Circ Cardiovasc Qual
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Circ Cardiovasc Qual · Nov 2012
ReviewHow small is too small? A systematic review of center volume and outcome after cardiac transplantation.
The aim of this study was to assess the relationship between the volume of cardiac transplantation procedures performed in a center and the outcome after cardiac transplantation. ⋯ There is a relationship between center volume and mortality in heart transplantation. The existence of a minimum acceptable center volume or threshold is unproven. However, a level of 10 to 12 heart transplants per year corresponds to the upper limit of low-volume categories that may have relatively higher mortality. It is not known whether outcomes for patients treated in low-volume transplant centers would be improved by reorganizing centers to ensure volumes in excess of 10 to 12 heart transplants per year.
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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.