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Article ; Online: Importance of integrated management system applied in health establishments in order to raise treatment quality

Dodić Biljana / Miljković Tatjana / Bjelobrk Marija / Ađić Čemerlić Nada / Ađić Filip / Dodić Slobodan

Medicinski Pregled, Vol 69, Iss 1-2, Pp 31-

2016 Volume 36

Abstract: Introduction. The term “management” is best characterized as “managing” economic or social processes to achieve objectives through a rational use of material and immaterial resources by applying the principles, functions, and management methods. This ... ...

Abstract	Introduction. The term “management” is best characterized as “managing” economic or social processes to achieve objectives through a rational use of material and immaterial resources by applying the principles, functions, and management methods. This study has been aimed at evaluating the value of an integrated quality management system implemented at the Institute of Cardiovascular Diseases of Vojvodina to improve the quality of treatment. Material and Methods. In the period from 2008 to 2010 about 40 employees from the Institute of Cardiovascular Diseases of Vojvodina attended various courses given by the lecturers of the Faculty of Technical Sciences, where the function and significance of the “International Standards Organization” were explained, after which standards of interest were implemented at the Institute of Cardiovascular Diseases of Vojvodina. Results. The Department of Cardiology has introduced 11 cardiac procedures with 5 special instructions, 14 general procedures, and 7 specific procedures with 2 instructions. The Department of Cardiac Surgery has introduced 7 procedures to be implemented. The “Vojvodina score” model was put into practice for the perioperative evaluation of cardiac surgery risk. During 2014, the Institute of Cardiovascular Diseases of Vojvodina obtained accreditation for the period of 7 years. Conclusion. The integrated quality management system must be applied in order to achieve a high level of health care in the shortest possible time and with the least possible consumption of material and human resources. The application of this system in practice gives a realistic insight into the working processes and facilitates their functioning. It demands and requires constant monitoring of the system efficiency along with continuous changes and improvements of all elements of the working processes and functional units.
Keywords	Quality of Health Care ; Integrated Advances Information Management System ; Quality Indicators ; Health Care ; Organization and Administration ; Health Services ; Medicine (General) ; R5-920 ; Medicine ; R
Subject code	360
Language	Serbian
Publishing date	2016-01-01T00:00:00Z
Publisher	Serbian Medical Society, Society of Physicians of Vojvodina, Novi Sad
Document type	Article ; Online
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Article ; Online: The level of grammar school students’ knowledge on cardiovascular disease risk factors

Jaraković Milana / Mihajlović Bojan / Čemerlić Snežana / Ađić Filip / Sladojević Miroslava / Mihajlović Bogoljub

Medicinski Pregled, Vol 68, Iss 3-4, Pp 98-

2015 Volume 102

Abstract: Introduction. Cardiovascular diseases are one of the leading causes of mortality and morbidity worldwide. The atherosclerotic process in the aorta starts in childhood, while atheroclerotic changes of coronary heart vessels start in adolescence. The aim ... ...

Abstract	Introduction. Cardiovascular diseases are one of the leading causes of mortality and morbidity worldwide. The atherosclerotic process in the aorta starts in childhood, while atheroclerotic changes of coronary heart vessels start in adolescence. The aim of the study was to evaluate the knowledge of the students attending all four grades of grammar school about the risk factors for cardiovascular disease, with special attention to the risk factors that can be influenced by modification of life-style. Material and Methods. Data from the entrance and exit tests were collected from 197 students attending a grammar school in Novi Sad. Chi-square test and Student T-test or Mann-Whitney U test were used to examine the statistical difference between categorized variables and the continuous variables, respectively. Results. The difference between the number of correct answers for all the students on the entrance test and exit test was statistically significant (p<0.0005) and the overall knowledge level after lectures was increased by 29.4%. The lowest level of knowledge on the entrance tests was noted among the students of the third grade of grammar school and after the lectures, the student’s knowledge level was increased by 82.3% (p<0.0005). Conclusion. Children and adolescents from Vojvodina and Serbia should be well informed about the cardiovascular disease risk factors and their prevention with special attention paid to the risk factors that can be influenced by changing lifestyle habits.
Keywords	Cardiovascular Diseases ; Risk Factors ; Adolescent ; Students ; Life Style ; Risk Reduction Behavior ; Health Knowledge ; Attitudes ; Practice ; Medicine (General) ; R5-920 ; Medicine ; R
Subject code	370
Language	Serbian
Publishing date	2015-01-01T00:00:00Z
Publisher	Serbian Medical Society, Society of Physicians of Vojvodina, Novi Sad
Document type	Article ; Online
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Article ; Online: Data mining approach for in-hospital treatment outcome in patients with acute coronary syndrome

Sladojević Miroslava / Čanković Milenko / Čemerlić Snežana / Mihajlović Bojan / Ađić Filip / Jaraković Milana

Medicinski Pregled, Vol 68, Iss 5-6, Pp 157-

2015 Volume 161

Abstract: Introduction. Risk stratification is nowadays crucial when estimating the patient’s prognosis in terms of treatment outcome and it also helps in clinical decision making. Several risk assessment models have been developed to predict short-term outcomes ... ...

Abstract	Introduction. Risk stratification is nowadays crucial when estimating the patient’s prognosis in terms of treatment outcome and it also helps in clinical decision making. Several risk assessment models have been developed to predict short-term outcomes in patients with acute coronary syndrome. This study was aimed at developing an outcome prediction model for patients with acute coronary syndrome submitted to percutaneus coronary intervention using data mining approach. Material and Methods. A total of 2030 patients hospitalized for acute coronary syndrome and treated with percutaneous coronary intervention from December 2008 to December 2011 were assigned to a derivation cohort. Demographic and anamnestic data, clinical characteristics on admission, biochemical analysis of blood parameters on admission, and left ventricular ejection fraction formed the basis of the study. A number of machine learning algorithms available within Waikato Environment for Knowledge Discovery had been evaluated and the most successful was chosen. The predictive model was subsequently validated in a different population of 931 patients (validation cohort), hospitalized during 2012. Results. The best prediction results were achieved using Alternating Decision Tree classifier, which was able to predict in-hospital mortality with 89% accuracy, and preserved good performance on validation cohort with 87% accuracy. Alternating Decision Tree classifier identified a subset of 6 attributes most relevant to mortality prediction: systolic and diastolic blood pressure, heart rate, left ventricular ejection fraction, age, and troponin value. Conclusion. Data mining approach enabled the authors to develop a model capable of predicting the in-hospital outcome following percutaneous coronary intervention. The model showed excellent sensitivity and specificity during internal validation.
Keywords	Data Mining ; Treatment Outcome ; Acute Coronary Syndrome ; Risk Assessment ; Mortality ; Medicine (General) ; R5-920 ; Medicine ; R
Subject code	610
Language	Serbian
Publishing date	2015-01-01T00:00:00Z
Publisher	Serbian Medical Society, Society of Physicians of Vojvodina, Novi Sad
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: IMPORTANCE OF INTEGRATED MANAGEMENT SYSTEM APPLIED IN HEALTH ESTABLISHMENTS IN ORDER TO RAISE TREATMENT QUALITY.

Dodić, Biljana / Miljković, Tatjana / Bjelobrk, Marija / Cemerlic Ađić, Nada / Ađić, Filip / Dodić, Slobodan

Medicinski pregled

2016 Volume 69, Issue 1-2, Page(s) 31–36

Abstract: Introduction: The term "management" is best characterized as "managing" economic or social processes to achieve objectives through a rational use of material and immaterial resources by applying the principles, functions, and management methods. This ... ...

Abstract	Introduction: The term "management" is best characterized as "managing" economic or social processes to achieve objectives through a rational use of material and immaterial resources by applying the principles, functions, and management methods. This study has been aimed at evaluating the value of an integrated quality management system implemented at the Institute of Cardiovascular Diseases of Vojvodina to improve the quality of treatment. Material and methods: In the period from 2008 to 2010 about 40 employees from the Institute of Cardiovascular Diseases of Vojvodina attended various courses given by the lecturers of the Faculty of Technical Sciences, where the function and significance of the "International Standards Organization" were explained, after which standards of interest were implemented at the Institute of Cardiovascular Diseases of Vojvodina. Results: The Department of Cardiology has introduced 11 cardiac procedures with 5 special instructions, 14 general procedures, and 7 specific procedures with 2 instructions. The Department of Cardiac Surgery has introduced 7 procedures to be implemented. The "Vojvodina score" model was put into practice for the perioperative evaluation of cardiac surgery risk. During 2014, the Institute of Cardiovascular Diseases ofVojvodina obtained accreditation for the period of 7 years. Conclusion: The integrated quality management system must be applied in order to achieve a high level of health care in the shortest possible time and with the least possible consumption of material and human resources. The application of this system in practice gives a realistic insight into the working processes and facilitates their functioning. It demands and requires constant monitoring of the system efficiency along with continuous changes and improvements of all elements of the working processes and functional units.
MeSH term(s)	Cardiology/organization & administration ; Health Services Research ; Hospital Departments/organization & administration ; Humans ; Quality Improvement/organization & administration ; Quality of Health Care/organization & administration ; Serbia ; Thoracic Surgery/organization & administration
Language	English
Publishing date	2016-07-29
Publishing country	Serbia
Document type	Journal Article
ZDB-ID	131108-6
ISSN	0025-8105
ISSN	0025-8105
DOI	10.2298/mpns1602031d
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Article: THE LEVEL OF GRAMMAR SCHOOL STUDENTS' KNOWLEDGE ON CARDIOVASCULAR DISEASE RISK FACTORS.

Jaraković, Milana / Mihajlović, Bojan / Ćemerlić, Snežana / Ađić, Filip / Sladojević, Miroslava / Mihajlović, Boaoliub

Medicinski pregled

2015 Volume 68, Issue 3-4, Page(s) 98–102

Abstract: Introduction: Cardiovascular diseases are one of the leading causes of mortality and morbidity worldwide. The atherosclerotic process in the aorta starts in childhood, while atheroclerotic changes of coronary heart vessels start in adolescence. The aim ... ...

Abstract	Introduction: Cardiovascular diseases are one of the leading causes of mortality and morbidity worldwide. The atherosclerotic process in the aorta starts in childhood, while atheroclerotic changes of coronary heart vessels start in adolescence. The aim of the study was to evaluate the knowledge of the students attending all four grades of grammar school about the risk factors for cardiovascular disease, with special attention to the risk factors that can be influenced by modification of life-style. Material and methods: Data from the entrance and exit tests were collected from 197 students attending a grammar school in Novi Sad. Chi-square test and Student T-test or Mann-Whitney U test were used to examine the statistical difference between categorized variables and the continuous variables, respectively. Results: The difference between the number of correct answers for all the students on the entrance test and exit test was statistically significant (p<0.0005) and the overall knowledge level after lectures was increased by 29.4%. The lowest level of knowledge on the entrance tests was noted among the students of the third grade of grammar school and after the lectures, the student's knowledge level was increased by 82.3% (p<0.0005). Conclusion: Children and adolescents from Vojvodina and Serbia should be well informed about the cardiovascular disease risk factors and their prevention with special attention paid to the risk factors that can be influenced by changing lifestyle habits.
MeSH term(s)	Adolescent ; Cardiovascular Diseases/psychology ; Child ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Pilot Projects ; Serbia ; Students/psychology
Language	English
Publishing date	2015-07-11
Publishing country	Serbia
Document type	Journal Article
ZDB-ID	131108-6
ISSN	0025-8105
ISSN	0025-8105
DOI	10.2298/mpns1504098j
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Article: DATA MINING APPROACH FOR IN-HOSPITAL TREATMENT OUTCOME IN PATIENTS WITH ACUTE CORONARY SYNDROME.

Sladojević, Miroslava / Čanković, Milenko / Čemerlić, Snežana / Mihajlović, Bojan / Ađić, Filip / Jaraković, Milana

Medicinski pregled

2015 Volume 68, Issue 5-6, Page(s) 157–161

Abstract: Introduction: Risk stratification is nowadays crucial when estimating the patient's prognosis in terms of treatment outcome and it also helps in clinical decision making. Several risk assessment models have been developed to predict short-term outcomes ... ...

Abstract	Introduction: Risk stratification is nowadays crucial when estimating the patient's prognosis in terms of treatment outcome and it also helps in clinical decision making. Several risk assessment models have been developed to predict short-term outcomes in patients with acute coronary syndrome. This study was aimed at developing an outcome prediction model for patients with acute coronary syndrome submitted to percutaneus coronary intervention using data mining approach. Material and methods: A total of 2030 patients hospitalized for acute coronary syndrome and treated with percutaneous coronary intervention from December 2008 to December 2011 were assigned to a derivation cohort. Demographic and anamnestic data, clinical characteristics on admission, biochemical analysis of blood parameters on admission, and left ventricular ejection fraction formed the basis ofthe study. A number of machine learning algorithms available within Waikato Environment for Knowledge Discovery had been evaluated and the most successful was chosen. The predictive model was subsequently validated in a different population of 931 patients (validation cohort), hospitalized during 2012. Results: The best prediction results were achieved using Alternating Decision Tree classifier, which was able to predict in-hospital mortality with 89% accuracy, and preserved good performance on validation cohort with 87% accuracy. Alternating Decision Tree classifier identified a subset of 6 attributes most relevant to mortality prediction: systolic and diastolic blood pressure, heart rate, left ventricular ejection fraction, age, and troponin value. Conclusion: Data mining approach enabled the authors to develop a model capable of predicting the in-hospital outcome following percutaneous coronary intervention. The model showed excellent sensitivity and specificity during internal validation.
MeSH term(s)	Acute Coronary Syndrome/mortality ; Acute Coronary Syndrome/surgery ; Aged ; Data Mining/methods ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Serbia/epidemiology ; Survival Rate/trends ; Treatment Outcome
Language	English
Publishing date	2015-07-30
Publishing country	Serbia
Document type	Journal Article
ZDB-ID	131108-6
ISSN	0025-8105
ISSN	0025-8105
DOI	10.2298/mpns1506157s
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Article ; Online: Effect of Body Mass Index on Effectiveness of CT versus Invasive Coronary Angiography in Stable Chest Pain: The DISCHARGE Trial.

Sykes, Robert / Collison, Damien / Merkely, Bela / Kofoed, Klaus F / Donnelly, Patrick / Rodríguez-Palomares, José / Erglis, Andrejs / Veselka, Josef / Šakalytė, Gintarė / Ađić, Nada Čemerlić / Gutberlet, Matthias / Dodd, Jonathan D / Diez, Ignacio / Davis, Gershan / Zimmermann, Elke / Kępka, Cezary / Vidakovic, Radosav / Francone, Marco / Ilnicka-Suckiel, Małgorzata /

Plank, Fabian / Knuuti, Juhani / Faria, Rita / Schröder, Stephen / Berry, Colin / Saba, Luca / Ruzsics, Balazs / Rieckmann, Nina / Kubiak, Christine / Hansen, Kristian Schultz / Müller-Nordhorn, Jacqueline / Maurovich-Horvat, Pál / Knudsen, Andreas D / Benedek, Imre / Orr, Clare / Valente, Filipa Xavier / Zvaigzne, Ligita / Horváth, Martin / Jankauskas, Antanas / Ađić, Filip / Woinke, Michael / Keane, Stephen / Lecumberri, Iñigo / Thwaite, Erica / Laule, Michael / Kruk, Mariusz / Zivanic, Aleksandra / Mancone, Massimo / Kuśmierz, Donata / Feuchtner, Gudrun / Pietilä, Mikko / Ribeiro, Vasco Gama / Drosch, Tanja / Delles, Christian / Porcu, Michele / Fisher, Michael / Bárány, Tamás / Sørum, Charlotte / Aurelian, Rosca / Kelly, Stephanie / Garcia Del Blanco, Bruno / Rubio, Ainhoa / Szilveszter, Bálint / Abdulla, Jawdat / Rodean, Ioana / Regan, Susan / Cuéllar Calabria, Hug / Vecsey-Nagy, Milán / Jurlander, Birgit / Hodas, Roxana / Feger, Sarah / Mohamed, Mahmoud / Serna-Higuita, Lina M / Neumann, Konrad / Dreger, Henryk / Rief, Matthias / Wieske, Viktoria / Ferencik, Maros / Estrella, Melanie / Bosserdt, Maria / Martus, Peter / Benedek, Theodora / Dewey, Marc

Radiology

2024 Volume 310, Issue 2, Page(s) e230591

Abstract: Background Recent trials support the role of cardiac CT in the evaluation of symptomatic patients suspected of having coronary artery disease (CAD); however, body mass index (BMI) has been reported to negatively impact CT image quality. Purpose To ... ...

Abstract	Background Recent trials support the role of cardiac CT in the evaluation of symptomatic patients suspected of having coronary artery disease (CAD); however, body mass index (BMI) has been reported to negatively impact CT image quality. Purpose To compare initial use of CT versus invasive coronary angiography (ICA) on clinical outcomes in patients with stable chest pain stratified by BMI category. Materials and Methods This prospective study represents a prespecified BMI subgroup analysis of the multicenter Diagnostic Imaging Strategies for Patients with Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial conducted between October 2015 and April 2019. Adult patients with stable chest pain and a CAD pretest probability of 10%-60% were randomly assigned to undergo initial CT or ICA. The primary end point was major adverse cardiovascular events (MACE), including cardiovascular death, nonfatal myocardial infarction, or stroke. The secondary end point was an expanded MACE composite, including transient ischemic attack, and major procedure-related complications. Competing risk analyses were performed using the Fine and Gray subdistribution Cox proportional hazard model to assess the impact of the relationship between BMI and initial management with CT or ICA on the study outcomes, whereas noncardiovascular death and unknown causes of death were considered competing risk events. Results Among the 3457 participants included, 831 (24.0%), 1358 (39.3%), and 1268 (36.7%) had a BMI of less than 25, between 25 and 30, and greater than 30 kg/m
MeSH term(s)	Adult ; Humans ; Coronary Artery Disease/diagnostic imaging ; Body Mass Index ; Coronary Angiography ; Patient Discharge ; Prospective Studies ; Chest Pain/diagnostic imaging
Language	English
Publishing date	2024-02-13
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.230591
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Article ; Online: Coronary Artery Calcium Score Predicts Major Adverse Cardiovascular Events in Stable Chest Pain.

Biavati, Federico / Saba, Luca / Boussoussou, Melinda / Kofoed, Klaus F / Benedek, Theodora / Donnelly, Patrick / Rodríguez-Palomares, José / Erglis, Andrejs / Štěchovský, Cyril / Šakalytė, Gintarė / Čemerlić Ađić, Nada / Gutberlet, Matthias / Dodd, Jonathan D / Diez, Ignacio / Davis, Gershan / Zimmermann, Elke / Kępka, Cezary / Vidakovic, Radosav / Francone, Marco /

Ilnicka-Suckiel, Małgorzata / Plank, Fabian / Knuuti, Juhani / Faria, Rita / Schröder, Stephen / Berry, Colin / Ruzsics, Balazs / Rieckmann, Nina / Kubiak, Christine / Hansen, Kristian Schultz / Müller-Nordhorn, Jacqueline / Maurovich-Horvat, Pál / Sigvardsen, Per E / Benedek, Imre / Orr, Clare / Valente, Filipa Xavier / Zvaigzne, Ligita / Suchánek, Vojtěch / Jankauskas, Antanas / Ađić, Filip / Woinke, Michael / Cadogan, Diarmaid / Lecumberri, Iñigo / Thwaite, Erica / Kruk, Mariusz / Neskovic, Aleksandar N / Mancone, Massimo / Kuśmierz, Donata / Feuchtner, Gudrun / Pietilä, Mikko / Ribeiro, Vasco Gama / Drosch, Tanja / Delles, Christian / Cau, Riccardo / Fisher, Michael / Merkely, Bela / Kragelund, Charlotte / Aurelian, Rosca / Kelly, Stephanie / García Del Blanco, Bruno / Rubio, Ainhoa / Szilveszter, Bálint / Hove, Jens D / Rodean, Ioana / Regan, Susan / Cuéllar Calabria, Hug / Édes, István Ferenc / Larsen, Linnea / Hodas, Roxana / Napp, Adriane E / Haase, Robert / Feger, Sarah / Mohamed, Mahmoud / Serna-Higuita, Lina M / Neumann, Konrad / Dreger, Henryk / Rief, Matthias / Wieske, Viktoria / Budoff, Matthew J / Estrella, Melanie / Martus, Peter / Bosserdt, Maria / Dewey, Marc

Radiology

2024 Volume 310, Issue 3, Page(s) e231557

Abstract: Background Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose To assess the prognostic value of CAC scoring for ... ...

Abstract	Background Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose To assess the prognostic value of CAC scoring for MACE in participants with stable chest pain initially referred for invasive coronary angiography (ICA). Materials and Methods This prespecified subgroup analysis from the Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial, conducted between October 2015 and April 2019 across 26 centers in 16 countries, focused on adult patients with stable chest pain referred for ICA. Participants were randomly assigned to undergo either ICA or coronary CT. CAC scores from noncontrast CT scans were categorized into low, intermediate, and high groups based on scores of 0, 1-399, and 400 or higher, respectively. The end point of the study was the occurrence of MACE (myocardial infarction, stroke, and cardiovascular death) over a median 3.5-year follow-up, analyzed using Cox proportional hazard regression tests. Results The study involved 1749 participants (mean age, 60 years ± 10 [SD]; 992 female). The prevalence of obstructive coronary artery disease (CAD) at CT angiography rose from 4.1% (95% CI: 2.8, 5.8) in the CAC score 0 group to 76.1% (95% CI: 70.3, 81.2) in the CAC score 400 or higher group. Revascularization rates increased from 1.7% to 46.2% across the same groups (
MeSH term(s)	Adult ; Humans ; Female ; Middle Aged ; Calcium ; Coronary Artery Disease/diagnostic imaging ; Chest Pain/diagnostic imaging ; Myocardial Infarction
Chemical Substances	Calcium (SY7Q814VUP)
Language	English
Publishing date	2024-03-05
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.231557
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Article ; Online: Age and Computed Tomography and Invasive Coronary Angiography in Stable Chest Pain: A Prespecified Secondary Analysis of the DISCHARGE Randomized Clinical Trial.

Bosserdt, Maria / Serna-Higuita, Lina M / Feuchtner, Gudrun / Merkely, Bela / Kofoed, Klaus F / Benedek, Theodora / Donnelly, Patrick / Rodriguez-Palomares, José / Erglis, Andrejs / Štechovský, Cyril / Šakalyte, Gintare / Adic, Nada Cemerlic / Gutberlet, Matthias / Dodd, Jonathan D / Diez, Ignacio / Davis, Gershan / Zimmermann, Elke / Kepka, Cezary / Vidakovic, Radosav /

Francone, Marco / Ilnicka-Suckiel, Malgorzata / Plank, Fabian / Knuuti, Juhani / Faria, Rita / Schröder, Stephen / Berry, Colin / Saba, Luca / Ruzsics, Balazs / Rieckmann, Nina / Kubiak, Christine / Hansen, Kristian Schultz / Müller-Nordhorn, Jacqueline / Szilveszter, Bálint / Sigvardsen, Per E / Benedek, Imre / Orr, Clare / Valente, Filipa Xavier / Zvaigzne, Ligita / Suchánek, Vojtech / Jankauskas, Antanas / Adic, Filip / Woinke, Michael / Hensey, Mark / Lecumberri, Iñigo / Thwaite, Erica / Laule, Michael / Kruk, Mariusz / Neskovic, Aleksandar N / Mancone, Massimo / Kusmierz, Donata / Pietilä, Mikko / Ribeiro, Vasco Gama / Drosch, Tanja / Delles, Christian / Porcu, Maurizio / Fisher, Michael / Boussoussou, Melinda / Kragelund, Charlotte / Aurelian, Rosca / Kelly, Stephanie / Garcia Del Blanco, Bruno / Rubio, Ainhoa / Maurovich-Horvat, Pál / Hove, Jens D / Rodean, Ioana / Regan, Susan / Cuellar-Calabria, Hug / Molnár, Levente / Larsen, Linnea / Hodas, Roxana / Napp, Adriane E / Haase, Robert / Feger, Sarah / Mohamed, Mahmoud / Neumann, Konrad / Dreger, Henryk / Rief, Matthias / Wieske, Viktoria / Estrella, Melanie / Martus, Peter / Sox, Harold C / Dewey, Marc

JAMA cardiology

2024 Volume 9, Issue 4, Page(s) 346–356

Abstract: Importance: The effectiveness and safety of computed tomography (CT) and invasive coronary angiography (ICA) in different age groups is unknown.: Objective: To determine the association of age with outcomes of CT and ICA in patients with stable chest ...

Abstract	Importance: The effectiveness and safety of computed tomography (CT) and invasive coronary angiography (ICA) in different age groups is unknown. Objective: To determine the association of age with outcomes of CT and ICA in patients with stable chest pain. Design, setting, and participants: The assessor-blinded Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) randomized clinical trial was conducted between October 2015 and April 2019 in 26 European centers. Patients referred for ICA with stable chest pain and an intermediate probability of obstructive coronary artery disease were analyzed in an intention-to-treat analysis. Data were analyzed from July 2022 to January 2023. Interventions: Patients were randomly assigned to a CT-first strategy or a direct-to-ICA strategy. Main outcomes and measures: MACE (ie, cardiovascular death, nonfatal myocardial infarction, or stroke) and major procedure-related complications. The primary prespecified outcome of this secondary analysis of age was major adverse cardiovascular events (MACE) at a median follow-up of 3.5 years. Results: Among 3561 patients (mean [SD] age, 60.1 [10.1] years; 2002 female [56.2%]), 2360 (66.3%) were younger than 65 years, 982 (27.6%) were between ages 65 to 75 years, and 219 (6.1%) were older than 75 years. The primary outcome was MACE at a median (IQR) follow-up of 3.5 (2.9-4.2) years for 3523 patients (99%). Modeling age as a continuous variable, age, and randomization group were not associated with MACE (hazard ratio, 1.02; 95% CI, 0.98-1.07; P for interaction = .31). Age and randomization group were associated with major procedure-related complications (odds ratio, 1.15; 95% CI, 1.05-1.27; P for interaction = .005), which were lower in younger patients. Conclusions and relevance: Age did not modify the effect of randomization group on the primary outcome of MACE but did modify the effect on major procedure-related complications. Results suggest that CT was associated with a lower risk of major procedure-related complications in younger patients. Trial registration: ClinicalTrials.gov Identifier: NCT02400229.
MeSH term(s)	Female ; Humans ; Middle Aged ; Chest Pain/etiology ; Chest Pain/diagnosis ; Coronary Angiography/methods ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnostic imaging ; Tomography, X-Ray Computed ; Male ; Aged
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ISSN	2380-6591
ISSN (online)	2380-6591
DOI	10.1001/jamacardio.2024.0001
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Article ; Online: Erratum. Computed Tomography Versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease. Diabetes Care 2023;46:2015-2023.

Benedek, Theodora / Wieske, Viktoria / Szilveszter, Bálint / Kofoed, Klaus F / Donnelly, Patrick / Rodriguez-Palomares, José / Erglis, Andrejs / Veselka, Josef / Šakalytė, Gintarė / Ađić, Nada Čemerlić / Gutberlet, Matthias / Diez, Ignacio / Davis, Gershan / Zimmermann, Elke / Kępka, Cezary / Vidakovic, Radosav / Francone, Marco / Ilnicka-Suckiel, Małgorzata / Plank, Fabian /

Knuuti, Juhani / Faria, Rita / Schröder, Stephen / Berry, Colin / Saba, Luca / Ruzsics, Balazs / Rieckmann, Nina / Kubiak, Christine / Hansen, Kristian Schultz / Müller-Nordhorn, Jacqueline / Merkely, Bela / Sigvardsen, Per E / Benedek, Imre / Orr, Clare / Valente, Filipa Xavier / Zvaigzne, Ligita / Horváth, Martin / Jankauskas, Antanas / Ađić, Filip / Woinke, Michael / Mulvihill, Niall / Lecumberri, Iñigo / Thwaite, Erica / Laule, Michael / Kruk, Mariusz / Stefanovic, Milica / Mancone, Massimo / Kuśmierz, Donata / Feuchtner, Gudrun / Pietilä, Mikko / Ribeiro, Vasco Gama / Drosch, Tanja / Delles, Christian / Melis, Marco / Fisher, Michael / Boussoussou, Melinda / Kragelund, Charlotte / Aurelian, Rosca / Kelly, Stephanie / Blanco, Bruno Garcia Del / Rubio, Ainhoa / Károlyi, Mihály / Hove, Jens D / Rodean, Ioana / Regan, Susan / Calabria, Hug Cuéllar / Gellér, László / Larsen, Linnea / Hodas, Roxana / Napp, Adriane E / Haase, Robert / Feger, Sarah / Mohamed, Mahmoud / Serna-Higuita, Lina M / Neumann, Konrad / Dreger, Henryk / Rief, Matthias / Danesh, John / Estrella, Melanie / Bosserdt, Maria / Martus, Peter / Dodd, Jonathan D / Dewey, Marc

Diabetes care

2024 Volume 47, Issue 5, Page(s) 898

Language	English
Publishing date	2024-02-21
Publishing country	United States
Document type	Published Erratum
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc24-er05a
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 1434: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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