Cardiovascular Diseases Commons^™

30-Year Trends In Patient Characteristics, Treatment Practices, And Long-Term Outcomes Of Adults Aged 35 To 54 Years Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Joel Gore, Jorge Yarzebski, Andrew Coles, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Much of our knowledge about the characteristics, clinical management, and postdischarge outcomes of acute myocardial infarction (AMI) is derived from clinical studies in middle-aged and older subjects with little contemporary information available about the descriptive epidemiology of AMI in relatively young men and women. The objectives of our population-based study were to describe >3-decade-long trends in the clinical features, treatment practices, and long-term outcomes of young adults aged 35 to 54 years discharged from the hospital after AMI. The study population consisted of 2,142 residents of the Worcester (Massachusetts) metropolitan area who were hospitalized with AMI at all central Massachusetts …

Decade-Long Trends In The Characteristics, Management And Hospital Outcomes Of Diabetic Patients With St-Segment Elevation Myocardial Infarction, Mayra Tisminetzky, Samuel Joffe, David Mcmanus, Chad Darling, Joel Gore, Jorge Yarzebski, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

PURPOSE: Our objectives were to describe recent trends in the characteristics and in-hospital outcomes in diabetic as compared with non-diabetic patients hospitalized with ST-segment elevation myocardial infarction (STEMI).

METHODS: We reviewed the medical records of 2537 persons with (n = 684) and without (n = 1853) a history of diabetes who were hospitalized for STEMI between 1997 and 2009 at 11 medical centres in Central Massachusetts.

RESULTS: Diabetic patients were more likely to be older, female and to have a higher prevalence of previously diagnosed comorbidities. Diabetic patients were more likely to have developed important in-hospital complications and to have …

In-Hospital Depression Predicts Early Hospital Readmission After An Acute Coronary Syndrome: Preliminary Data From Trace-Core, David Mcmanus, Jane Saczynski, Molly Waring, Milena Anatchkova, Richard Mcmanus, Robert Goldberg, Jeroan Allison, David Parish, Hamza Awad, Jerry Gurwitz, Arlene Ash, Catarina Kiefe

Richard H. McManus

Background: Hospital systems, patients and providers seek to avert rehospitalizations within 30 days for patients admitted with an acute coronary syndrome (ACS). Rehospitalizations within 30 days of discharge are often considered preventable and to reflect poor in-hospital management or discharge practices. However, independent associations of psychosocial factors with early rehospitalization in patients admitted with an ACS have not been examined. Methods: A multi-racial cohort of 1,540 patients admitted with an ACS reported psychosocial factors via standardized questionnaires in an in-hospital interview. One month following discharge, patients were interviewed via phone and reported hospital readmissions. We used logistic regression models to …

The Scientific Foundations Of The American Red Cross Cpr Training Standards, Richard N. Bradley

Richard N Bradley

The CPR (cardiopulmonary resuscitation) training and certification standards established by the ARC (American Red Cross) are based on a scientific review of the best available published literature. Minimal difference are present between the ARC and other national training organizations. These differences result from differing organizational opinions on the best way to implement standards from limited scientific evidence.

Weight-Based Discrimination And Medication Adherence Among Low-Income African Americans With Hypertension: How Much Of The Association Is Mediated By Self-Efficacy?, Michael Richardson, Molly Waring, Monica Wang, Lisa Nobel, Yendelela Cuffee, Sharina Person, Sandral Hullett, Catarina Kiefe, Jeroan Allison

Monica L. Wang

OBJECTIVES: Much of the excessive morbidity and mortality from cardiovascular disease among African Americans results from low adherence to anti-hypertensive medications. Therefore, we examined the association between weight-based discrimination and medication adherence. METHODS: We used cross-sectional data from low-income African Americans with hypertension. Ordinal logistic regression estimated the odds of medication non-adherence in relation to weight-based discrimination adjusted for age, sex, education, income, and weight. RESULTS: Of all participants (n = 780), the mean (SD) age was 53.7 (9.9) years and the mean (SD) weight was 210.1 (52.8) lbs. Reports of weight-based discrimination were frequent (28.2%). Weight-based discrimination (but not …

The Impact Of Cardiac And Noncardiac Comorbidities On The Short-Term Outcomes Of Patients Hospitalized With Acute Myocardial Infarction: A Population-Based Perspective, Han-Yang Chen, Jane S. Saczynski, David D. Mcmanus, Darleen M. Lessard, Jorge L. Yarzebski, Kate L. Lapane, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

OBJECTIVES: The objectives of our large observational study were to describe the prevalence of cardiac and noncardiac comorbidities in a community-based population of patients hospitalized with acute myocardial infarction (AMI) at all medical centers in central Massachusetts, and to examine whether multiple comorbidities were associated with in-hospital death rates and hospital length of stay. METHODS: The study sample consisted of 2,972 patients hospitalized with AMI at all eleven greater Worcester medical centers in central Massachusetts during the three study years of 2003, 2005, and 2007. RESULTS: The average age of this hospitalized population was 71 years, 55% were men, 93% …