Mark J Eisenberg

..The purpose of this study was to examine smoking cessation rates among smokers with AMI to determine whether bupropion, started in-hospital, is safe and can improve cessation rates at 1 year...

..However, few direct or indirect comparisons of such interventions have been conducted. We performed a meta-analysis to compare the treatment effects of 7 approved pharmacologic interventions for smoking cessation...

..Therefore, a meta-analysis of randomized controlled trials (RCTs) was performed to determine the efficacy of behavioural therapy and pharmacotherapy for smoking cessation in cardiac patients...

..However, discontinuation of antiplatelet therapy is an important risk factor for late stent thrombosis. Our objective was to examine the safety of short-term discontinuation of antiplatelet therapy...

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..Discharge from hospital provides a unique opportunity for physicians to modify the use of cardiovascular medical therapy among patients undergoing CABG surgery...

..73-0.76). Conclusions- Clinicians should use an integrative approach combining frailty, disability, and risk scores to better characterize elderly patients referred for cardiac surgery and identify those that are at increased risk...

..07, 95% CI 0.01-0.87, p = 0.04). Cardiac medical therapy among patients undergoing AAA repair is low throughout all periods of hospitalization. ACE inhibitor and ss-blocker use may be associated with decreased in-hospital mortality...

..It is unclear whether routine or selective functional testing is optimal following percutaneous coronary intervention (PCI) in high-risk patients...

..However, it is unclear how functional testing results have an impact on anti-anginal medication prescription patterns...

..The aim of this study was to compare outcomes after acute myocardial infarction between regions with low and high catheterization access...

..However, additional study is required to better define the role of routine functional testing in this subgroup of patients...

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..However, little is known about medication use among patients with coronary artery disease who undergo percutaneous coronary intervention (PCI)...

..However, current data do not support the use of beta-blockers, CCBs, and nitrates, and more evidence is needed regarding the use of ACE inhibitors...

..Smoking cessation aids effect a modest increase in smoking abstinence at 12 months compared with placebo. In spite the apparent success of cessation aids, smoking relapse rates are quite high...

..The objective of this study was to examine the impact of a routine ETT strategy early after PCI on follow-up cardiac events and procedures...

..There is little consensus regarding the use of functional testing after percutaneous transluminal coronary angioplasty (PTCA). Some physicians employ a routine functional testing strategy, and others employ a symptom-driven strategy...

..However, the use of these agents among patients undergoing coronary artery bypass graft (CABG) remains poorly understood...

..Although the management found at hospitals without on-site catheterization does not lead to increased mortality, little it known about its impact on resource utilization and non-fatal outcomes...

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..CONCLUSION: In practice, antiplatelet and anticoagulant combinations lead to modest increases in bleeding risk in elderly patients, but the overall risk is small...

..Coronary artery bypass graft surgery (CABG) in women has been associated with worse clinical outcomes than CABG in men. However, little is known about the impact of sex on the cost of CABG...

..Increased restrictions may reduce access to evidence-based therapy among patients with chronic disease. We sought to evaluate the impact of increased restrictions on medication use among heart failure (HF) patients...

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..We sought to determine whether there is a difference in in-hospital outcomes and costs for coronary artery bypass graft surgery (CABG) between the United States and Canada...

..Given the aging North American population, these results have important implications for health care planning for the next several decades...

..Hospital readmissions are common during the 6 months following AAA repair. Patients who are readmitted experience long lengths of stay and high mortality rates, and their care incurs high costs...

..Through the AMI-QUEBEC Study we sought to describe delays to reperfusion therapy for ST-segment elevation myocardial infarction (STEMI) and to identify factors associated with prolonged delays...

..This differential reflects increased nonsurgical costs among patients undergoing nonelective CABG rather than surgical costs...

..We conducted a systematic review and meta-analysis to examine the association between anemia and mortality among patients with ACS...

..New data from fibrate trials can be synthesized with the existing literature to better estimate their effects...

..The critical question of why peroxisome proliferator-activated receptor agonists seem to improve cardiovascular risk factors without significantly improving cardiovascular outcomes requires further investigation...

..Intensive statin therapy reduces major adverse cardiovascular events (MACE), but the effect on mortality is unclear...

..However, trials with long-term follow-up should be repeated in the current clinical context and should include both hard and softer outcome measures...

..We conducted a systematic review and meta-analysis to evaluate the efficacy of isolated aerobic exercise programs in overweight and obese populations...

..The inclusion of these costs renders the widespread use of DES not cost effective in the United States in terms of cost per quality-adjusted life-year gained and cost per revascularization avoided...

..These results suggest that diabetic patients may benefit from more aggressive surveillance during the first year after CABG surgery...

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..We sought to analyse the contemporary evidence for OPCAB vs. conventional coronary artery bypass (CCAB), incorporating recent larger trials, and adjusting for differences in trials using a technique known as meta-regression...

..Patients exposed to low-dose ionizing radiation from cardiac imaging and therapeutic procedures after acute myocardial infarction may be at increased risk of cancer...

..The purpose of this study was to test the value of gait speed, a clinical marker for frailty, to improve the prediction of mortality and major morbidity in elderly patients undergoing cardiac surgery...

..They also appear to be safe in the short to medium term, although definitive conclusions are not possible. Larger studies with longer follow-up are needed to define better the role of these new devices...

..For the secondary end points measuring functional status and quality of life, scores were also similar. There was little difference in the rates of invasive cardiac procedures for the 2 groups at 9 months...

..Prevention and targeted control of risk factors for CAD could potentially reduce the impact of CAD in the developing world as it has in industrialized nations...

..With a decreased risk for intracranial bleeding, they appear to have a favorable safety profile, making them promising alternatives to warfarin...

..In conclusion, the addition of cilostazol to dual antiplatelet therapy after percutaneous coronary intervention has favorable effects on TLR and TVR at 1 to 12 months, with no differences in adverse outcomes at any follow-up duration...

..We aimed to conduct a systematic review and meta-analysis of randomized-controlled trials (RCTs) in order to compare the mid- and long-term effects of RVA and RVNA pacing...

..Long-term treatment with beta-blockers reduces mortality after acute myocardial infarction (AMI). Whether beta-blockers exert a class effect is unknown...

..The objectives of this study were to determine the cost of hospitalization for AF and to identify the main determinants of this cost in a Canadian setting...

..Long-term treatment with statins reduces mortality in patients with congestive heart failure (CHF). Whether statin agents exert a class effect is unknown...

..The use of perioperative cardiac medical therapy among patients undergoing coronary artery bypass graft surgery (CABG) has not been closely examined...

..However, existing data from trials do not address whether all ACE inhibitors benefit patients similarly...

..CONCLUSION: Although cardiac drugs are under-prescribed to patients with AMI, once prescribed, patients are likely to adhere to these prescriptions, with high rates of compliance and persistence...

..However, it remains unclear whether functional status and quality of life are affected by an invasive strategy...

..Several clinical variables may help identify which hypertensive patients are at higher risk for clinical events...

..2). Thus, post-CABG patients have an increased risk of developing a cardiac event or needing a follow-up cardiac procedure during the 6 months after PTCA...

..CONCLUSION: If post-CABG functional testing is performed, stress ventricular imaging is superior to ETT alone for the diagnosis of graft stenosis or progression of disease in the native vessels...

..3%) and procedures (6.3%). CONCLUSIONS: Because routine functional testing 1 year after CABG is associated with extremely low event rates, this strategy does not appear to be warranted...

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..Acupuncture, hypnotherapy, and aversive smoking are the most frequently studied alternative smoking cessation aids. These aids are often used as alternatives to pharmacotherapies for smoking cessation; however, their efficacy is unclear...

..However, the observed trend is toward increasing use of therapeutic procedures with proven mortality benefit undertaken earlier in the disease course and away from diagnostic procedures in the subsequent years after AMI...

..The objective of this study was to determine the discordance in interpretations when meta-analysts are presented with identical data...

..CAP complicating percutaneous coronary intervention is rare, and its morbidity and mortality vary directly with Ellis classification. Management discrepancies highlight the need to establish a uniform treatment paradigm for CAP...

..The impact of routine revascularization on functional status and quality of life requires evaluation in specific, randomized, controlled trials...

..Maintaining dual antiplatelet therapy is the mainstay of perioperative ST prevention. However, short-term discontinuation of thienopyridines might be associated with relatively low risk if aspirin therapy is maintained perioperatively...

..Plasma DD may thus be used to identify subjects who are unlikely to benefit from further aortic imaging...

..CONCLUSIONS: There are minimal differences between the cardiology and radiology interpretations of coronary angiograms. Routine second reading by a radiologist may be redundant...

..This study was designed to determine whether statins reduce all-cause mortality in elderly patients with coronary heart disease...

..Further research and sound clinical judgment may lead to the identification of high-risk individuals in whom statins should be avoided...

..Data regarding mid-/long-term outcomes were limited and inconclusive. Large RCTs with longer follow-up are required to determine long-term safety and efficacy...

..Thus, GP IIb/IIIa inhibition may provide only limited benefits in the setting of acute ST-segment elevation MI...

..In these subsequent trials, sirolimus and paclitaxel DESs continued to exceed the therapeutic potential of BMSs, with a slight but consistent angiographic advantage being observed with the sirolimus DESs...

..In contrast, data from animal and human studies suggest that catheter-based intracoronary brachytherapy can prevent in-stent restenosis and reduce clinical events post-PCR...

..74; 95% CI: 0.65 to 0.84). CONCLUSION: Both early and late administration of ACE inhibitor therapy are associated with lower mortality following myocardial infarction, with the largest benefits observed with long-term mortality...

..There is mounting pathologic and immunologic evidence that Chlamydia pneumoniae plays a role in the atherogenic pathway. However, very few clinical studies have supported these findings...

..Although mortality rates do not differ, it is unknown if quality of life (QOL) and functional status differ...

..We assessed the impact of this drug policy reform on prescribing patterns for essential cardiac medications, utilization of medical care and related health outcomes after acute myocardial infarction...

..Our objective was to describe trends in revascularization procedures and outcomes in a provincial cohort of very elderly patients who had experienced acute myocardial infarction...

..There are a number of guidelines for the pre-flight assessment of patients with pulmonary and/or cardiac diseases. However, these data are based on small studies in patients with a limited group of diseases...

..Thus, long-acting calcium channel blockers may be safely used in the management of hypertension and angina. However, as a class, they are not as protective as other antihypertensive agents against heart failure...

..In the setting of CHF, rates of cardiac outcomes do not differ substantially between ARBs and ACE inhibitors. However, their combination may improve outcomes for patients with CHF...

..INTERPRETATION: Our results suggest that, under current usage, statins are equally effective for secondary prevention in elderly patients after AMI...

..Procedural rates did not differ significantly between the two groups. These results suggest that routine post-PCI FT in patients with diabetes is of little clinical value...

..Further research is, therefore, needed to elucidate the value of myocardial laser revascularization...

..The presence of interprovincial differences in risk-adjusted outcomes raises the possibility of variable quality of care for patients undergoing PCI across the Canadian provinces...

..We explore the major trials and use the latest clinical guidelines as a framework for our discussion on the applicability of this procedure in the setting of acute coronary syndromes and stable coronary disease...

..The difference in total treatment costs between Canadian and American hospitals was partially attributable to differences in direct costs, but was largely due to differences in overhead costs...

..Predictors of subsets of MADIT II patients most likely to benefit from ICD therapy are urgently needed in order to prioritize allocation of healthcare resources...

..8% vs. 6.6%; P=0.033). Our study suggests that routine functional testing may be beneficial to patients not treated with stents...