American heart journal
-
American heart journal · Jun 2010
Randomized Controlled Trial Multicenter Study Comparative StudySuboptimal use of evidence-based medical therapy in patients with acute myocardial infarction from the Korea Acute Myocardial Infarction Registry: prescription rate, predictors, and prognostic value.
Only limited data are available for the recent trend of optimal evidence-based medical therapy at discharge after acute myocardial infarction (AMI) in Asia. We evaluated the predictors for the use of optimal evidence-based medical therapy at discharge and the association between discharge medications and 6-month mortality after AMI. ⋯ The optimal evidence-based medical therapy is prescribed at suboptimal rates, particularly in patients with high-risk features. New educational strategies are needed to increase the use of these secondary preventive medical therapies.
-
American heart journal · Jun 2010
Randomized Controlled Trial Multicenter Study Comparative StudyBIVentricular versus right ventricular antitachycardia pacing to terminate ventricular tachyarrhythmias in patients receiving cardiac resynchronization therapy: the ADVANCE CRT-D Trial.
This multicenter, prospective, randomized, controlled, parallel trial compares the efficacy of biventricular (BIV) versus right ventricular (RV) antitachycardia pacing (ATP) in terminating all kinds of ventricular tachycardia (VT). ⋯ Antitachycardia pacing is effective in patients implanted with a CRT-D device. No significant differences in efficacy emerged between BIV- and RV-delivered ATP in the general population, whereas BIV ATP seems to present a safer profile in ischemic patients.
-
American heart journal · Jun 2010
Comparative StudyEarly ST-segment recovery after primary percutaneous coronary intervention accurately predicts long-term prognosis after acute myocardial infarction.
Several ancillary studies reported on the prognostic value of ST-segment recovery (STR) with measurement at 30 to 240 minutes after primary percutaneous coronary intervention (PCI). We determined the long-term prognostic value of early STR, assessed at the end of primary PCI, in unselected patients after ST-segment elevation myocardial infarction (STEMI). ⋯ Early STR assessment has strong, long-term prognostic properties in all-comer STEMI patients. Moreover, the prognostic power of early STR is not restricted to the early recovery phase after STEMI, but identifies high-risk subgroups among 1-year survivors.
-
American heart journal · Jun 2010
ReviewMaximizing scientific knowledge from randomized clinical trials.
Trialists have an ethical and financial responsibility to plan and conduct clinical trials in a manner that will maximize the scientific knowledge gained from the trial. However, the amount of scientific information generated by randomized clinical trials in cardiovascular medicine is highly variable. Generation of trial databases and/or biobanks originating in large randomized clinical trials has successfully increased the knowledge obtained from those trials. ⋯ This review focuses on the arguments for conducting posttrial database studies and presents examples of studies in which posttrial knowledge generation has been substantial. Possible strategies to ensure successful trial database or biobank generation are discussed, in particular with respect to collaboration with the trial sponsor and to analytic pitfalls. The advantages of creating screening databases in conjunction with a given clinical trial are described; and finally, the potential for posttrial database studies to become a platform for training young scientists is outlined.
-
American heart journal · Jun 2010
Multicenter Study Comparative StudyAssociation of insurance status with inpatient treatment for coronary artery disease: findings from the Get With the Guidelines program.
Prior studies have documented that patients' health insurance status can impact use of guideline-based care as well as acute outcomes for coronary artery disease. Whether insurance status remains a contemporary influence among centers participating in a national quality improvement initiative is unknown. ⋯ These findings suggest that among centers participating in a national quality improvement initiative patient insurance status may be associated with differences in cardiovascular care and outcomes.