Martha H Mackay

Martha H Mackay
University of British Columbia - Vancouver | UBC · School of Nursing

PhD

About

94
Publications
16,291
Reads
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709
Citations
Additional affiliations
April 2010 - present
University of British Columbia - Vancouver
Position
  • Research Assistant
July 1981 - present
Providence Health Care
Position
  • Clinical Nurse Specialist

Publications

Publications (94)
Article
Full-text available
Study objectives: Timely coronary reperfusion is critical for favorable outcomes after ST-elevation myocardial infarction (STEMI). A substantial proportion of the total ischemic time is patient related, occurring before first medical contact (FMC). We aimed to expand the limited current understanding of the associations between prehospital interva...
Article
Introduction: The impact of frailty on outcomes in a contemporary ST-segment-elevation myocardial infarction (STEMI) population is unclear. This study hypothesized that frail STEMI patients undergoing primary percutaneous coronary intervention (pPCI) have worse in-hospital and 1-year outcomes compared to non-frail STEMI patients. Methods: We retros...
Article
Full-text available
Despite being the leading cause of death of women globally, cardiovascular disease (CVD) research over the last several decades has focused primarily on men. CVD research has led to progress in diagnosis and treatment, medical education, and public awareness; however, few of these advances have applied specifically to women’s cardiovascular health....
Article
Full-text available
Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT...
Article
Background Guidelines recommend mineralocorticoid receptor antagonist (MRA) use in patients with left ventricular ejection fraction ≤40% following a myocardial infarction plus heart failure or diabetes mellitus, based on mortality benefit in the EPHESUS (Eplerenone Post‐Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) trial. T...
Article
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Background Women with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention historically experience worse in-hospital outcomes compared to men. Hypothesis Implementation of a regional STEMI system will reduce care gaps in reperfusion times and in-hospital outcomes between women and men. Methods 1928 pa...
Article
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Abdominal aortic aneurysm (AAA) is a potentially fatal condition predominantly affecting older adult men (60 years or over). Based on evidence, preventative health-care guidelines recommend screening older males for AAA using ultrasound. In attempts to reduce AAA mortality among men, screening has been utilized for early detection in some Western c...
Article
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Background Major bleeding (MB) is an independent predictor of mortality among ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI (pPCI). There has been significant focus on preventing access site MB. However, limited data exist on the influence of access site MB vs non-access site MB and subsequent association with adverse i...
Preprint
Full-text available
Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT...
Preprint
Full-text available
Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT...
Preprint
BACKGROUND Acute coronary syndrome (ACS) is a leading cause of hospital admission in North America. Many patients with ACS experience challenges after discharge that impact their clinical outcomes and psychosocial well-being. Text messaging has the potential to provide support to patients during this post-discharge period. OBJECTIVE This study pil...
Article
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Background Acute coronary syndrome (ACS) is a leading cause of hospital admission in North America. Many patients with ACS experience challenges after discharge that impact their clinical outcomes and psychosocial well-being. SMS text messaging has the potential to provide support to patients during this postdischarge period. Objective This study p...
Article
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Background ST-segment elevation myocardial infarction (STEMI) outcomes are influenced by the location of the culprit vessel with worse outcomes portended with a left anterior descending (LAD) culprit lesion. However, relatively little is known about the independent association of LAD involvement with clinical outcomes of patients with STEMI with an...
Article
Full-text available
Background ST-elevation myocardial infarction (STEMI) patients presenting to percutaneous coronary intervention (PCI)-capable hospitals often experience delays for primary PCI (pPCI). We sought to describe the effect of specific delay intervals and patient/system-level factors on STEMI reperfusion times. Methods We analyzed all consecutive STEMI p...
Article
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Aims & Objectives To determine the clinical and professional impacts of nurses’ and other clinicians’ involvement in a research training program. Background Evidence‐based practice (EBP) can be supported by nurses’ involvement in research. Registered nurses report common barriers to EBP and research, but training programs have been shown to overco...
Article
Dual antiplatelet therapy (DAPT) is critical in preventing stent thrombosis after percutaneous coronary intervention (PCI). Delays in DAPT after PCI have been associated with stent thrombosis, reinfarction, and death. Cases of death, stent thrombosis, and reinfarction at our institution have been attributed to patient delays in accessing DAPT on di...
Article
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Background: Anemia may confer a poor prognosis among patients with the acute coronary syndrome. However, few data exist on the association of anemia with in-hospital outcomes, including bleeding, among ST-segment-elevation myocardial infarction patients receiving primary percutaneous coronary intervention. Methods and results: We identified 1919...
Article
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Background Cardiovascular disease (CVD) is a leading cause of hospitalization and death around the world. The prevalence of CVD is increasing and, therefore, development and investigation of effective programs to help people better self-manage their CVD and prevent secondary complications are needed. Objective In this paper, we report on a protoco...
Preprint
BACKGROUND Cardiovascular disease (CVD) is a leading cause of hospitalization and death around the world. The prevalence of CVD is increasing and therefore development and investigation of effective programs to help people better self-manage their CVD and prevent secondary complications is needed. OBJECTIVE In this paper, we report on the protocol...
Article
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Background Investigators have identified important racial‐identity/ethnicity‐based differences in some aspects of acute coronary syndrome (ACS) care and outcomes (time to presentation, symptoms, receipt of coronary angiography/revascularization, repeat revascularization, mortality). Patient‐based differences such as pathophysiology and treatment‐se...
Article
Background: Elevated cardiac troponin (cTn), with signs/symptoms of ischemia, is a key element in a diagnosis of myocardial infarction (MI). Underdiagnosis of MI in women has been attributed to atypical symptoms, inconsistent ECG findings, and less diagnostic testing. We sought to determine if there are sex differences in cTn testing following pre...
Article
Objective: While sex differences in the treatment and outcomes of subjects with acute coronary syndromes are well documented, little is known about the impact of cardiac troponin (cTn) levels obtained in the emergency department (ED) on the observed sex differences. We sought to determine whether cTn levels by chest pain features modify sex differ...
Article
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Background: Patient-related delays in acquiring medical care for symptoms of acute coronary syndrome remain unacceptably long. Many clinical and sociodemographic characteristics associated with treatment-seeking delay are known; however, ethnicity has not been extensively evaluated. Objective: The purpose of this study was to examine ethnicity-b...
Article
Background: Investigators have identified important racial-identity/ethnicity-based differences in some aspects of acute coronary syndrome (ACS) care (time to presentation, symptoms, receipt of coronary angiography/revascularization). Patient-based differences (e.g. pathophysiology, treatment-seeking behaviour) account only partly for the differenc...
Article
Full-text available
Background: Acute coronary syndrome, including acute myocardial infarction (AMI), is one of the leading causes for hospitalization, with AMI 30-day readmission rates around 20%. Supporting patient information needs and increasing adherence to recommended self-management behaviors during transition from hospital to home has the potential to improve...
Article
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Background Previous data suggest significant ethnic differences in outcomes following percutaneous coronary revascularization (PCI), though previous studies have focused on subgroups of PCI patients or used administrative data only. We sought to compare outcomes in a population-based cohort of men and women of South Asian (SA), Chinese and “Other”...
Article
Evidence-based practice (EBP) is essential to high-quality patient care and can contribute to healthcare cost savings, yet nurses and other clinicians at the point of care report barriers to engagement with research and translating it to the clinical setting. Mentorship has been shown to improve nurses' understanding and implementation of EBP. In t...
Article
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Background: Men continue to smoke cigarettes in greater numbers than women. There is growing evidence for the value of developing targeted, men-centered health promotion programs. However, few smoking cessation interventions have been designed for men. A gender-specific website, QuitNow Men, was developed based on focus group interview findings, st...
Article
Background: The joint contribution of sex, ethnicity, and initial clinical presentation to the long-term outcomes of patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina, in whom there is angiographic evidence for obstructive coronary artery disease, remains unknown. Methods and results: We conducted a popu...
Article
In non-emergency department (ED) settings, women with atrial fibrillation and flutter (AFF) have different presentations, treatments, and outcomes than men: they are older, less likely to be treated with rhythm control strategies or appropriate anticoagulation, and more likely to have strokes. This has not been investigated in ED patients. Records...
Article
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Background: Depression and anxiety are common among patients with cardiovascular disease (CVD) and confer significant cardiac risk, contributing to CVD morbidity and mortality. Unfortunately, due to the lack of screening tools that address the specific needs of hospitalized patients, few cardiac inpatient programs offer routine screening for these...
Article
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Background Patients’ treatment-seeking delay remains a significant barrier to timely initiation of reperfusion therapy. Measurement of treatment-seeking delay is central to the large body of research that has focused on pre-hospital delay (PHD), which is primarily patient-related. This research has aimed to quantify PHD and its effects on morbidity...
Article
Full-text available
BACKGROUND: Patients’ treatment-seeking delay remains a significant barrier to timely initiation of reperfusion therapy. Measurement of treatment-seeking delay is central to research that focuses on pre-hospital delay (PHD). Investigators have aimed to quantify PHD and its effects on morbidity and mortality, identify contributing factors, and evalu...
Article
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Little is known on whether there are ethnic differences in outcomes following percutaneous coronary intervention (PCI) and coronary artery bypass grafting surgery (CABG) after acute myocardial infarction (AMI). We compared 30-day and long-term mortality, recurrent AMI, and congestive heart failure in South Asian, Chinese and White patients with AMI...
Article
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High demand for acute care nurse practitioners (ACNPs) in Canadian postoperative cardiac surgery settings has outpaced methodologically rigorous research to support the role. To compare the effectiveness of ACNP-led care to hospitalist-led care in a postoperative cardiac surgery unit in a Canadian, university-affiliated, tertiary care hospital. Pat...
Article
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To the Editor: In a study analyzing data from the National Registry of Myocardial Infarction, Dr Canto and colleagues1 emphasized sex differences in the presentation of MI without chest pain. However, 64.5% presented with chest pain (69.3% of men and 58.0% of women). In both sexes, chest pain/discomfort remains the most common presentation.2Canto e...
Article
Full-text available
Better understanding of symptoms of myocardial ischaemia is needed to improve timeliness of treatment for acute coronary syndromes (ACS). Although researchers have suggested sex differences exist in ischaemic symptoms, methodological issues prevent conclusions. Using percutaneous coronary intervention (PCI) balloon inflation as a model of myocardia...