Rajendra H Mehta

..However, the effects of the time of the day, the day of the week, or monthly/seasonal changes on acute aortic dissection (AAD) have not been well studied...

..Accordingly, the goal of present study was to evaluate clinical correlates of long-term mortality and to develop a simple bedside tool for risk stratification in patients undergoing SVG interventions...

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..Further studies are required to address the prognostic significance of VT/VF in patients with STEMI undergoing PPCI...

..These data highlight the importance of understanding factors associated with gender-related differences in bleeding and represent an opportunity for improving outcomes of women and men with fibrinolytic-treated STEMI...

..These data support the routine use of coronary stenting in most patients undergoing primary PCI, when feasible...

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..While highest incidence of AAD occurred in the morning and winter, clinical events (including mortality) were similar during the four different periods of the 24 h (chi2 = 1.9, p = 0.60) and seasonal (chi2 = 1.2, p = 0.75) periods...

..Importantly, our data suggest that no increase in mortality occur, if ITVR is promptly performed to treat recurrent ischemia after primary PCI...

..Adverse events occur following non-ST elevation acute coronary syndromes (NSTE ACS). However, the timing of these events in relation to index event is less clear...

..962 (95% CI 0.896 to 1.033). These data indicate that height-related differences in 30-day mortality are explained in large part by height-related differences in patients' clinical characteristics...

..These data provide insight into the clinical and angiographic factors that predict TLR at 9 months in ZES-treated patients, making possible the focused surveillance of selected ZES-treated patients who might be at greater risk of TLR...

..These differences should be kept in context when counseling patients undergoing CABG and may help facilitate targeted strategies to improve short- and long-term mortality risks after CABG...

..There exist few studies that characterize contemporary clinical features and outcomes or risk factors for operative mortality in cardiogenic shock (CS) patients undergoing coronary artery bypass grafting (CABG)...

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..Accordingly, the current study examines the relationship of African American race to patient-related clinical factors, angiographic findings, and clinical events...

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..The influence of an internal mammary artery (IMA) graft on long-term outcomes after percutaneous saphenous vein graft (SVG) intervention is currently unknown...

..This information may help physicians in deciding treatment options for patients with cardiogenic shock and counseling them about their risks...

..Estimation of an individual patient's risk for postoperative dialysis can support informed clinical decision making and patient counseling...

..However, the relative prognostic importance of these measures over other baseline variables is less known...

..We sought to determine recent trends in adherence to guideline-based therapies for NSTE ACS...

..We sought to assess the influence of emergency department (ED) structure and care processes on adherence to practice guidelines for the treatment of patients with non-ST-segment elevation acute coronary syndromes...

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..This low risk along with the less invasive nature of the procedure should make CAS an attractive and perhaps preferred option for the treatment of these patients...

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..Limited data exist on the long-term outcomes among diabetic patients undergoing saphenous vein graft (SVG) interventions. Thus, the baseline clinical factors associated with long-term adverse events in these patients are less known...

..While most comparisons of hospital outcomes adjust for patient characteristics, process performance comparisons typically do not...

..Whether the relatively lower dose results in lower effectiveness of fibrinolytic agents versus primary percutaneous coronary interventions (PCI) in patients with higher body mass index (BMI) is not known...

..However, these studies, because of the small number of patients, were unable to adequately account for patient case-mix and included both those undergoing elective surgery and those undergoing urgent surgery...

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..The purpose of this study was to examine the association between lower socioeconomic status (SES), as ascertained by years of education, and outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI)...

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..Thus, major emphasis should be on prevention of ARF in patients undergoing CABG...

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..Although both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are used in patients with CS with multivessel coronary disease, the optimal revascularization strategy in this setting remains unknown...

..Reoperation for bleeding represents an important complication in patients undergoing coronary artery bypass surgery (CABG). Yet, few studies have characterized risk factors and patient outcomes of this event...

..To evaluate the influence of achieving secondary prevention target treatment goals for cardiovascular (CV) risk factors on clinical outcomes in patients with prior coronary artery bypass surgery (CABG)...

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..Limited information exists on the impact of preoperative renal dysfunction on internal thoracic artery and saphenous vein graft failure and 2-year clinical outcomes in patients undergoing coronary artery bypass surgery...

..e., death and/or rehospitalization) in patients with HF in the design of treatment strategies for novel therapeutic agents in randomized controlled clinical trials...

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..Information on practice patterns and outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary interventions (PCIs) in Canada vs United States is limited...

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..In this retrospective analysis, we examined the relationship between VGF, assessed by coronary angiography 12 to 18 months after coronary artery bypass graft surgery, and subsequent clinical outcomes...

..Developing and fostering a collaborative culture allowed hospital teams to avoid barriers or overcome them successfully based on others' experiences and collectively solve problems, and it shortened the learning curve and accelerated QI...

..The purpose of this study was to examine the in-hospital outcome and influence of glycoprotein (GP) IIb/IIIa antagonists on patients with acute coronary syndromes (ACS) across a range of renal function...

..The objective of this analysis was to describe the survival of patients with sustained ventricular tachycardia/ventricular fibrillation after myocardial infarction according to antiarrhythmic drug treatment...

..We compared the 5-year clinical outcomes of patients in PREVENT IV treated with edifoligide and placebo to identify predictors of long-term clinical outcomes...

..0% vs. 73.6%, P = 0.05). CONCLUSION: Elderly patients are less likely to receive guideline-indicated therapies when hospitalized with myocardial infarction. The effects of age were largest for acute reperfusion and smallest for aspirin...

..Whereas quality of care is lower in patients with secondary diagnosis of AF, opportunity for quality improvement exists for both groups of patients with AF...

..This risk is accentuated in troponin-negative, CK-MB positive patients who do not demonstrate ST elevation by electrocardiogram...

..59 (0.41-0.86), P<0.0001]. CONCLUSION: Our data suggest that the combination of clopidogrel with a statin has synergistic effects on the clinical outcomes of patients with non-ST-segment elevation ACS...

..These data highlight the need for caution when ascribing a causal relationship to associations between incorrect dosing and adverse outcomes...

..We investigated whether greater use of secondary prevention medications after coronary artery bypass graft surgery is associated with improved clinical outcomes...

..Since the broad dissemination of practice guidelines, the association of specialty care with the treatment of patients with acute coronary syndromes has not been studied...

..Clearly targeted large-scale clinical trials are needed to evaluate the relative merits of available reperfusion strategies as well as newer antithrombotic adjunctive therapies in the elderly with STEMI...

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..Additional studies are needed to confirm these preliminary findings and to determine the financial implications of the new criteria...

..The relationship between catheterization timing and acute kidney injury after proximal aortic surgery remains unknown...

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..Recently, 30-day readmission rates have been proposed as a metric for care of patients with STEMI. However, international rates and predictors of 30-day readmission after STEMI have not been studied...

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..Phase 2 trial data suggest that MC-1 may reduce death or MI in high-risk patients undergoing CABG surgery...

..Although preferably D2B times should be <or=90 minutes, it is unclear how consistently this is achieved in community practice, particularly in women, elderly people, and minorities...

..Identifying high-risk heart failure (HF) patients at hospital discharge may allow more effective triage to management strategies...

..Despite its high mortality, prognosis can be improved with timely and effective use of evidence-based treatment in the acute setting. This review outlines the critical care management strategies for ST-segment MI (STEMI)...

..Ultimately, the failure or success of this initiative will depend on an indication that the demonstrated improvement in the quality indicators is sustained over time...

..This initial project provides a foundation for future initiatives aimed at quality improvement...

..Higher quality of care, as documented by better performance based on measures derived from practice guidelines, is associated with improved outcomes in patients with cardiovascular disease...

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..We performed a phase 2 randomized trial to evaluate the safety and feasibility of M118 in the setting of elective percutaneous coronary intervention...

..Because depression has also been shown to be associated with increased mortality in these patients, it remains unclear if this association is attributable to the use of antidepressants or to depression...

..However, their preoperative risk factors, and in-hospital and long-term outcomes have not been thoroughly investigated...

..We investigated whether these and other measures improved after a quality improvement initiative...

..If these complications are excluded, syncope alone does not appear to increase the risk of death independently...

..This study evaluated clinical outcomes in patients with acute myocardial infarction (MI) treated with fibrinolytic therapy in hospitals with and without coronary revascularization capability...

..Rather, patients' clinical risk score is the overriding determinant of clinical outcomes. Our findings emphasize the power of a well-organized high-volume system to minimize the impact of operator factors on outcomes of PCI...

..The prognostic significance of specific findings on imaging studies is less well described. We sought to identify the prognostic value of transesophageal echocardiography (TEE) in medically and surgically treated patients with AAD...

..In addition, identification of an at-risk subset may allow modification of reversible periprocedural factors that may help decrease postprocedural ARF...

..The care process itself must be reengineered to build in the systems and time required to accomplish continuous evaluation and improvement...

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..The clustering of final TIMI < or =2 flow in high-risk groups may partially explain the poor prognosis of these patients. Awareness of these risk factors may be useful to clinicians to triage and treat patients undergoing primary PCI...

..This study describes several quality indicators of care in hospitalized stroke patients in Michigan from 1998 to 1999...

..Evidence-based cardiac therapies are underutilized in elderly patients. We assessed differences in practice patterns, comorbidities, and in-hospital event rates, by age and type of acute coronary syndrome (ACS)...

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..This could be of practical interest for emergency doctors and could have significant implications for acute treatment, because several studies have reported a lowered efficacy of thrombolytic drugs in the morning hours...

..Our data support the importance of aneurysm surveillance and prophylactic surgical intervention for patients with Marfan's syndrome to potentially reduce the risk of mortality...

..Few data exist on gender-related differences in clinical presentation, diagnostic findings, management, and outcomes in acute aortic dissection (AAD)...

..The low rates of adherence to quality indicators in patients undergoing CABG suggest that these patients should be particularly targeted for quality improvement efforts...

..Statins administered early in patients with acute coronary syndromes may lead to modest reductions in recurrent ischemic events...

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..Upon recognition, renal impairment indicates a need for close monitoring, aggressive blood pressure control, and evaluation of aortic branch vessel circulations...

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