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Cost-Effectiveness of Intravascular Imaging-Guided Complex PCI: Prespecified Analysis of RENOVATE-COMPLEX-PCI Trial Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-03-13 David Hong, Jin Lee, Hankil Lee, Juhee Cho, Eliseo Guallar, Ki Hong Choi, Seung Hun Lee, Doosup Shin, Jong-Young Lee, Seung-Jae Lee, Sang Yeub Lee, Sang Min Kim, Kyeong Ho Yun, Jae Young Cho, Chan Joon Kim, Hyo-Suk Ahn, Chang-Wook Nam, Hyuck-Jun Yoon, Yong Hwan Park, Wang Soo Lee, Taek Kyu Park, Jeong Hoon Yang, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Young Bin Song, Joo-Yong Hahn, Danbee Kang, Joo Myung
Background:Although clinical benefits of intravascular imaging-guided percutaneous coronary intervention (PCI) in patients with complex coronary artery lesions have been observed in previous trials, the cost-effectiveness of this strategy is uncertain.Methods:RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance vs Angiography-Guidance on Clinical Outcomes After Complex
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Compression-Only or Standard Cardiopulmonary Resuscitation for Trained Laypersons in Out-of-Hospital Cardiac Arrest: A Nationwide Randomized Trial in Sweden Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-03-06 Gabriel Riva, Erik Boberg, Mattias Ringh, Martin Jonsson, Andreas Claesson, Anette Nord, Sten Rubertsson, Hans Blomberg, Per Nordberg, Sune Forsberg, Mårten Rosenqvist, Leif Svensson, Cecilia Andréll, Johan Herlitz, Jacob Hollenberg
BACKGROUND:The ongoing TANGO2 (Telephone Assisted CPR. AN evaluation of efficacy amonGst cOmpression only and standard CPR) trial is designed to evaluate whether compression-only cardiopulmonary resuscitation (CPR) by trained laypersons is noninferior to standard CPR in adult out-of-hospital cardiac arrest. This pilot study assesses feasibility, safety, and intermediate clinical outcomes as part of
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Patient Characteristics Associated With Using Transcatheter Left Atrial Appendage Occlusion Versus Oral Anticoagulants for Atrial Fibrillation Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-03-05 Kueiyu Joshua Lin, Daniel E. Singer, Jerry Avorn, E. Kevin Heist, Sushama Kattinakere Sreedhara, Priyanka Anand, Yichi Zhang, Theodore N. Tsacogianis, Sebastian Schneeweiss
BACKGROUND:Transcatheter left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation, but the predictors of LAAO use in routine care are unclear. We aimed to assess the utilization trends of LAAO and compare the change in characteristics of LAAO users versus OACs since its marketing.METHODS:Using the US Medicare claims
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Catalyzing Restructure of a Broken Health Care System Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-02-20 Khadijah Breathett, Kimberly D. Manning
I am and always will be a catalyst for change.1 —Shirley Chisholm In 1968—the same year when Martin Luther King, Jr., was assassinated—the tenacious Shirley Chisholm would become the first Black woman to obtain a seat in the US Congress.1 From her humble beginnings growing up in Brooklyn, NY, as the child of immigrants, she saw problems as possibilities and set out to change them. Shortly after her
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Sex-Based Disparities in Acute Myocardial Infarction Treatment Patterns and Outcomes in Older Adults Hospitalized Across 6 High-Income Countries: An Analysis From the International Health Systems Research Collaborative Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-02-08 Hannah Lu, Laura A. Hatfield, Saeed Al-Azazi, Pieter Bakx, Amitava Banerjee, Nitzan Burrack, Yu-Chin Chen, Christina Fu, Michal Gordon, Renaud Heine, Nicole Huang, Dennis T. Ko, Lisa M. Lix, Victor Novack, Laura Pasea, Feng Qiu, Therese A. Stukel, Carin A. Uyl-de Groot, Gabe Weinreb, Bruce E. Landon, Peter Cram
BACKGROUND:Sex differences in acute myocardial infarction treatment and outcomes are well documented, but it is unclear whether differences are consistent across countries. The objective of this study was to investigate the epidemiology, use of interventional procedures, and outcomes for older females and males hospitalized with ST-segment–elevation myocardial infarction (STEMI) and non–ST-segment–elevation
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Safety and Effectiveness of the High-Sensitivity Cardiac Troponin HEART Pathway in Patients With Possible Acute Coronary Syndrome Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-02-08 Simon A. Mahler, Nicklaus P. Ashburn, Brennan E. Paradee, Jason P. Stopyra, James C. O’Neill, Anna C. Snavely
BACKGROUND:The HEART Pathway (History, Electrocardiogram, Age, Risk factors, Troponin) can be used with high-sensitivity cardiac troponin to risk stratify emergency department patients with possible acute coronary syndrome. However, data on whether a high-sensitivity HEART Pathway (hs-HP) are safe and effective is lacking.METHODS:An interrupted time series study was conducted at 5 North Carolina sites
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Impact of Residential Social Deprivation on Prediction of Heart Failure in Patients With Type 2 Diabetes: External Validation and Recalibration of the WATCH-DM Score Using Real World Data Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-02-08 Salil V. Deo, Sadeer Al-Kindi, Issam Motairek, David McAllister, Anoop S.V. Shah, Yakov E. Elgudin, Eiran Z. Gorodeski, Salim Virani, Mark C. Petrie, Sanjay Rajagopalan, Naveed Sattar
Background:Patients with type 2 diabetes are at risk of heart failure hospitalization. As social determinants of health are rarely included in risk models, we validated and recalibrated the WATCH-DM score in a diverse patient-group using their social deprivation index (SDI).Methods:We identified US Veterans with type 2 diabetes without heart failure that received outpatient care during 2010 at Veterans
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Cost of Cardiovascular Disease Event and Cardiovascular Disease Treatment–Related Complication Hospitalizations in the United States Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-02-08 Gabriel S. Tajeu, Natalia Ruiz-Negrón, Andrew E. Moran, Zugui Zhang, Paul Kolm, William S. Weintraub, Adam P. Bress, Brandon K. Bellows
BACKGROUND:Cardiovascular disease (CVD) is among the costliest conditions in the United States, and cost-effectiveness analyses can be used to assess economic impact and prioritize CVD treatments. We aimed to develop standardized, nationally representative CVD events and selected possible CVD treatment–related complication hospitalization costs for use in cost-effectiveness analyses.METHODS:Nationally
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Impact of Embedding a Venous Thromboembolism Risk Assessment Model in the Electronic Health Record Versus Usual Care: A Cluster-Randomized Trial Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-02-06 Michael B. Rothberg, Aaron C. Hamilton, Bo Hu, Megan Sheehan, Jacqueline Fox, Alex Milinovich, Oleg Lisheba, Toyomi Goto, Sidra L. Speaker, Matthew A. Pappas
Background:There are multiple risk assessment models (RAMs) for venous thromboembolism prophylaxis, but it is unknown whether they increase appropriate prophylaxis.Methods:To determine the impact of a RAM embedded in the electronic health record, we conducted a stepped-wedge hospital-level cluster-randomized trial conducted from October 1, 2017 to February 28, 2019 at 10 Cleveland Clinic hospitals
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Classification Algorithm to Distinguish Between Type 1 and Type 2 Myocardial Infarction in Administrative Claims Data Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-01-19 Jason H. Wasfy, Mary Price, Sharon-Lise T. Normand, James L. Januzzi Jr, Cian P. McCarthy, John Hsu
BACKGROUND:Type 2 myocardial infarction (T2MI) and type 1 myocardial infarction (T1MI) differ with respect to demographics, comorbidities, treatments, and clinical outcomes. Reliable quality and outcomes assessment depends on the ability to distinguish between T1MI and T2MI in administrative claims data. As such, we aimed to develop a classification algorithm to distinguish between T1MI and T2MI that
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Role of Biomarkers of Myocardial Injury to Predict Adverse Outcomes in Hypertrophic Cardiomyopathy Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2024-01-19 Yu Zhang, Minghao Liu, Channa Zhang, Yubao Zou, Lianming Kang, Lei Song
BACKGROUND:Serum troponins and CK-MB (creatine kinase-MB) are readily detectable and reliable cardiac-specific biomarkers of subclinical myocardial injury. This study explores the roles of cTnI (cardiac troponin I) and CK-MB in hypertrophic cardiomyopathy (HCM).METHODS:This study included 1045 patients with HCM who had baseline cTnI and CK-MB measurements at Fuwai Hospital between 1999 and 2019. Patients
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Examination of Sexual Identity Differences in the Prevalence of Hypertension and Antihypertensive Medication Use Among US Adults: Findings From the Behavioral Risk Factor Surveillance System Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-20 Yashika Sharma, Anisha Bhargava, Danny Doan, Billy A. Caceres
Background:Recent evidence suggests that sexual minority (eg, gay/lesbian, bisexual) adults might be at increased risk of hypertension compared with heterosexual adults. However, disparities by sexual identity in antihypertensive medication use among adults with hypertension have not been comprehensively examined.Methods:We analyzed data from the Behavioral Risk Factor Surveillance System (2015–2019)
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Perioperative Considerations for Pediatric Patients With Congenital Heart Disease Presenting for Noncardiac Procedures: A Scientific Statement From the American Heart Association Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-15 Viviane G. Nasr, Larry W. Markham, Mark Clay, James A. DiNardo, David Faraoni, Danielle Gottlieb-Sen, Wanda C. Miller-Hance, Nancy A. Pike, Chloe Rotman, on behalf of the American Heart Association Council on Lifelong Congenital Heart Disease and Heart Health in the Young and Council on Cardiovascular Radiology and Intervention
Continuous advances in pediatric cardiology, surgery, and critical care have significantly improved survival rates for children and adults with congenital heart disease. Paradoxically, the resulting increase in longevity has expanded the prevalence of both repaired and unrepaired congenital heart disease and has escalated the need for diagnostic and interventional procedures. Because of this expansion
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Efforts to Improve Survival Outcomes of Out-of-Hospital Cardiac Arrest in China: BASIC-OHCA Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-12 Xi Xie, Jiaqi Zheng, Wen Zheng, Chang Pan, Yu Ma, Yimin Zhu, Huiqiong Tan, Xiaotong Han, Shengtao Yan, Guoqiang Zhang, Chaoqian Li, Fei Shao, Chunyi Wang, Jianbo Zhang, Yuan Bian, Jingjing Ma, Kai Cheng, Rugang Liu, Shaowei Sang, Yongsheng Zhang, Bryan McNally, Marcus E.H. Ong, Chuanzhu Lv, Yuguo Chen, Feng Xu, on behalf of the BASIC-OHCA Coordinators and Investigators
Background:Establishing registries to collect demographic characteristics, processes of care, and outcomes of patients with out-of-hospital cardiac arrest (OHCA) can better understand epidemiological trends, measure care quality, and identify opportunities for improvement. This study aimed to describe the design, implementation, and scientific significance of a nationwide registry―the BASIC-OHCA (Baseline
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Association Between Income and Risk of Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-12 Benjamin P. van Nieuwenhuizen, Hanno L. Tan, Marieke T. Blom, Anton E. Kunst, Irene G.M. van Valkengoed
BACKGROUND:Previous studies have observed a higher out-of-hospital cardiac arrest (OHCA) risk among lower socioeconomic groups. However, due to the cross-sectional and ecological designs used in these studies, the magnitude of these inequalities is uncertain. This study is the first to assess the individual-level association between income and OHCA using a large-scale longitudinal study.Methods:This
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Association of Parental Cardiovascular Health With Disability-Adjusted Life Years in the Offspring: Results From the Framingham Heart Study Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-09 James M. Muchira, Philimon N. Gona, Mulubrhan F. Mogos, Eileen M. Stuart-Shor, Suzanne G. Leveille, Mariann R. Piano, Laura L. Hayman
Background:Disability-adjusted life years (DALYs) are used to evaluate the relative burden of diseases in populations to help set prevention or treatment priorities. The impact of parental cardiovascular health (CVH) on healthy life years lost from cardiovascular disease (CVD) in adult offspring is unknown. We compared parent-offspring CVD DALYs trends over the life course and examined the association
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Patient Preferences for Pharmaceutical and Device-based Treatments for Uncontrolled Hypertension: Discrete Choice Experiment Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-09 David E. Kandzari, Michael A. Weber, Christine Poulos, Joshua Coulter, Sidney A. Cohen, Vanessa DeBruin, Denise Jones, Atul Pathak
BACKGROUND:Discrete choice experiment is a survey method used to understand how individuals make decisions and to quantify the relative importance of features. Using discrete choice experiment methods, we quantified patient benefit–risk preferences for hypertension treatments, including pharmaceutical and interventional treatments, like renal denervation.METHODS:Respondents from the United States with
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Patient-Reported Versus Physician-Assessed Health Status in Heart Failure With Reduced and Preserved Ejection Fraction From ASIAN-HF Registry Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-09 Kanako Teramoto, Wan Ting Tay, Jasper Tromp, Tiew-Hwa Katherine Teng, Chanchal Chandramouli, Wouter Ouwerkerk, Claire A. Lawson, Weiting Huang, Chung-Lieh Hung, Vijay Chopra, Inder Anand, Arthur Mark Richards, Carolyn S.P. Lam
BACKGROUND:We aimed to assess if discordance between patient-reported Kansas City Cardiomyopathy Questionnaire (KCCQ)-overall summary (os) score and physician-assessed New York Heart Association (NYHA) class is common among patients with heart failure (HF) with reduced or preserved ejection fraction, and determine its association with outcomes.METHODS:A total of 4818 patients with HF were classified
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Nationwide Implementation of a Population Management Dashboard for Monitoring Direct Oral Anticoagulants: Insights From the Veterans Affairs Health System Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-09 Michael P. Dorsch, Charity S. Chen, Arthur L. Allen, Anne E. Sales, F. Jacob Seagull, Patrick Spoutz, Jeremy B. Sussman, Geoffrey D. Barnes
BACKGROUND:Direct oral anticoagulants are first-line therapy for common thrombotic conditions, including atrial fibrillation and venous thromboembolism. Despite their strong efficacy and safety profile, evidence-based prescribing can be challenging given differences in dosing based on indication, renal function, and drug-drug interactions. The Veterans Health Affairs developed and implemented a population
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Implementation of an Electronic Health Records–Based Safe Contrast Limit for Preventing Contrast-Associated Acute Kidney Injury After Percutaneous Coronary Intervention Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-07 Neal Yuan, Justin Zhang, Rakan Khaki, Derek Leong, Chandrashekhar Bhoopalam, Steven W. Tabak, Yaron Elad, Joshua M. Pevnick, Susan Cheng, Joseph E. Ebinger
Background:Contrast-associated acute kidney injury (CA-AKI) after percutaneous coronary intervention is associated with increased mortality. We assessed the effectiveness of an electronic health records safe contrast limit tool in predicting CA-AKI risk and reducing contrast use and CA-AKI.Methods:We created an alert displaying the safe contrast limit to cardiac catheterization laboratory staff prior
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Population-Based Epidemiology of Heart Failure in a Low-Income Country: The Haiti Cardiovascular Disease Cohort Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-06 Justin R. Kingery, Nicholas L. Roberts, Jean Lookens Pierre, Rodney Sufra, Eliezer Dade, Vanessa Rouzier, Rodolphe Malebranche, Michel Theard, Parag Goyal, Altaf Pirmohamed, Lily D. Yan, Myung Hee Lee, Denis Nash, Miranda Metz, Robert N. Peck, Monika M. Safford, Daniel Fitzgerald, Marie M. Deschamps, Jean W. Pape, Margaret McNairy
Background:Cardiovascular disease disproportionately affects persons living in low- and middle-income countries and heart failure (HF) is thought to be a leading cause. Population-based studies characterizing the epidemiology of HF in these settings are lacking. We describe the age-standardized prevalence, survival, subtypes, risk factors, and 1-year mortality of HF in the population-based Haiti Cardiovascular
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Association of Clinical Setting With Sociodemographics and Outcomes Following Endovascular Femoropopliteal Artery Revascularization in the United States Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-06 Aishwarya Raja, Rishi K. Wadhera, Eunhee Choi, Siyan Chen, Changyu Shen, Jose F. Figueroa, Robert W. Yeh, Eric A. Secemsky
Background:After the Centers for Medicare and Medicaid Services modified reimbursement rates for outpatient peripheral vascular intervention in 2008 with the intent of improving access to care, providers began to increasingly perform peripheral vascular interventions in privately owned office-based clinics. Little is known about the characteristics of patients treated in this setting and their long-term
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Sex Disparities in Failure to Rescue After Cardiac Surgery in California and New York Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-02 Sundos Alabbadi, Georgina Rowe, George Gill, Ageliki Vouyouka, Joanna Chikwe, Natalia Egorova
Background:Women have a higher risk of mortality than men after cardiac surgery independent of other risk factors. The reason for this may not be limited to patient-specific variables. Failure to rescue (FTR) patients from death after a postoperative complication is a nationally endorsed quality care metric. We aimed to identify whether sex disparities exist in the quality of care after cardiac surgery
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Comparative Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin Among Adults With Cancer and Atrial Fibrillation Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-12-01 Hemalkumar B. Mehta, Huijun An, Shirin Ardeshirrouhanifard, Mukaila A. Raji, G. Caleb Alexander, Jodi B. Segal
Background:While clinical guidelines recommend direct-acting oral anticoagulants (DOAC) over warfarin to treat isolated nonvalvular atrial fibrillation, guidelines are silent regarding nonvalvular atrial fibrillation treatment among individuals with cancer, reflecting the paucity of evidence in this setting. We quantified relative risk of ischemic stroke or systemic embolism and major bleeding (primary
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In Pursuit of Health: Implementation Science and Community-Engaged Research in Cardiovascular Medicine Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-11-15 Prateeti Khazanie, Lesli E. Skolarus, Geoffrey D. Barnes
The cardiovascular community has a robust armamentarium of scientific evidence for disease prevention, medical therapies, and devices. Yet, cardiovascular disease continues to be a leading cause of morbidity and mortality worldwide, with significant gaps in health care equity, quality, outcomes, and value. The vast gaps between research evidence and medical practice are well documented. But how will
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Contributions of Structural Racism to the Food Environment: A Photovoice Study of Black Residents With Hypertension in Baltimore, MD Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-11-15 Anika L. Hines, Rebecca Brody, Zehui Zhou, Sarah V. Collins, Chiazam Omenyi, Edgar R. Miller III, Lisa A. Cooper, Deidra C. Crews
Background:Disproportionate exposure to poor food environments and food insecurity among Black Americans may partially explain critical chronic disease disparities by race and ethnicity. A complex set of structural factors and interactions between Black residents and their food environments, including store types, quantity, proximity, and quality of goods and consumer interactions within stores, may
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Development and Piloting of a Community-Partnered Heart Failure Training Course for Home Health Care Workers Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-11-15 Madeline R. Sterling, Jacklyn Cho, Peggy B. Leung, Ariel F. Silva, Joanna Ringel, Faith Wiggins, Natasha Herring, Alena Powell, Oscar Toro, Ann Lee, Julia Loughman, Michael Obodai, Anthony Poon, Parag Goyal, Lisa M. Kern, Monika M. Safford
Background:Despite their unique contributions to heart failure (HF) care, home healthcare workers (HHWs) have unmet educational needs and many lack HF caregiving self-efficacy. To address this, we used a community-partnered approach to develop and pilot a HF training course for HHWs.Methods:We partnered with the Training and Employment Fund, a benefit fund of the largest healthcare union in the United
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Experiences Implementing a Suite of Decision Aids for Implantable Cardioverter Defibrillators: Qualitative Insights From the DECIDE-ICD Trial Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-11-15 Christopher E. Knoepke, Bryan C. Wallace, Larry A. Allen, Carmen L. Lewis, Sanjaya K. Gupta, Pamela N. Peterson, Daniel B. Kramer, Scott C. Brancato, Paul D. Varosy, John M. Mandrola, Wendy S. Tzou, Daniel D. Matlock
Background:Shared decision making (SDM) is gaining importance in cardiology, including Centers for Medicare & Medicaid Services (CMS) reimbursement policies requiring documented SDM for patients considering primary prevention implantable cardioverter defibrillators. The DECIDE-ICD Trial (Decision Support Intervention for Patients offered implantable Cardioverter-Defibrillators) assessed the implementation
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Improvements and Maintenance of Clinical and Functional Measures Among Rural Women: Strong Hearts, Healthy Communities-2. 0 Cluster Randomized Trial Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-11-15 Rebecca A. Seguin-Fowler, Galen D. Eldridge, Chad D. Rethorst, Meredith L. Graham, Margaret Demment, David Strogatz, Sara C. Folta, Jay E. Maddock, Miriam E. Nelson, Seungyeon Ha
Background:Cardiovascular disease is the leading cause of death in the United States; however, women and rural residents face notable health disparities compared with male and urban counterparts. Community-engaged programs hold promise to help address disparities through health behavior change and maintenance, the latter of which is critical to achieving clinical improvements and public health impact
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Increasing Uptake of Depression Screening and Treatment Guidelines in Cardiac Patients: A Behavioral and Implementation Science Approach to Developing a Theory-Informed, Multilevel Implementation Strategy Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-11-15 Katja Reuter, Kirali Genao, Emily M. Callanan, Diane E. Cannone, Elsa-Grace Giardina, Bruce L. Rollman, Jessica Singer, Amy R. Slutzky, Siqin Ye, Andrea T. Duran, Nathalie Moise
Background:Depression leads to poor health outcomes in patients with coronary heart disease (CHD). Despite guidelines recommending screening and treatment of depressed patients with CHD, few patients receive optimal care. We applied behavioral and implementation science methods to (1) identify generalizable, multilevel barriers to depression screening and treatment in patients with CHD and (2) develop
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Cardiac Rehabilitation and the COVID-19 Pandemic: Persistent Declines in Cardiac Rehabilitation Participation and Access Among US Medicare Beneficiaries Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-31 Merilyn S. Varghese, Alexis L. Beatty, Yang Song, Jiaman Xu, Laurence S. Sperling, Gregg C. Fonarow, Steven J. Keteyian, Kevin W. McConeghy, Joanne Penko, Robert W. Yeh, Jose F. Figueroa, Wen-Chih Wu, Dhruv S. Kazi
Background:The impact of the COVID-19 pandemic on participation in and availability of cardiac rehabilitation (CR) is unknown.Methods:Among eligible Medicare fee-for-service beneficiaries, we evaluated, by month, the number of CR sessions attended per 100 000 beneficiaries, individuals eligible to initiate CR, and centers offering in-person CR between January 2019 and December 2021. We compared these
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Lipid-Lowering Therapy Use and Intensification Among United States Veterans Following Myocardial Infarction or Coronary Revascularization Between 2015 and 2019 Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-14 Alexander R. Zheutlin, Catherine G. Derington, Jennifer S. Herrick, Robert S. Rosenson, Bharat Poudel, Monika M. Safford, Todd M. Brown, Elizabeth A. Jackson, Mark Woodward, Stephanie Reading, Kate Orroth, Jason Exter, Salim S. Virani, Paul Muntner, Adam P. Bress
Background:Understanding how statins, ezetimibe, and PCSK9i (proprotein convertase subtilisin/kexin type 9 serine protease inhibitors) are prescribed after a myocardial infarction (MI) or elective coronary revascularization may improve lipid-lowering therapy (LLT) intensification and reduce recurrent atherosclerotic cardiovascular disease events. We described the use and intensification of LLT among
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Early Stage and Established Hypertension in Sub-Saharan Africa: Results From Population Health Surveys in 17 Countries, 2010–2017 Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-13 Saate S. Shakil, Dike Ojji, Chris T. Longenecker, Gregory A. Roth
Background:Multiple studies have reported a high burden of hypertension in sub-Saharan Africa, but none have examined early stage hypertension. We examined contemporary prevalence of diagnosed, treated, and controlled stage I (130–139/80–89 mm Hg) and II (≥140/90 mm Hg) hypertension in the general population of sub-Saharan Africa.Methods:We analyzed World Health Organization STEPwise Approach to Noncommunicable
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Cost-Effectiveness of Empagliflozin in Patients With Heart Failure and Preserved Ejection Fraction Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-11 Jennifer Zhou, Danny Liew, David M. Kaye, Sophia Zoungas, Dion Stub
Background:Empagliflozin is the first medication to demonstrate clinical benefit in patients with heart failure with preserved ejection fraction, but its cost-effectiveness is unknown. We aimed to evaluate the cost-effectiveness of adding empagliflozin to standard therapy in patients with heart failure with preserved ejection fraction.Methods:A Markov model from the perspective of the Australian health
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Inpatient Quality-of-Care Measures for Heart Failure: Treatment Gaps and Opportunities in the Contemporary Era Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-11 Alberta L. Warner, Lingyun Lu, Zunera Ghaznavi, Cynthia A. Jackevicius
Background:Quality of care measures are vital tools to assess processes of care within and between health care systems. The 2020 American College of Cardiology/AHA performance measures for heart failure provide a new set of such measures. We evaluated the achievement of these and other performance measures within the Veterans Affairs hospital system in a contemporary cohort of patients hospitalized
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Relationship Between Preexisting Cardiovascular Disease and Death and Cardiovascular Outcomes in Critically Ill Patients With COVID-19 Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-04 Alexi Vasbinder, Chelsea Meloche, Tariq U. Azam, Elizabeth Anderson, Tonimarie Catalan, Husam Shadid, Hanna Berlin, Michael Pan, Patrick O’Hayer, Kishan Padalia, Pennelope Blakely, Ibrahim Khaleel, Erinleigh Michaud, Yiyuan Huang, Lili Zhao, Rodica Pop-Busui, Shruti Gupta, Kim Eagle, David E. Leaf, Salim S. Hayek, for the STOP-COVID Investigators‡
Background:Preexisting cardiovascular disease (CVD) is perceived as a risk factor for poor outcomes in patients with COVID-19. We sought to determine whether CVD is associated with in-hospital death and cardiovascular events in critically ill patients with COVID-19.Methods:This study used data from a multicenter cohort of adults with laboratory-confirmed COVID-19 admitted to intensive care units at
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Guideline-Directed Medical Therapy Attainment and Outcomes in Dialysis-Requiring Versus Nondialysis Chronic Kidney Disease in the ISCHEMIA-CKD Trial Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-04 Roy O. Mathew, David J. Maron, Rebecca Anthopolos, Jerome L. Fleg, Sean M. O’Brien, Frank W. Rockhold, Carlo Briguori, Marek F. Roik, Tomasz Mazurek, Marcin Demkow, Robert Malecki, Zhiming Ye, Upendra Kaul, Marius Miglinas, Gregg W. Stone, Ron Wald, David M. Charytan, Mandeep S. Sidhu, Judith S. Hochman, Sripal Bangalore
Background:Patients with chronic kidney disease (CKD) on dialysis (CKD G5D) have worse cardiovascular outcomes than patients with advanced nondialysis CKD (CKD G4-5: estimated glomerular filtration rate <30 mL/[min·1.73m2]). Our objective was to evaluate the relationship between achievement of cardiovascular guideline-directed medical therapy (GDMT) goals and clinical outcomes for CKD G5D versus CKD
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Long-Term Outcomes for Out-of-Hospital Cardiac Arrest in Elderly Patients: An Analysis of Cardiac Arrest Registry to Enhance Survival Data Linked to Medicare Files Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-10-04 Paul S. Chan, Bryan McNally, Anping Chang, Saket Girotra, Rabab Al-Araji, Minaz Mawani, Ki Ok Ahn, Robert Merritt
Background:Most studies on out-of-hospital cardiac arrest have primarily focused on in-hospital or short-term survival. Little is known about long-term outcomes and resource use among survivors of out-of-hospital cardiac arrest.Methods:In this observationsl study, we describe overall long-term outcomes for patients from the national Cardiac Arrest Registry to Enhance Survival linked to Medicare files
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Incidence of Timely Outpatient Follow-Up Care After Emergency Department Encounters for Acute Heart Failure Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-09-08 Austin S. Kilaru, Nicholas Illenberger, Zachary F. Meisel, Peter W. Groeneveld, Manqing Liu, Angira Mondal, Nandita Mitra, Raina M. Merchant
Background:Patients who are discharged from the emergency department (ED) after an encounter for acute heart failure are at high risk for return hospitalization. These patients may benefit from timely outpatient follow-up care to reassess volume status, adjust medications, and reinforce self-care strategies. This study examines the incidence of outpatient follow-up care after ED encounters for acute
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Moving Beyond the Individual: Multilevel Solutions for Equitable Hypertension Control Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-09-06 Kiarri N. Kershaw, Sadiya S. Khan
Approximately 122 million adults in the United States aged ≥20 years have hypertension, but less than half have controlled blood pressure.1 Control is even lower in non-Hispanic Black and low-income adults compared with their non-Hispanic White and higher-income counterparts. Although the cardiovascular risks of uncontrolled blood pressure are well-established, achieving optimal blood pressure control
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Association Between Care Fragmentation and Total Spending After Durable Left Ventricular Device Implant: A Mediation Analysis of Health Care–Associated Infections Within a National Medicare-Society of Thoracic Surgeons Intermacs Linked Dataset Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-09-06 K. Dennie Kim, Russell J. Funk, Hechuan Hou, Austin Airhart, Khalil Nassar, Francis D. Pagani, Min Zhang, P. Paul Chandanabhumma, Keith D. Aaronson, Carol E. Chenoweth, Ahmad Hider, Lourdes Cabrera, Donald S. Likosky, on behalf of the Michigan Congestive Heart Failure Investigators
Background:Care fragmentation is associated with higher rates of infection after durable left ventricular assist device (LVAD) implant. Less is known about the relationship between care fragmentation and total spending, and whether this relationship is mediated by infections.Methods:Total payments were captured from admission to 180 days post-discharge. Drawing on network theory, a measure of care
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Examining the Linear Association Between Blood Pressure Levels and Cardiovascular Diseases in the Absence of Major Risk Factors in China Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-09-06 Ruizhi Zheng, Yu Xu, Mian Li, Jieli Lu, Shujing Wu, Jingya Niu, Zhiyun Zhao, Li Chen, Yanan Huo, Min Xu, Tiange Wang, Shuangyuan Wang, Hong Lin, Guijun Qin, Li Yan, Qin Wan, Lulu Chen, Lixin Shi, Ruying Hu, Xulei Tang, Qing Su, Xuefeng Yu, Yingfen Qin, Gang Chen, Zhengnan Gao, Guixia Wang, Feixia Shen, Zuojie Luo, Yuhong Chen, Yinfei Zhang, Chao Liu, Youmin Wang, Shengli Wu, Tao Yang, Qiang Li, Yiming
Background:Many studies demonstrate a J-shaped association between blood pressure and cardiovascular diseases (CVDs), but the findings are plagued by confounding from other traditional cardiovascular risk factors (CVRFs). Our aims were to examine the associations of systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels with CVD in individuals without major CVRFs and whether there
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Urban Spatial Accessibility of Primary Care and Hypertension Control and Awareness on Chicago’s South Side: A Study From the COMPASS Cohort Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-09-06 Jiajun Luo, Muhammad G. Kibriya, Paul Zakin, Andrew Craver, Liz Connellan, Saira Tasmin, Tamar Polonsky, Karen Kim, Habibul Ahsan, Briseis Aschebrook-Kilfoy
Background:Understanding the relationship between hypertension and spatial accessibility of primary care can inform interventions to improve hypertension control and awareness, especially among disadvantaged populations. This study aims to investigate the association between spatial accessibility of primary care and hypertension control and awareness.Methods:Participant data from the COMPASS (Chicago
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Association of Rapid Response Teams With Hospital Mortality in Medicare Patients Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-09-06 Saket Girotra, Philip G. Jones, Mary Ann Peberdy, Mary S. Vaughan-Sarrazin, Paul S. Chan
Background:Although rapid response teams have been widely promoted as a strategy to reduce unexpected hospital deaths, most studies of rapid response teams have not adjusted for secular trends in mortality before their implementation. We examined whether implementation of a rapid response team was associated with a reduction in hospital mortality after accounting for preimplementation mortality trends
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Association Between Medicare Program Type and Health Care Access, Acute Care Utilization, and Affordability Among Adults With Cardiovascular Disease Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-09-02 Andrew S. Oseran, Tianyu Sun, Rahul Aggarwal, Ashley Kyalwazi, Robert W. Yeh, Rishi K. Wadhera
Background:Medicare Advantage plans now provide health insurance coverage to >24 million older adults in the United States, and enrollment is increasing among individuals with cardiovascular disease (CVD). Whether Medicare Advantage enrollment is associated with similar health care access, acute care utilization, and financial strain for adults with CVD compared with traditional Medicare is unknown
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2022 ACC/AHA Key Data Elements and Definitions for Chest Pain and Acute Myocardial Infarction: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Data Standards Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-08-30 H.V. (“Skip”) Anderson, Sofia Carolina Masri, Mouin S. Abdallah, Anna Marie Chang, Mauricio G. Cohen, Islam Y. Elgendy, Martha Gulati, Kathleen LaPoint, Nidhi Madan, Issam D. Moussa, Jorge Ramirez, April W. Simon, Vikas Singh, Stephen W. Waldo, Marlene S. Williams
Top 10 Take-Home Messages...820 Preamble...820 1. Introduction...821 1.1 Abbreviations...822 2. Methodology...822 2.1 Writing Committee Composition...822 2.2 Relationships With Industry and Other Entities...822 2.3 Review of Literature and Existing Data Definitions...822 2.4 Development of Terminology Concepts...823 2.5 Consensus Development...823 2.6 Relation to Other Standards...823 2.7 Peer Review
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Characterizing the Accuracy of International Classification of Diseases, Tenth Revision Administrative Claims for Aortic Valve Disease Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-08-27 Jordan B. Strom, Jiaman Xu, Tianyu Sun, Yang Song, Jonathan Sevilla-Cazes, Zaid I. Almarzooq, Lawrence J. Markson, Rishi K. Wadhera, Robert W. Yeh
Background:Administrative claims for aortic stenosis (AS) regurgitation may be useful, but their accuracy and ability to identify individuals at risk for valve-related outcomes have not been well characterized.Methods:Using echocardiographic (transthoracic echocardiogram [TTE]) reports linked to US Medicare claims, 2017 to 2018, the performance of candidate International Classification of Diseases
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Maintaining a National Acute Kidney Injury Risk Prediction Model to Support Local Quality Benchmarking Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-08-12 Sharon E. Davis, Jeremiah R. Brown, Chad Dorn, Dax Westerman, Richard J. Solomon, Michael E. Matheny
Background:The utility of quality dashboards to inform decision-making and improve clinical outcomes is tightly linked to the accuracy of the information they provide and, in turn, accuracy of underlying prediction models. Despite recognition of the need to update prediction models to maintain accuracy over time, there is limited guidance on updating strategies. We compare predefined and surveillance-based
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Indications for Left Atrial Appendage Occlusion in the United States and Associated In-Hospital Outcomes: Results From the NCDR LAAO Registry Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-08-12 Usama A. Daimee, Yongfei Wang, Frederick A. Masoudi, Paul D. Varosy, Daniel J. Friedman, Chengan Du, Cristina Koutras, Vivek Y. Reddy, Jacqueline Saw, Matthew J. Price, Fred M. Kusumoto, Jeptha P. Curtis, James V. Freeman
Background:The Food and Drug Administration approved left atrial appendage occlusion with the Watchman device for patients who are at increased stroke risk and are suitable for oral anticoagulation but who have an appropriate reason to seek a nondrug alternative. These broad criteria raise the question of their interpretation in clinical practice. There is a lack of studies comprehensively evaluating
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Artificial Intelligence–Enabled Model for Early Detection of Left Ventricular Hypertrophy and Mortality Prediction in Young to Middle-Aged Adults Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-08-12 Chih-Min Liu, Ming-En Hsieh, Yu-Feng Hu, Tzu-Yin Wei, I-Chien Wu, Pei-Fen Chen, Yenn-Jiang Lin, Satoshi Higa, Nobumori Yagi, Shih-Ann Chen, Vincent S. Tseng
Background:Concealed left ventricular hypertrophy (LVH) is a prevalent condition that is correlated with a substantial risk of cardiovascular events and mortality, especially in young to middle-aged adults. Early identification of LVH is warranted. In this work, we aimed to develop an artificial intelligence (AI)–enabled model for early detection and risk stratification of LVH using 12-lead ECGs.Methods:By
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Honor's Role Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-19 Brahmajee K. Nallamothu
In this issue of Circulation: Cardiovascular Quality and Outcomes, we are honored to publish a special Cardiovascular Perspective by Dr Tracy Wang from Duke University.1 Dr Wang has received the 2022 American Heart Association Quality of Care and Outcomes Research (QCOR) Lifetime Achievement Award. She is a friend and collaborator to many of us in the QCOR community. Her wide-ranging career has demonstrated
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My Journey With Ischemia and Nonobstructed Coronary Arteries Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-19 Lucy Flanagan
I was a 45-year-old healthy, fit, nonsmoker who worked as a corporate executive in Ireland and led a very busy and fulfilled life. Suddenly, I was like an invalid, unable to work, socialize, or exercise. Without any real diagnosis, I thought at first I would get better, but my illness just continued on and on. See Clinical Commentary by Tavella and Beltrame Initially, I had sudden onset of chest pain
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Shortcomings in Managing Patients With Ischemia With Nonobstructed Coronary Arteries Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-19 Rosanna Tavella, John F. Beltrame
In this issue of the Journal, Lucy Flanagan details her dreadful journey with ischemia with nonobstructed coronary arteries (INOCA), and unfortunately, this scenario is far too common among patients with this condition. Many similar experiences can be found on social media and have prompted the development of patient support groups, such as INOCA International (https://inocainternational.com/) and
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County-Level Social Vulnerability is Associated With In-Hospital Death and Major Adverse Cardiovascular Events in Patients Hospitalized With COVID-19: An Analysis of the American Heart Association COVID-19 Cardiovascular Disease Registry Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-18 Shabatun J. Islam, Gargya Malla, Robert W. Yeh, Arshed A. Quyyumi, Dhruv S. Kazi, Wei Tian, Yang Song, Aditi Nayak, Anurag Mehta, Yi-An Ko, James A. de Lemos, Fatima Rodriguez, Abhinav Goyal, Rishi K. Wadhera
Background:The COVID-19 pandemic has disproportionately affected low-income and racial/ethnic minority populations in the United States. However, it is unknown whether hospitalized patients with COVID-19 from socially vulnerable communities experience higher rates of death and/or major adverse cardiovascular events (MACEs). Thus, we evaluated the association between county-level social vulnerability
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Psychological Outcomes and Interventions for Individuals With Congenital Heart Disease: A Scientific Statement From the American Heart Association Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-14 Adrienne H. Kovacs, Judith Brouillette, Patricia Ibeziako, Jamie L. Jackson, Nadine A. Kasparian, Yuli Y. Kim, Tracy Livecchi, Christina Sillman, Lazaros K. Kochilas, on behalf of the American Heart Association Council on Lifelong Congenital Heart Disease and Heart Health in the Young, and Stroke Council
Although resilience and high quality of life are demonstrated by many individuals with congenital heart disease, a range of significant psychological challenges exists across the life span for this growing patient population. Psychiatric disorders represent the most common comorbidity among people with congenital heart disease. Clinicians are becoming increasingly aware of the magnitude of this problem
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Thirty-Day and 90-Day Episode of Care Spending Following Heart Failure Hospitalization Among Medicare Beneficiaries Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-05 Samuel W. Reinhardt, Katherine A.A. Clark, Xin Xin, Craig S. Parzynski, Ralph J. Riello III, Phil Sarocco, Tariq Ahmad, Nihar R. Desai
BACKGROUND:Despite growing interest in value-based models, utilization patterns and costs for heart failure (HF) admissions are not well understood. We sought to characterize Medicare spending for patients with HF for 30- and 90-day episodes of care (which include an index hospitalization and 30 or 90 days following discharge) and to describe the patterns of post-acute care spending.METHODS:Using Medicare
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Long-Term Outcomes of Perioperative Versus Nonoperative Myocardial Infarction: A Danish Population-Based Cohort Study (2000–2016) Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-05 Søren Korsgaard, Morten Schmidt, Michael Maeng, Lars Jakobsen, Lars Pedersen, Christian Fynbo Christiansen, Henrik Toft Sørensen
Background:Perioperative myocardial infarction is a serious cardiovascular complication of noncardiac surgery. The clinical course of perioperative myocardial infarction, other than all-cause mortality, is largely unknown. We examined long-term fatal and nonfatal outcomes of perioperative myocardial infarction compared with nonoperative myocardial infarction.Methods:We conducted a population-based
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Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-07-05 Antonio Fagundes Jr, David D. Berg, Jeong-Gun Park, Vivian M. Baird-Zars, L. Kristin Newby, Gregory W. Barsness, P. Elliott Miller, Sean van Diepen, Jason N. Katz, Nicholas Phreaner, Robert O. Roswell, Venu Menon, Lori B. Daniels, David A. Morrow, Erin A. Bohula, for the CCCTN Investigators
Background:With the improvement in outcomes for acute coronary syndrome (ACS), the practice of routine admission to cardiac intensive care units (CICUs) is evolving. We aimed to describe the epidemiology of patients with ACS admitted to contemporary CICUs.Methods:Using the CCCTN (Critical Care Cardiology Trials Network) Registry for consecutive medical CICU admissions across 26 advanced CICUs in North
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2022 AHA/ACC Key Data Elements and Definitions for Cardiovascular and Noncardiovascular Complications of COVID-19: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-06-23 Biykem Bozkurt, Sandeep R. Das, Daniel Addison, Aakriti Gupta, Hani Jneid, Sadiya S. Khan, George Augustine Koromia, Prathit A. Kulkarni, Kathleen LaPoint, Eldrin F. Lewis, Erin D. Michos, Pamela N. Peterson, Mohit K. Turagam, Tracy Y. Wang, Clyde W. Yancy
Top 10 Take-Home Messages..........e541 Preamble..........e541 Introduction..........e543 Special Considerations..........e543 Abbreviations..........e543 Methodology..........e543 Writing Committee Composition..........e543 Relationships With Industry and Other Entities..........e544 Review of Literature and Existing Data Definitions..........e544 Development of Terminology Concepts..........e544
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Role of Blinding in N-of-1 Trials Circ. Cardiovasc. Qual. Outcomes (IF 6.9) Pub Date : 2022-06-14 James Howard, Skanda Rajasundaram
Recently, there has been much interest in several blinded crossover N-of-1 trials of statin side effects.1–4 These personalized trials allow patients with previous statin side effects to repeatedly crossover between periods of taking a statin and periods of taking a placebo to explore their own symptoms. The trials seem to indicate that the symptoms patients often associate with taking statins are