2003
National and State Trends in Quality of Care for Acute Myocardial Infarction Between 1994-1995 and 1998-1999: The Medicare Health Care Quality Improvement Program
Burwen DR, Galusha DH, Lewis JM, Bedinger MR, Radford MJ, Krumholz HM, Foody JM. National and State Trends in Quality of Care for Acute Myocardial Infarction Between 1994-1995 and 1998-1999: The Medicare Health Care Quality Improvement Program. JAMA Internal Medicine 2003, 163: 1430-1439. PMID: 12824092, DOI: 10.1001/archinte.163.12.1430.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAged, 80 and overAngioplasty, Balloon, CoronaryAngiotensin-Converting Enzyme InhibitorsAspirinFemaleHealth Care SurveysHumansMaleMedicareMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsQuality Indicators, Health CareQuality of Health CareSmoking CessationThrombolytic TherapyTime FactorsUnited StatesConceptsAcute myocardial infarctionQuality of careHospital arrivalEarly administrationMedian timeMyocardial infarctionPrimary percutaneous transluminal coronary angioplastyHealth Care Quality Improvement ProgramPercutaneous transluminal coronary angioplastyAcute reperfusion therapyBeta-blocker prescriptionEnzyme inhibitor prescriptionTransluminal coronary angioplastyGuideline-recommended processesQuality Improvement ProgramPopulation-based improvementsCessation counselingReperfusion therapySystolic dysfunctionInhibitor prescriptionCoronary angioplastyThrombolytic therapyMedicare patientsTherapyTime points
2002
Thrombolysis for Acute Stroke in Routine Clinical Practice
Bravata DM, Kim N, Concato J, Krumholz HM, Brass LM. Thrombolysis for Acute Stroke in Routine Clinical Practice. JAMA Internal Medicine 2002, 162: 1994-2001. PMID: 12230423, DOI: 10.1001/archinte.162.17.1994.Peer-Reviewed Original ResearchConceptsMajor protocol deviationsRoutine clinical practiceConnecticut cohortProtocol deviationsHospital mortalityAcute strokeThrombolytic therapyClinical practiceExtracranial hemorrhageCommunity-based patientsMinor protocol deviationsHigh rateIntravenous thrombolysisAdverse eventsRetrospective cohortHemorrhage ratePatient outcomesConnecticut hospitalsPatientsThrombolysisNeurological disordersCohortExperienced cliniciansStudy settingTherapy
2000
Intracranial Hemorrhage Associated With Thrombolytic Therapy for Elderly Patients With Acute Myocardial Infarction
Brass L, Lichtman J, Wang Y, Gurwitz J, Radford M, Krumholz H. Intracranial Hemorrhage Associated With Thrombolytic Therapy for Elderly Patients With Acute Myocardial Infarction. Stroke 2000, 31: 1802-1811. PMID: 10926938, DOI: 10.1161/01.str.31.8.1802.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionThrombolytic therapyIntracranial hemorrhageMyocardial infarctionElderly patientsIntracranial Hemorrhage AssociatedRetrospective cohort studyRisk stratification scaleMain outcome measuresAcute care hospitalsTissue plasminogen activatorExcessive anticoagulationPrior strokeCohort studyOlder patientsBlood pressureHemorrhage AssociatedIndependent predictorsMedical chartsSerious complicationsMedian weightAlternate therapyBlack racePrincipal diagnosisMedicare patientsThrombolytic therapy in older patients
Berger A, Radford M, Wang Y, Krumholz H. Thrombolytic therapy in older patients. Journal Of The American College Of Cardiology 2000, 36: 366-374. PMID: 10933344, DOI: 10.1016/s0735-1097(00)00723-3.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrimary angioplastyThrombolytic therapyOlder patientsBundle branch blockAcute reperfusionBranch blockST-segment elevationPatients age 65Population-based cohortReperfusion strategyReperfusion therapyHospital arrivalSurvival benefitSymptom onsetSegment elevationPhysician factorsST elevationMyocardial infarctionNational cohortAngioplastyBetter survivalMedicare beneficiariesLower mortalityPatientsFactors associated with delay in reperfusion therapy in elderly patients with acute myocardial infarction: Analysis of the Cooperative Cardiovascular Project
Berger A, Radford M, Krumholz H. Factors associated with delay in reperfusion therapy in elderly patients with acute myocardial infarction: Analysis of the Cooperative Cardiovascular Project. American Heart Journal 2000, 139: 985-992. PMID: 10827378, DOI: 10.1067/mhj.2000.105703.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnistreplaseElectrocardiographyFemaleHumansMaleMyocardial InfarctionPatient AdmissionPlasminogen ActivatorsQuality Indicators, Health CareRetrospective StudiesRisk FactorsStreptokinaseSurvival RateThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment FailureUnited StatesConceptsAcute myocardial infarctionHospital arrivalElderly patientsMortality rateMyocardial infarctionCardiology/American Heart Association guidelinesAmerican Heart Association guidelinesAdministration of thrombolysisHistory of hypertensionHeart Association guidelinesCooperative Cardiovascular Project databaseCooperative Cardiovascular ProjectCardiac catheterization laboratoryReperfusion therapyClinical characteristicsHeart failureST elevationThrombolytic therapyAssociation guidelinesHospital characteristicsCatheterization laboratoryAmerican CollegeThrombolysisPatientsRapid treatment
1997
Thrombolytic Therapy for Elderly Patients With Myocardial Infarction-Reply
Krumholz H. Thrombolytic Therapy for Elderly Patients With Myocardial Infarction-Reply. JAMA 1997, 278: 1401-1402. DOI: 10.1001/jama.1997.03550170031017.Peer-Reviewed Original ResearchThrombolytic Therapy for Eligible Elderly Patients With Acute Myocardial Infarction
Krumholz HM, Murillo JE, Chen J, Vaccarino V, Radford MJ, Ellerbeck EF, Wang Y. Thrombolytic Therapy for Eligible Elderly Patients With Acute Myocardial Infarction. JAMA 1997, 277: 1683-1688. PMID: 9169894, DOI: 10.1001/jama.1997.03540450039032.Peer-Reviewed Original ResearchConceptsST-segment elevationAcute myocardial infarctionThrombolytic therapyBundle branch blockMyocardial infarctionChest painElderly patientsMental statusBranch blockTotal ST-segment elevationEligible elderly patientsThrombolytic therapy useRetrospective cohort studyHours of symptomsOnset of symptomsPopulation-based sampleLack of treatmentDirect angioplastyEligible patientsAbsolute contraindicationBypass surgeryCohort studyMedical chartsTherapy useContiguous leads
1995
Aspirin in the treatment of acute myocardial infarction in elderly Medicare beneficiaries. Patterns of use and outcomes.
Krumholz H, Radford M, Ellerbeck E, Hennen J, Meehan T, Petrillo M, Wang Y, Kresowik T, Jencks S. Aspirin in the treatment of acute myocardial infarction in elderly Medicare beneficiaries. Patterns of use and outcomes. Circulation 1995, 92: 2841-7. PMID: 7586250, DOI: 10.1161/01.cir.92.10.2841.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionUse of aspirinDays of hospitalizationElderly patientsMyocardial infarctionMedicare beneficiariesHospital medical recordsElderly Medicare beneficiariesHigh-risk characteristicsPopulation-based sampleDelivery of careQuality of careAspirin therapyMore comorbiditiesAspirin useChest painAbsolute contraindicationHeart failureThrombolytic therapyPotential confoundersMedical recordsSafe treatmentEffective therapyHigh riskLower oddsA cost-effectiveness model of thrombolytic therapy for acute myocardial infarction
Kalish S, Gurwitz J, Krumholz H, Avorn J. A cost-effectiveness model of thrombolytic therapy for acute myocardial infarction. Journal Of General Internal Medicine 1995, 10: 321-330. PMID: 7562123, DOI: 10.1007/bf02599951.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsTissue plasminogen activatorAcute myocardial infarctionAdditional quality-adjusted life yearMyocardial infarctionGUSTO trialThrombolytic therapyOne-year mortality dataOccluded Coronary Arteries (GUSTO-I) trialMortality dataPlasminogen activatorLong-term medical costsCoronary Arteries trialOne-year mortalityUse of streptokinaseInferior wall infarctionCost-effective therapyCost-effectiveness modelDecision analysis modelSurvival benefitSymptom onsetClinical outcomesRelative survival advantageThrombolytic agentsSurvival advantage
1994
Relationship of Age with Eligibility for Thrombolytic Therapy and Mortality Among Patients with Suspected Acute Myocardial Infarction
Krumholz H, Friesinger G, Cook E, Lee T, Rouan G, Goldman L. Relationship of Age with Eligibility for Thrombolytic Therapy and Mortality Among Patients with Suspected Acute Myocardial Infarction. Journal Of The American Geriatrics Society 1994, 42: 127-131. PMID: 8126322, DOI: 10.1111/j.1532-5415.1994.tb04938.x.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionEmergency departmentMyocardial infarctionThrombolytic therapyElderly patientsRelationship of agePain studiesEligible elderly patientsLateral chest painOnset of painPercentage of patientsProspective cohort studyFrequency of patientsPathologic Q wavesST-segment elevationMyocardial infarction patientsInvestigation of patientsCurrent eligibility criteriaChest painCohort studyAcute infarctionChief complaintLocal traumaInfarction patientsUniversity Hospital
1992
Cost Effectiveness of Thrombolytic Therapy with Streptokinase in Elderly Patients with Suspected Acute Myocardial Infarction
Krumholz H, Pasternak R, Weinstein M, Friesinger G, Ridker P, Tosteson A, Goldman L. Cost Effectiveness of Thrombolytic Therapy with Streptokinase in Elderly Patients with Suspected Acute Myocardial Infarction. New England Journal Of Medicine 1992, 327: 7-13. PMID: 1598117, DOI: 10.1056/nejm199207023270102.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionThrombolytic therapyRisk of deathMyocardial infarctionElderly patientsPatients 75 yearsST-segment elevationOnset of symptomsUse of streptokinaseOne-way sensitivity analysesDecision analytic modelYears of lifeCost-effective treatmentRelative reductionHospital deathStreptokinase therapyOlder patientsClinical circumstancesThrombolytic agentsInfarctionPatientsCost effectivenessTherapyLack of consensusStreptokinase
1991
Reperfusion arrhythmias after thrombolysis. Electrophysiologic tempest, or much ado about nothing.
Krumholz HM, Goldberger AL. Reperfusion arrhythmias after thrombolysis. Electrophysiologic tempest, or much ado about nothing. CHEST Journal 1991, 99: 135s-140s. PMID: 2009810, DOI: 10.1378/chest.99.4.135s.Peer-Reviewed Original ResearchConceptsThrombolytic therapyMyocardial infarctionAcute myocardial infarctionSignificant clinical interestReperfusion arrhythmiasSuccessful reperfusionMyocardial reperfusionIdioventricular rhythmClinical eventsVentricular tachyarrhythmiasNoninvasive markerAnimal studiesArrhythmiasConsistent markerReperfusionClinical interestInfarctionTherapyCurrent dataMarkersThrombolysisTachyarrhythmias