International journal of cardiology
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The pre-procedural neutrophil to lymphocyte ratio (N/L) is associated with adverse outcomes among patients with coronary artery disease but its prognostic value in ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. This study evaluated the relations between pre-procedural N/L ratio and the in-hospital and long-term outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PCI). ⋯ The N/L ratio was an independent predictor of both in-hospital and long-term adverse outcomes among STEMI patients undergoing primary PCI. Our findings suggest that this inexpensive, universally available hematological marker may be incorporated into the current established risk assessment model for STEMI.
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Multicenter Study
Five-year outcomes of surgical or percutaneous myocardial revascularization in diabetic patients.
The study compares five-year clinical outcomes of CABG vs PCI in a real world population of diabetic patients with multivessel coronary disease since it is not clear whether to prefer surgical or percutaneous revascularization. ⋯ Diabetics show a higher incidence of MACCE with PCI than with CABG: thus diabetes and its degree of control should be considered when choosing the type of revascularization.
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Multicenter Study Comparative Study Observational Study
Long-term survival after hospitalization for acute heart failure--differences in prognosis of acutely decompensated chronic and new-onset acute heart failure.
To analyze the five-year mortality after hospitalization for acute heart failure (AHF) and compare predictors of prognosis in patients with and without a previous history of heart failure. ⋯ The long-term prognosis after hospitalization for AHF is poor, with a significantly different survival observed in patients with de-novo AHF compared to ADCHF. A previous history of heart failure is an independent predictor of five-year mortality. Distinction between ADCHF and de-novo AHF may improve our understanding of patients with AHF.
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Multicenter Study
Provider profiling models for acute coronary syndrome mortality using administrative data.
Administrative data have been used to construct risk-adjustment models for provider profiling to benchmark hospital performance for acute myocardial infarction (AMI), but much less for acute coronary syndrome (ACS). We assess the impact on risk model performance and hospital-level mortality rate ratios (SMRs) of three key issues: comorbidity measurement methods, inter-hospital transfers and post-discharge deaths. ⋯ Models for comparing hospitals' ACS mortality can be constructed with good discrimination using English administrative hospital data. Adjusting for transfers in and capturing post-discharge deaths are more important than the choice of comorbidity adjustment.