International journal of cardiology
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Continuity of care refers to the ongoing management of a patient's care over time and across practitioners, and the patient's experience of this care as coherent and consistent with their medical needs and context. Continuity of cardiac care is integral to secondary prevention and improved health outcomes. ⋯ Given the benefits of continuity of care, it is important to promote cardiac rehabilitation participation, a significant correlate of continuity, and to solicit various supports throughout the process of cardiac recovery.
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Comparative Study
Benefit of direct ambulance to coronary care unit admission of acute myocardial infarction patients undergoing primary percutaneous intervention.
Early reperfusion therapy in ST-segment elevation myocardial infarction (STEMI) patients improves left ventricular (LV) function and survival. However, emergency room (ER) triage may unnecessarily delay this time-dependent treatment. We sought to determine whether direct admission of STEMI patients from the mobile intensive care units to the intensive coronary care unit (ICCU), bypassing the ER, can shorten the time intervals for primary PCI (PPCI) and improve prognosis. ⋯ Directly admitted STEMI patients differ from patients admitted via the ER; Direct ICCU admission, based on a pre-hospital ECG, can substantially shorten time to treatment.
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Controlled Clinical Trial
Pre-hospital detection of acute myocardial infarction with ultra-rapid human fatty acid-binding protein (H-FABP) immunoassay.
To evaluate the diagnostic performance of a portable semi-quantitative whole blood immunoassay measuring soluble human fatty acid-binding protein [H-FABP] (CardioDetect) for the pre-hospital detection of myocardial infarction (MI). ⋯ Early assessment of H-FABP in patients presenting with chest pain improves the diagnosis of ongoing MI.
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Letter Case Reports
A 64-year old man who sustained many episodes of acute cardiogenic pulmonary edema successfully treated with Boussignac continuous positive airway pressure: a case report.
Continuous positive airway pressure (CPAP) is standard treatment for patients with acute cardiogenic pulmonary edema. We describe a patient who had 21 episodes of acute cardiogenic pulmonary edema due to very poor patient compliance. ⋯ The BCPAP system is a simple, disposable, FDA-approved device that delivers positive pressure without a ventilator. This extraordinary case underscores the utility of the BCPAP system to avoid repeated intubation and mechanical ventilation in patients with cardiogenic pulmonary edema.
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Randomized Controlled Trial Comparative Study
Home-based versus hospital-based rehabilitation after myocardial infarction: A randomized trial with preference arms--Cornwall Heart Attack Rehabilitation Management Study (CHARMS).
Participation in cardiac rehabilitation after acute myocardial infarction is sub-optimal. Offering home-based rehabilitation may improve uptake. We report the first randomized study of cardiac rehabilitation to include patient preference. ⋯ Home-based cardiac rehabilitation with the Heart Manual was as effective as hospital-based rehabilitation for patients after myocardial infarction. Choosing a rehabilitation programme did not significantly affect clinical outcomes.