COURS DE BIOSTATISTIQUE PCEM1 PDF

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Comparative effectiveness of primary PCI versus fibrinolytic therapy for ST elevation myocardial infarction: This study confirms that a strategy of early hospital discharge within two days of admission after a STEMI does not raise the risk of mortality in selected patients.

According to new recommendations given in 9the European Society of Cardiology ESC estimates that after a STEMI it is reasonable to consider an early hospital discharge after about 72 hours in selected patients at low risk and subject to a prior organization of a cardiac follow-up with rehabilitation.

Moreover, it would certainly have important cost-efficiency impacts. All of the aforementioned parameters taken from “real-life” conditions corresponded to and validated the criteria described in the literature to aid in the numerically scoring of the post-STEMI risk An additional limitation to our study was the missing data of the presence or absence of multi-vessel coronary disease.

Time-based risk assessment after myocardial infarction. Association of changes in clinical characteristics and management with improvement in survival among patients with ST-elevation myocardial infarction. Primary Angioplasty in Myocardial Infarction. Declining length of stay for patients hospitalized ckurs AMI: Their exclusion criteria biostatistiique numerous.

Relation of length of hospital stay in acute myocardial infarction to postdischarge mortality. In comparison to the late discharge group, the earlier discharged patients were younger in age 57[] vs.

It is an honor to have you present for the day of my thesis defense. Early discharge after primary percutaneous coronary intervention. Indeed, these criteria determined which patients were at low risk of complications and who would benefit from an early hospital discharge 13— Comparisons between groups were performed with the Kruskal Wallis Non-Parametric test or the Pearson Chi-squared test as appropriate.

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InSatilmisoglu et al. Categorical variables are presented as frequencies and percentages. Moreover it would allow for a rapid cardiac rehabilitation associated with an educational program on cardiac follow-up.

Feasibility and safety of an early discharge strategy after low-risk acute myocardial infarction treated with primary percutaneous coronary intervention: The determinants of early discharge were established using logistic regression. Five-year evolution of reperfusion strategies and early mortality in patients with ST-segment elevation myocardial infarction in France.

In our study population, patients transferred after CICU to another unit instead of returning home were younger in age 59[] vs. Vous m’avez fait vivre les meilleurs moments de mon internat: Early discharge after primary percutaneous coronary intervention couurs ST-elevation myocardial infarction. Prasugrel versus clopidogrel in patients with acute coronary syndromes. Heusch G, Gersh BJ.

Moreover, it would certainly have important costefficiency impacts. There are no formal recommendations about the optimal duration of hospitalization due to a lack of data in the literature, often dating from before the time of the major radial approach in primary percutaneous coronary intervention PPCI and new anti-platelet therapy.

Hence, the number of patients potentially concerned by a strategy of early discharge is very large and, in a similar manner, an increase in the economic savings in perspective could be envisioned since our study showed that there was no long-term mortality rise. Timing, setting and incidence of cardiovascular complications in patients with acute myocardial infarction submitted to primary percutaneous coronary intervention.

Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17, cases of suspected acute myocardial infarction: This network is a regional emergency cardiovascular network Eastern region of France that links ten large PPCI centers together which provide hour service.

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In the univariate analyses, we selected and tested the criteria which seemed to be relevant according to the literature; i. Je perfectionnerai mes connaissances pour assurer au mieux ma mission. Discharge after primary angioplasty at 24 h: One could speculate that the increasing use of Thienopyridines would lead to a decreased use of AntiGp2b3a.

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One could speculate that an early discharge from the hospital would reduce the information given to the patient concerning the state of his health after a STEMI and would complicate the patient’s therapeutic education and the correct introduction of the treatments recommended for post-STEMI secondary prevention treatments.

Comparison of mortality benefit of immediate thrombolytic therapy versus delayed primary angioplasty for acute myocardial infarction. The primary clinical end-point was all-cause mortality at one-year follow-up. Eur J Prev Cardiol. Therefore, their cuors are less able to be extrapolated and to be used in the everyday practice in a CICU.

Moreover, during this same period, the short-term prognostic of the STEMI’s has improved 3—6 due to several elements such as a better understanding of the delay in the onset of complications, improvements in strategies and equipments for reperfusion and improvements in drug therapies.

LOS has gradually shortened over time Safety and feasibility of early hospital discharge in ST-segment elevation myocardial infarction–a prospective and randomized trial in low-risk primary percutaneous coronary intervention patients the Safe-Depart Trial. Heart Br Card Soc. Statistical analyses were performed using the software R 2. We focused on comparing group 1a vs. We chose the limit value of 48 hours to conduct our study since, according to the literature, complications acute heart failure, arrhythmias and conduction disturbances, recurrent myocardial infarctions, renal failure, hemorrhagic complications and deathmost frequently occur within the first 48 hours 33 GOOD CC BY-NC-ND 2.

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Merci de m’avoir soutenu dans l’aboutissement de ce projet. One must take into account each patient’s history, post-interventional monitoring as well as the usual procedures as practiced in each service.

The pathophysiology of acute myocardial infarction and strategies of protection beyond reperfusion: