No abstract

ncidence rates (IR) of diseases related to major causes of death and disability are essential in developing health strategies to prepare medical resources and measure effects of intervention on a patient's health status. Acute coronary syndrome (ACS) consisting of acute myocardial infarction (AMI), unstable angina (UAP), and sudden cardiac death (SCD), is a major cause of death and disability worldwide. 1,2 The IRs of ACS have been reported in several countries; for example, IRs of ACS per 100,000 population were 417 in the United Kingdom,

Background: Left ventricular ejection fraction (LVEF) is a basic clinical index that determines the heart failure (HF) treatment strategy. We aimed to evaluate the association between hospitalization costs for HF patient and LVEF in an advanced aging society in a region in Japan. Methods and Results: Consecutive HF patients admitted to Miyazaki Prefectural Nobeoka Hospital between January 2015 and March 2018 were included in the study. The 346 HF patients (mean age 78 years) were divided into 2 groups: HF with reduced ejection fraction (HFrEF; LVEF <40%; n=129) and HF with preserved ejection fraction (HFpEF; LVEF ≥40%; n=217). Median hospitalization costs (in 2017 US dollars) were higher in the HFrEF than HFpEF group, but the difference was not statistically significant ($7,128 vs. $6,580; P=0.189). However, in older adults (age ≥75 years; n=252), median hospitalization costs were significantly higher in the HFrEF than HFpEF group ($7,240 vs. $6,471; P=0.014), and LVEF was an independent factor of hospitalization costs (β=−0.0301, P=0.006). Median hospitalization costs were significantly lower in the older than younger HFpEF group ($6,471 vs. $7,250; P=0.011), but there was no significant difference in costs between the older and younger HFrEF groups ($7,240 vs. $6,760; P=0.351). Conclusions: The relationship between LVEF and hospitalization costs became more pronounced with age, and LVEF was a negative independent factor for hospitalization costs in the older population.

Management of acute myocardial infarction (AMI) requires urgent diagnostic and therapeutic procedures. Percutaneous coronary intervention (PCI) is an established treatment strategy for patients with AMI, and the speed with which it is performed has a major influence on clinical outcomes during the first few hours after the onset of symptoms [1,2]. Delay can occur in several steps, including time to obtain an electrocardiogram (ECG), time from ECG to diagnosis of AMI, and time from diagnosis of AMI to activation of the catheterization laboratory [3,4]. Therefore, it is difficult to maintain high medical standards for AMI all the time.

Background: Cancer is a known prognostic factor in patients with acute coronary syndrome (ACS), but few risk assessments of cancer development after ACS have been established.