Douglas S Lee

..These quality indicators will serve as a foundation for future studies evaluating the quality of CHF care in Canada...

..Higher blood pressure and BMI in midlife are harbingers of increased risk of heart failure in later life. Early risk factor modification may decrease heart failure burden...

..Administrative data sources could be used to track cardiac procedures, but sources of such data have not been validated against clinical registries...

..Heart failure contributes to millions of emergency department (ED) visits, but hospitalization-versus-discharge decisions are often not accompanied by prognostic risk quantification...

..This study examined the predictors of early complications after defibrillator implantation...

..Higher blood pressure in acute heart failure has been associated with improved survival; however, the relationship between blood pressure and survival in stabilized patients at hospital discharge has not been established...

..Although approximately one third of patients with heart failure (HF) visiting the emergency department (ED) are discharged home, little is known about their care and outcomes...

..We determined if a "dose-dependent" relationship exists between heart failure events and death, accounting for temporal changes in age, comorbidities, and disease severity...

..The type of outpatient physician care after an emergency department visit for heart failure may affect patients' outcomes. Methods and..

..The aim of this study was to determine the impact of myocardial perfusion imaging (MPI) on the outcomes of death, myocardial infarction (MI), and late coronary revascularization procedures...

..To determine whether serum gamma-glutamyl transferase (GGT) predicts cardiovascular disease (CVD) morbidity and mortality, accounting for temporal changes in known CVD risk factors and C-reactive protein (CRP)...

..We sought to examine outcomes in recipients of implantable cardioverter-defibrillators (ICDs) and the effect of age, gender, and comorbidities on survival...

..Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear...

..Understanding the reasons underlying this mismatch may facilitate improvements in care and outcomes for patients with heart failure...

..Hospital readmissions for heart failure (HF) contribute to increased morbidity and resource burden. Predictors of hospitalization and patterns of cardiovascular events over the lifetime of patients with HF have not been elucidated...

..In addition, replacement may be a discretionary decision in the context of an advisory or borderline device performance and patient, device, and implanter factors that predict adverse outcome may assist in clinical decision-making...

..Cardiac troponins (cTn) may be elevated among patients with acute heart failure syndromes (AHFS). However, the optimal approach to management of AHFS with elevated cTn is unknown...

..We examined recent national trends in mortality and rates of hospital admission for these 3 conditions...

..However, previous studies have focused on predicting shorter-term mortality and limited data currently exist to predict expected survival among hospitalized patients with HF...

..The influence of statin therapy in heart failure (HF) has been of considerable interest. The objective of this study was to determine if statins are associated with improved outcomes in patients discharged after hospitalization for HF...

..There are scarce population-based data on the use, complication rates, and outcomes of patients receiving implantable cardioverter defibrillators (ICDs)...

..These data raise the need to identify specialty-driven differences in processes of care for heart failure patients, which may explain the observed disparity in clinical outcomes that presently favor cardiologist care...

..Examination of hospitalization data up to 1 year prior to the index admission improves comorbidity detection and may provide enhancements to future studies of heart failure mortality...

..Sex differences in the use and outcomes of implantable cardioverter-defibrillators (ICDs) have not been fully studied...

..The survival of patients with heart failure with preserved ejection fraction was similar to that of patients with reduced ejection fraction...

..CONCLUSION: During 1992 to 2000, mortality and morbidity improved among elderly patients with heart failure, with increased utilization of beta-blockers contributing most to the beneficial trends in outcomes...

..Data are limited on the relative contributions of cardiovascular versus noncardiovascular diseases to death in individuals with HF in the community...

..Publicly released report cards on hospital performance are increasingly common, but whether they are an effective method for improving quality of care remains uncertain...

..The objective of this study was to examine the influence of age, gender, place of residence, and socioeconomic status on rates of ICD implantation for the primary prevention of death...

..The influence of age and comorbidities on sex-specific implantable cardioverter-defibrillator (ICD) use for primary or secondary prevention is undefined...

..Quality indicators in coronary heart disease (CHD) measure the practice gap between optimal care and current clinical practice. However, the potential impact of achieving quality indicator benchmarks remains unknown...

..We sought to determine the prognostic value of bundle branch blocks in patients hospitalized with heart failure...

..Our objectives were to compare real-world outcomes of patients with HF treated in HF clinics versus usual therapy and identify HF clinic features associated with improved outcomes...

..CONCLUSIONS: Post-stress and reversible RWMA, as shown by exercise stress Tc-99m-gated SPECT MPI, are significant predictors of angiographic disease and add incremental value to MPI for the assessment of angiographic severity...

..Specialized multidisciplinary clinics have been shown to reduce mortality in heart failure (HF). Our objective was to evaluate the cost-effectiveness of this model of care delivery...

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..We examined the relationship of dynamic furosemide dose with mortality and hospitalizations for cardiovascular disease and renal dysfunction...

..We aimed to compare rates of admission for congestive heart failure in elderly patients who were newly dispensed COX-2 inhibitors or non-selective NSAIDs...

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..The externally validated predictive index may assist clinicians in estimating heart failure mortality risk and in providing quantitative guidance for decision making in heart failure care...

..3%, P = .98). CONCLUSION: Patients with heart failure who are hospitalized in the United States had lower short-term mortality at 30 days, but 1-year mortality rates were not significantly different between the United States and Canada...

..Given the cost of the device strategy, policies of targeted intervention based on the future risk of arrhythmia are warranted...

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..There are no life-tables quantifying the average life-spans of post-hospitalized heart failure populations across various strata of risk...

..The extent to which better spending produces higher-quality care and better patient outcomes in a universal health care system with selective access to medical technology is unknown...

..The mortality and readmission rates for this condition are high and exhibit variation among health regions and provinces. Factors contributing to regional variations in these outcomes merit further study...

..Reporting of ischemic heart disease (IHD) prevalence in Canada has been based on self-report or patients presenting to hospital. However, IHD often presents and can be managed in the outpatient setting...

..To compare the predictive accuracy of regression trees with that of logistic regression models for predicting in-hospital mortality in patients hospitalized with heart failure...

..Established ECG patterns for diagnosis of posterior infarction are insensitive and poor predictors of severity. The SQS and UTV 1 are effective for the diagnosis of posterior infarction and useful for the estimation of infarct severity...

..However, variations in outcomes suggest that assurance of optimal outcomes at each PCI centre without on-site surgery is needed...

..In the data-mining and machine-learning literature, alternate classification schemes have been developed. These include bootstrap aggregation (bagging), boosting, random forests, and support vector machines...

..Although guidelines recommend primary care physician (PCP) follow-up for patients who are subsequently discharged, little is known about the relationship between physician follow-up and clinical outcomes...

..Heart failure is a leading cause of admission to hospital, but whether the incidence of heart failure is increasing or decreasing is uncertain. We examined temporal trends in the incidence and outcomes of heart failure in Ontario, Canada...

..The use of observation units may also be a cost-effective adjunctive strategy that can assist in determining disposition from the emergency department...

..While warfarin-related intracranial hemorrhage (ICH) occurs in 0.25%-1.1% patients per year, little is known about the practice and outcomes of anticoagulant reinitiation...

..Coronary heart disease (CHD) mortality has declined substantially in Canada since 1994...

..We performed a meta-analysis to evaluate the effectiveness of multidisciplinary heart failure management programs on hospital admission rates...

..It remains unclear whether these findings reflect differences in patient characteristics, processes of care, practice setting, or a combination of these factors...

..Given the potential for between-study variability, reliance on studies with small sample size may lead to unrealistic expectations when extrapolating preclinical experimental results to future research...

..New epidemiologic and mechanistic data regarding DHF highlight the urgency with which the scientific community must address this important public health problem...

..In health care settings without unlimited resources, optimal use of this therapy will require better risk stratification methods or lowering of the initial device cost...

..The concept of the marginally matched subject can be used as a sensitivity analysis to examine the impact of the matching method on the estimates of treatment effectiveness...

..Recent clinical trials on anticoagulation and HF are reviewed, including WATCH, WASH, and WARCEF. The absence of compelling clinical trial data leaves many unanswered questions regarding systemic anticoagulation in patients with HF...

..Use of angiotensin-converting-enzyme (ACE) inhibitors is also indicated in these patients. However, life-threatening hyperkalemia can occur when these drugs are used together...

..It is anticipated that these indicators will be useful to clinicians and researchers who want to measure and improve the quality of AMI patient care in Canada...

..The purpose of this review is to summarize the recent literature regarding the familial heritability of heart failure and to discuss the possible mechanisms through which this risk is mediated...

..This case suggests that in clinical and pathological investigation of a cardiac mass, knowledge of previous extracardiac involvement with soft tissue sarcoma is essential...

..The objective of this study was to examine whether case-generic measures of queue performance appropriately reflected the waiting-list experiences of those patients with greatest disease severity...

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..Further investigation and development of antagonists of T-type calcium channels with fewer adverse drug interactions is warranted and may be promising in the management of ischemic heart disease...

..The present paper reviews the potential contributions of genomic and proteomic approaches in developing a more personalized approach to cardiovascular medicine...

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..Our data emphasize the contribution of familial factors to the heart-failure burden in the community...

..To determine what proportion of patients with heart failure are eligible for cardiac resynchronization therapy (CRT)...

..We compared and contrasted the use of implantable cardioverter defibrillator therapy in Canada and the United States among adults who survived a cardiac arrest...

..There have been major advances in the treatment of this condition over the past two decades, yet little information is currently available regarding the current status of CHF management in Canada...

..There is a paucity of studies that have evaluated CHF management in a rural setting. We therefore reviewed hospital and outpatient care in this setting as an initial step toward improving CHF care...

..Additional studies are warranted to confirm these findings...