Abstract:
BACKGROUND:Myocardial infarction (MI) complicated by cardiogenic shock (CS) is associated with high mortality. Early coronary revascularization improves survival, but the optimal mode of revascularization remains uncertain. We sought to characterize practice patterns and outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with MI complicated by CS. METHODS:Patients hospitalized for MI with CS between 2002 and 2014 were identified from the United States National Inpatient Sample. Trends in management were evaluated over time. Propensity score matching was performed to identify cohorts with similar baseline characteristics and MI presentations who underwent PCI and CABG. The primary outcome was in-hospital all-cause mortality. RESULTS:A total of 386,811 hospitalizations for MI with CS were identified; 67% were STEMI. Overall, 62.4% of patients underwent revascularization, with PCI in 44.9%, CABG in 14.1%, and a hybrid approach in 3.4%. Coronary revascularization for MI and CS increased over time, from 51.5% in 2002 to 67.4% in 2014 (P for trend < .001). Patients who underwent CABG were more likely to have diabetes mellitus (35.5% vs. 29.2%, P < .001) and less likely to present with STEMI (48.7% vs. 80.9%, P < .001) than those who underwent PCI. CABG (without PCI) was associated with lower mortality than PCI (without CABG) overall (18.9% vs. 29.0%, P < .001) and in a propensity-matched subgroup of 19,882 patients (19.0% vs. 27.0%, P < .001). CONCLUSIONS:CABG was associated with lower in-hospital mortality than PCI among patients with MI complicated by CS. Due to the likelihood of residual confounding, a randomized trial of PCI versus CABG in patients with MI, CS, and multi-vessel coronary disease is warranted.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Smilowitz NR,Alviar CL,Katz SD,Hochman JSdoi
10.1016/j.ahj.2020.01.020subject
Has Abstractpub_date
2020-08-01 00:00:00pages
255-263eissn
0002-8703issn
1097-6744pii
S0002-8703(20)30080-6journal_volume
226pub_type
杂志文章abstract::To better characterize the cardiac structural and functional changes that are associated with aging, Doppler-echocardiography was performed on 23 young (mean age, 25 years) and 30 old (mean age, 70 years) healthy normotensive subjects. Left ventricular cavity dimensions and wall thickness were determined and left vent...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90201-r
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Beta-endorphin has been reported to play a role in the mechanism of silent myocardial ischemia. OBJECTIVES:Plasma beta-endorphin levels during coronary angioplasty-induced silent and symptomatic myocardial ischemia were compared with those during exercise-induced silent ischemia. METHODS AND RESULTS:The st...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70039-0
更新日期:1998-05-01 00:00:00
abstract::Symptoms of myocardial ischemia, such as chest pain (sometimes with anginal features), acute myocardial infarction, and segmental wall motion abnormalities (including left ventricular apical aneurysm), frequently occur in patients with Chagas' heart disease. Because these clinical findings occur in the presence of nor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90122-1
更新日期:1995-05-01 00:00:00
abstract::To test the hypothesis that elevated plasma levels of natriuretic peptides may serve to identify patients with left ventricular (LV) dysfunction, we assessed the predictive diagnostic value of natriuretic peptide levels, in addition to clinical and electro-cardiographic risk factors, as noninvasive indicators of cardi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70079-6
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Coronary artery disease in women appears 10 to 15 years later than in men. To test the hypothesis that the effects of estrogen may manifest themselves as histologic differences in coronary plaques, we examined the hearts of premenopausal and postmenopausal women who died suddenly from coronary artery disease...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.109946
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Elevated cardiac troponin T is a well-documented marker of cardiomyocyte damage and poor prognosis in patients with heart failure. We prospectively evaluated the relationship between this marker and hematopoietic disturbances in heart failure. METHODS:Data were analyzed from 254 patients in the UNITE-HF Bio...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.07.033
更新日期:2010-12-01 00:00:00
abstract::Left circumflex coronary blood flow was increased significantly (20 per cent) during stimulation of somatic afferent fibers. The change in CBF was associated with significant increases in heart rate and arterial pressure and significant decrease in coronary vascular resistance. Controlling heart rate or preventing car...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90318-1
更新日期:1979-07-01 00:00:00
abstract::Sudden cardiac death syndrome remains a major health problem responsible for approximately 400,000 deaths annually in the US. Effective therapies exist but are costly and are associated with potential complications. Currently used strategies for selection of the best candidates for implantable cardioverter defibrillat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2007.01.024
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Vascular wall shear stress (WSS) has been implied in the pathogenesis of atherosclerosis and vascular remodeling. Our aim was to calculate WSS after balloon angioplasty and evaluate its predictive value for long-term outcome. METHODS:WSS was calculated proximal to, in, and distal to the lesion after angiogr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.123110
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess whether pharmacologic preconditioning by exogenous or endogenous adenosine prevents the deterioration of hemodynamic function and left ventricular performance during percutaneous transluminal coronary angioplasty (PTCA). Ischemic preconditioning renders the heart more ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2000.110287
更新日期:2000-11-01 00:00:00
abstract::The objectives of this study were to assess current practice patterns in pharmacotherapy for congestive heart failure at an academic medical center and to analyze temporal trends in management of congestive heart failure from 1990 to 1995. Records of all patients discharged from the hospital in 1990 or 1995 with a pri...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70309-6
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Bleeding is associated with adverse outcome in acute coronary syndromes. However, the precise pathophysiologic mechanisms have not been elucidated. We sought to determine the relationship between bleeding and myocardial ischemia detected by concurrent continuous electrocardiogram (ECG) monitoring and their i...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.05.022
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. METHODS:In this open-label, m...
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.2019.06.010
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The speed of reperfusion (door-to-balloon [D2B] time) is a well established performance metric for patients with ST-elevation myocardial infarction. Although preferably D2B times should be journal_title:American heart journal pub_type: 杂志文章 doi:10.1016/j.ahj.2008.01.010 更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Noninvasive estimation of pulmonary capillary wedge pressure (PCWP) with Doppler-derived mitral inflow pattern has been shown to correlate well with invasively measured PCWP; however, it has not yet been determined whether Doppler-derived mitral inflow pattern can be used to estimate PCWP accurately in heart...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70280-7
更新日期:1998-04-01 00:00:00
abstract::The single-dose pharmacokinetics of amiodarone have been studied in volunteer subjects given 400 mg doses by the intravenous and oral routes. The data show the compound to have a very large volume of distribution, a low total clearance, and a long and variable terminal elimination half-life. In patients the terminal e...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90006-6
更新日期:1983-10-01 00:00:00
abstract::Clinical and electrophysiologic characteristics associated with spontaneous and inducible atrial fibrillation and ventricular tachyarrhythmia were assessed in 20 consecutive patients with Wolff-Parkinson-White (WPW) syndrome undergoing surgical division (n = 12) or transcatheter electrical ablation (n = 8) of accessor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90342-x
更新日期:1986-12-01 00:00:00
abstract::Nearly 800,000 of the 1 million patients hospitalized with acute heart failure (AHF) every year are initially treated by emergency physicians. Signs and symptoms are typically most severe at initial presentation, but with timely diagnostic and therapeutic management, rapid improvement can be achieved. As a direct resu...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2013.03.009
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Standard gray-scale imaging (GSI), three-dimensional (3D) echocardiography has been shown to be superior to two-dimensional echocardiography in measuring left ventricular volume. However, the often relatively poor quality of transthoracic gray-scale data can limit the potential application of this technique....
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70061-4
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The long-term prognostic significance of elevated cardiac markers in an undifferentiated patient population with chest pain is unknown. METHODS:Serum troponin I (cTnI), creatine kinase-MB (CK-MB), and myoglobin were measured at presentation in 951 consecutive patients evaluated in the emergency department f...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.06.020
更新日期:2008-11-01 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:Protocols incorporating high-sensitivity troponin to guide decision making in the disposition of patients with suspected acute coronary syndromes (ACS) in the emergency department have received a lot of attention. Traditionally, patients with chest pain have required long periods of observation in emergency ...
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.2017.05.004
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Carcinoid syndrome may involve right carcinoid heart disease (CHD), secondary to the release of vasoactive substances. Left CHD is rare, as the inactivation of serotonin by the lung protects the left heart. We attempted to evaluate the prevalence of CHD and patent foramen ovale (PFO) with seria...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.02.019
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The purpose of this investigation was to quantify the amount of intralesional calcium detected by intravascular ultrasound (IVUS) compared with undecalcified histology in human arteries. This method preserves intralesional calcium and reduces sectioning artifacts, thereby providing an accurate measure of cal...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70496-5
更新日期:1999-03-01 00:00:00
abstract::Adenosine thallium stress testing has a demonstrated utility in the detection of coronary artery disease. The optimal dose for diagnostic efficacy with minimal side effects has not been critically evaluated. A randomized 3- and 6-minute infusion of adenosine (140 micrograms/kg/min) was performed in 11 subjects. Subjec...
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(07)80015-9
更新日期:1993-07-01 00:00:00
abstract::Atrial depressurization time measurement by Doppler ultrasound can be used to quantify stenotic mitral valve area. In this report, we present the results of a blinded trial comparing the standard Doppler method for "pressure half-time" (A) and another Doppler method we devised (B) for measurement of atrial depressuriz...
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(87)90045-7
更新日期:1987-04-01 00:00:00
abstract::The effect of participation in cardiac rehabilitation on medical costs was determined by measuring hospitalization charges for cardiac admissions over a 3-year period in 580 post-coronary event patients (58% after coronary bypass surgery, 42% after myocardial infarction), of whom 230 entered a cardiac rehabilitation p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90696-s
更新日期:1992-04-01 00:00:00
abstract::It is often difficult to make the clinical distinction between acute mitral regurgitation caused by papillary muscle dysfunction or rupture and ventricular septal defect complicating an acute myocardial infarction. A case of a patient with rapidly progressive congestive heart failure and a loud murmur is presented. Ec...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(79)90291-6
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND:Long-term treatment with beta-blockers reduces mortality after acute myocardial infarction (AMI). Whether beta-blockers exert a class effect is unknown. METHODS:We analyzed mortality after AMI in Canadian patients 65 years or older who were discharged from hospital with a diagnosis of AMI from April 1996 to...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.11.008
更新日期:2007-02-01 00:00:00
abstract::High blood pressure is the leading cause of preventable morbidity and mortality globally. Many patients remain on single-drug treatment with poor control, although guidelines recognize that most require combination therapy for blood pressure control. Our hypothesis is that a single-pill combination of 4 blood pressure...
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.2020.09.017
更新日期:2021-01-01 00:00:00