Circ Cardiovasc Qual
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Circ Cardiovasc Qual · Sep 2012
Review Meta AnalysisAssociation of obstructive sleep apnea with risk of serious cardiovascular events: a systematic review and meta-analysis.
The relationship between obstructive sleep apnea (OSA) and cardiovascular events remains unclear. We conducted a systematic review to determine the incident risk of cardiovascular events among patients with OSA. ⋯ OSA appears to be associated with stroke, but the relationship with ischemic heart disease and cardiovascular mortality needs further research.
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Circ Cardiovasc Qual · Sep 2012
Multicenter StudyVariability in surgeons' perioperative practices may influence the incidence of low-output failure after coronary artery bypass grafting surgery.
Postoperative low-output failure (LOF) is an important contributor to morbidity and mortality after coronary artery bypass grafting surgery. We sought to understand which pre- and intra-operative factors contribute to postoperative LOF and to what degree the surgeon may influence rates of LOF. ⋯ Rates of LOF significantly varied across surgeons and could not be explained solely by patient case mix, suggesting that variability in perioperative practices influences risk of LOF.
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Circ Cardiovasc Qual · Sep 2012
Multicenter Study Comparative StudyGuideline adherence after ST-segment elevation versus non-ST segment elevation myocardial infarction.
Clinical guidelines recommend similar medical therapy for patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation MI (NSTEMI). ⋯ Among hospitals participating in GWTG-CAD, adherence with guideline-based medical therapy was high for patients with both STEMI and NSTEMI. Yet, there is still room for further improvement, particularly in the care of NSTEMI patients.
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Circ Cardiovasc Qual · Sep 2012
Multicenter Study Comparative StudyLeft ventricular ejection fraction assessment among patients with acute myocardial infarction and its association with hospital quality of care and evidence-based therapy use.
The left ventricular ejection fraction (LVEF) has prognostic and therapeutic utility after acute myocardial infarction (AMI). Although LVEF assessment is a key performance measure among AMI patients, contemporary rates of in-hospital assessment and its association with therapy use have not been well characterized. ⋯ The assessment of LVEF among patients with AMI has improved significantly over time, yet significant interhospital variability exists. Patients who did not have in-hospital LVEF assessment were less likely to receive evidence-based medications at discharge. These patients represent targets for future quality improvement efforts.
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Circ Cardiovasc Qual · Sep 2012
Multicenter StudyDemographics, trends, and outcomes in pediatric acute myocarditis in the United States, 2006 to 2011.
There is a lack of clear diagnostic and management guidelines for acute myocarditis in the pediatric population. We used a multi-institutional database to characterize demographics, practice variability, and outcomes in this population. ⋯ There is significant temporal and regional variation in the diagnostic modalities and management used for pediatric myocarditis, which continues to have high morbidity and mortality. Extracorporeal membrane oxygenation, ventricular assist device, and vasoactive medications are independently associated with increased mortality/transplantation.