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1456 records – page 1 of 146.

3-year follow-up of patients randomised in the metoprolol in dilated cardiomyopathy trial. The Metoprolol in Dilated Cardiomyopathy (MDC) Trial Study Group.

https://arctichealth.org/en/permalink/ahliterature10861
Source
Lancet. 1998 Apr 18;351(9110):1180-1
Publication Type
Article
Date
Apr-18-1998

18F-FDG PET imaging of myocardial viability in an experienced center with access to 18F-FDG and integration with clinical management teams: the Ottawa-FIVE substudy of the PARR 2 trial.

https://arctichealth.org/en/permalink/ahliterature144812
Source
J Nucl Med. 2010 Apr;51(4):567-74
Publication Type
Article
Date
Apr-2010
Author
Arun Abraham
Graham Nichol
Kathryn A Williams
Ann Guo
Robert A deKemp
Linda Garrard
Ross A Davies
Lloyd Duchesne
Haissam Haddad
Benjamin Chow
Jean DaSilva
Rob S B Beanlands
Author Affiliation
National Cardiac PET Centre and Division of Cardiology, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Source
J Nucl Med. 2010 Apr;51(4):567-74
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Canada
Coronary Artery Disease - physiopathology - radionuclide imaging
Female
Fluorodeoxyglucose F18 - diagnostic use
Heart - physiopathology - radionuclide imaging
Heart Failure - physiopathology - radionuclide imaging
Humans
Male
Middle Aged
Myocardial Revascularization
Patient care team
Positron-Emission Tomography
Professional Competence
Radiopharmaceuticals - diagnostic use
Randomized Controlled Trials as Topic
Survival Analysis
Tissue Survival
Ventricular Dysfunction, Left - physiopathology - radionuclide imaging
Abstract
(18)F-FDG PET may assist decision making in ischemic cardiomyopathy. The PET and Recovery Following Revascularization (PARR 2) trial demonstrated a trend toward beneficial outcomes with PET-assisted management. The substudy of PARR 2 that we call Ottawa-FIVE, described here, was a post hoc analysis to determine the benefit of PET in a center with experience, ready access to (18)F-FDG, and integration with clinical teams.
Included were patients with left ventricular dysfunction and suspected coronary artery disease being considered for revascularization. The patients had been randomized in PARR 2 to PET-assisted management (group 1) or standard care (group 2) and had been enrolled in Ottawa after August 1, 2002 (the date that on-site (18)F-FDG was initiated) (n = 111). The primary outcome was the composite endpoint of cardiac death, myocardial infarction, or cardiac rehospitalization within 1 y. Data were compared with the rest of PARR 2 (PET-assisted management [group 3] or standard care [group 4]).
In the Ottawa-FIVE subgroup of PARR 2, the cumulative proportion of patients experiencing the composite event was 19% (group 1), versus 41% (group 2). Multivariable Cox proportional hazards regression showed a benefit for the PET-assisted strategy (hazard ratio, 0.34; 95% confidence interval, 0.16-0.72; P = 0.005). Compared with other patients in PARR 2, Ottawa-FIVE patients had a lower ejection fraction (25% +/- 7% vs. 27% +/- 8%, P = 0.04), were more often female (24% vs. 13%, P = 0.006), tended to be older (64 +/- 10 y vs. 62 +/- 10 y, P = 0.07), and had less previous coronary artery bypass grafting (13% vs. 21%, P = 0.07). For patients in the rest of PARR 2, there was no significant difference in events between groups 3 and 4. The observed effect of (18)F-FDG PET-assisted management in the 4 groups in the context of adjusted survival curves demonstrated a significant interaction (P = 0.016). Comparisons of the 2 arms in Ottawa-FIVE to the 2 arms in the rest of PARR 2 demonstrated a trend toward significance (standard care, P = 0.145; PET-assisted management, P = 0.057).
In this post hoc group analysis, a significant reduction in cardiac events was observed in patients with (18)F-FDG PET-assisted management, compared with patients who received standard care. The results suggest that outcome may be benefited using (18)F-FDG PET in an experienced center with ready access to (18)F-FDG and integration with imaging, heart failure, and revascularization teams.
Notes
Comment In: J Nucl Med. 2010 Apr;51(4):505-620237024
PubMed ID
20237039 View in PubMed
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30-year nationwide trends in incidence of atrial fibrillation in Denmark and associated 5-year risk of heart failure, stroke, and death.

https://arctichealth.org/en/permalink/ahliterature286741
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Publication Type
Article
Date
Dec-15-2016
Author
Morten Schmidt
Sinna Pilgaard Ulrichsen
Lars Pedersen
Hans Erik Bøtker
Jens Cosedis Nielsen
Henrik Toft Sørensen
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Date
Dec-15-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Atrial Fibrillation - epidemiology - mortality - therapy
Cohort Studies
Death
Denmark - epidemiology
Female
Follow-Up Studies
Heart Failure - epidemiology - mortality - therapy
Hospitalization - trends
Humans
Incidence
Male
Middle Aged
Population Surveillance - methods
Registries
Risk factors
Stroke - epidemiology - mortality - therapy
Time Factors
Abstract
Long-term nationwide trends in atrial fibrillation (AF) incidence and 5-year outcomes are rare.
We conducted a population-based cohort study using the Danish National Patient Registry covering all Danish hospitals. We computed standardized incidence rates during 1983-2012. We used Cox regression to estimate hazard ratios (HRs) of heart failure, stroke, and death within 5years, comparing 5-year calendar periods with the earliest period (1983-1987) as reference.
We identified 312,420 patients with first-time hospital-diagnosed AF. The incidence rate per 100,000person-years increased from 98 in 1983 to 307 in 2012. The mean annual increase during the 30-year study period was 4%, with a 6% increase annually until 2000 and a 1.4% increase annually thereafter. The incidence trends were most pronounced among men and persons above 70years. Among high-risk subgroups, AF incidence was consistently highest in patients with valvular heart disease or heart failure. The rate of heart failure following AF declined by 50% over the entire study period (HR: 0.49, 95% confidence interval (CI): 0.48-0.51) and the mortality rate declined by 40% (HR: 0.62, 95% CI: 0.61-0.63). Within the last two decades, the rate for ischemic stroke declined by 20% (HR 0.81, 95% CI: 0.78-0.84), but increased almost as much for haemorrhagic stroke (HR: 1.14, 95% CI: 1.01-1.29).
The long-term risk of heart failure, ischemic stroke, and death following onset of AF has decreased remarkably over the last three decades. Still, the threefold increased incidence of hospital-diagnosed AF during the same period is a major public health concern.
PubMed ID
27705839 View in PubMed
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40 years after the first atrial switch procedure in patients with transposition of the great arteries: long-term results in Toronto and Zurich.

https://arctichealth.org/en/permalink/ahliterature197150
Source
Thorac Cardiovasc Surg. 2000 Aug;48(4):233-7
Publication Type
Article
Date
Aug-2000
Author
E. Oechslin
R. Jenni
Author Affiliation
Division of Cardiology, University Hospital, Zurich, Switzerland. erwin.oechslin@dim.usz.ch
Source
Thorac Cardiovasc Surg. 2000 Aug;48(4):233-7
Date
Aug-2000
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Actuarial Analysis
Adolescent
Adult
Analysis of Variance
Arrhythmias, Cardiac - etiology
Cause of Death
Death, Sudden, Cardiac - epidemiology - etiology
Echocardiography
Follow-Up Studies
Heart Failure - etiology - mortality
Humans
Ontario - epidemiology
Proportional Hazards Models
Quality of Life
Reoperation - statistics & numerical data
Severity of Illness Index
Survival Analysis
Switzerland - epidemiology
Time Factors
Transposition of Great Vessels - complications - mortality - psychology - surgery
Treatment Outcome
Ventricular Dysfunction, Right - etiology - mortality
Abstract
The atrial switch procedure dramatically improved the prognosis of children with complete transposition of the great arteries (TGA). Overall actuarial survival was approximately 75% after 25 years and was better in patients with simple TGA than in those with complex TGA. Mortality by any cause (16%) and cardiovascular mortality (12% and 13%) were comparable in both centers. Progressive congestive heart failure and sudden death were the principal modes of death. Most of the survivors denied any symptoms or had mild limitations in their daily activities. However, long-term problems in this growing population of adults are challenging and include late arrhythmias (up to two thirds of the patients), systemic ventricular (SV) failure, systemic atrioventricular valve regurgitation and reoperations, such as baffle reconstruction, being the most frequent. Objective assessment of SV function obtained by echocardiography is difficult. It may include fractional area change and tricuspid annular motion. Survivors after an atrial switch procedure are unique and have a good quality of life. However, the definitive and true history of the RV supporting the systemic circulation is not as yet known.
PubMed ID
11005599 View in PubMed
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The 2011 Canadian Cardiovascular Society heart failure management guidelines update: focus on sleep apnea, renal dysfunction, mechanical circulatory support, and palliative care.

https://arctichealth.org/en/permalink/ahliterature134302
Source
Can J Cardiol. 2011 May-Jun;27(3):319-38
Publication Type
Article
Author
Robert S McKelvie
Gordon W Moe
Anson Cheung
Jeannine Costigan
Anique Ducharme
Estrellita Estrella-Holder
Justin A Ezekowitz
John Floras
Nadia Giannetti
Adam Grzeslo
Karen Harkness
George A Heckman
Jonathan G Howlett
Simon Kouz
Kori Leblanc
Elizabeth Mann
Eileen O'Meara
Miroslav Rajda
Vivek Rao
Jessica Simon
Elizabeth Swiggum
Shelley Zieroth
J Malcolm O Arnold
Tom Ashton
Michel D'Astous
Paul Dorian
Haissam Haddad
Debra L Isaac
Marie-Hélène Leblanc
Peter Liu
Bruce Sussex
Heather J Ross
Author Affiliation
Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada. robert.mckelvie@phri.ca
Source
Can J Cardiol. 2011 May-Jun;27(3):319-38
Language
English
Publication Type
Article
Keywords
Canada
Combined Modality Therapy
Comorbidity
Female
Heart Failure - diagnosis - epidemiology - therapy
Heart-Assist Devices
Humans
Kidney Failure, Chronic - diagnosis - epidemiology - therapy
Kidney Function Tests
Male
Palliative Care - standards
Practice Guidelines as Topic
Prognosis
Risk assessment
Sleep Apnea Syndromes - diagnosis - epidemiology - therapy
Societies, Medical
Survival Analysis
Treatment Outcome
Abstract
The 2011 Canadian Cardiovascular Society Heart Failure (HF) Guidelines Focused Update reviews the recently published clinical trials that will potentially impact on management. Also reviewed is the less studied but clinically important area of sleep apnea. Finally, patients with advanced HF represent a group of patients who pose major difficulties to clinicians. Advanced HF therefore is examined from the perspectives of HF complicated by renal failure, the role of palliative care, and the role of mechanical circulatory support (MCS). All of these topics are reviewed from a perspective of practical applications. Important new studies have demonstrated in less symptomatic HF patients that cardiac resynchronization therapy will be of benefit. As well, aldosterone receptor antagonists can be used with benefit in less symptomatic HF patients. The important role of palliative care and the need to address end-of-life issues in advanced HF are emphasized. Physicians need to be aware of the possibility of sleep apnea complicating the course of HF and the role of a sleep study for the proper assessment and management of the conditon. Patients with either acute severe or chronic advanced HF with otherwise good life expectancy should be referred to a cardiac centre capable of providing MCS. Furthermore, patients awaiting heart transplantation who deteriorate or are otherwise not likely to survive until a donor organ is found should be referred for MCS.
Notes
Comment In: Can J Cardiol. 2011 Nov-Dec;27(6):871.e721885242
PubMed ID
21601772 View in PubMed
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Absence of effect on exercise capacity of 12-weeks treatment with ramipril in patients with moderate congestive heart failure. Ramipril Study Group.

https://arctichealth.org/en/permalink/ahliterature50173
Source
Eur Heart J. 1994 Dec;15(12):1659-65
Publication Type
Article
Date
Dec-1994
Author
T. Gundersen
K. Swedberg
O. Amtorp
J. Remes
B. Nilsson
Author Affiliation
Medical Department, Aust-Agder Central Hospital, Arendal, Norway.
Source
Eur Heart J. 1994 Dec;15(12):1659-65
Date
Dec-1994
Language
English
Publication Type
Article
Keywords
Cardiac Output, Low - drug therapy
Double-Blind Method
Exercise Test
Heart Failure, Congestive - drug therapy
Humans
Ramipril - therapeutic use
Research Support, Non-U.S. Gov't
Treatment Outcome
Abstract
Pharmacological therapy in cases of chronic congestive heart failure (CHF) is usually evaluated by maximal exercise time. To assess the effect of an angiotensin converting enzyme inhibitor, ramipril, 223 patients with moderate CHF were studied in 24 centres in four Nordic countries in a randomized, double-blind, placebo-controlled, parallel group design. The study drug was titrated from 1.25 mg to a maximum of 10 mg once daily (o.d) over a period of 4 weeks (mean dose 8 mg). A symptom-limited bicycle exercise test, starting at 30 watts and increasing by 10 watts.min-1, was used to evaluate exercise capacity. Reproducible tests were required at baseline, and the test was repeated after 4, 8 and 12 weeks of treatment. Seven deaths were recorded in the placebo group and one death in the ramipril group. A total of 195 patients completed 12 weeks of treatment (placebo group n = 91, ramipril group n = 104). The groups had similar baseline characteristics. Maximal exercise time was increased by mean (SD) 35 s (9) and 41 s (8) in the placebo and ramipril groups, respectively. The adjusted difference between the groups at 12 weeks was 9 s (12) (ns). A significant decrease in blood pressure and rate-pressure product at rest and at end of exercise was obtained by ramipril as compared with placebo. Significantly fewer patients deteriorated in NYHA class from baseline to 12 weeks of ramipril treatment compared to placebo (P = 0.012). Concomitant medication for CHF increased significantly in the placebo group as compared with ramipril-treated patients (P = 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
7698136 View in PubMed
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Absolute risk reductions and numbers needed to treat can be obtained from adjusted survival models for time-to-event outcomes.

https://arctichealth.org/en/permalink/ahliterature149699
Source
J Clin Epidemiol. 2010 Jan;63(1):46-55
Publication Type
Article
Date
Jan-2010
Author
Peter C Austin
Author Affiliation
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada. peter.austin@ices.on.ca
Source
J Clin Epidemiol. 2010 Jan;63(1):46-55
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Female
Heart Failure - drug therapy - mortality
Humans
Male
Ontario - epidemiology
Proportional Hazards Models
Research Design
Risk Reduction Behavior
Survival Analysis
Treatment Outcome
Abstract
Cox proportional hazards regression models are frequently used to determine the association between exposure and time-to-event outcomes in both randomized controlled trials and in observational cohort studies. The resultant hazard ratio is a relative measure of effect that provides limited clinical information.
A method is described for deriving absolute reductions in the risk of an event occurring within a given duration of follow-up time from a Cox regression model. The associated number needed to treat can be derived from this quantity. The method involves determining the probability of the outcome occurring within the specified duration of follow-up if each subject in the cohort was treated and if each subject was untreated, based on the covariates in the regression model. These probabilities are then averaged across the study population to determine the average probability of the occurrence of an event within a specific duration of follow-up in the population if all subjects were treated and if all subjects were untreated.
Risk differences and numbers needed to treat.
Absolute measures of treatment effect can be derived in prospective studies when Cox regression is used to adjust for possible imbalance in prognostically important baseline covariates.
PubMed ID
19595575 View in PubMed
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[A case report. Rosiglitazone treatment was highly effective yet had to be terminated]

https://arctichealth.org/en/permalink/ahliterature47573
Source
Lakartidningen. 2002 Jan 31;99(5):407-10
Publication Type
Article
Date
Jan-31-2002
Author
Martin Ridderstråle
Leif Groop
Author Affiliation
Endokrinologiska kliniken, Universitetssjukhuset MAS, Malmö. martin.ridderstrale@endo.mas.lu.se
Source
Lakartidningen. 2002 Jan 31;99(5):407-10
Date
Jan-31-2002
Language
Swedish
Publication Type
Article
Keywords
Administration, Oral
Diabetes Mellitus, Type 2 - complications - drug therapy
English Abstract
Female
Heart Failure, Congestive - complications - drug therapy
Hemoglobin A, Glycosylated - drug effects
Humans
Hypoglycemic Agents - administration & dosage - contraindications
Insulin - therapeutic use
Middle Aged
Thiazoles - administration & dosage - contraindications
Thiazolidinediones
Treatment Outcome
Abstract
The thiazolidinediones were introduced as oral hypoglycemic drugs in Sweden during the fall of 2000. A case is reported in which a woman with insulin-dependent type-2 diabetes and both macro- and microangiopathy and pronounced insulin resistance was treated with rosiglitazone (Avandia). Within three months insulin doses could be reduced by 36% (from 176 to 112 units insulin daily) and concomitantly Ery-HbA1c was reduced from 8.4 to 5.3%. In spite of this dramatic effect on glucose homeostasis administration of the drug had to be discontinued due to critical congestive heart failure.
PubMed ID
11881246 View in PubMed
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Access to heart failure care post emergency department visit: do we meet established benchmarks and does it matter?

https://arctichealth.org/en/permalink/ahliterature114344
Source
Am Heart J. 2013 May;165(5):725-32
Publication Type
Article
Date
May-2013
Author
Debbie Ehrmann Feldman
Thao Huynh
Julie Des Lauriers
Nadia Giannetti
Marc Frenette
François Grondin
Caroline Michel
Richard Sheppard
Martine Montigny
Serge Lepage
Viviane Nguyen
Hassan Behlouli
Louise Pilote
Author Affiliation
Université de Montréal, Montreal, Quebec, Canada. debbie.feldman@umontreal.ca
Source
Am Heart J. 2013 May;165(5):725-32
Date
May-2013
Language
English
Publication Type
Article
Keywords
Aged
Benchmarking
Continuity of Patient Care - standards
Emergencies
Emergency Service, Hospital - organization & administration
Female
Heart Failure - therapy
Humans
Male
Office Visits - utilization
Quebec
Abstract
The Canadian Cardiology Society recommends that patients should be seen within 2 weeks after an emergency department (ED) visit for heart failure (HF). We sought to investigate whether patients who had an ED visit for HF subsequently consult a physician within the current established benchmark, to explore factors related to physician consultation, and to examine whether delay in consultation is associated with adverse events (AEs) (death, hospitalization, or repeat ED visit).
Patients were recruited by nurses at 8 hospital EDs in Québec, Canada, and interviewed by telephone within 6 weeks of discharge and subsequently at 3 and 6 months. Clinical variables were extracted from medical charts by nurses. We used Cox regression in the analysis.
We enrolled 410 patients (mean age 74.9 ± 11.1 years, 53% males) with a confirmed primary diagnosis of HF. Only 30% consulted with a physician within 2 weeks post-ED visit. By 4 weeks, 51% consulted a physician. Over the 6-month follow-up, 26% returned to the ED, 25% were hospitalized, and 9% died. Patients who were followed up within 4 weeks were more likely to be older and have higher education and a worse quality of life. Patients who consulted a physician within 4 weeks of ED discharge had a lower risk of AEs (hazard ratio 0.59, 95% CI 0.35-0.99).
Prompt follow-up post-ED visit for HF is associated with lower risk for major AEs. Therefore, adherence to current HF guideline benchmarks for timely follow-up post-ED visit is crucial.
PubMed ID
23622909 View in PubMed
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Accreditation and improvement in process quality of care: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature274471
Source
Int J Qual Health Care. 2015 Oct;27(5):336-43
Publication Type
Article
Date
Oct-2015
Author
Søren Bie Bogh
Anne Mette Falstie-Jensen
Paul Bartels
Erik Hollnagel
Søren Paaske Johnsen
Source
Int J Qual Health Care. 2015 Oct;27(5):336-43
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Accreditation - statistics & numerical data
Denmark
Follow-Up Studies
Guideline Adherence - statistics & numerical data
Heart Failure - therapy
Hospital Bed Capacity
Hospitals, Public - statistics & numerical data
Humans
Peptic Ulcer - therapy
Practice Guidelines as Topic
Quality Improvement - statistics & numerical data
Quality Indicators, Health Care - statistics & numerical data
Residence Characteristics
Stroke - therapy
Abstract
To examine whether performance measures improve more in accredited hospitals than in non-accredited hospital.
A historical follow-up study was performed using process of care data from all public Danish hospitals in order to examine the development over time in performance measures according to participation in accreditation programs.
All patients admitted for acute stroke, heart failure or ulcer at Danish hospitals.
Hospital accreditation by either The Joint Commission International or The Health Quality Service.
The primary outcome was a change in opportunity-based composite score and the secondary outcome was a change in all-or-none scores, both measures were based on the individual processes of care. These processes included seven processes related to stroke, six processes to heart failure, four to bleeding ulcer and four to perforated ulcer.
A total of 27 273 patients were included. The overall opportunity-based composite score improved for both non-accredited and accredited hospitals (13.7% [95% CI 10.6; 16.8] and 9.9% [95% 5.4; 14.4], respectively), but the improvements were significantly higher for non-accredited hospitals (absolute difference: 3.8% [95% 0.8; 8.3]). No significant differences were found at disease level. The overall all-or-none score increased significantly for non-accredited hospitals, but not for accredited hospitals. The absolute difference between improvements in the all-or-none score at non-accredited and accredited hospitals was not significant (3.2% [95% -3.6:9.9]).
Participating in accreditation was not associated with larger improvement in performance measures for acute stroke, heart failure or ulcer.
PubMed ID
26239473 View in PubMed
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1456 records – page 1 of 146.