Abstract:
AIMS:Despite advances in the treatment of acute coronary syndromes based on randomized trial data and published guidelines, the extent to which such treatments are applied in practice remains uncertain. Data from clinical trials derive from selected geographical areas and in highly selected populations of patients, and hence may not reflect the overall population. The aim of the study was to investigate variations in hospital management and outcome using unselected data collected in the prospective Global Registry of Acute Coronary Events (GRACE). METHODS AND RESULTS:The 95 hospitals in GRACE were organized into 18 population-based clusters in 14 countries. Information was recorded about patient management and outcome during hospitalization and after discharge. Data on treatments administered were analysed by baseline condition, hospital type, by the presence or absence of a catheterization laboratory, and by geographical region. Of 11543 patients, 44% had an admission diagnosis of unstable angina, 36% presented with myocardial infarction, 9% were admitted to rule out a myocardial infarction, 7% had chest pain and 4% were hospitalized for 'other cardiac' and 'non-cardiac' diagnoses. Of the total GRACE population 38% had a final diagnosis of unstable angina, 30% ST-segment elevation myocardial infarction, 25% non-ST-segment elevation myocardial infarction, and 7% of 'other cardiac' and 'non-cardiac' final diagnoses. The event rates for hospital death or reinfarction were six and 2% for non-ST-segment elevation myocardial infarction, seven and 3% for ST-segment elevation myocardial infarction, and 3% hospital death for unstable angina. The use of aspirin was similar across all hospital types and geographical regions. In contrast, the use of percutaneous coronary intervention and glycoprotein IIb/IIIa inhibitors was higher (P<0.0001) in teaching hospitals and hospitals with catheterization laboratories and was also higher in the United States. At discharge a higher percentage (P<0.0001) of patients received angiotensin-converting enzyme inhibitors in hospitals without catheterization laboratories. The use of statins was lower in non-teaching hospitals and in centres without a catheterization laboratory. CONCLUSIONS:The GRACE study reveals substantial differences in the management of patients based on hospital type and geographical location. Further analyses will determine whether such variations translate into differences in longer term outcomes. GRACE provides a multinational reference for the implementation of therapies of proven efficacy.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Fox KA,Goodman SG,Klein W,Brieger D,Steg PG,Dabbous O,Avezum Adoi
10.1053/euhj.2001.3081subject
Has Abstractpub_date
2002-08-01 00:00:00pages
1177-89issue
15eissn
0195-668Xissn
1522-9645pii
S0195668X01930817journal_volume
23pub_type
杂志文章abstract::One of the main areas of interest in interventional cardiology is the understanding, and ultimate prevention of restenosis after an initially successful percutaneous transluminal coronary angioplasty. Restenosis is the recurrence of luminal narrowing following angioplasty, and still frustrates the late results in the ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验,评审
doi:10.1093/eurheartj/16.suppl_l.56
更新日期:1995-11-01 00:00:00
abstract::Intracoronary blood flow velocity measurements with a Doppler balloon catheter and the radiographic assessment of myocardial perfusion with contrast media, before and after the intracoronary administration of papaverine, have previously been used to investigate regional coronary flow reserve. In the present study we a...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059557
更新日期:1989-08-01 00:00:00
abstract::Large-scale randomized clinical trials have established the efficacy of cholesterol-lowering, blood pressure-lowering, and anti-platelet therapy to prevent cardiovascular diseases. A challenge for clinicians is to apply group-level evidence from these trials to individual patients. Trials typically report a single tre...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu004
更新日期:2014-04-01 00:00:00
abstract::The alterations of the beta-adrenoceptor adenylyl cyclase are reviewed. In failing myocardium, the down-regulation of beta 1-adrenoceptors is accompanied by a decrease in steady state mRNA levels, as studied with quantitative polymerase chain reactions in dilated and ischaemic cardiomyopathy. The density of beta 2-adr...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/15.suppl_d.30
更新日期:1994-12-01 00:00:00
abstract::Reactive thrombocytosis following cardiopulmonary bypass surgery is generally considered to be a benign condition which is transient and does not require specific therapy. We describe three patients who developed stroke in association with reactive thrombocytosis in the late recovery period following cardiopulmonary b...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060642
更新日期:1994-08-01 00:00:00
abstract:AIMS:Aortic aneurysm/dissection (AAD) is a life-threatening disorder lacking effective pharmacotherapeutic remedies. Aldehyde dehydrogenase 2 (ALDH2) polymorphism is tied with various risk factors for AAD including hypertension, atherosclerosis, and hypercholesterolaemia although direct correlation between the two rema...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa352
更新日期:2020-07-07 00:00:00
abstract:AIMS:Fetuin-A has been identified as a potent circulating inhibitor of ectopic calcification. We investigated the relationship between baseline fetuin-A serum levels and the rate of progression of aortic valve calcification (AVC) in non-dialyzed patients with aortic valve disease (AVD). METHODS AND RESULTS:Seventy-sev...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehp158
更新日期:2009-08-01 00:00:00
abstract:AIMS:The aim of this study was to investigate the 12-month incidence, predictive factors, and prognosis of sustained ventricular tachycardia (VT) in chronic heart failure patients implanted with biventricular pacemakers without a back-up defibrillator (CRT-P), assessed by continuous intracardiac ventricular electrogram...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehp071
更新日期:2009-05-01 00:00:00
abstract:Aims:The ESC-EHRA Atrial Fibrillation Ablation Long-Term registry is a prospective, multinational study that aims at providing an accurate picture of contemporary real-world ablation for atrial fibrillation (AFib) and its outcome. Methods and results:A total of 104 centres in 27 European countries participated and wer...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehw564
更新日期:2017-05-01 00:00:00
abstract:AIMS:To describe patient characteristics, pre-hospital delay, treatment, complications and outcome in patients with acute myocardial infarction admitted to hospitals in Germany. METHODS AND RESULTS:The study was of prospective observational multicentre design. Those involved were consecutive patients with acute Q-wave...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/oxfordjournals.eurheartj.a015470
更新日期:1997-09-01 00:00:00
abstract::As a rule, left ventricular relaxation is impaired in patients with coronary artery disease and congestive heart failure. In addition, the passive elastic properties in early and late diastole change when the ventricle dilates. Diastolic properties of the left ventricle were studied in 11 patients with congestive hear...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/13.suppl_e.52
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:The EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot) provides systematic collection of contemporary data regarding the management and treatment of 3119 subjects with AF from 9 member European Society of Cardiology (ESC) countries. In this analysis, we repor...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehu374
更新日期:2014-12-14 00:00:00
abstract::We examined two 'cohorts' of elderly men, 60 and 67 years old. The two 'cohorts' overlapped to a large extent in terms of numbers but not in the follow-up periods. The mean have been followed-up for 7 and 8 years respectively. Among the 748 60-year-old men without prior myocardial infarction the 7-year incidence of co...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::Over two decades after the introduction of cardiac resynchronization therapy (CRT) into clinical practice, ∼30% of candidates continue to fail to respond to this highly effective treatment of drug-refractory heart failure (HF). Since the causes of this non-response (NR) are multifactorial, it will require multidiscipl...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehw270
更新日期:2017-05-14 00:00:00
abstract:AIMS:To investigate whether an ambulance crew's length of experience affected the outcome of out-of-hospital cardiac arrest. METHODS AND RESULTS:This was a population-based, retrospective observational study of attempted resuscitations in 1547 consecutive arrests of cardiac aetiology by Nottinghamshire Emergency Ambul...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1998.1334
更新日期:1999-04-01 00:00:00
abstract:AIMS:No-reflow after a primary percutaneous coronary intervention (PCI) is associated with a high incidence of left ventricular (LV) failure and a poor prognosis. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor peptide and an important modulator of neutrophil function. Elevated systemic ET-1 levels ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl119
更新日期:2006-08-01 00:00:00
abstract::Measurement of the pre-ejection period (PEP) can give valuable information on myocardial function in rats. Depressed cardiac function is accompanied by prolongation of PEP, which shortens when cardiac function improves. Left ventricular ejection time (LVET) may be shortened with ageing in spontaneously hypertensive ra...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/11.suppl_i.114
更新日期:1990-12-01 00:00:00
abstract::Nisoldipine is a calcium antagonist with potent coronary vasodilating effects in patients with chronic stable angina pectoris. We studied the acute effects of nisoldipine in six patients within 24 h (mean 14 +/- 4 h) after the onset of myocardial infarction. Nisoldipine was administered as a 4.5 micrograms kg-1 intrav...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060125
更新日期:1992-12-01 00:00:00
abstract:AIMS:Statins protect against cardiovascular-related mortality but induce skeletal muscle toxicity. To investigate mechanisms of statins, we tested the hypothesis that statins optimized cardiac mitochondrial function but impaired vulnerable skeletal muscle by inducing different level of reactive oxygen species (ROS). M...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr224
更新日期:2012-06-01 00:00:00
abstract:AIMS:To determine the diagnostic utility of circulating angiopoietin-1 (Ang-1) and its antagonist angiopoietin-2 (Ang-2) as potential biomarkers of disease severity or response to treatment in idiopathic pulmonary arterial hypertension (IPAH). Imbalances in angiogenic factors including vascular endothelial cell growth ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq226
更新日期:2010-09-01 00:00:00
abstract::The treatment of hypertensive aircrew should also include changes in dietary habits, and advice against smoking. Relaxation exercises and changes in life style may prove of benefit. Increasing age, hypertension and smoking multiply to give a risk of cardiovascular event which merits careful assessment. ...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/5.suppl_a.33
更新日期:1984-03-01 00:00:00
abstract::Stephan Achenbach reviews the history of coronary computer tomography angiography and discusses its further evolution. ...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:2016-02-21 00:00:00
abstract:AIMS:To investigate the prevalence of diabetes mellitus in patients with acute myocardial infarction and to determine whether casual blood glucose and haemoglobin A1c measured at admission could be used to diagnose diabetes mellitus. METHODS AND RESULTS:A prospective study that included all patients with acute myocard...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.2445
更新日期:2001-07-01 00:00:00
abstract::This case report describes the delayed improvement of left ventricular function by recanalization of an occluded coronary artery in a patient with intractable heart failure and three-vessel disease. The left anterior descending coronary artery was occluded distal to the first septal branch, the dominant right coronary...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059698
更新日期:1990-03-01 00:00:00
abstract:AIM:Cardiosphere-derived cells (CDCs) produce regenerative effects in the post-infarct setting. However, it is unclear whether CDCs are beneficial in non-ischaemic dilated cardiomyopathy (DCM). We tested the effects of CDC transplantation in mice with cardiac-specific Gαq overexpression, which predictably develop progr...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu196
更新日期:2015-03-21 00:00:00
abstract::A necessary part of the strategy of modification of hypercholesterolaemia to prevent coronary heart disease (CHD) is the detection and treatment, by diet or by drugs, of high risk individuals. There are several drawbacks to this approach: (1) the cost of screening to find individuals at risk and of monitoring by physi...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/8.suppl_e.71
更新日期:1987-08-01 00:00:00
abstract::Myocardial bridging of the left anterior descending coronary artery producing complete systolic occlusion was demonstrated in a patient with hypertrophic cardiomyopathy, who had localized myocardial hypertrophy in the lateral left ventricular wall outside the territory of that artery. Although a cause and effect relat...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/8.7.793
更新日期:1987-07-01 00:00:00
abstract:AIMS:Statins have modest adverse effects on glycaemic control. Alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, lowers low-density lipoprotein cholesterol. This study assessed the effects of alirocumab on new-onset diabetes and pre-diabetes incidence in individuals without diabetes at baseline. M...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehw292
更新日期:2016-10-14 00:00:00
abstract::To assess the clinical significance of monitoring during physical training in post-myocardial infarction (MI) patients with asymptomatic exercise-induced ischaemia, we studied 232 patients who were survivors of first recent acute MI and consecutively admitted to the same CCU, who underwent an exercise test (ET) and co...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_n.176
更新日期:1988-12-01 00:00:00
abstract::Five patients with recurrent tachycardias exhibiting right bundle branch block with left axis deviation were referred for investigation. In each case, a supraventricular mechanism was suspected. During sinus rhythm the QRS morphology and axis (-10 to +60 degrees) and HV intervals were normal. Tachycardia was initiated...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061589
更新日期:1984-11-01 00:00:00