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  • 1
    Online Resource
    Online Resource
    Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton consensus panel
    Elsevier BV ; 2000
    In:  The American Journal of Cardiology Vol. 86, No. 2 ( 2000-07), p. 175-181
    Details
    In: The American Journal of Cardiology, Elsevier BV, Vol. 86, No. 2 ( 2000-07), p. 175-181
    Type of Medium: Online Resource
    ISSN: 0002-9149
    URL: Article
    DOI: 10.1016/S0002-9149(00)00896-1
    RVK:
    XA 18500
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2000
    detail.hit.zdb_id: 2019595-3
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  • 2
    Online Resource
    Online Resource
    Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton consensus panel
    Elsevier BV ; 2000
    In:  The American Journal of Cardiology Vol. 86, No. 2 ( 2000-07), p. 62-68
    Details
    In: The American Journal of Cardiology, Elsevier BV, Vol. 86, No. 2 ( 2000-07), p. 62-68
    Type of Medium: Online Resource
    ISSN: 0002-9149
    URL: Article
    DOI: 10.1016/S0002-9149(00)01117-6
    RVK:
    XA 18500
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2000
    detail.hit.zdb_id: 2019595-3
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  • 3
    Online Resource
    Online Resource
    Association Between Vaccination Status and Outcomes in Patients Admitted to the ICU With COVID-19*
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Critical Care Medicine Vol. 51, No. 9 ( 2023-09), p. 1201-1209
    Details
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 9 ( 2023-09), p. 1201-1209
    Abstract: Although COVID-19 vaccines can reduce the need for intensive care unit admission in COVID-19, their effect on outcomes in critical illness remains unclear. We evaluated outcomes in vaccinated patients admitted to the ICU with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the association between vaccination and booster status on clinical outcomes. DESIGN: Retrospective cohort. SETTING AND PATIENTS: All patients were admitted to an ICU between January 2021 (after vaccination was available) and July 2022 with a diagnosis of COVID-19 based on a SARS-CoV-2 polymerase chain reaction test in Alberta, Canada. INTERVENTIONS: None. MEASUREMENT: The propensity-matched primary outcome of all-cause in-hospital mortality was compared between vaccinated and unvaccinated patients, and vaccinated patients were stratified by booster dosing. Secondary outcomes were mechanical ventilation (MV) duration ICU length of stay (LOS). MAIN RESULTS: The study included 3,293 patients: 743 (22.6%) were fully vaccinated (54.6% with booster), 166 (5.0%) were partially vaccinated, and 2,384 (72.4%) were unvaccinated. Unvaccinated patients were more likely to require invasive MV (78.4% vs 68.2%), vasopressor use (71.1% vs 66.6%), and extracorporeal membrane oxygenation (2.1% vs 0.5%). In a propensity-matched analysis, in-hospital mortality was similar (31.8% vs 34.0%, adjusted odds ratio [OR], 1.25; 95% CI, 0.97–1.61), but median duration MV (7.6 vs 4.7 d; p 〈 0.001) and ICU LOS (6.6 vs 5.2 d; p 〈 0.001) were longer in unvaccinated compared to fully vaccinated patients. Among vaccinated patients, greater than or equal to 1 booster had lower in-hospital mortality (25.5% vs 40.9%; adjusted OR, 0.50; 95% CI, 0.0.36–0.68) and duration of MV (3.8 vs 5.6 d; p = 0.025). CONCLUSIONS: Nearly one in four patients admitted to the ICU with COVID-19 after widespread COVID-19 vaccine availability represented a vaccine-breakthrough case. Mortality risk remains substantial in vaccinated patients and similar between vaccinated and unvaccinated patients after the onset of critical illness. However, COVID-19 vaccination is associated with reduced ICU resource utilization and booster dosing may increase survivability from COVID-19-related critical illness.
    Type of Medium: Online Resource
    ISSN: 0090-3493
    URL: Article
    DOI: 10.1097/CCM.0000000000005928
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2034247-0
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  • 4
    Online Resource
    Online Resource
    Impact of Sex on Long-term Mortality From Acute Myocardial Infarction vs Unstable Angina
    American Medical Association (AMA) ; 2003
    In:  Archives of Internal Medicine Vol. 163, No. 20 ( 2003-11-10), p. 2476-
    Details
    In: Archives of Internal Medicine, American Medical Association (AMA), Vol. 163, No. 20 ( 2003-11-10), p. 2476-
    Type of Medium: Online Resource
    ISSN: 0003-9926
    URL: Article
    DOI: 10.1001/archinte.163.20.2476
    RVK:
    XA 29200
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2003
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  • 5
    Online Resource
    Online Resource
    Abstract 13385: Long Term Outcomes in Catheter Ablation of Atrial Fibrillation Compared to Medical Therapy
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: The long-term effects of catheter ablation (CA) compared to medical therapy on cardiovascular outcomes for atrial fibrillation (AF) remain undetermined. We examined the outcomes associated with CA compared to rate or rhythm control therapy in a population cohort with AF. Methods: Using Alberta administrative data, patients with AF as the primary diagnosis during hospitalization or emergency department/physician visit were included between 2008-2018. Based on therapy received, patients were assigned to CA, rate (digoxin, calcium channel or beta blocker) or rhythm control (amiodarone, sotalol, flecainide, propafenone, dronedarone). If treatment changed over time, the patient was censored in the prior treatment arm and assigned to the new arm. The association of treatment (included as time-varying covariate) with the primary composite outcome of death, hospitalization for heart failure or stroke was examined using multivariable Cox models after adjusting for age, sex, comorbidities and baseline medications. Secondary outcomes included cardiovascular hospitalizations, and individual components of the composite. Results: There were 2,149 (4.0%) patients treated with CA and 51,315 with medical treatment (rate : 41,948, (81.5%) rhythm: 9,367 (18.2%). During a median follow-up of 4.2 years, CA for AF was associated with a lower crude incidence of the composite outcome (rate per 100 person-years was 3.3 for CA, 9.5 for rate control, and 6.3 for rhythm control). In multivariate analysis, compared to CA, both rate (adjusted hazard ratio (aHR) 1.55, 95% confidence interval (CI), 1.44 to 1.68) and rhythm control (aHR 1.37; 95% CI 1.27 to 1.49) were associated with a higher risk of the primary composite outcome.(Figure) Secondary outcomes are shown in the Figure. Conclusions: Only a small percentage of patients with AF undergo CA. Patients selected for CA have a lower risk of long-term adverse outcomes compared to medical therapy in patients with AF.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.13385
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 6
    Online Resource
    Online Resource
    Abstract 19018: Variation in Treatment and Outcomes in ACS: Insights from the Alberta Contemporary Acute Coronary Syndrome Patients Invasive Treatment Strategy (COAPT) Study
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: In a universal health care system, we examined variations in treatment strategies and clinical outcomes in a contemporary cohort of acute coronary syndrome (ACS) patients. Methods: Hospitalization claims of 15,264 patients with ACS between April 1, 2010 and March 2012 were deterministically linked to the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) angiographic database. We compared baseline characteristics and use of diagnostic and therapeutic procedures across 3 invasive sites. For patients who underwent an invasive strategy, we examined 1-year rates of death and repeat revascularization. Results: Of the study cohort, 14.3% were medically treated at 91 non-invasive hospitals without transfer to an invasive site and had a 9.3% rate of in-hospital death. The remaining patients were admitted or transferred to one of the three invasive sites (A 5935 pts [40.4% transfer]; B 3910 pts [47.1% transfer] ; C 3243 pts [57.4% transfer]). The majority were treated with an invasive strategy: A 87.4%, B 88.9%, C 90.1%, p 〈 0.001). Patient characteristics according to invasive site are reported below (Table). Most notable are the dissimilar rates of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) along with the different use of drug-eluting stents (DES). Mortality rates were similar (in-hospital and 1-year). However, significant differences in one-year repeat revascularization were observed. Conclusion: Results from this large contemporary Canadian study suggest variation in revascularization strategies exist resulting in differences in clinical outcome at one year. Further investigations are warranted to allow alignment of best practice and patient outcomes for patients with ACS.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.19018
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 7
    Online Resource
    Online Resource
    18 F-Sodium Fluoride Imaging of Coronary Atherosclerosis in Ambulatory Patients With Diabetes Mellitus
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 39, No. 2 ( 2019-02), p. 276-284
    Details
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 2 ( 2019-02), p. 276-284
    Abstract: Although patients with diabetes mellitus (DM) are considered at high risk of cardiovascular events, there is growing evidence that this notion is incorrect. Atherosclerosis imaging may identify patients at risk. Approach and Results— We performed coronary atherosclerosis with 18 F-sodium fluoride (NaF) positron emission tomography/computed tomography and gated chest computed tomography for coronary artery calcium in 88 consecutive ambulatory patients with DM on a stable medical regimen. NaF has been shown to localize avidly in culprit lesions of patients with acute coronary syndromes and may identify unstable plaques. NaF activity was measured as target (coronary arteries)-to-background (left ventricular pool) ratio (TBR). High TBR was defined as ≥1.5. The mean age of the cohort was 54±14 years, 55% had type 2 DM, 65% were men, the median HgbA1c (hemoglobin A1c) and LDL (low-density lipoprotein) cholesterol were 7.5% (interquartile range, 7.1–8.5) and 1.9 mmol/L (interquartile range, 1.5–2.6), respectively. Mean coronary artery calcium score was 374±773, and median TBR was 1.2. Coronary artery TBR ≥1.5 was detected in 13 (15%) patients. In univariable analyses, male sex ( P =0.0002), estimated glomerular filtration rate ( P =0.02), and total coronary artery calcium score ( P =0.04) were associated with TBR. In multivariable analyses, TBR 〉 median was associated with male sex ( P =0.0001) and statin use ( P =0.042). Conclusions— In ambulatory patients with DM asymptomatic for cardiovascular disease, the prevalence of potentially vulnerable plaques detected with NaF was low, but in the absence of follow-up data at this stage, we cannot assess the import of this information. Future research will establish whether NaF imaging helps risk stratify patients with DM. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT03530176.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    URL: Article
    DOI: 10.1161/ATVBAHA.118.311711
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1494427-3
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  • 8
    Online Resource
    Online Resource
    Ischemic Stroke Profile, Risk Factors, and Outcomes in India : The Indo-US Collaborative Stroke Project
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. 1 ( 2018-01), p. 219-222
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 1 ( 2018-01), p. 219-222
    Abstract: The Indo-US Collaborative Stroke Project was designed to characterize ischemic stroke across 5 high-volume academic tertiary hospitals in India. Methods— From January 2012 to August 2014, research coordinators and physician coinvestigators prospectively collected data on 2066 patients with ischemic stroke admitted 〈 2 weeks after onset. Investigator training and supervision and data monitoring were conducted by the US site (Massachusetts General Hospital, Boston). Results— The mean age was 58.3±14.7 years, 67.2% men. The median admission National Institutes of Health Stroke Scale score was 10 (interquartile range, 5–15) and 24.5% had National Institutes of Health Stroke Scale ≥16. Hypertension (60.8%), diabetes mellitus (35.7%), and tobacco use (32.2%, including bidi/smokeless tobacco) were common risk factors. Only 4% had atrial fibrillation. All patients underwent computed tomography or magnetic resonance imaging; 81% had cerebrovascular imaging. Stroke etiologic subtypes were large artery (29.9%), cardiac (24.9%), small artery (14.2%), other definite (3.4%), and undetermined (27.6%, including 6.7% with incomplete evaluation). Intravenous or intra-arterial thrombolysis was administered in 13%. In-hospital mortality was 7.9%, and 48% achieved modified Rankin Scale score 0 to 2 at 90 days. On multivariate analysis, diabetes mellitus predicted poor 3-month outcome and younger age, lower admission National Institutes of Health Stroke Scale and small-artery etiology predicted excellent 3-month outcome. Conclusions— These comprehensive and novel clinical imaging data will prove useful in refining stroke guidelines and advancing stroke care in India.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.117.018700
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1467823-8
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  • 9
    Online Resource
    Online Resource
    Long-Term Mortality of Patients With Acute Myocardial Infarction in the United States and Canada : Comparison of Patients Enrolled in Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-I
    Ovid Technologies (Wolters Kluwer Health) ; 2004
    In:  Circulation Vol. 110, No. 13 ( 2004-09-28), p. 1754-1760
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 110, No. 13 ( 2004-09-28), p. 1754-1760
    Abstract: Background— In a previous substudy of the GUSTO-I trial, we observed better functional and quality-of-life outcomes among patients in the United States (US patients) compared with patients in Canada. Rates of invasive therapy were significantly higher in the United States and were associated with a small mortality benefit (0.4%, adjusted P =0.02). We sought to determine whether Canadian–US differences in practice patterns in GUSTO-I had an impact on 5-year mortality. Methods and Results— Mortality data for 23 105 US and 2898 Canadian patients enrolled in GUSTO-I were obtained from national mortality databases. Median follow-up was 5.46 years in the US and 5.33 years in the Canadian cohort. Five-year mortality rate was 19.6% among US and 21.4% among Canadian patients ( P =0.02). After baseline adjustment, enrollment in Canada was associated with a higher hazard of death (1.17; 95% confidence interval, 1.07 to 1.28, P =0.001). Revascularization rates during the index hospitalization in the United States were almost 3 times those in Canada: 30.5% versus 11.4% for angioplasty and 13.1% versus 4.0% for bypass surgery ( P 〈 0.01 for both). After accounting for revascularization status as a time-dependent covariate, country was no longer a significant predictor of long-term mortality. These results were confirmed in a propensity-matched analysis. Conclusions— Our results suggest, for the first time, that the more conservative pattern of care with regard to early revascularization in Canada for ST-segment elevation acute myocardial infarction may have a detrimental effect on long-term survival. Our results have important policy implications for cardiac care in countries and healthcare systems wherein use of invasive procedures is similarly conservative.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/01.CIR.0000142671.06167.91
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2004
    detail.hit.zdb_id: 1466401-X
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  • 10
    Online Resource
    Online Resource
    Ischemic Stroke in Young Asian Women: Risk Factors, Subtypes and Outcome
    S. Karger AG ; 2010
    In:  Cerebrovascular Diseases Vol. 30, No. 4 ( 2010), p. 418-422
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 30, No. 4 ( 2010), p. 418-422
    Abstract: 〈 i 〉 Background and Objective: 〈 /i 〉 The objective of our study was to describe risk factors, mechanisms and outcome of young Asian women with ischemic stroke. 〈 i 〉 Methods: 〈 /i 〉 Twelve tertiary-care centers in 8 Asian countries participated. Women aged 15–45 years were included if they had an ischemic stroke supported by neuroimaging. Data on age, risk factor history, stroke mechanism and discharge status were collected. 〈 i 〉 Results: 〈 /i 〉 A total of 958 subjects were included, their mean age was 34 years. Large-vessel thrombosis comprised 24%, cerebral venous thrombosis 21%, cardioembolism 19% and small-vessel thrombosis 15%. The stroke risk factors included hypertension (29%), diabetes (14%), pregnancy (11%), valvular heart disease (10%) and cigarette smoking (3%). Anemia was found in 42%, and mortality was 4%; at discharge, 17% had modified Rankin score (mRS) 〉 4 and 83% mRS 0–3. 〈 i 〉 Conclusion: 〈 /i 〉 Unlike among Caucasians, large-vessel thrombosis, cerebral venous thrombosis and cardioembolism are common among young Asian women with stroke. A high proportion are pregnancy-related. More studies are needed.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000317075
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1482069-9
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