Heart : official journal of the British Cardiac Society
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To test if delay-to-angiography (>72 hours from admission) in patients presenting with high-risk non-ST-elevation acute coronary syndromes (NSTE-ACS) is associated with adverse outcomes. ⋯ High-risk NSTE-ACS is suboptimally managed with 43% not undergoing angiography. One-third of those undergoing angiography are delayed >72 hours. Longer delays were more likely with higher risk, sicker patients. These delays were associated with adverse outcomes at six months. Very long delay was associated with lower MACE, but not mortality, compared to conservative management.
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Multicenter Study
Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes: the Global Registry of Acute Coronary Events.
To assess whether sex differences exist in the angiographic severity, management and outcomes of acute coronary syndromes (ACS). ⋯ Women with ACS were more likely to have cardiovascular disease risk factors and atypical symptoms such as nausea compared with men, but were more likely to have normal/mild angiographic coronary artery disease. Further study regarding sex differences related to disease severity is warranted.
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Multicenter Study
The Northern Ireland Public Access Defibrillation (NIPAD) study: effectiveness in urban and rural populations.
To assess the impact of mobile automated external defibrillators (AEDs) on out-of-hospital cardiac arrests (OHCAs) in urban and rural populations. ⋯ Despite improvement in CRI there was no impact on survival (witnessed arrest 32.8%, VF 15.6%).
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Randomized Controlled Trial Multicenter Study
Cost-effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care.
To determine if a disease management programme for patients with coronary heart disease and heart failure represents an efficient use of health services resources. ⋯ The use of a nurse-led disease management programme is associated with increased costs in other coronary heart disease-related services as well as for the costs of the clinics. They are also associated with improvements in health. Even in the short term these disease management programmes may represent a cost-effective service, as additional QALY are generated at an acceptable extra cost.
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Multicenter Study
Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score.
To develop, in patients referred for syncope to an emergency department (ED), a diagnostic score to identify those patients likely to have a cardiac cause. ⋯ A simple score derived from clinical history can be usefully employed for the triage and management of patients with syncope in an ED.