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(Circulation. 2007;115:157.)
© 2007 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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REGIONAL DIFFERENCES IN PROCESS OF CARE AND OUTCOMES FOR OLDER ACUTE MYOCARDIAL INFARCTION PATIENTS IN THE UNITED STATES AND ONTARIO, CANADA, by Ko et al. |
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Contrasting the care of patients in different countries can provide insights into the effect of clinical strategies and systems on patient outcomes. Several studies have investigated whether the more expensive care in the United States for patients with acute myocardial infarction provides better outcomes than those achieved in Canada, where care is less expensive. These studies, however, have generally been limited by the use of administrative claims data, which lack clinical detail. Investigators from both countries have now made use of data sets derived from extensive medical record abstractions to evaluate how the practice and outcomes for patients in Ontario compare with various regions of the United States. The study by Ko and colleagues reveals striking variations in practice, along with some similarities, and raises questions about whether the contrasting styles translate into differences in mortality rates. See p 196 (editorial p 158).
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EFFECTS OF CARDIAC RESYNCHRONIZATION THERAPY WITH OR WITHOUT A DEFIBRILLATOR ON SURVIVAL AND HOSPITALIZATIONS IN PATIENTS WITH NEW YORK HEART ASSOCIATION CLASS IV HEART FAILURE, by Lindenfeld et al. |
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Cardiac resynchronization therapy and the implantable defibrillator, alone or in combination, for the appropriate patients, have been proven to be a lifesaving adjunct to medical therapy in patients with heart failure. Although the clinical benefits of these sophisticated electrophysiological devices are unquestioned, patient selection to optimize risk-benefit and cost effectiveness remains a difficult challenge. In this issue of Circulation, Lindenfeld et al probe the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) study data and show that these devices can reduce rates of death and hospitalizations in ambulatory New York Heart Association class IV patients. See p 204 (editorial p 161).
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SUBCLINICAL CORONARY AND AORTIC ATHEROSCLEROSIS DETECTED BY MAGNETIC RESONANCE IMAGING IN TYPE 1 DIABETES WITH AND WITHOUT DIABETIC NEPHROPATHY, by Kim et al. |
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