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Chest pain centers: moving toward proactive acute coronary care


Abstract | Introduction | History of coronary care in the United States
Development of chest pain centers | Treatment protocols for chest pain patients
Patient education | Medical outcomes
Economic outcomes from chest pain centers
Conclusion | References

References

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[3] National Heart, Lung and Blood Institute. Morbidity and mortality: chartbook on cardiovascular, lung and blood diseases, Bethesda, MD: US Department of Health and Human Services, Public Health Service, National Institute of Health, 1992.
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[17] Lee TJ, Goldman L. The coronary care unit turns 25: Historical trends and future directions. Ann Intern Med 1988;108:887-94.
[18] Bahr RD. Prodromal symptoms of a heart attack, [Letter]. J Am Coll Cardiol 1992;20:751-2.
[19] Braunwald E. Shattuck lecture - cardiovascular medicine at the turn of the millenium: Triumphs, concerns, and opportunities. New Engl J Med 1997;337:1360-9.
[20] Bahr RD. Access to early cardiac care: chest pain as a risk factor for heart attacks and the emergence of early cardiac care centers. Maryland Med J Feb 1992;41(2):133-7.
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[23] National Heart, Lung, and Blood Institute, National Institute of Health, Bethesda, Maryland - National Heart Attack Alert program Coordinating Committee. Emergency department. Rapid identification and treatment of patients with acute myocardial infarction. Ann Emerg Med 1994;23:311-29.
[24] Health Care Investment Analysts, Inc, Baltimore, Maryland, 1997.
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[26] Bahr RD. Acute outpatient care and comprehensive management of acute myocardial ischemia in chest pain emergency departments. MD Med J 1995;44:691-3.
[27] EPIC Investigators. Use of a monoclonal antibody directed against the platelet glycoprotein Ilb/Illa receptor in high-risk coronary angioplasty. New Eng] J Med 1994;330:956-61.
[28] EPILOG Investigators. Platelet glycoprotein IIb/IIIA receptor blockade and low-dose heparin during percutaneous coronary revascularization. New Engl J Med 1997;336:1689-96.
[29] IMPACT II Investigators. Randomized placebo-controlled trial of effect of eptifibatide on complication of percutaneous coronary intervention: IMPACT II. Integrelin to minimize platelet aggregation and coronary thrombosis-II. Lancet 1997;349:1422-8.
[30] PARAGON Investigators. International, randomized, controlled trial of lamifiban (a platelet glycoprotein IIb/IIIa inhibitor), heparin, or both in unstable angina. platelet IIb/IIIa antagonism for the reduction of acute coronary syndrome events in a global organization network. Circulation 1998;97:2386-95.
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[35] Bahr RD. The EHAC strategy: citizens chart the course for healthy people in the year 2000. J Cardiovasc Manag 1995;May /June: 1923.
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[37] Bahr RD, Granger CG, Moliterno DJ et al. [for the GUSTO Ilb Investigators]. The myths and realities of the impact of prodromal symptoms on outcome of acute myocardial infarction. In: The American College of Cardiology [Abstract] 46th Annual Scientific Session, 1997.
[38] Bahr RD. Wiping out heart disease before the year 2000: an obtainable goal, a prediction for the future. J Cardiovasc Manag 1993;4:40-3.
[39] Bahr RD. The concept and the development of chest pain emergency departments as a strategy in the war against heart attack. In: Gould KA, editor, Critical care nursing clinics of North America, Vol 10, 1988, pp. 41-51.
[40] The GUSTO Investigators. An international randomization trial comparing four thrombolytic strategies for acute myocardial infarction. New Engl J Med 1993;329:673-82.
[41] Giblet WB, Walsh RA, Levy RC et al. Rapid diagnostic and treatment centers in the emergency department for patients with chest pain. Circulation 1992;86([suppl]):1-15, [Abstract 56] 65th Annual Scientific Sessions, American Heart Association 1992.
[42] Lewis WR, Lee TY, Amsterdam EA. Immediate exercise in the assessment of low risk patients presenting to the emergency room with acute chest pain. Circulation 1991;84:575, [Abstract 2283]. A 65th Annual Scientific Session. American Heart Association.
[43] Rodriques S, Cowfer JP, Lyston DJ. Clinical efficacy and cost effectiveness of rapid emergency department rule out myocardial infarction and noninvasive cardiac evaluation in patients with acute chest pain. J Am Coll Cardiol 1994;2848, Abstract 771-775 Atlanta Georgia: American College of Cardiology 1994 Scientific Sessions.
[44] Levin E, Lowery M, Furlong RB et al. Suspected ischemic chest pain: Accuracy and cost efficiency of emergency department-based evaluation. [Abstract 990-50] New Orleans American College of Cardiology 44th Annual Scientific Session. J Am Coll Cardiol 313Am, 1995.
[45] Stewart RE, Dickinson CZ, Weissman I et al. Emergency care center Tc~99m-sestamibi SPECT imaging for unexplained chest pain: cost savings and outcome analysis. I Am Coll Cardiol 1995;25(Suppl):211a, [Abstract 959-105].
[46] for the ROMIO study group, Gomez MA, Anderson JL, Karafounis LA et al. An emergency department based protocol for rapidly ruling out myocardial ischemia reduces hospital time and expense: results of a randomized study [ROMIO. J Am Coll Cardiol 1996;28:25-33.
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[48] Gibler WB. Evaluating patients with chest pain in the emergency department: Improving speed, efficiency, and cost-effectiveness, or teaching an old dog new tricks. Ann Emerg Med 1994;23:381-2.
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[50] Healthy people 2000: citizens chart the course. In: Soto MA, Behrens R, Rosemont C, editors, Institute of Medicine. National Academy of Sciences, Washington, DC, Vol. 92, National Academy Press, 1990.


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