Treatment of Acute Myocardial Infarction in the Elderly

老年人急性心肌梗死的治疗

基本信息

批准号：
7261239
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
项目类别：
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/7261239
关键词：
Acute Acute myocardial infarction Address Adrenergic beta-Antagonists Advisory Committees Age Ageism American American Heart Association Angiotensin-Converting Enzyme Inhibitors Area Aspirin Biological Markers Biometry Cardiac Cardiac Catheterization Procedures Cardiology Cardiovascular Diseases Cardiovascular system Caring Characteristics Cities Clinical Communities Comorbidity Consultations Coronary Coronary Angiography Coronary Artery Bypass Coronary heart disease Country County Data Data Set Databases Decision Making Depth Descriptor Development Plans Diagnosis Diagnostic Disease Educational Curriculum Elderly Electrocardiogram Elevation Eligibility Determination Epidemiologic Studies Epidemiology Event Focus Groups Funding General Population Geriatrics Grant Guidelines Health Professional Health Services Research Heart Hospital Mortality Hospitals Intervention Intervention Studies Interview Invasive Lipids Literature Massachusetts Medical Medical Records Mind Minnesota Monitor Morbidity - disease rate Myocardial Infarction Observational Study Outcome Patients Pattern Patterns of Care Personal Satisfaction Pharmaceutical Preparations Pilot Projects Play Population Population Study Procedures Process Public Health Quality of Care Randomized Clinical Trials Reperfusion Therapy Research Research Personnel Research Project Grants Role Science Selection Bias Series Serum Services Severities Severity of illness Standards of Weights and Measures Surveys Symptoms Testing Therapeutic Time Training Twin Multiple Birth United States United States National Institutes of Health abstracting base career college coronary angioplasty day design experience forging geographic difference improved metropolitan mortality novel older patient prognostic regional difference skills stem therapy design thrombolysis trend

项目摘要

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）：文献中已经确立了急性心肌梗塞（AMI）患者年龄的预后意义。药理学和侵入性程序在AMI中的功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较少。该研究的总体目的是了解老年患者是否受到不同的治疗，如果是的，无论是年龄歧视还是其他因素在AMI的诊断中起作用，（（2）AMI诊断和治疗的延迟（3）（3 ）利用药理学疗法和介入程序，（4）AMI护理的地理差异以及（5）AMI患者的结果。这些目标将使用明尼苏达州心脏调查（MHS，R01 HL65755）来解决，其中包括一个基于人群的数据库，该数据库在2001 - 2002年在明尼阿波利斯-ST住院的AMI患者的5000多名抽象病历。保罗大都会地区。研究人员将对选定的MHS医院的医疗保健专业人员进行一系列焦点小组访谈，以探索进入老年患者决策过程的因素。然后，他将开发针对老年人护理质量的多面干预措施。该干预措施将在K08项目中进行试点测试，以评估其作为R01赠款的基础的可行性。申请人在代表流行病学和老年医学的咨询委员会的支持下，制定了一项重点的5年职业发展计划，并有75％的保证受保护时间进行研究。流行病学，生物统计学和健康服务研究领域的高级课程课程将为申请人提供流行病学公共卫生硕士学位。申请人将通过董事会审查课程，研讨会，咨询服务和科学会议的结合，进行老年医学的深入培训。 K08培训将提供必要的技能，以允许申请人成功竞争R01赠款。