Search

Your search keyword '"Klein, Lloyd"' showing total 243 results
Start Over Author "Klein, Lloyd" Search Limiters Full Text Language english
243 results on '"Klein, Lloyd"'

11. Assessing Quality in Interventional Practice: Identifying Meaningful and Actionable Metrics.

Author

Klein, Lloyd W.

Abstract

Interventional cardiologists should insist on quality assessment techniques that indisputably reflect the merit of care delivered. Only measurable outcomes and metrics that are modifiable should be identified and collected. An evaluation process should be adopted that genuinely appraises clinical practice, incorporating appropriate benchmarks for comparison. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

22. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography: Endorsed by the American Society of Echocardiography and the Heart Rhythm Society

Author

Patel, Manesh R., Dehmer, Gregory J., Hirshfeld, John W., Smith, Peter K., Spertus, John A., Masoudi, Frederick A., Chambers, Charles E., Ferguson, Bruce T., Jr., Garcia, Mario J., Grover, Frederick L., Holmes, David R., Jr., Klein, Lloyd W., Limacher, Marian C., Mack, Michael J., Malenka, David J., Park, Myung H., Ragosta, Michael, III, Ritchie, James L., Rose, Geoffrey A., Rosenberg, Alan B., Russo, Andrea M., Shemin, Richard J., Weintraub, William S., Wolk, Michael J., Bailey, Steven R., Douglas, Pamela S., Hendel, Robert C., Kramer, Christopher M., Min, James K., Shaw, Leslee, Stainback, Raymond F., and Allen, Joseph M.

Published
2012
Full Text
View/download PDF

23. In-hospital outcomes of transapical versus surgical aortic valve replacement: from the U.S. national inpatient sample.

Author

Abugroun, Ashraf, Hallak, Osama, Taha, Ahmed, Sanchez-Nadales, Alejandro, Awadalla, Saria, Daoud, Hussein, Igbinomwanhia, Efehi, and Klein, Lloyd W.

Subjects
HEALTH outcome assessment, AORTIC valve transplantation, PRIMARY health care, HOSPITAL mortality, PERICARDIUM paracentesis
Abstract

OBJECTIVE To compare the outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) and surgical aortic valve replacement (SAVR) using a large US population sample. METHODS The U.S. National Inpatient Sample was queried for all patients who underwent TA-TAVR or SAVR during the years 2016-2017. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were in-hospital stroke, pericardiocentesis, pacemaker insertion, mechanical ventilation, vascular complications, major bleeding, acute kidney injury, length of stay, and cost of hospitalization. Outcomes were modeled using multi-variable logistic regression for binary outcomes and generalized linear models for continuous outcomes. RESULTS A total of 1 560 TA-TAVR and 44,280 SAVR patients were included. Patients who underwent TA-TAVR were older and frailer. Compared to SAVR, TA-TAVR correlated with a higher mortality (4.5% vs. 2.7%, effect size (SMD) = 0.1) and higher periprocedural complications. Following multivariable analysis, both TA-TAVR and SAVR had a similar adjusted risk for in-hospital mortality. TA-TAVR correlated with lower odds of bleeding with (adjusted OR (aOR) = 0.26; 95% CI: 0.18-0.38; P < 0.001), and a shorter length of stay (adjusted mean ratio (aMR) = 0.77; 95% CI: 0.69-0.84; P < 0.001), but higher cost (aMR = 1.18; 95% CI: 1.10-1.28; P < 0.001). No significant differences in other study outcomes. In subgroup analysis, TA-TAVR in patients with chronic lung disease had higher odds for mortality (aOR = 3.11; 95%CI: 1.37-7.08; P = 0.007). CONCLUSION The risk-adjusted analysis showed that TA-TAVR has no advantage over SAVR except for patients with chronic lung disease where TA-TAVR has higher mortality. [ABSTRACT FROM AUTHOR]

Published
2021
Full Text
View/download PDF

24. ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: A report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training

Author

Hirshfeld, John W., Jr, Balter, Stephen, Brinker, Jeffrey A., Kern, Morton J., Klein, Lloyd W., Lindsay, Bruce D., Tommaso, Carl L., Tracy, Cynthia M., Wagner, Louis K., Creager, Mark A., Elnicki, Michael, Lorell, Beverly H., Rodgers, George P., and Weitz, Howard H.

Published
2004
Full Text
View/download PDF

34. Temporal Trends in and Factors Associated With Bleeding Complications Among Patients Undergoing Percutaneous Coronary Intervention: A Report From the National Cardiovascular Data CathPCI Registry

Author

Subherwal, Sumeet, Peterson, Eric D., Dai, David, Thomas, Laine, Messenger, John C., Xian, Ying, Brindis, Ralph G., Feldman, Dmitriy N., Senter, Shaun, Klein, Lloyd W., Marso, Steven P., Roe, Matthew T., and Rao, Sunil V.

Subjects
Male, Time Factors, Myocardial Infarction, Hemorrhage, Middle Aged, bleeding, outcomes, Article, surgical procedures, operative, Elective Surgical Procedures, Humans, Female, cardiovascular diseases, Angina, Unstable, Registries, Angioplasty, Balloon, Coronary, catheterization, Aged
Abstract

ObjectivesThe purpose of this study was to examine temporal trends in post-percutaneous coronary intervention (PCI) bleeding among patients with elective PCI, unstable angina (UA)/non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).BackgroundThe impact of bleeding avoidance strategies on post-PCI bleeding rates over time is unknown.MethodsUsing the CathPCI Registry, we examined temporal trends in post-PCI bleeding from 2005 to 2009 among patients with elective PCI (n = 599,524), UA/NSTEMI (n = 836,103), and STEMI (n = 267,632). We quantified the linear time trend in bleeding using 3 sequential logistic regression models: 1) clinical factors; 2) clinical + vascular access strategies (femoral vs. radial, use of closure devices); and 3) clinical, vascular strategies + antithrombotic treatments (anticoagulant ± glycoprotein IIb/IIIa inhibitor [GPI]). Changes in the odds ratio for time trend in bleeding were compared using bootstrapping and converted to risk ratio.ResultsAn approximate 20% reduction in post-PCI bleeding was seen (elective PCI: 1.4% to 1.1%; UA/NSTEMI: 2.3% to 1.8; STEMI: 4.9% to 4.5%). Radial approach remained low (

Published
2012

41. Composite Outcomes in Coronary Bypass Surgery Versus Percutaneous Intervention.

Author

Edwards, Fred H., Shahian, David M., Grau-Sepulveda, Maria V., Grover, Frederick L., Mayer, John E., O'Brien, Sean M., DeLong, Elizabeth, Peterson, Eric D., McKay, Charles, Shaw, Richard E., Garratt, Kirk N., Dangas, George D., Messenger, John, Klein, Lloyd W., Popma, Jeffrey J., and Weintraub, William S.

Abstract

Background. Recent observational studies show that patients with multivessel coronary disease have a long-term survival advantage with coronary artery bypass grafting (CABG) compared with percutaneous coronary intervention (PCI). Important nonfatal outcomes may also affect optimal treatment recommendation. Methods. CABG was compared with percutaneous catheter intervention by using a composite of death, myocardial infarction (MI), or stroke. Medicare patients undergoing revascularization for stable multivessel coronary disease from 2004 through 2008 were identified in national registries. Short-term clinical information from the registries was linked to Medicare data to obtain long-term follow-up out to 4 years from the time of the procedure. Propensity scoring with inverse probability weighting was used to adjust for baseline risk factors. Results. There were 86,244 CABG and 103,549 PCI patients. The mean age was 74 years, with a median 2.67 years of follow-up. At 4 years, the propensity-adjusted adjusted cumulative incidence of MI was 3.2% in CABG compared with 6.6% in PCI (risk ratio, 0.49; 95% confidence interval, 0.45 to 0.53). At 4 years, the cumulative incidence of stroke was 4.5% in CABG compared with 3.1% in PCI patients (risk ratio, 1.43; 95% confidence interval, 1.31 to 1.54). This difference was primarily due to the higher 30-day stroke rate for CABG (1.55% vs 0.37%). For the composite of death, MI, or stroke, the 4-year adjusted cumulative incidence was 21.6% for CABG and 26.7% for PCI (risk ratio, 0.81; 95% confidence interval, 0.78 to 0.83). Conclusions. The 4-year composite event rate of death, MI, and stroke favored CABG, whereas the risk of stroke alone favored PCI. [ABSTRACT FROM AUTHOR]

Published
2014
Full Text
View/download PDF

42. Angiographic Validation of the American College of Cardiology Foundation-The Society of Thoracic Surgeons Collaboration on the Comparative Effectiveness of Revascularization Strategies Study.

Author

Chakrabarti, Anjan K., Grau-Sepulveda, Maria V., O’Brien, Sean, Abueg, Cassandra, Ponirakis, Angelo, Delong, Elizabeth, Peterson, Eric, Klein, Lloyd W., Garratt, Kirk N., Weintraub, William S., and Gibson, C. Michael

Abstract

The goal of this study was to compare angiographic interpretation of coronary arteriograms by sites in community practice versus those made by a centralized angiographic core laboratory.The study population consisted of 2013 American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR) records with 2- and 3- vessel coronary disease from 54 sites in 2004 to 2007. The primary analysis compared Registry (NCDR)-defined 2- and 3-vessel disease versus those from an angiographic core laboratory analysis. Vessel-level kappa coefficients suggested moderate agreement between NCDR and core laboratory analysis, ranging from kappa=0.39 (95% confidence intervals, 0.32-0.45) for the left anterior descending artery to kappa=0.59 (95% confidence intervals, 0.55-0.64) for the right coronary artery. Overall, 6.3% (n=127 out of 2013) of those patients identified with multivessel disease at NCDR sites had had 0- or 1-vessel disease by core laboratory reading. There was no directional bias with regard to overcall, that is, 12.3% of cases read as 3-vessel disease by the sites were read as <3-vessel disease by the core laboratory, and 13.9% of core laboratory 3-vessel cases were read as <3-vessel by the sites. For a subset of patients with left main coronary disease, registry overcall was not linked to increased rates of mortality or myocardial infarction.There was only modest agreement between angiographic readings in clinical practice and those from an independent core laboratory. Further study will be needed because the implications for patient management are uncertain. [ABSTRACT FROM AUTHOR]

Published
2014
Full Text
View/download PDF

45. Prediction of Long-Term Mortality After Percutaneous Coronary Intervention in Older Adults.

Author

Weintraub, William S., Grau-Sepulveda, Maria V., Weiss, Jocelyn M., DeLong, Elizabeth R., Peterson, Eric D., O'Brien, Sean M., Kolm, Paul, Klein, Lloyd W., Shaw, Richard E., McKay, Charles, Ritzenthaler, Laura L., Popma, Jeffrey J., Messenger, John C., Shahian, David M., Grover, Frederick L., Mayer, John E., Garratt, Kirk N., Moussa, Issam D., Edwards, Fred H., and Dangas, George D.

Published
2012
Full Text
View/download PDF

46. Predictors of Long-Term Survival After Coronary Artery Bypass Grafting Surgery.

Author

Shahian, David M., O'Brien, Sean M., Sheng, Shubin, Grover, Frederick L., Mayer, John E., Jacobs, Jeffrey P., Weiss, Jocelyn M., DeLong, Elizabeth R., Peterson, Eric D., Weintraub, William S., Grau-Sepulveda, Maria V., Klein, Lloyd W., Shaw, Richard E., Garratt, Kirk N., Moussa, Issam D., Shewan, Cynthia M., Dangas, George D., and Edwards, Fred H.

Published
2012
Full Text
View/download PDF

49. Trends in the Association Between Age and In-Hospital Mortality After Percutaneous Coronary Intervention.

Author

Singh, Mandeep, Peterson, Eric D., Roe, Matthew T., Fang-Shu Ou, Spertus, John A., Rumsfeld, John S., Anderson, H. Vernon, Klein, Lloyd W., Ho, Kalon K.L., and Holmes, David R.

Subjects
AGE, MORTALITY, HOSPITALS, ANGIOPLASTY, OLDER patients
Abstract

The article investigates the temporal trends in the association between age and in-hospital mortality of stratified age groups after percutaneous coronary intervention using data from the U.S. National Cardiovascular Data Registry. It determines the difference between in-hospital mortality rates among the age groups who were admitted from January 1, 2001 to December 31, 2006. The largest reduction in in-hospital mortality was observed among patients 80 years of age or older.

Published
2009
Full Text
View/download PDF

50. Impact of ethnicity and gender differences on angiographic coronary artery disease prevalence and in-hospital mortality in the American College of Cardiology-National Cardiovascular Data Registry.

Author

Shaw LJ, Shaw RE, Merz CN, Brindis RG, Klein LW, Nallamothu B, Douglas PS, Krone RJ, McKay CR, Block PC, Hewitt K, Weintraub WS, Peterson ED, American College of Cardiology National Cardiovascular Data Registry Investigators, Shaw, Leslee J, Shaw, Richard E, Merz, C Noel Bairey, Brindis, Ralph G, Klein, Lloyd W, and Nallamothu, Brahmajee

Published
2008
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results