Abstract:
BACKGROUND:During daytime working hours, outcomes may be worse when percutaneous coronary intervention (PCI) is performed later in the day because of operator fatigue and differences in process of care. METHODS:Using the APPROACH database, we analyzed 2,492 consecutive nonurgent PCI procedures performed during working hours. Patients undergoing PCI for acute coronary syndromes were excluded. Patients were separated into 2 groups based on whether PCI was started in the morning (7:00 am-12:00 pm, n = 1,446) or after noon (12:01 pm-6:00 pm, n = 1,037). Outcomes included procedural complications; target vessel revascularization (TVR); and death at 7 days, 30 days, and 1 year. RESULTS:Patients undergoing PCI in the afternoon were more likely to have heart failure, reduced ejection fraction, and Canadian Cardiovascular Society class IV or atypical angina symptoms; more likely to be inpatients; less likely to have stable angina; and less likely to receive glycoprotein IIb/IIIa inhibitors. Patients undergoing PCI in the afternoon had significantly higher unadjusted rates of the composite of death and TVR at 7 days (0.9% vs 0.3%, P = .04) and 30 days (2.0% vs 1.0%, P = .04) and death at 1 year (2.2% vs 1.1%, P = .03) compared with PCI performed in the morning. After multivariate adjustment, the differences in the composite of death and TVR at 30 days and at 1 year were not statistically significant. CONCLUSION:Patients undergoing nonurgent PCI during working hours after noon had higher rates of TVR in the first 30 days and death at 1 year. Further study is required to determine whether patient characteristics, operator fatigue, differences in process of care, or a combination of these factors accounts for the difference in outcomes.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Cantor WJ,Strauss BH,Graham MM,Southern DA,Woo K,Tyrrell B,Knudtson M,Ghali WAdoi
10.1016/j.ahj.2010.03.010subject
Has Abstractpub_date
2010-06-01 00:00:00pages
1133-8issue
6eissn
0002-8703issn
1097-6744pii
S0002-8703(10)00235-8journal_volume
159pub_type
杂志文章abstract::The manner in which concealed anterograde impulse penetration may affect retrograde atrioventricular nodal conduction was studied systematically in 12 patients with intact ventriculoatrial (VA) conduction. After the last beat of a basic atrial drive (A1), an extrastimulus (A2) was introduced 20 msec inside the effecti...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90539-4
更新日期:1987-12-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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abstract:BACKGROUND:Relationships between long-term use and level of dual antiplatelet therapy and outcomes after drug-eluting stent implantation are not well established. METHODS:This is a retrospective cohort study of 9,256 patients receiving drug-eluting stents between January 2003 and August 2006. We classified patients ac...
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pub_type: 杂志文章
doi:10.1016/j.ahj.2009.11.031
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abstract::To study the left ventricular (LV) diastolic function in uncomplicated insulin-dependent diabetic patients without hypertension (n = 25) and comparable controls (n = 15), the effect of acute administration of nitroglycerin and nifedipine on cavity dimensions and transmitral flow pattern was investigated by Doppler ech...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90542-h
更新日期:1993-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(93)90405-x
更新日期:1993-09-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章
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更新日期:1988-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.09.007
更新日期:2005-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90228-3
更新日期:1981-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
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更新日期:1996-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90740-4
更新日期:1994-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(92)90635-9
更新日期:1992-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:In patients with severe heart failure additional therapeutic support with intravenous inotropic or vasodilator drugs is frequently used in the attempt to obtain hemodynamic control. The nature and extent to which diastolic filling, atrial function, and mitral regurgitation are modified by these drugs have no...
journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1997-12-01 00:00:00
abstract::To assess the prevalence and prognostic implications of complicated ventricular ectopic depolarizations (VEDs) after hospital discharge in patients with acute myocardial infarction (AMI), we obtained serial 24-hour Holter recordings in 85 patients during the first 6 weeks after AMI. Recordings were obtained during two...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90745-2
更新日期:1984-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.12.014
更新日期:2011-02-01 00:00:00
abstract::This study investigated the correlation between cardiac abnormalities and cytosine-thymine-guanine (CTG) trinucleotide repeat expansion in patients with myotonic dystrophy (MD). We studied 18 patients with the adult form of classical MD and 18 age-matched control subjects. In patients with MD, left ventricular systoli...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70137-6
更新日期:1997-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/S0002-8703(03)00512-X
更新日期:2003-10-01 00:00:00
abstract::The conducting tissue of the heart was studied in 25 human cases of Chagas' myocarditis with a method which employs complete serial sections mounted on continuous transparent plastic tape. The pathological changes were correlated with electrocardiographic findings. The inflammation of the acute phase of Chagas' myocar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90362-9
更新日期:1978-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1053/hj.1998.v136.90226
更新日期:1998-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1996-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.01.020
更新日期:2005-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-02-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-04-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2006.11.020
更新日期:2007-03-01 00:00:00
abstract::Sodium-glucose cotransporter 2 inhibitor (SGLT2i) use is associated with improved cardiovascular and kidney outcomes. However, the magnitude and potential heterogeneity of effect across patients with varying types of cardiometabolic and kidney disease is unclear. To examine the effect of SGLT2i on cardiovascular and k...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2020.10.064
更新日期:2021-02-01 00:00:00