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Background There is significant interest in measuring health care value, but this concept has not been operationalized in specific patient cohorts. The longitudinal outcomes and costs for patients after percutaneous coronary intervention (PCI) provide an opportunity to measure an aspect of health care value. Objectives This study evaluated variations in 1-year outcomes (risk-adjusted mortality) and risk-standardized costs of care for all patients undergoing PCI in the Veterans Affairs (VA) system from 2007 to 2010. Methods This retrospective cohort study evaluated all veterans undergoing PCI at any of 60 hospitals in the VA health care system, using data from the national VA Clinical Assessment, Reporting, and Tracking (CART) program. Primary outcomes were 1-year mortality and costs following PCI. Risk-standardized mortality and cost ratios were calculated, adjusting for cardiac and noncardiac comorbidities. Results A median of 261 PCIs were performed in the 60 hospitals during the study period. Median 1-year unadjusted hospital mortality rate was 6.13%. Four hospitals were significantly above the 1-year risk-standardized median mortality rate, with median mortality ratios ranging from 1.23 to 1.28. No hospitals were significantly below median mortality. Median 1-year total unadjusted hospital costs were $46,302 per patient. There were 16 hospitals above and 19 hospitals below the risk-standardized median cost, with risk-standardized ratios ranging from 0.45 to 2.09, reflecting a much larger magnitude of variability in costs than in mortality. Conclusions There is much smaller variation in 1-year risk adjusted mortality than in risk-standardized costs after PCI in the VA. These findings suggest that there are opportunities to improve PCI value by reducing costs without compromising outcomes. This approach to evaluating outcomes and costs together may be a model for other health systems and accountable care organizations interested in operationalizing value measurement.

Early myocardial reperfusion therapy ( 12 h) remains controversial. In this study, the effects of late reperfusion versus standard drug therapy on the

Disabled-2 (Dab2) is a clathrin and cargo binding endocytic adaptor protein and cell biology studies revealed that Dab2 plays a role in cellular trafficking of a number of transmembrane receptors and signaling proteins. However, little to nothing is known about its involvement or significance in

In human, vesicular endocytosis is an efficient way of dietary cholesterol absorption. Flotillins proteins included Flotillin-1, Flotillin-2 are considered to be the components of lipid rafts and are commonly used as marker proteins for lipid microdomains. Therefore, we investigated the association

This multiple-ethnic, community-based, cross-sectional study was conducted to estimate the prevalence and distribution of congenital heart disease (CHD) in Xinjiang, northwestern part of China. Four major ethnics, Han, Uygur, Kazakh, and Hui Chinese in this region were investigated during February

Impaired myocardial reperfusion is associated with adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to investigate the impact of admission mean platelet volume (MPV) on the myocardial reperfusion and 30-day all-cause mortality

The triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C) might be a good predictor of cardiovascular diseases. To determine whether triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C), which has been shown to be an indicator of the metabolic syndrome (MetS) and insulin

There is significant interest in measuring health care value, but this concept has not been operationalized in specific patient cohorts. The longitudinal outcomes and costs for patients after percutaneous coronary intervention (PCI) provide an opportunity to measure an aspect of health care value.This study evaluated variations in 1-year outcomes (risk-adjusted mortality) and risk-standardized costs of care for all patients undergoing PCI in the Veterans Affairs (VA) system from 2007 to 2010.This retrospective cohort study evaluated all veterans undergoing PCI at any of 60 hospitals in the VA health care system, using data from the national VA Clinical Assessment, Reporting, and Tracking (CART) program. Primary outcomes were 1-year mortality and costs following PCI. Risk-standardized mortality and cost ratios were calculated, adjusting for cardiac and noncardiac comorbidities.A median of 261 PCIs were performed in the 60 hospitals during the study period. Median 1-year unadjusted hospital mortality rate was 6.13%. Four hospitals were significantly above the 1-year risk-standardized median mortality rate, with median mortality ratios ranging from 1.23 to 1.28. No hospitals were significantly below median mortality. Median 1-year total unadjusted hospital costs were $46,302 per patient. There were 16 hospitals above and 19 hospitals below the risk-standardized median cost, with risk-standardized ratios ranging from 0.45 to 2.09, reflecting a much larger magnitude of variability in costs than in mortality.There is much smaller variation in 1-year risk adjusted mortality than in risk-standardized costs after PCI in the VA. These findings suggest that there are opportunities to improve PCI value by reducing costs without compromising outcomes. This approach to evaluating outcomes and costs together may be a model for other health systems and accountable care organizations interested in operationalizing value measurement.

Limiting infarct size at the acute phase is a clinical goal. Cardiac ischemic-reperfusion (IR) injury following percutaneous coronary intervention (PCI) has become a hurdle in improving patient outcome. We investigate whether remote ischemic per-conditioning (RIPerC) performed in patients with ST

Background In animal models, secreted frizzled related protein 1 (Sfrp1) inhibition of the Wnt signaling pathway is beneficial because Sfrp1 reduces myocardial apoptosis and prevents heart failure. The mechanisms mediating the cellular survival effect of Sfrp1 has not been completely elucidated. The present study was designed to investigate the possible protective actions of Sfrp1 on cardiac muscle cells using an in vitro model of ischemia/reperfusion, and to evaluate the possible involvement of the Wnt signaling pathway.

Complement 5a receptor (C5aR) was demonstrated a receptor of complement 5a (C5a) which is involved in many inflammatory diseases. The functional responses attributed to C5a results from its interaction with its receptors C5aR, which stimulates food intake, plays a role in increasing the inflammatory

To understand the blood glucose levels and ankle brachial index (ABI) and peripheral arterial disease (PAD) of the Uighur population in Xinjiang, explore Uighur population in Xinjiang impaired fasting glucose, diabetes and the related risk factors for ankle brachial index (ABI). Four-stage selected

CYP4F2 is responsible for metabolizing arachidonic acid to 20-hydroxyeicosatetraenoic acid (20-HETE), which plays a crucial part in the regulation of blood pressure in humans. The aim of the present study was to assess the association between the human CYP4F2 gene polymorphism and essential

We aimed to explore the appropriate WHR cutoffs to identify people at high risk of cardiovascular disease of Uygur adults in Xinjiang. The cardiovascular risk survey(CRS) in Xinjiang was conducted from October 2007 to March 2010, using 4-stagestratified random sampling method to select 14618

To explore the optimal time point of recombinant adeno-associated virus serotype 9-enhanced green fluorescent protein (rAAV9-eGFP) expression in the aorta of atherosclerosis mice. Atherosclerosis model was established with high-fat diet in 30 ApoE-/- mice for 16 weeks. Among them, 25 mice were