{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T14:53:03Z","timestamp":1785595983900,"version":"3.56.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Little evidence is available about the number of cardiologists required for appropriate treatment of heart failure (\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              ). Our objective was to determine the association between the number of cardiologists per cardiology beds for treating patients with acute\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              and in\u2010hospital mortality.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This was a cross\u2010sectional study, and we used the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination discharge database. The data of patients with HF on emergency admission from April 1, 2012, to March 31, 2014, were extracted. The patients were categorized into 4 groups by the quartiles of the numbers of cardiologists per 50 cardiovascular beds (first group: median, 4.4 [interquartile range, 3.5\u20135.0]; second group: median, 6.7 [interquartile range, 6.5\u20137.5]; third group: median, 9.7 [interquartile range, 8.8\u201310.1]; and fourth group: median, 16.7 [interquartile range, 14.0\u201323.8]). Using multilevel mixed\u2010effect logistics regression, we determined adjusted odds ratios for in\u2010hospital mortality. We identified 154\u00a0290 patients with HF on emergency admissions. There were 29\u00a0626, 36\u00a0587, 46\u00a0451, and 41\u00a0626 patients in the first, second, third, and fourth groups, respectively.\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              severity, on the basis of New York Heart Association classification, was similar in the 3 groups. Adjusted odds ratios (95% CIs) for in\u2010hospital mortality were 0.92 (0.82\u20131.04;\n              <jats:italic>P<\/jats:italic>\n              =0.20), 0.82 (0.72\u20130.92;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and 0.70 (0.61\u20130.80;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) for the second, third, and fourth groups, respectively. The proportion of medication used, including angiotensin\u2010converting enzyme inhibitors or angiotensin receptor blockers, \u03b2 blockers, and mineralocorticoid receptor antagonists, was positively correlated to the number of cardiologists.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients hospitalized for\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              in hospitals with larger numbers of cardiologists per cardiovascular beds had lower 30\u2010day mortality.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012282","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T09:04:06Z","timestamp":1568019846000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Number of Cardiologists per Cardiovascular Beds and In\u2010Hospital Mortality for Acute Heart Failure: A Nationwide Study in Japan"],"prefix":"10.1161","volume":"8","author":[{"given":"Koshiro","family":"Kanaoka","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Okayama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michikazu","family":"Nakai","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Sumita","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Onoue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsunenari","family":"Soeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Nishimura","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rika","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Okura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Yasuda","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Tsutsui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyushu University Graduate School of Medical Sciences Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issei","family":"Komuro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The University of Tokyo Graduate School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisao","family":"Ogawa","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nara Medical University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.12.038"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn309"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S2287"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32520-5"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22638"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006955"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.0924"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.109.883256"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa0907130"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.000064"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-16-0196"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035858"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.46.855"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000177872.87960.61"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g3072"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005988"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.116.2.346"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000509"},{"key":"e_1_3_1_21_2","unstructured":"Japanese Registry of All Cardiac and Vascular Diseases (JROAD) . Survey on medical cardiovascular disease 2016. http:\/\/www.j-circ.or.jp\/jittai_chosa\/jittai_chosa2016web.pdf. Accessed November 10 2018."}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.012282","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:46:31Z","timestamp":1715600791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.012282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,17]]},"references-count":20,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2019,9,17]]}},"alternative-id":["10.1161\/JAHA.119.012282"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.012282","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,17]]},"assertion":[{"value":"2019-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e012282"}}