National Trends in Coronary Artery Disease Imagingassociations with Health Care Outcomes and Costs

2021 ◽  
Author(s):  
Jonathan Weir-McCall ◽  
Michelle C. Williams ◽  
Anoop Shah ◽  
Giles Roditi ◽  
James Rudd ◽  
...  
Author(s):  
Andreas Beckmann ◽  
Eva-Maria Bitzer ◽  
Mareike Lederle ◽  
Peter Ihle ◽  
Jochen Walker ◽  
...  

AbstractCoronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are available for revascularization of coronary artery disease (CAD) with the aims to reduce cardiovascular morbidity and mortality and to improve disease-related quality of life in particular. The German National Care Guideline (NVL-cKHK) on chronic CAD recommends the establishment of so-called heart teams for decision making in myocardial revascularization to improve the quality of care. Preferred recommendations for PCI or CABG are given for different patient subgroups depending on patient characteristics, concomitant diseases, and coronary morphology. The myocardial revascularization study (REVASK) is a noninterventional cohort study on care of patients undergoing PCI or CABG based on retrospective statutory health insurance (SHI) routine data, registry data from the German Cardiac Society (DGK) resp., the German Society for Thoracic and Cardiovascular Surgery (DGTHG), combined with prospective primary data collection from health care providers and patients. The primary goal is to investigate whether and to which extent heart teams, consisting of cardiologists and cardiac surgeons, increase guideline adherence in decision making for myocardial revascularization. Ultimately the study project aims to improve patient care in terms of decision making for appropriate myocardial revascularization. Through the consistent implementation of the German National Care Guideline on chronic Coronary Artery Disease (NVL-cKHK) and the European Guidelines on myocardial revascularization, the reduction of morbidity, mortality and the reduced need for subsequent revascularization procedures are also desirable from a health economics perspective.


2020 ◽  
Vol 20 (2) ◽  
pp. 78-107
Author(s):  
Modjadji Mosima Choshi ◽  
Anne G Rosenfeld ◽  
Mary S Koithan

Purpose: Self-care is an essential component of secondary prevention of coronary artery disease (CAD) for rural women after undergoing invasive coronary interventions (ICI). The purpose of the study was to describe self-care behavior experiences of rural women with CAD post-ICI. The specific aims were: to identify and describe self-care behaviors initiated by rural women post-ICI; and to identify and describe barriers to and facilitators of self-care behavior adoption. The language used to describe self-care can be different between health care providers, who are guided by the American Heart Association (AHA), and rural women whose descriptions are based on their life experiences. Methods: Qualitative descriptive methods were used to purposefully sample women (N=10) from two rural Arizona counties. Data were collected using semi-structured face-to-face interviews, lasting approximately 25minutes. Atlas.ti Mac Version 1.5.2 (462) was used for data analysis. Findings: Aim 1: Healthy diet was the most common self-care behavior described by rural women. When describing self-care behaviors, rural women used a different language, which was in alignment with AHA guidelines for self-care behaviors. Aim 2: Themes identified and described for barriers were: residential environment, health and physical ailments, family conditions, and personal characteristics; and for facilitators were relationships, available resources, and personal outcomes. Conclusions: Regardless of poor health-promoting environment, such as unavailability of fresh food stores and access to exercise opportunities rural women took advantage of what they had to keep healthy. They performed self-care behaviors that they described as good for their health and made them happy without associating them the expected self-care behaviors to prevent reoccurrences and complications post-ICI. Rural health care providers must recognize these challenges, acknowledge the positive assets wihin rural women, and incorporate them into the programs for self-care behavior modification strategies. Keywords: Self-care, rural women, coronary artery disease, invasive coronary interventions DOI:  http://doi.org/10.14574/ojrnhc.v20i2.629  


2004 ◽  
Vol 52 ◽  
pp. S144-S145
Author(s):  
H. L. Helton ◽  
S. V. Moore ◽  
K. Salunkhe ◽  
S. Kralick-Goldberg ◽  
D. L. Lappe ◽  
...  

2016 ◽  
Vol 12 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Peter H. Brubaker ◽  
James H. Ross ◽  
Kee Chan Joo

Health care professionals engaged in the management of coronary artery disease (CAD) patients, both in primary and secondary prevention settings, should possess the knowledge to develop and modify both aerobic exercise as well as musculoskeletal resistance exercise training programs. The traditional exercise prescription (ExRx) for aerobic-type exercise describes the intensity, frequency, duration, and mode of exercise, as well as the rate of progression. The more contemporary ExRx focuses on the energy expenditure associated with all physical activity not just structured exercise bouts. The total “volume or dose” of physical activity is associated with important health outcomes, including the potential to prevent and potentially reverse CAD lesions. Also, emerging evidence supporting the use of high-intensity interval training in CAD patients will also be provided. Furthermore, this review will also address the issue of generating an appropriate ExRx in the absence of maximal exercise “stress” test data, a common occurrence in the primary care setting and in this era of health care cost containment. Prescribing resistance exercise for CAD patients requires careful consideration and will be discussed in this review. Finally, this review will conclude with a section that describes the special considerations and/or modifications for some common comorbidities seen in CAD patients


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