Association Between Prehospital Time Interval and Short-Term Outcome in Acute Heart Failure Patients

Takahashi, Masashi; Kohsaka, Shun; Matsubara, Hiroaki; Yoshikawa, Tsutomu; Takagi, Atsutoshi; Harada, Kazumasa; Miyamoto, Takamichi; Sakai, Tetsuo; Nagao, Ken; Sato, Naoki; Takayama, Morimasa

doi:10.1016/j.cardfail.2011.05.005

Cited by 57 publications

(42 citation statements)

References 16 publications

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“…The Tokyo CCU network database is an continually ongoing multicenter registry that prospectively collects information regarding emergency admissions to acute care facilities [6, 7]. The Tokyo CCU network was originally comprised of 12 major participating hospitals in 1978.…”

Section: Methodsmentioning

confidence: 99%

Current characteristics and management of ST elevation and non-ST elevation myocardial infarction in the Tokyo metropolitan area: from the Tokyo CCU network registered cohort

et al. 2016

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Limited data exists on ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) managed by a well-organized cardiac care network in a metropolitan area. We analyzed the Tokyo CCU network database in 2009–2010. Of 4329 acute myocardial infarction (AMI) patients including STEMI (n = 3202) and NSTEMI (n = 1127), percutaneous coronary intervention (PCI) was performed in 88.8 % of STEMI and 70.4 % of NSTEMI patients. Mean onset-to-door and door-to-balloon times in STEMI patients were shorter than those in NSTEMI patients (167 vs 233 and 60 vs 145 min, respectively, p < 0.001). Coronary artery bypass graft surgery was performed in 4.2 % of STEMI and 11.4 % of NSTEMI patients. In-hospital mortality was significantly higher in STEMI patients than NSTEMI patients (7.7 vs 5.1 %, p < 0.007). Independent correlates of in-hospital mortality were advanced age, low blood pressure, and high Killip classification, statin-treated dyslipidemia and PCI within 24 h were favorable predictors for STEMI. High Killip classification, high heart rate, and hemodialysis were significant predictors of in-hospital mortality, whereas statin-treated dyslipidemia was the only favorable predictor for NSTEMI. In conclusion, patients with MI received PCI frequently (83.5 %) and promptly (door-to-balloon time; 66 min), and had favorable in-hospital prognosis (in-hospital mortality; 7.0 %). In addition to traditional predictors of in-hospital death, statin-treated dyslipidemia was a favorable predictor of in-hospital mortality for STEMI and NSTEMI patients, whereas hemodialysis was the strongest predictor for NSTEMI patients.

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Section: Methodsmentioning

confidence: 99%

Current characteristics and management of ST elevation and non-ST elevation myocardial infarction in the Tokyo metropolitan area: from the Tokyo CCU network registered cohort

et al. 2016

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“…The transportation time is clearly related to outcome of HHF patients, which was demonstrated with data from the Tokyo CCU network [31]. In HHF patients, the longer transportation time, the poorer outcome.…”

Section: Introduction: An Open Forummentioning

confidence: 94%

Site selection in global clinical trials in patients hospitalized for heart failure: perceived problems and potential solutions

et al. 2012

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There are over 1 million hospitalizations for heart failure (HF) annually in the United States alone, and a similar number has been reported in Europe. Recent clinical trials investigating novel therapies in patients with hospitalized HF (HHF) have been negative, and the post-discharge event rate remains unacceptably high. The lack of success with HHF trials stem from problems with understanding the study drug, matching the drug to the appropriate HF subgroup, and study execution. Related to the concept of study execution is the importance of including appropriate study sites in HHF trials. Often overlooked issues include consideration of the geographic region and the number of patients enrolled at each study center. Marked differences in baseline patient co-morbidities, serum biomarkers, treatment utilization and outcomes have been demonstrated across geographic regions. Furthermore, patients from sites with low recruitment may have worse outcomes compared to sites with higher enrollment patterns. Consequently, sites with poor trial enrollment may influence key patient end points and likely do not justify the costs of site training and maintenance. Accordingly, there is an unmet need to develop strategies to identify the right study sites that have acceptable patient quantity and quality. Potential approaches include, but are not limited to, establishing a pre-trial registry, developing site performance metrics, identifying a local regionally involved leader and bolstering recruitment incentives. This manuscript summarizes the roundtable discussion hosted by the Food and Drug Administration between members of academia, the National Institutes of Health, industry partners, contract research organizations and academic research organizations on the importance of selecting optimal sites for successful trials in HHF.

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“…The large number of patients presenting to hospitals in the network affords a unique opportunity to collect data that are likely to be highly representative of cardiovascular diseases -including AAD -in the real world. [1][2][3][4] In practice, we generally divided patients with AAD into 2 groups: those with a communicating false lumen and those in whom the false lumen is non-communicating. 5-7 The mechanism of the development of each type of aortic dissection, however, remains unclear.…”

Section: Patientsmentioning

confidence: 99%

Acute Type B Aortic Dissection With Communicating vs. Non-Communicating False Lumen

Akutsu

Yoshino²,

Tobaru³

et al. 2015

Circ J

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Background:In practice, patients with acute aortic dissection (AAD) are generally divided into 2 groups according to the status of the false lumen: non-communicating or communicating. The similarities and differences between the 2 groups, however, have not been fully determined in a large population. Methods and Results:We studied 502 patients with Stanford type B AAD. Clinical background at symptom onset was compared, and similarities and differences characterized, for patients with non-communicating (NC group, n=288) vs. communicating (C group, n=214) false lumens. Time of day (00.00-06.00 hours, 06.00-12.00 hours, 12.00-18.00 hours, and 18.00-24.00 hours) and extent of physical activity (extreme exertion, slight exertion, at rest, and sleeping) at symptom onset were similar between groups. Patients in the NC group were older (mean age, 71±11 years vs. 64±14 years, P<0.01) and had lower prevalence of distally extended aortic dissection (26% vs. 8%, P<0.01) and deaths in hospital (2% vs. 7%, P=0.011) than those in the C group. Conclusions:At symptom onset, clinical circumstances and physical activity were similar between the groups, and old age and a background of DeBakey IIIa aortic dissection may be associated with determination of false lumen status. The outcome in the NC group was better than in the C group. (Circ J 2015; 79: 567 -573)

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Association Between Prehospital Time Interval and Short-Term Outcome in Acute Heart Failure Patients

Cited by 57 publications

References 16 publications

Current characteristics and management of ST elevation and non-ST elevation myocardial infarction in the Tokyo metropolitan area: from the Tokyo CCU network registered cohort

Current characteristics and management of ST elevation and non-ST elevation myocardial infarction in the Tokyo metropolitan area: from the Tokyo CCU network registered cohort

Site selection in global clinical trials in patients hospitalized for heart failure: perceived problems and potential solutions

Acute Type B Aortic Dissection With Communicating vs. Non-Communicating False Lumen

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