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(Circulation. 2006;114:1555.)
© 2006 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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IMPLICATIONS OF THE FAILURE TO IDENTIFY HIGH-RISK ELECTROCARDIOGRAM FINDINGS FOR THE QUALITY OF CARE OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: RESULTS OF THE EMERGENCY DEPARTMENT QUALITY IN MYOCARDIAL INFARCTION (EDQMI) STUDY, by Masoudi et al. |
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The appropriate diagnosis and treatment of patients with an acute myocardial infarction depends largely on the correct interpretation of the electrocardiogram in the emergency department. Despite the importance of the skill of correctly interpreting the electrocardiogram, relatively little is known about the prevalence of misinterpretations and their consequences. This retrospective study by Masoudi et al examined the failure to identify high-risk electrocardiographic findings in patients presenting to 1 of 5 emergency departments in California and Colorado. The authors report the failure to identify important ST-segment depressions, elevations or T-wave inversions on the first electrocardiogram of patients with a confirmed acute myocardial infarction. They also investigated the association of the misinterpretations with the quality of patient care and in-hospital mortality. The present study identifies an important opportunity for us to improve care. See p 1565.
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DRAWBACKS AND PROGNOSTIC VALUE OF FORMULAS ESTIMATING RENAL FUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE AND SYSTOLIC DYSFUNCTION, by Smilde et al. |
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The adverse prognostic impact of impaired renal function has been well demonstrated across the entire spectrum of cardiovascular diseases. In this issue of Circulation, Smilde and colleagues performed a detailed comparison of the 2 widely-used creatinine-based estimates of renal function (Cockcroft-Gault and Modification of Diet in Renal Disease equations) with the much more difficult to perform "gold standard" iothalamate clearance, in patients with chronic heart failure and reduced left ventricular ejection fraction. Although subtle differences were observed between these assessments of renal function, each provided important prognostic information regarding subsequent cardiovascular outcomes. See p 1572.
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HIGH SERUM C-REACTIVE PROTEIN LEVEL IS NOT AN INDEPENDENT PREDICTOR FOR STROKE: THE ROTTERDAM STUDY, by Bos et al. |
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Increasingly, C-reactive protein (CRP) is recommended for cardiovascular risk prediction. Major adverse events in subjects at risk or
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