Abstract：
OBJECTIVES:The objective of this study is to assess trends in evidence-based therapy use and short- and long-term mortality over time among older patients with non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND:With the prevalence of national quality improvement efforts, the use of evidence-based therapies has improved over time among patients with NSTEMI, yet it is unclear whether these improvements have been associated with significant change in short- and long-term mortality for older patients. METHODS:We linked detailed clinical data for 28,603 NSTEMI patients aged ≥65 years at 171 hospitals in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines Registry with longitudinal Centers for Medicare & Medicaid claims data and compared trends in annual unadjusted and risk-adjusted inhospital and long-term mortality from 2003 to 2006. RESULTS:The median age of our NSTEMI study population was 77 years, 48% were female, and 87% were white. Overall, inhospital and 1-year mortality rates were 6.0% and 24.5%, respectively. When compared with patients treated in 2003, NSTEMI patients treated in 2006 were more likely to receive guideline-recommended inhospital medications and early invasive treatment. Inhospital mortality decreased significantly over the study period (5.5% vs 7.2% [adjusted odds ratio 0.82, 95% CI 0.67-1.00, P = .045] for 2006 vs 2003), but there was no significant change in 1-year mortality from the index admission (24.0% vs 26.0% [adjusted hazard ratio 0.99, 95% CI 0.90-1.08] for 2006 vs 2003). CONCLUSIONS:Between 2003 and 2006, there was a significant reduction in inhospital mortality that corresponded to an increase in the use of evidence-based NSTEMI care. Nevertheless, long-term outcomes have not changed over time, suggesting a need for improved care transition and longitudinal secondary prevention.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Chin CT,Wang TY,Chen AY,Mathews R,Alexander KP,Roe MT,Peterson EDdoi
10.1016/j.ahj.2013.10.008subject
Has Abstractpub_date
2014-01-01 00:00:00pages
36-42.e1issue
1eissn
0002-8703issn
1097-6744pii
S0002-8703(13)00716-3journal_volume
167pub_type
杂志文章abstract：:The effects of amiodarone on delayed afterdepolarization (DAD) and triggered automaticity induced by low potassium (0.5 mEq/L) were evaluated on isolated rabbit right ventricular muscles, by means of standard microelectrode techniques. Triggered automaticity was induced in 6 of 10 muscles in the control group, in four...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(87)90267-5
更新日期：1987-02-01 00:00:00
abstract：BACKGROUND:Declines in case fatality post-myocardial infarction (MI) have been observed over the past 3 decades. Few studies report socioeconomic disparities in survival post-MI. METHODS:We assessed 1-year case fatality among 9,116 incident MI patients included in the Atherosclerosis Risk in Communities community surv...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2012.10.022
更新日期：2013-01-01 00:00:00
abstract：:We developed a new angiographic score of the extent of coronary disease (extent score), which we compared with conventional stenosis and vessel scores that emphasize the severity of stenosis. Scores were determined in 132 patients (29 women, 103 men with a mean age of 55 +/- 10 years) who underwent elective coronary a...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/s0002-8703(05)80173-5
更新日期：1990-06-01 00:00:00
abstract：:To assess the effects of pacing-induced tachycardia on phasic coronary blood flow pattern and flow reserve of left anterior descending artery, we examined 16 patients with chest pain and angiographically normal coronary arteries by using an intravascular Doppler catheter with spectral analysis of the velocity signal. ...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(94)90661-0
更新日期：1994-03-01 00:00:00
abstract：BACKGROUND:Technetium Tc 99m gated single photon emission computed tomography (SPECT) has become the cornerstone of noninvasive risk stratification in patients with ischemic heart disease, but its role in patients with heart failure is not as well established. STUDY DESIGN:This study is a substudy of the Heart Failure...
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.2007.03.045
更新日期：2007-07-01 00:00:00
abstract：BACKGROUND:Diabetes mellitus and impaired glucose metabolism are associated with increased risk for cardiovascular disease (CVD). However, it is still not clear whether glucose levels can predict CVD risk among patients without diabetes. The primary aim of this study is to assess whether normoglycemic fasting plasma gl...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2012.03.023
更新日期：2012-07-01 00:00:00
abstract：:The Institute of Medicine report on the frequency and consequences of medical errors in clinical practice has stimulated physicians to evaluate current practice and means of improving medical care. In the treatment of patients with acute myocardial infarction, previous studies have found that dosing of fibrinolytic th...
journal_title：American heart journal
pub_type： 杂志文章,评审
doi：10.1067/mhj.2000.111605
更新日期：2000-12-01 00:00:00
abstract：BACKGROUND:In the setting of ST-segment elevation myocardial infarction, timely restoration of normal blood flow is associated with improved myocardial salvage and survival. Despite improvements in door-to-needle and door-to-balloon times, there remains an unmet need with respect to improved symptom-to-door times. A pr...
journal_title：American heart journal
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/j.ahj.2014.05.010
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Intramyocardial injection of autologous bone marrow (ABM) may induce angiogenesis. We tested the safety and feasibility of catheter-based direct percutaneous intramyocardial delivery of ABM in patients with refractory angina pectoris. METHODS:Ten patients (9 men, 67 +/- 8 years) with refractory angina (Cana...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2005.04.033
更新日期：2006-03-01 00:00:00
abstract：:Exercise stress testing is a well-established method for the diagnostic, prognostic, and functional assessment of patients with known or suspected CAD. A variety of alternative tests have been described in patients unable to perform leg exercise. Atrial pacing and dipyridamole imaging have been evaluated most extensiv...
journal_title：American heart journal
pub_type： 杂志文章,评审
doi：10.1016/0002-8703(89)90417-1
更新日期：1989-06-01 00:00:00
abstract：:Probucol, a new cholesterol-lowering agent, was administered to ambulatory outpatients representing several classes of hyperlipoproteinemia (HL) for two years without dietary restriction. In 32 patients with Type II HL and 12 with Type IIB HL, statistically significant reduction in mean serum cholesterol levels occurr...
journal_title：American heart journal
pub_type： 临床试验,杂志文章
doi：10.1016/0002-8703(78)90088-1
更新日期：1978-08-01 00:00:00
abstract：:The appearance of perivalvular cavities (PCs) in patients with infectious endocarditis (IE) was studied by transesophageal echocardiography (TEE) color Doppler examinations to determine whether the color Doppler TEE presentation was in keeping with the current concept of PCs representing abscesses. Two heart centers p...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(95)90241-4
更新日期：1995-07-01 00:00:00
abstract：:To investigate the significance of atrial natriuretic polypeptide (ANP) in essential hypertension, we measured plasma ANP concentrations in 43 subjects with essential hypertension uncomplicated by cardiac or renal failure, in 16 subjects with borderline hypertension, and in 17 normotensive control subjects. Plasma ANP...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(87)90929-x
更新日期：1987-05-01 00:00:00
abstract：BACKGROUND:ISAR-REACT was a trial designed to evaluate whether the glycoprotein IIb/IIIa inhibitor abciximab is beneficial in patients undergoing elective percutaneous coronary intervention (PCI) with stent placement after pretreatment with a 600 mg loading dose of clopidogrel. Objective for the angiographic substudy w...
journal_title：American heart journal
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ahj.2005.08.002
更新日期：2006-06-01 00:00:00
abstract：:Reperfusion therapy has lowered the mortality in patients suffering acute myocardial infarction. Failure to reperfuse is associated with significantly higher risk of short- and long-term mortality. Detection of reperfusion is thus important. In a prospective pilot study, we used continuous on-line computerized vectorc...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(91)90455-q
更新日期：1991-10-01 00:00:00
abstract：BACKGROUND:Peripheral endothelial dysfunction (ED) quantified by the determination of flow-mediated dilation (FMD%) of the brachial artery with the use of high-resolution ultrasound is an early marker of atherosclerosis. Although a positive correlation with coronary artery disease (CAD) has been reported, the unanswere...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/s0002-8703(99)70189-4
更新日期：1999-10-01 00:00:00
abstract：BACKGROUND:Prior studies regarding the effect of racial status on post-myocardial infarction (MI) in subjects with diabetes have yielded conflicting results. We evaluated the effect of diabetes status on racial differences in post-MI mortality and morbidity for a 7-year period, from 1990 through 1997. METHODS:All pati...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2005.02.042
更新日期：2005-11-01 00:00:00
abstract：BACKGROUND:Balloon inflation during coronary angioplasty results in shear stress-induced vessel wall injury with development of restenosis. This randomized trial compared the impact of two different balloon inflation strategies (slow versus fast) on restenosis after coronary angioplasty. METHODS:Two hundred seven pati...
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(98)70290-x
更新日期：1998-04-01 00:00:00
abstract：:Studies were conducted in 15 patients with coronary artery disease to determine if the type of pacing used to induce an extrasystole had a bearing on subsequent postextrasystolic potentiation (PESP) and if the fact that these were evaluated in jeopardized or nonjeopardized portions of the ventricle altered the ability...
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(86)90149-3
更新日期：1986-02-01 00:00:00
abstract：BACKGROUND:Experimental evidence shows that activation of the autonomic nervous system influences ventricular repolarization and, therefore, the QT interval on the ECG. To test the hypothesis that the QT interval is abnormal in autonomic dysfunction, we examined ECGs in patients with severe primary autonomic failure an...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/s0002-8703(98)70014-6
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:Although controversial, reducing low-density lipoprotein cholesterol (LDL-C) to target levels remains a common therapeutic goal after acute myocardial infarction (AMI). We sought to illuminate patient and provider characteristics associated with LDL-C goal nonattainment after AMI. METHODS:In an observationa...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2012.10.005
更新日期：2013-01-01 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：:This study was designed to investigate the hypothesis that mitral valve prolapse (MVP) can be induced after diuresis in women without the abnormality who have characteristic body habitus. Fifteen tall, slim, healthy female volunteers with a normal cardiac findings, echocardiogram, and history were investigated after m...
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)90068-7
更新日期：1992-12-01 00:00:00
abstract：:It has been suggested that the myocardium is able to recruit endogenous protective mechanisms in response to repeated ischemia and reperfusion. We set out to study whether this is manifested in patients with coronary artery disease in the form of fewer signs of myocardial ischemia during the second of two successive e...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/s0002-8703(96)90272-0
更新日期：1996-04-01 00:00:00
abstract：:Little is known about the impact of accountable care organizations (ACO) on hospitalized heart failure (HF) patients, a high-cost and high-risk population. OBJECTIVE:We linked Medicare fee-for-service claims from 2013 to 2015 with data from American Heart Association Get With The Guidelines-HF registry to compare HF ...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/j.ahj.2020.04.028
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Atrial fibrillation (AF) ablation is superior to pharmacologic therapy in achieving maintenance of normal sinus rhythm in selected patient populations. However, the procedure is resource intensive, and repeat ablations are sometimes required. We examined the predictors and trends of repeat ablation using a l...
journal_title：American heart journal
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ahj.2015.10.015
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND:Peroxisome proliferator-activated receptors (PPARs) regulate transcription of genes involved in glucose uptake, lipid metabolism, and inflammation. Aleglitazar is a potent dual PPAR agonist with insulin-sensitizing and glucose-lowering actions and favorable effects on lipid profiles and biomarkers of cardiov...
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.2013.05.013
更新日期：2013-09-01 00:00:00
abstract：:High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work ind...
journal_title：American heart journal
pub_type： 临床试验,杂志文章
doi：10.1016/0002-8703(91)90834-5
更新日期：1991-06-01 00:00:00
abstract：OBJECTIVE:Implantation of drug-eluting stents has emerged as the predominant percutaneous revascularization strategy in diabetic patients, despite limited outcomes data. Accordingly, our aim was to conduct a meta-analysis to assess the benefit and safety profile of drug-eluting stents in diabetic patients. METHODS:We ...
journal_title：American heart journal
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.ahj.2007.11.017
更新日期：2008-04-01 00:00:00
abstract：BACKGROUND:The aim of the study was to describe the incidence and consequences of minor surgery after drug-eluting stent (DES) implantation. METHODS:The Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) Registry prospectively enrolled unselected patients undergoing percutaneous coronary intervention at 47 ...
journal_title：American heart journal
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ahj.2010.09.028
更新日期：2011-02-01 00:00:00
