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Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience
AIMS: The aim of this study is to evaluate the implementation of the cardiac amyloidosis (CA) clinical pathway on awareness among referring cardiologists, diagnostic delay, and severity of CA at diagnosis. METHODS AND RESULTS: Patients with CA were retrospectively included in this study and divided...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242028/ https://www.ncbi.nlm.nih.gov/pubmed/35919127 http://dx.doi.org/10.1093/ehjopen/oeac011 |
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author | Brons, Maaike Muller, Steven A Rutten, Frans H van der Meer, Manon G Vrancken, Alexander F J E Minnema, Monique C Baas, Annette F Asselbergs, Folkert W Oerlemans, Marish I F J |
author_facet | Brons, Maaike Muller, Steven A Rutten, Frans H van der Meer, Manon G Vrancken, Alexander F J E Minnema, Monique C Baas, Annette F Asselbergs, Folkert W Oerlemans, Marish I F J |
author_sort | Brons, Maaike |
collection | PubMed |
description | AIMS: The aim of this study is to evaluate the implementation of the cardiac amyloidosis (CA) clinical pathway on awareness among referring cardiologists, diagnostic delay, and severity of CA at diagnosis. METHODS AND RESULTS: Patients with CA were retrospectively included in this study and divided into two periods: pre-implementation of the CA clinical pathway (2007–18; T1) and post-implementation (2019–20; T2). Patients’ and disease characteristics were extracted from electronic health records and compared. In total, 113 patients (mean age 67.8 ± 8.5 years, 26% female) were diagnosed with CA [T1 (2007–18): 56; T2 (2019–20): 57]. The number of CA diagnoses per year has increased over time. Reasons for referral changed over time, with increased awareness of right ventricular hypertrophy (9% in T1 vs. 36% in T2) and unexplained heart failure with preserved ejection fraction (22% in T1 vs. 38% in T2). Comparing T1 with T2, the diagnostic delay also improved (14 vs. 8 months, P < 0.01), New York Heart Association Class III (45% vs. 23%, P = 0.03), and advanced CA stage (MAYO/Gillmore Stage III/IV; 61% vs. 33%, P ≤ 0.01) at time of diagnosis decreased. CONCLUSION: After implementation of the CA clinical pathway, the awareness among referring cardiologists improved, diagnostic delay was decreased, and patients had less severe CA at diagnosis. Further studies are warranted to assess the prognostic impact of CA clinical pathway implementation. |
format | Online Article Text |
id | pubmed-9242028 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-92420282022-08-01 Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience Brons, Maaike Muller, Steven A Rutten, Frans H van der Meer, Manon G Vrancken, Alexander F J E Minnema, Monique C Baas, Annette F Asselbergs, Folkert W Oerlemans, Marish I F J Eur Heart J Open Original Article AIMS: The aim of this study is to evaluate the implementation of the cardiac amyloidosis (CA) clinical pathway on awareness among referring cardiologists, diagnostic delay, and severity of CA at diagnosis. METHODS AND RESULTS: Patients with CA were retrospectively included in this study and divided into two periods: pre-implementation of the CA clinical pathway (2007–18; T1) and post-implementation (2019–20; T2). Patients’ and disease characteristics were extracted from electronic health records and compared. In total, 113 patients (mean age 67.8 ± 8.5 years, 26% female) were diagnosed with CA [T1 (2007–18): 56; T2 (2019–20): 57]. The number of CA diagnoses per year has increased over time. Reasons for referral changed over time, with increased awareness of right ventricular hypertrophy (9% in T1 vs. 36% in T2) and unexplained heart failure with preserved ejection fraction (22% in T1 vs. 38% in T2). Comparing T1 with T2, the diagnostic delay also improved (14 vs. 8 months, P < 0.01), New York Heart Association Class III (45% vs. 23%, P = 0.03), and advanced CA stage (MAYO/Gillmore Stage III/IV; 61% vs. 33%, P ≤ 0.01) at time of diagnosis decreased. CONCLUSION: After implementation of the CA clinical pathway, the awareness among referring cardiologists improved, diagnostic delay was decreased, and patients had less severe CA at diagnosis. Further studies are warranted to assess the prognostic impact of CA clinical pathway implementation. Oxford University Press 2022-02-24 /pmc/articles/PMC9242028/ /pubmed/35919127 http://dx.doi.org/10.1093/ehjopen/oeac011 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Brons, Maaike Muller, Steven A Rutten, Frans H van der Meer, Manon G Vrancken, Alexander F J E Minnema, Monique C Baas, Annette F Asselbergs, Folkert W Oerlemans, Marish I F J Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience |
title | Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience |
title_full | Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience |
title_fullStr | Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience |
title_full_unstemmed | Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience |
title_short | Evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience |
title_sort | evaluation of the cardiac amyloidosis clinical pathway implementation: a real-world experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242028/ https://www.ncbi.nlm.nih.gov/pubmed/35919127 http://dx.doi.org/10.1093/ehjopen/oeac011 |
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