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https://www.readbyqxmd.com/read/29759808/implementation-of-a-clinical-nursing-pathway-for-percutaneous-coronary-intervention-a-prospective-study
#1
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/29739432/emergency-management-of-patients-with-st-segment-elevation-myocardial-infarction-in-eastern-austria-a-descriptive-quality-control-study
#2
Helmut Trimmel, Thomas Bayer, Wolfgang Schreiber, Wolfgang G Voelckel, Lukas Fiedler
BACKGROUND: Myocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STEMI) network in Easternern Austria. METHODS: The Eastern Austrian STEMI network serves a population of approx. 766.000 inhabitants within a region of 4186 km2 . Established in 2007, it now comprises 20 pre-hospital emergency medical service (EMS) units (10 of these physician-staffed), 4 hospitals and 3 cardiac intervention centres...
May 9, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29736670/impact-of-shorter-door-to-balloon-time-on-prognosis-of-patients-with-stemi-single-center-analysis-with-a-large-proportion-of-the-patients-treated-within-30-min
#3
Takeshi Yamada, Akihiko Takahashi, Yukio Mizuguchi, Sho Hashimoto, Norimasa Taniguchi, Shunsuke Nakajima, Tetsuya Hata
Several recent studies suggested that the door-to-balloon time (DTBT) for patients with ST-segment elevation myocardial infarction (STEMI) should be as short as possible, despite the existing guideline for STEMI. This study aimed to evaluate the clinical outcomes of the STEMI patient cohort having the highest proportion of patients treated with a DTBT of ≤ 30 min ever reported. We evaluated 527 consecutive patients with STEMI who underwent percutaneous coronary intervention between 2007 and 2015. The mean age was 68...
May 7, 2018: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29736558/modifiable-factors-associated-with-prolonged-door-to-balloon-time-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#4
Masahiko Noguchi, Junya Ako, Takeshi Morimoto, Yosuke Homma, Takashi Shiga, Kotaro Obunai, Hiroyuki Watanabe
Door to balloon (D2B) time was reported an important factor of the clinical outcome of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). D2B time is influenced by various factors; however, modifiable factors have not been adequately evaluated. The purpose of this study was to identify modifiable factors associated with prolonged D2B time. We historically included 239 consecutive STEMI patients who visited emergency department and underwent primary PCI between April 2013 and September 2016...
May 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29708085/weekly-checks-improve-real-time-prehospital-ecg-transmission-in-suspected-stemi
#5
Nicole T D'Arcy, Nichole Bosson, Amy H Kaji, Quang T Bui, William J French, Joseph L Thomas, Yvonne Elizarraraz, Natalia Gonzalez, Jose Garcia, James T Niemann
IntroductionField identification of ST-elevation myocardial infarction (STEMI) and advanced hospital notification decreases first-medical-contact-to-balloon (FMC2B) time. A recent study in this system found that electrocardiogram (ECG) transmission following a STEMI alert was frequently unsuccessful.HypothesisInstituting weekly test ECG transmissions from paramedic units to the hospital would increase successful transmission of ECGs and decrease FMC2B and door-to-balloon (D2B) times. METHODS: This was a natural experiment of consecutive patients with field-identified STEMI transported to a single percutaneous coronary intervention (PCI)-capable hospital in a regional STEMI system before and after implementation of scheduled test ECG transmissions...
April 30, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29705386/gender-is-not-a-predictor-of-mortality-or-major-adverse-cardiovascular-events-in-patients-undergoing-percutaneous-coronary-intervention-for-acute-coronary-syndromes
#6
Angeline Josiah, Ahmad Farshid
BACKGROUND: Historically, studies of percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) have reported worse outcomes for women. We sought to determine if contemporary PCI techniques eliminate gender differences in PCI outcomes. METHODS: This was a retrospective study of 4776 consecutive patients who underwent PCI for acute coronary syndromes between January 2008 and July 2015. Primary outcomes studied were major adverse cardiovascular events (MACE) and death at 1year...
April 4, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29697806/decreasing-triage-time-effects-of-implementing-a-step-wise-esi-algorithm-in-an-ehr
#7
Stephen Villa, Ellen J Weber, Steven Polevoi, Christopher Fee, Andrew Maruoka, Tina Quon
Objectives: To determine if adapting a widely-used triage scale into a computerized algorithm in an electronic health record (EHR) shortens emergency department (ED) triage time. Design: Before-and-after quasi-experimental study. Setting: Urban, tertiary care hospital ED. Participants: Consecutive adult patient visits between July 2011 and June 2013. Intervention: A step-wise algorithm, based on the Emergency Severity Index (ESI-5) was programmed into the triage module of a commercial EHR...
April 25, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29657235/reduction-in-door-to-balloon-time-with-training-for-effective-and-efficient-action-in-medical-service-better-process-teams-bp-at-a-community-hospital-in-japan
#8
Hiroki Isono, Tetsuhiro Maeno, Shigeyuki Watanabe
ST-elevation myocardial infarction (STEMI) is a fatal condition. Prompt primary percutaneous coronary intervention is associated with lower mortality. However, community hospitals in Japan lack human and medical resources, and implementation of the same strategies as those used in the USA, such as an on-call cardiologist at the hospital, to achieve a door-to-balloon time of ≤ 90 min appears particularly challenging. Therefore, we used Training for Effective and Efficient Action in Medical Service-Better Process (TEAMS-BP) to develop a new process and assessed its effectiveness in reducing door-to-balloon time...
2018: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29577589/correlation-of-infarct-size-with-invasive-hemodynamics-in-patients-with-st-elevation-myocardial-infarction
#9
Allie E Goins, Robert Rayson, Melissa C Caughey, Michael Sola, Kiran Venkatesh, Xuming Dai, Michael Yeung, George A Stouffer
OBJECTIVES: To identify invasive hemodynamic parameters that correlate with infarction size in patients with ST-elevation myocardial infarction (STEMI). BACKGROUND: Invasive hemodynamics obtained during primary percutaneous coronary intervention (PPCI) are predictive of mortality in STEMI, but which parameters correlate best with the size of the infarction are unknown. METHODS: This is a single-center study of 405 adult patients with STEMI who had left ventricular end-diastolic pressure (LVEDP) measured during PPCI...
March 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29570469/door-to-balloon-time-and-cardiac-mortality-in-acute-myocardial-infarction-by-total-occlusion-of-the-left-circumflex-artery
#10
Min Gyu Kang, Kyehwan Kim, Hyun Woong Park, Jin-Sin Koh, Jeong Rang Park, Seok-Jae Hwang, Jong-Hwa Ahn, Yongwhi Park, Young-Hoon Jeong, Choong Hwan Kwak, Myung Ho Jeong, Shung Chull Chae, Hyo-Soo Kim, Young Jo Kim, Myeong Chan Cho, Chong Jin Kim, Jin-Yong Hwang
BACKGROUND: Acute myocardial infarction (AMI) caused by total occlusion of the left circumflex artery (LCX) can present as non-ST-segment elevation myocardial infarction (NSTEMI). We evaluate whether door-to-balloon time (DBT) is associated with cardiac mortality in patients with total occlusion of the LCX. PATIENTS AND METHODS: From the Korea Acute Myocardial Infarction Registry, patients with AMI who had total occlusion with a Thrombolysis In Myocardial Infarction flow grade of 0 were included...
March 22, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29545356/comparison-of-epidemiology-treatments-and-outcomes-of-st-segment-elevation-myocardial-infarction-between-young-and-elderly-patients
#11
Pin Pin Pek, Huili Zheng, Andrew Fu Wah Ho, Win Wah, Huay Cheem Tan, Ling Li Foo, Marcus Eng Hock Ong
BACKGROUND: With an ageing population, there is a need to understand the relative risk/benefit of interventions for elderly ST segment elevation myocardial infarction (STEMI) patients. The primary aim of this study was to compare epidemiology, treatments and outcomes between young and elderly STEMI patients. Our secondary aim was to determine the cut-off age when the benefits of primary percutaneous coronary intervention (PCI) were less pronounced. METHODS: Data were collected by the Singapore Myocardial Infarction Registry...
May 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29544612/the-taiwan-heart-registries-its-influence-on-cardiovascular-patient-care
#12
REVIEW
Cho-Kai Wu, Jyh-Ming Jimmy Juang, Jiun-Yang Chiang, Yi-Heng Li, Chia-Ti Tsai, Fu-Tien Chiang
Taiwanese heart registries for the main cardiovascular diseases have been conducted in the past 10 years, with the goal of examining the quality of cardiovascular patient care, which cannot be guaranteed by the universal Taiwan National Health Insurance. The results show suboptimal adherence to guideline recommendations. Door-to-balloon time and dual antiplatelet therapy use in acute coronary syndrome, standard medications for management of heart failure, low-density lipoprotein cholesterol levels in dyslipidemia, anticoagulant agent use in atrial fibrillation, and the understanding of sudden arrhythmia death syndrome were all found to be inadequate...
March 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29542414/clinical-presentation-quality-of-care-risk-factors-and-outcomes-in-women-with-acute-st-elevation-myocardial-infarction-stemi-an-observational-report-from-six-middle-eastern-countries
#13
Abdulla Shehab, Khalid F AlHabib, Akshaya Srikanth Bhagavathul, Ahmad Hersi, Hussam Alfaleh, Mostafa Q Alshamiri, Anhar Ullah, Khadim Sulaiman, Wael Almahmeed, Jassim Al Suwaidi, Alwai A Alsheikh-Ali, Haitham Amin, Mohammed Al Jarallah, Amar M Salam
BACKGROUND: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. AIM: To examine the clinical presentation, patient management, quality of care, risk factors and in-hospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. METHODS: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries...
March 14, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29535061/four-step-protocol-for-disparities-in-stemi-care-and-outcomes-in-women
#14
Chetan P Huded, Michael Johnson, Kathleen Kravitz, Venu Menon, Mouin Abdallah, Travis C Gullett, Scott Hantz, Stephen G Ellis, Seth R Podolsky, Stephen W Meldon, Damon M Kralovic, Deborah Brosovich, Elizabeth Smith, Samir R Kapadia, Umesh N Khot
BACKGROUND: Women with STEMI receive suboptimal care and have worse outcomes than men. Whether strategies to reduce STEMI care variability impact disparities in the care and outcomes of women with STEMI is unknown. OBJECTIVES: We assessed the care and outcomes of men vs. women with STEMI before and after implementation of a comprehensive STEMI protocol. METHODS: On 7/15/14 we implemented: (1) emergency department catheterization lab activation, (2) STEMI Safe Handoff Checklist, (3) immediate transfer to an immediately available catheterization lab, and (4) radial first approach to percutaneous coronary intervention (PCI)...
March 7, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29521450/sustained-sex-based-treatment-differences-in-acute-coronary-syndrome-care-insights-from-the-american-heart-association-get-with-the-guidelines-coronary-artery-disease-registry
#15
Jacob A Udell, Gregg C Fonarow, Thomas M Maddox, Christopher P Cannon, W Frank Peacock, Warren K Laskey, Maria V Grau-Sepulveda, Eric E Smith, Adrian F Hernandez, Eric D Peterson, Deepak L Bhatt
BACKGROUND: Sex-based differences in acute coronary syndrome (ACS) mortality may attenuate with age due to better symptom recognition and prompt care. HYPOTHESIS: Age is a modifier of temporal trends in sex-based differences in ACS care. METHODS: Among 104 817 eligible patients with ACS enrolled in the AHA Get With the Guidelines-Coronary Artery Disease registry between 2003 and 2008, care and in-hospital mortality were evaluated stratified by sex and age...
March 9, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29514807/sex-differences-in-timeliness-of-reperfusion-in-young-patients-with-st-segment-elevation-myocardial-infarction-by-initial-electrocardiographic-characteristics
#16
Aakriti Gupta, Jose A Barrabes, Kelly Strait, Hector Bueno, Andreu Porta-Sánchez, J Gabriel Acosta-Vélez, Rosa-Maria Lidón, Erica Spatz, Mary Geda, Rachel P Dreyer, Nancy Lorenze, Judith Lichtman, Gail D'Onofrio, Harlan M Krumholz
BACKGROUND: Young women with ST-segment-elevation myocardial infarction experience reperfusion delays more frequently than men. Our aim was to determine the electrocardiographic correlates of delay in reperfusion in young patients with ST-segment-elevation myocardial infarction. METHODS AND RESULTS: We examined sex differences in initial electrocardiographic characteristics among 1359 patients with ST-segment-elevation myocardial infarction in a prospective, observational, cohort study (2008-2012) of 3501 patients with acute myocardial infarction, 18 to 55 years of age, as part of the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study at 103 US and 24 Spanish hospitals enrolling in a 2:1 ratio for women/men...
March 7, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29437704/coronary-intervention-door-to-balloon-time-and-outcomes-in-st-elevation-myocardial-infarction-a-meta-analysis
#17
Chee Yoong Foo, Kwadwo Osei Bonsu, Brahmajee K Nallamothu, Christopher M Reid, Teerapon Dhippayom, Daniel D Reidpath, Nathorn Chaiyakunapruk
OBJECTIVE: This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. METHODS: We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure...
February 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29432371/clinical-outcomes-of-transferred-versus-onsite-primary-percutaneous-coronary-intervention-for-patients-with-stemi-time-to-look-beyond-door-to-balloon-time
#18
Jaya Mallidi, Paul Visintainer, Indupriya Pallekonda, Daniel Fisher, Kurt Barringhaus, Aaron Kugelmass, Amir Lotfi
BACKGROUND: It is currently unknown if the delay due to practical aspects associated with transfer of patients from a non-percutaneous coronary intervention (PCI) facility to a primary PCI facility is associated with adverse outcomes. METHODS: We conducted a retrospective cohort study of all patients who presented with ST-segment elevation myocardial infarction (STEMI) and underwent primary PCI in 2 large regional STEMI centers in Massachusetts between January 2005 and June 2009...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29356080/striving-to-meet-targets-for-ideal-treatment-of-acute-myocardial-infarction-in-brazil-data-from-the-midwest-region
#19
Gustavo Carvalho, Salvador Rassi, Enio Guérios, Fernando A M Curado, Ana Tereza Bastos
OBJECTIVES: To evaluate the systematic chain of care for patients with acute ST-elevation myocardial infarction (STEMI) referred for primary angioplasty in a capital city in Midwestern Brazil. BACKGROUND: Acute myocardial infarction is recognized as an important cause of morbidity and mortality and as a public health problem worldwide. Early specialized care is crucial for a good prognosis. METHODS: All STEMI patients receiving care through the public health system at two tertiary care centers from March 2012 to June 2014 were retrospectively analyzed...
January 21, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29344747/healthcare-based-on-cloud-electrocardiogram-system-a-medical-center-experience-in-middle-taiwan
#20
Xiu-Shu Zhang, Fang-Yie Leu, Ching-Wen Yang, Lai-Shiun Lai
Electrocardiogram (ECG) as one of the best methods to measure irregular heartbeats is a dispensable method for doctor to diagnose Acute Myocardial Infarction (AMI) patients. Most medical centers in Taiwan implement the reduction of Door to Balloon (D2B) time, which is defined as the time interval starting when an Acute-Myocardial-Infarction patient arrives at the Emergency Department, and ending when a catheter guide wire crosses the culprit lesion as the acute-myocardial-infarction treatment on the patient in the cardiac catheterization room...
January 17, 2018: Journal of Medical Systems
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