The American journal of medicine
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Cardiovascular disease is the most common cause of mortality and hospitalization in the United States. Transitional care initiatives can improve outcomes for cardiac patients, but it is unclear whether patients with different baseline comorbidity burden benefit equally. We evaluated the effectiveness of the Bridging the Discharge Gap Effectively (BRIDGE) program, a nurse-practitioner-led transitional care clinic, in mitigating adverse clinical outcomes in cardiac patients with varying Charlson comorbidity index (CCI). ⋯ Attendance at a transitional care clinic is inversely associated with risk of readmission and a composite endpoint in cardiac patients with low CCI. Future research should investigate modified transitional care programs in patients with varying comorbidity burden.
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Observational Study
Statin therapy and intensity: Prognosis in patients with myocardial injury.
No guideline-directed pharmacological therapy has been established for patients with myocardial injury without type 1 myocardial infarction. We investigated the impact of statin treatment in patients with myocardial injury. ⋯ Patients with myocardial injury may benefit from high-intensity statin treatment, but the associations were not statistically significant when adjusting for confounders.
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As surgical techniques evolve and patient outcomes improve over time, a renewed analysis of the cardiac risk of noncardiac surgeries is needed. The goal of this study was to investigate and categorize the cardiac risk of elective noncardiac surgeries. ⋯ Categorization of noncardiac surgeries according to cardiac risk may help to identify populations who are most likely to benefit from preoperative cardiac evaluation when indicated.
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The use of dietary supplements by young warfighters is pervasive and comes with a readiness cost, especially in the deployed setting. Predatory targeting and marketing by various unscrupulous companies put this population at risk for a higher than baseline risk for adverse events. ⋯ The military dietary supplement issue needs exposure, review, and action at the highest levels of government.