Cardiology Commons^™

Perceiving One's Heart Condition To Be Cured Following Hospitalization For Acute Coronary Syndromes: Implications For Patient-Provider Communication, Molly Waring, David Mcmanus, Stephenie Lemon, Joel Gore, Milena Anatchkova, Richard Mcmanus, Arlene Ash, Robert Goldberg, Catarina Kiefe, Jane Saczynski

Richard H. McManus

OBJECTIVE: We examined the proportion of patients perceiving their heart condition to be cured following hospitalization for ACS and identified characteristics associated with these perceptions.

METHODS: We conducted a prospective cohort study of adults hospitalized with ACS (N=396). Patient interviews during hospitalization and one week post-discharge provided demographic and psychosocial characteristics. Medical records provided clinical characteristics. At one week, patients who rated "My heart condition is cured" as "definitely true" or "mostly true" were considered to perceive their heart condition cured.

RESULTS: Participants were aged 60.7 (SD:11.0) years, 26.5% female, and 89.0% non-Hispanic white; 16.7% had unstable angina, 59.6% NSTEMI, …

Rapid Door-To-Balloon Time (≤ 30 Minutes) In The Treatment Of Acute St-Elevation Myocardial Infarction (Stemi) Is Associated With Reduced Length Of Hospital Stay And Improved Clinical Outcomes, Yassir Nawaz Md, Ataul Qureshi Md, Navin K. Subrayappa Md, Orlando E. Rivera Rn, Bruce Feldman Do, Nainesh C. Patel Md

Bruce A. Feldman DO

No abstract provided.

Characteristics Of Contemporary Patients Discharged From The Hospital After An Acute Coronary Syndrome, Robert Goldberg, Jane Saczynski, David Mcmanus, Molly Waring, Richard Mcmanus, Jeroan Allison, David Parish, Darleen Lessard, Sharina Person, Joel Gore, Catarina Kiefe

Richard H. McManus

BACKGROUND: Limited contemporary data compare the clinical and psychosocial characteristics and acute management of patients hospitalized with an initial vs a recurrent episode of acute coronary disease. We describe these factors in a cohort of patients recruited from 6 hospitals in Massachusetts and Georgia after an acute coronary syndrome. MATERIALS AND METHODS: We performed structured baseline in-person interviews and medical record abstractions for 2174 eligible and consenting patients surviving hospitalization for an acute coronary syndrome between April 2011 and May 2013. RESULTS: The average patient age was 61 years, 64% were men, and 47% had a high school education or …

Characteristics, Treatment Practices, And In-Hospital Outcomes Of Older Adults Hospitalized With Acute Myocardial Infarction, Han-Yang Chen, David Mcmanus, Jane Saczynski, Jerry Gurwitz, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVES: To examine overall and decade-long trends (1999-2009), characteristics, treatment practices, and hospital outcomes in individuals aged 65 and older hospitalized for acute myocardial infarction (AMI) and to describe how these factors varied in the youngest, middle, and oldest-old individuals.

DESIGN: Retrospective cohort study.

SETTING: Population-based Worcester Heart Attack Study.

MEASUREMENTS: Analyses were conducted to examine the sociodemographic and clinical characteristics, cardiac treatments, and hospital outcomes of older adults in three age strata (65-74, 75-84, > /=85).

PARTICIPANTS: The study sample consisted of 3,851 individuals aged 65 and older hospitalized with AMI every other year between 1999 and 2009; 32% were …

Health Action Process Approach: Application To Medication Adherence In Cardiac Rehabilitation Patients, Anna Greer, Kerry Milner, Richard Marcello, Katie Mazin

Anna E. Greer

The purpose of this study was to examine the relationship between Health Action Process Approach (HAPA) post-intentional constructs (maintenance self-efficacy, recovery self-efficacy, action planning, coping planning) and medication adherence among phase II cardiac rehabilitation (CR) patients. Research Method: Purposive sampling was used to recruit 91 phase II CR patients age 50 years and over. All respondents completed paper and pencil questionnaire examining HAPA post-intentional constructs (action planning, coping planning, maintenance self-efficacy, recovery self-efficacy), medication adherence, and demographic characteristics. Validity and reliability were confirmed for all scales included in the questionnaire. Descriptive statistics were used to describe respondents’ characteristics. Bivariate statistics …

Possible Molecular Mechanisms Underlying Age-Related Cardiomyocyte Apoptosis In The F344xbn Rat Heart, Sunil Kakarla, Kevin Rice, Anjaiah Katta, Satyanarayana Paturi, Miaozong Wu, Madhukar Kolli, Saba Keshavarzian, Kamran Manzoor, Paulette Wehner, Eric Blough

Paulette S. Wehner

Despite advances in treatment, age-related cardiac dysfunction still remains a leading cause of cardiovascular death. Recent data have suggested that increases in cardiomyocyte apoptosis may be involved in the pathological remodeling of heart. Here, we examine the effects of aging on cardiomyocyte apoptosis in 6-, 30-, and 36-month-old Fischer344xBrown Norway F1 hybrid rats (F344XBN). Compared with 6-month hearts, aged hearts exhibited increased TdT-mediated dUTP nick end labeling–positive nuclei, caspase-3 activation, caspase-dependent cleavage of α-fodrin and diminished phosphorylation of protein kinase B/Akt (Thr 308). These age-dependent increases in cardiomyocyte apoptosis were associated with alterations in the composition of the cardiac dystrophin …

Possible Molecular Mechanisms Underlying Age-Related Cardiomyocyte Apoptosis In The F344xbn Rat Heart, Sunil Kakarla, Kevin Rice, Anjaiah Katta, Satyanarayana Paturi, Miaozong Wu, Madhukar Kolli, Saba Keshavarzian, Kamran Manzoor, Paulette Wehner, Eric Blough

Kevin M Rice

Despite advances in treatment, age-related cardiac dysfunction still remains a leading cause of cardiovascular death. Recent data have suggested that increases in cardiomyocyte apoptosis may be involved in the pathological remodeling of heart. Here, we examine the effects of aging on cardiomyocyte apoptosis in 6-, 30-, and 36-month-old Fischer344xBrown Norway F1 hybrid rats (F344XBN). Compared with 6-month hearts, aged hearts exhibited increased TdT-mediated dUTP nick end labeling–positive nuclei, caspase-3 activation, caspase-dependent cleavage of α-fodrin and diminished phosphorylation of protein kinase B/Akt (Thr 308). These age-dependent increases in cardiomyocyte apoptosis were associated with alterations in the composition of the cardiac dystrophin …

Possible Molecular Mechanisms Underlying Age-Related Cardiomyocyte Apoptosis In The F344xbn Rat Heart, Sunil Kakarla, Kevin Rice, Anjaiah Katta, Satyanarayana Paturi, Miaozong Wu, Madhukar Kolli, Saba Keshavarzian, Kamran Manzoor, Paulette Wehner, Eric Blough

Eric Blough

Despite advances in treatment, age-related cardiac dysfunction still remains a leading cause of cardiovascular death. Recent data have suggested that increases in cardiomyocyte apoptosis may be involved in the pathological remodeling of heart. Here, we examine the effects of aging on cardiomyocyte apoptosis in 6-, 30-, and 36-month-old Fischer344xBrown Norway F1 hybrid rats (F344XBN). Compared with 6-month hearts, aged hearts exhibited increased TdT-mediated dUTP nick end labeling–positive nuclei, caspase-3 activation, caspase-dependent cleavage of α-fodrin and diminished phosphorylation of protein kinase B/Akt (Thr 308). These age-dependent increases in cardiomyocyte apoptosis were associated with alterations in the composition of the cardiac dystrophin …

Elevated Serum Glucose Levels And Survival After Acute Heart Failure: A Population-Based Perspective, Benjamin Helfand, Nicholas Maselli, Darleen Lessard, Jorge Yarzebski, Joel Gore, David Mcmanus, Jane Saczynski, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data are available about the characteristics, treatment and survival in patients without diabetes mellitus (DM), previously diagnosed DM and patients with hyperglycaemia who present with acute decompensated heart failure (ADHF). Our objectives were to examine differences in these endpoints in patients hospitalized with ADHF. METHODS: Patients hospitalized with ADHF during 1995, 2000, 2002 and 2004 comprised the study population. RESULTS: A total of 5428 non-diabetic patients were hospitalized with ADHF, 3807 with diagnosed DM and 513 with admission hyperglycaemia. Patients with admission hyperglycaemia experienced the highest in-hospital death rates (9.9%) compared to those with diagnosed DM (6.5%) and …

Mi Alert St-Segment Elevation Myocardial Infarction (Stemi) Real Time Data Feedback: A Patient Quality Of Care Initiative, Orlando Rivera, Nainesh Patel, Bruce Feldman

Nainesh C Patel MD

No abstract provided.

Atrial Fibrillation--Advances In Drug Therapy, Sudip Nanda, Sultan Siddique, Matthew Martinez, Shree Sharma, Nainesh Patel, Santo Longo

Nainesh C Patel MD

No abstract provided.

Cardiopulmonary Resuscitation Prescription Program: A Pilot Randomized Comparator Trial, Marna Greenberg, Gavin Barr, Valerie Rupp, Nainesh Patel, Kevin Weaver, Kimberly Hamilton, James Reed

Nainesh C Patel MD

No abstract provided.

Early Cardiac Catheterization Is Associated With Improved Survival In Comatose Survivors Of Cardiac Arrest Without Stemi, Ryan Hollenbeck, John Mcpherson, Michael Mooney, Barbara Unger, Nainesh Patel, Paul Mcmullan, Chiu-Hsieh Hsu, David Seder, Karl Kern

Nainesh C Patel MD

AIM: To determine if early cardiac catheterization (CC) is associated with improved survival in comatose patients who are resuscitated after cardiac arrest when electrocardiographic evidence of ST-elevation myocardial infarction (STEMI) is absent.

METHODS: We conducted a retrospective observational study of a prospective cohort of 754 consecutive comatose patients treated with therapeutic hypothermia (TH) following cardiac arrest.

RESULTS: A total of 269 (35.7%) patients had cardiac arrest due to a ventricular arrhythmia without STEMI and were treated with TH. Of these, 122 (45.4%) received CC while comatose (early CC). Acute coronary occlusion was discovered in 26.6% of patients treated with early …

Cardiopulmonary Resuscitation Prescription Program: A Prospective Randomized Pilot Study, Marna Greenberg, Gavin Barr, Valerie Rupp, Nainesh Patel, Kevin Weaver, Kimberly Hamilton, James Reed

Nainesh C Patel MD

No abstract provided.

Therapeutic Medical Hypothermia--A Multispecialty Approach, Sudip Nanda, Nainesh Patel, Surya Bhatt, Claranne Mathiesen, John Castaldo, Shree Sharma, Santo Longo

Nainesh C Patel MD

No abstract provided.

Thrombocytosis And Coronary Occlusion, Amit Nanavati, Nainesh Patel, James Burke

Nainesh C Patel MD

No abstract provided.

Long Term Stemi Outcome Data Acquisition, Tina Ruhf, Orlando Rivera, Nainesh Patel, Bruce Feldman, J Kleaveland, Mercedes Rios-Scott, Kevin Whalen, Susan Bernhard, David Cox

Nainesh C Patel MD

No abstract provided.

Sex Differences In Cardiac Arrest Survivors Who Receive Therapeutic Hypothermia, Marna Greenberg, Amy Ahnert, Nainesh Patel, Courtney Bennett, Nicole Elliott, Mark Lundquist, Andrew Miller, Ellina Feiner, Anita Kurt, Bernadette Gl-Porter, Mercedes Rios-Scott, David Burmeister

Nainesh C Patel MD

OBJECTIVE: Sex differences have not been well defined for patients undergoing therapeutic hypothermia (TH). We aimed to determine sex differences in mortality and Cerebral Performance Category (CPC) scores at discharge among those receiving TH. METHODS: This retrospective cohort study used data abstracted from an "ICE alert" database, an institutional protocol expediting mild TH for postarrest patients. Quality assurance variables (such as age, time to TH, CPC scores, and mortality) were reviewed and compared by sex. χ(2) Test and Wilcoxon rank sum test were used. Stepwise logistic regression was used to assess the association between mortality and sex, while controlling for …

Bradyarrhythmias, Michael Pistoria, Nainesh Patel

Nainesh C Patel MD

No abstract provided.

Interrupted Aortic Arch In The Adult, Amit Nanavati, Matthew Martinez, Nainesh Patel

Nainesh C Patel MD

No abstract provided.

Therapeutic Hypothermia In Cardiac Arrest, Nainesh Patel, Sudip Nanda, Barbara Unger, Michael Mooney

Nainesh C Patel MD

No abstract provided.

Neurological And Cardiovascular Outcomes After Cardiac Arrest At Six Regional Interventional Cardiology Centers In The United States 2007-2011, David Seder, Nainesh Patel, J Mcpherson, P Mcmullen, K Kern, B Unger, J Browning, Sudip Nanda, M Hacobian, M Kelley, N Nielsen, M Mooney

Nainesh C Patel MD

No abstract provided.

Geriatric Experience Following Cardiac Arrest At Six Interventional Cardiology Centers In The United States 2007-2011, David Seder, Nainesh Patel, John Mcpherson, Paul Mcmullen, Karl Kern, Barbara Unger, J Browning, Sudip Nanda, Melkon Hacobian, Michael Kelley, Niklas Nielsen, Michael Mooney

Nainesh C Patel MD

No abstract provided.

Thirty Day Hospital Re-Admissions In Patients With Non St-Segment Elevation Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Nathaniel Erskine, Jane Saczynski, Jorge Yarzebski, Edgard Granillo, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data exist about relatively recent trends in the magnitude and characteristics of patients who are rehospitalized shortly after admission for a non ST-segment elevation acute myocardial infarction (NSTEMI). This observational study describes decade-long trends (1999-2009) in the magnitude and characteristics of patients readmitted to the hospital within 30 days of hospitalization for an incident (initial) episode of NSTEMI.

METHODS: We reviewed the medical records of 2,249 residents of the Worcester (MA) metropolitan area who were hospitalized for an initial NSTEMI in 6 biennial periods between 1999 and 2009 at 3 central MA medical centers.

RESULTS: The average age …

Primary Deficiency Of Microsomal Triglyceride Transfer Protein In Human Abetalipoproteinemia Is Associated With Loss Of Cd1 Function, Sebastian Zeissig, Stephanie Dougan, Duarte Barral, Yvonne Junker, Zhangguo Chen, Arthur Kaser, Madelyn Ho, Hannah Mandel, Adam Mcintyre, Susan Kennedy, Gavin Painter, Natacha Veerapen, Gurdyal Besra, Vincenzo Cerundolo, Simon Yue, Sarah Beladi, Samuel Behar, Xiuxu Chen, Jenny Gumperz, Karine Breckpot, Anna Raper, Amanda Baer, Mark Exley, Robert Hegele, Marina Cuchel, Daniel Rader, Nicholas Davidson, Richard Blumberg

Samuel M. Behar

Abetalipoproteinemia (ABL) is a rare Mendelian disorder of lipid metabolism due to genetic deficiency in microsomal triglyceride transfer protein (MTP). It is associated with defects in MTP-mediated lipid transfer onto apolipoprotein B (APOB) and impaired secretion of APOB-containing lipoproteins. Recently, MTP was shown to regulate the CD1 family of lipid antigen-presenting molecules, but little is known about immune function in ABL patients. Here, we have shown that ABL is characterized by immune defects affecting presentation of self and microbial lipid antigens by group 1 (CD1a, CD1b, CD1c) and group 2 (CD1d) CD1 molecules. In dendritic cells isolated from ABL patients, …

Post Transapical Aortic Valve Replacement (Tavr) Pseudoaneurysm., Michael W Manning, Leonel Diaz, Michael Weigner, Colin L Donnelly, Marna Greenberg

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Sildenafil For The Treatment Of Pulmonary Hypertension In Pediatric Patients, Alice Huddleston, Chad Knoderer, Jennifer Morris, Eric Ebenroth

Chad A. Knoderer

Sildenafil is a phosphodiesterase 5 inhibitor widely used for the treatment of pulmonary hypertension in children. Despite limited available safety and efficacy evidence, use of sildenafil continues to increase. To date, sildenafil use for pediatric pulmonary hypertension has been characterized for 193 children through 16 studies and 28 case series and reports. The primary efficacy data suggest that sildenafil is beneficial for facilitating the weaning of inhaled nitric oxide in children after cardiac surgery. Compiled safety data suggest that sildenafil is well tolerated among children with idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease. This …

Efficacy Of Limited Cefuroxime Prophylaxis In Pediatric Patients After Cardiovascular Surgery, Chad Knoderer, Elaine Cox, Michelle Berg, Andrea Webster, Mark Turrentine

Chad A. Knoderer

Purpose The efficacy of limited cefuroxime prophylaxis in pediatric patients after cardiovascular surgery was evaluated. Methods All patients age 18 years or younger who underwent cardiovascular surgery and received postoperative care from the cardiovascular surgery team between February and July 2006 (preintervention group) and between August 2006 and January 2007 (postintervention group) were eligible for study inclusion. Patients were excluded if they did not receive cefuroxime as postoperative prophylaxis, had a preexisting infection, underwent cardiac transplantation or extracorporeal membrane oxygenation, or underwent delayed sternal closure. The preintervention group received prolonged cefuroxime prophylaxis, and the postintervention group received 24 hours of …

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 …