Identifying patients for early discharge: performance of decision rules among patients with acute chest pain.

Background: The HEART score and North American Chest Pain Rule (NACPR) are decision rules designed to identify acute chest pain patients for early discharge without stress testing or cardiac imaging. This study compares the clinical utility of these decision rules combined with serial troponin determinations.

Methods And Results: A secondary analysis was conducted of 1005 participants in the Myeloperoxidase In the Diagnosis of Acute coronary syndromes Study (MIDAS).

Myeloperoxidase in the diagnosis of acute coronary syndromes: the importance of spectrum.

Background: Myeloperoxidase (MPO) is proposed for risk stratification in patients with suspected acute coronary syndromes (ACSs). We determined if MPO has diagnostic value in patients being evaluated for ACS.

Method: MIDAS was an 18-center prospective study enrolling suspected ACS emergency department patients who presented <8 hours after symptom onset and in whom serial cardiac markers and objective cardiac perfusion testing were planned.

Efficacy of multidisciplinary outpatient management (MOM) program in long term heart failure care.

Background: Heart failure (HF) management programs worldwide have reported conflicting outcomes in the past.

Objectives: We sought to determine retrospectively whether the multidisciplinary outpatient management (MOM) program [heart failure clinic (HFC)], decreased readmission rates (RR), duration of hospital stay, and/or mortality in HF patients.

Methods: Records of 138 HF patients who had their first encounter either as admission for HF at St.

Explaining racial differences in receipt of coronary angiography: the role of physician referral and physician specialty.

The authors examine three hypotheses regarding race differences in utilization of coronary angiography (CA): (1) patients with a cardiology consultation are more likely to obtain a referral for CA, (2) African American patients are less likely to have a cardiology consultation, and (3) among patients referred for CA, there is no difference by race in receipt of the procedure. To determine if they obtained a referral for or received CA, 2.623 candidates for CA were followed.

The cardiac access longitudinal study. A study of access to invasive cardiology among African American and white patients.

Objectives: We sought to identify factors contributing to racial disparity in the receipt of coronary angiography (CA).

Background: Numerous studies have demonstrated that African American patients are less likely to receive needed diagnostic and therapeutic coronary procedures than white patients. This report summarizes the methods and findings of a study linking medical records with patient and physician interviews to address racial disparities in the utilization of CA.

Physician referral patterns and race differences in receipt of coronary angiography.

Objective: This study addresses the following research questions: (1) Is race a predictor of obtaining a referral for coronary angiography (CA) among patients who are appropriate candidates for the procedure? (2) Is there a race disparity in obtaining CA among patients who obtain a referral for the procedure?

Study Setting: Three community hospitals in Baltimore, Maryland.

Study Design: We abstracted hospital records of 7,927 patients from three hospitals to identify 2,653 patients who were candidates for CA. Patients were contacted by telephone to determine if they received a referral for CA.