The American journal of cardiology
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Natriuretic peptides have proved useful in the diagnosis of heart failure in patients presenting to the emergency department with shortness of breath. Dyspnea and orthopnea in heart failure are clinical expressions of pulmonary capillary congestion and leakage, which may be assessed by the percentage of pulmonary hemosiderin-laden macrophages (HLM) in induced sputum. ⋯ N-BNP concentrations were positively associated with the percentage of HLM in patients with acute dyspnea (r = 0.6; p < 0.0001). N-BNP, in addition to being a ventricular dysfunction marker, may reflect the severity of pulmonary capillary congestion and leakage in patients with acute shortness of breath.
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Comparative Study
Comparison of three-year outcomes in blacks versus whites with coronary heart disease following percutaneous coronary intervention.
There are limited data regarding the effect of race on survival after percutaneous coronary intervention (PCI) in the modern era. The investigators analyzed the impact of race on 3-year survival in 3,783 consecutive patients who underwent PCI in 1998 and 1999.
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There are limited data regarding the effect of chronic obstructive pulmonary disease (COPD) on the survival of patients with coronary artery disease. Prospectively developed and collected data elements on 4,284 consecutive patients who underwent percutaneous coronary intervention in 3 hospitals in 1998 and 1999 were pooled and analyzed. ⋯ At 3-year follow-up, mortality for patients with COPD was 21% versus 9% for patients without COPD (log-rank p < 0.001). COPD was independently associated with a 2-fold increase in the hazard of long-term mortality (hazard ratio 2.146, 95% confidence interval 1.525 to 3.021, p < 0.001).
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Despite numerous epidemiologic studies, few data exist on recent trends in admissions to United States hospitals of patients with atrial fibrillation (AF) as a primary diagnosis and on the determinants of outcome of these hospitalizations. In the present study, we investigated recent trends in the incidence of AF admissions to United States hospitals from 1996 to 2001 using a representative sample of all acute-care hospital admissions in the United States provided by the Centers for Disease Control, with special attention to the importance of age, gender, race, and other determinants of outcome, namely, in-hospital mortality.
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The availability of cardiac ultrasound is limited in developing countries. We evaluated the feasibility and diagnostic capability of a hand-carried cardiac ultrasound device in 126 patients (age 44 +/- 24 years) referred for consultation to a cardiology clinic in rural Mexico. The hand-carried cardiac ultrasound device identified 86 cardiac findings and obviated the need for further comprehensive echocardiographic evaluation in 90% of patients (113 of 126).