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OBJECTIVE To determine whether ratings of coronary angiography appropriateness derived by an expert panel on hypothetical patients are associated with actual angiographic findings, mortality, and subsequent revascularisation in the ACRE (appropriateness of coronary revascularisation) study. DESIGN Population based, prospective study. The ACRE expert panel(More)
BACKGROUND Ratings by an expert panel of the appropriateness of treatments may offer better guidance for clinical practice than the variable decisions of individual clinicians, yet there have been no prospective studies of clinical outcomes. We compared the clinical outcomes of patients treated medically after angiography with those of patients who(More)
BACKGROUND Deep sternal wound infection (mediastinitis) occurred in 21 out of 4043 consecutive patients who underwent a cardiopulmonary bypass procedure (incidence of 0.4%). METHODS Clinical characteristics of patients who developed mediastinitis (group I) were compared to those of patients who had no mediastinal infection (group II). RESULTS Hospital(More)
Nifedipine, a slow-channel calcium blocker, is thought to provide useful myocardial protection during prolonged total ischemia and reperfusion. An isolated, isovolumic, feline heart model was used to asses the effectiveness of nifedipine in both cardioplegic (100 microgram/10 ml) and noncardioplegic (10 microgram/10 ml) doses for providing myocardial(More)
OBJECTIVE To examine the cardioprotective efficacy of allopurinol in patients undergoing elective coronary artery surgery. DESIGN Prospective randomised trial. SETTING London teaching hospital. PATIENTS Twenty patients with at least moderately good left ventricular function undergoing elective coronary artery surgery and requiring at least two bypass(More)
BACKGROUND Previous studies investigating the appropriateness of invasive management of coronary disease had not reported the internal consistency of their ratings and may now be out of date. The aim of this study was to measure the influence of clinical factors on contemporary ratings of the appropriateness of coronary angiography, percutaneous(More)
Treatment with the combination of aspirin and dipyridamole is believed to reduce the incidence of coronary vein graft occlusion. A double blind randomised controlled trial was carried out in which aspirin 990 mg and dipyridamole 225 mg daily or placebo were added to the routine postoperative management (warfarin for three months) of 320 patients undergoing(More)
OBJECTIVE This study was conducted in order to determine the outcome of cardiac re-operations in patients over the age of 70. METHODS All patients who underwent 're-do' cardiac surgery at our institution, between January 1987 and October 1995 were identified. The case notes of patients over the age of 70 were reviewed retrospectively and follow-up was by(More)