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Costs Myocardial infarction

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https://www.readbyqxmd.com/read/29784004/positive-impact-of-retrograde-autologous-priming-in-adult-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#1
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#2
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29778317/appropriate-use-of-noninvasive-ischemia-testing-to-guide-revascularization-decision-making-following-acute-st-elevation-myocardial-infarction-in-latin-american-countries-results-from-an-expert-panel-meeting-of-the-international-atomic-energy-agency
#3
I Berrocal, A Peix, F Mut, L J Shaw, G Karthikeyan, E Estrada Lobato, D Paez
Across Latin American and Caribbean countries, cardiovascular disease and especially ischemic heart disease is currently the main cause of death both in men and in women. For most Latin American and Caribbean countries, public and community health efforts aim to define care strategies which are both clinically and cost effective and promote primary and secondary prevention, resulting in improved patient outcomes. The optimal approach to deal with acute events such as ST-elevation myocardial infarction (STEMI) is a matter of controversy; however, there is an expanding role for assessing residual ischemic burden in STEMI patients following primary percutaneous coronary intervention...
May 16, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/29774749/excess-costs-of-non-infectious-comorbidities-among-people-living-with-hiv-estimates-from-denmark-and-sweden
#4
Frida Hjalte, Paul S Calara, Anders Blaxhult, Marie Helleberg, Karoline Wallace, Peter Lindgren
People living with HIV have an increased risk of comorbidities with non-communicable diseases such as cardiovascular disease, chronic kidney disease and osteoporotic fractures, compared to the general population. The burden of these comorbidities is expected to rise as the HIV-infected population ages. This development may require additional health care resources and it is relevant to ascertain the costs associated with these comorbidities. The population attributed risk approach was applied to estimate excess costs associated with the higher rates of comorbidities among HIV patients in Denmark and Sweden compared to their respective general populations...
May 18, 2018: AIDS Care
https://www.readbyqxmd.com/read/29774564/mortality-in-sepsis-comparison-of-outcomes-between-patients-with-demand-ischemia-acute-myocardial-infarction-and-neither-demand-ischemia-nor-acute-myocardial-infarction
#5
Mahek Shah, Soumya Patnaik, Obiora Maludum, Brijesh Patel, Byomesh Tripathi, Manyoo Agarwal, Lohit Garg, Sahil Agrawal, Ulrich P Jorde, Matthew W Martinez
INTRODUCTION: Elevation in cardiac troponins is common among septic patients. We sought to explore outcomes among those admitted with demand ischemia(DI), acute myocardial infarction(AMI) and neither DI nor AMI in sepsis. METHODS: We analyzed data from the 2011-2014 National Inpatient Sample among patients admitted for sepsis. We compared outcomes among sepsis patients with i)DI versus AMI and ii)DI versus neither DI nor AMI using separate propensity matched cohorts...
May 18, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29764686/comparison-of-transcatheter-versus-surgical-aortic-valve-implantation-in-high-risk-patients-a-nationwide-study-in-france
#6
Xavier Armoiry, Jean-François Obadia, Léa Pascal, Stéphanie Polazzi, Antoine Duclos
OBJECTIVE: To compare the clinical outcomes and direct costs at 5 years between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) using real-world evidence. METHODS: We performed a nationwide longitudinal study using data from the French Hospital Information System from 2009 to 2015. We matched, inside hospitals, 2 cohorts of adults who underwent TAVI or SAVR during 2010 on propensity score based on patient characteristics...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29759808/implementation-of-a-clinical-nursing-pathway-for-percutaneous-coronary-intervention-a-prospective-study
#7
Meng Li, Huimin Liu
This study is to evaluate the effect of a clinical nursing pathway (CNP) on the clinical outcomes of the transradial approach for emergency percutaneous coronary intervention (PCI). A total of 118 subjects diagnosed with acute myocardial infarction (AMI) were enrolled in the study. They were randomly divided into a control group receiving conventional nursing and a clinical nursing pathway group. The differences in door-to-balloon time, length of hospital stay, hospitalization cost, postoperative complications, and patient satisfaction with nursing care between the two groups were determined and analyzed statistically...
May 11, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29759512/drug-eluting-stents-versus-bare-metal-stents-in-saphenous-vein-grafts-a-double-blind-randomised-trial
#8
Emmanouil S Brilakis, Robert Edson, Deepak L Bhatt, Steven Goldman, David R Holmes, Sunil V Rao, Kendrick Shunk, Bavana V Rangan, Kreton Mavromatis, Kodangudi Ramanathan, Anthony A Bavry, Santiago Garcia, Faisal Latif, Ehrin Armstrong, Hani Jneid, Todd A Conner, Todd Wagner, Judit Karacsonyi, Lauren Uyeda, Beverly Ventura, Aaron Alsleben, Ying Lu, Mei-Chiung Shih, Subhash Banerjee
BACKGROUND: Few studies have examined the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure compared with bare-metal stents (BMS) in patients undergoing stenting of de-novo SVG lesions. We assessed the risks and benefits of the use of DES versus BMS in de-novo SVG lesions. METHODS: Patients were recruited to our double-blind, randomised controlled trial from 25 US Department of Veterans Affairs centres. Eligible participants were aged at least 18 years and had at least one significant de-novo SVG lesion (50-99% stenosis of a 2·25-4·5 mm diameter SVG) requiring percutaneous coronary intervention with intent to use embolic protection devices...
May 11, 2018: Lancet
https://www.readbyqxmd.com/read/29749130/effects-of-coronary-artery-revascularization-with-a-polymer-free-biolimus-a9-coated-biofreedom-stent-versus-bypass-surgery-before-noncardiac-surgery
#9
Kyu Kim, Choongki Kim, Byeong Keuk Kim, Ji Yong Jang, Ae Young Her, Seunghwan Kim, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang
PURPOSE: The present study aimed to evaluate the efficacy and safety of polymer-free drug-coated BioFreedom stent implantation in comparison to coronary artery bypass graft (CABG) before major noncardiac surgery. MATERIALS AND METHODS: In a multicenter registry, 55 patients required revascularization before major noncardiac surgery that should not be delayed >6 months. Of them, 27 underwent BioFreedom stent implantation and 28 underwent CABG. Primary outcomes included rate of noncardiac surgery, time from revascularization to noncardiac surgery, and occurrence of composite outcomes (all-cause death, myocardial infarction, stent thrombosis, stroke, repeat revascularization, or major bleeding)...
June 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29736894/smoking-cessation-a-comparison-of-two-model-structures
#10
Becky Pennington, Alex Filby, Lesley Owen, Matthew Taylor
BACKGROUND: Most economic evaluations of smoking cessation interventions have used cohort state-transition models. Discrete event simulations (DESs) have been proposed as a superior approach. OBJECTIVE: We developed a state-transition model and a DES using the discretely integrated condition event (DICE) framework and compared the cost-effectiveness results. We performed scenario analysis using the DES to explore the impact of alternative assumptions. METHODS: The models estimated the costs and quality-adjusted life years (QALYs) for the intervention and comparator from the perspective of the UK National Health Service and Personal Social Services over a lifetime horizon...
May 8, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29735299/discontinuation-of-tyrosine-kinase-inhibitor-therapy-in-chronic-myeloid-leukaemia-euro-ski-a-prespecified-interim-analysis-of-a-prospective-multicentre-non-randomised-trial
#11
Susanne Saussele, Johan Richter, Joelle Guilhot, Franz X Gruber, Henrik Hjorth-Hansen, Antonio Almeida, Jeroen J W M Janssen, Jiri Mayer, Perttu Koskenvesa, Panayiotis Panayiotidis, Ulla Olsson-Strömberg, Joaquin Martinez-Lopez, Philippe Rousselot, Hanne Vestergaard, Hans Ehrencrona, Veli Kairisto, Katerina Machová Poláková, Martin C Müller, Satu Mustjoki, Marc G Berger, Alice Fabarius, Wolf-Karsten Hofmann, Andreas Hochhaus, Markus Pfirrmann, Francois-Xavier Mahon
BACKGROUND: Tyrosine kinase inhibitors (TKIs) have improved the survival of patients with chronic myeloid leukaemia. Many patients have deep molecular responses, a prerequisite for TKI therapy discontinuation. We aimed to define precise conditions for stopping treatment. METHODS: In this prospective, non-randomised trial, we enrolled patients with chronic myeloid leukaemia at 61 European centres in 11 countries. Eligible patients had chronic-phase chronic myeloid leukaemia, had received any TKI for at least 3 years (without treatment failure according to European LeukemiaNet [ELN] recommendations), and had a confirmed deep molecular response for at least 1 year...
May 4, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29734199/are-shorter-durations-of-dual-antiplatelet-therapy-acceptable-following-percutaneous-coronary-intervention
#12
Jessica M Lewis, James J Nawarskas
Much debate has centered on whether or not the standard 12 month duration of dual antiplatelet therapy (DAPT) is still necessary post-percutaneous coronary intervention (PCI) given recent improvements in stent technology. The benefits of shorter (3-6 months) durations of DAPT include a potential lower risk for bleeding and less patient drug cost and pill burden. While randomized clinical trials have shown non-inferiority for shorter versus longer DAPT regimens in many regards, some endpoints (e.g. myocardial infarction) may still occur less frequently with longer DAPT regimens, particularly in higher risk populations (e...
May 4, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29731659/meta-analysis-of-the-association-of-the-haptoglobin-genotype-with-cardiovascular-outcomes-and-the-pharmacogenomic-interactions-with-vitamin-e-supplementation
#13
Rabea Asleh, Alexandros Briasoulis, Elliot M Berinstein, Joshua B Wiener, Mohan Palla, Sudhir S Kushwaha, Andrew P Levy
Objectives: The objectives of the study were to compile and summarize the data from all of the clinical trials designed to examine the association between haptoglobin (Hp) genotype and incidence of cardiovascular (CV) events in patients with diabetes mellitus (DM) and to assess the impact of vitamin E treatment on CV outcomes according to the Hp genotype. Background: The Hp genotype could serve as a predictive biomarker to DM patients who may benefit from vitamin E therapy...
2018: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/29731350/the-cost-effectiveness-of-pcsk9-inhibitors-the-australian-healthcare-perspective
#14
Radya Kumar, Andrew Tonkin, Danny Liew, Ella Zomer
BACKGROUND: For patients in whom statins are not tolerated or effective as monotherapy, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) represent a new class of lipid lowering therapies that may reduce low-density lipoprotein cholesterol (LDL-C) levels by up to 50% and lower cardiovascular events. While an important treatment option, the cost-effectiveness of PCSK9i in Australia remains unknown. This study aimed to determine the cost-effectiveness of PCSK9i compared to placebo in the prevention of atherosclerotic cardiovascular disease (CVD)...
April 26, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29724635/mandatory-criteria-for-cardiac-rehabilitation-programs-2018-guidelines-from-the-portuguese-society-of-cardiology
#15
Ana Abreu, Miguel Mendes, Hélder Dores, Conceição Silveira, Paulo Fontes, Madalena Teixeira, Helena Santa Clara, João Morais
Cardiac rehabilitation (CR) is a multidisciplinary process for patients recovering after an acute cardiac event or with chronic cardiovascular disease that reduces mortality and morbidity and improves quality of life. It is considered a cost-effective intervention and is expressly indicated in the guidelines of the major medical societies. In Portugal, only 8% of patients discharged from hospital after myocardial infarction are included in CR programs. In Europe overall, the percentage admitted to CR programs is 30%, while in the USA it is 20-30%...
April 30, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29723207/benefit-risk-and-cost-of-new-oral-anticoagulants-and-warfarin-in-atrial-fibrillation-a-multicriteria-decision-analysis
#16
Jose Mendoza-Sanchez, Federico Silva, Lady Rangel, Linda Jaramillo, Leidy Mendoza, Jenny Garzon, Andrea Quiroga
INTRODUCTION: Warfarin and new oral anticoagulants are effective in reducing stroke in atrial fibrillation; however, the benefits and risks rates in clinical trials show heterogeneity for each anticoagulant, and is unknown the cost influence on a model considering most of the treatment consequences. We designed a benefit-risk and cost assessment of oral anticoagulants. DESIGN: We followed the roadmap proposed by IMI-PROTECT and the considerations of emerged good practice to perform Multi-Criteria Decision Analysis (MCDA)...
2018: PloS One
https://www.readbyqxmd.com/read/29717509/impact-of-delirium-on-patients-hospitalized-for-myocardial-infarction-a-propensity-score-analysis-of-the-national-inpatient-sample
#17
Abdullah Abdullah, George Eigbire, Amr Salama, Abdul Wahab, Mohanad Awadalla, Ryan Hoefen, Richard Alweis
BACKGROUND: Delirium is associated with worse outcomes in critically ill patients. In the subset of patients with myocardial infarction (MI), the impact on clinical outcomes of delirium is not as well elucidated. HYPOTHESIS: Delirium is associated with increased mortality in patients hospitalized for MI METHODS: The study used data from the National Inpatient Sample (NIS) 2012 - 2014, Healthcare Cost and Utilization Project (HCUP). We included discharges associated with the primary diagnosis of MI using the relevant ICD-9-CM codes...
May 1, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29715703/icu-readmission-after-cardiac-surgery-still-a-matter-of-concern
#18
Philipp Kolat, Patricia Guttenberger, Michael Ried, Julia Kapahnke, Assad Haneya, Christof Schmid, Claudius Diez
BACKGROUND:  Despite improvements in diagnostics and perioperative care, readmission to intensive care unit (ICU) after cardiac surgery is still a severe drawback for patients with considerable morbidity, mortality, and costs. Aim of this retrospective analysis was to disentangle independent risk factors for ICU readmission. MATERIAL AND METHODS:  Between 01/2004 and 12/2012, 336 out of 9,555 (3.5%) patients undergoing cardiac surgery at the Department of Cardiothoracic Surgery in Regensburg (Germany) were readmitted to ICU...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29694293/development-of-a-pharmacoeconomic-model-to-demonstrate-the-effect-of-clinical-pharmacist-involvement-in-diabetes-management
#19
Heather Ourth, Jordan Nelson, Patrick Spoutz, Anthony P Morreale
BACKGROUND: A data collection tool was developed and nationally deployed to clinical pharmacists (CPs) working in advanced practice provider roles within the Department of Veterans Affairs to document interventions and associated clinical outcomes. Intervention and short-term clinical outcome data derived from the tool were used to populate a validated clinical outcomes modeling program to predict long-term clinical and economic effects. OBJECTIVE: To predict the long-term effect of CP-provided pharmacotherapy management on outcomes and costs for patients with type 2 diabetes...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29693381/coreactant-free-and-label-free-eletrochemiluminescence-immunosensor-for-copeptin-based-on-luminescent-immuno-gold-nanoassemblys
#20
Zhili Han, Jiangnan Shu, Qiaoshi Jiang, Hua Cui
In this work, the eletrochemiluminescence (ECL) behavior of Cu2+ /cysteine complexes and N-(aminobutyl)-N-(ethylisoluminol) (ABEI) functionalized gold nanoparticles combined with chitosan (Cu2+ -Cys-ABEI-GNPs-CS) were studied by cyclic voltammetry and a double-step potential, which exhibited excellent ECL properties without any coreactant. It was found that the ECL intensity of Cu2+ -Cys-ABEI-GNPs-CS could increase at least one order of magnitude compared with that of Cu2+ -Cys-ABEI-GNPs. Furthermore, a coreactant-free and label-free ECL immunosensor has been established for the determination of early acute myocardial infarction biomarker copeptin based on luminescent immuno-gold nanoassemblys consisting of Cu2+ -Cys-ABEI-GNPs-CS and immuno-gold nanoparticles prepared by connecting copeptin antibody with trisodium citrate stabilized gold nanoparticles...
April 25, 2018: Analytical Chemistry
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