Abstract:
:Background The Institute of Medicine has called for actions to understand and target sex-related differences in care and outcomes for out-of-hospital cardiac arrest patients. We assessed changes in bystander and first-responder interventions and outcomes for males versus females after statewide efforts to improve cardiac arrest care. Methods and Results We identified out-of-hospital cardiac arrests from North Carolina (2010-2014) through the CARES (Cardiac Arrest Registry to Enhance Survival) registry. Outcomes for men versus women were examined through multivariable logistic regression analyses adjusted for (1) nonmodifiable factors (age, witnessed status, and initial heart rhythm) and (2) nonmodifiable plus modifiable factors (bystander cardiopulmonary resuscitation and defibrillation before emergency medical services), including interactions between sex and time (ie, year and year2). Of 8100 patients, 38.1% were women. From 2010 to 2014, there was an increase in bystander cardiopulmonary resuscitation (men, 40.5%-50.6%; women, 35.3%-51.8%; P for each <0.0001) and in the combination of bystander cardiopulmonary resuscitation and first-responder defibrillation (men, 15.8%-23.0%, P=0.007; women, 8.5%-23.7%, P=0.004). From 2010 to 2014, the unadjusted predicted probability of favorable neurologic outcome was higher and increased more for men (men, from 6.5% [95% confidence interval (CI), 5.1-8.0] to 9.7% [95% CI, 8.1-11.3]; women, from 6.3% [95% CI, 4.4-8.3] to 7.4% [95% CI, 5.5-9.3%]); while adjusted for nonmodifiable factors, it was slightly higher but with a nonsignificant increase for women (from 9.2% [95% CI, 6.8-11.8] to 10.2% [95% CI, 8.0-12.5]; men, from 5.8% [95% CI, 4.6-7.0] to 8.4% [95% CI, 7.1-9.7]). Adding bystander cardiopulmonary resuscitation and defibrillation before EMS (modifiable factors) did not substantially change the results. Conclusions Bystander and first-responder interventions increased for men and women, but outcomes improved significantly only for men. Additional strategies may be necessary to improve survival among female cardiac arrest patients.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Malta Hansen C,Kragholm K,Dupre ME,Pearson DA,Tyson C,Monk L,Rea TD,Starks MA,Nelson D,Jollis JG,McNally B,Corbett CM,Granger CBdoi
10.1161/JAHA.118.009873subject
Has Abstractpub_date
2018-09-18 00:00:00pages
e009873issue
18issn
2047-9980journal_volume
7pub_type
杂志文章,多中心研究abstract::Background We aim to generate a line of "universal donor" human induced pluripotent stem cells (hi PSC s) that are nonimmunogenic and, therefore, can be used to derive cell products suitable for allogeneic transplantation. Methods and Results hi PSC s carrying knockout mutations for 2 key components (β2 microglobulin ...
journal_title:Journal of the American Heart Association
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doi:10.1161/JAHA.118.010239
更新日期:2018-12-04 00:00:00
abstract:BACKGROUND:Increasing evidence has suggested that major depression (MD) is associated with an increased risk of ischemic heart disease (IHD). We examined this association in Chinese adults using data from the China Kadoorie Biobank study. METHODS AND RESULTS:Over 0.5 million adults aged 30 to 79 years were followed fr...
journal_title:Journal of the American Heart Association
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doi:10.1161/JAHA.116.004687
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abstract::Background Some, but not all, studies report associations between shift work and hypertension, suggesting that particular subgroups may be at risk. We examined moderating effects of sleep duration and circadian preference on the relationship between shift work and new blood pressure (BP) medicine use at follow-up. Met...
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doi:10.1161/JAHA.119.013269
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abstract::Background Hypertrophic cardiomyopathy is caused by pathogenic sarcomere gene variants. Individuals with a thin-filament variant present with milder hypertrophy than carriers of thick-filament variants, although prognosis is poorer. Herein, we defined if decreased energetic status of the heart is an early pathomechani...
journal_title:Journal of the American Heart Association
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abstract::Background To assess differences in platelet inhibition during ticagrelor monotherapy (TIC) or dual therapy with ticagrelor and aspirin (TIC+ASP) in patients after percutaneous coronary intervention using a comprehensive panel of functional tests. Methods and Results In a single-center parallel group, open label, rand...
journal_title:Journal of the American Heart Association
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doi:10.1161/JAHA.120.016495
更新日期:2020-12-15 00:00:00
abstract:BACKGROUND:The 4-variable risk score from University of California, Los Angeles (UCLA) demonstrated superior discrimination in advanced heart failure, compared to established risk scores. However, the model has not been externally validated, and its suitability as a selection tool for heart transplantation (HT) and lef...
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abstract::BACKGROUND The development of congenital heart disease (CHD) is multifactorial with genetic and environmental influences. We sought to determine the relationship between socioeconomic and environmental factors with the incidence of CHD among live-born infants in California and to determine whether maternal comorbiditi...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.015255
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abstract::Background The "no-reflow phenomenon" compromises percutaneous coronary intervention outcomes. There is an unmet need for a device that prevents no-reflow phenomenon. Our goal was to develop a guidewire platform comprising a nondisruptive hydrophilic coating that allows continuous delivery of adenosine throughout a pe...
journal_title:Journal of the American Heart Association
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更新日期:2019-05-21 00:00:00
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journal_title:Journal of the American Heart Association
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abstract::Background Previous studies have reported an association between the timing of menarche and cardiovascular disease ( CVD ). However, emerging studies have not examined the timing of menarche in relation to role of estrogen over a lifetime and major adverse cardiac events ( MACE ). Methods and Results A total of 648 wo...
journal_title:Journal of the American Heart Association
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doi:10.1161/JAHA.119.012406
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pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.012008
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journal_title:Journal of the American Heart Association
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abstract::Background Recent evidence suggests that racial/ethnic differences in circulating levels of free or bioavailable 25-hydroxy vitamin D (25[ OH ]D) rather than total 25( OH )D may explain apparent racial disparities in cardiovascular disease ( CVD ). We prospectively examined black-white differences in the associations ...
journal_title:Journal of the American Heart Association
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更新日期:2019-02-19 00:00:00
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