Treatment of Acute Myocardial Infarction in the Elderly

老年人急性心肌梗塞的治疗

• 批准号: 6967417
• 负责人: ALAN KEITH BERGER
• 金额: $ 12.95万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6967417
• 关键词: age difference; behavioral /social science research tag; biomarker; cardiovascular disorder chemotherapy; cardiovascular disorder diagnosis; cardiovascular disorder epidemiology; cardiovascular disorder therapy; cardiovascular surgery; clinical research; electrocardiography; focus groups; geographic difference; health care personnel; health care personnel performance; health care service evaluation; health disparity; health services research tag; human data; human mortality; human old age (65+); human subject; myocardial infarction; outcomes research

DESCRIPTION (provided by applicant): The prognostic significance of age in patients with acute myocardial infarction (AMI) is well established in the literature. The efficacy of pharmacologic and invasive procedures in AMI have been based primarily on younger patients and observational studies suggest a lower use of these interventions in the elderly. The overall aim of the research is to understand whether older patients are treated differently and, if so, whether ageism or other factors play a role in the (1) diagnosis of AMI, (2) delay in diagnosis and treatment of AMI, (3) utilization of pharmacologic therapies and interventional procedures, (4) geographic variation in AMI care, and (5) outcomes of AMI patients. These objectives will be addressed using the Minnesota Heart Survey (MHS, R01 HL65755), which includes a population-based database of over 5000 abstracted medical records of AMI patients hospitalized in 2001-2002 in the Minneapolis-St. Paul metropolitan area. The investigator will conduct a series of focus group interviews with health care professionals at selected MHS hospitals to explore the factors that enter into the decision-making process of elderly patients. He will then develop a multi-faceted intervention directed at quality of care improvement in the elderly. This intervention will be pilot-tested in the K08 project to assess its feasibility as the basis of an R01 grant. The applicant, with the support of an advisory committee representing both epidemiology and geriatrics, has developed a focused 5-year career development plan with 75% guaranteed protected time for research. The advanced course curriculum in the fields of epidemiology, biostatistics, and health services research will provide the applicant with a Masters in Public Health in Epidemiology. The applicant will achieve an in-depth training in geriatric medicine through the combination of a board-review course, seminars, consultation services, and scientific meetings. The K08 training will provide the necessary skills to permit the applicant to compete successfully for an R01 grant.

描述（由申请人提供）：年龄对于急性心肌梗塞（AMI）患者的预后意义在文献中已得到充分证实。药物和侵入性治疗对 AMI 的疗效主要基于年轻患者，观察性研究表明这些干预措施在老年人中的使用率较低。该研究的总体目的是了解老年患者是否受到不同的治疗，如果是，年龄歧视或其他因素是否在以下情况中发挥作用：(1) AMI 诊断，(2) AMI 诊断和治疗延迟，(3 ) 药物治疗和介入手术的利用，(4) AMI 护理的地理差异，以及 (5) AMI 患者的结果。这些目标将通过明尼苏达州心脏调查（MHS，R01 HL65755）来实现，该调查包括一个基于人群的数据库，其中包含 2001 年至 2002 年在明尼阿波利斯-圣路易斯住院的 AMI 患者的 5000 多份摘要医疗记录。保罗都会区。研究者将与选定的 MHS 医院的医疗保健专业人员进行一系列焦点小组访谈，以探讨影响老年患者决策过程的因素。然后，他将制定一项多方面的干预措施，旨在改善老年人的护理质量。该干预措施将在 K08 项目中进行试点测试，以评估其作为 R01 拨款基础的可行性。 申请人在代表流行病学和老年病学的咨询委员会的支持下，制定了一项重点突出的 5 年职业发展计划，其中保证 75% 的研究保护时间。流行病学、生物统计学和卫生服务研究领域的高级课程将为申请人提供流行病学公共卫生硕士学位。申请人将通过委员会审查课程、研讨会、咨询服务和科学会议相结合，获得老年医学方面的深入培训。 K08 培训将提供必要的技能，使申请人能够成功竞争 R01 补助金。