Effect of difficulty affording health care on health status after coronary revascularization.

Abstract:

BACKGROUND:An objective of the United States' Healthy People 2010 Initiative is to eliminate disparities based on socioeconomic status. We assessed the effect of difficulty affording health care on the health status (symptoms, function, and quality of life) of patients treated with percutaneous coronary intervention or CABG. METHODS AND RESULTS:A consecutive, single-center cohort of 480 patients undergoing coronary revascularization received the Seattle Angina Questionnaire at the time of their procedure and at subsequent monthly intervals for 6 months. At baseline, patients who reported somewhat of a burden to a severe burden in affording health care had significantly lower scores on the Seattle Angina Questionnaire (mean+/-SD) with respect to angina (55+/-29 versus 68+/-25, P<0.0001), physical limitation (55+/-26 versus 72+/-24, P<0.0001), and quality of life (46+/-22 versus 56+/-22, P<0.0001) than those who did not perceive healthcare costs to be burdensome. Although both groups of patients improved after revascularization, poorer health status persisted among those with difficulty affording health care after percutaneous coronary intervention (6-month mean+/-SE: angina 79+/-2.5 versus 88+/-1.9, P=0.002; physical function 61+/-2.7 versus 80+/-2.0, P<0.0001; quality of life 67+/-2.4 versus 82+/-1.8, P<0.0001) but not after CABG (angina 91+/-2.5 versus 93+/-1.6, P=0.47; physical function 75+/-3.4 versus 81+/-2.2, P=0.13; quality of life 84+/-3.1 versus 84+/-2.0, P=0.81). Similar differences remained after adjustment for demographic and clinical characteristics. CONCLUSIONS:Patients reporting difficulty affording health care have worse health status at the time of coronary revascularization. A persistent disparity exists after percutaneous but not surgical revascularization. Additional inquiry into the mechanism of this disparity is needed so that the goals of equitable health care, irrespective of treatment strategy, can be achieved.

journal_name

Circulation

journal_title

Circulation

authors

Spertus J,Decker C,Woodman C,House J,Jones P,O'Keefe J,Borkon AM

doi

10.1161/CIRCULATIONAHA.104.474775

subject

Has Abstract

pub_date

2005-05-24 00:00:00

pages

2572-8

issue

20

eissn

0009-7322

issn

1524-4539

pii

CIRCULATIONAHA.104.474775

journal_volume

111

pub_type

杂志文章
  • Myocardial thallium-201 kinetics in normal and ischemic myocardium.

    abstract::The initial myocardial uptake of thallium-201 depends on myocardial blood flow distribution. The phenomenon of delayed thallium redistribution after transiently or chronically altered myocardial perfusion has been described. The net myocardial accumulation of thallium-201 after injection depends upon the net balance b...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.64.3.610

    authors: Grunwald AM,Watson DD,Holzgrefe HH Jr,Irving JF,Beller GA

    更新日期:1981-09-01 00:00:00

  • Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations.

    abstract::Recent reports of selected observational studies and a meta-analysis have stirred controversy and have become the impetus for calls to abandon recommendations for reduced sodium intake by the US general population. A detailed review of these studies documents substantial methodological concerns that limit the usefulne...

    journal_title:Circulation

    pub_type: 共识发展会议,杂志文章

    doi:10.1161/CIR.0b013e318279acbf

    authors: Whelton PK,Appel LJ,Sacco RL,Anderson CA,Antman EM,Campbell N,Dunbar SB,Frohlich ED,Hall JE,Jessup M,Labarthe DR,MacGregor GA,Sacks FM,Stamler J,Vafiadis DK,Van Horn LV

    更新日期:2012-12-11 00:00:00

  • Disruption in the temporal sequence of regional ventricular contraction. I. Characteristics and incidence in coronary artery disease.

    abstract::While spatial asynergy at end-systole has been well characterized in patients with coronary artery disease, assessment of regional asynchrony has been hampered by technical constraints. We developed a computer-assisted method for analyzing regional asynchrony from the equilibrium (ECG-gated) radionuclide ventriculogra...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.61.6.1075

    authors: Holman BL,Wynne J,Idoine J,Neill J

    更新日期:1980-06-01 00:00:00

  • Vitamin E reduces progression of atherosclerosis in low-density lipoprotein receptor-deficient mice with established vascular lesions.

    abstract:BACKGROUND:A growing body of evidence from animal studies supports the hypothesis that oxidative stress-mediated mechanisms play a central role in early atherogenesis. In contrast, clinical trials with antioxidant vitamins have not produced consistent results in humans with established atherosclerosis. METHODS AND RES...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000055186.40785.c4

    authors: Cyrus T,Yao Y,Rokach J,Tang LX,Praticò D

    更新日期:2003-02-04 00:00:00

  • Oxygen uptake kinetics are determined by cardiac function at onset of exercise rather than peak exercise in patients with prior myocardial infarction.

    abstract:BACKGROUND:Resting cardiac function does not necessarily affect exercise capacity. However, to determine whether it affects early dynamics of oxygen uptake (VO2) during exercise, we measured VO2 during a constant work rate and during incremental exercise testing in patients with a history of myocardial infarction. VO2 ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.90.5.2324

    authors: Koike A,Hiroe M,Adachi H,Yajima T,Yamauchi Y,Nogami A,Ito H,Miyahara Y,Korenaga M,Marumo F

    更新日期:1994-11-01 00:00:00

  • Three-dimensional echocardiography. In vivo validation for right ventricular volume and function.

    abstract:BACKGROUND:Current two-dimensional echocardiographic measures of right ventricular volume are limited by the asymmetrical and crescentic shape of the ventricle and by difficulty in obtaining standardized views. Three-dimensional echocardiographic reconstruction, which does not require geometric assumptions or standardi...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.89.5.2342

    authors: Jiang L,Siu SC,Handschumacher MD,Luis Guererro J,Vazquez de Prada JA,King ME,Picard MH,Weyman AE,Levine RA

    更新日期:1994-05-01 00:00:00

  • Pathophysiologically relevant concentrations of tumor necrosis factor-alpha promote progressive left ventricular dysfunction and remodeling in rats.

    abstract:BACKGROUND:Although patients with heart failure express elevated circulating levels of tumor necrosis factor-alpha (TNF-alpha) in their peripheral circulation, the structural and functional effects of circulating levels of pathophysiologically relevant concentrations of TNF-alpha on the heart are not known. METHODS AN...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.97.14.1382

    authors: Bozkurt B,Kribbs SB,Clubb FJ Jr,Michael LH,Didenko VV,Hornsby PJ,Seta Y,Oral H,Spinale FG,Mann DL

    更新日期:1998-04-14 00:00:00

  • Genetic variation in lectin-like oxidized low-density lipoprotein receptor 1 (LOX1) gene and the risk of coronary artery disease.

    abstract:BACKGROUND:We examined the association of 3 polymorphisms in the lectin-like oxidized LDL receptor-1 (LOX1 or OLR1) gene with coronary artery disease in the Women's Ischemia Syndrome Evaluation (WISE) study population. METHODS AND RESULTS:The WISE sample comprised 589 white and 122 black women who underwent angiograph...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/01.CIR.0000074207.85796.36

    authors: Chen Q,Reis SE,Kammerer C,Craig WY,LaPierre SE,Zimmer EL,McNamara DM,Pauly DF,Sharaf B,Holubkov R,Bairey Merz CN,Sopko G,Bontempo F,Kamboh MI

    更新日期:2003-07-01 00:00:00

  • Plasma von Willebrand factor and soluble p-selectin as indices of endothelial damage and platelet activation in 1321 patients with nonvalvular atrial fibrillation: relationship to stroke risk factors.

    abstract:BACKGROUND:Epidemiological studies have identified clinical and echocardiographic factors associated with increased stroke risk in atrial fibrillation (AF), but mechanisms linking these factors to stroke in AF are incompletely understood. We hypothesized that stroke risk factors may be associated with increased endothe...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1161/01.cir.0000033220.97592.9a

    authors: Conway DS,Pearce LA,Chin BS,Hart RG,Lip GY

    更新日期:2002-10-08 00:00:00

  • Prospective study of breakfast eating and incident coronary heart disease in a cohort of male US health professionals.

    abstract:BACKGROUND:Among adults, skipping meals is associated with excess body weight, hypertension, insulin resistance, and elevated fasting lipid concentrations. However, it remains unknown whether specific eating habits regardless of dietary composition influence coronary heart disease (CHD) risk. The objective of this stud...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.113.001474

    authors: Cahill LE,Chiuve SE,Mekary RA,Jensen MK,Flint AJ,Hu FB,Rimm EB

    更新日期:2013-07-23 00:00:00

  • Effect of septal myotomy and myectomy on left ventricular systolic function at rest and during exercise in patients with IHSS.

    abstract::Patients with idiopathic hypertrophic subaortic stenosis (IHSS) have supernormal left ventricular systolic function at rest. Septal myotomy/myectomy reduces outflow obstruction and symptoms. However, it has been proposed that operation causes myocardial damage, with consequent reduction in left ventricular function an...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.60.2.82

    authors: Borer JS,Bacharach SL,Green MV,Kent KM,Rosing DR,Seides SF,Morrow AG,Epstein SE

    更新日期:1979-08-01 00:00:00

  • Effects of estrogen replacement on infarct size, cardiac remodeling, and the endothelin system after myocardial infarction in ovariectomized rats.

    abstract:BACKGROUND:Estrogen may increase the long-term survival of women who have suffered from a myocardial infarction (MI). We examined the acute and chronic influence of estrogen on MI in the rat left coronary artery ligation model. METHODS AND RESULTS:Female Sprague-Dawley rats (10 to 12 weeks, n=93), divided into 3 group...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.24.2983

    authors: Smith PJ,Ornatsky O,Stewart DJ,Picard P,Dawood F,Wen WH,Liu PP,Webb DJ,Monge JC

    更新日期:2000-12-12 00:00:00

  • Recommendations for Cardiovascular Health and Disease Surveillance for 2030 and Beyond: A Policy Statement From the American Heart Association.

    abstract::The release of the American Heart Association's 2030 Impact Goal and associated metrics for success underscores the importance of cardiovascular health and cardiovascular disease surveillance systems for the acquisition of information sufficient to support implementation and evaluation. The aim of this policy statemen...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIR.0000000000000756

    authors: Roger VL,Sidney S,Fairchild AL,Howard VJ,Labarthe DR,Shay CM,Tiner AC,Whitsel LP,Rosamond WD,American Heart Association Advocacy Coordinating Committee.

    更新日期:2020-03-03 00:00:00

  • Early predictors of survival to and after heart transplantation in children with dilated cardiomyopathy.

    abstract:BACKGROUND:The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined. METHODS AND RESULTS:The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome ...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.110.011999

    authors: Pietra BA,Kantor PF,Bartlett HL,Chin C,Canter CE,Larsen RL,Edens RE,Colan SD,Towbin JA,Lipshultz SE,Kirklin JK,Naftel DC,Hsu DT

    更新日期:2012-08-28 00:00:00

  • Firing properties of single muscle vasoconstrictor neurons in the sympathoexcitation associated with congestive heart failure.

    abstract:BACKGROUND:Congestive heart failure (CHF) in humans is associated with a marked sympathoexcitation, including an augmented muscle sympathetic nerve activity (MSNA) in intraneural multiunit recordings. In the present study, single-unit recording was used to evaluate whether the firing properties of individual muscle vas...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.100.16.1708

    authors: Macefield VG,Rundqvist B,Sverrisdottir YB,Wallin BG,Elam M

    更新日期:1999-10-19 00:00:00

  • Reciprocating tachycardia using bilateral anomalous pathways: electrophysiologic and clinical implications.

    abstract::A patient who had disabling supraventricular tachycardia showed electrophysiologic evidence of coexistent right and left Kent bundles. The supraventricular tachycardia was accelerated by sequential antegrade and retrograde conduction over the right and left Kent bundles, respectively. Spontaneous blocking of the condu...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.62.3.657

    authors: Cinca J,Valle V,Gutierrez L,Figueras J,Rius J

    更新日期:1980-09-01 00:00:00

  • Biventricular circulatory support with two miniaturized implantable assist devices.

    abstract:BACKGROUND:Up to 30% of patients with end-stage heart failure experience biventricular failure that requires biventricular mechanical support. For these patients, only bulky extracorporeal or implantable displacement pumps or the total artificial heart have been available to date, which enables only limited quality of ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.110.011502

    authors: Krabatsch T,Potapov E,Stepanenko A,Schweiger M,Kukucka M,Huebler M,Hennig E,Hetzer R

    更新日期:2011-09-13 00:00:00

  • A history of the American Heart Association's Council on Clinical Cardiology.

    abstract::This essay reviews the founding and early history of the Council on Clinical Cardiology of the American Heart Association (AHA), the largest of the AHA's 14 councils. Based on archival research, it stresses the factors that led to the council's formation and shaped its agenda. The council was established in the contex...

    journal_title:Circulation

    pub_type: 历史文章,杂志文章

    doi:10.1161/01.cir.87.3.1057

    authors: Fye WB

    更新日期:1993-03-01 00:00:00

  • Predictors of new-onset diastolic and systolic hypertension: the Framingham Heart Study.

    abstract:BACKGROUND:Factors leading differentially to the development of isolated diastolic (IDH), systolic-diastolic (SDH), and isolated systolic (ISH) hypertension are poorly understood. We examined the relations of blood pressure (BP) and clinical risk factors to the new onset of the 3 forms of hypertension. METHODS AND RES...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000157159.39889.EC

    authors: Franklin SS,Pio JR,Wong ND,Larson MG,Leip EP,Vasan RS,Levy D

    更新日期:2005-03-08 00:00:00

  • Acute cardiovascular effects of fetal surgery in the human.

    abstract:BACKGROUND:Prenatal surgery for congenital anomalies can prevent fetal demise or alter the course of organ development, resulting in a more favorable condition at birth. The indications for fetal surgery continue to expand, yet little is known about the acute sequelae of fetal surgery on the human cardiovascular system...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:10.1161/01.CIR.0000142294.95388.C4

    authors: Rychik J,Tian Z,Cohen MS,Ewing SG,Cohen D,Howell LJ,Wilson RD,Johnson MP,Hedrick HL,Flake AW,Crombleholme TM,Adzick NS

    更新日期:2004-09-21 00:00:00

  • Unlocking the Secrets of Mitochondria in the Cardiovascular System: Path to a Cure in Heart Failure—A Report from the 2018 National Heart, Lung, and Blood Institute Workshop

    abstract::Mitochondria have emerged as a central factor in the pathogenesis and progression of heart failure, and other cardiovascular diseases, as well, but no therapies are available to treat mitochondrial dysfunction. The National Heart, Lung, and Blood Institute convened a group of leading experts in heart failure, cardiova...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:10.1161/CIRCULATIONAHA.119.040551

    authors: Tian R,Colucci WS,Arany Z,Bachschmid MM,Ballinger SW,Boudina S,Bruce JE,Busija DW,Dikalov S,Dorn GW II,Galis ZS,Gottlieb RA,Kelly DP,Kitsis RN,Kohr MJ,Levy D,Lewandowski ED,McClung JM,Mochly-Rosen D,O'Brien KD,O'R

    更新日期:2019-10-01 00:00:00

  • Abrupt withdrawal of beta-blockade therapy in patients with myocardial infarction: effects on infarct size, left ventricular function, and hospital course.

    abstract::The effects of abrupt withdrawal or continuation of beta-blockade therapy during acute myocardial infarction were evaluated in 326 patients participating in the Multicenter Investigation of the Limitation of Infarct Size (MILIS). Thirty-nine patients previously receiving a beta-blocker and randomly selected for withdr...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.73.6.1281

    authors: Croft CH,Rude RE,Gustafson N,Stone PH,Poole WK,Roberts R,Strauss HW,Raabe DS Jr,Thomas LJ,Jaffe AS

    更新日期:1986-06-01 00:00:00

  • RR variability in healthy, middle-aged persons compared with patients with chronic coronary heart disease or recent acute myocardial infarction.

    abstract:BACKGROUND:The purpose of this investigation was to establish normal values of RR variability for middle-aged persons and compare them with values found in patients early and late after myocardial infarction. We hypothesized that presence or absence of coronary heart disease, age, and sex (in this order of importance) ...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1161/01.cir.91.7.1936

    authors: Bigger JT Jr,Fleiss JL,Steinman RC,Rolnitzky LM,Schneider WJ,Stein PK

    更新日期:1995-04-01 00:00:00

  • Acetylcholine release in human heart atrium: influence of muscarinic autoreceptors, diabetes, and age.

    abstract:BACKGROUND:An imbalance of sympathetic and parasympathetic drive to the heart is an important risk factor for cardiac death in patients with coronary heart disease, diabetes, and renal insufficiency. The amount of neurotransmitter released from peripheral autonomic nerves is modulated by presynaptic receptor systems. I...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.103.12.1638

    authors: Oberhauser V,Schwertfeger E,Rutz T,Beyersdorf F,Rump LC

    更新日期:2001-03-27 00:00:00

  • Accuracy of volume measurement by conductance catheter in isolated, ejecting canine hearts.

    abstract::We evaluated the accuracy of the recently reported technique of estimating intraventricular volume by measurement of intracavitary electrical conductance in six isolated, ejecting, canine left ventricles. Left ventricular volumes were measured directly by a previously validated servosystem that employed an electrocond...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.72.2.440

    authors: Burkhoff D,van der Velde E,Kass D,Baan J,Maughan WL,Sagawa K

    更新日期:1985-08-01 00:00:00

  • Inaccuracy of mitral pressure half-time immediately after percutaneous mitral valvotomy. Dependence on transmitral gradient and left atrial and ventricular compliance.

    abstract::Mitral pressure half-time (T1/2) is widely used as an independent measure of mitral valve area in patients undergoing percutaneous mitral valvotomy. However, fluid dynamics theory predicts T1/2 to be strongly dependent on chamber compliance and the peak transmitral gradient, which are variables that change dramaticall...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.78.4.980

    authors: Thomas JD,Wilkins GT,Choong CY,Abascal VM,Palacios IF,Block PC,Weyman AE

    更新日期:1988-10-01 00:00:00

  • Exercise conditioning in older coronary patients. Submaximal lactate response and endurance capacity.

    abstract:BACKGROUND:Older coronary patients are at high risk of cardiac disability. Exercise conditioning programs have been demonstrated to improve functional capacity, particularly in younger coronary patients. In this study, the effects of aerobic conditioning on submaximal and maximal indicators of exercise performance were...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.88.2.572

    authors: Ades PA,Waldmann ML,Poehlman ET,Gray P,Horton ED,Horton ES,LeWinter MM

    更新日期:1993-08-01 00:00:00

  • Survival after coronary artery bypass surgery in specific patient groups.

    abstract::The results of coronary bypass 5-10 years after operation at the Baylor College of Medicine are reported. The late results demonstrate that good relief of symptoms of angina pectoris persisted in 89% of patients at 10 years of follow-up. An overall annual attrition rate of 3% has been fairly constant through 10 years ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.65.7.43

    authors: Lawrie GM,Morris GC Jr

    更新日期:1982-06-01 00:00:00

  • Clinical Profile and Consequences of Atrial Fibrillation in Hypertrophic Cardiomyopathy.

    abstract:BACKGROUND:Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.117.029267

    authors: Rowin EJ,Hausvater A,Link MS,Abt P,Gionfriddo W,Wang W,Rastegar H,Estes NAM,Maron MS,Maron BJ

    更新日期:2017-12-19 00:00:00

  • Influence of compression rate on initial success of resuscitation and 24 hour survival after prolonged manual cardiopulmonary resuscitation in dogs.

    abstract::The influence of chest compression rate on initial resuscitation success and 24 hr survival after prolonged manual cardiopulmonary resuscitation (CPR) was investigated in 26 morphine-anesthetized dogs (17 to 30 kg). After placement of aortic and right atrial micromanometers and induction of ventricular fibrillation, m...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.77.1.240

    authors: Feneley MP,Maier GW,Kern KB,Gaynor JW,Gall SA Jr,Sanders AB,Raessler K,Muhlbaier LH,Rankin JS,Ewy GA

    更新日期:1988-01-01 00:00:00