International journal of cardiology
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Comparative Study
Benefit of direct ambulance to coronary care unit admission of acute myocardial infarction patients undergoing primary percutaneous intervention.
Early reperfusion therapy in ST-segment elevation myocardial infarction (STEMI) patients improves left ventricular (LV) function and survival. However, emergency room (ER) triage may unnecessarily delay this time-dependent treatment. We sought to determine whether direct admission of STEMI patients from the mobile intensive care units to the intensive coronary care unit (ICCU), bypassing the ER, can shorten the time intervals for primary PCI (PPCI) and improve prognosis. ⋯ Directly admitted STEMI patients differ from patients admitted via the ER; Direct ICCU admission, based on a pre-hospital ECG, can substantially shorten time to treatment.
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Controlled Clinical Trial
Pre-hospital detection of acute myocardial infarction with ultra-rapid human fatty acid-binding protein (H-FABP) immunoassay.
To evaluate the diagnostic performance of a portable semi-quantitative whole blood immunoassay measuring soluble human fatty acid-binding protein [H-FABP] (CardioDetect) for the pre-hospital detection of myocardial infarction (MI). ⋯ Early assessment of H-FABP in patients presenting with chest pain improves the diagnosis of ongoing MI.
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Continuity of care refers to the ongoing management of a patient's care over time and across practitioners, and the patient's experience of this care as coherent and consistent with their medical needs and context. Continuity of cardiac care is integral to secondary prevention and improved health outcomes. ⋯ Given the benefits of continuity of care, it is important to promote cardiac rehabilitation participation, a significant correlate of continuity, and to solicit various supports throughout the process of cardiac recovery.
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Randomized Controlled Trial Comparative Study
Home-based versus hospital-based rehabilitation after myocardial infarction: A randomized trial with preference arms--Cornwall Heart Attack Rehabilitation Management Study (CHARMS).
Participation in cardiac rehabilitation after acute myocardial infarction is sub-optimal. Offering home-based rehabilitation may improve uptake. We report the first randomized study of cardiac rehabilitation to include patient preference. ⋯ Home-based cardiac rehabilitation with the Heart Manual was as effective as hospital-based rehabilitation for patients after myocardial infarction. Choosing a rehabilitation programme did not significantly affect clinical outcomes.
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Letter Case Reports
Aortic insufficiency due to a partial left-coronary aortic valve prolapse and the detection of two small interatrial jets after blunt thoracic trauma.
Aortic valve regurgitation due to blunt thoracic trauma is a rare complication. Autopsy studies have been shown that the aortic valve is the most often lacerated one among the heart valves. Actually, we describe a case of a 47 year old man with the signs of heart failure after a blunt thoracic trauma 2 months before caused by aortic insufficiency due to a partial left-coronary aortic valve prolapse. Furthermore, transthoracic and transesophageal echocardiography revealed two small jets between the left and the right atrium.