Circulation. 2007;116:1865
doi: 10.1161/CIRCULATIONAHA.107.185636
(Circulation. 2007;116:1865.)
© 2007 American Heart Association, Inc.
Issue Highlights
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GLOBAL THEMED ISSUE ON POVERTY AND HUMAN DEVELOPMENT IMPROVEMENT IN CONGENITAL HEART SURGERY IN A DEVELOPING COUNTRY: THE GUATEMALAN EXPERIENCE, by Larrazabal et al.
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In collaboration with science journals throughout the world
and as part of a Global Themed Issue on Poverty and Human Development,
this week’s
Circulation includes 2 original articles pertinent
to this topic. First, the article by Larrazabal et al discusses
the progress made in congenital heart disease surgery in Guatemala.
This study describes an effort that was made in 1997 to disseminate
US pediatric cardiac surgical practices in Guatemala with the
objective of examining the reduction in mortality in the new
Guatemalan cardiovascular program as compared with similar programs
in the United States. When comparing the Guatemalan mortality
rate against the United States benchmark (KID 2000 database),
a decrease in standardized mortality ratio from 10 in 1997 to
1999 to 5.7 in 2003 to 2004 was observed (
P=0.008). The authors
address some potential confounders, and despite these potential
limitations, the study suggests that, with a dedicated effort,
third-world countries can improve the quality of care provided
within their borders. See p 1882 (editorials pp
1874 and
1876).
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INTERNATIONAL DAY FOR THE EVALUATION OF ABDOMINAL OBESITY (IDEA): A STUDY OF WAIST CIRCUMFERENCE, CARDIOVASCULAR DISEASE, AND DIABETES MELLITUS IN 168 000 PRIMARY CARE PATIENTS IN 63 COUNTRIES, by Balkau et al.
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In the second article, Balkau and colleagues randomly selected
primary care physicians to measure waist circumference and body
mass index and to record the presence of cardiovascular disease
and diabetes. Of those tested, 24% of the men and 27% of women
were determined to be obese, and another 40% of the men and
30% of the women were found to be overweight; also, 29% of the
men and 48% of the women had a higher waist circumference. The
authors found that, after adjusting for age, region, and smoking
status, the frequency of cardiovascular disease and diabetes
increased with waist circumference in both men and women, in
each body mass index category and with body mass index in each
waist circumference tertile. See p
1942.
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ACUTE NONCARDIAC CONDITIONS AND IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION, by Lichtman et al.
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In clinical practice, many patients have a complex array of
clinical conditions that require attention. Prior literature
addressing concomitant conditions has primarily focused on chronic
conditions. A recent, small, single-center study reported that
many patients admitted to the hospital with an acute myocardial
infarction (AMI) also have an acute, severe, concomitant, noncardiac
condition that requires swift medical attention. Such acute
noncardiac conditions can affect patients’ eligibility
for certain medications and increase their risk. This article
describes the prevalence and prognostic importance of concomitant,
life-threatening acute conditions among 3907 patients with AMI
enrolled in the Prospective Registry Evaluating Myocardial Infarction:
Event and Recovery, Quality Improvement (PREMIER-QI) study,
a multisite observational study. These patients with AMI and
an acute, life-threatening condition are largely excluded from
studies of cardiovascular interventions, and clinical practice
guidelines generally do not address how best to choose strategies
for these patients. See p
1925.
Visit http://circ.ahajournals.org
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Images in Cardiovascular Medicine
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Three-Dimensional Echocardiography in Criss-Cross Heart: Could
a Specimen Be Better? See p
e414.
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Correspondence.
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See p
e416.
Related Articles:
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Congenital Heart Surgery in a Developing Country: A Few Men for a Great Challenge
- Noedir A.G. Stolf
Circulation 2007 116: 1874-1875.
[Full Text]
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Establishing Pediatric Cardiovascular Services in the Developing World: A Wake-Up Call
- Magdi H. Yacoub
Circulation 2007 116: 1876-1878.
[Full Text]
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International Day for the Evaluation of Abdominal Obesity (IDEA): A Study of Waist Circumference, Cardiovascular Disease, and Diabetes Mellitus in 168 000 Primary Care Patients in 63 Countries
- Beverley Balkau, John E. Deanfield, Jean-Pierre Després, Jean-Pierre Bassand, Keith A.A. Fox, Sidney C. Smith, Jr, Philip Barter, Chee-Eng Tan, Luc Van Gaal, Hans-Ulrich Wittchen, Christine Massien, and Steven M. Haffner
Circulation 2007 116: 1942-1951.
[Abstract]
[Full Text]
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Three-Dimensional Echocardiography in Criss-Cross Heart: Could a Specimen Be Better?
- Alessia Del Pasqua, Stephen Pruett Sanders, and Gabriele Rinelli
Circulation 2007 116: e414-e415.
[Full Text]
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Letter by Schlaich et al Regarding Article, "Relationship Between Central Sympathetic Drive and Magnetic Resonance Imaging–Determined Left Ventricular Mass in Essential Hypertension"
- Markus P. Schlaich, Gavin W. Lambert, Elisabeth A. Lambert, and Murray D. Esler
Circulation 2007 116: e416.
[Full Text]
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Acute Noncardiac Conditions and In-Hospital Mortality in Patients With Acute Myocardial Infarction
- Judith H. Lichtman, John A. Spertus, Kimberly J. Reid, Martha J. Radford, John S. Rumsfeld, Norrina B. Allen, Frederick A. Masoudi, William S. Weintraub, and Harlan M. Krumholz
Circulation 2007 116: 1925-1930.
[Abstract]
[Full Text]
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