with age in out-of-hospital life-threatening situations SO SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE LA English DT Article DE Ageing; Out-of-hospital emergency medical services; Cardiopulmonary resuscitation; Critical care medicine; Decision-making ID INTERNATIONAL LIAISON COMMITTEE; CARDIOVASCULAR CARE COMMITTEE; AMERICAN-HEART-ASSOCIATION; ACUTE CORONARY SYNDROMES; CARDIAC-ARREST; EMERGENCY-DEPARTMENT; OLDER-ADULTS; RESUSCITATION; CARDIOPULMONARY; SURVIVAL AB Background: The use of out-of-hospital emergency medical services by old and very old individuals is increasing. These patients frequently require complex evaluation and decision-making processes to determine a strategy of care, therapeutic choices or withdrawal of care in life-threatening situations. During out-of-hospital missions, thorough decision-making is difficult because of the limited amount of time and lack of direct access to medical charts or to pre-existing advance directives. In this setting, age may be used as a proxy to determine strategy of care, therapeutic choices or withdrawal of care, particularly in relation to advanced medical interventions. We aimed to determine how an emergency physician's initiation of out-of-hospital advanced medical interventions varies with the patient's age. Methods: We performed a retrospective analysis of the missions conducted by the emergency physicians-staffed emergency medical services in a Swiss region. We used logistic regression analysis to determine whether the probability of receiving an advanced medical intervention was associated with the patient's age. Results: Among 21,922 out-of-hospital emergency adult missions requiring an emergency physician, the probability of receiving an advanced medical intervention decreased with age. It was highest among those aged 18-58 years and significantly lower among those aged >= 89 years (OR = 0.66; 95 % CI: 0.53 - 0.82). The probability of cardiopulmonary resuscitation attempts progressively decreased with age and was significantly lower for the three oldest age deciles (80 - 83, 84 - 88 and >= 89 years). Conclusion: The number of out-of-hospital advanced medical interventions significantly decreased for patients aged >= 89 years. It is unknown whether this lower rate of interventions was related only to age or to other medical characteristics of these patients, such as the number or severity of comorbidities. Thus, further studies are needed to confirm whether this observation corresponds to underuse of advanced medical interventions in very old patients. C1 [Carron, Pierre-Nicolas; Yersin, Bertrand] Univ Lausanne Hosp, Emergency Dept, CH-1011 Lausanne, Switzerland. [Tavares, Vania; Taffe, Patrick; Burnand, Bernard; Pittet, Valerie] Univ Lausanne Hosp, Inst Social & Prevent Med, Lausanne, Switzerland. C3 University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV) RP Carron, PN (通讯作者)，Univ Lausanne Hosp, Emergency Dept, CH-1011 Lausanne, Switzerland. EM pierre-nicolas.carron@chuv.ch RI Taffé, Patrick/AAW-2701-2020 OI Taffe, Patrick/0000-0002-2049-6651; Pittet, Valerie/0000-0003-2208-966X FU Institute of Social and Preventive Medicine; Emergency Service, Lausanne University Hospital, Lausanne, Switzerland FX This study was supported by the Institute of Social and Preventive Medicine and by the Emergency Service, Lausanne University Hospital, Lausanne, Switzerland. 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J. Trauma Resusc. Emerg. Med. PD AUG 24 PY 2016 VL 24 AR 103 DI 10.1186/s13049-016-0294-4 PG 9 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA DV0JS UT WOS:000382604400001 PM 27554262 OA Green Published, gold DA 2023-05-13 ER PT J AU O'Connor, RE Nichol, G Gonzales, L Manoukian, SV Moyer, PH Rokos, I Sayre, MR Solomon, RC Wingrove, GL Brady, WJ McBride, S Lorden, AL Roettig, ML Acuna, A Jacobs, AK AF O'Connor, Robert E. Nichol, Graham Gonzales, Louis Manoukian, Steven V. Moyer, Peter H. Rokos, Ivan Sayre, Michael R. Solomon, Robert C. Wingrove, Gary L. Brady, William J. McBride, Susan Lorden, Andrea L. Roettig, Mayme Lou Acuna, Anna Jacobs, Alice K. TI Emergency medical services management of ST-segment elevation myocardial infarction in the United States-a report from the American Heart Association Mission: Lifeline Program SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ACUTE CORONARY SYNDROMES; 2010 INTERNATIONAL CONSENSUS; CARDIOVASCULAR CARE SCIENCE; CARDIOPULMONARY-RESUSCITATION; TASK-FORCE; SYSTEMS; INTEGRATION; QUALITY; STROKE; IMPACT AB Objective: ST-segment elevation myocardial infarction (STEMI) is a major cause of morbidity and mortality in the United States. Emergency medical services (EMS) agencies play a critical role in its initial identification and treatment. We conducted this study to assess EMS management of STEMI care in the United States. Methods: A structured questionnaire was administered to leaders of EMS agencies to define the elements of STEMI care related to 4 core measures: (1) electrocardiogram (ECG) capability at the scene, (2) destination protocols, (3) catheterization laboratory activation before hospital arrival, and (4) 12-lead ECG quality review. Geographic areas were grouped into large metropolitan, small metropolitan, micropolitan, and noncore (or rural) by using Urban Influence Codes, with a stratified analysis. Results: Data were included based on responses from 5296 EMS agencies (36% of those in the United States) serving 91% of the US population, with at least 1 valid response from each of the 50 states and the District of Columbia. Approximately 63% of agencies obtained ECGs at the scene using providers trained in ECG acquisition and interpretation. A total of 46% of EMS systems used protocols to determine hospital destination, cardiac catheterization laboratory activation, and communications with the receiving hospital. More than 75% of EMS systems used their own agency funds to purchase equipment, train personnel, and provide administrative oversight. A total of 49% of agencies have quality review programs in place. In general, EMS systems covering higher population densities had easier access to resources needed to maintain STEMI systems of care. Emergency medical services systems that have adopted all 4 core elements cover 14% of the US population. Conclusions: There are large differences in EMS systems of STEMI care in the United States. Most EMS agencies have implemented at least 1 of the 4 core elements of STEMI care, with many having implemented multiple elements. (C) 2014 Elsevier Inc. All rights reserved. C1 [O'Connor, Robert E.; Brady, William J.] Univ Virginia, Sch Med, Dept Emergency Med, Charlottesville, VA 22908 USA. [Nichol, Graham] Univ Washington, Harborview Ctr Prehosp Emergency Care, Seattle, WA 98195 USA. [Gonzales, Louis] City Austin Travis Cty EMS Syst, Austin, TX USA. [Manoukian, Steven V.] Hosp Corp Amer, Clin & Phys Serv Grp, Nashville, TN USA. [Moyer, Peter H.] Boston Emergency Med Serv, Boston, MA USA. [Rokos, Ivan] Univ Calif Los Angeles, Geffen Sch Med, Dept Emergency Med, Los Angeles, CA USA. [Sayre, Michael R.] Univ Washington, Dept Med, Div Emergency Med, Seattle, WA USA. [Solomon, Robert C.] West Penn Allegheny Hlth Syst, Pittsburgh, PA USA. [Wingrove, Gary L.] Mayo Clin Med Transport, Gold Cross, Rochester, MN USA. [McBride, Susan] Texas Tech Univ, Hlth Sci Ctr, Sch Nursing, Lubbock, TX 79430 USA. [Lorden, Andrea L.] Texas A&M Hlth Sci Ctr, Dept Hlth Policy & Management, College Stn, TX USA. [Roettig, Mayme Lou] Duke Univ, Duke Clin Res Inst, Durham, NC USA. [Acuna, Anna] Amer Heart Assoc, Dallas, TX USA. [Jacobs, Alice K.] Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA. C3 University of Virginia; Harborview Medical Center; University of Washington; University of Washington Seattle; Hospital Corporation of America; University of California System; University of California Los Angeles; University of California Los Angeles Medical Center; David Geffen School of Medicine at UCLA; University of Washington; University of Washington Seattle; Texas Tech University System; Texas Tech University; Texas Tech University Health Science Center; Texas A&M University System; Texas A&M University College Station; Texas A&M Health Science Center; Duke University; Boston University RP O'Connor, RE (通讯作者)，Univ Virginia Hlth Syst, Dept Emergency Med, POB 800699, Charlottesville, VA 22908 USA. EM REO4X@hscmail.mcc.virginia.edu RI Wingrove, Gary/E-2426-2018; Sayre, Michael R/E-8383-2017; Nichol, Graham/Z-4996-2019 OI Wingrove, Gary/0000-0002-5241-3507; Sayre, Michael R/0000-0003-0322-3181; Gonzales, Louis/0000-0001-9300-1069 CR [Anonymous], 1994, Ann Emerg Med, V23, P311 Bossaert L, 2010, RESUSCITATION, V81, pE175, DOI 10.1016/j.resuscitation.2010.09.001 Camp-Rogers T, 2011, AM J EMERG MED, V29, P1117, DOI 10.1016/j.ajem.2010.08.005 Chevarley FM, 2006, AMBUL PEDIATR, V6, P241, DOI 10.1016/j.ambp.2006.06.004 Davis DP, 2007, PREHOSP EMERG CARE, V11, P399, DOI 10.1080/10903120701536784 Frendl DM, 2009, J ELECTROCARDIOL, V42, P426, DOI 10.1016/j.jelectrocard.2009.03.011 Go AS, 2013, CIRCULATION, V127, pE6, DOI 10.1161/CIR.0b013e31828124ad Hutter AM, 2000, J AM COLL CARDIOL, V35, P846 Jacobs AK, 2007, CIRCULATION, V116, P217, DOI 10.1161/CIRCULATIONAHA.107.184043 Jann B, 2005, STATA J, V5, P92, DOI 10.1177/1536867X0500500113 Le May MR, 2008, NEW ENGL J MED, V358, P231, DOI 10.1056/NEJMoa073102 Moyer P, 2007, CIRCULATION, V116, pE43, DOI 10.1161/CIRCULATIONAHA.107.184047 Nallamothu BK, 2007, CIRCULATION, V116, pE68, DOI 10.1161/CIRCULATIONAHA.107.184052 O'Connor RE, 2010, CIRCULATION, V122, pS787, DOI 10.1161/CIRCULATIONAHA.110.971028 O'Connor RE, 2010, CIRCULATION, V122, P8422, DOI 10.1161/CIRCULATIONAHA.110.985549 O'Gara PT, 2013, CIRCULATION, V127, pE362, DOI 10.1161/CIR.0b013e3182742cf6 Patel M, 2012, J AM COLL CARDIOL, V60, P806, DOI 10.1016/j.jacc.2012.03.071 Rokos IC, 2006, AM HEART J, V152, P661, DOI 10.1016/j.ahj.2006.06.001 Rokos IC, 2009, JACC-CARDIOVASC INTE, V2, P339, DOI 10.1016/j.jcin.2008.11.013 Scholz KH, 2008, AM J CARDIOL, V101, P46, DOI 10.1016/j.amjcard.2007.07.078 Schwamm L, 2010, STROKE, V41, P1051, DOI 10.1161/STR.0b013e3181d2da7d Ting HH, 2008, CIRCULATION, V118, P1066, DOI 10.1161/CIRCULATIONAHA.108.190402 USDA, MEAS RUR RUR URB CON Williams David M, 2007, JEMS, V32, P38, DOI 10.1016/S0197-2510(07)70050-5 NR 24 TC 12 Z9 13 U1 0 U2 2 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 2014 VL 32 IS 8 BP 856 EP 863 DI 10.1016/j.ajem.2014.04.029 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AR1AK UT WOS:000343311000006 PM 24865499 DA 2023-05-13 ER PT J AU Vallone, MG Vazquez, C Chuliber, FA Privitera, V Ferraris, A Cantarella, RF Indo, MF Thomas, DMS Peuchot, VA Vazquez, FJ AF Vallone, Marcelo G. Vazquez, Carolina Chuliber, Fernando A. Privitera, Veronica Ferraris, Augusto Cantarella, Ramiro F. Indo, Maria F. Thomas, Diego M. Sanchez Peuchot, Veronica A. Vazquez, Fernando J. TI Low Incidence of Symptomatic Thrombotic Events in Adult Patients Hospitalized with Coronavirus 19: A Retrospective Cohort Study SO CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS LA English DT Article DE Covid 19; thrombosis; pulmonary embolism; deep venous thrombosis AB Background Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic, there have been many reports of increased incidence of venous thromboembolism and arterial events as a complication. Objective To determine the incidence of symptomatic thrombotic events (TEs) in patients hospitalized for SARS-CoV2 disease (coronavirus 19 [Covid-19]). Methods A retrospective single-center cohort study with adult patients with a positive reverse transcriptase-polymerase chain reaction (rt-PCR) for SARS-CoV2, included from the date of diagnosis of Covid-19 and followed for 90 days or until death. Results A total of 1621 patients were included in this study. The median age was 73 years (interquartile range(25th-75th) [IQR] 53-87 years) and 57% (913) were female. Overall mortality was 21.6% (348). The overall incidence of symptomatic TEs within 90 days of diagnosis was 1.8% (30 of 1621) occurring in 28 patients, including an incidence of pulmonary embolism of 0.9% (15, 95% confidence interval [CI] 0.60%-1.6%), deep venous thrombosis of 0.61% (10, 95% CI 0.2%-1%), ischemic stroke of 0.25% (4, 95% CI 0.09%-0.65%), and ischemic arterial events of 0.06% (1, 95% CI 0.008%-0.43%). No acute coronary syndrome events were recorded. The incidence of symptomatic TEs was significantly lower in the general ward than in intensive care units (1.2% vs 5.7%; p < .001). The median time since positive rt-PCR for SARS-CoV2 to symptomatic TE was 22.5 days (IQR 19-43 days). There was no significant difference in the proportion of patients receiving (53.6%) and not receiving thromboprophylaxis (66.5%) and the development of TEs. Conclusion The overall incidence of symptomatic TEs among these patients was lower than the incidence previously reported. C1 [Vallone, Marcelo G.; Vazquez, Carolina; Chuliber, Fernando A.; Privitera, Veronica; Ferraris, Augusto; Cantarella, Ramiro F.; Indo, Maria F.; Thomas, Diego M. Sanchez; Peuchot, Veronica A.; Vazquez, Fernando J.] Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina. [Ferraris, Augusto] Univ Buenos Aires, Buenos Aires, DF, Argentina. C3 Hospital Italiano de Buenos Aires; University of Buenos Aires; University of Buenos Aires RP Vallone, MG (通讯作者)，Hosp Italiano Buenos Aires, Clin Med, JD Peron 4190,ZIP C1181ACH, Buenos Aires, DF, Argentina. EM marcelo.vallone@hospitalitaliano.org.ar RI Vallone, Marcelo/AAJ-2826-2021 OI VALLONE, MARCELO GABRIEL/0000-0003-1331-8264; Vazquez, Fernando/0000-0003-1480-5101 CR Anjum O, 2019, EMERG RADIOL, V26, P29, DOI 10.1007/s10140-018-1641-8 Arabi YM, 2019, NEW ENGL J MED, V380, P1305, DOI 10.1056/NEJMoa1816150 ATTACC, ACTIV 4A REMAP CAP M Barbar S, 2010, J THROMB HAEMOST, V8, P2450, DOI 10.1111/j.1538-7836.2010.04044.x Bilaloglu S, 2020, JAMA-J AM MED ASSOC, V324, P799, DOI 10.1001/jama.2020.13372 Bunce PE, 2011, CLIN INFECT DIS, V52, pE14, DOI 10.1093/cid/ciq125 Chen YA, 2015, EMERG RADIOL, V22, P221, DOI 10.1007/s10140-014-1265-6 Cui SP, 2020, J THROMB HAEMOST, V18, P1421, DOI 10.1111/jth.14830 Grande Ratti Maria Florencia, 2018, Rev Fac Cien Med Univ Nac Cordoba, V75, P82, DOI 10.31053/1853.0605.v75.n2.17243 Vazquez FJ, 2014, BMC PULM MED, V14, DOI 10.1186/1471-2466-14-200 Klok FA, 2020, THROMB RES, V191, P145, DOI [10.1016/j.thromres.2020.04.013, 10.1016/j.thromres.2020.04.041] Liu YF, 2020, AGING-US, V12, P15946, DOI 10.18632/aging.103745 Lodigiani C, 2020, THROMB RES, V191, P9, DOI 10.1016/j.thromres.2020.04.024 Malas MB, 2020, ECLINICALMEDICINE, V29-30, DOI 10.1016/j.eclinm.2020.100639 Menter T, 2020, HISTOPATHOLOGY, V77, P198, DOI 10.1111/his.14134 Middeldorp S, 2020, J THROMB HAEMOST, V18, P1995, DOI 10.1111/jth.14888 Roser M, 2020, WHY DID RENEWABLES B Sadeghipour P, 2021, JAMA-J AM MED ASSOC, V325, P1620, DOI 10.1001/jama.2021.4152 Schulman S, 2005, J THROMB HAEMOST, V3, P692, DOI 10.1111/j.1538-7836.2005.01204.x Spyropoulos AC, 2020, J THROMB HAEMOST, V18, P1859, DOI 10.1111/jth.14929 Taccone FS, 2020, CRIT CARE MED, V48, pE1087, DOI 10.1097/CCM.0000000000004548 Yang X., 2020, LANCET RESP MED, V8, P475, DOI DOI 10.1016/S2213-2600(20)30079-5 Zhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 Zuo Y, 2020, SCI TRANSL MED, V12, DOI 10.1126/scitranslmed.abd3876 NR 24 TC 0 Z9 0 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1076-0296 EI 1938-2723 J9 CLIN APPL THROMB-HEM JI Clin. Appl. Thromb.-Hemost. PD OCT PY 2021 VL 27 AR 10760296211051712 DI 10.1177/10760296211051712 PG 8 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA WP6JD UT WOS:000713234600001 PM 34714177 OA Green Published, gold DA 2023-05-13 ER PT J AU Gaffey, AE Gathright, EC Fletcher, LM Goldstein, CM AF Gaffey, Allison E. Gathright, Emily C. Fletcher, Lauren M. Goldstein, Carly M. TI Screening for Psychological Distress and Risk of Cardiovascular Disease and Related Mortality A SYSTEMATIZED REVIEW, META-ANALYSIS, AND CASE FOR PREVENTION SO JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION LA English DT Review DE cardiovascular diseases; prevention; program management; psychological health; risk factors ID CORONARY-HEART-DISEASE; MYOCARDIAL-INFARCTION; DEPRESSIVE SYMPTOMS; PERCEIVED STRESS; SEX-DIFFERENCES; ASSOCIATION; AMERICAN; ANXIETY; LIFE; CARE AB Background: Psychological distress-elevated symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), or psychosocial stress-has been associated with risk for cardiovascular disease (CVD). Despite increasing attention to the importance of these factors for CVD prevention, the state of this science requires updated synthesis to enable practice recommendations. Moreover, it is unknown whether psychological distress based on screeners, validated self-report instruments that efficiently identify those who may require mental health services or additional support, is associated with incident CVD. Methods: MEDLINE, Embase, and PsycInfo were searched for studies published 2017-2022, including adults without a past psychiatric diagnosis, who were screened at baseline for depression, anxiety, PTSD, stress, or general mental health symptoms, and followed for >6 mo to determine their risk for incident CVD (ie, atrial fibrillation, acute coronary syndrome, coronary heart disease, peripheral vascular disease, heart failure, or a composite). A meta-analysis was used to aggregate results to determine whether clinically significant levels of psychological distress were associated with CVD onset. Results: The search identified 28 investigations that represented 658 331 participants (58% women). Fifteen studies had adequate data for the primary meta-analysis, which indicated that those reporting high psychological distress showed a 28% greater risk of incident CVD compared with those with low or no distress. Conclusions: Rapid screening for psychological distress is a helpful and efficient approach to understanding the CVD risk profile of an individual. Additional investigations are needed to improve prospective evidence concerning psychosocial stress. Conducting analyses by sex may better elucidate the benefits of psychological distress screening for men and women, respectively, and encourage more widespread adoption in CVD prevention. C1 [Gaffey, Allison E.] Yale Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. [Gaffey, Allison E.] VA Connecticut Healthcare Syst, West Haven, CT USA. [Gathright, Emily C.; Goldstein, Carly M.] Miriam Hosp, Ctr Behav & Prevent Med, Providence, RI 02906 USA. [Gathright, Emily C.; Goldstein, Carly M.] Brown Univ, Dept Psychiat & Human Behav, Warren Alpert Sch Med, Providence, RI 02912 USA. [Fletcher, Lauren M.] Brown Univ, Brown Univ Lib, Providence, RI 02912 USA. [Goldstein, Carly M.] Brown Univ, Dept Psychiat & Human Behav, Weight Control & Diabet Res Ctr, Warren Alpert Sch Med, Providence, RI 02912 USA. C3 Yale University; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Connecticut Healthcare System; Lifespan Health Rhode Island; Miriam Hospital; Brown University; Brown University; Brown University RP Gaffey, AE (通讯作者)，Yale Sch Med, 333 Cedar St, New Haven, CT 06510 USA. EM allison.gaffey@yale.edu OI Fletcher, Lauren/0000-0002-6026-5823 FU Department of Veterans Affairs VISN1 Career Development Award [K23 AG061214, K23 HL136845] FX A.E.G. was supported by a Department of Veterans Affairs VISN1 Career Development Award. E.C.G. was supported by K23 AG061214. C.M.G. was supported by K23 HL136845. 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Cardiopulm. Rehabil. Prev. PD NOV PY 2022 VL 42 IS 6 BP 404 EP 415 DI 10.1097/HCR.0000000000000751 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 5Y7ST UT WOS:000879483500013 PM 36342683 OA Bronze DA 2023-05-13 ER PT J AU Delvaux, N Piessens, V De Burghgraeve, T Mamouris, P Vaes, B Vander Stichele, R Cloetens, H Thomas, J Ramaekers, D De Sutter, A Aertgeerts, B AF Delvaux, Nicolas Piessens, Veerle Burghgraeve, Tine De Mamouris, Pavlos Vaes, Bert Stichele, Robert Vander Cloetens, Hanne Thomas, Josse Ramaekers, Dirk Sutter, An De Aertgeerts, Bert TI Clinical decision support improves the appropriateness of laboratory test ordering in primary care without increasing diagnostic error: the ELMO cluster randomized trial SO IMPLEMENTATION SCIENCE LA English DT Article ID SYSTEMS AB Background: Inappropriate laboratory test ordering poses an important burden for healthcare. Clinical decision support systems (CDSS) have been cited as promising tools to improve laboratory test ordering behavior. The objectives of this study were to evaluate the effects of an intervention that integrated a clinical decision support service into a computerized physician order entry (CPOE) on the appropriateness and volume of laboratory test ordering, and on diagnostic error in primary care. Methods: This study was a pragmatic, cluster randomized, open-label, controlled clinical trial. Setting: Two hundred eighty general practitioners (GPs) from 72 primary care practices in Belgium. Patients: Patients aged >= 18 years with a laboratory test order for at least one of 17 indications: cardiovascular disease management, hypertension, check-up, chronic kidney disease (CKD), thyroid disease, type 2 diabetes mellitus, fatigue, anemia, liver disease, gout, suspicion of acute coronary syndrome (ACS), suspicion of lung embolism, rheumatoid arthritis, sexually transmitted infections (STI), acute diarrhea, chronic diarrhea, and follow-up of medication. Interventions: The CDSS was integrated into a computerized physician order entry (CPOE) in the form of evidence-based order sets that suggested appropriate tests based on the indication provided by the general physician. Measurements: The primary outcome of the ELMO study was the proportion of appropriate tests over the total number of ordered tests and inappropriately not-requested tests. Secondary outcomes of the ELMO study included diagnostic error, test volume, and cascade activities. Results: CDSS increased the proportion of appropriate tests by 0.21 (95% CI 0.16-0.26, p < 0.0001) for all tests included in the study. GPs in the CDSS arm ordered 7 (7.15 (95% CI 3.37-10.93, p = 0.0002)) tests fewer per panel. CDSS did not increase diagnostic error. The absolute difference in proportions was a decrease of 0.66% (95% CI 1.4% decrease-0.05% increase) in possible diagnostic error. Conclusions: A CDSS in the form of order sets, integrated within the CPOE improved appropriateness and decreased volume of laboratory test ordering without increasing diagnostic error. C1 [Delvaux, Nicolas; Burghgraeve, Tine De; Mamouris, Pavlos; Vaes, Bert; Ramaekers, Dirk; Aertgeerts, Bert] Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Kapucijnenvoer 33 Blok J PB 7001, B-3000 Leuven, Belgium. [Piessens, Veerle; Sutter, An De] Univ Ghent, Dept Publ Hlth & Primary Care, C Heymanslaan 10, B-9000 Ghent, Belgium. [Stichele, Robert Vander] Univ Ghent, Dept Basic & Appl Med Sci, C Heymanslaan 10, B-9000 Ghent, Belgium. [Cloetens, Hanne] Univ Antwerp, Gouverneur Kinsbergen Ctr, Ctr Gen Practice, Doornstr 331, B-2610 Antwerp, Belgium. [Thomas, Josse] PharmaCS, Merchtem, Belgium. C3 KU Leuven; Ghent University; Ghent University Hospital; Ghent University; Ghent University Hospital; University of Antwerp RP Delvaux, N (通讯作者)，Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Kapucijnenvoer 33 Blok J PB 7001, B-3000 Leuven, Belgium. EM nicolas.delvaux@kuleuven.be RI Bert, Vaes/I-6850-2019; Piessens, Veerle/HCI-3563-2022 OI Bert, Vaes/0000-0001-5244-1930; Mamouris, Pavlos/0000-0001-7902-5355; Aertgeerts, Bert/0000-0003-1142-5402 FU Belgian Health Care Knowledge Centre (KCE) Trials Programme [KCE16011] FX The ELMO Study was funded through the Belgian Health Care Knowledge Centre (KCE) Trials Programme agreement KCE16011. KCE provided feedback on the design and conduct of the study but was not involved in the collection, management, analysis, or interpretation of the data. KCE provided comments on the drafted clinical study report and the manuscript for publication, but no publication restrictions apply. 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Sci. PD NOV 4 PY 2020 VL 15 IS 1 AR 100 DI 10.1186/s13012-020-01059-y PG 10 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 OS3WV UT WOS:000590096300003 PM 33148311 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Sagel, D Vlaar, PJ van Roosmalen, R Waardenburg, I Nieuwland, W Lettinga, R van Barneveld, R Jorna, E Kijlstra, R van Well, C Oomen, A Bartels, L Anthonio, R Hagens, V Hofma, S Gu, YL Drenth, D Addink, R van Asselt, T van der Meer, P Lipsic, E Orozco, LJ van der Harst, P AF Sagel, Dennis Vlaar, Pieter Jan van Roosmalen, Radboud Waardenburg, Ingmar Nieuwland, Wybe Lettinga, Roelof van Barneveld, Robert Jorna, Edward Kijlstra, Roelof van Well, Carien Oomen, Antoon Bartels, Louis Anthonio, Rutger Hagens, Vincent Hofma, Sjoerd Gu, Youlan Drenth, Derk Addink, Ryanne van Asselt, Thea van der Meer, Peter Lipsic, Eric Orozco, Luis Juarez van der Harst, Pim TI Prehospital risk stratification in patients with chest pain SO EMERGENCY MEDICINE JOURNAL LA English DT Article DE cost effectiveness; emergency ambulance systems; effectiveness; cardiac care; acute coronary syndrome; prehospital care ID HEART SCORE AB Objectives The History, ECG, Age, Risk Factors and Troponin (HEART) Score is a decision support tool applied by physicians in the emergency department developed to risk stratify low-risk patients presenting with chest pain. We assessed the potential value of this tool in prehospital setting, when applied by emergency medical services (EMS), and derived and validated a tool adapted to the prehospital setting in order to determine if it could assist with decisions regarding conveyance to a hospital. Methods In 2017, EMS personnel prospectively determined the HEART Score, including point-of-care (POC) troponin measurements, in patients presenting with chest pain, in the north of the Netherlands. The primary endpoint was a major adverse cardiac event (MACE), consisting of acute myocardial infarction or death, within 3 days. The components of the HEART Score were evaluated for their discriminatory value, cut-offs were calibrated for the prehospital setting and sex was substituted for cardiac risk factors to develop a prehospital HEART (preHEART) Score. This score was validated in an independent prospective cohort of 435 patients in 2018. Results Among 1208 patients prospectively recruited in the first cohort, 123 patients (10.2%) developed a MACE. The HEART Score had a negative predictive value (NPV) of 98.4% (96.4-99.3), a positive predictive value (PPV) of 35.5% (31.8-39.3) and an area under the receiver operating characteristic curve (AUC) of 0.81 (0.78-0.85). The preHEART Score had an NPV of 99.3% (98.1-99.8), a PPV of 49.4% (42.0-56.9) and an AUC of 0.85 (0.82-0.88), outperforming the HEART Score or POC troponin measurements on their own. Similar results were found in a validation cohort. Conclusions The HEART Score can be used in the prehospital setting to assist with conveyance decisions and choice of hospitals; however, the preHEART Score outperforms both the HEART Score and single POC troponin measurements when applied by EMS personnel in the prehospital setting. C1 [Sagel, Dennis; van der Harst, Pim] Univ Med Ctr Groningen, Expt Cardiol, NL-9700 RB Groningen, Netherlands. [Vlaar, Pieter Jan] Catharina Hosp, Dept Cardiol, Eindhoven, Netherlands. [van Roosmalen, Radboud] Wilhelmina Hosp Assen, Dept Cardiol, Assen, Netherlands. [Waardenburg, Ingmar; Nieuwland, Wybe; van der Meer, Peter; Lipsic, Eric; Orozco, Luis Juarez] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands. [Lettinga, Roelof] Univ Groningen, Univ Med Ctr Groningen, Dept Anthesiol, Groningen, Netherlands. [van Barneveld, Robert] Univ Med Ctr Groningen, Dept Emergency Med Serv, Groningen, Netherlands. [Jorna, Edward] Hosp Nij Smellinghe, Dept Anesthesiol, Drachten, Netherlands. [Kijlstra, Roelof; van Well, Carien] Kijlstra Ambulance Zorg, Emergency Med Serv, Drachten, Netherlands. [Oomen, Antoon] Antonius Hosp Sneek, Cardiol, Sneek, Netherlands. [Bartels, Louis] Martini Ziekenhuis, Dept Cardiol, Groningen, Netherlands. [Anthonio, Rutger] Treant Zorggrp Locatie Scheper, Cardiol, Emmen, Netherlands. [Hagens, Vincent] Ommelander Hosp Groningen, Dept Cardiol, Scheemda, Netherlands. [Hofma, Sjoerd] Med Ctr Leeuwarden, Dept Cardiol, Leeuwarden, Netherlands. [Gu, Youlan] Hosp Nij Smellinghe, Dept Cardiol, Drachten, Netherlands. [Drenth, Derk] Avicenna Gen Practice Paterswolde, Paterswolde, Netherlands. [Addink, Ryanne] Middelstum Gen Practice, Middelstum, Netherlands. [van Asselt, Thea] Univ Med Ctr Groningen, Dept Epidemiol, Groningen, Netherlands. C3 University of Groningen; Catharina Hospital; University of Groningen; University of Groningen; University of Groningen; Martini Hospital; Medical Center Leeuwarden; University of Groningen RP Sagel, D (通讯作者)，Univ Med Ctr Groningen, Expt Cardiol, NL-9700 RB Groningen, Netherlands. EM d.c.sagel@umcg.nl RI van der Harst, Pim/HOH-5622-2023 OI van der Harst, Pim/0000-0002-2713-686X; sagel, dennis/0000-0001-7681-5896 CR Abbott I., MAIN WEBPAGE ABBOTT Backus BE, 2013, INT J CARDIOL, V168, P2153, DOI 10.1016/j.ijcard.2013.01.255 Bank IEM, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.116.005373 Bidmead T, 2015, EMERG MED J, V32, P439, DOI 10.1136/emermed-2014-203678 DELONG ER, 1988, BIOMETRICS, V44, P837, DOI 10.2307/2531595 Ebben RHA, 2017, SCAND J TRAUMA RESUS, V25, DOI 10.1186/s13049-017-0409-6 Goodacre S, 2005, HEART, V91, P229, DOI 10.1136/hrt.2003.027599 IBM SI, 2008, SPSS WINDOWS Ishak M, 2018, EUR HEART J-ACUTE CA, V7, P102, DOI 10.1177/2048872616687116 Oosterwold J, 2018, BMJ OPEN, V8, DOI 10.1136/bmjopen-2018-021732 Pickering JW, 2018, JAMA CARDIOL, V3, P1108, DOI 10.1001/jamacardio.2018.3368 Poldervaart JM, 2013, BMC CARDIOVASC DISOR, V13, DOI 10.1186/1471-2261-13-77 Ras M, 2017, BMJ OPEN, V7, DOI 10.1136/bmjopen-2017-017259 Stopyra JP, 2018, PREHOSP DISASTER MED, V33, P58, DOI 10.1017/S1049023X17007154 Tolsma RT., 2017, EUR HEART J, V38, DOI [10.1093/eurheartj/ehx501.48, DOI 10.1093/EURHEARTJ/EHX501.48] van Dongen DN, 2020, EUR HEART J-ACUTE CA, V9, P5, DOI 10.1177/2048872618813846 van Dongen DN, 2018, AM J CARDIOL, V122, P1610, DOI 10.1016/j.amjcard.2018.07.037 NR 17 TC 8 Z9 8 U1 3 U2 4 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 2021 VL 38 IS 11 BP 814 EP 819 DI 10.1136/emermed-2020-210212 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA WP5JF UT WOS:000713167100006 PM 34373266 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Taylor, R Dalal, HM McDonagh, STJ AF Taylor, Rod S. Dalal, Hasnain M. McDonagh, Sinead T. J. TI The role of cardiac rehabilitation in improving cardiovascular outcomes SO NATURE REVIEWS CARDIOLOGY LA English DT Review ID NATIONAL HEART FOUNDATION; QUALITY-OF-LIFE; SECONDARY PREVENTION; HEALTH-CARE; CORONARY; FAILURE; DISEASE; ASSOCIATION; GUIDELINES; MANAGEMENT AB Cardiac rehabilitation is a complex intervention that seeks to improve the functional capacity, wellbeing and health-related quality of life of patients with heart disease. A substantive evidence base supports cardiac rehabilitation as a clinically effective and cost-effective intervention for patients with acute coronary syndrome or heart failure with reduced ejection fraction and after coronary revascularization. In this Review, we discuss the major contemporary challenges that face cardiac rehabilitation. Despite the strong recommendation in current clinical guidelines for the referral of these patient groups, global access to cardiac rehabilitation remains poor. The COVID-19 pandemic has contributed to a further reduction in access to cardiac rehabilitation. An increasing body of evidence supports home-based and technology-based models of cardiac rehabilitation as alternatives or adjuncts to traditional centre-based programmes, especially in low-income and middle-income countries, in which cardiac rehabilitation services are scarce, and scalable and affordable models are much needed. Future approaches to the delivery of cardiac rehabilitation need to align with the growing multimorbidity of an ageing population and cater to the needs of the increasing numbers of patients with cardiac disease who present with two or more chronic diseases. Future research priorities include strengthening the evidence base for cardiac rehabilitation in other indications, including heart failure with preserved ejection fraction, atrial fibrillation and congenital heart disease and after valve surgery or heart transplantation, and evaluation of the implementation of sustainable and affordable models of delivery that can improve access to cardiac rehabilitation in all income settings. In this Review, Taylor and colleagues provide a summary of the current evidence base supporting the use of cardiac rehabilitation, an overview of international guidelines for cardiac rehabilitation and a discussion of major contemporary issues facing cardiac rehabilitation delivery around the world. C1 [Taylor, Rod S.] Univ Glasgow, Inst Hlth & Well Being, MRC CSO Social & Publ Hlth Sci Unit, Glasgow, Lanark, Scotland. [Taylor, Rod S.] Univ Glasgow, Inst Hlth & Well Being, Robertson Ctr Biostat, Glasgow, Lanark, Scotland. [Taylor, Rod S.] Univ Exeter, Coll Med & Hlth, Exeter, Devon, England. [Dalal, Hasnain M.; McDonagh, Sinead T. J.] Univ Exeter, Med Sch Primary Care, Smeall Bldg,St Lukes Campus, Exeter, Devon, England. C3 MRC/CSO SOCIAL AND PUBLIC HEALTH SCIENCES UNIT; RLUK- Research Libraries UK; University of Glasgow; RLUK- Research Libraries UK; University of Glasgow; RLUK- Research Libraries UK; University of Exeter; RLUK- Research Libraries UK; University of Exeter RP Taylor, R (通讯作者)，Univ Glasgow, Inst Hlth & Well Being, MRC CSO Social & Publ Hlth Sci Unit, Glasgow, Lanark, Scotland.; Taylor, R (通讯作者)，Univ Glasgow, Inst Hlth & Well Being, Robertson Ctr Biostat, Glasgow, Lanark, Scotland.; Taylor, R (通讯作者)，Univ Exeter, Coll Med & Hlth, Exeter, Devon, England. 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Rev. Cardiol. PD MAR PY 2022 VL 19 IS 3 BP 180 EP 194 DI 10.1038/s41569-021-00611-7 EA SEP 2021 PG 15 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZC2SD UT WOS:000696437900001 PM 34531576 OA Bronze, Green Accepted, Green Published DA 2023-05-13 ER PT J AU Lusebrink, E Orban, M Kupka, D Scherer, C Hagl, C Zimmer, S Luedike, P Thiele, H Westermann, D Massberg, S Schafer, A Orban, M AF Luesebrink, Enzo Orban, Mathias Kupka, Danny Scherer, Clemens Hagl, Christian Zimmer, Sebastian Luedike, Peter Thiele, Holger Westermann, Dirk Massberg, Steffen Schaefer, Andreas Orban, Martin TI Prevention and treatment of pulmonary congestion in patients undergoing venoarterial extracorporeal membrane oxygenation for cardiogenic shock SO EUROPEAN HEART JOURNAL LA English DT Article DE Cardiogenic shock; Venoarterial extracorporeal membrane oxygenation (ECMO); Percutaneous microaxial pump; Extracorporeal life support (ECLS) ID ACUTE MYOCARDIAL-INFARCTION; LIFE-SUPPORT; CANNULATION STRATEGIES; LEFT-VENTRICLE; ECMO; HEART; SURVIVAL; ADULTS; RESUSCITATION; IMPLANTATION AB Cardiogenic shock is still a major driver of mortality on intensive care units and complicates similar to 10% of acute coronary syndromes with contemporary mortality rates up to 50%. In the meantime, percutaneous circulatory support devices, in particular venoarterial extracorporeal membrane oxygenation (VA-ECMO), have emerged as an established salvage intervention for patients in cardiogenic shock. Venoarterial extracorporeal membrane oxygenation provides temporary circulatory support until other treatments are effective and enables recovery or serves as a bridge to ventricular assist devices, heart transplantation, or decision-making. In this critical care perspective, we provide a concise overview of VA-ECMO utilization in cardiogenic shock, considering rationale, critical care management, as well as weaning aspects. We supplement previous literature by focusing on therapeutic issues related to the vicious circle of retrograde aortic VA-ECMO flow, increased left ventricular (LV) afterload, insufficient LV unloading, and severe pulmonary congestion limiting prognosis in a relevant proportion of patients receiving VA-ECMO treatment. We will outline different modifications in percutaneous mechanical circulatory support to meet this challenge. Besides a strategy of running ECMO at lowest possible flow rates, novel therapeutic options including the combination of VA-ECMO with percutaneous microaxial pumps or implementation of a venoarteriovenous-ECMO configuration based on an additional venous cannula supplying towards pulmonary circulation are most promising among LV unloading and venting strategies. The latter may even combine the advantages of venovenous and venoarterial ECMO therapy, providing potent respiratory and circulatory support at the same time. However, whether VA-ECMO can reduce mortality has to be evaluated in the urgently needed, ongoing prospective randomized studies EURO-SHOCK (NCT03813134), ANCHOR (NCT04184635), and ECLS-SHOCK (NCT03637205). These studies will provide the opportunity to investigate indication, mode, and effect of LV unloading in dedicated sub-analyses. In future, the Heart Teams should aim at conducting a dedicated randomized trial comparing VA-ECMO support with vs. without LV unloading strategies in patients with cardiogenic shock. C1 [Luesebrink, Enzo; Orban, Mathias; Kupka, Danny; Scherer, Clemens; Massberg, Steffen; Orban, Martin] Klinikum Univ Munchen, Intens Care Unit, Med Klin & Poliklin 1, Marchioninistr 15, D-81377 Munich, Germany. [Luesebrink, Enzo; Orban, Mathias; Kupka, Danny; Scherer, Clemens; Massberg, Steffen; Orban, Martin] Klinikum Univ Munchen, DZHK German Ctr Cardiovasc Res, Med Klin & Poliklin 1, Partner Site Munich Heart Alliance, Marchioninistr 15, D-81377 Munich, Germany. [Hagl, Christian] Klinikum Univ Munchen, Herzchirurg Klin & Poliklin, Marchioninistr 15, D-81377 Munich, Germany. [Zimmer, Sebastian] Universitatsklinikum Bonn, Med Klin & Poliklin 2, Sigmund Freud Str 25, D-53127 Bonn, Germany. [Luedike, Peter] Univ Hosp Essen, West German Heart & Vasc Ctr, Dept Cardiol & Vasc Med, Hufelandstr 55, D-45122 Essen, Germany. [Thiele, Holger] Univ Leipzig, Leipzig Heart Inst, Dept Internal Med Cardiol, Heart Ctr Leipzig, Strumpellstr 39, D-04289 Leipzig, Germany. [Westermann, Dirk] Universitatsklinikum Hamburg Eppendorf, Klin Allgemeine & Interventionelle Kardiol, Martinistr 52, D-20251 Hamburg, Germany. [Schaefer, Andreas] Hannover Med Sch, Klin Kardiol & Angiol, Carl Neuberg Str 1, D-30625 Hannover, Germany. C3 University of Munich; German Centre for Cardiovascular Research; Munich Heart Alliance; University of Munich; University of Munich; University of Bonn; University of Hamburg; University Medical Center Hamburg-Eppendorf; University of Duisburg Essen; Heart Center Leipzig GMBH; Leipzig University; University of Hamburg; University Medical Center Hamburg-Eppendorf; Hannover Medical School RP Orban, M (通讯作者)，Klinikum Univ Munchen, Intens Care Unit, Med Klin & Poliklin 1, Marchioninistr 15, D-81377 Munich, Germany.; Orban, M (通讯作者)，Klinikum Univ Munchen, DZHK German Ctr Cardiovasc Res, Med Klin & Poliklin 1, Partner Site Munich Heart Alliance, Marchioninistr 15, D-81377 Munich, Germany. EM martin.orban@med.uni-muenchen.de RI Orban, Martin/AAE-6902-2020; Westermann, Dirk/D-1344-2011; Schäfer, Andreas/AAQ-9512-2021; Massberg, Steffen/AAN-6054-2021 OI Orban, Martin/0000-0001-9830-1941; kupka, danny/0000-0002-6125-4114; Westermann, Dirk/0000-0002-7542-1956; Scherer, Clemens/0000-0003-2816-6793; Thiele, Holger/0000-0002-0169-998X CR Akanni OJ, 2019, ASAIO J, V65, P219, DOI 10.1097/MAT.0000000000000804 Alhussein M, 2017, J CARDIAC SURG, V32, P396, DOI 10.1111/jocs.13146 Anderson MB, 2015, J HEART LUNG TRANSPL, V34, P1549, DOI 10.1016/j.healun.2015.08.018 Andrews J, 2016, TRANSFUS MED REV, V30, P223, DOI 10.1016/j.tmrv.2016.07.005 Baran DA, 2019, CATHETER CARDIO INTE, V94, P29, DOI 10.1002/ccd.28329 Batsides G, 2018, INNOVATIONS, V13, P254, DOI 10.1097/IMI.0000000000000535 Becher PM, 2018, CIRCULATION, V138, P2298, DOI 10.1161/CIRCULATIONAHA.118.036691 Bembea MM, 2013, PEDIATR CRIT CARE ME, V14, pE77, DOI 10.1097/PCC.0b013e31827127e4 Biscotti M, 2014, ASAIO J, V60, P635, DOI 10.1097/MAT.0000000000000139 Bonnefoy-Cudraz E, 2018, EUR HEART J-ACUTE CA, V7, P80, DOI 10.1177/2048872617724269 Boulate D, 2013, EUR J CARDIO-THORAC, V44, P544, DOI 10.1093/ejcts/ezt125 Burkhoff D, 2015, J AM COLL CARDIOL, V66, P2664, DOI 10.1016/j.jacc.2015.10.017 Cakici M, 2018, INTERACT CARDIOV TH, V26, P112, DOI 10.1093/icvts/ivx259 Carroll BJ, 2015, AM J CARDIOL, V116, P1624, DOI 10.1016/j.amjcard.2015.08.030 Cavarocchi NC, 2013, J THORAC CARDIOV SUR, V146, P1474, DOI 10.1016/j.jtcvs.2013.06.055 Corsi F, 2017, CRIT CARE, V21, DOI 10.1186/s13054-017-1655-8 Fiedler AG, 2018, J CARDIOTHOR VASC AN, V32, P2585, DOI 10.1053/j.jvca.2018.05.019 Flierl U, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0183193 Guglin M, 2019, J AM COLL CARDIOL, V73, P698, DOI 10.1016/j.jacc.2018.11.038 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Ius F, 2019, EUR RESPIR J, V53, DOI 10.1183/13993003.01773-2018 Jenks CL, 2017, ASAIO J, V63, P787, DOI 10.1097/MAT.0000000000000575 Keebler ME, 2018, JACC-HEART FAIL, V6, P503, DOI 10.1016/j.jchf.2017.11.017 Lim HS, 2017, ARTIF ORGANS, V41, P1109, DOI 10.1111/aor.12923 Lusebrink E, 2019, CRITICAL CARE EXPLOR, V6, pe0018 Meani P, 2017, EUR J HEART FAIL, V19, P84, DOI 10.1002/ejhf.850 Meneveau N, 2018, EUR HEART J, V39, P4196, DOI 10.1093/eurheartj/ehy464 Muller G, 2016, INTENS CARE MED, V42, P370, DOI 10.1007/s00134-016-4223-9 Napp LC, 2017, HERZ, V42, P27, DOI 10.1007/s00059-016-4523-4 Napp LC, 2017, JACC-CARDIOVASC INTE, V10, pE231, DOI 10.1016/j.jcin.2017.07.047 Napp LC, 2016, CLIN RES CARDIOL, V105, P283, DOI 10.1007/s00392-015-0941-1 Napp LC, 2015, INT J CARDIOL, V187, P164, DOI 10.1016/j.ijcard.2015.03.311 Pappalardo F, 2017, EUR J HEART FAIL, V19, P404, DOI 10.1002/ejhf.668 Pappalardo F, 2015, J CARDIOTHOR VASC AN, V29, P906, DOI 10.1053/j.jvca.2014.12.011 Patel SM, 2019, ASAIO J, V65, P21, DOI 10.1097/MAT.0000000000000767 Petroni T, 2014, CRIT CARE MED, V42, P2075, DOI 10.1097/CCM.0000000000000410 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Rajan S, 2016, CIRCULATION, V134, P2095, DOI 10.1161/CIRCULATIONAHA.116.024400 Rao P, 2018, CIRC-HEART FAIL, V11, DOI 10.1161/CIRCHEARTFAILURE.118.004905 Rihal CS, 2015, J AM COLL CARDIOL, V65, pE7, DOI 10.1016/j.jacc.2015.03.036 Ristalli F, 2019, CURR CARDIOL REP, V21, DOI 10.1007/s11886-019-1245-2 Rouge A, 2017, J INTENSIVE CARE, V5, DOI 10.1186/s40560-017-0235-y Rousse N, 2015, INT J CARDIOL, V187, P620, DOI 10.1016/j.ijcard.2015.03.283 Rupprecht L, 2015, HEART LUNG VESSEL, V7, P320 Schafer A, 2019, INT J CARDIOL, V291, P96, DOI 10.1016/j.ijcard.2019.05.044 Schafer A, 2019, ESC HEART FAIL, V6, P457, DOI 10.1002/ehf2.12417 Schmidt M, 2015, EUR HEART J, V36, P2246, DOI 10.1093/eurheartj/ehv194 Schmidt M, 2014, CRIT CARE, V18, DOI 10.1186/cc13702 Schrage B, 2018, JACC-HEART FAIL, V6, P1035, DOI 10.1016/j.jchf.2018.09.009 Silvetti S, 2015, ARTIF ORGANS, V39, P176, DOI 10.1111/aor.12335 Sorokin V, 2017, EUR J HEART FAIL, V19, P75, DOI 10.1002/ejhf.849 Staudacher DL, 2017, J CRIT CARE, V37, P130, DOI 10.1016/j.jcrc.2016.09.017 Thiagarajan RR, 2017, ASAIO J, V63, P60, DOI 10.1097/MAT.0000000000000475 Thiele H, 2012, NEW ENGL J MED, V367, P1287, DOI 10.1056/NEJMoa1208410 Tongers J, 2020, CIRC-HEART FAIL, V13, DOI 10.1161/CIRCHEARTFAILURE.118.005853 van Diepen S, 2017, CIRCULATION, V136, pE232, DOI 10.1161/CIR.0000000000000525 Vincent F, 2018, J AM COLL CARDIOL, V71, P2106, DOI 10.1016/j.jacc.2018.02.075 Zhang Z, 2017, CAN RESPIR J, V2017, P1, DOI DOI 10.1016/J.SCIT0TENV.2017.01.179 NR 58 TC 38 Z9 39 U1 1 U2 6 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0195-668X EI 1522-9645 J9 EUR HEART J JI Eur. Heart J. PD OCT 7 PY 2020 VL 41 IS 38 BP 3753 EP + DI 10.1093/eurheartj/ehaa547 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OW6TS UT WOS:000593017200019 PM 33099278 DA 2023-05-13 ER PT J AU Toprak, ID Saglam, S Asikoglu, B Eruzun, H Oksuz, S Altunok, ES AF Toprak, Ilkim Deniz Saglam, Selin Asikoglu, Bilge Eruzun, Hasan Oksuz, Sila Altunok, Elif Sargin TI DO AGE, HYPERTENSION, CORONARY ARTERY DISEASE, ACE-I, ARB OR BETA-BLOCKERS THERAPY INCREASE THE RISK OF MORTALITY IN COVID 19 PATIENTS? THE RESULTS OF A TERTIARY CENTER IN TURKEY SO ACTA MEDICA MEDITERRANEA LA English DT Article DE Ace inhibitor; beta blocker; sulfonylurea; covid-19 ID OUTCOMES AB Introduction: Herein, we will present the details of the patients admitted to a tertiary center, in Turkey, with laboratory-confirmed COVID-19 who were carrying the criteria for in-patient treatment. The definite clinical outcomes (death or discharge) of the patients are recorded and we aimed to determine the effects of comorbidities and the drugs they were using on outcomes. Materials and methods: Patient records were retrospectively evaluated from medical records. The detection of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory specimens is performed by next-generation sequencing or real-time RT-PCR methods. Results: Totally 298 patients diagnosed with and in-patient followed for COVID-19 infection were included in the study. During follow-ups, 239 were discharged without intensive care unit (ICU) requirements. The mortality rate was 8.7% in these hospitalized patients. The mean age of the expired and discharged patients were significantly different (69.48 +/- 10.02 vs. 56.82 +/- 15.52, p:0.001). ACE-I-ARB and beta-blocker usages were significantly more common in expired patients. Risk estimates were performed with crosstabs. Regarding these findings, age >= 65 years increased the risk of mortality for 5.145 times (2.130 - 12.426); the presence of hypertension increased the risk of mortality for 3.55 times (1.63-7.74); coronary artery disease for 3.07 times (1.39-6.78); ACE-I-ARB usage for 2.77 times (1.32 - 5.82); beta-blocker usage for 2.88 times (1.33-6.23) and sulfonylurea usage for 3.42 times (1.34-8.72). Conclusion: Older age, presence of hypertension and coronary artery disease and using ACE-I, ARB or beta-blockers were increasing the risk of mortality. C1 [Toprak, Ilkim Deniz; Asikoglu, Bilge; Oksuz, Sila] Univ Hlth Sci Turkey, Gaziosmanpasa Training & Res Hosp, Dept Internal Med, Istanbul, Turkey. [Saglam, Selin] Prof Dr Cemil Tascioglu Urban Hosp, Dept Internal Med, Istanbul, Turkey. [Eruzun, Hasan] Univ Hlth Sci Turkey, Samsun Training & Res Hosp, Dept Internal Med, Samsun, Turkey. [Altunok, Elif Sargin] Univ Hlth Sci Turkey, Gaziosmanpasa Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey. C3 Samsun Training & Research Hospital RP Eruzun, H (通讯作者)，Univ Hlth Sci Turkey, Samsun Training & Res Hosp, Dept Internal Med, Samsun, Turkey. 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PY 2021 VL 37 IS 1 BP 547 EP 552 DI 10.19193/0393-6384_2021_1_85 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA QM4UO UT WOS:000621776000085 DA 2023-05-13 ER PT J AU Pres, D Niedziela, J Kurek, A Golba, K Mizia-Stec, K Gasior, Z Nowalany-Kozielska, E Wojakowski, W Tajstra, M Gierlotka, M Gasior, M AF Pres, Damian Niedziela, Jacek Kurek, Anna Golba, Krzysztof Mizia-Stec, Katarzyna Gasior, Zbigniew Nowalany-Kozielska, Ewa Wojakowski, Wojciech Tajstra, Mateusz Gierlotka, Marek Gasior, Mariusz TI In-hospital and long-term prognosis in patients after implantation of implantable cardioverter-defibrillators and cardiac resynchronization therapy: 10-year results of the SILCARD registry SO POLISH ARCHIVES OF INTERNAL MEDICINE-POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ LA English DT Article DE cardiac resynchronization therapy; implantable cardioverter-defibrillator; prognosis ID HEART-FAILURE; TEMPORAL TRENDS; ICD; PREVENTION; SOCIETY; CARDIOMYOPATHY; COMPLICATIONS; GUIDELINES; RECIPIENTS; MORTALITY AB INTRODUCTION During the last 20 years, there has been a considerable increase in the number of implanted implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy (CRT) devices. However, there have been only single reports on clinical events, including rehospitalizations, in the long-term follow-up. OBJECTIVES We analyzed the baseline clinical characteristics, medical procedures used, and complications of patients with implantation of an ICD or CRT device. Moreover, we analyzed the causes of rehospitalization and the types of treatment used in the 12-month follow-up. PATIENTS AND METHODS Out of 1 208 440 hospitalizations of patients with cardiovascular diseases included in the SILCARD registry, hospitalizations with an ICD-9 code for an ICD or CRT device implantation between 2006 and 2016 were selected. RESULTS The analysis included 12 147 patients with an ICD or CRT device. The total number of hospitalizations was 14552. Over the years, a significant increase in the number of implanted devices and a higher percentage of CRT defibrillators was observed. Before the implantation, approximately 48.2% of patients underwent revascularization. In-hospital and 12-month mortality rates were 0.4% and 8.1%, respectively. Rehospitalizations due to cardiovascular causes were reported for approximately 40.3% of patients, with a significant reduction in the analyzed period. The most frequent cause of rehospitalization was heart failure (51.4%), while stable coronary artery disease and acute coronary syndromes constituted approximately 16% of the causes. In the 12-month follow-up, nearly every tenth patient was subjected to coronary angiography. Approximately 5% of patients required revascularization. CONCLUSIONS The relatively high rates of hospital readmissions and their causes indicate the need for a comprehensive care of patients before implantation of ICD or CRT devices and after discharge. C1 [Pres, Damian; Niedziela, Jacek; Kurek, Anna; Tajstra, Mateusz; Gierlotka, Marek; Gasior, Mariusz] Med Univ Silesia, Div Dent Zabrze, Dept Cardiol 3, Sch Med, Katowice, Poland. [Pres, Damian; Niedziela, Jacek; Kurek, Anna; Tajstra, Mateusz; Gierlotka, Marek; Gasior, Mariusz] Silesian Ctr Heart Dis Zabrze, Ul M Curie Sklodowskiej 9, PL-41800 Zabrze, Poland. [Golba, Krzysztof] Med Univ Silesia, Dept Electrocardiol & Heart Failure, Katowice, Poland. [Mizia-Stec, Katarzyna] Med Univ Silesia, Sch Med Katowice, Dept Cardiol 1, Katowice, Poland. [Gasior, Zbigniew; Nowalany-Kozielska, Ewa] Med Univ Silesia, Dept Cardiol 2, Katowice, Poland. [Wojakowski, Wojciech] Med Univ Silesia, Dept Cardiol 3, Sch Med Katowice, Katowice, Poland. [Gierlotka, Marek] Univ Opole, Univ Hosp, Fac Nat Sci & Technol, Dept Cardiol, Opole, Poland. C3 Medical University Silesia; Silesian Center for Heart Diseases; Medical University Silesia; Medical University Silesia; Medical University Silesia; Medical University Silesia; University of Opole RP Pres, D (通讯作者)，Med Univ Silesia, Div Dent Zabrze, Dept Cardiol 3, Sch Med, Katowice, Poland.; Pres, D (通讯作者)，Silesian Ctr Heart Dis Zabrze, Ul M Curie Sklodowskiej 9, PL-41800 Zabrze, Poland. EM damianpres@wp.pl RI Gierlotka, Marek/U-6969-2019; Tajstra, Mateusz MT/R-6890-2016; Mizia-Stec, Katarzyna/HLV-8003-2023; Niedziela, Jacek T./N-1147-2014 OI Gierlotka, Marek/0000-0001-5639-2128; Mizia-Stec, Katarzyna/0000-0001-6907-2799; Nowalany-Kozielska, Ewa/0000-0002-5977-513X; Niedziela, Jacek T./0000-0001-5016-8862; Tajstra, Mateusz/0000-0003-4145-5485; Golba, Krzysztof/0000-0001-5722-7976 CR Alzueta J, 2013, REV ESP CARDIOL, V66, P881, DOI 10.1016/j.rec.2013.07.001 Ambrosy AP, 2014, J AM COLL CARDIOL, V63, P1123, DOI 10.1016/j.jacc.2013.11.053 Amit G, 2014, EUROPACE, V16, P1175, DOI 10.1093/europace/euu015 Borne RT, 2014, CIRCULATION, V130, P845, DOI 10.1161/CIRCULATIONAHA.114.008653 Bristow MR, 2004, NEW ENGL J MED, V350, P2140, DOI 10.1056/NEJMoa032423 Buxton M, 2006, HEALTH TECHNOL ASSES, V10, P1 Dodson JA, 2014, CIRCULATION, V129, P580, DOI 10.1161/CIRCULATIONAHA.113.003747 Gadler F, 2015, EUROPACE, V17, P69, DOI 10.1093/europace/euu233 Gasior M, 2016, POL ARCH MED WEWN, V126, P754, DOI 10.20452/pamw.3557 Gasior M, 2016, KARDIOL POL, V74, P523, DOI 10.5603/KP.a2015.0224 Greenberg H, 2004, J AM COLL CARDIOL, V43, P1459, DOI 10.1016/j.jacc.2003.11.038 Hammill SC, 2010, HEART RHYTHM, V7, P1340, DOI 10.1016/j.hrthm.2010.07.015 Jhund PS, 2009, CIRCULATION, V119, P515, DOI 10.1161/CIRCULATIONAHA.108.812172 Kadish A, 2006, J AM COLL CARDIOL, V47, P2477, DOI 10.1016/j.jacc.2005.11.090 Khazanie P, 2014, CIRC-HEART FAIL, V7, P926, DOI 10.1161/CIRCHEARTFAILURE.113.000838 Lee DS, 2010, J AM COLL CARDIOL, V55, P774, DOI 10.1016/j.jacc.2009.11.029 Polewczyk A, 2017, POL ARCH INTERN MED, V127, P597, DOI 10.20452/pamw.4065 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Raatikainen MJP, 2015, EUROPACE, V17, pI1, DOI 10.1093/europace/euu300 Ranasinghe I, 2014, PLOS MED, V11, DOI 10.1371/journal.pmed.1001737 Sandoe JAT, 2015, J ANTIMICROB CHEMOTH, V70, P325, DOI 10.1093/jac/dku383 van Bommel RJ, 2010, EUR HEART J, V31, P2783, DOI 10.1093/eurheartj/ehq252 Wasmer K, 2013, CLIN RES CARDIOL, V102, P513, DOI 10.1007/s00392-013-0559-0 NR 23 TC 3 Z9 3 U1 0 U2 3 PU MEDYCYNA PRAKTYCZNA PI KRAKOW PA UL KRAKOWSKA 41, KRAKOW, 31-066, POLAND SN 0032-3772 EI 1897-9483 J9 POL ARCH INTERN MED JI Pol. Intern. Med. PY 2018 VL 128 IS 10 BP 580 EP 586 DI 10.20452/pamw.4332 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA GY8LJ UT WOS:000448878500003 PM 30215623 OA Bronze DA 2023-05-13 ER PT J AU Salgia, A Krueger, CK Gillette, MA AF Salgia, Alok Krueger, Chelsea K. Gillette, Michael A. TI Perioperative Antiplatelet Bridging With Cangrelor: A Cohort Study and Narrative Review SO ANNALS OF PHARMACOTHERAPY LA English DT Review; Early Access DE acute coronary syndrome; antiplatelets; bare metal stent; cardiovascular drugs; coronary artery disease; drug-eluting stent; ischemic heart disease; MI; percutaneous coronary intervention ID NONCARDIAC SURGERY; THERAPY; PREDICTORS; CONSENSUS; STENTS AB Background: In patients who received a cardiac stent, practice guidelines recommend dual antiplatelet therapy (DAPT). However, an urgent procedure may be required necessitating interruption of DAPT. Intravenous cangrelor was previously shown to be an alternative due its short-half life and quick onset/offset. Objective: To determine the safety and effectiveness of cangrelor bridging for patients undergoing invasive procedures in a veteran population. Methods: Retrospective cohort of patients from Michael E. DeBakey VA Medical Center and the VA North Texas Health Care Systems who underwent perioperative cangrelor bridging. The primary outcome was the incidence of bleeding using the Bleeding Academic Research Consortium (BARC) criteria. The secondary outcome was a composite of nonfatal stroke, myocardial infarction (MI), mortality, and unplanned revascularization within 30 days. A narrative review was also performed to summarize cangrelor bridging for noncardiac invasive procedure. Results: There were 41 patients that met the eligibility criteria. Patients were predominantly Caucasian (57.5%) men with a median age of 70 years. The median duration on cangrelor bridging was 2.6 days with 11 and 30 patients undergoing cardiac and noncardiac invasive procedures, respectively. Nine patients (22%) had a bleeding event of which 8 were minor. One was severe due to significant iliopsoas hematoma following drain placement. All bleeding events occurred postoperatively except for 2 perioperative events that occurred during orthopedic procedures. Ischemic events up to 30 days occurred in 3 patients (7.3%) which consisted of 1 (2.4%) nonfatal MI requiring revascularization and 2 (4.9%) deaths, 1 of which was sudden cardiac. Conclusion and Relevance: This study suggests that cangrelor bridging may be a reasonable alternative to holding oral P2Y12 inhibitors in patients requiring interruption of antiplatelet therapy for an urgent surgery/invasive procedure. C1 [Salgia, Alok] Michael E DeBakey VA Med Ctr, Dept Pharm, Houston, TX USA. [Krueger, Chelsea K.] VA North Texas Hlth Care Syst, Dept Pharm, 4500 S Lancaster Rd Bldg 7,Rt 119A, Dallas, TX 75216 USA. [Gillette, Michael A.] South Texas Vet Hlth Care Syst, Dept Pharm, San Antonio, TX USA. C3 Baylor College of Medicine; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA North Texas Health Care System; US Department of Veterans Affairs; Veterans Health Administration (VHA); Audie L. Murphy Memorial Veterans Hospital RP Krueger, CK (通讯作者)，VA North Texas Hlth Care Syst, Dept Pharm, 4500 S Lancaster Rd Bldg 7,Rt 119A, Dallas, TX 75216 USA. EM Chelsea.Krueger@ttuhsc.edu OI Salgia, Alok/0000-0002-3714-4839 CR Amsterdam EA, 2014, CIRCULATION, V130, P2354, DOI 10.1161/CIR.0000000000000133 Angiolillo DJ, 2017, CIRCULATION, V136, P1955, DOI 10.1161/CIRCULATIONAHA.117.031164 Angiolillo DJ, 2012, JAMA-J AM MED ASSOC, V307, P265, DOI 10.1001/jama.2011.2002 Banerjee S, 2017, J AM COLL CARDIOL, V69, P1861, DOI 10.1016/j.jacc.2017.02.012 Berger PB, 2010, JACC-CARDIOVASC INTE, V3, P920, DOI 10.1016/j.jcin.2010.03.021 Botto F, 2014, ANESTHESIOLOGY, V120, P564, DOI 10.1097/ALN.0000000000000113 Bowman S, 2019, ANN PHARMACOTHER, V53, P171, DOI 10.1177/1060028018795840 Brodie BR, 2015, CIRC-CARDIOVASC INTE, V8, DOI 10.1161/CIRCINTERVENTIONS.114.002568 Bruck C, 2018, CARDIOL THER, V7, P209, DOI 10.1007/s40119-018-0113-2 Cahoon William D Jr, 2017, J Pharm Pract, V30, P270, DOI 10.1177/0897190016636750 Calnan MW, 2020, J PHARM PRACT, V33, P231, DOI 10.1177/0897190018795343 Choxi R, 2020, CARDIOVASC REVASCULA, V21, pS94, DOI 10.1016/j.carrev.2019.12.036 Dargham BB, 2019, CARDIOVASC REVASCULA, V20, P805, DOI 10.1016/j.carrev.2018.11.018 Devereaux PJ, 2008, LANCET, V371, P1839, DOI 10.1016/S0140-6736(08)60601-7 Devereaux PJ, 2011, ANN INTERN MED, V154, P523, DOI 10.7326/0003-4819-154-8-201104190-00003 Gandhi NK, 2011, CATHETER CARDIO INTE, V77, P972, DOI 10.1002/ccd.22744 Godier A, 2019, BRIT J ANAESTH, V123, pE2, DOI 10.1016/j.bja.2019.03.019 Hu TY, 2019, A A PRACT, V13, P69, DOI 10.1213/XAA.0000000000000994 Iakovou I, 2005, JAMA-J AM MED ASSOC, V293, P2126, DOI 10.1001/jama.293.17.2126 Johnson BV, 2021, J INVASIVE CARDIOL, V33, pE998 Kabadi RA, 2019, PHARMACOTHERAPY, V39, P521, DOI 10.1002/phar.2219 Khan Abdul A., 2020, Cardiovascular & Hematological Disorders - Drug Targets, V20, P227, DOI 10.2174/1871529X20666200228114925 Levine GN, 2016, J AM COLL CARDIOL, V68, P1082, DOI 10.1016/j.jacc.2016.03.513 Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Rossini Roberta, 2020, TH Open, V4, pe437, DOI 10.1055/s-0040-1721504 Rossini R, 2018, JACC-CARDIOVASC INTE, V11, P417, DOI 10.1016/j.jcin.2017.10.051 Shaw AD, 2018, PERIOPER MED-LONDON, V7, DOI 10.1186/s13741-018-0103-x Spence J, 2019, CAN MED ASSOC J, V191, pE830, DOI 10.1503/cmaj.190221 Succar L, 2022, PHARMACOTHERAPY, V42, P263, DOI 10.1002/phar.2661 Valenti R, 2022, PLATELETS, V33, P687, DOI 10.1080/09537104.2021.1983162 Virani SS, 2021, CIRCULATION, V143, pe254, DOI 10.1161/CIR.0000000000000950 Yun AN, 2022, J CARDIOVASC PHARM, V79, P383, DOI 10.1097/FJC.0000000000001192 NR 32 TC 0 Z9 0 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1060-0280 EI 1542-6270 J9 ANN PHARMACOTHER JI Ann. Pharmacother. DI 10.1177/10600280221120310 EA AUG 2022 PG 9 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA 3Z2ZN UT WOS:000844288100001 PM 36004393 DA 2023-05-13 ER PT J AU Kambic, T Sarabon, N Hadzic, V Lainscak, M AF Kambic, Tim Sarabon, Nejc Hadzic, Vedran Lainscak, Mitja TI High-Load and Low-Load Resistance Exercise in Patients with Coronary Artery Disease: Feasibility and Safety of a Randomized Controlled Clinical Trial SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE strength training; aerobic training; cardiac rehabilitation; hemodynamic response; acute coronary syndrome; exercise training ID CARDIAC REHABILITATION; HEART-DISEASE; CARDIOVASCULAR-DISEASE; SECONDARY PREVENTION; SCIENTIFIC STATEMENT; PHYSICAL-ACTIVITY; BLOOD-PRESSURE; 2007 UPDATE; STRENGTH; INTENSITY AB Resistance exercise (RE) remains underused in cardiac rehabilitation; therefore, there is insufficient evidence on safety, feasibility, and hemodynamic adaptations to high-load (HL) and low-load (LL) RE in patients with coronary artery disease (CAD). This study aimed to compare the safety, feasibility of HL-RE and LL-RE when combined with aerobic exercise (AE), and hemodynamic adaptations to HL and LL resistance exercise following the intervention. Seventy-nine patients with CAD were randomized either to HL-RE (70-80% of one-repetition maximum [1-RM]) and AE, LL-RE (35-40% of 1-RM) and AE or solely AE (50-80% of maximal power output) as a standard care, and 59 patients completed this study. We assessed safety and feasibility of HL-RE and LL-RE and we measured 1-RM on leg extension machine and hemodynamic response during HL- and LL-RE at baseline and post-training. The training intervention was safe, well tolerated, and completed without any adverse events. Adherence to RE protocols was excellent (100%). LL-RE was better tolerated than HL-RE, especially from the third to the final mesocycle of this study (Borgs' 0-10 scale difference: 1-2 points; p = 0.001-0.048). Improvement in 1-RM was greater following HL-RE (+31%, p < 0.001) and LL-RE (+23%, p < 0.001) compared with AE. Participation in HL-RE and LL-RE resulted in a decreased rating of perceived exertion during post-training HL- and LL-RE, but in the absence of post-training hemodynamic adaptations. The implementation of HL-RE or LL-RE combined with AE was safe, well tolerated and can be applied in the early phase of cardiac rehabilitation for patients with stable CAD. C1 [Kambic, Tim] Gen Hosp Murska Sobota, Dept Res & Educ, Cardiac Rehabil Unit, Ul Dr Vrbnjaka 6, Murska Sobota 9000, Slovenia. [Sarabon, Nejc] Univ Primorska, Fac Hlth Sci, Polje 42, Izola 6310, Slovenia. [Sarabon, Nejc] Human Hlth Dept, InnoRenew CoE, Livade 6, Izola 6310, Slovenia. [Sarabon, Nejc] Sci Practice Ltd, Lab Motor Control & Motor Behav, S2P, Tehnoloski Pk 19, Ljubljana 1000, Slovenia. [Hadzic, Vedran] Univ Ljubljana, Fac Sport, Gortanova Ul 22, Ljubljana 1000, Slovenia. [Lainscak, Mitja] Gen Hosp Murska Sobota, Div Cardiol, Ul Dr Vrbnjaka 6, Murska Sobota 9000, Slovenia. [Lainscak, Mitja] Univ Ljubljana, Fac Med, Vrazov Trg 2, Ljubljana 1000, Slovenia. C3 University of Primorska; University of Ljubljana; University of Ljubljana RP Kambic, T (通讯作者)，Gen Hosp Murska Sobota, Dept Res & Educ, Cardiac Rehabil Unit, Ul Dr Vrbnjaka 6, Murska Sobota 9000, Slovenia.; Lainscak, M (通讯作者)，Gen Hosp Murska Sobota, Div Cardiol, Ul Dr Vrbnjaka 6, Murska Sobota 9000, Slovenia.; Lainscak, M (通讯作者)，Univ Ljubljana, Fac Med, Vrazov Trg 2, Ljubljana 1000, Slovenia. EM tim.kambic@gmail.com; nejc.sarabon@fvz.upr.si; vedran.hadzic@fsp.uni-li.si; mitja.lainscak@guest.arnes.si RI Kambic, Tim/HFZ-9159-2022; Hadzic, Vedran/M-4090-2016 OI Kambic, Tim/0000-0003-3571-7928; Hadzic, Vedran/0000-0002-6918-9994; Lainscak, Mitja/0000-0002-5922-4098; Sarabon, Nejc/0000-0003-0747-3735 FU Slovenian Research Agency [P5-0147, V5-2101] FX This research was funded by a research fellowship grant received by T.K. from the Slovenian Research Agency (fellowship grant no. 630-72/2019-1). M.L. was funded by the Slovenian Research Agency (research grants no. J3-9292, J3-9284 and J3-3076). V.H. was funded by the Slovenian Research Agency (research program grants no. P5-0147 and V5-2101). The funding agency had no impact on data collection, analysis or interpretation of this study. 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Clin. Med. PD JUL PY 2022 VL 11 IS 13 AR 3567 DI 10.3390/jcm11133567 PG 16 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 2W0TO UT WOS:000824247500001 PM 35806853 OA gold, Green Published DA 2023-05-13 ER PT J AU Clark, RA Conway, A Poulsen, V Keech, W Tirimacco, R Tideman, P AF Clark, Robyn A. Conway, Aaron Poulsen, Vanessa Keech, Wendy Tirimacco, Rosy Tideman, Phillip TI Alternative models of cardiac rehabilitation: A systematic review SO EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY LA English DT Article DE Acute coronary syndrome; cardiac rehabilitation; cardiovascular diseases; coronary disease; internet; myocardial infarction; risk factors; systematic review; telemedicine ID CORONARY-HEART-DISEASE; RANDOMIZED CONTROLLED-TRIAL; HOME-BASED EXERCISE; QUALITY-OF-LIFE; POSTMYOCARDIAL INFARCTION PATIENTS; SECONDARY PREVENTION PROGRAMS; HOSPITAL-BASED REHABILITATION; INCREASE PHYSICAL-ACTIVITY; MYOCARDIAL-INFARCTION; FOLLOW-UP AB The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or home-based, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences. C1 [Clark, Robyn A.] Flinders Univ S Australia, Sch Nursing & Midwifery, Adelaide, SA 5001, Australia. [Conway, Aaron] Queensland Univ Technol, Sch Nursing, Brisbane, Qld 4001, Australia. [Conway, Aaron] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld 4001, Australia. C3 Flinders University South Australia; Queensland University of Technology (QUT); Queensland University of Technology (QUT) RP Clark, RA (通讯作者)，Flinders Univ S Australia, Sch Nursing & Midwifery, Sturt Rd,Bedford Pk 5042,GPO Box 2100, Adelaide, SA 5001, Australia. EM robyn.clark@flinders.edu.au RI Clark, Robyn A/D-1604-2009; Conway, Aaron/T-2421-2018 OI Clark, Robyn A/0000-0002-5063-2618; Conway, Aaron/0000-0002-9583-8636; Keech, Wendy/0000-0002-2742-3578 FU South Australian Statewide Cardiology Clinical Network, Prevention and Rehabilitation Workgroup members, SA Health FX The members of the review update team wish to acknowledge the contribution of Dr Kylie Johnstone and members of the team at the International Centre for Allied Health Evidence, University of South Australia. They also acknowledge the contribution and support of the South Australian Statewide Cardiology Clinical Network, Prevention and Rehabilitation Workgroup members, SA Health, the Chief Medical Officer, Professor Paddy Phillips and contributions from the South Australian Cardiovascular Health and Rehabilitation Association. The review team also acknowledges the support of Petra Lawrence, The Prince Charles Hospital, and Prof Patsy Yates, School of Nursing, Queensland University of Technology, Queensland, Australia. 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J. Prev. Cardiol. PD JAN PY 2015 VL 22 IS 1 BP 35 EP 74 DI 10.1177/2047487313501093 PG 40 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA AW9DJ UT WOS:000346557500005 PM 23943649 OA Green Submitted DA 2023-05-13 ER PT J AU Al-Asadi, JN Kadhim, FN AF Al-Asadi, J. N. Kadhim, F. N. TI Day of admission and risk of myocardial infarction mortality in a cardiac care unit in Basrah, Iraq SO NIGERIAN JOURNAL OF CLINICAL PRACTICE LA English DT Article DE In-hospital mortality; myocardial infarction; weekend ID IN-HOSPITAL MORTALITY; ACUTE CORONARY SYNDROMES; LINE CHARACTERISTICS; MEDICAL ADMISSIONS; WEEKDAY ADMISSION; DIABETES-MELLITUS; INTENSIVE-CARE; WEEKEND; TIME; OUTCOMES AB Background: Among many factors that may affect the in-hospital mortality among acute myocardial infarction (AMI) patients admitted to the cardiac care unit (CCU), the day and time of admission have been reported to play some role, but such relationship is controversial. Objective: The objective of the following study is to assess the effect of the day and time of admission on in-hospital mortality of patients with AMI. Subjects and Methods: Retrospective analysis of data of all patients with AMI who were admitted to the CCU in Al-Sadr Teaching Hospital, Basrah, Iraq during 2010 was conducted. Results: A total of 419 patients were included in this analysis. The mean age of patients was 62.4 +/- 11.6 years, 64.9% of them were men. Admission during weekdays was greater than that during weekends (63.2% vs. 36.8%). Admission during off hours was greater than that during regular-hours (59.9% vs. 41.1%). Weekend admissions were more likely to be presenting with ST elevation myocardial infarction, complications and hypotension. A likewise pattern of baseline characteristics was found among patients admitted at the off-hours time. The overall in-hospital mortality rate was 16.5%. The weekend admission was associated with a higher unadjusted hospital mortality rate than that for weekday admission (23.4% vs. 12.5%, respectively; odds ratio [OR], 2.14; 95% confidence interval [CI], 1.27-3.61; P = 0.004). In multivariate analyzes, no statistically significant difference in mortality was found between weekend and weekday admissions (OR, 0.658; 95% CI, 0.311-1.392). Whereas, off-hours admission was significantly associated with a higher mortality (25.5% vs. 3%; P < 0.001), adjusted OR, 12.178; 95% CI, 3.846-38.442. Conclusion: Of predictors for the in-hospital outcome of AMI, day of admission had no significant influence on mortality, whereas off-hour admission was associated with an increased risk of AMI in-hospital mortality. C1 [Al-Asadi, J. N.] Univ Basrah, Coll Med, Dept Community Med, Basrah, Iraq. [Kadhim, F. N.] Basrah Hlth Directorate, Al Junaina PHC Ctr, Basrah, Iraq. C3 University of Basrah RP Al-Asadi, JN (通讯作者)，Univ Basrah, Coll Med, Dept Community Med, Basrah, Iraq. EM alasadijasim1951@yahoo.com RI Al-Asadi, Jasim N/G-9426-2019 OI Al-Asadi, Jasim/0000-0003-1507-9738 CR Al-Hamandi ZN, 2011, IRAQI POSTGRAD MED J, V10, P46 AlHabib KF, 2011, J SAUDI HEART ASSOC, V23, P233, DOI 10.1016/j.jsha.2011.05.004 Andrikopoulos GK, 2001, EUR HEART J, V22, P776, DOI 10.1053/euhj.2000.2315 Angus DC, 2006, CRIT CARE MED, V34, P1016, DOI 10.1097/01.CCM.0000206105.05626.15 Antman Elliott M., 2004, J Am Coll Cardiol, V44, pE1, DOI 10.1016/j.jacc.2004.07.014 Arabi Y, 2006, CRIT CARE MED, V34, P605, DOI 10.1097/01.CCM.0000203947.60552.DD Aronson D, 1997, ANN INTERN MED, V126, P296, DOI 10.7326/0003-4819-126-4-199702150-00006 Aujesky D, 2009, CIRCULATION, V119, P962, DOI 10.1161/CIRCULATIONAHA.108.824292 Aylin P, 2010, QUAL SAF HEALTH CARE, V19, P213, DOI 10.1136/qshc.2008.028639 Bajraktari G, 2008, ANN SAUDI MED, V28, P430 Becker DJ, 2007, HEALTH SERV RES, V42, P1589, DOI 10.1111/j.1475-6773.2006.00663.x Bell CM, 2001, NEW ENGL J MED, V345, P663, DOI 10.1056/NEJMsa003376 Berger A, 2008, AM J CARDIOL, V101, P422, DOI 10.1016/j.amjcard.2007.09.092 Canto JG, 2012, JAMA-J AM MED ASSOC, V307, P813, DOI 10.1001/jama.2012.199 Clarke MS, 2010, INTERN MED J, V40, P777, DOI 10.1111/j.1445-5994.2009.02067.x Di Chiara A, 2003, EUR HEART J, V24, P1616, DOI 10.1016/S0195-668X(03)00278-1 Elosua R, 2007, EUR J CARDIOV PREV R, V14, P561, DOI 10.1097/HJR.0b013e32804955b3 Freemantle N, 2012, J ROY SOC MED, V105, P74, DOI 10.1258/jrsm.2012.120009 Gourlay Steven G, 2002, Nicotine Tob Res, V4, P101, DOI 10.1080/14622200110103205 GURWITZ JH, 1994, ARCH INTERN MED, V154, P2202 Jneid H, 2008, CIRCULATION, V117, P2502, DOI 10.1161/CIRCULATIONAHA.107.752113 Juneja Deven, 2012, World J Crit Care Med, V1, P10, DOI 10.5492/wjccm.v1.i1.10 Kang SH, 2013, NICOTINE TOB RES, V15, P1230, DOI 10.1093/ntr/nts248 Kostis WJ, 2007, NEW ENGL J MED, V356, P1099, DOI 10.1056/NEJMoa063355 Kuijsten HAJM, 2010, INTENS CARE MED, V36, P1765, DOI 10.1007/s00134-010-1918-1 LaBounty T, 2006, CLIN CARDIOL, V29, P542, DOI 10.1002/clc.22 LANGER A, 1995, J AM COLL CARDIOL, V25, P610, DOI 10.1016/0735-1097(94)00459-4 Laupland KB, 2008, J CRIT CARE, V23, P317, DOI 10.1016/j.jcrc.2007.09.001 Maggs F, 2010, J ROY COLL PHYS EDIN, V40, P115, DOI 10.4997/JRCPE.2010.205 Magid DJ, 2005, JAMA-J AM MED ASSOC, V294, P803, DOI 10.1001/jama.294.7.803 Maier B, 2010, CLIN RES CARDIOL, V99, P565, DOI 10.1007/s00392-010-0158-2 Meynaar IA, 2009, CRIT CARE, V13, DOI 10.1186/cc7904 Newell MC, 2011, AM HEART J, V161, P664, DOI 10.1016/j.ahj.2010.12.018 Peberdy MA, 2008, JAMA-J AM MED ASSOC, V299, P785, DOI 10.1001/jama.299.7.785 Pehnec Z, 2009, SIGNA VITAE, V4, P14, DOI 10.22514/SV41.042009.3 Salarifar M, 2009, IRAN J PUBLIC HEALTH, V38, P97 Sanguanwong Sopon, 2007, Journal of the Medical Association of Thailand, V90, P91 Sayer JW, 1998, J AM COLL CARDIOL, V32, P1962, DOI 10.1016/S0735-1097(98)00481-1 Schilling PL, 2010, MED CARE, V48, P224, DOI 10.1097/MLR.0b013e3181c162c0 Shabbir Muhammad, 2008, J Ayub Med Coll Abbottabad, V20, P14 Shiraki T, 2011, ACTA MED OKAYAMA, V65, P307 STONE PH, 1989, J AM COLL CARDIOL, V14, P49, DOI 10.1016/0735-1097(89)90053-3 Strike PC, 2003, CLIN CARDIOL, V26, P495, DOI 10.1002/clc.4960261103 Takada JY, 2012, ARQ BRAS CARDIOL, V98, P104, DOI 10.1590/S0066-782X2012005000005 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] TOFLER GH, 1987, NEW ENGL J MED, V316, P1514, DOI 10.1056/NEJM198706113162405 Trappolini M, 1996, Minerva Cardioangiol, V44, P609 Yang SC, 2010, ACTA CARDIOL SIN, V26, P81 ZARICH SW, 1989, AM HEART J, V118, P1000, DOI 10.1016/0002-8703(89)90236-6 Zia S., 2004, JPMA Journal of the Pakistan Medical Association, V54, P73 NR 50 TC 3 Z9 3 U1 0 U2 2 PU WOLTERS KLUWER MEDKNOW PUBLICATIONS PI MUMBAI PA WOLTERS KLUWER INDIA PVT LTD , A-202, 2ND FLR, QUBE, C T S NO 1498A-2 VILLAGE MAROL, ANDHERI EAST, MUMBAI, Maharashtra, INDIA SN 1119-3077 J9 NIGER J CLIN PRACT JI Niger. J. Clin. Pract. PD SEP-OCT PY 2014 VL 17 IS 5 BP 579 EP 584 DI 10.4103/1119-3077.141422 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AQ6MB UT WOS:000342925700008 PM 25244267 DA 2023-05-13 ER PT J AU Suh, D Keller, DI Hof, D von Eckardstein, A Gawinecka, J AF Suh, Durie Keller, Dagmar I. Hof, Danielle von Eckardstein, Arnold Gawinecka, Joanna TI Rule-out of non-ST elevation myocardial infarction by five point of care cardiac troponin assays according to the 0 h/3 h algorithm of the European Society of Cardiology SO CLINICAL CHEMISTRY AND LABORATORY MEDICINE LA English DT Article DE acute myocardial infarction; point of care (POC) troponin ID HIGH-SENSITIVITY TROPONIN; PERFORMANCE; DEFINITION; DIAGNOSIS; COLLEGE; MARKERS; TIME AB Background: Point of care (POC) assays for cardiac troponins I or T (cTnI or cTnT) may accelerate the diagnosis of patients with suspected acute coronary syndrome (ACS). However, their clinical utility according to the 0 h/3 h algorithm recommended by the European Society of Cardiology (ESC) for non-ST elevation myocardial infarction (NSTEMI) is unknown. Methods: Blood samples from 90 patients with suspected ACS were obtained at hospital admission and 3 h later. Concentrations of cTn were determined using five POC assays (AQT90 FLEX cTnI and cTnT; PATHFAST (TM) cTnI; Stratus CS 200 cTnI; and Triage MeterPro cTnI) and two guideline-acceptable high-sensitivity (hs) immunoassays. Results: For the diagnosis of NSTEMI (n = 15), AUCs for Abbott hs-cTnI and Roche hs-cTnT were 0.86 [95% confidence interval (CI), 0.75-0.96] and 0.88 (95% CI, 0.80-0.95), respectively, at admission, and 0.96 and 0.94, respectively, 3 h later. With the 99th percentile cutoff, their sensitivities were 62% and 92%, respectively, at admission, and 77% and 100%, respectively, 3 h later. The PATHFAST (TM) cTnI assay showed AUCs of 0.90 (95% CI, 0.82-0.97) and 0.94 (95% CI, 0.89-1.00), respectively, and sensitivities of 67% and 75% at admission and 3 h later, respectively. The other cTn POC assays had AUCs of 0.71 (95% CI, 0.53-0.89) to 0.84 (95% CI, 0.71-0.96) and 0.86 (95% CI, 0.72-0.99) to 0.87 (95% CI, 0.75-0.99) and sensitivities of 39%-50% and 62%-77% at admission and 3 h later, respectively. Conclusions: PATHFAST (TM) cTnI assay proved itself as comparable to ESC-guideline acceptable hs-cTn assays. The lower sensitivity of the other POC assays limits their clinical utility and would require longer follow-up monitoring of patients for the safe NSTEMI rule-out. C1 [Suh, Durie; von Eckardstein, Arnold; Gawinecka, Joanna] Univ Zurich, Univ Hosp Zurich, Inst Clin Chem, Raemistr 100, CH-8091 Zurich, Switzerland. [Keller, Dagmar I.] Univ Hosp Zurich, Emergency Dept, Zurich, Switzerland. [Hof, Danielle] Unilabs, Dubendorf, Switzerland. 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PD APR PY 2018 VL 56 IS 4 BP 649 EP 657 DI 10.1515/cclm-2017-0486 PG 9 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA FY2PI UT WOS:000426657400024 PM 29257750 OA Green Accepted DA 2023-05-13 ER PT J AU Qu, YY Zhang, XG Ju, CW Su, YM Zhang, R Zuo, WJ Ji, ZJ Chen, LJ Ma, GS AF Qu, Yang-Yang Zhang, Xiao-Guo Ju, Cheng-Wei Su, Ya-Min Zhang, Rui Zuo, Wen-Jie Ji, Zhen-Jun Chen, Li-Juan Ma, Gen-Shan CA CCC ACS Investigators TI Age-Related Utilization of Thrombus Aspiration in Patients With ST-Segment Elevation Myocardial Infarction: Findings From the Improving Care for Cardiovascular Disease in China Project SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Article DE thrombus aspiration; primary percutaneous coronary intervention; ST-segment elevation myocardial infarction; age; adverse cardiac events; stroke ID PERCUTANEOUS CORONARY INTERVENTION; 1-YEAR FOLLOW-UP; TASK-FORCE; OUTCOMES; MANAGEMENT; BURDEN; TRIAL AB BackgroundThere are some controversies on the utilization and benefits of thrombus aspiration in patients with ST-segment elevation myocardial infarction (STEMI). However, a few studies investigated this issue and the age-associated effects among the large population in China. Hence, we aimed to figure out the age-associated utilization and in-hospital outcomes of thrombus aspiration to improve therapeutic decisions in clinical routine. MethodsWe retrospectively recruited 13,655 eligible STEMI patients from the database of the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project. These subjects were allocated into primary percutaneous coronary intervention (PPCI)-only group and thrombus aspiration group after being subdivided into three age groups (G(21-50), G(51-75), and G(76-95)). After 1:1 propensity score matching for PPCI-only and thrombus aspiration groups, a total of 8,815 matched patients were enrolled for the subsequent analysis. The primary outcome was in-hospital cardiovascular death, and the key safety outcome was in-hospital stroke. ResultsWe observed that the ratio of STEMI patients undergoing thrombus aspiration to PPCI-only reduced with aging. For patients <= 75 years, the culprit lesion suffered from thrombus aspiration was mainly located in the left anterior descending branch, and left-ventricular ejection fraction (LVEF) was lower (G(21-50): 54.9 +/- 8.9 vs. 56.0 +/- 8.7%, P = 0.01; G(51-75): 53.9 +/- 9.6 vs. 54.8 +/- 9.0%, P = 0.001) and the rate of regional wall motion abnormality was higher (G(21-50): 75.7 vs. 66.5%, P < 0.001; G(51-75): 75.4 vs. 69.1%, P < 0.001) in the thrombus aspiration group. By contrast, for patients > 75 years, the right coronary artery was the predominant culprit lesion undergoing thrombus aspiration, LVEF (63.1 +/- 10.5 vs. 53.1 +/- 9.5%, P = 0.985) and the regional wall motion abnormality (79.2 vs. 74.2%, P = 0.089) were comparable between the two treatment groups. Thrombus aspiration neither reduced the in-hospital risk of cardiovascular death, all-cause death, recurrent myocardial infarction, acute stent thrombosis, heart failure, cardiogenic shock, and sudden cardiac arrest nor increased stroke risk compared with the PPCI-only group. However, after adjustment for age, thrombus aspiration presented the tendency to reduce the incidence of sudden cardiac arrest (4.9 vs. 2.5%, P = 0.06) and in-hospital cardiovascular death at 3 days (hazard ratio 0.46; 95% CI, 0.20-1.06; log-rank P = 0.08) in G(76-95) group and tended to increase the incidence of heart failure in G(51-75) (5.7 vs. 6.9%, P = 0.07). ConclusionThe thrombus aspiration neither significantly reduced the in-hospital incidence of major adverse cardiac events nor increased stroke risk. However, it might play a protective role in reducing in-hospital sudden cardiac arrest and increasing survival from cardiovascular death at 3 days for the elderly. C1 [Qu, Yang-Yang; Zhang, Xiao-Guo; Ju, Cheng-Wei; Su, Ya-Min; Zhang, Rui; Zuo, Wen-Jie; Ji, Zhen-Jun; Chen, Li-Juan; Ma, Gen-Shan; CCC ACS Investigators] Southeast Univ, Sch Med, Zhongda Hosp, Dept Cardiol, Nanjing, Peoples R China. C3 Southeast University - China RP Chen, LJ; Ma, GS (通讯作者)，Southeast Univ, Sch Med, Zhongda Hosp, Dept Cardiol, Nanjing, Peoples R China. EM chenlijuan@seu.edu.cn; magenshan@hotmail.com RI zuo, wenjie/GYD-5889-2022; chen, lijuan/HSE-1019-2023 CR Ahmed TAN, 2012, EUROINTERVENTION, V7, P1396, DOI 10.4244/EIJV7I12A219 Anderson JL, 2017, NEW ENGL J MED, V376, P2053, DOI 10.1056/NEJMra1606915 Angeras O, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.007680 China Society of Cardiology of Chinese Medical Association, 2010, Zhonghua Xin Xue Guan Bing Za Zhi, V38, P675 Chinese Society of Cardiology of Chinese Medical Association, 2012, Zhonghua Xin Xue Guan Bing Za Zhi, V40, P353 Epstein SE, 2012, CIRCULATION, V125, P3211, DOI 10.1161/CIRCULATIONAHA.111.079038 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 Gao L, 2014, CLIN INTERV AGING, V9, P1241, DOI 10.2147/CIA.S62642 Ge JH, 2019, CATHETER CARDIO INTE, V93, pE269, DOI 10.1002/ccd.27944 Hao YC, 2019, CIRCULATION, V139, P1776, DOI 10.1161/CIRCULATIONAHA.118.037655 Hao YC, 2016, AM HEART J, V179, P107, DOI 10.1016/j.ahj.2016.06.005 Ibanez B, 2018, EUR HEART J, V39, P119, DOI 10.1093/eurheartj/ehx393 Jolly SS, 2015, NEW ENGL J MED, V372, P1389, DOI 10.1056/NEJMoa1415098 Jolly SS, 2018, J AM COLL CARDIOL, V72, P1589, DOI 10.1016/j.jacc.2018.07.047 Jolly SS, 2016, LANCET, V387, P127, DOI 10.1016/S0140-6736(15)00448-1 Jolly SS, 2014, AM HEART J, V167, P315, DOI 10.1016/j.ahj.2013.12.002 Lagerqvist B, 2014, NEW ENGL J MED, V371, P1111, DOI 10.1056/NEJMoa1405707 Mahmoud KD, 2016, NAT REV CARDIOL, V13, P418, DOI 10.1038/nrcardio.2016.38 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] Puricel S, 2013, SWISS MED WKLY, V143, DOI 10.4414/smw.2013.13816 Rehman I., 2019, ANATOMY THORAX HEART Svilaas T, 2006, AM HEART J, V151, DOI 10.1016/j.ahj.2005.11.010 Svilaas T, 2008, NEW ENGL J MED, V358, P557, DOI 10.1056/NEJMoa0706416 Tong JL, 2016, J GERIATR CARDIOL, V13, P830, DOI 10.11909/j.issn.1671-5411.2016.10.001 Vlaar PJ, 2008, LANCET, V371, P1915, DOI 10.1016/S0140-6736(08)60833-8 NR 26 TC 0 Z9 0 U1 2 U2 3 PU FRONTIERS MEDIA SA PI LAUSANNE PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND SN 2297-055X J9 FRONT CARDIOVASC MED JI Front. Cardiovasc. Med. PD FEB 21 PY 2022 VL 9 AR 791007 DI 10.3389/fcvm.2022.791007 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZP3LI UT WOS:000766326300001 PM 35265677 OA Green Published, gold DA 2023-05-13 ER PT J AU Wang, JJ Dietrich, MS Bell, SP Maxwell, CA Simmons, SF Kripalani, S AF Wang, Jinjiao Dietrich, Mary S. Bell, Susan P. Maxwell, Cathy A. Simmons, Sandra F. Kripalani, Sunil CA VICS TI Changes in vulnerability among older patients with cardiovascular disease in the first 90 days after hospital discharge: A secondary analysis of a cohort study SO BMJ OPEN LA English DT Article ID COMPREHENSIVE GERIATRIC ASSESSMENT; HOME HEALTH-CARE; FUNCTIONAL DECLINE; HEART-FAILURE; FRAILTY TRANSITIONS; ELDERS SURVEY; ADULTS; DISABILITY; PEOPLE; READMISSION AB Objectives (1) To compare changes in vulnerability after hospital discharge among older patients with cardiovascular disease who were discharged home with self-care versus a home healthcare (HHC) referral and (2) to examine factors associated with changes in vulnerability in this period. Design Secondary analysis of longitudinal data from a cohort study. Participants and setting 834 older (>= 65 years) patients hospitalised for acute coronary syndromes and/or acute decompensated heart failure who were discharged home with self-care (n=713) or an HHC referral (n=121). Outcome Vulnerability was measured using Vulnerable Elders Survey 13 (VES-13) at baseline (prior to hospital admission) and 30 days and/or 90 days after hospital discharge. Effects of HHC referral on postdischarge change in vulnerability were examined using three linear regression approaches, with potential confounding on HHC referral adjusted by propensity score matching. Results Overall, 44.4% of the participants were vulnerable at prehospitalisation baseline and 34.4% were vulnerable at 90 days after hospital discharge. Compared with self-care patients, HHC-referred patients were more vulnerable at baseline (66.9% vs 40.3%), had more increase (worsening) in VES-13 score change (B=-1.34(-2.07, -0.61), p<0.001) in the initial 30 days and more decrease (improvement) in VES-13 score change (B=0.83(0.20, 1.45), p=0.01) from 30 to 90 days after hospital discharge. Baseline vulnerability and the HHC referral attributed to 14%-16% of the variance in vulnerability change during the 90 postdischarge days, and 6% was attributed by patient age, race (African-American), depressive symptoms, and outpatient visits and hospitalisations in the past year. Conclusion After adjusting for preceding vulnerability and covariates, older hospitalised patients with cardiovascular disease referred to HHC had delayed recovery in vulnerability in first initial 30 days after hospital discharge and greater improvement in vulnerability from 30 to 90 days after hospital discharge. HHC seemed to facilitate improvement in vulnerability among older patients with cardiovascular disease from 30 to 90 days after hospital discharge. C1 [Wang, Jinjiao] Univ Rochester, Med Ctr, Sch Nursing, Rochester, NY 14642 USA. [Dietrich, Mary S.; Maxwell, Cathy A.] Vanderbilt Univ, Sch Nursing, Nashville, TN 37240 USA. [Dietrich, Mary S.] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USA. [Dietrich, Mary S.] Vanderbilt Univ, Med Ctr, Dept Psychiat, Nashville, TN USA. [Bell, Susan P.; Simmons, Sandra F.] Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN USA. [Bell, Susan P.; Simmons, Sandra F.] Vanderbilt Univ, Med Ctr, Ctr Qual Aging, Nashville, TN USA. [Simmons, Sandra F.] VA Tennessee Valley Healthcare Syst, GRECC, Nashville, TN USA. [Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Ctr Clin Qual & Implementat Res, Nashville, TN USA. C3 University of Rochester; 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; Vanderbilt University RP Wang, JJ (通讯作者)，Univ Rochester, Med Ctr, Sch Nursing, Rochester, NY 14642 USA. EM jinjiao_wang@urmc.rochester.edu OI Wang, Jinjiao/0000-0002-5629-8497 FU National Institute of Health, National Heart, Lung, and Blood Institute [R01 HL109388-06]; National Institute on Aging [K23 AG048347-03]; Vanderbilt University School of Nursing Post-Doctoral Fund; National Center for Advancing Translational Sciences [2 UL1 TR000445-06] FX This work was supported by the National Institute of Health, National Heart, Lung, and Blood Institute (R01 HL109388-06) to SK; National Institute on Aging (K23 AG048347-03) to SPB; the Vanderbilt University School of Nursing Post-Doctoral Fund to JW, and in part by grant 2 UL1 TR000445-06 from the National Center for Advancing Translational Sciences. 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Social Science Citation Index (SSCI) SC General & Internal Medicine GA IC6XU UT WOS:000471116800203 PM 30700484 OA Green Published, gold DA 2023-05-13 ER PT J AU Okazaki, H Shirakabe, A Hata, N Kobayashi, N Matsushita, M Shibata, Y Nishigoori, S Uchiyama, S Kiuchi, K Asai, K Shimizu, W AF Okazaki, Hirotake Shirakabe, Akihiro Hata, Noritake Kobayashi, Nobuaki Matsushita, Masato Shibata, Yusaku Nishigoori, Suguru Uchiyama, Saori Kiuchi, Kazutaka Asai, Kuniya Shimizu, Wataru TI Prognostic benefit of acute heart failure associated with atherosclerosis: the importance of prehospital medication in patients with severely decompensated acute heart failure SO HEART AND VESSELS LA English DT Article DE Acute heart failure syndrome; Atherosclerosis; Pre-hospital medication ID ACUTE MYOCARDIAL-INFARCTION; HIGH-RISK; CARDIOVASCULAR EVENTS; BLOOD-PRESSURE; MORTALITY; CAPTOPRIL; HYPERTENSION; MANAGEMENT; LOSARTAN; SURVIVAL AB Atherosclerotic diseases sometimes contribute to acute heart failure (AHF). The aim of the present study is to elucidate the prognostic impact of AHF with atherosclerosis. A total of 1226 AHF patients admitted to the intensive care unit were analyzed. AHF associated with atherosclerosis was defined by the etiology: atherosclerosis-AHF group (n=708) (patients whose etiologies were ischemic heart disease or hypertensive heart disease) or AHF not associated with atherosclerosis (non-atherosclerosis-AHF) group (n=518). Kaplan-Meier curves showed that the survival rate of the atherosclerosis-AHF group was significantly better than that of the non-atherosclerosis-AHF group within 730days of follow-up. Regarding pre-hospital medications, atherosclerosis-AHF patients were more likely to be administered nitroglycerin (20.3 vs. 13.7%, p=0.003), nicorandil (18.8 vs. 7.5%, p<0.001), angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) (46.5 vs. 38.6%, p=0.006), -blocker (33.2 vs. 26.6%, p=0.014) and statin (30.1 vs. 22.4%, p=0.003) because of a previous coronary event or atherosclerotic diseases. In sub-group analysis of medication including administered3 drugs within 5 medications and ACE-I/ARB, atherosclerosis-AHF significantly decreased the rate of all-cause death within 180days (hazard ratio (HR) 0.215, 95% CI 0.078-0.593 and HR 0.395, 95% CI 0.244-0.641, respectively) with a significant interaction (p value for interaction 0.022 and 0.005, respectively). Kaplan-Meier curves showed that the 180-days survival rate of the atherosclerosis-AHF group with ACE-I/ARB and3 drugs were significantly better than other groups. The AHF patients associated with atherosclerosis lead to be a good long-term outcome. A relationship may exist between efficient treatment including ACE-Is before admission and a good outcome in mid-term. C1 [Okazaki, Hirotake; Shirakabe, Akihiro; Hata, Noritake; Kobayashi, Nobuaki; Matsushita, Masato; Shibata, Yusaku; Nishigoori, Suguru; Uchiyama, Saori; Kiuchi, Kazutaka] Chiba Hokusoh Hosp, Nippon Med Sch, Div Intens Care Unit, 1715 Kamagari, Inzai, Chiba 2701694, Japan. [Asai, Kuniya; Shimizu, Wataru] Nippon Med Sch, Dept Cardiovasc Med, Tokyo, 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, Inzai, Chiba 2701694, Japan. EM s6042@nms.ac.jp RI Kobayashi, Nobuaki/J-4222-2019; Shimizu, Wataru/IAM-9119-2023 OI Kobayashi, Nobuaki/0000-0001-6757-4779; Shimizu, Wataru/0000-0001-9941-8973 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] Dickstein K, 2002, LANCET, V360, P752, DOI 10.1016/S0140-6736(02)09895-1 Gattis WA, 2004, J AM COLL CARDIOL, V43, P1534, DOI 10.1016/j.jacc.2003.12.040 Gheorghiade M, 2005, CIRCULATION, V112, P3958, DOI 10.1161/CIRCULATIONAHA.105.590091 Gheorghiade M, 2006, JAMA-J AM MED ASSOC, V296, P2217, DOI 10.1001/jama.296.18.2217 Granger CB, 2003, LANCET, V362, P772, DOI 10.1016/S0140-6736(03)14284-5 Jacobs L, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.116.005231 Jamerson K, 2008, NEW ENGL J MED, V359, P2417, DOI 10.1056/NEJMoa0806182 Mebazaa Alexandre, 2008, Crit Care Med, V36, pS129, DOI 10.1097/01.CCM.0000296274.51933.4C Mozaffarian D, 2016, CIRCULATION, V133, pE38, DOI 10.1161/CIR.0000000000000350 Nieminen MS, 2005, AM J CARDIOL, V96, p5G, DOI 10.1016/j.amjcard.2005.07.015 Nissen SE, 2004, JAMA-J AM MED ASSOC, V292, P2217, DOI 10.1001/jama.292.18.2217 O'Gara PT, 2013, J AM COLL CARDIOL, V61, P485, DOI [10.1016/j.jacc.2012.11.018, 10.1161/CIR.0b013e3182742c84] Okazaki H, 2017, HEART VESSELS, V32, P436, DOI 10.1007/s00380-016-0893-z Pfeffer MA, 2003, NEW ENGL J MED, V349, P1893, DOI 10.1056/NEJMoa032292 Pitt B, 2000, LANCET, V355, P1582, DOI 10.1016/S0140-6736(00)02213-3 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Sato N, 2013, CIRC J, V77, P944, DOI 10.1253/circj.CJ-13-0187 Shimamoto K, 2014, HYPERTENS RES, V37, P69, DOI 10.1038/hr.2013.80 Shirakabe A, 2012, J CARDIOL, V59, P374, DOI 10.1016/j.jjcc.2012.01.009 SWEDBERG K, 1988, AM J CARDIOL, V62, pA60, DOI 10.1016/S0002-9149(88)80087-0 Yasue H, 2004, AM J CARDIOL, V93, P969, DOI 10.1016/j.amjcard.2004.01.006 Yusuf S, 2008, NEW ENGL J MED, V358, P1547, DOI 10.1056/NEJMoa0801317 NR 23 TC 0 Z9 0 U1 0 U2 1 PU SPRINGER PI NEW YORK PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES SN 0910-8327 EI 1615-2573 J9 HEART VESSELS JI Heart Vessels PD DEC PY 2018 VL 33 IS 12 BP 1496 EP 1504 DI 10.1007/s00380-018-1204-7 PG 9 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HD1IQ UT WOS:000452263900009 PM 29943232 DA 2023-05-13 ER PT J AU Probst, S Cech, C Haentschel, D Scholz, M Ender, J AF Probst, Stefan Cech, Christof Haentschel, Dirk Scholz, Markus Ender, Joerg TI A specialized post-anaesthetic care unit improves fast-track management in cardiac surgery: a prospective randomized trial SO CRITICAL CARE LA English DT Article ID ARTERY-BYPASS GRAFT; LENGTH-OF-STAY; EARLY TRACHEAL EXTUBATION; RESOURCE UTILIZATION; RISK-FACTORS; EFFICACY; REMIFENTANIL; OPTIMIZATION; PROTOCOL; IMPACT AB Introduction: Fast-track treatment in cardiac surgery has become the global standard of care. We compared the efficacy and safety of a specialised post-anaesthetic care unit (PACU) to a conventional intensive care unit (ICU) in achieving defined fast-track end points in adult patients after elective cardiac surgery. Methods: In a prospective, single-blinded, randomized study, 200 adult patients undergoing elective cardiac surgery (coronary artery bypass graft (CABG), valve surgery or combined CABG and valve surgery), were selected to receive their postoperative treatment either in the ICU (n = 100), or in the PACU (n = 100). Patients who, at the time of surgery, were in cardiogenic shock, required renal dialysis, or had an additive EuroSCORE of more than 10 were excluded from the study. The primary end points were: time to extubation (ET), and length of stay in the PACU or ICU (PACU/ICU LOS respectively). Secondary end points analysed were the incidences of: surgical re-exploration, development of haemothorax, new-onset cardiac arrhythmia, low cardiac output syndrome, need for cardiopulmonary resuscitation, stroke, acute renal failure, and death. Results: Median time to extubation was 90 [50; 140] min in the PACU vs. 478 [305; 643] min in the ICU group (P <0.001). Median length of stay in the PACU was 3.3 [2.7; 4.0] hours vs. 17.9 [10.3; 24.9] hours in the ICU (P <0.001). Of the adverse events examined, only the incidence of new-onset cardiac arrhythmia (25 in PACU vs. 41 in ICU, P = 0.02) was statistically different between groups. Conclusions: Treatment in a specialised PACU rather than an ICU, after elective cardiac surgery leads to earlier extubation and quicker discharge to a step-down unit, without compromising patient safety. C1 [Probst, Stefan; Cech, Christof; Ender, Joerg] Univ Leipzig, Dept Anaesthesiol & Intens Care Med 2, Leipzig Heart Ctr, D-04289 Leipzig, Germany. [Cech, Christof] Univ Leipzig, Fac Med, Dept Anaesthesiol & Intens Care Med, D-04103 Leipzig, Germany. [Haentschel, Dirk] Heart Ctr Coswig, Dept Anaesthesiol & Intens Care Med, D-06869 Coswig, Germany. [Scholz, Markus] Univ Leipzig, Inst Med Informat Stat & Epidemiol, D-04107 Leipzig, Germany. C3 Heart Center Leipzig GMBH; Leipzig University; Leipzig University; Leipzig University RP Probst, S (通讯作者)，Univ Leipzig, Dept Anaesthesiol & Intens Care Med 2, Leipzig Heart Ctr, Struempellstr 39, D-04289 Leipzig, Germany. EM stefan.probst@web.de OI Ender, Joerg/0000-0002-8507-5321 FU Ethics Committee, Medical Faculty, University of Leipzig, Haertelstrasse [16-18, 04107, 097-2008] FX The study was funded entirely by the host institution. Approved by: Ethics Committee, Medical Faculty, University of Leipzig, Haertelstrasse 16-18, 04107 Leipzig, Reference number 097-2008. CR Akhtar Mohammad Irfan, 2009, J Pak Med Assoc, V59, P154 Carl M, 2010, GMS GER MED SCI, V8, P1 Chamchad D, 2010, J CARDIOTHOR VASC AN, V24, P780, DOI 10.1053/j.jvca.2010.04.002 Cheng DCH, 1996, J THORAC CARDIOV SUR, V112, P755, DOI 10.1016/S0022-5223(96)70062-4 Cheng DCH, 1996, ANESTHESIOLOGY, V85, P1300, DOI 10.1097/00000542-199612000-00011 Cheng DCH, 2001, ANESTH ANALG, V92, P1094 Constantinides VA, 2006, CRIT CARE MED, V34, P2877, DOI 10.1097/01.CCM.0000248724.02907.1B Ender J, 2008, ANESTHESIOLOGY, V109, P61, DOI 10.1097/ALN.0b013e31817881b3 Flynn M, 2004, EUR J CARDIO-THORAC, V25, P116, DOI 10.1016/S1010-7940(03)00608-0 Gooch RA, 2014, JAMA-J AM MED ASSOC, V311, P567, DOI 10.1001/jama.2013.283800 Gooi Julian, 2007, Asian Cardiovasc Thorac Ann, V15, P139 Hantschel D, 2009, ANAESTHESIST, V58, P379, DOI 10.1007/s00101-009-1508-1 Kapoor PM, 2008, ANN CARD ANAESTH, V11, P27, DOI 10.4103/0971-9784.38446 Kumar K, 2009, ANN THORAC SURG, V88, P1153, DOI 10.1016/j.athoracsur.2009.04.070 Lassnigg A, 2002, INTENS CARE MED, V28, P1453, DOI 10.1007/s00134-002-1445-9 Lee TWR, 2003, ANESTHESIOLOGY, V98, P499, DOI 10.1097/00000542-200302000-00032 Lison S, 2007, J CARDIOTHOR VASC AN, V21, P35, DOI 10.1053/j.jvca.2006.03.011 McKendry M, 2004, BMJ-BRIT MED J, V329, P258, DOI 10.1136/bmj.38156.767118.7C Montes FR, 2000, ANESTH ANALG, V91, P776, DOI 10.1097/00000539-200010000-00003 Moon MC, 2001, J CARDIAC SURG, V16, P319, DOI 10.1111/j.1540-8191.2001.tb00528.x Nicholson DJ, 2002, J CARDIOTHOR VASC AN, V16, P27, DOI 10.1053/jcan.2002.29648 Rivers EP, 2007, CRIT CARE MED, V35, P2016, DOI 10.1097/01.CCM.0000281637.08984.6E Silbert BS, 2009, ANESTH ANALG, V108, P689, DOI 10.1213/ane.0b013e318193c439 Straka Z, 2002, ANN THORAC SURG, V74, P1544, DOI 10.1016/S0003-4975(02)03934-6 Svircevic V, 2009, ANESTH ANALG, V108, P727, DOI 10.1213/ane.0b013e318193c423 Tempe DK, 2006, J CARDIOTHOR VASC AN, V20, P128, DOI 10.1053/j.jvca.2005.05.018 Toraman F, 2010, HEART SURG FORUM, V13, pE212, DOI 10.1532/HSF98.20101009 van Mastrigt GAPG, 2006, CRIT CARE MED, V34, P1624, DOI 10.1097/01.CCM.0000217963.87227.7B Wong DT, 1999, ANESTHESIOLOGY, V91, P936, DOI 10.1097/00000542-199910000-00012 Wunsch H, 2011, AM J RESP CRIT CARE, V183, P1666, DOI 10.1164/rccm.201012-1961OC Zarbock A, 2009, CHEST, V135, P1252, DOI 10.1378/chest.08-1602 Zhu F, 2012, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD003587.pub2 NR 32 TC 36 Z9 38 U1 0 U2 9 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1466-609X EI 1364-8535 J9 CRIT CARE JI Crit. Care PY 2014 VL 18 IS 4 AR 468 DI 10.1186/s13054-014-0468-2 PG 11 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CA4MJ UT WOS:000348878200057 PM 25123092 OA gold, Green Published DA 2023-05-13 ER PT J AU Smolderen, KG Buchanan, DM Gosch, K Whooley, M Chan, PS Vaccarino, V Parashar, S Shah, AJ Ho, PM Spertus, JA AF Smolderen, Kim G. Buchanan, Donna M. Gosch, Kensey Whooley, Mary Chan, Paul S. Vaccarino, Viola Parashar, Susmita Shah, Amit J. Ho, P. Michael Spertus, John A. TI Depression Treatment and 1-Year Mortality After Acute Myocardial Infarction Insights From the TRIUMPH Registry (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status) SO CIRCULATION LA English DT Article DE depression; mortality; myocardial infarction; survival ID ACUTE CORONARY SYNDROME; HEART-DISEASE; MAJOR DEPRESSION; SYMPTOMS; RECOMMENDATIONS; ASSOCIATION; EFFICACY; EVENTS; CARE; IMPLEMENTATION AB BACKGROUND: Depression among patients with acute myocardial infarction (AMI) is prevalent and associated with an adverse quality of life and prognosis. Despite recommendations from some national organizations to screen for depression, it is unclear whether treatment of depression in patients with AMI is associated with better outcomes. We aimed to determine whether the prognosis of patients with treated versus untreated depression differs. METHODS: The TRIUMPH study (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status) is an observational multicenter cohort study that enrolled 4062 patients aged >= 18 years with AMI between April 11, 2005, and December 31, 2008, from 24 US hospitals. Research coordinators administered the Patient Health Questionnaire-9 (PHQ-9) during the index AMI admission. Depression was defined by a PHQ-9 score of >= 10. Depression was categorized as treated if there was documentation of a discharge diagnosis, medication prescribed for depression, or referral for counseling, and as untreated if none of these 3 criteria was documented in the medical records despite a PHQ score >= 10. One-year mortality was compared between patients with AMI having: (1) no depression (PHQ-9<10; reference); (2) treated depression; and (3) untreated depression adjusting for demographics, AMI severity, and clinical factors. RESULTS: Overall, 759 (18.7%) patients met PHQ-9 criteria for depression and 231 (30.4%) were treated. In comparison with 3303 patients without depression, the 231 patients with treated depression had 1-year mortality rates that were not different (6.1% versus 6.7%; adjusted hazard ratio, 1.12; 95% confidence interval, 0.63-1.99). In contrast, the 528 patients with untreated depression had higher 1-year mortality in comparison with patients without depression (10.8% versus 6.1%; adjusted hazard ratio, 1.91; 95% confidence interval, 1.39-2.62). CONCLUSIONS: Although depression in patients with AMI is associated with increased long-term mortality, this association may be confined to patients with untreated depression. C1 [Smolderen, Kim G.; Buchanan, Donna M.; Gosch, Kensey; Chan, Paul S.; Spertus, John A.] St Lukes Mid Amer Heart Inst, Kansas City, MO USA. [Smolderen, Kim G.; Buchanan, Donna M.; Chan, Paul S.; Spertus, John A.] Univ Missouri, Kansas City, MO 64110 USA. [Whooley, Mary] Univ Calif San Francisco, Med Ctr, Dept Vet Affairs, San Francisco, CA USA. [Vaccarino, Viola; Shah, Amit J.] Emory Univ, Dept Epidemiol, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. [Vaccarino, Viola; Shah, Amit J.] Emory Univ, Sch Med, Div Cardiol, Dept Med, Atlanta, GA 30322 USA. [Shah, Amit J.] Atlanta Vet Affairs Med Ctr, Decatur, GA USA. [Ho, P. Michael] Denver Vet Affairs Med Ctr, Denver, CO USA. C3 Saint Luke's Mid America Heart Institute; University of Missouri System; University of Missouri Kansas City; University of California System; University of California San Francisco; Emory University; Rollins School Public Health; Emory University; US Department of Veterans Affairs; Veterans Health Administration (VHA); Atlanta VA Health Care System; US Department of Veterans Affairs; Veterans Health Administration (VHA); Veterans Affairs Medical Center - Denver RP Smolderen, KG (通讯作者)，UMKC Sch Med, Biomed & Hlth Informat, Implementat Sci, 1000 E 24th St,5th Floor, Kansas City, MO 64108 USA. EM smolderenk@umkc.edu RI Parashar, Susmita/GYJ-3885-2022; Spertus, John/ABD-3075-2021; , Viola/AAW-5600-2020 OI Smolderen, Kim/0000-0001-6104-6254; Shah, Amit/0000-0001-9099-9687 FU National Heart, Lung, and Blood Institute Specialized Center of Clinically Oriented Research in Cardiac Dysfunction and Disease [P50 HL077113]; Patient Centered Outcomes Research Institute [CE-1304-6677]; National Heart Lung and Blood Institute [1R01HL123980]; National Center for Advancing Translational Sciences of the National institutes of Health [UL1TR000454, KL2TR000455]; American Heart Association [15SDG25310017] FX The TRIUMPH study was supported by grants from the National Heart, Lung, and Blood Institute Specialized Center of Clinically Oriented Research in Cardiac Dysfunction and Disease (grant P50 HL077113). Dr Smolderen is supported by the Patient Centered Outcomes Research Institute [CE-1304-6677]. Dr Chan is supported by funding from the National Heart Lung and Blood Institute (1R01HL123980). Dr Shah is supported by funding from the National Center for Advancing Translational Sciences of the National institutes of Health under Award Numbers UL1TR000454 and KL2TR000455 and the American Heart Association, 15SDG25310017. The funding organizations and sponsors of the study 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; and decision to submit the manuscript for publication. 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However, emergency overcrowding is not improved. We assessed the laboratory efficiency of emergency department (ED) in Shanghai hospitals. MethodsWe recorded the turn around times for processing laboratory biomarkers to assess laboratory efficiency at 17 EDs in national/regional hospitals. We compared TAT between national and regional hospitals and between central and ED laboratories to analyze the relationship between the laboratory efficiency and the ED overcrowding. ResultsAll the participating hospitals have an emergency laboratory. The median TAT for c-TNT was 61 min (46-76 min) at regional EDs compared with 64 min (46-87 min) at national EDs; therefore, the TAT at regional EDs were more efficient (P < 0.05). The TAT were longer (65 min (53-85 min)) at ED labs than (60 min (42-83 min)) at central labs (P < 0.05), independent of the hospital tier and working period. We discovered that only 9% of investigated samples at Tier II EDs and 5% at Tier III EDs were assayed by point-of-care (POC) instruments. ConclusionOur TAT level is approaching the recommended international standard. However, the TAT evaluation from ED laboratories demonstrates that their existence does not decrease the waiting time for laboratory reports compared to central laboratory. Thus, they have not yet approached a level to share the burden of the ED overcrowding. Further arrangement should be assigned to separate the function of emergency laboratory and central laboratory. It is worth deploying the POC assay in the ED, which will save twice the TAT level. The idea of evaluating routine laboratory efficiency by TAT at ED is fast, convenient, although it does not represent the general level of laboratory efficiency. C1 [Lu, Yiming; Leong, Waiian; Wei, Bohua; Yu, Ping; Wang, Cuicui; Ying, Yilin; Wang, Tingsong; Tong, Jianjing; Ye, Jing] Shanghai Jiao Tong Univ, Sch Med, Emergency Dept, Shanghai Ruijin Hosp, 197 Ruijin Er Rd, Shanghai, Peoples R China. [Zhu, Dingliang] Shanghai Jiao Tong Univ, Sch Med, Joint Lab Vasc Biol, Hlth Sci Ctr, Shanghai, Peoples R China. [Zhu, Dingliang] Shanghai Jiao Tong Univ, Sch Med, Shanghai Inst Hypertens, Ruijin Hosp, Shanghai, Peoples R China. C3 Shanghai Jiao Tong University; Shanghai Jiao Tong University; Shanghai Jiao Tong University RP Zhu, DL (通讯作者)，Shanghai Jiao Tong Univ, Sch Med, Emergency Dept, Shanghai Ruijin Hosp, 197 Ruijin Er Rd, Shanghai, Peoples R China. EM zhudingliang@sibs.ac.cn FU National Natural Science Foundation of China [81000875, 81171846, 81270433, 81372099]; Shanghai Foundation for Basic Research of Science and Technology, China [13JC1404001]; Foundation for Committee of Science and Technology in Shanghai [11ZR1422100]; Foundation for City Star of Science and Technology in Shanghai [11QA1404400]; National Clinical Key Subject, China; National Natural Science Foundation of China [81000875, 81171846, 81270433, 81372099]; Shanghai Foundation for Basic Research of Science and Technology, China [13JC1404001]; Foundation for Committee of Science and Technology in Shanghai [11ZR1422100]; Foundation for City Star of Science and Technology in Shanghai [11QA1404400]; National Clinical Key Subject, China FX Grant sponsor: National Natural Science Foundation of China; Grant numbers: 81000875, 81171846, 81270433, and 81372099; Grant sponsor: Shanghai Foundation for Basic Research of Science and Technology, China; Grant number: 13JC1404001; Grant sponsor: Foundation for Committee of Science and Technology in Shanghai; Grant number: 11ZR1422100; Grant sponsor: Foundation for City Star of Science and Technology in Shanghai; Grant number: 11QA1404400. National Clinical Key Subject, China. CR Apple FS, 2006, CLIN CHIM ACTA, V370, P191, DOI 10.1016/j.cca.2006.02.011 Bingisser R, 2012, AM J EMERG MED, V30, P1639, DOI 10.1016/j.ajem.2012.03.004 Caragher TE, 2002, J EMERG MED, V22, P1, DOI 10.1016/S0736-4679(01)00429-2 Chen Z, 2009, LANCET, V373, P1322, DOI 10.1016/S0140-6736(09)60753-4 Christenson RH, 2007, CLIN CHEM, V53, P545, DOI 10.1373/clinchem.2006.079749 Collinson PO, 2001, CLIN CHIM ACTA, V307, P197, DOI 10.1016/S0009-8981(01)00428-4 Gong P, 2012, LANCET, V379, P843, DOI 10.1016/S0140-6736(11)61878-3 Meng Q, 2012, LANCET, V379, P805, DOI 10.1016/S0140-6736(12)60278-5 Novis DA, 2004, ARCH PATHOL LAB MED, V128, P158 Ryan RJ, 2009, ANN EMERG MED, V53, P321, DOI 10.1016/j.annemergmed.2008.06.464 Tong JJ, 2012, AM J EMERG MED, V30, P1313, DOI 10.1016/j.ajem.2012.05.012 TSAI WW, 1994, CLIN THER, V16, P898 Yip WC, LANCET, V379, P833 NR 13 TC 3 Z9 4 U1 1 U2 8 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 2015 VL 29 IS 4 BP 334 EP 341 DI 10.1002/jcla.21775 PG 8 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA CN2KQ UT WOS:000358250300016 PM 25130759 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Alrwisan, A Eworuke, E AF Alrwisan, Adel Eworuke, Efe TI ARE DISCREPANCIES IN WAITING TIME FOR CHEST PAIN AT EMERGENCY DEPARTMENTS BETWEEN AFRICAN AMERICANS AND WHITES IMPROVING OVER TIME? SO JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE African American; disparity; emergency department; race; waiting time ID UNITED-STATES; DISPARITIES; INSURANCE; CARE AB Background: One of the Healthy People 2010 goals was to eliminate racial disparities in the U.S health system. To date, we have limited knowledge about the impact of Healthy People on racial disparities at emergency departments (EDs). Objective: We sought to investigate whether there has been an improvement in ED waiting time to see a physician for African Americans (AAs) compared to whites with chest pain symptoms that suggest acute coronary syndrome (ACS). Methods: A retrospective analysis of the National Hospital and Ambulatory Care Survey data from 2004 to 2011 was conducted in adults with visits related to ACS. We compared covariate-adjusted odds ratios for race for each study year and 2011. In addition, adjusted average differences in waiting times (i.e., time to see a physician) for AAs and whites for each study year were compared. Results: A total of 15,438 visits related to ACS symptoms were made during the study period. The waiting time for AAs (median, 33 min) was statistically longer compared to whites (median, 21 min). In addition, the adjusted waiting time for AAs was 30% longer compared to whites (95% confidence interval, 24-36%). Pairwise comparison of adjusted odds ratios between the year 2011 and other years was not significantly different (all p values = 0.32), suggesting no change in the difference in waiting times during the study period. Conclusion: Among patients presenting to the ED with symptoms suggesting ACS, AA compared to whites waited longer to receive care. In addition, this difference in waiting time persisted during the study period, even after the implementation of the Healthy People 2010 initiative. Additional research is warranted to investigate the underlying reasons for unequal care offered to AAs at EDs and the implications on disease outcome. (C) 2016 Elsevier Inc. C1 [Alrwisan, Adel] Univ Florida, Coll Pharm, Dept Pharmaceut Outcomes & Policy, POB 100496, Gainesville, FL 32610 USA. [Alrwisan, Adel] Saudi Food & Drug Author Vigilance & Crisis Manag, Riyadh, Saudi Arabia. [Eworuke, Efe] US FDA, Div Epidemiol 2, Off Pharmacovigilance & Epidemiol, Off Surveillance & Epidemiol,Ctr Drug Evaluat & R, Washington, DC 20204 USA. C3 State University System of Florida; University of Florida; US Food & Drug Administration (FDA) RP Alrwisan, A (通讯作者)，Univ Florida, Coll Pharm, Dept Pharmaceut Outcomes & Policy, POB 100496, Gainesville, FL 32610 USA. CR American Hospital Association, 2010, TRENDW CHARTB 2008 T HALVORSEN R, 1980, AM ECON REV, V70, P474 Hambrook JT, 2010, CONGENIT HEART DIS, V5, P285, DOI 10.1111/j.1747-0803.2010.00414.x Hsia RY, 1978, JAMA-J AM MED ASSOC, V2011, P305 Institute of Medicine Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, 2002, UN TREATM WHAT HEALT Institute of Medicine (US), 2012, FAR HAVE WE COME RED Jha AK, 2007, ARCH INTERN MED, V167, P1177, DOI 10.1001/archinte.167.11.1177 Karve SJ, 2011, J STROKE CEREBROVASC, V20, P30, DOI 10.1016/j.jstrokecerebrovasdis.2009.10.006 Lopez L, 2010, ACAD EMERG MED, V17, P801, DOI 10.1111/j.1553-2712.2010.00823.x Mannix R, 2012, ACAD EMERG MED, V19, P808, DOI 10.1111/j.1553-2712.2012.01394.x McCaig L. F, PLANT OPERATION NA 1 Napoli Anthony M, 2013, Crit Pathw Cardiol, V12, P9, DOI 10.1097/HPC.0b013e31827c9a86 National Center for Health Statistics, 2012, STATUS TURTLES QATAR Pallin DJ, 2008, INT J EMERG MED, V1, P97, DOI 10.1007/s12245-008-0024-4 Park CY, 2009, HEALTH SERV RES, V44, P2022, DOI 10.1111/j.1475-6773.2009.01020.x Pines JM, 2009, ACAD EMERG MED, V16, P617, DOI 10.1111/j.1553-2712.2009.00456.x Smedley B. D., 2003, UNEQUAL TREATMENT CO, P782 Smolderen KG, 2013, J AM COLL CARDIOL, V61, P1069, DOI 10.1016/j.jacc.2012.11.058 Sondik E, 2006, PROGR REV FOCUS AREA Sonnenfeld N, 2012, MED CARE, V50, P335, DOI 10.1097/MLR.0b013e318245a53c Tamayo-Sarver JH, 2003, AM J PUBLIC HEALTH, V93, P2067, DOI 10.2105/AJPH.93.12.2067 NR 21 TC 17 Z9 17 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0736-4679 EI 1090-1280 J9 J EMERG MED JI J. Emerg. Med. PD FEB PY 2016 VL 50 IS 2 BP 349 EP 354 DI 10.1016/j.jemermed.2015.07.033 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Emergency Medicine GA DI2BB UT WOS:000373299600041 PM 26371975 DA 2023-05-13 ER PT J AU Howard, I Cameron, P Wallis, L Castren, M Lindstrom, V AF Howard, Ian Cameron, Peter Wallis, Lee Castren, Maaret Lindstrom, Veronica TI Identifying quality indicators for prehospital emergency care services in the low to middle income setting: The South African perspective SO AFRICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Emergency medical service; Quality indicators; Patient safety; South Africa ID DELPHI TECHNIQUE; HEALTH-CARE; GUIDELINES; MANAGEMENT; COUNTRIES; MORTALITY; PATIENT; BURDEN AB Introduction: Historically, performance within the Prehospital Emergency Care (PEC) setting has been assessed primarily based on response times. While easy to measure and valued by the public, overall, response time targets are a poor predictor of quality of care and clinical outcomes. Over the last two decades however, significant progress has been made towards improving the assessment of PEC performance, largely in the form of the development of PEC-specific quality indicators (QIs). Despite this progress, there has been little to no development of similar systems within the low- to middle-income country setting. As a result, the aim of this study was to identify a set of QIs appropriate for use in the South African PEC setting. Methods: A three-round modified online Delphi study design was conducted to identify, refine and review a list of QIs for potential use in the South African PEC setting. Operational definitions, data components and criteria for use were developed for 210 QIs for inclusion into the study. Results: In total, 104 QIs reached consensus agreement including, 90 clinical QIs, across 15 subcategories, and 14 non-clinical QIs across two subcategories. Amongst the clinical category, airway management (n = 13 QIs; 14%); out-of-hospital cardiac arrest (n = 13 QIs; 14%); and acute coronary syndromes (n = 11 QIs; 12%) made up the majority. Within the non-clinical category, adverse events made up the significant majority with nine QIs (64%). Conclusion: Within the South Africa setting, there are a multitude of QIs that are relevant and appropriate for use in PEC. This was evident in the number, variety and type of QIs reaching consensus agreement in our study. Furthermore, both the methodology employed, and findings of this study may be used to inform the development of PEC specific QIs within other LMIC settings. C1 [Howard, Ian] Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden. [Howard, Ian; Wallis, Lee] Stellenbosch Univ, Div Emergency Med, Stellenbosch, South Africa. [Cameron, Peter] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia. [Castren, Maaret] Univ Helsinki, Helsinki Univ Hosp, Dept Emergency Med & Serv, Helsinki, Finland. [Lindstrom, Veronica] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Nursing, Acad EMS, Stockholm, Sweden. C3 Karolinska Institutet; Sodersjukhuset Hospital; Stellenbosch University; Monash University; University of Helsinki; Helsinki University Central Hospital; Karolinska Institutet RP Howard, I (通讯作者)，Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden. EM ian.howard@ki.se OI Lindstrom, Veronica/0000-0003-1386-3203; Howard, Ian/0000-0001-7543-7707 CR Ambulance Victoria, 2016, CLIN PRACT GUID AMB BANTEL KA, 1993, PSYCHOL REP, V73, P35, DOI 10.2466/pr0.1993.73.1.35 Barber RM, 2017, LANCET, V390, P231, DOI [10.1016/S0140-6736(17)30818-8, 10.1016/s0140-6736(17)30818-8] Boulkedid R, 2011, PLOS ONE, V6, DOI 10.1371/journal.pone.0020476 British Thoracic Society Standards of Care Committee, 2011, THORAX S2, V66, P1 Cole ZD, 2013, ENVIRON MANAGE, V51, P511, DOI 10.1007/s00267-012-0005-5 Department of Health, 2007, POL QUAL HLTH CAR S DONABEDIAN A, 1966, MILBANK FUND Q, V44, P166, DOI 10.2307/3348969 Fullman N, 2018, LANCET, V391, P2236, DOI 10.1016/s0140-6736(18)30994-2 Gara PTO, 2013, CIRCULATION, pe362 Heath G, 2007, PUBLIC MONEY MANAGE, V27, P223, DOI 10.1111/j.1467-9302.2007.00583.x Howard I, 2017, QUALITY INDICATORS E, V33, P43 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Japanese Soc Anesthesiologists, 2014, J ANESTH, V28, P482, DOI 10.1007/s00540-014-1844-4 Kobusingye OC, 2005, B WORLD HEALTH ORGAN, V83, P626 Kobusingye OC, 2006, DISEASE CONTROL PRIORITIES IN DEVELOPING COUNTRIES, 2ND EDITION, P1261 Kruk ME, 2018, LANCET GLOB HEALTH, V6, pE1196, DOI 10.1016/S2214-109X(18)30386-3 Link MS, 2015, CIRCULATION, V132, pS444, DOI 10.1161/CIR.0000000000000261 Mainz J, 2003, INT J QUAL HEALTH C, V15, P523, DOI 10.1093/intqhc/mzg081 Maio RF, 1999, ANN EMERG MED, V33, P423, DOI 10.1016/S0196-0644(99)70307-0 McGlynn EA, 1998, AM J PREV MED, V14, P14, DOI 10.1016/S0749-3797(97)00032-9 Mebazaa A, 2009, CRIT CARE MED S, V36, pS129 Murphy A, 2016, EMERG MED J, V33, P286, DOI 10.1136/emermed-2015-204793 National Academies of Sciences; Engineering and Medicine, 2018, CROSS GLOB QUAL CHAS National Association of State EMS Officials, 2017, NAT MOD EMS GUID Pillay-van Wyk V, 2016, LANCET GLOB HEALTH, V4, pE642, DOI 10.1016/S2214-109X(16)30113-9 Pons PT, 2002, J EMERG MED, V23, P43, DOI 10.1016/S0736-4679(02)00460-2 Powell C, 2003, J ADV NURS, V41, P376, DOI 10.1046/j.1365-2648.2003.02537.x Powers WJ, 2018, STROKE, V49, pE46, DOI 10.1161/STR.0000000000000158 Pre-Hospital Emergency Care Council, 2014, CLIN PRACT GUID Price L, 2006, QUAL SAF HEALTH CARE, V15, P127, DOI 10.1136/qshc.2005.015651 Professional Board for Emergency Care, 2018, PROFESSIONAL BOARD E Rubin HR, 2001, INT J QUAL HEALTH C, V13, P489, DOI 10.1093/intqhc/13.6.489 Spaite DW, 2001, ANN EMERG MED, V37, P657, DOI 10.1067/mem.2001.115215 Walker A, 2014, BR J THER REHABIL, V3, P677 WILLIAMS PL, 1994, J ADV NURS, V19, P180, DOI 10.1111/j.1365-2648.1994.tb01066.x NR 36 TC 10 Z9 10 U1 0 U2 4 PU ELSEVIER PI AMSTERDAM PA RADARWEG 29a, 1043 NX AMSTERDAM, NETHERLANDS SN 2211-419X EI 2211-4203 J9 AFR J EMERG MED JI Afr. J. Emerg. Med. PD DEC PY 2019 VL 9 IS 4 BP 185 EP 192 DI 10.1016/j.afjem.2019.07.003 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA JX4QS UT WOS:000503721400006 PM 31890482 OA gold, Green Published DA 2023-05-13 ER PT J AU Khan, BA Shakeel, N Siddiqui, EU Kazi, G Khan, IQ Khursheed, M Feroz, A Ejaz, K Khan, ST Adel, H AF Khan, Badar Afzal Shakeel, Nishi Siddiqui, Emad Uddin Kazi, Ghazala Khan, Irum Qamar Khursheed, Munawer Feroz, Asher Ejaz, Kiran Khan, Sumaiya Tauseeq Adel, Hatem TI Impact of delay in admission on the outcome of critically ill patients presenting to the emergency department of a tertiary care hospital from low income country SO JOURNAL OF THE PAKISTAN MEDICAL ASSOCIATION LA English DT Article DE Emergency department; Critical patients; Delays in admission; Karachi; Pakistan ID LENGTH-OF-STAY; INTENSIVE-CARE; MEDICAL PATIENTS; UNIT ADMISSION; SEPTIC SHOCK; ICU; ASSOCIATION; MORTALITY; CAPACITY; TIME AB Objective: To assess the impact of admission delay on the outcome of critical patients. Methods: The retrospective chart review was done at Aga Khan University Hospital, Karachi, and comprised adult patients visiting the Emergency Department during 2010. Outcome measures assessed were total hospital length of stay, total cost of the visit and in-hospital mortality. Patients admitted within 6 hours of presentation at Emergency Department were defined as non-delayed. Data was analysed using SPSS 19. Results: Of the 49,532 patients reporting at the Emergency Department during the study period, 17,968 (36.3%) were admitted. Of them 2356(13%) were admitted to special or intensive care units, 1595(67.7%) of this sub-group stayed in the Emergency Department for > 6 hours before being shifted to intensive care. The study focussed on 325(0.65%) of the total patients; 164(50.5%) in the non-delayed group and 161(49.5%) in the delayed group. The admitting diagnosis of myocardial infarction (p= 0.00) and acute coronary syndrome (p= 0.01) was significantly more common in the non-delayed group compared to other diagnoses like cerebrovascular attacks (p= 0.03) which was significantly more common in the delayed group. There was no significant difference in the hospital length of stay between the two groups (p> 0.05). The Emergency Department cost was significantly increased in the delayed group (p< 0.05), but there was no difference in the overall hospital cost between the groups (p> 0.05). Conclusions: There was no significant difference in the delayed and non-delayed groups, but long Emergency Department stays are distressing for both physicians and patients. C1 [Khan, Badar Afzal; Shakeel, Nishi; Siddiqui, Emad Uddin; Kazi, Ghazala; Khan, Irum Qamar; Khursheed, Munawer; Feroz, Asher; Ejaz, Kiran; Khan, Sumaiya Tauseeq; Adel, Hatem] Aga Khan Univ Hosp, Dept Emergency Med, Karachi, Pakistan. C3 Aga Khan University RP Khan, BA (通讯作者)，Aga Khan Univ Hosp, Dept Emergency Med, Karachi, Pakistan. 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Pak. Med. Assoc. PD MAY PY 2016 VL 66 IS 5 BP 509 EP 516 PG 8 WC Medicine, General & Internal; Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Research & Experimental Medicine GA DM9LA UT WOS:000376686400004 PM 27183926 DA 2023-05-13 ER PT J AU Loewenstein, D Stake, C Cichon, M AF Loewenstein, Devin Stake, Christine Cichon, Mark TI Assessment of using fingerstick blood sample with i-STAT point-of-care device for cardiac troponin I assay SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ACUTE CORONARY SYNDROMES; EARLY-DIAGNOSIS; TRIAL AB Purposes: The purpose of this study is to compare fingerstick point-of-care (POC) testing for cardiac troponin I to conventional venipuncture POC testing using the i-STAT device. Basic procedures: This study was conducted with institutional review board approval in the emergency department (ED) of a 535-bed suburban level I trauma center from June to August 2011. Fingerstick blood samples were collected from consenting patients for whom standard-of-care venipuncture POC troponin (POCT) testing had been ordered as part of their workup. Cardiac troponin I (cTnI) assays were performed using the i-STAT 1 device (Abbott Point of Care, Princeton, NJ). The data were subjected to categorical comparison, linear regression, and Bland-Altman agreement analysis using SAS 9.2 software (SAS, Cary, NC). Main findings: Eighty-nine cTnI levels were measured by both fingerstick and standard venipuncture ED POC testing. Four resulted in cartridge error; the remaining 85 were analyzed. Fingerstick testing, compared with standard ED POCT, has a positive predictive value of 1.00 (0.48, 1.00), negative predictive value of 0.96 (0.89, 0.99), sensitivity of 0.625 (0.24, 0.91), and specificity of 1.00 (0.95, 1.00). The relationship between methods appears linear, with linear regression equation ED POCT level = 0.0062 + 1.3752 * fingerstick level (P < 0.0001). Bland-Altman agreement analysis yielded a mean difference between fingerstick and ED POCT of -0.0095 with limits of agreement of -0.0625 to 0.0435. Principal conclusions: Fingerstick cTnI testing using the i-STAT device is not accurate enough to determine the exact troponin level without the application of a corrective term. Fingerstick testing is, however, accurate in qualifying troponin levels as negative, borderline, or positive and is, therefore, capable of providing clinical information that may guide diagnostic and therapeutic decision making. (C) 2013 Elsevier Inc. All rights reserved. C1 [Loewenstein, Devin] Loyola Univ Chicago, Stritch Sch Med, Maywood, IL USA. [Stake, Christine] Loyola Univ, Med Ctr, Emergency Med Serv, Maywood, IL 60153 USA. [Cichon, Mark] Loyola Univ, Med Ctr, Dept Emergency Med, Maywood, IL 60153 USA. C3 Loyola University Chicago; Loyola University Chicago; Loyola University Chicago RP Loewenstein, D (通讯作者)，Loyola Univ Chicago, Stritch Sch Med, Maywood, IL USA. EM dloewenstein@lumc.edu FU Department of Emergency Medicine, Loyola University Medical Center FX Internally funded by the Department of Emergency Medicine, Loyola University Medical Center. CR Collinson P, 2012, HEART, V98, P312, DOI 10.1136/heartjnl-2011-300723 Keller T, 2009, NEW ENGL J MED, V361, P868, DOI 10.1056/NEJMoa0903515 Loten C, 2009, EMERG MED AUSTRALAS, V21, P286, DOI 10.1111/j.1742-6723.2009.01198.x Renaud B, 2008, ACAD EMERG MED, V15, P216, DOI 10.1111/j.1553-2712.2008.00069.x Ryan RJ, 2009, ANN EMERG MED, V53, P321, DOI 10.1016/j.annemergmed.2008.06.464 Venge P, 2010, AM HEART J, V160, P835, DOI 10.1016/j.ahj.2010.07.036 Venturini J, 2011, P AM AC EM MED ANN M NR 7 TC 13 Z9 13 U1 0 U2 13 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 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD AUG PY 2013 VL 31 IS 8 BP 1236 EP 1239 DI 10.1016/j.ajem.2013.04.031 PG 4 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 201SN UT WOS:000323163400015 PM 23731621 DA 2023-05-13 ER PT J AU Ulrich, R Pischon, T Robra, BP Freier, C Heintze, C Herrmann, WJ AF Ulrich, Raven Pischon, Tobias Robra, Bernt-Peter Freier, Christian Heintze, Christoph Herrmann, Wolfram J. TI Health care utilisation and medication one year after myocardial infarction in Germany - a claims data analysis SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Myocardial infarction; Aftercare; Long-term care; Secondary prevention; Pharmacotherapy; General practice ID ACUTE CORONARY SYNDROMES; ST-SEGMENT ELEVATION; SECONDARY PREVENTION; CARDIOVASCULAR-DISEASE; GENDER-DIFFERENCES; CASE-FATALITY; ADHERENCE; MORTALITY; TRENDS; AGE AB Background: After myocardial infarction, guidelines recommend pharmaceutical treatment with a combination of five different types of drugs for prevention in patients. However, studies from different countries have shown that this goal is not achieved in many patients. The aim of this study was to assess both healthcare and prescribed pharmaceutical treatment in the fourth quarter after index myocardial infarction. Methods: We conducted a claims data analysis with the data of patients who had had a myocardial infarction in the years 2013 or 2014, using information from the largest German health insurance fund ('AOK'). We analysed contact with physicians, hospital care and actual prescriptions for medication recommended in international guidelines, referring to beta-blockers, ACE inhibitors or angiotensin II receptor blockers, P2Y12-antiplatelet agents, acetylsalicylic acid and statins, one year after myocardial infarction. Analysis was stratified by age and sex, compared between patient groups and over time. Results: We identified 2352 patients who had survived myocardial infarction. Some 96.9% of these participants had at least one contact with their general practitioner (GP) one year after myocardial infarction, 22.8% contacted a cardiologist and 19.7% were hospitalised. Prescription rates range from 37.8% for acetylsalicylic acid to 70.4% for ACE inhibitors. However, only 24.1% received statins, beta-blockers, ACE inhibitors and an antiplatelet drug simultaneously. Prescription of recommended drugs after myocardial infarction decreased steadily over time. Discussion: Long-term medical prevention after myocardial infarction is improvable. GPs should take care of the pharmaceutical prevention after myocardial infarction as they are the physicians seen most intensively in this period. (C) 2019 Elsevier B.V. All rights reserved. C1 [Ulrich, Raven; Freier, Christian; Heintze, Christoph; Herrmann, Wolfram J.] Charite Univ Med Berlin, Berlin, Germany. [Pischon, Tobias] Max Delbruck Ctr Mol Med, Berlin, Germany. [Herrmann, Wolfram J.] Hsch Furtwangen Univ, Robert Gerwig Pl 1, D-78120 Furtwangen, Germany. [Robra, Bernt-Peter] Otto von Guericke Univ, Magdeburg, Germany. C3 Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Helmholtz Association; Max Delbruck Center for Molecular Medicine; Otto von Guericke University RP Herrmann, WJ (通讯作者)，Hsch Furtwangen Univ, Robert Gerwig Pl 1, D-78120 Furtwangen, Germany. EM wolfram.herrmann@hs-furtwangen.de RI Pischon, Tobias/HGE-8577-2022; Herrmann, Wolfram/C-8972-2013 OI Pischon, Tobias/0000-0003-1568-767X; Herrmann, Wolfram/0000-0002-9505-4911; Heintze, Christoph/0000-0002-2179-8192 CR [Anonymous], 2017, Z ALLGEMEINMED [Anonymous], [No title captured] [Anonymous], [No title captured] [Anonymous], [No title captured] Aubert RE, 2010, AM J MANAG CARE, V16, P459 Ayanian JZ, 2002, NEW ENGL J MED, V347, P1678, DOI 10.1056/NEJMsa020080 Bally K, 2013, SWISS MED WKLY, V143, DOI 10.4414/smw.2013.13896 Bauer T, 2010, EUR J CARDIOV PREV R, V17, P576, DOI 10.1097/HJR.0b013e328338e5da Dullaghan L, 2014, EUR J CARDIOVASC NUR, V13, P270, DOI 10.1177/1474515113491649 Eindhoven DC, 2018, EUR J PREV CARDIOL, V25, P181, DOI 10.1177/2047487317744363 Gellad WF, 2011, AM J GERIATR PHARMAC, V9, P11, DOI 10.1016/j.amjopharm.2011.02.004 Goch Aleksander, 2009, Clin Cardiol, V32, pE46, DOI 10.1002/clc.20354 Goldberg RJ, 1999, J AM COLL CARDIOL, V33, P1533, DOI 10.1016/S0735-1097(99)00040-6 Granger BB, 2009, EUR J HEART FAIL, V11, P1092, DOI 10.1093/eurjhf/hfp142 Heer T, 2006, AM J CARDIOL, V98, P160, DOI 10.1016/j.amjcard.2006.01.072 Heller G, 2008, DTSCH ARZTEBL INT, V105, P279, DOI 10.3238/arztebl.2008.0279 Hoffmann F, 2012, GESUNDHEITSWESEN, V74, P291, DOI 10.1055/s-0031-1275711 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Jaunzeme J, 2013, BUNDESGESUNDHEITSBLA, V56, P447, DOI 10.1007/s00103-012-1626-9 Kiyota Y, 2004, AM HEART J, V148, P99, DOI 10.1016/j.ahj.2004.02.013 Kotseva K, 2016, EUR J PREV CARDIOL, V23, P636, DOI 10.1177/2047487315569401 Kruger K, 2018, BRIT J GEN PRACT, V68, pE401, DOI 10.3399/bjgp18X696173 Kyto V, 2015, EUR J PREV CARDIOL, V22, P1003, DOI 10.1177/2047487314539434 Mackay FJ, 1999, BRIT J CLIN PHARMACO, V47, P111 Mangiapane S, 2011, DTSCH ARZTEBL INT, V108, P856, DOI 10.3238/arztebl.2011.0856 McManus DD, 2011, AM J MED, V124, P40, DOI 10.1016/j.amjmed.2010.07.023 Mosca L, 2005, CIRCULATION, V111, P499, DOI 10.1161/01.CIR.0000154568.43333.82 National Institute for Health and Care Excellence (NICE), 2013, MYOC INF CARD REH PR Nichols M, 2014, EUR HEART J, V35, P2950, DOI 10.1093/eurheartj/ehu299 Obaya M, 2015, EGYPT J CRIT CARE ME, V3, P69, DOI 10.1016/j.ejccm.2015.12.002 Prugger C, 2012, DTSCH ARZTEBL INT, V109, P303, DOI 10.3238/arztebl.2012.0303 R Core Team, 2015, R LANG ENV STAT COMP Radzimanowski M, 2018, INT J CARDIOL, V251, P1, DOI 10.1016/j.ijcard.2017.10.048 Rana JS, 2018, J GEN INTERN MED, V33, P1621, DOI 10.1007/s11606-018-4519-2 Rasmussen JN, 2007, JAMA-J AM MED ASSOC, V297, P177, DOI 10.1001/jama.297.2.177 Roffi M, 2015, REV ESP CARDIOL, V68, P1125, DOI 10.1016/j.rec.2015.10.009 Roger VL, 2002, ANN INTERN MED, V136, P341, DOI 10.7326/0003-4819-136-5-200203050-00005 Rosamond WD, 2012, CIRCULATION, V125, P1848, DOI 10.1161/CIRCULATIONAHA.111.047480 Smolina K, 2015, CIRC-CARDIOVASC QUAL, V8, P586, DOI 10.1161/CIRCOUTCOMES.115.001987 Somma KA, 2012, CIRC-CARDIOVASC QUAL, V5, P654, DOI 10.1161/CIRCOUTCOMES.111.963959 van der Elst ME, 2005, CLIN THER, V27, P1806, DOI 10.1016/j.clinthera.2005.11.003 van Peet PG, 2015, BRIT J GEN PRACT, V65, pE739, DOI 10.3399/bjgp15X687373 Vermeer NS, 2008, J CLIN PHARM THER, V33, P591, DOI 10.1111/j.1365-2710.2008.00950.x Wong CK, 2007, AM HEART J, V154, P313, DOI 10.1016/j.ahj.2007.04.031 NR 44 TC 5 Z9 5 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 FEB 1 PY 2020 VL 300 BP 20 EP 26 DI 10.1016/j.ijcard.2019.07.050 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KB5ZH UT WOS:000506572600004 PM 31371116 DA 2023-05-13 ER PT J AU Oguz, EG Yeter, HH Akcay, OF Besli, S Selen, T Derici, U Sencan, I Ayli, MD AF Oguz, Ebru Gok Yeter, Haci Hasan Akcay, Omer Faruk Besli, Sevval Selen, Tamer Derici, Ulver Sencan, Irfan Ayli, Mehmet Deniz TI Predictive value of neutrophil-to-lymphocyte ratio in terms of need for intensive care unit and mortality in maintenance hemodialysis patients with COVID-19 SO HEMODIALYSIS INTERNATIONAL LA English DT Article DE COVID-19; hemodialysis; intensive care unit; mortality; neutrophil-to-lymphocyte-ratio; systemic inflammatory index AB Introduction The transmission risk of Severe Acute Respiratory Syndrome Coronavirus-2 virus infection is increased in maintenance hemodialysis (MHD) patients, and also the disease causes much higher mortality than the normal population. The aim of this study is to define the predictive value of neutrophil-to-lymphocyte ratio (NLR) in terms of worse outcomes in MHD patients. Methods A total of 123 MHD patients who had received inpatient care due to COVID-19 infection were included in this multicentered retrospective study. Receiver operating curve analysis were plotted to illustrate C reactive protein (C-rp), systemic inflammatory index (SII) and NLR best cut-off values for estimation of need for intensive care unit (ICU) and mortality. Multivariate regression analysis and Cox proportional hazard models were constructed to determine the association between C-rp, SII and NLR and mortality. Results Twenty-eight (23%) patients with MHD were dead due to COVID-19. Nonsurvivor patients was significantly older than the survivors (p < 0.001) and also had higher rates of diabetes mellitus (p = 0.01) and coronary artery disease (p = 0.02). Cox regression analysis revealed that NLR >5.17 significantly associated with mortality [HR: 6.508, p < 0.001]. Similarly, SII > 726 [HR: 3.124, p = 0.006] and C-rp > 88 [HR: 4.590, p = 0.002] were significantly associated with mortality due to COVID-19 in hospitalized MHD patients. Multivarite logistic regression analysis showed that age older than 60 years, higher ferritin, and NLR > 5.17 were independent factors associated with mortality. Conclusion NLR had favorable predictive value than the C-rp and SII in terms of need for ICU and mortality in MHD patients. Determining the poor prognosis with simple and easily applicable markers may reduce mortality in these patients with early supportive treatments. C1 [Oguz, Ebru Gok; Besli, Sevval; Selen, Tamer; Ayli, Mehmet Deniz] Univ Hlth Sci, Diskapi Yildirim Beyazit Educ & Res Hosp, Dept Nephrol, Ankara, Turkey. [Yeter, Haci Hasan] Sivas Numune State Hosp, Dept Nephrol, Sivas, Turkey. [Akcay, Omer Faruk; Derici, Ulver] Gazi Univ, Dept Nephrol, Fac Med, Ankara, Turkey. [Sencan, Irfan] Univ Hlth Sci, Diskapi Yildirim Beyazit Educ & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey. C3 Diskapi Yildirim Beyazit Training & Research Hospital; University of Health Sciences Turkey; Sivas Numune Hospital; Gazi University; Diskapi Yildirim Beyazit Training & Research Hospital; University of Health Sciences Turkey RP Oguz, EG (通讯作者)，Univ Hlth Sci, Diskapi Yildirim Beyazit Educ & Res Hosp, Dept Nephrol, Ankara, Turkey. EM ebrugokoguz@hotmail.com RI YETER, Hasan Haci/O-3297-2019 OI YETER, Hasan Haci/0000-0002-5787-1048 CR Alfano G, 2021, J NEPHROL, V34, P1387, DOI 10.1007/s40620-021-01136-5 Gansevoort RT, 2020, NAT REV NEPHROL, V16, P705, DOI 10.1038/s41581-020-00349-4 Geng YT, 2016, SCI REP-UK, V6, DOI 10.1038/srep39482 Goicoechea M, 2020, KIDNEY INT, V98, P27, DOI 10.1016/j.kint.2020.04.031 Grasselli G, 2020, JAMA-J AM MED ASSOC, V323, P1545, DOI 10.1001/jama.2020.4031 Henry BM, 2020, INT UROL NEPHROL, V52, P1193, DOI 10.1007/s11255-020-02451-9 Huang C, 2020, LANCET, V395, P496, DOI [10.1016/S0140-6736(20)30252-X, 10.1016/S0140-6736(20)30183-5] Huang ZW, 2020, AM J EMERG MED, V38, P641, DOI 10.1016/j.ajem.2019.10.023 Kilercik M, 2021, PLOS ONE, V16, DOI 10.1371/journal.pone.0254073 Lattanzi S, 2019, TRANSL STROKE RES, V10, P137, DOI 10.1007/s12975-018-0649-4 Mahase E, 2020, BMJ-BRIT MED J, V368, DOI 10.1136/bmj.m641 Marin BG, 2021, REV MED VIROL, V31, DOI 10.1002/rmv.2146 Min YL, 2021, INT UROL NEPHROL, V53, P797, DOI 10.1007/s11255-020-02700-x Muhammad S, 2021, PATHOGENS, V10, DOI 10.3390/pathogens10010058 Naicker S, 2020, KIDNEY INT, V97, P824, DOI 10.1016/j.kint.2020.03.001 Sevinc C, 2021, SEMIN DIALYSIS, V34, P347, DOI 10.1111/sdi.13004 Song M, 2021, SCI REP-UK, V11, DOI 10.1038/s41598-020-79431-7 Syed-Ahmed M, 2019, ADV CHRONIC KIDNEY D, V26, P8, DOI 10.1053/j.ackd.2019.01.004 Vaziri ND, 2012, J RENAL NUTR, V22, P149, DOI 10.1053/j.jrn.2011.10.020 Yang Q, 2021, BMC INFECT DIS, V21, DOI 10.1186/s12879-021-06478-w Yilmaz E, 2022, SAO PAULO MED J, V140, P41, DOI [10.1590/1516-3180.2021.0298.R1.27052021, 10.1590/1516-3180.2021.0298.r1.27052021] Zahorec R, 2020, BRATISL MED J, V121, P466, DOI 10.4149/BLL_2020_077 Zhong JH, 2017, ONCOTARGET, V8, P75381, DOI 10.18632/oncotarget.18856 Zhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 NR 24 TC 2 Z9 2 U1 4 U2 5 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1492-7535 EI 1542-4758 J9 HEMODIAL INT JI Hemodial. Int. PD JUL PY 2022 VL 26 IS 3 BP 377 EP 385 DI 10.1111/hdi.13001 EA JAN 2022 PG 9 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA 2X6NV UT WOS:000740541600001 PM 35001488 DA 2023-05-13 ER PT J AU Lenz, M Krychtiuk, KA Goliasch, G Distelmaier, K Wojta, J Heinz, G Speidl, WS AF Lenz, Max Krychtiuk, Konstantin A. Goliasch, Georg Distelmaier, Klaus Wojta, Johann Heinz, Gottfried Speidl, Walter S. TI N-terminal pro-brain natriuretic peptide and high-sensitivity troponin T exhibit additive prognostic value for the outcome of critically ill patients SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Troponin; NT-proBNP; critical ill; type-2 myocardial infarction ID ACUTE CORONARY SYNDROMES; CARDIAC TROPONIN; HEART-FAILURE; MYOCARDIAL INJURY; PREDICTIVE-VALUE; EVENTS; EMERGENCY; MANAGEMENT; INFARCTION; MARKER AB Background: Patients treated at medical intensive care units suffer from various pathologies and often present with elevated troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Both markers may reflect different forms of cardiac involvement in critical illness. Therefore, the aim of our study was to examine the synergistic prognostic potential of NT-proBNP and high-sensitivity TnT (hs)TnT in unselected critically ill patients. Methods: We included all consecutive patients admitted to our intensive care unit within one year, excluding those suffering from acute myocardial infarction or undergoing cardiac surgery and measured NT-proBNP and TnT plasma levels on the day of admission and 72 hours thereafter. Results: Of the included 148 patients, 52% were male, mean age was of 64.2 +/- 16.8 years and 30-day mortality was 33.2%. Non-survivors showed significantly higher NT-proBNP and TnT plasma levels as compared with survivors (p<0.01). An elevation of both markers exhibited an additive effect on mortality, as those with both NT-proBNP and TnT levels above the median had a 30-day mortality rate of 51.0%, while those with both markers below the median had a 16.7% mortality rate (hazard ratio 3.7). These findings were independent of demographic and clinical parameters (p<0.05). Conclusions: Our findings regarding the individual predictive properties of NT-proBNP and TnT are in line with literature. However, we were able to highlight that they exhibit additive prognostic potential which exceeds their individual value. This might be attributed to a difference in underlying pathomechanisms and an assessment of synergistic risk factors. C1 [Lenz, Max; Krychtiuk, Konstantin A.; Goliasch, Georg; Distelmaier, Klaus; Wojta, Johann; Heinz, Gottfried; Speidl, Walter S.] Univ Vienna, Dept Internal Med 2, Div Cardiol, Vienna, Austria. [Lenz, Max; Krychtiuk, Konstantin A.; Wojta, Johann] Ludwig Boltzmann Cluster Cardiovasc Res, Vienna, Austria. [Wojta, Johann] Med Univ Vienna, Core Facil, Vienna, Austria. C3 University of Vienna; Ludwig Boltzmann Institute; Medical University of Vienna RP Speidl, WS (通讯作者)，Med Univ Vienna, Dept Internal Med 2, Waehringer Guertel 18-20, A-1090 Vienna, Austria. EM walter.speidl@muv.ac.at RI Wojta, Johann/AAC-8433-2020 OI Wojta, Johann/0000-0002-1282-9276; Krychtiuk, Konstantin/0000-0001-7792-2837; Goliasch, Georg/0000-0002-6219-6104; Lenz, Max/0000-0003-3539-994X; Speidl, Walter/0000-0002-7267-3138 FU Association for the Promotion of Research on Arteriosclerosis, Thrombosis and Vascular Biology (ATVB); Ludwig Boltzmann Cluster for Cardiovascular Research FX This work was supported by the Association for the Promotion of Research on Arteriosclerosis, Thrombosis and Vascular Biology (ATVB) and the Ludwig Boltzmann Cluster for Cardiovascular Research. CR Anand IS, 2003, CIRCULATION, V107, P1278, DOI 10.1161/01.CIR.0000054164.99881.00 Baron JM, 2014, AM J CLIN PATHOL, V141, P488, DOI 10.1309/AJCPLVQQY35XTFVN Bergenzaun L, 2012, BMC ANESTHESIOL, V12, DOI 10.1186/1471-2253-12-25 Biener M, 2013, EUR HEART J-ACUTE CA, V2, P314, DOI 10.1177/2048872613498517 Bone RC, 1996, ANN INTERN MED, V125, P680, DOI 10.7326/0003-4819-125-8-199610150-00009 Collet JP, 2016, EUR HEART J, V37, pE1, DOI 10.1093/eurheartj/ehv407 Coquet I, 2008, CRIT CARE, V12, DOI 10.1186/cc7110 Doust JA, 2005, BRIT MED J, V330, P625, DOI 10.1136/bmj.330.7492.625 Everett BM, 2015, NEW ENGL J MED, V373, P610, DOI 10.1056/NEJMoa1415921 Fernandes CJ, 1999, INTENS CARE MED, V25, P1165, DOI 10.1007/s001340051030 Gerber Y, 2012, MAYO CLIN PROC, V87, P247, DOI 10.1016/j.mayocp.2011.11.013 GUEST TM, 1995, JAMA-J AM MED ASSOC, V273, P1945, DOI 10.1001/jama.273.24.1945 Gunnewiek JMTK, 2003, INTENS CARE MED, V29, P2317, DOI 10.1007/s00134-003-1953-2 Haines R, 2017, CRIT CARE, V21, DOI 10.1186/s13054-017-1674-5 Harrison A, 2002, ANN EMERG MED, V39, P131, DOI 10.1067/mem.2002.121483 Hartmann F, 2004, CIRCULATION, V110, P1780, DOI 10.1161/01.CIR.0000143059.68996.A7 Januzzi JL, 2006, EUR HEART J, V27, P330, DOI 10.1093/eurheartj/ehi631 Jarai R, 2005, THROMB HAEMOSTASIS, V94, P926, DOI 10.1160/TH05-06-0395 Jarai R, 2009, CRIT CARE MED, V37, P1837, DOI 10.1097/CCM.0b013e31819fe896 Lim W, 2006, AM J CRIT CARE, V15, P280 Lim W, 2006, ARCH INTERN MED, V166, P2446, DOI 10.1001/archinte.166.22.2446 Maisel A, 2008, EUR J HEART FAIL, V10, P824, DOI 10.1016/j.ejheart.2008.07.014 Mayr A, 2011, INT J CARDIOL, V147, P118, DOI 10.1016/j.ijcard.2009.09.537 Meisel SR, 2012, EUR HEART J-ACUTE CA, V1, P99, DOI 10.1177/2048872612447049 Meyer B, 2007, CRIT CARE MED, V35, P2268, DOI 10.1097/01.CCM.0000284509.23439.5B Mueller C, 2004, NEW ENGL J MED, V350, P647, DOI 10.1056/NEJMoa031681 Olatidoye AG, 1998, AM J CARDIOL, V81, P1405, DOI 10.1016/S0002-9149(98)00200-8 Oluleye OW, 2013, ANN EPIDEMIOL, V23, P66, DOI 10.1016/j.annepidem.2012.11.004 Pencina MJ, 2008, STAT MED, V27, P157, DOI 10.1002/sim.2929 Quenot JP, 2005, CHEST, V128, P2758, DOI 10.1378/chest.128.4.2758 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Varpula M, 2007, CRIT CARE MED, V35, P1277, DOI 10.1097/01.CCM.0000261893.72811.0F NR 32 TC 1 Z9 1 U1 1 U2 1 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 PD AUG PY 2020 VL 9 IS 5 BP 496 EP 503 DI 10.1177/2048872618768088 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OS1UG UT WOS:000589950100018 PM 29617154 OA Bronze DA 2023-05-13 ER PT J AU Hoshino, T Uchiyama, S Wong, LKS Sissani, L Albers, GW Bornstein, NM Caplan, LR Donnan, GA Ferro, JM Hennerici, MG Labreuche, J Lavallee, PC Molina, C Rothwell, PM Steg, PG Touboul, PJ Vicaut, E Amarenco, P AF Hoshino, Takao Uchiyama, Shinichiro Wong, Lawrence K. S. Sissani, Leila Albers, Gregory W. Bornstein, Natan M. Caplan, Louis R. Donnan, Geoffrey A. Ferro, Jose M. Hennerici, Michael G. Labreuche, Julien Lavallee, Philippa C. Molina, Carlos Rothwell, Peter M. Steg, Philippe Gabriel Touboul, Pierre-Jean Vicaut, Eric Amarenco, Pierre CA TIAregistry Org Investigators TI Differences in Characteristics and Outcomes Between Asian and Non-Asian Patients in the TIAregistry.org SO STROKE LA English DT Article DE ischemic stroke; population; prognosis; race and ethnicity; transient ischemic attack ID TRANSIENT ISCHEMIC ATTACK; MINOR STROKE; URGENT TREATMENT; POPULATION; ALCOHOL; RISK; EXPRESS; DISEASE; BURDEN; CARE AB Background and Purpose-This study provides the contemporary causes and prognosis of transient ischemic attack (TIA) and minor stroke in Asians and the direct comparisons with non-Asians. Methods-The TIAregistry.org enrolled 4789 patients (1149 Asians and 3640 non-Asians) with a TIA or minor ischemic stroke within 7 days of onset. Every participating facility had systems dedicated to urgent intervention of TIA/stroke patients by specialists. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome. Results-Approximately 80% of patients were evaluated within 24 hours of symptom onset. At 1 year, there were no differences in the rates of composite cardiovascular events (6.8% versus 6.0%; P=0.38) and stroke (6.0% versus 4.8%; P=0.11) between Asians and non-Asians. Asians had a lower risk of cerebrovascular disease (stroke or TIA) than non-Asians (adjusted hazard ratio, 0.79; 95% confidence interval, 0.63-0.98; P=0.03); the difference was primarily driven by a lower rate of TIA in Asians (4.2% versus 8.3%; P<0.001). Moderately severe bleeding was more frequent in Asians (0.8% versus 0.3%; P=0.02). In multivariable analysis, multiple acute infarcts (P=0.005) and alcohol consumption (P=0.02) were independent predictors of stroke recurrence in Asians, whereas intracranial stenosis (P<0.001), ABCD(2) score (P<0.001), atrial fibrillation (P=0.008), extracranial stenosis (P=0.03), and previous stroke or TIA (P=0.03) were independent predictors in non-Asians. Conclusions-The short-term stroke risk after a TIA or minor stroke was lower than expected when urgent evidence-based care was delivered, irrespective of race/ethnicity or region. However, the predictors of stroke were different for Asians and non-Asians. C1 [Hoshino, Takao; Sissani, Leila; Lavallee, Philippa C.; Touboul, Pierre-Jean; Amarenco, Pierre] Univ Paris Diderot, APHP, Dept Neurol, Sorbonne Paris Cite, Paris, France. [Hoshino, Takao; Sissani, Leila; Lavallee, Philippa C.; Touboul, Pierre-Jean; Amarenco, Pierre] Univ Paris Diderot, Bichat Hosp, Stroke Ctr, Sorbonne Paris Cite,INSERM LVTS U1148,DHU FIRE, Paris, France. [Uchiyama, Shinichiro] Int Univ Hlth & Welf, Sanno Hosp, Ctr Brain & Cerebral Vessels, Clin Res Ctr Med, Tokyo, Japan. [Uchiyama, Shinichiro] Sanno Med Ctr, Tokyo, Japan. [Wong, Lawrence K. S.] Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China. [Albers, Gregory W.] Stanford Univ, Med Ctr, Dept Neurol & Neurol Sci, Stanford Stroke Ctr, Stanford, CA 94305 USA. [Bornstein, Natan M.] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, Dept Neurol, Tel Aviv, Israel. [Caplan, Louis R.] Harvard Univ, Beth Israel Deaconess Med Ctr, Cerebrovasc Dis Serv, Boston, MA 02215 USA. [Donnan, Geoffrey A.] Univ Melbourne, Florey Inst Neurosci & Mental Hlth, Parkville, Vic, Australia. [Ferro, Jose M.] Univ Lisbon, Hosp Santa Maria, Dept Neurosci, Lisbon, Portugal. [Hennerici, Michael G.] Univ Med Mannheim, Dept Neurol, Heidelberg, Germany. [Labreuche, Julien] Univ Lille, CHU Lille, EA Sante Publ Epidemiol & Qualite Soins 2694, Lille, France. [Molina, Carlos] Univ Autonoma Barcelona, Vall dHebron Univ Hosp, Dept Neurol, Stroke Unit, Barcelona, Spain. [Rothwell, Peter M.] Univ Oxford, Nuffield Dept Clin Neurosci, Stroke Prevent Res Unit, Oxford, England. [Steg, Philippe Gabriel] Univ Paris Diderot, Hop Bichat, APHP,Sorbonne Paris Cite, Dept Cardiol,INSERM LVTS U1148,DHU FIRE, Paris, France. [Steg, Philippe Gabriel] NHLI Imperial Coll, ICMS Royal Brompton Hosp, London, England. [Vicaut, Eric] Univ Paris Diderot, Fernand Widal Hosp, APHP, Dept Biostat,Sorbonne Paris Cite, Paris, France. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Hotel-Dieu - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Bichat-Claude Bernard - APHP; International University of Health & Welfare; Chinese University of Hong Kong; Prince of Wales Hospital; Stanford University; Tel Aviv University; Sackler Faculty of Medicine; Tel Aviv Sourasky Medical Center; Harvard University; Beth Israel Deaconess Medical Center; Florey Institute of Neuroscience & Mental Health; University of Melbourne; Universidade de Lisboa; Hospital Santa Maria; Ruprecht Karls University Heidelberg; Universite de Lille - ISITE; CHU Lille; Universite de Lille; Autonomous University of Barcelona; Hospital Universitari Vall d'Hebron; RLUK- Research Libraries UK; University of Oxford; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Pitie-Salpetriere - 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 Bichat-Claude Bernard - APHP; Hopital Universitaire Hotel-Dieu - APHP; RLUK- Research Libraries UK; Imperial College London; Royal Brompton Hospital; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - APHP; Hopital Universitaire Saint-Louis - APHP RP Amarenco, P (通讯作者)，Hop Xavier Bichat, Dept Neurol, 46 Rue Henri Huchard, F-75018 Paris, France.; Amarenco, P (通讯作者)，Hop Xavier Bichat, Stroke Ctr, 46 Rue Henri Huchard, F-75018 Paris, France. EM pierre.amarenco@aphp.fr RI Ferro, José/ABA-1779-2021; STEG, Philippe Gabriel/Z-1567-2019; Rothwell, Peter/ABE-5913-2020; Wong, Ka Sing Lawrence/N-3434-2015 OI Rothwell, Peter/0000-0001-9739-9211; Wong, Ka Sing Lawrence/0000-0002-2031-9866; Albers, Gregory/0000-0003-0263-4632; STEG, Philippe Gabriel/0000-0001-6896-2941; Touboul, Pierre-Jean/0000-0002-8872-9917; Lavallee, Philippa/0000-0002-8148-7679 FU Sanofi; Bristol-Myers Squibb FX This study was an investigator-driven initiative and received unrestricted grants from Sanofi and Bristol-Myers Squibb, both of whom were not involved in the design and conduct of study, analysis of data, and writing of the article. CR ADAMS HP, 1993, STROKE, V24, P35, DOI 10.1161/01.STR.24.1.35 Amarenco P, 2016, NEW ENGL J MED, V374, P1533, DOI 10.1056/NEJMoa1412981 Bazzano LA, 2007, ANN NEUROL, V62, P569, DOI 10.1002/ana.21194 Cochrane J, 2003, ALCOHOL ALCOHOLISM, V38, P537, DOI 10.1093/alcalc/agg111 Correia M, 2006, STROKE, V37, P50, DOI 10.1161/01.STR.0000195209.26543.8f Feigin VL, 2014, LANCET, V383, P245, DOI 10.1016/S0140-6736(13)61953-4 Ghali WA, 2001, JAMA-J AM MED ASSOC, V286, P1494, DOI 10.1001/jama.286.12.1494 Giles MF, 2010, STROKE, V41, P1907, DOI 10.1161/STROKEAHA.110.578971 Gorelick PB, 2008, STROKE, V39, P2396, DOI 10.1161/STROKEAHA.107.505776 Higuchi S, 2007, ADDICTION, V102, P1849, DOI 10.1111/j.1360-0443.2007.01902.x Hill MD, 2004, NEUROLOGY, V62, P2015, DOI 10.1212/01.WNL.0000129482.70315.2F Kernan WN, 2014, STROKE, V45, P2160, DOI 10.1161/STR.0000000000000024 KIYOHARA Y, 1995, STROKE, V26, P368, DOI 10.1161/01.STR.26.3.368 Lavallee PC, 2007, LANCET NEUROL, V6, P953, DOI 10.1016/S1474-4422(07)70248-X Luengo-Fernandez R, 2009, LANCET NEUROL, V8, P235, DOI 10.1016/S1474-4422(09)70019-5 Meseguer E, 2010, ANN NEUROL, V68, P9, DOI 10.1002/ana.21921 Rothwell PM, 2007, LANCET, V370, P1432, DOI 10.1016/S0140-6736(07)61448-2 Stansbury JP, 2005, STROKE, V36, P374, DOI 10.1161/01.STR.0000153065.39325.fd TOPOL E, 1993, NEW ENGL J MED, V329, P673, DOI 10.1056/nejm199309023291001 Toyoda K, 2015, STROKE, V46, P1474, DOI 10.1161/STROKEAHA.115.008781 van Asch CJJ, 2010, LANCET NEUROL, V9, P167, DOI 10.1016/S1474-4422(09)70340-0 Wang YL, 2015, CIRCULATION, V132, P40, DOI 10.1161/CIRCULATIONAHA.114.014791 Wu CM, 2007, ARCH INTERN MED, V167, P2417, DOI 10.1001/archinte.167.22.2417 NR 23 TC 15 Z9 16 U1 0 U2 8 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 JUL PY 2017 VL 48 IS 7 BP 1779 EP + DI 10.1161/STROKEAHA.117.016874 PG 19 WC Clinical Neurology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA EY5TX UT WOS:000404044100030 PM 28584002 OA Green Submitted DA 2023-05-13 ER PT J AU Douketis, J Bell, AD Eikelboom, J Liew, A AF Douketis, James Bell, Alan David Eikelboom, John Liew, Aaron TI Approach to the new oral anticoagulants in family practice Part 2: addressing frequently asked questions SO CANADIAN FAMILY PHYSICIAN LA English DT Review ID ACUTE CORONARY SYNDROME; FACTOR XA INHIBITOR; TISSUE-PLASMINOGEN ACTIVATOR; DABIGATRAN ETEXILATE; STROKE PATIENT; TOTAL HIP; ANTIPLATELET THERAPY; ISCHEMIC-STROKE; CONCOMITANT USE; RIVAROXABAN AB Objective To address common "what if" questions that arise relating to the long-term clinical follow-up and management of patients receiving the new oral anticoagulants (NOACs). Sources of information For this narrative review, we searched the PubMed database for recent (January 2008 to week 32 of 2013) clinical studies relating to NOAC use for stroke prevention in atrial fibrillation and for the treatment of acute venous thromboembolism. We used this evidence base to address prespecified questions relating to NOAC use in primary care settings. Main message Dabigatran and rivaroxaban should be taken with meals to decrease dyspepsia and increase absorption, respectively. There are no dietary restrictions with any of the NOACs, beyond moderating alcohol intake, and rivaroxaban and apixaban can be crushed if required. The use of acid suppressive therapies does not appear to affect the efficacy of the NOACs. As with warfarin, patients taking NOACs should avoid long-term use of nonsteroidal anti-inflammatory and antiplatelet drugs. For patients requiring surgery, generally NOACs should be stopped 2 to 5 days before the procedure, depending on bleeding risk, and the NOAC should usually be resumed at least 24 hours after surgery. Preoperative coagulation testing is generally unnecessary. In patients who develop bleeding, minor bleeding typically does not require laboratory testing or discontinuation of NOACs; with major bleeding, the focus should be on local measures to control the bleeding and supportive care, and coagulation testing should be performed. There are currently no antidotes to reverse NOACs. The NOACs should not be used in patients with valvular heart disease, prosthetic heart valves, cancer-associated deep vein thrombosis, or superficial thrombophlebitis. Conclusion Management of "what if" scenarios for patients taking NOACs have been proposed, but additional study is needed to address these issues, especially periprocedural management and bleeding. C1 [Douketis, James] McMaster Univ, Dept Med, Hamilton, ON, Canada. [Bell, Alan David] Univ Toronto, Dept Family & Community Med, Toronto, ON M5S 1A1, Canada. [Eikelboom, John; Liew, Aaron] McMaster Univ, Dept Med, Hamilton, ON L8S 4L8, Canada. C3 McMaster University; University of Toronto; McMaster University RP Douketis, J (通讯作者)，50 Charlton Ave E, Hamilton, ON L8N 4A6, Canada. EM jdouket@mcmaster.ca RI Eikelboom, John/AAG-6117-2019; Douketis, James/AAO-5659-2021 OI Eikelboom, John/0000-0003-4126-1285; Liew, Aaron/0000-0002-6274-0253 FU Canadian Cardiovascular Society; Thrombosis Canada; Boehringer Ingelheim; Bayer; Pfizer; Bristol-Myers Squibb; AstraZeneca; Daiichi-Sankyo; Eli Lilly; GlaxoSmithKline; Janssen; Sanofi-Aventis; Merck Sharp Dohme; Novo Nordisk; Novartis; Medtronic FX Dr Douketis has been a consultant or has attended advisory meetings (in the past 10 years) for Bayer, Boehringer Ingelheim, Biotie, AstraZeneca, Pfizer, Medicines Co, Bristol-Myers Squibb, and Sanofi-Aventis. Dr Bell has received research funding and consulting fees from the Canadian Cardiovascular Society, Thrombosis Canada, Boehringer Ingelheim, Bayer, Pfizer, and Bristol-Myers Squibb. Dr Eikelboom has received honoraria or consulting fees from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, Eli Lilly, GlaxoSmithKline, Pfizer, Janssen, and Sanofi-Aventis, and grants or in-kind support from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Pfizer, Janssen, and Sanofi-Aventis. Dr Liew has received educational and research support from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Merck Sharp & Dohme, Novo Nordisk, Novartis, Sanofi-Aventis, and Medtronic. 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Fam. Phys. PD NOV PY 2014 VL 60 IS 11 BP 997 EP 1001 PG 5 WC Primary Health Care; Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AW2XW UT WOS:000346150900014 PM 25392439 DA 2023-05-13 ER PT J AU Feldstein, LR Rose, EB Horwitz, SM Collins, JP Newhams, MM Son, MBF Newburger, JW Kleinman, LC Heidemann, SM Martin, AA Singh, AR Li, S Tarquinio, KM Jaggi, P Oster, ME Zackai, SP Gillen, J Ratner, AJ Walsh, RF Fitzgerald, JC Keenaghan, MA Alharash, H Doymaz, S Clouser, KN Giuliano, JS Gupta, A Parker, RM Maddux, AB Havalad, V Ramsingh, S Bukulmez, H Bradford, TT Smith, LS Tenforde, MW Carroll, CL Riggs, BJ Gertz, SJ Daube, A Lansell, A Munoz, AC Hobbs, CV Marohn, KL Halasa, NB Patel, MM Randolph, AG AF Feldstein, Leora R. Rose, Erica B. Horwitz, Steven M. Collins, Jennifer P. Newhams, Margaret M. Son, Mary Beth F. Newburger, Jane W. Kleinman, Lawrence C. Heidemann, Sabrina M. Martin, Amarilis A. Singh, Aalok R. Li, Simon Tarquinio, Keiko M. Jaggi, Preeti Oster, Matthew E. Zackai, Sheemon P. Gillen, Jennifer Ratner, Adam J. Walsh, Rowan F. Fitzgerald, Julie C. Keenaghan, Michael A. Alharash, Hussam Doymaz, Sule Clouser, Katharine N. Giuliano, John S. Gupta, Anjali Parker, Robert M. Maddux, Aline B. Havalad, Vinod Ramsingh, Stacy Bukulmez, Hulya Bradford, Tamara T. Smith, Lincoln S. Tenforde, Mark W. Carroll, Christopher L. Riggs, Becky J. Gertz, Shira J. Daube, Ariel Lansell, Amanda Coronado Munoz, Alvaro Hobbs, Charlotte V. Marohn, Kimberly L. Halasa, Natasha B. Patel, Manish M. Randolph, Adrienne G. CA Overcoming COVID-19 Investigators CDC Covid-19 Response Team TI Multisystem Inflammatory Syndrome in US Children and Adolescents SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID TOXIC-SHOCK-SYNDROME; KAWASAKI-DISEASE; INFLUENZA AB This report describes the epidemiology and clinical course of patients younger than 21 years of age from 26 states who had multisystem inflammatory syndrome. Many were infected with SARS-CoV-2 at least 1 to 2 weeks before syndrome onset. The median age of the patients was 8.3 years, and 73% were previously healthy. Background Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome. Methods We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms. Results We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores >= 2.5) were documented in 15 patients (8%), and Kawasaki's disease-like features were documented in 74 (40%). Most patients (171 [92%]) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%). Conclusions Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents. (Funded by the Centers for Disease Control and Prevention.) C1 [Feldstein, Leora R.; Rose, Erica B.; Collins, Jennifer P.; Tenforde, Mark W.; Patel, Manish M.] Ctr Dis Control & Prevent, COVID 19 Response, Atlanta, GA USA. [Tarquinio, Keiko M.] Emory Univ, Sch Med, Dept Pediat, Div Crit Care Med, Atlanta, GA USA. [Jaggi, Preeti] Emory Univ, Sch Med, Dept Pediat, Div Infect Dis, Atlanta, GA USA. [Oster, Matthew E.] Emory Univ, Sch Med, Dept Pediat, Div Cardiol, Atlanta, GA USA. [Feldstein, Leora R.; Rose, Erica B.; Patel, Manish M.] Public Hlth Serv Commissioned Corps, Rockville, MD USA. [Riggs, Becky J.] Johns Hopkins Sch Med, Div Pediat Anesthesiol & Crit Care Med, Dept Anesthesiol & Crit Care Med, Baltimore, MD USA. [Horwitz, Steven M.] Rutgers State Univ, Robert Wood Johnson Med Sch, Bristol Myers Squibb Childrens Hosp, Div Pediat Crit Care,Dept Pediat, New Brunswick, NJ USA. [Kleinman, Lawrence C.] Rutgers Robert Wood Johnson Med Sch, Div Populat Hlth Qual & Implementat Sci PopQuIS, Dept Pediat, New Brunswick, NJ USA. [Walsh, Rowan F.] Childrens Hosp New Jersey, Newark Beth Israel, Div Pediat Cardiol, Dept Pediat, Newark, NJ USA. [Clouser, Katharine N.] Hackensack Univ, Div Hosp Med, Dept Pediat, Med Ctr, Hackensack, NJ USA. [Gertz, Shira J.] St Barnabas Hosp, Dept Pediat, Div Pediat Crit Care, Livingston, NJ USA. [Newhams, Margaret M.; Randolph, Adrienne G.] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA. [Son, Mary Beth F.] Boston Childrens Hosp, Div Immunol, Boston, MA USA. [Newburger, Jane W.] Boston Childrens Hosp, Dept Cardiol, Boston, MA USA. [Son, Mary Beth F.; Newburger, Jane W.; Randolph, Adrienne G.] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA. [Randolph, Adrienne G.] Harvard Med Sch, Dept Anaesthesia, Boston, MA 02115 USA. [Marohn, Kimberly L.] Baystate Med Ctr, Pediat Crit Care, Dept Pediat, Springfield, MA USA. [Heidemann, Sabrina M.; Martin, Amarilis A.] Cent Michigan Univ, Dept Pediat, Div Pediat Crit Care Med, Detroit, MI USA. [Singh, Aalok R.; Li, Simon] Maria Fareri Childrens Hosp, Westchester Med Ctr, Pediat Crit Care Div, Valhalla, NY USA. [Singh, Aalok R.; Li, Simon] New York Med Coll, Valhalla, NY 10595 USA. [Zackai, Sheemon P.; Gillen, Jennifer] Icahn Sch Med Mt Sinai, Kravis Childrens Hosp, Dept Pediat, Pediat Crit Care Med, New York, NY 10029 USA. [Ratner, Adam J.] NYU, Grossman Sch Med, Div Pediat Infect Dis, Dept Microbiol, New York, NY USA. [Keenaghan, Michael A.; Alharash, Hussam] Kings Cty Hosp, New York City Hlth & Hosp, Pediat Crit Care, New York, NY USA. [Doymaz, Sule] SUNY Downstate Hlth Sci Univ, Dept Pediat, Div Pediat Crit Care, New York, NY USA. [Daube, Ariel] Maimonides Childrens Hosp, Div Pediat Crit Care, Dept Pediat, New York, NY USA. [Fitzgerald, Julie C.] Univ Penn, Perelman Sch Med, Dept Anesthesiol & Crit Care, Div Crit Care, Philadelphia, PA 19104 USA. [Giuliano, John S.; Gupta, Anjali] Yale Univ, Sch Med, Dept Pediat, Div Crit Care, New Haven, CT 06510 USA. [Parker, Robert M.; Carroll, Christopher L.] Connecticut Childrens, Div Crit Care, Hartford, CT USA. [Maddux, Aline B.] Univ Colorado, Sch Med, Dept Pediat, Sect Crit Care Med, Aurora, CO USA. [Maddux, Aline B.] Childrens Hosp Colorado, Aurora, CO USA. [Havalad, Vinod; Ramsingh, Stacy] Advocate Childrens Hosp, Dept Pediat, Div Pediat Crit Care Med, Chicago, IL USA. [Bukulmez, Hulya] Case Western Reserve Univ, Dept Pediat, Div Pediat Rheumatol, MetroHlth Med Ctr, Cleveland, OH 44106 USA. [Lansell, Amanda] Rainbow Babies & Childrens Hosp, Div Pediat Hosp Med, 2101 Adelbert Rd, Cleveland, OH 44106 USA. [Bradford, Tamara T.] Louisiana State Univ, Hlth Sci Ctr, Div Cardiol, Dept Pediat, New Orleans, LA USA. [Bradford, Tamara T.] Childrens Hosp New Orleans, New Orleans, LA USA. [Smith, Lincoln S.] Univ Washington, Dept Pediat, Div Pediat Crit Care Med, Seattle, WA 98195 USA. [Coronado Munoz, Alvaro] Univ Texas Hlth Sci Ctr Houston, Dept Pediat, Pediat Crit Care Div, Houston, TX 77030 USA. [Hobbs, Charlotte V.] Univ Mississippi, Med Ctr, Dept Microbiol, Dept Pediat,Div Infect Dis, Jackson, MS 39216 USA. [Halasa, Natasha B.] Vanderbilt Univ, Med Ctr, Dept Pediat, Div Pediat Infect Dis, Nashville, TN 37232 USA. C3 Centers for Disease Control & Prevention - USA; Emory University; Emory University; Emory University; Johns Hopkins University; Johns Hopkins Medicine; Bristol-Myers Squibb; Rutgers State University New Brunswick; Rutgers State University Medical Center; Rutgers State University New Brunswick; Rutgers State University Medical Center; Newark Beth Israel Medical Center; Hackensack University Medical Center; Harvard University; Boston Children's Hospital; Harvard University; Boston Children's Hospital; Harvard University; Boston Children's Hospital; Harvard University; Harvard Medical School; Harvard University; Harvard Medical School; Baystate Medical Center; Central Michigan University; Westchester Medical Center; New York Medical College; Icahn School of Medicine at Mount Sinai; New York University; University of Pennsylvania; Pennsylvania Medicine; Yale University; University of Colorado System; University of Colorado Anschutz Medical Campus; Children's Hospital Colorado; Case Western Reserve University; MetroHealth System; Case Western Reserve University; Case Western Reserve University Hospital; University Hospitals of Cleveland; Rainbow Babies & Children's Hospital; Louisiana State University System; Louisiana State University Health Sciences Center New Orleans; Children's Hospital of New Orleans; University of Washington; University of Washington Seattle; University of Texas System; University of Texas Health Science Center Houston; University of Mississippi; University of Mississippi Medical Center; Vanderbilt University RP Patel, MM (通讯作者)，Ctr Dis Control & Prevent, Influenza Div, 1600 Clifton Rd,MS H24-7, Atlanta, GA 30329 USA.; Randolph, AG (通讯作者)，Boston Childrens Hosp, Div Crit Care Med, Bader 634, Boston, MA 02115 USA. EM mpatel@cdc.gov; adrienne.randolph@childrens.harvard.edu RI Harwayne-Gidansky, Ilana/I-9528-2019; Hymes, Saul Robert/V-5312-2019; Coronado Munoz, Alvaro Jose/AAL-4569-2020; Kleinman, Lawrence/AAS-6934-2021; Gertz, Shira J/AAT-2711-2020 OI Harwayne-Gidansky, Ilana/0000-0001-7987-6440; Hymes, Saul Robert/0000-0002-2276-7160; Coronado Munoz, Alvaro Jose/0000-0001-5349-5260; McCulloh, Russell/0000-0002-0403-6639; Hume, Janet/0000-0002-8891-6800; Hobbs, Charlotte/0000-0003-4829-0791; Lansell, Amanda/0000-0002-5501-3373; Randolph, Adrienne/0000-0002-3084-3071; keenaghan, michael/0000-0001-8363-8541; Ratner, Adam/0000-0003-1761-794X; Maddux, Aline/0000-0002-0949-4284; Giuliano, John/0000-0003-2753-8460; Bukulmez, Hulya/0000-0002-2256-9068; Gertz, Shira/0000-0001-8119-6006; Li, Simon/0000-0002-5371-1995; Son, Mary Beth/0000-0002-7394-2862 FU Centers for Disease Control and Prevention [75D30120C07725] FX Supported by the Centers for Disease Control and Prevention under a contract to Boston Children's Hospital (75D30120C07725). 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PD JUL 23 PY 2020 VL 383 IS 4 BP 334 EP 346 DI 10.1056/NEJMoa2021680 PG 13 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA MU1XJ UT WOS:000555465900018 PM 32598831 OA Green Published DA 2023-05-13 ER PT J AU Isogai, T Matsui, H Tanaka, H Fushimi, K Yasunaga, H AF Isogai, Toshiaki Matsui, Hiroki Tanaka, Hiroyuki Fushimi, Kiyohide Yasunaga, Hideo TI In-hospital Takotsubo syndrome versus in-hospital acute myocardial infarction among patients admitted for non-cardiac diseases: a nationwide inpatient database study SO HEART AND VESSELS LA English DT Article DE Takotsubo syndrome; Acute myocardial infarction; In-hospital complication; Non-cardiac disease; Mortality ID ST-SEGMENT ELEVATION; TASK-FORCE; CLINICAL CHARACTERISTICS; DIAGNOSTIC-CRITERIA; EUROPEAN-SOCIETY; RISK-FACTORS; HEALTH-CARE; CARDIOMYOPATHY; MORTALITY; OUTCOMES AB Takotsubo syndrome (TTS) and acute myocardial infarction (AMI) occasionally occur during hospitalization for non-cardiac diseases. However, no study has compared the clinical characteristics between in-hospital TTS and AMI. Using the Diagnosis Procedure Combination database in Japan between 2010 and 2014, we retrospectively identified eligible inpatients who were admitted for non-cardiac diseases and developed TTS (n = 230) or AMI (n = 611) as an early in-hospital complication diagnosed by coronary angiography within 7 days after admission. We examined factors associated with developing in-hospital TTS or AMI using multivariable logistic regression. We also compared 30-day and overall in-hospital mortality between patients with TTS and AMI using 1:1 propensity score matching. Despite similar age (72.7 +/- 12.4 vs. 72.8 +/- 10.4 years), patients with TTS were more often female (63.5 vs. 32.9%) and underweight (24.8 vs. 14.1%) and were more likely to have had impaired activities of daily living (ADL) and impaired consciousness than those with AMI. Multivariable logistic regression analysis showed that female sex [adjusted odds ratio: 4.16 (95% confidence interval: 2.73-6.34)], impaired ADL [2.33 (1.18-4.60)], chronic pulmonary disease [3.33 (1.49-7.44)], and pneumonia [3.00 (1.81-4.98)] were associated with developing TTS relative to AMI, while overweight status, aortic disease, cerebrovascular disease, peripheral arterial disease, and dyslipidemia were associated with developing AMI relative to TTS. Propensity score-matched analysis (189 pairs) showed that 30-day in-hospital mortality was not significantly different between patients with TTS and AMI (15.3 vs. 19.0%, p = 0.41), but overall in-hospital mortality was significantly lower in patients with TTS than in those with AMI (19.6 vs. 29.1%, p = 0.041). This study suggests that although in-hospital TTS and in-hospital AMI are similarly likely to occur in older patients, in-hospital TTS is more likely to occur in female patients with impaired ADL and/or respiratory disease and carries a similar 30-day mortality risk but a lower overall in-hospital mortality risk compared with in-hospital AMI. Our results indicate the importance of differentiating TTS from AMI in hospital settings. C1 [Isogai, Toshiaki; Matsui, Hiroki; Yasunaga, Hideo] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan. [Isogai, Toshiaki; Tanaka, Hiroyuki] Tokyo Metropolitan Tama Med Ctr, Dept Cardiol, Tokyo, Japan. [Fushimi, Kiyohide] Tokyo Med & Dent Univ, Grad Sch Med, Dept Hlth Policy & Informat, Tokyo, Japan. C3 University of Tokyo; Tokyo Medical & Dental University (TMDU) RP Isogai, T (通讯作者)，Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan.; Isogai, T (通讯作者)，Tokyo Metropolitan Tama Med Ctr, Dept Cardiol, Tokyo, Japan. EM toisogai-circ@umin.ac.jp OI Yasunaga, Hideo/0000-0002-6017-469X FU Ministry of Health, Labour and Welfare, Japan [H30-Policy-Designated-004, H29-ICT-General-004]; Ministry of Education, Culture, Sports, Science and Technology, Japan [17H04141] FX This study was funded by Grants from the Ministry of Health, Labour and Welfare, Japan (Grant numbers: H30-Policy-Designated-004 and H29-ICT-General-004) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (Grant number: 17H04141). The funders had no role in the execution of this study or the interpretation of the results. 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The purpose was to provide recommendations for educational interventions for high-risk patients with both ACS and T2DM. Design Umbrella review of systematic reviews and meta-analyses. Setting Inpatient and postdischarge settings. Participants Patients with ACS and T2DM. Data sources CINAHL, Cochrane Library, Joanna Briggs Institute, Journals@Ovid, EMBase, Medline, PubMed and Web of Science databases from January 2000 through May 2016. Outcomes measures Clinical outcomes (such as glycated haemoglobin), behavioural outcomes (such as smoking), psychosocial outcomes (such as anxiety) and medical service use. Results Fifty-one eligible reviews (15 for ACS and 36 for T2DM) consisting of 1324 relevant studies involving 2 88 057 patients (15 papers did not provide the total sample); 30 (58.8%) reviews were rated as high quality. Nurses only and multidisciplinary teams were the most frequent professionals to provide education, and most educational interventions were delivered postdischarge. Face-to-face sessions were the most common delivery formats, and many education sessions were also delivered by telephone or via web contact. The frequency of educational sessions was weekly or monthly, and an average of 3.7 topics was covered per education session. Psychoeducational interventions were generally effective at reducing smoking and admissions for patients with ACS. Culturally appropriate health education, self-management educational interventions, group medical visits and psychoeducational interventions were generally effective for patients with T2DM. Conclusions Results indicate that there is a body of current evidence about the efficacy of health education, its content and delivery methods for patients with ACS or T2DM. These results provide recommendations about the content for, and approach to, health education intervention for these high-risk patients. C1 [Liu, Xian-liang; Shi, Yan] Tongji Univ, Peoples Hosp 10, Shanghai, Peoples R China. [Liu, Xian-liang] Australian Catholic Univ, Sch Nursing Midwifery & Paramed, Brisbane, Qld, Australia. [Liu, Xian-liang] Jinggangshan Univ, Sch Nursing, Jian, Jiangxi, Peoples R China. [Willis, Karen] La Trobe Univ, Melbourne Hlth, Melbourne, Vic, Australia. [Wu, Chiung-Jung (Jo)] Univ Sunshine Coast, Sch Nursing Midwifery & Paramed, Sunshine Coast, Australia. [Wu, Chiung-Jung (Jo)] Queensland Univ Technol, Sch Nursing, Brisbane, Qld, Australia. [Wu, Chiung-Jung (Jo)] RBWH, Herston, Qld, Australia. [Wu, Chiung-Jung (Jo)] Univ Queensland, MMRI, Brisbane, Qld, Australia. [Johnson, Maree] Australian Catholic Univ, Fac Hlth Sci, Sydney, NSW, Australia. [Johnson, Maree] Ingham Inst Appl Med Res, Sydney, NSW, Australia. C3 Tongji University; Australian Catholic University; Jinggangshan University; La Trobe University; University of the Sunshine Coast; Queensland University of Technology (QUT); Royal Brisbane & Women's Hospital; Mater Research; University of Queensland; Australian Catholic University; Ingham Institute for Applied Medical Research RP Liu, XL (通讯作者)，Tongji Univ, Peoples Hosp 10, Shanghai, Peoples R China.; Liu, XL (通讯作者)，Australian Catholic Univ, Sch Nursing Midwifery & Paramed, Brisbane, Qld, Australia.; Liu, XL (通讯作者)，Jinggangshan Univ, Sch Nursing, Jian, Jiangxi, Peoples R China. EM liu.xianliang@myacu.edu.au OI Willis, Karen/0000-0001-8036-8814; Liu, Xian-Liang/0000-0002-3296-5339 FU Australian Catholic University Faculty of Health Sciences Tongji University Cotutelle PhD Scholarship FX This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The lead author is a recipient of an Australian Catholic University Faculty of Health Sciences Tongji University Cotutelle PhD Scholarship. 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NR 83 TC 17 Z9 19 U1 0 U2 12 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 OCT PY 2017 VL 7 IS 10 AR e016857 DI 10.1136/bmjopen-2017-016857 PG 30 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA FS7VN UT WOS:000422617500110 PM 29042383 OA gold, Green Submitted, Green Accepted, Green Published DA 2023-05-13 ER PT J AU Odermatt, J Hersberger, L Bolliger, R Graedel, L Christ-Crain, M Briel, M Bucher, HC Mueller, B Schuetz, P AF Odermatt, Jonas Hersberger, Lara Bolliger, Rebekka Graedel, Lena Christ-Crain, Mirjam Briel, Matthias Bucher, Heiner C. Mueller, Beat Schuetz, Philipp TI The natriuretic peptide MR-proANP predicts all-cause mortality and adverse outcome in community patients: a 10-year follow-up study SO CLINICAL CHEMISTRY AND LABORATORY MEDICINE LA English DT Article DE all-cause mortality; atrial natriuretic peptide; general practitioner; MR-proANP; primary care ID ACUTE HEART-FAILURE; LONG-TERM SURVIVAL; RESPIRATORY-TRACT INFECTIONS; GERMAN COMPETENCE NETWORK; ACUTE CORONARY SYNDROME; B-TYPE; ACQUIRED PNEUMONIA; MIDREGIONAL PROATRIAL; CARDIOVASCULAR EVENTS; MULTIPLE BIOMARKERS AB Background: The precursor peptide of atrial natriuretic peptide (MR-proANP) has a physiological role in fluid homeostasis and is associated with mortality and adverse clinical outcomes in heart failure patients. Little is known about the prognostic potential of this peptide for long-term mortality prediction in community-dwelling patients. We evaluated associations of MR-proANP levels with 10-year all-cause mortality in patients visiting their general practitioner for a respiratory tract infection. Methods: In this post-hoc analysis including 359 patients (78.5%) of the original trial, we calculated cox regression models and area under the receiver operating characteristic curve (AUC) to assess associations of MR-proANP blood levels with mortality and adverse outcome including death, pulmonary embolism, and major adverse cardiac or cerebrovascular events. Results: After a median follow-up of 10.0 years, 9.8% of included patients died. Median admission MR-proANP levels were significantly elevated in non-survivors compared to survivors (80.5 pmol/L, IQR 58.6-126.0; vs. 45.6 pmol/L, IQR 34.2-68.3; p < 0.001) and associated with 10-year all-cause mortality (age-adjusted HR 2.0 [95% CI 1.3-3.1, p = 0.002]; AUC 0.79). Results were similar for day 7 blood levels and also for the prediction of other adverse outcomes. Conclusions: Increased MR-proANP levels were associated with 10-year all-cause mortality and adverse clinical outcome in a sample of community-dwelling patients. If diagnosis-specific cut-offs are confirmed in future studies, this marker may help to direct preventive measures in primary care. C1 [Odermatt, Jonas; Hersberger, Lara; Bolliger, Rebekka; Graedel, Lena; Mueller, Beat; Schuetz, Philipp] Med Univ Clin, Kantonsspital Aarau, Dept Endocrinol Diabetol & Metab, Tellstr, CH-5001 Aarau, Switzerland. [Odermatt, Jonas; Hersberger, Lara; Bolliger, Rebekka; Graedel, Lena; Christ-Crain, Mirjam; Briel, Matthias; Bucher, Heiner C.; Mueller, Beat; Schuetz, Philipp] Univ Basel, Basel, Switzerland. [Christ-Crain, Mirjam] Univ Hosp Basel, Dept Endocrinol Diabetol & Metab, Dept Clin Res, Basel, Switzerland. [Briel, Matthias; Bucher, Heiner C.] Univ Hosp Basel, Basel Inst Clin Epidemiol & Biostat, Dept Clin Res, Basel, Switzerland. [Briel, Matthias] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada. C3 Kantonsspital Aarau AG (KSA); University of Basel; University of Basel; University of Basel; McMaster University RP Schuetz, P (通讯作者)，Med Univ Clin, Kantonsspital Aarau, Dept Endocrinol Diabetol & Metab, Tellstr, CH-5001 Aarau, Switzerland.; Schuetz, P (通讯作者)，Univ Basel, Basel, Switzerland. EM schuetzph@gmail.com RI Mueller, Beat/G-2662-2012; schuetz, philipp/C-8475-2013; Briel, Matthias/AAT-9284-2021 OI schuetz, philipp/0000-0001-6400-4949; Christ-Crain, Mirjam/0000-0002-6336-0965; Briel, Matthias/0000-0002-2070-5230 FU Swiss National Science Foundation [3300C0-107772]; Association for the Promotion of Science and Postgraduate Training of the University Hospital Basel; Freiwillige Akademische Gesellschaft; Department of Endocrinology, Diabetology and Clinical Nutrition; Department of Clinical Chemistry, all Basel, Switzerland; B.r.a.h.m.s.; bioMerieux FX The investigator-initiated PARTI trial was sponsored by a grant from the Swiss National Science Foundation (3300C0-107772) and by the Association for the Promotion of Science and Postgraduate Training of the University Hospital Basel. B.r.a.h.m.s. AG provided assay and kit material related to the study. Dr. Schuetz and Dr. Christ-Crain were supported by funds of the Freiwillige Akademische Gesellschaft, the Department of Endocrinology, Diabetology and Clinical Nutrition, and the Department of Clinical Chemistry, all Basel, Switzerland. Drs. Christ-Crain, Mueller and Schuetz, received support from B.r.a.h.m.s. to attend meetings and fulfilled speaking engagements. Drs. Schuetz, Christ-Crain and Mueller received support from bioMerieux to attend meetings and fulfilled speaking engagements. Dr. Mueller has served as a consultant and received research support from B.r.a.h.m.s. and bioMerieux. Heiner C. Bucher has received research support from B.r.a.h.m.s. 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PD SEP PY 2017 VL 55 IS 9 BP 1407 EP 1416 DI 10.1515/cclm-2016-0760 PG 10 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA FD0SV UT WOS:000407249900027 PM 28107168 OA Green Accepted, Green Submitted DA 2023-05-13 ER PT J AU Hambraeus, K Tyden, P Lindahl, B AF Hambraeus, Kristina Tyden, Patrik Lindahl, Bertil TI Time trends and gender differences in prevention guideline adherence and outcome after myocardial infarction: Data from the SWEDEHEART registry SO EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY LA English DT Article DE Secondary prevention; myocardial infarction; registry study; Guideline adherence ID ACUTE CORONARY SYNDROMES; CARDIAC REHABILITATION; HEART-DISEASE; CARDIOVASCULAR-DISEASE; SECONDARY PREVENTION; EUROPEAN COUNTRIES; EUROASPIRE III; RISK; CARE; READMISSION AB Background While secondary prevention improves prognosis after acute myocardial infarction (AMI), previous studies have suggested suboptimal guideline adherence, lack of improvement over time and gender differences. This study contributes contemporary data from a large national cohort. Method We identified 51,620 patients <75 years examined at two and/or twelve months post AMI in the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Risk factor control and readmissions at one year were compared between the 2005 and 2012 cohorts, and between genders. Results Lipid control (LDL-cholesterol <2.5mmol/L) improved from 67.9% to 71.1% (p=0.016) over time, achieved by 67.9% vs 63.3%, p<0.001 of men vs women. Blood pressure control (<140mmHg systolic) increased over time (59.1% vs 69.5%, p<0.001 in 2005 and 2012 cohorts) and was better in men (66.4% vs 61.9%, p<0.001). Smoking cessation rate was 55.6% without differences between genders or over time. Cardiac readmissions occurred in 18.2% of women and 15.5% of men, decreasing from 2005 to 2012 (20.8% vs 14.9%). Adjusted odds ratio was 1.22 (95% CI 1.14-1.32) for women vs men and 0.94 (95% CI 0.92-0.96) for the 2012 vs the 2005 cohort. Conclusions Although this study compares favourably to previous studies of risk factor control post AMI, improvement over time was mainly seen regarding blood pressure, revealing substantial remaining preventive potential. The reasons for gender differences seen in risk factor control and readmissions require further analysis. C1 [Hambraeus, Kristina] Falun Cent Hosp, Dept Cardiol, S-79182 Falun, Sweden. [Hambraeus, Kristina; Lindahl, Bertil] Uppsala Univ, Dept Med Sci, Uppsala, Sweden. [Tyden, Patrik] Skane Univ Hosp, Dept Cardiol, Lund, Sweden. [Lindahl, Bertil] Uppsala Clin Res Ctr, Uppsala, Sweden. C3 Falun Hospital; Uppsala University; Lund University; Skane University Hospital; Uppsala University RP Hambraeus, K (通讯作者)，Falun Cent Hosp, Dept Cardiol, S-79182 Falun, Sweden. EM Kristina.hambraeus@ltdalarna.se RI Demchuk, Andrew M/E-1103-2012 OI Demchuk, Andrew M/0000-0002-4930-7789; Hambraeus, Kristina/0000-0002-0768-2484 FU Swedish government; Swedish Association of Local Authorities and Regions; National Board of Health and Welfare; Centre for Clinical Research, County of Dalarna, Sweden FX The SWEDEHEART-registry is co-funded by the Swedish government and the Swedish Association of Local Authorities and Regions and the National Board of Health and Welfare. This study was also funded by Centre for Clinical Research, County of Dalarna, Sweden. 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J. Prev. Cardiol. PD MAR PY 2016 VL 23 IS 4 BP 340 EP 348 DI 10.1177/2047487315585293 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DD6YS UT WOS:000370071300001 PM 25986497 OA Bronze DA 2023-05-13 ER PT J AU Rosenfeld, A Christensen, V Daya, M AF Rosenfeld, Anne Christensen, Vivian Daya, Mohamud TI Long Enough to Act? Symptom and Behavior Patterns Prior to Out-of-Hospital Sudden Cardiac Death SO JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE myocardial infarction; narrative analysis; out-of-hospital death; sudden cardiac death; symptoms ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; TREATMENT-SEEKING DELAY; HEART-DISEASE; UNITED-STATES; FAMILY REPORTS; REDUCE DELAY; WOMEN; ARREST; CARE AB Background: Sudden cardiac death is a major cause of death in the United States. Most cases occur outside the hospital, yet little is known about the symptoms and actions of individuals who die before reaching the hospital. Objective: The purpose of this study was to describe the symptoms, symptom management, and care-seeking patterns in sudden cardiac death victims. Methods: This cross-sectional study used qualitative and quantitative data collection methods to obtain descriptions of symptoms and treatment-seeking delay from family members and bystanders (respondents) in 140 cases of sudden cardiac death due to presumed myocardial infarction. Decedents were identified from death certificate data from the state of Oregon in the United States. Respondents completed a survey of demographics and myocardial infarction symptoms and an in-depth interview. Narrative analysis was used to analyze qualitative data. Results: Three behavior patterns or trajectory types were developed focusing on key characteristics of the symptom patterns, the meanings attributed to those symptoms, the actions taken by the decedents and their family members or bystanders, and the time course of events. Each case was categorized as 1 trajectory type. The trajectory types are Normal Day (n = 49), Something Not Right (n = 62), and Thought It Was Something Else (n = 29). The key distinction across the trajectory types is the perception and interpretation of symptoms and the resulting actions between symptom perception and death. Conclusions: This study is 1 of the first to describe what victims of sudden cardiac death are doing and thinking during the period between symptom onset and collapse. The trajectory types identified in this study suggest that misinterpretation of symptoms (the Something Not Right and Thought It Was Something Else groups) is common among victims and bystanders. C1 [Rosenfeld, Anne] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR 97201 USA. [Christensen, Vivian] Portland VA Med Ctr, Evidence Based Synth Program, Coordinating Ctr, Portland, OR USA. [Daya, Mohamud] Oregon Hlth & Sci Univ, Dept Emergency Med, Portland, OR 97201 USA. C3 Oregon Health & Science University; US Department of Veterans Affairs; Veterans Health Administration (VHA); Portland VA Medical Center; Oregon Health & Science University RP Rosenfeld, A (通讯作者)，Univ Arizona, Coll Nursing, POB 210203, Tucson, AZ 85721 USA. EM arosenfeld@nursing.arizona.edu RI Daya, Mohamud R/A-9322-2012 OI Christensen, Vivian/0000-0002-1303-5371 FU American Heart Association Pacific Mountain Affiliate [0450040Z] FX This study was funded by American Heart Association Pacific Mountain Affiliate Grant in Aid 0450040Z. 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Cardiovasc. Nurs. PD MAR-APR PY 2013 VL 28 IS 2 BP 166 EP 175 DI 10.1097/JCN.0b013e3182452410 PG 10 WC Cardiac & Cardiovascular Systems; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology; Nursing GA 091AR UT WOS:000315021600015 PM 22343214 DA 2023-05-13 ER PT J AU Rodriguez, JBC Cu, C Siddiqui, T AF Rodriguez, Jose B. Cruz Cu, Cameron Siddiqui, Tariq TI Narrative review in the current role of angiotensin receptor-neprilysin inhibitors SO ANNALS OF TRANSLATIONAL MEDICINE LA English DT Review DE Sacubitril; sacubitril/valsartan; neprilysin; LCZ696; angiotensin receptor neprilysin inhibitor (ARNI) AB Heart failure (HF) accounts for a tremendous burden on health care systems and the society. Since the landmark PARADIGM- HF trial, sacubitril/valsartan, the first in the class of angiotensin receptor neprilysin inhibitor (ARNI) showed superiority to enalapril in patients with HF with reduced ejection fraction (HFrEF). We performed a narrative literature review, hand-searched the reference lists of included articles and relevant reviews. Inhibition of neprilysin increases bradykinin, natriuretic peptides and adrenomedullin levels counteract the neurohormal activation that leads to sodium retention, vasoconstriction, and cardiac remodeling. In PARADIGM-HF the primary outcome of CV death or HF hospitalization was reduced 20% in the ARNI group (HR 0.80, P<0.001) similar to mortality due to cardiovascular cause (HR 0.80, P<0.001) in patients with HFrEF, rendering a number needed to treat of 21 patients. This effect was consistent across subgroups. The safety of starting ARNI inpatient once the acute decompensation of HF is stabilized was demonstrated in PIONEER-HF trial. With willingness-topay thresholds commonly acceptable in the United States, sacubitril/valsartan is likely to be cost effective, which might not be in other health systems. Although its safety has been reassured in some clinical trials, common side effects are hypotension, worsening kidney function, hyperkalemia and angioedema. In HFpEF (PARAGON-HF), sacubitril/valsartan showed decrease in the level of the cardiac biomarkers, with improve functional NYHA and decrease in hospitalizations, predominately in women and patients with borderline ejection fraction. Some ongoing studies aim to demonstrate the effects of ARNI in acute coronary syndrome, stable ischemic heart disease, advanced HF, mitral regurgitation, aortic impedance and pulmonary hypertension. In conclusion, sacubitril/valsartan has proven to be an effective addition to the HFrEF arsenal, with safety comparable to current standard of care. In HFpEF, it improves quality of life, particularly in women and in patients with borderline ejection fraction, with no effect on mortality. C1 [Rodriguez, Jose B. Cruz; Siddiqui, Tariq] Texas Tech Univ, Hlth Sci Ctr, Div Cardiovasc Dis, 4800 Alberta Ave, El Paso, TX 79905 USA. [Cu, Cameron] Texas Tech Univ, Hlth Sci Ctr, Dept Internal Med, El Paso, TX USA. C3 Texas Tech University System; Texas Tech University; Texas Tech University Health Science Center; Texas Tech University System; Texas Tech University RP Rodriguez, JBC (通讯作者)，Texas Tech Univ, Hlth Sci Ctr, Div Cardiovasc Dis, 4800 Alberta Ave, El Paso, TX 79905 USA. 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TRANSL. MED. PD MAR PY 2021 VL 9 IS 6 AR 518 DI 10.21037/atm-20-4038 PG 9 WC Oncology; Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology; Research & Experimental Medicine GA RF9BT UT WOS:000635133500003 PM 33850915 OA Green Published, gold DA 2023-05-13 ER PT J AU Miller, RJH Southern, D Wilton, SB James, MT Har, B Schnell, G van Diepen, S Grant, ADM AF Miller, Robert J. H. Southern, Danielle Wilton, Stephen B. James, Matthew T. Har, Bryan Schnell, Greg van Diepen, Sean Grant, Andrew D. M. TI Comparative Prognostic Accuracy of Risk Prediction Models for Cardiogenic Shock SO JOURNAL OF INTENSIVE CARE MEDICINE LA English DT Article DE cardiogenic shock; risk prediction; shock; acute coronary syndrome ID MYOCARDIAL-INFARCTION; VALIDATION; MANAGEMENT; SUPPORT; DEATH; SCORE; TIME AB Objectives: Despite advances in medical therapy, reperfusion, and mechanical support, cardiogenic shock remains associated with excess morbidity and mortality. Accurate risk stratification may improve patient management. We compared the accuracy of established risk scores for cardiogenic shock. Methods: Patients admitted to tertiary care center cardiac care units in the province of Alberta in 2015 were assessed for cardiogenic shock. The Acute Physiology and Chronic Health Evaluation-II (APACHE-II), CardShock, intra-aortic balloon pump (IABP) Shock II, and sepsis-related organ failure assessment (SOFA) risk scores were compared. Receiver operating characteristic curves were used to assess discrimination of in-hospital mortality and compared using DeLong's method. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. Results: The study included 3021 patients, among whom 510 (16.9%) had cardiogenic shock. Patients with cardiogenic shock had longer median hospital stays (median 11.0 vs 4.1 days, P < .001) and were more likely to die (29.0% vs 2.5%, P < .001). All risk scores were adequately calibrated for predicting hospital morality except for the APACHE-II score (Hosmer-Lemeshow P < .001). Discrimination of in-hospital mortality with the APACHE-II (area under the curve [AUC]: 0.72, 95% confidence interval [CI]: 0.66-0.76) and IABP-Shock II (AUC: 0.73, 95% CI: 0.68-0.77) scores were similar, while the CardShock (AUC: 0.76, 95% CI: 0.72-0.81) and SOFA (AUC: 0.76, 95%CI: 0.72-0.81) scores had better discrimination for predicting in-hospital mortality. Conclusions: In a real-world population of patients with cardiogenic shock, existing risk scores had modest prognostic accuracy, with no clear superior score. Further investigation is required to improve the discriminative abilities of existing models or establish novel methods. C1 [Miller, Robert J. H.; Wilton, Stephen B.; Har, Bryan; Schnell, Greg; Grant, Andrew D. M.] Univ Calgary, Cumming Sch Med, Libin Cardiovasc Inst Alberta, Dept Cardiac Sci, Room C-835,1403-29th St NW, Calgary, AB T2N 2Y8, Canada. [Southern, Danielle; Wilton, Stephen B.; James, Matthew T.] Univ Calgary, Dept Community Hlth Sci, OBrien Inst Publ Hlth, Cumming Sch Med, Calgary, AB, Canada. [James, Matthew T.] Univ Calgary, Cumming Sch Med, Libin Cardiovasc Inst Alberta, Dept Med, Calgary, AB, Canada. [van Diepen, Sean] Univ Alberta, Fac Med, Div Cardiol, Dept Crit Care, Edmonton, AB, Canada. C3 Libin Cardiovascular Institute Of Alberta; University of Calgary; University of Calgary; Libin Cardiovascular Institute Of Alberta; University of Calgary; University of Alberta RP Grant, ADM (通讯作者)，Univ Calgary, Cumming Sch Med, Libin Cardiovasc Inst Alberta, Dept Cardiac Sci, Room C-835,1403-29th St NW, Calgary, AB T2N 2Y8, Canada. 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Intensive Care Med. PD DEC PY 2020 VL 35 IS 12 BP 1513 EP 1519 DI 10.1177/0885066619878125 PG 7 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA OS5FS UT WOS:000590190300021 PM 31610748 DA 2023-05-13 ER PT J AU Limon, O Atilla, R Oray, NC Limon, G Doylan, O AF Limon, O. Atilla, R. Oray, N. C. Limon, G. Doylan, O. TI Serial measurement of heart-type fatty acid binding protein for the rapid diagnosis of acute coronary syndromes in the emergency department SO HONG KONG JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Acute phase protein; biological marker; early diagnosis; point of care system; sensitivity and specificity ID MYOCARDIAL-INFARCTION; AMERICAN-COLLEGE; MARKER; ASSOCIATION; GUIDELINES; CARDIOLOGY; ACCURACY; SOCIETY AB Introduction: We aimed to investigate the diagnostic accuracy of heart-type fatty acid binding protein (H-FABP) at admission and the third and sixth hour after admission in patients presenting to the emergency department (ED) with chest pain or equivalent symptoms. Methods: This prospective study was performed over two months in the ED. Patients presenting with ischaemic-type chest pain or other symptoms suggestive of myocardial ischaemia were included in the study. A bedside, point-of-care, quantitative H-FABP level was measured. If the initial electrocardiography (ECG) was non-diagnostic, the patients were observed for six hours. During the observation period, serial H-FABP measurements were obtained at admission, the third hour and the sixth hour; serial measurements of total creatine kinase (CK), CK-MB, troponin I and myoglobin were recorded at admission and the sixth hour. Results: A total of 183 patients were included in the study. Initial H-FABP was measured in a joint group of ST segment elevation myocardial infarction (STEMI) and non ST segment elevation myocardial infarction (NSTEMI) patients, with a sensitivity of 80.9%, specificity of 19.2%, positive predictive value (PPV) of 23% and negative predictive value (NPV) of 77.1%. The third-hour H-FABP was measured in the NSTEMI group, with a sensitivity of 46.7%, specificity of 80.2%, PPV of 42.4% and NPV of 82.6%. The sixth-hour H-FABP had a sensitivity of 33.3%, specificity of 73.9%, PPV of 24.2% and NPV of 81.5%. Conclusion: H-FABP is superior to myoglobin for diagnosing myocardial infarction in a joint group of STEMI and NSTEMI patients. The third-hour NPV value for H-FABP indicates that, for safety considerations, the cardiac observation time should not be shortened. C1 [Limon, O.] Izmir Univ, Dept Emergency Med, Fac Med, Izmir, Turkey. [Atilla, R.; Oray, N. C.] Dokuz Eylul Univ, Dept Emergency Med, Fac Med, Izmir, Turkey. [Limon, G.] Buca Seyfi Demirsoy State Hosp, Dept Emergency Med, Izmir, Turkey. [Doylan, O.] Bagcilar Training & Res Hosp, Dept Emergency Med, Istanbul, Turkey. C3 Izmir University; Dokuz Eylul University; Seyfi Demirsoy State Hospital; Istanbul Bagcilar Training & Research Hospital RP Limon, O (通讯作者)，Izmir Univ, Dept Emergency Med, Fac Med, Izmir, Turkey. EM dronderlimon@yahoo.com RI Lmn, Nd/Q-6127-2019; oray, nese colak/Q-3568-2019; Limon, Onder/HGU-4105-2022 OI Lmn, Nd/0000-0002-3541-2289; oray, nese colak/0000-0001-6821-9031; Limon, Onder/0000-0002-3541-2289 CR Alhashemi JA, 2006, AM J EMERG MED, V24, P149, DOI 10.1016/j.ajem.2005.08.002 Valle HA, 2008, EUR J EMERG MED, V15, P140, DOI 10.1097/MEJ.0b013e3282efd47a Anderson JL, 2007, CIRCULATION, V116, P803, DOI 10.1161/CIRCULATIONAHA.107.185752 Body R, 2011, RESUSCITATION, V82, P1041, DOI 10.1016/j.resuscitation.2011.03.015 BRAUNWALD E, 1989, CIRCULATION, V80, P410, DOI 10.1161/01.CIR.80.2.410 Cavus U, 2006, J NATL MED ASSOC, V98, P1067 Chan CPY, 2004, Z KARDIOL, V93, P388, DOI 10.1007/s00392-004-0080-6 Charpentier S, 2011, ARCH CARDIOVASC DIS, V104, P524, DOI 10.1016/j.acvd.2011.07.002 Figiel L, 2008, KARDIOL POL, V66, P253 Fihn SD, 2012, CIRCULATION, V126, pE354, DOI 10.1161/CIR.0b013e318277d6a0 Glatz JFC, 2002, J CLIN LIGAND ASSAY, V25, P167 Ilva T, 2009, CLIN CHIM ACTA, V400, P82, DOI 10.1016/j.cca.2008.10.005 Jaffe AS, 2001, CARDIOLOGY Lloyd-Jones D, 2009, CIRCULATION, V119, pE21, DOI 10.1161/CIRCULATIONAHA.108.191261 Nakata T, 2003, CARDIOLOGY, V99, P96, DOI 10.1159/000069726 O'Connor RE, 2010, CIRCULATION, V122, pS787, DOI 10.1161/CIRCULATIONAHA.110.971028 OCKNER RK, 1972, SCIENCE, V177, P56, DOI 10.1126/science.177.4043.56 Orak M, 2010, AM J EMERG MED, V28, P891, DOI 10.1016/j.ajem.2009.05.012 Slot MHEB, 2010, HEART, V96, P1957, DOI 10.1136/hrt.2010.208272 Verheugt FWA, 2001, CARDIOLOGY, P141 Wagner GS, 2009, J AM COLL CARDIOL, V53, P1003, DOI 10.1016/j.jacc.2008.12.016 NR 21 TC 0 Z9 0 U1 0 U2 8 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1024-9079 EI 2309-5407 J9 HONG KONG J EMERG ME JI Hong Kong J. Emerg. Med. PD JUL PY 2014 VL 21 IS 4 BP 213 EP 221 DI 10.1177/102490791402100403 PG 9 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AL9KS UT WOS:000339460600003 DA 2023-05-13 ER PT J AU Ghassemi, M Marshall, J Singh, N Stone, DJ Celi, LA AF Ghassemi, Marzyeh Marshall, John Singh, Nakul Stone, David J. Celi, Leo Anthony TI Leveraging a Critical Care Database Selective Serotonin Reuptake Inhibitor Use Prior to ICU Admission Is Associated With Increased Hospital Mortality SO CHEST LA English DT Article ID DEPRESSION; OUTCOMES; RISKS AB Background: Observational studies have found an increased risk of adverse effects such as hemorrhage, stroke, and increased mortality in patients taking selective serotonin reuptake inhibitors (SSRIs). The impact of prior use of these medications on outcomes in critically ill patients has not been previously examined. We performed a retrospective study to determine if preadmission use of SSRIs or serotonin norepinephrine reuptake inhibitors (SNRIs) is associated with mortality differences in patients admitted to the ICU. Methods: The retrospective study used a modifiable data mining technique applied to the publicly available Multiparameter Intelligent Monitoring in Intensive Care (MIMIC) 2.6 database. A total of 14,709 patient records, consisting of 2,471 in the SSRI/SNRI group and 12,238 control subjects, were analyzed. The study outcome was in-hospital mortality. Results: After adjustment for age, Simplified Acute Physiology Score, vasopressor use, ventilator use, and combined Elixhauser score, SSRI/SNRI use was associated with significantly increased in-hospital mortality (OR, 1.19; 95% CI, 1.02-1.40; P =.026). Among patient subgroups, risk was highest in patients with acute coronary syndrome (OR, 1.95; 95% CI, 1.21-3.13; P =.006) and patients admitted to the cardiac surgery recovery unit (OR, 1.51; 95% CI, 1.11-2.04; P =.008). Mortality appeared to vary by specific SSRI, with higher mortalities associated with higher levels of serotonin inhibition. Conclusions: We found significant increases in hospital stay mortality among those patients in the ICU taking SSRI/SNRIs prior to admission as compared with control subjects. Mortality was higher in patients receiving SSRI/SNRI agents that produce greater degrees of serotonin reuptake inhibition. The study serves to demonstrate the potential for the future application of advanced data examination techniques upon detailed (and growing) clinical databases being made available by the digitization of medicine. C1 [Ghassemi, Marzyeh; Celi, Leo Anthony] MIT, Cambridge, MA 02139 USA. [Marshall, John; Celi, Leo Anthony] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. [Singh, Nakul] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. [Stone, David J.] Univ Virginia, Sch Med, Charlottesville, VA 22908 USA. C3 Massachusetts Institute of Technology (MIT); Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Harvard T.H. Chan School of Public Health; University of Virginia RP Celi, LA (通讯作者)，MIT, 77 Massachusetts Ave,E25-505, Cambridge, MA 02139 USA. EM lceli@bidmc.harvard.edu FU NIBIB NIH HHS [R01 EB001659] Funding Source: Medline; NLM NIH HHS [T15 LM007092] Funding Source: Medline CR Auerbach AD, 2013, JAMA INTERN MED, V173, P1075, DOI 10.1001/jamainternmed.2013.714 Damen NL, 2013, EUR J PREV CARDIOL, V20, P127, DOI 10.1177/2047487312436452 Elixhauser A, 1998, MED CARE, V36, P8, DOI 10.1097/00005650-199801000-00004 Friedman CP, 2010, SCI TRANSL MED, V2, DOI 10.1126/scitranslmed.3001456 Hollander M, 1999, NONPARAMETRIC STAT M HOLM S, 1979, SCAND J STAT, V6, P65 Kendall M.G., 1990, RANK CORRELATION MET Martin GS, 2003, NEW ENGL J MED, V348, P1546, DOI 10.1056/NEJMoa022139 Mojtabai R, 2013, PSYCHOTHER PSYCHOSOM, V82, P161, DOI 10.1159/000345968 Mojtabai R, 2009, PSYCHIAT SERV, V60, P297, DOI 10.1176/appi.ps.60.3.297 Moses C, 2013, POPUL HEALTH MANAG, V16, P147, DOI 10.1089/pop.2012.0100 Olfson M, 2009, ARCH GEN PSYCHIAT, V66, P848, DOI 10.1001/archgenpsychiatry.2009.81 Pan A, 2011, STROKE, V42, P2770, DOI 10.1161/STROKEAHA.111.617043 Pearl J, 2000, CAUSALITY MODELS REA, P331, DOI DOI 10.1037/1040-3590.7.4.524 Petersen T, 2002, PROG NEURO-PSYCHOPH, V26, P177, DOI 10.1016/S0278-5846(01)00250-0 Pirraglia Paul A., 2003, Prim Care Companion J Clin Psychiatry, V5, P153 Prasad V, 2013, JAMA-J AM MED ASSOC, V309, P241, DOI 10.1001/jama.2012.96867 Ramasubbu R, 2012, ANN CLIN PSYCHIATRY, V24, P91 Smoller JW, 2009, ARCH INTERN MED, V169, P2128, DOI 10.1001/archinternmed.2009.436 Stang PE, 2010, ANN INTERN MED, V153, P600, DOI 10.7326/0003-4819-153-9-201011020-00010 Strand K, 2008, ACTA ANAESTH SCAND, V52, P467, DOI 10.1111/j.1399-6576.2008.01586.x Tatsumi M, 1997, EUR J PHARMACOL, V340, P249, DOI 10.1016/S0014-2999(97)01393-9 Tsai YC, 2012, AM J KIDNEY DIS, V60, P54, DOI 10.1053/j.ajkd.2012.02.325 van Walraven Carl, 2009, Med Care, V47, P626, DOI 10.1097/MLR.0b013e31819432e5 NR 24 TC 25 Z9 25 U1 0 U2 9 PU ELSEVIER PI AMSTERDAM PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS SN 0012-3692 EI 1931-3543 J9 CHEST JI Chest PD APR PY 2014 VL 145 IS 4 BP 745 EP 752 DI 10.1378/chest.13-1722 PG 8 WC Critical Care Medicine; Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Respiratory System GA AE6JO UT WOS:000334097700017 PM 24371841 OA Green Published DA 2023-05-13 ER PT J AU Wei, JH Chen, ZJ Zhang, HT Sun, XG Qian, XY Yu, CT AF Wei, Jinhua Chen, Zujun Zhang, Haitao Sun, Xiaogang Qian, Xiangyang Yu, Cuntao TI In-hospital major adverse outcomes of acute Type A aortic dissection SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY LA English DT Article DE Type A aortic dissection; Mortality; Major adverse outcome; Risk factor; Coronary artery ID GERMAN REGISTRY; RISK-FACTORS; ARCH; MORTALITY; SURGERY AB OBJECTIVES Acute Type A aortic dissection exhibits poor in-hospital outcomes after emergency surgery. Evaluation of risk predictors for in-hospital major adverse outcomes (MAO) is key to reducing the mortality rate and improving the quality of care. METHODS We enrolled 70 patients who presented with postoperative MAO and 195 patients who recovered well. Through univariate and multivariate analyses, clinical characteristics were compared between the patients in the 2 groups. RESULTS In-hospital mortality was 6.4% in this series. The patients in the MAO group were older and had a higher frequency of coronary artery involvement by dissection (60.0% vs 21.0%) (P<0.05). Preoperatively, when compared to the group of patients without MAO, the patients in the MAO group were more likely to have a neurological deficit (18.6% vs 9.7%) and, to a certain extent, lower limb symptoms encompassing visceral and renal malperfusion (20.0% vs 8.2%) (P<0.05). Compared to patients with MAO, patients without MAO experienced longer duration from initial onset of symptoms to surgery and had an ascending aorta with a larger diameter. In patients with MAO, the average durations of cardiopulmonary bypass (CPB), cardiac arrest and hypothermic circulatory arrest were much longer than those in patients with no MAO (all P<0.001). Multivariate analysis showed that in-hospital adverse outcomes were associated with older age [odds ratio (OR) = 1.047 (1.008-1.087), P<0.05], presentation of lower limb symptoms prior to surgery [OR=2.905 (1.109-7.608), P<0.05] and long CPB duration [OR=1.011 (1.005-1.018), P<0.01]. When patients with acute Type A aortic dissection experienced a duration from symptom onset to surgery [OR=0.993 (0.987-0.999), P<0.05] or had an ascending aorta with a large diameter [OR=0.942 (0.892-0.995), P<0.05], the number of postoperative adverse events decreased significantly. CONCLUSIONS At a centre that has a large caseload, where practitioners can become proficient through experience as well as training, good outcomes can be dependably produced in patients with acute Type A aortic dissection and without malperfusion syndromes. For patients presenting with these risk features, MAO need to be anticipated, and the incidence of a composite end point of major adverse events remains unsatisfactory. C1 [Wei, Jinhua; Chen, Zujun; Zhang, Haitao; Sun, Xiaogang; Qian, Xiangyang; Yu, Cuntao] Chinese Acad Med Sci, FuWai Hosp, Dept Cardiovasc Surg, Natl Ctr Cardiovasc Dis, South Nanli Rd 167, Beijing 100037, Peoples R China. [Wei, Jinhua; Chen, Zujun; Zhang, Haitao; Sun, Xiaogang; Qian, Xiangyang; Yu, Cuntao] Peking Union Med Coll, South Nanli Rd 167, Beijing 100037, 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 RP Yu, CT (通讯作者)，Chinese Acad Med Sci, FuWai Hosp, Dept Cardiovasc Surg, Natl Ctr Cardiovasc Dis, South Nanli Rd 167, Beijing 100037, Peoples R China.; Yu, CT (通讯作者)，Peking Union Med Coll, South Nanli Rd 167, Beijing 100037, Peoples R China. 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PD FEB PY 2019 VL 55 IS 2 BP 345 EP 350 DI 10.1093/ejcts/ezy269 PG 6 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA HQ8XZ UT WOS:000462711700026 PM 30657909 OA Bronze DA 2023-05-13 ER PT J AU Tolonen, A Pakarinen, T Sassi, A Kytta, J Cancino, W Rinta-Kiikka, I Pertuz, S Arponen, O AF Tolonen, Antti Pakarinen, Tomppa Sassi, Antti Kytta, Jere Cancino, William Rinta-Kiikka, Irina Pertuz, Said Arponen, Otso TI Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review SO EUROPEAN JOURNAL OF RADIOLOGY LA English DT Review DE Computed tomography; Body composition; Body composition analysis; Sarcopenia ID VISCERAL ADIPOSE-TISSUE; DUAL-ENERGY CT; SKELETAL-MUSCLE MASS; CORONARY-ARTERY-DISEASE; NEOADJUVANT CHEMOTHERAPY; SUBCUTANEOUS FAT; PROGNOSTIC VALUE; SARCOPENIC OBESITY; NUTRITIONAL-STATUS; METABOLIC SYNDROME AB Purpose of the review: We aim to review the methods, current research evidence, and future directions in body composition analysis (BCA) with CT imaging. Recent findings: CT images can be used to evaluate muscle tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) compartments. Manual and semiautomatic segmentation methods are still the gold standards. The segmentation of skeletal muscle tissue and VAT and SAT compartments is most often performed at the level of the 3rd lumbar vertebra. A decreased amount of CT-determined skeletal muscle mass is a marker of impaired survival in many patient populations, including patients with most types of cancer, some surgical patients, and those admitted to the intensive care unit (ICU). Patients with increased VAT are more susceptible to impaired survival / worse outcomes; however, those patients who are critically ill or admitted to the ICU or who will undergo surgery appear to be exceptions. The independent significance of SAT is less well established. Recently, the roles of the CT-determined decrease of muscle mass and increased VAT area and epicardial adipose tissue (EAT) volume have been shown to predict a more debilitating course of illness in patients suffering from severe acute respiratory syndrome coronavirus 2 (COVID-19) infection. Summary: The field of CT-based body composition analysis is rapidly evolving and shows great potential for clinical implementation. C1 [Tolonen, Antti; Pakarinen, Tomppa; Sassi, Antti; Kytta, Jere; Rinta-Kiikka, Irina; Arponen, Otso] Tampere Univ, Fac Med & Hlth Sci, Kauppi Campus,Arvo Ylpon Katu 34, Tampere 33520, Finland. [Pakarinen, Tomppa; Sassi, Antti; Rinta-Kiikka, Irina; Arponen, Otso] Tampere Univ Hosp, Dept Radiol, Kuntokatu 2, Tampere 33520, Finland. [Cancino, William; Pertuz, Said] Univ Ind Santander, Connect & Signal Proc Grp, Cl 9 Cra 27, Bucaramanga, Colombia. 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PD DEC PY 2021 VL 145 AR 109943 DI 10.1016/j.ejrad.2021.109943 EA NOV 2021 PG 14 WC Radiology, Nuclear Medicine & Medical Imaging WE Science Citation Index Expanded (SCI-EXPANDED) SC Radiology, Nuclear Medicine & Medical Imaging GA YJ0NB UT WOS:000744234900011 PM 34839215 OA hybrid DA 2023-05-13 ER PT J AU Dieval, C Deligny, C Meyer, A Cluzel, P Champtiaux, N Lefevre, G Saadoun, D Sibilia, J Pellegrin, JL Hachulla, E Benveniste, O Hervier, B AF Dieval, Celine Deligny, Christophe Meyer, Alain Cluzel, Philippe Champtiaux, Nicolas Lefevre, Guillaume Saadoun, David Sibilia, Jean Pellegrin, Jean-Luc Hachulla, Eric Benveniste, Olivier Hervier, Baptiste TI Myocarditis in Patients With Antisynthetase Syndrome Prevalence, Presentation, and Outcomes SO MEDICINE LA English DT Article ID CARDIAC INVOLVEMENT; HEART; DERMATOMYOSITIS; POLYMYOSITIS AB Antisynthetase syndrome (aSS) corresponds to an overlapping inflammatory myopathy identified by various myositis-specific autoantibodies (directed against tRNA-synthetases). Myocardial involvement in this condition is poorly described. From a registry of 352 aSS patients, 12 cases of myocarditis were retrospectively identified on the basis of an unexplained increase in troponin T/I levels associated with either suggestive cardiac magnetic resonance imaging (MRI) findings, nonsignificant coronary artery abnormalities or positive endomyocardial biopsy. The prevalence of myocarditis in aSS is 3.4% and was not linked to any autoantibody specificity: anti-Jo1 (n = 8), anti-PL7 (n = 3), and anti-PL12 (n = 1). Myocarditis was a part of the first aSS manifestations in 42% of the cases and was asymptomatic (n = 2) or revealed by an acute (n = 4) or a subacute (n = 6) cardiac failure. It should be noted that myocarditis was always associated with an active myositis. When performed (n = 11), cardiac MRI revealed a late hypersignal in the T1-images in 73% of the cases (n = 8). Half of the patients required intensive care. Ten patients (83%) received dedicated cardiotropic drugs. Steroids and at least 1 immunosuppressive drug were given in all cases. After a median follow-up of 11 months (range 0-84) 9 (75%) patients recovered whereas 3 (25%) developed a chronic cardiac insufficiency. No patient died. The prevalence of myocarditis in aSS is similar to that of other inflammatory myopathies. Although the prognosis is relatively good, myocarditis is a severe condition and should be carefully considered as a possible manifestation in active aSS patients. C1 Ctr Hosp Rochefort, Serv Malad Infect & Malad Sang, Rochefort, France. Ctr Hosp Univ Ft France, Serv Med Interne, Fort De France, Martinique, France. [Meyer, Alain; Sibilia, Jean] Hosp Univ Strasbourg, Serv Rhumatol, Ctr Natl Reference Malad Autoimmunes & Syst Rares, Strasbourg, France. [Cluzel, Philippe] Hop La Pitie Salpetriere, DHU I2B, Ctr Natl Reference Malad Neuromusculaires, Serv Radiol Vasc & Intervent, Paris 13, France. [Champtiaux, Nicolas; Saadoun, David; Benveniste, Olivier; Hervier, Baptiste] Hop La Pitie Salpetriere, DHU I2B, Ctr Natl Reference Malad Neuromusculaires, Dept Med Interne & Immunol Clin, Paris 13, France. [Lefevre, Guillaume; Hachulla, Eric] Univ Lille, Hop Claude Huriez, Serv Med Interne, Ctr Natl Reference Malad Autoimmunes & Syst Rares, Lille, France. [Pellegrin, Jean-Luc] Hop Haut Leveque, Serv Med Interne, Pessac, France. C3 CHU Martinique; CHU Strasbourg; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Universite de Lille - ISITE; CHU Lille; Universite de Lille; CHU Bordeaux; UDICE-French Research Universities; Universite de Bordeaux RP Hervier, B (通讯作者)，Hop La Pitie Salpetriere, AP HP, Paris 13, France. 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Michael Hernandez, Adrian F. Hull, Russell D. Kazmi, Syed Hassan A. Younes, Ahmed Walia, Sargun S. Pitliya, Anmol Singh, Amandeep Kahe, Farima Kalayci, Arzu Nafee, Tarek Kerneis, Mathieu AlKhalfan, Fahad Cohen, Alexander T. Harrington, Robert A. Goldhaber, Samuel Z. TI Association of Anemia with Venous Thromboembolism in Acutely Ill Hospitalized Patients: An APEX Trial Substudy SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Anemia; Anticoagulants; Factor Xa inhibitors; hemoglobin; Venous thrombosis; Venous thromboembolism ID ACUTE CORONARY SYNDROMES; ENDOTHELIAL DYSFUNCTION; ACUTE CATHETERIZATION; HEMOGLOBIN LEVELS; MEDICAL PATIENTS; EVENTS; RISK; THROMBOSIS; MORTALITY; STRATEGY AB BACKGROUND: Anemia is a common finding and independent predictor for adverse outcomes in hospitalized patients with medical illness. It remains unclear whether anemia is a risk factor for venous thromboembolism and whether the presence of anemia can refine risk assessment for prediction of venous thromboembolism, thereby adding incremental utility to a validated model. METHODS: In the Acute Medically Ill Venous Thromboembolism Prevention with Extended Duration Betrixaban trial (APEX). 7513 hospitalized medical patients were randomized to receive either betrixaban or standard-of-care enoxaparin for thromboprophylaxis. Baseline hemoglobin concentrations were obtained in 6861 patients, with a follow-up of 77 days. Symptomatic venous thromboembolism events, including symptomatic deep vein thrombosis, pulmonary embolism, and venous thromboembolism-related mortality, were compared between low-hemoglobin and normal-hemoglobin groups (normal range: 12.5-17.0 g/dL for males and 11.0-15.5 g/dL for females). The relationship between anemia and venous thromboembolism events was assessed by fitting a univariable and multivariable logistic regression model composed of thromboprophylaxis and risk factors. Venous thromboembolism risk refinement by hemoglobin measurement was evaluated in the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) risk assessment model. RESULTS: Low hemoglobin at baseline was associated with a greater risk of symptomatic venous thromboembolism (relative risk [RR] 1.94 [95% confidence interval, 1.27-2.98]; P = .002), symptomatic deep vein thrombosis (RR 2.29 [1.12-4.68]; P = .019), and nonfatal pulmonary embolism (RR 2.63 [1.22-5.65]; P = .010) but not venous thromboembolism-related mortality (RR 1.47 [0.71-3.04]; P = .30). After adjusting for thromboprophylaxis, history of previous venous thromboembolism, intensive or coronary unit admission. and D-dimer. low hemoglobin (as a categorical or continuous variable) remained associated with an increased likelihood of venous thromboembolism (adjusted odds ratio 1.71 [95% confidence interval, 1.092.69]; P = .020). Low hemoglobin also improved risk discrimination and reclassification after inclusion in the IMPROVE model. CONCLUSIONS: Anemia was independently associated with a greater risk of symptomatic venous thromboembolism among acutely ill medical patients despite the provision of thromboprophylaxis. Hemoglobin measurement also improved risk stratification by the IMPROVE venous thromboembolism risk score. (C) 2018 Elsevier Inc. All rights reserved. C1 [Chi, Gerald; Gibson, C. Michael; Kazmi, Syed Hassan A.; Younes, Ahmed; Walia, Sargun S.; Pitliya, Anmol; Singh, Amandeep; Kahe, Farima; Kalayci, Arzu; Nafee, Tarek; Kerneis, Mathieu; AlKhalfan, Fahad] Harvard Med Sch, Dept Med, Beth Israel Deaconess Med Ctr, Div Cardiovasc Med, 930 Commonwealth Ave 3, Boston, MA 02215 USA. [Hernandez, Adrian F.] Duke Univ, Durham, NC USA. [Hernandez, Adrian F.] Duke Clin Res Inst, Durham, NC USA. [Hull, Russell D.] Univ Calgary, Fac Med, Div Cardiol, Calgary, AB, Canada. [Cohen, Alexander T.] Kings Coll London, Guys Hosp, Dept Haematol Med, London, England. [Cohen, Alexander T.] Kings Coll London, St Thomas Hosp, Dept Haematol Med, London, England. [Harrington, Robert A.] Stanford Univ, Dept Med, Div Cardiovasc Med, Stanford, CA 94305 USA. [Goldhaber, Samuel Z.] Harvard Med Sch, Brigham & Womens Hosp, Div Cardiovasc Med, Boston, MA USA. C3 Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; Duke University; Duke University; University of Calgary; Guy's & St Thomas' NHS Foundation Trust; RLUK- Research Libraries UK; University of London; King's College London; Guy's & St Thomas' NHS Foundation Trust; RLUK- Research Libraries UK; University of London; King's College London; Stanford University; Harvard University; Brigham & Women's Hospital; Harvard Medical School RP Chi, G (通讯作者)，Harvard Med Sch, Dept Med, Beth Israel Deaconess Med Ctr, Div Cardiovasc Med, 930 Commonwealth Ave 3, Boston, MA 02215 USA. EM geraldcchi@gmail.com RI Gibson, C. Michael/AAE-8212-2019; Pitliya, Anmol/L-8886-2019; Hernandez, Adrian F/A-7818-2016; Chi, Gerald/M-7855-2017; Salerno, Rebecca/HKM-4100-2023; Kalayci, Arzu/ABB-7214-2020 OI Pitliya, Anmol/0000-0002-5142-9638; Hernandez, Adrian F/0000-0003-3387-9616; Chi, Gerald/0000-0002-8371-1689; Kerneis, Mathieu/0000-0002-7141-5209 FU Portola Pharmaceuticals, Inc. FX Portola Pharmaceuticals, Inc. 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J. Med. PD AUG PY 2018 VL 131 IS 8 AR 972.e1 DI 10.1016/j.amjmed.2018.03.031 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA GQ2UM UT WOS:000441513900039 PM 29660351 DA 2023-05-13 ER PT J AU Hessami, A Shamshirian, A Heydari, K Pourali, F Alizadeh-Navaei, R Moosazadeh, M Abrotan, S Shojaie, L Sedighi, S Shamshirian, D Rezaei, N AF Hessami, Amirhossein Shamshirian, Amir Heydari, Keyvan Pourali, Fatemeh Alizadeh-Navaei, Reza Moosazadeh, Mahmood Abrotan, Saeed Shojaie, Layla Sedighi, Sogol Shamshirian, Danial Rezaei, Nima TI Cardiovascular diseases burden in COVID-19: Systematic review and meta-analysis SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Review DE COVID-19; Cardiovascular disease; Meta-analysis ID RESPIRATORY SYNDROME CORONAVIRUS; CLINICAL CHARACTERISTICS; SARS-COV-2 INFECTION; MYOCARDIAL INJURY; CHEST CT; D-DIMER; PNEUMONIA; WUHAN; OUTCOMES; COMORBIDITIES AB Background: High rate of cardiovascular disease (CVD) have been reported among patients with novel coronavirus disease (COVID-19). Meanwhile there were controversies among different studies about CVD burden in COVID-19 patients. Hence, we aimed to study CVD burden among COVID-19 patients, using a systematic review and meta-analysis. Methods: We have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar. Meta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs. We have also performed a descriptive meta-analysis on different CVDs. Results: Fifty-six studies entered into meta-analysis for ICU admission and mortality outcome and 198 papers for descriptive outcomes, including 159,698 COVID-19 patients. Results of meta-analysis indicated that acute cardiac injury, (OR: 13.29, 95% CI 7.35-24.03), hypertension (OR: 2.60, 95% CI 2.11-3.19), heart Failure (OR: 6.72, 95% CI 3.34-13.52), arrhythmia (OR: 2.75, 95% CI 1.43-5.25), coronary artery disease (OR: 3.78, 95% CI 2.42-5.90), and cardiovascular disease (OR: 2.61, 95% CI 1.89-3.62) were significantly associated with mortality. Arrhythmia (OR: 7.03, 95% CI 2.79-17.69), acute cardiac injury (OR: 15.58, 95% CI 5.15-47.12), coronary heart disease (OR: 2.61, 95% CI 1.09-6.26), cardiovascular disease (OR: 3.11, 95% CI 1.59-6.09), and hypertension (OR: 1.95, 95% CI 1.41-2.68) were also significantly associated with ICU admission in COVID-19 patients. Conclusion: Findings of this study revealed a high burden of CVDs among COVID-19 patients, which was signifi-cantly associated with mortality and ICU admission. Proper management of CVD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations. (c) 2020 Elsevier Inc. All rights reserved. C1 [Hessami, Amirhossein; Heydari, Keyvan; Pourali, Fatemeh] Mazandaran Univ Med Sci, Sch Med, Student Res Comm, Sari, Iran. [Hessami, Amirhossein] Universal Sci Educ & Res Network USERN, Systemat Review & Meta Anal Expert Grp SRMEG, Tehran, Iran. [Hessami, Amirhossein; Rezaei, Nima] Universal Sci Educ & Res Network USERN, Network Immun Infect Malignancy & Autoimmun NIIMA, Tehran, Iran. [Shamshirian, Amir; Heydari, Keyvan; Alizadeh-Navaei, Reza; Moosazadeh, Mahmood] Mazandaran Univ Med Sci, Gastrointestinal Canc Res Ctr, Noncommunicable Dis Inst, Sari, Iran. [Shamshirian, Amir] Mazandaran Univ Med Sci, Sch Allied Med Sci, Dept Med Lab Sci, Sari, Iran. [Moosazadeh, Mahmood] Mazandaran Univ Med Sci, Hlth Sci Res Ctr, Addict Inst, Sari, Iran. [Abrotan, Saeed] Babol Univ Med Sci, Dept Cardiol, Babol, Iran. [Shojaie, Layla] Univ Southern Calif, Res Ctr Liver Dis, Keck Sch Med, Dept Med, Los Angeles, CA 90007 USA. [Sedighi, Sogol] Shiraz Univ Med Sci, Student Res Comm, Shiraz, Iran. [Shamshirian, Danial] Shahid Beheshti Univ Med Sci, Chron Resp Dis Res Ctr, Natl Res Inst TB & Lung Dis NRITLD, Tehran, Iran. [Rezaei, Nima] Univ Tehran Med Sci, Res Ctr Immunodeficiencies, Childrens Med Ctr, Tehran, Iran. [Rezaei, Nima] Univ Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran. C3 Mazandaran University Medical Sciences; Universal Scientific Education & Research Network (USERN); Universal Scientific Education & Research Network (USERN); Mazandaran University Medical Sciences; Mazandaran University Medical Sciences; Mazandaran University Medical Sciences; Babol University of Medical Sciences; University of Southern California; Shiraz University of Medical Science; Shahid Beheshti University Medical Sciences; Tehran University of Medical Sciences; Tehran University of Medical Sciences RP Rezaei, N (通讯作者)，Childrens Med Ctr Hosp, Res Ctr Immunodeficiencies, Dr Qarib St,Keshavarz Blvd, Tehran 14194, Iran. EM rezaei_nima@tums.ac.ir RI moosazadeh, mahmood/F-3730-2017; Alizadeh-Navaei, Reza/B-2207-2017; Hessami, Amirhossein/ABB-5460-2020; Shamshirian, Amir/K-4975-2017; Rezaei, Nima/B-4245-2008 OI moosazadeh, mahmood/0000-0002-5452-514X; Alizadeh-Navaei, Reza/0000-0003-0580-000X; Hessami, Amirhossein/0000-0002-1219-1081; Shamshirian, Amir/0000-0002-2735-0209; Shojaie, Layla/0000-0002-5020-5181; Rezaei, Nima/0000-0002-3836-1827; Heydari, Keyvan/0000-0002-2843-7832; Pourali, Fatemeh/0000-0002-3375-4699; Sedighi, Sogol/0000-0003-0136-5821; Shamshirian, Danial/0000-0001-8461-3477 FU Student Research Committee, Mazandaran University of Medical Sciences [7396] FX Student Research Committee, Mazandaran University of Medical Sciences (code number: 7396) . 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PD AUG PY 2021 VL 46 BP 382 EP 391 DI 10.1016/j.ajem.2020.10.022 EA JUL 2021 PG 10 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA TU8UX UT WOS:000681307200069 PM 33268238 OA Green Published DA 2023-05-13 ER PT J AU Asaria, P Elliott, P Douglass, M Obermeyer, Z Soljak, M Majeed, A Ezzati, M AF Asaria, Perviz Elliott, Paul Douglass, Margaret Obermeyer, Ziad Soljak, Michael Majeed, Azeem Ezzati, Majid TI Acute myocardial infarction hospital admissions and deaths in England: a national follow-back and follow-forward record-linkage study SO LANCET PUBLIC HEALTH LA English DT Article ID HEART-DISEASE MORTALITY; ACUTE CORONARY SYNDROME; 4 US COMMUNITIES; CASE-FATALITY; PREHOSPITAL DELAY; TRENDS; ASSOCIATION; OUTCOMES; STROKE; RATES AB Background Little information is available on how primary and comorbid acute myocardial infarction contribute to the mortality burden of acute myocardial infarction, the share of these deaths that occur during or after a hospital admission, and the reasons for hospital admission of those who died from acute myocardial infarction. Our aim was to fill in these gaps in the knowledge about deaths and hospital admissions due to acute myocardial infarction. Methods We used individually linked national hospital admission and mortality data for England from 2006 to 2010 to identify all primary and comorbid diagnoses of acute myocardial infarction during hospital stay and their associated fatality rates (during or within 28 days of being in hospital). Data were obtained from the UK Small Area Health Statistics Unit and supplied by the Health and Social Care Information Centre (now NHS Digital) and the Office of National Statistics. We calculated event rates (reported as per 100 000 population for relevant age and sex groups) and case-fatality rate for primary acute myocardial infarction diagnosed during the first physician encounter or during subsequent encounters, and acute myocardial infarction diagnosed only as a comorbidity. We also calculated what proportion of deaths from acute myocardial infarction occurred in people who had been in hospital on or within the 28 days preceding death, and whether acute myocardial infarction was one of the recorded diagnoses in such admissions. Findings Acute myocardial infarction was diagnosed in the first physician encounter in 307 496 (69%) of 446 744 admissions with a diagnosis of acute myocardial infarction, in the second or later physician encounter in 52 374 (12%) admissions, and recorded only as a comorbidity in 86 874 (19%) admissions. Patients with comorbid diagnoses of acute myocardial infarction had two to three times the case-fatality rate of patients in whom acute myocardial infarction was a primary diagnosis. 135 950 deaths were recorded as being caused by acute myocardial infarction as the underlying cause of death, of which 66 490 (49%) occurred in patients who were in hospital on the day of death or in the 28 days preceding death. AMI was the primary diagnosis in 32 695 (49%) of these 66 490 patients (27 678 [42%] diagnosed in the first physician encounter and 5017 [8%] in a second or subsequent encounter), was a comorbid diagnosis in 12 118 (18%), and was not mentioned at all in the remaining 21 677 (33%). The most common causes of admission in people who did not have an acute myocardial infarction diagnosis but went on to die of acute myocardial infarction as the underlying cause of death were other circulatory conditions (7566 [35%] of 21 677 deaths), symptomatic diagnoses including non-specific chest pain, dyspnoea and syncope (1368 [6%] deaths), and respiratory disorders (2662 [12%] deaths), mainly pneumonia and chronic obstructive airways disease. Interpretation As many acute myocardial infarction deaths occurring within 28 days of being in hospital follow a non-acute myocardial infarction admission as follow an acute myocardial infarction admission. These people are often diagnosed with other circulatory disorders or symptoms of circulatory disturbance. Further investigation is needed to establish whether there are symptoms and information that can be used to predict the risk of a fatal acute myocardial infarction in such patients, which can contribute to reducing the mortality burden of acute myocardial infarction. C1 [Asaria, Perviz; Elliott, Paul; Douglass, Margaret; Ezzati, Majid] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London W2 1PG, England. [Elliott, Paul; Douglass, Margaret; Ezzati, Majid] Imperial Coll London, MRC PHE Ctr Environm & Hlth, UK Small Area Hlth Stat Unit, London, England. [Soljak, Michael; Majeed, Azeem] Imperial Coll London, Sch Publ Hlth, Dept Primary Care & Publ Hlth, London, England. [Asaria, Perviz; Elliott, Paul] Imperial Coll Healthcare NHS Trust, London, England. [Obermeyer, Ziad] Harvard Univ, Harvard Med Sch, Dept Emergency Med & Hlth Care Policy, Boston, MA 02115 USA. [Obermeyer, Ziad] Brigham & Womens Hosp, Dept Emergency Med, 75 Francis St, Boston, MA 02115 USA. C3 RLUK- Research Libraries UK; Imperial College London; RLUK- Research Libraries UK; Imperial College London; RLUK- Research Libraries UK; Imperial College London; RLUK- Research Libraries UK; Imperial College London; Harvard University; Harvard Medical School; Harvard University; Brigham & Women's Hospital RP Ezzati, M (通讯作者)，Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London W2 1PG, England. EM majid.ezzati@imperial.ac.uk OI Elliott, Paul/0000-0002-7511-5684; Majeed, Azeem/0000-0002-2357-9858; Soljak, Michael/0000-0002-0303-1617 FU Wellcome Trust; Medical Research Council; Public Health England; National Institute for Health Research; Medical Research Council [G0801056, MR/L01341X/1, MR/L01632X/1] Funding Source: researchfish; National Institute for Health Research [NF-SI-0611-10136] Funding Source: researchfish; MRC [G0801056, MR/L01632X/1, MR/L01341X/1] Funding Source: UKRI FX Wellcome Trust, Medical Research Council, Public Health England, National Institute for Health Research. 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A. Mueller, C. Greenslade, J. H. Wildi, K. Pickering, J. Than, M. Aldous, S. Boeddinghaus, J. Hammett, C. J. Hawkins, T. Nestelberger, T. Reichlin, T. Reidt, S. Gimenez, M. Rubin Tate, J. R. Twerenbold, R. Ungerer, J. P. Cullen, L. TI Validation of NICE diagnostic guidance for rule out of myocardial infarction using high-sensitivity troponin tests SO HEART LA English DT Article ID ACUTE CORONARY SYNDROME; EMERGENCY-DEPARTMENT; T ASSAY; PROTOCOL; RISK AB Objective To validate the National Institute for Health and Care Excellence (NICE) recommended algorithms for high-sensitivity troponin (hsTn) assays in adults presenting with chest pain. Methods International post hoc analysis of three prospective, observational studies from tertiary hospital emergency departments. The primary endpoint was cardiac death or acute myocardial infarction (AMI) within 24 hours of presentation, and the secondary endpoint was major adverse cardiac events (MACE) at 30 days. Results 15% of patients were diagnosed with non-ST elevation myocardial infarction (MI) on admission. The hsTnI algorithm classified 2506/3128 (80.1%) of patients as 'ruled out' with 50 (2.0%) missed MI. 943/3128 (30.1%) of patients had a troponin I level below the limit of detection on admission with 2 (0.2%) missed MI. For the hsTnT algorithm, 1794/3374 (53.1%) of patients were 'ruled out' with 7 (0.4%) missed MI. 490/3374 (14.5%) of patients had a troponin T below the limit of blank on admission with no MI. MACE at 30 days occurred in 10.7% and 8.5% of patients 'ruled out' defined by the hsTnI and hsTnT algorithms, respectively. Conclusions The NICE algorithms could identify patients with low probability of AMI within 2 hours; however, neither strategy performed as predicted by the NICE diagnostic guidance model. Additionally, the rate of MACE at 30 days was sufficiently high that the algorithms should only be used as one component of a more extensive model of risk stratification. C1 [Parsonage, W. A.; Greenslade, J. H.; Hammett, C. J.; Hawkins, T.; Tate, J. R.; Ungerer, J. P.; Cullen, L.] Royal Brisbane & Womens Hosp, Herston, Qld, Australia. [Mueller, C.; Wildi, K.; Boeddinghaus, J.; Nestelberger, T.; Reichlin, T.; Reidt, S.; Gimenez, M. Rubin; Twerenbold, R.] Univ Hosp, Cardiovasc Res Inst, Basel, Switzerland. [Pickering, J.; Than, M.; Aldous, S.] Christchurch Hosp, Christchurch, New Zealand. C3 Royal Brisbane & Women's Hospital; Christchurch Hospital New Zealand RP Parsonage, WA (通讯作者)，Royal Brisbane & Womens Hosp, Dept Cardiol, Herston, Qld 4029, Australia. EM w.parsonage@mac.com RI Cullen, Louise A/D-2274-2013; Greenslade, Jaimi/D-7832-2011; Cullen, Louise/ABC-9266-2021; Pickering, John W/A-9453-2009; Ungerer, Jacobus PJ/J-3881-2017; Wildi, Karin/AAN-3644-2020; Pickering, John/ABC-8089-2021; Twerenbold, Raphael/H-3533-2018; Parsonage, William/O-9233-2018 OI Cullen, Louise A/0000-0001-6611-8229; Greenslade, Jaimi/0000-0002-6970-5573; Cullen, Louise/0000-0001-6611-8229; Pickering, John W/0000-0001-9475-0344; Ungerer, Jacobus PJ/0000-0003-4929-0929; Wildi, Karin/0000-0002-6520-2696; Pickering, John/0000-0001-9475-0344; Twerenbold, Raphael/0000-0003-3814-6542; Hawkins, Tracey/0000-0001-9815-7150; Nestelberger, Thomas/0000-0003-2173-5738; Parsonage, William/0000-0002-0223-5378 CR Aldous SJ, 2012, CAN MED ASSOC J, V184, pE260, DOI 10.1503/cmaj.110773 Aldous SJ, 2011, ANN CLIN BIOCHEM, V48, P241, DOI 10.1258/acb.2010.010219 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], 2012, 12014 IM ROCH DIAGN Apple FS, 2012, CLIN CHEM, V58, P1599, DOI 10.1373/clinchem.2012.194985 Apple FS, 2009, CLIN CHEM, V55, P1303, DOI 10.1373/clinchem.2009.128363 Aroney CN, 2006, MED J AUSTRALIA, V184, pS1 Bandstein N, 2014, J AM COLL CARDIOL, V63, P2569, DOI 10.1016/j.jacc.2014.03.017 Bhuiya Farida A, 2010, NCHS Data Brief, P1 Body R, 2011, J AM COLL CARDIOL, V58, P1333, DOI 10.1016/j.jacc.2011.06.026 Boeddinghaus J, 2016, CLIN CHEM, V62, P494, DOI 10.1373/clinchem.2015.249508 Christ M, 2010, AM J MED, V123, P1134, DOI 10.1016/j.amjmed.2010.07.015 Cullen L, 2010, EMERG MED AUSTRALAS, V22, P35, DOI 10.1111/j.1742-6723.2010.01256.x George T, 2013, EMERG MED AUSTRALAS, V25, P340, DOI 10.1111/1742-6723.12091 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Higgins JPT, 2003, BRIT MED J, V327, P557, DOI 10.1136/bmj.327.7414.557 Hoeller R, 2013, HEART, V99, P1567, DOI 10.1136/heartjnl-2013-303643 National Institute for Health and Care Excellence, 2014, MYOC INF AC EARL RUL National Institute for Health and Clinical Excellence, 2010, CHEST PAIN REC ONS A Parsonage WA, 2014, CLIN CHEM LAB MED, V52, pE25, DOI 10.1515/cclm-2013-0490 Reichlin T, 2012, ARCH INTERN MED, V172, P1211, DOI 10.1001/archinternmed.2012.3698 Reichlin T, 2009, NEW ENGL J MED, V361, P858, DOI 10.1056/NEJMoa0900428 Reiter M, 2011, EUR HEART J, V32, P1379, DOI 10.1093/eurheartj/ehr033 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Shah ASV, 2015, LANCET, V386, P2481, DOI 10.1016/S0140-6736(15)00391-8 Than M, 2013, INT J CARDIOL, V166, P752, DOI 10.1016/j.ijcard.2012.09.171 Than M, 2012, J AM COLL CARDIOL, V59, P2091, DOI 10.1016/j.jacc.2012.02.035 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Wildi K, 2015, CIRCULATION, V131, P2032, DOI 10.1161/CIRCULATIONAHA.114.014129 Zamora Javier, 2006, BMC Med Res Methodol, V6, P31, DOI 10.1186/1471-2288-6-31 NR 30 TC 21 Z9 22 U1 2 U2 7 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 AUG PY 2016 VL 102 IS 16 BP 1279 EP 1286 DI 10.1136/heartjnl-2016-309270 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DV0BA UT WOS:000382581300008 PM 27288278 DA 2023-05-13 ER PT J AU Davies, BM Mowforth, O Wood, H Karimi, Z Sadler, I Tetreault, L Milligan, J Wilson, JRF Kalsi-Ryan, S Furlan, JC Kawaguchi, Y Ito, M Zipser, CM Boerger, TF Vaccaro, AR Murphy, RKJ Hutton, M Rodrigues-Pinto, R Koljonen, PA Harrop, JS Aarabi, B Rahimi-Movaghar, V Kurpad, SN Guest, JD Wilson, JR Kwon, BK Kotter, MRN Fehlings, MG AF Davies, Benjamin M. Mowforth, Oliver Wood, Helen Karimi, Zahabiya Sadler, Iwan Tetreault, Lindsay Milligan, Jamie Wilson, Jamie R. F. Kalsi-Ryan, Sukhvinder Furlan, Julio C. Kawaguchi, Yoshiharu Ito, Manabu Zipser, Carl Moritz Boerger, Timothy F. Vaccaro, Alexander R. Murphy, Rory K. J. Hutton, Mike Rodrigues-Pinto, Ricardo Koljonen, Paul A. Harrop, James S. Aarabi, Bizhan Rahimi-Movaghar, Vafa Kurpad, Shekar N. Guest, James D. Wilson, Jefferson R. Kwon, Brian K. Kotter, Mark R. N. Fehlings, Michael G. TI Improving Awareness Could Transform Outcomes in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 1] SO GLOBAL SPINE JOURNAL LA English DT Article DE cervical; myelopathy; spondylosis; spondylotic; stenosis; disc herniation; ossification posterior longitudinal ligament; degenerative cervical myelopathy; disability; prioritization; research prioritization; review; policy ID ACUTE MYOCARDIAL-INFARCTION; QUALITY-OF-LIFE; SPONDYLOTIC MYELOPATHY; SURGICAL TECHNIQUES; CLINICAL NEUROLOGY; PUBLIC-EDUCATION; TIME; STROKE; IMPACT; SURGERY AB Study Design: Literature Review (Narrative) Objective: To introduce the number one research priority for Degenerative Cervical Myelopathy (DCM): Raising Awareness. Methods: Raising awareness has been recognized by AO Spine RECODE-DCM as the number one research priority. This article reviews the evidence that awareness is low, the potential drivers, and why this must be addressed. Case studies of success from other diseases are also reviewed, drawing potential parallels and opportunities for DCM. Results: DCM may affect as many as 1 in 50 adults, yet few will receive a diagnosis and those that do will wait many years for it. This leads to poorer outcomes from surgery and greater disability. DCM is rarely featured in healthcare professional training programs and has received relatively little research funding (<2% of Amyotrophic Lateral Sclerosis or Multiple Sclerosis over the last 25 years). The transformation of stroke and acute coronary syndrome services, from a position of best supportive care with occasional surgery over 50 years ago, to avoidable disability today, represents transferable examples of success and potential opportunities for DCM. Central to this is raising awareness. Conclusion: Despite the devastating burden on the patient, recognition across research, clinical practice, and healthcare policy are limited. DCM represents a significant unmet need that must become an international public health priority. C1 [Davies, Benjamin M.; Mowforth, Oliver; Wood, Helen; Karimi, Zahabiya; Sadler, Iwan; Kotter, Mark R. N.] Myelopathy Org, Int Char Degenerat Cerv Myelopathy, Cambridge, England. [Davies, Benjamin M.; Mowforth, Oliver; Kotter, Mark R. N.] Univ Cambridge, Dept Neurosurg, Hills Rd, Cambridge CB2 0QQ, England. [Tetreault, Lindsay] NYU, Dept Neurol, Langone Hlth, Grad Med Educ, New York, NY 10016 USA. [Milligan, Jamie] McMaster Univ, Dept Family Med, Hamilton, ON, Canada. [Wilson, Jamie R. F.] Univ Nebraska Med Ctr, Dept Neurosurg, Omaha, NE USA. [Kalsi-Ryan, Sukhvinder; Furlan, Julio C.] Univ Hlth Network, KITE Res Inst, Toronto, ON, Canada. [Kalsi-Ryan, Sukhvinder; Furlan, Julio C.] Univ Toronto, Dept Med, Div Phys Med & Rehabil, Toronto, ON, Canada. [Kawaguchi, Yoshiharu] Univ Toyama, Dept Orthopaed Surg, Toyama, Japan. [Ito, Manabu] Natl Hosp Org Hokkaido Med Ctr, Dept Orthopaed Surg, Sapporo, Hokkaido, Japan. [Zipser, Carl Moritz] Balgrist Univ Hosp, Univ Spine Ctr, Zurich, Switzerland. [Boerger, Timothy F.; Kurpad, Shekar N.] Med Coll Wisconsin, Dept Neurosurg, Wauwatosa, WI USA. [Vaccaro, Alexander R.] Thomas Jefferson Univ, Dept Orthopaed Surg, Rothman Orthopaed Inst, Philadelphia, PA 19107 USA. [Murphy, Rory K. J.] St Josephs Hosp, Barrow Neurol Inst, Dept Neurosurg, Phoenix, AZ USA. [Hutton, Mike] Royal Devon & Exeter NHS Fdn Trust, Exeter, Devon, England. [Rodrigues-Pinto, Ricardo] Ctr Hosp Univ Porto, Dept Orthopaed, Spinal Unit UVM, Hosp Santo Antonio, Porto, Portugal. [Rodrigues-Pinto, Ricardo] Inst Ciencias Biomed Abel Salazar, Porto, Portugal. [Koljonen, Paul A.] Univ Hong Kong, Li Ka Shing Fac Med, Dept Orthopaed & Traumatol, Hong Kong, Peoples R China. [Harrop, James S.] Thomas Jefferson Univ, Dept Neurol Surg, Philadelphia, PA 19107 USA. [Aarabi, Bizhan] Univ Maryland, Sch Med, Dept Neurosurg, Baltimore, MD 21201 USA. [Rahimi-Movaghar, Vafa] Univ Tehran Med Sci, Sina Trauma & Surg Res Ctr, Dept Neurosurg, Tehran, Iran. [Guest, James D.] Univ Miami, Miller Sch Med, Dept Neurosurg, Miami, FL 33136 USA. [Guest, James D.] Univ Miami, Miller Sch Med, Miami Project Cure Paralysis, Miami, FL 33136 USA. [Wilson, Jefferson R.; Fehlings, Michael G.] Univ Toronto, Dept Surg, Div Neurosurg, Toronto, ON, Canada. [Kwon, Brian K.] Univ British Columbia, Vancouver Spine Surg Inst, Dept Orthoped, Vancouver, BC, Canada. C3 RLUK- Research Libraries UK; University of Cambridge; New York University; McMaster University; University of Nebraska System; University of Nebraska Medical Center; University of Toronto; University Health Network Toronto; Toronto Rehabilitation Institute; University of Toronto; University of Toyama; University of Zurich; Medical College of Wisconsin; Jefferson University; Rothman Institute; Barrow Neurological Institute; St. Joseph's Hospital and Medical Center; RLUK- Research Libraries UK; University of Exeter; Universidade do Porto; University of Hong Kong; Jefferson University; University System of Maryland; University of Maryland Baltimore; Tehran University of Medical Sciences; University of Miami; University of Miami; University of Toronto; University of British Columbia RP Davies, BM (通讯作者)，Univ Cambridge, Dept Neurosurg, Hills Rd, Cambridge CB2 0QQ, England.; Fehlings, MG (通讯作者)，Univ Toronto, Dept Surg, Div Neurosurg, Toronto, ON, Canada. EM bd375@cam.ac.uk; michael.fehlings@uhn.ca RI Zipser, Carl Moritz/ACR-8199-2022; Boerger, Timothy/AAL-4142-2021; Boerger, Tim/ABC-5483-2020; Rodrigues-Pinto, Ricardo/B-5028-2013; Davies, Benjamin/AAB-6000-2019; Furlan, Julio/Q-8290-2018 OI Zipser, Carl Moritz/0000-0002-4396-4796; Boerger, Timothy/0000-0003-1587-3704; Rodrigues-Pinto, Ricardo/0000-0002-6903-348X; Davies, Benjamin/0000-0003-0591-5069; Koljonen, Paul Aarne/0000-0002-9250-653X; Furlan, Julio/0000-0002-2038-0018; Mowforth, Oliver/0000-0001-6788-745X; Wood, Helen/0000-0001-6976-4736 FU AO Spine through the AO Spine Knowledge Forum Spinal Cord Injury; AO Spine Research Department; National Institute for Health Research (NIHR) Brain Injury MedTech Co-operative based at Cambridge University Hospitals NHS Foundation Trust; University of Cambridge; NIHR Clinical Doctoral Research Fellowship FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research priorities were organized and funded by AO Spine through the AO Spine Knowledge Forum Spinal Cord Injury, a focused group of international Spinal Cord Injury experts. AO Spine is a clinical division of the AO Foundation, which is an independent medically guided not-for-profit organization. Study support was provided directly through the AO Spine Research Department. MRNK is supported by the National Institute for Health Research (NIHR) Brain Injury MedTech Co-operative based at Cambridge University Hospitals NHS Foundation Trust and University of Cambridge, andBMD an NIHR Clinical Doctoral Research Fellowship. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, or the Department of Health and Social Care. 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CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 2192-5682 EI 2192-5690 J9 GLOB SPINE J JI Glob. Spine J. PD FEB PY 2022 VL 12 IS 1_SUPPL SU 1_ SI SI BP 28S EP 38S DI 10.1177/21925682211050927 PG 11 WC Clinical Neurology; Orthopedics WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Orthopedics GA ZD6SJ UT WOS:000758327200004 PM 35174734 OA Green Published, gold DA 2023-05-13 ER PT J AU Sibila, O Mortensen, EM Anzueto, A Laserna, E Restrepo, MI AF Sibila, Oriol Mortensen, Eric M. Anzueto, Antonio Laserna, Elena Restrepo, Marcos I. TI Prior cardiovascular disease increases long-term mortality in COPD patients with pneumonia SO EUROPEAN RESPIRATORY JOURNAL LA English DT Article ID COMMUNITY-ACQUIRED PNEUMONIA; OBSTRUCTIVE PULMONARY-DISEASE; ACUTE CORONARY SYNDROMES; UNITED-STATES; CARE; HOSPITALIZATIONS; COMORBIDITY; INFECTION; PATTERNS; OUTCOMES AB There is controversy regarding the impact of chronic obstructive pulmonary disease (COPD) in clinical outcomes in elderly patients with pneumonia. Comorbidities such as cardiovascular disease have been reported to play an important role in patients with acute exacerbations of COPD. However, limited data are available regarding the impact of cardiovascular disease in elderly COPD patients who require hospitalisation for pneumonia. We examined a cohort of subjects with pneumonia and pre-existing COPD. Prior cardiovascular disease was defined as history of myocardial infarction, congestive heart failure, cardiac arrhythmia, unstable angina or stroke. Outcomes examined included 30-day, 90-day, 6-month and 1-year mortality. We included 17 140 elderly COPD patients who were hospitalised for pneumonia. Prior cardiovascular disease was present in 10 240 (59.7%) patients. Prior cardiovascular disease was independently associated with 90-day mortality (21.3% versus 19.4%; hazard ratio (HR) 1.29, 95% CI 1.02-1.17), 6-month mortality (29.0% versus 26.1%; HR 1.28, 95% CI 1.07-1.50) and 12-month mortality (39.2% versus 34.5%; HR 1.33, 95% CI 1.15-1.54) when compared to no prior cardiovascular disease. The temporal differential effect between groups increases from 1.0% at 30 days to 4.7% at 1 year. Prior cardiovascular disease is associated with increased long-term mortality in elderly COPD patients with pneumonia. Differences in mortality rates increased over time. C1 [Sibila, Oriol; Anzueto, Antonio; Laserna, Elena; Restrepo, Marcos I.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Mortensen, Eric M.] Vet Affairs North Texas Hlth Care Syst, San Antonio, TX USA. [Mortensen, Eric M.] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA. [Anzueto, Antonio; Restrepo, Marcos I.] South Texas Vet Hlth Care Syst, San Antonio, TX USA. [Restrepo, Marcos I.] Vet Evidence Based Res Disseminat & Implementat C, San Antonio, TX USA. [Sibila, Oriol] Hosp Santa Creu & Sant Pau, Serv Pneumol, Barcelona, Spain. [Laserna, Elena] Hosp Comarcal Mollet, Mollet Del Valles, Spain. C3 University of Texas System; University of Texas Health San Antonio; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA North Texas Health Care System; University of Texas System; University of Texas Southwestern Medical Center Dallas; US Department of Veterans Affairs; Veterans Health Administration (VHA); Audie L. Murphy Memorial Veterans Hospital; Hospital of Santa Creu i Sant Pau RP Restrepo, MI (通讯作者)，South Texas Vet Hlth Care Syst ALMD, VERDICT 11C6, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM restrepom@uthscsa.edu RI Sibila, Oriol/T-4366-2017; Mortensen, Eric/AAF-2713-2020; Restrepo, Marcos I/H-4442-2014 OI Sibila, Oriol/0000-0002-4833-6713; Mortensen, Eric/0000-0002-3880-5563 FU Howard Hughes Medical Institute faculty-start up grant [00378-001]; Dept of Veteran Affairs Veterans Integrated Service Network 17 new faculty grant; Instituto de Salud Carlos III [BAE11/00102]; Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR); Societat Catalana de Pneumologia (SOCAP); Fundacio Catalana de Pneumologia (FUCAP); National Heart, Lung, and Blood Institute [K23HL096054] FX This research was supported by Howard Hughes Medical Institute faculty-start up grant 00378-001 and a Dept of Veteran Affairs Veterans Integrated Service Network 17 new faculty grant. O. Sibila is supported by Instituto de Salud Carlos III (BAE11/00102). O. Sibila and E. Laserna are supported by Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR), Societat Catalana de Pneumologia (SOCAP) and Fundacio Catalana de Pneumologia (FUCAP). M.I. Restrepo's time is partially protected by Award Number K23HL096054 from the National Heart, Lung, and Blood Institute. 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 Dept of Veterans Affairs. CR Agabiti N, 2010, EUR RESPIR J, V35, P1031, DOI 10.1183/09031936.00056209 Agusti A, 2012, AM J RESP CRIT CARE, V185, P1171, DOI 10.1164/rccm.201203-0505UP Anzueto Antonio, 2007, Proc Am Thorac Soc, V4, P554, DOI 10.1513/pats.200701-003FM CHARLSON M, 1994, J CLIN EPIDEMIOL, V47, P1245, DOI 10.1016/0895-4356(94)90129-5 Cooke CR, 2011, BMC HEALTH SERV RES, V11, DOI 10.1186/1472-6963-11-37 Corrales-Medina VF, 2010, LANCET INFECT DIS, V10, P83, DOI 10.1016/S1473-3099(09)70331-7 Curkendall SM, 2006, ANN EPIDEMIOL, V16, P63, DOI 10.1016/j.annepidem.2005.04.008 Dewan NA, 2000, CHEST, V117, P662, DOI 10.1378/chest.117.3.662 Holguin F, 2005, CHEST, V128, P2005, DOI 10.1378/chest.128.4.2005 Joo MJ, 2008, COPD, V5, P360, DOI 10.1080/15412550802522346 Kafkas Nikolaos, 2008, Acute Card Care, V10, P30, DOI 10.1080/17482940701534800 Kaplan V, 2002, AM J RESP CRIT CARE, V165, P766, DOI 10.1164/ajrccm.165.6.2103038 Liapikou A, 2012, EUR RESPIR J, V39, P855, DOI 10.1183/09031936.00067111 LIUZZO G, 1994, NEW ENGL J MED, V331, P417, DOI 10.1056/NEJM199408183310701 Macchia A, 2007, EUR J HEART FAIL, V9, P942, DOI 10.1016/j.ejheart.2007.06.004 Madjid M, 2007, TEX HEART I J, V34, P11 Menendez R, 2004, THORAX, V59, P960, DOI 10.1136/thx.2003.017756 Minino AM, 2011, NATL VITAL STAT REP, V59, P1 Molinos L, 2009, J INFECTION, V58, P417, DOI 10.1016/j.jinf.2009.03.003 Mortensen EM, 2011, EUR RESPIR J, V37, P1306, DOI 10.1183/09031936.00194110 Mortensen EM, 2003, CLIN INFECT DIS, V37, P1617, DOI 10.1086/379712 Mortensen EM, 2002, ARCH INTERN MED, V162, P1059, DOI 10.1001/archinte.162.9.1059 Naghavi M, 2003, CIRCULATION, V107, P762, DOI 10.1161/01.CIR.0000048190.68071.2B Perry TW, 2011, AM J MED, V124, P244, DOI 10.1016/j.amjmed.2010.11.014 Rello J, 2006, EUR RESPIR J, V27, P1210, DOI 10.1183/09031936.06.00139305 Restrepo MI, 2006, EUR RESPIR J, V28, P346, DOI 10.1183/09031936.06.00131905 Sidney S, 2005, CHEST, V128, P2068, DOI 10.1378/chest.128.4.2068 Sohn Min-Woong, 2006, Popul Health Metr, V4, P2, DOI 10.1186/1478-7954-4-2 Torres A, 1996, AM J RESP CRIT CARE, V154, P1456, DOI 10.1164/ajrccm.154.5.8912764 Waterer GW, 2004, AM J RESP CRIT CARE, V169, P910, DOI 10.1164/rccm.200310-1448OC Yende S, 2007, J AM GERIATR SOC, V55, P518, DOI 10.1111/j.1532-5415.2007.01100.x NR 31 TC 22 Z9 23 U1 0 U2 5 PU EUROPEAN RESPIRATORY SOC JOURNALS LTD PI SHEFFIELD PA 442 GLOSSOP RD, SHEFFIELD S10 2PX, ENGLAND SN 0903-1936 EI 1399-3003 J9 EUR RESPIR J JI Eur. Resp. J. PD JAN PY 2014 VL 43 IS 1 BP 36 EP 42 DI 10.1183/09031936.00117312 PG 7 WC Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC Respiratory System GA 287ON UT WOS:000329552200009 PM 23598950 OA Green Accepted, Bronze DA 2023-05-13 ER PT J AU Coventry, LL Bremner, AP Williams, TA Celenza, A AF Coventry, Linda L. Bremner, Alexandra P. Williams, Teresa A. Celenza, Antonio TI The Effect of Presenting Symptoms and Patient Characteristics on Prehospital Delay in MI Patients Presenting to Emergency Department by Ambulance: A Cohort Study SO HEART LUNG AND CIRCULATION LA English DT Article DE Myocardial infarction; Prehospital delay; Symptom presentation; Emergency Department; Emergency medical service ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; POSSIBLE HEART-ATTACK; SEX-DIFFERENCES; TIME; AUSTRALIA; MORTALITY; ARRIVAL; IMPACT AB Introduction There is little recent information about prehospital delay time for Australian patients with myocardial infarction (MI). Objectives This study: (1) describes prehospital delay time for patients with MI; (2) identifies variables and presenting symptoms which contribute to the delay. Methods This retrospective cohort study identified patients with an Emergency Department (ED) discharge diagnosis of MI, transported by ambulance to one of the seven Perth metropolitan EDs, between January 2008 and October 2009. Prehospital delay times were analysed using linear regression models. Non-numeric (word descriptions) of delay time were categorised. Results Of 1,633 patients, symptom onset-time was available for 1,003. For 829 patients with a numeric onset-time, median delay was 2.2 hours; decreased delay was associated with age <70 years, presenting with chest pain, and diaphoresis. Increased delay was associated with being with a primary health care provider, and if the patient was at home and if the person who called the ambulance was anyone other than the spouse. For 174 patients with non-numeric onset-times, 37% patients delayed one to three days and 110 (64.0%) patients described their symptoms as intermittent and/or of gradual onset. Conclusion Given that prehospital delay times remain longer than is optimal, public awareness of MI symptoms should be enhanced in order to decrease prehospital delay. C1 [Coventry, Linda L.; Bremner, Alexandra P.] Univ Western Australia, Sch Populat Hlth, Perth, WA 6009, Australia. [Coventry, Linda L.; Williams, Teresa A.; Celenza, Antonio] Univ Western Australia, Discipline Emergency Med, Sch Primary Aboriginal & Rural Hlth Care, Perth, WA 6009, Australia. [Coventry, Linda L.] Edith Cowan Univ, Fac Hlth Engn & Sci, Sch Nursing & Midwifery, Perth, WA 6027, Australia. [Williams, Teresa A.] St John Ambulance, Perth, WA 6984, Australia. [Williams, Teresa A.] Curtin Univ, Sch Nursing & Midwifery, Prehosp Resuscitat & Emergency Care Res Unit, Perth, WA 6845, Australia. C3 University of Western Australia; University of Western Australia; Edith Cowan University; Curtin University RP Coventry, LL (通讯作者)，Edith Cowan Univ, Fac Hlth Engn & Sci, Sch Nursing & Midwifery, Bldg 21,270 Joondalup Dr, Joondalup, WA 6027, Australia. EM linda.coventry@ecu.edu.au OI Celenza, Antonio/0000-0001-9792-9526; Bremner, Alexandra/0000-0002-4068-4860; Coventry, Linda/0000-0002-3598-9942 CR Australian Bureau of Statistics, STATS TALK WA Australian Institute of Health and Welfare, CARD DIS AUSTR FACTS Bett JHN, 2005, INTERN MED J, V35, P279, DOI 10.1111/j.1445-5994.2004.00798.x BETT N, 1993, AUST NZ J MED, V23, P157, DOI 10.1111/j.1445-5994.1993.tb01810.x Brokalaki H, 2011, INT NURS REV, V58, P470, DOI 10.1111/j.1466-7657.2011.00914.x Coventry LL, 2013, PREHOSP EMERG CARE, V17, P193, DOI 10.3109/10903127.2012.722175 Coventry LL, 2014, PREHOSP EMERG CARE, P1 DeVon HA, 2010, J CARDIOVASC NURS, V25, P106, DOI 10.1097/JCN.0b013e3181bb14a0 Dracup K, 1997, MED J AUSTRALIA, V166, P233, DOI 10.5694/j.1326-5377.1997.tb140101.x Dracup K, 2009, CIRC-CARDIOVASC QUAL, V2, P524, DOI 10.1161/CIRCOUTCOMES.109.852608 Gao Y, 2013, J INT MED RES, V41, P1724, DOI 10.1177/0300060513488511 Goldberg RJ, 2009, AM J CARDIOL, V103, P598, DOI 10.1016/j.amjcard.2008.10.038 Horne R, 2000, HEART, V83, P388, DOI 10.1136/heart.83.4.388 Ingarfield Sharyn L, 2005, Emerg Med Australas, V17, P218 Kelly AM, 2003, MED J AUSTRALIA, V178, P381, DOI 10.5694/j.1326-5377.2003.tb05255.x King KB, 2007, HEART LUNG, V36, P235, DOI 10.1016/j.hrtlng.2006.08.008 LEITCH JW, 1989, MED J AUSTRALIA, V150, P6, DOI 10.5694/j.1326-5377.1989.tb136310.x McGinn AP, 2005, AM HEART J, V150, P392, DOI 10.1016/j.ahj.2005.03.064 McKee G, 2013, INT J CARDIOL, V168, P2706, DOI 10.1016/j.ijcard.2013.03.022 McKinley S, 2000, HEART LUNG, V29, P237, DOI 10.1067/mhl.2000.106940 McKinley S, 2011, EMERG MED AUSTRALAS, V23, P153, DOI 10.1111/j.1742-6723.2011.01385.x Menees DS, 2013, NEW ENGL J MED, V369, P901, DOI 10.1056/NEJMoa1208200 Moser DK, 2006, CIRCULATION, V114, P168, DOI 10.1161/CIRCULATIONAHA.106.176040 Nguyen HL, 2010, CIRC-CARDIOVASC QUAL, V3, P82, DOI 10.1161/CIRCOUTCOMES.109.884361 Rathore S, 2009, BMJ-BRIT MED J, V338, P1 Taylor David McD, 2005, Emerg Med Australas, V17, P204 Terkelsen CJ, 2010, JAMA-J AM MED ASSOC, V304, P763, DOI 10.1001/jama.2010.1139 NR 27 TC 12 Z9 13 U1 0 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1443-9506 EI 1444-2892 J9 HEART LUNG CIRC JI Heart Lung Circ. PD OCT PY 2015 VL 24 IS 10 BP 943 EP 950 DI 10.1016/j.hlc.2015.02.026 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CT6FJ UT WOS:000362907800005 PM 25922230 DA 2023-05-13 ER PT J AU Teixeira, AB Zancaner, LF Ribeiro, FFD Pintya, JP Schmidt, A Maciel, BC Neto, JAM Miranda, CH AF Teixeira, Alessandra Batista Zancaner, Leonardo Fiaschi de Franca Ribeiro, Fernando Fonseca Pintya, Jose Paulo Schmidt, Andre Maciel, Benedito Carlos Neto, Jose Antonio Marin Miranda, Carlos Henrique TI Reperfusion Therapy Optimization in Acute Myocardial Infarction with ST-Segment Elevation using WhatsApp (R)-Based Telemedicine SO ARQUIVOS BRASILEIROS DE CARDIOLOGIA LA English DT Article DE ST Elevation Myocardial Infarction; Acute Coronary Syndrome; Telemedicine/trends; Reperfusion/therapy ID CARE; SYSTEMS AB Background: About 40% of patients with ST-segment elevation myocardial infarction (STEMI) in Brazil do not receive reperfusion therapy. Objective: The use of a telemedicine network based on WhatsApp (R) could increase the percentage of patients receiving reperfusion therapy. Methods: A cross-sectional study analyzed outcomes before and after the organization of a telemedicine network to send the electrocardiogram via WhatsApp (R) of patients suspected of STEMI from 25 municipalities that are members of the Regional Health Department of Ribeirao Preto (DRS-XIII) to a tertiary hospital, which could authorize immediate patient transfer using the same system. The analyzed outcomes included the percentage of patients who received reperfusion therapy and the in-hospital mortality rate. A p value < 0.05 was considered statistically significant. Results: The study compared 82 patients before (February 1, 2016 to January 31, 2018) with 196 patients after this network implementation (February 1, 2018 to January 31, 2020). After implementing this network, there was a significant increase in the proportion of patients who received reperfusion therapy (60% vs. 92%), relative risk (RR): 1.594 [95% confidence interval (CI) 1.331 - 1.909], p < 0.0001 and decrease in the in-hospital mortality rate (13.4% vs. 5.6%), RR: 0.418 [95%CI 0.189 - 0.927], p = 0.028. Conclusion: The use of WhatsApp (R)-based telemedicine has led to an increase in the percentage of patients with STEMI who received reperfusion therapy and a decrease in the in-hospital mortality rate. C1 [Teixeira, Alessandra Batista; Zancaner, Leonardo Fiaschi; Pintya, Jose Paulo; Miranda, Carlos Henrique] Univ Sao Paulo, Fac Med Ribeirao Preto, Div Med Emergencia, Dept Clin Med, Rua Bernardino De Campos 1000, BR-14040900 Ribeirao Preto, RP, Brazil. [de Franca Ribeiro, Fernando Fonseca; Schmidt, Andre; Maciel, Benedito Carlos; Neto, Jose Antonio Marin] Univ Sao Paulo, Fac Med Ribeirao Preto, Ctr Cardiol, Ribeirao Preto, RP, Brazil. C3 Universidade de Sao Paulo; Universidade de Sao Paulo RP Miranda, CH (通讯作者)，Univ Sao Paulo, Fac Med Ribeirao Preto, Div Med Emergencia, Dept Clin Med, Rua Bernardino De Campos 1000, BR-14040900 Ribeirao Preto, RP, Brazil. 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Bras. Cardiol. PY 2022 VL 118 IS 3 BP 556 EP 564 DI 10.36660/abc.20201243 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 0Z6TU UT WOS:000791209200002 PM 35137785 OA gold, Green Submitted, Green Published DA 2023-05-13 ER PT J AU Huded, CP Benck, LR Stone, NJ Sweis, RN Ricciardi, MJ Malaisrie, C Davidson, CJ Flaherty, JD AF Huded, Chetan P. Benck, Lillian R. Stone, Neil J. Sweis, Ranya N. Ricciardi, Mark J. Malaisrie, Chris Davidson, Charles J. Flaherty, James D. TI Relation of Intensity of Statin Therapy and Outcomes After Transcatheter Aortic Valve Replacement SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; ACUTE CORONARY SYNDROMES; MYOCARDIAL-INFARCTION; CARDIAC-SURGERY; ATORVASTATIN; IMPLANTATION; STENOSIS; DISEASE; SIMVASTATIN; RISK AB Statin therapy is associated with improved survival in patients at high risk for cardiovascular mortality, but the impact of statin therapy in patients treated with transcatheter aortic valve replacement (TAVR) is unknown. We reviewed 294 consecutive cases of TAVR performed at a single tertiary care medical center. We defined high-intensity statin therapy as atorvastatin 40 to 80 mg/day or rosuvastatin 20 to 40 mg/day. Study outcomes included post-TAVR adverse events, 30-day mortality, and overall survival. At the time, of TAVR, 14% (n = 41) were on high-intensity statin therapy, 59% (n = 173) were on low- or moderate-intensity statin therapy, and 27% (n = 80) were not on statin therapy. There was no association between statin therapy and the rate of post-TAVR stroke, myocardial infarction, acute kidney injury, in-hospital mortality, or 30-day mortality. At 2 years, 83% of patients in the high-intensity statin group were alive, 70% in the low/moderate-intensity statin group were alive, and 57% in the no statin group were alive (log-rank p = 0.016). In a risk-adjusted model, high-intensity statin therapy was associated with a 64% reduction in all-cause mortality (hazard ratio 0.36, 95% CI 0.14 to 0.90, p = 0.029) compared with no statin therapy. In conclusion, statin therapy is associated with improved overall survival after TAVR in a dose-dependent manner. (C) 2017 Elsevier Inc. All rights reserved. C1 [Huded, Chetan P.] Cleveland Clin Fdn, Dept Cardiovasc Med, 9500 Euclid Ave, Cleveland, OH 44195 USA. [Benck, Lillian R.] Northwestern Univ, Feinberg Sch Med, Dept Med, Chicago, IL 60611 USA. [Stone, Neil J.; Sweis, Ranya N.; Ricciardi, Mark J.; Malaisrie, Chris; Davidson, Charles J.; Flaherty, James D.] Northwestern Univ, Feinberg Sch Med, Bluhm Cardiovasc Inst, Chicago, IL 60611 USA. C3 Cleveland Clinic Foundation; Northwestern University; Feinberg School of Medicine; Northwestern University; Feinberg School of Medicine RP Flaherty, JD (通讯作者)，Northwestern Univ, Feinberg Sch Med, Bluhm Cardiovasc Inst, Chicago, IL 60611 USA. EM jflahert@nm.org RI Fonarow, Gregg C/D-5988-2014; Stone, Neil/ABB-6039-2021 OI Fonarow, Gregg C/0000-0002-3192-8093; Stone, Neil/0000-0002-6927-7783 CR Arnold SV, 2016, J AM COLL CARDIOL, V68, P1868, DOI 10.1016/j.jacc.2016.07.762 Borger MA, 2010, ANN THORAC SURG, V89, P773, DOI 10.1016/j.athoracsur.2009.12.001 Briguori C, 2009, J AM COLL CARDIOL, V54, P2157, DOI 10.1016/j.jacc.2009.07.005 Cannon CP, 2004, NEW ENGL J MED, V350, P1495, DOI 10.1056/NEJMoa040583 Clavel MA, 2010, CIRCULATION, V122, P1928, DOI 10.1161/CIRCULATIONAHA.109.929893 Duncan A, 2015, JACC-CARDIOVASC INTE, V8, P645, DOI 10.1016/j.jcin.2015.01.009 Gnjidic D, 2013, BMJ OPEN, V3, DOI 10.1136/bmjopen-2012-002333 Herrmann HC, 2013, CIRCULATION, V127, P2316, DOI 10.1161/CIRCULATIONAHA.112.001290 Holmes DR, 2015, JAMA-J AM MED ASSOC, V313, P1019, DOI 10.1001/jama.2015.1474 Kappetein AP, 2012, J AM COLL CARDIOL, V60, P1438, DOI [10.1016/j.jacc.2012.09.001, 10.1093/ejcts/ezs533] Kuhn EW, 2015, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD008493.pub3 Kuhn EW, 2013, ANN THORAC SURG, V96, P1508, DOI 10.1016/j.athoracsur.2013.04.096 LaRosa JC, 2005, NEW ENGL J MED, V352, P1425, DOI 10.1056/NEJMoa050461 Liakopoulos OJ, 2008, EUR HEART J, V29, P1548, DOI 10.1093/eurheartj/ehn198 Pasceri V, 2004, CIRCULATION, V110, P674, DOI 10.1161/01.CIR.0000137828.06205.87 Patti G, 2007, J AM COLL CARDIOL, V49, P1272, DOI 10.1016/j.jacc.2007.02.025 Pedersen TR, 2005, JAMA-J AM MED ASSOC, V294, P2437, DOI 10.1001/jama.294.19.2437 Pedersen TR, 2004, ATHEROSCLEROSIS SUPP, V5, P81, DOI 10.1016/j.atherosclerosissup.2004.08.027 Pilotto A, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0130946 Pullan M, 2014, EUR J CARDIO-THORAC, V45, P419, DOI 10.1093/ejcts/ezt399 Rossebo AB, 2008, NEW ENGL J MED, V359, P1343, DOI 10.1056/NEJMoa0804602 Schwartz GG, 2001, JAMA-J AM MED ASSOC, V285, P1711, DOI 10.1001/jama.285.13.1711 Scott D, 2009, QJM-INT J MED, V102, P625, DOI 10.1093/qjmed/hcp093 Shepherd J, 2002, LANCET, V360, P1623, DOI 10.1016/S0140-6736(02)11600-X Stone NJ, 2014, J AM COLL CARDIOL, V63, P2889, DOI 10.1016/j.jacc.2013.11.002 Tamburino C, 2011, CIRCULATION, V123, P299, DOI 10.1161/CIRCULATIONAHA.110.946533 Vahl TP, 2016, J AM COLL CARDIOL, V67, P1472, DOI 10.1016/j.jacc.2015.12.059 Virani SS, 2008, AM J CARDIOL, V102, P1235, DOI 10.1016/j.amjcard.2008.06.055 Yamamoto M, 2013, J AM COLL CARDIOL, V62, P869, DOI 10.1016/j.jacc.2013.04.057 Zheng Z, 2016, NEW ENGL J MED, V374, P1744, DOI 10.1056/NEJMoa1507750 NR 30 TC 21 Z9 21 U1 0 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 JUN 1 PY 2017 VL 119 IS 11 BP 1832 EP 1838 DI 10.1016/j.amjcard.2017.02.042 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EX0ZP UT WOS:000402949600021 PM 28395888 DA 2023-05-13 ER PT J AU Trimaille, A Ribeyrolles, S Fauvel, C Chaumont, C Weizman, O Pommier, T Cellier, J Geneste, L Panagides, V Marsou, W Deney, A Attou, S Delmotte, T Chemaly, P Karsenty, C Giordano, G Gautier, A Guilleminot, P Sagnard, A Pastier, J Duceau, B Sutter, W Waldmann, V Pezel, T Mika, D Cohen, A Bonnet, G AF Trimaille, Antonin Ribeyrolles, Sophie Fauvel, Charles Chaumont, Corentin Weizman, Orianne Pommier, Thibaut Cellier, Joffrey Geneste, Laura Panagides, Vassili Marsou, Wassima Deney, Antoine Attou, Sabir Delmotte, Thomas Chemaly, Pascale Karsenty, Clement Giordano, Gauthier Gautier, Alexandre Guilleminot, Pierre Sagnard, Audrey Pastier, Julie Duceau, Baptiste Sutter, Willy Waldmann, Victor Pezel, Theo Mika, Delphine Cohen, Ariel Bonnet, Guillaume TI Cardiovascular Characteristics and Outcomes of Young Patients with COVID-19 SO JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE LA English DT Article DE COVID-19; SARS-CoV-2; young; myocarditis; pericarditis ID ACUTE CORONARY SYNDROMES; LESS-THAN-45 YEARS-OLD; EUROPEAN-SOCIETY; ESC GUIDELINES; MANAGEMENT; DIAGNOSIS; PROFILE AB Although 18-45-year-old (y-o) patients represent a significant proportion of patients hospitalized for COVID-19, data concerning the young population remain scarce. The Critical COVID France (CCF) study was an observational study including consecutive patients hospitalized for COVID-19 in 24 centers between 26 February and 20 April 2020. The primary composite outcome included transfer to the intensive care unit (ICU) or in-hospital death. Secondary outcomes were cardiovascular (CV) complications. Among 2868 patients, 321 (11.2%) patients were in the 18-45-y-o range. In comparison with older patients, young patients were more likely to have class 2 obesity and less likely to have hypertension, diabetes and dyslipidemia. The primary outcome occurred less frequently in 18-45-y-o patients in comparison with patients > 45 years old (y/o) (16.8% vs. 30.7%, p < 0.001). The 18-45-y-o patients presented with pericarditis (2.2% vs. 0.5%, p = 0.003) and myocarditis (2.5% vs. 0.6%, p = 0.002) more frequently than patients >45 y/o. Acute heart failure occurred less frequently in 18-45-y-o patients (0.9% vs. 7.2%, p < 0.001), while thrombotic complications were similar in young and older patients. Whereas both transfer to the ICU and in-hospital death occurred less frequently in young patients, COVID-19 seemed to have a particular CV impact in this population. C1 [Trimaille, Antonin] Ctr Hosp Reg Univ Strasbourg, F-67000 Strasbourg, France. [Ribeyrolles, Sophie] Inst Mutualiste Montsouris, F-75014 Paris, France. [Fauvel, Charles; Chaumont, Corentin] Ctr Hosp Univ Rouen, F-76000 Rouen, France. [Weizman, Orianne; Giordano, Gauthier] Ctr Hosp Reg Univ Nancy, F-54511 Vandoeuvre Les Nancy, France. [Pommier, Thibaut; Guilleminot, Pierre; Sagnard, Audrey; Pastier, Julie] Ctr Hosp Univ Dijon, F-21000 Dijon, France. [Cellier, Joffrey; Sutter, Willy; Waldmann, Victor] Univ Paris, Hop Europeen Georges Pompidou, F-75015 Paris, France. [Geneste, Laura] Ctr Hosp Univ Amiens Picardie, F-80000 Amiens, France. [Panagides, Vassili] Ctr Hosp Univ Marseille, F-13005 Marseille, France. [Marsou, Wassima] Univ Catholique Lille, Fac Med & Maieut, GCS Grp Hop Inst Catholique Lille, F-59800 Lille, France. [Deney, Antoine; Karsenty, Clement] Ctr Hosp Univ Toulouse, F-31400 Toulouse, France. [Attou, Sabir] Ctr Hosp Univ Caen Normandie, F-14000 Caen, France. [Delmotte, Thomas] Ctr Hosp Univ Reims, F-51100 Reims, France. [Chemaly, Pascale; Gautier, Alexandre] Inst Cardiovasc Paris Sud, F-91300 Paris, France. [Duceau, Baptiste; Sutter, Willy; Waldmann, Victor; Bonnet, Guillaume] Univ Paris, INSERM, UMR S970, Paris Cardiovasc Res Ctr PARCC,Paris Translat Res, F-75015 Paris, France. [Pezel, Theo] Univ Paris, Hop Lariboisiere, APHP, F-75010 Paris, France. [Mika, Delphine] Univ Paris Saclay, INSERM, UMR S 1180, Signaling & Cardiovasc Pathophysiol, F-92296 Paris, France. [Cohen, Ariel] Hop St Antoine, F-75012 Paris, France. [Bonnet, Guillaume] Univ Bordeaux, Hop Cardiol Haut Leveque, Unite Med Chirurg Valvulopathies & Cardiomyopathi, F-33600 Pessac, France. C3 CHU Strasbourg; UDICE-French Research Universities; Universites de Strasbourg Etablissements Associes; Universite de Strasbourg; UDICE-French Research Universities; Universite Paris Cite; Institute Mutualiste Montsouris; Universite de Rouen Normandie; CHU de Rouen; CHU de Nancy; CHU Dijon Bourgogne; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Europeen Georges-Pompidou - APHP; Picardie Universites; Universite de Picardie Jules Verne (UPJV); CHU Amiens; UDICE-French Research Universities; Aix-Marseille Universite; Universite Catholique de Lille; CHU de Toulouse; CHU de Caen NORMANDIE; Universite de Caen Normandie; CHU de Reims; Universite de Reims Champagne-Ardenne; UDICE-French Research Universities; Universite Paris Saclay; 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); Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - 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 Saclay; UDICE-French Research Universities; Sorbonne Universite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Saint-Antoine - APHP; CHU Bordeaux; UDICE-French Research Universities; Universite de Bordeaux RP Cohen, A (通讯作者)，Hop St Antoine, F-75012 Paris, France. EM antonin.trimaille@chru-strasbourg.fr; sophie.ribeyrolles@gmail.com; charles_fauvel@orange.fr; corentinchaumont@hotmail.com; Orianne.weizman@gmail.com; thibaut.pommier@hotmail.fr; cellier.joffrey@gmail.com; laura.geneste@hotmail.fr; vassili.panagides@gmail.com; marsou.w@gmail.com; antoine.deney@gmail.com; sabir.attou@gmail.com; tdelmotte@chu-reims.fr; pascale.chemaly@laposte.net; clement.karsenty@hotmail.fr; gauthier.giordano@gmail.com; gautier.alx@gmail.com; guilleminot.pierre@gmail.com; audreysagnard@gmail.com; july.bonzay@hotmail.fr; bduceau@gmail.com; willy.sutter@gmail.com; victor.waldmann@gmail.com; theo.pezelccf@gmail.com; delphine.mika@u-psud.fr; ariel.cohen@aphp.fr; unbonnet@gmail.com RI Mika, Delphine/Q-2808-2018; Trimaille, Antonin/AAS-2188-2021 OI Trimaille, Antonin/0000-0001-9279-4220; Chaumont, Corentin/0000-0001-7188-2686; Fauvel, Charles/0000-0001-6243-2544; Guilleminot, Pierre/0000-0003-0837-9150; Gautier, Alexandre/0000-0003-4378-299X; PANAGIDES, Vassili/0000-0002-0012-1289; karsenty, clement/0000-0002-3303-5854; BONNET, Guillaume/0000-0002-3027-1771 CR Abuelgasim E, 2020, CURR PROB CARDIOLOGY, V45, DOI 10.1016/j.cpcardiol.2020.100621 Adler Y, 2015, EUR HEART J, V36, P2921, DOI 10.1093/eurheartj/ehv318 [Anonymous], S KOR COVID 19 CAS A [Anonymous], 2020, JAMA-J AM MED ASSOC, DOI [DOI 10.1001/JAMA.2020.6775, 10.1001/jama.2020.7681] Belle L, 2017, ARCH CARDIOVASC DIS, V110, P366, DOI 10.1016/j.acvd.2017.05.001 Bonnet G, 2021, ARCH CARDIOVASC DIS, V114, P352, DOI 10.1016/j.acvd.2021.01.003 Caforio ALP, 2013, EUR HEART J, V34, P2636, DOI 10.1093/eurheartj/eht210 CDC COVID-19 Response Team, 2020, MMWR-MORBID MORTAL W, V69, P343, DOI 10.15585/mmwr.mm6915e4 Chen TSC, 2014, HEART LUNG CIRC, V23, P49, DOI 10.1016/j.hlc.2013.05.648 Cocker MS, 2009, HEART, V95, P1925, DOI 10.1136/hrt.2008.164061 Cremer PC, 2016, J AM COLL CARDIOL, V68, P2311, DOI 10.1016/j.jacc.2016.07.785 Cunningham JW, 2021, JAMA INTERN MED, V181, P379, DOI 10.1001/jamainternmed.2020.5313 Fauvel C, 2020, EUR HEART J, V41, P3058, DOI 10.1093/eurheartj/ehaa500 Gao M, 2021, LANCET DIABETES ENDO, V9, P350, DOI 10.1016/S2213-8587(21)00089-9 Gomez-Zorita S, 2021, INT J MOL SCI, V22, DOI 10.3390/ijms22157975 Grasselli G, 2020, JAMA-J AM MED ASSOC, V323, P1574, DOI 10.1001/jama.2020.5394 Guan W, 2020, NEW ENGL J MED, V382, P1708, DOI 10.1056/NEJMoa2002032 Gupta AK, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.120.017013 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Khan IH, 2020, J CARDIAC SURG, V35, P1287, DOI 10.1111/jocs.14596 Kyto V, 2014, CIRCULATION, V130, P1601, DOI 10.1161/CIRCULATIONAHA.114.010376 Liu K, 2020, J INFECTION, V80, pE14, DOI 10.1016/j.jinf.2020.03.005 Liu Y, 2020, LANCET INFECT DIS, V20, P656, DOI 10.1016/S1473-3099(20)30232-2 Mallapaty S, 2021, NATURE, V595, P343, DOI 10.1038/d41586-021-01862-7 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Powers WJ, 2019, STROKE, V50, pE344, DOI 10.1161/STR.0000000000000211 Ryan PM, 2020, OBESITY, V28, P1191, DOI 10.1002/oby.22843 Sabatino J, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0237131 Schoenenberger AW, 2011, INT J CARDIOL, V148, P300, DOI 10.1016/j.ijcard.2009.11.009 Thygesen K., 2018, J AM COLL HEALTH Tota-Maharaj R, 2012, EUR HEART J, V33, P2955, DOI 10.1093/eurheartj/ehs230 Ukimura Akira, 2012, Influenza Res Treat, V2012, P351979, DOI 10.1155/2012/351979 Williamson EJ, 2020, NATURE, V584, P430, DOI 10.1038/s41586-020-2521-4 World Health Organization (WHO), 2020, CONS QUAR IND CONT C Zaim S, 2020, CURR PROB CARDIOLOGY, V45, DOI 10.1016/j.cpcardiol.2020.100618 Zhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 NR 36 TC 3 Z9 3 U1 1 U2 1 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 2308-3425 J9 J CARDIOVASC DEV DIS JI J. Cardiovasc. Dev. Dis. PD DEC PY 2021 VL 8 IS 12 AR 165 DI 10.3390/jcdd8120165 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA YJ5AH UT WOS:000744544000001 PM 34940520 OA Green Published, gold DA 2023-05-13 ER PT J AU Peng, YG Feng, JJ Guo, LF Li, N Liu, WH Li, GJ Hao, G Zu, XL AF Peng, Ya Guang Feng, Jing Jing Guo, Lu Fen Li, Nan Liu, Wen Heng Li, Guo Ju Hao, Guang Zu, Xiao Lin TI Factors associated with prehospital delay in patients with ST-segment elevation acute myocardial infarction in China SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID EMERGENCY MEDICAL-SERVICES; ACUTE CORONARY SYNDROMES; SYMPTOM-ONSET; TRENDS; TIME; MORTALITY; CARE; PREDICTORS; OUTCOMES; SEX AB Background: Prehospital delay is the most critical factor to prognosis of ST-elevation myocardial infarction (STEMI). Few study had examined a series of predictors of prehospital delay by multivariate analysis of sociodemographic and clinical characteristics, onset features, and symptom condition of STEMI in China. Methods: A total of 1088 hospitalized STEMI participants were screened to collect sociodemographic data, medical history information, and symptom onset status from clinical medical records. Factors associated with prehospital delay were examined using bivariate and multivariate analysis method. Results: The median prehospital delay time (PDT) was 130 minutes in STEMI participants. Multivariate regression models examining 8 predictors were associated with prehospital delay, including senior high school or above educational level, myocardial infarction (MI) history, vertigo onset symptom, ambulance transportation, onset in daytime (6:00-18:00), onset at home, anterior wall MI, and posterior wall MI. Mortality in PDT more than 120 minutes group was 5.5%, whereas it was 4.3% in PDT 120 minutes of less group without significant statistically difference (P N.05). Conclusions: Multivariate analysis results found that symptom onset-related variables strongly influenced PDT. Onset-related status of STEMI needed to be combined into interventions of participants, and more emergency education should be recommended to both participants and their relatives. Most importantly, more efforts should be taken to educate the public about the symptoms and signs to increase the recognition of STEMI. (C) 2014 Elsevier Inc. All rights reserved. C1 [Peng, Ya Guang; Liu, Wen Heng; Hao, Guang] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, State Key Lab Cardiovasc Dis, Beijing 100037, Peoples R China. [Peng, Ya Guang; Feng, Jing Jing; Liu, Wen Heng; Hao, Guang] Peking Union Med Coll, Beijing 100037, Peoples R China. [Feng, Jing Jing] Chinese Acad Med Sci, Inst Med Informat, Beijing 100730, Peoples R China. [Guo, Lu Fen; Li, Nan; Zu, Xiao Lin] Capital Med Univ, Beijing Anzhen Hosp, Emergency Ctr, Beijing 100029, Peoples R China. [Li, Guo Ju] Wei Fang Med Univ, Weifang, Shandong, 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; Chinese Academy of Medical Sciences - Peking Union Medical College; Institute of Medical Information - CAMS; Capital Medical University RP Li, N (通讯作者)，Capital Med Univ, Beijing Anzhen Hosp, Emergency Ctr, Beijing 100029, Peoples R China. 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J. Emerg. Med. PD APR PY 2014 VL 32 IS 4 BP 349 EP 355 DI 10.1016/j.ajem.2013.12.053 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AE2JS UT WOS:000333799700013 PM 24512889 DA 2023-05-13 ER PT J AU Ali, L Fors, A Ekman, I AF Ali, Lilas Fors, Andreas Ekman, Inger TI Need of support in people with chronic obstructive pulmonary disease SO JOURNAL OF CLINICAL NURSING LA English DT Article DE chronic illness; chronic obstructive pulmonary disease; clinical nursing; nursing education; support ID PERSON-CENTERED CARE; ACUTE CORONARY SYNDROME; YOUNG INFORMAL CARERS; CHRONIC HEART-FAILURE; MENTAL-ILLNESS; PATIENT; EDUCATION; COMMUNICATION; EXPERIENCES; INTERNET AB Aim and objectiveThe aim of this study was to describe peoples' experiences and expectations of support when living with chronic obstructive pulmonary disease. MethodWe conducted and analysed face-to-face or telephone interviews with 17 individuals (aged 44-77 years) diagnosed with chronic obstructive pulmonary disease. The interviewer asked open-ended questions aimed at encouraging further narration, and we analysed the participants' narratives using a phenomenological hermeneutical approach. This report adheres to the COREQ guidelines. ResultsThe overall theme suggests that people with chronic obstructive pulmonary disease describe support as shared knowledge and experiences, based on the following subthemes; similar experiences, the need of genuine professional knowledge, self-reliance versus self-blame, and the Internet - feeling safe but uncertain. ConclusionsPeople with chronic obstructive pulmonary disease find their strength through shared knowledge and dialogical support with others who have similar experiences and with professionals. A person-centred eHealth approach may be suitable for this group as it offers both collaboration and support. Relevance to clinical practiceThere is a demand for access to genuine professional knowledge as additional support to patients' own capabilities and needs. Patient associations were assessed as reliable sources of information and to some extent also support, but the importance of access to professional sources was also stressed. C1 [Ali, Lilas; Fors, Andreas; Ekman, Inger] Univ Gothenburg, Inst Hlth & Care Sci, Sahlgrenska Acad, Gothenburg, Sweden. [Ali, Lilas; Fors, Andreas; Ekman, Inger] Univ Gothenburg, Ctr Person Centred Care GPCC, Gothenburg, Sweden. [Fors, Andreas] Reg Vastra Gotaland, Narhalsan Res & Dev, Primary Hlth Care, Gothenburg, Sweden. C3 University of Gothenburg; University of Gothenburg RP Ali, L (通讯作者)，Univ Gothenburg, Inst Hlth & Care Sci, Sahlgrenska Acad, Gothenburg, Sweden. EM lilas.ali@gu.se OI Ali, Lilas/0000-0001-7027-4371 FU Swedish Heart and Lung Foundation; Centre for Person-Centred Care at the University of Gothenburg (GPCC) FX The Swedish Heart and Lung Foundation; Centre for Person-Centred Care at the University of Gothenburg (GPCC) CR Ahnfeldt-Mollerup P., 2016, BMC HEALTH SERV RES, V16, P1 Ali L, 2014, PATIENT EDUC COUNS, V94, P362, DOI 10.1016/j.pec.2013.10.020 Ali L, 2013, ISSUES MENT HEALTH N, V34, P611, DOI 10.3109/01612840.2013.791736 Anttila M, 2012, INT J MED INFORM, V81, P424, DOI 10.1016/j.ijmedinf.2012.02.004 Bender JL, 2013, PATIENT EDUC COUNS, V93, P472, DOI 10.1016/j.pec.2013.07.009 Berger BE, 2011, WESTERN J NURS RES, V33, P916, DOI 10.1177/0193945910384602 Borge CR, 2015, PATIENT EDUC COUNS, V98, P182, DOI 10.1016/j.pec.2014.10.017 Brannstrom M, 2014, EUR J HEART FAIL, V16, P1142, DOI 10.1002/ejhf.151 Button D, 2014, NURS EDUC TODAY, V34, P1311, DOI 10.1016/j.nedt.2013.05.002 Camerini L, 2013, PATIENT EDUC COUNS, V92, P229, DOI 10.1016/j.pec.2013.04.007 Chang YY, 2016, J NURS SCHOLARSHIP, V48, P466, DOI 10.1111/jnu.12230 De Hert M, 2011, WORLD PSYCHIATRY, V10, P52, DOI 10.1002/j.2051-5545.2011.tb00014.x Ekman Inger, 2005, Eur J Cardiovasc Nurs, V4, P251, DOI 10.1016/j.ejcnurse.2005.01.006 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 Elf M, 2011, INFORM HEALTH SOC CA, V36, P206, DOI 10.3109/17538157.2011.553298 Eysenbach G, 2001, J MED INTERNET RES, V3, DOI 10.2196/jmir.3.2.e20 Findahl O., 2013, MILJON SVENSKAR VILL Findahl O., 2015, SVENSKARNA INTERNET Fors A, 2016, INT J CARDIOL, V221, P957, DOI 10.1016/j.ijcard.2016.07.060 Fors A, 2016, EUR J CARDIOVASC NUR, V15, P186, DOI 10.1177/1474515115623437 Fors A, 2015, INT J CARDIOL, V187, P693, DOI 10.1016/j.ijcard.2015.03.336 Fors A, 2014, INT J NURS STUD, V51, P430, DOI 10.1016/j.ijnurstu.2013.06.012 Foster D, 2016, SOC SCI MED, V166, P25, DOI 10.1016/j.socscimed.2016.08.007 Fox S., 2013, HLTH ONLINE Gammon D, 2015, J MED INTERNET RES, V17, P78, DOI 10.2196/jmir.3547 Greene J, 2015, HEALTH AFFAIR, V34, P431, DOI 10.1377/hlthaff.2014.0452 Helsper EJ, 2017, NEW MEDIA SOC, V19, P1253, DOI 10.1177/1461444816634676 Imison C., 2016, DELIVERING BENEFITS Janssen Daisy J A, 2010, Chron Respir Dis, V7, P147, DOI 10.1177/1479972310369285 Lindqvist G, 2010, J HEALTH PSYCHOL, V15, P456, DOI 10.1177/1359105309353646 Lindseth A, 2004, SCAND J CARING SCI, V18, P145, DOI 10.1111/j.1471-6712.2004.00258.x Mathers CD, 2006, PLOS MED, V3, DOI 10.1371/journal.pmed.0030442 McCarthy B, 2015, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD003793.pub3 Moreo Kathleen, 2016, BMJ Qual Improv Rep, V5, DOI 10.1136/bmjquality.u210329.w4679 Osler M, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0086758 Pumar MI, 2014, J THORAC DIS, V6, P1615, DOI 10.3978/j.issn.2072-1439.2014.09.28 Ricoeur P., 1976, INTERPRETATION THEOR Ritchie CS, 2016, TRANSL BEHAV MED, V6, P428, DOI 10.1007/s13142-016-0422-8 Sjogren K, 2015, J CLIN NURS, V24, P1310, DOI 10.1111/jocn.12734 Sommer I, 2015, BMC PUBLIC HEALTH, V15, DOI 10.1186/s12889-015-2227-y Soriano JB, 2017, LANCET RESP MED, V5, P691, DOI 10.1016/S2213-2600(17)30293-X Spinuzzi C, 2005, TECH COMMUN-STC, V52, P163 Strang S, 2013, PALLIAT SUPPORT CARE, V6, P1 Timmins Fiona, 2005, Nurs Crit Care, V10, P174 Ventura F, 2016, CIN-COMPUT INFORM NU, V34, P231, DOI 10.1097/CIN.0000000000000225 Vestbo J, 2013, AM J RESP CRIT CARE, V187, P347, DOI 10.1164/rccm.201204-0596PP Willems S, 2005, PATIENT EDUC COUNS, V56, P139, DOI 10.1016/j.pec.2004.02.011 World Medical Association General Assembly, 2004, J Int Bioethique, V15, P124 Xiao N, 2014, DECIS SUPPORT SYST, V57, P417, DOI 10.1016/j.dss.2012.10.047 Yli-Uotila T, 2013, EUR J CANCER CARE, V22, P261, DOI 10.1111/ecc.12025 [No title captured] [No title captured] [No title captured] NR 54 TC 13 Z9 13 U1 1 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 MAR PY 2018 VL 27 IS 5-6 BP E1089 EP E1096 DI 10.1111/jocn.14170 PG 8 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA GA6CB UT WOS:000428419400021 PM 29149463 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Verbelen, M Weale, ME Lewis, CM AF Verbelen, M. Weale, M. E. Lewis, C. M. TI Cost-effectiveness of pharmacogenetic-guided treatment: are we there yet? SO PHARMACOGENOMICS JOURNAL LA English DT Review ID GENOMIC SCREENING-PROGRAMS; ACUTE CORONARY SYNDROME; ECONOMIC-EVALUATION; WARFARIN THERAPY; PHARMACOECONOMIC ANALYSIS; ANTIPLATELET THERAPY; ATRIAL-FIBRILLATION; GENOTYPE; AZATHIOPRINE; MANAGEMENT AB Pharmacogenetics (PGx) has the potential to personalize pharmaceutical treatments. Many relevant gene drug associations have been discovered, but PGx-guided treatment needs to be cost-effective as well as clinically beneficial to be incorporated into standard health-care. We reviewed economic evaluations for PGx associations listed in the US Food and Drug Administration (FDA) Table of Pharmacogenomic Biomarkers in Drug Labeling. We determined the proportion of evaluations that found PGx-guided treatment to be cost-effective or dominant over the alternative strategies, and estimated the impact on this proportion of removing the cost of genetic testing. Of the 137 PGx associations in the FDA table, 44 economic evaluations, relating to 10 drugs, were identified. Of these evaluations, 57% drew conclusions in favour of PGx testing, of which 30% were cost-effective and 27% were dominant (cost-saving). If genetic information was freely available, 75% of economic evaluations would support PGx-guided treatment, of which 25% would be cost-effective and 50% would be dominant. Thus, PGx-guided treatment can be a cost-effective and even a cost-saving strategy. Having genetic information readily available in the clinical health record is a realistic future prospect, and would make more genetic tests economically worthwhile. C1 [Verbelen, M.; Lewis, C. M.] Kings Coll London, Inst Psychiat Psychol & Neurosci, MRC, Social Genet & Dev Psychiat Ctr, De Crespigny Pk, London SE5 8AF, England. [Weale, M. E.; Lewis, C. M.] Kings Coll London, Fac Life Sci & Med, Div Med & Mol Genet, London, England. C3 RLUK- Research Libraries UK; University of London; King's College London; RLUK- Research Libraries UK; University of London; King's College London RP Lewis, CM (通讯作者)，Kings Coll London, Inst Psychiat Psychol & Neurosci, MRC, Social Genet & Dev Psychiat Ctr, De Crespigny Pk, London SE5 8AF, England. EM cathryn.lewis@kcl.ac.uk RI Lewis, Cathryn/M-8766-2019; Weale, Michael E/F-2587-2010; Lewis, Cathryn M/A-5225-2010 OI Lewis, Cathryn/0000-0002-8249-8476; Weale, Michael E/0000-0003-4593-1186; Lewis, Cathryn M/0000-0002-8249-8476 FU Medical Research Council; Eli Lilly and Company Ltd.; National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London; Medical Research Council [1390045] Funding Source: researchfish FX This study was funded by an industrial CASE studentship to MV from the Medical Research Council with Eli Lilly and Company Ltd. This paper represents independent research part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. 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PD OCT PY 2017 VL 17 IS 5 BP 395 EP 402 DI 10.1038/tpj.2017.21 PG 8 WC Genetics & Heredity; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Genetics & Heredity; Pharmacology & Pharmacy GA FI3HS UT WOS:000411849200001 PM 28607506 OA Green Submitted, Green Published, hybrid DA 2023-05-13 ER PT J AU Carmo, GA Calderaro, D Gualandro, DM Pastana, AF Yu, PC Marques, AC Caramelli, B AF Carmo, G. A. Calderaro, D. Gualandro, D. M. Pastana, A. F. Yu, P. C. Marques, A. C. Caramelli, B. TI The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery SO ANGIOLOGY LA English DT Article DE ankle-brachial index; atherosclerosis; cardiovascular risk; perioperative care ID PERIOPERATIVE MYOCARDIAL-INFARCTION; BLOOD-PRESSURE INDEX; LONG-TERM SURVIVAL; CARDIAC RISK; TROPONIN; VALIDATION; GUIDELINES; MORTALITY; ISCHEMIA; EVENTS AB Background: This study evaluated the association of the ankle-brachial index (ABI) and cardiovascular complications after noncardiac surgery. Methods: We prospectively evaluated patients referred for noncardiac surgery. The ABI was performed before surgery. Patients with abnormal ABI (0.9) were included in the peripheral artery disease (PAD) group and the remaining constituted the control group. Cardiac troponin and electrocardiogram were obtained 72 hours after surgery. Patients were followed up to 30 days, and primary end point was the occurrence of any cardiovascular event: cardiovascular death, acute coronary syndrome, isolated troponin elevation (ITE), decompensated heart failure, cardiogenic shock, unstable arrhythmias, nonfatal cardiac arrest, pulmonary edema, stroke, or PAD symptoms increase. Results: We evaluated 124 patients (61.3% male; mean age 65.4 years). During the study, 57.9% of patients in the PAD group had an event versus 25.7% in the control group (P = .011). The ITE was the most observed event (24.2%). After logistic regression, the odds ratio for ITE was 7.4 (95% confidence interval 2.2-25.0, P = .001). Conclusions: In patients submitted to noncardiac surgery, abnormal ABI is associated with a higher occurrence of a cardiovascular event. C1 [Carmo, G. A.; Calderaro, D.; Gualandro, D. M.; Pastana, A. F.; Yu, P. C.; Marques, A. C.; Caramelli, B.] Univ Sao Paulo, Sch Med, Inst Heart, Interdisciplinary Med Cardiol Unit, Ave Dr Eneas Carvalho Aguiar 44, Sao Paulo, Brazil. C3 Universidade de Sao Paulo RP Caramelli, B (通讯作者)，Univ Sao Paulo, Sch Med, Inst Heart, Interdisciplinary Med Cardiol Unit, Ave Dr Eneas Carvalho Aguiar 44, Sao Paulo, Brazil. EM bcaramel@usp.br RI Gualandro, Danielle M/G-8386-2012; Caramelli, Bruno/B-9916-2008 OI Gualandro, Danielle M/0000-0001-9041-6250; Caramelli, Bruno/0000-0001-6718-8456 FU Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [11/12935-9, 11/22944-5]; CNPq [304024/2012-0]; Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [11/12935-9] Funding Source: FAPESP FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP grant numbers11/12935-9 and 11/22944-5). CNPq (grant number 304024/2012-0) CR Aboyans V, 2003, J CLIN EPIDEMIOL, V56, P215, DOI 10.1016/S0895-4356(02)00584-X Aboyans V, 2012, CIRCULATION, V126, P2890, DOI 10.1161/CIR.0b013e318276fbcb Boersma E, 2005, AM J MED, V118, P1134, DOI 10.1016/j.amjmed.2005.01.064 Carmo GAL, 2012, REV ASSOC MED BRAS, V58, P505 DETSKY AS, 1986, J GEN INTERN MED, V1, P211, DOI 10.1007/BF02596184 Devereaux PJ, 2012, JAMA-J AM MED ASSOC, V307, P2295, DOI 10.1001/jama.2012.5502 Devereaux PJ, 2011, ANN INTERN MED, V154, P523, DOI 10.7326/0003-4819-154-8-201104190-00003 Durazzo AES, 2004, J VASC SURG, V39, P967, DOI 10.1016/j.jvs.2004.01.004 Endres Heinz G, 2006, BMC Cardiovasc Disord, V6, P33, DOI 10.1186/1471-2261-6-33 Fisher BW, 2008, ANESTH ANALG, V107, P149, DOI 10.1213/ane.0b013e31817c6186 Fleisher LA, 2007, J AM COLL CARDIOL, V50, P1707, DOI 10.1016/j.jacc.2007.09.001 Flu WJ, 2010, EUR J VASC ENDOVASC, V39, P62, DOI 10.1016/j.ejvs.2009.09.002 Fowkes FGR, 2008, JAMA-J AM MED ASSOC, V300, P197, DOI 10.1001/jama.300.2.197 GOLDMAN L, 1981, CIRCULATION, V64, P1227, DOI 10.1161/01.CIR.64.6.1227 Gualandro DM, 2008, J AM COLL CARDIOL, V51, P1825, DOI 10.1016/j.jacc.2008.01.035 Gualandro DM, 2012, ATHEROSCLEROSIS, V222, P191, DOI 10.1016/j.atherosclerosis.2012.02.021 Gualandro DM, 2011, ARQ BRAS CARDIOL, V96, P1 Landesberg G, 2003, J AM COLL CARDIOL, V42, P1547, DOI 10.1016/j.jacc.2003.05.001 Landesberg G, 2005, CRIT CARE MED, V33, P1281, DOI 10.1097/01.CCM.0000166607.22550.87 Lee TH, 1999, CIRCULATION, V100, P1043, DOI 10.1161/01.CIR.100.10.1043 Leng GC, 1996, BMJ-BRIT MED J, V313, P1440, DOI 10.1136/bmj.313.7070.1440 Levy M, 2011, ANESTHESIOLOGY, V114, P796, DOI 10.1097/ALN.0b013e31820ad503 LopezJimenez F, 1997, J AM COLL CARDIOL, V29, P1241, DOI 10.1016/S0735-1097(97)82754-4 Makdisse M, 2007, ARQ BRAS CARDIOL, V88, P501, DOI 10.1590/S0066-782X2007000500001 Mostaza JM, 2009, J VASC SURG, V49, P104, DOI 10.1016/j.jvs.2008.07.074 Muehlschlegel JD, 2011, ANESTHESIOLOGY, V114, P732, DOI 10.1097/ALN.0b013e31820ad520 Norgren L, 2007, EUR J VASC ENDOVASC, V33, pS5, DOI 10.1016/j.ejvs.2006.09.024 Pinho C, 2007, CLINICS, V62, P17, DOI 10.1590/S1807-59322007000100004 Poldermans D, 2008, J AM COLL CARDIOL, V51, P1913, DOI 10.1016/j.jacc.2008.03.005 Poldermans D, 2009, EUR HEART J, V30, P2769, DOI 10.1093/eurheartj/ehp337 Redfern G, 2011, ANAESTHESIA, V66, P604, DOI 10.1111/j.1365-2044.2011.06763.x Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 NR 32 TC 11 Z9 14 U1 0 U2 4 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0003-3197 EI 1940-1574 J9 ANGIOLOGY JI Angiology PD FEB PY 2016 VL 67 IS 2 BP 187 EP 192 DI 10.1177/0003319715589684 PG 6 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DC2MA UT WOS:000369049600014 PM 26058673 DA 2023-05-13 ER PT J AU Nseir, W Haj, S Beshara, B Mograbi, J Cohen, O AF Nseir, William Haj, Shehadeh Beshara, Basma Mograbi, Julnar Cohen, Ohad TI Seeking Out High Risk Population: The Prevalence Characteristics and Outcome of Diabetic Patients of Arab Ethnicity Hospitalized in Internal Medical and Acute Coronary Units in Israel SO INTERNATIONAL JOURNAL OF ENDOCRINOLOGY LA English DT Article ID METABOLIC SYNDROME; IMPACT; ADMISSIONS; JEWS AB Aims. To seek high risk population for diabetes and to improve their health care by investigating the characteristics and outcome of hospitalization in hospitals with predominant Arab patients in Northern Israel. Methods. Retrospective analysis of the prevalence of diabetes and the outcome of diabetic in comparison to nondiabetic patients hospitalized in the internal medicine and intensive cardiac units in two major hospitals with one-year postdischarge data between 1.1.2009 and 31.12.2009. Results. Thirty-nine percent of the patients were diagnosed with diabetes. The preponderance of women in the diabetes group was noted. Diabetic patients had an increase in the duration of hospitalization (P = 0.0008), with one hospital having a high readmission rate for the diabetic patients. The average glycemia during hospitalization exceeded the recommended threshold of 180 mg% without major changes in the therapeutic regimens in comparison to preadmission regimens. Conclusions. Arab populations, women in particular, in westernizing societies are at high risk for diabetes which exemplifies as high rate of patients with diabetes among hospitalized patients. Areas for intervention during hospitalization and at predischarge have been identified to improve health outcomes and prevent readmissions. C1 [Nseir, William; Mograbi, Julnar] Holy Family Hosp, Nazareth, Israel. [Haj, Shehadeh; Beshara, Basma] EMMS, Nazareth Hosp, Dept Med, Nazareth, Israel. [Cohen, Ohad] Tel Aviv Univ, Sackler Sch Med, IL-69978 Tel Aviv, Israel. C3 Tel Aviv University; Sackler Faculty of Medicine RP Cohen, O (通讯作者)，Tel Aviv Univ, Sackler Sch Med, IL-69978 Tel Aviv, Israel. EM ohdcohen@sheba.health.gov.il CR Abdul-Ghani MA, 2005, ISR MED ASSOC J, V7, P143 El-Sayed AM, 2009, BMC PUBLIC HEALTH, V9, DOI 10.1186/1471-2458-9-272 Hamar GB, 2013, POPUL HEALTH MANAG, V16, P125, DOI 10.1089/pop.2012.0027 Jaber LA, 2004, DIABETES CARE, V27, P234, DOI 10.2337/diacare.27.1.234 Kalter-Leibovici O, 2007, ISR MED ASSOC J, V9, P525 Kalter-Leibovici O, 2010, ARCH INTERN MED, V170, P970, DOI 10.1001/archinternmed.2010.103 Kandalaft Khoury M., 2012, WORLD C CONTR CONS D LEVETAN CS, 1995, AM J MED, V99, P22, DOI 10.1016/S0002-9343(99)80100-4 Moghissi ES, 2009, DIABETES CARE, V32, P1119, DOI 10.2337/dc09-9029 Na'amnih W, 2010, INT J EPIDEMIOL, V39, P1324, DOI 10.1093/ije/dyq073 RICHENS ER, 1988, DIABETIC MED, V5, P231, DOI 10.1111/j.1464-5491.1988.tb00975.x RUBIN RJ, 1994, J CLIN ENDOCR METAB, V78, pA809, DOI 10.1210/jcem.78.4.8157701 Steg PG, 2002, AM J CARDIOL, V90, P358, DOI 10.1016/S0002-9149(02)02489-X Whiting DR, 2011, DIABETES RES CLIN PR, V94, P311, DOI 10.1016/j.diabres.2011.10.029 Whitston M, 2012, DIABETIC MED, V29, P1199, DOI 10.1111/j.1464-5491.2011.03535.x Wild S, 2004, DIABETES CARE, V27, P1047, DOI 10.2337/diacare.27.5.1047 Zimmet P, 2001, NATURE, V414, P782, DOI 10.1038/414782a NR 17 TC 2 Z9 2 U1 0 U2 0 PU HINDAWI LTD PI LONDON PA ADAM HOUSE, 3RD FLR, 1 FITZROY SQ, LONDON, W1T 5HF, ENGLAND SN 1687-8337 EI 1687-8345 J9 INT J ENDOCRINOL JI Int. J. Endocrinol. PY 2013 VL 2013 AR 371608 DI 10.1155/2013/371608 PG 6 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism GA 177CZ UT WOS:000321354400001 PM 23861680 OA gold, Green Published, Green Submitted DA 2023-05-13 ER PT J AU Yamano, T Kotani, K Kitano, N Morimoto, J Emori, H Takahata, M Fujita, S Wada, T Ota, S Satogami, K Kashiwagi, M Shiono, Y Kuroi, A Tanimoto, T Tanaka, A AF Yamano, Takashi Kotani, Kazuhiko Kitano, Naomi Morimoto, Junko Emori, Hiroki Takahata, Masahiro Fujita, Suwako Wada, Teruaki Ota, Shingo Satogami, Keisuke Kashiwagi, Manabu Shiono, Yasutsugu Kuroi, Akio Tanimoto, Takashi Tanaka, Atsushi TI Telecardiology in Rural Practice: Global Trends SO INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH LA English DT Review DE rural and remote medicine; information and communication technology; telecardiology; tele-consultation; telemedical system; monitoring system; prehospital triage; tele-training ID ACUTE CORONARY SYNDROMES; EMERGENCY MEDICAL-SERVICE; ELECTROCARDIOGRAM TRIAGE; HEALTH-CARE; TELEMEDICINE; MANAGEMENT; CARDIOLOGY; SYSTEM; CONSENSUS; NETWORK AB The management of cardiovascular diseases in rural areas is plagued by the limited access of rural residents to medical facilities and specialists. The development of telecardiology using information and communication technology may overcome such limitation. To shed light on the global trend of telecardiology, we summarized the available literature on rural telecardiology. Using PubMed databases, we conducted a literature review of articles published from January 2010 to December 2020. The contents and focus of each paper were then classified. Our search yielded nineteen original papers from various countries: nine in Asia, seven in Europe, two in North America, and one in Africa. The papers were divided into classified fields as follows: seven in tele-consultation, four in the telemedical system, four in the monitoring system, two in prehospital triage, and two in tele-training. Six of the seven tele-consultation papers reported the consultation from rural doctors to urban specialists. More reports of tele-consultations might be a characteristic of telecardiology specific to rural practice. Further work is necessary to clarify the improvement of cardiovascular outcomes for rural residents. C1 [Yamano, Takashi; Morimoto, Junko; Emori, Hiroki; Takahata, Masahiro; Fujita, Suwako; Wada, Teruaki; Ota, Shingo; Satogami, Keisuke; Kashiwagi, Manabu; Shiono, Yasutsugu; Kuroi, Akio; Tanimoto, Takashi; Tanaka, Atsushi] Wakayama Med Univ, Dept Cardiovasc Med, Wakayama 6410012, Japan. [Kotani, Kazuhiko] Jichi Med Univ, Div Community & Family Med, Shimotsuke, Tochigi 3290498, Japan. [Kitano, Naomi] Wakayama Med Univ, Hlth Adm Ctr, Wakayama 6410012, Japan. C3 Wakayama Medical University; Jichi Medical University; Wakayama Medical University RP Yamano, T (通讯作者)，Wakayama Med Univ, Dept Cardiovasc Med, Wakayama 6410012, Japan. EM ymntks@wakayama-med.ac.jp; kazukotani@jichi.ac.jp; naomiuk@wakayama-med.ac.jp; morijun_men_kote@yahoo.co.jp; hiroki_emori_wakayama@yahoo.co.jp; masahiro.t72@gmail.com; swkswk.414.414@gmail.com; w_teruaki1026@yahoo.co.jp; wakayama_hirosaki@yahoo.co.jp; itsmeks14@gmail.com; mkashi@wakayama-med.ac.jp; yshiono@wakayama-med.ac.jp; akkuroi@gmail.com; tmkktanimoto@gmail.com; a-tanaka@wakayama-med.ac.jp RI Kitano, Naomi/C-8856-2011 OI Kitano, Naomi/0000-0001-6103-4907; Yamano, Takashi/0000-0003-3229-3672; Tanaka, Atsushi/0000-0001-7569-5394; Shiono, Yasutsugu/0000-0003-4150-0899 FU JSPS KAKENHI [20K18856]; Ministry of Health, Labor, and Welfare Science Research Grant [21IA2004]; Grants-in-Aid for Scientific Research [20K18856] Funding Source: KAKEN FX This study was supported by JSPS KAKENHI Grant Number 20K18856 and by the Ministry of Health, Labor, and Welfare Science Research Grant (21IA2004). 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Public Health PD APR PY 2022 VL 19 IS 7 AR 4335 DI 10.3390/ijerph19074335 PG 11 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 0L4IR UT WOS:000781439800001 PM 35410012 OA gold, Green Published DA 2023-05-13 ER PT J AU Michel, JP Ecarnot, F AF Michel, Jean-Pierre Ecarnot, Fiona TI Healthy Ageing and Vaccines: Application of the P4 Medicine Concept to Immunizations SO GERONTOLOGY LA English DT Review DE Healthy ageing; P4 medicine; Vaccines; Antimicrobial resistance; Non-communicable diseases ID VACCINATION REDUCES HOSPITALIZATION; ACUTE CORONARY SYNDROMES; INFLUENZA VACCINATION; FLU VACCINATION; SECONDARY PREVENTION; DIABETES-MELLITUS; ELDERLY-PATIENTS; DISEASE; POPULATION; FLUVACS AB In today's tormented world, it appears useful to take advantage of communication channels to promote life-course immunization and affirm its major role in healthy ageing. Instead of developing the argument of chronological age, we demonstrate the life-course principle here based on the P4 medicine concept. Are vaccines "preventive, personalized, predictive, and participatory?" Based on detailed analysis of research findings, we successively demonstrate the seminal role of vaccines on preventable infectious diseases, post-sepsis functional decline, non-communicable diseases (cardio-neuro-vascular, respiratory, and renal diseases), community protection, antimicrobial resistance, and perhaps even old-age dementia. Healthy ageing and the promotion of immunization are closely dependent on health literacy and provision of information by skilled health-care professionals. However, personal autonomy and individual freedom are influenced by psycho-cognitive hurdles (cultural approaches, beliefs, emotions, and behaviours), the opinions of the public/family/friends, and the increasing role of social media, which challenges scientific evidence. A similar phenomenon exists when dealing with the issue of healthy ageing, whose success depends greatly on life-course immunization. C1 [Michel, Jean-Pierre] Med Univ Geneva, Dept Rehabil & Geriatr, Geneva, Switzerland. [Ecarnot, Fiona] Univ Hosp Besancon, Dept Cardiol, Besancon, France. [Ecarnot, Fiona] Univ Franche Comte, EA3920, Besancon, France. C3 University of Geneva; Universite de Franche-Comte; CHU Besancon; Universite de Franche-Comte RP Ecarnot, F (通讯作者)，Univ Hosp Besancon, Dept Cardiol, Besancon, France.; Ecarnot, F (通讯作者)，Univ Franche Comte, EA3920, Besancon, France. EM fiona.ecarnot@univ-fcomte.fr OI Ecarnot, Fiona/0000-0002-4224-9731 CR Arora VM, 2020, JAMA-J AM MED ASSOC, V324, P2367, DOI 10.1001/jama.2020.4263 Beard JR, 2016, LANCET, V387, P2145, DOI 10.1016/S0140-6736(15)00516-4 Bragazzi Nicola Luigi, 2013, Health Psychol Res, V1, pe5, DOI 10.4081/hpr.2013.e5 Bragazzi NL, 2013, PATIENT PREFER ADHER, V7, P353, DOI 10.2147/PPA.S38578 Centers for Disease Control and Prevention, 2005, MMWR-MORBID MORTAL W, V54, P893 Centers for Disease Control and Prevention, 2016, DIAB TYP 1 TYP 2 AD Charu V, 2011, PLOS ONE, V6, DOI 10.1371/journal.pone.0026282 Ciszewski A, 2008, EUR HEART J, V29, P1350, DOI 10.1093/eurheartj/ehm581 Davis MM, 2006, J AM COLL CARDIOL, V48, P1498, DOI 10.1016/j.jacc.2006.09.004 Doherty TM, 2020, GERONTOLOGY, V66, P238, DOI 10.1159/000503141 Edwards KM, 2017, PLOTKINS VACCINES, P1512 Fang YA, 2016, ACTA CARDIOL SIN, V32, P290, DOI 10.6515/ACS20150424L Flores M, 2013, PERS MED, V10, P565, DOI 10.2217/pme.13.57 Forbes HJ, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0206163 Fountoulaki K, 2018, CARDIOLOGY, V141, P98, DOI 10.1159/000493572 Goeijenbier M, 2017, VACCINE, V35, P5095, DOI 10.1016/j.vaccine.2017.07.095 Gurfinkel EP, 2004, TEX HEART I J, V31, P28 Gurfinkel EP, 2004, EUR HEART J, V25, P25, DOI 10.1016/j.ehj.2003.10.018 Gusmano MK, 2009, AGING CLIN EXP RES, V21, P258, DOI 10.1007/BF03324907 Hibbard JH, 2003, ANNU REV PUBL HEALTH, V24, P413, DOI 10.1146/annurev.publhealth.24.100901.141005 Hood Lee, 2011, Nat Biotechnol, V29, P191, DOI 10.1038/nbt.1809 Jansen KU, 2018, HUM VACC IMMUNOTHER, V14, P2142, DOI 10.1080/21645515.2018.1476814 Jansen KU, 2018, NAT MED, V24, P10, DOI 10.1038/nm.4465 Kingwell K, 2018, NAT REV DRUG DISCOV, V17, P229, DOI 10.1038/nrd.2018.8 Lang PO, 2012, EXPERT REV VACCINES, V11, P167, DOI [10.1586/erv.11.187, 10.1586/ERV.11.187] Loeb M, 2010, JAMA-J AM MED ASSOC, V303, P943, DOI 10.1001/jama.2010.250 Lorini C, 2018, HUM VACC IMMUNOTHER, V14, P478, DOI 10.1080/21645515.2017.1392423 Michel JP, 2021, J NUTR HEALTH AGING, V25, P698, DOI 10.1007/s12603-021-1627-1 Michel JP, 2020, AGING CLIN EXP RES, V32, P1401, DOI 10.1007/s40520-020-01638-5 Michel JP, 2017, J AM MED DIR ASSOC, V18, P460, DOI 10.1016/j.jamda.2017.03.008 Michel JP, 2011, REJUV RES, V14, P75, DOI 10.1089/rej.2010.1078 Modin D, 2019, CIRCULATION, V139, P575, DOI 10.1161/CIRCULATIONAHA.118.036788 Mostel Z, 2019, MOL MED, V26, DOI 10.1186/s10020-019-0132-z Pal R, 2021, DIABETES METAB SYND, V15, P505, DOI 10.1016/j.dsx.2021.02.026 Perrett KP, 2019, JAMA PEDIATR, V173, P280, DOI 10.1001/jamapediatrics.2018.4578 Philip RK, 2018, EXPERT REV VACCINES, V17, P851, DOI 10.1080/14760584.2018.1527690 Phillips NA, 2020, J AM GERIATR SOC, V68, P1390, DOI 10.1111/jgs.16559 Reichert TA, 2001, NEW ENGL J MED, V344, P889, DOI 10.1056/NEJM200103223441204 Rogers MAM, 2019, SCI REP-UK, V9, DOI 10.1038/s41598-019-44193-4 Siscovick DS, 2000, AM J EPIDEMIOL, V152, P674, DOI 10.1093/aje/152.7.674 Sochocka M, 2017, CURR NEUROPHARMACOL, V15, P996, DOI 10.2174/1570159X15666170313122937 Sorensen K, 2012, BMC PUBLIC HEALTH, V12, DOI 10.1186/1471-2458-12-80 Sung LC, 2014, VACCINE, V32, P3843, DOI 10.1016/j.vaccine.2014.04.064 Van Hooste WLC, 2019, INT J ENV RES PUB HE, V16, DOI 10.3390/ijerph16203981 Verreault R, 2001, CAN MED ASSOC J, V165, P1495 World Health Organisation, 2015, WORLD REP AG HLTH GE World Health Organisation, 2013, HLTH LIT SOL FACTS World Health Organisation, 2013, GLOB VACC ACT PLAN World Health Organization, 2020, WHO COVID 19 CAS DEF Zhang F, 2020, BMC GERIATR, V20, DOI 10.1186/s12877-020-1504-5 NR 50 TC 3 Z9 3 U1 0 U2 5 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0304-324X EI 1423-0003 J9 GERONTOLOGY JI Gerontology PD MAY PY 2022 VL 68 IS 5 BP 481 EP 487 DI 10.1159/000517211 EA JUL 2021 PG 7 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Geriatrics & Gerontology GA 5Z1CY UT WOS:000673934800001 PM 34247174 OA Bronze DA 2023-05-13 ER PT J AU Nicolau, JC Corbalan, R Diaz, R Bahit, C Armstrong, PW Granger, CB Lopes, RD AF Nicolau, Jose C. Corbalan, Ramon Diaz, Rafael Bahit, Cecilia Armstrong, Paul W. Granger, Christopher B. Lopes, Renato D. TI Cardiovascular clinical research in South America SO AMERICAN HEART JOURNAL LA English DT Article ID ACUTE CORONARY SYNDROMES; ELEVATION MYOCARDIAL-INFARCTION; MULTIFACETED INTERVENTION; GLOBAL REGISTRY; THERAPIES; COUNTRIES; OUTCOMES; ENOXAPARIN; INSIGHTS; DISEASE AB In recent years, international clinical trials have increasingly included large numbers of patients and research sites from developing countries. In South America particularly, enrollment in randomized clinical trials has increased substantially. Despite this significant growth of late, there has been little systematic assessment of the role of this region in cardiovascular clinical trials. South America has several strengths with respect to conducting and participating in clinical trials. These include a large population, a high prevalence of cardiovascular diseases, reliable quality of data, a track record of important contributions to previous clinical trials, and good patient adherence and retention in trials. Labor costs also tend to be lower than those in high-income countries. On the other hand, clinical research in this region of the world faces limitations posed by a relatively small clinical trials network with limited operations expertise, as well as prolonged regulatory approval timelines, diversity in health care systems, limited training opportunities in clinical research, and a low patient level of education. Thus, there are many opportunities to improve the conduct of clinical research in South America, but strategies and systems must be developed to overcome barriers in this economically growing region and to establish a robust infrastructure for clinical trials, including high-quality investigator networks. C1 [Nicolau, Jose C.] Univ Sao Paulo, Sch Med, Heart Inst InCor, Sao Paulo, Brazil. [Corbalan, Ramon] Univ Catolica Chile, Santiago, Chile. [Diaz, Rafael; Bahit, Cecilia] Fdn ECLA, Rosario, Argentina. [Armstrong, Paul W.] Univ Alberta, Edmonton, AB, Canada. [Granger, Christopher B.; Lopes, Renato D.] Duke Clin Res Inst, Durham, NC USA. C3 Universidade de Sao Paulo; Pontificia Universidad Catolica de Chile; Universidad Catolica del Norte; University of Alberta; Duke University RP Nicolau, JC (通讯作者)，Aureliano Coutinho 355-14 Andar, BR-01224020 Sao Paulo, Brazil. EM corjnicolau@incor.usp.br RI Nicolau, Jose C/E-1487-2012; Granger, Christopher B/D-3458-2014 OI Nicolau, Jose C/0000-0002-9680-3689; Granger, Christopher B/0000-0002-0045-3291; Armstrong, Paul/0000-0002-0460-3445 FU Duke Clinical Research Institute FX This work was supported internally by the Duke Clinical Research Institute. CR Antman EM, 2006, NEW ENGL J MED, V354, P1477, DOI 10.1056/NEJMoa060898 Bank World, WORLD DEV IND Bazzino O, 2011, AM HEART J, V162, DOI 10.1016/j.ahj.2011.07.029 Berwanger O, 2012, JAMA-J AM MED ASSOC, V307, P2041, DOI 10.1001/jama.2012.413 Berwanger O, 2012, AM HEART J, V163, P323, DOI 10.1016/j.ahj.2012.02.004 Bove AA, 2009, J AM COLL CARDIOL, V54, P177, DOI 10.1016/j.jacc.2009.06.001 Budaj A, 2003, AM HEART J, V146, P999, DOI 10.1016/S0002-8703(03)00509-X Fox KAA, 2003, EUR HEART J, V24, P1414, DOI 10.1016/S0195-668X(03)00315-4 Infoplease, LIF EXP COUNTR Iniguez L, 2003, REV CUB SALUD PUBLIC, V29, P330 International Monetary Fund, WORLD EC FIN SURV Labra ME, 2001, CIENC SAUDE COLETIVA, V6, P361 Majumdar SR, 2008, ARCH INTERN MED, V168, P657, DOI 10.1001/archinternmed.2007.124 Nicolau JC, 2009, EUR HEART J, V30, P312 Nicolau JC, 1996, AM J CARDIOL, V78, P1049, DOI 10.1016/S0002-9149(96)00535-8 Nicolau JC, 2012, ARQ BRAS CARDIOL, V98, P282, DOI 10.1590/S0066-782X2012000400001 Orlandini A, 2006, EUR HEART J, V27, P527, DOI 10.1093/eurheartj/ehi701 PAOLASSO E, 1993, LANCET, V342, P767 Schafer PE, 2011, CIRC-CARDIOVASC QUAL, V4, P408, DOI 10.1161/CIRCOUTCOMES.110.960187 Steinberg BA, 2007, AM HEART J, V154, P54, DOI 10.1016/j.ahj.2007.03.047 U.S. National Institutes of Health, TRENDS CHARTS MAPS L Vianna D, CUSTO EFECTIVIDADE S World Health Organization, GEN GOV EXP HLTH PER Yusuf S, 2011, LANCET, V378, P1231, DOI 10.1016/S0140-6736(11)61215-4 NR 24 TC 3 Z9 3 U1 0 U2 6 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 JUN PY 2013 VL 165 IS 6 BP 848 EP 853 DI 10.1016/j.ahj.2013.02.004 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 151DD UT WOS:000319439900005 PM 23708154 DA 2023-05-13 ER PT J AU Moon, JY Franchi, F Rollini, F Angiolillo, DJ AF Moon, Jae Youn Franchi, Francesco Rollini, Fabiana Angiolillo, Dominick J. TI Role for Thrombin Receptor Antagonism With Vorapaxar in Secondary Prevention of Atherothrombotic Events: From Bench to Bedside SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS LA English DT Review DE vorapaxar; protease activator receptor-1 inhibitor; antiplatelet therapy ID ACUTE CORONARY SYNDROME; PROTEASE-ACTIVATED RECEPTORS; PERIPHERAL ARTERY-DISEASE; PREVIOUS MYOCARDIAL-INFARCTION; ANTIPLATELET THERAPY; ANTITHROMBOTIC THERAPY; DIABETES-MELLITUS; PLATELET-FUNCTION; DOUBLE-BLIND; SCH 530348 AB In spite of treatment with the current standard of care antiplatelet regimens including dual antiplatelet therapy, recurrence rates of ischemic events remain elevated for high-risk patients with atherosclerotic disease. This may be in part attributed to the fact that other key platelet activation pathways remain uninhibited and can thus continue to trigger platelet activation and lead to thrombotic complications. Thrombin is a powerful inducer of platelet activation and mediates its effects directly on platelets through protease activator receptors (PARs), particularly the PAR-1 subtype, making PAR-1 inhibition an attractive approach for reducing atherothrombotic events. These observations have led to the development of several PAR-1 antagonists. Vorapaxar is a direct inhibitor of PAR-1 and the only agent of this class approved for the prevention of recurrent ischemic events in patients with prior myocardial infarction or peripheral artery disease. In the present manuscript, we present a review of the pathophysiologic role of thrombin on thrombotic complications, the impact of vorapaxar on outcomes, including the most recent updates deriving from clinical trials, as well as future perspectives in the field. C1 [Moon, Jae Youn; Franchi, Francesco; Rollini, Fabiana; Angiolillo, Dominick J.] Univ Florida, Coll Med Jacksonville, Div Cardiol, 655 West 8th St, Jacksonville, FL 32209 USA. C3 State University System of Florida; University of Florida RP Angiolillo, DJ (通讯作者)，Univ Florida, Coll Med Jacksonville, Div Cardiol, 655 West 8th St, Jacksonville, FL 32209 USA. 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10.1016/j.jacc.2013.10.048 Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 Wiviott SD, 2011, CIRCULATION, V123, P1854, DOI 10.1161/CIRCULATIONAHA.110.001404 Yusuf S, 2001, NEW ENGL J MED, V345, P494 NR 83 TC 15 Z9 15 U1 1 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1074-2484 EI 1940-4034 J9 J CARDIOVASC PHARM T JI J. Cardiovasc. Pharmacol. Ther. PD JAN PY 2018 VL 23 IS 1 BP 23 EP 37 DI 10.1177/1074248417708617 PG 15 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA FQ0LP UT WOS:000418048000003 PM 28565918 DA 2023-05-13 ER PT J AU Courtie, E Veenith, T Logan, A Denniston, AK Blanch, RJ AF Courtie, E. Veenith, T. Logan, A. Denniston, A. K. Blanch, R. J. TI Retinal blood flow in critical illness and systemic disease: a review SO ANNALS OF INTENSIVE CARE LA English DT Review DE Critical illness; Retinal blood flow; Optical coherence tomography angiography ID OPTICAL COHERENCE TOMOGRAPHY; SUBLINGUAL MICROCIRCULATION; SEVERE SEPSIS; ANGIOGRAPHY; PERFUSION; AUTOREGULATION; EYE; ARTERIOLES; IMPAIRMENT; HEALTH AB Background Assessment and maintenance of end-organ perfusion are key to resuscitation in critical illness, although there are limited direct methods or proxy measures to assess cerebral perfusion. Novel non-invasive methods of monitoring microcirculation in critically ill patients offer the potential for real-time updates to improve patient outcomes. Main body Parallel mechanisms autoregulate retinal and cerebral microcirculation to maintain blood flow to meet metabolic demands across a range of perfusion pressures. Cerebral blood flow (CBF) is reduced and autoregulation impaired in sepsis, but current methods to image CBF do not reproducibly assess the microcirculation. Peripheral microcirculatory blood flow may be imaged in sublingual and conjunctival mucosa and is impaired in sepsis. Retinal microcirculation can be directly imaged by optical coherence tomography angiography (OCTA) during perfusion-deficit states such as sepsis, and other systemic haemodynamic disturbances such as acute coronary syndrome, and systemic inflammatory conditions such as inflammatory bowel disease. Conclusion Monitoring microcirculatory flow offers the potential to enhance monitoring in the care of critically ill patients, and imaging retinal blood flow during critical illness offers a potential biomarker for cerebral microcirculatory perfusion. C1 [Courtie, E.; Blanch, R. J.] Univ Birmingham, Coll Med & Dent Sci, Inst Inflammat & Ageing, Neurosci & Ophthalmol, Birmingham, W Midlands, England. [Courtie, E.; Denniston, A. K.; Blanch, R. J.] Univ Hosp Birmingham NHS Fdn Trust, Ophthalmol Dept, Birmingham, W Midlands, England. [Courtie, E.; Blanch, R. J.] Univ Hosp Birmingham NHS Fdn Trust, NIHR Surg Reconstruct & Microbiol Res Ctr, Birmingham, W Midlands, England. [Veenith, T.] Univ Hosp Birmingham NHS Fdn Trust, Crit Care Unit, Birmingham, W Midlands, England. [Veenith, T.] Univ Birmingham, Coll Med & Dent Sci, Inst Inflammat & Ageing, Birmingham Acute Care Res Grp, Birmingham, W Midlands, England. [Logan, A.] Axolotl Consulting Ltd, Droitwich WR9 0JS, Worcs, England. [Logan, A.] Univ Warwick, Warwick Med Sch, Div Biomed Sci, Coventry CV4 7HL, W Midlands, England. [Denniston, A. K.] Moorfields Eye Hosp NHS Fdn Trust, NIHR Biomed Res Ctr Ophthalmol, London, England. [Denniston, A. K.] UCL Inst Ophthalmol, London, England. [Denniston, A. K.] Birmingham Hlth Partners, Inst Translat Med, Ctr Rare Dis, Birmingham, W Midlands, England. [Blanch, R. J.] Royal Ctr Def Med, Acad Dept Mil Surg & Trauma, Birmingham, W Midlands, England. C3 RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; University of Warwick; University of London; RLUK- Research Libraries UK; University College London; Moorfields Eye Hospital NHS Foundation Trust; RLUK- Research Libraries UK; University of London; University College London; Royal Centre for Defence Medicine RP Blanch, RJ (通讯作者)，Univ Birmingham, Coll Med & Dent Sci, Inst Inflammat & Ageing, Neurosci & Ophthalmol, Birmingham, W Midlands, England. EM r.j.blanch@bham.ac.uk RI Veenith, Tonny/A-9948-2010; Veenith, T/AAI-3067-2020; Denniston, Alastair/ABD-1238-2020 OI Veenith, Tonny/0000-0002-4125-8804; Veenith, T/0000-0002-4125-8804; Denniston, Alastair/0000-0001-7849-0087; , Ella/0000-0002-8668-388X FU National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre (SRMRC); MRC [MC_PC_19005] Funding Source: UKRI FX This project is funded by the National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre (SRMRC). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. 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Intensive Care PD NOV 12 PY 2020 VL 10 IS 1 AR 152 DI 10.1186/s13613-020-00768-3 PG 18 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA OQ9GP UT WOS:000589084600001 PM 33184724 OA Green Published, gold DA 2023-05-13 ER PT J AU Abraham, NS AF Abraham, Neena S. TI Gastrointestinal bleeding in cardiac patients: epidemiology and evolving clinical paradigms SO CURRENT OPINION IN GASTROENTEROLOGY LA English DT Review DE anticoagulant; antiplatelet; antithrombotic therapy; cardiogastroenterology; shared decision-making ID ACUTE CORONARY SYNDROMES; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; SHARED DECISION-MAKING; ANTIPLATELET THERAPY; ORAL ANTICOAGULANTS; ATRIAL-FIBRILLATION; ARTERY-DISEASE; RISK; CLOPIDOGREL; PRASUGREL AB Purpose of review Cardiac patients are a fast emerging population vulnerable to gastrointestinal bleeding (GIB) due to their use of antithrombotic medications. This review will quantify the GIB risk of cardiac patients prescribed antithrombotic medications, summarize risk-management strategies and highlight knowledge gaps. Recent findings As the American population ages, it is anticipated that there will be an increased incidence of upper and lower GIB related to age-specific disease, higher burden of comorbidity and increased use of anticoagulants, antiplatelets and aspirin to treat cardiac disease. New evidence has highlighted the significant and clinically relevant GB risk. The increased use of aggressive antiplatelet and anticoagulant therapies will alter our current understanding of the epidemiology of GIB. Summary The magnitude of gastrointestinal risk in this vulnerable patient population is still relatively unexplored due to a paucity of literature. This review will highlight changing GB trends and explore current knowledge regarding GB risk in cardiac patients. An emphasis on a multidisciplinary approach to the care of these patients will be supported, which involves active patient participation and collaboration between cardiologists and gastroenterologists. Finally, risk-minimization strategies will be suggested and knowledge gaps will be identified. C1 [Abraham, Neena S.] Dept Med, Div Gastroenterol, Scottsdale, AZ USA. [Abraham, Neena S.] Dept Hlth Serv Res, Div Healthcare Policy & Res, Rochester, MN USA. RP Abraham, NS (通讯作者)，Mayo Clin, 13400 East Shea Blvd, Scottsdale, AZ 85259 USA. 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Opin. Gastroenterol. PD NOV PY 2014 VL 30 IS 6 BP 609 EP 614 DI 10.1097/MOG.0000000000000122 PG 6 WC Gastroenterology & Hepatology WE Science Citation Index Expanded (SCI-EXPANDED) SC Gastroenterology & Hepatology GA AR5NZ UT WOS:000343632400014 PM 25216111 DA 2023-05-13 ER PT J AU Hill, AD Fowler, RA Pinto, R Herridge, MS Cuthbertson, BH Scales, DC AF Hill, A. D. Fowler, R. A. Pinto, R. Herridge, M. S. Cuthbertson, B. H. Scales, D. C. TI Long-term outcomes and healthcare utilization following critical illness - a population-based study SO CRITICAL CARE LA English DT Article DE Critical care; Outcomes; Healthcare utilization ID QUALITY-OF-LIFE; RESPIRATORY-DISTRESS-SYNDROME; RANDOMIZED CONTROLLED-TRIAL; INTENSIVE-CARE; ADMINISTRATIVE DATA; HOSPITALIZED-PATIENTS; COMORBIDITY INDEX; UNIT SURVIVORS; MORTALITY; COHORT AB Background: The purpose of this study was to examine hospital mortality, long-term mortality, and health service utilization among critically ill patients. We also determined whether these outcomes differed according to demographic and clinical characteristics. Methods: We conducted a retrospective cohort study of adults (age >= 18 years) who survived admission to an intensive care unit (ICU) in Ontario, Canada, between 1 April 2002 and 31 March 2012, excluding isolated admissions to step-down or intermediate ICUs, coronary care ICUs, or cardiac surgery ICUs. Adults (age >= 18 years) who survived an acute hospitalization that did not include an ICU stay formed the comparator group. The primary outcome was mortality following hospital discharge. Secondary outcomes were healthcare utilization, including emergency room admissions and hospital readmissions during follow-up. Results: Over the study interval, 500,124 patients were admitted to ICUs and 420,187 (84 %) survived to hospital discharge. Median follow-up for survivors was 5.3 (interquartile range 2.5, 8.2) years. Patients admitted to an ICU were more likely to subsequently visit the emergency department, be readmitted to the hospital and ICU, receive home care support, require rehabilitation, and be admitted for long-term care. Those requiring more resources within the ICU required more resources after discharge. One-third of patients admitted to the ICU died during long-term follow-up, with overall probabilities of death of 11 % and 29 % at 1 year and 5 years, respectively. In the adjusted analysis, there was an increasing hazard of death with increasing age, reaching a hazard ratio of 18.08 (95 % confidence interval 16.60-19.68) for those >= 85 years of age compared with those aged 18-24 years. Conclusions: Healthcare utilization after hospital discharge was higher among ICU patients, and also among those requiring more healthcare resources during their ICU admission, than among all hospitalized patients as a group. One-third of ICU patients died within the 5 years following discharge, and age was the most influential determinant of outcome. These findings should help target post-ICU discharge services for high-risk groups and better inform goals-of-care discussions for elderly critically ill patients. C1 [Hill, A. D.; Fowler, R. A.; Pinto, R.; Cuthbertson, B. H.; Scales, D. C.] Sunnybrook Hlth Sci Ctr, Dept Crit Care Med, Toronto, ON M4N 3M5, Canada. [Hill, A. D.; Fowler, R. A.; Cuthbertson, B. H.; Scales, D. C.] Sunnybrook Res Inst, Toronto, ON, Canada. [Fowler, R. A.; Herridge, M. S.; Cuthbertson, B. H.; Scales, D. C.] Univ Toronto, Interdept Div Crit Care, Toronto, ON, Canada. [Herridge, M. S.] Univ Hlth Network, Toronto Gen Hosp, Toronto, ON, Canada. C3 University of Toronto; Sunnybrook Health Science Center; Sunnybrook Research Institute; University of Toronto; Sunnybrook Health Science Center; Sunnybrook Research Institute; University of Toronto; University of Toronto; University Health Network Toronto; Toronto General Hospital RP Hill, AD (通讯作者)，Sunnybrook Hlth Sci Ctr, Dept Crit Care Med, Toronto, ON M4N 3M5, Canada.; Hill, AD (通讯作者)，Sunnybrook Res Inst, Toronto, ON, Canada. EM Andrea.Hill@Sunnybrook.ca OI Herridge, Margaret/0000-0002-2903-1631 FU Heart and Stroke Foundation, Ontario Provincial Office; Physicians' Services Incorporated Foundation; Institute for Clinical Evaluative Sciences (ICES) - Ontario Ministry of Health and Long-Term Care (MOHLTC) FX RAF acknowledges that this work was supported by a personnel award from the Heart and Stroke Foundation, Ontario Provincial Office. DCS held a fellowship in translational health research from the Physicians' Services Incorporated Foundation.; This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. 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I., 1996, TECHNICAL REPORT Williams JI, 1996, PATTERNS HLTH CARE O, V2nd, P339 Williams TA, 2010, BRIT J ANAESTH, V104, P459, DOI 10.1093/bja/aeq025 Wunsch H, 2010, JAMA-J AM MED ASSOC, V303, P849, DOI 10.1001/jama.2010.216 NR 32 TC 113 Z9 117 U1 0 U2 11 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1466-609X EI 1364-8535 J9 CRIT CARE JI Crit. Care PD MAR 31 PY 2016 VL 20 AR 76 DI 10.1186/s13054-016-1248-y PG 10 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA DH8WN UT WOS:000373077700001 PM 27037030 OA Green Published, gold DA 2023-05-13 ER PT J AU Gemenetzis, G Gourgiotis, S Aravosita, P Mystakelli, C Aloizos, S AF Gemenetzis, George Gourgiotis, Stavros Aravosita, Paraskevi Mystakelli, Christina Aloizos, Stavros TI Takotsubo cardiomyopathy: a hidden enemy of the hypovolemic patient? SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID STRESS AB Takotsubo cardiomyopathy (TCM) is an underrecognized transient left ventricular dysfunction that mimics clinically an acute coronary syndrome. It has been linked to emotional stress and several clinical entities that provoke a catecholamine surge in the blood stream. We investigated the case of a young female patient who was admitted to the intensive care unit after a significant blood loss due to miscarriage. The patient was fully monitored and was treated for the hypovolemia. A dramatic aggravation of her clinical status was directly linked to the appearance of TCM 1 hour after her admission. This study sought to assess the appearance of TCM in a hypovolemic patient. We found no reports in the literature linking these 2 clinical entities. The blood loss and the pathophysiology of hypovolemia, especially through the excess of catecholamines that are released in the blood stream, seem to provoke the appearance of a subclinical form of TCM. As a result, TCM worsened further the general condition of the patient. There is a high possibility that TCM and hypovolemia can be closely related, and therefore, the treatment of hypovolemia can be adjusted to new standards. Because it has already been proved that TCM can be induced by emotional stress and various pathological entities, further investigations are necessary. C1 [Gemenetzis, George; Gourgiotis, Stavros; Aravosita, Paraskevi; Mystakelli, Christina; Aloizos, Stavros] Mitera Obstet & Gynecol Hosp, Intens Care Unit, Athens, Greece. RP Gemenetzis, G (通讯作者)，Mitera Obstet & Gynecol Hosp, Intens Care Unit, Athens, Greece. EM drsgourgiotis@tiscali.co.uk RI Gourgiotis, Stavros/AAD-8696-2019 OI Gourgiotis, Stavros/0000-0002-7923-6395; ALOIZOS, STAVROS/0000-0001-5868-7413 CR Lyon AR, 2008, NAT CLIN PRACT CARD, V5, P22, DOI 10.1038/ncpcardio1066 Maron BJ, 2006, CIRCULATION, V113, P1807, DOI 10.1161/CIRCULATIONAHA.106.174287 Wittstein IS, 2005, NEW ENGL J MED, V352, P539, DOI 10.1056/NEJMoa043046 NR 3 TC 3 Z9 3 U1 0 U2 3 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 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD JAN PY 2013 VL 31 IS 1 AR 262.e5 DI 10.1016/j.ajem.2012.03.029 PG 3 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 062WM UT WOS:000312954600055 PM 22633718 DA 2023-05-13 ER PT J AU Suzuki, M Saito, Y Kitahara, H Saito, K Takahara, M Himi, T Kobayashi, Y AF Suzuki, Masahiro Saito, Yuichi Kitahara, Hideki Saito, Kan Takahara, Masayuki Himi, Toshiharu Kobayashi, Yoshio TI Impact of in-hospital blood pressure variability on clinical outcomes in patients with symptomatic peripheral arterial disease SO HYPERTENSION RESEARCH LA English DT Article DE Blood pressure variability; Endovascular therapy; Peripheral artery disease ID EVENT RATES; MORTALITY; CORONARY; ASSOCIATION; STIFFNESS; STROKE; COHORT; AGE AB Various types of blood pressure (BP) variability have been recognized as risk factors for future cardiovascular events. However, the prognostic impact of in-hospital BP variability in patients with symptomatic peripheral arterial disease (PAD) has not yet been thoroughly investigated. A total of 386 patients with PAD who underwent endovascular therapy in two hospitals were retrospectively included. BP variability was assessed by the coefficient of variation (CV) of systolic BP measured during hospitalization by trained nurses. The primary endpoint was a composite of major adverse cardiovascular events (cardiovascular death, acute coronary syndrome, stroke, and hospitalization for heart failure) and major adverse limb events (major amputation, acute limb ischemia, and surgical limb revascularization). The mean systolic BP and the CV of systolic BP during hospitalization were 130.8 +/- 15.7 mmHg and 11.2 +/- 4.1%, respectively. During the median follow-up period of 22 months, 80 patients (21%) reached the primary endpoint. Receiver operating characteristic curve analysis showed that the CV of systolic BP significantly predicted major adverse cardiovascular and limb events (area under the curve 0.60, best cutoff value 9.8, P = 0.01). Using the best cutoff value, patients with high BP variability (n = 242) had a higher risk of clinical events than those with low BP variability (n = 144) (26% vs. 12%, P < 0.001). Multivariable analysis indicated that the CV of systolic BP, age, hemodialysis, and atrial fibrillation were associated with the primary endpoint. In conclusion, greater in-hospital systolic BP variability was associated with major adverse cardiovascular and limb events in patients with symptomatic PAD undergoing endovascular therapy. C1 [Suzuki, Masahiro; Saito, Yuichi; Kitahara, Hideki; Saito, Kan; Kobayashi, Yoshio] Chiba Univ, Grad Sch Med, Dept Cardiovasc Med, Chiba, Japan. [Takahara, Masayuki; Himi, Toshiharu] Kimitsu Chuo Hosp, Div Cardiol, Kisarazu, Japan. C3 Chiba University RP Suzuki, M (通讯作者)，Chiba Univ, Grad Sch Med, Dept Cardiovasc Med, Chiba, Japan. 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Res. PD AUG PY 2021 VL 44 IS 8 BP 1002 EP 1008 DI 10.1038/s41440-021-00648-8 EA APR 2021 PG 7 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA TU8XZ UT WOS:000639762100001 PM 33850306 DA 2023-05-13 ER PT J AU Okere, AN Ezendu, K Berthe, A Diaby, V AF Okere, Arinze Nkemdirim Ezendu, Kyrian Berthe, Abdrahmane Diaby, Vakaramoko TI An Evaluation of the Cost-effectiveness of Comprehensive MTM Integrated with Point-of-Care Phenotypic and Genetic Testing for US Elderly Patients After Percutaneous Coronary Intervention SO JOURNAL OF MANAGED CARE & SPECIALTY PHARMACY LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; CYTOCHROME-P450 2C19 GENOTYPE; ANTIPLATELET THERAPY; SECONDARY PREVENTION; CYP2C19 GENOTYPE; HEART-DISEASE; CLOPIDOGREL; TICAGRELOR; MANAGEMENT; READMISSION AB BACKGROUND: Poor health outcomes after percutaneous coronary intervention (PCI) in elderly patients is an area of concern among policymakers and administrators. In an effort to determine the best strategy to improve outcomes among elderly patients who underwent PCI, several studies have evaluated the cost-effectiveness of genotype-guided antiplatelet therapy compared with universal use of any one of the antiplatelet drugs indicated for patients with acute coronary syndrome (ACS) who underwent PCI. The results have either been in favor of genotype-guided antiplatelet therapy or universal use of ticagrelor. However, no study has yet evaluated the cost-effectiveness of pharmacist-provided face-to-face medication therapy management (MTM) combined with point-of-care genotype-guided antiplatelet therapy (POCP) when compared with universal use of ticagrelor or clopidogrel for the elderly after PCI. OBJECTIVE: To evaluate the cost-effectiveness of a pharmacist integration of MTM with POCP (MTM-POCP) when compared with universal use of ticagrelor or clopidogrel combined with MTM (MTM-ticagrelor or MTM-clopidogrel). METHODS: We conducted a cost-effectiveness analysis from the perspective of the U.S. health care system. A hybrid model, consisting of a 1-year decision tree and a 20-year Markov model, was used to simulate a cohort of elderly patients (aged at least 65 years) with ACS who underwent PCI. Treatment strategies available to patients were POCP, POCP-MTM, MTM-clopidogrel, or MTM-ticagrelor. Data used to populate the model were obtained from the PLATO trial and other published studies. Outcome measures were costs, quality-adjusted life-years (QALYs) and incremental cost per QALY gained. A deterministic and probabilistic sensitivity analysis was conducted to account for the joint uncertainty around the key parameters of the model. Finally, a benchmark willingness to pay of $50,000-200,000 was considered. RESULTS: The use of PCOP (with dual antiplatelet therapy) resulted in 5.29 QALYs, at a cost of $50,207. MTM-clopidogrel resulted in 5.34 QALYs, at a cost of $50,011. The use of POCP-MTM resulted in 5.36 QALYs, at a cost of $50,270. Finally, MTM-ticagrelor resulted in 5.42 QALYs, at a cost of $53,346. MTM-ticagrelor was found to be cost-effective compared with MTM-clopidogrel or MTM-POCP, irrespective of the willingness to pay. The deterministic and probabilistic sensitivity analyses confirmed the robustness of the base-case analysis. CONCLUSIONS: The combination of MTM-ticagrelor was cost-effective when compared with MTM-POCP or MTM-clopidogrel. The transitional probabilities, however, were mostly based on published studies. Analysis based on a prospective randomized clinical study, comparing all the treatment strategies included in this study, is warranted to confirm our findings. Copyright (C) 2018, Academy of Managed Care Pharmacy. All rights reserved. C1 [Okere, Arinze Nkemdirim; Ezendu, Kyrian] Florida A&M Univ, Coll Pharm & Pharmaceut Sci, 1415 S Martin Luther King Jr Blvd, Tallahassee, FL 32307 USA. [Berthe, Abdrahmane] Consortium Management Evaluat & Decis Aid, Longueuil, PQ, Canada. [Diaby, Vakaramoko] Univ Florida, Coll Pharm, Gainesville, FL USA. C3 State University System of Florida; Florida A&M University; State University System of Florida; University of Florida RP Okere, AN (通讯作者)，Florida A&M Univ, Coll Pharm & Pharmaceut Sci, 1415 S Martin Luther King Jr Blvd, Tallahassee, FL 32307 USA. 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Manag. Care Spec. Pharm. PD FEB PY 2018 VL 24 IS 2 BP 142 EP 152 DI 10.18553/jmcp.2018.24.2.142 PG 11 WC Health Care Sciences & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Pharmacology & Pharmacy GA FX1GL UT WOS:000425797000006 PM 29384027 OA Bronze DA 2023-05-13 ER PT J AU Wang, QJ Feng, WQ Kuang, JT Wu, JL Yang, J Li, CX Fan, RX AF Wang, Qiuji Feng, Weiqi Kuang, Juntao Wu, Jinlin Yang, Jue Li, Chenxi Fan, Ruixin TI Prediction model for postoperative severe acute lung injury in patients undergoing acute type A aortic dissection surgery SO JOURNAL OF CARDIAC SURGERY LA English DT Article DE acute lung injury; acute type A aortic dissection; logistic regression analyses; nomogram; prediction model ID RESPIRATORY-DISTRESS-SYNDROME; RISK-FACTORS AB Objective This study aimed to establish a risk assessment model to predict postoperative severe acute lung injury (ALI) risk in patients with acute type A aortic dissection (ATAAD). Methods Consecutive patients with ATAAD admitted to our hospital were included in this retrospective assessment and placed in the postoperative severe ALI and nonsevere ALI groups based on the presence or absence of ALI within 72 h postoperatively (oxygen index [OI] <= 100 mmHg). Patients were then randomly divided into training and validation groups in a ratio of 8:2. Univariate and multivariate stepwise forward logistic regression analyses were used to statistically assess data and establish the prediction model. The prediction model's effectiveness was evaluated via 10-fold cross-validation of the validation group to facilitate the construction of a nomogram. Results After the screening, 479 patients were included in the study: 132 (27.6%) in the postoperative severe ALI group and 347 (72.4%) in the postoperative nonsevere ALI group. Based on multivariate logistics regression analyses, the following variables were included in the model: coronary heart disease, cardiopulmonary bypass (CPB) >= 257.5 min, left atrium diameter >= 35.5 mm, hemoglobin <= 139.5 g/L, preCPB OI <= 100 mmHg, intensive care unit OI <= 100 mmHg, left ventricular posterior wall thickness >= 10.5 mm, and neutrophilic granulocyte percentage >= 0.824. The area under the receiver operating characteristic (ROC) curve of the modeling group was 0.805 and differences between observed and predicted values were not deemed statistically significant via the Hosmer-Lemeshow test (chi(2) = 6.037, df = 8, p = .643). For the validation group, the area under the ROC curve was 0.778, and observed and predicted value differences were insignificant when assessed using the Hosmer-Lemeshow test (chi(2) = 3.3782, df = 7; p = .848). The average 10-fold cross-validation score was 0.756. Conclusions This study established a prediction model and developed a nomogram to determine the risk of postoperative severe ALI after ATAAD. Variables used in the model were easy to obtain clinically and the effectiveness of the model was good. C1 [Wang, Qiuji; Feng, Weiqi; Wu, Jinlin; Yang, Jue; Li, Chenxi; Fan, Ruixin] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Dept Cardiac Surg, 96 Dongchuan Rd, Guangzhou, Peoples R China. [Wang, Qiuji] Southern Med Univ, Sch Clin Med 2, Dept Clin Med, Guangzhou, Peoples R China. [Feng, Weiqi] South China Univ Technol, Sch Med, Dept Clin Med, Guangzhou, Peoples R China. [Kuang, Juntao] Guangzhou First Peoples Hosp, Dept Cardiovasc Surg, Guangzhou, Peoples R China. C3 Guangdong Academy of Medical Sciences & Guangdong General Hospital; Southern Medical University - China; South China University of Technology; South China University of Technology RP Fan, RX (通讯作者)，Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Dept Cardiac Surg, 96 Dongchuan Rd, Guangzhou, Peoples R China. EM fanruixin@163.com OI Wu, Jinlin/0000-0003-2997-4565 FU Science and Technology Planning Project of Guangdong Province FX Science and Technology Planning Project of Guangdong Province CR Bhutta H, 2011, VASC ENDOVASC SURG, V45, P227, DOI 10.1177/1538574410396590 Cattadori G, 2017, EUR J INTERN MED, V37, P56, DOI 10.1016/j.ejim.2016.09.011 Chen MF, 2016, J THORAC DIS, V8, P2862, DOI 10.21037/jtd.2016.10.10 Ge HQ, 2018, BMC ANESTHESIOL, V18, DOI 10.1186/s12871-018-0612-7 Girdauskas E, 2010, EUR J CARDIO-THORAC, V37, P691, DOI 10.1016/j.ejcts.2009.07.016 Gong M, 2019, J CARDIOTHORAC SURG, V14, DOI 10.1186/s13019-019-0888-9 Grammer TB, 2014, ATHEROSCLEROSIS, V236, P292, DOI 10.1016/j.atherosclerosis.2014.07.002 Ju F, 2016, Zhonghua Yi Xue Za Zhi, V96, P1001, DOI 10.3760/cma.j.issn.0376-2491.2016.13.004 Liew PX, 2019, PHYSIOL REV, V99, P1223, DOI 10.1152/physrev.00012.2018 Liu N, 2017, INTERACT CARDIOV TH, V24, P251, DOI 10.1093/icvts/ivw272 Ranieri VM, 2012, JAMA-J AM MED ASSOC, V307, P2526, DOI 10.1001/jama.2012.5669 Sobczyk D, 2015, CARDIOVASC ULTRASOUN, V13, DOI 10.1186/s12947-015-0008-5 Su IL, 2019, MEDICINE, V98, DOI 10.1097/MD.0000000000016303 Wang YH, 2013, J CARDIOTHORAC SURG, V8, DOI 10.1186/1749-8090-8-118 Wang Y, 2022, PERFUSION-UK, V37, P95, DOI 10.1177/0267659120982226 Wei JH, 2019, EUR J CARDIO-THORAC, V55, P345, DOI 10.1093/ejcts/ezy269 Yang C., 2020, J INT MED RES, V2020 Yuan SM, 2019, BRAZ J CARDIOVA SURG, V34, P596, DOI 10.21470/1678-9741-2018-0287 Zhou J, 2021, ANN PALLIAT MED, V10, P7388, DOI 10.21037/apm-21-1428 NR 19 TC 2 Z9 2 U1 0 U2 6 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0886-0440 EI 1540-8191 J9 J CARDIAC SURG JI J. Card. Surg. PD JUN PY 2022 VL 37 IS 6 BP 1602 EP 1610 DI 10.1111/jocs.16447 EA MAR 2022 PG 9 WC Cardiac & Cardiovascular Systems; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Surgery GA 0P7SW UT WOS:000773993700001 PM 35348246 OA Green Submitted DA 2023-05-13 ER PT J AU Chasse, M Mathieu, P Voisine, P Despres, JP Pibarot, P Baillot, R Lellouche, F Poirier, P AF Chasse, Michael Mathieu, Patrick Voisine, Pierre Despres, Jean-Pierre Pibarot, Philippe Baillot, Richard Lellouche, Francois Poirier, Paul TI The Underestimated Belly Factor: Waist Circumference Is Linked to Significant Morbidity Following Isolated Coronary Artery Bypass Grafting SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Article ID BODY-MASS INDEX; ACUTE-RENAL-FAILURE; ATRIAL-FIBRILLATION; RISK-FACTORS; CARDIOVASCULAR-DISEASE; CARDIOMETABOLIC RISK; SCIENTIFIC STATEMENT; METABOLIC SYNDROME; EXTREME OBESITY; CARDIAC-SURGERY AB Background: Waist circumference (WC) and body mass index (BMI) are clinically used to assess adiposity. The aim of the present study was to evaluate the association of WC with postoperative morbidity and mortality in patients who underwent isolated coronary artery bypass grafting (CABG) in relation to patients' BMI category. Methods: We analyzed the associations of WC and BMI with short-term postoperative outcomes in a cohort of 7446 patients who underwent isolated CABG. We performed univariate and adjusted analyses on main postoperative outcomes after CABG for WC and BMI. Results: Adverse events researched included postoperative mortality, intensive care unit and hospital length of stay, cardiovascular and cerebrovascular events, respiratory complications, infectious, hemostasis complications, and renal complications. WC was independently associated with all postoperative outcomes except prolonged intubation and mortality. Overall, patients in the upper WC quartile in each BMI category were at increased risk of adverse events compared with patients in the lower 3 WC quartiles, with a maximal incremental risk of 1.91 (95% confidence interval, 1.23-2.95) among patients with a BMI >= 35. This association was observed for men and women, across all overweight and obesity categories. Neither WC nor BMI was associated with short-term postoperative mortality. Conclusions: In our large cohort of patients who underwent isolated CABG, WC was significantly associated with clinical adverse events, independently of BMI. These findings provide further evidence on the added value of measuring WC as a simple and easy to measure anthropometric marker to refine risk assessment beyond BMI among patients who undergo CABG. C1 [Chasse, Michael; Mathieu, Patrick; Voisine, Pierre; Despres, Jean-Pierre; Pibarot, Philippe; Baillot, Richard; Lellouche, Francois; Poirier, Paul] Univ Laval, Inst Univ Cardiol & Pneumol Quebec, Ste Foy, PQ, Canada. [Chasse, Michael; Mathieu, Patrick; Voisine, Pierre; Despres, Jean-Pierre; Pibarot, Philippe; Baillot, Richard; Lellouche, Francois] Univ Laval, Fac Med, Ste Foy, PQ, Canada. [Poirier, Paul] Univ Laval, Fac Pharm, Ste Foy, PQ, Canada. C3 Laval University; Laval University; Laval University RP Poirier, P (通讯作者)，Univ Laval, Fac Pharm, Inst Univ Cardiol & Pneumol Quebec, 2725 Chemin Ste Foy, Ste Foy, PQ G1V 4G5, Canada. EM paul.poirier@criucpq.ulaval.ca RI Chassé, Michaël/L-7906-2017; Pibarot, Philippe/ABD-5300-2021; Lellouche, Francois/AAB-9014-2019; Chassé, Michaël/Y-7820-2019 OI Chassé, Michaël/0000-0001-7075-1924; Chassé, Michaël/0000-0001-7075-1924 FU Institut universitaire de cardiologie et de pneumologie de Quebec Foundation FX This study was supported in part by funding from the Institut universitaire de cardiologie et de pneumologie de Quebec Foundation. 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J. Cardiol. PD MAR PY 2016 VL 32 IS 3 BP 327 EP 335 DI 10.1016/j.cjca.2015.06.031 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DE6SK UT WOS:000370763700013 PM 26481079 DA 2023-05-13 ER PT J AU Jentzer, JC Anavekar, NS Reddy, YNV Murphree, DH Wiley, BM Oh, JK Borlaug, BA AF Jentzer, Jacob C. Anavekar, Nandan S. Reddy, Yogesh N., V Murphree, Dennis H. Wiley, Brandon M. Oh, Jae K. Borlaug, Barry A. TI Right Ventricular Pulmonary Artery Coupling and Mortality in Cardiac Intensive Care Unit Patients SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE cardiac intensive care unit; Doppler; echocardiography; mortality; pulmonary hypertension; right heart failure; right ventricle AB Background Impaired right ventricular (RV) pulmonary artery coupling has been associated with higher mortality in patients with chronic heart disease, but few studies have examined this metric in critically ill patients. We sought to evaluate the association between RV pulmonary artery coupling, defined by the ratio of tricuspid annular peak systolic tissue Doppler velocity (TASV)/estimated RV systolic pressure (RVSP), and mortality in cardiac intensive care unit patients. Methods and Results Using a database of unique cardiac intensive care unit admissions from 2007 to 2018, we included patients with TASV/RVSP ratio measured within 1 day of hospitalization. Hospital mortality was analyzed using multivariable logistic regression, and 1-year mortality was analyzed using multivariable Cox proportional-hazards analysis. We included 4259 patients with a mean age of 69 +/- 15 years (40.1% women). Admission diagnoses included acute coronary syndrome in 56%, heart failure in 52%, respiratory failure in 24%, and cardiogenic shock in 12%. The mean TASV/RVSP ratio was 0.31 +/- 0.14, and in-hospital mortality occurred in 7% of patients. Higher TASV/RVSP ratio was associated with lower in-hospital mortality (adjusted unit odds ratio, 0.68 per each 0.1-unit higher ratio; 95% CI, 0.58-0.79; P<0.001) and lower 1-year mortality among hospital survivors (adjusted unit hazard ratio, 0.83 per each 0.1-unit higher ratio; 95% CI, 0.77-0.90; P<0.001). Stepwise decreases in hospital and 1-year mortality were observed in each higher TASV/RVSP quintile. The TASV/RVSP ratio remained associated with mortality after adjusting for left ventricular systolic and diastolic function. Conclusions A low TASV/RVSP ratio is associated with increased short-term and long-term mortality among cardiac intensive care unit patients, emphasizing importance of impaired RV pulmonary artery coupling as a determinant of poor prognosis. Further study is required to determine whether interventions to optimize RV pulmonary artery coupling can improve outcomes. C1 [Jentzer, Jacob C.; Anavekar, Nandan S.; Reddy, Yogesh N., V; Wiley, Brandon M.; Oh, Jae K.; Borlaug, Barry A.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Jentzer, Jacob C.; Reddy, Yogesh N., V] Mayo Clin, Div Pulm & Crit Care Med, Rochester, MN 55905 USA. [Murphree, Dennis H.] Mayo Clin, Dept Hlth Sci Res, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic 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, Div Pulm & Crit Care Med, Dept Internal Med, 200 First St SW, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu OI Jentzer, Jacob/0000-0002-6366-2859; Borlaug, Barry/0000-0001-9375-0596; Wiley, Brandon/0000-0003-3651-7231 CR Amsallem M, 2018, JACC-HEART FAIL, V6, P891, DOI 10.1016/j.jchf.2018.05.022 Andersen MJ, 2015, CIRC-HEART FAIL, V8, P542, DOI 10.1161/CIRCHEARTFAILURE.114.002114 Aubert R, 2018, J AM SOC ECHOCARDIOG, V31, P905, DOI 10.1016/j.echo.2018.04.013 Beigel R, 2013, J AM SOC ECHOCARDIOG, V26, P1033, DOI 10.1016/j.echo.2013.06.004 Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 Borlaug BA, 2019, JACC-HEART FAIL, V7, P574, DOI 10.1016/j.jchf.2019.03.021 Borlaug BA, 2016, EUR HEART J, V37, P3294, DOI 10.1093/eurheartj/ehw241 Braganca Bruno, 2020, J Cardiovasc Imaging, V28, P109, DOI 10.4250/jcvi.2019.0094 Eleid MF, 2019, JACC-CARDIOVASC INTE, V12, P2145, DOI 10.1016/j.jcin.2019.07.025 Ghio S, 2017, EUR J HEART FAIL, V19, P873, DOI 10.1002/ejhf.664 Guazzi M, 2013, AM J PHYSIOL-HEART C, V305, pH1373, DOI 10.1152/ajpheart.00157.2013 Guazzi M, 2017, JACC-CARDIOVASC IMAG, V10, P1211, DOI 10.1016/j.jcmg.2016.12.024 Harjola VP, 2016, EUR J HEART FAIL, V18, P226, DOI 10.1002/ejhf.478 Herasevich V, 2010, MAYO CLIN PROC, V85, P247, DOI 10.4065/mcp.2009.0479 Iacoviello M, 2017, INT J CARDIOL, V241, P318, DOI 10.1016/j.ijcard.2017.04.051 Innocenti F, 2020, INTERN EMERG MED, V15, P1281, DOI 10.1007/s11739-020-02325-z Jentzer JC, 2019, J AM COLL CARDIOL, V74, P2117, DOI 10.1016/j.jacc.2019.07.077 Jentzer JC, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013675 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2020, SHOCK, V53, P452, DOI 10.1097/SHK.0000000000001390 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, 2016, J INTENSIVE CARE MED, V31, P369, DOI 10.1177/0885066615583652 Konstam MA, 2018, CIRCULATION, V137, pE578, DOI 10.1161/CIR.0000000000000560 Kukulski T, 2015, J THORAC CARDIOV SUR, V149, P1312, DOI 10.1016/j.jtcvs.2014.09.117 Lala A, 2018, J CARD FAIL, V24, P148, DOI 10.1016/j.cardfail.2017.10.009 Landesberg G, 2014, CRIT CARE MED, V42, P790, DOI 10.1097/CCM.0000000000000107 Mehmood M, 2020, HEART LUNG CIRC, V29, P867, DOI 10.1016/j.hlc.2019.05.186 Nie L, 2019, MEDICINE, V98, DOI 10.1097/MD.0000000000017369 Nochioka K, 2018, JAMA CARDIOL, V3, P939, DOI 10.1001/jamacardio.2018.2454 Noordegraaf AV, 2017, J AM COLL CARDIOL, V69, P236, DOI 10.1016/j.jacc.2016.10.047 Obokata M, 2020, EUR RESPIR J, V55, DOI 10.1183/13993003.01617-2019 Reddy YNV, 2019, EUR HEART J, V40, P3721, DOI 10.1093/eurheartj/ehz713 Reddy YNV, 2019, CIRC RES, V124, P306, DOI 10.1161/CIRCRESAHA.118.313832 Rudski LG, 2010, J AM SOC ECHOCARDIOG, V23, P685, DOI 10.1016/j.echo.2010.05.010 Santas E, 2019, AM J CARDIOL, V124, P567, DOI 10.1016/j.amjcard.2019.05.024 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Stamm Jason A, 2011, Pulm Circ, V1, P95, DOI 10.4103/2045-8932.78104 Tello K, 2019, CIRC-CARDIOVASC IMAG, V12, DOI 10.1161/CIRCIMAGING.119.009047 Vallabhajosyula S, 2019, J CRIT CARE, V50, P201, DOI 10.1016/j.jcrc.2018.12.008 Vallabhajosyula S, 2017, ANN INTENSIVE CARE, V7, DOI 10.1186/s13613-017-0319-9 Vriz O, 2020, J HYPERTENS, V38, P274, DOI 10.1097/HJH.0000000000002238 NR 42 TC 8 Z9 8 U1 0 U2 0 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 APR 6 PY 2021 VL 10 IS 7 AR e019015 DI 10.1161/JAHA.120.019015 PG 23 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA RJ6ZI UT WOS:000637748900063 PM 33775107 OA gold, Green Published DA 2023-05-13 ER PT J AU Burstein, B van Diepen, S Wiley, BM Anavekar, NS Jentzer, JC AF Burstein, Barry van Diepen, Sean Wiley, Brandon M. Anavekar, Nandan S. Jentzer, Jacob C. TI Biventricular Function and Shock Severity Predict Mortality in Cardiac ICU Patients SO CHEST LA English DT Article DE cardiac ICU; cardiogenic shock; coronary care unit; echocardiography; heart failure; shock ID RIGHT-VENTRICULAR DYSFUNCTION; CARDIOGENIC-SHOCK; MYOCARDIAL-INFARCTION; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; RIGHT HEART; ECHOCARDIOGRAPHY; EPIDEMIOLOGY; OUTCOMES; ADULTS AB BACKGROUND: Ventricular function, including left ventricular systolic dysfunction (LVSD), right ventricular systolic dysfunction (RVSD), and biventricular dysfunction (BVD), contribute to shock in cardiac ICU (CICU) patients, but the prognostic usefulness remains unclear. RESEARCH QUESTION: Do patients with ventricular dysfunction have higher mortality at each Society for Cardiovascular Angiography and Intervention (SCAI) shock stage? STUDY DESIGN AND METHODS: We identified patients in the CICU admitted with available echocardiography data. LVSD was defined as left ventricular ejection fraction < 40%, RVSD as moderate or greater systolic dysfunction by semiquantitative measurement, and BVD as the presence of both. Multivariate logistic regression determined the relationship between ventricular dysfunction and adjusted in-hospital mortality as a function of SCAI stage. RESULTS: The study population included 3,158 patients with a mean +/- SD age of 68.2 +/- 14.6 years, of which 51.8% had acute coronary syndromes. LVSD was present in 22.3%, RVSD in 11.8%, and BVD in 16.4%. After adjustment for SCAI shock stage, no difference in in-hospital mortality was found between patients with LVSD or RVSD and those without ventricular dysfunction (P>.05), but BVD was associated independently with higher in-hospital mortality (adjusted hazard ratio, 1.815; 95% CI, 1.237-2.663; P=.0023). The addition of ventricular dysfunction to the SCAI staging criteria increased discrimination for hospital mortality (area under the receiver operating characteristic curve, 0.784 vs 0.766; P<.001). INTERPRETATION: Among patients admitted to the CICU, only BVD was associated independently with higher hospital mortality. The addition of echocardiography assessment to the SCAI shock criteria may facilitate improved clinical risk stratification. C1 [Burstein, Barry] Univ Toronto, Trillium Hlth Partners, Div Cardiol, Toronto, ON, Canada. [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. [Wiley, Brandon M.; Anavekar, Nandan S.; Jentzer, Jacob C.] Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA. [Jentzer, Jacob C.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN 55905 USA. C3 University of Toronto; Trillium Health Partners; University of Alberta; University of Alberta; Mayo Clinic; Mayo Clinic RP Jentzer, JC (通讯作者)，Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA.; Jentzer, JC (通讯作者)，Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN 55905 USA. 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Objectives: The main objective is to determine in patients with ACS and OSA if CPAP treatment reduces the incidence of cardiovascular events (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, and hospitalization for unstable angina or transient ischemic attack). The secondary objectives are to determine the prevalence of nonsleepy OSA in patients with ACS; assess the effect of CPAP on the incidence of newly diagnosed diabetes mellitus, symptoms, and quality of life; identify biomarkers of risk involved in cardiovascular complications in these patients; and conduct a cost-effectiveness analysis of diagnosis and treatment. Population and Methodology: Multicenter, prospective, randomized and controlled study. Patients are admitted to the coronary care unit with diagnosis of ACS and without daytime sleepiness (Epworth Sleepiness Scale <= 10) at 15 teaching hospitals in Spain. All patients undergo a sleep study by cardiorespiratory polygraphy. Patients with an apnea-hypopnea index >= 15/hour will be randomized to treatment with CPAP (group 1, 632 patients) or conservative treatment (group 2, 632 patients). Patients with an apnea-hypopnea index <15/hour (group 3, 600 patients) will be followed as a reference group. Patients will be monitored at baseline (T0), 1 month (T1), 3 months (T2), 6 months (T3), 12 months (T4), and every 6 months thereafter (where applicable) during the follow-up period. Conclusions: The ISAACC trial will contribute to evaluating the effect of CPAP treatment on cardiovascular events in patients with ACS and OSA. C1 [Esquinas, Cristina; Flores, Marina; Barbe, Ferran] Hosp Univ Arnau de Vilanova Santa Maria, Resp Dept, Lleida, Spain. [Sanchez-de-la Torre, Manuel; Barcelo, Antonia; Barbe, Ferran] CIBERES, Madrid, Spain. [Esquinas, Cristina; Sanchez-de-la Torre, Manuel; Martinez, Montserrat; Barbe, Ferran] IRBLleida, Resp Med Res Grp, Lleida, Spain. [Aldoma, Albina] Hosp Univ Arnau de Vilanova Santa Maria, Dept Cardiol, Lleida, Spain. [Barcelo, Antonia] Hosp Univ Son Espases, Clin Anal Serv, Palma De Mallorca, Spain. C3 University Hospital Arnau de Vilanova; CIBER - Centro de Investigacion Biomedica en Red; CIBERES; University Hospital Arnau de Vilanova; Hospital Universitari Son Espases RP Barbe, F (通讯作者)，Hosp Arnau Vilanova, Resp Dis Res Unit, IRB Lleida, Rovira Roure 80, Lleida 25198, Spain. EM febarbe.lleida.ics@gencat.cat RI Sánchez-de-la-Torre, Manuel/AAC-9514-2022; Martínez-Alonso, Montserrat/B-5582-2009; de la Torre, Manuel Sanchez/B-5578-2009; Sanchez-de-la-Torre, Manuel/AAP-2663-2020; Barbé, Ferran/A-5988-2010 OI Martínez-Alonso, Montserrat/0000-0003-1504-8552; de la Torre, Manuel Sanchez/0000-0002-5695-348X; Sanchez-de-la-Torre, Manuel/0000-0002-5695-348X; Barbé, Ferran/0000-0002-2340-8928; Barcelo Bennasar, Antonia/0000-0002-3170-5439 FU Fondo de Investigacion Sanitaria [PI10/02763, PI10/02745]; Spanish Respiratory Society (SEPAR); Catalonian Cardiology Society; ResMed Ltd. (Australia); Esteve-Teijin (Spain); Oxigen Salud (Spain); ALLER FX This work was supported by Fondo de Investigacion Sanitaria (PI10/02763 and PI10/02745), the Spanish Respiratory Society (SEPAR), the Catalonian Cardiology Society, ResMed Ltd. (Australia), Esteve-Teijin (Spain), Oxigen Salud (Spain), and ALLER. No sponsor contributed to the study design, data collection, analysis, or interpretation of data, or the submission of the report for publication. Trial registration: ClinicalTrials.gov, NCT01335087. Protocol version: January 2012, V2. The authors have no other funding, financial relationships, or conflicts of interest to disclose. 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Cardiol. PD SEP PY 2013 VL 36 IS 9 BP 495 EP 501 DI 10.1002/clc.22166 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 213LF UT WOS:000324058000004 PM 23843147 OA Green Published DA 2023-05-13 ER PT J AU Reinhart, WH AF Reinhart, Walter H. TI The optimum hematocrit SO CLINICAL HEMORHEOLOGY AND MICROCIRCULATION LA English DT Article DE Erythrocyte; hematocrit; viscosity; oxygen transport; microcirculation ID BLOOD-CELL TRANSFUSION; ERYTHROPOIESIS-STIMULATING AGENTS; CHRONIC KIDNEY-DISEASE; DARBEPOETIN-ALPHA; OXYGEN-TRANSPORT; RESTRICTIVE TRANSFUSION; POSTOPERATIVE OUTCOMES; CARDIOVASCULAR-DISEASE; CORONARY HEMODYNAMICS; PREOPERATIVE ANEMIA AB The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70 mu m channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values. In healthy, well trained athletes an increase of the Hct to supra-normal levels can increase exercise performance. These data with healthy individuals suggest that the optimum Hct for oxygen transport may be higher than the physiological range (35-40% in women, 39-50% in men). This is in contrast to clinical observations. Large clinical studies have repeatedly shown that a correction of anemia in a variety of disorders such as chronic kidney disease, heart failure, coronary syndrome, oncology, acute gastrointestinal bleeding, critical care, or surgery have better clinical outcomes when restrictive transfusion strategies are applied. Actual guidelines, therefore, recommend a transfusion threshold of 7-8 g/dL hemoglobin (Hct 20-24%) in stable, hospitalized patients. The discrepancy between the optimum Hct in health and disease may be due to factors such as decreased perfusion pressures (low cardiac output, vascular stenoses, change in vascular tone), endothelial cell dysfunction, leukocyte adhesion and others. C1 [Reinhart, Walter H.] Kantonsspital Graubunden, Chur, Switzerland. C3 Kantonsspital Graubunden RP Reinhart, WH (通讯作者)，Calunaweg 19, CH-7000 Chur, Switzerland. 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Hemorheol. Microcirc. PY 2016 VL 64 IS 4 BP 575 EP 585 DI 10.3233/CH-168032 PG 11 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA EN3UU UT WOS:000395934200010 PM 27767984 DA 2023-05-13 ER PT J AU Charytan, DM Natwick, T Solid, CA Li, SL Gong, TT Herzog, CA AF Charytan, David M. Natwick, Tanya Solid, Craig A. Li, Shuling Gong, Tingting Herzog, Charles A. TI Comparative Effectiveness of Medical Therapy, Percutaneous Revascularization, and Surgical Coronary Revascularization in Cardiovascular Risk Subgroups of Patients With CKD: A Retrospective Cohort Study of Medicare Beneficiaries SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article ID CHRONIC KIDNEY-DISEASE; DIALYSIS PATIENTS; SURVIVAL; SURGERY; INDIVIDUALS; ANGIOGRAPHY; TRIALS; IMPACT; DEATH AB Rationale & Objective: Prior studies suggesting that medical therapy is inferior to percutaneous (percutaneous coronary intervention [PCI]) or surgical (coronary artery bypass grafting [CABG]) coronary revascularization in chronic kidney disease (CKD) have not adequately considered medication optimization or baseline cardiovascular risk and have infrequently evaluated progression to kidney failure. We compared, separately, the risks for kidney failure and death after treatment with PCI, CABG, or optimized medical therapy for coronary disease among patients with CKD stratified by cardiovascular disease risk. Study Design: Retrospective cohort study. Setting & Participants: 34,385 individuals with CKD identified from a national 20% Medicare sample who underwent angiography or diagnostic stress testing without (low risk) or with (medium risk) prior cardiovascular disease or who presented with acute coronary syndrome (high risk). Exposures: PCI, CABG, or optimized medical therapy (defined by the addition of cardiovascular medications in the absence of coronary revascularization). Outcomes: Death, kidney failure, composite outcome of death or kidney failure. Analytical Approach: Adjusted relative rates of death, kidney failure, and the composite of death or kidney failure estimated from Cox proportional hazards models. Results: Among low-risk patients, 960 underwent PCI, 391 underwent CABG, and 6,426 received medical therapy alone; among medium-risk patients, 1,812 underwent PCI, 512 underwent CABG, and 9,984 received medical therapy alone; and among high-risk patients, 4,608 underwent PCI, 1,330 underwent CABG, and 8,362 received medical therapy alone. Among low- and medium-risk patients, neither CABG (HRs of 1.22 [95% CI, 0.96-1.53] and 1.08 [95% CI, 0.91-1.29] for low- and medium-risk patients, respectively) nor PCI (HRs of 1.14 [95% CI, 0.98-1.33] and 1.02 [95% CI, 0.93-1.12], respectively) were associated with reduced mortality compared with medical therapy, but in low-risk patients, CABG was associated with a higher rate of the composite, death or kidney failure (HR, 1.25; 95% CI, 1.02-1.53). In high-risk patients, CABG and PCI were associated with lower mortality (HRs of 0.57 [95% CI, 0.51-0.63] and 0.70 [95% CI, 0.66-0.74], respectively). Also, in high-risk patients, CABG was associated with a higher rate of kidney failure (HR, 1.40; 95% CI, 1.16-1.69). Limitations: Possible residual confounding; lack of data for coronary angiography or left ventricular ejection fraction; possible differences in decreased kidney function severity between therapy groups. Conclusions: Outcomes associated with cardiovascular therapies among patients with CKD differed by baseline cardiovascular risk. Coronary revascularization was not associated with improved survival in low-risk patients, but was associated with improved survival in high-risk patients despite a greater observed rate of kidney failure. These findings may inform clinical decision making in the care of patients with both CKD and cardiovascular disease. C1 [Charytan, David M.] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA. [Natwick, Tanya; Solid, Craig A.; Li, Shuling; Gong, Tingting] Hennepin Healthcare Res Inst, Chron Dis Res Grp, Minneapolis, MN USA. [Herzog, Charles A.] Hennepin Healthcare, Dept Med, Minneapolis, MN USA. [Herzog, Charles A.] Univ Minnesota, Minneapolis, MN USA. [Natwick, Tanya] OptumLabs, Minneapolis, MN USA. [Solid, Craig A.] Solid Res Grp LLC, St Paul, MN USA. C3 Harvard University; Brigham & Women's Hospital; University of Minnesota System; University of Minnesota Twin Cities; Optum RP Charytan, DM (通讯作者)，NYU, Langone Med Ctr, 426 1st Ave C & D 689, New York, NY 10010 USA. EM david.charytan@nyulangone.org OI charytan, david/0000-0002-7695-3583 FU National Institutes of Health [HL118314-01] FX This study was funded by the National Institutes of Health (grant number HL118314-01). The funders of this study had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication. 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J. Kidney Dis. PD OCT PY 2019 VL 74 IS 4 BP 463 EP 473 DI 10.1053/j.ajkd.2019.04.018 PG 11 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA IY7WX UT WOS:000486606900008 PM 31255335 DA 2023-05-13 ER PT J AU Kreuziger, LB Karkouti, K Tweddell, J Massicotte, MP AF Kreuziger, L. Baumann Karkouti, K. Tweddell, J. Massicotte, M. P. TI Antithrombotic therapy management of adult and pediatric cardiac surgery patients SO JOURNAL OF THROMBOSIS AND HAEMOSTASIS LA English DT Review DE anticoagulants; cardiac surgical procedures; cardiopulmonary bypass; heart-assist devices; platelet aggregation inhibitors ID HEPARIN-INDUCED THROMBOCYTOPENIA; VENTRICULAR ASSIST DEVICES; DUAL ANTIPLATELET THERAPY; BYPASS GRAFT-SURGERY; CLINICAL-PRACTICE GUIDELINES; AORTIC-VALVE-REPLACEMENT; 2011 ACCF/AHA GUIDELINE; ASSOCIATION TASK-FORCE; CARDIOPULMONARY BYPASS; AMERICAN-COLLEGE AB Despite the development of catheter-based interventions for ischemic and valvular heart disease, hundreds of thousands of people undergo open heart surgery annually for coronary artery bypass graft (CABG), valve replacement or cardiac assist device implantation. Cardiac surgery patients are unique because therapeutic anticoagulation is required during cardiopulmonary bypass. Developmental hemostasis and altered drug metabolism affect management in children. This narrative review summarizes the current evidence-based and consensus guidelines regarding perioperative, intraoperative and postoperative antithrombotic therapy in patients undergoing cardiac surgery. Anticoagulation preoperatively is required in the setting of cardiac arrhythmias, prior valve replacement or history of venous thromboembolism. In patients with ischemic heart disease, aspirin is continued in the perioperative period, whereas oral P2Y(12) antagonists are withheld for 5-7 days to reduce the risk of perioperative bleeding. Intraoperative management of cardiopulmonary bypass in adults and children includes anticoagulation with unfractionated heparin. Variability in dose-response to heparin and influence of other medical conditions on dosing and reversal of heparin make intraoperative anticoagulation challenging. Vitamin K antagonist therapy is the standard anticoagulant after mechanical heart valve or left ventricular assist device (LVAD) implantation. Longer duration of dual antiplatelet therapy is recommended after CABG if patients undergo surgery because of acute coronary syndrome. Antiplatelet therapy after LVAD implantation includes aspirin, dipyridamole and/or clopidogrel in children and aspirin in adults. A coordinated approach between hematology, cardiology, anesthesiology, critical care and cardiothoracic surgery can assist to balance the risk of thrombosis and bleeding in patients undergoing cardiac surgery. C1 [Kreuziger, L. Baumann] BloodCtr Wisconsin, Blood Res Inst, Milwaukee, WI USA. [Kreuziger, L. Baumann] Med Coll Wisconsin, Dept Med, Div Hematol & Oncol, Milwaukee, WI 53226 USA. [Karkouti, K.] Univ Toronto, Univ Hlth Network, Toronto Gen Hosp, Dept Anesthesia & Pain Management,Res Inst, Toronto, ON, Canada. [Tweddell, J.] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Dept Surg & Pediat, Cincinnati, OH USA. [Massicotte, M. P.] Univ Alberta, Dept Pediat, Edmonton, AB, Canada. C3 Versiti Blood Center of Wisconsin; Medical College of Wisconsin; University of Toronto; University Health Network Toronto; Toronto General Hospital; Cincinnati Children's Hospital Medical Center; University System of Ohio; University of Cincinnati; University of Alberta RP Kreuziger, LB (通讯作者)，BloodCtr Wisconsin, 8733 Watertown Plank Rd, Milwaukee, WI 53226 USA. 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Thromb. Haemost. PD NOV PY 2018 VL 16 IS 11 BP 2133 EP 2146 DI 10.1111/jth.14276 PG 14 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA HB2EU UT WOS:000450850600004 PM 30153372 OA Bronze DA 2023-05-13 ER PT J AU Eslam, RB Lang, IM Koppensteiner, R Calatzis, A Panzer, S Gremmel, T AF Eslam, Roza Badr Lang, Irene M. Koppensteiner, Renate Calatzis, Andreas Panzer, Simon Gremmel, Thomas TI Residual platelet activation through protease-activated receptors (PAR)-1 and-4 in patients on P2Y12 inhibitors SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Thrombin; PAR-1; PAR-4; Antiplatelet therapy ID ACUTE CORONARY SYNDROMES; OF-CARE ANALYSIS; STENT IMPLANTATION; PROGNOSTIC-SIGNIFICANCE; GLYCOPROTEIN-IB; CLOPIDOGREL; THROMBIN; REACTIVITY; AGGREGATION; ANTAGONIST AB Background: Dual antiplatelet therapy with aspirin and thienopyridines has improved outcomes of patients after coronary stent implantation. However, current knowledge suggests that thrombin generation is not affected by inhibition of the P2Y12 receptor, and therefore, platelet activation may still occur. Methods: The response to agonists specific for protease-activated receptors (PAR)-1 and -4 was tested by multiple electrode impedance aggregometry in 82 patients on stable doses of clopidogrel or prasugrel, and in 55 healthy controls. Results: Based on the consensus cut-off value for adenosine diphosphate (ADP) responsiveness, only one out of 19 patients on prasugrel, but 22 out of 63 patients on clopidogrel had high on-treatment residual platelet reactivity in response to exogenous ADP (p=0.01). Among the patients with adequate ADP P2Y12 receptor inhibition (n=59), we still observed 32 patients (54.2%) with normal response to the PAR-1 activator SFLLRN (26 patients on clopidogrel, 81.2%; 6 patients on prasugrel, 18.8%), and 37 patients (63.8%) with a normal response to the PAR-4 activator AYPGKF (29 patients on clopidogrel, 78.4%; 8 patients on prasugrel, 21.6%). The degree of PAR-agonists inducible platelet activation was directly correlated with the activation induced by ADP (r>0.5 and p<0.001 for both agonists). Moreover, SFLLRN and AYPGKF inducible platelet reactivities were strongly correlated (r=0.75, p<0.001). Conclusion: PAR responsiveness is preserved in the majority of patients with adequate clopidogrel-mediated inhibition of the platelet P2Y12 receptor, and still in about 20% of those with adequate inhibition by prasugrel. (c) 2012 Elsevier Ireland Ltd. All rights reserved. C1 [Eslam, Roza Badr; Lang, Irene M.; Koppensteiner, Renate; Gremmel, Thomas] Med Univ Vienna, Dept Internal Med 2, A-1090 Vienna, Austria. [Calatzis, Andreas] Univ Munich, Inst Prevent Cardiovasc Dis, Munich, Germany. [Panzer, Simon] Med Univ Vienna, Dept Blood Grp Serol & Transfus Med, A-1090 Vienna, Austria. C3 Medical University of Vienna; University of Munich; Medical University of Vienna RP Gremmel, T (通讯作者)，Med Univ Vienna, Dept Internal Med 2, Waehringer Guertel 18-20, A-1090 Vienna, Austria. EM thomas.gremmel@meduniwien.ac.at OI Gremmel, Thomas/0000-0001-9554-7292; Lang, Irene/0000-0003-0485-2692 CR Adam F, 2003, EUR J BIOCHEM, V270, P2959, DOI 10.1046/j.1432-1033.2003.03670.x Angiolillo DJ, 2010, EUR HEART J, V31, P17, DOI 10.1093/eurheartj/ehp504 Aradi D, 2010, AM HEART J, V160, P543, DOI 10.1016/j.ahj.2010.06.004 Bonello L, 2010, J AM COLL CARDIOL, V56, P919, DOI 10.1016/j.jacc.2010.04.047 Cattaneo M, 2004, ARTERIOSCL THROM VAS, V24, P1980, DOI 10.1161/01.ATV.0000145980.39477.a9 Chackalamannil S, 2008, J MED CHEM, V51, P3061, DOI 10.1021/jm800180e Chintala M, 2010, ARTERIOSCL THROM VAS, V30, P2143, DOI 10.1161/ATVBAHA.110.203414 Dormann D, 2000, BLOOD, V96, P2469, DOI 10.1182/blood.V96.7.2469.h8002469_2469_2478 Eikelboom JW, 2002, EUR HEART J, V23, P1771, DOI 10.1053/euhj.2000.3234 Geisler T, 2006, EUR HEART J, V27, P2420, DOI 10.1093/eurheartj/ehl275 Gremmel T, 2010, PLATELETS, V21, P515, DOI 10.3109/09537104.2010.493587 Gremmel T, 2009, THROMB HAEMOSTASIS, V101, P333, DOI 10.1160/TH08-09-0577 Gurbel PA, 2005, J AM COLL CARDIOL, V46, P1820, DOI 10.1016/j.jacc.2005.07.041 Holinstat M, 2006, J BIOL CHEM, V281, P26665, DOI 10.1074/jbc.M602174200 Jakubowski JA, 2007, J CARDIOVASC PHARM, V49, P167, DOI 10.1097/FJC.0b013e318031301b Jurk K, 2004, THROMB HAEMOSTASIS, V91, P334, DOI 10.1160/TH03-01-0044 Kahn ML, 1999, J CLIN INVEST, V103, P879, DOI 10.1172/JCI6042 Kim S, 2002, BLOOD, V99, P3629, DOI 10.1182/blood.V99.10.3629 Leger AJ, 2006, CIRCULATION, V114, P1070, DOI 10.1161/CIRCULATIONAHA.105.574830 Marcucci R, 2009, CIRCULATION, V119, P237, DOI 10.1161/CIRCULATIONAHA.108.812636 Morrow DA, 2012, NEW ENGL J MED, V366, P1404, DOI 10.1056/NEJMoa1200933 Ofosu FA, 2008, J BIOL CHEM, V283, P26886, DOI 10.1074/jbc.M802237200 Price MJ, 2008, EUR HEART J, V29, P992, DOI 10.1093/eurheartj/ehn046 Serebruany VL, 2009, THROMB HAEMOSTASIS, V102, P111, DOI 10.1160/TH08-12-0805 Shankar H, 2006, J THROMB HAEMOST, V4, P638, DOI 10.1111/j.1538-7836.2006.01789.x Sibbing D, 2010, J THROMB HAEMOST, V8, P250, DOI 10.1111/j.1538-7836.2009.03709.x 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 Smyth SS, 2009, ARTERIOSCL THROM VAS, V29, P449, DOI 10.1161/ATVBAHA.108.176388 Soslau G, 2001, J BIOL CHEM, V276, P21173, DOI 10.1074/jbc.M008249200 Tricoci P, 2012, NEW ENGL J MED, V366, P20, DOI 10.1056/NEJMoa1109719 Yusuf S, 2001, NEW ENGL J MED, V345, P494 NR 32 TC 23 Z9 23 U1 0 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 SEP 20 PY 2013 VL 168 IS 1 BP 403 EP 406 DI 10.1016/j.ijcard.2012.09.103 PG 4 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 231IL UT WOS:000325409800075 PM 23041015 DA 2023-05-13 ER PT J AU Asghari, S Aref-Eshghi, E Godwin, M Duke, P Williamson, T Mahdavian, M AF Asghari, Shabnam Aref-Eshghi, Erfan Godwin, Marshall Duke, Pauline Williamson, Tyler Mahdavian, Masoud TI Single and mixed dyslipidaemia in Canadian primary care settings: findings from the Canadian primary care sentinel surveillance network database SO BMJ OPEN LA English DT Article ID DENSITY-LIPOPROTEIN CHOLESTEROL; DECISION-SUPPORT-SYSTEMS; ACUTE-CORONARY-SYNDROME; LIPID-LOWERING THERAPY; CARDIOVASCULAR-DISEASE; RISK-FACTORS; MYOCARDIAL-INFARCTION; GENERAL-PRACTICE; LDL CHOLESTEROL; HEART-DISEASE AB Objectives Dyslipidaemia is a major risk factor to cardiovascular disease (CVD)the leading cause of death worldwide. Limited data are available about the prevalence of various dyslipidaemia in Canada. The objective of this study is to describe the prevalence of various single and mixed dyslipidaemia within the Canadian population in a primary care setting. Setting A cross-sectional study, using the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), was undertaken. Participants Non-pregnant adults older than 20years were included. Outcome measures Canadian guidelines were used to define dyslipidaemia. Descriptive statistics and multivariate regression analyses were conducted to compare the prevalence of single/mixed dyslipidaemia. Results 134074 individuals with a mean age of 59.2 (55.8% women) were identified. 34.8% of this population had no lipid abnormality, whereas 35.8%, 17.3% and 3.2% had abnormalities in one, two and three lipid components, respectively. Approximately 86% of these patients did not receive any lipid-lowering medication. Among the medication users (14%), approximately 12% were on statin monotherapy. Statin users (n=16036) had a lower rate of low-density lipoprotein dyslipidaemia compared to non-medication users (3% vs 17%), whereas the prevalence of high-density lipoprotein (HDL) (20% vs 12%) and triglycerides (TG) (12% vs 7%) dyslipidaemia were higher in statin users. Statin users had a greater prevalence of HDL, TG and combined HDL-TG dyslipidaemia compared to non-medication users (OR 1.44, 95% CI 1.36 to 153), (OR 1.18, 95% CI 1.10 to 1.27) and (OR 1.30, 95% CI 1.22 to 1.38), respectively, (all p values<0.0001). Conclusions One of every five patients in primary care settings in Canada is suffering from mixed dyslipidaemia. The overall prevalence of dyslipidaemia remains the same between treated and untreated groups, although the type of abnormal lipid component is considerably different. Among the CVD risk factors, obesity has the greatest effect on the prevalence of all types of dyslipidaemia. C1 [Asghari, Shabnam; Aref-Eshghi, Erfan; Godwin, Marshall; Duke, Pauline] Mem Univ Newfoundland, St Johns Newfoundland & Labrador, Fac Med, St John, NF A1C 5S7, Canada. [Williamson, Tyler] Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada. [Mahdavian, Masoud] Univ Ottawa, Fac Med, Ottawa, ON, Canada. C3 Memorial University Newfoundland; University of Calgary; University of Ottawa RP Asghari, S (通讯作者)，Mem Univ Newfoundland, St Johns Newfoundland & Labrador, Fac Med, St John, NF A1C 5S7, Canada. 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Lane, Deirdre A. Fauchier, Laurent Marin, Francisco Nabauer, Michael Potpara, Tatjana S. Dan, Gheorghe-Andrei Boriani, Giuseppe Lip, Gregory Y. H. CA ESC-EHRA EORP-AF Long-Term Gen Reg TI Real-world applicability and impact of early rhythm control for European patients with atrial fibrillation: a report from the ESC-EHRA EORP-AF Long-Term General Registry SO CLINICAL RESEARCH IN CARDIOLOGY LA English DT Article DE Atrial fibrillation; Rhythm control; Rate control; Outcomes ID MOBILE HEALTH TECHNOLOGY; FOLLOW-UP; STROKE; RISK; MANAGEMENT; CARE AB Background Use of rate/rhythm control is essential to control symptoms in patients with atrial fibrillation (AF). Recently, the EAST-AFNET 4 trial described how early rhythm control strategy was associated with a lower risk of adverse clinical outcomes. Objectives The aim was to evaluate the real-world applicability and impact of an early rhythm control strategy in patients with AF. Methods Use of an early rhythm control strategy was assessed in a European cohort of AF patients derived from the EHRA-ESC EORP-AF General Long-Term Registry. Early rhythm control was defined as use of antiarrhythmic drugs or cardioversion/catheter ablation. The primary outcome included cardiovascular death, stroke, acute coronary syndrome, and worsening of heart failure. Quality of life and health-care resource usage were also assessed as outcomes. Results Among the 10,707 patients evaluated for eligibility to EAST-AFNET 4, a total of 3774 (34.0%) were included. Early rhythm control was associated with better quality of life, but with greater use of health-care resources. During follow-up, the primary outcome occurred less often in early rhythm control patients than in those with no rhythm control (13.6% vs. 18.5%, p < 0.001). In the multivariate adjusted Cox regression model, no significant difference was found between no rhythm control and early rhythm control, for the primary outcome. No difference in the primary outcome between early rhythm control and 'no rhythm control patients' adherent to Atrial fibrillation Better Care (ABC) pathway' was evident (p = 0.753) Conclusions Use of an early rhythm control strategy was associated with a lower rate of major adverse events, but this difference was non-significant on multivariate analysis, being mediated by differences in baseline characteristics and clinical risk profile. Early rhythm control was associated with a higher use of health-care resources and risk of hospital admission, despite showing better quality of life. Graphic abstract C1 [Proietti, Marco; Vitolo, Marco; Harrison, Stephanie L.; Lane, Deirdre A.; Lip, Gregory Y. H.] Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England. [Proietti, Marco; Vitolo, Marco; Harrison, Stephanie L.; Lane, Deirdre A.; Lip, Gregory Y. H.] Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England. [Proietti, Marco] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy. [Proietti, Marco] IRCCS Ist Clin Sci Maugeri, Geriatr Unit, Milan, Italy. [Vitolo, Marco; Boriani, Giuseppe] Univ Modena & Reggio Emilia, Policlin Modena, Dept Biomed Metab & Neural Sci, Cardiol Div, Modena, Italy. [Lane, Deirdre A.; Lip, Gregory Y. H.] Aalborg Univ, Dept Clin Med, Aalborg, Denmark. [Fauchier, Laurent] Ctr Hosp Univ Trousseau, Serv Cardiol, Tours, France. [Marin, Francisco] Univ Murcia, CIBERCV, Dept Cardiol, Hosp Univ Virgen de la Arrixaca,IMIB Arrixaca, Murcia, Spain. [Nabauer, Michael] Ludwig Maximilians Univ Munchen, Dept Cardiol, Munich, Germany. [Potpara, Tatjana S.] Univ Belgrade, Sch Med, Belgrade, Serbia. [Potpara, Tatjana S.] Clin Ctr Serbia, Cardiol Clin, Intens Arrhythmia Care, Belgrade, Serbia. [Dan, Gheorghe-Andrei] Carol Davila Univ Med, Colentina Univ Hosp, Bucharest, Romania. C3 N8 Research Partnership; RLUK- Research Libraries UK; University of Liverpool; Liverpool Heart & Chest Hospital; University of Milan; Istituti Clinici Scientifici Maugeri IRCCS; Universita di Modena e Reggio Emilia; Aalborg University; CHU Tours; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; Hospital Clinico Universitario Virgen de la Arrixaca; University of Murcia; University of Munich; University of Belgrade; Clinical Centre of Serbia; Carol Davila University of Medicine & Pharmacy RP Proietti, M; Lip, GYH (通讯作者)，Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England.; Proietti, M; Lip, GYH (通讯作者)，Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England.; Proietti, M (通讯作者)，Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy.; Proietti, M (通讯作者)，IRCCS Ist Clin Sci Maugeri, Geriatr Unit, Milan, Italy.; Lip, GYH (通讯作者)，Aalborg Univ, Dept Clin Med, Aalborg, Denmark. EM marco.proietti@unimi.it; gregory.lip@liverpool.ac.uk RI Proietti, Marco/K-8060-2016; fauchier, laurent/HDN-2353-2022; Canpolat, Ugur/S-3482-2018; Kuridze, Nika/AAY-7544-2021; Ryabaya, Irina N./ABF-8491-2021; Mirrakhimov, Erkin/E-6900-2017; Vitolo, Marco/W-1038-2019; Marin, Francisco/AAD-9429-2022; Boriani, Giuseppe/AAC-3406-2022 OI Proietti, Marco/0000-0003-1452-2478; Canpolat, Ugur/0000-0002-4250-1706; Kuridze, Nika/0000-0002-2586-7909; Mirrakhimov, Erkin/0000-0003-2982-6108; Vitolo, Marco/0000-0002-5196-6249; Boriani, Giuseppe/0000-0002-9820-4815; Riahi, Sam/0000-0003-1849-9463; Perez-Cabeza, Alejandro Isidoro/0000-0002-4799-4263; Marin, Francisco/0000-0001-7246-7708; Lane, Deirdre/0000-0002-5604-9378; Azhari, Amirhossein/0000-0002-3249-7491 FU Universita degli Studi di Milano within the CRUI-CARE Agreement; Abbott Vascular Int; Amgen Cardiovascular; Astra-Zeneca; Bayer; Boehringer Ingelheim; Boston Scientific; Bristol Myers Squibb; Pfizer Alliance; Alliance Daiichi Sankyo Europe GmbH; Eli Lilly and Company; Edwards; Gedeon Richter Plc.; Menarini Int. Op.; MSD-Merck Co.; Novartis Pharma AG; ResMed; Sanofi; SERVIER; Vifor FX Open access funding provided by Universita degli Studi di Milano within the CRUI-CARE Agreement. Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011-2021), Amgen Cardiovascular (2009-2018), Astra-Zeneca (2014-2021), Bayer (2009-2018), Boehringer Ingelheim (2009-2019), Boston Scientific (2009-2012), The Bristol Myers Squibb and Pfizer Alliance (2011-2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011-2017), Edwards (2016-2019), Gedeon Richter Plc. (2014-2017), Menarini Int. Op. (2009-2012), MSD-Merck & Co. (2011-2014), Novartis Pharma AG (2014-2020), ResMed (2014-2016), Sanofi (2009-2011), SERVIER (2010-2021), Vifor (2019-2022). CR Al-Khatib SM, 2014, ANN INTERN MED, V160, P760, DOI 10.7326/M13-1467 Asad ZU, 2019, CIRC-ARRHYTHMIA ELEC, V12, DOI 10.1161/CIRCEP.119.007414 Boriani G, 2019, EUROPACE, V21, P1013, DOI 10.1093/europace/euz032 Boriani G, 2018, INT J CARDIOL, V271, P68, DOI 10.1016/j.ijcard.2018.05.034 Boriani G, 2018, EUROPACE, V20, P747, DOI 10.1093/europace/eux301 Bunch TJ, 2020, NEW ENGL J MED, V383, P1383, DOI 10.1056/NEJMe2027180 Chao TF, 2018, THROMB HAEMOSTASIS, V118, P768, DOI 10.1055/s-0038-1636534 Chao TF, 2018, J AM COLL CARDIOL, V71, P122, DOI 10.1016/j.jacc.2017.10.085 Dudink EAMP, 2018, EUROPACE, V20, P929, DOI 10.1093/europace/eux217 Fauchier L, 2020, J CLIN MED, V9, DOI 10.3390/jcm9041234 Galiuto L, 2020, EUR HEART J, V41, P3987, DOI 10.1093/eurheartj/ehaa812 Goette A, 2018, EUROPACE, V20, P1936, DOI 10.1093/europace/euy141 Goette A, 2016, EUROPACE, V18, P1455, DOI 10.1093/europace/euw161 Guo YT, 2020, EUR J INTERN MED, V82, P105, DOI 10.1016/j.ejim.2020.09.024 Guo YT, 2020, AM J MED, V133, P1195, DOI 10.1016/j.amjmed.2020.03.019 Guo YT, 2020, J AM COLL CARDIOL, V75, P1523, DOI 10.1016/j.jacc.2020.01.052 Hindricks Gerhard, 2021, Eur Heart J, V42, P373, DOI 10.1093/eurheartj/ehaa612 Kirchhof P, 2020, NEW ENGL J MED, V383, P1305, DOI 10.1056/NEJMoa2019422 Kirchhof P, 2013, AM HEART J, V166, P442, DOI 10.1016/j.ahj.2013.05.015 Lip GYH, 2017, NAT REV CARDIOL, V14, P627, DOI 10.1038/nrcardio.2017.153 Lip GYH, 2014, EUR HEART J, V35, P3365, DOI 10.1093/eurheartj/ehu374 Lip GYH, 2014, EUROPACE, V16, P308, DOI 10.1093/europace/eut373 Lip GYH, 2010, CHEST, V137, P263, DOI 10.1378/chest.09-1584 Marrouche NF, 2018, NEW ENGL J MED, V378, P417, DOI 10.1056/NEJMoa1707855 Masnoon N, 2017, BMC GERIATR, V17, DOI 10.1186/s12877-017-0621-2 Noheria Amit, 2016, JACC Clin Electrophysiol, V2, P221, DOI 10.1016/j.jacep.2015.11.001 Pisters R, 2010, CHEST, V138, P1093, DOI 10.1378/chest.10-0134 Proietti M, 2021, EUROPACE, V23, P174, DOI 10.1093/europace/euaa274 Proietti M, 2017, EUROPACE, V19, P722, DOI 10.1093/europace/euw112 Purmah Y, 2018, EUROPACE, V20, P243, DOI 10.1093/europace/euw421 Rockwood K, 2007, J GERONTOL A-BIOL, V62, P722, DOI 10.1093/gerona/62.7.722 Romiti GF, 2022, THROMB HAEMOSTASIS, V122, P406, DOI 10.1055/a-1515-9630 Sethi NJ, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0186856 Tsadok MA, 2012, CIRCULATION, V126, P2680, DOI 10.1161/CIRCULATIONAHA.112.092494 Van Gelder IC, 2016, LANCET, V388, P818, DOI 10.1016/S0140-6736(16)31258-2 Wyse DG, 2002, NEW ENGL J MED, V347, P1825, DOI 10.1056/nejmoa021328 Yang E, 2021, HEART RHYTHM, V18, P674, DOI 10.1016/j.hrthm.2020.12.025 Yoon M, 2018, THROMB HAEMOSTASIS, V118, P1296, DOI 10.1055/s-0038-1651482 NR 38 TC 14 Z9 14 U1 1 U2 5 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 JAN PY 2022 VL 111 IS 1 SI SI BP 70 EP 84 DI 10.1007/s00392-021-01914-y EA AUG 2021 PG 15 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA YI6HJ UT WOS:000690359200001 PM 34448931 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Kany, S Cardoso, VR Bravo, L Williams, JA Schnabel, R Fabritz, L Gkoutos, GV Kirchhof, P AF Kany, Shinwan Cardoso, Victor Roth Bravo, Laura Williams, John A. Schnabel, Renate Fabritz, Larissa Gkoutos, Georgios V. Kirchhof, Paulus TI Eligibility for early rhythm control in patients with atrial fibrillation in the UK Biobank SO HEART LA English DT Article ID PREVENTION AB Objective The Early Treatment of Atrial Fibrillation for Stroke Prevention (EAST-AFNET4) trial showed a clinical benefit of early rhythm-control therapy in patients with recently diagnosed atrial fibrillation (AF). The generalisability of the results in the general population is not known. Methods Participants in the population-based UK Biobank were assessed for eligibility based on the EAST-AFNET4 inclusion/exclusion criteria. Treatment of all eligible participants was classified as early rhythm-control (antiarrhythmic drug therapy or AF ablation) or usual care. To assess treatment effects, primary care data and Hospital Episode Statistics were merged with UK Biobank data. Efficacy and safety outcomes were compared between groups in the entire cohort and in a propensity-matched data set. Results AF was present in 35 526/502 493 (7.1%) participants, including 8340 (988 with AF <1 year) with AF at enrolment and 27 186 with incident AF during follow-up. Most participants (22 003/27 186; 80.9%) with incident AF were eligible for early rhythm-control. Eligible participants were older (70 years vs 63 years) and more likely to be female (42% vs 21%) compared with ineligible patients. Of 9004 participants with full primary care data, 874 (9.02%) received early rhythm-control. Safety outcomes were not different between patients receiving early rhythm-control and controls. The primary outcome of EAST-AFNET 4, a composite of cardiovascular death, stroke/transient ischaemic attack and hospitalisation for heart failure or acute coronary syndrome occurred less often in participants receiving early rhythm-control compared with controls in the entire cohort (HR 0.82, 95% CI 0.71 to 0.94, p=0.005). In the propensity-score matched analysis, early rhythm-control did not significantly decrease of the primary outcome compared with usual care (HR 0.87, 95% CI 0.72 to 1.04, p=0.124). Conclusion Around 80% of participants diagnosed with AF in the UK population are eligible for early rhythm-control. Early rhythm-control therapy was safe in routine care. C1 [Kany, Shinwan; Schnabel, Renate; Fabritz, Larissa; Kirchhof, Paulus] Univ Med Ctr Hamburg Eppendorf, Dept Cardiol, Hamburg, Germany. [Kany, Shinwan] Broad Inst MIT & Harvard, Cardiovasc Dis Initiat, Cambridge, MA 02142 USA. [Kany, Shinwan; Schnabel, Renate; Fabritz, Larissa; Kirchhof, Paulus] German Ctr Cardiovasc Sci DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany. [Cardoso, Victor Roth; Fabritz, Larissa; Kirchhof, Paulus] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England. [Cardoso, Victor Roth; Bravo, Laura; Williams, John A.; Gkoutos, Georgios V.] Univ Hosp Birmingham NHS Fdn Trust, Inst Translat Med, Birmingham, W Midlands, England. [Cardoso, Victor Roth; Bravo, Laura; Williams, John A.; Gkoutos, Georgios V.] Hlth Data Res UK, Midlands Site, Birmingham, W Midlands, England. [Cardoso, Victor Roth; Bravo, Laura; Williams, John A.; Gkoutos, Georgios V.] Univ Birmingham, Inst Canc & Genom Sci, Birmingham, W Midlands, England. C3 University of Hamburg; University Medical Center Hamburg-Eppendorf; Harvard University; Massachusetts Institute of Technology (MIT); Broad Institute; RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; University of Birmingham RP Kirchhof, P (通讯作者)，Univ Med Ctr Hamburg Eppendorf, Dept Cardiol, Hamburg, Germany. EM p.kirchhof@uke.de OI Kany, Shinwan/0000-0001-8113-733X; Schnabel, Renate B/0000-0001-7170-9509; Gkoutos, Georgios/0000-0002-2061-091X; Fabritz, Larissa/0000-0002-9241-1733; Kirchhof, Paulus/0000-0002-1881-0197; Williams, John/0000-0002-0357-5454 FU EU [965286]; British Heart Foundation [AA/18/2/34218, FS/13/43/30324, PG/17/30/32961, PG/20/22/35093]; European Research Council (early rhythm control) under the European Union's Horizon 2020 research and innovation programme [648131]; European Union's Horizon 2020 research and innovation program [847770]; German Center for Cardiovascular Research (DZHK e.V.) [81Z1710103]; German Ministry of Research and Education [BMBF 01ZX1408A]; ERACoSysMed3 [031L0239]; European Union CATCH ME [633196]; BigData@Heart [EU IMI 116074]; German Centre for Cardiovascular Research - German Ministry of Education and Research (DZHK); Leducq Foundation; National Institute for Health and Care Research (NIHR) Birmingham ECMC; NIHR Birmingham SRMRC; Nanocommons H2020--EU [731032]; MRC Heath Data Research UK [HDRUK/CFC/01]; UK Research and Innovation, Department of Health and Social Care (England) FX LF and GVG are funded by EU Horizon 2020 MAESTRIA (Grant agreement ID 965286). The Institute of Cardiovascular Research, University of Birmingham, has received an Accelerator Award by the British Heart Foundation AA/18/2/34218. RS has received funding from the European Research Council (early rhythm control) under the European Union's Horizon 2020 research and innovation programme under the grant agreement No. 648131, from the European Union's Horizon 2020 research and innovation program under the grant agreement No. 847770 (AFFECT-EU), and German Center for Cardiovascular Research (DZHK e.V.) (81Z1710103); German Ministry of Research and Education (BMBF 01ZX1408A); and ERACoSysMed3 (031L0239). PK and LF were partially supported by European Union CATCH ME (grant agreement number 633196) BigData@Heart (grant agreement EU IMI 116074), British Heart Foundation (FS/13/43/30324, PG/17/30/32961 and PG/20/22/35093). PK is partially supported by German Centre for Cardiovascular Research supported by the German Ministry of Education and Research (DZHK, via a grant to AFNET), and Leducq Foundation. GVG and VRC also acknowledge support from the National Institute for Health and Care Research (NIHR) Birmingham ECMC, NIHR Birmingham SRMRC, Nanocommons H2020--EU (731032) and the MRC Heath Data Research UK (HDRUK/CFC/01), an initiative funded by UK Research and Innovation, Department of Health and Social Care (England) and the devolved administrations, and leading medical research charities. CR Andrade JG, 2021, NEW ENGL J MED, V384, P305, DOI 10.1056/NEJMoa2029980 Chandra P., 2008, CONCISE ENCY STAT, P325, DOI [10.1007/978-0-387-32833-1_240, DOI 10.1007/978-0-387-32833-1_240] Chugh SS, 2014, CIRCULATION, V129, P837, DOI 10.1161/CIRCULATIONAHA.113.005119 Dickow J, 2022, J AM HEART ASSOC, V11, DOI 10.1161/JAHA.121.024214 Fry A, 2017, AM J EPIDEMIOL, V186, P1026, DOI 10.1093/aje/kwx246 Kim D, 2021, BMJ-BRIT MED J, V373, DOI 10.1136/bmj.n991 Kirchhof P, 2020, NEW ENGL J MED, V383, P1305, DOI 10.1056/NEJMoa2019422 Kirchhof P, 2014, EUROPACE, V16, P6, DOI 10.1093/europace/eut263 Kirchhof P, 2013, AM HEART J, V166, P442, DOI 10.1016/j.ahj.2013.05.015 Littlejohns TJ, 2019, EUR HEART J, V40, P1158, DOI 10.1093/eurheartj/ehx254 Marijon E, 2013, CIRCULATION, V128, P2192, DOI 10.1161/CIRCULATIONAHA.112.000491 Martin-Doyle W, 2011, J CARDIOVASC ELECTR, V22, P548, DOI 10.1111/j.1540-8167.2010.01950.x Packer DL, 2021, CIRCULATION, V143, P1377, DOI 10.1161/CIRCULATIONAHA.120.050991 Patel MR, 2011, NEW ENGL J MED, V365, P883, DOI 10.1056/NEJMoa1009638 Phillips K, 2022, HEART, V108, P517, DOI 10.1136/heartjnl-2021-319338 Quan HD, 2013, BMJ OPEN, V3, DOI 10.1136/bmjopen-2013-003716 Rillig A, 2021, CIRCULATION, V144, P845, DOI 10.1161/CIRCULATIONAHA.121.056323 Van Gelder IC, 2002, NEW ENGL J MED, V347, P1834, DOI 10.1056/NEJMoa021375 Willems S, 2022, EUR HEART J, V43, P1219, DOI 10.1093/eurheartj/ehab593 Willems S, 2019, EUR HEART J, V40, P3793, DOI 10.1093/eurheartj/ehz782 NR 20 TC 3 Z9 3 U1 0 U2 1 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 DEC PY 2022 VL 108 IS 23 BP 1873 EP 1880 DI 10.1136/heartjnl-2022-321196 EA JUL 2022 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 7W9AQ UT WOS:000827091400001 PM 35835543 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Di Martino, M Alagna, M Cappai, G Mataloni, F Lallo, A Perucci, CA Davoli, M Fusco, D AF Di Martino, Mirko Alagna, Michela Cappai, Giovanna Mataloni, Francesca Lallo, Adele Perucci, Carlo Alberto Davoli, Marina Fusco, Danilo TI Adherence to evidence-based drug therapies after myocardial infarction: is geographic variation related to hospital of discharge or primary care providers? A cross-classified multilevel design SO BMJ OPEN LA English DT Article ID ACUTE CORONARY SYNDROMES; SECONDARY PREVENTION; MEDICATION ADHERENCE; LOGISTIC-REGRESSION; OUTCOMES; HEALTH; MORTALITY; DISEASE AB Objectives: To measure the adherence to polytherapy after myocardial infarction (MI), to compare the proportions of variation attributable to hospitals of discharge and to primary care providers, and to identify determinants of adherence to medications. Setting: This is a population-based study. Data were obtained from the Information Systems of the Lazio Region, Italy (5 million inhabitants). Participants: Patients hospitalised with incident MI in 2007-2010. Outcome measure: The outcome was chronic polytherapy after MI. Adherence was defined as a medication possession ratio >= 0.75 for at least three of the following drugs: antiplatelets, beta-blockers, ACEI angiotensin receptor blockers, statins. Design and analysis: A 2-year cohort study was performed. Cross-classified multilevel models were applied to analyse geographic variation and compare proportions of variability attributable to hospitals of discharge and primary care providers. The variance components were expressed as median ORs MORs. If the MOR is 1.00, there is no variation between clusters. If there is considerable between-cluster variation, the MOR will be large. Results: A total of 9606 patients were enrolled. About 63% were adherent to chronic polytherapy. Adherence was higher for patients discharged from cardiology wards (OR= 1.56 vs other wards, p< 0.001) and for patients with general practitioners working in group practice (OR= 1.14 vs single-handed, p= 0.042). A relevant variation in adherence was detected between local health districts (MOR= 1.24, p< 0.001). When introducing the hospital of discharge as a cross-classified level, the variation between local health districts decreased (MOR= 1.13, p= 0.020) and the variability attributable to hospitals of discharge was significantly higher (MOR= 1.37, p< 0.001). Conclusions: Secondary prevention pharmacotherapy after MI is not consistent with clinical guidelines. The relevant geographic variation raises equity issues in access to optimal care. Adherence was influenced more by the hospital that discharged the patient than by the primary care providers. Cross-classified models proved to be a useful tool for defining priority areas for more targeted interventions. C1 [Di Martino, Mirko; Cappai, Giovanna; Mataloni, Francesca; Lallo, Adele; Davoli, Marina; Fusco, Danilo] Lazio Reg Hlth Serv, Dept Epidemiol, Rome, Italy. [Alagna, Michela] Free Univ Bolzano, Fac Educ, Bolzano, Italy. C3 Free University of Bozen-Bolzano RP Di Martino, M (通讯作者)，Lazio Reg Hlth Serv, Dept Epidemiol, Rome, Italy. EM m.dimartino@deplazio.it RI Mataloni, Francesca/AAC-5013-2022; Fusco, Danilo/K-1383-2016; Di Martino, Mirko/K-6543-2018; Davoli, Marina/K-1975-2016; Fusco, Danilo/AAB-8646-2019 OI Mataloni, Francesca/0000-0003-4273-2384; Fusco, Danilo/0000-0003-1759-5621; Di Martino, Mirko/0000-0002-6033-7591; Davoli, Marina/0000-0003-4521-032X; Fusco, Danilo/0000-0003-1759-5621; Cappai, Giovanna/0000-0002-9692-6179 FU Italian Ministry of Health [GR-2011-02350559] FX This work was partially funded by the Italian Ministry of Health. Research project code: GR-2011-02350559. 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Rajagopalan, Sanjay Suri, Kunal Mishra, Sundeep Iqbal, Romaina Virani, Salim S. TI Overview of Coronary Heart Disease Risk Initiatives in South Asia SO CURRENT ATHEROSCLEROSIS REPORTS LA English DT Review DE Cardiovascular care; India; CARRS; PIQIP; PURE; Kerala ID LOW-INCOME COUNTRIES; QUALITY IMPROVEMENT PROGRAM; RURAL EPIDEMIOLOGY PURE; CARDIOVASCULAR-DISEASE; AMERICAN-COLLEGE; INDIA; PREVALENCE; CARRS; OUTCOMES; REGISTRY AB Purpose of Review Cardiovascular disease (CVD) is now the leading cause of morbidity and mortality worldwide. Industrialization and economic growth have led to an unprecedented increment in the burden of CVD and their risk factors in less industrialized regions of the world. While there are abundant data on CVD and their risk factors from longitudinal cohort studies done in the West, good-quality data from South Asia are lacking. Recent Findings Several multi-institutional, observational, prospective registries, and epidemiologic cohorts in South Asia have been established to systematically evaluate the burden of CVD and their risk factors. The PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP), the Kerala Acute Coronary Syndrome (ACS), and Trivandrum Heart Failure registries have focused on secondary prevention of CVD and performance measurement in both outpatient and inpatient settings, respectively. The Prospective Urban and Rural Epidemiology (PURE), Centre for Cardiometabolic Risk Reduction in South Asia (CARRS), and other epidemiologic and genetic studies have focused on primary prevention of CVD and evaluated variables such as environment, smoking, physical activity, health systems, food and nutrition policy, dietary consumption patterns, socioeconomic factors, and healthy neighborhoods. Summary The international cardiovascular community has been responsive to a burgeoning cardiovascular disease burden in South Asia. Several collaborations have formed between the West (North America in particular) and South Asia to catalyze evidence-based and data-driven changes in the federal health policy in this part of the world to promote cardiovascular health and mitigate cardiovascular risk. C1 [Kalra, Ankur; Suri, Kunal] SRCNC Sri Ram Cardio Thorac & Neurosci Ctr Pvt Lt, Kalra Hosp, New Delhi, India. [Kalra, Ankur] Houston Methodist Hosp, Houston Methodist DeBakey Heart & Vasc Ctr, Houston, TX USA. [Kalra, Ankur] Weill Cornell Med Coll, New York, NY USA. [Kalra, Ankur] Harvard Med Sch, Safety Qual Informat & Leadership, Boston, MA USA. [Bhatt, Deepak L.] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA USA. [Rajagopalan, Sanjay] Case Western Reserve Univ, Univ Hosp, Cleveland Med Ctr, Harrington Heart & Vasc Inst, Cleveland, OH 44106 USA. [Rajagopalan, Sanjay] Case Western Reserve Univ, Div Cardiovasc Med, Cleveland, OH 44106 USA. [Mishra, Sundeep] All India Inst Med Sci, New Delhi, India. [Iqbal, Romaina] Aga Khan Univ, Karachi, Pakistan. [Virani, Salim S.] Michael E DeBakey VA Med Ctr, Hlth Serv Res & Dev Ctr Innovat, Hlth Policy Qual & Informat Program, 2002 Holcombe Blvd, Houston, TX 77030 USA. [Virani, Salim S.] Baylor Coll Med, Dept Med, Sect Cardiovasc Res, Houston, TX 77030 USA. C3 The Methodist Hospital System; The Methodist Hospital - Houston; Methodist DeBakey Heart & Vascular Center; Cornell University; Weill Cornell Medicine; Harvard University; Harvard Medical School; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Case Western Reserve University; Case Western Reserve University Hospital; University Hospitals of Cleveland; US Department of Veterans Affairs; Veterans Health Administration (VHA); Louis Stokes Cleveland Veterans Affairs Medical Center; Case Western Reserve University; All India Institute of Medical Sciences (AIIMS) New Delhi; Aga Khan University; Baylor College of Medicine; Baylor College of Medicine RP Virani, SS (通讯作者)，Michael E DeBakey VA Med Ctr, Hlth Serv Res & Dev Ctr Innovat, Hlth Policy Qual & Informat Program, 2002 Holcombe Blvd, Houston, TX 77030 USA.; Virani, SS (通讯作者)，Baylor Coll Med, Dept Med, Sect Cardiovasc Res, Houston, TX 77030 USA. EM virani@bcm.edu RI Virani, Salim/AAF-1432-2019 OI Kalra, MD, FACP, FACC, FSCAI, Ankur/0000-0003-0080-1660; Virani, Salim/0000-0001-9541-6954 FU Amarin; Amgen; AstraZeneca; Bristol-Myers Squibb; Eisai; Ethicon; Forest Laboratories; Ischemix; Lilly; Medtronic; Pfizer; Roche; Sanofi Aventis; Medicines Company; National Institutes of Health; American Heart Association; American Diabetes Association; Baylor Global Initiatives; Department of Veterans Affairs; Population Health Research Institute; Hamilton Health Sciences FX 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, Lilly, Medtronic, Pfizer, Roche, Sanofi Aventis, The Medicines Company; 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.; Sanjay Rajagopalan discloses the following relationships-Advisory Board/consultancy agreements: Takeda Pharmaceuticals; Steering Committee: Glaxo Smith Kline and Janssen; research; grant support: National Institutes of Health.; Salim S. Virani is supported by grant support from the American Heart Association, the American Diabetes Association, Baylor Global Initiatives, and the Department of Veterans Affairs. Honorarium: American College of Cardiology (Associate Editor for Innovations, ACC.org).; Romaina Iqbal declares grant support from the Population Health Research Institute, Hamilton Health Sciences for carrying out PURE study in Pakistan. CR Alexander T, 2014, GLOB HEART, V9, P419, DOI 10.1016/j.gheart.2014.04.005 Alexander T, 2012, HEART, V98, P15, DOI 10.1136/heartjnl-2011-301009 Ali MK, 2016, EUR J PREV CARDIOL, V23, P408, DOI 10.1177/2047487315580891 Anand S, 2015, KIDNEY INT, V88, P178, DOI 10.1038/ki.2015.58 Berg CJ, 2015, BMC PUBLIC HEALTH, V15, DOI 10.1186/s12889-015-1817-z Chow CK, 2013, JAMA-J AM MED ASSOC, V310, P959, DOI 10.1001/jama.2013.184182 Chowdhury R, 2015, EUR J EPIDEMIOL, V30, P577, DOI 10.1007/s10654-015-0037-2 Das J, 2008, J ECON PERSPECT, V22, P93, DOI 10.1257/jep.22.2.93 Deepa M, 2015, DIABETES RES CLIN PR, V110, P172, DOI 10.1016/j.diabres.2015.09.005 Harikrishnan S, 2015, EUR J HEART FAIL, V17, P794, DOI 10.1002/ejhf.283 IHME (Institute for Health Metrics and Evaluation), 2013, GLOB BURD DIS GEN EV Kalra Ankur, 2016, Indian Heart J, V68 Suppl 3, pS1, DOI 10.1016/j.ihj.2016.09.005 Kalra Ankur, 2016, Indian Heart J, V68, P434, DOI 10.1016/j.ihj.2016.01.002 Kalra A, 2016, INT J CARDIOL, V215, P248, DOI 10.1016/j.ijcard.2016.04.058 Kalra A, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.001910 Miller V, 2016, LANCET GLOB HEALTH, V4, pE695, DOI 10.1016/S2214-109X(16)30186-3 Mohanan PP, 2013, EUR HEART J, V34, P121, DOI 10.1093/eurheartj/ehs219 Murray CJL, 1997, LANCET, V349, P1269, DOI 10.1016/S0140-6736(96)07493-4 Nair M, 2012, BMC PUBLIC HEALTH, V12, DOI 10.1186/1471-2458-12-701 Patel A, 2015, GLOB HEART, V10, P274, DOI 10.1016/j.gheart.2015.06.002 Pokharel Y, 2016, CLIN CARDIOL, V39, P145, DOI 10.1002/clc.22519 Saleheen D, 2009, EUR J EPIDEMIOL, V24, P329, DOI 10.1007/s10654-009-9334-y Teo K, 2013, JAMA-J AM MED ASSOC, V309, P1613, DOI 10.1001/jama.2013.3519 Teo K, 2009, AM HEART J, V158, P1, DOI 10.1016/j.ahj.2009.04.019 World Health Organization, 2011, UN HIGH LEV M NCDS Xavier D, 2008, LANCET, V371, P1435, DOI 10.1016/S0140-6736(08)60623-6 NR 26 TC 8 Z9 8 U1 0 U2 8 PU CURRENT MEDICINE GROUP PI PHILADELPHIA PA 400 MARKET STREET, STE 700, PHILADELPHIA, PA 19106 USA SN 1523-3804 EI 1534-6242 J9 CURR ATHEROSCLER REP JI Curr. Atheroscleros. Rep. PD JUN PY 2017 VL 19 IS 6 AR 25 DI 10.1007/s11883-017-0662-1 PG 8 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EV2DA UT WOS:000401563100001 PM 28417301 DA 2023-05-13 ER PT J AU Dibben, GO Dalal, HM Taylor, RS Doherty, P Tang, LH Hillsdon, M AF Dibben, Grace Olivia Dalal, Hasnain M. Taylor, Rod S. Doherty, Patrick Tang, Lars Hermann Hillsdon, Melvyn TI Cardiac rehabilitation and physical activity: systematic review and meta-analysis SO HEART LA English DT Review ID RANDOMIZED CONTROLLED-TRIAL; ACUTE CORONARY SYNDROME; QUALITY-OF-LIFE; HEART-FAILURE; MYOCARDIAL-INFARCTION; EXERCISE PROGRAM; COMPREHENSIVE REHABILITATION; FOLLOW-UP; DISEASE; STYLE AB Objective To undertake a systematic review and meta-analysis to assess the impact of cardiac rehabilitation (CR) on physical activity (PA) levels of patients with heart disease and the methodological quality of these studies. Methods Databases (MEDLINE, EMBASE, CENTRAL, CINAHL, PsychINFO and SportDiscus) were searched without language restriction from inception to January 2017 for randomised controlled trials (RCTs) comparing CR to usual care control in adults with heart failure (HF) or coronary heart disease (CHD) and measuring PA subjectively or objectively. The direction of PA difference between CR and control was summarised using vote counting (ie, counting the positive, negative and nonsignificant results) and meta-analysis. Results Forty RCTs, (6480 patients: 5825 CHD, 655 HF) were included with 26% (38/145) PA results showing a statistically significant improvement in PA levels with CR compared with control. This pattern of results appeared consistent regardless of type of CR intervention (comprehensive vs exercise-only) or PA measurement (objective vs subjective). Meta-analysis showed PA increases in the metrics of steps/day (1423, 95% CI 757.07 to 2089.43, p<0.0001) and proportion of patients categorised as physically active (relative risk 1.55, 95% CI 1.19 to 2.02, p=0.001). The included trials were at high risk of bias, and the quality of the PA assessment and reporting was relatively poor. Conclusion Overall, there is moderate evidence of an increase in PA with CR participation compared with control. High-quality trials are required, with robust PA measurement and data analysis methods, to assess if CR definitely leads to important improvements in PA. C1 [Dibben, Grace Olivia; Dalal, Hasnain M.] Univ Exeter, Sch Med, Royal Cornwall Hosp NHS Trust, European Ctr Environm & Human Hlth,Knowledge Spa, Truro, England. [Dalal, Hasnain M.; Taylor, Rod S.] Univ Exeter, Sch Med, Inst Hlth Res Primary Care, Exeter, Devon, England. [Doherty, Patrick] Univ York, Dept Hlth Sci, York, N Yorkshire, England. [Tang, Lars Hermann] Univ Southern Denmark, Odense Univ Hosp, Natl Knowledge Ctr Rehabil & Palliat Care, Odense, Denmark. [Hillsdon, Melvyn] Univ Exeter, Dept Sport & Hlth Sci, Exeter, Devon, England. C3 RLUK- Research Libraries UK; University of Exeter; Royal Cornwall Hospital; RLUK- Research Libraries UK; University of Exeter; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of York - UK; University of Southern Denmark; Odense University Hospital; RLUK- Research Libraries UK; University of Exeter RP Dibben, GO (通讯作者)，Univ Exeter, Sch Med, Royal Cornwall Hosp NHS Trust, Knowledge Spa, Truro TR13HD, England. EM gd318@exeter.ac.uk RI Dibben, Grace/R-9012-2019; Taylor, Rod/R-9581-2019 OI Dibben, Grace/0000-0002-7254-5187; Taylor, Rod/0000-0002-3043-6011; Doherty, Patrick Joseph/0000-0002-1887-0237; Tang, Lars Hermann/0000-0001-6055-8696 FU University of Exeter Postgraduate Studentship Grant FX This study was supported by a University of Exeter Postgraduate Studentship Grant. 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Subramanyam, Pritha Gianos, Eugenia Reynolds, Harmony R. Shah, Binita Sedlis, Steven P. TI Treatment and outcomes of type 2 myocardial infarction and myocardial injury compared with type 1 myocardial infarction SO CORONARY ARTERY DISEASE LA English DT Article DE acute coronary syndrome; biomarkers; demand ischemia; ischemic heart disease; mortality ID UNIVERSAL DEFINITION; CLASSIFICATION; MORTALITY; MANAGEMENT; TRIAL AB BackgroundType 2 myocardial infarction (MI) is defined by a rise and fall of cardiac biomarkers and evidence of ischemia without unstable coronary artery disease (CAD) because of a mismatch in myocardial oxygen supply and demand. Myocardial injury is similar but does not fulfill the clinical criteria for MI. There is uncertainty in terms of the clinical characteristics, management, and outcomes of type 2 MI and myocardial injury in comparison with type 1 MI.Patients and methodsPatients admitted to a Veterans Affairs tertiary care hospital with a rise and fall in cardiac troponin were identified. MI and injury subtypes, presentation, management, and outcomes were determined.ResultsType 1 MI, type 2 MI, and myocardial injury occurred in 137, 146, and 175 patients, respectively. Patients with type 2 MI were older (P=0.02), had lower peak cardiac troponin (P<0.001), and were less likely to receive aspirin and statin at discharge (P<0.001) than type 1 MI survivors. All-cause mortality (median follow-up: 1.8 years) was not different between patient groups (type 1 MI mortality: 29.9%, type 2 MI: 30.8%, myocardial injury: 29.7%; log rank P=0.94). A significant proportion of deaths were attributed to cardiovascular causes in all subgroups (type 1 MI: 34.1%, type 2 MI: 17.8%, myocardial injury: 30.8%).ConclusionPatients with type 2 MI and myocardial injury were less likely to receive medical therapy for CAD than those with type 1 MI. No differences in all-cause mortality among MI subtypes were observed. Additional studies to determine optimal medical therapy and risk stratification strategies for these high-risk populations are warranted. C1 [Smilowitz, Nathaniel R.; Gianos, Eugenia; Reynolds, Harmony R.; Shah, Binita; Sedlis, Steven P.] NYU, Sch Med, Dept Med, Div Cardiol, New York, NY USA. [Subramanyam, Pritha] Icahn Sch Med Mt Sinai, Dept Med, New York, NY 10029 USA. [Shah, Binita; Sedlis, Steven P.] Vet Affairs New York Harbor Healthcare Syst, Cardiol Sect, Dept Med, New York Campus,423 East 23rd St, New York, NY 10010 USA. C3 New York University; Icahn School of Medicine at Mount Sinai RP Sedlis, SP (通讯作者)，Vet Affairs New York Harbor Healthcare Syst, Cardiol Sect, Dept Med, New York Campus,423 East 23rd St, New York, NY 10010 USA. EM steven.sedlis@va.gov RI Reynolds, Harmony/AAU-3154-2021 OI Reynolds, Harmony/0000-0003-0284-0655; Gianos, Eugenia/0000-0001-7720-7470; Sedlis, Steven/0000-0002-8194-8017; Shah, Binita/0000-0001-8872-8001 FU Biomedical Laboratory Research and Development Service of the VA Office of Research and Development [IK2 CX001074] FX Binita Shah, MD is supported in part by the Biomedical Laboratory Research and Development Service of the VA Office of Research and Development (IK2 CX001074). 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PD JAN PY 2018 VL 29 IS 1 BP 46 EP 52 DI 10.1097/MCA.0000000000000545 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FQ6GJ UT WOS:000418461500009 PM 28746145 OA Green Accepted DA 2023-05-13 ER PT J AU Thomas, GS Cullom, SJ Kitt, TM Feaheny, KM Ananthasubramaniam, K Gropler, RJ Jain, D Thompson, RC AF Thomas, Gregory S. Cullom, S. James Kitt, Therese M. Feaheny, Kathleen M. Ananthasubramaniam, Karthikeyan Gropler, Robert J. Jain, Diwakar Thompson, Randall C. TI The EXERRT trial: "EXErcise to Regadenoson in Recovery Trial": A phase 3b, open-label, parallel group, randomized, multicenter study to assess regadenoson administration following an inadequate exercise stress test as compared to regadenoson without exercise for myocardial perfusion imaging using a SPECT protocol SO JOURNAL OF NUCLEAR CARDIOLOGY LA English DT Article DE Exercise; pharmacologic stress; vasodilator stress; myocardial perfusion imaging; regadenoson ID EMISSION COMPUTED-TOMOGRAPHY; INITIAL CLINICAL-EXPERIENCE; AMERICAN-HEART-ASSOCIATION; HEALTH-CARE PROFESSIONALS; SYMPTOM-LIMITED EXERCISE; LEVEL TREADMILL EXERCISE; CORONARY-ARTERY-DISEASE; PHARMACOLOGICAL STRESS; DIPYRIDAMOLE STRESS; ADENOSINE INFUSION AB This study assessed the non-inferiority and safety of regadenoson administration during recovery from inadequate exercise compared with administration without exercise. Patients unable to achieve adequate exercise stress were randomized to regadenoson 0.4 mg either during recovery (Ex-Reg) or 1 hour after inadequate exercise (Regadenoson) (MPI1). All patients also underwent non-exercise regadenoson MPI 1-14 days later (MPI2). The number of segments with reversible perfusion defects (RPDs) detected using single photon emission computerized tomography imaging was categorized. The primary analysis evaluated the majority agreement rate between Ex-Reg and Regadenoson groups. 1,147 patients were randomized. The lower bound of the 95% confidence interval of the difference in agreement rates (-6%) was above the -7.5% non-inferiority margin, demonstrating non-inferiority of Ex-Reg to Regadenoson. Adverse events were numerically less with Ex-Reg (MPI1). In the Ex-Reg group, one patient developed an acute coronary syndrome and another had a myocardial infarction following regadenoson after exercise. Upon review, both had electrocardiographic changes consistent with ischemia prior to regadenoson. Administering regadenoson during recovery from inadequate exercise results in comparable categorization of segments with RPDs and with careful monitoring appears to be well tolerated in patients without signs/symptoms of ischemia during exercise and recovery. C1 [Thomas, Gregory S.] MemorialCare Heart & Vasc Inst, Long Beach Mem, 2801 Atlantic Ave, Long Beach, CA 90806 USA. [Thomas, Gregory S.] Univ Calif Irvine, Irvine, CA USA. [Cullom, S. James] AdaptivePharma, Leawood, KS USA. [Cullom, S. James] Univ Missouri, Columbia, MO USA. [Kitt, Therese M.; Feaheny, Kathleen M.] Astellas Pharma Global Dev Inc, Northbrook, IL USA. [Ananthasubramaniam, Karthikeyan] Henry Ford Hosp, Dept Internal Med, Heart & Vasc Inst, Detroit, MI 48202 USA. [Gropler, Robert J.] Washington Univ, Mallinckrodt Inst Radiol, Sch Med, Div Radiol Sci, St Louis, MO USA. [Jain, Diwakar] New York Med Coll, Cardiovasc Nucl Imaging Lab, Westchester Med Ctr, Valhalla, NY 10595 USA. [Thompson, Randall C.] St Lukes Mid Amer Heart Inst, Kansas City, MO USA. [Thompson, Randall C.] Univ Missouri, Kansas City, MO 64110 USA. C3 University of California System; University of California Irvine; University of Missouri System; University of Missouri Columbia; Astellas Pharmaceuticals; Henry Ford Health System; Henry Ford Hospital; Washington University (WUSTL); New York Medical College; Westchester Medical Center; Saint Luke's Mid America Heart Institute; University of Missouri System; University of Missouri Kansas City RP Thomas, GS (通讯作者)，MemorialCare Heart & Vasc Inst, Long Beach Mem, 2801 Atlantic Ave, Long Beach, CA 90806 USA. EM gthomas1@memorialcare.org FU Astellas Pharma Global Development, Inc. FX The authors thank the independent expert readers, the investigators (Electronic Supplementary Material Acknowledgments), and the patients for their participation in the trial. The study was funded by Astellas Pharma Global Development, Inc. Copyediting services and figure development were provided by Tara Miller, Ed Parr, and Jayne Lanigan of Envision Scientific Solutions and funded by Astellas Pharma Global Development, Inc. CR Ahlberg AW, 2008, J NUCL CARDIOL, V15, P42, DOI 10.1016/j.nuclcard.2007.09.025 AlJaroudi WA, 2013, EUR J NUCL MED MOL I, V40, P341, DOI 10.1007/s00259-012-2296-4 Astellas Pharma US Inc, LEXISCAN REGADENOSON CASALE PN, 1988, AM J CARDIOL, V62, P799, DOI 10.1016/0002-9149(88)91225-8 Cerqueira MD, 2002, CIRCULATION, V105, P539, DOI 10.1161/hc0402.102975 Duvall WL, 2015, J NUCL CARDIOL, V22, P539, DOI 10.1007/s12350-014-0051-x Fletcher GF, 2001, CIRCULATION, V104, P1694, DOI 10.1161/hc3901.095960 Gibbons RJ, 2002, J AM COLL CARDIOL, V40, P1531, DOI 10.1016/S0735-1097(02)02164-2 Hendel RC, 2005, J AM COLL CARDIOL, V46, P2069, DOI 10.1016/j.jacc.2005.05.097 Henzlova MJ, 2016, J NUCL CARDIOL, V23, P606, DOI 10.1007/s12350-015-0387-x Henzlova MJ, 2009, J NUCL CARDIOL, DOI [10.1007/s12350-009-9062-4, DOI 10.1007/S12350-009-9062-4] Holly TA, 2003, J NUCL CARDIOL, V10, P291, DOI 10.1016/S1071-3581(02)43236-9 Iskandrian AE, 2007, J NUCL CARDIOL, V14, P645, DOI 10.1016/j.nuclcard.2007.06.114 Klocke FJ, 2003, J AM COLL CARDIOL, V42, P1318, DOI 10.1016/j.jacc.2003.08.011 Kwon DH, 2010, J NUCL CARDIOL, V17, P853, DOI 10.1007/s12350-010-9229-z Lieu HD, 2007, J NUCL CARDIOL, V14, P514, DOI 10.1016/j.nuclcard.2007.02.016 Matsumoto N, 2006, CIRC J, V70, P1585, DOI 10.1253/circj.70.1585 Newcombe RG, 1998, STAT MED, V17, P857, DOI 10.1002/(SICI)1097-0258(19980430)17:8<857::AID-SIM777>3.0.CO;2-E Parker MW, 2013, J NUCL CARDIOL, V20, P185, DOI 10.1007/s12350-012-9641-7 Partington SL, 2012, J NUCL CARDIOL, V19, P970, DOI 10.1007/s12350-012-9562-5 Rehm PK, 1996, NUCL MED COMMUN, V17, P851, DOI 10.1097/00006231-199610000-00005 Ross MI, 2013, J NUCL CARDIOL, V20, P197, DOI 10.1007/s12350-013-9679-1 Samady H, 2002, J NUCL CARDIOL, V9, P188, DOI 10.1067/mnc.2002.119973 Thomas GS, 2009, J NUCL CARDIOL, V16, P63, DOI 10.1007/s12350-008-9001-9 Thomas GS, 2000, J NUCL CARDIOL, V7, P439, DOI 10.1067/mnc.2000.108030 Thompson RC, 2015, J NUCL CARDIOL, V22, P552, DOI 10.1007/s12350-015-0072-0 Thompson RC, 2013, J NUCL CARDIOL, V20, P214, DOI 10.1007/s12350-012-9660-4 Vitola JV, 2001, J NUCL CARDIOL, V8, P652, DOI 10.1067/mnc.2001.117204 NR 28 TC 15 Z9 15 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1071-3581 EI 1532-6551 J9 J NUCL CARDIOL JI J. Nucl. Cardiol. PD JUN PY 2017 VL 24 IS 3 BP 788 EP 802 DI 10.1007/s12350-017-0813-3 PG 15 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 EZ5OZ UT WOS:000404768200005 PM 28224449 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Awaisu, A Hamou, F Mekideche, L Muabby, N Mahfouz, A Mohammed, S Saad, A AF Awaisu, Ahmed Hamou, Fatima Mekideche, Lylia Muabby, Nisrine El Mahfouz, Ahmed Mohammed, Shaban Saad, Ahmad TI Proton pump inhibitor co-prescription with dual antiplatelet therapy among patients with acute coronary syndrome in Qatar SO INTERNATIONAL JOURNAL OF CLINICAL PHARMACY LA English DT Article DE Case-control study; Co-prescription; Dual antiplatelet therapy; Proton pump inhibitors; Prescription; Qatar ID EXPERT CONSENSUS DOCUMENT; DRUG-INTERACTION PROFILES; FOUNDATION TASK-FORCE; GASTROINTESTINAL RISKS; MYOCARDIAL-INFARCTION; CONCOMITANT USE; NSAID USE; CLOPIDOGREL; ASPIRIN; ASSOCIATION AB Background There are increasing concerns about clinically significant interactions between proton pump inhibitors (PPIs) and clopidogrel, resulting in adverse cardiovascular outcomes in patients with acute coronary syndromes (ACS). However, published evidence on the prevalence and predictors of PPI use with dual antiplatelet therapy (DAPT) is scarce. Objective This study investigated the prevalence of PPI use among patients with ACS receiving DAPT and possible predictors of co-prescribing the PPIs with the DAPT. Setting Heart Hospital, a specialized tertiary care center in Qatar. Methodology A retrospective observational study of a prescription database was conducted. Subjects included 626 patients admitted between January and December 2012 with the diagnosis of ACS who received DAPT and discharged with or without a PPI. Univariate analysis and multivariate binary logistic regression analysis were performed to determine the predictors of PPI-DAPT co-prescription. Main outcome measures Prevalence of PPI co-prescribing with DAPT in proportions and percentages and odd ratios for the predictors of PPI-DAPT co-prescribing. Results A total of 626 patients were analyzed for PPI prevalence, with 200 patients (32 %) being prescribed PPI with DAPT upon discharge. After controlling for confounders, PPI use on admission (aOR 14.5; 95 % CI 7.6-27.6, p < 0.001), nationality (aOR 3.2; 95 % CI 1.1-9.9, p = 0.041), and having a history of diabetes (aOR 0.5; 95 % CI 0.24-0.99, p = 0.046) significantly influenced PPI-DAPT co-prescribing. Users of PPI on admission compared to nonusers were about 15 times more likely to be prescribed PPI with DAPT upon discharge; likewise, having Qatari nationality increased the likelihood of co-prescribing PPI with DAPT upon discharge by three folds. Lastly, patients with a history of diabetes were 50 % less likely to be prescribed PPIs upon discharge compared to those with no history of diabetes. Conclusion The rate of PPI co-prescribing with DAPT in the population studied was relatively high. The strongest predictor of PPI co-prescription with DAPT upon discharge was PPI use on admission. Furthermore, PPI prescribing was significantly predicted by nationality and not having diabetes. Further studies are warranted to better predict the factors associated with PPI-DAPT co-prescription and to investigate rational prescribing of PPIs among ACS patients. C1 [Awaisu, Ahmed] Qatar Univ, Coll Pharm, POB 2713, Doha, Qatar. [Hamou, Fatima; Mekideche, Lylia; Muabby, Nisrine El; Mahfouz, Ahmed; Mohammed, Shaban; Saad, Ahmad] Hamad Med Corp, Heart Hosp, Dept Pharm, Doha, Qatar. C3 Qatar University; Hamad Medical Corporation RP Awaisu, A (通讯作者)，Qatar Univ, Coll Pharm, POB 2713, Doha, Qatar. EM aawaisu@qu.edu.qa RI Awaisu, Ahmed/AAU-3959-2020; Mahfouz, Ahmed/AAL-3870-2020 OI Awaisu, Ahmed/0000-0002-9029-8925; Mahfouz, Ahmed/0000-0002-6253-1670 CR Abraham NS, 2011, CURR OPIN GASTROEN, V27, P558, DOI 10.1097/MOG.0b013e32834a382e Abraham NS, 2010, J AM COLL CARDIOL, V56, P2051, DOI 10.1016/j.jacc.2010.09.010 Agewall S, 2013, EUR HEART J, V34, P1708, DOI 10.1093/eurheartj/eht042 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] Bhatt DL, 2008, J AM COLL CARDIOL, V52, P1502, DOI 10.1016/j.jacc.2008.08.002 Bhatt DL, 2010, NEW ENGL J MED, V363, P1909, DOI 10.1056/NEJMoa1007964 Bhatt DL, 2006, NEW ENGL J MED, V354, P1706, DOI 10.1056/NEJMoa060989 Bhurke SM, 2012, PHARMACOTHERAPY, V32, P809, DOI 10.1002/j.1875-9114.2012.01112.x Blume H, 2006, DRUG SAFETY, V29, P769, DOI 10.2165/00002018-200629090-00002 Burkard T, 2012, J INTERN MED, V271, P257, DOI 10.1111/j.1365-2796.2011.02423.x Bursac Z, 2008, SOURCE CODE BIOL MED, V3, DOI 10.1186/1751-0473-3-17 Diener HC, 2004, LANCET, V364, P331, DOI 10.1016/S0140-6736(04)16721-4 Gaspar A, 2010, REV PORT CARDIOL, V29, P1511 Gerson L. 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J. Clin. Phar,. PD APR PY 2016 VL 38 IS 2 BP 353 EP 361 DI 10.1007/s11096-016-0250-4 PG 9 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA DJ6MG UT WOS:000374326900025 PM 26749343 DA 2023-05-13 ER PT J AU Megaly, M Glogoza, M Xenogiannis, I Vemmou, E Nikolakopoulos, I Willson, L Monyak, DJ Sullivan, P Stanberry, L Sorajja, P Chavez, I Mooney, M Traverse, J Wang, Y Garcia, S Poulose, A Burke, MN Brilakis, ES AF Megaly, Michael Glogoza, Matthew Xenogiannis, Iosif Vemmou, Evangelia Nikolakopoulos, Ilias Willson, Laura Monyak, David J. Sullivan, Patsa Stanberry, Larissa Sorajja, Paul Chavez, Ivan Mooney, Michael Traverse, Jay Wang, Yale Garcia, Santiago Poulose, Anil Burke, Martin Nicholas Brilakis, Emmanouil S. TI Outcomes of intravascular brachytherapy for recurrent drug-eluting in-stent restenosis SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE in-stent restenosis; intravascular brachytherapy; vascular brachytherapy ID BARE-METAL STENTS; GAMMA-RADIATION THERAPY; INTRACORONARY BRACHYTHERAPY; VASCULAR BRACHYTHERAPY; CORONARY-ARTERY; IMPLANTATION; ANGIOPLASTY; ASSOCIATION; GUIDELINES; THROMBOSIS AB Objectives To examine the outcomes of vascular brachytherapy (VBT) for recurrent drug-eluting stents (DES) in-stent restenosis (ISR). Background Recurrent DES-ISR can be challenging to treat. VBT has been used with encouraging results. Methods We report the long-term outcomes of patients with recurrent DES-ISR treated with VBT between January 2014 and September 2018 at a tertiary care institution. The main outcome was target lesion failure (TLF), defined as the composite of clinically driven target lesion revascularization (TLR), target lesion myocardial infarction (MI), and target lesion-related cardiac death. Cox proportional hazards analysis was performed to identify variables associated with recurrent TLF. Results During the study period, 116 patients (143 lesions) underwent VBT. Median follow-up was 24.7 (14.5-35.4) months. The incidence of TLR, target-lesion MI, and TLF was 18.9%, 5.6%,and 20.1% at 1 year, and 29.4%, 10.5%, and 32.9% at 2 years.Initial presentation with acute coronary syndrome (ACS) was independently associated with TLF (hazard ratio = 1.975, 95% CI [1.120, 3.485], p = .019). Lesions treated with intravascular ultrasound (IVUS) guidance had a lower incidence of TLR (14.3% vs. 39.6%, log-rank p = .038), and a trend toward lower incidence of TLF (19% vs. 42.6%, log-rank p = .086). Conclusions VBT can improve the treatment of recurrent DES-ISR, but TLF occurs in approximately one in three patients at 2 years. Initial presentation with ACS was associated with higher TLF and the use of IVUS with a trend for lower incidence of TLF. C1 [Megaly, Michael; Glogoza, Matthew; Xenogiannis, Iosif; Vemmou, Evangelia; Nikolakopoulos, Ilias; Stanberry, Larissa; Sorajja, Paul; Chavez, Ivan; Mooney, Michael; Traverse, Jay; Wang, Yale; Garcia, Santiago; Poulose, Anil; Burke, Martin Nicholas; Brilakis, Emmanouil S.] Abbott NW Hosp, Minneapolis Heart Inst, 920 E 28th St 300, Minneapolis, MN 55407 USA. [Megaly, Michael] Hennepin Healthcare, Dept Cardiovasc Med, Minneapolis, MN USA. [Willson, Laura; Monyak, David J.; Sullivan, Patsa] Abbott NW Hosp, Dept Radiat Oncol, Minneapolis, MN 55407 USA. C3 Minneapolis Heart Institute Foundation RP Brilakis, ES (通讯作者)，Abbott NW Hosp, Minneapolis Heart Inst, 920 E 28th St 300, Minneapolis, MN 55407 USA.; Brilakis, ES (通讯作者)，Abbott NW Hosp, Minneapolis Heart Inst Fdn, 920 E 28th St 300, Minneapolis, MN 55407 USA. EM esbrilakis@gmail.com RI Nikolakopoulos, Ilias/AAB-5260-2019; Brilakis, Emmanouil/ABE-6947-2020; Nikolakopoulos, Ilias/AAP-6923-2020 OI Nikolakopoulos, Ilias/0000-0002-7408-8653; Brilakis, Emmanouil/0000-0001-9416-9701; Nikolakopoulos, Ilias/0000-0002-7408-8653; Megaly, Michael/0000-0003-3176-6677; Xenogiannis, Iosif/0000-0002-5004-6635 FU Minneapolis Heart Institute Foundation FX Minneapolis Heart Institute Foundation CR Alfonso F, 2014, J AM COLL CARDIOL, V63, P2659, DOI 10.1016/j.jacc.2014.02.545 Alfonso Fernando, 2009, EuroIntervention, V5 Suppl D, pD70 Amols H I, 1999, Cardiovasc Radiat Med, V1, P64, DOI 10.1016/S1522-1865(98)00006-7 Bennett MR, 2003, HEART, V89, P218, DOI 10.1136/heart.89.2.218 Buccheri D, 2016, J THORAC DIS, V8, pE1150, DOI 10.21037/jtd.2016.10.93 Byrne RA, 2013, EUROINTERVENTION, V9, P797, DOI 10.4244/EIJV9I7A132 Cutlip DE, 2007, CIRCULATION, V115, P2344, DOI 10.1161/CIRCULATIONAHA.106.685313 Elgendy IY, 2019, AM J CARDIOL, V123, P1186, DOI 10.1016/j.amjcard.2019.01.004 Greenland S, 1999, EPIDEMIOLOGY, V10, P37, DOI 10.1097/00001648-199901000-00008 Heinze G, 2017, TRANSPL INT, V30, P6, DOI 10.1111/tri.12895 Holmes DR, 2006, JAMA-J AM MED ASSOC, V295, P1264, DOI 10.1001/jama.295.11.1264 Kim SW, 2006, AM J CARDIOL, V97, P1292, DOI 10.1016/j.amjcard.2005.11.055 Kubo S, 2013, EUROINTERVENTION, V9, P788, DOI 10.4244/EIJV9I7A131 Kuchulakanti P, 2005, CARDIOVASC REVASCULA, V6, P108, DOI 10.1016/j.carrev.2005.05.003 Leon MB, 2001, NEW ENGL J MED, V344, P250, DOI 10.1056/NEJM200101253440402 Levine GN, 2011, CIRCULATION, V124, pE574, DOI 10.1161/CIR.0b013e31823ba622 MACANDER PJ, 1994, CATHETER CARDIO DIAG, V32, P125, DOI 10.1002/ccd.1810320206 Magalhaes MA, 2014, CIRC-CARDIOVASC INTE, V7, P768, DOI 10.1161/CIRCINTERVENTIONS.114.001341 Mangione FM, 2017, AM J CARDIOL, V120, P369, DOI 10.1016/j.amjcard.2017.04.036 Mehran R, 1999, CIRCULATION, V100, P1872, DOI 10.1161/01.CIR.100.18.1872 Nakazawa G, 2008, CIRCULATION, V118, P1138, DOI 10.1161/CIRCULATIONAHA.107.762047 Negi SI, 2016, JACC-CARDIOVASC INTE, V9, P1259, DOI 10.1016/j.jcin.2016.03.018 Neumann FJ, 2019, EUROINTERVENTION, V14, P1435, DOI [10.4244/EIJY19M01_01, 10.1093/ejcts/ezy289] Piccolo R, 2015, CIRC-CARDIOVASC INTE, V8, DOI 10.1161/CIRCINTERVENTIONS.114.002223 Raber L, 2014, INT J CARDIOL, V173, P259, DOI 10.1016/j.ijcard.2014.02.036 Royston P, 2008, MULTIVARIABLE MODEL Steinberg DH, 2009, AM J CARDIOL, V103, P491, DOI 10.1016/j.amjcard.2008.09.107 Stone GW, 2006, JAMA-J AM MED ASSOC, V295, P1253, DOI 10.1001/jama.295.11.1253 Taniwaki M, 2015, EUR HEART J, V36, P2167, DOI 10.1093/eurheartj/ehv227 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] Tsigkas GG, 2011, HELL J CARDIOL, V52, P149 VanderWeele TJ, 2011, BIOMETRICS, V67, P1406, DOI 10.1111/j.1541-0420.2011.01619.x Varghese MJ, 2018, CIRC-CARDIOVASC INTE, V11, DOI 10.1161/CIRCINTERVENTIONS.118.006832 Waksman R, 2000, CIRCULATION, V101, P2165, DOI 10.1161/01.CIR.101.18.2165 Waksman R, 2000, J AM COLL CARDIOL, V36, P65, DOI 10.1016/S0735-1097(00)00681-1 Waksman R, 1997, CIRCULATION, V96, P1944, DOI 10.1161/01.CIR.96.6.1944 Waksman R, 2018, CURR CARDIOL REP, V20, DOI 10.1007/s11886-018-1076-6 Wehinger A, 1999, J AM COLL CARDIOL, V33, P1005, DOI 10.1016/S0735-1097(98)00684-6 Wu S, 2017, MEDICINE, V96, DOI 10.1097/MD.0000000000006863 Yabushita H, 2018, CIRC-CARDIOVASC INTE, V11, DOI 10.1161/CIRCINTERVENTIONS.117.005935 NR 40 TC 8 Z9 8 U1 1 U2 4 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 32 EP 38 DI 10.1002/ccd.28716 EA JAN 2020 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PT1CR UT WOS:000506687800001 PM 31943747 DA 2023-05-13 ER PT J AU Zhang, HB Plutzky, J Ge, WD Shubina, M Turchin, A AF Zhang, Huabing Plutzky, Jorge Ge, Wendong Shubina, Maria Turchin, Alexander TI Predictors of a successful statin reattempt after an adverse reaction SO JOURNAL OF CLINICAL LIPIDOLOGY LA English DT Article DE Statins; Adverse reactions; Hyperlipidemia; Predictors; Reattempt ID ACUTE CORONARY SYNDROMES; RANDOMIZED-TRIALS; CARDIOVASCULAR-DISEASE; SECONDARY PREVENTION; BONFERRONI PROCEDURE; CLINIC EXPERIENCE; LDL CHOLESTEROL; MUSCLE SYMPTOMS; MULTIPLE TESTS; THERAPY AB BACKGROUND: Many patients can tolerate statin therapy after an adverse reaction. However, optimal patient selection criteria and methods of reattempting statin therapy after an adverse reaction are unknown. OBJECTIVE: To identify patient and treatment characteristics associated with a successful statin reattempt after an adverse reaction. METHODS: We retrospectively studied adults treated in primary care practices affiliated with 2 academic medical centers between 2000 and 2012 who reattempted statin therapy after an adverse reaction. Statin reattempts were considered successful if the patient had at least 2 statin prescriptions after discontinuation of the original statin, and had an active electronic medical record statin record at 2 years after the adverse reaction. RESULTS: Among 6196 patients included in the study, 4536 (73.2%) successfully reattempted statin therapy. In multivariable analysis, history of coronary artery disease, stroke, or diabetes (odds ratio [OR] 1.195; P = .008) and reattempted treatment with a different statin (OR 1.463; P < .0001) were associated with greater odds of a successful reattempt. Adverse reaction during the first year after statin initiation (OR 0.721; P < .0001) or myalgia or myopathy (OR 0.807; P = .001) as well as history of adverse reactions to nonstatin drugs (OR 0.908; P < .0001) were associated with lower odds. CONCLUSIONS: Nature and timing of the adverse reaction, patient's medical history and the medication prescribed affected the likelihood of a successful reattempt of statin therapy after an adverse reaction. These findings suggest that a patient-centered approach to restarting statins should be considered for patients at high cardiovascular risk to improve the chances of success. (C) 2018 National Lipid Association. All rights reserved. C1 [Zhang, Huabing] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Minist Hlth, Dept Endocrinol,Key Lab Endocrinol, Beijing, Peoples R China. [Plutzky, Jorge; Ge, Wendong; Turchin, Alexander] Harvard Med Sch, Boston, MA USA. [Turchin, Alexander] Baim Inst Clin Res, Boston, MA USA. [Zhang, Huabing; Ge, Wendong; Shubina, Maria] Brigham & Womens Hosp, Div Endocrinol, 221 Longwood Ave, Boston, MA 02115 USA. C3 Chinese Academy of Medical Sciences - Peking Union Medical College; Peking Union Medical College Hospital; Harvard University; Harvard Medical School; Harvard University; Brigham & Women's Hospital RP Turchin, A (通讯作者)，Brigham & Womens Hosp, Div Endocrinol, 221 Longwood Ave, Boston, MA 02115 USA. EM aturchin@bwh.harvard.edu RI Zhang, Huabing/ABD-6216-2020; Plutzky, Jorge/V-3410-2019 OI Zhang, Huabing/0000-0001-6259-7584; FU Chinese National Key Program of Clinical Science, Beijing, China [WBYZ2011-873]; Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, Beijing, China [CIFMS2016-12M-4-001]; Frontier Technology Breeding Project of Beijing Commission of Municipal Commission of Science and Technology [Z151100003915077] FX The work was supported in part by the Chinese National Key Program of Clinical Science, Beijing, China (WBYZ2011-873), Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, Beijing, China (CIFMS2016-12M-4-001), and Frontier Technology Breeding Project of Beijing Commission of Municipal Commission of Science and Technology (Z151100003915077). These organizations 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, or the decision to submit the article for publication. 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Clin. Lipidol. PD JUN PY 2018 VL 12 IS 3 BP 643 EP 651 DI 10.1016/j.jacl.2018.02.005 PG 9 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA GJ5MO UT WOS:000435425800009 PM 29567104 DA 2023-05-13 ER PT J AU Gurdal, A Keskin, K Sumerkan, MC Cetinkal, G Kilci, H Cetin, S Kilickesmez, KO AF Gurdal, Ahmet Keskin, Kudret Sumerkan, Mutlu Cagan Cetinkal, Gokhan Kilci, Hakan Cetin, Sukru Kilickesmez, Kadriye Orta TI Prognostic impact of infection in octogenarians with ST-segment elevation myocardial infarction SO EUROPEAN GERIATRIC MEDICINE LA English DT Article DE Coronary artery disease; Infection; ST-segment elevation myocardial infarction; Octogenarian ID ACUTE CORONARY SYNDROME; OLDER-ADULTS; FRAILTY; PREVALENCE; MORTALITY; CARE AB Key summary pointsAim The aim of this study was to investigate the impact and prognostic value of infection on long-term mortality in octogenarian patients with STEMI. Findings Patients with infection had a higher rate of in-hospital and long-term mortality. Message Infection is an independent predictor of long-term mortality in octogenarian patients with STEMI. Purpose Contemporary studies assessing outcomes in octogenarian patients presenting with ST-segment elevation myocardial infarction (STEMI) and infection are scarce. This study investigated the impact and prognostic value of infection on long-term mortality in octogenarian patients with STEMI. Methods A total of 1564 patients admitted with STEMI between May 2015 and September 2019 were retrospectively analyzed, and 110 octogenarians were identified and included. Predictors of mortality were determined by multivariate Cox regression analysis. Survival curves were generated using the Kaplan-Meier method. Results The mean age of the patients was 85 +/- 4 years, and 58 (52%) were male. Median follow-up was 41 months. Patients with infection had higher rates of in-hospital (16.4% vs. 8.2%,p = 0.001) and long-term (33.6% vs. 20%,p = 0.001) mortality. Multivariate Cox regression analysis revealed that infection (HR 3.16; 95% CI 1.52-6.59;p = 0.002) and C-reactive protein levels (HR 0.99; 95% CI 0.98-1.00;p = 0.042) were independent predictors of mortality in patients with infection. Kaplan-Meier analysis also showed that patients with infection had a significantly higher mortality rate (p < 0.001). Conclusion Infection is an independent predictor of long-term mortality in octogenarian patients with STEMI. C1 [Gurdal, Ahmet; Keskin, Kudret; Sumerkan, Mutlu Cagan; Cetinkal, Gokhan; Kilci, Hakan; Cetin, Sukru; Kilickesmez, Kadriye Orta] Univ Hlth Sci, Dept Cardiol, Sisli Hamidiye Etfal Educ & Res Hosp, TR-34360 Sisli, Turkey. C3 Istanbul Sisli Hamidiye Etfal Training & Research Hospital RP Gurdal, A (通讯作者)，Univ Hlth Sci, Dept Cardiol, Sisli Hamidiye Etfal Educ & Res Hosp, TR-34360 Sisli, Turkey. EM gurdal27@hotmail.com RI Cetinkal, Gokhan/AAC-4263-2020; Keskin, Kudret/AAC-9113-2022; Keskin, Kudret/Z-5735-2019; Keskin, Kudret/AAB-8198-2019; Çetin, Şükrü/AFO-7239-2022; Gürdal, Ahmet/AAG-9459-2020 OI Cetinkal, Gokhan/0000-0001-5291-0645; Keskin, Kudret/0000-0002-9049-1530; CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Cangemi R, 2014, J AM COLL CARDIOL, V64, P1917, DOI 10.1016/j.jacc.2014.07.985 Celermajer DS, 2012, J AM COLL CARDIOL, V60, P1207, DOI 10.1016/j.jacc.2012.03.074 Corrales-Medina VF, 2013, LANCET, V381, P496, DOI 10.1016/S0140-6736(12)61266-5 Dai XM, 2016, J GERIATR CARDIOL, V13, P101, DOI 10.11909/j.issn.1671-5411.2016.02.012 de Oliveira PP, 2016, AM HEART J, V181, P52, DOI 10.1016/j.ahj.2016.08.005 Dong M, 2011, INT J CARDIOL, V147, P479, DOI 10.1016/j.ijcard.2011.01.035 Ekerstad N, 2011, CIRCULATION, V124, P2397, DOI 10.1161/CIRCULATIONAHA.111.025452 Grandini Jr LC, 2006, ARQ BRAS CARDIOL, DOI [10.1590/S0066782X2006001600007, DOI 10.1590/S0066782X2006001600007] Keskin K, 2018, ARCH GERONTOL GERIAT, V76, P48, DOI 10.1016/j.archger.2018.01.012 Khandelwal D, 2012, J NUTR HEALTH AGING, V16, P732, DOI 10.1007/s12603-012-0369-5 Kwok CS, 2019, AM J CARDIOL, V124, P1002, DOI 10.1016/j.amjcard.2019.07.003 Limpawattana P, 2016, ARCH GERONTOL GERIAT, V62, P97, DOI 10.1016/j.archger.2015.08.016 Modica A, 2007, J THROMB HAEMOST, V5, P507, DOI 10.1111/j.1538-7836.2007.02378.x Newman AB, 2001, CIRCULATION, V104, P2679, DOI 10.1161/hc4601.099464 Roule V, 2016, CRIT CARE, V20, DOI 10.1186/s13054-016-1530-z Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Storey RF, 2014, PLATELETS, V25, P517, DOI 10.3109/09537104.2013.842965 Strandberg TE, 2007, LANCET, V369, P1328, DOI [10.1016/S0140-6736(07)60613-8, 10.1016/S0140-6736(12)62167-9] Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Truffa AAM, 2012, JACC-CARDIOVASC INTE, V5, P769, DOI 10.1016/j.jcin.2012.03.018 VINCENT JL, 1995, JAMA-J AM MED ASSOC, V274, P639, DOI 10.1001/jama.274.8.639 Widell C, 2020, EUR J CARDIOVASC NUR, V19, P521, DOI 10.1177/1474515120902315 NR 23 TC 1 Z9 1 U1 0 U2 2 PU SPRINGER PI NEW YORK PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES SN 1878-7649 EI 1878-7657 J9 EUR GERIATR MED JI Eur. Geriatr. Med. PD DEC PY 2020 VL 11 IS 6 BP 1073 EP 1078 DI 10.1007/s41999-020-00368-1 EA JUL 2020 PG 6 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Geriatrics & Gerontology GA PA6MF UT WOS:000550616100001 PM 32691387 DA 2023-05-13 ER PT J AU McLean, S Sheehy-Skeffington, B O'Leary, N O'Gorman, A AF McLean, S. Sheehy-Skeffington, B. O'Leary, N. O'Gorman, A. TI Pharmacological management of co-morbid conditions at the end of life: is less more? SO IRISH JOURNAL OF MEDICAL SCIENCE LA English DT Article DE Palliative; Co-morbid; Polypharmacy; Prescribing; End of life ID ACUTE CORONARY SYNDROMES; STATINS; DISCONTINUATION; APPROPRIATENESS; WITHDRAWAL; CARE AB Co-morbid conditions (CMCs) are present in over half of patients with cancer over 50 years of age. As life-limiting illnesses progress, the benefits and burdens of treatments for CMCs become unclear. Relevant issues include physiological changes in advanced illness, time-to-benefit of medications, burden of medications, and psychological impact of discontinuing medications. Optimal prescribing is unclear due to lack of evidence. The objectives are to determine prescribing practice, for CMCs, in a single SPC service. Patients referred to a single specialist palliative care (SPC) service, who died between 1/8/2010 and 30/9/2012, were identified. Medical notes were reviewed, and data collected on prescribing at 3 months, 1 month, and 1 week prior to death. Fifty-two patients with a median age of 74.5 years were identified; 41 patients (79 %) had a malignant condition. 50 % died in hospital. Patients had a mean of three CMCs. A mean of 4.6 medications for CMCs were prescribed to patients over 65. A mean of 10 medications in total were prescribed at 1 week before death. One week before death, one-third of patients continued to be prescribed aspirin, and over one-quarter a statin. Total medication burden increases as time to death shortens, due to continuation of medications for CMCs, and addition of medications for symptom control. There is a need for research to demonstrate the impact of polypharmacy at the end of life, in order to formulate a framework to guide practice. C1 [McLean, S.; Sheehy-Skeffington, B.; O'Leary, N.; O'Gorman, A.] Our Lady Lourdes Hosp, Dochas Ctr, Specialist Palliat Care Serv, Drogheda, Louth, Ireland. [McLean, S.] St Francis Hosp, Dublin 5, Ireland. RP McLean, S (通讯作者)，St Francis Hosp, Stn Rd, Dublin 5, Ireland. 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Med. Sci. PD MAR PY 2013 VL 182 IS 1 BP 107 EP 112 DI 10.1007/s11845-012-0841-6 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 063YQ UT WOS:000313038500017 PM 22843427 DA 2023-05-13 ER PT J AU Black, JA Cheng, K Flood, JA Hamilton, G Parker, S Enayati, A Khan, FS Marwick, T AF Black, James Andrew Cheng, Kevin Flood, Jo-Anne Hamilton, Garry Parker, Serena Enayati, Anees Khan, Faisal S. Marwick, Tom TI Evaluating the benefits of a rapid access chest pain clinic in Australia SO MEDICAL JOURNAL OF AUSTRALIA LA English DT Article ID NATIONAL-HEART-FOUNDATION; CARDIAC-SOCIETY; GUIDELINES; MANAGEMENT; SERVICES AB Objectives: To compare the outcomes and safety of a rapid access chest pain clinic (RACPC) in Australia with those of a general cardiology clinic. Design: Prospective comparison of the outcomes for patients attending an RACPC and those of historical controls. Setting: Royal Hobart Hospital cardiology outpatient department. Participants: 1914 patients referred for outpatient evaluation of new onset chest pain (1479 patients seen in the RACPC, 435 patients previously seen in the general cardiology clinic). Main outcome measures: Service outcomes (review times, number of clinic reviews); adverse events (unplanned emergency department re-attendances at 30 days and 12 months; major adverse cardiovascular events at 12 months, including unplanned revascularisation, acute coronary syndrome, stroke, cardiac death). Results: Median time to review was shorter for RACPC than for usual care patients (12 days [IQR, 8-15 days] v 45 days [IQR, 27-89 days]). All patients seen in the RACPC received a diagnosis at the first clinic visit, but only 139 patients in the usual care group (32.0%). There were fewer unplanned emergency department re-attendances for patients in the RACPC group at 30 days (1.6% v 4.4%) and 12 months (5.7% v 12.9%) than in the control group. Major adverse cardiovascular events were less frequent among patients evaluated in the RACPC (0.2% v 1.4%). Conclusions: Patients were evaluated more efficiently in the RACPC than in a traditional cardiology clinic, and their subsequent rates of emergency department re-attendances and adverse cardiovascular events were lower. C1 [Black, James Andrew; Cheng, Kevin; Flood, Jo-Anne; Parker, Serena; Enayati, Anees; Khan, Faisal S.] Royal Hobart Hosp, Hobart, Tas, Australia. [Hamilton, Garry] Austin Hlth, Melbourne, Vic, Australia. [Marwick, Tom] Baker IDI Heart & Diabet Inst, Melbourne, Vic, Australia. C3 Royal Hobart Hospital; Austin Research Institute; Florey Institute of Neuroscience & Mental Health; Baker Heart and Diabetes Institute RP Black, JA (通讯作者)，Royal Hobart Hosp, Hobart, Tas, Australia. EM andrew.black@ths.tas.gov.au RI Marwick, Thomas/AAK-3869-2021; Cheng, Kevin/AAQ-6334-2020; Cheng, Kevin/HDN-0268-2022 OI Marwick, Thomas/0000-0001-9065-0899; Cheng, Kevin/0000-0003-0745-6695; Cheng, Kevin/0000-0003-0745-6695 FU Tasmanian Community Fund; virtual Tasmanian Academic Health Sciences Precinct FX We gratefully acknowledge grants from the Tasmanian Community Fund and the virtual Tasmanian Academic Health Sciences Precinct. We thank the staff and patients of the Royal Hobart Hospital who attended or worked in the RACPC, as well as the National Heart Foundation for their ongoing support. We are grateful to James Sharman for his assistance with the statistical analyses. CR Aroney CN, 2006, MED J AUSTRALIA, V184, pS1 Ashrafi R, 2013, POSTGRAD MED J, V89, P251, DOI 10.1136/postgradmedj-2012-131098 Byrne J, 2002, POSTGRAD MED J, V78, P43, DOI 10.1136/pmj.78.915.43 Chew DP, 2016, HEART LUNG CIRC, V25, P895, DOI 10.1016/j.hlc.2016.06.789 Cullen L, 2015, MED J AUSTRALIA, V202, P427, DOI 10.5694/mja14.00472 Davie AP, 1998, QJM-MON J ASSOC PHYS, V91, P339, DOI 10.1093/qjmed/91.5.339 Debney MT, 2012, QJM-INT J MED, V105, P231, DOI 10.1093/qjmed/hcr182 Department of Health and Social Care, 2000, NAT SERV FRAM COR HE Dougan JP, 2001, QJM-INT J MED, V94, P679, DOI 10.1093/qjmed/94.12.679 Elford A, 2016, HEART LUNG CIRC S2, V25, pS63 Fox KF, 2009, INT J CARDIOL, V137, P42, DOI 10.1016/j.ijcard.2008.06.026 Klimis H, 2018, HEART LUNG CIRC, V27, P1381, DOI 10.1016/j.hlc.2018.05.201 Klimis H, 2017, INTERN MED J, V47, P986, DOI 10.1111/imj.13334 Nawar Eric W, 2007, Adv Data, P1 Sandoval Y, 2017, CLIN CHEM, V63, P369, DOI 10.1373/clinchem.2016.264523 Tenkorang JN, 2006, HEART, V92, P1084, DOI 10.1136/hrt.2005.079376 Yu C, 2018, HEART LUNG CIRC, V27, P1376, DOI 10.1016/j.hlc.2017.11.006 NR 17 TC 8 Z9 8 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 APR PY 2019 VL 210 IS 7 BP 321 EP 325 DI 10.5694/mja2.50021 PG 5 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA HT6DR UT WOS:000464654900013 PM 30773636 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Lazzeri, C Valente, S Chiostri, M Spini, V Angelotti, P Gensini, GF AF Lazzeri, Chiara Valente, Serafina Chiostri, Marco Spini, Valentina Angelotti, Paola Gensini, Gian Franco TI Uric acid and mild renal impairment in patients with ST-elevation myocardial infarction SO SCANDINAVIAN CARDIOVASCULAR JOURNAL LA English DT Article DE mild renal impairment; PCI; prognosis; ST-elevation myocardial infarction; uric acid ID ACUTE CORONARY SYNDROME; CHRONIC KIDNEY-DISEASE; LONG-TERM MORTALITY; PROGNOSTIC ROLE; HYPERURICEMIA; ASSOCIATION AB Aims. Mild renal impairment (estimated GFR 60-89 ml/min/1.73 m(2)) is a strong independent risk factor for mortality in ST-elevation myocardial infarction (STEMI), and is submitted to mechanical revascularization. Patients with renal impairment have decreased excretion of uric acid (UA) and they are thus particularly prone to have elevated serum UA concentrations. This study was aimed at assessing the association between increased UA and mortality in STEMI patients with mild renal impairment. Methods. We prospectively assessed, in 578 STEMI patients with mild renal impairment, whether elevated UA levels are associated with increased mortality both in the short term and in the long term. Results. Patients in the highest UA tertile showed a higher incidence of Killip class III -IV (p = 0.003) and lower values of ejection fraction (EF) (p < 0.001). Lower values for estimated glomerular filtration rate (eGFR) at admission, nadir, and discharge were detected in the highest UA tertile, together with the highest values of peak troponin I (Tn I) (p = 0.002), and NT-proBrain Natriuretic Peptide [NT-proBNP] (p < 0.001). No difference was found in mortality rates (both during their stay in the intensive cardiac care unit [ICCU], and at the 1-year post-discharge follow-up) among the UA tertiles. Conclusions. The UA levels seem to serve as markers of the severity of coronary artery disease, since they identify a subset of patients characterized by an advanced age, more hemodynamic derangement, and reduced renal function. However, neither short nor long-term mortality was affected. C1 [Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Spini, Valentina; Angelotti, Paola; Gensini, Gian Franco] Azienda Osped Univ Careggi, Heart & Vessel Dept, Intens Cardiac Coronary Unit, Florence, Italy. [Gensini, Gian Franco] Univ Florence, Dept Expt & Clin Med, AOU Careggi, Fdn Don Carlo Gnocchi IRCCS, Florence, Italy. C3 University of Florence; Azienda Ospedaliero Universitaria Careggi; IRCCS Fondazione Don Carlo Gnocchi Onlus; University of Florence; Azienda Ospedaliero Universitaria Careggi RP Lazzeri, C (通讯作者)，Heart & Vessel Dept, Intens Cardiac Care Unit, Viale Morgagni 85, I-50134 Florence, Italy. EM lazzeric@libero.it OI spini, valentina/0000-0002-3332-0778 CR Campbell NG, 2012, HEART, V98, P42, DOI 10.1136/heartjnl-2011-300024 Deedwania P, 2008, CIRCULATION, V117, P1610, DOI 10.1161/CIRCULATIONAHA.107.188629 Feig DI, 2008, NEW ENGL J MED, V359, P1811, DOI 10.1056/NEJMra0800885 Gagliardi ACM, 2009, ATHEROSCLEROSIS, V202, P11, DOI 10.1016/j.atherosclerosis.2008.05.022 Homayounfar S, 2007, SAUDI MED J, V28, P759 Kellum JA, 2008, CLIN J AM SOC NEPHRO, V3, P887, DOI 10.2215/CJN.04891107 Kojima S, 2005, AM J CARDIOL, V96, P489, DOI 10.1016/j.amjcard.2005.04.007 Kostis WJ, 2010, CIRC-CARDIOVASC QUAL, V3, P581, DOI 10.1161/CIRCOUTCOMES.110.957803 Kowalczyk J, 2010, NEPHRON CLIN PRACT, V116, pC114, DOI 10.1159/000314660 Lazzeri C, 2014, HEART VESSELS, V29, P769, DOI 10.1007/s00380-013-0429-8 Lazzeri C, 2014, INT J CARDIOL, V171, pE26, DOI 10.1016/j.ijcard.2013.11.124 Lazzeri C, 2012, INTERN EMERG MED, V7, P33, DOI 10.1007/s11739-011-0515-9 Lazzeri C, 2010, INT J CARDIOL, V138, P206, DOI 10.1016/j.ijcard.2008.06.024 Lazzeri C, 2009, EUR J ANAESTH, V26, P856, DOI 10.1097/EJA.0b013e32832a235c Levey AS, 2009, ANN INTERN MED, V150, P604, DOI 10.7326/0003-4819-150-9-200905050-00006 Ma Y, 2013, EXP THER MED, V5, P1206, DOI 10.3892/etm.2013.927 Smith GL, 2008, J AM SOC NEPHROL, V19, P141, DOI 10.1681/ASN.2007050554 Strazzullo P, 2007, NUTR METAB CARDIOVAS, V17, P409, DOI 10.1016/j.numecd.2007.02.011 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 Valente S, 2012, EUR J PREV CARDIOL, V19, P233, DOI 10.1177/1741826711400511 Valente S, 2011, CLIN CARDIOL, V34, P90, DOI 10.1002/clc.20842 Yin ZX, 2013, CARDIOLOGY, V125, P204, DOI 10.1159/000350953 NR 22 TC 7 Z9 8 U1 0 U2 4 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 2-4 PARK SQUARE, MILTON PARK, ABINGDON OR14 4RN, OXON, ENGLAND SN 1401-7431 EI 1651-2006 J9 SCAND CARDIOVASC J JI Scand. Cardiovasc. J. PD FEB PY 2015 VL 49 IS 1 BP 14 EP 19 DI 10.3109/14017431.2015.1005662 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CC1ML UT WOS:000350104900003 PM 25659042 DA 2023-05-13 ER PT J AU Hudzik, B Korzonek-Szlacheta, I Szkodzinski, J Gierlotka, M Lekston, A Zubelewicz-Szkodzinska, B Gasior, M AF Hudzik, Bartosz Korzonek-Szlacheta, Ilona Szkodzinski, Janusz Gierlotka, Marek Lekston, Andrzej Zubelewicz-Szkodzinska, Barbara Gasior, Mariusz TI Prognostic impact of multimorbidity in patients with type 2 diabetes and ST-elevation myocardial infarction SO ONCOTARGET LA English DT Article DE myocardial infarction; diabetes mellitus; comorbidity; multimorbidity; prognosis ID MULTIPLE CHRONIC CONDITIONS; HOSPITAL MORTALITY; EUROPEAN-SOCIETY; TASK-FORCE; PREVALENCE; COMORBIDITY; COMPLICATIONS; GUIDELINES; MELLITUS; DISEASES AB Introduction: There is an increasing body of evidence on the clinical importance of multimorbidity, which is defined as the coexistence of two or more chronic conditions. Type 2 diabetes (T2DM) is one of the most frequent chronic conditions. Most adults with type 2 diabetes have at least 1 coexisting chronic condition and approximately 40% have 3 or more. Prior studies have suggested that cardiovascular (CVD) and non-CVD comorbid conditions yield worse outcomes in patients hospitalized with ST-elevation myocardial infarction (STEMI). It is unclear, however, the extent to which multimorbidity has a cumulative effect on long-term risk. Therefore we have set out to determine the prognostic value of multiple comorbidity on long-term outcomes in this population of patients. Methods: A total of 277 patients with T2DM and STEMI undergoing primary percutaneous coronary intervention (PCI) were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N= 58) with <= 1 comorbidity and group 2 (N= 219) with >= 2 comorbidities. Results: Comorbid conditions were prevalent among study participants (Figure 1). The median number of comorbidities was three. 15.9% of patients had one comorbidity and 22.0%, 34.3%, and 22.7% of patients had two, three or at least four comorbid conditions respectively. A majority of patients had at least one CVD comorbidity (6.1% of patients had none), whereas 53.1% of patients did not have any non-CVD comorbidity. During hospitalization 3 out of 58 patients (5.2%) died in group 1 and 25 of 219 patients (11.4%) died in group 2. The number of comorbid conditions was not an independent predictor of in-hospital death. During 12-month follow-up, 5 of 58 patients (8.6%) and 42 of 219 patients (19.9%) died, respectively in group 1 and 2 (P= 0.05). The number of comorbid conditions proved in ROC analysis that for 12-month mortality, the prognostic value was modest, but for 12-month acute coronary syndromes the prognostic value was good. Increase in the number of comorbid conditions by one was associated with a 15% increase in the relative risk of 12-month mortality and a 41% increase in the relative risk of 12-month acute coronary syndromes (ACS). Conclusions: Comorbid conditions are highly prevalent among these groups of patients. Majority of patients have at least 2 other cardiovascular comorbidities and one or two non-cardiovascular comorbidities. In terms of long-term follow-up, multimorbidity was associated with worse outcomes. The risk of both long-term mortality and ACS increased with the increasing number of comorbidities. In summary, our findings highlight the importance of indentifying patients with multimorbidity. This, in turn, could allow for provision of better care to these high-risk and complex group of patients. C1 [Hudzik, Bartosz; Szkodzinski, Janusz; Gierlotka, Marek; Lekston, Andrzej; Gasior, Mariusz] Med Univ Silesia, Div Dent Zabrze, Sch Med, Silesian Ctr Heart Dis,Dept Cardiol 3, Zabrze, Poland. [Hudzik, Bartosz; Korzonek-Szlacheta, Ilona; Zubelewicz-Szkodzinska, Barbara] Med Univ Silesia, Sch Publ Hlth Bytom, Dept Nutr Related Dis Prevent, Katowice, Poland. C3 Medical University Silesia; Silesian Center for Heart Diseases; Medical University Silesia RP Hudzik, B (通讯作者)，Med Univ Silesia, Div Dent Zabrze, Sch Med, Silesian Ctr Heart Dis,Dept Cardiol 3, Zabrze, Poland.; Hudzik, B (通讯作者)，Med Univ Silesia, Sch Publ Hlth Bytom, Dept Nutr Related Dis Prevent, Katowice, Poland. EM bartekh@mp.pl RI Hudzik, Bartosz/K-5095-2019; Gierlotka, Marek/U-6969-2019; Hudzik, Bartosz/AAZ-8263-2020 OI Gierlotka, Marek/0000-0001-5639-2128; Hudzik, Bartosz/0000-0003-3880-5325; Zubelewicz-Szkodzinska, Barbara/0000-0002-8670-8581; Korzonek-Szlacheta, Ilona/0000-0003-4736-7806 CR Alonso-Moran E, 2014, BMC PUBLIC HEALTH, V14, DOI 10.1186/1471-2458-14-1059 Ani C, 2010, CARDIOL RES PRACT, V2010, DOI 10.4061/2010/752765 Chen HY, 2013, CLIN EPIDEMIOL, V5, P439, DOI [DOI 10.2147/CLEP.S49485, 10.2147/CLEP.S49485] Diederichs C, 2011, J GERONTOL A-BIOL, V66, P301, DOI 10.1093/gerona/glq208 Druss BG, 2001, HEALTH AFFAIR, V20, P233, DOI 10.1377/hlthaff.20.6.233 Fortin M, 2007, BMJ-BRIT MED J, V334, P1016, DOI 10.1136/bmj.39201.463819.2C Gili M, 2011, REV ESP CARDIOL, V64, P1130, DOI [10.1016/j.rec.2011.07.009, 10.1016/j.recesp.2011.07.010] Nguyen HL, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0108998 Iglay K, 2016, CURR MED RES OPIN, V32, P1243, DOI 10.1185/03007995.2016.1168291 Lin PJ, 2015, AM J MANAG CARE, V21, pE23 Lynch CP, 2015, J GEN INTERN MED, V30, P25, DOI 10.1007/s11606-014-2990-y McManus David D, 2012, Clin Epidemiol, V4, P115, DOI 10.2147/CLEP.S30883 Parekh AK, 2010, JAMA-J AM MED ASSOC, V303, P1303, DOI 10.1001/jama.2010.381 Parker AB, 2006, CAN J CARDIOL, V22, P131, DOI 10.1016/S0828-282X(06)70252-5 Radovanovic D, 2014, HEART, V100, P288, DOI 10.1136/heartjnl-2013-304588 Rogers WJ, 2008, AM HEART J, V156, P1026, DOI 10.1016/j.ahj.2008.07.030 Ryden L, 2007, EUR HEART J, V28, P88, DOI [10.1093/eurheartj/ehl260, 10.1093/eurheartj/ehm124] Sachdev M, 2004, J AM COLL CARDIOL, V43, P576, DOI 10.1016/j.jacc.2003.10.031 Schmidt M, 2012, BMJ-BRIT MED J, V344, DOI 10.1136/bmj.e356 Silber S, 2005, EUR HEART J, V26, P804, DOI 10.1093/eurheartj/ehi138 Smith SM, 2012, BMJ-BRIT MED J, V345, DOI 10.1136/bmj.e5205 Teljeur C, 2013, EUR J GEN PRACT, V19, P17, DOI 10.3109/13814788.2012.714768 van den Akker M, 1998, J CLIN EPIDEMIOL, V51, P367, DOI 10.1016/S0895-4356(97)00306-5 Vogeli C, 2007, J GEN INTERN MED, V22, P391, DOI 10.1007/s11606-007-0322-1 WHO, INN CAR CHRON COND B Wolff JL, 2002, ARCH INTERN MED, V162, P2269, DOI 10.1001/archinte.162.20.2269 NR 26 TC 2 Z9 3 U1 0 U2 3 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 NOV 28 PY 2017 VL 8 IS 61 BP 104467 EP 104477 DI 10.18632/oncotarget.22324 PG 11 WC Oncology; Cell Biology WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology; Cell Biology GA FS1TY UT WOS:000419562500137 PM 29262654 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Islamoglu, MS Dokur, M Ozdemir, E Unal, OF AF Islamoglu, Mehmet Sami Dokur, Mehmet Ozdemir, Emrah Unal, Omer Faruk TI Massive pulmonary embolism presenting with hemoptysis and S1Q3T3 ECG findings SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Massive pulmonary embolism; Typical electrocardiographic findings; Hemoptysis ID PROGNOSIS AB Background Venous thromboembolism clinically presenting with a deep vein thrombosis or pulmonary embolism is among the most commonly seen cardiovascular syndromes. The aim of this case presentation is to emphasise the typical electrocardiographic findings that are detected with massive pulmonary embolism along with the electrocardiographic S1Q3 and S1Q3T3 accompanied by T negativity at the D3 derivation based on prevalent T negativity. Case presentation We present the case of an adult male who presented with a massive pulmonary embolism that was associated with tachycardia, haemoptysis and typical S1Q3T3 electrocardiographic findings. Tomographic findings showed filling defects in the two main pulmonary artery lumens, which were found to be compatible with a massive embolism. Intravenous heparin was injected (5000 IU), and low molecule weight heparin (LMWH) treatment was initiated. After two days of observation and treatment in the coronary intensive care unit, the patient was discharged for outpatient care. Discussion Massive pulmonary embolism is an urgent life-threatening clinical situation that is frequently confused with acute ST elevation myocardial infarction. The definitive diagnosis of massive pulmonary embolism was made with a computed tomography pulmonary angiogram. Electrocardiographic findings and hypoxic hypercarbia in the blood gas analysis are typical. Early diagnosis with laboratory and imaging investigations is vital in the treatment and prognosis of pulmonary embolism. Conclusions Ventricular overload signs accompanied by ST segment elevation in electrocardiography and S1Q3 and prevalent T negativity are crucial features in terms of distinguishing between pulmonary embolism and myocardial infarction and selecting effective treatments for patients admitted to the emergency department. C1 [Islamoglu, Mehmet Sami] Biruni Univ, Dept Internal Med, Fac Med, Istanbul, Turkey. [Dokur, Mehmet] Biruni Univ, Dept Emergency Med, Fac Med, Istanbul, Turkey. [Ozdemir, Emrah] Biruni Univ, Dept Cardiol, Fac Med, Istanbul, Turkey. [Unal, Omer Faruk] Biruni Univ, Dept Radiodiagnost, Fac Med, Istanbul, Turkey. C3 Biruni University; Biruni University; Biruni University; Biruni University RP Islamoglu, MS (通讯作者)，Biruni Univ, Dept Internal Med, Fac Med, Istanbul, Turkey. EM mislamoglu@biruni.edu.tr RI Islamoglu, Mehmet Sami/ABH-2138-2021 OI Islamoglu, Mehmet sami/0000-0003-3426-6950 CR Cohen AT, 2007, THROMB HAEMOSTASIS, V98, P756, DOI 10.1160/TH07-03-0212 Digby GC, 2015, ANN NONINVAS ELECTRO, V20, P207, DOI 10.1111/anec.12278 Dronkers CEA, 2017, J THROMB HAEMOST, V15, P1040, DOI 10.1111/jth.13654 Franco RF, 2001, HUM GENET, V109, P369, DOI 10.1007/s004390100593 Konstantinides SV, 2019, EUR RESPIR J, V54, DOI [10.1093/eurheartj/ehz405, 10.1183/13993003.01647-2019] Kukla P, 2011, KARDIOL POL, V69, P933 Munzel T., 2020, EUR HEART J, V41, P522529 Oner Ferda, 2003, Tuberk Toraks, V51, P60 Raskob GE, 2014, ARTERIOSCL THROM VAS, V34, P2363, DOI 10.1161/ATVBAHA.114.304488 Shopp JD, 2015, ACAD EMERG MED, V22, P1127, DOI 10.1111/acem.12769 Wendelboe AM, 2016, CIRC RES, V118, P1340, DOI 10.1161/CIRCRESAHA.115.306841 Zhan ZQ, 2014, ANN NONINVAS ELECTRO, V19, P543, DOI 10.1111/anec.12163 NR 12 TC 0 Z9 0 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 MAY 1 PY 2021 VL 21 IS 1 AR 224 DI 10.1186/s12872-021-02035-0 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA SO5SD UT WOS:000659031000002 PM 33932981 OA gold, Green Published DA 2023-05-13 ER PT J AU Sotiriou, S Samara, AA Vamvakopoulou, D Vamvakopoulos, KO Sidiropoulos, A Vamvakopoulos, N Janho, MB Gourgoulianis, KI Boutlas, S AF Sotiriou, Sotirios Samara, Athina A. Vamvakopoulou, Dimitra Vamvakopoulos, Konstantinos-Odysseas Sidiropoulos, Andreas Vamvakopoulos, Nikolaos Janho, Michel B. Gourgoulianis, Konstantinos, I Boutlas, Styllianos TI Susceptibility of beta-Thalassemia Heterozygotes to COVID-19 SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE COVID-19; beta-thalassemia; risk; coronavirus ID STATINS AB Background: beta-Thalassemia is the most prevalent single gene blood disorder, while the assessment of its susceptibility to coronavirus disease 2019 (COVID-19) warrants it a pressing biomedical priority. Methods: We studied 255 positive COVID-19 participants unvaccinated against severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), consecutively recruited during the last trimester of 2020. Patient characteristics including age, sex, current smoking status, atrial fibrillation, chronic respiratory disease, coronary disease, diabetes, neoplasia, hyperlipidemia, hypertension, and beta-thalassemia heterozygosity were assessed for COVID-19 severity, length of hospitalization, intensive care unit (ICU) admission and mortality from COVID-19. Results: We assessed patient characteristics associated with clinical symptoms, ICU admission, and mortality from COVID-19. In multivariate analysis, severe-critical COVID-19 was strongly associated with male sex (p = 0.023), increased age (p < 0.001), and beta-thalassemia heterozygosity (p = 0.002, OR = 2.89). Regarding the requirement for ICU care, in multivariate analysis there was a statistically significant association with hypertension (p = 0.001, OR = 5.12), while beta-thalassemia heterozygosity had no effect (p = 0.508, OR = 1.33). Mortality was linked to male sex (p = 0.036, OR = 2.09), increased age (p < 0.001) and beta-thalassemia heterozygosity (p = 0.010, OR = 2.79) in multivariate analysis. It is worth noting that hyperlipidemia reduced mortality from COVID-19 (p = 0.008, OR = 0.38). No statistically significant association of current smoking status with patient characteristics studied was observed. Conclusions: Our pilot observations indicate enhanced mortality of beta-thalassemia heterozygotes from COVID-19. C1 [Sotiriou, Sotirios; Samara, Athina A.; Vamvakopoulos, Konstantinos-Odysseas; Janho, Michel B.] Univ Thessaly, Fac Med, Sch Hlth Sci, Dept Embryol, Larisa 41110, Greece. [Vamvakopoulou, Dimitra] Agia Sophia Childrens Hosp, Neonatal Intens Care Unit 1, Athens 11527, Greece. [Sidiropoulos, Andreas] Papageorgiou Gen Hosp, Cardiol Dept, Thessaloniki 56403, Greece. [Vamvakopoulos, Nikolaos] Univ Thessaly, Fac Med, Dept Biol, Larisa 41110, Greece. [Gourgoulianis, Konstantinos, I; Boutlas, Styllianos] Univ Thessaly, Fac Med, Dept Resp Med, Larisa 41110, Greece. C3 University of Thessaly; The Aghia Sophia Children's Hospital; Papageorgiou Hospital; University of Thessaly; University of Thessaly RP Samara, AA (通讯作者)，Univ Thessaly, Fac Med, Sch Hlth Sci, Dept Embryol, Larisa 41110, Greece. EM sotiriousoti@yahoo.gr; at.samara93@gmail.com; gina_dimitra@hotmail.com; kostantinos753@gmail.com; achsid@gmail.com; nvamvak@yahoo.com; Micheljanho@live.co.uk; kgourg@med.uth.gr; sboutlas@gmail.com RI Janho, Michel/HNI-1128-2023; Samara, Athina/ABC-1412-2021; Sotiriou, Sotirios/AAB-7730-2022 OI Janho, Michel/0000-0003-1776-0009; Samara, Athina/0000-0002-6177-7281; Sotiriou, Sotirios/0000-0002-9466-6086 CR Aleksova A, 2021, INT J MOL SCI, V22, DOI 10.3390/ijms22094526 Alloubani A, 2021, CURR CARDIOL REV, V17, DOI 10.2174/1573403X16999201210200342 Cho KH, 2021, J CLIN MED, V10, DOI 10.3390/jcm10010038 Chung MK, 2021, CIRC RES, V128, P1214, DOI 10.1161/CIRCRESAHA.121.317997 De Franceschi L, 2013, OXID MED CELL LONGEV, V2013, DOI 10.1155/2013/985210 De Sanctis V, 2017, MEDITERR J HEMATOL I, V9, DOI 10.4084/MJHID.2017.018 Dean A.G., 2011, EPI INFO TM DATABASE Deng H, 2021, PATHOGENS, V10, DOI 10.3390/pathogens10050582 Drouin E, 2020, MED HYPOTHESES, V143, DOI 10.1016/j.mehy.2020.110014 Gheblawi M, 2020, CIRC RES, V126, P1456, DOI 10.1161/CIRCRESAHA.120.317015 Kow CS, 2020, AM J CARDIOL, V134, P153, DOI 10.1016/j.amjcard.2020.08.004 Lansiaux E, 2020, MED HYPOTHESES, V142, DOI 10.1016/j.mehy.2020.109827 Lee KCH, 2020, INT J INFECT DIS, V96, P615, DOI 10.1016/j.ijid.2020.05.115 Li XC, 2017, PHARMACOL RES, V125, P21, DOI 10.1016/j.phrs.2017.06.005 Martinez MML, 2020, CLIN INVEST ARTERIOS, V32, P278, DOI 10.1016/j.arteri.2020.06.003 Lopez A, 2016, LANCET, V387, P907, DOI 10.1016/S0140-6736(15)60865-0 O'Brien J, 2020, J OVARIAN RES, V13, DOI 10.1186/s13048-020-00734-4 Ondei Luciana de Souza, 2013, Rev. 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PD AUG PY 2021 VL 10 IS 16 AR 3645 DI 10.3390/jcm10163645 PG 9 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA UG4BR UT WOS:000689200500001 PM 34441941 OA Green Published, gold DA 2023-05-13 ER PT J AU Cecconi, M Piovani, D Brunetta, E Aghemo, A Greco, M Ciccarelli, M Angelini, C Voza, A Omodei, P Vespa, E Pugliese, N Parigi, TL Folci, M Danese, S Bonovas, S AF Cecconi, Maurizio Piovani, Daniele Brunetta, Enrico Aghemo, Alessio Greco, Massimiliano Ciccarelli, Michele Angelini, Claudio Voza, Antonio Omodei, Paolo Vespa, Edoardo Pugliese, Nicola Parigi, Tommaso Lorenzo Folci, Marco Danese, Silvio Bonovas, Stefanos CA Humanitas Covid-19 Task Force TI Early Predictors of Clinical Deterioration in a Cohort of 239 Patients Hospitalized for Covid-19 Infection in Lombardy, Italy SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE SARS-CoV-2; 2019 novel coronavirus; severe acute respiratory syndrome coronavirus 2; 2019-nCoV; COVID-19 ID SEPSIS; GUIDELINES; MANAGEMENT; MORTALITY; INJURY; MODELS AB We described features of hospitalized Covid-19 patients and identified predictors of clinical deterioration. We included patients consecutively admitted at Humanitas Research Hospital (Rozzano, Milan, Italy); retrospectively extracted demographic; clinical; laboratory and imaging findings at admission; used survival methods to identify factors associated with clinical deterioration (defined as intensive care unit (ICU) transfer or death), and developed a prognostic index. Overall; we analyzed 239 patients (29.3% females) with a mean age of 63.9 (standard deviation [SD]; 14.0) years. Clinical deterioration occurred in 70 patients (29.3%), including 41 (17.2%) ICU transfers and 36 (15.1%) deaths. The most common symptoms and signs at admission were cough (77.8%) and elevated respiratory rate (34.1%), while 66.5% of patients had at least one coexisting medical condition. Imaging frequently revealed ground-glass opacity (68.9%) and consolidation (23.8%). Age; increased respiratory rate; abnormal blood gas parameters and imaging findings; coexisting coronary heart disease; leukocytosis; lymphocytopenia; and several laboratory parameters (elevated procalcitonin; interleukin-6; serum ferritin; C-reactive protein; aspartate aminotransferase; lactate dehydrogenase; creatinine; fibrinogen; troponin-I; and D-dimer) were significant predictors of clinical deterioration. We suggested a prognostic index to assist risk-stratification (C-statistic; 0.845; 95% CI; 0.802-0.887). These results could aid early identification and management of patients at risk, who should therefore receive additional monitoring and aggressive supportive care. C1 [Cecconi, Maurizio; Piovani, Daniele; Brunetta, Enrico; Aghemo, Alessio; Greco, Massimiliano; Ciccarelli, Michele; Angelini, Claudio; Voza, Antonio; Omodei, Paolo; Vespa, Edoardo; Pugliese, Nicola; Parigi, Tommaso Lorenzo; Folci, Marco; Danese, Silvio; Bonovas, Stefanos] Humanitas Univ, Dept Biomed Sci, I-20090 Milan, Italy. [Cecconi, Maurizio; Piovani, Daniele; Brunetta, Enrico; Aghemo, Alessio; Greco, Massimiliano; Ciccarelli, Michele; Angelini, Claudio; Voza, Antonio; Omodei, Paolo; Vespa, Edoardo; Pugliese, Nicola; Parigi, Tommaso Lorenzo; Folci, Marco; Danese, Silvio; Bonovas, Stefanos] Humanitas Clin & Res Ctr IRCCS, I-20089 Milan, Italy. C3 Humanitas University RP Piovani, D (通讯作者)，Humanitas Univ, Dept Biomed Sci, I-20090 Milan, Italy.; Piovani, D (通讯作者)，Humanitas Clin & Res Ctr IRCCS, I-20089 Milan, Italy. EM maurizio.cecconi@hunimed.eu; daniele.piovani@humanitasresearch.it; enrico.brunetta@humanitas.it; alessio.aghemo@hunimed.eu; massimiliano.greco@hunimed.eu; michele.ciccarelli@humanitas.it; claudio.angelini@humanitas.it; antonio.voza@humanitas.it; paolo.omodei@humanitas.it; edoardo.vespa@humanitas.it; nicola.pugliese@humanitas.it; tommaso.parigi@humanitas.it; marco.folci@humanitas.it; silvio.danese@hunimed.eu; stefanos.bonovas@hunimed.eu RI Danese, Silvio/ABH-9571-2020; Aghemo, Alessio/ABE-5976-2021; Ciccarelli, Michele/GZG-8536-2022; Bonovas, Stefanos/GZG-4609-2022; Cecconi, Maurizio/HDN-8785-2022; greco, massimiliano/AAB-8278-2022; Parigi, Tommaso Lorenzo/AFJ-6307-2022; Brunetta, Enrico/AAT-6524-2021; Omodei, Paolo Dario/HKE-7995-2023; pugliese, nicola/ABC-7622-2020; greco, massimiliano/GNM-8140-2022; Cecconi, Maurizio/A-6241-2012; Voza, Antonio/AEW-4659-2022; Marco, Folci/ABB-9609-2021 OI Danese, Silvio/0000-0001-7341-1351; Aghemo, Alessio/0000-0003-0941-3226; Ciccarelli, Michele/0000-0002-8617-4153; Bonovas, Stefanos/0000-0001-6102-6579; Cecconi, Maurizio/0000-0002-4376-6538; greco, massimiliano/0000-0003-1003-4637; Parigi, Tommaso Lorenzo/0000-0002-3398-0231; Omodei, Paolo Dario/0000-0002-4364-9737; pugliese, nicola/0000-0001-6466-1412; greco, massimiliano/0000-0003-1003-4637; Cecconi, Maurizio/0000-0002-4376-6538; Voza, Antonio/0000-0001-7309-6929; Marco, Folci/0000-0001-5618-2876; ANGELINI, CLAUDIO/0000-0002-4814-8712; Piovani, Daniele/0000-0002-1414-6639; Brunetta, Enrico/0000-0002-0676-1228 CR Alatassi A, 2018, BMC ANESTHESIOL, V18, DOI 10.1186/s12871-018-0515-7 Alhazzani W, 2020, INTENSIVE CARE MED, V45, P854, DOI DOI 10.1007/500134-020-06022-5 Angus DC, 2013, NEW ENGL J MED, V369, P840, DOI 10.1056/NEJMra1208623 [Anonymous], JAMA J AM MED ASSOC [Anonymous], 2020, BMJ-BRIT MED J, DOI DOI 10.1136/bmj.m1091 [Anonymous], 2020, JAMA Blackburn R, 2018, CLIN INFECT DIS, V67, P8, DOI 10.1093/cid/cix1144 Chen NS., 2020, LANCET, V395, P507, DOI [DOI 10.1016/S0140-6736(20)30211-7, 10.1016/S0140-6736(20)30211-7] COLLINS GS, 2015, BMJ, V0350, P07594 Cooke CR, 2008, CRIT CARE MED, V36, P1412, DOI 10.1097/CCM.0b013e318170a375 Gorbalenya AE, 2020, NAT MICROBIOL, V5, P536, DOI 10.1038/s41564-020-0695-z Grasselli G, 2020, JAMA-J AM MED ASSOC, V323, P1545, DOI 10.1001/jama.2020.4031 Harrell FE, 1996, STAT MED, V15, P361, DOI 10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4 Huang C., 2020, ANN INTERN MED, V395, P497, DOI [DOI 10.1016/S0140-6736(20)30183-5, 10.1016/s0140-6736(20)30183-5] Huang C, 2020, BIOSENS BIOELECTRON, V395, P497, DOI [DOI 10.1016/J.BIOS.2020.112752, DOI 10.1056/NEJMoa2002032] Karbing DS, 2020, CRIT CARE, V24, DOI 10.1186/s13054-020-2834-6 Khwaja A, 2012, NEPHRON CLIN PRACT, V120, pC179, DOI 10.1159/000339789 KNAUS WA, 1985, CRIT CARE MED, V13, P818, DOI 10.1097/00003246-198510000-00009 Lipsitch M, 2020, NEW ENGL J MED, V382, P1194, DOI 10.1056/NEJMp2002125 Newson RB, 2010, STATA J, V10, P339, DOI 10.1177/1536867X1001000303 Phelan AL, 2020, JAMA-J AM MED ASSOC, V323, P709, DOI 10.1001/jama.2020.1097 Prin M, 2012, CURR OPIN CRIT CARE, V18, P700, DOI 10.1097/MCC.0b013e32835914d5 Ranieri VM, 2012, JAMA-J AM MED ASSOC, V307, P2526, DOI 10.1001/jama.2012.5669 Remuzzi A, 2020, LANCET, V395, P1225, DOI 10.1016/S0140-6736(20)30627-9 Rhodes A, 2017, INTENS CARE MED, V43, P304, DOI 10.1007/s00134-017-4683-6 Rosenbaum L, 2020, NEW ENGL J MED, V382, P1873, DOI 10.1056/NEJMp2005492 Royston P, 2013, BMC MED RES METHODOL, V13, DOI 10.1186/1471-2288-13-33 Ruan QR, 2020, INTENS CARE MED, V46, P846, DOI 10.1007/s00134-020-05991-x Seymour CW, 2016, JAMA-J AM MED ASSOC, V315, P762, DOI 10.1001/jama.2016.0288 Spina S, 2020, LANCET, V395, pE49, DOI 10.1016/S0140-6736(20)30493-1 van Houwelingen HC, 2000, STAT MED, V19, P3401, DOI 10.1002/1097-0258(20001230)19:24<3401::AID-SIM554>3.0.CO;2-2 Villar J, 2007, AM J RESP CRIT CARE, V176, P795, DOI 10.1164/rccm.200610-1534OC Vincent JL, 1996, INTENS CARE MED, V22, P707, DOI 10.1007/BF01709751 Wang HE, 2012, AM J NEPHROL, V35, P349, DOI 10.1159/000337487 Wynants L, 2020, BMJ-BRIT MED J, V369, DOI 10.1136/bmj.m1328 Yang X, 2020, LANCET RESP MED, V8, pE26 Zhou F, 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 38 TC 111 Z9 112 U1 0 U2 7 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 MAY PY 2020 VL 9 IS 5 AR 1548 DI 10.3390/jcm9051548 PG 16 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA LY0OO UT WOS:000540223800305 PM 32443899 OA gold, Green Published DA 2023-05-13 ER PT J AU Yamamoto, K Goto, T Ohira, T Kato, R Konno, Y Aoki, K Ogasawara, J Kimura, M Minakawa, M Fukuda, I AF Yamamoto, Keigo Goto, Takeshi Ohira, Tomoyuki Kato, Ryutaro Konno, Yukiya Aoki, Kaori Ogasawara, Junko Kimura, Masaomi Minakawa, Masahito Fukuda, Ikuo TI The utility of extracorporeal membrane oxygenation in patients with circulatory collapse by electrical storm SO JOURNAL OF ARTIFICIAL ORGANS LA English DT Article DE Electrical storm; Extracorporeal membrane oxygenation; Acute coronary syndrome AB In patients experiencing electrical storm, intensive care using extracorporeal membrane oxygenation (ECMO) is an efficient treatment to overcome a hemodynamically unstable condition. The aim of this study was to examine the utility of ECMO in patients with circulatory collapse by electrical storm. We retrospectively examined 17 consecutive patients receiving veno-arterial ECMO for electrical storm between January 2016 and December 2018 in our institution. We compared survivors (n = 11) and non-survivors (n = 6). Thirteen were weaned from ECMO, of whom 11 patients (64.7%) survived and were discharged from hospital, while 6 patients died (35.3%). In comparisons between survivors and non-survivors, blood pH before starting ECMO was significantly higher in survivors (pH 7.32) than in non-survivors (pH 6.89, p = 0.027). Blood lactate level was significantly lower in survivors (6.2 mmol/L) than in non-survivors (12.2 mmol/L, p = 0.044). Complications of hypoxic ischemic encephalopathy were found in 4 non-survivors (66.7%), compared to survivors (0%, p = 0.006). Durations of intensive care unit stay and hospital stay were significantly longer in survivors (271 h, 62 days) than in non-survivors (50 h, 3 days, respectively). Outcomes of treatment using ECMO in patients with circulatory collapse due to electrical storm proved satisfactory. Increases in blood lactate level and decreases in blood pH before starting ECMO were thought to be related to mortality due to suspected irreversible organ damage by hypoxia before ECMO. C1 [Yamamoto, Keigo; Goto, Takeshi; Ohira, Tomoyuki; Kato, Ryutaro; Konno, Yukiya; Aoki, Kaori; Ogasawara, Junko] Hirosaki Univ, Dept Clin Engn, Sch Med & Hosp, 53 Hon Cho, Hirosaki, Aomori, Japan. [Kimura, Masaomi] Hirosaki Univ, Dept Cardiol, Grad Sch Med, Hirosaki, Aomori, Japan. [Minakawa, Masahito; Fukuda, Ikuo] Hirosaki Univ, Dept Thorac & Cardiovasc Surg, Grad Sch Med, Hirosaki, Aomori, Japan. C3 Hirosaki University; Hirosaki University; Hirosaki University RP Goto, T (通讯作者)，Hirosaki Univ, Dept Clin Engn, Sch Med & Hosp, 53 Hon Cho, Hirosaki, Aomori, Japan. 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Organs PD SEP PY 2021 VL 24 IS 3 BP 407 EP 411 DI 10.1007/s10047-020-01233-5 EA JAN 2021 PG 5 WC Engineering, Biomedical; Transplantation WE Science Citation Index Expanded (SCI-EXPANDED) SC Engineering; Transplantation GA UD4CO UT WOS:000608654400003 PM 33459912 DA 2023-05-13 ER PT J AU Turin, A Pandit, J Stone, NJ AF Turin, Alexander Pandit, Jay Stone, Neil J. TI Statins and Nonadherence: Should We RELATE Better? SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS LA English DT Review DE statin; nonadherence; ASCVD ID ACUTE CORONARY SYNDROMES; RANDOMIZED CONTROLLED-TRIAL; HEALTH-CARE COSTS; OF-THE-LITERATURE; PHYSICIAN-PATIENT COMMUNICATION; MEDICATION REFILL ADHERENCE; CARDIOVASCULAR RISK; MYOCARDIAL-INFARCTION; PRIMARY PREVENTION; DISEASE METAANALYSIS AB Statin nonadherence is a major challenge to optimal management. Patients nonadherent to statin therapy do not receive the expected benefit relative to the degree of low-density lipoprotein cholesterol (LDL-C) lowering obtained. This is important because new evidence guidelines recommend statins as the first-line therapy for those in high-risk groups (secondary prevention, patients with diabetes 40-75 years of age, and LDL-C 190 mg/dL) and in selected primary prevention patients. Statin assignment in the latter group occurs only in those with an estimated 7.5% 10-year atherosclerotic cardiovascular disease risk after shared decision making in a clinician-patient risk discussion. However, in numerous studies, statin nonadherence shows little or no benefit in reducing cardiovascular events or mortality compared to placebo, effectively negating the risk reduction expected from statin use and concomitantly increasing the total cost of health care. The causes and solutions for nonadherence are multifactorial and include patient, clinician, and health system factors. We believe that a clinician-patient partnership that facilitates patients' understanding of the potential for optimal benefit with the least adverse effects is an important first step toward improving adherence. A transtheoretical model of stages of behavior change helps clinicians address many of the common factors limiting adherence to statins. We conclude with a teaching tool emphasizing a structured approach to statin therapy with patient-centered risk discussions. C1 [Turin, Alexander] Loyola Univ, Dept Internal Med, Med Ctr, Maywood, IL 60153 USA. [Pandit, Jay; Stone, Neil J.] Northwestern Univ, Bluhm Cardiovasc Inst, Dept Cardiol, Chicago, IL USA. C3 Loyola University Chicago; Northwestern University RP Turin, A (通讯作者)，Loyola Univ, Dept Internal Med, Med Ctr, 2160S Ist Ave,Room 7609, Maywood, IL 60153 USA. 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Cardiovasc. Pharmacol. Ther. PD SEP PY 2015 VL 20 IS 5 BP 447 EP 456 DI 10.1177/1074248415578170 PG 10 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 CP5KR UT WOS:000359921200001 PM 25827856 DA 2023-05-13 ER PT J AU Tcheugui, JBE Guan, J Fu, LD Retnakaran, R Shah, BR AF Tcheugui, Justin B. Echouffo Guan, Jun Fu, Longdi Retnakaran, Ravi Shah, Baiju R. TI Association of Concomitant Gestational Hypertensive Disorders and Gestational Diabetes With Cardiovascular Disease SO JAMA NETWORK OPEN LA English DT Article ID RISK-FACTORS; PREGNANCY; WOMEN; MELLITUS; OUTCOMES; PREVALENCE; VALIDATION; ONTARIO; HISTORY; TRENDS AB IMPORTANCE Accruing evidence suggests that gestational hypertensive disorders (GHTD) and gestational diabetes (GD) are each associated with an increased risk of cardiovascular disease (CVD). However, the extent to which the co-occurrence of GHTD and GD is associated with the risk of CVD remains largely unknown. OBJECTIVE To estimate the individual and joint associations of GHTD and GD with incident CVD. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study used the Ministry of Health and Long-Term Care of Ontario (Canada) health care administrative databases. All women in Ontario with a GHTD and/or GD diagnosis, and a live-birth singleton delivery between July 1, 2007, and March 31, 2018, were considered for inclusion. Women with pregravid diabetes, hypertension, or cardiovascular disease were excluded. Statistical analysis was performed from November 2021 to September 2022. EXPOSURES GD and/or GHTD, defined using diagnosis coding. MAIN OUTCOMES AND MEASURES Individual and joint associations of GHTD and GD with incident CVD (including a composite of myocardial infarction, acute coronary syndrome, stroke, coronary artery bypass grafting, percutaneous coronary intervention, or carotid endarterectomy), estimated using Cox regression models, adjusting for relevant cardiometabolic risk factors. The follow-up extended from the index pregnancy until March 31, 2020. RESULTS Among 886 295 eligible women (mean [SD] age, 30 [5.6] years; 43 861 [4.9%] with isolated GHTD, 54 061 [6.1%] with isolated GD, and 4975 [0.6%] with GHTD and GD), there were 1999 CVD events over 12 years of follow-up. In the early postpartum phase (first 5 years post partum), there was no association of co-occurrence of GTHD and GD (adjusted hazard ratio [a HR], 1.42, 95% CI, 0.78-2.58) or GD alone (aHR, 0.80; 95% CI, 0.60-1.06) with CVD; there was an association between isolated GTHD and incident CVD compared with no GTHD and no GD (aHR, 1.90; 95% Cl, 1.51-2.35). In the late postpartum period (after the initial 5 years post partum), compared with no GD and no GHTD, isolated GHTD (aHR, 1.41, 95% CI, 1.12-1.76) and co-occurrence of GHTD and GD (aHR, 2.43, 95% CI, 1.60-3.67) were each associated with a higher risk of incident CVD. There was no association between isolated GD and incident CVD. CONCLUSIONS AND RELEVANCE In this cohort study, GHTD was associated with a high risk of CVD post partum, and the co-occurrence of GD and GHTD was associated with a much greater postpartum CVD risk. These findings suggest that CVD preventive care is particularly needed in the aftermath of combined GD and GHTD. C1 [Tcheugui, Justin B. Echouffo] Johns Hopkins Univ, Dept Med, Div Endocrinol Diabet & Metab, Baltimore, MD USA. [Guan, Jun; Fu, Longdi; Shah, Baiju R.] Inst Clin Evaluat Sci, Toronto, ON, Canada. [Retnakaran, Ravi] Mt Sinai Hosp, Leadership Sinai Ctr Diabet, Toronto, ON, Canada. [Retnakaran, Ravi] Mt Sinai Hosp, Lunenfeld Tanenbaum Res Inst, Toronto, ON, Canada. [Retnakaran, Ravi; Shah, Baiju R.] Univ Toronto, Div Endocrinol, Toronto, ON, Canada. [Shah, Baiju R.] Sunnybrook Hlth Sci Ctr, Dept Med, Toronto, ON, Canada. [Shah, Baiju R.] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada. C3 Johns Hopkins University; University of Toronto; University of Toronto; Sinai Health System Toronto; Lunenfeld Tanenbaum Research Institute; University of Toronto; Sinai Health System Toronto; Lunenfeld Tanenbaum Research Institute; University of Toronto; University of Toronto; Sunnybrook Health Science Center; Sunnybrook Research Institute; University of Toronto RP Tcheugui, JBE (通讯作者)，Johns Hopkins Univ, Sch Med, 5501 Hopkins Bayview Circle, Baltimore, MD 21224 USA. EM jechouf1@jhmi.edu FU Ontario Ministry of Health and LongTerm Care (MOHLTC); NIH/NHLBI [K23 HL153774]; Johns Hopkins School of Medicine Diversity Award; Sun Life Financial Program FX The ICES is a nonprofit research institute funded by the Ontario Ministry of Health and LongTerm Care (MOHLTC) that provided data used in the study. Parts of this report are based on data or information compiled and provided by Canadian Institute for Health Information (CIHI). Dr Echouffo Tcheugui was supported by the NIH/NHLBI grant K23 HL153774, and the Johns Hopkins School of Medicine Diversity Award. Dr Retnakaran holds the Boehringer Ingelheim Chair in Beta-cell Preservation, Function and Regeneration at Mount Sinai Hospital (Toronto, Ontario, Canada) and his research program is supported by the Sun Life Financial Program to Prevent Diabetes inWomen. 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Open PD NOV 23 PY 2022 VL 5 IS 11 AR e2243618 DI 10.1001/jamanetworkopen.2022.43618 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 7B2CE UT WOS:000898947400006 PM 36416822 OA Green Published, gold DA 2023-05-13 ER PT J AU Maddison, R Jiang, YN Stewart, R Scott, T Kerr, A Whittaker, R Benatar, J Rolleston, A Estabrooks, P Dale, L AF Maddison, Ralph Jiang, Yannan Stewart, Ralph Scott, Tony Kerr, Andrew Whittaker, Robyn Benatar, Jocelyn Rolleston, Anna Estabrooks, Paul Dale, Leila TI An Intervention to Improve Medication Adherence in People With Heart Disease (Text4HeartII): Randomized Controlled Trial SO JMIR MHEALTH AND UHEALTH LA English DT Article DE cardiovascular disease; self-management; text messaging; risk factors ID BEHAVIOR-CHANGE INTERVENTIONS; RE-AIM FRAMEWORK; MOBILE TECHNOLOGIES; HEALTH-PROMOTION; SELF-MANAGEMENT; CARE AB Background: Mobile health technologies have the potential to improve the reach and delivery of interventions for promoting long-term secondary prevention of coronary heart disease. Objective: This study aims to determine the effectiveness of an SMS text messaging intervention (Text4HeartII) for improving adherence to medication and lifestyle changes over and above usual care in people with coronary heart disease at 24 and 52 weeks. Methods: A two-arm, parallel, randomized controlled trial was conducted in New Zealand. Participants with a recent acute coronary syndrome were randomized to receive usual cardiac services alone (control, n=153) or a 24-week SMS text message program for supporting self-management plus usual cardiac services (n=153). The primary outcome was adherence to medication at 24 weeks, defined as a medication possession ratio of 80% or more for aspirin, statin, and antihypertensive therapy. Secondary outcomes included medication possession ratio at 52 weeks, self-reported medication adherence, adherence to healthy lifestyle behaviors, and health-related quality of life at 24 and 52 weeks. Results: Participants were predominantly male (113/306, 80.3%) and European New Zealanders (210/306, 68.6%), with a mean age of 61 years (SD 11 years). Groups were comparable at baseline. National hospitalization and pharmacy dispensing records were available for all participants; 92% (282/306, 92.1%) of participants completed a 24-week questionnaire and 95.1% (291/306) of participants completed a 52-week questionnaire. Adherence with 3 medication classes were lower in the intervention group than in the control group (87/153, 56.8% vs 105/153, 68.6%, odds ratio 0.60, 95% CI 0.38-0.96; P=.03) and 52 weeks (104/153, 67.9% vs 83/153, 54.2%; odds ratio 0.56, 95% CI 0.35-0.89; P=.01). Self-reported medication adherence scores showed the same trend at 52 weeks (mean difference 0.3; 95% CI 0.01-0.59; P=.04). Moreover, self-reported adherence to health-related behaviors was similar between groups. Conclusions: Text4HeartII did not improve dispensed medication or adherence to a favorable lifestyle over and above usual care. This finding contrasts with previous studies and highlights that the benefits of text interventions may depend on the context in which they are used. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12616000422426; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370398. International Registered Report Identifier (IRRID): RR2-10.1186/s13063-018-2468-z C1 [Maddison, Ralph] Deakin Univ, Inst Phys Act & Nutr, 221 Burwood Highway, Burwood 3125, Australia. [Jiang, Yannan] Univ Auckland, Dept Stat, Auckland, New Zealand. [Stewart, Ralph; Benatar, Jocelyn] Auckland Dist Hlth Board, Dept Cardiol, Auckland, New Zealand. [Scott, Tony] Waitemata Dist Hlth Board, Dept Cardiol, Auckland, New Zealand. [Kerr, Andrew] Univ Auckland, Sect Epidemiol & Biostat, Auckland, New Zealand. [Kerr, Andrew] Univ Auckland, Sch Med, Auckland, New Zealand. [Whittaker, Robyn; Dale, Leila] Univ Auckland, Natl Inst Hlth Innovat, Auckland, New Zealand. [Whittaker, Robyn] Waitemata Dist Hlth Board, Auckland, New Zealand. [Rolleston, Anna] Ctr Hlth, Tauranga, New Zealand. [Estabrooks, Paul] Univ Nebraska Med Ctr, Dept Hlth Promot Social & Behav Hlth, Omaha, NE USA. C3 Deakin University; University of Auckland; Auckland District Health Board; University of Auckland; University of Auckland; University of Auckland; University of Nebraska System; University of Nebraska Medical Center RP Maddison, R (通讯作者)，Deakin Univ, Inst Phys Act & Nutr, 221 Burwood Highway, Burwood 3125, Australia. EM ralph.maddison@deakin.edu.au OI Jiang, Yannan/0000-0002-7663-9164; Rolleston, Anna/0000-0002-4804-8869; Scott, Tony/0000-0003-4149-699X; Whittaker, Robyn/0000-0003-0901-9149; Estabrooks, Paul/0000-0003-2261-9886; Maddison, Ralph/0000-0001-8564-5518; benatar, jocelyne/0000-0002-6724-8997 FU Health Research Council of New Zealand; National Heart Foundation FX The authors would like to thank all the participants involved in the Text4HeartII trial. The authors would also like to acknowledge the participating hospitals (Auckland, North Shore, and Waitakere) and the cardiac staff who assisted with recruitment and conduct of the trial. Finally, the authors wish to thank the Vascular Informatics Using Epidemiology and the Web and the ANZACS-QI teams for providing access to data for this study. The Text4HeartII trial was funded by the Health Research Council of New Zealand and the National Heart Foundation. 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Rhudy, Lori M. Chamberlain, Alanna M. DeVon, Holli A. TI Fatigue, dyspnea, and intermittent symptoms are associated with treatment-seeking delay for symptoms of atrial fibrillation before diagnosis SO EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE Atrial fibrillation; treatment-seeking delay; symptom representation; Leventhal's common sense model of self-regulation; patient education ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; NURSE-LED CARE; PREHOSPITAL DELAY; TIME; BURDEN; STROKE; RISK; POPULATION; SURVIVAL AB Background: Delay in seeking treatment for symptoms of atrial fibrillation (AF) at onset results in a missed opportunity for vital early treatment of AF which is important for reducing stroke, tachycardia induced heart failure, and treatment-resistant AF. Little is known about factors that contribute to treatment-seeking delay for symptoms of AF. Purpose: The purpose of this study was to identify factors associated with treatment-seeking delay for symptoms of AF before diagnosis. Methods: For this descriptive study, 150 participants with recently detected AF completed structured interviews to collect data about symptoms, symptom characteristics, symptom representation regarding cause, seriousness, controllability of symptoms, responses to symptoms before diagnosis, and time from symptom onset to treatment-seeking. Chi-square analysis was used to identify factors associated with delay (>1 week) versus no delay (1 week) in treatment-seeking after symptom onset. Results: Participants were 51% female (n=76) with a mean age of 66.5 (standard deviation (SD)11.1) years. A majority (70%, n=105) delayed treatment-seeking. Factors associated with delay included experiencing fatigue, dyspnea, intermittent symptoms, attributing symptoms to deconditioning, overwork, inadequate sleep, and perceiving symptoms as not very serious and amenable to self-management. Responses such as a wait and see approach, working through symptoms, reporting no fear of symptoms, or attempting to ignore symptoms were associated with delay. Conclusion: Experiencing fatigue, dyspnea and intermittent symptoms produced symptom representations and emotional and behavioral responses associated with treatment-seeking delay. There is a critical need to develop and test educational interventions to increase awareness of the spectrum and characteristics of AF symptoms and appropriate treatment-seeking behaviors. C1 [McCabe, Pamela J.; Rhudy, Lori M.] Mayo Clin, Dept Nursing, SL 41-E,200 First St SW, Rochester, MN 55905 USA. [Rhudy, Lori M.] Univ Minnesota, Sch Nursing, Minneapolis, MN 55455 USA. [Chamberlain, Alanna M.] Mayo Coll Med, Div Epidemiol, Rochester, MN USA. [DeVon, Holli A.] Univ Illinois, Coll Nursing, Chicago, IL USA. C3 Mayo Clinic; University of Minnesota System; University of Minnesota Twin Cities; Mayo Clinic; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital RP McCabe, PJ (通讯作者)，Mayo Clin, Dept Nursing, SL 41-E,200 First St SW, Rochester, MN 55905 USA. EM mccabe.pamela2@mayo.edu RI Rhudy, Lori/AAC-2696-2022 OI Rhudy, Lori/0000-0002-2537-6368; Chamberlain, Alanna/0000-0003-1888-9584; DeVon, Holli/0000-0002-4526-9631 CR Alshahrani H, 2014, EUR J CARDIOVASC NUR, V13, P399, DOI 10.1177/1474515113507159 American Heart Association, 2014, SYMPT DIAGN HEART AT Antic NA, 2009, AM J RESP CRIT CARE, V179, P501, DOI 10.1164/rccm.200810-1558OC Arrhythmia Alliance, 2012, KNOW YOUR PULS Ball J, 2013, INT J CARDIOL, V167, P1807, DOI 10.1016/j.ijcard.2012.12.093 Boriani G, 2014, EUR HEART J, V35, P508, DOI 10.1093/eurheartj/eht491 BURNETT RE, 1995, AM J CARDIOL, V75, P1019, DOI 10.1016/S0002-9149(99)80716-4 Camm AJ, 2010, EUROPACE, V12, P1360, DOI [10.1093/europace/euq350, 10.1093/eurheartj/ehq278] Chugh SS, 2014, CIRCULATION, V129, P837, DOI 10.1161/CIRCULATIONAHA.113.005119 Cosio FG, 2008, EUROPACE, V10, P21, DOI 10.1093/europace/eum276 DeVon HA, 2010, J CARDIOVASC NURS, V25, P106, DOI 10.1097/JCN.0b013e3181bb14a0 Glotzer T, 2009, CIRC-ARRHYTHMIA ELEC, V2, P274 Gupta S, 2014, INT J CARDIOL, V172, P40, DOI 10.1016/j.ijcard.2013.12.180 Harbman P, 2014, INT J NURS STUD, V51, P1542, DOI 10.1016/j.ijnurstu.2014.04.004 Hendriks JML, 2012, EUR HEART J, V33, P2692, DOI 10.1093/eurheartj/ehs071 Hwang SY, 2012, EUR J CARDIOVASC NUR, V11, P154, DOI 10.1016/j.ejcnurse.2010.11.002 Jaarsma T, 2006, Eur J Cardiovasc Nurs, V5, P197, DOI 10.1016/j.ejcnurse.2006.04.002 January CT, 2014, J AM COLL CARDIOL, V64, P2304, DOI 10.1016/j.jacc.2014.04.004 Jiang XL, 2007, J CLIN NURS, V16, P1886, DOI 10.1111/j.1365-2702.2007.01838.x Kallmunzer B, 2014, NEUROLOGY, V83, P598, DOI 10.1212/WNL.0000000000000690 Kerr CR, 2005, AM HEART J, V149, P489, DOI 10.1016/j.ahj.2004.09.053 King KB, 2007, HEART LUNG, V36, P235, DOI 10.1016/j.hrtlng.2006.08.008 LAUPACIS A, 1992, CHEST, V102, pS426, DOI 10.1378/chest.102.4_Supplement.426S Leventhal H., 2012, HDB HLTH PSYCHOL, V2nd, P3 Lovlien M, 2007, Eur J Cardiovasc Nurs, V6, P308, DOI 10.1016/j.ejcnurse.2007.03.002 McCabe PJ, 2016, WESTERN J NURS RES, V38, P200, DOI 10.1177/0193945915570368 McCabe PJ, 2015, J CLIN NURS, V24, P786, DOI 10.1111/jocn.12708 McCabe PJ, 2011, J CARDIOVASC NURS, V26, P336, DOI 10.1097/JCN.0b013e31820019b9 McKinley S, 2000, HEART LUNG, V29, P237, DOI 10.1067/mhl.2000.106940 Moser DK, 2007, J CARDIOVASC NURS, V22, P326, DOI 10.1097/01.JCN.0000278963.28619.4a Munschauer Frederick E 3rd, 2004, J Stroke Cerebrovasc Dis, V13, P208, DOI 10.1016/j.jstrokecerebrovasdis.2004.08.001 Nymark C, 2014, EUR J CARDIOVASC NUR, V13, P41, DOI 10.1177/1474515113475953 O'Donnell S, 2014, J EMERG MED, V46, P507, DOI 10.1016/j.jemermed.2013.08.038 Rienstra M, 2012, CIRCULATION, V125, P2933, DOI 10.1161/CIRCULATIONAHA.111.069450 Rohrbacker NJ, 2010, J OCCUP ENVIRON MED, V52, P383, DOI 10.1097/JOM.0b013e3181d967bc Sheifer SE, 2000, CIRCULATION, V102, P1651, DOI 10.1161/01.CIR.102.14.1651 Stewart S, 2015, LANCET, V385, P775, DOI 10.1016/S0140-6736(14)61992-9 Stromberg A, 2003, EUR HEART J, V24, P1014, DOI 10.1016/S0195-668X(03)00112-X Thrall G, 2006, AM J MED, V119, DOI 10.1016/jamjmed.2005.10.057 Virtanen R, 2014, EUR J PREV CARDIOL, V21, P1437, DOI 10.1177/2047487313494041 WOLF PA, 1991, STROKE, V22, P983, DOI 10.1161/01.STR.22.8.983 Zerwic JJ, 2003, NURS RES, V52, P159, DOI 10.1097/00006199-200305000-00005 NR 42 TC 20 Z9 20 U1 2 U2 15 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 OCT PY 2016 VL 15 IS 6 BP 459 EP 468 DI 10.1177/1474515115603901 PG 10 WC Cardiac & Cardiovascular Systems; Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology; Nursing GA DY0UX UT WOS:000384812800008 PM 26318825 DA 2023-05-13 ER PT J AU Vo, TN Kats, AM Langsetmo, L Taylor, BC Schousboe, JT Redline, S Kunisaki, KM Stone, KL Ensrud, KE AF Vo, Tien N. Kats, Allyson M. Langsetmo, Lisa Taylor, Brent C. Schousboe, John T. Redline, Susan Kunisaki, Ken M. Stone, Katie L. Ensrud, Kristine E. CA Osteoporotic Fractures Men MrOS St TI Association of sleep-disordered breathing with total healthcare costs and utilization in older men: the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study SO SLEEP LA English DT Article DE sleep-disordered breathing; sleep apnea; Medicare; hospitalization; healthcare costs and utilizations; older men ID CORONARY-HEART-DISEASE; OSTEOPOROTIC FRACTURES; APNEA SYNDROME; CARDIAC-ARRHYTHMIA; TELOMERE LENGTH; DETERMINANTS; MORBIDITY; DESIGN; RISK AB Study Objectives: To determine the associations of sleep-disordered breathing (SDB) with subsequent healthcare costs and utilization including inpatient and post-acute care facility stays among community-dwelling older men. Methods: Participants were 1,316 men (mean age 76.1 [SD = 5.7] years) in the Outcomes of Sleep Disorders in Older Men (MrOS sleep) study (from December 2003 to March 2005), who were enrolled in a Medicare Fee-For-Service plan. Primary SDB measures including apnea hypopnea index (AHI) and oxygen desaturation index (ODI) were collected using in-home level 2 polysomnography. Incident healthcare costs and utilization were determined from claims data in the subsequent 3-year period post-MrOS sleep visit. Results: Five hundred and twenty-nine (40.2%) men had at least one hospitalization in the 3-year period. Compared with those without sleep apnea (AHI < 5/hour), men with moderate to severe sleep apnea (AHI = 15/hour) had a higher odds of all-cause hospitalization (odds ratio [OR] adjusted for age and site 1.43, 95% confidence interval [CI]: 1.07-1.90). This association was slightly attenuated after further adjustment for traditional prognostic factors including education, body mass index, comorbid medical conditions, and health status (OR = 1.36; 95% CI: 1.01-1.83). Similar associations were observed for ODI. However, measures of SDB were not related to subsequent healthcare costs (total or outpatient) or odds of post-acute skilled nursing facility stay. Conclusions: Older men with SDB have an increased risk of hospitalization, not entirely explained by the greater prevalence of comorbid conditions, but not higher subsequent total healthcare costs. These findings indicate a need to evaluate the impact of SDB treatment on subsequent healthcare utilization. C1 [Vo, Tien N.; Kats, Allyson M.; Langsetmo, Lisa; Taylor, Brent C.; Ensrud, Kristine E.] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA. [Taylor, Brent C.; Kunisaki, Ken M.; Ensrud, Kristine E.] Univ Minnesota, Dept Med, Box 736 UMHC, Minneapolis, MN 55455 USA. [Taylor, Brent C.; Ensrud, Kristine E.] VA Hlth Care Syst, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. [Schousboe, John T.] Pk Nicollet Clin, Minneapolis, MN USA. [Schousboe, John T.] HealthPartners Inst, Minneapolis, MN USA. [Schousboe, John T.] Univ Minnesota, Div Hlth Policy & Management, Minneapolis, MN USA. [Redline, Susan] Harvard Med Sch, Dept Med, Brigham & Womens Hosp, Boston, MA 02115 USA. [Redline, Susan] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA. [Kunisaki, Ken M.] Minneapolis VA Hlth Care Syst, Pulm & Sleep, Minneapolis, MN USA. [Stone, Katie L.] Calif Pacific Med Ctr Res Inst, San Francisco, CA USA. C3 University of Minnesota System; University of Minnesota Twin Cities; University of Minnesota System; University of Minnesota Twin Cities; University of Minnesota System; University of Minnesota Twin Cities; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; US Department of Veterans Affairs; Veterans Health Administration (VHA); Minneapolis VA Health Care System; California Pacific Medical Center; California Pacific Medical Center Research Institute RP Vo, TN (通讯作者)，One Vet Dr 111-0, Minneapolis, MN 55417 USA. EM voxxx139@umn.edu RI Taylor, Brent C/A-8069-2009; Langsetmo, Lisa/T-2619-2017; Kunisaki, Ken/A-6950-2009 OI Taylor, Brent C/0000-0002-2140-8377; Langsetmo, Lisa/0000-0003-2245-1657; Kunisaki, Ken/0000-0001-8644-2827; Ensrud, Kristine/0000-0002-9069-3036 FU National Institute on Aging (NIA) [U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128]; National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) [U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128]; National Center for Advancing Translational Sciences (NCATS) [U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128]; NIH Roadmap for Medical Research [U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128]; National Heart, Lung, and Blood Institute (NHLBI) [5R35 HL135818, R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, R01 HL070839] FX The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128.; The National Heart, Lung, and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study "Outcomes of Sleep Disorders in Older Men" under the following grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839. Dr. Redline was supported in part by 5R35 HL135818. The funding agencies had no direct role in the conduct of the study; the collection, management, analyses, and interpretation of the data; or preparation or approval of the manuscript. 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Blankstein, Ron TI Causes of Troponin Elevation and Associated Mortality in Young Patients SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Cardiac contusion; Cardiac troponin; Cardiomyopathy; End-stage renal disease; Myocardial infarction; Myocarditis; Myositis; Pulmonary embolism; Rhabdomyolysis; Seizure; Stroke; Subarachnoid hemorrhage ID MYOCARDIAL-INFARCTION; HOSPITALIZED-PATIENTS; PROGNOSTIC IMPLICATIONS; CARDIAC TROPONINS; CORONARY SYNDROME; CHEST-PAIN; DISEASE; DEATH; RISK; OUTCOMES AB BACKGROUND: While increased serum troponin levels are often due to myocardial infarction, increased levels may also be found in a variety of other clinical scenarios. Although these causes of troponin elevation have been characterized in several studies in older adults, they have not been well characterized in younger individuals. METHODS: We conducted a retrospective review of patients 50 years of age or younger who presented with elevated serum troponin levels to 2 large tertiary care centers between January 2000 and April 2016. Patients with prior known coronary artery disease were excluded. The cause of troponin elevation was adjudicated via review of electronic medical records. All-cause death was determined using the Social Security Administration's death master file. RESULTS: Of the 6081 cases meeting inclusion criteria, 3574 (58.8%) patients had a myocardial infarction, while 2507 (41.2%) had another cause of troponin elevation. Over a median follow-up of 8.7 years, all-cause mortality was higher in patients with nonmyocardial infarction causes of troponin elevation compared with those with myocardial infarction (adjusted hazard ratio [HR] 1.30; 95% confidence interval [CI], 1.15-1.46; P < .001). Specifically, mortality was higher in those with central nervous system pathologies (adjusted HR 2.21; 95% CI, 1.85-2.63; P < .001), nonischemic cardiomyopathies (adjusted HR 1.66; 95% CI, 1.37-2.02; P < .001), and end-stage renal disease (adjusted HR 1.36; 95% CI, 1.07-1.73; P = .013). However, mortality was lower in patients with myocarditis compared with those with an acute myocardial infarction (adjusted HR 0.43; 95% CI:, 0.31-0.59; P < .001). CONCLUSION: There is a broad differential for troponin elevation in young patients, which differs based on demographic features. Most nonmyocardial infarction causes of troponin elevation are associated with higher all-cause mortality compared with acute myocardial infarction. (C) 2018 Elsevier Inc. All rights reserved. C1 [Wu, Candace; Singh, Avinainder; Collins, Bradley; Fatima, Amber; Gupta, Ankur; Hainer, Jon; Klein, Josh; Di Carli, Marcelo; Blankstein, Ron] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Cardiovasc Imaging Program, Boston, MA USA. [Wu, Candace; Singh, Avinainder; Collins, Bradley; Fatima, Amber; Gupta, Ankur; Hainer, Jon; Klein, Josh; Di Carli, Marcelo; Blankstein, Ron] Harvard Med Sch, Brigham & Womens Hosp, Dept Radiol, Cardiovasc Imaging Program, Boston, MA USA. [Qamar, Arman; Bhatt, Deepak L.] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Div Cardiovasc, Boston, MA USA. [Jarolim, Petr] Harvard Med Sch, Brigham & Womens Hosp, Dept Pathol, Boston, MA USA. [Nasir, Khurram] Baptist Hlth South Florida, Miami Cardiac & Vasc Inst, Miami, FL USA. C3 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; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Baptist Cardiac & Vascular Institute RP Blankstein, R (通讯作者)，Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA. EM rblankstein@bwh.harvard.edu RI Singh, Avinainder/AAJ-2920-2020 OI Singh, Avinainder/0000-0003-1717-005X; Hainer, Jon/0000-0002-0572-912X CR Apple FS, 2002, CIRCULATION, V106, P2941, DOI 10.1161/01.CIR.0000041254.30637.34 Baillard C, 2003, INTENS CARE MED, V29, P584, DOI 10.1007/s00134-003-1635-0 Bangalore S, 2012, AM J MED, V125, P1000, DOI 10.1016/j.amjmed.2011.11.016 Becattini C, 2007, CIRCULATION, V116, P427, DOI 10.1161/CIRCULATIONAHA.106.680421 Blich M, 2008, AM J CARDIOL, V101, P1384, DOI 10.1016/j.amjcard.2008.01.011 Brown JL, 2012, PEDIATR CARDIOL, V33, P337, DOI 10.1007/s00246-011-0149-8 Chua SK, 2010, CLIN CARDIOL, V33, P140, DOI 10.1002/clc.20718 Davis MB, 2014, CLIN CARDIOL, V37, P395, DOI 10.1002/clc.22263 de Lemos JA, 2010, JAMA-J AM MED ASSOC, V304, P2503, DOI 10.1001/jama.2010.1768 Dhesi S, 2015, CAN J CARDIOL, V31, P296, DOI 10.1016/j.cjca.2014.11.032 Doughty M, 2002, AM HEART J, V143, P56, DOI 10.1067/mhj.2002.120300 Everett BM, 2015, NEW ENGL J MED, V373, P610, DOI 10.1056/NEJMoa1415921 Foo RSY, 2005, J CLIN INVEST, V115, P565, DOI 10.1172/JCI200524569 Freda BJ, 2002, J AM COLL CARDIOL, V40, P2065, DOI 10.1016/S0735-1097(02)02608-6 Gaggin HK, 2017, CIRCULATION, V135, P116, DOI 10.1161/CIRCULATIONAHA.116.023052 Harvell B, 2016, AM J EMERG MED, V34, P145, DOI 10.1016/j.ajem.2015.09.037 Hijazi Z, 2012, CIRCULATION, V125, P1605, DOI 10.1161/CIRCULATIONAHA.111.038729 HOIT BD, 1986, CIRCULATION, V74, P712, DOI 10.1161/01.CIR.74.4.712 Kerr G, 2009, CEREBROVASC DIS, V28, P220, DOI 10.1159/000226773 Korff S, 2006, HEART, V92, P987, DOI 10.1136/hrt.2005.071282 Masson S, 2016, CRIT CARE MED, V44, P707, DOI 10.1097/CCM.0000000000001473 MAYER SA, 1994, NEUROLOGY, V44, P815, DOI 10.1212/WNL.44.5.815 Naidech AM, 2005, CIRCULATION, V112, P2851, DOI 10.1161/CIRCULATIONAHA.105.533620 Pagidipati NJ, 2013, CIRCULATION, V127, P749, DOI 10.1161/CIRCULATIONAHA.112.128413 Pandey A, 2017, JAMA CARDIOL, V2, P136, DOI 10.1001/jamacardio.2016.4726 SAMUELS M A, 1987, American Journal of Cardiology, V60, p15J, DOI 10.1016/0002-9149(87)90678-3 Schwartz MC, 2013, CARDIOL YOUNG, V23, P353, DOI 10.1017/S1047951112001278 Scirica BM, 2016, JAMA CARDIOL, V1, P989, DOI 10.1001/jamacardio.2016.3030 Thankavel PP, 2014, CARDIOL YOUNG, V24, P283, DOI 10.1017/S1047951113000231 Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Thygesen K, 2010, EUR HEART J, V31, P2197, DOI 10.1093/eurheartj/ehq251 Twerenbold R, 2012, EUR HEART J, V33, P579, DOI 10.1093/eurheartj/ehr492 US Census Bureau, 2015, HOUS INC 12 MONTHS 2 Vaduganathan M, 2017, AM J NEPHROL, V45, P301, DOI 10.1159/000458453 Vaduganathan M, 2016, AM J NEPHROL, V43, P170, DOI 10.1159/000445363 Wencker D, 2003, J CLIN INVEST, V111, P1497, DOI 10.1172/JCI200317664 Wrigley P, 2017, STROKE, V48, P1226, DOI 10.1161/STROKEAHA.116.014561 NR 37 TC 28 Z9 29 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0002-9343 EI 1555-7162 J9 AM J MED JI Am. J. Med. PD MAR PY 2018 VL 131 IS 3 BP 284 EP + DI 10.1016/j.amjmed.2017.10.026 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA FW1WY UT WOS:000425092300040 PM 29784201 OA Green Accepted DA 2023-05-13 ER PT J AU Lin, JH Wu, BX Lin, LQ Ding, YN Zhong, BY Huang, ZW Lin, MY Xu, DP AF Lin, Jinhai Wu, Bingxin Lin, Luoqi Ding, Yining Zhong, Biying Huang, Zhiwei Lin, Miaoyang Xu, Dan-Ping TI Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis SO BMJ OPEN LA English DT Review DE cardiomyopathy; thromboembolism; internal medicine ID CARDIOMYOPATHY; THERAPY; RECURRENCE; MORTALITY; OUTCOMES AB Introduction Takotsubo syndrome (TTS) is a sudden reversible weakening of the left ventricle function induced by severe stress and resembles many features as acute coronary syndrome. Even though many guidelines had been published about TTS, there is no consensus regarding the long-term treatment. Aspirin is one of the most common prescribed medicines at discharge for patients with the intention to reduce thrombus events and improve the overall prognosis. However, existing studies yielded conflicting results concerning its effects. This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management. Methods and analysis After searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TTS recurrence, stroke, transient ischaemic attack or myocardial infarction at 30-day and 5-year follow-up will be examined. Risk of bias will be assessed by Newcastle-Ottawa quality assessment scale for observational studies and Cochrane Effective Practice and Organization of Care evaluation tool for interventional studies. Grading of Recommendations Assessment, Development and Evaluations method will be applied to assess the quality of evidence. If available, the effects of aspirin on the above outcomes for patients with TTS will be evaluated using random-effect modelling with relative risk at 95% CIs. Subgroup analysis and sensitivity analysis will also be performed when possible. Ethics and dissemination Ethics approval was not required due to the retrospective nature of the study. Results of the review will be published in a peer-reviewed journal. PROSPERO registration number CRD42020212729. C1 [Lin, Jinhai; Wu, Bingxin; Lin, Luoqi; Ding, Yining; Zhong, Biying; Huang, Zhiwei; Lin, Miaoyang] Guangzhou Univ Chinese Med, Clin Med Coll 2, Guangzhou, Peoples R China. [Xu, Dan-Ping] Sun Yat Sen Univ, Dept Tradit Chinese Med, Affiliated Hosp 8, Shenzhen, Peoples R China. C3 Guangzhou University of Chinese Medicine; Sun Yat Sen University RP Xu, DP (通讯作者)，Sun Yat Sen Univ, Dept Tradit Chinese Med, Affiliated Hosp 8, Shenzhen, Peoples R China. EM xudanping@hotmail.com OI zhong, bi ying/0000-0001-5307-1695; Lin, Jinhai/0000-0003-0745-0904 CR Abanador-Kamper N, 2017, BMC CARDIOVASC DISOR, V17, DOI 10.1186/s12872-017-0661-8 Akashi YJ, 2008, CIRCULATION, V118, P2754, DOI 10.1161/CIRCULATIONAHA.108.767012 Anfossi G, 1996, EUR J CLIN INVEST, V26, P353, DOI 10.1046/j.1365-2362.1996.150293.x Bertaina M, 2017, EUR HEART J, V38, P647 Boland TA, 2015, CRIT CARE MED, V43, P686, DOI 10.1097/CCM.0000000000000851 Moreno CCC, 2018, EUR J HEART FAIL, V20, P487 Dastidar AG, 2015, HEART FAIL REV, V20, P415, DOI 10.1007/s10741-015-9489-4 Deshmukh A, 2012, AM HEART J, V164, P66, DOI 10.1016/j.ahj.2012.03.020 Dias A, 2016, HEART VESSELS, V31, P1285, DOI 10.1007/s00380-015-0729-2 Dias AM, 2020, J AM COLL CARDIOL, V75, P879 El-Battrawy I, 2019, ANGIOLOGY, V70, P838, DOI 10.1177/0003319719842682 Fazio G, 2008, INT J CARDIOL, V127, P121, DOI 10.1016/j.ijcard.2007.04.013 Ghadri JR, 2018, EUR HEART J, V39, P2047, DOI 10.1093/eurheartj/ehy077 Ghadri JR, 2018, EUR HEART J, V39, P2032, DOI 10.1093/eurheartj/ehy076 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] de Chazal HM, 2018, J AM COLL CARDIOL, V72, P1955, DOI 10.1016/j.jacc.2018.07.072 Pelliccia F, 2017, CIRCULATION, V135, P2426, DOI 10.1161/CIRCULATIONAHA.116.027121 Pirzer R, 2012, HEART VESSELS, V27, P186, DOI 10.1007/s00380-011-0132-6 Redfors B, 2015, INT J CARDIOL, V185, P282, DOI 10.1016/j.ijcard.2015.03.162 Santoro F, 2014, CLIN CARDIOL, V37, P434, DOI 10.1002/clc.22280 Stang A, 2010, EUR J EPIDEMIOL, V25, P603, DOI 10.1007/s10654-010-9491-z Stroup DF, 2000, JAMA-J AM MED ASSOC, V283, P2008, DOI 10.1001/jama.283.15.2008 Templin C, 2015, NEW ENGL J MED, V373, P929, DOI 10.1056/NEJMoa1406761 Templin C, 2016, J AM COLL CARDIOL, V67, P1937, DOI 10.1016/j.jacc.2016.03.006 Tornvall P, 2016, J AM COLL CARDIOL, V67, P1931, DOI 10.1016/j.jacc.2016.02.029 NR 25 TC 2 Z9 2 U1 1 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 2021 VL 11 IS 8 AR e046727 DI 10.1136/bmjopen-2020-046727 PG 4 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA TZ1BB UT WOS:000684209200003 PM 34376444 OA gold, Green Published DA 2023-05-13 ER PT J AU Ibrahim, K Christoph, M Schmeinck, S Schmieder, K Steiding, K Schoener, L Pfluecke, C Quick, S Mues, C Jellinghaus, S Wunderlich, C Strasser, RH Kolschmann, S AF Ibrahim, K. Christoph, M. Schmeinck, S. Schmieder, K. Steiding, K. Schoener, L. Pfluecke, C. Quick, S. Mues, C. Jellinghaus, S. Wunderlich, C. Strasser, R. H. Kolschmann, S. TI High rates of prasugrel and ticagrelor non-responder in patients treated with therapeutic hypothermia after cardiac arrest SO RESUSCITATION LA English DT Article DE Therapeutic hypothermia; Clopidogrel; Prasugrel; Ticagrelor; Non-responder ID PERCUTANEOUS CORONARY INTERVENTION; ACUTE MYOCARDIAL-INFARCTION; ADVERSE CARDIOVASCULAR EVENTS; CLOPIDOGREL RESISTANCE; PLATELET-AGGREGATION; VASP PHOSPHORYLATION; STENT THROMBOSIS; TASK-FORCE; RESPONSIVENESS; IMPLANTATION AB Introduction: After cardiac arrest due to acute coronary syndromes (ACS) therapeutic hypothermia (HT) is the standard care to reduce neurologic damage. Additionally, the concomitant medical treatment with aspirin and a P2Y12 receptor inhibitor like clopidogrel (Cl), prasugrel (Pr) or ticagrelor (Ti) is mandatory. The platelet inhibitory effect of these drugs under hypothermia remains unclear. Methods: 164 patients with ACS were prospectively enrolled in this study. 84 patients were treated with HT, 80 patients were under normothermia (NT). All patients were treated with aspirin and one of the P2Y12 receptor inhibitors Cl, Pr or Ti. 24 h after the initial loading dose the platelet reactivity index (PRI/VASP-index) was determined to achieve the platelet inhibitory effect. Results: In the HT-group the PRI/VASP-index was significantly higher compared to the NT-group (54.86% +/- 25.1 vs. 28.98% +/- 22.8; p < 0.001). In patients under HT receiving Cl, the platelet inhibition was most markedly reduced (HT vs. NT: 66.39% +/- 19.1 vs. 33.36% +/- 22.1; p < 0.001) compared to Pr (HT vs. NT: 37.6% +/- 25.0 vs. 27.04% +/- 25.5; p = 0.143) and Ti (HT vs. NT: 41.5% +/- 21.0 vs. 17.83% +/- 14.5; p = 0.009). The rate of non-responder defined as PRI/VASP-index > 50% was increased in HT compared to NT (60.7% vs. 22.5%; p < 0.001) with the highest rates in the group receiving Cl (CL: 82% vs. 26%, p < 0.001; Pr: 32% vs. 23%; n.s.; Ti: 30% vs. 8%, n.s.). Conclusion: The platelet inhibitory effect in patients treated with HT after cardiac arrest is significantly reduced. This effect was most marked with the use of Cl. The new P2Y12-inhibitors Pr and Ti improved platelet inhibition in HT, but could not completely prevent non-responsiveness. (C) 2014 Elsevier Ireland Ltd. All rights reserved. C1 [Ibrahim, K.; Christoph, M.; Schmeinck, S.; Schmieder, K.; Steiding, K.; Schoener, L.; Pfluecke, C.; Quick, S.; Mues, C.; Jellinghaus, S.; Wunderlich, C.; Strasser, R. H.; Kolschmann, S.] Tech Univ Dresden, Ctr Heart, Univ Hosp, Dept Internal Med & Cardiol, Dresden, Germany. C3 Technische Universitat Dresden; Carl Gustav Carus University Hospital; University of Hamburg; University Medical Center Hamburg-Eppendorf RP Ibrahim, K (通讯作者)，Tech Univ Dresden, Ctr Heart, Univ Hosp, Dept Internal Med & Cardiol, Dresden, Germany. EM karim.ibrahim@mailbox.tu-dresden.de RI Quick, Silvio/AAD-7848-2021 OI Quick, Silvio/0000-0002-8599-4790 CR Angiolillo DJ, 2009, AM J CARDIOL, V103, p27A, DOI 10.1016/j.amjcard.2008.11.020 [Anonymous], 2002, N ENGL J MED, V346, P549 Bauriedel G, 2003, AM HEART J, V145, P343 Ben-Dor I, 2009, AM J CARDIOL, V104, P227, DOI 10.1016/j.amjcard.2009.03.022 Bernard SA, 2002, NEW ENGL J MED, V346, P557, DOI 10.1056/NEJMoa003289 Bjelland TW, 2010, RESUSCITATION, V81, P1627, DOI 10.1016/j.resuscitation.2010.07.002 Bonello L, 2007, J THROMB HAEMOST, V5, P1630, DOI 10.1111/j.1538-7836.2007.02609.x Bonello L, 2008, J AM COLL CARDIOL, V51, P1404, DOI 10.1016/j.jacc.2007.12.044 Bonello L, 2011, J AM COLL CARDIOL, V58, P467, DOI 10.1016/j.jacc.2011.04.017 Cuisset T, 2012, HUM GENET, V131, P653, DOI 10.1007/s00439-011-1130-6 Erlinge D, 2013, EUROINTERVENTION, V8, P1435, DOI 10.4244/EIJV8I12A217 Flemming Kerstin, 2006, Ger Med Sci, V4, pDoc04 Ge HL, 2012, ANGIOLOGY, V63, P62, DOI 10.1177/0003319711406432 Geisler T, 2006, EUR HEART J, V27, P2420, DOI 10.1093/eurheartj/ehl275 Gurbel PA, 2010, CIRCULATION, V121, P1188, DOI 10.1161/CIRCULATIONAHA.109.919456 Hamm CW, 2011, EUR HEART J Hoye A, 2006, J AM COLL CARDIOL, V47, P1949, DOI 10.1016/j.jacc.2005.11.083 Iakovou I, 2005, JAMA-J AM MED ASSOC, V293, P2126, DOI 10.1001/jama.293.17.2126 Ibrahim K, 2008, CLIN RES CARDIOL, V97, P797, DOI 10.1007/s00392-008-0679-0 Kazui M, 2010, DRUG METAB DISPOS, V38, P92, DOI 10.1124/dmd.109.029132 Matetzky S, 2004, CIRCULATION, V109, P3171, DOI 10.1161/01.CIR.0000130846.46168.03 Matetzky S, 2008, AM J CARDIOL, V102, P524, DOI 10.1016/j.amjcard.2008.04.028 McNally B, 2011, MMWR SURVEILL SUMM, V60, P1 Mega JL, 2009, NEW ENGL J MED, V360, P354, DOI 10.1056/NEJMoa0809171 Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Mehta SR, 2001, LANCET, V358, P527, DOI 10.1016/S0140-6736(01)05701-4 Morel O., 2007, Annales de Cardiologie et d'Angeiologie, V56, P21, DOI 10.1016/j.ancard.2006.11.005 Nguyen NQ, 2008, INTENS CARE MED, V34, P454, DOI 10.1007/s00134-007-0942-2 Nguyen TA, 2005, J AM COLL CARDIOL, V45, P1157, DOI 10.1016/j.jacc.2005.01.034 Nolan JP, 2003, RESUSCITATION, V57, P231, DOI 10.1016/S0300-9572(03)00184-9 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] Osmancik P, 2010, CATHETER CARDIO INTE, V75, P158, DOI 10.1002/ccd.22248 Park DW, 2009, CIRCULATION, V120, P1987, DOI 10.1161/CIRCULATIONAHA.109.876763 Penela D, 2013, J AM COLL CARDIOL, V61, P686, DOI 10.1016/j.jacc.2012.10.029 Polderman KH, 2009, CRIT CARE MED, V37, pS186, DOI 10.1097/CCM.0b013e3181aa5241 Schwarz UR, 1999, THROMB HAEMOSTASIS, V82, P1145, DOI 10.1055/s-0037-1614344 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Testori C, 2011, RESUSCITATION, V82, P1162, DOI 10.1016/j.resuscitation.2011.05.022 Tortorici MA, 2007, CRIT CARE MED, V35, P2196, DOI 10.1097/01.CCM.0000281517.97507.6E 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 Zhou JQ, 2011, DRUG METAB DISPOS, V39, P2209, DOI 10.1124/dmd.111.040642 NR 42 TC 96 Z9 96 U1 0 U2 6 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0300-9572 J9 RESUSCITATION JI Resuscitation PD MAY PY 2014 VL 85 IS 5 BP 649 EP 656 DI 10.1016/j.resuscitation.2014.02.004 PG 8 WC Critical Care Medicine; Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Emergency Medicine GA AJ0GX UT WOS:000337329500024 PM 24555950 DA 2023-05-13 ER PT J AU Gerber, Y Weston, SA Enriquez-Sarano, M Jaffe, AS Manemann, SM Jiang, RX Roger, VL AF Gerber, Yariv Weston, Susan A. Enriquez-Sarano, Maurice Jaffe, Allan S. Manemann, Sheila M. Jiang, Ruoxiang Roger, Veronique L. TI Contemporary Risk Stratification After Myocardial Infarction in the Community: Performance of Scores and Incremental Value of Soluble Suppression of Tumorigenicity-2 SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE biomarkers; mortality; myocardial infarction; risk scores ID ACUTE CORONARY SYNDROME; GLOBAL REGISTRY; HEART-FAILURE; ST2; MORTALITY; GRACE; TIMI; TRENDS; EPIDEMIOLOGY; BIOMARKERS AB Background-Current American Heart Association/American College of Cardiology guidelines recommend the GRACE (Global Registry of Acute Coronary Events) and TIMI (Thrombolysis in Myocardial Infarction) scores to assess myocardial infarction (MI) prognosis. Changes in the epidemiological characteristics of MI and the availability of new biomarkers warrant an assessment of the performance of these scores in contemporary practice. We assessed the following: (1) the performance of GRACE and TIMI to predict 1-year mortality in a cohort of patients stratified by ST-segment elevation MI (STEMI) and non-STEMI (NSTEMI) and (2) the incremental discriminatory power of soluble suppression of tumorigenicity-2, a myocardial fibrosis biomarker. Methods and Results-Olmsted County, Minnesota, residents with incident MI (N=1401) were recruited prospectively from November 1, 2002 to December 31, 2012 (mean age, 67 years; 61% men; 79% with NSTEMI). Baseline data were used to calculate risk scores; soluble suppression of tumorigenicity-2 was measured in stored plasma samples obtained at index MI. C-statistics adapted to survival data were used to assess the discriminatory power of the risk scores and the improvement gained by adding other markers. During the first year of follow-up, 190 patients (14%) died. The discriminatory performance to predict death was reasonable for GRACE and poor for TIMI, and was generally worse in those with NSTEMI versus those with STEMI. In people with NSTEMI, sequential addition of comorbidities and soluble suppression of tumorigenicity-2 substantially improved the c-statistic over GRACE (from 0.78 to 0.80 to 0.84) and TIMI (from 0.61 to 0.73 to 0.81), respectively (all P=0.05). Conclusions-Guideline-recommended scores for risk assessment after MI underperform in contemporary community patients, particularly those with NSTEMI, which now represents most infarcts. Incorporating comorbidities and soluble suppression of tumorigenicity-2 substantially improves risk prediction, thereby delineating opportunities to improve clinical care. C1 [Gerber, Yariv; Weston, Susan A.; Manemann, Sheila M.; Jiang, Ruoxiang; Roger, Veronique L.] Mayo Clin, Dept Hlth Sci Res, Rochester, MN 55905 USA. [Enriquez-Sarano, Maurice; Jaffe, Allan S.; Roger, Veronique L.] Mayo Clin, Div Cardiovasc Dis, Dept Internal Med, Rochester, MN 55905 USA. [Gerber, Yariv] Tel Aviv Univ, Sch Publ Hlth, Dept Epidemiol & Prevent Med, Sackler Fac Med, Tel Aviv, Israel. C3 Mayo Clinic; Mayo Clinic; Tel Aviv University; Sackler Faculty of Medicine RP Roger, VL (通讯作者)，Mayo Clin, 200 First St SW, Rochester, MN 55905 USA. EM roger.veronique@mayo.edu RI Roger, Veronique/AAV-5951-2020; Gerber, Yariv/AAU-8222-2021 OI Enriquez-Sarano, Maurice/0000-0003-0910-5450 FU National Institutes of Health, Bethesda, MD [R01 HL120957]; Rochester Epidemiology Project, Rochester, MN from the National Institute on Aging, Bethesda, MD [R01 AG034676] FX This study was supported by the National Institutes of Health, Bethesda, MD (R01 HL120957), and made possible by the Rochester Epidemiology Project, Rochester, MN (R01 AG034676), from the National Institute on Aging, Bethesda, MD. The funding sources played no role in the design, conduct, or reporting of this study. 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Am. Heart Assoc. PD OCT PY 2017 VL 6 IS 10 AR e005958 DI 10.1161/JAHA.117.005958 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FR3BF UT WOS:000418940300019 PM 29054840 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Rahman, S Singh, K Dhingra, S Charan, J Sharma, P Islam, S Jahan, D Iskandar, K Samad, N Haque, M AF Rahman, Sayeeda Singh, Keerti Dhingra, Sameer Charan, Jaykaran Sharma, Paras Islam, Salequl Jahan, Dilshad Iskandar, Katia Samad, Nandeeta Haque, Mainul TI The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population - Public Health Implications SO THERAPEUTICS AND CLINICAL RISK MANAGEMENT LA English DT Review DE elderly; COVID-19; pandemic; viral infection; polypharmacy; co-morbidity; public health ID RESPIRATORY SYNCYTIAL VIRUS; ADVERSE DRUG EVENTS; ANTICHOLINERGIC RISK SCALE; OLDER-PEOPLE; UNITED-STATES; DEPRESCRIBING GUIDELINE; CLINICAL CONSEQUENCES; HOSPITALIZED-PATIENTS; PHYSICAL FUNCTION; INFLUENZA-VIRUS AB COVID-19 pandemic is inducing acute respiratory distress syndrome, multiorgan failure, and eventual death. Respiratory failure is the leading cause of mortality in the elderly population with pre-existing medical conditions. This group is particularly vulnerable to infections due to a declined immune system, comorbidities, geriatric syndrome, and potentially inappropriate polypharmacy. These conditions make the elderly population more susceptible to the harmful effects of medications and the deleterious consequences of infections, including MERS-CoV, SARS-CoV, and SARS-CoV-2. Chronic diseases among elderlies, including respiratory diseases, hypertension, diabetes, and coronary heart diseases, present a significant challenge for healthcare professionals. To comply with the clinical guidelines, the practitioner may prescribe a complex medication regimen that adds up to the burden of pre-existing treatment, potentially inducing adverse drug reactions and leading to harmful side-effects. Consequently, the geriatric population is at increased risk of falls, frailty, and dependence that enhances their susceptibility to morbidity and mortality due to SARS-CoV-2 respiratory syndrome, particularly interstitial pneumonia. The major challenge resides in the detection of infection that may present as atypical manifestations in this age group. Healthy aging can be possible with adequate preventive measures and appropriate medication regimen and follow-up. Adherence to the guidelines and recommendations of WHO, CDC, and other national/regional/international agencies can reduce the risks of SARS-CoV-2 infection. Better training programs are needed to enhance the skill of health care professionals and patient's caregivers. This review explains the public health implications associated with polypharmacy on the geriatric population with pre-existing comorbidities during the COVID-19 pandemic. C1 [Rahman, Sayeeda] Amer Univ Integrat Sci, Sch Med, Bridgetown, Barbados. [Singh, Keerti] Univ West Indies, Fac Med Sci, Cave Hill Campus, Wanstead, Barbados. [Dhingra, Sameer] Univ West Indies, Fac Med Sci, Sch Pharm, St Augustine Campus,Eric Williams Med Sci Complex, Mt Hope, Trinidad Tobago. [Charan, Jaykaran] All India Inst Med Sci, Dept Pharmacol, Jodhpur, Rajasthan, India. [Sharma, Paras] BVM Coll Pharm, Dept Pharmacognosy, Gwalior, Madhya Pradesh, India. [Islam, Salequl] Jahangirnagar Univ, Dept Microbiol, Dhaka 1342, Bangladesh. [Jahan, Dilshad] Asgar Ali Hosp, Dept Hematol, Dhaka 1204, Bangladesh. [Iskandar, Katia] Lebanese Univ, Sch Pharm, Beirut, Lebanon. [Samad, Nandeeta] North South Univ, Dept Publ Hlth, Dhaka 1229, Bangladesh. [Haque, Mainul] Nas Malaysia Natl Def Univ Malaysia, Fac Med, Unit Pharmacol, Kuala Lumpur 57000, Kem Perdana Sun, Malaysia. [Haque, Mainul] Nas Malaysia Natl Def Univ Malaysia, Def Hlth Univ Pertahanan, Kuala Lumpur 57000, Kem Perdana Sun, Malaysia. C3 University West Indies Mona Jamaica; University West Indies Cave Hill Campus; University West Indies Mona Jamaica; University West Indies Saint Augustine; All India Institute of Medical Sciences (AIIMS) Jodhpur; Jahangirnagar University; Lebanese University; North South University (NSU) RP Haque, M (通讯作者)，Nas Malaysia Natl Def Univ Malaysia, Fac Med, Unit Pharmacol, Kuala Lumpur 57000, Kem Perdana Sun, Malaysia.; Haque, M (通讯作者)，Nas Malaysia Natl Def Univ Malaysia, Def Hlth Univ Pertahanan, Kuala Lumpur 57000, Kem Perdana Sun, Malaysia. 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Clin. Risk Manag. PY 2020 VL 16 BP 1007 EP 1022 DI 10.2147/TCRM.S272908 PG 16 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA OH1TH UT WOS:000582353400001 PM 33116550 OA gold, Green Published DA 2023-05-13 ER PT J AU Yu, C Sheriff, J Ng, A Brazete, S Gullick, J Brieger, D Kritharides, L Lowe, HC AF Yu, Christopher Sheriff, Javed Ng, Austin Brazete, Susana Gullick, Janice Brieger, David Kritharides, Leonard Lowe, Harry C. TI A Rapid Access Chest Pain Clinic (RACPC): Initial Australian Experience SO HEART LUNG AND CIRCULATION LA English DT Article ID MYOCARDIAL-INFARCTION; EMERGENCY-DEPARTMENT; TROPONIN-T; RISK; DIAGNOSIS; RATES AB Background Chest pain is the second most common presenting symptom to emergency departments (ED) in Australia, although up to 85% of these patients do not have an acute coronary syndrome (ACS). Cardiologist-led rapid access chest pain clinics (RACPC) have been proposed overseas to assist in the management of such patients, with prompt outpatient assessment if patients are deemed low risk and discharged from the ED. The use of RACPCs in Australia has been only recently proposed; we therefore sought to examine one such RACPC in an Australian context. Methods and Results 1133 consecutive patients were seen at a metropolitan RACPC, between August 2008 and February 2017. There was a high preponderance of cardiovascular risk factors. Exercise stress testing (EST) was the default investigation upon discharge from ED, with a total of 1038 ESTs performed in 1113 patients (93%), with low numbers of other functional tests, and a small, but increasing number of coronary computed tomography (CT) scans performed over this period. Eighteen patients subsequently underwent revascularisation (1.6% of the total cohort), and none of these patients were readmitted at any time with an ACS between the interval of their index ED presentation to these investigations or treatments. Five (0.4%) patients represented to ED within 48 hours, none due to a cardiovascular cause. A total of 24 (2.1%) patients represented between 2 and 28 days, with none of these due to an ACS. Conclusions Following ED assessment of acute chest pain as low risk-with direct ED referral for exercising testing followed by RACPC review-results in very low readmission rates at 48 hours and at 28 days. Moreover, these readmissions were almost always not of cardiovascular aetiology, and occurred despite relatively longer waiting periods for both EST (8 days) and between EST and RACPC review (11 days), than the prespecified 72 to 96 hours as defined by the clinic protocol. Further investigation into this model of care in Australia is suggested. C1 [Yu, Christopher; Sheriff, Javed; Ng, Austin; Brazete, Susana; Brieger, David; Kritharides, Leonard; Lowe, Harry C.] Concord Repatriat Gen Hosp, Dept Cardiol, Sydney, NSW, Australia. [Ng, Austin; Gullick, Janice; Brieger, David; Kritharides, Leonard; Lowe, Harry C.] Univ Sydney, Sydney, NSW, Australia. C3 Concord Repatriation General Hospital; University of Sydney RP Lowe, HC (通讯作者)，Concord Repatriat Gen Hosp, Cardiol Dept, Hosp Rd, Concord, NSW 2139, Australia. EM h.lowe@bigpond.net.au RI Kritharides, Leonard/AAQ-2720-2020; Ng, Austin Chin Chwan/AAQ-3192-2021; Gullick, Janice/AAZ-4258-2020 OI Kritharides, Leonard/0000-0001-5818-8024; Gullick, Janice/0000-0002-9878-5533; Yu, Christopher/0000-0003-1025-5480; Brieger, David/0000-0001-6115-0326; Ng, Austin Chin Chwan/0000-0002-1317-876X CR *AIHW, 2016, AUSTR I HLTH WELF HL, V72 Aldous S, 2012, EMERG MED J, V29, P805, DOI 10.1136/emermed-2011-200222 Australasian College for Emergency Medicine, 2013, POL AUSTR TRIAG SCAL Australian Institute of Health and Welfare, 2012, AUSTR HLTH 2012 Australian Institute of Health and Welfare (AIHW), 2015, AIHW CARD DIAB CHRON, V4 Bandstein N, 2014, J AM COLL CARDIOL, V63, P2569, DOI 10.1016/j.jacc.2014.03.017 Chew DP, 2016, HEART LUNG CIRC, V25, P895, DOI 10.1016/j.hlc.2016.06.789 Cullen L, 2015, MED J AUSTRALIA, V202, P427, DOI 10.5694/mja14.00472 Fathieh S, 2018, HEART LUNG CIRC, V27, pE15, DOI 10.1016/j.hlc.2016.09.015 Fox KF, 2009, INT J CARDIOL, V137, P42, DOI 10.1016/j.ijcard.2008.06.026 Hoffmann U, 2012, NEW ENGL J MED, P67 Klimis H, 2017, INTERN MED J, V47, P986, DOI 10.1111/imj.13334 Neumann JT, 2016, JAMA CARDIOL, V1, P397, DOI 10.1001/jamacardio.2016.0695 Nudy M, 2017, CIRCULATION, V136 Parsonage WA, 2016, EUR HEART J, V37, P228 Rajpura A, 2007, J EVAL CLIN PRACT, V13, P326, DOI 10.1111/j.1365-2753.2006.00696.x Reichlin T, 2009, NEW ENGL J MED, V361, P858, DOI 10.1056/NEJMoa0900428 Tenkorang JN, 2006, HEART, V92, P1084, DOI 10.1136/hrt.2005.079376 Weigold WG, 2013, J AM COLL CARDIOL, V61, P893, DOI 10.1016/j.jacc.2013.01.002 Zhelev Z, 2015, BMJ-BRIT MED J, P350 NR 20 TC 6 Z9 6 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1443-9506 EI 1444-2892 J9 HEART LUNG CIRC JI Heart Lung Circ. PD NOV PY 2018 VL 27 IS 11 BP 1376 EP 1380 DI 10.1016/j.hlc.2017.11.006 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GV2KB UT WOS:000445916500018 PM 29655571 DA 2023-05-13 ER PT J AU Borowicz, A Nadolny, K Bujak, K Ciesla, D Gasior, M Hudzik, B AF Borowicz, Artur Nadolny, Klaudiusz Bujak, Kamil Ciesla, Daniel Gasior, Mariusz Hudzik, Bartosz TI Paramedic versus physician-staffed ambulances and prehospital delays in the management of patients with ST-segment elevation myocardial infarction SO CARDIOLOGY JOURNAL LA English DT Article DE acute myocardial infarction; paramedic-only staffed ambulances; physician-staffed ambulances; time delays ID PERCUTANEOUS CORONARY INTERVENTION; PRIMARY ANGIOPLASTY; ELECTROCARDIOGRAM TELETRANSMISSION; REPERFUSION THERAPY; DIRECT ADMISSION; TIME; MORTALITY; TRIAGE; IMPACT; TELEMEDICINE AB Background: Time delays to reperfusion therapy in ST-segment elevation myocardial infarction (STEMI) still remain a considerable drawback in many healthcare systems. Emergency medical service (EMS) has a critical role in the early management of STEMI. Under investigation herein, was whether the use of physician-staffed ambulances leads to shorter pre-hospital delays in STEMI patients. Methods: This was an observational and retrospective study, using data from the registry of the Silesian regional EMS system in Katowice, Poland and the Polish Registry on Acute Coronary Syndromes (PL-ACS) for a study period of January 1, 2013 to December 31, 2016. The study population (n = 717) was divided into two groups: group 1 (n = 546 patients) - physician-staffed ambulances and group 2 (n = 171 patients) - paramedic-staffed ambulances. Results: Responses during the day and night shifts were similar. Paramedic-led ambulances more often transmitted 12-lead electrocardiogram (ECG) to the percutaneous coronary intervention centers. All EMS time intervals were similar in both groups. The type of EMS dispatched to patients (physicianstaffed vs. paramedic/nurse-only staffed ambulance) was adjusted for ECG transmission, sex had no impact on in-hospital mortality (odds ratio [OR] 1.41; 95% confidence interval [CI] 0.79-1.95; p = 0.4). However, service time exceeding 42 min was an independent predictor of in-hospital mortality (OR 4.19; 95% CI 1.27-13.89; p = 0.019). In-hospital mortality rate was higher in the two upper quartiles of service time in the entire study population. Conclusions: These findings suggest that both physician-led and paramedic-led ambulances meet the criteria set out by the Polish and European authorities. All EMS time intervals are similar regardless of the type of EMS unit dispatched. A physician being present on board did not have a prognostic impact on outcomes. C1 [Borowicz, Artur; Nadolny, Klaudiusz] Voivodeship Rescue Serv Katowice, Katowice, Poland. [Nadolny, Klaudiusz] Med Univ Bialystok, Dept Emergency Med, Bialystok, Poland. [Nadolny, Klaudiusz] Univ Strateg Planning Dabrowa Gornicza, Dabrowa Gornicza, Poland. [Bujak, Kamil; Gasior, Mariusz; Hudzik, Bartosz] Med Univ Silesia, Fac Med Sci Zabrze, Silesian Ctr Heart Dis, Dept Cardiol 3, Katowice, Poland. [Ciesla, Daniel] Silesian Ctr Heart Dis, Dept Sci, Biostat & New Technol, Zabrze, Poland. [Hudzik, Bartosz] Med Univ Silesia, Fac Hlth Sci Bytom, Dept Cardiovasc Dis Prevent, Katowice, Poland. C3 Medical University of Bialystok; Medical University Silesia; Silesian Center for Heart Diseases; Silesian Center for Heart Diseases; Medical University Silesia RP Hudzik, B (通讯作者)，Silesian Ctr Heart Dis, Dept Cardiol 3, Ul Curie Sklodowskiej 9, PL-41800 Zabrze, Poland. EM bartekh@mp.pl RI Bujak, Kamil/AAW-4776-2020; Hudzik, Bartosz/AAZ-8263-2020 OI Bujak, Kamil/0000-0002-1951-1981; Hudzik, Bartosz/0000-0003-3880-5325; Nadolny, Klaudiusz/0000-0003-0355-241X CR Beygui F, 2020, EUR HEART J-ACUTE CA, V9, P59, DOI 10.1177/2048872615604119 Bottiger BW, 2016, CRIT CARE, V20, DOI 10.1186/s13054-015-1156-6 Brunetti ND, 2017, INT J CARDIOL, V232, P5, DOI 10.1016/j.ijcard.2017.01.055 Busk M, 2008, EUR HEART J, V29, P1259, DOI 10.1093/eurheartj/ehm392 Chan AW, 2012, JACC-CARDIOVASC INTE, V5, P1239, DOI 10.1016/j.jcin.2012.07.013 Curtis JP, 2006, J AM COLL CARDIOL, V47, P1544, DOI 10.1016/j.jacc.2005.10.077 Brunetti ND, 2015, INT J CARDIOL, V185, P224, DOI 10.1016/j.ijcard.2015.03.138 De Luca G, 2004, CIRCULATION, V109, P1223, DOI 10.1161/01.CIR.0000121424.76486.20 Goldstein P, 2009, EUR J EMERG MED, V16, P244, DOI 10.1097/MEJ.0b013e328329794e Hagihara A, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0084424 Haner A, 2015, J ACUTE DIS, V4, P63, DOI 10.1016/S2221-6189(14)60086-X Henry TD, 2007, CIRCULATION, V116, P721, DOI 10.1161/CIRCULATIONAHA.107.694141 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Kawecki D, 2017, JACC-CARDIOVASC INTE, V10, P438, DOI 10.1016/j.jcin.2016.11.028 Kleinrok A, 2014, KARDIOL POL, V72, P345, DOI 10.5603/KP.a2013.0352 Kristensen SD, 2014, EUR HEART J, V35, P1957, DOI 10.1093/eurheartj/eht529 Le May MR, 2012, J AM COLL CARDIOL, V60, P1223, DOI 10.1016/j.jacc.2012.07.008 McGinn AP, 2005, AM HEART J, V150, P392, DOI 10.1016/j.ahj.2005.03.064 Morrison LJ, 2006, ACAD EMERG MED, V13, P84, DOI 10.1197/j.aem.2005.07.042 Nakatsuma K, 2016, CIRC J, V80, P1764, DOI 10.1253/circj.CJ-16-0204 O'Donnell D, 2015, J ELECTROCARDIOL, V48, P93, DOI 10.1016/j.jelectrocard.2014.09.003 Polonski L, 2007, KARDIOL POL, V65, P861 Savage ML, 2014, HEART LUNG CIRC, V23, P435, DOI 10.1016/j.hlc.2013.11.015 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Widimsky P, 2010, EUR HEART J, V31, P943, DOI 10.1093/eurheartj/ehp492 Wohrle J, 2010, AM J CARDIOL, V106, P1218, DOI 10.1016/j.amjcard.2010.06.049 Zimoch WJ, 2015, POSTEP KARDIOL INTER, V11, P212, DOI 10.5114/pwki.2015.54016 NR 27 TC 3 Z9 3 U1 0 U2 0 PU VIA MEDICA PI GDANSK PA UL SWIETOKRZYSKA 73, 80-180 GDANSK, POLAND SN 1897-5593 EI 1898-018X J9 CARDIOL J JI Cardiol. J. PD JAN PY 2021 VL 28 IS 1 BP 110 EP 117 DI 10.5603/CJ.a2019.0072 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA QT7JZ UT WOS:000626766200013 PM 31313273 OA gold, Green Published DA 2023-05-13 ER PT J AU Callachan, EL Alsheikh-Ali, AA Nair, SC Bruijns, S Wallis, LA AF Callachan, Edward L. Alsheikh-Ali, Alawi A. Nair, Satish Chandrasekhar Bruijns, Stevan Wallis, Lee A. TI Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates SO WESTERN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; EMERGENCY MEDICAL-SERVICES; PERCUTANEOUS CORONARY INTERVENTION; TO-BALLOON TIMES; CARDIOGENIC-SHOCK; CARE; REPERFUSION; IMPACT; REGISTRY; SYSTEMS AB Introduction: The purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities. Methods: This multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi. We collected electronic medical records from EMS and hospitals, and conducted interviews with patients in person or via telephone. Chi-square tests and Kruskal-Wallis tests were used to examine differences in variables by mode of transportation. Results: Results indicated significant differences in modes of transportation when considering symptom-onset-to-balloon time (p < 0.001), door-to-balloon time (p < 0.001), and health status at sixmonth and one-year follow-up (p < 0.001). Median times (interquartile range) for patients transported by EMS, private vehicle, or transferred from an outside facility were as follows: symptom-onsetto- balloon time in hours, 3.1 (1.8-4.3), 3.2 (2.1-5.3), and 4.5 (3.0-7.5), respectively; door-toballoon time in minutes, 70 (48-78), 81 (64-105), and 62 (46-77), respectively. In all cases, EMS transportation was associated with a shorter time to treatment than other modes of transportation. However, the EMS group experienced greater rates of in-hospital events, including cardiac arrest and mortality, than the private transport group. Conclusion: Our results contribute data supporting EMS transportation for patients with acute coronary syndrome. Although a lack of follow-up data made it difficult to draw conc lusions about long-term outcomes, our findings clearly indicate that EMS transportation can speed time to treatment, including time to balloon inflation, potentially r educing readmission and adverse events. We conclude that future efforts should focus on encouraging the use of EMS and improving transfer practices. Such efforts could improve outcomes for patients presenting with STEMI. C1 [Callachan, Edward L.; Bruijns, Stevan; Wallis, Lee A.] Univ Cape Town, Dept Surg, Div Emergency Med, Bellville, South Africa. [Alsheikh-Ali, Alawi A.] Mohammed Bin Rashid Univ Med & Hlth Sci, Coll Med, Dubai, U Arab Emirates. [Alsheikh-Ali, Alawi A.] Sheikh Khalifa Med City, Inst Cardiac Sci, Abu Dhabi, U Arab Emirates. [Nair, Satish Chandrasekhar] Johns Hopkins Med Affiliate, Tawam Hosp, Clin Res, Al Ain, U Arab Emirates. C3 University of Cape Town RP Callachan, EL (通讯作者)，Univ Cape Town, Dept Med, Div Emergency Med, POB 53507, Abu Dhabi, U Arab Emirates. EM eddieca@eim.ae RI Nair, Satish C/ABG-8442-2021 OI Bruijns, Stevan/0000-0001-7805-7347; Wallis, Lee/0000-0003-2711-3139 CR AlHabib KF, 2014, ANGIOLOGY, V65, P703, DOI 10.1177/0003319713502846 Babaev A, 2005, JAMA-J AM MED ASSOC, V294, P448, DOI 10.1001/jama.294.4.448 Boothroyd LJ, 2013, PREHOSP EMERG CARE, V17, P187, DOI 10.3109/10903127.2012.755583 Canto JG, 2002, CIRCULATION, V106, P3018, DOI 10.1161/01.CIR.0000041246.20352.03 Chia YC, 2012, CRIT CARE, V16, P183 Clark CL, 2012, PREHOSP EMERG CARE, V16, P115, DOI 10.3109/10903127.2011.615012 Davis MT, 2011, CAN J EMERG MED, V13, P372, DOI 10.2310/8000.2011.110390 Drew BJ, 2006, J ELECTROCARDIOL, V39, pS157, DOI 10.1016/j.jelectrocard.2006.05.033 Fares S, 2011, J EMERG MED, V41, P310, DOI 10.1016/j.jemermed.2010.05.002 Kukla Piotr, 2006, Kardiol Pol, V64, P275 Levisman J, 2015, AM J CARDIOL, V115, P11, DOI 10.1016/j.amjcard.2015.01.002 Mathews R, 2011, CIRCULATION, V124, P154, DOI 10.1161/CIRCULATIONAHA.110.002345 Mensah GA, 2007, CIRCULATION, V116, pE33, DOI 10.1161/CIRCULATIONAHA.107.184045 Mixon TA, 2014, J EMERG MED, V47, P247, DOI 10.1016/j.jemermed.2014.02.003 Park JK, 2014, J TELEMED TELECARE, V20, P242, DOI 10.1177/1357633X14536350 Rathore SS, 2009, BMJ-BRIT MED J, V338, DOI 10.1136/bmj.b1807 Reynolds HR, 2008, CIRCULATION, V117, P686, DOI 10.1161/CIRCULATIONAHA.106.613596 Shiraishi J, 2010, J CARDIOL, V55, P217, DOI 10.1016/j.jjcc.2009.11.001 Song L, 2008, CHINESE MED J-PEKING, V121, P771, DOI 10.1097/00029330-200805010-00001 Squire BT, 2014, PREHOSP EMERG CARE, V18, P1, DOI 10.3109/10903127.2013.836263 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Terkelsen CJ, 2005, EUR HEART J, V26, P770, DOI 10.1093/eurheartj/ehi100 Ting HH, 2007, CIRCULATION, V116, P729, DOI 10.1161/CIRCULATIONAHA.107.699934 Tubaro M, 2011, Acute Card Care, V13, P56, DOI 10.3109/17482941.2011.581292 van Uden CJT, 2005, J GEN INTERN MED, V20, P612, DOI 10.1111/j.1525-1497.2005.0091.x Wang YC, 2012, INT J CLIN PRACT, V66, P69, DOI 10.1111/j.1742-1241.2011.02775.x NR 27 TC 8 Z9 8 U1 0 U2 0 PU WESTJEM PI ORANGE PA C/O SHAHRAM LOTFIPOUR, MD, MPH, 333 CITY BLVD W STE 640, RT 128-01, ORANGE, CA 92868 USA SN 1936-900X EI 1936-9018 J9 WEST J EMERG MED JI West. J. Emerg. Med. PD APR PY 2017 VL 18 IS 3 BP 349 EP 355 DI 10.5811/westjem.2017.1.32593 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA FI8AT UT WOS:000412222900006 PM 28435484 OA Green Published, gold DA 2023-05-13 ER PT J AU Masyuko, SJ Page, ST Kinuthia, J Osoti, AO Polyak, SJ Otieno, FC Kibachio, JM Mogaka, JN Temu, TM Zifodya, JS Otedo, A Nakanjako, D Hughes, JP Farquhar, C AF Masyuko, Sarah J. Page, Stephanie T. Kinuthia, John Osoti, Alfred O. Polyak, Stephen J. Otieno, Fredrick C. Kibachio, Joseph M. Mogaka, Jerusha N. Temu, Tecla M. Zifodya, Jerry S. Otedo, Amos Nakanjako, Damalie Hughes, James P. Farquhar, Carey TI Metabolic syndrome and 10-year cardiovascular risk among HIV-positive and HIV-negative adults A cross-sectional study SO MEDICINE LA English DT Article DE cardiovascular risk score; HIV; Kenya; metabolic syndrome ID CORONARY-HEART-DISEASE; ACUTE MYOCARDIAL-INFARCTION; ANTIRETROVIRAL THERAPY; INFECTED PATIENTS; HEALTH; ASSOCIATION; PREVALENCE; COUNTRIES; AFRICA; BURDEN AB To determine the prevalence and correlates of metabolic syndrome (MetS) and compare 10-year cardiovascular disease (CVD) risk among Kenyan adults with and without HIV infection. We conducted a cross-sectional study among adults >= 30 years of age with and without HIV infection seeking care at Kisumu County Hospital. Participants completed a health questionnaire and vital signs, anthropomorphic measurements, and fasting blood were obtained. MetS was defined using 2009 Consensus Criteria and 10-year Atherosclerotic CVD (ASCVD) risk score was calculated. Chi-square, independentttests, Wilcoxon ranksum test and multivariable logistic regression were used to determine differences and associations between HIV and MetS, CVD risk factors and ASCVD risk score. A total of 300 people living with HIV (PLWHIV) and 298 HIV-negative participants with median age 44 years enrolled, 50% of whom were female. The prevalence of MetS was 8.9% overall, but lower among PLWHIV than HIV-negative participants (6.3% vs 11.6%, respectively;P = .001). The most prevalent MetS components were elevated blood pressure, decreased high density lipoprotein, and abdominal obesity. Adjusting for covariates, PLWHIV were 66% less likely to have MetS compared to HIV-negative participants (adjusted odds ratio [aOR] 0.34; 95% confidence interval [95%CI] 0.18, 0.65;P = .005). Median ASCVD risk score was also lower among PLWHIV compared to HIV-negative participants (1.7% vs 3.0%,P = .002). MetS was more common among HIV-negative than HIV-positive adults, and HIV-negative adults were at greater risk for CVD compared to PLWHIV. These data support integration of routine CVD screening and management into health programs in resource-limited settings, regardless of HIV status. C1 [Masyuko, Sarah J.; Kibachio, Joseph M.; Otedo, Amos] Minist Hlth, Nairobi, Kenya. [Masyuko, Sarah J.; Page, Stephanie T.; Osoti, Alfred O.; Temu, Tecla M.; Farquhar, Carey] Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA. [Page, Stephanie T.; Mogaka, Jerusha N.; Farquhar, Carey] Univ Washington, Dept Med, Seattle, WA USA. [Kinuthia, John] Kenyatta Natl Hosp, Dept Res & Programs, Nairobi, Kenya. [Osoti, Alfred O.] Univ Nairobi, Dept Obstet & Gynecol, Nairobi, Kenya. [Polyak, Stephen J.] Univ Washington, Dept Lab Med, Seattle, WA 98195 USA. [Otieno, Fredrick C.] Univ Nairobi, Coll Hlth Sci, Dept Clin Med & Therapeut, Nairobi, Kenya. [Zifodya, Jerry S.] Tulane Univ, Dept Med, New Orleans, LA 70118 USA. [Nakanjako, Damalie] Makerere Univ, Sch Med, Dept Med, Coll Hlth Sci, Kampala, Uganda. [Hughes, James P.] Univ Washington, Dept Biostat, Seattle, WA 98195 USA. [Farquhar, Carey] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. C3 University of Washington; University of Washington Seattle; University of Washington; University of Washington Seattle; Kenyatta National Hospital; University of Nairobi; University of Washington; University of Washington Seattle; University of Nairobi; Tulane University; Makerere University; University of Washington; University of Washington Seattle; University of Washington; University of Washington Seattle RP Masyuko, SJ (通讯作者)，Minist Hlth, Natl AIDS & STI Control Program, POB 13131, Nairobi 00202, Kenya. EM smasyuko@uw.edu OI Temu, Tecla/0000-0002-0056-4143 FU National Institutes of Health (NIH) [R21TW010459]; Fogarty International Center (FIC) [D43 TW009580] FX This study was funded by National Institutes of Health (NIH) R21TW010459 and Fogarty International Center (FIC) D43 TW009580. 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Sherling, Dawn Hennekens, Charles H. TI Prospects for the Primary Prevention of Myocardial Infarction and Stroke SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS LA English DT Review DE acute myocardial infarction; stroke; lifestyle changes; adjunctive drug therapies ID CORONARY-HEART-DISEASE; CARDIOVASCULAR-DISEASE; SECONDARY PREVENTION; ALCOHOL-CONSUMPTION; METABOLIC SYNDROME; SMOKING-CESSATION; DIABETES-MELLITUS; PHYSICAL-ACTIVITY; BLOOD-PRESSURE; URGENT NEED AB Cardiovascular disease (CVD), principally myocardial infarction (MI) and stroke, is the leading clinical and public health problem in the United States and is rapidly becoming so worldwide. Their primary prevention is promising, in theory, but difficult to achieve in practice. The principal modalities that have demonstrated efficacy include therapeutic lifestyle changes (TLCs) and adjunctive drug therapies under the guidance of the health-care provider and tailored to the individual patient. The prevention and treatment of the pandemic of overweight and obesity and lack of regular physical activity, both of which are alarmingly common in the United States, prevention and treatment of hypertension, avoidance and cessation of cigarette smoking, adoption and maintenance of a healthy diet, and avoidance of heavy alcohol consumption all have proven benefits in decreasing the risks of a first MI and stroke as well as other clinical manifestations of CVD. Although adoption of TLCs would avoid the need for adjunctive drug therapies in many primary prevention subjects, this strategy is difficult to achieve or maintain for most and may be insufficient for many, especially those at high risk with metabolic syndrome. The criteria for metabolic syndrome, affecting over 40% of the adult population older than 40 in the United States, include overweight or obesity, dyslipidemia, hypertension, and insulin resistance, a precursor of diabetes. The adjunctive therapies of proven benefit in the primary prevention of MI and stroke include statins, blood pressure medications, aspirin, and drugs to treat insulin resistance and hyperglycemia. Fortunately, even for patients who prefer prescription of pills to proscription of harmful lifestyles, these drug therapies still have net benefits. The adoption and maintenance of TLCs and adjunctive drug therapies into clinical practice will reduce both the incidence of and mortality from a first MI and stroke as well as other major clinical manifestations of CVD. C1 [Caldwell, Madison; Martinez, Lisa; Foster, Jennifer G.; Sherling, Dawn; Hennekens, Charles H.] Florida Atlantic Univ, Charles E Schmidt Coll Med, Boca Raton, FL 33431 USA. C3 State University System of Florida; Florida Atlantic University RP Hennekens, CH (通讯作者)，Florida Atlantic Univ, Charles E Schmidt Coll Med, Boca Raton, FL 33431 USA. EM chenneke@health.fau.edu OI Hennekens, Charles/0000-0003-1214-1663 FU Charles E. Schmidt College of Medicine of Florida Atlantic University FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: DrsMartinez, Foster, Sherling and Professor Hennekens report that they are funded by the Charles E. Schmidt College of Medicine of Florida Atlantic University. 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S. Department of Health and Human Services PHS Office of the Surgeon General, 2014, HLTH CONSMOK 50 YE US Department of Health and Human Services, 2008, 2008 PHYS ACT GUID A, VU0036 Whitlock G, 2009, LANCET, V373, P1083, DOI 10.1016/S0140-6736(09)60318-4 Wilson PWF, 2005, CIRCULATION, V112, P3066, DOI 10.1161/CIRCULATIONAHA.105.539528 NR 55 TC 27 Z9 27 U1 2 U2 12 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1074-2484 EI 1940-4034 J9 J CARDIOVASC PHARM T JI J. Cardiovasc. Pharmacol. Ther. PD MAY PY 2019 VL 24 IS 3 BP 207 EP 214 DI 10.1177/1074248418817344 PG 8 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA HZ4IY UT WOS:000468812100001 PM 30563358 OA Bronze DA 2023-05-13 ER PT J AU Kozinski, M Krintus, M Kubica, J Sypniewska, G AF Kozinski, Marek Krintus, Magdalena Kubica, Jacek Sypniewska, Grazyna TI High-sensitivity cardiac troponin assays: From improved analytical performance to enhanced risk stratification SO CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES LA English DT Review DE Cardiac troponins; high-sensitivity cardiac troponin assays; myocardial infarction; risk stratification ID ACUTE MYOCARDIAL-INFARCTION; EMERGENCY-DEPARTMENT PATIENTS; ACUTE CORONARY SYNDROMES; UPPER REFERENCE LIMITS; TERM BIOLOGICAL VARIATION; 99TH PERCENTILE VALUES; CHEST-PAIN SYMPTOMS; EARLY RULE-OUT; EARLY-DIAGNOSIS; I ASSAYS AB Implementation of cardiac troponin (cTn) assays has revolutionized the diagnosis, risk stratification, triage and management of patients with suspected myocardial infarction (MI). The Universal Definition of MI brought about a shift in the diagnostics of MI, from an approach primarily based on electrocardiography (ECG) to one primarily based on biomarkers. Currently, detection of a rise and/ or fall in concentration or activity of myocardial necrosis biomarkers, preferentially cTns, with at least one value above the 99th percentile upper reference limit (URL), is the essential component for the diagnosis of MI. High-sensitivity cardiac troponin (hs-cTn) assays with their superior analytical performance were designed to further facilitate clinical decision making. The ability of hs-cTn assays to detect measurable cTn concentrations in at least 50% of healthy individuals, along with their improved precision (expressed as coefficient of variation <= 10% at the 99th percentile URL) associated with increased recognition of changing values, leads to enhanced risk stratification of patients with suspected MI, and also enables them to be used as prognostic tools potentially useful in other patient subsets. In this comprehensive review, we aim to integrate updated laboratory and clinical knowledge regarding hs-cTn assays in order to promote their optimal use in daily practice. We primarily focus on the role of hs-cTn assays in patients with suspected MI, discussing recommended diagnostic algorithms and result interpretation. Emphasis is also placed on the release of cTns following myocardial injury, the characteristics of antibodies used in available cTn immunoassays, and analytical performance of hs-cTn assays. In this paper, we also review potential challenges related to the selection of a healthy reference population in determining 99th percentile values, biological variation of hs-cTns, inequality between hs-cTn assays, and outline the current status of cTnI standardization. Finally, we discuss in detail the diagnostic and prognostic value of hs-cTn assays, including non-coronary causes of cTn elevation, the potential benefits and risks of point-of-care testing, and the unjustified skepticism of some clinicians regarding implementation of hs-cTn assays. In everyday clinical practice, hs-cTn assays are an important diagnostic advance, predominantly for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), with suspected non-ST-segment elevation myocardial infarction (NSTEMI). In the NSTE-ACS setting, recently introduced short diagnostic algorithms using hs-cTn assays integrated with careful clinical and ECG assessment were found to substantially reduce the time to final diagnosis, shorten visits to the emergency department and allow earlier safe discharge of low risk subjects. Hs-cTn assays have significantly higher sensitivity and negative predictive value for NSTEMI in comparison to contemporary cTn tests, particularly in early NSTE-ACS presenters. However, due to frequently occurring mild hs-cTn elevations, they are also associated with lower specificity and reduced positive predictive value when compared to previous generations of assays. Our review underscores the need for the education of clinicians and medical laboratory professionals regarding appropriate use and interpretation of hs-cTn assays. Adequate training and clinical experience in using these tests are essential to translate the improved analytical performance of hs-cTn assays into enhanced risk stratification and hopefully better patient outcomes. C1 [Kozinski, Marek] Nicolaus Copernicus Univ, Collegium Med, Dept Principles Clin Med, Bydgoszcz, Poland. [Krintus, Magdalena; Sypniewska, Grazyna] Nicolaus Copernicus Univ, Collegium Med, Dept Lab Med, 9 Sklodowskiej Curie St, PL-85094 Bydgoszcz, Poland. [Kubica, Jacek] Nicolaus Copernicus Univ, Collegium Med, Dept Cardiol & Internal Med, Bydgoszcz, Poland. C3 Nicolaus Copernicus University; Nicolaus Copernicus University; Nicolaus Copernicus University RP Krintus, M (通讯作者)，Nicolaus Copernicus Univ, Collegium Med, Dept Lab Med, 9 Sklodowskiej Curie St, PL-85094 Bydgoszcz, Poland. 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10.1515/cclm-2014-0619 NR 161 TC 33 Z9 35 U1 0 U2 18 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 2-4 PARK SQUARE, MILTON PARK, ABINGDON OR14 4RN, OXON, ENGLAND SN 1040-8363 EI 1549-781X J9 CRIT REV CL LAB SCI JI Crit. Rev. Clin. Lab. Sci. PD MAY PY 2017 VL 54 IS 3 BP 143 EP 172 DI 10.1080/10408363.2017.1285268 PG 30 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA EU7XS UT WOS:000401250100001 PM 28457177 DA 2023-05-13 ER PT J AU Mohammedi, K Preaubert, N Cariou, T Rigalleau, V Foussard, N Piazza, L Bairras-Martin, C Couffinhal, T Bezin, J Benard, A AF Mohammedi, Kamel Preaubert, Nathalie Cariou, Tanguy Rigalleau, Vincent Foussard, Ninon Piazza, Laurent Bairras-Martin, Celine Couffinhal, Thierry Bezin, Julien Benard, Antoine TI Cost-effectiveness of screening of coronary artery disease in patients with type 2 DIABetes at a very high cardiovascular risk (SCADIAB study) rational and design SO CARDIOVASCULAR DIABETOLOGY LA English DT Article DE Type 2 diabetes; Coronary artery disease; Cardiovascular risk; Major adverse cardiac events; Screening; Real-world evidence study; Cost-effectiveness; Economic impact AB BackgroundScreening for coronary artery disease (CAD) remains broadly performed in patients with type 2 diabetes (T2DM), although the lack of evidence. We conduct a real-world evidence (RWE) study to assess the risk of major clinical outcomes and economic impact of routine CAD screening in T2DM individuals at a very high cardiovascular risk.MethodsSCADIAB is a comparative nationwide cohort study using data from the French National Health Data System. The main inclusion criteria are: age >= 40 years, DT2 diagnosed for >= 7 years, with >= 2 additional cardiovascular risk factors plus a history of microvascular or macrovascular disease, except CAD. We estimated >= 90,000 eligible participants for our study. Data will be extracted from 01/01/2008 to 31/12/2019. Eligible participants will be identified during a first 7-year selection period (2008-2015). Each participant will be assigned either in experimental (CAD screening procedure during the selection period) or control group (no CAD screening) on 01/01/2015, and followed for 5 years. The primary endpoint is the incremental cost per life year saved over 5 years in CAD screening group versus no CAD screening. The main secondary endpoints are: total 5-year direct costs of each strategy; incidence of major cardiovascular (acute coronary syndrome, hospitalization for heart failure, coronary revascularization or all-cause death), cerebrovascular (hospitalization for transient ischemic attack, stroke, or carotid revascularization) and lower-limb events (peripheral artery disease, ischemic diabetic foot, lower-limb revascularization or amputation); and the budget impact for the French Insurance system to promote the cost-effective strategy. Analyses will be adjusted for a high-dimension propensity score taking into account known and unknown confounders. SCADIAB has been funded by the French Ministry of Health and the protocol has been approved by the French ethic authorities. Data management and analyses will start in the second half of 2021.DiscussionSCADIAB is a large and contemporary RWE study that will assess the economic and clinical impacts of routine CAD screening in T2DM people at a very high cardiovascular risk. It will also evaluate the clinical practice regarding CAD screening and help to make future recommendations and optimize the use of health care resources.Trial registration ClinicalTrials.gov Identifier: NCT04534530 (https://clinicaltrials.gov/ct2/show/NCT04534530) C1 [Mohammedi, Kamel; Rigalleau, Vincent; Foussard, Ninon] Bordeaux Univ Hosp, Hop Haut Leveque, Dept Endocrinol Diabet & Nutr, Ave Magellan, F-33604 Pessac, France. [Mohammedi, Kamel; Rigalleau, Vincent; Couffinhal, Thierry; Bezin, Julien] Univ Bordeaux, Fac Med, Bordeaux, France. [Mohammedi, Kamel; Couffinhal, Thierry] INSERM, Unit 1034, Biol Cardiovasc Dis, Pessac, France. [Preaubert, Nathalie; Piazza, Laurent] Bordeaux Univ Hosp, Hlth Econ Unit, Clin Res Dept, Talence, France. [Cariou, Tanguy; Benard, Antoine] Bordeaux Univ Hosp, Clin Epidemiol Unit USMR, CIC EC 14 01, Bordeaux, France. [Bairras-Martin, Celine] Bordeaux Univ Hosp, DCRI, Internal Promot Dept, Talence, France. [Couffinhal, Thierry] Bordeaux Univ Hosp, Dept Cardiol, Hop Haut Leveque, Bordeaux, France. [Bezin, Julien] Bordeaux Populat Hlth Res Ctr, INSERM, U1219, Team Pharmacoepidemiol, Bordeaux, France. [Bezin, Julien] Bordeaux Univ Hosp, Dept Pharmacol, Bordeaux, France. [Benard, Antoine] Bordeaux Populat Hlth Res Ctr, INSERM, U1219, Team EMOS0, Bordeaux, France. C3 CHU Bordeaux; UDICE-French Research Universities; Universite de Bordeaux; UDICE-French Research Universities; Universite de Bordeaux; Institut National de la Sante et de la Recherche Medicale (Inserm); CHU Bordeaux; CHU Bordeaux; CHU Bordeaux; CHU Bordeaux; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite de Bordeaux; CHU Bordeaux; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite de Bordeaux RP Mohammedi, K (通讯作者)，Bordeaux Univ Hosp, Hop Haut Leveque, Dept Endocrinol Diabet & Nutr, Ave Magellan, F-33604 Pessac, France. EM km.mmohammedi@gmail.com RI Couffinhal, Thierry/GYJ-6434-2022; Couffinhal, Thierry/M-6857-2014 OI Bezin, Julien/0000-0002-2568-1928; Couffinhal, Thierry/0000-0002-9217-2533; Mohammedi, Kamel/0000-0001-6139-1197 FU French Ministry of Health [PRME 20190006] FX SCADIAB study has been funded by the French Ministry of Health (PRME 20190006) (https://solidarites-sante.gouv.fr/systeme-de-sante -et-medico-social/recherche-et-innovation/l-innovation-et-la-recherche-c linique/appels-a-proje ts/article/les-projets-retenus). 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Diabetol. PD MAR 13 PY 2021 VL 20 IS 1 AR 63 DI 10.1186/s12933-021-01253-2 PG 8 WC Cardiac & Cardiovascular Systems; Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Endocrinology & Metabolism GA QW9TO UT WOS:000628991200001 PM 33714278 OA Green Published, gold DA 2023-05-13 ER PT J AU Daliri, S Kooij, MJ Reimer, WJMSO Riet, G Jepma, P Verweij, L Peters, RJG Buurman, BM Karapinar-Carkit, F AF Daliri, Sara Kooij, Marcel J. Reimer, Wilma J. M. Scholte Op Riet, Gerben Jepma, Patricia Verweij, Lotte Peters, Ron J. G. Buurman, Bianca M. Karapinar-Carkit, Fatma TI Effects of a transitional care programme on medication adherence in an older cardiac population: A randomized clinical trial SO BRITISH JOURNAL OF CLINICAL PHARMACOLOGY LA English DT Article DE adherence; cardiovascular; elderly; medication errors ID ACUTE CORONARY SYNDROME; HOSPITAL DISCHARGE; ADVERSE OUTCOMES; HEART-FAILURE; NONADHERENCE; INTERVENTION; PERSISTENCE; RISK; TERM; PHARMACOTHERAPY AB Aims Medication non-adherence post-discharge is common among patients, especially those suffering from chronic medical conditions, and contributes to hospital admissions and mortality. This study aimed to evaluate the effect of the Cardiac Care Bridge (CCB) intervention on medication adherence post-discharge. Methods We performed a secondary analysis of the CCB randomized single-blind trial, a study in patients >= 70 years, at high risk of functional loss and admitted to cardiology departments in six hospitals. In this multi-component intervention study, community nurses performed medication reconciliation and observed medication-related problems (MRPs) during post-discharge home visits, and pharmacists provided recommendations to resolve MRPs. Adherence to high-risk medications was measured using the proportion of days covered (PDC), using pharmacy refill data. Furthermore, MRPs were assessed in the intervention group. Results For 198 (64.7%) of 306 CCB patients, data were available on adherence (mean age: 82 years; 58.9% of patients used a multidose drug dispensing [MDD] system). The mean PDC before admission was 92.3% in the intervention group (n = 99) and 88.5% in the control group (n = 99), decreasing to 85.2% and 84.1% post-discharge, respectively (unadjusted difference: -2.6% (95% CI -9.8 to 4.6, P = .473); adjusted difference -3.3 (95% CI -10.3 to 3.7, P = .353)). Post-hoc analysis indicated that a modest beneficial intervention effect may be restricted to MDD non-users (P-interaction = .085). In total, 77.0% of the patients had at least one MRP post-discharge. Conclusions Our findings indicate that a multi-component intervention, including several components targeting medication adherence in older cardiac patients discharged from hospital back home, did not benefit their medication adherence levels. A modest positive effect on adherence may potentially exist in those patients not using an MDD system. This finding needs replication. C1 [Daliri, Sara; Karapinar-Carkit, Fatma] OLVG Hosp, Dept Clin Pharm, Amsterdam, Netherlands. [Daliri, Sara; Buurman, Bianca M.] Amsterdam UMC, Sect Geriatr Med, Dept Internal Med, Amsterdam, Netherlands. [Kooij, Marcel J.] Serv Apotheek Koning, Community Pharm, Amsterdam, Netherlands. [Reimer, Wilma J. M. Scholte Op; Riet, Gerben; Jepma, Patricia; Verweij, Lotte; Peters, Ron J. G.] Amsterdam UMC, Dept Cardiol, Acad Med Ctr, Amsterdam, Netherlands. [Reimer, Wilma J. M. Scholte Op] Univ Appl Sci Utrecht, Res Grp Chron Dis, Utrecht, Netherlands. [Riet, Gerben; Jepma, Patricia; Verweij, Lotte; Buurman, Bianca M.] Amsterdam Univ Appl Sci, Fac Hlth, Ctr Expertise Urban Vital, Amsterdam, Netherlands. C3 University of Amsterdam; University of Amsterdam; Academic Medical Center Amsterdam RP Karapinar-Carkit, F (通讯作者)，Jan Tooropstr 164, NL-1061 AE Amsterdam, Netherlands. EM f.karapinar@olvg.nl OI Daliri, Sara/0000-0003-3999-3444; Verweij, Lotte/0000-0002-4727-0126 FU SIA RAAK-mkb [MKB08.011]; ZonMw [520002002] FX SIA RAAK-mkb, Grant/Award Number: RAAK. 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PD MAR PY 2022 VL 88 IS 3 BP 965 EP 982 DI 10.1111/bcp.15044 EA OCT 2021 PG 18 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Pharmacology & Pharmacy GA ZA2LJ UT WOS:000710307800001 PM 34410011 OA Bronze DA 2023-05-13 ER PT J AU Chua, HR Zheng, KP Vathsala, A Ngiam, KY Yap, HK Lu, LJ Tiong, HY Mukhopadhyay, A MacLaren, G Lim, SL Akalya, K Ooi, BC AF Chua, Horng-Ruey Zheng, Kaiping Vathsala, Anantharaman Ngiam, Kee-Yuan Yap, Hui-Kim Lu, Liangjian Tiong, Ho-Yee Mukhopadhyay, Amartya MacLaren, Graeme Lim, Shir-Lynn Akalya, K. Ooi, Beng-Chin TI Health Care Analytics With Time-Invariant and Time-Variant Feature Importance to Predict Hospital-Acquired Acute Kidney Injury: Observational Longitudinal Study SO JOURNAL OF MEDICAL INTERNET RESEARCH LA English DT Article DE acute kidney injury; artificial intelligence; biomarkers; clinical deterioration; electronic health records; hospital medicine; machine learning ID CONTRAST-INDUCED NEPHROPATHY; INTERVENTION; PROGRAM; TRENDS AB Background: Acute kidney injury (AKI) develops in 4% of hospitalized patients and is a marker of clinical deterioration and nephrotoxicity. AKI onset is highly variable in hospitals, which makes it difficult to time biomarker assessment in all patients for preemptive care. Objective: The study sought to apply machine learning techniques to electronic health records and predict hospital-acquired AKI by a 48-hour lead time, with the aim to create an AKI surveillance algorithm that is deployable in real time. Methods: The data were sourced from 20,732 case admissions in 16,288 patients over 1 year in our institution. We enhanced the bidirectional recurrent neural network model with a novel time-invariant and time-variant aggregated module to capture important clinical features temporal to AKI in every patient. Time-series features included laboratory parameters that preceded a 48-hour prediction window before AKI onset; the latter's corresponding reference was the final in-hospital serum creatinine performed in case admissions without AKI episodes. Results: The cohort was of mean age 53 (SD 25) years, of whom 29%, 12%, 12%, and 53% had diabetes, ischemic heart disease, cancers, and baseline eGFR <90 mL/min/1.73 m(2), respectively. There were 911 AKI episodes in 869 patients. We derived and validated an algorithm in the testing dataset with an AUROC of 0.81(0.78-0.85) for predicting AKI. At a 15% prediction threshold, our model generated 699 AKI alerts with 2 false positives for every true AKI and predicted 26% of AKIs. A lowered 5% prediction threshold improved the recall to 60% but generated 3746 AKI alerts with 6 false positives for every true AKI. Representative interpretation results produced by our model alluded to the top-ranked features that predicted AKI that could be categorized in association with sepsis, acute coronary syndrome, nephrotoxicity, or multiorgan injury, specific to every case at risk. Conclusions: We generated an accurate algorithm from electronic health records through machine learning that predicted AKI by a lead time of at least 48 hours. The prediction threshold could be adjusted during deployment to optimize recall and minimize alert fatigue, while its precision could potentially be augmented by targeted AKI biomarker assessment in the high-risk cohort identified. C1 [Chua, Horng-Ruey; Vathsala, Anantharaman; Akalya, K.] Natl Univ Singapore Hosp, Dept Med, Div Nephrol, Level 10 Med,NUHS Tower Block,1E Kent Ridge Rd, Singapore 119228, Singapore. [Chua, Horng-Ruey; Vathsala, Anantharaman; Mukhopadhyay, Amartya; Lim, Shir-Lynn] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Med, Singapore, Singapore. [Zheng, Kaiping; Ooi, Beng-Chin] Natl Univ Singapore, Sch Comp, Dept Comp Sci, Singapore, Singapore. [Ngiam, Kee-Yuan] Natl Univ Singapore Hosp, Dept Surg, Div Endocrine Surg, Singapore, Singapore. [Ngiam, Kee-Yuan; Tiong, Ho-Yee; MacLaren, Graeme] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Surg, Singapore, Singapore. [Yap, Hui-Kim; Lu, Liangjian] Natl Univ Childrens Med Inst, Dept Paediat, Div Paediat Nephrol, Singapore, Singapore. [Yap, Hui-Kim; Lu, Liangjian] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Paediat, Singapore, Singapore. [Tiong, Ho-Yee] Natl Univ Singapore Hosp, Dept Urol, Singapore, Singapore. [Mukhopadhyay, Amartya] Natl Univ Singapore Hosp, Dept Med, Div Resp & Crit Care Med, Singapore, Singapore. [MacLaren, Graeme] Natl Univ Singapore Hosp, Dept Cardiac Thorac & Vasc Surg, Cardiothorac Intens Care Unit, Singapore, Singapore. [Lim, Shir-Lynn] Natl Univ Heart Ctr, Dept Cardiol, Singapore, Singapore. C3 National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore; National University of Singapore RP Chua, HR (通讯作者)，Natl Univ Singapore Hosp, Dept Med, Div Nephrol, Level 10 Med,NUHS Tower Block,1E Kent Ridge Rd, Singapore 119228, Singapore. EM horng_ruey_chua@nuhs.edu.sg RI Tiong, Ho Yee/F-1013-2012; Ngiam, Kee Yuan/S-5501-2017 OI Tiong, Ho Yee/0000-0003-0077-7904; Ngiam, Kee Yuan/0000-0001-5676-2520; Lim, Shir Lynn/0000-0002-1151-2357; MacLaren, Graeme/0000-0002-1307-4274; Vathsala, Anantharaman/0000-0002-6701-412X; Chua, Horng-Ruey/0000-0003-1379-0585; Lu, Liangjian/0000-0002-8363-4353; Mukhopadhyay, Amartya/0000-0002-9747-5277 FU Artificial Intelligence Singapore; National Research Foundation; Data and Technology Office, National University Health System, Singapore FX This study was supported by a grant from Artificial Intelligence Singapore (100 Experiments Grant), a program supported by the National Research Foundation and hosted by the National University of Singapore. The granting body was not involved in the review or approval of the manuscript for publication. The publication was supported by the Data and Technology Office, National University Health System, Singapore. We thank our institution's EHR data managers, Mr Khong-Hai Wang and Mr Mohammad Shaheryar Furqan, and administrator, Ms Mar Mar Win, for their invaluable support. 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Med. Internet Res. PD DEC 24 PY 2021 VL 23 IS 12 AR e30805 DI 10.2196/30805 PG 14 WC Health Care Sciences & Services; Medical Informatics WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Medical Informatics GA YD3ZQ UT WOS:000740355000001 PM 34951595 OA Green Published, gold DA 2023-05-13 ER PT J AU Chowdhury, IZ Amin, MN Chowdhury, MZ Rahman, SM Ahmed, M Cader, FA AF Chowdhury, Ishmum Zia Amin, Md. Nurul Chowdhury, Mashhud Zia Rahman, Sharar Muhib Ahmed, Mohsin Cader, F. Aaysha TI Pre hospital delay and its associated factors in acute myocardial infarction in a developing country SO PLOS ONE LA English DT Article ID ACUTE CORONARY SYNDROMES; 2013 ACCF/AHA GUIDELINE; PREHOSPITAL DELAY; GLOBAL BURDEN; PRIMARY ANGIOPLASTY; TIME-DELAY; TASK-FORCE; MORTALITY; OUTCOMES; MANAGEMENT AB Background Early revascularization and treatment is key to improving clinical outcomes and reducing mortality in acute myocardial infarction (AMI). In low- and middle-income countries such as Bangladesh, timely management of AMI is challenging, with pre-hospital delays playing a significant role. This study was designed to investigate pre-hospital delay and its associated factors among patients presenting with AMI in the capital city of Dhaka. Methods This retrospective cohort study was conducted on 333 patients presenting with AMI over a 3-month period at two of the largest primary reperfusion-capable tertiary cardiac care centres in Dhaka. Of the total patients, 239(71.8%) were admitted in the National Institute of Cardiovascular Diseases, Dhaka and 94(28.2%) at Ibrahim Cardiac Hospital & Research Institute, Dhaka Data were collected from patients by semi-structured interview and hospital medical records. Pre-hospital delay (median and inter-quartile range) was calculated. Statistical significance was determined by Chi-square test. Multivariate logistic regression analysis was done to determine the independent predictors of pre-hospital delay. Results The mean age of the respondents was 53.8 +/- 11.2 years. Two-thirds (67.6%) of the respondents were males. Median total pre-hospital delay was 11.5 (IQR-18.3) hours with median decision time from symptom onset to seeking medical care being 3.0 (IQR: 11.0) hours. Nearly half (48.9%) of patients presented to the hospital more than 12 hours after symptom onset. On multivariate logistic regression analysis, AMI patients with absence of typical chest pain [OR 5.21; (95% CI: 2.5-9.9)], diabetes [OR: 1.7 (95% CI: 1.0-2.9)], residing/staying > 30 km away from nearest hospital at the time of onset [OR: 4.3(95% CI = 2.3-7.2)] and belonged to lower and middle class [OR: 1.9(95% CI = 1.0-3.5)] were significantly associated with pre-hospital delays. Conclusion Acute myocardial infarction (AMI) patients with atypical chest pain, diabetes, staying far away from nearest hospital and belonged to lower and middle socioeconomic strata were significantly associated with pre-hospital delays. The findings could have immense implications for improvements about timely reaching of AMI patients to the hospital within the context of their sociodemographic status and geographic barriers of the city. C1 [Chowdhury, Ishmum Zia; Rahman, Sharar Muhib] BIRDEM Gen Hosp, Dhaka, Bangladesh. [Amin, Md. Nurul] Ibrahim Cardiac Hosp & Res Inst, Dhaka, Bangladesh. [Chowdhury, Mashhud Zia; Cader, F. Aaysha] Ibrahim Cardiac Hosp & Res Inst, Dept Cardiol, Dhaka, Bangladesh. [Ahmed, Mohsin] Natl Inst Cardiovasc Dis, Dept Cardiol, Dhaka, Bangladesh. RP Chowdhury, IZ (通讯作者)，BIRDEM Gen Hosp, Dhaka, Bangladesh. 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However, a detailed prognostic risk stratification of HD patients with acute myocardial infarction (AMI) has not yet been performed in the modern interventional era. We examined 4509 AMI patients (89 AMI/HD and 4420 AMI/non-HD) from the Mie ACS registry and detailed prognostic analyses based on the Killip classification were performed (Cohort A). In addition, prognosis of Killip class1 AMI/HD was compared with those of 313 non-AMI/HD patients from the MIE-CARE HD study using propensity score-matching method (Cohort B). Primary endpoint was all-cause mortality for up to 2 years. All-cause death occurred in 13.0% of AMI/non-HD and 35.8% of AMI/HD during follow-up, and patients with Killip class 1 had lower 30-day and 2-year mortality than those with Killip class >= 2 in both AMI/non-HD and AMI/HD. Cox regression analyses identified that Killip class >= 2 was the strongest independent prognostic factor of 30-day mortality with a hazard ratio of 7.44 (p < 0.001), whereas both presence of HD and Killip class >= 2 were the independent prognostic factors of mortality for up to 2 years. In Cohort B, a propensity score-matching analysis revealed similar all-cause mortality rates between Killip class 1 AMI/HD and non-AMI/HD. In HD patients with Killip class 1 AMI, 30-day mortality was around 6%, and long-term mortality among 30-day survivors after AMI was comparable with the natural course of HD patients in the modern interventional era. C1 [Takasaki, Akihiro; Kurita, Tairo; Hirabayashi, Yosuke; Katayama, Kan; Ito, Masaaki; Dohi, Kaoru] Mie Univ, Dept Cardiol & Nephrol, Grad Sch Med, 2-174 Edobashi, Tsu, Mie 5148507, Japan. [Matsuo, Hiroshi] Suzuka Kaisei Hosp, Dept Nephrol, Suzuka, Japan. [Tanoue, Akiko] Murase Hosp, Dept Nephrol, Suzuka, Japan. [Masuda, Jun] Mie Prefectural Gen Med Ctr, Dept Cardiol, Yokaichi, Japan. [Yamanaka, Takashi] Yokkaichi Hazu Med Ctr, Dept Cardiol, Yokaichi, Japan. [Machida, Hirofumi] Takeuchi Hosp, Dept Nephrol, Tsu, Mie, Japan. [Ichikawa, Takehiko] Kuwana City Med Ctr, Dept Cardiol, Kuwana, Japan. C3 Mie University RP Kurita, T (通讯作者)，Mie Univ, Dept Cardiol & Nephrol, Grad Sch Med, 2-174 Edobashi, Tsu, Mie 5148507, Japan. EM k_siho_yuu@hotmail.com OI Kurita, Tairo/0000-0002-2882-6512 FU incorporated nonprofit organization ' Mie cardiovascular and renal disease network; Suzuken Memorial Foundation, Japan FX Mie ACS registry was funded by incorporated nonprofit organization ' Mie cardiovascular and renal disease network. (http://www.medic.mie-u.ac.jp/miecrnet/) MIE-CARE HD study was funded in part by Suzuken Memorial Foundation, Japan. CR Akashi N, 2018, HEART VESSELS, V33, P713, DOI 10.1007/s00380-018-1122-8 Fox CS, 2010, CIRCULATION, V121, P357, DOI 10.1161/CIRCULATIONAHA.109.865352 Fox KAA, 2002, EUR HEART J, V23, P1177, DOI 10.1053/euhj.2001.3081 Fujii T, 2014, CIRC J, V78, P2950, DOI 10.1253/circj.CJ-14-0808 Fukuoka S, 2019, INT J CARDIOL, V289, P12, DOI 10.1016/j.ijcard.2019.01.011 Garcia-Garcia HM, 2018, EUR HEART J, V39, P2192, DOI 10.1093/eurheartj/ehy223 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Gurm HS, 2012, AM J CARDIOL, V109, P19, DOI 10.1016/j.amjcard.2011.07.062 Herzog CA, 1998, NEW ENGL J MED, V339, P799, DOI 10.1056/NEJM199809173391203 Hioki H, 2016, HEART VESSELS, V31, P687, DOI 10.1007/s00380-015-0673-1 Iseki K, 2000, AM J KIDNEY DIS, V36, P820, DOI 10.1053/ajkd.2000.17676 KILLIP T, 1967, AM J CARDIOL, V20, P457, DOI 10.1016/0002-9149(67)90023-9 Komiyama K, 2018, J CARDIOL, V71, P251, DOI 10.1016/j.jjcc.2017.09.006 Masuda J, 2018, CIRC J, V82, P1666, DOI 10.1253/circj.CJ-17-1275 Matsuo H, 2018, CIRC J, V82, P586, DOI 10.1253/circj.CJ-17-0393 Movahed MR, 2009, AM J CARDIOL, V104, P1030, DOI 10.1016/j.amjcard.2009.05.051 Nitta K, 2020, RENAL REPLACE THER, V6, DOI 10.1186/s41100-020-00290-z Shroff GR, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.002460 Shroff GR, 2012, AM HEART J, V163, P399, DOI 10.1016/j.ahj.2011.12.002 Szummer K, 2019, CIRC-CARDIOVASC QUAL, V12, DOI 10.1161/CIRCOUTCOMES.119.005879 Takasaki A, 2021, CIRC J, V85, P9, DOI 10.1253/circj.CJ-20-0112 Wakasugi M, 2013, THER APHER DIAL, V17, P298, DOI 10.1111/j.1744-9987.2012.01144.x Yeh RW, 2010, NEW ENGL J MED, V362, P2155, DOI 10.1056/NEJMoa0908610 NR 23 TC 2 Z9 2 U1 0 U2 0 PU SPRINGER PI NEW YORK PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES SN 0910-8327 EI 1615-2573 J9 HEART VESSELS JI Heart Vessels PD FEB PY 2022 VL 37 IS 2 BP 208 EP 218 DI 10.1007/s00380-021-01919-7 EA AUG 2021 PG 11 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA YQ3GD UT WOS:000681278400001 PM 34347137 DA 2023-05-13 ER PT J AU Jaeger, C Wildi, K Twerenbold, R Reichlin, T Gimenez, MR Neuhaus, JD Grimm, K Boeddinghaus, J Hillinger, P Nestelberger, T Singeisen, H Gugala, M Pretre, G Puelacher, C Wagener, M Honegger, U Schumacher, C Weidmann, ZM Kreutzinger, P Krivoshei, L Freese, M Stelzig, C Dietsche, S Ernst, S Rentsch, K Osswald, S Mueller, C AF Jaeger, Cedric Wildi, Karin Twerenbold, Raphael Reichlin, Tobias Gimenez, Maria Rubini Neuhaus, Jean-Daniel Grimm, Karin Boeddinghaus, Jasper Hillinger, Petra Nestelberger, Thomas Singeisen, Helene Gugala, Mathias Pretre, Gil Puelacher, Christian Wagener, Max Honegger, Ursina Schumacher, Carmela Weidmann, Zoraida Moreno Kreutzinger, Philipp Krivoshei, Lian Freese, Michael Stelzig, Claudia Dietsche, Sebastian Ernst, Susanne Rentsch, Katharina Osswald, Stefan Mueller, Christian TI One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin SO AMERICAN HEART JOURNAL LA English DT Article ID ACCELERATED DIAGNOSTIC PROTOCOL; ACUTE CORONARY SYNDROMES; EMERGENCY-DEPARTMENT; CT ANGIOGRAPHY; OF-CARDIOLOGY; RAPID RULE; COPEPTIN; ASSAYS; VALIDATION; RISK AB Objective We aimed to prospectively derive and validate a novel 0-/1-hour algorithm using high-sensitivity cardiac troponin I (hs-cTnI) for the early "rule-out" and "rule-in" of acute myocardial infarction (AMI). Methods In a prospective multicenter diagnostic study, we enrolled 1,500 patients presenting with suspected AMI to the emergency department. The final diagnosis was centrally adjudicated by 2 independent cardiologists blinded to hs-cTnI concentrations. The hs-cTnI (Siemens Vista) 0-/1-hour algorithm incorporated measurements performed at baseline and absolute changes within 1 hour, was derived in the first 750 patients (derivation cohort), and then validated in the second 750 (validation cohort). Results Overall, AMI was the final diagnosis in 16% of patients. Applying the hs-cTnI 0-/1-hour algorithm developed in the derivation cohort to the validation cohort, 57% of patients could be classified as "rule-out"; 10%, as "rule-in"; and 33%, as "observe." In the validation cohort, the sensitivity and the negative predictive value for AMI in the "rule-out" zone were 100% (95% CI 96%100%) and 100% (95% CI 99%-100%), respectively. The specificity and the positive predictive value (PPV) for AMI in the "rule-in" zone were 96% (95% CI 94%-97%) and 70% (95% CI 60%-79%), respectively. Negative predictive value and positive predictive value of the 0-/1-hour algorithm were higher compared to the standard of care combining hs-cTnI with the electrocardiogram (both P<.001). Conclusion The hs-cTnI 0-/1-hour algorithm performs very well for early rule-out as well as rule-in of AMI. The clinical implications are that used in conjunction with all other clinical information, the 0-/1-hour algorithm will be a safe and effective approach to substantially reduce time to diagnosis. C1 [Jaeger, Cedric; Wildi, Karin; Twerenbold, Raphael; Reichlin, Tobias; Gimenez, Maria Rubini; Neuhaus, Jean-Daniel; Grimm, Karin; Boeddinghaus, Jasper; Hillinger, Petra; Nestelberger, Thomas; Singeisen, Helene; Gugala, Mathias; Pretre, Gil; Puelacher, Christian; Wagener, Max; Honegger, Ursina; Schumacher, Carmela; Weidmann, Zoraida Moreno; Kreutzinger, Philipp; Krivoshei, Lian; Freese, Michael; Stelzig, Claudia; Dietsche, Sebastian; Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland. [Jaeger, Cedric; Wildi, Karin; Twerenbold, Raphael; Reichlin, Tobias; Gimenez, Maria Rubini; Neuhaus, Jean-Daniel; Grimm, Karin; Boeddinghaus, Jasper; Hillinger, Petra; Nestelberger, Thomas; Singeisen, Helene; Gugala, Mathias; Pretre, Gil; Puelacher, Christian; Wagener, Max; Honegger, Ursina; Schumacher, Carmela; Weidmann, Zoraida Moreno; Kreutzinger, Philipp; Krivoshei, Lian; Freese, Michael; Stelzig, Claudia; Dietsche, Sebastian; Mueller, Christian] Univ Basel Hosp, Cardiovasc Res Inst Basel, CH-4031 Basel, Switzerland. [Gimenez, Maria Rubini] Hosp del Mar, Serv Urgencias & Pneumol, CIBERES ISC 3, Inst Municipal Invest Med, Barcelona, Spain. [Ernst, Susanne] Kantonsspital, Dept Internal Med, Olten, Switzerland. [Rentsch, Katharina] Univ Basel Hosp, Lab Med, CH-4031 Basel, Switzerland. C3 University of Basel; University of Basel; CIBER - Centro de Investigacion Biomedica en Red; CIBERES; Institut Hospital del Mar d'Investigacions Mediques (IMIM); Hospital del Mar; Kantonsspital Aarau AG (KSA); Kantonsspital Olten; University of Basel RP Mueller, C (通讯作者)，Univ Basel Hosp, Dept Cardiol, Petersgraben 4, CH-4031 Basel, Switzerland. EM Christian.Mueller@usb.ch RI Wildi, Karin/AAN-3644-2020; Twerenbold, Raphael/H-3533-2018; Osswald, Stefan/A-6904-2018; Rubini, Maria/ABC-2639-2020; Müller, Christian/AAB-4783-2022 OI Wildi, Karin/0000-0002-6520-2696; Twerenbold, Raphael/0000-0003-3814-6542; Osswald, Stefan/0000-0002-9240-6731; Müller, Christian/0000-0002-1120-6405; Rubini Gimenez, Maria/0000-0003-2384-8250; Wagener, Max/0000-0002-7970-8989; Nestelberger, Thomas/0000-0003-2173-5738 FU Swiss National Science Foundation [PASMP3-136995]; Swiss Heart Foundation; Cardiovascular Research Foundation Basel; 8sense; Abbott; ALERE; Brahms; Critical Diagnostics; Nanosphere; Roche; Siemens; University Hospital Basel; University of Basel; Professor Max Cloetta Foundation; Department of Internal Medicine FX 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, Brahms, Critical Diagnostics, Nanosphere, Roche, Siemens, and the University Hospital Basel, as well as travel support or speaker/consultinghonoraria from Abbott, ALERE, Astra Zeneca, BG medicine, Biomerieux, Brahms, Cardiorentis, Daiichi Sankyo, Lilly, Novartis, Pfizer, Roche, and Siemens. We disclose that Dr Reichlin has received research grants from the Swiss National Science Foundation (PASMP3-136995); the Swiss Heart Foundation; the University of Basel; the Professor Max Cloetta Foundation; and the Department of Internal Medicine, University Hospital Basel, as well as speakers honoraria from Brahms and Roche. All other authors declare that they have no conflict of interest with this study. The sponsors 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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Heart J. PD JAN PY 2016 VL 171 IS 1 BP 92 EP 102 DI 10.1016/j.ahj.2015.07.022 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CZ5EV UT WOS:000367126200012 PM 26699605 DA 2023-05-13 ER PT J AU Rashid, M Curzen, N Kinnaird, T Lawson, CA Myint, PK Kontopantelis, E Mohamed, MO Shoaib, A Gale, CP Timmis, A Mamas, MA AF Rashid, Muhammad Curzen, Nick Kinnaird, Tim Lawson, Claire A. Myint, Phyo K. Kontopantelis, Evangelos Mohamed, Mohamed O. Shoaib, Ahmad Gale, Chris P. Timmis, Adam Mamas, Mamas A. TI Baseline risk, timing of invasive strategy and guideline compliance in NSTEMI: Nationwide analysis from MINAP SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Invasive strategy; Non-ST elevation acute myocardial infarction; Timing; Risk stratification; Guidelines indicated care ID ELEVATION MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; UNSTABLE ANGINA; INTERVENTION; METAANALYSIS; ASSOCIATION; MANAGEMENT; OUTCOMES AB Background: International guidelines recommend that for NSTEMI, the timing of invasive strategy (IS) is a function of patient's baseline risk. The extent to which this is delivered across and within healthcare systems is unknown. Methods: Data were derived from 137,265 patients admitted with an NSTEMI diagnosis between 2010 and 2015 in England and Wales. Patients were stratified into low, intermediate and high-risk in keeping with international guidelines. Time to IS was categorised into early (24 h), intermediate (25-72 h) and late (>72 h). Multivariable logistic regression models were used to identify independent predictors of guidelines recommended receipt of IS. Results: There were 3608 (2.6%) low, 5037 (3.7%) intermediate and 128,621 (93.7%) high-risk patients. Guidelines recommended use of IS was significantly lower in high-risk (16.4%) compared to intermediate (64.7%) and low-risk (62.5%) groups. Both men and women in the low-risk category were almost twice as likely to receive early IS compared to high-risk men (28.9% vs 17%, p < 0.001) and women (26.9% vs 15%, p < 0.001). Women (OR 0.91 95%CI 0.88-0.94), troponin elevation (OR 0.39 95%CI 0.36-0.43) and acute heart failure on admission (OR 0.65 95%CI 0.61-0.70) were strong negative predictors of receiving IS within recommended time in the high-risk group. Conclusion: Our study shows that IS for management of NSTEMI is not delivered according to international guidelines recommendations. Specifically, the disconnect between baseline risk and utility of IS increases with increasing risk and women achieve slower access than men to IS. (C) 2019 Elsevier B.V. All rights reserved. C1 [Rashid, Muhammad; Mohamed, Mohamed O.; Shoaib, Ahmad; Mamas, Mamas A.] Keele Univ, Ctr Prognosis Res, Inst Primary Care Sci, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England. [Rashid, Muhammad; Mohamed, Mohamed O.; Shoaib, Ahmad; Mamas, Mamas A.] Univ Hosp North Midlands, Dept Cardiol, Stoke On Trent, Staffs, England. [Curzen, Nick] Univ Southampton, Univ Hosp Southampton, Coronary Res Grp, Southampton, Hants, England. [Curzen, Nick] Univ Southampton, Fac Med, Southampton, Hants, England. [Kinnaird, Tim] Univ Hosp Wales, Dept Cardiol, Cardiff, Wales. [Lawson, Claire A.] Univ Leicester, Diabet Res Ctr, Real World Evidence Unit, Leicester, Leics, England. [Myint, Phyo K.] Univ Aberdeen, Inst Appl Hlth Sci, Aberdeen, Scotland. [Kontopantelis, Evangelos] Univ Manchester, Div Populat Hlth Hlth Serv Res & Primary Care, Manchester, Lancs, England. [Gale, Chris P.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, W Yorkshire, England. [Timmis, Adam] Queen Mary Univ London, Barts Heart Ctr, London, England. C3 Keele University; RLUK- Research Libraries UK; University of Southampton; RLUK- Research Libraries UK; University of Southampton; RLUK- Research Libraries UK; Cardiff University; RLUK- Research Libraries UK; University of Leicester; RLUK- Research Libraries UK; University of Aberdeen; N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; RLUK- Research Libraries UK; University of London; Queen Mary University London RP Rashid, M (通讯作者)，Keele Univ, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England. EM doctorrashid7@gmail.com RI Mohamed, Mohamed Osama/O-8339-2019; Kontopantelis, Evangelos/H-2966-2019; Lawson, Claire/AAK-1740-2021; Mamas, Mamas Andreas/A-2549-2019 OI Mohamed, Mohamed Osama/0000-0002-9678-5222; Kontopantelis, Evangelos/0000-0001-6450-5815; Mamas, Mamas Andreas/0000-0001-9241-8890; Lawson, Claire/0000-0003-0127-5236; Gale, Chris/0000-0003-4732-382X; Curzen, Nick/0000-0001-9651-7829 CR Alabas OA, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.007123 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, pE139, DOI [10.1016/j.jacc.2014.09.017, 10.1016/j.jacc.2014.09.016] Bassand JP, 2000, EUR HEART J, V21, P1289, DOI 10.1053/euhj.2000.2256 Bavry AA, 2006, J AM COLL CARDIOL, V48, P1319, DOI 10.1016/j.jacc.2006.06.050 Bonello L, 2016, JACC-CARDIOVASC INTE, V9, P2267, DOI 10.1016/j.jcin.2016.09.017 Bugiardini R, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.005968 Canto JG, 2012, JAMA-J AM MED ASSOC, V307, P813, DOI 10.1001/jama.2012.199 Chapman AR, 2018, HEART de Winter RJ, 2005, NEW ENGL J MED, V353, P1095, DOI 10.1056/NEJMoa044259 Dondo TB, 2017, EUR HEART J-ACUTE CA, V6, P412, DOI 10.1177/2048872616647705 Engel J, 2017, CURR CARDIOL REV, V13, P3, DOI 10.2174/1573403X12666160504100025 Fox KAA, 2002, LANCET, V360, P743, DOI 10.1016/S0140-6736(02)09894-X Fox KAA, 2006, BMJ-BRIT MED J, V333, P1091, DOI 10.1136/bmj.38985.646481.55 Gale CP, 2012, EUR HEART J, V33, P630, DOI 10.1093/eurheartj/ehr381 Hall M, 2016, JAMA-J AM MED ASSOC, V316, P1073, DOI 10.1001/jama.2016.10766 Herrett E, 2010, HEART, V96, P1264, DOI 10.1136/hrt.2009.192328 Jobs A, 2017, LANCET, V390, P737, DOI 10.1016/S0140-6736(17)31490-3 Katritsis DG, 2011, EUR HEART J, V32, P32, DOI 10.1093/eurheartj/ehq276 Lindholm D, 2017, EUR HEART J, V3, P53, DOI 10.1093/ehjqcco/qcw044 Mariathas M, 2019, BMJ-BRIT MED J, V364, DOI 10.1136/bmj.l729 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 Montalescot G, 2005, AM J CARDIOL, V95, P1397, DOI 10.1016/j.amjcard.2005.02.004 Potts J, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0203325 Rashid M., 2019, CORON ARTERY DIS Rashid M, 2019, SCI REP-UK, V9, DOI 10.1038/s41598-018-36504-y Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Schneider Eric C, 2013, Rand Health Q, V2, P5 Shah ASV, 2017, BMJ-BRIT MED J, V359, DOI 10.1136/bmj.j4788 Simms AD, 2013, HEART, V99, P35, DOI 10.1136/heartjnl-2012-302632 Tilson Elizabeth Cuervo, 2015, N C Med J, V76, P251, DOI 10.18043/ncm.76.4.251 Welsh P, 2018, CLIN CHEM, V64, P1607, DOI 10.1373/clinchem.2018.292086 NR 33 TC 27 Z9 27 U1 0 U2 3 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 FEB 15 PY 2020 VL 301 BP 7 EP 13 DI 10.1016/j.ijcard.2019.11.146 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KC0NP UT WOS:000506884700002 PM 31810815 OA Green Submitted, Green Accepted, Green Published DA 2023-05-13 ER PT S AU Mingels, AMA Kimenai, DM AF Mingels, Alma M. A. Kimenai, Dorien M. BE Kerkhof, PLM Miller, VM TI Sex-Related Aspects of Biomarkers in Cardiac Disease SO SEX-SPECIFIC ANALYSIS OF CARDIOVASCULAR FUNCTION SE Advances in Experimental Medicine and Biology LA English DT Article; Book Chapter DE Acute myocardial infarction; Age dependence; Biomarkers; Cardiac troponin I; Cardiac troponin T; Estrogen; Heart failure; Natriuretic peptides; BNP; NT-proBNP; Pregnancy; Review ID BRAIN NATRIURETIC PEPTIDE; ACUTE CORONARY SYNDROMES; SENSITIVITY TROPONIN-I; MEDICINE PRACTICE GUIDELINES; CONGESTIVE-HEART-FAILURE; MYOCARDIAL-INFARCTION; CARDIOVASCULAR EVENTS; RENAL-FUNCTION; NT-PROBNP; CLINICAL-BIOCHEMISTRY AB Biomarkers play an important role in the clinical management of cardiac care. In particular, cardiac troponins (cTn) and natriuretic peptides are the cornerstones for the diagnosis of acute myocardial infarction (AMI) and for the diagnosis of heart failure (HF), respectively. Current guidelines do not make a distinction between women and men. However, the commonly used "one size fits all" algorithms are topic of debate to improve assessment of prognosis, particularly in women. Due to the high-sensitivity assays (hs-cTn), lower cTn levels (and 99th percentile upper reference limits) were observed in women as compared with men. Sex-specific diagnostic thresholds may improve the diagnosis ofAMI in women, though clinical relevance remains controversial and more trials are needed. Also other diagnostic aspects are under investigation, like combined biomarkers approach and rapid measurement strategies. For the natriuretic peptides, previous studies observed higher concentrations in women than in men, especially in premenopausal women who might benefit from the cardioprotective actions. Contrary to hs-cTn, natriuretic peptides are particularly incorporated in the ruling-out algorithms for the diagnosis of HF and not ruling-in. Clinical relevance of sex differences here seems marginal, as clinical research has shown that negative predictive values for ruling-out HF were hardly effected when applying a universal diagnostic threshold that is independent from sex or other risk factors. Apart from the diagnostic issues of AMI in women, we believe that in the future most sex-specific benefits of cardiac biomarkers can be obtained in patient follow-up (guiding therapy) and prognostic applications, fitting modern ideas on preventive and personalized medicine. C1 [Mingels, Alma M. A.; Kimenai, Dorien M.] Maastricht Univ, Med Ctr, Dept Clin Chem, Cent Diagnost Lab, Maastricht, Netherlands. C3 Maastricht University RP Mingels, AMA (通讯作者)，Maastricht Univ, Med Ctr, Dept Clin Chem, Cent Diagnost Lab, Maastricht, Netherlands. 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PY 2018 VL 1065 BP 545 EP 564 DI 10.1007/978-3-319-77932-4_33 D2 10.1007/978-3-319-77932-4 PG 20 WC Biology; Cardiac & Cardiovascular Systems; Medicine, Research & Experimental WE Book Citation Index– Science (BKCI-S); Science Citation Index Expanded (SCI-EXPANDED) SC Life Sciences & Biomedicine - Other Topics; Cardiovascular System & Cardiology; Research & Experimental Medicine GA BL6GX UT WOS:000453874000035 PM 30051406 DA 2023-05-13 ER PT J AU Mark, DG Shan, J Huang, J Ballard, DW Vinson, DR Kene, MV Sax, DR Rauchwerger, AS Reed, ME AF Mark, Dustin G. Shan, Judy Huang, Jie Ballard, Dustin W. Vinson, David R. Kene, Mamata, V Sax, Dana R. Rauchwerger, Adina S. Reed, Mary E. CA Kaiser Permanente CREST Network In TI Higher intensity of 72-h noninvasive cardiac test referral does not improve short-term outcomes among emergency department patients with chest pain SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID ACUTE CORONARY SYNDROME; INTERMEDIATE RISK; HEART; INTERVENTIONS; ANGIOGRAPHY; DISCHARGE; PATHWAY; DISEASE; IMPACT AB Background: It is unclear whether referral for cardiac noninvasive testing (NIT) following emergency department (ED) chest pain encounters improves short-term outcomes. Methods: This was a retrospective cohort study of patients presenting with chest pain, without ST-elevation myocardial infarction or myocardial injury by serum troponin testing, between 2013 and 2019 to 21 EDs within an integrated health care system. We examined the association between NIT referral (within 72 h of the ED encounter) and a primary outcome of 60-day major adverse cardiac events (MACE). Secondary outcomes were 60-day MACE without coronary revascularization (MACE-CR) and 60-day all-cause mortality. To account for confounding by indication for NIT, we grouped patient encounters into ranked tertiles of NIT referral intensity based on the likelihood of 72-h NIT referral associated with the initially assigned emergency physician, relative to local peers and within discrete time periods. Associations between NIT referral-intensity tertile and outcomes were assessed using risk-adjusted multivariable logistic regression. Results: Among 210,948 eligible patient encounters, 72-h NIT referral frequency was 11.9%, 18.3%, and 25.9% in low, intermediate, and high NIT referral-intensity encounters, respectively. Compared with the low referral-intensity tertile, there was a higher risk of 60-day MACE within the high referral-intensity tertile (odds ratio [OR] = 1.11, 95% confidence interval [CI] = 1.04 to 1.17) due to more coronary revascularizations without corresponding differences in MACE-CR or all-cause mortality. In analyses stratified by patients' estimated risk (HEART score; 50.5% lower risk, 38.7% moderate risk, 10.8% higher risk), the difference in 60-day MACE was primarily attributable to moderate-risk encounters (OR = 1.15, 95% CI = 1.08 to 1.24), with no differences among either lower-(OR = 1.10, 95% CI = 0.92 to 1.31) or higher- (OR = 1.01, 95% CI = 0.90 to 1.14) risk encounters. Conclusion: Higher referral intensity for 72-h NIT was associated with higher risk of coronary revascularization but no difference in adverse events within 60 days. These findings further call into question the urgency of NIT among ED patients without objective evidence of myocardial injury. C1 [Mark, Dustin G.; Sax, Dana R.] Kaiser Permanente Oakland Med Ctr, Dept Emergency Med, Oakland, CA 94611 USA. [Mark, Dustin G.; Shan, Judy; Huang, Jie; Ballard, Dustin W.; Vinson, David R.; Sax, Dana R.; Rauchwerger, Adina S.; Reed, Mary E.] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA. [Shan, Judy] Univ Calif San Francisco, Sch Med, San Francisco, CA USA. [Ballard, Dustin W.] Kaiser Permanente San Rafael Med Ctr, Dept Emergency Med, San Rafael, CA USA. [Vinson, David R.] Kaiser Permanente Roseville Med Ctr, Dept Emergency Med, Roseville, CA USA. [Kene, Mamata, V] Kaiser Permanente San Leandro Med Ctr, Dept Emergency Med, San Leandro, CA USA. C3 Kaiser Permanente; Kaiser Permanente; University of California System; University of California San Francisco; Kaiser Permanente; Kaiser Permanente; Kaiser Permanente RP Mark, DG (通讯作者)，Kaiser Permanente Oakland Med Ctr, Dept Emergency Med, Oakland, CA 94611 USA.; Mark, DG (通讯作者)，Kaiser Permanente Oakland Med Ctr, Dept Crit Care Med, Oakland, CA 94611 USA. EM dustin.g.mark@kp.org RI Mark, Dustin George/AEB-1783-2022 OI Mark, Dustin George/0000-0002-5001-7228; Shan, Judy/0000-0002-3596-3240; Kene, Mamata/0000-0001-7493-8438; Vinson, David/0000-0001-6559-1858 FU Permanente Medical Group (TPMG) Delivery Science Research Program FX The Permanente Medical Group (TPMG) Delivery Science Research Program 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] Austin PC, 2009, STAT MED, V28, P3083, DOI 10.1002/sim.3697 Backus BE, 2013, INT J CARDIOL, V168, P2153, DOI 10.1016/j.ijcard.2013.01.255 Cairns C, 2022, NATL HOSP AMBULATORY, DOI [10.15620/cdc:115748, DOI 10.15620/CDC:115748] Cotterill PG, 2015, ACAD EMERG MED, V22, P955, DOI 10.1111/acem.12728 Cullen L, 2010, EMERG MED AUSTRALAS, V22, P35, DOI 10.1111/j.1742-6723.2010.01256.x Derington CG, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0231100 Du LP, 2017, EUR J PREV CARDIOL, V24, P962, DOI 10.1177/2047487317695628 Foy AJ, 2015, JAMA INTERN MED, V175, P428, DOI 10.1001/jamainternmed.2014.7657 Gordon Nancy, 2016, Perm J, V20, P15, DOI 10.7812/TPP/15-225 Greene DN, 2015, CLIN CHIM ACTA, V444, P149, DOI 10.1016/j.cca.2015.02.005 Greenslade JH, 2015, HEART LUNG CIRC, V24, P879, DOI 10.1016/j.hlc.2015.03.025 HOLM S, 1979, SCAND J STAT, V6, P65 Kavsak PA, 2007, CLIN CHEM, V53, P220, DOI 10.1373/clinchem.2006.076885 Kawatkar AA, 2020, JAMA INTERN MED, V180, P1621, DOI 10.1001/jamainternmed.2020.4325 Kini V, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.007854 Levesque LE, 2010, BRIT MED J, V340, DOI 10.1136/bmj.b5087 Linde JJ, 2015, JACC-CARDIOVASC IMAG, V8, P1404, DOI 10.1016/j.jcmg.2015.07.015 Magnani JW, 2018, CIRCULATION, V138, pE48, DOI 10.1161/CIR.0000000000000579 Mahler SA, 2018, CIRCULATION, V138, P2456, DOI 10.1161/CIRCULATIONAHA.118.036528 Mark DG., 2020, AM J EMERG MED, V38, P2760 Mark DG, 2021, J AM HEART ASSOC, V10, DOI 10.1161/JAHA.121.022539 Mark DG, 2020, ACAD EMERG MED, V27, P1028, DOI 10.1111/acem.14068 Mark DG, 2018, J AM COLL CARDIOL, V71, P606, DOI 10.1016/j.jacc.2017.11.064 Meyer MC, 2006, ANN EMERG MED, V47, P427, DOI 10.1016/j.annemergmed.2005.10.010 Musey PI, 2021, ACAD EMERG MED, V28, P718, DOI 10.1111/acem.14296 Natsui S, 2021, CIRC-CARDIOVASC QUAL, V14, P6, DOI 10.1161/CIRCOUTCOMES.119.006297 Natsui S, 2019, ANN EMERG MED, V74, P216, DOI 10.1016/j.annemergmed.2019.01.027 Newby D, 2015, LANCET, V385, P2383, DOI 10.1016/S0140-6736(15)60291-4 Newby DE, 2018, NEW ENGL J MED, V379, P924, DOI 10.1056/NEJMoa1805971 Otto CM, 2021, CIRCULATION, V143, pe72, DOI [10.1161/CIR.0000000000000923, 10.1161/CIR.0000000000001030, 10.1016/j.jacc.2020.11.018] Rahman F, 2010, EMERG MED AUSTRALAS, V22, P449, DOI 10.1111/j.1742-6723.2010.01331.x Reinhardt SW, 2018, JAMA INTERN MED, V178, P212, DOI 10.1001/jamainternmed.2017.7360 Roifman I, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.120.017330 Roifman I, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.119.015724 Roifman I, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013824 Safavi KC, 2014, JAMA INTERN MED, V174, P546, DOI 10.1001/jamainternmed.2013.14407 Sandhu AT, 2017, JAMA INTERN MED, V177, P1175, DOI 10.1001/jamainternmed.2017.2432 Tang WHW, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.114.000960 Tomaszewski CA, 2018, ANN EMERG MED, V72, pE65, DOI 10.1016/j.annemergmed.2018.07.045 Wereski R, 2020, JAMA CARDIOL, V5, P1302, DOI 10.1001/jamacardio.2020.2867 NR 41 TC 1 Z9 1 U1 0 U2 0 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1069-6563 EI 1553-2712 J9 ACAD EMERG MED JI Acad. Emerg. Med. PD JUN PY 2022 VL 29 IS 6 BP 736 EP 747 DI 10.1111/acem.14448 PG 12 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 2I2BT UT WOS:000814788400007 PM 35064989 DA 2023-05-13 ER PT J AU Bhatia, MS Sharda, SC Attri, R Pannu, AK Dahiya, N AF Bhatia, M. S. Sharda, S. C. Attri, R. Pannu, A. K. Dahiya, N. TI Correlation of mortality with Pro-BNP and precipitating factors of acute heart failure in patients presenting to a medical emergency of tertiary care hospital: an observational study from north India SO EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES LA English DT Article DE Acute coronary syndrome; Heart failure with reduced ejection fraction; Heart failure with preserved ejection fraction; Myocardial infarction; Acute heart failure; B-type natriuretic peptide ID ATRIAL-FIBRILLATION; PROGNOSTIC-SIGNIFICANCE; NT-PROBNP; ANEMIA; READMISSION; PREVALENCE; PREDICTOR; OUTCOMES; PROGRAM; IMPACT AB OBJECTIVE: Acute heart failure is a syndrome defined as the new onset de no-vo heart failure or worsening [acutely decom-pensated heart failure (ADHF)] leading to symp-toms and signs of HF, mostly related to system-ic congestion as based on the European Society of Cardiology (ESC) definition. India has a huge burden of heart failure patients. Several factors have been identified as precipitating acute HF hospitalizations. These include myocardial isch-emia, no adherence to medications, arrhythmias, infection, uncontrolled hypertension (HTN), ane-mia, renal impairment, and diet. However, there is a dearth of studies assessing their effect on mor-tality in patients admitted with acute heart failure. Many previous studies have shown that BNP and NT-pro-BNP are independent predictors of mor-tality and other cardiac outcomes in patients with heart failure (HF) and ADHF. However, no studies have provided any clear direction with respect to the critical cut-off values that suggest high mor-tality. Comprehensive knowledge of the correla-tion of Pro-BNP and precipitating factors of heart failure with mortality can help in prognostication and clinical management of AHF patients.PATIENTS AND METHODS: This was a pro-spective observational cross-sectional study conducted in the Emergency Department of the Postgraduate Institute of Medical Education and Research, Chandigarh which is a teaching and research hospital located in North India. Patients were enrolled from 1st August 2021 to 28th Febru-ary 2022. Patients who met inclusion criteria were enrolled; they were followed for 5 days. After 5 days outcomes were recorded. Various precipi-tating factors for hospitalization were identified and their clinical impact on mortality was noted. Pro-BNP values were obtained at admission and their correlation with mortality and patient out-come after 5 days was noted. Values of Pro-BNP were compared among those who survived after 5 days vs. those who had fatal outcomes.RESULTS: The most common precipitating fac-tor for AHF was poor medical compliance which did not affect mortality. It was followed by sepsis which significantly increases mortality in patients of AHF. ACS was also an important precipitating factor for AHF, though it had no effect on mor-tality. The mortality in the group of patients with very high Pro-BNP levels >= 2000 pg/ml was sig-nificantly higher than in the group of patients who had moderately elevated Pro-BNP < 2000 pg/ml. The median value of Pro-BNP was significantly higher in patients who had fatal outcomes [3670 (IQR-2745 to 3980)] as compared to patients who survived after 5 days of hospitalization [1340 (IQR-987 to 1670)].CONCLUSIONS: Poor compliance with med-ications and sepsis are the most common pre-cipitating factors for acute heart failure in north Indian patients. Sepsis as a precipitating factor is a significant risk factor for in-hospital mortality in acute heart failure patients presenting to the emergency department. Pro-BNP values above 2000 pg/ml in patients with acute heart failure requiring emergency admission are associated with a poor prognosis. C1 [Bhatia, M. S.; Sharda, S. C.; Pannu, A. K.] Postgrad Inst Med Educ & Res PGIMER, Dept Internal Med, Chandigarh, India. [Attri, R.] Dept Gen Med, Dr B R Ambedkar State Inst Med Sci, Mohali, Punjab, India. [Dahiya, N.] Postgrad Inst Med Educ & Res PGIMER, Dept Cardiol, Chandigarh, India. C3 Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh; Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh RP Sharda, SC (通讯作者)，Postgrad Inst Med Educ & Res PGIMER, Dept Internal Med, Chandigarh, India. EM saurabhcsharda@gmail.com OI Pannu, Ashok/0000-0002-4476-3478 CR Adams KF, 2005, AM HEART J, V149, P209, DOI 10.1016/j.ahj.2004.08.005 Tejedo AA, 2017, EMERGENCIAS, V29, P185 Ambrosy AP, 2014, J AM COLL CARDIOL, V63, P1123, DOI 10.1016/j.jacc.2013.11.053 Anand IS, 2018, CIRCULATION, V138, P80, DOI 10.1161/CIRCULATIONAHA.118.030099 Arrigo M, 2017, EUR J HEART FAIL, V19, P201, DOI 10.1002/ejhf.682 Arrigo M, 2016, ESC HEART FAIL, V3, P115, DOI 10.1002/ehf2.12083 Avellino A, 2011, BIOMARKERS, V16, P379, DOI 10.3109/1354750X.2011.574234 Balion CM, 2008, CLIN BIOCHEM, V41, P266, DOI 10.1016/j.clinbiochem.2007.10.006 Berkovitch A, 2015, MEDICINE, V94, DOI 10.1097/MD.0000000000002330 CARSON PE, 1993, CIRCULATION, V87, P102 Chaturvedi V., 2016, J PRACT CARDIOVASC S, V2, P28, DOI [10.4103/2395-5414.182988, DOI 10.4103/2395-5414.182988] Cleland JGF, 2003, EUR HEART J, V24, P442, DOI 10.1016/S0195-668X(02)00823-0 Desai NR, 2016, JAMA-J AM MED ASSOC, V316, P2647, DOI 10.1001/jama.2016.18533 Di Angelantonio E, 2009, CIRCULATION, V120, P2177, DOI 10.1161/CIRCULATIONAHA.109.884866 Doust JA, 2005, BRIT MED J, V330, P625, DOI 10.1136/bmj.330.7492.625 Drozd M, 2020, CIRC-HEART FAIL, V13, DOI 10.1161/CIRCHEARTFAILURE.119.006746 Dunlay SM, 2017, NAT REV CARDIOL, V14, DOI 10.1038/nrcardio.2017.65 From AM, 2006, AM J MED, V119, P591, DOI 10.1016/j.amjmed.2006.05.024 Gerber Y, 2015, JAMA INTERN MED, V175, P996, DOI 10.1001/jamainternmed.2015.0924 Go AS, 2006, CIRCULATION, V113, P2713, DOI 10.1161/CIRCULATIONAHA.105.577577 Kotecha D, 2019, BMC MED, V17, DOI 10.1186/s12916-019-1306-9 Lam CSP, 2018, EUR HEART J, V39, P1770, DOI 10.1093/eurheartj/ehy005 Mahoney P, 1999, AM J CARDIOL, V83, P1544, DOI 10.1016/S0002-9149(99)00144-7 MIDDLEKAUFF HR, 1991, CIRCULATION, V84, P40, DOI 10.1161/01.CIR.84.1.40 Miro O, 2015, MED CLIN-BARCELONA, V145, P385, DOI 10.1016/j.medcli.2015.01.014 Oremus M, 2008, CLIN BIOCHEM, V41, P260, DOI 10.1016/j.clinbiochem.2007.09.011 Salam AM, 2020, MED PRIN PRACT, V29, P270, DOI 10.1159/000503334 Searle J, 2016, ESC HEART FAIL, V3, P65, DOI 10.1002/ehf2.12092 Shindler DM, 1996, AM J CARDIOL, V77, P1017, DOI 10.1016/S0002-9149(97)89163-1 Tang YD, 2008, HEART FAIL REV, V13, P387, DOI 10.1007/s10741-008-9089-7 Vesbianu D, 2008, WORLD HEART J, V1, P349 Worster A, 2008, CLIN BIOCHEM, V41, P250, DOI 10.1016/j.clinbiochem.2007.08.008 NR 32 TC 0 Z9 0 U1 0 U2 0 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. PY 2022 VL 26 IS 18 BP 6459 EP 6468 PG 10 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA 5I4DW UT WOS:000868310400007 PM 36196696 DA 2023-05-13 ER PT J AU Arias, FGR Alonso-Fernandez-Gatta, M Dominguez, MP Martinez, JM Veloso, PR Bermejo, RMA Alvarez, DI Merchan-Gomez, S Diego-Nieto, A Casas, CAJ Alvarez, BA Ferrero, TG Antonio, CC Muinos, PJA Acuna, JMG Sanchez, PL Juanatey, JRG AF Garcia-Rodeja Arias, Federico Alonso-Fernandez-Gatta, Marta Dominguez, Marta Perez Martinez, Jesus Martinon Rigueiro Veloso, Pedro Agra Bermejo, Rosa Maria Iglesias Alvarez, Diego Merchan-Gomez, Soraya Diego-Nieto, Alejandro Jokh Casas, Charigan Abou Alvarez Alvarez, Belen Gonzalez Ferrero, Teba Cacho Antonio, Carla Antunez Muinos, Pablo Jose Garcia Acuna, Jose Maria Sanchez, Pedro L. Gonzalez Juanatey, Jose Ramon TI Predictive Model and Risk Score for In-Hospital Mortality in Patients with All-Cause Cardiogenic Shock Santiago Shock Score (S3) SO INTERNATIONAL HEART JOURNAL LA English DT Article DE Critical care; CardShock score; Score validation; Heart failure; Risk stratification ID ACUTE MYOCARDIAL-INFARCTION; ACUTE PHYSIOLOGY; MANAGEMENT; TRIAL AB Cardiogenic shock (CS) is a condition associated with high morbidity and mortality. Our study aimed to perform a risk score for in-hospital mortality that allows for stratifying the risk of death in patients with CS. This is a retrospective analysis, which included 135 patients from a Spanish university hospital between 2011 and 2020. The Santiago Shock Score (S3) was created using clinical, analytical, and echocardiographic variables obtained at the time of admission. The in-hospital mortality rate was 41.5%, and acute coronary syndrome (ACS) was the responsible cause of shock in 60.7% of patients. Mitral regurgitation grade III-IV, age, ACS etiology, NT-proBNP, blood hemoglobin, and lactate at admission were included in the score. The S3 had good accuracy for predicting in-hospital mortality area under the receiver operating characteristic curve (AUC) 0.85 (95% confidence interval (CI) 0.78-0.90), higher than the AUC of the CardShock score, which was 0.74 (95% CI 0.66-0.83). Predictive power in a cohort of 131 patients with profound CS was similar to that of CardShock with an AUC of 0.601 (95% CI 0.496-0.706) versus an AUC of 0.558 (95% CI 0.453-0.664). Three risk categories were created according to the S3: low (scores 0-6), intermediate (scores 7-10), and high (scores 11-16) risks, with an observed mortality of 12.9%, 49.1%, and 87.5% respectively (P < 0.001). The S3 score had excellent predictive power for in-hospital mortality in patients with nonprofound CS. It could aid the initial risk stratification of patients and thus, guide treatment and clinical decision making in patients with CS. C1 [Garcia-Rodeja Arias, Federico; Dominguez, Marta Perez; Martinez, Jesus Martinon; Rigueiro Veloso, Pedro; Agra Bermejo, Rosa Maria; Iglesias Alvarez, Diego; Jokh Casas, Charigan Abou; Alvarez Alvarez, Belen; Gonzalez Ferrero, Teba; Cacho Antonio, Carla; Antunez Muinos, Pablo Jose; Garcia Acuna, Jose Maria; Gonzalez Juanatey, Jose Ramon] Complejo Hosp Univ Santiago Compostela, Dept Dept, Santiago De Compostela, Spain. [Garcia-Rodeja Arias, Federico; Dominguez, Marta Perez; Martinez, Jesus Martinon; Rigueiro Veloso, Pedro; Agra Bermejo, Rosa Maria; Iglesias Alvarez, Diego; Jokh Casas, Charigan Abou; Alvarez Alvarez, Belen; Gonzalez Ferrero, Teba; Cacho Antonio, Carla; Antunez Muinos, Pablo Jose; Garcia Acuna, Jose Maria; Gonzalez Juanatey, Jose Ramon] Biomed Res Networking Ctr Cardiovasc Dis CIBERCV, Madrid, Spain. [Alonso-Fernandez-Gatta, Marta; Merchan-Gomez, Soraya; Diego-Nieto, Alejandro; Garcia Acuna, Jose Maria] Univ Salamanca, Hosp Univ Salamanca IBSAL, Dept Cardiol, Salamanca, Spain. C3 Complexo Hospitalario Universitario de Santiago de Compostela; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; University of Salamanca RP Arias, FGR (通讯作者)，Complejo Hosp Univ Santiago Compostela, Dept Cardiol, Rua Choupana S-N, Santiago De Compostela, Spain. 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Heart J. PD NOV PY 2022 VL 63 IS 6 BP 1034 EP 1040 DI 10.1536/ihj.22-303 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 7J9VY UT WOS:000904934900003 PM 36372409 OA gold DA 2023-05-13 ER PT J AU Alexander, T Victor, SM Jayakumaran, B Rajan, S Mullasari, SA AF Alexander, Thomas Victor, Suma M. Jayakumaran, Balakumaran Rajan, Sabari Mullasari, S. Ajit TI Sex-Related Differences in Outcomes for Patients With ST Elevation Myocardial Infarction (STEMI): A Tamil Nadu-STEMI Program Subgroup Analysis SO HEART LUNG AND CIRCULATION LA English DT Article DE Sex-related differences; ST elevation myocardial infarction ID ACUTE CORONARY SYNDROMES; GENDER-DIFFERENCES; EARLY MORTALITY; INDIA; TIMI; THROMBOLYSIS; THERAPY; CARE AB Background ST elevation myocardial infarction (STEMI) represents a large proportion of the clinical presentation of coronary artery disease in Indian people. Owing to multiple factors contributing to the sex difference, women with STEMI are thought to have a higher risk of adverse outcomes than men. The aim of this study was to evaluate sex-related differences in the clinical characteristics and prognosis of patients with STEMI within a system of care. Method This study was a subgroup analysis of the Tamil Nadu-STEMI (TN-STEMI) program, a multicentre, prospective, observational study of a quality-improvement program studying patients with STEMI at four hub-and-spoke clusters in the southern state of Tamil Nadu, India. In total, 2,420 patients were enrolled between 2012 and 2014, and the data from all four clusters, pre- and postimplementation of integrated STEMI systems, were combined for this analysis, with a 1-year follow-up. Results The mean +/- SD age of presentation of female patients (16%) was significantly later (60.1 +/- 10.9 years) compared with males (84%; 53.7 +/- 12 years). Diabetes was more prevalent in women (35.2% vs 23.8%; p<0.001), as was hypertension (35.2% vs 22.9%; p<0.001). Symptom to first medical contact in female patients was significantly delayed compared with males (193 mins vs 170 mins; p <= 0.009). Women had higher mortality, both in hospital (10.4% vs 4.8%; p <= 0.001) and at 1 year (26.7% vs 13%; p <= 0.001). This pattern was persistent, even in the younger STEMI (<45 years) population (in-hospital: 9.1% vs 3% [p <= 0.05]; at 1 year: 18.2% vs 3% [p <= 0.05]). In the regression model, females had a 1.8 times increased likelihood (p<0.04) of mortality after adjusting for confounders. Conclusions Among patients with STEMI, women have an unfavourable risk profile and adverse short- and long-term prognoses when compared to men. C1 [Alexander, Thomas; Jayakumaran, Balakumaran; Rajan, Sabari] Kovai Med Ctr Hosp, Coimbatore, Tamil Nadu, India. [Victor, Suma M.; Mullasari, S. Ajit] Madras Med Mission, 4-A,JJ Nagar, Chennai 600037, Tamil Nadu, India. RP Victor, SM (通讯作者)，Madras Med Mission, 4-A,JJ Nagar, Chennai 600037, Tamil Nadu, India. EM sumavictor@yahoo.com CR Alexander T, 2017, JAMA CARDIOL, V2, P498, DOI 10.1001/jamacardio.2016.5977 [Anonymous], 2016, LANCET, V387, P506, DOI 10.1016/S0140-6736(16)00267-1 BOVILL EG, 1991, ANN INTERN MED, V115, P256, DOI 10.7326/0003-4819-115-4-256 Bucholz EM, 2014, CIRCULATION, V130, P757, DOI 10.1161/CIRCULATIONAHA.114.009480 Chandrasekhar J, 2018, INT J WOMENS HEALTH, V10, P267, DOI 10.2147/IJWH.S107371 D'Onofrio G, 2015, CIRCULATION, V131, P1324, DOI 10.1161/CIRCULATIONAHA.114.012293 DEMIROVIC J, 1995, AM J CARDIOL, V75, P1096, DOI 10.1016/S0002-9149(99)80737-1 DeVon HA, 2011, JOGNN-J OBST GYN NEO, V40, P372, DOI 10.1111/j.1552-6909.2011.01241.x Gibson CM, 2001, CIRCULATION, V103, P2550 Jneid H, 2008, CIRCULATION, V118, P2803, DOI 10.1161/CIRCULATIONAHA.108.789800 Joshi P, 2007, JAMA-J AM MED ASSOC, V297, P286, DOI 10.1001/jama.297.3.286 Maas AHEM, 2010, NETH HEART J, V18, P598, DOI 10.1007/s12471-010-0841-y MAYNARD C, 1992, ARCH INTERN MED, V152, P972, DOI 10.1001/archinte.152.5.972 Mohanan PP, 2013, EUR HEART J, V34, P121, DOI 10.1093/eurheartj/ehs219 Mozaffarian D, 2015, CIRCULATION, V131, pE29, DOI 10.1161/CIR.0000000000000152 Otten AM, 2013, EUR HEART J-ACUTE CA, V2, P334, DOI 10.1177/2048872612475270 Pagidipati NJ, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0062061 PASSAMANI E, 1985, NEW ENGL J MED, V312, P932 Prabhakaran Dorairaj, 2005, Indian Heart J, V57, P217 Vaccarino V, 1999, NEW ENGL J MED, V341, P217, DOI 10.1056/NEJM199907223410401 Xavier D, 2008, LANCET, V371, P1435, DOI 10.1016/S0140-6736(08)60623-6 NR 21 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1443-9506 EI 1444-2892 J9 HEART LUNG CIRC JI Heart Lung Circ. PD DEC PY 2021 VL 30 IS 12 BP 1870 EP 1875 DI 10.1016/j.hlc.2021.04.017 EA NOV 2021 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA WV6OP UT WOS:000717354300025 PM 34088626 DA 2023-05-13 ER PT J AU Bucholz, EM Normand, SLT Wang, Y Ma, SG Lin, HQ Krumholz, HM AF Bucholz, Emily M. Normand, Sharon-Lise T. Wang, Yun Ma, Shuangge Lin, Haiqun Krumholz, Harlan M. TI Life Expectancy and Years of Potential Life Lost After Acute Myocardial Infarction by Sex and Race A Cohort-Based Study of Medicare Beneficiaries SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE acute coronary syndromes; population perspective; survival ID LONG-TERM PROGNOSIS; RACIAL-DIFFERENCES; REVASCULARIZATION PROCEDURES; SURVIVAL; WOMEN; CARE; MEN; MORTALITY; OUTCOMES; DISPARITIES AB BACKGROUND Most studies of sex and race differences after acute myocardial infarction (AMI) have not taken into account differences in life expectancy in the general population. Years of potential life lost (YPLL) is a metric that takes into account the burden of disease and can be compared by sex and race. OBJECTIVES This study sought to determine sex and race differences in long-term survival after AMI using life expectancy and YPLL to account for differences in population-based life expectancy. METHODS Using data from the Cooperative Cardiovascular Project, a prospective cohort study of Medicare beneficiaries hospitalized for AMI between 1994 and 1995 (N = 146,743), we calculated life expectancy and YPLL using Cox proportional hazards regression with extrapolation using exponential models. RESULTS Of the 146,743 patients with AMI, 48.1% were women and 6.4% were black; the average age was 75.9 years. Post-AMI life expectancy estimates were similar for men and women of the same race but lower for black patients than white patients. On average, women lost 10.5% (SE 0.3%) more of their expected life than men, and black patients lost 6.2% (SE 0.6%) more of their expected life than white patients. After adjustment, women still lost an average of 7.8% (0.3%) more of their expected life than men, but black race became associated with a survival advantage, suggesting that racial differences in YPLL were largely explained by differences in clinical presentation and treatment between black and white patients. CONCLUSIONS Women and black patients lost more years of life after AMI, on average, than men and white patients, an effect that was not explained in women by clinical or treatment differences. (C) 2015 by the American College of Cardiology Foundation. C1 [Bucholz, Emily M.] Yale Univ, Sch Med, New Haven, CT 06510 USA. [Bucholz, Emily M.] Yale Univ, Sch Publ Hlth, New Haven, CT 06510 USA. [Normand, Sharon-Lise T.] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. [Normand, Sharon-Lise T.] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA. [Wang, Yun; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Ma, Shuangge; Lin, Haiqun] Yale Univ, Sch Publ Hlth, Dept Biostat, New Haven, CT 06510 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 06510 USA. [Krumholz, Harlan M.] Yale Univ, Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT 06510 USA. C3 Yale University; Yale University; Harvard University; Harvard Medical School; Harvard University; Harvard T.H. Chan School of Public Health; Yale University; Yale University; 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 OI Normand, Sharon-Lise/0000-0001-7027-4769; Lin, Haiqun/0000-0002-3114-9671 FU National Heart, Lung, and Blood Institute [F30HL120498-01A1, U01 HL105270-05]; NIGMS Medical Scientist Training Program [T32GM07205] FX Dr. Bucholz is supported by F30 Training grant F30HL120498-01A1 from the National Heart, Lung, and Blood Institute and by NIGMS Medical Scientist Training Program grant T32GM07205. Dr. Krumholz is supported by grant U01 HL105270-05 (Center for Cardiovascular Outcomes Research at Yale University) from the National Heart, Lung, and Blood Institute. Dr. Normand is a member of the Board of Directors of Frontier Science and Technology. Dr. Krumholz has received research agreements from Medtronic, Inc. and Johnson and Johnson through Yale University for the purpose of disseminating clinical trials; works under contract with the Centers for Medicare and Medicaid Services to develop and maintain performance measures; and chairs the Cardiac Scientific Advisory Board for United Health. 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 AUG 11 PY 2015 VL 66 IS 6 BP 645 EP 655 DI 10.1016/j.jacc.2015.06.022 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CO4OF UT WOS:000359139600007 PM 26248991 OA Green Accepted DA 2023-05-13 ER PT J AU Lazar, MH Fadel, R Gardner-Gray, J Tatem, G Caldwell, MT Swiderek, J Jennings, JH AF Lazar, Michael H. Fadel, Raef Gardner-Gray, Jayna Tatem, Geneva Caldwell, Martina T. Swiderek, Jennifer Jennings, Jeffrey H. TI Racial Differences in a Detroit, MI, ICU Population of Coronavirus Disease 2019 Patients SO CRITICAL CARE MEDICINE LA English DT Article DE acute respiratory distress syndrome; coronavirus disease 2019; critical care; length of stay; mechanical ventilation; race ID OUTCOMES; SEPSIS; RACE AB OBJECTIVES: To investigate the potential influence of racial differences in outcomes of patients infected by coronavirus disease 2019-positive patients who require intensive care in an urban hospital. DESIGN: Retrospective cohort study. SETTING: Henry Ford Health System Multidisciplinary ICU, a total of 156 beds spread throughout the hospital in Detroit, MI. PATIENTS: We obtained data from the electronic medical record of all adult severe acute respiratory syndrome coronavirus-2-positive patients managed in the ICU of Henry Ford Hospital in Detroit, MI, between March 13, 2020, and July 31, 2020. Included patients were divided into two groups: people of color (including Black, Asian, Hispanic/Latino, and Arab) and White. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 365 patients were evaluated: 219 were Black (60.0%), 129 were White (35.3%), two were Asian (0.6%), eight were Hispanic/Latino (2.2%), and seven were Arab (1.9%). People of color were younger (62.8 vs 67.1; p = 0.007), with equal distribution of sex. People of color had less coronary artery disease (34 [14.4%] vs 35 [27.1%]; p =0.003) and less self-reported use of regular alcohol consumption (50 [21.2%] vs 12 [9.3%]; p = 0.004) than Whites, with no differences in diabetes (125 [53.0%] vs 66 [51.2%]; p = 0.742), hypertension (188 [79.7%] vs 99 [76.8%]; p = 0.516), congestive heart failure (41 [17.4%] vs 32 [24.8%]; p = 0.090), or chronic kidney disease (123 [54.1%] vs 55 [42.6%]; p = 0.083). There was no difference in ICU length of stay between people of color (18 d [CI, 7-47 d]) and Whites (18 d [CI, 6-48 d]; p = 0. 0.979). Neither frequency (72.5% vs 71.3%; p = ns) nor median time to mechanical ventilation between people of color (9 d [CI, 6-15 d]) and Whites (10 d [CI, 5-16 d]; p = 0.733) was different. Overall, 188 patients (51.5 %) died in the hospital. The 28-day mortality was lower in people of color (107/236; 45.3%) versus Whites (73/129; 56.6%) (adjusted odds ratio 0.60; p = 0.034), and there was an increased median survival time in people of color (20 d) versus Whites (13.5 d; hazard ratio 0.62; p = 0.002). The inhospital mortality was lower in people of color versus White, but the difference was not statistically significant (113 [47.9%] vs 75 [58.1%], respectively; p = 0.061). Finally, there was no significant difference in days of symptoms prior to admission, frequency of presenting symptoms, or frequency or severity of acute respiratory distress syndrome between the two groups. CONCLUSIONS: In critically ill patients infected with coronavirus disease 2019, people of color had a lower 28-day mortality than Whites with no difference in hospital mortality, ICU length of stay, or rates of intubation. These findings are contrary to previously held beliefs surrounding the pandemic. C1 [Lazar, Michael H.; Gardner-Gray, Jayna; Tatem, Geneva; Swiderek, Jennifer; Jennings, Jeffrey H.] Henry Ford Hlth Syst, Div Pulm & Crit Care Med, Dept Internal Med, Detroit, MI 48202 USA. [Fadel, Raef] Henry Ford Hlth Syst, Dept Internal Med, Detroit, MI USA. [Gardner-Gray, Jayna; Caldwell, Martina T.] Henry Ford Hlth Syst, Dept Emergency Med, Detroit, MI USA. C3 Henry Ford Health System; Henry Ford Hospital; Henry Ford Health System; Henry Ford Hospital; Henry Ford Health System; Henry Ford Hospital RP Jennings, JH (通讯作者)，Henry Ford Hlth Syst, Div Pulm & Crit Care Med, Dept Internal Med, Detroit, MI 48202 USA. 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PD MAR PY 2021 VL 49 IS 3 BP 482 EP 489 DI 10.1097/CCM.0000000000004735 PG 8 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA RL9UC UT WOS:000639307500034 PM 33372746 OA Bronze DA 2023-05-13 ER PT J AU Del Pino, R Diez-Cirarda, M Ustarroz-Aguirre, I Gonzalez-Larragan, S Caprino, M Busnatu, S Gand, K Schlieter, H Gabilondo, I Gomez-Esteban, JC AF Del Pino, Rocio Diez-Cirarda, Maria Ustarroz-Aguirre, Iker Gonzalez-Larragan, Susana Caprino, Massimo Busnatu, Stefan Gand, Kai Schlieter, Hannes Gabilondo, Inigo Carlos Gomez-Esteban, Juan TI Costs and effects of telerehabilitation in neurological and cardiological diseases: A systematic review SO FRONTIERS IN MEDICINE LA English DT Review DE cost-effectiveness; telerehabilitation; cardiological diseases; neurological disease; systematic review ID CARDIAC TELEREHABILITATION; CORE COMPONENTS; REHABILITATION; STROKE; PROGRAM; PREVENTION; CARE AB Introduction: Telerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system. Methods: The systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out. Results: A total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies assessed telerehabilitation in cardiological diseases (chronic heart failure, coronary heart disease, acute coronary syndrome, and cardiovascular diseases). The duration of the telerehabilitation ranged from 6 to 48 weeks. The studies included cost-analysis, cost-benefit, cost-effectiveness, or cost-utility. In total, four studies found significant cost/savings per person between $565.66 and $2,352.00 (p < 0.05). In contrast, most studies found differences in costs and clinical effects between the telerehabilitation performed and the rehabilitation performed at the clinic. Just one study found quality-adjusted life years (QALY) significant differences between groups [Incremental cost-effectiveness ratio (ICER) per QALY ($-21,666.41/QALY). Discussion: Telerehabilitation is an excellent alternative to traditional center rehabilitation, which increases the accessibility to rehabilitation to more people, either due to the geographical situation of the patients or the limitations of the health systems. Telerehabilitation seems to be as clinical and cost-effective as traditional rehabilitation, even if, generally, telerehabilitation is less costly. More research is needed to evaluate health-related quality of life and cost-effectiveness in other neurological diseases. C1 [Del Pino, Rocio; Diez-Cirarda, Maria; Gabilondo, Inigo; Carlos Gomez-Esteban, Juan] Biocruces Bizkaia Hlth Res Inst, Neurodegenerat Dis Grp, Baracaldo, Spain. [Ustarroz-Aguirre, Iker] Cruces Univ Hosp, Econ Evaluat Dept, Baracaldo, Spain. [Gonzalez-Larragan, Susana] Cruces Univ Hosp, Dept Hlth Sci Lib, Baracaldo, Spain. [Caprino, Massimo] Casa Cura Policlin Spa, Dept Neurorehabil Sci, Milan, Italy. [Busnatu, Stefan] Carol Davila Univ Med & Pharm, Fac Med, Bucharest, Romania. [Gand, Kai; Schlieter, Hannes] Tech Univ Dresden, Fac Business & Econ, Res Grp Digital Hlth Dresden, Dresden, Germany. [Gabilondo, Inigo] Ikerbasque, Basque Fdn Sci Bilbao, Bilbao, Spain. [Gabilondo, Inigo; Carlos Gomez-Esteban, Juan] Cruces Univ Hosp, Dept Neurol, Baracaldo, Spain. [Carlos Gomez-Esteban, Juan] Univ Pais Vasco Euskal Herriko Unibertsitatea, Dept Neurosci, Univ Basque Country, Leioa, Spain. C3 Hospital Universitario Cruces; Hospital Universitario Cruces; Carol Davila University of Medicine & Pharmacy; Technische Universitat Dresden; Basque Foundation for Science; Hospital Universitario Cruces; University of Basque Country RP Del Pino, R (通讯作者)，Biocruces Bizkaia Hlth Res Inst, Neurodegenerat Dis Grp, Baracaldo, Spain. EM delpinorocio@gmail.com RI del pino, rocio/HKW-3303-2023; Cirarda, Maria Diez/AAS-9951-2020; Busnatu, Stefan Sebastian/K-7025-2019; Gabilondo, Iñigo/I-8274-2012 OI Cirarda, Maria Diez/0000-0001-6768-189X; Busnatu, Stefan Sebastian/0000-0002-4678-9655; Gabilondo, Iñigo/0000-0001-6045-2840; Del Pino, Rocio/0000-0002-6612-4757 FU European Union; [769807] FX This project has received funding from the European Union's Horizon 2020 Research and Innovation Program under grant agreement no: 769807. 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Med. PD NOV 29 PY 2022 VL 9 AR 832229 DI 10.3389/fmed.2022.832229 PG 14 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 7A5WA UT WOS:000898524800001 PM 36523783 OA Green Published, gold DA 2023-05-13 ER PT J AU Angiolillo, DJ Been, L Rubinstein, M Martin, M Rollini, F Franchi, F AF Angiolillo, Dominick J. Been, Latonya Rubinstein, Marc Martin, Michael Rollini, Fabiana Franchi, Francesco TI Use of the VerifyNow point of care assay to assess the pharmacodynamic effects of loading and maintenance dose regimens of prasugrel and ticagrelor SO JOURNAL OF THROMBOSIS AND THROMBOLYSIS LA English DT Article DE Platelet function; Prasugrel; Ticagrelor AB Prasugrel and ticagrelor are potent oral platelet P2Y(12) inhibitors and are recommended over clopidogrel in patients with acute coronary syndrome (ACS). Oral platelet P2Y(12) inhibitors are characterized by varying degrees of pharmacodynamic response profiles as assessed by a variety of commercially available assays. Because of its ease of use, rapid turnaround times and ability to provide results specific to P2Y(12) inhibitory effects, VerifyNow has emerged as one of the most commonly utilized platelet function assays. However, reference ranges with VerifyNow have been reported mainly for clopidogrel and there has not yet been any study specifically conducted to provide the expected on treatment reference ranges following administration of prasugrel and ticagrelor. This was a prospective single center investigation conducted in 120 patients with ACS who were treated with prasugrel or ticagrelor as per standard of care. Patients who underwent percutaneous coronary interventions (PCI) were treated with a loading dose of prasugrel (60 mg) or ticagrelor (180 mg), and patients who were on maintenance therapy were taking prasugrel (10 mg qd or 5 mg qd) or ticagrelor (90 mg bid). Platelet function testing was performed using the VerifyNow (TM) PRUTest (TM). The overall range of PRUTest values was lower than that observed in studies of patients treated with clopidogrel. The use of a maintenance dose regimen had a wider range of PRUTest values compared to the use of a loading dose for both prasugrel (1-179 vs. 2-128) and ticagrelor (1-196 vs. 1-177). The average PRUTest values in patients on prasugrel and ticagrelor maintenance dosing were 20% and 9% higher those observed in patients treated with a loading dose. PRUTest results following loading dose administration were very similar between drugs, but were 20% higher with prasugrel compared with ticagrelor during maintenance dosing. This study establishes expected PRUTest ranges for patients taking loading and maintenance doses of prasugrel and ticagrelor. Clinical Trial Registration Unique Identifier: NCT04492423, registered July 2020 retrospectively registered. C1 [Angiolillo, Dominick J.; Been, Latonya; Rollini, Fabiana; Franchi, Francesco] Univ Florida, Coll Med, 655 West 8th St, Jacksonville, FL 32209 USA. [Rubinstein, Marc; Martin, Michael] Instrumentat Lab, San Diego, CA USA. C3 State University System of Florida; University of Florida RP Angiolillo, DJ (通讯作者)，Univ Florida, Coll Med, 655 West 8th St, Jacksonville, FL 32209 USA. EM dominick.angiolillo@jax.ufl.edu OI Angiolillo, Dominick/0000-0001-8451-2131; Martin, Michael/0000-0001-7806-8038; Rubinstein, Marc/0000-0003-3017-0505 FU Accriva Diagnostics FX The present study was funded by an investigator-initiated grant from Accriva Diagnostics. CR Angiolillo DJ, 2007, J AM COLL CARDIOL, V49, P1505, DOI 10.1016/j.jacc.2006.11.044 Angiolillo DJ, 2012, J THROMB THROMBOLYS, V34, P44, DOI 10.1007/s11239-012-0737-3 Bae Jay P, 2014, Hosp Pract (1995), V42, P7, DOI 10.3810/hp.2014.10.1139 Capodanno D, 2020, CIRCULATION, V142, P2172, DOI 10.1161/CIRCULATIONAHA.120.045465 Capodanno D, 2018, J AM COLL CARDIOL, V72, P2915, DOI 10.1016/j.jacc.2018.09.057 Defining establishing and verifying reference intervals in the clinical laboratory, EP28A3 CLSI Franchi F, 2019, JACC-CARDIOVASC INTE, V12, P1538, DOI 10.1016/j.jcin.2019.05.028 Franchi F, 2019, CIRCULATION, V139, P1661, DOI 10.1161/CIRCULATIONAHA.118.038317 Franchi F, 2017, NAT REV CARDIOL, V14, P361, DOI 10.1038/nrcardio.2017.18 Franchi F, 2016, CIRCULATION, V134, P780, DOI 10.1161/CIRCULATIONAHA.116.023402 Franchi F, 2015, NAT REV CARDIOL, V12, P30, DOI 10.1038/nrcardio.2014.156 Jernberg T, 2006, EUR HEART J, V27, P1166, DOI 10.1093/eurheartj/ehi877 Ferreiro JL, 2011, CIRCULATION, V123, P798, DOI 10.1161/CIRCULATIONAHA.109.913376 Malinin A, 2007, THROMB RES, V119, P277, DOI 10.1016/j.thromres.2006.01.019 Michelson AD, 2009, EUR HEART J, V30, P1753, DOI 10.1093/eurheartj/ehp159 Michelson AD, 2009, AM J CARDIOL, V103, p20A, DOI 10.1016/j.amjcard.2008.11.019 Price MJ, 2011, CIRCULATION, V124, P1132, DOI 10.1161/CIRCULATIONAHA.111.029165 Rollini F, 2017, JACC-CARDIOVASC INTE, V10, P1374, DOI 10.1016/j.jcin.2017.04.027 Rollini F, 2016, EUR HEART J, V37, P2722, DOI 10.1093/eurheartj/ehv744 Rollini F, 2014, JACC-CARDIOVASC INTE, V7, P426, DOI 10.1016/j.jcin.2013.11.019 Sibbing D, 2019, JACC-CARDIOVASC INTE, V12, P1521, DOI 10.1016/j.jcin.2019.03.034 Stone GW, 2013, LANCET, V382, P614, DOI 10.1016/S0140-6736(13)61170-8 Storey RF, 2006, CURR PHARM DESIGN, V12, P1255, DOI 10.2174/138161206776361318 Storey RF, 2010, J AM COLL CARDIOL, V56, P1456, DOI 10.1016/j.jacc.2010.03.100 VerifyNow PRUTest, PLAT REACT TEST DEV 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 NR 27 TC 3 Z9 3 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 APR PY 2021 VL 51 IS 3 BP 741 EP 747 DI 10.1007/s11239-021-02386-7 EA FEB 2021 PG 7 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Hematology GA RN7SR UT WOS:000617817900002 PM 33582955 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Tscherny, K Kienbacher, C Fuhrmann, V Schreiber, W Herkner, H Roth, D AF Tscherny, Katharina Kienbacher, Calvin Fuhrmann, Verena Schreiber, Wolfgang Herkner, Harald Roth, Dominik TI Early identification of patients with chest pain at very low risk of acute myocardial infarction using clinical information and ECG only SO INTERNATIONAL JOURNAL OF CLINICAL PRACTICE LA English DT Article DE acute coronary syndrome; emergency department; rule-out ID HOUR RULE-IN; GUIDELINES; DISEASE AB Background A considerable proportion of patients with angina-like symptoms in an emergency department have very low pretest probability for acute myocardial infarction (AMI). Numerous algorithms exist for the exclusion of AMI, usually including laboratory tests. We aimed to investigate whether patients with very low risk can safely be identified by ECG and clinical information without biomarker testing, contributing to saving time and costs. Methods Prospective diagnostic test accuracy study. We included all consecutive patients presenting with angina at the department of emergency medicine of a tertiary care hospital during a 1-year period. Using clinical information without biomarker testing and ECG, the "Mini-GRACE score," based on the well-established GRACE-score without using laboratory parameters was calculated. In a cohort design we compared the index test Mini-GRACE to AMI as reference standard in the final diagnosis using standard measures of diagnostic test accuracy. Results We included 2755 patients (44% female, age 44 +/- 17 years). AMI was diagnosed in 103 (4%) patients, among those 44% with STEMI. Overall 2562 patients (93%) had a negative "Mini-GRACE," four (0.2%) of these patients had myocardial infarction, and this results in a sensitivity of 96.1% (95% CI 90.4%-98.9%), specificity 96.5% (95.7%-97.1%), positive predictive value 51.3% (46.3%-56.3%) and negative predictive value 99.8% (99.6%-99.9%). Model performance according to C statistic (0.90) and Brier score (0.0045) was excellent. In rule-out patients 30-day mortality was 0.3% and 1-year mortality was 0.8%. Conclusions Patients with very low risk of AMI can be identified with high certainty using clinical information without biomarker testing and ECG. Cardiac biomarkers might be avoided in such cases, potentially leading to a significant cost reduction. C1 [Tscherny, Katharina; Kienbacher, Calvin; Fuhrmann, Verena; Schreiber, Wolfgang; Herkner, Harald; Roth, Dominik] Med Univ Vienna, Dept Emergency Med, Vienna, Austria. C3 Medical University of Vienna RP Herkner, H (通讯作者)，Med Univ Vienna, Dept Emergency Med, Vienna, Austria. EM herald.herkner@meduniwien.ac.at OI Herkner, Harald/0000-0003-1329-6149 CR Amsterdam EA, 2014, CIRCULATION, V130, P2354, DOI 10.1161/CIR.0000000000000133 Anderson JL, 2013, J AM COLL CARDIOL, V61, pE179, DOI 10.1016/j.jacc.2013.01.014 [Anonymous], EUR HEART J ACU 0712 [Anonymous], 2017, CIRCULATION, DOI DOI 10.1161/CIR.0000000000000485 Flynn MR, 2005, EUR HEART J, V26, P308, DOI 10.1093/eurheartj/ehi079 Fox KAA, 2006, BMJ-BRIT MED J, V333, P1091, DOI 10.1136/bmj.38985.646481.55 Hess EP, 2016, BMJ-BRIT MED J, V355, DOI 10.1136/bmj.i6165 Jaeger C, 2016, AM HEART J, V171, P92, DOI 10.1016/j.ahj.2015.07.022 Lopez AD, 2006, LANCET, V367, P1747, DOI 10.1016/S0140-6736(06)68770-9 Manzano-Fernandez S, 2016, AM J CARDIOL, V117, P1047, DOI 10.1016/j.amjcard.2015.12.048 Mockel M, 2015, EUR HEART J, V36, P369, DOI 10.1093/eurheartj/ehu178 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Gimenez MR, 2015, AM J MED, V128, P861, DOI 10.1016/j.amjmed.2015.01.046 Smith J, 2017, EMERG MED J, V34, P454, DOI 10.1136/emermed-2017-206702 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Steyerberg EW, 2010, EPIDEMIOLOGY, V21, P128, DOI 10.1097/EDE.0b013e3181c30fb2 Wang AZ, 2020, ACAD EMERG MED, V27, P6, DOI 10.1111/acem.13766 Wang Y, 2019, CLIN BIOCHEM, V70, P34, DOI 10.1016/j.clinbiochem.2019.06.002 Wildi K, 2019, INT J CARDIOL, V283, P41, DOI 10.1016/j.ijcard.2018.11.140 NR 19 TC 2 Z9 2 U1 0 U2 1 PU WILEY-HINDAWI PI LONDON PA ADAM HOUSE, 3RD FL, 1 FITZROY SQ, LONDON, WIT 5HE, ENGLAND SN 1368-5031 EI 1742-1241 J9 INT J CLIN PRACT JI Int. J. Clin. Pract. PD AUG PY 2020 VL 74 IS 8 AR e13526 DI 10.1111/ijcp.13526 EA MAY 2020 PG 8 WC Medicine, General & Internal; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Pharmacology & Pharmacy GA MT3YU UT WOS:000534584500001 PM 32383504 OA Green Published, gold DA 2023-05-13 ER PT J AU Ouchi, S Miyazaki, T Shimada, K Sugita, Y Shimizu, M Murata, A Kato, T Aikawa, T Suda, S Shiozawa, T Hiki, M Takahashi, S Kasai, T Miyauchi, K Daida, H AF Ouchi, Shohei Miyazaki, Tetsuro Shimada, Kazunori Sugita, Yurina Shimizu, Megumi Murata, Azusa Kato, Takao Aikawa, Tatsuro Suda, Shoko Shiozawa, Tomoyuki Hiki, Masaru Takahashi, Shuhei Kasai, Takatoshi Miyauchi, Katsumi Daida, Hiroyuki TI Decreased circulating dihomo-gamma-linolenic acid levels are associated with total mortality in patients with acute cardiovascular disease and acute decompensated heart failure SO LIPIDS IN HEALTH AND DISEASE LA English DT Article DE Polyunsaturated fatty acids; Dihomo-gamma-linolenic acid; Arachidonic acid; Omega-6; Inflammation; Nutrition ID POLYUNSATURATED FATTY-ACIDS; LEFT-VENTRICULAR FUNCTION; RISK; METAANALYSIS; METABOLISM; NUTRITION; JAPANESE; CELLS; PUFAS AB Background: Polyunsaturated fatty acids (PUFAs) have important roles in the pathogenesis of cardiovascular diseases. However, the clinical significance of omega-6 PUFAs in acute cardiovascular disease remains unknown. Methods: We enrolled 417 consecutive patients with acute cardiovascular disease admitted to the cardiac intensive care unit at Juntendo University Hospital between April 2012 and October 2013. We investigated the association between serum PUFA levels and long-term mortality. Blood samples were collected after an overnight fast, within 24 h of admission. We excluded patients who received eicosapentaenoic acid therapy and those with malignancy, end-stage kidney disease, chronic hepatic disease, and connective tissue disease. Results: Overall, 306 patients (mean age: 66.4 +/- 15.0 years) were analysed. During the follow-up period of 2.4 +/- 1.2 years, 50 patients (16.3%) died. The dihomo-gamma-linolenic acid (DGLA) levels, arachidonic acid (AA) levels, and DGLA/AA ratio were significantly lower in the nonsurvivor group than in the survivor group (DGLA: 23.2 +/- 9.8 vs. 31.5 +/- 12.0 mu g/ml, AA: 151.1 +/- 41.6 vs. 173.3 +/- 51.6 mu g/ml, and DGLA/AA: 0.16 +/- 0.05 vs. 0.19 +/- 0.06, all p < 0.01). Kaplan-Meier curves showed that survival rates were significantly higher in the higher DGLA, AA, and DGLA/AA groups than in their lower counterparts (DGLA and AA; p < 0.01, DGLA/AA; p = 0.01), although omega-3 PUFAs were not associated with prognosis. Furthermore, in patients with acute decompensated heart failure (ADHF), survival rates were significantly higher in the higher DGLA, AA, and DGLA/AA groups than in their lower counterparts (DGLA and AA; p < 0.01, DGLA/AA; p = 0.04). However, among patients with acute coronary syndrome, none of the PUFA levels were associated with prognosis. Among patients with ADHF, after controlling for confounding variables, DGLA and DGLA/AA were associated with long-term mortality [ DGLA: hazard ratio (HR), 0.94; 95% confidence interval (CI), 0.88-0.99; p = 0.01 and DGLA/AA: HR, 0.87; 95% CI, 0.77-0.97; p < 0.01], whereas AA was not associated with prognosis. Conclusion: Low omega-6 PUFA levels, particularly DGLA, and a low DGLA/AA ratio predict long-term mortality in patients with acute cardiovascular disease and ADHF. C1 [Ouchi, Shohei; Miyazaki, Tetsuro; Shimada, Kazunori; Sugita, Yurina; Shimizu, Megumi; Murata, Azusa; Kato, Takao; Aikawa, Tatsuro; Suda, Shoko; Shiozawa, Tomoyuki; Hiki, Masaru; Takahashi, Shuhei; Kasai, Takatoshi; Miyauchi, Katsumi; Daida, Hiroyuki] Juntendo Univ, Dept Cardiovasc Med, Sch Med, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan. C3 Juntendo University RP Miyazaki, T (通讯作者)，Juntendo Univ, Dept Cardiovasc Med, Sch Med, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan. EM tetsuro@juntendo.ac.jp RI 葛西, 隆敏/HJY-9104-2023 FU JSPS KAKENHI [JP15K00845]; Grants-in-Aid for Scientific Research [15K00845, 17K01470] Funding Source: KAKEN FX This study was supported partly by JSPS KAKENHI Grant Number JP15K00845. 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PD AUG 14 PY 2017 VL 16 AR 150 DI 10.1186/s12944-017-0542-2 PG 8 WC Biochemistry & Molecular Biology; Nutrition & Dietetics WE Science Citation Index Expanded (SCI-EXPANDED) SC Biochemistry & Molecular Biology; Nutrition & Dietetics GA FD7OS UT WOS:000407716000001 PM 28806965 OA Green Published, gold DA 2023-05-13 ER PT J AU Li, YH Ueng, KC Jeng, JS Charng, MJ Lin, TH Chien, KL Wang, CY Chao, TH Liu, PY Su, CH Chien, SC Liou, CW Tang, SC Lee, CC Yu, TY Chen, JW Wu, CC Yeh, HI AF Li, Yi-Heng Ueng, Kwo-Chang Jeng, Jiann-Shing Charng, Min-Ji Lin, Tsung-Hsien Chien, Kuo-Liong Wang, Chih-Yuan Chao, Ting-Hsing Liu, Ping-Yen Su, Cheng-Huang Chien, Shih-Chieh Liou, Chia-Wei Tang, Sung-Chun Lee, Chun-Chuan Yu, Tse-Ya Chen, Jaw-Wen Wu, Chau-Chung Yeh, Hung-, I CA Writing Grp 2017 Taiwan Lipid TI 2017 Taiwan lipid guidelines for high risk patients SO JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION LA English DT Review DE high risk; hyperlipidemia; guidelines; statin; Taiwan ID ACUTE-CORONARY-SYNDROME; HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA; CHRONIC KIDNEY-DISEASE; DENSITY-LIPOPROTEIN-CHOLESTEROL; ACUTE MYOCARDIAL-INFARCTION; RECURRENT ISCHEMIC EVENTS; TYPE-2 DIABETES-MELLITUS; EARLY STATIN THERAPY; HEART-DISEASE; CARDIOVASCULAR EVENTS AB In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), ischemic stroke and peripheral arterial disease (PAD). Because the risk of ASCVD is high in patients with diabetes mellitus (DM), chronic kidney disease (CKD) and familial hypercholesterolemia (FH), lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG) levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins), cholesterol absorption inhibitors (ezetimibe), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, nicotinic acids (niacin), fibric acids derivatives (fibrates), and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS) and stable CAD, LDL-C < 70 mg/dL is the major target. A lower target of LDL-C < 55 mg/dL can be considered in ACS patients with DM. After treating LDL-C to target, non-HDL-C can be considered as a secondary target for patients with TG >= 200 mg/dL. The suggested non-HDL-C target is < 100 mg/dL in ACS and CAD patients. For patients with ischemic stroke or transient ischemic attack presumed to be of atherosclerotic origin, statin therapy is beneficial and LDL-C < 100 mg/dL is the suggested target. For patients with symptomatic carotid stenosis or intracranial arterial stenosis, in addition to antiplatelets and blood pressure control, LDL-C should be lowered to < 100 mg/dL. Statin is necessary for DM patients with CV disease and the LDL-C target is < 70 mg/dL. For diabetic patients who are >= 40 years of age, or who are < 40 years of age but have additional CV risk factors, the LDL-C target should be < 100 mg/dL. After achieving LDL-C target, combination of other lipid-lowering agents with statin is reasonable to attain TG < 150 mg/dL and HDL-C >40 in men and >50 mg/dL in women in DM. LDL-C increased CV risk in patients with CKD. In adults with glomerular filtration rate (GFR) < 60 mL/min/1.73m(2) without chronic dialysis (CKD stage 3-5), statin therapy should be initiated if LDL-C >= 100 mg/dL. Ezetimibe can be added to statin to consolidate the CV protection in CKD patients. Mutations in LDL receptor, apolipoprotein B and PCSK9 genes are the common causes of FH. Diagnosis of FH usually depends on family history, clinical history of premature CAD, physical findings of xanthoma or corneal arcus and high levels of LDL-C. In addition to conventional lipid lowering therapies, adjunctive treatment with mipomersen, lomitapide, or PCSK9 inhibitors become necessary to further reduce LDL-C in patients with FH. Overall, these recommendations are to help the health care professionals in Taiwan to treat hyperlipidemia with current scientific evidences. We hope the prescription rate of lipid lowering drugs and control rate of hyperlipidemia in high risk patients could be increased by implementation of the clinical guidelines. The major purpose is to improve clinical outcomes of these high risk patients through the control of hyperlipidemia. Copyright (C) 2016, Formosan Medical Association. Published by Elsevier Taiwan LLC. C1 [Li, Yi-Heng; Chao, Ting-Hsing; Liu, Ping-Yen] Natl Cheng Kung Univ, Coll Med & Hosp, Dept Internal Med, Div Cardiol, Tainan, Taiwan. [Ueng, Kwo-Chang] Chung Shan Med Univ, Sch Med, Taichung, Taiwan. [Ueng, Kwo-Chang] Chung Shan Med Univ Hosp, Dept Internal Med, Taichung, Taiwan. [Jeng, Jiann-Shing; Tang, Sung-Chun] Natl Taiwan Univ Hosp, Stroke Ctr, Taipei, Taiwan. [Jeng, Jiann-Shing; Tang, Sung-Chun] Natl Taiwan Univ Hosp, Dept Neurol, Taipei, Taiwan. [Charng, Min-Ji; Chen, Jaw-Wen] Taipei Vet Gen Hosp, Div Cardiol, Taipei, Taiwan. [Charng, Min-Ji; Chen, Jaw-Wen] Natl Yang Ming Univ, Sch Med, Fac Med, Taipei, Taiwan. [Lin, Tsung-Hsien] Kaohsiung Med Univ Hosp, Div Cardiol, Dept Internal Med, Kaohsiung, Taiwan. [Lin, Tsung-Hsien] Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung, Taiwan. [Chien, Kuo-Liong] Natl Taiwan Univ, Inst Epidemiol & Prevent Med, Coll Publ Hlth, Taipei, Taiwan. [Chien, Kuo-Liong; Wang, Chih-Yuan; Wu, Chau-Chung] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan. [Su, Cheng-Huang; Chien, Shih-Chieh; Lee, Chun-Chuan; Yeh, Hung-, I] Mackay Mem Hosp, Dept Internal Med, Taipei, Taiwan. [Su, Cheng-Huang; Chien, Shih-Chieh; Lee, Chun-Chuan; Yeh, Hung-, I] Mackay Mem Hosp, Dept Med Res, Taipei, Taiwan. [Su, Cheng-Huang; Yeh, Hung-, I] Mackay Med Coll, Dept Med, New Taipei, Taiwan. [Liou, Chia-Wei] Kaohsiung Chang Gung Mem Hosp, Dept Neurol, Kaohsiung, Taiwan. [Yu, Tse-Ya] Far Eastern Mem Hosp, Dept Internal Med, Taipei, Taiwan. [Chen, Jaw-Wen] Taipei Vet Gen Hosp, Dept Med Res, Taipei, Taiwan. C3 National Cheng Kung University; Chung Shan Medical University; Chung Shan Medical University; Chung Shan Medical University Hospital; National Taiwan University; National Taiwan University Hospital; National Taiwan University; National Taiwan University Hospital; Taipei Veterans General Hospital; National Yang Ming Chiao Tung University; Kaohsiung Medical University; Kaohsiung Medical University Hospital; Kaohsiung Medical University; National Taiwan University; National Taiwan University; National Taiwan University Hospital; Mackay Memorial Hospital; Mackay Memorial Hospital; Mackay Medical College; Chang Gung Memorial Hospital; Far Eastern Memorial Hospital; Taipei Veterans General Hospital RP Yeh, HI (通讯作者)，MacKay Mem Hosp, Div Cardiol, 92,Sect 2,Chung Shan North Rd, Taipei 10449, Taiwan. EM hungi.yeh@msa.hinet.net RI LI, yi/HKO-0480-2023 OI Lin, Tsung-Hsien/0000-0002-7226-8730; CHIEN, KUO-LIONG/0000-0003-4979-8351; Tang, Sung-Chun/0000-0003-3731-5973; WANG, CHIH-YUAN/0000-0002-6742-3935; JENG, JIANN-SHING/0000-0002-1456-3686 FU Taiwan Society of Lipids and Atherosclerosis; Taiwan Society of Lipids and Atherosclerosis FX This study is supported by Taiwan Society of Lipids and Atherosclerosis. The guidelines were endorsed by the Taiwan Society of Cardiology, Taiwan Society of Cardiovascular Intervention, Taiwan Stroke Society, Taiwan Diabetes Association, Taiwanese Association of Diabetes Educators, and Taiwan Nephrology Association. 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10.1016/j.atherosclerosis.2009.07.024 Zhang X, 2003, INT J EPIDEMIOL, V32, P563, DOI 10.1093/ije/dyg106 Zhao SP, 2014, ATHEROSCLEROSIS, V233, P707, DOI 10.1016/j.atherosclerosis.2013.12.003 NR 220 TC 102 Z9 103 U1 2 U2 33 PU ELSEVIER TAIWAN PI TAIPEI PA RM N-412, 4F, CHIA HSIN BUILDING 11, NO 96, ZHONG SHAN N ROAD SEC 2, TAIPEI, 10449, TAIWAN SN 0929-6646 EI 1876-0821 J9 J FORMOS MED ASSOC JI J. Formos. Med. Assoc. PD APR PY 2017 VL 116 IS 4 BP 217 EP 248 DI 10.1016/j.jfma.2016.11.013 PG 32 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA EV7EC UT WOS:000401936400002 PM 28242176 OA gold DA 2023-05-13 ER PT J AU Gabet, A De Peretti, C Iliou, MC Nicolau, J Olie, V AF Gabet, Amelie De Peretti, Christine Iliou, Marie-Christine Nicolau, Javier Olie, Valerie TI National trends in admission for cardiac rehabilitation after a myocardial infarction in France from 2010 to 2014 SO ARCHIVES OF CARDIOVASCULAR DISEASES LA English DT Article DE Cardiac rehabilitation; Acute myocardial infarction; Hospitalizations; Trends; France ID ACUTE CORONARY SYNDROMES; ST-ELEVATION; MANAGEMENT; MORTALITY; SURVIVAL; PREVENTION; GUIDELINES; INSIGHTS; REGISTRY AB Background. - Follow-up care and rehabilitation services [soins de suite et readaptation (SSR)], especially cardiac rehabilitation (CR), constitute a key stage for patients who have had an acute myocardial myocardial infarction (AMI). Aims. - To study admission to SSR, especially for CR, among patients hospitalized for AMI in France in 2014, and its temporal trend between 2010 and 2014. Methods. - We used the French National Hospital Database to select patients hospitalized with a main diagnosis of AMI (identified by ICD-10 codes 121 to 123) in the first semester of each year from 2010 to 2014. We then searched for rehabilitation admission in the 6 months after the index hospitalization. We calculated age-standardized rates of admission for CR and for other rehabilitation purposes. The average annual percentage change in admission rates was analysed by Poisson regression. Results. - In 2014, among the 29,424 patients hospitalized for an AMI in the first 6 months of the year, 10,873 (36.9%) were subsequently admitted to SSR units. More specifically, the age-standardized rate of patients hospitalized in CR units reached 28.4% (n= 8380), and was greater among men (29.6%, n= 6707) than among women (24.9%, n=1673). Between 2010 and 2014, rates of admission for CR increased by 5.0% per year in men and 6.6% per year in women. We found a great increase in ambulatory CR management, which accounted for half of the admissions for CR in 2014. Conclusions. - Favourable trends in rates of admission for CR were reported in both sexes and at all ages, except the oldest. The increase in ambulatory management contributed to these changes. Despite these trends, rates of admission for CR after AMI remain low. (C) 2017 Elsevier Masson SAS. All rights reserved. C1 [Gabet, Amelie; Nicolau, Javier; Olie, Valerie] French Publ Hlth Agcy, 12 Rue Val dOsne, F-94410 St Maurice, France. [De Peretti, Christine] Directorate Res Studies Evaluat & Stat, 14 Ave Duquesne, F-75350 Paris, France. [Iliou, Marie-Christine] Corentin Celton Hosp, AP HP, F-92130 Issy Les Moulineaux, France. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Paul-Brousse - APHP; UDICE-French Research Universities; Universite Paris Cite; Hopital Universitaire Corentin-Celton - APHP; Hopital Universitaire Hotel-Dieu - APHP RP Gabet, A (通讯作者)，French Publ Hlth Agcy, 12 Rue Val dOsne, F-94410 St Maurice, France. 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Cardiovasc. Dis. PD NOV PY 2018 VL 111 IS 11 BP 625 EP 633 DI 10.1016/j.acvd.2017.07.003 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HG4VO UT WOS:000454973300002 PM 29133181 DA 2023-05-13 ER PT J AU Szlachetka, WA Pana, TA Mamas, MA Bettencourt-Silva, JH Metcalf, AK Potter, JF McLernon, DJ Myint, PK AF Szlachetka, Weronika A. Pana, Tiberiu A. Mamas, Mamas A. Bettencourt-Silva, Joao H. Metcalf, Anthony K. Potter, John F. McLernon, David J. Myint, Phyo K. TI Predicting 10-year stroke mortality: development and validation of a nomogram SO ACTA NEUROLOGICA BELGICA LA English DT Article DE Ischaemic stroke; Long-term mortality; Prediction score; Prognosis; Cerebrovascular disease ID ACUTE ISCHEMIC-STROKE; CLASSIFICATION; TERM AB Predicting long-term stroke mortality is a clinically important and unmet need. We aimed to develop and internally validate a 10-year ischaemic stroke mortality prediction score. In this UK cohort study, 10,366 patients with first-ever ischaemic stroke between January 2003 and December 2016 were followed up for a median (interquartile range) of 5.47 (2.96-9.15) years. A Cox proportional-hazards model was used to predict 10-year post-admission mortality. The predictors associated with 10-year mortality included age, sex, Oxfordshire Community Stroke Project classification, estimated glomerular filtration rate (eGFR), pre-stroke modified Rankin Score, admission haemoglobin, sodium, white blood cell count and comorbidities (atrial fibrillation, coronary heart disease, heart failure, cancer, hypertension, chronic obstructive pulmonary disease, liver disease and peripheral vascular disease). The model was internally validated using bootstrap resampling to assess optimism in discrimination and calibration. A nomogram was created to facilitate application of the score at the point of care. Mean age (SD) was 78.5 +/- 10.9 years, 52% female. Most strokes were partial anterior circulation syndromes (38%). 10-year mortality predictors were: total anterior circulation stroke (hazard ratio, 95% confidence intervals) (2.87, 2.62-3.14), eGFR < 15 (1.97, 1.55-2.52), 1-year increment in age (1.04, 1.04-1.05), liver disease (1.50, 1.20-1.87), peripheral vascular disease (1.39, 1.23-1.57), cancers (1.37, 1.27-1.47), heart failure (1.24, 1.15-1.34), 1-point increment in pre-stroke mRS (1.20, 1.17-1.22), atrial fibrillation (1.17, 1.10-1.24), coronary heart disease (1.09, 1.02-1.16), chronic obstructive pulmonary disease (1.13, 1.03-1.25) and hypertension (0.77, 0.72-0.82). Upon internal validation, the optimism-adjusted c-statistic was 0.76 and calibration slope was 0.98. Our 10-year mortality model uses routinely collected point-of-care information. It is the first 10-year mortality score in stroke. While the model was internally validated, further external validation is also warranted. C1 [Szlachetka, Weronika A.; Pana, Tiberiu A.; Myint, Phyo K.] Univ Aberdeen, Sch Med Med Sci & Nutr, Inst Appl Hlth Sci, Ageing Clin & Expt Res Team, Aberdeen, Scotland. [Mamas, Mamas A.] Keele Univ, Ctr Prognosis Res, Keele Cardiovasc Res Grp, Stoke On Trent, Staffs, England. [Bettencourt-Silva, Joao H.; Metcalf, Anthony K.] Univ East Anglia, Norwich Med Sch, Norwich, Norfolk, England. [Bettencourt-Silva, Joao H.] Univ Cambridge, Dept Med, Clin Informat, Cambridge, England. [Potter, John F.; Myint, Phyo K.] Norfolk & Norwich Univ Hosp, Norwich, Norfolk, England. [Potter, John F.; Myint, Phyo K.] Univ East Anglia, Norwich Med Sch, Norwich Cardiovasc Res Grp, Norwich Res Pk, Norwich, Norfolk, England. [McLernon, David J.] Univ Aberdeen, Sch Med, Inst Appl Hlth Sci, Med Stat Team, Aberdeen, Scotland. [Myint, Phyo K.] Aberdeen Royal Infirm, NHS Grampian, Aberdeen, Scotland. [Myint, Phyo K.] Sch Med Med Sci & Nutr, Polwarth Bldg,Room 4 013 Foresterhill, Aberdeen AB25 2ZD, Scotland. C3 RLUK- Research Libraries UK; University of Aberdeen; Keele University; RLUK- Research Libraries UK; University of East Anglia; RLUK- Research Libraries UK; University of Cambridge; Norfolk & Norwich University Hospitals NHS Foundation Trust; Norfolk & Norwich University Hospital; RLUK- Research Libraries UK; University of East Anglia; RLUK- Research Libraries UK; University of Aberdeen; RLUK- Research Libraries UK; University of Aberdeen; RLUK- Research Libraries UK; University of Aberdeen RP Myint, PK (通讯作者)，Univ Aberdeen, Sch Med Med Sci & Nutr, Inst Appl Hlth Sci, Ageing Clin & Expt Res Team, Aberdeen, Scotland.; Myint, PK (通讯作者)，Norfolk & Norwich Univ Hosp, Norwich, Norfolk, England.; Myint, PK (通讯作者)，Univ East Anglia, Norwich Med Sch, Norwich Cardiovasc Res Grp, Norwich Res Pk, Norwich, Norfolk, England.; Myint, PK (通讯作者)，Aberdeen Royal Infirm, NHS Grampian, Aberdeen, Scotland.; Myint, PK (通讯作者)，Sch Med Med Sci & Nutr, Polwarth Bldg,Room 4 013 Foresterhill, Aberdeen AB25 2ZD, Scotland. EM phyo.myint@abdn.ac.uk RI Mamas, Mamas Andreas/A-2549-2019; McLernon, David/D-5167-2012; myint, phyo/G-5730-2013 OI Mamas, Mamas Andreas/0000-0001-9241-8890; McLernon, David/0000-0001-8905-2429; Szlachetka, Weronika/0000-0002-2465-029X; Pana, Tiberiu/0000-0002-1423-8111; myint, phyo/0000-0003-3852-6158 FU Medical Research Scotland 2019 Vacation Scholarship [VAC-1424-2019] FX WAS received the Medical Research Scotland 2019 Vacation Scholarship [Grant Number VAC-1424-2019] to perform the research. The NNUH Stroke Register is maintained by the NNUH Stroke Services. 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Belg. PD JUN PY 2022 VL 122 IS 3 BP 685 EP 693 DI 10.1007/s13760-021-01752-9 EA AUG 2021 PG 9 WC Clinical Neurology; Neurosciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology GA 1W8EM UT WOS:000686065800003 PM 34406610 OA Green Accepted, Green Published, hybrid DA 2023-05-13 ER PT J AU Beloin-Jubinville, B Joly-Mischlich, T Rouleau, ED Noiseux, P Blais, L Forget, A Beauchesne, MF AF Beloin-Jubinville, Bianca Joly-Mischlich, Thomas Rouleau, Emilie Dufort Noiseux, Pascale Blais, Lucie Forget, Amelie Beauchesne, Marie-France TI Does Hospitalization Influence Patients' Medication Adherence and Community Pharmacists' Interventions? SO ANNALS OF PHARMACOTHERAPY LA English DT Article DE respiratory disease; cardiovascular disease; hospitalization; adherence to medication; pharmacist ID PHARMACEUTICAL CARE; SERVICES; THERAPY; IMPACT; DRUGS; NEEDS AB Background: Medication adherence reduces disease morbidity. Data regarding changes in a patient's adherence before and after hospitalization and how this hospitalization influences a pharmacist's interventions are scarce. Objective: To assess changes in adherence to cardiovascular and respiratory medications in the year preceding and following a hospitalization; explore patients' perceptions about medication adherence and the pharmacist's role; and describe pharmacists' interventions regarding medication adherence. Methods: This cohort study included patients hospitalized for acute coronary syndrome, acute worsening of heart failure, or acute COPD exacerbations. Adherence to cardiovascular and respiratory medications was measured by calculating the proportion of days covered (PDC) from prescription refills. Patient interviews were completed to explore their perceptions about medication adherence and the role of the pharmacist. Community pharmacists were invited to complete an online survey and to participate in focus groups to discuss interventions to improve medication adherence. Results: Medication adherence was assessed for 61 patients; the mean PDC was 69.8% 12 months before hospitalization and 72.4% 12 months following hospitalization. Patients reported that they felt the need to take their medications to prevent worsening of their disease. They were satisfied with current pharmaceutical services. A total of 136 questionnaires completed by pharmacists were analyzed and 9 participants attended the focus groups. Most pharmacists reported monitoring prescription renewals to assess adherence, with no significant influence from the hospitalization itself. The patient's interest was reported to be an important facilitator, whereas a lack of time and face-to-face interaction with patients who had their medication delivered to their home was reported a main barrier to interventions. This study was limited by a small sample size. Conclusions: Patient medication adherence did not significantly change following hospitalization. Hospitalization does not appear to significantly influence patient and pharmacist behavior towards medication adherence. C1 [Beloin-Jubinville, Bianca; Joly-Mischlich, Thomas; Rouleau, Emilie Dufort; Beauchesne, Marie-France] CHU Sherbrooke, Sherbrooke, PQ J1H 5N4, Canada. [Noiseux, Pascale] CSSS Energie, Shawinigan, PQ, Canada. [Blais, Lucie; Beauchesne, Marie-France] Univ Montreal, Fac Pharm, Montreal, PQ H3C 3J7, Canada. [Blais, Lucie; Forget, Amelie] Hop Sacre Coeur, Ctr Rech, Montreal, PQ H4J 1C5, Canada. C3 University of Sherbrooke; Universite de Montreal; Universite de Montreal RP Beauchesne, MF (通讯作者)，CHU Sherbrooke, Sherbrooke, PQ J1H 5N4, Canada. EM Marie-france.beauchesne@umontreal.ca OI Joly-Mischlich, Thomas/0000-0002-8745-7286 CR Amsler M R, 2001, J Am Pharm Assoc (Wash), V41, P850 Andrade SE, 2006, PHARMACOEPIDEM DR S, V15, P565, DOI 10.1002/pds.1230 Bell H, 1998, J SOC ADMIN PHARM, V15, P284 Berger B A, 1997, J Am Pharm Assoc (Wash), VNS37, P535 Calvert SB, 2012, AM HEART J, V163, P657, DOI 10.1016/j.ahj.2012.01.019 Dunbar-Jacob J, 2001, J CLIN EPIDEMIOL, V54, pS57, DOI 10.1016/S0895-4356(01)00457-7 Evans CD, 2011, ANN PHARMACOTHER, V45, P615, DOI 10.1345/aph.1P615 Fang Y, 2011, HEALTH SOC CARE COMM, V19, P189, DOI 10.1111/j.1365-2524.2010.00959.x Fitzgerald AA, 2011, J CARD FAIL, V17, P664, DOI 10.1016/j.cardfail.2011.04.011 Hansen LO, 2011, ANN INTERN MED, V155, P520, DOI 10.7326/0003-4819-155-8-201110180-00008 Hess LM, 2006, ANN PHARMACOTHER, V40, P1280, DOI 10.1345/aph.1H018 Holsclaw Susan L, 2005, J Manag Care Pharm, V11, P403 Jones EJM, 2005, ANN PHARMACOTHER, V39, P1527, DOI 10.1345/aph.1E456 Khdour MR, 2012, EUR J CLIN PHARMACOL, V68, P1365, DOI 10.1007/s00228-012-1279-5 Krigsman K, 2007, J CLIN PHARM THER, V32, P603, DOI 10.1111/j.1365-2710.2007.00866.x Kucukarslan SN, 2012, RES SOC ADMIN PHARM, V8, P321, DOI 10.1016/j.sapharm.2011.08.003 Lamb DA, 2009, CIRC-CARDIOVASC QUAL, V2, P228, DOI 10.1161/CIRCOUTCOMES.108.813600 Ma YS, 2010, CHOLESTEROL, DOI 10.1155/2010/383281 Mangan Michelle N, 2013, J Pharm Pract, V26, P376, DOI 10.1177/0897190012466896 McDonough RP, 1998, J AM PHARM ASSOC, V38, P87, DOI DOI 10.1016/S1086-5802(16)30296-0 Moczygemba LR, 2010, RES SOC ADMIN PHARM, V6, P143, DOI 10.1016/j.sapharm.2010.03.005 Naderi SH, 2012, AM J MED, V125, P882, DOI 10.1016/j.amjmed.2011.12.013 O'Loughlin J, 1999, PREV MED, V28, P324, DOI 10.1006/pmed.1998.0436 Osterberg L, 2005, NEW ENGL J MED, V353, P487, DOI 10.1056/NEJMra050100 Perreault S, 2010, BRIT J CLIN PHARMACO, V69, P74, DOI 10.1111/j.1365-2125.2009.03547.x Rene-Henri N, 2009, ANN PHARMACOTHER, V43, P104, DOI 10.1345/aph.1L308 Roberts AS, 2008, ANN PHARMACOTHER, V42, P861, DOI 10.1345/aph.1K617 Rosenthal M, 2009, CAN PHARM J, V142, P284, DOI 10.3821/1913-701X-142.6.284 Scahill Shane, 2009, Int J Pharm Pract, V17, P135 Simoni-Wastila L, 2012, AM J GERIATR PHARMAC, V10, P201, DOI 10.1016/j.amjopharm.2012.04.002 Sokol MC, 2005, MED CARE, V43, P521, DOI 10.1097/01.mlr.0000163641.86870.af Steiner JF, 1997, J CLIN EPIDEMIOL, V50, P105, DOI 10.1016/S0895-4356(96)00268-5 Tordoff J, 2012, INT J CLIN PHARM-NET, V34, P342, DOI 10.1007/s11096-012-9612-8 Touchette DR, 2010, PHARMACOTHERAPY, V30, P425, DOI 10.1592/phco.30.5.425 World Health Organization, MORT GLOB BURD DIS Wu JR, 2008, HEART LUNG, V37, P8, DOI 10.1016/j.hrtlng.2007.02.003 NR 36 TC 9 Z9 10 U1 0 U2 4 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1060-0280 EI 1542-6270 J9 ANN PHARMACOTHER JI Ann. Pharmacother. PD SEP PY 2013 VL 47 IS 9 BP 1143 EP 1152 DI 10.1177/1060028013503123 PG 10 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA 225UR UT WOS:000324989700005 PM 24259729 DA 2023-05-13 ER PT J AU Zhang, S Xu, YD Li, JY Wu, K Wang, T Su, XF Han, Q Xi, Y Gao, Y Wang, HB Hu, Y Liu, CL Ran, PX Zhang, NF Zhong, NS AF Zhang, Sun Xu, Yuanda Li, Jieying Wu, Kang Wang, Tao Su, Xiaofen Han, Qian Xi, Yin Gao, Yong Wang, Hongbo Hu, Yu Liu, Chunli Ran, Pixin Zhang, Nuofu Zhong, Nanshan TI Symptomless multi-variable apnea prediction index assesses adverse outcomes in patients with Corona Virus Disease 2019 SO SLEEP MEDICINE LA English DT Article DE sMVAP index; OSAHS; SARS-CoV-2; COVID-19 AB Purpose: To explore the relationship between symptomless multi-Variable apnea prediction (sMVAP) index and adverse outcomes of patients with Corona Virus Disease 2019 (COVID-19). Methods: According to the sMVAP quartiles, we divided all patients into four groups. The clinical elec-tronic medical records, nursing records, laboratory findings, and radiological examinations for all patients with laboratory confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection were reviewed. Cox proportional hazard ratio (HR) models were used to determine the risk factors associated with in hospital death. Results: A total of 97 patients were included in this study. The "Quartile 4" group 's ICU transfer rate was significantly higher than the "Quartile 1" group. Coronary heart disease, high d-dimer and sMVAP at admission were associated with increased odds of death. Conclusions: Using the sMVAP index for obstructive sleep apnea hypopnea syndrome (OSAHS) risk assessment, and then predicting the adverse outcomes of COVID-19 patients, is an effective method. Therefore, the use of sMVAP index for OSAHS screening for inpatients with COVID-19 should be vigorously promoted, and high-risk patients should be effectively managed. (c) 2020 Elsevier B.V. All rights reserved. C1 [Zhang, Sun; Xu, Yuanda; Li, Jieying; Wu, Kang; Wang, Tao; Su, Xiaofen; Han, Qian; Xi, Yin; Liu, Chunli; Ran, Pixin; Zhang, Nuofu; Zhong, Nanshan] Guangzhou Med Univ, Affiliated Hosp 1, Natl Clin Res Ctr Resp Dis, State Key Lab Resp Dis,Guangzhou Inst Resp Hlth, Guangzhou, Guangdong, Peoples R China. [Gao, Yong; Wang, Hongbo; Hu, Yu] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Hubei, Peoples R China. C3 Guangzhou Medical University; State Key Laboratory of Respiratory Disease; Huazhong University of Science & Technology RP Zhang, NF; Zhong, NS (通讯作者)，151 Yanjiang Rd, Guangzhou, Guangdong, Peoples R China. EM nfzhanggird@163.com; nanshan@vip.163.com OI Sun, Zhang/0000-0003-2908-9865 FU National Clinical Research Center for Respiratory Disease Independent Project [2020B1111340018] FX This work was supported by the National Clinical Research Center for Respiratory Disease Independent Project (grant number 2020B1111340018). CR Arentz M, 2020, JAMA-J AM MED ASSOC, V323, P1612, DOI 10.1001/jama.2020.4326 Ayas NT, 2020, CHEST Barman HA, 2021, CORONARY ARTERY DIS, V32, P359, DOI 10.1097/MCA.0000000000000914 Bhatraju PK, 2020, NEW ENGL J MED, V382, P2012, DOI 10.1056/NEJMoa2004500 Chung F, 2008, ANESTHESIOLOGY, V108, P812, DOI 10.1097/ALN.0b013e31816d83e4 Eckardt KU, 2012, KIDNEY INT SUPPL, V2, P7, DOI 10.1038/kisup.2012.8 Grote L, 2020, EUR RESPIR J, V55, DOI 10.1183/13993003.01323-2020 Huang C., 2020, ANN INTERN MED, V395, P497, DOI [DOI 10.1016/S0140-6736(20)30183-5, 10.1016/s0140-6736(20)30183-5] Lighter J, 2020, CLIN INFECT DIS, V71, P896, DOI 10.1093/cid/ciaa415 Lyons MM, 2017, SLEEP, V40, DOI 10.1093/sleep/zsw081 Marti-Soler H, 2016, LANCET RESP MED, V4, P742, DOI 10.1016/S2213-2600(16)30075-3 McSharry D, 2020, J CLIN SLEEP MED, V16, P1645, DOI 10.5664/jcsm.8538 National Health Commission of the People's Republic of China, 2020, CHIN MAN GUID COVID Ranieri VM, 2012, JAMA-J AM MED ASSOC, V307, P2526, DOI 10.1001/jama.2012.5669 Salles C, 2020, J CLIN SLEEP MED, V16, P1647, DOI 10.5664/jcsm.8606 Sattar N, 2020, CIRCULATION, V142, P4, DOI 10.1161/CIRCULATIONAHA.120.047659 Sun HY, 2020, J AM GERIATR SOC, V68, pE19, DOI 10.1111/jgs.16533 Tufik S, 2020, J CLIN SLEEP MED, V16, P1425, DOI 10.5664/jcsm.8596 World Health Organization, 2020, CLIN MANAGEMENT COVI Yu CZ, 2020, AM J PREV MED, V59, P168, DOI 10.1016/j.amepre.2020.05.002 NR 20 TC 5 Z9 4 U1 2 U2 37 PU ELSEVIER PI AMSTERDAM PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS SN 1389-9457 EI 1878-5506 J9 SLEEP MED JI Sleep Med. PD NOV PY 2020 VL 75 BP 294 EP 300 DI 10.1016/j.sleep.2020.08.031 PG 7 WC Clinical Neurology WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology GA OT3QB UT WOS:000590764000043 PM 32937279 OA Green Published DA 2023-05-13 ER PT J AU Cruz-Cobo, C Bernal-Jimenez, MA Vazquez-Garcia, R Santi-Cano, MJ AF Cruz-Cobo, Celia Bernal-Jimenez, Maria Angeles Vazquez-Garcia, Rafael Santi-Cano, Maria Jose TI Effectiveness of mHealth Interventions in the Control of Lifestyle and Cardiovascular Risk Factors in Patients After a Coronary Event: Systematic Review and Meta-analysis SO JMIR MHEALTH AND UHEALTH LA English DT Review DE coronary disease; acute coronary syndrome; mobile health; smartphone; mobile apps; mobile phone ID CARDIAC REHABILITATION; PHYSICAL-ACTIVITY; HEART-DISEASE; SECONDARY PREVENTION; ARTERY-DISEASE; SMARTPHONE; TELEREHABILITATION; ADHERENCE AB Background: Coronary artery disease is the main cause of death and loss of disability-adjusted life years worldwide. Information and communication technology has become an important part of health care systems, including the innovative cardiac rehabilitation services through mobile phone and mobile health (mHealth) interventions.Objective: In this study, we aimed to determine the effectiveness of different kinds of mHealth programs in changing lifestyle behavior, promoting adherence to treatment, and controlling modifiable cardiovascular risk factors and psychosocial outcomes in patients who have experienced a coronary event.Methods: A systematic review of the literature was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A thorough search of the following biomedical databases was conducted: PubMed, Embase, Web of Science, SciELO, CINAHL, Scopus, The Clinical Trial, and Cochrane. Articles that were randomized clinical trials that involved an intervention consisting of an mHealth program using a mobile app in patients after a coronary event were included. The articles analyzed some of the following variables as outcome variables: changes in lifestyle behavior, cardiovascular risk factors, and anthropometric and psychosocial variables. A meta-analysis of the variables studied was performed with the Cochrane tool. The risk of bias was assessed using the Cochrane Collaboration tool; the quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation tool; and heterogeneity was measured using the I2 test.Results: A total of 23 articles were included in the review, and 20 (87%) were included in the meta-analysis, with a total sample size of 4535 patients. Exercise capacity measured using the 6-minute walk test (mean difference=21.64, 95% CI 12.72-30.55; P<.001), physical activity (standardized mean difference [SMD]=0.42, 95% CI 0.04-0.81; P=.03), and adherence to treatment (risk difference=0.19, 95% CI 0.11-0.28; P<.001) were significantly superior in the mHealth group. Furthermore, both the physical and mental dimensions of quality of life were better in the mHealth group (SMD=0.26, 95% CI 0.09-0.44; P=.004 and SMD=0.27, 95% CI 0.06-0.47; P=.01, respectively). In addition, hospital readmissions for all causes and cardiovascular causes were statistically higher in the control group than in the mHealth group (SMD=-0.03, 95% CI -0.05 to -0.00; P=.04 vs SMD=-0.04, 95% CI -0.07 to -0.00; P=.05).Conclusions: mHealth technology has a positive effect on patients who have experienced a coronary event in terms of their exercise capacity, physical activity, adherence to medication, and physical and mental quality of life, as well as readmissions for all causes and cardiovascular causes. C1 [Cruz-Cobo, Celia; Bernal-Jimenez, Maria Angeles; Santi-Cano, Maria Jose] Univ Cadiz, Fac Nursing & Physiotherapy, Cadiz, Spain. [Cruz-Cobo, Celia; Bernal-Jimenez, Maria Angeles; Vazquez-Garcia, Rafael; Santi-Cano, Maria Jose] Inst Biomed Res & Innovat Cadiz INiBICA, Cadiz, Spain. [Cruz-Cobo, Celia; Bernal-Jimenez, Maria Angeles; Santi-Cano, Maria Jose] Univ Cadiz, Res Grp Nutr Mol Pathophysiol & Social Issues, Cadiz, Spain. [Vazquez-Garcia, Rafael] Puerta Mar Univ Hosp, Cardiol Unit, Cadiz, Spain. C3 Universidad de Cadiz; Universidad de Cadiz; Universidad de Cadiz; Hospital Universitario Puerta del Mar RP Santi-Cano, MJ (通讯作者)，Univ Cadiz, Fac Nursing & Physiotherapy, Ave Ana Viya 52, Cadiz 11009, Spain. EM mariajose.santi@uca.es OI Cruz - Cobo, Celia/0000-0002-3842-9449; Santi-Cano, Maria Jose/0000-0002-4430-6031 FU Research and Innovation in Biomedical and Health Sciences [PI-0014-20219]; Andalusian European Regional Development Fund Operational Program 2014-2020; Ministry of Health and Families FX This project is supported by a grant to fund Research and Innovation in Biomedical and Health Sciences within the framework of the Integrated Territorial Initiative 2014-2020 for the province of Cadiz. Reference code: PI -0014-20219. The project was cofinanced with 80% funds from the Andalusian European Regional Development Fund Operational Program 2014-2020 and was also funded by Ministry of Health and Families. 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There are three main types of ACS: ST segment elevation myocardial infarction (STEMI), non-ST segment elevation myocardial infarction (NSTEMI) and unstable angina (UA). One treatment for ACS is percutaneous coronary intervention (PCI) plus adjunctive treatment with antiplatelet drugs. Dual therapy antiplatelet treatment [aspirin plus either prasugrel (Efient(R), Daiichi Sankyo Company Ltd UK/Eli Lilly and Company Ltd), clopidogrel or ticagrelor (Brilique(R), AstraZeneca)] is standard in UK clinical practice. Prasugrel is the focus of this review. Objectives: The remit is to appraise the clinical effectiveness and cost-effectiveness of prasugrel within its licensed indication for the treatment of ACS with PCI and is a review of National Institute for Health and Care Excellence technology appraisal TA182. Data sources: Four electronic databases (MEDLINE, EMBASE, The Cochrane Library, PubMed) were searched from database inception to June 2013 for randomised controlled trials (RCTs) and to August 2013 for economic evaluations comparing prasugrel with clopidogrel or ticagrelor in ACS patients undergoing PCI. Methods: Clinical outcomes included non-fatal and fatal cardiovascular (CV) events, adverse effects of treatment and health-related quality of life (HRQoL). Cost-effectiveness outcomes included incremental cost per life-year gained and incremental cost per quality-adjusted life-year (QALY) gained. An independent economic model assessed four mutually exclusive subgroups: ACS patients treated with PCI for STEMI and with and without diabetes mellitus and ACS patients treated with PCI for UA or NSTEMI and with and without diabetes mellitus. Results: No new RCTs were identified beyond that reported in TA182. TRITON-TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel Thrombolysis in Myocardial Infarction 38) compared prasugrel with clopidogrel in ACS patients scheduled for PCI. No relevant economic evaluations were identified. Our analyses focused on a key subgroup of patients: those aged <75 years who weighed >60 kg (no previous stroke or transient ischaemic attack). For the primary composite end point (death from CV causes, non-fatal myocardial infarction or non-fatal stroke) statistically significantly fewer events occurred in the prasugrel arm (8.3%) than in the clopidogrel arm (11%). No statistically significant difference in major bleeding events was noted. However, there was a significant difference in favour of clopidogrel when major and minor bleeding events were combined (3.0 vs. 3.9%). No conclusions could be drawn regarding HRQoL. The results of sensitivity analyses confirmed that it is likely that, for all four ACS subgroups, within 5-10 years prasugrel is a cost-effective treatment option compared with clopidogrel at a willingness-to-pay threshold of 20,000 pound to 30,000 pound per QALY gained. At the full 40-year time horizon, all estimates are <10,000 pound per QALY gained. Limitations: Lack of data precluded a clinical comparison of prasugrel with ticagrelor; the comparative effectiveness of prasugrel compared with ticagrelor therefore remains unknown. The long-term modelling exercise is vulnerable to major assumptions about the continuation of early health outcome gains. Conclusion: A key strength of the review is that it demonstrates the cost-effectiveness of prasugrel compared with clopidogrel using the generic price of clopidogrel. Although the report demonstrates the cost-effectiveness of prasugrel compared with clopidogrel at a threshold of 20,000 pound to 30,000 pound per QALY gained, the long-term modelling is vulnerable to major assumptions regarding long-term gains. Lack of data precluded a clinical comparison of prasugrel with ticagrelor; the comparative effectiveness of prasugrel compared with ticagrelor therefore remains unknown. Well-audited data are needed from a long-term UK clinical registry on defined ACS patient groups treated with PCI who receive prasugrel, ticagrelor and clopidogrel. C1 [Greenhalgh, Janette; Bagust, Adrian; Boland, Angela; Dwan, Kerry; Beale, Sophie; Fleeman, Nigel; Dundar, Yenal; Richardson, Marty] Univ Liverpool, Liverpool Reviews & Implementat Grp, Liverpool L69 3BX, Merseyside, England. [McEntee, Joanne] North West Med Informat Ctr, Pharm Practice Unit, Liverpool, Merseyside, England. [Fisher, Michael] Liverpool Heart & Chest Hosp, Inst Cardiovasc Med & Sci, Liverpool, Merseyside, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; University of Liverpool; Liverpool Heart & Chest Hospital RP Greenhalgh, J (通讯作者)，Univ Liverpool, Liverpool Reviews & Implementat Grp, Liverpool L69 3BX, Merseyside, England. EM Janette.Greenhalgh@liverpool.ac.uk RI Dwan, Kerry/AAG-4726-2022; Dwan, Kerry/AFK-6469-2022; Dundar, Yenal/AAU-8336-2020 OI Dwan, Kerry/0000-0001-6918-1215; Dwan, Kerry/0000-0001-6918-1215; Dundar, Yenal/0000-0002-9847-1622; Richardson, Marty/0000-0002-7097-8704 FU National Institute for Health Research Health Technology Assessment programme FX The National Institute for Health Research Health Technology Assessment programme. 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PD APR PY 2015 VL 19 IS 29 BP 1 EP + DI 10.3310/hta19290 PG 132 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services GA CG8PW UT WOS:000353572700001 PM 25896573 OA gold, Green Published DA 2023-05-13 ER PT J AU Sotiropoulos, K Yerly, P Monney, P Garnier, A Regamey, J Hugli, O Martin, D Metrich, M Antonietti, JP Hullin, R AF Sotiropoulos, Konstantinos Yerly, Patrick Monney, Pierre Garnier, Antoine Regamey, Julien Hugli, Olivier Martin, David Metrich, Melanie Antonietti, Jean-Philippe Hullin, Roger TI Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction SO ESC HEART FAILURE LA English DT Article DE Red cell distribution width; Prognosis; Acute heart failure; Left ventricular ejection fraction ID CLINICAL CHARACTERISTICS; PROGNOSTIC MARKER; EUROPEAN-SOCIETY; HF REGISTRY; OUTCOMES; RISK; GUIDELINES; ESC; INFLAMMATION; ASSOCIATION AB Background Elevated red blood cell distribution width (RDW) is a valid predictor of outcome in acute heart failure (AHF). It is unknown whether elevated RDW remains predictive in AHF patients with either preserved left ventricular ejection fraction (LVEF) >= 50% or reduced LVEF (<50%). Methods and results Prospective local registry including 402 consecutive hospitalized AHF patients without acute coronary syndrome or need of intensive care. The primary outcome was all-cause mortality (ACM) at 1 year after admission. Demographic and clinical data derive from admission, echocardiographic examinations (n = 269; 67%) from hospitalization. The Cox proportional hazard model including all patients (P < 0.001) was adjusted for age, gender, and RDW quartiles. Independent predictors of 1-year ACM were cardiogenic shock (HR 2.86; CI: 1.3-6.4), male sex (HR 1.9; CI: 1.2-2.9), high RDW quartile (HR 1.66; CI: 1.02-2.8), chronic HF (HR 1.61; CI: 1.05-2.5), valvular heart disease (HR 1.61; CI: 1.09-2.4), increased diastolic blood pressure (HR 1.02 per mmHg; CI: 1.01-1.03), increasing age (HR 1.04 by year; CI: 1.02-1.07), platelet count (HR 1.002 per G/l; CI: 1.0-1.004), systolic blood pressure (HR 0.99 per mmHg; CI: 0.98-0.99), and weight (HR 0.98 per kg; CI: 0.97-0.99). A total of 114 patients (28.4%) died within the first year; ACM of all patients increased with quartiles of rising RDW (chi(2) 18; P< 0.001). ACM was not different between RDW quartiles of patients with reduced LVEF (n = 153; chi(2) 6.6; P = 0.084). In AHF with LVEF >= 50% the probability of ACM increased with rising RDW (n = 116; chi(2) 9.9; P = 0.0195). Conclusions High RDW is associated with increased ACM in AHF patients with preserved but not with reduced LVEF in this study population. C1 [Sotiropoulos, Konstantinos; Garnier, Antoine] Univ Lausanne, CHU Vaudois, Med Interne, Lausanne, Switzerland. [Yerly, Patrick; Monney, Pierre; Regamey, Julien; Martin, David; Metrich, Melanie; Hullin, Roger] Univ Lausanne, CHU Vaudois, Dept Med Interne, Serv Cardiol, Lausanne, Switzerland. [Hugli, Olivier] Univ Lausanne, CHU Vaudois, Serv Urgences, Lausanne, Switzerland. [Antonietti, Jean-Philippe] Univ Lausanne, Quartier UNIL Dorigny, Inst Psychol, Batiment Geopolis, Lausanne, Switzerland. C3 University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne RP Hullin, R (通讯作者)，Univ Lausanne, CHUV, Dept Internal Med, Cardiol, Rue Bugnon 46, CH-1011 Lausanne, Switzerland. EM roger.hullin@chuv.ch RI Hugli, Olivier/AAA-7057-2020; Garnier, Antoine/J-6454-2018 OI Garnier, Antoine/0000-0001-8361-2210; Hugli, Olivier/0000-0003-2312-1625 FU CARDIOMET, an initiative of the CHUV; Swiss National Science Foundation [320030_147121/1]; SWISSHEART Foundation FX CARDIOMET, an initiative of the CHUV to improve quality of care in cardiovascular and metabolic disease; Swiss National Science Foundation (320030_147121/1), SWISSHEART Foundation, to R.H. CR Allen LA, 2010, J CARD FAIL, V16, P230, DOI 10.1016/j.cardfail.2009.11.003 Ambrosy AP, 2014, J AM COLL CARDIOL, V63, P1123, DOI 10.1016/j.jacc.2013.11.053 Borne Y, 2011, EUR J HEART FAIL, V13, P1355, DOI 10.1093/eurjhf/hfr127 Collier P, 2011, EUR J HEART FAIL, V13, P1087, DOI 10.1093/eurjhf/hfr079 Curtis LH, 2008, ARCH INTERN MED, V168, P2481, DOI 10.1001/archinte.168.22.2481 Emans ME, 2013, INT J CARDIOL, V168, P3550, DOI 10.1016/j.ijcard.2013.05.002 Felker GM, 2007, J AM COLL CARDIOL, V50, P40, DOI 10.1016/j.jacc.2007.02.067 Fonarow GC, 2007, J AM COLL CARDIOL, V50, P768, DOI 10.1016/j.jacc.2007.04.064 Forhecz Z, 2009, AM HEART J, V158, P659, DOI 10.1016/j.ahj.2009.07.024 Gheorghiade M, 2006, JAMA-J AM MED ASSOC, V296, P2217, DOI 10.1001/jama.296.18.2217 Hartmann F, 2004, CIRCULATION, V110, P1780, DOI 10.1161/01.CIR.0000143059.68996.A7 Jenei ZM, 2014, INT J CARDIOL, V174, P783, DOI 10.1016/j.ijcard.2014.04.107 Kalogeropoulos A, 2010, J AM COLL CARDIOL, V55, P2129, DOI 10.1016/j.jacc.2009.12.045 Lassus J, 2013, INT J CARDIOL, V168, P2186, DOI 10.1016/j.ijcard.2013.01.228 Lund LH, 2014, JAMA-J AM MED ASSOC, V312, P2008, DOI 10.1001/jama.2014.15241 Maggioni AP, 2013, EUR J HEART FAIL, V15, P808, DOI 10.1093/eurjhf/hft050 Makhoul BF, 2013, INT J CARDIOL, V167, P1412, DOI 10.1016/j.ijcard.2012.04.065 Mancia G, 2013, J HYPERTENS, V31, P1925, DOI 10.1097/HJH.0b013e328364ca4c McMurray JJV, 2012, EUR HEART J, V33, P1787, DOI 10.1093/eurheartj/ehs104 Milo-Cotter O, 2011, CARDIOLOGY, V119, P96, DOI 10.1159/000330409 Nieminen MS, 2006, EUR HEART J, V27, P2725, DOI 10.1093/eurheartj/ehl193 O'Connor CM, 2005, J CARD FAIL, V11, P200, DOI 10.1016/j.cardfail.2004.08.160 Pascual-Figal DA, 2009, EUR J HEART FAIL, V11, P840, DOI 10.1093/eurjhf/hfp109 Paulus WJ, 2013, J AM COLL CARDIOL, V62, P263, DOI 10.1016/j.jacc.2013.02.092 Russi EW, 2013, RESPIRATION, V85, P160, DOI 10.1159/000346025 Tanner H, 2007, J HEART LUNG TRANSPL, V26, P622, DOI 10.1016/j.healun.2007.01.033 van Kimmenade RRJ, 2010, EUR J HEART FAIL, V12, P129, DOI 10.1093/eurjhf/hfp179 World Health Organization, 1999, 992 WHO Zalawadiya SK, 2011, J CARD FAIL, V17, P292, DOI 10.1016/j.cardfail.2010.11.006 NR 29 TC 40 Z9 41 U1 0 U2 6 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 SEP PY 2016 VL 3 IS 3 BP 198 EP 204 DI 10.1002/ehf2.12091 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DT8QA UT WOS:000381755300007 PM 27818784 OA gold, Green Published DA 2023-05-13 ER PT J AU Tahhan, AS Vaduganathan, M Greene, SJ Alrohaibani, A Raad, M Gafeer, M Mehran, R Fonarow, GC Douglas, PS Bhatt, DL Butler, J AF Tahhan, Ayman Samman Vaduganathan, Muthiah Greene, Stephen J. Alrohaibani, Alaaeddin Raad, Mohamed Gafeer, Mazen Mehran, Roxana Fonarow, Gregg C. Douglas, Pamela S. Bhatt, Deepak L. Butler, Javed TI Enrollment of Older Patients, Women, and Racial/Ethnic Minority Groups in Contemporary Acute Coronary Syndrome Clinical Trials A Systematic Review SO JAMA CARDIOLOGY LA English DT Review ID ACUTE MYOCARDIAL-INFARCTION; OUTCOMES; CARE; REPRESENTATION; INTERVENTION; INCLUSION; ISCHEMIA; THERAPY; TRENDS; HEART AB Importance Although age, sex, and race/ethnicity are important factors when generalizing the findings of clinical trials to routine practice, trends in the representation of these groups in contemporary acute coronary syndrome (ACS) trials are not well defined. Objective To characterize the representation of older patients, women, and racial/ ethnic minorities in ACS randomized trials. Evidence Review A systemic search was conducted of ACS trials published in 8 major medical journals between January 2001 and December 2018. Overall, 1 067 520 patients from 460 trials were included. Findings were compared with epidemiologic studies of patients with ACS. Findings The median number of participants per trial was 711 (interquartile range, 324-2163) and the median number of sites per trial was 21 (interquartile range, 5-73). Overall, 207 trials (45.0%) studied drug therapy, and 210 (45.7%) evaluated procedural interventions. The mean (SD) age of trial participants was 62.9 (10.7) years and increased from 62.3 (11.2) years in 2001-2006 to 64.0 (10.4) years in 2013-2018 (P = .01). The corresponding mean (SD) age was 66.4 (14.8) years in US epidemiologic studies and 70.0 (13.5) years in European epidemiologic studies. The overall proportion of women enrolled was 26.8% and decreased over time, from 27.8% in 2001-2006 to 24.9% in 2013-2018 (P = .21 for trend). The corresponding weighted proportions of women were 38.0% in US epidemiologic studies and 32.0% in European studies. The distribution of racial/ethnic groups was reported in only 99 trials (21.5%). In trials with reported data, 15.0% of the trial participants were nonwhite, which increased from 12.0% in 2001-2006 to 14.0% in 2013-2018. Black patients represented 3.7% of all patients during the entire study time frame, Asian patients represented 9.6%, and Hispanic patients represented 7.8%. Trends in the representation of black patients remained unchanged from 2001-2006 (5.2%) to 2013-2018 (4.9%), while the enrollment of Asian and Hispanic patients increased from 2001-2006 to 2013-2018 (from 1.9% to 10.8% for Asian patients and from 5.4% to 14.5% for Hispanic patients). Conclusions and Relevance Older patients and women are underrepresented in contemporary ACS trials compared with epidemiologic studies. Over time, there has been modest improvement in the representation of older patients but not women patients. More than three-quarters of trials did not report race/ethnicity data, with available data suggesting a modest increase in the enrollment of nonwhite patients owing to the enrollment of Asian and Hispanic patients. Enrollment of black patients remained low over time. C1 [Tahhan, Ayman Samman; Alrohaibani, Alaaeddin; Gafeer, Mazen] Emory Univ, Sch Med, Emory Clin Cardiovasc Res Inst, Atlanta, GA USA. [Vaduganathan, Muthiah; Bhatt, Deepak L.] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA. [Greene, Stephen J.; Douglas, Pamela S.] Duke Univ, Sch Med, Duke Clin Res Inst, Div Cardiol, Durham, NC USA. [Raad, Mohamed] Henry Ford Hlth Syst, Dept Cardiol, Detroit, MI USA. [Mehran, Roxana] Icahn Sch Med Mt Sinai, Zena & Michael Wiener Cardiovasc Inst, New York, NY 10029 USA. [Fonarow, Gregg C.] Univ Calif Los Angeles, Ahmanson UCLA Cardiomyopathy Ctr, Los Angeles, CA USA. [Butler, Javed] Univ Mississippi, Med Ctr, Dept Med, Jackson, MS 39216 USA. C3 Emory University; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Duke University; Henry Ford Health System; Henry Ford Hospital; Icahn School of Medicine at Mount Sinai; University of California System; University of California Los Angeles; University of Mississippi; University of Mississippi Medical Center RP Butler, J (通讯作者)，Univ Mississippi, Dept Med L650, 2500 N State St, Jackson, MS 39216 USA. EM jbutler4@umc.edu RI Mehran, Roxana/ABF-4160-2021 OI Raad, Mohamad/0000-0002-5446-3786; Douglas, Pamela/0000-0001-9876-4049 CR [Anonymous], 2017, 2016 J CITATION REPO Arora S, 2019, CIRCULATION, V139, P1047, DOI 10.1161/CIRCULATIONAHA.118.037137 Benjamin EJ, 2019, CIRCULATION, V139, pE56, DOI [10.1161/CIR.0000000000000659, 10.1161/CIR.0000000000000746] Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Bernard MA, 2018, JAMA-J AM MED ASSOC, V320, P1535, DOI 10.1001/jama.2018.12368 Cherry N, 2002, LANCET, V360, P2001 Cohen MG, 2010, CIRCULATION, V121, P2294, DOI 10.1161/CIRCULATIONAHA.109.922286 Ferreira-Gonzalez I, 2008, REV ESP CARDIOL, V61, P803, DOI 10.1016/S1885-5857(08)60228-5 FREEDMAN LS, 1995, CONTROL CLIN TRIALS, V16, P277, DOI 10.1016/0197-2456(95)00048-8 Harris DJ, 2000, NEW ENGL J MED, V343, P475, DOI 10.1056/NEJM200008173430706 Hodis HN, 2003, NEW ENGL J MED, V349, P535, DOI 10.1056/NEJMoa030830 Kragholm K, 2015, CIRC-CARDIOVASC QUAL, V8, P357, DOI 10.1161/CIRCOUTCOMES.114.001615 LaMori Joyce C, 2014, J Med Econ, V17, P191, DOI 10.3111/13696998.2014.885907 Lee PY, 2001, JAMA-J AM MED ASSOC, V286, P708, DOI 10.1001/jama.286.6.708 McManus DD, 2012, AM J MED, V125, P1076, DOI 10.1016/j.amjmed.2012.05.024 Melloni C, 2009, WOMENS HEALTH, V5, P339, DOI [10.2217/whe.09.25, 10.2217/WHE.09.25] Melloni C, 2010, CIRC-CARDIOVASC QUAL, V3, P135, DOI 10.1161/CIRCOUTCOMES.110.868307 Morrison DA, 2001, J AM COLL CARDIOL, V38, P143, DOI 10.1016/S0735-1097(01)01366-3 Peterson ED, 2009, CIRC-CARDIOVASC QUAL, V2, P491, DOI 10.1161/CIRCOUTCOMES.108.847145 Scott PE, 2018, J AM COLL CARDIOL, V71, P1960, DOI 10.1016/j.jacc.2018.02.070 Singh JA, 2014, BMC MED, V12, DOI 10.1186/s12916-014-0190-6 Tahhan AS, 2018, JAMA CARDIOL, V3, P1011, DOI 10.1001/jamacardio.2018.2559 Tse T, 2009, CHEST, V136, P295, DOI 10.1378/chest.08-3022 US Food and Drug Administration, 2016, COLL RAC ETHN DAT CL Vaduganathan M, 2016, CIRC-HEART FAIL, V9, DOI 10.1161/CIRCHEARTFAILURE.116.003192 Yasuda SU, 2008, CLIN PHARMACOL THER, V84, P417, DOI 10.1038/clpt.2008.141 Zaman MJ, 2014, EUR HEART J, V35, P1551, DOI 10.1093/eurheartj/ehu039 NR 27 TC 48 Z9 48 U1 0 U2 2 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 JUN PY 2020 VL 5 IS 6 BP 714 EP 722 DI 10.1001/jamacardio.2020.0359 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA MF8QI UT WOS:000545603400017 PM 32211813 DA 2023-05-13 ER PT J AU Choi, AR Jeong, MH Hong, YJ Sohn, SJ Kook, HY Sim, DS Ahn, YK Lee, KH Cho, JY Kim, YJ Cho, MC Kim, CJ AF Choi, Ah-Ra Jeong, Myung Ho Hong, Young Joon Sohn, Seok-Joon Kook, Hyun Yi Sim, Doo Sun Ahn, Young Keun Lee, Ki Hong Cho, Jae Yeong Kim, Young Jo Cho, Myeong Chan Kim, Chong Jin CA Korea Acute Myocardial Infarction TI Clinical characteristics and outcomes in acute myocardial infarction patients with versus without any cardiovascular risk factors SO KOREAN JOURNAL OF INTERNAL MEDICINE LA English DT Article DE Risk factors; Myocardial infarction; Prognosis ID ACUTE CORONARY SYNDROMES; ST-SEGMENT ELEVATION; MORTALITY; DISEASE; ASSOCIATION; PREVALENCE; MANAGEMENT; REGISTRY; MEN AB Background/Aims: Although cardiovascular (CV) risk factors are well established, some patients experience acute myocardial infarction (AMI) even without any risk factors. Methods: We analyzed total 11,390 patients (63.6 +/- 12.6 years old, 8,401 males) with AMI enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health from November, zoii to December, 2015. Patients were divided into two groups according to the presence of any CV risk factors (group I, without risk factors, n = 1,420 [12.5%]; group II, with risk factors, n = 9,970 [87.5%]). In-hospital outcomes were defined as in-hospital mortality and complications. One-year clinical outcomes were defined as the composite of major adverse cardiac events (MACE). Results: Group I was older (67.3 +/- 11.6 years old vs. 63.0 +/- 12.7 years old, p < 0.001) and had higher prevalence of female gender (36.2% vs. 24.8%, p < 0.001) than the group II. Group I experienced less previous history of angina pectoris (7.0% vs. 9.4%, p = 0.003) and the previous history of cerebrovascular accidents (3.4% vs. 6.9%, p < 0.001). In-hospital mortality (2.6% vs. 3.0%, p = 0.450) and complications (20.6% vs. 20.0%, p = 0.647) were no differences between the groups. And 1 year clinical outcomes (5.7% vs. 5.1%, p = 0.337) were no differences between the groups. In multivariate logistic regression analysis, serum creatinine level (hazard ratio, 1.35; 95% confidence interval, 1.05 to 1.75; p = 0.021) were independent predictors of 1 year MACE in patients without any CV risk factors. Conclusions: Elderly female patients were prone to develop AMI even without any modifiable CV risk factors. We suggest that more intensive care is needed in AMI patients without any CV risk factors who have high serum creatinine levels. C1 [Choi, Ah-Ra; Jeong, Myung Ho; Hong, Young Joon; Kook, Hyun Yi; Sim, Doo Sun; Ahn, Young Keun; Lee, Ki Hong; Cho, Jae Yeong] Chonnam Natl Univ Hosp, Heart Ctr, 42 Jebong Ro, Gwangju 61469, South Korea. [Sohn, Seok-Joon] Chonnam Natl Univ, Dept Prevent Med, Med Sch, Gwangju, South Korea. [Kim, Young Jo] Yeungnam Univ, Dept Cardiol, Med Ctr, Daegu, South Korea. [Cho, Myeong Chan] Chungbuk Natl Univ Hosp, Dept Cardiol, Cheongju, South Korea. [Kim, Chong Jin] Kyung Hee Univ Hosp, Dept Cardiol, Seoul, South Korea. C3 Chonnam National University; Chonnam National University Hospital; Chonnam National University; Yeungnam University; Chungbuk National University; Chungbuk National University Hospital; Kyung Hee University; Kyung Hee University Hospital RP Jeong, MH (通讯作者)，Chonnam Natl Univ Hosp, Heart Ctr, 42 Jebong Ro, Gwangju 61469, South Korea. EM myungho@chollian.net RI Cho, Jae Yeong/GVT-2986-2022; Hong, Young Joon/A-2792-2011 OI Cho, Jae Yeong/0000-0002-9393-2821; Hong, Young Joon/0000-0002-1831-8004; Jeong, Myung Ho/0000-0003-2424-810X FU Research of Korea Centers for Disease Control and Prevention, Republic of Korea [2016-ER6304-01] FX The authors thank all of the clinical investigators who contributed time and effort to this study, Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) Investigators. The KAMIR-NIH was supported by a fund (2016-ER6304-01) from Research of Korea Centers for Disease Control and Prevention, Republic of Korea. 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Intern. Med. PD SEP PY 2019 VL 34 IS 5 BP 1040 EP 1049 DI 10.3904/kjim.2018.056 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA IU2SS UT WOS:000483430700012 PM 30257551 OA Green Submitted, gold, Green Published DA 2023-05-13 ER PT J AU Ferrieres, J Lautsch, D Ambegaonkar, BM De Ferrari, GM Vyas, A Baxter, CA Bash, LD Velkovski-Rouyer, M Horack, M Almahmeed, W Chiang, FT Poh, KK Elisaf, M Brudi, P Gitt, AK AF Ferrieres, Jean Lautsch, Dominik Ambegaonkar, Baishali M. De Ferrari, Gaetano M. Vyas, Ami Baxter, Carl A. Bash, Lori D. Velkovski-Rouyer, Maja Horack, Martin Almahmeed, Wael Chiang, Fu-Tien Poh, Kian Keong Elisaf, Moses Brudi, Philippe Gitt, Anselm K. TI Use of guideline-recommended management in established coronary heart disease in the observational DYSIS II study SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Cardiovascular diseases; Secondary prevention; Guideline adherence; Evidence-based therapy ID ACUTE MYOCARDIAL-INFARCTION; DENSITY-LIPOPROTEIN CHOLESTEROL; DUAL ANTIPLATELET THERAPY; ASSOCIATION TASK-FORCE; ALL-CAUSE MORTALITY; SECONDARY PREVENTION; ESC/EAS GUIDELINES; AMERICAN-COLLEGE; ARTERY-DISEASE; DRUG-THERAPY AB Background: Guidelines recommend lifestyle modification and medications to control risk factors in coronary heart disease (CHD). Using data from the observational DYSIS II study, we sought to evaluate the use of guideline-recommended treatments at discharge for acute coronary syndromes (ACS) or in the chronic phase for CHD, and participation in rehabilitation/secondary prevention programs. Methods and results: Between 2013 and 2014, 10,661 patients (3867 with ACS, 6794 with stable CHD) were enrolled in 332 primary and secondary care centers in 18 countries (Asia, Europe, Middle East). Patients with incident ACS were younger and more likely to be smokers than patients with recurrent ACS or stable CHD (both p < 0.0001). Sedentary lifestyle was common (44.4% of ACS patients; 44.2% of stable CHD patients); 22.8% of ACS patients and 24.3% of stable CHD patients were obese. Prevalence of low high-density lipoprotein cholesterol (<40 mg/dL in men/50 mg/dL in women) was 46.9% in chronic CHD and 55.0% in ACS. Rates of secondary prevention medications were lower among CHD versus ACS (all p < 0.0001): antiplatelet 94.3% vs 98.0%, beta-blocker 72.0% vs 80.0%, lipid-lowering therapy 94.7 vs 97.5%, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers 69.4% vs 73.7%, respectively. Attendance at cardiac rehabilitation (16.8% of patients with a first ACS, 10.8% with recurrent ACS) or a secondary prevention program (3.7% of ACS and 11.7% of stable CHD patients) was infrequent. Conclusions: The high prevalence of risk factors in all CHD patients and reduced rates of secondary prevention medications in stable CHD offer areas for improvement. Translational aspects: The findings of DYSIS II may reinforce the importance of adopting a healthy lifestyle and prescribing (by clinicians) and adhering (by patients) to evidence-based medications in the management of CHD, not only during the short term but also over the longer term after a cardiac ischemic event. The results may help to increase the proportion of ACS patients who are referred to cardiac rehabilitation centres. (c) 2018 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 [Ferrieres, Jean] Toulouse Rangueil Univ Hosp CHU, Dept Cardiol, Toulouse, France. [Ferrieres, Jean] Univ Toulouse, Dept Epidemiol & Publ Hlth, UMR INSERM 1027, INSERM, Toulouse, France. [Lautsch, Dominik; Ambegaonkar, Baishali M.; Bash, Lori D.; Brudi, Philippe] Merck & Co Inc, Kenilworth, NJ USA. [De Ferrari, Gaetano M.] Univ Pavia, IRCCS Fdn Policlin San Matteo, Dept Cardiol, Pavia, Italy. [Vyas, Ami] Rutgers State Univ, Sch Publ Hlth, Piscataway, NJ USA. [Baxter, Carl A.] MSD Ltd, Hoddesdon, England. [Velkovski-Rouyer, Maja] MSD France, Paris, France. [Horack, Martin] Stiftung Inst Herzinfarktforsch, Ludwigshafen, Germany. [Almahmeed, Wael] Sheikh Khalifa Med City, Abu Dhabi, U Arab Emirates. [Almahmeed, Wael] Cleveland Clin Abu Dhabi, Inst Heart & Vasc, Abu Dhabi, U Arab Emirates. [Chiang, Fu-Tien] Natl Taiwan Univ Hosp, Taipei, Taiwan. [Poh, Kian Keong] Natl Univ Heart Ctr, Yong Loo Lin Sch Med, Singapore, Singapore. [Elisaf, Moses] Univ Ioannina, Sch Med, Ioannina, Greece. [Gitt, Anselm K.] Herzzentrum Ludwigshafen, Ludwigshafen, Germany. [Gitt, Anselm K.] Inst Herzinfarktforsch Ludwigshafen, Ludwigshafen, Germany. C3 CHU de Toulouse; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Toulouse; Merck & Company; IRCCS Fondazione San Matteo; University of Pavia; Rutgers State University New Brunswick; Merck & Company; Institute Heart Attack Research; Cleveland Clinic Foundation; National Taiwan University; National Taiwan University Hospital; National University of Singapore; University of Ioannina; Institute Heart Attack Research RP Ferrieres, J (通讯作者)，Toulouse Rangueil Univ Hosp CHU, Dept Cardiol, Toulouse, France. EM jean.ferrieres@univ-tlse3.fr RI Poh, Kian-Keong/AAS-2658-2021; De Ferrari, Gaetano M/K-5188-2016 OI De Ferrari, Gaetano M/0000-0003-4940-0876 FU Merck & Co., Inc., Kenilworth, NJ, USA FX This work was supported by Merck & Co., Inc., Kenilworth, NJ, USA. 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J. Cardiol. PD NOV 1 PY 2018 VL 270 BP 21 EP 27 DI 10.1016/j.ijcard.2018.06.008 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GT6GO UT WOS:000444609000004 PM 29934227 OA hybrid, Green Accepted DA 2023-05-13 ER PT J AU Puymirat, E Aissaoui, N Collet, JP Chaib, A Bonnet, JL Bataille, V Drouet, E Mulak, G Ferrieres, J Blanchard, D Simon, T Danchin, N AF Puymirat, Etienne Aissaoui, Nadia Collet, Jean-Philippe Chaib, Aures Bonnet, Jean-Louis Bataille, Vincent Drouet, Elodie Mulak, Genevieve Ferrieres, Jean Blanchard, Didier Simon, Tabassome Danchin, Nicolas TI Comparison of bleeding complications and one-year survival of low molecular weight heparin versus unfractioned heparin for acute myocardial infarction in elderly patients. The FAST-MI registry SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Acute myocardial infarction; Bleeding; Elderly; Low molecular weight heparin; Unfractioned heparin ID ACUTE CORONARY SYNDROMES; HIGH-RISK PATIENTS; ST-ELEVATION; TIMI 11B; ENOXAPARIN; MANAGEMENT; THROMBOCYTOPENIA; THROMBOLYSIS; EFFICACY; OUTCOMES AB Background: There are limited data on the safety and efficacy of low molecular weight heparin (LMWH) in elderly patients with acute myocardial infarction (AMI). Methods: We aimed to compare LMWH with unfractioned heparin (UFH) in themanagement of AMI in elderly patients. FAST-MI is a nationwide registry carried out over a 1-month period in 2005, including consecutive patients with AMI admitted to intensive care unit <48 h from symptom onset in 223 participating centers. We assessed the impact of LMWH on bleeding, the need for blood transfusion and one-year survival in elderly patients (>= 75 years). Results: 963 patients treated with heparin were included (mean age 82 +/- 5 years; 51% women; 42.5% ST-elevation myocardial infarction). Major bleeding (2.4% vs. 6.1%, P = 0.004) and blood transfusions (4.6% vs. 9.7%, P = 0.002) were significantly less frequent with LMWH compared with the UFH, a difference that persisted after multivariate adjustment (OR = 0.41, 95% CI: 0.20-0.83 and OR = 0.49, 95% CI: 0.28-0.85, respectively). One-year survival and stroke and reinfarction-free survival were also significantly higher with LMWH compared with UFH (OR = 0.66, 95% CI: 0.50-0.85 and OR = 0.71, 95% CI: 0.56-0.91, respectively). In two cohorts of patients matched on a propensity score for getting LMWH and with similar baseline characteristics (328 patients per group), major bleeding and transfusion were significantly lower while one-year survival was significantly higher in patients receiving LMWH. Conclusions: The present data show that in elderly patients admitted for AMI, use of LMWH is associated with less bleeding, less need for transfusion, and higher survival, compared with the use of UFH. (c) 2011 Elsevier Ireland Ltd. All rights reserved. C1 [Puymirat, Etienne; Aissaoui, Nadia; Chaib, Aures; Blanchard, Didier; Danchin, Nicolas] Univ Paris 05, Hop Europeen Georges Pompidou, AP HP, Div Coronary Artery Dis & Intens Cardiac Care, Paris, France. [Collet, Jean-Philippe] Hop La Pitie Salpetriere, AP HP, Dept Cardiol, Paris, France. [Bonnet, Jean-Louis] CHU Timone, Dept Cardiol, Marseille, France. [Bataille, Vincent; Ferrieres, Jean] Toulouse Univ Hosp, Dept Cardiol B, NSERM U558, Toulouse, France. [Drouet, Elodie; Simon, Tabassome] St Antoine Hosp, APHP, URC EST, Paris, France. [Mulak, Genevieve] Soc Francaise Cardiol, Paris, France. [Simon, Tabassome] UPMC Paris 06 Univ, Paris, France. [Bataille, Vincent; Ferrieres, Jean] Toulouse Univ Hosp, Dept Epidemiol, NSERM U558, Toulouse, 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 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 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; UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille; CHU de Toulouse; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Toulouse; Universite Toulouse III - Paul Sabatier; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Hotel-Dieu - APHP; UDICE-French Research Universities; Sorbonne Universite; CHU de Toulouse; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Toulouse; Universite Toulouse III - Paul Sabatier RP Puymirat, E (通讯作者)，Hop Europeen Georges Pompidou, Div Coronary Artery Dis, 20 Rue Leblanc, F-75015 Paris, France. EM etiennepuymirat@yahoo.fr RI Danchin, Nicolas/AAN-8291-2020; Puymirat, Etienne/AAP-8895-2021; Ferrieres, Jean/S-7993-2016 OI , Drouet/0000-0002-2271-0076; Bataille, Vincent/0000-0002-5780-2333; SIMON, Tabassome/0000-0002-4550-0450; Ferrieres, Jean/0000-0001-6144-1297 FU Pfizer; Servier FX The FAST-MI registry is a registry from the French Society of Cardiology supported by unrestricted grants from Pfizer and Servier. We are indebted to all investigators and all patients participating in the registry. 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J. Cardiol. PD JUN 5 PY 2013 VL 166 IS 1 BP 106 EP 110 DI 10.1016/j.ijcard.2011.10.008 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 144UO UT WOS:000318966300027 PM 22078393 DA 2023-05-13 ER PT J AU Sawant, AC Adhikari, P Narra, SR Srivatsa, SV Mills, PK Srivatsa, SS AF Sawant, Abhishek C. Adhikari, Prabhat Narra, Swapna R. Srivatsa, Shantanu V. Mills, Paul K. Srivatsa, Sanjay S. TI Neutrophil to lymphocyte ratio predicts short- and long-term mortality following revascularization therapy for ST elevation myocardial infarction SO CARDIOLOGY JOURNAL LA English DT Article DE neutrophil to lymphocyte ratio; ST elevation myocardial infarction; Thrombolysis In Myocardial Infarction risk score; predictors of mortality; percutaneous coronary revascularization ID CORONARY-ARTERY-DISEASE; HEART-FAILURE; RISK SCORE; HOSPITAL MORTALITY; PROGNOSTIC VALUE; COUNT; TIMI; INTERVENTION; ANGIOGRAPHY; SEVERITY AB Background: Several inflammation biomarkers have been implicated in the pathogenesis and prognosis of acute coronary syndromes. However, the prognostic role of the neutrophil-lymphocyte white cell interactive response to myocardial injury in predicting short-and long-term mortality after ST elevation myocardial infarction (STEMI) remains poorly defined. Methods: We evaluated 250 consecutive STEMI patients presenting acutely for revascularization to our tertiary care center over 1 year. Patients with acute sepsis, trauma, recent surgery, autoimmune diseases, or underlying malignancy were excluded. Data gathered included demographics, clinical presentation, leukocyte markers, electrocardiograms, evaluations, therapy, major adverse cardiac events, and all-cause mortality. Results: Mean age was 62 +/- 15 years, 70.4% of subjects were males while majority (49.4%) were Caucasians. Mean duration of follow-up was 571 +/- 291 days (median 730 days). Univariate analysis of several inflammatory biomarkers including C-reactive protein, revealed white cell count (OR = 1.09, p < 0.001) and neutrophil to lymphocyte ratio (NLR) (OR = 1.05, p = 0.011) as predictors of short- and long-term mortality; but not mean neutrophil count (OR = 1.04, p = 0.055) or lymphocyte count alone (OR = 0.96, p = 0.551). Multivariate analysis using backward stepwise regression revealed NLR (OR = 2.64, p = 0.026), female gender (OR = 5.35, p < 0.001), cerebrovascular accident history (OR = 3.36, p = 0.023), low glomerular filtration rate (OR = 0.98, p = 0.012) and cardiac arrest on admission (OR = 17.43, p < 0.001) as robust independent predictors of long-term mortality. NLR was divided into two sub-groups based on an optimal cut off value of 7.4. This provided the best discriminatory cut off point for predicting adverse mortality outcome. Both short-term (<= 30 days) and long-term (<= 2 years) mortality were predicted with Kaplan-Meier survival curve separation best stratified by a NLR cut off value of 7.4. Conclusions: NLR based on an optimal cut off value of 7.4, was an excellent predictor of short-and long-term survival in patients with revascularized STEMI and warrants larger scale multi-center prospective evaluation, as a prognostic indicator. NLR offers improved prognostic capacity when combined with conventional clinical scoring systems, such as the Thrombolysis In Myocardial Infarction risk score. C1 [Sawant, Abhishek C.; Adhikari, Prabhat; Narra, Swapna R.; Srivatsa, Shantanu V.; Srivatsa, Sanjay S.] Community Reg Med Ctr, Fresno, CA USA. [Mills, Paul K.] Univ Calif San Francisco, Fresno Med Educ Program, Fresno, CA USA. C3 University of California System; University of California San Francisco; University of California San Francisco at Fresno RP Srivatsa, SS (通讯作者)，7215 North Fresno St,Suite 103, Fresno, CA 93720 USA. 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J. PY 2014 VL 21 IS 5 BP 500 EP 508 DI 10.5603/CJ.a2013.0148 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AW0PQ UT WOS:000345995800008 PM 24142685 OA Green Submitted, gold DA 2023-05-13 ER PT J AU Fang, XY Li, S Yu, H Wang, PH Zhang, Y Chen, Z Li, Y Cheng, LQ Li, WB Jia, H Ma, XY AF Fang, Xiaoyu Li, Shen Yu, Hao Wang, Penghao Zhang, Yao Chen, Zheng Li, Yang Cheng, Liqing Li, Wenbin Jia, Hong Ma, Xiangyu TI Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis SO AGING-US LA English DT Review DE COVID-19; meta-analysis; SARS-Cov-2; 2019-nCoV ID RESPIRATORY SYNDROME AB A systematic review and meta-analysis was conducted in an attempt to systematically collect and evaluate the associations of epidemiological, comorbidity factors with the severity and prognosis of coronavirus disease 2019 (COVID-19). The systematic review and meta-analysis was conducted according to the guidelines proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Sixty nine publications met our study criteria, and 61 studies with more than 10,000 COVID-19 cases were eligible for the quantitative synthesis. We found that the males had significantly higher disease severity (RR: 1.20, 95% CI: 1.13-1.27, P <0.001) and more prognostic endpoints. Older age was found to be significantly associated with the disease severity and six prognostic endpoints. Chronic kidney disease contributed mostly for death (RR: 7.10, 95% CI: 3.14-16.02), chronic obstructive pulmonary disease (COPD) for disease severity (RR: 4.20, 95% CI: 2.82-6.25), admission to intensive care unit (ICU) (RR: 5.61, 95% CI: 2.68-11.76), the composite endpoint (RR: 8.52, 95% CI: 4.36-16.65,), invasive ventilation (RR: 6.53, 95% CI: 2.70-15.84), and disease progression (RR: 7.48, 95% CI: 1.60-35.05), cerebrovascular disease for acute respiratory distress syndrome (ARDS) (RR: 3.15, 95% CI: 1.23-8.04), coronary heart disease for cardiac abnormality (RR: 5.37, 95% CI: 1.74-16.54). Our study highlighted that the male gender, older age and comorbidities owned strong epidemiological evidence of associations with the severity and prognosis of COVID-19. C1 [Fang, Xiaoyu; Jia, Hong] Southwest Med Univ, Coll Publ Hlth, Luzhou, Sichuan, Peoples R China. [Fang, Xiaoyu; Zhang, Yao; Chen, Zheng; Ma, Xiangyu] Third Mil Med Univ, Coll Prevent Med, Dept Epidemiol, Chongqing, Peoples R China. [Li, Shen; Wang, Penghao] Chongqing Med Univ, Clin Coll 2, Chongqing, Peoples R China. [Yu, Hao] Northern Theater Command Gen Hosp, Dept Endocrinol, Shenyang, Peoples R China. [Li, Yang] Army Med Univ, NCO Sch, Shijiazhuang, Hebei, Peoples R China. [Cheng, Liqing] Third Mil Med Univ, Southwest Hosp, Dept Endocrinol & Metab, Chongqing, Peoples R China. [Li, Wenbin] Dali Retreat Ctr Former Cadres Yunnan Mil Reg, Outpatient Clin, Dali, Peoples R China. C3 Southwest Medical University; Army Medical University; Chongqing Medical University; Army Medical University; Army Medical University RP Ma, XY (通讯作者)，Third Mil Med Univ, Coll Prevent Med, Dept Epidemiol, Chongqing, Peoples R China. EM xymacq@hotmail.com RI 翔宇, 马/ABH-3164-2021 OI 翔宇, 马/0000-0001-7967-3950; Shen, Li/0000-0002-0653-0649 FU Science Foundation for Outstanding Young People of the Army Medical University; National Natural Science Foundation of China [81600636] FX The present study was funded by the Science Foundation for Outstanding Young People of the Army Medical University (grant to Pro Xiangyu Ma), and a grant from National Natural Science Foundation of China (No. 81600636). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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World Health Organization, 2020, 77 WHO Wu CM, 2020, JAMA INTERN MED, V180, P934, DOI 10.1001/jamainternmed.2020.0994 Xia Y, 2020, LANCET ONCOL, V21, pE180, DOI 10.1016/S1470-2045(20)30150-9 Xu XW, 2020, BMJ-BRIT MED J, V368, DOI [10.1136/bmj.m606, 10.1136/bmj.m792] Yang XB, 2020, LANCET RESP MED, V8, P475, DOI 10.1016/S2213-2600(20)30079-5 Zhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 NR 35 TC 193 Z9 196 U1 7 U2 12 PU IMPACT JOURNALS LLC PI ORCHARD PARK PA 6666 E QUAKER ST, STE 1, ORCHARD PARK, NY 14127 USA SN 1945-4589 J9 AGING-US JI Aging-US PD JUL 15 PY 2020 VL 12 IS 13 BP 12493 EP 12503 DI 10.18632/aging.103579 PG 11 WC Cell Biology; Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Cell Biology; Geriatrics & Gerontology GA NU8OQ UT WOS:000573897700005 PM 32658868 OA Green Published, gold DA 2023-05-13 ER PT J AU Brouillette, J Nattel, S AF Brouillette, Judith Nattel, Stanley TI A Practical Approach to Avoiding Cardiovascular Adverse Effects of Psychoactive Medications SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Review ID CLINICAL-PRACTICE GUIDELINES; ACUTE CORONARY SYNDROME; NEW-ZEALAND COLLEGE; SCIENTIFIC STATEMENT; ANTIPSYCHOTIC-DRUGS; HEART-DISEASE; RISK; DEPRESSION; SCHIZOPHRENIA; ANTIDEPRESSANT AB Drugs that act on mental state, generally termed "psychoactive agents," are among the most widely used medications in medicine. Psychoactive agents can affect the cardiovascular system and must be used carefully to avoid negative cardiovascular consequences. In the present article we review the potential adverse cardiovascular consequences of psychoactive medications and provide suggestions for practical approaches to avoiding them. We consider adverse reactions in terms of: (1) arrhythmias (particularly acquired long QT syndrome); (2) blood pressure; (3) ventricular function; (4) effect on risk factors; (5) teratogenicity; and (6) drug interactions. Minimizing QT liability requires a consideration of patient-specific risk factors and the risk profile of drugs available to treat the psychiatric condition. Drugs with QT-prolonging properties can be used safely, provided that appropriate precautions are taken. Fear of QT-prolongation should not deprive patients of needed psychiatric therapy. For example, one large study reported substantially increased all-cause mortality/hospitalization, death/depression-hospitalization, and death/arrhythmia-hospitalization in patients for whom citalopram dosage was reduced over QT-concerns after the Food and Drug Administration Black Box Warning. In general, attention to drug-specific cardiac adverse effect risks is needed, along with appropriate patient-related drug selection and follow-up, to detect adverse reactions early and adjust accordingly. Treatment should begin with low doses, followed by careful dose titration and adjustment of drug regimen according to clinical responses. Particular care is needed to minimize negative consequences on cardiovascular/metabolic risk profile, which might have very detrimental long-term effects on cardiovascular health. It is crucial that fear of cardiovascular adverse effects not deprive patients of appropriate psychoactive drug-therapy. C1 [Brouillette, Judith] Univ Montreal, Dept Psychiat, Fac Med, Montreal, PQ, Canada. [Brouillette, Judith; Nattel, Stanley] Montreal Heart Inst, Res Ctr, Montreal, PQ, Canada. [Brouillette, Judith; Nattel, Stanley] Univ Montreal, Montreal, PQ, Canada. [Nattel, Stanley] Univ Montreal, Dept Med, Fac Med, Montreal, PQ, Canada. [Nattel, Stanley] McGill Univ, Dept Pharmacol & Therapeut, Montreal, PQ, Canada. [Nattel, Stanley] Univ Duisburg Essen, Inst Pharmacol, West German Heart & Vasc Ctr, Fac Med, Essen, Germany. C3 Universite de Montreal; Universite de Montreal; Universite de Montreal; Universite de Montreal; McGill University; University of Duisburg Essen RP Brouillette, J; Nattel, S (通讯作者)，Montreal Heart Inst, 5000 Belanger, Montreal, PQ H1T 1C8, Canada. EM judith.brouillette@icm-mhi.org; stanley.nattel@icm-mhi.org FU Canadian Institutes of Health Research; Heart and Stroke Foundation of Canada FX Funded by the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Canada. 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J. Cardiol. PD DEC PY 2017 VL 33 IS 12 BP 1577 EP 1586 DI 10.1016/j.cjca.2017.09.001 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA FO1KM UT WOS:000416518900012 PM 29173600 DA 2023-05-13 ER PT J AU Gamez-Gonzalez, LB Murata, C Munoz-Ramirez, M Yamazaki-Nakashimada, M AF Berenise Gamez-Gonzalez, Luisa Murata, Chiharu Munoz-Ramirez, Mireya Yamazaki-Nakashimada, Marco TI Clinical manifestations associated with Kawasaki disease shock syndrome in Mexican children SO EUROPEAN JOURNAL OF PEDIATRICS LA English DT Article DE Kawasaki disease; Shock; Gastrointestinal involvement; IVIG resistance ID YOUNG AB Recently, there have been increasing reports of severe forms of Kawasaki disease (KD) associated with shock that have been managed in pediatric intensive care units. It has been suggested that KD is more severe in the Hispanic population. We conducted a study to determine the frequency of Kawasaki disease shock syndrome (KDSS) in our population and compared characteristics between patients with KD without shock and patients with KDSS. Data from 214 patients with KD treated in a tertiary pediatric hospital were collected during a 12-year period. We compared clinical and laboratory features of KD patients without shock and KDSS patients. Of 214 consecutive patients with KD, 11 (5 %) met the definition for KDSS. All of these patients received fluid resuscitation, seven (64 %) required inotropic treatment, and six (54 %), ventilatory support. On admission, seven of these patients (64 %) had an incomplete presentation of the disease, whereas in the group of patients without shock, the relative frequency of an incomplete presentation was 29 %. Twenty percent (3/11) of patients with KDSS presented giant coronary aneurysms versus none of 203 KD patients without shock (p = 0.001); myocardial infarction, 27 % (3/11), versus 1 % (2/203) (p = 0.001); and intravenous immunoglobulin (IVIG) resistance, 60 % (6/11), versus 12 % (24/203). Gastrointestinal manifestations in the acute phase occurred in 91 % of KDSS patients versus 30 % patients without shock (p = 0.001). Conclusion. Patients with KD presenting in shock seem to have an increase in gastrointestinal manifestations, incomplete presentation, IVIG resistance, and worse cardiac outcomes. Larger, prospective, multicentre studies should be carried out to corroborate these findings. C1 [Berenise Gamez-Gonzalez, Luisa; Yamazaki-Nakashimada, Marco] Inst Nacl Pediat, Serv Inmunol Clin, Mexico City, DF, Mexico. [Murata, Chiharu] Inst Nacl Pediat, Dept Invest, Mexico City, DF, Mexico. [Munoz-Ramirez, Mireya] Inst Nacl Pediat, Dept Terapia Intens, Mexico City, DF, Mexico. RP Yamazaki-Nakashimada, M (通讯作者)，Inst Nacl Pediat, Serv Inmunol Clin, Insurgentes Sur 3700-C Col Insurgentes Cuicuilco, Mexico City, DF, Mexico. 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J. Pediatr. PD MAR PY 2013 VL 172 IS 3 BP 337 EP 342 DI 10.1007/s00431-012-1879-1 PG 6 WC Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Pediatrics GA 097PE UT WOS:000315485200008 PM 23152158 DA 2023-05-13 ER PT J AU Ordovas, KG Baldassarre, LA Bucciarelli-Ducci, C Carr, J Fernandes, JL Ferreira, VM Frank, L Mavrogeni, S Ntusi, N Ostenfeld, E Parwani, P Pepe, A Raman, SV Sakuma, H Schulz-Menger, J Sierra-Galan, LM Valente, AM Srichai, MB AF Ordovas, Karen G. Baldassarre, Lauren A. Bucciarelli-Ducci, Chiara Carr, James Fernandes, Juliano Lara Ferreira, Vanessa M. Frank, Luba Mavrogeni, Sophie Ntusi, Ntobeko Ostenfeld, Ellen Parwani, Purvi Pepe, Alessia Raman, Subha, V Sakuma, Hajime Schulz-Menger, Jeanette Sierra-Galan, Lilia M. Valente, Anne Marie Srichai, Monvadi B. TI Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) SO JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE LA English DT Review DE Cardiovascular magnetic resonance; Women; Cardiovascular disease; Society for Cardiovascular Magnetic Resonance; Position statement ID ASSOCIATION TASK-FORCE; EXPERT CONSENSUS; AMERICAN-COLLEGE; HEART-DISEASE; MANAGEMENT; GUIDELINE; DIAGNOSIS AB This document is a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in women with cardiovascular disease. The document was prepared by the SCMR Consensus Group on CMR Imaging for Female Patients with Cardiovascular Disease and endorsed by the SCMR Publications Committee and SCMR Executive Committee. The goals of this document are to (1) guide the informed selection of cardiovascular imaging methods, (2) inform clinical decision-making, (3) educate stakeholders on the advantages of CMR in specific clinical scenarios, and (4) empower patients with clinical evidence to participate in their clinical care. The statements of clinical utility presented in the current document pertain to the following clinical scenarios: acute coronary syndrome, stable ischemic heart disease, peripartum cardiomyopathy, cancer therapy-related cardiac dysfunction, aortic syndrome and congenital heart disease in pregnancy, bicuspid aortic valve and aortopathies, systemic rheumatic diseases and collagen vascular disorders, and cardiomyopathy-causing mutations. The authors cite published evidence when available and provide expert consensus otherwise. Most of the evidence available pertains to translational studies involving subjects of both sexes. However, the authors have prioritized review of data obtained from female patients, and direct comparison of CMR between women and men. This position statement does not consider CMR accessibility or availability of local expertise, but instead highlights the optimal utilization of CMR in women with known or suspected cardiovascular disease. Finally, the ultimate goal of this position statement is to improve the health of female patients with cardiovascular disease by providing specific recommendations on the use of CMR. C1 [Ordovas, Karen G.] Univ Washington, Seattle, WA 98195 USA. [Baldassarre, Lauren A.] Yale Univ, New Haven, CT USA. [Bucciarelli-Ducci, Chiara] Bristol Heart Inst, Bristol, Avon, England. [Bucciarelli-Ducci, Chiara] Bristol Natl Inst Hlth Res NIHR Biomed, Res Ctr, Bristol, Avon, England. [Bucciarelli-Ducci, Chiara] Univ Hosp Bristol, Bristol, Avon, England. [Bucciarelli-Ducci, Chiara] Univ Bristol, Bristol, Avon, England. [Carr, James] Northwestern Univ, Feinberg Sch Med, Dept Radiol, Chicago, IL 60611 USA. [Fernandes, Juliano Lara] Jose Michel Kalaf Res Inst, Radiol Clin Campinas, Sao Paulo, Brazil. [Ferreira, Vanessa M.] Univ Oxford, British Heart Fdn Ctr Res Excellence, Oxford Ctr Clin Magnet Resonance Res OCMR, Oxford NIHR Biomed Res Ctr,Div Cardiovasc Med, Oxford, England. [Frank, Luba] Med Coll Wisconsin, Milwaukee, WI 53226 USA. [Mavrogeni, Sophie] Onassis Cardiac Surg Ctr, Athens, Greece. [Mavrogeni, Sophie] Kapodistrian Univ Athens, Athens, Greece. [Ntusi, Ntobeko] Univ Cape Town, Cape Town, South Africa. [Ntusi, Ntobeko] Groote Schuur Hosp, Cape Town, South Africa. [Ostenfeld, Ellen] Lund Univ, Skane Univ Hosp Lund, Dept Clin Sci Lund, Clin Physiol, Lund, Sweden. [Parwani, Purvi] Loma Linda Univ Hlth, Dept Med, Div Cardiol, Loma Linda, CA USA. [Pepe, Alessia] Fdn G Monasterio CNR, Magnet Resonance Imaging Unit, Pisa, Italy. [Raman, Subha, V] Indiana Univ, Krannert Inst Cardiol, Indianapolis, IN 46204 USA. [Sakuma, Hajime] Mie Univ, Dept Radiol, Sch Med, Tsu, Mie, Japan. [Schulz-Menger, Jeanette] Univ Berlin, Harite Hosp, Berlin, Germany. [Schulz-Menger, Jeanette] HELIOS Clin Berlin Buch, Berlin, Germany. [Sierra-Galan, Lilia M.] Amer British Cowdray Med Ctr, Mexico City, DF, Mexico. [Valente, Anne Marie] Brigham & Womens Hosp, Boston Childrens Hosp, 75 Francis St, Boston, MA 02115 USA. [Srichai, Monvadi B.] Georgetown Univ, Sch Med, Washington, DC USA. C3 University of Washington; University of Washington Seattle; Yale University; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Bristol; Northwestern University; Feinberg School of Medicine; RLUK- Research Libraries UK; University of Oxford; Medical College of Wisconsin; Onassis Cardiac Surgery Center; National & Kapodistrian University of Athens; University of Cape Town; University of Cape Town; Lund University; Skane University Hospital; Loma Linda University; Consiglio Nazionale delle Ricerche (CNR); Indiana University System; Indiana University-Purdue University Indianapolis; Mie University; Harvard University; Boston Children's Hospital; Brigham & Women's Hospital; Georgetown University RP Ordovas, KG (通讯作者)，Univ Washington, Seattle, WA 98195 USA. 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PD MAY 10 PY 2021 VL 23 IS 1 AR 52 DI 10.1186/s12968-021-00746-z PG 17 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 RZ5UB UT WOS:000648661100001 PM 33966639 OA Green Published, gold, Green Accepted DA 2023-05-13 ER PT J AU Young, C Kwan, A Yepez, L McCarty, M Chan, A Hsu, D Han, J Taneja, T Park, S Hayward, R Liu, TI AF Young, Charlie Kwan, Annie Yepez, Lisa McCarty, Meghan Chan, Amanda Hsu, Dora Han, Jennifer Taneja, Taresh Park, Shirley Hayward, Robert Liu, Taylor, I TI Contemporary procedure characteristics and outcomes of accessory atrioventricular pathway ablations in an integrated community-based health care system using a tiered approach SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Radiofrequency ablation; Accessory pathway ablation outcome; Wolff Parkinson White Syndrome ID RADIOFREQUENCY CATHETER ABLATION; PARKINSON-WHITE-SYNDROME; RECURRENCE AB BackgroundSince the early descriptions of large series of accessory atrioventricular pathway ablations in adults and adolescents over 20 years ago, there have been limited published reports based on more recent experiences of large referral centers. We aimed to characterize accessory pathway distribution and features in a large community-based population that influence ablation outcomes using a tiered approach to ablation.MethodsRetrospective analysis of 289 patients (age 14-81) who underwent accessory ablation from 2015-2019 was performed. Pathways were categorized into anteroseptal, left freewall, posteroseptal, and right freewall locations. We analyzed patient and pathway features to identify factors associated with prolonged procedure time parameters.ResultsInitial ablation success rate was 94.7% with long-term success rate of 93.4% and median follow-up of 931 days. Accessory pathways were in left freewall (61.6%), posteroseptal (24.6%), right freewall (9.6%), and anteroseptal (4.3%) locations. Procedure outcome was dependent on pathway location. Acute success was highest for left freewall pathways (97.1%) with lowest case times (14468 min) and fluoroscopy times (15 +/- 19 min). Longest procedure time parameters were seen with anteroseptal, left anterolateral, epicardial-coronary sinus, and right anterolateral pathway ablations.Conclusions In this community-based adult and adolescent population, majority of the accessory pathways are in the left freewall and posteroseptal region and tend to be more easily ablated. A tiered approach with initial use of standard ablation equipment before the deployment of more advance tools, such as irrigated tips and 3D mapping, is cost effective without sacrificing overall efficacy. C1 [Young, Charlie; Kwan, Annie; Yepez, Lisa; McCarty, Meghan; Chan, Amanda; Hsu, Dora; Han, Jennifer; Taneja, Taresh; Park, Shirley; Hayward, Robert; Liu, Taylor, I] Kaiser Santa Clara Med Ctr, Dept Cardiac Electrophysiol, Kaiser Permanente NCAL, 710 Lawrence Expressway,Dept 342, Santa Clara, CA 95051 USA. RP Liu, TI (通讯作者)，Kaiser Santa Clara Med Ctr, Dept Cardiac Electrophysiol, Kaiser Permanente NCAL, 710 Lawrence Expressway,Dept 342, Santa Clara, CA 95051 USA. 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Disord. PD JUN 30 PY 2021 VL 21 IS 1 AR 319 DI 10.1186/s12872-021-02132-0 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA TG2TG UT WOS:000671261900002 PM 34193076 OA Green Published, gold DA 2023-05-13 ER PT J AU Lichtman, JH Leifheit, EC Safdar, B Bao, H Krumholz, HM Lorenze, NP Daneshvar, M Spertus, JA D'Onofrio, G AF Lichtman, Judith H. Leifheit, Erica C. Safdar, Basmah Bao, Haikun Krumholz, Harlan M. Lorenze, Nancy P. Daneshvar, Mitra Spertus, John A. D'Onofrio, Gail TI Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction Evidence from the VIRGO Study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) SO CIRCULATION LA English DT Article DE delay; diagnosis; help-seeking behavior; medical care; myocardial infarction; women ID AMERICAN-HEART-ASSOCIATION; ACUTE CORONARY SYNDROMES; SCIENTIFIC STATEMENT; PREHOSPITAL DELAY; SEEKING TREATMENT; MORTALITY; WOMEN; AGE; DISEASE; STROKE AB Background: Some studies report that women are less likely to present with chest pain for acute myocardial infarction (AMI). Information on symptom presentation, perception of symptoms, and care-seeking behaviors is limited for young patients with AMI. Methods: We interviewed 2009 women and 976 men aged 18 to 55 years hospitalized for AMI at 103 US hospitals participating in the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients). Structured patient interviews during the index AMI hospitalization were used to collect information on symptom presentation, perception of symptoms, and care-seeking behaviors. We compared patient characteristics and presentation information by sex. Multivariable hierarchical logistic regression was used to evaluate the association between sex and symptom presentation. Results: The majority of women (87.0%) and men (89.5%) presented with chest pain (defined as pain, pressure, tightness, or discomfort). Women were more likely to present with 3 associated symptoms than men (eg, epigastric symptoms, palpitations, and pain or discomfort in the jaw, neck, arms, or between the shoulder blades; 61.9% for women versus 54.8% for men, P<0.001). In adjusted analyses, women with an ST-segment-elevation AMI were more likely than men to present without chest pain (odds ratio, 1.51; 95% confidence interval, 1.03-2.22). In comparison with men, women were more likely to perceive symptoms as stress/anxiety (20.9% versus 11.8%, P<0.001) but less likely to attribute symptoms to muscle pain (15.4% versus 21.2%, P=0.029). Approximately 29.5% of women and 22.1% of men sought medical care for similar symptoms before their hospitalization (P<0.001); however, 53% of women reported that their provider did not think these symptoms were heart-related in comparison with 37% of men (P<0.001). Conclusions: The presentation of AMI symptoms was similar for young women and men, with chest pain as the predominant symptom for both sexes. Women presented with a greater number of additional non-chest pain symptoms regardless of the presence of chest pain, and both women and their healthcare providers were less likely to attribute their prodromal symptoms to heart disease in comparison with men. C1 [Lichtman, Judith H.; Leifheit, Erica C.] Yale Sch Publ Hlth, Dept Chron Dis Epidemiol, 60 Church St,POB 208034, New Haven, CT 06520 USA. [Krumholz, Harlan M.] Yale Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT 06520 USA. [Lichtman, Judith H.; Bao, Haikun; Krumholz, Harlan M.; Lorenze, Nancy P.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, 20 York St, New Haven, CT 06504 USA. [Safdar, Basmah; D'Onofrio, Gail] Yale Sch Med, Dept Emergency Med, New Haven, CT USA. [Krumholz, Harlan M.] Yale Sch Med, Sect Cardiovasc Med, Dept Internal Med, New Haven, CT USA. [Daneshvar, Mitra] Hosp Univ Penn, Dept Phys Med & Rehabil, 3400 Spruce St, Philadelphia, PA 19104 USA. [Spertus, John A.] St Lukes Mid Amer Heart Inst, Kansas City, MO USA. [Spertus, John A.] Univ Missouri, Kansas City, MO 64110 USA. C3 Yale University; Yale University; Yale University; Yale University; University of Pennsylvania; Pennsylvania Medicine; Saint Luke's Mid America Heart Institute; University of Missouri System; University of Missouri Kansas City RP Lichtman, JH (通讯作者)，Yale Sch Publ Hlth, Dept Chron Dis Epidemiol, 60 Church St,POB 208034, New Haven, CT 06520 USA. EM Judith.Lichtman@yale.edu RI , Harlan/AAI-2875-2020; Spertus, John/ABD-3075-2021 FU National Heart, Lung, and Blood Institute [R01 HL081153] FX VIRGO was supported by grant R01 HL081153 from the National Heart, Lung, and Blood Institute. The funding organization 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. CR [Anonymous], 2016, LANCET, V387, P506, DOI 10.1016/S0140-6736(16)00267-1 Canto JG, 2012, JAMA-J AM MED ASSOC, V307, P813, DOI 10.1001/jama.2012.199 D'Onofrio G, 2015, CIRCULATION, V131, P1324, DOI 10.1161/CIRCULATIONAHA.114.012293 De Luca G, 2004, CIRCULATION, V109, P1223, DOI 10.1161/01.CIR.0000121424.76486.20 DeStefano F, 1993, Ann Epidemiol, V3, P27 DeVon HA, 2011, JOGNN-J OBST GYN NEO, V40, P372, DOI 10.1111/j.1552-6909.2011.01241.x Gupta A, 2014, J AM COLL CARDIOL, V64, P337, DOI 10.1016/j.jacc.2014.04.054 Harralson TL, 2007, HEART LUNG, V36, P96, DOI 10.1016/j.hrtlng.2006.08.002 Khan NA, 2013, JAMA INTERN MED, V173, P1863, DOI 10.1001/jamainternmed.2013.10149 Leifheit-Limson EC, 2015, J AM COLL CARDIOL, V66, P1949, DOI 10.1016/j.jacc.2015.08.859 Lichtman JH, 2015, CIRC-CARDIOVASC QUAL, V8, pS31, DOI 10.1161/CIRCOUTCOMES.114.001612 Lichtman JH, 2010, CIRC-CARDIOVASC QUAL, V3, P684, DOI 10.1161/CIRCOUTCOMES.109.928713 Luepker RV, 2000, JAMA-J AM MED ASSOC, V284, P60, DOI 10.1001/jama.284.1.60 McSweeney J C, 2001, J Cardiovasc Nurs, V15, P26 McSweeney JC, 1998, J WOMEN AGING, V10, P67, DOI 10.1300/J074v10n02_06 McSweeney JC, 2000, RES NURS HEALTH, V23, P135, DOI 10.1002/(SICI)1098-240X(200004)23:2<135::AID-NUR6>3.0.CO;2-1 McSweeney JC, 2003, CIRCULATION, V108, P2619, DOI 10.1161/01.CIR.0000097116.29625.7C McSweeney Jean C, 2005, Prog Cardiovasc Nurs, V20, P48, DOI 10.1111/j.0889-7204.2005.04447.x Milner KA, 2001, NURS RES, V50, P233, DOI 10.1097/00006199-200107000-00007 Milner KA, 1999, AM J CARDIOL, V84, P396, DOI 10.1016/S0002-9149(99)00322-7 Mochari-Greenberger H, 2012, J WOMENS HEALTH, V21, P476, DOI 10.1089/jwh.2011.3428 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 Nguyen HL, 2010, CIRC-CARDIOVASC QUAL, V3, P82, DOI 10.1161/CIRCOUTCOMES.109.884361 O'Keefe-McCarthy S, 2016, J CARDIOVASC NURS, V31, pE1, DOI 10.1097/JCN.0000000000000207 Ting HH, 2008, ARCH INTERN MED, V168, P959, DOI 10.1001/archinte.168.9.959 Vaccarino V, 1999, NEW ENGL J MED, V341, P217, DOI 10.1056/NEJM199907223410401 Vaccarino V, 2009, ARCH INTERN MED, V169, P1767, DOI 10.1001/archinternmed.2009.332 NR 28 TC 128 Z9 135 U1 0 U2 17 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 FEB 20 PY 2018 VL 137 IS 8 BP 781 EP 790 DI 10.1161/CIRCULATIONAHA.117.031650 PG 10 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA FW7TC UT WOS:000425526600007 PM 29459463 OA Bronze, Green Accepted DA 2023-05-13 ER PT J AU Bergrath, S Czaplik, M Rossaint, R Hirsch, F Beckers, SK Valentin, B Wielputz, D Schneiders, MT Brokmann, JC AF Bergrath, Sebastian Czaplik, Michael Rossaint, Rolf Hirsch, Frederik Beckers, Stefan Kurt Valentin, Bernd Wielpuetz, Daniel Schneiders, Marie-Therese Brokmann, Joerg Christian TI Implementation phase of a multicentre prehospital telemedicine system to support paramedics: feasibility and possible limitations SO SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE LA English DT Article DE Telemedicine; Teleconsultation; Telepresence; Emergency medical service; Analgesia ID ACUTE MYOCARDIAL-INFARCTION; EMERGENCY MEDICAL-SERVICE; CONTROLLED-TRIAL; STROKE; MORPHINE; TRAUMA; INTERVENTION; TRANSMISSION; CARDIOLOGIST; MANAGEMENT AB Background: Legal regulations often limit the medical care that paramedics can provide. Telemedical solutions could overcome these limitations by remotely providing expert support. Therefore, a mobile telemedicine system to support paramedics was developed. During the implementation phase of this system in four German emergency medical services (EMS), the feasibility and possible limitations of this system were evaluated. Methods: After obtaining ethical approval and providing a structured training program for all medical professionals, the system was implemented on three paramedic-staffed ambulances on August 1st, 2012. Two more ambulances were included subsequently during this month. The paramedics could initiate a consultation with EMS physicians at a teleconsultation centre. Telemedical functionalities included audio communication, real-time vital data transmission, 12-lead electrocardiogram, picture transmission on demand, and video streaming from a camera embedded into the ceiling of each ambulance. After each consultation, telephone-based debriefings were conducted. Data were retrieved from the documentation protocols of the teleconsultation centre and the EMS. Results: During a one month period, teleconsultations were conducted during 35 (11.8%)of 296 emergency missions with a mean duration of 24.9 min (SD 12.5). Trauma, acute coronary syndromes, and circulatory emergencies represented 20 (57%) of the consultation cases. Diagnostic support was provided in 34 (97%) cases, and the administration of 50 individual medications, including opioids, was delegated by the teleconsultation centre to the paramedics in 21 (60%) missions (range: 1-7 per mission). No medical complications or negative interpersonal effects were reported. All applications functioned as expected except in one case in which the connection failed due to the lack of a viable mobile network. Conclusion: The feasibility of the telemedical approach was demonstrated. Teleconsultation enabled early initiation of treatments by paramedics operating under the real-time medical direction. Teleconsultation can be used to provide advanced care until the patient is under a physician's care; moreover, it can be used to support the paramedics who work alone to provide treatment in non-life-threatening cases. Non-availability of mobile networks may be a relevant limitation. A larger prospective controlled trial is needed to evaluate the rate of complications and outcome effects. C1 [Bergrath, Sebastian; Czaplik, Michael; Rossaint, Rolf; Hirsch, Frederik; Beckers, Stefan Kurt; Valentin, Bernd; Wielpuetz, Daniel] Univ Hosp Aachen, Dept Anesthesiol, Aachen, Germany. [Bergrath, Sebastian; Beckers, Stefan Kurt] Fire Dept, Emergency Med Serv, Aachen, Germany. [Schneiders, Marie-Therese] Rhein Westfal TH Aachen, Inst Informat Management Mech Engn, Aachen, Germany. [Brokmann, Joerg Christian] Univ Hosp Aachen, Emergency Dept, Aachen, Germany. C3 RWTH Aachen University; RWTH Aachen University Hospital; RWTH Aachen University; RWTH Aachen University; RWTH Aachen University Hospital RP Bergrath, S (通讯作者)，Univ Hosp Aachen, Dept Anesthesiol, Aachen, Germany. EM sbergrath@ukaachen.de RI Hirsch, Frederik/O-6652-2019; Beckers, Stefan K/C-6776-2011; Beckers, Stefan K./O-2943-2019; Hirsch, Frederik/C-3501-2015; Bergrath, Sebastian/AAK-6999-2021; Czaplik, Michael/G-1120-2012 OI Hirsch, Frederik/0000-0002-5333-7497; Beckers, Stefan K/0000-0002-2896-7948; Beckers, Stefan K./0000-0002-2896-7948; Hirsch, Frederik/0000-0002-5333-7497; FU Philips Healthcare (Hamburg, Germany); P3 communications (Aachen, Germany); European Union; Ministry of Innovation, Science, and Research of North Rhine-Westphalia, Germany (MIWF) [PtJ-Az. 0909im002b, 005-1003-0034] FX The study was conducted within the joint research project "TemRas" funded by the European Union and the Ministry of Innovation, Science and Research of Northrhine Westphalia, Germany (MIWF), Project-No.: PtJ-Az. 0909im002b, Funding code 005-1003-0034. Philips Healthcare (Hamburg, Germany) and P3 communications (Aachen, Germany) contributed their own financial resources. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No author had financial relationships with or other non-financial dependencies on the funding sponsors.; The study was conducted as part of the joint research project "TemRas", which was funded by the European Union and the Ministry of Innovation, Science, and Research of North Rhine-Westphalia, Germany (MIWF), Project-No.: PtJ-Az. 0909im002b, Funding code 005-1003-0034. 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J. Trauma Resusc. Emerg. Med. PD JUL 11 PY 2013 VL 21 AR 54 DI 10.1186/1757-7241-21-54 PG 10 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 182KS UT WOS:000321741700001 PM 23844941 OA gold, Green Published DA 2023-05-13 ER PT J AU Jhand, A Atti, V Gwon, Y Dhawan, R Turagam, MK Mamas, MA Brilakis, ES Kumar, A Katta, N Chatzizisis, Y Parikh, M Abbott, JD Kirtane, AJ Bhatt, DL Velagapudi, P AF Jhand, Aravdeep Atti, Varunsiri Gwon, Yeongjin Dhawan, Rahul Turagam, Mohit K. Mamas, Mamas A. Brilakis, Emmanouil S. Kumar, Arnav Katta, Natraj Chatzizisis, Yiannis Parikh, Manish Abbott, J. Dawn Kirtane, Ajay J. Bhatt, Deepak L. Velagapudi, Poonam TI Meta-Analysis of Transradial vs Transfemoral Access for Percutaneous Coronary Intervention in Patients With ST Elevation Myocardial Infarction SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID FEMORAL ACCESS; RADIAL APPROACH; FEASIBILITY; ANGIOGRAPHY; ADOPTION; OUTCOMES; SAFETY; RISK; PCI AB Transradial access (TRA) has emerged as an alternative to transfemoral access (TFA) for percutaneous coronary intervention (PCI) in ST elevation myocardial infarction (STEMI) patients. However, the rate of TRA adoption has been much slower in the acute coronary syndrome (ACS) patient population. This meta-analysis was conducted to assess clinical outcomes of TRA compared with TFA in STEMI patients undergoing PCI. A manual search of PubMed, EMBASE, Cochrane library database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ClinicalTrials.gov, and recent major scientific conference sessions from inception to October 15th, 2019 was performed. Primary outcomes in our analysis were all-cause mortality and trial-defined major bleeding. Secondary outcomes included vascular complications, myocardial infarction, stroke, procedure, and fluoroscopy time. 17 randomized controlled trials (RCTs) (N = 12,018) met inclusion criteria. TRA was associated with lower all-cause mortality (risk ratio [RR]: 0.71, 95% confidence interval [CI]: 0.57 to 0.88), major bleeding (RR: 0.59, 95 % CI: 0.45 to 0.77), and vascular complications (RR: 0.42, 95% CI: 0.32 to 0.56) compared with TFA. There was no difference in the incidence of myocardial infarction (MI), stroke, or procedure duration between the 2 groups. The difference in all-cause mortality between TRA and TFA was statistically nonsignificant when major bleeding was held constant. In conclusion, TRA was associated with lower risk of all-cause mortality, major bleeding, and vascular complications compared with TFA in STEMI patients undergoing PCI. (C) 2020 Elsevier Inc. All rights reserved. C1 [Jhand, Aravdeep; Gwon, Yeongjin; Dhawan, Rahul; Katta, Natraj; Chatzizisis, Yiannis; Velagapudi, Poonam] Univ Nebraska Med Ctr, Omaha, NE 68198 USA. [Atti, Varunsiri] Michigan State Univ, Lansing, MI USA. [Turagam, Mohit K.] Icahn Sch Med Mt Sinai, New York, NY 10029 USA. [Mamas, Mamas A.] Keele Univ, Keele Cardiovasc Res Grp, Keele, Staffs, England. [Brilakis, Emmanouil S.] Minneapolis Heart Inst, Minneapolis, MN USA. [Kumar, Arnav] Emory Univ, Atlanta, GA 30322 USA. [Parikh, Manish] Weill Cornell Med, Brooklyn, NY USA. [Abbott, J. Dawn] Brown Univ, Providence, RI 02912 USA. [Kirtane, Ajay J.] Columbia Univ, Irving Med Ctr, New York Presbyterian Hosp, New York, NY USA. [Kirtane, Ajay J.] Columbia Univ, Cardiovasc Res Fdn, New York, NY USA. [Bhatt, Deepak L.] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA. C3 University of Nebraska System; University of Nebraska Medical Center; Michigan State University; Icahn School of Medicine at Mount Sinai; Keele University; Minneapolis Heart Institute Foundation; Emory University; Cornell University; Weill Cornell Medicine; Brown University; Columbia University; NewYork-Presbyterian Hospital; Cardiovascular Research Foundation (CRF); Columbia University; Harvard University; Brigham & Women's Hospital; Harvard Medical School RP Velagapudi, P (通讯作者)，Univ Nebraska Med Ctr, Omaha, NE 68198 USA. EM poonamchou@gmail.com RI Brilakis, Emmanouil/ABE-6947-2020; Mamas, Mamas Andreas/A-2549-2019; Abbott, J/AAU-4065-2021 OI Brilakis, Emmanouil/0000-0001-9416-9701; Mamas, Mamas Andreas/0000-0001-9241-8890; GWON, YEONGJIN/0000-0001-6974-337X CR Baklanov DV, 2013, J AM COLL CARDIOL, V61, P420, DOI 10.1016/j.jacc.2012.10.032 Bernat I, 2014, J AM COLL CARDIOL, V63, P964, DOI 10.1016/j.jacc.2013.08.1651 Brasselet C, 2007, HEART, V93, P1556, DOI 10.1136/hrt.2007.117309 Chodor P, 2009, CARDIOL J, V16, P332 Cooper CJ, 1999, AM HEART J, V138, P430, DOI 10.1016/S0002-8703(99)70143-2 Feldman DN, 2013, CIRCULATION, V127, P2295, DOI 10.1161/CIRCULATIONAHA.112.000536 Ferrante G, 2016, JACC-CARDIOVASC INTE, V9, P1419, DOI 10.1016/j.jcin.2016.04.014 Gan L., 2009, J NANJING MED U INTE, V23, P270 Giustino G, 2017, J AM COLL CARDIOL, V70, P1846, DOI 10.1016/j.jacc.2017.08.018 Hou L, 2010, SAUDI MED J, V31, P158 Howe MJ, 2015, CIRC-CARDIOVASC INTE, V8, DOI 10.1161/CIRCINTERVENTIONS.114.002036 Jolly SS, 2011, LANCET, V377, P1409, DOI 10.1016/S0140-6736(11)60404-2 LE M, 2020, JAMA CARDIOL, V5, P126 Levine GN, 2016, CATHETER CARDIO INTE, V87, P1001, DOI 10.1002/ccd.26325 Li WM, 2007, CHINESE MED J-PEKING, V120, P598, DOI 10.1097/00029330-200704010-00014 Rao SV, 2014, CATHETER CARDIO INTE, V83, P228, DOI 10.1002/ccd.25209 Rao SV, 2013, JACC-CARDIOVASC INTE, V6, P897, DOI 10.1016/j.jcin.2013.04.016 Romagnoli E, 2012, J AM COLL CARDIOL, V60, P2481, DOI 10.1016/j.jacc.2012.06.017 Saito S, 2003, CATHETER CARDIO INTE, V59, P26, DOI 10.1002/ccd.10493 Sciahbasi A, 2011, AM J CARDIOL, V108, P185, DOI 10.1016/j.amjcard.2011.03.022 Singh S, 2016, CAN J CARDIOL, V32, P777, DOI 10.1016/j.cjca.2015.08.019 Valle JA, 2017, JACC-CARDIOVASC INTE, V10, P2242, DOI 10.1016/j.jcin.2017.07.020 Vazquez-Rodriguez JM, 2009, THESIS U CORUNA CORU Vranckx P, 2017, EUR HEART J, V38, P1069, DOI 10.1093/eurheartj/ehx048 Wang YB, 2012, J INVASIVE CARDIOL, V24, P412 Yan ZX, 2008, CHINESE MED J-PEKING, V121, P782, DOI 10.1097/00029330-200805010-00004 2009, BMJ-BRIT MED J, V151, P264 NR 27 TC 10 Z9 10 U1 1 U2 7 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 15 PY 2021 VL 141 BP 23 EP 30 DI 10.1016/j.amjcard.2020.11.016 EA JAN 2021 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA QL0PZ UT WOS:000620784200004 PM 33220324 DA 2023-05-13 ER PT J AU Alkhalil, M Biasiolli, L Akbar, N Galassi, F Chai, JT Robson, MD Choudhury, RP AF Alkhalil, Mohammad Biasiolli, Luca Akbar, Naveed Galassi, Francesca Chai, Joshua T. Robson, Matthew D. Choudhury, Robin P. TI T2 mapping MRI technique quantifies carotid plaque lipid, and its depletion after statin initiation, following acute myocardial infarction SO ATHEROSCLEROSIS LA English DT Article DE Carotid plaque; Atherosclerosis; Lipid; Statin; T2 mapping; Biomarkers ID CHOLESTEROL EFFLUX CAPACITY; ATHEROSCLEROTIC LESIONS; HDL CHOLESTEROL; THERAPY; RISK AB Background & aims: A recently-validated, highly-sensitive T2 mapping magnetic resonance (MRI) technique accurately quantifies carotid plaque lipid. The aims of this study were to determine: (i) the extent of carotid plaque lipid in patients with acute coronary syndromes (ACS); (ii) the effects of initiation of high-intensity statin on plaque lipid content and (iii) whether plaque lipid content is related to standard or 'functional' blood lipid measurements. Methods: Statin naive subjects presenting with ACS underwent carotid artery MRI at 3 T scanner to quantify plaque lipid. Patients were subsequently commenced on high dose statin as part of clinical care and underwent a second MRI after three months. Plaque composition was measured using objective semi-automated techniques. Results: 23 out of 24 patients had measurable lipid. Three months after statin initiation there was a significant reduction in carotid lipid percentage [from 10.3% (7.2-14.2) to 7.4% (5.4-10.0), p=0.002] and a significant increase in fibrous percentage [from 83.3% +/- 6.6-85.5% +/- 4.8, p=0.039]. None of the studied functional blood biomarkers were related to either baseline carotid plaque lipid content or its propensity to change with statin treatment. Conclusions: T2-mapping demonstrated depleted carotid plaque lipid following the initiation of high-intensity statin treatment. Standard or 'functional' blood biomarkers were dissociated from plaque lipid content or changes with treatment. These findings further reinforce the importance of disease characterisation over risk factor assessment. Subject to clinical trial findings, quantification of plaque lipid may provide the basis for an approach to identify patients suitable for intensive lipid reduction regimes. C1 [Alkhalil, Mohammad; Biasiolli, Luca; Galassi, Francesca; Chai, Joshua T.; Robson, Matthew D.; Choudhury, Robin P.] Univ Oxford, Radcliffe Dept Med, Acute Vasc Imaging Ctr, Oxford, England. [Alkhalil, Mohammad; Akbar, Naveed; Choudhury, Robin P.] Univ Oxford, Radcliffe Dept Med, Div Cardiovasc Med, Oxford, England. C3 RLUK- Research Libraries UK; University of Oxford; RLUK- Research Libraries UK; University of Oxford RP Choudhury, RP (通讯作者)，Univ Oxford, John Radcliffe Hosp, Radcliffe Dept Med, Div Cardiovasc Med, Oxford OX3 9DU, England. EM robin.choudhury@cardiov.ox.ac.uk RI ALKHALIL, MOHAMMAD/AAK-3456-2020 OI ALKHALIL, MOHAMMAD/0000-0002-3088-8878; Biasiolli, Luca/0000-0002-0452-8756; Akbar, Naveed/0000-0003-4620-6373 FU Oxford NIHR Biomedical Research Centre; British Heart Foundation Centre of Research Excellence, Oxford FX The authors recognize the support of the Oxford NIHR Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Oxford. 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Despite many overwhelming meta-analysis related to cardiac complications following COVID-19 disease, no umbrella meta-analysis study has been conducted. Objectives: We aimed to report the summarized pooled incidences of cardiac complications in the overall, critically ill, and deceased patients, compare the cardiac complications between the severe/non-severe or deceased/non-deceased patients, and also compare poor outcomes between patients with without acute myocardial injury (AMI). Methods: PubMed, Scopus, web of science, Cochrane, ProQuest, Springer, Sage journals were searched before April 2021. After assessing the quality and duplicate data, data were run by the random/fixed-effect models, 12 heterogeneity index, Egger's test, and sensitivity analysis. Results: After removing duplicate data, in the overall COVID-19 patients, the pooled incidence of AMI, heart failure, arrhythmia, cardiac arrest, and acute coronary syndrome (ACS) were 21%, 14%, 16%, 3.46%, and 1.3%, respectively. In the patients with severe disease, the pooled incidence of AMI and shock were 33 and 35%, respectively. Similarly, in the deceased COVID-19 patients, the pooled incidence rate of AMI and arrhythmia were 56% and 47.5%, respectively. The patients with severe disease were at higher risk of AMI (RR = 5.27) and shock (OR = 20.18) compared with the non-severe cases. Incidence of AMI was associated with transfer to the intensive care units (ICU) (RR = 2.92) and mortality (RR = 2.57, OR = 8.36), significantly. Conclusion: Cardiac complications were found to be increased alarmingly in COVID-19 patients. Baseline and during hospitalization checking with electrocardiography, echocardiography, and measuring of cardiac biomarkers should be applied. (C) 2022 Elsevier Inc. All rights reserved. C1 [Jafari-Oori, Mehdi; Moradian, Seyed Tayeb] Baqiyatallah Univ Med Sci, Fac Nursing, Atherosclerosis Res Ctr, Nursing, Tehran, Iran. [Ebadi, Abbas] Baqiyatallah Univ Med Sci, Fac Nursing, Behav Sci Res Ctr, Life Style Inst,Nursing, Tehran, Iran. [Jafari, Mojtaba] Bam Univ Med Sci, Fac Nursing, Nursing, Bam, Iran. [Dehi, Manijeh] Maragheh Univ Med Sci, Dept Nursing, Nursing, Maragheh, Iran. C3 Baqiyatallah University of Medical Sciences (BMSU); Baqiyatallah University of Medical Sciences (BMSU) RP Dehi, M (通讯作者)，Maragheh Univ Med Sci, Dept Nursing, Nursing, Maragheh, Iran. EM manigehdehister@gmail.com RI Ebadi, Abbas/S-3847-2018; Dehi, Manijeh/W-1577-2017 OI Ebadi, Abbas/0000-0002-2911-7005; Dehi, Manijeh/0000-0002-5095-6882; Jafari, Mojtaba/0000-0003-0230-289X FU Baqiyatallah University of Medical Sciences (BUMS) FX This work was supported by Baqiyatallah University of Medical Sciences (BUMS). 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MED, V21, P759, DOI 10.2459/JCM.0000000000001064 NR 68 TC 6 Z9 6 U1 0 U2 2 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0147-9563 EI 1527-3288 J9 HEART LUNG JI Heart Lung PD MAR-APR PY 2022 VL 52 BP 136 EP 145 DI 10.1016/j.hrtlng.2022.01.001 EA JAN 2022 PG 10 WC Cardiac & Cardiovascular Systems; Nursing; Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Nursing; Respiratory System GA ZP8AA UT WOS:000766639700013 PM 35074740 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Wallmann, R Llorca, J Gomez-Acebo, I Ortega, AC Roldan, FR Dierssen-Sotos, T AF Wallmann, Reinhard Llorca, Javier Gomez-Acebo, Ines Castellanos Ortega, Alvaro Rojo Roldan, Fernando Dierssen-Sotos, Trinidad TI Prediction of 30-day cardiac-related-emergency-readmissions using simple administrative hospital data SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Cardiac hospitalizations; Readmissions; Cohort; Risk model; Screening ID HEART-FAILURE; FOLLOW-UP; STATISTICAL-MODELS; PATIENT PREDICTORS; RISK; ADMISSIONS; ICD-9-CM; OUTCOMES; PEOPLE; IMPACT AB Background: Control and reduction of cardiovascular-disease-related readmissions is clinically, logistically and politically challenging. Recent strategies focus on 30-day readmissions. A screening tool for the detection of potential cases is necessary to make further case management more efficient. Methods: Cohort study. Hospital administrative data were analyzed in order to obtain information about cardiac-related hospitalizations from 2003 to 2009 at a Spanish academic tertiary care center. Predictor-variables of admissions that presented or did not present 30-day cardiac-related readmission were compared. A prediction model was constructed and tested on a validation sample. Model performance was assessed for all cardiac diseases and for 24 main-cardiac-disease-sets. Results: The study sample was 35531 hospital-admissions. The model included 11 predictors: number of previous emergency admission in 180 days, residence out of area, no procedure applied during hospitalization, major or minor therapeutic procedure applied during hospitalization, anemia, hypertensive disease, acute coronary syndrome, congestive heart failure, diabetes and renal disease. The performance indicators applied on all cardiac diseases were: C-statistic = 0.75, Sensitivity = 0.66, Specificity = 0.70, Positive predictive value = 0.10, Negative predictive value = 0.98, Positive likelihood ratio = 2.21 and Negative likelihood ratio = 0.48. Diseases for discriminative prediction are: stenting, circulatory disorders, acute myocardial infarction and defibrillator and pacemaker implantation. Conclusions: This study provides a prediction model for 30-day cardiac-related diseases based on available administrative data ready to be integrated as a screening tool. 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J. Cardiol. PD APR 5 PY 2013 VL 164 IS 2 BP 193 EP 200 DI 10.1016/j.ijcard.2011.06.119 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 112NO UT WOS:000316599200013 PM 21775001 DA 2023-05-13 ER PT J AU Hemingway, H Asselbergs, FW Danesh, J Dobson, R Maniadakis, N Maggioni, A van Thiel, GJM Cronin, M Brobert, G Vardas, P Anker, SD Grobbee, DE Denaxas, S AF Hemingway, Harry Asselbergs, Folkert W. Danesh, John Dobson, Richard Maniadakis, Nikolaos Maggioni, Aldo van Thiel, Ghislaine J. M. Cronin, Maureen Brobert, Gunnar Vardas, Panos Anker, Stefan D. Grobbee, Diederick E. Denaxas, Spiros CA BigData Heart Consortium Acad Ind TI Big data from electronic health records for early and late translational cardiovascular research: challenges and potential SO EUROPEAN HEART JOURNAL LA English DT Review DE Electronic health records; Heattll informatics; Bio-informatics; e-Health; Precision medicine; Translational research ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; HEART-FAILURE; ST-ELEVATION; THROMBUS ASPIRATION; CARDIAC CONDUCTION; ANGINA-PECTORIS; CLINICAL-TRIALS; LIFETIME RISKS; MINI-SENTINEL AB Aims Cohorts of millions of people's health records, whole genome sequencing, imaging, sensor, societal and publicly available data present a rapidly expanding digital trace of health. We aimed to critically review, for the first time, the challenges and potential of big data across early and late stages of translational cardiovascular disease research. Methods and results We sought exemplars based on literature reviews and expertise across the BigData@Heart Consortium. We identified formidable challenges including: data quality, knowing what data exist, the legal and ethical framework for their use, data sharing, building and maintaining public trust, developing standards for defining disease, developing tools for scalable, replicable science and equipping the clinical and scientific work force with new inter-disciplinary skills. Opportunities claimed for big health record data include: richer profiles of health and disease from birth to death and from the molecular to the societal scale; accelerated understanding of disease causation and progression, discovery of new mechanisms and treatment-relevant disease sub-phenotypes, understanding health and diseases in whole populations and whole health systems and returning actionable feedback loops to improve (and potentially disrupt) existing models of research and care, with greater efficiency. In early translational research we identified exemplars including: discovery of fundamental biological processes e.g. linking exome sequences to lifelong electronic health records (EHR) (e.g. human knockout experiments); drug development: genomic approaches to drug target validation; precision medicine: e.g. DNA integrated into hospital EHR for pre-emptive pharmacogenomics. In late translational research we identified exemplars including: learning health systems with outcome trials integrated into clinical care; citizen driven health with 24/7 multi-parameter patient monitoring to improve outcomes and population-based linkages of multiple EHR sources for higher resolution clinical epidemiology and public health. Conclusion High volumes of inherently diverse ('big') EHR data are beginning to disrupt the nature of cardiovascular research and care. Such big data have the potential to improve our understanding of disease causation and classification relevant for early translation and to contribute actionable analytics to improve health and healthcare. C1 [Hemingway, Harry; Asselbergs, Folkert W.; Dobson, Richard; Denaxas, Spiros] UCL, Farr Inst Hlth Informat Res, Res Dept Clin Epidemiol, 222 Euston Rd, London NW1 2DA, England. [Hemingway, Harry; Asselbergs, Folkert W.; Dobson, Richard; Denaxas, Spiros] Univ Coll London Hosp NHS Fdn Trust, Univ Coll London, Natl Inst Hlth Res Biomed Res Ctr, 222 Euston Rd, London NW1 2DA, England. [Asselbergs, Folkert W.; van Thiel, Ghislaine J. M.] Univ Med Ctr Utrecht, Dept Cardiol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands. [Danesh, John] Univ Cambridge, Dept Publ Hlth & Primary Care, MRC BHF Cardiovasc Epidemiol Unit, Worts Causeway, Cambridge CB1 8RN, England. [Dobson, Richard] Kings Coll London, NIHR Biomed Res Ctr Mental Hlth IOP, De Crespigny Pk, London SE5 8AF, England. [Maniadakis, Nikolaos; Maggioni, Aldo; Vardas, Panos] ESC, 2035 Route Colles,Templiers CS 80179 Biot, F-06903 Sophia Antipolis, France. [Cronin, Maureen] Vifor Pharma Ltd, Lughofstr 61, CH-8152 Zurich, Switzerland. [Brobert, Gunnar] Bayer Pharma AG, Dept Epidemiol, Mullerstr 178, D-13353 Berlin, Germany. [Anker, Stefan D.] Charite, Berlin Brandenburg Ctr Regenerat Therapies BCRT, Div Cardiol & Metab Heart Failure Cachexia & Sarc, Charitepl 1, D-10117 Berlin, Germany. [Anker, Stefan D.] Charite, Berlin Brandenburg Ctr Regenerat Therapies BCRT, Dept Cardiol CVK, Charitepl 1, D-10117 Berlin, Germany. [Anker, Stefan D.] UMG, Dept Cardiol & Pneumol, Robert Koch Str 40, D-37099 Gottingen, Germany. [Grobbee, Diederick E.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands. C3 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; Utrecht University; Utrecht University Medical Center; RLUK- Research Libraries UK; University of Cambridge; RLUK- Research Libraries UK; University of London; King's College London; Vifor Pharma; Bayer AG; Bayer Healthcare Pharmaceuticals; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Utrecht University; Utrecht University Medical Center RP Hemingway, H (通讯作者)，UCL, Farr Inst Hlth Informat Res, Res Dept Clin Epidemiol, 222 Euston Rd, London NW1 2DA, England.; Hemingway, H (通讯作者)，Univ Coll London Hosp NHS Fdn Trust, Univ Coll London, Natl Inst Hlth Res Biomed Res Ctr, 222 Euston Rd, London NW1 2DA, England. EM h.hemingway@ucl.ac.uk RI Cronin, Maureen/ABC-4218-2021; Vardas, Panos/AAP-5694-2021; Maggioni, Aldo Pietro/AAL-5334-2020; Vardas, Panos/AAD-5219-2022; Asselbergs, Folkert W./ABD-6752-2021; Van Thiel, Ghislaine/R-8977-2019; vardas, panos/ABF-7144-2020; Kotecha, Dipak/Q-2827-2016; Hemingway, Harry/C-1219-2009; dobson, richard/C-9269-2011 OI Maggioni, Aldo Pietro/0000-0003-2764-6779; Asselbergs, Folkert W./0000-0002-1692-8669; Kotecha, Dipak/0000-0002-2570-9812; Hemingway, Harry/0000-0003-2279-0624; Denaxas, Spiros/0000-0001-9612-7791; van Thiel, Ghislaine/0000-0003-1799-1894; dobson, richard/0000-0003-4224-9245 FU Medical Research Council; Arthritis Research UK; British Heart Foundation; Cancer Research UK; Chief Scientist Office; Economic and Social Research Council; Engineering and Physical Sciences Research Council; NIHR; National Institute for Social Care and Health Research; Wellcome Trust [MR/006584/1]; Innovative Medicines Initiative-2 Joint Undertaking [116074]; European Union's Horizon 2020 research and innovation programme; EFPIA; MRC [MR/L003120/1] Funding Source: UKRI; British Heart Foundation [RG/08/014/24067] Funding Source: researchfish; Medical Research Council [MR/L003120/1, HDR-9004, HDR-9003, HDR-9001, 1135013, HDR-2006, HDR-9006, MR/K006584/1] Funding Source: researchfish; National Institute for Health Research [CL-2010-09-002, CL-2014-18-007, CDF-2015-08-074, NF-SI-0512-10165] Funding Source: researchfish FX The Farr Institute is funded from the Medical Research Council, Arthritis Research UK, British Heart Foundation, Cancer Research UK, Chief Scientist Office, Economic and Social Research Council, Engineering and Physical Sciences Research Council, NIHR, National Institute for Social Care and Health Research, and Wellcome Trust (grant MR/006584/1). The BigData@Heart Consortium is funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement No. 116074. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA; it is chaired, by DE Grobbee and SD Anker, partnering with 20 academic and industry partners and ESC. 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Heart J. PD APR 21 PY 2018 VL 39 IS 16 BP 1481 EP + DI 10.1093/eurheartj/ehx487 PG 19 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA GD7XB UT WOS:000430725600023 PM 29370377 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Davidson, JA Banerjee, A Muzambi, R Smeeth, L Warren-Gash, C AF Davidson, Jennifer Anne Banerjee, Amitava Muzambi, Rutendo Smeeth, Liam Warren-Gash, Charlotte TI Validity of acute cardiovascular outcome diagnoses in European electronic health records: a systematic review protocol SO BMJ OPEN LA English DT Review ID HOSPITAL DISCHARGE; QUALITY; STROKE; COST AB Introduction Cardiovascular diseases (CVDs) are among the leading causes of death globally. Electronic health records (EHRs) provide a rich data source for research on CVD risk factors, treatments and outcomes. Researchers must be confident in the validity of diagnoses in EHRs, particularly when diagnosis definitions and use of EHRs change over time. Our systematic review provides an up-to-date appraisal of the validity of stroke, acute coronary syndrome (ACS) and heart failure (HF) diagnoses in European primary and secondary care EHRs. Methods and analysis We will systematically review the published and grey literature to identify studies validating diagnoses of stroke, ACS and HF in European EHRs. MEDLINE, EMBASE, SCOPUS, Web of Science, Cochrane Library, OpenGrey and EThOS will be searched from the dates of inception to April 2019. A prespecified search strategy of subject headings and free-text terms in the title and abstract will be used. Two reviewers will independently screen titles and abstracts to identify eligible studies, followed by full-text review. We require studies to compare clinical codes with a suitable reference standard. Additionally, at least one validation measure (sensitivity, specificity, positive predictive value or negative predictive value) or raw data, for the calculation of a validation measure, is necessary. We will then extract data from the eligible studies using standardised tables and assess risk of bias in individual studies using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data will be synthesised into a narrative format and heterogeneity assessed. Meta-analysis will be considered when a sufficient number of homogeneous studies are available. The overall quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation tool. C1 [Davidson, Jennifer Anne; Muzambi, Rutendo; Smeeth, Liam; Warren-Gash, Charlotte] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, London, England. [Banerjee, Amitava] UCL, Farr Inst Hlth Informat Res, London, England. C3 University of London; London School of Hygiene & Tropical Medicine; RLUK- Research Libraries UK; University of London; University College London RP Davidson, JA (通讯作者)，London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, London, England. EM jennifer.davidson@lshtm.ac.uk RI ; Banerjee, Amitava/D-4381-2014; Smeeth, Liam/X-5862-2018 OI Davidson, Jennifer/0000-0003-1599-7504; Banerjee, Amitava/0000-0001-8741-3411; Warren-Gash, Charlotte/0000-0003-4524-3180; Smeeth, Liam/0000-0002-9168-6022; Muzambi, Rutendo/0000-0003-0732-131X FU British Heart Foundation PhD Studentship [FS/18/71/33938] FX JAD was supported by a British Heart Foundation PhD Studentship (FS/18/71/33938). 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Mattson, Alicia E. Brown, Caitlin S. Cabrera, Daniel Mara, Kristin C. Bellolio, M. Fernanda TI Safety of parenteral ketorolac use for analgesia in geriatric emergency department patients SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Ketorolac; Analgesia; Geriatrics; Emergency service, hospital; Patient safety; Drug-related side effects and adverse reactions ID ANTIINFLAMMATORY DRUG-USE; OLDER-ADULTS; PAIN CARE; MEDICATION; RISK AB Objective: To assess the safety of a single dose of parenteral ketorolac for analgesia management in geriatric emergency department (ED) patients. Methods: This was a retrospective study of all administrations of parenteral ketorolac to adults >= 65 years of age and matched controls. The primary outcome was the occurrence of any of the following adverse events within 30 days of the ED visit: gastrointestinal bleeding, intracranial bleeding, acute decompensated heart failure, acute coronary syndrome, dialysis, transfusion, and death. The secondary outcome was the occurrence of an increase in serum creatinine of >= 1.5 times baseline within 7 and 30 days of the ED visit. Results: There were 480 patients included in the final analysis, of which 120 received ketorolac (3: 1 matching). The primary outcome occurred in 14 of 360 patients who did not receive ketorolac and 2 of 120 ketorolac patients (3.9% vs 1.7%, p=0.38; OR 2.39, 95% CI 0.54-10.66). There was no occurrence of dialysis or death in either group. The secondary outcome occurred in 1 of 13 and 1 of 23 ketorolac patients with both a baseline serum creatinine and a measure within 7 and 30 days, respectively, but did not occur in patients who did not receive ketorolac (7 days: 7.7% vs 0.0%, p = 0.29; 30 days: 4.4% vs 0.0%, p=0.22). Conclusion: The use of single doses of parenteral ketorolac for analgesia management was not associated with an increased incidence of adverse cardiovascular, gastrointestinal, or renal adverse outcomes in a select group of older adults. (c) 2019 Elsevier Inc. All rights reserved. C1 [Anderson, Gabrielle L.; Mattson, Alicia E.; Brown, Caitlin S.] Mayo Clin, Dept Pharm, 200 First St SW, Rochester, MN 55905 USA. [Cabrera, Daniel; Bellolio, M. Fernanda] Mayo Clin, Dept Emergency Med, 200 First St SW, Rochester, MN 55905 USA. [Mara, Kristin C.] Mayo Clin, Div Biomed Stat & Informat, 200 First St SW, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic RP Mattson, AE (通讯作者)，Mayo Clin, 200 First St SW, Rochester, MN 55905 USA. EM mattson.alicia@mayo.edu OI Cabrera, Daniel/0000-0002-5891-0459; Bellolio, Fernanda/0000-0002-1632-4750; Mara, Kristin/0000-0002-8783-0191 FU Mayo Clinic Department of Pharmacy FX This work was funded in part by a grant from the Mayo Clinic Department of Pharmacy. CR Bosley BN, 2004, J AM GERIATR SOC, V52, P247, DOI 10.1111/j.1532-5415.2004.52063.x Cordell WH, 2002, AM J EMERG MED, V20, P165, DOI 10.1053/ajem.2002.32643 Eckardt KU, 2012, KIDNEY INT SUPPL, V2, P7, DOI 10.1038/kisup.2012.8 Feldman HI, 1997, ANN INTERN MED, V126, P193, DOI 10.7326/0003-4819-126-3-199702010-00003 Ferrell B, 2002, J AM GERIATR SOC, V50, pS205, DOI 10.1046/j.1532-5415.50.6s.1.x GRIFFIN MR, 1991, ANN INTERN MED, V114, P257, DOI 10.7326/0003-4819-114-4-257 GURWITZ JH, 1990, J AM GERIATR SOC, V38, P542, DOI 10.1111/j.1532-5415.1990.tb02406.x Hwang U, 2014, PAIN, V155, P2568, DOI 10.1016/j.pain.2014.09.017 Hwang U, 2010, J AM GERIATR SOC, V58, P2122, DOI 10.1111/j.1532-5415.2010.03152.x Ickowicz E, 2009, PAIN MED, V10, P1062, DOI 10.1111/j.1526-4637.2009.00699.x Kim M, 2017, DRUG HEALTHC PATIENT, V9, P105, DOI 10.2147/DHPS.S143341 Mamdani M, 2004, LANCET, V363, P1751, DOI 10.1016/S0140-6736(04)16299-5 Marcum Zachary A, 2010, Ann Longterm Care, V18, P24 Motov S, 2017, ANN EMERG MED, V70, P177, DOI 10.1016/j.annemergmed.2016.10.014 Pilotto A, 2010, SURG ONCOL, V19, P167, DOI 10.1016/j.suronc.2009.11.014 Platts-Mills TF, 2012, ANN EMERG MED, V60, P199, DOI 10.1016/j.annemergmed.2011.09.014 Radcliff S, 2015, J AM GERIATR SOC, V63, P2227, DOI 10.1111/jgs.13702 Solomon DH, 2010, ARCH INTERN MED, V170, P1968, DOI 10.1001/archinternmed.2010.391 Strom BL, 1996, JAMA-J AM MED ASSOC, V275, P376, DOI 10.1001/jama.275.5.376 Todd KH, 2007, J PAIN, V8, P460, DOI 10.1016/j.jpain.2006.12.005 NR 20 TC 6 Z9 6 U1 0 U2 1 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 APR PY 2020 VL 38 IS 4 BP 727 EP 730 DI 10.1016/j.ajem.2019.06.009 PG 4 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Emergency Medicine GA MI4KE UT WOS:000547378200006 PM 31201117 DA 2023-05-13 ER PT J AU Arnold, SV Kosiborod, M Tang, FM Zhao, ZX McCollam, PL Birt, J Spertus, JA AF Arnold, Suzanne V. Kosiborod, Mikhail Tang, Fengming Zhao, Zhenxiang McCollam, Patrick L. Birt, Julie Spertus, John A. TI Changes in Low-Density Lipoprotein Cholesterol Levels After Discharge for Acute Myocardial Infarction in a Real-World Patient Population SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE cholesterol; cholesterol-lowering drugs; myocardial infarction; statins ID ACUTE CORONARY SYNDROME; REGISTRY; PRAVASTATIN; STATINS; TRIAL AB Aggressively managing low-density lipoprotein cholesterol (LDL-C) after myocardial infarction (MI) is a cornerstone of secondary prevention. The changes in LDL-C after MI and the factors associated with LDL-C levels are unknown. Therefore, we directly measured fasting LDL-C levels in 797 MI patients from 24 US hospitals from 2005 to 2008. Mean LDL-C levels at discharge, 1 month, and 6 months were 95.1, 81.9, and 87.1 mg/dL, respectively. In a hierarchical, multivariable, repeated measures model, older age, male sex, and hypertension were associated with lower LDL-C levels, whereas self-reported avoidance of health care because of cost was associated with higher LDL-C. Both the presence and intensity of statin therapy at discharge were strongly associated with LDL-C levels, with adjusted mean 6-month changes of -3.4 mg/dL (95% confidence interval (CI): -12.1, 5.3) for no statins; 1.7 mg/dL (95% CI: -4.7, 8.1) for low statins; -10.2 mg/dL (95% CI: -14.5, -6.0) for moderate statins; and -13.9 mg/dL (95% CI: -19.7, -8.0) for intensive statins (P < 0.001). In conclusion, we found that greater reductions in LDL-C levels after MI were strongly associated with the presence and intensity of statin therapy, older age, male sex, hypertension, and better socioeconomic status. These findings support the use of intensive statin therapy in post-MI patients and provide estimates of the expected LDL-C changes after MI in a real-world population. C1 [Arnold, Suzanne V.; Kosiborod, Mikhail; Tang, Fengming; Spertus, John A.] St Lukes Mid Amer Heart Inst, Dept Cardiovasc Res, Kansas City, MO 64111 USA. [Arnold, Suzanne V.; Kosiborod, Mikhail; Spertus, John A.] Univ Missouri, Dept Med, Kansas City, MO 64110 USA. [Zhao, Zhenxiang; McCollam, Patrick L.; Birt, Julie] Eli Lilly & Co, Indianapolis, IN 46285 USA. C3 Saint Luke's Mid America Heart Institute; University of Missouri System; University of Missouri Kansas City; Eli Lilly 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 Spertus, John/ABD-3075-2021; Kosiborod, Mikhail/HDO-1541-2022 OI Kosiborod, Mikhail/0000-0002-3750-9789 FU National Institutes of Health (National Heart, Lung, Blood Institute) (Washington University School of Medicine Specialized Centers of Clinically Oriented Research grant) [P50HL 077113-01]; Eli Lilly and Company, Indianapolis, Indiana; Eli Lilly and Company FX The TRIUMPH study was sponsored by the National Institutes of Health (National Heart, Lung, Blood Institute) (Washington University School of Medicine Specialized Centers of Clinically Oriented Research grant P50HL 077113-01).; The funding organization for the overall study did not play a role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript. The analyses for this study were sponsored by Eli Lilly and Company, Indianapolis, Indiana.; Conflict of interest: Drs. Zhenxiang Zhao, Patrick L. McCollam, and Julie Birt are employees of Eli Lilly and Company. Drs. Suzanne V. Arnold and John A. Spertus received research grant support from Eli Lilly and Company. 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J. Epidemiol. PD JUN 1 PY 2014 VL 179 IS 11 BP 1293 EP 1300 DI 10.1093/aje/kwu060 PG 8 WC Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED) SC Public, Environmental & Occupational Health GA AI6ZI UT WOS:000337027400004 PM 24743066 OA Green Submitted, hybrid, Green Published DA 2023-05-13 ER PT J AU Pechlivani, N Ajjan, RA AF Pechlivani, Nikoletta Ajjan, Ramzi A. TI Thrombosis and Vascular Inflammation in Diabetes: Mechanisms and Potential Therapeutic Targets SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Review DE atherosclerosis; diabetes mellitus; thrombosis; endothelial dysfunction; vascular inflammation ID ACUTE CORONARY SYNDROMES; ACUTE MYOCARDIAL-INFARCTION; SOLUBLE GUANYLATE-CYCLASE; COA REDUCTASE INHIBITORS; BETA-CELL FAILURE; LOW-DOSE ASPIRIN; ENDOTHELIAL DYSFUNCTION; CARDIOVASCULAR EVENTS; ANTIPLATELET THERAPY; PLATELET INHIBITION AB Cardiovascular disease remains the main cause of morbidity and mortality in patients with diabetes. The risk of vascular ischemia is increased in this population and outcome following an event is inferior compared to individuals with normal glucose metabolism. The reasons for the adverse vascular profile in diabetes are related to a combination of more extensive atherosclerotic disease coupled with an enhanced thrombotic environment. Long-term measures to halt the accelerated atherosclerotic process in diabetes have only partially addressed vascular pathology, while long-term antithrombotic management remains largely similar to individuals without diabetes. We address in this review the pathophysiological mechanisms responsible for atherosclerosis with special emphasis on diabetes-related pathways. We also cover the enhanced thrombotic milieu, characterized by increased platelet activation, raised activity of procoagulant proteins together with compromised function of the fibrinolytic system. Potential new therapeutic targets to reduce the risk of atherothrombosis in diabetes are explored, including alternative use of existing therapies. Special emphasis is placed on diabetes-specific therapeutic targets that have the potential to reduce vascular risk while keeping an acceptable clinical side effect profile. It is now generally acknowledged that diabetes is not a single clinical entity but a continuum of various stages of the condition with each having a different vascular risk. Therefore, we propose that future therapies aiming to reduce vascular risk in diabetes require a stratified approach with each group having a "stage-specific" vascular management strategy. This "individualized care" in diabetes may prove to be essential to improve vascular outcome in this high risk population. C1 [Pechlivani, Nikoletta; Ajjan, Ramzi A.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Sch Med, Leeds, W Yorkshire, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds RP Ajjan, RA (通讯作者)，Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Sch Med, Leeds, W Yorkshire, England. 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Cardiovasc. Med. PD JAN 19 PY 2018 VL 5 AR 1 DI 10.3389/fcvm.2018.00001 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FX5OY UT WOS:000426130700001 PM 29404341 OA Green Published, gold DA 2023-05-13 ER PT J AU Sundquist, K Chang, BP Parsons, F Dalrymple, N Edmondson, D Sumner, JA AF Sundquist, Kevin Chang, Bernard P. Parsons, Faith Dalrymple, Nathan Edmondson, Donald Sumner, Jennifer A. TI Treatment rates for PTSD and depression in recently hospitalized cardiac patients SO JOURNAL OF PSYCHOSOMATIC RESEARCH LA English DT Article DE Depression; Cardiac patients; Posttraumatic stress disorder; Treatment receipt ID POSTTRAUMATIC-STRESS-DISORDER; MYOCARDIAL-INFARCTION; EVENTS AB Objective: Posttraumatic stress disorder (PTSD) and depression are common after evaluation for suspected acute coronary syndrome (ACS), and are associated with poor prognosis. However, it is unclear whether patients discharged after suspected ACS access treatments for subsequent psychological distress. We examined self-reported rates of receiving psychotherapy and/or medication for psychological distress in patients one month after a suspected ACS event. Methods: A sample of 448 adults (age 60.4 +/- 12.5; 47.8% female; 52.7% Hispanic, 32.1% Black) presenting to the emergency department with suspected ACS were recruited for the REactions to Acute Care and Hospitalization (REACH) study, an ongoing cohort study of medical and psychological outcomes after ACS evaluation. Socio-demographics and depressive symptoms were assessed in-hospital, and PTSD symptoms related to the suspected ACS event were queried via phone one month after enrollment. Participants also indicated whether they received either medication or counseling to deal with their emotions and coping after their heart problem. Results: Approximately 15% (n = 68) of the sample reported receiving some form of treatment. Treatment rate did not differ significantly as a function of demographics, ACS status, or insurance coverage, ps > 0.1. Over a quarter of participants (25.3%) who screened positive for PTSD and/or depression reported receiving treatment. Participants with PTSD and depression had a higher treatment rate (47.6%) vs. those with only depression (12.8%) or PTSD (30%) or no psychopathology (10.3%). Conclusion: Findings suggest that 1 in 4 patients who screened positive for PTSD and/or depression reported receiving counseling or medication in the first month after a suspected ACS event. (C) 2016 Elsevier Inc. All rights reserved. C1 [Sundquist, Kevin; Parsons, Faith; Dalrymple, Nathan; Edmondson, Donald; Sumner, Jennifer A.] Columbia Univ, Med Ctr, Ctr Behav Cardiovasc Hlth, 622 West 168th St,PH9-315, New York, NY 10032 USA. [Chang, Bernard P.] Columbia Univ, Med Ctr, Dept Emergency Med, 622 West 168th St,PH9-315, New York, NY 10032 USA. [Sumner, Jennifer A.] Harvard Univ, Dept Epidemiol, TH Chan Sch Publ Hlth, Boston, MA 02115 USA. C3 Columbia University; Columbia University; Harvard University; Harvard T.H. Chan School of Public Health RP Sumner, JA (通讯作者)，Columbia Univ, Med Ctr, Ctr Behav Cardiovasc Hlth, 622 West 168th St,PH9-315, New York, NY 10032 USA. EM js4456@cumc.columbia.edu RI Chang, Bernard P./AAI-1139-2019; Edmondson, Donald/G-7486-2016 OI Edmondson, Donald/0000-0002-4518-8196; CHANG, BERNARD/0000-0001-8800-7140 FU National Heart, Lung, and Blood Institute (NHLBI) [R01 HL117832, R01 HL128497, K01 HL130650] FX Dr. Edmondson was supported by the National Heart, Lung, and Blood Institute (NHLBI): R01s HL117832 and HL128497. Dr. Sumner was supported by NHLBI K01 HL130650. CR Bliese PD, 2008, J CONSULT CLIN PSYCH, V76, P272, DOI 10.1037/0022-006X.76.2.272 Edmondson D, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0066435 Edmondson D, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0038915 Freedland KE, 2003, PSYCHOSOM MED, V65, P119, DOI 10.1097/01.PSY.0000038938.67401.85 Ghafoori B, 2014, J NERV MENT DIS, V202, P239, DOI 10.1097/NMD.0000000000000108 Hollon SD, 2002, PSYCHOL SCI, P39, DOI 10.1111/1529-1006.00008 Huffman JC, 2006, AM J CARDIOL, V98, P319, DOI 10.1016/j.amjcard.2006.02.033 Institutes of Medicine, 2008, TREATM POSTTR STRESS Kroenke K, 2001, J GEN INTERN MED, V16, P606, DOI 10.1046/j.1525-1497.2001.016009606.x Roberts AL, 2011, PSYCHOL MED, V41, P71, DOI 10.1017/S0033291710000401 Sumner JA, 2015, J AFFECT DISORDERS, V186, P178, DOI 10.1016/j.jad.2015.06.013 Van der Kooy K, 2007, INT J GERIATR PSYCH, V22, P613, DOI 10.1002/gps.1723 van Melle JP, 2004, PSYCHOSOM MED, V66, P814, DOI 10.1097/01.psy.0000146294.82810.9c WEATHERS FW, 1993, 6 ANN M INT SOC TRAU NR 14 TC 12 Z9 12 U1 0 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3999 EI 1879-1360 J9 J PSYCHOSOM RES JI J. Psychosomat. Res. PD JUL PY 2016 VL 86 BP 60 EP 62 DI 10.1016/j.jpsychores.2016.05.007 PG 3 WC Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry GA DP4KY UT WOS:000378466000010 PM 27302548 OA Green Accepted, Green Submitted DA 2023-05-13 ER PT J AU Amirian, J Javdan, O Misher, J Diamond, J Raio, C Rudolph, G Druz, RS AF Amirian, Jossef Javdan, Omid Misher, Jason Diamond, Joseph Raio, Christopher Rudolph, Gary Druz, Regina S. TI Comparative efficiency of exercise stress testing with and without stress-only myocardial perfusion imaging in patients with low-risk chest pain SO JOURNAL OF NUCLEAR CARDIOLOGY LA English DT Article DE Exercise stress testing; outcomes; stress-only myocardial perfusion imaging; observation unit; low-risk chest pain ID COMPUTED TOMOGRAPHIC ANGIOGRAPHY; ACUTE CARDIAC ISCHEMIA; EMERGENCY-DEPARTMENT; CT-STAT; TRIAGE AB Objectives. To compare major adverse cardiac event (MACE), downstream resource utilization, and direct cost of care for low-risk chest pain patients observed in the clinical decision unit (CDU) with exercise treadmill testing (ETT) and with stress-only myocardial perfusion imaging (sMPI). Background. CDUs are poised to increase efficiency and resource utilization. However, the optimal testing strategy that would assure favorable outcomes while decreasing cost is not defined. Methods. 1016 subjects from 2 locations were propensity score-matched (PSM) by age, gender, pre-test likelihood, Duke treadmill score, and test results. Outcomes were length of stay >24 hours, MACE (acute coronary syndrome, revascularization, cardiac death), downstream resource use (admission for chest pain, repeat testing, angiography), and mean direct cost per patient. Results. PSM yielded 680 patients (340 matches). 98% of all tests were normal. 96.6% of patients were discharged from the CDU within 24 hours but twice as many exceeded 24 hours in the sMPI group. There were no cardiac deaths. MACE rate was 1.47% at 72 hours and 1% at 1 year. Downstream resource use was 4.82% at 72 hours, and 7.69% at 1 year. The sMPI group was event-free longer than the ETT group reflecting less repeat testing. The mean direct cost was 30% higher for sMPI ($3168.70) vs. ETT ($2226.96). Conclusion. Low-risk chest pain patients in the observation unit had low MACE rate, not different for ETT vs. sMPI. The majority of ETT and sMPI tests were normal. The sMPI reduced additional testing, but resulted in greater expense and longer stay. C1 [Amirian, Jossef] Icahn Sch Med Mt Sinai, Dept Cardiol, Div Cardiovasc Dis, Mt Sinai Heart,Mt Sinai Beth Israel, First Ave 17th St,5 Baird Hall, New York, NY 10003 USA. [Druz, Regina S.] St Johns Episcopal Hosp, Dept Med, Div Cardiol, Far Rockaway, NY USA. [Amirian, Jossef; Javdan, Omid] North Shore Univ Hosp, Dept Med, Manhasset, NY USA. [Misher, Jason; Diamond, Joseph] Long Isl Jewish Med Ctr, Dept Cardiol, New Hyde Pk, NY USA. [Raio, Christopher; Rudolph, Gary] Northwell Hofstra Univ, Sch Med, Dept Emergency Med, Uniondale, NY USA. C3 Icahn School of Medicine at Mount Sinai; Northwell Health; North Shore University Hospital; Northwell Health RP Amirian, J (通讯作者)，Icahn Sch Med Mt Sinai, Dept Cardiol, Div Cardiovasc Dis, Mt Sinai Heart,Mt Sinai Beth Israel, First Ave 17th St,5 Baird Hall, New York, NY 10003 USA. 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Nucl. Cardiol. PD AUG PY 2018 VL 25 IS 4 BP 1274 EP 1282 DI 10.1007/s12350-016-0774-y 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 GR5JX UT WOS:000442667600033 PM 28083830 DA 2023-05-13 ER PT J AU Chen, CL Kan, T Li, S Qiu, C Gui, L AF Chen, Chulin Kan, Ting Li, Shuang Qiu, Chen Gui, Li TI Use and implementation of standard operating procedures and checklists in prehospital emergency medicine: a literature review SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Review ID INTENSIVE-CARE-UNIT; LIFE-SUPPORT; ERROR MANAGEMENT; RAPID CHECKLIST; GUIDELINES; DOCUMENTATION; ANESTHESIA; PROTOCOLS; PHYSICIAN; COMMUNICATION AB Objectives: This review aimed to analyze published literature to introduce the use and implementation of standard operating procedures (SOPs) and checklists in prehospital emergency medicine and their impact on guideline adherence and patient outcome. Methods: An English literature search was carried out using the Cochrane Library, MEDLINE, EMBASE, Springer, Elsevier, and ProQuest databases. Original articles describing the use and implementation of SOPs or checklists in prehospital emergency medicine were included. Editorials, comments, letters, bulletins, news articles, conference abstracts, and notes were excluded from the analysis. Relevant information was extracted relating to application areas, development of SOPs/checklists, educational preparation and training regarding SOPs/checklists implementation, staff attitudes and the effects of SOPs/checklists use on guideline adherence and patient outcomes. Results: The literature search found 2187 potentially relevant articles, which were narrowed down following an abstract review and a full text review. A final total of 13 studies were identified that described the use and implementation of SOPs (9 studies) and checklists (4 studies) in different areas of prehospital emergency medicine including prehospital management of patients with acute exacerbated chronic obstructive pulmonary disease and acute coronary syndrome, prehospital airway management, medical documentation, Emergency Medical Services triage, and transportation of patients. Conclusions: The use and implementation of SOPs and checklists in prehospital emergency medicine have shown some benefits of improving guidelines adherence and patient outcomes in airway management, patient records, identification and triage, and other prehospital interventions. More research in this area is necessary to optimize the future use and implementation of SOPs and checklists to improve emergency personnel performance and patient outcomes. (C) 2016 Elsevier Inc. All rights reserved. C1 [Chen, Chulin; Kan, Ting; Li, Shuang; Qiu, Chen; Gui, Li] Second Mil Med Univ, Sch Nursing, Dept Emergency Nursing, Shanghai, Peoples R China. C3 Naval Medical University RP Gui, L (通讯作者)，Second Mil Med Univ, Sch Nursing, Dept Emergency Nursing, Shanghai, Peoples R China. EM hzla884309@163.com; echokanting@163.com; 578079960@foxmail.com; 442932039@foxmail.com; guili2000@foxmail.com RI gui, li/GQQ-2739-2022 OI Kan, Ting/0000-0002-1644-4330 FU Program of Shanghai Peak Disciplines FX This work was supported by Program of Shanghai Peak Disciplines. 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J. Emerg. Med. PD DEC PY 2016 VL 34 IS 12 BP 2432 EP 2439 DI 10.1016/j.ajem.2016.09.057 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA EJ2OO UT WOS:000393050100033 PM 27742522 DA 2023-05-13 ER PT J AU Perez, A Eraso, LH Merli, GJ AF Perez, A. Eraso, L. H. Merli, G. J. TI Implications of new anticoagulants in primary practice SO INTERNATIONAL JOURNAL OF CLINICAL PRACTICE LA English DT Article ID FACTOR-XA INHIBITOR; ORAL DIRECT THROMBIN; EXTENDED MAINTENANCE THERAPY; ACUTE CORONARY SYNDROMES; DABIGATRAN VS. PLACEBO; ATRIAL-FIBRILLATION; DOUBLE-BLIND; VENOUS THROMBOEMBOLISM; ANTIPLATELET THERAPY; ANTITHROMBOTIC THERAPY AB Background: Effective prophylaxis and treatment of thromboembolic disorders remain suboptimal in many healthcare systems, partly owing to limitations of traditional anticoagulants. New oral anticoagulants have been developed and among these, rivaroxaban, apixaban and dabigatran etexilate are in the most advanced stage of clinical development. Method: A literature search using the PubMed and ClinicalTrials.gov databases was performed to identify English-language publications. The search was performed up to 31 December 2011 with the terms rivaroxaban OR Xarelto, apixaban OR Eliquis and dabigatran OR Pradaxa. Ongoing, completed and published phase III randomised controlled trials were selected as the primary source of information for the clinical development programme of each drug. Results: The new oral agents demonstrate several advantages over traditional anticoagulants, including administration at fixed doses and no requirement for routine coagulation monitoring On the basis of phase III clinical trials, rivaroxaban, apixaban and dabigatran etexilate have been approved in many countries for the prevention of venous thromboembolism after hip and knee replacement surgery. Dabigatran etexilate and rivaroxaban have also been approved for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation in Europe and the US. In addition, rivaroxaban has been approved in Europe for the treatment of acute deep vein thrombosis and prevention of recurrent venous thromboembolism. Approval of these agents and postapproval monitoring of their safety and efficacy will have implications for primary care. Conclusion: Rivaroxaban, apixaban and dabigatran etexilate offer the possibility of simplified prevention and treatment strategies for thromboembolic disorders in the outpatient setting. C1 [Perez, A.; Eraso, L. H.; Merli, G. J.] Thomas Jefferson Univ Hosp, Jefferson Med Coll, Jefferson Vasc Ctr, Philadelphia, PA 19107 USA. C3 Jefferson University RP Merli, GJ (通讯作者)，Thomas Jefferson Univ Hosp, Jefferson Med Coll, Jefferson Vasc Ctr, 111 S 11th St,Suite 6270, Philadelphia, PA 19107 USA. EM geno.merli@jefferson.edu OI /0000-0002-7890-4902 FU Bayer HealthCare Pharmaceuticals; Janssen Research & Development, LLC. FX The authors acknowledge Claudia Wiedemann, who provided editorial support with funding from Bayer HealthCare Pharmaceuticals and Janssen Research & Development, LLC. 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J. Clin. Pract. PD FEB PY 2013 VL 67 IS 2 BP 139 EP 156 DI 10.1111/ijcp.12023 PG 18 WC Medicine, General & Internal; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Pharmacology & Pharmacy GA 072QX UT WOS:000313688400008 PM 23305476 DA 2023-05-13 ER PT J AU Winchester, DE Hymas, J Meral, R Nguyen, D Dusaj, R Shaw, LJ Beyth, RJ AF Winchester, David E. Hymas, Joseph Meral, Ryan Nguyen, Daniel Dusaj, Raman Shaw, Leslee J. Beyth, Rebecca J. TI Clinician-dependent variations in inappropriate use of myocardial perfusion imaging: Training, specialty, and location SO JOURNAL OF NUCLEAR CARDIOLOGY LA English DT Article DE Myocardial perfusion imaging; appropriate use criteria; coronary artery disease ID APPROPRIATE USE CRITERIA; ECHOCARDIOGRAPHY; GUIDELINES AB Inappropriate use of myocardial perfusion imaging (MPI) may vary depending on the training, specialty, or practice location of the clinician. We conducted a cross-sectional investigation of consecutive patients who underwent MPI at our Veterans Affairs medical center between December 2010 and July 2011. Characteristics of the MPI ordering clinicians were extracted to investigate any associations with inappropriate use. 582 patients were included, 9.8% were inappropriate. No difference in inappropriate use was observed between cardiology and non-cardiology clinicians (n = 21, 9.5% vs n = 36, 10.0%, P = .83); no difference was noted between nurse practitioners/physician assistants, attending physicians, and housestaff (7.5% vs 11.2% vs 1.8%, P = .06). Comparing inpatient, emergency department and outpatient clinician groups, the difference was null (8.6% vs 6.3% vs 10.1%, P = .75). For most clinician groups, the most common inappropriate indication was an asymptomatic scenario; however, some groups were different: definite acute coronary syndrome for inpatient clinicians and low risk syncope for emergency medicine clinicians. Clinician groups appear to order inappropriate MPI at similar rates, regardless of their training, specialty, or practice location. Differences in the most common type of inappropriate testing suggest that interventions to reduce inappropriate use should be tailored to specific clinician types. C1 [Winchester, David E.; Dusaj, Raman; Beyth, Rebecca J.] Malcom Randall VA Med Ctr, Gainesville, FL 32608 USA. [Winchester, David E.; Hymas, Joseph; Meral, Ryan; Nguyen, Daniel; Dusaj, Raman; Beyth, Rebecca J.] Univ Florida, Coll Med, Gainesville, FL USA. [Shaw, Leslee J.] Emory Univ, Sch Med, Atlanta, GA USA. C3 State University System of Florida; University of Florida; Emory University RP Winchester, DE (通讯作者)，Malcom Randall VA Med Ctr, 1601 SW Archer Rd 111D, Gainesville, FL 32608 USA. EM david.winchester@va.gov RI Winchester, David/AAR-5536-2020 OI Winchester, David/0000-0002-5224-2891 FU NIH [T35-HL007489-28] FX Ryan Chauffe, DO and Scott Ryals, MD are acknowledged for their participation in gathering of data for this investigation. This investigation was supported by NIH T35 Training Grant: T35-HL007489-28. This work was supported by resources provided by the North Florida/South Georgia Veterans Health System. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. 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Nucl. Cardiol. PD JUN PY 2014 VL 21 IS 3 BP 598 EP 604 DI 10.1007/s12350-014-9887-3 PG 7 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 AH6YI UT WOS:000336278000020 PM 24671699 DA 2023-05-13 ER PT J AU Baugh, CW Kosowsky, JM Morrow, DA Sonis, JD Gold, AG Ronan, CE Pallin, DJ AF Baugh, Christopher W. Kosowsky, Joshua M. Morrow, David A. Sonis, Jonathan D. Gold, Allen G. Ronan, Clare E. Pallin, Daniel J. TI Death or revascularization among nonadmitted ED patients with low-positive vs negative troponin T results SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ELEVATED CARDIAC TROPONIN; EMERGENCY-DEPARTMENT PATIENTS; CRITICALLY-ILL PATIENTS; ACUTE CORONARY SYNDROME; CHEST-PAIN; RISK-FACTOR; MORTALITY; DIAGNOSIS; ANGIOGRAPHY; ISCHEMIA AB Study objective: Compare outcomes among emergency department (ED) patients with low-positive (0.01-0.02 ng/mL) vs negative troponin T. Methods: Retrospective cohort study of nonadmitted ED patients with troponin testing at a tertiary-care hospital. Trained research assistants used a structured tool to review charts from all nonadmitted ED patients with troponin testing, 12/1/2009 to 11/30/2010. Outcomes of death and coronary revascularization were assessed at 30 days and 6 months via medical record review, Social Security Death Index searches, and patient contact. Results: There were 57596 ED visits; with 33388 (58%) discharged immediately, 6410 (11%) assigned to the observation unit, and 17798 (31%) admitted or other. Troponin was measured in 2684 (6.7%) of the nonadmitted cases. Troponin was negative in 2523 (94.0%), low positive in 78 (2.9%), and positive (>= 0.03 ng/mL) in 83 (3.1%). Of troponin-negative cases, 0.8% (95% CI, 0.4-1.1%) died or were revascularized by 30 days, vs 2.8% (95% CI, 0.0-6.7%) of low-positive cases (risk difference [RD], 2.0%; 95% CI, - 1.8 to 5.9%). At 6 months, the rates were 1.7% (95% CI, 1.1-2.2%) and 12.9% (95% CI, 5.0-20.7%) (RD, 11%; 95% CI, 3.3-19.1%). Death alone at 30 days occurred in 0.4% (95% CI, 0.1-0.6%) vs 1.3% (95% CI, 0.0-3.8%) (RD, 0.9%; 95% CI, - 1.6 to 3.4%). Death at 6 months occurred in 1.2% (95% CI, 0.8-1.6%) vs 11.7% (95% CI, 4.5-18.9%) (RD, 10%; 95% CI, 3.3-17.7%). Conclusion: Among patients not initially admitted, rates of death and coronary revascularization differed insignificantly at 30 days but significantly at 6 months. Detailed inspection of our results reveals that the bulk of the added risk at 6 months was due to non-cardiac mortality. (C) 2014 Elsevier Inc. All rights reserved. C1 [Baugh, Christopher W.; Kosowsky, Joshua M.; Sonis, Jonathan D.; Ronan, Clare E.; Pallin, Daniel J.] Brigham & Womens Hosp, Dept Emergency Med, Boston, MA 02115 USA. [Morrow, David A.] Brigham & Womens Hosp, Dept Cardiol, Boston, MA 02115 USA. [Baugh, Christopher W.; Kosowsky, Joshua M.; Morrow, David A.; Pallin, Daniel J.] Harvard Univ, Sch Med, Cambridge, MA 02138 USA. [Sonis, Jonathan D.] Harvard Affiliated Emergency Med Residency, Boston, MA USA. [Gold, Allen G.] New York Inst Technol, Coll Osteopath Med, New York, NY USA. C3 Harvard University; Brigham & Women's Hospital; Harvard University; Brigham & Women's Hospital; Harvard University; Harvard University; Harvard Medical School; New York Institute Technology RP Baugh, CW (通讯作者)，75 Francis St, Boston, MA 02115 USA. EM cbaugh@partners.org RI Baugh, Christopher William/AAJ-3688-2021; Pallin, Daniel J/H-6382-2013 OI Baugh, Christopher William/0000-0002-2360-1891; Pallin, Daniel J/0000-0002-8517-9702 FU Eleanor and Miles Shore Fellowship Program FX This research was made possible by support from the Eleanor and Miles Shore Fellowship Program for Scholars in Medicine, administrated by the Department of Emergency Medicine at Brigham and Women's Hospital. 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J. Emerg. Med. PD AUG PY 2014 VL 32 IS 8 BP 923 EP 928 DI 10.1016/j.ajem.2014.05.013 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AR1AK UT WOS:000343311000018 PM 24953787 DA 2023-05-13 ER PT J AU Christ, G Siller-Matula, JM Francesconi, M Dechant, C Grohs, K Podczeck-Schweighofer, A AF Christ, Guenter Siller-Matula, Jolanta M. Francesconi, Marcel Dechant, Cornelia Grohs, Katharina Podczeck-Schweighofer, Andrea TI Individualising dual antiplatelet therapy after percutaneous coronary intervention: the IDEAL-PCI registry SO BMJ OPEN LA English DT Article ID DRUG-ELUTING STENTS; MULTIPLE ELECTRODE AGGREGOMETRY; TREATMENT PLATELET REACTIVITY; MYOCARDIAL-INFARCTION; RANDOMIZED-TRIAL; CLOPIDOGREL; THROMBOSIS; EVENTS; IMPLANTATION; AGGREGATION AB Objective: To evaluate the clinical utility of individualising dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in an all-comers population, including ST-elevation myocardial infarction (STEMI) patients. Setting: Tertiary care single centre registry. Participants: 1008 consecutive PCI patients with stent implantation, without exclusion criteria. Intervention: Peri-interventional individualisation of DAPT, guided by multiple electrode aggregometry (MEA), to overcome high on-treatment platelet reactivity (HPR) to ADP-induced (>= 50 U) and arachidonic acid (AA)-induced aggregation (>35 U). Outcome measures: The primary efficacy end point was definite stent thrombosis (ST) at 30 days. The primary safety end point was thrombolysis in myocardial infarction (TIMI) major and minor bleeding. Secondary end points were probable ST, myocardial infarction, cardiovascular death and the combined end point: major cardiac adverse event (MACE). Results: 53% of patients presented with acute coronary syndrome (9% STEMI, 44% non-ST-elevation). HPR to ADP after 600 mg clopidogrel loading occurred in 30% of patients (73 +/- 19 U vs 28 +/- 11 U; p<0.001) and was treated by prasugrel or ticagrelor (73%), or clopidogrel (27%) reloading (22 +/- 12 U; p< 0.001). HPR to ADP after prasugrel loading occurred in 2% of patients (82 +/- 26 U vs 19 +/- 10 U; p< 0.001) and was treated with ticagrelor (34 +/- 15 U; p=0.02). HPR to AA occurred in 9% of patients with a significant higher proportion in patients with HPR to ADP (22% vs 4%, p<0.001) and was treated with aspirin reloading. Definite ST occurred in 0.09% of patients (n=1); probable ST, myocardial infarction, cardiovascular death and MACE occurred in 0.19% (n=2), 0.09% (n=1) and 1.8% (n=18) of patients. TIMI major and minor bleeding did not differ between patients without HPR and individualised patients (2.6% for both). Conclusions: Individualisation of DAPT with MEA minimises early thrombotic events in an all-comers PCI population to an unreported degree without increasing bleeding. A randomised multicentre trial utilising MEA seems warranted. C1 [Christ, Guenter; Francesconi, Marcel; Dechant, Cornelia; Podczeck-Schweighofer, Andrea] Kaiser Franz Josef Hosp, Dept Med Cardiol 5, Vienna, Austria. [Siller-Matula, Jolanta M.] Med Univ Vienna, Dept Cardiol, Vienna, Austria. [Grohs, Katharina] Kaiser Franz Josef Hosp, Clin Inst Lab Med, Vienna, Austria. C3 Kaiser-Franz-Josef Hospital; Medical University of Vienna; Kaiser-Franz-Josef Hospital RP Christ, G (通讯作者)，Kaiser Franz Josef Hosp, Dept Med Cardiol 5, Vienna, Austria. EM guenter.christ@wienkav.at RI Jolanta Siller-Matula, PD/J-8992-2015 OI Jolanta Siller-Matula, PD/0000-0001-6041-1635 FU Kaiser Franz Josef Hospital FX Kaiser Franz Josef Hospital. CR Al-Azzam SI, 2012, ACTA CARDIOL, V67, P445, DOI 10.1080/AC.67.4.2170686 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 Bhatt DL, 2013, NEW ENGL J MED, V368, P1303, DOI 10.1056/NEJMoa1300815 Bonello L, 2008, J AM COLL CARDIOL, V51, P1404, DOI 10.1016/j.jacc.2007.12.044 Breet NJ, 2011, HEART, V97, P983, DOI 10.1136/hrt.2010.220491 Brodie B, 2012, JACC-CARDIOVASC INTE, V5, P1043, DOI 10.1016/j.jcin.2012.06.013 CHESEBRO JH, 1987, CIRCULATION, V76, P142, DOI 10.1161/01.CIR.76.1.142 Christ G, 2013, THROMB RES, V132, pE36, DOI 10.1016/j.thromres.2013.05.029 Collet JP, 2012, NEW ENGL J MED, V367, P2100, DOI 10.1056/NEJMoa1209979 Cornelissen I, 2010, P NATL ACAD SCI USA, V107, P18605, DOI 10.1073/pnas.1013309107 Cutlip DE, 2007, CIRCULATION, V115, P2344, DOI 10.1161/CIRCULATIONAHA.106.685313 Hesstermans AACM, 2010, J THROMB HAEMOST, V8, P2385, DOI 10.1111/j.1538-7836.2010.04046.x Iqbal J, 2013, EUROINTERVENTION, V9, P62, DOI 10.4244/EIJV9I1A10 Kreutz RP, 2012, THROMB RES, V130, P198, DOI 10.1016/j.thromres.2012.02.049 Price MJ, 2011, JAMA-J AM MED ASSOC, V305, P1097, DOI 10.1001/jama.2011.290 Sibbing D, 2009, J AM COLL CARDIOL, V53, P849, DOI 10.1016/j.jacc.2008.11.030 Siller-Matula JM, 2010, J THROMB HAEMOST, V8, P351, DOI 10.1111/j.1538-7836.2009.03699.x Siller-Matula JM, 2008, J AM COLL CARDIOL, V52, P1557, DOI 10.1016/j.jacc.2008.07.055 Siller-Matula JM, 2013, THROMB HAEMOSTASIS, V110, P628, DOI 10.1160/TH13-03-0250 Siller-Matula JM, 2013, INT J CARDIOL, V167, P2018, DOI 10.1016/j.ijcard.2012.05.040 Siller-Matula JM, 2013, INT J CARDIOL, V167, P430, DOI 10.1016/j.ijcard.2012.01.016 Stone GW, 2008, NEW ENGL J MED, V358, P2218, DOI 10.1056/NEJMoa0708191 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 Toth O, 2006, THROMB HAEMOSTASIS, V96, P781, DOI 10.1160/TH06-05-0242 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, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 NR 29 TC 21 Z9 21 U1 0 U2 5 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 2014 VL 4 IS 10 AR e005781 DI 10.1136/bmjopen-2014-005781 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AT2OP UT WOS:000344774500035 PM 25361837 OA Green Published, gold DA 2023-05-13 ER PT J AU Morishita, T Takada, D Shin, JH Higuchi, T Kunisawa, S Fushimi, K Imanaka, Y AF Morishita, Tetsuji Takada, Daisuke Shin, Jung-ho Higuchi, Takuya Kunisawa, Susumu Fushimi, Kiyohide Imanaka, Yuichi TI Effects of the COVID-19 pandemic on heart failure hospitalizations in Japan: interrupted time series analysis SO ESC HEART FAILURE LA English DT Article DE Coronavirus Disease 2019; Heart failure; In-hospital mortality; Angiotensin-converting enzyme inhibitor; Angiotensin II receptor blocker ID ADMISSIONS; MORTALITY; TRENDS AB Aims The Coronavirus Disease 2019 (COVID-19) pandemic has had unprecedented effects on health care utilization for acute cardiovascular diseases. Although hospitalizations for acute coronary syndrome decreased during the COVID-19 pandemic, there is a paucity of data on the trends and management of heart failure (HF) cases. Furthermore, concerns have been raised that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may increase susceptibility to COVID-19. This study aimed to elucidate changes in HF hospitalizations from the COVID-19 state of emergency in Japan and investigated changes in the prescription of ACEIs and ARBs, and in-hospital mortality. Methods and results We performed an interrupted time series analysis of HF hospitalizations in Japan to verify the impacts of the COVID-19 state of emergency. Changes in the weekly volume of HF hospitalizations were taken as the primary outcome measure. Between 1 April 2018 and 4 July 2020, 109 429 HF cases required admission. After the state of emergency, an immediate decrease was observed in HF cases per week [-3.6%; 95% confidence interval (CI): -0.3% to -6.7%, P = 0.03]. There was no significant change in the prescription of ACEIs or ARBs after the state of emergency (4.2%; 95% CI: -0.3% to 8.9%, P = 0.07). The COVID-19 pandemic had no effect on in-hospital mortality among HF patients (5.3%; 95% CI: -4.9% to 16.6%, P = 0.32). Conclusions We demonstrated a decline in HF hospitalizations during the COVID-19 pandemic in Japan, with no clear evidence of a negative effect on the prescription of ACEIs and ARBs or in-hospital mortality. C1 [Morishita, Tetsuji; Takada, Daisuke; Shin, Jung-ho; Higuchi, Takuya; Kunisawa, Susumu; Imanaka, Yuichi] Kyoto Univ, Grad Sch Med, Dept Healthcare Econ & Qual Management, Sakyo Ku, Yoshida Konoe Cho, Kyoto, Kyoto 6068501, Japan. [Morishita, Tetsuji] Matsunami Gen Hosp, Dept Internal Med, Gifu, Japan. [Fushimi, Kiyohide] Tokyo Med & Dent Univ, Dept Hlth Policy & Informat, Grad Sch, Tokyo, Japan. C3 Kyoto University; Tokyo Medical & Dental University (TMDU) RP Imanaka, Y (通讯作者)，Kyoto Univ, Grad Sch Med, Dept Healthcare Econ & Qual Management, Sakyo Ku, Yoshida Konoe Cho, Kyoto, Kyoto 6068501, Japan. EM imanaka-y@umin.net RI Yuichi, Imanaka/GYR-2098-2022; KUNISAWA, Susumu/HCH-1094-2022; SHIN, Jung-ho/HCH-1481-2022 OI Yuichi, Imanaka/0000-0003-4613-2159; Higuchi, Takuya/0000-0003-0757-1650 FU JSPS KAKENHI from the Japan Society for the Promotion of Science [JP19H01075]; Ministry of Health, Labour and Welfare, Japan [20HA2003]; GAP Fund Program of Kyoto University type B; Health, Labour and Welfare Policy Research Grants for Research on Policy Planning and Evaluation [20AA2005] FX This study was supported by the JSPS KAKENHI (Grant Number JP19H01075) from the Japan Society for the Promotion of Science, by a Health Labour Sciences Research Grant from the Ministry of Health, Labour and Welfare, Japan (20HA2003), and by the GAP Fund Program of Kyoto University type B (recipient: Yuichi Imanaka). This study was also supported by a Health, Labour and Welfare Policy Research Grants for Research on Policy Planning and Evaluation (Grant Number: 20AA2005) (recipient: Kiyohide Fushimi). The funders played no role in the study design, data collection and analysis, decision to publish, or manuscript preparation. 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PD FEB PY 2022 VL 9 IS 1 BP 31 EP 38 DI 10.1002/ehf2.13744 EA DEC 2021 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZV9OX UT WOS:000730585500001 PM 34913269 OA Green Published DA 2023-05-13 ER PT J AU Kucher, N Aujesky, D Beer, JH Mazzolai, L Baldi, T Banyai, M Hayoz, D Kaeslin, T Korte, W Escher, R Husmann, M Frauchiger, B Baumgartner, I Spirk, D AF Kucher, Nils Aujesky, Drahomir Beer, Jurg H. Mazzolai, Lucia Baldi, Thomas Banyai, Martin Hayoz, Daniel Kaeslin, Thomas Korte, Wolfgang Escher, Robert Husmann, Marc Frauchiger, Beat Baumgartner, Iris Spirk, David TI Rivaroxaban for the treatment of venous thromboembolism The SWISS Venous ThromboEmbolism Registry (SWIVTER) SO THROMBOSIS AND HAEMOSTASIS LA English DT Article DE Anticoagulation; rivaroxaban; venous thromboembolism ID ORAL RIVAROXABAN; THERAPY; MANAGEMENT; WARFARIN; SAFETY AB We investigated three-month clinical outcomes in patients with venous thromboembolism (VTE) treated with rivaroxaban or conventional anticoagulation in routine clinical practice. Between November 2012 and February 2015, 2,062 consecutive patients with VTE from 11 acute care hospitals in Switzerland were enrolled in the SWISS Venous ThromboEmbolism Registry (SWIVTER). Overall, 417 (20%) patients were treated with rivaroxaban. In comparison to 1,645 patients on conventional anticoagulation, patients on rivaroxaban were younger (56 18 vs. 65 17 years; p<0.001), less often had pulmonary embolism (38% vs 66%; p<0.001), hypertension (26% vs 41 %; p<0.001), cancer (10% vs 28%; p<0.001), congestive heart failure (10% vs 17%; p=0.001), diabetes (8% vs 15%; p<0.001), chronic lung disease (7% vs 13%; p=0.001), renal insufficiency (7% vs 13%; p=0.001), recent surgery (7% vs 14%; p<0.001), and acute coronary syndrome (1 % vs 4%; p=0.009). VTE reperfusion therapy was more frequently used (28% vs 9%; p<0.001) and indefinite-duration anticoagulation treatment less often planned (26% vs 39%; p<0.001), respectively. In the propensity score-adjusted population, the risk of recurrent VTE was similar in patients on rivaroxaban vs conventional anticoagulation (1.2% vs 2.1 %, hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.18-1.65; p=0.29); the risk of major bleeding was also similar, respectively (0.5% vs 0.5%, HR 1.00, 95%CI 0.14-7.07; p=1.00). Conventional anticoagulation is still frequently used for the treatment of VTE, particularly in the elderly and those with comorbidities. Early clinical outcomes were comparable between propensity score-adjusted patient populations on rivaroxaban and conventional anticoagulation. C1 [Kucher, Nils; Baumgartner, Iris] Univ Hosp Bern, Swiss Cardiovasc Ctr, Bern, Switzerland. [Aujesky, Drahomir] Univ Hosp Bern, Div Gen Internal Med, Bern, Switzerland. [Beer, Jurg H.] Cantonal Hosp Baden, Dept Internal Med, Baden, Switzerland. [Mazzolai, Lucia] Univ Lausanne Hosp, Clin Angiol, Lausanne, Switzerland. [Baldi, Thomas] Univ Basel Hosp, Dept Internal Med, Basel, Switzerland. [Banyai, Martin] Cantonal Hosp Lucerne, Dept Internal Med, Luzern, Switzerland. [Hayoz, Daniel] Cantonal Hosp Fribourg, Dept Internal Med, Fribourg, Switzerland. [Kaeslin, Thomas] Cantonal Hosp Obwalden, Dept Internal Med, Sarnen, Switzerland. [Korte, Wolfgang] Cantonal Hosp St Gallen, Dept Internal Med, St Gallen, Switzerland. [Escher, Robert] Reg Hosp Burgdorf, Dept Internal Med, Burgdorf, Switzerland. [Husmann, Marc] Univ Zurich Hosp, Clin Angiol, Zurich, Switzerland. [Frauchiger, Beat] Cantonal Hosp Frauenfeld, Internal Med, Frauenfeld, Switzerland. [Spirk, David] Univ Bern, Inst Pharmacol, Bern, Switzerland. C3 University of Bern; University Hospital of Bern; University of Bern; University Hospital of Bern; University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Basel; Lucerne Cantonal Hospital; Kantonsspital St. Gallen; University of Zurich; University Zurich Hospital; University of Bern RP Kucher, N (通讯作者)，Univ Hosp Bern, Div Vasc Med, Swiss Cardiovasc Ctr, CH-3010 Bern, Switzerland. EM nils.kucher@insel.ch RI Lodigiani, Corrado/AAW-1964-2020 OI Lodigiani, Corrado/0000-0002-9152-9385; Beer, Jurg Hans/0000-0002-7199-0406 FU International Society on Thrombosis and Haemostasis (ISTH) Presidential Fund; Sanofi-Aventis (Suisse) SA, Vernier; Bayer (Schweiz) AG, Zurich; Pfizer AG, Zurich; Bristol-Myers Squibb AG, Cham, Switzerland FX This study was funded by the International Society on Thrombosis and Haemostasis (ISTH) 2007 Presidential Fund, Sanofi-Aventis (Suisse) SA, Vernier, Bayer (Schweiz) AG, Zurich, Pfizer AG, Zurich, and Bristol-Myers Squibb AG, Cham, Switzerland. CR Ageno W, 2016, LANCET HAEMATOL, V3, pE12, DOI 10.1016/S2352-3026(15)00257-4 Agnelli G, 2013, NEW ENGL J MED, V369, P799, DOI 10.1056/NEJMoa1302507 Bauersachs R, 2010, NEW ENGL J MED, V363, P2499, DOI 10.1056/NEJMoa1007903 Beyer-Westendorf J, 2014, BLOOD, V124, P955, DOI 10.1182/blood-2014-03-563577 Buller HR, 2013, NEW ENGL J MED, V369, P1406, DOI 10.1056/NEJMoa1306638 Buller HR, 2012, NEW ENGL J MED, V366, P1287, DOI 10.1056/NEJMoa1113572 Carrier M, 2014, THROMB RES, V134, P1214, DOI 10.1016/j.thromres.2014.09.039 Dault R, 2015, CLIN APPL THROMB HEM Geldhof V, 2014, THROMB J, V12, DOI 10.1186/1477-9560-12-21 Kearon C, 2016, CHEST, V149, P315, DOI 10.1016/j.chest.2015.11.026 Kearon Clive, 2012, Chest, V141, pe419S, DOI 10.1378/chest.11-2301 Konstantinides SV, 2014, EUR HEART J, V35, P3033, DOI 10.1093/eurheartj/ehu283 Prins MH, 2013, THROMB J, V11, DOI 10.1186/1477-9560-11-21 Robertson L, 2015, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD010957.pub2 Robertson L, 2015, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD010956.pub2 Schulman S, 2009, NEW ENGL J MED, V361, P2342, DOI 10.1056/NEJMoa0906598 van der Hulle T, 2014, J THROMB HAEMOST, V12, P320, DOI 10.1111/jth.12485 NR 17 TC 36 Z9 36 U1 0 U2 4 PU GEORG THIEME VERLAG KG PI STUTTGART PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY SN 0340-6245 EI 2567-689X J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD SEP PY 2016 VL 116 IS 3 BP 472 EP 479 DI 10.1160/TH16-03-0209 PG 8 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA DV0HQ UT WOS:000382599000011 PM 27346301 DA 2023-05-13 ER PT J AU Goodman, DA Kavsak, PA Hill, SA Worster, A AF Goodman, Daniel A. Kavsak, Peter A. Hill, Stephen A. Worster, Andrew TI Presenting characteristics of patients undergoing cardiac troponin measurements in the emergency department SO CANADIAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE characteristics; demographics; elderly; emergency department; myocardial infarction; troponin ID ACUTE MYOCARDIAL-INFARCTION; CLINICAL-PREDICTION RULE; SOCIETY; CARE; CARDIOLOGY AB Introduction: Not all patients with suspected acute coronary syndrome (ACS) receiving cardiac troponin (cTn) testing present to the emergency department (ED) with cardiac chest pain. Since elderly patients (age >= 70) have increased morbidity and mortality associated with ACS, complaints other than cardiac chest pain may justify cTn testing. Our primary objective was to characterize the population of ED patients who receive cTn testing. The secondary objective was to determine if elderly patients underwent cTn testing for different presenting complaints than their younger counterparts. Methods: We created an electronic database including Canadian Emergency Department Information Systems (CEDIS) presenting complaints, age, sex, disposition, and Canadian Triage Acuity Scale (CTAS) score, for patients who received cTn testing in three Canadian EDs during 2011. We analyzed the data for patient characteristics and sorted by age (< 70 and >= 70) for further analysis. Results: In the 15,824 included patients, the average age was 66 (51%, 70; 51% female). The most common presenting complaints were cardiac chest pain (n = 3,267) and shortness of breath (n = 2,266). The elderly underwent cTn testing for significantly (p < 0.0001) different complaints than their younger counterparts. They more commonly presented with generalized weakness (n = 898), whereas younger patients more frequently had abdominal pain (n = 576). Conclusions: Cardiac chest pain and shortness of breath are presenting complaints in one-third of patients undergoing ED cTn testing. The majority of patients undergoing cTn testing did not have typical ACS symptoms. Half of all cTn testing in the ED is on the elderly, who present with different complaints than their younger counterparts. C1 [Goodman, Daniel A.; Kavsak, Peter A.; Hill, Stephen A.; Worster, Andrew] McMaster Univ, Div Emergency Med, Hamilton, ON L8S 4L8, Canada. C3 McMaster University RP Goodman, DA (通讯作者)，Hamilton Gen Hosp, McMaster Clin, Div Emergency Med, Room 251,237 Barton St East, Hamilton, ON L8L 2X2, Canada. EM Daniel.goodman@medportal.ca RI Kavsak, Pete/K-8089-2019 CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Alpert JS, 2008, HEART, V94, P1335, DOI 10.1136/hrt.2008.151233 Alpert JS, 2000, EUR HEART J, V21, P1502, DOI 10.1053/euhj.2000.2305 Amsterdam EA, 2010, CIRCULATION, V122, P1756, DOI 10.1161/CIR.0b013e3181ec61df Bullard MJ, 2008, CAN J EMERG MED, V10, P136 Christenson J, 2006, ANN EMERG MED, V47, P1, DOI 10.1016/j.annemergmed.2005.08.007 Eggers KM, 2013, CLIN CHEM, V59, P1068, DOI 10.1373/clinchem.2012.196634 Gale CP, 2012, EUR HEART J, V33, P630, DOI 10.1093/eurheartj/ehr381 Grafstein E, 2008, CAN J EMERG MED, V10, P151 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Hammarsten O, 2012, CLIN CHEM, V58, P628, DOI 10.1373/clinchem.2011.171496 Hess EP, 2012, ANN EMERG MED, V59, P115, DOI 10.1016/j.annemergmed.2011.07.026 Reiter M, 2011, EUR HEART J, V32, P1379, DOI 10.1093/eurheartj/ehr033 Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184 Vasikaran SD, 2012, CLIN BIOCHEM, V45, P513, DOI 10.1016/j.clinbiochem.2012.01.011 Wu AH, 2013, J AM COLL CARDIOL NR 16 TC 1 Z9 1 U1 0 U2 5 PU SPRINGER HEIDELBERG PI HEIDELBERG PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY SN 1481-8035 EI 1481-8043 J9 CAN J EMERG MED JI Can. J. Emerg. Med. PD JAN PY 2015 VL 17 IS 1 BP 62 EP 66 DI 10.2310/8000.2013.131298 PG 5 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA CB8FD UT WOS:000349863300009 PM 25781385 OA Bronze DA 2023-05-13 ER PT J AU Janosi, A Ferenci, T Ofner, P Lupkovics, G Becker, D Falukozy, J Polgar, P Koszegi, Z Horvath, I Jambrik, Z Szentes, V Merkely, B Dersi, CA AF Janosi, Andras Ferenci, Tamas Ofner, Peter Lupkovics, Geza Becker, David Falukozy, Jdzsef Polgar, Peter Koszegi, Zsolt Horvath, Ivan Jambrik, Zoltan Szentes, Veronika Merkely, Bela Dersi, Csaba Andras TI Does Gender Have Prognostic Value Among Patients with Myocardial Infarction? Analysis of the Data from the Hungarian Myocardial Infarction Registry SO JOURNAL OF WOMENS HEALTH LA English DT Article DE myocardial infarction; gender difference; prognosis; mortality; percutaneous coronary intervention ID LONG-TERM MORTALITY; ACUTE CORONARY SYNDROMES; SEX-DIFFERENCES; INVASIVE STRATEGY; WOMEN; MEN; REVASCULARIZATION; CARE; INTERVENTION; MANAGEMENT AB Background: The authors analyzed data from the Hungarian Myocardial Infarction Registry (HUMIR) to examine the potential impact of gender on the treatment and 30-day and 1-year mortality of patients with myocardial infarction (MI). Materials and Methods: The National Registry of Myocardial Infarction included 42,953 patients between January 1, 2013 and December 31, 2016; 19,875 of whom were diagnosed with ST-elevation myocardial infarction (STEMI) and 23,078 with non-ST-elevation myocardial infarction (NSTEMI). The proportion of women was 39% and 41.9% in the two groups, respectively. Logistic regression analysis was performed adjusting for age, the year and month of hospital admission, smoking, as well as for five concomitant diseases and anamnestic data. We found that the odds ratio (OR) of performing percutaneous coronary intervention (PCI) was influenced by age, the year of treatment, prior stroke, and peripheral artery disease (PAD) in both patient groups. Results: Gender had an impact on treatment in both cases; women had significantly fewer PCIs (OR = 0.86 confidence interval [95% CI: 0.77-0.95] in the STEMI group, OR = 0.75 [95% CI: 0.70-0.82] in the NSTEMI group). Age and PCI, PAD, and diabetes mellitus proved to be prognostic factors for 30-day and 1-year mortality in both groups. In the STEMI group, hypertension proved to be of prognostic value for both 30-day and 1-year mortality, whereas prior MI, stroke, and smoking only affected 1-year mortality. Similarly, in the NSTEMI group, prior stroke was also of prognostic value for 30-day and 1-year mortality, whereas prior MI, hypertension and smoking were only associated with 1-year mortality. Conclusions: The independent prognostic value of gender could not be proven for any of the MI types or follow-up periods. In conclusion, gender influenced the treatment of patients with MI but had no significant impact on prognosis in itself. C1 [Janosi, Andras; Ofner, Peter] Gottsegen Gyorgy Hungarian Inst Cardiol, Budapest, Hungary. [Ferenci, Tamas] Univ Obuda, Neumann Janos Fac Informat, Physiol Controls Res Ctr, Budapest, Hungary. [Lupkovics, Geza] Zala Cty St Raphael Hosp, Zalaegerszeg, Hungary. [Becker, David; Merkely, Bela] Semmelweis Univ Heart & Vasc Ctr, Budapest, Hungary. [Falukozy, Jdzsef] State Hosp Cardiol, Balatonfured, Hungary. [Polgar, Peter; Koszegi, Zsolt] Josa Andras Szabolcs Szatmar Bereg Cty Hosp, Nyiregyhaza, Hungary. [Polgar, Peter; Koszegi, Zsolt] Univ Teaching Hosp, Nyiregyhaza, Hungary. [Horvath, Ivan] Univ Pecs, Heart Inst, Pecs, Hungary. [Jambrik, Zoltan] Pandy Kalman Bekes Cty Cent Hosp, Gyula, Hungary. [Szentes, Veronika; Dersi, Csaba Andras] Petz Aladar Cty Teaching Hosp, Dept Cardiol, 2-4 Vasvari Pal St, H-9024 Gyor, Hungary. C3 Semmelweis University; University of Pecs RP Dersi, CA (通讯作者)，Petz Aladar Cty Teaching Hosp, Dept Cardiol, 2-4 Vasvari Pal St, H-9024 Gyor, Hungary. EM dcsa62@gmail.com RI Ferenci, Tamás/H-4682-2012; Koszegi, Zsolt/L-1856-2013 OI Ferenci, Tamás/0000-0001-6791-3080; Koszegi, Zsolt/0000-0002-2817-6900 FU New National Excellence Program of the Ministry of Human Capacities [UNKP-17-4-I-OE-779/71] FX T.F. is supported by the UNKP-17-4-I-OE-779/71 New National Excellence Program of the Ministry of Human Capacities. 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Womens Health PD DEC 1 PY 2018 VL 27 IS 12 BP 1491 EP 1498 AR 12 DI 10.1089/jwh.2017.6763 EA OCT 2018 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA HE0UX UT WOS:000447016000001 PM 30307791 DA 2023-05-13 ER PT J AU Farag, M Gorog, DA AF Farag, Mohamed Gorog, Diana A. TI Platelet Function Testing: A Role for Personalised Therapy in Coronary Disease SO CURRENT PHARMACEUTICAL DESIGN LA English DT Review DE Platelet function tests; platelet reactivity; thrombosis; bleeding; individualized antiplatelet therapy; cardiovascular risk ID ELEVATION MYOCARDIAL-INFARCTION; CLOPIDOGREL-TREATED PATIENTS; PATIENTS SHOWING RESISTANCE; ASPIRIN AND/OR RESISTANCE; GLOBAL THROMBOSIS TEST; OF-CARE ASSAY; ADENOSINE-DIPHOSPHATE; ANTIPLATELET THERAPY; WHOLE-BLOOD; CARDIOVASCULAR EVENTS AB Whilst there exist general guidelines regarding administration of antiplatelet therapy to prevent thrombotic events in patients with cardiovascular disease, the optimal therapy for a particular individuals in particular settings remains unclear. For patients with acute coronary syndrome (ACS) or those undergoing percutaneous coronary intervention (PCI), the use of potent antiplatelet agent combinations is recommended. However, some patients continue to have thrombotic events or experience bleeding events, which have been linked to the widely known variability in individual response to antiplatelet therapy, particularly to clopidogrel. Platelet function tests (PFTs) have been used in an attempt to predict ongoing thrombotic risk and to monitor the response to antiplatelet drugs. Although the cause of both thrombotic and bleeding events is multifactorial in origin, the observation that enhanced platelet reactivity is associated with recurrent thrombosis and reduced platelet reactivity with bleeding has raised hopes of identifying those at risk through the use of PFTs. Consequently, there was initial enthusiasm for the use of PFTs to guide individualized antiplatelet therapy. Few studies have been conducted, but the alteration of treatment based on the results of PFTs has not been shown to influence outcomes. Inherent limitations of the studies utilizing PFTs may indeed have contributed to the failure of this approach. Further, there are important limitations to the relevance of currently available PFTs to the in vivo situation. Refinement of existing techniques to allow the use of native blood, high shear, use of a global stimulus instead of individual agonists, assessment of thrombin generation by activated platelets, and assessment of fibrinolytic potential, should be considered to make these tests more physiological. Perhaps the results of PFTs need to be considered in combination with other prognostic factors in a more complex prediction model. The present manuscript provides an overview on the role of and value of available PFTs in contemporary clinical practice, with particular focus on possible individualized antiplatelet regimens in high risk patients. C1 [Farag, Mohamed; Gorog, Diana A.] Univ Hertfordshire, Postgrad Med Sch, Hatfield, Herts, England. [Gorog, Diana A.] Imperial Coll, Natl Heart & Lung Inst, London, England. C3 University of Hertfordshire; RLUK- Research Libraries UK; Imperial College London RP Gorog, DA (通讯作者)，Imperial Coll, London, England. EM d.gorog@imperial.ac.uk RI Farag, Mohamed/X-1076-2019 OI Farag, Mohamed/0000-0003-0811-7679; Gorog, Diana/0000-0002-9286-1451 FU Thromboquest Ltd FX DAG has no conflicts of interest to disclose pertaining to this manuscript. DAG is related to a company director of Thromboquest Ltd., manufacturer of the Global Thrombosis Test, but she, her spouse, and her children have no financial involvement or equity interest in, and have received no financial assistance, support, or grants from Thromboquest Ltd. MF has no conflicts to disclose. 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DOI 10.3109/09537104.2013.849804 Wurtz M, 2012, THROMB RES, V130, P753, DOI 10.1016/j.thromres.2012.08.312 Yamamoto J, 2014, THROMB RES, V133, P919, DOI 10.1016/j.thromres.2014.02.018 NR 146 TC 4 Z9 4 U1 0 U2 6 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y-2, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1381-6128 EI 1873-4286 J9 CURR PHARM DESIGN JI Curr. Pharm. Design PY 2017 VL 23 IS 9 BP 1315 EP 1327 DI 10.2174/1381612823666170126160359 PG 13 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA ET7ZJ UT WOS:000400517700006 PM 28137225 DA 2023-05-13 ER PT J AU Sacks, JH Flueckiger, PB Spandorfer, PR Mahle, WT Costello, BE AF Sacks, Jeffrey H. Flueckiger, Peter B. Spandorfer, Philip R. Mahle, William T. Costello, Brian E. TI Adult Chest Pain in the Pediatric Emergency Department: Treatment and Timeliness From Door In To Door Out SO PEDIATRIC EMERGENCY CARE LA English DT Article DE standard of care; cardiology; chest pain ID ELEVATION MYOCARDIAL-INFARCTION; QUALITY-OF-CARE; SCIENTIFIC STATEMENT; OUTCOMES RESEARCH; 2007 GUIDELINES; MANAGEMENT; PATIENT; IMPLEMENTATION; COUNCIL; BLOCK AB Objectives The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. Methods Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012. Patients older than 18 years with a diagnosis suggestive of ACS and an initial ECG interpretation were identified. Proportions of patients receiving ASA were calculated as well as median times to ECG and DIDO. Bivariate analysis of ECG and DIDO time and the proportion of the patients receiving ASA was conducted for ECG findings positive and negative for ACS. Results One hundred thirteen patients were identified. Aspirin was administered in 69% of eligible cases. Electrocardiogram and DIDO times met recommended intervals in 42% (median, 12 minutes) and 5% (median, 59 minutes) of the patients, respectively. No significant differences between positive (22% of total) and negative (78% of total) ECG findings groups were detected in median DIDO time (57 vs 59 minutes, P = 0.99), time to ECG (14 vs 12 minutes, P = 0.45), or the proportion receiving ASA (84% vs 64%, P = 0.08). Conclusions Despite the use of an emergency department protocol, compliance with the American College of Cardiology Foundation/American Heart Association guidelines for adults with suspected ACS remained challenging at this pediatric center. The ECG findings did not seem to impact ASA administration, ECG time, or DIDO time. C1 [Sacks, Jeffrey H.; Mahle, William T.; Costello, Brian E.] Emory Univ, Sch Med, Dept Pediat, 2835 Brandywine Rd 300, Atlanta, GA 30341 USA. [Sacks, Jeffrey H.; Mahle, William T.] Childrens Healthcare Atlanta, Sibley Heart Ctr, 2835 Brandywine Rd 300, Atlanta, GA 30341 USA. [Flueckiger, Peter B.] Wake Forest Univ, Dept Med, Winston Salem, NC USA. [Spandorfer, Philip R.; Costello, Brian E.] Emory Univ, Childrens Healthcare Atlanta, Emergency Serv, Sch Med, Atlanta, GA 30341 USA. [Spandorfer, Philip R.] Emory Univ, Sch Med, Pediat Emergency Med Associates, Atlanta, GA 30341 USA. [Costello, Brian E.] Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA 30341 USA. C3 Emory University; Children's Healthcare of Atlanta (CHOA); Wake Forest University; Children's Healthcare of Atlanta (CHOA); Emory University; Emory University; Emory University RP Sacks, JH (通讯作者)，Emory Univ, Sch Med, Dept Pediat, 2835 Brandywine Rd 300, Atlanta, GA 30341 USA.; Sacks, JH (通讯作者)，Childrens Healthcare Atlanta, Sibley Heart Ctr, 2835 Brandywine Rd 300, Atlanta, GA 30341 USA. EM jhsacks@gmail.com CR Achar SA, 2005, AM FAM PHYSICIAN, V72, P119 Anderson JL, 2013, J AM COLL CARDIOL, V61, pE179, DOI 10.1016/j.jacc.2013.01.014 Anderson JL, 2011, J AM COLL CARDIOL, V57, pE215, DOI 10.1016/j.jacc.2011.02.011 BAKER MD, 1993, ANN EMERG MED, V22, P1136, DOI 10.1016/S0196-0644(05)80978-3 Bourgeois FT, 2003, PEDIATRICS, V111, P1268, DOI 10.1542/peds.111.6.1268 Di Chiara A, 2006, EUR HEART J, V27, P1, DOI 10.1093/eurheartj/ehi622 Gibler WB, 2005, CIRCULATION, V111, P2699, DOI 10.1161/01.CIR.0000165556.44271.BE GUPTA MC, 1978, ANGIOLOGY, V29, P749, DOI 10.1177/000331977802901005 Haywood LJ, 2005, J AM COLL CARDIOL, V46, P39, DOI 10.1016/j.jacc.2005.04.002 Kibar CR, 2006, PEDIATR EMERG CARE, V22, P321, DOI 10.1097/01.pec.0000215140.36662.29 O'Gara PT, 2013, CIRCULATION, V127, pE362, DOI 10.1161/CIR.0b013e3182742cf6 Rhine T, 2012, PEDIATR EMERG CARE, V28, P141, DOI 10.1097/PEC.0b013e3182442d9c Schmitt J, 2009, EUR HEART J, V30, P1038, DOI 10.1093/eurheartj/ehn579 Ting HH, 2008, CIRCULATION, V118, P1066, DOI 10.1161/CIRCULATIONAHA.108.190402 NR 14 TC 1 Z9 1 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0749-5161 EI 1535-1815 J9 PEDIATR EMERG CARE JI Pediatr. Emerg. Care PD NOV PY 2017 VL 33 IS 11 BP 740 EP 744 DI 10.1097/PEC.0000000000001081 PG 5 WC Emergency Medicine; Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine; Pediatrics GA FM6AX UT WOS:000415128500017 PM 28328689 DA 2023-05-13 ER PT J AU White, WB Heller, SR Cannon, CP Howitt, H Khunti, K Bergenstal, RM AF White, William B. Heller, Simon R. Cannon, Christopher P. Howitt, Heena Khunti, Kamlesh Bergenstal, Richard M. CA EXAMINE Investigators TI Alogliptin in Patients with Type 2 Diabetes Receiving Metformin and Sulfonylurea Therapies in the EXAMINE Trial SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Alogliptin; Cardiovascular disease; Diabetes; Hypoglycemia; Metformin; Sulphonylurea ID FOLLOW-UP; OUTCOMES; SAFETY AB BACKGROUND: We evaluated the antihyperglycemic efficacy and safety of adding the dipeptidyl dipeptidase-4 inhibitor alogliptin to metformin and sulphonylurea in the treatment of type 2 diabetes in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care Trial. METHODS: Patients with type 2 diabetes and recent acute coronary syndrome were randomized to alogliptin or placebo and standard of care. Participants were followed for up to 40 (median 18) months. In a subgroup taking metformin and sulphonylurea at baseline, we evaluated change from baseline in glycated hemoglobin (HbA1c), adverse events, cardiovascular outcomes, laboratory data, and other safety parameters. RESULTS: There were 1398 patients receiving baseline dual therapy (metformin and sulphonylurea only) randomized to alogliptin (N = 693) or placebo (N = 705); 550 patients receiving alogliptin and 505 patients receiving placebo completed the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care without addition of other antihyperglycemic therapies (P =.008). Changes from baseline to last visit in HbA1c were -0.4% on alogliptin and +0.1% on placebo (P <.001) in all those with baseline dual therapy and -0.4% for alogliptin and +0.2% for placebo (P <.001) in those without additional therapies. Reported rates of hypoglycemia were 8.8% for alogliptin and 6.7% for placebo (P =.16). Cardiovascular death and all-cause mortality rates were lower in those receiving alogliptin compared with those receiving placebo (hazard ratio, 0.49; 95% confidence interval, 0.28-0.84 and hazard ratio, 0.61; 95% confidence interval, 0.38-0.96, respectively). CONCLUSIONS: Addition of the dipeptidyl peptidase-4 inhibitor alogliptin to dual therapy with metformin plus sulfonylurea significantly reduced HbA1c and was well tolerated. Lower mortality rates were seen in patients treated with alogliptin in this subgroup. (C) 2018 Elsevier Inc. All rights reserved. C1 [White, William B.] Univ Connecticut, Sch Med, Calhoun Cardiol Ctr, Farmington, CT 06030 USA. [Heller, Simon R.] Univ Sheffield, Sheffield, S Yorkshire, England. [Cannon, Christopher P.] Baim Inst Clin Res, Boston, MA USA. [Howitt, Heena] Takeda UK Ltd, Wooburn Green, England. [Khunti, Kamlesh] Univ Leicester, Diabet Res Ctr, Leicester, Leics, England. [Bergenstal, Richard M.] Pk Nicollet Clin, Int Diabet Ctr, Minneapolis, MN USA. C3 University of Connecticut; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Sheffield; RLUK- Research Libraries UK; University of Leicester; International Diabetes Center RP White, WB (通讯作者)，Univ Connecticut, Sch Med, Calhoun Cardiol Ctr, Farmington, CT 06030 USA. EM wwhite@uchc.edu RI /GQB-2573-2022; Cannon, Christopher P/AAY-7644-2020; Nikolaev, Konstantin/P-4750-2017; /ABC-9527-2021 OI Cannon, Christopher P/0000-0003-4596-2791; Nikolaev, Konstantin/0000-0003-4601-6203; Heller, Simon/0000-0002-2425-9565; Costa Duarte Barbosa, Eduardo/0000-0002-4361-936X; Khunti, Kamlesh/0000-0003-2343-7099 FU Takeda Pharmaceuticals, Inc.; Grants-in-Aid for Scientific Research [17K09562] Funding Source: KAKEN FX Takeda Pharmaceuticals, Inc. CR Cahn A, 2016, DIABETES CARE, V39, P1329, DOI 10.2337/dc15-2763 Engel SS, 2017, DIABETES OBES METAB, V19, P1587, DOI 10.1111/dom.12983 Holman RR, 2008, NEW ENGL J MED, V359, P1577, DOI 10.1056/NEJMoa0806470 Holman RR, 2008, NEW ENGL J MED, V359, P1565, DOI 10.1056/NEJMoa0806359 Kay S, 2017, DIABETES THER, V8, P251, DOI 10.1007/s13300-017-0245-8 Khunti K, 2013, DIABETES CARE, V36, P3411, DOI 10.2337/dc13-0331 National Institute for Health and Care Excellence (NICE), TYP 2 DIAB AD MAN NG Salvo F, 2016, BMJ-BRIT MED J, V353, DOI 10.1136/bmj.i2231 Scirica BM, 2013, NEW ENGL J MED, V369, P1317, DOI 10.1056/NEJMoa1307684 White WB, 2013, NEW ENGL J MED, V369, P1327, DOI 10.1056/NEJMoa1305889 White WB, 2011, AM HEART J, V162, P620, DOI 10.1016/j.ahj.2011.08.004 NR 11 TC 12 Z9 14 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 EI 1555-7162 J9 AM J MED JI Am. J. Med. PD JUL PY 2018 VL 131 IS 7 BP 813 EP + DI 10.1016/j.amjmed.2018.02.023 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA GK9NC UT WOS:000436577000035 PM 29581078 DA 2023-05-13 ER PT J AU Kulchaitanaroaj, P Brooks, JM Chaiyakunapruk, N Goedken, AM Chrischilles, EA Carter, BL AF Kulchaitanaroaj, Puttarin Brooks, John M. Chaiyakunapruk, Nathorn Goedken, Amber M. Chrischilles, Elizabeth A. Carter, Barry L. TI Cost-utility analysis of physician-pharmacist collaborative intervention for treating hypertension compared with usual care SO JOURNAL OF HYPERTENSION LA English DT Article DE cardiovascular diseases; cost-effectiveness; cost-utility; hypertension; physician-pharmacist collaboration; quality-adjusted life years; team-based care ID CLUSTER-RANDOMIZED-TRIAL; BLOOD-PRESSURE CONTROL; HEART-FAILURE; MEDICARE BENEFICIARIES; AMERICAN-COLLEGE; TASK-FORCE; STROKE; RISK; MANAGEMENT; MORTALITY AB Objective: To estimate long-term costs and outcomes attributable to a physician-pharmacist collaborative intervention compared with physician management alone for treating essential hypertension. Methods: A Markov model cohort simulation with a 6-month cycle length to predict acute coronary syndrome, stroke, and heart failure throughout lifetime was performed. A cohort of 399 patients was obtained from two prospective, cluster randomized controlled clinical trials implementing physician-pharmacist collaborative interventions in community-based medical offices in the Midwest, USA. Framingham risk equations and other algorithms were used to predict the vascular diseases. SBP reduction due to the interventions deteriorated until 5 years. Direct medical costs using a payer perspective were adjusted to 2015 dollar value, and the main outcome was quality-adjusted life years (QALYs); both were discounted at 3%. The intervention costs were estimated from the trials, whereas the remaining parameters were from published studies. A series of sensitivity analyses including changing patient risks of vascular diseases, probabilistic sensitivity analysis, and a cost-effectiveness acceptability curve were performed. Results: The lifetime incremental costs were $26 807.83 per QALY (QALYs gained = 0.14). The intervention provided the greatest benefit for the high-risk patients, moderate benefit for the trial patients, and the lowest benefit for the low-risk patients. If a payer is willing to pay $ 50 000 per QALY gained, in 48.6% of the time the intervention would be cost-effective. Conclusion: Team-based care such as a physician-pharmacist collaboration appears to be a cost-effective strategy for treating hypertension. The intervention is most cost-effective for high-risk patients. C1 [Kulchaitanaroaj, Puttarin; Goedken, Amber M.; Carter, Barry L.] Univ Iowa, Coll Pharm, Dept Pharm Practice & Sci, Iowa City, IA 52242 USA. [Kulchaitanaroaj, Puttarin] Brunel Univ London, Coll Hlth & Life Sci, Dept Life Sci, HERG, Uxbridge, Middx, England. [Brooks, John M.] Univ South Carolina, Dept Hlth Serv Policy & Management, Arnold Sch Publ Hlth, Columbia, SC USA. [Chaiyakunapruk, Nathorn] Monash Univ Malaysia, Sch Pharm, Subang Jaya, Selangor, Malaysia. [Chaiyakunapruk, Nathorn] Naresuan Univ, Dept Pharm Practice, Fac Pharmaceut Sci, CPOR, Phitsanulok, Thailand. [Chaiyakunapruk, Nathorn] Univ Wisconsin, Sch Pharm, 425 N Charter St, Madison, WI 53706 USA. [Chaiyakunapruk, Nathorn] Univ Queensland, Sch Populat Hlth, Brisbane, Qld, Australia. [Chrischilles, Elizabeth A.] Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Iowa City, IA USA. C3 University of Iowa; Brunel University; University of South Carolina System; University of South Carolina Columbia; Monash University; Monash University Sunway; Naresuan University; University of Wisconsin System; University of Wisconsin Madison; University of Queensland; University of Iowa RP Kulchaitanaroaj, P (通讯作者)，Univ Iowa, Coll Pharm, Dept Pharm Practice & Sci, Iowa City, IA 52242 USA. EM puttarin-kulchaitanaroaj@uiowa.edu RI Brooks, John/R-3585-2019; Goedken, Amber Marie/AAV-5800-2020; Brooks, John/HLW-2505-2023 OI Goedken, Amber Marie/0000-0001-6749-1471; Brooks, John/0000-0001-7365-4417; Chaiyakunapruk, Nathorn/0000-0003-4572-8794 CR Agarwal SK, 2012, CIRC-HEART FAIL, V5, P422, DOI 10.1161/CIRCHEARTFAILURE.111.964841 Ammar KA, 2007, CIRCULATION, V115, P1563, DOI 10.1161/CIRCULATIONAHA.106.666818 Bassand JP, 2007, EUR HEART J, V28, P1598, DOI 10.1093/eurheartj/ehm161 Battes L, 2013, AM J CARDIOL, V112, P27, DOI 10.1016/j.amjcard.2013.02.049 Berlowitz DR, 1998, NEW ENGL J MED, V339, P1957, DOI 10.1056/NEJM199812313392701 Braunschweig F, 2011, EUROPACE, V13, pII13, DOI 10.1093/europace/eur081 Brown TM, 2015, AM HEART J, V170, P249, DOI 10.1016/j.ahj.2015.04.027 Carter BL, 2008, J CLIN HYPERTENS, V10, P260, DOI 10.1111/j.1751-7176.2008.07434.x Carter BL, 2015, CIRC-CARDIOVASC QUAL, V8, P235, DOI 10.1161/CIRCOUTCOMES.114.001283 Carter BL, 2012, J CLIN HYPERTENS, V14, P51, DOI 10.1111/j.1751-7176.2011.00542.x Carter BL, 2010, PHARMACOTHERAPY, V30, P228, DOI 10.1592/phco.30.3.228 Carter BL, 2009, ARCH INTERN MED, V169, P1996, DOI 10.1001/archinternmed.2009.358 Chen J, 2011, JAMA-J AM MED ASSOC, V306, P1669, DOI 10.1001/jama.2011.1474 Chen SY, 2013, CLINICOECONOMIC OUTC, V5, P181, DOI 10.2147/CEOR.S43672 Chobanian AV, 2003, HYPERTENSION, V42, P1206, DOI 10.1161/01.HYP.0000107251.49515.c2 D'Agostino RB, 2008, CIRCULATION, V117, P743, DOI 10.1161/CIRCULATIONAHA.107.699579 D'Agostino RB, 2000, AM HEART J, V139, P272, DOI 10.1016/S0002-8703(00)90236-9 Demaerschalk BM, 2010, AM J MANAG CARE, V16, P525 Desai M, 2006, AAPS J, V8, pE146, DOI 10.1208/aapsj080117 Diener HC, 2005, EXPERT OPIN PHARMACO, V6, P755, DOI 10.1517/14656566.6.5.755 Garg JP, 2005, AM J HYPERTENS, V18, P619, DOI 10.1016/j.amjhyper.2004.11.021 Go AS, 2014, CIRCULATION, V129, pE28, DOI 10.1161/01.cir.0000441139.02102.80 Godwin KM, 2011, TOP STROKE REHABIL, V18, P676, DOI 10.1310/tsr18s01-676 Goldberg RJ, 2005, AM J MED, V118, P728, DOI 10.1016/j.amjmed.2005.04.013 H-CUP Projections, 2012, CARD CER COND PROC 2 Houle SKD, 2014, CURR OPIN CARDIOL, V29, P344, DOI 10.1097/HCO.0000000000000071 Houle SKD, 2012, PHARMACOTHERAPY, V32, P527, DOI 10.1002/j.1875-9114.2012.01097.x Hyman DJ, 2001, NEW ENGL J MED, V345, P479, DOI 10.1056/NEJMoa010273 Jessup M., 2010, CARDIOVASCULAR MED H Kim BJ, 2010, VASCULAR SYSTEM STRO Korves Caroline, 2012, J Med Econ, V15, P925, DOI 10.3111/13696998.2012.685136 Krumholz HM, 2000, AM HEART J, V139, P72, DOI 10.1016/S0002-8703(00)90311-9 Kulchaitanaroaj P, 2015, RES SOC ADMIN PHARM, V11, pE69, DOI 10.1016/j.sapharm.2014.07.007 Kulchaitanaroaj P, 2012, PHARMACOTHERAPY, V32, P772, DOI 10.1002/j.1875-9114.2012.01103.x Lee WC, 2007, ADV THER, V24, P258, DOI 10.1007/BF02849893 Leonardi-Bee J, 2002, STROKE, V33, P1315, DOI 10.1161/01.STR.0000014509.11540.66 National Center for Health Statistics, 2013, MORT MULT CAUS MICR National Heart Lung and Blood Institute, 2014, QUAL ASS TOOL OBS CO Norton C, 2011, PROG CARDIOVASC DIS, V54, P78, DOI 10.1016/j.pcad.2011.04.002 Oliveria SA, 2002, ARCH INTERN MED, V162, P413, DOI 10.1001/archinte.162.4.413 Polgreen LA, 2015, HYPERTENSION, V66, P1145, DOI 10.1161/HYPERTENSIONAHA.115.06023 Porter R, 2011, MERCK MANUAL DIAGNOS, pChapter 210 Rajan KB, 2014, STROKE, V45, P2563, DOI 10.1161/STROKEAHA.114.005143 Santschi V, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.113.000718 Shiroiwa T, 2010, HEALTH ECON, V19, P422, DOI 10.1002/hec.1481 Siegel JE, 1997, PHARMACOECONOMICS, V11, P159, DOI 10.2165/00019053-199711020-00005 SONNENBERG FA, 1993, MED DECIS MAKING, V13, P322, DOI 10.1177/0272989X9301300409 Sullivan PW, 2006, MED DECIS MAKING, V26, P401, DOI 10.1177/0272989X06290496 Sullivan PW, 2005, MED CARE, V43, P736, DOI 10.1097/01.mlr.0000172050.67085.4f System AHCCC, 2015, PHYS FEE SCHED Von Muenster SJ, 2008, PHARM WORLD SCI, V30, P128, DOI 10.1007/s11096-007-9155-6 Wentzlaff DM, 2011, J CLIN HYPERTENS, V13, P431, DOI 10.1111/j.1751-7176.2011.00435.x Yancy CW, 2013, J AM COLL CARDIOL, V62, pE147, DOI 10.1016/j.jacc.2013.05.019 Yu JH, 2013, J MANAGE CARE PHARM, V19, P102, DOI 10.18553/jmcp.2013.19.2.102 Zuckerman S, 2012, MUCH WILL MED PHYS F NR 55 TC 21 Z9 22 U1 0 U2 16 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0263-6352 EI 1473-5598 J9 J HYPERTENS JI J. Hypertens. PD JAN PY 2017 VL 35 IS 1 BP 178 EP 187 DI 10.1097/HJH.0000000000001126 PG 10 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EF3SG UT WOS:000390244100026 PM 27684354 DA 2023-05-13 ER PT J AU Liu, CH Wei, YC Lin, JR Chang, CH Chang, TY Huang, KL Chang, YJ Ryu, SJ Lin, LC Lee, TH AF Liu, Chi-Hung Wei, Yi-Chia Lin, Jr-Rung Chang, Chien-Hung Chang, Ting-Yu Huang, Kuo-Lun Chang, Yeu-Jhy Ryu, Shan-Jin Lin, Leng-Chieh Lee, Tsong-Hai CA Stroke Registry Chang Healthcare TI Initial blood pressure is associated with stroke severity and is predictive of admission cost and one-year outcome in different stroke subtypes: a SRICHS registry study SO BMC NEUROLOGY LA English DT Article DE Blood pressure; Stroke; Ischemia; Hemorrhage; Cost; Outcome ID ACUTE INTRACEREBRAL HEMORRHAGE; ACUTE CORONARY SYNDROMES; ACUTE ISCHEMIC-STROKE; LENGTH-OF-STAY; CARDIOVASCULAR EVENTS; SHAPED RELATIONSHIP; CLINICAL-OUTCOMES; CARE PATIENTS; ACUTE-PHASE; MORTALITY AB Background: To investigate if initial blood pressure (BP) on admission is associated with stroke severity and predictive of admission costs and one-year-outcome in acute ischemic (IS) and hemorrhagic stroke (HS). Methods: This is a single-center retrospective cohort study. Stroke patients admitted within 3 days after onset between January 1st and December 31st in 2009 were recruited. The initial BP on admission was subdivided into high (systolic BP >= 211 mmHg or diastolic BP >= 111 mmHg), medium (systolic BP 111-210 mmHg or diastolic BP 71-110 mmHg), and low (systolic BP <= 110 mmHg or diastolic BP <= 70 mmHg) groups and further subgrouped with 25 mmHg difference in systole and 10 mmHg difference in diastole for the correlation analysis with demographics, admission cost and one-year modified Rankin scale (mRS). Results: In 1173 IS patients (mean age: 67.8 +/- 12.8 years old, 61.4 % male), low diastolic BP group had higher frequency of heart disease (p = 0.001), dehydration (p = 0.03) and lower hemoglobin level (p < 0.001). The extremely high and low systolic BP subgroups had worse National Institutes of Health Stroke Scale (NIHSS) score (p = 0.03), higher admission cost (p < 0.001), and worse one-year mRS (p = 0.03), while extremely high and low diastolic BP subgroups had higher admission cost (p < 0.01). In 282 HS patients (mean age: 62.4 +/- 15.4 years old, 60.6 % male), both low systolic and diastolic BP groups had lower hemoglobin level (systole: p = 0.05; diastole: p < 0.001). The extremely high and low BP subgroups had worse NIHSS score (p = 0.01 and p < 0.001, respectively), worse one-year mRS (p = 0.002 and p = 0.001, respectively), and higher admission cost (diastole: p < 0.002). Conclusions: Stroke patients with extremely high and low BP on admission have not only worse stroke severity but also higher admission cost and/or worse one-year outcome. In those patients with low BP, low admission hemoglobin might be a contributing factor. C1 [Liu, Chi-Hung; Chang, Chien-Hung; Chang, Ting-Yu; Huang, Kuo-Lun; Chang, Yeu-Jhy; Ryu, Shan-Jin; Lee, Tsong-Hai] Chang Gung Univ, Linkou Med Ctr, Chang Gung Mem Hosp, Stroke Ctr, 5 Fu Hsing St, Taoyuan 33333, Taiwan. [Liu, Chi-Hung; Chang, Chien-Hung; Chang, Ting-Yu; Huang, Kuo-Lun; Chang, Yeu-Jhy; Ryu, Shan-Jin; Lee, Tsong-Hai] Chang Gung Univ, Linkou Med Ctr, Chang Gung Mem Hosp, Dept Neurol, 5 Fu Hsing St, Taoyuan 33333, Taiwan. [Liu, Chi-Hung; Chang, Chien-Hung; Chang, Ting-Yu; Huang, Kuo-Lun; Chang, Yeu-Jhy; Ryu, Shan-Jin; Lee, Tsong-Hai] Chang Gung Univ, Coll Med, 5 Fu Hsing St, Taoyuan 33333, Taiwan. [Liu, Chi-Hung] Chang Gung Univ, Coll Med, Div Med Educ, Grad Inst Clin Med Sci, Taoyuan 33333, Taiwan. [Wei, Yi-Chia] Keelung Chang Gung Mem Hosp, Dept Neurol, Keelung, Taiwan. [Lin, Jr-Rung] Chang Gung Univ, Clin Informat & Med Stat Res Ctr, Taoyuan 33333, Taiwan. [Chang, Chien-Hung] Chang Gung Univ, Coll Engn, Dept Elect Engn, Taoyuan 33333, Taiwan. [Lin, Leng-Chieh] Chiayi Chang Gung Mem Hosp, Dept Emergency Med, Chiayi, Taiwan. C3 Chang Gung Memorial Hospital; Chang Gung University; Chang Gung Memorial Hospital; Chang Gung University; Chang Gung Memorial Hospital; Chang Gung University; Chang Gung University; Chang Gung Memorial Hospital; Chang Gung University; Chang Gung University; Chang Gung Memorial Hospital RP Lee, TH (通讯作者)，Chang Gung Univ, Linkou Med Ctr, Chang Gung Mem Hosp, Stroke Ctr, 5 Fu Hsing St, Taoyuan 33333, Taiwan.; Lee, TH (通讯作者)，Chang Gung Univ, Linkou Med Ctr, Chang Gung Mem Hosp, Dept Neurol, 5 Fu Hsing St, Taoyuan 33333, Taiwan.; Lee, TH (通讯作者)，Chang Gung Univ, Coll Med, 5 Fu Hsing St, Taoyuan 33333, Taiwan. EM thlee@adm.cgmh.org.tw RI Lin, Jr-Rung/AGS-4743-2022 OI Lin, Jr-Rung/0000-0002-8522-6601; Chang, Ting-Yu/0000-0003-4642-7352; Wei, Yi-Chia/0000-0001-6085-3134 FU Chang Gung Memorial Hospital [CMRPG35072, 35073, 39082, 39083, CMRPG3B0611, CMPRG3A0352, CMRPG3B0111] FX We thank Chang Gung Memorial Hospital for financial support under medical research contract nos. CMRPG35072, 35073, 39082, 39083, CMRPG3B0611, CMPRG3A0352, and CMRPG3B0111. 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PD FEB 29 PY 2016 VL 16 AR 27 DI 10.1186/s12883-016-0546-y PG 8 WC Clinical Neurology WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology GA DF3SL UT WOS:000371267700001 PM 26923538 OA Green Published, gold DA 2023-05-13 ER PT J AU Erkens, R Wernly, B Masyuk, M Muessig, JM Franz, M Schulze, PC Lichtenauer, M Kelm, M Jung, C AF Erkens, Ralf Wernly, Bernhard Masyuk, Maryna Muessig, Johanna M. Franz, Marcus Schulze, Paul Christian Lichtenauer, Michael Kelm, Malte Jung, Christian TI Admission Body Temperature in Critically Ill Patients as an Independent Risk Predictor for Overall Outcome SO MEDICAL PRINCIPLES AND PRACTICE LA English DT Article DE Admission body temperature; Risk stratification; Risk predictor; Critically ill patients; Prognostication; Intensive care unit ID INTENSIVE-CARE-UNIT; SEPTIC SHOCK; HYPOTHERMIA; FEVER; MORTALITY; SEPSIS; MANAGEMENT AB Introduction: Body temperature (BT) abnormalities are frequently observed in critically ill patients. We aimed to assess admission BT in a heterogeneous critically ill patient population admitted to an intensive care unit (ICU) as a prognostic parameter for intra-ICU and long-term mortality. Methods: A total of 6,514 medical patients (64 +/- 15 years) admitted to a German ICU between 2004 and 2009 were included. A follow-up of patients was performed retrospectively. The association of admission BT with both intra-ICU and long-term mortality was investigated by logistic regression. Results: Patients with hypothermia (<36 degrees C BT) were clinically worse and had more pronounced signs of multi-organ failure. Admission BT was associated with adverse overall outcome, with a 2-fold increase for hyperthermia (mortality 12%; odds ratio [OR] 1.80, 95% confidence interval [CI] 1.43-2.26; p < 0.001), and a 4-fold increase for the risk of hypothermia (mortality 24%; OR 4.05, 95% CI 3.38-4.85; p < 0.001) with respect to intra-ICU and long-term mortality. Moreover, hypothermia was even more harmful than hyperthermia, and both were strongly associated with intra-ICU mortality, especially in patients admitted with acute coronary syndrome (hypothermia: hazard ratio 6.12, 95% CI 4.12-9.11; p < 0.001; hyperthermia: OR 2.70, 95% CI 1.52-4.79; p< 0.001). Conclusion: Admission BT is an independent risk predictor for both overall intra-ICU and long-term mortality in critically ill patients admitted to an ICU. Therefore, BT at admission might not only serve as a parameter for individual risk stratification but can also influence individual therapeutic decision-making. C1 [Erkens, Ralf; Masyuk, Maryna; Muessig, Johanna M.; Kelm, Malte; Jung, Christian] Heinrich Heine Univ Dusseldorf, Fac Med, Div Cardiol Pulmonol & Vasc Med, Moorenstr 5, DE-40225 Dusseldorf, Germany. [Erkens, Ralf; Masyuk, Maryna; Muessig, Johanna M.; Kelm, Malte; Jung, Christian] Heinrich Heine Univ Dusseldorf, Fac Med, Cardiovasc Res Inst Dusseldorf, CARID, Dusseldorf, Germany. [Wernly, Bernhard; Lichtenauer, Michael] Paracelsus Med Univ Salzburg, Clin Internal Med 2, Dept Cardiol, Salzburg, Austria. [Franz, Marcus; Schulze, Paul Christian] Jena Univ Hosp, Clin Internal Med 1, Dept Cardiol, Jena, Germany. C3 Heinrich Heine University Dusseldorf; Heinrich Heine University Dusseldorf; Paracelsus Private Medical University; Friedrich Schiller University of Jena RP Jung, C (通讯作者)，Heinrich Heine Univ Dusseldorf, Fac Med, Div Cardiol Pulmonol & Vasc Med, Moorenstr 5, DE-40225 Dusseldorf, Germany. EM christian.jung@med.uni-duesseldorf.de RI Lichtenauer, Michael/H-5139-2019; Schulze, Christian/AGJ-7744-2022; Jung, Christian/AAN-4537-2021; Franz, Marcus/ABA-4688-2021 OI Lichtenauer, Michael/0000-0001-8403-3931; Schulze, Christian/0000-0001-9442-7141; Jung, Christian/0000-0001-8325-250X; Franz, Marcus/0000-0001-6543-4684; Masyuk, Maryna/0000-0003-2856-6893 CR [Anonymous], [No title captured] Bota DP, 2004, INTENS CARE MED, V30, P811, DOI 10.1007/s00134-004-2166-z BRIVET F, 1994, CRIT CARE MED, V22, P533, DOI 10.1097/00003246-199403000-00029 Cheshire WP, 2016, AUTON NEUROSCI-BASIC, V196, P91, DOI 10.1016/j.autneu.2016.01.001 CLEMMER TP, 1992, CRIT CARE MED, V20, P1395, DOI 10.1097/00003246-199210000-00006 den Hartog AW, 2010, CRIT CARE, V14, DOI 10.1186/cc9077 Faizi M, 2014, INJURY, V45, P1942, DOI 10.1016/j.injury.2014.09.024 Goetzenich A, 2009, J CARDIOVASC SURG, V50, P239 Kaplan V, 2002, CRIT CARE MED, V30, P703, DOI 10.1097/00003246-200203000-00037 Kawashima C, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.116.005463 KRAMER MR, 1989, ARCH INTERN MED, V149, P1521, DOI 10.1001/archinte.149.7.1521 Laupland KB, 2008, CRIT CARE MED, V36, P1531, DOI 10.1097/CCM.0b013e318170efd3 Laupland KB, 2012, CRIT CARE MED, V40, P145, DOI 10.1097/CCM.0b013e31822f061d Laupland KB, 2009, CRIT CARE MED, V37, pS273, DOI 10.1097/CCM.0b013e3181aa6117 LEGALL JR, 1993, JAMA-J AM MED ASSOC, V270, P2957, DOI 10.1001/jama.270.24.2957 Lichtenauer M, 2017, INT J MOL SCI, V18, DOI 10.3390/ijms18091893 Masyuk M, 2019, INTENS CARE MED, V45, P1174, DOI 10.1007/s00134-019-05655-5 Moreno RP, 2005, INTENS CARE MED, V31, P1345, DOI 10.1007/s00134-005-2763-5 Nakajima Y, 2016, J ANESTH, V30, P873, DOI 10.1007/s00540-016-2200-7 Parry SM, 2015, INTENS CARE MED, V41, P744, DOI 10.1007/s00134-015-3672-x Payvar S, 2013, EUR J HEART FAIL, V15, P1382, DOI 10.1093/eurjhf/hft113 Remick DG, 2006, FRONT BIOSCI-LANDMRK, V11, P1006, DOI 10.2741/1858 Romanovsky AA, 2007, AM J PHYSIOL-REG I, V292, pR37, DOI 10.1152/ajpregu.00668.2006 Ruborg R, 2017, BMC NEUROL, V17, DOI 10.1186/s12883-017-1002-3 Sunden-Cullberg J, 2017, CRIT CARE MED, V45, P591, DOI 10.1097/CCM.0000000000002249 Theilen H, 2007, ANAESTHESIST, V56, P949, DOI 10.1007/s00101-007-1211-z Wernly B, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0170987 Wunderlich CA., 1871, MED THERMOMETRY HUMA Young PJ, 2019, INTENS CARE MED, V45, P1275, DOI 10.1007/s00134-019-05668-0 Young PJ, 2019, INTENS CARE MED, V45, P468, DOI 10.1007/s00134-019-05553-w Young PJ, 2014, CRIT CARE, V18, DOI 10.1186/cc13773 NR 31 TC 9 Z9 9 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1011-7571 EI 1423-0151 J9 MED PRIN PRACT JI Med. Princ. Pract. PD JUL PY 2020 VL 29 IS 4 BP 389 EP 395 DI 10.1159/000505126 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA PP6JY UT WOS:000605967900012 PM 31786567 OA gold, Green Published DA 2023-05-13 ER PT J AU Fanaroff, AC Chen, ANY van Diepen, S Peterson, ED Wang, TY AF Fanaroff, Alexander C. Chen, Anita Y. van Diepen, Sean Peterson, Eric D. Wang, Tracy Y. TI Association Between Intensive Care Unit Usage and Long-Term Medication Adherence, Mortality, and Readmission Among Initially Stable Patients With Non-ST-Segment-Elevation Myocardial Infarction SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE acute coronary syndrome; healthcare quality; hospital readmission; intensive care unit; medication adherence; non-segment-elevation myocardial infarction ID OUTCOMES; PATTERNS; MANAGEMENT; THERAPIES; ADMISSION; TRANSFERS; INSIGHTS; HEALTH; IMPACT AB Background Hospitals in the United States vary in their use of intensive care units (ICUs) for hemodynamically stable patients with non-ST-segment-elevation myocardial infarction (NSTEMI). The association between ICU use and long-term outcomes after NSTEMI is unknown. Methods and Results Using data from the National Cardiovascular Data Registry linked to Medicare claims, we identified 65 256 NSTEMI patients aged >= 65 years without cardiogenic shock or cardiac arrest on presentation between 2011 and 2014. We compared 1-year medication non-adherence, cardiovascular readmission, and mortality across hospitals by ICU use using multivariable regression models. Among 520 hospitals, 154 (29.6%) were high ICU users (>70% of stable NSTEMI patients admitted to ICU), 270 (51.9%) were intermediate (30%-70%), and 196 (37.7%) were low (<30%). Compared with low ICU usage hospitals, no differences were observed in the risks of 1-year medication non-adherence (adjusted odds ratio 1.08, 95% CI, 0.97-1.21), mortality (adjusted hazard ratio 1.06, 95% CI, 0.98-1.15), and cardiovascular readmission (adjusted hazard ratio 0.99, 95% CI, 0.95-1.04) at high usage hospitals. Patients hospitalized at intermediate ICU usage hospitals had lower rates of evidence-based therapy and diagnostic catheterization within 24 hours of hospital arrival, and higher risks of 1-year mortality (adjusted hazard ratio 1.07, 95% CI, 1.02-1.12) and medication non-adherence (adjusted odds ratio 1.09, 95% CI, 1.02-1.15) compared with low ICU usage hospitals. Conclusions Routine ICU use is unlikely to be beneficial for hemodynamically stable NSTEMI patients; medication adherence, long-term mortality, and cardiovascular readmission did not differ for high ICU usage hospitals compared with hospitals with low ICU usage rates. C1 [Fanaroff, Alexander C.] Univ Penn, Penn Cardiovasc Outcomes Qual & Evaluat Res Ctr, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. [Fanaroff, Alexander C.] Univ Penn, Div Cardiovasc Med, Philadelphia, PA 19104 USA. [Chen, Anita Y.] Univ Rochester, Dept Biostat & Computat Biol, Rochester, NY 14627 USA. [van Diepen, Sean] Univ Alberta, Div Crit Care, Edmonton, AB, Canada. [van Diepen, Sean] Univ Alberta, Div Cardiol, Edmonton, AB, Canada. [Peterson, Eric D.; Wang, Tracy Y.] Duke Univ, Div Cardiol, Durham, NC USA. [Peterson, Eric D.; Wang, Tracy Y.] Duke Univ, Duke Clin Res Inst, Durham, NC USA. C3 University of Pennsylvania; University of Pennsylvania; University of Rochester; University of Alberta; University of Alberta; Duke University; Duke University RP Fanaroff, AC (通讯作者)，Perelman Ctr Adv Med, 3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM alexander.fanaroff@pennmedicine.upenn.edu RI Peterson, Eric David/ABF-5033-2021 OI Fanaroff, Alexander/0000-0002-9060-5307 FU American Heart Association; Duke Clinical Research Institute FX This manuscript was supported by a career development grant from the American Heart Association to Dr Fanaroff, and by internal grants to Dr Fanaroff from the Duke Clinical Research Institute. 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Am. Heart Assoc. PD MAR 17 PY 2020 VL 9 IS 6 AR e015179 DI 10.1161/JAHA.119.015179 PG 21 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KW7GX UT WOS:000521353000023 PM 32174210 OA Green Published, gold DA 2023-05-13 ER PT J AU Hu, HT Xu, S Wang, J Rao, X AF Hu, Hong-tao Xu, Shen Wang, Jing Rao, Xin TI Respiratory Support in Severely or Critically Ill ICU Patients With COVID-19 in Wuhan, China SO CURRENT MEDICAL SCIENCE LA English DT Article DE COVID-19; SARS-CoV-2; acute respiratory distress syndrome; intensive care unit; respiratory support ID CORONAVIRUS OUTBREAK; GLOBAL HEALTH; LUNG INJURY AB This case series aimed to describe the clinical characteristics of severely or critically ill patients with COVID-19 and compare the clinical characteristics of patients who received invasive respiratory support with those of patients who received noninvasive respiratory support. We included all confirmed severe or critical illness cases of COVID-19 admitted to the Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University, a COVID-19-designated hospital, from January 8 to March 12, 2020. Cases were analyzed for epidemiological, demographic, clinical, APACHE II, SOFA, radiological features and laboratory data. Outcomes of all patients were followed up as of March 12, 2020. This newly emerging virus had caused 55 confirmed severe or critical illness cases in ICU of a COVID-19-designated hospital. Most of the infected patients were men; more than half had underlying diseases, including hypertension, coronary artery disease and diabetes. The median age was 63 years old. Common symptoms at onset of illness were fever, fatigue and dry cough. Five (9.1%) hospitalized patients were presumed to have been infected in the hospital, and 4 (7.3%) health care workers were infected in their work. Of the 55 confirmed severe or critical illness cases, 10 (18.2%) patients died during the follow-up period as of March 12 with the median follow-up period of 28 days (interquartile range 16-35). Nine patients received VV-ECMO for severe respiratory failure and 4 (44.4%) patients died. Moreover, 28 patients received invasive respiratory support and 14 (50.0%) patients died. In this single-center study, 55 severely or critically ill ICU patients were confirmed to have COVID-19 in Wuhan and the overall mortality was 29.1%. Totally 28 (50.9%) of severely or critically ill ICU patients received invasive respiratory support and 14 (50.0%) died during the follow-up period. C1 [Hu, Hong-tao; Wang, Jing; Rao, Xin] Wuhan Univ, Dept Crit Care Med, Zhongnan Hosp, Wuhan 430071, Peoples R China. [Xu, Shen] Gen Hosp Yangtze River Shipping, Dept Nephrol, Wuhan 430010, Peoples R China. C3 Wuhan University RP Rao, X (通讯作者)，Wuhan Univ, Dept Crit Care Med, Zhongnan Hosp, Wuhan 430071, Peoples R China. EM huht2014@126.com; snk_xs2016@163.com; raoxin4169@163.com CR Brochard L, 2017, AM J RESP CRIT CARE, V195, P438, DOI 10.1164/rccm.201605-1081CP Brodie D, 2019, JAMA-J AM MED ASSOC, V322, P557, DOI 10.1001/jama.2019.9302 Chan JFW, 2020, LANCET, V395, P514, DOI 10.1016/S0140-6736(20)30154-9 Fan E, 2005, JAMA-J AM MED ASSOC, V294, P2889, DOI 10.1001/jama.294.22.2889 Feng ZJ, 2020, CHINA CDC WEEKLY, V2, P113, DOI [10.3760/cma.j.issn.0254-6450.2020.02.003, 10.46234/ccdcw2020.032] Fichtner F, 2019, RESPIRATION, V98, P357, DOI 10.1159/000502157 Huang C, 2020, BIOSENS BIOELECTRON, V395, P497, DOI [DOI 10.1016/J.BIOS.2020.112752, DOI 10.1056/NEJMoa2002032] Hui DS, 2020, INT J INFECT DIS, V91, P264, DOI 10.1016/j.ijid.2020.01.009 Lu HZ, 2020, J MED VIROL, V92, P401, DOI [10.1002/jmv.25678, 10.1002/jmv.2567] Phan LT, 2020, NEW ENGL J MED, V382, P872, DOI 10.1056/NEJMc2001272 Russell CD, 2020, LANCET, V395, P473, DOI 10.1016/S0140-6736(20)30317-2 Slutsky AS, 2013, NEW ENGL J MED, V369, P2126, DOI [10.1056/NEJMra1208707, 10.1056/NEJMc1400293] Song FX, 2020, RADIOLOGY, V295, P210, DOI [10.1148/radiol.2020200274, 10.1148/radiol.2020209021] Wang C, 2020, LANCET, V395, P470, DOI 10.1016/S0140-6736(20)30185-9 Wang DW, 2020, JAMA-J AM MED ASSOC, V323, P1061, DOI 10.1001/jama.2020.1585 Ware LB, 2000, NEW ENGL J MED, V342, P1334, DOI 10.1056/NEJM200005043421806 Xu Z, 2020, LANCET RESP MED, V8, P420, DOI 10.1016/S2213-2600(20)30076-X Yang X, 2020, CRIT CARE MED, V48, P1289, DOI 10.1097/CCM.0000000000004447 Zhu N, 2020, NEW ENGL J MED, V382, P727, DOI 10.1056/NEJMoa2001017 NR 19 TC 8 Z9 8 U1 0 U2 3 PU SPRINGER PI NEW YORK PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES SN 2096-5230 EI 2523-899X J9 CURR MED SCI JI Curr. Med. Sci. PD AUG PY 2020 VL 40 IS 4 BP 636 EP 641 DI 10.1007/s11596-020-2227-8 EA AUG 2020 PG 6 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA NF9YT UT WOS:000557124300003 PM 32767265 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Jentzer, JC Kashou, AH Attia, ZI Lopez-Jimenez, F Kapa, S Friedman, PA Noseworthy, PA AF Jentzer, Jacob C. Kashou, Anthony H. Attia, Zachi I. Lopez-Jimenez, Francisco Kapa, Suraj Friedman, Paul A. Noseworthy, Peter A. TI Left ventricular systolic dysfunction identification using artificial intelligence-augmented electrocardiogram in cardiac intensive care unit patients SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Electrocardiogram; Artificial intelligence; Left ventricular dysfunction; Echocardiography; Cardiac intensive care unit ID ASSOCIATION TASK-FORCE; ELEVATION MYOCARDIAL-INFARCTION; 2013 ACCF/AHA GUIDELINE; AMERICAN-COLLEGE; ST-ELEVATION; MANAGEMENT; SOCIETY; DISEASE; UPDATE; ADULTS AB Background: An artificial intelligence-augmented electrocardiogram (AI-ECG) can identify left ventricular systolic dysfunction (LVSD). We examined the accuracy of AI ECG for identification of LVSD (defined as LVEF <= 40% by transthoracic echocardiogram [TIE]) in cardiac intensive care unit (CICU) patients. Method: We included unique Mayo Clinic CICU patients admitted from 2007 to 2018 who underwent AI-ECG and TIE within 7 days, at least one of which was during hospitalization. Discrimination of the AI-ECG for LVSD was determined using receiver-operator characteristic curve (AUC) values. Results: We included 5680 patients with a mean age of 68 +/- 15 years (37% females). Acute coronary syndrome (ACS) was present in 55%. LVSD was present in 34% of patients (mean LVEF 48 +/- 16%). The AI-ECG had an AUC of 0.83 (95% confidence interval 0.82-0.84) for discrimination of LVSD. Using the optimal cut-off, the AI-ECG had 73%, specificity 78%, negative predictive value 85% and overall accuracy 76% for LVSD. AUC values were higher for patients aged <70 years (0.85 versus 0.80), males (0.84 versus 0.79), patients without ACS (0.86 versus 0.80), and patients who did not undergo revascularization (0.84 versus 0.80). Conclusions: The AI-ECG algorithm had very good discrimination for LVSD in this critically-ill CICU cohort with a high prevalence of LVSD. Performance was better in younger male patients and those without ACS, highlighting those CICU patients in whom screening for LVSD using Al ECG may be more effective. The Al-ECG might potentially be useful for identification of LVSD in resource-limited settings when TTE is unavailable. (C) 2020 Elsevier B.V. All rights reserved. C1 [Jentzer, Jacob C.; Attia, Zachi I.; Lopez-Jimenez, Francisco; Kapa, Suraj; Friedman, Paul A.; Noseworthy, Peter A.] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA. [Jentzer, Jacob C.] Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, Rochester, MN USA. [Jentzer, Jacob C.; Noseworthy, Peter A.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN USA. [Kashou, Anthony H.] Mayo Clin, Dept Internal Med, 200 First St SW, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic RP Jentzer, JC (通讯作者)，Mayo Clin, Dept Internal Med, 200 First St SW, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu; Kashou.Anthony@mayo.edu; attia.itzhak@mayo.edu; lopez@mayo.edu; Kapa.Suraj@mayo.edu; Friedman.Paul@mayo.edu; Noseworthy.Peter@mayo.edu OI Kapa, Suraj/0000-0003-2283-4340 CR Al-Khatib SM, 2018, CIRCULATION, V138, pE272, DOI [10.1161/CIR.0000000000000549, 10.1161/CIR.0000000000000548] Amsterdam EA., 2014, CIRCULATION, V130, pE344, DOI [10.1016/j.jacc.2014.09.017, DOI 10.1161/CIR.0000000000000134] [Anonymous], 2014, CIRCULATION, DOI DOI 10.1161/CIR.0000000000000040 Attia ZI, 2019, J CARDIOVASC ELECTR, V30, P668, DOI 10.1111/jce.13889 Attia ZI, 2019, NAT MED, V25, P70, DOI 10.1038/s41591-018-0240-2 Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 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 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 Herasevich V, 2010, MAYO CLIN PROC, V85, P247, DOI 10.4065/mcp.2009.0479 January CT, 2014, J AM COLL CARDIOL, V64, pE1, DOI [10.1016/j.jacc.2014.02.537, 10.1016/j.jacc.2014.03.022] Jentzer JC, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013675 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 Jneid H, 2017, J AM COLL CARDIOL, V70, P2048, DOI 10.1016/j.jacc.2017.06.032 Lang RM, 2015, EUR HEART J-CARD IMG, V16, P233, DOI 10.1093/ehjci/jev014 Noseworthy PA, 2020, CIRC-ARRHYTHMIA ELEC, V13, DOI 10.1161/CIRCEP.119.007988 O'Gara PT, 2013, CIRCULATION, V127, P529, DOI 10.1161/CIR.0b013e3182742c84 Olesen LL, 2016, ESC HEART FAIL, V3, P44, DOI 10.1002/ehf2.12067 Pack QR, 2019, JAMA INTERN MED, V179, P1176, DOI 10.1001/jamainternmed.2019.1051 Papolos A, 2016, J AM COLL CARDIOL, V67, P502, DOI 10.1016/j.jacc.2015.10.090 Schlegel TT, 2010, BMC CARDIOVASC DISOR, V10, DOI 10.1186/1471-2261-10-28 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Yancy CW, 2017, CIRCULATION, V136, pE137, DOI [10.1161/CIR.0000000000000509, 10.1016/j.cardfail.2017.04.014] Yao XX, 2020, AM HEART J, V219, P31, DOI 10.1016/j.ahj.2019.10.007 NR 27 TC 14 Z9 15 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 MAR 1 PY 2021 VL 326 BP 114 EP 123 DI 10.1016/j.ijcard.2020.10.074 EA FEB 2021 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA QI8VG UT WOS:000619263500023 PM 33152415 DA 2023-05-13 ER PT J AU Jansen, S Bhangu, J de Rooij, S Daams, J Kenny, RA van der Velde, N AF Jansen, Sofie Bhangu, Jaspreet de Rooij, Sophia Daams, Joost Kenny, Rose Anne van der Velde, Nathalie TI The Association of Cardiovascular Disorders and Falls: A Systematic Review SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Review DE Cardiovascular disorders; falls; syncope; blood pressure; cardiac arrhythmia ID CAROTID-SINUS SYNDROME; RISK-INCREASING DRUGS; BLOOD-PRESSURE; ORTHOSTATIC HYPOTENSION; OLDER-ADULTS; POPULATION; WITHDRAWAL AB Objective: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care. Design: Systematic review. Data Sources: Medline and Embase. Eligibility criteria for selecting studies: studies addressing persons aged 50 years and older that described cardiovascular risk factors for falls. Key search terms for cardiovascular abnormalities included all synonyms for the following groups: structural cardiac abnormalities, cardiac arrhythmia, blood pressure abnormalities, carotid sinus hypersensitivity (CSH), orthostatic hypotension (OH), vasovagal syncope (VVS), postprandial hypotension (PPH), arterial stiffness, heart failure, and cardiovascular disease. Quality of studies was assed using the Newcastle-Ottawa Scale. Results: Eighty-six studies were included. Of studies that used a control group, most consistent associations with falls were observed for low blood pressure (BP) (4/5 studies showing a positive association), heart failure (4/5), and cardiac arrhythmia (4/6). Higher prevalences of CSH (4/6), VVS (2/2), and PPH (3/4) were reported in fallers compared with controls in most studies, but most of these studies failed to show clear association measures. Coronary artery disease (6/10), orthostatic hypotension (9/25), general cardiovascular disease (4/9), and hypertension (7/25) all showed inconsistent associations with falls. Arterial stiffness was identified as an independent predictor for falls in one study, as were several echocardiographic abnormalities. Conclusion: Several cardiovascular associations with falls were identified, including low BP, heart failure, and arrhythmia. These results provide several angles for optimizing fall-preventive care, but further work on standard definitions, as well as the exact contribution of individual risk factors on fall incidence is now important to find potential areas for preventive interventions. (c) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine. C1 [Jansen, Sofie; de Rooij, Sophia; van der Velde, Nathalie] Univ Amsterdam, Acad Med Ctr, Dept Internal Med, Geriatr Med Sect, NL-1105 AZ Amsterdam, Netherlands. [Bhangu, Jaspreet; Kenny, Rose Anne] Trinity Coll Dublin, Dept Med Gerontol, Dublin, Ireland. [Bhangu, Jaspreet; Kenny, Rose Anne] St James Hosp, Mercers Inst Successful Ageing, Dublin 8, Ireland. [de Rooij, Sophia] Univ Groningen, Univ Med Ctr Groningen, Univ Ctr Geriatr Med, NL-9713 AV Groningen, Netherlands. [Daams, Joost] Univ Amsterdam, Acad Med Ctr, Dept Clin Lib, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands. C3 University of Amsterdam; Academic Medical Center Amsterdam; RLUK- Research Libraries UK; Trinity College Dublin; RLUK- Research Libraries UK; Trinity College Dublin; University of Groningen; University of Amsterdam; Academic Medical Center Amsterdam RP Bhangu, J (通讯作者)，St James Hosp, Trinity Coll Dublin, Dept Med Gerontol, Dublin 8, Ireland. 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Am. Med. Dir. Assoc. PD MAR 1 PY 2016 VL 17 IS 3 BP 193 EP 199 DI 10.1016/j.jamda.2015.08.022 PG 7 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Geriatrics & Gerontology GA DE9IK UT WOS:000370950000004 PM 26455926 DA 2023-05-13 ER PT J AU Tang, HZ Wei, SY Zheng, XL Tan, CQ AF Tang Hezhen Wei Shuying Zheng Xiaoli Tan Chunqing TI Effect of gatifloxacin in the treatment of ophthalmological diseases and continuous nursing intervention SO PAKISTAN JOURNAL OF PHARMACEUTICAL SCIENCES LA English DT Article DE Gatifloxacin; bacterial clearance rate; drug resistance level; nursing intervention; levofloxacin ID ENDOSCOPIC SUBMUCOSAL DISSECTION; EARLY GASTRIC-CANCER; ACUTE CORONARY SYNDROMES; SEX; REVASCULARIZATION; OUTCOMES; LESIONS; GENDER; IMPACT; RISK AB Gatifloxacin is a fourth-generation antibiotic and its antibacterial activity is better. It can play an obvious antiseptic effect in gram-positive bacteria, mycobacterium, mycoplasma, anaerobes and chlamydia. This study analyzed the treatment of the foreign body of the cornea by gatifloxacin eye drops. The results showed that gatifloxacin has a high bacterial clearance rate, which can reach 96.1%. The clinical effect is accurate and the adverse reaction is less. Compared with the control drug levofloxacin, its efficacy and safety were not statistically significant. Moreover, MIC determination of bacteria isolated from the study showed that gatifloxacin had stronger antibacterial activity. At the same time, it can be seen that nursing intervention can effectively improve the satisfaction of the treatment, before the operation, the patient's eye abnormalities, the psychological status of the patient, and the suitability of drug allergy should.be evaluated. C1 [Tang Hezhen; Wei Shuying; Zheng Xiaoli; Tan Chunqing] Liaocheng City Peoples Hosp, Dept Ophthalmol, Liaocheng, Peoples R China. RP Tan, CQ (通讯作者)，Liaocheng City Peoples Hosp, Dept Ophthalmol, Liaocheng, Peoples R China. 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J. Pharm. Sci. PD JUL PY 2018 VL 31 IS 4 SI SI BP 1707 EP 1712 PG 6 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA GT1HZ UT WOS:000444221300022 PM 30203767 DA 2023-05-13 ER PT J AU Romanelli, RJ Ito, MK Karalis, DG Huang, HC Iorga, SR Kam, IW Thompson, S Azar, KMJ AF Romanelli, Robert J. Ito, Matthew K. Karalis, Dean G. Huang, Hsiao-Ching Iorga, Serban R. Kam, Ivy W. Thompson, Stephen Azar, Kristen M. J. TI Statin utilization and low-density lipoprotein cholesterol in statin-treated patients with atherosclerotic cardiovascular disease: Trends from a community-based health care delivery system, 2002-2016 SO JOURNAL OF CLINICAL LIPIDOLOGY LA English DT Article DE Statins; Atherosclerotic cardiovascular disease; Electronic health records; Real-world ID ACUTE CORONARY SYNDROME; LIPID-LOWERING THERAPY; GENDER-DIFFERENCES; ADHERENCE; RISK; INSIGHTS; AMERICA; PANEL; GAPS; GUIDELINE AB BACKGROUND: A better understanding of patterns in statin utilization and low-density lipoprotein cholesterol (LDL-C) among patients with atherosclerotic cardiovascular disease (ASCVD) in a clinical practice setting is needed. Objectives: The objective of this study was to examine statin utilization and LDL-C among new statin users with ASCVD. METHODS: This retrospective study used an electronic health record database from a community-based health care system. We identified ASCVD patients >= 21 years of age with a new statin prescription during the study period (2002-2016). Outcomes included high-intensity statin therapy (HIST) prescribing at treatment initiation, medication adherence (defined as proportion of days covered >= 0.80), statin therapy titrations rates, and changes in LDL-C during follow-up. RESULTS: Among 6199 eligible patients, mean follow-up was 16.8 months. At treatment initiation, 16.6% of patients received HIST. Approximately 53% of patients were adherent to statin regimens. Mean percent reduction in LDL-c was 25% during follow-up; 18% of patients, overall, and 30% of those initiating on HIST attained LDL-C reductions >50%. Rates of statin intensity-level increases were 8.4 per 100 person-years. HIST prescribing increased over time, beginning after generic atorvastatin availability and preceded treatment guidelines by two years. Initiation on HIST, higher adherence, and treatment intensification during follow-up were independent predictors of attaining LDL-C goals of <70 mg/dL or <100 mg/dL. CONCLUSIONS: In a community-based health care system, modest LDL-C lowering for secondary ASCVD prevention is likely driven by suboptimal adherence and low HIST prescribing and treatment intensification rates. Clinician and patient education are needed to reduce clinical inertia and improve medication adherence to better manage ASCVD. (C) 2020 National Lipid Association. Published by Elsevier Inc. C1 [Romanelli, Robert J.; Huang, Hsiao-Ching] Palo Alto Med Fdn Res Inst, Ctr Hlth Syst Res, Sutter Hlth, Ames Bldg, Palo Alto, CA 94301 USA. [Ito, Matthew K.; Thompson, Stephen] Sanofi, Med Affairs, Bridgewater, NJ USA. [Karalis, Dean G.] Thomas Jefferson Univ Hosp, Sidney Kimmel Coll Med, Philadelphia, PA 19107 USA. [Iorga, Serban R.; Kam, Ivy W.] Regeneron Pharmaceut Inc, 777 Old Saw Mill River Rd, Tarrytown, NY 10591 USA. [Azar, Kristen M. J.] Sutter Hlth, Ctr Hlth Syst Res, Div Res Dev & Disseminat, Walnut Creek, CA USA. C3 Palo Alto Medical Foundation Research Institute; Sanofi-Aventis; Jefferson University; Regeneron RP Romanelli, RJ (通讯作者)，Palo Alto Med Fdn Res Inst, Ctr Hlth Syst Res, Sutter Hlth, Ames Bldg, Palo Alto, CA 94301 USA. EM romanerj1@sutterhealh.org OI Huang, Hsiao-Ching/0000-0001-8933-7774 CR Backholer K, 2017, J EPIDEMIOL COMMUN H, V71, P550, DOI 10.1136/jech-2016-207890 Banach M, 2016, INT J CARDIOL, V225, P184, DOI 10.1016/j.ijcard.2016.09.075 Bellows BK, 2016, J MANAG CARE SPEC PH, V22, P892, DOI 10.18553/jmcp.2016.22.8.892 Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Bradley CK, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011765 Bruckert E, 2005, CARDIOVASC DRUG THER, V19, P403, DOI 10.1007/s10557-005-5686-z Cannon CP, 2015, NEW ENGL J MED, V372, P2387, DOI 10.1056/NEJMoa1410489 Clark D, 2016, J AM COLL CARDIOL, V67, P1895, DOI 10.1016/S0735-1097(16)31896-4 Cleeman JI, 2001, JAMA-J AM MED ASSOC, V285, P2486, DOI 10.1001/jama.285.19.2486 Cohen JD, 2012, J CLIN LIPIDOL, V6, P208, DOI 10.1016/j.jacl.2012.03.003 Cone C, 2011, AM J HEALTH-SYST PH, V68, P511, DOI 10.2146/ajhp100271 Fernandez-Friera L, 2017, J AM COLL CARDIOL, V70, P2979, DOI 10.1016/j.jacc.2017.10.024 Fung V, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0191817 Grundy SM, 2019, CIRCULATION, V139, pE1082, DOI 10.1161/CIR.0000000000000625 Grundy SM, 2004, CIRCULATION, V110, P227, DOI 10.1161/01.CIR.0000133317.49796.0E Harrison TN, 2018, CARDIOVASC DRUG THER, V32, P397, DOI 10.1007/s10557-018-6810-1 Hirsh BJ, 2015, J AM COLL CARDIOL, V66, P184, DOI 10.1016/j.jacc.2015.05.030 Karalis DG, 2016, J CLIN LIPIDOL, V10, P833, DOI 10.1016/j.jacl.2016.02.016 Kato ET, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.006901 Maddox TM, 2014, J AM COLL CARDIOL, V63, P539, DOI 10.1016/j.jacc.2013.09.053 McGinnis B, 2007, ANN PHARMACOTHER, V41, P1805, DOI 10.1345/aph.1K209 Murphy SA, 2016, J AM COLL CARDIOL, V67, P353, DOI 10.1016/j.jacc.2015.10.077 Okerson T, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.116.004909 Olufade T, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.116.005205 Parker BA, 2013, CIRCULATION, V127, P96, DOI 10.1161/CIRCULATIONAHA.112.136101 Quan HD, 2011, AM J EPIDEMIOL, V173, P676, DOI 10.1093/aje/kwq433 Robinson JG, 2015, NEW ENGL J MED, V372, P1489, DOI 10.1056/NEJMoa1501031 Rodriguez F, 2019, JAMA CARDIOL, V4, P206, DOI 10.1001/jamacardio.2018.4936 Rodriguez F, 2016, AM HEART J, V182, P97, DOI 10.1016/j.ahj.2016.09.007 Rodriguez F, 2016, J WOMENS HEALTH, V25, P697, DOI 10.1089/jwh.2015.5282 Rosenson RS, 2017, J AM COLL CARDIOL, V69, P2696, DOI 10.1016/j.jacc.2017.03.585 Rosenson RS, 2015, J AM COLL CARDIOL, V65, P270, DOI 10.1016/j.jacc.2014.09.088 Sabatine MS, 2017, LANCET DIABETES ENDO, V5, P941, DOI 10.1016/S2213-8587(17)30313-3 Sabatine MS, 2017, NEW ENGL J MED, V376, P1713, DOI [10.1056/NEJMoa1615664, 10.4997/JRCPE.2017.212] Salami JA, 2017, JAMA CARDIOL, V2, P56, DOI 10.1001/jamacardio.2016.4700 Schwartz GG, 2018, NEW ENGL J MED, V379, P2097, DOI 10.1056/NEJMoa1801174 Steen DL, 2017, CLIN CARDIOL, V40, P155, DOI 10.1002/clc.22641 Steiner JF, 1997, J CLIN EPIDEMIOL, V50, P105, DOI 10.1016/S0895-4356(96)00268-5 Stone NJ, 2014, CIRCULATION, V129, pS1, DOI 10.1161/01.cir.0000437738.63853.7a Superko HR, 2019, CLIN CARDIOL, V42, P101, DOI 10.1002/clc.23115 Victor BM, 2014, AM J CARDIOL, V113, P1611, DOI 10.1016/j.amjcard.2014.02.018 Wei MY, 2013, J CLIN LIPIDOL, V7, P472, DOI 10.1016/j.jacl.2013.03.001 Wood M, 2019, PHARM PRACT-GRANADA, V17, DOI [10.18549/PharmPract.2019.2.1402, 10.18549/pharmpract.2019.2.1402] Wu HF, 2017, J PHARM SCI-US, V106, P2751, DOI 10.1016/j.xphs.2017.03.027 Yeaw J, 2009, J MANAGE CARE PHARM, V15, P728, DOI 10.18553/jmcp.2009.15.9.728 Yu S, 2019, J CLIN LIPIDOL, V13, P432, DOI 10.1016/j.jacl.2019.03.002 Zhang HB, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0155228 NR 47 TC 6 Z9 6 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1933-2874 EI 1876-4789 J9 J CLIN LIPIDOL JI J. Clin. Lipidol. PD MAY-JUN PY 2020 VL 14 IS 3 BP 305 EP 314 DI 10.1016/j.jacl.2020.03.006 PG 10 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA LY5DE UT WOS:000540548500006 PM 32362513 OA hybrid DA 2023-05-13 ER PT J AU Nishimoto, Y Ohbe, H Matsui, H Nakajima, M Sasabuchi, Y Goto, T Morita, K Fushimi, K Sato, Y Yasunaga, H AF Nishimoto, Yuji Ohbe, Hiroyuki Matsui, Hiroki Nakajima, Mikio Sasabuchi, Yusuke Goto, Tadahiro Morita, Kojiro Fushimi, Kiyohide Sato, Yukihito Yasunaga, Hideo TI Predictive ability of the sequential organ failure assessment score for in-hospital mortality in patients with cardiac critical illnesses: a nationwide observational study SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Organ dysfunction scores; Cardiac intensive care unit; Hospital mortality; Prognosis ID INTENSIVE-CARE-UNIT; SOFA SCORE; DIAGNOSIS AB Aims Several studies have reported a high predictive ability of the Sequential Organ Failure Assessment (SOFA) score for in-hospital mortality specifically for patients with cardiac critical illnesses, however, differences according to the admission classification (surgical or non-surgical) are unknown. The present study aimed to evaluate the predictive ability of the SOFA score in surgical and non-surgical patients with cardiac critical illnesses. Methods and results Using the Japanese nationwide Diagnosis Procedure Combination database, we identified patients with cardiac critical illnesses, defined as patients admitted to the intensive care unit (ICU) and treated by cardiologists or cardiovascular surgeons as their physicians in charge from April 2018 to March 2020. The discriminatory ability of the SOFA score for in-hospital mortality was assessed by calculating the area under the receiver operating characteristic curve (AUROC). Among 52 819 eligible patients with available data on their SOFA scores, 33 526 (64%) were postoperative cardiac surgeries. The median SOFA score on ICU admission was 5.0 (interquartile range, 2.0-8.0) and overall in-hospital mortality 6.8%. The AUROC of the SOFA score was 0.75 [95% confidence interval (CI), 0.75-0.76]. In the subgroup analyses, the AUROCs were 0.76 (95% CI, 0.74-0.77) in the surgical patients, 0.83 (95% CI, 0.83-0.84) in the non-surgical patients, and 0.88 (95% CI, 0.87-0.89) in the non-surgical acute coronary syndrome patients. Conclusions The predictive ability of the SOFA score on the day of ICU admission for in-hospital mortality was confirmed to be acceptable in the patients with cardiac critical illnesses and varied according to the admission classification and primary diagnoses. C1 [Nishimoto, Yuji; Sato, Yukihito] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, 2-17-77 Higashinaniwa Cho, Amagasaki, Hyogo 6608550, Japan. [Ohbe, Hiroyuki; Matsui, Hiroki; Nakajima, Mikio; Goto, Tadahiro; Yasunaga, Hideo] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan. [Nakajima, Mikio] Fdn Ambulance Serv Dev, Emergency Life Saving Tech Acad Tokyo, 4-6 Minamiosawa, Hachi, Tokyo 1920364, Japan. [Sasabuchi, Yusuke] Jichi Med Univ, Data Sci Ctr, 3311-1 Yakushiji, Shimotsuke, Tochigi 3290498, Japan. [Goto, Tadahiro] TXP Med Co Ltd, Bunkyo Ku, 7-3-1-252 Hongo, Tokyo 1138454, Japan. [Morita, Kojiro] Univ Tokyo, Global Nursing Res Ctr, Grad Sch Med, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan. [Fushimi, Kiyohide] Tokyo Med & Dent Univ, Dept Hlth Policy & Informat, Grad Sch Med, Bunkyo Ku, 1-5-45 Yushima, Tokyo 1138510, Japan. C3 University of Tokyo; Jichi Medical University; University of Tokyo; Tokyo Medical & Dental University (TMDU) RP Ohbe, H (通讯作者)，Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan. EM hohbey@gmail.com RI Nishimoto, Yuji/P-3975-2019; Ohbe, Hiroyuki/ABB-6008-2021 OI Nishimoto, Yuji/0000-0003-1996-8540; Ohbe, Hiroyuki/0000-0001-8544-2569 FU Ministry of Health, Labour and Welfare, Japan [19AA2007, 20AA2005]; Ministry of Education, Culture, Sports, Science and Technology, Japan [20H03907] FX This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (19AA2007 and 20AA2005) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907). 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Heart J.-Acute Cardiovasc. Care PD JUN 7 PY 2022 VL 11 IS 4 BP 312 EP 321 DI 10.1093/ehjacc/zuac011 EA FEB 2022 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 1X8MG UT WOS:000764163600001 PM 35156119 OA Bronze DA 2023-05-13 ER PT J AU Gopi, V Milles, B Spanuth, E Muller-Hennessen, M Biener, M Stoyanov, K Frey, N Giannitsis, E AF Gopi, Vinajak Milles, Barbara Spanuth, Eberhard Mueller-Hennessen, Matthias Biener, Moritz Stoyanov, Kiril Frey, Norbert Giannitsis, Evangelos TI Comparison of the analytical performance of the PATHFAST high sensitivity cardiac troponin I using fresh whole blood vs. fresh plasma samples SO CLINICAL CHEMISTRY AND LABORATORY MEDICINE LA English DT Article DE high-sensitivity; method comparison; plasma; point-of-care; troponin; whole blood ID ASSAY AB Objectives: The PATHFAST hs-cTnI (high-sensitivity cardiac troponin) assay is the first point-of-care assay with a high-sensitivity designation that received FDA approval for diagnosis of myocardial infarction (MI). Testing from whole blood does not need centrifugation and therefore is faster and more convenient in the emergency room instead of plasma. However, there is sparse evidence whether point-of-care testing of Tn from whole blood is as reliable as from plasma samples. Methods: We investigated the agreement between plasma and whole blood hs-cTnI by using the PATHFAST hs-cTnI assay. Hs-cTnT measured on Cobas 602 in the central laboratory and compared to a final diagnosis of NSTEMI using serial hs-cTnT served as reference. We assessed biases, limits of agreement (+/- 1.96 SD) and coefficients of correlation, and tested the discriminatory ability of the baseline sample of plasma and whole blood hs-cTnI and plasma hs-cTnT to discriminate non-ST-segment elevation myocardial infarction (NSTEMI). Results: A total of 224 paired fresh samples were collected simultaneously from 191 patients presenting with suspected acute coronary syndrome. There was an excellent correlation between plasma and whole blood hs-cTnI (r=0.99), and a very good inter-rater agreement (k=0.93) between elevated and normal plasma and whole blood results. Precision evaluation according to CLSI ep 15 revealed comparable coefficients of variation (CV) in whole blood and plasma. The discriminatory ability of baseline hs-cTnT, plasma and whole blood hs-cTnI was excellent (AUC 0.967, AUC 0.954 and AUC 0.953) without significant difference. Conclusions: Whole blood can be used interchangeably with plasma for more convenient and less time and labor-consuming testing of hs-cTnI on the PATHFAST instrument. C1 [Gopi, Vinajak; Milles, Barbara; Mueller-Hennessen, Matthias; Biener, Moritz; Stoyanov, Kiril; Frey, Norbert; Giannitsis, Evangelos] Heidelberg Univ Hosp, Dept Cardiol Angiol & Pulmonol, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. [Spanuth, Eberhard] DIAneering GmbH, Heidelberg, Germany. C3 Ruprecht Karls University Heidelberg RP Giannitsis, E (通讯作者)，Heidelberg Univ Hosp, Dept Cardiol Angiol & Pulmonol, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. EM evangelos.giannitsis@med.uni-heidelberg.de RI Stoyanov, Kiril/GZM-7970-2022; Frey, Norbert/M-7749-2019 OI Stoyanov, Kiril/0000-0001-9698-9228; Frey, Norbert/0000-0001-7611-378X CR Apple FS, 2021, CLIN CHEM, V67, P70, DOI 10.1093/clinchem/hvaa264 BABLOK W, 1988, J CLIN CHEM CLIN BIO, V26, P783 Boeddinghaus J, 2020, J AM COLL CARDIOL, V75, P1111, DOI 10.1016/j.jacc.2019.12.065 Christenson RH, 2018, CLIN BIOCHEM, V56, P4, DOI 10.1016/j.clinbiochem.2018.05.004 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 Collinson PO, 2019, CLIN CHEM LAB MED, V57, P623, DOI 10.1515/cclm-2018-1211 Giannitsis E, 2020, CLIN BIOCHEM, V78, P18, DOI 10.1016/j.clinbiochem.2019.11.013 Pickering JW, 2018, JAMA CARDIOL, V3, P1108, DOI 10.1001/jamacardio.2018.3368 Saenger AK, 2011, CLIN CHIM ACTA, V412, P748, DOI 10.1016/j.cca.2010.12.034 Sorensen NA, 2019, CLIN CHEM, V65, P1592, DOI 10.1373/clinchem.2019.307405 Stoyanov KM, 2020, BMJ OPEN, V10, DOI 10.1136/bmjopen-2020-041757 Thygesen K, 2019, EUR HEART J, V40, P237, DOI [10.1016/j.jacc.2018.08.1038, 10.1093/eurheartj/ehy462, 10.1016/j.rec.2018.11.011] Venge P, 2017, CLIN CHIM ACTA, V469, P119, DOI 10.1016/j.cca.2017.03.023 Wu AHB, 2018, CLIN CHEM, V64, P645, DOI 10.1373/clinchem.2017.277186 NR 14 TC 6 Z9 6 U1 0 U2 0 PU WALTER DE GRUYTER GMBH PI BERLIN PA GENTHINER STRASSE 13, D-10785 BERLIN, GERMANY SN 1434-6621 EI 1437-4331 J9 CLIN CHEM LAB MED JI Clin. Chem. Lab. Med. PD AUG PY 2021 VL 59 IS 9 BP 1579 EP 1584 DI 10.1515/cclm-2021-0354 PG 6 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA TW0XK UT WOS:000682134300022 PM 34087961 OA hybrid DA 2023-05-13 ER PT J AU Getachew, H Srikanth, A Bhagavathula Abebe, TB Belachew, SA AF Getachew, Henok Srikanth, Akshaya Bhagavathula Abebe, Tamrat Befekadu Belachew, Sewunet Admasu TI Inappropriate prescribing of antithrombotic therapy in Ethiopian elderly population using updated 2015 STOPP/START criteria: a cross-sectional study SO CLINICAL INTERVENTIONS IN AGING LA English DT Article DE prevalence; inappropriate prescribing; antithrombotic; STOPP/START criteria; elderly; Ethiopia ID NONVALVULAR ATRIAL-FIBRILLATION; NURSING-HOME RESIDENTS; MEDICATION USE; OLDER-ADULTS; CONSENSUS PANEL; EXPLICIT CRITERIA; GENERAL-PRACTICE; BEERS CRITERIA; RISK-FACTORS; PREVENTION AB Background: Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes. The aim of this study was to assess the prevalence of inappropriate prescribing of antithrombotic therapy in hospitalized elderly patients. Methods: A retrospective cross-sectional, single-center study was conducted at the Gondar University Hospital. A total of 156 hospitalized elderly patients fulfilling the inclusion/-exclusion criteria were included in the study. The Screening Tool for Older Person's Prescription/Screening Tool to Alert doctors to Right Treatment criteria version 2 were applied to patients' data to identify the total number of inappropriate prescribing (IPs) including potentially inappropriate medications and potential prescribing omissions. Results: A total of 70 IPs were identified in 156 patients who met the inclusion criteria. Of these, 36 (51.4%) were identified as potentially inappropriate medications by the Screening Tool for Older Person's Prescription criteria. The prevalence of IP per patient indicated that 58 of the 156 (37.2%) patients were exposed to at least one IP. Of these, 32 (55.2%) had at least one potentially inappropriate medication and 33 (56.9%) had at least one potential prescribing omission. Patients hospitalized due to venous thromboembolism (adjusted odds ratio [AOR] = 29.87, 95% confidence interval [CI], 1.26-708.6), stroke (AOR = 7.74, 95% CI, 1.27-47.29), or acute coronary syndrome (AOR = 13.48, 95% CI, 1.4-129.1) were less likely to be exposed to an IP. An increase in Charlson comorbidity index score was associated with increased IP exposure (AOR = 0.60, 95% CI, 0.39-0.945). IPs were about six times more likely to absent in patients prescribed with antiplatelet only therapy (AOR = 6.23, 95% CI, 1.90-20.37) than those receiving any other groups of antithrombotics. Conclusion: IPs are less common in elderly patients primarily admitted due to venous thromboembolism, stroke, and acute coronary syndrome, and those elderly patients prescribed with only antiplatelet. Patients with higher Charlson comorbidity index were, however, associated with increased IPs exposure. Our study may guide further research to reduce high-risk prescription of antithrombotics in the elderly. C1 [Getachew, Henok; Srikanth, Akshaya; Bhagavathula; Abebe, Tamrat Befekadu; Belachew, Sewunet Admasu] Univ Gondar, Dept Clin Pharm, Sch Pharm, Coll Med & Hlth Sci, POB 196, Gondar, Ethiopia. C3 University of Gondar RP Getachew, H (通讯作者)，Univ Gondar, Dept Clin Pharm, Sch Pharm, Coll Med & Hlth Sci, POB 196, Gondar, Ethiopia. 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Interv. Aging PY 2016 VL 11 BP 819 EP 827 DI 10.2147/CIA.S107394 PG 9 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Geriatrics & Gerontology GA DO9EC UT WOS:000378086100001 PM 27382265 OA Green Published, Green Submitted, gold DA 2023-05-13 ER PT J AU Auer, R Gencer, B Tango, R Nanchen, D Matter, CM Luscher, TF Windecker, S Mach, F Cornuz, J Humair, JP Rodondi, N AF Auer, Reto Gencer, Baris Tango, Rodrigo Nanchen, David Matter, Christian M. Luscher, Thomas Felix Windecker, Stephan Mach, Francois Cornuz, Jacques Humair, Jean-Paul Rodondi, Nicolas TI Uptake and efficacy of a systematic intensive smoking cessation intervention using motivational interviewing for smokers hospitalised for an acute coronary syndrome: a multicentre before-after study with parallel group comparisons SO BMJ OPEN LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; CARDIAC REHABILITATION; MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; MORTALITY; PREDICTORS; GUIDELINES; MANAGEMENT; ENROLLMENT; RATES AB Objectives: To compare the efficacy of a proactive approach with a reactive approach to offer intensive smoking cessation intervention using motivational interviewing (MI). Design: Before-after comparison in 2 academic hospitals with parallel comparisons in 2 control hospitals. Setting: Academic hospitals in Switzerland. Participants: Smokers hospitalised for an acute coronary syndrome (ACS). Intervention: In the intervention hospitals during the intervention phase, a resident physician trained in MI systematically offered counselling to all smokers admitted for ACS, followed by 4 telephone counselling sessions over 2 months by a nurse trained in MI. In the observation phase, the in-hospital intervention was offered only to patients whose clinicians requested a smoking cessation intervention. In the control hospitals, no intensive smoking cessation intervention was offered. Primary and secondary outcomes: The primary outcome was 1 week smoking abstinence (point prevalence) at 12 months. Secondary outcomes were the number of smokers who received the in-hospital smoking cessation intervention and the duration of the intervention. Results: In the intervention centres during the intervention phase, 87% of smokers (N=193/225) received a smoking cessation intervention compared to 22% in the observational phase (p<0.001). Median duration of counselling was 50 min. During the intervention phase, 78% received a phone follow-up for a median total duration of 42 min in 4 sessions. Prescription of nicotine replacement therapy at discharge increased from 18% to 58% in the intervention phase (risk ratio (RR): 3.3 (95% CI 2.4 to 4.3; p <= 0.001). Smoking cessation at 12-month increased from 43% to 51% comparing the observation and intervention phases (RR=1.20, 95% CI 0.98 to 1.46; p=0.08; 97% with outcome assessment). In the control hospitals, the RR for quitting was 1.02 (95% CI 0.84 to 1.25; p=0.8, 92% with outcome assessment). Conclusions: A proactive strategy offering intensive smoking cessation intervention based on MI to all smokers hospitalised for ACS significantly increases the uptake of smoking cessation counselling and might increase smoking abstinence at 12 months. C1 [Auer, Reto; Nanchen, David; Cornuz, Jacques] Univ Lausanne, Dept Ambulatory & Community Med, Lausanne, Switzerland. [Auer, Reto; Rodondi, Nicolas] Univ Bern, Inst Primary Hlth Care BIHAM, Bern, Switzerland. [Gencer, Baris; Mach, Francois] Univ Hosp Geneva, Div Cardiol, Fac Med, Geneva, Switzerland. [Tango, Rodrigo; Humair, Jean-Paul] Univ Hosp Geneva, Div Primary Care Med, Fac Med, Geneva, Switzerland. [Matter, Christian M.; Luscher, Thomas Felix] Univ Zurich Hosp, Dept Cardiol, Zurich, Switzerland. [Windecker, Stephan] Univ Bern, Univ Hosp Bern, Dept Cardiol, Bern, Switzerland. [Rodondi, Nicolas] Univ Bern, Univ Hosp Bern, Inselspital, Dept Gen Internal Med, Bern, Switzerland. C3 University of Lausanne; University of Bern; University of Geneva; University of Geneva; University of Zurich; University Zurich Hospital; University of Bern; University Hospital of Bern; University of Bern; University Hospital of Bern RP Auer, R (通讯作者)，Univ Lausanne, Dept Ambulatory & Community Med, Lausanne, Switzerland.; Auer, R (通讯作者)，Univ Bern, Inst Primary Hlth Care BIHAM, Bern, Switzerland. EM Reto.Auer@hospvd.ch RI Gencer, Baris/AAO-2305-2020; Nanchen, David/AAQ-1118-2021 OI Gencer, Baris/0000-0002-8954-9694; Nanchen, David/0000-0002-2493-3505; Rodondi, Nicolas/0000-0001-9083-6896; Auer, Reto/0000-0003-4222-4849 FU Swiss National Science Foundation [SPUM 33CM30-124112, PBLAP3-136774]; Swiss Tobacco Prevention Fund [FPT 10.000046]; Department of University Medicine and Community Care (DUMSC) of the University of Lausanne, Switzerland; Swiss Heart Foundation; Societe Academique Vaudoise; SICPA Foundation FX The SPUM-ACS cohort is supported by the Swiss National Science Foundation (SPUM 33CM30-124112, Inflammation and acute coronary syndromes (ACS)-Novel strategies for prevention and clinical management). This project is supported by a research grant from the Swiss Tobacco Prevention Fund (FPT 10.000046). The project was also supported by a grant from the Department of University Medicine and Community Care (DUMSC) of the University of Lausanne, Switzerland and the Swiss Heart Foundation. RA's research on cardiovascular prevention is additionally supported by a grant for prospective researchers from the Swiss National Science Foundation PBLAP3-136774, the Societe Academique Vaudoise and the SICPA Foundation. The founding organisations 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 manuscript; and decision to submit the manuscript for publication. 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Ojetti, V. Merra, G. Carroccia, A. Marsiliani, D. Mangiola, F. Calabro, G. Iacomini, P. Zuccala, G. Franceschi, F. TI Recurrent use of the Emergency Department in patients with anxiety disorder SO EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES LA English DT Article DE Panic attack; Anxiety disorder; Psychosomatic symptoms; Emergency Department. ID CHEST-PAIN PATIENTS; PANIC DISORDER; PRIMARY-CARE; COMORBIDITY; AGORAPHOBIA; ATTACKS; DEPRESSION; EFFICACY; ROOM AB OBJECTIVE: Panic disorder is characterized by the spontaneous and unexpected occurrence of panic attacks. During panic attacks, patients (pts) refer to the Emergency Department (ED). The diagnostic work-up for any panic attack is expensive since symptoms at presentation mimic other diseases such acute coronary syndrome or neurological emergencies. The aim of the present study was to describe a 10 years cohort of pts diagnosed with panic disorder in the ED in terms of ED visit recurrence. METHODS: Case-control study, in a tertiary care, involving pts presenting to the ED and diagnosed with panic attack according to the International Classification of Diseases 9nt Revision (ICD-9). From January 2001 to Dec 2009 were extracted from the electronic clinical database 469 pts and were divided into "recurrent ED visit" (multiple ED access for panic attack) (N= 361) and "no recurrent ED visit" (only one ED access for panic attack in 9 years) (N= 108). RESULTS: At univariate analysis cases and controls differed for male prevalence (p < 0.01), neurological symptoms at presentation (p = 0.02) and history of other psychiatry disorder (p < 0.01). In multivariate analysis independent predictors were male gender, age under 40 year old, palpitations at presentations, 1 or more cardiovascular risk factors and previous other psychiatry conditions. CONCLUSIONS: Male under 40 years old with palpitations or cardiovascular risk and other psychiatric diseases, have a higher recurrence of panic attacks. General psychiatric evaluation and treatment with benzodiazepine in ED is not useful to prevent recurrences. Identifying those patients at high risk of panic attack and ED visit recurrence might be useful to establish ad-hoc interventions, improve patients' morbidity and save precious resources. C1 [Buccelletti, F.; Ojetti, V.; Merra, G.; Carroccia, A.; Marsiliani, D.; Mangiola, F.; Calabro, G.; Iacomini, P.; Zuccala, G.; Franceschi, F.] Univ Cattolica Sacro Cuore, Sch Med, Agostino Gemelli Hosp, Emergency Dept, I-00168 Rome, Italy. C3 Catholic University of the Sacred Heart; IRCCS Policlinico Gemelli RP Merra, G (通讯作者)，Univ Cattolica Sacro Cuore, Sch Med, Agostino Gemelli Hosp, Emergency Dept, I-00168 Rome, Italy. EM merra@libero.it RI Merra, Giuseppe/M-5003-2015; Merra, Giuseppe/HRB-3769-2023; ojetti, veronica/AAB-3633-2019; Franceschi, Francesco/AAB-3458-2019; Zuccalà, Giuseppe/AAC-4677-2022; Mangiola, Francesca/AAM-9101-2020; Buccelletti, Francesco/AAS-3826-2020 OI ojetti, veronica/0000-0002-8953-0707; Franceschi, Francesco/0000-0002-9090-8244; Zuccalà, Giuseppe/0000-0002-2567-2220; Merra, Giuseppe/0000-0003-4753-3528; Mangiola, Francesca/0000-0002-2143-8381 CR Amer Psychiat Assoc, 1998, AM J PSYCHIAT, V155, P1 American Psychiatric Association, 1987, DIAGNOSTIC STAT MANU, V3rd American Psychiatric Association, 2000, DIAGN STAT MAN MENT, VFourth BANDELOW B, 1995, INT CLIN PSYCHOPHARM, V10, P73, DOI 10.1097/00004850-199506000-00003 Batelaan NM, 2010, ACTA PSYCHIAT SCAND, V122, P56, DOI 10.1111/j.1600-0447.2009.01488.x BEITMAN BD, 1988, J CLIN PSYCHOPHARM, V8, P127 BEITMAN BD, 1989, J FAM PRACTICE, V28, P177 BROWN TA, 1992, J CONSULT CLIN PSYCH, V60, P835, DOI 10.1037/0022-006X.60.6.835 CARTER C, 1994, AM J CARDIOL, V74, P296, DOI 10.1016/0002-9149(94)90381-6 Chen YH, 2011, ACTA PSYCHIAT SCAND, V123, P55, DOI 10.1111/j.1600-0447.2010.01541.x Croon KF, 2009, CNS DRUGS, V23, P427, DOI 10.2165/00023210-200923050-00006 Dammen T, 1999, GEN HOSP PSYCHIAT, V21, P323, DOI 10.1016/S0163-8343(99)00037-7 Fleet Richard P, 2003, CJEM, V5, P247 Fleet RP, 1996, AM J MED, V101, P371, DOI 10.1016/S0002-9343(96)00224-0 Fleet RP, 1997, ANN BEHAV MED, V19, P124, DOI 10.1007/BF02883329 Freire RC, 2011, EXPERT OPIN PHARMACO, V12, P1419, DOI 10.1517/14656566.2011.562200 Johnson MR, 2000, INT J PSYCHIAT MED, V30, P367, DOI 10.2190/TXNB-V7VU-7H32-C7YT Kessler RC, 2006, ARCH GEN PSYCHIAT, V63, P415, DOI 10.1001/archpsyc.63.4.415 Kinley DJ, 2011, J CLIN PSYCHIAT, V72, P66, DOI 10.4088/JCP.09m05587blu KLERMAN GL, 1991, JAMA-J AM MED ASSOC, V265, P742, DOI 10.1001/jama.265.6.742 LEE TH, 1985, ARCH INTERN MED, V145, P65, DOI 10.1001/archinte.145.1.65 LELLIOTT P, 1989, ARCH GEN PSYCHIAT, V46, P1000 NOYES R, 1980, ARCH GEN PSYCHIAT, V37, P173 Pelland ME, 2011, AM J EMERG MED, V29, P1051, DOI 10.1016/j.ajem.2010.06.027 Robins LN, 1991, PSYCHIAT DISORDERS A SIMPSON RJ, 1994, BRIT J GEN PRACT, V44, P352 SPITZER RL, 1994, JAMA-J AM MED ASSOC, V272, P1749, DOI 10.1001/jama.272.22.1749 SWINSON RP, 1992, AM J PSYCHIAT, V149, P944 THE NIMH GENETICS WORKGROUP, 1998, NIH PUBLICATION, V98-4268 Tueth MJ, 1997, AM J EMERG MED, V15, P170, DOI 10.1016/S0735-6757(97)90094-2 Watanabe N, 2009, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD005335.pub2 World Health Organization, INT CLASS DIS Wulsin L, 2002, ANN EMERG MED, V39, P139, DOI 10.1067/mem.2002.121484 Wulsin LR, 1999, INT J PSYCHIAT MED, V29, P97, DOI 10.2190/X6N2-8HYG-7LLJ-X6U2 YINGLING KW, 1993, J GEN INTERN MED, V8, P231 Zun LS, 1997, ANN EMERG MED, V30, P92, DOI 10.1016/S0196-0644(97)70117-3 NR 36 TC 14 Z9 14 U1 0 U2 6 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 FEB PY 2013 VL 17 SU 1 BP 100 EP 106 PG 7 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA 152GC UT WOS:000319518400014 PM 23436671 DA 2023-05-13 ER PT J AU Yavuz, D Ozen, DSK Demirag, MD AF Yavuz, Demet Ozen, Duriye Sila Karagoz Demirag, Mehmet Derya TI COVID-19: mortality rates of patients on hemodialysis and peritoneal dialysis SO INTERNATIONAL UROLOGY AND NEPHROLOGY LA English DT Article DE COVID-19; SARS-CoV-2; Maintenance hemodialysis; Peritoneal dialysis; Mortality ID OUTCOMES AB Objective Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection might have a higher mortality rate in patients with end-stage renal disease due to immunosuppression. This study investigates the mortality rates of SARS-CoV-2 infection and the factors affecting mortality among patients who were on maintenance hemodialysis and continuous ambulatory peritoneal dialysis. Materials and methods A total of 200 patients, including 157 maintenance hemodialysis and 43 continuous ambulatory peritoneal dialysis patients followed in our hospital, were included in the study. The patients' sociodemographic characteristics, comorbidities, history of SARS-CoV-2 infection in the previous year, death event, source of death (SARS-CoV-2 or not), presence of hospitalization due to SARS-CoV-2 infection, need for intensive care unit, need for ventilatory support in intensive care unit were obtained from the clinical file records. Results 85 of the 200 patients had a history of SARS-Cov-2 infection during the last 12 months. Forty-two (49.5%) patients with SARS-CoV-2 infection were hospitalized. Patients with SARS-CoV-2 had longer dialysis time, increased mortality, and significantly higher comorbidities such as coronary artery disease, congestive heart failure. Besides, heart failure and hypertension were the determining factors in the risk factor analysis for SARS-CoV-2 infection. In dialysis patients, the mortality rate in the last year, due to all causes, including SARS-CoV-2 infection, was 23% while the mortality rate due to "SARS-CoV-2 infection only" was 13%) (p > 0.05). Our findings are important in guiding clinical decision-making and informing the public and health authorities about the risk of death associated with COVID-19 in this patient group. C1 [Yavuz, Demet] Samsun Educ & Res Hosp, Div Nephrol, Samsun, Turkey. [Ozen, Duriye Sila Karagoz] Samsun Educ & Res Hosp, Clin Internal Med, Samsun, Turkey. [Demirag, Mehmet Derya] Samsun Univ, Samsun Educ & Res Hosp, Sch Med, Clin Internal Med, Samsun, Turkey. C3 Samsun Training & Research Hospital; Samsun Training & Research Hospital; Samsun Training & Research Hospital RP Ozen, DSK (通讯作者)，Samsun Educ & Res Hosp, Clin Internal Med, Samsun, Turkey. EM silakaragoz@yahoo.com RI demirag, mehmet d/H-9616-2014; Yavuz, Demet/ABG-9980-2021; ÖZEN, SILA/HKF-1633-2023 OI Yavuz, Demet/0000-0002-4082-6320; CR Ferrey AJ, 2020, AM J NEPHROL, V51, P337, DOI 10.1159/000507417 Goicoechea M, 2020, KIDNEY INT, V98, P27, DOI 10.1016/j.kint.2020.04.031 Goyal P, 2020, NEW ENGL J MED, V382, P2372, DOI 10.1056/NEJMc2010419 Grasselli G, 2020, JAMA-J AM MED ASSOC, V323, P1545, DOI 10.1001/jama.2020.4031 Ikizler TA, 2020, AM J KIDNEY DIS, V76, P1, DOI 10.1053/j.ajkd.2020.03.008 Jatlaoui TC, 2019, MMWR-MORBID MORTAL W, V68, P1081, DOI 10.15585/mmwr.mm6846e2 Kurts C, 2013, NAT REV IMMUNOL, V13, P738, DOI 10.1038/nri3523 Lai CC, 2020, J MICROBIOL IMMUNOL, V53, P404, DOI 10.1016/j.jmii.2020.02.012 Ma Y., 2020, COVID 19 HEMODIALYSI, DOI 10.1101/2020.02.24.20027201 Madjid M, 2020, JAMA CARDIOL, V5, P831, DOI 10.1001/jamacardio.2020.1286 Myers LC, 2020, JAMA-J AM MED ASSOC, V323, P2195, DOI 10.1001/jama.2020.7202 Rombola G, 2020, J NEPHROL, V33, P401, DOI 10.1007/s40620-020-00737-w Ronco C, 2020, PERITON DIALYSIS INT, V40, P363, DOI 10.1177/0896860820927697 Rosenberg ES, 2020, JAMA-J AM MED ASSOC, V323, P2493, DOI 10.1001/jama.2020.8630 Valeri AM, 2020, J AM SOC NEPHROL, V31, P1409, DOI 10.1681/ASN.2020040470 Wilkie M, 2020, PERITON DIALYSIS INT, V40, P357, DOI 10.1177/0896860820921657 Yeter HH, 2021, SEMIN DIALYSIS, V34, P147, DOI 10.1111/sdi.12940 NR 17 TC 5 Z9 5 U1 2 U2 2 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0301-1623 EI 1573-2584 J9 INT UROL NEPHROL JI Int. Urol. Nephrol. PD OCT PY 2022 VL 54 IS 10 BP 2713 EP 2718 DI 10.1007/s11255-022-03193-6 EA APR 2022 PG 6 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA 4L2CF UT WOS:000779026000001 PM 35381932 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Halder, D Mathew, R Jamshed, N Yadav, S Brunda, RL Aggarwal, P Narang, R AF Halder, Dipanjan Mathew, Roshan Jamshed, Nayer Yadav, Sakshi Brunda, R. L. Aggarwal, Praveen Narang, Rajiv TI UTILITY OF HEART PATHWAY IN IDENTIFYING LOW-RISK CHEST PAIN IN EMERGENCY DEPARTMENT SO JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE acute coronary syndrome; ma-jor adverse cardiac event; emergency; chest pain ID ADVERSE CARDIAC EVENTS; MYOCARDIAL-INFARCTION; PROTOCOL; SCORE; VALIDATION; GRACE; TIME AB Background: Chest pain is a common presenting symptom in the emergency department (ED). The HEART (history, electroencephalogram [ ECG], age, risk factors, and troponin I) score, with addition of troponin at 3 h, helps to determine appropriate risk stratification of the patients. Objective: This study evaluated the utility of the HEART pathway as a decision aid designed for risk stratification of patients with acuteonset chest pain for early and safe disposition. Methods: This was a prospective observational study done in a tertiary care center. Focused history, 12-lead ECG, and baseline troponin I level on arrival and at hour 3 were recorded. Subjects were classified as low risk (HEART score 0- 3) or high risk (HEART score >= 4). Patients with a HEART score of 0-3 with negative troponin I at 3 h were discharged and were followed up for major adverse cardiac events (MACEs) within 30 days of ED presentation. Results: A total of 250 patients were screened for the study, of which 151 were included for the final analysis. One hundred and two patients (68%) were male and 54% of patients were younger than 45 years. HEART scores of 0 (n = 16), 1 (n = 43), 2 (n = 44), and 3 (n = 48) were observed. There was only 1 MACE (0.7%) in 30 days after ED discharge in the study population. The mean length of ED stay in the low- risk group was 4.5 h. Conclusions: Low-risk patients, as per the HEART pathway, can be discharged safely from the ED, which reduces ED stay and health care resource use. (C) 2020 Elsevier Inc. All rights reserved. C1 [Halder, Dipanjan; Mathew, Roshan; Jamshed, Nayer; Yadav, Sakshi; Brunda, R. L.; Aggarwal, Praveen] All India Inst Med Sci, Dept Emergency Med, New Delhi 110029, India. [Narang, Rajiv] All India Inst Med Sci, Dept Cardiol, New Delhi, India. C3 All India Institute of Medical Sciences (AIIMS) New Delhi; All India Institute of Medical Sciences (AIIMS) New Delhi RP Mathew, R (通讯作者)，All India Inst Med Sci, Dept Emergency Med, New Delhi 110029, India. RI Mathew, Roshan/AAX-7803-2020 OI Mathew, Roshan/0000-0001-7047-0399; Yadav, Sakshi/0000-0003-1801-944X CR Allen Brandon R, 2018, Crit Pathw Cardiol, V17, P184, DOI 10.1097/HPC.0000000000000155 Backus Barbra E, 2010, Crit Pathw Cardiol, V9, P164, DOI 10.1097/HPC.0b013e3181ec36d8 Bhuiya Farida A, 2010, NCHS Data Brief, P1 Brady W, 2018, TURK J EMERG MED, V18, P47, DOI 10.1016/j.tjem.2018.04.004 de Hoog VC, 2018, EUR HEART J-ACUTE CA, V7, P591, DOI 10.1177/2048872617700870 Dorairaj P, 2016, CIRCULATION, V133, P1605 Frisoli Tiberio M, 2017, CIRCULATION, V10 GOLDMAN L, 1988, NEW ENGL J MED, V318, P797, DOI 10.1056/NEJM198803313181301 Gomez MA, 1996, J AM COLL CARDIOL, V28, P25, DOI 10.1016/0735-1097(96)00093-9 Hamad MMAA, 2018, CLIN MED, V18, P69, DOI 10.7861/clinmedicine.18-1-69 Hyams JM, 2018, J EMERG MED, V54, P549, DOI 10.1016/j.jemermed.2017.12.038 Kline Jeffrey A, 2005, BMC Med Inform Decis Mak, V5, P26, DOI 10.1186/1472-6947-5-26 Knockaert D C, 2002, Eur J Emerg Med, V9, P25, DOI 10.1097/00063110-200203000-00007 Mahler SA, 2016, JMIR RES PROTOC, V5, DOI 10.2196/resprot.4802 Mahler SA, 2015, CIRC-CARDIOVASC QUAL, V8, P195, DOI 10.1161/CIRCOUTCOMES.114.001384 Mahler Simon A, 2011, Crit Pathw Cardiol, V10, P128, DOI 10.1097/HPC.0b013e3182315a85 Melki Dina, 2013, Crit Pathw Cardiol, V12, P127, DOI 10.1097/HPC.0b013e3182953359 Natarajan B, 2015, INT J EMERG MED, V8, pP5, DOI [10.1186/1865-1380-8-S1-P5, DOI 10.1186/1865-1380-8-S1-P5] Nieuwets A, 2016, BMJ OPEN, V6, DOI 10.1136/bmjopen-2015-010694 Niven WGP, 2018, EMERG MED J, V35, P732, DOI 10.1136/emermed-2018-207540 Oliver JJ, 2018, INTERN EMERG MED, V13, P1249, DOI 10.1007/s11739-018-1809-y Poldervaart JM, 2017, INT J CARDIOL, V227, P656, DOI 10.1016/j.ijcard.2016.10.080 Riley RF, 2017, AM J EMERG MED, V35, P77, DOI 10.1016/j.ajem.2016.10.005 Saddichha S, 2009, INTERN EMERG MED, V4, P235, DOI 10.1007/s11739-009-0246-3 Sakamoto JT, 2016, INT J CARDIOL, V221, P759, DOI 10.1016/j.ijcard.2016.07.147 Schull MJ, 2006, ANN EMERG MED, V48, P647, DOI 10.1016/j.annemergmed.2006.03.025 Sharma M, 2005, VASC HEALTH RISK MAN, V1, P217 Sivadasanpillai H, 2014, RACE TIME CHALLENGE, V2nd 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 Sun Benjamin C, 2016, Crit Pathw Cardiol, V15, P1, DOI 10.1097/HPC.0000000000000066 Than M, 2013, INT J CARDIOL, V166, P752, DOI 10.1016/j.ijcard.2012.09.171 Wu WK, 2017, AM J EMERG MED, V35, P132, DOI 10.1016/j.ajem.2016.09.058 Yusuf S, 2014, NEW ENGL J MED, V371, P818, DOI 10.1056/NEJMoa1311890 Yusuf S, 2004, LANCET, V364, P937, DOI 10.1016/S0140-6736(04)17018-9 NR 35 TC 2 Z9 2 U1 1 U2 2 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 APR PY 2020 VL 60 IS 4 BP 421 EP 427 DI 10.1016/j.jemermed.2020.12.004 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA RT3LS UT WOS:000644364300001 PM 33485742 DA 2023-05-13 ER PT J AU Aimoli, US Miranda, CH AF Aimoli, Ugo Stocco Miranda, Carlos Henrique TI Clinical Competence in ST-segment Elevation Myocardial Infarction Management by Recently Graduated Physicians Applying for a Medical Residency Program SO ARQUIVOS BRASILEIROS DE CARDIOLOGIA LA English DT Article DE ST Elevation Myocardial Infarction; Medical Staff, Hospital; Education, Medical; Clinical Competence; Internship and Residence ID ACUTE CORONARY SYNDROME; CARE; ELECTROCARDIOGRAM; METAANALYSIS; TIME AB Background: A significant reduction in the morbidity and mortality related to ST-segment elevation myocardial infarction (STEMI) has been achieved with the development of reperfusion therapies. Early diagnosis and correct initial management are important to ensure this benefit. In Brazil, recent graduates in medicine are responsible for a large part of the initial care provided for these patients. Objective: To assess the clinical competence in the diagnosis and initial treatment of STEMI by newly graduated physicians applying for a medical residency program. Methods: We assessed the performance of 771 applicants for the direct entry selection process of the FMRP-USP Clinical Hospital Medicine Residency Program, performed in a simulated setting of STEMI, with professional actors and medical evaluators, using a standardized checklist following the recommendations of the Brazilian Guidelines for the management of disease. Results: The general performance score presented a median of 7 and an interquartile range of 5.5-8.0. In relation to the items assessed: 83% required ECG monitoring, 57% requested the insertion of a peripheral venous access catheter, 95% administered acetylsalicylic acid, 80% administered a second antiplatelet agent (p2y12 inhibitor), 66% administered nitrate, 71% administered morphine, 69% recognized the diagnosis of STEMI, 71% assessed the pain duration, 63% recognized the need for immediate transfer, 34% showed adequate communication skills and only 25% insisted on the transfer even in case of non-availability of beds. Conclusions: The initial diagnosis and management of STEMI need to be improved in medical undergraduate courses and inserted into the reality of the hierarchical network structure of the Brazilian Unified Health System (SUS). C1 [Aimoli, Ugo Stocco; Miranda, Carlos Henrique] Univ Sao Paulo, Div Med Emergencia, Dept Clin Med, Campus Ribeirao Preto, Ribeirao Preto, SP, Brazil. C3 Universidade de Sao Paulo RP Miranda, CH (通讯作者)，Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Clin Med, Div Med Emergencia, Rua Bernardino de Campos 10, BR-14040900 Ribeirao Preto, SP, Brazil. EM chmiranda@fmrp.usp.br RI Miranda, Carlos Henrique/B-6247-2014 OI Miranda, Carlos Henrique/0000-0002-5968-4879 CR Anderson JL, 2017, NEW ENGL J MED, V376, P2053, DOI 10.1056/NEJMra1606915 Brunetti ND, 2017, INT J CARDIOL, V232, P5, DOI 10.1016/j.ijcard.2017.01.055 DeWaay DJ, 2014, AM J MED SCI, V347, P452, DOI 10.1097/MAJ.0b013e3182a562d7 Fox KAA, 2007, JAMA-J AM MED ASSOC, V297, P1892, DOI 10.1001/jama.297.17.1892 Ghanem E, 2018, EMERGENCY, V6 Gibson CM, 2001, CIRCULATION, V104, P2632, DOI 10.1161/circ.104.22.2632 Lana MLL, 2017, INT J QUAL HEALTH C, V29, P499, DOI 10.1093/intqhc/mzx059 Little B, 2001, ULSTER MED J, V70, P108 McEvoy MD, 2014, ACAD MED, V89, P618, DOI 10.1097/ACM.0000000000000192 McGaghie WC, 2011, ACAD MED, V86, P706, DOI 10.1097/ACM.0b013e318217e119 Mea Schefer, 2018, DEMOGRAFIA MED BRASI Mussi FC, 2007, REV ASSOC MED BRAS, V53, P234, DOI 10.1590/S0104-42302007000300021 O'Dwyer G, 2013, BMC HEALTH SERV RES, V13, DOI 10.1186/1472-6963-13-70 Patricio MF, 2013, MED TEACH, V35, P503, DOI 10.3109/0142159X.2013.774330 Piegas LS, 2015, ARQ BRAS CARDIOL, V105, P1, DOI 10.5935/abc.20150107 Ribeiro ALP, 2009, ARQ BRAS CARDIOL, V93, P78, DOI 10.1590/S0066-782X2009000800003 Schroedl CJ, 2012, J CRIT CARE, V27, DOI 10.1016/j.jcrc.2011.08.006 Siddiqi TJ, 2018, AM J CARDIOL, V122, P542, DOI 10.1016/j.amjcard.2018.04.057 Wang R, 2014, ARQ BRAS CARDIOL, V102, P319, DOI 10.5935/abc.20140033 NR 19 TC 2 Z9 3 U1 1 U2 1 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 J9 ARQ BRAS CARDIOL JI Arq. Bras. Cardiol. PD JAN PY 2020 VL 114 IS 1 BP 35 EP 43 DI 10.36660/abc.20180309 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KM0HZ UT WOS:000513799500007 PM 32049168 OA gold, Green Published DA 2023-05-13 ER PT J AU Anjan, S Khatri, A Viotti, JB Cheung, T Garcia, LAC Simkins, J Loebe, M Phancao, A O'Brien, CB Sinha, N Ciancio, G Vianna, RM Andrews, D Abbo, LM Guerra, G Natori, Y AF Anjan, Shweta Khatri, Akshay Viotti, Julia Bini Cheung, Teresa Garcia, Leopoldo A. Cordova Simkins, Jacques Loebe, Matthias Phancao, Anita O'Brien, Christopher B. Sinha, Neeraj Ciancio, Gaetano Vianna, Rodrigo M. Andrews, David Abbo, Lilian M. Guerra, Giselle Natori, Yoichiro TI Is the Omicron variant truly less virulent in solid organ transplant recipients? SO TRANSPLANT INFECTIOUS DISEASE LA English DT Article DE COVID-19; omicron; SARS-CoV-2; solid organ transplant AB Solid organ transplant (SOT) recipients are at high risk for severe disease with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Emerging variants of concern have disproportionately affected this population. Data on severity and outcomes with the Omicron variant in SOT recipients are limited. Thus we conducted this single-center, retrospective cohort study of SOT recipients diagnosed with SARS-CoV2 infection from December 18, 2021 to January 18, 2022, when prevalence of the Omicron variant was more than 80%-95% in the community. Univariate and multivariate logistic regression analysis was performed to identify risk factors for hospital admission. We identified 166 SOT patients: 112 (67.5%) kidney, 22 (13.3%) liver, 10 (6.0%) lung, seven (4.2%) heart, and 15 (9.0%) combined transplants. SARS-CoV-2 vaccine series was completed in 59 (35.5%) recipients. Ninety-nine (59.6%) and 13 (7.8%) recipients received casirivimab/imdevimab and sotrovimab, respectively. Fifty-three (32%) recipients required hospital admission, of which 19 (35.8%) required intensive care unit level of care. Median follow-up was 50 (interquartile range, 25-59) days, with mortality reported in six (3.6%) patients. Risk factors identified for hospital admission were African American race (p < .001, odds ratio [OR] 4.00, 95% confidence interval [CI] 1.84-8.70), history of coronary artery disease (p = .031, OR 3.50, 95% CI 1.12-10.87), and maintenance immunosuppression with corticosteroids (p = .048, OR 2.00, 95% CI 1.01-4.00). In conclusion, contrary to that in the general population, we found a higher hospital admission rate in SOT recipients with omicron variant infection. Further studies to investigate the efficacy of newer treatments are necessary, even as outcomes continue to improve. C1 [Anjan, Shweta; Khatri, Akshay; Viotti, Julia Bini; Cheung, Teresa; Garcia, Leopoldo A. Cordova; Simkins, Jacques; Abbo, Lilian M.; Natori, Yoichiro] Univ Miami, Miller Sch Med, Div Infect Dis, Dept Med, 1801 NW 9th Ave,Suite 733, Miami, FL 33136 USA. [Anjan, Shweta; Simkins, Jacques; Loebe, Matthias; Phancao, Anita; O'Brien, Christopher B.; Sinha, Neeraj; Ciancio, Gaetano; Vianna, Rodrigo M.; Abbo, Lilian M.; Guerra, Giselle; Natori, Yoichiro] Jackson Hlth Syst, Miami Transplant Inst, 1801 NW 9th Ave, Miami, FL 33136 USA. [Loebe, Matthias; Ciancio, Gaetano; Vianna, Rodrigo M.] Univ Miami, Miller Sch Med, Dept Surg, Miami, FL 33136 USA. [Phancao, Anita] Univ Miami, Miller Sch Med, Div Cardiol, Dept Med, Miami, FL 33136 USA. [O'Brien, Christopher B.] Univ Miami, Miller Sch Med, Div Hepatol, Dept Med, Miami, FL 33136 USA. [Sinha, Neeraj] Univ Miami, Miller Sch Med, Div Pulmonol, Dept Med, Miami, FL 33136 USA. [Andrews, David] Univ Miami, Miller Sch Med, Dept Pathol, Miami, FL 33136 USA. [Guerra, Giselle] Univ Miami, Miller Sch Med, Dept Med, Div Nephrol, Miami, FL 33136 USA. C3 University of Miami; University of Miami; University of Miami; University of Miami; University of Miami; University of Miami; University of Miami RP Natori, Y (通讯作者)，Univ Miami, Miller Sch Med, Div Infect Dis, Dept Med, 1801 NW 9th Ave,Suite 733, Miami, FL 33136 USA.; Guerra, G (通讯作者)，Jackson Hlth Syst, Miami Transplant Inst, 1801 NW 9th Ave, Miami, FL 33136 USA. EM gguerra@med.miami.edu RI Khatri, Akshay/HJZ-4322-2023 OI Khatri, Akshay/0000-0001-5821-048X; anjan, shweta/0000-0002-7761-1163; Abbo, Lilian/0000-0002-2364-8358; Phancao, Anita/0000-0002-4294-8524 CR Abramowicz M, 2022, JAMA-J AM MED ASSOC, V327, P384, DOI 10.1001/jama.2021.24931 Acosta AM, 2021, JAMA NETW OPEN, V4, DOI 10.1001/jamanetworkopen.2021.30479 [Anonymous], 2021, THIS IS UNPRECEDENTE Behr CL, 2022, JAMA-J AM MED ASSOC, V327, P980, DOI 10.1001/jama.2022.1243 Bierle D. M., 2021, Journal of Primary Care & Community Health, V12, DOI 10.1177/21501327211019282 Chandorkar A, 2020, TRANSPL INFECT DIS, V22, DOI 10.1111/tid.13416 Faqihi F, 2021, INT J ANTIMICROB AG, V57, DOI 10.1016/j.ijantimicag.2021.106334 Gottlieb RL, 2022, NEW ENGL J MED, V386, P305, DOI 10.1056/NEJMoa2116846 Hall VG, 2021, NEW ENGL J MED, V385, P1244, DOI 10.1056/NEJMc2111462 Heldman Madeleine R, 2022, Clin Infect Dis, DOI 10.1093/cid/ciac159 Heldman MR, 2022, AM J TRANSPLANT, V22, P279, DOI 10.1111/ajt.16840 Horby P, 2021, NEW ENGL J MED, V384, P693, DOI [10.1056/NEJMoa2021436, 10.1056/NEJMoa2022926] Iuliano AD, 2022, MMWR-MORBID MORTAL W, V71, P146, DOI [10.1101/2021.12.30.21268560v2, 10.15585/mmwr.mm7104e4] Kamar N, 2021, JAMA NETW OPEN, V4, DOI 10.1001/jamanetworkopen.2021.36030 Kates Olivia S, 2021, Clin Infect Dis, V73, pe4090, DOI 10.1093/cid/ciaa1097 Ko JY, 2021, CLIN INFECT DIS, V72, pE695, DOI 10.1093/cid/ciaa1419 Kumar D, 2020, AM J TRANSPLANT, V20, P1773, DOI 10.1111/ajt.15876 Qin CX, 2021, TRANSPLANTATION, V105, pE265, DOI 10.1097/TP.0000000000003907 Raja MA, 2021, TRANSPLANT REV-ORLAN, V35, DOI 10.1016/j.trre.2020.100588 Solera JT, 2022, CLIN INFECT DIS, V75, P2193, DOI 10.1093/cid/ciac324 Villanego F, 2022, TRANSPLANTATION, V106, pE304, DOI 10.1097/TP.0000000000004126 WHO R&D Blueprint, COVID 19 THER TRIAL NR 22 TC 4 Z9 4 U1 4 U2 6 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1398-2273 EI 1399-3062 J9 TRANSPL INFECT DIS JI Transpl. Infect. Dis. PD DEC PY 2022 VL 24 IS 6 AR e13923 DI 10.1111/tid.13923 EA AUG 2022 PG 6 WC Immunology; Infectious Diseases; Transplantation WE Science Citation Index Expanded (SCI-EXPANDED) SC Immunology; Infectious Diseases; Transplantation GA 7K8PA UT WOS:000839604000001 PM 35915957 OA Green Published DA 2023-05-13 ER PT J AU Cornelius, T Moise, N Birk, JL Edmondson, D Chang, BP AF Cornelius, Talea Moise, Nathalie Birk, Jeffrey L. Edmondson, Donald Chang, Bernard P. TI The presence of companions during emergency department evaluation and its impact on perceptions of clinician-patient communication SO EMERGENCY MEDICINE JOURNAL LA English DT Article ID CARE AB Objectives Research in outpatient setting suggests that the presence of companions during a medical encounter can improve clinician-patient communication. It is not known if the presence of companions has a similar effect in the acutely stressful context of the ED. This study tested whether the presence of companions in the ED relate to stronger clinician-patient communication. We further explored effect modification by demographic factors (race/ethnicity, education and language) thought to compromise communication. Methods Participants were drawn from an observational cohort study of patients with suspected acute coronary syndrome (n=876) recruited from an urban academic medical centre between 2013 and 2016. Patient interviews occurred both in the ED and post-ED discharge; communication was assessed using the Interpersonal Processes of Care Survey with possible range of scores of 14-70. Companions were categorised as close others (ie, partner/spouse or child), non-close others (eg, neighbour) or no one. Results Perceptions of clinician-patient communication were high (mean=57.1, SD=10.6;). There was no association between companions (close/non-close/no one) and clinician-patient communication, p=0.262. Demographic factors were unrelated to communication. There was a significant interaction between education and companions. Having a close other in the ED was associated with stronger clinician-patient communication only for patients with high school education or less, p=0.027. Conclusions Neither the presence of companions nor demographic factors were related to clinician-patient communication. The interaction effect suggesting that patients completing high school or less have the most to gain from the presence of close others warrants further exploration. C1 [Cornelius, Talea; Moise, Nathalie; Birk, Jeffrey L.; Edmondson, Donald] Columbia Univ, Med Ctr, Ctr Behav Cardiovasc Hlth, New York, NY 10032 USA. [Chang, Bernard P.] Columbia Univ, Med Ctr, Dept Emergency Med, New York, NY USA. C3 Columbia University; Columbia University RP Cornelius, T (通讯作者)，Columbia Univ, Med Ctr, Ctr Behav Cardiovasc Hlth, New York, NY 10032 USA. EM tmc2184@cumc.columbia.edu RI Chang, Bernard P./AAI-1139-2019; Edmondson, Donald/G-7486-2016 OI Edmondson, Donald/0000-0002-4518-8196; Moise, Nathalie/0000-0002-5660-5573; Birk, Jeffrey/0000-0002-1313-0993; Cornelius, Talea/0000-0001-7181-0981; CHANG, BERNARD/0000-0001-8800-7140 FU National Heart, Lung, and Blood Institute (NHLBI) [R01HL117832, R01HL128310, R01HL123368, R01 HS025198]; National Institute of Health/NCAT [KL2TR0001874]; NY Empire Clinical Research Investigator Program FX This work was supported by National Heart, Lung, and Blood Institute (NHLBI) grants to DE (grant numbers R01HL117832, R01HL128310), IK (R01HL123368) and NM (R01 HS025198]. BPC is supported by a mentored career development grant by the National Institute of Health/NCAT (KL2 TRANSFORM: KL2TR0001874) and the NY Empire Clinical Research Investigator Program. CR Betancourt JR, 2003, PUBLIC HEALTH REP, V118, P293, DOI 10.1093/phr/118.4.293 Burley Duncan, 2011, Emerg Nurse, V19, P32 CHARLSON M, 1994, J CLIN EPIDEMIOL, V47, P1245, DOI 10.1016/0895-4356(94)90129-5 Edmondson D, 2013, JAMA INTERN MED, V173, P472, DOI 10.1001/jamainternmed.2013.2536 Fox KAA, 2006, BMJ-BRIT MED J, V333, P1091, DOI 10.1136/bmj.38985.646481.55 Gordon Jane, 2010, Int Emerg Nurs, V18, P80, DOI 10.1016/j.ienj.2009.05.004 Schilling LM, 2002, J FAM PRACTICE, V51, P685 Stewart AL, 2007, HEALTH SERV RES, V42, P1235, DOI 10.1111/j.1475-6773.2006.00637.x Stoklosa H, 2018, EMERG MED J, V35, P406, DOI 10.1136/emermed-2017-207119 Zolnierek KBH, 2009, MED CARE, V47, P826, DOI 10.1097/MLR.0b013e31819a5acc NR 10 TC 3 Z9 3 U1 0 U2 4 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 2018 VL 35 IS 11 BP 701 EP 703 DI 10.1136/emermed-2018-207735 PG 3 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Emergency Medicine GA HA6UV UT WOS:000450416800012 PM 30131354 OA Green Accepted DA 2023-05-13 ER PT J AU Poli, A Marangoni, F Avogaro, A Barba, G Bellentani, S Bucci, M Cambieri, R Catapano, AL Costanzo, S Cricelli, C de Gaetano, G Di Castelnuovo, A Faggiano, P Fattirolli, F Fontana, L Forlani, G Frattini, S Giacco, R La Vecchia, C Lazzaretto, L Loffredo, L Lucchin, L Marelli, G Marrocco, W Minisola, S Musicco, M Novo, S Nozzoli, C Pelucchi, C Perri, L Pieralli, F Rizzoni, D Sterzi, R Vettor, R Violi, F Visioli, F AF Poli, A. Marangoni, F. Avogaro, A. Barba, G. Bellentani, S. Bucci, M. Cambieri, R. Catapano, A. L. Costanzo, S. Cricelli, C. de Gaetano, G. Di Castelnuovo, A. Faggiano, P. Fattirolli, F. Fontana, L. Forlani, G. Frattini, S. Giacco, R. La Vecchia, C. Lazzaretto, L. Loffredo, L. Lucchin, L. Marelli, G. Marrocco, W. Minisola, S. Musicco, M. Novo, S. Nozzoli, C. Pelucchi, C. Perri, L. Pieralli, F. Rizzoni, D. Sterzi, R. Vettor, R. Violi, F. Visioli, F. TI Moderate alcohol use and health: A consensus document SO NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES LA English DT Review DE Alcohol; Cardiovascular disease; Cancer; Prevention; Polyphenols; Diabetes; Metabolic syndrome; Cognitive decline; Overall mortality ID CORONARY-HEART-DISEASE; PERIPHERAL ARTERIAL-DISEASE; BONE-MINERAL DENSITY; SUDDEN CARDIAC DEATH; 3RD NATIONAL-HEALTH; RED WINE; CARDIOVASCULAR-DISEASE; INSULIN SENSITIVITY; BLOOD-PRESSURE; RISK-FACTORS AB Aims: The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities. Data synthesis: In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, or cardiovascular patients should discuss with their physician their drinking habits. No abstainer should be advised to drink for health reasons. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician. Conclusions: The choice to consume alcohol should be based on individual considerations, taking into account the influence on health and diet, the risk of alcoholism and abuse, the effect on behaviour and other factors that may vary with age and lifestyle. Moderation in drinking and development of an associated lifestyle culture should be fostered. (C) 2013 Elsevier B.V. All rights reserved. C1 [Poli, A.; Marangoni, F.] NFI, I-20124 Milan, Italy. [Avogaro, A.] Univ Padua, I-35100 Padua, Italy. [Barba, G.] CNR, Italian Natl Res Council, Inst Food Sci, SIIA Italian Soc Hypertens, Avellino, Italy. [Bellentani, S.] Ramazzini Hosp, Local Hlth Agcy Modena, Gastroenterol & Liver Ctr, Carpi, Italy. [Bucci, M.] Univ G dAnnunzio, Univ G DAnnunzio Fdn, SISA Italian Soc Study Atherosclerosis, Chieti, Italy. [Bucci, M.] Univ G dAnnunzio, Univ G DAnnunzio Fdn, Clin Res Ctr Ce SI, Chieti, Italy. [Cambieri, R.] SNAMID Natl Soc Med Educ, Milan, Italy. [Catapano, A. L.] Univ Milan, SITECS Italian Soc Clin & Expt Therapy, I-20122 Milan, Italy. [Catapano, A. L.] Univ Milan, Dept Pharmacol & Biomol Sci, I-20122 Milan, Italy. [Costanzo, S.] Catholic Univ, Lab Genet & Environm Epidemiol, Campobasso, Italy. [Cricelli, C.] SIMG Italian Soc Gen Med, Florence, Italy. [de Gaetano, G.] Catholic Univ, John Paul Fdn Res & Treatment 2, Res Labs, Campobasso, Italy. [Di Castelnuovo, A.] Catholic Univ, John Paul Fdn Res & Treatment 2, Lab Genet & Environm Epidemiol, Campobasso, Italy. [Faggiano, P.] Univ Brescia, ANMCO Italian Natl Assoc Hosp Cardiologists, I-25121 Brescia, Italy. [Faggiano, P.] Univ Brescia, Chair Cardiol, I-25121 Brescia, Italy. [Fattirolli, F.] Careggi Hosp, ANMCO Italian Natl Assoc Hosp Cardiologists, Florence, Italy. [Fattirolli, F.] Univ Florence, I-50121 Florence, Italy. [Fontana, L.] Sandro Pertini Hosp, AMD Italian Assoc Diabetologists, Dietol Diabetol & Metab Dis Unit, Rome, Italy. [Forlani, G.] Univ Bologna, AMD Italian Assoc Diabetologists, Unit Metab Dis & Clin Dietet, Alma Mater Studiorum, I-40126 Bologna, Italy. [Frattini, S.] Ist Ospitalieri Cremona, ANMCO Italian Natl Assoc Hosp Cardiologist, Cremona, Italy. [Frattini, S.] Ist Ospitalieri Cremona, Cardiol Unit, Cremona, Italy. [Giacco, R.] Natl Res Council CNR, SID, Avellino, Italy. [Giacco, R.] Natl Res Council CNR, Inst Food Sci, Avellino, Italy. [La Vecchia, C.; Pelucchi, C.] Univ Milan, Mario Negri Pharmacol Res Inst, I-20122 Milan, Italy. [La Vecchia, C.; Pelucchi, C.] Univ Milan, Dept Clin Sci & Community Hlth, I-20122 Milan, Italy. [Lazzaretto, L.; Marrocco, W.] FIMMG Italian Federat Gen Med Doctors, Rome, Italy. [Loffredo, L.; Perri, L.; Violi, F.] Univ Roma La Sapienza, SIMI, Dept Internal Med & Med Specialties, Rome, Italy. [Lucchin, L.] ADI, Dietet & Clin Nutr Unit, Bolzano, Italy. [Minisola, S.] Univ Roma La Sapienza, SIOMMMS Italian Soc Osteoporosis Mineral Metab &, Dept Internal Med, Rome, Italy. [Minisola, S.] Univ Roma La Sapienza, Med Disciplines, Rome, Italy. [Musicco, M.] CNR, ITB, I-20133 Milan, Italy. [Novo, S.] Univ Palermo, SIC, Chair Cardiovasc Dis, Dept Biomed Internal & Special DIBIMIS, I-90133 Palermo, Italy. [Nozzoli, C.; Pieralli, F.] Univ Hosp Careggi, FADOI Italian Federat Assoc Internal Med Phys, Florence, Italy. [Rizzoni, D.] Univ Brescia, SIIA Italian Soc Hypertens, Dept Clin & Expt Sci, I-25121 Brescia, Italy. [Sterzi, R.] Azienda Osped Niguarda Ca Granda, Italian Stroke Forum, Milan, Italy. [Vettor, R.] Azienda Osped Univ Padova, SIO, Dept Med & Surg Sci, Padua, Italy. [Visioli, F.] CEI UAM CSIC, Lab Funct Foods, Madrid Inst Adv Studies IMDEA Food, Madrid, Spain. C3 University of Padua; Consiglio Nazionale delle Ricerche (CNR); Istituto di Scienze dell' Alimentazione (ISA-CNR); G d'Annunzio University of Chieti-Pescara; G d'Annunzio University of Chieti-Pescara; University of Milan; University of Milan; Catholic University of the Sacred Heart; Catholic University of the Sacred Heart; Catholic University of the Sacred Heart; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO); University of Brescia; University of Brescia; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO); University of Florence; Azienda Ospedaliero Universitaria Careggi; University of Florence; Ospedale Sandro Pertini; University of Bologna; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO); Consiglio Nazionale delle Ricerche (CNR); Istituto di Scienze dell' Alimentazione (ISA-CNR); Istituto di Ricerche Farmacologiche Mario Negri IRCCS; University of Milan; University of Milan; Sapienza University Rome; Sapienza University Rome; Sapienza University Rome; Consiglio Nazionale delle Ricerche (CNR); Istituto di Tecnologie Biomediche (ITB-CNR); University of Palermo; University of Florence; Azienda Ospedaliero Universitaria Careggi; University of Brescia; IRCCS Ca Granda Ospedale Maggiore Policlinico; Ospedale Niguarda Ca' Granda; University of Padua; Azienda Ospedaliera - Universita di Padova; Consejo Superior de Investigaciones Cientificas (CSIC); IMDEA Food Institute RP Poli, A (通讯作者)，NFI, Viale Tunisia 38, I-20124 Milan, Italy. EM poli@nutrition-foundation.it RI VETTOR, ROBERTO/K-7121-2016; Avogaro, Angelo/S-3808-2016; nozzoli, carlo/AAW-9197-2020; Cricelli, Claudio/E-7607-2010; Di Castelnuovo, Augusto Filippo/AAC-2436-2022; Loffredo, Lorenzo/K-4873-2016; Di Castelnuovo, Augusto Filippo/K-5517-2016; Bellentani, Stefano/L-3600-2019; Visioli, Francesco/J-9356-2013; Violi, Francesco/K-1509-2016; Costanzo, Simona/K-5076-2016; Catapano, alberico/AAC-2827-2019; Visioli, Francesco/AAE-8510-2020 OI Cricelli, Claudio/0000-0002-9607-5802; Di Castelnuovo, Augusto Filippo/0000-0001-9767-7998; Loffredo, Lorenzo/0000-0002-6542-6235; Di Castelnuovo, Augusto Filippo/0000-0001-9767-7998; Visioli, Francesco/0000-0002-1756-1723; Violi, Francesco/0000-0002-6610-7068; Costanzo, Simona/0000-0003-4569-1186; Catapano, alberico/0000-0002-7593-2094; Bellentani, Stefano/0000-0003-2836-8870; Novo, Salvatore/0000-0002-7995-184X; AVOGARO, ANGELO/0000-0002-1177-0516; Vettor, Roberto/0000-0003-0625-6667; La Vecchia, 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Metab. Carbiovasc. Dis. PD JUN PY 2013 VL 23 IS 6 BP 487 EP 504 DI 10.1016/j.numecd.2013.02.007 PG 18 WC Cardiac & Cardiovascular Systems; Endocrinology & Metabolism; Nutrition & Dietetics WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Endocrinology & Metabolism; Nutrition & Dietetics GA 167QE UT WOS:000320646000004 PM 23642930 OA Green Published DA 2023-05-13 ER PT J AU Jentzer, JC Tabi, M Wiley, BM Singam, NSV Anavekar, NS AF Jentzer, Jacob C. Tabi, Meir Wiley, Brandon M. Singam, Narayana S., V Anavekar, Nandan S. TI Echocardiographic Correlates of Mortality Among Cardiac Intensive Care Unit Patients With Cardiogenic Shock SO SHOCK LA English DT Article DE Cardiogenic shock; CICU; doppler; echocardiography; hemodynamics; mortality; shock; stroke volume ID RIGHT-VENTRICULAR DYSFUNCTION; MYOCARDIAL-INFARCTION; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; RISK PREDICTION; ADULTS; TRIAL; HEART AB Background: Prior studies have shown worse outcomes in patients with cardiogenic shock (CS) who have reduced left ventricular ejection fraction (LVEF), but the association between other transthoracic echocardiogram (TTE) findings and mortality in CS patients remains uncertain. We hypothesized that Doppler TTE measurements would outperform LVEF for risk stratification. Methods: Retrospective analysis of cardiac intensive care unit patients with an admission diagnosis of CS and a TTE within 1 day of admission. Hospital survivors and inpatient deaths were compared, and multivariable logistic regression was used to analyze the associations between TTE variables and hospital mortality. Results: We included 1,085 patients, with a median age of 69.5 (59.6, 77.5) years; 37% were females and 62% had an acute coronary syndrome. Most patients (66%) had moderate or severe left ventricular (LV) systolic dysfunction, and 48% had moderate or severe right ventricular (RV) systolic dysfunction. Hospital mortality occurred in 31%, and inpatient deaths had a lower median LVEF (29% vs. 35%, P < 0.001). Patients with mild or no LV or RV dysfunction were at lower risk of adjusted hospital mortality (P < 0.01). The LV outflow tract (LVOT) velocity-time integral (VTI) was the single best predictor of hospital mortality. After multivariable adjustment, both the LVEF and LVOT VTI remained strongly associated with hospital mortality (P < 0.001). Conclusions: Early comprehensive Doppler TTE can provide important prognostic insights in CS patients, highlighting its potential utility in clinical practice. The LVOT VTI, reflecting forward flow, is an important measurement to obtain on bedside TTE. C1 [Jentzer, Jacob C.; Tabi, Meir; Wiley, Brandon M.; Anavekar, Nandan S.] Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA. [Jentzer, Jacob C.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN 55905 USA. [Singam, Narayana S., V] Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, Rochester, MN 55905 USA. C3 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. EM jentzer.jacob@mayo.edu OI Singam, Narayana Sarma/0000-0002-6289-2273 CR Acharya D, 2018, CARDIOL REV, V26, P255, DOI 10.1097/CRD.0000000000000190 Aissaoui N, 2011, INTENS CARE MED, V37, P1738, DOI 10.1007/s00134-011-2358-2 Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 Bohula EA, 2019, JAMA CARDIOL, V4, P928, DOI 10.1001/jamacardio.2019.2467 De Backer D, 2018, INTENS CARE MED, V44, P730, DOI 10.1007/s00134-018-5187-8 Engstrom AE, 2010, EUR J HEART FAIL, V12, P276, DOI 10.1093/eurjhf/hfp204 Fincke R, 2004, J AM COLL CARDIOL, V44, P340, DOI 10.1016/j.jacc.2004.03.060 Garan AR, 2020, JACC-HEART FAIL, V8, P903, DOI 10.1016/j.jchf.2020.08.012 Harjola VP, 2015, EUR J HEART FAIL, V17, P501, DOI 10.1002/ejhf.260 Jentzer JC, 2021, J AM HEART ASSOC, V10, DOI 10.1161/JAHA.120.019015 Jentzer JC, 2020, CIRC-CARDIOVASC IMAG, V13, DOI 10.1161/CIRCIMAGING.120.011642 Jentzer JC, 2021, JACC-CARDIOVASC IMAG, V14, P321, DOI 10.1016/j.jcmg.2020.05.038 Jentzer JC, 2020, AM HEART J, V224, P57, DOI 10.1016/j.ahj.2020.02.018 Jentzer JC, 2020, CATHETER CARDIO INTE, V96, P1350, DOI 10.1002/ccd.28854 Jentzer JC, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013675 Jentzer JC, 2019, J CRIT CARE, V54, P284, DOI 10.1016/j.jcrc.2019.07.011 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2020, SHOCK, V53, P452, DOI 10.1097/SHK.0000000000001390 Jentzer JC, 2018, AM J CARDIOL, V122, P1773, DOI 10.1016/j.amjcard.2018.08.011 Jentzer JC, 2018, J CRIT CARE, V47, P114, DOI 10.1016/j.jcrc.2018.06.016 Jentzer JC, 2018, RESUSCITATION, V126, P1, DOI 10.1016/j.resuscitation.2018.01.050 Jentzer JC, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008169 Jentzer JC, 2015, BIOMED RES INT, V2015, DOI 10.1155/2015/314796 Jentzer JC., 2021, INT J CARDIOL, V23 Lala A, 2018, J CARD FAIL, V24, P148, DOI 10.1016/j.cardfail.2017.10.009 Lang RM, 2015, J AM SOC ECHOCARDIOG, V28, P1, DOI 10.1016/j.echo.2014.10.003 Mele D, 2020, J AM SOC ECHOCARDIOG, V33, P135, DOI 10.1016/j.echo.2019.09.009 Papolos A, 2016, J AM COLL CARDIOL, V67, P502, DOI 10.1016/j.jacc.2015.10.090 Picard MH, 2003, CIRCULATION, V107, P279, DOI 10.1161/01.CIR.0000045667.11911.F6 Rudski LG, 2010, J AM SOC ECHOCARDIOG, V23, P685, DOI 10.1016/j.echo.2010.05.010 Sionis A, 2020, J INTENSIVE CARE MED, V35, P1426, DOI 10.1177/0885066619828959 Tabi M, 2022, J INTENSIVE CARE MED, V37, P518, DOI 10.1177/0885066621998936 Thayer KL, 2020, CIRC-HEART FAIL, V13, DOI 10.1161/CIRCHEARTFAILURE.120.007099 Torgersen C, 2009, CRIT CARE, V13, DOI 10.1186/cc8114 van Diepen S, 2017, CIRCULATION, V136, pE232, DOI 10.1161/CIR.0000000000000525 NR 35 TC 4 Z9 4 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1073-2322 EI 1540-0514 J9 SHOCK JI Shock PD MAR PY 2022 VL 57 IS 3 BP 336 EP 343 DI 10.1097/SHK.0000000000001877 PG 8 WC Critical Care Medicine; Hematology; Surgery; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Hematology; Surgery; Cardiovascular System & Cardiology GA ZI9WY UT WOS:000761963400003 PM 34710882 DA 2023-05-13 ER PT J AU Jentzer, JC Wiley, BM Anavekar, NS AF Jentzer, Jacob C. Wiley, Brandon M. Anavekar, Nandan S. TI Echocardiographic left ventricular stroke work index: An integrated noninvasive measure of shock severity SO PLOS ONE LA English DT Article ID CARDIOGENIC-SHOCK; EUROPEAN ASSOCIATION; FILLING PRESSURES; AMERICAN SOCIETY; CARDIAC POWER; MORTALITY; CARE; HEART; RECOMMENDATIONS; GUIDELINES AB BackgroundEchocardiographic findings vary with shock severity, as defined by the Society for Cardiovascular Angiography and Intervention (SCAI) shock stage. Left ventricular stroke work index (LVSWI) measured by transthoracic echocardiography (TTE) can predict mortality in the cardiac intensive care unit (CICU). We sought to determine whether LVSWI could refine mortality risk stratification by the SCAI shock classification in the CICU. MethodsWe included consecutive CICU patients from 2007 to 2015 with TTE data available to calculate the LVSWI, specifically the mean arterial pressure, stroke volume index and medial mitral E/e' ratio. In-hospital mortality as a function of LVSWI was evaluated across the SCAI shock stages using logistic regression, before and after multivariable adjustment. ResultsWe included 3635 unique CICU patients, with a mean age of 68.1 +/- 14.5 years (36.5% females); 61.1% of patients had an acute coronary syndrome. The LVSWI progressively decreased with increasing shock severity, as defined by increasing SCAI shock stage. A total of 203 (5.6%) patients died during hospitalization, with higher in-hospital mortality among patients with lower LVSWI (adjusted OR 0.66 per 10 J/m2 higher) or higher SCAI shock stage (adjusted OR 1.24 per each higher stage). A LVSWI <33 J/m2 was associated with higher adjusted in-hospital mortality, particularly among patients with shock (SCAI stages C, D and E). ConclusionsThe LVSWI by TTE noninvasively characterizes the severity of shock, including both systolic and diastolic parameters, and can identify low-risk and high-risk patients at each level of clinical shock severity. C1 [Jentzer, Jacob C.; Wiley, Brandon M.; Anavekar, Nandan S.] Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA. [Jentzer, Jacob C.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic RP Jentzer, JC (通讯作者)，Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA.; Jentzer, JC (通讯作者)，Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN 55905 USA. 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Chan, Daniel L. deLaforcade, Armelle M. Rozanski, Elizabeth Sharp, Claire R. TI American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines: Small animal SO JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE LA English DT Article DE anticoagulant; antiplatelet agent; cats; dogs; thromboprophylaxis ID MOLECULAR-WEIGHT HEPARIN; MEDIATED HEMOLYTIC-ANEMIA; FACTOR XA INHIBITOR; ACUTE CORONARY SYNDROMES; NEUTROPHIL EXTRACELLULAR TRAPS; DUAL ANTIPLATELET THERAPY; PORTAL-VEIN THROMBOSIS; SPONTANEOUS ECHOCARDIOGRAPHIC CONTRAST; CARDIOGENIC ARTERIAL THROMBOEMBOLISM; ELEVATION MYOCARDIAL-INFARCTION AB Objectives To systematically review available evidence and establish guidelines related to the risk of developing thrombosis and the management of small animals with antithrombotics. Design Standardized, systematic evaluation of the literature (identified by searching Medline via PubMed and CAB abstracts) was carried out in 5 domains (Defining populations at risk; Defining rational therapeutic use; Defining evidence-based protocols; Refining and monitoring antithrombotic therapies; and Discontinuing antithrombotic therapies). Evidence evaluation was carried out using Population, Intervention, Comparison, Outcome generated within each domain questions to address specific aims. This was followed by categorization of relevant articles according to level of evidence and quality (Good, Fair, or Poor). Synthesis of these data led to the development of a series of statements. Consensus on the final guidelines was achieved via Delphi-style surveys. Draft recommendations were presented at 2 international veterinary conferences and made available for community assessment, review, and comment prior to final revisions and publication. Settings Academic and referral veterinary medical centers. Results Over 500 studies were reviewed in detail. Worksheets from all 5 domains generated 59 statements with 83 guideline recommendations that were refined during 3 rounds of Delphi surveys. A high degree of consensus was reached across all guideline recommendations. Conclusions Overall, systematic evidence evaluations yielded more than 80 recommendations for the treatment of small animals with or at risk of developing thrombosis. Numerous significant knowledge gaps were highlighted by the evidence reviews undertaken, indicating the need for substantial additional research in this field. C1 [Goggs, Robert] Cornell Univ, Coll Vet Med, Dept Clin Sci, C3-502D CPC,930 Campus Rd, Ithaca, NY 14853 USA. [Blais, Marie-Claude] Univ Montreal, Fac Vet Med, Dept Clin Sci, St Hyacinthe, PQ, Canada. [Brainard, Benjamin M.] Univ Georgia, Dept Small Anim Med & Surg, Athens, GA 30602 USA. [Chan, Daniel L.] Royal Vet Coll, Dept Clin Sci & Serv, London, England. [deLaforcade, Armelle M.; Rozanski, Elizabeth] Tufts Univ, Cummings Sch Vet Med, Dept Clin Sci, North Grafton, MA USA. [Sharp, Claire R.] Murdoch Univ, Coll Vet Med, Sch Vet & Life Sci, Murdoch, WA, Australia. C3 Cornell University; Universite de Montreal; University System of Georgia; University of Georgia; University of London; University of London Royal Veterinary College; Tufts University; Murdoch University RP Goggs, R (通讯作者)，Cornell Univ, Coll Vet Med, Dept Clin Sci, C3-502D CPC,930 Campus Rd, Ithaca, NY 14853 USA. 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Vet. Emerg. Crit. Care PD JAN-FEB PY 2019 VL 29 IS 1 SI SI BP 12 EP 36 DI 10.1111/vec.12801 PG 25 WC Veterinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Veterinary Sciences GA HI2CQ UT WOS:000456252700003 PM 30654421 OA Green Accepted DA 2023-05-13 ER PT J AU Ghassemi, MM Richter, SE Eche, IM Chen, TW Danziger, J Celi, LA AF Ghassemi, Mohammad M. Richter, Stefan E. Eche, Ifeoma M. Chen, Tszyi W. Danziger, John Celi, Leo A. TI A data-driven approach to optimized medication dosing: a focus on heparin SO INTENSIVE CARE MEDICINE LA English DT Article DE Observational; Heparin; Clinical informatics; Dosing; Optimization ID ACUTE CORONARY SYNDROMES; INTENSIVE-CARE; THERAPY; NOMOGRAM AB To demonstrate a novel method that utilizes retrospective data to develop statistically optimal dosing strategies for medications with sensitive therapeutic windows. We illustrate our approach on intravenous unfractionated heparin, a medication which typically considers only patient weight and is frequently misdosed. We identified available clinical features which impact patient response to heparin and extracted 1,511 patients from the multi-parameter intelligent monitoring in intensive care II database which met our inclusion criteria. These were used to develop two multivariate logistic regressions, modeling sub- and supra-therapeutic activated partial thromboplastin time (aPTT) as a function of clinical features. We combined information from these models to estimate an initial heparin dose that would, on a per-patient basis, maximize the probability of a therapeutic aPTT within 4-8 h of the initial infusion. We tested our model's ability to classifying therapeutic outcomes on a withheld dataset and compared performance to a weight-alone alternative using volume under surface (VUS) (a multiclass version of AUC). We observed statistically significant associations between sub- and supra-therapeutic aPTT, race, ICU type, gender, heparin dose, age and Sequential Organ Failure Assessment scores with mean validation AUC of 0.78 and 0.79 respectively. Our final model improved outcome classification over the weight-alone alternative, with VUS values of 0.48 vs. 0.42. This work represents an important step in the secondary use of health data in developing models to optimize drug dosing. The next step would be evaluating whether this approach indeed achieves target aPTT more reliably than the current weight-based heparin dosing in a randomized controlled trial. C1 [Ghassemi, Mohammad M.; Celi, Leo A.] MIT, Lab Computat Physiol, Cambridge, MA 02139 USA. [Richter, Stefan E.] Univ Calif Los Angeles, Los Angeles, CA USA. [Eche, Ifeoma M.; Chen, Tszyi W.; Danziger, John; Celi, Leo A.] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. C3 Massachusetts Institute of Technology (MIT); University of California System; University of California Los Angeles; Harvard University; Beth Israel Deaconess Medical Center RP Ghassemi, MM (通讯作者)，MIT, Lab Computat Physiol, E25-505,77 Massachusetts Ave, Cambridge, MA 02139 USA. EM ghassemi@mit.edu; srichter@mednet.ucla.edu; ieche@bidmc.harvard.edu; twchen@bidmc.harvard.edu; jdanzige@bidmc.harvard.edu; lceli@mit.edu FU National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (NIH) [R01 EB001659] FX Grant R01 EB001659 from the National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (NIH). The sponsors of this research played no role in the research process of this work beyond their important financial contribution. 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PD SEP PY 2014 VL 40 IS 9 BP 1332 EP 1339 DI 10.1007/s00134-014-3406-5 PG 8 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AO5IK UT WOS:000341377400014 PM 25091788 OA Green Submitted, Green Accepted DA 2023-05-13 ER PT J AU Pacak, K AF Pacak, Karel TI New Biology of Pheochromocytoma and Paraganglioma SO ENDOCRINE PRACTICE LA English DT Review DE pheochromocytoma; paraganglioma; metanephrine; genetics; imaging; therapy ID FUNCTIONAL IMAGING MODALITIES; VON-HIPPEL-LINDAU; METASTATIC PHEOCHROMOCYTOMA; PLASMA-FREE; MALIGNANT PHEOCHROMOCYTOMA; BIOCHEMICAL-DIAGNOSIS; MANAGEMENT; MUTATIONS; PET/CT; NORMETANEPHRINE AB Pheochromocytomas and paragangliomas continue to be defined by significant morbidity and mor-tality despite their several recent advances in diagnosis, localization, and management. These adverse outcomes are largely related to mass effect as well as catecholamine-induced hypertension, tachy-arrhythmias and consequent target organ damage, acute coronary syndromes, and strokes (ischemic and hemorrhagic stroke). Thus, a proper understanding of the physiology and pathophysiology of these tumors and recent advances are essential to affording optimal care. These major developments largely include a redefinition of metastatic behavior, a novel clinical categorization of these tumors into 3 genetic clusters, and an enhanced understanding of catecholamine metabolism and consequent specific biochemical phenotypes. Current advances in imaging of these tumors are shifting the paradigm from poorly specific anatomical modalities to more precise characterization of these tumors using the advent and development of functional imaging modalities. Furthermore, recent advances have revealed new molecular events in these tumors that are linked to their genetic landscape and, therefore, provide new therapeutic platforms. A few of these prospective therapies translated into new clinical trials, especially for patients with metastatic or inoperable tumors. Finally, outcomes are ever-improving as patients are cared for at centers with cumulative experience and well-established multidisciplinary tumor boards. In parallel, these centers have supported national and international collaborative efforts and worldwide clinical trials. These concerted efforts have led to improved guidelines collaboratively developed by healthcare professionals with a growing expertise in these tumors and consequently improving detection, prevention, and identification of genetic susceptibility genes in these patients.Published by Elsevier Inc. on behalf of the AACE. C1 [Pacak, Karel] Eunice Kennedy Shriver Natl Inst Child Hlth & Huma, Sect Med Neuroendocrinol, NIH, Bethesda, MD USA. [Pacak, Karel] Eunice Kennedy Shriver NICHD, Sect Med Neuroendocrinol, Dev Endocrinol Metab Genet & Endocrine Oncol Affin, NIH,CRC, Bldg 10,Room 1E-3140,10 Ctr Dr MSC-1109, Bethesda, MD 20892 USA. C3 National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) RP Pacak, K (通讯作者)，Eunice Kennedy Shriver NICHD, Sect Med Neuroendocrinol, Dev Endocrinol Metab Genet & Endocrine Oncol Affin, NIH,CRC, Bldg 10,Room 1E-3140,10 Ctr Dr MSC-1109, Bethesda, MD 20892 USA. EM karel@mail.nih.gov FU National Institutes of Health [Z1AHD008735]; Intramural Research Program of the National Institutes of Health; Eunice Kennedy Shriver National Institute of Child Health and Human Development FX I thank Alan Hoofring who assisted with medical illustration of Figures 1 to 4 and 6. This study was funded by the National Institutes of Health (grant number Z1AHD008735) awarded to Karel Pacak. This work was supported, by the Intramural Research Program of the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development. 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Pract. PD DEC PY 2022 VL 28 IS 12 BP 1253 EP 1269 DI 10.1016/j.eprac.2022.09.003 EA DEC 2022 PG 17 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism GA 6W7HH UT WOS:000895897300009 PM 36150627 DA 2023-05-13 ER PT J AU Jentzer, JC van Diepen, S Henry, TD Baran, DA Barsness, GW Holmes, DR AF Jentzer, Jacob C. van Diepen, Sean Henry, Timothy D. Baran, David A. Barsness, Gregory W. Holmes, David R., Jr. TI Influence of intra-aortic balloon pump on mortality as a function of cardiogenic shock severity SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE cardiogenic; intra‐ aortic balloon pump; mechanical circulatory support; mortality; organ failure; shock; shockCICU ID MYOCARDIAL-INFARCTION; CARE; COUNTERPULSATION; SUPPORT; TRENDS; RISK AB Background Randomized studies of intra-aortic balloon pump (IABP) in cardiogenic shock (CS) have focused exclusively on patients with acute coronary syndromes (ACS) without stratification according to shock severity. We examined the association between IABP and mortality in CS patients across the Society for Cardiovascular Angiography and Intervention (SCAI) shock stages. Methods We included cardiac intensive care unit patients admitted from 2007 to 2015 with CS from any etiology. In-hospital mortality associated with IABP was examined in each SCAI shock stage. Multivariable logistic regression was performed using inverse probability of treatment weighting (IPTW) to determine the association between IABP and in-hospital mortality. Results We included 934 patients, with a mean age of 68 +/- 14 years; 60% had ACS. The distribution of SCAI shock stages was: B, 41%; C, 13%; D, 38%; E, 8%. In-hospital mortality was lower in the 39% of patients who received IABP (27% vs. 43%, adjusted OR with IABP after IPTW 0.53, 95% CI 0.40-0.72, p < .0001). IABP use was associated with lower crude in-hospital mortality in each SCAI shock stage (all p < .05, except p = .08 in SCAI shock stage E). We did not observe any significant heterogeneity in the association between IABP use and in-hospital mortality as a function of SCAI shock stage. Conclusions IABP use was associated with substantially lower in-hospital mortality in patients with CS, without differences in this effect across the SCAI shock stages. Future studies should account for the severity and etiology of shock when evaluating the efficacy of IABP for CS. C1 [Jentzer, Jacob C.; Barsness, Gregory W.; Holmes, David R., Jr.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Jentzer, Jacob C.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN USA. [van Diepen, Sean] Univ Alberta Hosp, Dept Crit Care Med, Edmonton, AB, Canada. [van Diepen, Sean] Univ Alberta Hosp, Dept Med, Div Cardiol, Edmonton, AB, Canada. [Henry, Timothy D.] Christ Hosp Hlth Network, Carl & Edyth Lindner Ctr Res & Educ, Cincinnati, OH USA. [Baran, David A.] Sentara Heart Hosp, Adv Heart Failure Ctr, Norfolk, VA USA. [Baran, David A.] Eastern Virginia Med Sch, Norfolk, VA 23501 USA. C3 Mayo Clinic; Mayo Clinic; University of Alberta; University of Alberta; Christ Hospital - Ohio; Sentara Healthcare; Eastern Virginia Medical School 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, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu OI Jentzer, Jacob/0000-0002-6366-2859; Baran, David/0000-0002-7754-9953 CR Austin PC, 2015, STAT MED, V34, P3661, DOI 10.1002/sim.6607 Baran DA, 2019, CATHETER CARDIO INTE, V94, P29, DOI 10.1002/ccd.28329 Baran DA, 2018, CATHETER CARDIO INTE, V92, P703, DOI 10.1002/ccd.27387 Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 den Uil CA, 2019, EUROINTERVENTION, V15, P586, DOI 10.4244/EIJ-D-19-00254 Dhruva SS, 2020, JAMA-J AM MED ASSOC, V323, P734, DOI 10.1001/jama.2020.0254 Gul B, 2019, AM J CARDIOL, V123, P750, DOI 10.1016/j.amjcard.2018.11.041 Harjola VP, 2015, EUR J HEART FAIL, V17, P501, DOI 10.1002/ejhf.260 Jentzer JC, 2021, AM HEART J, V232, P94, DOI 10.1016/j.ahj.2020.10.054 Jentzer JC, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006956 Jentzer JC, 2021, JACC-CARDIOVASC IMAG, V14, P321, DOI 10.1016/j.jcmg.2020.05.038 Jentzer JC, 2020, CATHETER CARDIO INTE, V96, P1350, DOI 10.1002/ccd.28854 Jentzer JC, 2020, CLIN CARDIOL, V43, P516, DOI 10.1002/clc.23339 Jentzer JC, 2020, AM HEART J, V219, P37, DOI 10.1016/j.ahj.2019.10.012 Jentzer JC, 2019, MAYO CLIN PROC, V94, P1994, DOI 10.1016/j.mayocp.2019.04.038 Jentzer JC, 2019, J AM COLL CARDIOL, V74, P2117, DOI 10.1016/j.jacc.2019.07.077 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2020, SHOCK, V53, P452, DOI 10.1097/SHK.0000000000001390 Jentzer JC, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0216177 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 Padkins M, 2020, ESC HEART FAIL, V7, P3971, DOI 10.1002/ehf2.12995 Prondzinsky R, 2012, SHOCK, V37, P378, DOI 10.1097/SHK.0b013e31824a67af Prondzinsky R, 2010, CRIT CARE MED, V38, P152, DOI 10.1097/CCM.0b013e3181b78671 Rathod KS, 2018, EUR HEART J-ACUTE CA, V7, P16, DOI 10.1177/2048872617741735 Rayes HA, 2020, CLIN RES CARDIOL, V109, P616, DOI 10.1007/s00392-019-01549-0 Rihal CS., 2015, J AM COLL HEALTH Schrage B, 2020, CATHETER CARDIO INTE, V96, pE213, DOI 10.1002/ccd.28707 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 Ternus BW, 2017, J INVASIVE CARDIOL, V29, P309 Thiele H, 2017, NEW ENGL J MED, V377, P2419, DOI 10.1056/NEJMoa1710261 Thiele H, 2017, EUR HEART J, V38, P3523, DOI 10.1093/eurheartj/ehx363 Thiele H, 2012, NEW ENGL J MED, V367, P1287, DOI 10.1056/NEJMoa1208410 Vallabhajosyula S, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0238046 van Diepen S, 2020, CAN J CARDIOL, V36, P151, DOI 10.1016/j.cjca.2019.11.030 van Diepen S, 2017, CIRCULATION, V136, pE232, DOI 10.1161/CIR.0000000000000525 Visveswaran GK, 2017, CATHETER CARDIO INTE, V90, pE63, DOI 10.1002/ccd.26908 Zeymer U, 2020, EUR HEART J-ACUTE CA, V9, P183, DOI 10.1177/2048872619894254 NR 39 TC 5 Z9 5 U1 0 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 FEB PY 2022 VL 99 IS 2 BP 293 EP 304 DI 10.1002/ccd.29800 EA MAY 2021 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ZI1LZ UT WOS:000655608400001 PM 34047486 DA 2023-05-13 ER PT J AU Rouleau, CR King-Shier, KM Tomfohr-Madsen, LM Bacon, SL Aggarwal, S Arena, R Campbell, TS AF Rouleau, Codie R. King-Shier, Kathryn M. Tomfohr-Madsen, Lianne M. Bacon, Simon L. Aggarwal, Sandeep Arena, Ross Campbell, Tavis S. TI The evaluation of a brief motivational intervention to promote intention to participate in cardiac rehabilitation: A randomized controlled trial SO PATIENT EDUCATION AND COUNSELING LA English DT Article DE Cardiac rehabilitation; Motivational interviewing; Enrollment; Adherence; Intention; Randomized controlled trial ID CHANGING PHYSICAL-ACTIVITY; SELF-EFFICACY; MYOCARDIAL-INFARCTION; ENROLLMENT; RISK; ATTENDANCE; ADHERENCE; BEHAVIOR; OUTCOMES; CLIENTS AB Objectives: Cardiac rehabilitation (CR) is an effective treatment for cardiovascular disease, yet many referred patients do not participate. Motivational interviewing could be beneficial in this context, but efficacy with prospective CR patients has not been examined. This study investigated the impact of motivational interviewing on intention to participate in CR. Methods: Individuals recovering from acute coronary syndrome (n = 96) were randomized to motivational interviewing or usual care, following CR referral but before CR enrollment. The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, barriers, self-efficacy, illness perception, social support, intervention acceptability, and CR participation. Results: Compared to those in usual care, patients who received the motivational intervention reported higher intention to attend CR (p = .001), viewed CR as more necessary (p = .036), had fewer concerns about exercise (p = .011), and attended more exercise sessions (p = .008). There was an indirect effect of the intervention on CR enrollment (b = 0.45, 95% CI 0.04-1.18) and CR adherence (b = 2.59, 95% CI 0.95-5.03) via higher levels of intention. Overall, patients reported high intention to attend CR (M = 6.20/7.00, SD = 1.67), most (85%) enrolled, and they attended an average of 65% of scheduled CR sessions. Conclusion: A single collaborative conversation about CR can increase both intention to attend CR and actual program adherence. Practice Implications: The findings will inform future efforts to optimize behavioral interventions to enhance CR participation. (c) 2018 Elsevier B.V. All rights reserved. C1 [Rouleau, Codie R.; Aggarwal, Sandeep] TotalCardiol Rehabil, 2225 Macleod Trail SE, Calgary, AB T2G 5B6, Canada. [Rouleau, Codie R.; Arena, Ross] Univ Illinois, Dept Phys Therapy, Chicago, IL USA. [King-Shier, Kathryn M.] Univ Calgary, Nursing & Community Hlth Sci, Calgary, AB, Canada. [Rouleau, Codie R.; Tomfohr-Madsen, Lianne M.; Campbell, Tavis S.] Univ Calgary, Dept Psychol, Calgary, AB, Canada. [Bacon, Simon L.] Hop Sacre Coeur Montreal, CIUSSS NIM, Montreal Behav Med Ctr, Montreal, PQ, Canada. [Bacon, Simon L.] Concordia Univ, Dept Exercise Sci, Montreal, PQ, Canada. [Aggarwal, Sandeep] Univ Calgary, Dept Cardiac Sci, Calgary, AB, Canada. C3 University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital; University of Calgary; University of Calgary; Universite de Montreal; Concordia University - Canada; University of Calgary RP Rouleau, CR (通讯作者)，TotalCardiol Rehabil, 2225 Macleod Trail SE, Calgary, AB T2G 5B6, Canada. EM crouleau@totalcardiology.ca RI Arena, Ross/AAY-7646-2020; Arena, Ross/A-3141-2008; Bacon, Simon/B-2637-2012 OI Arena, Ross/0000-0002-6675-1996; Tomfohr-Madsen, Lianne/0000-0002-0860-5392; Aggarwal, Sandeep/0000-0001-6901-7124; Bacon, Simon/0000-0001-7075-0358 FU Canadian Institutes of Health Research (CIHR); Alberta Innovates Health Solutions (AIHS) Graduate Studentship FX The authors declare they have no conflicts of interest. C.R. received funding from the Canadian Institutes of Health Research (CIHR) Doctoral Award and an Alberta Innovates Health Solutions (AIHS) Graduate Studentship. C.R. and S. A. are currently employed at TotalCardiology Rehabilitation, the setting where this research was conducted. S.B. reports personal fees from Novartis, Sygesa, and Astra Zenica outside of the submitted work. These sources of funding did not play any role in the design of the study; the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. Excerpts from this manuscript are derived from a doctoral dissertation (C.R.), which is available through an institutional thesis repository (The Vault, University of Calgary, http://theses.ucalgary.ca) and Library and Archives Canada (http://collections-canada.gc.ca/obj/s4/f2/frm-nl59-2-e.pdf). 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PD NOV PY 2018 VL 101 IS 11 BP 1914 EP 1923 DI 10.1016/j.pec.2018.06.015 PG 10 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA GV9CX UT WOS:000446452600006 PM 30017536 OA Green Accepted DA 2023-05-13 ER PT J AU Teng, KT McGreevy, PD Toribio, JALML Raubenheimer, D Kendall, K Dhand, NK AF Teng, K. T. McGreevy, P. D. Toribio, J. A. L. M. L. Raubenheimer, D. Kendall, K. Dhand, N. K. TI Associations of body condition score with health conditions related to overweight and obesity in cats SO JOURNAL OF SMALL ANIMAL PRACTICE LA English DT Article ID CARE VETERINARY PRACTICES; URINARY-TRACT DISEASES; CORONARY-HEART-DISEASE; MASS INDEX; RISK-FACTORS; WEIGHT-LOSS; CARDIOVASCULAR-DISEASE; ACUTE-PANCREATITIS; ADIPOSE-TISSUE; METABOLIC SYNDROME AB OBJECTIVES: To explore the associations of cat body condition score with various health conditions, such as diabetes mellitus, dermatological conditions and hypertension, that have been shown to relate to overweight and/or obesity in cats, dogs or humans. MATERIALS AND METHODS: Electronic patient records between January 3, 2005 and June 21, 2015 were obtained from a cat-focused primary accession clinic in metropolitan Sydney where the body condition score of cats was routinely evaluated. Binomial logistic regression modelling was conducted to investigate the associations, after adjusting for age, sex and breed, between 21 health conditions and body condition score recorded on a 9-point scale. RESULTS: Fourteen of the 21 health conditions examined showed significant associations with an increased body condition score, particularly those of 7 and above. These were dermatological conditions, atopic dermatitis, musculoskeletal conditions, arthritis, hypertension, respiratory conditions, asthma, oral conditions, diarrhoea, general and lower urinary tract conditions, ophthalmic conditions, diabetes mellitus and allergic conditions. Additionally, cats with body condition score of 8 or 9 had significantly higher odds for gastrointestinal conditions and upper urinary tract conditions when compared with cats with body condition score of 5. CLINICAL SIGNIFICANCE: As far as we know, this is the first study reporting positive associations of high body condition score with atopic dermatitis, hypertension, asthma, diarrhoea, ophthalmic conditions and allergic conditions in cats. A large number of positive associations between health conditions and high body condition score indicates that excess fat mass should be given a greater emphasis in preventive health care for cats. C1 [Teng, K. T.; McGreevy, P. D.; Toribio, J. A. L. M. L.; Raubenheimer, D.; Kendall, K.; Dhand, N. K.] Univ Sydney, Fac Sci, Sydney Sch Vet Sci, Sydney, NSW 2006, Australia. C3 University of Sydney RP Teng, KT (通讯作者)，Univ Sydney, Fac Sci, Sydney Sch Vet Sci, Sydney, NSW 2006, Australia. EM kendy.t.teng@gmail.com RI Dhand, Navneet K/H-5762-2019 OI Dhand, Navneet K/0000-0002-4362-3596; Raubenheimer, David/0000-0001-9050-1447; Teng, Kendy/0000-0003-3200-1545; McGreevy, Paul/0000-0001-7220-8378 FU Sydney School of Veterinary Science, Faculty of Science, University of Sydney FX The authors greatly thank Dr Randolph Baral for selflessly sharing his expertise to facilitate the completion of the study, Mr Doug Bail for technical help in data extraction and Nestle Purina for the consent of using the cat body condition score chart in the publication. The authors are grateful to the Sydney School of Veterinary Science, Faculty of Science, University of Sydney for funding this project. 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Small Anim. Pract. PD OCT PY 2018 VL 59 IS 10 BP 603 EP 615 DI 10.1111/jsap.12905 PG 13 WC Veterinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Veterinary Sciences GA HI8QN UT WOS:000456721100002 PM 30033652 DA 2023-05-13 ER PT J AU Okafor, N Payne, VL Chathampally, Y Miller, S Doshi, P Singh, H AF Okafor, Nnaemeka Payne, Velma L. Chathampally, Yashwant Miller, Sara Doshi, Pratik Singh, Hardeep TI Using voluntary reports from physicians to learn from diagnostic errors in emergency medicine SO EMERGENCY MEDICINE JOURNAL LA English DT Article ID MALPRACTICE CLAIMS; ADVERSE EVENTS; PRIMARY-CARE; HEALTH-CARE; PATIENT-SAFETY; SYSTEM AB Objectives Diagnostic errors are common in the emergency department (ED), but few studies have comprehensively evaluated their types and origins. We analysed incidents reported by ED physicians to determine disease conditions, contributory factors and patient harm associated with ED-related diagnostic errors. Methods Between 1 March 2009 and 31 December 2013, ED physicians reported 509 incidents using a department-specific voluntary incident-reporting system that we implemented at two large academic hospital-affiliated EDs. For this study, we analysed 209 incidents related to diagnosis. A quality assurance team led by an ED physician champion reviewed each incident and interviewed physicians when necessary to confirm the presence/absence of diagnostic error and to determine the contributory factors. We generated descriptive statistics quantifying disease conditions involved, contributory factors and patient harm from errors. Results Among the 209 incidents, we identified 214 diagnostic errors associated with 65 unique diseases/conditions, including sepsis (9.6%), acute coronary syndrome (9.1%), fractures (8.6%) and vascular injuries (8.6%). Contributory factors included cognitive (n=317), system related (n=192) and non-remedial (n=106). Cognitive factors included faulty information verification (41.3%) and faulty information processing (30.6%) whereas system factors included high workload (34.4%) and inefficient ED processes (40.1%). Non-remediable factors included atypical presentation (31.3%) and the patients' inability to provide a history (31.3%). Most errors (75%) involved multiple factors. Major harm was associated with 34/209 (16.3%) of reported incidents. Conclusions Most diagnostic errors in ED appeared to relate to common disease conditions. While sustaining diagnostic error reporting programmes might be challenging, our analysis reveals the potential value of such systems in identifying targets for improving patient safety in the ED. C1 [Okafor, Nnaemeka; Chathampally, Yashwant; Miller, Sara; Doshi, Pratik] Univ Texas Hlth Sci Ctr Houston, Sch Med, Dept Emergency Med, 5431 Fannin St, Houston, TX 77030 USA. [Payne, Velma L.; Singh, Hardeep] Michael E DeBakey VA Med Ctr, Houston Vet Affairs Ctr Innovat Qual Effectivene, Houston, TX USA. [Payne, Velma L.; Singh, Hardeep] Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. C3 University of Texas System; University of Texas Health Science Center Houston; Baylor College of Medicine; Baylor College of Medicine RP Okafor, N (通讯作者)，Univ Texas Hlth Sci Ctr Houston, Sch Med, Dept Emergency Med, 5431 Fannin St, Houston, TX 77030 USA. EM Nnaemeka.G.Okafor@uth.tmc.edu OI SINGH, HARDEEP/0000-0002-4419-8974 FU Keck Center AHRQ Training Program in Patient Safety and Quality of the Gulf Coast Consortia (AHRQ) [1 T32HS017586-01]; AHRQ Training Program grant; VA Office of Academic Affiliations, Washington, DC; Houston VA Center for Innovations in Quality, Effectiveness and Safety [CIN 13-413]; VA Health Services Research and Development Service [CRE 12-033, 14-274]; VA National Center for Patient Safety; Agency for Health Care Research and Quality [R01HS022087]; Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety [CIN 13-413] FX This work was partially supported by a training fellowship from the Keck Center AHRQ Training Program in Patient Safety and Quality of the Gulf Coast Consortia (AHRQ Grant No. 1 T32HS017586-01). NO was supported by the AHRQ Training Program grant. VLP is supported by the VA Office of Academic Affiliations, Washington, DC and the Houston VA Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413). HS is supported by the VA Health Services Research and Development Service (CRE 12-033; Presidential Early Career Award for Scientists and Engineers USA 14-274), the VA National Center for Patient Safety and the Agency for Health Care Research and Quality (R01HS022087) and partially supported by the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413). CR AHRQ, AHRQ COMM FORM WEBS Brown TW, 2010, ACAD EMERG MED, V17, P553, DOI 10.1111/j.1553-2712.2010.00729.x Cosby KS, 2008, ANN EMERG MED, V51, P251, DOI 10.1016/j.annemergmed.2007.06.483 Croskerry P, 2004, ACAD EMERG MED, V11, P289, DOI 10.1197/j.aem.2003.05.013 Croskerry P, 2001, CJEM, V3, P271 Fordyce J, 2003, ANN EMERG MED, V42, P324, DOI 10.1016/S0196-0644(03)00398-6 Freund Y, 2013, J EMERG MED, V45, P157, DOI 10.1016/j.jemermed.2012.11.061 Graber ML, 2008, AM J MED, V121, P43, DOI 10.1016/j.amjmed.2008.02.006 Graber ML, 2014, DIAGNOSIS, V1, P223, DOI 10.1515/dx-2014-0019 Graber ML, 2014, JT COMM J QUAL PATIE, V40, P102, DOI 10.1016/S1553-7250(14)40013-8 Graber ML, 2013, BMJ QUAL SAF, V22, pii21, DOI 10.1136/bmjqs-2012-001615 Graber ML, 2005, ARCH INTERN MED, V165, P1493, DOI 10.1001/archinte.165.13.1493 Holohan TV, 2005, SOUTH MED J, V98, P1083, DOI 10.1097/01.smj.0000170729.51651.f7 Institute of medicine, 2006, HOSP BASED EMERGENCY Institute of Medicine, 1999, ERR IS HUMAN BUILDIN Kachalia A, 2007, ANN EMERG MED, V49, P196, DOI 10.1016/j.annemergmed.2006.06.035 Kaldjian LC, 2006, J GEN INTERN MED, V21, P942, DOI 10.1007/BF02743142 Karsh BT, 2006, APPL ERGON, V37, P283, DOI 10.1016/j.apergo.2005.07.003 Kostopoulou O, 2007, QUAL SAF HEALTH CARE, V16, P95, DOI 10.1136/qshc.2006.020909 Leape LL, 2002, NEW ENGL J MED, V347, P1633, DOI 10.1056/NEJMNEJMhpr011493 Milch CE, 2006, J GEN INTERN MED, V21, P165, DOI 10.1111/j.1525-1497.2006.00322.x Okafor N, 2015, W J EMERGEN IN PRESS Phillips RL, 2004, QUAL SAF HEALTH CARE, V13, P121, DOI 10.1136/qshc.2003.008029 Salvador D, 2010, ADDRESSING DIAGNOSTI Schiff GD, 2009, ARCH INTERN MED, V169, P1881, DOI 10.1001/archinternmed.2009.333 Sevdalis N, 2010, J EVAL CLIN PRACT, V16, P1276, DOI 10.1111/j.1365-2753.2009.01328.x Singh H, 2015, BMJ QUAL SAF, V24, P103, DOI 10.1136/bmjqs-2014-003675 Singh H, 2014, JT COMM J QUAL PATIE, V40, P99, DOI 10.1016/S1553-7250(14)40012-6 Singh H, 2013, JAMA INTERN MED, V173, P418, DOI 10.1001/jamainternmed.2013.2777 Singh H, 2010, JT COMM J QUAL PATIE, V36, P226, DOI 10.1016/S1553-7250(10)36037-5 Smits M, 2009, BMC EMERG MED, V9, DOI 10.1186/1471-227X-9-16 Sonderegger-Iseli K, 2000, LANCET, V355, P2027, DOI 10.1016/S0140-6736(00)02349-7 Tehrani ASS, 2013, BMJ QUAL SAF, V22, P672, DOI 10.1136/bmjqs-2012-001550 Tuttle D, 2004, QUAL SAF HEALTH CARE, V13, P281, DOI 10.1136/qshc.2003.009100 Upadhyay DK, 2014, DIAGNOSIS, V1, P283, DOI 10.1515/dx-2014-0064 Zwaan L, 2015, DIAGNOSIS, V2, P97, DOI 10.1515/dx-2014-0069 Zwaan L, 2013, BMJ QUAL SAF, V22, pii52, DOI 10.1136/bmjqs-2012-001624 NR 37 TC 35 Z9 35 U1 0 U2 6 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 APR PY 2016 VL 33 IS 4 BP 245 EP 252 DI 10.1136/emermed-2014-204604 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA DH0IN UT WOS:000372467700003 PM 26531860 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Jentzer, JC Ahmed, AM Vallabhajosyula, S Burstein, B Tabi, M Barsness, GW Murphy, JG Best, PJ Bell, MR AF Jentzer, Jacob C. Ahmed, Abdelrahman M. Vallabhajosyula, Saraschandra Burstein, Barry Tabi, Meir Barsness, Gregory W. Murphy, Joseph G. Best, Patricia J. Bell, Malcolm R. TI Shock in the cardiac intensive care unit: Changes in epidemiology and prognosis over time SO AMERICAN HEART JOURNAL LA English DT Article ID MYOCARDIAL-INFARCTION; CARDIOGENIC-SHOCK; RISK PREDICTION; NOREPINEPHRINE; MORTALITY; SUPPORT; TRENDS AB Background There are few studies documenting the changing epidemiology and outcomes of shock in cardiac intensive care unit (CICU) patients. We sought to describe the changes in shock epidemiology and outcomes over time in a CICU population. Methods We included 1859 unique patients admitted to the Mayo Clinic Rochester CICU from 2007 through 2018 with an admission diagnosis of shock. Temporal trends, including mortality, were assessed across 3-year periods. Results Shock comprised 15.1% of CICU admissions during the study period, increasing from 8.8% of CICU admissions in 2007 to 21.6% in 2018 (P .01 for trend). Mean age was 68 +/- 14 years (38% females). Shock was cardiogenic in 65%, septic in 10% and mixed cardiogenic-septic in 15%. Concomitant diagnoses in patients with cardiogenic shock (CS) included acute coronary syndrome (ACS) in 17%, heart failure (HF) in 35% and both in 40%. There was no significant change in the prevalence of individual shock subtypes over time (P .1). Among patients with CS, the prevalence of ACS decreased and the prevalence of HF increased over time (P < .01). Hospital mortality was highest among patients with mixed shock (39%; P = .05). Among patients with CS, hospital mortality was lower among those with HF compared to those without HF (31% vs. 40%, P < .01). Hospital mortality decreased over time among patients with shock (P < .01) and CS (P = .02). Conclusions The prevalence of shock in the CICU has increased over time, with a substantial prevalence of mixed CS. The etiology of CS has changed over the last decade with HF overtaking ACS as the most common cause of CS in the CICU. C1 [Jentzer, Jacob C.; Vallabhajosyula, Saraschandra; Tabi, Meir; Barsness, Gregory W.; Murphy, Joseph G.; Best, Patricia J.; Bell, Malcolm R.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [Jentzer, Jacob C.; Ahmed, Abdelrahman M.; Vallabhajosyula, Saraschandra; Burstein, Barry] Mayo Clin, Div Pulm & Crit Care Med, Dept Internal Med, 200 First St SW, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic 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, Div Pulm & Crit Care Med, Dept Internal Med, 200 First St SW, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu RI Vallabhajosyula, Saraschandra/I-9707-2019 OI Vallabhajosyula, Saraschandra/0000-0002-1631-8238; Ahmed, Abdelrahman/0000-0001-9285-7535 CR Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] 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 De Backer D, 2010, NEW ENGL J MED, V362, P779, DOI 10.1056/NEJMoa0907118 Goldfarb M, 2019, J INTENSIVE CARE MED, V34, P537, DOI 10.1177/0885066617741873 Harjola VP, 2015, EUR J HEART FAIL, V17, P501, DOI 10.1002/ejhf.260 Herasevich V, 2010, MAYO CLIN PROC, V85, P247, DOI 10.4065/mcp.2009.0479 Holland EM, 2017, J AM COLL CARDIOL, V69, P1999, DOI 10.1016/j.jacc.2017.02.033 Jeger RV, 2008, ANN INTERN MED, V149, P618, DOI 10.7326/0003-4819-149-9-200811040-00005 Jentzer JC, 2020, AM HEART J, V224, P57, DOI 10.1016/j.ahj.2020.02.018 Jentzer JC, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013675 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2020, SHOCK, V53, P452, DOI 10.1097/SHK.0000000000001390 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 Joffe SW, 2013, J AM HEART ASSOC, V2, DOI 10.1161/JAHA.113.000053 Katz JN, 2010, CRIT CARE MED, V38, P375, DOI 10.1097/CCM.0b013e3181cb0a63 Kohsaka S, 2005, ARCH INTERN MED, V165, P1643, DOI 10.1001/archinte.165.14.1643 Kolte D, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.113.000590 Law AC, 2019, CRIT CARE MED, V47, P1493, DOI 10.1097/CCM.0000000000003956 Levy B, 2018, J AM COLL CARDIOL, V72, P173, DOI 10.1016/j.jacc.2018.04.051 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Sinha SS, 2017, CIRC-CARDIOVASC QUAL, V10, DOI 10.1161/CIRCOUTCOMES.117.003616 Tehrani BN, 2019, J AM COLL CARDIOL, V73, P1659, DOI 10.1016/j.jacc.2018.12.084 Thiele H, 2012, NEW ENGL J MED, V367, P1287, DOI 10.1056/NEJMoa1208410 Vallabhajosyula S, 2019, CIRC-HEART FAIL, V12, DOI 10.1161/CIRCHEARTFAILURE.119.005929 Vallabhajosyula S, 2021, EUROINTERVENTION, V16, pE1254, DOI 10.4244/EIJ-D-19-00226 van Diepen S, 2017, CIRCULATION, V136, pE232, DOI 10.1161/CIR.0000000000000525 Watson RA, 2019, EUR HEART J-ACUTE CA, V8, P755, DOI 10.1177/2048872618789053 Yandrapalli S, 2019, AM HEART J, V213, P18, DOI 10.1016/j.ahj.2019.03.015 NR 31 TC 28 Z9 28 U1 0 U2 2 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 FEB PY 2021 VL 232 BP 94 EP 104 DI 10.1016/j.ahj.2020.10.054 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA QA6KK UT WOS:000613552300010 PM 33257304 DA 2023-05-13 ER PT J AU Liao, Y Zhang, RT Shi, SS Zhao, YK He, YB Liao, LH Lin, XQ Guo, Q Wang, YN Chen, LL Li, WG Li, SA Chen, KH Fang, Y AF Liao, Ying Zhang, Rongting Shi, Shanshan Zhao, Yukun He, Yibo Liao, Lihua Lin, Xueqin Guo, Qian Wang, Yani Chen, Liling Li, Weiguo Li, Shihai Chen, Kaihong Fang, Yong TI Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients SO CARDIOVASCULAR DIABETOLOGY LA English DT Article DE Triglyceride-glucose index; Insulin resistance; Intensive care unit; All-cause mortality ID FASTING PLASMA-GLUCOSE; INSULIN-RESISTANCE; INTENSIVE-CARE; TYG INDEX; SENSITIVITY; SEVERITY; ILLNESS AB Background Triglyceride-glucose (TyG) index as a reliable surrogate of insulin resistance (IR) has been shown to be related to adverse clinical outcomes in patients with acute coronary syndrome, heart failure, ischemic stroke and so on. However, the relationship between TyG index and all-cause mortality in intensive care unit (ICU) patients remains unknown. The purpose of this study was to investigate the correlation between TyG index and all-cause mortality to evaluate the impact of IR on the prognosis of this population. Methods This was a retrospective observational study that included 3026 patients who had an initial triglyceride and glucose data on the first day of ICU admission, and all data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. These patients were grouped into quartiles (Q1-Q4) according to TyG index. The Kaplan-Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality. Results During 10.46 years of follow-up, 1148 (37.9%) patients died, of which 350 (11.6%) occurred during the hospital stay and 258 (8.5%) occurred during the ICU stay. Kaplan-Meier analysis showed that the risk of all-cause mortality was significantly higher in patients with higher TyG index (log-rank P = 0.021). Multivariable Cox proportional hazards analyses showed that the TyG index was an independent risk predictor of ICU death (HR: 1.72, 95% CI 1.18-2.52, P = 0.005) and hospital death (HR: 2.19, 95% CI 1.59-3.03, P < 0.001), and each 1-unit increased in the TyG index, a 1.19-fold increase in the risk of death during the hospital stay. Conclusions TyG index is strongly related to the all-cause mortality increasing in critically ill patients. This finding indicates that the TyG index might be useful in identifying people at high risk of ICU death and hospital death. C1 [Liao, Ying; Zhang, Rongting; Shi, Shanshan; Zhao, Yukun; Liao, Lihua; Lin, Xueqin; Guo, Qian; Wang, Yani; Chen, Liling; Li, Weiguo; Chen, Kaihong; Fang, Yong] Fujian Med Univ, Longyan Affiliated Hosp 1, Dept Cardiol, Longyan 364000, Peoples R China. [Zhang, Rongting; Shi, Shanshan; Zhao, Yukun; Liao, Lihua; Lin, Xueqin; Guo, Qian; Wang, Yani] Fujian Med Univ, Grad Sch Clin Med, Fuzhou 350000, Peoples R China. [He, Yibo] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Dept Cardiol, Guangzhou 510080, Peoples R China. [He, Yibo] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Dept Guangdong Prov Key Lab Coronary Heart Dis Pr, Guangzhou 510080, Peoples R China. [Li, Shihai] Fujian Med Univ, Dept Anesthesiol, Longyan Affiliated Hosp 1, Longyan 364000, Peoples R China. C3 Fujian Medical University; Fujian Medical University; Guangdong Academy of Medical Sciences & Guangdong General Hospital; Guangdong Academy of Medical Sciences & Guangdong General Hospital; Fujian Medical University RP Chen, KH; Fang, Y (通讯作者)，Fujian Med Univ, Longyan Affiliated Hosp 1, Dept Cardiol, Longyan 364000, Peoples R China.; Li, SA (通讯作者)，Fujian Med Univ, Dept Anesthesiol, Longyan Affiliated Hosp 1, Longyan 364000, Peoples R China. EM 13959002329@139.com; chenkaihong1964@163.com; fjly7008@163.com OI Liao, Ying/0000-0002-3219-0318 FU Longyan City Science and Technology Plan Project [2021LYF17025, 2021LYF17039] FX This research was funded and sponsored by Longyan City Science and Technology Plan Project (Grant Numbers: 2021LYF17025, 2021LYF17039). The funders had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript. 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Diabetol. PD JUL 8 PY 2022 VL 21 IS 1 AR 128 DI 10.1186/s12933-022-01563-z PG 14 WC Cardiac & Cardiovascular Systems; Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Endocrinology & Metabolism GA 2T2XT UT WOS:000822341600002 PM 35804386 OA Green Published, gold DA 2023-05-13 ER PT J AU Brooker, JA Hastings, JW Major-Monfried, H Maron, CP Winkel, M Wijeratne, HRS Fleischman, W Weingart, S Newman, DH AF Brooker, Julie A. Hastings, Jeffrey W. Major-Monfried, Hannah Maron, Chad P. Winkel, Maia Wijeratne, H. R. Sagara Fleischman, William Weingart, Scott Newman, David H. TI The Association Between Medicolegal and Professional Concerns and Chest Pain Admission Rates SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID EMERGENCY-DEPARTMENT; RISK; PHYSICIANS; DECISIONS; ISCHEMIA; PROTOCOL; TRIAGE AB ObjectivesFor patients in whom acute coronary syndrome (ACS) is a concern, disposition decisions are complex and multifactorial and have traditionally been a source of considerable variation. An important factor in disposition decisions for these patients may be physician-perceived medicolegal risk and related professional concerns. The study aim was to determine, at the point of care, how much less frequently physicians report that they would admit possible ACS patients if there was either zero or a defined medicolegal risk. MethodsThis was a point-of-care emergency physician survey. Research assistants approached physicians at or immediately following the moment of disposition decisions for patients who were being admitted for ACS. The primary outcome measures were the proportion of physicians reporting that patients would not have been admitted if medicolegal issues were of no concern and the proportion of physicians reporting that patients would not have been admitted if there was an acceptable miss rate of 1% to 2% for ACS patients. ResultsDuring the 3-month study period, 576 patients were admitted to an inpatient unit or to the ED observation protocol. Physicians were approached in 271 cases, and 259 surveys were completed. When presented with hypothetical zero medicolegal risk, physicians answered that they would not have admitted the patients in 30% of cases. With a hypothetical 1% to 2% acceptable miss rate, physicians indicated that they would not have admitted the patients in 29% of the cases. ConclusionsED medicolegal and professional concerns may substantially increase admissions for possible ACS. An acceptable miss rate or a zero medicolegal risk environment could potentially lead to a major reduction in admissions that physicians feel to be clinically unnecessary. C1 [Brooker, Julie A.; Hastings, Jeffrey W.; Major-Monfried, Hannah; Maron, Chad P.; Winkel, Maia; Wijeratne, H. R. Sagara; Fleischman, William; Weingart, Scott; Newman, David H.] Icahn Sch Med Mt Sinai, Dept Emergency Med, New York, NY 10029 USA. [Fleischman, William] Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT USA. [Weingart, Scott] SUNY Stony Brook, Dept Emergency Med, Stony Brook, NY 11794 USA. C3 Icahn School of Medicine at Mount Sinai; Yale University; State University of New York (SUNY) System; State University of New York (SUNY) Stony Brook RP Newman, DH (通讯作者)，Icahn Sch Med Mt Sinai, Dept Emergency Med, New York, NY 10029 USA. 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Emerg. Med. PD JUL PY 2015 VL 22 IS 7 BP 883 EP 886 DI 10.1111/acem.12708 PG 4 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA CM8JV UT WOS:000357947400017 PM 26118834 OA Bronze DA 2023-05-13 ER PT J AU Eser, P Marcin, T Prescott, E Prins, LF Kolkman, E Bruins, W van der Velde, AE Gil, CP Iliou, MC Ardissino, D Zeymer, U Meindersma, EP Van'tHof, AWJ de Kluiver, EP Wilhelm, M AF Eser, Prisca Marcin, Thimo Prescott, Eva Prins, Leonie F. Kolkman, Evelien Bruins, Wendy van der Velde, Astrid E. Gil, Carlos Pena Iliou, Marie-Christine Ardissino, Diego Zeymer, Uwe Meindersma, Esther P. Van'tHof, Arnoud W. J. de Kluiver, Ed P. Wilhelm, Matthias TI Predictors for one-year outcomes of cardiorespiratory fitness and cardiovascular risk factor control after cardiac rehabilitation in elderly patients: The EU-CaRE study SO PLOS ONE LA English DT Article ID EXERCISE CAPACITY; PREVENTION; SURVIVAL; SURGERY; DISEASE; IMPACT AB Introduction Studies on effectiveness of cardiac rehabilitation (CR) in elderly cardiovascular disease patients are rare, and it is unknown, which patients benefit most. We aimed to identify predictors for 1-year outcomes of cardiorespiratory fitness and CV risk factor (CVRF) control in patients after completing CR programs offered across seven European countries. Methods Cardiovascular disease patients with minimal age 65 years who participated in comprehensive CR were included in this observational study. Peak oxygen uptake (VO2), body mass index (BMI), resting systolic blood pressure (BPsys), and low-density lipoprotein-cholesterol (LDL-C) were assessed before CR (T0), at termination of CR (T1), and 12 months after start of CR (T2). Predictors for changes were identified by multivariate regression models. Results Data was available from 1241 out of 1633 EU-CaRE patients. The strongest predictor for improvement in peak VO2 was open chest surgery, with a nearly four-fold increase in surgery compared to non-surgery patients. In patients after surgery, age, female sex, physical inactivity and time from index event to T0 were negative predictors for improvement in peak VO2. In patients without surgery, previous acute coronary syndrome and higher exercise capacity at T0 were the only negative predictors. Neither number of attended training sessions nor duration of CR were significantly associated with change in peak VO2. Non-surgery patients were more likely to achieve risk factor targets (BPsys, LDL-C, BMI) than surgery patients. Conclusions In a previously understudied population of elderly CR patients, time between index event and start of CR in surgery and disease severity in non-surgery patients were the most important predictors for long-term improvement of peak VO2. Non-surgery patients had better CVRF control. C1 [Eser, Prisca; Marcin, Thimo; Wilhelm, Matthias] Univ Bern, Bern Univ Hosp, Inselspital, Dept Cardiol, Bern, Switzerland. [Marcin, Thimo] Univ Bern, Grad Sch Hlth Sci, Bern, Switzerland. [Prescott, Eva] Bispebjerg Frederiksberg Univ Hosp, Dept Cardiol, Copenhagen, Denmark. [Prins, Leonie F.; Kolkman, Evelien] Diagram BV, Zwolle, Netherlands. [Bruins, Wendy; van der Velde, Astrid E.; Van'tHof, Arnoud W. J.; de Kluiver, Ed P.] Isala Heart Ctr, Zwolle, Netherlands. [Gil, Carlos Pena] Univ Santiago de Compostela, CIBER CV, Hosp Clin Univ Santiago, Dept Cardiol,SERGAS,FIDIS, La Coruna, Spain. [Iliou, Marie-Christine] AP HP, Dept Cardiac Rehabil, Paris, France. [Ardissino, Diego] Parma Univ Hosp, Dept Cardiol, Parma, Italy. [Zeymer, Uwe] Klinikum Ludwigshafen, Ludwigshafen, Germany. [Zeymer, Uwe] Inst Herzinfarktforsch Ludwigshafen, Ludwigshafen, Germany. [Meindersma, Esther P.] Radboud Univ Nijmegen, Dept Cardiol, Nijmegen, Netherlands. [Van'tHof, Arnoud W. J.] Maastricht Univ, Med Ctr, Dept Cardiol, Maastricht, Netherlands. [Van'tHof, Arnoud W. J.] Zuyderland Med Ctr, Dept Cardiol, Heerlen, Netherlands. C3 University of Bern; University Hospital of Bern; University of Bern; University of Copenhagen; Bispebjerg Hospital; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; Complejo Hospitalario Universitario A Coruna; Universidade de Santiago de Compostela; 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; University of Parma; University Hospital of Parma; Ludwigshafen Hospital; Institute Heart Attack Research; Radboud University Nijmegen; Maastricht University RP Wilhelm, M (通讯作者)，Univ Bern, Bern Univ Hosp, Inselspital, Dept Cardiol, Bern, Switzerland. EM Matthias.wilhelm@insel.ch RI Meindersma, E.P./L-4517-2015; Ardissino, Diego/AAC-4041-2022; Wilhelm, Matthias/AAS-9456-2020 OI Wilhelm, Matthias/0000-0003-4541-3995; Eser, Prisca/0000-0001-9734-0682; Bruins, Wendy/0000-0003-3287-1321; Marcin, Thimo/0000-0001-7229-5985; solinas, emilia/0000-0003-3532-1317; van 't Hof, Arnoud/0000-0002-2344-7564 FU European Union [634439]; [15.0139] FX For the Swiss consortium partner (TM, PE, MW), funding was received by the Swiss State Secretariat for Education, Research and Innovation under contract number 15.0139. All other authors received funding by the European Union's Horizon 2020 research and innovation programme under grant agreement No 634439. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. None of the commercial partners who provided financial support to any of the coauthors had any role in the perception, conduction, analysis, interpretation nor dissemination of this study. 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Philip, Sephy Reynolds, Kristi Granowitz, Craig B. O'Keeffe-Rosetti, Maureen Fazio, Sergio TI Comparison of Medical Care Utilization and Costs Among Patients With Statin-Controlled Low-Density Lipoprotein Cholesterol With Versus Without Hypertriglyceridemia SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE-CORONARY-SYNDROME; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; TRIGLYCERIDE LEVELS; DIABETES-MELLITUS; EVENTS; TRENDS; TRIAL AB High triglyceride (TG) levels are associated with higher medical costs, but the long-term impact of high TG on costs among patients with statin-controlled low-density lipoprotein cholesterol (LDL-C) is unclear. We compared medical utilization and costs over 6.5 years between patients with high (200 to 400 mg/dl) versus normal (<150 mg/dl) TG levels, all of whom had established atherosclerotic cardiovascular disease (ASCVD). This was an observational cohort study of 17,183 patients with TG measured in 2010 and followed until death, disenrollment or the end of 2016. All patients had LDL-C levels between 40 and 100 mg/dl and were receiving statin therapy at the time of their TG measurement. We compared annualized medical utilization adjusted for differences between group in age, sex, race, and study site. We also compared annualized medical costs, further adjusting for baseline costs as a proxy for resource-intensive comorbidities. After multivariable adjustment, patients with high TG levels (n=2,702) had a mean of 13% more inpatient admissions per year (p <0.001). Despite adjustment for comorbidities such as diabetes and chronic kidney disease, total outpatient costs were 5% greater (p = 0.035) among those with high TG, including emergency care costs (6% greater) and hospital ambulatory costs (25% greater). The overall difference in annual costs of $964 per patient in the high TG cohort totaled over $2.6 million per year in excess annual costs and more than $13.5 million over the mean follow-up of 5.2 years. (C) 2018 The Authors. Published by Elsevier Inc. C1 [Nichols, Gregory A.; O'Keeffe-Rosetti, Maureen] Kaiser Permanente Ctr Hlth Res, Portland, OR 97227 USA. [Philip, Sephy; Granowitz, Craig B.] Amarin Pharma Inc, Bedminster, NJ USA. [Reynolds, Kristi] Kaiser Permanente Southern Calif, Pasadena, CA USA. [Fazio, Sergio] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. C3 Kaiser Permanente; Kaiser Permanente; Oregon Health & Science University RP Nichols, GA (通讯作者)，Kaiser Permanente Ctr Hlth Res, Portland, OR 97227 USA. EM greg.nichols@kpchr.org RI Reynolds, Kristi/AAN-1434-2021 OI Reynolds, Kristi/0000-0001-7619-1649; Nichols, Gregory/0000-0002-7563-6236 CR Berglund L, 2012, J CLIN ENDOCR METAB, V97, P2969, DOI 10.1210/jc.2011-3213 Bhatt DL, 2017, CLIN CARDIOL, V40, P138, DOI 10.1002/clc.22692 Budoff M, 2016, AM J CARDIOL, V118, P138, DOI 10.1016/j.amjcard.2016.04.004 Christian JB, 2012, J CLIN LIPIDOL, V6, P450, DOI 10.1016/j.jacl.2012.08.007 ClinicalTrials. gov, 2017, PEM RED CARD OUTCOME ClinicalTrials. gov, 2018, OUTC STUD ASS STATIN Faergeman O, 2009, AM J CARDIOL, V104, P459, DOI 10.1016/j.amjcard.2009.04.008 Kastelein JJP, 2008, CIRCULATION, V117, P3002, DOI 10.1161/CIRCULATIONAHA.107.713438 Miller M, 2008, J AM COLL CARDIOL, V51, P724, DOI 10.1016/j.jacc.2007.10.038 Miller M, 2011, CIRCULATION, V123, P2292, DOI 10.1161/CIR.0b013e3182160726 Nichols GA, 2017, AM J CARDIOL, V119, P410, DOI 10.1016/j.amjcard.2016.10.029 Nichols GA, 2012, J CLIN LIPIDOL, V6, P443, DOI 10.1016/j.jacl.2012.03.002 Nichols GA, 2011, AM J CARDIOL, V107, P225, DOI 10.1016/j.amjcard.2010.09.010 Nichols GA, 2010, AM J MANAG CARE, V16, pE86 Preis SR, 2009, CIRCULATION, V120, P212, DOI 10.1161/CIRCULATIONAHA.108.846519 Rosamond WD, 2012, CIRCULATION, V125, P1848, DOI 10.1161/CIRCULATIONAHA.111.047480 Ross Tyler R, 2014, EGEMS (Wash DC), V2, P1049, DOI 10.13063/2327-9214.1049 Schwartz GG, 2015, J AM COLL CARDIOL, V65, P2267, DOI 10.1016/j.jacc.2015.03.544 Yeh RW, 2010, NEW ENGL J MED, V362, P2155, DOI 10.1056/NEJMoa0908610 NR 19 TC 8 Z9 8 U1 0 U2 1 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 1 PY 2018 VL 122 IS 7 BP 1128 EP 1132 DI 10.1016/j.amjcard.2018.06.029 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GZ2UR UT WOS:000449244400003 PM 30086877 OA hybrid DA 2023-05-13 ER PT J AU Tanislav, C Jacob, L Kostev, K AF Tanislav, Christian Jacob, Louis Kostev, Karel TI Consultations Decline for Stroke, Transient Ischemic Attack, and Myocardial Infarction during the COVID-19 Pandemic in Germany SO NEUROEPIDEMIOLOGY LA English DT Article DE Coronavirus disease 2019; Pandemic; Stroke; Transient ischemic attack; Myocardial infarction; Germany ID ACUTE CORONARY SYNDROME; CHEST-PAIN; CARE; IMPACT AB Background: The coronavirus disease 2019 (COVID-19) pandemic raises the concern that other non-COVID conditions will be affected by a decline in care. Therefore, we aimed to investigate the decline in ambulatory presentations for vascular events (stroke, transient ischemic attack [TIA], and myocardial infarction [MI]) during the COVID-19 pandemic. Methods: Patients with a diagnosis of ischemic stroke, TIA, or MI documented anonymously in 1,262 general practices in Germany were included. We studied the differences between 2019 and 2020 (between April and June) in terms of rates and baseline characteristics by comparing monthly absolute frequencies. Results: A total of 3,496 patients with stroke (mean age: 72.2 years), 1,608 patients with TIA (mean age: 71.5 years), and 2,385 patients with MI (mean age: 66.8 years) were identified between April and June 2020, indicating a decrease of 10% (stroke), 16% (TIA), and 9% (MI) compared to 2019. For patients with stroke, the decrease in men was 13% (women: -6%) but reached 17% in the age category 51-60 years. For MI, the decrease was only obvious in males (14%). The largest decrease in stroke (-17%) and MI (-19%) was noted in April, while that for TIA occurred in May (-22%). In June for all 3 conditions, the previous year's level was achieved. Only in TIA, the age differs between 2019 and 2020 (mean age: 69.9 vs. 71.5 years; p < 0.05). In patients with stroke and MI, the proportions of men were lower in 2019 than in 2020 (stroke: 54.8-50.5%, p < 0.05 and MI: 64-60.2%, p < 0.05). Conclusion: Although the decline in the number of patients presenting with stroke, TIA, and MI was not as noticeable in the ambulatory sector as it was in the area of emergency hospital-based care, our data indicate that the COVID-19 pandemic affected all sectors within the medical care system. C1 [Tanislav, Christian] Diakonie Hosp Jung Stilling Siegen, Dept Geriatr & Neurol, Wichernstr 40, DE-57074 Siegen, Germany. [Jacob, Louis] Univ Versailles St Quentin En Yvelines, Fac Med, Montigny Le Bretonneux, France. [Jacob, Louis] Parc Sanitari St Joan Deu, CIBERSAM, Res & Dev Unit, Barcelona, Spain. [Kostev, Karel] IQVIA, Epidemiol, Frankfurt, Germany. C3 UDICE-French Research Universities; Universite Paris Saclay; CIBER - Centro de Investigacion Biomedica en Red; CIBERSAM; IQVIA RP Tanislav, C (通讯作者)，Diakonie Hosp Jung Stilling Siegen, Dept Geriatr & Neurol, Wichernstr 40, DE-57074 Siegen, Germany. EM christian.tanislav@diakonie-sw.de RI Jacob, Louis/AAL-3956-2020; Kostev, Karel/S-4755-2019 OI Jacob, Louis/0000-0003-1071-1239; Kostev, Karel/0000-0002-2124-7227 CR Agarwal S, 2020, J STROKE CEREBROVASC, V29, DOI 10.1016/j.jstrokecerebrovasdis.2020.105068 Amort M, 2011, CEREBROVASC DIS, V32, P57, DOI 10.1159/000327034 Bartley EJ, 2013, BRIT J ANAESTH, V111, P52, DOI 10.1093/bja/aet127 Benke C, 2022, PSYCHOL MED, V52, P3739, DOI 10.1017/S0033291720003438 Braiteh N, 2020, AM HEART J, V226, P147, DOI 10.1016/j.ahj.2020.05.009 De Filippo O, 2020, NEW ENGL J MED, V383, P88, DOI 10.1056/NEJMc2009166 Dombrowski SU, 2015, INT J STROKE, V10, P324, DOI 10.1111/ijs.12353 Dopfer C, 2020, BMC PEDIATR, V20, DOI 10.1186/s12887-020-02303-6 Eslick GD, 2004, GASTROENTEROL CLIN N, V33, P1, DOI 10.1016/S0889-8553(03)00125-0 Fleet RP, 1996, AM J MED, V101, P371, DOI 10.1016/S0002-9343(96)00224-0 Fletcher Kalen, 2013, J Support Oncol, V11, P126 Flynn D, 2020, HEALTH POLICY TECHN, V9, P673, DOI 10.1016/j.hlpt.2020.08.003 Folino AF, 2020, AM HEART J, V226, P26, DOI 10.1016/j.ahj.2020.04.021 Hammoudeh AJ, 1996, NEW ENGL J MED, V335, P2001, DOI 10.1056/NEJM199612263352617 Hartnett KP, 2020, MMWR-MORBID MORTAL W, V69, P699, DOI 10.15585/mmwr.mm6923e1 Hodes GE, 2019, BIOL PSYCHIAT, V86, P421, DOI 10.1016/j.biopsych.2019.04.028 Jafarzadeh-Esfehani R, 2020, ARCH IRAN MED, V23, P561, DOI 10.34172/aim.2020.60 Jones AT, 2020, EUR J NEUROL, V27, P18, DOI 10.1111/ene.14069 Kolikonda MK, 2020, NEUROEPIDEMIOLOGY, V54, P370, DOI 10.1159/000510134 Kwok CS, 2020, HEART, V106, P1805, DOI 10.1136/heartjnl-2020-317650 Lazzerini M, 2020, LANCET CHILD ADOLESC, V4, pE10, DOI 10.1016/S2352-4642(20)30108-5 Liebeskind D., 2020, F1000RES, V9, pF1000 Lowe B, 2018, PSYCHOSOM MED, V80, P412, DOI 10.1097/PSY.0000000000000594 Mafham MM, 2020, LANCET, V396, P381, DOI 10.1016/S0140-6736(20)31356-8 Marroquin B, 2020, PSYCHIAT RES, V293, DOI 10.1016/j.psychres.2020.113419 Metzler B, 2020, EUR HEART J, V41, P1852, DOI 10.1093/eurheartj/ehaa314 Nishijima H, 2016, NEUROL SCI, V37, P105, DOI 10.1007/s10072-015-2372-1 Rathmann W, 2018, INT J CLIN PHARM TH, V56, P459, DOI 10.5414/CP203320 Rudilosso S, 2020, STROKE, V51, P1991, DOI 10.1161/STROKEAHA.120.030329 Schlachetzki F, 2022, J TELEMED TELECARE, V28, P481, DOI 10.1177/1357633X20943327 Schwarz V, 2020, CLIN RES CARDIOL, V109, P1500, DOI 10.1007/s00392-020-01688-9 Sharma M, 2020, STROKE VASC NEUROL, V5, P403, DOI 10.1136/svn-2020-000441 Siegler JE, 2020, J STROKE CEREBROVASC, V29, DOI 10.1016/j.jstrokecerebrovasdis.2020.104953 Slagman A, 2020, DTSCH ARZTEBL INT, V117, P545, DOI 10.3238/arztebl.2020.0545 Tam CCF, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006631 Teo KC, 2020, STROKE, V51, P2228, DOI 10.1161/STROKEAHA.120.030105 Wang W, 2012, PAIN PHYSICIAN, V15, pE131 Wertli MM, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0211615 Wilkins SS, 2018, PSYCHOSOM MED, V80, P416, DOI 10.1097/PSY.0000000000000563 Wolf EH, 2020, SWISS MED WKLY, V150, DOI 10.4414/smw.2020.20331 NR 40 TC 10 Z9 10 U1 0 U2 3 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0251-5350 EI 1423-0208 J9 NEUROEPIDEMIOLOGY JI Neuroepidemiology PD MAR PY 2021 VL 55 IS 1 BP 70 EP 77 DI 10.1159/000513812 EA FEB 2021 PG 8 WC Public, Environmental & Occupational Health; Clinical Neurology WE Science Citation Index Expanded (SCI-EXPANDED) SC Public, Environmental & Occupational Health; Neurosciences & Neurology GA QY6NU UT WOS:000614593200001 PM 33530092 OA Green Published DA 2023-05-13 ER PT J AU Bhalla, MC Frey, J Dials, S Baughman, K AF Bhalla, Mary Colleen Frey, Jennifer Dials, Sarah Baughman, Kristin TI Outcomes of non-STEMI patients transported by emergency medical services vs private vehicle SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ACUTE CORONARY SYNDROME; MORTALITY; MANAGEMENT; INTERVENTION; GUIDELINES; IMPACT AB Background: Non-ST-segment elevation myocardial infarctions (NSTEMIs) are more common but less studied than ST-segment elevation myocardial infarctions (STEMIs) treated by emergency medical services (EMS). Objective: The purpose of this study was to evaluate the differences in baseline characteristics and outcomes of NSTEMI patients when arriving by EMS vs self-transport. Methods: We performed a retrospective medical record review of 96 EMS patients and 96 self-transport patients with the diagnosis of NSTEMI based on billing code. Results: The mean age of patients arriving by EMS was 75 vs 65 years for self-transport patients (P <=.000). Patients arriving by self-transport received cardiac catheterization more often than patients arriving by EMS (84% vs 49%, P <=.001). Emergency medical services patients had significantly longer average hospital length of stay and intensive care unit length of stay than did patients arriving by self-transport (6.5 vs 4 days [P <=.001] and 4.1 vs 2.7 days [P=.019]). Significantly more EMS patients were discharged to a new extended care facility (25% vs 3.1%, P <=.001). Finally, more EMS patients died in the hospital (18.8 vs 4.2%, P=.002). Conclusions: Patients with NSTEMI who arrived by EMS are older, are more ill, and have worse outcomes compared with patients who arrived by self-transport. Further research into patient reasoning for mode of transportation to the ED may influence public health interventions, public policy development, and EMS and hospital protocols for management of NSTEMIs. The high mortality in prehospital cohort should prompt further investigation to develop evidence-based protocols. (C) 2015 Elsevier Inc. All rights reserved. C1 [Bhalla, Mary Colleen; Frey, Jennifer] Summa Akron City Hosp, 525 East Market St, Akron, OH 44304 USA. [Bhalla, Mary Colleen; Dials, Sarah; Baughman, Kristin] Northeast Ohio Med Univ, Rootstown, OH USA. [Dials, Sarah] Akron Gen Med Ctr, 1 Akron Gen Ave, Akron, OH 44307 USA. C3 Summa Health System; Northeast Ohio Medical University (NEOMED); Akron General Medical Center RP Bhalla, MC (通讯作者)，Summa Akron City Hosp, 525 East Market St, Akron, OH 44304 USA. EM bhallam@summahealth.org; freyja@summahealth.org; sdials@neomed.edu; kbaughma@neomed.edu RI Baughman, Kristin Renae/B-8991-2009 OI Baughman, Kristin Renae/0000-0002-3128-3627 CR Anderson JL, 2013, CIRCULATION, V127, pE663, DOI 10.1161/CIR.0b013e31828478ac Andre R, 2014, HEART, V100, P1201, DOI 10.1136/heartjnl-2013-305196 [Anonymous], 2013, HLTH US 2012 SPEC FE Braunwald E, 2003, CIRCULATION, V108, P28 Brennan JM, 2013, JACC-CARDIOVASC INTE, V6, P790, DOI 10.1016/j.jcin.2013.03.020 Chin CT, 2014, AM HEART J, V167, P36, DOI 10.1016/j.ahj.2013.10.008 Elbarouni B, 2008, AM HEART J, V156, P262, DOI 10.1016/j.ahj.2008.03.025 Harris PA, 2009, J BIOMED INFORM, V42, P377, DOI 10.1016/j.jbi.2008.08.010 Le May MR, 2012, J AM COLL CARDIOL, V60, P1223, DOI 10.1016/j.jacc.2012.07.008 Naegeli B, 2011, EUR J CARDIOV PREV R, V18, P297, DOI 10.1177/1741826710389386 Quinn T, 2014, HEART, V100, P944, DOI 10.1136/heartjnl-2013-304599 Tekin K, 2013, KOREAN CIRC J, V43, P725, DOI 10.4070/kcj.2013.43.11.725 Ting HH, 2010, ARCH INTERN MED, V170, P1834, DOI 10.1001/archinternmed.2010.385 United States Census Bureau, 2012, STAT COUNT QUICKF SU United States Census Bureau, 2010, STAT COUNT QUICKF AK US Department of Health and Human Services, 2013, HLTH PEOPL 2020 Vogel B, 2012, INT J CARDIOL, V159, P198, DOI 10.1016/j.ijcard.2011.02.073 NR 17 TC 2 Z9 2 U1 0 U2 3 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 MAR PY 2016 VL 34 IS 3 BP 531 EP 535 DI 10.1016/j.ajem.2015.12.070 PG 5 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA DI4TB UT WOS:000373491100033 PM 26809927 DA 2023-05-13 ER PT J AU Allanson, ER Tuncalp, O Vogel, JP Khan, DN Oladapo, OT Long, Q Gulmezoglu, AM AF Allanson, Emma R. Tuncalp, Ozge Vogel, Joshua P. Khan, Dina N. Oladapo, Olufemi T. Long, Qian Gulmezoglu, Ahmet Metin TI Implementation of effective practices in health facilities: a systematic review of cluster randomised trials SO BMJ GLOBAL HEALTH LA English DT Review ID ACUTE CORONARY SYNDROMES; IMPROVE ANTIBIOTIC USE; QUALITY-OF-CARE; MULTIFACETED INTERVENTION; PUBLIC INVOLVEMENT; CLINICAL PATHWAYS; HEART-FAILURE; STRATEGY; IMPACT; GUIDELINES AB Background The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of evidence-based practices. We aimed to systematically review available evidence to identify and evaluate the components in the implementation process at the facility level using cluster RCT designs. Methods All cluster RCTs where the healthcare facility was the unit of randomisation, published or written from 1990 to 2014, were assessed. Included studies were analysed for the components of implementation interventions employed in each. Through iterative mapping and analysis, we synthesised a master list of components used and summarised the effects of different combinations of interventions on practices. Results Forty-six studies met the inclusion criteria and covered the specialty groups of obstetrics and gynaecology (n=9), paediatrics and neonatology (n=4), intensive care (n=4), internal medicine (n=20), and anaesthetics and surgery (n=3). Six studies included interventions that were delivered across specialties. Nine components of multifaceted implementation interventions were identified: leadership, barrier identification, tailoring to the context, patient involvement, communication, education, supportive supervision, provision of resources, and audit and feedback. The four main components that were most commonly used were education (n=42, 91%), audit and feedback (n=26, 57%), provision of resources (n=23, 50%) and leadership (n=21, 46%). Conclusions Future implementation research should focus on better reporting of multifaceted approaches, incorporating sets of components that facilitate the translation of research into practice, and should employ rigorous monitoring and evaluation. C1 [Allanson, Emma R.] Univ Western Australia, Sch Womens & Infants Hlth, Fac Med Dent & Hlth Sci, Crawley, Australia. [Allanson, Emma R.; Tuncalp, Ozge; Vogel, Joshua P.; Khan, Dina N.; Oladapo, Olufemi T.; Long, Qian; Gulmezoglu, Ahmet Metin] WHO, Dept Reprod Hlth & Res, UNDP UNFPA UNICEF WHO World Bank Special Programm, Geneva, Switzerland. C3 University of Western Australia; The World Bank; United Nations Population Fund; World Health Organization RP Tuncalp, O (通讯作者)，WHO, Dept Reprod Hlth & Res, UNDP UNFPA UNICEF WHO World Bank Special Programm, Geneva, Switzerland. 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Health PD MAR PY 2017 VL 2 IS 2 AR e000266 DI 10.1136/bmjgh-2016-000266 PG 11 WC Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Public, Environmental & Occupational Health GA FF2SG UT WOS:000408746500029 PM 29081997 OA Green Published, gold DA 2023-05-13 ER PT J AU Desai, NR Peterson, ED Chen, AY Wiviott, SD Sabatine, MS Alexander, KP Roe, MT Shah, BR AF Desai, Nihar R. Peterson, Eric D. Chen, Anita Y. Wiviott, Stephen D. Sabatine, Marc S. Alexander, Karen P. Roe, Matthew T. Shah, Bimal R. TI Balancing the risk of mortality and major bleeding in the treatment of NSTEMI patients - A report from the National Cardiovascular Data Registry SO AMERICAN HEART JOURNAL LA English DT Article ID ELEVATION MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; INTERVENTION OUTCOMES NETWORK; ASSOCIATION TASK-FORCE; QUALITY IMPROVEMENT; GUIDELINE ADHERENCE; INVASIVE MANAGEMENT; AMERICAN-COLLEGE; UNSTABLE ANGINA; PATTERNS AB Objectives We sought to describe real-world patterns of care in NSTEMI patients across different risk profiles for bleeding and mortality. Background The NCDR ACTION Registry-GWTG in-hospital mortality and major bleeding risk scores were developed to assess patient risk and optimize treatment decisions. However, little is known about the alignment of contemporary clinical management patterns with these risk estimates. Methods We studied 61,366 NSTEMI patients in the NCDR ACTION-Registry-GWTG from January 2007 to March 2009, stratifying them into four groups based on estimated risk of mortality and major bleeding. Results There were 24,709 (40.3%) patients in each of the concordant risk groups (low: low; high: high) and 5974 (9.7%) in each of the discordant risk groups (low: high; high: low). Subjects at high estimated risk for both mortality and major bleeding were least likely to receive guideline-based adjunctive pharmacotherapy or to undergo angiography within 48 hours but most likely to receive an excess dose of an antithrombotic agent. Patients at low estimated risk for mortality and bleeding received the most intensive adjunctive therapy and were most likely to undergo invasive angiography. Conclusion There are significant differences in contemporary patterns of care across varying risk profiles of mortality and major bleeding. Despite practice patterns which seem to emphasize avoiding harm with reduced use of antithrombotic therapy, patients at high risk for major bleeding continue to receive excess doses of antithrombotic therapy. Additional performance improvement efforts are needed to optimize outcomes in NSTEMI patients with high risk for both bleeding and mortality. C1 [Desai, Nihar R.; Wiviott, Stephen D.; Sabatine, Marc S.] Brigham & Womens Hosp, Dept Med, Div Cardiovasc Med, TIMI Study Grp, Boston, MA 02115 USA. [Desai, Nihar R.; Wiviott, Stephen D.; Sabatine, Marc S.] Harvard Univ, Sch Med, Boston, MA USA. [Peterson, Eric D.; Chen, Anita Y.; Alexander, Karen P.; Roe, Matthew T.; Shah, Bimal R.] Duke Univ, Dept Med, Div Cardiovasc Med, Duke Clin Res Inst, Durham, NC USA. C3 Harvard University; Brigham & Women's Hospital; Harvard University; Harvard Medical School; Duke University RP Shah, BR (通讯作者)，2400 Pratt St, Durham, NC 27712 USA. EM bimal.shah@duke.edu RI Wiviott, Stephen/HIK-2534-2022; Sabatine, Marc/AAJ-6751-2020; Peterson, Eric David/ABF-5033-2021 OI Sabatine, Marc/0000-0002-0691-3359; FU American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR); AstraZeneca; Merck-Schering Plough; Daiichi Sankyo; Eli Lilly; Bristol-Myers Squibb/Sanofi-Aventis Joint Venture; Merck; Pfizer; Sanofi-Aventis; KAI Pharmaceuticals; American College of Cardiology; American Heart Association FX Funding Information: This research was supported by the American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR). The views expressed in this manuscript 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.; S. D. W. has received research grant support from AstraZeneca, Merck-Schering Plough, Daiichi Sankyo, and Eli Lilly and honoraria for lectures and consultation from Bayer, ARENA, Ortho McNeil, Bristol-Myers Squibb, AstraZeneca, Eli Lilly, Daiichi Sankyo, Novartis, and Schering Plough.; MSS has received research grant support from AstraZeneca, Bristol-Myers Squibb/Sanofi-Aventis Joint Venture, Merck, and Pfizer and honoraria for lectures and consultation from Amgen and Bristol-Myers Squibb/Sanofi-Aventis Joint Venture.; MTR reports research support: Eli Lilly, Sanofi-Aventis, KAI Pharmaceuticals, American College of Cardiology, American Heart Association; consulting or honoraria: Bristol-Myers Squibb, Glaxo Smith Kline, Daiichi-Sankyo, Merck, Janssen Pharmaceuticals, Astra Zeneca, Regeneron. 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TI Cardiovascular Actions and Clinical Outcomes With Glucagon-Like Peptide-1 Receptor Agonists and Dipeptidyl Peptidase-4 Inhibitors SO CIRCULATION LA English DT Article DE acute myocardial infarction; cardiovascular events; cardiovascular outcomes trials; congestive heart failure; DPP-4Is; GLP-1; GLP-1R agonists; incretin; stroke ID LEFT-VENTRICULAR DYSFUNCTION; TYPE-2 DIABETES-MELLITUS; ATRIAL-NATRIURETIC-PEPTIDE; PRESERVES CARDIAC-FUNCTION; MYOCARDIAL GLUCOSE-UPTAKE; CHRONIC HEART-FAILURE; FATTY LIVER-DISEASE; DRUG-NAIVE PATIENTS; REDUCED EJECTION FRACTION; INDUCED OXIDATIVE STRESS AB Potentiation of glucagon-like peptide-1 (GLP-1) action through selective GLP-1 receptor (GLP-1R) agonism or by prevention of enzymatic degradation by inhibition of dipeptidyl peptidase-4 (DPP-4) promotes glycemic reduction for the treatment of type 2 diabetes mellitus by glucose-dependent control of insulin and glucagon secretion. GLP-1R agonists also decelerate gastric emptying, reduce body weight by reduction of food intake and lower circulating lipoproteins, inflammation, and systolic blood pressure. Preclinical studies demonstrate that both GLP-1R agonists and DPP-4 inhibitors exhibit cardioprotective actions in animal models of myocardial ischemia and ventricular dysfunction through incompletely characterized mechanisms. The results of cardiovascular outcome trials in human subjects with type 2 diabetes mellitus and increased cardiovascular risk have demonstrated a cardiovascular benefit (significant reduction in time to first major adverse cardiovascular event) with the GLP-1R agonists liraglutide (LEADER trial [Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Ourcome Results], -13%) and semaglutide (SUSTAIN-6 trial [Trial to Evaluate Cardiovascular and Other Long-term Outcomes with Semaglutide], -24%). In contrast, cardiovascular outcome trials examining the safety of the shorter-acting GLP-1R agonist lixisenatide (ELIXA trial [Evaluation of Lixisenatide in Acute Coronary Syndrom]) and the DPP-4 inhibitors saxagliptin (SAVOR-TIMI 53 trial [Saxagliptin Assessment of Vascular Outcomes Recorded in Patients With Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53]), alogliptin (EXAMINE trial [Examination of Cardiovascular Outcomes With Alogliptin Versus Standard of Care in Patients With Type 2 Diabetes Mellitus and Acute Coronary Syndrome]), and sitagliptin (TECOS [Trial Evaluating Cardiovascular Outcomes With Sitagliptin]) found that these agents neither increased nor decreased cardiovascular events. Here we review the cardiovascular actions of GLP-1R agonists and DPP-4 inhibitors, with a focus on the translation of mechanisms derived from preclinical studies to complementary findings in clinical studies. We highlight areas of uncertainty requiring more careful scrutiny in ongoing basic science and clinical studies. As newer more potent GLP-1R agonists and coagonists are being developed for the treatment of type 2 diabetes mellitus, obesity, and nonalcoholic steatohepatitis, the delineation of the potential mechanisms that underlie the cardiovascular benefit and safety of these agents have immediate relevance for the prevention and treatment of cardiovascular disease. C1 [Nauck, Michael A.; Meier, Juris J.; Abd El Aziz, Mirna] Ruhr Univ Bochum, St Josef Hosp, Diabet Ctr Bochum Hattingen, Bochum, Germany. [Cavender, Matthew A.] Univ N Carolina, Dept Med, Chapel Hill, NC USA. [Drucker, Daniel J.] Univ Toronto, Mt Sinai Hosp, Lunenfeld Tanenbaum Res Inst, Dept Med, Toronto, ON, Canada. C3 Ruhr University Bochum; University of North Carolina; University of North Carolina Chapel Hill; University of Toronto; Sinai Health System Toronto; Lunenfeld Tanenbaum Research Institute RP Nauck, MA (通讯作者)，Ruhr Univ Bochum, St Josef Hosp, Diabet Ctr Bochum Hattingen, Dept Med 1, Gudrunstr 56, D-44791 Bochum, Germany. EM michael.nauck@rub.de RI Drucker, Daniel J/A-4092-2010; Nauck, Michael Albrecht/ABA-9752-2021 OI Nauck, Michael Albrecht/0000-0002-5749-6954 FU Deutsche Forschungsgemeinschaft, Bonn-Bad-Godesberg, Germany; CIHR [123391]; Canada Research Chairs Program; BBDC-Novo Nordisk Chair in Incretin Biology FX Drs Nauck and Meier have been supported by grants from the Deutsche Forschungsgemeinschaft, Bonn-Bad-Godesberg, Germany. Dr Drucker is supported by CIHR grant 123391, the Canada Research Chairs Program, and a BBDC-Novo Nordisk Chair in Incretin Biology. 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Kristen Lord, Bill Shipp, Carol TI Fluency and confidence predict paramedic diagnostic intuition: An experimental study of applied dual-process theory SO INTERNATIONAL EMERGENCY NURSING LA English DT Article DE Paramedic; Emergency medical services; Decision making; Diagnosis; Dual process theory; Fuzzy trace theory ID DECISION-MAKING; MYOCARDIAL-INFARCTION; TREATMENT DELAY; CHEST-PAIN; PATIENT; REDUCTION; JUDGMENT; MODELS; IMPACT; CARE AB Introduction: We report an experiment using Australian paramedics (n = 64) and Australian paramedicine undergraduates (n = 44), on the processes underlying the formation of an intuitive diagnostic impression, based on limited dispatch information. Previous research has signalled roles for objective likelihood of the disease, subjective typicality of the disease, and the ease with which the diagnosis comes to mind (answer fluency) as important in impression formation. Method: Participants completed four brief written clinical vignettes under time pressure and with a concurrent navigation task to simulate conditions faced by paramedics prior to meeting a patient. Diagnostic impression, confidence and subjective typicality of the vignette were self-reported while answer fluency was measured. The vignettes varied the objective likelihood of a diagnosis of Acute Coronary Syndrome (ACS), a condition often encountered by paramedics. Results: Likelihood, answer fluency, self-reported typicality and confidence predicted the impression but there was no effect of experience. Students and experienced paramedics had comparable accuracy and performance. Conclusion: The results support a role for answer fluency and confidence in forming that impression. We have shown it is possible to experimentally manipulate various factors associated with paramedic diagnostic impressions. These experimental methods can form the basis for additional studies into paramedic decision making. C1 [Keene, Toby] Australian Natl Univ, Acton, Australia. [Pammer, Kristen] Univ Newcastle, Callaghan, NSW, Australia. [Lord, Bill] Monash Univ, Clayton, Vic, Australia. [Shipp, Carol] Australian Capital Terr Ambulance Serv, Canberra, ACT, Australia. C3 Australian National University; University of Newcastle; Monash University RP Keene, T (通讯作者)，Australian Natl Univ, Res Sch Psychol, Acton, ACT 2600, Australia. EM Toby.keene@anu.edu.au OI Lord, Bill/0000-0001-8821-5353; Pammer, Kristen/0000-0002-3183-5268 FU Australian Government Research Training Program Scholarship FX This research is supported by an Australian Government Research Training Program Scholarship. CR Alexander M., 2010, REASONING PROCESSES Backdash JZ., 2018, RMCORR REPEATED MEAS Bates D, 2015, J STAT SOFTW, V67, P1, DOI 10.18637/jss.v067.i01 Blalock SJ, 2016, HEALTH PSYCHOL, V35, P781, DOI 10.1037/hea0000384 Body R, 2010, RESUSCITATION, V81, P281, DOI 10.1016/j.resuscitation.2009.11.014 Christie A, 2016, EMERG MED AUSTRALAS, V28, P525, DOI 10.1111/1742-6723.12618 Colbeck M., 2016, AUSTRALASIAN J PARAM, V13, P1, DOI [10.33151/ajp.13.4.523, DOI 10.33151/AJP.13.4.523] Corbin JC, 2015, J APPL RES MEM COGN, V4, P344, DOI 10.1016/j.jarmac.2015.09.001 Crocco TJ, 2007, J EMERG MED, V33, P255, DOI 10.1016/j.jemermed.2007.02.056 De Neys W, 2006, Q J EXP PSYCHOL, V59, P1070, DOI 10.1080/02724980543000123 Fanaroff AC, 2015, JAMA-J AM MED ASSOC, V314, P1955, DOI 10.1001/jama.2015.12735 Gigerenzer G, 2011, ANNU REV PSYCHOL, V62, P451, DOI 10.1146/annurev-psych-120709-145346 Glockner A, 2010, THINK REASONING, V16, P1, DOI 10.1080/13546780903395748 Gross BW, 2007, AM J CARDIOL, V99, P1360, DOI 10.1016/j.amjcard.2006.12.058 Hafenbradl S, 2016, J APPL RES MEM COGN, V5, P215, DOI 10.1016/j.jarmac.2016.04.011 Harencarova H, 2017, J COGN ENG DECIS MAK, V11, P42, DOI 10.1177/1555343416674814 Jensen JL, 2016, CAN J EMERG MED, V18, P213, DOI 10.1017/cem.2015.95 Jensen JL, 2011, CAN J EMERG MED, V13, P310, DOI 10.2310/8000.2011.110405 Jensen JL, 2010, THESIS DALHOUSIE U Kahneman D, 2003, AM PSYCHOL, V58, P697, DOI 10.1037/0003-066X.58.9.697 Kahneman D., 2011, THINKING FAST SLOW Koivulahti O, 2020, SCAND J TRAUMA RESUS, V28, DOI 10.1186/s13049-020-00761-6 Kreidler SM, 2013, J STAT SOFTW, V54, P1, DOI 10.18637/jss.v054.i10 Luke SG, 2017, BEHAV RES METHODS, V49, P1494, DOI 10.3758/s13428-016-0809-y MacIver K, 2017, THESIS WHITIREIA COM Magezi DA, 2015, FRONT PSYCHOL, V6, DOI 10.3389/fpsyg.2015.00002 MillarCraig MW, 1997, HEART, V78, P456, DOI 10.1136/hrt.78.5.456 Mosley I, 2007, STROKE, V38, P2765, DOI 10.1161/STROKEAHA.107.483446 O'Hara R, 2015, J HEALTH SERV RES PO, V20, P45, DOI 10.1177/1355819614558472 Perona M, 2019, AUSTRALASIAN J PARAM, V16, DOI [10.33151/ajp.16.586, DOI 10.33151/AJP.16.586] R. 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A., 1997, NATURALISTIC DECISIO NR 43 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1755-599X EI 1878-013X J9 INT EMERG NURS JI Int. Emerg. Nurs. PD MAR PY 2022 VL 61 AR 101126 DI 10.1016/j.ienj.2021.101126 EA JAN 2022 PG 7 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA 0N0VF UT WOS:000782565400006 PM 35065389 OA Green Submitted DA 2023-05-13 ER PT J AU MacKenzie, M Hall, R AF MacKenzie, Meghan Hall, Richard TI Pharmacogenomics and pharmacogenetics for the intensive care unit: a narrative review SO CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE LA English DT Review ID IMPLEMENTATION CONSORTIUM GUIDELINES; SEPTIC SHOCK SUSCEPTIBILITY; COMMON GENETIC-VARIATION; ACUTE CORONARY SYNDROME; HEART-FAILURE; PERSONALIZED MEDICINE; VENOUS THROMBOEMBOLISM; PROMOTER POLYMORPHISM; POSTOPERATIVE NAUSEA; CYTOCHROME-P450 2D6 AB Purpose Knowledge of how alterations in pharmacogenomics and pharmacogenetics may affect drug therapy in the intensive care unit (ICU) has received little study. We review the clinically relevant application of pharmacogenetics and pharmacogenomics to drugs and conditions encountered in the ICU. We selected relevant literature to illustrate the important concepts contained within. Two main approaches have been used to identify genetic abnormalities - the candidate gene approach and the genome-wide approach. Genetic variability in response to drugs may occur as a result of alterations of drug-metabolizing (cytochrome P [CYP]) enzymes, receptors, and transport proteins leading to enhancement or delay in the therapeutic response. Of relevance to the ICU, genetic variation in CYP-450 isoenzymes results in altered effects of midazolam, fentanyl, morphine, codeine, phenytoin, clopidogrel, warfarin, carvedilol, metoprolol, HMG-CoA reductase inhibitors, calcineurin inhibitors, non-steroidal anti-inflammatory agents, proton pump inhibitors, and ondansetron. Changes in cholinesterase enzyme function may affect the disposition of succinylcholine, benzylisoquinoline muscle relaxants, remifentanil, and hydralazine. Genetic variation in transport proteins leads to differences in the response to opioids and clopidogrel. Polymorphisms in drug receptors result in altered effects of beta-blockers, catecholamines, antipsychotic agents, and opioids. Genetic variation also contributes to the diversity and incidence of diseases and conditions such as sepsis, malignant hyperthermia, drug-induced hypersensitivity reactions, cardiac channelopathies, thromboembolic disease, and congestive heart failure. Application of pharmacogenetics and pharmacogenomics has seen improvements in drug therapy. Ongoing study and incorporation of these concepts into clinical decision making in the ICU has the potential to affect patient outcomes. C1 [MacKenzie, Meghan] Nova Scotia Hlth Author, Dept Pharm, Halifax, NS, Canada. [MacKenzie, Meghan] Dalhousie Univ, Coll Pharm, Halifax, NS, Canada. [Hall, Richard] Dalhousie Univ, Dept Anesthesia Pain Management & Perioperat Med, Halifax, NS B3H 3A7, Canada. [Hall, Richard] Dalhousie Univ, Dept Crit Care Med & Pharmacol, Halifax, NS B3H 3A7, Canada. [Hall, Richard] Nova Scotia Hlth Author, Halifax, NS B3H 3A7, Canada. C3 Dalhousie University; Dalhousie University; Dalhousie University RP Hall, R (通讯作者)，Dalhousie Univ, Dept Anesthesia Pain Management & Perioperat Med, Halifax, NS B3H 3A7, Canada.; Hall, R (通讯作者)，Dalhousie Univ, Dept Crit Care Med & Pharmacol, Halifax, NS B3H 3A7, Canada.; Hall, R (通讯作者)，Nova Scotia Hlth Author, Halifax, NS B3H 3A7, Canada. 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J. Anesth. PD JAN PY 2017 VL 64 IS 1 BP 45 EP 64 DI 10.1007/s12630-016-0748-1 PG 20 WC Anesthesiology WE Science Citation Index Expanded (SCI-EXPANDED) SC Anesthesiology GA EH4TO UT WOS:000391763700007 PM 27752976 OA Bronze DA 2023-05-13 ER PT J AU Chen, L Chen, K Hong, YC Xing, LF Zhang, JJ Zhang, K Zhang, ZH AF Chen, Lin Chen, Kun Hong, Yucai Xing, Lifeng Zhang, Jianjun Zhang, Kai Zhang, Zhongheng TI The landscape of isoform switches in sepsis: a multicenter cohort study SO SCIENTIFIC REPORTS LA English DT Article ID FLOT2; TRANSCRIPTOME; EXPRESSION; INVASION; PROTEIN; RISK AB Sepsis is caused by an uncontrolled inflammatory response, whose underlying mechanisms are not fully understood. It is well known that the majority of human genes can be expressed as alternative isoforms. While isoform switching is implicated in many diseases and is particularly prominent in cancer, it has never been reported in the context of sepsis. Patients presented to the emergency department of three tertiary care hospitals from January 2020 to December 2020 were enrolled. Clinical variables and genome-wide transcriptome of peripheral blood mononuclear cells (PBMC) were obtained. Isoform switching analysis were performed to identify significant isoform switches and relevant biological consequences. A total of 48 subjects with sepsis, involving 42 survivors and 6 non-survivors, admitted to the emergency department of three tertiary care hospitals were enrolled in this study. PBMCs were extracted for RNA sequencing (RNA-seq). Patients (n = 4) with mild stroke or acute coronary syndrome without infection were enrolled in this study as controls. The most frequent functional changes resulting from isoform switching were changes affecting the open reading frame, protein domains and intron retention. Many genes without differences in gene expression showed significant isoform switching. Many genes with significant isoform switches (vertical bar dIF vertical bar> 0.1) were associated with higher mortality risk, including PIGS, CASP3, LITAF, HBB and RUVBL2. The study for the first time described the landscape of isoform switching in sepsis, including differentially expressed isoform fractions between patients with and without sepsis and survivors and nonsurvivors. The biological consequences of isoform switching, including protein domain loss, signal peptide gain, and intron retention, were identified. C1 [Chen, Lin; Chen, Kun] Zhejiang Univ, Sch Med, Dept Crit Care Med, Jinhua Hosp, Jinhua, Zhejiang, Peoples R China. [Hong, Yucai; Xing, Lifeng] Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Emergency Med, Hangzhou 310016, Peoples R China. [Zhang, Jianjun] Zigong Fourth Peoples Hosp, Emergency Dept, 19 Tanmulin Rd, Zigong, Sichuan, Peoples R China. [Zhang, Kai] Huzhou Cent Hosp, Dept Emergency Med, Huzhou 310016, Peoples R China. [Zhang, Zhongheng] Zhejiang Univ, Key Lab Precis Med Diag & Monitoring Res Zhejiang, Sir Run Run Shaw Hosp, Dept Emergency Med,Sch Med, 3 East Qingchun Rd, Hangzhou 310016, Zhejiang, Peoples R China. C3 Zhejiang University; Zhejiang University; Huzhou University; Zhejiang University RP Zhang, ZH (通讯作者)，Zhejiang Univ, Key Lab Precis Med Diag & Monitoring Res Zhejiang, Sir Run Run Shaw Hosp, Dept Emergency Med,Sch Med, 3 East Qingchun Rd, Hangzhou 310016, Zhejiang, Peoples R China. EM zh_zhang1984@zju.edu.cn RI Zhang, Zhongheng/E-1282-2011 OI Zhang, Zhongheng/0000-0002-2336-5323 FU Public Research Project of Emergency Prevention and Treatment of COVID19 of Jinhua City [2020XG-06]; Key Research and Development Project of Zhejiang Province [2020C03019, 2021C03071]; Research project of Zigong City Science & Technology and Intellectual Property Right Bureau [2021ZC22]; Yilu "Gexin"-Fluid Therapy Research Fund Project [YLGX-ZZ-2020005] FX The study was supported by the Public Research Project of Emergency Prevention and Treatment of COVID19 of Jinhua City (2020XG-06), Key Research and Development Project of Zhejiang Province (2020C03019), Key Research and Development project of Zhejiang Province (2021C03071) and Yilu "Gexin"-Fluid Therapy Research Fund Project (YLGX-ZZ-2020005). JZ received funding from Research project of Zigong City Science & Technology and Intellectual Property Right Bureau (2021ZC22). 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Borlaug, Barry A. Barsness, Gregory W. Kane, Garvan C. Oh, Jae K. Jentzer, Jacob C. TI Noninvasive echocardiographic cardiac power output predicts mortality in cardiac intensive care unit patients SO AMERICAN HEART JOURNAL LA English DT Article ID CARDIOGENIC-SHOCK; HEART-FAILURE; DYSFUNCTION; EXERCISE AB Background : Low cardiac power output (CPO), measured invasively, can identify critically ill patients at increased risk of adverse outcomes, including mortality. We sought to determine whether non-invasive, echocardiographic CPO measurement was associated with mortality in cardiac intensive care unit (CICU) patients. Methods : Patients admitted to CICU between 2007 and 2018 with echocardiography performed within one day (before or after) admission and who had available data necessary for calculation of CPO were evaluated. Multivariable logistic regression determined the relationship between CPO and adjusted hospital hospital mortality. Results : A total of 5,585 patients (age of 68.3 +/- 14.8 years, 36.7% female) were evaluated with admission diagnoses including acute coronary syndrome (ACS) in 56.7%, heart failure (HF) in 50.1%, cardiac arrest (CA) in 12.2%, shock in 15.5%, and cardiogenic shock (CS) in 12.8%. The mean left ventricular ejection fraction (LVEF) was 47.3 +/- 16.2%, and the mean CPO was 1.04 +/- 0.37 W. There were 419 in-hospital deaths (7.5%). CPO was inversely associated with the risk of hospital mortality, an association that was consistent among patients with ACS, HF, and CS. On multivariable analysis, higher CPO was associated with reduced hospital mortality (OR 0.960 per 0.1 W, 95CI 0.0.926-0.996, P = .03). Hospital mortality was particularly high in patients with low CPO coupled with reduced LVEF, increased vasopressor requirements, or higher admission lactate. Conclusions : Echocardiographic CPO was inversely associated with hospital mortality in unselected CICU patients, particularly among patients with increased lactate and vasopressor requirements. Routine calculation and reporting of CPO should be considered for echocardiograms performed in CICU patients. C1 [Burstein, Barry; Jentzer, Jacob C.] Mayo Clin, Div Pulm & Crit Care Med, Rochester, MN 55905 USA. [Anand, Vidhu; Tabi, Meir; Anavekar, Nandan S.; Borlaug, Barry A.; Barsness, Gregory W.; Kane, Garvan C.; Oh, Jae K.; Jentzer, Jacob C.] Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA. [Ternus, Bradley] Univ Wisconsin, Div Cardiovasc Med, Madison, WI USA. C3 Mayo Clinic; Mayo Clinic; University of Wisconsin System; University of Wisconsin Madison RP Jentzer, JC (通讯作者)，Mayo Clin, Med, Dept Cardiovasc Med, Dept Internal Med, 200 First Sheet SW, Rochester, MN 55905 USA.; Jentzer, JC (通讯作者)，Mayo Clin, Div Pulm & Crit Care Med, Dept Internal Med, 200 First Sheet SW, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu OI Burstein, Barry/0000-0003-0203-9294; Jentzer, Jacob/0000-0002-6366-2859; Tabi, Meir/0000-0002-9199-9985 CR Baran DA, 2019, CATHETER CARDIO INTE, V94, P29, DOI 10.1002/ccd.28329 Basir MB, 2019, CATHETER CARDIO INTE, V93, P1173, DOI 10.1002/ccd.28307 Bennett CE, 2019, J CRIT CARE, V50, P242, DOI 10.1016/j.jcrc.2018.12.012 Berg DD, 2019, CIRC-CARDIOVASC QUAL, P12 Bhella PS, 2011, EUR J HEART FAIL, V13, P1296, DOI 10.1093/eurjhf/hfr133 Bohula EA, 2019, JAMA CARDIOL, V4, P928, DOI 10.1001/jamacardio.2019.2467 Burstein Barry, 2016, Acute Card Care, V18, P35, DOI 10.1080/17482941.2017.1293831 Cortigiani L, 2017, EUR HEART J-CARD IMG, V18, P153, DOI 10.1093/ehjci/jew073 Cotter G, 2003, EUR J HEART FAIL, V5, P443, DOI 10.1016/S1388-9842(03)00100-4 Dini FL, 2013, J CARDIOVASC MED, V14, P214, DOI 10.2459/JCM.0b013e32834ae7fe Fincke R, 2004, J AM COLL CARDIOL, V44, P340, DOI 10.1016/j.jacc.2004.03.060 Jentzer JC, 2021, JACC-CARDIOVASC IMAG, V14, P321, DOI 10.1016/j.jcmg.2020.05.038 Jentzer JC, 2020, AM HEART J, V224, P57, DOI 10.1016/j.ahj.2020.02.018 Jentzer JC, 2019, J AM COLL CARDIOL, V74, P2117, DOI 10.1016/j.jacc.2019.07.077 Jentzer JC, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013675 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2020, SHOCK, V53, P452, DOI 10.1097/SHK.0000000000001390 Jentzer JC, 2018, AM J CARDIOL, V122, P1773, DOI 10.1016/j.amjcard.2018.08.011 Jentzer JC, 2018, J CRIT CARE, V47, P114, DOI 10.1016/j.jcrc.2018.06.016 Jentzer JC, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008169 Kashiyama N, 2020, SEMIN THORAC CARDIOV, V32, P698, DOI 10.1053/j.semtcvs.2019.10.007 Klasnja AV, 2013, CLIN PHYSIOL FUNCT I, V33, P201, DOI 10.1111/cpf.12013 Konstam MA, 2017, CIRCULATION, V135, P717, DOI 10.1161/CIRCULATIONAHA.116.025795 Lang CC, 2009, CIRC-HEART FAIL, V2, P33, DOI 10.1161/CIRCHEARTFAILURE.108.798611 Lim HS, 2020, CIRC-HEART FAIL, V13, DOI 10.1161/CIRCHEARTFAILURE.120.007393 Mele D, 2020, J AM SOC ECHOCARDIOG, V33, P135, DOI 10.1016/j.echo.2019.09.009 Mendoza DD, 2007, AM HEART J, V153, P366, DOI 10.1016/j.ahj.2006.11.014 Mueller HS, 1998, J AM COLL CARDIOL, V32, P840, DOI 10.1016/S0735-1097(98)00327-1 Otasevic P, 2006, HEART, V92, P1253, DOI 10.1136/hrt.2005.073999 Pugliese NR, 2019, EUR HEART J-CARD IMG, V20, P700, DOI 10.1093/ehjci/jey172 Rimehaug AE, 2016, PHYSIOL REP, V4, DOI 10.14814/phy2.12989 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Spencer KT, 2013, J AM SOC ECHOCARDIOG, V26, P567, DOI 10.1016/j.echo.2013.04.001 Tannvik TD, 2018, PHYSIOL REP, V6, DOI 10.14814/phy2.13781 Tehrani BN, 2019, J AM COLL CARDIOL, V73, P1659, DOI 10.1016/j.jacc.2018.12.084 Torgersen C, 2009, CRIT CARE, V13, DOI 10.1186/cc8114 Vallabhajosyula S, 2018, SHOCK, V49, P144, DOI 10.1097/SHK.0000000000000952 van Diepen S, 2018, AM HEART J, V202, P84, DOI 10.1016/j.ahj.2018.05.003 NR 38 TC 5 Z9 5 U1 0 U2 0 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 MAR PY 2022 VL 245 BP 149 EP 159 DI 10.1016/j.ahj.2021.12.007 EA JAN 2022 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 3E6KA UT WOS:000830090400017 PM 34953769 DA 2023-05-13 ER PT J AU Gorog, DA Becker, RC AF Gorog, Diana A. Becker, Richard C. TI Point-of-care platelet function tests: relevance to arterial thrombosis and opportunities for improvement SO JOURNAL OF THROMBOSIS AND THROMBOLYSIS LA English DT Article DE Platelet aggregation; Platelet function test; Thrombosis; Fibrinolysis; Citrate; Shear ID ACUTE CORONARY SYNDROME; ADJUST ANTIPLATELET THERAPY; FRESH WHOLE-BLOOD; SERUM-CALCIUM; RISK-FACTOR; HIGH-SHEAR; OPEN-LABEL; AGGREGATION; FLOW; ACTIVATION AB Studies using whole blood platelet aggregometry as a laboratory research tool, provided important insights into the mechanism and modulators of platelet aggregation. Subsequently, a number of point-of-care (POC) platelet function tests (PFTs) were developed for clinical use, based on the concept that an individual's thrombotic profile could be assessed in vitro by assessing the response to stimulation of platelet aggregation by specific, usually solo agonists such as adenosine diphosphate (ADP), collagen and thrombin. However, adjusting antiplatelet medication in order to improve the results of such POC PFTs has not translated into a meaningful reduction in cardiovascular events, which may be attributable to important differences between the POC PFT techniques and in vivo conditions, including patient-to-patient variability. Important limitations of most tests include the use of citrate-anticoagulated blood. Citrate directly and irreversibly diminishes platelet function and even after recalcification, it may result in altered platelet aggregation in response to ADP, epinephrine or collagen, and interfere with thrombin generation from activated platelets. Furthermore, most tests do not employ flowing blood and therefore do not assess the effect of high shear forces on platelets that initiate, propagate and stabilize arterial thrombi. Finally, the effect of endogenous thrombolysis, due to fibrinolysis and dislodgement, which ultimately determines the outcome of a thrombotic stimulus, is mostly not assessed. In order to accurately reflect an individual's predisposition to arterial thrombosis, future tests of thrombotic status which overcome these limitations should be used, to improve cardiovascular risk prediction and to guide pharmacotherapy. C1 [Gorog, Diana A.] Imperial Coll, Natl Heart & Lung Inst, Dovehouse St, London SW3 6LY, England. [Gorog, Diana A.] Univ Hertfordshire, Hatfield, Herts, England. [Becker, Richard C.] Univ Cincinnati, Coll Med, Cincinnati, OH USA. C3 RLUK- Research Libraries UK; Imperial College London; University of Hertfordshire; University System of Ohio; University of Cincinnati RP Gorog, DA (通讯作者)，Imperial Coll, Natl Heart & Lung Inst, Dovehouse St, London SW3 6LY, England.; Gorog, DA (通讯作者)，Univ Hertfordshire, Hatfield, Herts, England. 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Thromb. Thrombolysis PD JAN PY 2021 VL 51 IS 1 BP 1 EP 11 DI 10.1007/s11239-020-02170-z EA JUN 2020 PG 11 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Hematology GA PW8IY UT WOS:000539813600002 PM 32529549 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Coventry, LL van Schalkwyk, JW Thompson, PL Hawkins, SA Hegney, DG AF Coventry, Linda L. van Schalkwyk, Johanna W. Thompson, Peter L. Hawkins, Scott A. Hegney, Desley G. TI Myocardial infarction, patient decision delay and help-seeking behaviour: a thematic analysis SO JOURNAL OF CLINICAL NURSING LA English DT Article DE decision-making; emergency care; heart disease; patients' experience; qualitative study ID ACUTE CORONARY SYNDROME; PREHOSPITAL DELAY; EMERGENCY-DEPARTMENT; REDUCING DELAY; SYMPTOMS; WOMEN; TIME; PREDICTORS; CARE; INTERVENTION AB Aims and objectives. To explore patient decision delay, the symptom experience and factors that motivated the patient experiencing myocardial infarction to go to the emergency department. Background. Reperfusion for myocardial infarction is more effective if performed as soon as possible after the onset of symptoms. Multiple studies show that pre-hospital delay is long and can average several hours. Design. A qualitative descriptive design using semi-structured interviews. Methods. All consecutive myocardial infarction patients who between July 2013-January 2014 at a single-centre metropolitan tertiary hospital in Western Australia were included. Patient responses to an open-ended question were recorded and transcribed verbatim. Data were analysed using Braun & Clarke (Qual Res Psychol, 3, 2006, 77-101) thematic analysis method. Results. Of the 367 eligible, 255 provided consent. Three themes emerged from the qualitative analyses: (1) onset and response to symptoms, and this included three subthemes: context of the event, diversity of symptom interpretation and response to symptoms; (2) help-seeking behaviour, and this included the patient seeking help from various lay and professional sources; and (3) help-seeking outcomes, which include calling the emergency ambulance, going to emergency department, seeing a general practitioner, seeing a general practitioner who advised them to go home. Conclusion. The context of the event, their symptomatology and the layperson who was the first point of contact influenced the decision for the patient to go to the emergency department. Many patients used private transport or contacted their general practitioner. New knowledge from this study emphasises the importance of the layperson understanding the appropriate response is to seek prompt care through immediate emergency transport by ambulance to emergency department. Relevance to clinical practice. This study highlights the need to educate both the patient and the wider public, not only to seek prompt care but to also to call the emergency ambulance to arrange transport to the emergency department. C1 [Coventry, Linda L.; van Schalkwyk, Johanna W.; Hegney, Desley G.] Sir Charles Gairdner Hosp, Ctr Nursing Res, Nedlands, WA, Australia. [Coventry, Linda L.] Edith Cowan Univ, Sch Nursing & Midwifery, Bldg 21,270 Joondalup Dr, Joondalup, WA 6027, Australia. [Thompson, Peter L.] Heart Res Inst, Perth, WA, Australia. [Thompson, Peter L.] Sir Charles Gairdner Hosp, Perth, WA, Australia. [Thompson, Peter L.] Harry Perkins Inst Med Res, Perth, WA, Australia. [Thompson, Peter L.] Univ Western Australia, Med, Perth, WA, Australia. [Hawkins, Scott A.] Sir Charles Gairdner Hosp, Staff Dev, Nedlands, WA, Australia. [Hegney, Desley G.] Cent Queensland Univ, North Rockhampton, Qld, Australia. [Hegney, Desley G.] Univ Southern Queensland, Sch Nursing & Midwifery, Nursing, Toowoomba, Qld, Australia. [Hegney, Desley G.] Adelaide Univ, Sch Nursing, Nursing, Adelaide, SA, Australia. C3 University of Western Australia; Edith Cowan University; University of Sydney; Heart Research Institute; University of Western Australia; Harry Perkins Institute of Medical Research; University of Western Australia; University of Western Australia; Central Queensland University; University of Southern Queensland; University of Adelaide RP Coventry, LL (通讯作者)，Edith Cowan Univ, Sch Nursing & Midwifery, Bldg 21,270 Joondalup Dr, Joondalup, WA 6027, Australia. EM l.coventry@ecu.edu.au RI Hegney, Desley/U-8004-2019 OI Hegney, Desley/0000-0003-1267-1760; Coventry, Linda/0000-0002-3598-9942; van Schalkwyk, Johanna/0000-0002-8087-1863 FU Sir Charles Gairdner Research Advisory Council FX This work was supported by a research grant from the Sir Charles Gairdner Research Advisory Council. The funding body had no involvement in the study design; data collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication. 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Clin. Nurs. PD JUL PY 2017 VL 26 IS 13-14 BP 1993 EP 2005 DI 10.1111/jocn.13607 PG 13 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA FA3DX UT WOS:000405323200023 PM 27706869 DA 2023-05-13 ER PT J AU Sutton, J Gu, LO Diercks, DB AF Sutton, James Gu, Leon Diercks, Deborah B. TI Impact of Social Determinants of Health, Health Literacy, Self-perceived Risk, and Trust in the Emergency Physician on Compliance with Follow-up SO WESTERN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ADHERENCE; CARE AB Introduction: Patients presenting to the emergency department (ED) with "low-risk" acute coronary syndrome (ACS) symptoms can be discharged with outpatient follow-up. However, follow-up compliance is low for unknown nonclinical reasons. We hypothesized that a patient's social factors, health literacy, self-perceived risk, and trust in the emergency physician may impact follow-up compliance. Methods: This was a prospective study of a convenience sample of discharged ED patients presenting with chest pain and given a follow-up appointment prior to departing the ED. Patients were asked about social and demographic factors and to estimate their own risk for heart disease; they also completed the Short Assessment of Health Literacy-English (SAHL-E) and the Trust in Physician Scale (TiPS). Results: We enrolled146 patients with a follow-up rate of 36.3%. Patients who had a low self-perceived heart disease risk (10% or less) were significantly less likely to attend follow-up than those with a higher perceived risk (23% vs 44%, P = 0.01). Other factors did not significantly predict follow-up rates. Conclusion: In an urban county ED, in patients who were deemed low risk for ACS and discharged, only self-perception of risk was associated with compliance with a follow-up appointment. C1 [Sutton, James; Gu, Leon] Univ Texas Southwestern Sch Med, Dallas, TX USA. [Diercks, Deborah B.] Univ Texas Southwestern, Dept Emergency Med, 5323 Harry Hines Blvd, Dallas, TX 75320 USA. C3 University of Texas System; University of Texas Southwestern Medical Center Dallas RP Diercks, DB (通讯作者)，Univ Texas Southwestern, Dept Emergency Med, 5323 Harry Hines Blvd, Dallas, TX 75320 USA. EM Deborah.Diercks@UTSouthwestern.edu CR ANDERSON LA, 1990, PSYCHOL REP, V67, P1091, DOI 10.2466/pr0.1990.67.3f.1091 Atzema CL, 2017, ACAD EMERG MED, V24, P201, DOI 10.1111/acem.13125 Braveman P, 2014, PUBLIC HEALTH REP, V129, P19, DOI 10.1177/00333549141291S206 Graham JL, 2015, AIDS PATIENT CARE ST, V29, P661, DOI 10.1089/apc.2015.0156 Hussein Haitham M, 2008, J Vasc Interv Neurol, V1, P106 Lee SYD, 2010, HEALTH SERV RES, V45, P1105, DOI 10.1111/j.1475-6773.2010.01119.x Likert R. A., 1952, EDUC PSYCHOL MEAS, V12, P313, DOI DOI 10.1177/001316445201200214 Milano Peter, 2011, Crit Pathw Cardiol, V10, P35, DOI 10.1097/HPC.0b013e31820fd9bd Miller TA, 2016, PATIENT EDUC COUNS, V99, P1079, DOI 10.1016/j.pec.2016.01.020 Montalescot G, 2013, EUR HEART J, V34, P2949, DOI 10.1093/eurheartj/eht296 Story M, 2016, AM J EMERG MED, V34, P790, DOI 10.1016/j.ajem.2015.12.083 Versteylen MO, 2011, J NUCL CARDIOL, V18, P904, DOI 10.1007/s12350-011-9425-5 Wong MKY, 2015, CAN MED ASSOC J, V187, pE160, DOI 10.1503/cmaj.141294 NR 13 TC 2 Z9 2 U1 2 U2 5 PU WESTJEM PI ORANGE PA C/O SHAHRAM LOTFIPOUR, MD, MPH, 333 CITY BLVD W STE 640, RT 128-01, ORANGE, CA 92868 USA SN 1936-900X EI 1936-9018 J9 WEST J EMERG MED JI West. J. Emerg. Med. PD MAY PY 2021 VL 22 IS 3 BP 667 EP 671 DI 10.5811/westjem.2020.12.48981 PG 5 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA SN5XX UT WOS:000658363300032 PM 34125044 OA gold, Green Published DA 2023-05-13 ER PT J AU ten Cate, TJF Kelder, JC Plokker, HWM Verzijlbergen, JF van Hemel, NM AF ten Cate, T. J. F. Kelder, J. C. Plokker, H. W. M. Verzijlbergen, J. F. van Hemel, N. M. TI Patients with left bundle branch block pattern and high cardiac risk myocardial SPECT: does the current management suffice? SO NETHERLANDS HEART JOURNAL LA English DT Review DE Prognosis; LBBB; Pacing; SPECT ID CORONARY-ARTERY-DISEASE; EMISSION COMPUTED-TOMOGRAPHY; SICK SINUS SYNDROME; PROGNOSTIC VALUE; PERFUSION DEFECTS; STRESS ECHOCARDIOGRAPHY; PERMANENT PACEMAKERS; ATRIAL-FIBRILLATION; SESTAMIBI SPECT; NORMAL EXERCISE AB Myocardial perfusion SPECT (MPS) is frequently used for cardiovascular risk stratification. The significance of MPS in patients with abnormal electrical ventricular activation is often questionable. This review assesses the value of MPS for risk stratification of patients with intrinsic left bundle branch block or that due to right ventricular apical pacing. We reviewed the literature by a search of the MEDLINE database (January 1980 to September 2010). The terms prognosis or prognostic value were combined with SPECT and LBBB or pacing or pacemakers. MPS was categorised as low and high risk according to the original definitions. We identified 11 studies suitable for review. A low-risk MPS is associated with a low risk of cardiac events whereas high-risk MPS carries a 4.8-fold increased risk, 95% CI [3.2 - 7.2] (p < 0.0001). Despite secondary prevention and an improved medical and interventional care, these figures have hardly changed over time. A low-risk MPS permits a policy of watchful waiting whereas a high-risk MPS requires further analysis and treatment. The persistent high cardiac death and acute myocardial infarction rate after a high-risk MPS suggest that the current management of these patients does not suffice and needs reconsideration. C1 [ten Cate, T. J. F.; Verzijlbergen, J. F.] St Antonius Hosp, Dept Nucl Med, NL-3435 CM Nieuwegein, Netherlands. [ten Cate, T. J. F.; Kelder, J. C.; Plokker, H. W. M.] St Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands. [van Hemel, N. M.] Univ Utrecht, Utrecht, Netherlands. C3 St. Antonius Hospital Utrecht; St. Antonius Hospital Utrecht; Utrecht University RP ten Cate, TJF (通讯作者)，St Antonius Hosp, Dept Nucl Med, Koekoekslaan 1, NL-3435 CM Nieuwegein, Netherlands. EM timtencate@yahoo.com RI Verzijlbergen, Fred/E-8951-2018; tencate, tim/P-8704-2015; Verzijlbergen, Fred J/E-7848-2016 OI Verzijlbergen, Fred/0000-0002-4776-816X; Verzijlbergen, Fred J/0000-0002-4776-816X CR America YGCJ, 2007, J NUCL CARDIOL, V14, P75, DOI 10.1016/j.nuclcard.2006.10.018 Biagini E, 2006, EUR J NUCL MED MOL I, V33, P1442, DOI 10.1007/s00259-006-0156-9 Elhendy A, 2000, J NUCL CARDIOL, V7, P432, DOI 10.1067/mnc.2000.107426 Elhendy A, 2003, J NUCL CARDIOL, V10, P261, DOI 10.1016/S1071-3581(02)43219-9 Eriksson P, 2005, EUR HEART J, V26, P2300, DOI 10.1093/eurheartj/ehi580 Fahy GJ, 1996, AM J CARDIOL, V77, P1185, DOI 10.1016/S0002-9149(96)00160-9 Geleijnse ML, 2000, EUR HEART J, V21, P1666, DOI 10.1053/euhj.1999.2008 Gil VM, 1998, J NUCL CARDIOL, V5, P414, DOI 10.1016/S1071-3581(98)90147-7 Groutars RGEJ, 2000, J NUCL CARDIOL, V7, P333, DOI 10.1067/mnc.2000.105634 Groutars RGEJ, 2003, INT J CARDIOVAS IMAG, V19, P229, DOI 10.1023/A:1023637804898 Hachamovitch R, 2002, CIRCULATION, V105, P823, DOI 10.1161/hc0702.103973 Hesse B, 2001, AM J MED, V110, P253, DOI 10.1016/S0002-9343(00)00713-0 Ibrahim NS, 1998, AM J CARDIOL, V82, P832, DOI 10.1016/S0002-9149(98)00480-9 Imanishi R, 2006, AM J CARDIOL, V98, P644, DOI 10.1016/j.amjcard.2006.03.044 KRISHNAN R, 1993, AM HEART J, V126, P578, DOI 10.1016/0002-8703(93)90407-Z Kristensen L, 2004, HEART, V90, P661, DOI 10.1136/hrt.2003.016063 Lakkis NM, 1997, J AM COLL CARDIOL, V29, P1221, DOI 10.1016/S0735-1097(97)82753-2 Lapeyre AC, 2005, J NUCL CARDIOL, V12, P37, DOI 10.1016/j.nuclcard.2004.08.004 Lapeyre AC, 2004, AM J CARDIOL, V94, P811, DOI 10.1016/j.amjcard.2004.05.071 LARCOS G, 1991, AM J CARDIOL, V68, P756, DOI 10.1016/0002-9149(91)90649-6 Lebtahi NE, 1997, J NUCL CARDIOL, V4, P266, DOI 10.1016/S1071-3581(97)90103-3 Nallamothu N, 1997, J NUCL CARDIOL, V4, P487, DOI 10.1016/S1071-3581(97)90006-4 Nielsen JC, 2003, J AM COLL CARDIOL, V42, P614, DOI 10.1016/S0735-1097(03)00757-5 Nielsen JC, 1998, CIRCULATION, V97, P987 Nigam A, 1998, J NUCL MED, V39, P579 Peteiro J, 2000, AM J CARDIOL, V85, P890, DOI 10.1016/S0002-9149(99)00889-9 Sharir T, 2000, AM J CARDIOL, V86, P1171, DOI 10.1016/S0002-9149(00)01206-6 Shaw LJ, 2003, J NUCL MED, V44, P134 Skalidis EI, 2001, J AM COLL CARDIOL, V37, P124, DOI 10.1016/S0735-1097(00)01096-2 Soares Adelina, 2002, Rev Port Cardiol, V21, P1241 Sweeney MO, 2007, NEW ENGL J MED, V357, P1000, DOI 10.1056/NEJMoa071880 Tanguay JF, 2003, J AM COLL CARDIOL, V41, p404A ten Cate TJF, 2010, J NUCL CARDIOL, V17, P216, DOI 10.1007/s12350-009-9183-9 Ten Cate TJF, 2009, NUCL MED COMMUN, V30, P232, DOI 10.1097/MNM.0b013e328321cdcc ten Cate TJF, 2005, HEART RHYTHM, V2, P1058, DOI 10.1016/j.hrthm.2005.07.013 Tse HF, 1997, J AM COLL CARDIOL, V29, P744, DOI 10.1016/S0735-1097(96)00586-4 Usmani S, 2009, MED PRIN PRACT, V18, P310, DOI 10.1159/000215730 Wagdy HM, 1998, CIRCULATION, V97, P1563, DOI 10.1161/01.CIR.97.16.1563 Yanik A, 2000, CORONARY ARTERY DIS, V11, P545 NR 39 TC 5 Z9 5 U1 0 U2 6 PU BOHN STAFLEU VAN LOGHUM BV PI HOUTEN PA POSTBUS 246, 3990 GA HOUTEN, NETHERLANDS SN 1568-5888 EI 1876-6250 J9 NETH HEART J JI Neth. Heart J. PD MAR PY 2013 VL 21 IS 3 BP 118 EP 124 DI 10.1007/s12471-011-0174-5 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 096EX UT WOS:000315388100003 PM 21695525 OA Green Published DA 2023-05-13 ER PT J AU Ersoy, AO Oztas, E Ozler, S Ersoy, E Erkenekli, K Uygur, D Caglar, AT Danisman, N AF Ersoy, Ali Ozgur Oztas, Efser Ozler, Sibel Ersoy, Ebru Erkenekli, Kudret Uygur, Dilek Caglar, Ali Turhan Danisman, Nuri TI Can venous ProBNP levels predict placenta accreta? SO JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE LA English DT Article DE Cardiac biomarkers; placenta accreta; placenta previa; pro-brain natriuretic peptide; Troponin I ID BRAIN NATRIURETIC PEPTIDE; ENDOTHELIAL GROWTH-FACTOR; ACUTE CORONARY SYNDROME; CREATINE-KINASE; POSTPARTUM HEMORRHAGE; MYOCARDIAL-INFARCTION; CARDIAC TROPONIN; MB ISOENZYME; NORMAL LABOR; ELEVATION AB Aim: Placenta previa (PP) is a potential life-threatening pregnancy complication. Pro-brain natriuretic peptide (ProBNP), creatine kinase (CK), cardiac form of CK (CK-MB) and Troponin I are circulatory biomarkers related to cardiac functions. We aimed to determine whether these biomarkers are related to PP and placenta accreta.Methods: In this case-control study, fifty-four pregnant women who attended our tertiary care center for perinatology with the diagnosis of PP totalis, and of them, 14 patients with placenta accreta were recruited as the study groups. Forty-six uncomplicated control patients who were matched for age, BMI were also included. Maternal venous ProBNP, CK, CK-MB and Troponin I levels were compared between the three groups.Results: Obstetric history characteristics were comparable among groups, generally. CK and CK-MB levels were similar among three groups. Troponin I levels in the previa and accreta groups were significantly higher than the controls. ProBNP levels in the accreta group were significantly higher than other two groups. The multivariate regression model revealed that ProBNP could predict placental adhesion anomalies.Conclusions: Troponin I and ProBNP levels in PP cases were higher than controls and ProBNP could predict placenta accreta. C1 [Ersoy, Ali Ozgur; Oztas, Efser; Ozler, Sibel; Ersoy, Ebru; Erkenekli, Kudret; Uygur, Dilek; Caglar, Ali Turhan; Danisman, Nuri] Zekai Tahir Burak Womens Hlth Care Training & Res, Dept Obstet & Gynecol, Ankara, Turkey. C3 Dr. Zekai Tahir Burak Women's Health Research & Education Hospital RP Ersoy, AO (通讯作者)，Zekai Tahir Burak Womens Hlth Care Training & Res, Talatpasa Bulv Hamamonu, TR-06230 Ankara, Turkey. 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Matern.-Fetal Neonatal Med. PD DEC PY 2016 VL 29 IS 24 BP 4020 EP 4024 DI 10.3109/14767058.2016.1152576 PG 5 WC Obstetrics & Gynecology WE Science Citation Index Expanded (SCI-EXPANDED) SC Obstetrics & Gynecology GA DX8ZF UT WOS:000384680900016 PM 26864469 DA 2023-05-13 ER PT J AU McCarthy, CP Donnellan, E Phelan, D Griffin, BP Enriquez-Sarano, M McEvoy, JW AF McCarthy, Cian P. Donnellan, Eoin Phelan, Dermot Griffin, Brian P. Enriquez-Sarano, Maurice McEvoy, John W. TI High sensitivity troponin and valvular heart disease SO TRENDS IN CARDIOVASCULAR MEDICINE LA English DT Article DE High sensitiity troponin; Valvular heart disease; Biomarkers ID BRAIN-NATRIURETIC-PEPTIDE; AORTIC-VALVE-REPLACEMENT; ATRIAL-FIBRILLATION; EXERCISE TOLERANCE; MYOCARDIAL INJURY; ADVERSE OUTCOMES; PROGNOSTIC VALUE; T LEVELS; TRANSCATHETER; RISK AB Blood-based biomarkers have been extensively studied in a range of cardiovascular diseases and have established utility in routine clinical care, most notably in the diagnosis of acute coronary syndrome (e.g., troponin) and the management of heart failure (e.g., brain-natriuretic peptide). The role of biomarkers is less well established in the management of valvular heart disease (VHD), in which the optimal timing of surgical intervention is often challenging. One promising biomarker that has been the subject of a number of recent VHD research studies is high sensitivity troponin (hs-cTn). Novel high-sensitivity assays can detect subclinical myocardial damage in asymptomatic individuals. Thus, hs-cTn may have utility in the assessment of asymptomatic patients with severe VHD who do not have a clear traditional indication for surgical intervention. In this state-of-the-art review, we examine the current evidence for hs-cTn as a potential biomarker in the most commonly encountered VHD conditions, aortic stenosis and mitral regurgitation. This review provides a synopsis of early evidence indicating that hs-cTn has promise as a biomarker in VHD. However, the impact of its measurement on clinical practice and VHD outcomes needs to be further assessed in prospective studies before routine clinical use becomes a reality. C1 [McCarthy, Cian P.] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA. [Donnellan, Eoin] Cleveland Clin Hosp, Dept Med, Cleveland, OH USA. [Phelan, Dermot; Griffin, Brian P.] Cleveland Clin Hosp, Dept Cardiovasc Med Heart & Vasc Inst, Cleveland, OH USA. [Enriquez-Sarano, Maurice] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA. [McEvoy, John W.] Johns Hopkins Univ, Johns Hopkins Coronary Care Unit, Sch Med, Baltimore, MD USA. [McEvoy, John W.] Johns Hopkins Univ, Sch Med, Dept Med, Div Cardiol, Baltimore, MD 21205 USA. C3 Harvard University; Massachusetts General Hospital; Cleveland Clinic Foundation; Cleveland Clinic Foundation; Mayo Clinic; Johns Hopkins University; Johns Hopkins University RP McEvoy, JW (通讯作者)，Johns Hopkins Coronary Care Unit, Carnegie 524C,600 N Wolfe St, Baltimore, MD 21287 USA.; McEvoy, JW (通讯作者)，Div Cardiol, Dept Med, Carnegie 524C,600 N Wolfe St, Baltimore, MD 21287 USA. EM jmcevoy1@jhmi.edu OI Enriquez-Sarano, Maurice/0000-0003-0910-5450 FU Edwards LLC FX Dr Maurice Enriquez-Sarano has received grant support from Edwards LLC. 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Med. PD JUL PY 2017 VL 27 IS 5 BP 326 EP 333 DI 10.1016/j.tcm.2017.01.004 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EZ6MT UT WOS:000404832700005 PM 28256378 DA 2023-05-13 ER PT J AU Mumaw, MM De La Fuente, M Noble, DN Nieman, MT AF Mumaw, M. M. De La Fuente, M. Noble, D. N. Nieman, M. T. TI Targeting the anionic region of human protease-activated receptor 4 inhibits platelet aggregation and thrombosis without interfering with hemostasis SO JOURNAL OF THROMBOSIS AND HAEMOSTASIS LA English DT Article DE antibodies; G-protein-coupled receptors; hemostasis; platelet aggregation inhibitors; protease-activated receptor-4 protein, human; thrombosis ID ALPHA-2-BETA-1 INTEGRIN; COUPLED RECEPTORS; ALPHA-THROMBIN; PAR4; ANTIPLATELET; COLLAGEN; CLEAVAGE; RECOGNITION; ASSOCIATION; PEPTIDES AB Background: Human platelet activation and aggregation is a complex process. To date, many therapies have been developed targeting proteins that mediate this process to prevent unwanted activation. However, the current standard of care for acute coronary syndromes still has limitations, including bleeding risk. Objective: To evaluate the protease-activated receptor 4 (PAR4) anionic cluster as a viable antiplatelet target by using a polyclonal antibody (CAN12). Methods: We used western blotting, aggregation and secretion ex vivo to evaluate the ability of CAN12 to interact with PAR4 and inhibit platelet activation. The effects of CAN12 in vivo were evaluated with the Rose Bengal arterial thrombosis model and two models of hemostasis. Results: CAN12 was able to interact with human PAR4 and delay PAR4 cleavage. In addition, CAN12 inhibited thrombin-induced human platelet aggregation and secretion in a dose-dependent manner. The specificity of CAN12 was agonist-dependent. In vivo, we determined that CAN12 was able to inhibit arterial thrombosis, and, using two independent methods, we found that CAN12 did not influence hemostasis. Conclusion: Targeting the extracellular anionic cluster on PAR4 is a viable novel strategy as an antiplatelet therapy. C1 [Mumaw, M. M.; De La Fuente, M.; Noble, D. N.; Nieman, M. T.] Case Western Reserve Univ, Dept Pharmacol, Cleveland, OH 44106 USA. C3 Case Western Reserve University RP Nieman, MT (通讯作者)，Case Western Reserve Univ, Dept Pharmacol, 2109 Adelbert Rd W305C, Cleveland, OH 44106 USA. EM nieman@case.edu FU American Heart Association (AHA Beginning Grant In Aid) [0865441D]; American Heart Association (AHA Scientist Development Grant) [10SDG2600021]; American Society for Hematology (ASH Scholar Award); NIH [HL098217]; Cardiovascular Training Grant [5T32HL105338]; CWRU/UH Center for AIDS Research [NIH P30 AI036219] FX The authors would like to thank M. Bilodeau and L. Nayak for helpful discussions. We also thank A. Schmaier for use of the thrombosis equipment. The work was supported by grants from the American Heart Association (AHA Beginning Grant In Aid, 0865441D, and AHA Scientist Development Grant, 10SDG2600021), the American Society for Hematology (ASH Scholar Award) and the NIH (HL098217) to M. T. Nieman, the Cardiovascular Training Grant 5T32HL105338 (M. M. Mumaw), and the CWRU/UH Center for AIDS Research (NIH P30 AI036219). 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Thromb. Haemost. PD AUG PY 2014 VL 12 IS 8 BP 1331 EP 1341 DI 10.1111/jth.12619 PG 11 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA AP5TX UT WOS:000342142700019 PM 24888424 OA Bronze, Green Accepted DA 2023-05-13 ER PT J AU Hertz, JT Madut, DB Tesha, RA William, G Simmons, RA Galson, SW Sakita, FM Maro, VP Bloomfield, GS Crump, JA Rubach, MP AF Hertz, Julian T. Madut, Deng B. Tesha, Revogatus A. William, Gwamaka Simmons, Ryan A. Galson, Sophie W. Sakita, Francis M. Maro, Venance P. Bloomfield, Gerald S. Crump, John A. Rubach, Matthew P. TI Perceptions of chest pain and healthcare seeking behavior for chest pain in northern Tanzania: A community-based survey SO PLOS ONE LA English DT Article ID ACUTE CORONARY SYNDROMES; HEART-DISEASE AB Background Little is known about community perceptions of chest pain and healthcare seeking behavior for chest pain in sub-Saharan Africa. Methods A two-stage randomized population-based cluster survey with selection proportional to population size was performed in northern Tanzania. Self-identified household healthcare decision-makers from randomly selected households were asked to list all possible causes of chest pain in an adult and asked where they would go if an adult household member had chest pain. Results Of 718 respondents, 485 (67.5%) were females. The most commonly cited causes of chest pain were weather and exercise, identified by 342 (47.6%) and 318 (44.3%) respondents. Two (0.3%) respondents identified 'heart attack' as a possible cause of chest pain. A hospital was selected as the preferred healthcare facility for an adult with chest pain by 277 (38.6%) respondents. Females were less likely to prefer a hospital than males (OR 0.65, 95% CI 0.47-0.90, p = 0.008). Conclusions There is little community awareness of cardiac causes of chest pain in northern Tanzania, and most adults reported that they would not present to a hospital for this symptom. There is an urgent need for educational interventions to address this knowledge deficit and guide appropriate care-seeking behavior. C1 [Hertz, Julian T.; Galson, Sophie W.] Duke Univ, Med Ctr, Div Emergency Med, Durham, NC 27708 USA. [Madut, Deng B.; Rubach, Matthew P.] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. [Tesha, Revogatus A.] Duke Univ, Dept Stat Sci, Durham, NC USA. [William, Gwamaka] Kilimanjaro Christian Med Ctr, Moshi, Tanzania. [Simmons, Ryan A.] Duke Univ, Duke Global Hlth Inst, Durham, NC USA. [Sakita, Francis M.] Kilimanjaro Christian Med Ctr, Dept Emergency Med, Moshi, Tanzania. [Maro, Venance P.] Kilimanjaro Christian Med Ctr, Dept Med, Moshi, Tanzania. [Bloomfield, Gerald S.] Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA. [Crump, John A.] Univ Otago, Otago Global Hlth Inst, Dunedin, New Zealand. C3 Duke University; Duke University; Duke University; Kilimanjaro Christian Medical Centre; Duke University; Kilimanjaro Christian Medical Centre; Kilimanjaro Christian Medical Centre; Duke University; University of Otago RP Hertz, JT (通讯作者)，Duke Univ, Med Ctr, Div Emergency Med, Durham, NC 27708 USA. EM julian.hertz@duke.edu RI Crump, John A./AAZ-6289-2020; Crump, John A./AAZ-6412-2020 OI Crump, John A./0000-0002-4529-102X; Crump, John A./0000-0002-4529-102X; Madut, Deng/0000-0003-4023-3928; Rubach, Matthew/0000-0001-5262-1421; Hertz, Julian/0000-0002-7396-4789; Sakita, Francis/0000-0001-5879-6564; Simmons, Ryan/0000-0003-0855-4334 FU Bill & Melinda Gates Foundation [OPP1158210]; US National Institutes of Health Fogarty International Center [D43TW009337]; US National Institutes of Health National Institute of Allergy and Infectious Diseases (NIAID) [R01AI121378]; US National Institutes of Health NIAID [K23AI116869] FX This study was funded by Bill & Melinda Gates Foundation (www.gatesfoundation.org) grant OPP1158210 (Awarded to JAC). JTH and DBM received support from US National Institutes of Health Fogarty International Center grant D43TW009337; JAC from US National Institutes of Health National Institute of Allergy and Infectious Diseases (NIAID) grant R01AI121378; and MPR from US National Institutes of Health NIAID grant K23AI116869. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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Jenq, Grace Y. Horwitz, Leora I. TI Predictors for patients understanding reason for hospitalization SO PLOS ONE LA English DT Article ID HEALTH LITERACY; DISCHARGE; CARE; COMMUNICATION; ASSOCIATION; OUTCOMES; QUALITY AB Objective To examine predictors for understanding reason for hospitalization. Methods This was a retrospective analysis of a prospective, observational cohort study of patients 65 years or older admitted for acute coronary syndrome, heart failure, or pneumonia and discharged home. Primary outcome was complete understanding of diagnosis, based on post-discharge patient interview. Predictors assessed were the following: jargon on discharge instructions, type of medical team, whether outpatient provider knew if the patient was admitted, and whether the patient reported more than one day notice before discharge. Results Among 377 patients, 59.8% of patients completely understood their diagnosis. Bivariate analyses demonstrated that outpatient provider being aware of admission and having more than a day notice prior to discharge were not associated with patient understanding diagnosis. Presence of jargon was not associated with increased likelihood of understanding in a multivariable analysis. Patients on housestaff and cardiology teams were more likely to understand diagnosis compared to non-teaching teams (OR 2.45, 95% CI 1.30-4.61, p < 0.01 and OR 3.83, 95% CI 1.92-7.63, p < 0.01, respectively). Conclusions Non-teaching team patients were less likely to understand their diagnosis. Further investigation of how provider-patient interaction differs among teams may aid in development of tools to improve hospital to community transitions. C1 [Weerahandi, Himali; Horwitz, Leora I.] NYU, Sch Med, Dept Med, New York, NY 10003 USA. [Weerahandi, Himali; Horwitz, Leora I.] NYU, Sch Med, Dept Populat Hlth, New York, NY 10003 USA. [Ziaeian, Boback] Univ Calif Los Angeles, Med Ctr, Div Cardiol, Los Angeles, CA 90024 USA. [Ziaeian, Boback] Vet Affairs Greater Los Angeles Healthcare Syst, Div Cardiol, Los Angeles, CA USA. [Fogerty, Robert L.] Yale Sch Med, Div Gen Internal Med, New Haven, CT USA. [Jenq, Grace Y.] Univ Michigan, Div Geriatr & Palliat Med, Ann Arbor, MI 48109 USA. [Horwitz, Leora I.] NYU, Langone Med Ctr, Ctr Healthcare Innovat & Delivery Sci, New York, NY USA. C3 New York University; New York University; University of California System; University of California Los Angeles; University of California Los Angeles Medical Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Greater Los Angeles Healthcare System; Yale University; University of Michigan System; University of Michigan; New York University; NYU Langone Medical Center RP Weerahandi, H (通讯作者)，NYU, Sch Med, Dept Med, New York, NY 10003 USA.; Weerahandi, H (通讯作者)，NYU, Sch Med, Dept Populat Hlth, New York, NY 10003 USA. EM Himali.Weerahandi@nyumc.org RI Horwitz, Leora/ABD-1292-2020; Ziaeian, Boback/A-3433-2016; Weerahandi, Himali/P-9560-2019 OI Ziaeian, Boback/0000-0001-9787-3649; Fogerty, Robert/0000-0001-9119-7707; Weerahandi, Himali/0000-0001-9614-345X FU CTSA grants from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) [UL1 RR024139, KL2 RR024138]; National Institute on Aging [K08 AG038336]; American Federation for Aging Research through the Paul B. Beeson Career Development Award Program; Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine [P30AG021342 NIH/NIA]; NYU CTSA Grant [UL 1TR001445, KL2 TR001446]; NIH roadmap for Medical Research FX At the time this study was conducted, Dr. Horwitz was supported by the CTSA grants UL1 RR024139 and KL2 RR024138 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH roadmap for Medical Research, and was a Centers of Excellence Scholar in Geriatric Medicine by The John A. Hartford Foundation and the American Federation for Aging Research. Dr. Horwitz was also supported by the National Institute on Aging (K08 AG038336) and by the American Federation for Aging Research through the Paul B. Beeson Career Development Award Program. This work was also supported by a grant from the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (P30AG021342 NIH/NIA). Dr. Weerahandi is supported by the NYU CTSA Grant UL 1TR001445 and KL2 TR001446. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.; At the time this study was conducted, Dr. Horwitz was supported by the CTSA Grant UL1 RR024139 and KL2 RR024138 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH roadmap for Medical Research, and was a Centers of Excellence Scholar in Geriatric Medicine by The John A. Hartford Foundation and the American Federation for Aging Research. Dr. Horwitz was also supported by the National Institute on Aging (K08 AG038336) and by the American Federation for Aging Research through the Paul B. Beeson Career Development Award Program. This work was also supported by a grant from the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (P30AG021342 NIH/NIA). Dr. Weerahandi is supported by the NYU CTSA Grant UL 1TR001445 and KL2 TR001446. CR Chroinin DN, 2011, EUR GERIATR MED, V2, P74, DOI 10.1016/j.eurger.2011.01.004 Go JT, 2010, J HOSP MED, V5, P133, DOI 10.1002/jhm.612 Horwitz LI, 2013, JAMA INTERN MED, V173, P1715, DOI 10.1001/jamainternmed.2013.9318 Horwitz LI, 2013, J HOSP MED, V8, P436, DOI 10.1002/jhm.2021 Howrey BT, 2011, MED CARE, V49, P701, DOI 10.1097/MLR.0b013e3182166cb6 Jencks SF, 2009, NEW ENGL J MED, V360, P1418, DOI 10.1056/NEJMsa0803563 Kripalani S, 2007, J HOSP MED, V2, P314, DOI 10.1002/jhm.228 Kripalani S, 2006, J GEN INTERN MED, V21, P888, DOI 10.1111/j.1525-1497.2006.00543.x Kuo YF, 2011, ANN INTERN MED, V155, P152, DOI 10.7326/0003-4819-155-3-201108020-00005 Makaryus AN, 2005, MAYO CLIN PROC, V80, P991, DOI 10.4065/80.8.991 Pearson M. 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SO CLINICAL CHEMISTRY LA English DT Review ID CARDIAC TROPONIN-T; ELEVATION MYOCARDIAL-INFARCTION; 3RD UNIVERSAL DEFINITION; ASSOCIATION TASK-FORCE; HIGHLY SENSITIVE ASSAY; SEX-BASED DIFFERENCES; LONG-TERM MORTALITY; NATRIURETIC-PEPTIDE; EJECTION FRACTION; AMERICAN-COLLEGE AB BACKGROUND: Sex-based differences exist in the circulating concentrations of certain novel and established biomarkers in patients with acute coronary syndromes (ACS) and heart failure (HF). However, to date, few studies have compared the diagnostic and prognostic utility of these markers in men vs women. CONTENT: This mini-review contains a discussion of the published reports of studies that have explored whether differences in biomarker concentrations exist between men and women with ACS or HF. It also examines those studies that have compared the utility of biomarkers for diagnosis or risk stratification in women vs men. Because biomarkers are often used to make therapeutic and triage decisions in patient care, the potential clinical implications for any observed differences in biomarker reference limits for men and women is discussed. SUMMARY: Although the concentration distributions may differ between men and women for certain biomarkers in clinical use, the clinical implications of these observations remain unclear. Because elements of the pathophysiology of ACS and HF may differ between the sexes, further research is needed to better evaluate the diagnostic and prognostic utility of biomarkers in men vs women. (C) 2013 American Association for Clinical Chemistry C1 [Motiwala, Shweta R.] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA. [Sarma, Amy] Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA. [Januzzi, James L.] Massachusetts Gen Hosp, Div Cardiovasc, Boston, MA 02114 USA. [O'Donoghue, Michelle L.] Brigham & Womens Hosp, Div Cardiovasc, Boston, MA 02115 USA. C3 Harvard University; Massachusetts General Hospital; Harvard University; Brigham & Women's Hospital; Harvard University; Massachusetts General Hospital; Harvard University; Brigham & Women's Hospital RP Januzzi, JL (通讯作者)，Massachusetts Gen Hosp, 55 Fruit St, Boston, MA 02114 USA. EM jjanuzzi@partners.org; modonoghue@partners.org RI Januzzi, James/Y-2436-2019 CR Anand IS, 2010, CIRCULATION, V122, P1387, DOI 10.1161/CIRCULATIONAHA.109.928846 Anderson JL, 2007, CIRCULATION, V116, pE148, DOI 10.1161/CIRCULATIONAHA.107.181940 Antman EM, 2008, CIRC-CARDIOVASC INTE, V1, P3, DOI 10.1161/CIRCINTERVENTIONS.108.799858 Apple FS, 2007, CLIN CHEM, V53, P1558, DOI 10.1373/clinchem.2007.087718 Apple FS, 2012, CLIN CHEM, V58, P1574, DOI 10.1373/clinchem.2012.192716 Apple FS, 2010, CLIN BIOCHEM, V43, P1034, DOI 10.1016/j.clinbiochem.2010.05.014 Apple FS, 2004, CLIN CHEM, V50, P1477, DOI 10.1373/clinchem.2004.036129 Braga Julio Cesar Vieira, 2006, Arq. Bras. 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Chem. PD JAN PY 2014 VL 60 IS 1 BP 35 EP 43 DI 10.1373/clinchem.2013.202531 PG 9 WC Medical Laboratory Technology WE Science Citation Index Expanded (SCI-EXPANDED) SC Medical Laboratory Technology GA AG0ZZ UT WOS:000335145900011 PM 24255075 OA Bronze DA 2023-05-13 ER PT J AU Singh, J Durr, MRR Deptuch, E Sultana, S Mehta, N Garcia, S Henry, TD Dehghani, P AF Singh, Jyotpal Durr, Michael-Roy R. Deptuch, Elena Sultana, Sabiha Mehta, Neha Garcia, Santiago Henry, Timothy D. Dehghani, Payam TI Cardiac Registries During the COVID-19 Pandemic: Lessons Learned SO CURRENT CARDIOLOGY REPORTS LA English DT Review DE Registry; Cardiac; COVID-19; Collaboration ID ELEVATION MYOCARDIAL-INFARCTION; INTERNATIONAL PROSPECTIVE REGISTRY; CORONAVIRUS DISEASE 2019; OUTCOMES; ARRHYTHMIAS; INSIGHTS; ARREST; INJURY AB Purpose of this Review We discuss the role of observational studies and cardiac registries during the COVID-19 pandemic. We focus on published cardiac registries and highlight contributions to the field that have had clinical implications. Recent Findings We included observational studies of COVID-19 patients published in peer-reviewed medical journals with defined inclusion and exclusion criteria, defined study design, and primary outcomes. A PubMed and MEDLINE literature review results in 437 articles, of which 52 include patients with COVID-19 with cardiac endpoints. From July 2020 to December 2021, the average time from last data collected to publication was 8.9 +/- 4.1 months, with an increasing trend over time (R = 0.9444, p < 0.0001). Of the 52 articles that met our inclusion criteria, we summarize main findings of 4 manuscripts on stroke, 14 on acute coronary syndrome, 4 on cardiac arrest, 7 on heart failure, 7 on venous thromboembolism, 5 on dysrhythmia, and 11 on different populations at risk for cardiovascular. Registries are cost effective, not disruptive to essential health services, and can be rapidly disseminated with short intervals between last data point collected and publication. In less than 2 years, cardiac registries have filled important gaps in knowledge and informed the care of COVID-19 patients with cardiovascular conditions. C1 [Singh, Jyotpal; Durr, Michael-Roy R.; Deptuch, Elena; Sultana, Sabiha; Mehta, Neha; Dehghani, Payam] Prairie Vasc Res Inc, Regina, SK, Canada. [Garcia, Santiago] Minneapolis Heart Inst Fdn, Minneapolis, MN USA. [Henry, Timothy D.] Christ Hosp, Carl & Edyth Lindner Ctr Res & Educ, Cincinnati, OH 45219 USA. C3 Minneapolis Heart Institute Foundation; Christ Hospital - Ohio RP Dehghani, P (通讯作者)，Prairie Vasc Res Inc, Regina, SK, Canada. 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Cardiol. Rep. PD JUN PY 2022 VL 24 IS 6 BP 659 EP 665 DI 10.1007/s11886-022-01686-5 EA APR 2022 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 2A5UZ UT WOS:000779022500001 PM 35380385 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Richards, SH Campbell, JL Dickens, C Anderson, R Gandhi, M Gibson, A Kessler, D Knight, L Kuyken, W Richards, DA Taylor, RS Turner, K Ukoumunne, OC Davey, A Warren, FC Winder, RE Wright, CA AF Richards, Suzanne H. Campbell, John L. Dickens, Christopher Anderson, Rob Gandhi, Manish Gibson, Andy Kessler, David Knight, Luke Kuyken, Willem Richards, David A. Taylor, Rod S. Turner, Katrina Ukoumunne, Obioha C. Davey, Antoinette Warren, Fiona C. Winder, Rachel E. Wright, Christine A. TI Enhanced psychological care in cardiac rehabilitation services for patients with new-onset depression: the CADENCE feasibility study and pilot RCT SO HEALTH TECHNOLOGY ASSESSMENT LA English DT Article ID CORONARY-HEART-DISEASE; QUALITY-OF-LIFE; RANDOMIZED-CONTROLLED-TRIAL; COGNITIVE-BEHAVIORAL THERAPY; MYOCARDIAL-INFARCTION; RISK-FACTOR; PROGNOSTIC ASSOCIATION; CARDIOVASCULAR EVENTS; PSYCHIATRIC-DISORDER; UNSTABLE ANGINA AB Background: Around 19% of people screened by UK cardiac rehabilitation programmes report having moderate or severe symptoms of depression. These individuals are at an increased risk of cardiac mortality and morbidity, reduced quality of life and increased use of health resources compared with their non-depressed counterparts. Maximising psychological health is a goal of cardiac rehabilitation, but psychological care is patchy. Objective(s): To examine the feasibility and acceptability of embedding enhanced psychological care (EPC) within cardiac rehabilitation, we tested the feasibility of developing/implementing EPC and documented the key uncertainties associated with undertaking a definitive evaluation. Design: A two-stage multimethods study; a feasibility study and a qualitative evaluation, followed by an external pilot cluster randomised controlled trial (RCT) with a nested qualitative study. Setting: UK comprehensive cardiac rehabilitation teams. Participants: Adults eligible for cardiac rehabilitation following an acute coronary syndrome with new-onset depressive symptoms on initial nurse assessment. Patients who had received treatment for depression in the preceding 6 months were excluded. Interventions: The EPC intervention comprised nurse-led mental health-care co-ordination and behavioural activation within cardiac rehabilitation. The comparator was usual cardiac rehabilitation care. Main outcome measures: Measures at baseline, and at the 5-(feasibility and pilot) and 8-month follow-ups (pilot only). Process measures related to cardiac team and patient recruitment, and participant retention. Outcomes included depressive symptoms, cardiac mortality and morbidity, anxiety, health-related quality of life and service resource use. Interviews explored participant and nurses' views and experiences. Results: Between September 2014 and May 2015, five nurses from four teams recruited participants into the feasibility study. Of the 203 patients screened, 30 were eligible and nine took part (the target was 20 participants). At interview, participants and nurses gave valuable insights into the EPC intervention design and delivery. Although acceptable, the EPC delivery was challenging for nurses (e.g. the ability to allocate sufficient time within existing workloads) and the intervention was modified accordingly. Between December 2014 and February 2015, 8 out of 20 teams approached agreed to participate in the pilot RCT [five were randomised to the EPC arm and three were randomised to the usual-care (UC) arm]. Of the 614 patients screened, 55 were eligible and 29 took part (the target was 43 participants). At baseline, the trial arms were well matched for sex and ethnicity, although the EPC arm participants were younger, from more deprived areas and had higher depression scores than the UC participants. A total of 27 out of 29 participants were followed up at 5 months. Interviews with 18 participants (12 in the EPC arm and six in the UC arm) and seven nurses who delivered EPC identified that both groups acknowledged the importance of receiving psychological support embedded within routine cardiac rehabilitation. For those experiencing/delivering EPC, the intervention was broadly acceptable, albeit challenging to deliver within existing care. Limitations: Both the feasibility and the pilot studies encountered significant challenges in recruiting patients, which limited the power of the pilot study analyses. Conclusions: Cardiac rehabilitation nurses can be trained to deliver EPC. Although valued by both patients and nurses, organisational and workload constraints were significant barriers to implementation in participating teams, suggesting that future research may require a modified approach to intervention delivery within current service arrangements. We obtained important data informing definitive research regarding participant recruitment and retention, and optimal methods of data collection. Future research: Consideration should be given to the delivery of EPC by dedicated mental health practitioners, working closely with cardiac rehabilitation services. C1 [Richards, Suzanne H.; Campbell, John L.; Taylor, Rod S.; Davey, Antoinette; Warren, Fiona C.; Winder, Rachel E.; Wright, Christine A.] Univ Exeter, Med Sch, Primary Care Res Grp, Exeter, Devon, England. [Dickens, Christopher; Anderson, Rob; Richards, David A.; Taylor, Rod S.] Univ Exeter, Med Sch, Inst Hlth Serv Res, Exeter, Devon, England. [Gandhi, Manish; Knight, Luke] Royal Devon & Exeter NHS Fdn Trust, Exeter, Devon, England. [Gibson, Andy] Univ West England, Dept Hlth & Social Sci, Bristol, Avon, England. [Kessler, David; Turner, Katrina] Univ Bristol, Sch Social & Community Med, Ctr Acad Primary Care, Bristol, Avon, England. [Kuyken, Willem] Univ Oxford, Univ Dept Psychiat, Warneford Hosp, Oxford, England. [Ukoumunne, Obioha C.] Univ Exeter, Med Sch, NIHR Collaborat Leadership Appl Hlth Res & Care S, Exeter, Devon, England. C3 RLUK- Research Libraries UK; University of Exeter; RLUK- Research Libraries UK; University of Exeter; RLUK- Research Libraries UK; University of Exeter; University of West England; RLUK- Research Libraries UK; University of Bristol; RLUK- Research Libraries UK; University of Oxford; RLUK- Research Libraries UK; University of Exeter RP Campbell, JL (通讯作者)，Univ Exeter, Med Sch, Primary Care Res Grp, Exeter, Devon, England. RI Kuyken, Willem/ABC-5152-2021; Richards, David A/B-4807-2009; Kessler, david/ABB-6489-2021; Campbell, John/L-4542-2019; Taylor, Rod/R-9581-2019; Warren, Fiona/AGE-5194-2022 OI Richards, David A/0000-0002-8821-5027; Campbell, John/0000-0002-6752-3493; Taylor, Rod/0000-0002-3043-6011; Warren, Fiona/0000-0002-3833-0182; Richards, Suzanne/0000-0003-1416-0569; Kuyken, Willem/0000-0002-8596-5252; Turner, Katrina/0000-0002-6375-2918; Anderson, Rob/0000-0002-3523-8559; Davey, Antoinette/0000-0002-5118-6912; Dickens, Chris/0000-0001-6326-7544; Winder, Rachel/0000-0002-9926-1280; kessler, david/0000-0001-5333-132X; Gibson, Andy/0000-0002-9524-984X FU National Institute for Health Research (NIHR) Health Technology Assessment programme; MRC [MR/K025643/1] Funding Source: UKRI FX This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 30. 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PU NIHR JOURNALS LIBRARY PI SOUTHAMPTON PA UNIV SOUTHAMPTON, EVALUATION, TRIALS & STUDIES COORDINATING CENTRE, ALPHA HOUSE, ENTERPRISE RD, SOUTHAMPTON, SO16 7NS, ENGLAND SN 1366-5278 EI 2046-4924 J9 HEALTH TECHNOL ASSES JI Health Technol. Assess. PD MAY PY 2018 VL 22 IS 30 BP 1 EP + DI 10.3310/hta22300 PG 221 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA GH6QB UT WOS:000433568000001 PM 29856312 OA Green Published, Green Accepted, Green Submitted, gold DA 2023-05-13 ER PT J AU Nilsson, G Mooe, T Soderstrom, L Samuelsson, E AF Nilsson, Gunnar Mooe, Thomas Soderstrom, Lars Samuelsson, Eva TI Pre-hospital delay in patients with first time myocardial infarction: an observational study in a northern Swedish population SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Myocardial infarction; Observational study; Pre-hospital delay; Primary care ID ACUTE CORONARY SYNDROME; WORCESTER HEART-ATTACK; PRIMARY-CARE PATIENTS; SWEDEN MONICA; CHEST-PAIN; INTERMITTENT CLAUDICATION; THROMBOLYTIC TREATMENT; HOSPITAL PRESENTATION; GENDER-DIFFERENCES; SEEKING TREATMENT AB Background: In myocardial infarction (MI), pre-hospital delay is associated with increased mortality and decreased possibility of revascularisation. We assessed pre-hospital delay in patients with first time MI in a northern Swedish population and identified determinants of a pre-hospital delay >= 2 h. Methods: A total of 89 women (mean age 72.6 years) and 176 men (mean age 65.8 years) from a secondary prevention study were enrolled in an observational study after first time MI between November 2009 and March 2012. Total pre-hospital delay was defined as the time from the onset of symptoms suggestive of MI to admission to the hospital. Decision time was defined as the time from the onset of symptoms until the call to Emergency Medical Services (EMS). The time of symptom onset was assessed during the episode of care, and the time of call to EMS and admission to the hospital was based on recorded data. The first medical contact was determined from a mailed questionnaire. Determinants associated with pre-hospital delay >= 2 h were identified by multivariable logistic regression. Results: The median total pre-hospital delay was 5.1 h (IQR 18.1), decision time 3.1 h (IQR 10.4), and transport time 1.2 h (IQR 1.0). The first medical contact was to primary care in 52.3 % of cases (22.3 % as a visit to a general practitioner and 30 % by telephone counselling), 37.3 % called the EMS, and 10.4 % self-referred to the hospital. Determinants of a pre-hospital delay >= 2 h were a visit to a general practitioner (OR 10.77, 95 % CI 2.39-48.59), call to primary care telephone counselling (OR 3.82, 95 % CI 1.68-8.68), chest pain as the predominant presenting symptom (OR 0.24, 95 % CI 0.08-0.77), and distance from the hospital (OR 1.03, 95 % CI 1.02-1.04). Among patients with primary care as the first medical contact, 67.0 % had a decision time >= 2 h, compared to 44.7 % of patients who called EMS or self-referred (p = 0.002). Conclusions: Pre-hospital delay in patients with first time MI is prolonged considerably, particularly when primary care is the first medical contact. Actions to shorten decision time and increase the use of EMS are still necessary. C1 [Nilsson, Gunnar] Umea Univ, Unit Res Educ & Dev Ostersund, Dept Publ Hlth & Clin Med, Umea, Sweden. [Mooe, Thomas; Samuelsson, Eva] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. [Soderstrom, Lars] Ostersund Hosp, Unit Res Educ & Dev, Ostersund, Sweden. C3 Umea University; Umea University RP Nilsson, G (通讯作者)，Umea Univ, Unit Res Educ & Dev Ostersund, Dept Publ Hlth & Clin Med, Umea, Sweden. EM gunnar.nilsson@regionjh.se RI Nilsson, Gunnar/O-8019-2019 OI Nilsson, Gunnar/0000-0002-1640-0813; Samuelsson, Eva/0000-0002-8549-0007 FU Unit of Research, Education and Development, Ostersund Hospital, Region Jamtland Harjedalen, Sweden [Dnr-JLL-370941, 368631, 467081] FX This study was funded by grants from the Unit of Research, Education and Development, Ostersund Hospital, Region Jamtland Harjedalen, Sweden (Dnr-JLL-370941, 368631 and 467081). The funders had no role in the study design, data collection, data analysis, or in writing of the report. 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Disord. PD MAY 12 PY 2016 VL 16 AR 93 DI 10.1186/s12872-016-0271-x PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA DM9ZP UT WOS:000376724500001 PM 27176816 OA Green Published, gold DA 2023-05-13 ER PT J AU Akilli, NB Yortanli, M Mutlu, H Gunaydin, YK Koylu, R Akca, HS Akinci, E Dundar, ZD Cander, B AF Akilli, Nazire Belgin Yortanli, Mehmet Mutlu, Huseyin Gunaydin, Yahya Kemal Koylu, Ramazan Akca, Hatice Seyma Akinci, Emine Dundar, Zerrin Defne Cander, Basar TI Prognostic importance of neutrophil-lymphocyte ratio in critically ill patients: short- and long-term outcomes SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID INTENSIVE-CARE; EMERGENCY; SEPSIS; ASSOCIATION; ADMISSION; FAILURE; TRAUMA; ONSET; SHOCK AB Study objective: The number of critically ill patients admitted to the emergency department increases daily. To decrease mortality, interventions and treatments should be conducted in a timely manner. It has been found that the neutrophil-lymphocyte ratio (NLR) is related to mortality in some disease groups, such as acute coronary syndrome and pulmonary emboli. The effect of the NLR on mortality is unknown in critically ill patients who are admitted to the emergency department. Our aim in this study is to evaluate the effect of the NLR on mortality in critically ill patients. Methods: This study was planned as a prospective, observational cohort study. Patients who were admitted to the emergency department because they were critically ill and required the intensive care unit were included in the study. Demographic characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sepsis-related Organ Failure Assessment, Glasgow Coma Score, and NLR values were recorded upon emergency department admission. The patients were followed up for sepsis, ventilator-associated pneumonia, multiorgan failure, in-hospital mortality, and 6-month mortality. Results: The median (interquartile range) age of the 373 patients was 74 (190) years, and 54.4% were men. Neutrophil-lymphocyte ratio values were divided into quartiles, as follows: less than 3.48, 3.48 to 6.73, 6.74-13.6, and more than 13.6. There was no difference among these 4 groups regarding demographic characteristics, APACHE II score, Sepsis-related Organ Failure Assessment score, Glasgow Coma Score, and length of hospital stay (P > .05). In the multivariable Cox regression model, in-hospital mortality and 6-month mortality NLR were hazard ratio (HR), 1.63 (1.110-2.415; P = .01) and HR, 1.58 (1.136-2.213; P = .007), respectively, and APACHE II scores were detected as independent indicators. Conclusion: The NLR is a simple, cheap, rapidly available, and independent indicator of short- and long-term mortalities. We suggest that the NLR can provide direction to emergency department physicians for interventions, particularly within a few hours after admission, in the critically ill patient group. (C) 2014 Elsevier Inc. All rights reserved. C1 [Akilli, Nazire Belgin; Yortanli, Mehmet; Mutlu, Huseyin; Gunaydin, Yahya Kemal; Koylu, Ramazan; Akca, Hatice Seyma] Konya Educ & Res Hosp, Dept Emergency Med, Konya, Turkey. [Akinci, Emine] Kecioren Educ & Res Hosp, Dept Emergency Med, Ankara, Turkey. [Dundar, Zerrin Defne; Cander, Basar] Necmettin Erbakan Univ, Meram Fac Med, Dept Emergency Med, Konya, Turkey. C3 Konya Egitim Training & Research Hospital; Ankara Kecioren Training & Research Hospital; Necmettin Erbakan University RP Akilli, NB (通讯作者)，Konya Egitim & Arastirma Hastanesi, Acil Servis Bolumu, TR-42080 Konya, Turkey. EM drbelginakilli@hotmail.com RI Dundar, Zerrin Defne/AAR-4130-2020; Akilli, Nazire/AAD-9457-2020; Koylu, Ramazan/AGQ-8717-2022 OI Akilli, Nazire/0000-0001-9329-0964; Emektar, Emine/0000-0002-6056-4401; Dundar, Zerrin Defne/0000-0001-6431-5800 CR Arendts G, 2013, EMERG MED AUSTRALAS, V25, P271, DOI 10.1111/1742-6723.12073 Ayala A, 1996, BLOOD, V87, P4261, DOI 10.1182/blood.V87.10.4261.bloodjournal87104261 Azab B, 2010, AM J CARDIOL, V106, P470, DOI 10.1016/j.amjcard.2010.03.062 Blow O, 1999, J TRAUMA, V47, P964, DOI 10.1097/00005373-199911000-00028 DIONIGI R, 1994, HEPATO-GASTROENTEROL, V41, P471 Galus MA, 1998, J INTERN MED, V244, P351, DOI 10.1046/j.1365-2796.1998.00409.x Garrard C, 1998, BMJ-BRIT MED J, V316, P1841 Jilma B, 1999, AM J RESP CRIT CARE, V159, P857, DOI 10.1164/ajrccm.159.3.9805087 Kayrak M, 2014, HEART LUNG CIRC, V23, P56, DOI 10.1016/j.hlc.2013.06.004 KNAUS WA, 1985, CRIT CARE MED, V13, P818, DOI 10.1097/00003246-198510000-00009 Lundberg JS, 1998, CRIT CARE MED, V26, P1020, DOI 10.1097/00003246-199806000-00019 Martin-Khan M, 2013, BMC EMERG MED, V13, DOI 10.1186/1471-227X-13-23 Meggs WJ, 1999, ACAD EMERG MED, V6, P1030, DOI 10.1111/j.1553-2712.1999.tb01188.x Menges T, 1999, CRIT CARE MED, V27, P733, DOI 10.1097/00003246-199904000-00026 Nguyen HB, 2000, ACAD EMERG MED, V7, P1354, DOI 10.1111/j.1553-2712.2000.tb00492.x Rivers E, 2001, NEW ENGL J MED, V345, P1368, DOI 10.1056/NEJMoa010307 Tamhane UU, 2008, AM J CARDIOL, V102, P653, DOI 10.1016/j.amjcard.2008.05.006 Uthamalingam S, 2011, AM J CARDIOL, V107, P433, DOI 10.1016/j.amjcard.2010.09.039 Vincent JL, 1996, INTENS CARE MED, V22, P707, DOI 10.1007/BF01709751 Vinton DT, 2014, EMERG MED J, P1 Zahorec R, 2001, Bratisl Lek Listy, V102, P5 NR 21 TC 51 Z9 56 U1 3 U2 19 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 2014 VL 32 IS 12 BP 1476 EP 1480 DI 10.1016/j.ajem.2014.09.001 PG 5 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AW6AX UT WOS:000346353000007 PM 25264245 DA 2023-05-13 ER PT J AU Kang, HG Kim, BJ Lee, SH Kang, DW Kwon, SU Kim, JS AF Kang, Hyun Goo Kim, Bum Joon Lee, Sang Hun Kang, Dong-Wha Kwon, Sun U. Kim, Jong S. TI Lateral Medullary Infarction with or without Extra-Lateral Medullary Lesions: What Is the Difference? SO CEREBROVASCULAR DISEASES LA English DT Article DE Lateral medullary infarction; Prognosis; Stroke mechanism ID ACUTE ISCHEMIC-STROKE; BRAIN-STEM AB Background: Lateral medullary infarction (LMI) is not an uncommon disease. Although lesions are usually restricted to the lateral medullary area, some patients have additional infarcts in other parts of the brain. The clinical features and prognosis of isolated LMI (pure LMI, LMIpr) have been investigated. However, it remains unclear whether clinical characteristics, prognosis and factors associated with prognosis differ between patients with LMIpr and those with additional lesions (LMI plus, LMIpl). Methods: Patients with LMI identified by MRI were enrolled. The demographic and clinical characteristics, in-hospital outcome (intensive care unit [ICU] admission, pneumonia and modified Rankin scale [mRS] at discharge), and long-term residual symptoms (vertigo/dizziness, sensory disturbances, dysphagia) and outcomes (occurrence of stroke, acute coronary syndrome [ACS], death, and mRS at follow-up) were compared between LMIpr and LMIpl patients. Factors associated with poor functional outcome (mRS 2-6) at the follow-up were analyzed. Results: Among 248 LMI patients, 161 (64.9%) had LMIpr and 87 (35.1%) had LMIpl. During admission, patients with LMIpl more frequently experienced ICU care, pneumonia and had a higher discharge mRS (3 vs. 2; p < 0.001) than LMIpr patients. The occurrence of stroke, ACS, frequency of death and functional outcome was not different during follow-up. However, residual neurologic symptoms such as dizziness (p = 0.002), dysphagia (p = 0.04) and sensory symptoms (p < 0.001) were more frequent in LMIpr than in LMIpl patients. In LMIpr patients, the rostral location of LMI was associated with poor functional outcome (p = 0.041), whereas in LMIpl patients, the presence of medial posterior-inferior cerebellar artery lesion was associated with good functional outcome (p = 0.030). Conclusion: Although the short-term outcome is poorer in LMIpl than LMIpr patients, long-term residual symptoms are more common in LMIpr patients. The location of the LMI and extra-medullary lesion affects the long-term functional outcome of LMIpr and LMIpl patients respectively. (c) 2018 S. Karger AG, Basel C1 [Kang, Hyun Goo] Chosun Univ Hosp, Dept Neurol, Gwang Ju, South Korea. [Kim, Bum Joon] Kyung Hee Univ, Coll Med, Kyung Hee Univ Hosp, Dept Neurol, Seoul, South Korea. [Lee, Sang Hun; Kang, Dong-Wha; Kwon, Sun U.; Kim, Jong S.] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Neurol, 88 Olymp Ro, Seoul 138736, South Korea. C3 Chosun University; Kyung Hee University; Kyung Hee University Hospital; University of Ulsan; Asan Medical Center RP Kim, JS (通讯作者)，Univ Ulsan, Coll Med, Asan Med Ctr, Dept Neurol, 88 Olymp Ro, Seoul 138736, South Korea. EM jongskim@amc.seoul.kr RI Kim, Bum Joon/AAS-2541-2020; lee, sang hun/Q-4650-2019; Kim, Bum Joon/S-2156-2017 OI lee, sang hun/0000-0002-9005-5966; lee, sang hun/0000-0002-9538-446X; Kim, Bum Joon/0000-0002-3278-3252 FU Ministry for Health, Welfare and Family Affairs, Republic of Korea [HI14C1985] FX This work was supported by a grant from the Ministry for Health, Welfare and Family Affairs, Republic of Korea (HI14C1985). CR ADAMS HP, 1993, STROKE, V24, P35, DOI 10.1161/01.STR.24.1.35 BARTH A, 1994, J NEUROL NEUROSUR PS, V57, P1073, DOI 10.1136/jnnp.57.9.1073 Choi YJ, 2015, J STROKE, V17, P238, DOI 10.5853/jos.2015.17.3.238 FISHER CM, 1961, J NEUROPATH EXP NEUR, V20, P323, DOI 10.1097/00005072-196107000-00001 Han M, 2014, EUR RADIOL, V24, P3017, DOI 10.1007/s00330-014-3296-5 Kim BJ, 2014, J STROKE, V16, P131, DOI 10.5853/jos.2014.16.3.131 Kim JS, 2012, STROKE, V43, P3313, DOI 10.1161/STROKEAHA.112.658500 Kim JS, 1998, STROKE, V29, P645, DOI 10.1161/01.STR.29.3.645 KIM JS, 1994, STROKE, V25, P1405, DOI 10.1161/01.STR.25.7.1405 Kim JS, 2003, BRAIN, V126, P1864, DOI 10.1093/brain/awg169 Kim JS, 1999, STROKE, V30, P2697, DOI 10.1161/01.STR.30.12.2697 Kim JS, STROKE SYNDROME, P461 Kim TJ, 2015, J CLIN NEUROL, V11, P349, DOI 10.3988/jcn.2015.11.4.349 Martin PJ, 1998, J NEUROL NEUROSUR PS, V64, P392, DOI 10.1136/jnnp.64.3.392 Nelles G, 1998, NEUROLOGY, V50, P1418, DOI 10.1212/WNL.50.5.1418 SACCO RL, 1993, ARCH NEUROL-CHICAGO, V50, P609, DOI 10.1001/archneur.1993.00540060049016 Tatu L, 1996, NEUROLOGY, V47, P1125, DOI 10.1212/WNL.47.5.1125 TOYODA K, 1994, STROKE, V25, P2171, DOI 10.1161/01.STR.25.11.2171 VUILLEUMIER P, 1995, BRAIN, V118, P1013, DOI 10.1093/brain/118.4.1013 NR 19 TC 7 Z9 8 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1015-9770 EI 1421-9786 J9 CEREBROVASC DIS JI Cerebrovasc. Dis. PY 2018 VL 45 IS 3-4 BP 132 EP 140 DI 10.1159/000487672 PG 9 WC Clinical Neurology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA GG2YG UT WOS:000432558200007 PM 29558752 DA 2023-05-13 ER PT J AU Li, J Li, X Wang, Q Hu, S Wang, YF Masoudi, FA Spertus, JA Krumholz, HM Jiang, LX AF Li, Jing Li, Xi Wang, Qing Hu, Shuang Wang, Yongfei Masoudi, Frederick A. Spertus, John A. Krumholz, Harlan M. Jiang, Lixin CA China PEACE Collaborative Grp TI 被撤回的出版物: ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data (Retracted article. See vol. 385, pg. 402, 2015) SO LANCET LA English DT Article; Retracted Publication ID ACUTE CORONARY SYNDROMES; STANDARDIZED MORTALITY-RATES; QUALITY-OF-CARE; REPERFUSION THERAPY; PRACTICE PATTERNS; IMPROVEMENT; TRANSITION; TRENDS; REFORM AB Background Despite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatment, and outcomes for patients with STEMI in China between 2001 and 2011. Methods In a retrospective analysis of hospital records, we used a two-stage random sampling design to create a nationally representative sample of patients in China admitted to hospital for STEMI in 3 years (2001, 2006, and 2011). In the first stage, we used a simple random-sampling procedure stratified by economic-geographical region to generate a list of participating hospitals. In the second stage we obtained case data for rates of STEMI, treatments, and baseline characteristics from patients attending each sampled hospital with a systematic sampling approach. We weighted our findings to estimate nationally representative rates and assess changes from 2001 to 2011. This study is registered with ClinicalTrials.gov, number NCT01624883. Findings We sampled 175 hospitals (162 participated in the study) and 18 631 acute myocardial infarction admissions, of which 13 815 were STEMI admissions. 12 264 patients were included in analysis of treatments, procedures, and tests, and 11 986 were included in analysis of in-hospital outcomes. Between 2001 and 2011, estimated national rates of hospital admission for STEMI per 100 000 people increased (from 3.5 in 2001, to 7.9 in 2006, to 15.4 in 2011; p(trend)<0.0001) and the prevalence of risk factors-including smoking, hypertension, diabetes, and dyslipidaemia-increased. We noted significant increases in use of aspirin within 24 h (79.7% [95% CI 77.9-81.5] in 2001 vs 91.2% [90.5-91.8] in 2011, p(trend)<0.0001) and clopidogrel (1.5% [95% CI 1.0-2.1] in 2001 vs 82.1% [81.1-83.0] in 2011, p(trend)<0.0001) in patients without documented contraindications. Despite an increase in the use of primary percutaneous coronary intervention (10.6% [95% CI 8.6-12.6] in 2001 vs 28.1% [26.6-29.7] in 2011, p(trend)<0.0001), the proportion of patients who did not receive reperfusion did not significantly change (45.3% [95% CI 42.1-48.5] in 2001 vs 44.8% [43.1-46.5] in 2011, p(trend)=0.69). The median length of hospital stay decreased from 12 days (IQR 7-18) in 2001 to 10 days (6-14) in 2011 (p(trend)<0.0001). Adjusted in-hospital mortality did not significantly change between 2001 and 2011 (odds ratio 0.82, 95% CI 0.62-1.10, p(trend)=0.07). Interpretation During the past decade in China, hospital admissions for STEMI have risen; in these patients, comorbidities and the intensity of testing and treatment have increased. Quality of care has improved for some treatments, but important gaps persist and in-hospital mortality has not decreased. National efforts are needed to improve the care and outcomes for patients with STEMI in China. C1 [Li, Jing; Li, Xi; Wang, Qing; Hu, Shuang; Jiang, Lixin] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, State Key Lab Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis,Fuwai Hosp, Beijing 100730, Peoples R China. [Li, Jing; Li, Xi; Wang, Qing; Hu, Shuang; Jiang, Lixin] Peking Union Med Coll, Beijing 100021, Peoples R China. [Wang, Yongfei; Krumholz, Harlan M.] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Wang, Yongfei; 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, Dept Internal Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. [Krumholz, Harlan M.] Yale Univ, Dept Hlth Policy & Management, Sch Publ Hlth, New Haven, CT USA. [Masoudi, Frederick A.] Univ Colorado, Div Cardiol, Aurora, CO USA. [Spertus, John A.] Univ Missouri, St Lukes Mid Amer Heart Inst, Kansas City, MO 64110 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; Yale University; Yale University; 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 RP Jiang, LX (通讯作者)，Fuwai Hosp, Natl Ctr Cardiovasc Dis, State Key Lab Cardiovasc Dis, Natl Clin Res Ctr Cardiovasc Dis, Beijing 100037, Peoples R China. EM jiangl@fwoxford.org RI Spertus, John/ABD-3075-2021; Masoudi, Frederick/Q-7467-2019; , Harlan/AAI-2875-2020 OI Normand, Sharon-Lise/0000-0001-7027-4769; Li, Xi/0000-0003-2249-688X FU National Health and Family Planning Commission of China FX National Health and Family Planning Commission of China. 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Guarracino, Fabio Bove, Tiziana Grigoryev, Evgeny, V Monaco, Fabrizio Boboshko, Vladimir A. Likhvantsev, Valery V. Scandroglio, Anna M. Paternoster, Gianluca Lembo, Rosalba Frassoni, Samuele Comis, Marco Pasyuga, Vadim V. Navalesi, Paolo Lomivorotov, Vladimir V. CA CHEETAH Study Grp TI Effect of Levosimendan on Renal Outcome in Cardiac Surgery Patients With Chronic Kidney Disease and Perioperative Cardiovascular Dysfunction: A Substudy of a Multicenter Randomized Trial SO JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA LA English DT Article DE low cardiac output syndrome; acute kidney injury; mitral valve surgery; cardiac surgery; chronic kidney disease; hemodynamic support; levosimendan; inotropes ID CORONARY-ARTERY-BYPASS; GLOMERULAR-FILTRATION-RATE; CARDIOPULMONARY BYPASS; AFTERLOAD MISMATCH; EJECTION FRACTION; CLINICAL-PRACTICE; HEART-FAILURE; METAANALYSIS; INJURY; RISK AB Objective: Acute kidney injury (AKI) occurs frequently after cardiac surgery. Levosimendan might reduce the incidence of AKI in patients undergoing cardiac surgery. The authors investigated whether levosimendan administration could reduce AKI incidence in a high-risk cardiac surgical population. Design: Post hoc analysis of a multicenter randomized trial. Setting: Cardiac surgery operating rooms and intensive care units of 14 centers in 3 countries. Participants:: The study comprised 90 patients who underwent mitral valve surgery with an estimated glomerular filtration rate < 60 mL/min/ 1.73 m(2) and perioperative myocardial dysfunction. Interventions: Patients were assigned randomly to receive levosimendan (0.025-0.2 mu g/kg/min) or placebo in addition to standard inotropic treatment. Measurements and Main Results: Forty-six patients were assigned to receive levosimendan and 44 to receive placebo. Postoperative AKI occurred in 14 (30%) patients in the levosimendan group versus 23 (52%) in the placebo group (absolute difference -21.8; 95% confidence interval -41.7 to -1.97; p = 0.035). The incidence of major complications also was lower (18 [39%]) in the levosimendan group versus that in the placebo group (29 [66%]) (absolute difference -26.8 [-46.7 to -6.90]; p = 0.011). A trend toward lower serum creatinine at intensive care unit discharge was observed in the levosimendan group (1.18 [0.99-1.49] mg/dL) versus that in the placebo group (1.39 [1.05-1.76] mg/dL) (95% confidence interval -0.23 [-0.49 to 0.01]; p = 0.07). Conclusions: Levosimendan may improve renal outcome in cardiac surgery patients with chronic kidney disease undergoing mitral valve surgery who develop perioperative myocardial dysfunction. Results of this exploratory analysis should be investigated in future properly designed randomized controlled trials. (C) 2018 Elsevier Inc. All rights reserved. C1 [Zangrillo, Alberto; Belletti, Alessandro; Calabro, Maria G.; Bove, Tiziana; Monaco, Fabrizio; Scandroglio, Anna M.; Lembo, Rosalba; Frassoni, Samuele] IRCCS San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Via Olgettina 60, I-20132 Milan, Italy. [Zangrillo, Alberto; Navalesi, Paolo] Univ Vita Salute San Raffaele, Milan, Italy. [Alvaro, Gabriele] AOU Mater Domini Germaneto, Dept Anesthesia & Intens Care, Catanzaro, Italy. [Pisano, Antonio] AORN dei Colli Monaldi Hosp, Div Cardiac Anesthesia, Naples, Italy. [Pisano, Antonio] AORN dei Colli Monaldi Hosp, Intens Care Unit, Naples, Italy. [Brazzi, Luca] AOU Citta Salute & Sci, Dept Anesthesia & Intens Care, Turin, Italy. [Brazzi, Luca] Univ Turin, Dept Surg Sci, Turin, Italy. [Guarracino, Fabio] AOU Pisana, Dept Anesthesia & Crit Care Med, Div Cardiothorac Anesthesia & Intens Care, Pisa, Italy. [Grigoryev, Evgeny, V; Lomivorotov, Vladimir V.] State Res Inst Complex Issues Cardiovasc Dis, Dept Anesthesiol & Intens Care, Kemerovo, Russia. [Boboshko, Vladimir A.] E Meshalkin Natl Med Res Ctr, Dept Anesthesiol & Intens Care, Novosibirsk, Russia. [Likhvantsev, Valery V.] Moscow Reg Clin & Res Inst, Dept Anesthesiol & Intens Care, Moscow, Russia. [Paternoster, Gianluca] San Carlo Hosp, Dept Anesthesia & Intens Care, Potenza, Italy. [Comis, Marco] AO Ordine Mauriziano, Dept Cardiovasc Anesthesia & Intens Care, Turin, Italy. [Pasyuga, Vadim V.] Fed Ctr Cardiovasc Surg Astrakhan, Dept Anesthesiol & Intens Care, Astrakhan, Russia. [Navalesi, Paolo] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Catanzaro, Italy. C3 Vita-Salute San Raffaele University; IRCCS Ospedale San Raffaele; Vita-Salute San Raffaele University; A.O.U. Citta della Salute e della Scienza di Torino; University of Turin; University of Pisa; Azienda Ospedaliero Universitaria Pisana; Russian Academy of Medical Sciences; Research Institute for Complex Issues of Cardiovascular Diseases; Meshalkin National Medical Research Center; A.O.U. Citta della Salute e della Scienza di Torino; AOU San Giovanni Battista-Molinette; Magna Graecia University of Catanzaro RP Belletti, A (通讯作者)，IRCCS San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Via Olgettina 60, I-20132 Milan, Italy. EM belletti.ale@gmail.com RI Brazzi, Luca/AAS-4978-2020; Bove, Tiziana/AAC-2109-2022; Belletti, Alessandro/I-1981-2019; Navalesi, Paolo/F-9559-2010; Navalesi, Paolo/I-9584-2019; Pisano, Antonio/AAG-1028-2020; Grigoryev, Evgeny/A-2321-2017; Zangrillo, Alberto/AAH-2037-2019; Lomivorotov, Vladimir/L-7868-2014; Likhvantsev, Valery/A-4893-2016; Monaco, Fabrizio/GZA-9167-2022 OI Brazzi, Luca/0000-0001-7059-0622; Belletti, Alessandro/0000-0003-3131-0565; Navalesi, Paolo/0000-0002-3733-3453; Navalesi, Paolo/0000-0002-3733-3453; Pisano, Antonio/0000-0002-5118-444X; Grigoryev, Evgeny/0000-0001-8370-3083; Zangrillo, Alberto/0000-0002-7687-7648; Lomivorotov, Vladimir/0000-0001-8591-6461; Likhvantsev, Valery/0000-0002-5442-6950; Monaco, Fabrizio/0000-0001-5186-1976; FRASSONI, SAMUELE/0000-0002-4265-2627; BOVE, Tiziana/0000-0002-5489-2898; Guarracino, Fabio/0000-0002-2562-0199 FU Orion (Deerfield, IL); Baxter (Deerfield, IL); Italian Ministry of Health [RF-2009-1519827] FX V. Likhvantsev has lectured for Orion (Espoo, Finland); V. Lomivorotov has received speaker fees from Orion; F. Guarracino received speaker fees from Orion and Baxter (Deerfield, IL); L. Brazzi has lectured for Medtronic (Minneapolis, MN); and MSD and has consulted for BBraun Italia (Mirandola, Italy).; The trial was funded by the Italian Ministry of Health (Grant No. RF-2009-1519827). Levosimendan was provided free of charge by the manufacturer (Orion, Espoo, Finland) to centers that recruited patients in Italy. The funders and Orion had no role in the trial design, data collection and analysis, writing of the article, or decision to submit the article for publication. 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Cardiothorac. Vasc. Anesth. PD OCT PY 2018 VL 32 IS 5 BP 2152 EP 2159 DI 10.1053/j.jvca.2018.02.039 PG 8 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 GX5UU UT WOS:000447817300019 PM 29580796 OA Green Submitted DA 2023-05-13 ER PT J AU Lavoie, KL Paine, NJ Pelletier, R Arsenault, A Diodati, JG Campbell, TS Pilote, L Bacon, SL AF Lavoie, Kim L. Paine, Nicola J. Pelletier, Roxanne Arsenault, Andre Diodati, Jean G. Campbell, Tavis S. Pilote, Louise Bacon, Simon L. TI Relationship Between Antidepressant Therapy and Risk for Cardiovascular Events in Patients With and Without Cardiovascular Disease SO HEALTH PSYCHOLOGY LA English DT Article DE antidepressant treatment; depression; cardiovascular disease; major adverse cardiovascular events ID ACUTE CORONARY SYNDROME; ACUTE MYOCARDIAL-INFARCTION; BECK DEPRESSION INVENTORY; LONG-TERM MORTALITY; HEART-DISEASE; 52 COUNTRIES; SYMPTOMS; PROGNOSIS; IMPACT; CARE AB Objective: The American Heart Association has endorsed depression as a cardiac risk factor and recommends screening as part of routine practice. This has been met with controversy due to inconsistencies in the data linking depression treatment to better cardiovascular outcomes. Our objective was to prospectively assess the association between depression treatment (defined as being prescribed antidepressant medication) and major adverse cardiovascular events (MACE) in patients referred for exercise stress tests. Method: Two thousand three hundred eighty-five consecutive patients presenting for myocardial perfusion exercise stress tests underwent a sociodemographic. medical. and psychiatric interview (Primary Care Evaluation of Mental Disorders [PRLME-MD]) and completed the Beck Depression Inventory (BDI). History of cardiovascular disease (CVD) and antidepressant use was self-reported and verified via chart review. Participants followed over an 8.8-year follow up, and information regarding MACE incidence (including cardiac mortality, nonfatal myocardial infarction. revascularization procedures, cerebrovascular events) was obtained from provincial administrative databases. Results: 8% (n = 190) of the sample were taking antidepressants at baseline, 41% (n = 916) had a history of CVD, and 38.7% (n = 921) had depression according to the PRIME-MD or BDI. Antidepressant treatment was associated with a 30% reduced risk of MACE (Hazard ratio [HR] = 0.697; 95% confidence interval [CI] = [0.504, 0.964]; p = .029). A 46% reduction in risk was associated with antidepressant treatment among those without CVD (HR = 0.542; 95% CI [0.299, 0.981]; p = .043). In depressed patients, a 33% reduction in risk of MACE associated with antidepressant use was seen (adjusted HR = 0.674; 95% CI [0.440,1.033]; p = .07). Conclusions: Antidepressants may be cardio-protective among patients presenting for stress testing independent of risk factors including CVD and depression. Results support treating depression with antidepressants in this population to reduce risk of MACE. C1 [Lavoie, Kim L.] Univ Quebec Montreal, Dept Psychol, Montreal, PQ, Canada. [Lavoie, Kim L.] Hop Sacre Coeur Montreal, CIUSSS NIM, Ctr Integree Univ Serv Sante & Sociaux Nord Ile, Montreal Behav Med Ctr,Res Ctr, Montreal, PQ, Canada. [Paine, Nicola J.; Pelletier, Roxanne; Arsenault, Andre; Diodati, Jean G.; Bacon, Simon L.] Hop Sacre Coeur Montreal, CIUSSS NIM, Montreal Behav Med Ctr, Res Ctr, Montreal, PQ, Canada. [Paine, Nicola J.] Loughborough Univ, Sch Sport Exercise & Hlth Sci, Loughborough, Leics, England. [Campbell, Tavis S.] Univ Calgary, Dept Psychol, Calgary, AB, Canada. [Pilote, Louise] McGill Univ Hlth Ctr, Div Clin Epidemiol, Montreal, PQ, Canada. [Pilote, Louise] McGill Univ Hlth Ctr, Res Inst, Montreal, PQ, Canada. [Bacon, Simon L.] Concordia Univ, Dept Hlth Kinesiol & Appl Physiol, Montreal, PQ, Canada. C3 University of Quebec; University of Quebec Montreal; Universite de Montreal; Universite de Montreal; Loughborough University; University of Calgary; McGill University; McGill University; Concordia University - Canada RP Lavoie, KL (通讯作者)，Univ Quebec Montreal UQAM, Dept Psychol, CP 8888,Succursale Ctr Ville, Montreal, PQ H3C 3P8, Canada. EM lavoie.kim@uqam.ca RI Lavoie, Kim L/J-8969-2014; Bacon, Simon/B-2637-2012 OI Lavoie, Kim/0000-0003-2606-1357; Bacon, Simon/0000-0001-7075-0358; Paine, Nicola/0000-0001-9988-9310 FU Canadian Institutes of Health Research (CIHR) [MOP 79445, 89965]; Heart and Stroke Foundation of Canada; Fonds de la recherche du Quebec-sante (FRQS); CIHR; FRQS; CIHR [MFE 146764]; Social Sciences and Humanities Research Council FX This study was supported by the Canadian Institutes of Health Research (CIHR; Grants MOP 79445 and 89965, Kim L. Lavoie, Simon L. Bacon) and the Heart and Stroke Foundation of Canada, salary awards from the Fonds de la recherche du Quebec-sante (FRQS; Kim L. Lavoie, Simon L. Bacon) and CIHR (Kim L. Lavoie, Simon L. Bacon), postdoctoral fellowships from FRQS and CIHR (MFE 146764; both Nicola J. Paine), and graduate scholarship support from the Social Sciences and Humanities Research Council, CIHR and FRQS (all Roxanne Pelletier). 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PD NOV PY 2018 VL 37 IS 11 BP 989 EP 999 DI 10.1037/hea0000602 PG 11 WC Psychology, Clinical; Psychology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychology GA GW7PK UT WOS:000447160600001 PM 30247064 OA Green Accepted, Green Published DA 2023-05-13 ER PT J AU Lelubre, C Vincent, JL Taccone, FS AF Lelubre, Christophe Vincent, Jean-Louis Taccone, Fabio S. TI Red blood cell transfusion strategies in critically ill patients: lessons from recent randomized clinical studies SO MINERVA ANESTESIOLOGICA LA English DT Article DE Erythrocytes; Blood transfusion; Sepsis; Critical illness ID INTENSIVE-CARE-UNIT; SEPTIC SHOCK; RESTRICTIVE TRANSFUSION; SEVERE SEPSIS; REQUIREMENTS; MULTICENTER; THRESHOLD; MORTALITY; ANEMIA; INJURY AB A randomized, multicenter trial conducted in 32 northern European general intensive care units (ICUs) enrolled some patients with septic shock randomly assigned to receive a red blood cell transfusion when the hemoglobin (Hb) level was <= 7 g/dL (" lower threshold"; N.= 502) or <= 9 g/dL (" higher threshold"; N.= 496) throughout the ICU stay. Patients were excluded if they had an acute coronary syndrome, life-threatening bleeding, acute burn injury, had already been transfused or had previously experienced transfusion-related reactions. The two groups of patients had comparable severity of disease scores and chronic cardiovascular conditions. Median Hb values were 7.7 g/dL in the lower and 9.3 g/dL in the higher threshold groups and these values remained stable during the study period. There was no significant difference in 90-day mortality (primary end-point) between the two groups (216/502, 43.0% in the lower vs. 223/496, 45.0% in the higher group, RR 0.94 [95% CI: 0.78-1.09; P= 0.44]), even after adjustment for several confounders. In the higher threshold group, approximately twice as many transfusions were given (3088 vs. 1545 units transfused, P< 0.001) as in the lower threshold group. In the lower threshold group, more patients received no RBC transfusion (36% vs. 1.2%, P< 0.001) than in the higher threshold group, but there were also more temporary protocol suspensions (5.9 % vs. 2.2%, P= 0.004), in particular because of myocardial ischemia (6/488, 1.2% vs. 0/489), life-threatening bleeding (18/488, 3.7% vs. 9/489, 1.8%) and need for higher Hb levels during extracorporeal membrane oxygenation therapy. We discuss how anemia should be managed in patients with sepsis or other critical illness, especially in the context of the potential risks associated with RBC transfusion and data from other recent large randomized trials. C1 [Lelubre, Christophe; Vincent, Jean-Louis; Taccone, Fabio S.] Univ Libre Bruxelles, Hop Erasme, Dept Intens Care, Route Lennik 808, B-1070 Brussels, Belgium. C3 Universite Libre de Bruxelles RP Taccone, FS (通讯作者)，Univ Libre Bruxelles, Hop Erasme, Dept Intens Care, Route Lennik 808, B-1070 Brussels, Belgium. 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PD SEP PY 2016 VL 82 IS 9 BP 1010 EP 1016 PG 7 WC Anesthesiology; Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Anesthesiology; General & Internal Medicine GA EA8NC UT WOS:000386891100015 PM 26756380 DA 2023-05-13 ER PT J AU Boothroyd, LJ Segal, E Bogaty, P Nasmith, J Eisenberg, MJ Boivin, JF Vadeboncoeur, A de Champlain, F AF Boothroyd, Lucy J. Segal, Eli Bogaty, Peter Nasmith, James Eisenberg, Mark J. Boivin, Jean-Francois Vadeboncoeur, Alain de Champlain, Francois TI INFORMATION ON MYOCARDIAL ISCHEMIA AND ARRHYTHMIAS ADDED BY PREHOSPITAL ELECTROCARDIOGRAMS SO PREHOSPITAL EMERGENCY CARE LA English DT Article DE electrocardiography; emergency medicine; acute myocardial infarction; ischemia; arrhythmias; patient care management ID ACUTE CORONARY SYNDROMES; GUIDELINES WRITING COMMITTEE; ASSOCIATION TASK-FORCE; TO-BALLOON TIMES; AMERICAN-COLLEGE; EUROPEAN-SOCIETY; CARDIOLOGY COMMITTEE; OF-CARDIOLOGY; INFARCTION; IMPACT AB Background. The prehospital electrocardiogram (ECG) allows earlier identification of acute ST-segment elevation myocardial infarction (STEMI). Its utility for detection of other acute cardiac events, as well as for transient ST-segment abnormalities no longer present when the first hospital ECG is performed, is not well characterized. Objective. We sought to examine whether the prehospital ECG adds supplemental information to the first ECG obtained in hospital, by comparing data on possible cardiac ischemia and arrhythmias provided by the two ECGs, in ambulance patients later diagnosed as having cardiac disorders, including STEMI. Methods. Ambulance personnel acquired 12-lead ECGs for patients suspected of having an acute ischemic event, prior to transport to hospital. The first emergency department 12-lead ECG was provided by medical records at the receiving hospital, and the principal hospital diagnosis for the event was extracted from chart data. Two cardiologists, blinded to the hospital diagnosis, provided their consensus interpretation of 1,209 pairs of ECGs, noting the presence or absence of specific abnormalities on each tracing. Results. Among the 82 patients who had an eventual hospital diagnosis of STEMI, the study cardiologists identified 71 with ST-segment elevations on the ECGs they examined. The vast majority of these (97%) were observed on both ECGs, but the prehospital ECG showed ST-segment elevation for two additional patients (3%). No additional instances were seen only on the hospital ECG. Among the 116 patients with a hospital diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI), the cardiologists identified 36 with ST-segment depressions: 28 (78%) of these were present on both ECGs, seven (19%) only on the prehospital ECG, and one (3%) only on the hospital ECG. Among the 567 patients with any cardiac hospital diagnosis, the cardiologists identified 87 with arrhythmias: 73 (84%) on both ECGs, 12 (14%) only on the prehospital ECG, and two (2%) only on the hospital ECG. Conclusions. Beyond identifying ST-segment elevation earlier, prehospital ECGs detect important transient abnormalities, information not otherwise available from the first emergency department ECG. These data can expedite diagnosis and clinical management decisions among patients suspected of having an acute cardiac event. The prehospital ECG should be fully integrated into emergency medicine practice. C1 [Boothroyd, Lucy J.; Bogaty, Peter] Inst Natl Excellence Sante & Serv Sociaux, Montreal, PQ H3A 2S9, Canada. [Boothroyd, Lucy J.; Eisenberg, Mark J.; Boivin, Jean-Francois] McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada. [Segal, Eli; de Champlain, Francois] McGill Univ, Dept Family Med, Montreal, PQ H3A 2T5, Canada. [Segal, Eli] McGill Univ, Jewish Gen Hosp, Dept Emergency Med, Montreal, PQ H3T 1E2, Canada. [Segal, Eli; de Champlain, Francois] Corp dUrgences Sante, Montreal, PQ, Canada. [Bogaty, Peter] Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada. [Nasmith, James] St Pauls Hosp, Div Cardiol, Vancouver, BC V6Z 1Y6, Canada. [Eisenberg, Mark J.] McGill Univ, Jewish Gen Hosp, Div Cardiol, Montreal, PQ H3T 1E2, Canada. [Eisenberg, Mark J.; Boivin, Jean-Francois] McGill Univ, Jewish Gen Hosp, Lady Davis Inst Med Res, Ctr Clin Epidemiol & Community Studies, Montreal, PQ H3T 1E2, Canada. [Vadeboncoeur, Alain] Montreal Heart Inst, Dept Emergency Med, Montreal, PQ H1T 1C8, Canada. [de Champlain, Francois] McGill Univ, Montreal Gen Hosp, Dept Emergency Med, Ctr Hlth, Montreal, PQ H3G 1A4, Canada. C3 McGill University; McGill University; McGill University; St. Paul's Hospital; McGill University; Lady Davis Institute; McGill University; Universite de Montreal; McGill University RP Boothroyd, LJ (通讯作者)，Inst Natl Excellence Sante & Serv Sociaux, 2021 Union Ave,Suite 10-083, Montreal, PQ H3A 2S9, Canada. EM lucy.boothroyd@inesss.qc.ca RI Segal, Eli/GPW-8146-2022 FU Urgences-Sante ambulance company; Quebec Ministry of Health; Urgences-Sante FX Dr. Eisenberg is a chercheur national of the Fonds de la Recherche en Sante du Quebec. Dr. Boothroyd received financial support from the Urgences-Sante ambulance company and the Quebec Ministry of Health during the course of this study. The research archivists were paid with funds from Urgences-Sante. Neither organization had a role in the design and conduct of the study, the analysis and interpretation of the data, or the preparation, review, and approval of the manuscript. 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Emerg. Care PD APR-JUN PY 2013 VL 17 IS 2 BP 187 EP 192 DI 10.3109/10903127.2012.755583 PG 6 WC Emergency Medicine; Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine; Public, Environmental & Occupational Health GA 099PU UT WOS:000315634500008 PM 23414085 DA 2023-05-13 ER PT J AU Nihici, T Boardman, HMP Baig, K Stafford, JL Cernei, C Bodger, O Westaby, S AF Nihici, Tamara Boardman, Henry M. P. Baig, Kamran Stafford, Jody L. Cernei, Cristina Bodger, Owen Westaby, Stephen TI Mechanical assist devices for acute cardiogenic shock SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS LA English DT Review ID ACUTE MYOCARDIAL-INFARCTION; EXTRACORPOREAL LIFE-SUPPORT; RANDOMIZED CONTROLLED-TRIAL; INTRAAORTIC BALLOON PUMP; ACUTE CORONARY SYNDROMES; CIRCULATORY SUPPORT; EARLY REVASCULARIZATION; SCIENTIFIC STATEMENT; EARLY INITIATION; CLINICAL-TRIAL AB Background Cardiogenic shock (CS) is a state of critical end-organ hypoperfusion due to a primary cardiac disorder. For people with refractory CS despite maximal vasopressors, inotropic support and intra-aortic balloon pump, mortality approaches 100%. Mechanical assist devices provide mechanical circulatory support (MCS) which has the ability to maintain vital organ perfusion, to unload the failing ventricle thus reduce intracardiac filling pressures which reduces pulmonary congestion, myocardial wall stress and myocardial oxygen consumption. This has been hypothesised to allow time for myocardial recovery (bridge to recovery) or allow time to come to a decision as to whether the person is a candidate for a longer-term ventricular assist device (VAD) either as a bridge to heart transplantation or as a destination therapy with a long-term VAD. Objectives To assess whether mechanical assist devices improve survival in people with acute cardiogenic shock. Search methods We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid) and Web of Science Core Collection in November 2019. In addition, we searched three trials registers in August 2019. We scanned reference lists and contacted experts in the field to obtain further information. There were no language restrictions. Selection criteria Randomised controlled trials on people with acute CS comparing mechanical assist devices with best current intensive care management, including intra-aortic balloon pump and inotropic support. Data collection and analysis We performed data collection and analysis according to the published protocol. Primary outcomes were survival to discharge, 30 days, 1 year and secondary outcomes included, quality of life, major adverse cardiovascular events (30 days/end of follow-up), dialysis-dependent (30 days/end of follow-up), length of hospital stay and length of intensive care unit stay and major adverse events. We used the five GRADE considerations (study limitations, consistency of e"ect, imprecision, indirectness, and publication bias) to assess the quality of a body of evidence as it relates to the studies which contribute data to the meta-analyses for the prespecified outcomes Summary statistics for the primary endpoints were risk ratios (RR), hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs). Main results The search identified five studies from 4534 original citations reviewed. Two studies included acute CS of all causes randomised to treatment using TandemHeart percutaneous VAD and three studies included people with CS secondary to acute myocardial infarction who were randomised to Impella CP or best medical management. Meta-analysis was performed only to assess the 30-day survival as there were insufficient data to perform any further meta-analyses. The results from the five studies with 162 participants showed mechanical assist devices may have little or no effect on 30-day survival (RR of 1.01 95% CI 0.76 to 1.35) but the evidence is very uncertain. Complications such as sepsis, thromboembolic phenomena, bleeding and major adverse cardiovascular events were not infrequent in both the MAD and control group across the studies, but these could not be pooled due to inconsistencies in adverse event definitions and reporting. We identified four randomised control trials assessing mechanical assist devices in acute CS that are currently ongoing. C1 [Nihici, Tamara] Morriston Hosp, Cardiothorac Surg, Swansea, W Glam, Wales. [Boardman, Henry M. P.] Oxford Univ Hosp NHS Fdn Trust, John Radcliffe Hosp, Radcliffe Dept Med, Oxford, England. [Baig, Kamran] Guys & St Thomas NHS Fdn Trust, Dept Cardiac Surg, London, England. [Stafford, Jody L.] Univ Hosp Wales, Perfus Cardiothorac Surg, Cardiff, Wales. [Cernei, Cristina; Bodger, Owen] Swansea Univ, Med Sch, Swansea, W Glam, Wales. [Westaby, Stephen] Oxford Univ Hosp NHS Fdn Trust, John Radcliffe Hosp, Cardiothorac Surg, Oxford, England. C3 Morriston Hospital; Oxford University Hospitals NHS Foundation Trust; RLUK- Research Libraries UK; University of Oxford; Guy's & St Thomas' NHS Foundation Trust; RLUK- Research Libraries UK; Cardiff University; Swansea University; Oxford University Hospitals NHS Foundation Trust; RLUK- Research Libraries UK; University of Oxford RP Nihici, T (通讯作者)，Morriston Hosp, Cardiothorac Surg, Swansea, W Glam, Wales. EM tamaranihici@gmail.com OI Bodger, Owen/0000-0002-4022-9964 FU NIHR Infrastructure funding, UK; National Institute for Health Research (NIHR), via Cochrane Infrastructure funding FX External sources; NIHR Infrastructure funding, UK; This project was supported by the National Institute for Health Research (NIHR), via Cochrane Infrastructure funding to the Heart Group. 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PY 2020 IS 6 AR CD013002 DI 10.1002/14651858.CD013002.pub2 PG 47 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA ME7WM UT WOS:000544865300018 PM 32496607 OA Green Published DA 2023-05-13 ER PT J AU Calvo-Sanchez, M Perello, R Perez, I Mateo, MG Junyent, M Laguno, M Blanco, JL Martinez-Rebollar, M Sanchez, M Mallolas, J Gatell, JM Domingo, P Martinez, E AF Calvo-Sanchez, M. Perello, R. Perez, I. Mateo, M. G. Junyent, M. Laguno, M. Blanco, J. L. Martinez-Rebollar, M. Sanchez, M. Mallolas, J. Gatell, J. M. Domingo, P. Martinez, E. TI Differences between HIV-infected and uninfected adults in the contributions of smoking, diabetes and hypertension to acute coronary syndrome: two parallel case-control studies SO HIV MEDICINE LA English DT Article DE diabetes; heart; health care; hypertension; risk factors; smoking ID MYOCARDIAL-INFARCTION; RISK-FACTORS; ANTIRETROVIRAL TREATMENT; HEART-DISEASE; IMMUNODEFICIENCY; PREVALENCE; CESSATION; THERAPY; MARKERS; RATES AB Objectives The aim of the study was to assess the separate contributions of smoking, diabetes and hypertension to acute coronary syndrome (ACS) in HIV-infected adults relative to uninfected adults. Methods Two parallel casecontrol studies were carried out. In the first study, HIV-positive adults diagnosed with ACS between 1997 and 2009 (HIV+/ACS) were matched for age, gender and known duration of HIV infection with HIV-positive adults without ACS (HIV+/noACS), each individual in the HIV+/ACS group being matched with three individuals in the HIV+/noACS group. In the second study, each individual in the HIV+/ACS group in the first study was matched for age, gender and calendar date of ACS diagnosis with three HIV-negative individuals diagnosed with ACS between 1997 and 2009 (HIV/ACS). Each individual in the HIV/ACS group was then matched for age and gender with an HIV-negative adult without ACS (HIV/noACS). After matching, the ratio of numbers of individuals in the HIV+/ACS, HIV+/noACS, HIV/ACS and HIV/noACS groups was therefore 1?:?3?:?3?:?3, respectively. We performed logistic regression analyses to identify risk factors for ACS in each casecontrol study and calculated population attributable risks (PARs) for smoking, diabetes and hypertension in HIV-positive and HIV-negative individuals. Results There were 57 subjects in the HIV+/ACS group, 173 in the HIV+/noACS group, 168 in the HIV/ACS group, and 171 in the HIV/noACS group. 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Method 221 patients >= 50 years with COPD and/or CHF were randomized to usual care vs. usual care plus a person-centred telephone-support intervention and followed for six months. Patients in the intervention group were telephoned by a registered nurse initially to co-create a person-centred health plan with the patient and subsequently to discuss and evaluate the plan. The primary outcome measure was a composite score comprising General Self-Efficacy (GSE), re-hospitalization and death. Patients were classified as deteriorated if GSE had decreased by >= 5 points, or if they had been re-admitted to hospital for unscheduled reasons related to COPD and/or CHF or if they had died. Results At six-month follow-up no difference in the composite score was found between the two study groups (57.6%, n = 68 vs. 46.6%, n = 48; OR = 1.6, 95% CI: 0.9-2.7; P = 0.102) in the intention-to-treat analysis (n = 221); however, significantly more patients in the control group showed a clinically important decrease in GSE (>= 5 units) (22.9%, n = 27 vs. 9.7%, n = 10; OR = 2.8, 95% CI: 1.3-6.0; P = 0.011). There were 49 clinical events (14 deaths, 35 readmissions) in the control group and 41 in the intervention group (9 deaths, 32 re-admissions). Per-protocol analysis (n = 202) of the composite score showed that more patients deteriorated in the control group than in the intervention group (57.6%, n = 68 vs. 42.9%, n = 36; OR = 1.8, 95% CI 1.0-3.2; P = 0.039). Conclusion Person-centred support via telephone mitigates worsening self-efficacy without increasing the risk of clinical events in chronically ill patients with CHF and/or COPD. This indicates that a patient-healthcare professional partnership may be established without the need for face-to-face consultations, even in vulnerable patient groups. C1 [Fors, Andreas; Blanck, Elin; Ali, Lilas; Kjellberg, Irma Lindstrom; Taft, Charles; Ekman, Inger] Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden. [Fors, Andreas; Blanck, Elin; Ali, Lilas; Kjellberg, Irma Lindstrom; Swedberg, Karl; Taft, Charles; Ekman, Inger] Univ Gothenburg, Ctr Person Ctr Care GPCC, Gothenburg, Sweden. [Fors, Andreas] Narhalsan Res & Dev Primary Hlth Care, Gothenburg, Sweden. [Ekberg-Jansson, Ann] Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Resp Med & Allergol, Gothenburg, Sweden. [Ekberg-Jansson, Ann] Res & Dev Dept, Halmstad, Sweden. [Fu, Michael; Swedberg, Karl] Univ Gothenburg, Sahlgrenska Acad, Dept Mol & Clin Med, Gothenburg, Sweden. [Makitalo, Asa] Univ Gothenburg, Dept Educ Commun & Learning, Gothenburg, Sweden. [Swedberg, Karl] Imperial Coll, Natl Heart & Lung Inst, London, England. C3 University of Gothenburg; University of Gothenburg; University of Gothenburg; University of Gothenburg; University of Gothenburg; RLUK- Research Libraries UK; Imperial College London RP Fors, A (通讯作者)，Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden.; Fors, A (通讯作者)，Univ Gothenburg, Ctr Person Ctr Care GPCC, Gothenburg, Sweden.; Fors, A (通讯作者)，Narhalsan Res & Dev Primary Hlth Care, Gothenburg, Sweden. EM andreas.fors@gu.se RI Swedberg, Karl/B-2475-2008 OI Fors, Andreas/0000-0001-8980-0538; Makitalo, Asa/0000-0003-3711-3781 FU Centre for Person-Centred Care at the University of Gothenburg (GPCC), Sweden; Swedish Government's grant for Strategic Research Areas, Care Sciences [2009-1088]; University of Gothenburg, Sweden; Swedish Research Council [521-2013-2723]; Swedish agreement between the government and the county councils concerning economic support for providing an infrastructure for research and education of doctors [ALFGBG-444681]; Research and Development Unit, Primary Health Care, Region Vastra Gotaland FX This work was supported by the Centre for Person-Centred Care at the University of Gothenburg (GPCC), Sweden. GPCC is funded by the Swedish Government's grant for Strategic Research Areas, Care Sciences (Application to Swedish Research Council no. 2009-1088) (IE) and co-funded by the University of Gothenburg, Sweden. The Swedish Research Council (DNr 521-2013-2723) (IE), the Swedish agreement between the government and the county councils concerning economic support for providing an infrastructure for research and education of doctors (ALFGBG-444681) (IE), and Research and Development Unit, Primary Health Care, Region Vastra Gotaland also contributed to the funding of the study (AF). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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Methods: A total of 192 patients with ST-elevation AMI were retrospectively analyzed. They were divided into a hypocalcemia group (serum calcium levels <2.14 mM, 84 cases) and normal serum calcium group (>= 2.14 mM, 108 cases). General patient data, cardiogenic shock, acute renal failure, ventricular aneurysm, ventricular septal perforation, cardiac function, short-term prognosis of 30 days, and long-term mortality of 150 days of the two groups were compared and independent risk factors for patients with AMI were analyzed using multivariate logistic regression. Results: No significant differences were observed in gender, heart rate, hypertension, diabetes, smoking, serum potassium, and serum chlorine between the hypocalcemia group and normal serum calcium group (all P>0.05). However, there were significant differences in age (t=2.220, P=0.028), hyperlipidemia (chi(2)=5.578, P=0.018), Killip classification (chi(2)=4.701, P=0.030), and serum sodium (t=2.723, P=0.007). Compared with patients in the normal serum calcium group, cardiogenic shock, ventricular aneurysm, and interventricular septum perforation of patients in the hypocalcemia group were not significantly different (all P>0.05), but risk of acute renal failure was significantly higher (chi(2)=4.443, P=0.035). Left ventricular ejection fraction of hypocalcemia patients was significantly lower than those with normal serum calcium (t=2.188, P=0.030). Serum calcium (OR=4.309, 95% CI: 1.538-9.735, P=0.009), age (OR=3.410, 95% CI: 1.322-8.655, P=0.016), and serum sodium (OR=3.272, 95% CI: 1290-6.104, P=0.022) were risk factors for death in patients with acute myocardial infarction, while hyperlipidemia and Killip classification >= 3 did not have high prognostic value (both P>0.05). Conclusion: Hypocalcemia is a risk factor for AMI and could be used as an independent predictor for prognosis of AMI, providing a theoretical basis for choice of nursing scheme for patients with hypocalcemia. C1 [Jiang, Meiling; Yang, Baofa] Jining 1 Peoples Hosp, Dept Cardiol, Jining, Shandong, Peoples R China. [Zhang, Guangjing] Jining 1 Peoples Hosp, Dept Thorac Surg, Jining, Shandong, Peoples R China. [Wang, Hui] Jining 1 Peoples Hosp, Dept Spinal Surg, 6 Jiankang Rd, Jining 272011, Shandong, Peoples R China. RP Wang, H (通讯作者)，Jining 1 Peoples Hosp, Dept Spinal Surg, 6 Jiankang Rd, Jining 272011, Shandong, Peoples R China. 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PY 2018 VL 11 IS 9 BP 9762 EP 9767 PG 6 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA GY8AL UT WOS:000448839700105 DA 2023-05-13 ER PT J AU Cafagna, G Seghieri, C AF Cafagna, Gianluca Seghieri, Chiara TI Educational level and 30-day outcomes after hospitalization for acute myocardial infarction in Italy SO BMC HEALTH SERVICES RESEARCH LA English DT Article DE Education; Socioeconomic status; Acute myocardial infarction; Short-term mortality; Short-term readmission; Italy; Health care outcomes; Hospital performance; Health equity; Health services research ID PERFORMANCE EVALUATION SYSTEM; ACUTE CORONARY SYNDROME; HEALTH-CARE-SYSTEM; SOCIOECONOMIC-STATUS; HEART-FAILURE; MEDICARE BENEFICIARIES; MORTALITY-RATES; INCOME INEQUALITY; READMISSION RATES; 1-YEAR MORTALITY AB Background: There is a growing interest in the factors that influence short-term mortality and readmission after hospitalization for acute myocardial infarction (AMI) since such outcomes are commonly considered as hospital performance measures. Socioeconomic status (SES) is one of the factors contributing to healthcare outcomes after hospitalization for AMI. However, no study has been published on education and 30-day readmission in Europe. The objective of this study is to examine the association between educational level and 30-day mortality and readmission among patients hospitalized for AMI in Tuscany (Italy). Methods: A retrospective cohort study using data from hospital discharge records was conducted. The analysis included all patients discharged with a principal diagnosis of AMI between January 1, 2011, and November 30, 2014, from all hospitals in Tuscany. Educational level was categorized as low (no middle school diploma), mid (middle school diploma) and high (high school diploma or more). Three multilevel models were developed, sequentially controlling for patient-level socio-demographic and clinical variables and hospital-level variables. Patients were stratified by age (<= 75 and > 75 years). Results: Mortality analysis included 23,402 patients, readmission analysis included 22,181 patients. In both unadjusted and full-adjusted models, patients with a high education had lower odds of 30-day mortality compared to those patients with low education (OR age <= 75 years 0.67, 95% CI: 0.47-0.94; OR age > 75 years 0.72, 95% CI: 0.54-0.95). With regard to 30-day readmission, only patients aged over 75 years with a high education had lower odds of short-term readmission compared to those patients with low education (OR age > 75 0.73, 95% CI: 0.58-0.93). Conclusions: Among patients hospitalized in Tuscany for AMI, low levels of education were associated with increased odds of 30-day mortality for both age groups and increased odds of 30-day readmission only for patients aged over 75 years. Our findings suggest that the educational component should not be underestimated in order to improve short-term outcomes, which are considered as performance measures at the hospital level. Hospital managers might consider strategies that are sensitive to patients with low SES, such as providing post-hospitalization support to less-educated patients and promoting a healthier lifestyle, to improve both health equity and performance outcomes. C1 [Cafagna, Gianluca; Seghieri, Chiara] St Anna Sch Adv Studies, Inst Management, Hlth & Management Lab, MeS Lab, Piazza Martiri della Liberta 24, Pisa, Italy. C3 Scuola Superiore Sant'Anna RP Cafagna, G (通讯作者)，St Anna Sch Adv Studies, Inst Management, Hlth & Management Lab, MeS Lab, Piazza Martiri della Liberta 24, Pisa, Italy. 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Res. PD JAN 9 PY 2017 VL 17 AR 18 DI 10.1186/s12913-016-1966-5 PG 11 WC Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services GA EH6YG UT WOS:000391919200001 PM 28069004 OA Green Published, gold DA 2023-05-13 ER PT J AU Yao, Y Guo, YT Lip, GYH AF Yao, Yuan Guo, Yutao Lip, Gregory Y. H. CA MAF-App II Trial Investigators TI The Effects of Implementing a Mobile Health-Technology Supported Pathway on Atrial Fibrillation-Related Adverse Events Among Patients With Multimorbidity The mAFA-II Randomized Clinical Trial SO JAMA NETWORK OPEN LA English DT Article ID ASSOCIATION; CARE AB IMPORTANCE The Mobile Health Technology for Improved Screening and Optimized Integrated Care in Atrial Fibrillation (mAFA-II) trial is a prospective cluster randomized trial that found a significant reduction in the composite clinical outcome of stroke or thromboembolism, all-cause death, and rehospitalization among patients with atrial fibrillation (AF) who used a mobile health (mHealth) technology that implemented the Atrial Fibrillation Better Care (ABC) pathway (ie, A, anticoagulation/avoid stroke; B, better symptom control; and C, cardiovascular disease and comorbidity management) compared with those receiving usual care. Multimorbidity (defined as >= 2 chronic long-term conditions) is common in older patients with AF, but the impact of integrated or holistic care (based on the ABC pathway) on clinical outcomes in this population is uncertain. OBJECTIVE To evaluate whether implementation of the integrated ABC pathway, supported by mHealth technology, would reduce AF-related adverse events in patients with multimorbidity. DESIGN, SETTING, AND PARTICIPANTS This prespecified ancillary analysis of data from the extended follow-up of the mAFA II trial was conducted between June 2018 and April 2021. Adult patients with AF were included in the analysis if they had at least 2 comorbidities. Participants were enrolled across 40 centers in China. INTERVENTION Integrated care supported by mHealth technology (mAFA intervention) vs usual care. MAIN OUTCOMES AND MEASURES The main outcome was the composite outcome of stroke or thromboembolism, all-cause death, and rehospitalization. Cox proportional hazard modeling was performed for adverse outcomes after adjusting for cluster effect and baseline risk factors. RESULTS Of 1890 patients, 833 (mean [SD] age, 72.0 [12.0] years; 278 [33.4%] women) with multimorbidity were allocated to the intervention group (ABC pathway), with a mean (SD) follow-up of 419 (257) days, and 1057 patients (mean [SD] age, 72.8 [13.0] years; 443 [41.9%] women) with multimorbidity were allocated to usual care, with a mean (SD) follow-up of 457 (154) days. Compared with usual care, the composite outcome of stroke or thromboembolism, all-cause death, and rehospitalization was significantly reduced in the intervention group (hazard ratio [HR], 0.37; 95% CI, 0.26-0.53; P < .001), as were rehospitalizations alone (HR, 0.42; 95% CI, 0.27-0.64; P < .001). For the C criterion of the ABC pathway, rates of acute coronary syndrome, heart failure, and uncontrolled blood pressure during follow-up were lower in the intervention group than the usual care group (27 patients [3.2%] vs 145 patients [13.7%]; HR, 0.29; 95% CI, 0.19-0.45; P < .001). Subgroup analyses by age, prior stroke, and sex demonstrated consistently lower HRs for the primary composite outcome and rehospitalization for patients with AF allocated to the intervention group compared with patients receiving usual care. CONCLUSIONS AND RELEVANCE In this study, mHealth technology-based integrated care that facilitated the implementation of the ABC pathway reduced meaningful clinical adverse events in older patients with AF and multimorbidity vs usual care. C1 [Yao, Yuan] Chinese Peoples Liberat Army Gen Hosp, Inst Hosp Management Res, Beijing, Peoples R China. [Guo, Yutao; Lip, Gregory Y. H.] Chinese Peoples Liberat Army Gen Hosp, Med Sch Chinese PLA, Dept Pulm Vessel & Thrombot Dis, Beijing, Peoples R China. [Guo, Yutao; Lip, Gregory Y. H.] Univ Liverpool, Liverpool Heart & Chest Hosp, Liverpool Ctr Cardiovasc Sci, William Henry Duncan Bldg, Liverpool L69 7TX, Merseyside, England. [Lip, Gregory Y. H.] Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark. C3 Chinese People's Liberation Army General Hospital; Chinese People's Liberation Army General Hospital; Liverpool Heart & Chest Hospital; N8 Research Partnership; RLUK- Research Libraries UK; University of Liverpool; Aalborg University RP Lip, GYH (通讯作者)，Univ Liverpool, Liverpool Heart & Chest Hosp, Liverpool Ctr Cardiovasc Sci, William Henry Duncan Bldg, Liverpool L69 7TX, Merseyside, England.; Guo, YT (通讯作者)，Chinese Peoples Liberat Army Gen Hosp, Dept Pulm Vessel & Thrombot Dis, Five Fucheng Rd, Beijing 100048, Peoples R China. EM dor.guoyt@hotmail.com; gregory.lip@liverpool.ac.uk OI Yao, Yuan/0000-0002-9426-4415; Lane, Deirdre/0000-0002-5604-9378 FU National Natural Science Foundation of China [H2501] FX This research projectwas funded by the National Natural Science Foundation of China (H2501). This study was an investigator-initiated project, with limited funding by independent research and educational grants. 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Open PD DEC 21 PY 2021 VL 4 IS 12 AR e2140071 DI 10.1001/jamanetworkopen.2021.40071 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA XV4JL UT WOS:000734910000005 PM 34932104 OA gold, Green Published DA 2023-05-13 ER PT J AU Conti, A Alesi, A Aspesi, G Bigiarini, S Bianchi, S Angeli, E Zanobetti, M Innocenti, F Pini, R Gensini, GF AF Conti, Alberto Alesi, Andrea Aspesi, Giovanna Bigiarini, Sofia Bianchi, Simone Angeli, Elena Zanobetti, Maurizio Innocenti, Francesca Pini, Riccardo Gensini, Gian Franco TI Comparison of exercise electrocardiogram and exercise echocardiography in intermediate-risk chest pain patients SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID FREQUENCY QRS COMPONENTS; ASSOCIATION TASK-FORCE; ST-SEGMENT DEVIATION; STRESS ECHOCARDIOGRAPHY; MYOCARDIAL-ISCHEMIA; PRACTICE GUIDELINES; AMERICAN-COLLEGE; PROGNOSTIC VALUE; CORONARY; DIAGNOSIS AB Background: The novel exercise computer-assisted high-frequency QRS analysis (HF/QRS) has demonstrated improved sensitivity and specificity over the conventional ST/electrocardiogram-segment analysis (ST/ECG) in the detection of myocardial ischemia. The aim of the present study was to compare the diagnostic value of the validated exercise echocardiography (ex-Echo) with the novel exercise ECG (ex-ECG) including HF/QRS and ST/ECG analysis. Methods: A prospective cohort study was conducted in the emergency department of a tertiary care teaching Hospital. Patients with chest pain (CP), normal resting ECGs, troponins, and echocardiography, labeled as "intermediate- risk" for adverse coronary events, underwent the novel ex-ECG and ex-Echo. An ST-segment depression of at least 2 mV or at least 1 mV when associated with CP was considered as an index of ischemia, as well as a decrease of at least 50% in HF/QRS intensity, or new wall motion abnormalities on ex-Echo. Exclusion criteria were QRS duration of at least 120 milliseconds, poor echo-acoustic window, and inability to exercise. Patients were followed up to 3 months. The end point was the composite of coronary stenoses of 50% or greater at angiography or acute coronary syndrome, revascularization, and cardiovascular death on the 3-month follow-up. Results: Of 188 patients enrolled, 18 achieved the end point. The novel ex-ECG and ex-Echo showed comparable negative predictive value (97% vs 96%; P= . 930); however, sensitivity was 83% vs 61%, respectively (P = .612), and specificity was 64% vs 92%, respectively,(P = .026). The areas on receiver operating characteristic analysis were comparable (ex-ECG: 0.734 [ 95% confidence interval, or CI, 0.62-0.85] vs ex-Echo: 0.767 [CI, 0.63-0.91]; C statistic, P = .167). On multivariate analysis, both ex-ECG (hazard ratio, 5; CI, 1-20; P = .017) and ex-Echo (HR, 12; CI, 4-40; P < .001) were predictors of the end point. Conclusions: In intermediate-risk CP patients, the novel ex-ECG including HF/QRS added to ST/ECG analysis was a valuable diagnostic tool and might be proposed to avoid additional imaging. However, the novel test needs additional study before it can be recommended as a replacement for current techniques. (C) 2014 Elsevier Inc. All rights reserved. C1 [Conti, Alberto; Alesi, Andrea; Aspesi, Giovanna; Bigiarini, Sofia; Bianchi, Simone; Angeli, Elena] Careggi Univ Hosp, Dept Crit Care Med & Surg, Emergency Med & Chest Pain Clin, Florence, Italy. [Zanobetti, Maurizio; Innocenti, Francesca; Pini, Riccardo] Careggi Univ Hosp, Dept Crit Care Med & Surg, Florence, Italy. [Gensini, Gian Franco] Careggi Univ Hosp, Dept Cardiol, Florence, Italy. C3 University of Florence; Azienda Ospedaliero Universitaria Careggi; University of Florence; Azienda Ospedaliero Universitaria Careggi; University of Florence; Azienda Ospedaliero Universitaria Careggi RP Conti, A (通讯作者)，Careggi Univ Hosp, Dept Crit Care Med & Surg, Emergency Med & Chest Pain Clin, Florence, Italy. EM xalbertoconti@gmail.com RI alesi, andrea/GSN-7202-2022 OI Pini, Riccardo/0000-0002-7940-7908; Innocenti, Francesca/0000-0002-7805-7619; Bianchi, Simone/0000-0003-2292-4303; Zanobetti, Maurizio/0000-0003-0798-1393 CR ABBOUD S, 1993, PROG CARDIOVASC DIS, V35, P311, DOI 10.1016/0033-0620(93)90009-3 ABBOUD S, 1990, INT J CARDIOL, V26, P285, DOI 10.1016/0167-5273(90)90084-I ABBOUD S, 1991, CIRC RES, V68, P1751, DOI 10.1161/01.RES.68.6.1751 ABBOUD S, 1987, COMPUT BIOMED RES, V20, P384, DOI 10.1016/0010-4809(87)90052-8 Amsterdam EA, 2010, CIRCULATION, V122, P1756, DOI 10.1161/CIR.0b013e3181ec61df Antman EM, 2000, JAMA-J AM MED ASSOC, V284, P835, DOI 10.1001/jama.284.7.835 Bouzas-Mosquera A, 2009, J AM COLL CARDIOL, V53, P1981, DOI 10.1016/j.jacc.2009.01.067 Cheitlin MD, 2003, CIRCULATION, V108, P1146, DOI 10.1161/01.CIR.0000073597.57414.A9 Conti A, 2005, AM HEART J, V149, P894, DOI 10.1016/j.ahj.2004.09.048 Conti A, 2010, AM J EMERG MED, V28, P135, DOI 10.1016/j.ajem.2008.10.023 DIAMOND GA, 1980, J CLIN INVEST, V65, P1210, DOI 10.1172/JCI109776 Eagle KA, 2010, CIRCULATION, V121, P1447, DOI 10.1161/CIRCULATIONAHA.109.904029 Erhardt L, 2002, EUR HEART J, V23, P1153, DOI 10.1053/euhj.2002.3194 Geleijnse ML, 2000, EUR HEART J, V21, P397, DOI 10.1053/euhj.1999.1860 Genders TSS, 2011, EUR HEART J, V32, P1316, DOI 10.1093/eurheartj/ehr014 Gibbons RJ, 2002, CIRCULATION, V106, P1883, DOI 10.1161/01.CIR.0000034670.06526.15 Goncalves PDA, 2005, EUR HEART J, V26, P865, DOI 10.1093/eurheartj/ehi187 Grady D, 2010, ARCH INTERN MED, V170, P749, DOI 10.1001/archinternmed.2010.90 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Higgins JP, 2007, INT J CARDIOL, V116, P285, DOI 10.1016/j.ijcard.2006.04.047 Jeetley P, 2007, J AM COLL CARDIOL, V49, p123A Jeetley P, 2007, EUR HEART J, V28, P204 Kligfield P, 2006, CIRCULATION, V114, P2070, DOI 10.1161/CIRCULATIONAHA.105.561944 Lee TH, 2000, NEW ENGL J MED, V342, P1187, DOI 10.1056/NEJM200004203421607 Montalescot G, 2013, EUR HEART J, V34, P2949, DOI 10.1093/eurheartj/eht296 MORAVI V, 1987, CIRCULATION, V76, P237, DOI 10.1161/01.CIR.76.1.237 PAUKER SG, 1980, NEW ENGL J MED, V302, P1109, DOI 10.1056/NEJM198005153022003 Pettersson J, 2000, J AM COLL CARDIOL, V36, P1827, DOI 10.1016/S0735-1097(00)00936-0 Redberg R, 2011, ARCH INTERN MED, V171, P619, DOI 10.1001/archinternmed.2010.465 Safavi KC, 2014, JAMA INTERN MED, V174, P546, DOI 10.1001/jamainternmed.2013.14407 Sanchis J, 2005, J AM COLL CARDIOL, V46, P443, DOI 10.1016/j.jacc.2005.04.037 Sharir T, 2012, AM J CARDIOL, V109, P642, DOI 10.1016/j.amjcard.2011.10.022 Sicari R, 2008, EUR J ECHOCARDIOGR, V9, P415, DOI 10.1093/ejechocard/jen175 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Thygesen K, 2010, EUR HEART J, V31, P2197, DOI 10.1093/eurheartj/ehq251 Toledo E, 2009, J ELECTROCARDIOL, V42, P240, DOI 10.1016/j.jelectrocard.2008.12.023 Watanabe T, 1998, JPN CIRC J, V62, P844, DOI 10.1253/jcj.62.844 NR 37 TC 1 Z9 1 U1 0 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 0735-6757 EI 1532-8171 J9 AM J EMERG MED JI Am. 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PD JAN PY 2015 VL 33 IS 1 BP 7 EP 13 DI 10.1016/j.ajem.2014.09.035 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AY1GC UT WOS:000347340800002 PM 25445858 DA 2023-05-13 ER PT J AU Carrero, JJ Franko, MA Obergfell, A Gabrielsen, A Jernberg, T AF Carrero, Juan Jesus Franko, Mikael Andersson Obergfell, Achim Gabrielsen, Anders Jernberg, Tomas TI hsCRP Level and the Risk of Death or Recurrent Cardiovascular Events in Patients With Myocardial Infarction: a Healthcare-Based Study SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE acute coronary syndrome; inflammation; monitoring; outcome ID C-REACTIVE PROTEIN; INFLAMMATION; OUTCOMES; CANAKINUMAB; INHIBITION; ELEVATION; MARKERS; DISEASE AB Background-Beyond the controlled setting of trials, scarce information exists on the burden, predictors, and outcomes associated with elevated hsCRP (high-sensitivity C-reactive protein) in "real-world" patients with myocardial infarction (MI). Methods and Results-We included all-coming MI survivors undergoing hsCRP testing >30 days after an MI during routine health care in Stockholm, Sweden (2006-2011). hsCRP tests measured during hospitalization/emergency department visits, followed by antibiotics or indicative of acute illness, were excluded, together with patients with ongoing/recent cancer, chronic infections, or immunosuppression. Inflammation was defined over a 3-month baseline window and associated with subsequent death and major adverse cardiovascular events (composite of MI, ischemic stroke, or cardiovascular death). Included were 17 464 patients (63% men; mean age, 72.6 years) with a median hsCRP level of 2.2 (interquartile range, 1.0-6.0) mg/L and a median of 2.2 (interquartile range, 0.8-4.9) years since their MI. Most (66%) had hsCRP >= 2 mg/L, and 40% had hsCRP >3 mg/L. Lower hemoglobin, lower estimated glomerular filtration rate, and comorbidities (eg, heart failure, peripheral vascular disease, stroke, atrial fibrillation, diabetes mellitus, and rheumatoid diseases) were associated with higher odds of hsCRP >= 2 mg/L. Conversely, previous percutaneous coronary intervention, ongoing renin-angiotensin blockade, and statins were associated with lower hsCRP >= 2 mg/L odds. Patients with hsCRP >= 2 mg/L were at higher risk of major adverse cardiovascular events (n=3900; adjusted hazard ratio, 1.28; 95% CI, 1.18-1.38) and death (n=4138; adjusted hazard ratio, 1.42; 95% CI, 1.31-1.53). Results were robust across subgroups of patients and after exclusion of events occurring during the first 6 to 12 months. On a continuous scale, the association between hsCRP and outcomes was linear until hsCRP >5 mg/L, plateauing thereafter. Conclusions-Most patients with MI exhibit elevated hsCRP levels. Besides identifying populations at high-inflammatory risk, this study extends the prognostic validity of this biomarker from trial evidence to real-world healthcare settings. C1 [Carrero, Juan Jesus; Franko, Mikael Andersson] Karolinska Univ Hosp Solna, Dept Med Epidemiol & Biostat, Solna, Sweden. [Gabrielsen, Anders] Karolinska Univ Hosp Solna, Dept Med Solna, Cardiovasc Med Unit, Solna, Sweden. [Jernberg, Tomas] Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden. [Obergfell, Achim] Novartis Pharma AG, Zurich, Switzerland. C3 Karolinska Institutet; Karolinska University Hospital; Karolinska Institutet; Karolinska University Hospital; Danderyds Hospital; Karolinska Institutet; Novartis RP Carrero, JJ (通讯作者)，Karolinska Inst, Dept Med Epidemiol & Biostat, Nobels Vag 12A,Box 281, S-17177 Stockholm, Sweden. EM juan.jesus.carrero@ki.se OI Jernberg, Tomas/0000-0003-1695-379X FU Novartis Pharma AG; Swedish Heart and Lung Foundation; Stockholm County Council; Martin Rind's Foundation; Westman's Foundation FX This study was supported by an institutional grant from Novartis Pharma AG, the manufacturer of canakinumab, to Karolinska Institutet. In addition, we acknowledge grant support from the Swedish Heart and Lung Foundation, the Stockholm County Council, Martin Rind's and Westman's Foundations. 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PD JUN 4 PY 2019 VL 8 IS 11 AR e012638 DI 10.1161/JAHA.119.012638 PG 27 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA IV9HZ UT WOS:000484576200027 PM 31140334 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Dyrbus, K Osadnik, T Desperak, P Desperak, A Gasior, M Banach, M AF Dyrbus, Krzysztof Osadnik, Tadeusz Desperak, Piotr Desperak, Aneta Gasior, Mariusz Banach, Maciej TI Evaluation of dyslipidaemia and the impact of hypolipidemic therapy on prognosis in high and very high risk patients through the Hyperlipidaemia Therapy in tERtiary Cardiological cEnTer (TERCET) Registry SO PHARMACOLOGICAL RESEARCH LA English DT Article DE Hyperlipidaemia; Coronary artery disease; Secondary prevention; Statins ID ESC GUIDELINES; MANAGEMENT; METAANALYSIS; CHOLESTEROL; PREVENTION; PREVALENCE; DISEASE; POLAND; CARE AB The use of statins in the treatment of hyperlipidaemia leads to a significant decrease in cardiovascular (CV) endpoints, and therapy effects are proportional to the reduction of cholesterol levels. In Poland, information about the effects of statin therapy is scarcely available. The information gathered in the Hyperlipidaemia Therapy in the tERtiary Cardiological cEnTer (TERCET) Registry on high-risk and very high-risk patients might improve our knowledge on this issue and help to introduce suitable activities. The main aim of the TERCET Registry is to achieve the target value of low density lipoprotein cholesterol (LDL-C) during a 1-year follow-up: LDL-C <70 mg/dL in very high-risk patients and LDL-C <100 mg/dL in high-risk patients. All consecutive patients with either stable coronary artery disease (sCAD) or acute coronary syndrome (ACS) have been included in the Registry, and the information on all-cause mortality, nonfatal myocardial infarction (MI), and planned or ACS-caused revascularisation have been being gathered within 12-month follow-up. At the moment, the TERCET Registry includes 14,873 patients (66.8% male) at an average age of 64.8 +/- 10.2 with a significantly higher age of women (67.5 +/- 10.3 vs. 63.5 +/- 9.7; p<.001). The causes of hospitalisation were as the following: sCAD (n=9375 patients, 63% of the investigated population), ST-elevated myocardial infarction (n=2328 [15.6%]), non-ST-elevated myocardial infarction (n=1700 [11.4%]), and unstable coronary artery disease (n=1466 [10%]). 62,7% (n=9144) of the patients were diagnosed with hyperlipidaemia before hospital admission, with no significant difference between male and female patients. The TERCET registry will allow unveiling real lipid profiles of the high- and very-high risk patients treated in the tertiary hospital. The results may play an essential role in establishing the patients' future clinical outcomes and help to assess if the lipid lowering therapy modifications changed the occurrence of CV endpoints. The registry data will summarize the number of patients unable to reach their LDL-C goals, and who in the future might become candidates suitable for new hypolipidemic therapies (ID: NCT03065543). (C) 2017 Elsevier Ltd. All rights reserved. C1 [Dyrbus, Krzysztof; Osadnik, Tadeusz; Desperak, Piotr; Desperak, Aneta; Gasior, Mariusz] Med Univ Silesia, Sch Med, Div Dent Zabrze, Chair 3,Silesian Ctr Heart Dis, Ul Sklodowskiej Curie 9, PL-41800 Zabrze, Poland. [Dyrbus, Krzysztof; Osadnik, Tadeusz; Desperak, Piotr; Desperak, Aneta; Gasior, Mariusz] Med Univ Silesia, Sch Med, Div Dent Zabrze, Dept Cardiol,Silesian Ctr Heart Dis, Ul Sklodowskiej Curie 9, PL-41800 Zabrze, Poland. [Banach, Maciej] Med Univ Lodz, Dept Hypertens, WAM Univ Hosp Lodz, Zeromskiego 113, Lodz, Poland. [Banach, Maciej] PMMHRI, Lodz, Poland. [Banach, Maciej] Univ Zielona Gora, Cardiovasc Res Ctr, Zielona Gora, Poland. C3 Medical University Silesia; Silesian Center for Heart Diseases; Medical University Silesia; Silesian Center for Heart Diseases; Medical University Lodz; University of Zielona Gora RP Dyrbus, K (通讯作者)，Med Univ Silesia, Sch Med, Div Dent Zabrze, Chair 3,Silesian Ctr Heart Dis, Ul Sklodowskiej Curie 9, PL-41800 Zabrze, Poland.; Dyrbus, K (通讯作者)，Med Univ Silesia, Sch Med, Div Dent Zabrze, Dept Cardiol,Silesian Ctr Heart Dis, Ul Sklodowskiej Curie 9, PL-41800 Zabrze, Poland. EM K.Dyrbus@sccs.pl RI Banach, Maciej/A-1271-2009; Osadnik, Tadeusz/P-5844-2014; Dyrbuś, Krzysztof/T-2469-2019 OI Banach, Maciej/0000-0001-6690-6874; Osadnik, Tadeusz/0000-0002-3202-6972; Dyrbuś, Krzysztof/0000-0003-1323-1089 CR Adams SP, 2015, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD008226.pub3 Authors/Task Force Members:, 2016, Atherosclerosis, V253, P281, DOI 10.1016/j.atherosclerosis.2016.08.018 Baigent C, 2010, LANCET, V376, P1670, DOI 10.1016/S0140-6736(10)61350-5 Banach M, 2017, EUR HEART J, V38, P1116 Banach M, 2017, ARCH MED SCI, V13, P1, DOI 10.5114/aoms.2017.64712 Banach M, 2016, INT J CARDIOL, V225, P184, DOI 10.1016/j.ijcard.2016.09.075 Banach M, 2016, J CACHEXIA SARCOPENI, V7, P396, DOI 10.1002/jcsm.12109 Banach M, 2015, BMC MED, V13, DOI 10.1186/s12916-015-0459-4 Booth JN, 2016, INT J CARDIOL, V207, P196, DOI 10.1016/j.ijcard.2016.01.001 Choi HD, 2014, CURR MED RES OPIN, V30, P1, DOI 10.1185/03007995.2013.842165 Dragan S, 2015, J CARDIOVASC PHARM T, V20, P157, DOI 10.1177/1074248414539562 Drygas W, 2016, KARDIOL POL, V74, P681, DOI 10.5603/KP.a2015.0235 European Heart Network, 2008, EUROPEAN CARDIOVASCU Falk E, 2013, EUR HEART J, V34, P719, DOI 10.1093/eurheartj/ehs411 Ho PM, 2009, CIRCULATION, V119, P3028, DOI 10.1161/CIRCULATIONAHA.108.768986 Hobbs FDR, 2016, BMC MED, V14, DOI 10.1186/s12916-016-0550-5 Jankowski Piotr, 2003, Przegl Lek, V60, P142 Levi F, 2009, EUR J CARDIOV PREV R, V16, P333, DOI 10.1097/HJR.0b013e328325d67d Montalescot G, 2013, EUR HEART J, V34, P2949, DOI 10.1093/eurheartj/eht296 Pajak A, 2005, KARDIOL POL S4, V63, P620 Pajak A, 2016, POL ARCH MED WEWN, V126, P642, DOI 10.20452/pamw.3464 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] Piepoli MF, 2016, EUR HEART J, V37, P2315, DOI 10.1093/eurheartj/ehw106 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Roffi M, 2015, REV ESP CARDIOL, V68, P1125, DOI 10.1016/j.rec.2015.10.009 Rosenson RS, 2017, J AM COLL CARDIOL, V70, P1290, DOI 10.1016/j.jacc.2017.07.752 Rosenson RS, 2017, J AM COLL CARDIOL, V69, P2696, DOI 10.1016/j.jacc.2017.03.585 Ryden R., 2013, EUR HEART J, V34, P3035, DOI DOI 10.1093/EURHEARTJ/EHT108 Sabatine MS, 2017, NEW ENGL J MED, V376, P1713, DOI [10.1056/NEJMoa1615664, 10.4997/JRCPE.2017.212] Sahebkar A, 2017, BMC MED, V15, DOI 10.1186/s12916-017-0787-7 Sahebkar A, 2016, PHARMACOL RES, V103, P236, DOI 10.1016/j.phrs.2015.12.001 SANCHISGOMAR F, 2016, ANN TRANSL MED, V4, DOI [DOI 10.21037/ATM.2016.06.33, 10.21037/atm.2016.06.33] Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Stone NJ, 2014, CIRCULATION, V129, pS1, DOI 10.1161/01.cir.0000437738.63853.7a Stulc T, 2017, ARCH MED SCI, V13, P705, DOI 10.5114/aoms.2016.64865 Tomasik T, 2013, J CARDIOVASC PHARM T, V18, P234, DOI 10.1177/1074248412471196 Tomasik T, 2011, EUR J CARDIOV PREV R, V18, P287, DOI 10.1177/1741826710389366 Ursoniu S, 2017, PHARMACOL RES, V122, P105, DOI 10.1016/j.phrs.2017.06.002 Walicka M, 2015, CLIN DIABETOL, V4, P232, DOI 10.5603/DK.2015.0031 Zdrojewski T, 2016, KARDIOL POL, V74, P213, DOI [10.5603/KP.2016.0029, 10.5603/KP.2016.0051] NR 40 TC 18 Z9 18 U1 3 U2 11 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1043-6618 EI 1096-1186 J9 PHARMACOL RES JI Pharmacol. Res. PD JUN PY 2018 VL 132 BP 204 EP 210 DI 10.1016/j.phrs.2017.12.015 PG 7 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA GL1ZY UT WOS:000436914000021 PM 29258913 DA 2023-05-13 ER PT J AU Neves, JS Guerreiro, V Carvalho, D Serrao, R Sarmento, A Freitas, P AF Neves, Joao Sergio Guerreiro, Vanessa Carvalho, Davide Serrao, Rosario Sarmento, Antonio Freitas, Paula TI Metabolically Healthy or Metabolically Unhealthy Obese HIV-Infected Patients: Mostly a Matter of Age? SO FRONTIERS IN ENDOCRINOLOGY LA English DT Article DE obesity; HIV; metabolic syndrome; metabolically healthy obesity; aging ID BODY-MASS INDEX; CARDIOVASCULAR-DISEASE RISK; ACUTE CORONARY SYNDROME; TO-HEIGHT RATIO; WAIST CIRCUMFERENCE; ANTIRETROVIRAL THERAPY; WEIGHT-GAIN; ADIPOSE-TISSUE; ENERGY-EXPENDITURE; PRIMARY-CARE AB Background: Life expectancy of HIV-infected patients has increased with antiretroviral treatment (ART). Chronic diseases associated with aging, including metabolic and cardiovascular diseases are becoming more prevalent in this population. We aimed to evaluate the association of obesity and aging with cardiometabolic comorbidities and metabolic health status among patients with HIV infection. Methods: We evaluated 580 HIV-1 infected patients (71.7% male, mean age of 47.7 +/- 11.5 years). We analyzed the association of age and obesity (defined by and by central obesity) with gender, duration of HIV infection, and ART, anthropometric parameters, cardiometabolic comorbidities, Framingham risk score (FRS), blood pressure, lipid profile, uric acid, liver biochemical tests, and glycemic profile. Furthermore, we analyzed the above-mentioned associations according to the category and central obesity into the metabolically healthy (MH) and unhealthy (MUH) categories. To evaluate the association of anthropometric parameters with cardiometabolic comorbidities, we performed unadjusted and adjusted logistic regression models. Results: The prevalence of excessive weight and cardiometabolic comorbidities increased with age. Patients with normal weight were younger and there was a higher proportion of female patients in the obesity group. The prevalence of hypertension and metabolic syndrome were higher among patients who were overweight or with obesity. The FRS was higher among patients with obesity. The proportion of MUH patients was higher among patients with excessive weight and central obesity. MUH patients had more cardiometabolic comorbidities and a higher FRS. In the normal weight group, MUH patients were older, and in the obesity group they were more likely to be male. The anthropometric parameter most associated with metabolic syndrome was waist circumference and that most associated with hypertension was waist-to-height ratio. The anthropometric parameter most associated with diabetes and FRS was waist-to-hip ratio. Conclusion: Patients with HIV present a high prevalence of obesity and related comorbidities. Ageing significantly contributes to metabolic dysfunction in this population. The proportion of MUH patients is higher among groups with excessive weight and central obesity, with those patients presenting a higher cardiovascular risk. Our results highlight the importance of evaluating and addressing obesity in patients with HIV, as well as metabolic comorbidities and cardiovascular risk. C1 [Neves, Joao Sergio; Guerreiro, Vanessa; Carvalho, Davide; Freitas, Paula] Ctr Hosp Univ Sao Joao, Dept Endocrinol Diabet & Metab, EPE, Porto, Portugal. [Neves, Joao Sergio] Univ Porto, Dept Cirurgia & Fisiol, Fac Med, Unidade Invest Cardiovasc, Porto, Portugal. [Carvalho, Davide; Serrao, Rosario; Freitas, Paula] Univ Porto, Fac Med, Inst Invest & Inovacao Saude, Porto, Portugal. [Serrao, Rosario; Sarmento, Antonio] Ctr Hosp Univ Sao Joao, EPE, Infect Dis Dept, Porto, Portugal. C3 Universidade do Porto; Universidade do Porto; i3S - Instituto de Investigacao e Inovacao em Saude, Universidade do Porto RP Neves, JS (通讯作者)，Ctr Hosp Univ Sao Joao, Dept Endocrinol Diabet & Metab, EPE, Porto, Portugal.; Neves, JS (通讯作者)，Univ Porto, Dept Cirurgia & Fisiol, Fac Med, Unidade Invest Cardiovasc, Porto, Portugal. EM joaosergioneves@gmail.com RI Freitas, Paula/HNP-1602-2023; Carvalho, Davide/AAR-2081-2020; Neves, João Sérgio/ADV-0717-2022; Sarmento, António/M-5235-2013 OI Freitas, Paula/0000-0002-8732-8046; Carvalho, Davide/0000-0002-3156-3741; Neves, João Sérgio/0000-0002-8173-8255; Sarmento, António/0000-0001-5269-7231; Serrao, Rosario/0000-0002-3030-1205 FU Associacao dos Amigos do Servico de Endocrinologia do Hospital de Sao Joao FX This work was supported by Associacao dos Amigos do Servico de Endocrinologia do Hospital de Sao Joao. 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Endocrinol. PD NOV 16 PY 2018 VL 9 AR 681 DI 10.3389/fendo.2018.00681 PG 18 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism GA HA6ZD UT WOS:000450429400002 PM 30505292 OA Green Published, gold DA 2023-05-13 ER PT J AU Pignatelli, R Antona, CV Rivera, IR Zenteno, PA Acosta, YT Huertas-Quinones, M Murillo, CA Torres, FM Cabalin, CF Camacho, AG Perez, AA Lombardi, AB Soares, AM Garcia, CT Borges, CT Villalba, CN Lechado, CR Dias, DT Morales, DA Copete, EM Goldenberg, GL Salazar, JS Moreira, JA Asakura, J Sabando, KS Branco, KC Rosas, LT Duarte, MP Carbajal, MJ Hernandez, MR Martinez, MM Echeverria, NG Caneva, OM Sepulveda, PR Diaz, PA Pluas, RR Alvarado, TC Faundes, LT Diaz, YB Zachariah, JP AF Pignatelli, Ricardo Antona, Clara Vazquez Rivera, Ivan Romero Zenteno, Patricia Alvarez Acosta, Yanet Toribio Huertas-Quinones, Manuel Murillo, Carlos Alvarez Torres, Franklin Mendoza Cabalin, Carlos Fernandez Camacho, Ana Galvan Perez, Alex Alcantara Lombardi, Ana Braga Soares, Andressa Mussi Garcia, Carolina Torres Borges, Cibelle Teixeira Villalba, Claudia Natalia Lechado, Cristhian Ramirez Dias, Deborah Trevisan Morales, Diana Aravena Copete, Elizabeth Mora Goldenberg, Guillermo Larios Salazar, Jahaira Sussety Moreira, Jessica Alchundia Asakura, Junko Sabando, Karla Solorzano Branco, Klebia Castello Rosas, Lida Toro Duarte, Magna Pereira Carbajal, Maria Jimenez Hernandez, Martha Rubio Martinez, Moises Mier Echeverria, Nancy Garay Caneva, Olga Maza Sepulveda, Patricia Romero Diaz, Paulina Agurto Pluas, Ruth Rugel Alvarado, Theo Contreras Faundes, Lorena Tapia Diaz, Yeny Briones Zachariah, Justin P. TI Pediatric multisystem SARS COV2 with versus without cardiac involvement: a multicenter study from Latin America SO EUROPEAN JOURNAL OF PEDIATRICS LA English DT Article DE Pediatric cardiology; Coronary aneurysm; Myocarditis; SARS COV2 AB Latin America (LATAM) children offer special insight into Severe Acute Respiratory Syndrome Coronavirus 2 (SARS COV2) due to high-risk race/ethnicity, variability in medical resources, diverse socioeconomic background, and numerous involved organ systems. This multinational study of LATAM youth examined the distinguishing features of acute or late multisystem SARS COV2 with versus without cardiac involvement. A consecutive sample of youth 0-18 years old (N = 98;50% male) presenting with multisystem SARS COV2 to 32 centers in 10 Latin American countries participating in a pediatric cardiac multi-imaging society were grouped as with versus without cardiac involvement, defined as abnormal echocardiographic findings or arrhythmia. Collected clinical data were analyzed by Student's t-test or Fisher's exact test. Cardiac (N = 48, 50% male) versus no cardiac (N = 50, 50% male) were similar in age; weight; nonrespiratory symptoms; and medical history. The cardiac group had 1 death and symptoms including coronary artery dilation, ejection fraction <50%, pericardial effusion, peripheral edema, arrhythmia, and pulmonary artery thrombus. The cardiac group had higher risk of ICU admission (77% vs 54%, p = 0.02); invasive ventilation (23% vs 4%,p = 0.007); vasoactive infusions (27% vs 4%, p = 0.002); prominent respiratory symptoms (60% vs 36%, p < 0.03); abnormal chest imaging (69% vs 34%, p = 0.001); troponin (33% vs 12%, p = 0.01); alanine aminotransferase (33% vs 12%, p = 0.02); and thrombocytopenia (46% vs 22%, p = 0.02). Receiver operating curve analysis showed that abnormal laboratories had 94% sensitivity and 98% negative predictive value on the need for ICU interventions. Conclusion: In LATAM children with multisystem SARS COV2, cardiac involvement was prevalent. Cardiac involvement was more likely to require ICU interventions, certain abnormal labs, and respiratory involvement. What is Known: SARS COV2 can be asymptomatic in children but in some cases can have serious multisystemic involvement. Hispanic ethnicity is purportedly at high risk of SARS COV2 in nations where they are often disadvantaged minority populations. What is New: Latin American children presenting with multisystem SARS COV2 frequently have cardiac involvement which was associated with ICU interventions; prominent respiratory symptoms; abnormal chest X-ray; elevated troponin, ALT, and thrombocytopenia. Elevated troponin, ALT or thrombocytopenia had high sensitivity and negative predictive value on the need for intensive care interventions. C1 [Pignatelli, Ricardo; Zachariah, Justin P.] Baylor Coll Med, Texas Childrens Hosp, Dept Pediat, Sect Pediat Cardiol, 6651 Main St Legacy Tower,20th Floor, Houston, TX 77030 USA. [Antona, Clara Vazquez] Inst Nacl Cardiol Ignacio Chavez, Mexico City, DF, Mexico. [Rivera, Ivan Romero] Univ Fed Alagoas, Maceio, Alagoas, Brazil. [Zenteno, Patricia Alvarez] Hosp Dr Roberto Rio, Santiago, Chile. [Acosta, Yanet Toribio] CEDIMAT, Santo Domingo, Dominican Rep. [Huertas-Quinones, Manuel] Fdn Cardioinfantil Cardiol Inst, Bogota, Colombia. [Murillo, Carlos Alvarez; Torres, Franklin Mendoza] Inst Nacl Salud Nino San Borja, Lima, Peru. [Cabalin, Carlos Fernandez] Clin Santa Maria, Santiago, Chile. [Camacho, Ana Galvan] Hosp Militar Especialidades, Mexico City, DF, Mexico. [Perez, Alex Alcantara; Rosas, Lida Toro] Complejo Asistencial Dr Sotero Rio, Santiago, Chile. [Lombardi, Ana Braga] Univ Fed Rio Grande do Norte, Natal, RN, Brazil. [Soares, Andressa Mussi] Hosp Evangelico Cachoeiro Itapemirim, Cachoeiro De Itapemirim, Brazil. [Garcia, Carolina Torres] Ctr Policlin Olaya, Bogota, Colombia. [Borges, Cibelle Teixeira] Hosp Sao Camilo Cura Dars, Fortaleza, Ceara, Brazil. [Villalba, Claudia Natalia] Hosp Britanico, Buenos Aires, DF, Argentina. [Lechado, Cristhian Ramirez] Hosp Solidaridad, Managua, Nicaragua. [Dias, Deborah Trevisan] Real Hosp Portugues Beneficencia, Recife, PE, Brazil. [Morales, Diana Aravena; Diaz, Paulina Agurto; Diaz, Yeny Briones] Hosp Dr Luis Calvo Mackenna, Santiago, Chile. [Copete, Elizabeth Mora] Clin La Colina, Bogota, Colombia. [Goldenberg, Guillermo Larios] Pontificia Univ Catolica Chile, Santiago, Chile. [Salazar, Jahaira Sussety; Moreira, Jessica Alchundia; Sabando, Karla Solorzano] Hosp Especialidades Ctr Med La Raza, Portoviejo, Ecuador. [Asakura, Junko] Hosp UNIMED, Maceio, Alagoas, Brazil. [Branco, Klebia Castello] Univ Fed Ceara, Fortaleza, Ceara, Brazil. [Duarte, Magna Pereira] Hosp Geral Estado Alagoas, Maceio, Alagoas, Brazil. [Carbajal, Maria Jimenez] Ctr Med ABC, Mexico City, DF, Mexico. [Hernandez, Martha Rubio] Hosp Cent Dr Ignacio Morones, San Luis Potosi, San Luis Potosi, Mexico. [Martinez, Moises Mier] Ctr Pediat Corazon ABC Kardias, Mexico City, DF, Mexico. [Echeverria, Nancy Garay] Hosp Gen Pediat Acosta Nu, Asuncion, Paraguay. [Caneva, Olga Maza] Clin Gen Norte, Barranquilla, Colombia. [Sepulveda, Patricia Romero] CEDIMAT, San Cristobal, Dominican Rep. [Pluas, Ruth Rugel] Omnihosp, Guayaquil, Ecuador. [Alvarado, Theo Contreras] IMSS Hosp Cardiol 34, Monterrey, Mexico. [Faundes, Lorena Tapia] Univ Chile, Fac Med, Dept Pediat Norte, Santiago, Chile. C3 Baylor College of Medicine; National Institute of Cardiology - Mexico; Universidade Federal de Alagoas; Instituto Nacional de Salud del Nino - San Borja; Universidade Federal do Rio Grande do Norte; Hospital Britanico de Buenos Aires; Pontificia Universidad Catolica de Chile; Universidade Federal do Ceara; Universidad de Chile RP Zachariah, JP (通讯作者)，Baylor Coll Med, Texas Childrens Hosp, Dept Pediat, Sect Pediat Cardiol, 6651 Main St Legacy Tower,20th Floor, Houston, TX 77030 USA. EM cardiop@bcm.edu; cvazquezant@yahoo.com.mx; irrivera@uol.com.br; pazenteno@yahoo.com; jantor85@gmail.com; manuelhuertasmd@gmail.com; doccalvarezm@hotmail.com; franklinmendozaipnc@gmail.com; cfernandez@sochicar.cl; dra.karen.galvan.alergologa@gmail.com; alexalcantarap@gmail.com; analuizabragabm@hotmail.com; amussisoares@gmail.com; ctorres.2278@gmail.com; cibelletb@gmail.com; villalbacn76@gmail.com; Cristinoram@Hotmail.com; trevisancardio@gmail.com; dianaaravenam@gmail.com; elimorac@gmail.com; gqlarios@uc.cl; susety22@hotmail.com; dra.jessicaneumoinfantil@gmail.com; junkoxabo@yahoo.com.br; drakarlasolorzano@gmail.com; klebiacb@gmail.com; lidatoro@gmail.com; magnardo@hotmail.com; mgjcmed@yahoo.com.mx; martharubio2003@yahoo.com.mx; dr_mier@hotmail.com; nancygareche@hotmail.com; omazacaneva@gmail.com; patriciar_2487@hotmail.com; paulinadoc@gmail.com; mipretty_rut@hotmail.com; theoyca@hotmail.com; lorenaisabeltapia@gmail.com; yeny.brione@gmail.com; justin.zachariah@bcm.edu OI Mier Martinez, Moises/0000-0002-0927-4054; Rugel Pluas, Ruth E./0000-0002-7307-4970 FU SISIAC (Society of Cardiovascular Imaging of the Interamerican Society of Cardiology); NHLBI [R01 HL148217] FX This work was supported by the SISIAC (Society of Cardiovascular Imaging of the Interamerican Society of Cardiology) (RP) and NHLBI R01 HL148217 (JPZ). 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J. Pediatr. PD SEP PY 2021 VL 180 IS 9 BP 2879 EP 2888 DI 10.1007/s00431-021-04052-9 EA APR 2021 PG 10 WC Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Pediatrics GA TW6KI UT WOS:000635478000001 PM 33791862 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Cartledge, S Thomas, E Hollier, K Maddison, R AF Cartledge, Susie Thomas, Emma Hollier, Kerry Maddison, R. TI Development of standardised programme content for phase II cardiac rehabilitation programmes in Australia using a modified Delphi process SO BMJ OPEN LA English DT Article ID NATIONAL HEART FOUNDATION; ACUTE CORONARY SYNDROMES; SECONDARY PREVENTION; AMERICAN ASSOCIATION; CLINICAL GUIDELINES; MANAGEMENT; SOCIETY; DISEASE; CARDIOLOGY; STATEMENT AB Objective To develop standardised programme content for Australian phase II cardiac rehabilitation (CR) programme. Design Using the RAND/UCLA appropriateness method (RAM), a two-phase process including a comprehensive literature review and a two round modified Delphi process was undertaken to develop and validate content of a standardised CR programmes. Participants An invited multidisciplinary expert advisory group (EAG; n=16), including CR health professionals (nurses, allied health professionals, cardiologist), academics, policy makers, representation from the Australian Cardiovascular Health and Rehabilitation Association and consumers, provided oversight of the literature review and assisted with development of best practice statements. Twelve members of the EAG went onto participate in the modified Delphi process rating the necessity of statements in two rounds on a scale of 1 (not necessary) to 9 (essential). Main outcome measure Best practice statements that achieved a median score of >= 8 on a nine-point scale were categorised as 'essential'; statements that achieved a median score of >= 6 were categorised as 'desirable' and statements with a median score of <6 were omitted. Results 49 best practice statements were developed from the literature across ten areas of care within four module domains (CR foundations, developing heart health knowledge, psychosocial health and life beyond CR). At the end of a two-round validation process a total of 47 best practice statements were finalised; 29 statements were rated as essential, 18 as desirable and 2 statements were omitted. Conclusions For the first time in Australia, an evidence-based and consensus-led standardised programme content for phase II CR has been developed that can be provided to CR coordinators. C1 [Cartledge, Susie; Thomas, Emma; Maddison, R.] Deakin Univ, Inst Phys Act & Nutr, Geelong, Vic, Australia. [Thomas, Emma] Univ Melbourne, Melbourne, Vic, Australia. [Hollier, Kerry] Natl Heart Fdn Australia, Melbourne, Vic, Australia. C3 Deakin University; University of Melbourne RP Cartledge, S (通讯作者)，Deakin Univ, Inst Phys Act & Nutr, Geelong, Vic, Australia. EM susie.cartledge@deakin.edu.au RI Thomas, Emma/AAJ-6492-2020 OI Thomas, Emma/0000-0001-8415-0521; Cartledge, Susie/0000-0002-6837-2244 FU Safer Care Victoria FX This work was supported by Safer Care Victoria. 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10.1016/j.ijcard.2014.10.154 Karmali KN, 2014, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD007131.pub3 Kravitz RL, 1997, HEALTH POLICY, V42, P135, DOI 10.1016/S0168-8510(97)00064-X Leon AS, 2005, CIRCULATION, V111, P369, DOI 10.1161/01.CIR.0000151788.08740.5C MAGRATH R, 2017, COCHRANE DB SYST REV, P314 McGory ML, 2009, ANN SURG, V250, P338, DOI 10.1097/SLA.0b013e3181ae575a National Health and Medical Research Council, 2009, NHMRC ADD LEV EV GRA National Heart Foundation Australia, 2017, ON HEART OUR 2018 20 National Heart Foundation of Australia, 2014, IMPR DEL CARD REH AU National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand, 2012, RED RISK HEART DIS E National Heart Foundation of Australia Australian Cardiac Rehabilitation Association, 2004, REC FRAM CARD REH National Institute for Health and Care Excellence (NICE), 2013, MYOC INF CARD REH PR New Zealand Guidelines Group, 2002, BEST PRACT EV BAS GU Nichols M., 2016, AUSTR HEART DIS STAT Piepoli MF, 2016, ATHEROSCLEROSIS, V252, P207, DOI [10.1177/2047487316653709, 10.1016/j.atherosclerosis.2016.05.037] Piepoli MF, 2014, EUR J PREV CARDIOL, V21, P664, DOI 10.1177/2047487312449597 Power E, 2015, BMJ OPEN, V5, DOI 10.1136/bmjopen-2015-007641 Queensland Health, 2018, STAT CARD CLIN NETW Redfern J, 2014, HEART, V100, P1281, DOI 10.1136/heartjnl-2013-305296 Richardson S, 2017, C PROC SOC EXP MECH, P67, DOI 10.1007/978-3-319-54109-9_8 Risom SS, 2017, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD011197.pub2 Schimmack S, 2014, EPIGENET CHROMATIN, V7, DOI 10.1186/1756-8935-7-15 Scottish Intercollegiate Guidelines Network, 2017, CARD REH NAT CLIN GU Sibilitz KL, 2016, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD010876.pub2 South Australian Academic Health Science and Translation Centre, 2018, IMPR CARD REH MEAS A Supervia M, 2019, ECLINICALMEDICINE, V13, P46, DOI 10.1016/j.eclinm.2019.06.006 The British Association for Cardiovascular Prevention and Rehabilitation, 2017, BACPR STAND COR COMP THOMAS N, 2018, HEART LUNG CIRC, P27, DOI DOI 10.1007/978-3-319-90212-8_2 Vernon W, 2009, INT J THER REHABIL, V16, P69, DOI 10.12968/ijtr.2009.16.2.38892 Woodruffe S, 2015, HEART LUNG CIRC, V24, P430, DOI 10.1016/j.hlc.2014.12.008 World Health Organisation, 1993, NEEDS ACT PRIOR CARD, P6 World Health Organization, 2007, PREV CARD DIS GUID A World Health Organization, 2015, NONC DIS FACTSH Zecchin R, 2019, HEART LUNG CIRC, V28, P1622, DOI 10.1016/j.hlc.2018.08.004 NR 61 TC 6 Z9 6 U1 2 U2 4 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 DEC PY 2019 VL 9 IS 12 AR e032279 DI 10.1136/bmjopen-2019-032279 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA KK5HS UT WOS:000512773400159 PM 31796485 OA Green Published, gold DA 2023-05-13 ER PT J AU Breining, A Negers, A Mora, L Moisi, L Golmard, JL Cohen, A Verny, M Collet, JP Boddaert, J AF Breining, Alice Negers, Antonin Mora, Lucie Moisi, Laura Golmard, Jean L. Cohen, Ariel Verny, Marc Collet, Jean P. Boddaert, Jacques TI Determinants of clinical presentation on outcomes in older patients with myocardial infarction SO GERIATRICS & GERONTOLOGY INTERNATIONAL LA English DT Article DE chest pain; comorbidity; mortality; myocardial infarction; older patients ID ACUTE CORONARY SYNDROMES; ILLNESS RATING-SCALE; ELDERLY-PATIENTS; CHEST-PAIN; INVASIVE STRATEGY; GLOBAL REGISTRY; MORTALITY; RISK; COMORBIDITIES; MANAGEMENT AB Aim Myocardial infarction without chest pain misleads the clinician, resulting in a diagnosis delay and an increase of mortality. The main objective of the present study was to determine the risk factors of atypical presentation in older patients with myocardial infarction. Methods All consecutive patients aged >= 75 years presenting with myocardial infarction and hospitalized in the cardiology intensive care unit were included in the present prospective multicenter observational study. All patients benefited from both specialized cardiac management and geriatric assessment. Results A total of 215 consecutive patients were included. The mean age was 85 +/- 6 years. A total of 142 patients (66%) had a typical presentation (i.e. chest pain) and 73 patients (34%) had an atypical clinical presentation (i.e. no chest pain). A total of 29 (13.5%) patients died within 30 days of the index hospitalization. Higher Cumulative Illness Rating Score-Geriatric severity index score (P = 0.019) and initial atrial fibrillation (P = 0.022) were predictive of 30-day all-cause mortality. Typical presentation (P = 0.010) was a protective factor of 30-day all-cause mortality. A Cumulative Illness Rating Score for Geriatrics total score increase (P = 0.0003) and residing in a nursing home (P = 0.024) emerged as independent risk factors for atypical presentation. Conclusions In "real-life" elderly patients, comorbidities influence the prognosis of myocardial infarction, but also clinical presentation. Identification of patients at risk of atypical presentation; that is, patients with multiple comorbid conditions, might help refine the prognostic value in older patients with myocardial infarction. Geriatr Gerontol Int 2018; 18: 1591-1596. C1 [Breining, Alice; Mora, Lucie; Verny, Marc; Boddaert, Jacques] Pitie Salpetriere Charles Foix Univ Hosp, AP HP, DHU FAST, Dept Geriatr, Paris, France. [Negers, Antonin; Moisi, Laura] St Antoine Univ Hosp, AP HP, Acute Geriatr Care Unit, Paris, France. [Golmard, Jean L.] Pitie Salpetriere Charles Foix Univ Hosp, AP HP, Dept Biostat, Paris, France. [Cohen, Ariel] St Antoine Univ Hosp, AP HP, Dept Cardiol, Paris, France. [Verny, Marc; Boddaert, Jacques] Univ Paris 06, UPMC, Sorbonne Univ, Paris, France. [Collet, Jean P.] Pitie Salpetriere Charles Foix Univ Hosp, AP HP, Dept Cardiol, Paris, France. C3 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 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; 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 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 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; 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); 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 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 Breining, A (通讯作者)，Grp Hosp Pitie Salpetriere, Ctr Geriatr, 47-83 Bd Hop, F-75651 Paris 13, France. EM alice.breining@aphp.fr OI breining, alice/0000-0003-4082-3151 CR Bach RG, 2004, ANN INTERN MED, V141, P186, DOI 10.7326/0003-4819-141-3-200408030-00007 Balzi D, 2006, AM HEART J, V151, P1094, DOI 10.1016/j.ahj.2005.06.037 Brieger D, 2004, CHEST, V126, P461, DOI 10.1378/chest.126.2.461 Canto JG, 2000, JAMA-J AM MED ASSOC, V283, P3223, DOI 10.1001/jama.283.24.3223 Canto JG, 2002, AM J CARDIOL, V90, P248, DOI 10.1016/S0002-9149(02)02463-3 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 Coventry LL, 2015, HEART LUNG CIRC, V24, P796, DOI 10.1016/j.hlc.2015.01.015 De Luca G, 2004, EUR HEART J, V25, P1009, DOI 10.1016/j.ehj.2004.03.021 Decourcelle V, 2013, AM J CRIT CARE, V22, pE1, DOI 10.4037/ajcc2013451 Devlin G, 2008, EUR HEART J, V29, P1275, DOI 10.1093/eurheartj/ehn124 Eagle KA, 2004, JAMA-J AM MED ASSOC, V291, P2727, DOI 10.1001/jama.291.22.2727 Galasso G, 2015, AM J CARDIOL, V115, P576, DOI 10.1016/j.amjcard.2014.12.005 GILLUM RF, 1984, AM HEART J, V108, P150, DOI 10.1016/0002-8703(84)90558-1 Hudon C, 2005, J CLIN EPIDEMIOL, V58, P603, DOI 10.1016/j.jclinepi.2004.10.017 Hwang SY, 2009, J KOREAN MED SCI, V24, P789, DOI 10.3346/jkms.2009.24.5.789 INOUYE SK, 1990, ANN INTERN MED, V113, P941, DOI 10.7326/0003-4819-113-12-941 Jackson CA, 2015, AGE AGEING, V44, P810, DOI 10.1093/ageing/afv095 KATZ S, 1970, GERONTOLOGIST, V10, P20, DOI 10.1093/geront/10.1_Part_1.20 Krumholz HM, 2001, J AM COLL CARDIOL, V38, P453, DOI 10.1016/S0735-1097(01)01395-X LAWTON MP, 1969, GERONTOLOGIST, V9, P179, DOI 10.1093/geront/9.3_Part_1.179 Manfrini O, 2016, INT J CARDIOL, V217, pS37, DOI 10.1016/j.ijcard.2016.06.221 MEDALIE JH, 1976, ANN INTERN MED, V84, P526, DOI 10.7326/0003-4819-84-5-526 MILLER MD, 1992, PSYCHIAT RES, V41, P237, DOI 10.1016/0165-1781(92)90005-N Nagaratnam N, 2007, ARCH GERONTOL GERIAT, V44, P29, DOI 10.1016/j.archger.2006.02.002 Negers A, 2017, J GERIATR CARDIOL, V14, P465, DOI 10.11909/j.issn.1671-5411.2017.07.001 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 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 Vassalli G, 2015, SWISS MED WKLY, V145, DOI 10.4414/smw.2015.14049 Yang XD, 2011, J GERIATR CARDIOL, V8, P31, DOI 10.3724/SP.J.1263.2011.00031 NR 30 TC 5 Z9 5 U1 0 U2 3 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 DEC PY 2018 VL 18 IS 12 BP 1591 EP 1596 DI 10.1111/ggi.13530 PG 6 WC Geriatrics & Gerontology; Gerontology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Geriatrics & Gerontology GA HE1QD UT WOS:000453046900002 PM 30311337 DA 2023-05-13 ER PT J AU Miller, DD AF Miller, D. Douglas TI Machine Intelligence in Cardiovascular Medicine SO CARDIOLOGY IN REVIEW LA English DT Review DE artificial intelligence; machine learning; artificial neural networks; algorithms; data science ID MYOCARDIAL-PERFUSION SPECT; CORONARY-ARTERY-DISEASE; ARTIFICIAL-INTELLIGENCE; HEART-FAILURE; HEALTH-CARE; PREDICTION; ISCHEMIA; ETHICS; PCA AB The computer science technology trend called artificial intelligence (AI) is not new. Both machine learning and deep learning AI applications have recently begun to impact cardiovascular medicine. Scientists working in the AI domain have long recognized the importance of data quality and provenance to AI algorithm efficiency and accuracy. A diverse array of cardiovascular raw data sources of variable quality-electronic medical records, radiological picture archiving and communication systems, laboratory results, omics, etc.-are available to train AI algorithms for predictive modeling of clinical outcomes (in-hospital mortality, acute coronary syndrome risk stratification, etc.), accelerated image interpretation (edge detection, tissue characterization, etc.) and enhanced phenotyping of heterogeneous conditions (heart failure with preserved ejection fraction, hypertension, etc.). A number of software as medical device narrow AI products for cardiac arrhythmia characterization and advanced image deconvolution are now Food and Drug Administration approved, and many others are in the pipeline. Present and future health professionals using AI-infused analytics and wearable devices have 3 critical roles to play in their informed development and ethical application in practice: (1) medical domain experts providing clinical context to computer and data scientists, (2) data stewards assuring the quality, relevance and provenance of data inputs, and (3) real-time and post-hoc interpreters of AI black box solutions and recommendations to patients. The next wave of so-called contextual adaption AI technologies will more closely approximate human decision-making, potentially augmenting cardiologists' real-time performance in emergency rooms, catheterization laboratories, imaging suites, and clinics. However, before such higher order AI technologies are adopted in the clinical setting and by healthcare systems, regulatory agencies, and industry must jointly develop robust AI standards of practice and transparent technology insertion rule sets. C1 [Miller, D. Douglas] Med Coll Georgia, Dept Med Radiol & Populat Hlth Sci, Augusta, GA USA. C3 University System of Georgia; Augusta University RP Miller, DD (通讯作者)，Med Coll Georgia GB 3330, 1120 15th St, Augusta, GA 30912 USA. 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Rev. PD MAR-APR PY 2020 VL 28 IS 2 BP 53 EP 64 DI 10.1097/CRD.0000000000000294 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA LH5LL UT WOS:000528826400001 PM 32022759 DA 2023-05-13 ER PT J AU Wu, KH Cheng, SY Yen, YL Wu, CH Tsai, MT Cheng, FJ AF Wu, Kuan-Han Cheng, Shih-Yu Yen, Yung-Lin Wu, Chien-Hung Tsai, Ming-Ta Cheng, Fu-Jen TI An analysis of causative factors in closed criminal medical malpractice cases of the Taiwan Supreme Court: 2000-2014 SO LEGAL MEDICINE LA English DT Article DE Malpractice; Criminal; Taiwan ID CLAIMS; RISK; PHYSICIANS; CARE AB Most medical malpractice in Taiwan leads to criminal prosecution. This study examined the epidemiologic factors and clinical errors that led to medical malpractice convictions in Taiwanese criminal prosecutions. A retrospective, 15-year population-based review of criminal Supreme Court judgments pertaining to medical malpractice against physicians and nurses was conducted. Eighty-four cases were reviewed, yielding data that included the number and specialty involved, accused hospitals, the diagnosis, the time interval between incidents to closure, result of adjudication, the origin of cases (private vs. public prosecution), the result of medical appraisal, and the primary error. Overall, the cases averaged 7.6 years to achieve final adjudication. Seventy-five percent were settled in favor of the clinician; twenty-three physicians and three nurses were found guilty, but all of these avoided imprisonment via probation or replacement with forfeit. The single most risky specialty was emergency medicine (22.6% of the cases), with 36.8% of those resulting in guilty verdicts. The most common diagnosis groups were infectious diseases (23.8%), intracranial hemorrhages (10.7%), and acute coronary syndrome (9.5%). Public prosecutions had a 41.2% conviction rate; no guilty verdicts resulted from private prosecution. Nineteen (22.6%) cases were commuted, and 73.7% of those had a controversial appraisal result. The characteristics of criminal malpractice prosecution in Taiwan that could be improved to relieve the stress of frivolous lawsuits on the judicial process include lengthy jurisdiction process; low public-prosecution conviction rate; frequent commuted jurisdiction related to a controversial appraisal; and zero imprisonment rate for clinicians. (C) 2016 Elsevier Ireland Ltd. All rights reserved. C1 [Wu, Kuan-Han; Cheng, Shih-Yu; Yen, Yung-Lin; Wu, Chien-Hung; Tsai, Ming-Ta; Cheng, Fu-Jen] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Emergency Med, 123 Dapi Rd, Niaosong Township 833, Kaohsiung Count, Taiwan. C3 Chang Gung Memorial Hospital; Chang Gung University RP Wu, KH (通讯作者)，21F-3,123-11 Dapi Rd, Niaosong Township 833, Kaohsiung Count, Taiwan. EM hayatowu1120@gmail.com FU Kaohsiung Chang Gung Memorial Hospital [CMRP-G8E0471] FX This study was supported in part by research grants from the Kaohsiung Chang Gung Memorial Hospital (CMRP-G8E0471). CR Alhafaji Y, 2012, MED LAW, V31, P567 Baskerville JR, 2012, AM J EMERG MED, V30, P367, DOI 10.1016/j.ajem.2010.12.008 Di Landro AR, 2012, MED LAW, V31, P221 Ger Jiin, 2009, Leg Med (Tokyo), V11 Suppl 1, pS135, DOI 10.1016/j.legalmed.2009.01.032 Jena AB, 2011, NEW ENGL J MED, V365, P629, DOI 10.1056/NEJMsa1012370 Leflar RB, 2009, CLIN ORTHOP RELAT R, V467, P443, DOI 10.1007/s11999-008-0602-z Lin Pyng Jing, 2009, Leg Med (Tokyo), V11 Suppl 1, pS376, DOI 10.1016/j.legalmed.2009.01.006 Mello MM, 2010, HEALTH AFFAIR, V29, P1569, DOI 10.1377/hlthaff.2009.0807 Pettker CM, 2014, AM J OBSTET GYNECOL, V211, P319, DOI 10.1016/j.ajog.2014.04.038 Phillips RL, 2004, QUAL SAF HEALTH CARE, V13, P121, DOI 10.1136/qshc.2003.008029 Rohacek M, 2012, INTENS CARE MED, V38, P1345, DOI 10.1007/s00134-012-2595-z Stevenson DG, 2013, MED CARE, V51, P430, DOI 10.1097/MLR.0b013e3182881ccc Studdert DM, 2005, JAMA-J AM MED ASSOC, V293, P2609, DOI 10.1001/jama.293.21.2609 Wu KH, 2016, INT J QUAL HEALTH C, V28, P47, DOI 10.1093/intqhc/mzv093 Wu KH, 2014, AM J EMERG MED, V32, P990, DOI 10.1016/j.ajem.2014.05.033 Zhu S, 2011, LEGAL MED-TOKYO, V13, P116, DOI 10.1016/j.legalmed.2010.12.003 NR 16 TC 7 Z9 8 U1 0 U2 7 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 1344-6223 J9 LEGAL MED-TOKYO JI Leg. Med. PD NOV PY 2016 VL 23 BP 71 EP 76 DI 10.1016/j.legalmed.2016.10.001 PG 6 WC Medicine, Legal; Social Sciences, Biomedical WE Science Citation Index Expanded (SCI-EXPANDED) SC Legal Medicine; Biomedical Social Sciences GA EF7NW UT WOS:000390517300013 PM 27890107 DA 2023-05-13 ER PT J AU Cutlip, DE Kereiakes, DJ Mauri, L Stoler, R Dauerman, HL AF Cutlip, Donald E. Kereiakes, Dean J. Mauri, Laura Stoler, Robert Dauerman, Harold L. CA EDUCATE Investigators TI Thrombotic Complications Associated With Early and Late Nonadherence to Dual Antiplatelet Therapy SO JACC-CARDIOVASCULAR INTERVENTIONS LA English DT Article DE antiplatelet therapy; stent; thrombosis ID DRUG-ELUTING STENTS; PERCUTANEOUS CORONARY INTERVENTION; CARDIAC EVENTS; IMPLANTATION; DISCONTINUATION; PREDICTORS; DURATION; TRIAL; MULTICENTER; EFFICACY AB OBJECTIVES This study sought to assess the frequency and clinical impact of dual antiplatelet therapy (DAPT) nonadherence. BACKGROUND There are limited data on the impact of DAPT nonadherence during the first year after a second-generation drug-eluting stent placement. METHODS After successful Endeavor zotarolimus-eluting stent implantation, 2,265 patients were enrolled in a registry with limited exclusions and monitored during 12 months of prescribed DAPT. Predictors of any nonadherence (ANA) at 6 months were analyzed by multivariable analysis, and the association between ANA at 6 or 12 months with the endpoints of death, myocardial infarction, and stent thrombosis was assessed. RESULTS The study population included 30% female patients, 34% with diabetes and 36% with acute coronary syndromes. ANA occurred in 208 patients (9.6%) before 6 months and 378 patients (18.5%) before 1 year. Major bleeding (odds ratio [OR]: 12.83, 95% confidence interval [CI]: 7.55 to 21.80, p < 0.001) was the only predictor of ANA at 6 months. In time-dependent analyses, ANA before 6 months was associated with an increased risk of death or myocardial infarction (7.6% vs. 3.0%, p < 0.001) and a numerical increase in stent thrombosis (2.0% vs. 0.9%, p = 0.12). After adjustment for baseline differences, ANA within 6 months remained associated with death or MI (OR: 1.95, 95% CI: 1.02 to 3.75). ANA occurring after 6 months did not increase the risk of subsequent ischemic events. CONCLUSIONS DAPT ANA occurs frequently and is associated with increased risk for thrombotic complications if it occurs within the first 6 months. Major bleeding was a significant correlate of DAPT ANA within 6 months. (EDUCATE: The MEDTRONIC Endeavor Drug Eluting Stenting: Understanding Care, Antiplatelet Agents and Thrombotic Events; NCT01069003) (C) 2015 by the American College of Cardiology Foundation. C1 [Cutlip, Donald E.] Beth Israel Deaconess Med Ctr, Dept Med, Div Cardiol, Boston, MA 02215 USA. [Cutlip, Donald E.; Mauri, Laura] Harvard Univ, Sch Med, Boston, MA USA. [Kereiakes, Dean J.] Christ Hosp, Heart & Vasc Ctr, Cincinnati, OH 45219 USA. [Kereiakes, Dean J.] Lindner Res Ctr, Cincinnati, OH USA. [Mauri, Laura] Brigham & Womens Hosp, Dept Med, Div Cardiol, Boston, MA 02115 USA. [Stoler, Robert] Baylor Univ, Med Ctr, Coll Med, Texas A&M Hlth Sci Ctr,Baylor Heart & Vasc Inst, Dallas, TX USA. [Dauerman, Harold L.] Univ Vermont, Coll Med, Div Cardiol, Burlington, VT USA. C3 Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Harvard Medical School; Christ Hospital - Ohio; Harvard University; Brigham & Women's Hospital; Baylor University; Baylor University Medical Center; Texas A&M University System; Texas A&M University College Station; Texas A&M Health Science Center; University of Vermont RP Cutlip, DE (通讯作者)，Beth Israel Deaconess Med Ctr, 330 Brookline Ave, Boston, MA 02215 USA. EM dcutlip@bidmc.harvard.edu RI mauri, laura/GPS-4868-2022 FU Medtronic; Boston Scientific; Abbott Vascular; Celonova; Medpace; Ablative Solution Inc.; REVA Medical Inc.; Sanofi-Aventis; Bristol-Myers Squibb; Eli Lilly; Daiichi Sankyo; Biotronik; St. Jude Medical; Volcano Corporation; Medicines Company FX The study was funded by Medtronic. Medtronic provided data management and statistical analysis for the manuscript. Dr. Cutlip has received research grants or other funding paid to his institution from Medtronic, Boston Scientific, Abbott Vascular, and Celonova. Dr. Kereiakes has received consulting fees from Medpace, Ablative Solution Inc., Boston Scientific, Abbott Vascular, and REVA Medical Inc. Dr. Mauri has received research grants paid to her institution from Abbott Vascular, Boston Scientific, Cordis, Medtronic, Sanofi-Aventis, Bristol-Myers Squibb, Eli Lilly, and Daiichi Sankyo; and has received consulting fees from Medtronic, Biotronik, and St. Jude Medical. Dr. Stoler has received consulting fees from Medtronic and Boston Scientific; has served on the advisory boards of Medtronic and Boston Scientific; has received speaker fees from Volcano Corporation; and has served as a national proctor for CoreValve and Medtronic. Dr. Dauerman has received research grants from Medtronic and Abbott Vascular; and has received consulting fees from Medtronic and The Medicines Company. 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Interv. PD MAR PY 2015 VL 8 IS 3 BP 404 EP 410 DI 10.1016/j.jcin.2014.10.017 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CD6TC UT WOS:000351221300011 PM 25703885 OA Bronze DA 2023-05-13 ER PT J AU Zhang, HM Lauver, DA Hollenberg, PF AF Zhang, Haoming Lauver, D. Adam Hollenberg, Paul F. TI CYP-independent inhibition of platelet aggregation in rabbits by a mixed disulfide conjugate of clopidogrel SO THROMBOSIS AND HAEMOSTASIS LA English DT Article DE Clopidogrel; antiplatelet; mixed disulfide conjugate; inter-individual variability; active metabolite ID PHARMACOLOGICALLY ACTIVE METABOLITE; ELEVATION MYOCARDIAL-INFARCTION; ANTIAGGREGATING ACTIVITY; ANTIPLATELET AGENT; PRASUGREL; CYTOCHROME-P450; IDENTIFICATION; BIOACTIVATION; GLUTAREDOXIN; GLUTATHIONE AB Dual antiplatelet therapy with clopidogrel and aspirin has been the standard of care in the United States for patients with acute coronary syndromes (ACS) and/or undergoing percutaneous coronary interventions (PCI). However, the effectiveness of clopidogrel varies significantly among different sub-populations due to inter-individual variability. In this study we examined the antiplatelet potential of a novel mixed disulfide conjugate of clopidogrel with the aim to overcome the inter-individual variability. In the metabolic studies using human liver microsomes and cDNA-expressed P450s, we confirmed that multiple P450s are involved in the bioactivation of 2-oxoclopidogrel to H4, one of the diastereomers of the pharmacologically active metabolite (AM) possessing antiplatelet activity. Results from kinetic studies demonstrated that 2C19 is the most active in converting 2-oxoclopidogrel to H4 with a catalytic efficiency of 0.027 mu M(-1)min(-1) in the reconstituted system. On the basis of this finding, we were able to biosynthesise the conjugate of clopidogrel with 3-nitropyridine-2-thiol, referred to as clopNPT, and examined its antiplatelet activity in male New Zealand white rabbits. After administration as intravenous bolus at 2 mg/kg, the clopNPT conjugate was rapidly converted to the AM leading to the inhibition of platelet aggregation (IPA). Analyses of the blood samples drawn at various time points showed that intravenous administration of clopNPT led to similar to 70% IPA within 1 hour and the IPA persisted for more than 3 hours. Since the antiplatelet activity of clopNPT does not require bioactivation by P450s, the mixed disulfide conjugate of clopidogrel has the potential to overcome the inter-individual variability in clopidogrel therapy. C1 [Zhang, Haoming; Lauver, D. Adam; Hollenberg, Paul F.] Univ Michigan, Sch Med, Dept Pharmacol, Ann Arbor, MI 48109 USA. C3 University of Michigan System; University of Michigan RP Zhang, HM (通讯作者)，Univ Michigan, Sch Med, Dept Pharmacol, 1150 West Med Ctr Dr,2220A MSRB 3, Ann Arbor, MI 48109 USA. 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PD DEC PY 2014 VL 112 IS 6 BP 1304 EP 1311 DI 10.1160/TH14-04-0388 PG 8 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA AW1HJ UT WOS:000346040500026 PM 25230737 DA 2023-05-13 ER PT J AU Anastasiadis, K Antonitsis, P Haidich, AB Argiriadou, H Deliopoulos, A Papakonstantinou, C AF Anastasiadis, Kyriakos Antonitsis, Polychronis Haidich, Anna-Bettina Argiriadou, Helena Deliopoulos, Apostolos Papakonstantinou, Christos TI Use of minimal extracorporeal circulation improves outcome after heart surgery; a systematic review and meta-analysis of randomized controlled trials SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Review DE Minimal extracorporeal circulation; Cardiopulmonary bypass; Coronary artery bypass grafting; Meta-analysis ID CONVENTIONAL CARDIOPULMONARY BYPASS; INVASIVE CLOSED-CIRCUIT; ACUTE KIDNEY INJURY; INFLAMMATORY RESPONSE; AORTIC-VALVE; BEATING-HEART; ON-PUMP; MYOCARDIAL REVASCULARIZATION; CARDIOTOMY SUCTION; CORONARY AB Background: The question whether use of minimal extracorporeal circulation (MECC) influences patients' outcome remains unanswered. We performed a systemic review of the literature and a meta-analysis of randomized controlled trials to evaluate the impact of MECC compared to conventional extracorporeal circulation (CECC) on mortality and major adverse cardiovascular events in patients undergoing heart surgery. Methods: We independently conducted a systemic review of English and non-English articles using Medline, Embase and Cochrane database. Random allocation to treatment with a minimum of 40 patients in both groups was considered mandatory for inclusion in the meta-analysis. Primary outcomes were operative mortality and major adverse cardiac and cerebrovascular events comprising death before discharge, myocardial infarction and neurologic damage. Results: We included 24 studies comparing MECC vs. CECC with a total of 2770 patients. Use of MECC was associated with a significant decrease in mortality (0.5% vs. 1.7%, P=0.02), in the risk of postoperative myocardial infarction (1.0% vs. 3.8%, P=0.03) and reduced rate of neurologic events (2.3% vs. 4.0%, P=0.08). Additionally, MECC was associated with reduced systemic inflammatory response as measured by polymorphonuclear elastase, hemodilution as calculated by hematocrit drop after procedure, need for red blood cell transfusion, reduced levels of peak troponin release, incidence of low cardiac output syndrome, need for inotropic support, peak creatinine level, occurrence of postoperative atrial fibrillation, duration of mechanical ventilation and intensive care unit stay. Conclusions: Use of MECC in heart surgery resulted in improved short-term outcome as reflected by reduced mortality and morbidity compared with conventional extracorporeal circulation. (C) 2012 Elsevier Ireland Ltd. All rights reserved. C1 [Anastasiadis, Kyriakos; Antonitsis, Polychronis; Argiriadou, Helena; Deliopoulos, Apostolos; Papakonstantinou, Christos] Aristotle Univ Thessaloniki, Dept Cardiothorac Surg, AHEPA Hosp, GR-54006 Thessaloniki, Greece. [Haidich, Anna-Bettina] Aristotle Univ Thessaloniki, Sch Med, Dept Med Stat, Hyg Lab, GR-54006 Thessaloniki, Greece. C3 Aristotle University of Thessaloniki; Ahepa University Hospital; Aristotle University of Thessaloniki RP Antonitsis, P (通讯作者)，Sakellaridi 25, Thessaloniki 54248, Greece. 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PD APR 5 PY 2013 VL 164 IS 2 BP 158 EP 169 DI 10.1016/j.ijcard.2012.01.020 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 112NO UT WOS:000316599200009 PM 22325958 DA 2023-05-13 ER PT J AU Gobel, S Schwuchow-Thonke, S Jansen, T Karbach, S Emrich, T Gori, T Knies, F Schulz, E Munzel, T Keller, K Wenzel, P AF Goebel, Sebastian Schwuchow-Thonke, Soeren Jansen, Thomas Karbach, Susanne Emrich, Tilman Gori, Tommaso Knies, Finja Schulz, Eberhard Muenzel, Thomas Keller, Karsten Wenzel, Philip TI Safety of transradial and transfemoral left ventricular compared with transfemoral right ventricular endomyocardial biopsy SO ESC HEART FAILURE LA English DT Article DE Heart failure; Endomyocardial biopsy; Access site; Transradial artery access; Complication rate ID ACUTE CORONARY SYNDROMES; COMPLICATION RATE; DIAGNOSTIC-PROCEDURES; EUROPEAN-SOCIETY; FEMORAL APPROACH; ACCESS; MANAGEMENT; INTERVENTION; FEASIBILITY; MYOCARDITIS AB Aims With the present study, we sought to determine the safety of three different endomyocardial biopsy (EMB) access routes in 514 patients admitted for diagnostic workup of heart failure of unknown aetiology. Methods and results In this retrospective monocentric cohort study, we analysed 514 consecutive patients with heart failure without evidence of significant coronary artery disease or valvular disease undergoing EMB between November 2013 and December 2018, stratified in three access route groups: transradial arterial left ventricular (LV-)EMB (323 patients), transfemoral LV-EMB (138 patients), and transfemoral right ventricular (RV-)EMB (53 patients). Patients undergoing selective transradial LV-EMB were older compared with patients undergoing selective transfemoral LV-EMB or RV-EMB [transradial LV-EMB: 56.0 (45.0/64.0) vs. transfemoral LV-EMB: 53 (42.5/64.5), P = 0.455; transradial LV-EMB: 56 (45.0/64.0) vs. RV-EMB: 53 (42.5/64), P = 0.695] and presented more often in New York Heart Association-functional class III and IV. A total of eight major complications including permanent atrioventricular block requiring pacemaker implantation, pericardial tamponade necessitating pericardiocentesis, stroke and transient cerebral ischaemic attack as well as severe valvular damage, vascular access site complications, and ventricular fibrillation were documented with no significant differences between the groups (8/514, 1.5%). Minor complications such as transient chest pain, non-sustained electrocardiogram abnormalities, and transient atrioventricular block were rare and equally distributed between groups. Conclusions Transradial LV-EMB is a safe procedure for experienced radial operators and non-inferior compared with transfemoral LV-EMB and RV-EMB. An accurate peri-procedural and post-procedural monitoring and follow-up care should be recommended for all patients undergoing this procedure in order to identify potential complications. C1 [Goebel, Sebastian; Schwuchow-Thonke, Soeren; Jansen, Thomas; Karbach, Susanne; Gori, Tommaso; Knies, Finja; Schulz, Eberhard; Muenzel, Thomas; Keller, Karsten; Wenzel, Philip] Univ Med Ctr Mainz, Dept Cardiol, Langenbeckstr 1, D-55131 Mainz, Germany. [Goebel, Sebastian; Karbach, Susanne; Emrich, Tilman; Gori, Tommaso; Muenzel, Thomas; Keller, Karsten; Wenzel, Philip] 2German Ctr Cardiovascular Res DZHK, Partner Site Rhine Main, Mainz, Germany. [Karbach, Susanne; Wenzel, Philip] Ctr Thrombosis & Hemostasis, Mainz, Germany. [Emrich, Tilman] Univ Med Ctr Mainz, Ctr Diagnost & Intervent Radiol, Mainz, Germany. C3 Johannes Gutenberg University of Mainz; Johannes Gutenberg University of Mainz RP Wenzel, P (通讯作者)，Johannes Gutenberg Univ Mainz, Univ Med Ctr Mainz, Dept Cardiol, Langenbeckstr 1, D-55131 Mainz, Germany. EM wenzelp@uni-mainz.de RI Wenzel, Philip/Z-1503-2019; Wenzel, Philip/HIA-0033-2022; Gori, Tommaso/F-1575-2012; Karbach, Susanne/GPC-8804-2022; Munzel, Thomas/A-2912-2014 OI Wenzel, Philip/0000-0002-5397-2781; Wenzel, Philip/0000-0002-5397-2781; Munzel, Thomas/0000-0001-5503-4150; Emrich, Tilman/0000-0003-4156-7727 FU German Federal Ministry for Education and Research [Bundesministerium fur Bildung und Forschung (BMBF)] [01EO1503]; P.W. are Principal Investigators of the German Center for Cardiovascular Research (DZHK) FX P.W. was supported by grants from the German Federal Ministry for Education and Research [Bundesministerium fur Bildung und Forschung (BMBF) 01EO1503]. T.M. and P.W. are Principal Investigators of the German Center for Cardiovascular Research (DZHK). 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PD DEC PY 2020 VL 7 IS 6 BP 4015 EP 4023 DI 10.1002/ehf2.13006 EA SEP 2020 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PI0KH UT WOS:000570718200001 PM 32949187 OA Green Published, gold DA 2023-05-13 ER PT J AU Sharma, AS Pijls, RWM Weerwind, PW Delnoij, TSR de Jong, WC Gorgels, APM Maessen, JG AF Sharma, A. S. Pijls, R. W. M. Weerwind, P. W. Delnoij, T. S. R. de Jong, W. C. Gorgels, A. P. M. Maessen, J. G. TI Out-of-hospital cardiac arrest: the prospect of E-CPR in the Maastricht region SO NETHERLANDS HEART JOURNAL LA English DT Article DE Out-of-hospital cardiac arrest; Resuscitation; Shockable rhythm; Return of spontaneous circulation; Survivors; Extracorporeal cardiopulmonary resuscitation ID EXTRACORPOREAL LIFE-SUPPORT; CARDIOPULMONARY-RESUSCITATION; SURVIVAL; HEART; PROFESSIONALS; ASSOCIATION; MANAGEMENT; AMSTERDAM; STATEMENT; COMMITTEE AB Aim The current outcome of out-of-hospital cardiac arrest (OHCA) patients in the Maastricht region was analysed with the prospect of implementing extracorporeal cardiopulmonary resuscitation (E-CPR). Methods A retrospective analysis of adult patients who were resuscitated for OHCA during a 24-month period was performed. Results 195 patients (age 66 [57-75] years, 82 % male) were resuscitated for OHCA by the emergency medical services and survived to admission at the emergency department. Survival to hospital discharge was 46.2 %. Notable differences between non-survivors and survivors were observed and included: age (70 [58-79] years) vs. (63 [55-72] years, p = 0.01), chronic heart failure (18 vs. 7 %, p = 0.02), shockable rhythm (67 vs. 99 %, p < 0.01), and return of spontaneous circulation (ROSC) at departure from the site of the arrest (46 vs. 99 %, p < 0.01) and on arrival to the emergency department (43 vs. 98 %, p < 0.01), respectively. Acute coronary syndrome was diagnosed in 32 % of non-survivors vs. 59 % among survivors, p < 0.01. Therapeutic hypothermia was provided in non-survivors (20 %) vs. survivors (43 %), p < 0.01. Percutaneous coronary intervention (PCI) was performed in 14 % of non-survivors while 52 % of survivors received PCI (p < 0.01). No statistical significance was observed in terms of gender, witnessed arrest, bystander CPR, or automated external defibrillator deployed among the cohort. At hospital discharge, moderately severe neurological disability was present in six survivors. Conclusion These observations are compatible with the notion that a shockable rhythm, ROSC, and post-arrest care improve survival outcome. Potentially, initiating E-CPR in the resuscitation phase in patients with a shockable rhythm and no ROSC might serve as a bridge to definite treatment and improve survival outcome. C1 [Sharma, A. S.; Weerwind, P. W.; Maessen, J. G.] Maastricht Univ, Med Ctr, Dept Cardiothorac Surg, P Debyelaan 25, NL-6202 AZ Maastricht, Netherlands. [Pijls, R. W. M.; Delnoij, T. S. R.; Gorgels, A. P. M.] Maastricht Univ, Med Ctr, Dept Cardiol, NL-6202 AZ Maastricht, Netherlands. [Delnoij, T. S. R.] Maastricht Univ, Med Ctr, Dept Cardiol & Intens Care, NL-6202 AZ Maastricht, Netherlands. [de Jong, W. C.] Maastricht Univ, Med Ctr, Dept Transplantat, Cardiovasc Res Inst Maastricht, NL-6202 AZ Maastricht, Netherlands. C3 Maastricht University; Maastricht University Medical Centre (MUMC); Maastricht University; Maastricht University; Maastricht University RP Sharma, AS (通讯作者)，Maastricht Univ, Med Ctr, Dept Cardiothorac Surg, P Debyelaan 25, NL-6202 AZ Maastricht, Netherlands. EM ajay.sharma@maastrichtuniversity.nl OI Maessen, Jos G/0000-0003-3230-7712 CR Blom MT, 2014, CIRCULATION, V130, P1868, DOI 10.1161/CIRCULATIONAHA.114.010905 Boyce LW, 2015, NETH HEART J, V23, P20, DOI 10.1007/s12471-014-0617-x Cave DM, 2010, CIRCULATION, V122, pS720, DOI 10.1161/CIRCULATIONAHA.110.970970 Chan PS, 2014, CIRCULATION, V130, P1876, DOI 10.1161/CIRCULATIONAHA.114.009711 Chen YS, 2008, LANCET, V372, P554, DOI 10.1016/S0140-6736(08)60958-7 Conseil francais de reanimation cardiopulmonaire, 2009, Ann Fr Anesth Reanim, V28, P182, DOI 10.1016/j.annfar.2008.12.011 CUMMINS RO, 1991, CIRCULATION, V83, P1832, DOI 10.1161/01.CIR.83.5.1832 deVreedeSwagemakers JJM, 1997, J AM COLL CARDIOL, V30, P1500, DOI 10.1016/S0735-1097(97)00355-0 Fagnoul D, 2013, RESUSCITATION, V84, P1519, DOI 10.1016/j.resuscitation.2013.06.016 Frydlandad M, 2015, RESUSCITATION, V89, P142, DOI 10.1016/j.resuscitation.2014.12.033 Jacobs I, 2004, RESUSCITATION, V63, P233, DOI 10.1016/j.resuscitation.2004.09.008 Johnson NJ, 2014, RESUSCITATION, V85, P1527, DOI 10.1016/j.resuscitation.2014.08.028 Kagawa E, 2012, CIRCULATION, V126, P1605, DOI 10.1161/CIRCULATIONAHA.111.067538 Koster RW, 2015, NETH HEART J, V23, P18, DOI 10.1007/s12471-014-0635-8 Poppe M, 2015, RESUSCITATION, V91, P131, DOI 10.1016/j.resuscitation.2015.03.003 Proclemer A, 2012, EUROPACE, V14, P1195, DOI 10.1093/europace/eus232 RANKIN J, 1957, Scott Med J, V2, P200 Reynolds JC, 2013, CIRCULATION, V128, P2488, DOI 10.1161/CIRCULATIONAHA.113.002408 Sasson C, 2010, CIRC-CARDIOVASC QUAL, V3, P63, DOI 10.1161/CIRCOUTCOMES.109.889576 Waalewijn RA, 1998, RESUSCITATION, V38, P157, DOI 10.1016/S0300-9572(98)00102-6 Wang HE, 2012, RESUSCITATION, V83, P1343, DOI 10.1016/j.resuscitation.2012.07.013 Zive D, 2011, RESUSCITATION, V82, P277, DOI 10.1016/j.resuscitation.2010.10.022 NR 22 TC 8 Z9 9 U1 0 U2 1 PU BOHN STAFLEU VAN LOGHUM BV PI HOUTEN PA POSTBUS 246, 3990 GA HOUTEN, NETHERLANDS SN 1568-5888 EI 1876-6250 J9 NETH HEART J JI Neth. Heart J. PD FEB PY 2016 VL 24 IS 2 BP 120 EP 126 DI 10.1007/s12471-015-0782-6 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DK1YS UT WOS:000374712200005 PM 26728052 OA Green Published, gold DA 2023-05-13 ER PT J AU Sinnadurai, S Sowa, P Jankowski, P Gasior, Z Kosior, DA Haberka, M Czarnecka, D Pajak, A Setny, M Jamiolkowski, J Lapinska, M Kaminski, KA AF Sinnadurai, Siamala Sowa, Pawel Jankowski, Piotr Gasior, Zbigniew Kosior, Dariusz A. Haberka, Maciej Czarnecka, Danuta Pajak, Andrzej Setny, Malgorzata Jamiolkowski, Jacek Lapinska, Magda Kaminski, Karol A. TI Effects of cardiac rehabilitation on risk factor management and quality of life in patients with ischemic heart disease: a multicenter cross-sectional study SO POLISH ARCHIVES OF INTERNAL MEDICINE-POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ LA English DT Article DE cardiac  rehabilitation; ischemic heart disease; propensity; score matching  risk factors; secondary cardiovascular  prevention ID SECONDARY PREVENTION; POSTMYOCARDIAL INFARCTION; CORE COMPONENTS; CORONARY; ASSOCIATION; PROGRAM; CARE; ENROLLMENT; STATEMENT AB INTRODUCTION While cardiac rehabilitation (CR) improves survival outcomes in patients with ischemic heart disease (IHD), the long-term benefits of short-term programs are still discussed. OBJECTIVES The aim of the study was to assess the impact of CR on risk factor management in a multicenter real-life registry of patients with IHD. PATIENTS AND METHODS We included patients aged 80 years or younger who had been hospitalized due to acute coronary syndrome or for a myocardial revascularization procedure and interviewed 6 to 18 months later. Control of risk factors was compared between patients who participated in CR and those who did not. Propensity score matching was used to account for differences in patient characteristics between the groups. RESULTS Of 1012 interviewed patients (28.6% women), 35.6% were referred for CR and 76.1% of them completed the program. Those referred were younger (P <0.001), employed (P <0.001), have presented with ST-segment elevation myocardial infarction (P <0.001), had hypertension (P <0.001), and were current smokers (P <0.001). Logistics regression revealed that patients who participated in CR were more likely to stop smoking (odds ratio [OR], 2.42; 95% CI, 1.3 3-4.14), achieve acceptable glucose control (OR, 1.70; 95% CI, 1.02-2.83), and better quality of life (beta = 0.12; 95% CI, 0.00-0.24) compared with those who did not participate in CR. CONCLUSIONS Cardiac rehabilitation is moderately effective if performed only once and without a continuous support program. Further efforts to increase referrals for CR in patients with IHD must be C1 [Sinnadurai, Siamala; Sowa, Pawel; Jamiolkowski, Jacek; Lapinska, Magda; Kaminski, Karol A.] Med Univ Bialystok, Fac Med, Dept Populat Med & Lifestyle Dis Prevent, Div Dent, Ul Jerzego Waszyngtona 13A, PL-15269 Bialystok, Poland. [Sinnadurai, Siamala; Sowa, Pawel; Jamiolkowski, Jacek; Lapinska, Magda; Kaminski, Karol A.] Med Univ Bialystok, Div Med Educ English, Ul Jerzego Waszyngtona 13A, PL-15269 Bialystok, Poland. [Jankowski, Piotr; Czarnecka, Danuta] Jagiellonian Univ, Coll Med, Inst Cardiol, Dept Cardiol Intervent Elect & Hypertens, Krakow, Poland. [Gasior, Zbigniew; Haberka, Maciej] Med Univ Silesia, Sch Hlth Sci, Dept Cardiol, Katowice, Poland. [Kosior, Dariusz A.; Setny, Malgorzata] Cent Res Hosp, Minist Interior & Adm, Dept Cardiol & Hypertens, Electrophysiol Lab, Warsaw, Poland. [Kosior, Dariusz A.] Cardinal Stefan Wyszynski Univ Warsaw, Fac Med, Warsaw, Poland. [Pajak, Andrzej] Jagiellonian Univ, Coll Med, Fac Hlth Sci, Dept Epidemiol & Populat Studies, Krakow, Poland. C3 Medical University of Bialystok; Medical University of Bialystok; Jagiellonian University; Collegium Medicum Jagiellonian University; Medical University Silesia; Cardinal Stefan Wyszynski University in Warsaw; Jagiellonian University; Collegium Medicum Jagiellonian University RP Kaminski, KA (通讯作者)，Med Univ Bialystok, Fac Med, Dept Populat Med & Lifestyle Dis Prevent, Div Dent, Ul Jerzego Waszyngtona 13A, PL-15269 Bialystok, Poland.; Kaminski, KA (通讯作者)，Med Univ Bialystok, Div Med Educ English, Ul Jerzego Waszyngtona 13A, PL-15269 Bialystok, Poland. EM fizklin@wp.pl RI Jamiolkowski, Jacek/T-6324-2018; Kaminski, Karol/J-4515-2014 OI Jamiolkowski, Jacek/0000-0001-8442-9944; Jankowski, Piotr/0000-0001-6223-8821; Kosior, Dariusz/0000-0002-7821-4442; Kaminski, Karol/0000-0002-9465-2581 FU European Union [754432]; Polish Ministry of Science and Higher Education; Medical University of Bialystok [SUB/1/DN/19/006/1201] FX This research was conducted within the project which received funding from the European Union's Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement no. 754432 and the Polish Ministry of Science and Higher Education, from financial resources for science in 2018-2023 granted for the implementation of an international co-financed project; statutory funds from the Medical University of Bialystok [SUB/1/DN/19/006/1201; to SS]. The author thanks the Bialystok Polish Longitudinal University Study team for study coordination and data collection. CR Aldana SG, 2003, HEART LUNG, V32, P374, DOI 10.1016/S0147-9563(03)00106-7 Aragam KG, 2015, J AM COLL CARDIOL, V65, P2079, DOI 10.1016/j.jacc.2015.02.063 Balady GJ, 2011, CIRCULATION, V124, P2951, DOI 10.1161/CIR.0b013e31823b21e2 Balady GJ, 2000, CIRCULATION, V102, P1069, DOI 10.1161/01.CIR.102.9.1069 Caliani SE, 2004, REV ESP CARDIOL, V57, P53 Haberka M, 2020, ARCH MED SCI Ivers NM, 2020, BMJ-BRIT MED J, V369, DOI 10.1136/bmj.m1731 Jankowski P, 2020, CARDIOL J, V27, P533, DOI 10.5603/CJ.a2020.0072 Jankowski P, 2016, KARDIOL POL, V74, P800, DOI 10.5603/KP.2016.0118 Jankowski P, 2015, MEDICINE, V94, DOI 10.1097/MD.0000000000001257 Kotseva K, 2019, EUR J PREV CARDIOL, V26, P1150, DOI 10.1177/2047487319834770 Kotseva K, 2018, EUR J PREV CARDIOL, V25, P1242, DOI 10.1177/2047487318781359 Kotseva K, 2013, EUR J PREV CARDIOL, V20, P817, DOI 10.1177/2047487312449591 Lawler PR, 2011, AM HEART J, V162, P571, DOI 10.1016/j.ahj.2011.07.017 Mazzini MJ, 2008, AM J CARDIOL, V101, P1084, DOI 10.1016/j.amjcard.2007.11.063 Milionis HJ, 2001, ANGIOLOGY, V52, P575, DOI 10.1177/000331970105200901 Mitra R, 2016, STAT METHODS MED RES, V25, P188, DOI 10.1177/0962280212445945 Nieszporska S, 2017, EUR J HEALTH ECON, V18, P1, DOI 10.1007/s10198-016-0831-0 Pajak A, 2020, KARDIOL POL, V78, P429, DOI 10.33963/KP.15273 Piepoli MF, 2016, EUR HEART J, V37, P2315, DOI 10.1093/eurheartj/ehw106 Piepoli MF, 2014, EUR J PREV CARDIOL, V21, P664, DOI 10.1177/2047487312449597 ROSENBAUM PR, 1983, BIOMETRIKA, V70, P41, DOI 10.1093/biomet/70.1.41 Smith SC, 2011, J AM COLL CARDIOL, V58, P2432, DOI 10.1016/j.jacc.2011.10.824 Sterne JAC, 2009, BMJ-BRIT MED J, V339, DOI 10.1136/bmj.b2393 Sumner J, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0177658 van Halewijn G, 2017, INT J CARDIOL, V232, P294, DOI 10.1016/j.ijcard.2016.12.125 van Hout B, 2012, VALUE HEALTH, V15, P708, DOI 10.1016/j.jval.2012.02.008 Vigorito C, 2017, EUR J PREV CARDIOL, V24, P577, DOI 10.1177/2047487316682579 West RR, 2012, HEART, V98, P637, DOI 10.1136/heartjnl-2011-300302 Wita K, 2019, INT J CARDIOL, V296, P8, DOI 10.1016/j.ijcard.2019.06.040 NR 30 TC 3 Z9 3 U1 0 U2 3 PU MEDYCYNA PRAKTYCZNA SP K SP ZOO PI KRAKOW PA REJTANA 2, KRAKOW, 30-510 AP, POLAND SN 0032-3772 EI 1897-9483 J9 POL ARCH INTERN MED JI Pol. Intern. Med. PD AUG 30 PY 2021 VL 131 IS 7-8 BP 617 EP 625 DI 10.20452/pamw.16019 PG 9 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA UX5ME UT WOS:000700888500005 PM 34057335 OA gold DA 2023-05-13 ER PT J AU Salarifar, M Ghavami, M Poorhosseini, H Masoudkabir, F Jenab, Y Amirzadegan, A Alidoosti, M Aghajani, H Bozorgi, A Hosseini, K Lotfi-Tokaldany, M Mortazavi, SH Aein, A Ahmadian, T Sadeghian, S AF Salarifar, Mojtaba Ghavami, Mojgan Poorhosseini, Hamidreza Masoudkabir, Farzad Jenab, Yaser Amirzadegan, Alireza Alidoosti, Mohammad Aghajani, Hassan Bozorgi, Ali Hosseini, Kaveh Lotfi-Tokaldany, Masoumeh Mortazavi, Seyedeh Hamideh Aein, Afsaneh Ahmadian, Tahere Sadeghian, Saeed TI The impact of a dedicated coronavirus disease 2019 primary angioplasty protocol on time components related to ST-segment elevation myocardial infarction management in a 24/7 primary percutaneous coronary intervention-capable hospital SO KARDIOLOGIA POLSKA LA English DT Article DE coronavirus disease 2019 outbreak; primary angioplasty; ST-segment elevation; myocardial infarction ID TASK-FORCE AB BACKGROUND Primary percutaneous coronary intervention (PPCI) as the treatment of choice for ST-segment elevation myocardial infarction (STEMI) should be rapidly performed. It is necessary to use preventive strategies during the coronavirus disease 2019 (COVID-19) outbreak, which is an ongoing global concern. However, critical times in STEMI management may be influenced by the implementation of infection control protocols. AIMS We aimed to investigate the impact of our dedicated COVID-19 PPCI protocol on time components related to STEMI care and catheterization laboratory personnel safety. A subendpoint analysis to compare patient outcomes at a median time of 70 days during the pandemic with those of patients treated in the preceding year was another objective of our study. METHODS Patients with STEMI who underwent PPCI were included in this study. Chest computed tomography (CT) and real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) tests were performed in patients suspected of having COVID-19. A total of 178 patients admitted between February 29 and April 30, 2020 were compared with 146 patients admitted between March 1 and April 30, 2019. RESULTS Severe acute respiratory syndrome coronavirus 2 infection was confirmed by rRT-PCR in 7 cases. In 6 out of 7 patients, CT was indicative of COVID-19. There were no differences between the study groups regarding critical time intervals for reperfusion in STEMI. The 70-day mortality rate before and during the pandemic was 2.73% and 4.49%, respectively (P = 0.4). CONCLUSIONS The implementation of the dedicated COVID-19 PPCI protocol in patients with STEMI allowed us to achieve similar target times for reperfusion, short-term clinical outcomes, and staff safety as in the prepandemic era. C1 [Salarifar, Mojtaba; Ghavami, Mojgan; Poorhosseini, Hamidreza; Masoudkabir, Farzad; Jenab, Yaser; Amirzadegan, Alireza; Alidoosti, Mohammad; Aghajani, Hassan; Bozorgi, Ali; Hosseini, Kaveh; Lotfi-Tokaldany, Masoumeh; Mortazavi, Seyedeh Hamideh; Ahmadian, Tahere; Sadeghian, Saeed] Univ Tehran Med Sci, Tehran Heart Ctr, Sch Med, Cardiovasc Res Inst, North Kargar Ave, Tehran 1411713138, Iran. [Aein, Afsaneh] Iran Univ Med Sci, Sch Hlth, Dept Educ & Hlth Promot, Tehran, Iran. C3 Tehran University of Medical Sciences; Iran University of Medical Sciences RP Sadeghian, S (通讯作者)，Univ Tehran Med Sci, Tehran Heart Ctr, Sch Med, Cardiovasc Res Inst, North Kargar Ave, Tehran 1411713138, Iran. EM ssadeghian@sina.tums.ac.ir RI Jenab, Yaser/HRB-0980-2023 OI Jenab, Yaser/0000-0002-8291-8637; hosseini, kaveh/0000-0001-5676-3099; lotfi-tokaldany, masoumeh/0000-0001-8222-8794 CR Bai Y, 2020, JAMA-J AM MED ASSOC, V323, P1406, DOI [10.1001/jama.2020.2565, 10.1056/NEJMoa2001316] Daniels MJ, 2020, CIRCULATION, V141, P1948, DOI 10.1161/CIRCULATIONAHA.120.047122 de Arenaza DP, 2003, EUR HEART J, V24, P1798, DOI 10.1016/j.ehj.2003.06.001 Ebrahim SH, 2020, BMJ-BRIT MED J, V368, DOI 10.1136/bmj.m1066 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Kirtane AJ, 2020, CIRC-CARDIOVASC QUAL, V13, P287, DOI 10.1161/CIRCOUTCOMES.120.006885 Li Qun, 2020, New England Journal of Medicine, V382, P1199, DOI 10.1056/NEJMoa2001316 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 Tam CCF, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006631 Tsui Kin-Lam, 2005, J Invasive Cardiol, V17, P149 Welt FGP, 2020, J AM COLL CARDIOL, V75, P2372, DOI 10.1016/j.jacc.2020.03.021 Zeng J, 2020, INTENS CARE MED, V46, P1111, DOI 10.1007/s00134-020-05993-9 NR 13 TC 6 Z9 6 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 23 PY 2020 VL 78 IS 12 BP 1227 EP 1234 DI 10.33963/KP.15607 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PL3LR UT WOS:000603028000008 PM 32955819 OA gold DA 2023-05-13 ER PT J AU Ruel, M Chan, V Boodhwani, M McDonald, B Ni, XF Gill, G Lam, K Hendry, P Masters, R Mesana, T AF Ruel, Marc Chan, Vincent Boodhwani, Munir McDonald, Bernard Ni, Xiaofang Gill, Gurinder Lam, Khanh Hendry, Paul Masters, Roy Mesana, Thierry TI How detrimental is reexploration for bleeding after cardiac surgery? SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article DE atrial fibrillation; bleeding; length of stay; morbidity; readmission; reexploration; survival ID ARTERY-BYPASS SURGERY; ACUTE CORONARY SYNDROME; RE-EXPLORATION; UNFRACTIONATED HEPARIN; RISK-FACTORS; METAANALYSIS; OUTCOMES; COMPLICATIONS; TRANSFUSION; CLOPIDOGREL AB Objective: To establish the risk factors and impact of reexploration for bleeding in a large modern cardiac surgical cohort. Methods: At a tertiary referral center, baseline, index procedural, reexploration, outcome, and readmission characteristics of 16,793 consecutive adult cardiac surgery patients were prospectively entered into dedicated clinical databases. Correlates of reexploration for bleeding, as well as its association with outcomes and readmission, were examined with multivariable regression models. Results: The mean patient age was 65.9 +/- 12.1 years, and 11,991 patients (71.4%) patients were male. Perioperative mortality was 2.8% (458 of 16,132) in those who did not undergo reexploration for bleeding and 12.0% (81 of 661) in those who underwent reexploration for bleeding, corresponding to an odds ratio of 3.4 +/- 0.5 (P<. 001) over other predictors of mortality, including Euroscore II. Mortality was highest in patients who underwent reexploration after the day of index surgery (odds ratio, 6.4 +/- 1.1). Hospital stay was longer in patients who underwent reexploration for bleeding (median, 12 days, vs 7 days in patients who did not undergo reexploration; P < .001), to an extent beyond any other correlate. Reexploration for bleeding also was independently associated with new-onset postoperative atrial fibrillation, renal insufficiency, intensive care unit readmission, and wound infection. Risk factors for reexploration for bleeding were tricuspid valve repair, on-pump versus off-pump coronary artery bypass grafting, emergency status, cardiopulmonary bypass (CPB) duration, low body surface area, and lowest CPB hematocrit of <24%. Conclusions: Reexploration for bleeding is a lethal and morbid complication of cardiac surgery, with a detrimental effect that surpasses that of any other known potentially modifiable risk factor. All efforts should be made to minimize the incidence and burden of reexploration for bleeding, including further research on transfusion management during CPB. C1 [Ruel, Marc; Chan, Vincent; Boodhwani, Munir; Ni, Xiaofang; Gill, Gurinder; Lam, Khanh; Hendry, Paul; Masters, Roy; Mesana, Thierry] Univ Ottawa, Heart Inst, Div Cardiac Surg, 40 Ruskin St,Suite 3402, Ottawa, ON, Canada. [McDonald, Bernard] Univ Ottawa, Heart Inst, Div Cardiac Anesthesia, Ottawa, ON, Canada. C3 University of Ottawa; University of Ottawa Heart Institute; University of Ottawa; University of Ottawa Heart Institute RP Ruel, M (通讯作者)，Univ Ottawa, Heart Inst, Div Cardiac Surg, 40 Ruskin St,Suite 3402, Ottawa, ON, Canada. EM mruel@ottawaheart.ca FU Division of Cardiac Surgery Endowed Research Chair, University of Ottawa Heart Institute FX This study was funded by the Division of Cardiac Surgery Endowed Research Chair, University of Ottawa Heart Institute. CR Alghamdi AA, 2007, J CARDIAC SURG, V22, P247, DOI 10.1111/j.1540-8191.2007.00402.x Alstrom U, 2012, BRIT J ANAESTH, V108, P216, DOI 10.1093/bja/aer391 Biancari F, 2012, J CARDIOTHOR VASC AN, V26, P550, DOI 10.1053/j.jvca.2012.02.009 Biancari F, 2012, EUR J CARDIO-THORAC, V41, P50, DOI 10.1016/j.ejcts.2011.04.023 Canadyova J, 2012, INTERACT CARDIOV TH, V14, P704, DOI 10.1093/icvts/ivs087 Chan V, 2007, J CARDIAC SURG, V22, P493, DOI 10.1111/j.1540-8191.2007.00475.x Christensen MC, 2012, J CARDIOTHOR VASC AN, V26, P46, DOI 10.1053/j.jvca.2011.09.021 Christensen MC, 2009, J THORAC CARDIOV SUR, V138, P687, DOI 10.1016/j.jtcvs.2009.02.021 Filsoufi F, 2009, J CARDIOTHOR VASC AN, V23, P488, DOI 10.1053/j.jvca.2009.02.007 Guay J, 2014, J CARDIOTHOR VASC AN, V28, P90, DOI 10.1053/j.jvca.2013.03.013 Hall T S, 2001, Ann Thorac Cardiovasc Surg, V7, P352 Haneya A, 2015, THORAC CARDIOV SURG, V63, P51, DOI 10.1055/s-0034-1390154 Hansson EC, 2014, EUR J CARDIO-THORAC, V46, P699, DOI 10.1093/ejcts/ezt662 Jones HU, 2005, ANN THORAC SURG, V80, P518, DOI 10.1016/j.athoracsur.2005.02.009 Jones HU, 2002, CIRCULATION, V106, pI19, DOI 10.1161/01.cir.0000032917.33237.e0 Karthik S, 2004, ANN THORAC SURG, V78, P527, DOI 10.1016/j.athoracsur.2004.02.088 Kristensen KL, 2012, INTERACT CARDIOV TH, V14, P709, DOI 10.1093/icvts/ivs050 Le-Bert G, 2011, INTERACT CARDIOV TH, V13, P124, DOI 10.1510/icvts.2010.256677 Litmathe J, 2009, THORAC CARDIOV SURG, V57, P391, DOI 10.1055/s-0029-1185852 Loor G, 2013, J THORAC CARDIOV SUR, V146, P1480, DOI 10.1016/j.jtcvs.2013.06.033 Lu JCY, 2003, EUR J CARDIO-THORAC, V23, P943, DOI 10.1016/S1010-7940(03)00137-4 Moulton MJ, 1996, J THORAC CARDIOV SUR, V111, P1037, DOI 10.1016/S0022-5223(96)70380-X Murphy GJ, 2015, NEW ENGL J MED, V372, P997, DOI 10.1056/NEJMoa1403612 Omran AS, 2007, BMC INFECT DIS, V7, DOI 10.1186/1471-2334-7-112 Ranucci M, 2008, ANN THORAC SURG, V86, P1557, DOI 10.1016/j.athoracsur.2008.07.114 Wolfe R, 2007, QUAL SAF HEALTH CARE, V16, P192, DOI 10.1136/qshc.2004.012435 NR 26 TC 42 Z9 44 U1 0 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5223 EI 1097-685X J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD SEP PY 2017 VL 154 IS 3 BP 927 EP 934 DI 10.1016/j.jtcvs.2016.04.097 PG 8 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA FE1JW UT WOS:000407975500063 PM 28826154 OA Bronze DA 2023-05-13 ER PT J AU Ried, M Haneya, A Kolat, P Philipp, A Kobuch, R Hilker, M Schmid, C Diez, C AF Ried, Michael Haneya, Assad Kolat, Philipp Philipp, Alois Kobuch, Reinhard Hilker, Michael Schmid, Christof Diez, Claudius TI Emergency coronary artery bypass grafting using minimized versus standard extracorporeal circulation - a propensity score analysis SO JOURNAL OF CARDIOTHORACIC SURGERY LA English DT Article DE Coronary artery bypass surgery; Minimized extracorporeal circulation; Emergency revascularization; Mortality; Propensity score analysis ID ACUTE MYOCARDIAL-INFARCTION; CARDIOPULMONARY BYPASS; REVASCULARIZATION; SURGERY; SYSTEM; INTERVENTION; PUMP AB Background: The impact of minimized extracorporeal circulation (MECC) for emergency revascularization remains controversial. Methods: A total of 348 patients underwent emergency CABG with MECC (n=146) or conventional extracorporeal circulation (CECC; n=175) between January 2005 and December 2010. Using propensity score matching after binary logistic regression, 100 patients, who underwent CABG with MECC could be matched with 100 patients, who underwent CABG with CECC. Primary outcome was 30-day mortality. Results: Unadjusted 30-day mortality was 14.8% in patients with CECC and 6.9% in those with MECC (mean difference -7.9%; p=0.03). The adjusted mean difference (average treatment effect of the treated, ATT) after matching was -1.0% (95% CI -8.6 to 7.6; p=1.0). Intensive care unit stay (adjusted mean difference 1.0; 95% CI -0.2 to 3.2; p=0.70) and hospital stay (adjusted mean difference 1.0; 95% CI -2.0 to 3.6; p=0.40) did not show significant differences between both groups. The adjusted mean difference for postoperative low cardiac output syndrome was -1.1% (95% CI -7.3 to 7.1; p=0.83) without significant differences between CECC and MECC. Postoperative mechanical ventilation time, drain loss, postoperative rethoracotomy, postoperative neurological events, new onset renal replacement therapy and respiratory failure also had insignificant average treatment effects of the treated. In addition, all average treatment effects (ATEs) did not significantly differ between both groups. Conclusion: Using propensity score estimation and matching, we did not observe significant differences in terms of survival and further outcomes in patients who undergo emergency CABG with CECC or MECC, but our results call for further analysis. C1 [Ried, Michael; Haneya, Assad; Kolat, Philipp; Philipp, Alois; Kobuch, Reinhard; Hilker, Michael; Schmid, Christof; Diez, Claudius] Univ Med Ctr Regensburg, Dept Cardiothorac Surg, D-93053 Regensburg, Germany. C3 University of Regensburg RP Ried, M (通讯作者)，Univ Med Ctr Regensburg, Dept Cardiothorac Surg, Franz Josef Strauss Allee 11, D-93053 Regensburg, Germany. EM micha.ried@t-online.de RI Haneya, Assad/Q-7748-2017; Ried, Michael/AAC-4518-2022; Haneya, Assad/ABE-6281-2020 OI Ried, Michael/0000-0002-2365-4803; CR Anastasiadis K, 2010, PERFUSION-UK, V25, P197, DOI 10.1177/0267659110373840 Austin PC, 2007, J THORAC CARDIOV SUR, V134, P1128, DOI 10.1016/j.jtcvs.2007.07.021 Benedetto U, 2009, J THORAC CARDIOV SUR, V138, P1450, DOI 10.1016/j.jtcvs.2009.03.042 Biancari F, 2009, HEART, V95, P964, DOI 10.1136/hrt.2008.158709 Christiansen S, 2010, ANN THORAC CARDIOVAS, V16, P168 D'Agostino RB, 2007, CIRCULATION, V115, P2340, DOI 10.1161/CIRCULATIONAHA.105.594952 Danner BC, 2009, ANN THORAC SURG, V88, P1433, DOI 10.1016/j.athoracsur.2009.06.059 Darwazah Ahmad K, 2009, Asian Cardiovasc Thorac Ann, V17, P133, DOI 10.1177/0218492309103288 Eknoyan G, 2002, AM J KIDNEY DIS, V39, pS14, DOI 10.1053/ajkd.2002.30939 Fromes Y, 2002, EUR J CARDIO-THORAC, V22, P527, DOI 10.1016/S1010-7940(02)00372-X 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 Kerendi F, 2005, ANN THORAC SURG, V79, P801, DOI 10.1016/j.athoracsur.2004.08.010 Locker C, 2003, ANN THORAC SURG, V76, P771, DOI 10.1016/S0003-4975(03)00732-X Mazzei V, 2007, CIRCULATION, V116, P1761, DOI 10.1161/CIRCULATIONAHA.107.697482 Nashef SAM, 1999, EUR J CARDIO-THORAC, V16, P9, DOI 10.1016/S1010-7940(99)00134-7 Puehler T, 2010, THORAC CARDIOV SURG, V58, P204, DOI 10.1055/s-0029-1241028 Puehler T, 2009, ANN THORAC SURG, V87, P766, DOI 10.1016/j.athoracsur.2008.11.050 Rastan AJ, 2006, CIRCULATION, V114, pI477, DOI 10.1161/CIRCULATIONHA.105.001545 Roques F, 2003, EUR HEART J, V24, P881, DOI 10.1016/S0195-668X(02)00799-6 Schottler J, 2008, THORAC CARDIOV SURG, V56, P65, DOI 10.1055/s-2007-989336 Serruys PW, 2009, NEW ENGL J MED, V360, P961, DOI 10.1056/NEJMoa0804626 Sezai A, 2012, ANN THORAC CARDIOVAS, V18, P338, DOI 10.5761/atcs.oa.11.01821 Stamou SC, 2006, J THORAC CARDIOV SUR, V131, P28, DOI 10.1016/j.jtcvs.2005.08.059 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 White HD, 2005, CIRCULATION, V112, P1992, DOI 10.1161/CIRCULATIONAHA.105.540948 Wiesenack C, 2004, ARTIF ORGANS, V28, P1082, DOI 10.1111/j.1525-1594.2004.00030.x NR 27 TC 7 Z9 9 U1 0 U2 2 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND EI 1749-8090 J9 J CARDIOTHORAC SURG JI J. Cardiothorac. Surg. PD APR 2 PY 2013 VL 8 AR 59 DI 10.1186/1749-8090-8-59 PG 8 WC Cardiac & Cardiovascular Systems; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Surgery GA 121XY UT WOS:000317280100001 PM 23547910 OA Green Published, gold DA 2023-05-13 ER PT J AU McLeod, P Coffey, S Sneddon, K Williams, M Kerr, A Pemberton, J AF McLeod, Peter Coffey, Sean Sneddon, Katherine Williams, Michael Kerr, Andrew Pemberton, James TI Clinically Acquired High Sensitivity Cardiac Troponin T is a Poor Predictor of Reduced Left Ventricular Ejection Fraction After ST Elevation Myocardial Infarction: A National Cohort Study-ANZACS-QI 65 SO HEART LUNG AND CIRCULATION LA English DT Article DE ST elevation myocardial infarction; Troponin T; Left ventricular function ID PERCUTANEOUS CORONARY INTERVENTION; NEW-ZEALAND; CREATINE-KINASE; SIZE; RELEASE; DYSFUNCTION AB Objective Cardiac troponins (cTn) have been used historically to estimate infarct size in ST elevation myocardial infarction (STEMI). Within a resource constrained health care environment, cTn could therefore be used for prioritisation of patients for cardiac imaging, in particular echocardiography. We aimed to determine how useful routinely collected cTn would be in predicting significant left ventricular (LV) impairment. Methods All patients in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry with their first episode of STEMI between January 2013 and November 2018, who had high sensitivity troponin T measured, were included. We excluded patients with no left ventricular ejection fraction (LVEF) assessment, known LV dysfunction, or prior myocardial infarction. Results In total, 3,698 patients were included in the analysis. A higher mean hsTnT (admission and peak) was seen in patients with more severely impaired LV function but there was significant overlap in the range of hsTnT between the different LVEF categories. Cardiac troponins demonstrated poor discriminative ability to either predict or exclude significant LV impairment (LVEF,40%). At an optimal cutpoint of 3,405 ng/L, peak hsTnT had a sensitivity of 56.5% (95% confidence interval [CI] 42-62%), a specificity of 65.3% (95% CI 62-79%) and an area under the receiver operating curve of 0.62 (95% CI 0.60-0.64). Conclusion This is the largest study comparing clinically measured troponin levels and LV function in patients presenting with STEMI. A definite, but weak, association was seen between peak troponin and the degree of LV dysfunction, with significant overlap in troponin levels between levels of myocardial dysfunction. Routinely acquired troponin is not suitable for clinical use as a method of prioritising patients for cardiac imaging. C1 [McLeod, Peter; Coffey, Sean; Sneddon, Katherine; Williams, Michael; Pemberton, James] Univ Otago, Otago Med Sch, Dept Med, HeartOtago, Dunedin, New Zealand. [McLeod, Peter; Coffey, Sean; Williams, Michael; Pemberton, James] Southern Dist Hlth Board, Dept Cardiol, Dunedin, New Zealand. [Kerr, Andrew] Univ Auckland, Sch Populat Hlth, Auckland, New Zealand. [Kerr, Andrew] Univ Auckland, Dept Med, Auckland, New Zealand. [Kerr, Andrew] Middlemore Hosp, Cardiol Dept, Auckland, New Zealand. C3 University of Otago; Dunedin Public Hospital; University of Auckland; University of Auckland RP McLeod, P (通讯作者)，Dunedin Publ Hosp, 201 Great King St, Dunedin 9016, New Zealand. 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PD NOV PY 2022 VL 31 IS 11 BP 1513 EP 1523 DI 10.1016/j.hlc.2022.07.014 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 8R4JF UT WOS:000927859700019 PM 36041986 DA 2023-05-13 ER PT J AU Alrawashdeh, A Nehme, Z Williams, B Stub, D AF Alrawashdeh, Ahmad Nehme, Ziad Williams, Brett Stub, Dion TI Review article: Impact of 12-lead electrocardiography system of care on emergency medical service delays in ST-elevation myocardial infarction: A systematic review and meta-analysis SO EMERGENCY MEDICINE AUSTRALASIA LA English DT Review DE electrocardiography; emergency medical service; meta-analysis; ST-elevation myocardial infarction; time factors ID ACUTE CORONARY SYNDROME; SEGMENT-ELEVATION; PREHOSPITAL ELECTROCARDIOGRAM; TREATMENT TIMES; ECG; OUTCOMES; GUIDELINES; MANAGEMENT; HOSPITALS; MORTALITY AB To assess the impact of prehospital 12-lead electrocardiography (PH ECG) on emergency medical service (EMS) delay in patients with ST-elevation myocardial infarction (STEMI), we systematically searched five online electronic databases, includingMEDLINE, Embase, Emcare, Cochrane Library and CINAHL, between 1990 and August 2017. Controlled trials and observational studies comparing EMS time delays with and without PH ECG in STEMI patients were eligible. Two reviewers independently screened studies for eligibility, extracted data and appraised study quality. The primary outcome was the time elapsed between scene arrival and hospital arrival. The secondary outcomes were response time, scene time, transport time and emergency call-to-hospital arrival time. Random effects models were used to pool weighted mean differences in EMS delay. Seven moderate-quality studies (two controlled trials and five observational) involving 81 005 participants were included in the data synthesis. The primary treatment strategy was in-hospital thrombolysis and percutaneous coronary intervention in four and three studies, respectively. PH ECG was associated with a 7.0 min increase in scene arrival-to-hospital arrival time (three studies; n = 80 628; 95% CI 6.7-7.2; I-2 = 0.0%) and a 2.9 min increase in scene time (four studies; n = 377; 95% CI 1.2-4.6; I-2 = 0.0%). PH ECG had no effect on transport or call-to-hospital intervals, although both measures showed evidence of heterogeneity. In patients with STEMI, PH ECG is associated with a modest increase in EMS delays. Measurement and improvement of EMS system delays may help to expedite treatment for STEMI. C1 [Alrawashdeh, Ahmad; Nehme, Ziad; Williams, Brett] Monash Univ, Dept Community Emergency Hlth & Paramed Practice, Melbourne, Vic, Australia. [Nehme, Ziad; Stub, Dion] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia. [Nehme, Ziad] Ambulance Victoria, Ctr Res & Evaluat, Melbourne, Vic, Australia. [Stub, Dion] Alfred Hosp, Dept Cardiovasc Med, Melbourne, Vic, Australia. [Stub, Dion] Baker IDI Heart & Diabet Inst, Melbourne, Vic, Australia. C3 Monash University; Monash University; Florey Institute of Neuroscience & Mental Health; Baker Heart and Diabetes Institute RP Alrawashdeh, A (通讯作者)，Monash Univ, Dept Community Emergency Hlth & Paramed Practice, McMahons Rd, Frankston, Vic 3199, Australia. 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PD OCT PY 2019 VL 31 IS 5 BP 702 EP 709 DI 10.1111/1742-6723.13321 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA VJ7CK UT WOS:000619276100003 PM 31190379 DA 2023-05-13 ER PT J AU Bedet, A Tomberli, F Prat, G Bailly, P Kouatchet, A Mortaza, S Vivier, E Rosselli, S Lipskaia, L Carteaux, G Razazi, K Dessap, AM AF Bedet, Alexandre Tomberli, Francoise Prat, Gwenael Bailly, Pierre Kouatchet, Achille Mortaza, Sater Vivier, Emmanuel Rosselli, Sylvene Lipskaia, Larissa Carteaux, Guillaume Razazi, Keyvan Dessap, Armand Mekontso TI Myocardial ischemia during ventilator weaning: a prospective multicenter cohort study SO CRITICAL CARE LA English DT Article DE Weaning; Cardiac ischemia; Cardiac pulmonary edema; ST monitoring; Echocardiography ID MECHANICAL VENTILATION; UNIVERSAL DEFINITION; CARDIAC DYSFUNCTION; AMERICAN SOCIETY; FAILURE; ECHOCARDIOGRAPHY; RECOMMENDATIONS; DIAGNOSIS AB Background Weaning-induced cardiac pulmonary edema (WiPO) is one of the main mechanisms of weaning failure during mechanical ventilation. We hypothesized that weaning-induced cardiac ischemia (WiCI) may contribute to weaning failure from cardiac origin. Methods A prospective cohort study of patients mechanically ventilated for at least 24 h who failed a first spontaneous breathing trial (SBT) was conducted in four intensive care units. Patients were explored during a second SBT using multiple tools (echocardiography, continuous 12-lead ST monitoring, biomarkers) to scrutinize the mechanisms of weaning failure. WiPO definition was based on three criteria (echocardiographic signs of increased left atrial pressure, increase in B-type natriuretic peptides, or increase in protein concentration during SBT) according to a conservative definition (at least two criteria) and a liberal definition (at least one criterion). WiCI was diagnosed according to the third universal definition of myocardial infarction proposed by the European Society of Cardiology (ESC) and the American Heart Association (AHA) statement for exercise testing. Results Among patients who failed a first SBT, WiPO occurred in 124/208 (59.6%) and 44/208 (21.2%) patients, according to the liberal and conservative definition, respectively. Among patients with ST monitoring, WiCI was diagnosed in 36/177 (20.3%) and 12/177 (6.8%) of them, according to the ESC and AHA definitions, respectively. WiCI was not associated with WiPO and was not associated with weaning outcomes. Only two patients of the cohort were treated for an acute coronary syndrome after the second SBT, and seven other patients required coronary angiography during the weaning period. Conclusions This observational study showed the common occurrence of pulmonary edema in mechanically ventilated patients who failed a first SBT, but the association with cardiac ischemia and weaning outcomes was weak. C1 [Bedet, Alexandre; Lipskaia, Larissa; Carteaux, Guillaume; Razazi, Keyvan; Dessap, Armand Mekontso] Henri Mondor Univ Hosp, AP HP, Med Intens Care Unit, DHU A TVB, F-94010 Creteil, France. [Bedet, Alexandre; Lipskaia, Larissa; Carteaux, Guillaume; Razazi, Keyvan; Dessap, Armand Mekontso] Paris Est Creteil Univ, Mondor Inst Biomed Res, CARMAS Res Grp, F-94010 Creteil, France. [Tomberli, Francoise] Henri Mondor Univ Hosp, AP HP, Surg Intens Care Unit, DHU A TVB, F-94010 Creteil, France. [Prat, Gwenael; Bailly, Pierre] Brest Reg Univ Hosp, Intens Care Unit, Cavale Blanche, F-29200 Brest, France. [Kouatchet, Achille; Mortaza, Sater] Angers Univ Hosp, Med Intens Care Unit, F-49933 Angers, France. [Vivier, Emmanuel; Rosselli, Sylvene] St Joseph St Luc Hosp, Intens Care Unit, F-69007 Lyon, France. C3 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; 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; CHU Brest; Universite d'Angers; Centre Hospitalier Universitaire d'Angers RP Bedet, A (通讯作者)，Henri Mondor Univ Hosp, AP HP, Med Intens Care Unit, DHU A TVB, F-94010 Creteil, France.; Bedet, A (通讯作者)，Paris Est Creteil Univ, Mondor Inst Biomed Res, CARMAS Res Grp, F-94010 Creteil, France. EM alexandre.bedet@gmail.com RI Lipskaia, Larissa/AAK-9322-2020; Carteaux, Guillaume/AAH-3993-2021 OI Lipskaia, Larissa/0000-0002-7998-8378; Bedet, Alexandre/0000-0001-7419-0650 FU French Ministry of Health (DGOS, Programme Hospitalier de Recherche Clinique National 2005) [AOM05104] FX French Ministry of Health (DGOS, Programme Hospitalier de Recherche Clinique National 2005: AOM05104). 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Care PD SEP 18 PY 2019 VL 23 IS 1 AR 321 DI 10.1186/s13054-019-2601-8 PG 9 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA IY9NN UT WOS:000486720200002 PM 31533788 OA Green Published, gold DA 2023-05-13 ER PT J AU Jacobsen, L Grenne, B Olsen, RB Jortveit, J AF Jacobsen, Lars Grenne, Bjornar Olsen, Roy Bjorkholt Jortveit, Jarle TI Feasibility of prehospital identification of non-ST-elevation myocardial infarction by ECG, troponin and echocardiography SO EMERGENCY MEDICINE JOURNAL LA English DT Article ID ACUTE CORONARY SYNDROMES; GUIDELINES; OCCLUSION; ARTERY AB Background Prehospital identification and selection of treatment strategy in patients with suspected non-ST-elevation myocardial infarction (NSTEMI) is challenging. The aim of this study was to evaluate the feasibility and diagnostic accuracy of prehospital ECG, troponin T (TnT) and transthoracic echocardiography (TTE) acquired by paramedics in early identification of NSTEMI. Methods Consecutive patients requesting an ambulance from Sorlandet Hospital, Norway due to chest pain between November 2017 and January 2020 were screened for inclusion in the study. One ambulance was equipped with ECG recorder, point-of-care TnT test and TTE scanner, and six paramedics were given necessary training. ECG, TnT result and TTE images were acquired prehospitally and transferred to an in-hospital cardiologist. NSTEMI was suspected in patients with ischaemic ECG changes, elevated TnT or myocardial regional wall motion abnormalities (RWMA) at TTE. Results A total of 253 patients were included in the study. ECG was interpretable by cardiologists in 243 (96%), TnT in 238 (94%) and TTE images in 240 (95%) patients. NSTEMI was the discharge diagnosis in 22 (9%) of these patients. Four (18%) patients with NSTEMI had ischaemic ECG changes, elevated TnT and RWMA at TTE. Eight (36%) patients with NSTEMI had positive findings at two of the diagnostic methods, six (27%) patients had positive findings at one, and four (18%) patients had no positive findings in any of the diagnostic methods. In three patients (14%) with NSTEMI, RWMA was the only positive test. The negative and positive predictive values for RWMA were 42% and 96%, respectively. Conclusions Prehospital acquisition of ECG, TnT and interpretable TTE images by paramedics were feasible in most patients with chest pain. Based on these examinations, it was possible to identify the majority of cases with NSTEMI prehospitally and admit the patients directly to a hospital with facilities for percutaneous coronary intervention (PCI) for further treatment. C1 [Jacobsen, Lars] Norwegian Air Ambulance Fdn, Oslo, Norway. [Jacobsen, Lars; Olsen, Roy Bjorkholt] Sorlandet Hosp Arendal, Dept Anesthesiol, Arendal, Norway. [Grenne, Bjornar] St Olavs Hosp, Clin Cardiol, Trondheim, Norway. [Grenne, Bjornar] Norwegian Univ Sci & Technol, Ctr Innovat Ultrasound Solut, Trondheim, Norway. [Grenne, Bjornar] Norwegian Univ Sci & Technol, Dept Circulat & Med Imaging, Trondheim, Norway. [Jortveit, Jarle] Sorlandet Hosp Arendal, Dept Cardiol, Arendal, Norway. C3 Norwegian University of Science & Technology (NTNU); Norwegian University of Science & Technology (NTNU); Norwegian University of Science & Technology (NTNU) RP Jortveit, J (通讯作者)，Sorlandet Hosp Arendal, Arendal, Norway. EM jarle.jortveit@sshf.no RI Grenne, Bjornar/N-7182-2015 OI Grenne, Bjornar/0000-0002-2984-6865; Jortveit, Jarle/0000-0003-0524-9852; Jacobsen, Lars/0000-0002-8602-9618 FU Norwegian Air Ambulance Foundation; South-Eastern Norway Regional Health Authority FX The Norwegian Air Ambulance Foundation was the main sponsor of the project. General Electric Healthcare provided the telemedicine solution and gave support free of charge. The South-Eastern Norway Regional Health Authority provided financial support for telemedicine solution development through an innovation grant. 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Med. J. PD SEP PY 2022 VL 39 IS 9 BP 679 EP 684 DI 10.1136/emermed-2021-211179 EA JAN 2022 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 4D0ZY UT WOS:000746631400001 PM 35064012 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Zghebi, SS Steinke, DT Rutter, MK Emsley, RA Ashcroft, DM AF Zghebi, S. S. Steinke, D. T. Rutter, M. K. Emsley, R. A. Ashcroft, D. M. TI Comparative risk of major cardiovascular events associated with second-line antidiabetic treatments: a retrospective cohort study using UK primary care data linked to hospitalization and mortality records SO DIABETES OBESITY & METABOLISM LA English DT Article DE cardiovascular disease; DPP-4 inhibitor; pharmaco-epidemiology; sulphonylureas; thiazolidinediones; type 2 diabetes ID TYPE-2 DIABETES-MELLITUS; MYOCARDIAL-INFARCTION; ALL-CAUSE; METFORMIN; OUTCOMES; GLUCOSE; THERAPY; INSULIN; SULFONYLUREAS; PEOPLE AB Aims: To examine the risk of major cardiovascular events associated with second-line diabetes therapies, in patients with type 2 diabetes, after adjusting for known cardiovascular risk factors. Methods: This was a retrospective cohort study of patients prescribed second-line regimens between 1998 and 2011 after first-line metformin. The UK Clinical Practice Research Datalink, with linked national hospitalization and mortality data, for the period up to December 2013, was used. Inverse probability of treatment-weighted time-varying Cox regression models was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing a major cardiovascular event (cardiovascular death, myocardial infarction, stroke, acute coronary syndrome, unstable angina, or coronary revascularization) associated with second-line therapies. Analyses adjusted for patient demographic characteristics, comorbidities, glycated haemoglobin, socio-economic status, ethnicity, smoking status and concurrent medications. Results: A total of 10 118 initiators of a second-line add-on to metformin of either a sulphonylurea (n = 6740), dipeptidyl peptidase-4 (DPP-4) inhibitor (n = 1030) or thiazolidinedione (n = 2348) were identified. After a mean (standard deviation) of 2.4 (1.9) years of follow-up, 386, 36 and 95 major cardiovascular events occurred in sulphonylurea-, DPP-4 inhibitor-and thiazolidinedione-initiators, respectively. In comparison with the metformin-sulphonylurea regimen, adjusted HRs were 0.78 (95% CI 0.55; 1.11) for the metformin-DPP-4 inhibitor regimen and 0.68 (95% CI 0.54; 0.85) for the metformin-thiazolidinedione regimen. Conclusions: Thiazolidinedione add-on treatments to metformin were associated with lower risks of major cardiovascular disease or cardiovascular death compared with sulphonylurea add-on treatment to metformin. Lower, but non-statistically significant, risks were also found with DPP-4 inhibitor add-on therapies. C1 [Zghebi, S. S.; Steinke, D. T.; Ashcroft, D. M.] Univ Manchester, Manchester Pharm Sch, Ctr Pharmacoepidemiol & Drug Safety, Stopford Bldg,Oxford Rd, Manchester M13 9PT, Lancs, England. [Zghebi, S. S.] Univ Tripoli, Dept Pharmaceut, Fac Pharm, Tripoli, Libya. [Rutter, M. K.] Univ Manchester, Inst Human Dev, Endocrinol & Diabet Res Grp, Manchester, Lancs, England. [Rutter, M. K.] Cent Manchester Univ Hosp NHS Fdn Trust, Manchester Acad Hlth Sci Ctr, Manchester Diabet Ctr, Manchester, Lancs, England. [Emsley, R. A.] Univ Manchester, Manchester Acad Hlth Sci Ctr, Inst Populat Hlth, Ctr Biostat, Manchester, Lancs, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester RP Zghebi, SS (通讯作者)，Univ Manchester, Manchester Pharm Sch, Ctr Pharmacoepidemiol & Drug Safety, Stopford Bldg,Oxford Rd, Manchester M13 9PT, Lancs, England. EM salwasaadm.zghebi@manchester.ac.uk RI Emsley, Richard/N-1342-2016; Ashcroft, Darren/G-3244-2015 OI Emsley, Richard/0000-0002-1218-675X; Rutter, Martin/0000-0001-6380-539X; Ashcroft, Darren/0000-0002-2958-915X; Zghebi, Salwa/0000-0002-7978-1094 FU Libyan Ministry for Higher Education FX S. S. Z. would like to thank the Libyan Ministry for Higher Education for the scholarship provided for her PhD programme. This study is based on data from the CPRD obtained under licence from the UK Medicines and Healthcare products Regulatory Agency; however, the interpretation and conclusions contained in this paper are those of the authors alone. The study protocol was approved by CPRD's Independent Scientific Advisory Committee (reference: 13_186RA). 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Metab. PD SEP PY 2016 VL 18 IS 9 BP 916 EP 924 DI 10.1111/dom.12692 PG 9 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism GA DT7JX UT WOS:000381664000009 PM 27177784 OA Green Published, Green Submitted DA 2023-05-13 ER PT J AU Ross, SJ Shah, NH Njapo, SAN Cordiner, DJ Winchester, DE AF Ross, Steven J. Shah, Nikhil H. Njapo, Steve A. Noutong Cordiner, Daniel J. Winchester, David E. TI Use of Cardiac Troponin Testing in the Outpatient Setting SO SOUTHERN MEDICAL JOURNAL LA English DT Article DE acute coronary syndrome; cardiac troponin; high-sensitivity cardiac troponin; myocardial infarction; troponin ID HIGH-SENSITIVITY TROPONIN; HEART-FAILURE; DISEASE; MORTALITY; EVENTS; RISK AB Objectives: Cardiac troponin (cTn) measurement is useful for diagnosing myocardial infarction (MI), particularly in the inpatient setting. A growing body of literature suggests that cTn may be useful for evaluating chronic conditions in the outpatient environment; however, little is known regarding cTn ordering patterns in this setting. We sought to investigate patterns of care and outcomes for patients evaluated with cTn in the outpatient setting. We hypothesized that a majority of outpatient cTn orders would be for the purpose of diagnosing possible MI. Methods: We analyzed 228 patients who had outpatient orders for standard-sensitivity troponin T assays placed at our institution between January 1, 2013 and December 18, 2015. Data were divided into two cohorts based on the intended utility of cTn measurement: orders placed to evaluate for possible MI versus orders placed for some other purpose. Results: Of the 228 patients, 161 were evaluated for possible MI and 67 for other reasons. Risk factors (hypertension P = 0.32, diabetes mellitus P = 0.41, coronary disease P = 0.38, heart failure P = 0.098, and chronic kidney disease P = 0.70) were similar between the cohorts. In the suspected MI cohort, an electrocardiogram was obtained in only 77% of patients, and only 13.1% were sent to the emergency department (ED) for further evaluation. Within the suspected MI cohort, 10.5% (n = 17) had elevated cTn and the majority of these patients (n = 10) were not sent to the ED. Conclusions: The majority of outpatient cTn orders were intended to evaluate for MI, although electrocardiograms were frequently not ordered and few patients were sent for further ED evaluation. Providers should be encouraged to use cTn testing in a manner that minimizes the potential risk to patients with possible MI. C1 [Ross, Steven J.; Shah, Nikhil H.; Njapo, Steve A. Noutong; Cordiner, Daniel J.; Winchester, David E.] Univ Florida, Coll Med, Dept Med, Gainesville, FL USA. [Ross, Steven J.; Shah, Nikhil H.; Njapo, Steve A. Noutong; Cordiner, Daniel J.; Winchester, David E.] Univ Florida, Coll Med, Div Cardiovasc Med, 1600 SW Archer Rd,POB 100277, Gainesville, FL 32610 USA. C3 State University System of Florida; University of Florida; State University System of Florida; University of Florida RP Winchester, DE (通讯作者)，Univ Florida, Coll Med, Div Cardiovasc Med, 1600 SW Archer Rd,POB 100277, Gainesville, FL 32610 USA. EM david.winchester@medicine.ufl.edu RI Winchester, David/AAR-5536-2020 OI Winchester, David/0000-0002-5224-2891; Shah, Nikhil/0000-0003-2717-1427 FU Roche Diagnostics FX Funding was provided by Roche Diagnostics through an investigator-initiated proposal. Roche Diagnostics had no role in the design of the study, the collection and interpretation of the data, or drafting the manuscript. 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PD MAY PY 2019 VL 112 IS 5 BP 295 EP 300 DI 10.14423/SMJ.0000000000000971 PG 6 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA HW2RR UT WOS:000466535600012 PM 31050800 DA 2023-05-13 ER PT J AU Gunnell, AS Knuiman, MW Geelhoed, E Hobbs, MST Katzenellenbogen, JM Hung, J Rankin, JM Nedkoff, L Briffa, TG Ortiz, M Gillies, M Cordingley, A Messer, M Gardner, C Lopez, D Atkins, E Mai, Q Sanfilippo, FM AF Gunnell, Anthony S. Knuiman, Matthew W. Geelhoed, Elizabeth Hobbs, Michael S. T. Katzenellenbogen, Judith M. Hung, Joseph Rankin, Jamie M. Nedkoff, Lee Briffa, Thomas G. Ortiz, Michael Gillies, Malcolm Cordingley, Anne Messer, Mitch Gardner, Christian Lopez, Derrick Atkins, Emily Mai, Qun Sanfilippo, Frank M. TI Long-term use and cost-effectiveness of secondary prevention drugs for heart disease in Western Australian seniors (WAMACH): a study protocol SO BMJ OPEN LA English DT Article ID ACUTE CORONARY SYNDROME; MEDICATION ADHERENCE; MYOCARDIAL-INFARCTION; STATIN TREATMENT; THERAPY; POPULATION; PERSISTENCE; OUTCOMES; MANAGEMENT; CARE AB Introduction: Secondary prevention drugs for cardiac disease have been demonstrated by clinical trials to be effective in reducing future cardiovascular and mortality events (WAMACH is the Western Australian Medication Adherence and Costs in Heart disease study). Hence, most countries have adopted health policies and guidelines for the use of these drugs, and included them in government subsidised drug lists to encourage their use. However, suboptimal prescribing and non-adherence to these drugs remains a universal problem. Our study will investigate trends in dispensing patterns of drugs for secondary prevention of cardiovascular events and will also identify factors influencing these patterns. It will also assess the clinical and economic consequences of non-adherence and the cost-effectiveness of using these drugs. Methods and analysis: This population-based cohort study will use longitudinal data on almost 40 000 people aged 65 years or older who were hospitalised in Western Australia between 2003 and 2008 for coronary heart disease, heart failure or atrial fibrillation. Linking of several State and Federal government administrative data sets will provide person-based information on drugs dispensed precardiac and postcardiac event, reasons for hospital admission, emergency department visits, mortality and medical visits. Dispensed drug trends will be described, drug adherence measured and their association with future all-cause/cardiovascular events will be estimated. The cost-effectiveness of these long-term therapies for cardiac disease and the impact of adherence will be evaluated. Ethics and dissemination: Human Research Ethics Committee (HREC) approvals have been obtained from the Department of Health (Western Australian #2011/62 and Federal) and the University of Western Australia (RA/4/1/1130), in addition to HREC approvals from all participating hospitals. Findings will be published in peer-reviewed medical journals and presented at local, national and international conferences. Results will also be disseminated to consumer groups. C1 [Gunnell, Anthony S.; Knuiman, Matthew W.; Geelhoed, Elizabeth; Hobbs, Michael S. T.; Nedkoff, Lee; Briffa, Thomas G.; Gardner, Christian; Atkins, Emily; Sanfilippo, Frank M.] Univ Western Australia, Sch Populat Hlth, Crawley, WA, Australia. [Katzenellenbogen, Judith M.; Lopez, Derrick] Univ Western Australia, Western Australian Ctr Rural Hlth, Crawley, WA, Australia. [Hung, Joseph] Univ Western Australia, Sch Med & Pharmacol, Sir Charles Gairdner Hosp Unit, Nedlands, WA 6009, Australia. [Rankin, Jamie M.] Royal Perth Hosp, Dept Cardiol, Perth, WA 6001, Australia. [Ortiz, Michael] Univ New S Wales, St Vincents Clin Sch, Darlinghurst, NSW, Australia. [Gillies, Malcolm] NPS MedicineWise, MedicineInsight, Sydney, NSW, Australia. [Cordingley, Anne] Univ Western Australia, Consumer & Community Advisory Council, Sch Populat Hlth, Crawley, WA, Australia. [Messer, Mitch] Hlth Consumers Council WA Inc, Perth, WA, Australia. [Mai, Qun] Western Australian Dept Hlth, Clin Modelling Unit, Perth, WA, Australia. C3 University of Western Australia; University of Western Australia; University of Western Australia; Royal Perth Hospital; University of Western Australia; University of New South Wales Sydney; University of Western Australia; University of Western Australia RP Gunnell, AS (通讯作者)，Univ Western Australia, Sch Populat Hlth, Crawley, WA, Australia. EM anthony.gunnell@uwa.edu.au RI Lopez, Derrick/AAH-5046-2021; Ortiz, Michael Steven/A-9933-2011; Atkins, Emily R/J-5504-2013; Sanfilippo, Frank/H-9334-2013 OI Lopez, Derrick/0000-0003-0677-0420; Ortiz, Michael Steven/0000-0003-0183-9273; Atkins, Emily R/0000-0003-2522-3510; Gillies, Malcolm/0000-0001-9038-8050; Nedkoff, Lee/0000-0002-3970-625X; Geelhoed, Elizabeth/0000-0001-6718-9264; Katzenellenbogen, Judith/0000-0001-5287-5819; Sanfilippo, Frank/0000-0003-3639-0787; Knuiman, Matthew/0000-0001-8874-2305 FU National Health and Medical Research Council of Australia (NHMRC) [1066242]; National Health and Medical Research Council of Australia [1066242] Funding Source: NHMRC FX This research is supported by a project grant from the National Health and Medical Research Council of Australia (NHMRC project grant 1066242). CR ABS, 2008, HOUS EXP HLTH SNAPSH AIHW. 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Gustafsson, Kerstin M. Janzon, Magnus Jonasson, Lena Logander, Elisabeth Nilsson, Lennart Swahn, Eva TI Large early variation of residual platelet reactivity in Acute Coronary Syndrome patients treated with clopidogrel Results from Assessing Platelet Activity in Coronary Heart Disease (APACHE) SO THROMBOSIS RESEARCH LA English DT Article ID MULTIPLE ELECTRODE AGGREGOMETRY; ELEVATION MYOCARDIAL-INFARCTION; OF-CARE ANALYSIS; STENT THROMBOSIS; CARDIOVASCULAR EVENTS; ANTIPLATELET THERAPY; INCREASED RISK; ELUTING STENT; INTERVENTION; AGGREGATION AB Introduction: There is a large inter-individual variation in response to clopidogrel treatment and previous studies have indicated higher risk of thrombotic events in patients with high residual platelet reactivity (HRPR), but the optimal time-point for testing is not established. The aim of this study was to investigate the optimal time-point for aggregometry testing and the risk of major adverse cardiac events associated with HRPR. Method and results: We included 125 patients with ACS (73 with STEMI, and 71 received abciximab). The prevalence of HRPR varied substantially over time. The rate of HRPR in patients treated and not treated with abciximab were 43% vs 67% (p = 0.01) before, 2% vs 23% (p = 0.001) 6-8 h after, 8% vs 9% (p = 0.749) 3 days after, and 23% vs 12% (p = 0.138) 7-9 days after loading dose of clopidogrel. We found HRPR in 18% of the patients but only four ischemic events during 6 months follow-up, with no significant difference between HRPR patients compared to the rest of the population. There were 3 TIMI major bleedings, all of which occurred in the low residual platelet reactivity (LRPR) group. Conclusion: There is a large variation in platelet reactivity over time, also depending on adjunctive therapy, which has a large impact on optimal time-point for assessment. We found HRPR in almost 1 in 5 patients, but very few MACE, and not significantly higher in HRPR patients. In a contemporary ACS population, with low risk for stent thrombosis, the predictive value of HRPR for ischemic events will probably be low. (C) 2015 Elsevier Ltd. All rights reserved. C1 [Alfredsson, Joakim; Janzon, Magnus; Jonasson, Lena; Logander, Elisabeth; Nilsson, Lennart; Swahn, Eva] Linkoping Univ, Dept Cardiol, S-58185 Linkoping, Sweden. [Alfredsson, Joakim; Janzon, Magnus; Jonasson, Lena; Logander, Elisabeth; Nilsson, Lennart; Swahn, Eva] Linkoping Univ, Dept Med & Hlth Sci, S-58185 Linkoping, Sweden. [Lindahl, Tomas L.; Gustafsson, Kerstin M.] Linkoping Univ, Dept Clin & Expt Med, S-58185 Linkoping, Sweden. C3 Linkoping University; Linkoping University; Linkoping University RP Alfredsson, J (通讯作者)，Linkoping Univ, Dept Med & Hlth Sci, S-58185 Linkoping, Sweden. EM joakim.alfredsson@liu.se RI Lindahl, Tomas L/H-5150-2012 OI Lindahl, Tomas L/0000-0003-0174-8152 FU Linkoping University; County Council of Ostergotland FX Linkoping University, and the County Council of Ostergotland are acknowledged for financial support. CR Aradi D, 2010, AM HEART J, V160, P543, DOI 10.1016/j.ahj.2010.06.004 Bonello L, 2010, J AM COLL CARDIOL, V56, P919, DOI 10.1016/j.jacc.2010.04.047 Borna C, 2005, THROMB J, V3, DOI 10.1186/1477-9560-3-10 CHESEBRO JH, 1987, CIRCULATION, V76, P142, DOI 10.1161/01.CIR.76.1.142 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 Frobert O, 2014, NEW ENGL J MED, V370, P675, DOI 10.1056/NEJMc1315678 Gurbel PA, 2009, CIRCULATION, V120, P2577, DOI 10.1161/CIRCULATIONAHA.109.912550 Hazarbasanov D, 2012, J THROMB THROMBOLYS, V34, P85, DOI 10.1007/s11239-012-0684-z Hochholzer W, 2006, J AM COLL CARDIOL, V48, P1742, DOI 10.1016/j.jacc.2006.06.065 Jaremo P, 2002, J INTERN MED, V252, P233, DOI 10.1046/j.1365-2796.2002.01027.x Johnston LR, 2013, PLATELETS, V24, P303, DOI 10.3109/09537104.2012.694086 Lee S, 2014, THROMB RES, V133, P257, DOI 10.1016/j.thromres.2013.11.029 Lippi G, 2011, BIOMARK MED, V5, P63, DOI 10.2217/BMM.10.119 Matetzky S, 2004, CIRCULATION, V109, P3171, DOI 10.1161/01.CIR.0000130846.46168.03 Mehta Shamir R, 2003, J Invasive Cardiol, V15 Suppl B, p17B Parodi G, 2011, JAMA-J AM MED ASSOC, V306, P1215, DOI 10.1001/jama.2011.1332 Price MJ, 2011, JAMA-J AM MED ASSOC, V305, P1097, DOI 10.1001/jama.2011.290 Sabate M, 2012, LANCET, V380, P1482, DOI 10.1016/S0140-6736(12)61223-9 Serebruany VL, 2005, J AM COLL CARDIOL, V45, P246, DOI 10.1016/j.jacc.2004.09.067 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 Siller-Matula JM, 2010, J THROMB HAEMOST, V8, P351, DOI 10.1111/j.1538-7836.2009.03699.x Siller-Matula JM, 2013, INT J CARDIOL, V167, P2018, DOI 10.1016/j.ijcard.2012.05.040 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] Toth O, 2006, THROMB HAEMOSTASIS, V96, P781, DOI 10.1160/TH06-05-0242 Trenk D, 2012, J AM COLL CARDIOL, V59, P2159, DOI 10.1016/j.jacc.2012.02.026 WALLENTIN L, 1990, LANCET, V336, P827 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 Yusuf S, 2000, EUR HEART J, V21, P2033 NR 32 TC 4 Z9 4 U1 0 U2 10 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0049-3848 J9 THROMB RES JI Thromb. Res. PD AUG PY 2015 VL 136 IS 2 BP 335 EP 340 DI 10.1016/j.thromres.2015.05.021 PG 6 WC Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Hematology; Cardiovascular System & Cardiology GA CV0PN UT WOS:000363953000026 PM 26033398 DA 2023-05-13 ER PT J AU Naliganti, C Valupadas, C Akkinepally, RR Eesam, S AF Naliganti, Chandana Valupadas, Chandrasekhar Akkinepally, Raghuram Rao Eesam, Shivarani TI Evaluation of drug utilization in cardiovascular disease at a teaching and referral hospital in Northern Telangana SO INDIAN JOURNAL OF PHARMACOLOGY LA English DT Article DE Cardiovascular disease; defined daily dose; prescribing indicators; rational drug use ID ACUTE CORONARY SYNDROMES; MANAGEMENT; OUTCOMES; REGISTRY; EVENTS; GENDER AB OBJECTIVES: Cardiovascular disease (CVD) is the primary cause of death globally despite the advanced health-care facilities. Extensive disparity exists in pharmacotherapy pattern among CVD patients where rational drug use plays a pivotal role in promoting safety and efficacy. The study focused to evaluate drug utilization using the World Health Organization (WHO) prescribing indicators and defined daily dose (DDD) in patients admitted to a teaching/referral hospital in Northern Telangana. MATERIALS AND METHODS: A total of 1120 medical records were analyzed for drug utilization for a period of 7 months. Prescription pattern was assessed using the WHO prescribing indicators and DDD to measure individual drug utilization categorized under anatomical-therapeutic-chemical classification. RESULTS: Of the total admissions, 58.57% (55.19 +/- 15.19 years) were male and 41.43% (56.64 +/- 15.28 years) were female where coronary artery disease was the most common cause of admission followed by cardiomyopathy. Among prescribing indicators, percentage of drugs with generic names was least accounted with 26.86% and 18.95% during hospitalization and discharge, respectively. A mean of 11.55 (hospitalization) and 6.55 (discharge) drugs were prescribed per prescription. Antiplatelet (72.86%) and statin (80.62%) use was predominate during complete therapy. The DDD of furosemide (109.33) was found to be high, followed by atorvastatin (64.6), enalapril (58.44), aspirin (58.14) and clopidogrel (53.2). CONCLUSION: Polypharmacy and least use of generic name were observed in the study which may affect the rationality. The use of antiplatelets, statins, and angiotensin-converting enzyme-inhibitors was appropriate, but furosemide overuse is of major concern. Therefore, appropriate prescription writing improvises treatment compliance in the patients, which results in rationality. C1 [Naliganti, Chandana; Eesam, Shivarani] Kakatiya Univ, Univ Coll Pharmaceut Sci, Dept Pharmaceut Sci, Warangal, Telangana, India. [Valupadas, Chandrasekhar] Mahatma Gandhi Mem Hosp, Kakatiya Med Coll, Dept Gen Med, Warangal, Telangana, India. [Akkinepally, Raghuram Rao] Natl Inst Pharmaceut Educ & Res, Mohali 160062, Punjab, India. C3 Kakatiya University; Kakatiya Medical College; National Institute of Pharmaceutical Education & Research (NIPER); National Institute of Pharmaceutical Education & Research, S.A.S. Nagar (Mohali) RP Akkinepally, RR (通讯作者)，Natl Inst Pharmaceut Educ & Res, Mohali 160062, Punjab, India. EM raghumed@gmail.com OI Akkinepally, Raghuram Rao/0000-0003-3690-1348 FU UGC, New Delhi [RGNF-2016-17-SC-TEL-5373] FX The research was supported by the UGC, New Delhi [RGNF-2016-17-SC-TEL-5373]. 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Pharmacol. PD SEP-OCT PY 2019 VL 51 IS 5 BP 323 EP 329 AR PMID 31831921 DI 10.4103/ijp.IJP_743_17 PG 7 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA KL7YK UT WOS:000513634300005 PM 31831921 OA Green Published DA 2023-05-13 ER PT J AU Fishman, B Sharon, A Itelman, E Tsur, AM Fefer, P Barbash, IM Segev, A Matetzky, S Guetta, V Grossman, E Maor, E AF Fishman, Boris Sharon, Amir Itelman, Edward Tsur, Avishai M. Fefer, Paul Barbash, Israel Moshe Segev, Amit Matetzky, Shlomi Guetta, Victor Grossman, Ehud Maor, Elad TI Invasive Management in Older Adults (>= 80 Years) With Non-ST Elevation Myocardial Infarction SO MAYO CLINIC PROCEEDINGS LA English DT Article ID ACUTE CORONARY SYNDROME; ELDERLY-PATIENTS; FRAILTY; STRATEGY; OUTCOMES; DISEASE; ROUTINE; HEALTH; CARE AB Objective: To evaluate the association of invasive management (coronary angiogram) with all-cause mortality among older adult (>= 80 years of age) patients presenting with non-ST elevation myocardial infarction (NSTEMI) by frailty status. Patients and Methods: This study used a retrospective cohort of consecutive older adult patients who were hospitalized with NSTEMI as their primary clinical diagnosis between August 1, 2008, and December 31, 2019. Cox regression models were applied with stratification by frailty status (low, medium, and high). Extensive sensitivity analyses were conducted including propensity score matching and inverse probability treatment weighting models. Results: The study population included 2317 patients with median age of 86 years (IQR, 83-90 years) of whom 1243 (53.6%) were men. Patients who were managed invasively (n=581 [25%]) were less likely to be frail (7% vs 44%, P<.001). During the follow-up (median, 19 months, IQR, 4-41 months), 1599 (69%) patients died. In a multivariable Cox model, invasive approach was associated with adjusted hazard ratio (HR) of 0.61 (95% CI, 0.53 to 0.71) for the risk of death. The benefit of invasive approach was consistent among low, medium, and high frailty subgroups with adjusted HRs of 0.74 (95% CI, 0.58 to 0.93), 0.65 (95% CI, 0.50 to 0.85), and 0.52 (95% CI, 0.34 to 0.78), respectively (P for interaction = 0.48). Results were consistent with propensity score matching and inverse probability treatment weighting analyses (HR, 0.6; 95% CI, 0.50 to 0.71 and HR, 0.67; 95% CI, 0.55 to 0.82, respectively). Sensitivity analysis addressing potential immortal time bias and residual confounding yielded similar results. Conclusion: Invasive approach is associated with improved survival among older adults with NSTEMI irrespective of frailty status. (C) 2022 Mayo Foundation for Medical Education and Research. C1 [Fishman, Boris; Sharon, Amir; Itelman, Edward; Fefer, Paul; Barbash, Israel Moshe; Segev, Amit; Matetzky, Shlomi; Guetta, Victor; Maor, Elad] Sheba Med Ctr, Olga & Lev Leviev Heart Ctr, Tel Hashomer, Israel. [Fishman, Boris; Grossman, Ehud] Sheba Med Ctr, Dept Med D, Tel Hashomer, Israel. [Fishman, Boris; Grossman, Ehud] Sheba Med Ctr, Hypertens Unit, Tel Hashomer, Israel. [Tsur, Avishai M.] Sheba Med Ctr, Dept Med B, Zabludowicz Ctr Autoimmune Dis, Tel Hashomer, Israel. [Fishman, Boris; Sharon, Amir; Itelman, Edward; Tsur, Avishai M.; Fefer, Paul; Barbash, Israel Moshe; Segev, Amit; Matetzky, Shlomi; Guetta, Victor; Grossman, Ehud; Maor, Elad] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel. [Tsur, Avishai M.] Med Corps, Israel Def Forces, Ramat Gan, Israel. [Tsur, Avishai M.] Hebrew Univ Jerusalem, Dept Mil Med, Fac Med, Jerusalem, Israel. [Itelman, Edward] Sheba Med Ctr, Dept Med T, Tel Hashomer, Israel. C3 Chaim Sheba Medical Center; Chaim Sheba Medical Center; Chaim Sheba Medical Center; Chaim Sheba Medical Center; Tel Aviv University; Sackler Faculty of Medicine; Hebrew University of Jerusalem; Chaim Sheba Medical Center RP Maor, E (通讯作者)，Sheba Med Ctr, Olga & Lev Leviev Heart Ctr, IL-52621 Ramat Gan, Israel. EM elad.maor@sheba.health.gov.il RI Tsur, Avishai/I-8350-2019 OI Tsur, Avishai/0000-0002-1564-6395; Sharon, Amir/0000-0003-2492-0728; Itelman, Edward/0000-0003-0142-0253; Fishman, Boris/0000-0003-0645-6730 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 Bach RG, 2004, ANN INTERN MED, V141, P186, DOI 10.7326/0003-4819-141-3-200408030-00007 Bebb O, 2018, EUR HEART J-ACUTE CA, V7, P166, DOI 10.1177/2048872617700873 Behar DM, 2010, NATURE, V466, P238, DOI 10.1038/nature09103 Damluji AA, 2021, EUR HEART J, V42, P3856, DOI 10.1093/eurheartj/ehab468 Ekerstad N, 2011, CIRCULATION, V124, P2397, DOI 10.1161/CIRCULATIONAHA.111.025452 Elbadawi A, 2019, AM J CARDIOL, V123, P25, DOI 10.1016/j.amjcard.2018.09.030 Fishman B, 2020, AM J HYPERTENS, V33, P175, DOI 10.1093/ajh/hpz167 Forman DE, 2016, CAN J CARDIOL, V32, P1082, DOI 10.1016/j.cjca.2016.05.015 Gaggin HK, 2017, CIRCULATION, V135, P116, DOI 10.1161/CIRCULATIONAHA.116.023052 Gnanenthiran SR, 2017, HEART, V103, P1962, DOI 10.1136/heartjnl-2017-311233 Graham MM, 2013, CAN J CARDIOL, V29, P1610, DOI 10.1016/j.cjca.2013.08.016 Haneuse S, 2019, JAMA-J AM MED ASSOC, V321, P602, DOI 10.1001/jama.2018.21554 Hoogendijk EO, 2019, LANCET, V394, P1365, DOI 10.1016/S0140-6736(19)31786-6 Ijaz N, 2022, J AM COLL CARDIOL, V79, P482, DOI 10.1016/j.jacc.2021.11.029 Kahlert J, 2017, CLIN EPIDEMIOL, V9, P195, DOI 10.2147/CLEP.S129886 Kaura A, 2020, LANCET, V396, P623, DOI 10.1016/S0140-6736(20)30930-2 Levesque LE, 2010, BRIT MED J, V340, DOI 10.1136/bmj.b5087 Lindsay RS, 2001, J CLIN ENDOCR METAB, V86, P4061, DOI 10.1210/jc.86.9.4061 Madhavan MV, 2018, J AM COLL CARDIOL, V71, P2015, DOI 10.1016/j.jacc.2017.12.068 Puymirat E, 2012, JACC-CARDIOVASC INTE, V5, P893, DOI 10.1016/j.jcin.2012.05.008 Rabinovitz E, 2016, J CARDIOL, V67, P519, DOI 10.1016/j.jjcc.2016.01.017 Raphael CE, 2020, CIRCULATION, V141, P454, DOI 10.1161/CIRCULATIONAHA.119.043100 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Saraswat A, 2018, CAN J CARDIOL, V34, P274, DOI 10.1016/j.cjca.2017.11.020 Savonitto S, 2012, JACC-CARDIOVASC INTE, V5, P906, DOI 10.1016/j.jcin.2012.06.008 Silber H, 2017, INT J CARDIOL, V228, P694, DOI 10.1016/j.ijcard.2016.11.112 Singh M, 2008, MAYO CLIN PROC, V83, P1146, DOI 10.4065/83.10.1146 Singh M, 2020, MAYO CLIN PROC, V95, P1231, DOI 10.1016/j.mayocp.2019.09.003 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 NR 31 TC 2 Z9 2 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0025-6196 EI 1942-5546 J9 MAYO CLIN PROC JI Mayo Clin. Proc. PD JUL PY 2022 VL 97 IS 7 BP 1247 EP 1256 DI 10.1016/j.mayocp.2022.03.021 EA JUL 2022 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 5B9RT UT WOS:000863906300009 PM 35787854 DA 2023-05-13 ER PT J AU Bahramali, E Askari, A Zakeri, H Farjam, M Dehghan, A Zendehdel, K AF Bahramali, Ehsan Askari, Alireza Zakeri, Habib Farjam, Mojtaba Dehghan, Azizallah Zendehdel, Kazem TI Fasa Registry on Acute Myocardial Infarction (FaRMI): Feasibility Study and Pilot Phase Results SO PLOS ONE LA English DT Article ID ACUTE CORONARY SYNDROMES; MORTALITY; TRENDS; EVENTS AB Background Myocardial infarction (MI) is the leading cause of death in Iran. Every attempt to improve treatment patterns and patient outcomes needs a surveillance system to both consider the efficacy and safety measures. Fasa Registry on Myocardial Infarction (FaRMI) is the first population-based registry for acute MI in Iran targeted to provide meticulous description of patients' characteristics, to explore the management patterns of these patients, to discover the degree of adherence to the practice guidelines, and to investigate the determinants of poor in-hospital and later outcomes. Methods A diagnosis of acute MI (type I, II and III) was made upon the accepted criteria by the attending cardiologists and types IV and V MI were excluded. Two registrar nurses gathered data on demographics, place of residence and ethnicity, past medical history, risk factors, and the clinical course. Management patterns in the pre-hospital setting, during the hospital stay and at the discharge time were recorded. Routine laboratory results and cardiac biomarkers on three consecutive days were registered. Results pilot phase included the first 95 patients, 63.5% of whom were men and 31.5% were women. With a mean age of 62.89 +/- 13.75 years among participants, the rate of premature MI was 31.8%. ST segment elevation MI accounted for 68.2% cases and inferior wall was the most prevalent region involved followed by anterior and posterior walls. Discussion Obtained data on the characteristics of patients suffering an MI event revealed the major determinants of delay in initiation of therapies and contributors of poor outcome. Completeness of data was guaranteed upon involvement of multiple checkpoints and data quality was secured by means of automatic validation processes in addition to weekly physicians' roundups. Conclusion Execution of FaRMI in the form presented is feasible and it will build up a comprehensive population-based registry for MI in the region. C1 [Bahramali, Ehsan] Fasa Univ Med Sci, Dept Cardiol, Fasa, Iran. [Bahramali, Ehsan; Zakeri, Habib; Farjam, Mojtaba; Dehghan, Azizallah] Fasa Univ Med Sci, Noncommunicable Dis Res Ctr, Fasa, Iran. [Askari, Alireza] Shiraz Univ Med Sci, Fac Med, Shiraz, Iran. [Farjam, Mojtaba] Fasa Univ Med Sci, Sch Med, Dept Med Pharmacol, Fasa, Iran. [Zendehdel, Kazem] Univ Tehran Med Sci, Canc Inst Iran, Canc Res Ctr, Tehran, Iran. C3 Shiraz University of Medical Science; Tehran University of Medical Sciences RP Bahramali, E (通讯作者)，Fasa Univ Med Sci, Dept Cardiol, Fasa, Iran.; Bahramali, E (通讯作者)，Fasa Univ Med Sci, Noncommunicable Dis Res Ctr, Fasa, Iran. EM ebahramali@fums.ac.ir RI Dehghan, Azizallah/ABG-3704-2020; bahramali, ehsan/M-2673-2017; Zakeri, Habib/N-2431-2017; Dehghan, Azizallah/S-9306-2018; Farjam, Mojtaba/O-3475-2017; Askari, Alireza/Z-2099-2019 OI Dehghan, Azizallah/0000-0002-7345-0796; Zakeri, Habib/0000-0003-2495-8507; Farjam, Mojtaba/0000-0003-4826-2846; Bahramali, Ehsan/0000-0001-5454-0406; Zendehdel, Kazem/0000-0002-0269-4945 FU Iranian ministry of health, national center [1290007/10516] FX This work was funded by Iranian ministry of health, national center for disease registries grant number 1290007/10516 (http://hbi.ir/Forms/Special.aspx?hbsld=774&category=1&templateid=1&hdll d=61). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. CR Alnasser SMA, 2015, AM J MED, V128, P766, DOI 10.1016/j.amjmed.2014.12.007 [Anonymous], 2010, LANCET, DOI DOI 10.1016/S0140-6736(12)61728-0 Brown TM, 2015, AM HEART J, V170, P249, DOI 10.1016/j.ahj.2015.04.027 Degano IR, 2015, HEART, V101, P1413, DOI 10.1136/heartjnl-2014-307310 Hanssen M, 2012, HEART, V98, P699, DOI 10.1136/heartjnl-2012-301700 Hasdai D, 2002, EUR HEART J, V23, P1190, DOI 10.1053/euhj.2002.3193 Herrett E, 2010, HEART, V96, P1264, DOI 10.1136/hrt.2009.192328 Khademi H, 2012, OPIUM USE MORTALITY Schmidt Morten, 2012, BMJ, V344, pe356, DOI 10.1136/bmj.e356 Smolina Kate, 2012, BMJ, V344, pd8059, DOI 10.1136/bmj.d8059 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 NR 11 TC 7 Z9 7 U1 0 U2 6 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 DEC 1 PY 2016 VL 11 IS 12 AR e0167579 DI 10.1371/journal.pone.0167579 PG 10 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA EE3JC UT WOS:000389482700202 PM 27907128 OA Green Submitted, gold, Green Published DA 2023-05-13 ER PT J AU Morra, S Pitisci, L Su, FH Hossein, A Rabineau, J Racape, J Gorlier, D Herpain, A Migeotte, PF Creteur, J Van de Borne, P AF Morra, Sofia Pitisci, Lorenzo Su, Fuhong Hossein, Amin Rabineau, Jeremy Racape, Judith Gorlier, Damien Herpain, Antoine Migeotte, Pierre-Francois Creteur, Jacques Van de Borne, Philippe TI Quantification of Cardiac Kinetic Energy and Its Changes During Transmural Myocardial Infarction Assessed by Multi-Dimensional Seismocardiography SO FRONTIERS IN CARDIOVASCULAR MEDICINE LA English DT Article DE seismocardiography; kinetic energy; acute myocardial infarction; animal model for acute coronary syndrome; cardiac monitoring ID SEVOFLURANE; ISCHEMIA; ISOFLURANE; BALLISTOCARDIOGRAPHY; ACCELEROMETER; NORADRENALINE; MECHANISMS; HALOTHANE AB Introduction: Seismocardiography (SCG) records cardiac and blood-induced motions transmitted to the chest surface as vibratory phenomena. Evidences demonstrate that acute myocardial ischemia (AMI) profoundly affects the SCG signals. Multidimensional SCG records cardiac vibrations in linear and rotational dimensions, and scalar parameters of kinetic energy can be computed. We speculate that AMI and revascularization profoundly modify cardiac kinetic energy as recorded by SCG. Methods: Under general anesthesia, 21 swine underwent 90 min of myocardial ischemia induced by percutaneous sub-occlusion of the proximal left anterior descending (LAD) coronary artery and subsequent revascularization. Invasive hemodynamic parameters were continuously recorded. SCG was recorded during baseline, immediately and 80 min after LAD sub-occlusion, and immediately and 60 min after LAD reperfusion. iK was automatically computed for each cardiac cycle (iK(C)) in linear (iK(Lin)) and rotational (iK(Rot)) dimensions. iK was calculated as well during systole and diastole (iK(Sys) and iK(Dia), respectively). Echocardiography was performed at baseline and after revascularization, and the left ventricle ejection fraction (LVEF) along with regional left ventricle (LV) wall abnormalities were evaluated. Results: Upon LAD sub-occlusion, 77% of STEMI and 24% of NSTEMI were observed. Compared to baseline, troponins increased from 13.0 (6.5; 21.3) ng/dl to 170.5 (102.5; 475.0) ng/dl, and LVEF dropped from 65.0 +/- 0.0 to 30.6 +/- 5.7% at the end of revascularization (both p < 0.0001). Regional LV wall abnormalities were observed as follows: anterior MI, 17.6% (three out of 17); septal MI, 5.8% (one out of 17); antero-septal MI, 47.1% (eight out of 17); and infero-septal MI, 29.4% (five out of 17). In the linear dimension, iKLinCC, iKLinSys, and iKLinDia dropped by 43, 52, and 53%, respectively (p < 0.0001, p < 0.0001, and p = 0.03, respectively) from baseline to the end of reperfusion. In the rotational dimension, iKRotCC and iKRotSys dropped by 30 and 36%, respectively (p = 0.0006 and p < 0.0001, respectively), but iKRotDia did not change (p = 0.41). All the hemodynamic parameters, except the pulmonary artery pulse pressure, were significantly correlated with the parameters of iK, except for the diastolic component. Conclusions: In this very context of experimental AMI with acute LV regional dysfunction and no concomitant AMI-related heart valve disease, linear and rotational iK parameters, in particular, systolic ones, provide reliable information on LV contractile dysfunction and its effects on the downstream circulation. Multidimensional SCG may provide information on the cardiac contractile status expressed in terms of iK during AMI and reperfusion. This automatic system may empower health care providers and patients to remotely monitor cardiovascular status in the near future. C1 [Morra, Sofia; Pitisci, Lorenzo; Van de Borne, Philippe] Univ Libre Bruxelles, Erasme Hosp, Dept Cardiol, Brussels, Belgium. [Pitisci, Lorenzo; Su, Fuhong; Herpain, Antoine] Univ Libre Bruxelles, Erasme Hosp, Expt Lab Intens Care, Brussels, Belgium. [Hossein, Amin; Rabineau, Jeremy; Gorlier, Damien; Migeotte, Pierre-Francois] Univ Libre Bruxelles, Lab Phys & Physiol LPHYS, Brussels, Belgium. [Racape, Judith] Univ Libre Bruxelles ULB, Sch Publ Hlth, Res Ctr Epidemiol Biostat & Clin Res, Brussels, Belgium. [Herpain, Antoine; Creteur, Jacques] Univ Libre Bruxelles, Erasme Hosp, Dept Intens Care, Brussels, Belgium. C3 Universite Libre de Bruxelles; Universite Libre de Bruxelles; Universite Libre de Bruxelles; Universite Libre de Bruxelles; Universite Libre de Bruxelles RP Morra, S; Pitisci, L (通讯作者)，Univ Libre Bruxelles, Erasme Hosp, Dept Cardiol, Brussels, Belgium.; Pitisci, L (通讯作者)，Univ Libre Bruxelles, Erasme Hosp, Expt Lab Intens Care, Brussels, Belgium. EM sofia.morra@erasme.ulb.ac.be; lorenzo.pitisci@ulb.be RI Rabineau, Jeremy/CAG-0536-2022; Rabineau, Jeremy/HGT-9114-2022 OI Rabineau, Jeremy/0000-0002-7946-075X; Su, Fuhong/0000-0003-4962-7907; Hossein, Amin/0000-0002-5122-9927 FU Fonds Erasme pour la Recherche Biomedicale, of the Erasme hospital, Universite Libre de Bruxelles; Academie Royale de Medecine Belgique; FNRS, Fond National pour la Recherche Scientifique, Federation Wallonie Bruxelles, Belgium; Fonds pour la Chirurgie Cardiaque; European Space Agency; Belgian Federal Scientific Policy Office [PRODEX PEA 4000110826] FX This work was supported by the Fonds Erasme pour la Recherche Biomedicale, of the Erasme hospital, Universite Libre de Bruxelles (SM, LP); by the Academie Royale de Medecine Belgique (SM); by the FNRS, Fond National pour la Recherche Scientifique, Federation Wallonie Bruxelles, Belgium (SM, JRa); by the Fonds pour la Chirurgie Cardiaque (LP); by a grant from the European Space Agency and the Belgian Federal Scientific Policy Office (PRODEX PEA 4000110826) (AHo, DG, P-FM). 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PD MAR 8 PY 2021 VL 8 AR 603319 DI 10.3389/fcvm.2021.603319 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA QZ7TR UT WOS:000630925800001 PM 33763456 OA Green Published, gold DA 2023-05-13 ER PT J AU Le Corvoisier, P Bastuji-Garin, S Renaud, B Mahe, I Bergmann, JF Perchet, H Paillaud, E Mottier, D Montagne, O AF Le Corvoisier, Philippe Bastuji-Garin, Sylvie Renaud, Bertrand Mahe, Isabelle Bergmann, Jean-Francois Perchet, Herve Paillaud, Elena Mottier, Dominique Montagne, Olivier TI Functional status and co-morbidities are associated with in-hospital mortality among older patients with acute decompensated heart failure: a multicentre prospective cohort study SO AGE AND AGEING LA English DT Article DE older patients; acute decompensated heart failure; mortality; co-morbidities; functional status ID MINI-MENTAL-STATE; ELDERLY-PATIENTS; CLINICAL CHARACTERISTICS; NONDIABETIC PATIENTS; ADMISSION GLUCOSE; UNITED-STATES; HEALTH-CARE; KATZ INDEX; OCTOGENARIANS; PREDICTORS AB Background: among patients admitted for acute decompensated heart failure (ADHF), half are aged 75 years or over. The high prevalence of co-morbidities and functional impairments in this age group may affect patient outcomes. Objective: to assess the association between co-morbidities, functional status and in-hospital mortality in patients with ADHF aged a parts per thousand yen75 years. Design: a prospective, multicentre cohort study. Setting: five French hospitals. Subjects: five hundred and fifty-five patients aged a parts per thousand yen75 years admitted to the emergency department with ADHF. Methods: baseline clinical data and co-morbidities were recorded at admission. Functional status and cognition were assessed using the Katz index and Mini-Mental Status Examination score, respectively. The primary outcome was in-hospital mortality. Results: we found high prevalences of co-morbidities and functional impairments including hypertension (74.0%), atrial fibrillation (40.2%), prior acute coronary syndrome (32.3%) and diabetes (18.2%). The average creatinine clearance was 56.3 ml/min/1.73 m(2) (interquartile range, 39.2-77.0). In-hospital mortality was 67/555 (12.1%; 95% confidence interval, 9.4-14.8). In multivariate analysis, in-hospital mortality showed a statistically positive association with prior loss of self-sufficiency (Odds ratio [OR]: 5.85 [2.25-12.19]), hyperglycaemia (OR: 1.80 [1.26-2.54] per 1 SD increase), prior cerebral ischaemic event (OR: 3.56 [1.51-8.44]) and troponin I elevation above upper limit of normal (OR: 2.81 [1.37-5.77]). In addition, systolic blood pressure (OR: 0.98 [0.97-0.99] per 1 mmHg increase) and creatinine clearance (OR: 0.72 [0.51-1.00] per 1 SD increase) were negatively associated with in-hospital mortality. Conclusion: co-morbidities and functional impairments are associated with a worse short-term prognosis in patients aged a parts per thousand yen75 years admitted for ADHF. Assessing these parameters at admission may improve patient management. C1 [Le Corvoisier, Philippe; Montagne, Olivier] Hop Henri Mondor, APHP, INSERM, Clin Invest Ctr 1430, F-94010 Creteil, France. [Bastuji-Garin, Sylvie] Paris Est Univ UPE, LIC EA4393, F-94010 Creteil, France. [Bastuji-Garin, Sylvie] Hop Henri Mondor, APHP, Clin Res Unit URC Mondor, F-94010 Creteil, France. [Renaud, Bertrand] Cochin Hosp, APHP, Emergency Dept, F-75014 Paris, France. [Mahe, Isabelle] Hop Louis Mourier, APHP, Dept Internal Med, F-92700 Colombes, France. [Mahe, Isabelle] Univ Paris 07, Sorbonne Paris Cite, EA REMES Paris Diderot Univ, F-92700 Colombes, France. [Bergmann, Jean-Francois] Lariboisiere Fernand Vidal Hosp, APHP, Dept Internal Med, F-75010 Paris, France. [Perchet, Herve] Meaux Hosp, Dept Cardiol, F-77100 Meaux, France. [Paillaud, Elena] Hop Henri Mondor, APHP, Dept Geriatry, F-94010 Creteil, France. [Mottier, Dominique] Cavale Blanche Hosp, Dept Internal Med & Pneumol, EA GETBO 3878, F-29609 Brest, France. C3 Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Universite Paris-Est-Creteil-Val-de-Marne (UPEC); Hopital Universitaire Henri-Mondor - APHP; Institut National de la Sante et de la Recherche Medicale (Inserm); Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Universite Paris-Est-Creteil-Val-de-Marne (UPEC); Hopital Universitaire Henri-Mondor - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; 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; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; UDICE-French Research Universities; Universite Paris Cite; Hopital Universitaire Louis-Mourier - APHP; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Saint-Antoine - APHP; Universite Paris Cite; Hopital Universitaire Bichat-Claude Bernard - APHP; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Lariboisiere-Fernand-Widal - APHP; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Universite Paris-Est-Creteil-Val-de-Marne (UPEC); Hopital Universitaire Henri-Mondor - APHP; CHU Brest RP Le Corvoisier, P (通讯作者)，Hop Henri Mondor, APHP, INSERM, Clin Invest Ctr 1430, F-94010 Creteil, France. EM philippe.lecorvoisier@hmn.aphp.fr RI Bergmann, Jean-Francois/L-6044-2017; Mahé, Isabelle/ABA-3641-2020; le corvoisier, philippe/AAO-2862-2020; Bastuji-Garin, Sylvie/R-3479-2018; Paillaud, Elena/K-5616-2017 OI Bergmann, Jean-Francois/0000-0001-6861-9748; Mahé, Isabelle/0000-0003-1760-7880; Le Corvoisier, Philippe/0000-0003-0402-9591; Bastuji-Garin, Sylvie/0000-0001-9855-5183; Paillaud, Elena/0000-0002-5579-9927 FU Assistance Publique-Hopitaux de Paris; Health Ministry [AOM 0209] FX This work was supported by French public funding sources, the Assistance Publique-Hopitaux de Paris and the Health Ministry (Grant number AOM 0209). Neither funding source had any role in the design or execution of the study, analysis or interpretation of the data, or writing of the study report. 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S. Accorsi, Tarso A. D. Lima, Karine De Amicis Silva Filho, Jose R. de O. Morbeck, Renata A. Cordioli, Eduardo TI Cross-sectional study of the ambulance transport between healthcare facilities with medical support via telemedicine: Easy, effective, and safe tool SO PLOS ONE LA English DT Article ID EMERGENCY; GUIDELINES AB Background Feasibility and safety of ambulance transport between healthcare facilities with medical support exclusively via telemedicine are unknown. Methods This was a retrospective study with a single telemedicine center reference for satellite emergency departments of the same hospital. The study population was all critically ill patients admitted to one of the peripheral units from November 2016 to May 2020 and who needed to be transferred to the main building. Telemedicine-assisted transportation was performed by an emergency specialist. The inclusion criteria included patients above the age of 15 and initial stabilization performed at the emergency department. Unstable, intubated, ST-elevation myocardial infarction and acute stroke patients were excluded. There was a double-check of safety conditions by the nurse and the remote doctor before the ambulance departure. The primary endpoint was the number of telemedicine-guided interventions during transport. Results 2840 patients were enrolled. The population was predominantly male (53.2%) with a median age of 60 years. Sepsis was the most prevalent diagnosis in 28% of patients, followed by acute coronary syndromes (8.5%), arrhythmia (6.7%), venous thromboembolism (6.1%), stroke (6.1%), acute abdomen (3.6%), respiratory distress (3.3%), and heart failure (2.5%). Only 22 (0.8%) patients required telemedicine-assisted support during transport. Administration of oxygen therapy and analgesics were the most common recommendations made by telemedicine emergency physicians. There were no communication problems in the telemedicine-assisted group. Conclusions Telemedicine-assisted ambulance transportation between healthcare facilities of stabilized critically ill patients may be an option instead of an onboard physician. The frequency of clinical support requests by telemedicine is minimal, and most evaluations are of low complexity and easily and safely performed by trained nurses. C1 [Pedrotti, Carlos H. S.; Accorsi, Tarso A. D.; Lima, Karine De Amicis; Silva Filho, Jose R. de O.; Morbeck, Renata A.; Cordioli, Eduardo] Hosp Israelita Albert Einstein, Telemed Dept, Sao Paulo, Brazil. C3 Hospital Israelita Albert Einstein RP Pedrotti, CHS (通讯作者)，Hosp Israelita Albert Einstein, Telemed Dept, Sao Paulo, Brazil. 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The mechanisms of INJ in acute decompensated HF (ADHF) versus chronic HF (CHF) are still debated. This study's purpose was to evaluate the determinants of elevated hs-TnT in ADHF and CHF. Methods: We retrospectively analyzed consecutive HF patients with hs-TnT measured on admission, hospitalized in a tertiary-care hospital. Rehospitalizations, acute coronary syndromes, embolisms, infections, autoimmunity and malignancy were excluded. Cut-off point for hs-TnT was 14 ng/L. Results: Our study included 488 HF patients, 56.55% with ADHF. Mean age was 72.52 +/- 10.09 years. 53.89% were females. 67.75% ADHF and 45.75% CHF patients had elevated hs-TnT. Median hs-TnT was higher in ADHF versus CHF (21.05[IQR 12.74-33.81] vs 13.20[IQR 7.93-23.25], p<0.0001). In multivariable analysis in ADHF and CHF, log10NT-proBNP (HR=5.30, 95%CI 2.71-10.38, p<0.001, respectively HR=5.49, 95%CI 1.71-17.57, p=0.004) and eGFR (HR=0.72, 95%CI 0.62-0.85, p<0.001, respectively HR=0.71, 95%CI 0.55-0.93, p=0.014) were independent predictors for increased hs-TnT. Independent factors associated with elevated hs-TnT in ADHF were male sex (HR=2.52, 95%CI 1.31-4.87, p=0.006) and chronic pulmonary obstructive disease (COPD) (HR=10.57, 95%CI 1.26-88.40, p=0.029), while in CHF were age (HR=2.68, 95%CI 1.42-5.07, p=0.002) and previous stroke (HR=5.35, 95%CI 0.98-29.20, p=0.053). Conclusion: HF severity, expressed by NT-proBNP levels, and kidney disease progression, expressed by eGFR, were independent predictors associated with increased hs-TnT in both ADHF and CHF. Specific independent predictors were also indentified in ADHF (male sex, COPD) and CHF (age, history of stroke). C1 [Draghici, Anamaria; Buzea, Catalin Adrian; Delcea, Caterina; Vijan, Ancuta; Dan, Gheorghe Andrei] Carol Davila Univ Med & Pharm, Internal Med, Bucharest, Romania. [Draghici, Anamaria] Colentina Univ Hosp, Internal Med, Bucharest, Romania. [Buzea, Catalin Adrian; Delcea, Caterina; Vijan, Ancuta; Dan, Gheorghe Andrei] Colentina Univ Hosp, Cardiol, Bucharest, Romania. C3 Carol Davila University of Medicine & Pharmacy RP Buzea, CA (通讯作者)，Carol Davila Univ Med & Pharm, Internal Med, Bucharest, Romania. EM adrian_c_buzea@yahoo.com RI Vijan, Ancuta Elena/HHC-7766-2022; Delcea, Caterina/H-2479-2016; Vijan, Ancuta/AAC-9104-2022; Buzea, Catalin/F-4201-2014 OI Delcea, Caterina/0000-0001-7642-9290; Vijan, Ancuta/0000-0002-9617-9281; Buzea, Catalin/0000-0002-3365-9149 CR Bargnoux AS, 2016, ANN BIOL CLIN-PARIS, V74, P413, DOI 10.1684/abc.2016.1165 Bettencourt P, 2004, EUR J HEART FAIL, V6, P359, DOI 10.1016/j.ejheart.2004.01.008 Cai QJ, 2013, CURR CARDIOL REV, V9, P331, DOI 10.2174/1573403X10666140214122234 Campo G, 2015, CARDIOVASC DRUG THER, V29, P147, DOI 10.1007/s10557-014-6569-y Carlsson AC, 2017, INT J CARDIOL, V228, P253, DOI 10.1016/j.ijcard.2016.11.087 Chen M, 2017, AM J CARDIOL, V120, P2061, DOI 10.1016/j.amjcard.2017.08.026 Diez M, 2016, CARDIOL J, V23, P78, DOI 10.5603/CJ.a2015.0058 Felker GM, 2012, EUR J HEART FAIL, V14, P1257, DOI 10.1093/eurjhf/hfs110 Fu SH, 2018, FRONT PHYSIOL, V9, DOI 10.3389/fphys.2018.00692 Gore MO, 2014, J AM COLL CARDIOL, V63, P1441, DOI 10.1016/j.jacc.2013.12.032 Harrison Nicholas, 2019, Curr Heart Fail Rep, V16, P21, DOI 10.1007/s11897-019-0420-5 Hattori K, 2015, INT J CHRONIC OBSTR, V10, P309, DOI 10.2147/COPD.S76293 Hickman PE, 2010, CLIN CHIM ACTA, V411, P318, DOI 10.1016/j.cca.2009.12.009 Hijazi Z, 2015, CLIN CHEM, V61, P368, DOI 10.1373/clinchem.2014.226936 Januzzi JL, 2012, EUR HEART J, V33, P2265, DOI 10.1093/eurheartj/ehs191 Jarolim P, 2015, CLIN CHEM LAB MED, V53, P635, DOI 10.1515/cclm-2014-0565 Jeremias A, 2005, ANN INTERN MED, V142, P786, DOI 10.7326/0003-4819-142-9-200505030-00015 Kanderian AS, 2006, KIDNEY INT, V69, P1112, DOI 10.1038/sj.ki.5000174 Kirkman DL, 2018, AM J PHYSIOL-RENAL, V314, pF423, DOI 10.1152/ajprenal.00321.2017 Kociol RD, 2010, J AM COLL CARDIOL, V56, P1071, DOI 10.1016/j.jacc.2010.06.016 Korosoglou G, 2011, HEART, V97, P823, DOI 10.1136/hrt.2010.193201 LaVecchia L, 1997, AM J CARDIOL, V80, P88 Lee KK, 2019, J AM COLL CARDIOL, V74, P2032, DOI 10.1016/j.jacc.2019.07.082 Levey AS, 2009, ANN INTERN MED, V150, P604, DOI 10.7326/0003-4819-150-9-200905050-00006 Long B, 2020, AM J EMERG MED, V38, P990, DOI 10.1016/j.ajem.2019.11.041 Lowbeer C, 2004, SCAND J CLIN LAB INV, V64, P667, DOI 10.1080/00365510410003002 Missov ED, 1999, CLIN CHIM ACTA, V284, P175, DOI 10.1016/S0009-8981(99)00079-0 Ndumele CE, 2018, CLIN CHEM, V64, P201, DOI 10.1373/clinchem.2017.282798 Pandey A, 2017, JAMA CARDIOL, V2, P136, DOI 10.1001/jamacardio.2016.4726 Park KC, 2017, CARDIOVASC RES, V113, P1708, DOI 10.1093/cvr/cvx183 Pascual-Figal DA, 2012, AM HEART J, V163, P1002, DOI 10.1016/j.ahj.2012.03.015 Ponikowski P, 2016, EUR HEART J, V37, P2129, DOI 10.1093/eurheartj/ehw128 Rustamova Y, 2018, REV ROMANA MED LAB, V26, P267, DOI 10.2478/rrlm-2018-0031 Ryden L, 2019, AM J MED, V132, P833, DOI 10.1016/j.amjmed.2019.01.027 Santhanakrishnan R, 2012, EUR J HEART FAIL, V14, P1338, DOI 10.1093/eurjhf/hfs130 Shah KS, 2018, HEART FAIL CLIN, V14, P57, DOI 10.1016/j.hfc.2017.08.007 Yancy CW, 2017, J AM COLL CARDIOL, V70, P776, DOI 10.1016/j.jacc.2017.04.025 Zheng J, 2012, DIABETES RES CLIN PR, V97, P139, DOI 10.1016/j.diabres.2012.04.021 NR 38 TC 0 Z9 0 U1 1 U2 3 PU SCIENDO PI WARSAW PA BOGUMILA ZUGA 32A, WARSAW, MAZOVIA, POLAND SN 1841-6624 EI 2284-5623 J9 REV ROMANA MED LAB JI Rev. Romana Med. Lab. PD APR PY 2021 VL 29 IS 2 BP 153 EP 164 DI 10.2478/rrlm-2021-0015 PG 12 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA SM7GR UT WOS:000657769600003 OA gold DA 2023-05-13 ER PT J AU Pickering, JW Greenslade, JH Cullen, L Flaws, D Parsonage, W George, P Worster, A Kavsak, PA Than, MP AF Pickering, John W. Greenslade, Jaimi H. Cullen, Louise Flaws, Dylan Parsonage, William George, Peter Worster, Andrew Kavsak, Peter A. Than, Martin P. TI Validation of presentation and 3 h high-sensitivity troponin to rule-in and rule-out acute myocardial infarction SO HEART LA English DT Article ID ACUTE CORONARY SYNDROME; ACCELERATED DIAGNOSTIC PROTOCOL; CARDIAC TROPONIN; EMERGENCY-DEPARTMENT; CHEST-PAIN; T ASSAY; RISK STRATIFICATION; PROSPECTIVE COHORT; DEFINITIONS; BIOMARKER AB Objective International guidelines to rule-in acute myocardial infarction (AMI) in patients presenting with chest pain to the emergency department (ED) recommend an algorithm using high-sensitivity cardiac troponin (hs-cTn) sampling on presentation and 3 h following presentation. We tested the diagnostic accuracy of this algorithm by pooling data from five distinct cohorts from three countries of prospectively recruited patients with independently adjudicated outcomes. Method We measured high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) on presentation (0 h) and 3 h post-presentation samples in adult patients attending an ED with possible AMI to validate the European Society of Cardiology (ESC) Working Group on Acute Cardiac Care rule-in algorithm (ESC-rule-in). Specifically, (i) in patients with a 0 h hs-cTn concentration <= 99th percentile and a 3 h hs-cTn >99th percentile, positive patients are those with an absolute change in troponin >= 50% of the 99th percentile, and (ii) in patients with a 0 and 3 h hs-cTn >99th percentile, positive patients are those with a relative change in troponin of >= 20%. We concurrently assessed the efficacy of the 0 and 3 h hs-cTn <99th percentile to rule-out AMI. Results 1061 patients with hs-cTnI and 985 with hs-cTnT were included. The ESC-rule-in positive predictive value (PPV) was 83.5% (95% CI 74.9% to 90.1%) for hs-cTnI and 72.0% (95% CI 62.1% to 80.5%) for hs-cTnT. Forty-six AMIs (34.9%) were not ruled in using hs-cTnI and 62 (46.2%) using hs-cTnT. The sensitivity of the 99th percentile to rule-out AMI was 93.2% (95% CI 87.5% to 96.8%) for hs-cTnI and 94.8% (95% CI 89.5% to 97.9%) for hs-cTnT. Conclusions The ESC-rule-in algorithm has good PPV with hs-cTnI and reasonable with hs-cTnT and can rule-in over 50% of AMIs. However, the sensitivity of the 99th percentile to rule-out AMI is too low for clinical use. C1 [Pickering, John W.; Than, Martin P.] Christchurch Hosp, Emergency Dept, Private Bag 4710, Christchurch 8140, New Zealand. [Pickering, John W.] Univ Otago, Dept Med, Christchurch, New Zealand. [Greenslade, Jaimi H.; Cullen, Louise; Flaws, Dylan] Royal Brisbane & Womens Hosp, Dept Emergency Med, Brisbane, Qld, Australia. [Greenslade, Jaimi H.; Cullen, Louise; Flaws, Dylan] Univ Queensland, Brisbane, Qld, Australia. [Greenslade, Jaimi H.; Cullen, Louise; Flaws, Dylan] Queensland Univ Technol Brisbane, Sch Publ Hlth, Brisbane, Qld, Australia. [Parsonage, William] Royal Brisbane & Womens Hosp, Dept Cardiol, Brisbane, Qld, Australia. [George, Peter] Canterbury Hlth Labs, Christchurch, New Zealand. [Worster, Andrew; Kavsak, Peter A.] McMaster Univ, Hamilton, ON, Canada. C3 Christchurch Hospital New Zealand; University of Otago; Royal Brisbane & Women's Hospital; University of Queensland; Queensland University of Technology (QUT); Royal Brisbane & Women's Hospital; Canterbury Health Laboratories; McMaster University RP Than, MP (通讯作者)，Christchurch Hosp, Emergency Dept, Private Bag 4710, Christchurch 8140, New Zealand. EM martin.than@xtra.co.nz RI Pickering, John W/A-9453-2009; Pickering, John/ABC-8089-2021; Flaws, Dylan/AAX-1611-2020; Cullen, Louise/ABC-9266-2021; Cullen, Louise A/D-2274-2013; Kavsak, Pete/K-8089-2019; Greenslade, Jaimi/D-7832-2011; Parsonage, William/O-9233-2018 OI Pickering, John W/0000-0001-9475-0344; Pickering, John/0000-0001-9475-0344; Flaws, Dylan/0000-0002-4094-5936; Cullen, Louise/0000-0001-6611-8229; Cullen, Louise A/0000-0001-6611-8229; Greenslade, Jaimi/0000-0002-6970-5573; Parsonage, William/0000-0002-0223-5378 CR [Anonymous], 2015, MYOCARDIAL INFARCTIO Apple FS, 2012, CLIN CHEM, V58, P1574, DOI 10.1373/clinchem.2012.192716 Botto F, 2014, ANESTHESIOLOGY, V120, P564, DOI 10.1097/ALN.0000000000000113 Cullen L, 2010, EMERG MED AUSTRALAS, V22, P35, DOI 10.1111/j.1742-6723.2010.01256.x Giannitsis E, 2010, CLIN CHEM, V56, P254, DOI 10.1373/clinchem.2009.132654 Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236 Kavsak PA, 2008, CLIN CHEM, V54, P747, DOI 10.1373/clinchem.2007.094664 Kavsak PA, 2013, CLIN CHEM, V59, P1407, DOI 10.1373/clinchem.2013.208595 Kavsak PA, 2010, CLIN CHEM, V56, P487, DOI 10.1373/clinchem.2009.136689 Keller T, 2011, JAMA-J AM MED ASSOC, V306, P2684, DOI 10.1001/jama.2011.1896 Keller T, 2009, NEW ENGL J MED, V361, P868, DOI 10.1056/NEJMoa0903515 Luepker RV, 2003, CIRCULATION, V108, P2543, DOI 10.1161/01.CIR.0000100560.46946.EA Mueller M, 2012, CLIN CHEM, V58, P209, DOI 10.1373/clinchem.2011.171827 Pickering JW, 2015, CLIN BIOCHEM, V48, P1219, DOI 10.1016/j.clinbiochem.2015.07.033 R Core Team, 2014, R LANG ENV STAT COMP Reichlin T, 2015, CAN MED ASSOC J, V187, pE243, DOI 10.1503/cmaj.141349 Reichlin T, 2012, ARCH INTERN MED, V172, P1211, DOI 10.1001/archinternmed.2012.3698 Reichlin T, 2011, CIRCULATION, V124, P136, DOI 10.1161/CIRCULATIONAHA.111.023937 Shah ASV, 2015, BMJ-BRIT MED J, V350, DOI 10.1136/bmj.g7873 Than M, 2014, EMERG MED AUSTRALAS, V26, P34, DOI 10.1111/1742-6723.12164 Than M, 2014, JAMA INTERN MED, V174, P51, DOI 10.1001/jamainternmed.2013.11362 Than M, 2013, INT J CARDIOL, V166, P752, DOI 10.1016/j.ijcard.2012.09.171 Than M, 2012, J AM COLL CARDIOL, V59, P2091, DOI 10.1016/j.jacc.2012.02.035 Thygesen K, 2007, CIRCULATION, V116, P2634, DOI [10.1161/CIRCULATIONAHA.107.187397, 10.1016/j.jacc.2007.09.011] Thygesen K, 2012, EUR HEART J, V33, P2252, DOI 10.1093/eurheartj/ehs154 Wildi K, 2015, CLIN BIOCHEM, V48, P218, DOI 10.1016/j.clinbiochem.2014.09.003 Yang EH, 2006, CURR PROB CARDIOLOGY, V31, P769, DOI 10.1016/j.cpcardiol.2006.08.004 NR 27 TC 64 Z9 65 U1 3 U2 12 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 AUG PY 2016 VL 102 IS 16 BP 1270 EP 1278 DI 10.1136/heartjnl-2015-308505 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DV0BA UT WOS:000382581300007 PM 26955848 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Hoschar, S Pan, JQ Wang, Z Fang, XY Tang, XN Shi, WQ Tu, RX Xi, P Che, WL Wang, HB Li, YW Fritzsche, K Liu, XB Ladwig, KH Ma, WL AF Hoschar, Sophia Pan, Jiangqi Wang, Zhen Fang, Xiaoyan Tang, Xiane Shi, Weiqi Tu, Rongxiang Xi, Peng Che, Wenliang Wang, Hongbao Li, Yawei Fritzsche, Kurt Liu, Xuebo Ladwig, Karl-Heinz Ma, Wenlin TI The MEDEA FAR-EAST Study: Conceptual framework, methods and first findings of a multicenter cross-sectional observational study SO BMC EMERGENCY MEDICINE LA English DT Article DE Acute myocardial infarction; Prehospital delay; Cross-sectional observational; Multicenter study; China ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; PREHOSPITAL DELAY-TIME; CARE-SEEKING; CHEST-PAIN; SYMPTOMS; CHINA; ASSOCIATION; BEHAVIOR; IMPACT AB BackgroundThe substantial increase in cardiovascular diseases (CVD) in China over the last three decades warrants comprehensive preventive primary and secondary strategies. Prolonged prehospital delay (PHD) has been identified as a substantial barrier to timely therapeutic interventions for acute myocardial infarction (AMI). Despite worldwide efforts to decrease the patient's decision-making time, minimal change has been achieved so far. Here, we aim to describe the conceptual framework and methods and outline key data of the MEDEA FAR-EAST Study, which aimed to elucidate in-depth barriers contributing to delay in Chinese AMI-patients.MethodsData sources of this multicenter cross-sectional observational study are a standardized bedside interview, a self-administered tailored questionnaire tool and the patient chart. PHD was defined as the main outcome and triangulated at bedside. Standard operation procedures ensured uniform data collection by trained study personnel. The study was ethically approved by Tongji-Hospital and applied to all participating hospitals.ResultsAmong 379 consecutively screened patients, 296 (78.1%) fulfilled eligibility criteria. A total of 241 (81.4%) AMI-patients were male and 55 (18.6%) female. Mean age was 62.9years. Prehospital delay time was assessed for 294 (99.3%) patients. Overall median PHD was 151min with no significant sex difference. Symptom mismatch was present in 200 (69.7%) patients and 106 (39.0%)patients did not attribute their symptoms to cardiac origin. A total of 33 (12.4%) patients suffered from depression, 31 (11.7%) from anxiety and 141 (53.2%) patients employed denial as their major coping style.ConclusionThis is the first study on prehospital delay with emphasis on psychological variables in Chinese AMI-patients. A comprehensive assessment tool to measure clinical and psychological factors was successfully implemented. Socio-demographic key data proved a good fit into preexisting Chinese literature. Potential barriers including cardiac denial and symptom-mismatch were assessed for the first time in Chinese AMI-patients. The pretested selection of instruments allows future in depth investigations into barriers to delay of Chinese AMI-patients and enables inter-cultural comparisons. C1 [Hoschar, Sophia; Fang, Xiaoyan; Ladwig, Karl-Heinz] German Res Ctr Environm Hlth GmbH, Helmholtz Zentrum Munchen, Mental Hlth Res Unit, Inst Epidemiol 2, Ingolstadter Landstr 1, D-85764 Neuherberg, Germany. [Pan, Jiangqi; Wang, Zhen; Tang, Xiane; Shi, Weiqi; Tu, Rongxiang; Xi, Peng; Liu, Xuebo; Ma, Wenlin] Tongji Univ, Tongji Hosp, Dept Cardiol, Shanghai, Peoples R China. [Che, Wenliang] Tongji Univ, Hosp 10, Dept Cardiol, Shanghai, Peoples R China. [Wang, Hongbao] Tongji Univ, Yangpu Hosp, Dept Cardiol, Shanghai, Peoples R China. [Li, Yawei] Tongji Univ, Hosp 455, Dept Cardiol, Shanghai, Peoples R China. [Hoschar, Sophia; Fritzsche, Kurt] Univ Freiburg, Fac Med, Dept Psychosomat Med & Psychotherapy, Med Ctr, Freiburg, Germany. [Fang, Xiaoyan; Ladwig, Karl-Heinz] Tech Univ Munich, Dept Psychosomat Med & Psychotherapy, Munich, Germany. C3 Helmholtz Association; Helmholtz-Center Munich - German Research Center for Environmental Health; Tongji University; Tongji University; Tongji University; Tongji University; University of Freiburg; Technical University of Munich RP Ladwig, KH (通讯作者)，German Res Ctr Environm Hlth GmbH, Helmholtz Zentrum Munchen, Mental Hlth Res Unit, Inst Epidemiol 2, Ingolstadter Landstr 1, D-85764 Neuherberg, Germany.; Ladwig, KH (通讯作者)，Tech Univ Munich, Dept Psychosomat Med & Psychotherapy, Munich, Germany. EM ladwig@helmholtz-muenchen.de RI Ladwig, Karl-Heinz/B-5351-2014 OI Ladwig, Karl-Heinz/0000-0003-0710-1720 FU Science and Technology Committee Foundation of Shanghai, PR China [16411965500, 16511102802]; German Heart Foundation FX This work was supported by the Science and Technology Committee Foundation of Shanghai, PR China (16411965500, 16511102802) to Prof. Ma Wenlin and by the German Heart Foundation to Prof. Karl-Heinz Ladwig. The funding was used to cover printing fees and to pay the study personnel. 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10.1002/clc.20247 [张勇 ZHANG Yong], 2006, [中国行为医学科学, Chinese Journal of Behavioral Medical Science], V15, P757 NR 69 TC 3 Z9 3 U1 0 U2 1 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 MAY 2 PY 2019 VL 19 AR 31 DI 10.1186/s12873-019-0240-7 PG 13 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA HW7PV UT WOS:000466882700002 PM 31046724 OA Green Published, gold DA 2023-05-13 ER PT J AU Elbarsha, A Elhemri, M Lawgaly, SA Rajab, A Almoghrabi, B Elmehdawi, RR AF Elbarsha, Abdulwahab Elhemri, Maisoon Lawgaly, Sami A. Rajab, Ashraf Almoghrabi, Badia Elmehdawi, Rafik Ramadan TI Outcomes and hospital admission patterns in patients with diabetes during Ramadan versus a non-fasting period SO ANNALS OF SAUDI MEDICINE LA English DT Article ID DISEASE AB BACKGROUND: Fasting during Ramadan is a challenge for Muslim patients with diabetes and for their healthcare providers. However, data on the effects of Ramadan fasting on hospital admissions and outcomes in patients with diabetes are scarce. OBJECTIVES: Evaluate the characteristics of patients with diabetes admitted during the fasting month of Ramadan compared with the non-fasting month of Dhu al-Qidah. DESIGN: A retrospective cohort study medical record review. SETTING: A university teaching hospital. PATIENTS AND METHODS: We reviewed the records of all patients with diabetes admitted to the medical department at Benghazi Medical Center, including medical ward, intensive care unit and coronary care unit, during the months of Ramadan and Dhu al-Qidah, 2016. We compared differences in reasons for admission, length of stay and in-hospital mortality between patients admitted during Ramadan and Dhu al-Qidah and between patients who were fasting at time of admission during Ramadan and those who were not. MAIN OUTCOME MEASURES: Main reason for admission, length of stay and in-hospital mortality rate. SAMPLE SIZE: 402 patients with diabetes. RESULTS: During Ramadan, 186 patients were admitted compared with 216 during Dhul al-Qidah. There was no statistically significant difference in reasons for admission, length of hospital stay, or in-hospital mortality (borderline for mortality, P=.078), between patients with diabetes admitted during Ramadan and Dhu al-Qidah. Of those admitted in Ramadan, 59.1% were fasting on admission. Fasting patients admitted during Ramadan had a significantly higher proportion of the diseases of the circulatory system when compared with non-fasting patients (39.4% vs. 23.6%, P=.028) while in-hospital mortality was higher in non-fasting patients (29.2% vs. 8.7%, P<.001). There was no significant difference in length of stay between fasting and non-fasting patients. CONCLUSIONS: The frequency of admissions for most medical conditions were not changed during Ramadan but the frequency of acute coronary syndrome was higher in those who were fasting on admission. Patients with diabetes who were not fasting on admission had more high-risk features that prevented them from fasting and therefore are at increased risk of in-hospital mortality. LIMITATIONS: Single center and retrospective. C1 [Elbarsha, Abdulwahab; Elhemri, Maisoon; Lawgaly, Sami A.; Rajab, Ashraf; Almoghrabi, Badia; Elmehdawi, Rafik Ramadan] Benghazi Med Ctr, Dept Med, Second Ring Rd, Foyhat, Benghazi, Libya. [Elbarsha, Abdulwahab; Elmehdawi, Rafik Ramadan] Univ Benghazi, Dept Med, Fac Med, Benghazi, Libya. C3 University of Benghazi RP Elbarsha, A (通讯作者)，Benghazi Med Ctr, Dept Med, Second Ring Rd, Foyhat, Benghazi, Libya. EM elbarsha@hotmail.com RI Lawgaly, Sami/AAN-9039-2020 OI Lawgaly, Sami/0000-0003-3286-210X; Elbarsha, Abdulwahab/0000-0001-5973-308X; EL MEHDAWI, RAFIK/0000-0002-7480-1236 CR Al Assaad RG, 2017, EUR J EMERG MED Al Suwaidi J, 2004, HEART, V90, P695, DOI 10.1136/hrt.2003.012526 Al-Arouj M, 2010, DIABETES CARE, V33, P1895, DOI 10.2337/dc10-0896 Bragazzi NL, 2014, J RES MED SCI, V19, P665 El-Mitwalli A, 2009, EUR J NEUROL, V16, pE80, DOI 10.1111/j.1468-1331.2009.02566.x Elbarsha A, 2018, INT J DIABETES DEV C, V38, P191, DOI 10.1007/s13410-017-0575-0 Elmehdawi Rafik, 2009, Oman Med J, V24, P99, DOI 10.5001/omj.2009.23 Elmehdawi RR, 2010, LIBYAN J MED, V5, DOI 10.3402/ljm.v5i0.5036 Hassanein M, 2017, DIABETES RES CLIN PR, V126, P303, DOI 10.1016/j.diabres.2017.03.003 Jabbar A, 2017, DIABETES RES CLIN PR, V132, P19, DOI 10.1016/j.diabres.2017.07.014 Musleh AS, 2015, IBNOSINA J MED BS, V7, P223 Pekdemir M, 2010, J EMERG MED, V38, P253, DOI 10.1016/j.jemermed.2008.03.013 Salti I, 2004, DIABETES CARE, V27, P2306, DOI 10.2337/diacare.27.10.2306 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 Turin TC, 2016, J FAM COMMUNITY MED, V23, P73, DOI 10.4103/2230-8229.181006 World Health Organisation, 2016, INT STAT CLASS DIS R, DOI 10/2016/en NR 17 TC 8 Z9 8 U1 0 U2 0 PU K FAISAL SPEC HOSP RES CENTRE PI RIYADH PA PUBLICATIONS OFFICE PO BOX 3354, RIYADH 11211, SAUDI ARABIA SN 0256-4947 EI 1319-9226 J9 ANN SAUDI MED JI Ann. Saudi Med. PD SEP-OCT PY 2018 VL 38 IS 5 BP 344 EP 351 DI 10.5144/0256-4947.2018.344 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA HD2ZS UT WOS:000452381700004 PM 30284989 OA Green Submitted, Green Published, gold DA 2023-05-13 ER PT J AU Vanek, J Prasko, J Ociskova, M Genzor, S Sovova, E Sova, M Minarikova, KB Nesnidal, V Bocek, J Kantor, K Dacerova, VO AF Vanek, Jakub Prasko, Jan Ociskova, Marie Genzor, Samuel Sovova, Eliska Sova, Milan Minarikova, Kamila Belohradova Nesnidal, Vlastimil Bocek, Jonas Kantor, Krystof Dacerova, Veronika Ondrackova TI Screening for obstructive sleep apnoea in high-risk patients with mood disorders SO NEUROENDOCRINOLOGY LETTERS LA English DT Article DE sleep apnoea; OSA; depression; bipolar disorder; screening; obesity; snoring ID BREATHING DISORDERS; DEPRESSION; HYPERTENSION; ASSOCIATION; ANXIETY; SCALE; INDIVIDUALS; SEVERITY AB OBJECTIVE: Our study aimed to screen for obstructive sleep apnoea (OSA) in a clinical population of psychiatric patients with affective disorders and risk factors for OSA using screening devices in psychiatric clinical environments. METHODS: Inpatients admitted with mood disorders in an inpatient psychiatric department were selected via inclusion and exclusion criteria and assessed for the risk factors of OSA. The inclusion criteria were: a diagnosis of an affective disorder confirmed by two independent psychiatrists, snoring or apnoeic pauses witnessed during regular night check-ups by nurses, and BMI > 25 kg/m(2). The exclusion criteria were: a comorbid psychotic disorder, previously diagnosed OSA, intellectual disability, organic mental illness, acute coronary syndrome, acute or chronic heart failure, acute pulmonary diseases, a history of stroke, neuromuscular disorders, or a myorelaxant treatment. All included patients underwent overnight monitoring by a screening device SomnoCHECK Micro Cardio. A certified somnologist assessed obtained data. RESULTS: A total of 32 subjects (23 women and nine men) were included in the study. The mean age was 49.8 +/- 8.8 years. Most participants had major depressive disorder (n = 23); another nine individuals had bipolar disorder. Diagnostic criteria for OSA were found in 50% of the sample, specifically in 88% of men and 33% of women. The correlation analysis identified several risk factors and variables. CONCLUSIONS: This pilot study showed an increased risk of OSA in patients with mood disorders. Psychiatric patients with identified risk factors should be routinely screened for obstructive sleep apnoea and referred to proper treatment. C1 [Vanek, Jakub; Prasko, Jan; Ociskova, Marie; Minarikova, Kamila Belohradova; Nesnidal, Vlastimil; Bocek, Jonas; Kantor, Krystof] Univ Palacky Olomouc, Univ Hosp, Fac Med & Dent, Dept Psychiat, Olomouc 77520, Czech Republic. [Prasko, Jan] Inst Postgrad Educ Hlth Care, Prague, Czech Republic. [Prasko, Jan] Constantine Philosopher Univ Nitra, Fac Social Sci & Hlth Care, Dept Psychol Sci, Nitra, Slovakia. [Genzor, Samuel; Sova, Milan] Univ Hosp Olomouc, Dept Resp Med, Olomouc, Czech Republic. [Genzor, Samuel; Sova, Milan] Palacky Univ Olomouc, Fac Med & Dent, Olomouc, Czech Republic. [Sovova, Eliska] Palacky Univ Olomouc, Dept Exercise Med & Cardiovasc Rehabil, Olomouc, Czech Republic. [Sovova, Eliska] Univ Hosp Olomouc, Olomouc, Czech Republic. [Sova, Milan] Univ Hosp Brno, Dept Resp Med, Brno, Czech Republic. [Sova, Milan] Masaryk Univ Brno, Fac Med, Brno, Czech Republic. [Dacerova, Veronika Ondrackova] Masaryk Univ Brno, Fac Arts, Dept Psychol, Brno, Czech Republic. [Prasko, Jan; Ociskova, Marie] Jessenia Inc, Rehabil Hosp Beroun, Akeso Holding, Mindwell, Czech Republic. C3 Palacky University Olomouc; University Hospital Olomouc; Constantine the Philosopher University in Nitra; University Hospital Olomouc; Palacky University Olomouc; Palacky University Olomouc; University Hospital Olomouc; University Hospital Brno; Masaryk University Brno; Masaryk University Brno RP Prasko, J (通讯作者)，Univ Hosp Olomouc, Fac Med & Dent, Dept Psychiat, IP Pavlova 6, Olomouc 77520, Czech Republic. EM praskojan@seznam.cz OI Genzor, Samuel/0000-0002-6730-5832 FU Palacky University in Olomouc, Internal Grant Agency [IGA_LF_2018_014] FX Supported by Palacky University in Olomouc, Internal Grant Agency, grant nr. IGA_LF_2018_014. 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Lett. PY 2022 VL 43 IS 4 BP 218 EP 226 PG 9 WC Endocrinology & Metabolism; Neurosciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism; Neurosciences & Neurology GA 9M6UH UT WOS:000942361700004 PM 36528884 DA 2023-05-13 ER PT J AU Padkins, M Breen, T Anavekar, N van Diepen, S Henry, TD Baran, DA Barsness, GW Kashani, K Holmes, DR Jentzer, JC AF Padkins, Mitchell Breen, Thomas Anavekar, Nandan van Diepen, Sean Henry, Timothy D. Baran, David A. Barsness, Gregory W. Kashani, Kianoush Holmes, David R., Jr. Jentzer, Jacob C. TI Age and shock severity predict mortality in cardiac intensive care unit patients with and without heart failure SO ESC HEART FAILURE LA English DT Article DE Age; Shock; Mortality; Cardiac intensive care unit; Critical care; Cardiogenic shock; Outcomes ID ACUTE MYOCARDIAL-INFARCTION; CARDIOGENIC-SHOCK; ELDERLY-PATIENTS; EARLY REVASCULARIZATION; RISK PREDICTION; TERM MORTALITY; OLDER PATIENTS; PROGNOSIS; OUTCOMES; ILLNESS AB Aims Age is an important risk factor for mortality among patients with cardiogenic shock and heart failure (HF). We sought to assess the extent to which age modified the performance of the Society for Cardiovascular Angiography and Interventions (SCAI) shock stage for in-hospital and 1 year mortality in cardiac intensive care unit (CICU) patients with and without HF. Methods and results We retrospectively reviewed unique admissions to the Mayo Clinic CICU during 2007-2015 and stratified patients by age and SCAI shock stage. The association between age and in-hospital mortality was analysed using multivariable logistic regression, and 1 year mortality was analysed using Cox proportional hazards analysis, both in the entire cohort and among patients with an admission diagnosis of HF or acute coronary syndrome (ACS). The final study population included 10 004 unique patients with a mean age of 67 +/- 15 years, including 46.1% with HF and 43.1% with ACS. Older patients more frequently had HF and had more extensive co-morbidities, higher illness severity, more organ failure, and differential use of critical care therapies. The percentage of patients with SCAI shock stages A, B, C, D, and E were 46%, 30%, 16%, 7%, and 1%, respectively. Patients with HF were older, had greater severity of illness and higher SCAI shock stage, and had higher rates of death at all time points. In-hospital mortality occurred in 908 (9%) patients, including 549 (12%) patients with HF (61% of all hospital deaths). Age was independently associated with hospital mortality (adjusted odds ratio per 10 years 1.3, 95% confidence interval 1.2-1.4,P < 0.001) and 1 year mortality (adjusted hazard ratio per 10 years 1.2, 95% confidence interval 1.2-1.3,P < 0.001) in the overall cohort. The associations of age with both hospital mortality (adjusted odds ratio 1.6 vs. 1.3 per 10 years older) and 1 year mortality (adjusted hazard ratio 1.5 vs. 1.3 per 10 years older) were higher for patients with ACS compared with patients with HF. Older age was associated with higher adjusted hospital mortality and 1 year mortality in each SCAI shock stage (allP < 0.05). Additive increases in both hospital mortality and 1 year mortality were observed with increasing age and SCAI shock stage. Conclusions Age is an independent risk factor for mortality that modifies the relationship between the SCAI shock stage and mortality risk in CICU patients, providing robust risk stratification for in-hospital and 1 year mortality. Although patients with HF had a higher risk of dying, age was more strongly associated with mortality among patients with ACS. C1 [Padkins, Mitchell; Breen, Thomas] Mayo Clin, Mayo Clin Sch Grad Med Educ, Rochester, MN 55905 USA. [Anavekar, Nandan; Barsness, Gregory W.; Holmes, David R., Jr.; Jentzer, Jacob C.] Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. [van Diepen, Sean] Univ Alberta Hosp, Dept Crit Care Med, Edmonton, AB, Canada. [van Diepen, Sean] Univ Alberta Hosp, Dept Med, Div Cardiol, Edmonton, AB, Canada. [Henry, Timothy D.] Christ Hosp Hlth Network, Carl & Edyth Lindner Ctr Res & Educ, Cincinnati, OH 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. [Kashani, Kianoush; Jentzer, Jacob C.] Mayo Clin, Div Pulm & Crit Care Med, Dept Med, Rochester, MN 55905 USA. [Kashani, Kianoush] Mayo Clin, Div Nephrol & Hypertens, Dept Med, Rochester, MN 55905 USA. C3 Mayo Clinic; Mayo Clinic; University of Alberta; University of Alberta; Christ Hospital - Ohio; Sentara Healthcare; Eastern Virginia Medical School; Sentara Healthcare; Mayo Clinic; Mayo Clinic 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 Padkins, Mitchell/0000-0002-7144-5280; Baran, David/0000-0002-7754-9953; Jentzer, Jacob/0000-0002-6366-2859 CR Acharya D, 2018, CARDIOL REV, V26, P255, DOI 10.1097/CRD.0000000000000190 Baran DA, 2019, CATHETER CARDIO INTE, V94, P29, DOI 10.1002/ccd.28329 BENNETT CE, 2019, J CRIT CARE, V50, P242, DOI 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 Campanile A, 2019, J CARDIOVASC MED, V20, P327, DOI 10.2459/JCM.0000000000000785 Damluji AA, 2020, CIRCULATION, V141, pE6, DOI 10.1161/CIR.0000000000000741 Dzavik V, 2005, AM HEART J, V149, P1128, DOI 10.1016/j.ahj.2005.03.045 Dzavik V, 2003, EUR HEART J, V24, P828, DOI 10.1016/S0195-668X(02)00844-8 Goldfarb M, 2019, J INTENSIVE CARE MED, V34, P537, DOI 10.1177/0885066617741873 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Harjola VP, 2015, EUR J HEART FAIL, V17, P501, DOI 10.1002/ejhf.260 Herasevich V, 2010, MAYO CLIN PROC, V85, P247, DOI 10.4065/mcp.2009.0479 Hochman JS, 1999, NEW ENGL J MED, V341, P625, DOI 10.1056/NEJM199908263410901 Holland EM, 2017, J AM COLL CARDIOL, V69, P1999, DOI 10.1016/j.jacc.2017.02.033 Jentzer JC, 2020, AM HEART J, V224, P57, DOI 10.1016/j.ahj.2020.02.018 Jentzer JC, 2020, CATHETER CARDIO INTE, V96, P1350, DOI 10.1002/ccd.28854 Jentzer JC, 2020, CLIN CARDIOL, V43, P516, DOI 10.1002/clc.23339 Jentzer JC, 2020, AM HEART J, V219, P37, DOI 10.1016/j.ahj.2019.10.012 Jentzer JC, 2019, MAYO CLIN PROC, V94, P1994, DOI 10.1016/j.mayocp.2019.04.038 Jentzer JC, 2019, J AM COLL CARDIOL, V74, P2117, DOI 10.1016/j.jacc.2019.07.077 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2020, SHOCK, V53, P452, DOI 10.1097/SHK.0000000000001390 Jentzer JC, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0216177 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, 2009, AM HEART J, V158, P680, DOI 10.1016/j.ahj.2009.08.005 Lang RM, 2015, EUR HEART J-CARD IMG, V16, P233, DOI 10.1093/ehjci/jev014 Lyle M, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.119.012439 Poss J, 2017, J AM COLL CARDIOL, V69, P1913, DOI 10.1016/j.jacc.2017.02.027 Ratcliffe JA, 2014, CORONARY ARTERY DIS, V25, P60, DOI 10.1097/MCA.0000000000000043 Rocca WA, 2012, MAYO CLIN PROC, V87, P1202, DOI 10.1016/j.mayocp.2012.08.012 Rogers PA, 2014, INT J CARDIOL, V172, P239, DOI 10.1016/j.ijcard.2013.12.311 Rosenbaum AN, 2017, AM J CARDIOL, V120, P1421, DOI 10.1016/j.amjcard.2017.07.028 Schrage B, 2020, CATHETER CARDIO INTE, V96, pE213, DOI 10.1002/ccd.28707 Singh B, 2012, MAYO CLIN PROC, V87, P817, DOI 10.1016/j.mayocp.2012.04.015 Sujino Y, 2015, J CARDIOL, V66, P263, DOI 10.1016/j.jjcc.2014.12.001 Nguyen TV, 2019, CLIN INTERV AGING, V14, P2213, DOI 10.2147/CIA.S234597 Watson RA, 2019, EUR HEART J-ACUTE CA, V8, P755, DOI 10.1177/2048872618789053 Zeymer U, 2019, JACC-CARDIOVASC INTE, V12, P1853, DOI 10.1016/j.jcin.2019.04.027 NR 40 TC 15 Z9 15 U1 0 U2 0 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 DEC PY 2020 VL 7 IS 6 BP 3971 EP 3982 DI 10.1002/ehf2.12995 EA SEP 2020 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA PI0KH UT WOS:000567530200001 PM 32909377 OA Green Published, gold DA 2023-05-13 ER PT J AU Jesus, TS Papadimitriou, C Bright, FA Kayes, NM Pinho, CS Cott, CA AF Jesus, Tiago S. Papadimitriou, Christina Bright, Felicity A. Kayes, Nicola M. Pinho, Catia S. Cott, Cheryl A. TI Person-Centered Rehabilitation Model: Framing the Concept and Practice of Person-Centered Adult Physical Rehabilitation Based on a Scoping Review and Thematic Analysis of the Literature SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Review DE Models; theoretical; Patient-centered care; Rehabilitation; Review ID ACUTE CORONARY SYNDROME; SHARED DECISION-MAKING; STROKE SURVIVORS EXPERIENCES; RANDOMIZED CONTROLLED-TRIAL; OCCUPATIONAL-THERAPY; PATIENT-CENTEREDNESS; HEALTH-CARE; FOLLOW-UP; INJURY REHABILITATION; CLIENT-CENTEREDNESS AB Objective: To develop a cross-professional model framing the concept and practice of person-centered rehabilitation (PCR) in adult populations, based on a scoping review and thematic analysis of the literature. Data Sources: Key databases (PubMed, Scopus, Cumulative Index to Nursing and Allied Health), snowballing searches, and experts' consultation were the data sources for English-language empirical or conceptual articles published from January 2007-February 2020. Study Selection: Two independent reviewers selected adult-based articles addressing at least 1 of the 6 categories of PCR-related content, a priori specified in the published review protocol. From 6527 unique references, 147 were finally included in the analysis. Of those, 26 were exclusively conceptual articles. Data Extraction: Two independent reviewers extracted textual data on what PCR entails conceptually or as a practice. No quality appraisals were performed as is typical in scoping reviews. Data Synthesis: A thematic analysis produced thematic categories that were combined into an emergent model (the PCR Model), which was reviewed by 5 external experts. PCR was framed as a way of thinking about and providing rehabilitation services "with" the person. PCR is embedded in rehabilitation structures and practice across 3 levels: (1) the person-professional dyad; (2) the microsystem level (typically an interprofessional team, involving significant others); and (3) a macrosystem level (organization within which rehabilitation is delivered). Thematic categories are articulated within each level, detailing both the conceptual and practice attributes of PCR. Conclusions: The PCR Model can inform both clinical and service organization practices. The PCR Model may benefit from further developments including obtaining wider stakeholders' input, determining relevance in different cultural and linguistic groups, and further operationalization and testing in implementation projects. (c) 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved. C1 [Jesus, Tiago S.] NOVA Univ Lisbon, Global Hlth & Trop Med GHTM, Rua Junqueira 100, P-1349008 Lisbon, Portugal. [Jesus, Tiago S.] NOVA Univ Lisbon, WHO Collaborating Ctr Hlth Workforce Policy & Pla, Inst Hyg & Trop Med, Rua Junqueira 100, P-1349008 Lisbon, Portugal. [Papadimitriou, Christina] Oakland Univ, Sch Hlth Sci, Rochester, MI USA. [Bright, Felicity A.; Kayes, Nicola M.] Auckland Univ Technol, Sch Clin Sci, Ctr Person Cent Res, Auckland, New Zealand. [Pinho, Catia S.] ISVOUGA Super Inst Entre Douro & Vouga, Santa Maria Feira, Portugal. [Cott, Cheryl A.] Univ Toronto, Rehabil Sci Inst, Fac Med, Toronto, ON, Canada. C3 Universidade Nova de Lisboa; Universidade Nova de Lisboa; Institute of Hygiene & Tropical Medicine - UNL; Oakland University; Auckland University of Technology; University of Toronto RP Jesus, TS (通讯作者)，NOVA Univ Lisbon, Global Hlth & Trop Med GHTM, Rua Junqueira 100, P-1349008 Lisbon, Portugal.; Jesus, TS (通讯作者)，NOVA Univ Lisbon, WHO Collaborating Ctr Hlth Workforce Policy & Pla, Inst Hyg & Trop Med, Rua Junqueira 100, P-1349008 Lisbon, Portugal. 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PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 EI 1532-821X J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD JAN PY 2022 VL 103 IS 1 BP 106 EP 120 DI 10.1016/j.apmr.2021.05.005 EA DEC 2021 PG 15 WC Rehabilitation; Sport Sciences WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Rehabilitation; Sport Sciences GA XW1IJ UT WOS:000735381500015 PM 34228955 DA 2023-05-13 ER PT J AU Esplendori, GF Kobayashi, RM Puschel, VAD AF Esplendori, Gabriela Feitosa Kobayashi, Rika Miyahara Puschel, Vilanice Alves de Araujo TI Multisensory integration approach, cognitive domains, meaningful learning: reflections for undergraduate nursing education SO REVISTA DA ESCOLA DE ENFERMAGEM DA USP LA English DT Article DE Education; Nursing; Learning; Teaching Materials; Cardiology; Students; Perception AB Teaching with a multisensory approach helps students link new information to prior knowledge and understand relationships between concepts. This study aimed to reflect on convergences between the Multisensory Integration Approach Model with the Learning Assimilation Theory and Meaningful Retention with Bloom's Cognitive Process Domain, and to propose a taxonomic table of lesson planning for teaching Acute Coronary Syndrome, considering the confluence of these references. The three frameworks consider the importance of students' prior knowledge, the process of abstraction and generalization of knowledge, and the relationship between working and long-term memory. By observing such convergences and the taxonomic table produced, it is observed that teaching topics of interest to nursing undergraduate students, adopting the Multisensory Integration Approach Model as a taxonomic table component (pre-organizing or recall activities to arouse different sensory perceptions aligned with instructional objectives and forms of assessment), in the light of the Learning Assimilation Theory and Meaningful Retention, has the potential to favor the reception and processing of instructional content. C1 [Esplendori, Gabriela Feitosa; Puschel, Vilanice Alves de Araujo] Univ Sao Paulo, Escola Enfermagem, Sao Paulo, SP, Brazil. [Esplendori, Gabriela Feitosa; Kobayashi, Rika Miyahara] Inst Dante Pazzanese Cardiol, Sao Paulo, SP, Brazil. C3 Universidade de Sao Paulo; Instituto Dante Pazzanese de Cardiologia RP Esplendori, GF (通讯作者)，Rua Solidonio Leite 2718, BR-03275000 Sao Paulo, SP, Brazil. EM gabriela.lima@usp.br RI Kobayashi, Rika Miyahara/D-5633-2017 OI Kobayashi, Rika Miyahara/0000-0001-8569-4264; Esplendori, Gabriela/0000-0002-7654-8676 CR Aliakbari Fatemeh, 2015, J Educ Health Promot, V4, P2, DOI 10.4103/2277-9531.151867 Anderson LW., 2001, TAXONOMY LEARNING TE Ausubel D. P., 2003, AQUISICAO RETENCAO C Barron AB, 2015, TRENDS NEUROSCI, V38, P405, DOI 10.1016/j.tins.2015.04.008 Barron C, 2008, NURS EDUC TODAY, V28, P962, DOI 10.1016/j.nedt.2008.05.017 Chisholm A., 2017, PALRAP, V5, P26 Fang N, 2018, J COMPUT ASSIST LEAR, V34, P71, DOI 10.1111/jcal.12215 Ferraz Ana Paula do Carmo Marcheti, 2010, Gest. Prod., V17, P421, DOI 10.1590/S0104-530X2010000200015 Gogulski J, 2017, CEREB CORTEX, V27, P5343, DOI 10.1093/cercor/bhx219 Hutter RRC, 2016, MEMORY, V24, P496, DOI 10.1080/09658211.2015.1020814 Kandel ER, 2014, PRINCIPIOS NEUROCIEN, V5ed, P393 Macaden Leah, 2017, Br J Nurs, V26, P1057, DOI 10.12968/bjon.2017.26.19.1057 Menegaz Jouhanna do Carmo, 2018, Esc. 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USP PY 2022 VL 56 AR e20210381 DI 10.1590/1980-220X-REEUSP-2021-0381 PG 9 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA 0U0IJ UT WOS:000787343000001 PM 35421209 OA Green Published, gold DA 2023-05-13 ER PT J AU Wu, CQ Huo, XQ Liu, JM Zhang, LH Bai, XK Hu, S Li, X Lu, JP Zheng, X Li, J Zhang, HB AF Wu, Chaoqun Huo, Xiqian Liu, Jiamin Zhang, Lihua Bai, Xueke Hu, Shuang Li, Xi Lu, Jiapeng Zheng, Xin Li, Jing Zhang, Haibo TI Development and validation of a risk prediction model for in-hospital major cardiovascular events in patients hospitalised for acute myocardial infarction SO BMJ OPEN LA English DT Article DE myocardial infarction; risk management; stroke ID ST-SEGMENT ELEVATION; CENTERED EVALUATIVE ASSESSMENT; ACUTE CORONARY SYNDROMES; GLOBAL REGISTRY; MORTALITY; SCORE; TRIAL; DISEASE; BURDEN AB ObjectivesPatients admitted to hospital with acute myocardial infarction (AMI) have considerable variability in in-hospital risks, resulting in higher demands on healthcare resources. Simple risk-assessment tools are important for the identification of patients with higher risk to inform clinical decisions. However, few risk assessment tools have been built that are suitable for populations with AMI in China. We aim to develop and validate a risk prediction model, and further build a risk scoring system.DesignData from a nationally representative retrospective study was used to develop the model. Patients from a prospective study and another nationally representative retrospective study were both used for external validation.Setting161 nationally representative hospitals, and 53 and 157 other hospitals were involved in the above three studies, respectively.Participants8010 patients hospitalised for AMI were included as development sample, and 4485 and 11 223 other patients were included as validation samples in their corresponding studies.Primary and secondary outcome measuresThe in-hospital major adverse cardiovascular events (MACE) was defined as death from any cause, recurrent AMI, or ischaemic stroke.ResultsThe proportion of in-hospital MACE was 11.7%, 8.8% and 11.4% among the development sample and two external-validation samples, respectively. Nine predictors (ie, age, sex, left ventricular ejection fraction, Killip class, systolic blood pressure, creatinine, white blood cell count, heart rate and blood glucose) were independently associated with in-hospital MACE. The model performed well on both discrimination and calibration capability, with areas under the Receiver Operating Characteristic Curve (ROC) curve of 0.85, 0.74 and 0.80, and calibration slopes of 0.98, 0.84 and 0.97 in the development sample and two external validation samples, respectively. A point-based risk scoring system was built with good discrimination and reclassification ability.ConclusionsA prediction model using readily available clinical parameters was developed and externally validated to estimate risks of in-hospital MACE among patients with AMI, thereby better informing decision-making in improving clinical care. C1 [Wu, Chaoqun; Huo, Xiqian; Liu, Jiamin; Zhang, Lihua; Bai, Xueke; Hu, Shuang; Li, Xi; Lu, Jiapeng; Zheng, Xin; Li, Jing; Zhang, Haibo] Fuwai Hosp, Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis,Natl Clin Res Ctr Cardiov, NHC Key Lab Clin Res Cardiovasc Medicat,State Key, Beijing, Peoples R China. C3 Chinese Academy of Medical Sciences - Peking Union Medical College; Fu Wai Hospital - CAMS; Peking Union Medical College RP Zhang, HB (通讯作者)，Fuwai Hosp, Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis,Natl Clin Res Ctr Cardiov, NHC Key Lab Clin Res Cardiovasc Medicat,State Key, Beijing, Peoples R China. EM haibo.zhang@fwoxford.org RI Zhang, Haibo/HLP-9266-2023 FU National Key Research and Development Program from the Ministry of Science and Technology of China [2018YFC1311205, 2017YFC1310803, 2015BAI12B01]; National Health and Family Planning Commission of China [201202025] FX This work was supported by the National Key Research and Development Program from the Ministry of Science and Technology of China (2018YFC1311205, 2017YFC1310803, 2015BAI12B01); the Research Special Fund for Public Welfare Industry of Health (201202025) from the National Health and Family Planning Commission of China. The funder of the study had no role in study design, data collection, data analysis, data interpretation or the decision to submit the manuscript for publication. 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Graversen, Christina B. Ersboll, Annette K. TI Association of patient-reported psychosocial healthcare and risk of readmissions and mortality in patients with ischemic heart disease: A population-based cohort study SO JOURNAL OF PSYCHOSOMATIC RESEARCH LA English DT Article DE Hospital readmission; Ischemic heart disease; Mortality; Psychosocial factors; Psychosocial healthcare ID ACUTE CORONARY SYNDROME; CENTERED CARE; CARDIAC REHABILITATION; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; SCIENTIFIC STATEMENT; EUROPEAN-SOCIETY; DEPRESSION; OUTCOMES; PREVENTION AB Objective: Psychosocial risk factors are common in patients with ischemic heart disease (IHD) and linked to poor prognosis. Psychosocial healthcare is recommended in international guidelines and has demonstrated positive effects, primarily on psychosocial symptoms. We examined the association between patient-reported psycho social healthcare and hospital readmissions and mortality in patients with IHD. Methods: A population-based cohort study with register-based follow-up. Patient-reported psychosocial healthcare was measured by seven items in a survey sent to a random sample of patients with incident IHD in Denmark in 2014. We used multivariable Cox proportional hazards models and Poisson regression to examine the association between psychosocial healthcare and readmissions and all-cause mortality. Results: In total, 1083 (57%) patients were followed up to 41/2 years. Low psychosocial support was reported by 53.4%, medium by 26.2% and high by 20.4% patients. The hazard of acute cardiac readmission for patients reporting low psychosocial healthcare was 2.08 higher than for patients reporting high psychosocial healthcare (95%CI:1.01-4.30). No association was found with time to first all-cause readmission. The acute cardiac readmission rate was 3.24 (95%CI:1.66-6.29) and 4.23 (95%CI:2.15-8.33) times higher among patients reporting low and medium psychosocial healthcare compared to high, and the all-cause readmission rate was 1.30 (95% CI:1.16-1.46) and 1.32 (95%CI:1.17-1.49) times higher. The hazard of death was 2.86 (95%CI:1.23-6.69) and 2.88 (95%CI:1.18-7.04) times higher among patients reporting low and medium psychosocial healthcare compared to high. Conclusion: In patients with IHD, a high level of patient-reported psychosocial healthcare was significantly associated with reduced hospital readmissions and all-cause mortality. C1 [Zinckernagel, Line; Holmberg, Teresa; Ersboll, Annette K.] Univ Southern Denmark, Natl Inst Publ Hlth, Studiestr 6, DK-1455 Copenhagen K, Denmark. [Zwisler, Ann-Dorthe] Odense Univ Hosp, Danish Knowledge Ctr Rehabil & Palliat Care, REHPA, Nyborg, Denmark. [Zwisler, Ann-Dorthe] Univ Southern Denmark, Nyborg, Denmark. [Pedersen, Susanne S.] Univ Southern Denmark, Dept Psychol, Odense, Denmark. [Pedersen, Susanne S.] Odense Univ Hosp, Dept Cardiol, Odense, Denmark. [Graversen, Christina B.] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark. C3 University of Southern Denmark; University of Southern Denmark; Odense University Hospital; University of Southern Denmark; University of Southern Denmark; University of Southern Denmark; Odense University Hospital; Aalborg University; Aalborg University Hospital RP Zinckernagel, L (通讯作者)，Univ Southern Denmark, Natl Inst Publ Hlth, Studiestr 6, DK-1455 Copenhagen K, Denmark. EM lizi@sdu.dk; teho@sdu.dk; ann.dorthe.olsen.zwisler@rsyd.dk; sspedersen@health.sdu.dk; c.graversen@m.dk; ake@sdu.dk OI Pedersen, Susanne/0000-0001-8055-3251; Zinckernagel, Line/0000-0002-0141-4374 FU Danish Heart Foundation [15-R99-A5908-22941] FX This work was supported by The Danish Heart Foundation [grant number 15-R99-A5908-22941]. The funding source had no involvement in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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Psychosomat. Res. PD MAY PY 2022 VL 156 AR 110776 DI 10.1016/j.jpsychores.2022.110776 EA MAR 2022 PG 8 WC Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry GA 1D8HN UT WOS:000794037200004 PM 35276588 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Fernandes, P O'Neil, M Del Valle, S Cave, A Nagpal, D AF Fernandes, Philip O'Neil, Michael Del Valle, Samantha Cave, Anita Nagpal, Dave TI A 24-hour perioperative case study on argatroban use for left ventricle assist device insertion during cardiopulmonary bypass and veno-arterial extracorporeal membrane oxygenation SO PERFUSION-UK LA English DT Article DE argatroban; LVAD; ECMO; CPB; dosing ID HEPARIN-INDUCED THROMBOCYTOPENIA; PATIENT; BIVALIRUDIN; SUBSTITUTE AB A 44-year-old male with ongoing chest pain and left ventricular ejection fraction <20% was transferred from a peripheral hospital with intra-aortic balloon pump placement following a non-ST-elevation myocardial infarction (STEMI). The patient underwent emergent multi-vessel coronary artery bypass grafting requiring veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) on post-operative day (POD)#9 secondary to cardiogenic shock with biventricular failure. Due to clot formation, an oxygenator change-out was necessary shortly after initiation. Following a positive heparin-induced thrombocytopenia (HIT) assay, a total circuit exchange was required to eliminate all heparin coating and argatroban was deemed the anticoagulant of choice due to acute kidney injury. On POD#24, the decision was made to implant a left ventricle assist device (LVAD) as a bridge to heart transplantation. There was difficulty achieving an activated clotting time (ACT) >400 s: multiple argatroban bolus doses were required, along with accelerated up-titration of infusion dosing. Despite maintaining an ACT >484 s, clot formation was observed in the cardiotomy reservoir prior to separation. Subsequently, the patient developed severe disseminated intravascular coagulopathy, with both intra-cardiac and intravascular thrombi, requiring massive transfusion and continuous cell saving due to severe hemorrhage post cardiopulmonary bypass (CPB). The patient received a total of 105 units of plasma, 74 units of packed red cells, 19 units of platelets, 13 bottles of 5% albumin, 6 units of cryoprecipitate and 2 doses of factor VIIa intraoperatively over the course of 24 hours. A total of 19.7 L of washed red blood cells were returned to the patient from the cell saver. With the LVAD in place, the patient developed transfusion-related acute lung injury and acute respiratory distress syndrome with right ventricular dysfunction requiring VA ECMO once again. On POD#30, ECMO was discontinued and the patient was discharged from the intensive care unit (ICU) on POD 66. After a very complex post-operative stay with numerous surgeries and extensive rehabilitation, the patient was discharged home with the LVAD on POD#112. C1 [Fernandes, Philip; O'Neil, Michael; Del Valle, Samantha] London Hlth Sci Ctr, Clin Perfus Serv, London, ON, Canada. [Cave, Anita] London Hlth Sci Ctr, Cardiac Care, Perioperat Cardiac Anesthesiol, London, ON, Canada. [Nagpal, Dave] London Hlth Sci Ctr, Div Cardiac Surg, London, ON, Canada. [Nagpal, Dave] Western Univ, Lawson Hlth Res Ctr, London, ON, Canada. C3 London Health Sciences Centre; London Health Sciences Centre; London Health Sciences Centre; Western University (University of Western Ontario) RP Nagpal, D (通讯作者)，London Hlth Sci Ctr, Univ Hosp, Div Cardiac Surg, 339 Windermere Rd,Rm B6-104A, London, ON N6A 5A5, Canada. EM Dave.Nagpal@lhsc.on.ca OI Fernandes, Philip/0000-0002-6280-2864 CR Agarwal Shvetank, 2012, J Anaesthesiol Clin Pharmacol, V28, P106, DOI 10.4103/0970-9185.92458 Beiderlinden M, 2007, ARTIF ORGANS, V31, P461, DOI 10.1111/j.1525-1594.2007.00388.x Bouraghda A, 2015, CAN J ANESTH, V62, P518, DOI 10.1007/s12630-015-0339-6 Dyke CM, 2006, J THORAC CARDIOV SUR, V131, P533, DOI 10.1016/j.jtcvs.2005.09.057 Edwards JT, 2003, ANN THORAC SURG, V75, P1622, DOI 10.1016/S0003-4975(02)04782-3 Follis F, 2010, INTERACT CARDIOV TH, V10, P592, DOI 10.1510/icvts.2009.215848 Genzen JR, 2010, TRANSFUSION, V50, P801, DOI 10.1111/j.1537-2995.2009.02531.x Guy S, 2015, INT J LAB HEMATOL, V37, P834, DOI 10.1111/ijlh.12414 Koster A, 2007, ANN THORAC SURG, V83, P572, DOI 10.1016/j.athoracsur.2006.09.038 Kurup Viji, 2006, Conn Med, V70, P245 Phillips MR, 2014, ANAESTH INTENS CARE, V42, P97, DOI 10.1177/0310057X1404200117 Smith AI, 2008, EUR J CARDIO-THORAC, V34, P1113, DOI 10.1016/j.ejcts.2008.07.035 Tanigawa Y, 2013, J ANESTH, V27, P951, DOI 10.1007/s00540-013-1629-1 NR 13 TC 4 Z9 4 U1 1 U2 7 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0267-6591 EI 1477-111X J9 PERFUSION-UK JI Perfusion-UK PD MAY PY 2019 VL 34 IS 4 BP 337 EP 344 DI 10.1177/0267659118813043 PG 8 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HZ6ZJ UT WOS:000469001000014 PM 30583712 DA 2023-05-13 ER PT J AU Tan, C Dinh, D Brennan, A Hare, DL Kaye, D Lefkovits, J Lockwood, S Neil, C Prior, D Nasis, A Wilson, A Reid, CM Stub, D Driscoll, A AF Tan, Christianne Diem Dinh Brennan, Angela Hare, David L. Kaye, David Lefkovits, Jeffrey Lockwood, Siobhan Neil, Christopher Prior, David Nasis, Arthur Wilson, Andrew Reid, Christopher M. Stub, Dion Driscoll, Andrea TI Characteristics and Clinical Outcomes in Patients With Heart Failure With Preserved Ejection Fraction Compared to Heart Failure With Reduced Ejection Fraction: Insights From the VCOR Heart Failure Snapshot SO HEART LUNG AND CIRCULATION LA English DT Article DE Heart failure; Heart failure with preserved ejection fraction; Acute heart failure; Mortality; Readmission ID SYSTOLIC FUNCTION; POPULATION; PREVALENCE; THERAPIES; TRENDS AB Background Heart failure is increasing in prevalence, creating a greater public health and economic burden on our health care system. With a rising proportion of hospitalisations for heart failure with preserved ejection fraction (HFpEF) compared to heart failure with reduced ejection fraction (HFrEF) and lack of proven therapies for HFpEF, patient characterisation and defining clinical outcomes are important in determining optimal management of heart failure patients. There is scarce Australian-specific data with regards to the burden of disease of patients with HFpEF which further limits our ability to appropriately manage this syndrome. Aim To determine the characteristics, management practices and outcomes of patients with HFpEF compared to patients diagnosed with HFrEF. Method Data was sourced from the Victorian Cardiac Outcomes Registry-Heart Failure (VCOR-HF) snapshot of patients admitted with acute heart failure to one of 16 Victorian health services between 2014-2017 over one consecutive month annually. Outcomes measured were in-hospital mortality, and 30-day readmission and mortality. Results Of the 1,132 HF patients, 436 patients were diagnosed with HFpEF and were more likely to be female (59%) and older (81.5 +/- 9.8 vs 73.2 +/- 14.5 years). They were also more likely to have hypertension (80%), atrial fibrillation (59.9%), chronic obstructive airways disease (36.2%) and chronic kidney disease (68.8%). Patients with HFrEF were more likely to have ischaemic heart disease with a history of previous myocardial infarction (36.6%), percutaneous coronary intervention and cardiac bypass surgery (35.2%). There were no significant differences in 30-day mortality between HFpEF and HFrEF (10.2% vs 7.8%; p=0.19, respectively) and 30-day readmission rates (22.1% vs 25.9%; p=0.15, respectively). Conclusion VCOR-HF Snapshot data provides important insight into the burden of acute heart failure. Whilst patients with HFpEF and HFrEF have differing clinical profiles, morbidity, mortality and re-admission rates are similar. C1 [Tan, Christianne; Kaye, David; Stub, Dion] Alfred Hosp, Melbourne, Vic, Australia. [Diem Dinh; Brennan, Angela; Lefkovits, Jeffrey; Reid, Christopher M.; Stub, Dion; Driscoll, Andrea] Monash Univ, Melbourne, Vic, Australia. [Hare, David L.; Driscoll, Andrea] Austin Hlth, Melbourne, Vic, Australia. [Hare, David L.; Neil, Christopher] Univ Melbourne, Melbourne, Vic, Australia. [Kaye, David; Stub, Dion] Baker IDI Heart Diabet Inst, Melbourne, Vic, Australia. [Lefkovits, Jeffrey] Royal Melbourne Hosp, Melbourne, Vic, Australia. [Lockwood, Siobhan; Nasis, Arthur] Monash Hlth, Melbourne, Vic, Australia. [Neil, Christopher] Western Hlth, Melbourne, Vic, Australia. [Prior, David; Wilson, Andrew] St Vincents Hosp, Melbourne, Vic, Australia. [Nasis, Arthur; Wilson, Andrew] Safer Care Victoria, Dept Hlth & Human Serv, Melbourne, Vic, Australia. [Reid, Christopher M.] Curtin Univ, Perth, WA, Australia. [Driscoll, Andrea] Deakin Univ, Melbourne, Vic, Australia. C3 Florey Institute of Neuroscience & Mental Health; Monash University; Austin Research Institute; Florey Institute of Neuroscience & Mental Health; University of Melbourne; Baker Heart and Diabetes Institute; Royal Melbourne Hospital; St Vincent's Hospital Melbourne; Curtin University; Deakin University RP Driscoll, A (通讯作者)，Deakin Univ, Sch Nursing & Midwifery, Geelong, Vic, Australia. EM Andrea.Driscoll@deakin.edu.au OI Tan, Christianne/0000-0001-7882-4454; Dinh, Diem-Thuy/0000-0002-8167-3906; Lefkovits, Jeffrey/0000-0003-1923-4571 FU Department of Health and Human Services; Victorian Cardiac Clinical Network, Safer Care Victoria FX The project was funded by Department of Health and Human Services, Victorian Cardiac Clinical Network, Safer Care Victoria. CR Ather S, 2012, J AM COLL CARDIOL, V59, P998, DOI 10.1016/j.jacc.2011.11.040 Atherton JJ, 2018, MED J AUSTRALIA, V209, P363, DOI 10.5694/mja18.00647 Australian Institute of Health and Welfare, 2018, AUSTR HLTH 2018 Bhatia RS, 2006, NEW ENGL J MED, V355, P260, DOI 10.1056/NEJMoa051530 Bursi F, 2006, JAMA-J AM MED ASSOC, V296, P2209, DOI 10.1001/jama.296.18.2209 Butler J, 2014, JACC-HEART FAIL, V2, P97, DOI 10.1016/j.jchf.2013.10.006 Chan YK, 2016, BMC HEALTH SERV RES, V16, DOI 10.1186/s12913-016-1748-0 Cheng RK, 2014, AM HEART J, V168, P721, DOI 10.1016/j.ahj.2014.07.008 Diez-Villanueva P, 2016, J GERIATR CARDIOL, V13, P115, DOI 10.11909/j.issn.1671-5411.2016.02.009 Driscoll A, 2020, HEART LUNG CIRC, V29, P1347, DOI 10.1016/j.hlc.2020.03.004 Driscoll A, 2016, BMC CARDIOVASC DISOR, V16, DOI 10.1186/s12872-016-0371-7 Fonarow GC, 2007, J AM COLL CARDIOL, V50, P768, DOI 10.1016/j.jacc.2007.04.064 Gerber Y, 2015, JAMA INTERN MED, V175, P996, DOI 10.1001/jamainternmed.2015.0924 Kaneko H, 2013, J CARDIOL, V62, P102, DOI 10.1016/j.jjcc.2013.03.013 Lenzen MJ, 2004, EUR HEART J, V25, P1214, DOI 10.1016/j.ehj.2004.06.006 MARANTZ PR, 1988, CIRCULATION, V77, P607, DOI 10.1161/01.CIR.77.3.607 McCullough Peter A, 2005, Congest Heart Fail, V11, P6, DOI 10.1111/j.1527-5299.2005.03731.x Owan TE, 2006, NEW ENGL J MED, V355, P251, DOI 10.1056/NEJMoa052256 Parmar KR, 2015, OPEN HEART, V2, DOI 10.1136/openhrt-2014-000095 Reddy YNV, 2016, CURR PROB CARDIOLOGY, V41, P145, DOI 10.1016/j.cpcardiol.2015.12.002 Savarese Gianluigi, 2017, Card Fail Rev, V3, P7, DOI 10.15420/cfr.2016:25:2 Senni M, 2001, J AM COLL CARDIOL, V38, P1277, DOI 10.1016/S0735-1097(01)01567-4 Steinberg BA, 2012, CIRCULATION, V126, P65, DOI 10.1161/CIRCULATIONAHA.111.080770 Stub D, 2018, HEART LUNG CIRC, V27, P451, DOI 10.1016/j.hlc.2017.07.013 Tribouilloy C, 2008, EUR HEART J, V29, P339, DOI 10.1093/eurheartj/ehm554 van Riet EES, 2014, EUR J HEART FAIL, V16, P772, DOI 10.1002/ejhf.110 NR 26 TC 4 Z9 5 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1443-9506 EI 1444-2892 J9 HEART LUNG CIRC JI Heart Lung Circ. PD MAY PY 2022 VL 31 IS 5 BP 623 EP 628 DI 10.1016/j.hlc.2021.09.019 EA APR 2022 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 2S0DL UT WOS:000821472500012 PM 34742643 DA 2023-05-13 ER PT J AU Fardman, A Zahger, D Orvin, K Oren, D Kofman, N Mohsen, J Tsafrir, O Asher, E Rubinshtein, R Jamal, J Efraim, R Halabi, M Shacham, Y Fortis, LH Cohen, T Klempfner, R Segev, A Beigel, R Matetzky, S AF Fardman, Alexander Zahger, Doron Orvin, Katia Oren, Daniel Kofman, Natalia Mohsen, Jameel Tsafrir, Or Asher, Elad Rubinshtein, Ronen Jamal, Jafari Efraim, Roi Halabi, Majdi Shacham, Yacov Fortis, Lior Henri Cohen, Tal Klempfner, Robert Segev, Amit Beigel, Roy Matetzky, Shlomi TI Acute myocardial infarction in the Covid-19 era: Incidence, clinical characteristics and in-hospital outcomes-A multicenter registry SO PLOS ONE LA English DT Article ID TASK-FORCE; ELEVATION; ASSOCIATION; MANAGEMENT; DEATH AB Background We aimed to describe the characteristics and in-hospital outcomes of ST-segment elevation myocardial infarction (STEMI) patients during the Covid-19 era. Methods We conducted a prospective, multicenter study involving 13 intensive cardiac care units, to evaluate consecutive STEMI patients admitted throughout an 8-week period during the Covid-19 outbreak. These patients were compared with consecutive STEMI patients admitted during the corresponding period in 2018 who had been prospectively documented in the Israeli bi-annual National Acute Coronary Syndrome Survey. The primary end-point was defined as a composite of malignant arrhythmia, congestive heart failure, and/or in-hospital mortality. Secondary outcomes included individual components of primary outcome, cardiogenic shock, mechanical complications, electrical complications, re-infarction, stroke, and pericarditis. Results The study cohort comprised 1466 consecutive acute MI patients, of whom 774 (53%) were hospitalized during the Covid-19 outbreak. Overall, 841 patients were diagnosed with STEMI: 424 (50.4%) during the Covid-19 era and 417 (49.6%) during the parallel period in 2018. Although STEMI patients admitted during the Covid-19 period had fewer co-morbidities, they presented with a higher Killip class (p value = .03). The median time from symptom onset to reperfusion was extended from 180 minutes (IQR 122-292) in 2018 to 290 minutes (IQR 161-1080, p < .001) in 2020. Hospitalization during the Covid-19 era was independently associated with an increased risk of the combined endpoint in the multivariable regression model (OR 1.65, 95% CI 1.03-2.68, p value = .04). Furthermore, the rate of mechanical complications was four times higher during the Covid-19 era (95% CI 1.42-14.8, p-value = .02). However, in-hospital mortality remained unchanged (OR 1.73, 95% CI 0.81-3.78, p-value = .16). Conclusions STEMI patients admitted during the first wave of Covid-19 outbreak, experienced longer total ischemic time, which was translated into a more severe disease status upon hospital admission, and a higher rate of in-hospital adverse events, compared with parallel period. C1 [Fardman, Alexander; Oren, Daniel; Cohen, Tal; Klempfner, Robert; Segev, Amit; Beigel, Roy; Matetzky, Shlomi] Sheba Med Ctr, Lev Leviev Heart & Vasc Ctr, Tel Hashomer, Israel. [Fardman, Alexander; Orvin, Katia; Oren, Daniel; Kofman, Natalia; Rubinshtein, Ronen; Shacham, Yacov; Cohen, Tal; Klempfner, Robert; Segev, Amit; Beigel, Roy; Matetzky, Shlomi] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel. [Zahger, Doron] Soroka Univ, Dept Cardiol, Med Ctr, Beer Sheva, Israel. [Zahger, Doron; Jamal, Jafari; Fortis, Lior Henri] Ben Gurion Univ Negev, Fac Hlth Sci, Beer Sheva, Israel. [Orvin, Katia] Rabin Med Ctr, Dept Cardiol, Petah Tiqwa, Israel. [Kofman, Natalia] Shamir Med Ctr, Dept Cardiol, Zerifin, Israel. [Mohsen, Jameel] Hillel Yaffe Med Ctr, Dept Cardiol, Hadera, Israel. [Mohsen, Jameel; Efraim, Roi] Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Haifa, Israel. [Tsafrir, Or] Galilee Med Ctr, Div Cardiol, Nahariyya, Israel. [Tsafrir, Or; Halabi, Majdi] Bar Ilan Univ, Fac Med Galilee, Safed, Israel. [Asher, Elad] Shaare Zedek Med Ctr, Jesselson Integrated Heart Ctr, Jerusalem, Israel. [Asher, Elad] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel. [Rubinshtein, Ronen] Wolfson Med Ctr, Dept Cardiol, Holon, Israel. [Jamal, Jafari] Barzilai Univ, Cardiol Dept, Med Ctr, Ashqelon, Israel. [Efraim, Roi] Rambam Healthcare Campus, Dept Cardiol, Haifa, Israel. [Halabi, Majdi] Ziv Med Ctr, Dept Cardiol, Safed, Israel. [Shacham, Yacov] Tel Aviv Sourasky Med Ctr, Dept Cardiol, Tel Aviv, Israel. [Fortis, Lior Henri] Samson Assuta Ashdod Univ Hosp, Dept Cardiol, Ashdod, Israel. C3 Chaim Sheba Medical Center; Tel Aviv University; Sackler Faculty of Medicine; Ben Gurion University; Soroka Medical Center; Ben Gurion University; Rabin Medical Center; Shamir Medical Center (Assaf Harofeh); Technion Israel Institute of Technology; Rappaport Faculty of Medicine; Western Galilee Hospital; Bar Ilan University; Hebrew University of Jerusalem; Shaare Zedek Medical Center; Hebrew University of Jerusalem; Ben Gurion University; Barzilai Medical Center; Rambam Health Care Campus; Ziv Medical Center; Tel Aviv University; Sackler Faculty of Medicine; Tel Aviv Sourasky Medical Center RP Fardman, A (通讯作者)，Sheba Med Ctr, Lev Leviev Heart & Vasc Ctr, Tel Hashomer, Israel.; Fardman, A (通讯作者)，Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel. EM alexfardman@gmail.com RI Klempfner, Robert V/M-4989-2016; Asher, Elad/I-3544-2019 OI Asher, Elad/0000-0003-3381-605X; Oren, Daniel/0000-0002-2447-3713; Or, Tsafrir/0000-0001-7346-316X FU Fefer foundation for medical research FX This work was supported by a grant from a Fefer foundation for medical research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. CR Allegra JR, 2005, J URBAN HEALTH, V82, P358, DOI 10.1093/jurban/jti087 Bhatt AS, 2020, J AM COLL CARDIOL, V76, P280, DOI 10.1016/j.jacc.2020.05.038 De Rosa S, 2020, EUR HEART J, V41, P2083, DOI 10.1093/eurheartj/ehaa409 Ebinger JE, 2020, J AM COLL CARDIOL, V76, P289, DOI 10.1016/j.jacc.2020.05.039 Hu Y, 2020, J CLIN VIROL, V127, DOI 10.1016/j.jcv.2020.104371 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Leor J, 1996, NEW ENGL J MED, V334, P413, DOI 10.1056/NEJM199602153340701 Mafham MM, 2020, LANCET, V396, P381, DOI 10.1016/S0140-6736(20)31356-8 MEISEL SR, 1991, LANCET, V338, P660, DOI 10.1016/0140-6736(91)91234-L MESNIER J, 2020, LANCET PUBLIC HEALTH, V5, DOI DOI 10.1016/S2468-2667%2820%2930188-2 Metzler B, 2020, EUR HEART J, V41, P1852, DOI 10.1093/eurheartj/ehaa314 O'Gara PT, 2013, J AM COLL CARDIOL, V61, P485, DOI [10.1016/j.jacc.2012.11.018, 10.1161/CIR.0b013e3182742c84] Pessoa-Amorim G, 2020, EUR HEART J-QUAL CAR, V6, P210, DOI 10.1093/ehjqcco/qcaa046 Rodriguez-Leor O, 2021, EUROINTERVENTION, V16, P1426, DOI 10.4244/EIJ-D-20-00935 Rosengren A, 2004, LANCET, V364, P953, DOI 10.1016/S0140-6736(04)17019-0 Salinas P, 2021, INT HEART J, V62, P274, DOI 10.1536/ihj.20-574 Smolderen KG, 2010, JAMA-J AM MED ASSOC, V303, P1392, DOI 10.1001/jama.2010.409 Solomon MD, 2020, NEW ENGL J MED, V383, P691, DOI 10.1056/NEJMc2015630 Tam CCF, 2020, CIRC-CARDIOVASC QUAL, V13, DOI 10.1161/CIRCOUTCOMES.120.006631 Wilson SJ, 2020, CIRC-CARDIOVASC INTE, V13, DOI 10.1161/CIRCINTERVENTIONS.120.009438 NR 20 TC 20 Z9 20 U1 1 U2 4 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 JUN 18 PY 2021 VL 16 IS 6 AR e0253524 DI 10.1371/journal.pone.0253524 PG 14 WC Multidisciplinary Sciences WE Science Citation Index Expanded (SCI-EXPANDED) SC Science & Technology - Other Topics GA TG9BC UT WOS:000671690700069 PM 34143840 OA gold, Green Published DA 2023-05-13 ER PT J AU Alabas, OA Jernberg, T Pujades-Rodriguez, M Rutherford, MJ West, RM Hall, M Timmis, A Lindahl, B Fox, KAA Hemingway, H Gale, CP AF Alabas, Oras A. Jernberg, Tomas Pujades-Rodriguez, Mar Rutherford, Mark J. West, Robert M. Hall, Marlous Timmis, Adam Lindahl, Bertil Fox, Keith A. A. Hemingway, Harry Gale, Chris P. TI Statistics on mortality following acute myocardial infarction in 842 897 Europeans SO CARDIOVASCULAR RESEARCH LA English DT Article DE Mortality; Acute myocardial infarction; SWEDEHEART; MINAP; Sweden; UK ID FLEXIBLE PARAMETRIC MODELS; ACUTE CORONARY SYNDROMES; ST-SEGMENT ELEVATION; RELATIVE SURVIVAL; MANAGEMENT; GUIDELINES; SWEDEN; ESC AB Aims To compare ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) mortality between Sweden and the UK, adjusting for background population rates of expected death, case mix, and treatments. Methods and results National data were collected from hospitals in Sweden [n = 73 hospitals, 180 368 patients, Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART)] and the UK [n = 247, 662 529 patients, Myocardial Ischaemia National Audit Project (MINAP)] between 2003 and 2013. There were lower rates of revascularization [STEMI (43.8% vs. 74.9%); NSTEMI (27.5% vs. 43.6%)] and pharmacotherapies at time of hospital discharge including [aspirin (82.9% vs. 90.2%) and (79.9% vs. 88.0%), beta-blockers (73.4% vs. 86.4%) and (65.3% vs. 85.1%)] in the UK compared with Sweden, respectively. Standardized net probability of death (NPD) between admission and 1 month was higher in the UK for STEMI [8.0 (95% confidence interval 7.4-8.5) vs. 6.7 (6.5-6.9)] and NSTEMI [6.8 (6.4-7.2) vs. 4.9 (4.7-5.0)]. Between 6 months and 1 year and more than 1 year, NPD remained higher in the UK for NSTEMI [2.9 (2.5-3.3) vs. 2.3 (2.2-2.5)] and [21.4 (20.0-22.8) vs. 18.3 (17.6-19.0)], but was similar for STEMI [0.7 (0.4-1.0) vs. 0.9 (0.7-1.0)] and [8.4 (6.7-10.1) vs. 8.3 (7.5-9.1)]. Conclusion Short-term mortality following STEMI and NSTEMI was higher in the UK compared with Sweden. Mid- and longer-term mortality remained higher in the UK for NSTEMI but was similar for STEMI. Differences in mortality may be due to differential use of guideline-indicated treatments. C1 [Alabas, Oras A.] Univ Leeds, Leeds Inst Rheumat & Musculoskeletal Med, Leeds, W Yorkshire, England. [Jernberg, Tomas] Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden. [Pujades-Rodriguez, Mar; West, Robert M.] Univ Leeds, Leeds Inst Hlth Sci, Leeds, W Yorkshire, England. [Rutherford, Mark J.] Univ Leicester, Dept Hlth Sci, Leicester, Leics, England. [Hall, Marlous; Gale, Chris P.] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, W Yorkshire, Sweden. [Timmis, Adam] Barts Heart Ctr, Dept Cardiol, London, England. [Lindahl, Bertil] Uppsala Univ, Dept Med Sci, Uppsala, Sweden. [Lindahl, Bertil] Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden. [Fox, Keith A. A.] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland. [Hemingway, Harry] UCL, Hlth Data Res UK London, London, England. [Hemingway, Harry] UCL, Inst Hlth Informat, London, England. [Hemingway, Harry] UCL, Natl Inst Hlth Res, Univ Coll London Hosp, Biomed Res Ctr, London, England. [Gale, Chris P.] Univ Leeds, Leeds Inst Data Analyt, Leeds, W Yorkshire, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; Danderyds Hospital; Karolinska Institutet; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds; RLUK- Research Libraries UK; University of Leicester; Uppsala University; Uppsala University; RLUK- Research Libraries UK; University of Edinburgh; 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; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Leeds RP Alabas, OA (通讯作者)，Univ Leeds, Leeds Inst Rheumat & Musculoskeletal Med, Leeds, W Yorkshire, England. EM o.alabas@leeds.ac.uk RI Pujades-Rodriguez, Mar/T-1129-2018; Fox, keith A A/I-3742-2013; Hemingway, Harry/C-1219-2009 OI Pujades-Rodriguez, Mar/0000-0002-1375-1028; Timmis, Adam/0000-0003-1419-112X; Alabas, Oras/0000-0003-2002-0781; Hemingway, Harry/0000-0003-2279-0624; Fox, Keith/0000-0002-0140-2752; Jernberg, Tomas/0000-0003-1695-379X; West, Robert/0000-0001-7305-3654; Rutherford, Mark/0000-0003-1557-6697; Gale, Chris/0000-0003-4732-382X FU Swedish Heart and Lung Foundation; Stockholm County Council; Karolinska Institute FX This work was supported by grants from the Swedish Heart and Lung Foundation and the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institute. The Myocardial Ischaemia National Audit Project (MINAP) is commissioned by the Health Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and PatientOutcomes Programme (NCAPOP). CR Alabas OA, 2017, J EPIDEMIOL COMMUN H, V71, P25, DOI 10.1136/jech-2016-207402 Alabas OA, 2017, J AM HEART ASSOC, V6, DOI 10.1161/JAHA.117.007123 Alabas OA, 2014, AGE AGEING, V43, P779, DOI 10.1093/ageing/aft201 ANDERSON JR, 1983, J CLIN ONCOL, V1, P710, DOI 10.1200/JCO.1983.1.11.710 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 Coleman MP, 2008, LANCET ONCOL, V9, P730, DOI 10.1016/S1470-2045(08)70179-7 Dickman PW, 2004, STAT MED, V23, P51, DOI 10.1002/sim.1597 Dondo TB, 2017, EUR HEART J-ACUTE CA, V6, P412, DOI 10.1177/2048872616647705 Hall M, 2015, EUR HEART J-QUAL CAR, V1, P85, DOI 10.1093/ehjqcco/qcv011 Herrett E, 2010, HEART, V96, P1264, DOI 10.1136/hrt.2009.192328 Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Lambert PC, 2009, STATA J, V9, P265, DOI 10.1177/1536867X0900900206 Mandelzweig L, 2006, EUR HEART J, V27, P2285, DOI 10.1093/eurheartj/ehl196 McNamara RL, 2014, INT J CARDIOL, V175, P240, DOI 10.1016/j.ijcard.2014.04.270 Nelson CP, 2007, STAT MED, V26, P5486, DOI 10.1002/sim.3064 Pinto P, 2018, CHRON RESP DIS, V15, P60, DOI 10.1177/1479972317702140 Rapsomaniki E, 2016, EUR HEART J-QUAL CAR, V2, P172, DOI 10.1093/ehjqcco/qcw004 Roffi M, 2016, G ITAL CARDIOL, V17, P831, DOI [10.1714/2464.25804, 10.1093/eurheartj/ehv320] Spoon DB, 2014, CIRCULATION, V129, P1286, DOI 10.1161/CIRCULATIONAHA.113.006518 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Talback M, 2011, EUR J CANCER, V47, P2626, DOI 10.1016/j.ejca.2011.08.010 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Timmis A, 2018, EUR HEART J, V39, P508, DOI 10.1093/eurheartj/ehx628 NR 24 TC 20 Z9 22 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0008-6363 EI 1755-3245 J9 CARDIOVASC RES JI Cardiovasc. Res. PD JAN 1 PY 2020 VL 116 IS 1 BP 149 EP 157 DI 10.1093/cvr/cvz197 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KB9IO UT WOS:000506800400023 PM 31350550 OA Green Accepted, Green Published, Green Submitted DA 2023-05-13 ER PT J AU de Havenon, A Yaghi, S Mistry, EA Delic, A Hohmann, S Shippey, E Stulberg, E Tirschwell, D Frontera, JA Petersen, NH Anadani, M AF de Havenon, Adam Yaghi, Shadi Mistry, Eva A. Delic, Alen Hohmann, Samuel Shippey, Ernie Stulberg, Eric Tirschwell, David Frontera, Jennifer A. Petersen, Nils H. Anadani, Mohammad TI Endovascular thrombectomy in acute ischemic stroke patients with COVID-19: prevalence, demographics, and outcomes SO JOURNAL OF NEUROINTERVENTIONAL SURGERY LA English DT Article AB Background We aimed to compare the outcome of acute ischemic stroke (AIS) patients who received endovascular thrombectomy (EVT) with confirmed COVID-19 to those without. Methods We performed a retrospective analysis using the Vizient Clinical Data Base and included hospital discharges from April 1 to July 31 2020 with ICD-10 codes for AIS and EVT. The primary outcome was in-hospital death and the secondary outcome was favorable discharge, defined as discharge home or to acute rehabilitation. We compared patients with laboratory-confirmed COVID-19 to those without. As a sensitivity analysis, we compared COVID-19 AIS patients who did not undergo EVT to those who did, to balance potential adverse events inherent to COVID-19 infection. Results We identified 3165 AIS patients who received EVT during April to July 2020, in which COVID-19 was confirmed in 104 (3.3%). Comorbid COVID-19 infection was associated with younger age, male sex, diabetes, black race, Hispanic ethnicity, intubation, acute coronary syndrome, acute renal failure, and longer hospital and intensive care unit length of stay. The rate of in-hospital death was 12.4% without COVID-19 vs 29.8% with COVID-19 (P<0.001). In mixed-effects logistic regression that accounted for patient clustering by hospital, comorbid COVID-19 increased the odds of in-hospital death over four-fold (OR 4.48, 95% CI 3.02 to 6.165). Comorbid COVID-19 was also associated with lower odds of a favorable discharge (OR 0.43, 95% CI 0.30 to 0.61). In the sensitivity analysis, comparing AIS patients with COVID-19 who did not undergo EVT (n=2139) to the AIS EVT patients with COVID-19, there was no difference in the rate of in--hospital death (30.6% vs 29.8%, P=0.868), and AIS EVT patients had a higher rate of favorable discharge (32.4% vs 47.1%, P=0.002). Conclusion In AIS patients treated with EVT, comorbid COVID-19 infection was associated with in-hospital death and a lower odds of favorable discharge compared with patients without COVID-19, but not compared with AIS patients with COVID-19 who did not undergo EVT. AIS EVT patients with COVID-19 were younger, more likely to be male, have systemic complications, and almost twice as likely to be black and over three times as likely to be Hispanic. C1 [de Havenon, Adam; Delic, Alen; Stulberg, Eric] Univ Utah Hlth, Dept Neurol, Salt Lake City, UT 84132 USA. [Yaghi, Shadi; Frontera, Jennifer A.] NYU, Sch Med, Neurol, Brooklyn, NY USA. [Mistry, Eva A.] Vanderbilt Univ, Med Ctr, Neurol, Nashville, TN USA. [Hohmann, Samuel; Shippey, Ernie] Vizient Inc, Irving, TX USA. [Tirschwell, David] Univ Washington, Seattle, WA 98195 USA. [Petersen, Nils H.] Yale Univ, New Haven, CT USA. [Anadani, Mohammad] Washington Univ, Sch Med St Louis, St Louis, MO 63110 USA. C3 Utah System of Higher Education; University of Utah; New York University; Vanderbilt University; University of Washington; University of Washington Seattle; Yale University; Saint Louis University; Washington University (WUSTL) RP de Havenon, A (通讯作者)，Univ Utah Hlth, Dept Neurol, Salt Lake City, UT 84132 USA. EM adam.dehavenon@hsc.utah.edu RI Yaghi, Shadi/Q-8258-2019 OI de Havenon, Adam/0000-0001-8178-8597 FU NIH-NINDS [K23NS105924] FX Dr. de Havenon is supported by NIH-NINDS K23NS105924. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. CR Abello A, 2020, UROL PRACT, V7, P174, DOI 10.1097/UPJ.0000000000000080 Agarwal S, 2020, J STROKE CEREBROVASC, V29, DOI 10.1016/j.jstrokecerebrovasdis.2020.105068 Banks JL, 2007, STROKE, V38, P1091, DOI 10.1161/01.STR.0000258355.23810.c6 CDB, HEALTHC AN PLATF CLI Centers for Disease Control and Prevention, 2020, INT INF PREV CONTR R Chang TE, 2019, STROKE, V50, P1959, DOI 10.1161/STROKEAHA.118.024092 EFRON B, 1987, J AM STAT ASSOC, V82, P171, DOI 10.2307/2289144 Goyal M, 2016, LANCET, V387, P1723, DOI 10.1016/S0140-6736(16)00163-X Kansagra AP, 2020, NEW ENGL J MED, V383, P400, DOI 10.1056/NEJMc2014816 Kerleroux B, 2020, STROKE, V51, P2012, DOI 10.1161/STROKEAHA.120.030373 Lange SJ, 2020, MMWR-MORBID MORTAL W, P69 Markus HS, 2020, INT J STROKE, V15, P361, DOI 10.1177/1747493020923472 McClure ES, 2020, AM J EPIDEMIOL, V189, P1244, DOI 10.1093/aje/kwaa126 Ntaios G, 2020, STROKE, V51, pE254, DOI 10.1161/STROKEAHA.120.031208 Oxley TJ, 2020, NEW ENGL J MED, V382, DOI 10.1056/NEJMc2009787 Poi BP, 2004, STATA J, V4, P312, DOI 10.1177/1536867X0400400308 Pokala B, 2019, HERNIA, V23, P593, DOI 10.1007/s10029-019-01934-8 Richardson Safiya, 2020, JAMA, V323, P2052, DOI 10.1001/jama.2020.6775 Schirmer CM, 2020, J NEUROINTERV SURG, V12, P639, DOI 10.1136/neurintsurg-2020-016299 Wang AR, 2020, J NEUROINTERV SURG, V12, P648, DOI 10.1136/neurintsurg-2020-016220 WHO, EM US ICD COVID 19 D Wu ZY, 2020, JAMA-J AM MED ASSOC, V323, P1239, DOI 10.1001/jama.2020.2648 Yaghi S, 2020, STROKE, V51, P2002, DOI 10.1161/STROKEAHA.120.030335 Zhang Y, 2020, NEW ENGL J MED, V382, DOI 10.1056/NEJMc2007575 NR 24 TC 28 Z9 28 U1 0 U2 5 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1759-8478 EI 1759-8486 J9 J NEUROINTERV SURG JI J. NeuroInterventional Surg. PD NOV PY 2020 VL 12 IS 11 BP 1045 EP 1048 DI 10.1136/neurintsurg-2020-016777 PG 4 WC Neuroimaging; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Surgery GA OE3TY UT WOS:000580458200005 PM 32989032 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Tan, L Xu, Q Shi, RZ AF Tan, Liao Xu, Qian Shi, Ruizheng TI A Nomogram for Predicting Hospital Mortality in Intensive Care Unit Patients with Acute Myocardial Infarction SO INTERNATIONAL JOURNAL OF GENERAL MEDICINE LA English DT Article DE prediction; acute myocardial infarction; ICU; nomogram; hospital mortality ID ACUTE CORONARY SYNDROME; LONG-TERM OUTCOMES; RISK SCORE; VALIDATION; HYPERGLYCEMIA; ACTIVATION; TIMI AB Background: This study aims to construct and validate an early-stage nomogram for predicting hospital mortality of ICU patients with acute myocardial infarction (AMI), to help clinicians determine the appropriate intervention. Methods: The primary cohort of 2704 patients diagnosed with acute myocardial infarction in admission records from eICU-Collaborative Research Database (eICU-CRD) v2.0. Univariate logistic regression analysis and multivariate logistic regression analysis were enrolled for the construction of the predictive nomogram. Demographic factors, history of clinical cardiovascular disease, vital signs, the use of vasopressors, urine output, and serum variables in the first 24 hours were included in this analysis. The nomogram was evaluated by performance traits including Harrell's concordance index (C-index) and area under the receiver operating characteristic (AUC) analysis, calibration curve, and decision curve analysis (DCA). The nomogram was validated in a different cohort containing 1026 subjects collected from MIMIC-III Database v1.4. Finally, in order to compare the performance with other classic prediction models, AUC analysis, calibration curve, DCA and accuracy analysis (net reclassification improvement (NRI)) were conducted for three ICU scores in validated cohort. Results: The nomogram revealed 14 predictors of the first 24 hours derived from univariate and multivariable analyses, including age, history of peripheral vascular disease, atrial fibrillation, cardiogenic shock and cardiac arrest, the use of norepinephrine, urine output, white blood cell (WBC), hemoglobin (Hb), red blood cell (RBC), red cell distribution width (RDW), glucose, bicarbonate and magnesium. The C-index of this nomogram was 0.834 (95% CI 0.812 to 0.856). Then, the result of AUC analysis, the DCA and calibration curve indicated that our nomogram was feasible for clinical prediction. The predictive ability and clinical use of the nomogram were verified in the validated cohort. The AUC analysis of ICU scores showed that the AUC of these score systems was ranged from 0.811 to 0.860 (the AUC of nomogram: 0.885). Moreover, our nomogram also showed a better performance in calibration curve and DCA NRI. Conclusion: The study presents a prediction nomogram incorporating 14 variables that could help identify AMI patients admitted in ICU who might have a high risk of hospital mortality in the first hospitalized 24 hours. This nomogram showed a better performance than normal ICU score systems. C1 [Tan, Liao] Cent South Univ Changsha, Xiangya Hosp 3, Dept Cardiol, Changsha, Hunan, Peoples R China. [Tan, Liao; Shi, Ruizheng] Cent South Univ, Xiangya Hosp, Dept Cardiovasc Med, 88 Xiangya Rd, Changsha 410013, Hunan, Peoples R China. [Xu, Qian] Cent South Univ, Xiangya Hosp, Dept Cardiovasc Surg, Changsha, Hunan, Peoples R China. C3 Central South University; Central South University; Central South University RP Shi, RZ (通讯作者)，Cent South Univ, Xiangya Hosp, Dept Cardiovasc Med, 88 Xiangya Rd, Changsha 410013, Hunan, Peoples R China. EM xyshiruizheng@csu.edu.cn FU National Program on Key Basic Research Project of China [2019YFF0216304]; Chinese Cardiovascular Association V.G foundation FX The work was supported by grants from the National Program on Key Basic Research Project of China (Nos. 2019YFF0216304 to S.R.Z.) and the Chinese Cardiovascular Association V.G foundation (Nos.2017-CCA-VG-005 to S.R.Z). 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J. Gen. Med. PY 2021 VL 14 BP 5863 EP 5877 DI 10.2147/IJGM.S326898 PG 15 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA US5QQ UT WOS:000697484000002 PM 34566426 OA gold, Green Published DA 2023-05-13 ER PT J AU Marsilio, M Fusco, F Gheduzzi, E Guglielmetti, C AF Marsilio, Marta Fusco, Floriana Gheduzzi, Eleonora Guglielmetti, Chiara TI Co-Production Performance Evaluation in Healthcare. A Systematic Review of Methods, Tools and Metrics SO INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH LA English DT Review DE co-production; co-creation; performance; evaluation; measure; outcome; performance evaluation system; healthcare ID VALUE CO-CREATION; PERSON-CENTERED CARE; PATIENT EDUCATION MATERIALS; VALUE COCREATION ACTIVITIES; SELF-MANAGEMENT PROGRAM; ACUTE CORONARY SYNDROME; QUALITY-OF-LIFE; JOB-SATISFACTION; CUSTOMER PARTICIPATION; CITIZEN COPRODUCTION AB Co-produced practices and publications in the healthcare sector are gaining momentum, since they can be a useful tool in addressing the sustainability and resilience challenges of health systems. However, the investigation of positive and, mainly, negative outcomes is still confused and fragmented, and above all, a comprehensive knowledge of the metrics used to assess these outcomes is lacking. To fill this gap, this study aims to systematically review the extant literature to map the methods, tools and metrics used to empirically evaluate co-production in health services. The search took place in six databases: Scopus, Web of Science, Psych INFO, PubMed, Cochrane and CINAHL. A total of 2311 articles were screened and 203 articles were included in the analysis, according to PRISMA guidelines. Findings show that outcomes are mainly investigated through qualitative methods and from the lay actor or provider perspective. Moreover, the detailed categorisation of the quantitative measures found offers a multidimensional performance measurement system and highlights the impact areas where research is needed to develop and test new measures. Findings should also promote improvements in empirical data collection on the multiple faceted co-produced activities and spur the consciousness of the adoption of sustainable co-productive initiatives. C1 [Marsilio, Marta; Fusco, Floriana; Guglielmetti, Chiara] Univ Milan, Dept Econ Management & Quantitat Methods DEMM, Via Conservatorio 7, I-20122 Milan, Italy. [Gheduzzi, Eleonora] Politecn Milan, Sch Management, Via Lambruschini 4, I-20156 Milan, Italy. C3 University of Milan; Polytechnic University of Milan RP Marsilio, M (通讯作者)，Univ Milan, Dept Econ Management & Quantitat Methods DEMM, Via Conservatorio 7, I-20122 Milan, Italy. EM marta.marsilio@unimi.it; floriana.fusco@unimi.it; eleonora.gheduzzi@polimi.it; chiara.guglielmetti@unimi.it RI GHEDUZZI, ELEONORA/AGZ-0938-2022; guglielmetti, chiara/J-3474-2012; Marsilio, Marta/K-9258-2017 OI GHEDUZZI, ELEONORA/0000-0001-7449-3379; guglielmetti, chiara/0000-0002-1866-2796; Fusco, Floriana/0000-0002-3488-4970; Marsilio, Marta/0000-0001-9191-7284 FU University of Milan through APC initiative FX The authors acknowledge the support from the University of Milan through APC initiative. 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J. Environ. Res. Public Health PD APR PY 2021 VL 18 IS 7 AR 3336 DI 10.3390/ijerph18073336 PG 28 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 RK7RS UT WOS:000638489200001 PM 33804862 OA Green Published, gold DA 2023-05-13 ER PT J AU Koyanagi, A Kohler-Forsberg, O Benros, ME Laursen, TM Haro, JM Nordentoft, M Hjorthoj, C AF Koyanagi, A. Kohler-Forsberg, O. Benros, M. E. Laursen, T. Munk Haro, J. M. Nordentoft, Merete Hjorthoj, Carsten TI Mortality in unipolar depression preceding and following chronic somatic diseases SO ACTA PSYCHIATRICA SCANDINAVICA LA English DT Article DE timing; depression; somatic diseases; mortality ID ACUTE CORONARY SYNDROME; MAJOR DEPRESSION; HEART-DISEASE; PALLIATIVE CARE; MENTAL-ILLNESS; D PERSONALITY; RISK-FACTORS; METAANALYSIS; SYMPTOMS; REGISTER AB Objective Method It is largely unknown how depression prior to and following somatic diseases affects mortality. Thus, we examined how the temporal order of depression and somatic diseases affects mortality risk. Data were from a Danish population-based cohort from 1995 to 2013, which included all residents in Denmark during the study period (N = 4 984 912). Nineteen severe chronic somatic disorders from the Charlson Comorbidity Index were assessed. The date of first diagnosis of depression and somatic diseases was identified. Multivariable Cox proportional Hazard models with time-varying covariates were constructed to assess the risk for all-cause and non-suicide deaths for individual somatic diseases. Results Conclusion For all somatic diseases, prior and/or subsequent depression conferred a significantly higher mortality risk. Prior depression was significantly associated with a higher mortality risk when compared to subsequent depression for 13 of the 19 somatic diseases assessed, with the largest difference observed for moderate/severe liver disease (HR = 2.08; 95% CI = 1.79-2.44), followed by metastatic solid tumor (HR = 1.48; 95% CI = 1.39-1.58), and myocardial infarction (HR = 1.40; 95% CI = 1.34-1.49). A particularly high mortality risk was observed in the presence of prior depression for most somatic diseases. Future studies that assess the underlying mechanisms are necessary to adequately address the excessive mortality associated with comorbid depression. C1 [Koyanagi, A.; Haro, J. M.] Univ Barcelona, Fundacio St Joan Deu, Parc Sanitari St Joan Deu, Barcelona, Spain. [Koyanagi, A.; Haro, J. M.] CIBERSAM, Inst Salud Carlos III, Ctr Invest Biomed Red Salud Mental, Madrid, Spain. [Koyanagi, A.; Benros, M. E.; Laursen, T. Munk; Nordentoft, Merete; Hjorthoj, Carsten] iPSYCH, Lundbeck Fdn Initiat Integrat Psychiat Res, Copenhagen, Denmark. [Koyanagi, A.; Benros, M. E.; Laursen, T. Munk; Nordentoft, Merete; Hjorthoj, Carsten] iPSYCH, Lundbeck Fdn Initiat Integrat Psychiat Res, Aarhus, Denmark. [Kohler-Forsberg, O.] Aarhus Univ Hosp, Psychosis Res Unit, Risskov, Denmark. [Kohler-Forsberg, O.; Benros, M. E.; Nordentoft, Merete; Hjorthoj, Carsten] Copenhagen Univ Hosp, Mental Hlth Ctr Copenhagen, Hellerup, Denmark. [Kohler-Forsberg, O.] Aarhus Univ, Dept Clin Med, Aarhus, Denmark. [Laursen, T. Munk] Aarhus Univ, Natl Ctr Register Based Res, Dept Econ & Business, Aarhus, Denmark. C3 University of Barcelona; CIBER - Centro de Investigacion Biomedica en Red; CIBERSAM; Instituto de Salud Carlos III; Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH); Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH); Aarhus University; University of Copenhagen; Aarhus University; Aarhus University RP Koyanagi, A (通讯作者)，Univ Barcelona, Fundacio St Joan Deu, Res & Dev Unit, Parc Sanitari St Joan Deu,Dr Antoni Pujadas 42, Barcelona, Spain. EM a.koyanagi@pssjd.org RI Laursen, Thomas Munk/AFQ-8066-2022; Benros, Michael Eriksen/N-5868-2016; Haro, Josep Maria/D-1423-2011; Koyanagi, Ai/D-3833-2018; Nordentoft, Merete/AAH-3253-2019 OI Benros, Michael Eriksen/0000-0003-4939-9465; Haro, Josep Maria/0000-0002-3984-277X; Koyanagi, Ai/0000-0002-9565-5004; Kohler-Forsberg, Ole/0000-0001-5121-1287; Nordentoft, Merete/0000-0003-4895-7023; Laursen, Thomas Munk/0000-0001-6934-1784 FU Miguel Servet contract [CP13/00150, PI15/00862, MV16/00026]; European Regional Development Fund (ERDF-FEDER); ISCIII - General Branch Evaluation and Promotion of Health Research FX Ai Koyanagi's work is supported by the Miguel Servet contract financed by the CP13/00150, PI15/00862, and MV16/00026 projects, integrated into the National R + D + I and funded by the ISCIII - General Branch Evaluation and Promotion of Health Research - and the European Regional Development Fund (ERDF-FEDER). 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Scand. PD DEC PY 2018 VL 138 IS 6 BP 500 EP 508 DI 10.1111/acps.12899 PG 9 WC Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychiatry GA GZ6CZ UT WOS:000449521200003 PM 29761489 DA 2023-05-13 ER PT J AU Southern, WN Drainoni, ML Smith, BD Koppelman, E McKee, MD Christiansen, CL Gifford, AL Weinbaum, CM Litwin, AH AF Southern, William N. Drainoni, Mari-Lynn Smith, Bryce D. Koppelman, Elisa McKee, M. Diane Christiansen, Cindy L. Gifford, Allen L. Weinbaum, Cindy M. Litwin, Alain H. TI Physician Nonadherence With a Hepatitis C Screening Program SO QUALITY MANAGEMENT IN HEALTH CARE LA English DT Article DE clinical practice patterns; community-based participatory research; guideline adherence; hepatitis C; intervention studies; mass screening ID SEXUALLY-TRANSMITTED-DISEASES; ACUTE CORONARY SYNDROMES; VIRUS-INFECTION; UNITED-STATES; MENTAL-ILLNESS; PLUS RIBAVIRIN; RISK-FACTORS; PREVALENCE; MANAGEMENT; DYSLIPIDEMIA AB Background: Testing for patients at risk for hepatitis C virus (HCV) infection is recommended, but it is unclear whether providers adhere to testing guidelines. We aimed to measure adherence to an HCV screening protocol during a multifaceted continuous intervention. Subjects and Methods: Prospective cohort design to examine the associations between patient-level, physician-level, and visit-level characteristics and adherence to an HCV screening protocol. Study participants included all patients with a visit to 1 of the 3 study clinics and the physicians who cared for them. Adherence to the HCV screening protocol and patient-level, physician-level, and visit-level predictors of adherence were measured. Results: A total of 8981 patients and 154 physicians were examined. Overall protocol adherence rate was 36.1%. In multivariate analysis, patient male sex (odds ratio [OR] = 1.18), new patient (OR = 1.23), morning visit (OR = 1.32), and patients' preferred language being non-English (OR = 0.87) were significantly associated with screening adherence. There was a wide variation in overall adherence among physicians (range, 0%-92.4%). Screening adherence continuously declined from 59.1% in week 1 of the study to 13.7% in week 15 (final week). When implementing complex clinical practice guidelines, planners should address physician attitudinal barriers as well as gaps in knowledge to maximize adherence. C1 [Southern, William N.; Litwin, Alain H.] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA. [Southern, William N.] Montefiore Med Ctr, Albert Einstein Coll Med, Div Hosp Med, Bronx, NY 10467 USA. [Litwin, Alain H.] Montefiore Med Ctr, Albert Einstein Coll Med, Div Gen Internal Med, Bronx, NY 10467 USA. [McKee, M. Diane] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Family & Social Med, Bronx, NY 10467 USA. [Drainoni, Mari-Lynn; Koppelman, Elisa; Christiansen, Cindy L.; Gifford, Allen L.] Boston Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA USA. [Drainoni, Mari-Lynn; Gifford, Allen L.] Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA. [Gifford, Allen L.] Boston Univ, Sch Med, Div Gen Internal Med, Boston, MA 02118 USA. [Drainoni, Mari-Lynn] Boston Univ, Sch Med, Infect Dis Sect, Boston, MA 02118 USA. [Drainoni, Mari-Lynn; Koppelman, Elisa; Christiansen, Cindy L.; Gifford, Allen L.] ENRM Vet Adm Hosp, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. [Smith, Bryce D.; Weinbaum, Cindy M.] Ctr Dis Control & Prevent, Div Viral Hepatitis, Natl Ctr HIV Viral Hepatitis STD TB Prevent, Atlanta, GA USA. C3 Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine; Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine; Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine; Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine; Boston University; Boston University; Boston University; Boston University; Centers for Disease Control & Prevention - USA RP Southern, WN (通讯作者)，Montefiore Med Ctr, Dept Med, Div Hosp Med, 111 E 210th St, Bronx, NY 10467 USA. EM wsouther@montefiore.org RI ; Gifford, Allen L/D-9329-2016 OI Litwin, Alain/0000-0002-6717-0288; Drainoni, Mari-Lynn/0000-0001-7214-8037; Gifford, Allen L/0000-0001-6442-1128 FU Centers for Disease Control and Prevention (CDC) via Agency Health Care Research and Quality (AHRQ) ACTION initiative [HHSA2902006000012 T0#4]; Clinical Investigation Core of the Center for AIDS Research at the Albert Einstein College of Medicine; Montefiore Medical Center - National Institutes of Health (NIH) [P30 AI51519]; CTSA from the National Center for Research Resources of the National Institutes of Health [UL1 RR025750, KL2 RR025749, TL1 RR025748] FX This project was funded by a Centers for Disease Control and Prevention (CDC) contract via the Agency Health Care Research and Quality (AHRQ) ACTION initiative to Boston University (contract HHSA2902006000012 T0#4). The content is solely the responsibility of the authors and does not necessarily represent the official views of the AHRQ or CDC. Additional support was provided the Clinical Investigation Core of the Center for AIDS Research at the Albert Einstein College of Medicine and Montefiore Medical Center, funded by the National Institutes of Health (NIH P30 AI51519), and the CTSA grant UL1 RR025750 and KL2 RR025749 and TL1 RR025748, from the National Center for Research Resources, a component of the National Institutes of Health. 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Manag. Health Care PD JAN-MAR PY 2014 VL 23 IS 1 BP 1 EP 9 DI 10.1097/QMH.0000000000000007 PG 9 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 CD0EM UT WOS:000350743300001 PM 24368717 OA Green Accepted DA 2023-05-13 ER PT J AU Antoniou, S AF Antoniou, Sotiris TI Rivaroxaban for the treatment and prevention of thromboembolic disease SO JOURNAL OF PHARMACY AND PHARMACOLOGY LA English DT Review DE anticoagulant; pharmacodynamics; pharmacokinetics; rivaroxaban; thromboembolism ID FACTOR-XA INHIBITOR; DEEP-VEIN THROMBOSIS; MOLECULAR-WEIGHT HEPARIN; ACUTE CORONARY SYNDROMES; VENOUS THROMBOEMBOLISM; TOTAL HIP; COST-EFFECTIVENESS; BAY 59-7939; ANTITHROMBOTIC THERAPY; STROKE PREVENTION AB ObjectivesA number of direct oral anticoagulants are now available and offer alternative strategies for anticoagulation therapy. Rivaroxaban, a direct oral Factor Xa inhibitor, is approved for use across several thromboembolic indications. This article aims to provide an overview of the key pharmacological characteristics of rivaroxaban and the rationale and evidence for the use of different dose regimens across its licenced indications, and offer practical guidance to healthcare professionals on responsible use. References were sourced via PubMed searches using the search string (rivaroxaban AND (pharmacokinetics OR pharmacodynamics OR (clinical studies) OR (drug interaction)) NOT review NOT (children OR pediatrics OR paediatrics OR adolescent)). Key findingsRivaroxaban exhibits predictable pharmacokinetics and pharmacodynamics, and thus does not require routine coagulation monitoring, unlike vitamin K antagonists (e.g. warfarin). Rivaroxaban also has a lower potential for drug-drug and food-drug interactions compared with warfarin; however, co-administration with strong inhibitors of both cytochrome P450 3A4 and P-glycoprotein is not recommended. The data indicate that dose adjustment is not necessary for age, gender or body weight. The dosing regimens of rivaroxaban vary depending on the indication, and phase III studies have demonstrated a favourable benefit-risk profile of rivaroxaban compared with traditional standard of care. SummaryRivaroxaban may offer an anticoagulant option that could simplify and improve the management of patients with thromboembolic disorders. C1 Barts Hlth NHS Trust, St Bartholomews Hosp, Dept Clin Pharm, London EC1A 7BE, England. C3 Barts Health NHS Trust; RLUK- Research Libraries UK; University of London; Queen Mary University London RP Antoniou, S (通讯作者)，Barts Hlth NHS Trust, St Bartholomews Hosp, Dept Clin Pharm, London EC1A 7BE, England. 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10.1111/j.1538-7836.2005.01374.x Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482 You JJ, 2012, CHEST, V141, pE531S, DOI 10.1378/chest.11-2304 Zhao HJ, 2011, CHEST, V139, P260, DOI 10.1378/chest.09-3083 NR 70 TC 13 Z9 16 U1 1 U2 11 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-3573 EI 2042-7158 J9 J PHARM PHARMACOL JI J. Pharm. Pharmacol. PD AUG PY 2015 VL 67 IS 8 BP 1119 EP 1132 DI 10.1111/jphp.12387 PG 14 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA CM8LS UT WOS:000357953300009 PM 26059702 OA Bronze DA 2023-05-13 ER PT J AU Khan, MA Hossain, FS Ahmed, I Muthukumar, N Mohsen, A AF Khan, Muhammad Asim Hossain, Fahad Siddique Ahmed, Iftikhar Muthukumar, Nagarajan Mohsen, Amr TI Predictors of early mortality after hip fracture surgery SO INTERNATIONAL ORTHOPAEDICS LA English DT Article DE Trauma; Hip fracture; Neck of femur; Co-morbidities; 30-day mortality; Risk factors ID CARDIOVASCULAR-DISEASES; RISK; MORBIDITY AB Purpose The aim of this study was to examine causes and potential risk factors for 30-day mortality after hip fracture surgery (HFS) at a high-volume tertiary-care hospital. Methods We retrospectively reviewed 467 patients who underwent HFS at our institution. Multivariate analysis was undertaken to identify potential predictors of early mortality. Results The 30-day mortality rate was 7.5 % (35/467). The most common causes of death were pneumonia (37.1 %, 13/35), acute coronary syndrome (31.4 %, 11/35) and sepsis (14.3 %, 5/35). Surgery after 48 hours of admission had a significantly higher 30-day mortality rate (11 % versus 4 %, p = 0.006). There was a significant difference in age (p = 0.034), admission source (p < 0.001), preoperative haemoglobin (p < 0.001), walking ability (p = 0.004), number of comorbidities (p = 0.004) and pre-existing dementia (p = 0.01), cardiac disease (p < 0.001), chronic obstructive pulmonary disorder (COPD) (p = 0.036) and renal failure (p = 0.007) between the 30-day mortality group and the rest of the cohort. Surgical delay greater than 48 hours, admission source and pre-existing cardiac disease were identified as the strongest predictors of 30-day mortality. Conclusion Surgical delay is an important but avoidable determinant of early mortality after HFS. Respiratory and cardiac function needs to be optimised postoperatively with early intervention in patients with signs of cardiovascular compromise or infection. C1 [Khan, Muhammad Asim; Hossain, Fahad Siddique; Ahmed, Iftikhar; Muthukumar, Nagarajan; Mohsen, Amr] Hull Royal Infirm, Dept Trauma & Orthopaed, Kingston Upon Hull HU2 8JS, N Humberside, England. [Khan, Muhammad Asim] Banstead Court, London W12 0QJ, England. C3 University of Hull RP Khan, MA (通讯作者)，Banstead Court, Flat 101,60 Westway, London W12 0QJ, England. EM asim2002@yahoo.com RI Hossain, Fahad/I-1771-2019 OI Hossain, Fahad/0000-0002-1983-0464; Khan, Muhammad Asim Abbas/0000-0001-5172-7718 CR Aoki Akiko, 2003, Nihon Ronen Igakkai Zasshi, V40, P615, DOI 10.3143/geriatrics.40.615 Bass E, 2007, ANN EPIDEMIOL, V17, P514, DOI 10.1016/j.annepidem.2006.12.004 Beringer T R O, 2006, Ulster Med J, V75, P200 Brauer CA, 2009, JAMA-J AM MED ASSOC, V302, P1573, DOI 10.1001/jama.2009.1462 Carretta E, 2011, INT ORTHOP, V35, P419, DOI 10.1007/s00264-010-1004-x Dawson-Bowling S, 2008, INJURY, V39, P775, DOI 10.1016/j.injury.2008.01.025 French DD, 2008, J AM GERIATR SOC, V56, P705, DOI 10.1111/j.1532-5415.2007.01479.x Gupta BP, 2012, J HOSP MED, V7, P713, DOI 10.1002/jhm.1967 Hu FK, 2012, INJURY, V43, P676, DOI 10.1016/j.injury.2011.05.017 KEENE GS, 1993, BRIT MED J, V307, P1248, DOI 10.1136/bmj.307.6914.1248 Khan MA, 2012, J BONE JOINT SURG BR, V94B, P690, DOI 10.1302/0301-620X.94B5.28933 Maxwell MJ, 2008, BRIT J ANAESTH, V101, P511, DOI 10.1093/bja/aen236 Muraki S, 2006, J BONE MINER METAB, V24, P100, DOI 10.1007/s00774-005-0654-z Nettleman MD, 1996, J GEN INTERN MED, V11, P765, DOI 10.1007/BF02598997 Nielsen KA, 2009, BMC HEALTH SERV RES, V9, DOI 10.1186/1472-6963-9-186 PARKER MJ, 1991, PUBLIC HEALTH, V105, P443, DOI 10.1016/S0033-3506(05)80614-6 PEREZ JV, 1995, INJURY, V26, P237, DOI 10.1016/0020-1383(95)90008-L Pioli G, 2006, AGING CLIN EXP RES, V18, P381 Sandhu A, 2013, OSTEOPOROSIS INT, V24, P1145, DOI 10.1007/s00198-012-2116-5 Sennerby U, 2007, OSTEOPOROSIS INT, V18, P1355, DOI 10.1007/s00198-007-0386-0 Sennerby U, 2009, JAMA-J AM MED ASSOC, V302, P1666, DOI 10.1001/jama.2009.1463 Simunovic N, 2010, CAN MED ASSOC J, V182, P1609, DOI 10.1503/cmaj.092220 Talsnes O, 2013, INT ORTHOP, V37, P1135, DOI 10.1007/s00264-013-1851-3 Talsnes O, 2011, INT ORTHOP, V35, P903, DOI 10.1007/s00264-010-1149-7 The National Hip Fracture Database, 2011, NATL HIP FRACTURE DA Vestergaard P, 2007, J AM GERIATR SOC, V55, P1720, DOI 10.1111/j.1532-5415.2007.01420.x Vochteloo AJH, 2012, INT ORTHOP, V36, P1709, DOI 10.1007/s00264-012-1526-5 World Health Organization, 2010, INT CLASS DIS ICD 10 NR 28 TC 100 Z9 107 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0341-2695 EI 1432-5195 J9 INT ORTHOP JI Int. Orthop. PD NOV PY 2013 VL 37 IS 11 BP 2119 EP 2124 DI 10.1007/s00264-013-2068-1 PG 6 WC Orthopedics WE Science Citation Index Expanded (SCI-EXPANDED) SC Orthopedics GA 240NT UT WOS:000326104400002 PM 23982637 OA Green Published DA 2023-05-13 ER PT J AU Tierney, S Deaton, C Mamas, M AF Tierney, Stephanie Deaton, Christi Mamas, Mamas TI Heart failure among South Asians: a narrative review of risk, nature, outcomes and management SO HEART FAILURE REVIEWS LA English DT Review DE Ethnic minority groups; Heart failure; Nature; Outcomes; South Asians; Treatment ID C-REACTIVE PROTEIN; VENTRICULAR SYSTOLIC DYSFUNCTION; CORONARY-ARTERY-DISEASE; ETHNIC-DIFFERENCES; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; UNITED-KINGDOM; CARDIAC REHABILITATION; INSULIN-RESISTANCE; ACUTE ADMISSIONS AB Individuals of South Asian descent have a high prevalence of comorbidities that are risk factors for the development of heart failure (HF), including diabetes mellitus and metabolic syndrome. However, little is known about the prevalence of HF, its management and prognosis for this population compared to Caucasians. Therefore, a literature review relating to the nature, outcome and treatment of HF in South Asian patients compared to Caucasians was conducted. It was anticipated that collating existing studies in this manner would be useful for guiding professionals in managing HF within this ethnic group, given that to achieve optimal care, regimens need to take into account cultural differences that may impact on adherence. Reviewed literature showed that South Asians with HF were more likely to be younger and have diabetes and hypertension. These papers also implied that outcomes for South Asians with HF were similar or even better than for Caucasians. The review highlighted the under-representation of South Asians in HF trials, meaning that evidence-based recommendations tailored to this specific population are limited. This is an important consideration because ethnic differences in response to medication have been reported; it cannot be assumed that treatments shown to work for Caucasians will be efficacious for those from minority ethnic groups. C1 [Tierney, Stephanie; Deaton, Christi; Mamas, Mamas] Univ Manchester, Sch Nursing Midwifery & Social Work, Manchester M13 9PL, Lancs, England. [Deaton, Christi; Mamas, Mamas] Cent Manchester Univ Hosp NHS Fdn Trust, Manchester, Lancs, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester RP Tierney, S (通讯作者)，Univ Manchester, Sch Nursing Midwifery & Social Work, Univ Pl,Oxford Rd, Manchester M13 9PL, Lancs, England. EM stephanie.tierney@manchester.ac.uk RI Deaton, Christi/F-6485-2010; Mamas, Mamas Andreas/A-2549-2019 OI Mamas, Mamas Andreas/0000-0001-9241-8890; Deaton, Christi/0000-0003-3209-0752 FU Greater Manchester Collaboration for Leadership in Applied Health Research and Care (CLAHRC); Manchester Academic Health Sciences Centre; Central Manchester Foundation Trust Bio-medical Research Centre FX The authors acknowledge the support of The Greater Manchester Collaboration for Leadership in Applied Health Research and Care (CLAHRC), the Manchester Academic Health Sciences Centre and the Central Manchester Foundation Trust Bio-medical Research Centre. 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Rev. PD MAR PY 2013 VL 18 IS 2 BP 197 EP 206 DI 10.1007/s10741-012-9319-x PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA 105OW UT WOS:000316082600009 PM 22562808 DA 2023-05-13 ER PT J AU Freundt, M Philipp, A Kolat, P Rupprecht, L Friedrich, C Hirt, SW Haneya, A AF Freundt, Miriam Philipp, Alois Kolat, Philipp Rupprecht, Leopold Friedrich, Christine Hirt, Stephan W. Haneya, Assad TI Impact of Elevated Donor Troponin I as Predictor of Adverse Outcome in Adult Heart Transplantation: A Single-center Experience SO THORACIC AND CARDIOVASCULAR SURGEON LA English DT Article DE heart transplantation; organ donor selection; transplant outcome; troponin I ID ACUTE CORONARY SYNDROMES; CARDIAC ALLOGRAFTS; GRAFT DYSFUNCTION; ORGAN DONORS; SHORT-TERM; SURVIVAL; SOCIETY; VALUES AB Background Due to globally increasing donor organ shortage, investigation of previously described risk factors for utilizing marginal donor hearts is needed. The aim of this study was to determine the impact of elevated donor serum troponin I (TnI) levels on outcome after heart transplantation (HTx). Methods Between January 1996 and August 2013, 161 patients were reviewed for donor TnI serum levels (>0.3 ng/mL was considered elevated), postoperative outcome parameters, 30-day mortality, and 1-, 3-, and 5-year survival. Results TnI levels were elevated in 45 (28.0%) donors. Recipients of hearts with elevated TnI had higher incidence of postoperative systolic dysfunction, prolonged inotropic support, prolonged mechanical ventilation, and longer intensive care unit (ICU) stay ( p <0.001). This group had higher 30-day mortality (22.2% vs 8.6%, p =0.03) and lower 1-, 3-, and 5-year survival (56%, 53%, and 50% versus 82%, 76%, and 69%, p =0.032). Elevated TnI was the only independent risk factor for 30-day mortality (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.28-10.27, p =0.015). Conclusions Elevated donor TnI serum concentration seems to be a marker for adverse outcome and increased short- and long-term mortality after HTx. Nevertheless, many other perioperative variables and parameters can be associated with outcome. C1 [Freundt, Miriam; Philipp, Alois; Kolat, Philipp; Rupprecht, Leopold; Hirt, Stephan W.; Haneya, Assad] Univ Med Ctr Regensburg, Dept Cardiothorac Surg, Regensburg, Germany. [Kolat, Philipp; Friedrich, Christine; Haneya, Assad] Univ Schleswig Holstein, Dept Cardiovasc Surg, Campus Kiel,Arnold Heller Str 3,Hs 18, D-24105 Kiel, Germany. C3 University of Regensburg; University of Kiel; Schleswig Holstein University Hospital RP Haneya, A (通讯作者)，Univ Schleswig Holstein, Dept Cardiovasc Surg, Campus Kiel,Arnold Heller Str 3,Hs 18, D-24105 Kiel, Germany. EM assad.haneya@uksh.de RI Haneya, Assad/ABE-6281-2020; Haneya, Assad/Q-7748-2017; Freundt, Miriam/ABB-5994-2020 CR Alpert JS, 2000, J AM COLL CARDIOL, V36, P959, DOI 10.1016/S0735-1097(00)00804-4 Boccheciampe N, 2007, INT J CARDIOL, V117, P136, DOI 10.1016/j.ijcard.2006.05.036 Boccheciampe N, 2009, INT J CARDIOL, V133, P80, DOI 10.1016/j.ijcard.2007.12.006 Chen JM, 2002, J HEART LUNG TRANSPL, V21, P608, DOI 10.1016/S1053-2498(01)00367-9 Freundt M, 2015, J AM COLL CARDIOL, V65, pA785, DOI 10.1016/S0735-1097(15)60785-9 Fukushima N, 2013, TRANSPL P, V45, P2871, DOI 10.1016/j.transproceed.2013.08.037 Khush KK, 2013, CIRC-HEART FAIL, V6, P300, DOI 10.1161/CIRCHEARTFAILURE.112.000165 Kirklin JK, 2012, J HEART LUNG TRANSPL, V31, P117, DOI 10.1016/j.healun.2011.12.001 Kutschmann M, 2014, TRANSPL INT, V27, P152, DOI 10.1111/tri.12221 Lima B, 2006, CIRCULATION, V114, pI27, DOI 10.1161/CIRCULATIONAHA.105.000737 Lin KY, 2011, J HEART LUNG TRANSPL, V30, P920, DOI 10.1016/j.healun.2011.02.011 OTT GY, 1994, ANN THORAC SURG, V57, P76, DOI 10.1016/0003-4975(94)90368-9 Pinzon OW, 2011, AM J TRANSPLANT, V11, P2755, DOI 10.1111/j.1600-6143.2011.03744.x RIOU B, 1995, CIRCULATION, V92, P409, DOI 10.1161/01.CIR.92.3.409 Sheehy E, 2003, NEW ENGL J MED, V349, P667, DOI 10.1056/NEJMsa021271 Stehlik J, 2011, J HEART LUNG TRANSPL, V30, P1078, DOI 10.1016/j.healun.2011.08.003 Tanindi A, 2011, VASC HEALTH RISK MAN, V7, P597, DOI 10.2147/VHRM.S24509 Venkateswaran RV, 2009, EUR J CARDIO-THORAC, V36, P286, DOI 10.1016/j.ejcts.2009.02.031 Wallentin L, 2014, AM HEART J, V168, P622, DOI 10.1016/j.ahj.2014.07.006 Weiss ES, 2012, J HEART LUNG TRANSPL, V31, P266, DOI 10.1016/j.healun.2011.10.004 NR 20 TC 5 Z9 5 U1 0 U2 0 PU GEORG THIEME VERLAG KG PI STUTTGART PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY SN 0171-6425 EI 1439-1902 J9 THORAC CARDIOV SURG JI Thorac. Cardiovasc. Surg. PD AUG PY 2018 VL 66 IS 5 DI 10.1055/s-0037-1606363 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA GP8NG UT WOS:000441166900013 PM 28922671 DA 2023-05-13 ER PT J AU Vilchinsky, N Dekel, R Revenson, TA Liberman, G Mosseri, M AF Vilchinsky, Noa Dekel, Rachel Revenson, Tracey A. Liberman, Gabriel Mosseri, Morris TI Caregivers' Burden and Depressive Symptoms: The Moderational Role of Attachment Orientations SO HEALTH PSYCHOLOGY LA English DT Article DE attachment; burden; cardiac illness; caregiving; depression ID CARDIAC PATIENTS; HEART-FAILURE; STYLE; ILLNESS; INVENTORY; DYNAMICS; SUPPORT; ASSOCIATION; PERCEPTIONS; PERSPECTIVE AB Objective: The current study explored whether attachment orientations moderate the associations between caregiver burden and depressive symptoms among women coping with their partners' first time acute coronary syndrome. The association between burden and depression was hypothesized to be stronger among caregivers high on anxious attachment than among caregivers low on this dimension. In addition, the association between burden and depressive symptoms was hypothesized to be weaker among caregivers higher on avoidant attachment than among those lower on this dimension. Method: The sample consisted of 111 female caregivers of male patients admitted to the cardiac care unit of a hospital in Israel. Caregivers completed a measure of attachment orientations during patients' hospitalization (baseline). Caregiver burden was measured 1 month later. Depressive symptoms were measured at baseline and again at 6-month follow-up. Structural equation modeling was used to test the moderational models. Results: The association between caregiver burden and depressive symptoms at follow-up was moderated by attachment-related anxiety but not attachment-related avoidance. Congruent with predictions, a stronger association between caregiver burden and depressive symptoms occurred for caregivers with greater (vs. lower) attachment anxiety. Conclusions: The findings shed light on the possible dynamics among attachment orientations and affect regulation when coping with one's partner's illness. The findings are discussed in light of Pietromonaco, Uchino, and Dunkel Schetter's (2013) model of integrating attachment into health psychology research. C1 [Vilchinsky, Noa] Bar Ilan Univ, Dept Psychol, IL-52900 Ramat Gan, Israel. [Dekel, Rachel] Bar Ilan Univ, Louis & Gabi Weisfeld Sch Social Work, IL-52900 Ramat Gan, Israel. [Revenson, Tracey A.] CUNY Hunter Coll, New York, NY 10021 USA. [Revenson, Tracey A.] CUNY, Grad Ctr, New York, NY USA. [Liberman, Gabriel] Data Graph Res & Stat Consulting, Holon, Israel. [Mosseri, Morris] Meir Med Ctr, Dept Cardiol, Kefar Sava, Israel. C3 Bar Ilan University; Bar Ilan University; City University of New York (CUNY) System; Hunter College (CUNY); City University of New York (CUNY) System; Tel Aviv University; Sackler Faculty of Medicine RP Vilchinsky, N (通讯作者)，Bar Ilan Univ, Dept Psychol, IL-52900 Ramat Gan, Israel. 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PD MAR PY 2015 VL 34 IS 3 BP 262 EP 269 DI 10.1037/hea0000121 PG 8 WC Psychology, Clinical; Psychology WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Psychology GA CB4QR UT WOS:000349613400009 PM 25110853 DA 2023-05-13 ER PT J AU Amar, D Park, B Zhang, H Shi, WJ Fleisher, M Thaler, HT Rusch, VW AF Amar, David Park, Bernard Zhang, Hao Shi, Weiji Fleisher, Martin Thaler, Howard T. Rusch, Valerie W. TI Beneficial effects of perioperative statins for major pulmonary resection SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article ID POSTOPERATIVE ATRIAL-FIBRILLATION; ACUTE CORONARY SYNDROME; C-REACTIVE PROTEIN; THORACIC-SURGERY; CARDIAC-SURGERY; LUNG INJURY; RANDOMIZED-TRIAL; ATORVASTATIN; MYELOPEROXIDASE; PREVENTION AB Objectives: Statins improve overall outcomes after noncardiac surgery. The primary aim of the study was to determine whether use of perioperative atorvastatin reduced the rate of postoperative complications in patients undergoing pulmonary resection. Methods: This was a prospective, randomized, placebo-controlled, double-blind trial of patients undergoing elective pulmonary resection who received atorvastatin (40 mg daily) or placebo beginning 1 week before surgery and continued for 1 week postoperatively. Patient characteristics and postoperative complications were recorded. Plasma inflammatory markers were sampled at baseline, in the post-anesthesia care unit, and on postoperative day 3. Because of difficulty enrolling statin-naive patients, the study was stopped at the interim analysis. Results: Postoperative complications occurred in 16 of 72 patients (22%) receiving placebo and in 8 of 65 patients (12%) receiving atorvastatin (P = .13). For patients undergoing major anatomic resection, there were 24 complications in 15 of 45 placebo-treated patients and 8 complications in 7 of 43 atorvastatintreated patients (P = .04). Plasma levels of C-reactive protein, tumor necrosis factor-a, and myeloperoxidase did not differ between the 2 treatment arms during the study. Conclusions: After a 2-week perioperative course of atorvastatin (40 mg) in statin-naive patients undergoing major pulmonary resection, we found evidence of a reduction in the number of clinically important cardiovascular and pulmonary complications compared with placebo. These promising results merit evaluation in a larger, perhaps multicenter study. C1 [Amar, David; Zhang, Hao] Mem Sloan Kettering Canc Ctr, Dept Anesthesiol & Crit Care Med, New York, NY 10021 USA. [Park, Bernard; Rusch, Valerie W.] Mem Sloan Kettering Canc Ctr, Dept Surg, New York, NY 10021 USA. [Fleisher, Martin] Mem Sloan Kettering Canc Ctr, Dept Lab Med, New York, NY 10021 USA. [Thaler, Howard T.] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10021 USA. C3 Memorial Sloan Kettering Cancer Center; Memorial Sloan Kettering Cancer Center; Memorial Sloan Kettering Cancer Center; Memorial Sloan Kettering Cancer Center RP Amar, D (通讯作者)，Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA. EM amard@mskcc.org OI Rusch, Valerie/0000-0003-2345-6900 FU National Institutes of Health [P30 CA008748] FX W.S. and H.T.T. are partly supported by a National Institutes of Health Core Grant P30 CA008748. 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Thorac. Cardiovasc. Surg. PD JUN PY 2015 VL 149 IS 6 BP 1532 EP 1538 DI 10.1016/j.jtcvs.2014.12.016 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA CJ8HI UT WOS:000355740400033 PM 25623903 OA Green Accepted, Bronze DA 2023-05-13 ER PT J AU Kaufmann, CC Ahmed, A Burger, AL Muthspiel, M Jager, B Wojta, J Huber, K AF Kaufmann, Christoph C. Ahmed, Amro Burger, Achim Leo Muthspiel, Marie Jager, Bernhard Wojta, Johann Huber, Kurt TI Biomarkers Associated with Cardiovascular Disease in COVID-19 SO CELLS LA English DT Review DE COVID-19; cardiac biomarkers; myocardial injury; troponin; BNP ID PROATRIAL NATRIURETIC PEPTIDE; MID-REGIONAL PROADRENOMEDULLIN; ACUTE CORONARY SYNDROME; PRO-ADRENOMEDULLIN; RISK STRATIFICATION; HEART-FAILURE; SOLUBLE ST2; CARDIAC BIOMARKERS; ENDOTHELIAL DYSFUNCTION; PREDICTING MORTALITY AB Coronavirus disease-19 (COVID-19) emerged late December 2019 in the city of Wuhan, China and has since spread rapidly all over the world causing a global pandemic. While the respiratory system is the primary target of disease manifestation, COVID-19 has been shown to also affect several other organs, making it a rather complex, multi-system disease. As such, cardiovascular involvement has been a topic of discussion since the beginning of the COVID-19 pandemic, primarily due to early reports of excessive myocardial injury in these patients. Treating physicians are faced with multiple challenges in the management and early triage of patients with COVID-19, as disease severity is highly variable ranging from an asymptomatic infection to critical cases rapidly deteriorating to intensive care treatment or even fatality. Laboratory biomarkers provide important prognostic information which can guide decision making in the emergency department, especially in patients with atypical presentations. Several cardiac biomarkers, most notably high-sensitive cardiac troponin (hs-cTn) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), have emerged as valuable predictors of prognosis in patients with COVID-19. The purpose of this review was to offer a concise summary on prognostic cardiac biomarkers in COVID-19 and discuss whether routine measurements of these biomarkers are warranted upon hospital admission. C1 [Kaufmann, Christoph C.; Ahmed, Amro; Burger, Achim Leo; Muthspiel, Marie; Jager, Bernhard; Huber, Kurt] Klin Ottakring Wilhelminen Hosp, Med Dept Cardiol & Intens Care Med 3, Montleartstr 37, A-1160 Vienna, Austria. [Jager, Bernhard; Huber, Kurt] Sigmund Freud Univ, Med Sch, A-1090 Vienna, Austria. [Wojta, Johann] Med Univ Vienna, Dept Internal Med 2, Div Cardiol, A-1090 Vienna, Austria. [Wojta, Johann] Med Univ Vienna, Core Facil, A-1090 Vienna, Austria. [Wojta, Johann; Huber, Kurt] Ludwig Boltzmann Inst Cardiovasc Res, A-1020 Vienna, Austria. C3 Medical University of Vienna; Medical University of Vienna; Ludwig Boltzmann Institute RP Kaufmann, CC (通讯作者)，Klin Ottakring Wilhelminen Hosp, Med Dept Cardiol & Intens Care Med 3, Montleartstr 37, A-1160 Vienna, Austria. EM christoph.c.kaufmann@gmail.com; amro.ahmed@wienkav.at; achim.burger@wienkav.at; marie.muthspiel@extern.wienkav.at; bernhard.jaeger@wienkav.at; johann.wojta@meduniwien.ac.at; kurt.huber@meduniwien.ac.at OI Sekgota Nemphagane, Wendy Maphefo/0000-0002-3113-7275 FU Association for the Promotion of Research on Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB); Ludwig Boltzmann Institute for Cardiovascular Research FX This work was supported by the Association for the Promotion of Research on Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB) and by the Ludwig Boltzmann Institute for Cardiovascular Research. 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CH-4052 BASEL, SWITZERLAND EI 2073-4409 J9 CELLS-BASEL JI Cells PD MAR PY 2022 VL 11 IS 6 AR 922 DI 10.3390/cells11060922 PG 19 WC Cell Biology WE Science Citation Index Expanded (SCI-EXPANDED) SC Cell Biology GA 0D1LA UT WOS:000775762600001 PM 35326373 OA Green Published, gold DA 2023-05-13 ER PT J AU Dosedel, M Hendrychova, T Maly, J Kubena, A Byma, S Vlcek, J AF Dosedel, Martin Hendrychova, Tereza Maly, Josef Kubena, Ales Byma, Svatopluk Vlcek, Jiri TI PRESCRIPTION OF EVIDENCE-BASED MEDICINE DRUGS BY GENERAL PRACTITIONERS TO PATIENTS AFTER MYOCARDIAL INFARCTION: OUTCOMES FROM THE CZECH REPUBLIC SO ACTA POLONIAE PHARMACEUTICA LA English DT Article DE myocardial infarction; general practitioners; secondary prevention; evidence-based medicine ID ACUTE CORONARY SYNDROMES; SECONDARY PREVENTION; ELDERLY-PATIENTS; THERAPY AB Ischemic heart disease is the most frequent cause of both serious morbidity and mortality of adult population in developed countries. The main aim of the study was to carry out the analysis of general practitioners (GP) prescription of evidence-based therapy in patients after myocardial infarction (MI). Data were retrospectively collected in 2011, by a single application with the help of software that GPs use in their surgeries. All patients of a particular GP who had MI in their history and who were at the time of data collection treated only by GPs (not by the specialists of internal medicine or cardiology) were always included. Four hundred ninety one patients were included in the study. The average age was 70.7 (+/-11.6) and 69.2% of the involved patients were men. Seventy nine percent of patients used beta-blockers, 80% antiplatelet drugs, 77% statins and 79% used angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs/ARBs). Forty four percent of patients used drugs from all four groups. The significant prescription decrease was proved in all four groups in dependence on patients' age (p < 0.05). Although the evidence-based medicine usage in patients after MI in the Czech Republic is comparable to other countries, it is not optimal. More intensive involvement of pharmacists in the care of patients after MI would further improve the situation. C1 [Dosedel, Martin; Hendrychova, Tereza; Maly, Josef; Kubena, Ales; Vlcek, Jiri] Charles Univ Prague, Fac Pharm Hradec Kralove, Dept Social & Clin Pharm, Hradec Kralove 50005, Czech Republic. [Byma, Svatopluk] Charles Univ Prague, Fac Med Hradec Kralove, Dept Social Med, Div Pract & Family Med, Hradec Kralove 50038, Czech Republic. [Byma, Svatopluk] Czech Med Assoc JE Purkyne, Soc Gen Practice, Prague 10000 10, Czech Republic. C3 Charles University Prague; Charles University Prague; University Hospital Hradec Kralove RP Dosedel, M (通讯作者)，Charles Univ Prague, Fac Pharm Hradec Kralove, Dept Social & Clin Pharm, Heyrovskeho 1203, Hradec Kralove 50005, Czech Republic. EM martin.dosedel@faf.cuni.cz; tereza.hendrychova@faf.cuni.cz RI dosedel, martin/U-9091-2017; Hendrychova, Tereza/ABD-6028-2020; Býma, Svatopluk/E-3823-2017; Vlcek, Jiri/U-4417-2017; Kuběna, Aleš Antonín/A-3766-2015; Maly, Josef/T-9294-2017 OI dosedel, martin/0000-0001-5253-7967; Býma, Svatopluk/0000-0002-1334-1803; Vlcek, Jiri/0000-0002-8431-8897; Kuběna, Aleš Antonín/0000-0002-9599-8277; Maly, Josef/0000-0002-6538-1639 FU SVV from Charles University in Prague [265 005] FX The study was supported by SVV 265 005 from the Charles University in Prague. 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PHARM. PD JAN-FEB PY 2014 VL 71 IS 1 BP 189 EP 195 PG 7 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA AP0HX UT WOS:000341743200019 PM 24779207 DA 2023-05-13 ER PT J AU Liberale, L Montecucco, F Tardif, JC Libby, P Camici, GG AF Liberale, Luca Montecucco, Fabrizio Tardif, Jean-Claude Libby, Peter Camici, Giovanni G. TI Inflamm-ageing: the role of inflammation in age-dependent cardiovascular disease SO EUROPEAN HEART JOURNAL LA English DT Review DE Inflamm-ageing; Vascular ageing; Inflammation; Endothelial dysfunction; Cardiovascular disease ID C-REACTIVE PROTEIN; ACUTE CORONARY SYNDROMES; SELECTIN ANTAGONIST INCLACUMAB; CLONAL HEMATOPOIESIS; MYOCARDIAL-INFARCTION; GUT MICROBIOTA; HEART-DISEASE; RHEUMATOID-ARTHRITIS; ADIPOSE-TISSUE; RECURRENT PERICARDITIS AB The ongoing worldwide increase in life expectancy portends a rising prevalence of age-related cardiovascular (CV) diseases in the coming decades that demands a deeper understanding of their molecular mechanisms. Inflammation has recently emerged as an important contributor for CV disease development. Indeed, a state of chronic sterile low-grade inflammation characterizes older organisms (also known as inflamm-ageing) and participates pivotally in the development of frailty, disability, and most chronic degenerative diseases including age-related CV and cerebrovascular afflictions. Due to chronic activation of inflammasomes and to reduced endogenous anti-inflammatory mechanisms, inflamm-ageing contributes to the activation of leucocytes, endothelial, and vascular smooth muscle cells, thus accelerating vascular ageing and atherosclerosis. Furthermore, inflamm-ageing promotes the development of catastrophic athero-thrombotic complications by enhancing platelet reactivity and predisposing to plaque rupture and erosion. Thus, inflamm-ageing and its contributors or molecular mediators might furnish targets for novel therapeutic strategies that could promote healthy ageing and conserve resources for health care systems worldwide. Here, we discuss recent findings in the pathophysiology of inflamm-ageing, the impact of these processes on the development of age-related CV diseases, results from clinical trials targeting its components and the potential implementation of these advances into daily clinical practice. C1 [Liberale, Luca; Camici, Giovanni G.] Univ Zurich, Ctr Mol Cardiol, Wagistr 12, CH-8952 Schlieren, Switzerland. [Liberale, Luca; Montecucco, Fabrizio] Univ Genoa, Dept Internal Med, Clin Internal Med 1, Vle Benedetto XV 10, I-16132 Genoa, Italy. [Montecucco, Fabrizio] IRCCS Osped Policlin San Martino Genoa Italian Ca, Lgo Rosanna Benzi 10, I-16132 Genoa, Italy. [Montecucco, Fabrizio] Univ Genoa, Ctr Excellence Biomed Res CEBR, Vle Benedetto XV 10, I-16132 Genoa, Italy. [Tardif, Jean-Claude] Univ Montreal, Montreal Heart Inst, Rue Belanger 5000, Montreal, PQ H1T 1C8, Canada. [Libby, Peter] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Div Cardiovasc Med, Francis St 75, Boston, MA 02115 USA. [Camici, Giovanni G.] Univ Hosp Zurich, Univ Heart Ctr, Dept Cardiol, Ramistr 100, CH-8091 Zurich, Switzerland. [Camici, Giovanni G.] Univ Hosp Zurich, Dept Res & Educ, Ramistr 100, CH-8091 Zurich, Switzerland. C3 University of Genoa; University of Genoa; Universite de Montreal; Harvard University; Brigham & Women's Hospital; Harvard Medical School; University of Zurich; University Zurich Hospital; University of Zurich; University Zurich Hospital RP Camici, GG (通讯作者)，Univ Zurich, Ctr Mol Cardiol, Wagistr 12, CH-8952 Schlieren, Switzerland.; Camici, GG (通讯作者)，Univ Hosp Zurich, Univ Heart Ctr, Dept Cardiol, Ramistr 100, CH-8091 Zurich, Switzerland.; Camici, GG (通讯作者)，Univ Hosp Zurich, Dept Res & Educ, Ramistr 100, CH-8091 Zurich, Switzerland. EM giovanni.camici@uzh.ch RI Cardia, Carolina/HZH-2845-2023; Libby, Peter/AAY-6404-2021; Liberale, Luca/H-1560-2018; Montecucco, Fabrizio/K-8543-2016 OI Libby, Peter/0000-0002-1502-502X; Liberale, Luca/0000-0003-1472-7975; Tardif, Jean-Claude/0000-0002-8200-8983; Montecucco, Fabrizio/0000-0003-0823-8729 FU Swiss National Science Foundation [310030_175546]; Swiss Heart Foundation; Alfred and Annemarie von Sick Grants for Translational and Clinical Research Cardiology and Oncology; Sheikh Khalifa's Foundation Ass. Professorship at the Faculty of Medicine, University of Zurich; National Heart, Lung, and Blood Institute [R01HL080472]; American Heart Association [18CSA34080399]; RRM Charitable Fund; Foundation for Cardiovascular Research-Zurich Heart House FX This work was supported by the Swiss National Science Foundation [310030_175546], the Swiss Heart Foundation, the Alfred and Annemarie von Sick Grants for Translational and Clinical Research Cardiology and Oncology and the Foundation for Cardiovascular Research-Zurich Heart House to G.G.C. G.G.C. is also the recipient of a Sheikh Khalifa's Foundation Ass. Professorship at the Faculty of Medicine, University of Zurich. P.L. received funding by National Heart, Lung, and Blood Institute [R01HL080472], American Heart Association [18CSA34080399], and RRM Charitable Fund. 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Heart J. PD AUG 14 PY 2020 VL 41 IS 31 BP 2974 EP + DI 10.1093/eurheartj/ehz961 PG 14 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA OF1WM UT WOS:000581007100012 PM 32006431 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Ratcliffe, EG Jankowski, JA AF Ratcliffe, Elizabeth G. Jankowski, Janusz A. TI Gastroesophageal reflux disease and Barrett esophagus: an overview of evidence-based guidelines SO POLISH ARCHIVES OF INTERNAL MEDICINE-POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ LA English DT Review DE Barrett esophagus; cancer; chemoprevention; mortality; prevention ID PROTON-PUMP INHIBITORS; LAPAROSCOPIC NISSEN FUNDOPLICATION; RANDOMIZED CONTROLLED-TRIAL; ACUTE CORONARY SYNDROMES; HIGH-GRADE DYSPLASIA; QUALITY-OF-LIFE; CHEST-PAIN; ANTIREFLUX SURGERY; COST-EFFECTIVENESS; TEMPORAL TRENDS AB Gastroesophageal reflux disease is an extremely common condition worldwide, with the published prevalence rates varying from 2.5% in China to 51.2% in Greece. Its economic and morbidity burden is vast, and optimizing care for this condition carries huge financial and patient-related benefits. The disease can be complicated by progression to Barrett esophagus (BE), a precancerous condition that affects approximately 2% of the population and remains undiagnosed in many individuals. The National Institute of Clinical Excellence has produced guidelines on cost-effective management of gastroesophageal reflux disease in patients in the United Kingdom, and the Benign Barrett's and Cancer Taskforce consensus was the largest international review of evidence known on the management of benign BE complications. This paper is a review of these guidelines with updates on new evidence. Areas for future development involve risk-stratifying patients to surveillance, chemoprevention agents, and genetic biomarkers to help decide who will be at highest risk of malignant progression. Evidence supports the safety of proton pump inhibitors for symptom control in the medium term (ie, 9 years) and reducing the risk of progression of BE, while surgical options are cost-effective treatments for certain patients. Barrett esophagus surveillance should be directed towards high-risk groups, while those at lower risk may benefit from chemoprevention strategies. C1 [Ratcliffe, Elizabeth G.] Wriglitington Wigan & Leigh NHS Trust, Endoscopy Unit, Leigh, England. [Jankowski, Janusz A.] Sherwood Forest Hosp NHS Trust, Sutton In Ashfield, England. [Jankowski, Janusz A.] Natl Inst Hlth & Care Excellence, London, England. [Jankowski, Janusz A.] Univ Liverpool, Liverpool, Merseyside, England. C3 National Institute for Health & Care Excellence; N8 Research Partnership; RLUK- Research Libraries UK; University of Liverpool RP Ratcliffe, EG (通讯作者)，Wrightington Wigan & Leigh & NHS Trust, Endoscopy Dept, Leigh Infirm, Leigh WN7 1HS, England. EM elizabeth.ratcliffe@mwl.nhs.uk OI Ratcliffe, Elizabeth/0000-0001-6521-2133 FU Cancer Research UK FX JJ has received funding for research trials from Cancer Research UK. 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Intern. Med. PD AUG 29 PY 2019 VL 129 IS 7-8 BP 516 EP 525 DI 10.20452/pamw.14828 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA IV5XG UT WOS:000484342900012 PM 31080232 OA gold DA 2023-05-13 ER PT J AU Santra, G AF Santra, Gouranga TI Assessment of adherence to cardiovascular medicines in rural population: An observational study in patients attending a tertiary care hospital SO INDIAN JOURNAL OF PHARMACOLOGY LA English DT Article DE Cardiovascular medicines; congestive cardiac failure; essential hypertension; ischemic heart disease ID ACUTE CORONARY SYNDROME; MEDICATION ADHERENCE; THERAPY AB Introduction: Nonadherence to cardiovascular medicines is a major concern. It increases the morbidity and mortality of cardiovascular patients. The work was conducted to evaluate the adherence to cardiovascular medicines in patients of rural India. Methods: The study was conducted in the Department of Medicine involving rural patients with essential hypertension (HTN), congestive cardiac failure (CCF), and ischemic heart disease (IHD) over 12 months period. Patients were prescribed with cardiovascular medicines at the initial visit and adherence to medicines was assessed in the subsequent visit. Four items Morisky's Medication Adherence Scale (MMAS-4) was used for assessing medication adherence. Patients were considered adherent to medication if they answered negatively to all four questions. Results: Overall adherence to medication was 20.83%, 28.37% and 32% in HTN, CCF, and IHD patients, respectively. Nonadherence was highest in patients of HTN. Among the four reasons of nonadherence assessed by MMAS-4, carelessness was the most common and forgetfulness was the least common cause of nonadherence in all the three groups of patients. Conclusion: Patients of rural India adhere poorly to cardiovascular medicines. Nonadherence should be considered as a public health problem. Strategies for detecting the level of adherence of cardiovascular medicines, its barriers, and subsequent interventions should be developed by policy-makers to reduce morbidity and mortality due to cardiovascular disorders. C1 [Santra, Gouranga] Midnapore Med Coll, Dept Med, Paschim Medinipur, W Bengal, India. C3 Midnapore Medical College RP Santra, G (通讯作者)，Midnapore Med Coll, Dept Med, Paschim Medinipur, W Bengal, India. EM g.santra@yahoo.com OI SANTRA, GOURANGA/0000-0001-6023-0615 CR Alakhali KM, 2013, INDIAN J PHARM SCI, V75, P557 Baroletti S, 2010, CIRCULATION, V121, P1455, DOI 10.1161/CIRCULATIONAHA.109.904003 Bhandari S, 2015, ASIA-PAC J PUBLIC HE, V27, pNP74, DOI 10.1177/1010539511423568 Bowry ADK, 2011, J GEN INTERN MED, V26, P1479, DOI 10.1007/s11606-011-1825-3 Chowdhury R, 2013, EUR HEART J, V34, P2940, DOI 10.1093/eurheartj/eht295 Castro Raquel Azevedo de, 2010, Rev. 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Pharmacol. PD NOV-DEC PY 2015 VL 47 IS 6 BP 600 EP 604 DI 10.4103/0253-7613.169573 PG 5 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA CX4UK UT WOS:000365695600004 PM 26729949 OA Green Published DA 2023-05-13 ER PT J AU Montastruc, F Benevent, J Touafchia, A Chebane, L Araujo, M Guitton-Bondon, E Durrieu, G Arbus, C Schmitt, L Begaud, B Montastruc, JL AF Montastruc, Francois Benevent, Justine Touafchia, Anthony Chebane, Leila Araujo, Melanie Guitton-Bondon, Emmanuelle Durrieu, Genevieve Arbus, Christophe Schmitt, Laurent Begaud, Bernard Montastruc, Jean-Louis TI Atropinic (anticholinergic) burden in antipsychotic-treated patients SO FUNDAMENTAL & CLINICAL PHARMACOLOGY LA English DT Article DE anticholinergic burden; antipsychotics; atropinic burden ID ACUTE CORONARY SYNDROME; MYOCARDIAL-INFARCTION; TASK-FORCE; MANAGEMENT; DATABASES; FRANCE; STROKE; CARE; PREVENTION; GUIDELINES AB Antipsychotic drugs possess side atropinic (anticholinergic) properties that may induce several adverse drug reactions (ADRs), such as memory loss or cognitive impairment. The aim of this study was to investigate anticholinergic burden in patients treated with antipsychotic drugs. All ADR reports including at least one antipsychotic and registered between 2000 and 2015 in the Midi-Pyrenees PharmacoVigilance Database were extracted and analyzed using the Anticholinergic Duran's list. The primary objective of this cross-sectional study was to calculate anticholinergic burden in antipsychotic-treated patients; the secondary one was to investigate associated factors. Among the 1948 reports, the average number of atropinic drugs per report was 2.4 +/- 1.4. At least one atropinic drug was found in 59.4% of reports (1158), in addition to antipsychotic drugs. The mean anticholinergic burden per report was 3.9 +/- 2.9. A value >= 3 was found in 61.7% of the reports. A significant association between anticholinergic burden, age, and male gender of patients was found. The mean value of anticholinergic burden remained stable during the study period. This study showed high values of anticholinergic burden in patients receiving antipsychotics. Thus, considering the potential noxious clinical impact of atropinic properties on cognitive functions, an appropriate approach should be used to reduce prescription of antipsychotics with a high anticholinergic burden but also coprescription of other frequently associated atropinic drugs, such as antiparkinsonians, H1 antihistamines, or imipraminic antidepressants in these patients. C1 [Montastruc, Francois; Benevent, Justine; Touafchia, Anthony; Chebane, Leila; Araujo, Melanie; Guitton-Bondon, Emmanuelle; Durrieu, Genevieve; Montastruc, Jean-Louis] CHU Toulouse, Ctr Midipyrenees PharmacoVigilance Pharmacoepidem, Lab Pharmacol Med & Clin, INSERM,UMR 1027,CIC 1436,Fac Med Toulouse, Toulouse, France. [Montastruc, Francois; Begaud, Bernard] Univ Bordeaux, Dept Pharmacol Med, INSERM, Medicaments & Sante Populat U 1219, Bordeaux, France. [Arbus, Christophe; Schmitt, Laurent] CHU Toulouse, Fac Med Toulouse, Serv Hosp Univ Psychiat & Psychol Med, 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; Institut National de la Sante et de la Recherche Medicale (Inserm); UDICE-French Research Universities; Universite de Bordeaux; CHU de Toulouse; Universite de Toulouse; Universite Toulouse III - Paul Sabatier RP Montastruc, JL (通讯作者)，CHU Toulouse, Ctr Midipyrenees PharmacoVigilance Pharmacoepidem, Lab Pharmacol Med & Clin, INSERM,UMR 1027,CIC 1436,Fac Med Toulouse, Toulouse, France. EM jean-louis.montastruc@univ-tlse3.fr RI Montastruc, François/ABE-9903-2020 OI Montastruc, François/0000-0001-7056-8126; Araujo, Melanie/0000-0003-3057-9554; BENEVENT, Justine/0000-0001-9048-5336 CR Aboa-Eboule C, 2013, J NEUROL, V260, P605, DOI 10.1007/s00415-012-6686-0 Bezin J, 2014, EUR J CLIN PHARMACOL, V70, P429, DOI 10.1007/s00228-013-1614-5 Bezin J, 2017, PHARMACOEPIDEM DR S, V26, P954, DOI 10.1002/pds.4233 Bezin J, 2015, FUND CLIN PHARMACOL, V29, P586, DOI 10.1111/fcp.12143 Birman-Deych E, 2005, MED CARE, V43, P480, DOI 10.1097/01.mlr.0000160417.39497.a9 Danchin N, 2011, CIRC-CARDIOVASC QUAL, V4, P619, DOI 10.1161/CIRCOUTCOMES.111.961193 Fang M.C., 2016, MED CARE IN PRESS Giroud M, 2015, EUR NEUROL, V74, P92, DOI 10.1159/000438859 Ko RH, 2017, FRONT PEDIATR, V5, DOI 10.3389/fped.2017.00012 Konstantinides S.V., 2014, EUR HEART J, V35, p3069a Konstantinides SV, 2014, EUR HEART J, V35, P3033, DOI 10.1093/eurheartj/ehu283 Levine GN, 2016, CIRCULATION, V134, pE123, DOI 10.1161/CIR.0000000000000404 Moulis G, 2015, REV MED INTERNE, V36, P411, DOI 10.1016/j.revmed.2014.11.009 Neumann A, 2014, PHARMACOEPIDEM DR S, V23, P240, DOI 10.1002/pds.3544 Rodeghiero F, 2016, AM J HEMATOL, V91, P39, DOI 10.1002/ajh.24234 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Sadeghi B, 2015, MED CARE, V53, pE37, DOI 10.1097/MLR.0b013e318287d59e Schneeweiss S, 2005, J CLIN EPIDEMIOL, V58, P323, DOI 10.1016/j.jclinepi.2004.10.012 Sundboll J, 2016, BMJ OPEN, V6, DOI 10.1136/bmjopen-2016-012832 Tolonen H, 2007, EUR J CARDIOV PREV R, V14, P380, DOI 10.1097/01.hjr.0000239466.26132.f2 Tuppin P, 2014, ARCH PEDIATRIE, V21, P1305, DOI 10.1016/j.arcped.2014.08.023 Tuppin P, 2010, REV EPIDEMIOL SANTE, V58, P286, DOI 10.1016/j.respe.2010.04.005 WHO, 2019, CARD DIS CVDS World Health Organization, INT CLASS DIS ICD NR 24 TC 11 Z9 11 U1 0 U2 1 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0767-3981 EI 1472-8206 J9 FUND CLIN PHARMACOL JI Fundam. Clin. Pharmacol. PD FEB PY 2018 VL 32 IS 1 BP 114 EP 119 DI 10.1111/fcp.12321 PG 6 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA FS8UU UT WOS:000422691000014 PM 28887902 DA 2023-05-13 ER PT J AU Saraswat, A Rahman, A Singh, K AF Saraswat, Avadhesh Rahman, Atifur Singh, Kuljit TI An Invasive vs a Conservative Approach in Elderly Patients with None-ST-Segment Elevation Myocardial Infarction: Systematic Review and Meta-Analysis SO CANADIAN JOURNAL OF CARDIOLOGY LA English DT Review ID ACUTE CORONARY SYNDROMES; STRATEGY; ROUTINE; CARE; AGE AB Background: Elderly (>= 75 years) patients form a large sub-group of noneST-segment elevation myocardial infarction (NSTEMI) population but are vastly under-represented in trials. Thus, the benefits of an early angiography in the elderly remain unclear. In this systematic review, we compared outcomes of "invasive" and "conservative" strategies of NSTEMI management in elderly patients. Methods: A comprehensive search of major databases was performed. We included comparative studies of any design that enrolled patients >= 75 years, and where outcomes of both strategies of NSTEMI management were available. Results: Among the included studies (3 randomized and 6 observational), there were 6340 patients in the "invasive" group and 13,358 patients in the "conservative" group. The 12-month mortality rate (odds ration [OR], 0.45; p < 0.00001), the 30-day mortality (OR, 0.50; p = 0.0009), and events of stroke (OR, 0.42; p < 0.00001) were significantly lower in the invasive group. Major bleeding was higher in the invasive cohort (OR, 1.63; p = 0.03). Analysis of randomised studies showed lower reinfarction with invasive approach at 12 months (p = 0.0001). Significant heterogeneity was noted among studies according to study design. Conclusion: The overall benefit with invasive strategy comes from the data of observational studies that are prone to selection bias. We believe that there is a need for a large randomized study in the elderly patients regarding management of NSTEMI. C1 [Saraswat, Avadhesh; Rahman, Atifur; Singh, Kuljit] Gold Coast Univ Hosp, Dept Cardiol, Gold Coast, Qld, Australia. [Rahman, Atifur; Singh, Kuljit] Griffith Univ, Dept Med, Gold Coast, Qld, Australia. [Singh, Kuljit] Univ Adelaide, Dept Med, Adelaide, SA, Australia. C3 Gold Coast University Hospital; Griffith University; University of Adelaide RP Singh, K (通讯作者)，Griffith Univ, Gold Coast Univ Hosp, Dept Cardiol, 1 Hosp Blvd, Southport, Qld, Australia. 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J. Cardiol. PD MAR PY 2018 VL 34 IS 3 BP 274 EP 280 DI 10.1016/j.cjca.2017.11.020 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FX8QB UT WOS:000426358900009 PM 29395710 DA 2023-05-13 ER PT J AU Schumann, J Henrich, EC Strobl, H Prondzinsky, R Weiche, S Thiele, H Werdan, K Frantz, S Unverzagt, S AF Schumann, Julia Henrich, Eva C. Strobl, Hellen Prondzinsky, Roland Weiche, Sophie Thiele, Holger Werdan, Karl Frantz, Stefan Unverzagt, Susanne TI Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS LA English DT Review DE Cardiac Output, Low [drug therapy; etiology]; Cardiotonic Agents [therapeutic use]; Dobutamine [therapeutic use]; Enoximone [therapeutic use]; Hydrazones [therapeutic use]; Myocardial Infarction [complications]; Nitric Oxide [therapeutic use]; Pyridazines [therapeutic use]; Randomized Controlled Trials as Topic; Shock, Cardiogenic [drug therapy; etiology]; Vasodilator Agents [therapeutic use]; Humans ID ACUTE MYOCARDIAL-INFARCTION; CORONARY-ARTERY-BYPASS; ACUTE HEART-FAILURE; LEFT-VENTRICULAR DYSFUNCTION; CRITICALLY-ILL PATIENTS; INTRAAORTIC BALLOON COUNTERPULSATION; LONG-TERM SURVIVAL; DOUBLE-BLIND; EARLY REVASCULARIZATION; CARDIOPULMONARY BYPASS AB Background Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs. This is the first update of a Cochrane review originally published in 2014. Objectives To assess efficacy and safety of cardiac care with positive inotropic agents and vasodilator strategies in people with CS or LCOS due to AMI, HF or cardiac surgery. Search methods We searched CENTRAL, MEDLINE, Embase and CPCI-S Web of Science in June 2017. We also searched four registers of ongoing trials and scanned reference lists and contacted experts in the field to obtain further information. No language restrictions were applied. Selection criteria Randomised controlled trials in people with myocardial infarction, heart failure or cardiac surgery complicated by cardiogenic shock or LCOS. Data collection and analysis We used standard methodological procedures expected by Cochrane. Main results We identified 13 eligible studies with 2001 participants (mean or median age range 58 to 73 years) and two ongoing studies. We categorised studies into eight comparisons, all against cardiac care and additional other active drugs or placebo. These comparisons investigated the efficacy of levosimendan versus dobutamine, enoximone or placebo, epinephrine versus norepinephrine-dobutamine, amrinone versus dobutamine, dopexamine versus dopamine, enoximone versus dopamine and nitric oxide versus placebo. All trials were published in peer-reviewed journals, and analysis was done by the intention-to-treat (ITT) principle. Twelve of 13 trials were small with few included participants. Acknowledgement of funding by the pharmaceutical industry or missing conflict of interest statements emerged in five of 13 trials. In general, confidence in the results of analysed studies was reduced due to serious study limitations, very serious imprecision or indirectness. Domains of concern, which show a high risk of more than 50%, include performance bias (blinding of participants and personnel) and bias affecting the quality of evidence on adverse events. Levosimendan may reduce short-term mortality compared to a therapy with dobutamine (RR 0.60, 95% CI 0.37 to 0.95; 6 studies; 1776 participants; low-quality evidence; NNT: 16 (patients with moderate risk), NNT: 5 (patients with CS)). This initial short-term survival benefit with levosimendan vs. dobutamine is not confirmed on long-term follow up. There is uncertainty (due to lack of statistical power) as to the effect of levosimendan compared to therapy with placebo (RR 0.48, 95% CI 0.12 to 1.94; 2 studies; 55 participants, very low-quality evidence) or enoximone (RR 0.50, 95% CI 0.22 to 1.14; 1 study; 32 participants, very low-quality evidence). All comparisons comparing other positive inotropic, inodilative or vasodilative drugs presented uncertainty on their effect on short-term mortality with very low-quality evidence and based on only one RCT. These single studies compared epinephrine with norepinephrine-dobutamine (RR 1.25, 95% CI 0.41 to 3.77; 30 participants), amrinone with dobutamine (RR 0.33, 95% CI 0.04 to 2.85; 30 participants), dopexamine with dopamine (no in-hospital deaths from 70 participants), enoximone with dobutamine (two deaths from 40 participants) and nitric oxide with placebo (one death from three participants). Authors' conclusions Apart from low quality of evidence data suggesting a short-term mortality benefit of levosimendan compared with dobutamine, at present there are no robust and convincing data to support a distinct inotropic or vasodilator drug-based therapy as a superior solution to reduce mortality in haemodynamically unstable people with cardiogenic shock or LCOS. Considering the limited evidence derived from the present data due to a generally high risk of bias and imprecision, it should be emphasised that there remains a great need for large, well-designed randomised trials on this topic to close the gap between daily practice in critical care medicine and the available evidence. It seems to be useful to apply the concept of 'early goal-directed therapy' in cardiogenic shock and LCOS with early haemodynamic stabilisation within predefined timelines. Future clinical trials should therefore investigate whether such a therapeutic concept would influence survival rates much more than looking for the 'best' drug for haemodynamic support. C1 [Schumann, Julia] Martin Luther Univ Halle Wittenberg, Dept Anaesthesiol & Surg Intens Care, Halle, Germany. [Henrich, Eva C.; Strobl, Hellen; Unverzagt, Susanne] Martin Luther Univ Halle Wittenberg, Inst Med Epidemiol Biostat & Informat, Halle, Germany. [Prondzinsky, Roland] Carl von Basedow Klinikum Merseburg, Cardiol Intens Care Med, Merseburg, Germany. [Weiche, Sophie; Werdan, Karl; Frantz, Stefan] Martin Luther Univ Halle Wittenberg, Dept Internal Med 3, Halle, Germany. [Thiele, Holger] Univ Clin Schleswig Holstein, Med Clin Kardiol Angiol Intens Care Med 2, Campus Lubeck, Lubeck, Germany. C3 Martin Luther University Halle Wittenberg; Martin Luther University Halle Wittenberg; Martin Luther University Halle Wittenberg; University of Kiel; Schleswig Holstein University Hospital RP Schumann, J (通讯作者)，Martin Luther Univ Halle Wittenberg, Dept Anaesthesiol & Surg Intens Care, Halle, Germany. EM julia.schumann@uk-halle.de RI Thiele, Holger/ABE-6792-2020; Frantz, Stefan/G-1723-2012; Unverzagt, Susanne/AGE-2574-2022 OI Thiele, Holger/0000-0002-0169-998X; FU Northwestern University Feinberg School of Medicine; Northwestern University Clinical and Translational Science (NUCATS) Institute, USA [UL1TR000150]; National Institute for Health Research, via Cochrane Infrastructure to Cochrane Heart FX External sourcesr The Cochrane Heart US Satellite is supported by intramural support from the Northwestern University Feinberg School of Medicine and the Northwestern University Clinical and Translational Science (NUCATS) Institute (UL1TR000150), USA.r This project was supported by the National Institute for Health Research, via Cochrane Infrastructure to Cochrane Heart. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health, UK. 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PY 2018 IS 1 AR CD009669 DI 10.1002/14651858.CD009669.pub3 PG 115 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA FU6QN UT WOS:000423977300030 PM 29376560 OA Green Published DA 2023-05-13 ER PT J AU Napoli, AM AF Napoli, Anthony M. TI The Association Between Pretest Probability of Coronary Artery Disease and Stress Test Utilization and Outcomes in a Chest Pain Observation UnitLa Asociacion entre la Probabilidad Pretest de Enfermedad de la Arteria Coronaria y la Realizacion de la Prueba de Esfuerzo y Sus Resultados en Una Unidad de Dolor Toracico SO ACADEMIC EMERGENCY MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; EMERGENCY-DEPARTMENT; AMERICAN-COLLEGE; UNSTABLE ANGINA; LOW-RISK; HEART-ASSOCIATION; EUROPEAN-SOCIETY; GUIDELINE UPDATE; OF-CARDIOLOGY; TASK-FORCE AB AbstractObjectives Cardiology consensus guidelines recommend use of the Diamond and Forrester (D&F) score to augment the decision to pursue stress testing. However, recent work has reported no association between pretest probability of coronary artery disease (CAD) as measured by D&F and physician discretion in stress test utilization for inpatients. The author hypothesized that D&F pretest probability would predict the likelihood of acute coronary syndrome (ACS) and a positive stress test and that there would be limited yield to diagnostic testing of patients categorized as low pretest probability by D&F score who are admitted to a chest pain observation unit (CPU). Methods This was a prospective observational cohort study of consecutively admitted CPU patients in a large-volume academic urban emergency department (ED). Cardiologists rounded on all patients and stress test utilization was driven by their recommendations. Inclusion criteria were as follows: age > 18 years, American Heart Association (AHA) low/intermediate risk, nondynamic electrocardiograms (ECGs), and normal initial troponin I. Exclusion criteria were as follows: age older than 75 years with a history of CAD. A D&F score for likelihood of CAD was calculated on each patient independent of patient care. Based on the D&F score, patients were assigned a priori to low-, intermediate-, and high-risk groups (< 10, 10 to 90, and > 90%, respectively). ACS was defined by ischemia on stress test, coronary artery occlusion of >= 70% in at least one vessel, or elevations in troponin I consistent with consensus guidelines. A true-positive stress test was defined by evidence of reversible ischemia and subsequent angiographic evidence of critical stenosis or a discharge diagnosis of ACS. An estimated 3,500 patients would be necessary to have 1% precision around a potential 0.3% event rate in low-pretest-probability patients. Categorical comparisons were made using Pearson chi-square testing. Results A total of 3,552 patients with index visits were enrolled over a 29-month period. The mean (+/- standard deviation [SD]) age was 51.3 (+/- 9.3) years. Forty-nine percent of patients received stress testing. Pretest probability based on D&F score was associated with stress test utilization (p < 0.01), risk of ACS (p < 0.01), and true-positive stress tests (p = 0.03). No patients with low pretest probability were subsequently diagnosed with ACS (95% CI = 0 to 0.66%) or had a true-positive stress test (95% CI = 0 to 1.6%). Conclusions Physician discretionary decision-making regarding stress test use is associated with pretest probability of CAD. However, based on the D&F score, low-pretest-probability patients who meet CPU admission criteria are very unlikely to have a true-positive stress test or eventually receive a diagnosis of ACS, such that observation and stress test utilization may be obviated. C1 Brown Univ, Warren Alpert Med Sch, Dept Emergency Med, Providence, RI 02912 USA. C3 Brown University RP Napoli, AM (通讯作者)，Brown Univ, Warren Alpert Med Sch, Dept Emergency Med, Providence, RI 02912 USA. 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Emerg. Med. PD APR PY 2014 VL 21 IS 4 BP 401 EP 407 DI 10.1111/acem.12354 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA AE8YE UT WOS:000334288100006 PM 24730402 OA Bronze DA 2023-05-13 ER PT J AU Sanchez-de-la-Torre, M Sanchez-de-la-Torre, A Bertran, S Abad, J Duran-Cantolla, J Cabriada, V Mediano, O Masdeu, MJ Alonso, ML Masa, JF Barcelo, A de la Pena, M Mayos, M Coloma, R Montserrat, JM Chiner, E Perello, S Rubinos, G Minguez, O Pascual, L Cortijo, A Martinez, D Aldoma, A Dalmases, M McEvoy, RD Barbe, F AF Sanchez-de-la-Torre, Manuel Sanchez-de-la-Torre, Alicia Bertran, Sandra Abad, Jorge Duran-Cantolla, Joaquin Cabriada, Valentin Mediano, Olga Jose Masdeu, Maria Luz Alonso, Mari Fernando Masa, Juan Barcelo, Antonia de la Pena, Monica Mayos, Merce Coloma, Ramon Montserrat, Josep M. Chiner, Eusebi Perello, Salvador Rubinos, Gemma Minguez, Olga Pascual, Lydia Cortijo, Anunciacion Martinez, Dolores Aldoma, Albina Dalmases, Mireia McEvoy, R. Doug Barbe, Ferran CA Spanish Steep Network TI Effect of obstructive sleep apnoea and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome (ISAACC study): a randomised controlled trial SO LANCET RESPIRATORY MEDICINE LA English DT Article ID RESISTANT HYPERTENSION; CPAP; METAANALYSIS; ASSOCIATION; SEVERITY; OUTCOMES; STROKE AB Background Despite the improvement in the prognosis of acute coronary syndrome (ACS), substantial morbidity and mortality remain. We aimed to evaluate the effect of obstructive sleep apnoea (OSA) and its treatment with continuous positive airway pressure (CPAP) on the clinical evolution of patients with ACS. Methods We designed a multicentre, open-label, parallel-group, randomised controlled trial of patients with ACS at 15 hospitals in Spain. Eligible non-sleepy patients were men and women aged 18 years and older, admitted to hospital for documented symptoms of ACS. All patients underwent respiratory polygraphy during the first 24-72 h after admission. OSA patients were randomly assigned (1:1) to CPAP treatment plus usual care (CPAP group) or usual care alone (UC group) by a computerised system available 24 h a day. A group of patients with ACS but without OSA was also included as a reference group. Because of the nature of the intervention, the trial intervention could not be masked to either investigators or patients. Patients were monitored and followed for a minimum of 1 year. Patients were examined at the time of inclusion; after 1 month, 3 months, 6 months, 12 months, 18 months, 24 months, 30 months, and 36 months; and every 12 months thereafter, if applicable, during the follow-up period. The primary endpoint was the prevalence of a composite of cardiovascular events (cardiovascular death or non-fatal events [Acute myocardial infarction, non-fatal stroke, hospital admission for heart failure, and new hospitalisations for unstable angina or transient ischaemic attack]) in patients followed up for a minimum of 1 year. The primary analysis was done according to the intention-to-treat principle. This study is registered with Clinicaltrials.gov, NCT01335087 and is now closed. Findings Between April 25, 2011, and Feb 2, 2018, a total of 2834 patients with ACS had respiratory polygraphy, of whom 2551 (90 center dot 01%) were recruited. 1264 (49 center dot 55%) patients had OSA and were randomly assigned to the CPAP group (n=633) or the UC group (n=631). 1287 (50 center dot 45%) patients did not have OSA, of whom 603 (46 center dot 85%) were randomly assigned to the reference group. Patients were followed up for a median of 3 center dot 35 years (IQR 1 center dot 50-5 center dot 31). The prevalence of cardiovascular events was similar in the CPAP and UC groups (98 events [16%] vs 108 events [17%]; hazard ratio [HR] 0 center dot 89 [95% CI 0 center dot 68-1 center dot 17]; p=0 center dot 40) during follow-up. Mean time of adherence to CPAP treatment was 2 center dot 78 h/night (SD 2 center dot 73). The prevalence of cardio-vascular events was similar between patients in the reference group (90 [15%] events) and those in the UC group (102 (17%) events) during follow-up (1 center dot 01 [0 center dot 76-1 center dot 35]; p=0 center dot 93). The prevalence of cardiovascular events seem not to be related to CPAP compliance or OSA severity. 464 (74%) of 629 patients in the CPAP group had 1538 serious adverse events and 406 (65%) of 626 patients in the UC group had 1764 serious adverse events. Interpretation Among non-sleepy patients with ACS, the presence of OSA was not associated with an increased prevalence of cardiovascular events and treatment with CPAP did not significantly reduce this prevalence. Copyright (c) 2019 Elsevier Ltd. All rights reserved. C1 [Sanchez-de-la-Torre, Manuel; Sanchez-de-la-Torre, Alicia; Bertran, Sandra; Minguez, Olga; Pascual, Lydia; Cortijo, Anunciacion; Martinez, Dolores; Dalmases, Mireia; Barbe, Ferran] Hosp Univ Arnau Vilanova Santa Maria, IRB Lleida, Translat Res Resp Med, Lleida, Spain. [Sanchez-de-la-Torre, Manuel; Sanchez-de-la-Torre, Alicia; Abad, Jorge; Duran-Cantolla, Joaquin; Mediano, Olga; Luz Alonso, Mari; Fernando Masa, Juan; Mayos, Merce; Montserrat, Josep M.; Dalmases, Mireia; Barbe, Ferran] Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain. [Abad, Jorge] Hosp Badalona Germans Trias & Pujol, Resp Dept, Barcelona, Spain. [Duran-Cantolla, Joaquin] Hosp Univ Araba, Serv Invest OSI, IIS Bioaraba, Vitoria, Spain. [Cabriada, Valentin] Hosp Univ Cruces, Resp Dept, Bizkaia, Spain. [Mediano, Olga] Hosp Univ Guadalajara, Resp Dept, Guadalajara, Spain. [Jose Masdeu, Maria] Univ Autonoma Barcelona, Resp & Sleep Dept, Hosp Univ Pan Tauli, Inst Invest & Innovacio Parc Tauli, Sabadell, Spain. [Luz Alonso, Mari] Hosp Univ Burgos, Resp Dept, Burgos, Spain. [Fernando Masa, Juan] Hosp San Pedro Alcantara, Resp Dept, Caceres, Spain. [Barcelo, Antonia; de la Pena, Monica] Hosp Univ Son Espases, Inst Invest Sanitaria Palma IdisPa, Clin Anal & Resp Serv, Palma De Mallorca, Spain. [Mayos, Merce] Hosp Santa Creu & Sant Pau, Dept Resp Med, Sleep Unit, Barcelona, Spain. [Coloma, Ramon] Hosp Gen Univ Albacete, Resp Dept, Albacete, Spain. [Montserrat, Josep M.] Hosp Clin Barcelona, Resp Dept, Barcelona, Spain. [Chiner, Eusebi] Hosp Univ St Joan dAlacant, Resp Dept, Alicante, Spain. [Perello, Salvador] Hosp Joan 23, Resp Dept, Tarragona, Spain. [Rubinos, Gemma] Hosp Univ Cent Asturias, Resp Dept, Oviedo, Spain. [Aldoma, Albina] Hosp Arnau Vilanova, Cardiol Dept, IRBLleida, Lleida, Spain. [McEvoy, R. Doug] Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide Inst Sleep Hlth, Adelaide, SA, Australia. C3 Institut de Recerca Biomedica - IRB Lleida; University Hospital Arnau de Vilanova; CIBER - Centro de Investigacion Biomedica en Red; CIBERES; Hospital Germans Trias i Pujol; Bioaraba Health Research Institute; University Hospital of Araba; Hospital Universitario Cruces; Autonomous University of Barcelona; Parc Tauli Hospital Universitari; Hospital Universitari Son Espases; Institut Investigacio Sanitaria Illes Balears (IdISBa); Hospital of Santa Creu i Sant Pau; University of Barcelona; Hospital Clinic de Barcelona; Universitat Rovira i Virgili; Central University Hospital Asturias; University Hospital Arnau de Vilanova; Flinders University South Australia RP Barbe, F (通讯作者)，Hosp Univ Arnau Vilanova Santa Maria, IRB Lleida, CIBERES, Translat Res Resp Med, Lleida 25198, Spain. EM febarbe.lleida.ics@gencat.cat RI Sanchez-de-la-Torre, Manuel/AAP-2663-2020; Bardaji, Alfredo/V-7985-2019; Carrero, Paloma PGC Giménez/C-3567-2016; de la Torre, Manuel Sanchez/B-5578-2009; Barbé, Ferran/A-5988-2010; Chiner, Eusebi/AAM-5120-2020; Mediano, Olga/AAZ-2784-2021; Sánchez-de-la-Torre, Manuel/AAC-9514-2022; McEvoy, Doug/ABB-8052-2020; Farre, Nuria/I-2668-2019; CABRIADA, VALENTIN/HKE-7161-2023 OI Sanchez-de-la-Torre, Manuel/0000-0002-5695-348X; Bardaji, Alfredo/0000-0003-1900-6974; Carrero, Paloma PGC Giménez/0000-0003-0139-2037; de la Torre, Manuel Sanchez/0000-0002-5695-348X; Barbé, Ferran/0000-0002-2340-8928; Mediano, Olga/0000-0001-7824-1523; Farre, Nuria/0000-0003-3110-6572; Barcelo Bennasar, Antonia/0000-0002-3170-5439; Pinar, Maria/0000-0003-1613-839X; Vicente, Ignacio/0000-0002-1378-0232; Urrutia Gajate, Amaia/0000-0002-4088-4088; Egea, Carlos/0000-0002-7618-7444; COLOMA, Ramon/0000-0002-4280-415X; VIGIL GIMENEZ, LAURA/0000-0002-0837-9524; Masdeu Margalef, Maria Jose/0000-0003-0437-2074; Villena, Cristina/0000-0002-4141-6489; Penacoba, Patricia/0000-0001-8943-7425; CABRIADA, VALENTIN/0000-0003-1124-7108; de la Pena, Monica/0000-0003-3276-776X; Abad Capa, Jorge/0000-0002-8129-7859; Munoz-Ferrer, Aida/0000-0001-6722-0639 FU ResMed (Australia); Fondo de Investigacion Sanitaria (Fondo Europeo de Desarrollo Regional); Spanish Respiratory Society; Catalonian Cardiology Society; Esteve-Teijin; Oxigen Salud; ALLER FX ResMed (Australia), Fondo de Investigacion Sanitaria (Fondo Europeo de Desarrollo Regional), the Spanish Respiratory Society, the Catalonian Cardiology Society, Esteve-Teijin, Oxigen Salud, and ALLER. 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Kondal, Dimple Zhao, Lihui Ali, Mumtaj Arumugan, Prasad Aneesh, Theckethottathil Chacko Rajesh Anoop Natarajan Raj, Sujith Bahuleyan Jinbert Pramod Varghese, Vineesh Nambiar Bindu Kathalankal Susamma Renga Alphonsa Ibrahimkutty Joseph Tony Ullas Ajmal Siar Pravya Syam Sajitha Robby Prasanna Manikandan Lekha Somanathan Abilash Binu Aneesh Mathew Andrews Gopi, Arun Chacko Libin Abraham Rony, Alphonsa Ullas Govindanunny William, Lance Frank Raveendran Athira Vijayaraghavan Kavitha Saleem Joshy Kumar Alpha Venugopal Vipin Jayagopal Devaki Sasikumar George, Midhun Madhu Abdullakutty Mathew Serrin Joseph Rajesh Kumar, Sujith Sandeep, Ria Haridas Deepa Viswanathan Sivaprasad Sreenivas Gagan Koshy Raji Jayaprakash Brijesh Mustafa Anooja Tahsin Pradeesh Ukken Sudheer, Teena Punnoose Kurian, Binoy James, K. J. Sreedharan Mohan, Anju Sebastian Robin Nair Aneesh Manjooran Jacob Blessan Nisha Showjad Dhamoadharan Ramadas Jobson Suresh Divy Chacko Saranya Eapen Sindhu Shaji Krishnan Harikrishnan Ajit Suresh Menon Nisha Mathew, Jubil Thomas Betto, Sr Muralidharan Abraham, Mathew Narayanan Kumar Manoj Jayakumar Thampy, Sagar Abhilash Santhosh Manoj, E. B. Davies, Divin CA ACS QUIK Investigators TI Microeconomic Costs, Insurance, and Catastrophic Health Spending Among Patients With Acute Myocardial Infarction in India Substudy of a Randomized Clinical Trial SO JAMA NETWORK OPEN LA English DT Article ID MORTALITY; EXPENDITURE; ASIA AB IMPORTANCE Ischemic heart disease is the leading cause of death in India, and treatment can be costly. OBJECTIVE To evaluate individual- and household-level costs and impoverishing effects of acute myocardial infarction among patients in Kerala, India. DESIGN, SETTING, AND PARTICIPANTS This investigation was a prespecified substudy of the Acute Coronary Syndrome Quality Improvement in Kerala study, a stepped-wedge, cluster randomized clinical trial conducted between November 2014 and November 2016 across 63 hospitals in Kerala, India. In this cross-sectional substudy, individual- and household-level cost data were collected 30 days after hospital discharge from a sample of 2114 respondents from November 2014 to July 2016. Data were analyzed from July through October 2018 and in March 2019. EXPOSURES Health insurance status. MAIN OUTCOMES AND MEASURES The primary outcomes were detailed direct and indirect cost data associated with acute myocardial infarction and respondent ability to pay as well as catastrophic health spending and distress financing. Catastrophic health spending was defined as 40% or more of household expenditures minus food costs spent on health, and distress financing was defined as borrowing money or selling assets to cover health costs. Hierarchical regression models were used to evaluate the association between health insurance and measures of financial risk. Costs were converted from Indian rupees to international dollars (represented herein as "$"). RESULTS Among 2114 respondents, the mean (SD) age was 62.3 (12.7) years, 1521 (71.9%) were men, 1144 (54.1%) presented with an ST-segment elevation myocardial infarction, and 1600 (75.7%) had no health insurance. The median (interquartile range) expenditure among respondents was $480.4 ($112.5-$1733.0) per acute myocardial infarction encounter, largely driven by in-hospital expenditures. There was greater than 15-fold variability between the 25th and 75th percentiles. Individuals with or without health insurance had similar monthly incomes and annual household expenditures, yet individuals without health insurance had approximately $400 higher out-of-pocket cardiovascular health care costs (median [interquartile range] total cardiovascular expenditures among uninsured, $560.3 [$134.1-$1733.6] vs insured, $161.4 [$23.2-$1726.9]; P < .001). Individuals without health insurance also had a 24% higher risk of catastrophic health spending (adjusted risk ratio, 1.24; 95% CI, 1.07-1.43) and 3-fold higher risk of distress financing (adjusted risk ratio; 3.05; 95% CI, 1.45-6.44). CONCLUSIONS AND RELEVANCE The results of this study indicate that acute myocardial infarction carries substantial financial risk for patients in Kerala. Expansion of health insurance may be an important strategy for financial risk protection to disrupt the poverty cycle associated with cardiovascular diseases in India. C1 [Huffman, Mark D.; Baldridge, Abigail S.; Zhao, Lihui; Lloyd-Jones, Donald M.] Northwestern Univ, Feinberg Sch Med, 680 N Lake Shore Dr,Ste 1400, Chicago, IL 60611 USA. [Mohanan, Padinhare P.] WestFort Hitech Hosp Ltd, Dept Cardiol, Trichur, India. [Devarajan, Raji; Kondal, Dimple; Ali, Mumtaj yyyyyyyyyy; Prabhakaran, Dorairaj] Ctr Chron Dis Control, Gurgaon, India. [Devarajan, Raji; Kondal, Dimple; Ali, Mumtaj yyyyyyyyyy; Prabhakaran, Dorairaj; Reddy, K. Srinath] Publ Hlth Fdn India, Gurgaon, India. [Joseph] Caritas Hosp, Dept Cardiol, Kottyam, India. [Eapen, Koshy] Samaritan Hosp, Dept Cardiol, Pazhangad, India. [Krishnan, Mangalath N.] Med Coll Hosp, Dept Cardiol, Kozikhode, India. [Menon, Jaideep] Sree Narayana Inst Med Sci, Dept Cardiol, Ernakulam, India. [Thomas, Manoj] St Josephs Hosp, Dept Cardiol, Dharmagiri, India. [Harikrishnan, Sivadasanpillai] Sree Chitra Tirunal Inst Med Sci & Technol, Dept Cardiol, Trivandrum, Kerala, India. [Prabhakaran, Dorairaj] London Sch Hyg & Trop Med, London, England. [Vijayaraghavan, G.; Kavitha] Kerala Inst Med Sci, Thiruvananthapuram, Kerala, India. [Nambiar, Ashokan; Nambiar; Bindu] Baby Mem Hosp, Kozhikode, India. [Zachariah, Geevar] Mother Hosp, Trichur, India. [Manjooran, Rajan J.; Manjooran; Jacob] Pushpagiri Med Coll, Tiruvalla, India. [Sivasankaran, S.; Harikrishnan, S.; Shaji; Harikrishnan] Sree Chitra Tirunal Inst Med Sci & Technol, Trivandrum, Kerala, India. [Huffman, Mark D.; Baldridge, Abigail S.; Zhao, Lihui; Lloyd-Jones, Donald M.; Bonow, Robert O.; Labarthe, Darwin R.] Northwestern Univ, Chicago, IL 60611 USA. [Smith, Sidney C., Jr.] Univ N Carolina, Chapel Hill, NC 27515 USA. [Nallamothu, Brahmajee] Univ Michigan, Ann Arbor, MI 48109 USA. [Alexander, Thomas] Kovai Med Ctr & Hosp, Coimbatore, Tamil Nadu, India. [Hemming, Karla] Univ Birmingham, Birmingham, W Midlands, England. [Thom, Simon] Imperial Coll London, London, England. [Sundaram, K. R.] Amrita Inst Med Sci, Ernakulam, India. [Cooper, Lawton] NHLBI, Bldg 10, Bethesda, MD 20892 USA. [Mohanan, Padinhare; Davies, Divin] Westfort Hitech Hosp Ltd, Trichur, India. [Arumugan, Prasad; Ibrahimkutty] Caritas Hosp, Kottyam, India. [Aneesh, Theckethottathil Chacko; Sebastian; Robin] PRS Hosp, Thiruvananthapuram, Kerala, India. [Rajesh; Anoop] Amala Med Coll, Trichur, India. [Natarajan; Raj, Sujith] Amrita Inst Med Sci & Res Ctr, Ernakulam, India. [Bahuleyan; Jinbert] Anathapurai Hosp, Thiruvananthapuram, Kerala, India. [Pramod] Aswini Hosp, Trichur, India. [Kathalankal; Susamma] Bharath Heart Inst, Kottayam, Kerala, India. [Renga; Alphonsa] Bishop Benziger Hosp, Kollam, India. [Ibrahimkutty] CH Mem Hosp, Valanchery, India. [Ullas; Ajmal] Daya Specialty Hosp, Trichur, India. [Siar; Pravya] Dist Hosp, Palakkad, India. [Syam; Sajitha] Dist Hosp, Kollam, India. [Robby; Prasanna] Dr Damodaran Mem Hosp, Kollam, India. [Manikandan; Lekha] Elite Miss Hosp, Trichur, India. [Somanathan] EMS Hosp, Perintalmanna, India. [Abilash; Binu; Aneesh] Gokulam Med Coll, Thiruvananthapuram, Kerala, India. [Mathew; Andrews; Gopi, Arun] Govt Med Coll, Trichur, India. [Chacko; Libin] Holy Cross Hosp, Kottayam, Kerala, India. [Abraham; Rony, Alphonsa] Indira Gandhi Cooperat Hosp, Ernakulam, India. [Ullas; George, Midhun] Irinjalakuda Cooperat Hosp, Trichur, India. [Govindanunny; William, Lance Frank] Jubilee Miss Hosp, Trichur, India. [Raveendran; Athira] Kannur Med Coll, Kannur, India. [Vijayaraghavan; Kavitha] Kerala Inst Med Sci, Thiruvananthapuram, Kerala, India. [Saleem; Joshy] KMCT Heart Inst, Manassery, India. [Kumar; Alpha] Koyili Hosp, Kannur, India. [Venugopal; Vipin] KVM Hosp, Cherthala, India. [Jayagopal; Devaki] Lakshmi Hosp, Palakkad, India. [Sasikumar] Lakshmi Hosp, Ernakulam, India. [Madhu] Lal Mem Hosp, Irinjalakuda, India. [Mathew; Abdullakutty; Serrin] Lisie Hosp, Ernakulam, India. [Rajesh; Joseph] Little Flower Hosp, Angamaly, India. [Kumar, Sujith; Sandeep, Ria] Lourdes Hosp, Ernakulam, India. [Haridas; Deepa] Med Coll Hosp, Kozhikode, India. [Viswanathan; Sivaprasad; Sreenivas; Gagan] Med Coll Hosp, Alappuzha, India. [Koshy; Raji] Med Coll, Thiruvananthapuram, Kerala, India. [Jayaprakash; Brijesh] Med Coll, Kottayam, Kerala, India. [Mustafa; Anooja] Metro Int Cardiac Ctr, Kozhikode, India. [Tahsin; Pradeesh] MIMS Heart, Malappuram, India. [Ukken; Sudheer, Teena] Modern Hosp, Kodungallur, India. [Punnoose; Kurian, Binoy] MOSCM Hosp, Ernakulam, India. [James, K. J.] Mother Hosp Ltd, Trichur, India. [Sreedharan; Mohan, Anju] NIMS Hosp, Thiruvananthapuram, Kerala, India. [Sebastian; Robin] Pariyaram Med Coll, Kannur, India. [Blessan; Nisha] PVS Mem Hosp, Ernakulam, India. [Showjad; Dhamoadharan] Rajah Hosp, Guruvayoor, India. [Ramadas; Jobson] Ramdas Nursing Home, Perinthalmana, India. [Suresh; Divy] SK Hosp, Thiruvananthapuram, Kerala, India. [Chacko; Saranya] SH Med Ctr Hosp, Kottayam, Kerala, India. [Eapen; Sindhu] Samaritan Hosp, Pazhangad, India. [Shaji; Krishnan] Santhi Nursing Home, Punnayoorkulam, India. C3 Northwestern University; Feinberg School of Medicine; Public Health Foundation of India; Department of Science & Technology (India); Sree Chitra Tirunal Institute for Medical Sciences Technology (SCTIMST); University of London; London School of Hygiene & Tropical Medicine; Department of Science & Technology (India); Sree Chitra Tirunal Institute for Medical Sciences Technology (SCTIMST); Northwestern University; University of North Carolina; University of North Carolina Chapel Hill; University of Michigan System; University of Michigan; RLUK- Research Libraries UK; University of Birmingham; RLUK- Research Libraries UK; Imperial College London; Amrita Vishwa Vidyapeetham; Amrita Vishwa Vidyapeetham Kochi; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI); Amrita Vishwa Vidyapeetham RP Huffman, MD (通讯作者)，Northwestern Univ, Feinberg Sch Med, 680 N Lake Shore Dr,Ste 1400, Chicago, IL 60611 USA. EM m-huffman@northwestern.edu RI Prabhakaran, Dorairaj/B-4147-2011; Lloyd-Jones, Donald M/C-5899-2009; S, Harikrishnan/AAT-8083-2021; Hemming, karla/AAB-3391-2021 OI Prabhakaran, Dorairaj/0000-0002-3172-834X; Hemming, karla/0000-0002-2226-6550; Lloyd-Jones, Donald/0000-0003-0847-6110; Harikrishnan, Sivadasanpillai/0000-0002-7509-0712 FU National Heart, Lung, and Blood Institute [R00 HL107749]; Cardiological Society of India, Kerala chapter; Centre for Chronic Disease Control; Northwestern University Global Health Initiative Fund; Northwestern University Clinical and Translational Science Institute [UL1TR001422] FX This project was funded by the National Heart, Lung, and Blood Institute (R00 HL107749) with support from the Cardiological Society of India, Kerala chapter; Centre for Chronic Disease Control; Northwestern University Global Health Initiative Fund; and Northwestern University Clinical and Translational Science Institute (UL1TR001422). 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Open PD MAY PY 2019 VL 2 IS 5 AR e193831 DI 10.1001/jamanetworkopen.2019.3831 PG 13 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA IK7XE UT WOS:000476806200049 PM 31099866 OA Green Published, gold DA 2023-05-13 ER PT J AU Kuo, HC Lo, MH Hsieh, KS Guo, MMH Huang, YH AF Kuo, Ho-Chang Lo, Mao-Hung Hsieh, Kai-Sheng Guo, Mindy Ming-Huey Huang, Ying-Hsien TI High-Dose Aspirin Is Associated with Anemia and Does Not Confer Benefit to Disease Outcomes in Kawasaki Disease SO PLOS ONE LA English DT Article ID CORONARY-ARTERY LESIONS; IMMUNOGLOBULIN TREATMENT FAILURE; LONG-TERM MANAGEMENT; INTRAVENOUS IMMUNOGLOBULIN; CARDIOVASCULAR-DISEASE; HEALTH-PROFESSIONALS; RHEUMATIC-FEVER; DIAGNOSIS; ENDOCARDITIS; RESISTANCE AB Background Kawasaki disease (KD) is also known as multiple mucocutaneous lymph node syndrome of systemic vasculitis and is a leading cause of coronary artery lesions (CAL) in childhood. Intravenous immunoglobulin (IVIG) has been proven to effectively reduce the incidence of CAL, but the role and effect dose of aspirin in KD is still unclear. Moreover, overt bleeding and anemia are associated with the use of aspirin, and anemia is common in patients with KD. Thus, the aim of this study was conducted to compare the treatment efficacy, degree of anemia and inflammation, and changes in serum hepcidin in children who received a combination of high-dose aspirin and IVIG in the acute stage of KD, and those who received IVIG alone. Materials and Methods KD patients from two medical centers were retrospectively analyzed from 1999-2009. All patients were initially treated with a single dose of IVIG (2 g/kg) as the standard care of treatment. In group 1, high-dose aspirin was prescribed (> 30 mg/kg/day) until the fever subsided, and then low- dose aspirin (3-5 mg/kg/day) was prescribed until all the inflammation signs had resolved. In group 2, low- dose aspirin was prescribed without high-dose aspirin. Laboratory data were collected for analysis in both groups. Results A total of 851 KD patients (group 1, N = 305, group 2, N = 546) were enrolled in this study. There were no significant differences between group 1 and group 2 in terms of gender (p = 0.51), IVIG resistance rate (31/305 vs. 38/546, p = 0.07), CAL formation (52/305 vs. 84/546, p = 0.67), and duration of hospitalization (6.3 +/- 0.2 vs. 6.7 +/- 0.2 days, p = 0.13). There were also initially no significant differences in total white blood cell count, hemoglobin level, platelet count, and CRP before IVIG treatment between groups (all p>0.1). After IVIG treatment, group 1 had significantly lower levels of hemoglobin (p = 0.006) and higher CRP (p<0.001) as well as a smaller decrease in CRP level (p = 0.012). Furthermore, there was also a higher serum level of hepcidin and a delayed decrease in hepcidin level after receiving IVIG in group 1 (p = 0.04 and 0.02, respectively). Conclusions These results provide evidence demonstrating that high-dose aspirin in the acute phase of KD does not confer any benefit with regards to inflammation and it does not appear to improve treatment outcomes. Therefore, high-dose aspirin is unnecessary in acute phase KD. C1 [Kuo, Ho-Chang; Lo, Mao-Hung; Hsieh, Kai-Sheng; Guo, Mindy Ming-Huey; Huang, Ying-Hsien] Kaohsiung Chang Gung Mem Hosp, Dept Pediat, Kaohsiung 83301, Taiwan. [Kuo, Ho-Chang; Lo, Mao-Hung; Hsieh, Kai-Sheng; Guo, Mindy Ming-Huey; Huang, Ying-Hsien] Chang Gung Univ, Coll Med, Kaohsiung 83301, Taiwan. [Kuo, Ho-Chang; Lo, Mao-Hung; Hsieh, Kai-Sheng; Guo, Mindy Ming-Huey; Huang, Ying-Hsien] Kaohsiung Chang Gung Mem Hosp, Kawasaki Dis Ctr, Kaohsiung 83301, Taiwan. C3 Chang Gung Memorial Hospital; Chang Gung University; Chang Gung Memorial Hospital RP Huang, YH (通讯作者)，Kaohsiung Chang Gung Mem Hosp, Dept Pediat, Kaohsiung 83301, Taiwan. EM yhhuang123@yahoo.com.tw RI Kuo, Ho-Chang/AAQ-6644-2020 OI Kuo, Ho-Chang/0000-0002-3295-2984; Hsieh, Kai-Sheng/0000-0002-0294-9872 FU Ministry of Science and Technology of Taiwan [102-2314-B-182A-022, 102-2314-B-182-053MY3]; Chang Gung Memorial Hospital [CMRPG8E0021, CMRPG8E0031, CMRPF6E0041, CMRPG8E0051, CMRPG8E0061, CMRPG8C1081, CMRPG8D0521] FX This study was supported by grants from the Ministry of Science and Technology of Taiwan (102-2314-B-182A-022 and 102-2314-B-182-053MY3) and grants from Chang Gung Memorial Hospital (CMRPG8E0021, CMRPG8E0031, CMRPF6E0041, CMRPG8E0051, CMRPG8E0061, CMRPG8C1081 and CMRPG8D0521). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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Lord, Joanne Griffith, Kathryn E. Stevens, Paul Taal, Maarten W. Stevenson, Diane Fraser, Simon D. Lown, Mark Hawkey, Christopher J. Roderick, Paul J. TI Aspirin to target arterial events in chronic kidney disease (ATTACK): study protocol for a multicentre, prospective, randomised, open-label, blinded endpoint, parallel group trial of low-dose aspirin vs. standard care for the primary prevention of cardiovascular disease in people with chronic kidney disease SO TRIALS LA English DT Article DE Chronic kidney disease; Cardiovascular disease; Aspirin; Primary care; Primary prevention ID GLOMERULAR-FILTRATION-RATE; STAGE RENAL-DISEASE; ACUTE MYOCARDIAL-INFARCTION; SIMVASTATIN PLUS EZETIMIBE; ACUTE CORONARY SYNDROME; COLLABORATIVE METAANALYSIS; ANTIPLATELET THERAPY; ALL-CAUSE; HIGHER ALBUMINURIA; REDUCING EVENTS AB Background: Chronic kidney disease (CKD) is a very common long-term condition and powerful risk factor for cardiovascular disease (CVD). Low-dose aspirin is of proven benefit in the secondary prevention of myocardial infarction (MI) and stroke in people with pre-existing CVD. However, in people without CVD, the rates of MI and stroke are much lower, and the benefits of aspirin in the primary prevention of CVD are largely balanced by an increased risk of bleeding. People with CKD are at greatly increased risk of CVD and so the absolute benefits of aspirin are likely to be greater than in lower-risk groups, even if the relative benefits are the same. Post hoc evidence suggests the relative benefits may be greater in the CKD population but the risk of bleeding may also be higher. A definitive study of aspirin for primary prevention in this high-risk group, recommended by the National Institute for Health and Care Excellence (NICE) in 2014, has never been conducted. The question has global significance given the rising burden of CKD worldwide and the low cost of aspirin. Methods: ATTACK is a pragmatic multicentre, prospective, randomised, open-label, blinded endpoint adjudication superiority trial of aspirin 75 mg daily vs. standard care for the primary prevention of CVD in 25,210 people aged 18 years and over with CKD recruited from UK Primary Care. Participants aged 18 years and over with CKD (GFR category G1-G4) will be identified in Primary Care and followed up using routinely collected data and annual questionnaires for an average of 5 years. The primary outcome is the time to first major vascular event (composite of non-fatal MI, non-fatal stroke and cardiovascular death [excluding confirmed intracranial haemorrhage and other fatal cardiovascular haemorrhage]). Deaths from other causes (including fatal bleeding) will be treated as competing events. The study will continue until 1827 major vascular events have occurred. The principal safety outcome is major intracranial and extracranial bleeding; this is hypothesised to be increased in those randomised to take aspirin. The key consideration is then whether and to what extent the benefits of aspirin from the expected reduction in CVD events exceed the risks of major bleeding. Discussion: This will be the first definitive trial of aspirin for primary CVD prevention in CKD patients. The research will be of great interest to clinicians, guideline groups and policy-makers, in the UK and globally, particularly given the high and rising prevalence of CKD that is driven by population ageing and epidemics of obesity and diabetes. The low cost of aspirin means that a positive result would be of relevance to low- and middle-income countries and the impact in the developed world less diluted by any inequalities in health care access. C1 [Gallagher, Hugh] Epsom & St Helier Univ Hosp NHS Trust, SW Thames Renal Unit, Epsom, Surrey, England. [Dumbleton, Jennifer; Stevenson, Diane; Hawkey, Christopher J.] Univ Nottingham, Fac Med & Hlth Sci, Nottingham, England. [Maishman, Tom; Whitehead, Amy] Univ Southampton, Southampton Clin Trials Unit, Southampton, Hants, England. [Moore, Michael, V; Fraser, Simon D.; Lown, Mark; Roderick, Paul J.] Univ Southampton, Fac Med, Dept Primary Care & Populat Sci, Southampton, Hants, England. [Fuat, Ahmet] Univ Durham, Sch Med Pharm & Hlth, Durham, England. [Fuat, Ahmet] Carmel Med Practice, Nunnery Lane, Darlington, Durham, England. [Fitzmaurice, David] Univ Warwick, Coventry CV4 7AL, W Midlands, England. [Henderson, Robert A.] Nottingham Univ Hosp NHS Trust, Trent Cardiac Ctr, Nottingham, England. [Lord, Joanne] Univ Southampton, Fac Med, Hlth Technol Assessment Ctr, Southampton, Hants, England. [Stevens, Paul] East Kent Hosp Univ Fdn Trust, Kent Kidney Care Ctr, Canterbury, Kent, England. [Taal, Maarten W.] Univ Nottingham, Sch Med, Nottingham, England. [Taal, Maarten W.] Univ Hosp Derby & Burton NHS Fdn Trust, Derby, England. C3 RLUK- Research Libraries UK; University of Nottingham; RLUK- Research Libraries UK; University of Southampton; RLUK- Research Libraries UK; University of Southampton; N8 Research Partnership; RLUK- Research Libraries UK; Durham University; RLUK- Research Libraries UK; University of Warwick; Nottingham University Hospital NHS Trust; RLUK- Research Libraries UK; University of Southampton; RLUK- Research Libraries UK; University of Nottingham RP Gallagher, H (通讯作者)，Epsom & St Helier Univ Hosp NHS Trust, SW Thames Renal Unit, Epsom, Surrey, England. EM hugh.gallagher1@nhs.net RI Fraser, Simon DS/HCH-3208-2022; Moore, Michael/C-3447-2011; Lord, Joanne/H-1417-2011 OI Fraser, Simon D/0000-0002-4172-4406; Moore, Michael/0000-0002-5127-4509; Lown, Mark/0000-0001-8309-568X; Lord, Joanne/0000-0003-1086-1624 FU National Institute for Health Research Health Technology Assessment Programme (HTA Project) [16/31/127]; British Heart Foundation [SP/17/14/33355] FX ATTACK is jointly funded by the National Institute for Health Research Health Technology Assessment Programme (HTA Project: 16/31/127) and the British Heart Foundation (Ref: SP/17/14/33355). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. 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Yangxin Wang, Jingfeng Guo, Qi TI Minimum heart rate and mortality in critically ill myocardial infarction patients: an analysis of the MIMIC-III database SO ANNALS OF TRANSLATIONAL MEDICINE LA English DT Article DE Minimum heart rate (MHR); myocardial infarction (MI); mortality; risk factor; intensive care unit (ICU) ID ACUTE CORONARY SYNDROMES; CARDIOVASCULAR MORTALITY; CARDIOGENIC-SHOCK; ARTERY-DISEASE; INTENSIVE-CARE; RISK-FACTOR; OUTCOMES; ASSOCIATION; PREDICTION; APACHE AB Background: Low minimum heart rate (MHR) is common in critically ill myocardial infarction (MI) patients. However, the association between MHR and the mortality of critically ill MI patients remains unclear. Methods: In this retrospective cohort study, a total of 2,031 critically ill MI patients were enrolled from the Medical Information Mart for Intensive Care (MIMIC)-III database. Patients were divided into a low MHR group [MHR <60 beats per minute (bpm)] and a high MHR group (MHR >= 60 bpm). A Cox proportional hazard model was used to elucidate the association between these two groups and the mortality of MI patients. The association between mortality and MHR as a continuous variable was analyzed non parametrically using restricted cubic splines. Sensitivity analyses were conducted to determine the impact of different admission heart rate, hypertension, atrial fibrillation, and vasopressor use on our results. Results: MI patients in the low MHR group had higher 30-day and 1-year mortality than those in the high MHR group (20.59% vs. 10.91%, P<0.001 and 29.76% vs. 19.31%, P<0.001, respectively). After adjustment, the low MHR group was significantly correlated with 30-day mortality [hazard ratio, 1.779, 95% confidence interval (CI), 1.400-2.261, P<0.001] and 1-year mortality (hazard ratio, 1.537, 95% CI, 1.272-1.859, P<0.001). This correlation remained remarkable in patients with low or high admission heart rate, with or without hypertension, and with or without atrial fibrillation. An apparent L-curve relationship was observed between the 30-day mortality or 1-year mortality and MHR as a continuous variable. Conclusions: MHR under 60 bpm may be associated with a higher risk for both 30-day and 1-year mortality in critically ill MI patients. These findings highlight the possibility of MHR as an early risk indicator and potential therapeutic target for mortality in critically ill MI patients, which warrants further investigation. C1 [Wang, Junjie; Zhou, Lingqu; Zhang, Yinyin; Zhang, Haifeng; Xie, Yong; Chen, Zhiteng; Huang, Boshui; Lei, Juan; Mai, Jingting; Chen, Yangxin; Wang, Jingfeng; Guo, Qi] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Cardiol, 107 West Yanjiang Rd, Guangzhou 510120, Peoples R China. [Wang, Junjie; Zhou, Lingqu; Zhang, Yinyin; Zhang, Haifeng; Xie, Yong; Chen, Zhiteng; Huang, Boshui; Lei, Juan; Mai, Jingting; Chen, Yangxin; Wang, Jingfeng; Guo, Qi] Guangdong Prov Key Lab Arrhythmia & Electrophysio, Guangzhou, Peoples R China. [Zeng, Kuan] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Cardiac Surg, Guangzhou, Peoples R China. [Pan, Yue] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Med Res Ctr, Guangdong Prov Key Lab Malignant Tumor Epigenet &, Guangzhou, Peoples R China. C3 Sun Yat Sen University; Sun Yat Sen University; Sun Yat Sen University RP Chen, YX; Wang, JF; Guo, Q (通讯作者)，Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Cardiol, 107 West Yanjiang Rd, Guangzhou 510120, Peoples R China. EM chenyx39@mail.sysu.edu.cn; wjingf@mail.sysu.edu.cn; guoq69@mail.sysu.edu.cn RI wang, xu/IAN-4886-2023; wang, jian/HRB-9588-2023; wang, jing/HJA-5384-2022; Guo, Qi/U-5576-2019; wang, jing/GRS-7509-2022; wang, jing/GVT-8700-2022; Wang, Jin/GYA-2019-2022; Zhang, Haifeng/A-3123-2013; li, jian/IAQ-2794-2023; wang, jie/HTQ-4920-2023 OI Guo, Qi/0000-0003-3145-1309; FU National Natural Science Foundation of China [82070237, 81870170, 81770229, 81900443, 81970200]; Guangdong Basic and Applied Basic Research Foundation [2020A1515110313, 2018A030313749]; Guangdong Basic and Applied Basic Research Foundation for distinguished Young Scholars [2020B1515020027]; Guangzhou Science and Technology Plan Project [201803040010, 201707010206, 202002020070]; Guangzhou Regenerative Medicine and Health Guangdong Laboratory [2019GZR110406004]; PhD Natural Sciences Startup Foundation of Guangdong [2017A030310230]; Yatsen Startup Foundation [YXQH202014] FX This study was funded by grants from the National Natural Science Foundation of China (No. 82070237, 81870170, 81770229, 81900443, 81970200), Guangdong Basic and Applied Basic Research Foundation (No. 2020A1515110313, 2018A030313749), Guangdong Basic and Applied Basic Research Foundation for distinguished Young Scholars (No. 2020B1515020027), Guangzhou Science and Technology Plan Project (No. 201803040010, 201707010206, 202002020070), Guangzhou Regenerative Medicine and Health Guangdong Laboratory (No. 2019GZR110406004), PhD Natural Sciences Startup Foundation of Guangdong (No. 2017A030310230) and Yatsen Startup Foundation (No. YXQH202014). 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TRANSL. MED. PD MAR PY 2021 VL 9 IS 6 AR 496 DI 10.21037/atm-21-992 PG 9 WC Oncology; Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology; Research & Experimental Medicine GA RF8LL UT WOS:000635089700006 PM 33850893 OA gold, Green Published DA 2023-05-13 ER PT J AU Ibrahim, NE Gaggin, HK Rabideau, DJ Gandhi, PU Mallick, A Januzzi, JL AF Ibrahim, Nasrien E. Gaggin, Hanna K. Rabideau, Dustin J. Gandhi, Parul U. Mallick, Aditi Januzzi, James L., Jr. TI Worsening Renal Function during Management for Chronic Heart Failure with Reduced Ejection Fraction: Results From the Pro-BNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) Study SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE Heart failure; biomarkers; renal failure ID VENTRICULAR SYSTOLIC DYSFUNCTION; NATRIURETIC-PEPTIDE-MEASUREMENTS; CARDIORENAL SYNDROME; CYSTATIN C; CKD-EPI; EQUATIONS; OUTCOMES; DESIGN; KIDNEY; RISK AB Objectives: To assess prognostic meaning of worsening renal failure (WRF) occurring during management of chronic heart failure (HF) with reduced ejection fraction. Background: When WRF develops during titration of HF medical therapy, it commonly leads to less aggressive care. Methods: A total of 151 patients enrolled in a prospective, randomized study of standard of care (SOC) HF therapy versus SOC plus a goal N-terminal pro-B type natriuretic peptide (NT-proBNP) <1000 pg/mL were examined. Cardiovascular (CV) event (defined as worsening HF, hospitalization for HF, significant ventricular arrhythmia, acute coronary or cerebral ischemia, or CV death) at 1 year relative to WRF (defined as any reduction in estimated glomerular filtration rate) 90 days postenrollment were tabulated. Results: Those developing WRF by 3 months had an average 14% reduction in estimated glomerular filtration rate. There was no difference in incidence of WRF between study arms (43% in SOC, 57% in NT-proBNP, P=.29). During the first 3 months of therapy titration, incident WRF was associated with numerically fewer CV events at 1 year compared with those without WRF (mean 0.81 vs 1.16 events, P=.21). WRF was associated trend toward fewer CV events in the SOC arm (hazard ratio 0.45, 95% confidence interval 0.16-1.24, P=.12); the NT-proBNP-guided arm had numerically lower CV event rates regardless of WRF. Subjects with NT-proBNP <1000 pg/mL and WRF received higher doses of guideline directed medical therapies, lower doses of loop diuretics, and had significantly lower CV event rates (P<.001). Conclusions: Modest degrees of WRF are common during aggressive HF with reduced ejection fraction management, but we found no significant association with CV outcomes. HF care guided by NT-proBNP was not associated with more WRF compared with SOC, and led to benefit regardless of final renal function. C1 [Ibrahim, Nasrien E.; Gaggin, Hanna K.; Mallick, Aditi; Januzzi, James L., Jr.] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA. [Ibrahim, Nasrien E.; Gaggin, Hanna K.; Januzzi, James L., Jr.] Harvard Clin Res Inst, Boston, MA USA. [Rabideau, Dustin J.] Massachusetts Gen Hosp, Ctr Biostat, Boston, MA 02114 USA. [Gandhi, Parul U.] Yale Univ, Sch Med, Div Cardiol, Vet Adm Connecticut Healthcare Syst, New Haven, CT USA. C3 Harvard University; Massachusetts General Hospital; Harvard University; Harvard Medical School; Harvard University; Massachusetts General Hospital; Yale University RP Januzzi, JL (通讯作者)，Massachusetts Gen Hosp, 32 Fruit St,Yawkey 5984, Boston, MA 02114 USA. EM jjanuzzi@partners.org RI Januzzi, James/Y-2436-2019 FU Dennis and Marilyn Barry Fellowship in Cardiology; Ruth and James Clark Fund for Cardiac Research Innovation; Hutter Family Professorship in Cardiology FX Dr. Ibrahim is supported by the Dennis and Marilyn Barry Fellowship in Cardiology. Dr. Gaggin is supported in part by the Ruth and James Clark Fund for Cardiac Research Innovation. Dr. Januzzi is supported in part by the Hutter Family Professorship in Cardiology. 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Card. Fail. PD FEB PY 2017 VL 23 IS 2 BP 121 EP 130 DI 10.1016/j.cardfail.2016.07.440 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA EJ9GT UT WOS:000393535300006 PM 27469482 DA 2023-05-13 ER PT J AU Chin, CT Wang, TY Chen, AY Mathews, R Alexander, KP Roe, MT Peterson, ED AF Chin, Chee Tang Wang, Tracy Y. Chen, Anita Y. Mathews, Robin Alexander, Karen P. Roe, Matthew T. Peterson, Eric D. TI Trends in outcomes among older patients with non-ST-segment elevation myocardial infarction SO AMERICAN HEART JOURNAL LA English DT Article ID ACUTE CORONARY SYNDROMES; LONG-TERM MORTALITY; UNSTABLE ANGINA; HOSPITAL MORTALITY; TREATMENT PATTERNS; ELDERLY-PATIENTS; GUIDELINES; MANAGEMENT; CARE; IMPROVEMENT AB Objectives The objective of this study is to assess trends in evidence-based therapy use and short-and long-term mortality over time among older patients with non-ST-segment elevation myocardial infarction (NSTEMI). Background With the prevalence of national quality improvement efforts, the use of evidence-based therapies has improved over time among patients with NSTEMI, yet it is unclear whether these improvements have been associated with significant change in short-and long-term mortality for older patients. Methods We linked detailed clinical data for 28,603 NSTEMI patients aged >= 65 years at 171 hospitals in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines Registry with longitudinal Centers for Medicare & Medicaid claims data and compared trends in annual unadjusted and risk-adjusted inhospital and long-term mortality from 2003 to 2006. Results The median age of our NSTEMI study population was 77 years, 48% were female, and 87% were white. Overall, inhospital and 1-year mortality rates were 6.0% and 24.5%, respectively. When compared with patients treated in 2003, NSTEMI patients treated in 2006 were more likely to receive guideline-recommended inhospital medications and early invasive treatment. Inhospital mortality decreased significantly over the study period (5.5% vs 7.2% [adjusted odds ratio 0.82, 95% CI 0.67-1.00, P = .045] for 2006 vs 2003), but there was no significant change in 1-year mortality from the index admission (24.0% vs 26.0% [adjusted hazard ratio 0.99, 95% CI 0.90-1.08] for 2006 vs 2003). Conclusions Between 2003 and 2006, there was a significant reduction in inhospital mortality that corresponded to an increase in the use of evidence-based NSTEMI care. Nevertheless, long-term outcomes have not changed over time, suggesting a need for improved care transition and longitudinal secondary prevention. C1 [Chin, Chee Tang; Wang, Tracy Y.; Chen, Anita Y.; Mathews, Robin; Alexander, Karen P.; Roe, Matthew T.; Peterson, Eric D.] Duke Clin Res Inst, Durham, NC USA. [Chin, Chee Tang] Natl Heart Ctr Singapore, Singapore 168752, Singapore. C3 Duke University; National Heart Centre Singapore RP Chin, CT (通讯作者)，Natl Heart Ctr Singapore, 17 3rd Hosp Ave, Singapore 168752, Singapore. EM chin.chee.tang@nhcs.com.sg RI Peterson, Eric David/ABF-5033-2021 CR Alexander KP, 2005, J AM COLL CARDIOL, V46, P1479, DOI 10.1016/j.jacc.2005.05.084 Amsterdam EA, 2009, AM HEART J, V158, P748, DOI 10.1016/j.ahj.2009.09.008 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 Braunwald E, 2002, J AM COLL CARDIOL, V40, P1366, DOI 10.1016/S0735-1097(02)02336-7 Braunwald E, 2000, J AM COLL CARDIOL, V36, P970, DOI 10.1016/S0735-1097(00)00889-5 Bueno H, 2013, AM HEART J, V165, P8, DOI 10.1016/j.ahj.2012.10.018 Chin CT, 2011, AM HEART J, V162, DOI 10.1016/j.ahj.2011.08.021 Chin CT, 2011, AM HEART J, V161, DOI 10.1016/j.ahj.2010.10.004 Choudhry NK, 2011, NEW ENGL J MED, V365, P2088, DOI 10.1056/NEJMsa1107913 Giugliano RP, 1998, ARCH INTERN MED, V158, P1113, DOI 10.1001/archinte.158.10.1113 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Hammill BG, 2009, AM HEART J, V157, P995, DOI 10.1016/j.ahj.2009.04.002 Hoekstra JW, 2002, ACAD EMERG MED, V9, P1146, DOI 10.1111/j.1553-2712.2002.tb01569.x McLaughlin TJ, 1996, ARCH INTERN MED, V156, P799, DOI 10.1001/archinte.156.7.799 Mehta RH, 2006, ARCH INTERN MED, V166, P2027, DOI 10.1001/archinte.166.18.2027 Peterson ED, 2006, JAMA-J AM MED ASSOC, V295, P1912, DOI 10.1001/jama.295.16.1912 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 Vogel B, 2012, INT J CARDIOL, V159, P198, DOI 10.1016/j.ijcard.2011.02.073 Wang TY, 2009, ARCH INTERN MED, V169, P1411, DOI 10.1001/archinternmed.2009.223 ZEGER SL, 1986, BIOMETRICS, V42, P121, DOI 10.2307/2531248 NR 22 TC 8 Z9 8 U1 0 U2 2 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 2014 VL 167 IS 1 BP 36 EP + DI 10.1016/j.ahj.2013.10.008 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 272KG UT WOS:000328458600007 PM 24332140 DA 2023-05-13 ER PT J AU Vafaie, M Biener, M Mueller, M Abu Sharar, H Hartmann, O Hertel, S Katus, HA Giannitsis, E AF Vafaie, Mehrshad Biener, Moritz Mueller, Matthias Abu Sharar, Haitham Hartmann, Oliver Hertel, Sabine Katus, Hugo A. Giannitsis, Evangelos TI Addition of copeptin improves diagnostic performance of point-of-care testing (POCT) for cardiac troponin T in early rule-out of myocardial infarction - A pilot study SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Point of care testing; High sensitivity troponin T; Copeptin; Sensitivity and specificity ID EMERGENCY-DEPARTMENT; NATIONAL ACADEMY; RAPID RULE; SENSITIVITY; ASSAY; GUIDELINES AB Background: Point of care testing (POCT) assays for cardiac troponin (cTn) are hampered by lower analytical sensitivity and thus suboptimal rule-out of myocardial infarction (MI). We investigated, whether additional measurement of copeptin using an ultrasensitive assay improves diagnostic performance of POCT for cTn T compared to a high sensitivity troponin T (hsTnT) assay. Methods: 131 patients with suspected acute coronary syndrome were prospectively enrolled in our center 08/2010 to 11/2011. In blood samples obtained at presentation, ultrasensitive copeptin (Kryptor, BRAHMS) and two commercially available POCT assays, AQT90 Flex Radiometer (Radiometer) and Cobas h232 POC-System (Cobas), were tested. HsTnT (Cobas E411, Roche) at baseline and after 3 and 6 h in the central laboratory served as reference. Results: Copeptin improved rule-out of non-STEMI combined with all tested troponin assays. Addition of copeptin increased sensitivity of Cobas from 67.9% (95% CI: 0.506; 0.852) to 89.3% (95% CI: 0.778; 1.007) and Radiometer from 71.4% (95% CI: 0.547; 0.882) to 85.7% (95% CI: 0.728; 0.987), achieving the sensitivity of hsTnT alone at admission of 85.7% (95% CI: 0.728; 0.987). The area under the curve (AUC) of Radiometer (0.822) was numerically but insignificantly (p = 0.17) higher than AUC of Cobas (0.725). Addition of copeptin increased AUC of Radiometer to 0.826 (p = 0.96) and AUC of Cobas to 0.814 (p = 0.20). Conclusions: Additional use of ultrasensitive copeptin improves diagnostic performance of conventional sensitive POCT assays overcoming lower sensitivities at the cost of a drop of clinical specificity. When hsTn is temporarily unavailable, copeptin and POCT for cTn may allow initial evaluation at a comparable performance as hsTnT at admission. (C) 2015 Elsevier Ireland Ltd. All rights reserved. C1 [Vafaie, Mehrshad; Biener, Moritz; Mueller, Matthias; Abu Sharar, Haitham; Katus, Hugo A.; Giannitsis, Evangelos] Univ Heidelberg Hosp, Cardiol, Dept Internal Med 3, Heidelberg, Germany. [Hartmann, Oliver; Hertel, Sabine] Thermo Fisher Sci, Thermo Sci Biomarkers, Hennigsdorf, Germany. C3 Ruprecht Karls University Heidelberg; Thermo Fisher Scientific RP Giannitsis, E (通讯作者)，Med Klin 3, Neuenheimer Feld 410, D-69120 Heidelberg, Germany. EM evangelos_giannitsis@med.uni-heidelberg.de OI Abu Sharar, Haitham/0000-0002-8917-1126 FU Bayer Healthcare Germany; Octapharma; Lilly Germany; GlaxoSmithKline; Roche Diagnostics; Brahms; Leo Pharma; Abbott; Roche Diagnostics Ltd, Switzerland; Mitsubishi Chemicals, Germany; Siemens Healthcare; BRAHMS Biomarkers; Clinical Diagnostics Division, Thermo Fisher Scientific, Germany FX MV has received financial support for clinical trials from Bayer Healthcare Germany and has been reimbursed for travel expenses and fees associated with attending seminars and conferences by Octapharma, Lilly Germany, GlaxoSmithKline, Roche Diagnostics, Brahms, Leo Pharma, and Abbott. MB has received support for clinical trials from AstraZeneca and travel support from Brahms, Germany. HAK has developed the cTnT assay and holds a patent jointly with Roche Diagnostics. He has received grants and research support from several companies, and has received honoraria for lectures from Roche Diagnostics. EG has received financial support for clinical trials from Roche Diagnostics Ltd, Switzerland, Mitsubishi Chemicals, Germany, Siemens Healthcare, BRAHMS Biomarkers, Clinical Diagnostics Division, Thermo Fisher Scientific, Germany. He is consultant to Roche Diagnostics and BRAHMS Biomarkers and has received speaker's honoraria from Roche Diagnostics, Siemens Healthcare, BRAHMS Biomarkers, and Mitsubishi Chemicals. 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J. Cardiol. PD NOV 1 PY 2015 VL 198 BP 26 EP 30 DI 10.1016/j.ijcard.2015.06.122 PG 5 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA CQ0XA UT WOS:000360319900007 PM 26149334 DA 2023-05-13 ER PT J AU Niven, DJ Laupland, KB Tabah, A Vesin, A Rello, J Koulenti, D Dimopoulos, G de Waele, J Timsit, JF AF Niven, Daniel J. Laupland, Kevin B. Tabah, Alexis Vesin, Aurelien Rello, Jordi Koulenti, Despoina Dimopoulos, George de Waele, Jan Timsit, Jean-Francois CA EUROBACT Investigators TI Diagnosis and management of temperature abnormality in ICUs: a EUROBACT investigators' survey SO CRITICAL CARE LA English DT Article DE Fever; hypothermia; intensive care unit; sepsis; septic shock; bacteremia ID CRITICALLY-ILL ADULTS; ANTIPYRETIC THERAPY; RANDOMIZED-TRIAL; FEVER; THERMOMETRY; SAFETY; DETERMINANTS; FEASIBILITY; IBUPROFEN; MORTALITY AB Introduction: Although fever and hypothermia are common abnormal physical signs observed in patients admitted to intensive care units (ICU), little data exist on their optimal management. The objective of this study was to describe contemporary practices and determinants of management of temperature abnormalities among patients admitted to ICUs. Methods: Site leaders of the multi-national EUROBACT study were surveyed regarding diagnosis and management of temperature abnormalities among patients admitted to their ICUs. Results: Of the 162 ICUs originally included in EUROBACT, responses were received from 139 (86%) centers in 23 countries in Europe (117), South America (8), Asia (5), North America (4), Australia (3) and Africa (2). A total of 117 (84%) respondents reported use of a specific temperature threshold in their ICU to define fever. A total of 14 different discrete levels were reported with a median of 38.2 degrees C (inter-quartile range, IQR, 38.0 degrees C to 38.5 degrees C). The use of thermometers was protocolized in 91 (65%) ICUs and a wide range of methods were reportedly used, with axillary, tympanic and urinary bladder sites as the most common as primary modalities. Only 31 (22%) of respondents indicated that there was a formal written protocol for temperature control among febrile patients in their ICUs. In most or all cases practice was to control temperature, to use acetaminophen, and to perform a full septic workup in febrile patients and that this was usually directed by physician order. While reported practice was to treat nearly all patients with neurological impairment and most patients with acute coronary syndromes and infections, severe sepsis and septic shock, this was not the case for most patients with liver failure and fever. Conclusions: A wide range of definitions and management practices were reported regarding temperature abnormalities in the critically ill. Documenting temperature abnormality management practices, including variability in clinical care, is important to inform planning of future studies designed to optimize infection and temperature management strategies in the critically ill. C1 [Niven, Daniel J.; Laupland, Kevin B.] Peter Lougheed Ctr, Calgary, AB T1Y 6J4, Canada. [Niven, Daniel J.; Laupland, Kevin B.] Univ Calgary, Calgary, AB T1Y 6J4, Canada. [Laupland, Kevin B.] Royal Inland Hosp, Intens Care Unit, Kamloops, BC V2C 2T1, Canada. [Laupland, Kevin B.; Tabah, Alexis; Vesin, Aurelien; Timsit, Jean-Francois] Univ Grenoble 1, Albert Bonniot Inst, Team Outcome Mech Ventilated Patients & Resp Canc, U823, F-38042 Grenoble, France. [Tabah, Alexis] Royal Brisbane & Womens Hosp, Dept Intens Care Med, Brisbane, Qld 4029, Australia. [Tabah, Alexis] Univ Queensland, Burns Trauma & Crit Care Res Ctr, Brisbane, Qld 4029, Australia. [Rello, Jordi] Vall dHebron Univ Hosp, Crit Care Dept, Barcelona 08035, Spain. [Rello, Jordi] Univ Autonoma Barcelona, CIBERES, Barcelona 08035, Spain. [Koulenti, Despoina; Dimopoulos, George] Univ Athens, Sch Med, Dept Crit Care, Univ Hosp ATTIKON, Athens 14569, Greece. [de Waele, Jan] Ghent Univ Hosp, B-9000 Ghent, Belgium. [Timsit, Jean-Francois] Univ Grenoble 1, Med ICU, Albert Michallon Univ Hosp, F-38043 Grenoble, France. C3 University of Calgary; UDICE-French Research Universities; Communaute Universite Grenoble Alpes; Universite Grenoble Alpes (UGA); Royal Brisbane & Women's Hospital; University of Queensland; Hospital Universitari Vall d'Hebron; Autonomous University of Barcelona; CIBER - Centro de Investigacion Biomedica en Red; CIBERES; Athens Medical School; National & Kapodistrian University of Athens; University Hospital Attikon; Ghent University; Ghent University Hospital; CHU Grenoble Alpes; UDICE-French Research Universities; Communaute Universite Grenoble Alpes; Universite Grenoble Alpes (UGA) RP Laupland, KB (通讯作者)，Peter Lougheed Ctr, 3500 26th St NE, Calgary, AB T1Y 6J4, Canada. EM klaupland@gmail.com RI Seguin, Philippe/P-9487-2019; Zaragoza, Rafael/ABI-3840-2020; Laupland, kevin/AAJ-6339-2020; Rocco, Monica/B-8407-2013; De Waele, Jan J/E-2704-2013; de Carvalho, Frederico Bruzzi/ABB-3911-2020; Laupland, Kevin/AAG-3656-2020; Chiche, Jean-Daniel/P-5220-2017; Leditschke, Isabel/M-1186-2015; Ferrer, Ricard/K-9022-2017; Rello, Jordi/P-2402-2019; Filipescu, Daniela/HKV-6031-2023; Antonelli, Massimo/K-9915-2016; Tabah, Alexis/B-6982-2014; Kipnis, Eric/C-6286-2016; Koulenti, Despoina/D-4851-2010; Dimopoulos, George/X-9742-2018 OI Seguin, Philippe/0000-0002-7774-4257; Zaragoza, Rafael/0000-0002-6593-5486; Laupland, kevin/0000-0002-1205-5354; Rocco, Monica/0000-0001-8380-3607; De Waele, Jan J/0000-0003-1017-9748; de Carvalho, Frederico Bruzzi/0000-0002-9752-5625; Chiche, Jean-Daniel/0000-0002-6433-6254; Leditschke, Isabel/0000-0003-2212-2140; Ferrer, Ricard/0000-0002-4859-4747; Rello, Jordi/0000-0003-0676-6210; Antonelli, Massimo/0000-0003-3007-1670; Tabah, Alexis/0000-0003-3513-2778; Kipnis, Eric/0000-0001-8887-7330; Koulenti, Despoina/0000-0003-4364-2612; Dimopoulos, George/0000-0002-3784-3103; Megarbane, Bruno/0000-0002-2522-2764; Smuszkiewicz, Piotr/0000-0003-3067-8229; MONTINI, Luca/0000-0003-4602-5134; Schultz, Marcus/0000-0003-3969-7792; Santos, Lurdes/0000-0002-0622-6823; Filipescu, Daniela/0000-0003-2144-464X; Armestar, Fernando/0000-0002-6374-1418 FU ECCRN FX The original EUROBACT study was designed by the infection section of the European Society of Intensive Care Medicine (ESICM) and was endorsed by the European Critical Care Research Network (ECCRN). A Clinical Research Award and 20,000 Euro research grant was received from the ECCRN. No funding was specifically obtained for this survey study. 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Care PY 2013 VL 17 IS 6 AR R289 DI 10.1186/cc13153 PG 8 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AB1HQ UT WOS:000331542500026 PM 24326145 OA Green Published, gold DA 2023-05-13 ER PT J AU Gryka, RJ Buckley, LF Anderson, SM AF Gryka, Rebecca J. Buckley, Leo F. Anderson, Sarah M. TI Vorapaxar: The Current Role and Future Directions of a Novel Protease-Activated Receptor Antagonist for Risk Reduction in Atherosclerotic Disease SO DRUGS IN R&D LA English DT Review ID ACUTE CORONARY SYNDROMES; SINGLE-DOSE PHARMACOKINETICS; PERIPHERAL ARTERY-DISEASE; CLINICAL EVENT REDUCTION; SECONDARY PREVENTION; PAR-1 ANTAGONIST; SCH 530348; PHARMACODYNAMICS; FOOD AB Introduction Despite the current standard of care, patients with cardiovascular disease remain at a high risk for recurrent events. Inhibition of thrombin-mediated platelet activation through protease-activated receptor-1 antagonism may provide reductions in atherosclerotic disease beyond those achievable with the current standard of care. Objective Our primary objective is to evaluate the clinical literature regarding the role of vorapaxar (Zontivity TM) in the reduction of cardiovascular events in patients with a history of myocardial infarction and peripheral artery disease. In particular, we focus on the potential future directions for protease-activating receptor antagonists in the treatment of a broad range of atherosclerotic diseases. Data Sources A literature search of PubMed and EBSCO was conducted to identify randomized clinical trials from August 2005 to June 2016 using the search terms: 'vorapaxar', 'SCH 530348', 'protease-activated receptor-1 antagonist', and 'Zontivity(TM)'. Bibliographies were searched and additional resources were obtained. Results Vorapaxar is a first-in-class, protease-activated receptor-1 antagonist. The Thrombin Receptor Antagonist for Clinical Event Reduction (TRACER) trial did not demonstrate a significant reduction in a broad primary composite endpoint. However, the Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2 degrees P-TIMI 50) trial examined a more traditional composite endpoint and found a significant benefit with vorapaxar. Vorapaxar significantly increased bleeding compared with standard care. Ongoing trials will help define the role of vorapaxar in patients with peripheral arterial disease, patients with diabetes mellitus, and other important subgroups. The use of multivariate modeling may enable the identification of subgroups with maximal benefit and minimal harm from vorapaxar. Conclusion Vorapaxar provides clinicians with a novel mechanism of action to further reduce the burden of ischemic heart disease. Identification of patients with a high ischemic risk and low bleeding risk would enable clinicians to maximize the utility of this unique agent. C1 [Gryka, Rebecca J.] Cedarville Univ, Sch Pharm, Dept Pharmaceut Sci, 251 North Main St, Cedarville, OH 45314 USA. [Buckley, Leo F.] Virginia Commonwealth Univ, Sch Pharm, Dept Pharmacotherapy & Outcomes Sci, Cedarville, OH USA. [Anderson, Sarah M.] Duquesne Univ, Ctr Pharm Care, Pittsburgh, PA 15219 USA. C3 Cedarville University; Duquesne University RP Gryka, RJ (通讯作者)，Cedarville Univ, Sch Pharm, Dept Pharmaceut Sci, 251 North Main St, Cedarville, OH 45314 USA. EM rgryka@cedarville.edu RI Buckley, Leo/P-8434-2014 OI Buckley, Leo/0000-0003-1570-1486 CR Angiolillo DJ, 2008, AM HEART J, V156, pS10, DOI 10.1016/j.ahj.2008.06.004 Angiolillo DJ, 2010, EUR HEART J, V31, P17, DOI 10.1093/eurheartj/ehp504 Behm MO, 2013, CLIN PHARM DRUG DEV, V2, P310, DOI 10.1002/cpdd.38 Bohula EA, 2015, CIRCULATION, V132, P1871, DOI 10.1161/CIRCULATIONAHA.114.015042 Bonaca MP, 2014, J AM COLL CARDIOL, V64, P2318, DOI 10.1016/j.jacc.2014.07.997 Bonaca MP, 2013, CIRCULATION, V127, P1522, DOI 10.1161/CIRCULATIONAHA.112.000679 Cavender MA, 2013, CIRCULATION, V128 Cavender MA, 2015, CIRCULATION, V131, P1047, DOI 10.1161/CIRCULATIONAHA.114.013774 Chackalamannil S, 2008, J MED CHEM, V51, P3061, DOI 10.1021/jm800180e Cho JR, 2014, VASC HEALTH RISK MAN, V10, P177, DOI 10.2147/VHRM.S36045 Cornel JH, 2015, AM J CARDIOL, V115, P1325, DOI 10.1016/j.amjcard.2015.02.043 Coughlin SR, 2005, J THROMB HAEMOST, V3, P1800, DOI 10.1111/j.1538-7836.2005.01377.x Ghosal A, 2011, DRUG METAB DISPOS, V39, P30, DOI 10.1124/dmd.110.035493 Harrington RA, 2009, AM HEART J, V158, P327, DOI 10.1016/j.ahj.2009.07.001 Hiatt WR, 2013, NAT REV CARDIOL, V10, P367, DOI 10.1038/nrcardio.2013.66 Jones WS, 2014, AM HEART J, V168, P588, DOI 10.1016/j.ahj.2014.06.017 Kosoglou T, 2013, CLIN PHARM DRUG DEV, V2, P90, DOI 10.1002/cpdd.11 Kosoglou T, 2013, CLIN PHARM DRUG DEV, V2, P223, DOI 10.1002/cpdd.30 Kosoglou T, 2013, J CLIN PHARMACOL, V53, P540, DOI 10.1002/jcph.20 Kosoglou T, 2012, EUR J CLIN PHARMACOL, V68, P1509, DOI 10.1007/s00228-012-1271-0 Kosoglou T, 2012, EUR J CLIN PHARMACOL, V68, P1049, DOI 10.1007/s00228-012-1217-6 Kosoglou T, 2012, EUR J CLIN PHARMACOL, V68, P249, DOI 10.1007/s00228-011-1120-6 Morrow DA, 2013, STROKE, V44, P691, DOI 10.1161/STROKEAHA.111.000433 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 Ossovskaya VS, 2004, PHYSIOL REV, V84, P579, DOI 10.1152/physrev.00028.2003 Shah R, 2009, AM HEART J, V157, P253, DOI 10.1016/j.ahj.2008.09.025 Sharma A, 2017, INT J CARDIOL, V227, P617, DOI 10.1016/j.ijcard.2016.10.088 Statkevich P, 2012, EUR J CLIN PHARMACOL, V68, P1501, DOI 10.1007/s00228-012-1269-7 Storey RF, 2014, THROMB HAEMOSTASIS, V111, P883, DOI 10.1160/TH13-07-0624 Tricoci P, 2012, EUR HEART J, V33, P495 Tricoci P, 2012, CIRCULATION, V126 Tricoci P, 2014, AM HEART J, V168, P869, DOI 10.1016/j.ahj.2014.09.002 Tricoci P, 2012, NEW ENGL J MED, V366, P20, DOI 10.1056/NEJMoa1109719 Verrier ED, 1996, ANN THORAC SURG, V62, P915 Versteeg HH, 2013, PHYSIOL REV, V93, P327, DOI 10.1152/physrev.00016.2011 Whellan DJ, 2014, J AM COLL CARDIOL, V63, P1048, DOI 10.1016/j.jacc.2013.10.048 *WHO, 2014, ATLAS HEART DIS STRO NR 43 TC 25 Z9 27 U1 0 U2 4 PU SPRINGER INTERNATIONAL PUBLISHING AG PI CHAM PA GEWERBESTRASSE 11, CHAM, CH-6330, SWITZERLAND SN 1174-5886 EI 1179-6901 J9 DRUGS R&D JI Drugs R&D PD MAR PY 2017 VL 17 IS 1 BP 65 EP 72 DI 10.1007/s40268-016-0158-4 PG 8 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA EQ5OU UT WOS:000398133200004 PM 28063023 OA Green Published, gold DA 2023-05-13 ER PT J AU Surbhi, S Graetz, I Wan, JY Gatwood, J Bailey, JE AF Surbhi, Satya Graetz, Ilana Wan, Jim Y. Gatwood, Justin Bailey, James E. TI The Effect of Opioid Use and Mental Illness on Chronic Disease Medication Adherence in Superutilizers SO JOURNAL OF MANAGED CARE & SPECIALTY PHARMACY LA English DT Article ID MULTIPLE CHRONIC CONDITIONS; CARE-SENSITIVE CONDITIONS; ACUTE CORONARY SYNDROMES; ADVERSE DRUG EVENTS; HEALTH-CARE; ANTIHYPERTENSIVE MEDICATION; MYOCARDIAL-INFARCTION; HOSPITAL DISCHARGE; SUPER-UTILIZERS; MANAGED CARE AB BACKGROUND: Nonadherence to essential chronic medications has been identified as a potential driver of high health care costs in superutilizers of inpatient services. Few studies, however, have documented the levels of nonadherence and factors associated with nonadherence in this high-cost, vulnerable population. OBJECTIVE: To examine the factors associated with nonadherence to essential chronic medications, with special emphasis on mental illness and use of opioid medications. METHODS: This study was a retrospective panel analysis of 2-year baseline data for Medicare Part D beneficiaries eligible for the SafeMed care transitions program in Memphis, Tennessee, from February 2013 to December 2014. The 2-year baseline data for each patient were divided into four, 6-month patient periods. The study included Medicare superutilizers (defined as patients with >= 3 hospitalizations or >= 2 hospitalizations with >= 2 emergency visits in 6 months) with continuous Part D coverage who had filled at least 1 drug class used to treat hypertension, diabetes mellitus, congestive heart failure, coronary artery disease, or chronic lung disease. The outcome included medication nonadherence assessed using proportion of days covered (PDC), with PDC < 80% defined as nonadherent, and the main exposure variables included mental illness (defined as a diagnosis of depression or anxiety or >= 1 anxiolytic or antidepressant fill) and opioid medication fills assessed in each 6-month period. Pooled observations from the four 6-month periods were used for multivariable analyses using the patient periods as the unit of analysis. A random effects model with robust standard errors and a binary distribution were used to examine associations between independent variables (time invariant and time variant factors) and medication nonadherence. The model included lagged effects of time variant factors measured in each period. RESULTS: Overall nonadherence to essential chronic medications ranged from 39.3% to 58.4%, with the highest for chronic lung disease medications (49.1%-64.4%). Factors associated with nonadherence included >= 4 opioid medication fills in the previous 6-month period (adjusted odds ratio [OR]=1.90, 95% CI=1.32-2.73); age 22-44 and 45-64 years vs. >= 65 years (OR=3.57, 95% CI=2.07-6.16, and OR=2.07, 95% CI=1.49-2.88); and a higher number of unique prescribers (OR=1.10, 95% CI=1.04-1.17). Factors protecting against nonadherence included higher number of unique medications filled (OR=0.95, 95% CI=0.92-0.98) and >= 1 physician office visit in the previous 6-month period (OR=0.66, 95% CI=0.46-0.94). CONCLUSIONS: This study demonstrated that high levels of opioid medication use are significantly associated with essential chronic disease medication nonadherence among superutilizers. Other risk factors for nonadherence were aged < 65 years, low-income status, and a higher number of unique prescribers. Factors protecting against nonadherence were physician office visits and filling higher number of medications. Medication management interventions targeting superutilizers should focus on supporting chronic disease medication adherence. Copyright (C) 2018, Academy of Managed Care Pharmacy. All rights reserved. C1 [Surbhi, Satya] Univ Tennessee, Ctr Hlth Sci, Dept Med Gen Internal Med, Ctr Hlth Syst Improvement, Memphis, TN 38163 USA. [Graetz, Ilana] Univ Tennessee, Ctr Hlth Sci, Dept Prevent Med, Memphis, TN 38163 USA. [Wan, Jim Y.] Univ Tennessee, Ctr Hlth Sci, Dept Med Gen Internal Med & Urol, Memphis, TN 38163 USA. [Gatwood, Justin] Univ Tennessee, Ctr Hlth Sci, Clin Pharm, Memphis, TN 38163 USA. [Bailey, James E.] Univ Tennessee, Ctr Hlth Sci, Dept Med, Memphis, TN 38163 USA. [Bailey, James E.] Univ Tennessee, Ctr Hlth Sci, Dept Prevent Med, Memphis, TN 38163 USA. C3 University of Tennessee System; University of Tennessee Health Science Center; University of Tennessee System; University of Tennessee Health Science Center; University of Tennessee System; University of Tennessee Health Science Center; University of Tennessee System; University of Tennessee Health Science Center; University of Tennessee System; University of Tennessee Health Science Center; University of Tennessee System; University of Tennessee Health Science Center RP Surbhi, S (通讯作者)，Univ Tennessee, Ctr Hlth Sci, 956 Court Ave,Coleman D224 A, Memphis, TN 38163 USA. EM ssurbhi@uthsc.edu FU Centers for Medicare & Medicaid Services [1C1CMS331067-01-00]; Pharmaceutical Research and Manufacturers of America Foundation; Center for Medicare and Medicaid Innovation FX This project was supported by Funding Opportunity Number 1C1CMS331067-01-00 from the Centers for Medicare & Medicaid Services, Center for Medicare and Medicaid Innovation. Support was also provided by the Pharmaceutical Research and Manufacturers of America Foundation. The content of this study is solely the responsibility of the authors. The authors declare no relevant conflicts of interest or financial relationships. 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Manag. Care Spec. Pharm. PD MAR PY 2018 VL 24 IS 3 BP 198 EP + PG 11 WC Health Care Sciences & Services; Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Health Care Sciences & Services; Pharmacology & Pharmacy GA GA3UI UT WOS:000428254700002 PM 29485952 OA Bronze DA 2023-05-13 ER PT J AU Mountain, D Ercleve, T Allely, P McQuillan, B Yamen, E Beilby, J Lim, EM Rogers, J Geelhoed, E AF Mountain, David Ercleve, Tor Allely, Peter McQuillan, Brendan Yamen, Eric Beilby, John Lim, Ee-Mun Rogers, Jeremy Geelhoed, Elizabeth TI REACTED - Reducing Acute Chest pain Time in the ED: A prospective pre-/post-interventional cohort study, stratifying risk using early cardiac multi-markers, probably increases discharges safely SO EMERGENCY MEDICINE AUSTRALASIA LA English DT Article DE chest pain; emergency service; hospital; patient discharge; risk assessment; troponin ID ACUTE CORONARY SYNDROME; EMERGENCY-DEPARTMENT; DIAGNOSTIC PROTOCOL; CARE; EFFICIENCY; POINT; OUTCOMES AB Objective: ED chest pain assessments can be challenging, lengthy and contribute to overcrowding. Rapid accurate risk stratification strategies should improve ED length of stay (EDLOS). Emergency, Biochemistry and Cardiology implemented new guidelines using paired (<3 h) multiple cardiac markers to stratify patients. The intervention would reduce chest pain EDLOS. We observed for safety and disposition effects. Methods: This is a single-site, prospective observational, before and after intervention study. In December 2009, paired multiple cardiac markers, the second at least 4 h from pain, replaced late troponins. The 4 h rule (ED flow improvement) started in April 2009 (unplanned confounder). Demographics, clinical features, risk assessment and disposition; preferably prospective. Administrative datasets provided disposition outcomes, 4 months pre-/post-intervention. Follow up with partially blinded adjudications assessed for 45 day major adverse cardiac events (MACE). Before intervention, consecutive patients were enrolled with mixed prospective/retrospective data. After, sampling occurred whenever prospective data were collected. Results: Adjudicated patients were n = 1029 (14.2% MI, 14.9% MACE), 426 before, 603 after. EDLOS reduced 87 min (416-329; P<0.001), similar to triage 2 patients without chest pain. Possibly, avoidable MACE occurred in five of 598 discharges (0.8%, CI 0.3-1.8%) with non-significant decreases (0.5%, CI 0.1-1.8%) post-intervention. Disposition changes included greater observation ward use (3.8-12.3%; P<0.001), more discharges (47.4-52.9%, P=0.002), less transfers (9.3-6.9%, P=0.014) and less late inpatient discharge decisions (15.2-8.7%, P=0.001). Conclusion: Paired cardiac markers performed adequately for avoidable MACE, and disposition improved significantly. A confounding system change meant the reduced EDLOS (primary outcome) was unable to be associated with the intervention. C1 [Mountain, David; Ercleve, Tor; Allely, Peter] Univ Western Australia, Sch Primary Aboriginal & Rural Hlth Care Emergenc, Perth, WA, Australia. [McQuillan, Brendan] Univ Western Australia, Sch Med & Pharmacol, Perth, WA, Australia. [Geelhoed, Elizabeth] Univ Western Australia, Sch Populat Hlth, Perth, WA, Australia. [Beilby, John; Lim, Ee-Mun] Univ Western Australia, Sch Pathol & Lab Med, Perth, WA, Australia. [Rogers, Jeremy] Univ Western Australia, Fac Med Dent & Hlth Sci, Perth, WA, Australia. [Mountain, David; Ercleve, Tor; Allely, Peter] Sir Charles Gairdner Hosp, Dept Emergency Med, Perth, WA, Australia. [McQuillan, Brendan; Yamen, Eric] Sir Charles Gairdner Hosp, Dept Cardiovasc Med, Perth, WA, Australia. [Beilby, John; Lim, Ee-Mun] Pathwest, Dept Biochem, Perth, WA, Australia. C3 University of Western Australia; University of Western Australia; University of Western Australia; University of Western Australia; University of Western Australia; University of Western Australia; University of Western Australia; University of Western Australia RP Mountain, D (通讯作者)，Univ Western Australia, Sch Primary Aboriginal & Rural Hlth Care Emergenc, Dept Acad Emergency Med, QEII Med Ctr, R Block,Verdun St, Nedlands, WA 6008, Australia. EM dmount63@gmail.com RI Mountain, David/ABB-5672-2021; McQuillan, Brendan/B-8271-2013 OI Mountain, David/0000-0002-6552-4855; McQuillan, Brendan/0000-0002-2130-8114; allely, peter/0000-0003-2229-2668; Geelhoed, Elizabeth/0000-0001-6718-9264; Beilby, John/0000-0002-4915-2254 FU Department of Health Western Australia; State Health Research Advisory Council [RSD 11698] FX This study was supported by the Department of Health Western Australia and a State Health Research Advisory Council grant (no. RSD 11698). We would like to acknowledge the great assistance of the ED administration officer Ms Sandra O'Keefe and hospital data officer Ms Alison Sewell in providing reports/datasets of administrative emergency and hospital data. Many thanks to our initial data collectors Drs Bjorn Makein and Judith Cubitt, and research nurses Philippa Bain (who stayed the whole 5 years) and Kane Guthrie. CR 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 Chew DP, 2013, MED J AUSTRALIA, V199, P185, DOI 10.5694/mja12.11854 Christenson J, 2004, CAN MED ASSOC J, V170, P1803, DOI 10.1503/cmaj.1031315 Cullen L, 2010, EMERG MED AUSTRALAS, V22, P35, DOI 10.1111/j.1742-6723.2010.01256.x Fesmire FM, 2006, ANN EMERG MED, V48, P270, DOI 10.1016/j.annemergmed.2006.07.005 Forero R, 2011, CRIT CARE, V15, DOI 10.1186/cc9998 Forster AJ, 2003, ACAD EMERG MED, V10, P127, DOI 10.1111/j.1553-2712.2003.tb00029.x Foy AJ, 2015, JAMA INTERN MED, V175, P428, DOI 10.1001/jamainternmed.2014.7657 Goodacre S, 2005, HEART, V91, P229, DOI 10.1136/hrt.2003.027599 Goodacre S, 2011, HEALTH TECHNOL ASSES, V15, P1, DOI 10.3310/hta15230 Kline Jeffrey A, 2005, BMC Med Inform Decis Mak, V5, P26, DOI 10.1186/1472-6947-5-26 Loten C, 2010, EMERG MED J, V27, P194, DOI 10.1136/emj.2008.069427 Loten C, 2009, EMERG MED AUSTRALAS, V21, P455, DOI 10.1111/j.1742-6723.2009.01229.x Meek R, 2012, EMERG MED AUSTRALAS, V24, P285, DOI 10.1111/j.1742-6723.2012.01541.x Montassier E, 2012, J EMERG MED, V42, P341, DOI 10.1016/j.jemermed.2010.11.036 Pines JM, 2009, ACAD EMERG MED, V16, P617, DOI 10.1111/j.1553-2712.2009.00456.x Singer AJ, 2005, ACAD EMERG MED, V12, P965, DOI 10.1197/j.aem.2005.06.007 Solinas Lucia, 2003, Ital Heart J, V4, P318 Storrow AB, 2009, POINT CARE, V8, P121, DOI 10.1097/POC.0b013e3181b316b9 Than M, 2014, JAMA INTERN MED, V174, P51 Than M, 2014, JAMA INTERN MED, V174, P51, DOI 10.1001/jamainternmed.2013.11362 Than M, 2011, LANCET, V377, P1077, DOI 10.1016/S0140-6736(11)60310-3 Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184 Weinstock MB, 2015, JAMA INTERN MED, V175, P1207, DOI 10.1001/jamainternmed.2015.1674 Willson AB, 2010, MED J AUSTRALIA, V193, P207, DOI 10.5694/j.1326-5377.2010.tb03869.x Yiadom MYAB, 2011, EMERG MED CLIN N AM, V29, P689, DOI 10.1016/j.emc.2011.08.006 NR 27 TC 2 Z9 4 U1 0 U2 2 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1742-6731 EI 1742-6723 J9 EMERG MED AUSTRALAS JI Emerg. Med. Australas. PD AUG PY 2016 VL 28 IS 4 BP 383 EP 390 DI 10.1111/1742-6723.12590 PG 8 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA EC7IO UT WOS:000388310700003 PM 27250806 DA 2023-05-13 ER PT J AU Neumann, TJ Weimann, J Sorensen, AN Hartikainen, ST Haller, MP Lehmacher, J Brocks, C Tenhaeff, S Karakas, M Renne, T Blankenberg, S Zeller, T Westermann, D AF Neumann, T. Johannes Weimann, Jessica Sorensen, Nils A. Hartikainen, S. Tau Haller, M. Paul Lehmacher, Jonas Brocks, Celine Tenhaeff, Sophia Karakas, Mahir Renne, Thomas Blankenberg, Stefan Zeller, Tanja Westermann, Dirk TI A Biomarker Model to Distinguish Types of Myocardial Infarction and Injury SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE biomarker; copeptin; myocardial infarction; myocardial injury; NT-proBNP; troponin; type 1; type 2; acute coronary syndrome ID HIGH-SENSITIVITY TROPONIN; APOLIPOPROTEIN A-II; UNIVERSAL DEFINITION; CHEST-PAIN; GUIDELINES; MANAGEMENT; ESC AB BACKGROUND Discrimination among patients with type 1 myocardial infarction (T1MI), type 2 myocardial infarction (T2MI), and myocardial injury is difficult. OBJECTIVES The aim of this study was to investigate the discriminative value of a 29-biomarker panel in an emergency department setting. METHODS Patients presenting with suspected myocardial infarction (MI) were recruited. The final diagnosis in all pa-tients was adjudicated on the basis of the fourth universal definition of MI. A panel of 29 biomarkers was measured, and multivariable logistic regression analysis was used to evaluate the associations of these biomarkers with the diagnosis of MI or myocardial injury. Biomarkers were chosen using backward selection. The model was internally validated using bootstrapping. RESULTS Overall, 748 patients were recruited (median age 64 years), of whom 138 had MI (107 T1MI and 31 T2MI) and 221 had myocardial injury. In the multivariable model, 4 biomarkers (apolipoprotein A-II, N-terminal prohormone of brain natriuretic peptide, copeptin, and high-sensitivity cardiac troponin I) remained significant discriminators between T1MI and T2MI. Internal validation of the model showed an area under the curve of 0.82. For discrimination between MI and myocardial injury, 6 biomarkers (adiponectin, N-terminal prohormone of brain natriuretic peptide, pulmonary and activation-regulated chemokine, transthyretin, copeptin, and high-sensitivity troponin I) were selected. Internal valida-tion showed an area under the curve of 0.84. CONCLUSIONS Among 29 biomarkers, 7 were identified to be the most relevant discriminators between subtypes of MI or myocardial injury. Regression models based on these biomarkers allowed good discrimination. (Biomarkers in Acute Cardiac Care [BACC]; NCT02355457) (J Am Coll Cardiol 2021;78:781-790) (c) 2021 by the American College of Cardiology Foundation. C1 [Neumann, T. Johannes; Weimann, Jessica; Sorensen, Nils A.; Hartikainen, S. Tau; Haller, M. Paul; Lehmacher, Jonas; Brocks, Celine; Tenhaeff, Sophia; Karakas, Mahir; Blankenberg, Stefan; Zeller, Tanja; Westermann, Dirk] Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany. [Neumann, T. Johannes; Sorensen, Nils A.; Haller, M. Paul; Karakas, Mahir; Blankenberg, Stefan; Zeller, Tanja; Westermann, Dirk] German Ctr Cardiovasc Res, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany. [Neumann, T. Johannes] Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Australia. [Renne, Thomas] Univ Med Ctr Hamburg Eppendorf, Inst Clin Chem & Lab Med, Hamburg, Germany. C3 German Centre for Cardiovascular Research; Monash University; University of Hamburg; University Medical Center Hamburg-Eppendorf RP Neumann, TJ (通讯作者)，Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany. EM j.neumann@uke.de OI Renne, Thomas/0000-0003-4594-5975; Zeller, Tanja/0000-0003-3379-2641; Hartikainen, Tau/0000-0003-0966-7250; Neumann, Johannes/0000-0002-9478-2757; Haller, Paul/0000-0002-7714-4446; Blankenberg, Stefan/0000-0001-6488-2362 FU German Center for Cardio-vascular Research; Abbott Diagnostics; Deutsche Forschungsgemeinschaft [NE 2165/11]; Faculty of Medicine, University of Hamburg; Prevencio FX The BACC study was supported by the German Center for Cardio-vascular Research, an unrestricted grant by Abbott Diagnostics, and Prevencio, which also partly covered the biomarker measurements. Dr Neumann is a recipient of a fellowship from Deutsche Forschungsgemeinschaft (NE 2165/11) ; has received lecture fees from Siemens Healthineers; and has received consultant fees from Roche Diagnostics. Dr Haller has received lecture fees from Beckman Coulter; has received travel grants from the German Center for Car-diovascular Research; and is supported by a grant from the Faculty of Medicine, University of Hamburg. Dr Blankenberg has received hon-oraria from Abbott Diagnostics, Siemens, Thermo Fisher, and Roche Diagnostics; and is a consultant for Thermo Fisher. Dr Westermann has received personal fees from Bayer, Boehringer Ingelheim, Berlin Chemie, AstraZeneca, Biotronik, and Novartis. 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 AUG 24 PY 2021 VL 78 IS 8 BP 781 EP 790 DI 10.1016/j.jacc.2021.06.027 EA AUG 2021 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA UE7HT UT WOS:000688055600003 PM 34412811 OA Bronze DA 2023-05-13 ER PT J AU Shah, PP Patel, K Vasudev, R Patel, H Thakkar, S Adalja, D Doshi, R AF Shah, Priyank P. Patel, Krunalkumar Vasudev, Rahul Patel, Hiten Thakkar, Samarthkumar Adalja, Devina Doshi, Rajkumar TI Gender differences in the revascularization rates and in-hospital outcomes in hospitalizations with ST segment elevation myocardial infarction SO IRISH JOURNAL OF MEDICAL SCIENCE LA English DT Article DE Gender difference; In-hospital outcomes; ST segment elevated myocardial infarction ID ACUTE CORONARY SYNDROMES; TEMPORAL TRENDS; SEX-DIFFERENCES; PLATELET INHIBITION; MORTALITY; WOMEN; AGE; INTERVENTION; PREDICTORS; TICAGRELOR AB Background Gender differences have been noted in patients presenting with ST segment elevated myocardial infarction (STEMI) but the reason remained poorly defined. We hypothesize that women presenting with STEMI are associated with poor reperfusion strategies which leads to worse in-hospital outcomes. Our goal is to identify age-stratified gender differences in revascularizations and in-hospital outcomes in patients presented with STEMI. Methods We used the 2012 to 2015 Nation Inpatient Sample databases to identify all patients >= 18 years of age hospitalized with STEMI. Resource utilization including revascularization strategies and in-hospital outcomes were compared in propensity-matched women and men in the overall cohort as well as two major age groups (< 65 years and >= 65 years). Results Less women presented with STEMI (32.3%). After propensity matching, women were less likely to receive revascularization compared to men. These disparities were seen in both age groups. The in-hospital mortality in the overall cohort was significantly higher in women (10.6% vs 8.9%,P < 0.001). In-hospital mortality was higher in women in both age groups (5.8% vs 4.4% and 14% vs 12.2% in groups 1 and 2, respectively,P < 0.001 for both). The length of stay was higher in women in both age groups compared to men (group 1-4.6 vs 4.3 days,P < 0.001; group 2-5.4 vs 5.3 days,P < 0.01). Conclusions Regardless of age, women presenting with STEMI are less likely to receive revascularization and have higher in-hospital mortality, longer length of stay, and more likely to be discharged to other acute care facility. C1 [Shah, Priyank P.] Phoebe Putney Mem Hosp, Dept Cardiol, Albany, GA USA. [Shah, Priyank P.] Med Coll Georgia, Dept Internal Med, Southwest Clin Campus, Albany, GA USA. [Patel, Krunalkumar] North Shore Univ Hosp, Dept Cardiol, Manhasset, NY USA. [Vasudev, Rahul; Patel, Hiten] St Josephs Reg Med Ctr, New York Med Coll, Dept Cardiol, Paterson, NJ USA. [Thakkar, Samarthkumar] Rochester Gen Hosp, Dept Internal Med, Rochester, NY 14621 USA. [Adalja, Devina] Gotri Med Educ & Res Ctr, Dept Gen Med, Vadodara, Gujarat, India. [Doshi, Rajkumar] Univ Nevada, Dept Internal Med, Sch Med, 1155 Mill St W1, Reno, NV 89502 USA. C3 Northwell Health; North Shore University Hospital; New York Medical College; Rochester General Hospital; Nevada System of Higher Education (NSHE); University of Nevada Reno RP Doshi, R (通讯作者)，Univ Nevada, Dept Internal Med, Sch Med, 1155 Mill St W1, Reno, NV 89502 USA. EM rdoshi@med.unr.edu RI Patel, Krunalkumar/S-2110-2018; Doshi, Rajkumar Prakashbhai/G-7744-2017 OI Patel, Krunalkumar/0000-0002-0636-6498; Doshi, Rajkumar Prakashbhai/0000-0002-5618-2750 CR Austin PC, 2009, STAT MED, V28, P3083, DOI 10.1002/sim.3697 Baim DS, 1998, CIRCULATION, V97, P322 Bangalore S, 2012, AM J MED, V125, P1000, DOI 10.1016/j.amjmed.2011.11.016 Benamer H, 2016, EUROINTERVENTION, V12, pE542, DOI 10.4244/EIJV12I5A93 Benamer H, 2011, EUROINTERVENTION, V6, P1073, DOI 10.4244/EIJV6I9A187 Benjamin EJ, 2018, CIRCULATION, V137, pE67, DOI [10.1161/CIR.0000000000000558, 10.1161/CIR.0000000000000485, 10.1161/CIR.0000000000000530] Berger JS, 2009, JAMA-J AM MED ASSOC, V302, P874, DOI 10.1001/jama.2009.1227 Burkhoff D, 2015, J AM COLL CARDIOL, V66, P2664, DOI 10.1016/j.jacc.2015.10.017 Canto JG, 2012, JAMA-J AM MED ASSOC, V307, P813, DOI 10.1001/jama.2012.199 De Carlo M, 2015, JACC-CARDIOVASC INTE, V8, P791, DOI 10.1016/j.jcin.2014.12.240 Dodson JA, 2015, JACC-CARDIOVASC INTE, V8, P797, DOI 10.1016/j.jcin.2015.02.006 Dudas K, 2011, CIRCULATION, V123, P46, DOI 10.1161/CIRCULATIONAHA.110.964999 Fitchett D, 2007, CAN J CARDIOL, V23, P663, DOI 10.1016/S0828-282X(07)70229-5 Gevaert SA, 2014, EUROINTERVENTION, V9, P95, DOI [10.4244/EIJV919A184, 10.4244/EIJV9I9A184] Huded Chetan P, 2018, J Am Coll Cardiol, V71, P2122, DOI 10.1016/j.jacc.2018.02.039 Husted S, 2014, EUR HEART J, V35, P1541, DOI 10.1093/eurheartj/ehu075 Izadnegahdar M, 2014, CAN J CARDIOL, V30, P713, DOI 10.1016/j.cjca.2013.08.020 James S, 2009, AM HEART J, V157, P599, DOI 10.1016/j.ahj.2009.01.003 Khera S, 2015, J AM COLL CARDIOL, V66, P1961, DOI 10.1016/j.jacc.2015.08.865 Khera S, 2013, INT J CARDIOL, V168, P3683, DOI 10.1016/j.ijcard.2013.06.021 Kolte D, 2014, J AM HEART ASSOC, V3, DOI 10.1161/JAHA.113.000590 Lawesson SS, 2018, BMJ OPEN, V8, DOI 10.1136/bmjopen-2017-020211 Lawesson SS, 2012, BMJ OPEN, V2, DOI 10.1136/bmjopen-2011-000726 Leurent G, 2014, ARCH CARDIOVASC DIS, V107, P291, DOI 10.1016/j.acvd.2014.04.005 Lewis WR, 2009, CIRC-CARDIOVASC QUAL, V2, P633, DOI 10.1161/CIRCOUTCOMES.108.824763 Mahmoud KD, 2013, EUR HEART J-ACUTE CA, V2, P166, DOI 10.1177/2048872613481449 McNair PW, 2019, IJC HEART VASC, V22, P156, DOI 10.1016/j.ijcha.2019.02.002 Radovanovic D, 2012, EUR HEART J-ACUTE CA, V1, P183, DOI 10.1177/2048872612454021 Rogers WJ, 2008, AM HEART J, V156, P1026, DOI 10.1016/j.ahj.2008.07.030 Scholz KH, 2018, EUR HEART J, V39, P1065, DOI 10.1093/eurheartj/ehy004 Vaccarino V, 2005, NEW ENGL J MED, V353, P671, DOI 10.1056/NEJMsa032214 VACCARINO V, 1995, CIRCULATION, V91, P1861, DOI 10.1161/01.CIR.91.6.1861 Yeh RW, 2010, NEW ENGL J MED, V362, P2155, DOI 10.1056/NEJMoa0908610 Zhang LL, 2019, HEART FAIL CLIN, V15, P41, DOI 10.1016/j.hfc.2018.08.005 Zhang ZF, 2012, AM J CARDIOL, V109, P1097, DOI 10.1016/j.amjcard.2011.12.001 NR 35 TC 4 Z9 4 U1 0 U2 0 PU SPRINGER LONDON LTD PI LONDON PA 236 GRAYS INN RD, 6TH FLOOR, LONDON WC1X 8HL, ENGLAND SN 0021-1265 EI 1863-4362 J9 IRISH J MED SCI JI Irish J. Med. Sci. PD AUG PY 2020 VL 189 IS 3 BP 873 EP 884 DI 10.1007/s11845-019-02147-9 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA MK3DS UT WOS:000548664700015 PM 31853738 DA 2023-05-13 ER PT J AU Snoek, JA Prescott, EI van der Velde, AE Eijsvogels, TMH Mikkelsen, N Prins, LF Bruins, W Meindersma, E Gonzalez-Juanatey, JR Pena-Gil, C Gonzalez-Salvado, V Moatemri, F Iliou, MC Marcin, T Eser, P Wilhelm, M Van't Hof, AWJ de Kluiver, EP AF Snoek, Johan A. Prescott, Eva, I van der Velde, Astrid E. Eijsvogels, Thijs M. H. Mikkelsen, Nicolai Prins, Leonie F. Bruins, Wendy Meindersma, Esther Gonzalez-Juanatey, Jose R. Pena-Gil, Carlos Gonzalez-Salvado, Violeta Moatemri, Feriel Iliou, Marie-Christine Marcin, Thimo Eser, Prisca Wilhelm, Matthias Van't Hof, Arnoud W. J. de Kluiver, Ed P. TI Effectiveness of Home-Based Mobile Guided Cardiac Rehabilitation as Alternative Strategy for Nonparticipation in Clinic-Based Cardiac Rehabilitation Among Elderly Patients in Europe A Randomized Clinical Trial SO JAMA CARDIOLOGY LA English DT Article ID PROGRAMS; REPRODUCIBILITY; PREDICTORS AB IMPORTANCE Although nonparticipation in cardiac rehabilitation is known to increase cardiovascular mortality and hospital readmissions, more than half of patients with coronary artery disease in Europe are not participating in cardiac rehabilitation. OBJECTIVE To assess whether a 6-month guided mobile cardiac rehabilitation (MCR) program is an effective therapy for elderly patients who decline participation in cardiac rehabilitation. DESIGN, SETTING, AND PARTICIPANTS Patients were enrolled in this parallel multicenter randomized clinical trial from November 11, 2015, to January 3, 2018, and follow-up was completed on January 17, 2019, in a secondary care system with 6 cardiac institutions across 5 European countries. Researchers assessing primary outcome were masked for group assignment. A total of 4236 patients were identified with a recent diagnosis of acute coronary syndrome, coronary revascularization, or surgical or percutaneous treatment for valvular disease, or documented coronary artery disease, of whom 996 declined to start cardiac rehabilitation. Subsequently, 179 patients who met the inclusion and exclusion criteria consented to participate in the European Study on Effectiveness and Sustainability of Current Cardiac Rehabilitation Programmes in the Elderly trial. Data were analyzed from January 21 to October 11, 2019. INTERVENTIONS Six months of home-based cardiac rehabilitation with telemonitoring and coaching based on motivational interviewing was used to stimulate patients to reach exercise goals. Control patients did not receive any form of cardiac rehabilitation throughout the study period. MAIN OUTCOMES AND MEASURES The primary outcome parameter was peak oxygen uptake (Vo(2)peak) after 6 months. RESULTS Among 179 patients randomized (145 male [81%]; median age, 72 [range, 65-87] years), 159 (89%) were eligible for primary end point analysis. Follow-up at 1 year was completed for 151 patients (84%). Peak oxygen uptake improved in the MCR group (n = 89) at 6 and 12 months (1.6 [95% CI, 0.9-2.4] mL/kg(-1)/min(-1) and 1.2 [95% CI, 0.4-2.0] mL/kg(-1)/min(-1), respectively), whereas there was no improvement in the control group (n = 90) (+0.2 [95% CI, -0.4 to 0.8] mL/kg(-1)/min(-1) and +0.1 [95% CI, -0.5 to 0.7] mL/kg(-1)/min(-1), respectively). Changes in Vo(2)peak were greater in the MCR vs control groups at 6 months (+1.2 [95% CI, 0.2 to 2.1] mL/kg(-1)/min(-1)) and 12 months (+0.9 [95% CI, 0.05 to 1.8] mL/kg(-1)/min(-1)). The incidence of adverse events was low and did not differ between the MCR and control groups. CONCLUSIONS AND RELEVANCE These results suggest that a 6-month home-based MCR program for patients 65 years or older with coronary artery disease or a valvular intervention was safe and beneficial in improving Vo(2)peak when compared with no cardiac rehabilitation. C1 [Snoek, Johan A.; van der Velde, Astrid E.; de Kluiver, Ed P.] Isala Heart Ctr, Dokter Van Heesweg 2, NL-8025 AB Zwolle, Netherlands. [Snoek, Johan A.] Sports Med Dept Isala, Zwolle, Netherlands. [Prescott, Eva, I; Mikkelsen, Nicolai] Bispebjerg Frederiksberg Univ Hosp, Dept Cardiol, Copenhagen, Denmark. [Eijsvogels, Thijs M. H.] Radboud Univ Nijmegen, Radboud Inst Hlth Sci, Dept Physiol, Med Ctr, Nijmegen, Netherlands. [Prins, Leonie F.] Diagram, Zwolle, Netherlands. [Meindersma, Esther] Radboud Univ Nijmegen, Dept Cardiol, Med Ctr, Nijmegen, Netherlands. [Gonzalez-Juanatey, Jose R.; Pena-Gil, Carlos; Gonzalez-Salvado, Violeta] Hosp Clin Univ Santiago, Inst Invest Sanitaria, Dept Cardiol, CIBER CV, Madrid, Spain. [Moatemri, Feriel; Iliou, Marie-Christine] AP HP, Dept Cardiac Rehabil, Paris, France. [Marcin, Thimo; Eser, Prisca; Wilhelm, Matthias] Univ Bern, Bern Univ Hosp, Dept Cardiol, Inselspital, Bern, Switzerland. [Van't Hof, Arnoud W. J.] Maastricht Univ, Dept Cardiol, Med Ctr, Maastricht, Netherlands. [Van't Hof, Arnoud W. J.] Zuyderland Med Ctr, Dept Cardiol, Heerlen, Netherlands. C3 University of Copenhagen; Bispebjerg Hospital; Radboud University Nijmegen; Radboud University Nijmegen; CIBER - Centro de Investigacion Biomedica en Red; CIBERCV; 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; University of Bern; University Hospital of Bern; Maastricht University RP de Kluiver, EP (通讯作者)，Isala Heart Ctr, Dokter Van Heesweg 2, NL-8025 AB Zwolle, Netherlands. EM e.p.de.kluiver@isala.nl RI Eijsvogels, Thijs/P-7201-2015; Wilhelm, Matthias/AAS-9456-2020; de Kluiver, Ed/AAX-7135-2021; Meindersma, E.P./L-4517-2015; Prescott, Eva/AAJ-7441-2020; Eser, Prisca/AAE-3758-2021 OI Eijsvogels, Thijs/0000-0003-0747-4471; Wilhelm, Matthias/0000-0003-4541-3995; Pena-Gil, Carlos/0000-0002-5263-5572; van 't Hof, Arnoud/0000-0002-2344-7564; Marcin, Thimo/0000-0001-7229-5985 FU European Union's Horizon 2020 Research and Innovation Programme [634439]; Swiss State Secretariat for Education, Research and Innovation [15.0139] FX This study was supported by grant 634439 from the European Union's Horizon 2020 Research and Innovation Programme and contract 15.0139 from the Swiss State Secretariat for Education, Research and Innovation. CR Abreu A, 2019, EUR J PREV CARDIOL, V26, P1131, DOI 10.1177/2047487319827453 ADES PA, 1993, CIRCULATION, V88, P572, DOI 10.1161/01.CIR.88.2.572 [Anonymous], 2009, NUTR REV, V67, P114, DOI 10.1111/j.1753-4887.2008.00136.x Doll JA, 2015, JAMA INTERN MED, V175, P1700, DOI 10.1001/jamainternmed.2015.3819 Keteyian SJ, 2010, CHEST, V138, P950, DOI 10.1378/chest.09-2624 Kotseva K, 2016, EUR J PREV CARDIOL, V23, P636, DOI 10.1177/2047487315569401 Lopes RD, 2015, AM J MED, V128, P582, DOI 10.1016/j.amjmed.2014.12.032 Oerkild B, 2012, BMJ OPEN, V2, DOI 10.1136/bmjopen-2012-001820 Piercy KL, 2018, JAMA-J AM MED ASSOC, V320, P2020, DOI 10.1001/jama.2018.14854 Prescott E, 2020, EUR J PREV CARDIOL, V27, P1716, DOI 10.1177/2047487320903869 Prescott E, 2016, EUR J PREV CARDIOL, V23, P27, DOI 10.1177/2047487316670063 Sankaran S, 2019, JMIR MHEALTH UHEALTH, V7, DOI 10.2196/10874 Skinner JS, 1999, MED SCI SPORT EXER, V31, P1623, DOI 10.1097/00005768-199911000-00020 Uddin J, 2016, EUR J PREV CARDIOL, V23, P683, DOI 10.1177/2047487315604311 Worcester MUC, 2004, EUR J CARDIOV PREV R, V11, P328, DOI 10.1097/01.hjr.0000137083.20844.54 World Medical Association, 2013, JAMA-J AM MED ASSOC, V310, P2191, DOI [10.1001/jama.2013.281053, DOI 10.1001/JAMA.2013.281053] NR 16 TC 27 Z9 29 U1 6 U2 18 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 APR PY 2021 VL 6 IS 4 BP 463 EP 468 DI 10.1001/jamacardio.2020.5218 EA OCT 2020 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA RN9GX UT WOS:000586810300002 PM 33112363 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Koenig, W AF Koenig, Wolfgang TI High-sensitivity C-reactive protein and atherosclerotic disease: From improved risk prediction to risk-guided therapy SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Review DE Inflammation; Biomarkers; Hs-CRP; Atherosclerosis; Canakinumab; Cardiovascular disease ID INTERLEUKIN-1 RECEPTOR ANTAGONIST; ACUTE CORONARY SYNDROME; LONG-TERM MORTALITY; RECURRENT CARDIOVASCULAR EVENTS; AORTIC ENDOTHELIAL-CELLS; HEART-DISEASE; PLAQUE INSTABILITY; STATIN THERAPY; TROPONIN-T; FOLLOW-UP AB There is compelling experimental and clinical evidence suggesting a crucial role for inflammation in the initiation and also the progression of atherosclerosis. Numerous biomarkers involved at various levels of the inflammation cascade have been shown to be associated with adverse cardiovascular outcomes. Yet, to date, it is not clear whether inflammation simply accompanies the atherosclerotic process or represents a major driver. Among all blood biomarkers, C-reactive protein (CRP), the classical acute phase reactant that can be measured with high-sensitivity (hs) assays seems to be the most promising candidate. It has already found its way into the guidelines in primary prevention. Hs-CRP can also be used to identify a high-risk group for recurrent events in patients with manifest atherosclerosis. Several post hoc analyses of large-scale randomized clinical trials testing various statins have indicated that, besides low density lipoprotein (LDL) cholesterol, hs-CRP levels might also further aid in tailoring statin treatment. The large JUPITER trial has prospectively confirmed these findings in primary prevention in patients with elevated hs-CRP but normal LDL cholesterol levels. Still, statin therapy is not a specific anti-inflammatory regime acting on the inflammation cascade. Thus, to directly test the inflammation hypothesis, a novel, more proximally located cytokine-based approach is needed. Canakinumab, a fully human monoclonal antibody against interleukin-1 beta, might represent a promising compound in this regard and provide a proof of concept. If successful, this may become a novel strategy to treat high-risk patients with stable atherosclerotic disease to prevent recurrent events on top of standard medical care. (C) 2013 Elsevier Ireland Ltd. All rights reserved. C1 Univ Ulm, Med Ctr, Dept Internal Med Cardiol 2, D-89081 Ulm, Germany. C3 Ulm University RP Koenig, W (通讯作者)，Univ Ulm, Med Ctr, Dept Internal Med Cardiol 2, Albert Einstein Allee 23, D-89081 Ulm, Germany. 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PD OCT 15 PY 2013 VL 168 IS 6 BP 5126 EP 5134 DI 10.1016/j.ijcard.2013.07.113 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 242EN UT WOS:000326220300010 PM 23978367 DA 2023-05-13 ER PT J AU Yoshioka, N Takagi, K Morishima, I Morita, Y Uemura, Y Inoue, Y Umemoto, N Shibata, N Negishi, Y Yoshida, R Tanaka, A Ishii, H Murohara, T AF Yoshioka, Naoki Takagi, Kensuke Morishima, Itsuro Morita, Yasuhiro Uemura, Yusuke Inoue, Yosuke Umemoto, Norio Shibata, Naoki Negishi, Yosuke Yoshida, Ruka Tanaka, Akihito Ishii, Hideki Murohara, Toyoaki CA N-Registry Investigators TI Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction SO CIRCULATION JOURNAL LA English DT Article DE Frailty; Octogenarians; Prognoses; ST-elevation myocardial infarction ID BODY-MASS INDEX; ACUTE CORONARY SYNDROME; SEGMENT ELEVATION; CLINICAL-OUTCOMES; SERUM CREATININE; ELDERLY-PATIENTS; IMPACT; MORTALITY; SCALE; ANGIOPLASTY AB Background: Octogenarians, who are frequently frail, represent a large proportion of patients admitted for ST-segment elevation myocardial infarction (STEMI). We investigated the relationship between frailty, assessed by the Canadian Study of Health and Aging Clinical Frailty Scale (CFS), and short- and mid-term prognoses in octogenarian STEMI patients. Methods and Results: We used a multicenter registry data of 1,301 patients with STEMI undergoing percutaneous coronary intervention (PCI) between January 2014 and December 2016. Of them, 273 were retrospectively analyzed after categorization into 3 groups based on the preadmission CFS (CFS 1-3, 140 patients; CFS 4-5, 99 patients; and CFS 6-8, 34 patients). We evaluated the influence of CFS on overall mortality at 2 years and on non-home discharge, defined as the composite of in-hospital death and new transfer to a hospital or nursing home. During the study period (median, 565 days), the overall mortality and ratio of non-home discharge increased as CFS increased. After adjustment for multivariable analysis, the severely frail continued to be significantly associated with an increased risk of overall mortality (adjusted hazard ratio 2.37; 95% confidence interval [CI] 1.11-5.05; P=0.026) and non-home discharge (adjusted odds ratio 9.50; 95% CI 3.48-25.99; P<0.001). Conclusions: Frailty, as assessed by CFS, had an influence on short- and mid-term prognoses in octogenarian patients with STEMI. C1 [Yoshioka, Naoki; Takagi, Kensuke; Morishima, Itsuro; Morita, Yasuhiro] Ogaki Municipal Hosp, Dept Cardiol, Ogaki, Japan. [Uemura, Yusuke] Anjo Kosei Hosp, Dept Cardiol, Anjo, Aichi, Japan. [Inoue, Yosuke] Tosei Gen Hosp, Dept Cardiol, Seto, Japan. [Umemoto, Norio; Shibata, Naoki] Ichinomiya Municipal Hosp, Dept Cardiol, Ichinomiya, Japan. [Negishi, Yosuke; Yoshida, Ruka; Tanaka, Akihito; Ishii, Hideki; Murohara, Toyoaki] Nagoya Univ, Grad Sch Med, Dept Cardiol, Nagoya, Aichi, Japan. C3 Ogaki Municipal Hospital; Tosei General Hospital; Nagoya University RP Morishima, I (通讯作者)，Ogaki Municipal Hosp, 4-86 Minaminokawa Cho, Ogaki 5038502, Japan. 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PD JAN PY 2020 VL 84 IS 1 BP 109 EP 118 DI 10.1253/circj.CJ-19-0467 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA JY5MY UT WOS:000504460200018 PM 31787661 OA gold DA 2023-05-13 ER PT J AU Bruggmann, C Adjedj, J Sardy, S Muller, O Voirol, P Sadeghipour, F AF Bruggmann, Christel Adjedj, Julien Sardy, Sylvain Muller, Olivier Voirol, Pierre Sadeghipour, Farshid TI Effects of the Interactive Web-Based Video "Mon Coeur, Mon BASIC" on Drug Adherence of Patients With Myocardial Infarction: Randomized Controlled Trial SO JOURNAL OF MEDICAL INTERNET RESEARCH LA English DT Article DE acute coronary syndrome; eHealth; drug adherence; mHealth; mobile phone ID ST-SEGMENT ELEVATION; LONG-TERM ADHERENCE; MEDICATION ADHERENCE; HEART-FAILURE; INTERVENTION; THERAPY; PHARMACOTHERAPY; MANAGEMENT; MORTALITY AB Background: Secondary prevention strategies after acute coronary syndrome (ACS) presentation with the use of drug combinations are essential to reduce the recurrence of cardiovascular events. However, lack of drug adherence is known to be common in this population and to be related to treatment failure. To improve drug adherence, we developed the "Mon Coeur, Mon BASIC" video. This online video has been specifically designed to inform patients about their disease and their current medications. Interactivity has been used to increase patient attention, and the video can also be viewed on smartphones and tablets. Objective: The objective of this study was to assess the long-term impact of an informative web-based video on drug adherence in patients admitted for an ACS. Methods: This randomized study was conducted with consecutive patients admitted to University Hospital of Lausanne for ACS. We randomized patients to an intervention group, which had access to the web-based video and a short interview with the pharmacist, and a control group receiving usual care. The primary outcome was the difference in drug adherence, assessed with the Adherence to Refills and Medication Scale (ARMS; 9 multiple-choice questions, scores ranging from 12 for perfect adherence to 48 for lack of adherence), between groups at 1, 3, and 6 months. We assessed the difference in ARMS score between both groups with the Wilcoxon rank sum test. Secondary outcomes were differences in knowledge, readmissions, and emergency room visits between groups and patients' satisfaction with the video. Results: Sixty patients were included at baseline. The median age of the participants was 59 years (IQR 49-69), and 85% (51/60) were male. At 1 month, 51 patients participated in the follow-up, 50 patients participated at 3 months, and 47 patients participated at 6 months. The mean ARMS scores at 1 and 6 months did not differ between the intervention and control groups (13.24 vs 13.15, 13.52 vs 13.68, respectively). At 3 months, this score was significantly lower in the intervention group than in the control group (12.54 vs 13.75; P=.03). We observed significant increases in knowledge from baseline to 1 and 3 months, but not to 6 months, in the intervention group. Readmissions and emergency room visits have been very rare, and the proportion was not different among groups. Patients in the intervention group were highly satisfied with the video. Conclusions: Despite a lower sample size than we expected to reach, we observed that the "Mon Coeur, Mon BASIC" web-based interactive video improved patients' knowledge and seemed to have an impact on drug adherence. These results are encouraging, and the video will be offered to all patients admitted to our hospital with ACS. C1 [Bruggmann, Christel; Voirol, Pierre; Sadeghipour, Farshid] Univ Lausanne, Univ Hosp Lausanne, Dept Pharm, Lausanne, Switzerland. [Bruggmann, Christel; Voirol, Pierre; Sadeghipour, Farshid] Univ Geneva, Inst Pharmaceut Sci Western Switzerland, Geneva, Switzerland. [Bruggmann, Christel] Univ Hosp Geneva, Dept Pharm, Rue Gabrielle Perret Gentil 4, CH-1205 Geneva, Switzerland. [Adjedj, Julien; Muller, Olivier] Univ Lausanne, Univ Hosp Lausanne, Dept Cardiol, Lausanne, Switzerland. [Sardy, Sylvain] Univ Geneva, Sect Math, Geneva, Switzerland. C3 University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Geneva; University of Geneva; University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Geneva RP Bruggmann, C (通讯作者)，Univ Hosp Geneva, Dept Pharm, Rue Gabrielle Perret Gentil 4, CH-1205 Geneva, Switzerland. EM cbruggmann@gmail.com RI Sadeghipour, Farshid/GOE-5562-2022 OI Sadeghipour, Farshid/0000-0003-0817-5393; Muller, Olivier/0000-0003-2441-5799; Bruggmann, Christel/0000-0003-2919-8383; Voirol, Pierre/0000-0002-4671-0820; Adjedj, Julien/0000-0002-0902-8347 FU "e-learning commission" from the University Hospital of Lausanne FX This work was supported by an "e-learning commission" from the University Hospital of Lausanne. The funder had no role in the design of the study; collection, analysis, or interpretation of data; or writing of the manuscript. We sincerely thank all individuals who participated in the development of the "Mon Coeur, Mon BASIC" video, including Alienor Held, Pierre-Antoine Dubois, Ana Loureiro Soares, Anaelle Morf, and Anne-Sylvie Diezi; we thank Marc Sohrmann for his advice on video content and Laurence Iseli for video narration. 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Med. Internet Res. PD AUG 30 PY 2021 VL 23 IS 8 AR e21938 DI 10.2196/21938 PG 15 WC Health Care Sciences & Services; Medical Informatics WE Science Citation Index Expanded (SCI-EXPANDED) SC Health Care Sciences & Services; Medical Informatics GA UK0RX UT WOS:000691683700001 PM 34459744 OA Green Published, gold DA 2023-05-13 ER PT J AU Wong, EC Fordyce, CB Wong, G Lee, T Perry-Arnesen, M Mackay, M Singer, J Cairns, JA Turgeon, RD AF Wong, Eric C. Fordyce, Christopher B. Wong, Graham Lee, Terry Perry-Arnesen, Michele Mackay, Martha Singer, Joel Cairns, John A. Turgeon, Ricky D. TI Predictors of the Use of Mineralocorticoid Receptor Antagonists in Patients With Left Ventricular Dysfunction Post-ST-Segment-Elevation Myocardial Infarction SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE acute coronary syndrome; aldosterone antagonist; heart failure ID REDUCED EJECTION FRACTION; HEART-FAILURE; SYSTOLIC DYSFUNCTION; TASK-FORCE; ASSOCIATION; EPLERENONE; GUIDELINES; MANAGEMENT; OUTCOMES; THERAPY AB Background Guidelines recommend mineralocorticoid receptor antagonist (MRA) use in patients with left ventricular ejection fraction <= 40% following a myocardial infarction plus heart failure or diabetes mellitus, based on mortality benefit in the EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) trial. The objective of this study was to evaluate the real-world utilization of MRAs for patients with ST-segment-elevation myocardial infarction (STEMI) with left ventricular dysfunction. Methods and Results The prospective, population-based, Vancouver Coastal Health Authority STEMI database was linked with local outpatient cardiology records from 2007 to 2018. EPHESUS criteria were used to define post-STEMI MRA eligibility (left ventricular ejection fraction <= 40% plus clinical heart failure or diabetes mellitus, and no dialysis-dependent renal dysfunction). The primary outcome was MRA prescription among eligible patients at discharge and the secondary outcome was MRA prescription within 3 months postdischarge. Of 2691 patients with STEMI, 317 (12%) were MRA eligible, and 70 (22%) eligible patients were prescribed an MRA at discharge. Among eligible patients with no MRA at discharge, 12/126 (9.5%) with documented postdischarge follow-up were prescribed an MRA within 3 months. In multivariable analysis, left ventricular ejection fraction (odds ratio [OR], 1.55 per 5% left ventricular ejection fraction decrease; 95% CI, 1.26-1.90) and calendar year (OR, 1.23 per year, 95% CI, 1.11-1.37) were associated with MRA prescription at discharge. Other prespecified variables were not associated with MRA prescription. Conclusions In this contemporary STEMI cohort, only 1 in 4 MRA-eligible patients were prescribed an MRA within 3 months following hospitalization despite high-quality evidence for use. Novel decision-support tools are required to optimize pharmacotherapy decisions during hospitalization and follow-up to target this gap in post-STEMI care. C1 [Wong, Eric C.] Univ British Columbia, Dept Med, Div Gen Internal Med, Vancouver, BC, Canada. [Fordyce, Christopher B.; Wong, Graham; Cairns, John A.; Turgeon, Ricky D.] Univ British Columbia, Dept Med, Div Cardiol, Vancouver, BC, Canada. [Fordyce, Christopher B.; Lee, Terry; Mackay, Martha; Singer, Joel; Turgeon, Ricky D.] Univ British Columbia, Ctr Hlth Evaluat & Outcome Sci, Providence Hlth Care Res Inst, Vancouver, BC, Canada. [Fordyce, Christopher B.; Wong, Graham] Vancouver Coastal Hlth Author, Vancouver, BC, Canada. [Perry-Arnesen, Michele] Fraser Hlth Author, Vancouver, BC, Canada. [Mackay, Martha] Univ British Columbia, Sch Nursing, Vancouver, BC, Canada. [Mackay, Martha] St Pauls Hosp Heart Ctr, Vancouver, BC, Canada. [Singer, Joel] Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada. [Turgeon, Ricky D.] Univ British Columbia, Fac Pharmaceut Sci, Vancouver, BC, Canada. C3 University of British Columbia; University of British Columbia; University of British Columbia; Vancouver Coastal Health Research Institute; University of British Columbia; St. Paul's Hospital; University of British Columbia; University of British Columbia RP Turgeon, RD (通讯作者)，Univ British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada. EM ricky.turgeon@ubc.ca RI Turgeon, Ricky/V-3522-2019 OI Turgeon, Ricky/0000-0002-3967-1528; Singer, Joel/0000-0002-7220-4382; Perry Arnesen, Michele/0000-0003-4056-9210; cairns, john/0000-0001-8875-8841 FU Vancouver Coastal Health Research Institute FX This study was funded by the Vancouver Coastal Health Research Institute. 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Am. Heart Assoc. PD JUL 20 PY 2021 VL 10 IS 14 AR e019167 DI 10.1161/JAHA.120.019167 PG 13 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA TL1XZ UT WOS:000674649600028 PM 34227405 OA Green Published DA 2023-05-13 ER PT J AU Jiang, HQ Holm, J Vidlund, M Vanky, F Friberg, O Yang, YQ Svedjeholm, R AF Jiang, Huiqi Holm, Jonas Vidlund, Marten Vanky, Farkas Friberg, Orjan Yang, Yanqi Svedjeholm, Rolf TI The impact of glutamate infusion on postoperative NT-proBNP in patients undergoing coronary artery bypass surgery: a randomized study SO JOURNAL OF TRANSLATIONAL MEDICINE LA English DT Article DE Glutamic acid; Natriuretic peptide; Heart failure; Coronary artery bypass surgery; Postoperative care ID BRAIN NATRIURETIC PEPTIDE; VENOUS OXYGEN-SATURATION; CARDIAC-SURGERY; HEART-FAILURE; AMINO-ACIDS; MYOCARDIAL GLUTAMATE; TROPONIN-T; ASSOCIATION; DYSFUNCTION; METABOLISM AB Background Glutamate, a key intermediate in myocardial metabolism, may enhance myocardial recovery after ischemia and possibly reduce the incidence and severity of postoperative heart failure in coronary artery bypass surgery (CABG). N-terminal pro-B-type natriuretic peptide (NT-proBNP) can be used to assess postoperative heart failure (PHF) after CABG. Our hypothesis was that glutamate enhances myocardial recovery in post-ischemic heart failure and, therefore, will be accompanied by a mitigated postoperative increase of NT-proBNP. Methods Substudy of the GLUTAmate for Metabolic Intervention in Coronary Surgery (GLUTAMICS) trial (ClinicalTrials.gov Identifier: NCT00489827) a prospective triple-center double-blind randomized clinical trial on 399 patients undergoing CABG with or without concomitant procedure for acute coronary syndrome at three Swedish Cardiac Surgery centres (Linkoping, orebro, and Karlskrona) from May 30, 2007 to November 12, 2009. Patients were randomly assigned to intravenous infusion of 0.125 M l-glutamic acid or saline (1.65 mL/kg of body weight per hour) intraoperatively and postoperatively. Plasma NT-proBNP was measured preoperatively, the first (POD1) and third postoperative morning (POD3). A Clinical Endpoints Committee, blinded to both intervention and NT-proBNP used prespecified criteria to diagnose PHF. The primary endpoints were the absolute levels of postoperative NT-proBNP and the difference between preoperative and postoperative levels of NT-proBNP. Results Overall no significant difference was detected in postoperative NT-proBNP levels between groups. However, in high-risk patients (upper quartile of EuroSCORE II >= 4.15; glutamate group n = 56; control group n = 45) glutamate was associated with significantly lower postoperative increase of NT-proBNP (POD3-Pre: 3900 [2995-6260] vs. 6745 [3455-12,687] ng center dot L-1, p = 0.012) and lower NT-proBNP POD3 (POD3: 4845 [3426-7423] vs. 8430 [5370-14,100] ng center dot L-1, p = 0.001). After adjusting for significant differences in preoperative demographics, NT-proBNP POD3 in the glutamate group was 0.62 times of that in the control group (p = 0.002). Patients in the glutamate group also had shorter ICU stay (21 [19-26] vs. 25 [22-46] h, p = 0.025) and less signs of myocardial injury (Troponin T POD3 (300 [170-500] vs. 560 [210-910] ng center dot L-1, p = 0.025). Conclusions Post hoc analysis of postoperative NT-proBNP suggests that intravenous infusion of glutamate may prevent or mitigate myocardial dysfunction in high-risk patients undergoing CABG. Further studies are necessary to confirm these findings. Trial registration Swedish Medical Products Agency 151:2003/70403 (prospectively registered with amendment about this substudy filed March 17, 2007). ClinicalTrials.gov Identifier: NCT00489827 (retrospectively registered) (retrospectively registered) https://clini caltrials.gov/ct2/show/NCT00489827?term=glutamics&draw=1&rank=1 C1 [Jiang, Huiqi; Holm, Jonas; Vanky, Farkas; Yang, Yanqi; Svedjeholm, Rolf] Linkoping Univ, Fac Med & Hlth Sci, Unit Cardiovasc Sci, Dept Cardiothorac Surg, Linkoping, Sweden. [Jiang, Huiqi; Yang, Yanqi] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Cardiothorac Surg, Guangzhou, Guangdong, Peoples R China. [Vidlund, Marten; Friberg, Orjan] 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, Unit Cardiovasc Sci, Dept Cardiothorac Surg, Linkoping, Sweden. EM rolf.svedjeholm@regionostergotland.se RI Friberg, Örjan/AAQ-8685-2020; Friberg, Orjan/GXH-9180-2022 OI Friberg, Orjan/0000-0003-2708-1376 FU Linkoping University; Swedish Heart-Lung Foundation [20030595, 20140633]; Region Ostergotland [LIO-443891, LIO-693091] FX Open access funding provided by Linkoping University. This work was supported by grants from The Swedish Heart-Lung Foundation [20030595, 20140633]; and Region Ostergotland [LIO-443891, LIO-693091]. No relationship with industry exists. 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Transl. Med. PD MAY 11 PY 2020 VL 18 IS 1 AR 193 DI 10.1186/s12967-020-02351-7 PG 11 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA LP4LY UT WOS:000534291800002 PM 32393387 OA Green Published, gold DA 2023-05-13 ER PT J AU Alotaibi, A Body, R Carley, S Pennington, E AF Alotaibi, Ahmed Body, Richard Carley, Simon Pennington, Elspeth TI Towards enhanced telephone triage for chest pain: a Delphi study to define life-threatening conditions that must be identified SO BMC EMERGENCY MEDICINE LA English DT Article DE Prehospital; Triage; Telephone-triage; EMS; Chest pain; Life-threatening condition; Dispatch ID ACUTE CORONARY SYNDROME; EMERGENCY AB Background Improving telephone triage for patients with chest pain has been identified as a national research priority. However, there is a lack of strong evidence to define the life-threatening conditions (LTCs) that telephone triage ought to identify. Therefore, we aimed to build consensus for the LTCs associated with chest pain that ought to be identified during telephone triage for emergency calls. Methods We conducted a Delphi study in three rounds. Twenty experts in pre-hospital care and emergency medicine experience from the UK were invited to participate. In round I, experts were asked to list all LTCs that would require priority 1, 2, and 4 ambulance responses. Round II was a ranking evaluation, and round III was a consensus round. Consensus level was predefined at > = 70%. Results A total of 15 participants responded to round one and 10 to rounds two and three. Of 185 conditions initially identified by the experts, 26 reached consensus in the final round. Ten conditions met consensus for requiring priority 1 response: oesophageal perforation/rupture; ST elevation myocardial infarction; non-ST elevation myocardial infarction with clinical compromise (defined, also by consensus, as oxygen saturation < 90%, heart rate < 40/min or systolic blood pressure < 90 mmHg); acute heart failure; cardiac tamponade; life-threatening asthma; cardiac arrest; tension pneumothorax and massive pulmonary embolism. An additional six conditions met consensus for priority 2 response, and three for priority 4 response. Conclusion Using expert consensus, we have defined the LTCs that may present with chest pain, which ought to receive a high-priority ambulance response. This list of conditions can now form a composite primary outcome for future studies to derive and validate clinical prediction models that will optimise telephone triage for patients with a primary complaint of chest pain. C1 [Alotaibi, Ahmed] Univ Manchester, Core Technol Facil, Div Cardiovasc Sci, 46 Grafton St, Manchester M13 9WU, Lancs, England. [Alotaibi, Ahmed] King Saud bin Abdulaziz Univ Hlth Sci, Coll Appl Med Sci, Riyadh, Saudi Arabia. [Body, Richard; Carley, Simon] Manchester Univ NHS Fdn Trust, Emergency Dept, Manchester, Lancs, England. [Carley, Simon] Manchester Metropolitan Univ, Fac Hlth Social Care & Psychol, Manchester, Lancs, England. [Pennington, Elspeth] North West Ambulance Serv NHS Trust, Bolton, England. C3 N8 Research Partnership; RLUK- Research Libraries UK; University of Manchester; King Saud Bin Abdulaziz University for Health Sciences; Manchester Metropolitan University RP Alotaibi, A (通讯作者)，Univ Manchester, Core Technol Facil, Div Cardiovasc Sci, 46 Grafton St, Manchester M13 9WU, Lancs, England.; Alotaibi, A (通讯作者)，King Saud bin Abdulaziz Univ Hlth Sci, Coll Appl Med Sci, Riyadh, Saudi Arabia. EM ahmed.alotaibi@postgrad.manchester.ac.uk RI carley, simon/GXV-1178-2022; Body, Richard/C-2736-2010 OI Pennington, Elspeth/0000-0002-9187-0524; Body, Richard/0000-0001-9089-8130 FU cardiovascular department, University of Manchester, UK FX The publication fee is funded by the cardiovascular department, University of Manchester, UK. No grant or award number. CR Ashley Brown M, 2017, JEMS, V42 Body R, 2019, HEART, V105, P768, DOI 10.1136/heartjnl-2018-313825 Bohm K, 2018, SCAND J TRAUMA RESUS, V26, DOI 10.1186/s13049-018-0528-8 Burman RA, 2011, BMC EMERG MED, V11, DOI 10.1186/1471-227X-11-9 Cantrill JA, 2011, INT J PHARM PRACT, V4, P67, DOI [DOI 10.1111/J.2042-7174.1996.TB00844.X, 10.1111/j.2042-7174.1996.tb00844.x] Dami F, 2015, BMC EMERG MED, V15, DOI 10.1186/s12873-015-0058-x Deakin CD, 2006, EMERG MED J, V23, P232, DOI 10.1136/emj.2004.022962 Fevang E, 2011, SCAND J TRAUMA RESUS, V19, DOI 10.1186/1757-7241-19-57 George S, 2019, USING STRUCTURED CLI, P59 Hoikka M, 2016, SCAND J TRAUMA RESUS, V24, DOI 10.1186/s13049-016-0336-y Janette Turner RJ., 2017, AMBULANCE RESPONSE P Jensen JL, 2013, CAN J EMERG MED, V15, P73, DOI 10.2310/8000.2013.130894 Johnson K, 2019, CHEST PAIN Lidal IB, 2013, SCAND J TRAUMA RESUS, V21, DOI 10.1186/1757-7241-21-28 Lindstrom V., 2018, BMJ OPEN, V8, pA19 Maio RF, 1999, ANN EMERG MED, V33, P423, DOI 10.1016/S0196-0644(99)70307-0 Mol KA, 2018, OPEN HEART, V5, DOI 10.1136/openhrt-2018-000859 Pedersen CK, 2019, SCAND J TRAUMA RESUS, V27, DOI 10.1186/s13049-019-0659-6 Schmidt Terri A, 2004, Prehosp Emerg Care, V8, P126, DOI 10.1016/j.prehos.2003.12.003 Snooks H, 2009, EMERG MED J, V26, P549, DOI 10.1136/emj.2008.065862 Thangaratinam S, 2005, OBSTET GYNAECOL, V7, P120, DOI 10.1576/toag.7.2.120.27071 Torlen K, 2017, SCAND J TRAUMA RESUS, V25, DOI 10.1186/s13049-017-0464-z Turner J., 2015, HLTH SERVICES DELIVE, V3, P1, DOI [10.3310/hsdr03430, DOI 10.3310/HSDR03430] van de Glind I, 2016, SCAND J TRAUMA RESUS, V24, DOI 10.1186/s13049-015-0195-y Wouters LT, 2020, FAM PRACT, V37, P473, DOI 10.1093/fampra/cmaa005 NR 25 TC 0 Z9 0 U1 0 U2 0 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 DEC 15 PY 2021 VL 21 IS 1 AR 158 DI 10.1186/s12873-021-00553-w PG 10 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA XP0EZ UT WOS:000730549300003 PM 34911466 OA Green Published, gold DA 2023-05-13 ER PT J AU Milovancev, A Miljkovic, T Petrovic, M Kovacevic, M Ilic, A Bjelobrk, M Lozanov-Crvenkovic, Z Milosavljevic, AS Tadic, S Bulatovic, T AF Milovancev, Aleksandra Miljkovic, Tatjana Petrovic, Milovan Kovacevic, Mila Ilic, Aleksandra Bjelobrk, Marija Lozanov-Crvenkovic, Zagorka Milosavljevic, Anastazija Stojsic Tadic, Snezana Bulatovic, Tamara TI Impact of the COVID-19 Pandemic on Cardiology Emergency Department Visits SO INTERNATIONAL HEART JOURNAL LA English DT Article DE   Coronavirus disease; Cardiovascular diseases; Mortality; Acute medical conditions; Emergency room AB In 2020, decreased emergency department (ED) visits and hospitalization rates during the COVID-19 out-break were reported. There is no data about cardiovascular emergencies and mortality for the whole COVID-19 year. This study aimed to compare the rates of cardiology ED visits, hospital admissions, and intrahospital mor-tality between the pre-COVID-19 and COVID-19 years in a single high-volume center. The retrospective observational cross-sectional study analyzed data on the number of ED visits, hospital admissions by different cardiovascular diagnoses, and outcomes. A total of 11744 patients visited the cardiology ED in the pre-COVID-19 year compared with 9145 in the COVID-19 year, indicating an overall decrease of 22.1% (P = 0.02) (IR 78.76 versus 61.33; incidence rate ra-tios (IRR) 1.28, P = 0.00), with an observed decrease of 25.5% in the number of hospitalizations (33.1% versus 31.6%, P = 0.02). A marked decrease in hospitalizations for cardiovascular emergencies was observed for hy-pertensive heart disease (-72.8%, P < 0.0001), acute coronary syndrome (-17.8%, P < 0.0001), myocardial and pericardial diseases and endocarditis (-61.2%, P = 0.00), and valvular heart disease (-70.8%, P < 0.0001). In the COVID-19 year, patients had increased need for mechanical ventilatory support (7% versus 6.3%, P = 0.03) with no overall difference in intrahospital mortality (IR 2.71 versus 2.78, IRR 0.98, 95% CI 0.82-1.16, P = 0.39). Decreased ED visits and hospitalizations not just in outbreaks but through the whole COVID-19 year high-light the risk of continuous delay of needed care for emergency life-threatening cardiovascular diseases. Urgent comprehensive strategies that will address patient-and system-related factors to decrease morbidity and mortal-ity and prevent collateral damage of the pandemic are needed. C1 [Milovancev, Aleksandra; Miljkovic, Tatjana; Petrovic, Milovan; Kovacevic, Mila; Ilic, Aleksandra; Bjelobrk, Marija; Milosavljevic, Anastazija Stojsic; Tadic, Snezana] Univ Novi Sad, Fac Med, Hajduk Veljkova 3, Novi Sad 21000, Serbia. [Milovancev, Aleksandra; Miljkovic, Tatjana; Petrovic, Milovan; Kovacevic, Mila; Ilic, Aleksandra; Bjelobrk, Marija; Milosavljevic, Anastazija Stojsic; Tadic, Snezana; Bulatovic, Tamara] Inst Cardiovasc Dis Vojvodina, Sremska Kamenica, Serbia. [Lozanov-Crvenkovic, Zagorka] Univ Novi Sad, Fac Sci, Novi Sad, Serbia. C3 University of Novi Sad; University of Novi Sad RP Milovancev, A (通讯作者)，Univ Novi Sad, Fac Med, Hajduk Veljkova 3, Novi Sad 21000, Serbia.; Milovancev, A (通讯作者)，Inst Cardiovasc Dis Vojvodina, Sremska Kamenica, Serbia. 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Heart J. PD JUL PY 2022 VL 63 IS 4 BP 749 EP 754 DI 10.1536/ihj.21-750 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 3Q4EI UT WOS:000838185800015 PM 35831145 OA gold DA 2023-05-13 ER PT J AU Mixon, AS Myers, AP Leak, CL Jacobsen, JML Cawthon, C Goggins, KM Nwosu, S Schildcrout, JS Schnelle, JF Speroff, T Kripalani, S AF Mixon, Amanda S. Myers, Amy P. Leak, Cardella L. Jacobsen, J. Mary Lou Cawthon, Courtney Goggins, Kathryn M. Nwosu, Samuel Schildcrout, Jonathan S. Schnelle, John F. Speroff, Theodore Kripalani, Sunil TI Characteristics Associated With Postdischarge Medication Errors SO MAYO CLINIC PROCEEDINGS LA English DT Article ID ADVERSE DRUG EVENTS; PATIENTS AFTER-DISCHARGE; HEALTH LITERACY; HOSPITAL DISCHARGE; INPATIENT; ADHERENCE; CARE; RECONCILIATION; NUMERACY; OUTCOMES AB Objective: To examine the association of patient-and medication-related factors with postdischarge medication errors. Patients and Methods: The Vanderbilt Inpatient Cohort Study includes adults hospitalized with acute coronary syndromes and/or acute decompensated heart failure. We measured health literacy, subjective numeracy, marital status, cognition, social support, educational attainment, income, depression, global health status, and medication adherence in patients enrolled from October 1, 2011, through August 31, 2012. We used binomial logistic regression to determine predictors of discordance between the discharge medication list and the patient-reported list during postdischarge medication review. Results: Among 471 patients (mean age, 59 years), the mean total number of medications reported was 12, and 79 patients (16.8%) had inadequate or marginal health literacy. A total of 242 patients (51.4%) were taking 1 or more discordant medication (ie, appeared on either the discharge list or patient-reported list but not both), 129 (27.4%) failed to report a medication on their discharge list, and 168 (35.7%) reported a medication not on their discharge list. In addition, 279 participants (59.2%) had a misunderstanding in indication, dose, or frequency in a cardiac medication. In multivariable analyses, higher subjective numeracy (odds ratio [OR], 0.81; 95% CI, 0.67-0.98) was associated with lower odds of having discordant medications. For cardiac medications, participants with higher health literacy (OR, 0.84; 95% CI, 0.74-0.95), with higher subjective numeracy (OR, 0.77; 95% CI, 0.63-0.95), and who were female (OR, 0.60; 95% CI, 0.46-0.78) had lower odds of misunderstandings in indication, dose, or frequency. Conclusion: Medication errors are present in approximately half of patients after hospital discharge and are more common among patients with lower numeracy or health literacy. (C) 2014 Mayo Foundation for Medical Education and Research C1 [Mixon, Amanda S.; Schnelle, John F.; Speroff, Theodore] Tennessee Valley Healthcare Syst Geriatr Res Educ, Dept Vet Affairs, Nashville, TN USA. [Mixon, Amanda S.; Kripalani, Sunil] Dept Med, Div Gen Internal Med & Publ Hlth, Sect Hosp Med, Cambridge, England. [Mixon, Amanda S.; Leak, Cardella L.; Jacobsen, J. Mary Lou; Cawthon, Courtney; Goggins, Kathryn M.; Speroff, Theodore; Kripalani, Sunil] Ctr Hlth Serv, Cambridge, England. C3 Geriatric Research Education & Clinical Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Tennessee Valley Healthcare System RP Mixon, AS (通讯作者)，Suite 6000 MCE,North Tower,1215 21st Ave S, Nashville, TN 37232 USA. EM Amanda.S.Mixon@Vanderbilt.edu RI Leak, Cardella/J-8272-2019 FU National Heart, Lung, and Blood Institute [R01 HL109388]; National Center for Research Resources [UL1 RR024975-01]; National Center for Advancing Translational Sciences [2 UL1 TR000445-06] FX This study was supported by grant R01 HL109388 from the National Heart, Lung, and Blood Institute (Dr Kripalani) and in part by grant UL1 RR024975-01 from the National Center for Research Resources and grant 2 UL1 TR000445-06 from the National Center for Advancing Translational Sciences. 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Proc. PD AUG PY 2014 VL 89 IS 8 BP 1042 EP 1051 DI 10.1016/j.mayocp.2014.04.023 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA AO5UQ UT WOS:000341411200007 PM 24998906 OA Green Accepted DA 2023-05-13 ER PT J AU Alzahrani, SH Al-Rabia, MW AF Alzahrani, Sami H. Al-Rabia, Mohammed W. TI Cardiac Injury Biomarkers and the Risk of Death in Patients with COVID-19: A Systematic Review and Meta-Analysis SO CARDIOLOGY RESEARCH AND PRACTICE LA English DT Review ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; CORONAVIRUS; PNEUMONIA; OUTBREAK; TROPONIN AB Background. Cardiac complications may develop in a proportion of patients with the novel coronavirus disease (COVID-19), which may influence their prognosis. Objectives. To assess the role of cardiac injury biomarkers measured on admission and during hospitalization as risk factors for subsequent death in COVID-19 patients. Methods. A systematic review and meta-analysis was carried out involving cohort studies that compared the levels of cardiac injury biomarkers in surviving and dead COVID-19 patients. Cardiac injury is defined as an elevation of the definitive markers (cardiac troponin (cTnI and cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)) above the 99th percentile upper reference limit. Secondary markers included creatine kinase-myocardial bound (CK-MB), myoglobin, interleukin-6 (IL-6), and C-reactive protein (CRP). The risk of death and the differences in marker concentrations were analyzed using risk ratios (RRs) and standardized mean differences (SMDs), respectively. Results. Nine studies met the inclusion criteria (1799 patients, 53.36% males, 20.62% with cardiac injury). The risk of death was significantly higher in patients with elevated cTn than those with normal biomarker levels (RR = 5.28, P<0.0001). Compared to survivors, dead patients had higher levels of cTn (SMD = 2.15, P=0.001), IL-6 (SMD = 3.13, P=0.03), hs-CRP (SMD = 2.78, P<0.0001), and CK-MB (SMD = 0.97, P<0.0001) on admission and a significant rise of plasma cTnT during hospitalization. Conclusion. COVID-19 patients with elevated cTn on admission, possibly due to immune-mediated myocardial injury, are at increased risk for mortality. This requires further radiographic investigations, close monitoring, and aggressive care to reduce the risk of severe complications and death. C1 [Alzahrani, Sami H.] King Abdulaziz Univ, Fac Med, Family Med Dept, Jeddah, Saudi Arabia. [Al-Rabia, Mohammed W.] King Abdulaziz Univ, Fac Med, Dept Med Microbiol & Parasitol, Jeddah, Saudi Arabia. C3 King Abdulaziz University; King Abdulaziz University RP Alzahrani, SH (通讯作者)，King Abdulaziz Univ, Fac Med, Family Med Dept, Jeddah, Saudi Arabia. EM drsamihz@gmail.com RI alzahrani, sami/C-8235-2015 OI alzahrani, sami/0000-0001-6786-7184 FU Deanship of Scientific Research (DSR), King Abdulaziz University, Jeddah, Saudi Arabia FX The authors are thankful to the administration of King Abdulaziz University for their support to the team during the work of this article.This research was funded by the Deanship of Scientific Research (DSR), King Abdulaziz University, Jeddah, Saudi Arabia. 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Res. Pract. PD MAR 18 PY 2021 VL 2021 AR 9363569 DI 10.1155/2021/9363569 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA RH5UF UT WOS:000636282700001 PM 33815838 OA gold, Green Published DA 2023-05-13 ER PT J AU Roncella, A Pristipino, C Cianfrocca, C Scorza, S Pasceri, V Pelliccia, F Denollet, J Pedersen, SS Speciale, G AF Roncella, Adriana Pristipino, Christian Cianfrocca, Cinzia Scorza, Silvia Pasceri, Vincenzo Pelliccia, Francesco Denollet, Johan Pedersen, Susanne S. Speciale, Giulio TI One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial SO INTERNATIONAL JOURNAL OF CARDIOLOGY LA English DT Article DE Angioplasty; Myocardial infarction; Prevention; Psychotherapy ID ACUTE CORONARY SYNDROMES; SECONDARY PREVENTION; CARDIAC PATIENTS; STRESS-RESPONSE; HEART-DISEASE; DEPRESSION; THERAPY; CARE; BEHAVIOR; EVENTS AB Background: Previous studies on cognitive and interpersonal interventions have yielded inconsistent results in ischemic heart disease patients. Methods: 101 patients aged <= 70 years, and enrolled one week after complete revascularization with urgent/emergent angioplasty for an AMI, were randomized to standard cardiological therapy plus short-term humanistic-existential psychotherapy (STP) versus standard cardiological therapy only. Primary composite end point was: one-year incidence of new cardiological events (re-infarction, death, stroke, revascularization, life-threatening ventricular arrhythmias, and the recurrence of typical and clinically significant angina) and of clinically significant new comorbidities. Secondary end points were: rates for individual components of the primary outcome, incidence of re-hospitalizations for cardiological problems, New York Heart Association class, and psychometric test scores at follow-up. Results: 94 patients were analyzed at one year. The two treatment groups were similar across all baseline characteristics. At follow-up, STP patients had had a lower incidence of the primary endpoint, relative to controls (21/49 vs. 35/45 patients; p < 0.0006, respectively; NNT = 3); this benefit was attributable to the lower incidence of recurrent angina and of new comorbidities in the STP group (14/49 vs. 22/45 patients, p = 0.04, NNT = 5; and 5/49 vs. 25/45, p < 0.0001, NNT = 3, respectively). Patients undergoing STP also had statistically fewer rehospitalizations, a better NYHA class, higher quality of life, and lower depression scores. Conclusion: Adding STP to cardiological therapy improves cardiological symptoms, quality of life, and psychological and medical outcomes one year post AMI, while reducing the need for re-hospitalizations. Larger studies remain necessary to confirm the generalizability of these results. Clinical trial registration: ClinicalTrial.gov: NCT00769366 (c) 2013 Elsevier Ireland Ltd. All rights reserved. C1 [Roncella, Adriana; Pristipino, Christian; Scorza, Silvia; Pasceri, Vincenzo; Pelliccia, Francesco; Speciale, Giulio] San Filippo Neri Hosp, Intervent Cardiol Unit, I-00135 Rome, Italy. [Cianfrocca, Cinzia] San Filippo Neri Hosp, Dept Cardiol, I-00135 Rome, Italy. [Denollet, Johan; Pedersen, Susanne S.] Tilburg Univ, CoRPS Ctr Res Psychol Somat Dis, NL-5000 LE Tilburg, Netherlands. [Denollet, Johan; Pedersen, Susanne S.] Erasmus MC, Dept Cardiol, Ctr Thorax, Rotterdam, Netherlands. [Denollet, Johan] Univ Antwerp Hosp, Dept Cardiol, Antwerp, Belgium. C3 San Filippo Neri Hospital; San Filippo Neri Hospital; Tilburg University; Erasmus University Rotterdam; Erasmus MC; University of Antwerp RP Pristipino, C (通讯作者)，Via Alessandro Poerio 140, I-00152 Rome, Italy. 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J. Cardiol. PD DEC 10 PY 2013 VL 170 IS 2 BP 132 EP 139 DI 10.1016/j.ijcard.2013.08.094 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA 264OU UT WOS:000327889200018 PM 24239154 DA 2023-05-13 ER PT J AU Holman, RR Bethel, MA Mentz, RJ Thompson, VP Lokhnygina, Y Buse, JB Chan, JC Choi, J Gustavson, SM Iqbal, N Maggioni, AP Marso, SP Ohman, P Pagidipati, NJ Poulter, N Ramachandran, A Zinman, B Hernandez, AF AF Holman, Rury R. Bethel, M. Angelyn Mentz, Robert J. Thompson, Vivian P. Lokhnygina, Yuliya Buse, John B. Chan, Juliana C. Choi, Jasmine Gustavson, Stephanie M. Iqbal, Nayyar Maggioni, Aldo P. Marso, Steven P. Ohman, Peter Pagidipati, Neha J. Poulter, Neil Ramachandran, Ambady Zinman, Bernard Hernandez, Adrian F. CA EXSCEL Study Grp TI Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID GLUCOSE CONTROL; MORTALITY; RISK AB BACKGROUND The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P < 0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P = 0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. C1 [Holman, Rury R.; Bethel, M. Angelyn] Univ Oxford, Oxford Ctr Diabet Endocrinol & Metab, Diabet Trials Unit, Oxford, England. [Poulter, Neil] Imperial Coll London, Int Ctr Circulatory Hlth, London, England. [Mentz, Robert J.; Thompson, Vivian P.; Lokhnygina, Yuliya; Pagidipati, Neha J.; Hernandez, Adrian F.] Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA. [Buse, John B.] Univ N Carolina, Sch Med, Div Endocrinol, Chapel Hill, NC USA. [Chan, Juliana C.] Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China. [Choi, Jasmine; Gustavson, Stephanie M.; Iqbal, Nayyar; Ohman, Peter] AstraZeneca Res & Dev, Gaithersburg, MD USA. [Maggioni, Aldo P.] Assoc Nazl Med Cardiol Osped ANMCO Res Ctr, Florence, Italy. [Marso, Steven P.] Univ Texas Southwestern Med Ctr Dallas, Dept Cardiol, Dallas, TX 75390 USA. [Ramachandran, Ambady] India Diabet Res Fdn, Madras, Tamil Nadu, India. [Ramachandran, Ambady] Dr Ramachandrans Diabet Hosp, Madras, Tamil Nadu, India. [Zinman, Bernard] Mt Sinai Hosp, Lunenfeld Tanenbaum Res Inst, Toronto, ON, Canada. [Zinman, Bernard] Univ Toronto, Toronto, ON, Canada. C3 RLUK- Research Libraries UK; University of Oxford; RLUK- Research Libraries UK; Imperial College London; Duke University; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of Medicine; Chinese University of Hong Kong; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO); University of Texas System; University of Texas Southwestern Medical Center Dallas; University of Toronto; Sinai Health System Toronto; Lunenfeld Tanenbaum Research Institute; University of Toronto RP Holman, RR (通讯作者)，Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, Diabet Trials Unit, Oxford OX3 7LJ, England. EM rury.holman@dtu.ox.ac.uk RI Khokhlov, Alexander L./E-2765-2017; Hernandez, Adrian F/A-7818-2016; Chan, Juliana/B-7918-2016; Lyudmila, Suplotova A/J-3596-2014; Panina, Svitlana/W-2900-2019; Dziemidok, Piotr/A-7283-2013; Maggioni, Aldo Pietro/AAL-5334-2020; GUERRERO, DIEGO BELLIDO/C-9446-2017; Mentz, Robert/AAV-4758-2021; Koshelskaya, Olga/M-8197-2016; Martynyuk, Liliya/AAE-5475-2019; Zinman, Bernard/E-7266-2013; Urina-Triana, Miguel A/H-2605-2016; Fernández-Balsells, Mercè/AHC-4689-2022; Buse, John Bernard/J-9742-2019; Genovese, Stefano/F-9706-2017; Urbanavicius, Vaidotas/D-4907-2016 OI Khokhlov, Alexander L./0000-0002-0032-0341; Hernandez, Adrian F/0000-0003-3387-9616; Chan, Juliana/0000-0003-1325-1194; Lyudmila, Suplotova A/0000-0001-9253-8075; Panina, Svitlana/0000-0003-1080-7185; Maggioni, Aldo Pietro/0000-0003-2764-6779; GUERRERO, DIEGO BELLIDO/0000-0003-0631-2710; Koshelskaya, Olga/0000-0002-6679-1269; Urina-Triana, Miguel A/0000-0001-6003-4622; Fernández-Balsells, Mercè/0000-0001-8221-4237; Buse, John Bernard/0000-0002-9723-3876; Wong, Yee Weng/0000-0003-2645-154X; Jordan, Dedrick/0000-0002-0706-9583; Mentz, Robert/0000-0002-3222-1719; Arguelles, Inaki/0000-0002-2144-7413; Cuddihy, Robert/0000-0003-1296-0511; Barrientos Perez, Margarita/0000-0002-7089-7576; tripathy, devjit/0000-0003-2797-0659; Lecube, Albert/0000-0001-9684-0183; Hancu, Nicolae/0000-0002-4688-5110; Pieber, Thomas/0000-0003-3554-0405; Barkai, Laszlo Lajos/0000-0003-2970-3263; Olexa, Peter/0000-0002-1846-4554; Lanas, Fernando/0000-0003-3595-9759; Genovese, Stefano/0000-0002-6085-437X; Tinahones, Francisco J/0000-0001-6871-4403; Urbanavicius, Vaidotas/0000-0002-8601-4563; Gorelick, Fred/0000-0001-8293-6803; Andres-Castillo, Alcira/0000-0002-6622-9436 FU Amylin Pharmaceuticals; AstraZeneca FX Supported by Amylin Pharmaceuticals, a wholly owned subsidiary of AstraZeneca. CR Blonde L, 2015, CARDIOVASC DIABETOL, V14, DOI 10.1186/s12933-014-0171-2 Department of Health and Human Services, 2008, GUID IND DIAB MELL E European Medicines Agency, 2011, ASS REP BYD European Medicines Agency, 2012, GUID CLIN INV MED PR Green JB, 2015, NEW ENGL J MED, V373, P232, DOI 10.1056/NEJMoa1501352 GRIMM M, 2013, POSTGRAD MED, V125 Henry RR, 2016, DIABETES TECHNOL THE, V18, P677, DOI 10.1089/dia.2016.0107 Holman RR, 2016, AM HEART J, V174, P103, DOI 10.1016/j.ahj.2015.12.009 Knop FK, 2017, EXPERT OPIN PHARMACO, V18, P555, DOI 10.1080/14656566.2017.1282463 Lorenzi G, 2010, CLIN DIABETES, V28, P157 Marso SP, 2016, NEW ENGL J MED, V375, P311, DOI 10.1056/NEJMoa1603827 Mentz RJ, 2017, AM HEART J, V187, P1, DOI 10.1016/j.ahj.2017.02.005 Neal B, 2017, NEW ENGL J MED, V377, P644, DOI 10.1056/NEJMoa1611925 Pfeffer MA, 2015, NEW ENGL J MED, V373, P2247, DOI 10.1056/NEJMoa1509225 Sarwar N, 2010, LANCET, V375, P2215, DOI 10.1016/S0140-6736(10)60484-9 Scirica BM, 2013, NEW ENGL J MED, V369, P1317, DOI 10.1056/NEJMoa1307684 Tancredi M, 2015, NEW ENGL J MED, V373, P1720, DOI 10.1056/NEJMoa1504347 Turnbull FM, 2009, DIABETOLOGIA, V52, P2288, DOI 10.1007/s00125-009-1470-0 Turner RC, 1998, LANCET, V352, P837, DOI 10.1016/s0140-6736(98)07019-6 White WB, 2013, NEW ENGL J MED, V369, P1327, DOI 10.1056/NEJMoa1305889 Zinman B, 2015, NEW ENGL J MED, V373, P2117, DOI 10.1056/NEJMoa1504720 Zoungas S, 2017, LANCET DIABETES ENDO, V5, P431, DOI 10.1016/S2213-8587(17)30104-3 NR 22 TC 1149 Z9 1198 U1 5 U2 117 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 EI 1533-4406 J9 NEW ENGL J MED JI N. Engl. J. Med. PD SEP 28 PY 2017 VL 377 IS 13 BP 1228 EP 1239 DI 10.1056/NEJMoa1612917 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA FI3DU UT WOS:000411838100006 PM 28910237 OA Green Published, Green Accepted DA 2023-05-13 ER PT J AU Ekerstad, N Javadzadeh, D Alexander, KP Bergstrom, O Eurenius, L Fredrikson, M Gudnadottir, G Held, C Angerud, KH Jahjah, R Jernberg, T Mattsson, E Melander, K Mellbin, L Ohlsson, M Ravn-Fischer, A Svennberg, L Yndigegn, T Alfredsson, J AF Ekerstad, Niklas Javadzadeh, Dariush Alexander, Karen P. Bergstrom, Olle Eurenius, Lars Fredrikson, Mats Gudnadottir, Gudny Held, Claes Angerud, Karin Hellstrom Jahjah, Radwan Jernberg, Tomas Mattsson, Ewa Melander, Kjell Mellbin, Linda Ohlsson, Monica Ravn-Fischer, Annica Svennberg, Lars Yndigegn, Troels Alfredsson, Joakim TI Clinical Frailty Scale classes are independently associated with 6-month mortality for patients after acute myocardial infarction SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Myocardial infarction; Clinical Frailty Scale; Risk prediction; Mortality ID ACUTE CORONARY SYNDROMES; ELDERLY-PATIENTS; OUTCOMES; IMPACT; CARE; MANAGEMENT; STRATEGY; CHOICE; OLDER AB Aims Data on the prognostic value of frailty to guide clinical decision-making for patients with myocardial infarction (MI) are scarce. To analyse the association between frailty classification, treatment patterns, in-hospital outcomes, and 6-month mortality in a large population of patients with MI. Methods and results An observational, multicentre study with a retrospective analysis of prospectively collected data using the SWEDEHEART registry. In total, 3381 MI patients with a level of frailty assessed using the Clinical Frailty Scale (CFS-9) were included. Of these patients, 2509 (74.2%) were classified as non-vulnerable non-frail (CFS 1-3), 446 (13.2%) were vulnerable non-frail (CFS 4), and 426 (12.6%) were frail (CFS 5-9). Frailty and non-frail vulnerability were associated with worse in-hospital outcomes compared with non-frailty, i.e. higher rates of mortality (13.4% vs. 4.0% vs. 1.8%), cardiogenic shock (4.7% vs. 2.5% vs. 1.9%), and major bleeding (4.5% vs. 2.7% vs. 1.1%) (all P < 0.001), and less frequent use of evidence-based therapies. In Cox regression analyses, frailty was strongly and independently associated with 6-month mortality compared with non-frailty, after adjustment for age, sex, the GRACE risk score components, and other potential risk factors [hazard ratio (HR) 3.32, 95% confidence interval (CI) 2.30-4.79]. A similar pattern was seen for vulnerable non-frail patients (fully adjusted HR 2.07, 95% CI 1.41-3.02). Conclusion Frailty assessed with the CFS was independently and strongly associated with all-cause 6-month mortality, also after comprehensive adjustment for baseline differences in other risk factors. Similarly, non-frail vulnerability was independently associated with higher mortality compared with those with preserved functional ability. C1 [Ekerstad, Niklas] Linkoping Univ, Dept Hlth Med & Caring Sci, Unit Hlth Care Anal, Sandbacksgatan 7, S-758183 Linkoping, Sweden. [Ekerstad, Niklas] Linkoping Univ, Natl Ctr Prior Hlth, Sandbacksgatan 7, S-758183 Linkoping, Sweden. [Ekerstad, Niklas] NU Hosp Grp, Res & Dev Unit, Trollhattan, Sweden. [Javadzadeh, Dariush] NU Hosp Grp, Dept Cardiol, Trollhattan, Sweden. [Alexander, Karen P.] Duke Univ, Duke Clin Res Inst, Durham, NC USA. [Bergstrom, Olle] Vaxjo Cty Hosp, Dept Med, Vaxjo, Sweden. [Eurenius, Lars] Karolinska Univ Hosp, Dept Clin Physiol, Stockholm, Sweden. [Fredrikson, Mats] Linkoping Univ, Fac Med & Hlth, Dept Biomed & Clin Sci, Linkoping, Sweden. [Gudnadottir, Gudny] Sahlgrens Univ Hosp, Dept Acute Med & Geriatr, Sect Geriatr, Gothenburg, Sweden. [Held, Claes] Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden. [Angerud, Karin Hellstrom] Umea Univ, Heart Ctr, Dept Nursing, Umea, Sweden. [Jahjah, Radwan; Alfredsson, Joakim] Linkoping Univ, Dept Cardiol, Unit Cardiovasc Sci, Linkoping, Sweden. [Jahjah, Radwan; Alfredsson, Joakim] Linkoping Univ, Dept Hlth Med & Caring Sci, Unit Cardiovasc Sci, Linkoping, Sweden. [Jernberg, Tomas] Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden. [Mattsson, Ewa] Skane Univ Hosp, Dept Cardiol, Lund, Sweden. [Melander, Kjell] Kalix Hosp, Dept Med, Kalix, Sweden. [Mellbin, Linda] Karolinska Inst, Dept Med Solna, Stockholm, Sweden. [Ohlsson, Monica] Karolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden. [Ravn-Fischer, Annica] Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Cardiol, Gothenburg, Sweden. [Svennberg, Lars] Reg Gavleborg, Dept Cardiol, Cty Hosp Gavle, Gavle, Sweden. [Yndigegn, Troels] Lund Univ, Dept Cardiol, Lund, Sweden. C3 Linkoping University; Linkoping University; NU Hospital Group; NU Hospital Group; Duke University; Karolinska Institutet; Karolinska University Hospital; Linkoping University; Sahlgrenska University Hospital; Uppsala University; Umea University; Linkoping University; Linkoping University; Danderyds Hospital; Karolinska Institutet; Lund University; Skane University Hospital; Karolinska Institutet; Karolinska Institutet; Karolinska University Hospital; University of Gothenburg; Lund University RP Ekerstad, N (通讯作者)，Linkoping Univ, Dept Hlth Med & Caring Sci, Unit Hlth Care Anal, Sandbacksgatan 7, S-758183 Linkoping, Sweden.; Ekerstad, N (通讯作者)，Linkoping Univ, Natl Ctr Prior Hlth, Sandbacksgatan 7, S-758183 Linkoping, Sweden.; Ekerstad, N (通讯作者)，NU Hosp Grp, Res & Dev Unit, Trollhattan, Sweden.; Alfredsson, J (通讯作者)，Linkoping Univ, Dept Cardiol, Unit Cardiovasc Sci, Linkoping, Sweden. EM niklas.ekerstad@liu.se; joakim.alfredsson@liu.se RI Mellbin, Linda/L-8779-2017 OI Held, Claes/0000-0001-9402-7404 CR Alegre O, 2016, CLIN CARDIOL, V39, P373, DOI 10.1002/clc.22550 Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Salinas GLA, 2018, GERONTOLOGY, V64, P422, DOI 10.1159/000488390 Anand A, 2020, BMC GERIATR, V20, DOI 10.1186/s12877-020-1500-9 Batty J, 2019, INT J CARDIOL, V274, P45, DOI 10.1016/j.ijcard.2018.09.086 Dodson JA, 2020, ANN INTERN MED, V172, P12, DOI 10.7326/M19-0974 Dou QY, 2019, BMC GERIATR, V19, DOI 10.1186/s12877-019-1242-8 Eagle KA, 2004, JAMA-J AM MED ASSOC, V291, P2727, DOI 10.1001/jama.291.22.2727 Ekerstad N, 2018, EUR J PREV CARDIOL, V25, P1813, DOI 10.1177/2047487318799438 Ekerstad N, 2011, CIRCULATION, V124, P2397, DOI 10.1161/CIRCULATIONAHA.111.025452 Fried LP, 2001, J GERONTOL A-BIOL, V56, pM146, DOI 10.1093/gerona/56.3.M146 Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345 Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Kaeppeli T, 2020, ANN EMERG MED, V76, P291, DOI 10.1016/j.annemergmed.2020.03.028 Koo TK, 2016, J CHIROPR MED, V15, P155, DOI 10.1016/j.jcm.2016.02.012 Kundi H, 2019, JAMA CARDIOL, V4, P1084, DOI 10.1001/jamacardio.2019.3511 Patel A, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.118.009859 Rittger H, 2020, CLIN INTERV AGING, V15, P723, DOI 10.2147/CIA.S249017 Rockwood K, 2005, CAN MED ASSOC J, V173, P489, DOI 10.1503/cmaj.050051 Rockwood K, 2020, CAN GERIATR J, V23, P254, DOI 10.5770/cgj.23.463 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Rothwell PM, 2005, LANCET, V365, P82, DOI 10.1016/S0140-6736(04)17670-8 Savonitto S, 2012, JACC-CARDIOVASC INTE, V5, P906, DOI 10.1016/j.jcin.2012.06.008 Shimura T, 2017, CIRCULATION, V135, P2013, DOI 10.1161/CIRCULATIONAHA.116.025630 Swedeheart, RIKS HIA ARSR 2018 Tegn N, 2016, LANCET, V387, P1057, DOI 10.1016/S0140-6736(15)01166-6 The Swedish National Board of Health and Welfare, 2019, REP NAT BOARD HLTH W Theou O, 2018, BMC GERIATR, V18, DOI 10.1186/s12877-018-0823-2 Thygesen K., 2018, GLOB HEART, V138, P618, DOI 10.1161/CIR.0000000000000617 Walker DM, 2018, EUR HEART J-ACUTE CA, V7, P176, DOI 10.1177/2048872618758931 White HD, 2016, EUR HEART J-ACUTE CA, V5, P231, DOI 10.1177/2048872615581502 Wild D, 2005, VALUE HEALTH, V8, P94, DOI 10.1111/j.1524-4733.2005.04054.x World Health Organization (WHO), 2015, FACT SHEET AG HLTH NR 33 TC 5 Z9 5 U1 1 U2 2 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 PD FEB 8 PY 2022 VL 11 IS 2 BP 89 EP 98 DI 10.1093/ehjacc/zuab114 EA DEC 2021 PG 10 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA YW0LC UT WOS:000753112100003 PM 34905049 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Ganasegeran, K Rashid, A AF Ganasegeran, Kurubaran Rashid, Abdul TI The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia SO PATIENT PREFERENCE AND ADHERENCE LA English DT Article DE medication nonadherence; myocardial infarction; perceived barriers; psychology ID ACUTE MYOCARDIAL-INFARCTION; SECONDARY PREVENTION MEDICATIONS; ACUTE CORONARY SYNDROME; LONG-TERM ADHERENCE; SELF-RATED HEALTH; PREHOSPITAL DELAY; LIFE CHAOS; CARE; POPULATION; ASSOCIATION AB Background: Although evidence-based practice has shown the benefits of prescribed cardioprotective drugs in post-myocardial infarction (MI) survivors, adherence rates remain suboptimal. The aim of this study was to determine the prevalence and factors associated with medication nonadherence among post-MI survivors in Malaysia. Materials and methods: This cross-sectional study was conducted from February to September 2016 among 242 post-MI survivors aged 24-96 years at the cardiology outpatient clinic in a Malaysian cardiac specialist center. The study utilized an interviewer-administered questionnaire that consisted of items adapted and modified from the validated Simplified Medication Adherence Questionnaire, sociodemographics, health factors, perceived barriers, and novel psychological attributes, which employed the modified Confusion, Hubbub, and Order Scale and the Verbal Denial in Myocardial Infarction questionnaire. Results: The prevalence of medication nonadherence was 74%. In the multivariable model, denial of illness (AOR 1.2, 95% CI 0.9-1.8; P=0.032), preference to traditional medicine (AOR 8.7, 95% CI 1.1-31.7; P=0.044), lack of information about illness (AOR 3.3, 95% CI 1.1-10.6; P=0.045), fear of side effects (AOR 6.4, 95% CI 2.5-16.6; P<0.001), and complex regimen (AOR 5.2, 95% CI 1.9-14.2; P=0.001) were statistically significant variables associated with medication nonadherence. Conclusion: The relatively higher medication-nonadherence rate in this study was associated with patient-, provider-, and therapy-related factors and the novel psychological attribute denial of illness. Future research should explore these factors using robust methodological techniques to determine temporality among these factors. C1 [Ganasegeran, Kurubaran; Rashid, Abdul] Penang Med Coll, Dept Publ Hlth Med, George Town 10450, Penang, Malaysia. RP Ganasegeran, K (通讯作者)，Penang Med Coll, Dept Publ Hlth Med, George Town 10450, Penang, Malaysia. EM medkuru@yahoo.com RI ; Ganasegeran, Kurubaran/E-4931-2013 OI rashid, abdul/0000-0003-1520-8480; Ganasegeran, Kurubaran/0000-0002-9480-1815 FU Clinical Research Centre of Tengku Ampuan Rahimah Hospital [CRC-HTAR-01/16] FX We thank Dr Kamaraj Selvaraj (deputy head of department, Cardiology Unit of Serdang Hospital), Dr Muralitharan Perumal (head of unit, Clinical Research Centre of Tengku Ampuan Rahimah Hospital), Dr Bahanordin Jaafar (head of Rehabilitation Unit, Tengku Ampuan Rahimah Hospital), Dr Rohisham Zainal Abidin (head of Anesthesiology Department, Tengku Ampuan Rahimah Hospital), and Mr Wilson Perianayagam (chief medical assistant for Selangor state, Selangor Health Department) for their support, encouragement, advice, and approval for conducting this study. This research project was funded by a mini-research seed grant from the Clinical Research Centre of Tengku Ampuan Rahimah Hospital (grant CRC-HTAR-01/16). 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Adherence PY 2017 VL 11 BP 1975 EP 1985 DI 10.2147/PPA.S151053 PG 11 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA FP6HB UT WOS:000417724700001 PM 29263654 OA Green Submitted, Green Published, gold DA 2023-05-13 ER PT J AU Arora, S Stouffer, GA Kucharska-Newton, A Vaduganathan, M Qamar, A Matsushita, K Kolte, D Reynolds, HR Bangalore, S Rosamond, WD Bhatt, DL Caughey, MC AF Arora, Sameer Stouffer, George A. Kucharska-Newton, Anna Vaduganathan, Muthiah Qamar, Arman Matsushita, Kunihiro Kolte, Dhaval Reynolds, Harmony R. Bangalore, Sripal Rosamond, Wayne D. Bhatt, Deepak L. Caughey, Melissa C. TI Fifteen-Year Trends in Management and Outcomes of Non-ST-Segment-Elevation Myocardial Infarction Among Black and White Patients: The ARIC Community Surveillance Study, 2000-2014 SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE guideline adherence; myocardial infarction; quality of care; race ID ACUTE CORONARY SYNDROMES; RACIAL-DIFFERENCES; HEART-DISEASE; REVASCULARIZATION PROCEDURES; CARDIOVASCULAR HEALTH; ATHEROSCLEROSIS RISK; SCIENTIFIC STATEMENT; ETHNIC-DIFFERENCES; AFRICAN-AMERICANS; CRUSADE AB Background-Standardization of evidence-based medical therapies has improved outcomes for patients with non-ST-segment-elevation myocardial infarction (NSTEMI). Although racial differences in NSTEMI management have previously been reported, it is uncertain whether these differences have been ameliorated over time. Methods and Results-The ARIC (Atherosclerosis Risk in Communities) Community Surveillance study conducts hospital surveillance of acute myocardial infarction in 4 US communities. NSTEMI was classified by physician review, using a validated algorithm. From 2000 to 2014, 17 755 weighted hospitalizations for NSTEMI (patient race: 36% black, 64% white) were sampled by ARIC. Black patients were younger (aged 60 versus 66 years), more often female (45% versus 38%), and less likely to have medical insurance (88% versus 93%) but had more comorbidities. Black patients were less often administered aspirin (85% versus 92%), other antiplatelet therapy (45% versus 60%), beta-blockers (85% versus 88%), and lipid-lowering medications (68% versus 76%). After adjustments, black patients had a 24% lower probability of receiving nonaspirin antiplatelets (relative risk: 0.76; 95% confidence interval, 0.71-0.81), a 29% lower probability of angiography (relative risk: 0.71; 95% confidence interval, 0.67-0.76), and a 45% lower probability of revascularization (relative risk: 0.55; 95% confidence interval, 0.50-0.60). No suggestion of a changing trend over time was observed for any NSTEMI therapy (P values for interaction, all > 0.20). Conclusions-This longitudinal community surveillance of hospitalized NSTEMI patients suggests black patients have more comorbidities and less likelihood of receiving guideline-based NSTEMI therapies, and these findings persisted across the 15-year period. Focused efforts to reduce comorbidity burden and to more consistently implement guideline-directed treatments in this high-risk population are warranted. C1 [Arora, Sameer; Stouffer, George A.; Caughey, Melissa C.] Univ N Carolina, Sch Med, Div Cardiol, Chapel Hill, NC 27515 USA. [Kucharska-Newton, Anna; Rosamond, Wayne D.] Univ N Carolina, Dept Epidemiol, Gillings Sch Global Publ Hlth, Chapel Hill, NC 27515 USA. [Vaduganathan, Muthiah; Qamar, Arman; Bhatt, Deepak L.] Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA. [Vaduganathan, Muthiah; Qamar, Arman; Bhatt, Deepak L.] Harvard Med Sch, Boston, MA USA. [Matsushita, Kunihiro] Johns Hopkins Bloomberg, Dept Epidemiol, Sch Publ Hlth, Baltimore, MD USA. [Matsushita, Kunihiro] Johns Hopkins Sch Med, Div Cardiol, Baltimore, MD USA. [Kolte, Dhaval] Brown Univ, Div Cardiol, Warren Alpert Med Sch, Providence, RI 02912 USA. [Reynolds, Harmony R.; Bangalore, Sripal] NYU, Sch Med, Leon H Charney Div Cardiol, New York, NY USA. C3 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; Harvard University; Brigham & Women's Hospital; Harvard University; Harvard Medical School; Johns Hopkins University; Johns Hopkins Bloomberg School of Public Health; Johns Hopkins University; Johns Hopkins Medicine; Brown University; New York University RP Caughey, MC (通讯作者)，Univ N Carolina, Div Cardiol, Chapel Hill, NC 27599 USA. EM caughey@med.unc.edu RI Reynolds, Harmony/AAU-3154-2021; Kolte, Dhaval/AAL-4032-2020; Matsushita, Kunihiro/AAJ-5817-2020; Stouffer, George/AAK-4763-2021 OI Reynolds, Harmony/0000-0003-0284-0655; Matsushita, Kunihiro/0000-0002-7179-718X; Bangalore, Sripal/0000-0001-9485-0652; Arora, Sameer/0000-0002-6387-3015 FU NHLBI (National Heart, Lung, and Blood Institute) [HHSN-268201100005C, HHSN268201100006C, HHSN26820-1100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN-268201100012C] FX The ARIC (Atherosclerosis Risk in Communities) study is carried out as a collaborative study supported by NHLBI (National Heart, Lung, and Blood Institute) contracts (HHSN-268201100005C, HHSN268201100006C, HHSN26820-1100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN-268201100012C). 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Am. Heart Assoc. PD OCT 2 PY 2018 VL 7 IS 19 AR e010203 DI 10.1161/JAHA.118.010203 PG 20 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA HD8QG UT WOS:000452823000039 PM 30371336 OA Green Published, gold DA 2023-05-13 ER PT J AU Alvarez-Rodrgiuez, E Morales, IL Tuya, AR Santamaria, RT Martinez, AM Riquelme, PL Palomares, RM Sanchez, IP AF Alvarez-Rodrgiuez, Esther Laguna Morales, Inmaculada Rosende Tuya, Alicia Tapia Santamaria, Raquel Martin Martinez, Alfonso Lopez Riquelme, Pascual Merinero Palomares, Ral Portero Sanchez, Isabel TI Frequency and management of diabetes and hyperglycemia at emergency departments: The GLUCE-URG study SO ENDOCRINOLOGIA DIABETES Y NUTRICION LA English DT Article DE Diabetes; Emergency room; Hyperglycemia ID INTENSIVE INSULIN THERAPY; ACUTE MYOCARDIAL-INFARCTION; CRITICALLY-ILL PATIENTS; ACUTE CORONARY SYNDROME; CLINICAL INERTIA; MORTALITY; MELLITUS; CARE; ADMISSION; MARKER AB Introduction: Hyperglycemia is a common finding at hospital emergency rooms in diabetic patients, but few data are available on its frequency, management, and subsequent impact based on the assessment made at emergency rooms. Objectives: To ascertain the frequency of diabetes mellitus and hyperglycemia in patients admitted from emergency rooms. Second, to describe management of hyperglycemia at emergency rooms, and to analyze its potential impact on the course and management of patients during admission. Patients and methods: All patients admitted from the emergency room for three consecutive weeks were enrolled. Hyperglycemia was defined as two blood glucose measurements >= 180 mg/dL in the first 48 h after admission. Results: 36.6% of patients admitted from the emergency room were diabetic, and 58% of these had early, sustained hyperglycemia. On the other hand, 27% of patients admitted from the emergency room had hyperglycemia (78.3% of diabetic patients and 21.7% with no known diabetes). Diabetic patients with hyperglycemia had higher blood glucose levels than non-diabeticpatients (p < 0.01). Average hospital stay was 8 +/- 6.4 days, with no differences between the groups. Hyperglycemia is rarely reported as a diagnosis in the emergency rooms discharge report. In standard hospitalization, this diagnosis appears more commonly in patients with known diabetes (OR 2.5; p < 0.001). Conclusions: Prevalence of diabetic patients admitted from emergency rooms is very high. In addition, although hyperglycemia is very common in patients admitted from emergency rooms, there is a trend to underestimate its significance. Based on our results, we think that implementation of measures to give greater visibility to diagnosis of hyperglycemia could help improve application of established protocols. (C) 2017 SEEN. Published by Elsevier Espana, S.L.U. All rights reserved. C1 [Alvarez-Rodrgiuez, Esther; Martin Martinez, Alfonso; Lopez Riquelme, Pascual] Hosp Univ Severo Ochoa, Serv Urgencias Gener, Madrid, Spain. [Alvarez-Rodrgiuez, Esther; Laguna Morales, Inmaculada; Rosende Tuya, Alicia; Tapia Santamaria, Raquel; Martin Martinez, Alfonso; Lopez Riquelme, Pascual] Univ Alfonso X el Sabio, Madrid, Spain. [Alvarez-Rodrgiuez, Esther] Grp Trabajo SEMES Diabet, Madrid, Spain. [Merinero Palomares, Ral; Portero Sanchez, Isabel] Univ Complutense, Fac Med, Dept Med, Madrid, Spain. C3 Severo Ochoa University Hospital; Universidad Alfonso X el Sabio (UAX); Complutense University of Madrid RP Alvarez-Rodrgiuez, E (通讯作者)，Hosp Univ Severo Ochoa, Serv Urgencias Gener, Madrid, Spain.; Alvarez-Rodrgiuez, E (通讯作者)，Univ Alfonso X el Sabio, Madrid, Spain.; Alvarez-Rodrgiuez, E (通讯作者)，Grp Trabajo SEMES Diabet, Madrid, Spain. EM diabetes@portalsemes.org RI Martin, Alfonso/O-8996-2017 OI Martin, Alfonso/0000-0003-3874-7401; Alvarez-Rodriguez, Esther/0000-0002-6596-9299; Portero Sanchez, Isabel/0000-0003-4770-8332 CR Villa TA, 2015, EMERGENCIAS, V27, P150 Amer Diabet Assoc, 2014, DIABETES CARE, V37, pS14, DOI 10.2337/dc14-S014 Baker EH, 2006, THORAX, V61, P284, DOI 10.1136/thx.2005.051029 Cabrerizo-Garcia JL, 2011, REV CLIN ESP, V211, P275, DOI 10.1016/j.rce.2011.01.009 Capes SE, 2001, STROKE, V32, P2426, DOI 10.1161/hs1001.096194 Cook CB, 2007, J HOSP MED, V2, P203, DOI 10.1002/jhm.188 Cook Curtiss B, 2008, J Diabetes Sci Technol, V2, P925 Cook Curtiss B, 2009, J Hosp Med, V4, pE7, DOI 10.1002/jhm.533 Abadal AC, 2008, REV ESP CARDIOL, V61, P447, DOI 10.1016/S1885-5857(08)60156-5 Deedwania P, 2008, CIRCULATION, V117, P1610, DOI 10.1161/CIRCULATIONAHA.107.188629 Griesdale DEG, 2009, CAN MED ASSOC J, V180, P821, DOI 10.1503/cmaj.090206 Griffith ML, 2012, J CLIN ENDOCR METAB, V97, P2019, DOI 10.1210/jc.2011-3216 Hellkvist F, 2011, DAN MED BULL, V58 Knecht LAD, 2006, J HOSP MED, V1, P151, DOI 10.1002/jhm.94 Kosiborod M, 2005, CIRCULATION, V111, P3078, DOI 10.1161/CIRCULATIONAHA.104.517839 Lee PH, 2014, DIABETES TECHNOL THE, V16, P150, DOI 10.1089/dia.2013.0168 Malmberg K, 1999, CIRCULATION, V99, P2626, DOI 10.1161/01.CIR.99.20.2626 Metchick LN, 2002, AM J MED, V113, P317, DOI 10.1016/S0002-9343(02)01213-5 Perez Antonio Perez, 2009, Endocrinol Nutr, V56, P303, DOI 10.1016/S1575-0922(09)71945-X Perez AP, 2009, MED CLIN-BARCELONA, V132, P465, DOI 10.1016/j.medcli.2009.02.001 Soriguer F, 2012, DIABETOLOGIA, V55, P88, DOI 10.1007/s00125-011-2336-9 Umpierrez GE, 2002, J CLIN ENDOCR METAB, V87, P978, DOI 10.1210/jc.87.3.978 Umpierrez G, 2006, J HOSP MED, V1, P141, DOI 10.1002/jhm.101 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 Zelihic E, 2015, EUR J EMERG MED, V22, P181, DOI 10.1097/MEJ.0000000000000199 NR 26 TC 4 Z9 5 U1 0 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 2530-0180 J9 ENDOCRINOL DIAB NUTR JI Endocrinol. Diabetes Nutr. PD FEB PY 2017 VL 64 IS 2 BP 67 EP 74 DI 10.1016/j.endien.2017.03.005 PG 8 WC Endocrinology & Metabolism; Nutrition & Dietetics WE Science Citation Index Expanded (SCI-EXPANDED) SC Endocrinology & Metabolism; Nutrition & Dietetics GA EY2IS UT WOS:000403792400002 PM 28440780 DA 2023-05-13 ER PT J AU Shen, L Shah, BR Li, S Thomas, L Wang, TY Alexander, KP Peterson, ED He, B Roe, MT AF Shen, Lan Shah, Bimal R. Li, Shuang Thomas, Laine Wang, Tracy Y. Alexander, Karen P. Peterson, Eric D. He, Ben Roe, Matthew T. TI The Association of Transfer Rate From Hospitals Without Revascularization Capabilities and Mortality Risk for Older Non-ST-Segment Elevation Myocardial Infarction Patients SO CLINICAL CARDIOLOGY LA English DT Article ID ACUTE CORONARY SYNDROMES; QUALITY-OF-CARE; ELDERLY-PATIENTS; COLLABORATION; INTERVENTION; MANAGEMENT; CARDIOLOGY; EMERGENCY; OUTCOMES; SOCIETY AB Background: Interhospital transfer invasive management patterns and implications for older non-ST-segment elevation myocardial infarction (NSTEMI) patients initially presenting to non-revascularization-capable hospitals have not been explored. Hypothesis: Patients admitted to hospitals with a higher transfer proportion have lower risk of long-term mortality. Methods: We linked CRUSADE Registry data on 5678 patients age >= 65 years from 65 United States non-revascularization-capable hospitals (2003-2006) with inpatient Medicare longitudinal claims. Hospitals were categorized according to hospital-level patient transfer-out rates, low (<= 40%) vs high (>40%). The associations between transfer-out rates and 30-day, 6-month, and 3-year mortality risk were evaluated using Cox proportional hazard models. Results: Hospital-level transfer-out rates varied widely (median, 43%; interquartile range, 31%-54%). Compared with patients from low-transfer-out hospitals (n = 2715), patients from high-transfer-out hospitals (n = 2963) were more likely to be male, less likely to have renal insufficiency and prior heart failure, and had lower long-term CRUSADE mortality risk scores. These patients also more commonly received evidence-based acute medications before transfer and underwent subsequent revascularization after transfer. The adjusted risks of mortality at various time intervals were similar for those from high-vs low-transfer-out hospitals: 30 days (hazard ratio: 0.95, 95% confidence interval: 0.79-1.14), 6 months (0.97, 0.84-1.12), and 3 years (1.01, 0.91-1.11). Conclusions: Transfer rates for older NSTEMI patients vary widely among non-revascularization-capable hospitals. Despite lower predicted mortality risk and higher rates of post-transfer revascularization, patients from high-transfer-out hospitals had a similar risk for short-and long-term mortality compared with those from low-transfer-out hospitals. C1 [Shen, Lan; He, Ben] Shanghai Jiao Tong Univ, Shanghai Renji Hosp, Sch Med, Dept Cardiol, Shanghai 200030, Peoples R China. [Shah, Bimal R.; Wang, Tracy Y.; Alexander, Karen P.; Peterson, Eric D.; Roe, Matthew T.] Duke Clin Res Inst, Dept Med, Durham, NC 27705 USA. [Li, Shuang; Thomas, Laine] Duke Clin Res Inst, Dept Biostat & Bioinformat, Durham, NC 27705 USA. C3 Shanghai Jiao Tong University; Duke University; Duke University RP Roe, MT (通讯作者)，Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA. EM matthew.roe@dm.duke.edu RI Peterson, Eric David/ABF-5033-2021 FU Schering-Plough Corporation; Bristol-Myers Squibb/Sanofi-Aventis Pharmaceuticals; Millennium Pharmaceuticals, Inc. FX CRUSADE is funded by the Schering-Plough Corporation. Bristol-Myers Squibb/Sanofi-Aventis Pharmaceuticals Partnership provided additional funding support. Millennium Pharmaceuticals, Inc. also funded this work. CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Barreto JA, 2014, JAMA INTERN MED, V174, P213, DOI 10.1001/jamainternmed.2013.11944 Brown JR, 2013, CLIN CARDIOL, V36, P570, DOI 10.1002/clc.22156 de Winter RJ, 2005, NEW ENGL J MED, V353, P1095, DOI 10.1056/NEJMoa044259 Hammill BG, 2009, AM HEART J, V157, P995, DOI 10.1016/j.ahj.2009.04.002 Henry TD, 2007, CIRCULATION, V116, P721, DOI 10.1161/CIRCULATIONAHA.107.694141 Hoekstra JW, 2002, ACAD EMERG MED, V9, P1146, DOI 10.1111/j.1553-2712.2002.tb01569.x Jneid H, 2012, CIRCULATION, V126, P875, DOI 10.1161/CIR.0b013e318256f1e0 Mehta RH, 2010, AM HEART J, V160, P405, DOI 10.1016/j.ahj.2010.06.025 Mehta SR, 2005, JAMA-J AM MED ASSOC, V293, P2908, DOI 10.1001/jama.293.23.2908 Montalescot G, 2009, JAMA-J AM MED ASSOC, V302, P947, DOI 10.1001/jama.2009.1267 Roe MT, 2008, AM HEART J, V156, P185, DOI 10.1016/j.ahj.2008.01.033 Roe MT, 2011, AM HEART J, V162, DOI 10.1016/j.ahj.2011.08.010 Savonitto S, 2012, JACC-CARDIOVASC INTE, V5, P906, DOI 10.1016/j.jcin.2012.06.008 Thukkani AK, 2014, CLIN CARDIOL, V37, P285, DOI 10.1002/clc.22246 NR 15 TC 3 Z9 3 U1 0 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0160-9289 EI 1932-8737 J9 CLIN CARDIOL JI Clin. Cardiol. PD DEC PY 2015 VL 38 IS 12 BP 733 EP 739 DI 10.1002/clc.22480 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DB1PA UT WOS:000368279600006 PM 26511331 OA Bronze, Green Published DA 2023-05-13 ER PT J AU Rymer, J McCoy, LA Thomas, L Peterson, ED Wang, TY AF Rymer, Jennifer McCoy, Lisa A. Thomas, Laine Peterson, Eric D. Wang, Tracy Y. TI Persistence of Evidence-Based Medication Use After Discharge from Academic Versus Nonacademic Hospitals Among Patients With Non-ST-Segment Elevation Myocardial Infarction SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE CORONARY SYNDROMES; LONG-TERM MORTALITY; CARE; NONADHERENCE; OUTCOMES AB There is increasing emphasis on optimizing evidence-based medication (EBM) persistence as a means to improve longitudinal patient outcomes after acute myocardial infarction (MI); yet it is unknown whether differences in medication persistence exist between patients discharged from academic versus nonacademic hospitals. We linked Medicare pharmacy claims data with 3,184 patients with non-ST-segment elevation MI >65 years of age who were treated in 2006 at 253 hospitals participating in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology and American Heart Association guidelines registry. Using multivariate regression, we compared persistent filling of beta blockers, angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers, clopidogrel, and statins at 90 days and 1 year postdischarge between patients discharged from academic and nonacademic hospitals. Patients treated at academic hospitals were more frequently nonwhite (19% vs 8%, p <0.001) and had a greater co-morbidity burden (Charlson score >= 4 in 36% vs 30%, p = 0.001) than patients treated at nonacademic hospitals. Composite persistence to all EBMs prescribed at discharge was low and not significantly different between academic and nonacademic hospitals at 90 days (46% vs 45%, adjusted incidence rate ratio = 0.99, 95% confidence interval 0.95 to 1.04) and at 1 year (39% vs 39%, adjusted incidence rate ratio = 1.02, 95% confidence interval 0.98 to 1.07). Rates of persistence to EBMs were similar between patients with MI >65 years old treated at academic versus nonacademic hospitals; however, persistence rates are low both early and late postdischarge, highlighting a continued need for quality improvement efforts to optimize post-MI management. (C) 2014 Elsevier Inc. All rights reserved. C1 [Rymer, Jennifer; Peterson, Eric D.; Wang, Tracy Y.] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. [McCoy, Lisa A.; Thomas, Laine; Peterson, Eric D.; Wang, Tracy Y.] Duke Clin Res Inst, Durham, NC USA. C3 Duke University; Duke University RP Rymer, J (通讯作者)，Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. EM Jennifer.rymer@duke.edu RI Peterson, Eric David/ABF-5033-2021 OI Rymer, Jennifer/0000-0001-9841-2393 FU National Institutes of Health/National Cancer Institute [KM1CA156687] FX This project was supported by grant number KM1CA156687 from the National Institutes of Health/National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health/National Cancer Institute. CR Allison JJ, 2000, JAMA-J AM MED ASSOC, V284, P1256, DOI 10.1001/jama.284.10.1256 Bhatt DL, 2004, JAMA-J AM MED ASSOC, V292, P2096, DOI 10.1001/jama.292.17.2096 Chen J, 1999, NEW ENGL J MED, V340, P286, DOI 10.1056/NEJM199901283400407 Choudhry NK, 2011, NEW ENGL J MED, V365, P2088, DOI 10.1056/NEJMsa1107913 Hammill BG, 2009, AM HEART J, V157, P995, DOI 10.1016/j.ahj.2009.04.002 Ho PM, 2008, AM HEART J, V155, P772, DOI 10.1016/j.ahj.2007.12.011 Hoekstra JW, 2002, ACAD EMERG MED, V9, P1146, DOI 10.1111/j.1553-2712.2002.tb01569.x Jackevicius CA, 2008, CIRCULATION, V117, P1028, DOI 10.1161/CIRCULATIONAHA.107.706820 Makaryus AN, 2005, MAYO CLIN PROC, V80, P991, DOI 10.4065/80.8.991 Patel MR, 2007, AM J MED, V120, P40, DOI 10.1016/j.amjmed.2006.10.008 Rao Krishnasree K, 2013, AM HEART J, V166, P709 Rasmussen JN, 2007, JAMA-J AM MED ASSOC, V297, P177, DOI 10.1001/jama.297.2.177 Roe MT, 2011, AM HEART J, V162, DOI 10.1016/j.ahj.2011.08.010 NR 13 TC 11 Z9 11 U1 0 U2 1 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 NOV 15 PY 2014 VL 114 IS 10 BP 1479 EP 1484 DI 10.1016/j.amjcard.2014.08.010 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA AT3LY UT WOS:000344837500003 PM 25440500 OA Green Accepted DA 2023-05-13 ER PT J AU Chen, QJ Wang, LL Li, C Hu, WH Fan, YM Chen, ZS Wu, LL Lu, ZJ Ye, JF Chen, SY Tong, JL Ruan, LM Mei, J Lu, HY AF Chen, Qijian Wang, Lingling Li, Chang Hu, Weihua Fan, Yameng Chen, Zaishu Wu, Longlong Lu, Zhanjin Ye, Jianfang Chen, Shiyan Tong, Junlu Ruan, Liemin Mei, Jin Lu, Hongyun TI Chronic Cardio-Metabolic Disease Increases the Risk of Worse Outcomes Among Hospitalized Patients With COVID-19: A Multicenter, Retrospective, and Real-World Study SO JOURNAL OF THE AMERICAN HEART ASSOCIATION LA English DT Article DE cardio-metabolic disease; complications; COVID-19; in-hospital mortality; risk factors; SARS-CoV-2 ID CORONAVIRUS; COMORBIDITIES AB Background Although chronic cardio-metabolic disease is a common comorbidity among patients with COVID-19, its effects on the clinical characteristics and outcome are not well known. Methods and Results This study aimed to explore the association between underlying cardio-metabolic disease and mortality with COVID-19 among hospitalized patients. This multicenter, retrospective, and real-world study was conducted from January 22, 2020 to March 25, 2020 in China. Data between patients with and without 5 main cardio-metabolic diseases including hypertension, diabetes mellitus, coronary heart disease, cerebrovascular disease, and hyperlipidemia were compared. A total of 1303 hospitalized patients were included in the final analysis. Of them, 520 patients (39.9%) had cardio-metabolic disease. Compared with patients without cardio-metabolic disease, more patients with cardio-metabolic disease had COVID-related complications including acute respiratory distress syndrome (9.81% versus 3.32%; P<0.001), acute kidney injury (4.23% versus 1.40%; P=0.001), secondary infection (13.9% versus 9.8%; P=0.026), hypoproteinemia (12.1% versus 5.75%; P<0.001), and coagulopathy (19.4% versus 10.3%; P<0.001), had higher incidences of the severe type of COVID-19 (32.9% versus 16.7%; P<0.001), more were admitted to the intensive care unit (11.7% versus 7.92%; P=0.021), and required mechanical ventilation (9.8% versus 4.3%; P<0.001). When the number of the patients' cardio-metabolic diseases was 0, 1, and >2, the mortality was 4.2%, 11.1%, and 19.8%, respectively. The multivariable-adjusted hazard ratio of mortality among patients with cardio-metabolic disease was 1.80 (95% CI, 1.17-2.77). Conclusions Cardio-metabolic disease was a common condition among hospitalized patients with COVID-19, and it was associated with higher risks of in-hospital mortality. C1 [Chen, Qijian] Fifth Hosp Wuhan, Dept Emergency, Wuhan, Hubei, Peoples R China. [Wang, Lingling; Lu, Zhanjin; Ye, Jianfang; Chen, Shiyan; Tong, Junlu] Sun Yat Sen Univ, Affiliated Hosp 5, Dept Endocrinol & Metab, Zhuhai, Guangdong, Peoples R China. [Wang, Lingling] Sun Yat Sen Univ, Affiliated Hosp 5, Dept Gerontol, Zhuhai, Guangdong, Peoples R China. [Li, Chang] Jianghan Univ, Hubei Peoples Hosp 3, Dept Cardiol, Wuhan, Hubei, Peoples R China. [Hu, Weihua] Yangtze Univ, Hosp Jingzhou 1, Clin Med Coll, Dept Resp Med, Jingzhou, Hubei, Peoples R China. [Fan, Yameng] Wuhan Univ, Sch Hlth Sci, Wuhan, Hubei, Peoples R China. [Chen, Zaishu] Peoples Hosp Jiayu Cty, Xianning, Hubei, Peoples R China. [Wu, Longlong] Peoples Hosp Nanzhang Cty, Nanzhang, Hubei, Peoples R China. [Ruan, Liemin; Mei, Jin] Zhejiang Univ, Ningbo Hosp 1, Cent Lab, Ningbo 315010, Zhejiang, Peoples R China. [Mei, Jin] Wenzhou Med Univ, Wenzhou Univ Town, Anat Dept, Ningbo, Zhejiang, Peoples R China. [Lu, Hongyun] Jinan Univ, Zhuhai Peoples Hosp, Zhuhai Hosp, Dept Endocrinol & Metab, Zhuhai 519000, Guangdong, Peoples R China. C3 Sun Yat Sen University; Sun Yat Sen University; Jianghan University; Yangtze University; Wuhan University; Zhejiang University; Wenzhou Medical University; Jinan University RP Mei, J (通讯作者)，Zhejiang Univ, Ningbo Hosp 1, Cent Lab, Ningbo 315010, Zhejiang, Peoples R China.; Mei, J (通讯作者)，Wenzhou Med Univ, Wenzhou Univ Town, Anat Dept, Ningbo, Zhejiang, Peoples R China.; Lu, HY (通讯作者)，Jinan Univ, Zhuhai Peoples Hosp, Zhuhai Hosp, Dept Endocrinol & Metab, Zhuhai 519000, Guangdong, Peoples R China. EM tibetcn@aliyun.com; luhongy@mail.sysu.edu.cn OI WANG, Lingling/0000-0001-8066-7638 FU National Natural Science Foundation of China [81570608]; Guangdong Basic and Applied Basic Research Foundation [2020A1515010124]; Special Fund for Innovation Strategy of Science and Technology Plan of Guangdong Province [2019A030317011] FX This study was supported by the National Natural Science Foundation of China (Grant 81970653 to Mei); National Natural Science Foundation of China (Grant 81570608 to Mei); Guangdong Basic and Applied Basic Research Foundation (Grant 2020A1515010124 to H. Lu); and Special Fund for Innovation Strategy of Science and Technology Plan of Guangdong Province (2019A030317011 to H. Lu). 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Am. Heart Assoc. PD JUN 15 PY 2021 VL 10 IS 12 AR e018451 DI 10.1161/JAHA.120.018451 PG 16 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA SS1VK UT WOS:000661529600013 PM 34096317 OA Green Published, gold DA 2023-05-13 ER PT J AU Mayberry, LS Schildcrout, JS Wallston, KA Goggins, K Mixon, AS Rothman, RL Kripalani, S AF Mayberry, Lindsay S. Schildcrout, Jonathan S. Wallston, Kenneth A. Goggins, Kathryn Mixon, Amanda S. Rothman, Russell L. Kripalani, Sunil CA Vanderbilt Inpatient Cohort Study TI Health Literacy and I-Year Mortality: Mechanisms of Association in Adults Hospitalized for Cardiovascular Disease SO MAYO CLINIC PROCEEDINGS LA English DT Article ID QUALITY-OF-LIFE; HEART-FAILURE; SELF-EFFICACY; CARE; OUTCOMES; NUMERACY; VALIDATION; RISK; COEFFICIENTS; PERCEPTIONS AB Objective: To test theorized patient-level mediators in the causal pathway between health literacy (HL) and 1-year mortality in adults with cardiovascular disease (CVD). Patients and Methods: A total of 3000 adults treated at Vanderbilt University Hospital from October 11, 2011, through December 18, 2015, for acute coronary syndrome or acute decompensated heart failure (ADHF) participated in the Vanderbilt Inpatient Cohort Study. Participants completed a bedside-administered survey and consented to health record review and longitudinal follow-up. Multivariable mediation models examined the direct and indirect effects of HL (a latent variable with 4 indicators) with 1-year mortality after discharge (dichotomous). Hypothesized mediators included social support, health competence, health behavior, comorbidity index, type of CVD diagnosis, and previous-year hospitalizations. Results: Of the 2977 patients discharged from the hospital (60% male; mean age, 61 years; 83% non-Hispanic white, 37% admitted for ADHF), 17% to 23% had inadequate HL depending on the measure, and 10% (n=304) died within 1 year. The total effect of lower HL on 1-year mortality (adjusted odds ratio [AOR]=1.31; 95% CI, 1.01-1.69) was decomposed into an indirect effect (AOR=1.50; 95% CI, 1.35-1.67) via the mediators and a nonsignificant direct effect (AOR=0.87; 95% CI, 0.66-1.14). Each SD decrease in HL was associated with an absolute 3.2 percentage point increase in the probability of 1-year mortality via mediators admitted for ADHF, comorbidities, health behavior, health competence, and previous-year hospitalizations (listed by contribution to indirect effect). Conclusion: Patient-level factors link low HL and mortality. Health competence and health behavior are modifiable mediators that could be targeted by interventions post hospitalization for CVD. (C) 2018 Mayo Foundation for Medical Education and Research. C1 [Mayberry, Lindsay S.; Mixon, Amanda S.; Rothman, Russell L.; Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN 37203 USA. [Mayberry, Lindsay S.] Vanderbilt Univ, Med Ctr, Ctr Hlth Behav & Hlth Educ, Nashville, TN 37203 USA. [Mayberry, Lindsay S.; Wallston, Kenneth A.; Goggins, Kathryn; Mixon, Amanda S.; Rothman, Russell L.; Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Ctr Hlth Serv Res, Nashville, TN 37203 USA. [Mayberry, Lindsay S.; Wallston, Kenneth A.; Goggins, Kathryn; Rothman, Russell L.; Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Ctr Effect Hlth Commun, Nashville, TN 37203 USA. [Schildcrout, Jonathan S.] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN 37203 USA. [Goggins, Kathryn; Kripalani, Sunil] Vanderbilt Univ, Med Ctr, Ctr Clin Qual & Implementat Res, Nashville, TN 37203 USA. [Wallston, Kenneth A.] Vanderbilt Univ, Sch Nursing, Nashville, TN 37203 USA. [Mixon, Amanda S.] VA Tennessee Valley Healthcare Syst, Geriatr Res Educ & Clin Ctr, Nashville, TN USA. C3 Vanderbilt University; 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 Mayberry, LS (通讯作者)，Vanderbilt Univ, Med Ctr, Dept Med, Div Gen Internal Med & Publ Hlth, 2525 W End Ave,Ste 370, Nashville, TN 37203 USA. EM lindsay.mayberry@vumc.org OI Bachmann, Justin/0000-0003-1064-5008; Rothman, Russsell/0000-0002-1506-3990 FU National Heart, Lung, and Blood Institute [R01 HL109388]; National Center for Advancing Translational Sciences [2 UL1 TR000445-06]; National Institute of Diabetes and Digestive and Kidney Diseases [K01 DK106306]; U.S. Department of Veterans Affairs Health Services Research and Development Program [12-168] FX The Vanderbilt Inpatient Cohort Study was supported by grant R01 HL109388 from the National Heart, Lung, and Blood Institute and in part by grant 2 UL1 TR000445-06 from the National Center for Advancing Translational Sciences. Dr Mayberry was supported by career development award K01 DK106306 from the National Institute of Diabetes and Digestive and Kidney Diseases. Dr Mixon was supported by Career Development Award 12-168 from the U.S. Department of Veterans Affairs Health Services Research and Development Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs. The funding agencies were not involved 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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Proc. PD DEC PY 2018 VL 93 IS 12 BP 1728 EP 1738 DI 10.1016/j.mayocp.2018.07.024 PG 11 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC General & Internal Medicine GA HC7UE UT WOS:000452006300009 PM 30414733 OA Green Accepted DA 2023-05-13 ER PT J AU Kavsak, PA Hewitt, MK Mondoux, SE Cerasuolo, JO Ma, JH Clayton, N McQueen, M Griffith, LE Perez, R Seow, H Ainsworth, C Ko, DT Worster, A AF Kavsak, Peter A. Hewitt, Mark K. Mondoux, Shawn E. Cerasuolo, Joshua O. Ma, Jinhui Clayton, Natasha McQueen, Matthew Griffith, Lauren E. Perez, Richard Seow, Hsien Ainsworth, Craig Ko, Dennis T. Worster, Andrew TI Diagnostic Performance of Serial High-Sensitivity Cardiac Troponin Measurements in the Emergency Setting SO JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE LA English DT Article DE death; myocardial infarction; high-sensitivity cardiac troponin; emergency department; diagnostic ID MYOCARDIAL-INFARCTION; RULE-OUT; RISK STRATIFICATION; OUTCOMES; ASSOCIATION; VALIDATION; ALGORITHMS; NG/L AB Serial high-sensitivity cardiac troponin (hsTn) testing in the emergency department (ED) and the intensive cardiac care unit may assist physicians in ruling out or ruling in acute myocardial infarction (MI). There are three major algorithms proposed for high-sensitivity cardiac troponin I (hsTnI) using serial measurements while incorporating absolute concentration changes for MI or death following ED presentation. We sought to determine the diagnostic estimates of these three algorithms and if one was superior in two different Canadian ED patient cohorts with serial hsTnI measurements. An undifferentiated ED population (Cohort-1) and an ED population with symptoms suggestive of acute coronary syndrome (ACS; Cohort-2) were clinically managed with non-hsTn testing with the hsTnI testing performed in real-time with physicians blinded to these results (i.e., hsTnI not reported). The three algorithms evaluated were the European Society of Cardiology (ESC), the High-STEACS pathway, and the COMPASS-MI algorithm. The diagnostic estimates were derived for each algorithm for the 30-day MI/death outcome for the rule-out and rule-in arm in each cohort and compared to proposed diagnostic benchmarks (i.e., sensitivity >= 99.0% and specificity >= 90.0%) with 95% confidence intervals (CI). In Cohort-1 (n = 2966 patients, 15.3% had outcome) and Cohort-2 (n = 935 patients, 15.6% had outcome), the algorithm that obtained the highest sensitivity (97.8%; 95% CI: 96.0-98.9 and 98.6%; 95% CI: 95.1-99.8, respectively) in both cohorts was COMPASS-MI. Only Cohort-2 with both the ESC and COMPASS-MI algorithms exceeded the specificity benchmark (97.0%; 95% CI: 95.5-98.0 and 96.7%; 95% CI: 95.2-97.8, respectively). Patient selection for serial hsTnI testing will affect specificity estimates, with no algorithm achieving a sensitivity >= 99% for 30-day MI or death. C1 [Kavsak, Peter A.; McQueen, Matthew] McMaster Univ, Dept Pathol & Mol Med, Hamilton, ON L8S 4L8, Canada. [Hewitt, Mark K.; Mondoux, Shawn E.; Worster, Andrew] McMaster Univ, Div Emergency Med, Hamilton, ON L8S 4L8, Canada. [Cerasuolo, Joshua O.; Perez, Richard; Seow, Hsien] McMaster Univ, Fac Hlth Sci, ICES McMaster, Hamilton, ON L8S 4K1, Canada. [Ma, Jinhui; Griffith, Lauren E.] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON L8S 4L8, Canada. [Clayton, Natasha] McMaster Univ, Dept Med, Hamilton, ON L8S 4L8, Canada. [Ainsworth, Craig] McMaster Univ, Div Cardiol, Hamilton, ON L8S 4L8, Canada. [Ko, Dennis T.] Sunnybrook Hlth Sci Ctr, ICES Cent, Toronto, ON M4N 3M5, Canada. C3 McMaster University; McMaster University; McMaster University; McMaster University; McMaster University; McMaster University; University of Toronto; Sunnybrook Health Science Center; Sunnybrook Research Institute RP Kavsak, PA (通讯作者)，McMaster Univ, Dept Pathol & Mol Med, Hamilton, ON L8S 4L8, Canada. EM kaysakp@mcmaster.ca; mark.hewitt@medportal.ca; shawn.e.mondoux@gmail.com; joshua.cerasuolo@ices.on.ca; maj26@mcmaster.ca; clayton@mcmaster.ca; mcquemat@hhsc.ca; griffith@mcmaster.ca; richard.perez@ices.on.ca; seowh@mcmaster.ca; ainswoc@mcmaster.ca; dennis.ko@ices.on.ca; worstea@mcmaster.ca RI Ko, Dennis/HNJ-5653-2023; Seow, Hsien/AAQ-1438-2021 OI Seow, Hsien/0000-0001-6701-1714; Ainsworth, Craig/0000-0002-4367-940X; Hewitt, Mark/0000-0002-8258-995X; Kavsak, Peter/0000-0003-4576-4744; Cerasuolo, Joshua/0000-0002-7882-6457 FU ICES - Ontario Ministry of Health (MOH); Ministry of Long-Term Care (MLTC) FX This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). Content enclosed is based on data and information compiled and provided by CIHI. Analyses, conclusions, opinions, and statements expressed herein are those of the authors and not necessarily those of CIHI; no endorsement is intended or should be inferred. We thank IQVIA Solutions Canada Inc. for use of their Drug Information File. CR Allen BR, 2021, CIRCULATION, V143, P1659, DOI 10.1161/CIRCULATIONAHA.120.049298 Anand A, 2021, CIRCULATION, V143, P2214, DOI [10.1161/circulationaha.120.052380, 10.1161/CIRCULATIONAHA.120.052380] Bossuyt PM, 2015, BMJ-BRIT MED J, V351, DOI [10.1136/bmj.h5527, 10.1148/radiol.2015151516, 10.1373/clinchem.2015.246280] Chapman AR, 2017, JAMA-J AM MED ASSOC, V318, P1913, DOI 10.1001/jama.2017.17488 Clifford-Mobley O, 2021, ANN CLIN BIOCHEM, V58, P157, DOI 10.1177/0004563220963852 Collet JP, 2021, EUR HEART J, V42, P1289, DOI 10.1093/eurheartj/ehaa575 Duceppe E, 2020, J AM COLL CARDIOL, V75, P110 Hammarsten O, 2013, CLIN BIOCHEM, V46, P1055, DOI 10.1016/j.clinbiochem.2013.03.022 Hickmand PE, 2018, CLIN BIOCHEM, V58, P60, DOI 10.1016/j.clinbiochem.2018.05.007 Kavsak PA, 2021, J CARDIOVASC DEV DIS, V8, DOI 10.3390/jcdd8030031 Kavsak PA, 2021, J CLIN MED, V10, DOI 10.3390/jcm10051014 Kavsak Peter A, 2020, CMAJ Open, V8, pE676, DOI 10.9778/cmajo.20200047 Kavsak PA, 2020, INT J CARDIOL, V319, P140, DOI 10.1016/j.ijcard.2020.06.066 Kavsak PA, 2020, J CLIN MED, V9, DOI 10.3390/jcm9092948 Kavsak Peter A, 2020, CJC Open, V2, P296, DOI 10.1016/j.cjco.2020.03.004 Kavsak PA, 2018, CAN MED ASSOC J, V190, pE974, DOI 10.1503/cmaj.180144 Kavsak PA, 2017, CAN J CARDIOL, V33, P898, DOI 10.1016/j.cjca.2017.04.011 Kavsak PA, 2015, CLIN CHEM, V61, P1209, DOI 10.1373/clinchem.2015.243345 Kaysak PA, 2017, CLIN CHEM, V63, P1043, DOI 10.1373/clinchem.2017.271361 Kufaishi H, 2016, ANN CLIN BIOCHEM, V53, P516, DOI 10.1177/0004563215613533 Lambrakis K, 2021, CIRCULATION, V144, P113, DOI 10.1161/CIRCULATIONAHA.121.055009 Lau G, 2020, AM HEART J, V221, P84, DOI 10.1016/j.ahj.2019.12.007 Meah MN, 2020, LANCET, V395, P1878, DOI 10.1016/S0140-6736(20)30635-8 Neumann JT, 2019, NEW ENGL J MED, V380, P2529, DOI 10.1056/NEJMoa1803377 Pickering JW, 2019, CIRCULATION, V139, P1351, DOI 10.1161/CIRCULATIONAHA.118.038418 Pickering JW, 2017, ANN INTERN MED, V166, P715, DOI 10.7326/M16-2562 Pickering JW, 2016, CIRCULATION, V134, P1532, DOI 10.1161/CIRCULATIONAHA.116.022677 Reichlin T, 2015, CAN MED ASSOC J, V187, pE243, DOI 10.1503/cmaj.141349 Sandoval Y, 2021, CLIN CHEM, V67, P321, DOI 10.1093/clinchem/hvaa263 Sandoval Y, 2019, J AM COLL CARDIOL, V74, P271, DOI 10.1016/j.jacc.2019.05.058 Shah ASV, 2015, LANCET, V386, P2481, DOI 10.1016/S0140-6736(15)00391-8 Shortt C, 2017, CLIN CHEM, V63, P403, DOI 10.1373/clinchem.2016.261545 Than M, 2013, INT J CARDIOL, V166, P752, DOI 10.1016/j.ijcard.2012.09.171 Than MP, 2019, CIRCULATION, V140, P899, DOI 10.1161/CIRCULATIONAHA.119.041980 Thygesen K., 2018, CIRCULATION 2018 Wildi K, 2021, CLIN BIOCHEM, V91, P16, DOI 10.1016/j.clinbiochem.2021.02.006 Wu AHB, 2018, CLIN CHEM, V64, P645, DOI 10.1373/clinchem.2017.277186 NR 37 TC 8 Z9 8 U1 0 U2 0 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 2308-3425 J9 J CARDIOVASC DEV DIS JI J. 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PD AUG PY 2021 VL 8 IS 8 AR 97 DI 10.3390/jcdd8080097 PG 12 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA UI5KC UT WOS:000690644800001 PM 34436239 OA gold, Green Published DA 2023-05-13 ER PT J AU Rodriguez-Gonzalez, M Castellano-Martinez, A Cascales-Poyatos, HM Perez-Reviriego, AA AF Rodriguez-Gonzalez, Moises Castellano-Martinez, Ana Cascales-Poyatos, Helena Maria Perez-Reviriego, Alvaro Antonio TI Cardiovascular impact of COVID-19 with a focus on children: A systematic review SO WORLD JOURNAL OF CLINICAL CASES LA English DT Review DE COVID-19; SARS-CoV-2; Congenital heart diseases; Myocardial dysfunction; Pediatric Multisystem Inflammatory Syndrome; Cardiac Biomarkers ID MULTISYSTEM INFLAMMATORY SYNDROME; KAWASAKI-LIKE DISEASE; CONGENITAL HEART-DISEASE; SARS-COV-2 INFECTION; CORONAVIRUS DISEASE; MIS-C; CLINICAL CHARACTERISTICS; HOSPITALIZED-PATIENTS; MANAGEMENT; STATEMENT AB BACKGROUND Since the beginning of the pandemic, coronavirus disease-2019 (COVID-19) in children has shown milder cases and a better prognosis than adults. Although the respiratory tract is the primary target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cardiovascular involvement is emerging as one of the most significant and life-threatening complications of SARS-CoV-2 infection in adults. AIM To summarize the current knowledge about the potential cardiovascular involvement in pediatric COVID-19 in order to give a perspective on how to take care of them during the current pandemic emergency. METHODS Multiple searches in MEDLINE, PubMed were performed using the search terms "COVID-19" or "SARS-CoV-2" were used in combination with "myocardial injury" or "arrhythmia" or "cardiovascular involvement" or "heart disease" or "congenital heart disease" or "pulmonary hypertension" or "long QT" or "cardiomyopathies" or "channelopathies" or "Multisystem inflammatory system" or "PMIS" or "MIS-C" or "Pediatric multisystem inflammatory syndrome" or "myocarditis" or "thromboembolism to identify articles published in English language from January 1st, 2020 until July 31st, 2020. The websites of World Health Organization, Centers for Disease control and Prevention, and the Johns Hopkins Coronavirus Resource Center were reviewed to provide up to date numbers and infection control recommendations. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts concerning the subject were reviewed by the authors, and the data were extracted using a standardized collection tool. Data were subsequently analyzed with descriptive statistics. For Pediatric multisystemic inflammatory syndrome temporally associated with COVID-19 (PMIS), multiple meta-analyses were conducted to summarize the pooled mean proportion of different cardiovascular variables in this population in pseudo-cohorts of observed patients. RESULTS A total of 193 articles were included. Most publications used in this review were single case reports, small case series, and observational small-sized studies or literature reviews. The meta-analysis of 16 studies with size > 10 patients and with complete data about cardiovascular involvement in children with PMIS showed that PMIS affects mostly previously healthy school-aged children and adolescents presenting with Kawasaki disease-like features and multiple organ failure with a focus on the heart, accounting for most cases of pediatric COVID-19 mortality. They frequently presented cardiogenic shock (53%), ECG alterations (27%), myocardial dysfunction (52%), and coronary artery dilation (15%). Most cases required PICU admission (75%) and inotropic support (57%), with the rare need for extracorporeal membrane oxygenation (4%). Almost all of these children wholly recovered in a few days, although rare deaths have been reported (2%). Out of PMIS cases we identified 10 articles reporting sporadic cases of myocarditis, pulmonary hypertension and cardiac arrythmias in previously healthy children. We also found another 10 studies reporting patients with pre-existing heart diseases. Most cases consisted in children with severe COVID-19 infection with full recovery after intensive care support, but cases of death were also identified. The management of different cardiac conditions are provided based on current guidelines and expert panel recommendations. CONCLUSION There is still scarce data about the role of cardiovascular involvement in COVID-19 in children. Based on our review, children (previously healthy or with pre-existing heart disease) with acute COVID-19 requiring hospital admission should undergo a cardiac workup and close cardiovascular monitoring to identify and treat timely life-threatening cardiac complications. C1 [Rodriguez-Gonzalez, Moises] Puerta Mar Univ Hosp, Div Pediat Cardiol, 21 Ana Viya Ave, Cadiz 11009, Spain. [Rodriguez-Gonzalez, Moises; Castellano-Martinez, Ana] Puerta Mar Univ Hosp, Biomed Res & Innovat Inst Cadiz, Cadiz 11009, Spain. 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Clin. Cases PD NOV 6 PY 2020 VL 8 IS 21 BP 5250 EP 5283 DI 10.12998/wjcc.v8.i21.5250 PG 34 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA PA5RI UT WOS:000595692200017 PM 33269260 OA gold, Green Published DA 2023-05-13 ER PT J AU Vazquez-Benitez, G Desai, JR Xu, S Goodrich, GK Schroeder, EB Nichols, GA Segal, J Butler, MG Karter, AJ Steiner, JF Newton, KM Morales, LS Pathak, RD Thomas, A Reynolds, K Kirchner, HL Waitzfelder, B Lafata, JE Adibhatla, R Xu, ZY O'Connor, PJ AF Vazquez-Benitez, Gabriela Desai, Jay R. Xu, Stanley Goodrich, Glenn K. Schroeder, Emily B. Nichols, Gregory A. Segal, Jodi Butler, Melissa G. Karter, Andrew J. Steiner, John F. Newton, Katherine M. Morales, Leo S. Pathak, Ram D. Thomas, Abraham Reynolds, Kristi Kirchner, H. Lester Waitzfelder, Beth Lafata, Jennifer Elston Adibhatla, Renuka Xu, Zhiyuan O'Connor, Patrick J. TI Preventable Major Cardiovascular Events Associated With Uncontrolled Glucose, Blood Pressure, and Lipids and Active Smoking in Adults With Diabetes With and Without Cardiovascular Disease: A Contemporary Analysis SO DIABETES CARE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; POSITIVE PREDICTIVE-VALUE; RISK-FACTORS; HEART-FAILURE; ATTRIBUTABLE FRACTIONS; ATHEROSCLEROSIS RISK; MORTALITY; DIAGNOSIS; BURDEN; COMMUNITIES AB OBJECTIVEThe objective of this study was to assess the incidence of major cardiovascular (CV) hospitalization events and all-cause deaths among adults with diabetes with or without CV disease (CVD) associated with inadequately controlled glycated hemoglobin (A1C), high LDL cholesterol (LDL-C), high blood pressure (BP), and current smoking.RESEARCH DESIGN AND METHODSStudy subjects included 859,617 adults with diabetes enrolled for more than 6 months during 2005-2011 in a network of 11 U.S. integrated health care organizations. Inadequate risk factor control was classified as LDL-C 100 mg/dL, A1C 7% (53 mmol/mol), BP 140/90 mm Hg, or smoking. Major CV events were based on primary hospital discharge diagnoses for myocardial infarction (MI) and acute coronary syndrome (ACS), stroke, or heart failure (HF). Five-year incidence rates, rate ratios, and average attributable fractions were estimated using multivariable Poisson regression models.RESULTSMean (SD) age at baseline was 59 (14) years; 48% of subjects were female, 45% were white, and 31% had CVD. Mean follow-up was 59 months. Event rates per 100 person-years for adults with diabetes and CVD versus those without CVD were 6.0 vs. 1.7 for MI/ACS, 5.3 vs. 1.5 for stroke, 8.4 vs. 1.2 for HF, 18.1 vs. 40 for all CV events, and 23.5 vs. 5.0 for all-cause mortality. The percentages of CV events and deaths associated with inadequate risk factor control were 11% and 3%, respectively, for those with CVD and 34% and 7%, respectively, for those without CVD.CONCLUSIONSAdditional attention to traditional CV risk factors could yield further substantive reductions in CV events and mortality in adults with diabetes. C1 [Vazquez-Benitez, Gabriela; Desai, Jay R.; Adibhatla, Renuka; Xu, Zhiyuan; O'Connor, Patrick J.] HealthPartners Inst Educ & Res, Minneapolis, MN 55440 USA. [Xu, Stanley; Goodrich, Glenn K.; Schroeder, Emily B.; Steiner, John F.] Kaiser Permanente Inst Hlth Res, Denver, CO USA. [Nichols, Gregory A.] Kaiser Permanente Ctr Hlth Res, Portland, OR USA. [Segal, Jodi] Johns Hopkins Med, Baltimore, MD USA. [Butler, Melissa G.] Kaiser Permanente Georgia, Ctr Hlth Res Southeast, Atlanta, GA USA. [Karter, Andrew J.] Kaiser Permanente No Calif, Div Res, Oakland, CA USA. [Newton, Katherine M.] Grp Hlth Res Inst, Seattle, WA USA. [Morales, Leo S.] Univ Washington, Sch Med, Seattle, WA USA. [Pathak, Ram D.] Marshfield Clin Fdn Med Res & Educ, Dept Endocrinol, Marshfield, WI USA. [Thomas, Abraham; Lafata, Jennifer Elston] Lutheran Med Ctr, Brooklyn, NY USA. [Reynolds, Kristi] Kaiser Permanente So Calif, Dept Res & Evaluat, Pasadena, CA 91101 USA. [Kirchner, H. Lester] Geisinger Hlth Syst, Danville, PA USA. [Waitzfelder, Beth] Kaiser Permanente Ctr Hlth Res, Honolulu, HI USA. [Lafata, Jennifer Elston] Virginia Commonwealth Univ, Sch Med, Richmond, VA USA. C3 Kaiser Permanente; Kaiser Permanente; Johns Hopkins University; Johns Hopkins Medicine; Kaiser Permanente; Kaiser Permanente; University of Washington; University of Washington Seattle; Marshfield Clinic; Kaiser Permanente; Geisinger Health System; Kaiser Permanente; Virginia Commonwealth University RP Vazquez-Benitez, G (通讯作者)，HealthPartners Inst Educ & Res, Minneapolis, MN 55440 USA. EM gabriela.x.vazquezbenitez@healthpartners.com RI Reynolds, Kristi/AAN-1434-2021; Morales, Leo S/N-3793-2014; O'Connor, Patrick/HII-2987-2022 OI Reynolds, Kristi/0000-0001-7619-1649; O'Connor, Patrick/0000-0002-2324-6228; Desai, Jay/0000-0002-3010-8501 FU Agency for Healthcare Research and Quality [R01HS019859] FX This project was supported by grant number R01HS019859 from the Agency for Healthcare Research and Quality. 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Method: Data collected included patients' responses to the self-administrated 'Outpatient Cardiac Rehabilitation Program Evaluation' form, after attending a cardiac rehabilitation program. The evaluation involved analysis of 9 binary and open ended questions. A retrospective study was completed on data collected from January 2010 to December 2015 (6 years) and included 643 adult cases comprising 500 men and 143 women. A between subject t-Test was used to compare patient means before and after attendance of perceived changes to their lifestyle, and overall sense of physical and emotional well-being. Fishers Exact Test was used to compare attendance percentages, gender distribution, and primary diagnosis. Results: Two hundred and seventy nine (43.4%) of the 643 invited patients participated in the cardiac rehabilitation program, while 364 (56.6%) declined, with this result being significantly lower (p < 0.001) than those reported in other Australian locations. The sex distribution of those that participated was 234 (83.8%) males and 45 (16.2%) females while those that declined were 266 (73.1%) males and 98 (23.9%) females. The male prevalence of both attendance and non-attendance was significant (p < 0.001). Patients with a primary referral diagnosis of having a percutaneous coronary intervention and acute myocardial infarction were significantly (p <0.05) more likely to decline cardiac rehabilitation. Of those who participated, 96.1% indicated they received benefits from attending the cardiac rehabilitation program, with 96.8% identifying significant changes to their lifestyle (p < 0.01) and sense of well-being improvement (p < 0.001) as key benefits, in addition to perceived quicker recovery. According to participants, these positive outcomes resulted from a healthier diet, exercise, better stress management, and support from other patients with similar conditions. The major reasons for declining participation was not wanting to attend' (19.3%), 'referred to another hospital service' (10.6%), and 'work related commitments' (7.3%). Conclusion: Considering the reported benefits of attending cardiac rehabilitation, the number of people who decline to attend has important implications for their health and related health system costs related to ongoing disease. (C) 2018 Australian College of Nursing Ltd. Published by Elsevier Ltd. C1 [Gardiner, Fergus William; Nwose, Ezekiel Uba; Crockett, Judith] Charles Sturt Univ, Sch Community Hlth, Bathurst, NSW, Australia. [Gardiner, Fergus William; Regan, Elizabeth; Park, Bo Kyung] Calvary Publ Hosp Bruce, Bruce, ACT, Australia. [Bwititi, Phillip Taderera; Wang, Lexin] Charles Sturt Univ, Sch Biomed Sci, Bathurst, NSW, Australia. C3 Charles Sturt University; Charles Sturt University RP Gardiner, FW (通讯作者)，Charles Sturt Univ, Sch Community Hlth, Bathurst, NSW, Australia. EM gus.gardiner@health.gov.au RI Nwose, Uba/AAM-8625-2021; wang, le/HKN-3406-2023; Gardiner, Fergus William/U-2226-2019; Bwititi, Phillip/HTP-8025-2023 OI Nwose, Uba/0000-0003-1318-9853; Gardiner, Fergus William/0000-0001-7592-832X; CR ADES PA, 1992, AM J CARDIOL, V69, P1422, DOI 10.1016/0002-9149(92)90894-5 ADES PA, 1992, ARCH INTERN MED, V152, P1033, DOI 10.1001/archinte.152.5.1033 Aragam KG, 2011, AM HEART J, V161, P544, DOI 10.1016/j.ahj.2010.11.016 Arena R, 2012, CIRCULATION, V125, P1321, DOI 10.1161/CIR.0b013e318246b1e5 Bardach SH, 2016, J COMMUN HEALTH, V41, P22, DOI 10.1007/s10900-015-0058-5 Black PH, 2002, J PSYCHOSOM RES, V52, P1, DOI 10.1016/S0022-3999(01)00302-6 Brotman DJ, 2007, LANCET, V370, P1089, DOI 10.1016/S0140-6736(07)61305-1 Burns DM, 2003, PROG CARDIOVASC DIS, V46, P11, DOI 10.1016/S0033-0620(03)00079-3 Clark AM, 2012, AM HEART J, V164, P835, DOI 10.1016/j.ahj.2012.08.020 Clark AM, 2005, ANN INTERN MED, V143, P659, DOI 10.7326/0003-4819-143-9-200511010-00010 Cooper AF, 2002, CLIN REHABIL, V16, P541, DOI 10.1191/0269215502cr524oa de Vries H, 2015, EUR HEART J, V36, P1519, DOI 10.1093/eurheartj/ehv111 Dunlay SM, 2009, AM HEART J, V158, P852, DOI 10.1016/j.ahj.2009.08.010 Gardiner FW, 2017, DIABETES METAB SYND, V11, pS1025, DOI 10.1016/j.dsx.2017.07.034 Heran BS, 2011, COCHRANE DB SYST REV, DOI [10.1002/14651858.CD001800.pub3, 10.1002/14651858.CD001800.pub2] Keib CN, 2010, HEART LUNG, V39, P504, DOI 10.1016/j.hrtlng.2009.11.006 Lakka HM, 2002, JAMA-J AM MED ASSOC, V288, P2709, DOI 10.1001/jama.288.21.2709 Laukkanen JA, 2015, EUR HEART J, V36, P1500, DOI 10.1093/eurheartj/ehv138 Lavie CJ, 2011, PROG CARDIOVASC DIS, V53, P397, DOI 10.1016/j.pcad.2011.02.008 MCGEE HM, 1992, BRIT MED J, V305, P283, DOI 10.1136/bmj.305.6848.283-a Oldridge N.B., 1992, J CARDIOPULM REHABIL, V12, P25 Papadakis S, 2005, EUR J CARDIOV PREV R, V12, P513 Perk J, 2012, EUR HEART J, V33, P1635, DOI 10.1093/eurheartj/ehs092 Piepoli MF, 2010, EUR J CARDIOV PREV R, V17, P1, DOI 10.1097/HJR.0b013e3283313592 Schuster P M, 1991, Rehabil Nurs, V16, P248 Sjoland H, 1999, J INTERN MED, V245, P445, DOI 10.1046/j.1365-2796.1999.00500.x Taylor RS, 2004, AM J MED, V116, P682, DOI 10.1016/j.amjmed.2004.01.009 The Heart Foundation of Australia, 2004, REC FRAM CARD REH NA Wenger NK, 2008, J AM COLL CARDIOL, V51, P1619, DOI 10.1016/j.jacc.2008.01.030 WENGER NK, 1993, NEW ENGL J MED, V329, P247, DOI 10.1056/NEJM199307223290406 Worcester MUC, 2004, EUR J CARDIOV PREV R, V11, P328, DOI 10.1097/01.hjr.0000137083.20844.54 World Health Organization, 2013, CARDIOVASCULAR DIS NR 32 TC 5 Z9 5 U1 0 U2 12 PU ELSEVIER PI AMSTERDAM PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS SN 1322-7696 EI 1876-7575 J9 COLLEGIAN JI Collegian PD OCT PY 2018 VL 25 IS 5 BP 479 EP 485 DI 10.1016/j.colegn.2018.01.001 PG 7 WC Nursing WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Nursing GA GX4VI UT WOS:000447735300002 DA 2023-05-13 ER PT J AU Thorup, C Hansen, J Gronkjaer, M Andreasen, JJ Nielsen, G Sorensen, EE Dinesen, BI AF Thorup, Charlotte Hansen, John Gronkjaer, Mette Andreasen, Jan Jesper Nielsen, Gitte Sorensen, Erik Elgaard Dinesen, Birthe Irene TI Cardiac Patients' Walking Activity Determined by a Step Counter in Cardiac Telerehabilitation: Data From the Intervention Arm of a Randomized Controlled Trial SO JOURNAL OF MEDICAL INTERNET RESEARCH LA English DT Article DE heart disease; rehabilitation; step counters; physical activity; telerehabilitation ID INCREASE PHYSICAL-ACTIVITY; SECONDARY PREVENTION; POSTMYOCARDIAL INFARCTION; RISK-FACTORS; REHABILITATION; EXERCISE; FAILURE; ADULTS; CARE; PEDOMETERS AB Background: Walking represents a large part of daily physical activity. It reduces both overall and cardiovascular diseases and mortality and is suitable for cardiac patients. A step counter measures walking activity and might be a motivational tool to increase and maintain physical activity. There is a lack of knowledge about both cardiac patients' adherence to step counter use in a cardiac telerehabilitation program and how many steps cardiac patients walk up to 1 year after a cardiac event. Objective: The purpose of this substudy was to explore cardiac patients' walking activity. The walking activity was analyzed in relation to duration of pedometer use to determine correlations between walking activity, demographics, and medical and rehabilitation data. Methods: A total of 64 patients from a randomized controlled telerehabilitation trial (Teledi@log) from Aalborg University Hospital and Hjoerring Hospital, Denmark, from December 2012 to March 2014 were included in this study. Inclusion criteria were patients hospitalized with acute coronary syndrome, heart failure, and coronary artery bypass grafting or valve surgery. In Teledi@log, the patients received telerehabilitation technology and selected one of three telerehabilitation settings: a call center, a community health care center, or a hospital. Monitoring of steps continued for 12 months and a step counter (Fitbit Zip) was used to monitor daily steps. Results: Cardiac patients walked a mean 5899 (SD 3274) steps per day, increasing from mean 5191 (SD 3198) steps per day in the first week to mean 7890 (SD 2629) steps per day after 1 year. Adherence to step counter use lasted for a mean 160 (SD 100) days. The patients who walked significantly more were younger (P=. 01) and continued to use the pedometer for a longer period (P=. 04). Furthermore, less physically active patients weighed more. There were no significant differences in mean steps per day for patients in the three rehabilitation settings or in the disease groups. Conclusions: This study indicates that cardiac telerehabilitation at a call center can support walking activity just as effectively as telerehabilitation at either a hospital or a health care center. In this study, the patients tended to walk fewer steps per day than cardiac patients in comparable studies, but our study may represent a more realistic picture of walking activity due to the continuation of step counter use. Qualitative studies on patients' behavior and motivation regarding step counter use are needed to shed light on adherence to and motivation to use step counters. C1 [Thorup, Charlotte; Andreasen, Jan Jesper] Aalborg Univ Hosp, Dept Cardiothorac Surg, Sondre Skovvej 5,313, DK-9000 Aalborg, Denmark. [Thorup, Charlotte; Andreasen, Jan Jesper; Sorensen, Erik Elgaard] Aalborg Univ, Dept Clin Med, Aalborg, Denmark. [Hansen, John] Aalborg Univ, Fac Med, Dept Hlth Sci & Technol, Lab Cardio Technol,Med Informat Grp, Aalborg, Denmark. [Gronkjaer, Mette; Sorensen, Erik Elgaard] Aalborg Univ Hosp, Clin Nursing Res Unit, Aalborg, Denmark. [Nielsen, Gitte] Vendsyssel Hosp, Dept Cardiol, Hjorring, Denmark. [Dinesen, Birthe Irene] Aalborg Univ, Fac Med, Dept Hlth Sci & Technol, Lab Assist Technol Telehlth & Telerehabil,SMI, Aalborg, Denmark. C3 Aalborg University; Aalborg University Hospital; Aalborg University; Aalborg University; Aalborg University; Aalborg University Hospital; Aalborg University RP Thorup, C (通讯作者)，Aalborg Univ Hosp, Dept Cardiothorac Surg, Sondre Skovvej 5,313, DK-9000 Aalborg, Denmark. EM cbt@rn.dk RI Hansen, John/I-5886-2012 OI Hansen, John/0000-0003-4989-8117; Sorensen, Erik Elgaard/0000-0001-6293-0447; Andreasen, Jan Jesper/0000-0002-2382-3734; Gronkjaer, Mette/0000-0003-1558-7062; Hoffmann Kusk, Kathrine/0000-0002-7695-3639 FU Eir Research and Business Park; European Regional Development Fund; UNIK Partnership; Danish Council of Research and Innovation; Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg University; Department of Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg University; Lundbeck Foundation [FP25/2013] FX The research was funded by Eir Research and Business Park, The European Regional Development Fund, UNIK Partnership, Danish Council of Research and Innovation, Departments of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg University, and the Lundbeck Foundation (FP25/2013). The authors wish to thank the research team behind Teledi@log for support on data collection and analysis throughout the research and writing of this paper. 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PD APR PY 2016 VL 18 IS 4 AR e69 DI 10.2196/jmir.5191 PG 13 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 EC9VZ UT WOS:000388493700001 PM 27044310 OA gold, Green Published DA 2023-05-13 ER PT J AU Szunerits, S Mishyn, V Grabowska, I Boukherroub, R AF Szunerits, Sabine Mishyn, Vladyslav Grabowska, Iwona Boukherroub, Rabah TI Electrochemical cardiovascular platforms: Current state of the art and beyond SO BIOSENSORS & BIOELECTRONICS LA English DT Review DE Cardiac biomarkers; Immunosensors; Electrochemistry; Aptamers ID CARDIAC TROPONIN-I; LABEL-FREE DETECTION; MULTIWALLED CARBON NANOTUBES; MEDICINE PRACTICE GUIDELINES; PEPTIDE-BASED BIOSENSOR; REACTIVE PROTEIN CRP; GOLD NANOPARTICLES; NATRIURETIC PEPTIDE; GRAPHENE OXIDE; HORSERADISH-PEROXIDASE AB Cardiovascular diseases (CVD) remain the leading cause of death within industrialized nations as well as an increasing cause of mortality and morbidity in many developing countries. Smoking, alcohol consumption and increased level of blood cholesterol are the main CVD risk factors. Other factors, such as the prevalence of overweight/obesity and diabetes, have increased considerably in recent decades and are indirect causes of CVD. Among CVDs, the acute coronary syndrome (ACS) represents the most common cause of emergency hospital admission. Since the prognosis of ACS is directly associated with timely initiation of revascularization, missed, misdiagnosis or late diagnosis have unfavorable medical implications. Early ACS diagnosis can reduce complications and risk of recurrence, finally decreasing the economic burden posed on the health care system as a whole. To decrease the risk of ACS and related CVDs and to reduce associated costs to healthcare systems, a fast management of patients with chest pain has become crucial and urgent. Despite great efforts, biochemical diagnostic approaches of CVDs remain difficult and controversial medical challenges as cardiac biomarkers should be rapidly released into the blood at the time of ischemia and persistent for a sufficient length of time to allow diagnostics, with tests that should be rapid, easy to perform and relatively inexpensive. Early biomarker assessments have involved testing for the total enzyme activity of aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK), which cardiac troponins being the main accepted biomarkers for diagnosing myocardial injury and acute myocardial infarction (AMI). To allow rapid diagnosis, it is necessary to replace the traditional biochemical assays by cardiac biosensor platforms. Among the numerous of possibilities existing today, electrochemical biosensors are important players as they have many of the required characteristics for point-of-care tests. Electrochemical based cardiac biosensors are highly adapted for monitoring the onset and progress of cardiovascular diseases in a fast and accurate manner, while being cheap and scalable devices. This review outlines the state of the art in the development of cardiac electrochemical sensors for the detection of different cardiac biomarkers ranging from troponin to BNP, N-terminal proBNP, and others. C1 [Szunerits, Sabine; Mishyn, Vladyslav; Boukherroub, Rabah] Univ Valenciennes, Univ Lille, Cent Lille, ISEN,IEMN,CNRS,UMR 8520, F-59000 Lille, France. [Grabowska, Iwona] Polish Acad Sci, Inst Anim Reprod & Food Res, Tuwima 10, PL-10748 Olsztyn, Poland. C3 Centre National de la Recherche Scientifique (CNRS); CNRS - Institute for Engineering & Systems Sciences (INSIS); Universite de Lille - ISITE; Centrale Lille; Universite de Lille; Universite Polytechnique Hauts-de-France; Polish Academy of Sciences; Institute of Animal Reproduction & Food Research of the Polish Academy of Sciences RP Szunerits, S; Boukherroub, R (通讯作者)，Univ Valenciennes, Univ Lille, Cent Lille, ISEN,IEMN,CNRS,UMR 8520, F-59000 Lille, France. EM Sabine.szunerits@univ-lille.fr; rabah.boukherroub@univ-lille.fr RI Boukherroub, Rabah/I-4826-2017; Grabowska, Iwona/H-7178-2017 OI Boukherroub, Rabah/0000-0002-9795-9888; Grabowska, Iwona/0000-0002-5056-7828; Mishyn, Vladyslav/0000-0002-7500-7923; Szunerits, Sabine/0000-0002-1567-4943 FU Centre National de la Recherche Scientifique (CNRS), the University of Lille; Hauts-de-France region; CPER "Photonics for Society"; Agence Nationale de la Recherche (ANR) through FLAG-ERA JTC 2015-Graphtivity project FX Financial support from the Centre National de la Recherche Scientifique (CNRS), the University of Lille, the Hauts-de-France region, the CPER "Photonics for Society", and the Agence Nationale de la Recherche (ANR) through FLAG-ERA JTC 2015-Graphtivity project are acknowledged. 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PD APR 15 PY 2019 VL 131 BP 287 EP 298 DI 10.1016/j.bios.2019.02.010 PG 12 WC Biophysics; Biotechnology & Applied Microbiology; Chemistry, Analytical; Electrochemistry; Nanoscience & Nanotechnology WE Science Citation Index Expanded (SCI-EXPANDED) SC Biophysics; Biotechnology & Applied Microbiology; Chemistry; Electrochemistry; Science & Technology - Other Topics GA HR7AH UT WOS:000463303800039 PM 30851492 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Christensen, AV Ohlers, AA Zwisler, AD Svendsen, JH Berg, SK AF Christensen, Anne Vinggaard Ohlers, Anne Alexandrine Zwisler, Ann-Dorthe Svendsen, Jesper Hastrup Berg, Selina Kikkenborg TI Employment Status and Sick Leave After First-Time Implantable Cardioverter Defibrillator Implantation Results From the COPE-ICD Trial SO JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE implantable cardioverter defibrillators; return to work; rehabilitation; sick leave ID ACUTE CORONARY SYNDROME; CARDIAC REHABILITATION; MYOCARDIAL-INFARCTION; HEART-DISEASE; WORK; RETURN; ARRHYTHMIAS; PREVENTION; RECIPIENTS; MORTALITY AB Background: In the Copenhagen Outpatient Programme-Implantable Cardioverter Defibrillator (COPE-ICD) Trial, a positive effect from a cost-saving, comprehensive cardiac rehabilitation program was found on physical and mental health in patients with ICDs. Objective: In the context of the COPE-ICD Trial, the aims of this study is to investigate (a) employment status after ICD implantation, (b) the number of sick days related to ICD implantation, (c) differences in employment status and sick days between rehabilitation and usual care groups, and (d) predictors of employment status and sick leave. Method: Patients with first-time ICD implantation were randomized to comprehensive cardiac rehabilitation or usual care. One year after ICD implantation, patients answered questions about employment status and sick leave. Differences were tested using the Student t test and the chi(2) test. Predictors of employment status and sick leave were tested using logistic regression and linear regression models. Result: A total of 196 patients were randomized. The questionnaire was completed by 138 patients (70%). In total, 47% had worked before ICD implantation. After 1 year, 81% were still working and their mean (SD) number of sick days was 33.8 (58.3). Age 60 years or younger and secondary ICD indication were predictors of working after 1 year. Patients with secondary ICD indication had more sick days and patients who were not married had fewer sick days. Conclusion: Most patients who worked before ICD implantation returned to work after the ICD was placed. Those who were married and had an ICD for secondary prevention took more sick days after the ICD than did those without these characteristics. Those who were younger and have a secondary indication ICD were more likely to be working 1 year after ICD implantation. C1 [Christensen, Anne Vinggaard; Ohlers, Anne Alexandrine; Zwisler, Ann-Dorthe; Svendsen, Jesper Hastrup; Berg, Selina Kikkenborg] Copenhagen Univ Hosp, Rigshosp, Ctr Heart, Sect 2151,Blegdamsvej 9, DK-2100 Copenhagen, Denmark. [Zwisler, Ann-Dorthe; Berg, Selina Kikkenborg] Univ Southern Denmark, Natl Inst Publ Hlth, Copenhagen, Denmark. [Svendsen, Jesper Hastrup] Univ Copenhagen, Danish Natl Res Fdn Ctr Cardiac Arrhythmia DARC, Copenhagen, Denmark. [Svendsen, Jesper Hastrup] Univ Copenhagen, Fac Hlth Med Sci, Dept Clin Med, Copenhagen, Denmark. C3 Rigshospitalet; University of Copenhagen; University of Southern Denmark; Danmarks Grundforskningsfond; University of Copenhagen; University of Copenhagen RP Christensen, AV (通讯作者)，Copenhagen Univ Hosp, Rigshosp, Ctr Heart, Sect 2151,Blegdamsvej 9, DK-2100 Copenhagen, Denmark. EM anne.vinggaard.christensen@regionh.dk RI Svendsen, Jesper Hastrup/G-8573-2017 OI Svendsen, Jesper Hastrup/0000-0001-8466-8515; Berg, Selina Kikkenborg/0000-0002-9493-954X; Christensen, Anne Vinggaard/0000-0001-7468-9101 CR Al-Khatib SM, 2008, AM HEART J, V156, P613, DOI 10.1016/j.ahj.2008.05.027 Berg SK, 2011, BMC CARDIOVASC DISOR, V11, DOI 10.1186/1471-2261-11-33 Berg SK, 2015, J REHABIL MED, V47, P267, DOI 10.2340/16501977-1920 Berg SK, 2015, ARCH PHYS MED REHAB, V96, P426, DOI 10.1016/j.apmr.2014.11.001 Berg SK, 2015, EUR J CARDIOVASC NUR, V14, P34, DOI 10.1177/1474515114521920 Berg SK, 2014, PACE, V37, P1641, DOI 10.1111/pace.12490 Biering K, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0049268 Cohen J., 1988, STAT POWER ANAL BEHA Dunbar SB, 2012, CIRCULATION, V126, P2146, DOI 10.1161/CIR.0b013e31825d59fd ENGBLOM E, 1994, QUAL LIFE RES, V3, P207, DOI 10.1007/BF00435386 Floud S, 2014, BMC MED, V12, DOI 10.1186/1741-7015-12-42 Gurevitz O, 2003, PACE, V26, P1675, DOI 10.1046/j.1460-9592.2003.t01-1-00251.x Hallberg V, 2009, SCAND CARDIOVASC J, V43, P277, DOI 10.1080/14017430802506601 Hamalainen H, 2004, EUR J PUBLIC HEALTH, V14, P350, DOI 10.1093/eurpub/14.4.350 Hansen TB, 2015, OPEN HEART, V2, DOI 10.1136/openhrt-2015-000288 KALBFLEISCH KR, 1989, AM J CARDIOL, V64, P199, DOI 10.1016/0002-9149(89)90457-8 KOSKENVUO M, 1981, J EPIDEMIOL COMMUN H, V35, P192, DOI 10.1136/jech.35.3.192 Kruse M, 2009, EUR J CARDIOV PREV R, V16, P387, DOI 10.1097/HJR.0b013e32832a3333 Lidwall U, 2015, DISABIL REHABIL, V37, P396, DOI 10.3109/09638288.2014.923521 Lindback C, 2015, DISABIL REHABIL, V37, P1732, DOI 10.3109/09638288.2014.974835 Lynge E, 2011, SCAND J PUBLIC HLT S, V39, P30 Nielsen FE, 2004, J CLIN EPIDEMIOL, V57, P837, DOI 10.1016/j.jclinepi.2003.12.022 OECD, 2010, SICKN DIS WORK BREAK Osler M, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0086758 Parse R.R., 1998, HUMAN BECOMING SCH T Rankin SH, 2008, CARDIAC NURSING COMP Rohrbacker NJ, 2010, J OCCUP ENVIRON MED, V52, P383, DOI 10.1097/JOM.0b013e3181d967bc Sellier Philippe, 2003, Eur J Cardiovasc Prev Rehabil, V10, P469, DOI 10.1097/01.hjr.0000106837.97722.86 Slebus FG, 2012, SAF HEALTH WORK-KR, V3, P117, DOI 10.5491/SHAW.2012.3.2.117 Tu JV, 2001, J AM COLL CARDIOL, V37, P992, DOI 10.1016/S0735-1097(01)01109-3 Vassilev I, 2014, CHRONIC ILLN, V10, P273, DOI 10.1177/1742395314521641 Worcester MU, 2014, HEART LUNG CIRC, V23, P444, DOI 10.1016/j.hlc.2013.10.093 Zipes DP, 2006, EUROPACE, V8, P746, DOI 10.1093/europace/eul108 NR 33 TC 3 Z9 3 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0889-4655 EI 1550-5049 J9 J CARDIOVASC NURS JI J. Cardiovasc. Nurs. PD SEP-OCT PY 2017 VL 32 IS 5 BP 448 EP 454 DI 10.1097/JCN.0000000000000366 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 FD5TI UT WOS:000407592300014 PM 27631118 DA 2023-05-13 ER PT J AU Fenger-Gron, M Vestergaard, CH Frost, L Davydow, DS Parner, ET Christensen, B Ribe, AR AF Fenger-Gron, Morten Vestergaard, Claus H. Frost, Lars Davydow, Dimitry S. Parner, Erik T. Christensen, Bo Ribe, Anette R. TI Depression and Uptake of Oral Anticoagulation Therapy in Patients With Atrial Fibrillation A Danish Nationwide Cohort Study SO MEDICAL CARE LA English DT Article DE quality of health care; treatment outcome; atrial fibrillation; mental health; psychiatric comorbidity ID ACUTE CORONARY SYNDROME; MEDICATION ADHERENCE; HEART-FAILURE; RISK-FACTOR; STROKE; CARE; METAANALYSIS; WARFARIN; HOSPITALIZATIONS; MORTALITY AB Background: Oral anticoagulation therapy (OAT) in patients with atrial fibrillation (AF) is a highly important preventive intervention, perhaps especially in those with comorbid depression, who have a worse prognosis. However, OAT may pose particular challenges in depressed patients. Objectives: To assess whether AF patients with depression have lower OAT uptake. Methods: This nationwide register-based 2005-2016 cohort study of all Danes with AF and OAT indication (CHA(2)DS(2)VASc stroke risk score >= 2) assessed OAT initiation within 90 days in those with incident AF (N=147,162) and OAT prevalence in those with prevalent AF (N=192,656). The associations of depression with both outcomes were estimated in regression analyses with successive adjustment for socioeconomic characteristics and somatic and psychiatric comorbidity. Results: Comorbid depression was significantly associated with lower frequency of OAT initiation in incident AF patients {adjusted proportion differences (aPDs): -6.6% [95% confidence interval (CI), -7.4 to -5.9]} and lower prevalence of OAT [aPD: -4.2% (95% CI, -4.7 to -3.8)] in prevalent AF patients. Yet, the OAT uptake increased substantially during the period, particularly in depressed patients [aPD for OAT prevalence in 2016: -0.8% (95% CI, -1.6 to -0.0)]. Conclusions: Comorbid depression was associated with a significantly lower OAT uptake in patients with AF, which questions whether depressed patients receive sufficient support to manage this consequential cardiac condition. However, a substantial increase in the overall OAT uptake and a decrease of the depression-associated deficit in OAT were seen over the period during which OAT was developed through the introduction of new oral anticoagulation therapy. C1 [Fenger-Gron, Morten; Vestergaard, Claus H.; Ribe, Anette R.] Aarhus Univ, Res Unit Gen Practice, Aarhus, Denmark. [Fenger-Gron, Morten; Parner, Erik T.; Christensen, Bo] Aarhus Univ, Dept Publ Hlth, Aarhus, Denmark. [Frost, Lars] Aarhus Univ, Silkeborg Reg Hosp, Dept Clin Med, Silkeborg, Denmark. [Davydow, Dimitry S.] Comprehens Life Resources, Tacoma, WA USA. C3 Aarhus University; Aarhus University; Aarhus University; Silkeborg Central Hospital RP Fenger-Gron, M (通讯作者)，Res Unit Gen Practice, Bartholins Alle 2, DK-8000 Aarhus C, Denmark. EM mfgr@ph.au.dk RI Parner, Erik Thorlund/F-5532-2010 OI Parner, Erik Thorlund/0000-0003-3661-1922; Fenger-Gron, Morten/0000-0002-6354-5871; Vestergaard, Claus Hostrup/0000-0003-2916-1548 FU Lundbeck Foundation (MEPRICA) [R155-201211280]; Faculty of Health, Aarhus University; Health Research Fund of the Central Denmark Region; Novo Nordisk Foundation FX The study was supported by an unrestricted grant (grant number: R155-201211280) from the Lundbeck Foundation (MEPRICA). M.F.-G. was supported by a grant from the Faculty of Health, Aarhus University, L.F. by the Health Research Fund of the Central Denmark Region, and A.R.R. by an unrestricted grant from the Novo Nordisk Foundation. 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Care PD MAR PY 2020 VL 58 IS 3 BP 216 EP 224 DI 10.1097/MLR.0000000000001268 PG 9 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 KO5CX UT WOS:000515568500005 PM 31876644 DA 2023-05-13 ER PT J AU Angerud, KH Brulin, C Naslund, U Eliasson, M AF Angerud, Karin Hellstrom Brulin, Christine Naslund, Ulf Eliasson, Mats TI Longer pre-hospital delay in first myocardial infarction among patients with diabetes: an analysis of 4266 patients in the Northern Sweden MONICA Study SO BMC CARDIOVASCULAR DISORDERS LA English DT Article DE Myocardial infarction; Diabetes mellitus; Pre-hospital delay; Sex differences ID ACUTE CORONARY SYNDROME; HOSPITAL PRESENTATION; GENDER-DIFFERENCES; SEEK TREATMENT; SYMPTOM ONSET; HEART-ATTACK; TIME; DISEASE; WOMEN; CARE AB Background: Reperfusion therapy reduces both morbidity and mortality in myocardial infarction, but the effectiveness depends on how fast the patient receives treatment. Despite the time-dependent effectiveness of reperfusion therapy, many patients with myocardial infarction have delays in seeking medical care. The aim of this study was to describe pre-hospital delay in a first myocardial infarction among men and women with and without diabetes and to describe the association between pre-hospital delay time and diabetes, sex, age, symptoms and size of residential area as a proxy for distance to hospital. Methods: This population based study was based on data from 4266 people aged 25-74 years, with a first myocardial infarction registered in the Northern Sweden MONICA myocardial infarction registry between 2000 and 2008. Results: The proportion of patients with delay times >= 2 h was 64% for patients with diabetes and 58% for patients without diabetes. There was no difference in delay time >= 2 h between men and women with diabetes. Diabetes, older age and living in a town or rural areas were factors associated with pre-hospital delay times >= 2 h. Atypical symptoms were not a predictor for pre-hospital delay times >= 2 h, OR 0.59 (0.47; 0.75). Conclusions: A higher proportion of patients with diabetes have longer pre-hospital delay in myocardial infarction than patients without diabetes. There are no differences in pre-hospital delay between men and women with diabetes. The largest risk difference for pre-hospital delay >= 2 h is between women with and without diabetes. Diabetes, older age and living in a town or rural area are predictors for pre-hospital delay >= 2 h. C1 [Angerud, Karin Hellstrom; Naslund, Ulf] Umea Univ, Ctr Heart, Umea, Sweden. [Angerud, Karin Hellstrom; Brulin, Christine] Umea Univ, Dept Nursing, Umea, Sweden. [Naslund, Ulf; Eliasson, Mats] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden. C3 Umea University; Umea University; Umea University RP Angerud, KH (通讯作者)，Umea Univ, Ctr Heart, Umea, Sweden. EM karin.hellstrom.angerud@nurs.umu.se RI Ängerud, Karin Hellström/ABA-7548-2020 OI Naslund, Ulf/0000-0003-4100-8298 FU Swedish Medical Research Council; Faculty of Medicine, Umea University; Swedish Heart and Lung Foundation; Swedish Diabetes Foundation; County Council of Vasterbotten; County Council of Norrbotten; Heart Foundation of Northern Sweden FX This study was supported by the Swedish Medical Research Council, the Faculty of Medicine, Umea University, the Swedish Heart and Lung Foundation, the Swedish Diabetes Foundation, the County Councils of Vasterbotten and Norrbotten, and the Heart Foundation of Northern Sweden. 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PD JAN 29 PY 2013 VL 13 AR 6 DI 10.1186/1471-2261-13-6 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Cardiovascular System & Cardiology GA 085BQ UT WOS:000314586000001 PM 23356233 OA gold, Green Published DA 2023-05-13 ER PT J AU Rzonca, P Swiezewski, SP Jalali, R Gotlib, J Galazkowski, R AF Rzonca, Patryk Swiezewski, Stanislaw Pawel Jalali, Rakesh Gotlib, Joanna Galazkowski, Robert TI Helicopter Emergency Medical Service (HEMS) Response in Rural Areas in Poland: Retrospective Study SO INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH LA English DT Article DE Helicopter Emergency Medical Service; prehospital care; rural region; health of rural populations; sudden cardiac arrest; acute coronary syndromes; cardiovascular diseases ID HOSPITAL CARDIAC-ARREST; CARDIOVASCULAR RISK-FACTORS; TRAUMA PATIENTS; URBAN; EPIDEMIOLOGY; PERIOD; SCALE; COMA; CARE AB The aim of the study was to identify the characteristics of missions performed by HEMS (Helicopter Emergency Medical Service) crews and the analysis of health problems, which are the most common cause of intervention in rural areas in Poland. The study was conducted using a retrospective analysis based on the medical records of patients provided by the HEMS crew, who were present for the emergencies in rural areas in the period from January 2011 to December 2018. The final analysis included 37,085 cases of intervention by HEMS crews, which accounted for 54.91% of all the missions carried out in the study period. The majority (67.4%) of patients rescued were male, and just under a quarter of those rescued were aged between 50-64 years. Injuries (51.04%) and cardiovascular diseases (36.49%) were the main diagnoses found in the study group. Whereas injuries were significantly higher in the male group and patients below 64 years of age, cardiovascular diseases were higher in women and elderly patients (p < 0.001). Moreover, in the group of women myocardial infarction was significantly more frequent (30.95%) than men, while in the group of men head injuries (27.10%), multiple and multi-organ injuries (25.93%), sudden cardiac arrest (14.52%), stroke (12.19%), and epilepsy (4.95%) was significantly higher. Factors that are associated with the most common health problems of rural patients are: gender and age, as well as the seasons of the year and the values of the Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and National Advisory Committee for Aeronautics (NACA) used to assess the clinical status of patients. C1 [Rzonca, Patryk] Med Univ Lublin, Dept Emergency Med, Fac Hlth Sci, 4-6 Stasz St, PL-20081 Lublin, Poland. [Swiezewski, Stanislaw Pawel; Galazkowski, Robert] Med Univ Warsaw, Dept Emergency Med Serv, Fac Hlth Sci, 81 Zwirki & Wigury St, PL-02091 Warsaw, Poland. [Jalali, Rakesh] Univ Warmia & Mazury, Sch Med, Dept Emergency Med, Coll Med, 30 Aleja Warszawska St, PL-10082 Olsztyn, Poland. [Gotlib, Joanna] Med Univ Warsaw, Div Teaching & Outcomes Educ, Fac Hlth Sci, 81 Zwirki & Wigury St, PL-02091 Warsaw, Poland. C3 Medical University of Lublin; Medical University of Warsaw; University of Warmia & Mazury; Medical University of Warsaw RP Rzonca, P (通讯作者)，Med Univ Lublin, Dept Emergency Med, Fac Hlth Sci, 4-6 Stasz St, PL-20081 Lublin, Poland. EM patryk.rzonca@umlub.pl; stanislaw.swiezewski@gmail.com; rakesh.jalali@uwm.edu.pl; joanna.gotlib@wum.edu.pl; r.galazkowski@lpr.com.pl RI Swiezewski, Stanislaw SP/U-5745-2018; GALAZKOWSKI, ROBERT/X-2593-2018 OI Swiezewski, Stanislaw SP/0000-0001-9665-2182; GALAZKOWSKI, ROBERT/0000-0002-7205-2219; Gotlib, Joanna/0000-0002-2717-7741; Rzonca, Patryk/0000-0001-7008-1721; jalali, rakesh/0000-0002-2898-9434 CR Baker J, 2010, PREHOSP EMERG CARE, V14, P182, DOI 10.3109/10903120903564506 Bennett KJ, 2012, J RURAL HEALTH, V28, P227, DOI 10.1111/j.1748-0361.2011.00399.x Bien Barbara, 2002, Przegl Lek, V59, P211 Bigdeli M, 2010, BMC PUBLIC HEALTH, V10, DOI 10.1186/1471-2458-10-406 Carron PN, 2015, SWISS MED WKLY, V145, DOI 10.4414/smw.2015.14126 Cebula GM, 2016, KARDIOL POL, V74, P356, DOI 10.5603/KP.a2016.0001 Chen Y, 2013, CHRON DIS INJ CAN, V33, P95 Christensen EF, 2017, BMJ OPEN, V7, DOI 10.1136/bmjopen-2016-014508 El Sayed M, 2017, MEDICINE, V96, DOI 10.1097/MD.0000000000007570 Fan L, 2011, J RURAL HEALTH, V27, P39, DOI 10.1111/j.1748-0361.2010.00313.x Fazel MR, 2012, ARCH TRAUMA RES, V1, P63, DOI 10.5812/atr.6770 Goldstein J, 2015, CAN J EMERG MED, V17, P491, DOI 10.1017/cem.2015.20 Hawkes C, 2017, RESUSCITATION, V110, P133, DOI 10.1016/j.resuscitation.2016.10.030 Hess EP, 2007, RESUSCITATION, V72, P200, DOI 10.1016/j.resuscitation.2006.06.040 Huang CY, 2016, INT J ENV RES PUB HE, V13, DOI 10.3390/ijerph13020236 Kornhall D, 2018, BMC EMERG MED, V18, DOI 10.1186/s12873-018-0176-3 Kosydar-Bochenek J., 2012, ZDROWIE PUBLICZNE, V122, P70 Kottmann A, 2018, SCAND J TRAUMA RESUS, V26, DOI 10.1186/s13049-018-0520-3 Laskowska I, 2015, ANN AGR ENV MED, V22, P700, DOI 10.5604/12321966.1185779 Loggers SAI, 2017, EUR J TRAUMA EMERG S, V43, P823, DOI 10.1007/s00068-016-0744-8 Marti-Soler H, 2014, HEART, V100, P1517, DOI 10.1136/heartjnl-2014-305623 Maserati M, 2016, J NEUROSCI NURS, V48, P311, DOI 10.1097/JNN.0000000000000242 Mathiesen WT, 2018, CRIT CARE, V22, DOI 10.1186/s13054-018-2017-x McMullan JT, 2012, ACAD EMERG MED, V19, P153, DOI 10.1111/j.1553-2712.2011.01273.x Mosca L, 2011, CIRCULATION, V124, P2145, DOI 10.1161/CIRCULATIONAHA.110.968792 Nahhas GJ, 2014, PREV CHRONIC DIS, V11, DOI 10.5888/pcd11.140044 Newgard CD, 2017, JAMA SURG, V152, P11, DOI 10.1001/jamasurg.2016.3329 Newgard CD, 2013, HEALTH AFFAIR, V32, P1591, DOI 10.1377/hlthaff.2012.1142 Norum J, 2011, INT J EMERG MED, V4, DOI [10.1186/1865-1380-1-1, 10.1186/1865-1380-4-1] Osteras O, 2017, SCAND J TRAUMA RESUS, V25, DOI 10.1186/s13049-017-0442-5 Palomo L, 2014, BRIT J GEN PRACT, V64, pE627, DOI 10.3399/bjgp14X681793 Raatiniemi L, 2017, ACTA ANAESTH SCAND, V61, P557, DOI 10.1111/aas.12881 Raatiniemi L, 2015, SCAND J TRAUMA RESUS, V23, DOI 10.1186/s13049-015-0175-2 Rzoca P., 2016, J PUBLIC HLTH NURS M, V3, P17 Rzonca P, 2017, DISASTER EMERG MED J, V2, P64, DOI DOI 10.5603/DEMJ.2017.0013 Schewe JC, 2015, RESUSCITATION, V96, P232, DOI 10.1016/j.resuscitation.2015.07.025 Schuurman N, 2009, BMC EMERG MED, V9, DOI 10.1186/1471-227X-9-6 Starnes Andrew B, 2018, Air Med J, V37, P165, DOI 10.1016/j.amj.2018.01.006 TEASDALE G, 1974, LANCET, V2, P81 Totten V, 2013, ACAD EMERG MED, V20, P514, DOI 10.1111/acem.12126 Ucieklak-Je P., 2017, PROBLEMY DROBNYCH GO, V4, P117 Valet RS, 2009, J ALLERGY CLIN IMMUN, V123, P1220, DOI 10.1016/j.jaci.2008.12.1131 Wang HE, 2013, PREHOSP EMERG CARE, V17, P8, DOI 10.3109/10903127.2012.722178 Weiss M, 2001, ANAESTHESIST, V50, P150, DOI 10.1007/s001010170030 Wu SC, 2018, INT J ENV RES PUB HE, V15, DOI 10.3390/ijerph15112346 NR 45 TC 8 Z9 9 U1 0 U2 6 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND SN 1661-7827 EI 1660-4601 J9 INT J ENV RES PUB HE JI Int. J. Environ. Res. Public Health PD MAY 1 PY 2019 VL 16 IS 9 AR 1532 DI 10.3390/ijerph16091532 PG 12 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 IA4ER UT WOS:000469517300057 PM 31052200 OA gold, Green Published, Green Submitted DA 2023-05-13 ER PT J AU Adekkanattu, P Olfson, M Susser, LC Patra, B Vekaria, V Coombes, BJ Lepow, L Fennessy, B Charney, A Ryu, E Miller, KD Pan, LF Yangchen, T Talati, A Wickramaratne, P Weissman, M Mann, J Biernacka, JM Pathak, J AF Adekkanattu, Prakash Olfson, Mark Susser, Leah C. Patra, Braja Vekaria, Veer Coombes, Brandon J. Lepow, Lauren Fennessy, Brian Charney, Alexander Ryu, Euijung Miller, Kurt D. Pan, Lifang Yangchen, Tenzin Talati, Ardesheer Wickramaratne, Priya Weissman, Myrna Mann, John Biernacka, Joanna M. Pathak, Jyotishman TI Comorbidity and healthcare utilization in patients with treatment resistant depression: A large-scale retrospective cohort analysis using electronic health records SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE Treatment resistant depression; Major depressive disorder; Medical comorbidities; Healthcare utilization; Electronic health records ID OBSTRUCTIVE PULMONARY-DISEASE; ACUTE CORONARY SYNDROME; CHRONIC KIDNEY-DISEASE; MAJOR DEPRESSION; ECONOMIC BURDEN; ASSOCIATION; RISK; ANXIETY; SYMPTOMS; DISORDER AB Background: Medical comorbidity and healthcare utilization in patients with treatment resistant depression (TRD) is usually reported in convenience samples, making estimates unreliable. There is only limited large-scale clinical research on comorbidities and healthcare utilization in TRD patients. Methods: Electronic Health Record data from over 3.3 million patients from the INSIGHT Clinical Research Network in New York City was used to define TRD as initiation of a third antidepressant regimen in a 12-month period among patients diagnosed with major depressive disorder (MDD). Age and sex matched TRD and non-TRD MDD patients were compared for anxiety disorder, 27 comorbid medical conditions, and healthcare utilization. Results: Out of 30,218 individuals diagnosed with MDD, 15.2 % of patients met the criteria for TRD (n = 4605). Compared to MDD patients without TRD, the TRD patients had higher rates of anxiety disorder and physical comorbidities. They also had higher odds of ischemic heart disease (OR = 1.38), stroke/transient ischemic attack (OR = 1.57), chronic kidney diseases (OR = 1.53), arthritis (OR = 1.52), hip/pelvic fractures (OR = 2.14), and cancers (OR = 1.41). As compared to non-TRD MDD, TRD patients had higher rates of emergency room visits, and inpatient stays. In relation to patients without MDD, both TRD and non-TRD MDD patients had significantly higher levels of anxiety disorder and physical comorbidities. Limitations: The INSIGHT-CRN data lack information on depression severity and medication adherence. Conclusions: TRD patients compared to non-TRD MDD patients have a substantially higher prevalence of various psychiatric and medical comorbidities and higher health care utilization. These findings highlight the challenges of developing interventions and care coordination strategies to meet the complex clinical needs of TRD patients. C1 [Adekkanattu, Prakash; Susser, Leah C.; Patra, Braja; Vekaria, Veer; Pathak, Jyotishman] Weill Cornell Med, New York, NY 10021 USA. [Olfson, Mark; Pan, Lifang; Yangchen, Tenzin; Talati, Ardesheer; Wickramaratne, Priya; Weissman, Myrna; Mann, John] Columbia Univ, New York State Psychiat Inst, New York, NY USA. [Coombes, Brandon J.; Ryu, Euijung; Miller, Kurt D.; Biernacka, Joanna M.] Mayo Clin, Rochester, MN USA. [Lepow, Lauren; Fennessy, Brian; Charney, Alexander] Icahn Sch Med Mt Sinai, New York, NY USA. C3 Cornell University; Weill Cornell Medicine; Columbia University; New York State Psychiatry Institute; Mayo Clinic; Icahn School of Medicine at Mount Sinai RP Adekkanattu, P (通讯作者)，Weill Cornell Med, New York, NY 10021 USA. EM pra2008@med.cornell.edu RI Coombes, Brandon/Y-1263-2019; Talati, Ardesheer/GOP-3671-2022; PATRA, BRAJA GOPAL/P-7126-2018 OI Coombes, Brandon/0000-0003-4322-5923; PATRA, BRAJA GOPAL/0000-0003-2997-5314; Fennessy, Brian/0000-0002-6222-6190 FU National Institute of Mental Health (NIMH) [R01MH121922, R01MH121924, R01MH121923, R01MH121921] FX This study was supported by the National Institute of Mental Health (NIMH) grants: R01MH121922, R01MH121924, R01MH121923, and R01MH121921. 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Affect. Disord. PD MAR 1 PY 2023 VL 324 BP 102 EP 113 DI 10.1016/j.jad.2022.12.044 EA DEC 2022 PG 12 WC Clinical Neurology; Psychiatry WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Neurosciences & Neurology; Psychiatry GA 7V2IB UT WOS:000912641600001 PM 36529406 DA 2023-05-13 ER PT J AU Dejam, A Malley, BE Feng, ML Cismondi, F Park, S Samani, S Samani, ZA Pinto, DS Celi, LA AF Dejam, Andre Malley, Brian E. Feng, Mengling Cismondi, Federico Park, Shinhyuk Samani, Saira Samani, Zahra Aziz Pinto, Duane S. Celi, Leo Anthony TI The effect of age and clinical circumstances on the outcome of red blood cell transfusion in critically ill patients SO CRITICAL CARE LA English DT Article ID ACUTE CORONARY SYNDROMES; CARDIAC-SURGERY; ANEMIA; CARE; REQUIREMENTS; MULTICENTER; HEMOGLOBIN; STORAGE; INJURY; TRIAL AB Introduction: Whether red blood cell (RBC) transfusion is beneficial remains controversial. In both retrospective and prospective evaluations, transfusion has been associated with adverse, neutral, or protective effects. These varying results likely stem from a complex interplay between transfusion, patient characteristics, and clinical context. The objective was to test whether age, comorbidities, and clinical context modulate the effect of transfusion on survival. Methods: By using the multiparameter intelligent monitoring in intensive care II database (v. 2.6), a retrospective analysis of 9,809 critically ill patients, we evaluated the effect of RBC transfusion on 30-day and 1-year mortality. Propensity score modeling and logistic regression adjusted for known confounding and assessed the independent effect of transfusion on 30-day and 1-year mortality. Sensitivity analysis was performed by using 3,164 transfused and non-transfused pairs, matched according the previously validated propensity model for RBC transfusion. Results: RBC transfusion did not affect 30-day or 1-year mortality in the overall cohort. Patients younger than 55 years had increased odds of mortality (OR, 1.71; P < 0.01) with transfusion. Patients older than 75 years had lower odds of 30-day and 1-year mortality (OR, 0.70; P < 0.01) with transfusion. Transfusion was associated with worse outcome among patients undergoing cardiac surgery (OR, 2.1; P < 0.01). The propensity-matched population corroborated findings identified by regression adjustment. Conclusion: A complex relation exists between RBC transfusion and clinical outcome. Our results show that transfusion is associated with improved outcomes in some cohorts and worse outcome in others, depending on comorbidities and patient characteristics. As such, future investigations and clinical decisions evaluating the value of transfusion should account for variations in baseline characteristics and clinical context. C1 [Dejam, Andre; Pinto, Duane S.; Celi, Leo Anthony] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. [Malley, Brian E.; Feng, Mengling; Cismondi, Federico; Park, Shinhyuk; Celi, Leo Anthony] MIT, Harvard Mit Div Hlth Sci & Technol, Cambridge, MA 02139 USA. [Malley, Brian E.] Oakland Univ, William Beaumont Sch Med, Rochester, MI 48309 USA. [Samani, Saira] Mt Auburn Hosp, Cambridge, MA 02138 USA. [Samani, Zahra Aziz] Aga Khan Univ, Coll Med, Karachi 74800, Pakistan. [Feng, Mengling] Inst Infocomm Res, Singapore 138632, Singapore. C3 Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Massachusetts Institute of Technology (MIT); Oakland University; Harvard University; Mount Auburn Hospital; Aga Khan University; Agency for Science Technology & Research (A*STAR); A*STAR - Institute for Infocomm Research (I2R) RP Celi, LA (通讯作者)，Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. EM lceli@mit.edu OI Malley, Brian/0000-0002-1731-1046; Pinto, Duane/0000-0002-2309-8480 FU National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (NIH) [R01 EB001659]; AHA [10CRP2660009]; NIH [K23HL114963]; A*STAR Graduate Scholarship FX This research was supported by grant R01 EB001659 from the National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (NIH). Andre Dejam was supported by an AHA grant 10CRP2660009 and NIH grant K23HL114963. Mengling Feng was supported by A*STAR Graduate Scholarship. The funding bodies did not have any impact on design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. 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Care PY 2014 VL 18 IS 4 AR 487 DI 10.1186/s13054-014-0487-z PG 9 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CA4MJ UT WOS:000348878200064 PM 25175389 OA Green Published, gold DA 2023-05-13 ER PT J AU da Cunha, GSP Cerci, RJ Silvestre, OM Cavalcanti, AM Nadruz, W Fernandes-Silva, MM AF da Cunha, Gustavo Sarot Pereira Cerci, Rodrigo Julio Silvestre, Odilson Marcos Cavalcanti, Ana Maria Nadruz, Wilson Fernandes-Silva, Miguel Morita TI Sex- and Age-Related Impact of the COVID-19 Pandemic on Emergency Department Visits for Chest Pain in Curitiba, Brazil SO JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE chest pain; COVID-19; epidemiology; fe-male ID GENDER-DIFFERENCES AB Background: Women have higher mortality from acute coronary syndrome (ACS) compared with men. Women may hesitate to search for emergency care when ex-periencing chest pain, which delays treatment. Objective: Our aim was to evaluate the changes in emergency visits for chest pain according to sex and age during the COVID-19 pandemic period compared with previous years.Methods: We collected data on chest pain visits ( International Clas-sification of Diseases, Tenth Revision, Clinical Modification codes I20 [unstable angina], I21 [myocardial infarction], and R07.1-4 [chest pain]) from all public emergency departments (EDs) in Curitiba, Brazil. We compared the weekly rates of visits per 100,000 habitants on the epidemiologic weeks 11-52 of 2020 (COVID-19 pandemic period) with the aver-age rates of the same weeks of 2018 and 2019 using Poisson regression.Results: From 2018 to 2020, 37,448 individuals presented to the ED for chest pain, of whom 8493 presented during the COVID-19 pandemic period. Compared with previous years, we observed a 23% reduction in chest pain visits (10.1 vs. 13.0 visits per 100,000 habitants/week; p < 0.001), but this reduction was greater in women than in men (30% vs. 15%; p < 0.001). This reduction was associated with age among women (27%, 31%, and 36% for < 50 years, between 50 and 69 years and > 70 years, respectively, p for age-related trend = 0.041), but not among men.Conclusions: In this population-level study of Curitiba, Brazil, the reduc-tion in ED visits during the COVID-19 pandemic was greater in women than in men, particularly among those > 70 yearsof age, suggesting that the sex-and age-related disparities in health care delivery for ACS may have worsened during the COVID-19 pandemic. (c) 2022 Elsevier Inc. All rights re-served. C1 [da Cunha, Gustavo Sarot Pereira; Fernandes-Silva, Miguel Morita] Univ Fed Parana, Internal Med Dept, Curitiba, PR, Brazil. [Cerci, Rodrigo Julio; Fernandes-Silva, Miguel Morita] Quanta Diagnost Imagem, Curitiba, PR, Brazil. [Silvestre, Odilson Marcos] Univ Fed Acre, Internal Med Dept, Rio Branco, AC, Brazil. [Cavalcanti, Ana Maria] Municipal Hlth Secretary, Curitiba, PR, Brazil. [Nadruz, Wilson] Univ Estadual Campinas, Internal Med Dept, Campinas, SP, Brazil. [Fernandes-Silva, Miguel Morita] Univ Fed Parana, Internal Med Dept, 181 Gen Carneiro St, BR-80060900 Curitiba, PR, Brazil. C3 Universidade Federal do Parana; Universidade Federal do Acre (UFAC); Universidade Estadual de Campinas; Universidade Federal do Parana RP Fernandes-Silva, MM (通讯作者)，Univ Fed Parana, Internal Med Dept, 181 Gen Carneiro St, BR-80060900 Curitiba, PR, Brazil. 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Emerg. Med. PD NOV PY 2022 VL 63 IS 5 BP 656 EP 660 DI 10.1016/j.jemermed.2022.08.003 EA DEC 2022 PG 5 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 9Y7YP UT WOS:000950670600004 PM 36243615 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Singh, M Raghavan, D Williams, JS Martin, BC Hudson, TJ Owen, RR Jain, N AF Singh, Manisha Raghavan, Deepa Williams, James S. Martin, Bradley C. Hudson, Teresa J. Owen, Richard R. Jain, Nishank TI Prevalence of Chronic Kidney Disease, Thrombotic Cardiovascular Events, and Use of Oral P2Y(12) Inhibitors among Veterans SO AMERICAN JOURNAL OF NEPHROLOGY LA English DT Article DE Cardiovascular; Kidney; Outcomes; P2Y(12) inhibitors; Prevalence ID ACUTE CORONARY SYNDROMES; THERAPY; INTERVENTION; CLOPIDOGREL; MORTALITY; OUTCOMES AB Background: Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y(12) inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescription trend for P2Y12i remains unclear. Methods: Using national VA corporate warehouse data, we used International Classification of Diseases-9 codes to identify Veterans with CKD, dialysis-dependent CKD, and CV events. VA pharmacy data were used to count P2Y12i prescriptions for the federal fiscal years (FY) 2011 through 2015. Results: The period prevalence of Veterans with CKD was 378,233 (6.1%). The point prevalence of CKD increased by 49% from 132,979 (2.30%) in FY11 to 213,444 (3.42%) in FY15. The period prevalence of Veterans with dialysis- dependent CKD was 150,298 (2.4%). In all, 128,703 (56.7%) CV events occurred in Veterans with CKD. Veterans with CKD were given 50.1% of prescriptions for clopidogrel, 49.3% for prasugrel, and 60.4% for ticagrelor. In this patient population, year-to-year increases in P2Y12i prescriptions were observed with a dramatic increase in ticagrelor prescriptions. Conclusion: CKD is common among Veterans and its true prevalence is likely being underestimated. The prevalence of dialysis-dependent CKD is higher among Veterans than the non-Veteran US population. CV events are widely co-prevalent and these patients are commonly prescribed P2Y12i. The recent increase in ticagrelor prescriptions in this patient population and large cost differences between the 3 P2Y12i underline the need for future studies to identify the preferred P2Y12i for these patients. (C) 2018 The Author(s) Published by S. Karger AG, Basel C1 [Singh, Manisha; Raghavan, Deepa; Martin, Bradley C.; Hudson, Teresa J.; Jain, Nishank] Univ Arkansas Med Sci, 4301 W Markham St,Slot 501, Little Rock, AR 72205 USA. [Singh, Manisha; Raghavan, Deepa; Williams, James S.; Hudson, Teresa J.; Owen, Richard R.; Jain, Nishank] Cent Arkansas Vet Affairs Healthcare Syst, Little Rock, AR USA. C3 University of Arkansas System; University of Arkansas Medical Sciences; US Department of Veterans Affairs; Veterans Health Administration (VHA); Central Arkansas Veterans Healthcare System RP Jain, N (通讯作者)，Univ Arkansas Med Sci, 4301 W Markham St,Slot 501, Little Rock, AR 72205 USA. EM NJain2@uams.edu RI Singh, Manisha/HCJ-0070-2022; Owen, Richard/HTM-1385-2023; Singh, Manisha/F-2969-2018 OI Singh, Manisha/0000-0002-4640-8453; Singh, Manisha/0000-0002-6014-1337 FU American Heart Association Scientist Development Grant [16SDG31000045] FX This study was supported by the American Heart Association Scientist Development Grant 16SDG31000045 (N.J.). 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J. Nephrol. PY 2018 VL 47 IS 2 BP 67 EP 71 DI 10.1159/000486647 PG 5 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA FZ4XY UT WOS:000427596800001 PM 29393120 OA Green Published, hybrid DA 2023-05-13 ER PT J AU Luo, HY Liu, SQ Wang, YC Phillips-Howard, PA Ju, SH Yang, Y Wang, DL AF Luo, Huanyuan Liu, Songqiao Wang, Yuancheng Phillips-Howard, Penelope A. Ju, Shenghong Yang, Yi Wang, Duolao TI Age differences in clinical features and outcomes in patients with COVID-19, Jiangsu, China: a retrospective, multicentre cohort study SO BMJ OPEN LA English DT Article DE epidemiology; public health; infectious diseases ID ACUTE RESPIRATORY SYNDROME; IMMUNITY; FERRETS AB Objectives To determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and setting Retrospective, multicentre cohort study performed at 24 hospitals in Jiangsu, China. Participants 625 patients with COVID-19 enrolled between 10 January and 15 March 2020. Results Of the 625 patients (median age, 46 years; 329 (52.6%) men), 37 (5.9%) were children (18 years or younger), 261 (41.8%) young adults (19-44 years), 248 (39.7%) middle-aged adults (45-64 years) and 79 (12.6%) elderly adults (65 years or older). The incidence of hypertension, coronary heart disease, chronic obstructive pulmonary disease and diabetes comorbidities increased with age (trend test, p<0.0001, p=0.0003, p<0.0001 and p<0.0001, respectively). Fever, cough and shortness of breath occurred more commonly among older patients, especially the elderly, compared with children (chi(2)test, p=0.0008, 0.0146 and 0.0282, respectively). The quadrant score and pulmonary opacity score increased with age (trend test, both p<0.0001). Older patients had many significantly different laboratory parameters from younger patients. Elderly patients had the highest proportion of severe or critically-ill cases (33.0%, chi(2)test p<0.0001), intensive care unit use (35.4%, chi(2)test p<0.0001), respiratory failure (31.6%, chi(2)test p<0.0001) and the longest hospital stay (median 21 days, Kruskal-Wallis test p<0.0001). Conclusions Elderly (>= 65 years) patients with COVID-19 had the highest risk of severe or critical illness, intensive care use, respiratory failure and the longest hospital stay, which may be due partly to their having a higher incidence of comorbidities and poor immune responses to COVID-19. C1 [Luo, Huanyuan; Phillips-Howard, Penelope A.; Wang, Duolao] Univ Liverpool Liverpool Sch Trop Med, Dept Clin Sci, Liverpool, Merseyside, England. [Liu, Songqiao; Yang, Yi] Southeast Univ, Sch Med, Zhongda Hosp, Dept Crit Care Med,Jiangsu Prov Key Lab Crit Care, Nanjing, Peoples R China. [Wang, Yuancheng; Ju, Shenghong] Southeast Univ, Dept Radiol, Zhongda Hosp, Nanjing, Peoples R China. C3 Liverpool School of Tropical Medicine; Southeast University - China; Southeast University - China RP Wang, DL (通讯作者)，Univ Liverpool Liverpool Sch Trop Med, Dept Clin Sci, Liverpool, Merseyside, England.; Yang, Y (通讯作者)，Southeast Univ, Sch Med, Zhongda Hosp, Dept Crit Care Med,Jiangsu Prov Key Lab Crit Care, Nanjing, Peoples R China. EM yiyiyang2004@163.com; Duolao.Wang@lstmed.ac.uk RI wangwangwang, yuanyaunyuan/HHN-6432-2022; Wang, Yuan/HHC-1520-2022; 刘, 松桥/ACA-6923-2022 OI 刘, 松桥/0000-0002-1875-1131; Luo, Huanyuan/0000-0002-1898-4103; Wang, Duolao/0000-0003-2788-2464; Phillips-Howard, Penelope A/0000-0003-1018-116X FU Ministry of Science and Technology of the People's Republic of China [2020YFC0843700 67] FX This work was supported, in part, by Research Grant 2020YFC0843700 67 from the Ministry of Science and Technology of the People's Republic of China. 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D. Bremner, K. E. Luo, J. Alibhai, S. M. H. TI Health care costs for prostate cancer patients receiving androgen deprivation therapy: treatment and adverse events SO CURRENT ONCOLOGY LA English DT Article DE Prostatic neoplasms; androgen deprivation therapy; costs; adverse events; cost analysis ID CARDIOVASCULAR-DISEASE; ORCHIECTOMY; FRACTURE; TRENDS; TERM; MEN AB Background Serious adverse events have been associated with androgen deprivation therapy (ADT) for prostate cancer (PCA), but few studies address the costs of those events. Methods All PCA patients (ICD-9-CM 185) in Ontario who started 90 days or more of ADT or had orchiectomy at the age of 66 or older during 1995-2005 (n = 26,809) were identified using the Ontario Cancer Registry and drug and hospital data. Diagnosis dates of adverse events-myocardial infarction, acute coronary syndrome, congestive heart failure, stroke, deep vein thrombosis or pulmonary embolism, any diabetes, and fracture or osteoporosis-before and after ADT initiation were determined from administrative data. We excluded patients with the same diagnosis before and after ADT, and we allocated each patient's time from ADT initiation to death or December 31, 2007, into health states: ADT (no adverse event), ADT-AE (specified single adverse event), Multiple (>1 event), and Final (<= 180 days before death). We used methods for Canadian health administrative data to estimate annual total health care costs during each state, and we examined monthly trends. Results Approximately 50% of 21,811 patients with no pre-ADT adverse event developed 1 or more events after ADT. The costliest adverse event state was stroke ($26,432/year). Multiple was the most frequent (n = 2,336) and the second most costly health state ($24,374/year). Costs were highest in the first month after diagnosis (from $1,714 for diabetes to $14,068 for myocardial infarction). Costs declined within 18 months, ranging from $784 per 30 days (diabetes) to $1,852 per 30 days ( stroke). Adverse events increased the costs of ADT by 100% to 265%. Conclusions The economic burden of adverse events is relevant to programs and policies from clinic to government, and that burden merits consideration in the risks and benefits of ADT. C1 [Krahn, M. D.; Bremner, K. E.; Alibhai, S. M. H.] Toronto Gen Hosp, Toronto Gen Res Inst, Toronto, ON M5G 2C4, Canada. [Krahn, M. D.; Alibhai, S. M. H.] Toronto Gen Hosp, Dept Med, Toronto, ON M5G 2C4, Canada. [Krahn, M. D.] Toronto Gen Hosp, Fac Pharm, Toronto, ON M5G 2C4, Canada. [Krahn, M. D.] Univ Toronto, Dept Med, Toronto, ON, Canada. [Krahn, M. D.; Bremner, K. E.; Alibhai, S. M. H.] Toronto Hlth Econ & Technol Assessment Collaborat, Toronto, ON, Canada. [Krahn, M. D.; Luo, J.] Inst Clin Evaluat Sci, Toronto, ON, Canada. C3 University of Toronto; University Health Network Toronto; Toronto General Hospital; University of Toronto; University Health Network Toronto; Toronto General Hospital; University of Toronto; University Health Network Toronto; Toronto General Hospital; University of Toronto; University of Toronto RP Bremner, KE (通讯作者)，Toronto Gen Hosp, 200 Elizabeth St,Room EN13-222A, Toronto, ON M5G 2C4, Canada. EM kbremner@uhnresearch.ca OI Krahn, Murray/0000-0001-5836-397X FU Canadian Cancer Research Society under the Prostate Cancer Research Initiative [18090]; Ontario Public Drug Programs Drug Innovation Fund [2008-0100]; Canadian Cancer Society FX This work was supported by the Canadian Cancer Research Society under the Prostate Cancer Research Initiative (grant no. 18090), and the Ontario Public Drug Programs Drug Innovation Fund (grant no. 2008-0100). Other support was provided by the F. Norman Hughes Chair in Pharmacoeconomics (MDK), and a Research Scientist Award from the Canadian Cancer Society (SMHA). 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Oncol. PD JUN PY 2014 VL 21 IS 3 BP E457 EP E465 DI 10.3747/co.21.1865 PG 9 WC Oncology WE Science Citation Index Expanded (SCI-EXPANDED) SC Oncology GA AK5VQ UT WOS:000338495000009 PM 24940106 OA Green Published, gold, Green Submitted DA 2023-05-13 ER PT J AU Tedesco, NS Pinheiro, FAG Vieira, JM Taniguchi, LU AF Tedesco, Natalia Sarracceni Pinheiro, Frederico Augusto Gurgel Vieira Junior, Jose Mauro Taniguchi, Leandro Utino TI Effects of an educational intervention for rational cardiac enzyme requisitions in critically ill patients: a pre-post intervention study SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE clinical laboratory techniques; practice management; medical; education; continuing; biomarkers ID PUBLIC-HEALTH INTERVENTIONS; INTENSIVE-CARE-UNIT; CREATINE KINASE-MB; LABORATORY UTILIZATION; MYOCARDIAL-INFARCTION; IMPACT; QUALITY; SAPS-3; TESTS AB Background Although cardiac troponin is recommended as the biomarker of choice to evaluate myocardial injury, inappropriate low-value ordering practice is frequent, particularly routine ordering of creatine kinase-myocardial band (CK-MB) tests where troponin is available. Objective The aim of this study was to evaluate the impact of an educational intervention for rational request of cardiac biomarkers in the intensive care unit. Method We conducted a quasi-experimental, pre-post implementation study of an educational program (expository-dialogue presentation and disclosure of a decision algorithm) for rational cardiac biomarker testing in adult critically ill patients. The study was divided into two 12-month periods: pre-intervention (September 2017-August 2018) and post-intervention (October 2018-September 2019). An interrupted time series with a segmented regression model was applied to analyze variation over time in CK-MB and troponin testing. Results We included 4429 patients: 2181 patients in the pre-intervention period and 2248 patients in the post-intervention period. A reduction in the concomitance of CK-MB and troponin testing was observed (concomitance in 1415 tests in the pre-intervention period vs 348 tests in the post-intervention period). The interrupted time series analysis demonstrated a noticeable immediate reduction in the concomitance of CK-MB with troponin after the intervention (-0.13 tests per patient, P = 0.0016) but not in the secular trend for the concomitance. The proportion of patients with the acute coronary syndrome as a discharge diagnosis was not different between the pre- and post-intervention period. Conclusion Our pre-post interventional study demonstrated a significant decrease in the concomitance of CK-MB and troponin tests. A rational high-value ordering practice of cardiac biomarkers is possible in critically ill patients and might be suitable for educational interventions. C1 [Tedesco, Natalia Sarracceni; Pinheiro, Frederico Augusto Gurgel; Vieira Junior, Jose Mauro; Taniguchi, Leandro Utino] Hosp Sirio Libanes, Rua Daher Cutait 69, BR-01308060 Sao Paulo, Brazil. [Taniguchi, Leandro Utino] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Av Eneas de Carvalho Aguiar 255 Sala 5023, BR-05403000 Sao Paulo, Brazil. [Taniguchi, Leandro Utino] Brazilian Res Intens Care Network BRICNet, Rua Pedro de Toledo 980, BR-04039002 Sao Paulo, Brazil. C3 Universidade de Sao Paulo RP Taniguchi, LU (通讯作者)，Hosp Sirio Libanes, Rua Daher Cutait 69, BR-01308060 Sao Paulo, Brazil. 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J. Qual. Health Care PD NOV 21 PY 2022 VL 34 IS 4 AR mzac088 DI 10.1093/intqhc/mzac088 PG 6 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 6R4LB UT WOS:000892275600001 PM 36281982 DA 2023-05-13 ER PT J AU Aarnio, EJ Martikainen, JA Helin-Salmivaara, A Huupponen, RK Hartikainen, JEK Peura, PK Korhonen, MJ AF Aarnio, Emma J. Martikainen, Janne A. Helin-Salmivaara, Ada Huupponen, Risto K. Hartikainen, Juha E. K. Peura, Ptia K. Korhonen, Maarit Jaana TI Register-based predictors of adherence among new statin users in Finland SO JOURNAL OF CLINICAL LIPIDOLOGY LA English DT Article DE Adherence; Statins; Register-based study; Dispensation delay; Out-of-pocket costs; Explanatory model ID MEDICATION COMPLIANCE; THERAPY; PERSISTENCE; PATIENT; DISCONTINUATION; PRESCRIPTION; ASSOCIATION; PHYSICIAN; COPAYMENT; PHARMACY AB BACKGROUND: Although register-based studies on statin adherence are increasing, for administrative data, little is known about the explanatory power of the predictors that explain adherence. OBJECTIVE: The aim was to explore the ability of variables in administrative data to predict statin adherence in an unselected, universally insured population and, especially, to explore dispensation delay (time elapsed between prescription and dispensation) and out-of-pocket costs as explanatory factors. METHODS: Statin initiators who were aged 45 to 75 years in 2000-2004 (n = 247, 051) were identified in the Finnish Prescription Register. First-year statin adherence was measured as the proportion of days covered (PDC). The effect of variables related to patient, health care, and payment.was assessed with multivariable logistic regression. The C statistic was used to evaluate the explanatory power of different models. RESULTS: Overall, 54.6% of the cohort had good adherence (PDC >= 80%). The explanatory power of all the models was low (C = 0.666 for the full model). The multivariable models, including only payment variables, had a greater explanatory power (C = 0.627) than models with only patient (C = 0.602) or health care (C = 0.548) variables. A shorter dispensation delay and lower out-of-pocket costs predicted better adherence. Of other patient-related variables, age, presence of acute coronary syndrome, and use of cardiovascular medications were significant predictors of adherence. Type of statin and the prescriber's workplace were also significantly associated with adherence. CONCLUSIONS: Models based on administrative data do not provide useful prediction of statin adherence. Of the individual predictors, long dispensation delay may serve as a practical tool for identifying patients at risk of poor adherence. Increases nonadherence. (C) 2014 National Lipid Association. All rights reserved. C1 [Aarnio, Emma J.; Huupponen, Risto K.] Turku Univ Hosp, Tykslab, Dept Clin Pharmacol, FIN-20520 Turku, Finland. [Aarnio, Emma J.; Martikainen, Janne A.] Univ Eastern Finland, Sch Pharm, Kuopio 70211, Finland. [Helin-Salmivaara, Ada; Korhonen, Maarit Jaana] Univ Turku, Dept Pharmacol Drug Dev & Therapeut, Turku, Finland. [Helin-Salmivaara, Ada] Hosp Dist Helsinki & Uusimaa, Unit Primary Hlth Care, Helsinki, Finland. [Hartikainen, Juha E. K.] Kuopio Univ Hosp, Ctr Heart, SF-70210 Kuopio, Finland. [Hartikainen, Juha E. K.] Univ Eastern Finland, Sch Med, Kuopio, Finland. [Peura, Ptia K.] Finnish Med Agcy, Kuopio, Finland. [Korhonen, Maarit Jaana] Univ Turku, Dept Publ Hlth, Turku, Finland. C3 University of Turku; University of Eastern Finland; University of Turku; University of Helsinki; Helsinki University Central Hospital; Kuopio University Hospital; University of Eastern Finland; University of Eastern Finland; University of Turku RP Aarnio, EJ (通讯作者)，Turku Univ Hosp, Tykslab, Dept Clin Pharmacol, FIN-20520 Turku, Finland. EM emma.aarnio@uef.fi OI Korhonen, Maarit/0000-0002-2953-4757; Aarnio, Emma/0000-0002-6555-7833; Hartikainen, Juha/0000-0003-0847-107X FU state funding for university-level health research [L 3820]; Social Insurance Institution [10/26/2007]; Academy of Finland [138255]; ESiOR Ltd.; AstraZeneca; St Jude Medical; Medtronic; MSD; Novartis; Bayer; Academy of Finland (AKA) [138255] Funding Source: Academy of Finland (AKA) FX This work was supported by state funding for university-level health research (grant L 3820 to E.A.) and by the Social Insurance Institution (www.kela.fi; grant 10/26/2007 to A.H.-S. and M.J.K.) and the Academy of Finland (www.aka.fi decision number 138255 to A.H.-S. and M.J.K.). The funders had no role in the design, analyses, interpretation of data, writing the report, or in the decision to submit the manuscript.; Conflicts of interests: E.A. has received consultancy fees from ESiOR Ltd. J.M. is the senior partner of ESiOR Ltd, which provides health economic and outcomes research (HEOR) services for pharmaceutical companies and hospitals. R.H. is a member of the Advisory Board for Social and Medical Affairs of the Social Insurance Institution, has conducted consultancy for Orion Corporation as an independent external member of a Data Monitoring and Safety Committee in a clinical trial, and assisted Santen Pharmaceutical Co in pharmacokinetic calculations. J.H. has received lecturing fees from AstraZeneca, St Jude Medical, Medtronic, MSD, Novartis, and Bayer. A.H.-S., M.J.K., and P.P. declare that no competing interests exist. The authors declare no other financial or nonfinancial (professional or personal) conflict of interests. 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Clin. Lipidol. PD FEB PY 2014 VL 8 IS 1 BP 117 EP 125 DI 10.1016/j.jacl.2013.09.008 PG 9 WC Pharmacology & Pharmacy WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy GA AB7SV UT WOS:000331991900011 PM 24528692 OA Bronze DA 2023-05-13 ER PT J AU Dias, JD Pottgiesser, T Hartmann, J Duerschmied, D Bode, C Achneck, HE AF Dias, Joao D. Pottgiesser, Torben Hartmann, Jan Duerschmied, Daniel Bode, Christoph Achneck, Hardean E. TI Comparison of three common whole blood platelet function tests for in vitro P2Y12 induced platelet inhibition SO JOURNAL OF THROMBOSIS AND THROMBOLYSIS LA English DT Article DE Coagulation; Diagnostic; TEG (R); Platelet function; Platelets ID CLOPIDOGREL-TREATED PATIENTS; ADJUST ANTIPLATELET THERAPY; CARDIAC-SURGERY PATIENTS; ACUTE CORONARY SYNDROME; STENT THROMBOSIS; OPEN-LABEL; REACTIVITY; POINT; RISK; AGGREGOMETRY AB In the context of interventional cardiology, platelet function testing may identify patients treated with P2Y12-inhibitors at an increased risk of mortality, thrombosis and bleeding. Several whole blood point-of-care platelet function analyzers are available; however, inter-device differences have not been examined systematically. To compare three platelet function tests under standardized in vitro conditions. Healthy volunteer (n = 10) blood samples were spiked with increasing concentrations of ticagrelor (0-7500 ng/mL) and/or ASA (0-3280 ng/mL), measured on three platelet function analyzers (TEG (R) 6s, Multiplate (R), and VerifyNow (R)) and respective Effective Concentration (EC) levels EC10, EC50 and EC90 were calculated. Repeatability was assessed in a separate group of pooled blood samples (n = 10) spiked with ticagrelor at EC10, EC50 and EC90. ASA had no impact on ADP-activated channels for all three devices. TEG (R) 6s was able to distinguish (p <= 0.05) between all ticagrelor EC zones; VerifyNow (R) and Multiplate (R) were able to distinguish between three and two zones, respectively. Multiplate (R) showed the largest window between EC10 and EC90 (19-9153 ng/mL), followed by TEG (R) 6s (144-2589 ng/mL), and VerifyNow (R) (191-1100 ng/mL). Drug effect models distribution of disagreements were identified for TEG (R) 6s (5.0%), VerifyNow (R) (8.3%), and Multiplate (R) (13.3%). TEG (R) 6s showed the smallest average coefficient of variation between EC conditions (5.1%), followed by Multiplate (R) (14.1%), and VerifyNow (R) (17.7%). Linear models could be generated between TEG (R) 6s and Multiplate (R), but not VerifyNow (R). Significant differences were found between whole blood point-of-care platelet function analyzers and the clinical impact of these differences needs to be further investigated. C1 [Dias, Joao D.] Haemonet SA, Signy, Switzerland. [Pottgiesser, Torben; Duerschmied, Daniel; Bode, Christoph] Univ Freiburg, Heart Ctr Freiburg Univ, Fac Med, Dept Cardiol & Angiol 1, Freiburg, Germany. [Hartmann, Jan; Achneck, Hardean E.] Haemonetics Corp, Braintree, MA USA. C3 Universitats Herzzentrum Freiburg; University of Freiburg RP Dias, JD (通讯作者)，Haemonet SA, Signy, Switzerland. EM jdias@haemonetics.com RI Duerschmied, D./AAB-5139-2021; Duerschmied, Daniel/K-8182-2015 OI Duerschmied, D./0000-0001-5249-4012; Duerschmied, Daniel/0000-0001-5249-4012; Pottgiesser, Torben/0000-0003-4925-8478; Hartmann, Jan/0000-0003-4978-8014; Dias, Joao D./0000-0002-1150-4357 FU Haemonetics SA, Signy, Switzerland; Haemonetics Corp., Braintree, MA, USA FX The authors thank Meridian HealthComms, Plumley, UK for providing medical writing support, which was funded by Haemonetics SA, Signy, Switzerland in accordance with Good Publication Practice (GPP3). The authors also thank Clinstatdevice LLC, Lexington, MA, USA for providing biostatistics support, which was funded by Haemonetics Corp., Braintree, MA, USA. Finally, the authors would like to thank Elmar R. Burchardt MD, PhD for his comments on this work. 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Thromb. Thrombolysis PD JUL PY 2020 VL 50 IS 1 BP 135 EP 143 DI 10.1007/s11239-019-01971-1 EA OCT 2019 PG 9 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Hematology GA LY0ER UT WOS:000490888400001 PM 31620937 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Gual, M Ariza-Sole, A Marquez, MG Fernandez, C Bernal, JL Formiga, F Barrionuevo, MI Sanchez-Salado, JC Lorente, V Pascual, J Llao, I Alegre, O Cequier, A Elola, J AF Gual, Miquel Ariza-Sole, Albert Garcia Marquez, Maria Fernandez, Cristina Bernal, Jose L. Formiga, Francesc Barrionuevo, Maria-Isabel Sanchez-Salado, Jose C. Lorente, Victoria Pascual, Julia Llao, Isaac Alegre, Oriol Cequier, Angel Elola, Javier TI Diabetes mellitus, revascularization and outcomes in elderly patients with myocardial infarction-related cardiogenic shock SO JOURNAL OF GERIATRIC CARDIOLOGY LA English DT Article DE Cardiogenic shock; Diabetes mellitus; Myocardial infarction; Revascularization; The elderly ID ACUTE CORONARY SYNDROME; MORTALITY; MANAGEMENT; ISSUES; CARE AB Background The prognostic role of diabetes mellitus (DM) in elderly patients with myocardial infarction-related cardiogenic shock (MI-CS) remains controversial. Little information exists about the impact of intensive cardiac care unit (ICCU) and revascularization on outcomes of elderly patients with MI-CS. We aimed to assess the prognostic impact of DM according to age in patients with MI-CS, and to analyze the impact ICCU management and revascularization on in-hospital mortality in MI-CS patients at older ages. Methods Discharge episodes with diagnosis of CS associated with MI were selected from the Spanish National Health System's Basic Data Set. Centers were classified according to their availability of ICCU. Main outcome measured was in-hospital mortality. Results A total of 23,590 episodes of MI-CS were identified, of whom 12,447 (52.8%) were in patients aged >= 75 years. The impact of DM on in-hospital mortality was different among age subgroups. While in younger patients, DM was associated to a higher mortality risk (0.52 vs. 0.47, OR = 1.12, 95% CI: 1.06-1.18, chi(2) < 0.001), this association became non-significant in older patients (0.76 vs. 0.81, chi(2) = 0.09). Adjusted mortality rate of MI-CS aged = 75 years was lower in patients admitted to hospitals with ICCU (adjusted mortality rate: 74.2% vs. 77.7%, P < 0.001) and in patients undergoing revascularization (74.9% vs. 77.3%, P < 0.001). Conclusions Prognostic impact of DM in patients with MI-CS was different according to age, with a significantly lower impact at older ages. The availability of ICCU and revascularization were associated with better outcomes in these complex patients. C1 [Gual, Miquel; Ariza-Sole, Albert; Formiga, Francesc; Barrionuevo, Maria-Isabel; Sanchez-Salado, Jose C.; Lorente, Victoria; Pascual, Julia; Llao, Isaac; Alegre, Oriol; Cequier, Angel] Hosp Univ Bellvitge, Barcelona, Spain. [Garcia Marquez, Maria; Fernandez, Cristina; Bernal, Jose L.; Elola, Javier] Fdn Inst Mejora Asistencia Sanitaria, Madrid, Spain. [Fernandez, Cristina] Hosp Clin Univ San Carlos, Madrid, Spain. [Bernal, Jose L.] Hosp Univ 12 Octubre, Madrid, Spain. C3 Institut d'Investigacio Biomedica de Bellvitge (IDIBELL); Bellvitge University Hospital; University of Barcelona; Hospital Universitario 12 de Octubre RP Ariza-Sole, A (通讯作者)，Hosp Univ Bellvitge, Cardiol Dept, Barcelona, Spain. EM aariza@bellvitgehospital.cat RI ; Fernandez Perez, Cristina/I-2220-2015 OI Cequier, Angel/0000-0002-3230-0011; Pascual, Julia/0000-0003-2112-5358; Bernal, Jose L./0000-0001-7991-1875; Fernandez Perez, Cristina/0000-0001-9853-6257 FU Fundacion Interhospitalaria para la Investigacion Cardiovascular and Laboratorios Menarini S.L. (RECALCAR Project) FX This study was supported by the Fundacion Interhospitalaria para la Investigacion Cardiovascular and Laboratorios Menarini S.L. (RECALCAR Project). All authors had no conflicts of interest to disclose. The authors thank the Spanish Ministry of Health, Consumer Affairs and Social Welfare for the help provided to the Spanish Society of Cardiology to develop the RECALCAR study, with special gratitude to the General Directorate of Public Health, Quality, and Innovation. 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Geriatr. Cardiol. PY 2020 VL 17 IS 10 BP 604 EP 611 DI 10.11909/j.issn.1671-5411.2020.10.006 PG 8 WC Cardiac & Cardiovascular Systems; Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology; Geriatrics & Gerontology GA PS6XJ UT WOS:000608070700002 PM 33224179 DA 2023-05-13 ER PT J AU Jentzer, JC Kashani, KB Wiley, BM Patel, PC Baran, DA Barsness, GW Henry, TD Van Diepen, S AF Jentzer, Jacob C. Kashani, Kianoush B. Wiley, Brandon M. Patel, Parag C. Baran, David A. Barsness, Gregory W. Henry, Timothy D. Van Diepen, Sean TI Laboratory Markers of Acidosis and Mortality in Cardiogenic Shock: Developing a Definition of Hemometabolic Shock SO SHOCK LA English DT Article DE Cardiogenic shock; CICU; lactic acidosis; metabolic acidosis; mortality; organ failure; shock ID SHORT-TERM MORTALITY; RISK PREDICTION; CARE; MANAGEMENT; SUPPORT; LACTATE AB Background: Acidosis and higher lactate predict worse outcomes in cardiogenic shock (CS) patients. We sought to determine whether overall acidosis severity on admission predicted in-hospital mortality in CS patients. Methods: This retrospective descriptive analysis included CS patients admitted to a single academic tertiary cardiac intensive care unit from 2007 to 2015. Admission arterial pH, base excess, and anion gap values were used to generate a Composite Acidosis Score (range 0-5, with a score >= 2 defining Severe Acidosis). Adjusted in-hospital mortality was analyzed using multivariable logistic regression. Results: We included 1,065 patients with median age of 68.9 (59.0, 77.2) years (36.4% females). Concomitant diagnoses included cardiac arrest in 38.1% and acute coronary syndrome in 59.1%. Severe Acidosis was present in 35.2%, and these patients had worse shock and more organ failure. In-hospital mortality occurred in 34.1% and was higher among patients with Severe Acidosis (54.9% vs. 22.4%, adjusted odds ratio [OR] 2.01, 95% CI 1.43-2.83, P < 0.001). Increasing Composite Acidosis Score was associated with higher in-hospital mortality (adjusted OR 1.25 per point, 95% CI 1.11-1.40, P < 0.001). Severe Acidosis was associated with higher hospital mortality at every level of shock severity and organ failure (all P < 0.05). Admission lactate level had equivalent discrimination for in-hospital mortality as the Composite Acidosis Score (0.69 vs. 0.66; P = 0.32 by De Long test). Conclusion: Given its incremental association with higher in-hospital mortality among CS patients beyond shock severity and organ failure, we propose Severe Acidosis as a marker of hemometabolic shock. Lactate levels performed as well as a composite measure of acidosis for predicting mortality. C1 [Jentzer, Jacob C.; Wiley, Brandon M.; Barsness, Gregory W.] Mayo Clin, Dept Cardiovasc Med, Rochester, MN 55905 USA. [Jentzer, Jacob C.; Kashani, Kianoush B.] Mayo Clin, Dept Internal Med, Div Pulm & Crit Care Med, 200 First St SW, Rochester, MN 55905 USA. [Jentzer, Jacob C.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN 55905 USA. [Kashani, Kianoush B.] Mayo Clin, Dept Internal Med, Div Nephrol & Hypertens, Rochester, MN 55905 USA. [Patel, Parag C.] Mayo Clin, Dept Cardiovasc Med, Jacksonville, FL 32224 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. [Henry, Timothy D.] Christ Hosp Hlth Network, Carl & Edyth Lindner Ctr Res & Educ, Cincinnati, OH USA. [Van Diepen, Sean] Univ Alberta Hosp, Dept Crit Care Med, Edmonton, AB, Canada. [Van Diepen, Sean] Univ Alberta Hosp, Dept Med, Div Cardiol, Edmonton, AB, Canada. C3 Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Sentara Healthcare; Eastern Virginia Medical School; Sentara Healthcare; Christ Hospital - Ohio; University of Alberta; University of Alberta RP Jentzer, JC (通讯作者)，Mayo Clin, Dept Internal 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, Med, 200 First St SW, Rochester, MN 55905 USA. EM jentzer.jacob@mayo.edu CR Attana Paola, 2013, Acute Card Care, V15, P58, DOI 10.3109/17482941.2013.776691 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 Burstein B, 2021, SHOCK, V55, P613, DOI 10.1097/SHK.0000000000001582 Davis JW, 2018, AM J SURG, V215, P682, DOI 10.1016/j.amjsurg.2018.01.025 Esposito Michele L, 2017, F1000Res, V6, P737, DOI 10.12688/f1000research.11150.1 Fuernau G, 2020, JACC-CARDIOVASC INTE, V13, P2208, DOI 10.1016/j.jcin.2020.06.037 Fuernau G, 2019, CURR OPIN CRIT CARE, V25, P403, DOI 10.1097/MCC.0000000000000628 Gatz Rainer, 2014, Acute Card Care, V16, P34, DOI 10.3109/17482941.2013.859270 Ghauri SK, 2019, CUREUS, V11, DOI 10.7759/cureus.4297 Glasmacher SA, 2016, BMC ANESTHESIOL, V16, DOI 10.1186/s12871-016-0241-y Harjola VP, 2015, EUR J HEART FAIL, V17, P501, DOI 10.1002/ejhf.260 Jentzer JC, 2021, EUR HEART J-ACUTE CA, V10, P604, DOI 10.1093/ehjacc/zuaa035 Jentzer JC, 2020, J CRIT CARE, V60, P127, DOI 10.1016/j.jcrc.2020.07.031 Jentzer JC, 2020, AM HEART J, V224, P57, DOI 10.1016/j.ahj.2020.02.018 Jentzer JC, 2020, CATHETER CARDIO INTE, V96, P1350, DOI 10.1002/ccd.28854 Jentzer JC, 2020, CLIN CARDIOL, V43, P516, DOI 10.1002/clc.23339 Jentzer JC, 2020, AM HEART J, V219, P37, DOI 10.1016/j.ahj.2019.10.012 Jentzer JC, 2019, J AM COLL CARDIOL, V74, P2117, DOI 10.1016/j.jacc.2019.07.077 Jentzer JC, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.119.013675 Jentzer JC, 2019, AM HEART J, V215, P12, DOI 10.1016/j.ahj.2019.05.012 Jentzer JC, 2020, SHOCK, V53, P452, DOI 10.1097/SHK.0000000000001390 Jentzer JC, 2018, AM J CARDIOL, V122, P1773, DOI 10.1016/j.amjcard.2018.08.011 Jentzer JC, 2018, CHEST, V154, P416, DOI 10.1016/j.chest.2017.12.021 Jentzer JC, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.117.008169 Kimmoun A, 2015, CRIT CARE, V19, DOI 10.1186/s13054-015-0896-7 KNAUS WA, 1991, CHEST, V100, P1619, DOI 10.1378/chest.100.6.1619 Lambert L, 2012, CAN J CARDIOL, V28, P162, DOI 10.1016/j.cjca.2011.10.005 Ouweneel DM, 2017, J AM COLL CARDIOL, V69, P278, DOI 10.1016/j.jacc.2016.10.022 Poss J, 2017, J AM COLL CARDIOL, V69, P1913, DOI 10.1016/j.jacc.2017.02.027 Schmidt M, 2015, EUR HEART J, V36, P2246, DOI 10.1093/eurheartj/ehv194 Schrage B, 2020, CATHETER CARDIO INTE, V96, pE213, DOI 10.1002/ccd.28707 Thiele H, 2017, NEW ENGL J MED, V377, P2419, DOI 10.1056/NEJMoa1710261 Thiele H, 2012, NEW ENGL J MED, V367, P1287, DOI 10.1056/NEJMoa1208410 van Diepen S, 2017, CIRCULATION, V136, pE232, DOI 10.1161/CIR.0000000000000525 Wigger O, 2018, EUR HEART J-ACUTE CA, V7, P45, DOI 10.1177/2048872616683526 Zante B, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0205309 NR 37 TC 10 Z9 10 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 1073-2322 EI 1540-0514 J9 SHOCK JI Shock PD JAN PY 2022 VL 57 IS 1 BP 31 EP 40 DI 10.1097/SHK.0000000000001812 PG 10 WC Critical Care Medicine; Hematology; Surgery; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Hematology; Surgery; Cardiovascular System & Cardiology GA XO1HM UT WOS:000729944200005 PM 33988540 DA 2023-05-13 ER PT J AU Kirchhof, P Camm, AJ Goette, A Brandes, A Eckardt, L Elvan, A Fetsch, T van Gelder, IC Haase, D Haegeli, LM Hamann, F Heidbuchel, H Hindricks, G Kautzner, J Kuck, KH Mont, L Ng, GA Rekosz, J Schoen, N Schotten, U Suling, A Taggeselle, J Themistoclakis, S Vettorazzi, E Vardas, P Wegscheider, K Willems, S Crijns, HJGM Breithardt, G AF Kirchhof, Paulus Camm, A. John Goette, Andreas Brandes, Axel Eckardt, Lars Elvan, Arif Fetsch, Thomas van Gelder, Isabelle C. Haase, Doreen Haegeli, Laurent M. Hamann, Frank Heidbuchel, Hein Hindricks, Gerhard Kautzner, Josef Kuck, Karl-Heinz Mont, Lluis Ng, G. Andre Rekosz, Jerzy Schoen, Norbert Schotten, Ulrich Suling, Anna Taggeselle, Jens Themistoclakis, Sakis Vettorazzi, Eik Vardas, Panos Wegscheider, Karl Willems, Stephan Crijns, Harry J. G. M. Breithardt, Gunter CA EAST-AFNET 4 Trial Investigators TI Early Rhythm-Control Therapy in Patients with Atrial Fibrillation SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID CATHETER ABLATION; MANAGEMENT; RISK; STROKE; DRONEDARONE; GUIDELINES; SAFETY; DEATH AB BackgroundDespite improvements in the management of atrial fibrillation, patients with this condition remain at increased risk for cardiovascular complications. It is unclear whether early rhythm-control therapy can reduce this risk. MethodsIn this international, investigator-initiated, parallel-group, open, blinded-outcome-assessment trial, we randomly assigned patients who had early atrial fibrillation (diagnosed <= 1 year before enrollment) and cardiovascular conditions to receive either early rhythm control or usual care. Early rhythm control included treatment with antiarrhythmic drugs or atrial fibrillation ablation after randomization. Usual care limited rhythm control to the management of atrial fibrillation-related symptoms. The first primary outcome was a composite of death from cardiovascular causes, stroke, or hospitalization with worsening of heart failure or acute coronary syndrome; the second primary outcome was the number of nights spent in the hospital per year. The primary safety outcome was a composite of death, stroke, or serious adverse events related to rhythm-control therapy. Secondary outcomes, including symptoms and left ventricular function, were also evaluated. ResultsIn 135 centers, 2789 patients with early atrial fibrillation (median time since diagnosis, 36 days) underwent randomization. The trial was stopped for efficacy at the third interim analysis after a median of 5.1 years of follow-up per patient. A first-primary-outcome event occurred in 249 of the patients assigned to early rhythm control (3.9 per 100 person-years) and in 316 patients assigned to usual care (5.0 per 100 person-years) (hazard ratio, 0.79; 96% confidence interval, 0.66 to 0.94; P=0.005). The mean (SD) number of nights spent in the hospital did not differ significantly between the groups (5.821.9 and 5.1 +/- 15.5 days per year, respectively; P=0.23). The percentage of patients with a primary safety outcome event did not differ significantly between the groups; serious adverse events related to rhythm-control therapy occurred in 4.9% of the patients assigned to early rhythm control and 1.4% of the patients assigned to usual care. Symptoms and left ventricular function at 2 years did not differ significantly between the groups. Conclusions Early rhythm-control therapy was associated with a lower risk of adverse cardiovascular outcomes than usual care among patients with early atrial fibrillation and cardiovascular conditions. (Funded by the German Ministry of Education and Research and others; EAST-AFNET 4 ISRCTN number, ISRCTN04708680; ClinicalTrials.gov number, NCT01288352; EudraCT number, 2010-021258-20.) In this multicenter, randomized trial comparing early rhythm control with usual care in patients with early atrial fibrillation and cardiovascular conditions, early rhythm control reduced the rate of death from cardiovascular causes and cardiovascular complications and did not affect the number of nights in the hospital. C1 [Kirchhof, Paulus] Univ Med Ctr Hamburg Eppendorf, Inst Med Biometry & Epidemiol, Hamburg, Germany. [Suling, Anna; Vettorazzi, Eik; Wegscheider, Karl] Univ Med Ctr Hamburg Eppendorf, Inst Med Biometry & Epidemiol, Hamburg, Germany. [Kuck, Karl-Heinz] Asklepios Klin St Georg, LANS Cardio, Hamburg, Germany. [Willems, Stephan] Asklepios Klin St Georg, Dept Cardiol, Hamburg, Germany. [Kirchhof, Paulus; Goette, Andreas; Eckardt, Lars; Fetsch, Thomas; Haase, Doreen; Kuck, Karl-Heinz; Schoen, Norbert; Schotten, Ulrich; Taggeselle, Jens; Wegscheider, Karl; Willems, Stephan; Breithardt, Gunter] Univ Hosp Munster, Atrial Fibrillat Network AFNET, Munster, Germany. [Eckardt, Lars; Breithardt, Gunter] Univ Hosp Munster, Dept Cardiol Electrophysiol 2, Munster, Germany. [Kirchhof, Paulus; Wegscheider, Karl; Willems, Stephan] German Ctr Cardiovasc Res, Partner Site Hamburg Lubeck Kiel, Paderborn, Germany. [Goette, Andreas] St Vincenz Hosp, Paderborn, Germany. [Goette, Andreas] Univ Hosp Magdeburg, Working Grp Mol Electrophysiol, Magdeburg, Germany. [Fetsch, Thomas] Clin Res Inst, Munich, Germany. [Hamann, Frank] Hosp Konstanz, Constance, Germany. [Hindricks, Gerhard] Univ & Leart Ctr Helios, Dept Cardiol & Electrophysiol, Leipzig, Germany. [Hindricks, Gerhard] Leipzig Lean Inst, Leipzig, Germany. [Kuck, Karl-Heinz] Univ Heart & Vasc Ctr Hamburg, Campus Lubeck, Lubeck, Germany. [Schoen, Norbert] Cardiol Practice Schon, Muhldorf, Germany. [Taggeselle, Jens] Cardiol Practice Taggeselle, Markkleeberg, Germany. [Kirchhof, Paulus] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England. [Camm, A. John] St Georges Univ London, Cardiol Clin Acad Grp, Mol & Clin Sci Res Inst, London, England. [Ng, G. Andre] Univ Leicester, Dept Cardiovasc Sci, Natl Inst Hlth Res Leicester Biomed Res Ctr, Glenfield Hosp, Leicester, Leics, England. [Brandes, Axel] Odense Univ Hosp, Dept Cardiol, Odense, Denmark. [Brandes, Axel] Univ Southern Denmark, Dept Clin Res, Odense, Denmark. [Elvan, Arif] Isala Hosp & Diagram BV, Zwolle, Netherlands. [van Gelder, Isabelle C.] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands. [Schotten, Ulrich] Cardiovasc Res Inst Maastricht, Dept Physiol Cardiovasc, Maastricht, Netherlands. [Crijns, Harry J. G. M.] Maastricht Univ, Med Ctr, Dept Cardiol, Maastricht, Netherlands. [Crijns, Harry J. G. M.] Cardiovasc Res Inst Maastricht, Maastricht, Netherlands. [Haegeli, Laurent M.] Univ Hosp Zurich, Zurich, Switzerland. [Haegeli, Laurent M.] Kantonsspital Aarau, Div Cardiol, Med Univ Dept, Aarau, Switzerland. [Heidbuchel, Hein] Univ Hosp Antwerp, Antwerp, Belgium. [Heidbuchel, Hein] Antwerp Univ, Antwerp, Belgium. [Kautzner, Josef] Inst Clin & Expt Med, Prague, Czech Republic. [Mont, Lluis] Univ Barcelona, Hosp Clin, Barcelona, Spain. [Mont, Lluis] Inst Recerca Biomed August Pi Sunyer, Barcelona, Spain. [Mont, Lluis] Ctr Invest Biomed Red Cardiovasc, Madrid, Spain. [Rekosz, Jerzy] Hosp Wojewodzka Stacja Pogotowia Rutunkowego & Tr, Dept Cardiol, Warsaw, Poland. [Themistoclakis, Sakis] Osped Angelo, Dept Cardiol, Venice, Italy. [Vardas, Panos] Hygeia Hosp Grp, Heart Sect, Athens, Greece. C3 University of Hamburg; University Medical Center Hamburg-Eppendorf; University of Hamburg; University Medical Center Hamburg-Eppendorf; Asklepios Klinik St. Georg; Asklepios Klinik St. Georg; University of Munster; University of Munster; German Centre for Cardiovascular Research; University Hospital Magdeburg; RLUK- Research Libraries UK; University of Birmingham; St Georges University London; RLUK- Research Libraries UK; University of Leicester; University Hospitals of Leicester NHS Trust; Glenfield Hospital; University of Southern Denmark; Odense University Hospital; University of Southern Denmark; University of Groningen; Maastricht University; Maastricht University; Maastricht University; University of Zurich; University Zurich Hospital; Kantonsspital Aarau AG (KSA); University of Antwerp; University of Antwerp; Institute for Clinical & Experimental Medicine (IKEM); University of Barcelona; Hospital Clinic de Barcelona; University of Barcelona; Hospital Clinic de Barcelona; IDIBAPS; Centro Nacional de Investigaciones Cardiovasculares (CNIC); ULSS 3 Serenissima; Ospedale dell'Angelo Mestre RP Kirchhof, P (通讯作者)，Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52,Gebaude Ost 70, D-20246 Hamburg, Germany. EM p.kirchhof@uke.de RI Heidbuchel, Hein/AAU-2711-2021; Malik, Jan/K-8681-2019; Kirchhof, Paulus/AAT-7074-2021; Vardas, Panos/AAP-5694-2021; vardas, panos/ABF-7144-2020; Gallagher, Mark M/AAG-2787-2020; Vettorazzi, Eik/B-8130-2019; Brandes, Axel/L-3609-2019; Vardas, Panos/AAD-5219-2022 OI Heidbuchel, Hein/0000-0001-9301-8127; Malik, Jan/0000-0002-2386-3293; Kirchhof, Paulus/0000-0002-1881-0197; Gallagher, Mark M/0000-0002-6333-6420; Vettorazzi, Eik/0000-0002-3737-6402; Brandes, Axel/0000-0001-9145-6887; Julio, Marti Almor/0000-0001-9927-1190; Rekosz, Jerzy/0000-0002-4544-7004; de Bono, Joseph/0000-0001-7160-2074; Schotten, Ulrich/0000-0003-1532-3315; Ng, G. Andre/0000-0001-5965-0671 FU German Ministry of Education and Research; EAST-AFNET 4 ISRCTN [ISRCTN04708680]; ClinicalTrials.gov [NCT01288352]; EudraCT [2010-021258-20] FX Funded by the German Ministry of Education and Research and others; EAST-AFNET 4 ISRCTN number, ISRCTN04708680; ClinicalTrials.gov number, NCT01288352; EudraCT number, 2010-021258-20.) 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Engl. J. Med. PD OCT 1 PY 2020 VL 383 IS 14 BP 1305 EP 1316 DI 10.1056/NEJMoa2019422 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA NX3MO UT WOS:000575616600007 PM 32865375 OA Green Published, Green Accepted DA 2023-05-13 ER PT J AU Yerasi, C Koifman, E Weissman, G Wang, ZY Torguson, R Gai, JX Lindsay, J Satler, LF Pichard, AD Waksman, R Ben-Dor, I AF Yerasi, Charan Koifman, Edward Weissman, Gaby Wang, Zuyue Torguson, Rebecca Gai, Jiaxiang Lindsay, Joseph Satler, Lowell F. Pichard, Augusto D. Waksman, Ron Ben-Dor, Itsik TI Impact of triggering event in outcomes of stress-induced (Takotsubo) cardiomyopathy SO EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE LA English DT Article DE Takotsubo cardiomyopathy; triggers; outcomes; mortality ID TAKO-TSUBO CARDIOMYOPATHY; ST-SEGMENT ELEVATION; MYOCARDIAL-INFARCTION; HEART-FAILURE; MORTALITY AB Background: Takotsubo syndrome is also known as stress cardiomyopathy because of the regularity with which it has been associated with physical or emotional stress. Such stress may well be a trigger of the syndrome. Aims: This analysis was undertaken to describe our experience with this disorder and in particular to examine the effects of the underlying trigger on outcomes. Methods: We conducted a retrospective review of the medical records of 345 consecutive patients treated at our institution from 2006 to 2014. All presented with acute cardiac symptoms, a characteristic left ventricular contraction pattern (typical, atypical), and no major obstructive coronary artery disease. Patients were grouped based on their triggering event: (a) medical illness; (b) post-operative period; (c) emotional distress; or (d) no identified trigger. Baseline demographic characteristics, death in hospital, length of stay in hospital, and cardiac complications were abstracted from the patients' medical records. Results: The mean +/- SD age of the population was 72 +/- 12 years and 91% were women. No significant difference in baseline characteristics was noted between the groups except for a higher prevalence of African Americans in the group with a medical illness. ST elevation was noted in 13.3% of patients and the average peak troponin level was 5 +/- 12 ng/dl. An inotropic drug was required in 49 (14.2%) patients, an intra-aortic balloon pump in 37 (10.7%) patients, and mechanical ventilation in 54 (15.7%) patients; 43.5% required treatment in the intensive care unit. Overall, 12 (3.5%) patients died. In only two (16.7%) patients was a there a direct cardiac cause of death. In those patients in whom the cardiac manifestations seemed to be triggered by a medical illness, the death rate was 7.1% and this was significantly higher than in the other groups (p=0.03). Medical illness (odds ratio=6.25, p=0.02) and ST elevation (odds ratio=5.71, p=0.04) were both significantly associated with death. Conclusions: Our study showed that different triggers for Takotsubo syndrome confer different prognoses, with medical illness conferring the worst prognosis. Overall, the in-hospital death rate was low and mostly related to non-cardiac death secondary to the underlying medical illness. Although an unidentified trigger was prevalent in a third of this population, efforts should be made to identify the triggering event to classify the risk group of patients with Takotsubo syndrome. C1 [Yerasi, Charan; Koifman, Edward; Weissman, Gaby; Wang, Zuyue; Torguson, Rebecca; Gai, Jiaxiang; Lindsay, Joseph; Satler, Lowell F.; Pichard, Augusto D.; Waksman, Ron; Ben-Dor, Itsik] Medstar Washington Hosp Ctr, Suite 2A-50,110 Irving St NW, Washington, DC 20010 USA. C3 MedStar Washington Hospital Center RP Yerasi, C (通讯作者)，Medstar Washington Hosp Ctr, Suite 2A-50,110 Irving St NW, Washington, DC 20010 USA. EM charantejareddy.yerasi@gmail.com RI Koifman, Edward/M-6754-2017; Yerasi, Charan/N-2329-2017 OI Koifman, Edward/0000-0002-7907-6002; Yerasi, Charan/0000-0002-3916-3216 CR ALDRICH HR, 1988, AM J CARDIOL, V61, P749, DOI 10.1016/0002-9149(88)91060-0 Citro R, 2014, JACC-CARDIOVASC IMAG, V7, P119, DOI 10.1016/j.jcmg.2013.09.020 Deshmukh A, 2012, AM HEART J, V164, P66, DOI 10.1016/j.ahj.2012.03.020 Dib C, 2009, AM HEART J, V157, P933, DOI 10.1016/j.ahj.2008.12.023 Ghadri JR, 2014, HEART, V100, P1804, DOI 10.1136/heartjnl-2013-304691 Isogai T, 2014, INT J CARDIOL, V176, P413, DOI 10.1016/j.ijcard.2014.07.110 Jo YY, 2013, J CRIT CARE, V28, P618, DOI 10.1016/j.jcrc.2013.03.014 Kurisu S, 2004, CIRC J, V68, P903, DOI 10.1253/circj.68.903 Kurisu S, 2012, J CARDIOL, V60, P429, DOI 10.1016/j.jjcc.2012.06.015 Kurowski V, 2007, CHEST, V132, P809, DOI 10.1378/chest.07-0608 Lee PH, 2010, J AM SOC ECHOCARDIOG, V23, P766, DOI 10.1016/j.echo.2010.05.002 Lyon AR, 2016, EUR J HEART FAIL, V18, P8, DOI 10.1002/ejhf.424 Park JH, 2005, CHEST, V128, P296, DOI 10.1378/chest.128.1.296 Redfors B, 2015, INT J CARDIOL, V185, P282, DOI 10.1016/j.ijcard.2015.03.162 Schneider B, 2013, INT J CARDIOL, V166, P584, DOI 10.1016/j.ijcard.2011.11.027 Sharkey SW, 2014, CIRC J, V78, P2119, DOI 10.1253/circj.CJ-14-0770 Singh K, 2014, AM J CARDIOL, V113, P1420, DOI 10.1016/j.amjcard.2014.01.419 Sy F, 2013, AM J CARDIOL, V112, P479, DOI 10.1016/j.amjcard.2013.04.010 Takashio S, 2012, AM J CARDIOL, V109, P1651, DOI 10.1016/j.amjcard.2012.01.393 Yoshimura S, 2008, ANN NEUROL, V64, P547, DOI 10.1002/ana.21459 NR 20 TC 31 Z9 33 U1 0 U2 4 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 2017 VL 6 IS 3 BP 280 EP 286 DI 10.1177/2048872616633881 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA ES7TF UT WOS:000399753200010 PM 26888788 OA Bronze DA 2023-05-13 ER PT J AU Belay, ED Abrams, J Oster, ME Giovanni, J Pierce, T Meng, L Prezzato, E Balachandran, N Openshaw, JJ Rosen, HE Kim, M Richardson, G Hand, J Tobin-D'Angelo, M Wilson, S Hartley, A Jones, C Kolsin, J Mohamed, H Colles, Z Hammett, T Patel, P Stierman, B Campbell, AP Godfred-Cato, S AF Belay, Ermias D. Abrams, Joseph Oster, Matthew E. Giovanni, Jennifer Pierce, Timmy Meng, Lu Prezzato, Emily Balachandran, Neha Openshaw, John J. Rosen, Hilary E. Kim, Moon Richardson, Gillian Hand, Julie Tobin-D'Angelo, Melissa Wilson, Siri Hartley, Amanda Jones, Cassandra Kolsin, Jonathan Mohamed, Hani Colles, Zachary Hammett, Teresa Patel, Pragna Stierman, Bryan Campbell, Angela P. Godfred-Cato, Shana TI Trends in Geographic and Temporal Distribution of US Children With Multisystem Inflammatory Syndrome During the COVID-19 Pandemic SO JAMA PEDIATRICS LA English DT Article ID DISEASE AB IMPORTANCE Multiple inflammatory syndrome in children (MIS-C) occurs in association with the COVID-19 pandemic. OBJECTIVE To describe the clinical characteristics and geographic and temporal distribution of the largest cohort of patients with MIS-C in the United States to date. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analysis was conducted on clinical and laboratory data collected from patients with MIS-C. The analysis included patients with illness onset from March 2020 to January 2021 and met MIS-C case definition. MAIN OUTCOMES AND MEASURES Geographic and temporal distribution of MIS-C was compared with that of COVID-19 nationally, by region, and level of urbanicity by county. Clinical and laboratory findings and changes over time were described by age group and by presence or absence of preceding COVID-19. RESULTS A total of 1733 patients with MIS-C were identified; 994 (57.6%) were male and 1117 (71.3%) were Hispanic or non-Hispanic Black. Gastrointestinal symptoms, rash, and conjunctival hyperemia were reported by 53% (n = 931) to 67% (n = 1153) of patients. A total of 937 patients (54%) had hypotension or shock, and 1009 (58.2%) were admitted for intensive care. Cardiac dysfunction was reported in 484 patients (31.0%), pericardial effusion in 365 (23.4%), myocarditis in 300 (17.3%), and coronary artery dilatation or aneurysms in 258 (16.5%). Patients aged 0 to 4 years had the lowest proportion of severe manifestations, although 171 patients (38.4%) had hypotension or shock and 197 (44.3%) were admitted for intensive care. Patients aged 18 to 20 years had the highest proportions with myocarditis (17 [30.9%]), pneumonia (20 [36.4%]), acute respiratory distress syndrome (10 [18.2%]), and polymerase chain reaction positivity (39 [70.9%]). These older adolescents also had the highest proportion reporting preceding COVID-19-like illness (63%). Nationally, the first 2 MIS-C peaks followed the COVID-19 peaks by 2 to 5 weeks. The cumulative MIS-C incidence per 100 000 persons younger than 21 years was 2.1 and varied from 0.2 to 6.3 by state. Twenty-four patients (1.4%) died. CONCLUSIONS AND RELEVANCE In this cross-sectional study of a large cohort of patients with MIS-C, 2 peaks that followed COVID-19 peaks by 2 to 5 weeks were identified. The geographic and temporal association of MIS-C with the COVID-19 pandemic suggested that MIS-C resulted from delayed immunologic responses to SARS-CoV-2 infection. The clinical manifestations varied by age and by presence or absence of preceding COVID-19. (c) 2021 American Medical Association. All rights reserved. C1 [Belay, Ermias D.; Abrams, Joseph; Oster, Matthew E.; Giovanni, Jennifer; Pierce, Timmy; Meng, Lu; Prezzato, Emily; Balachandran, Neha; Hammett, Teresa; Patel, Pragna; Stierman, Bryan; Campbell, Angela P.; Godfred-Cato, Shana] US Ctr Dis Control & Prevent, COVID 19 Response Team, Atlanta, GA USA. [Pierce, Timmy] Oak Ridge Inst Sci & Educ, Oak Ridge, TN USA. [Meng, Lu] Apex Syst Affiliated Gen Dynam Informat Technol, Falls Church, VA USA. [Openshaw, John J.; Rosen, Hilary E.] Calif Dept Publ Hlth, Sacramento, CA USA. [Kim, Moon] Los Angeles Cty Dept Publ Hlth, Los Angeles, CA USA. [Richardson, Gillian; Hand, Julie] Louisana Dept Hlth, Baton Rouge, LA USA. [Tobin-D'Angelo, Melissa; Wilson, Siri] Georgia Dept Publ Hlth, Atlanta, GA USA. [Tobin-D'Angelo, Melissa; Hartley, Amanda; Jones, Cassandra] Tennessee Dept Hlth, Nashville, TN USA. [Kolsin, Jonathan] Texas Dept State Hlth Serv, Austin, TX USA. [Mohamed, Hani] South Carolina Dept Hlth & Environm Control, Columbia, SC USA. [Colles, Zachary] Ohio Dept Hlth, Columbus, OH 43266 USA. [Stierman, Bryan] US Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA USA. C3 Centers for Disease Control & Prevention - USA; Oak Ridge Associated Universities; United States Department of Energy (DOE); Oak Ridge Institute for Science & Education; California Department of Public Health; Los Angeles County Department of Public Health; Tennessee Department Health; Texas Department of State Health Services; Centers for Disease Control & Prevention - USA RP Belay, ED (通讯作者)，Ctr Dis Control & Prevent, 1600 Clifton Rd, Atlanta, GA 30333 USA. EM ebelay@cdc.gov RI Meng, Lu/GXN-0092-2022 OI Belay, Ermias/0000-0002-9837-0960; Meng, Lu/0000-0003-4078-8480 CR Abrams JY, 2020, J PEDIATR-US, V226, P45, DOI 10.1016/j.jpeds.2020.08.003 Belhadjer Z, 2020, CIRCULATION, V142, P2282, DOI 10.1161/CIRCULATIONAHA.120.050147 Belhadjer Z, 2020, CIRCULATION, V142, P429, DOI 10.1161/CIRCULATIONAHA.120.048360 Belot A, 2020, EUROSURVEILLANCE, V25, P2, DOI 10.2807/1560-7917.ES.2020.25.22.2001010 Centers for Disease Control and Prevention, 2020, COVID 19 CAS DAT SUR 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 Godfred-Cato S, 2020, MMWR-MORBID MORTAL W, V69, P1074, DOI 10.15585/mmwr.mm6932e2 Riphagen Shelley, 2020, Lancet, V395, P1607, DOI 10.1016/S0140-6736(20)31094-1 Rostad CA, 2020, PEDIATRICS, V146, DOI 10.1542/peds.2020-018242 Rowley AH, 2020, J PEDIATR-US, V224, P129, DOI 10.1016/j.jpeds.2020.06.057 Swann OV, 2020, BMJ-BRIT MED J, V370, DOI 10.1136/bmj.m3249 Torres JP, 2020, INT J INFECT DIS, V100, P75, DOI 10.1016/j.ijid.2020.08.062 Toubiana J, 2020, BMJ-BRIT MED J, V369, DOI 10.1136/bmj.m2094 United States Census Bureau, CENS REG DIV US United States Department of Housing and Urban Development, HUD USPS ZIP COD CRO US Centers for Disease Control and Prevention, 2013 NCHS URB RUR CL US Centers for Disease Control and Prevention, MULT INFL SYNDR CHIL USA Facts, US COR DEATHS TRACK Verdoni L, 2020, LANCET, V395, P1771, DOI 10.1016/S0140-6736(20)31103-X Whittaker E, 2020, JAMA-J AM MED ASSOC, V324, P259, DOI 10.1001/jama.2020.10369 NR 21 TC 138 Z9 140 U1 2 U2 14 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 2168-6203 EI 2168-6211 J9 JAMA PEDIATR JI JAMA Pediatr. PD AUG PY 2021 VL 175 IS 8 BP 837 EP 845 DI 10.1001/jamapediatrics.2021.0630 EA APR 2021 PG 9 WC Pediatrics WE Science Citation Index Expanded (SCI-EXPANDED) SC Pediatrics GA TV4TP UT WOS:000638292800002 PM 33821923 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Lin, JK Moran, AE Bibbins-Domingo, K Falase, B Tobias, AP Mandke, CN Kazi, DS AF Lin, John K. Moran, Andrew E. Bibbins-Domingo, Kirsten Falase, Bode Tobias, Andrea Pedroza Mandke, Charuta N. Kazi, Dhruv S. TI Cost-effectiveness of a fixed-dose combination pill for secondary prevention of cardiovascular disease in China, India, Mexico, Nigeria, and South Africa: a modelling study SO LANCET GLOBAL HEALTH LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; LOW-INCOME COUNTRIES; LIFE YEARS DALYS; RISK-FACTORS; SYSTEMATIC ANALYSIS; MIDDLE-INCOME; GLOBAL BURDEN; HEALTH; ADHERENCE AB Background Fewer than 25% of patients with atherosclerotic cardiovascular disease in countries of low and middle income (LMICs) use guideline-directed drugs for secondary prevention. A fixed-dose combination polypill might improve cardiovascular outcomes by increasing prescription rates and adherence, but the cost-effectiveness of this approach is uncertain. Methods We developed microsimulation models to assess the cost-effectiveness of a polypill containing aspirin, lisinopril, atenolol, and simvastatin for secondary prevention of atherosclerotic cardiovascular disease compared with current care in China, India, Mexico, Nigeria, and South Africa. We modelled baseline use of secondary prevention drugs on the Prospective Urban Rural Epidemiological study. In the intervention arm, we assumed that patients currently prescribed any prevention drug for atherosclerotic cardiovascular disease would receive the polypill instead, which would improve adherence by 32% (from a meta-analysis of two randomised trials in LMICs). We assessed the cost-effectiveness of the polypill at prices in the public sector and on the retail market. Key outcomes were major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) over a 5-year period and the incremental cost-effectiveness ratio (ICER) from the perspective of the health-care sector and a lifetime analytical horizon. We assumed a cost-effectiveness threshold equal to each country's per capita gross domestic product (GDP) per disability-adjusted life-year (DALY) averted. In sensitivity analyses, we examined the population health effect achievable by increasing the uptake of the polypill in the eligible population. Findings Among adults aged 30-84 years with established atherosclerotic cardiovascular disease, adoption of the polypill for secondary prevention compared with current care was projected to avert 40-54 major adverse cardiovascular events for every 1000 patients treated for 5 years and produce between three and ten additional serious adverse events. Assuming public-sector pharmaceutical prices, the ICER of the polypill compared with current care over a lifetime analytical horizon was Int$168 (95% UI 55 to 337) per DALY averted in China, $154 (57 to 289) in India, $88 (15 to 193) in Mexico, $364 (147 to 692) in Nigeria, and $64 (cost-saving to 203) in South Africa, amounting to 0.4-6.2% of the per capita GDP in these countries. The ICER of the polypill compared with current care increased to 3.3-14.6% of the per capita GDP at retail market pharmaceutical prices. Use of the polypill at current rates of prescription of secondary prevention drugs would produce modest health benefits, reducing DALYs from atherosclerotic cardiovascular disease among patients with established disease by 3.1-10.1% over 10 years. Increasing use to 50% or 75% of the eligible population would produce substantially larger health gains (up to 24.3% atherosclerotic cardiovascular disease DALYs averted). Interpretation The polypill is projected to be cost-effective compared with current care for secondary prevention of atherosclerotic cardiovascular disease in China, India, Mexico, Nigeria, and South Africa, particularly if it is made available at public-sector pricing. However, achieving meaningful improvements in cardiovascular health will require simultaneous investments in health infrastructure to increase the uptake of the polypill among patients with established atherosclerotic cardiovascular disease. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd. C1 [Lin, John K.] Vet Affairs Palo Alto Hlth Care Syst, Ctr Innovat Implementat, Palo Alto, CA USA. [Lin, John K.] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA. [Lin, John K.] Stanford Univ, Ctr Primary Care Outcomes Res, Stanford, CA 94305 USA. [Moran, Andrew E.] Columbia Univ, Div Gen Med, Med Ctr, New York, NY USA. [Bibbins-Domingo, Kirsten] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Bibbins-Domingo, Kirsten] Univ Calif San Francisco, Ctr Vulnerable Populat, San Francisco, CA 94143 USA. [Bibbins-Domingo, Kirsten] Univ Calif San Francisco, Global Hlth Sci, San Francisco, CA 94143 USA. [Falase, Bode] Lagos State Univ, Coll Med, Cardiothorac Div, Dept Surg, Lagos, Nigeria. [Tobias, Andrea Pedroza] Natl Inst Publ Hlth, Ctr Nutr & Hlth Res, Cuernavaca, Morelos, Mexico. [Mandke, Charuta N.] HBT Med Coll & Dr RN Cooper Hosp, Mumbai, Maharashtra, India. [Kazi, Dhruv S.] Beth Israel Deaconess Med Ctr, Richard A & Susan F Smith Ctr Outcomes Res Cardio, Boston, MA 02215 USA. [Kazi, Dhruv S.] Beth Israel Deaconess Med Ctr, Div Cardiol, Boston, MA 02215 USA. [Kazi, Dhruv S.] Harvard Med Sch, Boston, MA 02115 USA. C3 US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Palo Alto Health Care System; University of Pennsylvania; Pennsylvania Medicine; Stanford University; Columbia University; 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; Lagos State University; Instituto Nacional de Salud Publica; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Harvard Medical School RP Kazi, DS (通讯作者)，Beth Israel Deaconess Med Ctr, Richard A & Susan F Smith Ctr Outcomes Res Cardio, Boston, MA 02215 USA. EM dkazi@bidmc.harvard.edu RI Lin, John/HJA-2518-2022; Falase, Bode/AGE-7348-2022 OI Lin, John/0000-0003-2490-4453; Falase, Bode/0000-0002-2348-6926; Pedroza-Tobias, Andrea/0000-0002-7158-3667 FU Richard A and Susan F Smith Center for Outcomes Research in Cardiology; Hellman Family Foundation; Veterans Affairs Office of Academic Affiliations Advanced Fellowship in Health Services Research and Development; UCSF Resident Clinical and Translational Research Funding Program FX This study was supported in part by the Richard A and Susan F Smith Center for Outcomes Research in Cardiology (to DSK), a Hellman Family Foundation award (to DSK), the Veterans Affairs Office of Academic Affiliations Advanced Fellowship in Health Services Research and Development (to JKL), the University of California at San Francisco (UCSF) Global Health Pathways grant (to JKL), and the UCSF Resident Clinical and Translational Research Funding Program (to JKL). All views expressed are those of the authors and do not necessarily reflect the views of the US Department of Veterans Affairs. 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Health PD OCT PY 2019 VL 7 IS 10 BP E1346 EP E1358 DI 10.1016/S2214-109X(19)30339-0 PG 13 WC Public, Environmental & Occupational Health WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Public, Environmental & Occupational Health GA IX7NN UT WOS:000485871100030 PM 31477544 OA gold DA 2023-05-13 ER PT J AU Zorina, O Fatkulina, N Saduyeva, F Omarkulov, B Serikova, S AF Zorina, Olga Fatkulina, Natalja Saduyeva, Feruza Omarkulov, Bauyrzhan Serikova, Saltanat TI Patient Adherence to Therapy After Myocardial Infarction: A Review SO PATIENT PREFERENCE AND ADHERENCE LA English DT Review DE adherence; nursing; myocardial infarction ID HEALTH; PREVENTION AB Background: Patients with myocardial infarction have low adherence to secondary prevention. Patients with acute coronary syndromes usually decide not to take cardiac drugs for 7 days after discharge for various reasons and adherence rates are usually very low. The aim of this scoping review was to identify factors influencing treatment adherence after myocardial infarction and the role of interventions to improve treatment adherence.Methods: Two electronic databases (PubMed and Web of Science) were systematically searched for relevant published reviews of interventions for adherence after myocardial infarction. Inclusion criteria were study design: randomized control trial, systematic reviews; published in English; sample age >= 18 years. The methodological framework proposed by Arksey & O'Malley was used to guide the review process of the study.Results: Thirteen articles met the inclusion/exclusion criteria. Four of the thirteen studies assessed factors influencing patient adherence to therapy after myocardial infarction, the remaining studies examined various interventions increasing adherence to treatment after myocardial infarction.Conclusion: There is a need to improve adherence of patients to treatment after myocardial infarction. Studies show that the use of modern technologies and communication with the patients by phone improve adherence to treatment. C1 [Zorina, Olga; Saduyeva, Feruza; Serikova, Saltanat] Karaganda Med Univ, Res Sch, Karaganda, Kazakhstan. [Fatkulina, Natalja] Vilnius Univ, Inst Hlth Sci, Vilnius, Lithuania. [Omarkulov, Bauyrzhan] Karaganda Med Univ, Inst Publ Hlth & Profess Hlth, Karaganda, Kazakhstan. C3 Karaganda Medical University; Vilnius University; Karaganda Medical University RP Zorina, O (通讯作者)，Karaganda Med Univ, Res Sch, Karaganda, Kazakhstan.; Fatkulina, N (通讯作者)，Vilnius Univ, Inst Hlth Sci, Vilnius, Lithuania. EM zorina@qmu.kz; natalja.fatkulina@mf.vu.lt OI Fatkulina, Natalja/0000-0002-6562-053X; Saduyeva, Feruza/0000-0003-0332-2008 CR Aringazina A, 2018, CENT ASIAN J GLOB HE, V7, DOI 10.5195/cajgh.2018.321 Arksey H, 2005, INT J SOC RES METHOD, V8, P19, DOI 10.1080/1364557032000119616 BECKER MH, 1975, MED CARE, V13, P10, DOI 10.1097/00005650-197501000-00002 Bots Sophie H, 2021, Front Glob Womens Health, V2, P637398, DOI 10.3389/fgwh.2021.637398 Boyd AD, 2020, JMIR MHEALTH UHEALTH, V8, DOI 10.2196/15900 Crowley MJ, 2015, J GEN INTERN MED, V30, P83, DOI 10.1007/s11606-014-3072-x Davies P, 2010, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD007131.pub2 Desai Rupak, 2019, Cureus, V11, pe5389, DOI 10.7759/cureus.5389 Diem G, 2016, GLOB HEALTH PROMOT, V23, P5, DOI 10.1177/1757975914567513 Eurostat, DEATHS DUE COR HEART Goff DC, 2013, CIRCULATION, V25, pS49 Hsu Grace I-Hsuan, 2017, J Biocommun, V41, pe3, DOI 10.5210/jbc.v41i1.7499 Karmali KN, 2014, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD007131.pub3 Kirsch F, 2020, BMC HEALTH SERV RES, V20, DOI 10.1186/s12913-020-05946-4 LaValley G, 2019, J CARDIOPULM REHABIL, V39, P318, DOI 10.1097/HCR.0000000000000425 Militello LG, 2016, J COGN ENG DECIS MAK, V10, P74, DOI 10.1177/1555343416630875 Naderi SH, 2012, AM J MED, V125, P882, DOI 10.1016/j.amjmed.2011.12.013 Najafi Seyed Saeed, 2016, Int J Community Based Nurs Midwifery, V4, P199 Paterson M, 2017, INT J PHARM PRACT, V25, P185, DOI 10.1111/ijpp.12242 Pio CSD, 2019, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD007131.pub4 Radisauskas R, 2019, MEDICINA-LITHUANIA, V55, DOI 10.3390/medicina55070357 Riegel B, 2020, PHARMACOEPIDEM DR S, V29, P513, DOI 10.1002/pds.4988 Ruano-Ravina A, 2016, INT J CARDIOL, V223, P436, DOI 10.1016/j.ijcard.2016.08.120 Smedegaard L, 2018, PLOS ONE, V13, DOI 10.1371/journal.pone.0202177 Smith SC, 2010, CIRC-CARDIOVASC QUAL, V3, P226, DOI 10.1161/CIRCOUTCOMES.110.957183 Wolrd Health Organization, 2019, PREVENTION CONTROL N Wu Q, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0217535 Zhang YT, 2014, AM J MANAG CARE, V20, pE498 Zullig LL, 2019, HEALTH SERV RES, V54, P1255, DOI 10.1111/1475-6773.13200 NR 29 TC 0 Z9 0 U1 0 U2 0 PU DOVE MEDICAL PRESS LTD PI ALBANY PA PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND SN 1177-889X J9 PATIENT PREFER ADHER JI Patient Prefer. Adherence PY 2022 VL 16 BP 1613 EP 1622 DI 10.2147/PPA.S356653 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 2W6EK UT WOS:000824614900001 PM 35812765 OA gold, Green Published DA 2023-05-13 ER PT J AU Kasim, S Malek, S Cheen, S Safiruz, MS Ahmad, WAW Ibrahim, KS Aziz, F Negishi, K Ibrahim, N AF Kasim, Sazzli Malek, Sorayya Cheen, Song Safiruz, Muhammad Shahreeza Ahmad, Wan Azman Wan Ibrahim, Khairul Shafiq Aziz, Firdaus Negishi, Kazuaki Ibrahim, Nurulain TI In-hospital risk stratification algorithm of Asian elderly patients SO SCIENTIFIC REPORTS LA English DT Article ID ACUTE CORONARY SYNDROME; ELEVATION MYOCARDIAL-INFARCTION; FEATURE-SELECTION; 30-DAY MORTALITY; GLOBAL REGISTRY; CLASSIFICATION; OUTCOMES; DISEASE; CARE; PREDICTION AB Limited research has been conducted in Asian elderly patients (aged 65 years and above) for in-hospital mortality prediction after an ST-segment elevation myocardial infarction (STEMI) using Deep Learning (DL) and Machine Learning (ML). We used DL and ML to predict in-hospital mortality in Asian elderly STEMI patients and compared it to a conventional risk score for myocardial infraction outcomes. Malaysia's National Cardiovascular Disease Registry comprises an ethnically diverse Asian elderly population (3991 patients). 50 variables helped in establishing the in-hospital death prediction model. The TIMI score was used to predict mortality using DL and feature selection methods from ML algorithms. The main performance metric was the area under the receiver operating characteristic curve (AUC). The DL and ML model constructed using ML feature selection outperforms the conventional risk scoring score, TIMI (AUC 0.75). DL built from ML features (AUC ranging from 0.93 to 0.95) outscored DL built from all features (AUC 0.93). The TIMI score underestimates mortality in the elderly. TIMI predicts 18.4% higher mortality than the DL algorithm (44.7%). All ML feature selection algorithms identify age, fasting blood glucose, heart rate, Killip class, oral hypoglycemic agent, systolic blood pressure, and total cholesterol as common predictors of mortality in the elderly. In a multi-ethnic population, DL outperformed the TIMI risk score in classifying elderly STEMI patients. ML improves death prediction by identifying separate characteristics in older Asian populations. Continuous testing and validation will improve future risk classification, management, and results. C1 [Kasim, Sazzli; Ibrahim, Khairul Shafiq] Univ Teknol MARA UiTM, Fac Med, Cardiol Dept, Shah Alam, Selangor, Malaysia. [Malek, Sorayya; Cheen, Song; Aziz, Firdaus] Univ Malaya, Fac Sci, Inst Biol Sci, Bioinformat Div, Kuala Lumpur, Malaysia. [Kasim, Sazzli; Ibrahim, Khairul Shafiq] Univ Teknol MARA UiTM, Cardiac Vasc & Lung Res Inst, Shah Alam, Selangor, Malaysia. [Kasim, Sazzli; Ahmad, Wan Azman Wan; Ibrahim, Khairul Shafiq] Natl Heart Assoc Malaysia, Heart House, Kuala Lumpur, Malaysia. [Ahmad, Wan Azman Wan] Univ Malaya, Med Ctr, Div Cardiol, Kuala Lumpur, Malaysia. [Safiruz, Muhammad Shahreeza] Univ Malaya, Fac Comp Sci & Informat Technol, Dept Artificial Intelligence, Kuala Lumpur, Malaysia. [Negishi, Kazuaki] Univ Sydney, Charles Perkins Ctr Nepean, Fac Med & Hlth, Sydney Med Sch Nepean, Sydney, NSW, Australia. [Negishi, Kazuaki] Nepean Hosp, Sydney, NSW, Australia. [Kasim, Sazzli; Ibrahim, Nurulain] Univ Teknol MARA UiTM, Fac Med, Sungai Buloh Campus, Sungai Buloh, Malaysia. C3 Universiti Teknologi MARA; Universiti Malaya; Universiti Teknologi MARA; Universiti Malaya; Universiti Malaya; University of Sydney; Nepean Hospital RP Kasim, S (通讯作者)，Univ Teknol MARA UiTM, Fac Med, Cardiol Dept, Shah Alam, Selangor, Malaysia.; Malek, S (通讯作者)，Univ Malaya, Fac Sci, Inst Biol Sci, Bioinformat Div, Kuala Lumpur, Malaysia.; Kasim, S (通讯作者)，Univ Teknol MARA UiTM, Cardiac Vasc & Lung Res Inst, Shah Alam, Selangor, Malaysia.; Kasim, S (通讯作者)，Natl Heart Assoc Malaysia, Heart House, Kuala Lumpur, Malaysia.; Kasim, S (通讯作者)，Univ Teknol MARA UiTM, Fac Med, Sungai Buloh Campus, Sungai Buloh, Malaysia. EM sazzlikasim@gmail.com; sorayya@um.edu.my RI Malek, Sorayya/B-9830-2010; Aziz, Firdaus/GZK-7398-2022 OI Malek, Sorayya/0000-0001-6450-6404; Aziz, Firdaus/0000-0002-2090-4336; Ibrahim, Khairul Shafiq/0000-0002-0507-8865; Ibrahim, Nurulain/0000-0002-8120-9468 FU Kementerian Sains, Teknologi dan Inovasi, Malaysia [TDF03211036] FX This work was supported by Kementerian Sains, Teknologi dan Inovasi, Malaysia (Grant No: TDF03211036). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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WARFARIN; THERAPY; STOPP AB CONTEXT AND OBJECTIVE: Non-treatment of diseases or clinical conditions has been considered to constitute omission of care in several countries. The aim of the present study was to develop a transcultural adaptation of the Screening Tool to Alert Doctors to the Right Treatment (START) to Brazilian Portuguese and to validate the tool's content. DESIGN AND SETTING: Cultural adaptation and validation of the START criteria using the Delphi consensus technique. METHOD: START was translated from its original language into Brazilian Portuguese, followed by back-translation and validation by means of the modified Delphi technique. For this, an electronic form was developed and sent to 20 experts, who were asked to use a Likert scale to assess the statements included in START, in relation to their pertinence to Brazilian realities. All of the statements that exhibited mean scores greater than 4.0 were considered to have attained consensus. The experts' identities were kept confidential throughout the validation process. RESULTS: In the first phase of the validation process, 63.6% (14/22) of the statements in START attained consensus. The remaining statements were returned to the experts so that they could have the opportunity to review their comments and statements and to assess them again, based on the Likert scale used earlier. In this phase, 100% of the START instrument attained consensus. CONCLUSION: The content of START was entirely validated for Brazil, with all of the original criteria maintained. C1 Univ Fed Bahia, Prof Edgard Santos Univ Hosp Complex, Salvador, BA, Brazil. [Luz, Aline Cristina] Cardiopulm Inst, Salvador, BA, Brazil. [Oliveira, Marcio Galvao] Univ Fed Bahia, Multidisciplinary Hlth Inst, Clin Pharm, Vitoria Da Conquista, BA, Brazil. [Noblat, Lucia] Univ Fed Bahia, Sch Pharm, Clin Pharm, Salvador, BA, Brazil. C3 Universidade Federal da Bahia; Universidade Federal da Bahia; Universidade Federal da Bahia RP Luz, AC (通讯作者)，Av Leovigildo Filgueiras,361 Apto 31, BR-40100000 Salvador, BA, Brazil. 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J. PD JAN-FEB PY 2016 VL 134 IS 1 BP 20 EP 27 DI 10.1590/1516-3180.2014.00303101 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA DI4VV UT WOS:000373498400004 PM 26786612 OA gold, Green Submitted, Green Published DA 2023-05-13 ER PT J AU Massey, CN Feig, EH Duque-Serrano, L Wexler, D Moskowitz, JT Huffman, JC AF Massey, Christina N. Feig, Emily H. Duque-Serrano, Laura Wexler, Deborah Moskowitz, Judith Tedlie Huffman, Jeff C. TI Well-being interventions for individuals with diabetes: A systematic review SO DIABETES RESEARCH AND CLINICAL PRACTICE LA English DT Review DE Diabetes; Well-being; Positive psychology; Mindfulness; ACT; Resilience; Positive affect ID RANDOMIZED CONTROLLED-TRIAL; POSITIVE-AFFECT INTERVENTION; QUALITY-OF-LIFE; MINDFULNESS-BASED INTERVENTION; COGNITIVE-BEHAVIOR THERAPY; AFRICAN-AMERICAN ADULTS; ACUTE CORONARY SYNDROME; GLYCEMIC CONTROL; STRESS-REDUCTION; SELF-MANAGEMENT AB In patients with diabetes, psychological well-being constructs (e.g., optimism, positive affect) have been associated with superior medical outcomes, including better glucose control and lower mortality rates. Well-being interventions may be well-suited to individuals with diabetes, as they are simple to deliver, broadly applicable across a range of psychological distress, and may help increase self-efficacy and motivation for diabetes self-care. This systematic review, completed using PRISMA guidelines, examined peer-reviewed studies indexed in PubMed, PsycINFO, and/or Scopus between database inception and October 2017 that investigated the effects of well-being interventions (e.g., positive psychology interventions, mindfulness-based interventions, resilience-based interventions) on psychological and physical health outcomes in individuals with Type 1 or Type 2 diabetes. The search yielded 34 articles (N = 1635 participants), with substantial variability in intervention type, measures used, and outcomes studied; the majority found the intervention to provide benefit. Overall, results indicate that a range of well-being interventions appear to have promise in improving health outcomes in this population, but the literature does not yet provide definitive data about which specific interventions are most effective. The variability in interventions and outcomes points to a need for further rigorous, controlled, and well-powered studies of specific interventions, with well-accepted, clinically relevant outcome measures. (C) 2018 Elsevier B.V. All rights reserved. C1 [Massey, Christina N.; Feig, Emily H.; Duque-Serrano, Laura; Huffman, Jeff C.] Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02114 USA. [Massey, Christina N.; Feig, Emily H.; Duque-Serrano, Laura; Wexler, Deborah; Huffman, Jeff C.] Harvard Med Sch, Boston, MA USA. [Wexler, Deborah] Massachusetts Gen Hosp, Diabet Unit, Boston, MA 02114 USA. [Moskowitz, Judith Tedlie] Northwestern Univ, Dept Med Social Sci, Feinberg Sch Med, Chicago, IL 60611 USA. C3 Harvard University; Massachusetts General Hospital; Harvard University; Harvard Medical School; Harvard University; Massachusetts General Hospital; Northwestern University; Feinberg School of Medicine RP Massey, CN (通讯作者)，Massachusetts Gen Hosp, 15 Parkman St WAC 812, Boston, MA 02114 USA. EM cmassey1@mgh.harvard.edu RI Wexler, Deborah/AAE-4205-2019; Duque, Laura/AAU-8917-2021; Duque, Laura/X-7709-2018 OI Wexler, Deborah/0000-0001-6979-402X; Duque, Laura/0000-0002-6354-0720; Duque, Laura/0000-0002-6354-0720 FU NIH [R21DK109313-01]; American Diabetes Association [1-17-ICTS-099] FX This work was supported in part by NIH grant R21DK109313-01 and American Diabetes Association Grant 1-17-ICTS-099 (Huffman PI). The authors have no conflicts of interest to report and there were no other funding sources. 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Clin. Pract. PD JAN PY 2019 VL 147 BP 118 EP 133 DI 10.1016/j.diabres.2018.11.014 PG 16 WC Endocrinology & Metabolism WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI) SC Endocrinology & Metabolism GA HH7ZY UT WOS:000455951900016 PM 30500545 OA Green Accepted DA 2023-05-13 ER PT J AU McCunniff, PT Young, EY Ahmadinia, K Kusin, DJ Ahn, UM Ahn, NU AF McCunniff, Peter T. Young, Ernest Y. Ahmadinia, Kasra Kusin, David J. Ahn, Uri M. Ahn, Nicholas U. TI Chronic Antiplatelet Use Associated With Increased Blood Loss in Lumbar Spinal Surgery Despite Adherence to Protocols SO ORTHOPEDICS LA English DT Article ID ACUTE CORONARY SYNDROME; LOW-DOSE ASPIRIN; EPIDURAL HEMATOMA; MYOCARDIAL-INFARCTION; FUSION SURGERY; STOPPING CLOPIDOGREL; THERAPY; RISK; METAANALYSIS; COMPLICATIONS AB There are conflicting reports regarding postoperative bleeding risks associated with discontinuation of antiplatelet therapy at least 7 days preoperatively. Most of the studies in the spine literature are based on surveys or anecdotal evidence. The majority of surgeons discontinue therapy 7 days preoperatively, but this varies widely from 5 to 21 days. The purpose of this retrospective study was to assess whether chronic antiplatelet use is associated with increased intraoperative blood loss, need for transfusion, and perioperative complications. Of 454 patients who underwent elective lumbar spinal surgery, 85 were on antiplatelet therapy and 369 were not. All patients stopped antiplatelet therapy at least 7 days preoperatively with approval from their cardiologist or primary care provider. Multiple regression analysis was performed and corrected for age, sex, antiplatelet therapy, number of levels decompressed/fused/instrumented, preoperative hematocrit, and postoperative hematocrit. Results showed that preoperative antiplatelet therapy, despite at least 7 days of discontinuation, is a statistically significant predictor (P=.04) of increased intraoperative blood loss. Blood transfusion was not associated with antiplatelet use but was associated with the number of levels fused, age, and low preoperative hematocrit (all P<.01). There were no recorded complications in either group. The authors conclude that antiplatelet therapy is associated with an increased risk of intraoperative blood loss in spine patients despite discontinuation at least 7 days preoperatively, but the clinical significance of this is unclear given the lack of association with blood transfusions and perioperative complications. C1 [McCunniff, Peter T.; Young, Ernest Y.; Ahmadinia, Kasra; Kusin, David J.; Ahn, Nicholas U.] Univ Hosp Cleveland, Dept Orthopaed Surg, Cleveland, OH 44106 USA. [Ahn, Uri M.] New Hampshire NeuroSpine Inst, Bedford, NH USA. C3 University Hospitals of Cleveland RP McCunniff, PT (通讯作者)，408 West St Clair Ave 315, Cleveland, OH 44113 USA. EM pmccunniff@gmail.com FU Alphatec; Spine 360; K1; Stryker FX Drs McCunniff, Young, and Ahmadinia and Mr Kusin have no relevant financial relationships to disclose. Dr UM Ahn is a paid consultant for Alphatec, Spine 360, and K1; receives royalties from Spine 360; and holds stock in K1. Dr NU Ahn receives grants and research support from Stryker. CR [Anonymous], CLOP FULL PRESCR INF Bertrand ME, 2000, CIRCULATION, V102, P624, DOI 10.1161/01.CIR.102.6.624 Blake GJ, 2002, J INTERN MED, V252, P283, DOI 10.1046/j.1365-2796.2002.01019.x Blanchette CM, 2007, EUR SPINE J, V16, P353, DOI 10.1007/s00586-006-0066-3 Burger W, 2005, J INTERN MED, V257, P399, DOI 10.1111/j.1365-2796.2005.01477.x Busch MP, 2003, JAMA-J AM MED ASSOC, V289, P959, DOI 10.1001/jama.289.8.959 Carragee EJ, 2011, SPINE J, V11, pE1, DOI 10.1016/j.spinee.2010.10.013 Chassot PG, 2007, BRIT J ANAESTH, V99, P316, DOI 10.1093/bja/aem209 Chechik O, 2011, INJURY, V42, P1277, DOI 10.1016/j.injury.2011.01.011 Ciancio RAM, 2008, SPINE J, V8, P544, DOI 10.1016/j.spinee.2006.11.007 Dawood MM, 1996, INT J CARDIOL, V57, P37, DOI 10.1016/S0167-5273(96)02769-6 Di Minno MND, 2009, INTERN EMERG MED, V4, P279, DOI 10.1007/s11739-009-0265-0 Douketis JD, 2012, CHEST, V141, pE326S, DOI 10.1378/chest.11-2298 Dunning J, 2008, EUR J CARDIO-THORAC, V34, P934, DOI 10.1016/j.ejcts.2008.07.019 Elgafy H, 2010, SPINE, V35, pS47, DOI 10.1097/BRS.0b013e3181d833f6 Harder S, 2004, CLIN PHARMACOKINET, V43, P963, DOI 10.2165/00003088-200443140-00002 He J, 1998, JAMA-J AM MED ASSOC, V280, P1930, DOI 10.1001/jama.280.22.1930 Ho PM, 2008, JAMA-J AM MED ASSOC, V299, P532, DOI 10.1001/jama.299.5.532 Ho PM, 2010, CIRC-CARDIOVASC QUAL, V3, P303, DOI 10.1161/CIRCOUTCOMES.109.890707 Joseph Jibu J, 2007, Thromb J, V5, P6, DOI 10.1186/1477-9560-5-6 Kang SB, 2011, SPINE J, V11, P303, DOI 10.1016/j.spinee.2011.02.006 Karabatsou K, 2006, ZBL NEUROCHIR, V67, P210, DOI 10.1055/s-2006-933536 Kebaish Khaled M, 2004, Neurosurg Focus, V16, pe1 Kim T, 2012, J KOREAN NEUROSURG S, V52, P523, DOI 10.3340/jkns.2012.52.6.523 Kou J, 2002, SPINE, V27, P1670, DOI 10.1097/00007632-200208010-00016 Kreppel D, 2003, NEUROSURG REV, V26, P1, DOI 10.1007/s10143-002-0224-y Laffey JG, 2002, ANESTHESIOLOGY, V97, P215 Landesberg G, 1997, J VASC SURG, V26, P570, DOI 10.1016/S0741-5214(97)70054-5 Levine GN, 2001, ARCH INTERN MED, V161, P937, DOI 10.1001/archinte.161.7.937 Lim SH, 2011, NEUROL SCI, V32, P687, DOI 10.1007/s10072-011-0508-5 Moon HJ, 2009, J NEUROL SCI, V285, P254, DOI 10.1016/j.jns.2009.06.028 Nydick JA, 2010, J ORTHOP TRAUMA, V24, P383, DOI 10.1097/BOT.0b013e3181c3f3d9 Park HJ, 2014, EUR SPINE J, V23, P1777, DOI 10.1007/s00586-014-3294-y Park JH, 2013, SPINE, V38, P1561, DOI 10.1097/BRS.0b013e31829a84d2 Pickard AS, 2008, PHARMACOTHERAPY, V28, P376, DOI 10.1592/phco.28.3.376 Priebe HJ, 2004, BRIT J ANAESTH, V93, P9, DOI 10.1093/bja/aeh147 ROTH GJ, 1975, J CLIN INVEST, V56, P624, DOI 10.1172/JCI108132 ROTH GJ, 1975, P NATL ACAD SCI USA, V72, P3073, DOI 10.1073/pnas.72.8.3073 Seet RCS, 2005, EUR J NEUROL, V12, P811, DOI 10.1111/j.1468-1331.2005.01057.x Steele MJ, 2011, ANZ J SURG, V81, P774, DOI 10.1111/j.1445-2197.2010.05631.x Sung JH, 2007, J KOREAN MED SCI, V22, P577, DOI 10.3346/jkms.2007.22.3.577 Uribe Juan, 2003, Spine J, V3, P125, DOI 10.1016/S1529-9430(02)00535-1 VANE JR, 1971, NATURE-NEW BIOL, V231, P232, DOI 10.1038/newbio231232a0 VIAL JH, 1991, ADV PROSTAG THROMB L, V21, P157 Wang LS, 2012, J ORTHOP SURG-HONG K, V20, P386, DOI 10.1177/230949901202000326 Young EY, 2013, SPINE J, V13, P1253, DOI 10.1016/j.spinee.2013.05.052 Zheng FY, 2002, SPINE, V27, P818, DOI 10.1097/00007632-200204150-00008 NR 47 TC 6 Z9 6 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0147-7447 EI 1938-2367 J9 ORTHOPEDICS JI Orthopedics PD JUL-AUG PY 2016 VL 39 IS 4 BP E695 EP E700 DI 10.3928/01477447-20160419-04 PG 6 WC Orthopedics WE Science Citation Index Expanded (SCI-EXPANDED) SC Orthopedics GA EJ3IJ UT WOS:000393105500016 PM 27111080 DA 2023-05-13 ER PT J AU Park, SY Kim, MJ Park, I Kim, H Lee, M Park, YS Chung, SP AF Park, Shin Young Kim, Min Joung Park, Incheol Kim, Ha Yan Lee, Myeongjee Park, Yoo Seok Chung, Sung Phil TI Predisposing Factors and Neurologic Outcomes of Patients with Elevated Serum Amylase and/or Lipase after Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study SO JOURNAL OF CLINICAL MEDICINE LA English DT Article DE elevated serum pancreatic enzyme levels; out-of-hospital cardiac arrest; post-cardiac arrest syndrome; neurologic outcome; mortality ID INTERNATIONAL LIAISON COMMITTEE; AMERICAN-HEART-ASSOCIATION; ACUTE-PANCREATITIS; CARDIOPULMONARY-RESUSCITATION; ISCHEMIC PANCREATITIS; COMPUTED-TOMOGRAPHY; CARE; DYSFUNCTION; PROGNOSIS; MORTALITY AB This study investigated the patient outcomes, incidence, and predisposing factors of elevated pancreatic enzyme levels after OHCA. We conducted a retrospective cohort study of patients treated with targeted temperature management (TTM) after out-of-hospital cardiac arrest (OHCA). Elevation of pancreatic enzyme levels was defined as serum amylase or lipase levels that were at least three times the upper limit of normal. The factors associated with elevated pancreatic enzyme levels and their association with neurologic outcomes and mortality 28 days after OHCA were analyzed. Among the 355 patients, 166 (46.8%) patients developed elevated pancreatic enzyme levels. In the multivariable analysis (odds ratio, 95% confidence interval), initial shockable rhythm (0.62, 0.39-0.98, p = 0.04), time from collapse to return of spontaneous circulation (1.02, 1.01-1.04, p < 0.001), and history of coronary artery disease (1.7, 1.01-2.87, p = 0.046) were associated with elevated pancreatic enzyme levels. After adjusting for confounding factors, elevated pancreatic enzyme levels were associated with neurologic outcomes (5.44, 3.35-8.83, p < 0.001) and mortality (3.74, 2.39-5.86, p < 0.001). Increased pancreatic enzyme levels are common in patients treated with TTM after OHCA and are associated with unfavorable neurologic outcomes and mortality at 28 days after OHCA. C1 [Park, Shin Young; Kim, Min Joung; Park, Incheol; Park, Yoo Seok; Chung, Sung Phil] Yonsei Univ, Dept Emergency Med, Coll Med, 50 Yonsei Ro, Seoul 03722, South Korea. [Kim, Ha Yan; Lee, Myeongjee] Yonsei Univ, Dept Biomed Syst Informat, Biostat Collaborat Unit, Coll Med, 50 Yonsei Ro, Seoul 03722, South Korea. C3 Yonsei University; Yonsei University Health System; Yonsei University; Yonsei University Health System RP Park, YS (通讯作者)，Yonsei Univ, Dept Emergency Med, Coll Med, 50 Yonsei Ro, Seoul 03722, South Korea. EM chilli89@yuhs.ac; boringzzz@yuhs.ac; incheol@yuhs.ac; hykim1213@yuhs.ac; mlee1004@yuhs.ac; pys0905@yuhs.ac; emstar@yuhs.ac RI Chung, Sung Phil/F-8344-2016 OI Chung, Sung Phil/0000-0002-3074-011X; Park, Yoo Seok/0000-0003-1543-4664; Park, Incheol/0000-0001-7033-766X; Kim, Min Joung/0000-0003-1634-5209 FU Basic Science Research Program through the National Research Foundation of Korea - Ministry of Education [NRF-2018R1D1A2B07049888] FX FundingYoo Seok Park was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (NRF-2018R1D1A2B07049888). The funding bodies had no role in the design, collection, analysis, or interpretation of this study. For the remaining authors, no conflicts of interest or sources of funding are declared. 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Clin. Med. PD MAR PY 2022 VL 11 IS 5 AR 1426 DI 10.3390/jcm11051426 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA ZS5XV UT WOS:000768539800001 PM 35268517 OA Green Published, gold DA 2023-05-13 ER PT J AU Iblher, P Zupanic, M Karsten, J Brauer, K AF Iblher, Peter Zupanic, Michaela Karsten, Jan Brauer, Kirk TI May student examiners be reasonable substitute examiners for faculty in an undergraduate OSCE on medical emergencies? SO MEDICAL TEACHER LA English DT Article ID CARE; ACT AB Objectives: To compare the effect of student examiners (SE) to that of faculty examiners (FE) on examinee performance in an OSCE as well as on post-assessment evaluation in the area of emergency medicine management. Mehods: An OSCE test-format (seven stations: Advanced Cardiac Life Support (ACLS), Basic Life Support (BLS), Trauma-Management (TM), Pediatric-Emergencies (PE), Acute-Coronary-Syndrome (ACS), Airway-Management (AM), and Obstetrical-Emergencies (OE)) was administered to 207 medical students in their third year of training after they had received didactics in emergency medicine management. Participants were randomly assigned to one of the two simultaneously run tracks: either with SE (n = 110) or with FE (n = 98). Students were asked to rate each OSCE station and to provide their overall OSCE perception by means of a standardized questionnaire. The independent samples t-test was used and effect sizes were calculated (Cohens d). Results: Students achieved significantly higher scores for the OSCE stations "TM'', "AM'', and "OE'' as well as "overall OSCE score'' in the SE track, whereas the station score for "PE'' was significantly higher for students in the FE track. Mostly small effect sizes were reported. In the post-assessment evaluation portion of the study, students gave significant higher ratings for the ACS station and "overall OSCE evaluation'' in the FE track; also with small effect sizes. Conclusion: It seems quite admissible and justified to encourage medical students to officiate as examiners in undergraduate emergency medicine OSCE formative testing, but not necessarily in summative assessment evaluations. C1 [Iblher, Peter; Brauer, Kirk] Univ Lubeck, Sch Med, D-23538 Lubeck, Germany. [Iblher, Peter; Zupanic, Michaela] Univ Witten Herdecke, Witten, Germany. [Karsten, Jan] Hannover Med Sch, Hannover, Germany. C3 University of Lubeck; Witten Herdecke University; Hannover Medical School RP Iblher, P (通讯作者)，Univ Lubeck, Sch Med, Dept Anesthesiol & Intens Care, Ratzeburger Allee 160, D-23538 Lubeck, Germany. EM peter.iblher@uk-sh.de CR Beckers SK, 2009, BMC EMERG MED, V9, DOI 10.1186/1471-227X-9-7 Bortz J, 2006, FORSCHUNGSMETHODEN E, V3, P355 Chenot JF, 2007, MED EDUC, V41, P1032, DOI 10.1111/j.1365-2923.2007.02895.x Christ TJ, 2009, ASSES EFF INTERV, V34, P242, DOI 10.1177/1534508409336182 Cohen J., 1988, STAT POWER ANAL BEHA HARDEN RM, 1975, BRIT MED J, V1, P447, DOI 10.1136/bmj.1.5955.447 Humphrey-Murto S, 2005, ACAD MED, V80, pS59, DOI 10.1097/00001888-200510001-00017 Iblher P, 2011, ANASTH INTENSIVMED, V52, P812 Iblher P, 2009, ANAESTHESIST, V58, P362, DOI 10.1007/s00101-008-1506-8 Kelly M, 2004, MED TEACH, V26, P610, DOI 10.1080/01421590400005475 Martin JA, 1996, ACAD MED, V71, P170, DOI 10.1097/00001888-199602000-00025 MILLER GE, 1990, ACAD MED, V65, pS63, DOI 10.1097/00001888-199009000-00045 Moineau G, 2011, MED EDUC, V45, P183, DOI 10.1111/j.1365-2923.2010.03800.x Ogden GR, 2000, BRIT DENT J, V189, P160, DOI 10.1038/sj.bdj.4800711a Perkins GD, 2002, INTENS CARE MED, V28, P698, DOI 10.1007/s00134-002-1291-9 Urbaniak G.C., 2011, RES RANDOMIZER VERSI Wass V, 2001, LANCET, V357, P945, DOI 10.1016/S0140-6736(00)04221-5 NR 17 TC 16 Z9 16 U1 0 U2 5 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 2-4 PARK SQUARE, MILTON PARK, ABINGDON OR14 4RN, OXON, ENGLAND SN 0142-159X EI 1466-187X J9 MED TEACH JI Med. Teach. PD APR PY 2015 VL 37 IS 4 BP 374 EP 378 DI 10.3109/0142159X.2014.956056 PG 5 WC Education, Scientific Disciplines; Health Care Sciences & Services WE Science Citation Index Expanded (SCI-EXPANDED) SC Education & Educational Research; Health Care Sciences & Services GA CD5ND UT WOS:000351133900012 PM 25186850 DA 2023-05-13 ER PT J AU Bellbhudder, U Stanfliet, JC AF Bellbhudder, U. Stanfliet, J. C. TI Clinicians ignore best practice guidelines: Prospective audit of cardiac injury marker ordering in patients with chest pain SO SAMJ SOUTH AFRICAN MEDICAL JOURNAL LA English DT Article ID POINT-OF-CARE; TROPONIN AB Background. Chest pain is a frequent presenting symptom and is a diagnostic challenge. Recent recommendations state that high-sensitivity cardiac troponin assays are the only biochemical test required in the diagnosis of acute coronary syndrome (ACS) and that other biomarkers such as myoglobin or creatine kinase (CK)-MB isoform are not indicated. Objective. To establish whether clinician ordering in the setting of suspected ACS was in keeping with recent recommendations. Methods. A prospective audit was undertaken of all requests for cardiac troponin I (cTnI) and CK-MB received at a large tertiary hospital in Durban, South Africa, during a 20-day period in December 2012. Results. A total of 193 cardiac marker requests were received: 12 (6.2%) requests were for cTnI alone; 8 (4.1%) were for CK-MB alone; and the remaining 173 (89.7%) were for both cTnI and CK-MB. Therefore, a total of 181 (93.8%) incorrect requests were received during this period. A total of 103 (53.4%) patients had values below the cut-off point of 40 ng/l for cTnI, i.e. ACS was ruled out. Of these, 15 had CK-MB values above the reference interval. A total of 12 (6.2%) patients had cTnI values >500 ng/I, i.e. ACS was ruled in; 33.3% of this group had normal CK-MB values. Conclusion. Ordering patterns in the setting of ACS did not reflect current recommendations and were wasteful and potentially dangerous. C1 [Bellbhudder, U.; Stanfliet, J. C.] King Edward VIII Hosp, Dept Chem Pathol, Natl Hlth Lab Serv, Durban, South Africa. [Stanfliet, J. C.] Univ KwaZulu Natal, Nelson R Mandela Sch Med, Dept Chem Pathol, Durban, South Africa. C3 University of Kwazulu Natal RP Stanfliet, JC (通讯作者)，King Edward VIII Hosp, Dept Chem Pathol, Natl Hlth Lab Serv, Durban, South Africa. EM john.stanfliet@nhls.ac.za CR Bingisser R, 2012, AM J EMERG MED, V30, P1639, DOI 10.1016/j.ajem.2012.03.004 Cabana MD, 1999, JAMA-J AM MED ASSOC, V282, P1458, DOI 10.1001/jama.282.15.1458 Eggers KM, 2009, AM J CARDIOL, V103, P588, DOI 10.1016/j.amjcard.2008.11.007 El-Deeb Mohammed H, 2012, Crit Pathw Cardiol, V11, P139, DOI 10.1097/HPC.0b013e31825ac653 Fraser CG, 1987, ANN CLIN BIOCHEM, V24, P123 Fryer AA, 2009, ANN CLIN BIOCHEM, V46, P435, DOI 10.1258/acb.2009.009186 Hof Danielle, 2013, Methods Mol Biol, V963, P385, DOI 10.1007/978-1-62703-230-8_24 Lippi G, 2013, SEMIN THROMB HEMOST, V39, P202, DOI 10.1055/s-0032-1333543 Misra S, 2013, ANN CLIN BIOCHEM, V50, P400, DOI 10.1177/0004563213498712 Mistry NF, 2012, CARDIOL CLIN, V30, P617, DOI 10.1016/j.ccl.2012.07.010 Morrow DA, 2003, CLIN CHEM, V49, P537, DOI 10.1373/49.4.537 Venge P, 2010, AM HEART J, V160, P835, DOI 10.1016/j.ahj.2010.07.036 Venge P, 2009, CLIN CHEM, V55, P109, DOI 10.1373/clinchem.2008.106500 NR 13 TC 1 Z9 1 U1 0 U2 0 PU SA MEDICAL ASSOC PI PRETORIA PA BLOCK F CASTLE WALK CORPORATE PARK, NOSSOB STREET, ERASMUSKLOOF EXT3, PRETORIA, 0002, SOUTH AFRICA SN 0256-9574 EI 2078-5135 J9 SAMJ S AFR MED J JI SAMJ S. Afr. Med. J. PD APR PY 2014 VL 104 IS 4 BP 305 EP 306 DI 10.7196/SAMJ.7381 PG 2 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA AH2GT UT WOS:000335940200028 PM 25118560 OA Green Submitted DA 2023-05-13 ER PT J AU Labrosciano, C Air, T Tavella, R Beltrame, JF Ranasinghe, I AF Labrosciano, Clementine Air, Tracy Tavella, Rosanna Beltrame, John F. Ranasinghe, Isuru TI Readmissions following hospitalisations for cardiovascular disease: a scoping review of the Australian literature SO AUSTRALIAN HEALTH REVIEW LA English DT Review ID CLINIC-BASED MANAGEMENT; HEART-FAILURE; RISK PREDICTION; 30-DAY MORTALITY; ISCHEMIC-STROKE; OUTCOMES; QUALITY; PROGRAM; CARE; REHOSPITALIZATION AB Objective International studies suggest high rates of readmissions after cardiovascular hospitalisations, but the burden in Australia is uncertain. We summarised the characteristics, frequency, risk factors of readmissions and interventions to reduce readmissions following cardiovascular hospitalisation in Australia. Methods A scoping review of the published literature from 2000-2016 was performed using Medline, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases and relevant grey literature. Results We identified 35 studies (25 observational, 10 reporting outcomes of interventions). Observational studies were typically single-centre (11/25) and reported readmissions following hospitalisations for heart failure (HF; 10/25), acute coronary syndrome (7/25) and stroke (6/25), with other conditions infrequently reported. The definition of a readmission was heterogeneous and was assessed using diverse methods. Readmission rate, most commonly reported at 1 month (14/25), varied from 6.3% to 27%, with readmission rates of 10.1-27% for HF, 6.5-11% for stroke and 12.7-17% for acute myocardial infarction, with a high degree of heterogeneity among studies. Of the 10 studies of interventions to reduce readmissions, most (n = 8) evaluated HF management programs and three reported a significant reduction in readmissions. We identified a lack of national studies of readmissions and those assessing the cost and resource impact of readmissions on the healthcare system as well as a paucity of successful interventions to lower readmissions. Conclusions High rates of readmissions are reported for cardiovascular conditions, although substantial methodological heterogeneity exists among studies. Nationally standardised definitions are required to accurately measure readmissions and further studies are needed to address knowledge gaps and test interventions to lower readmissions in Australia. What is known about the topic? International studies suggest readmissions are common following cardiovascular hospitalisations and are costly to the health system, yet little is known about the burden of readmission in the Australian setting or the effectiveness of intervention to reduce readmissions. What does this paper add? We found relatively high rates of readmissions following common cardiovascular conditions although studies differed in their methodology making it difficult to accurately gauge the readmission rate. We also found several knowledge gaps including lack of national studies, studies assessing the impact on the health system and few interventions proven to reduce readmissions in the Australian setting. C1 [Labrosciano, Clementine; Air, Tracy; Ranasinghe, Isuru] Basil Hetzel Inst Translat Res, Hlth Performance & Policy Res Unit, 37A Woodville Rd, Woodville South, SA 5011, Australia. [Labrosciano, Clementine; Air, Tracy; Tavella, Rosanna; Beltrame, John F.] Basil Hetzel Inst Translat Res, Translat Vasc Funct Res Collaborat, 37A Woodville Rd, Woodville South, SA 5011, Australia. [Labrosciano, Clementine; Tavella, Rosanna; Beltrame, John F.; Ranasinghe, Isuru] Univ Adelaide, Discipline Med, 28 Woodville Rd, Woodville South, SA 5011, Australia. [Tavella, Rosanna; Beltrame, John F.; Ranasinghe, Isuru] Queen Elizabeth Hosp, SA Hlth, Cent Adelaide Local Hlth Network, 28 Woodville Rd, Woodville South, SA 5011, Australia. C3 University of Adelaide RP Ranasinghe, I (通讯作者)，Basil Hetzel Inst Translat Res, Hlth Performance & Policy Res Unit, 37A Woodville Rd, Woodville South, SA 5011, Australia.; Ranasinghe, I (通讯作者)，Univ Adelaide, Discipline Med, 28 Woodville Rd, Woodville South, SA 5011, Australia.; Ranasinghe, I (通讯作者)，Queen Elizabeth Hosp, SA Hlth, Cent Adelaide Local Hlth Network, 28 Woodville Rd, Woodville South, SA 5011, Australia. EM clementine.labrosiano@adelaide.edu.au; tracy.air@adelaide.edu.au; rosanna.tavella@adelaide.edu.au; john.beltrame@adelaide.edu.au; isuru.ranasinghe@adelaide.edu.au OI Air, Tracy/0000-0002-4834-4238; Ranasinghe, Isuru/0000-0003-0982-1561; Labrosciano, Clementine/0000-0001-5995-4616 FU Faculty of Health Sciences Divisional Scholarship from the University of Adelaide; National Heart Foundation Future Leader Fellowship [101186] FX Clementine Labrosciano is supported by a Faculty of Health Sciences Divisional Scholarship from the University of Adelaide. Isuru Ranasinghe is supported by a National Heart Foundation Future Leader Fellowship (Grant ID 101186). 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Health Rev. PY 2020 VL 44 IS 1 BP 93 EP 103 DI 10.1071/AH18028 PG 11 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 KI5TO UT WOS:000511412900012 PM 30779883 DA 2023-05-13 ER PT J AU Chen, M Gerson, H Eintracht, S Nessim, SJ MacNamara, E AF Chen, Michael Gerson, Howard Eintracht, Shaun Nessim, Sharon J. MacNamara, Elizabeth TI Effect of Hemodialysis on Levels of High-Sensitivity Cardiac Troponin T SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID PROGNOSTIC VALUE; MORTALITY; DISEASE; EVENTS; SERUM AB Cardiac troponin (cTn) is essential for the diagnosis of an acute coronary syndrome (ACS). However, in end-stage renal disease (ESRD) baseline cTn levels are often elevated, and it is unknown whether the hemodialysis (HD) procedure affects cTn levels. This leaves clinicians unsure of how to interpret cTn in HD patients with cardiac ischemia. We therefore sought to determine if plasma levels of high-sensitivity cardiac troponin T (hs-cTnT) vary during or after HD treatment. We prospectively enrolled 10 chronic HD patients who were admitted to our institution. All participants were receiving thrice weekly HD before admission and were medically stable. Those admitted for ACS or to critical care units were excluded. Baseline hs-cTnT was measured immediately before HD. For the subsequent 6 hours, hs-cTnT was measured every 2 hours and every 3 hours thereafter for a total collection period of 24 hours. A significant decline in mean hs-cTnT was noted with HD. During HD (2 hours after HD initiation), hs-cTnT decreased by 10.7% (confidence interval 5% to 17%). Immediately after HD (4 hours after HD initiation), a decline of 12% (confidence interval 5% to 19%) was observed. Thereafter hs-cTnT began to rise. Hs-cTnT levels returned to baseline by 11 hours after HD completion and remained stable for the reminder of the study. In conclusion, HD induces a short-lived negative bias in hs-cTnT. When measured for investigation of ACS, hs-cTnT concentration should be interpreted with respect to time of dialysis and specimen collection. (C) 2017 Elsevier Inc. All rights reserved. C1 [Chen, Michael; Gerson, Howard; Eintracht, Shaun; MacNamara, Elizabeth] Sir Mortimer B Davis Jewish Hosp, Dept Diagnost Med, Montreal, PQ, Canada. [Nessim, Sharon J.] Sir Mortimer B Davis Jewish Hosp, Dept Nephrol, Montreal, PQ, Canada. C3 McGill University; McGill University RP Chen, M (通讯作者)，Sir Mortimer B Davis Jewish Hosp, Dept Diagnost Med, Montreal, PQ, Canada. EM michaelx.chen@mail.mcgill.ca CR Apple FS, 2002, CIRCULATION, V106, P2941, DOI 10.1161/01.CIR.0000041254.30637.34 Bloch SH, 2014, NEW ZEAL MED J, V127, P97 Conway B, 2005, NEPHROL DIAL TRANSPL, V20, P2759, DOI 10.1093/ndt/gfi125 deFilippi C, 2003, JAMA-J AM MED ASSOC, V290, P353, DOI 10.1001/jama.290.3.353 Ellis K, 2001, SOUTHERN MED J, V94, P993 Fahim MA, 2015, CLIN CHEM LAB MED, V53, P715, DOI 10.1515/cclm-2014-0838 Fredericks S, 2001, CLIN CHIM ACTA, V310, P199, DOI 10.1016/S0009-8981(01)00547-2 Hassan HC, 2014, CLIN CHEM, V60, P389, DOI 10.1373/clinchem.2013.207142 Kumar N, 2011, NEPHROL DIAL TRANSPL, V26, P665, DOI 10.1093/ndt/gfq442 Labugger R, 2000, CIRCULATION, V102, P1221, DOI 10.1161/01.CIR.102.11.1221 McDonough JL, 1999, CIRC RES, V84, P9 McDonough JL, 2001, CIRCULATION, V103, P58 Mingels AMA, 2017, CLIN CHEM, V63, P683, DOI 10.1373/clinchem.2016.261644 Mishra RK, 2013, AM J KIDNEY DIS, V61, P701, DOI 10.1053/j.ajkd.2012.11.034 Ooi DS, 2000, CLIN CHEM, V46, P338 Peetz D, 2003, MED KLIN, V98, P188, DOI 10.1007/s00063-003-1243-3 Pianta TJ, 2012, NEPHROLOGY, V17, P636, DOI 10.1111/j.1440-1797.2012.01625.x Saenger AK, 2011, CLIN CHIM ACTA, V412, P748, DOI 10.1016/j.cca.2010.12.034 SARAN R, 2016, AM J KIDNEY DIS S, V67, pS1, DOI [DOI 10.1053/J.AJKD.2015.12.014, 10.1053/j.ajkd.2015.12.014, 10.1053/j.ajkd.2018.01.002] Schmidt A, 2001, AM J KIDNEY DIS, V37, P56, DOI 10.1053/ajkd.2001.20584 Speth M, 2002, CLIN BIOCHEM, V35, P355, DOI 10.1016/S0009-9120(02)00328-4 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Wu AHB, 2007, CLIN CHEM, V53, P2086, DOI 10.1373/clinchem.2007.095679 Yakupoglu U, 2002, TRANSPLANT P, V34, P2033, DOI 10.1016/S0041-1345(02)02841-5 NR 24 TC 12 Z9 13 U1 0 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 DEC 1 PY 2017 VL 120 IS 11 BP 2061 EP 2064 DI 10.1016/j.amjcard.2017.08.026 PG 4 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA FP8JO UT WOS:000417889000025 PM 29033047 DA 2023-05-13 ER PT J AU Kang, KR Wu, PD Li, WM Tang, SX Wang, JH Luo, XC Xie, MQ AF Kang, Keren Wu, Peidian Li, Wenmei Tang, Shixing Wang, Jihua Luo, Xiaochun Xie, Mingquan TI Evaluation of a newly developed quantitative heart-type fatty acid binding protein assay based on fluorescence immunochromatography using specific monoclonal antibodies SO SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION LA English DT Article DE Myocardial reperfusion injury; point-of-care testing; H-FABP; immunochromatography; molecular diagnostics ID ACUTE CORONARY SYNDROME; LONG-TERM MORTALITY; EARLY-DIAGNOSIS; INFARCTION; FABP AB Objectives. To develop a rapid, sensitive and specific assay for quantification of serum heart-type fatty acid binding protein (H-FABP) based on immunofluorescence of specific monoclonal antibodies. Design and Methods. We generated novel H-FABP-directed monoclonal antibodies by cloning of spleen cells of mice immunized with H-FABP. Epitopes were mapped and antigen affinity was assessed by surface plasmon resonance (SPR). The H-FABP specific monoclonal antibodies were coupled to fluorescent beads and sprayed onto a nitrocellulose membrane facilitating quantification of H-FABP by immunofluorescence. Reagent cross-reactivity, interference resistance, accuracy and sensitivity were examined. A total of 103 clinical samples were used to compare the sensitivity and specificity of the new assay to a commercially available Randox kit. Results. This new assay could be finished within 15 min, with sensitivity reaching 1 ng/ml. In a trial of 103 clinical serum samples, the new testing kit results were highly correlated with those from the Randox kit (R-2 = 0.9707). Using the Randox kit as the reference kit, the sensitivity of the new assay was 98.25%, and specificity was 100%. Conclusions. An immunofluorescence-based H-FABP assay employing novel monoclonal antibodies could rapidly, specifically and sensitively detect H-FABP in serum samples, providing an effective method for rapid clinical assessment of H-FABP index in the clinic. C1 [Kang, Keren; Li, Wenmei; Luo, Xiaochun; Xie, Mingquan] S China Univ Technol, Sch Biosci & Bioengn, Guangzhou 510641, Guangdong, Peoples R China. [Kang, Keren; Wu, Peidian; Li, Wenmei; Tang, Shixing; Wang, Jihua] Guangzhou Wondfo Biotech Co Ltd, Natl Engn Lab Point Of Care Testing, Guangzhou 510641, Guangdong, Peoples R China. C3 South China University of Technology RP Kang, KR (通讯作者)，S China Univ Technol, Sch Biosci & Bioengn, Guangzhou 510641, Guangdong, Peoples R China. EM keren_kang@hotmail.com; xcluo@scut.edu.cn RI Luo, Xiao-Chun/E-2377-2012 OI Luo, Xiao-Chun/0000-0001-9554-370X FU Strategic Emerging Industry Core Technology Research Project of Guangdong province (Immune fluorescence quantitative rapid detection technology in the application of the major disease detection) [2012A080800007]; national innovation fund 'Myocardial infarction heart failure' [12C26214405405] FX The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The project is supported by the Strategic Emerging Industry Core Technology Research Project of Guangdong province (Immune fluorescence quantitative rapid detection technology in the application of the major disease detection, 2012A080800007), and the national innovation fund 'Myocardial infarction heart failure' based on the technology of fluorescence immunoassay detection markers detection series product development (12C26214405405). CR Chan CPY, 2005, BIOSENS BIOELECTRON, V20, P2566, DOI 10.1016/j.bios.2004.09.028 Dellas C, 2010, J AM COLL CARDIOL, V55, P2150, DOI 10.1016/j.jacc.2009.10.078 Erenler AK, 2013, J PAK MED ASSOC, V63, P1176 Gururajan P, 2010, HEART LUNG CIRC, V19, P660, DOI 10.1016/j.hlc.2010.06.665 Kilcullen N, 2007, J AM COLL CARDIOL, V50, P2061, DOI 10.1016/j.jacc.2007.08.021 Kim Y, 2010, AM J CLIN PATHOL, V134, P157, DOI 10.1309/AJCP0F6AXRCJMQQG McCann CJ, 2008, EUR HEART J, V29, P2843, DOI 10.1093/eurheartj/ehn363 McMahon CG, 2012, AM J EMERG MED, V30, P267, DOI 10.1016/j.ajem.2010.11.022 Nakata T, 2003, CARDIOLOGY, V99, P96, DOI 10.1159/000069726 Okamoto F, 2000, CLIN CHEM LAB MED, V38, P231, DOI 10.1515/CCLM.2000.034 Pagani F, 2002, ANN CLIN BIOCHEM, V39, P404, DOI 10.1258/000456302760042173 Pearson IR, 2010, CIRCULATION, V122 ROOS W, 1995, J IMMUNOL METHODS, V183, P149, DOI 10.1016/0022-1759(95)00043-A Ruff CT, 2013, J THROMB THROMBOLYS, V36, P361, DOI 10.1007/s11239-013-0870-7 STJOHN LC, 1991, COMP BIOCHEM PHYS B, V99, P431, DOI 10.1016/0305-0491(91)90066-M Storch J, 2009, J LIPID RES, V50, pS126, DOI 10.1194/jlr.R800084-JLR200 Viswanathan K, 2010, J AM COLL CARDIOL, V55, P2590, DOI 10.1016/j.jacc.2009.12.062 Watanabe T, 2001, CLIN BIOCHEM, V34, P257, DOI 10.1016/S0009-9120(01)00200-4 Zaninotto M, 2006, CLIN CHEM LAB MED, V44, P1383, DOI 10.1515/CCLM.2006.246 NR 19 TC 3 Z9 5 U1 0 U2 14 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 2-4 PARK SQUARE, MILTON PARK, ABINGDON OR14 4RN, OXON, ENGLAND SN 0036-5513 EI 1502-7686 J9 SCAND J CLIN LAB INV JI Scand. J. Clin. Lab. Invest. PY 2015 VL 75 IS 8 BP 693 EP 698 DI 10.3109/00365513.2015.1054870 PG 6 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA DD4PW UT WOS:000369906000010 PM 26426850 DA 2023-05-13 ER PT J AU Mohammadzadeh, S Matani, N Soleimani, N Drissi, HB AF Mohammadzadeh, Sahand Matani, Nasim Soleimani, Neda Bazrafshan Drissi, Hamed TI Comparison of Point-of-Care and Highly Sensitive Laboratory Troponin Testing in Patients Suspicious of Acute Myocardial Infarction and Its Efficacy in Clinical Outcome SO CARDIOLOGY RESEARCH AND PRACTICE LA English DT Article ID CARDIOVASCULAR-DISEASE; PERFORMANCE; ELEVATION AB Background. The use of high-sensitivity troponin (hs-cTnI) assays is recommended in current guidelines for managing patients with acute coronary syndrome (ACS) symptoms. However, point-of-care (POC) assays are frequently used in emergency departments (EDs) to reduce turnaround time and length of stay. This study aimed to compare the results of POC-cTnI testing with those of the gold standard, automated central laboratory testing of troponin (i.e., hs-cTnI). The primary and secondary outcomes were the diagnostic performance of POC-cTnI in diagnosing acute myocardial infarction (AMI) and major adverse cardiovascular events (MACE) during 30 days, respectively. Materials and Methods. In this diagnostic accuracy study, 136 patients with suspected ACS who were referred or admitted to the Al Zahra Hospital, Shiraz, Iran, were included between March (2020) and July (2020). For the diagnosis of AMI, central laboratory cTnI levels were assessed at the time of presentation (0 hour) and reassessed at least 3 hours later. The POC-cTnI was measured at 0 hour in all patients and at 3 hours if a patient was diagnosed with AMI but had a 0-hour negative result for the POC-cTnI assay. Additionally, the 30-day follow-up period for these participants began on the day of the initial presentation to assess MACE. Results. Out of 180 patients, 136 patients (median age of 59.5 years; 57.5% male) were left for the qualitative POC-cTnI and hs-cTnI assays. In 86 (63.24%) subjects, hs-cTnI was positive (either initial or serial); however, AMI was diagnosed in 85 patients according to positivity of troponin by hs-cTnI and clinical signs and symptoms, which were diagnosed by a cardiologist. The sensitivity, specificity, and negative predictive value of 0-hour POC-cTnI were observed to be 91.76% (95% CI: 83.77-96.62%), 98.04% (95% CI: 89.55-99.95%), and 87.72% (95% CI: 77.82-93.56%), respectively. Moreover, considering both the 0-hour and 3-hour POC-cTnI, all AMI cases were correctly identified, yielding a perfect test performance result. None of the 50 patients with negative cTnI results (by 0-hour and 3-hour POC-cTnI and hs-cTnI) experienced at least one MACE. Conclusion. In this small sample-size study, a new qualitative POC-cTnI assay was statistically equal to a hs-cTnI assay in terms of diagnostic accuracy for AMI or MACE in patients with suspected myocardial infarction. The POC-cTnI was observed to be acceptable for the identification of AMI and prediction of MACE in the ED environment. C1 [Mohammadzadeh, Sahand; Matani, Nasim; Soleimani, Neda] Shiraz Univ Med Sci, Shiraz Med Sch, Dept Pathol, Shiraz, Iran. [Soleimani, Neda] Shiraz Univ Med Sci, Abu Ali Sina Hosp, Shiraz Transplant Ctr, Dept Pathol, Shiraz, Iran. [Bazrafshan Drissi, Hamed] Shiraz Univ Med Sci, Cardiovasc Dept, Shiraz, Iran. C3 Shiraz University of Medical Science; Shiraz University of Medical Science; Shiraz University of Medical Science RP Soleimani, N (通讯作者)，Shiraz Univ Med Sci, Shiraz Med Sch, Dept Pathol, Shiraz, Iran.; Soleimani, N (通讯作者)，Shiraz Univ Med Sci, Abu Ali Sina Hosp, Shiraz Transplant Ctr, Dept Pathol, Shiraz, Iran. EM mohammads@sums.ac.ir; inasmeh@yahoo.com; soleimani_n@sums.ac.ir; hamedbazrafshan@yahoo.com RI Bazrafshan drissi, Hamed/AAR-5558-2021; Soleimani, Neda/X-9358-2018; Mohammadzadeh, Sahand/U-1587-2019 OI Bazrafshan drissi, Hamed/0000-0002-5705-3504; Soleimani, Neda/0000-0001-5769-8452; Mohammadzadeh, Sahand/0000-0001-6974-1323 CR Agewall S, 2011, EUR HEART J, V32, P404, DOI 10.1093/eurheartj/ehq456 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] Anderson JL, 2017, NEW ENGL J MED, V376, P2053, DOI 10.1056/NEJMra1606915 Body R, 2019, HEART, V105, P768, DOI 10.1136/heartjnl-2018-313825 Boeddinghaus J, 2020, J AM COLL CARDIOL, V75, P1111, DOI 10.1016/j.jacc.2019.12.065 Christ M, 2018, CLIN CHEM LAB MED, V56, P1336, DOI 10.1515/cclm-2017-0693 Forouzanfar MH, 2015, LANCET, V386, P2287, DOI 10.1016/S0140-6736(15)00128-2 Juliano M, 2017, MIL MED, V182, pE1938, DOI 10.7205/MILMED-D-16-00387 Libby P, 2013, NEW ENGL J MED, V368, P2004, DOI 10.1056/NEJMra1216063 Maldonado N, 2012, AM J PHYSIOL-HEART C, V303, pH619, DOI 10.1152/ajpheart.00036.2012 Mehta SR, 2009, NEW ENGL J MED, V360, P2165, DOI 10.1056/NEJMoa0807986 Mohammad OH, 2020, OPEN ACCESS EMERG M, V12, P247, DOI 10.2147/OAEM.S259726 Mozaffarian D, 2016, CIRCULATION, V133, pE38, DOI 10.1161/CIR.0000000000000350 Murray CJL, 2012, LANCET, V380, P2197, DOI 10.1016/S0140-6736(12)61689-4 Nichols M, 2014, EUR HEART J, V35, P2929, DOI 10.1093/eurheartj/ehu378 Nichols M, 2014, EUR HEART J, V35, P2950, DOI 10.1093/eurheartj/ehu299 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] Peacock WF, 2016, ANN LAB MED, V36, P405, DOI 10.3343/alm.2016.36.5.405 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Soleimani N, 2021, J ANAL METHODS CHEM, V2021, DOI 10.1155/2021/9955990 Soleimani Neda, 2020, J Anal Methods Chem, V2020, P9857636, DOI 10.1155/2020/9857636 Thygesen K, 2012, J AM COLL CARDIOL, V60, P1581, DOI 10.1016/j.jacc.2012.08.001 Volz KA, 2012, AM J EMERG MED, V30, P188, DOI 10.1016/j.ajem.2010.10.016 Weintraub WS, 2011, CIRCULATION, V124, P967, DOI 10.1161/CIR.0b013e3182285a81 Yeh RW, 2010, NEW ENGL J MED, V362, P2155, DOI 10.1056/NEJMoa0908610 Yonetsu T, 2011, EUR HEART J, V32, P1251, DOI 10.1093/eurheartj/ehq518 NR 26 TC 1 Z9 1 U1 2 U2 3 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 FEB 24 PY 2022 VL 2022 AR 6914979 DI 10.1155/2022/6914979 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 0B0ID UT WOS:000774326800001 PM 35251711 OA gold, Green Published DA 2023-05-13 ER PT J AU Alhajji, S Mojiminiyi, S AF Alhajji, Salwa Mojiminiyi, Segun TI Adherence to Current Lipid Guidelines by Physicians in Kuwait SO MEDICAL PRINCIPLES AND PRACTICE LA English DT Article DE Clinical sciences; Clinical practice guidelines; Dyslipidemia ID IMPACT AB Background:Alarmingly high rates of dyslipidemia have been found in the Gulf region in patients presenting with acute coronary syndrome, with the highest being found in Kuwait (37%). Therefore, it is of utmost importance to treat dyslipidemia promptly and effectively. In an effort to understand the practices of local physicians, the use of evidence-based medicine, and adherence to lipid treatment guidelines, the objective of this study was to survey and assess the current standards of care.Methods:A survey questionnaire, designed to assess physicians' attitudes and practice towards lipid guidelines, was completed by 279 participants and returned between October 2015 and June 2016. Statistical analysis was done using SPSS.Results:Over 90% of physicians claimed to use lipid guidelines, with the majority rating themselves as knowledgeable. Younger physicians were found to be less knowledgeable and consequently used guidelines less frequently. The most important factor influencing clinical decision-making was the availability of clinical guidelines. The majority (72.4%) of physicians identified time limitation as a key barrier. The most commonly selected lipid guideline in daily practice was a guideline on the treatment of blood cholesterol published by the American College of Cardiology/American Heart Association in 2013. The most common risk assessment tool used was the Framingham risk score.Conclusions:Multiple interventions to improve guideline adherence are proposed in this study. We have taken into account the barriers to adherence, i.e., attitude, behavior, and (most importantly) knowledge, all 3 of which were reaffirmed in our investigation in Kuwait. C1 [Alhajji, Salwa; Mojiminiyi, Segun] Mubaraka Al Kabeer Hosp, Clin Biochem, Jabriya, Kuwait. RP Alhajji, S (通讯作者)，Mubaraka Al Kabeer Hosp, Clin Biochem Lab, Jabriya 43787, Kuwait. EM dr.salhajji@gmail.com CR Al Aqeel A, 2005, MED PRIN PRACT, V14, P41, DOI 10.1159/000081922 Al Sayed N, 2016, INT J CARDIOL, V225, P268, DOI 10.1016/j.ijcard.2016.09.081 Cabana MD, 1999, JAMA-J AM MED ASSOC, V282, P1458, DOI 10.1001/jama.282.15.1458 Central Statistical Bureau, 2015, ANN B HLTH STAT Chressanthis GA, 2012, J CLIN HYPERTENS, V14, P435, DOI 10.1111/j.1751-7176.2012.00651.x Davis D, 1999, JAMA-J AM MED ASSOC, V282, P867, DOI 10.1001/jama.282.9.867 El-Menyar A, 2011, CLIN CARDIOL, V34, P51, DOI 10.1002/clc.20873 GOULD AL, 1995, CIRCULATION, V91, P2274, DOI 10.1161/01.CIR.91.8.2274 Guyatt G, 2004, BRIT MED J, V329, P990, DOI 10.1136/bmj.329.7473.990 Hajjaj FM, 2010, J ROY SOC MED, V103, P178, DOI 10.1258/jrsm.2010.100104 Kosimbei G, 2011, HEALTH RES POLICY SY, V9, DOI 10.1186/1478-4505-9-24 Lugtenberg M, 2011, BMC FAM PRACT, V12, DOI 10.1186/1471-2296-12-98 Mantel-Teeuwisse AK, 2003, BRIT J CLIN PHARMACO, V55, P389, DOI 10.1046/j.1365-2125.2003.01769.x Ramsaran E, 2019, AM J CARDIOL, V124, P169, DOI 10.1016/j.amjcard.2019.04.017 Reschovsky JD, 2015, J GEN INTERN MED, V30, P555, DOI 10.1007/s11606-015-3366-7 Santoro SL, 2018, PEDIATRICS, V142, DOI 10.1542/peds.2017-4119 Schattner A., 2014, INTERNAL MED, V4, P1000152, DOI [10.4172/2165-8048.1000152, DOI 10.4172/2165-8048.1000152] Scholes J, 2007, NURS CRIT CARE, V281, P1458, DOI [10.1111/j.1478-5153.2007.00227.x, DOI 10.1111/j.1478-5153.2007.00227.x] Tsiga E, 2013, BMJ OPEN, V3, DOI 10.1136/bmjopen-2013-002700 WHO, 2015, GLOB HLTH WORKF STAT World Health Organization, 2016, GLOB HLTH OBS DAT TO World Health Organization, 2014, NONCOMMUNICABLE DIS NR 22 TC 3 Z9 3 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1011-7571 EI 1423-0151 J9 MED PRIN PRACT JI Med. Princ. Pract. PD SEP PY 2020 VL 29 IS 5 BP 436 EP 443 DI 10.1159/000505244 PG 8 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA NM2XO UT WOS:000567965000005 PM 31805555 OA Green Published, gold DA 2023-05-13 ER PT J AU Xiang, Q Wang, Z Zhang, HX Liu, ZY Xie, QF Hu, K Mu, GY Ma, LY Zhang, Z Jiang, J Cui, YM AF Xiang, Qian Wang, Zhe Zhang, Han-Xu Liu, Zhi-Yan Xie, Qiu-Fen Hu, Kun Mu, Guang-Yan Ma, Ling-Yue Zhang, Zhuo Jiang, Jie Cui, Yi-Min TI Predicting ischaemic events using platelet reactivity in patients receiving clopidogrel: Indirect meta-comparison among VerifyNow, light transmission aggregometry and thromboelastography SO BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY LA English DT Article DE light-transmission aggregometry; platelet reactivity; thromboelastography; VerifyNow ID ACUTE CORONARY SYNDROME; TERM CLINICAL-OUTCOMES; OF-CARE ASSAY; ELEVATION MYOCARDIAL-INFARCTION; ADVERSE CARDIOVASCULAR EVENTS; OPTIMAL CUTOFF VALUE; FUNCTION TESTS; RISK-FACTOR; ANTIPLATELET THERAPY; SYSTEMATIC REVIEWS AB The present study compared performances of the three major methods used for assessing platelet reactivity (PR)-VerifyNow, light transmission aggregometry (LTA) and thromboelastography (TEG)-to predict ischaemic events in patients receiving clopidogrel. PubMed, EMBASE and the Cochrane Library were searched from their inception to April 2019 for prospective studies that examined PR using VerifyNow, LTA or TEG and the incidence of ischaemic events. The investigated diagnostic indices include sensitivity, specificity, positive (PLR) and negative likelihood ratio (NLR), diagnostic odds ratio and area under the receiver operating characteristic curves (AUC) of VerifyNow, LTA and TEG, respectively. A total of 26 prospective studies involving 22 185 patients were included in the analysis. The pooled AUC was 0.71 (95% CI: 0.67-0.75) for VerifyNow, 0.60 (95% CI: 0.55-0.64) for LTA and 0.81 (95% CI: 0.77-0.84) for TEG. Results of indirect comparisons indicated the AUC of VerifyNow was higher than that of LTA (1.18, 95% CI: 1.08-1.30) and lower than that of TEG (0.88, 95% CI: 0.82-0.94). TEG outperformed the other two methods for assessing PR in all predictive measures, including sensitivity, specificity, PLR and NLR. Despite a lack of studies that directly compared the three methods, our findings suggest that TEG should be recommended. C1 [Xiang, Qian; Wang, Zhe; Zhang, Han-Xu; Liu, Zhi-Yan; Xie, Qiu-Fen; Hu, Kun; Mu, Guang-Yan; Ma, Ling-Yue; Zhang, Zhuo; Cui, Yi-Min] Peking Univ, Dept Pharm, Hosp 1, 6 Dahongluochang St, Beijing 100034, Peoples R China. [Jiang, Jie] Peking Univ, Hosp 1, Dept Cardiol, Beijing, Peoples R China. C3 Peking University; Peking University RP Cui, YM (通讯作者)，Peking Univ, Dept Pharm, Hosp 1, 6 Dahongluochang St, Beijing 100034, Peoples R China. EM cui.pharm@pkufh.com RI cui, yimin/ABD-8672-2021 FU National Key R&D Program of China [2016YFC0904900]; Natural Science Foundation of Beijing Municipality [7171012]; National Natural Science Foundation of China [81872940, 81973395]; National Science and Technology Major Projects for "Major New Drugs Innovation and Development" of China [2017ZX09304028] FX National Key R&D Program of China, Grant/Award Number: 2016YFC0904900; Natural Science Foundation of Beijing Municipality, Grant/Award Number: 7171012; National Natural Science Foundation of China, Grant/Award Number: 81872940 and 81973395; National Science and Technology Major Projects for "Major New Drugs Innovation and Development" of China, Grant/Award Number: 2017ZX09304028 CR Altman DG, 2003, BMJ-BRIT MED J, V326, P219, DOI 10.1136/bmj.326.7382.219 Aradi D, 2013, INT J CARDIOL, V167, P2140, DOI 10.1016/j.ijcard.2012.05.100 Brar SS, 2011, J AM COLL CARDIOL, V58, P1945, DOI 10.1016/j.jacc.2011.06.059 Breet NJ, 2010, JAMA-J AM 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V45, P87, DOI 10.1597/06-118.1 Spiliopoulos S, 2013, J AM COLL CARDIOL, V61, P2428, DOI 10.1016/j.jacc.2013.03.036 Stone GW, 2013, LANCET, V382, P614, DOI 10.1016/S0140-6736(13)61170-8 Tang XF, 2015, CHINESE MED J-PEKING, V128, P774, DOI 10.4103/0366-6999.152611 Tantry US, 2013, J AM COLL CARDIOL, V62, P2261, DOI 10.1016/j.jacc.2013.07.101 Thomas MR, 2014, PLATELETS, V25, P612, DOI 10.3109/09537104.2013.863858 Trinquart L, 2012, BMC MED RES METHODOL, V12, DOI 10.1186/1471-2288-12-150 Valenti R, 2015, J THROMB THROMBOLYS, V40, P76, DOI 10.1007/s11239-014-1159-1 Walter SD, 2002, STAT MED, V21, P1237, DOI 10.1002/sim.1099 Windecker S, 2014, EUROINTERVENTION, V10, pT23, DOI [10.4244/EIJV10SUA10, 10.4244/EIJV10STA5] Yamaguchi Y, 2013, PLATELETS, V24, P352, DOI 10.3109/09537104.2012.700969 Yang HC, 2015, INTERV NEURORADIOL, V21, P61, DOI 10.15274/INR-2014-10094 Youn YN, 2014, AM HEART J, V167, P818, DOI 10.1016/j.ahj.2014.01.016 Zhang HZ, 2014, PLATELETS, V25, P292, DOI 10.3109/09537104.2013.815341 NR 55 TC 0 Z9 0 U1 1 U2 8 PU WILEY PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1742-7835 EI 1742-7843 J9 BASIC CLIN PHARMACOL JI Basic Clin. Pharmacol. Toxicol. PD OCT PY 2020 VL 127 IS 4 BP 309 EP 319 DI 10.1111/bcpt.13429 EA JUN 2020 PG 11 WC Pharmacology & Pharmacy; Toxicology WE Science Citation Index Expanded (SCI-EXPANDED) SC Pharmacology & Pharmacy; Toxicology GA NR1MP UT WOS:000539719800001 PM 32374907 OA Bronze DA 2023-05-13 ER PT J AU Chhabra, S Eagles, D Kwok, ESH Perry, JJ AF Chhabra, Shawn Eagles, Debra Kwok, Edmund S. H. Perry, Jeffrey J. TI Interventions to reduce emergency department door-to- electrocardiogram times: A systematic review SO CANADIAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Electrocardiogram; emergency department; systematic review ID ELEVATION MYOCARDIAL-INFARCTION; BALLOON TIME; CHEST-PAIN; ECG TIME; PATIENT; IMPROVE; CARE AB Objectives: We sought to identify emergency department interventions that lead to improvement in door-to-electrocardiogram (ECG) times for adults presenting with symptoms suggestive of acute coronary syndrome. Methods: Two reviewers searched Medline, Embase, CINAHL, and Cochrane CENTRAL from inception to April 2018 for studies in adult emergency departments with an identifiable intervention to reduce median door-to-ECG times when compared with the institution's baseline. Quality was assessed using the Quality Improvement Minimum Quality Criteria Set critical appraisal tool. The primary outcome was the absolute median reduction in door-to-ECG times as calculated by the difference between the post-intervention time and pre-intervention time. Results: Two reviewers identified 809 unique articles, yielding 11 before-after quality improvement studies that met eligibility criteria (N = 15,622 patients). The majority of studies (10/11) reported bundled interventions, and most (10/11) showed statistical improvement in door-to-ECG times. The most common interventions were having a dedicated ECG machine and technician in triage (5/11); improved triage education (4/11); improved triage disposition (2/11); and data feedback mechanisms (2/11). Conclusions: There are multiple interventions that show potential for reducing emergency department door-to-ECG times. Effective bundled interventions include having a dedicated ECG technician, triage education, and better triage disposition. These changes can help institutions attain best practice guidelines. Emergency departments must first understand their local context before adopting any single or group of interventions. C1 [Chhabra, Shawn; Eagles, Debra; Kwok, Edmund S. H.; Perry, Jeffrey J.] Univ Ottawa, Dept Emergency Med, Ottawa, ON, Canada. [Eagles, Debra; Perry, Jeffrey J.] Ottawa Hosp Res Inst, Ottawa, ON, Canada. C3 University of Ottawa; University of Ottawa; Ottawa Hospital Research Institute RP Chhabra, S (通讯作者)，Ottawa Hosp Civ Campus, Dept Emergency Med, Room EM206,1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada. EM schhabra@toh.ca OI Kwok, Edmund/0000-0003-2339-1019 CR Anderson JL, 2007, J AM COLL CARDIOL, V50, P652, DOI 10.1016/j.jacc.2007.02.028 Atzema CL, 2011, CAN J EMERG MED, V13, P79, DOI 10.2310/8000.2011.110261 Bhuiya FA., 2010, EMERGENCY DEP VISITS Bradley EH, 2006, AM HEART J, V151, P1281, DOI 10.1016/j.ahj.2005.07.015 Canadian Institute for Health Information, 2014, SOURC POT AV EM DEP Coyne CJ, 2015, WEST J EMERG MED, V16, P184, DOI 10.5811/westjem.2014.10.23277 Diercks DB, 2006, AM J EMERG MED, V24, P1, DOI 10.1016/j.ajem.2005.05.016 Hempel S, 2015, BMJ QUAL SAF, V24, P796, DOI 10.1136/bmjqs-2014-003151 HIGGINS GL, 1993, AM J EMERG MED, V11, P576, DOI 10.1016/0735-6757(93)90004-U Kaila Kendeep S, 2007, Mcgill J Med, V10, P75 Keats A, 2018, J SAUDI HEART ASSOC, V30, P180, DOI 10.1016/j.jsha.2017.11.005 Lin JF, 2011, HEART VESSELS, V26, P25, DOI 10.1007/s00380-010-0030-3 Meils CM, 2002, J NURS CARE QUAL, V17, P83, DOI 10.1097/00001786-200210000-00010 Phelan Michael P, 2009, Crit Pathw Cardiol, V8, P119, DOI 10.1097/HPC.0b013e3181b5a6f3 Piggott Z, 2011, CAN J EMERG MED, V13, P325, DOI 10.2310/8000.2011.110284 Purim-Shem-Tov Yanina A, 2007, Crit Pathw Cardiol, V6, P165, DOI 10.1097/HPC.0b013e31815b565d Shavelle DM, 2014, AM J CARDIOL, V113, P798, DOI 10.1016/j.amjcard.2013.11.036 Sprockel John Jaime, 2015, Crit Pathw Cardiol, V14, P25, DOI 10.1097/HPC.0000000000000034 Takakuwa KM, 2009, ACAD EMERG MED, V16, P921, DOI 10.1111/j.1553-2712.2009.00493.x NR 19 TC 8 Z9 8 U1 1 U2 4 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 1481-8035 EI 1481-8043 J9 CAN J EMERG MED JI Can. J. Emerg. Med. PD SEP PY 2019 VL 21 IS 5 BP 607 EP 617 DI 10.1017/cem.2019.342 PG 11 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA JC5ST UT WOS:000489343900025 PM 31088589 OA Bronze DA 2023-05-13 ER PT J AU Eisenberg, MJ Habib, B Alcaraz, M Thombs, BD Filion, KB AF Eisenberg, Mark J. Habib, Bettina Alcaraz, Maria Thombs, Brett D. Filion, Kristian B. TI Bright light therapy for depressive symptoms in hospitalized cardiac patients: A randomized controlled pilot trial SO PLOS ONE LA English DT Article ID SEASONAL AFFECTIVE-DISORDER; ARTERY-BYPASS-SURGERY; DOUBLE-BLIND; OUTCOMES; METAANALYSIS; MORTALITY; EFFICACY; ANXIETY; CARE AB Depression is common among cardiac patients and associated with adverse cardiovascular outcomes. Bright light therapy has emerged as a promising treatment for depressive symptoms, however it has not yet been investigated in this population. We conducted a double-blind, randomized, placebo-controlled pilot trial to assess the feasibility of a larger-scale trial testing bright light therapy for depressive symptoms in cardiac patients. Patients hospitalized for an acute coronary syndrome or undergoing cardiac surgery were randomized to either bright light (10,000 lux) or dim light placebo (500 lux) lamps for 30 minutes each day over 4 weeks, beginning in-hospital. Depression was quantified using the Patient Health Questionnaire 9 (PHQ-9) and Depression Anxiety and Stress Scales (DASS-21). The Short-Form Health Survey 36 (SF-36) was used to measure quality of life. A total of 175 patients were screened and 15 were randomized (8 treatment, 7 placebo) (8.6%) over 10 months. Despite protocol amendments which broadened the inclusion criteria, the trial was terminated early for infeasibility based on the rate of enrollment (1-2 participants/month), with 39.5% of the target sample (38 participants) enrolled. Future trials should take into account the timing of the onset of depressive symptoms in these patients, and consider a less conservative approach to eligibility as well as ways to increase the acceptability of bright light therapy in hospitalized cardiac patients. Once enrolled, our findings suggest that most participants will adhere to the assigned treatment and complete follow-up. C1 [Eisenberg, Mark J.; Habib, Bettina; Alcaraz, Maria; Thombs, Brett D.; Filion, Kristian B.] Jewish Gen Hosp, Ctr Clin Epidemiol, Lady Davis Inst, Montreal, PQ, Canada. [Eisenberg, Mark J.; Thombs, Brett D.; Filion, Kristian B.] McGill Univ, Dept Med, Montreal, PQ, Canada. [Eisenberg, Mark J.; Thombs, Brett D.; Filion, Kristian B.] McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada. [Eisenberg, Mark J.] McGill Univ, Div Cardiol, Jewish Gen Hosp, Montreal, PQ, Canada. [Thombs, Brett D.] McGill Univ, Dept Psychiat, Montreal, PQ, Canada. [Thombs, Brett D.] McGill Univ, Dept Psychol, Montreal, PQ, Canada. [Thombs, Brett D.] McGill Univ, Dept Educ & Counselling Psychol, Montreal, PQ, Canada. C3 Lady Davis Institute; McGill University; McGill University; McGill University; McGill University; McGill University; McGill University; McGill University RP Eisenberg, MJ (通讯作者)，Jewish Gen Hosp, Ctr Clin Epidemiol, Lady Davis Inst, Montreal, PQ, Canada.; Eisenberg, MJ (通讯作者)，McGill Univ, Dept Med, Montreal, PQ, Canada.; Eisenberg, MJ (通讯作者)，McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada.; Eisenberg, MJ (通讯作者)，McGill Univ, Div Cardiol, Jewish Gen Hosp, Montreal, PQ, Canada. EM mark.eisenberg@ladydavis.ca FU Lady Davis Institute Clinical Research Pilot Project (CliPP) in 2015; McGill University FX BEAM-P received funding from the Lady Davis Institute Clinical Research Pilot Project (CliPP) in 2015. Lamps were donated by Northern Light Inc., Montreal, Quebec (https://northernlighttechnologies.ca/).KBF holds a salary support award from the Fonds de recherche du Quebec -sante (FRQS; Quebec Foundation for Health Research) and a William Dawson Scholar award from McGill University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 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Each patient's blood glucose control status was then monitored for 7 years. The incidence of stroke and acute coronary syndrome during this period was confirmed.Results: Overall, 9,776 patients were included. HbA1c values were lower in the Best_group than in the other groups at all time points (all P < 0.001). The rate of reaching targets of < 6.5% or < 7.0% HbA1c decreased over time; the rate at which the estimated glomerular filtration rate decreased to < 30 or < 60 mL/min/1.73m2 increased over time (all trends, P < 0.01).Conclusion: Blood glucose control status in the first 3 months after initiating hospital care enabled estimation of the patient's glycemic control status for the next 7 years. In cases with poor initial blood glucose control, a new or more active method of blood glucose control should be sought. C1 [Kim, Hyunah] Sookmyung Womens Univ, Coll Pharm, Seoul, South Korea. [Jung, Da Young] Catholic Univ Korea, Clin Res Coordinating Ctr, Catholic Med Ctr, Dept Biostat, Seoul, South Korea. [Lee, Seung-Hwan; Cho, Jae-Hyoung; Kim, Hun -Sung] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med,Div Endocrinol & Metab, Seoul St, Seoul, South Korea. [Yim, Hyeon Woo] Catholic Univ Korea, Coll Med, Dept Prevent Med, Seoul, South Korea. [Kim, Hun -Sung] Catholic Univ Korea, Coll Med, Dept Med Informat, Seoul, South Korea. [Kim, Hun -Sung] Catholic Univ Korea, Coll Med, Dept Med Informat, 222 Banpo daero, Seoul 06591, South Korea. C3 Sookmyung Women's University; Catholic University of Korea; Catholic University of Korea; Seoul St. Mary's Hospital; Catholic University of Korea; Catholic University of Korea; Catholic University of Korea RP Kim, HS (通讯作者)，Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med,Div Endocrinol & Metab, Seoul St, Seoul, South Korea.; Kim, HS (通讯作者)，Catholic Univ Korea, Coll Med, Dept Med Informat, 222 Banpo daero, Seoul 06591, South Korea. EM 01cadiz@hanmail.net RI ; Lee, Seung-Hwan/C-7568-2018 OI Kim, Hun-Sung/0000-0002-7002-7300; Lee, Seung-Hwan/0000-0002-3964-3877 FU Daewoong Pharmaceutical company FX This study was supported by the Daewoong Pharmaceutical company (2021). 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Korean Med. Sci. PD OCT 3 PY 2022 VL 37 IS 38 AR e281 DI 10.3346/jkms.2022.37.e281 PG 12 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA 5H1YV UT WOS:000867482000004 PM 36193638 OA gold, Green Published DA 2023-05-13 ER PT J AU LaMonte, MJ AF LaMonte, Michael J. TI Cardiorespiratory Fitness in the Prevention and Management of Cardiovascular Disease SO REVIEWS IN CARDIOVASCULAR MEDICINE LA English DT Review DE heart disease; exercise; physical activity; maximal oxygen uptake; risk assessment; exercise prescription; prognosis ID ALL-CAUSE MORTALITY; C-REACTIVE PROTEIN; ACUTE MYOCARDIAL-INFARCTION; CORONARY-ARTERY CALCIUM; TIME PHYSICAL-ACTIVITY; LONG-TERM RISK; METABOLIC SYNDROME; EXERCISE CAPACITY; SUBCLINICAL ATHEROSCLEROSIS; FUNCTIONAL-CAPACITY AB Cardiovascular disease (CVD) is the leading cause of death among adults in the U.S. and elsewhere. Variation in the presence, severity, and control of major modifiable risk factors accounts for much of the variation in CVD rates worldwide. Cardiorespiratory fitness (CRF) reflects the integration of ventilation, circulation, and metabolism for the delivery and utilization of oxygen in support of dynamic aerobic physical activity. The gold standard measure of CRF is maximal oxygen uptake. Because the primary factor underlying differences in this measure between individuals is maximal cardiac output, it can serve as a clinical indicator of cardiac function. Higher CRF is associated with favorable levels of major CVD risk factors, lower prevalence and severity of subclinical atherosclerosis, and lower risks of developing both primary and secondary clinical CVD events. The beneficial associations between CRF and CVD are seen in women and men, older and younger adults, in those with multiple coexisting risk factors or prior diagnosis of CVD. Exercise training and regular physical activity of at least moderate intensities and volumes improves CRF in adults, and improvements in CRF are associated with lower risks of subsequent CVD and mortality. Routine assessment of CRF in primary care settings could enhance individual-level CVD risk assessment and thereby guide implementation of appropriate measures to prevent future clinical events. C1 [LaMonte, Michael J.] Univ Buffalo SUNY, Sch Publ Hlth & Hlth Profess, Dept Epidemiol & Environm Hlth, Buffalo, NY 14214 USA. C3 State University of New York (SUNY) System; State University of New York (SUNY) Buffalo RP LaMonte, MJ (通讯作者)，Univ Buffalo SUNY, Sch Publ Hlth & Hlth Profess, Dept Epidemiol & Environm Hlth, Buffalo, NY 14214 USA. EM mlamonte@buffalo.edu FU NHLBI [75N92019R0031, HL151885, HL153462, HL150170, HL130591] FX This work was supported by NHLBI contract 75N92019R0031 and research grants HL151885, HL153462, HL150170, HL130591. 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Cardiovasc. Med. PD NOV PY 2022 VL 23 IS 11 AR 382 DI 10.31083/j.rcm2311382 PG 18 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 8C7TN UT WOS:000917806800028 OA gold DA 2023-05-13 ER PT J AU Bell, SP Schnelle, J Nwosu, SK Schildcrout, J Goggins, K Cawthon, C Mixon, AS Vasilevskis, EE Kripalani, S AF Bell, Susan P. Schnelle, John Nwosu, Samuel K. Schildcrout, Jonathan Goggins, Kathryn Cawthon, Courtney Mixon, Amanda S. Vasilevskis, Eduard E. Kripalani, Sunil CA Vanderbilt Inpatient Cohort Study TI Development of a multivariable model to predict vulnerability in older American patients hospitalised with cardiovascular disease SO BMJ OPEN LA English DT Article ID HEART-FAILURE; FRAILTY ASSESSMENT; HEALTH LITERACY; CO-MORBIDITY; CARE; MORTALITY; ADULTS; READMISSION; MANAGEMENT; NUMERACY AB Objectives: To identify vulnerable cardiovascular patients in the hospital using a self-reported function-based screening tool. Participants: Prospective observational cohort study of 445 individuals aged >= 65 years admitted to a university medical centre hospital within the USA with acute coronary syndrome and/or decompensated heart failure. Methods: Participants completed an inperson interview during hospitalisation, which included vulnerable functional status using the Vulnerable Elders Survey (VES-13), sociodemographic, healthcare utilisation practices and clinical patient-specific measures. A multivariable proportional odds logistic regression model examined associations between VES-13 and prior healthcare utilisation, as well as other coincident medical and psychosocial risk factors for poor outcomes in cardiovascular disease. Results: Vulnerability was highly prevalent (54%) and associated with a higher number of clinic visits, emergency room visits and hospitalisations (all p< 0.001). A multivariable analysis demonstrating a 1-point increase in VES-13 (vulnerability) was independently associated with being female (OR 1.55, p= 0.030), diagnosis of heart failure (OR 3.11, p< 0.001), prior hospitalisations (OR 1.30, p< 0.001), low social support (OR 1.42, p= 0.007) and depression (p< 0.001). A lower VES-13 score (lower vulnerability) was associated with increased health literacy (OR 0.70, p= 0.002). Conclusions: Vulnerability to functional decline is highly prevalent in hospitalised older cardiovascular patients and was associated with patient risk factors for adverse outcomes and an increased use of healthcare services. C1 [Bell, Susan P.] Vanderbilt Univ, Dept Med, Div Cardiovasc Med, Nashville, TN 37235 USA. [Bell, Susan P.; Schnelle, John] Vanderbilt Univ, Dept Med, Ctr Qual Aging, Div Gen Internal Med & Publ Hlth, Nashville, TN USA. [Nwosu, Samuel K.; Schildcrout, Jonathan] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USA. [Goggins, Kathryn; Mixon, Amanda S.; Vasilevskis, Eduard E.; Kripalani, Sunil] Ctr Clin Qual & Implementat Res, Nashville, TN USA. [Cawthon, Courtney; Kripalani, Sunil] Vanderbilt Univ, Ctr Hlth Serv Res, Nashville, TN 37235 USA. [Mixon, Amanda S.; Vasilevskis, Eduard E.] Tennessee Valley Healthcare Syst Geriatr Res Educ, Dept Vet Affairs, Nashville, TN USA. [Mixon, Amanda S.; Vasilevskis, Eduard E.; Kripalani, Sunil] Vanderbilt Univ, Dept Med, Sect Hosp Med, Div Gen Internal Med & Publ Hlth, Nashville, TN USA. C3 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; Vanderbilt University RP Bell, SP (通讯作者)，Vanderbilt Univ, Dept Med, Div Cardiovasc Med, Nashville, TN 37235 USA. EM susan.p.bell@vanderbilt.edu RI Vasilevskis, Eduard/AAA-3065-2019 OI Vasilevskis, Eduard/0000-0001-8165-5321 FU NIH/NHLBI [R01 HL109388]; National Center for Advancing Translational Sciences [2 UL1 TR000445-06]; NIH/NICHD [K12HD043483-11]; Eisenstein Women's Heart Fund; VA HSR&D Career Development; NIH/NIA [K23AG040157]; Veterans Affairs Clinical Research Center of Excellence; Geriatric Research, Education and Clinical Center (GRECC) FX This research was supported by NIH/NHLBI (R01 HL109388) and in part by the National Center for Advancing Translational Sciences (2 UL1 TR000445-06). SPB is supported by K12HD043483-11 from NIH/NICHD and by the Eisenstein Women's Heart Fund. ASM is a VA HSR&D Career Development awardee at the Nashville VA. EEV is supported by NIH/NIA under Award Number K23AG040157 and the Veterans Affairs Clinical Research Center of Excellence, and the Geriatric Research, Education and Clinical Center (GRECC). 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However, its prognostic impact has not been fully addressed. The objective of this study is to evaluate the impact of the change in the platelet number during IABP use on the prognosis after device removal. This is a retrospective observational study. Patients in the intensive cardiac care unit at three Juntendo University hospitals who underwent percutancous implantation of IABP with or without veno-arterial extracorporeal membrane oxygenation (V-A ECMO), since 2012-2016, were enrolled in the study (n = 439). Patients who died during mechanical circulatory support (n = 47) were excluded. We evaluated the prognostic impact of the ratio of platelet reduction from the baseline (% PLT reduction) during IABP use on cardiovascular mortality after device removal. The median and the range of follow-up period were 298 days and 0-1.869 days. respectively. Unadjusted Kaplan-Meier analysis demonstrated that patients with a higher % PLT reduction had higher cardiovascular (CV) mortality. An adjusted Cox proportional hazard analysis demonstrated that a 10% higher % PLT reduction was associated with higher cardiovascular (CV) mortality (Hazard ratio: 1.3, 95% Confidence interval: 1.1-1.6, P < 0.001). Moreover, % PLT reduction and the maximum C-reactive protein (CRP) level during IABP use were positively correlated (r = 0.326, P < 0.001). The reduced number of platelets during IABP use was associated with an increased risk of CV mortality. C1 [Takano, Asuka Minami; Mukaida, Hiroshi; Osawa, Shota] Juntendo Univ, Dept Clin Engn, Grad Sch Med, Tokyo, Japan. [Takano, Asuka Minami; Iwata, Hiroshi; Miyosawa, Katsutoshi; Doi, Shinichiro; Funamizu, Takehiro; Takasu, Kiyoshi; Okai, Iwao; Tamura, Hiroshi; Isoda, Kikuo; Okazaki, Shinya; Miyauchi, Katsumi; Daida, Hiroyuki] Juntendo Univ, Dept Cardiovasc Med, Grad Sch Med, Tokyo, Japan. [Kimura, Atsushi] Juntendo Univ, Dept Clin Engn, Nerima Hosp, Tokyo, Japan. [Kubota, Kyoko] Juntendo Univ, Dept Clin Engn, Shizuoka Hosp, Shizuoka, Japan. [Suwa, Satoru] Juntendo Univ, Dept Cardiovasc Med, Shizuoka Hosp, Shizuoka, Japan. [Sumiyoshi, Masataka] Juntendo Univ, Dept Cardiovasc Med, Nerima Hosp, Tokyo, Japan. [Amano, Atsushi] Juntendo Univ, Dept Cardiovasc Surg, Grad Sch Med, Tokyo, Japan. C3 Juntendo University; Juntendo University; Juntendo University; Juntendo University; Juntendo University; Juntendo University; Juntendo University RP Iwata, H (通讯作者)，Juntendo Univ, Dept Cardiovasc Med, Grad Sch Med, Bunkyo Ku, Hongo 2-1-1, Tokyo 1130033, Japan. EM hiroiwata-circ@umin.ac.jp CR Abrams D, 2016, INTENS CARE MED, V42, P844, DOI 10.1007/s00134-016-4312-9 Duerschmied D, 2013, BLOOD, V121, P1008, DOI 10.1182/blood-2012-06-437392 Dvir D, 2014, EUR HEART J, V35, P2663, DOI 10.1093/eurheartj/ehu082 Eikelboom JW, 2001, CIRCULATION, V103, P643 Gore JM, 2009, AM J CARDIOL, V103, P175, DOI 10.1016/j.amjcard.2008.08.055 Khashan MY, 2013, CRIT CARE, V17, DOI 10.1186/cc12520 Lauten A, 2013, CIRC-HEART FAIL, V6, P23, DOI 10.1161/CIRCHEARTFAILURE.112.967224 Losito I, 2015, LIPIDS, V50, P71, DOI 10.1007/s11745-014-3975-7 McCabe JM, 2014, CATHETER CARDIO INTE, V83, P633, DOI 10.1002/ccd.25206 McKusick V A, 1968, JAMA, V204, P113 Mojadidi MK, 2016, HEART LUNG CIRC, V25, P568, DOI 10.1016/j.hlc.2015.11.010 Oshima K, 2007, INT HEART J, V48, P743, DOI 10.1536/ihj.48.743 Puddu Paolo, 2010, Can J Cardiol, V26, P140 Rautou PE, 2011, CIRC RES, V109, P593, DOI 10.1161/CIRCRESAHA.110.233163 Roy SK, 2010, CLIN CARDIOL, V33, P30, DOI 10.1002/clc.20694 Sexton TR, 2016, J THROMB THROMBOLYS, V41, P384, DOI 10.1007/s11239-015-1326-z Vales L, 2011, J INVASIVE CARDIOL, V23, P116 Vanderschueren S, 2000, CRIT CARE MED, V28, P1871, DOI 10.1097/00003246-200006000-00031 Vonderheide RH, 1998, AM J MED, V105, P27, DOI 10.1016/S0002-9343(98)00128-4 Wang ZT, 2016, ATHEROSCLEROSIS, V248, P10, DOI 10.1016/j.atherosclerosis.2016.03.004 Yadav M, 2016, CAN J CARDIOL, V32, P226, DOI 10.1016/j.cjca.2015.05.020 NR 21 TC 0 Z9 0 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 JAN PY 2020 VL 61 IS 1 BP 89 EP 95 DI 10.1536/ihj.19-349 PG 7 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA KH1XL UT WOS:000510439400013 PM 31956149 OA gold DA 2023-05-13 ER PT J AU Toth, PP Danese, M Villa, G Qian, Y Beaubrun, A Lira, A Jansen, JP AF Toth, Peter P. Danese, Mark Villa, Guillermo Qian, Yi Beaubrun, Anne Lira, Armando Jansen, Jeroen P. TI Estimated burden of cardiovascular disease and value-based price range for evolocumab in a high-risk, secondary-prevention population in the US payer context SO JOURNAL OF MEDICAL ECONOMICS LA English DT Article DE Evolocumab; PCSK9 inhibition; low-density lipoprotein cholesterol (LDLC); cardiovascular disease (CVD); burden of disease; cost-effectiveness; value-based pricing ID HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA; DENSITY-LIPOPROTEIN CHOLESTEROL; COST-EFFECTIVENESS; STATIN THERAPY; HEALTH-CARE; MONOCLONAL-ANTIBODY; PCSK9 INHIBITION; 000 PARTICIPANTS; LDL CHOLESTEROL; INDIVIDUAL DATA AB Aim: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolo-cumab for a US-context, high-risk, secondary-prevention population. Materials and methods: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into four cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (n = 1448), acute coronary syndrome (ACS) (n = 602), ischemic stroke (IS) (n = 151), and heart failure (HF) (n = 291) incident cohorts. The value-based price range for evolocumab was assessed using a previously published economic model. The model incorporated CPRD CV event rates and considered CV event reduction rate ratios per 1 mmol/L reduction in low-density lipo-protein- cholesterol (LDL-C) from a meta-analysis of statin trials by the Cholesterol Treatment Trialists Collaboration (CTTC), i.e. CTTC relationship. Results: Multiple-event rates of composite CV events (ACS, IS, or coronary revascularization) per 100 patient-years were 12.3 for the high-risk prevalent ASCVD cohort, and 25.7, 13.3, and 23.3, respectively, for incident ACS, IS, and HF cohorts. Approximately one-half (42%) of the high-risk ASCVD patients with a new CV event during follow-up had a subsequent CV event. Combining these real-world event rates and the CTTC relationship in the economic model, the value-based price range (credible interval) under a willingness-to-pay threshold of $150,000/ quality-adjusted life-year gained for evolocumab was $11,990 ($9,341-$14,833) to $16,856 ($12,903-$20,678) in ASCVD patients with baseline LDL-C levels >= 70 mg/dL and >= 100 mg/dL, respectively. Conclusion: Real-world CVD burden is substantial. Using the observed CVD burden in CPRD and the CTTC relationship, the cost-effectiveness analysis showed that, accounting for uncertainties, the expected value-based price for evolocumab is higher than its current annual cost, as long as the payer discount off list price is greater than 20%. C1 [Toth, Peter P.] CGH Med Ctr, Sterling, IL USA. [Toth, Peter P.] Johns Hopkins Univ, Sch Med, Ciccarone Ctr Prevent Heart Dis, Lutherville Timonium, MD USA. [Danese, Mark] Outcomes Insights Inc, Westlake Village, CA USA. [Villa, Guillermo] Amgen Europe GmbH, Zug, Switzerland. [Qian, Yi; Beaubrun, Anne; Lira, Armando] Amgen Inc, Thousand Oaks, CA 91320 USA. [Jansen, Jeroen P.] Precis Hlth Econ, Oakland, CA USA. C3 Johns Hopkins University; Amgen; AMGEN Europe; Amgen RP Toth, PP (通讯作者)，CGH Med Ctr, 101 East Miller Rd, Sterling, IL 61081 USA. EM peter.toth@cghmc.com RI Toth, Peter/GMW-6552-2022; qian, yi/HZH-4175-2023 OI Jansen, Jeroen Paul/0000-0003-2686-9217 FU Amgen Inc. FX This study was sponsored by Amgen Inc. 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Med. Econ. PY 2017 VL 20 IS 6 BP 555 EP 564 DI 10.1080/13696998.2017.1284078 PG 10 WC Economics; Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC Business & Economics; Health Care Sciences & Services; General & Internal Medicine GA EV4WC UT WOS:000401763300001 PM 28097904 OA Bronze DA 2023-05-13 ER PT J AU Woudstra, P Kalkman, DN den Heijer, P Menown, IBA Erglis, A Suryapranata, H Arkenbout, KE Iniguez, A van 't Hof, AWJ Muller, P Tijssen, JGP de Winter, RJ AF Woudstra, Pier Kalkman, Deborah N. den Heijer, Peter Menown, Ian B. A. Erglis, Andrejs Suryapranata, Harry Arkenbout, Karin E. Iniguez, Andres van 't Hof, Arnoud W. J. Muller, Philippe Tijssen, Jan G. P. de Winter, Robbert J. TI 1-Year Results of the REMEDEE Registry Clinical Outcomes After Deployment of the Abluminal Sirolimus-Coated Bioengineered (Combo) Stent in a Multicenter, Prospective All-Comers Registry SO JACC-CARDIOVASCULAR INTERVENTIONS LA English DT Article DE clinical outcomes; Combo; endothelial progenitor cell; PCI; stent ID CORONARY-ARTERY LESIONS; PACLITAXEL-ELUTING STENTS; DOUBLE-BLIND; SLOW-RELEASE; TRIAL; 6-MONTH; THROMBOSIS; THERAPY; CAPTURE; POLYMER AB OBJECTIVES This registry evaluated the safety and clinical outcomes of the Combo stent in an all-comers population in routine clinical practice. We report 1-year results. BACKGROUND Limitations of current generation drug-eluting stents (DES) are 3-fold: stent thrombosis, neoatherosclerosis related to impaired healing, and repeat revascularization due to (late-) in-stent restenosis. The Combo stent combines an abluminal biodegradable coating eluting sirolimus and a luminal anti-CD34(+) antibody layer to attract endothelial progenitor cells in order to promote vessel healing, thus preventing neointima formation and restenosis. METHODS The REMEDEE (Randomized study to Evaluate the safety and effectiveness of an abluMinal sirolimus coatED bio-Engineered StEnt) post-market registry was an international, multicenter, prospective trial that evaluated clinical outcomes after deployment of the Combo stent, in an all-comers population of patients treated with a Combo stent in the setting of routine clinical care. Clinical endpoints were target lesion failure (TLF), defined as a composite of cardiac death, nonfatal myocardial infarction (MI), or target lesion revascularization (TLR). RESULTS Between June 2013 and March 2014, a total of 1,000 patients were included in the registry, 49.9% of whom presented with acute coronary syndrome. Mean age was 65 +/- 11 years old (range: 34 to 94 years of age), and 74% of patients were male; 58.9% of 1,255 lesions were American Heart Association type B2 or C lesions. The primary endpoints were 5.7% TLF, 1.7% cardiac death, 0.7% target vessel MI, and 4.4% TLR. Definite stent thrombosis occurred in 0.5% of subjects; no thrombosis occurred after 9 days post-stenting. CONCLUSIONS This registry showed excellent 1-year results of novel Combo bioengineered stent technology in an all-comers patient population. (Prospective Registry to Assess the Long-term Safety and Performance of the Combo Stent [REMEDEE]; NCT01874002) (C) 2016 by the American College of Cardiology Foundation. C1 [Woudstra, Pier; Kalkman, Deborah N.; Tijssen, Jan G. P.; de Winter, Robbert J.] Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Room B2-137,Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands. [den Heijer, Peter] Amphia Hosp Breda, Dept Cardiol, Breda, Netherlands. [Menown, Ian B. A.] Craigavon Cardiac Ctr, Dept Cardiol, Craigavon, North Ireland. [Erglis, Andrejs] Pauls Stradins Clin Univ Hosp, Dept Cardiol, Riga, Latvia. [Suryapranata, Harry] Radboud Univ Nijmegen, Dept Cardiol, Med Ctr, NL-6525 ED Nijmegen, Netherlands. [Arkenbout, Karin E.] Tergooi Ziekenhuis, Dept Cardiol, Blaricum, Netherlands. [Iniguez, Andres] Hosp Alvaro Cunqueiro Complejo Hosp Univ, Dept Cardiol, Vigo, Spain. [van 't Hof, Arnoud W. J.] Isala Klin, Dept Cardiol, Zwolle, Netherlands. [Muller, Philippe] Inst Natl Cardiochirurg & Cardiol Intervent, Dept Cardiol, Luxembourg, Luxembourg. C3 University of Amsterdam; Amphia Hospital; Pauls Stradins Clinical University Hospital; Radboud University Nijmegen; Tergooi Blaricum; Isala Clinics RP de Winter, RJ (通讯作者)，Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Room B2-137,Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands. EM r.j.dewinter@amc.uva.nl RI Erglis, Andrejs/HJP-3937-2023; Suryapranata, H./H-8095-2014; Menown, Ian/AAL-8439-2021; Woudstra, Pier/GLV-0473-2022; Kalkman, Deborah Nancy/AAH-3641-2020 OI Erglis, Andrejs/0000-0002-3999-0182; Menown, Ian/0000-0001-9971-4350; Woudstra, Pier/0000-0002-5870-9923; Kalkman, Deborah Nancy/0000-0002-1900-2116 FU OrbusNeich; Boston Scientific; Biosensors; Medicines Company; Abbott Laboratories; AstraZeneca; Stentys; Tryton FX OrbusNeich supported this study through an unrestricted grant to Academic Medical Center, University of Amsterdam, but had no part in site monitoring, collection, storage, or analysis of data or decision to submit the manuscript for publication. Dr. den Heijer is a consultant for Medtronic CoreValve and Direct Flow Medical. Dr. Menown has received grant support from Boston Scientific and Biosensors. Dr. van 't Hof has received grant support from The Medicines Company and Abbott Laboratories. Dr. de Winter has received grant support from OrbusNeich, Abbott Laboratories, AstraZeneca, Stentys, and Tryton; and consults for OrbusNeich. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Woudstra and Kalkman contributed equally to this work. 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Interv. PD JUN 13 PY 2016 VL 9 IS 11 BP 1127 EP 1134 DI 10.1016/j.jcin.2016.02.052 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DN9SF UT WOS:000377419700011 PM 27209254 DA 2023-05-13 ER PT J AU Teramoto, T Uno, K Miyoshi, I Khan, I Gorcyca, K Sanchez, RJ Yoshida, S Mawatari, K Masaki, T Arai, H Yamashita, S AF Teramoto, Tamio Uno, Kiyoko Miyoshi, Izuru Khan, Irfan Gorcyca, Katherine Sanchez, Robert J. Yoshida, Shigeto Mawatari, Kazuhiro Masaki, Tomoya Arai, Hidenori Yamashita, Shizuya TI Low-density lipoprotein cholesterol levels and lipid-modifying therapy prescription patterns in the real world: An analysis of more than 33,000 high cardiovascular risk patients in Japan SO ATHEROSCLEROSIS LA English DT Article DE Lipid management; Cardiovascular risk; Goal attainment; Japan ID INTIMA-MEDIA THICKNESS; EZETIMIBE PLUS STATIN; HYPERCHOLESTEROLEMIC PATIENTS; PRIMARY PREVENTION; LOWERING THERAPY; OPEN-LABEL; LDL CHOLESTEROL; ATHEROSCLEROSIS; EFFICACY; ROSUVASTATIN AB Background and aims: Low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor in the development of cardiovascular (CV) disease. In 2012, the Japan Atherosclerosis Society (JAS) issued guidelines recommending statins as first-line pharmacotherapy for lowering LDL-C in patients at high risk for CV events. This study assessed achievement of recommended LDL-C goals and lipid-modifying therapy (LMT) use in a high CV risk population in Japan. Methods: Patients from the Medical Data Vision (MDV) database, an electronic hospital-based claims database in Japan, who met the following inclusion criteria were included in this study: LDL-C measurement in 2013; >= 20 years of age; >= 2 years representation in the database; and a high CV risk condition (recent acute coronary syndrome (ACS), other coronary heart disease (CHD), ischemic stroke, peripheral arterial disease (PAD) or diabetes). LDL-C goal attainment was assessed based on LDL-C targets in the JAS guidelines. Results: A total of 33,325 high CV risk patients met the inclusion criteria. Overall, 68% of the cohort achieved guideline recommended LDL-C targets, with only 42% receiving current treatment with statins. Attainment of LDL-C goals was 68% for ACS, 55% for CHD, and 80% each for ischemic stroke, PAD, and diabetes patients. Concomitant use of non-statin LMTs was low. Conclusions: In a high CV risk population in a routine care setting in Japan, guideline recommended LDLC goal attainment and utilization of statins and other LMT was low. In addition, physicians appeared to be more likely to consider the initiation of statins in patients with higher baseline LDL-C levels. (C) 2016 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). C1 [Teramoto, Tamio] Teikyo Acad, Res Ctr, Itabashi Ku, 2-11-1 Kaga, Tokyo 1738605, Japan. [Uno, Kiyoko; Miyoshi, Izuru] Sanofi, Tokyo, Japan. [Khan, Irfan; Gorcyca, Katherine] Sanofi, Bridgewater, NJ USA. [Sanchez, Robert J.] Regeneron Pharmaceut Inc, 777 Old Saw Mill River Rd, Tarrytown, NY 10591 USA. [Yoshida, Shigeto; Mawatari, Kazuhiro; Masaki, Tomoya] IMS Japan KK, Tokyo, Japan. [Arai, Hidenori] Kyoto Univ, Grad Sch Med, Dept Human Hlth Sci, Kyoto, Japan. [Yamashita, Shizuya] Rinku Gen Med Ctr, Osaka, Japan. C3 Sanofi-Aventis; Sanofi-Aventis; Regeneron; Kyoto University RP Teramoto, T (通讯作者)，Teikyo Acad, Res Ctr, Itabashi Ku, 2-11-1 Kaga, Tokyo 1738605, Japan. EM ttera@med.teikyo-u.ac.jp RI Arai, Hidenori/P-9816-2017; Khan, Irfan/ABD-3838-2020 OI Arai, Hidenori/0000-0002-9000-6849; Khan, Irfan/0000-0002-9832-0904; Yoshida, Shigeto/0000-0001-5056-6473 FU Sanofi; Regeneron Pharmaceuticals, Inc. FX This study was funded by Sanofi and Regeneron Pharmaceuticals, Inc. CR [Anonymous], GLOB HLTH EST 2000 2 Baigent C, 2010, LANCET, V376, P1670, DOI 10.1016/S0140-6736(10)61350-5 Bhatt DL, 2006, JAMA-J AM MED ASSOC, V295, P180, DOI 10.1001/jama.295.2.180 Boekholdt SM, 2012, JAMA-J AM MED ASSOC, V307, P1302, DOI 10.1001/jama.2012.366 Cannon CP, 2015, NEW ENGL J MED, V372, P2387, DOI 10.1056/NEJMoa1410489 Daida H, 2014, J ATHEROSCLER THROMB, V21, P739, DOI 10.5551/jat.19109 Descamps O, 2015, ATHEROSCLEROSIS, V240, P482, DOI 10.1016/j.atherosclerosis.2015.03.004 Grundy SM, 2014, J CLIN LIPIDOL, V8, P29, DOI 10.1016/j.jacl.2013.12.005 Igase M, 2012, CLIN DRUG INVEST, V32, P513, DOI 10.2165/11633950-000000000-00000 Jacobson TA, 2014, J CLIN LIPIDOL, V8, P473, DOI 10.1016/j.jacl.2014.07.007 Johansen ME, 2014, ANN FAM MED, V12, P215, DOI 10.1370/afm.1641 Karlson B.W., 2016, EUR HEART J CARDIOVA Kawagoe Y, 2011, ENDOCR J, V58, P171, DOI 10.1507/endocrj.K10E-289 Kitagawa K., 2014, JPN J STROKE, V36, P144 Law MR, 2003, BRIT MED J, V326, P1423, DOI 10.1136/bmj.326.7404.1423 Liao JK, 2007, AM J CARDIOL, V99, P410, DOI 10.1016/j.amjcard.2006.08.051 Mabuchi Hiroshi, 2004, J Atheroscler Thromb, V11, P152 Morrone D, 2012, ATHEROSCLEROSIS, V223, P251, DOI 10.1016/j.atherosclerosis.2012.02.016 Naci H, 2013, EUR J PREV CARDIOL, V20, P641, DOI 10.1177/2047487313480435 Nakamura H, 2006, LANCET, V368, P1155, DOI 10.1016/S0140-6736(06)69472-5 Nohara R, 2012, CIRC J, V76, P221, DOI 10.1253/circj.CJ-11-0887 Park JE, 2012, EUR J PREV CARDIOL, V19, P781, DOI 10.1177/1741826710397100 Reiner Z, 2011, EUR HEART J, V32, P1769, DOI [10.1093/eurheartj/ehr158, 10.1016/j.atherosclerosis.2011.06.012] Saito Y, 2007, ATHEROSCLEROSIS, V194, P505, DOI 10.1016/j.atherosclerosis.2006.11.028 Saku K, 2011, CIRC J, V75, P1493, DOI 10.1253/circj.CJ-10-1281 Sasaki J, 2008, CLIN THER, V30, P1089, DOI 10.1016/j.clinthera.2008.05.017 Stone NJ, 2014, CIRCULATION, V129, pS1, DOI 10.1161/01.cir.0000437738.63853.7a Takahashi E, 2013, INTERNAL MED, V52, P295, DOI 10.2169/internalmedicine.52.9054 Teramoto T, 2013, J ATHEROSCLER THROMB, V20, P517, DOI 10.5551/jat.15792 Teramoto T, 2012, CURR THER RES CLIN E, V73, P1, DOI 10.1016/j.curtheres.2012.02.001 Teramoto T, 2010, J ATHEROSCLER THROMB, V17, P879, DOI 10.5551/jat.4176 Yamazaki Tsutomu, 2009, Ann Vasc Dis, V2, P159, DOI 10.3400/avd.AVDoa090019 Yamazaki T, 2013, INT HEART J, V54, P33, DOI 10.1536/ihj.54.33 Yokote K, 2008, ATHEROSCLEROSIS, V201, P345, DOI 10.1016/j.atherosclerosis.2008.02.008 Yoshida H, 2005, CURR THER RES CLIN E, V66, P613, DOI 10.1016/j.curtheres.2005.12.008 Yoshitomi Y, 2006, J ATHEROSCLER THROMB, V13, P108, DOI 10.5551/jat.13.108 Yusuf S, 2004, LANCET, V364, P937, DOI 10.1016/S0140-6736(04)17018-9 NR 37 TC 52 Z9 52 U1 0 U2 5 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0021-9150 EI 1879-1484 J9 ATHEROSCLEROSIS JI Atherosclerosis PD AUG PY 2016 VL 251 BP 248 EP 254 DI 10.1016/j.atherosclerosis.2016.07.001 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DT1SJ UT WOS:000381262100036 PM 27419905 OA hybrid DA 2023-05-13 ER PT J AU Gaspar, A Pereira, MA Azevedo, P Lourenco, A Marques, J Leite-Moreira, A AF Gaspar, Antonio Pereira, Miguel Alvares Azevedo, Pedro Lourenco, Andre Marques, Jorge Leite-Moreira, Adelino TI Remote ischemic conditioning in ST-elevation myocardial infarction as adjuvant to primary angioplasty (RIC-STEMI): study protocol for a randomized controlled trial SO TRIALS LA English DT Article ID REPERFUSION INJURY; SURGERY AB Background: ST-elevation myocardial infarction (STEMI) accounts for nearly one third of acute coronary syndromes. Despite improved STEMI patient care, mortality remains high, contributing significantly to the ischemic heart disease burden. This may partly be related to ischemia-reperfusion injury (IRI). Remote ischemic conditioning (RIC), through short cycles of ischemia-reperfusion applied to a limb, has been shown to reduce IRI in various clinical settings. Our primary hypothesis is that RIC will reduce adverse events related to STEMI when applied as adjunctive therapy to primary percutaneous coronary intervention (PCI). Methods/Design: "Remote ischemic conditioning in ST-elevation myocardial infarction as adjuvant to primary angioplasty" (RIC-STEMI) is an ongoing prospective, single-center, open-label, randomized controlled trial to assess whether RIC as an adjunctive therapy during primary PCI in patients presenting with STEMI can improve clinical outcomes. After enrollment, participants are randomized according to a computer-generated randomization schedule, in a ratio of 1: 1 to RIC or no intervention, in blocks of four individuals. RIC is begun at least 10 min before the estimated time of the first balloon inflation and its duration is 30 min. Ischemia is induced by three cycles of inflation of a blood pressure cuff placed on the left lower limb to 200 mmHg and then deflation to 0 mmHg for another 5 min. Primary endpoint is a combined endpoint of death from cardiac cause or hospitalization for heart failure (HF) on follow-up (including device implantation: implantable cardioverter defibrillator, cardiac resynchronization and left ventricular assist device). Secondary endpoints are myocardial infarction (MI) size (estimated by the 48 h area under the curve of serum troponin I levels), development of Q-wave MI, left ventricular function (assessed by echocardiography within the first 3 days after admission), contrast-induced nephropathy, in-hospital mortality, all-cause mortality and, finally, major adverse cardiovascular events. Patients will have a minimum follow-up period of 12 months. From 11 March 2013 to 31 December 2014, 324 patients have been enrolled and randomized. We expect to complete enrollment of the 494 patients deemed necessary within 3 years. C1 [Gaspar, Antonio; Lourenco, Andre; Leite-Moreira, Adelino] Univ Porto, Fac Med, Dept Physiol & Cardiothorac Surg, Cardiovasc R&D Unit, P-4200319 Oporto, Portugal. [Gaspar, Antonio; Pereira, Miguel Alvares; Azevedo, Pedro; Marques, Jorge] Hosp Braga, Dept Cardiol, Braga, Portugal. [Lourenco, Andre; Leite-Moreira, Adelino] Hosp Sao Joao, Dept Cardiothorac Surg, Oporto, Portugal. C3 Universidade do Porto; Hospital de Braga; Sao Joao Hospital RP Gaspar, A (通讯作者)，Univ Porto, Fac Med, Dept Physiol & Cardiothorac Surg, Cardiovasc R&D Unit, Alameda Prof Hernani Monteiro, P-4200319 Oporto, Portugal. EM antoniog80@portugalmail.com RI Leite-Moreira, Adelino F./A-1463-2018; Lourenço, André P./E-5878-2011 OI Leite-Moreira, Adelino F./0000-0001-7808-3596; Lourenço, André P./0000-0002-5756-9535; Gaspar, Antonio/0000-0002-1138-0614 FU Portuguese Foundation for Science and Technology through the Cardiovascular RD Unit [PEst-C/SAU/UI0051/2011, EXCL/BIM-MEC/0055/2012]; European Commission Grant FP7-Health (MEDIA) [261409]; Fundação para a Ciência e a Tecnologia [PEst-C/SAU/UI0051/2011] Funding Source: FCT FX Work funded by the Portuguese Foundation for Science and Technology (Projects PEst-C/SAU/UI0051/2011 and EXCL/BIM-MEC/0055/2012) through the Cardiovascular R&D Unit and by the European Commission Grant FP7-Health-2010 (MEDIA-261409). CR Botker HE, 2010, LANCET, V375, P727, DOI 10.1016/S0140-6736(09)62001-8 Boutron I, 2008, ANN INTERN MED, V148 Chan AW, 2013, BMJ-BRIT MED J, V346, DOI 10.1136/bmj.e7586 Cheung MMH, 2006, J AM COLL CARDIOL, V47, P2277, DOI 10.1016/j.jacc.2006.01.066 Dirksen MT, 2007, CARDIOVASC RES, V74, P343, DOI 10.1016/j.cardiores.2007.01.014 Eapen ZJ, 2012, CIRC-CARDIOVASC QUAL, V5, P594, DOI 10.1161/CIRCOUTCOMES.112.966150 Fox KAA, 2006, BMJ-BRIT MED J, V333, P1091, DOI 10.1136/bmj.38985.646481.55 Fox KAA, 2010, EUR HEART J, V31, P2755, DOI 10.1093/eurheartj/ehq326 Frohlich GM, 2013, EUR HEART J, V34, P1714, DOI 10.1093/eurheartj/eht090 Hausenloy DJ, 2007, LANCET, V370, P575, DOI 10.1016/S0140-6736(07)61296-3 Heusch G, 2015, J AM COLL CARDIOL, V65, P177, DOI 10.1016/j.jacc.2014.10.031 Hoole SP, 2009, CIRCULATION, V119, P820, DOI 10.1161/CIRCULATIONAHA.108.809723 Ibanez B, 2015, J AM COLL CARDIOL, V65, P1455, DOI 10.1016/j.jacc.2015.02.032 Rentoukas I, 2010, JACC-CARDIOVASC INTE, V3, P49, DOI 10.1016/j.jcin.2009.10.015 Schulz KF, 2010, BMJ-BRIT MED J, V340, DOI [10.1136/bmj.c332, 10.7326/0003-4819-154-4-201102150-00016] Sloth AD, 2014, EUR HEART J, V35, P168, DOI 10.1093/eurheartj/eht369 Yellow DM., 2007, NEW ENGL J MED, V357, P1121, DOI [10.1056/NEJMra071667, DOI 10.1056/NEJMRA071667] NR 17 TC 3 Z9 4 U1 0 U2 4 PU BMC PI LONDON PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND EI 1745-6215 J9 TRIALS JI Trials PD SEP 8 PY 2015 VL 16 AR 398 DI 10.1186/s13063-015-0937-1 PG 5 WC Medicine, Research & Experimental WE Science Citation Index Expanded (SCI-EXPANDED) SC Research & Experimental Medicine GA CQ8SF UT WOS:000360878000001 PM 26350480 OA gold, Green Published DA 2023-05-13 ER PT J AU Hansen, JK Anthony, DG Li, L Wheeler, D Sessler, DI Bashour, CA AF Hansen, Jennifer K. Anthony, David G. Li, Liang Wheeler, David Sessler, Daniel I. Bashour, C. Allen TI Comparison of Positive End-Expiratory Pressure of 8 versus 5 cm H2O on Outcome After Cardiac Operations SO JOURNAL OF INTENSIVE CARE MEDICINE LA English DT Review DE PEEP; anesthesia; cardiac surgery; coronary artery bypass grafting; mechanical ventilation ID RESPIRATORY-DISTRESS-SYNDROME; ACUTE LUNG INJURY; RANDOMIZED CONTROLLED-TRIAL; MECHANICAL VENTILATION; TIDAL VOLUMES; STRATEGY; RECRUITMENT; MORTALITY; SURGERY AB Purpose: Postoperative positive end-expiratory pressure (PEEP) selection in patients who are mechanically ventilated after cardiac operations often seems random. The aim of this investigation was to compare the 2 most common postoperative initial PEEP settings at our institution, 8 and 5 cm H2O, on postoperative initial tracheal intubation time (primary outcome); cardiovascular intensive care unit (CVICU); hospital length of stay (LOS); occurrence of pneumonia; and hospital mortality (secondary outcomes). Materials and Methods: The electronic medical records of patients who were mechanically ventilated after isolated coronary artery bypass grafting (CABG) or combined CABG and valve operations were reviewed. Propensity score matching was used to compare patients with an initial postoperative PEEP setting of 8 cm H2O (n = 4722 [25.9%]) with those who had PEEP of 5 cm H2O (n = 13 535 [74.1%]) on the primary and secondary outcomes listed earlier. Results: There was no difference in initial postoperative intubation time between the PEEP of 8 cm H2O and the PEEP of 5 cm H2O patient groups (mean 11.9 vs 12.0 hours [median 8.2 vs 8.8 hours], P = .89). The groups did not differ on the occurrence of pneumonia (0.43% vs 0.60%, P = .25) nor on hospital mortality (0.47% vs 0.43%, P = .76). Aspiration pneumonia occurrence approached a significant difference (0.06% vs 0.21%, P value = .052), as did CVICU LOS (mean: 47.9 vs 49.8 hours [median: 28.5 vs 28.4 hours], P = .057), but were not statistically different. There was a slight but likely clinically unimportant difference in hospital LOS (7.7 vs 7.4 days, PEEP = 8 vs 5, P < .001). Conclusion: Patients being mechanically ventilated after cardiac operations with an initial postoperative PEEP setting of 8 versus 5 cm H2O differed significantly only on hospital LOS but the difference was likely clinically unimportant. Thus, use of 8 cm H2O PEEP in these patients without a clinical indication, although likely not harmful, does not seem beneficial. C1 [Hansen, Jennifer K.] Cleveland Clin, Inst Anesthesiol, Cleveland, OH 44195 USA. [Anthony, David G.; Wheeler, David; Bashour, C. Allen] Cleveland Clin, Cardiothorac Anesthesia, Cleveland, OH 44195 USA. [Li, Liang] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USA. [Sessler, Daniel I.; Bashour, C. Allen] Cleveland Clin, Outcomes Res, Cleveland, OH 44195 USA. C3 Cleveland Clinic Foundation; Cleveland Clinic Foundation; University of Texas System; UTMD Anderson Cancer Center; Cleveland Clinic Foundation RP Bashour, CA (通讯作者)，Cleveland Clin, Dept Cardiothorac Anesthesia, 9500 Euclid Ave J4-331, Cleveland, OH 44195 USA. EM bashoua@ccf.org RI Sessler, Daniel Ira/D-3504-2011 OI Sessler, Daniel Ira/0000-0001-9932-3077 FU NCI NIH HHS [P30 CA016672] Funding Source: Medline CR Amato MBP, 1998, NEW ENGL J MED, V338, P347, DOI 10.1056/NEJM199802053380602 Branca P, 2001, CHEST, V119, P537, DOI 10.1378/chest.119.2.537 Brower RG, 2004, NEW ENGL J MED, V351, P327 Meade MO, 2008, JAMA-J AM MED ASSOC, V299, P637, DOI 10.1001/jama.299.6.637 Meier T, 2008, ANESTH ANALG, V107, P1265, DOI 10.1213/ane.0b013e3181806212 Mercat A, 2008, JAMA-J AM MED ASSOC, V299, P646, DOI 10.1001/jama.299.6.646 Phoenix SI, 2009, ANESTHESIOLOGY, V110, P1098, DOI 10.1097/ALN.0b013e31819fae06 Rady MY, 1999, CRIT CARE MED, V27, P340, DOI 10.1097/00003246-199902000-00041 Ranieri VM, 1999, JAMA-J AM MED ASSOC, V282, P54, DOI 10.1001/jama.282.1.54 Richard JC, 2003, CRIT CARE MED, V31, P89, DOI 10.1097/00003246-200301000-00014 Rouby JJ, 2002, AM J RESP CRIT CARE, V165, P1182, DOI 10.1164/ajrccm.165.8.2105122 Santos C, 2000, AM J RESP CRIT CARE, V161, P26, DOI 10.1164/ajrccm.161.1.9902084 Villar J, 2006, CRIT CARE MED, V34, P1311, DOI 10.1097/01.CCM.0000215598.84885.01 Wolthuis EK, 2008, ANESTHESIOLOGY, V108, P46, DOI 10.1097/01.anes.0000296068.80921.10 NR 14 TC 5 Z9 5 U1 0 U2 2 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0885-0666 EI 1525-1489 J9 J INTENSIVE CARE MED JI J. Intensive Care Med. PD SEP PY 2015 VL 30 IS 6 BP 338 EP 343 DI 10.1177/0885066613519571 PG 6 WC Critical Care Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CP6PA UT WOS:000360008400004 PM 24488037 DA 2023-05-13 ER PT J AU Aksoy, F Bas, HA Bagci, A Oskay, T AF Aksoy, Fatih Bas, Hasan Aydin Bagci, Ali Oskay, Tulay TI The CHA(2)DS(2)-VASc score for predicting atrial fibrillation in patients presenting with ST elevation myocardial infarction: prospective observational study SO SAO PAULO MEDICAL JOURNAL LA English DT Article DE Risk factors; Atrial fibrillation; Myocardial infarction ID ACUTE CORONARY SYNDROMES; 2016 ESC GUIDELINES; PROGNOSTIC-SIGNIFICANCE; SEGMENT ELEVATION; MANAGEMENT; COLLABORATION; INFLAMMATION; ASSOCIATION; MORTALITY AB BACKGROUND: Atrial fibrillation (AF) is the most common form of supraventricular arrhythmia following ST-elevation myocardial infarction (STEMI). The CHA(2)DS(2)-VASc and CHADS(2) scores are used to estimate thromboembolic risk in cases of AF. Their usefulness in predicting the development of AF in patients presenting STEMI is unknown. OBJECTIVE: To evaluate the predictive value of the CHADS(2) and CHA(2)DS(2)-VASc scores in patients with AF following STEMI. DESIGN AND SETTING: This prospective cohort study on 696 patients with STEMI was conducted at a tertiary-level cardiology clinic in a public university hospital. METHODS: Models including clinical and laboratory parameters were constructed to test the predictive value of CHADS(2) and CHA(2)DS(2)-VASc scores. Patients were divided into two groups: with and without AF. Predictors of AF were determined using multivariate regression analysis. RESULTS: In the patients with AF, CHADS(2) and CHA(2)DS(2)-VASc scores were significantly higher than in those without AF (for both P < 0.001). Factors associated with AF in multivariate analyses included CHA(2)DS(2)-VASc score (odds ratio, OR: 1.48; 95% confidence interval, CI: 1.25-1.75; P < 0.001), peak creatine kinase-myocardial binding (OR: 1.002; 95% CI: 1.00-1.003; P = 0.0024), duration of the coronary intensive care unit stay (OR: 1.69; 95% CI: 1.24-12.30; P = 0.001) and no use of renin-angiotensin system blockers (OR: 2.16; 95% CI: 1.14-4.10; P = 0.0017). Receiver operating characteristic curve analyses showed that CHA 2DS2-VASc scores were significant predictors for new-onset AF (C-statistic: 0.698; 95% CI: 0.631-0.765; P < 0.001). CONCLUSION: CHADS(2) and CHA(2)DS(2)-VASc scores predicted new AF in patients presenting STEMI. C1 [Aksoy, Fatih; Bas, Hasan Aydin; Bagci, Ali; Oskay, Tulay] Suleyman Demirel Univ, Tip Fak, Egitim & Arastirma Hastanesi, Isparta, Turkey. [Aksoy, Fatih] Suleyman Demirel Univ, Tip Fak, Dept Cardiol, Isparta, Turkey. [Bas, Hasan Aydin; Bagci, Ali] Isparta Sehir Hastanesi, Dept Cardiol, Isparta, Turkey. [Oskay, Tulay] Merzifon Devlet Hastanesi, Dept Cardiol, Amasya, Turkey. C3 Suleyman Demirel University; Suleyman Demirel University; Merzifon Karamustafa Pasha State Hospital RP Aksoy, F (通讯作者)，Suleyman Demirel Univ, Tip Fak, TR-32200 Isparta, Turkey. EM dr.aksoy@hotmail.com RI Aksoy, Fatih/ABE-2277-2020 OI AKSOY, FATIH/0000-0002-6480-4935; Bas, Hasan/0000-0001-7110-3443; Aksoy, Fatih/0000-0001-6749-4293 CR Al-Khatib SM, 2001, AM J CARDIOL, V88, P76, DOI 10.1016/S0002-9149(01)01593-4 Arslan A, 2016, MEDICINA-LITHUANIA, V52, P104, DOI 10.1016/j.medici.2016.02.006 Asanin M, 2005, EUR J HEART FAIL, V7, P671, DOI 10.1016/j.ejheart.2004.07.018 Barkas F, 2017, INT J CARDIOL, V241, P194, DOI 10.1016/j.ijcard.2017.04.062 Bas HA, 2017, SCAND J CLIN LAB INV, V77, P77, DOI 10.1080/00365513.2016.1244857 Eldar M, 1998, CIRCULATION, V97, P965 Folland E D, 1979, Compr Ther, V5, P47 Harada M, 2015, CIRC J, V79, P495, DOI 10.1253/circj.CJ-15-0138 Jabre P, 2011, CIRCULATION, V123, P2094, DOI 10.1161/CIRCULATIONAHA.110.990192 Kirchhof P, 2016, EUROPACE, V18, DOI [10.1016/j.rec.2016.11.033, 10.5603/KP.2016.0172, 10.1093/europace/euw295] Kirchhof P, 2016, EUR HEART J, V37, P2893, DOI 10.1093/eurheartj/ehw210 Kudaiberdieva Gulmira, 2007, Acute Card Care, V9, P69, DOI 10.1080/17482940600990285 Mehta RH, 2003, AM J CARDIOL, V92, P1031, DOI 10.1016/j.amjcard.2003.06.001 Ogunsua Adedotun A, 2015, Methodist Debakey Cardiovasc J, V11, P228, DOI 10.14797/mdcj-11-4-228 Ozaydin M, 2010, WORLD J CARDIOL, V2, P243, DOI 10.4330/wjc.v2.i8.243 Ozaydin M, 2010, INT J CARDIOL, V141, P147, DOI 10.1016/j.ijcard.2008.11.172 Pedersen OD, 2006, EUR HEART J, V27, P290, DOI 10.1093/eurheartj/ehi629 Pizzetti F, 2001, HEART, V86, P527, DOI 10.1136/heart.86.5.527 Steg PG, 2012, EUR HEART J, V33, P2569, DOI 10.1093/eurheartj/ehs215 Tateyama S, 2014, J ARRYTHM, V30, P460, DOI 10.1016/j.joa.2013.12.006 Thygesen K, 2012, GLOB HEART, V7, DOI 10.1016/j.gheart.2012.08.001 Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184 Tousoulis D, 2007, HEART, V93, P1001, DOI 10.1136/hrt.2006.088211 Uyarel H, 2008, TURK KARDIYOL DERN A, V36, P214 VAZIRI SM, 1994, CIRCULATION, V89, P724, DOI 10.1161/01.CIR.89.2.724 Yin L, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0123858 YOUDEN WJ, 1950, BIOMETRICS, V6, P172, DOI 10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3 NR 27 TC 11 Z9 12 U1 0 U2 0 PU ASSOCIACAO PAULISTA MEDICINA PI SAO PAULO PA AV BRIG LUIS ANTONIO, 278-7 ANDAR, SAO PAULO, CEP01318-901, BRAZIL SN 1516-3180 J9 SAO PAULO MED J JI Sao Paulo Med. J. PD MAY-JUN PY 2019 VL 137 IS 3 BP 248 EP 254 DI 10.1590/1516-3180.2018.0431140319 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA IV0HI UT WOS:000483959700006 PM 31340253 OA Green Published, gold DA 2023-05-13 ER PT J AU Gevaert, SA De Bacquer, D Evrard, P Renard, M Beauloye, C Coussement, P De Raedt, H Sinnaeve, PR Claeys, MJ AF Gevaert, Sofie A. De Bacquer, Dirk Evrard, Patrick Renard, Marc Beauloye, Christophe Coussement, Patrick De Raedt, Herbert Sinnaeve, Peter R. Claeys, Marc J. TI Renal dysfunction in STEMI-patients undergoing primary angioplasty: higher prevalence but equal prognostic impact in female patients; an observational cohort study from the Belgian STEMI registry SO BMC NEPHROLOGY LA English DT Article DE ST-segment elevation myocardial infarction (STEMI); Estimated glomerular filtration rate (eGFR); CKD-EPI; Renal dysfunction; Gender; In-hospital mortality; Primary angioplasty ID ELEVATION MYOCARDIAL-INFARCTION; GLOMERULAR-FILTRATION-RATE; ACUTE CORONARY SYNDROMES; IN-HOSPITAL MORTALITY; TIMI RISK SCORE; ST-ELEVATION; INDEPENDENT PREDICTOR; PRIMARY PCI; GENDER; OUTCOMES AB Background: Mortality in female patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty (pPCI) is higher than in men. We examined gender differences in the prevalence and prognostic performance of renal dysfunction at admission in this setting. Methods: A multicenter retrospective sub-analysis of the Belgian STEMI-registry identified 1,638 patients (20.6% women, 79.4% men) treated with pPCI in 8 tertiary care hospitals (January 2007-February 2011). The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation. Main outcome measure was in-hospital mortality. Results: More women than men suffered from renal dysfunction at admission (42.3% vs. 25.3%, p < 0.001). Mortality in women was doubled as compared to men (9.5 vs. 4.7%, OR (95% CI) = 2.12 (1.36-3.32), p<0.001). In-hospital mortality for men and women with vs. without renal dysfunction was much higher (10.7 and 15.3 vs. 2.3 and 2.4%, p < 0.001). In a multivariable regression analysis, adjusting for age, gender, peripheral artery disease (PAD), coronary artery disease (CAD), hypertension, diabetes and low body weight (< 67 kg), female gender was associated with renal dysfunction at admission (OR (95% CI) 1.65 (1.20-2.25), p = 0.002). In a multivariable model including TIMI risk score and renal dysfunction, renal dysfunction was an independent predictor of in-hospital mortality in both men (OR (95% CI) = 2.39 (1.27-4.51), p = 0.007) and women (OR (95% CI) = 4.03 (1.26-12.92), p = 0.02), with a comparable impact for men and women (p for interaction = 0.69). Conclusions: Female gender was independently associated with renal dysfunction at admission in pPCI treated patients. Renal dysfunction was equally associated with higher in-hospital mortality in both men and women. C1 [Gevaert, Sofie A.] Ghent Univ Hosp, Dept Cardiol, Ghent, Belgium. [De Bacquer, Dirk] Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium. [Evrard, Patrick] Catholic Univ Louvain, Dept Intens Care, Yvoir, Belgium. [Renard, Marc] Erasme Acad Hosp, Dept Cardiol, Brussels, Belgium. [Beauloye, Christophe] Catholic Univ Louvain, Dept Cardiol, B-1200 Brussels, Belgium. [Coussement, Patrick] Hosp St Jan, Dept Cardiol, Brugge, Belgium. [De Raedt, Herbert] OLV Hosp Aalst, Cardiovasc Ctr, Aalst, Belgium. [Sinnaeve, Peter R.] Katholieke Univ Leuven Hosp, Dept Cardiovasc Dis, Louvain, Belgium. [Claeys, Marc J.] Univ Antwerp Hosp, Dept Cardiol, Edegem, Belgium. C3 Ghent University; Ghent University Hospital; Ghent University; Universite Catholique Louvain; Universite Libre de Bruxelles; Universite Catholique Louvain; Cardiovascular Center Aalst; Flanders Institute for Biotechnology (VIB); KU Leuven; University Hospital Leuven; University of Antwerp RP Gevaert, SA (通讯作者)，Ghent Univ Hosp, Dept Cardiol, Ghent, Belgium. EM sofie.gevaert@ugent.be RI De Bacquer, Dirk/HGU-3191-2022; Claeys, Marc/ABH-8781-2020 OI De Bacquer, Dirk/0000-0002-3202-7238; Sinnaeve, Peter/0000-0003-4716-5892; Gevaert, Sofie/0000-0002-8721-3003; Claeys, Marc/0000-0002-6628-9543 FU Ministry of Social Affairs and Public Health of the Belgian government FX The Belgian STEMI-registry is financially supported by a grant from the Ministry of Social Affairs and Public Health of the Belgian government. 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PD MAR 18 PY 2013 VL 14 AR 62 DI 10.1186/1471-2369-14-62 PG 8 WC Urology & Nephrology WE Science Citation Index Expanded (SCI-EXPANDED) SC Urology & Nephrology GA 139XD UT WOS:000318617400001 PM 23506004 OA Green Published, gold DA 2023-05-13 ER PT J AU Matsuo, S Nakajima, K Takeishi, Y Nishimura, T AF Matsuo, Shinro Nakajima, Kenichi Takeishi, Yasuchika Nishimura, Tsunehiko TI Prognostic value of normal stress myocardial perfusion imaging and ventricular function in Japanese patients with chronic kidney disease: a study based on the J-ACCESS-3 database SO EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING LA English DT Article DE Prognosis; SPECT; Radionuclide imaging; Chronic kidney disease; eGFR ID EMISSION COMPUTED-TOMOGRAPHY; PERCUTANEOUS CORONARY INTERVENTION; OPTIMAL MEDICAL THERAPY; J-ACCESS; CARDIOVASCULAR-DISEASE; ASYMPTOMATIC PATIENTS; ARTERY-DISEASE; CARDIAC DEATH; OUTCOMES; RISK AB Background The purpose of this study is to test the hypothesis that a normal myocardial perfusion imaging (MPI) study in chronic kidney disease (CKD) can provide benign prognostic information for the prediction of major cardiovascular events. Methods The study group consisted of 431 CKD patients (males, 64%; mean age, 72 +/- 11 years) with normal SPECT imaging. Based on SPECT image and QGS data, 331 had a summed stress score of 3 or less, a summed difference score of 1 or less and normal cardiac function (males; end-systolic volume (ESV) <= 60 ml, females; ESV <= 40 ml, males, ejection fraction (EF) >= 49%; females, EF >= 50%). Results During a 3-year follow-up period, there were a total of 27 major cardiovascular events, including cardiac death (n = 3), sudden death (n = 3), and acute coronary syndrome (n = 3), and 19 were hospitalized because of congestive heart failure. Kaplan-Meier analysis showed that the number of major cardiovascular events in patients with higher eGFR of >= 15 ml/min) were very few, and regarded as low risk. According to the eGFR status, namely < 15 (n = 58), 15 to < 30 (n = 97), 30 to <45 (n = 131), >= 45 (n = 45), the higher cardiac event rate was observed in patients with eGFR of < 15 ml/min among the four groups. The major cardiovascular event rate in patients with the lowest eGFR (< 15) was twice as much than that in patients with eGFR of >= 30 ml/min. Lower hemoglobin (males, < 12 g/dl; females, < 11 g/dl) and higher CRP (CPR >= 0.3 mg/dl) were also the predictors of increased risk. Conclusions Normal stress SPECT images confer a benign prognosis in patients with CKD, but care must be taken for severely reduced renal function, which was associated with higher cardiac event. C1 [Matsuo, Shinro; Nakajima, Kenichi] Kanazawa Univ Hosp, Dept Nucl Med, 13-1 Takaramachi, Kanazawa, Ishikawa 9208641, Japan. [Takeishi, Yasuchika] Fukushima Med Univ, Dept Cardiovasc Med, Fukushima, Japan. [Nishimura, Tsunehiko] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Radiol, Kamigyo Ku, 465 Kajiicho Kawaramachi Hirokoji, Kyoto 6028566, Japan. C3 Kanazawa University; Fukushima Medical University; Kyoto Prefectural University of Medicine RP Matsuo, S (通讯作者)，Kanazawa Univ Hosp, Dept Nucl Med, 13-1 Takaramachi, Kanazawa, Ishikawa 9208641, Japan.; Nishimura, T (通讯作者)，Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Radiol, Kamigyo Ku, 465 Kajiicho Kawaramachi Hirokoji, Kyoto 6028566, Japan. EM smatsuo@nmd.m.kanazawa-u.ac.jp; nisimura@koto.kpu-m.ac.jp FU Japan Cardiovascular Research Foundation FX The J-ACCESS-3 study was supported by a grant from the Japan Cardiovascular Research Foundation. We thank the many physicians and technologists in the 62 hospitals who participated in the J-ACCESS-3 study for their cooperation. 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Benites Lopez, Carmen Camacho Cosavalente, Luis Chavez Huapalla, Edith Chois Malaga, Augusto Copaja Flores, Alex Farfan Aspilcueta, Julio Gallardo Rojas, Wilson Gallegos Cazorla, Alex Galvez Caballero, David Garcia Matheus, Julio Garrido Carrasco, Elizabeth Gomez Sanchez, Jorge Hernandez Zuniga, Jose Lu Galarreta, Libia Luna, Alejandro Manrique Hurtado, Helard Orihuela Pastor, Boris Maria Pando Alvarez, Rosa Sanchez Povis, Javier Torres Eguiluz, Pedro Valdivia Portugal, Angelica Vargas Gonzales, Rolando Zapata Rincon, Luis Aquitania, Grace Fortinez, Judy Theresa Go, Angelita Gomez, Maria Honolina Habaluyas, Ramoncito Jasul, Gabriel Magno, Marie Manalo, Carlo John Mirasol, Roberto Morales-Palomares, Ellen Salvador, David Raymund Sy, Rosa Allyn Tirador, Louie Yao, Christy Arciszewska, Malgorzata Bartkowiak, Radoslaw Czajkowska-Kaczmarek, Eugenia Gil, Robert Gniot, Jacek Janik, Krzysztof Janion, Marianna Jaworska, Krystyna Jozwa, Robert Kawecka-Jaszcz, Kalina Kawka-Urbanek, Teresa Kondys, Marek Korecki, Janusz Korzeniak, Romuald Kowalisko, Alicja Krzeminska-Pakula, Maria Kwiecien, Jolanta Nessler, Jadwiga Odrowaz-Pieniazek, Piotr Piepiorka, Marek Rajzer, Marek Skokowska, Ewa Spyra, Janusz Sroka, Michal Stasinska, Teresa Szymczyk, Ireneusz Trznadel-Morawska, Iwona Wysokinski, Andrzej Mateus, Pedro Matos, Pedro Mimoso, Jorge Monteiro, Pedro Caballero, Baruch Garcia-Rinaldi, Raul Gonzalez, Elena Ortiz-Carrasquillo, Ramon Roman, Amaury Sierra, Yolanda Unger, Nestor Vazquez-Tanus, Jose Alexandru, Tom Busegeanu, Mihaela Cozman, Doina Constanta Fica, Simona Minescu, Bogdan Morosanu, Magdalena Negrisanu, Gabriela Doina Pintilei, Ella Pop, Lavinia Szilagyi, Iosif Teodorescu, Iulia Tomescu, Mirela Barbarash, Olga Chumakova, Galina Churina, Svetlana Dogadin, Sergey Dvoryashina, Irina Esip, Valeria Glezer, Maria Gordeev, Ivan Gordienko, Alexander Gratsiansky, Nikolay Grineva, Elena Khasanov, Niaz Kostenko, Victor Meleshkevich, Tatiana Mikhin, Vadim Morugova, Tatyana Motylev, Igor Nikolaev, Konstantin Ponomareva, Asya Repin, Mikhail Reshetko, Olga Shustov, Sergey Shutemova, Elena Shvarts, Yury Simanenkov, Vladimir Sobolev, Konstantin Sukmanova, Irina Timofeev, Alexander Tsyba, Larisa Varvarina, Galina Vertkin, Arkadiy Vishnevsky, Alexander Volkov, Dmitry Vorobiev, Sergey Vorokhobina, Natalya Yakhontov, Davyd Zonova, Elena Zrazhevskiy, Konstantin Damjanovic, Svetozar Djordjevic, Dragan Pavlovic, Milan Perunicic, Jovan Ristic, Arsen Stojkovic, Sinisa Tasic, Nebojsa Bolvanska, Nora Buganova, Ingrid Dulkova, Katarina Dzupina, Andrej Fulop, Peter Gergel, Vladimir Kokles, Martin Micko, Karol Svoren, Peter Urban, Miroslav Vadinova, Silvia Vargova, Anna Burgess, Leslie Coetzee, Kathleen Du Toit, Jacques Gani, Mashra Joshi, Pankaj Naiker, Puvanesveri Nortje, Hendrik Sarvan, Mahomed Seeber, Mary Siebert, Mirna van Zyl, Louis Wellmann, Holger Calvo, Carlos De la Hera, Jesus De Teresa, Luis Melero-Pita, Antonio Mesa, Jordi Parra Barona, Juan Serrano, Pedro Soto, Alfonso Tofe, Santiago Hornestam, Bjorn Kempe, Anders Rosenqvist, Ulf Rydberg, Erik Tengmark, Bengt-Olov Torstensson, Ingemar Chang, Chwen-Tzuei Hsia, Te-Lin Hsieh, I-Chang Lai, Wen-Ter Wu, Chiung-Jen Hutayanon, Pisit Kosachunhanun, Natapong Marapracertsak, Mongkol Piamsomboon, Chumpol Seekaew, Samroeng Srimahachota, Suphot Sukhum, Pradub Suraamornkul, Swangjit Tantiwong, Puntip Wongvipaporn, Chaiyasith Amosova, Kateryna Barna, Olga Bazylevych, Andriy Berenfus, Vadym Dyadyk, Alexander Fushtey, Ivan Gyrina, Olga Iabluchanskyi, Mykola Karpenko, Oleksandr Kaydashev, Igor Korzh, Oleksii Kulynych, Roman Legkonogov, Olexandr Mankovsky, Boris Mostovoy, Yuriy Parkhomenko, Oleksandr Popik, Galyna Rudenko, Leonid Rudyk, Iurii Shevchuk, Sergii Sirenko, Yuriy Suprun, Yevgen Tryshchuk, Nadiya Tseluyko, Vira Vakaliuk, Igor Al Mahmeed, Wael Acheatel, Roger Ahmad, Anwar Akbar, Saleem Akhter, Faiq Albirini, Abdulhay Alexander, Arnold Al-Joundi, Bassam Al-Joundi, Tammam Allen, Gregory Aloi, Joseph Alvarado, Odilon Alzohaili, Opada Anderson, Corey Arastu, Anwar Arena, Charles Argoud, Georges Ariani, Mehrdad Arora, Chander Awasty, Vivek Barker, Barbara Barnum, Otis Bartkowiak, Anthony J. Barzilay, Joshua Behrens, Phillip Belledonne, Mario Bergman, Bradford Bilnoski, William Bisognano, John Bissette, Stephen Blumberg, Edwin Bonabi, Nagadeh Bradley, Arden Breton, Cristian Britos, Martin Broadstone, Vasti Budoff, Matthew Burge, Mark Butman, Samuel Carroll, Mary Challappa, Krishnan Chepuri, Vinaya Cherlin, Richard Cheung, Deanna Coats, Peter Collins, John Cruz, Humberto Daboul, Nizar Damberg, Greg David, William Dean, Julius Dedeke, Eric Deeb, Wasim DeHaven, Joseph Dobs, Adrian Donelan, Timothy Dy, Johnny Dykstra, Gary Eisen, Howard Farris, Neil Fattal, Peter Fishman, Norman Foster, Malcom Fredrickson, Sonja Gabra, Nashwa Gabriel, John Gatien, Lionel Giddings, Stephen Ginsberg, Burton Gips, Sanford Glandt, Mariela Goldfein, Aaron Gordon, Murray Gould, Randy Graf, Ronald Graham, Bruce Graves, Mark Grena, Paul Hahn, Richard Hamilton, Dale Hamroff, Glenn Hanke, Forrest Haque, Ihsan Harper, James, Jr. Harris, Anthony Harris, Sharon Henson, Bruce Hermanns, David Herndon, William Hershberger, Vernon Hyman, Daniel Isserman, Steven Iteld, Bruce Jacob, Moshir Jaffrani, Naseem Jamal, Aamir Johnson, David Johnson, Glover Kaluski, Edo Keller, Robert Kereiakes, Dean Khan, Muhammad Khan, Salman Khan, Misal Klein, Michael Knutson, Thomas Korban, Elie Kozinn, Marc Kraft, Philip Kroeze, James Kukuy, Eugene Lader, Ellis Laliotis, Aristotelis Lambert, Charles, Jr. Landau, Charles Latif, Kashif Lee, Kwan Lester, F. Levenson, David Levinson, Dennis Lewis, Derek Litt, Marc Littlefield, Ronald Lo, Eric Lovell, Charles Mahal, Sharan Makam, Satyaprakash Mandviwala, Mustafa Marar, Isam Masri, Bassem Mattson, Steven Mays, Maureen McGrew, Frank Meengs, Mark Mikell, Frank Miller, Michael Miranda, Francisco Moll, David Multani, Pramod Munuswamy, Karan Nallasivan, Mani Nayles, Lee Ong, Stephen Pacheco, Theodore Paez, Henry Patel, Shailendra Phillips, Roland Pierpont, Brien Prasad, Jeereddi Quinlan, Edward Quion, Jun Qureshi, Mansoor Rahman, Aref Raikhel, Marina Ramanathan, Kodangudi Randhawa, Preet Ravi, Ram Reddy, Rajneesh Rendell, Marc Rickner, Kyle Rictor, Kenneth Rivas, Jose Rosenblit, Paul Rosenstock, Julio Ross, Steven Salacata, Abraham Saririan, Mehrdrad Schima, Susan Schlau, Aron Schmedtje, John Scott, Cranford Scott, David Serru-Paez, Antonio Shah, Rakesh Shah, Anil Shaoulian, Emanuel Shomali, Mansur Shubrook, Jay Silver, Kevin Singh, Sanjay Speer, John Stevens, Jewel Stringam, Stanley Taussig, Andrew Taylor, Angela Tee, Howard Teixeira, Gilbert Tilley, Absalom Toggart, Edward Twahirwa, Marcel Unks, Dennis Vakili, Babak Vora, Kishor Wang, Xiangbing Warner, Alberta Wefald, Franklin Weinberg, Bradley Weinstein, Debra White, Lindsey Wu, Patricia Yasuda, Tsunehiro Yazdani, Shahram Yetman, Cornelius Zarich, Stuart Zebrack, James CA EXAMINE Investigators TI Angiotensin-Converting Enzyme Inhibitor Use and Major Cardiovascular Outcomes in Type 2 Diabetes Mellitus Treated With the Dipeptidyl Peptidase 4 Inhibitor Alogliptin SO HYPERTENSION LA English DT Article DE alogliptin; angiotensin II; angiotensin-converting enzyme inhibitors; dipeptidyl dipeptidase 4 inhibitors; heart rate; type 2 diabetes mellitus ID HEART-FAILURE; BLOOD-PRESSURE; IV INHIBITION; SITAGLIPTIN; VILDAGLIPTIN; EXAMINE; SAFETY AB Activation of the sympathetic nervous system when there is dipeptidyl peptidase 4 inhibition in the presence of highdose angiotensin-converting enzyme (ACE) inhibition has led to concerns of potential increases in cardiovascular events when the 2 classes of drugs are coadministered. We evaluated cardiovascular outcomes from the EXAMINE (Examination of Cardiovascular Outcomes With Alogliptin versus Standard of Care) trial according to ACE inhibitor use. Patients with type 2 diabetes mellitus and a recent acute coronary syndrome were randomly assigned to receive the dipeptidyl peptidase 4 inhibitor alogliptin or placebo added to existing antihyperglycemic and cardiovascular prophylactic therapies. Risks of adjudicated cardiovascular death, nonfatal myocardial infarction and stroke, and hospitalized heart failure were analyzed using a Cox proportional hazards model in patients according to ACE inhibitor use and dose. There were 3323 (62%) EXAMINE patients treated with an ACE inhibitor (1681 on alogliptin and 1642 on placebo). The composite rates of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke were comparable for alogliptin and placebo with ACE inhibitor (11.4% versus 11.8%; hazard ratio, 0.97; 95% confidence interval, 0.79-1.19; P=0.76) and without ACE inhibitor use (11.2% versus 11.9%; hazard ratio, 0.94; 95% confidence interval, 0.73-1.21; P=0.62). Composite rates for cardiovascular death and heart failure in patients on ACE inhibitor occurred in 6.8% of patients on alogliptin versus 7.2% on placebo (hazard ratio, 0.93; 95% confidence interval, 0.72-1.2; P=0.57). There were no differences for these end points nor for blood pressure or heart rate in patients on higher doses of ACE inhibitor. Cardiovascular outcomes were similar for alogliptin and placebo in patients with type 2 diabetes mellitus and coronary disease treated with ACE inhibitors. C1 [White, William B.] Univ Connecticut, Sch Med, Calhoun Cardiol Ctr, 263 Farmington Ave, Farmington, CT 06032 USA. [Wilson, Craig A.; Kupfer, Stuart] Takeda Dev Ctr Amer Inc, Deerfield, IL USA. [Bakris, George L.] Univ Chicago Med, Chicago, IL USA. [Bergenstal, Richard M.] Pk Nicollet Clin, Int Diabet Ctr, Minneapolis, MN USA. [Cannon, Christopher P.] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA USA. [Cushman, William C.] Univ Tennessee, Coll Med, Memphis Vet Affairs Med Ctr, Knoxville, TN 37996 USA. [Heller, Simon K.] Univ Sheffield, Sheffield S10 2TN, S Yorkshire, England. [Mehta, Cyrus R.] Harvard Sch Publ Hlth, Boston, MA USA. [Nissen, Steven E.] Cleveland Clin Fdn, Cleveland, OH USA. [Zannad, Faiez] Univ Lorraine, Nancy, France. C3 University of Connecticut; Takeda Pharmaceutical Company Ltd; Takeda Development Center Americas, Inc.; International Diabetes Center; Harvard University; Brigham & Women's Hospital; Harvard Medical School; University of Tennessee System; University of Tennessee Health Science Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); Memphis VA Medical Center; N8 Research Partnership; RLUK- Research Libraries UK; White Rose University Consortium; University of Sheffield; Harvard University; Harvard T.H. Chan School of Public Health; Cleveland Clinic Foundation; Universite de Lorraine RP White, WB (通讯作者)，Univ Connecticut, Sch Med, Calhoun Cardiol Ctr, 263 Farmington Ave, Farmington, CT 06032 USA. EM wwhite@uchc.edu RI Barna, Olga/ABC-6535-2020; VILELA-MARTIN, JOSE/I-8305-2014; Grineva, Ele N./V-8221-2018; Cosman, Doina/L-9087-2013; Maia, Lilia Nigro/AAV-6938-2021; Precoma, Dalton B/D-5674-2013; Chumakova, Galina A/L-5677-2015; Airaksinen, Juhani/AAC-7857-2021; Miller, Michael/AGX-6773-2022; Shevchuk, Sergii/Y-8642-2018; Piatti, Piermarco/AAN-3115-2020; Spyra, Janusz/W-4157-2018; Rha, Seung-Woon/AGE-5810-2022; Khan, Shahzeb/AAN-1515-2020; Sirenko, Yuriy M/C-8012-2019; Farsky, Pedro/HKE-7447-2023; Mankovsky, Boris/W-3061-2018; Tomescu, Mirela Cleopatra/M-9101-2014; Rudyk, Iurii/AAG-4668-2021; Igor, Vakaliuk P/I-6734-2018; Reshetko, Olga/I-7011-2013; Korzh, Oleksii/E-4291-2016; Volpe, Massimo/K-5240-2016; Yusof, Zurkurnai/AAA-5893-2021; Bazylevych, Andriy/G-2834-2019; Zainal Abidin, Imran/A-1394-2013; Nikolaev, Konstantin/P-4750-2017; Budoff, Matthew/ABD-5175-2021; Abhyankar, Atul/AAG-4551-2020; Piskorz, Daniel/AAJ-8751-2020; Sepúlveda, Pablo Espicel/HCI-5123-2022; Fushtey, Ivan M./HZI-0725-2023; Silveiro, Sandra P/M-8072-2013; Takagi, Gen/AGT-4565-2022; Calabro, Paolo/AAC-2704-2022; Reis, Gilmar/I-4500-2013; Sepúlveda, Pablo/GXF-5175-2022; Cannon, Christopher P/AAY-7644-2020; Wilding, John/ABB-6443-2020; Zannad, Faiez/K-4649-2019; Stojkovic, Sinisa/AAD-4977-2022; Barbosa, Eduardo/AAJ-5790-2020 OI VILELA-MARTIN, JOSE/0000-0001-6960-2825; Cosman, Doina/0000-0001-7102-2432; Chumakova, Galina A/0000-0002-2810-6531; Airaksinen, Juhani/0000-0002-0193-568X; Miller, Michael/0000-0002-1679-2095; Shevchuk, Sergii/0000-0002-5649-2775; Spyra, Janusz/0000-0002-4054-2029; Rha, Seung-Woon/0000-0001-9456-9852; Sirenko, Yuriy M/0000-0002-4091-4910; Mankovsky, Boris/0000-0001-8289-3604; Tomescu, Mirela Cleopatra/0000-0003-2117-0474; Igor, Vakaliuk P/0000-0002-4430-6816; Reshetko, Olga/0000-0003-3107-7636; Korzh, Oleksii/0000-0001-6838-4360; Volpe, Massimo/0000-0002-9642-8380; Bazylevych, Andriy/0000-0001-5053-2548; Zainal Abidin, Imran/0000-0002-3751-6946; Nikolaev, Konstantin/0000-0003-4601-6203; Budoff, Matthew/0000-0002-9616-1946; Piskorz, Daniel/0000-0002-8615-5446; Takagi, Gen/0000-0002-9527-5220; Reis, Gilmar/0000-0002-4847-1034; Cannon, Christopher P/0000-0003-4596-2791; Wilding, John/0000-0003-2839-8404; Barbosa, Eduardo/0000-0002-4361-936X FU Takeda Development Center, Inc, Deerfield, IL FX This study was supported by Takeda Development Center, Inc, Deerfield, IL. CR Ayaori M, 2013, J AM HEART ASSOC, V2, DOI 10.1161/JAHA.112.003277 Bosi E, 2007, DIABETES CARE, V30, P890, DOI 10.2337/dc06-1732 Brown NJ, 2012, J AM SOC HYPERTENS, V6, P163, DOI 10.1016/j.jash.2012.02.003 Busek P, 2008, PHYSIOL RES, V57, P443, DOI 10.33549/physiolres.931231 Devin JK, 2014, HYPERTENSION, V63, P951, DOI 10.1161/HYPERTENSIONAHA.113.02767 Fadini GP, 2011, VASC PHARMACOL, V55, P10, DOI 10.1016/j.vph.2011.05.001 Green JB, 2015, NEW ENGL J MED, V373, P232, DOI 10.1056/NEJMoa1501352 Jackson EK, 2008, CLIN EXP PHARMACOL P, V35, P29, DOI 10.1111/j.1440-1681.2007.04737.x Keating GM, 2015, DRUGS, V75, P777, DOI 10.1007/s40265-015-0385-y Marney A, 2010, HYPERTENSION, V56, P728, DOI 10.1161/HYPERTENSIONAHA.110.156554 McGuire DK, 2016, JAMA CARDIOL, V1, P126, DOI 10.1001/jamacardio.2016.0103 Ogawa S, 2011, TOHOKU J EXP MED, V223, P133, DOI 10.1620/tjem.223.133 Scirica BM, 2014, CIRCULATION, V130, P1579, DOI 10.1161/CIRCULATIONAHA.114.010389 Scirica BM, 2013, NEW ENGL J MED, V369, P1317, DOI 10.1056/NEJMoa1307684 Tofovic DS, 2010, CLIN EXP PHARMACOL P, V37, P689, DOI 10.1111/j.1440-1681.2010.05389.x van Poppel PCM, 2011, DIABETES CARE, V34, P2072, DOI 10.2337/dc10-2421 White WB, 2013, DIABETES OBES METAB, V15, P668, DOI 10.1111/dom.12093 White WB, 2013, NEW ENGL J MED, V369, P1327, DOI 10.1056/NEJMoa1305889 White WB, 2011, AM HEART J, V162, P620, DOI 10.1016/j.ahj.2011.08.004 Zannad F, 2015, LANCET, V385, P2067, DOI 10.1016/S0140-6736(14)62225-X NR 20 TC 22 Z9 22 U1 5 U2 24 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0194-911X EI 1524-4563 J9 HYPERTENSION JI Hypertension PD SEP PY 2016 VL 68 IS 3 BP 606 EP + DI 10.1161/HYPERTENSIONAHA.116.07797 PG 12 WC Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA DT1ZK UT WOS:000381280400017 PM 27480840 OA Bronze DA 2023-05-13 ER PT J AU Lawesson, SS Alfredsson, J Szummer, K Fredrikson, M Swahn, E AF Lawesson, Sofia Sederholm Alfredsson, Joakim Szummer, Karolina Fredrikson, Mats Swahn, Eva TI Prevalence and prognostic impact of chronic kidney disease in STEMI from a gender perspective: data from the SWEDEHEART register, a large Swedish prospective cohort SO BMJ OPEN LA English DT Article ID ACUTE CORONARY SYNDROMES; GLOMERULAR-FILTRATION-RATE; MYOCARDIAL-INFARCTION; RENAL-INSUFFICIENCY; CREATININE CLEARANCE; GLOBAL REGISTRY; OUTCOMES; ASSOCIATION; MORTALITY; SEX AB Objectives: Gender differences in prevalence and prognostic impact of chronic kidney disease (CKD) in ST segment elevation myocardial infarction (STEMI) have been poorly evaluated. In STEMI, female gender has been independently associated with an increased risk of mortality. CKD has been found to be an important prognostic marker in myocardial infarction. The aim of this study was to evaluate gender differences in prevalence and prognostic impact of CKD on short-term and long-term mortality. Design: Prospective observational cohort study. Setting: The national quality register SWEDEHEART was used. In the beginning of the study period, 94% of the Swedish coronary care units contributed data to the register, which subsequently increased to 100%. The glomerular filtration rate was estimated (eGFR) according to Modification of Diet in Renal Disease Study (MDRD) and Cockcroft-Gault (CG). Participants: All patients with STEMI registered in SWEDEHEART from the years 2003-2009 were included (37 991 patients, 66% men). Main results: Women had 1.6 (MDRD) to 2.2 (CG) times higher multivariable adjusted risk of CKD. Half of the women had CKD according to CG. CKD was associated with 2-2.5 times higher risk of in-hospital mortality and approximately 1.5 times higher risk of long-term mortality in both genders. Each 10 mL/min decline of eGFR was associated with an increased risk of in-hospital and long-term mortality (22-33% and 9-16%, respectively) and this did not vary significantly by gender. Both in-hospital and long-term mortality were doubled in women. After multivariable adjustment including eGFR, there was no longer any gender difference in early outcome and the long-term outcome was better in women. Conclusions: Among patients with STEMI, female gender was independently associated with CKD. Reduced eGFR was a strong independent risk factor for short-term and long-term mortality without a significant gender difference in prognostic impact and seems to be an important reason why women have higher mortality than men with STEMI. C1 [Lawesson, Sofia Sederholm; Alfredsson, Joakim; Swahn, Eva] Linkoping Univ, Dept Cardiol, Linkoping, Sweden. [Lawesson, Sofia Sederholm; Alfredsson, Joakim; Swahn, Eva] Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden. [Szummer, Karolina] Karolinska Univ Hosp, Dept Cardiol, Karolinska Inst, Inst Med H7, Stockholm, Sweden. [Fredrikson, Mats] Linkoping Univ, Dept Clin & Expt Med, Div Occupat & Environm Med, Linkoping, Sweden. [Fredrikson, Mats] Linkoping Univ, Forum Ostergotland, Fac Med & Hlth Sci, Linkoping, Sweden. C3 Linkoping University; Linkoping University; Karolinska Institutet; Karolinska University Hospital; Linkoping University; Linkoping University RP Lawesson, SS (通讯作者)，Linkoping Univ, Dept Cardiol, Linkoping, Sweden. EM sofia.lawesson@liu.se RI Demchuk, Andrew M/E-1103-2012 OI Demchuk, Andrew M/0000-0002-4930-7789 FU National Board of Health and Welfare; Swedish Society of Cardiology; Swedish Association of Local Authorities and Regions FX The SWEDEHEART register is supported by the National Board of Health and Welfare, the Swedish Society of Cardiology, and the Swedish Association of Local Authorities and Regions. CR Al Suwaidi J, 2002, CIRCULATION, V106, P974, DOI 10.1161/01.CIR.0000027560.41358.B3 Alpert JS, 2000, EUR HEART J, V21, P1502, DOI 10.1053/euhj.2000.2305 Anavekar NS, 2004, NEW ENGL J MED, V351, P1285, DOI 10.1056/NEJMoa041365 Baber U, 2008, KIDNEY INT, V73, P615, DOI 10.1038/sj.ki.5002716 Bostom AG, 1996, ATHEROSCLEROSIS, V125, P91, DOI 10.1016/0021-9150(96)05865-0 Champney KP, 2009, HEART, V95, P895, DOI 10.1136/hrt.2008.155804 Chen RL, 2006, AM J CARDIOL, V97, P630, DOI 10.1016/j.amjcard.2005.09.102 Cirillo M, 2005, NEPHROL DIAL TRANSPL, V20, P1791, DOI 10.1093/ndt/gfh962 COCKCROFT DW, 1976, NEPHRON, V16, P31, DOI 10.1159/000180580 Coresh J, 2007, JAMA-J AM MED ASSOC, V298, P2038, DOI 10.1001/jama.298.17.2038 Eknoyan G, 2002, AM J KIDNEY DIS, V39, pS14, DOI 10.1053/ajkd.2002.30939 Fliser D, 1998, KIDNEY INT, V53, P1343, DOI 10.1046/j.1523-1755.1998.00898.x Fox KAA, 2007, J AM COLL CARDIOL, V49, P2249, DOI 10.1016/j.jacc.2006.12.049 Gibson CM, 2004, EUR HEART J, V25, P1998, DOI 10.1016/j.ehj.2004.08.016 Hallan SI, 2006, J AM SOC NEPHROL, V17, P2275, DOI 10.1681/ASN.2005121273 Hochman JS, 1999, NEW ENGL J MED, V341, P226, DOI 10.1056/NEJM199907223410402 Jernberg T, 2010, HEART, V96, P1617, DOI 10.1136/hrt.2010.198804 Lawesson SS, 2012, BMJ OPEN, V2, DOI 10.1136/bmjopen-2011-000726 Lawesson SS, 2011, HEART, V97, P308, DOI 10.1136/hrt.2010.194282 Levey AS, 1998, AM J KIDNEY DIS, V32, P853, DOI 10.1016/S0272-6386(98)70145-3 Levey AS, 1999, ANN INTERN MED, V130, P461, DOI 10.7326/0003-4819-130-6-199903160-00002 McCullough PA, 2003, J AM COLL CARDIOL, V41, P725, DOI 10.1016/S0735-1097(02)02955-8 Mega JL, 2007, CIRCULATION, V115, P2822, DOI 10.1161/CIRCULATIONAHA.106.679548 Moscucci M, 2003, EUR HEART J, V24, P1815, DOI 10.1016/S0195-668X(03)00485-8 Reynolds HR, 2007, ARCH INTERN MED, V167, P2054, DOI 10.1001/archinte.167.19.2054 Sadeghi HM, 2003, CIRCULATION, V108, P2769, DOI 10.1161/01.CIR.0000103623.63687.21 Santopinto JJ, 2003, HEART, V89, P1003, DOI 10.1136/heart.89.9.1003 Shlipak MG, 2002, ANN INTERN MED, V137, P555, DOI 10.7326/0003-4819-137-7-200210010-00006 Stenvinkel P, 1999, KIDNEY INT, V55, P1899, DOI 10.1046/j.1523-1755.1999.00422.x Szummer K, 2010, J INTERN MED, V268, P40, DOI 10.1111/j.1365-2796.2009.02204.x Szummer K, 2010, AM HEART J, V159, P979, DOI 10.1016/j.ahj.2010.03.028 Thygesen K, 2007, EUR HEART J, V28, P2525 Tonelli M, 2005, CIRCULATION, V112, P2627, DOI 10.1161/CIRCULATIONAHA.105.553198 Wong JA, 2009, EUR HEART J, V30, P549, DOI 10.1093/eurheartj/ehp014 NR 34 TC 25 Z9 25 U1 0 U2 1 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 2015 VL 5 IS 6 AR e008188 DI 10.1136/bmjopen-2015-008188 PG 11 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA CU4EO UT WOS:000363479900096 PM 26105033 OA Green Published, gold DA 2023-05-13 ER PT J AU Short, S Kram, B Taylor, S Cheng, J Ali, K Vasquez, D AF Short, Shannon Kram, Bridgette Taylor, Scott Cheng, Jason Ali, Kamran Vasquez, Donald TI Effect of platelet inhibition on bleeding complications in trauma patients on preinjury clopidogrel SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY LA English DT Article DE Clopidogrel; trauma; platelet inhibition; bleeding; VerifyNow P2Y12 Test ID PERCUTANEOUS CORONARY INTERVENTION; OF-CARE ASSAY; ELDERLY-PATIENTS; INTRACRANIAL HEMORRHAGE; ANTIPLATELET AGENTS; TASK-FORCE; ANTICOAGULATION; MORTALITY; THERAPY; ASPIRIN AB BACKGROUND: Use of antiplatelet medications for acute coronary syndromes and stroke prevention continues to rise as the population ages, although their effects on trauma outcomes remain unclear. This study sought to determine if trauma patients on preinjury clopidogrel with a higher degree of platelet inhibition (PI), as determined by the VerifyNow P2Y12 Test, experienced bleeding complications more frequently than did patients with a lower degree of PI. METHODS: Retrospective, cohort study of adult trauma patients admitted to a Level 1 trauma center between October 1, 2009, and August 31, 2011, with documentation of clopidogrel as a home medication. Patients were excluded if they did not receive the P2Y12 assay, had a platelet count at the time of assay less than 100 x 10(9)/L, or had warfarin, dabigatran, or other thienopyridine therapy documented as a concomitant home medication. The primary outcome compared a composite of bleeding complications between patients with 20% PI or greater and those with less than 20% PI. Bleeding complications were defined as the progression of neurologic insult, postoperative hemorrhage or initiation of the institutional massive blood transfusion protocol. RESULTS: Baseline characteristics were similar between groups. The incidence of bleeding complications was not different between study groups (24.2% vs. 27.6%, p = 0.78). No difference in the secondary outcomes of length of stay, in-hospital mortality, and red blood cell transfusion were observed. Patients with 20% PI or greater received platelet transfusion more frequently than did patients with less than 20% PI (51.5% vs. 10.3%, p = 0.0008). CONCLUSION: The VerifyNow P2Y12 Test may be a tool to stratify trauma patients at a higher risk of bleeding and who subsequently may benefit from transfusion. More frequent platelet transfusion in patients with 20% PI or greater may have resulted in fewer bleeding complications, although confirmation in a prospective, randomized trial is warranted. (Copyright (C) 2013 by Lippincott Williams & Wilkins) C1 [Short, Shannon; Kram, Bridgette; Cheng, Jason; Ali, Kamran; Vasquez, Donald] Wesley Med Ctr, Wichita, KS 67214 USA. [Taylor, Scott] Via Christi Hosp Wichita Inc, Wichita, KS USA. RP Vasquez, D (通讯作者)，Wesley Med Ctr, Surg Intens Care Unit, Wesley Med Ctr 550 North Hillside Dr, Wichita, KS 67214 USA. EM dvasquez@kumc.edu FU Wichita Medical Research and Education Foundation, Wichita, Kansas FX This project was supported by funds from the Wichita Medical Research and Education Foundation, Wichita, Kansas. CR Accumetrics, VERIFYNOW P2Y12 US Ahmed N, 2009, SOUTH MED J, V102, P476, DOI 10.1097/SMJ.0b013e31819f97a3 [Anonymous], 1997, CLOP PACK INS Bansal V, 2011, J TRAUMA, V70, P65, DOI 10.1097/TA.0b013e318204fdae Ben-Dor I, 2009, AM J CARDIOL, V104, P227, DOI 10.1016/j.amjcard.2009.03.022 Campbell PG, 2010, WORLD NEUROSURG, V74, P279, DOI 10.1016/j.wneu.2010.05.030 Campo G, 2011, J AM COLL CARDIOL, V57, P2474, DOI 10.1016/j.jacc.2010.12.047 Cuisset T, 2007, THROMB RES, V120, P893, DOI 10.1016/j.thromres.2007.01.012 Dorsam RT, 2004, J CLIN INVEST, V113, P340, DOI 10.1172/JCI200420986 Downey DM, 2009, AM SURGEON, V75, P1100 Fortuna GR, 2008, SURGERY, V144, P598, DOI 10.1016/j.surg.2008.06.009 Fox KAA, 2004, CIRCULATION, V110, P1202, DOI 10.1161/01.CIR.0000140675.85342.1B Franko J, 2006, J TRAUMA, V61, P107, DOI 10.1097/01.ta.0000224220.89528.fc Furie KL, 2011, STROKE, V42, P227, DOI 10.1161/STR.0b013e3181f7d043 Gurbel PA, 2003, CIRCULATION, V107, P2908, DOI 10.1161/01.CIR.0000072771.11429.83 Hillis LD, 2011, CIRCULATION, V124, pE652, DOI 10.1161/CIR.0b013e31823c074e Holmes DR, 2010, J AM COLL CARDIOL, V56, P321, DOI 10.1016/j.jacc.2010.05.013 Howden L, 2010, AGE SEX COMP Ivascu FA, 2008, J TRAUMA, V65, P785, DOI 10.1097/TA.0b013e3181848caa Jones K, 2006, AM J SURG, V192, P743, DOI 10.1016/j.amjsurg.2006.08.037 Kushner FG, 2009, J AM COLL CARDIOL, V54, P2205, DOI 10.1016/j.jacc.2009.10.015 Lavoie A, 2004, J TRAUMA, V56, P802, DOI 10.1097/01.TA.0000066183.02177.AF McMillian WD, 2009, J TRAUMA, V66, P942, DOI 10.1097/TA.0b013e3181978e7b Mehta SR, 2001, LANCET, V358, P527, DOI 10.1016/S0140-6736(01)05701-4 Mina AA, 2002, J TRAUMA, V53, P668, DOI 10.1097/00005373-200210000-00008 Oestreich JH, 2009, CORONARY ARTERY DIS, V20, P207, DOI 10.1097/MCA.0b013e328329924b Ohm C, 2005, J TRAUMA, V58, P518, DOI 10.1097/01.TA.0000151671.35280.8B Ott MM, 2010, J TRAUMA, V68, P560, DOI 10.1097/TA.0b013e3181ad6600 Patti G, 2008, J AM COLL CARDIOL, V52, P1128, DOI 10.1016/j.jacc.2008.06.038 Price MJ, 2006, AM J CARDIOL, V98, P681, DOI 10.1016/j.amjcard.2006.03.054 Ringleb PA, 2004, STROKE, V35, P528, DOI 10.1161/01.STR.0000110221.54366.49 Serebruany VL, 2005, J AM COLL CARDIOL, V45, P246, DOI 10.1016/j.jacc.2004.09.067 Spiess BD, 2010, BEST PRACT RES-CLIN, V24, P65, DOI 10.1016/j.bpa.2009.11.001 Vlachojannis GJ, 2011, HELL J CARDIOL, V52, P236 Washington CW, 2011, J TRAUMA, V71, P358, DOI 10.1097/TA.0b013e318220ad7e Wong DK, 2008, J TRAUMA, V65, P1303, DOI 10.1097/TA.0b013e318185e234 NR 36 TC 6 Z9 6 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 2163-0755 EI 2163-0763 J9 J TRAUMA ACUTE CARE JI J. Trauma Acute Care Surg. PD JUN PY 2013 VL 74 IS 6 BP 1419 EP 1424 DI 10.1097/TA.0b013e31828dac3e PG 6 WC Critical Care Medicine; Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine; Surgery GA AB4DO UT WOS:000331739800006 PM 23694867 DA 2023-05-13 ER PT J AU Grinberg, T Bental, T Hammer, Y Assali, A Vaknin-Assa, H Wiessman, M Perl, L Kornowski, R Eisen, A AF Grinberg, Tzlil Bental, Tamir Hammer, Yoav Assali, Abid Vaknin-Assa, Hana Wiessman, Maya Perl, Leor Kornowski, Ran Eisen, Alon TI Management and outcome across the spectrum of high-risk patients with myocardial infarction according to the thrmobolysis in myocardial infarction (TIMI) risk-score for secondary prevention SO CLINICAL CARDIOLOGY LA English DT Article DE clinical outcomes; high-risk populations; myocardial infarction; risk-stratification; temporal trends ID ACUTE CORONARY SYNDROMES; IT IMPROVED REDUCTION; STATIN THERAPY; ELDERLY-PATIENTS; GUIDELINE ADHERENCE; ADDING EZETIMIBE; HEART-DISEASE; EFFICACY; CARE; STRATIFICATION AB Background Patients with myocardial infarction (MI) are at increased risk for recurrent cardiovascular events, yet some patients, such as the elderly and those with prior comorbidities, are particularly at the highest risk. Whether these patients benefit from contemporary management is not fully elucidated. Methods Included were consecutive patients with MI who underwent percutaneous coronary intervention (PCI) in a large tertiary medical center. Patients were stratified according to the thrombolysis in myocardial infarction (TIMI) risk score for secondary prevention (TRS2 degrees P) to high (TRS2 degrees P = 3), very high (TRS2 degrees P = 4), or extremely high-risk (TRS2 degrees P = 5-9). Excluded were low and intermediate-risk patients (TRS2 degrees P < 3). Outcomes included 30-day/1-year major adverse cardiac events (MACE) and 1-year mortality. Temporal trends were examined in the early (2004-2010) and late (2011-2016) time-periods. Results Among 2053 patients, 50% were high-risk, 30% very high-risk and 20% extremely high-risk. Extremely high-risk patients were older (age 74 +/- 10 year) and had significant comorbidities (chronic kidney disease 68%, prior CABG 40%, heart failure 78%, peripheral artery disease 29%). Drug-eluting stents and potent antiplatelets were more commonly used over time in all risk-strata. Over time, 30-day MACE rates have decreased, mainly attributed to the very high (11.3% to 5.1%, p = .006) and extremely high-risk groups (15.9% to 8.0%, p = .016), but not the high-risk group, with similar quantitative results for 1-year MACE. The rates of 1-year mortality remained unchanged in either group. Conclusion Within a particularly high-risk cohort of MI patients who underwent PCI, the implementation of guideline-recommended therapies has improved over time, with the highest-risk groups demonstrating the greatest benefit in outcomes. C1 [Grinberg, Tzlil; Bental, Tamir; Hammer, Yoav; Assali, Abid; Vaknin-Assa, Hana; Wiessman, Maya; Perl, Leor; Kornowski, Ran; Eisen, Alon] Rabin Med Ctr, Dept Cardiol, Derech Zeev Jabotinski 39, IL-4941492 Petah Tiqwa, Israel. [Bental, Tamir; Hammer, Yoav; Assali, Abid; Vaknin-Assa, Hana; Perl, Leor; Kornowski, Ran; Eisen, Alon] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel. C3 Rabin Medical Center; Tel Aviv University; Sackler Faculty of Medicine RP Eisen, A (通讯作者)，Rabin Med Ctr, Dept Cardiol, Derech Zeev Jabotinski 39, IL-4941492 Petah Tiqwa, Israel. EM alonei1@clalit.org.il OI Perl, Leor/0000-0002-0625-7937; , tzlil/0000-0001-7786-1886 CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Bach RG, 2004, ANN INTERN MED, V141, P186, DOI 10.7326/0003-4819-141-3-200408030-00007 Bauer T, 2007, EUR HEART J, V28, P2873, DOI 10.1093/eurheartj/ehm464 Bergmark BA, 2018, DIABETES CARE, V41, P577, DOI 10.2337/dc17-1736 Bohula EA, 2017, CIRCULATION, V136, P2440, DOI 10.1161/CIRCULATIONAHA.117.029095 Bohula EA, 2017, J AM COLL CARDIOL, V69, P911, DOI 10.1016/j.jacc.2016.11.070 Bohula EA, 2016, CIRCULATION, V134, P304, DOI 10.1161/CIRCULATIONAHA.115.019861 Bonaca MP, 2018, CIRCULATION, V137, P338, DOI 10.1161/CIRCULATIONAHA.117.032235 Cannon CP, 2015, NEW ENGL J MED, V372, P2387, DOI 10.1056/NEJMoa1410489 Eisen A, 2016, EUR HEART J, V37, P3576, DOI 10.1093/eurheartj/ehw377 Grinberg T, 2020, AM J MED, V133, P839, DOI 10.1016/j.amjmed.2019.12.027 Hammer Y, 2018, J AM HEART ASSOC, V7, DOI 10.1161/JAHA.118.009885 Jellinger PS, 2017, ENDOCR PRACT, V23, P479, DOI 10.4158/EP171764.GL Leonardi S, 2018, EUR HEART J-ACUTE CA, V7, P287, DOI 10.1177/2048872618761621 Mach F, 2019, ATHEROSCLEROSIS, V290, P140, DOI [10.1016/j.atherosclerosis.2019.08.014, 10.1093/eurheartj/ehz455] Motivala AA, 2011, J AM COLL CARDIOL, V58, P1760, DOI 10.1016/j.jacc.2011.06.050 Mukherjee D, 2005, HEART, V91, P381, DOI 10.1136/hrt.2004.036459 Puymirat E, 2019, ARCH CARDIOVASC DIS, V112, P459, DOI 10.1016/j.acvd.2019.04.002 Roe MT, 2006, AM HEART J, V151, P1205, DOI 10.1016/j.ahj.2005.08.006 Rosenblit PD, 2019, CURR DIABETES REP, V19, DOI 10.1007/s11892-019-1178-6 Scirica BM, 2012, LANCET, V380, P1317, DOI 10.1016/S0140-6736(12)61269-0 Shore S, 2015, HEART, V101, P800, DOI 10.1136/heartjnl-2014-306754 Szummer K, 2009, CIRCULATION, V120, P851, DOI 10.1161/CIRCULATIONAHA.108.838169 Tea V, 2019, EUR J PREV CARDIOL, V26, P411, DOI 10.1177/2047487318808638 NR 24 TC 0 Z9 0 U1 1 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 NOV PY 2021 VL 44 IS 11 BP 1535 EP 1542 DI 10.1002/clc.23715 EA SEP 2021 PG 8 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA WS3GP UT WOS:000691703900001 PM 34469003 OA gold, Green Published DA 2023-05-13 ER PT J AU Butala, NM Patel, NK Chhatwal, J Vahdat, V Pomerantsev, EV Albaghdadi, M Sakhuja, R Rosenzweig, A Elmariah, S AF Butala, Neel M. Patel, Nilay K. Chhatwal, Jagpreet Vahdat, Vahab Pomerantsev, Eugene V. Albaghdadi, Mazen Sakhuja, Rahul Rosenzweig, Anthony Elmariah, Sammy TI Patient and Provider Risk in Managing ST-Elevation Myocardial Infarction During the COVID-19 Pandemic A Decision Analysis SO CIRCULATION-CARDIOVASCULAR INTERVENTIONS LA English DT Article DE cardiac catheterization; coronavirus; COVID-19; pandemics; ST-segment– elevation myocardial infarction ID ACUTE RESPIRATORY SYNDROME; TRANSMISSION; INTUBATION; SARS AB Background: The optimal treatment strategy for treating ST-segment-elevation myocardial infarction (STEMI) in context of the coronavirus disease 2019 (COVID-19) pandemic is unclear given the potential risk of occupational exposure during primary percutaneous coronary intervention (PPCI). We quantified the impact of different STEMI treatment strategies on patient outcomes and provider risk in context of the COVID-19 pandemic. Methods: Using a decision-analytic framework, we evaluated the effect of PPCI versus the pharmaco-invasive strategy for managing STEMI on 30-day patient mortality and individual provider infection risk based on presence of cardiogenic shock, suspected coronary territory, and presence of known or presumptive COVID-19 infection. Results: For patients with low suspicion for COVID-19, PPCI had mortality benefit over the pharmaco-invasive strategy, and the risk of cardiac catheterization laboratory provider infection remained very low (<0.25%) across all subgroups. For patients with presumptive COVID-19 with cardiogenic shock, PPCI offered substantial mortality benefit to patients relative to the pharmaco-invasive strategy (7.9% absolute decrease in 30-day mortality), but also greater risk of provider infection (2.3% absolute increase in risk of provider infection). For patients with presumptive COVID-19 with nonanterior STEMI without cardiogenic shock, PPCI offered a 0.4% absolute mortality benefit over the pharmaco-invasive strategy with a 0.2% greater absolute risk of provider infection, and the tradeoff between patient and provider risk with PPCI became more apparent in sensitivity analysis with more severe COVID-19 infections. Conclusions: Usual care with PPCI remains the appropriate treatment strategy in the majority of cases presenting with STEMI in the setting of the COVID-19 pandemic. However, utilization of a pharmaco-invasive strategy in selected patients with STEMI with presumptive COVID-19 and low likelihood of mortality from STEMI and use of preventive strategies such as preprocedural intubation in high risk patients when PPCI is the preferred strategy may be reasonable to reduce provider risk of COVID-19 infection. C1 [Butala, Neel M.; Patel, Nilay K.; Pomerantsev, Eugene V.; Albaghdadi, Mazen; Rosenzweig, Anthony; Elmariah, Sammy] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA. [Chhatwal, Jagpreet; Vahdat, Vahab] Massachusetts Gen Hosp, Inst Technol Assessment, Boston, MA 02114 USA. [Butala, Neel M.; Patel, Nilay K.; Chhatwal, Jagpreet; Vahdat, Vahab; Pomerantsev, Eugene V.; Albaghdadi, Mazen; Sakhuja, Rahul; Rosenzweig, Anthony; Elmariah, Sammy] Harvard Med Sch, Boston, MA 02115 USA. C3 Harvard University; Massachusetts General Hospital; Harvard University; Massachusetts General Hospital; Harvard University; Harvard Medical School RP Elmariah, S (通讯作者)，55 Fruit St,Bigelow 815, Boston, MA 02114 USA. EM nbutala@partners.org; NPATEL28@PARTNERS.ORG; jagchhatwal@mgh.harvard.edu; VVAHDATZAD@MGH.HARVARD.EDU; Epomerantsev@mgh.harvard.edu; malbaghdadi@mgh.harvard.edu; rsakhuja@partners.org; arosenzweig@partners.org; selmariah@mgh.harvard.edu RI Vahdat, Vahab/GRO-2559-2022; Elmariah, Sammy/AAG-8752-2021 OI Vahdat, Vahab/0000-0001-7831-7567; Rosenzweig, Anthony/0000-0001-6387-0386; Elmariah, Sammy/0000-0002-8013-8733 CR [Anonymous], 2020, LANCET INFECT DIS, DOI DOI 10.1016/S1473-3099(20)30243-7 Argulian Edgar, 2020, JACC Case Rep, V2, P845, DOI 10.1016/j.jaccas.2020.04.005 Armstrong PW, 2013, NEW ENGL J MED, V368, P1379, DOI 10.1056/NEJMoa1301092 Bainey KR, 2020, CIRC-CARDIOVASC QUAL, V13, P284, DOI 10.1161/CIRCOUTCOMES.120.006834 Bangalore S, 2020, NEW ENGL J MED, V382, P2478, DOI 10.1056/NEJMc2009020 Bhatraju PK, 2020, NEW ENGL J MED, V382, P2012, DOI 10.1056/NEJMoa2004500 Caputo KM, 2006, CAN J ANAESTH, V53, P122, DOI 10.1007/BF03021815 Chou R, 2020, ANN INTERN MED, V173, pW123, DOI 10.7326/L20-1005 Chou R, 2020, ANN INTERN MED, V173, pW77, DOI 10.7326/M20-4806 Chou R, 2020, ANN INTERN MED, V173, P120, DOI 10.7326/M20-1632 Chu DK, 2020, LANCET, V395, P1973, DOI 10.1016/S0140-6736(20)31142-9 Daniels MJ, 2020, CIRCULATION, V141, P1948, DOI 10.1161/CIRCULATIONAHA.120.047122 Emanuel EJ, 2020, NEW ENGL J MED, V382, P2049, DOI 10.1056/NEJMsb2005114 Fowler RA, 2004, AM J RESP CRIT CARE, V169, P1198, DOI 10.1164/rccm.200305-715OC Frobert O, 2013, NEW ENGL J MED, V369, P1587, DOI 10.1056/NEJMoa1308789 Han YL, 2020, CIRCULATION, V141, pE810, DOI 10.1161/CIRCULATIONAHA.120.047011 Kirtane AJ, 2020, CIRC-CARDIOVASC QUAL, V13, P287, DOI 10.1161/CIRCOUTCOMES.120.006885 Loeb M, 2004, EMERG INFECT DIS, V10, P251, DOI 10.3201/eid1002.030838 Mahmud E, 2020, J AM COLL CARDIOL, V76, P1375, DOI 10.1016/j.jacc.2020.04.039 MILLAIRE A, 1995, EUR HEART J, V16, P333 Ng K, 2020, ANN INTERN MED, V172, P766, DOI 10.7326/L20-0175 Raboud J, 2010, PLOS ONE, V5, DOI 10.1371/journal.pone.0010717 Scales DC, 2003, EMERG INFECT DIS, V9, P1205, DOI 10.3201/eid0910.030525 Seto WH, 2003, LANCET, V361, P1519, DOI 10.1016/S0140-6736(03)13168-6 Smilowitz NR, 2013, CARDIOVASC REVASCULA, V14, P223, DOI 10.1016/j.carrev.2013.05.002 Thiele H, 2017, NEW ENGL J MED, V377, P2419, DOI 10.1056/NEJMoa1710261 TOPOL E, 1993, NEW ENGL J MED, V329, P673, DOI 10.1056/nejm199309023291001 Van de Werf F, 1999, LANCET, V354, P716, DOI 10.1016/S0140-6736(99)07403-6 Wood SN, 2021, LANCET INFECT DIS, V21, P27, DOI 10.1016/S1473-3099(20)30437-0 Zhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3 NR 30 TC 2 Z9 2 U1 1 U2 5 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 NOV PY 2020 VL 13 IS 11 AR e010027 DI 10.1161/CIRCINTERVENTIONS.120.010027 PG 9 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA OS3PC UT WOS:000590076200011 PM 33167699 OA Bronze DA 2023-05-13 ER PT J AU Zhao, Z Zhu, Y Fang, Y Ye, W McCollam, P AF Zhao, Z. Zhu, Y. Fang, Y. Ye, W. McCollam, P. TI Healthcare resource utilization and costs in working-age patients with high-risk atherosclerotic cardiovascular disease: findings from a multi-employer claims database SO JOURNAL OF MEDICAL ECONOMICS LA English DT Article DE Atherosclerotic cardiovascular disease; Cost; Resource use; Commercial payer AB Objective: Patients with coronary artery disease with diabetes, a history of acute coronary syndromes, cerebrovascular atherosclerotic disease, or peripheral arterial disease are at particularly high risk for a cardiovascular (CV) event and can be defined as having high-risk atherosclerotic cardiovascular disease (ASCVD). The objective of this study is to examine healthcare resource utilization (HRU) and total healthcare costs (THC) for patients with ASCVD in a commercially insured population. Methods: A retrospective cohort study was conducted using a large, US employer-based, claims database. Patients with an ASCVD diagnosis between October 1, 2008 to September 30, 2009 who met eligibility requirements were included. All-cause and ASCVD-related HRU and THC for the first and second year of follow-up were examined for all patients and by the number of arterial beds affected. Adjusted THC were compared across groups with and without polyvascular disease. Results: The analysis included 152,290 patients with ASCVD. Use of CV-related medications, hospitalizations, and office visits were highest among patients with three arterial beds affected. Mean all-cause THC for patients with ASCVD were similar to$19,000 per patient in Year 1 or Year 2, with medical costs as the main driver. ASCVD-related THC were also similar for Year 1 ($8699) and Year 2 ($7925) across all patients. Adjusted all-cause and ASCVD-related THC for both years were greatest for patients with three affected arterial beds compared with one or two affected beds (p<0.001 for each comparison). Conclusions: This is the first study in a managed care setting to systematically estimate all-cause and ASCVD-related THC for an aggregated population of ASCVD patients at high risk for a CV event. The economic burden of ASCVD in working-age patients in the US is substantial. Significantly higher HRU and costs were found in patients with polyvascular disease compared with those with only one affected bed. C1 [Zhao, Z.; Zhu, Y.; Ye, W.; McCollam, P.] Eli Lilly & Co, Indianapolis, IN 46221 USA. [Fang, Y.] PharmaNet i3, Indianapolis, IN USA. C3 Eli Lilly RP Zhao, Z (通讯作者)，Eli Lilly & Co, 1400 West Raymond St,DC 5024, Indianapolis, IN 46221 USA. EM zhaozhenxiang@lilly.com NR 0 TC 6 Z9 6 U1 0 U2 0 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1369-6998 EI 1941-837X J9 J MED ECON JI J. Med. Econ. PY 2015 VL 18 IS 9 BP 655 EP 665 DI 10.3111/13696998.2015.1041966 PG 11 WC Economics; Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC Business & Economics; Health Care Sciences & Services; General & Internal Medicine GA CR4VC UT WOS:000361336800001 PM 25891183 DA 2023-05-13 ER PT J AU Kalina, M AF Kalina, Michael TI Implementation of a Trauma Service Activation and Admission Policy for Very Elderly Trauma Patients: Impact on Hospital Efficiency and Patient Outcomes SO AMERICAN SURGEON LA English DT Article ID GERIATRIC TRAUMA AB Very elderly trauma patients (VETs) were routinely admitted to nonsurgical services at our institution; therefore, a trauma service activation and admission policy was implemented. Our goal was to determine policy success and impact on efficiency and outcomes. VETs, defined as trauma patients aged >89 years, admitted before and after policy implementation were reviewed. Demographics included age, gender, Injury Severity Score, Glasgow Coma Score, admission diagnosis, mechanism of injury, admission service, and comorbidities. Efficiency included intensive care unit length of stay (ICU-LOS) and hospital length of stay (H-LOS). Outcomes included complications, discharge disposition, and mortality. Statistical analysis included Chi square, Fisher's exact test, and regression analyses, significance denoted by P < 0.05. 375 VETs were investigated. Demographic analysis revealed differences in Injury Severity Score (9.4 + 5.4 vs 7.2 + 4.0, P < 0.001), coronary artery disease (2.1% vs 38.2%, P < 0.001), neurologic disease (7.4% vs 28.24%, P < 0.001), and intracranial hemorrhage (15.6% vs 6.1%, P = 0.01). The most common mechanism of injury and admission diagnosis was fall and femur fracture. VETs admitted to the trauma service increased from 28.3 per cent to 40.5 per cent, P = 0.02. Efficiency analysis revealed differences in ICU-LOS (4.0 + 4.2 days vs 0.7 + 1.3 days, P < 0.001) and H-LOS (7.3 + 4.9 days vs 6.3 + 5.5 days, P = 0.005). Outcomes analysis revealed differences in pneumonia (0.8% vs 5.3%, P = 0.01), acute respiratory distress syndrome (0% vs 2.3%, P = 0.04), discharge to skilled nursing facility (75.8% vs 57.3%, P < 0.001), but no difference in mortality. Regression analyses revealed that trauma service admission was associated with decreased ICU-LOS and H-LOS. The trauma service activation and admission policy for VETs led to improved hospital efficiency. C1 [Kalina, Michael] Staten Isl Univ Hosp, Emergency Gen Surg, 256 Mason Ave,Suite C, New York, NY 10305 USA. C3 Northwell Health RP Kalina, M (通讯作者)，Staten Isl Univ Hosp, Emergency Gen Surg, 256 Mason Ave,Suite C, New York, NY 10305 USA. EM mkalina@nshs.edu CR American College of Surgeons Committee on Trauma, RES OPT CAR INJ PAT Calland JF, 2012, J TRAUMA ACUTE CARE, V73, pS345, DOI 10.1097/TA.0b013e318270191f Hashmi A, 2014, J TRAUMA ACUTE CARE, V76, P894, DOI 10.1097/TA.0b013e3182ab0763 Heyland D, 2015, CRIT CARE MED, V43, P1352, DOI 10.1097/CCM.0000000000001024 Kozar RA, 2015, J TRAUMA ACUTE CARE, V78, P1197, DOI [10.1097/TA.0000000000000656, 10.1097/TA.0000000000000652] McGwin G, 2000, J TRAUMA, V49, P470, DOI 10.1097/00005373-200009000-00014 Zafar SN, 2015, J TRAUMA ACUTE CARE, V78, P852, DOI 10.1097/TA.0000000000000557 NR 7 TC 3 Z9 3 U1 0 U2 1 PU SOUTHEASTERN SURGICAL CONGRESS PI CUMMING PA 115 SAMARITAN DR, #200, CUMMING, GA 30040-2354 USA SN 0003-1348 EI 1555-9823 J9 AM SURGEON JI Am. Surg. PD JUN PY 2016 VL 82 IS 6 BP 493 EP 496 PG 4 WC Surgery WE Science Citation Index Expanded (SCI-EXPANDED) SC Surgery GA DO5XC UT WOS:000377855200008 PM 27305879 DA 2023-05-13 ER PT J AU Arnold, SV Spertus, JA Masoudi, FA Daugherty, SL Maddox, TM Li, Y Dodson, JA Chan, PS AF Arnold, Suzanne V. Spertus, John A. Masoudi, Frederick A. Daugherty, Stacie L. Maddox, Thomas M. Li, Yan Dodson, John A. Chan, Paul S. TI Beyond Medication Prescription as Performance Measures SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article DE myocardial infarction; performance measures; secondary prevention ID ACUTE CORONARY SYNDROME; ACUTE MYOCARDIAL-INFARCTION; CHRONIC HEART-FAILURE; QUALITY-OF-CARE; CLINICAL INERTIA; SECONDARY PREVENTION; RANDOMIZED-TRIALS; MORTALITY; OUTCOMES; ASSOCIATION AB Objectives The aim of this study was to examine the prescribing patterns of medications quantified by the performance measures for acute myocardial infarction (AMI). Background Current performance measures for AMI are designed to improve quality by quantifying the use of evidence-based treatments. However, these measures only assess medication prescription. Whether patients receive optimal dosing of secondary prevention medications at the time of and after discharge after AMI is unknown. Methods We assessed treatment doses of beta-blockers, statins, and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARBs) at discharge and 12 months after AMI among 6,748 patients from 31 hospitals enrolled in 2 U. S. registries (2003 to 2008). Prescribed doses were categorized as none, low (<50% target [defined from seminal clinical trials]), moderate (50% to 74% target), or goal (>= 75% target). Patients with contraindications were excluded from analyses for that medication. Results Most eligible patients (>87%) were prescribed some dose of each medication at discharge, although only 1 in 3 patients were prescribed these medications at goal doses. Of patients not discharged on goal doses, up-titration during follow-up occurred infrequently (approximately 25% of patients for each medication). At 12 months, goal doses of beta-blockers, statins, and ACEI/ARBs were achieved in only 12%, 26%, and 32% of eligible patients, respectively. After multivariable adjustment, prescription of goal dose at discharge was strongly associated with being at goal dose at follow-up: beta-blockers, adjusted odds ratio (OR): 6.08 (95% confidence interval [CI]: 3.70 to 10.01); statins, adjusted OR: 8.22 (95% CI: 6.20 to 10.90); ACEI/ARBs, adjusted OR: 5.80 (95% CI: 2.56 to 13.16); p < 0.001 for each. Conclusions Although nearly all patients after an AMI are discharged on appropriate secondary prevention medications, dose increases occur infrequently, and most patients are prescribed doses below those with proven efficacy in clinical trials. Integration of dose intensity into performance measures might help improve the use of optimal medical therapy after AMI. (C) 2013 by the American College of Cardiology Foundation C1 [Arnold, Suzanne V.; Spertus, John A.; Li, Yan; Chan, Paul S.] St Lukes Mid Amer Heart Inst, Kansas City, MO 64111 USA. [Arnold, Suzanne V.; Spertus, John A.; Chan, Paul S.] Univ Missouri, Kansas City, MO 64110 USA. [Masoudi, Frederick A.; Daugherty, Stacie L.] Univ Colorado, Denver, CO 80202 USA. [Maddox, Thomas M.] VA Eastern Colorado Hlth Care Syst, Denver, CO USA. [Dodson, John A.] Brigham & Womens Hosp, Boston, MA 02115 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; Harvard University; Brigham & Women's Hospital 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, and Blood Institute); SCCOR [P50HL077113]; Cardiovascular Therapeutics, Inc., Palo Alto, California; Clinical and Translational Science Award [1UL1RR033179]; National Heart, Lung, and Blood Institute [K08HL103776, K23HL102224]; Veterans Affairs Health Services Research and Development Service FX The TRIUMPH study was sponsored by a grant from the National Institutes of Health (National Heart, Lung, and Blood Institute): SCCOR Grant #P50HL077113. The PREMIER study (Prospective Registry Evaluating Myocardial Infarction: Events and Recovery) was principally supported by a grant from Cardiovascular Therapeutics, Inc., Palo Alto, California. The funding organizations 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. Dr. Spertus is supported by a Clinical and Translational Science Award (1UL1RR033179); discloses industry relationships with Lilly, Genentech, Amgen, EvaHeart, and Amorcyte; and has served on the United Healthcare Scientific Advisory Board. Dr. Masoudi discloses a contract with the American College of Cardiology Foundation. Dr. Daugherty is supported by a Career Development Grant Award (K08HL103776) from the National Heart, Lung, and Blood Institute. Dr. Maddox is supported by a Career Development Grant Award from the Veterans Affairs Health Services Research and Development Service. Dr. Chan is supported by a Career Development Grant Award (K23HL102224) from the National Heart, Lung, and Blood Institute. 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 NOV 5 PY 2013 VL 62 IS 19 BP 1791 EP 1801 DI 10.1016/j.jacc.2013.04.102 PG 11 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 242KI UT WOS:000326239100012 PM 23973701 OA Green Accepted, Bronze DA 2023-05-13 ER PT J AU de Havenon, A Ney, JP Callaghan, B Delic, A Hohmann, S Shippey, E Esper, GJ Stulberg, E Tirschwell, D Frontera, J Yaghi, S Anadani, M Majersik, JJ AF de Havenon, Adam Ney, John P. Callaghan, Brian Delic, Alen Hohmann, Samuel Shippey, Ernie Esper, Gregory J. Stulberg, Eric Tirschwell, David Frontera, Jennifer Yaghi, Shadi Anadani, Mohammad Majersik, Jennifer J. TI Impact of COVID-19 on Outcomes in Ischemic Stroke Patients in the United States SO JOURNAL OF STROKE & CEREBROVASCULAR DISEASES LA English DT Article DE COVID-19; Ischemic stroke; Outcome; Neurology/cerebrovascular disease; Epidemiology ID CARE AB Background: Studies have shown worse outcomes in patients with comorbid ischemic stroke (IS) and coronavirus disease 2019 (COVID-19), but have had small sample sizes. Methods: We retrospectively identified patients in the Vizient Clinical Data Base (R) with IS as a discharge diagnosis. The study outcomes were in-hospital death and favorable discharge (home or acute rehabilitation). In the primary analysis, we compared IS patients with laboratory-confirmed COVID-19 (IS-COVID) discharged April 1-July 31, 2020 to pre-COVID IS patients discharged in 2019 (IS controls). In a secondary analysis, we compared a matched cohort of IS-COVID patients to patients within the IS controls who had pneumonia (IS-PNA), created with inverse-probability-weighting (IPW). Results: In the primary analysis, we included 166,586 IS controls and 2086 IS-COVID from 312 hospitals in 46 states. Compared to IS controls, IS-COVID were less likely to have hypertension, dyslipidemia, or be smokers, but more likely to be male, younger, have diabetes, obesity, acute renal failure, acute coronary syndrome, venous thromboembolism, intubation, and comorbid intracerebral or subarachnoid hemorrhage (all p<0.05). Black and Hispanic patients accounted for 21.7% and 7.4% of IS controls, respectively, but 33.7% and 18.5% of IS-COVID (p<0.001). IS-COVID, versus IS controls, were less likely to receive alteplase (1.8% vs 5.6%, p<0.001), mechanical thrombectomy (4.4% vs. 6.7%, p<0.001), to have favorable discharge (33.9% vs. 66.4%, p <0.001), but more likely to die (30.4% vs. 6.5%, p<0.001). In the matched cohort of patients with IS-COVID and IS-PNA, IS-COVID had a higher risk of death (IPW-weighted OR 1.56, 95% CI 1.33-1.82) and lower odds of favorable discharge (IPW-weighted OR 0.63, 95% CI 0.54-0.73). Conclusions: Ischemic stroke patients with COVID-19 are more likely to be male, younger, and Black or Hispanic, with significant increases in morbidity and mortality compared to both ischemic stroke controls from 2019 and to patients with ischemic stroke and pneumonia. C1 [de Havenon, Adam; Delic, Alen; Stulberg, Eric; Majersik, Jennifer J.] Univ Utah, Dept Neurol, 175 N Med Dr, Salt Lake City, UT 84132 USA. [Ney, John P.] Boston Univ, Dept Neurol, Boston, MA USA. [Callaghan, Brian] Univ Michigan, Dept Neurol, Ann Arbor, MI USA. [Hohmann, Samuel; Shippey, Ernie] Vizient Inc, Res Analyt, Irving, TX USA. [Esper, Gregory J.] Emory Univ, Dept Neurol, Atlanta, GA USA. [Tirschwell, David] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Frontera, Jennifer; Yaghi, Shadi] NYU, Dept Neurol, New York, NY 10016 USA. [Anadani, Mohammad] Washington Univ, Dept Neurol, St Louis, MO USA. C3 Utah System of Higher Education; University of Utah; Boston University; University of Michigan System; University of Michigan; Emory University; University of Washington; University of Washington Seattle; New York University; Washington University (WUSTL) RP de Havenon, A (通讯作者)，Univ Utah, Dept Neurol, 175 N Med Dr, Salt Lake City, UT 84132 USA. RI Yaghi, Shadi/Q-8258-2019 OI de Havenon, Adam/0000-0001-8178-8597 FU NIH-NINDS [K23NS105924]; Utah Stimulating Access to Research in Residency Transition Scholar (StARRTS) [1R38HL143605-01] FX Dr. de Havenon is supported by NIH-NINDS K23NS105924. The research reported in this publication was supported (in part or in full) by the Utah Stimulating Access to Research in Residency Transition Scholar (StARRTS) under Award Number 1R38HL143605-01. 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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PD FEB PY 2021 VL 30 IS 2 AR 105535 DI 10.1016/j.jstrokecerebrovasdis.2020.105535 PG 8 WC Neurosciences; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA PT2AM UT WOS:000608421600041 PM 33310595 OA Green Published DA 2023-05-13 ER PT J AU Carlton, EW Khattab, A Greaves, K AF Carlton, Edward Watts Khattab, Ahmed Greaves, Kim TI Beyond triage: the diagnostic accuracy of emergency department nursing staff risk assessment in patients with suspected acute coronary syndromes SO EMERGENCY MEDICINE JOURNAL LA English DT Article ID CLINICAL-RESEARCH; DEFINITIONS; VALIDATION; TROPONIN; SCORE; RULE; CARE AB Objectives To establish the accuracy of emergency department (ED) nursing staff risk assessment using an established chest pain risk score alone and when incorporated with presentation high-sensitivity troponin testing as part of an accelerated diagnostic protocol (ADP). Design Prospective observational study comparing nursing and physician risk assessment using the modified Goldman (m-Goldman) score and a predefined ADP, incorporating presentation high-sensitivity troponin. Setting A UK District ED. Patients Consecutive patients, aged >= 18, with suspected cardiac chest pain and non-ischaemic ECG, for whom the treating physician determined serial troponin testing was required. Outcome measures 30-day major adverse cardiac events (MACE). Results 960 participants were recruited. 912/960 (95.0%) had m-Goldman scores recorded by physicians and 745/960 (77.6%) by nursing staff. The area under the curve of the m-Goldman score in predicting 30-day MACE was 0.647 (95% CI 0.594 to 0.700) for physicians and 0.572 (95% CI 0.510 to 0.634) for nursing staff (p= 0.09). When incorporated into an ADP, sensitivity for the rule-out of MACE was 99.2% (95% CI 94.8% to 100%) and 96.7% (90.3% to 99.2%) for physicians and nurses, respectively. One patient in the physician group (0.3%) and three patients (1.1%) in the nursing group were classified as low risk yet had MACE. There was fair agreement in the identification of low-risk patients (kappa 0.31, 95% CI 0.24 to 0.38). Conclusions The diagnostic accuracy of ED nursing staff risk assessment is similar to that of ED physicians and interobserver reliability between assessor groups is fair. When incorporating high-sensitivity troponin testing, a nurse-led ADP has a miss rate of 1.1% for MACE at 30 days. C1 [Carlton, Edward Watts] Southmead Hosp, Emergency Dept, Bristol, Avon, England. [Carlton, Edward Watts; Khattab, Ahmed] Bournemouth Univ, Sch Hlth & Social Care, Bournemouth, Dorset, England. [Greaves, Kim] Univ Sunshine Coast, Sunshine Coast Hosp & Hlth Serv, Dept Cardiol, Sunshine Coast, Qld, Australia. C3 Southmead Hospital; Bournemouth University; University of the Sunshine Coast RP Carlton, EW (通讯作者)，North Bristol NHS Trust, Southmead Hosp, Dept Emergency Med, Bristol BS10 5NB, Avon, England. EM eddcarlton@gmail.com OI Carlton, Edward/0000-0002-2064-4618 FU College of Emergency Medicine of the United Kingdom; Bournemouth University, UK FX The TRUST study was supported by a research grant from the College of Emergency Medicine of the United Kingdom and research fellowship funding from Bournemouth University, UK. 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Med. J. PD FEB PY 2016 VL 33 IS 2 BP 99 EP 104 DI 10.1136/emermed-2015-204780 PG 6 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA DD6BQ UT WOS:000370009100005 PM 26362581 OA Green Accepted DA 2023-05-13 ER PT J AU Varenne, O Cook, S Sideris, G Kedev, S Cuisset, T Carrie, D Hovasse, T Garot, P El Mahmoud, R Spaulding, C Helft, G Fernandez, JFD Brugaletta, S Pinar-Bermudez, E Ferre, JM Commeau, P Teiger, E Bogaerts, K Sabate, M Morice, MC Sinnaeve, PR AF Varenne, Olivier Cook, Stephane Sideris, Georgios Kedev, Sasko Cuisset, Thomas Carrie, Didier Hovasse, Thomas Garot, Philippe El Mahmoud, Rami Spaulding, Christian Helft, Gerard Diaz Fernandez, Jose F. Brugaletta, Salvatore Pinar-Bermudez, Eduardo Mauri Ferre, Josepa Commeau, Philippe Teiger, Emmanuel Bogaerts, Kris Sabate, Manel Morice, Marie-Claude Sinnaeve, Peter R. TI Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial SO LANCET LA English DT Article ID DUAL-ANTIPLATELET THERAPY; BARE-METAL STENTS; CARDIOVASCULAR CARE; OUTCOMES; REVASCULARIZATION; ASSOCIATION; CARDIOLOGY; DURATION; SOCIETY; DESIGN AB Background Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. Methods In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (>= 50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI). Exclusion criteria were indication for myocardial revascularisation by coronary artery bypass grafting; inability to tolerate, obtain, or comply with DAPT; requirement for additional surgery; non-cardiac comorbidities with a life expectancy of less than 1 year; previous haemorrhagic stroke; allergy to aspirin or P2Y 12 inhibitors; contraindication to P2Y 12 inhibitors; and silent ischaemia of less than 10% of the left myocardium with a fractional flow reserve of 0.80 or higher. After the intended duration of DAPT was recorded (1 month for patients with stable presentation and 6 months for those with unstable presentation), patients were randomly allocated (1: 1) by a central computer system (blocking used with randomly selected block sizes [two, four, eight, or 16]; stratified by site and antiplatelet agent) to either a DES or similar BMS in a single-blind fashion (ie, patients were masked), but those assessing outcomes were masked. The primary outcome was to compare major adverse cardiac and cerebrovascular events (ie, a composite of all-cause mortality, myocardial infarction, stroke, or ischaemia-driven target lesion revascularisation) between groups at 1 year in the intention-to-treat population, assessed at 30 days, 180 days, and 1 year. Findings Between May 21, 2014, and April 16, 2016, we randomly assigned 1200 patients (596 [50%] to the DES group and 604 [50%] to the BMS group). The primary endpoint occurred in 68 (12%) patients in the DES group and 98 (16%) in the BMS group (relative risk [RR] 0.71 [95% CI 0.52-0.94]; p= 0.02). Bleeding complications (26 [5%] in the DES group vs 29 [5%] in the BMS group; RR 0.90 [0.51-1.54]; p= 0.68) and stent thrombosis (three [1%] vs eight [1%]; RR 0.38 [0.00-1.48]; p= 0.13) at 1 year were infrequent in both groups. Interpretation Among elderly patients who have PCI, a DES and a short duration of DAPT are better than BMS and a similar duration of DAPT with respect to the occurrence of all-cause mortality, myocardial infarction, stroke, and ischaemia-driven target lesion revascularisation. A strategy of combination of a DES to reduce the risk of subsequent repeat revascularisations with a short BMS-like DAPT regimen to reduce the risk of bleeding event is an attractive option for elderly patients who have PCI. C1 [Varenne, Olivier] Hop Cochin, AP HP, F-75014 Paris, France. [Varenne, Olivier] Sorbonne Paris Cite, Univ Paris Descartes, Cardiol Dept, Paris, France. [Cook, Stephane] Univ & Hosp Fribourg, Cardiol Dept, Fribourg, Switzerland. [Sideris, Georgios] Univ Paris Diderot, AP HP, Hop Lariboisiere,Serv Cardiol, INSERM,U942, Serv Cardiol, Paris, France. [Kedev, Sasko] Univ St Cyril & Methodius, Cardiol Dept, Skopje, North Macedonia. [Cuisset, Thomas] CHU Timone, Dept Cardiol, Marseille, France. [Carrie, Didier] Univ Paul Sabatier, CHU Toulouse, Serv Cardiol, Toulouse, France. [Hovasse, Thomas; Garot, Philippe] Ramsay Gen Sante, Inst Cardiovasc Paris Sud, Massy Quincy, France. [El Mahmoud, Rami] Univ Versailles St Quentin & Yvelines, Hop Paris, AP HP, Versailles, France. [Spaulding, Christian] Paris Descartes Univ, Hop Europeen Georges Pompidou, AP HP, Serv Cardiol, Paris, France. [Spaulding, Christian] INSERM, Sudden Death Expert Ctr, U990, Paris, France. [Helft, Gerard] Univ Paris 06, Hop Pitie Salpetriere, AP HP, Inst Cardiol, Paris, France. [Helft, Gerard] Hop La Pitie Salpetriere, Inst Cardiometab & Nutr, Inst Hosp Univ, Paris, France. [Diaz Fernandez, Jose F.] Juan Ramon Jimenez Univ Hosp, Huelva, Spain. [Brugaletta, Salvatore] Inst Invest Biomed August Pi & Sunyer, Hosp Clin, Cardiovasc Inst, Barcelona, Spain. [Pinar-Bermudez, Eduardo] Hosp Univ Virgen Arrixaca, Murcia, Spain. [Mauri Ferre, Josepa] Hosp Badalona Germans Trias & Pujol, Badalona, Spain. [Commeau, Philippe] Polyclin Fleurs, Dept Cardiol Intervent, Ollioules, France. [Teiger, Emmanuel] Univ Paris Est Creteil, Hop Henri Mondor, AP HP, Serv Cardiol, Creteil, France. [Bogaerts, Kris] Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Interunivers Inst Biostat & Stat Bioinformat IBio, Leuven, Belgium. [Bogaerts, Kris] Univ Hasselt, Interunivers Inst Biostat & Stat Bioinformat IBio, Hasselt, Belgium. [Sabate, Manel] Inst Invest Biomed August Pi & Sunyer, Hosp Clin, Cardiovasc Inst, Intervent Cardiol Unit, Barcelona, Spain. [Morice, Marie-Claude] Cardiovasc European Res Ctr, Massy, France. [Sinnaeve, Peter R.] Univ Hosp Leuven, Dept Cardiovasc Med, Leuven, Belgium. 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 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; 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; 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; Saints Cyril & Methodius University of Skopje; UDICE-French Research Universities; Aix-Marseille Universite; Assistance Publique-Hopitaux de Marseille; CHU de Toulouse; Universite de Toulouse; Universite Toulouse III - Paul Sabatier; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Paul-Brousse - APHP; UDICE-French Research Universities; Universite Paris Cite; Hopital Universitaire Hotel-Dieu - APHP; 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 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); Institut National de la Sante et de la Recherche Medicale (Inserm); 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 Charles-Foix - APHP; Hopital Universitaire Pitie-Salpetriere - APHP; UDICE-French Research Universities; Sorbonne Universite; Hopital Universitaire Armand-Trousseau - APHP; University of Barcelona; Hospital Clinic de Barcelona; IDIBAPS; Hospital Clinico Universitario Virgen de la Arrixaca; Hospital Germans Trias i Pujol; 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; KU Leuven; Hasselt University; University of Barcelona; Hospital Clinic de Barcelona; IDIBAPS RP Varenne, O (通讯作者)，Hop Cochin, AP HP, F-75014 Paris, France. EM olivier.varenne@aphp.fr RI Sabate, Manel/AAX-7245-2021; Brugaletta, Salvatore/AAJ-2090-2020; Kedev, Sasko/ABB-2637-2021; Carrie, Didier/M-5781-2014; Brugaletta, Salvatore/E-1310-2018 OI Kedev, Sasko/0000-0003-4844-6434; Brugaletta, Salvatore/0000-0001-5845-1435; CARRIE, didier/0000-0003-2479-8144; Sinnaeve, Peter/0000-0003-4716-5892; Diaz Fernandez, Jose Francisco/0000-0002-2677-0674; Bogaerts, Kris/0000-0003-0188-8665; Sabate Tenas, Manel/0000-0002-2316-3705; TEIGER, emmanuel/0000-0001-7515-4344 FU Boston Scientific FX Boston Scientific. CR Alexander KP, 2007, CIRCULATION, V115, P2549, DOI 10.1161/CIRCULATIONAHA.107.182615 Baber U, 2016, J AM COLL CARDIOL, V67, P2224, DOI 10.1016/j.jacc.2016.02.064 Bonaa KH, 2016, NEW ENGL J MED, V375, P1242, DOI 10.1056/NEJMoa1607991 Byrne RA, 2015, EUR HEART J, V36, P2608, DOI 10.1093/eurheartj/ehv203 Colmenarez H, 2014, EUROINTERVENTION, V10, P942, DOI 10.4244/EIJV10I8A161 Cutlip DE, 2007, CIRCULATION, V115, P2344, DOI 10.1161/CIRCULATIONAHA.106.685313 D'Ascenzo F, 2017, EUR HEART J, V38, P3160, DOI 10.1093/eurheartj/ehx437 de Belder A, 2014, J AM COLL CARDIOL, V63, P1371, DOI 10.1016/j.jacc.2013.10.053 Forman DE, 2009, CIRC-CARDIOVASC INTE, V2, P178, DOI 10.1161/CIRCINTERVENTIONS.109.855221 Gerber RT, 2017, J INTERV CARDIOL, V30, P347, DOI 10.1111/joic.12400 Gerber Y, 2007, J AM COLL CARDIOL, V50, P1223, DOI 10.1016/j.jacc.2007.06.022 Ibanez B, 2018, KARDIOL POL, V76, P229, DOI 10.5603/KP.2018.0041 Levine GN, 2016, J AM COLL CARDIOL, V68, P1082, DOI 10.1016/j.jacc.2016.03.513 Li LX, 2017, LANCET, V390, P490, DOI 10.1016/S0140-6736(17)30770-5 Masoudi FA, 2017, J AM COLL CARDIOL, V69, P1424, DOI 10.1016/j.jacc.2016.12.004 Mauri L, 2014, NEW ENGL J MED, V371, P2155, DOI 10.1056/NEJMoa1409312 Mehran R, 2011, CIRCULATION, V123, P2736, DOI 10.1161/CIRCULATIONAHA.110.009449 Morice MC, 2017, INT J CARDIOL, V243, P110, DOI 10.1016/j.ijcard.2017.04.079 Palmerini T, 2017, EUR HEART J, V38, P1034, DOI 10.1093/eurheartj/ehw627 Palmerini T, 2015, J AM COLL CARDIOL, V65, P2496, DOI 10.1016/j.jacc.2015.04.017 Piccolo R, 2017, ANN INTERN MED, V167, P17, DOI 10.7326/M16-2389 Rich MW, 2016, J AM COLL CARDIOL, V67, P2419, DOI 10.1016/j.jacc.2016.03.004 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Thygesen K, 2012, EUR HEART J, V33, P2551, DOI 10.1093/eurheartj/ehs184 Urban P, 2015, NEW ENGL J MED, V373, P2038, DOI 10.1056/NEJMoa1503943 Valgimigli M, 2015, J AM COLL CARDIOL, V65, P805, DOI 10.1016/j.jacc.2014.11.053 Varenne O, 2017, EUROINTERVENTION, V12, P1614, DOI 10.4244/EIJY15M12_02 Windecker S, 2014, EUR HEART J, V35, P2541, DOI [10.5603/KP.2014.0224, 10.1093/eurheartj/ehu278, 10.1093/ejcts/ezu366] Yeh RW, 2016, JAMA-J AM MED ASSOC, V315, P1735, DOI 10.1001/jama.2016.3775 NR 29 TC 258 Z9 266 U1 4 U2 48 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 0140-6736 EI 1474-547X J9 LANCET JI Lancet PD JAN 6 PY 2018 VL 391 IS 10115 BP 41 EP 50 DI 10.1016/S0140-6736(17)32713-7 PG 10 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA FR9ZB UT WOS:000419432300028 PM 29102362 DA 2023-05-13 ER PT J AU Wang, A Wu, AG Wojdyla, D Lopes, RD Newby, LK Newman, MF Smith, PK Alexander, JH AF Wang, Alice Wu, Angie Wojdyla, Daniel Lopes, Renato D. Newby, L. Kristin Newman, Mark F. Smith, Peter K. Alexander, John H. TI Dual antiplatelet therapy for perioperative myocardial infarction following CABG surgery SO AMERICAN HEART JOURNAL LA English DT Article ID BYPASS GRAFT-SURGERY; CLOPIDOGREL USE; CORONARY; MORTALITY; OUTCOMES; PREDICTORS; MANAGEMENT; EFFICACY; ASPIRIN; IMPACT AB Objectives: Perioperative myocardial infarction (MI) after coronary artery bypass graft surgery (CABG) has been associated with adverse outcome. Whether perioperative MI should be treated with dual antiplatelet therapy (DAPT) is unknown. We compared the effect of DAPT versus aspirin alone on short-term outcomes among patients with perioperative MI following CABG. Methods: We used data from 3 clinical trials that enrolled patients undergoing isolated CABG: PREVENT IV (2002-2003), MEND-CABG II (2004-2005), and RED-CABG (2009-2010) (n = 9117). Perioperative MI was defined as CK-MB >5 times the upper limit of normal within 24 h of surgery (n = 2052). DAPT was defined as DAPT given after surgery and prior to discharge. A Cox regression model was used to assess the association between DAPT and 30-day nonfatal MI, stroke, or mortality after adjustment for baseline covariates. Results: DAPT (n = 527) and aspirin alone (n = 1525) cohorts were similar in baseline comorbidities. Off pump bypass was used in 5.2% (n = 106) of patients. There was no difference in the 30-day composite of death, MI or stroke between patients receiving DAPT versus aspirin alone, nor in any of the individual components. There were fewer all-cause re-hospitalizations at 30 days following surgery among patients in the DAPT group (adjusted HR 0.71, CI 0.52-0.97, P = .033). Conclusion: One-quarter of CABG patients who had perioperative MI were treated with DAPT. DAPT was not associated with a difference in MI, stroke, or mortality at 30 days, but was associated with fewer re-hospitalizations. Further studies are needed to determine the optimal antiplatelet regimen following perioperative MI. What is already known about this subject? Perioperative myocardial infarction portends poor outcome but optimal management is currently unclear. While dual antiplatelet therapy is standard of care for acute coronary syndrome, its role in perioperative myocardial infarction is unknown. What does this study add? Dual antiplatelet therapy use during perioperative myocardial infarction was not associated with a difference in myocardial infarction, stroke or mortality at 30 days. It was, however, associated with fewer re-hospitalizations at 30 days. How might this impact on clinical practice? Dual antiplatelet therapy may be a potential treatment option for perioperative myocardial infarction after CABG surgery. Further studies are needed to better understand treatment for this disease process. (c) 2018 Elsevier Inc. All rights reserved. C1 [Wang, Alice] Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA. [Wu, Angie; Wojdyla, Daniel] Duke Clin Res Inst, Dept Stat, 2400 Pratt St, Durham, NC USA. [Lopes, Renato D.; Newby, L. Kristin; Alexander, John H.] Duke Univ, Med Ctr, Dept Surg, Div Cardiol, Durham, NC 27710 USA. [Newman, Mark F.] Duke Univ, Med Ctr, Dept Anesthesiol, Div Cardiothorac, Durham, NC 27710 USA. [Smith, Peter K.] Duke Univ, Med Ctr, Dept Surg, Div Cardiovasc & Thorac Surg, Durham, NC 27710 USA. C3 Duke University; Duke University; Duke University; Duke University; Duke University RP Wang, A (通讯作者)，2400 Pratt St, Durham, NC 27705 USA. EM Aw100@duke.edu RI Alexander, John/GVS-7271-2022 OI Alexander, John/0000-0002-1444-2462 CR Alexander JH, 2005, JAMA-J AM MED ASSOC, V294, P2446 Alexander JH, 2008, JAMA-J AM MED ASSOC, V299, P1777, DOI 10.1001/jama.299.15.joc80027 Alexiou K, 2012, THORAC CARDIOV SURG, V60, P452, DOI 10.1055/s-0032-1304547 Botto F, 2014, ANESTHESIOLOGY, V120, P564, DOI 10.1097/ALN.0000000000000113 BURNS RJ, 1989, AM J CARDIOL, V63, P1429, DOI 10.1016/0002-9149(89)90002-7 Cannon CP, 2001, J AM COLL CARDIOL, V38, P2114, DOI 10.1016/S0735-1097(01)01702-8 Costa MA, 2001, CIRCULATION, V104, P2689, DOI 10.1161/hc4701.099789 Davierwala PM, 2013, CIRCULATION, V128, pS226, DOI 10.1161/CIRCULATIONAHA.112.000347 de Leon N, 2012, ANN PHARMACOTHER, V46, P678, DOI 10.1345/aph.1Q692 Deo SV, 2013, J CARDIAC SURG, V28, P109, DOI 10.1111/jocs.12074 Domanski MJ, 2011, JAMA-J AM MED ASSOC, V305, P585, DOI 10.1001/jama.2011.99 Ebrahimi R, 2014, ANN THORAC SURG, V97, P15, DOI 10.1016/j.athoracsur.2013.08.058 Gao CQ, 2009, ANN THORAC SURG, V88, P59, DOI 10.1016/j.athoracsur.2009.04.024 Greaves SC, 1996, AM HEART J, V132, P572, DOI 10.1016/S0002-8703(96)90240-9 Klatte K, 2001, J AM COLL CARDIOL, V38, P1070, DOI 10.1016/S0735-1097(01)01481-4 Levine GN, 2016, J AM COLL CARDIOL, V68, P1082, DOI 10.1016/j.jacc.2016.03.513 Newman MF, 2012, JAMA-J AM MED ASSOC, V308, P157, DOI 10.1001/jama.2012.7633 Prates PRL, 2016, BRAZ J CARDIOVA SURG, V31, P106, DOI 10.5935/1678-9741.20160019 Ramsay J, 2005, J THORAC CARDIOV SUR, V129, P300, DOI 10.1016/j.jtcvs.2004.06.005 Thygesen K, 2010, EUR HEART J, V31, P2197, DOI 10.1093/eurheartj/ehq251 Williams JB, 2013, J THROMB THROMBOLYS, V36, P384, DOI 10.1007/s11239-013-0904-1 Yau JM, 2008, AM J CARDIOL, V102, P546, DOI 10.1016/j.amjcard.2008.04.069 NR 22 TC 0 Z9 1 U1 1 U2 1 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 MAY PY 2018 VL 199 BP 150 EP 155 DI 10.1016/j.ahj.2018.02.006 PG 6 WC Cardiac & Cardiovascular Systems WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA GF7YC UT WOS:000432183300021 PM 29754654 DA 2023-05-13 ER PT J AU Czerniuk, MR Surma, S Romanczyk, M Nowak, JM Wojtowicz, A Filipiak, KJ AF Czerniuk, Maciej R. Surma, Stanislaw Romanczyk, Monika Nowak, Jacek M. Wojtowicz, Andrzej Filipiak, Krzysztof J. TI Unexpected Relationships: Periodontal Diseases: Atherosclerosis-Plaque Destabilization? From the Teeth to a Coronary Event SO BIOLOGY-BASEL LA English DT Article DE periodontal disease; atherosclerosis; atherosclerotic cardiovascular disease; acute coronary syndrome ID PORPHYROMONAS-GINGIVALIS LIPOPOLYSACCHARIDE; PERIPHERAL ARTERIAL-DISEASE; CARDIOVASCULAR-DISEASE; RISK-FACTORS; AGGREGATIBACTER-ACTINOMYCETEMCOMITANS; ACCELERATES ATHEROSCLEROSIS; MYOCARDIAL-INFARCTION; PLATELET ACTIVATION; GLOBAL BURDEN; ASSOCIATION AB Simple Summary Periodontal disease and atherosclerotic cardiovascular disease are very common around the world. Coronary artery disease is the leading cause of death. The main factor involved in the pathogenesis of atherosclerosis is inflammation. Therefore, a number of studies have indicated that periodontal disease (causes chronic inflammation) is a risk factor for the progression of atherosclerosis. The presence of periodontal pathogens has been found in human atherosclerotic plaques. A number of pathomechanisms have been demonstrated, thanks to which periodontal pathogens, especially Porphyromonas gingivalis, can directly increase the progression of atherosclerosis and the risk of cardiovascular disease. Observational studies found that patients with periodontal disease were at higher risk of developing atherosclerotic cardiovascular disease. Moreover, periodontal treatment leads to a reduction in cardiovascular risk therefore taking care of oral hygiene should be an important cardiovascular disease preventive measure. Atherosclerotic cardiovascular disease (ASCVD) and periodontal disease (PD) are global health problems. High frequency of ASCVD is associated with the spread of many risk factors, including poor diet, sedentary lifestyle, diabetes, hyperlipidemia, obesity, smoking, hypertension, chronic kidney disease, hypertension, hyperhomocysteinemia, hyperuricemia, excessive stress, virus infection, genetic predisposition, etc. The pathogenesis of ASCVD is complex, while inflammation plays an important role. PD is a chronic, multifactorial inflammatory disease caused by dysbiosis of the oral microbiota, causing the progressive destruction of the bone and periodontal tissues surrounding the teeth. The main etiological factor of PD is the bacteria, which are capable of activating the immune response of the host inducing an inflammatory response. PD is associated with a mixed microbiota, with the evident predominance of anaerobic bacteria and microaerophilic. The "red complex" is an aggregate of three oral bacteria: Tannerella forsythia Treponema denticola and Porphyromonas gingivalis responsible for severe clinical manifestation of PD. ASCVD and PD share a number of risk factors, and it is difficult to establish a causal relationship between these diseases. The influence of PD on ASCVD should be treated as a factor increasing the risk of atherosclerotic plaque destabilization and cardiovascular events. The results of observational studies indicate that PD significantly increases the risk of ASCVD. In interventional studies, PD treatment was found to have a beneficial effect in the prevention and control of ASCVD. This comprehensive review summarizes the current knowledge of the relationship between PD and ASCVD. C1 [Czerniuk, Maciej R.; Nowak, Jacek M.; Wojtowicz, Andrzej] Med Univ Warsaw, Dept Dent Surg, PL-02091 Warsaw, Poland. [Surma, Stanislaw; Romanczyk, Monika] Med Univ Silesia, Fac Med Sci Katowice, PL-40752 Katowice, Poland. [Filipiak, Krzysztof J.] Maria Sklodowska Curie Med Acad, Dept Clin Sci, PL-03411 Warsaw, Poland. C3 Medical University of Warsaw; Medical University Silesia RP Surma, S (通讯作者)，Med Univ Silesia, Fac Med Sci Katowice, PL-40752 Katowice, Poland. 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Suppl 1, P34 Zeng XT, 2016, INT J CARDIOL, V203, P1044, DOI 10.1016/j.ijcard.2015.11.092 Zhan YL, 2016, J LEUKOCYTE BIOL, V100, P1155, DOI 10.1189/jlb.4A1115-526RR Zhang B, 2013, BMC GENOMICS, V14, DOI 10.1186/1471-2164-14-770 Zhang T, 2010, FEMS IMMUNOL MED MIC, V59, P143, DOI 10.1111/j.1574-695X.2010.00674.x Zhou MC, 2022, GENES-BASEL, V13, DOI 10.3390/genes13010013 Zhou QB, 2017, J PERIODONTOL, V88, P711, DOI 10.1902/jop.2017.160447 NR 161 TC 8 Z9 10 U1 2 U2 6 PU MDPI PI BASEL PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND EI 2079-7737 J9 BIOLOGY-BASEL JI Biology-Basel PD FEB PY 2022 VL 11 IS 2 AR 272 DI 10.3390/biology11020272 PG 20 WC Biology WE Science Citation Index Expanded (SCI-EXPANDED) SC Life Sciences & Biomedicine - Other Topics GA ZR4JS UT WOS:000767752000001 PM 35205138 OA Green Published, gold DA 2023-05-13 ER PT J AU McDonald, N Little, N Grierson, R Weldon, E AF McDonald, Neil Little, Nicola Grierson, Rob Weldon, Erin TI Sex and Gender Equity in Prehospital Electrocardiogram Acquisition SO PREHOSPITAL AND DISASTER MEDICINE LA English DT Article DE 12-lead ECG; acute coronary syndrome; Emergency Medical Services; gender equity; sex ID MYOCARDIAL-INFARCTION; YOUNG-PATIENTS; 12-LEAD ECG; CHEST-PAIN; MANAGEMENT; SYMPTOMS; OUTCOMES; CARE; NATIONWIDE; MORTALITY AB Introduction: Research in cardiac care has identified significant gender-based differences across many outcomes. Women with heart disease are less likely both to be diagnosed and to receive standard care. Gender-based disparities in the prehospital setting are under-researched, but they were found to exist within rates of 12-lead electrocardiogram (ECG) acquisition within one urban Emergency Medical Services (EMS) agency. Study Objective: This study evaluates the quality improvement (QI) initiative that was implemented in that agency to raise overall rates of 12-lead ECG acquisition and reduce the gap in acquisition rates between men and women. Methods: This QI project included two interventions: revised indications for 12-lead acquisition, and training that highlighted sex- and gender-based differences relevant to patient care. To evaluate this project, a retrospective database review identified all patient contacts that potentially involved cardiac assessment over 18 months. The primary outcome was the rate of 12-lead acquisition among patients with qualifying complaints. This was assessed by mean rates of acquisition in before and after periods, as well as segmented regression in an interrupted time series. Secondary outcomes included differences in rates of 12-lead acquisition, both overall and in individual complaint categories, each compared between men/women and before/after the interventions. Results: Among patients with qualifying complaints, the mean rate of 12-lead acquisition in the lead-in period was 22.5% (95% CI, 21.8% - 23.2%) with no discernible trend. The protocol change and training were each associated with a significant absolute level increase in the acquisition rate: 2.09% (95% CI, 0.21% - 4.0%; P = .03) and 3.2% (95% CI, 1.18% - 5.22%; P = .003), respectively. When compared by gender and time period, women received fewer 12-leads than men overall, and more 12-leads were acquired after the interventions than before. There were also significant interactions between gender and period, both overall (2.8%; 95% CI, 1.9% - 3.6%; P < .0001) and in all complaint categories except falls and heart problems. Conclusion: This QI project resulted in an increase in 12-leads acquired. Pre-existing gaps in rates of acquisition between men and women were reduced but did not disappear. On-going research is examining the reasons behind these differences from the perspective of prehospital providers. C1 [McDonald, Neil; Little, Nicola; Grierson, Rob; Weldon, Erin] Winnipeg Fire Paramed Serv, 2546 McPhillips St, Winnipeg, MB R2P 2T2, Canada. [McDonald, Neil] Univ Manitoba, Appl Hlth Sci, Winnipeg, MB, Canada. [Grierson, Rob; Weldon, Erin] Univ Manitoba, Dept Emergency Med, Winnipeg, MB, Canada. [Grierson, Rob] Shared Hlth Manitoba Emergency Response Serv, Winnipeg, MB, Canada. C3 University of Manitoba; University of Manitoba RP McDonald, N (通讯作者)，Winnipeg Fire Paramed Serv, 2546 McPhillips St, Winnipeg, MB R2P 2T2, Canada. 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PD APR PY 2022 VL 37 IS 2 BP 164 EP 170 AR PII S1049023X2200036X DI 10.1017/S1049023X2200036X EA MAR 2022 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA ZY3IU UT WOS:000767043200001 PM 35260220 OA hybrid, Green Published DA 2023-05-13 ER PT J AU Navas, A Guzman, B Hassan, A Borawski, JB Harrison, D Manandhar, P Erkanli, A Limkakeng, AT AF Navas, Angelo Guzman, Billy Hassan, Almujtaba Borawski, Joseph B. Harrison, Dean Manandhar, Pratik Erkanli, Alaatin Limkakeng, Alexander T., Jr. TI Untapped Potential for Emergency Department Observation Unit Use: A National Hospital Ambulatory Medical Care Survey (NHAMCS) Study SO WESTERN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID CHEST-PAIN; SERVICES; HISTORY AB Introduction: Millions of people present to the emergency department (ED) with chest pain annually. Accurate and timely risk stratification is important to identify potentially life-threatening conditions such as acute coronary syndrome (ACS). An ED-based observation unit can be used to rapidly evaluate patients and reduce ED crowding, but the practice is not universal. We estimated the number of current hospital admissions in the United States (US) eligible for ED-based observation services for patients with symptoms of ACS. Methods: In this cross-sectional analysis we used data from the 2011-2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). Visits were included if patients presented with symptoms of ACS (eg, chest pain, dyspnea), had an electrocardiogram (ECG) and cardiac markers, and were admitted to the hospital. We excluded patients with any of the following: discharge diagnosis of myocardial infarction; cardiac arrest; congestive heart failure, or unstable angina; admission to an intensive care unit; hospital length of stay > 2 days; alteplase administration, central venous catheter insertion, cardiopulmonary resuscitation or endotracheal intubation; or admission after an initial ED observation stay. We extracted data on sociodemographics, hospital characteristics, triage level, disposition from the ED, and year of ED extracted from the NHAMCS. Descriptive statistics were performed using sampling weights to produce national estimates of ED visits. We provide medians with interquartile ranges for continuous variables and percentages with 95% confidence intervals for categorical variables. Results: During 2011-2015 there were an estimated 675,883,000 ED visits in the US. Of these, 14,353,000 patients with symptoms of ACS and an ED order for an ECG or cardiac markers were admitted to the hospital. We identified 1,883,000 visits that were amenable to ED observation services, where 987,000 (52.4%) were male patients, and 1,318,000 (70%) were White. Further-more, 739,000 (39.2%) and 234,000 (12.4%) were paid for by Medicare and Medicaid, respectively. The majority (45.1%) of observation-amenable hospitalizations were in the Southern US. Conclusion: Emergency department-based observation unit services for suspected ACS appear to be underused. Over half of potentially observation-amenable admissions were paid for by Medicare and Medicaid. Implementation of ED-based observation units would especially benefit hospitals and patients in the American South. C1 [Navas, Angelo; Guzman, Billy; Borawski, Joseph B.; Harrison, Dean; Limkakeng, Alexander T., Jr.] Duke Univ, Sch Med, Dept Emergency Med, Durham, NC 27710 USA. [Hassan, Almujtaba] King Fahad Armed Forces Hosp, Dept Crit Care Med, Jeddah, Saudi Arabia. [Manandhar, Pratik] Duke Univ, Duke Clin Res Inst, Med Ctr, Durham, NC USA. [Erkanli, Alaatin] Duke Univ, Dept Biostat & Bioinformat, Sch Med, Durham, NC USA. C3 Duke University; King Fahd Armed Forces Hospital; Duke University; Duke University RP Navas, A (通讯作者)，Duke Univ, Sch Med, Dept Emergency Med, Durham, NC 27710 USA. 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J. Emerg. Med. PD MAR PY 2022 VL 23 IS 2 BP 134 EP 140 DI 10.5811/westjem.2021.8.52231 PG 7 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 4L6OA UT WOS:000852748800005 PM 35302444 OA Green Published, gold DA 2023-05-13 ER PT J AU Smulders, KRR Demandt, JPA Vlaar, PJ AF Smulders, Kim R. R. Demandt, Jesse P. A. Vlaar, Pieter J. TI Early risk assessment in patients with suspected NSTE-ACS; a retrospective cohort study SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE Myocardial infarction; Risk score; Triage; EMS; HEART-score; NSTE-ACS; Paramedics; Pre-hospital; Pre-HEART ID CHEST-PAIN PATIENTS; EMERGENCY-DEPARTMENT; TIMI; CARE; VALIDATION; SCORES; HEART AB Introduction: Chest pain is among the most common reasons for Emergency Department (ED) presentation, while most patients should be considered low risk for Acute Coronary Syndrome (ACS). Management of these patients places a significant burden on our health care system. Various risk scores have been developed to facil-itate the triage of patients with chest pain. However, it remains unclear which score performs best in identifying low risk patients, in various settings. The aim of this study was to determine which risk score performs best in ruling out non-ST elevation ACS (NSTE-ACS).Methods: Data was collected from all patients >18 years presenting to the ED between 01 and 01-2019 and 01-07-2019, if they were suspected of NSTE-ACS. Primary endpoint was NSTE-ACS during presentation to the ED or hospitalization, according to the 2020 ESC guidelines. In a secondary analysis we determined the number low -risk patients, at set safety levels of 95% and 98%.Results: A total of 536 patients were included, 192 (35.9%) were admitted to the hospital and NSTE-ACS occurred in 134 of 536 patients (25.0%). When areas under the curve (AUC) were compared, pre-HEART (0.869; CI 0.835-0.903), T-MACS (0.862; CI 0.825-0.898) and HEART (0.850; CI 0.815-0.885) performed best. At a safety level of 98%, the HEART score was the best performing risk score and identified 28.9% of patients as low risk, and missed 0 cases of NSTE-ACS. Followed by the pre-HEART score, which identified 18.3% of all patients as low risk, and missed 0% of NSTE-ACS.Conclusions: The newly developed pre-HEART score is both practical and has accurate diagnostic properties, closely followed by the HEART score, and T-MACS. New pre-hospital risk scores are promising and much needed. Future studies should focus on the usage of pre -hospital scores for triage of patients with chest pain, in order to reduce the burden on emergency health care.(c) 2022 Elsevier Inc. All rights reserved. C1 [Smulders, Kim R. R.; Demandt, Jesse P. A.; Vlaar, Pieter J.] Catharina Hosp, Dept Cardiol, Michelangelolaan 2, NL-5623 Eindhoven, Netherlands. C3 Catharina Hospital RP Vlaar, PJ (通讯作者)，Catharina Hosp, Dept Cardiol, Michelangelolaan 2, NL-5623 Eindhoven, Netherlands. EM Pieter-Jan.Vlaar@Catharinaziekenhuis.nl CR Antman EM, 2000, JAMA-J AM MED ASSOC, V284, P835, DOI 10.1001/jama.284.7.835 Body R, 2017, EMERG MED J, V34, P349, DOI 10.1136/emermed-2016-205983 Cowper PA, 2019, J AM HEART ASSOC, V8, DOI 10.1161/JAHA.118.011322 Forberg JL, 2006, BMC EMERG MED, V6, DOI 10.1186/1471-227X-6-6 Fox KAA, 2006, BMJ-BRIT MED J, V333, P1091, DOI 10.1136/bmj.38985.646481.55 Goncalves PDA, 2005, EUR HEART J, V26, P865, DOI 10.1093/eurheartj/ehi187 Goodacre S, 2005, HEART, V91, P229, DOI 10.1136/hrt.2003.027599 Harskamp RE, 2021, NETH HEART J, V29, P338, DOI 10.1007/s12471-020-01529-4 Hoorweg BBN, 2017, HEART, V103, P1727, DOI 10.1136/heartjnl-2016-310905 Juarez-Orozco LE, 2019, EUR HEART J-CARD IMG, V20, P1198, DOI 10.1093/ehjci/jez054 Kashef Mohammad Amin, 2018, Crit Pathw Cardiol, V17, P1, DOI 10.1097/HPC.0000000000000136 Laureano-Phillips J, 2019, ANN EMERG MED, V74, P187, DOI 10.1016/j.annemergmed.2018.12.010 Leeflang MMG, 2009, J CLIN EPIDEMIOL, V62, P5, DOI 10.1016/j.jclinepi.2008.04.007 Mahler SA, 2015, CIRC-CARDIOVASC QUAL, V8, P195, DOI 10.1161/CIRCOUTCOMES.114.001384 Sagel DC, 2022, EMERG MED J, P814 Sakamoto JT, 2016, INT J CARDIOL, V221, P759, DOI 10.1016/j.ijcard.2016.07.147 Six AJ, 2012, NETH HEART J, V20, P499, DOI 10.1007/s12471-012-0322-6 Stopyra JP, 2020, PREHOSP EMERG CARE, V24, P751, DOI 10.1080/10903127.2020.1721740 Sun Benjamin C, 2016, Crit Pathw Cardiol, V15, P1, DOI 10.1097/HPC.0000000000000066 Than M, 2014, EMERG MED AUSTRALAS, V26, P34, DOI 10.1111/1742-6723.12164 Than M, 2013, INT J CARDIOL, V166, P752, DOI 10.1016/j.ijcard.2012.09.171 Than M, 2012, J AM COLL CARDIOL, V59, P2091, DOI 10.1016/j.jacc.2012.02.035 van Dongen DN, 2021, EUR J CARDIOVASC NUR, V20, P40, DOI 10.1177/1474515120927867 van Dongen DN, 2020, AM J EMERG MED, V38, P1616, DOI 10.1016/j.ajem.2019.158448 NR 24 TC 0 Z9 0 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 OCT PY 2022 VL 60 BP 106 EP 115 DI 10.1016/j.ajem.2022.07.053 EA AUG 2022 PG 10 WC Emergency Medicine WE Science Citation Index Expanded (SCI-EXPANDED) SC Emergency Medicine GA 5Z7ML UT WOS:000880152900019 PM 35939854 DA 2023-05-13 ER PT J AU Alatassi, A Habbal, M Tamim, H Sadat, M Al Qasim, E Arabi, YM AF Alatassi, Abdulaleem Habbal, Mohamad Tamim, Hani Sadat, Musharaf Al Qasim, Eman Arabi, Yaseen M. TI Association between troponin-l levels and outcome in critically ill patients admitted to non-cardiac intensive care unit with high prevalence of cardiovascular risk factors SO BMC ANESTHESIOLOGY LA English DT Article DE Troponin-l; Critical care; ICU; nMortality ID ACUTE CORONARY SYNDROMES; CARDIAC TROPONIN; MYOCARDIAL-INFARCTION; APACHE-II; MORTALITY; DISEASE; ISCHEMIA; NECROSIS; PREDICT; COHORT AB Background: The association of troponin-l levels and outcome in medical-surgical ICU patients has been studied before in populations with low to moderate prevalence of cardiovascular risk factors. The objective in this article is to examine the association of troponin-l levels with hospital mortality in patients with high prevalence of cardiovascular risk factors who were admitted with medical-surgical indications to a non-cardiac intensive care unit. Methods: This was a retrospective study of adult patients admitted to a tertiary medical-surgical ICU between July 2001 and November 2011. Data were extracted from prospectively collected ICU and clinical laboratory databases. Patients were stratified based on the highest troponin-l level in the first 72 h of admission into four groups (Group I < 0.03, Group II = 0.03-0.3, Group III = 0.3-3 and Group IV> 3 ng/mL). Hospital mortality was the primary outcome. To study the association between elevated troponin-l and hospital mortality, we carried out multivariate logistic regression analyses with Group I as a reference group. Results: During the study period, 3368 patients had troponin-l levels measured in the first 72 h, of whom 1293 (38.3%) were diabetic and 1356 (40.2%) were chronically hypertensive. Among the study population, 2719 (81%) had elevated troponin-l levels (0.03 ng/mL and higher). Hospital mortality increased steadily as the troponin-l levels increased. Hospital mortality was 23.4% for Group I, 33.2% for Group II (adjusted odds ratio (aOR) 1.08, 95% confidence interval (CI) 0.84, 1.38), 49.6% for Group III (aOR = 1.64, 95% CI 1.24, 2.17), and 57.4% for Group IV (aOR 1.80, 95% CI 1.30, 2.49). The association of increased mortality with increased troponin level was observed whether patients had underlying advanced heart failure or not. Subgroup analysis showed an increased mortality in patients aged < 50 years, non- diabetics and not on vasopressors. Conclusion: In a population with high prevalence of diabetes and hypertension, elevated troponin-l was freguently observed in medical-surgical critically ill patients, and showed a level-dependent association with hospital mortality. C1 [Alatassi, Abdulaleem; Sadat, Musharaf; Arabi, Yaseen M.] King Saud bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Intens Care Dept, Riyadh, Saudi Arabia. [Habbal, Mohamad] Univ Toronto, Internal Med Dept, Toronto, ON, Canada. [Tamim, Hani] Amer Univ Beirut, Med Ctr, Internal Med Dept, Beirut, Lebanon. [Al Qasim, Eman] King Saud bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Riyadh, Saudi Arabia. C3 King Abdulaziz Medical City; King Saud Bin Abdulaziz University for Health Sciences; King Abdulaziz Medical City - Riyadh; King Abdullah International Medical Research Center (KAIMRC); University of Toronto; American University of Beirut; King Saud Bin Abdulaziz University for Health Sciences RP Arabi, YM (通讯作者)，King Saud bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Intens Care Dept, Riyadh, Saudi Arabia. EM yaseenarabi@yahoo.com RI Arabi, Yaseen/ABF-3316-2020 OI Arabi, Yaseen/0000-0001-5735-6241 CR Alpert JS, 2000, J AM COLL CARDIOL, V36, P959, DOI 10.1016/S0735-1097(00)00804-4 Ammann P, 2004, BMJ-BRIT MED J, V328, P1028, DOI 10.1136/bmj.328.7447.1028 Antman EM, 1996, NEW ENGL J MED, V335, P1342, DOI 10.1056/NEJM199610313351802 Arlati S, 2000, INTENS CARE MED, V26, P31, DOI 10.1007/s001340050008 Baillard C, 2003, INTENS CARE MED, V29, P584, DOI 10.1007/s00134-003-1635-0 Devereaux PJ, 2012, JAMA-J AM MED ASSOC, V307, P2295, DOI 10.1001/jama.2012.5502 El Bcheraoui C, 2014, INT J HYPERTENS, V2014, DOI 10.1155/2014/564679 Hanefeld M, 1996, DIABETOLOGIA, V39, P1577, DOI 10.1007/s001250050617 Heidenreich PA, 2001, J AM COLL CARDIOL, V38, P478, DOI 10.1016/S0735-1097(01)01388-2 Hjortshoj S, 2008, SCAND J CLIN LAB INV, V68, P130, DOI 10.1080/00365510701639418 Jeremias A, 2005, ANN INTERN MED, V142, P786, DOI 10.7326/0003-4819-142-9-200505030-00015 Joffres M, 2013, BMJ OPEN, V3, DOI 10.1136/bmjopen-2013-003423 King DA, 2005, CRIT CARE, V9, pR390, DOI 10.1186/cc3731 KNAUS WA, 1985, CRIT CARE MED, V13, P818, DOI 10.1097/00003246-198510000-00009 Korff S, 2006, HEART, V92, P987, DOI 10.1136/hrt.2005.071282 Landesberg G, 2005, CRIT CARE MED, V33, P1281, DOI 10.1097/01.CCM.0000166607.22550.87 LEMESHOW S, 1993, JAMA-J AM MED ASSOC, V270, P2478, DOI 10.1001/jama.270.20.2478 Lim W, 2010, J CRIT CARE, V25, P322, DOI 10.1016/j.jcrc.2009.07.002 Lim W, 2006, ARCH INTERN MED, V166, P2446, DOI 10.1001/archinte.166.22.2446 Mehta NJ, 2004, INT J CARDIOL, V95, P13, DOI 10.1016/j.ijcard.2003.02.005 Noveanu M, 2009, CURR OPIN CRIT CARE, V15, P377, DOI 10.1097/MCC.0b013e32832e9705 Ohman EM, 1996, NEW ENGL J MED, V335, P1333, DOI 10.1056/NEJM199610313351801 Poe S, 2015, J INVEST MED, V63, P905, DOI 10.1097/JIM.0000000000000239 Shaw JE, 2010, DIABETES RES CLIN PR, V87, P4, DOI 10.1016/j.diabres.2009.10.007 Thygesen K, 2012, CIRCULATION, V126, P2020, DOI 10.1161/CIR.0b013e31826e1058 Tiruvoipati R, 2012, EMERG MED AUSTRALAS, V24, P151, DOI 10.1111/j.1742-6723.2011.01530.x ver Elst KM, 2000, CLIN CHEM, V46, P650 Webb IG, 2015, HEART LUNG CIRC, V24, P142, DOI 10.1016/j.hlc.2014.07.071 Wu TT, 2004, SHOCK, V22, P95, DOI 10.1097/01.shk.0000132484.97424.32 NR 29 TC 11 Z9 11 U1 0 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-2253 J9 BMC ANESTHESIOL JI BMC Anesthesiol. PD MAY 22 PY 2018 VL 18 AR 54 DI 10.1186/s12871-018-0515-7 PG 11 WC Anesthesiology WE Science Citation Index Expanded (SCI-EXPANDED) SC Anesthesiology GA GG6LS UT WOS:000432808700001 PM 29788912 OA Green Published, gold DA 2023-05-13 ER PT J AU Iqbal, K Hasanain, M Ahmed, J Iqbal, A Rathore, SS Monis, A Baig, MD Ul Haq, ZG AF Iqbal, Kinza Hasanain, Muhammad Ahmed, Jawad Iqbal, Ayman Rathore, Sawai Singh Monis, Arysha Baig, Mirza Daniyal Ul Haq, Zain Ghufran TI Association of Motoric Cognitive Risk Syndrome with Cardiovascular and Noncardiovascular Factors: A Systematic Review and Meta-Analysis SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Review DE Motoric cognitive risk syndrome; risk factors; associations; predementia syndrome ID OLDER-ADULTS; ALZHEIMERS-DISEASE; PHYSICAL-ACTIVITY; DEPRESSIVE SYMPTOMS; BRAIN ABNORMALITIES; ARTERIAL STIFFNESS; INCIDENT DEMENTIA; GAIT PERFORMANCE; IMPAIRMENT; POPULATION AB Objectives: Motoric cognitive risk syndrome (MCR) is a recently proposed predementia syndrome characterized by subjective cognitive impairment and slow gait. We aim to assess the cardiovascular and noncardiovascular factors associated with MCR. Design: Systematic review and meta-analysis. Setting and Participants: Studies comparing patients with MCR to those without MCR, and identifying the factors associated with MCR. Methods: We used databases, including PubMed, Cochrane CENTRAL, and Embase, to identify studies evaluating the factors associated with MCR. Mean differences, odds ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) with 95% CIs were calculated using Review Manager. Results: Meta-analysis revealed that all cardiovascular factors, including diabetes (21 studies; OR 1.50, 95% CI 1.37, 1.64), hypertension (21 studies; OR 1.20, 95% CI 1.08, 1.33), stroke (16 studies; OR 2.03, 95% CI 1.70, 2.42), heart disease (7 studies; OR 1.45, 95% CI 1.13,1.86), coronary artery disease (5 studies; OR 1.49, 95% CI 1.16,1.91), smoking (13 studies; OR 1.28, 95% CI 1.04,1.58), and obesity (12 studies; OR 1.34, 95% CI 1.13,1.59) were significantly higher in theMCRthan the non-MCR group. Noncardiovascular factors, including age (22 studies; MD = 1.08, 95% CI 0.55, 1.61), education (8 studies; OR 2.04, 95% CI 1.28, 3.25), depression (17 studies; OR 2.19, 95% CI 1.65, 2.91), prior falls (9 studies; OR 1.45, 95% CI 1.17, 1.80), arthritis (6 studies; OR 1.35, 95% CI 1.07, 1.70), polypharmacy (5 studies; OR 1.65, 95% CI 1.07, 2.54), and sedentary lifestyle (11 studies; OR 2.00, 95% CI 1.59, 2.52), were significantly higher in the MCR than in the non-MCR group. Alcohol consumption (6 studies; OR 0.84, 95% CI 0.72, 0.98), however, favored the MCR over the non-MCR group. Additionally, there was no significant association of MCR with gender (22 studies; OR 1.04, 95% CI 0.94, 1.15) and cancer (3 studies; OR 2.39, 95% CI 0.69, 8.28). MCR was also significantly associated with an increased likelihood of incident dementia (5 studies; HR 2.84, 95% CI 1.77, 4.56; P<.001), incident cognitive impairment [2 studies; adjusted hazard ratio (aHR) 1.76, 95% CI 1.44, 2.15], incident falls (4 studies; RR 1.37, 95% CI 1.17, 1.60), and mortality (2 studies; aHR 1.58, 95% CI 1.35, 1.85). Conclusions and Implications: MCR syndrome was significantly associated with diabetes, hypertension, stroke, obesity, smoking, low education, sedentary lifestyle, and depression. Moreover, MCR significantly increased the risk of incident dementia, cognitive impairment, falls, and mortality. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine. C1 [Iqbal, Kinza; Hasanain, Muhammad; Iqbal, Ayman; Baig, Mirza Daniyal] Dow Univ Hlth Sci, Dow Med Coll, Baba E Urdu Rd, Karachi 74200, Pakistan. [Ahmed, Jawad] Dow Univ Hlth Sci, Dept Internal Med, Karachi, Pakistan. [Rathore, Sawai Singh] Dr Sampurnanand Med Coll, Jodhpur, Rajasthan, India. [Monis, Arysha] Baqai Med Univ, Karachi, Pakistan. [Ul Haq, Zain Ghufran] Ziauddin Univ, Karachi, Pakistan. C3 Dow University of Health Sciences; Dow University of Health Sciences; Baqai Medical University; Ziauddin University RP Iqbal, K (通讯作者)，Dow Univ Hlth Sci, Dow Med Coll, Baba E Urdu Rd, Karachi 74200, Pakistan. 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U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA SN 1525-8610 EI 1538-9375 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD MAY PY 2022 VL 23 IS 5 BP 810 EP 822 DI 10.1016/j.jamda.2021.11.035 EA APR 2022 PG 13 WC Geriatrics & Gerontology WE Science Citation Index Expanded (SCI-EXPANDED) SC Geriatrics & Gerontology GA 2W3UE UT WOS:000824452100013 PM 34973959 DA 2023-05-13 ER PT J AU Pinto, P Rothnie, KJ Lui, K Timmis, A Smeeth, L Quint, JK AF Pinto, Paulo Rothnie, Kieran J. Lui, Kelvin Timmis, Adam Smeeth, Liam Quint, Jennifer K. TI Presentation, management and mortality after a first MI in people with and without asthma: A study using UK MINAP data SO CHRONIC RESPIRATORY DISEASE LA English DT Article DE Asthma; cardiovascular disease; mortality; epidemiology; quality of care; myocardial infarction ID OBSTRUCTIVE PULMONARY-DISEASE; ACUTE MYOCARDIAL-INFARCTION; EXHALED BREATH CONDENSATE; ACUTE CORONARY SYNDROMES; CARDIOVASCULAR-DISEASE; RISK; COPD; OUTCOMES; PREVALENCE; ASSOCIATION AB Asthma has been associated with a higher incidence of myocardial infarction (MI), higher prevalence of MI risk factors and higher burden of cardiovascular diseases. However, detailed associations between the presentation and initial management at the time of MI and post-MI outcomes in people with asthma compared to the general population have not been studied. A total of 300,161 people were identified with a first MI over the period 2003-2013 in the Myocardial Ischaemia National Audit Project database, of whom 8922 (3%) had asthma. Logistic regression was used to compare presentation, in-hospital care, in-hospital and 180-day post-discharge all-cause mortality in people with and without asthma adjusting for demographics and comorbidities, diagnosis on arrival and secondary prevention. People with asthma were more likely to have a delay in their MI diagnosis following an STEMI (ST-elevation myocardial infarction; odds ratio (OR) 1.38, confidence interval CI 1.06-1.79) but not an nSTEMI (non-ST-elevation myocardial infarction; OR 1.04, CI 0.92-1.17) compared to people without asthma and a delay in reperfusion (OR 1.19, CI 1.09-1.30) following an STEMI. They were much less likely to be discharged on a beta blocker following an STEMI or nSTEMI (OR 0.24, CI 0.21-0.28 and OR 0.27, CI 0.24-0.30, respectively). There was no difference in in-hospital or 180-day mortality (OR 0.98, CI 0.59-1.62 and OR 0.99, CI 0.72-1.36) following an STEMI or nSTEMI (OR 0.89, CI 0.47-1.68 and OR 1.05, CI 0.85-1.28). Although people with asthma were more likely to have a delay in diagnosis following an STEMI but not an nSTEMI compared to the general population, were more likely to have a delay in reperfusion therapy and were much less likely to receive beta blockers following an STEMI or nSTEMI, there was no difference in the prescriptions of other secondary prevention medications. None of the differences in presentation or management were associated with an increase in all-cause in-hospital or 180-day mortality in people with asthma compared to the general population. C1 [Pinto, Paulo; Rothnie, Kieran J.; Smeeth, Liam; Quint, Jennifer K.] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, London, England. [Rothnie, Kieran J.; Quint, Jennifer K.] Imperial Coll London, Natl Heart & Lung Inst, Emmanuel Kaye Bldg, London SW3 6LR, England. [Lui, Kelvin] UCL, Fac Life Sci, London, England. [Timmis, Adam] Queen Mary Univ London, Barts NIHR Biomed Res Unit, London, England. C3 University of London; London School of Hygiene & Tropical Medicine; RLUK- Research Libraries UK; Imperial College London; RLUK- Research Libraries UK; University of London; University College London; RLUK- Research Libraries UK; University of London; Queen Mary University London RP Quint, JK (通讯作者)，Imperial Coll London, Natl Heart & Lung Inst, Emmanuel Kaye Bldg, London SW3 6LR, England. EM j.quint@imperial.ac.uk RI quint, jennifer/ABE-3384-2020; Woodward, Mark/D-8492-2015; Smeeth, Liam/X-5862-2018 OI Rothnie, Kieran/0000-0003-4279-1624; Smeeth, Liam/0000-0002-9168-6022; Quint, Jennifer/0000-0003-0149-4869 FU MRC Population Health Scientist Fellowship [G0902135]; Barts; London NIHR Cardiovascular Biomedical Research Unit; NIHR; Wellcome Trust [098504/Z/12/Z]; MRC [MR/L01341X/1] Funding Source: UKRI; Medical Research Council [MR/L01341X/1] Funding Source: researchfish FX The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: JKQ is supported by an MRC Population Health Scientist Fellowship (G0902135) which funded this work. AT is supported by Barts and The London NIHR Cardiovascular Biomedical Research Unit, which is funded by the NIHR. LS is supported by a Wellcome Trust Senior Research Fellowship in Clinical Science (098504/Z/12/Z). 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Dis. PD FEB PY 2018 VL 15 IS 1 BP 60 EP 70 DI 10.1177/1479972317702140 PG 11 WC Respiratory System WE Science Citation Index Expanded (SCI-EXPANDED) SC Respiratory System GA FU9TP UT WOS:000424200300008 PM 28393591 OA Green Submitted, Green Published, gold, Green Accepted DA 2023-05-13 ER PT J AU Ahmadi, M Laumeier, I Ihl, T Steinicke, M Ferse, C Endres, M Grau, A Hastrup, S Poppert, H Palm, F Schoene, M Seifert, CL Kandil, FI Weber, JE von Weitzel-Mudersbach, P Wimmer, MLJ Algra, A Amarenco, P Greving, JP Busse, O Kohler, F Marx, P Audebert, HJ AF Ahmadi, Michael Laumeier, Inga Ihl, Thomas Steinicke, Maureen Ferse, Caroline Endres, Matthias Grau, Armin Hastrup, Sidsel Poppert, Holger Palm, Frederick Schoene, Martin Seifert, Christian L. Kandil, Farid I. Weber, Joachim E. von Weitzel-Mudersbach, Paul Wimmer, Martin L. J. Algra, Ale Amarenco, Pierre Greving, Jacoba P. Busse, Otto Kohler, Friedrich Marx, Peter Audebert, Heinrich J. TI A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial SO LANCET NEUROLOGY LA English DT Article ID MYOCARDIAL-INFARCTION; BLOOD-PRESSURE; INTERVENTION; STRATEGIES; MANAGEMENT; IMPLEMENTATION; RECURRENCE; THERAPY; IMPROVE; PROJECT AB Background Patients with recent stroke or transient ischaemic attack are at high risk for a further vascular event, possibly leading to permanent disability or death. Although evidence-based treatments for secondary prevention are available, many patients do not achieve recommended behavioural modifications and pharmaceutical prevention targets in the long-term. We aimed to investigate whether a support programme for enhanced secondary prevention can reduce the frequency of recurrent vascular events. Methods INSPiRE-TMS was an open-label, multicentre, international randomised controlled trial done at seven German hospitals with acute stroke units and a Danish stroke centre. Patients with non-disabling stroke or transient ischaemic attack within 2 weeks from study enrolment and at least one modifiable risk factor (ie, arterial hypertension, diabetes, atrial fibrillation, or smoking) were induded. Computerised randomisation was used to allocate patients (1:1) either to the support programme in addition to conventional care or to conventional care alone. The support programme used feedback and motivational interviewing strategies with eight outpatient visits over 2 years aiming to improve adherence to secondary prevention targets. The primary outcome was the composite of major vascular events consisting of stroke, acute coronary syndrome, and vascular death, assessed in the intention-to-treat population (all patients who underwent randomisation, did not withdraw study participation, and had at least one follow-up). Outcomes were assessed at annual follow-ups using time-to-first-event analysis. All-cause death was monitored as a safety outcome. This trial is registered with ClinicalTrials.gov , NCT01586702. Findings From Aug 22, 2011, to Oct 30, 2017, we enrolled 2098 patients. Of those, 1048 (50.0%) were randomly assigned to the support programme group and 1050 (50.0%) patients were assigned to the conventional care group. 1030 (98.3%) patients in the support group and 1042 (99.2%) patients in the conventional care group were included in the intention-to-treat analysis. The mean age of analysed participants was 67.4 years and 700 (34%) were women. After a mean follow-up of 3.6 years, the primary outcome of major vascular events had occurred in 163 (15.8%) of 1030 patients of the support programme group and in 175 (16.8%) of 1042 patients of the conventional care group (hazard ratio [HR] 0.92, 95% CI 0.75-1.14). Total major vascular event numbers were 209 for the support programme group and 225 for the conventional care group (incidence rate ratio 0.93, 95% CI 0.77-1.12; p=0.46) and all-cause death occurred in 73 (7.1%) patients in the support programme group and 85 (8.2%) patients in the conventional care group (HR 0.85, 0-62-1.17). More patients in the support programme group achieved secondary prevention targets (eg, in 1-year-follow-up 52% vs 42% [p<0.0001] for blood pressure, 62% vs 54% [p=0 0010]for LDL, 33% vs 19% [p<0 . 0001] for physical activity, and 51% vs 34% [p=0.0010] for smoking cessation). Interpretation Provision of an intensified secondary prevention programme in patients with non-disabling stroke or transient ischaemic attack was associated with improved achievement of secondary prevention targets but did not lead to a significantly lower rate of major vascular events. Further research is needed to investigate the effects of support programmes in selected patients who do not achieve secondary prevention targets soon after discharge. Copyright (C) 2019 Elsevier Ltd. All rights reserved. C1 [Ahmadi, Michael; Laumeier, Inga; Ihl, Thomas; Steinicke, Maureen; Ferse, Caroline; Schoene, Martin; Kandil, Farid I.; Weber, Joachim E.; Marx, Peter; Audebert, Heinrich J.] Charite Univ Med Berlin, Campus Benjamin Franklin, Klin & Hsch Ambulanz Neurol, Berlin, Germany. [Endres, Matthias] Charite Univ Med Berlin, Klin & Hsch Ambulanz Neurol, Berlin, Germany. [Endres, Matthias; Audebert, Heinrich J.] Charite Univ Med Berlin, Ctr Stroke Res Berlin, Berlin, Germany. [Ahmadi, Michael; Endres, Matthias; Weber, Joachim E.] Berlin Inst Hlth, Berlin, Germany. [Endres, Matthias] German Ctr Cardiovasc Res, Berlin, Germany. [Endres, Matthias] German Ctr Neurodegenerat Dis, Berlin, Germany. [Grau, Armin; Palm, Frederick] Klinikum Ludwigshafen, Ludwigshafen, Germany. [Hastrup, Sidsel; Seifert, Christian L.; von Weitzel-Mudersbach, Paul] Aarhus Univ Hosp, Danish Stroke Ctr, Neurol, Aarhus, Denmark. [Poppert, Holger; Seifert, Christian L.] Tech Univ Munich, Klinikum Rechts Isar, Munich, Germany. [Kandil, Farid I.] Univ Med Ctr Hamburg Eppendorf, Inst Computat Neurosci, Hamburg, Germany. [Wimmer, Martin L. J.] Praxis Neurol & Psychiatrie Prinzregentenplatz Mu, Munich, Germany. [Algra, Ale; Greving, Jacoba P.] Univ Med Ctr, Dept Neurol & Neurosurg, Utrecht, Netherlands. [Algra, Ale; Greving, Jacoba P.] Univ Med Ctr, Ctr Utrecht, Utrecht, Netherlands. [Algra, Ale; Greving, Jacoba P.] Univ Utrecht, Utrecht, Netherlands. [Amarenco, Pierre] Univ Paris Diderot, Dept Neurol, Bichat Hosp, Paris, France. [Amarenco, Pierre] Univ Paris Diderot, Stroke Ctr, Bichat Hosp, Paris, France. [Busse, Otto] German Stroke Soc, Berlin, Germany. [Kohler, Friedrich] Charite Univ Med Berlin, Dept Med, Div Cardiol & Angiol, Campus Charite Mitte,Ctr Cardiovasc Telemed, 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; Berlin Institute of Health; German Centre for Cardiovascular Research; Helmholtz Association; German Center for Neurodegenerative Diseases (DZNE); Ludwigshafen Hospital; Aarhus University; Technical University of Munich; University of Hamburg; University Medical Center Hamburg-Eppendorf; Utrecht University; Utrecht University Medical Center; Utrecht University; Utrecht University Medical Center; Utrecht University; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Bichat-Claude Bernard - APHP; UDICE-French Research Universities; Universite Paris Cite; Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Bichat-Claude Bernard - APHP; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin RP Audebert, HJ (通讯作者)，Charite Univ Med Berlin, Dept Neurol, Ctr Stroke Res, D-12200 Berlin, Germany. EM Heinrich.audebert@charite.de RI Steinicke, Frank/AAC-2976-2020; Weber, Joachim/AAL-2799-2020 OI Steinicke, Frank/0000-0001-9879-7414; Weber, Joachim/0000-0002-1666-6021; Audebert, Heinrich J./0000-0002-4785-0366; Endres, Matthias/0000-0001-6520-3720; Poppert, Holger/0000-0003-2189-7681; Kandil, Farid/0000-0003-3071-7902; Koehler, Friedrich/0000-0003-0441-4123; Ahmadi, Michael/0000-0001-5792-4704 FU German Federal Ministry of Education and Research within Center for Stroke Research Berlin; Pfizer; German Stroke Foundation; German Federal Ministry of Education and Research within the grant of the Center for Stroke Research Berlin at the Charite Universitaetsmedizin Berlin FX We thank the German Federal Ministry of Education and Research within the grant of the Center for Stroke Research Berlin, Pfizer, and the German Stroke Foundation for funding the study. The INSPIRE-TMS trial was funded by the German Federal Ministry of Education and Research within the grant of the Center for Stroke Research Berlin at the Charite Universitaetsmedizin Berlin. To finalise the study after the end of the second funding period (2018), both Pfizer and the German Stroke Foundation provided otherwise unrestricted research grants. We thank Gabriele Nieweler, Sabine Wunderlich, Gabriele May, Katrin Hayens, Katrin Haug, Melanie Heigl, Valentin Watermann, and Ramanan Ganeshan (all Charite Berlin), Kristina Eiskjaer Sorensen, Louise Madsen, Niels Hjort, and Noelia Morales (all Aarhus), Susanne Streib (Klinikum Ludwigshafen), and Manuela Tepper (Klinikum Rechts der Isar, Munich) for their high-quality work as prevention assistants or study nurses as well as Frank Hamilton, Bruno-Marcel Mackert (both Vivantes Auguste-Viktoria-Klinikum Berlin), and Darius Nabavi (Vivantes Klinikum Neukolln, Berlin) for supporting the trial by granting access to patients of their departments. We also thank Ulrike Grittner (Charite Berlin) for reviewing the statistical analyses. 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PD JAN PY 2020 VL 19 IS 1 BP 49 EP 60 DI 10.1016/S1474-4422(19)30369-2 PG 12 WC Clinical Neurology WE Science Citation Index Expanded (SCI-EXPANDED) SC Neurosciences & Neurology GA JV3SM UT WOS:000502286000028 PM 31708447 DA 2023-05-13 ER PT J AU Komeyama, S Takagi, K Tsuboi, H Tsuboi, S Morita, Y Yoshida, R Kanzaki, Y Nagai, H Ikai, Y Furui, K Tsuzuki, K Shibata, N Yoshioka, N Yamauchi, R Sugiyama, H Morishima, I AF Komeyama, Shotaro Takagi, Kensuke Tsuboi, Hideyuki Tsuboi, Shigeki Morita, Yasuhiro Yoshida, Ruka Kanzaki, Yasunori Nagai, Hiroaki Ikai, Yoshihiro Furui, Koichi Tsuzuki, Kazuhito Shibata, Naoki Yoshioka, Naoki Yamauchi, Ryota Sugiyama, Hiroki Morishima, Itsuro TI The Early Initiation of Extracorporeal Life Support May Improve the Neurological Outcome in Adults with Cardiac Arrest due to Cardiac Events SO INTERNAL MEDICINE LA English DT Article DE ECLS; cardiac arrest; neurological outcome ID CONVENTIONAL CARDIOPULMONARY-RESUSCITATION; MEMBRANE-OXYGENATION; SURVIVAL; REGISTRY; CARE AB Objective Extracorporeal life support (ECLS) is effective for improving the survival rate of patients with refractory cardiac arrest (rCA). As little data are available regarding the impact of ECLS on a favorable neurological outcome, the predictors of a favorable neurological outcome were evaluated in this study. Methods Between January 2007 and August 2016, we retrospectively recruited patients with rCA caused by cardiac events treated with ECLS in our institute. A favorable neurological outcome was defined as a Glasgow-Pittsburgh cerebral performance category score 1 at discharge. The study endpoint was the clinical outcomes and predictors of favorable neurologic patients at discharge. Results During the study period, 67 patients with CA caused by cardiac events (acute coronary syndrome, 57 patients; idiopathic ventricular fibrillation, 10 patients) were included. Of these, 20 patients (29.9%) were classified into the favorable neurological group. No marked difference was observed in the patient characteristics between those with and without a favorable outcome except for in the time from CA to starting ECLS (ECLS initiation time). A short ECLS initiation time resulted in a favorable outcome (37.8 +/- 28.1 minutes vs. 53.6 +/- 30.7 minutes, p=0.05). The cut-off time of ECLS initiation was 46 minutes, which was prolonged by the temporary return of spontaneous circulation before ECLS [odds ratio (OR), 3.69; 95% confidence interval (CI), 1.34-10.19; p=0.01] and transfer to the angiographic room (OR, 4.07; 95% CI, 1.44-11.53, p=0.008). Conclusion The early initiation of ECLS (within 46 minutes) might be associated with a favorable neurological outcome for patients with rCA caused by cardiac events. C1 [Komeyama, Shotaro; Takagi, Kensuke; Tsuboi, Hideyuki; Morita, Yasuhiro; Yoshida, Ruka; Kanzaki, Yasunori; Nagai, Hiroaki; Ikai, Yoshihiro; Furui, Koichi; Tsuzuki, Kazuhito; Shibata, Naoki; Yoshioka, Naoki; Yamauchi, Ryota; Sugiyama, Hiroki; Morishima, Itsuro] Ogaki Municipal Hosp, Dept Cardiol, Ogaki, Japan. [Tsuboi, Shigeki] Ogaki Municipal Hosp, Dept Emergency, Ogaki, Japan. C3 Ogaki Municipal Hospital; Ogaki Municipal Hospital RP Morishima, I (通讯作者)，Ogaki Municipal Hosp, Dept Cardiol, Ogaki, Japan. EM morishima-i@muc.biglobe.ne.jp RI Shibata, Naoki/AAB-3864-2021 OI Shibata, Naoki/0000-0001-6748-1505 CR Beckmann A, 2011, EUR J CARDIO-THORAC, V40, P676, DOI 10.1016/j.ejcts.2011.05.011 Chen YS, 2008, CRIT CARE MED, V36, P2529, DOI 10.1097/CCM.0b013e318183f491 Chen YS, 2008, LANCET, V372, P554, DOI 10.1016/S0140-6736(08)60958-7 Eisenberg MS, 2001, NEW ENGL J MED, V344, P1304, DOI 10.1056/NEJM200104263441707 Ferrari Markus, 2011, Acute Card Care, V13, P30, DOI 10.3109/17482941.2010.542466 Hajbaghery MA, 2005, RESUSCITATION, V66, P317, DOI 10.1016/j.resuscitation.2005.04.004 Haneya A, 2012, RESUSCITATION, V83, P1331, DOI 10.1016/j.resuscitation.2012.07.009 Hase M, 2005, CIRC J, V69, P1302, DOI 10.1253/circj.69.1302 Kagawa E, 2010, RESUSCITATION, V81, P968, DOI 10.1016/j.resuscitation.2010.03.037 Link MS, 2015, CIRCULATION, V132, pS444, DOI 10.1161/CIR.0000000000000261 Massetti M, 2005, ANN THORAC SURG, V79, P178, DOI 10.1016/j.athoracsur.2004.06.095 Morimura N, 2011, RESUSCITATION, V82, P10, DOI 10.1016/j.resuscitation.2010.08.032 Nagao K, 2010, CIRC J, V74, P77, DOI 10.1253/circj.CJ-09-0502 Peberdy MA, 2003, RESUSCITATION, V58, P297, DOI 10.1016/S0300-9572(03)00215-6 Sakamoto S, 2012, ANN THORAC SURG, V94, P1, DOI 10.1016/j.athoracsur.2012.01.032 Sakamoto T, 2014, RESUSCITATION, V85, P762, DOI 10.1016/j.resuscitation.2014.01.031 Shih CL, 2007, RESUSCITATION, V72, P394, DOI 10.1016/j.resuscitation.2006.07.020 Skrifvars MB, 2012, RESUSCITATION, V83, P728, DOI 10.1016/j.resuscitation.2011.11.036 Thiagarajan RR, 2009, ANN THORAC SURG, V87, P778, DOI 10.1016/j.athoracsur.2008.12.079 2005, ANN THORAC SURG, V79, P178, DOI DOI 10.1016/J.ATHORACSUR.2004.06.095 2013, CLIN RES CARDIOL, V102, P661, DOI DOI 10.1007/S00392-013-0580-3 NR 21 TC 8 Z9 8 U1 0 U2 1 PU JAPAN SOC INTERNAL MEDICINE PI TOKYO PA 34-3 3-CHOME HONGO BUNKYO-KU, TOKYO, 113, JAPAN SN 0918-2918 EI 1349-7235 J9 INTERNAL MED JI Intern. Med. PY 2019 VL 58 IS 10 BP 1391 EP 1397 DI 10.2169/internalmedicine.0864-18 PG 7 WC Medicine, General & Internal WE Science Citation Index Expanded (SCI-EXPANDED) SC General & Internal Medicine GA HY4EZ UT WOS:000468082100004 PM 30713299 OA Green Published, gold DA 2023-05-13 ER PT J AU Berikol, GB Aydin, H Dogan, H AF Berikol, Goksu Bozdereli Aydin, Hakan Dogan, Halil TI Early discharging patients with chest pain using EDACS-ADP and COMPASS-MI risk predictors SO HEART AND VESSELS LA English DT Article DE Acute coronary syndrome; Chest pain; Patient discharge; Troponin I ID EMERGENCY-DEPARTMENT ASSESSMENT; HIGH-SENSITIVITY TROPONIN; SCORE AB Deciding on the early discharge of low-risk patients with chest pain is still controversial in emergency care. Beyond the validated tools for risk assessment, high sensitive troponin levels on admission, whether to take the next serial sampling or when to take are the main issues affecting the unnecessary follow-ups that lead to the emergency crowd. We aimed to investigate the prediction performance of emergency department assessment of chest pain score and accelerated diagnostic protocol (EDACS-ADP) and calculation of MI risk probabilities to manage patients with suspicion of myocardial infarction (COMPASS-MI). We conducted a prospective cross-sectional study that included patients with chest pain followed-up in the emergency department with a serial troponin sampling. We calculated the performance tests of the risk scores after recording the patients' risk factors, chest pain types, troponin levels as defined in the risk assessment tools. Nine hundred eleven patients were included in the study. Thirty-eight patients had significant adverse cardiovascular events (MACE) within 30 days. Patients with a not-low-risk score at EDACS-ADP had a 3.975 (95% CI 2.136-7.396) fold higher risk of MACE than the patients with low-risk EDACS-ADP, and the absolute risk increase was 7.3%. Patients with high-risk late-stage risk in COMPASS-MI had a 3.581 (95% CI 1.660-7.726) fold higher risk of MACE than those with low-risk late-stage risk in COMPASS-MI, and absolute risk increase was 4.6%. We found EDACS-ADP and COMPASS-MI at a late time point (2 h hsTnI) with a high negative predictive value as a risk assessment tool for discharging chest pain patients. C1 [Berikol, Goksu Bozdereli; Aydin, Hakan; Dogan, Halil] Istanbul Bakirkoy Dr Sadi Konuk Training & Res Ho, Dept Emergency Med, Dr Tevfik Saglam Cd 11, TR-34147 Bakirkoy Istanbul, Turkey. C3 Bakirkoy Dr. Sadi Konuk Research & Training Hospital RP Berikol, GB (通讯作者)，Istanbul Bakirkoy Dr Sadi Konuk Training & Res Ho, Dept Emergency Med, Dr Tevfik Saglam Cd 11, TR-34147 Bakirkoy Istanbul, Turkey. EM gokxsu@hotmail.com RI AYDIN, HAKAN/HGD-5307-2022; Doğan, H/AGL-2540-2022; Berikol, Goksu/ABM-3605-2022 OI AYDIN, HAKAN/0000-0003-3195-1805; Doğan, H/0000-0003-4751-030X; CR Antman EM, 2000, JAMA-J AM MED ASSOC, V284, P835, DOI 10.1001/jama.284.7.835 Barnes C, 2021, HEART, V107, P721, DOI 10.1136/heartjnl-2020-317997 Boyle RSJ, 2021, ANN EMERG MED, V77, P433, DOI 10.1016/j.annemergmed.2020.10.020 Carlton EW, 2020, HEART, V106, P1586, DOI 10.1136/heartjnl-2020-316692 Dardas TF, EVALUATION EMERGENCY Gibbs J, 2020, AM HEART J, V227, P1, DOI 10.1016/j.ahj.2020.05.014 Leeflang MMG, 2013, CAN MED ASSOC J, V185, pE537, DOI 10.1503/cmaj.121286 Mokhtari A, 2017, ACAD EMERG MED, V24, P983, DOI 10.1111/acem.13224 Neumann JT, 2019, NEW ENGL J MED, V380, P2529, DOI 10.1056/NEJMoa1803377 Roffi M, 2016, EUR HEART J, V37, P267, DOI 10.1093/eurheartj/ehv320 Shah ASV, 2015, LANCET, V386, P2481, DOI 10.1016/S0140-6736(15)00391-8 Six AJ, 2008, NETH HEART J, V16, P191, DOI 10.1007/BF03086144 Smith LM., 2020, TINTINALLIS EMERGENC, P329 Stoyanov KM, 2020, EUR HEART J-ACUTE CA, V9, P39, DOI 10.1177/2048872619861911 Than M, 2014, EMERG MED AUSTRALAS, V26, P34, DOI 10.1111/1742-6723.12164 NR 15 TC 1 Z9 1 U1 1 U2 1 PU SPRINGER PI NEW YORK PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES SN 0910-8327 EI 1615-2573 J9 HEART VESSELS JI Heart Vessels PD AUG PY 2022 VL 37 IS 8 BP 1316 EP 1325 DI 10.1007/s00380-022-02036-9 EA FEB 2022 PG 10 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease WE Science Citation Index Expanded (SCI-EXPANDED) SC Cardiovascular System & Cardiology GA 2O4IA UT WOS:000752746300002 PM 35133498 OA Green Published, Bronze DA 2023-05-13 ER PT J AU Ferreira, JP Lamiral, Z Bakris, G Mehta, C White, WB Zannad, F AF Ferreira, Joao Pedro Lamiral, Zohra Bakris, George Mehta, Cyrus White, William B. Zannad, Faiez TI Red cell distribution width in patients with diabetes and myocardial infarction: An analysis from the EXAMINE trial SO DIABETES OBESITY & METABOLISM LA English DT Article DE alogliptin; outcomes; red cell distribution width; type 2 diabetes AB Aim To determine the clinical correlates of increased red blood cell distribution width (RDW), its potential mechanistic association with multiple circulating biomarkers, and its prognostic value in patients with type 2 diabetes (T2D) who had a recent acute coronary syndrome. Methods We used time-updated Cox models applied to patients enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial. Results A total of 5380 patients were included, the median age was 61 years and 32% were women. Patients with higher RDW were older, more frequently women, with a longer diabetes duration and increased co-morbidities. An RDW of more than 16.1% (both baseline and time-updated) was independently associated with the study primary composite outcome of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death (time-updated adjusted HR = 1.36, 95% CI = 1.16-1.61, p < .001), all-cause death (time-updated adjusted HR = 2.01, 95% CI = 1.60-2.53, p < .001), as well as mortality from non-cardiovascular causes (time-updated adjusted HR = 2.67, 95% CI = 1.72-4.15, p < .001). RDW had a weak-to-moderate correlation with haemoglobin and circulating markers that reflected inflammation, apoptosis, fibrosis and congestion. Alogliptin did not alter RDW values. Conclusions RDW is a marker of disease severity associated with a multitude of poor outcomes, including both cardiovascular and non-cardiovascular death. RDW correlated modestly with inflammatory, pro-apoptotic, pro-fibrotic and congestion markers, and its levels were not affected by alogliptin during the course of the trial. C1 [Ferreira, Joao Pedro; Lamiral, Zohra; Zannad, Faiez] Univ Lorraine, CHRU Nancy, Ctr Invest Clin Plurithemat, Inserm 1433,Inserm U1116,FCRIN INI CRCT, Nancy, France. [Bakris, George] Univ Chicago Med, Dept Med, Chicago, IL USA. [Mehta, Cyrus] Cytel Inc, Cambridge, MA USA. [White, William B.] Univ Connecticut, Sch Med, Calhoun Cardiol Ctr, Farmington, CT USA. C3 CHU de Nancy; Institut National de la Sante et de la Recherche Medicale (Inserm); Universite de Lorraine; University of Connecticut RP Ferreira, JP; Zannad, F (通讯作者)，CHRU Nancy, Hop Brabois, Inst Lorrain Coeur & Vaisseaux Louis Mathieu, Ctr Invest Clin Module Plurithemat 1433, 4 Rue Morvan, F-54500 Vandoeuvre Les Nancy, France. 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