Abstract:
BACKGROUND:Management of acute coronary syndrome (ACS) patients with nonobstructive epicardial coronary artery disease (CAD) remains poorly understood. HYPOTHESIS:Acute coronary syndrome patients with nonobstructive CAD are less likely to receive effective cardiac medications upon discharge from the hospital. METHODS:We identified patients hospitalized with ACS that underwent coronary angiography and had a 6-month follow-up. Patients were grouped by CAD severity: nonobstructive CAD (<50% blockage in all vessels) or obstructive CAD (> or =50% blockage in > or = 1 vessels). Data were collected on demographics, medications at discharge, and adverse outcomes at 6 months, for all patients. RESULTS:Of the 2264 ACS patients included in the study: 123 patients had nonobstructive CAD and 2141 had obstructive CAD. Cardiac risk factors including hypertension and diabetes were common among patients with nonobstructive CAD. Men and women with nonobstructive CAD were less likely to receive cardiac medications compared to patients with obstructive CAD including aspirin (87.8% vs 95.0%, P = 0.001), beta-blockers (74.0% vs 89.2%, P < 0.001), or statins (69.1% vs 81.2%, P = 0.001). No gender-related differences in discharge medications were observed for patients with nonobstructive CAD. However, women with nonobstructive CAD had similar rates of cardiac-related rehospitalization as men with obstructive CAD (23.3% and 25.9%, respectively). CONCLUSIONS:Patients with nonobstructive CAD are less likely to receive evidence-based medications compared to patients with obstructive CAD, despite the presence of CAD risk factors and occurrence of an ACS event. Further research is warranted to determine if receipt of effective cardiac medications among patients with nonobstructive CAD would reduce cardiac-related events.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Ramanath VS,Armstrong DF,Grzybowski M,Rahnama-Mohagdam S,Tamhane UU,Gordon K,Froehlich JB,Eagle KA,Jackson EAdoi
10.1002/clc.20701subject
Has Abstractpub_date
2010-01-01 00:00:00pages
36-41issue
1eissn
0160-9289issn
1932-8737journal_volume
33pub_type
杂志文章abstract::Rising costs have reached a point at which physicians must assume a major role in dealing with the cost of medicine. Little information is available regarding actual practice at the community hospital level. In order to develop some insight on this issue, a survey of cardiovascular specialists was conducted regarding ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140104
更新日期:1991-01-01 00:00:00
abstract::In 2002, coronary angiography is the only way to assess precisely the combination of proximal stenoses, distal target vessels, collaterals, microcirculation, and TIMI antegrade flow. At the time of coronary angiography, global LV function is best determined using biplane ventriculography in order to correlate wall mot...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.4950250802
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Acute coronary syndromes (ACS) are characterized by activation of systemic and local inflammatory mediators. The interrelation between these soluble inflammatory markers and their association with markers of myocardial necrosis have not been extensively studied. HYPOTHESIS:The study was undertaken to evalua...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960280405
更新日期:2005-04-01 00:00:00
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...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Implantable cardioverter-defibrillator (ICD) therapy for primary prevention is well established in ischemic cardiomyopathy (ICM). Data on the role of ICDs in patients with dilated cardiomyopathy (DCM) and no history of ventricular tachyarrhythmia (VT/VF) are more limited. HYPOTHESIS:DCM patients with an imp...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20949
更新日期:2011-10-01 00:00:00
abstract::Physical quantities and equations are used to define the laws of natural and engineering sciences. Clarity has been brought in equal measure into the the theory of physical quantities and the SI-system of units due to the basic work of Wallot and that of national and international institutions. For practical use in th...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960020410
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Although ischemic threshold reportedly is lower in the early morning than in the afternoon, the mechanisms that account for the diurnal change in minimal coronary vascular resistance in the potentially ischemic area are unknown. HYPOTHESIS:We hypothesized that calcium-channel blockers and alpha 1 blockers m...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960210512
更新日期:1998-05-01 00:00:00
abstract::Dobutamine stress echocardiography (DSE) is a reliable cardiac risk stratifier that has widespread applicability because of its clinical accuracy and cost effectiveness. Dobutamine has positive inotropic and chronotropic effects and is commonly used in patients who cannot exercise or achieve an adequate heart rate res...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230804
更新日期:2000-08-01 00:00:00
abstract::Cross-sectional echocardiography was performed on two patients with mitral regurgitation in whom M-mode echocardiographic findings were not specific for the etiology of mitral regurgitation. In one patient, flail motion of the free edge of the anterior mitral leaflet into the left atrium was demonstrated only by cross...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960010206
更新日期:1978-08-01 00:00:00
abstract:BACKGROUND:This study investigated the impact on all-cause mortality of airflow limitation indicative of chronic obstructive pulmonary disease or restrictive spirometry pattern (RSP) in a stable systolic heart failure population. HYPOTHESIS:Decreased lung function indicates poor survival in heart failure. METHODS:Inc...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22802
更新日期:2017-11-01 00:00:00
abstract::Until recently, instrumenting the pericardium was possible only when a pericardial effusion is present or by surgical exposure of the pericardium. Techniques are now being developed to instrument the normal pericardium. This development will allow clinicians and investigators to study pericardial fluid in health and i...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960221304
更新日期:1999-01-01 00:00:00
abstract::Therapy for acute myocardial infarction has advanced dramatically since the early 1980s with the use of early intravenous fibrinolytic therapy. Combining low-dose fibrinolysis and platelet lysis appears to provide an additional increase in infarct-related artery (IRA) patency, but the large-scale mortality reduction t...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960221605
更新日期:1999-08-01 00:00:00
abstract::Warfarin and other 4-hydroxycoumarins are effective antithrombotic agents. They affect four blood coagulation proteins that act sequentially to produce thrombin. Coumarin therapy decreases the biological activity of these proteins, and therefore decreases the rate at which blood clots. As the mechanism by which these ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1990-04-01 00:00:00
abstract::We evaluated the electrophysiological parameters before and after the intravenous infusion of diazepam (0.2 mg/kg) in 20 cardiac patients to investigate the drug's antiarrhythmic effect. Diazepam did not significantly change the arterial pressure. After the intravenous infusion of diazepam, the sinus cycle length sign...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140507
更新日期:1991-05-01 00:00:00
abstract::Pathophysiology of malignant hypertension, of which underlying disease was essential hypertension (EHT) in 33 cases and chronic glomerulonephritis (CGN) in 26 cases, was studied with reference to the renin-angiotensin system. Plasma renin activity (PRA) was significantly higher in the EHT than in the CGN group, and an...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100911
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:The role of warfarin in anterior ST-segment elevation myocardial infarction (STEMI) complicated by left ventricular (LV) dysfunction in patients treated with primary percutaneous coronary intervention (PCI) and dual antiplatelet therapy is unclear. Warfarin may prevent cardioembolic events but significantly ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22450
更新日期:2015-10-01 00:00:00
abstract::Despite advances in the treatment of congestive heart failure (CHF), the mortality rate continues to be high. A large number of the deaths are sudden, presumably due to ventricular arrhythmias. Complex ventricular arrhythmias are recorded in as many as 80% of patients with CHF, with nonsustained ventricular tachycardi...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960120910
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Contrast-induced nephropathy (CIN) is the third cause of acute deterioration of renal function in hospitalized patients. HYPOTHESIS:The purpose of the study was to compare the efficacy of saline infusion, saline infusion plus N-acetylcysteine (NAC), and sodium bicarbonate (SB) infusion to prevent CIN in pat...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.20576
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that viable but stunned myocardium displays contractile reserve and exhibits cardiac cycle-dependent variations of integrated backscatter (CVIB), whereas infarcted myocardium does not. HYPOTHESIS:This study was designed to clarify whether assessment of the acoustic properties of ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960261010
更新日期:2003-10-01 00:00:00
abstract::In this editorial, I would like to share some thoughts about clinical studies, including value and limitations using as an example a recently published randomized clinical trial. Randomized and non-randomized clinical trials, epidemiologic studies, and registries guide our clinical practice. They are good but not perf...
journal_title:Clinical cardiology
pub_type: 社论
doi:10.1002/clc.20598
更新日期:2009-04-01 00:00:00
abstract::This report describes a patient who developed acute severe exacerbation of mild rheumatic mitral regurgitation caused by ischemia in the territory of a small, non-dominant circumflex coronary artery without myocardial infarction. ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960151215
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:An acute-phase response in patients with acute myocardial infarction could contribute to the development of anemia. HYPOTHESIS:An association may exist between symptom duration, hemoglobin (Hb) concentration and serum C-reactive protein (CRP) values in patients presenting to an emergency department (ED) wit...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22215
更新日期:2014-02-01 00:00:00
abstract::A patient with severe pulmonary hypertension secondary to the CREST syndrome variant of scleroderma is described. Acute reductions in both pulmonary artery pressure and total pulmonary resistance were seen with nifedipine and oxygen administration. Reductions in resistance were maintained for over one month with this ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960070111
更新日期:1984-01-01 00:00:00
abstract::Although Hemophilus influenzae infections have long been considered to be a disease of childhood, recent reports have demonstrated an increasing frequency of serious Hemophilus influenzae infections in adults. A case of purulent H. influenzae pericarditis in a previously healthy adult without evidence of concurrent H....
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960051008
更新日期:1982-10-01 00:00:00
abstract::Approaches to the treatment of supraventricular arrhythmias, including atrial fibrillation, atrial flutter, atrial tachycardia, atrioventricular (AV) reentrant tachycardia, and AV nodal reentrant tachycardia, continue to evolve. Within the past two decades, many new and effective treatments have become available. Thes...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960171408
更新日期:1994-09-01 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::Long-acting oral isosorbide dinitrate (ISDN) was replaced by Nitroderm TTS, and the utility of this drug in long-term treatment was assessed in 69 patients with angina pectoris. The frequency of attacks (p < 0.001) and the consumption of sublingual nitrate tablets (p < 0.01) were found to be significantly lower at 2 w...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.4960170107
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Chronic heart failure (CHF) is associated with an increased risk of thrombosis and thromboembolic events, including stroke and venous thromboembolism. which may be related to a prothrombotic or hypercoagulable state. Acute vigorous exercise has been associated with activation of hemostasis, and this risk may...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960241107
更新日期:2001-11-01 00:00:00
abstract::To assess right ventricular (RV) diastolic filling in coronary artery disease (CAD), with special reference to the involved lesions of the coronary arteries and left ventricular (LV) systolic function, gated radionuclide ventriculography was performed at rest in 106 patients with single-vessel CAD. Based on the site o...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960161112
更新日期:1993-11-01 00:00:00
abstract::Thrombotic obstruction of aortic bioprostheses is rare. Few cases have been reported involving the use of the Carpentier-Edwards (CE) prosthesis, the Hancock bioprosthesis, or the Medtronic Intact porcine valve. Thrombolytic therapy for mechanical valve thrombosis has been used frequently even though it is known to ca...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160215
更新日期:1993-02-01 00:00:00