Scholars@Duke
Jie-Lena Sun

Jie-Lena Sun

Biostatistician, Senior
Duke Clinical Research Institute
sun00006@mc.duke.edu
DUMC # 3850, Location # 5716, Durham, NC 27715
200 Morris St., Durham, NC 27701

Selected Publications

Race- and Ethnicity-Specific Hospital Arrival and Emergency Medicine Service Activation Times by US State for Ischemic Stroke.

Journal Article J Am Heart Assoc · January 6, 2026 BACKGROUND: Delayed hospital arrival after 4.5 hours of stroke onset excludes patients from intravenous thrombolytic therapy. In the United States, prehospital triage is regulated by each state. Understanding race- and ethnicity-specific prehospital delays ... Full text Link to item Cite

Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis.

Journal Article JAMA Neurol · December 1, 2024 IMPORTANCE: Clinical trials have suggested that prehospital management in a mobile stroke unit (MSU) improves functional outcomes in patients with acute ischemic stroke who are potentially eligible for intravenous thrombolysis, but there is a paucity of re ... Full text Link to item Cite

Hospital Heart Failure Medical Therapy Score and Associated Clinical Outcomes and Costs.

Journal Article JAMA Cardiol · November 1, 2024 IMPORTANCE: A composite score for guideline-directed medical therapy (GDMT) for patients with heart failure (HF) is associated with increased survival. Whether hospital performance according to a GDMT score is associated with a broader array of clinical ou ... Full text Link to item Cite

Performance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines-Stroke Registry.

Journal Article Circulation · December 19, 2023 BACKGROUND: The thrombectomy-capable stroke center (TSC) is a recently introduced intermediate tier of accreditation for hospitals at which patients with acute ischemic stroke receive care. The comparative quality and clinical outcomes of reperfusion thera ... Full text Link to item Cite

Higher Procedural Volumes Are Associated with Faster Treatment Times, Better Functional Outcomes, and Lower Mortality in Patients Undergoing Endovascular Treatment for Acute Ischemic Stroke.

Journal Article Ann Neurol · September 20, 2023 OBJECTIVE: We aimed to characterize the association of hospital procedural volumes with outcomes among acute ischemic stroke (AIS) patients undergoing endovascular therapy (EVT). METHODS: This was a retrospective, observational cohort study using data pros ... Full text Link to item Cite

Variation in resource utilization and mortality among patients with varying MR type and severity.

Journal Article Am Heart J · June 2023 BACKGROUND: Limited data exists regarding the relationships between resource use and outcomes in patients with mitral regurgitation (MR). We examined resource utilization and outcomes across MR type and severity. METHODS: Using the Duke Echocardiography La ... Full text Link to item Cite

Clinical Profile, Health Care Costs, and Outcomes of Patients Hospitalized for Heart Failure With Severely Reduced Ejection Fraction.

Journal Article J Am Heart Assoc · May 16, 2023 Background Many patients with heart failure (HF) have severely reduced ejection fraction but do not meet threshold for consideration of advanced therapies (ie, stage D HF). The clinical profile and health care costs associated with these patients in US pra ... Full text Link to item Cite

Comparing New York Heart Association Class and Patient-Reported Outcomes Among Patients Hospitalized for Heart Failure.

Journal Article Circ Heart Fail · January 2023 BACKGROUND: Alignment between clinician-reported New York Heart Association (NYHA) class compared and patient-reported outcomes among patients hospitalized for heart failure is unclear. METHODS: ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritid ... Full text Link to item Cite

Machine learning to define phenotypes and outcomes of patients hospitalized for heart failure with preserved ejection fraction: Findings from ASCEND-HF.

Journal Article Am Heart J · December 2022 BACKGROUND: Heart Failure with Preserved Ejection Fraction (HFpEF) is a heterogenous disease with few therapies proven to provide clinical benefit. Machine learning can characterize distinct phenotypes and compare outcomes among patients with HFpEF who are ... Full text Link to item Cite

Titration of medical therapy and clinical outcomes among patients with heart failure with reduced ejection fraction: Findings from the HF-ACTION trial.

Journal Article Am Heart J · September 2022 BACKGROUND: Clinical guidelines recommend titration of angiotensin converting enzyme inhibitors (ACEi) and beta-blockers among patients with heart failure with reduced ejection fraction (HFrEF) to maximally tolerated doses. Patient characteristics associat ... Full text Link to item Cite

Atrial branch coronary artery stenosis as a mechanism for atrial fibrillation.

Journal Article Heart Rhythm · August 2022 BACKGROUND: The etiology of atrial fibrillation (AF) is multifactorial and incompletely understood. OBJECTIVE: The purpose of this study was to evaluate the association between coronary artery disease (CAD) affecting atrial tissue and AF. METHODS: Patients ... Full text Link to item Cite

Recovery of left ventricular function is associated with improved outcomes in LVAD recipients.

Journal Article J Heart Lung Transplant · August 2022 BACKGROUND: The significance of recovered left ventricular ejection fraction (LVEF) in LVAD recipients, outside of pump explantation, is unclear. METHODS: Patients undergoing first LVAD implantation at Duke University Hospital between 2006 and 2017 were ev ... Full text Link to item Cite

PROPHETIC EU: Prospective Identification of Pneumonia in Hospitalized Patients in the Intensive Care Unit in European and United States Cohorts.

Journal Article Open Forum Infect Dis · July 2022 BACKGROUND: The prospective identification of patients at high risk for hospital-acquired/ventilator-associated bacterial pneumonia may improve clinical trial feasibility and foster antibacterial development. In a prior study conducted in the United States ... Full text Open Access Link to item Cite

Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion.

Journal Article Circulation · March 22, 2022 BACKGROUND: Basilar artery occlusion (BAO) is a devastating condition without definitive evidence to guide treatment. Whereas the association between faster treatment times with endovascular therapy (EVT) and better outcomes in anterior circulation is well ... Full text Link to item Cite

Estimated Glomerular Filtration Rate Variability in Patients With Heart Failure and Chronic Kidney Disease.

Journal Article J Card Fail · November 2021 BACKGROUND: Greater variability in the estimated glomerular filtration rate (eGFR) is associated with higher mortality in patients with chronic kidney disease (CKD). Heart failure (HF) is common in CKD and may increase variability through changes in hemody ... Full text Link to item Cite

Outcomes of Endovascular Therapy in Patients With Prestroke Mobility Impairment.

Conference Stroke · November 2021 BACKGROUND AND PURPOSE: Patients with prestroke mobility impairment (PSMI) were excluded from endovascular clinical trials. There are limited data regarding safety and outcomes of endovascular thrombectomy in this population. We used a large, national data ... Full text Link to item Cite

Early diuretic strategies and the association with In-hospital and Post-discharge outcomes in acute heart failure.

Journal Article Am Heart J · September 2021 BACKGROUND: Decongestion is a primary goal during hospitalizations for decompensated heart failure (HF). However, data surrounding the preferred route and strategy of diuretic administration are limited with varying results in prior studies. METHODS: This ... Full text Link to item Cite

Estimating the real-world performance of the PROMISE minimal-risk tool.

Journal Article Am Heart J · September 2021 BACKGROUND: Stable chest pain is a common indication for cardiac catheterization. We assessed the prognostic value of the Prospective Multicenter Imaging Study for Evaluation (PROMISE) Minimal-Risk Tool in identifying patients who are at very low risk of o ... Full text Link to item Cite

Growth differentiation factor-15, treatment with liraglutide, and clinical outcomes among patients with heart failure.

Journal Article ESC Heart Fail · August 2021 AIMS: Associations between growth differentiation factor-15 (GDF-15), cardiovascular outcomes, and exercise capacity among patients with a recent hospitalization for heart failure (HHF) and heart failure with reduced ejection fraction (HFrEF) are unknown. ... Full text Link to item Cite

The Cost-Effectiveness of Palliative Care: Insights from the PAL-HF Trial.

Journal Article J Card Fail · June 2021 BACKGROUND: In a randomized control trial, Palliative Care in Heart Failure (PAL-HF) improved heart failure-related quality of life, though cost-effectiveness remains unknown. The aim of this study was to evaluate the cost-effectiveness of the PAL-HF trial ... Full text Link to item Cite

Prognostic Role of Prior Heart Failure Hospitalization Among Patients Hospitalized for Worsening Chronic Heart Failure.

Journal Article Circ Heart Fail · April 2021 BACKGROUND: Hospitalization for heart failure (HF) is associated with increased risk of death among patients with chronic HF. The degree to which hospitalization for HF is a distinct biologic entity with independent prognostic value versus a marker of high ... Full text Link to item Cite

Elevated Uric Acid Prevalence and Clinical Outcomes in Patients with Heart Failure with Preserved Ejection Fraction: Insights from RELAX.

Journal Article Am J Med · December 2020 PURPOSE: We aimed to 1) describe characteristics of patients with heart failure with preserved ejection fraction (HFpEF) enrolled in RELAX stratified by normal or elevated baseline serum uric acid (sUA) level; 2) evaluate the association between sUA level ... Full text Link to item Cite

PROPHETIC: Prospective Identification of Pneumonia in Hospitalized Patients in the ICU.

Journal Article Chest · December 2020 BACKGROUND: Pneumonia is the leading infection-related cause of death. The use of simple clinical criteria and contemporary epidemiology to identify patients at high risk of nosocomial pneumonia should enhance prevention efforts and facilitate development ... Full text Open Access Link to item Cite

Performance of Guideline Recommendations for Prevention of Myocardial Infarction in Young Adults.

Journal Article J Am Coll Cardiol · August 11, 2020 BACKGROUND: The 2018 cholesterol guidelines of the American Heart Association and the American College of Cardiology (AHA/ACC) changed 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor (statin) eligibility criteria for primary prevention to includ ... Full text Link to item Cite

Effects of Liraglutide on Worsening Renal Function Among Patients With Heart Failure With Reduced Ejection Fraction: Insights From the FIGHT Trial.

Journal Article Circ Heart Fail · May 2020 BACKGROUND: The FIGHT (Functional Impact of GLP-1 [glucagon-like peptide-1] for Heart Failure Treatment) trial randomized 300 patients with heart failure with reduced ejection fraction (HFrEF) and a recent hospitalization for heart failure to liraglutide v ... Full text Link to item Cite

Biomarker Profile of Left Atrial Myopathy in Heart Failure With Preserved Ejection Fraction: Insights From the RELAX Trial.

Journal Article J Card Fail · March 2020 BACKGROUND: Although left atrial (LA) mechanical dysfunction in heart failure with preserved ejection fraction (HFpEF) is associated with poor clinical outcomes, the influence of LA myopathy on temporal changes in cardiovascular biomarkers is unclear. METH ... Full text Link to item Cite

Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction.

Journal Article J Card Fail · February 2020 BACKGROUND: Patients with heart failure (HF) with preserved ejection fraction (HFpEF) and obesity display a number of pathophysiologic features that may render them more or less vulnerable to negative effects of decongestion on renal function, including gr ... Full text Link to item Cite

Lower urine sodium predicts longer length of stay in acute heart failure patients: Insights from the ROSE AHF trial.

Journal Article Clin Cardiol · January 2020 BACKGROUND: In patients hospitalized with acute heart failure (AHF), low urine sodium concentration (UNa ) after diuretic treatment may identify patients at risk for longer length of stay (LOS) and adverse events. We investigated the prognostic significanc ... Full text Link to item Cite

Characterization of the Obese Phenotype of Heart Failure With Preserved Ejection Fraction: A RELAX Trial Ancillary Study.

Journal Article Mayo Clin Proc · July 2019 OBJECTIVE: To characterize the obese heart failure with preserved ejection fraction (HFpEF) phenotype in a multicenter cohort. PATIENTS AND METHODS: This was a secondary analysis of the randomized clinical trial RELAX (Phosphodiesterase-5 Inhibition to Imp ... Full text Link to item Cite

Patient Phenotypes, Cardiovascular Risk, and Ezetimibe Treatment in Patients After Acute Coronary Syndromes (from IMPROVE-IT).

Journal Article Am J Cardiol · April 15, 2019 Risk prediction following acute coronary syndrome (ACS) remains challenging. Data-driven machine-learning algorithms can potentially identify patients at high risk of clinical events. The Improved Reduction of Outcomes: Vytorin Efficacy International Trial ... Full text Link to item Cite

Relationship between changing patient-reported outcomes and subsequent clinical events in patients with chronic heart failure: insights from HF-ACTION.

Journal Article Eur J Heart Fail · January 2019 AIMS: A 5-point change in the Kansas City Cardiomyopathy Questionnaire (KCCQ) is commonly considered to be a clinically significant difference in health status in patients with heart failure. We evaluated how the magnitude of change relates to subsequent c ... Full text Link to item Cite

High-Sensitivity Troponin I in Hospitalized and Ambulatory Patients With Heart Failure With Preserved Ejection Fraction: Insights From the Heart Failure Clinical Research Network.

Conference J Am Heart Assoc · December 18, 2018 Background We sought to study the prevalence of high-sensitivity troponin and its association with cardiac structure and outcomes in ambulatory and hospitalized patients with heart failure with a preserved ejection fraction ( HF p EF ). Methods and Results ... Full text Link to item Cite

Relationship Between Enrolling Country Income Level and Patient Profile, Protocol Completion, and Trial End Points.

Journal Article Circ Cardiovasc Qual Outcomes · October 2018 BACKGROUND: Globalization of clinical trials fosters inclusion of higher and lower income countries, but the influence of enrolling country income level on heart failure trial performance is unclear. This study sought to evaluate associations between enrol ... Full text Link to item Cite

Rate pressure product and the components of heart rate and systolic blood pressure in hospitalized heart failure patients with preserved ejection fraction: Insights from ASCEND-HF.

Journal Article Clin Cardiol · July 2018 BACKGROUND: Heart rate and systolic blood pressure (SBP) are prognostic markers in heart failure (HF) with reduced ejection fraction (HFrEF). Their combination in rate pressure product (RPP) as well as their role in heart failure with preserved ejection fr ... Full text Link to item Cite

Pro-Inflammatory Biomarkers in Stable Versus Acutely Decompensated Heart Failure With Preserved Ejection Fraction.

Journal Article J Am Heart Assoc · April 12, 2018 BACKGROUND: Underlying inflammation has been increasingly recognized in heart failure with a preserved ejection fraction (HFpEF). In this study we tested the hypothesis that pro-inflammatory biomarkers are elevated in patients with acutely decompensated HF ... Full text Link to item Cite

Sudden cardiac death after acute heart failure hospital admission: insights from ASCEND-HF.

Conference Eur J Heart Fail · March 2018 AIMS: The incidence of and factors associated with sudden cardiac death (SCD) early after an acute heart failure (HF) hospital admission have not been well defined. METHODS AND RESULTS: We assessed SCD and ventricular arrhythmias in the Acute Study of Clin ... Full text Link to item Cite

Apixaban following acute coronary syndromes in patients with prior stroke: Insights from the APPRAISE-2 trial.

Journal Article Am Heart J · March 2018 BACKGROUND AND PURPOSE: Patients with prior stroke are at greater risk for recurrent cardiovascular events post-acute coronary syndromes (ACS) and may have a different risk/benefit profile with antithrombotic therapy than patients without prior stroke. MET ... Full text Link to item Cite

Factors associated with reporting results for pulmonary clinical trials in ClinicalTrials.gov.

Journal Article Clin Trials · February 2018 Background/aims The Food and Drug Administration Amendments Act mandates that applicable clinical trials report basic summary results to the ClinicalTrials.gov database within 1 year of trial completion or termination. We aimed to determine the proportion ... Full text Link to item Cite

Relationship between baseline physical activity assessed by pedometer count and new-onset diabetes in the NAVIGATOR trial.

Journal Article BMJ Open Diabetes Res Care · 2018 OBJECTIVE: Physical activity is related to clinical outcomes, even after adjusting for body mass, but is rarely assessed in randomized clinical trials. RESEARCH DESIGN AND METHODS: We conducted an observational analysis of data from the Nateglinide and Val ... Full text Link to item Cite

The impact of a failing right heart in patients supported by intra-aortic balloon counterpulsation.

Journal Article Eur Heart J Acute Cardiovasc Care · December 2017 BACKGROUND: Intra-aortic balloon pumps (IABPs) provide primarily left ventricular support, yet few data detail the efficacy of this temporary mechanical circulatory support device in patients with concomitant right ventricular failure. We compared the effi ... Full text Link to item Cite

Platelet-related biomarkers and their response to inhibition with aspirin and p2y12-receptor antagonists in patients with acute coronary syndrome.

Journal Article J Thromb Thrombolysis · August 2017 The PLATelet inhibition and patient Outcomes (PLATO) trial showed that treatment with ticagrelor reduced the rate of death due to vascular causes, myocardial infarction and stroke when compared to clopidogrel in patients with ST-elevation or non-ST-elevati ... Full text Link to item Cite

Updated risk factors should be used to predict development of diabetes.

Journal Article J Diabetes Complications · May 2017 AIMS: Predicting incident diabetes could inform treatment strategies for diabetes prevention, but the incremental benefit of recalculating risk using updated risk factors is unknown. We used baseline and 1-year data from the Nateglinide and Valsartan in Im ... Full text Link to item Cite

Noncardiovascular deaths are more common than cardiovascular deaths in patients with cardiovascular disease or cardiovascular risk factors and impaired glucose tolerance: Insights from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial.

Journal Article Am Heart J · April 2017 BACKGROUND: Patients with impaired glucose tolerance have an elevated risk of cardiovascular (CV) death; however, the causes and risk factors associated with non-CV deaths are poorly understood. METHODS: The NAVIGATOR trial enrolled 9,306 participants with ... Full text Link to item Cite

International Variation in Outcomes Among People with Cardiovascular Disease or Cardiovascular Risk Factors and Impaired Glucose Tolerance: Insights from the NAVIGATOR Trial.

Journal Article J Am Heart Assoc · January 13, 2017 BACKGROUND: Regional differences in risk of diabetes mellitus and cardiovascular outcomes in people with impaired glucose tolerance are poorly characterized. Our objective was to evaluate regional variation in risk of new-onset diabetes mellitus, cardiovas ... Full text Link to item Cite

Implications of Serum Chloride Homeostasis in Acute Heart Failure (from ROSE-AHF).

Journal Article Am J Cardiol · January 1, 2017 Lower serum chloride (Cl) levels are strongly associated with increased long-term mortality after admission for acute heart failure (AHF). However, the therapeutic implications of serum Cl levels during AHF are unknown. We sought to determine the short-ter ... Full text Link to item Cite

Bivariate Mixed Effects Analysis of Clustered Data with Large Cluster Sizes.

Journal Article Statistics in biosciences · October 2016 Linear mixed effects models are widely used to analyze a clustered response variable. Motivated by a recent study to examine and compare the hospital length of stay (LOS) between patients undertaking percutaneous coronary intervention (PCI) and coronary ar ... Full text Cite

Influence of Clinical Trial Site Enrollment on Patient Characteristics, Protocol Completion, and End Points: Insights From the ASCEND-HF Trial (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure).

Journal Article Circ Heart Fail · September 2016 BACKGROUND: Most international acute heart failure trials have failed to show benefit with respect to key end points. The impact of site enrollment and protocol execution on trial performance is unclear. METHODS AND RESULTS: We assessed the impact of varyi ... Full text Link to item Cite

Association of standard clinical and laboratory variables with red blood cell distribution width.

Journal Article Am Heart J · April 2016 BACKGROUND: Red blood cell distribution width (RDW) strongly predicts clinical outcomes among patients with coronary disease and heart failure. The factors underpinning this association are unknown. METHODS: In 6,447 individuals enrolled in the Measurement ... Full text Link to item Cite

Psychosocial Factors, Exercise Adherence, and Outcomes in Heart Failure Patients: Insights From Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION).

Journal Article Circ Heart Fail · November 2015 BACKGROUND: Psychosocial factors may influence adherence with exercise training for heart failure (HF) patients. We aimed to describe the association between social support and barriers to participation with exercise adherence and clinical outcomes. METHOD ... Full text Link to item Cite

Venous thromboembolism and cardiovascular risk: results from the NAVIGATOR trial.

Journal Article Am J Med · March 2015 BACKGROUND: Contemporary studies suggest an association between venous thromboembolism and a higher incidence of major cardiovascular events, mostly attributed to arterial atherothrombosis. Using data from the Nateglinide and Valsartan in Impaired Glucose ... Full text Link to item Cite

Change in levels of physical activity after diagnosis of type 2 diabetes: an observational analysis from the NAVIGATOR study.

Journal Article Diabetes Obes Metab · December 2014 Increased physical activity is known to be beneficial in people with type 2 diabetes mellitus (T2DM), but it is not known whether individuals change their activity levels after T2DM diagnosis. The present Nateglinide and Valsartan in Impaired Glucose Toler ... Full text Link to item Cite

Myocardial viability and impact of surgical ventricular reconstruction on outcomes of patients with severe left ventricular dysfunction undergoing coronary artery bypass surgery: results of the Surgical Treatment for Ischemic Heart Failure trial.

Journal Article J Thorac Cardiovasc Surg · December 2014 OBJECTIVES: In the Surgical Treatment for Ischemic Heart Failure trial, surgical ventricular reconstruction plus coronary artery bypass surgery was not associated with a reduction in the rate of death or cardiac hospitalization compared with bypass alone. ... Full text Link to item Cite

Impact of baseline physical activity and diet behavior on metabolic syndrome in a pharmaceutical trial: results from NAVIGATOR.

Journal Article Metabolism · April 2014 OBJECTIVE: The cardiometabolic risk cluster metabolic syndrome (MS) includes ≥3 of elevated fasting glucose, hypertension, elevated triglycerides, reduced high-density lipoprotein cholesterol (HDL-c), and increased waist circumference. Each can be affected ... Full text Link to item Cite

Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study.

Journal Article BMJ · December 9, 2013 OBJECTIVE: To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes. DESIGN: Reanalysis of data from the Nateglinide and ... Full text Link to item Cite

Incidence of atrial fibrillation in a population with impaired glucose tolerance: the contribution of glucose metabolism and other risk factors. A post hoc analysis of the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial.

Journal Article Am Heart J · November 2013 BACKGROUND: The role of dysglycemia as an additional risk factor for atrial fibrillation (AF) is controversial. Therefore, it was of interest to assess risk factors for incident AF in a large, representative population of patients with cardiovascular risk ... Full text Link to item Cite

Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial.

Journal Article Stroke · September 2013 BACKGROUND AND PURPOSE: Risk factors for stroke are well-established in general populations but sparsely studied in individuals with impaired glucose tolerance. METHODS: We identified predictors of stroke among participants with impaired glucose tolerance ... Full text Link to item Cite

Trends in clinical trials of non-ST-segment elevation acute coronary syndromes over 15 years.

Journal Article Int J Cardiol · July 31, 2013 BACKGROUND: Data are limited on whether clinical trials have randomized higher-risk patients over time and how trends in risk profiles and evidence-based pharmacotherapies have influenced trial outcomes. We quantified changes in baseline risk, treatment, a ... Full text Link to item Cite

A novel risk classification paradigm for patients with impaired glucose tolerance and high cardiovascular risk.

Journal Article Am J Cardiol · July 15, 2013 We used baseline data from the NAVIGATOR trial to (1) identify risk factors for diabetes progression in those with impaired glucose tolerance and high cardiovascular risk, (2) create models predicting 5-year incident diabetes, and (3) provide risk classifi ... Full text Link to item Cite

Predictors of incident heart failure hospitalizations among patients with impaired glucose tolerance: insight from the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research study.

Journal Article Circ Heart Fail · March 2013 BACKGROUND: Impaired glucose tolerance and metabolic syndrome are associated with increased risk of heart failure (HF). However, predictors associated with the increased risk of incident HF have not been well characterized. We aimed to identify independent ... Full text Link to item Cite

Prior smoking status, clinical outcomes, and the comparison of ticagrelor with clopidogrel in acute coronary syndromes-insights from the PLATelet inhibition and patient Outcomes (PLATO) trial.

Journal Article Am Heart J · September 2012 BACKGROUND: Habitual smoking has been associated with increased platelet reactivity, increased risk of thrombotic complications and greater efficacy of clopidogrel therapy over placebo. In the PLATO trial, ticagrelor compared to clopidogrel in patients wit ... Full text Link to item Cite

Baseline metabolomic profiles predict cardiovascular events in patients at risk for coronary artery disease.

Journal Article Am Heart J · May 2012 BACKGROUND: Cardiovascular risk models remain incomplete. Small-molecule metabolites may reflect underlying disease and, as such, serve as novel biomarkers of cardiovascular risk. METHODS: We studied 2,023 consecutive patients undergoing cardiac catheteriz ... Full text Link to item Cite

Predictors of cardiovascular events in a contemporary population with impaired glucose tolerance: an observational analysis of the Nateglinide and Valsartan in impaired glucose tolerance outcomes research (NAVIGATOR) trial.

Journal Article BMJ Open · 2012 OBJECTIVES: Risk factors for cardiovascular events are well established in general populations and those with diabetes but have been sparsely studied in impaired glucose tolerance (IGT). We sought to identify predictors of (1) a composite cardiovascular ou ... Full text Link to item Cite

Center variation in hospital costs for patients undergoing congenital heart surgery.

Journal Article Circ Cardiovasc Qual Outcomes · May 2011 BACKGROUND: Congenital heart disease consumes significant health care resources; however, there are limited data regarding factors affecting resource utilization. The purpose of this study was to evaluate variation between centers in total hospital costs f ... Full text Link to item Cite

Prevalence and predictors of mechanical dyssynchrony as defined by phase analysis in patients with left ventricular dysfunction undergoing gated SPECT myocardial perfusion imaging.

Journal Article J Nucl Cardiol · February 2011 BACKGROUND: A novel method to quantify dyssynchrony using phase analysis of single-photon emission computed tomography (SPECT) myocardial perfusion imaging has been developed. We sought to determine the prevalence of SPECT-derived mechanical dyssynchrony, ... Full text Link to item Cite

Patterns of discharge antiplatelet therapy and late outcomes among 8,582 patients with bleeding during acute coronary syndrome: a pooled analysis from PURSUIT, PARAGON-A, PARAGON-B, and SYNERGY.

Journal Article Am Heart J · December 2010 BACKGROUND: Major bleeding during an acute coronary syndrome (ACS) is associated with increased late ischemic events. Patients with bleeding are often discharged without antiplatelet therapy (AT). The association between discharge AT use and late ischemic ... Full text Link to item Cite

Reclassification of cardiovascular risk using integrated clinical and molecular biosignatures: Design of and rationale for the Measurement to Understand the Reclassification of Disease of Cabarrus and Kannapolis (MURDOCK) Horizon 1 Cardiovascular Disease Study.

Journal Article Am Heart J · September 2010 BACKGROUND: Clinical predictive models leave gaps in our ability to stratify cardiovascular risk. High-throughput molecular profiling promises to improve risk classification. METHODS: Horizon 1 of the Measurement to Understand the Reclassification of Disea ... Full text Link to item Cite

Prognostic utility of quantifying evolutionary ST-segment depression on early follow-up electrocardiogram in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article European heart journal · April 2010 AimsAlthough ST-segment depression (STD) on the admission electrocardiogram (ECG) confers adverse prognosis in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), the implications of STD on follow-up ECG remain uncertain. W ... Full text Cite

In-hospital management of patients with atrial flutter.

Journal Article Am Heart J · March 2010 BACKGROUND: Little is known about the use of drugs or procedures for management of atrial flutter (AFl) in routine clinical practice. We describe the extent of use of conversion therapies during AFl hospitalizations. METHODS: We examined hospitalizations f ... Full text Link to item Cite

Does aspirin use adversely influence intermediate-term postdischarge outcomes for hospitalized patients who are treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers? Findings from Organized Program to Facilitate Life-Saving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF).

Journal Article Am Heart J · February 2010 BACKGROUND: Conflicting data exist regarding a potential deleterious association between aspirin (ASA) and angiotensin-converting enzyme inhibitors (ACEIs) when used concurrently in patients with heart failure (HF). How such an interaction may be influence ... Full text Link to item Cite

Improvement in health-related quality of life after hospitalization predicts event-free survival in patients with advanced heart failure.

Journal Article Journal of cardiac failure · November 2009 BackgroundHealth-related quality of life (HRQOL) is a major clinical outcome for heart failure (HF) patients. We aimed to determine the frequency, durability, and prognostic significance of improved HRQOL after hospitalization for decompensated HF ... Full text Cite

Assessing the economic attractiveness of coronary artery revascularization in chronic kidney disease patients.

Journal Article J Med Syst · August 2009 Chronic kidney disease (CKD) is associated with increased morbidity and mortality in coronary artery disease (CAD) patients. We compared the economic attractiveness of CAD revascularization procedures in patients with and without CKD. Our population includ ... Full text Link to item Cite

Age- and gender-related differences in quality of care and outcomes of patients hospitalized with heart failure (from OPTIMIZE-HF).

Journal Article Am J Cardiol · July 1, 2009 Previous studies have suggested that female and elderly patients with heart failure (HF) are less likely to receive guideline-recommended therapies, but these studies have involved select patient populations. We evaluated the differences in medical care an ... Full text Link to item Cite

Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-ST-elevation myocardial infarction.

Journal Article Circulation · June 23, 2009 BACKGROUND: There are limited contemporary data comparing long-term outcomes after cardiac catheterization for ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). METHODS AND RESULTS: We studied patients undergoing cardiac catheteriz ... Full text Link to item Cite

Do income level and race influence survival in patients receiving hemodialysis?

Journal Article Am J Med · February 2009 BACKGROUND: Residence in a lower-income area has been associated with higher mortality among patients receiving dialysis. We sought to determine whether these differences persist and whether the effect of income-area on mortality is different for African A ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · December 9, 2008 Full text Cite

Re-evaluating the volume-outcome relationship in hemodialysis patients.

Journal Article Health Policy · December 2008 OBJECTIVES: We sought to determine whether dialysis patient mortality rates are associated with differences in dialysis facility size, and whether this relationship differs among higher risk diabetic and lower-risk non-diabetic patients. METHODS: Using 186 ... Full text Link to item Cite

Dosing of beta-blocker therapy before, during, and after hospitalization for heart failure (from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure).

Journal Article Am J Cardiol · December 1, 2008 Heart failure (HF) guidelines recommend that beta blockers be titrated to achieve the target doses shown to be effective in major clinical trials, if tolerated. Little is known, however, regarding the doses of beta blockers used in patients with HF in rout ... Full text Link to item Cite

Empirical estimation of life expectancy from large clinical trials: use of left-truncated, right-censored survival analysis methodology.

Journal Article Stat Med · November 20, 2008 In the current era of ever-increasing health care costs, economic analyses are an essential component in the comprehensive evaluation of new medical interventions. Cost-effectiveness analysis (CEA)--the most common form of economic analysis used in medicin ... Full text Link to item Cite

Quality of life with defibrillator therapy or amiodarone in heart failure.

Journal Article N Engl J Med · September 4, 2008 BACKGROUND: Implantable cardioverter-defibrillator (ICD) therapy significantly prolongs life in patients at increased risk for sudden death from depressed left ventricular function. However, whether this increased longevity is accompanied by deterioration ... Full text Link to item Cite

Predictors of in-hospital mortality in patients hospitalized for heart failure: insights from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF).

Journal Article J Am Coll Cardiol · July 29, 2008 OBJECTIVES: The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population. BACKGROUND: Heart failure patients experience high rates of hospital stays and poor outcome ... Full text Link to item Cite

Influence of beta-blocker continuation or withdrawal on outcomes in patients hospitalized with heart failure: findings from the OPTIMIZE-HF program.

Journal Article J Am Coll Cardiol · July 15, 2008 OBJECTIVES: This study ascertains the relationship between continuation or withdrawal of beta-blocker therapy and clinical outcomes in patients hospitalized with systolic heart failure (HF). BACKGROUND: Whether beta-blocker therapy should be continued or w ... Full text Link to item Cite

Quality of care of and outcomes for African Americans hospitalized with heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry.

Journal Article J Am Coll Cardiol · April 29, 2008 OBJECTIVES: We sought to examine the characteristics, quality of care, and clinical outcomes for a large cohort of African-American patients hospitalized with heart failure (HF) in centers participating in a quality improvement initiative. BACKGROUND: Hear ... Full text Link to item Cite

Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF.

Journal Article Arch Intern Med · April 28, 2008 BACKGROUND: Few studies have examined factors identified as contributing to heart failure (HF) hospitalization, and, to our knowledge, none has explored their relationship to length of stay and mortality. This study evaluated the association between precip ... Full text Link to item Cite

Rhythm versus rate control in the contemporary management of atrial fibrillation in-hospital.

Journal Article Am J Cardiol · April 15, 2008 Little is presently known regarding whether a rhythm-control or a rate-control strategy is more frequently used in patients hospitalized for atrial fibrillation (AF). This study was conducted to assess patient and physician characteristics associated with ... Full text Link to item Cite

Relation of low hemoglobin and anemia to morbidity and mortality in patients hospitalized with heart failure (insight from the OPTIMIZE-HF registry).

Journal Article Am J Cardiol · January 15, 2008 Anemia in heart failure (HF) is increasingly recognized and treated, but little is known about the prevalence and its relation to outcomes in patients hospitalized for decompensated HF in a situation of both reduced and preserved systolic function. We hypo ... Full text Link to item Cite

International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Am J Cardiol · January 1, 2008 The purpose of this study was to determine international patterns of blood transfusion in patients with acute coronary syndrome (ACS). Previous studies showed geographic heterogeneity in some aspects of ACS care. Data for variability in the use of blood tr ... Full text Link to item Cite

Prospective evaluation of beta-blocker use at the time of hospital discharge as a heart failure performance measure: results from OPTIMIZE-HF.

Journal Article J Card Fail · November 2007 BACKGROUND: The objective of this study was to prospectively evaluate beta-blocker use at hospital discharge as an indicator of quality of care and outcomes in patients with heart failure (HF). METHODS AND RESULTS: Data from the Organized Program to Initia ... Full text Link to item Cite

Influence of diabetes on characteristics and outcomes in patients hospitalized with heart failure: A report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)

Journal Article American Heart Journal · October 1, 2007 Background: Diabetes, a common comorbidity in patients with heart failure (HF), is associated with worse long-term outcomes in patients with HF due to systolic dysfunction. Whether diabetes mellitus (DM) influences characteristics and outcomes in patients ... Full text Cite

Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: a report from the OPTIMIZE-HF Registry.

Journal Article J Am Coll Cardiol · August 21, 2007 OBJECTIVES: We sought to evaluate the characteristics, treatments, and outcomes of patients with preserved and reduced systolic function heart failure (HF). BACKGROUND: Heart failure with preserved systolic function (PSF) is common but not well understood. ... Full text Link to item Cite

Influence of diabetes on characteristics and outcomes in patients hospitalized with heart failure: a report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF).

Journal Article Am Heart J · August 2007 BACKGROUND: Diabetes, a common comorbidity in patients with heart failure (HF), is associated with worse long-term outcomes in patients with HF due to systolic dysfunction. Whether diabetes mellitus (DM) influences characteristics and outcomes in patients ... Full text Link to item Cite

Influence of a performance-improvement initiative on quality of care for patients hospitalized with heart failure: results of the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF).

Journal Article Arch Intern Med · July 23, 2007 BACKGROUND: Despite evidence-based national guidelines for optimal treatment of heart failure (HF), the quality of care remains inadequate. We sought to evaluate the effect of a national hospital-based initiative on quality of care in patients hospitalized ... Full text Link to item Cite

Predictors of delivery of hospital-based heart failure patient education: a report from OPTIMIZE-HF.

Journal Article J Card Fail · April 2007 BACKGROUND: Although recent heart failure (HF) management guidelines recommend delivery of patient education and discharge instructions, little is known about predictors of delivery of these materials or how such materials relate to outpatient disposition ... Full text Link to item Cite

Carvedilol use at discharge in patients hospitalized for heart failure is associated with improved survival: an analysis from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF).

Journal Article Am Heart J · January 2007 BACKGROUND: The IMPACT-HF trial demonstrated that carvedilol use at the time of heart failure (HF) hospital discharge significantly increased 90-day postdischarge treatment rates. Whether there is an early survival benefit associated with this therapeutic ... Full text Link to item Cite

Mortality by dialysis modality among patients who have end-stage renal disease and are awaiting renal transplantation.

Journal Article Clinical journal of the American Society of Nephrology : CJASN · July 2006 Comparing outcomes related to dialysis modality is complicated by selection bias introduced by patients and physicians. To address the impact of selection bias, this study compared mortality by initial dialysis modality among patients who had ESRD and were ... Full text Cite

Outcomes in heart failure patients after major noncardiac surgery.

Journal Article J Am Coll Cardiol · October 6, 2004 OBJECTIVES: The purpose of this study was to evaluate mortality and readmission rates of heart failure (HF) patients after major noncardiac surgery. BACKGROUND: There is a lack of generalizable outcome data on HF patients undergoing major noncardiac surger ... Full text Link to item Cite

The prognostic importance of comorbidity for mortality in patients with stable coronary artery disease.

Journal Article J Am Coll Cardiol · February 18, 2004 OBJECTIVES: To identify the prevalent and prognostically important coexisting illnesses among single coronary artery disease (CAD) patients. BACKGROUND: As the population ages, physicians are increasingly required to make decisions concerning patients with ... Full text Link to item Cite