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Myocardial infarction utilization

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https://www.readbyqxmd.com/read/28916174/evaluation-of-beat-to-beat-ventricular-repolarization-lability-from-standard-12-lead-ecg-during-acute-myocardial-ischemia
#1
Salah S Al-Zaiti, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, David Mortara, Jan Nemec
BACKGROUND: Acute myocardial ischemia is a common cause of ventricular arrhythmias, yet recent ECG methods predicting susceptibility to ventricular tachyarrhythmia have not been fully evaluated during spontaneous ischemia. We sought to evaluate the clinical utility of alternans and non-alternans components of repolarization variability from the standard 10-second 12-lead ECG signals to risk stratify patients with acute chest pain. METHODS: We enrolled consecutive, non-traumatic, chest pain patients transported through Emergency Medical Services (EMS) to three tertiary care hospitals with cardiac catheterization lab capabilities in Pittsburgh, PA...
August 10, 2017: Journal of Electrocardiology
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/28913687/non-atherosclerotic-vascular-disease-in-women
#3
REVIEW
Lee Joseph, Esther S H Kim
Takayasu arteritis, fibromuscular dysplasia (FMD), spontaneous arterial dissection, Raynaud's phenomenon, and chilblains are vascular conditions that are associated with an increased predisposition in women and are often underdiagnosed. Takayasu arteritis has an incidence rate of 2.6 cases per million individuals per year in the USA and predominantly affects women of childbearing age. HLA-B5 genetic locus is linked with Takayasu arteritis susceptibility. Methods to determine active disease are limiting; currently utilized clinical and imaging findings and laboratory tests are of limited value for this purpose...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
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/28895038/a-retrospective-external-validation-study-of-the-heart-score-among-patients-presenting-to-the-emergency-department-with-chest-pain
#5
Matthew Jay Streitz, Joshua James Oliver, Jessica Marie Hyams, Richard Michael Wood, Yevgeniy Mikhaylovich Maksimenko, Brit Long, Robert Michael Barnwell, Michael David April
Emergency physicians must be able to effectively prognosticate outcomes for patients presenting to the Emergency Department (ED) with chest pain. The HEART score offers a prognostication tool, but external validation studies are limited. We conducted an external retrospective validation study of the HEART score among ED patients presenting to our ED with chest pain from 1 January 2014 to 9 June 2014. We utilized chart review methodology to abstract data from each patient's electronic medical record. We collected data relevant to each of the five elements of the HEART score: history, electrocardiogram (ECG) interpretation, patient age, patient risk factors, and troponin levels...
September 11, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28890062/national-utilization-and-outcomes-of-redo-lower-extremity-bypass-vs-endovascular-intervention-after-previous-failed-bypass-redo-lower-extremity-bypass-superior-to-endovascular-intervention
#6
J Hunter Mehaffey, Alexander Shannon, Robert B Hawkins, Anna Fashandi, Margret C Tracci, Irving L Kron, Gilbert R Upchurch, William P Robinson
BACKGROUND: Redo Lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are options to treat critical limb ischemia after a failed prior lower extremity bypass but the utilization and outcomes of each are poorly described. The purpose of this study was to compare 30-day Major Adverse Limb Events (MALE) and Major Adverse Cardiovascular Events (MACE) after LEB and IEI in patients with a failed prior ipsilateral LEB and determine risk factors for each composite outcome...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28883853/cardiac-surgery-related-cardio-renal-syndrome-assessed-by-conventional-and-novel-biomarkers-under-or-overestimated-diagnosis
#7
Jowita Biernawska, Joanna Bober, Katarzyna Kotfis, Anna Bogacka, Edyta Barnik, Maciej Żukowski
INTRODUCTION: Serum creatinine is a 'gold standard' criterion of recognizing and staging of acute kidney injury (AKI) despite it being a suboptimal, delayed indicator. The interpretation of increased values of biomarkers imposes great difficulty regarding cardiac surgery procedures performed with cardiopulmonary bypass and may lead to under- or overestimated diagnosis. The aim of this study was to evaluate the clinical utility of the sole serum creatinine or urine neutrophil gelatinase-associated lipocalin (NGAL) concentration used for identification of patients with AKI after cardiac surgery...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28883718/contributions-of-copd-asthma-and-ten-comorbid-conditions-to-health-care-utilization-and-patient-centered-outcomes-among-us-adults-with-obstructive-airway-disease
#8
Terrence E Murphy, Gail J McAvay, Heather G Allore, Jason A Stamm, Paul F Simonelli
BACKGROUND: Among persons with obstructive airway disease, the relative contributions of chronic obstructive pulmonary disease (COPD), asthma, and common comorbid conditions to health care utilization and patient-centered outcomes (PCOs) have not been previously reported. METHODS: We followed a total of 3,486 persons aged ≥40 years with COPD, asthma, or both at baseline, from the Medical Expenditure Panel Survey (MEPS) cohorts enrolled annually from 2008 through 2012 for 1 year...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28874089/outcome-of-surgeon-modified-fenestrated-branched-stent-grafts-for-symptomatic-complex-aortic-pathologies-or-contained-rupture
#9
Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Holger Diener, Sabine Wipper, E Sebastian Debus, Tilo Kölbel
PURPOSE: To analyze the outcome of surgeon-modified fenestrated and branched stent-grafts (sm-FBSG) in high-risk patients with symptomatic complex aortic pathology or contained rupture. METHODS: A single-center retrospective analysis was conducted of 21 consecutive patients (mean age 70 years, range 58-87; 16 men) treated with a sm-FBSG from April 2014 to September 2016. The indications included 11 thoracoabdominal and 10 pararenal aortic pathologies, which presented as symptomatic in 8 and as contained rupture in 13 patients...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28867010/mid-term-clinical-outcomes-of-absorb-bioresorbable-vascular-scaffold-versus-everolimus-eluting-stent-for-coronary-bifurcation-lesions
#10
Toru Naganuma, Hiroyoshi Kawamoto, Vasileios F Panoulas, Azeem Latib, Akihito Tanaka, Satoru Mitomo, Neil Ruparelia, Richard J Jabbour, Alaide Chieffo, Mauro Carlino, Matteo Montorfano, Antonio Colombo
BACKGROUND: Data regarding bioresorbable vascular scaffolds (BVS) use in coronary bifurcation lesions are limited. The aim of this study was to compare mid-term clinical outcomes of all-comer patients treated with BVS versus everolimus-eluting stents (EES) for bifurcation lesions. METHODS: A total of 351 non-left-main bifurcation lesions in 323 all-comer patients were treated either with BVS (166 bifurcations in 147 patients) or EES (185 bifurcations in 176 patients)...
November 1, 2017: International Journal of Cardiology
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
#11
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/28862934/impact-of-spontaneous-extracranial-bleeding-events-on-health-state-utility-in-patients-with-atrial-fibrillation-results-from-the-engage-af-timi-48-trial
#12
Kaijun Wang, Haiyan Li, Winghan J Kwong, Elliott M Antman, Christian T Ruff, Robert P Giugliano, David J Cohen, Elizabeth A Magnuson
BACKGROUND: The impact of different types of extracranial bleeding events on health-related quality of life and health-state utility among patients with atrial fibrillation is not well understood. METHODS AND RESULTS: The ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) Trial compared edoxaban with warfarin with respect to the prevention of stroke or systemic embolism in atrial fibrillation...
August 11, 2017: Journal of the American Heart Association
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/28856523/hemodynamic-support-devices-for-shock-and-high-risk-pci-when-and-which-one
#15
REVIEW
George W Vetrovec
PURPOSE OF REVIEW: This article addresses evolving devices and uses of hemodynamic support in the management of high-risk PCI and AMI with cardiogenic shock. RECENT FINDINGS: Recent publications question the benefit of Intra-aortic Balloon Pump support for AMI Shock. Furthermore, in high-risk PCI, the Impella support system provides better late outcomes than does the intra-aortic balloon pump. We have entered a new era in which larger, higher flow devices that increase cardiac output while unloading the left ventricle provide better outcome...
August 31, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28852495/reasons-for-admission-and-predictors-of-national-30-day-readmission-rates-in-patients-with-end-stage-renal-disease-on-peritoneal-dialysis
#16
Lili Chan, Priti Poojary, Aparna Saha, Kinsuk Chauhan, Rocco Ferrandino, Bart Ferket, Steven Coca, Girish Nadkarni, Jaime Uribarri
BACKGROUND: The number of patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) has increased by over 30% between 2007 and 2014. The Centers for Medicare and Medicaid has identified readmissions in ESRD patients to be a quality measure; however, there is a paucity of studies examining readmissions in PD patients. METHODS: Utilizing the National Readmission Database for the year 2013, we aimed to determine reasons for admission, the associated rates of unplanned readmission and independent predictors of readmissions in PD patients...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28844991/recalibrating-reperfusion-waypoints
#17
Paul W Armstrong, Robert C Welsh
The realization that thrombus was the cause and not the consequence of acute myocardial infarction was a transformative pathophysiologic insight. An even more stunning observation was the subsequent discovery that restoration of coronary patency could salvage ischemic myocardium and improve clinical outcomes in ST-elevation acute myocardial infarction (STEMI). Assertive clinical investigations of both the content and process of STEMI care over the subsequent 4 decades has demonstrated that the ultimate success of reperfusion is modulated by the timeliness, efficiency, and efficacy with which it is applied...
August 27, 2017: Circulation
https://www.readbyqxmd.com/read/28844769/perioperative-outcomes-and-complications-in-patients-with-heart-failure-following-total-knee-arthroplasty
#18
Gannon L Curtis, Jared M Newman, Jaiben George, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Heart failure (HF) is a common comorbidity in the aging population and they will require major elective surgery. The purpose of this study is to determine if HF is a risk factor for adverse perioperative outcomes and short-term complications following total knee arthroplasty. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was utilized to identify all patients who underwent total knee arthroplasty for osteoarthritis from 2008 to 2014...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28840587/study-design-and-rationale-for-biomedical-shirt-based-electrocardiography-monitoring-in-relevant-clinical-situations-ecg-shirt-study
#19
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/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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