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Elizabeth G King, Alik Farber, Denis Rybin, Gheorghe Doros, Jeffrey A Kalish, Mohammad H Eslami, Jeffrey J Siracuse
INTRODUCTION: One of the main advantages of endovascular abdominal aortic aneurysm repair (EVAR) is shorter post-operative hospital length of stay (LOS) compared to open repair. However, patients with pre-existing conditions may be predisposed to a protracted LOS. Our aim was to identify pre-operative risk factors for prolonged post-operative LOS after elective EVAR. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2005-2013) was used to analyze all patients undergoing elective EVAR without adjunctive procedures...
April 4, 2017: Annals of Vascular Surgery
R Williams, F de Vries, W Kothny, C Serban, S Lopez-Leon, C Chu, R Schlienger
This non-interventional, multi-database, analytical cohort study assessed the cardiovascular (CV) safety of vildagliptin vs. other non-insulin antidiabetic drugs (NIADs) using real-world data from five European electronic healthcare databases. Patients with type 2 diabetes aged ≥18 years on NIAD treatment were enrolled. Adjusted incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) for the outcomes of interest (myocardial infarction [MI], acute coronary syndrome [ACS], stroke, congestive heart failure [CHF], individually and as a composite) were estimated using negative binomial regression...
March 24, 2017: Diabetes, Obesity & Metabolism
Veli-Pekka Puurunen, Antti Kiviniemi, Samuli Lepojärvi, Olli-Pekka Piira, Pirjo Hedberg, Juhani Junttila, Olavi Ukkola, Heikki Huikuri
INTRODUCTION: Leptin is an adipose tissue-derived hormone associated with cardiovascular risk factors. We examined whether leptin predicts major adverse cardiac events (MACE) in coronary artery disease (CAD) patients. METHODS: Fasting plasma leptin levels were measured in 1327 male and 619 female CAD patients. The patients were followed up for two years. The primary endpoint (MACE) was the composite of a hospitalisation for congestive heart failure (CHF) or a cardiac death...
March 16, 2017: Annals of Medicine
Patrick J Sweigert, Vinod K Bansal, Debra A Hoppensteadt, Jennifer L Saluk, Daneyal A Syed, Jawed Fareed
End-stage renal disease (ESRD) presents a complex syndrome in which inflammatory and metabolic processes contribute to disease progression and development of comorbid conditions. Over $1 trillion is spent globally on ESRD care. Plasma samples collected from 83 ESRD patients prior to hemodialysis were profiled for metabolic and inflammatory biomarker concentrations. Concentrations were compared between groups with and without history of stroke, acute coronary syndrome (ACS), congestive heart failure (CHF), and coronary artery disease (CAD)...
March 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
P J Chung, J S Lee, S Tam, A Schwartzman, M O Bernstein, L Dresner, A Alfonso, G Sugiyama
PURPOSE: Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. METHODS: A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous...
September 16, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Xiaohui Li, Xing Wu, Hongwei Li, Hui Chen, Yongliang Wang, Weiping Li, Xiaosong Ding, Xu Hong
BACKGROUND: Few clinical studies have assessed Rho kinase (ROCK) in patients with dia-betes mellitus (DM) and ST-segment elevation myocardial infarction (STEMI). This study aimed to determine whether ROCK activity in circulating leukocytes is increased in STEMI patients with DM and whether ROCK activity predicts the onset of cardiovascular events. METHODS: Blood samples were collected from 60 STEMI patients, divided into non-diabetes mellitus (NDM) and DM groups...
2016: Cardiology Journal
Faisal Aziz, Andrew Azab, Eric Schaefer, Amy B Reed
BACKGROUND: Acute renal failure (ARF) after surgical treatment of ruptured abdominal aortic aneurysm (AAA) is an independent predictor of post-operative mortality. Open repair for ruptured AAA has been the gold standard treatment; however, there has been a recent trend in increased utilization of endovascular repair (EVAR) for treatment of ruptured AAA. The purpose of this study was to retrospectively review and compare the incidence of ARF among patients treated with open versus endovascular repair of ruptured AAA...
August 2016: Annals of Vascular Surgery
Asha M Zimmerman, Jayson Marwaha, Hector Nunez, David Harrington, Daithi Heffernan, Sean Monaghan, Charles Adams, Andrew Stephen
BACKGROUND: Recent studies have linked postoperative serum troponin elevation to mortality in a range of different clinical scenarios. To date, there has been no investigation into the significance of preoperative troponin elevation in emergency general surgery (EGS) patients. We define this as preoperative myocardial injury (PMI). We hypothesize that PMI seen in EGS patients may predict postoperative morbidity and mortality. STUDY DESIGN: Using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database, we performed a retrospective review of all EGS cases between 2008 and 2014...
August 2016: Journal of the American College of Surgeons
Florence E Turrentine, Min-Woong Sohn, Rayford Scott Jones
BACKGROUND: Congestive heart failure (CHF) predicts surgical morbidity and mortality. However, few studies evaluate CHF's impact on noncardiac operations. Because of CHFs serious threat to health and survival, surgeons must understand risks CHF poses to patients undergoing a diverse array of operations. STUDY DESIGN: We used 2009 to 2013 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use Files to estimate the risk of serious morbidity, reoperation, readmission, mortality, and other postoperative complications associated with preoperative diagnosis of CHF...
June 2016: Journal of the American College of Surgeons
Toms Augustin, Eric Schneider, Diya Alaedeen, Matthew Kroh, Ali Aminian, David Reznick, Matthew Walsh, Stacy Brethauer
AIM: Patients undergoing emergency surgery for paraesophageal hernia (PEH) repair have a higher adjusted mortality risk based on Nationwide Inpatient Sample (NIS). We sought to examine this relationship in the National Surgical Quality Improvement Program (NSQIP), which adjusts for patient-level risk factors, including factors contributing to patient frailty. METHODS: This is a retrospective analysis of the NSQIP from 2009 through 2011. A modified frailty index was created based on previously validated methodology...
December 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jason C Simeone, Cliff Molife, Elizabeth Marrett, Feride Frech-Tamas, Mark B Effron, Beth L Nordstrom, Yajun E Zhu, Stuart Keller, Brian R Murphy, Kavita V Nair, George W Vetrovec, Robert L Page, Patrick L McCollam
OBJECTIVE: Our objective was to compare 1-year real-world healthcare resource utilization (HRU), associated charges, and antiplatelet treatment patterns among patients with acute coronary syndrome (ACS) managed with percutaneous coronary intervention (PCI) and treated with ticagrelor or prasugrel. METHODS: Using the ProMetis-Lx database, adult ACS-PCI patients treated with ticagrelor or prasugrel post-discharge were identified between 1 August 2011 and 31 May 2013 and propensity matched to adjust for baseline differences...
October 2015: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Clare L Atzema, Saba Khan, Hong Lu, Yvon E Allard, Storm J Russell, Mario R Gravelle, Julie Klein-Geltink, Peter C Austin
BACKGROUND: The burden of cardiovascular disease in the Métis, Canada's fastest growing Aboriginal group, is not well studied. We determined rates of five cardiovascular diseases and associated outcomes in Ontario Métis, compared to the general Ontario population. METHODS: Métis persons were identified using the Métis Nation of Ontario Citizenship Registry. Métis citizens aged 20-105 were linked to Ontario health databases for the period of April 2006 to March 2011...
2015: PloS One
Kurt Bestehorn, Timm Bauer, Eckart Fleck, Maike Bestehorn, Jürgen Pauletzki, Christian Hamm
OBJECTIVES: Evaluation of the classification of the patients with coronary procedures [CP: coronary angiography (CA) and/or percutaneous coronary intervention (PCI)] in Germany to provide valid data as a basis for the evaluation of resource planning and comparison of results from other countries. BACKGROUND: In the case of CP, most data are restricted to procedures related to acute coronary syndrome (ACS), either STEMI or NSTEMI, and does not cover the whole range of coronary angiographies and therapeutic procedures...
July 2015: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Vasanth Sathiyakumar, Sarah E Greenberg, Cesar S Molina, Rachel V Thakore, William T Obremskey, Manish K Sethi
INTRODUCTION: Hip fractures are one of the most common types of orthopaedic injury with high rates of morbidity. Currently, no study has compared risk factors and adverse events following the different types of hip fracture surgeries. The purpose of this paper is to investigate the major and minor adverse events and risk factors for complication development associated with five common surgeries for the treatment of hip fractures using the NSQIP database. METHODS: Using the ACS-NSQIP database, complications for five forms of hip surgeries were selected and categorized into major and minor adverse events...
April 2015: Injury
Garth Graham
This is a comprehensive narrative review of the literature on the current science and evidence of population-level differences in risk factors for heart disease among different racial and ethnic population in the United States (U.S.). It begins by discussing the importance of population-level risk assessment of heart disease in light of the growth rate of specific minority populations in the U.S. It describes the population-level dynamics for racial and ethnic minorities: a higher overall prevalence of risk factors for coronary artery disease that are unrecognized and therefore not treated, which increases their likelihood of experiencing adverse outcome and, therefore, potentially higher morbidity and mortality...
2015: Current Cardiology Reviews
David A McAllister, Nynke Halbesma, Kathryn Carruthers, Martin Denvir, Keith A Fox
BACKGROUND: Congestive heart failure (CHF) is a common and preventable complication of acute coronary syndrome (ACS). Nevertheless, ACS risk scores have not been shown to predict CHF risk. We investigated whether the at-discharge Global Registry of Acute Coronary Events (GRACE) score predicts heart failure admission following ACS. METHODS AND RESULTS: Five-year mortality and hospitalization data were obtained for patients admitted with ACS from June 1999 to September 2009 to a single centre of the GRACE registry...
April 2015: European Heart Journal. Acute Cardiovascular Care
William J French
For physicians who see and treat patients who present with AFib in routine clinical practice there are 4 important factors to understand and bear in mind when diagnosing and planning treatment strategies: age, gender, prior or incident heart failure, and underlying coronary artery disease (CAD) and acute coronary syndrome (ACS). (online video available at: This review addresses the clinical characteristics of each of these presentations in order...
April 2014: American Journal of Medicine
Ravi B Patel, Eric A Secemsky
This article provides a brief overview of the clinical presentation, laboratory and radiologic features, and basic management principles in patients with congestive heart failure (CHF) and acute coronary syndromes (ACS). CHF is a clinical syndrome that typically results in symptoms of congestion and hypoperfusion. A thorough physical examination complemented by cardiac biomarkers and imaging are essential in making the diagnosis. Medical and device therapies for CHF target improvement in survival as well as control of symptoms...
March 2014: Clinics in Laboratory Medicine
G Horstick
Mortality is increased in acute coronary syndrome (ACS) related to the extent of myocardial injury even if percutaneous coronary intervention (PCI) was successful. The development of congestive heart failure (CHF) after PCI in ACS is of prognostic interest. Non-invasive imaging plays a major role for determination of structural myocardial damage and loss of function. Secondary prevention regarding pharmacologic and non-pharmacologic therapy is dependent on myocardial function and the presence or absence of CHF...
January 2014: Deutsche Medizinische Wochenschrift
David Gasche, Tanja Ulle, Bernhard Meier, Roger-Axel Greiner
QUESTION UNDER STUDY: The aim of this study was to evaluate the cost-effectiveness of ticagrelor and generic clopidogrel as add-on therapy to acetylsalicylic acid (ASA) in patients with acute coronary syndrome (ACS), from a Swiss perspective. METHODS: Based on the PLATelet inhibition and patient Outcomes (PLATO) trial, one-year mean healthcare costs per patient treated with ticagrelor or generic clopidogrel were analysed from a payer perspective in 2011. A two-part decision-analytic model estimated treatment costs, quality-adjusted life years (QALYs), life years and the cost-effectiveness of ticagrelor and generic clopidogrel in patients with ACS up to a lifetime at a discount of 2...
2013: Swiss Medical Weekly
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