E P Havranek

..Ethnic minorities are at proportionately greater risk for developing extracoronary vascular disease including heart failure and cerebrovascular disease...

..We therefore sought to determine the extent to which provider and hospital characteristics contribute to small-area geographic variation in heart failure care after controlling for patient factors...

..The primary purpose of this study was to determine the acute and long-term hemodynamic and clinical effects of irbesartan in patients with heart failure...

..Serial decline in electrocardiographic voltage in patients with increased left ventricular mass has been associated with a lower risk of cardiovascular events...

..After 3 years of experience with the National Heart Failure project, it is appropriate to highlight the issues pertinent to future quality improvement initiatives in heart failure care...

..We sought to describe a contemporary national sample of elderly patients with HF and to examine the sample for age-related trends in clinical characteristics...

..The objective of this study was to identify the factors associated with the development of depressive symptoms in outpatients with heart failure (HF)...

..Identification and treatment of depressed CHF patients may significantly improve level of functioning in these patients...

..Other interventions, such as opinion leaders and patient-directed interventions, may be necessary in order to improve the care of AMI patients...

..1; 95% CI, 1.2-4.6; P =.04), treadmill time was not (RR = 0.87; 95% CI, 0.73-1.03; P = 0.11). CONCLUSIONS: A patient-reported measure of perceived health predicts events in patients with heart failure...

..These findings suggest that anemia may be predominantly a marker rather than a mediator of increased mortality risk in older patients with HF...

..Little is known, however, about the complexity and financial burden of medical therapy in this population...

..We studied the adoption of spironolactone therapy after publication of the Randomized Aldactone Evaluation Study (RALES) in national cohorts of older patients hospitalized for heart failure...

..CONCLUSIONS: Elevated glucose is common, rarely treated, and associated with increased mortality risk in elderly acute myocardial infarction patients, particularly those without recognized diabetes...

..Distinct morbidity and mortality burdens in black versus white patients underscore the importance of improving patient risk-stratification, defining optimal therapies, and exploring physiological underpinnings of racial differences...

..Whether this results in adverse outcomes is unknown...

..CONCLUSIONS: There were small sex differences in the quality of care provided to fee-for-service Medicare patients hospitalized with heart failure, although women had higher rates of survival than men up to 1 year after hospitalization...

..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...

..We tested the hypothesis that one health status measure, the Kansas City Cardiomyopathy Questionnaire (KCCQ), provides prognostic information independent of other clinical data in outpatients with heart failure (HF)...

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..Left ventricular hypertrophy is a major independent risk factor for cardiovascular mortality. The contribution of left ventricular hypertrophy to racial and ethnic differences in cardiovascular mortality is poorly understood...

..Electrocardiographic criteria for the diagnosis of left ventricular hypertrophy in current use were defined using autopsy results or echocardiography; criteria defined using mortality might be more clinically meaningful...

..Long-term trends in the clinical characteristics, quality of care, and outcomes for AMI over time from the health system perspective in geographically diverse populations are not well known...

..Prior studies have reported conflicting findings concerning the association of socioeconomic status (SES), treatment, and outcomes in patients hospitalized with heart failure (HF)...

..This association appears to be explained, in part, by coexistent depression. Future studies should evaluate interventions such as depression treatment to improve medication adherence and health status...

..Our objective was to evaluate the association between statin use and survival among a national sample of elderly patients hospitalized with HF...

..Although intimate partner violence is common, the prevalence in patients hospitalized on internal medicine services and whether it is associated with numerous positive responses to the review of systems are not known...

..Our objective was to determine the proportion of older persons meeting enrollment criteria of randomized controlled trials of agents that prolong life in heart failure...

..Further studies to establish the safety and effectiveness of this practice are needed to ensure optimal care of patients with diabetes and heart failure...

..Little is known regarding the use of secondary prevention in older patients undergoing CABG during hospitalization for acute myocardial infarction (AMI)...

..Several patient characteristics, including age and sex, were associated with the use of specialty care, suggesting that factors other than clinical presentation may independently influence the use of specialty care...

..Preserved systolic function increases in both men and women with CHF with increasing age, but women are far more likely than men to have preserved systolic function at all ages...

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..This study was designed to determine if women are more likely than men to have heart failure (HF) with preserved systolic function after adjustment for potential confounders, including age...

..CONCLUSIONS: Overt albuminuria predicts the occurrence of HF hospitalizations in type 2 diabetic patients. Thus early aggressive treatment of diabetic nephropathy should be investigated as a means of preventing of HF...

..This review highlights the importance of heart failure in the older population and identifies the specific areas where research and policy initiatives may be instrumental in reducing the impact of the condition...

..To increase the use of guideline-based pharmacotherapy in vulnerable patients (ethnic minorities and the poor) with coronary artery disease (CAD) through a nurse-based quality-improvement program...

..These results underscore the importance of treatments aimed at maintaining functional status in older persons with heart failure, including those with significant baseline functional limitations...

..Our objectives were to assess the correlates of ACE inhibitor use and the relationship between ACE inhibitor prescription and mortality in older patients with heart failure...

..Acute, simultaneous presentation of both life-threatening entities and the hemodynamic course have not been described...

..This relationship may be helpful in examining the cost-effectiveness of new treatments for heart failure...

..This approach will require a rationally designed health care delivery system that applies the best available evidence to the care of individual patients with heart failure...

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..An outpatient practice-based project, the Heart Failure Practice Improvement Effort (HF PIE), was described in the fourth and sixth columns. This column reports experience from the HF PIE project at the practice level in three states...

..This study compared 6-month rehospitalization rates among patients assigned to predischarge beta-blockade coupled with postdischarge nurse management (intervention) versus usual care...

..Older age is a risk factor for higher mortality after acute myocardial infarction (AMI), but the association with health status outcomes is largely unexplored...

..Only MDRD eGFR was less adequate in quantifying risks for patients with mild impairment. Novel estimators, such as the Mayo eGFR, may play an important role in outcomes' prognostication for these patients...

..Failure to respond to the need for palliative care puts at risk the mandate to treat the patient with heart failure during the entire course of illness...

..We sought to determine the impact of these insulin sensitizers on outcomes in diabetic patients after hospitalization with acute myocardial infarction (AMI)...

..This suggests that these measures may assess different aspects of heart failure severity, and that physiologic measures do not reflect patients' perceptions of the impact of heart failure on their health status...

..We sought to determine patterns of aspirin use and the relationship between aspirin prescription and outcomes in patients with coronary artery disease (CAD) and heart failure (HF)...

..Whether specialty care improves survival among patients with heart failure remains controversial...

..This article describes each of these challenges in turn...

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..CONCLUSION: Research on which to base advice for HF patients is greatly needed...

..To characterize the relationship between hydroxymethylglutaryl-CoA reductase inhibitors (statins) and outcomes in older persons with acute myocardial infarction (AMI)...