Abstract:
:In a prospective clinical trial of 195 consecutive unselected patients with acute myocardial infarction (AMI), systematic blinded clinical and echocardiographic examinations were performed by two observers on day 5. The purpose was to define low-risk patients with regard to in-hospital and 2-month mortality and predict the potential costs (lost patient lives) and benefits (saved in-patient days) if as a routine procedure these low-risk patients were discharged earlier. By design, low-risk patients as defined by clinical criteria were allocated to discharge on days 7 to 10 and by echocardiographic criteria on days 5 to 7 after AMI. The sensitivity of the echocardiographic low-risk identification procedure was more than twofold higher than the sensitivity of clinical low-risk identification (49% vs 24%). Both procedures were safe with a specificity of 100% for cardiac mortality. Optimal identification of low-risk patients was provided by combining data from echocardiographic and clinical evaluations (sensitivity 59%). Results of the study suggest that a bedside echocardiographic approach to estimation of global left ventricular function is more sensitive and equally specific and therefore more efficient for risk stratification on post-AMI day 5 than clinical examination alone. Thus echocardiographic examination allows identification of a larger subset of patients with AMI (greater than 40% of the population alive on day 5) who can be discharged earlier and safely, with a potential saving of in-patient days of 436 days in 87 low-risk patients minus the cost of echocardiographic studies in 195 patients. However, the best prediction was obtained by combining clinical and echocardiographic examination.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Am Heart Jjournal_title
American heart journalauthors
Launbjerg J,Berning J,Fruergaard P,Appleyard Mdoi
10.1016/0002-8703(92)90963-vsubject
Has Abstractpub_date
1992-10-01 00:00:00pages
846-53issue
4eissn
0002-8703issn
1097-6744pii
0002-8703(92)90963-Vjournal_volume
124pub_type
临床试验,杂志文章abstract:BACKGROUND:Chronic total occlusion (CTO) recanalizations remain extremely challenging procedures. With improvements in technology and techniques, success rates for recanalization of CTO continue to improve. However, the clinical benefits of this practice remain unclear. The aim of the study was to determine the effecti...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2010.04.015
更新日期:2010-07-01 00:00:00
abstract::ECGs taken from four patients with concealed atrial bigeminy were analyzed to find the mechanisms of disappearance and reappearance of extrasystoles. Observations in three patients showing the classic form of concealed bigeminy suggest that when the extrasystole disappeared, the first sinus impulse after the last mani...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90828-7
更新日期:1984-05-01 00:00:00
abstract::Although successful dilatation of a target lesion by means of percutaneous transluminal coronary angioplasty (PTCA) can be attained as frequently in elderly as in younger patients, elderly patients have a higher risk of complications. Furthermore, cohorts of patients older than 75 years and undergoing PTCA include mor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90267-4
更新日期:1994-10-01 00:00:00
abstract::A counterimmunoelectrophoresis technique for detection of serum myoglobin (Mb) was improved using non-ionic polymer dextran. Precipitin lines were graded according to their strength, which was ascertained by radioimmunoassay data. By this method, serum Mb in concentrations of 500 ng./ml. before stain and of 200 ng./ml...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90084-4
更新日期:1978-08-01 00:00:00
abstract:INTRODUCTION:Heart Failure (HF) is a common cause of hospitalization in older adults. The transition from hospital to home is high-risk, and gaps in transitional care can increase the risk of re-hospitalization and death. Combining health care services supported by meta-analyses, we designed the PACT-HF transitional ca...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2017.12.013
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Transradial approach (TRA) for cardiac catheterizations and interventions improves clinical outcomes compared with transfemoral access, and its use is increasing worldwide. However, there are limited data on successive use of same artery for repeat procedures. METHODS:Between May 2010 and May 2011, all cons...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.10.016
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The few available studies of the Centers for Medicare and Medicaid Services Hospital Inpatient Quality Reporting (IQR) care process indicators have not linked receipt of recommended care processes in heart failure (HF) with lower mortality. Because the Veterans Health Administration (VHA) also tracks hospita...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.06.024
更新日期:2014-11-01 00:00:00
abstract::The associations between socioeconomic status, ethnic origin, and risk factors for CHD were studied in 2,591 white and black children from two socioeconomically dissimilar populations in the New York City area. The study subjects were selected from all fourth graders in 44 elementary schools. Blood pressure, plasma li...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90724-1
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Although geographic variation in the treatment of acute myocardial infarction (AMI) has been recognized, the impact of evidence-based international treatment guidelines on such variation is unclear. We sought to characterize resource use and cost of initial hospitalization for AMI in 9 countries and compare ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.02.028
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to estimate the cost-effectiveness of beta-blocker therapy with either metoprolol or carvedilol in addition to conventional therapy for patients with heart failure (HF) in Canada. DESIGN:A Markov simulation was used to estimate the costs and life expectancy for treating patients...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.116479
更新日期:2001-09-01 00:00:00
abstract::Histological study of the sinoatrial node (SAN) was performed in 111 patients in order to estabilsh correlations between the ECG findings and the anatomical lesions. This series includes both patients with sinus rhythm and patients with atrial arrhythmias. The results are as fololows: (a) the amount of nodal cells in ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80070-7
更新日期:1977-06-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with an increased risk of stroke, heart failure, and death. Data on contemporary treatment patterns and outcomes associated with AF in clinical practice are limited. METHODS/DESIGN:The Outcomes Registry for Better Inf...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2011.07.001
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The purpose of the current study was to determine whether survival after revascularization (coronary artery bypass grafting or percutaneous transluminal coronary angioplasty) is influenced by the extent of electrocardiographic (ECG) evidence of previous myocardial infarction (MI) in patients with ischemic ca...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.119996
更新日期:2002-01-01 00:00:00
abstract::To determine correlates of and recent trends in aspirin use in middle-age men and women, we analyzed data from population-based samples selected in four U.S. communities. Aspirin use (during a 2-week period preceding the study examination) was more prevalent in whites than in blacks (30% vs 11%; p < 0.001) and in men ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,评审
doi:10.1016/s0002-8703(96)90173-8
更新日期:1996-05-01 00:00:00
abstract::This study prospectively assessed the electrophysiologic effects of parenteral magnesium sulfate administration on paroxysmal atrioventricular (AV) reentrant supraventricular tachycardia and the efficacy of magnesium to terminate these arrhythmias. Eleven normomagnesemic patients, seven with orthodromic reentrant supr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80021-3
更新日期:1990-02-01 00:00:00
abstract::An expression representative of the rate of change of ventricular power during ejection was derived. The primary advantages of the expression are its theoretical value and its ability to characterize ventricular performance. The rate of change of ventricular power, measured during ejection, is virtually free of assump...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80577-7
更新日期:1976-02-01 00:00:00
abstract::The presence and severity of functional mitral regurgitation were quantified by Doppler echocardiography in 17 patients with dilated cardiomyopathy and no evidence of primary valvular disease. Mitral regurgitant fraction was greater than 20% in 11 of the 17 patients, and exceeded 40% in four patients. Total stroke vol...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90334-1
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:Early lumen loss (ELL) may be detected in patients undergoing coronary interventions for in-stent restenosis. This phenomenon may contribute to recurrences. This prospective, randomized study was designed to determine if repeat stent implantation may prevent ELL in patients with in-stent restenosis. METHODS...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.ahj.2004.06.022
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Although the use of clopidogrel in patients "unlikely" to require coronary artery bypass grafting (CABG) is recommended in current guidelines of acute coronary syndrome (ACS) management, an important minority of patients require CABG. We assessed the ability to predict need for CABG from demographics known a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.12.002
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The optimal duration of dual antiplatelet therapy (DAPT) in acute coronary syndrome (ACS) patients treated with drug eluting stents (DES) is still under debate. Recent meta-analyses on ≤6months versus 12months DAPT suggest that bleeding rates can be reduced, without a higher rate of thrombotic complications....
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.2016.04.016
更新日期:2016-08-01 00:00:00
abstract::When AV conduction is normal, the absence of VA conduction is not abnormal. Analogous information about retrograde sinoatrial conduction is not available. Although the premature atrial stimulas (PAS) technique can demonstrate the presence of sinoatrial entrance block (SAEB), both its prevalence and its relationship to...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90484-1
更新日期:1981-12-01 00:00:00
abstract:BACKGROUND:Contrast-induced acute kidney injury (CIAKI) is a frequent complication after infusion of contrast media in patients undergoing percutaneous coronary intervention. A wide range of CIAKI rates occurs after intervention between 3% and 30%, depending on the definition. The aim of this study was to identify whic...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.02.004
更新日期:2011-05-01 00:00:00
abstract::We examined intraindividual variability in serum TC in 2912 men and women having TC measured at each of biennial examinations 2 through 7 of the FHS. RMSE described variability around the linear slope of an individual's TC during the baseline decade. Average biennial difference +/- SD was +3.7 +/- 6.7 mg/dl in men, +6...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90393-x
更新日期:1994-06-01 00:00:00
abstract::Mitochondria in skeletal and cardiac muscle have been found to be less stable in aging hamsters, in contrast to preparations from young animals. We have found previously that clofibrate (Atromid-S) will reverse this degeneration in the older hamsters. This study examined the exercise tolerance of aged hamsters, to see...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80040-9
更新日期:1977-10-01 00:00:00
abstract::After dipyridamole, canine studies have demonstrated a slower rate of myocardial thallium-201 clearance from zones distal to a coronary artery stenosis compared to normal zones. To determine if criteria based on canine myocardial thallium-201 clearance rates could be applied clinically, 40 patients with and 26 patient...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90088-7
更新日期:1984-03-01 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::Currently available internal cardiac defibrillators use a uniphasic, truncated exponential waveform morphology of about 6 msec in duration at an energy level of 23 to 33 joules. To determine if improved defibrillation could be achieved with a different waveform morphology, we implanted 4.5 cm2 titanium patches to the ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90187-7
更新日期:1989-08-01 00:00:00
abstract::This review focuses on selected aspects of the treatment of patients being evaluated for and undergoing cardiac transplantation. Cardiac transplantation is a potential therapeutic option for a variety of irreversible cardiac disorders when the symptomatic status and anticipated survival after transplantation exceeds t...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(95)90288-0
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. METHODS:From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the Un...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.07.022
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Firm evidence exists for reduction in mortality and morbidity by lipid-lowering therapy in patients with coronary artery disease (CAD), yet a significant proportion remain untreated. This prospective study determined the effectiveness of a planned strategy of management using a cardiac rehabilitation nurse i...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1067/mhj.2001.118739
更新日期:2001-12-01 00:00:00