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https://www.readbyqxmd.com/read/28807713/opioid-drug-use-and-acute-cardiac-events-among-pregnant-women-in-the-united-states
#1
Hamisu M Salihu, Jason L Salemi, Anjali Aggarwal, Beverly F Steele, Ross C Pepper, Mulubrhan F Mogos, Muktar H Aliyu
BACKGROUND: Cardiovascular disease remains a leading cause of pregnancy-associated deaths in the United States (US). The extent to which increasing opioid use among pregnant women contributes to fatal cardiovascular events is unknown. We examine trends in opioid use among pregnant women over the previous decade, and the association between changes in temporal trends in opioid drug use and the incidence of acute cardiac events among mothers. METHODS: In this retrospective analysis of the Healthcare and Cost Utilization Project (HCUP), we utilized a two-stage stratified cluster sampling of all inpatient hospital discharges from non-federal hospitals between 01/01/2002 through 12/31/2014...
August 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28781023/comparison-of-30-day-readmission-rates-after-hospitalization-for-acute-myocardial-infarction-in-men-versus-women
#2
Cashel O'Brien, Linda Valsdottir, Jason H Wasfy, Jordan B Strom, Eric A Secemsky, Yun Wang, Robert W Yeh
Readmission after hospitalization for acute myocardial infarction (AMI) significantly contributes to preventable morbidity and health-care costs. Outcomes after AMI vary by sex but the relationship of sex to readmissions warrants further exploration. Using the 2013 Nationwide Readmissions Database, we identified patients with a principal discharge diagnosis of AMI and stratified all-cause 30-day readmissions by sex and age. Of 214,824 patients, 44% were 18 to 64 years of age, 56% were ≥65 years, and 28% and 45%, respectively, were female...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28767576/association-between-costs-and-quality-of-acute-myocardial-infarction-care-hospitals-under-the-korea-national-health-insurance-program
#3
Hee-Chung Kang, Jae-Seok Hong
If cost reductions produce a cost-quality trade-off, healthcare policy makers need to be more circumspect about the use of cost-effective initiatives. Additional empirical evidence about the relationship between cost and quality is needed to design a value-based payment system. We examined the association between cost and quality performances for acute myocardial infarction (AMI) care at the hospital level.In 2008, this cross-sectional study examined 69 hospitals with 6599 patients hospitalized under the Korea National Health Insurance (KNHI) program...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28763308/revascularization-strategies-and-in-hospital-management-in-acute-coronary-syndromes-complicated-by-hemophilia-a-or-hemophilia-b
#4
Matthew J Reilley, Anne Blair, William H Matthai, Rolando Vega, Meghan Buckley, Phyllis A Gimotty, Patrick F Fogarty
: Among adult patients with hemophilia A and hemophilia B the emergent management of acute coronary syndromes (ACSs) is challenging, and exposure to antithrombotic agents and/or revascularization procedures may confer an enhanced risk of bleeding. We sought to identify clinical characteristics and in-hospital outcomes among ACS patients with hemophilia A/hemophilia B, compared with matched noncoagulopathic ACS controls. Case discharges from the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (1998-2011) had International Classification of Diseases, 9th Revision codes for hemophilia A/hemophilia B and ACS...
July 29, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28761679/the-safety-efficacy-and-cost-effectiveness-of-stress-echocardiography-in-patients-with-high-pretest-probability-of-coronary-artery-disease
#5
Alexandros Papachristidis, Daniela Cassar Demarco, Damian Roper, Ioannis Tsironis, Michael Papitsas, Jonathan Byrne, Khaled Alfakih, Mark J Monaghan
OBJECTIVE: In this study, we assess the clinical and cost-effectiveness of stress echocardiography (SE), as well as the place of SE in patients with high pretest probability (PTP) of coronary artery disease (CAD). METHODS: We investigated 257 patients with no history of CAD, who underwent SE, and they had a PTP risk score >61% (high PTP). According to the National Institute for Health and Care Excellence guidance (NICE CG95, 2010), these patients should be investigated directly with an invasive coronary angiogram (ICA)...
2017: Open Heart
https://www.readbyqxmd.com/read/28750576/smartphone-based-tele-electrocardiography-support-for-primary-care-physicians-reduces-the-pain-to-treatment-time-in-acute-coronary-syndrome
#6
Vivek Chauhan, P C Negi, Sujeet Raina, Sunil Raina, Mukul Bhatnagar, Rajesh Guleri, Vikrant Kanwar, Kumar S Pandey
Background The Himachal Pradesh state acute coronary syndrome registry recorded a median delay of 13 h between the time of onset of pain to the time of making the diagnosis and giving treatment for acute coronary syndrome. We conducted a pilot study on providing 24-h tele-electrocardiography (Tele-ECG) services in the district Kangra of Himachal Pradesh, with the aim to reduce the time taken for diagnosis of acute coronary syndrome. Methods The intervention group for the study included eight rural community health centres, each with one to three primary care physicians, who were all unskilled in electrocardiogram interpretation...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28695975/decreased-admissions-and-hospital-costs-with-a-neutral-effect-on-mortality-following-lowering-of-the-troponin-t-cutoff-point-to-the-99th-percentile
#7
Christian Bjurman, Matteus Zywczyk, Bertil Lindahl, Tobias Carlsson, Per Johanson, Max Petzold, Martin Holzmann, Michael Lx Fu, Ola Hammarsten
BACKGROUND: The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources. METHODS: Clinical and laboratory data from patients with chest pain or dyspnea at the emergency department (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28693601/effects-of-the-plate-model-as-part-of-dietary-intervention-on-modification-of-selected-cardiometabolic-risk-factors-in-post-myocardial-infarction-patients-study-protocol-for-a-randomized-controlled-trial
#8
Ranil Jayawardena, Pasindu Fernando, Niroshan Lokunarangoda, Anidu Keerthi Pathirana
BACKGROUND: Cardiovascular disease remains the leading cause of morbidity and mortality worldwide, and there is a rising global burden. The effects of diet on cardiometabolic risk factors have been studied extensively. Healthy eating as a cost-effective approach to risk reduction in post-myocardial infarction patients is proven to be beneficial, and the "plate model" is one of the practical methods to achieve this objective. METHODS/DESIGN: The study will be conducted as a randomized, single-blind, controlled clinical trial for a period of 3 months...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28683229/non-invasive-approach-to-mend-the-broken-heart-is-remote-conditioning-a-promising-strategy-for-application-in-humans
#9
Táňa Ravingerová, Veronika Ledvényiová-Farkašová, Lucia Griecsová, Martina Muráriková, Slavka Carnicka, Ľubomír Lonek, Miroslav Ferko, Jan Slezak, Marek Zálešák, Adriana Adameova, Vinoth Km Khandelwal, Antigone Lazou, Frantisek Kolar
Currently, there are no satisfactory interventions to protect the heart against the detrimental effects of ischemia-reperfusion injury. Although ischemic preconditioning (PC) is the most powerful form of intrinsic cardioprotection, its application in humans is limited to planned interventions, due to its short duration and technical requirements. However, many organs/tissues are capable of producing "remote" PC (RPC) when subjected to brief bouts of ischemia-reperfusion. RPC was first described in the heart where brief ischemia in one territory led to protection in other area...
July 6, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28676042/estimating-the-direct-costs-of-ischemic-heart-disease-evidence-from-a-teaching-hospital-in-brazil-a-retrospective-cohort-study
#10
Rosane Paixão Schlatter, Vânia Naomi Hirakata, Carisi Anne Polanczyk
BACKGROUND: Coronary artery disease is the most prevalent cardiovascular disease. In the United States, 7% of adults over 20 years of age are estimated to have coronary artery disease. In Brazil, a prevalence of 5 to 8% has been estimated in adults over 40 years of age, with an increased number of hospitalizations associated with both stable and acute clinical manifestations; and health care costs have quadrupled in the last decade. To estimate the direct costs of managing ischemic heart disease patient care in a teaching hospital in Brazil from the perspective of the service payer, the Brazilian Unified Health System...
July 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28674626/implications-of-the-pegasus-timi-54-trial-for-us-clinical-practice
#11
Steven M Bradley, Gregory P Hess, Patrick Stewart, Ehrin J Armstrong, Steven A Farmer, Jason H Wasfy, Javier Alfonso Valle, Amneet Sandhu, Thomas M Maddox
OBJECTIVES: This study aims to determine the proportion of real-world patients with myocardial infarction (MI) who would have been eligible for the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54) trial, to characterise their current use of P2Y12 inhibitors and to explore the estimated costs and ischaemic event consequences of increasing P2Y12 inhibitor use among these patients...
2017: Open Heart
https://www.readbyqxmd.com/read/28654972/effect-of-electronic-reminders-financial-incentives-and-social-support-on-outcomes-after-myocardial-infarction-the-heartstrong-randomized-clinical-trial
#12
Kevin G Volpp, Andrea B Troxel, Shivan J Mehta, Laurie Norton, Jingsan Zhu, Raymond Lim, Wenli Wang, Noora Marcus, Christian Terwiesch, Kristen Caldarella, Tova Levin, Mike Relish, Nathan Negin, Aaron Smith-McLallen, Richard Snyder, Claire M Spettell, Brian Drachman, Daniel Kolansky, David A Asch
Importance: Adherence to medications prescribed after acute myocardial infarction (AMI) is low. Wireless technology and behavioral economic approaches have shown promise in improving health behaviors. Objective: To determine whether a system of medication reminders using financial incentives and social support delays subsequent vascular events in patients following AMI compared with usual care. Design, Setting, and Participants: Two-arm, randomized clinical trial with a 12-month intervention conducted from 2013 through 2016...
August 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28647465/french-registry-on-acute-st-elevation-and-non-st-elevation-myocardial-infarction-2015-fast-mi-2015-design-and-baseline-data
#13
Loïc Belle, Guillaume Cayla, Yves Cottin, Pierre Coste, Khalife Khalife, Jean-Noël Labèque, Bruno Farah, Thibaut Perret, Patrick Goldstein, Pierre-Yves Gueugniaud, François Braun, Jacques Gauthier, Martine Gilard, Jean-Yves Le Heuzey, Nicolas Naccache, Elodie Drouet, Vincent Bataille, Jean Ferrières, Etienne Puymirat, François Schiele, Tabassome Simon, Nicolas Danchin
BACKGROUND: The FAST-MI programme, consisting of 1-month surveys of patients admitted to hospital for acute myocardial infarction (AMI) in France, has run since 2005. AIM: To gather data on the characteristics, management and outcomes of patients hospitalized for AMI at the end of 2015 in France and to provide comparisons with the previous surveys. METHODS: Consecutive adults with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment-elevation myocardial infarction (NSTEMI) with symptom onset≤48hours were included over a 1-month period, with a possible extension of recruitment for 1 additional month...
June 21, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28636749/annual-direct-medical-costs-associated-with-diabetes-related-complications-in-the-event-year-and-in-subsequent-years-in-hong-kong
#14
F Jiao, C K H Wong, S C W Tang, C S C Fung, K C B Tan, S McGhee, R Gangwani, C L K Lam
AIM: To develop models to estimate the direct medical costs associated with diabetes-related complications in the event year and in subsequent years. METHODS: The public direct medical costs associated with 13 diabetes-related complications were estimated among a cohort of 128 353 people with diabetes over 5 years. Private direct medical costs were estimated from a cross-sectional survey among 1825 people with diabetes. We used panel data regression with fixed effects to investigate the impact of each complication on direct medical costs in the event year and subsequent years, adjusting for age and co-existing complications...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28636181/identification-of-biomarkers-for-early-diagnosis-of-acute-myocardial-infarction
#15
Wen-Han Ge, Yong Lin, Sen Li, Xuefeng Zong, Zhong-Chun Ge
Acute myocardial infarction (AMI) is a common disease with serious consequences in mortality and cost. Here we aim to screen the differentially expressed genes (DEGs) as biomarkers for early diagnosis of AMI. The microarray data of AMI was downloaded from Gene Expression Omnibus (GEO), including two independent types of research GSE66360 and GSE62646. The DEGs between control and processed samples were screened out by using limma package. Meanwhile, we performed functional analysis of GO terms and/or KEGG pathways to observe the enriched pathways of the DEGs...
June 21, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28635339/methods-for-estimating-costs-in-patients-with-hyperlipidemia-experiencing-their-first-cardiovascular-event-in-the-united-kingdom
#16
Mark D Danese, Michelle Gleeson, Robert I Griffiths, David Catterick, Lucie Kutikova
AIMS: Methods for integrating external costs into clinical databases are not well-characterized. The purpose of this research was to describe and implement methods for estimating the cost of hospitalizations, prescriptions, and general practitioner and specialist visits used to manage hyperlipidemia patients experiencing cardiovascular (CV) events in the United Kingdom (UK). METHODS: This study was a retrospective cohort study using the Clinical Practice Research Datalink and Hospital Episode Statistics data...
September 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28630238/impact-of-sex-on-cardiac-troponin-concentrations-a-critical-appraisal
#17
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: The use of sex-specific cutoffs for cardiac troponin (cTn) is currently debated. Although endorsed by scientific working groups, concerns have been raised that sex-specific cutoffs may have only a small clinical effect at the cost of increased complexity in decision-making. METHODS: We reviewed studies investigating the interrelations between high-sensitivity (hs) cTn results and sex, diagnoses, and outcome. Investigated populations included community-dwelling subjects and patients with stable angina, congestive heart failure, or acute chest pain including those with acute coronary syndromes...
June 19, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28618915/coronary-artery-disease-risk-stratification-and-patient-selection-for-more-aggressive-secondary-prevention
#18
François Schiele, Fiona Ecarnot, Romain Chopard
In patients with stable coronary artery disease, clinical outcomes are predominantly characterized by the consequences of atherosclerosis on the myocardium, but also by complications of atherosclerosis, notably recurrent acute coronary syndrome or stroke. Secondary prevention therapy is therefore key in this patient population. Intensification of secondary prevention therapy is possible, at the price of a therapeutic risk or a high cost, therefore justifying careful selection of patients with a high residual risk and low therapeutic risk...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28603718/impact-of-sleep-apnea-on-in-hospital-outcomes-after-transcatheter-aortic-valve-replacement-insight-from-national-inpatient-sample-database-2011-2014
#19
Ilhwan Yeo, Hasan Ahmad, Wilbert S Aronow
BACKGROUND: Sleep apnea is associated with worse outcomes following various kinds of surgeries. There is a paucity of data on the association of sleep apnea with clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We used National Inpatient Sample (NIS) data 2011-2014 to identify patients undergoing TAVR. Association between sleep apnea and in-hospital postoperative outcomes were assessed by multivariate logistic regression and 1:1 propensity score matching analyses...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28602846/granulocyte-colony-stimulating-factor-for-the-treatment-of-cardiovascular-diseases-an-update-with-a-critical-appraisal
#20
REVIEW
Domenico D'Amario, Antonio Maria Leone, Josip Anđelo Borovac, Francesco Cannata, Andrea Siracusano, Giampaolo Niccoli, Filippo Crea
Heart failure and acute myocardial infarction are conditions that are associated with high morbidity and mortality. Significant dysfunction of the heart muscle can occur as the consequence of end-stage chronic cardiovascular diseases or acute ischemic events that are marked by large infarction area and significant tissue necrosis. Despite the remarkable improvement of conventional treatments, a substantial proportion of patients still develops severe heart failure that can only be resolved by heart transplantation or mechanical device implantation...
June 7, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
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