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Investigation and Management of Coro...

Rosso de Braga, Juarez.

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Investigation and Management of Coronary Artery Disease Among Patients with Heart Failure in Ontario.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Investigation and Management of Coronary Artery Disease Among Patients with Heart Failure in Ontario./
作者:	Rosso de Braga, Juarez.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
面頁冊數:	147 p.
附註:	Source: Dissertations Abstracts International, Volume: 82-01, Section: B.
Contained By:	Dissertations Abstracts International82-01B.
標題:	Medicine. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27834237
ISBN:	9798662393622

Investigation and Management of Coronary Artery Disease Among Patients with Heart Failure in Ontario.
Rosso de Braga, Juarez.

Investigation and Management of Coronary Artery Disease Among Patients with Heart Failure in Ontario. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 147 p.

Source: Dissertations Abstracts International, Volume: 82-01, Section: B.

Thesis (Ph.D.)--University of Toronto (Canada), 2020.

This item must not be sold to any third party vendors.

Background: The investigation and management of heart failure (HF) requires extensive use of healthcare resources in Ontario, Canada. Methods: Four cohort studies using administrative databases were conducted to describe the epidemiology of HF; to assess the use of cardiac imaging and coronary revascularization; and to determine the significance of non-obstructive coronary artery disease on clinical outcomes.Results: The incidence rate of HF decreased 32% from 380 new cases (95% CI, 376-384) per 100,000 individuals in 2002 to 256 (95% CI, 254-259) per 100,000 in 2016 (P < 0.001). The prevalence rate decreased from 2408 cases (95% CI, 2398-2417) per 100,000 in 2002 to 1979 (95% CI, 1972-1987) per 100,000 in 2016 (P < .001). Echocardiography was the most used cardiac imaging modality increasing from 386 tests (95% CI, 373-398) per 1000 HF patients in 2002 to 513 (95% CI, 501-526) per 1000 in 2011. After the initiation of an accreditation program in 2012, there was an immediate reduction in the use of echocardiography (-59.5 tests per 1000, P <.001). The use of percutaneous coronary intervention increased 100% from 13 procedures (95% CI, 11-15) per 1000 HF cases in 2002 to 26 procedures (95% CI, 22-30) per 1,000 in 2016. The use of surgical revascularization decreased 35% from 23 procedures (95% CI, 21-27) per 1000 HF cases in 2002 to 17 (95% CI, 14-21) per 1000 in 2016 (P < .001). Non-obstructive coronary artery disease was associated with an increased rate of cardiovascular death (HR 1.82; 95% CI; 1.27-2.62; p = 0.001) and death of any cause (HR 1.18; 95% CI 1.05-1.33; p = 0.005) in comparison to individuals with normal coronary arteries.Conclusions: Over a 15-year period, the overall incidence and prevalence of HF declined significantly. Rest echocardiography remained the most used cardiac imaging modality with a marked decline in utilization after a quality improvement initiative. There was an increase in use of percutaneous coronary intervention counterbalanced by a decline in surgical revascularization. Among HF patients, the presence of non-obstructive coronary artery disease was independently associated with an increased rate of death in comparison to individuals with normal coronary arteries.

ISBN: 9798662393622Subjects--Topical Terms:

641104
Medicine.
Subjects--Index Terms:

Coronary artery bypass

Investigation and Management of Coronary Artery Disease Among Patients with Heart Failure in Ontario.
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