Abstract:
BACKGROUND:There is growing interest in assessing therapy for acute myocardial infarction. Because thrombolysis was not a study therapy in the GISSI-3 trial, the decision about thrombolysis was left to the responsible physicians. We evaluated the data on thrombolytic therapy among patients with acute myocardial infarction enrolled in the GISSI-3 trial to study the relation between rate of prescription and the characteristics of patients and participating coronary care units. METHODS:Complete clinical data were available for 17,944 patients randomized between June 1991 and July 1993 from 200 coronary care units in Italy. Demographic and clinical information were obtained for each patient, and each coronary care unit was classified according to patient volume, level of technology, and wide geographic area in which it was located. A multivariate logistic regression was performed with administration of thrombolytic therapy as the dependent variable and previously defined clinical and structural variables as independent variables. RESULTS:The most important factor in administration of thrombolytic therapy was that less than 6 hours elapse from symptom onset to hospital admission (odds ratio [OR] 14.05; 95% confidence interval [CI] 12.3 to 16.0). Next were location of coronary care unit in southern Italy (OR 1.81; 95% CI 1.62 to 2.01), presence of ST elevation at entrance electrocardiogram ECG (OR 1.47; 95% CI 1.35 to 1.61), absence of previous myocardial infarction (OR 1.35; 95% CI 1.22 to 1.49), and presence of catheterization laboratory or cardiac surgery program or both in the same hospital (OR 1.24; 95% CI 1.14 to 1.35). Coronary care units with high or low patient volume did not show different rates of administration of thrombolytic agents. CONCLUSIONS:The GISSI-3 experience confirmed a high rate of prescription of thrombolytic therapy to patients admitted within 6 hours of symptom onset and those with ST-segment elevation on entrance electrocardiogram. It demonstrated that patients admitted to coronary care units with catheterization laboratories or cardiac programs or both have higher chances of receiving thrombolytic treatment than those admitted to hospitals without these capabilities.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Bobbio M,Bergerone S,Maggioni AP,Malacrida R,Franzosi MG,Barlera S,Tognoni G,GISSI-3 Investigators.doi
10.1016/s0002-8703(98)70320-5subject
Has Abstractpub_date
1998-03-01 00:00:00pages
443-8issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(98)70320-5journal_volume
135pub_type
杂志文章abstract:OBJECTIVES:To characterize patient profile and hemodynamic profile of those undergoing intra-aortic balloon pump (IABP) for cardiogenic shock and define predictors of hemodynamic failure of IABP support. BACKGROUND:Clinical characteristics of IABP support in cardiogenic shock not related to acute myocardial infarction...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.11.016
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Transcatheter foramen ovale closure (TPC) has emerged as a potential treatment option for patients with cryptogenic strokes and persistent foramen ovale (PFO). However, previous randomized controlled trials could hardly demonstrate any benefit compared to medical treatment (Med-Tx). Recently new data have be...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2018.03.025
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The long-term effects of smoking and smoking cessation on markers of cardiovascular disease (CVD) prognosis obtained during treadmill stress testing (TST) are unknown. The purpose of this study was to evaluate the long-term effects of smoking cessation and continued smoking on TST parameters that predict CVD...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.06.023
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Dobutamine and exercise echocardiography are accepted as tests of comparable efficacy for the diagnosis of coronary artery disease. Although dobutamine has been classified as "exercise simulating," the mechanisms of ischemia with dobutamine and exercise have not been well studied. This study sought to compar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70183-8
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Biolimus-eluting stents (BESs) with a biodegradable polymer in abluminal coating achieve more complete coverage at 9 months compared with sirolimus-eluting stents (SESs) with a durable polymer, as assessed by optical coherence tomography (OCT). Whether this advantage persists or augments after complete resor...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.09.005
更新日期:2011-11-01 00:00:00
abstract::This study prospectively assessed the electrophysiologic effects of parenteral magnesium sulfate administration on paroxysmal atrioventricular (AV) reentrant supraventricular tachycardia and the efficacy of magnesium to terminate these arrhythmias. Eleven normomagnesemic patients, seven with orthodromic reentrant supr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80021-3
更新日期:1990-02-01 00:00:00
abstract::The results of percutaneous transseptal balloon mitral valvuloplasty (PTBMV) in 30 Chinese patients with rheumatic mitral stenosis are reported. PTBMV with the Inoue balloon catheter was successfully performed in 27 patients without any significant complications. The mean left atrial pressure decreased from 20.15 +/- ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90061-0
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Although recent data support an early invasive management in acute coronary syndromes (ACS), overall evidence appears conflicting. We performed a metaregression to explore the impact of intracoronary stenting and aggressive antiplatelet treatment on the risk/benefit ratio of an early invasive approach. METH...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2004.10.026
更新日期:2005-03-01 00:00:00
abstract::The MAPHY Study was conducted to investigate whether metoprolol, a relatively beta 1-selective beta-blocker, given as initial antihypertensive treatment, would lower cardiovascular complications of high blood pressure to a greater extent than do thiazide diuretics as initial treatment at similar blood pressure control...
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(88)90112-3
更新日期:1988-07-01 00:00:00
abstract::The prognostic significance of changes in the mode of induction of ventricular tachycardia (VT) noted during therapy was studied in 49 patients with sustained VT or ventricular fibrillation. Before treatment, all patients had inducible sustained VT by programmed stimulation (one to three extrastimuli) and frequent (gr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90189-x
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Today most patients with congenital heart disease survive childhood to be cared for by adult cardiologists. The number of physicians that should be trained to manage these lesions is unknown because we do not know the number of patients. METHODS:To answer this question, the expected numbers of infants with ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.05.003
更新日期:2004-03-01 00:00:00
abstract::Percutaneous transluminal coronary angioplasty (PTCA) was performed in 110 consecutive patients (111 vessels) with chronically occluded coronary arteries and was successful in 69 patients (69 vessels). Successful initial PTCA was related to the extent of coronary artery disease, the morphology of the proximal surface ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90503-7
更新日期:1994-01-01 00:00:00
abstract::The hearts from 10 necropsy patients with Ebstein's anomaly of the tricuspid valve were examined for abnormalities of the mitral valve. Five patients were under 1 year of age and none had an abnormal mitral valve. The other five patients were ages 18 to 72 years (mean 36 years); all had focal fibrous thickening of the...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90663-3
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Under the hypothesis that the G-308A polymorphism in the promoter region of the tumor necrosis factor alpha gene might increase tumor necrosis factor alpha expression, several investigations have been performed to examine the influence of the -308A allele on the risk of cardiovascular events. The results of ...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2007.02.031
更新日期:2007-05-01 00:00:00
abstract::Tolerance to prolonged nitroglycerin (NTG) may be due to drug-induced intravascular expansion. To test the hypothesis that concomitant diuretics may reduce volume expansions and thus prevent NTG tolerance, we studied 23 healthy volunteers randomized to hydrochlorthiazide or placebo before and during 74-hour continuous...
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(95)90361-5
更新日期:1995-09-01 00:00:00
abstract::M-mode echocardiographic records of 26 patients with surgically proven complete atrioventricular canal defect were reviewed. Fragmentation of the interventricular septum and anterior displacement of the mitral annulus into the left ventricular outflow tract were noted in all patients. In 25 of 26 a common atrioventric...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90228-3
更新日期:1981-05-01 00:00:00
abstract::This article reviews the evidence that congestive heart failure is accompanied by an increased plasma norepinephrine concentration and that this is due not only to a reduced tissue clearance of the substance but also to a marked increase in sympathetic nerve activity. It also reports data that indicate that the sympat...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(90)90054-2
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Several studies have shown that patency of the epicardial vessel does not guarantee optimal myocardial perfusion in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI). The aim of the current study was to identify clinical and angiographic correlates of unsuccessful...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.10.044
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Previous works have suggested an association between Chlamydia pneumoniae infection and coronary heart disease. We evaluated the prevalence of C. pneumoniae infection in patients with acute myocardial infarction (AMI) and coronary heart disease (CHD). METHODS AND RESULTS:Ninety-eight patients with AMI, 80 p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70371-6
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Automated implantable cardioverter-defibrillators (ICDs) have become standard therapy for patients at high risk for sudden cardiac death. Linked data allow examination of trends in use and long-term survival after ICD implantation in an adult population. METHODS:Linked state-wide person-based data on hospit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.02.007
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Data on left atrial/left atrial appendage (LA/LAA) thrombus resolution after non-vitamin K antagonist (VKA) oral anticoagulant treatment are scarce. The primary objective of X-TRA was to explore the use of rivaroxaban for the resolution of LA/LAA thrombi in patients with nonvalvular atrial fibrillation (AF) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.05.007
更新日期:2016-08-01 00:00:00
abstract::Asymptomatic atrial fibrillation (AF) is common and may have the same prognostic implications as symptomatic AF. Among patients receiving dual-chamber pacemakers, it is now possible to quantify asymptomatic AF accurately. Most of these episodes are of short duration, often lasting only seconds to minutes and are calle...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.02.016
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:The study aimed to analyze the use of intensive lipid-lowering therapy (I-LLT) at discharge in a broad population of patients hospitalized with acute coronary syndrome (ACS). BACKGROUND:Early and intensive statin therapy in ACS has been shown to reduce cardiovascular morbidity and mortality. Utilization and...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.12.014
更新日期:2011-02-01 00:00:00
abstract::To test the feasibility of synchronized retroperfusion (SRP) as a support device of percutaneous transluminal coronary angioplasty (PTCA) for high-risk patients, 10 patients with left main trunk or near left main trunk obstruction underwent PTCA with SRP. An 8.5F retroperfusion catheter was inserted from the antecubit...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90004-s
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:Research has shown that vaccination with Streptococcus pneumoniae reduced the extent of atherosclerosis in experimental animal models. It is thought that phosphorylcholine lipid antigens in the S. pneumoniae cell wall induce the production of antibodies that cross-react with oxidized low-density lipoprotein,...
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.2016.04.003
更新日期:2016-07-01 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::The effects of nadolol (N) and propranolol (P) were studied in atrial and ventricular tachyarrhythmias. Interpretation of the results should take into account the dependence of the arrhythmia on the sympathetic tone, and the drug effect on the sinus node frequency. The day/night ratio of the sinus rate is too sensitiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90589-1
更新日期:1984-10-01 00:00:00
abstract::Although Q wave and non-Q wave MI are often referred to as "transmural" and "nontransmural," there is no anatomic evidence to justify this distinction. Nevertheless, a distinction is important, because the two entities have a different prognosis. At the present time, between 25% and 35% of MIs are non-Q wave. They are...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(89)90629-7
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Dilated and hypertrophic cardiomyopathies are primary myocardial diseases that cause considerable morbidity and mortality. Although these cardiomyopathies are clinically heterogeneous, genetic factors play an important role in their etiology and pathogenesis. The defects in the cardiac actin (ACTC) gene can ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.122514
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Performing preoperative coronary angiography (CA) before surgical repair of a type A acute aortic dissection (TA-AAD) remains controversial. Although the information provided by CA may be useful in planning the surgical approach, the potential delay to surgery and complications of CA may confer added risk of...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.01.010
更新日期:2011-04-01 00:00:00