American heart journal
-
American heart journal · Jan 2011
Randomized Controlled Trial Multicenter Study Comparative StudyTemporal trends in patient and treatment delay among men and women presenting with ST-elevation myocardial infarction.
over the last decade, there have been major changes in the treatment of ST-elevation myocardial infarction (STEMI). Whether these have resulted in changes in sex differences in time to treatment is unknown. We examined temporal trends in time to reperfusion therapy among men and women with STEMI. ⋯ in the last decade, there have been significant reductions in patient and system delay, especially among women. However, women continue to have longer presentation and treatment times, suggesting that there continue to be opportunities for improvement.
-
American heart journal · Jan 2011
Multicenter StudyRisk adjustment for in-hospital mortality of contemporary patients with acute myocardial infarction: the acute coronary treatment and intervention outcomes network (ACTION) registry-get with the guidelines (GWTG) acute myocardial infarction mortality model and risk score.
accurate risk adjustment is needed to guide quality improvement initiatives and research to improve care of patients with acute myocardial infarction (MI). We developed and validated a model to predict the risk of in-hospital mortality for contemporary patients with acute MI treated in routine clinical practice. ⋯ the ACTION Registry-GWTG™ in-hospital mortality model and risk score represent simple, accurate risk adjustment tools for contemporary patients with acute MI.
-
American heart journal · Jan 2011
Comparative StudyPrognostic value of sensitive troponin T in patients with stable and unstable angina and undetectable conventional troponin.
high-sensitivity cardiac troponin assays enable the measurement of cardiac troponin concentrations in the majority of patients with coronary artery disease. The objective of this study was to investigate the prognostic value of sensitive cardiac troponin in patients with stable and unstable angina presenting with undetectable levels of conventional troponin. ⋯ the elevated levels of sensitive cardiac troponin T in patients with stable or unstable angina presenting with undetectable conventional cardiac troponin T are significantly associated with reduced survival.
-
American heart journal · Jan 2011
EditorialAdenosine release: a potential explanation for the benefits of ticagrelor in the PLATelet inhibition and clinical outcomes trial?
the objective of the study was to hypothesize on the potential mechanism explaining the surprising mortality benefit of ticagrelor in the PLATO trial. ⋯ future randomized trials of ticagrelor in acute heart failure, sudden death prevention, and treatment of atrial fibrillation are warranted and will expand our understanding of the potential role of adenosine in the outcome benefit after pyrimidines.
-
American heart journal · Dec 2010
Randomized Controlled Trial Multicenter Study Comparative StudyRationale and design of the dual antiplatelet therapy study, a prospective, multicenter, randomized, double-blind trial to assess the effectiveness and safety of 12 versus 30 months of dual antiplatelet therapy in subjects undergoing percutaneous coronary intervention with either drug-eluting stent or bare metal stent placement for the treatment of coronary artery lesions.
Dual antiplatelet therapy with aspirin and thienopyridines (clopidogrel or prasugrel) is required after placement of coronary stents to prevent thrombotic complications. Although current clinical practice guidelines recommend 12-month treatment after drug-eluting stent placement, even longer durations may prevent thrombotic events. ⋯ This randomized trial is designed to define the relative safety and effectiveness of 12 versus 30 months of dual antiplatelet therapy across the broad spectrum of patients receiving coronary stents.