Do Existing Databases Answer Clinical Questions about Geriatric Cardiovascular Disease and Stroke?

Cheitlin, M.D.; Gerstenblith, Gary; Hazzard, William R.; Pasternak, Richard C.; Fried, Linda P.; Rich, Michael W.; Krumholz, Harlan M.; Peterson, Eric D.; Reves, J. G.; McKay, Charles R.; Saksena, Sanjeev; Shen, Win K.; Akhtar, Masood; Brass, Lawrence M.; Biller, José

doi:10.1111/j.1076-7460.2003.00696.x

Cited by 24 publications

(16 citation statements)

References 81 publications

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“…An early mortality gain with improved post-STEMI therapy may be at the cost of prolonged morbidity. Management of elderly patients with ACS and STEMI as suggested in the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines [12,22] can reduce mortality but survivors may increase the HF burden.…”

Section: Agingmentioning

confidence: 99%

Aging and heart failure: changing demographics and implications for therapy in the elderly

Jugdutt

2010

Heart Fail Rev

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The elderly population (age > or =65) is increasing and with it morbidity, hospitalizations, costs and mortality due to heart failure (HF). HF is a progressive disorder that is superimposed on an on-going aging process. The two broad categories of HF, HF with left ventricular (LV) systolic dysfunction or low ejection fraction (HF/low-EF) and HF with preserved ejection fraction (HF/PEF) are equally prevalent in the elderly. Trials of therapy for HF/low-EF in primarily non-elderly patients showed mortality benefit in elderly patients. In contrast, trials for HF/PEF have not shown mortality benefit in elderly or non-elderly patients. HF pharmacotherapy in the elderly is challenging and needs to be individualized and consider several aging-related changes. More research into the biology of aging and more clinical trials in elderly patients are needed to improve morbidity and mortality in elderly HF patients.

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Section: Agingmentioning

confidence: 99%

Aging and heart failure: changing demographics and implications for therapy in the elderly

Jugdutt

2010

Heart Fail Rev

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“…10, 50 The NHLBI has done an excellent job of making datasets available to investigators, and support for access to this national resource should be continued. In addition, we propose that mechanisms be expanded to provide funding support for proposals that make appropriate use of existing data to address important research questions.…”

Section: Promotion Of Research By Using Existing Databasesmentioning

confidence: 99%

Report of the National Heart, Lung, and Blood Institute Working Group on Outcomes Research in Cardiovascular Disease

et al. 2005

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Abstract-The National Heart, Lung, and Blood Institute convened a working group on outcomes research in cardiovascular disease (CVD). The working group sought to provide guidance on research priorities in outcomes research related to CVD. For the purposes of this document, "outcomes research" is defined as investigative endeavors that generate knowledge to improve clinical decision making and healthcare delivery to optimize patient outcomes. The working group identified the following priority areas: (1) national surveillance projects for high-prevalence CV conditions; (2) patient-centered care; (3) translation of the best science into clinical practice; and (4) studies that place the cost of interventions in the context of their real-world effectiveness. Within each of these topics, the working group described examples of initiatives that could serve the Institute and the public. In addition, the group identified the following areas that are important to the field: (1) promotion of the use of existing data; (2) O utcomes research is a field directed to the study and eventual improvement of the end results of health care. 1 "Outcomes research" can be defined as the study of the delivery and consequences of health care on outcomes from the perspective of patients, practitioners, and the healthcare system. Outcomes research focuses particularly on providing evidence to assess and promote the effectiveness of therapeutic interventions, enhancing the migration of best practice to clinical practice, improving decision making, elevating the quality of care, and supporting the optimal allocation of resources for all patients. Consequently, the research has a proximate and immediate connection to patient care and healthcare delivery.Despite the accelerating pace of basic and traditional clinical research in cardiovascular disease (CVD), there remains ample opportunity to improve clinical practice and healthcare delivery. Clinicians and policy makers often lack knowledge about gaps in healthcare delivery, disparities and inefficiencies, ineffectiveness of seemingly "proven" strategies, and the cumulative impact of interventions on the lives of patients. There is also a dearth of knowledge about how best to promote CV health and healthcare delivery in practice. 1-3 These gaps in knowledge hinder our ability to advance medical care even as our understanding of health and disease expands. We lack basic information about contemporary patterns of care and have a limited array of valid tools and strategies to quantify and improve clinical performance. We often demonstrate efficacy of treatments but commonly do not know the effectiveness of different clinical strategies in actual practice, as well as the impediments to achieving the true potential of the best interventions. We often do not know the impact of clinical and policy strategies on a broad range of patient outcomes, other than mortality and events. We lack basic information that would enhance clinical decision making from the patient's perspective. We lack evidence a...

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“…However, augmented life expectancy and increasing health care expenditures have led to questions concerning the routine use of electrotherapy in elderly patients 1 . More than 80% of pacemaker (PM) recipients in the United States are aged >65 years 2 . The selection of the pacing system has important clinical and economic implications 3 .…”

Section: Introductionmentioning

confidence: 99%

DDD versus VVIR Pacing in Patients, Ages 70 and Over, with Complete Heart Block

Ouali

Neffeti

Ghoul

et al. 2009

Pacing and Clinical Electrophysiology

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Do Existing Databases Answer Clinical Questions about Geriatric Cardiovascular Disease and Stroke?

Cited by 24 publications

References 81 publications

Aging and heart failure: changing demographics and implications for therapy in the elderly

Aging and heart failure: changing demographics and implications for therapy in the elderly

Report of the National Heart, Lung, and Blood Institute Working Group on Outcomes Research in Cardiovascular Disease

DDD versus VVIR Pacing in Patients, Ages 70 and Over, with Complete Heart Block

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