Coronary artery disease
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Coronary artery disease · Dec 2015
Variation in utilization of multivessel percutaneous coronary intervention: influence of hospital volume.
The purpose of this study was to investigate the contemporary trends in the utilization of multivessel percutaneous coronary interventions (MVPCIs) in the USA. ⋯ The utilization rate of MVPCI varied considerably among hospitals. Higher annual hospital volume was associated with a higher utilization rate of MVPCI.
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Coronary artery disease · Nov 2015
ReviewOut-of-hospital cardiac arrest: defining the role of coronary angiography and intervention.
Targeted temperature management and early coronary angiography have become the standard of care for postcardiac arrest patients remaining comatose and with ST-segment elevation on the ECG. Less clear is the optimal approach for similar patients without ST-segment elevation on the postresuscitation ECG. However, current data from nonrandomized cohort studies suggest that many of these patients also benefit from an aggressive approach to postresuscitation care. Recent reports of increased stent thrombosis in the postarrest population need further exploration.
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Coronary artery disease · Sep 2015
Cardiac troponin elevation pattern in patients undergoing a primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: characterization and relationship with cardiovascular events during hospitalization.
We aimed to describe the kinetics and associated prognostic implications of the cardiac troponin release curve after a primary percutaneous coronary intervention (PPCI) in patients presenting with ST-segment elevation myocardial infarction (STEMI). ⋯ The cardiac troponin elevation curve following PPCI for STEMI shows a single peak and is affected by the adequacy of myocardial reperfusion. This method can serve as a simple surrogate for risk stratification of patients with STEMI who undergo PPCI.
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Coronary artery disease · Jan 2015
ReviewQuality improvement in acute coronary syndromes: translating evidence into practice.
Despite the substantial progress in elucidating the pathophysiology of acute coronary syndromes (ACS) and developing an array of therapeutic advances for the management of these conditions, several challenges still persist. The use of guideline recommendations for the care of patients with ACS by both healthcare providers and hospitals can improve short-term and long-term outcomes and potentially reduce healthcare costs. ⋯ Several quality improvement programs, by both governmental and nongovernmental organizations, have been developed in an attempt to encourage maximal utilization of evidence-based interventions. In this review, we will examine the evidence for the importance of guideline adherence in the management of ACS, explore predictors of adherence to these guidelines, and provide evidence-based strategies for improving their implementation.