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Outpatient percutaneous coronary intervention

Wenhui Liu, Gary K Grunwald, P Michael Ho
Health care cost data often contain many zero values, for patients who did not use any care. Two-part models with logistic models for part I, probability of use (ie, nonzero cost) and log-link models for part II, mean cost of use (ie, nonzero cost) are often used. Effects of exposures or covariates on total (marginal) cost are often of interest, and recent work has proposed useful methods. Factors that affect total cost do so through a combination of effects on probability of use and cost of use. Such a decomposition is needed to understand and act on factors that affect total cost, but little work has been done on this question...
March 20, 2019: Statistics in Medicine
Elżbieta Gadula-Gacek, Mateusz Tajstra, Jacek Niedziela, Łukasz Pyka, Mariusz Gąsior
Electrical storm (ES) is a life-threatening condition with diverse clinical presentation, caused by recurrent malignant ventricular arrhythmia--≥3 episodes of ventricular tachycardia (VT) or ventricular fibrillation within 24hours and is associated with high mortality. The aim of this study was analysis of clinical profile, treatment, and prognosis of patients with ES admitted to a high-volume cardiovascular center. We present results of a single-center, retrospective, ongoing observational registry enrolling consecutive patients presenting with ES admitted between 2006 and 2017...
February 25, 2019: American Journal of Cardiology
Adriano Alatri, Lucia Mazzolai
Bleeding represents the most important complication of antithrombotic treatment, including anticoagulant and antiplatelet therapies. A number of scores were proposed to evaluate the risk of bleeding both for anticoagulant and antiplatelet treatment. In the last decade, 5 bleeding risk scores were published for use in atrial fibrillation patients, and 3 scores for patients receiving anticoagulants for venous thromboembolism therapy or prophylaxis. In addition, 3 scores were recently developed to assess in-hospital or short-term bleeding risk in patients receiving antiplatelet therapy after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI)...
February 11, 2019: Current Vascular Pharmacology
Zeev Israeli, Shahar Lavi, Samir B Pancholy, Luis Nombela-Franco, Ian C Gilchrist, Ian C Gilchrist, Andrés Aldazabal, Adi Sharabi-Nov, Yaniv Levi, Samual Hayman, Nikolaos Tzemos, Diana Ayán, Mamas A Mamas, Rodrigo Bagur
BACKGROUND: Coronary angiography and intervention to saphenous venous grafts (SVGs) remain challenging. This study aimed to investigate the feasibility and safety of the radial approach compared to femoral access in a large cohort of patients undergoing SVG angiography and intervention. METHODS: Data from 1,481 patients from Canada, United States, and Spain who underwent procedures between 2010 and 2016 were collected. Patients must have undergone SVG coronary angiography and/or intervention...
January 12, 2019: American Heart Journal
Ching-Wen Chien, Cheng-Hua Wang, Zi-Hao Chao, Song-Kong Huang, Pei-En Chen, Tao-Hsin Tung
To investigate relevant factors and patients with acute myocardial infarction (AMI) were admitted during between weekdays and weekends period.Retrospective population-based study setting: from the 2005 population-based national health insurance underwriting database of millions of people, random sampling (National Health Insurance Research Database [NHIRD]-Longitudinal Health Insurance Database [LHID] 2005).In 2000 to 2009 data of NHIRD, subjects presented with first episode AMI who had received the thrombolytic therapy (TPA), or percutaneous coronary artery intervention (PTCA) or coronary artery bypass graft (CABG) during between weekdays and weekends period...
January 2019: Medicine (Baltimore)
Devraj Sukul, Milan Seth, James M Dupree, John D Syrjamaki, Andrew M Ryan, Brahmajee K Nallamothu, Hitinder S Gurm
BACKGROUND: Percutaneous coronary intervention (PCI) is a common and expensive procedure that has become a target for bundled payment initiatives. We described the magnitude and determinants of variation in 90-day PCI episode payments across a diverse array of patients and hospitals. METHODS AND RESULTS: We linked clinical registry data from PCIs performed at 33 Michigan hospitals to 90-day episodes of care constructed using Medicare fee-for-service and commercial insurance claims from January 2012 to October 2016...
January 2019: Circulation. Cardiovascular Interventions
A M Abdelhalem, A M Shabana, A M Onsy, A E Gaafar
Background: Exercise-based Cardiac rehabilitation (CR) plays a major role in reducing mortality and morbidity in patients with coronary artery disease (CAD). The standard protocol is usually of moderate intensity exercise. High-intensity interval training (HIIT) consists of alternating periods of intensive aerobic exercise with periods of passive or active moderate/mild intensity recovery. Aim: This study aimed to assess HIIT program for ischemic patients attending CR after percutaneous coronary intervention (PCI) who have mild left ventricular dysfunction and to compare its effect on the functional capacity and quality of life with standard exercise CR program...
December 2018: Egyptian Heart Journal: EHJ
Kristen M Frechette, Sheila M Conley, Austin Tang, Terrence D Welch
PURPOSE: The cardiac rehabilitation (CR) program at Dartmouth-Hitchcock Medical Center (DHMC) devotes a nurse to the inpatient units in an attempt to optimize the referral process. This report defines the rates of referral and participation at DHMC and explores potential factors that affect participation. METHODS: Seven hundred ten consecutive patients who underwent percutaneous coronary intervention, coronary artery bypass grafting, or valve surgery from January 1, 2015 to June 30, 2015 were reviewed to determine whether the patient was referred for CR...
January 2019: Journal of Cardiopulmonary Rehabilitation and Prevention
Marc P Bonaca, Stephen D Wiviott, David A Morrow, P Gabriel Steg, Christian Hamm, Deepak L Bhatt, Robert F Storey, Marc Cohen, Julia Kuder, KyungAh Im, Giulia Magnani, Andrzej Budaj, José C Nicolau, Alexander Parkhomenko, José López-Sendón, Mikael Dellborg, Rafael Diaz, Frans Van de Werf, Ramón Corbalán, Assen Goudev, Eva C Jensen, Per Johanson, Eugene Braunwald, Marc S Sabatine
Background Ticagrelor reduced cardiovascular death, myocardial infarction (MI), or stroke in patients with prior MI in PEGASUS-TIMI 54 (Prevention of Cardiovascular Events [eg, Death From Heart or Vascular Disease, Heart Attack, or Stroke] in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin). MI can occur in diverse settings and with varying severity; therefore, understanding the types and sizes of MI events prevented is of clinical importance. Methods and Results MIs were adjudicated by a blinded clinical events committee and categorized by subtype and fold elevation of peak cardiac troponin over the upper limit of normal...
November 20, 2018: Journal of the American Heart Association
Rishi K Wadhera, Devraj Sukul, Eric A Secemsky, Changyu Shen, Hitinder S Gurm, William E Boden, Robert W Yeh
No abstract text is available yet for this article.
December 17, 2018: JAMA Internal Medicine
Alexis L Beatty, Jacob A Doll, David W Schopfer, Charles Maynard, Mary E Plomondon, Hui Shen, Mary A Whooley
Background Cardiac rehabilitation (CR) is strongly recommended after percutaneous coronary intervention (PCI), but it is underused. We sought to evaluate CR participation variation after PCI and its association with mortality among veterans. Methods and Results Patients undergoing PCI between 2007 and 2011 were identified in the Veterans Affairs Clinical Assessment, Reporting, and Tracking database and followed up until January 25, 2017. We excluded patients who died within 30 days of PCI and calculated the percentage participating in ≥1 outpatient CR visits within 12 months after PCI...
October 2, 2018: Journal of the American Heart Association
Lila M Martin, James L Januzzi, Ryan W Thompson, Timothy G Ferris, Jagmeet P Singh, Vijeta Bhambhani, Jason H Wasfy
Background Medicare's Hospital Readmissions Reduction Program assesses financial penalties to hospitals based on risk-standardized readmission rates after specific episodes of care, including acute myocardial infarction. Detailed information about the type of patients included in the penalty is unknown. Methods and Results Starting with administrative data from Medicare, we conducted physician-adjudicated chart reviews of all patients considered 30-day readmissions after acute myocardial infarction from July 2012 to June 2015...
August 21, 2018: Journal of the American Heart Association
Ghulam Abbas Shaikh, Ameema Asad, Syed Saadan Ahmed
Anomalies pertaining to the coronary vasculature are rare and generally asymptomatic, however, they can pose life-threatening risks in the form of sudden cardiac arrests or myocardial ischemia. We present a rare anomaly of a supradominant left circumflex artery (LCX) and a rudimentary left anterior descending artery (LAD). The patient presented in our outpatient department (OPD) with complaints of occasional chest pain and dyspnea on exertion. An exercise tolerance test (ETT) was carried out, which was inconclusive and an electrocardiogram (EKG) revealed a sinus rhythm with a nonspecific ST segment...
August 23, 2018: Curēus
Aleksandr Shek, Rano Alieva, Ravshanbek Kurbanov, Shavkat Hoshimov, Ulugbek Nizamov, Guzal Abdullaeva, Aleksandr Nagay
BACKGROUND AND AIMS: We aimed to assess the disease burden and to study the molecular genetic characteristics of heterozygous familial hypercholesterolemia (HeFH) patients within the Uzbek population to develop a program of early disease detection and effective treatment measures. METHODS: 201 patients were included in the study, of whom 57 with chronic stable coronary artery disease (SCAD) and HeFH, and 144 with SCAD without HeFH belonging to the control group, and divided into two subgroups: A, statin free before the study (n = 63) and B (n = 81), who took statin outpatiently...
October 2018: Atherosclerosis
Jiaying Fang, Bin Huang, Duanmin Xu, Jilin Li, William W Au
BACKGROUND: Medical care for the Chinese population has been focused on first-line activities, that is, therapy, but with little follow-up on treated patients. However, efficacy of therapy is highly dependent upon post-therapy recovery. For coronary heart disease (CHD), home-based cardiac telerehabilitation (HBCTR) is an alternative to hospital-based or center-based cardiac rehabilitation, and is an innovative approach to enhance recovery, but the approach is seldom used in China. Our preliminary survey in Shantou, China, indicated that most CHD patients showed a positive attitude toward the HBCTR technology...
September 7, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Kamran Zafar, Nirav Patil
The clinical characteristics and outcomes among patients with inpatient-onset non-ST-segment-elevation acute coronary syndrome have not been fully investigated. Therefore, we conducted a retrospective single-center analysis of patients who were ≥18 years old and diagnosed with acute coronary syndrome at our hospital during 2014. We performed logistic regression analysis to evaluate outcomes and made adjustments for age, race, family history of premature coronary artery disease, and comorbidities. Our search through 31,274 hospital discharge records identified 683 cases of acute coronary syndrome: 32 were inpatient-onset and 651 were outpatient-onset...
June 2018: Texas Heart Institute Journal
Kibum Kim, Todd A Lee, Daniel R Touchette, Robert J DiDomenico, Amer K Ardati, Surrey M Walton
BACKGROUND: In patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI), newer antiplatelet agents prasugrel and ticagrelor have lower rates of cardiovascular events when compared with clopidogrel. However, it is unclear whether there are differences in economic outcomes when comparing these agents in ACS-PCI patients. OBJECTIVE: To assess aggregated costs and medical resource utilization among ACS-PCI patients prescribed prasugrel, ticagrelor, or generic clopidogrel, using a large commercial insurance claims database...
August 2018: Journal of Managed Care & Specialty Pharmacy
Fen Cao, Baojian Zhang, Xinyi Li, Shu Duan
To explore the effect and difference of percutaneous coronary intervention (PCI) and medical therapy on quality of life and cognitive function in patients with coronary heart disease (CHD), and to investigate the relationship between quality of life and cognitive function.
 Methods: A total of 320 patients with CHD, who underwent coronary angiography and PCI (PCI group, n=160), or underwent coronary angiography and medical therapy (drug therapy group, n=160), were selected. The quality of life was assessed by using the Health Survey Form SF-36 (SF-36) and the Seattle Angina Questionnaire (SAQ), and the cognitive function was assessed by using the Mini-Mental State Examination (MMSE)...
May 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Wenjian Xie, Qian Yin, Mengran Zhang, Shengnan Li, Shaoliang Chen
To investigate the potential correlation between miR-223 level in leukocytes and platelet responses to clopidogrel in patients with coronary artery disease.
 Methods: A cohort of 188 outpatients, who conducted percutaneous coronary intervention (PCI) and received dual antiplatelet therapy, were recruited. The patient's electronic health data were collected, and their blood samples were obtained for measurement of adenosine diphosphate (ADP)-induced whole-blood platelet aggregation. Extreme cases of platelet responses to clopidogrel (ultra- vs...
April 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
B Acar, E Gucuk Ipek, S Unal, C Yayla, M Karanfil, C Burak, M Kara, F Bayraktar, M S Kuyumcu, S Aydogdu
INTRODUCTION: Lifestyle modification is an important component of the secondary prevention strategies; and a healthy diet is one of the cornerstones in management of the coronary heart disease. We aimed to investigate the dietary habits of the patients with history of coronary revascularization, characteristics of the ones with good adherence by using alternate MedDiet questionnaire. METHODS: We included outpatients who had a history of coronary revascularization at least 6 months prior to enrollment...
June 2018: Revista Clínica Española
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