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At least 451 records · Page 25Linked to original sources
PubMed1997

Predictors of quality of life after hospital admission for heart attack or angina.

This study tests the hypothesis that it is possible to predict people who will have a low quality of life (QOL) 6 months after hospital admission for acute myocardial infarction (AMI) or angina. Among 424 patients discharged from hospital in the Hunter Region of New South Wales with a diagnosis of AMI or angina, follow-up questionnaires were received from 303 at 6 months. Baseline data collected during hospitalisation included demographic variables and the 'emotional' factor of a disease-specific QOL measure using a modified and validated self-administered questionnaire. The full QOL measure comprises 'emotional', 'physical' and 'social' factors, each factor being assessed at the 6-month follow-up. Only baseline 'emotional' QOL score and sex predicted 6-month QOL scores in patients with AMI. Scores were consistently lower in patients with angina, in whom marital and employment status, having had a previous AMI, current cigarette smoking, the presence of cardiac failure and baseline emotional QOL were all significantly associated with the 6-month QOL scores. The assessment of simple measures during hospitalisation for angina can be helpful in predicting those who will have a low QOL 6 months later. They may represent a high-risk group at whom counselling could be directed.

Aged↗
PubMed2003

Impact of a region-wide approach to improving systems for heart attack care: the West Midlands thrombolysis project.

OBJECTIVE: To describe changes in delay to administration of thrombolytic therapy associated with a region-wide audit. DESIGN: Observational study of patients admitted with suspected myocardial infarction (MI) based on continuous audit. SUBJECTS: 18877 patients admitted to 23 hospitals with suspected MI between April 1995 and March 1998. RESULTS: Of 11232 patients with a discharge diagnosis of definite MI, 8802 (46.6%) received thrombolytic therapy during hospitalisation, with 5155 patients eligible for treatment on admission to hospital on the basis of established indications. Call-to-needle time for those eligible for treatment on admission fell from median 105 min in the first year of the project to 85 min in year 3 (P<0.001), and door-to-needle time fell from 45 to 35 min (P<0.001). Forty percent of eligible patients were treated within the then current national standard of 90 min from time of call for help, with nearly 49% in the final year and 20% being treated within the new national standard of 60 min, by the third year. CONCLUSION: The proportion of eligible patients receiving thrombolysis within 1 h of the call for help doubled during the 3-year project but the majority of patients still wait longer than 60-min 'call-to-needle'. New systems to reduce delays to administration of thrombolysis to within 60 min of call for help are required, including consideration of pre-hospital treatment.

Aged↗
PubMed1979

Heart attacks and geomagnetic activity.

Malin and Srivastava reported a remarkable correlation between daily variations in the geomagnetic field strength and daily admissions to the cardio-thoracic wards of hospitals in Hyderabad and Secunderabad, for cardiac emergencies, during 1967--72. We have now carried out a similar enquiry in the West Midlands region of the UK for the years 1969--70, but were unable to confirm the Indian results.

England↗
PubMed1985

Biologic determinants of propranolol disposition: results from 1308 patients in the Beta-Blocker Heart Attack Trial.

Our objective was to identify biologic determinants of propranolol serum levels in 1308 patients after myocardial infarction (MI). Patients had had their MI within the previous month. A steady-state propranolol dosage of 40 mg every 8 hours produced a mean trough concentration of 42 ng/ml with extremely great (fiftyfold) interindividual variability. Univariate and multivariate analyses suggested that this variability was the result of many biologic factors. Serum levels were higher in women, in older patients, and in patients receiving concomitant therapy with other antiarrhythmic drugs. Serum levels were also higher in patients with elevated serum creatinine and lactate dehydrogenase levels. Serum levels were lower in black patients than in white patients. Also, serum levels in smokers were lower than those in nonsmokers, but only markedly so in the outpatient setting (6 months after the MI). The influence of sex and race on drug disposition has not previously been reported for beta-blocking drugs. Although a genetic deficiency in the oxidative metabolism of propranolol has been indicated, the frequency distribution of serum propranolol levels did not demonstrate a bimodal distribution for genetically distinct populations.

Adult↗