Background: Little is known about variations in the quality of ambulatory care between urban and rural communities for patients with stable ischemic heart disease. The objectives of this study were to understand the effect of rurality on variations of ambulatory processes of care and outcomes for patients with stable ischemic heart disease.
Methods And Results: A population-based cohort study was conducted, which included all Ontario patients with stable ischemic heart disease confirmed on cardiac catheterization between October 1, 2008, and September 30, 2011. Patients were categorized as rural or urban based on the Rurality Index for Ontario score. Ambulatory processes of care of interest were diagnostic testing, medication usage, and access to general/speciality physicians over a 1-year time-horizon. Primary outcome was 1-year mortality. Secondary outcomes included 1-year myocardial infarction, repeat cardiac/all-cause hospitalization, and emergency department visits. The cohort consisted of 38 804 patients, of whom 34 949 (90%) were urban and 3855 (10%) were rural patients. After risk-adjustment, rural patients had lower rates of cholesterol assessment (odds ratios 0.41; 95% confidence interval [CI], 0.38-0.44; P<0.001), hemoglobin A1C assessment (odds ratios 0.41; 95% CI, 0.38-0.44; P<0.001), and statin use (odds ratios 0.67; 95% CI, 0.57-0.79; P<0.001) compared with urban patients. Rural patients had fewer total ambulatory physician visits (rate ratio 0.76; 95% CI, 0.75-0.78; P<0.001)), primary care (0.76; 95% CI, 0.74-0.78; P<0.001), and cardiology visits (0.71; 95% CI, 0.68-0.74; P<0.001) over 1 year. Emergency department utilization was higher among rural patients (odds ratios 1.82; 95% CI, 1.70-1.96; P<0.001), but myocardial infarction, hospitalization, and mortality rates were similar.
Conclusions: Despite variation in ambulatory processes of care between urban and rural patients with stable ischemic heart disease, there were no outcome differences.
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http://dx.doi.org/10.1161/CIRCOUTCOMES.114.001076 | DOI Listing |
Eur Heart J Qual Care Clin Outcomes
January 2025
First Clinical Medical School, Heilongjiang University of Chinese Medicine, Harbin, China, 150040.
Background: The burden of ischemic heart disease (IHD) due to low intake of seafood omega-3 fatty acids is a major global health concern, particularly impacting mortality and disability rates. Understanding these trends and demographic variations offers insights for targeted public health interventions.
Methods: This study used data from the Global Burden of Disease (GBD) 2021 database to analyze the IHD burden attributable to low omega-3 intake across 204 countries from 1990 to 2021, stratified by age, sex, and region.
Introduction: The infarcted heart is energetically compromised exhibiting a deficient production of adenosine triphosphate (ATP) and the ensuing impaired contractile function. Short-term blockade of the protein S100A9 improves cardiac performance in mice after myocardial infarction (MI). The implications upon ATP production during this process are not known.
View Article and Find Full Text PDFSteroids
January 2025
Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang 110122, China. Electronic address:
Due to the difference of estrogen levels in different phases of estrous cycle, it is necessary to exclude the influence of endogenous estrogen when studying the cardiovascular effects of estrogen and its analogues. In this study, the ischemia/reperfusion (I/R) injury of isolated heart were investigated in female rats during different phases of estrous cycle with male rats as comparison. The results indicated that the estrogen content in blood of rats during metestrus and diestrus (MD) was lower than those during proestrus and estrous (PE).
View Article and Find Full Text PDFCirculation
January 2025
Divisions of Cardiac Surgery (H.T., A.Q., R.E., R.V., M.M., J.H.C., S.V.), Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto, Ontario, Canada.
Redox Rep
December 2025
Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People's Republic of China.
Objective: Myocardial ischemia-reperfusion injury (MIRI) is a highly complex disease with high morbidity and mortality. Studying the molecular mechanism of MIRI and discovering new targets are crucial for the future treatment of MIRI.
Methods: We constructed the MIRI rat model and hypoxia/reoxygenation (H/R) injury cardiomyocytes model.
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