Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Jan 2015
Underutilization of high-intensity statin therapy after hospitalization for coronary heart disease.
National guidelines recommend use of high-intensity statins after hospitalization for coronary heart disease (CHD) events. ⋯ The majority of Medicare beneficiaries do not fill high-intensity statins after hospitalization for CHD.
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J. Am. Coll. Cardiol. · Jan 2015
Randomized Controlled Trial Multicenter StudyFrequency and practice-level variation in inappropriate aspirin use for the primary prevention of cardiovascular disease: insights from the National Cardiovascular Disease Registry's Practice Innovation and Clinical Excellence registry.
Among patients without cardiovascular disease (CVD) and low 10-year CVD risk, the risks of gastrointestinal bleeding and hemorrhagic strokes associated with aspirin use outweigh any potential atheroprotective benefit. According to the guidelines on primary prevention of CVD, aspirin use is considered appropriate only in patients with 10-year CVD risk ≥6% and inappropriate in patients with 10-year CVD risk <6%. ⋯ More than 1 in 10 patients in this national registry were receiving inappropriate aspirin therapy for primary prevention, with significant practice-level variations. Our findings suggest that there are important opportunities to improve evidence-based aspirin use for the primary prevention of CVD.
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J. Am. Coll. Cardiol. · Jan 2015
Multicenter StudyRole of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome.
The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined. ⋯ Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.
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J. Am. Coll. Cardiol. · Jan 2015
Costs associated with health care-associated infections in cardiac surgery.
Health care-associated infections (HAIs) are the most common noncardiac complications after cardiac surgery and are associated with increased morbidity and mortality. Current information about their economic burden is limited. ⋯ Hospital cost, LOS, and readmissions are strongly associated with HAIs. These associations suggest the potential for large reductions in costs if HAIs following cardiac surgery can be reduced. (Management Practices and the Risk of Infections Following Cardiac Surgery; NCT01089712).