Abstract:
BACKGROUND:The frequency of acute myocardial infarction (AMI) peaks on Mondays and in the mornings. However, the distribution of the types of acute coronary syndromes (ACS), including unstable angina (UA), has not been systematically evaluated. HYPOTHESIS:The distribution of the types of ACS and clinical presentations varies by time and day of admission. METHODS:A retrospective cohort study was conducted in 1,946 consecutive nontransfer ACS admissions (1999-2004) to a tertiary-care academic center to assess presenting clinical variables in patients admitted on days versus nights (6 P.M.-6 A.M.) and weekdays versus weekends (Friday 6 P.M.-Monday 6 A.M.). RESULTS:There were fewer ACS admissions than expected on nights and weekends (p < 0.001), but the proportion of patients with ACS presenting with ST-elevation myocardial infarction (STEMI) is 64% higher on weekends (p < 0.001) and 31% higher on nights (p = 0.022). This increased proportion with STEMI results in a greater proportion of ACS with AMI on weekends (up arrow 10%, p = 0.006) and nights (up arrow 7%, p = 0.033). Using multivariate modeling, the increase in patients with AMI on weekends was not explained by conventional risk predictors. CONCLUSIONS:Although fewer patients with ACS presented on nights and weekends, patients at those times were more likely to have an AMI, driven largely by an increased proportion with STEMI at those times. Consideration should be given to these findings when developing clinical care paradigms, health care staffing needs, and when comparing new treatment outcomes in patients with ACS.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
LaBounty T,Eagle KA,Manfredini R,Fang J,Tsai T,Smith D,Rubenfire Mdoi
10.1002/clc.22subject
Has Abstractpub_date
2006-12-01 00:00:00pages
542-6issue
12eissn
0160-9289issn
1932-8737journal_volume
29pub_type
杂志文章abstract:BACKGROUND:Identifying patients with advanced left atrial (LA) remodeling before catheter ablation (CA) of atrial fibrillation (AF) is crucial. HYPOTHESIS:This study aimed to identify echocardiographic parameters associated with changes in anatomy and conduction properties of the left atrium (LA). METHODS:We examined...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23515
更新日期:2021-01-01 00:00:00
abstract::A patient is presented who has mitral valve prolapse and syndactyly of the hands. This combination of findings has not been previously reported, but is consistent with one theory of the development of mitral valve prolapse. ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960050306
更新日期:1982-03-01 00:00:00
abstract::This study was conducted to determine the long-term effects of percutaneous transluminal coronary angioplasty (PTCA) on the incidence of myocardial infarction, survival, and relief of symptoms. A total of 124 patients were included in the study and were followed for 16 to 25 months. The success rate of PTCA was 91.2% ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120805
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:Late potentials (LP) on signal-averaged electrocardiography (SAECG), recorded 6 to 30 days after an acute myocardial infarction (AMI), identify patients at risk for late arrhythmic events. Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce ventricular remodeling and cardiovascular morta...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960230206
更新日期:2000-02-01 00:00:00
abstract::When evaluating patients with possible coronary artery disease, it is necessary to combine physiologic assessment (measurements of ischemia) with anatomic pathologic assessment (coronary angiography). Coronary angiography currently is the only way to assess the anatomic pathology of the coronary circulation with preci...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.4960270202
更新日期:2004-02-01 00:00:00
abstract::Sertraline is a selective serotonin reuptake inhibitor with established safety for the treatment of depression. Among the common adverse effects associated with sertraline are nausea, insomnia, diarrhea, somnolence, and dizziness. Cardiac arrest had not been reported in the literature, although tachycardia was frequen...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20647
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Cibenzoline, a class Ia antiarrhythmic drug, can be used to relieve left ventricular (LV) outflow obstruction in hypertrophic obstructive cardiomyopathy (HOCM). However, the mechanism of this agent in HOCM has been controversial. HYPOTHESIS:This study was designed to investigate the effect of cibenzoline on...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960230911
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Epicardial placement of the left ventricular (LV) lead via a video-assisted thoracoscopic (VAT) approach is an alternative to the standard transvenous technique. HYPOTHESIS:Long-term safety and efficacy of VAT and transvenous LV lead implantation are comparable. To test it, we reviewed our experience and we...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23300
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Heart failure is a significant cause of morbidity and mortality, yet patient risk stratification may be difficult. Prevention or treatment of atrial fibrillation (AF) may be an important strategy in these patients that could positively affect their outcome. It has been demonstrated that in patients with syst...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22736
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Patients with sinus node dysfunction (SND) have increased risk of atrial tachyarrhythmias, including atrial fibrillation (AF). To date, treatment patterns and outcomes of patients with SND and AF have not been well described. HYPOTHESIS:Patients with SND and AF have higher risk of adverse cardiovascular out...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
doi:10.1002/clc.22504
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Right ventricular dysfunction occurs in many patients with significant pulmonary valve regurgitation late after initial total repair of tetralogy of Fallot. Methods to predict which of these patients are at increased risk of late morbidity and mortality are not yet known. HYPOTHESIS:This study evaluated ele...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960221113
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Following successful cavotricuspid isthmus (CTI) ablation during typical atrial flutter (AFL), anticoagulation therapy is usually withdrawn. However, potential subsequent atrial fibrillation (AF) in these patients may increase embolic risk in the long term. Embolic rates in this setting have not been clearly...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22538
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Due to chronic inflammatory status, rheumatoid arthritis (RA) patients are exposed to changes in left ventricular (LV) geometry and function. We assessed prevalence, factors associated with, and prognostic role of concentric LV geometry and systolic dysfunction (LVSD) detected by echocardiography in a large ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22926
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Although the outcome of patients with angiographically insignificantly narrowed coronary arteries (INCA) is not clearly defined, such lesions can progress or rupture, thus causing cardiovascular morbidity. Preventive therapy with aspirin and lipid-lowering drugs therefore seems warranted in these patients. ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960270605
更新日期:2004-06-01 00:00:00
abstract::Patients with atrial fibrillation (AF) have an increased stroke risk compared with those in sinus rhythm, although the absolute risk for individual patients is modulated by the presence of various additional risk factors. Patient selection for oral anticoagulation for stroke prevention is based on risks of stroke and ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22122
更新日期:2013-06-01 00:00:00
abstract::Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic coronary artery disease but have other causes for their luminal narrowing. The third part of this three-part review of nonatherosclerotic causes of coronary narrowing focuses on coronary vasculitis, infectious diseases, Kawasaki'...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960190814
更新日期:1996-08-01 00:00:00
abstract::The majority of older patients who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). Patients with HFpEF have severe symptoms of exercise intolerance, poor quality-of-life, frequent hospitalizations, and increased mortality. The prevalence of HFpEF is in...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.23321
更新日期:2020-02-01 00:00:00
abstract::The prevalence of interatrial block (IAB) is high in the elderly, particularly in those with heart disease. Despite this high prevalence-and the association of IAB with the risk of atrial fibrillation (AF), stroke, and cognitive decline-little information exists about the prognosis of older patients with IAB. P-wave d...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.22647
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Diabetic cardiomyopathy (DCMP) is a common complication of diabetes and is associated with increased mortality. It has been suggested that a poor R-wave progression in a resting electrocardiogram (ECG) could be a sign of cardiomyopathy. HYPOTHESIS:The aim of this study was primarily to analyze the relations...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.20810
更新日期:2010-09-01 00:00:00
abstract::The hemodynamic and myocardial energetic changes due to pulsus alternans were investigated by left and right heart catheterization and by oxygen consumption measurements in three patients with dilative cardiomyopathy. In all three patients, pulsus alternans developed after intravenous administration of the phosphodies...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100506
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:It has been suggested that episodes of silent myocardial ischemia (SMI) might influence the prognosis of patients with ischemic heart disease, as its consequences are similar to those of myocardial ischemia accompanied by pain. Ambulatory electrocardiogram (ECG) is generally employed in diagnosis as well as ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190605
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Previously, perfusion defect in the left ventricle was detected by thallium-201 (201T1) single-photon emission computed tomography (SPECT) in aortic regurgitation (AR). The significance of 201T1 SPECT, however, has not been clarified. Limited information is available regarding the relationship between functi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960281206
更新日期:2005-12-01 00:00:00
abstract::Natural history studies in heart failure have shown that increases in left ventricular (LV) volume and LV mass are directly related to future deterioration in LV performance and a less favorable clinical course. Despite the recognized importance of remodeling in heart failure, very little is known about the basic mech...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960211304
更新日期:1998-12-01 00:00:00
abstract::Serial echocardiographic findings in a patient with an Omniscience mitral prosthesis presenting progressive perivalvular pannus ingrowth are described. The first echocardiographic study was carried out one year after prosthesis implantation and showed decreased prosthetic opening velocity. As prosthetic thrombosis was...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960101021
更新日期:1987-10-01 00:00:00
abstract::In patients with malignant ventricular arrhythmias, antiarrhythmic therapy is known to carry a substantial risk of proarrhythmia. This risk is usually considered to be low when supraventricular arrhythmias or benign ventricular arrhythmias are considered. We were able to collect data on four patients without a history...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960170410
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:It is known that exercise-induced ST-segment elevation in lead V1 (V1-E) detects left anterior descending (LAD) stenosis. It was also postulated that ST elevation in aVR and simultaneous ST depression in V5 (aVR-E + V5-D) is a marker of ischemia due to significant stenosis of the LAD in patients with single-...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260506
更新日期:2003-05-01 00:00:00
abstract::The coronary sinus (CS) is a small tubular structure just above the posterior left atrioventricular junction. The CS can be imaged in several different echocardiographic views. Using zoom M-mode recordings of the CS in apical two-chamber view, CS caliber can be sharply imaged and easily measured during different phase...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230304
更新日期:2000-03-01 00:00:00
abstract::In this report, a rare case of tricuspid stenosis uncomplicated by other valve lesions is presented, with clinical, hemodynamic, echocardiographic, and angiographic studies. The patient was markedly incapacitated, mostly as a result of a restricted cardiac output. Tricuspid commissurotomy was performed, with a stenoti...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960060406
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:Inflammatory process plays an important role in the pathogenesis of acute coronary syndromes. HYPOTHESIS:The study was undertaken to evaluate whether admission levels of C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6). and macrophage colony stimulating factor (MCSF) can predict short-term prognos...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960251106
更新日期:2002-11-01 00:00:00
abstract::Paradoxical interventricular septal motion with right ventricular dilatation has been considered the hallmark of right ventricular volume overload. We report a 43-year-old woman with severe pulmonary hypertension due to pulmonary veno-occlusive disease who exhibited these echocardiographic abnormalities. Right ventric...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960081111
更新日期:1985-11-01 00:00:00