Abstract:
BACKGROUND:Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well defined. We sought to determine the relationship between bleeding, blood transfusion, and measures of costs among patients with non-ST-segment elevation ACS. METHODS:We analyzed data from the economic substudy of the GUSTO IIb trial (n = 1235) to determine the relationship between bleeding; transfusion; and hospital costs, physician costs, total costs, and length of stay. Linear regression models were developed to determine the cost implications of each bleeding and transfusion event. RESULTS:Of the patients in the economic substudy of GUSTO IIb, 36.8% (n = 455) experienced a bleeding event. As bleeding severity increased, there was a stepwise increase in length of stay (no bleeding 5.4 days, mild bleeding 6.9 days, moderate bleeding 15.0 days, severe bleeding 16.4 days; P < .01) and unadjusted total costs (no bleeding $14,282, mild $21,674, moderate $45,798, severe $66,564; P < .01). After adjustment for baseline differences among patients, each moderate or severe bleeding event increased costs by $3770 and each transfusion event increased costs by $2080. Further modeling demonstrated that the increase in costs was driven by increases in length of stay. CONCLUSIONS:Bleeding and transfusion are associated with increased resource use among patients with NSTE ACS. These data suggest that strategies that reduce both ischemia and the risk for bleeding have the potential to produce important reductions in the costs of care for patients with NSTE ACS.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Rao SV,Kaul PR,Liao L,Armstrong PW,Ohman EM,Granger CB,Califf RM,Harrington RA,Eisenstein EL,Mark DBdoi
10.1016/j.ahj.2007.10.014subject
Has Abstractpub_date
2008-02-01 00:00:00pages
369-74issue
2eissn
0002-8703issn
1097-6744pii
S0002-8703(07)00827-7journal_volume
155pub_type
杂志文章,随机对照试验abstract::To determine the results of coronary angioplasty for a first restenosis, the clinical, anatomic, and procedural data of 400 consecutive patients were compared with the data of 507 consecutive patients undergoing a first angioplasty. After angioplasty for restenosis, emergency redilatation had to be performed in only 0...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90405-x
更新日期:1993-09-01 00:00:00
abstract::Fourteen fetuses with atrioventricular canal malformations were examined by two-dimensional echocardiography, pulsed-wave Doppler echocardiography, and color Doppler flow mapping. Eleven fetuses had complete and three fetuses had partial atrioventricular canal malformations. Nonimmune hydrops fetalis was associated wi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90156-c
更新日期:1991-05-01 00:00:00
abstract::A pilot study was performed to determine the safety and efficacy of coronary pulsed mid-infra-red laser angioplasty. The laser was coupled with a novel 2.0 mm multifiber catheter consisting of 37 optical fibers of 150 microns each arranged concentrically around a 0.018-inch central lumen and a soft leading tapered dis...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)91015-f
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Controversy remains regarding whether gender differences exist in clinical management after exercise treadmill testing (ETT). METHODS:We studied 7,506 patients (49.8% women) without documented coronary heart disease referred for ETT from July 2001 to June 2004 in a community-based setting. We assessed the r...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.03.022
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Carvedilol therapy during congestive heart failure demonstrated a good efficacy in mortality rate reduction and in improvement of left ventricular (LV) systolic performance. However, currently there is not any finding about the drug's effect on diastolic filling. The aim of this study was to evaluate the eff...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(03)00525-8
更新日期:2004-01-01 00:00:00
abstract::Changes in conduction times induced by ischemia (delta CT) have been shown to be quantitatively related to genesis of spontaneous ischemic ventricular fibrillation (VF). We studied conduction delay encountered by premature impulses in epicardium and endocardium in both anterograde and retrograde directions during isch...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90308-2
更新日期:1981-09-01 00:00:00
abstract:BACKGROUND:In 10,001 patients with stable coronary artery disease (CAD) enrolled in the Treating to New Targets (TNT) trial, 80 mg/d of atorvastatin (high-dose regimen) reduced the composite primary end point of death from CAD, nonfatal myocardial infarction, resuscitation from cardiac arrest, or stroke by 22% relative...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.05.032
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Recently, long (> or =20 mm) coronary stents were introduced for clinical use. They are intended as an alternative to multiple conventional stents to treat extensive dissections or suboptimal results of long lesions after balloon angioplasty. METHODS:In a total of 113 such consecutive vessels in 107 patient...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1053/hj.1998.v136.89578
更新日期:1998-08-01 00:00:00
abstract::TACT is an National Institutes of Health-sponsored, randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial testing the benefits and risks of 40 infusions of a multicomponent disodium EDTA chelation solution compared with placebo and of an oral, high-dose multivitamin and mineral supplement. TACT ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.10.002
更新日期:2012-01-01 00:00:00
abstract::Patients experiencing out-of-hospital cardiac arrest (OHCA) without ST-segment elevation are a heterogenic group with a variety of underlying causes. Up to one-third of patients display a significant coronary lesion compatible with myocardial infarction as OHCA trigger. There are no randomized data on patient selectio...
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.2018.12.005
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Despite a higher prevalence of sudden cardiac death (SCD), black individuals are less likely than whites to have an implantable cardioverter defibrillator (ICD) implanted. Racial differences in ICD utilization is in part explained by higher refusal rates in black individuals. Decision support can assist with...
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.2019.10.011
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is associated with an adverse prognosis in patients with coronary heart disease. Cardiac rehabilitation (CR) improves morbidity and mortality among patients with coronary heart disease, but its impact on patients with concomitant CKD has not been described. METHODS:We compared b...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.048
更新日期:2005-12-01 00:00:00
abstract::Radiofrequency-powered, thermal balloon angioplasty is a new technique that enhances luminal dilatation with less dissection than conventional angioplasty. The purpose of this study was to assess the effect of radiofrequency heating of balloon fluid on the pressure-volume mechanics of in vitro balloon angioplasty and ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90005-1
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Vascular wall shear stress (WSS) has been implied in the pathogenesis of atherosclerosis and vascular remodeling. Our aim was to calculate WSS after balloon angioplasty and evaluate its predictive value for long-term outcome. METHODS:WSS was calculated proximal to, in, and distal to the lesion after angiogr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.123110
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Lipid lowering through statin therapy significantly reduces the risk of cardiovascular events. The ENHANCE study is an international 2-year, randomized, double-blind, controlled trial designed to test the hypothesis that treatment of hypercholesterolemia by use of 2 complementary agents, ezetimibe (a specifi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.06.024
更新日期:2005-02-01 00:00:00
abstract::The prognostic significance of changes in the mode of induction of ventricular tachycardia (VT) noted during therapy was studied in 49 patients with sustained VT or ventricular fibrillation. Before treatment, all patients had inducible sustained VT by programmed stimulation (one to three extrastimuli) and frequent (gr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90189-x
更新日期:1987-11-01 00:00:00
abstract::The acute hemodynamic and hormonal effects of the oral angiotensin-converting enzyme (ACE) inhibitor lisinopril (MK-521) were assessed over a period of 96 hours in 12 patients with heart failure. This compound is the lysine analogue of enalaprilat (MK-422), is biologically active following absorption, and is cleared v...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90689-7
更新日期:1986-07-01 00:00:00
abstract::The present generation of implantable cardioverter defibrillators (ICDs) provides a very effective device for monitoring and treating life-threatening ventricular tachyarrhythmia. Patients at risk of sudden cardiac death who are directed to this form of treatment usually have severe coronary artery disease, previous m...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90087-6
更新日期:1994-04-01 00:00:00
abstract::With the availability of percutaneous transluminal coronary angioplasty (PTCA), the management of patients who present with recurrent angina following coronary artery bypass surgery (CABG) has changed. From January 1987 to December 1988, 149 symptomatic post CABG patients underwent coronary angiography at our institut...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90121-d
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Aggressive management to reduce pulmonary artery systolic pressure (PASP) and pulmonary capillary wedge pressure (PCWP) reduces hospitalization rates and is crucial for patients awaiting transplantation but may require periodic invasive monitoring with right heart catheterization. METHODS:The purpose of thi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(00)90008-5
更新日期:2000-05-01 00:00:00
abstract::Intracoronary delivery of argon laser energy was studied in eight anesthetized mongrel dogs. A No. 4.5 French single lumen catheter, with steerable guidewire and an optical fiber, was introduced through a Judkins-type femoral-coronary guiding catheter into three left anterior descending and eight left circumflex coron...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90007-x
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:The safety and efficacy of ticagrelor in patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolytic therapy remain uncertain. OBJECTIVES:The primary objective of the TicagRElor in pAtients with ST elevation myocardial infarction treated with Thrombolysis (TREAT) trial is to evaluate ...
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.2018.02.017
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:We sought to systematically evaluate whether percutaneous revascularization is associated with additional clinical benefit in patients with renal artery stenosis (RAS) as compared with medical management alone. METHODS:We included randomized controlled trials that compared percutaneous revascularization in ...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2010.12.006
更新日期:2011-03-01 00:00:00
abstract::We aimed to investigate long-term (≥5 years) outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) using a meta-analysis from updated published randomized trials. Our data showed that the risk of all-cause death as well as cardi...
journal_title:American heart journal
pub_type: 信件,meta分析
doi:10.1016/j.ahj.2020.06.001
更新日期:2020-09-01 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::Eight cases of top-ranking athletes with "repolarization disorders" are reported. All subjects were asymptomatic and were otherwise suited for excellent cardiovascular performances. Seven athletes did not show any evidence of heart disease. Seven had MVP (mitral valve prolapse). Umprompted variability of ECG tracings ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90117-9
更新日期:1980-08-01 00:00:00
abstract::Therapeutics involves the careful balance between treatment disadvantages and advantages--the so-called risk-benefit ratio. Even after 20 years beta-blockers must be selected carefully to suit the patient's needs. This review examines several problems associated with beta-blockade. Generally, beta1-cardioselectivity i...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(88)90130-5
更新日期:1988-11-01 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::Pulsed Doppler echocardiographic studies of both right and left ventricular diastolic inflow patterns were performed in 10 full-term newborn infants and serially during the first month of life in 21 premature (28 to 35 weeks' gestation) infants with no clinical cardiorespiratory disease. Results of studies performed d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90745-4
更新日期:1988-12-01 00:00:00
abstract::Antiplatelet therapy is the current criterion standard for the treatment of patients undergoing percutaneous coronary intervention and patients who have acute coronary syndromes. Clopidogrel in combination with aspirin is the current standard of care for reducing cardiovascular events in these patients. However, patie...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2008.06.003
更新日期:2008-08-01 00:00:00