Ischemic Heart Disease: Cost-Effective Acute Management and Secondary Prevention

2017 ◽  
pp. 135-155 ◽  
Author(s):  
Sagar B. Dugani ◽  
Andrew E. Moran ◽  
Robert O. Bonow ◽  
Thomas A. Gaziano
Keyword(s):  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Cost Effective ◽  
Ischemic Heart ◽  
Acute Management ◽  
Disease Cost

scholarly journals Unique referral system contributes to long-term net clinical benefits in patients undergoing secondary prevention therapy after percutaneous coronary intervention

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242707
Author(s):  
Shigetaka Kageyama ◽  
Koichiro Murata ◽  
Ryuzo Nawada ◽  
Tomoya Onodera ◽  
Yuichiro Maekawa
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Referral System ◽  
Clinical Events ◽  
Percutaneous Coronary ◽  
Clinical Benefits

Cardiovascular disease, including ischemic heart disease, is a leading cause of death worldwide. Improvement of the secondary prevention of ischemic heart disease is necessary. We established a unique referral system to connect hospitals and outpatient clinics to coordinate care between general practitioners and cardiologists. Here, we evaluated the impact and long-term benefits of our system for ischemic heart disease patients undergoing secondary prevention therapy after percutaneous coronary intervention. This single-center retrospective observational study included 3658 consecutive patients who underwent percutaneous coronary intervention at Shizuoka City Hospital between 2010 and 2019. After percutaneous coronary intervention, patients were considered conventional outpatients (conventional follow-up group) or subjected to our unique referral system (referral system group) at the attending cardiologist’s discretion. To audit compliance of the treatment with the latest Japanese guidelines, we adopted a circulation-type referral system, whereby general practitioners needed to refer registered patients at least once a year, even if no cardiac events occurred. Clinical events in each patient were evaluated. Net adverse clinical events were defined as a combination of major adverse cardiac, cerebrovascular, and major bleeding events. There were 2241 and 1417 patients in the conventional follow-up and referral system groups, with mean follow-ups of 1255 and 1548 days and cumulative net adverse clinical event incidences of 27.6% and 21.5%, respectively. Kaplan–Meier analysis showed that the occurrence of net adverse clinical events was significantly lower in the referral system group than in the conventional follow-up group (log-rank: P<0.001). Univariate and multivariate analyses revealed that the unique referral system was a significant predictor of the net clinical benefits (hazard ratio: 0.56, 95% confidence interval: 0.37–0.83, P = 0.004). This result was consistent after propensity-score matching. In summary, our unique referral system contributed to long-term net clinical benefits for the secondary prevention of ischemic heart disease after percutaneous coronary intervention.

scholarly journals The prediction model for cardiovascular disease using Yazd's health study data (YaHS)

2019 ◽  
Author(s):  
Seyed MohammadReza Tabatabaei Nodoushan1 ◽  
Fatemeh Saadatjoo ◽  
Masoud Mirzaei
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cost Effective ◽  
Mortality Rates ◽  
Study Data ◽  
Ischemic Heart ◽  
Health Study ◽  
Screening Methods ◽  
The People ◽  
Health And Disease

Introdution: Ischemic heart disease is one of the most common diseases, which has led to high mortality rates all over the world. This disease is caused by narrowing or blockage of coronary arteries, which are the provider of blood to the heart. Identifying the people susceptible to this disease and bringing changes in their lifestyles has been said to reduce the related mortality rates and increase the patient's longevity. Methods: Yazd people Health Study (YaHS) was conducted on a random sample of 10,000 people living in the city of Yazd, Iran in the years 2014-15 for a general health and disease survey. These data were first balanced by bootstrapping technique due to their unbalanced nature. Next, classification methods were used in the training phase. Various classifiers, such as artificial neural network, rule inducer, regression, and AdaBoost were used in order to evaluate the proposed method with two scenarios. Results: The results showed that the screening of the people susceptible to ischemic heart disease had the most significant effect on increasing the sensitivity of the discovery classifier of CN2 subgroup through using balanced data by bootstrapping method followed by their analysis for the purpose of producing a sample of the patients. This classifier proved to have the potential for detecting 83.6% of the people susceptible to this disease. Conclusion: Therefore, it can be concluded that data mining methods are effective in screening for susceptible people with ischemic heart disease. This method can be compared with other traditional screening methods in that it is more cost-effective and faster.

A critical reappraisal of aspirin for secondary prevention in patients with ischemic heart disease

2016 ◽  
Vol 181 ◽  
pp. 92-100 ◽  
Author(s):  
Robert C. Welsh ◽  
Matthew T. Roe ◽  
Philippe Gabriel Steg ◽  
Stefan James ◽  
Thomas J. Povsic ◽  
...  
Keyword(s):  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Ischemic Heart

scholarly journals Studies of the outcome of the treatment with beta-blockers in secondary prevention of the ischemic heart disease

2009 ◽  
Vol 62 (9-10) ◽  
pp. 450-455 ◽  
Author(s):  
Vesna Radovic
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Angina Pectoris ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Beta Blockers ◽  
Convincing Evidence ◽  
Ischemic Heart ◽  
Necessary Condition ◽  
Professional Literature

Convincing evidence of the decline of mortality has been achieved with beta-blockers in patients with an acute myocardial infarction and in post-infarction follow-up. The beta-blockers are also the most efficient antianginal medications for the decrease of ischemia in outpatients. They are highly efficient as a monotherapy for angina and are also a medication of choice for angina after the coronary. The objective of this work was an estimate of the use of beta-blockers in secondary prevention of the ischemic heart disease and eliminating doubts concerning their prescription. The method of the analysis sums up the results of a twenty-five- year study on of the outcome of the treatment with beta-blockers in secondary prevention of the ischemic heart disease. The method of the work implies an examination of the professional literature and the data-bases, such as MEDLINE, PubMed and KOBSON. The first studies concerned non-selective beta-blockers, used orally. The following studies concerned cardioselective beta-blockers, metoprolol and atenolol. Several studies followed also the effect of beta-blockers and heparin, or beta-blockers and antagonists of calcium towards placebo, in patients with an unstable angina pectoris. Beta-blockers are an essential drug in secondary prevention of the myocardial infarction and in chronic heart failure. The necessary condition for the efficiency of beta-blockers is an early use. Beta-blockers should be given within 12 hours after the appearance of pain. The continuation of the therapy with beta-blockers after the acute phase is considered to be important in the decrease of the infarction zone expansion. Prophylactic use of beta-blockers after the coronary has an excellent effect, above all in patients with a minor, uncomplicated coronary. Though certain groups of beta-blockers have some special characteristics, when it comes to the treatment of angina pectoris, all beta-blockers are efficient. Generally, patients react well to them. Preference is given to cardioselective remedies, in patients with diabetes or lung disease. Exhaustive controlled clinical studies affirm beta-blockers as drugs that reduce mortality in secondary prevention of the ischemic heart disease.

scholarly journals Antibiotics for the Secondary Prevention of Ischemic Heart Disease

2004 ◽  
Vol 164 (19) ◽  
pp. 2156 ◽  
Author(s):  
Brian J. Wells ◽  
Arch G. Mainous ◽  
Lori M. Dickerson
Keyword(s):  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Ischemic Heart
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