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Cardiac rehabilitation series: Canada.

https://arctichealth.org/en/permalink/ahliterature104797
Source
Prog Cardiovasc Dis. 2014 Mar-Apr;56(5):530-5
Publication Type
Article
Author
Sherry L Grace
Stephanie Bennett
Chris I Ardern
Alexander M Clark
Author Affiliation
School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada; Cardiovascular Prevention and Rehabilitation, University Health Network, Toronto, Canada. Electronic address: sgrace@yorku.ca.
Source
Prog Cardiovasc Dis. 2014 Mar-Apr;56(5):530-5
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cardiology - methods - standards
Guideline Adherence
Heart Diseases - diagnosis - epidemiology - rehabilitation
Humans
Incidence
Patient compliance
Physician's Practice Patterns
Practice Guidelines as Topic
Preventive Health Services
Program Development
Referral and Consultation
Risk assessment
Risk factors
Risk Reduction Behavior
Treatment Outcome
Abstract
Cardiovascular disease is among the leading causes of mortality and morbidity in Canada. Cardiac rehabilitation (CR) has a long robust history here, and there are established clinical practice guidelines. While the effectiveness of CR in the Canadian context is clear, only 34% of eligible patients participate, and strategies to increase access for under-represented groups (e.g., women, ethnic minority groups) are not yet universally applied. Identified CR barriers include lack of referral and physician recommendation, travel and distance, and low perceived need. Indeed there is now a national policy position recommending systematic inpatient referral to CR in Canada. Recent development of 30 CR quality indicators and the burgeoning national CR registry will enable further measurement and improvement of the quality of CR care in Canada. Finally, the Canadian Association of CR is one of the founding members of the International Council of Cardiovascular Prevention and Rehabilitation, to promote CR globally.
PubMed ID
24607018 View in PubMed
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Comparison of interventional cardiology in two European countries: a nationwide Internet based registry study.

https://arctichealth.org/en/permalink/ahliterature118194
Source
Int J Cardiol. 2013 Sep 30;168(2):1237-42
Publication Type
Article
Date
Sep-30-2013
Author
T. Gudnason
G S Gudnadottir
B. Lagerqvist
K. Eyjolfsson
T. Nilsson
G. Thorgeirsson
K. Andersen
S. James
Author Affiliation
Department of Cardiology, Landspitali University Hospital of Iceland, Reykjavik, Iceland; Cardiovascular Research Institute of Landspitali and the University of Iceland, Iceland; University of Iceland, Reykjavik, Iceland. Electronic address: thorgudn@landspitali.is.
Source
Int J Cardiol. 2013 Sep 30;168(2):1237-42
Date
Sep-30-2013
Language
English
Publication Type
Article
Keywords
Aged
Cardiology - methods - standards
Coronary Angiography - methods - standards
Europe - epidemiology
Female
Humans
Iceland - epidemiology
Internet - standards
Male
Middle Aged
Percutaneous Coronary Intervention - methods - standards
Prospective Studies
Radiography, Interventional - methods - standards
Registries
Sweden - epidemiology
Treatment Outcome
Abstract
The practice of interventional cardiology differs between countries and regions. In this study we report the results of the first nation-wide long-term comparison of interventional cardiology in two countries using a common web-based registry.
The Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to prospectively and continuously collect background-, quality-, and outcome parameters for all coronary angiographies (CA) and percutaneous coronary interventions (PCI) performed in Iceland and Sweden during one year.
The rate of CA per million inhabitants was higher in Iceland than in Sweden. A higher proportion of patients had CA for stable angina in Iceland than in Sweden, while the opposite was true for ST elevation myocardial infarction. Left main stem stenosis was more commonly found in Iceland than in Sweden. The PCI rate was similar in the two countries as was the general success rate of PCI, achievement of complete revascularisation and the overall stent use. Drug eluting stents were more commonly used in Iceland (23% vs. 19%). The use of fractional flow reserve (0.2% vs. 10%) and the radial approach (0.6% vs. 33%) was more frequent in Sweden than in Iceland. Serious complications and death were very rare in both countries.
By prospectively comparing interventional cardiology in two countries, using a common web based registry online, we have discovered important differences in technique and indications. A discovery such as this can lead to a change in clinical practice and inspire prospective multinational randomised registry trials in unselected, real world populations.
PubMed ID
23232456 View in PubMed
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Source
Tidsskr Nor Laegeforen. 2004 May 6;124(9):1276
Publication Type
Article
Date
May-6-2004
Author
Harald Arnesen
Author Affiliation
Hjertemedisinsk poliklinikk, Ullevål universitetssykehus, 0407 Oslo. harald.arnesen@ulleval.no
Source
Tidsskr Nor Laegeforen. 2004 May 6;124(9):1276
Date
May-6-2004
Language
Norwegian
Publication Type
Article
Keywords
Cardiology - methods - standards - trends
Heart Diseases - diagnosis - prevention & control - therapy
Humans
Norway
Research
PubMed ID
15131717 View in PubMed
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Survey of diabetes care in patients presenting with acute coronary syndromes in Canada.

https://arctichealth.org/en/permalink/ahliterature114333
Source
Can J Cardiol. 2013 Sep;29(9):1134-7
Publication Type
Article
Date
Sep-2013
Author
Blair J O'Neill
Ursula M Mann
Milan Gupta
Subodh Verma
Lawrence A Leiter
Author Affiliation
University of Alberta, Edmonton, Alberta, Canada. Blair.oneill@albertahealthservices.ca
Source
Can J Cardiol. 2013 Sep;29(9):1134-7
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - complications - therapy
Canada
Cardiology - methods - standards
Diabetes Mellitus - diagnosis - etiology - therapy
Endocrinology - methods - standards
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Hyperglycemia - etiology - therapy
Hypoglycemic agents - therapeutic use
Physician's Practice Patterns
Questionnaires
Abstract
Diabetes (DM) adversely affects prognosis in acute coronary syndromes (ACS). Guidelines promote optimal glycemic management. Cardiac care often occurs in subspecialty units where DM care might not be a primary focus. A questionnaire was circulated to 1183 cardiologists (CARDs), endocrinologists (ENDOs), and internists between February and May 2012 to determine current practices of DM management in patients presenting with ACS. The response rate was 14%. ENDOs differed in perception of DM frequency compared with CARDs and the availability of ENDO consultation within 24 hours and on routinely-ordered tests. Disparity also existed in who was believed to be primarily responsible for in-hospital DM care in ACS: ENDOs perceived they managed glycemia more often than CARDs believed they did. CARDs indicated they most often managed DM after discharge and ENDOs said this occurred much less. However, CARDs reported ENDOs were the best health care professional to follow patients after discharge. ENDOs had higher comfort initiating and titrating oral hypoglycemic agents or various insulin regimens. There was also no difference in these specialists' perceptions that optimizing glucose levels during the acute phase and in the long-term improves cardiovascular outcomes. Significant differences exist in the perception of the magnitude of the problem, acute and longer-term process of care, and comfort initiating new therapies. Nevertheless, all practitioners agree that optimal DM care affects short- and long-term outcomes of patients. Better systems of care are required to optimally manage ACS patients with DM during admission and after discharge from cardiology services.
PubMed ID
23623476 View in PubMed
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