Perioperative Cardiac Troponin T and Risk of Postoperative Atrial Fibrillation in Coronary Artery Bypass Graft Surgery
Conclusions:
Preoperative hs-cTnT level is associated with the risk of AF after isolated CABG in patients undergoing off-pump coronary bypass, but the accuracy of this biomarker is yet inadequate. Postoperative levels of hs-cTnT have no predictive value considering large influence by the surgical technique and the cardiac surgery itself. Therefore, perioperative hs-cTnT is not a clinically useful biomarker for predicting AF following CABG. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
Assessment of Left Ventricular Function and Mitral Regurgitation Severity Early After Percutaneous Device Closure of the Atrial Septal Defect
Background:
Atrial septal defect (ASD) is one the most prevalent forms of congenital heart disease in adults. Closure of ASDs eliminates left-to-right shunt and reduces right heart volumes, but the effects of ASD closure, on the left ventricle (LV) and mitral valve competence are somewhat inconsistent. Therefore, we designed this study to evaluate the early effect of percutaneous closure of ASD on LV function and mitral regurgitation (MR) severity.
Methods:
In this prospective study, we enrolled 32 patients with ASD secundum who underwent percutaneous device closure in Tehran Heart Center. We used transthoracic ...
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
Right-sided Electrocardiogram in Patients With Acute Pulmonary Embolism
Background:
Acute pulmonary embolism (APE) is an emergent condition. The diagnostic tools are CT angiography and echocardiography. However, all of these modalities can be used under stable and nonemergent conditions. As electrocardiographic (ECG) studies are more feasible under emergent situations, Objective: we aimed to study right-sided ECG (RS-ECG) in patients with APE with further analysis regarding echocardiographic findings and pulmonary embolism severity index (PESI).
Methods:
Right-sided and standard electrocardiogram were obtained from 143 patients with confirmed APE. T-wave inversion, ST segment elevat...
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
Clinical Features and Prognoses of Middle-Aged Women With ST-Elevation Myocardial Infarction With a Focus on Spontaneous Coronary Artery Dissection
Conclusions:
STEMI-SCAD is one of the known causes of STEMI in young women. Still, despite the complexity of revascularization in our patients with STEMI-SCAD, they had more favorable prognoses in both conservative and revascularization management modalities than our patients with STEMI-ATH. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
Outcomes, Temporal Trends, and Resource Utilization in Ischemic versus Nonischemic Cardiogenic Shock
Cardiogenic shock (CS) is associated with significant morbidity and mortality. Differentiating the etiologic factors driving CS has epidemiological significance and aids in optimization of therapeutic strategies, prognostication, and resource utilization. The aim herein is to investigate the epidemiology and clinical outcomes of CS in those with ischemic and nonischemic CS etiologies. Using International Classification of Diseases codes, we queried the national inpatient sample for CS hospitalization from 2007 to 2018 and divided the study sample into cohorts of ischemic (I-CS) and nonischemic cardiogenic shock (NI-CS). We...
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
The Impact of Accelerated Diagnostic Protocol Implementation on Chest Pain Observation Unit Utilization
The objective of this study is to determine how HEART Pathway implementation affects OU use.
Methods:
An analysis of OU registry data from October 2012 to October 2016, 2 years before and after HEART Pathway implementation at an academic medical center, was conducted. Adult patients placed in the OU for chest pain were included. The proportion of patients placed in the OU chest pain protocol per total OU volume and hospitalization and myocardial infarction (MI) rates were determined. Proportions before versus after implementation were compared using χ2 tests and age was compared using a Mann-Whitney U test.
Resu...
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
Impact of Sodium-glucose Cotransporter-2 Inhibitor Initiation in a Safety-net Hospital
In conclusion, the benefits of SGLT2i drugs reducing SBP, albuminuria, and HbA1c observed in clinical trials were duplicated in our safety-net population. Therefore, ongoing education and promotion to providers to ensure broadened utilization and timely renal function monitoring appear warranted. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
Prognostic Impact of Prediabetes on Patient Outcomes After Coronary Artery Bypass Grafting: A Single-center Cohort Study
Conclusions:
Diabetes is significantly associated with higher risk of mortality and MACCE; however, prediabetes did not show a prognostic impact in terms of overall and MACCE-free survival. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - November 26, 2021 Category: Cardiology Tags: Original Study Source Type: research
The Patient Pathway Review: A New Method of Evaluating Clinical Practices to Understand the Complexities of Real-world Care
Healthcare research has contributed to the good patient care that is delivered today. With the perpetual demand for higher quality, cost-effective care, the current approaches in research could be improved to answer important research questions related to actual healthcare practices. In this article, we introduce the concept of the patient pathway review, which focuses on the identification of what happens to patients based on clinical expertise and systematic evaluation. This approach can help understand real-world healthcare activities and explore reasons for clinically relevant patient events. The patient pathway is def...
Source: Critical Pathways in Cardiology - November 26, 2021 Category: Cardiology Tags: Review Article Source Type: research
Improving Appropriate Use of Omega-3 Fatty Acids for Patients With Dyslipidemia: Effect of Online CME
Hypertriglyceridemia is associated with an increased risk of atherosclerotic cardiovascular (CV) disease. Clinical trials have demonstrated the effectiveness of eicosapentaenoic acid ethyl ester (EPA), an omega-3 polyunsaturated fatty acid, on triglyceride lowering and on CV risk reduction. However, many clinicians have limited understanding of the effects of EPA and limited experience using EPA to reduce the risk of CV disease. An analysis was conducted to determine whether an online continuing medical education (CME) intervention could improve knowledge and competence of primary care physicians (PCPs) and cardiologists r...
Source: Critical Pathways in Cardiology - November 26, 2021 Category: Cardiology Tags: Original Study Source Type: research
Utilization of Chest Pain Decision Aids in a Community Hospital Emergency Department: A Mixed-methods Implementation Study
Conclusions:
Using evidence-based chest pain decision aids in a community hospital ED is feasible and acceptable. Key barriers and facilitators for implementation were identified. Further research in community hospitals is needed to verify findings, examine generalizability, and test implementation strategies. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - November 26, 2021 Category: Cardiology Tags: Original Study Source Type: research
Feasibility and Impact of the Combined Application of Coronary CT Angiography With the HEART Pathway in Patients With Suspected Acute Coronary Syndrome
Conclusions:
HEART-CT reclassified a large proportion of patients as safe for discharge, maintained a high sensitivity for detecting 30-day MACE, and had an acceptable ED LOS. Future studies should test the extent to which more automated clinical decision support improves provider adoption and clinical outcomes of HEART-CT. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - November 26, 2021 Category: Cardiology Tags: Original Study Source Type: research
Implementing “Chest Pain Pathway” Using Smartphone Messaging Application “WhatsApp” as a Corrective Action Plan to Improve Ischemia Time in “ST-Elevation Myocardial Infarction” in Primary PCI Capable Center “WhatsApp-STEMI Trial”
In this study, we aimed to assess the utility of structuring chest pain pathway (CPP) with the instantaneous case-by-case feedback protocol using WhatsApp and its impact on improving 2 major key performance indicators—the impact on initial emergency room (ER) door-to-electrocardiogram (ECG) time, and door-to-balloon time—in a predefined 6-month corrective action period.
Methods:
A prospective, quality improvement plan was set to reduce door-to-first-ECG and door-to-balloon times to less than 10 and 90 minutes, respectively, in all acute coronary syndrome cases (including STEMI cases), from August 2020 to April 3...
Source: Critical Pathways in Cardiology - November 26, 2021 Category: Cardiology Tags: Original Study Source Type: research
The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management
Background:
Whether American College of Cardiology (ACC) Chest Pain Center (CPC) accreditation alters guidelines adherence rates is unclear.
Methods:
We analyzed patient-level, hospital-reported, quality metrics for myocardial infarction (MI) patients from 644 hospitals collected in the ACC’s Chest Pain-MI Registry from January 1, 2019, to December 31, 2020, stratified by CPC accreditation for>1 year.
Results:
Of 192,374 MI patients, 67,462 (35.1%) received care at an accredited hospital. In general, differences in guideline adherence rates between accredited and nonaccredited hospitals were numerically...
Source: Critical Pathways in Cardiology - November 26, 2021 Category: Cardiology Tags: Original Study Source Type: research
Trends, Associations, and Impact of Atrial Fibrillation in Patients With Light-chain Cardiac Amyloidosis
In this study, we investigated the temporal trends in the prevalence and prognostic implication of atrial fibrillation (AF) in patient with light-chain cardiac amyloidosis (AL-CA).
Methods:
We identified 3030 patients with AL-CA from the 2015 to 2017 National Inpatient Sample, of which 1577 (52%) had AF. We used trend analysis to assess the temporal trends in the prevalence of AF by subtype from 2015 to 2017. We compared inhospital mortality, acute on chronic heart failure, stroke, length of stay (LOS), and total cost in patients with to those without AF, stratified by subtype of AF.
Results:
The prevalence o...
Source: Critical Pathways in Cardiology - August 28, 2021 Category: Cardiology Tags: Original Study Source Type: research
