Making treatment decisions for those with congenital heart disease in Turner syndrome: The need for evidence-based medicine

2006 ◽  
Vol 1298 ◽  
pp. 131-136 ◽  
Author(s):  
Michael Silberbach
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Turner Syndrome ◽  
Evidence Based Medicine ◽  
Congenital Heart ◽  
Treatment Decisions ◽  
Evidence Based ◽  
Based Medicine

scholarly journals Electronic Record Linkage cohort study of evidence-based management and outcomes in patients with ischaemic heart disease and atrial fibrillation

2021 ◽  
Author(s):  
◽  
Edward Daniel Harris
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Evidence Based Medicine ◽  
Lipid Lowering ◽  
Evidence Based ◽  
Lipid Lowering Therapy ◽  
Lipid Levels ◽  
Increased Risk ◽  
Based Medicine

BACKGROUND Implementation of evidence-based medicine is often suboptimal. The objectives of this thesis are to explore the delivery of evidence-based medicine and outcomes in patients with ischaemic heart disease (IHD) and atrial fibrillation (AF). METHODS Retrospective observational cohort studies were conducted using linked anonymised data from the secure anonymised information linkage (SAIL) databank. Patients included (i) those undergoing percutaneous coronary intervention, (ii) patients prescribed vitamin K antagonist (VKA) for AF, and (iii) patients with AF who had undergone successful PCI. RESULTS Amongst patients directed to take clopidogrel for one-year post-PCI, discontinuation was far lower (~6%) than in previous studies where the treatment duration was not known. Despite this, early discontinuation and/or bleeding was associated with an increased risk of adverse events. In a national cohort of PCI patients, we observed a low rate of achievement of international guideline target lipid levels (<25%) and low prescribing of intensive lipid lowering therapy amongst those not at target. Females and patients who had undergone elective PCI were least likely to have their lipid levels documented and be at target. In patients prescribed VKA for AF guideline defined poor anticoagulation control was common and associated with significantly higher bleeding event rates, independent of common comorbidities that are recognised as risk factors for stroke and bleeding. In patients with AF who had undergone PCI outcomes were poor: approximately 1 in 5 had either a stroke, acute coronary syndrome (ACS) or died in the year follow-up. Bleeding events were also common and associated with a five, three and four-fold increased risk of stroke, ACS, and death. CONCLUSION This thesis has characterised the nature of multiple therapeutic gaps and associated adverse outcomes with common clinical conditions. Thus, identifying opportunities to improve outcomes in individual patients and at population level.

The prevalence of adult congenital heart disease, results from a systematic review and evidence based calculation

2012 ◽  
Vol 164 (4) ◽  
pp. 568-575 ◽  
Author(s):  
Teun van der Bom ◽  
Berto J. Bouma ◽  
Folkert J. Meijboom ◽  
Aeilko H. Zwinderman ◽  
Barbara J.M. Mulder
Keyword(s):  
Systematic Review ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Evidence Based ◽  
Adult Congenital

Monitoring of congenital heart disease (CHD) and aortic dilatation in Turner syndrome: Italian experience

2006 ◽  
Vol 1298 ◽  
pp. 123-130 ◽  
Author(s):  
L. Mazzanti ◽  
D. Prandstraller ◽  
R. Fattori ◽  
L. Lovato ◽  
A. Cicognani
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Turner Syndrome ◽  
Congenital Heart ◽  
Aortic Dilatation ◽  
Italian Experience

Cardiovascular signs

ESC CardioMed ◽  
2018 ◽  
pp. 17-32
Author(s):  
Stuart D. Pringle ◽  
Samantha Fitzsimmons ◽  
Ingibjorg J. Gudmundsdottir ◽  
Joseph B. Esterson
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Signs ◽  
Evidence Based ◽  
Likelihood Ratios ◽  
Prognostic Information ◽  
Great Relevance

Physical examination remains an important part of cardiology practice because it facilitates the further investigation and treatment of those in whom heart disease is confirmed or suspected and helps to reassure those without a heart condition. Clinical signs can provide accurate, valuable diagnostic and prognostic information of great relevance to patients with most cardiac conditions particularly heart failure, coronary heart disease, valvular heart disease, and adults with congenital heart disease. This chapter reviews the most useful clinical signs in cardiology and discusses their relevance and accuracy expressed, wherever possible, as likelihood ratios; the reader should, however, be aware of the limitations of this sort of evidence-based approach because clinical signs should never be interpreted in isolation.

scholarly journals Development of an Online, Evidence-Based Patient Information Portal for Congenital Heart Disease: A Pilot Study

2017 ◽  
Vol 4 ◽  
Author(s):  
Jonathan R. G. Etnel ◽  
Arie P. J. van Dijk ◽  
Jolanda Kluin ◽  
Robin A. Bertels ◽  
Elisabeth M. W. J. Utens ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pilot Study ◽  
Patient Information ◽  
Congenital Heart ◽  
Evidence Based ◽  
Information Portal
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