Coronary angiography and angioplasty after acute myocardial infarction

Article Abstract:

Many patients who have had a heart attack are receiving angiography even though they may benefit little from the procedure. Angiography involves injecting a dye into the heart so physicians can detect coronary artery disease and other heart diseases. Patients who have atherosclerosis can then be treated with angioplasty, which opens up blocked arteries. However, angiography can have severe complications and many studies have shown that only patients with recurring angina or other symptoms may benefit. The US spends about $1 billion annually for angiography on heart attack patients.

Author: Leape, Lucian L., Bates, David W., Bernstein, Steven J., Miller, Elizabeth, Hauptman, Paul J.
Angiocardiography

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Effect of local medical opinion leaders on quality of care for acute myocardial infarction: a randomized controlled trial

Article Abstract:

Involving hospital opinion leaders may be an effective way to improve compliance with practice guidelines for treating elderly heart attack patients. Researchers met with opinion leaders at 20 Minnesota hospitals and encouraged them to follow guidelines recommending thrombolytic drugs, aspirin and beta blockers for eligible elderly heart attack patients. Compliance with these guidelines increased substantially compared to 17 hospitals that did not receive such guidance. Many doctors in the 20 participating hospitals were still reluctant to use thrombolytic drugs.

Author: Soumerai, Stephen B., Guadagnoli, Edward, McLaughlin, Thomas J., Gurwitz, Jerry H., Willison, Donald J., Gao, Xiaoming, Hauptman, Paul J., Borbas, Catherine, Morris, Nora, McLaughlin, Barbara, Asinger, Richard, Gobel, Fredarick
Usage, Medical care, Quality management, Medical care quality, Cardiac patients, Medical protocols

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Delayed hospital presentation in patients who have had acute myocardial infarction

Article Abstract:

Many persons having a heart attack delay seeking hospital care. Delay means that they may miss the window for treatment with clot-dissolving medications. Of 2,400 patients hospitalized for a heart attack, 40% delayed arrival at the hospital for more than six hours after symptom onset. Older patients and women were more likely to delay seeking care as were patients whose symptoms began in the evening and early morning hours. Chest pain and history of angioplasty or bypass surgery reduced the odds of delay. Only 40% arrived via ambulance.

Author: Soumerai, Stephen B., Guadagnoli, Edward, McLaughlin, Thomas J., Gurwitz, Jerry H., Willison, Donald J., Gao, Xiaoming, Hauptman, Paul J.
Emergency medical services, Medical care utilization

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Subjects list: Care and treatment, Heart attack
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