American heart journal
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American heart journal · May 2010
Anxiety disorders increase risk for incident myocardial infarction in depressed and nondepressed Veterans Administration patients.
Depression is a risk factor for incident myocardial infarction (MI), but little is known about the independent or additive risk from anxiety disorders. ⋯ In Veterans Administration patients free of heart disease in 1999 and 2000, those with depression, anxiety disorder unspecified, panic disorder, and PTSD were at increased risk of incident MI. Anxiety disorders are independent risk factors for MI. Depression partially accounts for the effect of anxiety disorders on risk of MI in patients with both conditions.
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American heart journal · May 2010
Red blood cell storage duration and mortality in patients undergoing percutaneous coronary intervention.
Blood transfusion has been associated with an increased mortality in patients undergoing percutaneous coronary intervention (PCI). Although the reasons for this remain unclear, it may be related to the structural and functional changes occurring within red blood cells (RBCs) during storage. We investigated whether RBC storage duration was associated with mortality in patients requiring transfusion after PCI. ⋯ Red blood cell transfusion is associated with increased 30-day mortality in patients undergoing PCI. Although current transfusion practice permits RBC storage for up to 42 days, the use of older red cells may pose an additional hazard to this patient group.
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American heart journal · May 2010
Comparative StudyCardiac arrest outside and inside hospital in a community: mechanisms behind the differences in outcome and outcome in relation to time of arrest.
The aim was to compare characteristics and outcome after cardiac arrest where cardiopulmonary resuscitation was attempted outside and inside hospital over 12 years. ⋯ Compared with OHCA, the survival of patients with IHCA increased 3-fold for shockable rhythm and 7-fold for nonshockable rhythm in our practice setting. If patients were found in a shockable rhythm, the higher survival after IHCA was only partly explained by a shorter treatment delay. The time and day of CA were associated with survival in IHCA but not OHCA.
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American heart journal · May 2010
Duration of red cell storage before transfusion and in-hospital mortality.
Red cell transfusions are lifesaving in severely anemic or acutely bleeding patients but may be associated with an increased risk of cardiovascular events in critically ill patients. The objective of the study was to examine the association between duration of pretransfusion storage of red cells and in-hospital mortality. ⋯ In hospitalized patients with a major diagnosis of cardiovascular disease, there is a modest independent association between increasing duration of storage of red cells and risk of in-hospital mortality that appears to be continuous and graded.
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American heart journal · May 2010
Implications and reasons for the lack of use of reperfusion therapy in patients with ST-segment elevation myocardial infarction: findings from the CRUSADE initiative.
Prompt reperfusion for patients with ST-segment elevation myocardial infarction (STEMI) is a class I guideline recommendation and has been shown to reduce mortality. However, many STEMI patients in contemporary practice still do not receive any form of reperfusion therapy. ⋯ More than 7% of STEMI patients without a reperfusion contraindication did not have an attempt to administer reperfusion therapy, and this was associated with greater in-hospital mortality. Age, sex, and comorbidity were factors related to lack of attempting reperfusion among apparently eligible patients. Quality improvement efforts should focus on maximizing reperfusion use among all eligible STEMI patients and in addressing the processes by which contraindications are defined, clinically determined, and reported.