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Costs Myocardial infarction

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https://www.readbyqxmd.com/read/28923845/high-sensitivity-cardiac-troponin-i-as-a-gatekeeper-for-coronary-computed-tomography-angiography-and-stress-testing-in-patients-with-acute-chest-pain
#1
Maros Ferencik, Thomas Mayrhofer, Michael T Lu, Pamela K Woodard, Quynh A Truong, W Frank Peacock, Fabian Bamberg, Benjamin C Sun, Jerome L Fleg, John T Nagurney, James E Udelson, Wolfgang Koenig, James L Januzzi, Udo Hoffmann
BACKGROUND: Most patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) undergo noninvasive cardiac testing with a low diagnostic yield. We determined whether a combination of high-sensitivity cardiac troponin I (hs-cTnI) and cardiovascular risk factors might improve selection of patients for cardiac testing. METHODS: We included patients from the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) I and II trials who presented to the ED with acute chest pain and were referred for cardiac testing...
September 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28914747/appropriate-use-criteria-for-cardiac-computed-tomography-does-computed-tomography-have-incremental-value-in-all-appropriate-use-criteria-categories
#2
Fernanda Erthal, Manuja Premaratne, Yeung Yam, Li Chen, Jasmine Lamba, Marissa Keenan, Tony Haddad, Kishu Pharasi, Saipriya Anand, Rob S Beanlands, Ian G Burwash, Girish Dwivedi, Terrence D Ruddy, Benjamin J W Chow
PURPOSE: Cardiac imaging expenditures have come under scrutiny, and a focus on appropriate use criteria (AUC) has arisen to ensure cost-effective resource utilization. Although AUC has been developed by clinical experts, it has not undergone rigorous quality assurance testing to ensure that inappropriate indications for testing yield little clinical benefit. The objective of the study was to evaluate the potential incremental prognostic value of coronary computed tomographic angiography (CCTA) in the different AUC categories...
September 13, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28902880/cost-and-cost-effectiveness-of-a-school-based-education-program-to-reduce-salt-intake-in-children-and-their-families-in-china
#3
Xian Li, Stephen Jan, Lijing L Yan, Alison Hayes, Yunbo Chu, Haijun Wang, Xiangxian Feng, Wenyi Niu, Feng J He, Jun Ma, Yanbo Han, Graham A MacGregor, Yangfeng Wu
OBJECTIVE: The School-based Education Program to Reduce Salt Intake in Children and Their Families study was a cluster randomized control trial among grade five students in 28 primary schools and their families in Changzhi, China. It achieved a significant effect in lowering systolic blood pressure (SBP) in all family adults by 2.3 mmHg and in elderlies (aged > = 60 years) by 9.5 mmHg. The aim of this study was to assess the cost-effectiveness of this salt reduction program. METHODS: Costs of the intervention were assessed using an ingredients approach to identify resource use...
2017: PloS One
https://www.readbyqxmd.com/read/28899233/differences-in-utility-elicitation-methods-in-cardiovascular-disease-a-systematic-review
#4
Marissa Blieden, Shravanthi R Gandra, Lung-I Cheng, Anna Szatkowski, Peter P Toth
AIMS: Utility values inform estimates of the cost-effectiveness of treatment for cardiovascular disease (CVD), but values can vary depending on the method used. The aim of this systematic literature review (SLR) was to explore how methods of elicitation impact utility values for CVD. MATERIALS AND METHODS: We identified English-language articles in Embase, MEDLINE, and the grey literature published between September 1992 and August 2015 using keywords for 'utilities' and 'stroke,' 'heart failure,' 'myocardial infarction,' or 'angina...
September 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28894554/exploring-the-adaptive-experiences-of-children-with-parents-of-myocardial-infarction-a-qualitative-study
#5
Tahere Hashemifard, Ali Akbar Vaezi, Seyed Saeed Mazloomy, Tahere Kamalikhah, Mehdi Khankolabi, Abbas Andishmand, Mohammad Hossein Baghianimoghadam
BACKGROUND: Cardiovascular diseases are the world's leading cause of mortality. These diseases are rooted in an unhealthy lifestyle. In order to confront this subject, it is essential to identify several risk factors that contribute to heart disease (HD) in people with different attitudes, values, beliefs, expectations and motivations. This study was therefore an attempt to explain the adaptive experiences of children whose parents were involved in myocardial infarction since they were more likely subjected to get the so-called disease...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28891865/opioid-prescription-levels-and-postoperative-outcomes-in-orthopedic-surgery
#6
Crispiana Cozowicz, Ashley Olson, Jashvant Poeran, Eva E Mörwald, Nicole Zubizarreta, Federico P Girardi, Alexander P Hughes, Madhu Mazumdar, Stavros G Memtsoudis
Given the basic need for opioids in the perioperative setting, we investigated associations between opioid prescription levels and postoperative outcomes using population based data of orthopedic surgery patients. We hypothesized that increased opioid amounts would be associated with higher risk for postoperative complications. Data was extracted from the national Premier Perspective database (2006-2013); N=1,035,578 lower joint arthroplasties and N= 220,953 spine fusions. Multilevel multivariable logistic regression models measured associations between opioid dose prescription and postoperative outcomes, studied by quartile of dispensed opioid dose...
September 1, 2017: Pain
https://www.readbyqxmd.com/read/28885386/a-delta-neutrophil-index-for-the-prediction-of-contrast-induced-nephropathy-in-patients-with-st-elevation-myocardial-infarction-followed-by-percutaneous-coronary-intervention
#7
Taeyoung Kong, Yoo Seok Park, Hye Sun Lee, Sinae Kim, Sehee Han, Claire H Eun, Jong Wook Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung
PURPOSE: We assessed the usefulness of the delta neutrophil index (DNI), reflecting immature granulocytes, to stratify risk for developing contrast-induced nephropathy (CIN) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) in a clinical setting. METHODS: This study retrospectively analyzed prospective data of eligible adult patients admitted to the ED with STEMI followed by PCI. We determined DNI at multiple time points and analyzed the development of CIN and in-hospital mortality according to CIN incidence...
September 6, 2017: Shock
https://www.readbyqxmd.com/read/28871571/acute-aortic-dissection-pathogenesis-risk-factors-and-diagnosis
#8
Joanna Gawinecka, Felix Schönrath, Arnold von Eckardstein
Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. Therefore, its prompt and proper diagnosis is vital to increase a patient's chance of survival and to prevent grievous complications. Typical symptoms of acute aortic dissection include severe chest pain, hypotension or syncope and, hence, mimic acute myocardial infarction or pulmonary embolism. Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk...
September 5, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28865979/comparison-of-30-day-readmission-rates-and-risk-factors-between-carotid-artery-stenting-and-endarterectomy
#9
Hanaa Dakour Aridi, Satinderjit Locham, Besma Nejim, Mahmoud B Malas
OBJECTIVE: The aim of this study was to analyze the rates, reasons, and risk factors of 30-day readmission, both planned and unplanned, after carotid revascularization as well as to evaluate major outcomes associated with those readmissions. METHODS: Using the Premier Healthcare database, we retrospectively identified patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) between 2009 and 2015. The primary outcome was 30-day all-cause readmission...
August 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28865892/comparison-of-readmission-rates-after-acute-myocardial-infarction-in-3-patient-age-groups-18-to-44-45-to-64-and-%C3%A2-65-years-in-the-united-states
#10
Rohan Khera, Snigdha Jain, Ambarish Pandey, Vijay Agusala, Dharam J Kumbhani, Sandeep R Das, Jarett D Berry, James A de Lemos, Saket Girotra
Postacute myocardial infarction (AMI) readmissions are common among Medicare beneficiaries (≥65 years) and are associated with significant resource utilization. However, patterns of AMI readmissions for younger age groups in the United States are not known. In the Nationwide Readmissions Database, a nationally representative all-payer database of inpatient hospitalizations, we identified 212,171 index AMI hospitalizations in January to November 2013, weighted to represent 478,247 hospitalizations nationally (mean age 66...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862479/cost-effectiveness-analysis-of-dabigatran-versus-rivaroxaban-for-stroke-prevention-in-patients-with-non-valvular-atrial-fibrillation-using-real-world-evidence-in-elderly-us-medicare-beneficiaries
#11
Siyang Peng, Kristen A Deger, Anastasia Ustyugova, Pranav Gandhi, Nan Qiao, Cheng Wang, Anuraag R Kansal
OBJECTIVE: Dabigatran and rivaroxaban have been approved by the US FDA to reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation (NVAF) patients. Newly published real-world evidence based on the US population found that elderly Medicare patients with NVAF treated with rivaroxaban experienced statistically significant increases in intracranial hemorrhage (ICH) and major extracranial bleeding, and statistically nonsignificant decreases in thromboembolic stroke and acute myocardial infarction (AMI) compared with dabigatran...
September 1, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28860018/comparison-of-in-hospital-outcomes-of-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-obese-body-mass-index%C3%A2-%C3%A2-%C3%A2-30%C3%A2-kg-m2-patients
#12
Tomo Ando, Emmanuel Akintoye, Naveen Trehan, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in obese (body mass index ≥ 30 kg/m(2)) patients are underexplored. Nationwide Inpatient Sample database was queried from 2011 to 2014, and those who underwent TAVI or SAVR with obesity were identified. A complete case analysis with multivariate analysis was performed to adjust for the difference in underlying co-morbidities. We identified a total of 12,525 patients (989 TAVI and 11,536 SAVR)...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28858942/colonoscopy-in-patients-with-postmyocardial-infarction-gastrointestinal-bleeding-a-nationwide-analysis
#13
Rohan M Modi, Feng Li, Khalid Mumtaz, Alice Hinton, Scott M Lilly, Hisham Hussan, Edward Levine, Cheng Zhang, Darwin L Conwell, Somashekar G Krishna, Peter P Stanich
GOALS: The goal of this study was to evaluate outcomes of colonoscopy in the setting of post myocardial infarction (MI) gastrointestinal bleeding (GIB) in a large population-based data set. BACKGROUND: The literature to substantiate the proposed safety of colonoscopy following an acute MI is limited. STUDY: The Nationwide Inpatient Sample (2007 to 2013) was utilized to identify all adult patients (age, 18 y or above) hospitalized with a primary diagnosis of ST-elevation MI and receiving left heart catheterization (STEMI-C)...
August 30, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28857149/seasonality-and-readmission-after-heart-failure-myocardial-infarction-and-pneumonia
#14
Neel M Butala, Eric A Secemsky, Jason H Wasfy, Kevin F Kennedy, Robert W Yeh
OBJECTIVE: To investigate whether hospital readmission after admission for heart failure (HF), myocardial infarction (MI), and pneumonia varies by season. DATA SOURCES: All patients in 2005-2009 Healthcare Cost and Utilization Project State Inpatient Databases for New York and California hospitalized for HF, MI, or pneumonia. STUDY DESIGN: The relationship between discharge season and unplanned readmission within 30 days was evaluated using multivariate modified Poisson regression...
August 31, 2017: Health Services Research
https://www.readbyqxmd.com/read/28854143/biases-in-individualized-cost-effectiveness-analysis-influence-of-choices-in-modeling-short-term-trial-based-mortality-risk-reduction-and-post-trial-life-expectancy
#15
David van Klaveren, John B Wong, David M Kent, Ewout W Steyerberg
BACKGROUND: The benefits and costs of a treatment are typically heterogeneous across individual patients. Randomized clinical trials permit the examination of individualized treatment benefits over the trial horizon but extrapolation to lifetime horizon usually involves combining trial-based individualized estimates of short-term risk reduction with less detailed (less granular) population life tables. However, the underlying assumption of equal post-trial life expectancy for low- and high-risk patients of the same sex and age is unrealistic...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28844989/acute-myocardial-infarction-changes-in-patient-characteristics-management-and-6-month-outcomes-over-a-period-of-20-years-in-the-fast-mi-program-french-registry-of-acute-st-elevation-or-non-st-elevation-myocardial-infarction-1995-to-2015
#16
Etienne Puymirat, Tabassome Simon, Guillaume Cayla, Yves Cottin, Meyer Elbaz, Pierre Coste, Gilles Lemesle, Pascal Motreff, Batric Popovic, Khalife Khalife, Jean Noel Labeque, Thibault Perret, Christophe Le Ray, Laurent Orion, Bernard Jouve, Didier Blanchard, Patrick Peycher, Johanne Silvain, P Gabriel Steg, Patrick Goldstein, Pascal J Gueret, Loic Belle, Nadia Aissaoui, Jean Ferrières, Francois Schiele, Nicolas Danchin
Background -ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI) management has evolved considerably over the past 2 decades. Little information on mortality trends in the most recent years is available. We assessed trends in characteristics, treatments, and outcomes for acute myocardial infarction in France between 1995 and 2015. Methods - We used data from 5 one-month registries, conducted 5 years apart, from 1995 to 2015, including 14 423 patients with acute myocardial infarction (59% STEMI) admitted to cardiac intensive care units in metropolitan France...
August 27, 2017: Circulation
https://www.readbyqxmd.com/read/28841230/rationale-and-design-of-the-drug-eluting-stents-vs-bare-metal-stents-in-saphenous-vein-graft-angioplasty-diva-trial
#17
Emmanouil S Brilakis, Subhash Banerjee, Robert Edson, Kendrick Shunk, Steven Goldman, David R Holmes, Deepak L Bhatt, Sunil V Rao, Mark W Smith, Mike Sather, Cindy Colling, Biswajit Kar, Lori Nielsen, Todd Conner, Todd Wagner, Bavana V Rangan, Beverly Ventura, Ying Lu, Mark Holodniy, Mei-Chiung Shih
VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28840587/study-design-and-rationale-for-biomedical-shirt-based-electrocardiography-monitoring-in-relevant-clinical-situations-ecg-shirt-study
#18
Paweł Balsam, Piotr Lodziński, Agata Tymińska, Krzysztof Ozierański, Łukasz Januszkiewicz, Renata Główczyńska, Katarzyna Wesołowska, Michał Peller, Radosław Pietrzak, Tomasz Książczyk, Sonia Borodzicz, Łukasz Kołtowski, Mariusz Borkowski, Bożena Werner, Grzegorz Opolski, Marcin Grabowski
BACKGROUND: Today, the main challenge for researchers is to develop new technologies which may help to improve the diagnoses of cardiovascular disease (CVD), thereby reducing healthcare costs and improving the quality of life for patients. This study aims to show the utility of biomedical shirt-based electrocardiography (ECG) monitoring of patients with CVD in different clinical situations using the Nuubo® ECG (nECG) system. METHODS: An investigator-initiated, multicentre, prospective observational study was carried out in a cardiology (adult and paediatric) and cardiac rehabilitation wards ...
August 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28840515/high-sensitivity-cardiac-troponin-for-the-diagnosis-of-patients-with-acute-coronary-syndromes
#19
REVIEW
Vlad C Vasile, Allan S Jaffe
PURPOSE OF REVIEW: High-sensitivity cardiac troponin (hscTn) assays are replacing the older-generation assays used to detect myocardial injury because they have improved analytical sensitivity and lead to a more rapid diagnosis of acute myocardial infarction (AMI) and enhanced risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). This review focuses on advantages and difficulties of using hscTn as diagnostic and prognostic tools in acute coronary syndromes (ACS)...
August 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28840487/revascularization-strategies-in-stemi-with-multivessel-disease-deciding-on-culprit-versus-complete-ad-hoc-or-staged
#20
REVIEW
Shalin Patel, Steven R Bailey
PURPOSE OF REVIEW: This review will address the clinical conundrum of those who may derive clinical benefit from complete revascularization of coronary stenosis that are discovered at the time of ST segment elevation myocardial infarction (STEMI). The decision to revascularize additional vessels with angiographic stenosis beyond the culprit lesion remains controversial, as does the timing of revascularization. RECENT FINDINGS: STEMI patients represent a high-risk patient population that have up to a 50% prevalence of multivessel disease...
August 24, 2017: Current Cardiology Reports
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