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 the contribution of length of stay (LOS) and procedure use to cost. METHODS:We applied country-specific cost estimates to data from the international AMI registry associated with the VALIANT trial. The registry includes demographic, medical history, treatment, and discharge information for 5573 patients with AMI admitted to 84 sites in 9 countries from November 1999 to June 2001. Hospitalization cost was estimated by imputed discharge diagnosis-related group code and adjusted for the LOS and procedures. Generalized linear regression was used to adjust cost by country; the contribution of LOS and procedures to cost was assessed by ordinary least squares regression. RESULTS:Unadjusted mean cost for initial AMI hospitalization was 9993 dollars (95% CI 9702 dollars-10,228 dollars). After adjustment for baseline patient-level variation, the lowest average cost was 1605 dollars (Argentina) and the highest was 9196 dollars (United States). Length of stay explained more of the variation in cost (50.7%) than did procedure intensity (31.9%). CONCLUSIONS:International differences in the cost of AMI persist, reflecting variations in procedure use and especially LOS. Relative differences in resource costs and incentives inherent in the provision and financing of health care likely contribute to treatment and cost variation and limit the widespread adoption of international practice guidelines.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Kauf TL,Velazquez EJ,Crosslin DR,Weaver WD,Diaz R,Granger CB,McMurray JJ,Rouleau JL,Aylward PE,White HD,Califf RM,Schulman KAdoi
10.1016/j.ahj.2005.02.028subject
Has Abstractpub_date
2006-01-01 00:00:00pages
206-12issue
1eissn
0002-8703issn
1097-6744pii
S0002-8703(05)00208-5journal_volume
151pub_type
杂志文章abstract::Out of 156 patients with stable coronary heart disease randomized to either an exercise intervention group or a control group, 41 had complete gas analysis data. Continuous gas exchange data, including the ventilatory threshold, and selected heart rates were determined initially and at 1 year. The mean attendance for ...
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(85)90548-4
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:Strenuous exercise can be a major trigger for coronary thrombosis and it enhances platelet aggregation. METHODS:We evaluated the effect of antiplatelet therapy on shear stress-induced platelet aggregation (SIPA), in addition to agonist-induced aggregation, before and immediately after ergometer exercise in ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2001.116485
更新日期:2001-08-01 00:00:00
abstract::Inducible ventricular tachycardia frequently persists despite solitary class I antiarrhythmic drug therapy. To determine the effect of metoprolol as adjuvant therapy, 19 patients with clinical ventricular tachycardia with baseline inducible sustained monomorphic ventricular tachycardia and persistently inducible ventr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90270-6
更新日期:1992-09-01 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::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:BACKGROUND:Although recent data support an early invasive management in acute coronary syndromes (ACS), overall evidence appears conflicting. We performed a metaregression to explore the impact of intracoronary stenting and aggressive antiplatelet treatment on the risk/benefit ratio of an early invasive approach. METH...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2004.10.026
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:A previous randomized controlled trial evaluating the use of spironolactone in heart failure patients reported a low risk of hyperkalemia (2%) and renal insufficiency (0%). Because treatments for heart failure have changed since the benefits of spironolactone were reported, the prevalence of these complicati...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.10.005
更新日期:2004-12-01 00:00:00
abstract::Eighty-seven patients with isolated ventricular septal defect (VSD) operated on in the first 5 years of life, that had a mean interval of 10 months between diagnostic catheterization and surgery, were studied retrospectively. The size of the VSD was correlated with diagnostic catheterization data and comparative analy...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80170-1
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Women with X-chromosome monosomy or Turner syndrome (TS) are at increased risk for aortic dilation and dissection. To better understand the pathology and develop tools to monitor the risk of aortic disease, we investigated N-terminal pro-brain natriuretic peptide (BNP) (NT-proBNP) levels in women with TS and...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.06.021
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions (PCIs) is uncertain. We aimed to assess the impact of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibition with eptifibatide in clinically stable subjects with diffuse coronary lesions. METHODS:Patients wit...
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.2012.02.009
更新日期:2012-05-01 00:00:00
abstract::The hemodynamic effects of dopamine (DPM) and dobutamine (DBM) were compared in 13 patients with acute cardiogenic circulatory collapse. All patients presented with acute pump failure and inadequate systemic perfusion, and most were hypotensive. Nine patients had an acute myocardial infarction (AMI); the other four pa...
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(82)90562-2
更新日期:1982-06-01 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::Percutaneous balloon mitral valvuloplasty has been shown to be an effective means of reducing mitral valve gradient and increasing mitral valve area in patients with mitral stenosis. Most techniques currently employed for performing this procedure involve delivery of one or two balloon valvuloplasty catheters through ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80279-0
更新日期:1990-03-01 00:00:00
abstract::Left ventricular (LV) filling was examined by Doppler and M-mode echocardiography in 24 patients with LV hypertrophy (five with aortic stenosis, six with hypertrophic cardiomyopathy, and 13 with LV hypertrophy secondary to systemic hypertension) and in 18 normal subjects. Patients with LV hypertrophy had significantly...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90657-0
更新日期:1987-06-01 00:00:00
abstract::This article reviews the evidence that congestive heart failure is accompanied by an increased plasma norepinephrine concentration and that this is due not only to a reduced tissue clearance of the substance but also to a marked increase in sympathetic nerve activity. It also reports data that indicate that the sympat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(90)90054-2
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:The study rationale was to compare the biomarker profile of metalloproteinases (MMPs) and inflammation markers (IMs) in patients requiring revascularization with that of patients with long-term, clinically quiescent coronary artery disease (CAD). METHODS:Seventy-eight patients with symptomatic CAD (S-CAD) (...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.08.021
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:ISAR-REACT was a trial designed to evaluate whether the glycoprotein IIb/IIIa inhibitor abciximab is beneficial in patients undergoing elective percutaneous coronary intervention (PCI) with stent placement after pretreatment with a 600 mg loading dose of clopidogrel. Objective for the angiographic substudy w...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2005.08.002
更新日期:2006-06-01 00:00:00
abstract::The P and the Ta waves of two patient groups with A-V block were magnified with a direct-current amplifier and recorded at a high paper speed. In Group A patients (those without serious cardiovascular complications except A-V block) the P and the Ta waves were recorded in the opposite direction in every lead and there...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80533-9
更新日期:1976-06-01 00:00:00
abstract:BACKGROUND:Recent experimental studies have suggested that the angiogenic cytokines hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) may play a role in the pathogenesis of congestive heart failure (CHF). The aim of the present study was to test the hypothesis that HGF and VEGF concentrations...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.047
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) in the setting of heart failure (HF) is linked to embolic stroke and exacerbation of HF. The rate of new-onset AF in patients with left ventricular dysfunction and mild to moderate HF enrolled in the SoLVD trials was significantly lower with enalapril than with placebo (5.4% vs 24% o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.07.027
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN:GALILEO is an international, randomized, ope...
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.2016.10.017
更新日期:2017-02-01 00:00:00
abstract::Atrial pacing-induced changes in the sum of R-wave amplitude were measured in leads V5, X, Y, and Z at rates of 100 bpm (phase I), 150 bpm (phase II), and immediately after pacing (phase III) in 33 patients undergoing cardiac catheterization for evaluation of chest pain. Seventeen (51%) patients showed evidence of isc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90133-9
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Acute myocardial infarction (AMI) has become a major cause of hospitalization and mortality in China. There has been limited data to date available to characterize AMI presentation, contemporary patterns of medical care, and outcomes in China. AIMS:The CAMI Registry is a national project with the objectives...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2015.04.014
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:We compared efficacy and safety of short- (3 or 6 months) versus long-term (≥12 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation, according to the presence of chronic kidney disease (CKD). METHODS:Patient-level pooled analysis was performed with 7242 patients (87.2% with ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2017.11.013
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Little is known about the management of elderly patients with congestive heart failure (CHF) although they represent the majority of the CHF population. Therefore, the TIME-CHF study was set up (1) to evaluate the medical management of very old patients (> or = 75 years) with CHF compared with younger patien...
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.2005.10.022
更新日期:2006-05-01 00:00:00
abstract::The aim of this prospective study was to compare the short-term reproducibility of the signal-averaged ECG (SAECG) with three analysis techniques, conventional time-domain analysis, spectral-temporal mapping (STM), and spectral-turbulence analysis (STA), in a large series of normal subjects and patients with acute myo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90202-3
更新日期:1995-11-01 00:00:00
abstract::Atherosclerosis and its vascular sequela are responsible for considerable morbidity and mortality rates. Several risk factors have been implicated in the pathogenesis of atherosclerosis, and the search for other risk factors continues on the medical horizon. Renin-angiotensin system (RAS), a multienzyme, multilocale a...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70089-9
更新日期:1997-09-01 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::The objective of treating patients with hypertension is not simply to reduce blood pressure but rather to prevent the associated morbidity and mortality. Recent assessments of clinical trials have shown that while the risk of stroke is consistently lower with antihypertensive therapy, the same degree of success has no...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(91)90451-m
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Erythropoietin mitigates myocardial damage and improves ventricular performance after experimental ischemic injury. This study assessed safety and efficacy markers relevant to the biological activity of recombinant human erythropoietin (rHuEpo) in patients with acute myocardial infarction (MI). METHODS:We c...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.06.032
更新日期:2009-12-01 00:00:00