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 guidelines. Resource consumption was recorded, and cost savings were then calculated by analyzing the specific supply and personnel costs that could change as a result of inpatient versus outpatient status. Of the total of 986 patients who underwent diagnostic catheterization, 240 (24%) were outpatients, 279 (28%) were inpatients but had no exclusion criteria for outpatient catheterization and 467 (47%) were inpatients who had one or more exclusions for outpatient catheterization. The most common reasons for exclusion from outpatient catheterization were congestive heart failure (22%), unstable angina (15%), noncoronary heart disease (14%), recent myocardial infarction (11%) and severe noncardiac disease (9%). Inpatients with no exclusions for the outpatient procedure tended to be sicker than outpatients because they were older (p = 0.002), had a lower ejection fraction (p = 0.009) and had more triple vessel coronary artery disease (p less than 0.0001). The cost of the catheterization procedure itself was not different between inpatients and outpatients. Laboratory testing was more frequent among inpatients, however, and "room and board" costs were significantly higher. Although the difference in hospital charges for inpatients and outpatients was $580, a rigorous analysis indicated that the potential cost savings was only 38% of this amount, or $218 per eligible patient.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Lee JC,Bengtson JR,Lipscomb J,Bashore TM,Mark DB,Califf RM,Pryor DB,Hlatky MAdoi
10.1016/s0735-1097(10)80066-xsubject
Has Abstractpub_date
1990-02-01 00:00:00pages
378-84issue
2eissn
0735-1097issn
1558-3597pii
S0735-1097(10)80066-Xjournal_volume
15pub_type
杂志文章abstract：:To date, attempted balloon dilation of stenotic standard Blalock-Taussig shunts has been largely disappointing. It has been suggested that this may be due to the use of balloons of insufficient diameter. Balloon dilation of stenotic Blalock-Taussig shunts was attempted with use of relatively large balloons in five pat...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(91)90613-e
更新日期：1991-08-01 00:00:00
abstract：:The knowledge and treatment of cardiology as practiced circa 1950 is discussed as abstracted from authoritative textbooks of that time and other sources. Advances in treatment and diagnostic techniques since 1950 are presented. Dramatic changes in cardiology have come at the expense of bedside cardiology which needs t...
journal_title：Journal of the American College of Cardiology
pub_type： 历史文章,杂志文章
doi：10.1016/s0735-1097(99)00027-3
更新日期：1999-04-01 00:00:00
abstract：:In recent times, there has been a considerable increase in the use of aortic bioprostheses (vs. mechanical prostheses) for treating aortic valve disease, and this tendency is likely to continue in the near future. However, the occurrence of structural valve degeneration, limiting valve durability, remains an important...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,评审
doi：10.1016/j.jacc.2017.07.715
更新日期：2017-08-22 00:00:00
abstract：:Acute myocardial ischemia is known to cause impairment of both left ventricular systolic and diastolic function. To further investigate these changes as well as their relation to common clinical variables (electrocardiographic [ECG] changes and chest pain), 32 patients were evaluated with Doppler echocardiography duri...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(87)80266-8
更新日期：1987-10-01 00:00:00
abstract：OBJECTIVES:This study evaluated the extent of the collagen network in neonatal heart muscle and whether the type I/type III collagen ratio is the same as in the adult heart. BACKGROUND:The functional integrity and the stress-strain relation of heart muscle depends largely on the extracellular collagen matrix. The ques...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(94)90612-2
更新日期：1994-04-01 00:00:00
abstract：OBJECTIVES:In this study, we assessed the utility of exercise thallium-201 scintigraphy and other clinical factors in predicting perioperative cardiac complications in patients undergoing elective vascular surgery. BACKGROUND:The risk of cardiac complications among such patients is very high. METHODS:The study group ...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(93)90307-m
更新日期：1993-05-01 00:00:00
abstract：BACKGROUND:Early in the prevention and treatment of bioprosthetic valve thrombosis (BPVT), anticoagulation is effective, but the long-term outcome after BPVT is unknown. OBJECTIVES:The goal of this study was to assess the long-term outcomes of patients with BPVT treated with anticoagulation. METHODS:This analysis was...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2019.12.037
更新日期：2020-03-03 00:00:00
abstract：OBJECTIVES:This study sought to characterize the spontaneous onset of atrial flutter in patients. BACKGROUND:Temporary epicardial electrodes are routinely placed on the atria of patients at the time of open heart surgery and brought out through the anterior chest wall for potential diagnostic and therapeutic use in th...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(96)00223-9
更新日期：1996-09-01 00:00:00
abstract：:Two-dimensional echocardiography can diagnose hypoplastic left heart syndrome. However, with the advent of the possibility of palliative open heart surgery, complete anatomic diagnosis is necessary. The anatomic findings of 15 neonates with hypoplastic left heart syndrome (age 1 to 10 days, mean 4.1) who had two-dimen...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(86)80472-7
更新日期：1986-03-01 00:00:00
abstract：:The antiarrhythmic effects of verapamil, 17-monochloracetylajmaline, mexiletine and amiodarone were compared in 14 patients with chagasic myocarditis. Drugs and placebo were administered orally in the following order: placebo and verapamil, placebo and 17-monochloracetylajmaline, placebo and mexiletine (1 week each) a...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(86)80232-7
更新日期：1986-05-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to evaluate the relative impact of demographic and clinical variables versus the cytochrome P450 2C19 (CYP2C19) polymorphism on antiplatelet effects of clopidogrel. BACKGROUND:Platelet responses to clopidogrel show a marked interindividual variability with substantial impact on cli...
journal_title：Journal of the American College of Cardiology
pub_type： 临床试验,杂志文章
doi：10.1016/j.jacc.2010.02.031
更新日期：2010-06-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to evaluate the immediate and long-term outcome of intracoronary stent implantation for the treatment of coronary artery bifurcation lesions. BACKGROUND:Balloon angioplasty of true coronary bifurcation lesions is associated with a lower success and higher complication rate than mos...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(99)00648-8
更新日期：2000-03-15 00:00:00
abstract：OBJECTIVES:The purpose of this investigator-driven, prospective, randomized, double-blinded, placebo-controlled phase II study was to compare the effects of granulocyte colony-stimulating factor (G-CSF) on the improvement of myocardial function in patients undergoing delayed percutaneous coronary intervention (PCI) for...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jacc.2006.07.044
更新日期：2006-10-17 00:00:00
abstract：:Right ventricular diastolic collapse has been demonstrated to be a sensitive and specific sign of cardiac tamponade. Because the shape and position of the right ventricular wall are related to the relative pressures within the pericardial space and the right ventricular chamber, the usefulness of right ventricular dia...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(85)80309-0
更新日期：1985-11-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to determine whether the release of nitric oxide (NO) from the ischemic heart increases during exercise in patients with effort angina. BACKGROUND:Myocardial ischemia increases NO production in the canine heart, but no such increase has been demonstrated in the ischemic human heart...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(98)00196-x
更新日期：1998-07-01 00:00:00
abstract：OBJECTIVES:This study was designed to determine whether coronary vasospasm in patients with variant angina pectoris (VAP) may produce focal organic lesions at the site of vasospasm that would contribute to disease progression. BACKGROUND:Recent clinical angiographic and experimental studies have demonstrated the poten...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(98)00520-8
更新日期：1999-01-01 00:00:00
abstract：OBJECTIVES:This study was designed to investigate the association between hypertension and aortic valve stenosis (AVS) in a rabbit model. BACKGROUND:Degenerative AVS is a prevalent disease in elderly persons. Its molecular mechanisms remain unclear, in part because of the absence of experimental models. Epidemiologic ...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2005.12.070
更新日期：2006-06-06 00:00:00
abstract：:Among 3,548 patients undergoing a percutaneous transluminal coronary angioplasty procedure, 714 had multilesion angioplasty (1,550 lesions) in a single session. Acute occlusion occurred in 22 patients (3.1%) and 29 lesions (1.9%). The patients were classified into a group undergoing multivessel angioplasty (348 patien...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(89)90499-3
更新日期：1989-02-01 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：:The effects of combined intravenous and intracoronary streptokinase without (Group I, n = 103) or with (Group II, n = 103) immediate coronary angioplasty were evaluated during a long-term (3 year) follow-up of 206 patients with acute transmural myocardial infarction. There were no baseline differences between the grou...
journal_title：Journal of the American College of Cardiology
pub_type： 临床试验,杂志文章
doi：10.1016/0735-1097(89)90173-3
更新日期：1989-08-01 00:00:00
abstract：OBJECTIVES:The goal of this study was to determine the magnitude and mechanisms of hemodynamic improvement of an automated, load-distributing band device (AutoPulse, Revivant Corp., Sunnyvale, California) compared with conventional cardiopulmonary resuscitation (C-CPR). BACKGROUND:Improved blood flow during cardiopulm...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2004.08.061
更新日期：2004-12-07 00:00:00
abstract：OBJECTIVES:This study sought to investigate whether pulse pressure (PP) is associated with endothelium-dependent vasodilation in a group of never-treated hypertensives. BACKGROUND:Pulse pressure represents a well-established independent predictor for cardiovascular morbidity and mortality. Forearm endothelial dysfunct...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(03)00295-x
更新日期：2003-05-21 00:00:00
abstract：BACKGROUND:Aortic stiffening and reduced nitric oxide (NO) availability may contribute to the pathophysiology of heart failure with preserved ejection fraction (HFpEF). OBJECTIVES:This study compared indices of arterial stiffness at rest and during exercise in subjects with HFpEF and hypertensive control subjects to e...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jacc.2017.05.029
更新日期：2017-07-11 00:00:00
abstract：OBJECTIVES:The goal of this study was to determine the association between Thrombolysis In Myocardial Infarction (TIMI) and Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) bleeding and clinical outcomes. BACKGROUND:There are limited data on the relative utility of either scale at predicting clinica...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2005.09.060
更新日期：2006-02-21 00:00:00
abstract：OBJECTIVES:We sought to analyze age-gender differences in the rate-corrected QT (QTc) interval in the presence of a QT-prolonging gene. BACKGROUND:Compared with men, women exhibit a longer QTc interval and an increased propensity toward torsade de pointes. In normal subjects, the QTc gender difference reflects QTc int...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/s0735-1097(96)00454-8
更新日期：1997-01-01 00:00:00
abstract：BACKGROUND:Exercise has been proposed as a trigger for arrhythmogenic right ventricular cardiomyopathy (ARVC) phenotype manifestation; however, research is hampered by the limited availability of animal models in which disease-associated mutations can be tested. OBJECTIVES:This study evaluated the impact of exercise o...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/j.jacc.2015.01.045
更新日期：2015-04-14 00:00:00
abstract：OBJECTIVES:Our aim was to clarify the anatomic substrate in hearts diagnosed as having tricuspid atresia by studying autopsy specimens and comparing the findings with those in two-dimensional echocardiograms. BACKGROUND:Traditionally, tricuspid atresia was thought, and is still believed by some, to be due to an imperf...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章
doi：10.1016/0735-1097(95)00250-8
更新日期：1995-09-01 00:00:00
abstract：:Incretin-based therapies are effective glucose-lowering drugs that have an increasing role in the treatment of type 2 diabetes because of their efficacy, safety, and ease of use. Both glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors are commonly used for glycemic control as adjuncts to m...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,评审
doi：10.1016/j.jacc.2015.12.058
更新日期：2016-03-29 00:00:00
abstract：OBJECTIVES:The purpose of this review is to assemble the widely dispersed information about cardiac alternans and to categorize the types and mechanisms of alternans, their clinical manifestations and possible therapeutic implications. BACKGROUND:The phenomena of mechanical and electrical alternans have been of contin...
journal_title：Journal of the American College of Cardiology
pub_type： 杂志文章,评审
doi：10.1016/0735-1097(92)90122-4
更新日期：1992-08-01 00:00:00
abstract：OBJECTIVES:The purpose of this study was to determine whether cilostazol reduces intimal hyperplasia in patients undergoing long zotarolimus-eluting stent implantation (stent length: ≥ 30 mm) for native long coronary lesions (length: ≥ 25 mm). BACKGROUND:Restenosis after drug-eluting stent implantation remains a signi...
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.2010.10.035
更新日期：2011-03-15 00:00:00
