scholarly journals The adherence of doctors to clinical guidelines for the management of patients with acute coronary syndrome.

2018 ◽  
Vol 96 (7) ◽  
pp. 633-640
Author(s):  
A. I. Akhmetova ◽  
E. B. Kleymenova ◽  
G. I. Nazarenko ◽  
L. P. Yashina
Keyword(s):  
Acute Coronary Syndrome ◽  
Length Of Stay ◽  
Clinical Guidelines ◽  
Healthcare Costs ◽  
Routine Practice ◽  
Evidence Based ◽  
Post Discharge ◽  
Coronary Syndrome ◽  
Factors Influencing ◽  
St Elevation

In the management of acute coronary syndrome (ACS) adherence to evidence-based clinical guidelines (CG) improves outcomes and reduces healthcare costs. However, in routine practice compliance with CG is often insufficient. The aim of the study was to assess the association of adherence to CG with the length of stay and outcomes ofACS treatment, as well as to identify factors influencing the CG compliance. The study included 464 patients with ACS. The CG adherence was assessed with 9 quality indicators: 1 point was assigned for each positive indicator; total score reflected CG adherence in each case. In ACS with ST elevation (STE-ACS) patients the rate of high CG adherence (8-9 points) was 60.6%, in ACS without ST-elevation (NSTE-ACS) - 51.2%. High CG adherence significantly reduced the 30-day and 6-month mortality in all ACS patients and 12-month mortality in STE-ACS patients. Low CG adherence (1-7 points) was accompanied by the increase by 16.8% the rate ofpatients with length of stay >14 days (OR=1.591, 95% CI: 1.094-2.312) and by 11.4% 1-year readmission for ACS (0R=0.406, 95% CI: 0.239-0.690). On conclusion, doctors ’ adherence to CG for ACS helps to reduce significantly hospital and post-discharge mortality, length of stay and the risk of 1-year read missions for ACS.

scholarly journals Effect of cardiac rehabilitation on 24-month all-cause hospital readmissions: A prospective cohort study

2018 ◽  
Vol 18 (3) ◽  
pp. 234-244 ◽  
Author(s):  
Emma Thomas ◽  
Mojtaba Lotfaliany ◽  
Sherry L Grace ◽  
Brian Oldenburg ◽  
C Barr Taylor ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Length Of Stay ◽  
Cardiac Rehabilitation ◽  
Hospital Readmission ◽  
Hospital Admissions ◽  
P Value ◽  
Post Discharge ◽  
Coronary Syndrome

Background: Ageing populations and increasing survival following acute coronary syndrome has resulted in large numbers of people living with cardiovascular disease and at high risk of hospitalizations. Rising hospital admissions have a significant financial cost to the healthcare system. Aim: The purpose of this study was to determine whether cardiac rehabilitation is protective against long-term hospital readmission (frequency and length) following acute coronary syndrome. Methods: Data from 416 Australian patients with acute coronary syndrome enrolled in the Anxiety Depression and heart rate Variability in cardiac patients: Evaluating the impact of Negative emotions on functioning after Twenty four months (ADVENT) prospective cohort study between January 2013–June 2014 was analyzed secondarily. Participants self-reported cardiac rehabilitation attendance over the 12 months post-discharge. All-cause readmission data were extracted from hospital records 24 months post-index event. The association between cardiac rehabilitation and all-cause readmission, frequency of readmissions, and length of stay was assessed using three methods (a) regression analysis, (b) propensity score matching, and (c) inverse probability treatment weighting. Results: Overall, 416 patients consented (53% of eligible patients), of which 414 (99.5%) survived the first 30 days post-discharge and were included in the analysis. Medical records were located for 409 participants after 24 months (98% follow-up rate). In total, 267 (65%) reported attending cardiac rehabilitation; there were 392 readmissions by 239 patients. Cardiac rehabilitation attendance was not associated with all-cause hospital readmission; however, it was associated with lower frequency of hospital admissions (odds ratio 0.53, 95% confidence interval: 0.31–0.91 p-value:0.022) and length of stay (coefficient –1.21 days, 95% confidence interval: –2.46–0.26; marginally significant p-value: 0.055) in adjusted models. Conclusion: This study substantiates the long-term benefits of cardiac rehabilitation on readmissions, including length of stay, which would result in lower costs to the healthcare system.

Predictive value of post-treatment platelet reactivity for occurrence of post-discharge bleeding after non-ST elevation acute coronary syndrome.

10.4244/51 ◽  
2009 ◽  
Vol 5 (3) ◽  
pp. 325-329 ◽  
Author(s):  
Thomas Cuisset ◽  
Guillaume Cayla ◽  
Corinne Frere ◽  
Jacques Quilici ◽  
Raphael Poyet ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Predictive Value ◽  
Platelet Reactivity ◽  
Post Treatment ◽  
Post Discharge ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome

Cardiology

2016 ◽  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Randomized Trials ◽  
Evidence Base ◽  
Evidence Based ◽  
Coronary Syndrome ◽  
The Past ◽  
Clinical Cardiology ◽  
Treatment Of Hypertension ◽  
St Elevation

To date, several thousand randomized trials of cardiac treatments have been published, and, over the past few decades, clinical cardiology has gradually evolved from an experience-based to an evidence-based specialty. This chapter focuses on familiarizing clinicians with some of the evidence underpinning contemporary cardiological practice and encourages interest in the future development of the cardiological evidence base. Using an eclectic selection and providing a balanced interpretation of trial results, it takes trials that have influenced cardiological practice, covering topics such as the optimal treatment of hypertension, non-ST elevation acute coronary syndrome, and heart failure.

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