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BACKGROUND In the general population, obesity is associated with increased risk of adverse outcomes. However, studies of patients with chronic disease suggest that overweight and obese patients may paradoxically have better outcomes than lean patients. We sought to examine the association of body mass index (BMI) and outcomes in stable outpatients with(More)
CONTEXT The Digitalis Investigation Group (DIG) trial reported that digoxin provided no overall mortality benefit and only a modest reduction in hospitalizations among patients with heart failure and depressed left ventricular systolic function. The clinical outcomes associated with digoxin therapy at different serum concentrations in the DIG trial have not(More)
BACKGROUND AND PURPOSE Although patterns of stroke occurrence and mortality have been well studied, few epidemiological data are available regarding the clinical characteristics of stroke events. METHODS We evaluated hospitalized stroke events reported in the Atherosclerosis Risk in Communities (ARIC) Study to describe the clinical characteristics of(More)
OBJECTIVE To evaluate the association between door-to-balloon time and mortality in hospital in patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction to assess the incremental mortality benefit of reductions in door-to-balloon times of less than 90 minutes. DESIGN Prospective cohort study of patients(More)
BACKGROUND Although ACE inhibitors are underprescribed for heart failure, factors associated with their use are not well described. Furthermore, the effectiveness of ACE inhibitors has been questioned in some populations, potentially contributing to underuse. Our objectives were to assess the correlates of ACE inhibitor use and the relationship between ACE(More)
BACKGROUND Health care expenditure per person is significantly higher in the United States compared with Canada, but whether there are differences in quality of care of many conditions is unknown. We compared the process of care and outcomes of patients with heart failure, the most common cause of hospitalization for individuals 65 years and older in both(More)
BACKGROUND The relationship between admission glucose levels and outcomes in older diabetic and nondiabetic patients with acute myocardial infarction is not well defined. METHODS AND RESULTS We evaluated a national sample of elderly patients (n=141,680) hospitalized with acute myocardial infarction from 1994 to 1996. Admission glucose was analyzed as a(More)
CONTEXT Black patients hospitalized with heart failure reportedly receive poorer quality of care and have worse outcomes than white patients. Because previous studies have been based on selected patient populations treated more than a decade ago, it is unclear if racial differences in quality of care and outcomes currently exist in the United States. (More)
We examined the association between JCAHO accreditation of hospitals, those hospitals' quality of care, and survival among Medicare patients hospitalized for acute myocardial infarction. Hospitals not surveyed by JCAHO had, on average, lower quality (less likely to use aspirin, beta-blockers, and reperfusion therapy) and higher thirty-day mortality rates(More)
OBJECTIVE To evaluate the effect of a mental illness diagnosis on quality of care and outcomes among patients with heart failure. DESIGN Retrospective, national, population-based sample of patients with heart failure hospitalized from April 1, 1998, through March 31, 1999, and July 1, 2000, through June 30, 2001. SETTING Nonfederal US acute care(More)