Abstract:
BACKGROUND:Rates of referral to cardiac rehabilitation after percutaneous coronary intervention (PCI) have been historically low despite the evidence that rehabilitation is associated with lower mortality in PCI patients. OBJECTIVES:This study sought to determine the prevalence of and factors associated with referral to cardiac rehabilitation in a national PCI cohort, and to assess the association between insurance status and referral patterns. METHODS:Consecutive patients who underwent PCI and survived to hospital discharge in the National Cardiovascular Data Registry between July 1, 2009 and March 31, 2012 were analyzed. Cardiac rehabilitation referral rates, and patient and institutional factors associated with referral were evaluated for the total study population and for a subset of Medicare patients presenting with acute myocardial infarction. RESULTS:Patients who underwent PCI (n = 1,432,399) at 1,310 participating hospitals were assessed. Cardiac rehabilitation referral rates were 59.2% and 66.0% for the overall population and the AMI/Medicare subgroup, respectively. In multivariable analyses, presentation with ST-segment elevation myocardial infarction (odds ratio 2.99; 95% confidence interval: 2.92 to 3.06) and non-ST-segment elevation myocardial infarction (odds ratio: 1.99; 95% confidence interval: 1.94 to 2.03) were associated with increased odds of referral to cardiac rehabilitation. Models adjusted for insurance status showed significant site-specific variability in referral rates, with more than one-quarter of all hospitals referring <20% of patients. CONCLUSIONS:Approximately 60% of patients undergoing PCI in the United States are referred for cardiac rehabilitation. Site-specific variation in referral rates is significant and is unexplained by insurance coverage. These findings highlight the potential need for hospital-level interventions to improve cardiac rehabilitation referral rates after PCI.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Aragam KG,Dai D,Neely ML,Bhatt DL,Roe MT,Rumsfeld JS,Gurm HSdoi
10.1016/j.jacc.2015.02.063subject
Has Abstractpub_date
2015-05-19 00:00:00pages
2079-88issue
19eissn
0735-1097issn
1558-3597pii
S0735-1097(15)01438-2journal_volume
65pub_type
杂志文章,多中心研究abstract::Seventy-four patients with chronic stable mild angina, mild coronary artery disease (83% had one- or two-vessel disease) and normal left ventricular function were studied to measure the response of treadmill exercise performance and painful and silent ischemia in the ambulatory setting to randomly assigned treatment w...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0735-1097(92)90499-d
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:The aim of this paper was to study mechanisms of formation of fractionated electrograms on the posterior left atrial wall (PLAW) in human paroxysmal atrial fibrillation (AF). BACKGROUND:The mechanisms responsible for complex fractionated atrial electrogram formation during AF are poorly understood. METHODS...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.09.066
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVES:We sought to determine whether nitroglycerin (NTG) withdrawal contributes to worsening of endothelial dysfunction and development of the rebound phenomenon during intermittent transdermal NTG therapy. BACKGROUND:Intermittent transdermal NTG therapy is recommended to avoid the development of tolerance. Howev...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(00)01140-2
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVES:We sought to compare emergency coronary angiography with or without rescue percutaneous coronary intervention (PCI) with conservative treatment in patients with failed fibrinolysis complicating ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Most patients with STEMI receive fibrinolytic thera...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2003.12.059
更新日期:2004-07-21 00:00:00
abstract::This study describes the long-term outcome of 33 patients with hypertrophic cardiomyopathy who experienced a cardiac arrest but were successfully resuscitated. Cardiac arrest occurred at ages 9 to 62 years (mean 32); five patients survived multiple (two or three) arrests. A variety of treatments were administered; 18 ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90302-1
更新日期:1989-05-01 00:00:00
abstract::The highest-risk patients with heart failure with reduced ejection fraction are those with ischemic cardiomyopathy and severe left ventricular systolic dysfunction (ejection fraction≤35%). The cornerstone of treatment is guideline-driven medical therapy for all patients and implantable device therapy for appropriately...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2014.10.070
更新日期:2015-02-17 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the influence of enrolling site location and enrollment performance on the generalizability of STICH (Surgical Treatment for Ischemic Heart Failure) trial results. BACKGROUND:The international STICH trial seeks to define the role of cardiac surgery for patients with ische...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2009.11.102
更新日期:2010-08-03 00:00:00
abstract:OBJECTIVES:Our aim was to assess the predictive value of myocardial infarct size assessed with late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) in medically treated patients with chronic myocardial infarction relative to contractile reserve on low-dose dobutamine magnetic resonance (DSMR) for long-term e...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jacc.2009.07.027
更新日期:2009-11-03 00:00:00
abstract:OBJECTIVES:This study outlines the clinical course, treatment and the late outcome of infants and children with multifocal atrial tachycardia (MAT). BACKGROUND:Multifocal atrial tachycardia is defined by three distinct P-waveforms, irregular P-P intervals, isoelectric baseline between P-waves and rapid rate on an elec...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/s0735-1097(01)01390-0
更新日期:2001-08-01 00:00:00
abstract::Ventricular arrhythmia (VA) in structurally normal hearts can be broadly considered under non-life-threatening monomorphic and life-threatening polymorphic rhythms. Monomorphic VA is classified on the basis of site of origin in the heart, and the most common areas are the ventricular outflow tracts and left ventricula...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2012.01.036
更新日期:2012-05-15 00:00:00
abstract::To determine the feasibility and cost-saving potential of substituting outpatient for inpatient cardiac catheterization, 986 consecutive procedures were studied at a large referral hospital. Patients were classified prospectively as to their eligibility for outpatient cardiac catheterization according to published gui...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80066-x
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVES:This study was undertaken to assess prospectively the prognostic power of early ST segment elevation resolution in a large cohort of patients with myocardial infarction and to test the value of differences in ST segment resolution as a surrogate end point. BACKGROUND:Previous studies revealed that the use o...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0735-1097(95)00372-x
更新日期:1995-12-01 00:00:00
abstract::Sustained ventricular tachycardia or fibrillation that develops during the early recovery period after acute myocardial infarction is a common clinical problem whose management remains controversial. Fifty-three patients who survived an initial episode of sustained ventricular tachycardia or fibrillation occurring bet...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80479-4
更新日期:1985-10-01 00:00:00
abstract::The immediate and long-term efficacy of coronary angioplasty in the elderly was determined by studying 752 patients greater than or equal to 65 years old and comparing patients greater than or equal to 75 years old with those 65 to 74 years old. The oldest patients were more highly symptomatic, were more likely to be ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80130-5
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVES:This study sought to evaluate the relationship between brain natriuretic peptide (BNP), renal function, and the severity of congestive heart failure (CHF). BACKGROUND:Both BNP and renal function are prognostic predictors in CHF patients. METHODS:We measured the plasma BNP level in the aortic root and coron...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2005.10.038
更新日期:2006-02-07 00:00:00
abstract:OBJECTIVES:The study was done to test the ability to predict the extent of angiographically determined coronary artery disease (CAD) by quantification of coronary calcium using electron-beam computed tomography (EBCT) and to compare it with more conventional parameters for delineating the angiographic extent of CAD, th...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00265-x
更新日期:1999-09-01 00:00:00
abstract::Thirty patients with stable exertional angina undergoing percutaneous transluminal coronary angioplasty of an isolated obstructive lesion of the proximal left anterior descending artery were prospectively evaluated to investigate the relation between angina induced by balloon inflation and the quantity and severity of...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80189-4
更新日期:1987-09-01 00:00:00
abstract::The effect of atrial pacing on intracoronary thromboxane production was investigated in 35 patients with stable (n = 19) or unstable (n = 16) angina. Arterial and coronary sinus thromboxane B2, the stable metabolite of thromboxane A2, myocardial lactate extraction and thermodilution coronary sinus flow were measured b...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80129-6
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVES:In the Heparin in Early Patency (HEAP) pilot study a beneficial effect of high-dose heparin on early patency in acute myocardial infarction (MI) was observed in a matched-control study. BACKGROUND:High dose bolus intravenous injection of heparin may achieve lysis of coronary thrombi and could enhance early ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(99)00597-5
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:This study examined plasma levels of certain matrix metalloproteinase (MMP) and tissue inhibitor of matrix metalloproteinase (TIMP) species before and after alcohol-induced myocardial infarction (MI) in patients with hypertrophic obstructive cardiomyopathy (HOCM). BACKGROUND:Matrix metalloproteinases contri...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)02595-0
更新日期:2002-12-18 00:00:00
abstract::The efficacy of truncated exponential waveform shocks using a cardioverter-defibrillator catheter with and without a 13.9 cm2 subcutaneous thoracic patch electrode was examined in 10 pentobarbital-anesthetized dogs. The cardioverter-defibrillator catheter was positioned through the external jugular vein with the dista...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80025-6
更新日期:1987-08-01 00:00:00
abstract::Previous studies have suggested that right ventricular systolic pressure can be predicted from noninvasive estimates of the interval between pulmonary valve closure and tricuspid valve opening. To determine the basis for this relation, phonocardiograms and high fidelity right atrial and ventricular pressures were reco...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90097-6
更新日期:1988-02-01 00:00:00
abstract::To compare the effects of isolated right ventricular pressure and volume overload on left ventricular diastolic geometry and filling, 11 patients with primary pulmonary hypertension, 11 patients with severe tricuspid regurgitation due to tricuspid valve resection and 11 normal subjects were studied with use of Doppler...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90056-s
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:This study sought to develop a regression-based method for characterization of QT interval behavior during exercise and to define the normal range of the resulting "dynamic" measures of repolarization during submaximal treadmill testing in men and women. BACKGROUND:The Bazett-corrected QT (QTc) interval dur...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(96)00351-8
更新日期:1996-11-15 00:00:00
abstract::The myocardial uptake of a new technetium-99m-labeled myocardial perfusion agent, methoxyisobutyl isonitrile (Tc-99m MIBI), and thallium-201 was correlated with microsphere flow in an open chest canine model of low coronary flow and postischemic dysfunction. Eighteen dogs were given an injection of thallium-201 (0.5 m...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90034-x
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVES:Our goal was to compare the safety and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, with clopidogrel in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). BACKGROUND:AZD6140 achieves higher mean levels of platelet inhibition than ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2007.07.053
更新日期:2007-11-06 00:00:00
abstract::Clot dissolution with restoration of infarct-related artery blood flow is the likely mechanism for the improved prognosis and mortality reduction seen after thrombolytic therapy of acute myocardial infarction. A pilot study has suggested that 100 mg of recombinant tissue-type plasminogen activator (rt-PA) infused over...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0735-1097(92)90131-6
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:We sought to derive gender-specific cardiovascular magnetic resonance (CMR) reference values for normative left ventricular (LV) anatomy and function in a healthy adult population of clinically relevant age. BACKGROUND:Cardiovascular magnetic resonance imaging is increasingly applied in the clinical setting...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)01712-6
更新日期:2002-03-20 00:00:00
abstract:OBJECTIVES:We assessed the hypothesis that changes in endothelial vasomotor function in response to optimized therapy for atherosclerotic coronary artery disease predict future cardiovascular events. BACKGROUND:Although endothelial vasomotor dysfunction is a predictor of cardiovascular events, it remains unclear wheth...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2008.08.074
更新日期:2009-01-27 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the mechanisms of sudden death (SD) in patients with ventricular tachyarrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]) treated with an implantable cardioverter defibrillator (ICD). BACKGROUND:Despite ICD therapy, some patients with VT/VF still...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)01784-9
更新日期:2002-04-17 00:00:00