D B Mark

..In the PURSUIT trial, eptifibatide significantly reduced the 30-day incidence of death and myocardial infarction relative to placebo in 9461 patients with an acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction)...

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..We examined long-term economic implications of these results...

..The impact of SVR on quality of life (QOL) and medical costs is unknown...

..Quality of life (QOL) outcomes for both the patient and spouse/companion were secondary end points...

..Reducing the length of hospitalizations can reduce short-term costs, but there are few data on the long-term clinical and economic consequences of early discharge...

..This study examined the impact of early hospital discharge on short-term clinical outcomes of elderly patients treated with coronary artery bypass graft surgery (CABG) in the United States in 1992...

..These findings also have implications for the design and interpretation of psychosocial interventions...

..We compared the acute and one year medical costs and outcomes of coronary stenting with those for balloon angioplasty (percutaneous transluminal coronary angioplasty) in contemporary clinical practice...

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..However, its usefulness for providing diagnostic estimates has yet to be determined...

..We compared the clinical and economic burden of CAD during the acute phase (first 30 days) with that in the postacute phase (31st day through 10 years)...

..We sought to determine the course of cognitive change during the five years after CABG and the effect of perioperative decline on long-term cognitive function...

..We studied the relationship between diabetes and survival after revascularization in a large prospective cohort of patients with multivessel coronary artery disease...

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..However, no data exist for the economic effect of stroke in the setting of acute MI (AMI). The purpose of this prospective study was to assess the effect of stroke on medical resource use and costs in AMI patients in the United States...

..The purpose of our investigation was to determine the association between cognitive dysfunction and long-term quality of life after cardiac surgery...

..This paper discusses these issues and suggests strategies to deal with them. A proposed methodology is developed, applied and evaluated on a large observational database that has long-term follow-up on nearly 10 000 patients...

..This investigation divided depressive symptoms into groups to assess their relative effectiveness in predicting survival...

..We sought to determine the ability of a treadmill score to provide accurate diagnostic and prognostic risk estimates in women...

..The aim of this study was to examine the effects of provider profiling on bypass surgery access and outcomes in elderly patients in New York...

..No increase in major bleeding was seen...

..To identify the prevalent and prognostically important coexisting illnesses among single coronary artery disease (CAD) patients...

..To describe long-term temporal trends in patient characteristics, processes of care, and in-hospital outcomes among unselected admissions within the contemporary coronary care unit...

..To evaluate the relationship between how much a new cardiovascular therapy improves clinical outcomes over current therapies and how much more it can cost while still remaining 'economically attractive'...

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..Interventions designed to reduce emotional distress could improve patient's perceived cognitive abilities following CABG...

..We evaluated the quality-of-life and economic outcomes associated with the use of this strategy...

..In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), 2521 patients with moderate heart failure were randomized to receive amiodarone, implanted cardioverter-defibrillators (ICDs), or placebo...

..However, in the range of survival benefit observed in MADIT-II, ICD therapy for these patients is economically attractive by conventional standards...

..At 37 months average follow-up, patients in both groups had similar mortality. We determined the incremental costs associated with the use of digoxin in this high-risk population...

..Ninety-nine percent of pacemakers implanted in the United States include an option for rate modulation...

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..Because the natural history of these patients is less defined, the appropriate end points for trials of novel revascularization therapies involving patients with advanced coronary artery disease are not certain...

..These individuals may subsequently require the greatest degree of care and potentially benefit most from intervention...

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..This study examined the descriptive relationship of self-rated health (SRH) with various psychosocial measures, sociodemographic variables, coronary artery disease (CAD) diagnostic/clinical measures, and medically abstracted comorbidities...

..However, there are few data regarding the costs of HF with normal EF. In a prospective, population-based cohort of elderly participants, we compared the costs and resource use of patients with HF and normal and reduced EF...

..We describe these issues and the controversies that merit continued investigation...

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..Recent studies of drug-eluting intracoronary stents suggest that current antiplatelet regimens may not be sufficient to prevent late stent thrombosis...

..To examine the NEO Personality Inventory (NEO PI) Openness to Experience (O) domain and its facets as predictors of cardiac deaths and all-cause mortality...

..In a prospective, longitudinal cohort of community-dwelling elderly from 4 regions, we examined the long-term costs and resource use of elderly patients with HF...

..This study examined the effect of early discharge after CABG on readmission/death and cost within 60 days of discharge home. Variability in hospitals' tendencies for early discharge and adverse outcomes was also explored...

..This study examined trends in postoperative LOS, associated rates of transfer at discharge and variation among hospitals in LOS at CABG hospitals in New York State...

..We sought to determine the impact of this postoperative cognitive dysfunction on quality of life (QOL) and to characterize the dysfunction from the patient's perspective...

..Trial data reflect how these therapies were delivered more than 20 years ago and do not indicate the relative benefits of medical therapy versus coronary artery bypass grafting in contemporary practice...

..The gentamicin-collagen sponge, an implantable topical antibiotic agent, is approved for surgical implantation in 54 countries. Since 1985, more than 1 million patients have been treated with the sponges...

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..The meeting took place on April 27 to 28, 2009, at the US Food and Drug Administration headquarters in Silver Spring, MD. This article summarizes the issues and directions presented and discussed at the meeting...

..Medical therapy was an economically attractive strategy vs. CABG surgery or PCI for three-vessel CAD patients with CKD, two-vessel CAD patients without CKD, and all single-vessel CAD patients...

..Lower levels of PE during follow-up were also related to increasing decline in function but only in men. Thus, our findings indicate that PE is associated with less decline in functional status following hospitalization for CAD...

..A large, 2-center, randomized trial in Sweden reported in 2005 that the sponge reduced surgical site infection by 50% in cardiac patients...

..We sought to determine whether these differences persist and whether the effect of income-area on mortality is different for African Americans versus patients of other races...

..The proposed methodology is developed, applied, and evaluated in both a large clinical trial cohort with 5-year follow-up on over 23,000 patients and a large observational database with long-term follow-up on over 4000 patients...

..For primary prevention in patients with moderate risk for a coronary event, we recommend aspirin, 75-100 mg/d, over either no antithrombotic therapy or vitamin K antagonist (Grade 1A)...

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..We sought to determine whether dialysis patient mortality rates are associated with differences in dialysis facility size, and whether this relationship differs among higher risk diabetic and lower-risk non-diabetic patients...

..The objective of this study was to compare the long-term clinical outcomes of patients receiving DES vs BMS in a clinical practice setting...

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..We sought to determine the relationship between bleeding, blood transfusion, and measures of costs among patients with non-ST-segment elevation ACS...

..Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 (APOE4) genotype and plasma biomarkers of brain injury and inflammation...

..The purpose of this study was to determine the value of a new anatomic score for prognosis after diagnostic catheterization in patients with previous coronary artery bypass grafting (CABG)...

..This study examined the ability of the total CMHS and an abbreviated form of the CMHS (ACM) to predict survival in a sample of patients with documented coronary artery disease (CAD) with increased statistical power...

..We sought to assess whether depression is associated with an increased risk of mortality...

..Results indicated that smoking and/or sedentary behavior may partially mediate the relation between depressive symptoms and mortality. No evidence for moderation was found...

..Among patients with severe CKD, PCI was not associated with improved survival. CABG is associated with greater mortality reduction than PCI in severe CKD...

..Based on experimental and clinical evidence, this study assessed the potential of intravenously administered lidocaine to reduce postoperative cognitive dysfunction after cardiac surgery using cardiopulmonary bypass...

..We sought to determine whether income-based disparities in care processes and outcome exist in patients with acute coronary syndromes...

..It is unclear whether research conducted at academic institutions adheres to these new standards...

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..An extensive body of research has demonstrated an association between negative affective states and health outcomes. Positive emotions may also influence physical health, however, their examination has received far less attention...

..We assessed the impact of increasing body mass index (BMI) on 10-year outcomes for ACS patients...

..They also had significantly fewer serious cardiac adverse events...

..After controlling for disease severity, there was a significant interaction between age and hostility. Hostility was significantly associated with poorer survival but only in younger (<61.2 years) patients...

..This document summarizes the evidence reviewed at that meeting and the discussions of that evidence...

..Adjusting for patient-mix differences and treating surgeons as random effects was the preferred approach. These results demonstrate the need for hospitals to reexamine their economic profiling methods...

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..Delineation of the various approaches to multinational economic evaluation may assist researchers, peer reviewers, journal editors, and decision makers in evaluating the strengths and limitations of particular studies...

..The US Department of Health and Human Services (HHS), recognizing the financial and clinical impact of this technology, recently proposed accelerated reimbursement to hospitals...

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..Social isolation has been linked to poor survival in patients with coronary artery disease (CAD). Few studies have closely examined the psychosocial characteristics of CAD patients who lack social contact...

..0001). The greatest effects appeared to be concentrated in those patients with less education (p = .04), and the program appeared to increase anxiety in nonwhite patients compared with white patients (p = 0.07)...

..Such time-based risk assessment could guide decision-making in other settings in which randomized studies are impractical...

..Our objective was to determine the prognostic value of estimated metabolic equivalents (METs) based on self-reported functional capacity by the Duke Activity Status Index (DASI) in symptomatic women...

..This review focuses on the standard treadmill exercise test...

..CONCLUSIONS: Hypothermic CPB does not provide additional central nervous system protection in adult cardiac surgical patients who were maintained at either 30 or 35 degrees C during CPB...

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..If not, this strategy should be avoided in this large subgroup of post-MI patients...

..However, patients in whom high-risk features are present after stent placement are at increased risk of ischemic cardiac events even with abciximab treatment...

..ClinicalTrials.gov number, NCT00004562 [ClinicalTrials.gov].)...

..Treatment with amiodarone or an implantable cardioverter-defibrillator (ICD) has been proposed to improve the prognosis in such patients...