American heart journal
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American heart journal · Jun 2012
Cardiogenic shock complicating acute coronary syndromes: insights from the Global Registry of Acute Coronary Events.
Despite advances in the management of patients with an acute coronary syndrome (ACS), cardiogenic shock (CS) remains the leading cause of death in these patients. The objective of this observational study was to describe the characteristics, management, and hospital outcomes of patients with an ACS complicated by CS. Our secondary study objective was to describe trends in the incidence and hospital case-fatality rates (CFRs) of CS and predictors of increased hospital mortality in these high-risk patients. ⋯ Continued efforts are needed to reduce the incidence and CFRs of CS complicating ACS.
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American heart journal · Jun 2012
Design and rationale of a retrospective clinical effectiveness study of aldosterone antagonist therapy in patients with heart failure.
Despite demonstrated efficacy in randomized trials, aldosterone antagonist therapy is not used in many eligible patients with heart failure. Questions remain about its clinical effectiveness and safety for patients who are underrepresented in randomized trials and those at risk for hyperkalemia. ⋯ The proposed study will evaluate the clinical effectiveness of aldosterone antagonist therapy in Medicare beneficiaries hospitalized for heart failure with reduced ejection fraction, an underrepresented population in clinical trials. By addressing this evidence gap, the study has the potential to inform clinical decision making and improve patient outcomes.