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| 1 | 非ST段抬高型急性冠状动脉综合征患者中的肥胖矛盾现象:来自CRUSADE(对不稳定型心绞痛患者进行快速风险分层能否减少早期实施ACC/AHA指南的不良预后)质量改进研究的结果显示文摘Background: Although obesity is a known risk factor for coronary artery disease, its impact on the presentation, treatment, and outcome of patients with acute coronary syndromes(ACS) has not been well studied. Methods: Using data from the CRUSADE Initiative, we compared inhospital treatments and clinical outcomes of 80 845 patients with high-risk non-ST-segment elevation(NSTE) ACS(positive cardiac markers and/or ischemic ST-segment changes) to determine whether there was an association with body mass index(BMI[kg/m2]). Patient weights were categorized according to World Health Organization classifications: Underweight(BMI< 18.5), Normal range(BMI 18.5-24.9), Overweight(BMI 25-29.9), Obese Class I(BMI 30-34.9), Obese Class Ⅱ(BMI 35-39.9), and Extremely Obese(BMI≥40). Results: Most(70.5%) of the CRUSADE patients were classified as overweight or obese; these patients were younger and more likely to present with comorbid conditions, including diabetes mellitus, hypertension, and hyperlipidemia. Medications given during the first 24 hours and invasive cardiac procedures recommended by the American College of Cardiology/American Heart Association guidelines for NSTE ACS were more commonly used in these patients. The incidence of death and death and reinfarction, adjusted for covariates, were generally lower in overweight and obese patients, compared with normal-weight patients, but higher in underweight and extremely obese patients. Conclusions: Most patients with NSTE ACS are overweight or obese. These patients receive more aggressive treatment, and, except for the extremely obese, have less adverse outcomes compared with underweight and normal-weight patients. Although obesity appears to be a risk factor for developing ACS at a younger age, it also appears to be associated with more aggressive ACS management and, ultimately, improved outcomes. | Diercks D.B. Roe M.T. Mulgund J. 罗亮 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，，12： | 2 |
| 2 | Patterns and correlates of acute (24 hours) use of beta-blockers for non-ST-segment elevation acute coronary syndromes: Results from the CRUSADE initiative显示文摘 | MILLER C D MULGUND J HOEKSTRA J W | 2005 | Ann Emergen Med2005，46，： | 1 |
| 3 | Neactlve oxygen spe- cies and sperm DNA damage in infertile men presenting with low level leukocytospermia显示文摘 | Agarwal A Mulgund A Alshahram | 2014 | Rep Biol Endoc2014，19，2： | 1 |
| 4 | Temporal trends in the use of early cardiac catheterization in patients with non-ST-segment elevation acute coronary syndromes(results from CRUSADE)显示文摘 | Tricoci P Peterson ED Mulgund J | | 0，，09： | 1 |
| 5 | Association between hospital process performance and outcomes among patients with acute coronary syndromes 显示文摘 | Peterson E D Roe M T Mulgund J | 2006 | JAMA2006，295，： | 1 |
| 6 | Impact of acute beta-blocker therapy for patients with non-ST-segment elevention myocardial infraction显示文摘 | Miller CD Roe MT Mulgund J | 2007 | Am J Med2007，120，8： | 1 |
| 7 | Associa- tion between hospital process performance and outcomes a- mong patients with acute coronary syndromes 显示文摘 | PETERSON E D ROE M T MULGUND J | 2006 | JAMA2006，295，16： | 1 |
| 8 | Treatment disparities in the care of patients with and with- out diabetes presenting with non-ST-segment elevation a- cute coronary syndr -ome 显示文摘 | BROGAN G X J R PETERSON E D MULGUND J | 2006 | Diabetes Care2006，29，： | 1 |
| 9 | Association between hos pital process per{ormance and outcomes among patients with acute coronary syndromes显示文摘 | Peterson E D Roe M T Mulgund J | 2006 | JAMA2006，295，16： | 1 |
| 10 | Impaet of acute beta-blocker therapy for patients with non-ST-segment elevation myocardial infarction显示文摘 | Miller CD Roe MT Mulgund J | 2007 | Am J Med2007，120，8： | 1 |
| 11 | 拟行冠状动脉搭桥术的非ST段抬高型急性冠状动脉综合征患者中急性使用氯吡格雷与预后的关系显示文摘Objectives: We sought to characterize patterns of clopidogrel use before coronary artery bypass grafting(CABG) and examine the drug’s impact on risks for postoperative transfusions among patients with non-ST-segment elevation acute coronary syndromes(NSTE ACS). Background: Adherence in community practice to American College of Cardiology/American Heart Association guidelines for clopidogrel use among NSTE ACS patients has not been previously characterized. Methods: We evaluated 2,858 NSTE ACS patients undergoing CABG at 264 hospitals participating in the CRUSADE(Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) Initiative. We examined the patterns of acute clopidogrel therapy and its association with bleeding risks among those having “early”CABG ≤5 days and again among those having “late”surgery >5 days after catheterization. Results: Within 24 h of admission, 852 patients(30%) received clopidogrel. In contrast to national guidelines, 87%of clopidogrel-treated patients underwent CABG ≤5 days after treatment. Among those receiving CABG within ≤5 days of last treatment, the use of clopidogrel was associated with a significant increase in blood transfusions(65.0%vs. 56.9%, adjusted odds ratio[OR] 1.36, 95%confidence interval[CI] 1.10 to 1.68) as well as the need for transfusion of ≥4 U of blood(27.7%vs. 18.4%, OR 1.70, 95%CI 1.32 to 2.19). In contrast, acute clopidogrel therapy was not associated with higher bleeding risks if CABG was delayed >5 days(adjusted OR 1.18, 95%CI 0.54 to 2.58). Conclusions: Despite guideline recommendations, the overwhelming majority of NSTE ACS patients treated with acute clopidogrel needing CABG have their surgery within ≤5 days of treatment. A failure to delay surgery is associated with increased blood transfusion requirements that must be weighed against the potential clinical and economic impacts of such delays. | Mehta R.H. Roe M.T. Mulgund J. 黄浙勇 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，，12： | 1 |
| 12 | Impact of acute beta-blocker therapy for patients with non-ST-segment elevation myocardial infarction显示文摘 | MILLER C D ROE M T MULGUND J | 2007 | Am J Med2007，120，： | 1 |
| 13 | Association between hospital process pedormance and outcomes among patients with acute corcnary syndromes显示文摘 | Peterson ED Roe MT Mulgund J | 2006 | JAMA2006，295，16： | 1 |
| 14 | Micropropagation of Dendrobium nobile from shoot tip sections显示文摘 | MALABADI R B MULGUND G S KALLAPPA N | | 0，，： | 1 |
| 15 | Treatmentdisparities in the care of patients with and without diabetespresenting with non-ST-segment elevation acute coronarysyndromes显示文摘 | Brogan GX Peterson ED Mulgund J | 2006 | Diabetes Care2006，29，： | 1 |
| 16 | Treatment disparties in the care of patients with and without diabets presenting with nonST-segment elevation acute coronary syndromes显示文摘 | Brogan GX Jr Peterson ED Mulgund J | 2006 | Diabets care2006，29，： | 1 |
| 17 | Treatment disparities in the care of patients with and without diabe- tes presenting with non-ST-segment elevation acute coro- nary syndromes 显示文摘 | Brogan GX Jr Petemon ED Mulgund J | 2006 | Diabetes Care2006，29，1： | 1 |
| 18 | Association be- tween hospital process performance and outcomes among patients with acute coronary syndromes显示文摘 | Peterson ED Roe MT Mulgund J | 2006 | JAMA2006，212，16： | 1 |
| 19 | A unique view on male infertility around the globe显示文摘 | AGARWAL A MULGUND A HAMADA A | 2015 | Reprod biology and endocrinology2015，13，1： | 1 |
| 20 | Assessing adherence to teriparatide therapy, causes of nonadherence and effect of adherence on bone mineral density measurements in osteoporotic patients at high risk for fracture显示文摘 | Mulgund M Beattie KA Wong AK | 2009 | Ther Adv Musculoskelet Dis2009，1，1： | 1 |
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