#Clc sequence viewer 7.5 workflow software

#Clc sequence viewer 7.5 workflow software

The CART software was designed using standardized definitions that conform to the definitions and standards of the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) 11 and incorporates features such as pull-down menus and automated clinical report generation to ensure uniformity of data entry by different providers and in different cardiac catheterization laboratories. 10 The software is embedded in the VA electronic health record and allows providers to enter patient and procedural information (preprocedure assessment, coronary angiography, and PCI) as part of routine clinical workflow. 9 A key feature of the CART program is a clinical software application designed to collect standardized data on all coronary angiograms and percutaneous coronary interventions (PCI). The VA Clinical Assessment Reporting and Tracking (CART) program is a national quality initiative launched in 2005 focusing on coronary revascularization procedures conducted in all VA cardiac catheterization laboratories. Insights from this analysis would be expected to inform more effective prevention and treatment options in this population. We then performed sequential, multivariable adjustment to assess the relationships with important confounders such as basic cardiac risk factors, risky behaviors (eg, alcohol and other substance abuse), and conditions directly affected by cocaine (eg, psychological disorders, CHF, and end-stage renal disease). To address this gap, we described the association of cocaine use with the 1-year risk of all-cause mortality, MI, and CVA in a Veterans Affairs (VA) population of coronary artery disease (CAD) patients undergoing cardiac catheterization. Better understanding of these mechanisms would help guide more effective prevention and treatment. 3 In addition, cocaine use has been associated with unhealthy lifestyle choices, 4 comorbid mental and substance-abuse disorders, 5, 6 poor socioeconomic status, 7 and medication noncompliance 8-all of which also can lead to adverse CV events.Ĭurrently, it is unclear how these potential mechanisms, individually and in aggregate, contribute to adverse CV outcomes.

1, 2 Several mechanisms of these effects have been proposed, including increased myocardial oxygen demand, coronary-artery vasoconstriction, enhanced platelet aggregation, and thrombus formation. Effective intervention programs to reduce cardiac events in this population will require multiple components addressing these factors.Ĭocaine has been associated with numerous toxic effects on the cardiovascular (CV) system, notably myocardial infarction (MI), arrhythmias, congestive heart failure (CHF), cerebrovascular accidents (CVA), and sudden cardiac death. Contributors to this association are multifaceted and specific to individual cardiovascular outcomes, including associated risky behaviors and direct effects of cocaine. ConclusionsĬocaine use is associated with adverse cardiac events in veterans with CAD. With continued adjustment, increased CVA risk remained significantly associated with cocaine use, whereas MI risk was mediated by risky behaviors and mortality was fully explained by conditions directly affected by cocaine. Cocaine users were younger (median 58.2 vs 65.3 years P < 0.001), more likely to be African American (58.9% vs 10.6% P < 0.001), and had fewer traditional cardiac risk factors. Resultsģ082 (2.5%) veterans were cocaine users. To explore factors contributing to these associations, we sequentially adjusted for cardiac risk factors, risky behaviors, and clinical conditions directly affected by cocaine. We analyzed association between cocaine use and 1-year all-cause mortality, myocardial infarction (MI), and cerebrovascular accident (CVA) among veterans with obstructive CAD (N = 122 035). We used the Veterans Affairs database to identify veterans undergoing coronary catheterization between 20. HypothesisĬocaine use is associated with worse outcomes in patients undergoing cardiac catheterization Methods It is unclear whether this is due to direct effects of cocaine or other factors. Cocaine use has been associated with adverse cardiovascular outcomes in patients with coronary artery disease (CAD).