Abstract:
BACKGROUND:New percutaneous coronary intervention (PCI) device technologies are often rapidly adopted into clinical practice, yet few studies have examined the overall impact of these new technologies on patient outcomes in community practice. METHODS:In hopes of determining temporal trends in PCI outcomes, we used data from the Centers for Medicare & Medicaid Service's Chronic Condition Warehouse (n = 3,250,836) by comparing patient characteristics and rates of 3-year major adverse cardiac events (MACE) across the balloon angioplasty (POBA) era (01/1991-09/1995), the bare metal stent (BMS) era (02/1998-04/2003), and the drug-eluting stent (DES) era (05/2004-10/2006). The adjusted association between era and outcomes was determined with Cox proportional hazards modeling (POBA era as reference). RESULTS:Compared with the POBA era, patients undergoing PCI were significantly older and had more medical comorbidities, and the risk for 3-year MACE was significantly lower during the BMS and DES eras (BMS vs. POBA adjusted HR [95% CI]: 0.930 [0.926-0.935]; DES vs. BMS: 0.831 [0.827-0.835]). Compared with males, the adjusted risk for 3-year MACE among females was lower during the POBA era, but slightly higher during the BMS and DES eras. Across all three eras, patients ≥75 years of age had higher adjusted risk for MACE compared with younger patients, and the risk for revascularization was lower for both females and older patients. CONCLUSIONS:Despite its application in older and sicker Medicare beneficiaries, there has been a significant decrease in post-PCI MACE over time. The risk for death or myocardial infarction is higher among females and older patients compared with males and younger patients; therefore, future studies should focus on improving clinical outcomes in these high-risk subgroups.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Rao SV,Hess CN,Dai D,Green CL,Peterson ED,Douglas PSdoi
10.1016/j.ahj.2013.05.006subject
Has Abstractpub_date
2013-08-01 00:00:00pages
273-281.e4issue
2eissn
0002-8703issn
1097-6744pii
S0002-8703(13)00347-5journal_volume
166pub_type
杂志文章abstract::The aortocaval fistula is a classic model of pure cardiac volume overload in rats. This model is characterized by dilation of the ventricular cavities and eccentric cardiac hypertrophy. There are also changes in peripheral arterial flow: high flow in the proximal part of the aorta, upstream of the shunt, and low flow ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90929-4
更新日期:1993-09-01 00:00:00
abstract::The objective of this investigation was to determine the prevalence and clinical associations of systolic anterior motion (SAM) of the mitral chordae (chordal SAM) in patients without evidence of hypertrophic cardiomyopathy. Although SAM of the mitral valve is thought to be a specific marker of hypertrophic obstructiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90282-3
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:In chronic heart failure the cause of exercise limitation is still unclear: ergoreceptors, muscle afferents sensitive to exercise metabolites, are proposed as a neural link between muscular abnormalities and the limited exercise responses in this syndrome. METHODS:In 92 stable patients with heart failure (3...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70361-3
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Patients with chronic kidney disease (CKD) experience poor outcomes after acute myocardial infarction (AMI). We sought to compare clinical characteristics of advanced CKD, dialysis, and non-CKD patients hospitalized with AMI. METHODS:This observational study used record-linked data from the US Renal Data Sy...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2011.12.002
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Knowledge of pressure gradients across valves, arteries, and ventricular septal defects (VSD) is important in patient management. It was determined how well such gradients can be estimated by auscultation of a murmur's frequencies. METHODS:In 151 patients with pulmonary stenosis (PS) (n = 77), aortic stenos...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.113222
更新日期:2001-03-01 00:00:00
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
abstract:BACKGROUND:Recent studies suggest that class III antiarrhythmic agents may have enhanced efficacy in the treatment of ventricular tachycardia. This study describes the first clinical assessment of the new class III agent ibutilide to suppress inducible monomorphic ventricular tachycardia (VT) in human beings. METHODS ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0002-8703(98)70071-7
更新日期:1998-06-01 00:00:00
abstract::Coronary arterial stenosis of varying severity and length were created in open-chest dogs. The reactive hyperemic responses (RHR) to 15 second occlusions were used to produce flow increases and judge the physiological significance of the narrowings. RHR are sensitive indices of functional impairment when resting flow ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80010-5
更新日期:1976-12-01 00:00:00
abstract:BACKGROUND:31-Phosphorus-magnetic resonance spectroscopy may provide pathophysiological insights into the high-energy phosphate metabolism of the myocardium as measured by phosphocreatine to adenosine triphosphate (PCr/ATP) ratio. Aim of the present study was to determine in vivo the relation between cardiac PCr/ATP ra...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.04.012
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Although angiotensin-converting enzyme inhibitor attenuates ventricular enlargement, whether beta-blocker therapy induces regression of left ventricular remodeling is not known. The purpose of this study was to compare the effects of bisoprolol therapy with those of imidapril therapy on left ventricular remo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1067/mhj.2000.110934
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Prescribing rate control medications with or without antiarrhythmic drugs is often the first course treatment for atrial fibrillation (AF). Clinical trial data suggest that antiarrhythmic drugs are only marginally effective and have multiple drawbacks, whereas rate control alone is sufficient for most patien...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.03.024
更新日期:2014-07-01 00:00:00
abstract::Hemodynamic studies were performed in 27 patients at a mean interval of 40.3 (range 24 to 59) months following mitral valve replacement with pericardial xenografts. Six patients had sequential studies, one before operation and two separate investigations at mean intervals of 11.2 and 42.8 months following valve replac...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90301-0
更新日期:1978-05-01 00:00:00
abstract::Cardiovascular anomalies are a frequently reported feature of the fetal alcohol syndrome, but only rarely have such children been catheterized. This article fully described the cardiac anomaly in two infants with this syndrome. The malformations found in both cases include a ventricular septal defect, and the rather u...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90290-4
更新日期:1979-11-01 00:00:00
abstract::The Magnum/Magnarail system consists of "over-the-wire" balloon catheters and a 0.021 inch (0.53 mm) guide wire with a 1 mm olive-shaped tip. To compare it to conventional systems, 100 consecutive unselected patients with chronic total coronary occlusions were randomly assigned to one of two groups. If the balloon cou...
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(92)91020-2
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:In patients with atrial fibrillation, incomplete adherence to anticoagulants increases risk of stroke. Non-warfarin oral anticoagulants (NOACs) are expensive; we evaluated whether higher copayments are associated with lower NOAC adherence. METHODS:Using a national claims database of commercially-insured pat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.12.010
更新日期:2021-01-14 00:00:00
abstract::The clinical course and coronary arteriographic findings in eight patients with Prinzmetal's variant angina pectoris are reviewed and contrasted to previously reported cases. In six patients with S-T-elevation inferiorly, three had normal coronary arteriograms, one had complete right coronary artery occlusion, one ha...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90501-3
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is a major public health problem in the United States. We assess the prevalence of diabetes in Dallas County, quantify the association between diabetes and subclinical cardiovascular disease, and assess the use of evidence-based cardiovascular disease risk-modifying therapies. METHODS:This...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.10.016
更新日期:2006-05-01 00:00:00
abstract::Percutaneous coronary interventions have been performed for 20 years. Despite the success and progress of these interventions, abrupt vessel closure has been a dramatic adverse event of coronary interventions. Closure has frequently led to the major complications of death, myocardial infarction, and emergency coronary...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(97)70069-3
更新日期:1997-09-01 00:00:00
abstract::Fifty adult men with mild to moderate hypertension were recruited to participate in a double-blind crossover study. Each subject received 14 days of drug treatment and 14 days of placebo treatment (random order). Half the subjects were assigned to a metoprolol (150 mg/day) vs placebo treatment regimen and half to an a...
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(88)90106-8
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Anginal chest pain without creatine kinase (CK) elevation is frequently observed in the first hours after coronary stenting. Possible causes of ischemic episodes are microembolism, side branch occlusion, coronary vasospasm, and disturbances of microvascular circulation. In a prospective, double-blind, random...
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(00)90306-5
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:In patients with chronic heart failure, the use of carvedilol therapy induces clinical and hemodynamic improvement. However, although the benefits of this beta-blocker have been established in patients with chronic heart failure, the mechanisms underlying them and the changes in left ventricular systolic fun...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(00)90036-x
更新日期:2000-04-01 00:00:00
abstract::The prevention of major bleeding during percutaneous coronary intervention is one of the most widely discussed and often controversial topics within interventional cardiology. The choice of arterial access should be considered a mechanism for bleeding avoidance, and various strategies have been proposed to prevent or ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2015.04.023
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Chronic periodontal infection is associated with an increased risk of coronary heart disease. Although the mechanism responsible for the relationship between periodontal disease and cardiovascular events is not fully understood, it is hypothesized that the chronic inflammatory burden of periodontal disease m...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.10.002
更新日期:2006-01-01 00:00:00
abstract::To assess the effects of standard therapeutic interventions on the total ischemic burden, 86 patients with stable angina underwent 48 hours of ambulatory ST segment monitoring and treadmill exercise testing before and at a mean of 10 weeks after coronary artery bypass surgery (CABG) (group 1, N = 46) or percutaneous t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90495-h
更新日期:1992-03-01 00:00:00
abstract::A-II exerts its activity on various target tissues by binding to its receptors. The discovery of local RASs and A-II receptors within various tissues has generated interest in the clinical usefulness of RAS inhibition by directly blocking the action of A-II at the receptor level. Different A-II receptor subtypes have ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(94)90061-2
更新日期:1994-05-01 00:00:00
abstract::The effects of handgrip and supine bicycle exercise on hemodynamics and left ventricular (LV) performance were compared in 25 patients with moderate to severe aortic regurgitation (AR) and normal LV ejection fraction at rest (greater than or equal to 50%) and in 10 control subjects. In both groups, heart rate, systoli...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90355-2
更新日期:1985-06-01 00:00:00
abstract::Three cases of large multiple coronary aneurysms, situated on both right and left coronary arteries, were seen in three middle-aged adult patients. These patients were hospitalized for myocardial infarction in two cases and for angina pectoris in the third case. On the coronary angiogram, the coronary lesions were qui...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90617-1
更新日期:1980-06-01 00:00:00
abstract::The proximal flow convergence method of multiplying color Doppler aliasing velocity by flow convergence surface area has yielded a new means of quantifying flow rate by noninvasively derived measurements. Unlike previous methods of visualizing the turbulent jet of mitral regurgitation on color flow Doppler mapping, fl...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90025-5
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:Peculiar asynergy, which consists of hypokinesis or akinesis from the mid portion to the apical area and hyperkinesis of the basal area on contrast left ventriculogram, is rare. Because the end-systolic left ventriculogram looks like a "tako-tsubo," which was used for trapping octopuses in Japan, we proposed...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.120403
更新日期:2002-03-01 00:00:00
abstract::A dilated cardiomyopathy picture has been produced by rapid atrial and ventricular rates sustained for a long period of time in some patients. The ventricular tachycardias have in some instances been associated with ventricular tumors as the cause of the tachycardia. Once the tumor is removed, the tachycardia stops an...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90811-3
更新日期:1988-03-01 00:00:00