Circ Cardiovasc Qual
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Circ Cardiovasc Qual · Mar 2014
Sources of hospital-level variation in major bleeding among patients with non-st-segment elevation myocardial infarction: a report from the National Cardiovascular Data Registry (NCDR).
Major bleeding has received increasing attention as a target for quality improvement in care of patients with acute myocardial infarction. However, little is known about variation in bleeding across hospitals and whether variation is attributable to quality of hospital care, treatments, or case mix. ⋯ In-hospital major bleeding rates varied widely across hospitals. Although patient factors and treatments explained less than one third of hospital-level variation, ≈70% of bleeding variation remains after adjustment. A better understanding of causes for substantial hospital-level bleeding variations is needed to help target high-risk patients or practices and to optimize care.
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Circ Cardiovasc Qual · Jan 2014
Randomized Controlled TrialThe effect of an EDTA-based chelation regimen on patients with diabetes mellitus and prior myocardial infarction in the Trial to Assess Chelation Therapy (TACT).
The Trial to Assess Chelation Therapy (TACT) showed clinical benefit of an EDTA-based infusion regimen in patients aged ≥50 years with prior myocardial infarction. Diabetes mellitus before enrollment was a prespecified subgroup. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT00044213.
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Circ Cardiovasc Qual · Jan 2014
Randomized Controlled Trial Multicenter StudyFactors associated with longer time to treatment for patients with suspected acute coronary syndromes: a cohort study.
Rapid treatment of acute coronary syndromes (ACS) is important; causes of delay in emergency medical services care of ACS are poorly understood. ⋯ We found delays throughout ACS care, resulting in substantial differences in total times for women and older individuals. These delays may impact outcomes; a comprehensive approach to reduce delay is needed.
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Circ Cardiovasc Qual · Jan 2014
Comparative StudyAssociation of body mass index and long-term outcomes in older patients with non-ST-segment-elevation myocardial infarction: results from the CRUSADE Registry.
Prior studies have found that obese patients have paradoxically lower in-hospital mortality after non-ST-segment-elevation myocardial infarction than their normal-weight counterparts, yet whether these associations persist long term is unknown. ⋯ All-cause long-term mortality was generally lower for overweight and obese older patients after non-ST-segment-elevation myocardial infarction relative to those with normal weight. Longitudinal readmissions were similar or higher with increasing BMI.