F A Spencer

..This manuscript reviews recent insights from work in this area, including recent important trials evaluating the impact of renin-angiotensin system inhibition, early beta-blockade, and aggressive reperfusion strategies...

..A secondary objective was to determine differences in demographic and clinical characteristics, treatment, and hospital death rates in patients presenting with HF compared with those developing HF after presentation...

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..It has been suggested that withdrawal of statin therapy during an acute coronary syndrome may attenuate any benefits of pretreatment, thereby providing indirect evidence of the importance of their non-lipid-lowering effects...

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

..26, 95% confidence interval 2.49 to 7.31). The results of this community-wide study provide insights into recent trends in the development of acute stroke after AMI and into the profile of high-risk patients...

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..In conclusion, data from this large national registry have indicated that most patients with a history of CAD were not receiving the recommended combination of cardiac medications before their AMI...

..The purpose of this study was to examine the magnitude, risk factors, management strategies, and outcomes in a population-based investigation of patients with upper, as compared with lower, extremity deep vein thrombosis diagnosed in 1999...

..Inpatient CR often represents cardiac patients' first exposure to risk factor modification education and acts as a gateway to outpatient programs...

..The efficacy and cost effectiveness of this strategy in these patients has not yet been determined in clinical trials...

..However, subjects enrolled in these studies may not be representative of patients seen in the community setting...

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..However, as the patient slowly stabilizes after appropriate interventions, it is necessary to de-escalate the treatment in accordance with decreasing net benefit of prolonged combination therapy...

..Unlike major hemorrhagic complications, there is no evidence that the intensity of anticoagulation associated with heparin or hirudin administration influences the occurrence of rupture...

..Despite its prevalence, the common demographic features, current hospital-based management, and short-term clinical outcome among patients with non-ST-segment elevation MI remain poorly defined...

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..The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI...

..The purpose of our study was to describe the use of different cardiac medications in 2463 patients with new-onset HF who were discharged from all greater Worcester, Massachusetts, hospitals during 2000...

..Dose adjustments or anti-Xa coagulation monitoring or both will be necessary rarely in routine clinical practice, with the exception of patients with severe renal insufficiency...

..To examine age-specific differences in clinical presentation, receipt of therapeutic practices and lifestyle recommendations, and hospital and long-term survival in patients hospitalized for acute heart failure HF...

..This observational study sought to determine whether cases of acute myocardial infarction (AMI) reported to the second National Registry of Myocardial Infarction (NRMI-2) varied by season...

..v.) unfractionated heparin among patients with acute coronary syndromes...

..The purpose of this study was to examine 2 decade-long trends in the use of aspirin and associated outcomes in patients hospitalized with acute myocardial infarction...

..Because these data are not generalizable to all patients with acute myocardial infarction, we sought to better understand the scope of this problem in a "real-world" setting...

..The long-term prognosis of patients with inferior MI and CHB is similar to that of patients in whom CHB did not develop. Patients with anterior MI and CHB may be at an increased risk of long-term mortality...

..These decisions must be tempered by our observation that major bleeding occurs frequently in these patients...

..The superiority of LMWH preparations characterized by high in vitro factor Xa to thrombin inhibitory capacity is supported by clinic trial data but requires further investigation...

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..While there have been marked advances in diagnostic and therapeutic strategies for venous thromboembolism, our understanding of its clinical epidemiology is based on studies conducted more than a decade ago...

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..Current practice guidelines recommend the routine use of several effective cardiac medications in hospital survivors of acute myocardial infarction (AMI)...

..In conclusion, our results indicate that the incidence and hospital death rates associated with VF have decreased during recent years...

..3% being HIT. Regardless of whether patients had clinically recognized HIT, GAT, or other thrombocytopenia, all 3 groups had significantly higher rates of major bleeding, recurrent infarction, stroke, and death...

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..Future study of antithrombotic strategies for VTE should be informed by this finding. Advances that result in decreased bleeding rates may paradoxically decrease the risk of VTE recurrence...

..We describe the use of antithrombotic therapy in the management of patients with acute coronary syndromes...

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..Limited contemporary data are available about changing trends in the use of coronary reperfusion strategies, particularly from a population-based perspective...

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..We sought to determine the temporal trend of in-hospital major bleeding among patients with NSTE-ACS, in relation to the evolving management pattern...

..The results of this study suggest changing patterns in death rates due to HF in a large northeastern community...

..Given the magnitude of AMI and evolving approaches to manage it, continued monitoring of these trends remains of considerable clinical and public health importance...

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..We hypothesized that the specificity of sensitive D-dimer assays could be improved without compromising sensitivity by using higher D-dimer cut-off values...

..The objective of this study was to examine the temporal trends and patterns of early clopidogrel use (within the first 24 hours of hospitalization) across the spectrum of patients with ACS in Canada...

..In conclusion, results of this population-based study suggest that a large proportion of patients with AMI continue to show prolonged prehospital delay...

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..Whether these changes will result in future declines in VTE incidence and/or improved outcomes in the community setting will require further surveillance...

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..The potential benefit that may be achieved by the replacement of these historically problematic narrow therapeutic index agents must be weighed against as yet undetermined long-term risks of hepatotoxicity...

..The purposes of this observational study were to describe the frequency of VTEs occurring in the outpatient setting, characterize the prevalence of previously identified risk factors for VTE, and identify previous use of VTE prophylaxis...

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..However, the nature and clinical significance of this association remain unclear, particularly as it relates to age of presentation...

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..Pretest probability assessment for DVT diagnosis has never been evaluated in pregnant women...

..Despite the considerable prevalence of HF in the United States, there are limited published data describing the contemporary long-term prognosis of patients hospitalized with decompensated HF...

..We examined the demographic and clinical characteristics of patients who received these diagnostic and interventional procedures and determined whether the profile of patients undergoing these procedures had changed over time...

..Trends in the magnitude of stroke in the setting of AMI are not well characterized, however, and neither have contemporary trends in the hospital death rates of patients developing acute stroke been examined...

..Warfarin and aspirin (acetylsalicylic acid [ASA]) are the most commonly used anticoagulant and antiplatelet drugs in the treatment of cardiovascular disease...

..The purpose of this study was to measure and compare clinical characteristics and outcomes of patients with validated symptomatic PE and isolated DVT in a New England community...

..Nevertheless, individual risk factors, or combinations thereof, can have important implications for the type and duration of appropriate prophylaxis and should be carefully reviewed to assess the overall risk of VTE in each patient...

..The differing effects of UFH and LMWH on vascular endothelial cell TFPI synthesis, release and reserve with prolonged administration require further investigation...

..Our data identify several high-risk groups that should be targeted for more aggressive surveillance and increased use of effective cardiac therapies and interventions...

..In conclusion, results of this large multinational registry provided insights into contemporary patterns of care-seeking behavior in patients with acute coronary disease...

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..0001). In conclusion, the use of statin therapy within the first 24 hours of hospitalization for AMI is associated with a significantly lower rate of early complications and in-hospital mortality...

..Although no differences in hospital death rates were evident in patients receiving triple therapy, this population was at significantly increased risk of major bleeding episodes during hospitalization...

..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...

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..This study examined the incidence and outcomes of hemorrhagic and nonhemorrhagic stroke and risk factors associated with stroke in patients with ACS...

..Our aim was to characterize the clinical practices for VTE prophylaxis in acutely ill hospitalized medical patients enrolled in the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE)...