American heart journal
-
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.
-
American heart journal · Jun 2012
Randomized Controlled TrialRacial differences in hospice use and patterns of care after enrollment in hospice among Medicare beneficiaries with heart failure.
We examined racial differences in patterns of care and resource use among Medicare beneficiaries with heart failure after enrollment in hospice. ⋯ Rates of hospice use have increased over time for both white and nonwhite patients. Nonwhite patients were less likely than white patients to enroll in hospice and had higher resource use after electing hospice care, regardless of disenrollment status.
-
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.
-
American heart journal · May 2012
Randomized Controlled Trial Comparative StudyVariations in practice and outcomes in patients undergoing primary percutaneous coronary intervention in the United States and Canada: insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX AMI) trial.
Information on practice patterns and outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary interventions (PCIs) in Canada vs United States is limited. ⋯ Compared with US patients, Canadian patients had shorter door-to-PCI time but similar 90-day outcomes. These data suggest an opportunity for US sites to examine and learn from the Canadian systems of processes of care and implement changes so as to improve the timeliness of primary PCI.
-
American heart journal · May 2012
Multicenter Study Comparative StudyProgression of atrial fibrillation in the REgistry on Cardiac rhythm disORDers assessing the control of Atrial Fibrillation cohort: clinical correlates and the effect of rhythm-control therapy.
Paroxysmal atrial fibrillation (AF) may progress to persistent AF. We studied the clinical correlates and the effect of rhythm-control strategy on AF progression. ⋯ Although heart failure and hypertension are associated with AF progression, rhythm control is associated with lower risk of AF progression.