Abstract:
BACKGROUND:Previous studies have documented the strong association between availability of on-site cardiac catheterization facilities and increased use of coronary angiography in patients with acute myocardial infarction (AMI). Although these studies have shown little influence of the availability of catheterization labs on hospital mortality, no long-term follow-up has been reported. METHODS AND RESULTS:From a cohort of 12,331 AMI patients admitted to 19 Seattle area hospitals, we compared long-term outcome in 7985 patients admitted to hospitals with and 4346 patients admitted to hospitals without on-site catheterization labs. During the index hospitalization, patients admitted to hospitals with on-site catheterization were more likely to undergo coronary angiography (67.1% versus 39.3%, P<.0001), coronary angioplasty (32.5% versus 13.2%, P<.0001), or coronary bypass surgery (12.5% versus 9.5%, P<.0001). At 3-year follow-up, patients admitted to hospitals with on-site catheterization labs were more likely to undergo postdischarge angiography (19.2% versus 15.2%, P=.0001) and coronary angioplasty (11.6% versus 8.2%, P<.0001). This was associated with approximately $2500.00 per patient in higher cumulative costs. Despite this higher rate of procedure use, there was no association between admission to a hospital with on-site catheterization facilities and lower long-term mortality (multivariate hazard ratio, 1.0; 95% CI, 0.93 to 1.1., the hazard being associated with admission to hospitals with on-site catheterization facilities). CONCLUSIONS:In an urban area with unconstrained patient transfer mechanisms and high overall cardiac procedure use rates, AMI patients admitted to hospitals without on-site catheterization facilities were managed with fewer procedures during hospitalization and follow-up. This more conservative treatment approach was not associated with any observed increase in long-term mortality.
journal_name
Circulationjournal_title
Circulationauthors
Every NR,Parsons LS,Fihn SD,Larson EB,Maynard C,Hallstrom AP,Martin JS,Weaver WDdoi
10.1161/01.cir.96.6.1770subject
Has Abstractpub_date
1997-09-16 00:00:00pages
1770-5issue
6eissn
0009-7322issn
1524-4539journal_volume
96pub_type
杂志文章相关文献
CIRCULATION文献大全abstract::To define the mechanisms of unexpected cardiac arrest in advanced heart failure, we reviewed the causes of cardiac arrest as established from electrocardiographic monitoring and from clinical and autopsy data in patients hospitalized for cardiac transplantation evaluation and management of advanced heart failure (mean...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.80.6.1675
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Systemic administration of heparin can decrease mortality and morbidity of acute ischemic coronary syndromes such as unstable angina and myocardial infarction. Hemorrhage is the major limiting factor in the clinical use of systemic heparin. The objective of the present study was to determine whether local de...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.7.1697
更新日期:1995-10-01 00:00:00
abstract::Trapidil (triazolopyrimidine) possesses activity against platelet-derived growth factor-induced cellular proliferation in vitro and intimal proliferation in vivo. The objective of this study was to determine if trapidil could prevent restenosis in experimentally induced atherosclerotic rabbits. New Zealand White rabbi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.81.3.1089
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Previous studies have reported an association between chronic Helicobacter pylori infection and ischemic heart disease. However, it is not clear whether this association is really due to the virulence of the bacterium or is merely the result of confounding factors (in particular, age and social class). METH...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.17.1675
更新日期:1998-05-05 00:00:00
abstract:BACKGROUND:We postulated that the hypoxic response in sickle cell disease (SCD) contributes to altered gene expression and pulmonary hypertension, a complication associated with early mortality. METHODS AND RESULTS:To identify genes regulated by the hypoxic response and not other effects of chronic anemia, we compared...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.005296
更新日期:2014-04-22 00:00:00
abstract:BACKGROUND:Together with pulmonary veins, many extrapulmonary vein areas may be the source of initiation and maintenance of atrial fibrillation. The left atrial appendage (LAA) is an underestimated site of initiation of atrial fibrillation. Here, we report the prevalence of triggers from the LAA and the best strategy f...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.109.928903
更新日期:2010-07-13 00:00:00
abstract::The anatomy of 58 specimens of aortic outflow tract atresia was studied. All cases had situs solitus and levocardia, 37 had atrioventricular (AV) concordance, two had common inlet to a right ventricle and 19 had mitral atresia. The great arteries were normally interrelated in all cases. Fifty-one cases had an intact v...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.59.1.173
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Sympathetic activation and respiratory abnormalities may each be implicated in the pathophysiology of congestive heart failure (CHF). Chemoreflexes are an important mechanism regulating both sympathetic drive and breathing. We therefore tested the hypothesis that chemoreflex function is altered in CHF. METH...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.100.3.262
更新日期:1999-07-20 00:00:00
abstract:BACKGROUND:Current knowledge of prevalence, incidence, and survival in thoracic aortic diseases (aneurysm and dissection) is based on small studies from a dated era of treatment and diagnostic procedures. The objective of the present study was to reappraise epidemiology and long-term outcomes in subjects with thoracic ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.630400
更新日期:2006-12-12 00:00:00
abstract:BACKGROUND:The cellular content of cAMP generated by activation of adenylylcyclase (AC) through the beta-adrenergic receptor (betaAR) is a key determinant of a cell's response to catecholamine stimulation. We tested the hypothesis that increased AC content, independently of betaAR number, increases responsiveness to ca...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.12.1618
更新日期:1999-03-30 00:00:00
abstract::Of 22 children with congenital complete heart block (CCHB) available for study, 14 (63.6%) were born to 11 mothers with clinical or laboratory evidence of connective tissue disease, primarily lupus erythematosus (LE). Seven mothers had both clinical and laboratory evidence of disease while four had only positive labor...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.56.1.82
更新日期:1977-07-01 00:00:00
abstract::The healthcare system is undergoing a transition from paying for volume to paying for value. Clinicians, as well as public and private payers, are beginning to implement alternative delivery and payment models, such as the patient-centered medical home, accountable care organizations, and bundled payment arrangements....
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/CIR.0000000000000516
更新日期:2017-08-15 00:00:00
abstract::One hundred eighteen consecutive patients undergoing valve replacement for aortic stenosis were analyzed to determine the incidence of and predisposing factors to postoperative atrial tachyarrhythmias. Univariate and multivariate analyses were performed on 70 clinical, hemodynamic, radiographic, electrocardiographic, ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Coronary artery bypass surgery (CABG) has been associated with a range of neurological and neuropsychological complications from stroke to cognitive problems such as memory and problem solving disturbance. However, little is known about the impact of percutaneous coronary intervention (PCI) on neuropsycholog...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.CIR.0000148366.80443.2B
更新日期:2004-11-30 00:00:00
abstract:BACKGROUND:Up to 50% of patients fail to meet ST-segment-elevation myocardial infarction (STEMI) guideline goals recommending a first medical contact-to-device time of <90 minutes for patients directly presenting to percutaneous coronary intervention-capable hospitals and <120 minutes for transferred patients. We sough...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.115.019474
更新日期:2016-08-02 00:00:00
abstract:BACKGROUND:Thioredoxin 2 (Trx2) is a key mitochondrial protein that regulates cellular redox and survival by suppressing mitochondrial reactive oxygen species generation and by inhibiting apoptosis stress kinase-1 (ASK1)-dependent apoptotic signaling. To date, the role of the mitochondrial Trx2 system in heart failure ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.114.012725
更新日期:2015-03-24 00:00:00
abstract:BACKGROUND:The outcome of patients with corrected transposition of the great arteries (CTGA) is variably affected by associated intracardiac defects, tricuspid valve competence, and systemic right ventricular (RV) function. The relative importance of these factors in long-term outcome has not been evaluated. METHODS A...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.10.997
更新日期:1998-09-08 00:00:00
abstract::Postoperative angiographic studies were carried out at 1 month, 1 year, and 10 years in two groups of patients: 238 patients with saphenous vein (SV) grafts and 40 patients with internal mammary artery (IMA) grafts. Cumulative patency was better in IMA grafts, both at 1 year (88.5% vs 76.4%) and at 10 years (84.1% vs ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Epinephrine has been the mainstay for cardiac resuscitation for more than 30 years. Its vasopressor effect by which it increases coronary perfusion pressure is likely to favor initial resuscitation. Its beta-adrenergic action, however, may have detrimental effects on postresuscitation myocardial function whe...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.10.3089
更新日期:1995-11-15 00:00:00
abstract:BACKGROUND:Serum bilirubin is an endogenous antioxidant that is routinely measured before a statin is prescribed primarily to assess liver function, but the association with cardiovascular disease (CVD) in this population has not been explored. METHOD AND RESULTS:We identified patients from a United Kingdom primary ca...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.112.114066
更新日期:2012-11-27 00:00:00
abstract:BACKGROUND:Alterations in the balance of matrix metalloproteinases (MMPs) and their specific tissue inhibitors (TIMPs) are involved in left ventricular (LV) remodeling. Whether their expression is related to interstitial fibrosis or LV dysfunction in patients with chronic pressure overload-induced LV hypertrophy, howev...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.516963
更新日期:2005-08-23 00:00:00
abstract::Carotid artery stenting, compared with carotid endarterectomy, is emerging as an effective and less invasive method of revascularization for extracranial carotid artery stenosis. Carotid stenting is established as the treatment of choice for certain high-risk patient subsets, and ongoing clinical trials are evaluating...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.595512
更新日期:2006-04-25 00:00:00
abstract:BACKGROUND:During heart development, the ventricular activation sequence changes from a base-to-apex to an apex-to-base pattern. We investigated the possibility of impulse propagation through remnants of atrioventricular (AV) connections in quail hearts. METHODS AND RESULTS:In 86 hearts (group A, HH30-34, n=15; group ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.658807
更新日期:2007-01-02 00:00:00
abstract:BACKGROUND:This study was performed to determine whether chronic cocaine abuse is associated with left ventricular hypertrophy in humans. METHODS AND RESULTS:A consecutive series of 40 chronic cocaine abusers 23-44 years old who were enrolled in an inpatient drug rehabilitation program were considered for the study. S...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.3.1130
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:In the patient with mitral regurgitation who is being considered for valvular surgery, cardiac catheterization is usually performed to quantify the severity of regurgitation and to determine its influence on left ventricular volumes and systolic function. Magnetic resonance imaging (MRI) potentially provides...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.5.1151
更新日期:1995-09-01 00:00:00
abstract::A patient who had disabling supraventricular tachycardia showed electrophysiologic evidence of coexistent right and left Kent bundles. The supraventricular tachycardia was accelerated by sequential antegrade and retrograde conduction over the right and left Kent bundles, respectively. Spontaneous blocking of the condu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.62.3.657
更新日期:1980-09-01 00:00:00
abstract:BACKGROUND:Dynamic intraventricular flow velocities after valve replacement for aortic stenosis have been associated with high in-hospital morbidity and mortality. The aims of the present study were to determine the mechanisms and preoperative predictors of abnormal flow velocity (AFV) after valve replacement for aorti...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.93.4.712
更新日期:1996-02-15 00:00:00
abstract:BACKGROUND:There is an inverse relationship between HDL cholesterol and coronary heart disease. Experimental studies have indicated that HDL cholesterol may exert an antiatherogenic effect by inducing regression of atherosclerotic plaques and by turning lipid-rich plaques into more fibrotic lesions. In this prospective...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.522706
更新日期:2005-07-26 00:00:00
abstract:BACKGROUND:Doxycycline has been shown to effectively inhibit aneurysm formation in animal models of abdominal aortic aneurysm. Although this effect is ascribed to matrix metalloproteinase-9 inhibition, such an effect is unclear in human studies. We reevaluated the effect of doxycycline on aortic wall protease content i...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.108.806505
更新日期:2009-04-28 00:00:00
abstract:BACKGROUND:Obesity is a risk factor for impaired cardiac performance, particularly in women. Animal studies suggest that alterations in myocardial fatty acid metabolism and efficiency in obesity can cause decreased cardiac performance. In the present study, we tested the hypothesis that myocardial fatty acid metabolism...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000127959.28627.F8
更新日期:2004-05-11 00:00:00