The American journal of cardiology
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Multicenter Study Comparative Study
Relation of timing of cardiac catheterization to outcomes in patients with non-ST-segment elevation myocardial infarction or unstable angina pectoris enrolled in the multinational global registry of acute coronary events.
We assessed whether timing of catheterization is associated with the type of non-ST-segment elevation acute coronary syndrome and/or outcome in patients who were enrolled in the Global Registry of Acute Coronary Events. Overall, 8,853 patients who had unstable angina pectoris or non-ST-elevation myocardial infarction were categorized according to timing of catheterization: expeditive (<24 hours), early (24 to 48 hours), and delayed (>48 hours). Patients in the delayed group were older, more frequently had previous myocardial infarction or stroke, and had a higher risk score compared with those in the expeditive and early groups (all p < or =0.001). ⋯ The highest incidence of death during follow-up occurred in the delayed group (3.8% delayed vs 2.8% expeditive/early, p = 0.0210). Multivariate regression analysis suggested that expeditive catheterization was related to in-hospital death and death from time of catheterization to 6 months. We conclude that expeditive catheterization is associated with unstable presenting features that contribute significantly to the higher risk of death and death or myocardial infarction in hospital compared with patients who undergo later catheterization.
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Multicenter Study Comparative Study
Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients.
Trends in the incidences of pulmonary embolism (PE), deep venous thrombosis (DVT), and venous thromboembolism (VTE) (PE or DVT, or both) in hospitalized adults (aged > or =20 years) were evaluated using data from the National Hospital Discharge Survey. From 1979 to 1999, the incidence of DVT in hospitalized patients increased from 0.8% of admissions to 1.3% of admissions. The incidence of PE was 0.4% of admissions and did not change over the 21-year period. Trends and incidences were similar or the same among men and women and whites and blacks.
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Comparative Study
Effectiveness of automated external defibrillators in high schools in greater Boston.
A program using a strategy of donating a single automatic external defibrillator to 35 schools in the Boston area resulted in compliance with American Heart Association guidelines on automatic external defibrillator placement and training and 2 successful resuscitations from sudden cardiac arrest. Participating schools indicated a high degree of satisfaction with the program.