Journal of the American Heart Association
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Multicenter Study Comparative Study Observational Study
Delayed Care and Mortality Among Women and Men With Myocardial Infarction.
Women with ST-segment-elevation myocardial infarction (STEMI) have higher mortality rates than men. We investigated whether sex-related differences in timely access to care among STEMI patients may be a factor associated with excess risk of early mortality in women. ⋯ URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01218776.
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Nearly 17% of patients are readmitted within 30 days of discharge after transcatheter aortic valve replacement. Selected patients are discharged to skilled nursing facilities, yet the association between a hospital's practice to discharge home versus to skilled nursing facilities, and readmission remains unclear. ⋯ There was no statistically significant association between hospital practice of direct home discharge post-transcatheter aortic valve replacement and 30-day readmission. Further research is needed to understand regional variations and optimum strategies for postdischarge care.
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Patients with a Fontan circulation have reduced exercise capacity and respiratory muscle strength. Inspiratory muscle training (IMT) improves exercise capacity and quality of life in adults with heart failure. We assessed whether 6 weeks of a home-based program of IMT improves inspiratory muscle strength and the ventilatory efficiency of exercise in adolescent patients with a Fontan circulation. ⋯ Six weeks of IMT is associated with improved inspiratory muscle strength, ventilatory efficiency of exercise, and resting cardiac output in young Fontan patients. IMT may be a simple beneficial addition to the current management of Fontan patients, potentially reducing exercise intolerance and long-term morbidity and mortality.
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Comparative Study Observational Study
Improving Outcomes of Witnessed Out-of-Hospital Cardiac Arrest After Implementation of International Liaison Committee on Resuscitation 2010 Consensus: A Nationwide Prospective Observational Population-Based Study.
The International Liaison Committee on Resuscitation (ILCOR) periodically updates the consensus recommendations for cardiopulmonary resuscitation to improve the outcomes of out-of-hospital cardiac arrest (OHCA). However, little is known about the differences in outcomes of witnessed OHCA following the publication of the ILCOR 2010 and the ILCOR 2005 recommendations. ⋯ Outcomes of witnessed OHCA were better in the ILCOR 2010 period than those in the ILCOR 2005 period. Our results can provide baseline data for many future prospective studies.