Abstract:
BACKGROUND:Previous studies have suggested that thrombolysis is used less often in blacks than in whites. However, whether the greater prevalence of contraindications or less specific electrocardiographic manifestations of myocardial infarction (MI) account for this difference is unclear. METHODS AND RESULTS:We studied 498 consecutive patients (32% blacks) with first MI. Initial electrocardiograms were analyzed, blinded to race and outcome, for ST-segment deviation and bundle branch block to determine eligibility for thrombolysis. The relation of electrocardiographic eligibility for thrombolysis and actual use of thrombolysis in both races was explored. Among blacks, 45% received thrombolysis compared with 66% of whites (P <.001). A similar proportion of blacks and whites were eligible for thrombolysis (59% and 66% respectively, P =. 116), but 62% of electrocardiography-eligible blacks were treated with thrombolysis compared with 75% of whites (P =.016). After accounting for eligibility for electrocardiography and other clinical variables likely to affect the decision to administer thrombolysis by means of conditional logistic regression, blacks were still less likely to receive thrombolysis (relative risk 0.73; 95% confidence interval 0.55 to 0.97). CONCLUSIONS:We conclude that the differences in thrombolysis administration to blacks and whites are not accounted for by differences in electrocardiographic presentation or other measured variables. Unmeasured differences in clinical presentation of MI may explain racial differences in thrombolysis and merits further study.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Manhapra A,Khaja F,Syed M,Rybicki BA,Wulbrecht N,Alam M,Sabbah H,Goldstein S,Borzak Sdoi
10.1067/mhj.2000.107173subject
Has Abstractpub_date
2000-08-01 00:00:00pages
200-5issue
2eissn
0002-8703issn
1097-6744pii
S0002-8703(00)69452-8journal_volume
140pub_type
杂志文章abstract::The antihypertensive effects of the renin inhibitor enalkiren were compared with those of the angiotensin-converting enzyme inhibitor enalaprilat in 17 hypertensive patients (14 white, 3 black; mean age 57 years), whose renin systems had been stimulated by diuretic pretreatment. Patients were studied on 3 separate in-...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90477-y
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVE:To assess whether serum uric acid, which is a marker of impaired oxidative metabolism, might correlate with left ventricular systolic and diastolic dysfunction in patients with chronic heart failure (CHF). BACKGROUND:Uric acid levels, which are frequently elevated in patients with CHF, correlate with leg vas...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.122122
更新日期:2002-06-01 00:00:00
abstract::In subjects without coronary disease, coronary perfusion pressure generated with closed-chest cardiopulmonary resuscitation (CPR) bears a direct relationship to myocardial blood flow. The effect of coronary lesions on this relationship was studied in an experimental porcine model not requiring thoracotomy. Coronary st...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90076-a
更新日期:1990-08-01 00:00:00
abstract::The systemic and renal hemodyanmic effects of bupicomide were studied in 10 male patients with uncomplicated essential hypertension of moderate severity. Bupicomide significantly reduced systolic, diastolic, and mean arterial pressure and peripheral vascular resistance and this hypotensive effect was associated with a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(76)80114-7
更新日期:1976-09-01 00:00:00
abstract::Intramuscular lidocaine administration is known to produce blood concentration levels considered to be therapeutic for prevention of premature ventricular contractions. This double blind study was designed to study the effect of intramuscular lidocaine in the prevention of PVC's in acute myocardial infarction. Forty-s...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(76)80323-7
更新日期:1976-04-01 00:00:00
abstract::The long-term prognosis of patients successfully resuscitated from cardiac arrest who do not have acute precipitating factors and in whom ventricular arrhythmias cannot be induced during baseline electrophysiologic testing is controversial. The purpose of this investigation was to evaluate the long-term risk of recurr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90245-s
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:We investigated the role of the renin-angiotensin system in women with signs and symptoms of ischemia without obstructive coronary artery disease (CAD). Although microvascular dysfunction has been suggested to explain this syndrome and recently was found to predict adverse outcomes, the mechanisms and treatm...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.07.011
更新日期:2011-10-01 00:00:00
abstract::A prospective study examining the relationship between psychological distress and ventricular ectopy was conducted with 125 post-myocardial infarction patients equipped with a transtelephonic ECG monitor. Subjects were subsequently grouped according to the occurrence (n = 59) or nonoccurrence (n = 65) of ventricular a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(88)90246-3
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Few telemedicine programs have undergone cost analyses, impeding their implementation into practice. We report on the economic analysis of a nurse-administered intervention designed to improve blood pressure control among hypertensive veterans. METHODS:We randomized hypertensive patients at the Durham Veter...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2010.05.024
更新日期:2010-08-01 00:00:00
abstract::We developed a new angiographic score of the extent of coronary disease (extent score), which we compared with conventional stenosis and vessel scores that emphasize the severity of stenosis. Scores were determined in 132 patients (29 women, 103 men with a mean age of 55 +/- 10 years) who underwent elective coronary a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80173-5
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Glycoprotein (GP) IIb/IIIa inhibitors can improve outcomes in patients with non-ST-segment elevation acute coronary syndromes but raise the risk of bleeding, particularly if dosed in excess. The impact of GP IIb/IIIa dosing feedback on safety and major bleeding is unknown. METHODS:Glycoprotein IIb/IIIa dosi...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.08.008
更新日期:2010-12-01 00:00:00
abstract::To investigate the incidence and clinical significance of postoperative pericardial effusion (PE), the presence of PE was evaluated by echocardiography, 1 and 2 weeks postoperatively, in 50 patients after insertion of a valve prosthesis and in 100 patients after coronary bypass surgery (50 patients receiving a combina...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90255-4
更新日期:1988-07-01 00:00:00
abstract::To explore the contribution of reperfusion injury to final infarct size after a short duration of ischemia, closed-chest dogs underwent 40 minutes of proximal left anterior descending artery occlusion followed by 3 days of reperfusion. Animals randomly received intracoronary adenosine (n = 8) at 3.75 mg/min during the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90272-j
更新日期:1991-12-01 00:00:00
abstract::The aim of our study was to compare the outcome of patients with a first acute myocardial infarction (AMI) among three large cohorts of patients hospitalized between 1966 and 1992 in Israel, in view of changes in treatment facilities and investigation methods. Patients with a first AMI constituted 71% of all myocardia...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0002-8703(95)90351-8
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Improvement in risk stratification of patients with non-ST-segment elevation acute coronary syndrome (ACS) is a gateway to a more judicious treatment. This study examines whether the routine determination of left ventricular ejection fraction (EF) adds significant prognostic information to currently recommen...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2004.09.027
更新日期:2005-08-01 00:00:00
abstract::A population of 2955 patients admitted to the hospital with acute myocardial infarction (AMI) was followed for 1 year after AMI or until death. Smokers as compared to nonsmokers were over 10 years younger (p less than 0.001) and had a lower prevalence of hypertension (p less than 0.01), congestive heart failure (p les...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90071-7
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Arterial compliance is related to left ventricular hypertrophy and risk for cardiovascular disease events; however, its association with coronary artery stenosis remains uncertain. We sought to assess the relation between lower extremity arterial compliance and presence of angiographically defined coronary a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00254-0
更新日期:2003-10-01 00:00:00
abstract::This prospective study evaluated the accuracy of phase analysis of scintigraphic imaging in defining the site of earliest ventricular activation in pediatric patients with electrophysiologic disorders. Twenty patients (10.8 +/- 5.5 years) with preexcitation (n = 16) or ventricular tachycardia (VT) (n = 4) were indepen...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90015-2
更新日期:1993-02-01 00:00:00
abstract::To assess the influence of viscosity and iodine concentration, three matched and standardized left coronary arteriograms were obtained in 20 patients using iopamidol (Isovue-370), ioversol (Optiray-320), and iohexol (Omnipaque-350). The order of contrast media was randomized and the administration of contrast was doub...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(92)90760-s
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:In the general population, obesity is associated with an increased risk of all-cause death. However, the importance of obesity in patients with established coronary heart disease is less well defined. METHODS:As part of the Determinants of Myocardial Infarction Onset Study, we performed a prospective cohort...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2003.12.015
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:While pharmacologic stress single photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) is used for noninvasive evaluation of patients who are unable to perform treadmill exercise, its impact on net reclassification improvement (NRI) of prognosis is unknown. METHODS:We evaluated the p...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2016.01.012
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Current practice related to the management of atrial fibrillation (AF) complicating coronary artery bypass grafting (CABG) is uncertain. METHODS:We examined management of post-CABG AF in the PREVENT-IV trial, and we explored patterns of use of postoperative rhythm versus rate control and anticoagulation for...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.09.003
更新日期:2009-11-01 00:00:00
abstract::To evaluate whether the identification of the different types of relations between premature ventricular contractions (PVCs) and the preceding sinus cycle length is capable of predicting the effect of beta-blockers on the PVCs themselves, 55 patients (43 men, 12 women, mean age 52.6 +/- 15.6 years) with different card...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(96)90529-3
更新日期:1996-03-01 00:00:00
abstract::CHD remains the leading cause of death in most developed countries; therefore, elucidation of risk factors and associated mechanisms for atherosclerosis and development of CHD has been a high priority. Data from the Framingham Heart Study and other large-scale epidemiologic studies have identified major risk factors a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(96)90096-4
更新日期:1996-06-01 00:00:00
abstract::To assess the effects of chronic left ventricular (LV) dysfunction on intravascular pulmonary blood volume (PBV) and extravascular lung water (EVLW) lung fluid volumes, 56 dogs were evaluated by means of double-indicator dilution techniques. PBV and EVLW were measured in seven control dogs, in eight dogs 4 hours after...
journal_title:American heart journal
pub_type: 杂志文章,收录出版
doi:10.1016/0002-8703(84)90421-6
更新日期:1984-09-01 00:00:00
abstract::To understand the process of atherosclerosis, the homeostatic and protective functions of the endothelium must be considered. The endothelium serves as the interface between blood flow and the vascular tissues. It normally regulates vascular tone and structure through the release of vasoactive substances and maintenan...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(94)90251-8
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Implantable cardioverter defibrillators (ICDs) effectively prevent sudden cardiac death, but selection of appropriate patients for implantation is complex. We evaluated whether risk stratification based on risk of sudden cardiac death alone was sufficient to predict the effectiveness and cost-effectiveness o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125501
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Although there is evidence linking smoking and heart failure (HF), the association between lifetime smoking exposure and HF in older adults and the strength of this association among current and past smokers is not well known. METHODS:We examined the association between smoking status, pack-years of exposur...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.05.013
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Device-detected subclinical atrial fibrillation (AF) refers to infrequent, short-lasting, asymptomatic AF that is detected only with long-term continuous monitoring. Subclinical AF is common and associated with an increased risk of stroke; however, the risk of stroke with subclinical AF is lower than for cli...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2017.04.008
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Decreased heart rate variability (HRV) is often assumed to be associated with mortality in all patients after myocardial infarction (MI), independent of clinical factors or time after MI. METHOD:HRV was determined from Holter tapes in the Cardiac Arrhythmia Suppression Trial (CAST). Patients were 71 +/- 120...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00520-9
更新日期:2004-02-01 00:00:00