68 results match your criteria: "St Luke's Mid-America Heart Institute and University of Missouri[Affiliation]"
Clin Res Cardiol
March 2018
Department of Anesthesiology and Critical Care and Burn Unit, St-Louis Hospital, Assistance Publique- Hôpitaux de Paris,, Paris, France.
Background: The interaction between chronic medications on admission and the association between serum potassium level and outcome in patients with acute heart failure (AHF) are unknown.
Methods: Observational intercontinental study of patients admitted with AHF. 15954 patients were included from 12 cohorts in 4 continents.
Diabetes Obes Metab
March 2018
Department of Cardiovascular Diseases, St Luke's Mid-America Heart Institute and University of Missouri, Kansas City, Missouri.
Aim: To assess whether the secular trends in type 2 diabetes prevalence differ between abdominally obese and non-obese individuals.
Methods: Data from the National Health and Nutrition Examination Surveys (NHANES) were used to estimate the prevalence of type 2 diabetes and abdominal obesity among individuals aged ≥20 years in the USA from 1999/2000 to 2013/2014, after standardization to the age, sex and ethnicity population distribution estimates on January 1, 2014, as published by the US Census Bureau.
Results: The prevalence of abdominal obesity in the US population increased from 47.
Background: Among patients with acute myocardial infarction (MI) who have multivessel disease, it is unclear if multivessel percutaneous coronary intervention (PCI) improves clinical and quality-of-life outcomes compared with culprit-only intervention. We sought to compare clinical and quality-of-life outcomes between multivessel and culprit-only PCI.
Methods And Results: Among 6061 patients with acute MI who have multivessel disease in the TRANSLATE-ACS (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) study, we used inverse probability-weighted propensity adjustment to study the associations between multivessel and culprit-only intervention during the index PCI and major adverse cardiovascular events, unplanned all-cause readmission, and angina frequency at 6 weeks and 1 year.
Background: Although guidelines and performance measures exist for patients with diabetes mellitus, achievement of these metrics is not well known. The Diabetes Collaborative Registry (DCR) was formed to understand the quality of diabetes mellitus care across the primary and specialty care continuum in the United States.
Methods And Results: We assessed the frequency of achievement of 7 diabetes mellitus-related quality metrics and variability across the Diabetes Collaborative Registry sites.
J Nucl Cardiol
October 2017
Memorial Care Heart & Vascular Institute, Long Beach Memorial Medical Center, Long Beach, USA.
Resuscitation
April 2017
University of Michigan Medical School, Ann Arbor, MI, United States.
Background: The duration of resuscitation efforts has implications for patient survival of in-hospital cardiac arrest (IHCA). It is unknown if patients with better predicted survival of IHCA receive longer attempts at resuscitation.
Methods: In a multicenter observational cohort of 40,563 adult non-survivors of resuscitation efforts for IHCA between 2000 and 2012, we determined the pre-arrest predicted probability of survival to discharge with good neurologic status, categorized into very low (<1%), low (1-3%), average (>3%-15%), and above average (>15%).
J Thorac Cardiovasc Surg
April 2017
Department of Cardiology, Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine, Kansas City, Mo.
Objective: To evaluate sternal healing, complications, and costs after sternotomy closure with rigid plate fixation or wire cerclage.
Methods: This prospective, single-blinded, multicenter trial randomized 236 patients at 12 US centers at the time of sternal closure to either rigid plate fixation (n = 116) or wire cerclage (n = 120). The primary endpoint, sternal healing at 6 months, was evaluated by a core laboratory using computed tomography and a 6-point scale (greater scores represent greater healing).
Pharmacol Res
November 2016
Department of Anesthesiology, Critical Care and Burn Unit, St. Louis Hospital, University Paris 7 Denis Diderot, UMR-S942, Inserm, France and F-CRIN INI-CRCT Nancy, and GREAT network, Paris, France.
Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment.
View Article and Find Full Text PDFJ Am Coll Cardiol
August 2016
Saint-Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
Background: As a foundation for quality improvement, assessing clinical outcomes across hospitals requires appropriate risk adjustment to account for differences in patient case mix, including presentation after cardiac arrest.
Objectives: The aim of this study was to develop and validate a parsimonious patient-level clinical risk model of in-hospital mortality for contemporary patients with acute myocardial infarction.
Methods: Patient characteristics at the time of presentation in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-GWTG (Get With the Guidelines) database from January 2012 through December 2013 were used to develop a multivariate hierarchical logistic regression model predicting in-hospital mortality.
Am Heart J
July 2016
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
Background: The use of oral P2Y12 receptor inhibitors after acute myocardial infarction (MI) can reduce risks of subsequent major adverse cardiovascular events (composite of all-cause death, recurrent MI, and stroke), yet medication persistence is suboptimal. Although copayment cost has been implicated as a factor influencing medication persistence, it remains unclear whether reducing or eliminating these costs can improve medication persistence and/or downstream clinical outcomes.
Design: ARTEMIS is a multicenter, cluster-randomized clinical trial designed to examine whether eliminating patient copayment for P2Y12 receptor inhibitor therapy affects medication persistence and clinical outcomes.
Circ Cardiovasc Qual Outcomes
May 2016
From the Department of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX (A.P., D.K.M., J.A.d.L., S.R.D., J.D.B., E.S.B., S.B., S.P.M., D.J.K.); Veterans Affairs North Texas Health Care System, Dallas, TX (E.S.B., S.B.); Division of Cardiology, Mayo Clinic, Rochester, MN (G.W.B.); Department of Medicine, Division of Cardiology, Duke Clinical Research Institute, Durham, NC (D.N.S., M.R.); Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA (A.G.); Department of Medicine, Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO (M.K.); and Department of Internal Medicine, University of California Davis, Sacramento, CA (E.A.A.).
Background: Current guidelines recommend surgical revascularization (coronary artery bypass graft [CABG]) over percutaneous coronary intervention (PCI) in patients with diabetes mellitus and multivessel coronary artery disease. Few data are available describing revascularization patterns among these patients in the setting of non-ST-segment-elevation myocardial infarction.
Methods And Results: Using Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines (ACTION Registry-GWTG), we compared the in-hospital use of different revascularization strategies (PCI versus CABG versus no revascularization) in diabetes mellitus patients with non-ST-segment-elevation myocardial infarction who had angiography, demonstrating multivessel coronary artery disease between July 2008 and December 2014.
J Heart Lung Transplant
June 2016
Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama.
Background: Gaps in the literature exist regarding health-related quality of life (HRQOL) early after left ventricular assist device (LVAD) surgery. The purposes of our study were to describe HRQOL over time, by age and gender, and identify risk factors for poor HRQOL early after LVAD implant.
Methods: Patients (n = 7,353) from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database received a continuous-flow LVAD as a primary implant at 133 United States hospitals.
Cardiol Young
April 2016
7Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons,New York,New York,United States of America.
Background: Hypoplastic left heart syndrome is the most expensive birth defect managed in the United States, with a 5-year survival rate below 70%. Increasing evidence suggests that hospital volumes are inversely associated with mortality for infants with single ventricles undergoing stage 1 surgical palliation. Our aim was to examine the relative effects of surgeon and institutional volumes on outcomes and resource utilisation for these children.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
July 2015
Columbia University Medical Center, New York Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York.
Objectives: We sought to estimate the direct costs (in-hospital and 30-day) associated with an intraprocedural thrombotic event (IPTE) among patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI).
Background: Patients with IPTE have higher rates of in-hospital and 30-day major adverse cardiac events than patients without IPTE. The extent to which IPTE also add to medical costs is unknown.
Am Heart J
January 2015
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT; Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT. Electronic address:
Background: Stroke is a common and important adverse event after acute myocardial infarction (AMI) in the elderly. It is unclear whether the risk of stroke after AMI has changed with improvements in treatments and outcomes for AMI in the last decade.
Methods: To assess trends in risk of stroke after AMI, we used a national sample of Medicare data to identify Fee-for-Service patients (n = 2,305,441) aged ≥65 years who were discharged alive after hospitalization for AMI from 1999 to 2010.
Interv Cardiol
August 2014
VA North Texas Healthcare System and University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, US.
Dual injection is recommended for nearly all chronic total occlusion (CTO) percutaneous coronary intervention (PCI) to determine the optimal crossing strategy and guide wire advancement into the distal true lumen. Strategies that provide enhanced guide catheter support (such as long sheaths, large-bore guiding catheters, use of guide catheter extensions, and anchor techniques) are important for maximising the success rate and efficiency of CTO PCI. Use of a microcatheter or over-the-wire balloon is strongly recommended in CTO PCI for enhancing the penetrating power of the guidewire, enabling change in tip shape and allowing guidewire change (stiff CTO guidewires are not optimal for crossing non-occluded coronary segments).
View Article and Find Full Text PDFInterv Cardiol
August 2014
VA North Texas Healthcare System and University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, US.
Coronary chronic total occlusions (CTOs) are commonly encountered in patients with coronary artery disease. Compared to patients without coronary CTOs, those with CTO have worse clinical outcomes and lower likelihood of complete coronary revascularisation. Successful CTO percutaneous coronary intervention (PCI) can significantly improve angina and improve left ventricular function.
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