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doctoral thesis
Real world management and outcomes in acute coronary syndrome: analysis of a large US cohort
2023. urn:nbn:hr:171:733089
Matetić, Andrija
University of Split
School of Medicine

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Matetić, A. (2023). Real world management and outcomes in acute coronary syndrome: analysis of a large US cohort (Doctoral thesis). Split: University of Split, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:171:733089

Matetić, Andrija. "Real world management and outcomes in acute coronary syndrome: analysis of a large US cohort." Doctoral thesis, University of Split, School of Medicine, 2023. https://urn.nsk.hr/urn:nbn:hr:171:733089

Matetić, Andrija. "Real world management and outcomes in acute coronary syndrome: analysis of a large US cohort." Doctoral thesis, University of Split, School of Medicine, 2023. https://urn.nsk.hr/urn:nbn:hr:171:733089

Matetić, A. (2023). 'Real world management and outcomes in acute coronary syndrome: analysis of a large US cohort', Doctoral thesis, University of Split, School of Medicine, accessed 22 April 2024, https://urn.nsk.hr/urn:nbn:hr:171:733089

Matetić A. Real world management and outcomes in acute coronary syndrome: analysis of a large US cohort [Doctoral thesis]. Split: University of Split, School of Medicine; 2023 [cited 2024 April 22] Available at: https://urn.nsk.hr/urn:nbn:hr:171:733089

A. Matetić, "Real world management and outcomes in acute coronary syndrome: analysis of a large US cohort", Doctoral thesis, University of Split, School of Medicine, Split, 2023. Available at: https://urn.nsk.hr/urn:nbn:hr:171:733089

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Metadata
TitleReal world management and outcomes in acute coronary syndrome: analysis of a large US cohort
Title (croatian)Rad ne sadrži naslov na drugom jeziku.
AuthorAndrija Matetić
MentorMamas A. Mamas (mentor)
VIAF: 628158790792438852316
Committee memberDuška Glavaš (predsjednik povjerenstva)
Committee memberJoško Božić (član povjerenstva)
Committee memberIvana Kolčić (član povjerenstva)
GranterUniversity of Split
School of Medicine
Split
Defense date and country2023-06-30, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Universal decimal classification
(UDC)		616 - Pathology. Clinical medicine
Abstract
Main objectives: The main aim of this doctoral dissertation and consolidated research studies was to compare the management and outcomes of patients with acute coronary syndrome based on their socioeconomic status, diagnostic coding priority, trial recruitment status and sex. Materials and methods: Using the complex adjustment models, analysis of the largest national registry National Inpatient Sample was performed from January 2004 to December 2018, depending on the sub-study. The analysis included ~11 million discharge records of patients with acute coronary syndrome. Main findings and scientific contribution: There were several main findings. First, patients with low socioeconomic status received less invasive management and had worse in-hospital prognosis. Second, patients with secondary-coded acute coronary syndrome were less likely to receive invasive management and more likely to experience in-hospital adverse events. Third, a higher utilization of invasive management and better in-hospital outcomes was observed in patients who were enrolled in a clinical trial. Fourth, female patients were less likely to receive invasive therapies and more likely to experience adverse outcomes. The scientific contribution of this doctoral dissertation and consolidated research studies is unequivocable. It represents a big data analysis of sufficiently powered registry with an excellent insight in the real-world contemporary state and detailed literature review. It is a result of an international collaboration with experts in the field of cardiovascular medicine. This research project warrants further incentives to equalize the quality of care and prognosis across the wide spectrum of acute coronary syndrome patients. Conclusions: The management and outcomes of patients with acute coronary syndrome is subjected to disparity based on socioeconomic status, diagnostic coding priority, trial recruitment status and sex. Future initiatives are encouraged to eliminate the disparity gap in this vulnerable population.
Abstract (croatian)
Glavni ciljevi: Glavni cilj ove doktorske disertacije i objedinjenih znanstvenih istraživanja bio je usporediti liječenje i ishode bolesnika s akutnim koronarnim sindromom na temelju njihova socioekonomskog statusa, prioriteta dijagnostičkog kodiranja, uključenja u kliničko ispitivanje i spola. Materijali i metode: Koristeći kompleksne statističke modele prilagodbe, učinjena je analiza najvećeg nacionalnog registra “National Inpatient Sample” iz Sjedinjenih Američkih Država za razdoblje od siječnja 2004. do prosinca 2018. godine, ovisno o pojedinom znanstvenom istraživanju. Analiza je uključila ~11 milijuna otpusnih zapisa o pacijentima s akutnim koronarnim sindromom. Glavni nalazi i znanstveni doprinos: Utvrđeno je nekoliko glavnih nalaza. Prvo, pacijenti s niskim socioekonomskim statusom su bili rjeđe podvrgnuti invazivnom liječenju i imali su lošiju unutarbolničku prognozu. Drugo, pacijenti sa sekundarno kodiranom dijagnozom akutnog koronarnog sindroma su rjeđe dobili invazivno liječenje uz lošije unutarbolničke ishode. Treće, utvrđena je veća primjena invazivnog liječenja, kao i bolji ishodi, u pacijenata koji su bili uključeni u kliničko ispitivanje. Četvrto, pacijentice su rjeđe dobile invazivno liječenje uz veći rizik za neželjene unutarbolničke ishode. Znanstveni doprinos ove doktorske disertacije i objedinjenih znanstvenih istraživanja jest značajan, a uključuje analizu velikog registra s izvrsnim uvidom u suvremeno stanje u stvarnom svijetu i detaljnim pregledom literature. Navedeni projekt je plod međunarodne suradnje sa stručnjacima iz područja kardiovaskularne medicine. Ovaj istraživački projekt potiče ujednačenje kvalitete skrbi, liječenja i prognoze u širokom spektru bolesnika s akutnim koronarnim sindromom. Zaključci: Liječenje i ishodi pacijenata s akutnim koronarnim sindromom podložni su razlikama na temelju socioekonomskog statusa, prioriteta dijagnostičkog kodiranja, uključenja u kliničko ispitivanje i spola. Potrebne su daljnje inicijative za smanjenjem različitosti u ovoj ranjivoj populaciji.
Keywords
Keywords (croatian)
Languageenglish
URN:NBNurn:nbn:hr:171:733089
Promotion2023
Study programmeTitle: Obtaining a doctorate of science outside of doctoral studies
Study programme type: university
Study level: postgraduate
Academic / professional title: doktor/doktorica znanosti (doktor/doktorica znanosti)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-07-14 20:07:10