Abstract:
BACKGROUND:Patients with unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) remain at risk for death and cardiac ischemic events after being discharged from the hospital. METHODS:We examined whether the Thrombolysis In Myocardial Infarction (TIMI) risk score for UA/NSTEMI, ascertained at presentation in patients enrolled in the TIMI 11B and Efficacy and Safety of Subcutaneous Enoxaparin in Unstable Angina and Non-Q-Wave MI (ESSENCE) trials, could be used to identify patients at high risk for major cardiac events after hospital discharge. RESULTS:There were a total of 1218 major cardiac events, defined as death, nonfatal myocardial infarction, or urgent revascularization, by day 43. Of these events, 336 (28%) occurred in patients after they were discharged from the hospital. Use of the TIMI risk score for UA/NSTEMI revealed a progressive, statistically significant increase in the rate of events after leaving the hospital as the patients' baseline level of risk increased (P <.001 for chi(2) test for trend). For patients with a risk score of 5 to 7, treatment with enoxaparin during the acute phase was associated with an odds ratio of 0.51 (95% CI 0.29-0.91) for the occurrence of death and cardiac ischemic events after hospital discharge. CONCLUSIONS:More than one fourth of the major cardiac events that will occur in the first 6 weeks occur after discharge from the hospital. Stratification at presentation on the basis of the TIMI risk score for UA/NSTEMI can be used to identify patients at high risk for these events. Among patients at high-risk, acute-phase treatment with enoxaparin significantly reduces the risk of major cardiac events after leaving the hospital.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Sabatine MS,McCabe CH,Morrow DA,Giugliano RP,de Lemos JA,Cohen M,Antman EM,Braunwald Edoi
10.1067/mhj.2002.122870subject
Has Abstractpub_date
2002-06-01 00:00:00pages
966-70issue
6eissn
0002-8703issn
1097-6744pii
S0002870302000091journal_volume
143pub_type
临床试验,杂志文章,随机对照试验abstract::Economic assessment can be incorporated into clinical trials to evaluate and compare the costs and benefits of different health care programs. In this article the three main types of evaluation are discussed: cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. The measurement of direct and i...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(05)80059-6
更新日期:1990-03-01 00:00:00
abstract:PURPOSE:Viable myocardium after acute myocardial infarction may be characterized by magnetic resonance imaging (MRI) either by demonstration of recovery of wall motion under dobutamine stress or by perfusion patterns after contrast medium administration. This study examines the relation between the two techniques. MAT...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70049-3
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Procedural volume has been shown to be associated with outcome in cardiac catheterization and intervention in adults. The impact of center-level factors (such as volume) and their interaction with subject- and procedure-level factors on outcome after cardiac catheterization in children is not well described....
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.02.018
更新日期:2015-06-01 00:00:00
abstract::In 10 treated and 2 control dogs, the short-term effects of intravenous propafenone (2 mg/kg/10 minutes, followed by 1 mg/min [n = 2] or 25 micrograms/kg/min [n = 8]) on the internal ventricular defibrillation energy requirements (DER) were investigated. Multiple stored energy levels were randomly tested and the perce...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90577-5
更新日期:1991-11-01 00:00:00
abstract::The antiarrhythmic efficacy and safety of intravenous amiodarone were evaluated in 13 patients with recurrent sustained ventricular tachycardia. All patients had been refractory to at least three prior antiarrhythmic agents (mean, 3.3 per patient), and 11 had multiple direct current cardioversions. Intravenous amiodar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90523-6
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:β-Blockers relieve angina/ischemia in stable coronary artery disease (CAD), and angiotensin-converting enzyme inhibitors prevent CAD outcomes. In EUROPA, the angiotensin-converting enzyme inhibitor perindopril reduced cardiovascular outcomes in low-risk stable CAD patients over 4.2 years. This post hoc analy...
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.2015.08.018
更新日期:2015-12-01 00:00:00
abstract::Electrolyte balance has been regarded as a factor important to cardiovascular stability, particularly in congestive heart failure. Among the common electrolytes, the significance of magnesium has been debated because of difficulty in accurate measurement and other associated factors, including other electrolyte abnorm...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(96)90253-7
更新日期:1996-09-01 00:00:00
abstract::Metoprolol or placebo was gradually withdrawn during 1 week in 115 patients participating in a 3-year, double-blind, postinfarction study. During the first month after withdrawal mental symptoms and increased cardiac symptoms occurred significantly more frequently in the metoprolol group. Disabling symptoms requiring ...
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(84)90408-3
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To analyze the effect of delay times on racial differences in thrombolysis for acute myocardial infarction. BACKGROUND:Lower rates of thrombolytic therapy in blacks with acute myocardial infarction have recently been reported, but the reasons for this disparity are unknown. We hypothesized that lower rates o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.109644
更新日期:2000-10-01 00:00:00
abstract::Fingolimod, a sphingosine-1-phosphate receptor (S1PR) modulator, was the first oral disease-modifying therapy approved for relapsing forms of multiple sclerosis; it reduces autoreactive lymphocytes' egress from lymphoid tissues by down-regulating S1PRs. Sphingosine-1-phosphate signaling is implicated in a range of phy...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2014.06.028
更新日期:2014-11-01 00:00:00
abstract::Positive deviance studies combining qualitative and quantitative designs-a mixed-methods approach-can discover strategies to produce exemplary performance. We present the SAMI study, a national positive deviance study to discover hospital strategies associated with lower 30-day hospital risk-standardized mortality rat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.09.004
更新日期:2011-12-01 00:00:00
abstract::To determine whether the first postpacing interval after entrainment was affected by recording and pacing sites, overdrive atrial pacing was undertaken in 13 episodes of atrial flutter with a mean flutter cycle length (FCL) of 140 +/- 8 msec induced in seven dogs. Atrial flutter was induced by means of an anatomic obs...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90259-7
更新日期:1989-09-01 00:00:00
abstract::Atrial depressurization time measurement by Doppler ultrasound can be used to quantify stenotic mitral valve area. In this report, we present the results of a blinded trial comparing the standard Doppler method for "pressure half-time" (A) and another Doppler method we devised (B) for measurement of atrial depressuriz...
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(87)90045-7
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:Procoagulant stress responses may contribute to atherosclerosis development and acute coronary thrombosis. In the present study, we examined the role of beta2-adrenergic receptor function and plasma catecholamines in the stress-induced increase in the 2 hypercoagulability markers thrombin-antithrombin III (T...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.123146
更新日期:2002-07-01 00:00:00
abstract::To determine whether a dose of 5 mg of nifedipine would be useful in the treatment of hypertensive emergencies, we compared the acute hypotensive effects of two different doses of nifedipine, 5 mg and 10 mg, in patients with severe hypertension. In this prospective, randomized, double-blind study, 30 consecutive black...
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)90283-2
更新日期:1992-09-01 00:00:00
abstract::Women with coronary artery disease are less likely to undergo percutaneous transluminal coronary angioplasty (PTCA) because of the potential referral bias in favor of men with coronary artery disease in the use of invasive diagnostic procedures and interventions. This difference may represent a sex bias in the deliver...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70056-5
更新日期:1997-10-01 00:00:00
abstract::In the United States there has been a dramatic decrease in age-adjusted coronary heart disease (CHD) mortality during the last 20 years. This article investigates the reasons for this decline and concludes that most of the decline in CHD has been the result of life-style changes, particularly reduction in serum choles...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(05)80054-7
更新日期:1990-03-01 00:00:00
abstract::Of 178 transseptal left heart catheterizations performed, 173 successful cases are reported, with the use of a Swan-Ganz, flow-directed, balloon-tipped catheter. By means of a modified Brockenbrough technique, which is described in detail, a 10F Teflon tube (3.3 mm outside diameter) was inserted into the left atrium. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90603-9
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:Perioperative myocardial injury (PMI) remains a major cause of perioperative morbidity and mortality but clinical strategies to prevent PMI are still uncertain. METHODS AND RESULTS:We comprehensively searched PubMed for major research articles concerning clinical strategies to prevent PMI. The key findings ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2007.07.025
更新日期:2007-12-01 00:00:00
abstract::A significant diuretic and natriuretic response occurs during paroxysmal supraventricular tachycardia (SVT). Although the diuresis may be secondary to suppression of vasopressin secretion, the etiology of the natriuresis remains unexplained. To determine if atrial natriuretic factor (ANF) could contribute to the polyu...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90301-7
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Systolic wall motion abnormality (WMA) after acute myocardial infarction (AMI) is a major determinant of outcome; the presence and importance of diastolic WMA after AMI are unknown. We therefore sought to detect diastolic WMA using color kinesis and to assess its relation to neurohormonal activation and its ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.11.024
更新日期:2005-10-01 00:00:00
abstract::Noninvasive risk assessment in survivors of AMI can effectively subdivide patients into groups with differing risk profiles after hospital discharge, but some patients at risk for late death or recurrent AMI may be incorrectly identified; data from cardiac catheterization and angiography provide complementary and gene...
journal_title:American heart journal
pub_type: 社论
doi:10.1016/0002-8703(91)90747-6
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) ablation is superior to pharmacologic therapy in achieving maintenance of normal sinus rhythm in selected patient populations. However, the procedure is resource intensive, and repeat ablations are sometimes required. We examined the predictors and trends of repeat ablation using a l...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.10.015
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The TRANSFER-AMI study demonstrated that early routine percutaneous coronary intervention post-fibrinolysis (pharmacoinvasive strategy) is superior to conservative management for ST-elevation myocardial infarction. However, it is not clear whether treatment efficacy differs between men and women. METHODS:In...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.05.022
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:It has been reported that mineralocorticoid receptor antagonist improves the prognosis of chronic heart failure (CHF). Recently, hemoglobin A₁(c) (HbA₁(c)) levels have been reported to be an independent risk factor for mortality in CHF, suggesting the important role of insulin resistance in CHF. We compared ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2010.04.024
更新日期:2010-11-01 00:00:00
abstract::An extremely athletic 56-year-old male physician was found to have profound sinus bradycardia. His only symptom was markedly increased alertness while actively exercising. During pacemaker insertion he had an episode of prolonged sinus arrest terminated by a precordial thump. This case suggests that exercise can alter...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90284-7
更新日期:1980-07-01 00:00:00
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:BACKGROUND:Platelet inhibition is critical in reducing both short- and long-term atherothrombotic risks after acute myocardial infarction (MI), especially among patients managed with percutaneous coronary intervention (PCI). Currently available antiplatelet medications, including adenosine diphosphate (ADP) receptor in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.08.021
更新日期:2011-11-01 00:00:00
abstract::Urodilatin [ANP-95-126] is a new natriuretic peptide of renal origin not subjected to tolerance in experimental congestive heart failure (CHF). To evaluate its therapeutic potentials in CHF, we investigated the efficacy of a prolonged infusion of urodilatin (15 ng/kg/min for 10 hours) in 12 patients with CHF (New York...
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(95)90328-3
更新日期:1995-04-01 00:00:00
abstract::A review of the clinical course of chronic heart failure demonstrates that current outcomes remain highly unsatisfactory both in mortality and perhaps more important in morbidity. The extraordinary satisfactory functional responses seen in patients who undergo cardiac transplantation clearly identify the primary cause...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(90)90056-4
更新日期:1990-12-01 00:00:00