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Myocardial infarction health utility

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https://www.readbyqxmd.com/read/27865485/comparison-of-the-effectiveness-of-stress-echocardiography-versus-myocardial-perfusion-imaging-in-patients-presenting-to-the-emergency-department-with-low-risk-chest-pain
#1
Rhian Davies, Guodong Liu, Christopher Sciamanna, William R Davidson, Douglas L Leslie, Andrew J Foy
The aim of this study was to compare clinically relevant cardiovascular outcomes and downstream resource utilization associated with stress echocardiography (SE) and myocardial perfusion imaging (MPI) in emergency department patients with low-risk chest pain. This was a retrospective analysis of health insurance claims data for a national sample of privately insured patients over the period January 1 to December 31, 2011. Subjects were selected who presented to the emergency department with a primary or secondary diagnosis of chest pain and underwent either SE or MPI...
December 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27848189/the-impact-of-disability-and-social-determinants-of-health-on-condition-specific-readmissions-beyond-medicare-risk-adjustments-a-cohort-study
#2
Jennifer Meddings, Heidi Reichert, Shawna N Smith, Theodore J Iwashyna, Kenneth M Langa, Timothy P Hofer, Laurence F McMahon
BACKGROUND: Readmission rates after pneumonia, heart failure, and acute myocardial infarction hospitalizations are risk-adjusted for age, gender, and medical comorbidities and used to penalize hospitals. OBJECTIVE: To assess the impact of disability and social determinants of health on condition-specific readmissions beyond current risk adjustment. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of Medicare patients using 1) linked Health and Retirement Study-Medicare claims data (HRS-CMS) and 2) Healthcare Cost and Utilization Project State Inpatient Databases (Florida, Washington) linked with ZIP Code-level measures from the Census American Community Survey (ACS-HCUP)...
November 15, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27811206/economic-considerations-of-early-rule-in-rule-out-algorithms-for-the-diagnosis-of-myocardial-infarction-in-the-emergency-department-using-cardiac-troponin-and-glycemic-biomarkers
#3
Colleen Shortt, Feng Xie, Richard Whitlock, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Guillaume Pare, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter Kavsak
BACKGROUND: We have previously demonstrated the utility of a rule-in/rule-out strategy for myocardial infarction (MI) using glycemic biomarkers in combination with cardiac troponin in the emergency department (ED). Given that the cost of assessing patients with possible MI in the ED is increasing, we sought to compare the health services cost of our previously identified early rule-in/rule-out approaches for MI among patients who present to the ED with symptoms suggestive of acute coronary syndrome (ACS)...
November 3, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27792657/predictors-of-cardiac-rehabilitation-utilization-in-england-results-from-the-national-audit
#4
Jennifer Sumner, Sherry L Grace, Patrick Doherty
BACKGROUND: Cardiac rehabilitation (CR) is grossly underused, with major inequities in access. However, use of CR and predictors of initiation in England where CR contracting is available is unknown. The aims were (1) to investigate CR utilization rates in England, and (2) to determine sociodemographic and clinical factors associated with CR initiation including social deprivation. METHODS AND RESULTS: Data from the National Audit of CR, between January 2012 and November 2015, were used...
October 21, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27778531/basic-mechanisms-of-platelet-receptor-shedding
#5
Robert K Andrews, Elizabeth E Gardiner
Proteolytic shedding of the extracellular ectodomain of platelet receptors provides a key mechanism for irreversible loss of ligand-binding capacity, and for regulating platelet function in health and disease. Platelets derived from megakaryocytes are small anucleate cells in peripheral blood, with the ability to rapidly adhere, become activated, and secrete an array of procoagulant and proinflammatory factors at sites of vascular injury or disease, and to form a platelet aggregate (thrombus) which is not only critical in normal hemostasis and wound healing, but in atherothrombotic diseases including myocardial infarction and ischemic stroke...
October 25, 2016: Platelets
https://www.readbyqxmd.com/read/27765481/cost-analysis-of-the-history-ecg-age-risk-factors-and-initial-troponin-heart-pathway-randomized-control-trial
#6
Robert F Riley, Chadwick D Miller, Gregory B Russell, Erin N Harper, Brian C Hiestand, James W Hoekstra, Cedric W Lefebvre, Bret A Nicks, David M Cline, Kim L Askew, Simon A Mahler
INTRODUCTION: The HEART Pathway is a diagnostic protocol designed to identify low-risk patients presenting to the emergency department with chest pain that are safe for early discharge. This protocol has been shown to significantly decrease health care resource utilization compared with usual care. However, the impact of the HEART Pathway on the cost of care has yet to be reported. METHODS AND RESULTS: We performed a cost analysis of patients enrolled in the HEART Pathway trial, which randomized participants to either usual care or the HEART Pathway protocol...
October 5, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27757693/hospitalization-rates-for-acute-myocardial-infarction-among-asian-american-subgroups-have-we-been-underestimating-the-problem
#7
Rosette J Chakkalakal, Justin P Fox, Jeremy C Green, Marcella Nunez-Smith, Brahmajee K Nallamothu, Romana Hasnain-Wynia
Concerns about the quality of race/ethnicity data collected by hospitals have limited our understanding of healthcare disparities affecting ethnic minorities in the United States. Using data from the New Jersey State Inpatient Databases and the American Community Survey, we calculated age-adjusted AMI hospitalization rates for Asian-American subgroups before (2005-2006) and after (2008-2009) New Jersey hospitals implemented standardized practices to collect more accurate granular race/ethnicity data from patients...
October 18, 2016: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/27720235/perioperative-risk-in-patients-with-epilepsy-undergoing-total-joint-arthroplasty
#8
Cory G Couch, Mariano E Menendez, C Lowry Barnes
BACKGROUND: Epilepsies is a spectrum of brain disorders ranging from severe, life threatening, and disabling to more benign, but little is known about its impact in the perioperative arthroplasty setting. We sought to determine whether epileptic patients undergoing elective total joint arthroplasty (TJA) would be at increased risk for in-hospital complications and death, prolonged stay, and nonroutine discharge. METHODS: Using discharge records from the Nationwide Inpatient Sample (2002-2011), we identified 6,054,344 patients undergoing elective primary TJA, of whom 31,865 (0...
August 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27695237/determining-rural-risk-for-aneurysmal-subarachnoid-hemorrhages-a-structural-equation-modeling-approach
#9
Linda Jayne Nichols, Seana Gall, Christine Stirling
An aneurysmal subarachnoid hemorrhage (aSAH) carries a high disability burden. The true impact of rurality as a predictor of outcome severity is unknown. Our aim is to clarify the relationship between the proposed explanations of regional and rural health disparities linked to severity of outcome following an aSAH. An initial literature search identified limited data directly linking geographical location, rurality, rural vulnerability, and aSAH. A further search noting parallels with ischemic stroke and acute myocardial infarct literature presented a number of diverse and interrelated predictors...
October 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/27629776/antiplatelet-versus-anticoagulation-treatment-for-patients-with-heart-failure-in-sinus-rhythm
#10
Eduard Shantsila, Gregory Yh Lip
BACKGROUND: Morbidity in patients with chronic heart failure is high, and this predisposes them to thrombotic complications, including stroke and thromboembolism, which in turn contribute to high mortality. Oral anticoagulants (e.g. warfarin) and antiplatelet agents (e.g. aspirin) are the principle oral antithrombotic agents. Many heart failure patients with sinus rhythm take aspirin because coronary artery disease is the leading cause of heart failure. Oral anticoagulants have become a standard in the management of heart failure with atrial fibrillation...
September 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27605689/trends-in-complication-rates-following-ankle-arthrodesis-and-total-ankle-replacement
#11
Alexandra I Stavrakis, Nelson F SooHoo
BACKGROUND: This study provides an updated comparison of the reoperation rates following primary ankle arthrodesis and total ankle replacement on the basis of observational, population-based data from California. We previously reported data from 1995 to 2004, and our current study includes new data from 2005 to 2010. Our hypothesis was that total ankle replacement would demonstrate increasing utilization and lower complication rates given advances in implant design and growth in surgeon experience...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27579167/influence-of-health-warnings-on-the-use-of-rosiglitazone-and-pioglitazone-in-an-area-of-spain-a-time-series-study
#12
Eduardo Carracedo-Martínez, Agustin Pia-Morandeira
BACKGROUND: Throughout 2007 and January 2008, several glitazones health warnings were published on rosiglitazone myocardial infarction risk. The impact of such warnings on glitazones prevalence of utilization has been extensively studied in the United States but only in one European country (England), which has showed different pattern from US studies. The aim of this study is to evaluate the impact of such safety warnings on glitazones utilization in an area of another European country...
2016: SAGE Open Medicine
https://www.readbyqxmd.com/read/27570759/validity-and-utility-of-icd-10-administrative-health-data-for-identifying-st-and-non-st-elevation-myocardial-infarction-based-on-physician-chart-review
#13
Alka B Patel, Hude Quan, Robert C Welsh, Jessica Deckert-Sookram, Wayne Tymchak, Sunil Sookram, Ian Surdhar, Padma Kaul
BACKGROUND: Health care administrative databases are useful for assessing the population-level burden of disease and examining issues related to access, costs and quality of care. In these databases, the diagnoses and procedures are coded with the use of the World Health Organization International Classification of Diseases (ICD). We examined the validity of 2 ICD-10 coding definitions for categorizing patients with acute myocardial infarction (MI) as having ST-elevation MI (STEMI) or non-ST-elevation MI (non-STEMI)...
October 2015: CMAJ Open
https://www.readbyqxmd.com/read/27566599/personality-factors-and-depression-as-predictors-of-hospital-based-health-care-utilization-following-acute-myocardial-infarction
#14
Mona Schlyter, Margareta Östman, Gunnar Engström, Lena André-Petersson, Patrik Tydén, Margrét Leosdottir
BACKGROUND: Whether personality factors and depressive traits affect patients' utilization of health care following an acute myocardial infarction is relatively unknown. The aim of this study was to examine whether hospital-based health care utilization after a myocardial infarction was correlated with patients' personality factors and depressive symptoms. METHODS: We studied 366 myocardial infarction patients admitted to Malmö University Hospital between 2002 and 2005 who subsequently participated in a cardiac rehabilitation programme...
August 26, 2016: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27547418/acute-post-disaster-medical-needs-of-patients-with-diabetes-emergency-department-use-in-new-york-city-by-diabetic-adults-after-hurricane-sandy
#15
David C Lee, Vibha K Gupta, Brendan G Carr, Sidrah Malik, Brandy Ferguson, Stephen P Wall, Silas W Smith, Lewis R Goldfrank
OBJECTIVE: To evaluate the acute impact of disasters on diabetic patients, we performed a geospatial analysis of emergency department (ED) use by New York City diabetic adults in the week after Hurricane Sandy. RESEARCH DESIGN AND METHODS: Using an all-payer claims database, we retrospectively analyzed the demographics, insurance status, and medical comorbidities of post-disaster ED patients with diabetes who lived in the most geographically vulnerable areas. We compared the patterns of ED use among diabetic adults in the first week after Hurricane Sandy's landfall to utilization before the disaster in 2012...
2016: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/27541822/treatment-outcomes-and-adherence-to-medication-regimens-among-dual-medicare-medicaid-eligible-adults-with-myocardial-infarction
#16
Jacob A Doll, Anne S Hellkamp, Abhinav Goyal, Nadia R Sutton, Eric D Peterson, Tracy Y Wang
Importance: Patients with dual Medicare-Medicaid eligibility have a higher burden of chronic disease conditions and increased health care utilization compared with patients with Medicare coverage alone, but the treatment patterns and outcomes of dual-eligible patients with myocardial infarction (MI) are unknown. Objective: To examine the association of dual-eligible status with clinical outcomes and adherence to medication regimens (hereinafter "medication adherence") among older adults after MI...
August 17, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27534534/the-rhesa-care-study-an-extended-baseline-survey-of-the-regional-myocardial-infarction-registry-of-saxony-anhalt-rhesa-design-and-objectives
#17
Katharina Hirsch, Stefanie Bohley, Wilfried Mau, Andrea Schmidt-Pokrzywniak
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of death in Europe. In Germany, a declining mortality rate from acute myocardial infarction (AMI) has been observed in the last decades. Nevertheless, there are large differences between the federal states when looking at the mortality and morbidity of AMI. Saxony-Anhalt is one of the federal states with the highest mortality rates for AMI in Germany. In 2012, the regional myocardial infarction registry of Saxony-Anhalt (RHESA) was established to investigate the individual, infrastructural, and health care factors with respect to an urban (city of Halle) and rural (region of Altmark) population...
2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27527344/a-multicentre-randomised-controlled-trial-of-transfusion-indication-threshold-reduction-on-transfusion-rates-morbidity-and-health-care-resource-use-following-cardiac-surgery-titre2
#18
Barnaby C Reeves, Katie Pike, Chris A Rogers, Rachel Cm Brierley, Elizabeth A Stokes, Sarah Wordsworth, Rachel L Nash, Alice Miles, Andrew D Mumford, Alan Cohen, Gianni D Angelini, Gavin J Murphy
BACKGROUND: Uncertainty about optimal red blood cell transfusion thresholds in cardiac surgery is reflected in widely varying transfusion rates between surgeons and cardiac centres. OBJECTIVE: To test the hypothesis that a restrictive compared with a liberal threshold for red blood cell transfusion after cardiac surgery reduces post-operative morbidity and health-care costs. DESIGN: Multicentre, parallel randomised controlled trial and within-trial cost-utility analysis from a UK NHS and Personal Social Services perspective...
August 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27474481/usefulness-of-a-cardiovascular-polypill-in-the-treatment-of-secondary-prevention-patients-in-spain-a-cost-effectiveness-study
#19
Vivencio Barrios, Lisette Kaskens, José María Castellano, Juan Cosin-Sales, José Emilio Ruiz, Ilonka Zsolt, Valentín Fuster, Alfredo Gracia
INTRODUCTION AND OBJECTIVES: To estimate the health benefits and cost-effectiveness of a polypill intervention (aspirin 100 mg, atorvastatin 20 mg, ramipril 10 mg) compared with multiple monotherapy for secondary prevention of cardiovascular events in adults with a history of myocardial infarction from the perspective of the Spanish National Health System. METHODS: An adapted version of a recently published Markov model developed and validated in Microsoft Excel was used to compare the cost-effectiveness of the polypill with that of its combined monocomponents over a 10-year time horizon...
July 26, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27432692/cost-effectiveness-of-left-atrial-appendage-closure-for-stroke-prevention-in-atrial-fibrillation-patients-with-contraindications-to-anticoagulation
#20
Jacqueline Saw, Maria C Bennell, Sheldon M Singh, Harindra C Wijeysundera
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) is increasingly performed as an alternative to oral anticoagulation (OAC) in patients with nonvalvular atrial fibrillation (AF). We sought to evaluate the cost-effectiveness of treating OAC contraindicated patients with LAAC compared with aspirin alone. METHODS: A probabilistic patient-level Markov microsimulation model with a lifetime horizon was performed to assess the discounted lifetime costs, quality-adjusted life years, and incremental cost-effectiveness ratio of LAAC compared with aspirin for patients with AF with contraindications to OAC...
February 23, 2016: Canadian Journal of Cardiology
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