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Background: The incidence and outcomes of out-of-hospital cardiac arrest vary widely across cities. It is unknown whether similar differences exist at the neighborhood level. Objective: To determine the extent to which neighborhoods have persistently high rates of cardiac arrest but low rates of bystander cardiopulmonary resuscitation (CPR). Design: Multilevel Poisson regression of 1108 cardiac arrests from 161 census tracts as captured by the Cardiac Arrest Registry to Enhance Survival (CARES). Setting: Fulton County, Georgia, between 1 October 2005 to 30 November 2008. Measurements: Incidence of cardiac arrest, by census tract and year and by rates of bystander CPR. Results: Adjusted rates of cardiac arrest varied across neighborhoods (interquartile range [IQR], 0.57 to 0.73 per 1000 persons; mean, 0.64 per 1000 persons [SD, 0.11]) but were stable from year to year (intraclass correlation, 0.36 [95% CI, 0.26 to 0.50]; P < 0.001). Adjusted bystander CPR rates also varied by census tract (IQR, 19% to 29%; mean, 25% [SD, 10%]). Limitation: Analysis was based on data from a single county. Conclusion: Surveillance data can identify neighborhoods with a persistently high incidence of cardiac arrest and low rates of bystander CPR. These neighborhoods are promising targets for community-based interventions. Primary Funding Source: Robert Wood Johnson Foundation Clinical Scholars Program, National Institutes of Health, and Centers for Disease Control and Prevention.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2009.09.013 Byline: Matthew I. Worthley, Anisha Prabhu, Paolo De Sciscio, Carlee Schultz, Prashanthan Sanders, Scott R. Willoughby Keywords: Endothelial function; Energy drinks; Myocardial infarction; Platelet aggregation; Sudden cardiac death Abstract: Energy drink consumption has been anecdotally linked with sudden cardiac death and, more recently, myocardial infarction. As myocardial infarction is strongly associated with both platelet and endothelial dysfunction, we tested the hypothesis that energy drink consumption alters platelet and endothelial function. Author Affiliation: Department of Cardiology, Cardiovascular Research Centre, Royal Adelaide Hospital, and Disciplines of Physiology and Medicine, University of Adelaide, Adelaide, Australia Article Note: (footnote) Funding: Dr. Sanders is supported by the National Heart Foundation of Australia., Conflict of Interest: No author has a conflict of interest with this work., Authorship: All authors have had access to the data and a role in the manuscript.

Background: Implantable defibrillators are recommended for the prevention of sudden cardiac death in patients with heart failure. However, criteria to identify those who would benefit most from this therapy are lacking. We assessed the maximum potential benefit of preventing sudden death in patients with repeated hospital admissions because of heart failure. Methods: Using a cohort assembled from an administrative database, we identified 14 374 patients admitted to hospital for the first time because of heart failure between Jan. 1, 2000, and Dec. 31, 2004. We followed subsequent admissions related to heart failure as well as mortality and causes of death to Mar. 31, 2006. We regarded all out-of-hospital cardiac deaths as sudden deaths. We calculated the maximum potential benefit of preventing sudden death by subtracting the observed survival after each hospital admission from the hypothetical survival whereby all out-of-hospital cardiac deaths were assumed to be preventable. Results: The mean age of the cohort was 77 years, 45% were women, 11% had cerebrovascular disease, and 21% had chronic kidney disease. Out-of-hospital cardiac deaths constituted 13.7% (1226/8967) of all deaths during 32 055 person-years of follow-up. The median survival declined with each subsequent hospital admission related to heart failure. The hypothetical prevention of all out-of-hospital deaths prolonged life by 0.63 (95% confidence interval [CI] 0.49 to 0.77) years after the first hospital admission. This potential benefit dropped to 0.28 (95% CI 0.10 to 0.46) years after 3 hospital admissions related to heart failure. Among patients less than 65 years old, and older patients without kidney disease, dementia or cancer, more than 50% survived longer than 2 years until they had 2 or 3 hospital admissions related to heart failure. Interpretation: The use of implantable defibrillators to prevent sudden death would provide limited benefit among older patients with comorbidities and among patients with multiple hospital admissions related to heart failure. Une version francaise de ce resume est disponible a l&apos;adresse www.cmaj.ca/cgi/content/full/180/6/611/DC1, The burden of heart failure is substantial, accounting for 106 130 related hospital admissions and 1.38 million days in hospital in 2001 in Canada. (1) In the United States it [...]

2016 DEC 3 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Heart Disorders and Diseases - Heart Attack have [...]

Background: The use of non-heart-beating donors could help shorten the list of patients who are waiting for a kidney transplant. Several reports describe acceptable results of transplantations from non-heart-beating donors who had in-hospital cardiac arrest, but few reports describe results of transplantations from non-heart-beating donors who had cardiac arrest that occurred outside of the hospital (Maastricht type I and type II donors). Objective: To compare graft survival rates among patients receiving kidneys from heart-beating donors versus type I or type II non-heart-beating donors. Design: Retrospective cohort study of transplantations performed from January 1989 to December 2004. Setting: Kidney transplant program of a teaching hospital in Madrid, Spain. Patients: 320 patients who received a kidney transplant from non-heart-beating donors (273 type I donors and 47 type II donors) and 584 patients who received a kidney transplant from heart-beating donors divided into 2 groups according to donor age (age Measurements: The primary outcome measure was graft survival. The median follow-up time was 68 months (range, 9 to 198 months). Results: One- and 5-year graft survival rates were 90.7% and 85.5%, respectively, for transplants from heart-beating donors younger than 60 years of age; 79.8% and 73.3%, respectively, for transplants from heart-beating donors 60 years of age or older (P < 0.001); and 87.4% and 82.1%, respectively, for transplants from non-heart-beating donors (P = 0.22 [vs. those from heart-beating donors < 60 years of age] and P = 0.014 [vs. those from heart-beating donors [greater than or equal to] 60 years of age]). Graft survival did not differ between patients who received kidneys from heart-beating donors younger than 60 years of age and patients who received kidneys from non-heart-beating donors. Limitations: This single-site, observational study was retrospective, and immunosuppressive therapy regimens given to transplant recipients varied over time. Conclusions: Outcomes of transplants from non-heart-beating donors and younger heart-beating donors are similar, and results for transplants from non-heart-beating donors improved compared with those from older heart-beating donors. On the basis of these results, the authors encourage other transplant units to adopt the use of type I and type II non-heart-beating donors.

One of the six strategies promoted by the Institute for Healthcare Improvement (IHI) to prevent avoidable deaths is a lifesaving innovation in which the rapid response team or medical emergency team (MET) intervenes when a patient's condition starts to deteriorate before he experiences cardiac arrest. In an informal survey of 300 nurses, most respondents felt that the MET program improved patient care and the nursing workplace.

The effect on cardiac arrests and overall hospital mortality of an intensive care-based medical emergency team is examined. The results state that the incidence of in-hospital cardiac arrest and death following cardiac arrest, bed occupancy related to cardiac arrest reduced with the introduction of an intensive care-based medical emergency team.

'GET MOVING, America? It's a common public health sermon that all of us hear in one version or another on a nearly daily basis. 'Too many of us are fat, [...]

Background: The associations of different components of body mass with disease outcomes are not well defined. Objective: We investigated the effects of body composition on risk of death from cardiac causes and cancer in adult men. Design: Middle-aged men (n = 7608) in the Paris Prospective Study were followed up for 15 y. At study entry, the following measurements were obtained: sagittal diameter, sum of midarm and midthigh circumferences, sum of 3 trunk skinfold thicknesses (estimate of trunk subcutaneous fat), and sum of 3 extremity skinfold thicknesses (estimate of extremity subcutaneous fat). To assess their relative contributions to cardiac and cancer mortality, we used multivariate Cox models in which the sagittal diameter adjusted for trunk skinfold thicknesses was used as an estimate of intraabdominal fat and the sum of midarm and midthigh circumferences adjusted for extremity skinfold thicknesses was used as an estimate of muscle mass. Results: In multivariate analyses in both smokers and nonsmokers, the sagittal diameter was the only significant predictor of cardiac death. The sum of midarm and midthigh circumferences was negatively associated and sagittal diameter was positively associated with cancer death, whereas extremity skinfold thicknesses exhibited a U-shape relation. Exclusion of subjects who died from cancer in the first 5 y of follow-up did not change these results. Conclusions: Intraabdominal fat appears to be the main body compartment involved in risk of cardiac death, whereas increased risk of cancer death is associated with lower muscle mass and lower subcutaneous fat, independent of smoking and after the exclusion of early mortality. Increased central fat distribution may confer additional risk of death from cancer. Am J Clin Nutr 2002;75:1107-13. KEY WORDS Body composition, fat distribution, body fat, muscle mass, mortality, cardiovascular disease, cardiac death, heart disease, cancer, prospective study