scholarly journals PCD4: THE IMPACT OF SECONDARY EVENTS ON THE COST OF ACUTE MYOCARDIAL INFARCTION

2000 ◽  
Vol 3 (2) ◽  
pp. 68-69
Author(s):  
J O'Brien ◽  
D Pierce ◽  
J Caro
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
The Cost ◽  
The Impact

Cost-Effectiveness of Thrombolytic Therapy for Acute Myocardial Infarction

1997 ◽  
Vol 31 (5) ◽  
pp. 596-603 ◽  
Author(s):  
Paul A Castillo ◽  
Cynthia S Palmer ◽  
Michael T Halpern ◽  
Evi J Hatziandreu ◽  
Bemard J Gersh
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cost Effectiveness ◽  
Thrombolytic Therapy ◽  
Hospital Discharge ◽  
Marginal Cost ◽  
Sensitivity Analyses ◽  
Time To Treatment ◽  
The Cost ◽  
The Impact

OBJECTIVE: TO estimate the cost-effectiveness of thrombolytic therapy versus no thrombolytic therapy for patients following acute myocardial infarction, focusing on the impact of time to treatment on outcome. METHODS: A decision model was developed to assess the benefits, risks, and costs associated with thrombolytic therapy for treatment of acute myocardial infarction compared with standard nonthrombolytic therapy. The model used pooled data from a recent study of nine large randomized, controlled clinical trials and 12-month outcome data from a recently published meta-analysis of thrombolytic therapy trial data. Outcomes were expressed in terms of survival to hospital discharge and survival to 1 year after discharge. The risks of treatment that led to death, morbidity, or added costs were estimated. The model determined excess and marginal costs per death averted to hospital discharge and at 1 year. Results were also estimated in terms of cost per year of life saved. Sensitivity analyses included variations in time to treatment and drug cost. RESULTS: The marginal cost of thrombolytic therapy per death averted at 1 year was $222 344, or $14 438 per year of life saved. For patients treated within 6 hours of acute myocardial infarction, the marginal cost per death averted was $181 536 at 1 year, or $11 788 per year of life saved. CONCLUSIONS: Thrombolytic therapy is significantly more cost-effective than many other cardiovascular interventions and compares favorably with other forms of medical therapy. Results suggest that shortening the time to treatment has a critical impact on the cost-effectiveness of thrombolytic therapy.

Correction to: The impact of epicardial adipose tissue in patients with acute myocardial infarction

2021 ◽  
Author(s):  
Christoph Fisser ◽  
Stefan Colling ◽  
Kurt Debl ◽  
Andrea Hetzenecker ◽  
Ulrich Sterz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
The Impact

scholarly journals Impact of COVID-19 pandemic lockdown on myocardial infarction care

2021 ◽  
Author(s):  
Timo Schmitz ◽  
Christa Meisinger ◽  
Inge Kirchberger ◽  
Christian Thilo ◽  
Ute Amann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hot Spot ◽  
Population Based ◽  
Downward Trend ◽  
German Model ◽  
Model Region ◽  
The Impact ◽  
The City

AbstractThe aim of this study was to evaluate the impact of the COVID-19 pandemic lockdown on acute myocardial infarction (AMI) care, and to identify underlying stressors in the German model region for complete AMI registration. The analysis was based on data from the population-based KORA Myocardial Infarction Registry located in the region of Augsburg, Germany. All cases of AMI (n = 210) admitted to one of four hospitals in the city of Augsburg or the county of Augsburg from February 10th, 2020, to May 19, 2020, were included. Patients were divided into three groups, namely pre-lockdown, strict lockdown, and attenuated lockdown period. An additional survey was conducted asking the patients for stress and fears in the 4 weeks prior to their AMI. The AMI rate declined by 44% in the strict lockdown period; in the attenuated lockdown period the rate was 17% lower compared to the pre-lockdown period. The downward trend in AMI rates during lockdown was seen in STEMI and NSTEMI patients, and independent of sex and age. The door-to-device time decreased by 70–80% in the lockdown-periods. In the time prior to the infarction, patients felt stressed mainly due to fear of infection with Sars-CoV-2 and less because of the restrictions and consequences of the lockdown. A strict lockdown due to the Covid-19 pandemic had a marked impact on AMI care even in a non-hot-spot region with relatively few cases of COVID-19. Fear of infection with the virus is presumably the main reason for the drop in hospitalizations due to AMI.

scholarly journals Sample Timing, Diagnosis of Subclinical Thyroid Dysfunction and Mortality in Acute Myocardial Infarction: ThyrAMI1 Study

2019 ◽  
Vol 105 (4) ◽  
pp. e1299-e1306 ◽  
Author(s):  
Salman Razvi ◽  
Owain Leng ◽  
Avais Jabbar ◽  
Arjola Bano ◽  
Lorna Ingoe ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Reference Interval ◽  
Reference Ranges ◽  
Diagnosis And Prognosis ◽  
Time Period ◽  
All Cause Mortality ◽  
The Impact

Abstract Objective The objective of this study was to determine the impact of blood sample timing on the diagnosis of subclinical thyroid dysfunction (SCTD) and mortality in patients with acute myocardial infarction (AMI). Patients, Design, and Main Outcome Measures Patients with AMI had thyroid function evaluated on admission between December 2014 and December 2016 and those with abnormal serum thyrotropin (TSH) had repeat thyroid function assessed at least a week later. The association between sample timing and SCTD was evaluated by logistic regression analysis. Secondary outcomes were confirmation of SCTD on repeat testing and all-cause mortality up to June 2018. Results Of the 1806 patients [29.2% women, mean (± standard deviation) age of 64.2 (±12.1) years] analyzed, the prevalence of subclinical hypothyroidism (SCH) was 17.2% (n = 311) and subclinical hyperthyroidism (SHyper) was 1.2% (n = 22) using a uniform TSH reference interval. The risk of being diagnosed with SCTD varied by sample timing in fully-adjusted models. The risk of SCH was highest between 00.01 and 06.00 hours and lowest between 12.01 and 18.00 hours, P for trend <.001, and risk of SHyper was highest between 12.01 hours and 18.00 hours and lowest between 00.01 hours and 06.00 hours. Furthermore, time of the initial sample was associated with the risk of remaining in a SCH state subsequently. Mortality in SCH patients was not elevated when a uniform TSH reference interval was utilized. However, when time period–specific TSH reference ranges were utilized, the mortality risk was significantly higher in SCH patients with HR (95% CI) of 2.26 (1.01–5.19), P = .04. Conclusions Sample timing impacts on the diagnosis and prognosis of SCH in AMI patients. If sample timing is not accounted for, SCH is systemically misclassified, and its measurable influence on mortality is lost.

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
R King ◽  
D Giedrimiene
Keyword(s):  
Myocardial Infarction ◽  
Primary Care ◽  
Acute Myocardial Infarction ◽  
Primary Care Physician ◽  
Care Physician ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

scholarly journals Effect of Short-Term Exposure to Fine Particulate Matter and Temperature on Acute Myocardial Infarction in Korea

2021 ◽  
Vol 18 (9) ◽  
pp. 4822
Author(s):  
Jiyoung Shin ◽  
Jongmin Oh ◽  
In Sook Kang ◽  
Eunhee Ha ◽  
Wook Bum Pyun
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Particulate Matter ◽  
Fine Particulate Matter ◽  
Ambient Air ◽  
Cold Season ◽  
Short Term ◽  
Fine Particulate ◽  
Short Term Exposure ◽  
The Impact

Background/Aim: Previous studies have suggested that the short-term ambient air pollution and temperature are associated with myocardial infarction. In this study, we aimed to conduct a time-series analysis to assess the impact of fine particulate matter (PM2.5) and temperature on acute myocardial infarction (AMI) among adults over 20 years of age in Korea by using the data from the Korean National Health Information Database (KNHID). Methods: The daily data of 192,567 AMI cases in Seoul were collected from the nationwide, population-based KNHID from 2005 to 2014. The monitoring data of ambient PM2.5 from the Seoul Research Institute of Public Health and Environment were also collected. A generalized additive model (GAM) that allowed for a quasi-Poisson distribution was used to analyze the effects of PM2.5 and temperature on the incidence of AMI. Results: The models with PM2.5 lag structures of lag 0 and 2-day averages of lag 0 and 1 (lag 01) showed significant associations with AMI (Relative risk [RR]: 1.011, CI: 1.003–1.020 for lag 0, RR: 1.010, CI: 1.000–1.020 for lag 01) after adjusting the covariates. Stratification analysis conducted in the cold season (October–April) and the warm season (May–September) showed a significant lag 0 effect for AMI cases in the cold season only. Conclusions: In conclusion, acute exposure to PM2.5 was significantly associated with AMI morbidity at lag 0 in Seoul, Korea. This increased risk was also observed at low temperatures.

scholarly journals The effect of statin treatment on survival and on the use of healthcare resources among patients with acute myocardial infarction

2018 ◽  
pp. 30-48
Author(s):  
Lien Nguyen ◽  
Unto Häkkinen ◽  
Henna Jurvanen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Linear Models ◽  
Statin Treatment ◽  
Data Set ◽  
Hospitalised Patients ◽  
Life Years ◽  
Matched Data ◽  
The Cost ◽  
Statin Use

The aim of this study was to investigate the cost-effectiveness of statin use by newly hospitalised patients with acute myocardial infarction (AMI) in Finland. The data were from the PERFECT database of patients hospitalised for AMI and discharged in 1998–2012 in Finland. Selected patients had first-time AMI and had not used statins earlier (N=60 404). We generated a matched data set from statin non-users for statin users based on propensity matching analysis (N=28 412), which was also used. Statin use was defined as statins purchased within the first week after hospital discharge. Healthcare costs included costs of inpatient and outpatient hospital care, costs of nursing homes and costs of prescribed medicines (at 2011 prices). The follow-up time was one year. Logit and generalised linear models were used. We measured the effects of statin use as life years (LYs) gained and computed costs per LY gained. Both data were analysed for the entire period and for subperiods 1998–2001, 2002–2007 and 2008–2011, without discount rates and with a 3% discount rate. An average patient would gain 0.26–0.51 more years. The estimated costs per LY gained ranged between EUR 800 and 15 000. They were highest (EUR 12 000–15 000) in 1998–2001 by the matched data, but were actually savings in 2008–2011. The estimated costs indicate that statin use in treating AMI was very cost-effective. However, our rather long study period may suggest that the cost estimates per LY gained could be overestimated, as the life expectancy of AMI patients is likely shorter than that of the general population.Published: Online April 2018.

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